Особенности кальций – фосфорного обмена у детей младшего возраста

Abstract

Проведено биохимическое исследование крови на содержание кальция и фосфора и мочи на выведение кальция и фосфора у 39 детей младшего возраста с множественным кариесом на фоне дисплазии соединительной ткани. Полученные результаты указывают на необходимость дифференцированного подхода к назначению препаратов кальция и фосфора у этой категории детей; Проведено біохімічне дослідження крові на вміст кальцію і фосфору та сечі на виведення кальцію і фосфору в 39 дітей молодшого віку з множинним карієсом на тлі дисплазії сполучної тканини. Отримані результати вказують на необхідність диференційованого підходу до призначення препаратів кальцію і фосфору в цієї категорії дітей; The issue of dental caries prevention has been discussed for many years; certain progress has been made in this area. An important element in this respect is adherence to the basic rules of medicine «Non nocere» (do no harm). Therefore, administration of any preventive medication should be strictly differentiated. Of particular concern are young children with diseases of hard dental tissue against a background of somatic pathology, for example, genetically caused connective-tissue disease. Connective-tissue dysplasia is a developmental disorder of the connective tissue in embryonic and postnatal periods as a result of genetically modified fibrillogenesis in the extracellular matrix, leading to homeostasis disorders at the tissue, organ, and organism levels in the form of a variety of morphological and functional defects of visceral and locomotive organs with a progressive course. Endogenous prevention allows subsequently a higher level of resistance to tooth decay. The use of calcium and phosphorus in the framework of the caries prevention programs is recognized as one of the most effective ways to prevent this disease. In this regard, the aim of our study was to investigate calcium-phosphorus metabolism against a background of connective-tissue dysplasia in early-age children. Materials and Methods. The study involved 39 children (the main group) aged from 1 year 2 months to 3 years with multiple caries and complicated forms of caries against a background of genetically caused connective- tissue disorder followed up at Dentistry Department of KhNMU. All children were divided into four groups according to the age. Group 1 consisted of 7 children aged 14-18 months; group 2 - 8 children aged 19-23 months; group 3 - 7 children aged 24-29 months, group 4 -. 17 children aged 30-36 months. Consequently, the largest group (17 persons) included the children aged 30-36 months. The children underwent biochemical tests of blood and urine for calcium and phosphorus content and excretion. Our research revealed that the levels of calcium and phosphorus in the blood of the children in all age groups were within the physiological norm. Calcium and phosphorus excretion with the urine in children of the main group was decreased (normal Ca excretion is 0.5-3.8 mmol/day, P – 1.0-25.0 mmol/day), thus at the age of 14-18 months Ca concentration was reduced by 0.1 mmol /day, P - 0.1 mmol/d., at the age of 19-23 months Ca concentration decreased by 0.15 mmol/day, P - 0.11 mmol/day, in children aged 24-30 months Ca concentration reduced by 0.1 mmol day, P - 0.18 mmol/day, in children aged 30-36 months Ca concentration decreased by 0.17 mmol/day, P - 0.17 mmol/day. Conclusions. 1. When endogenous prevention is performed in early-age children with genetically caused connective tissue disorders, it is necessary to take into account the level of calcium and phosphorus excretion with the urine. 2. When genetically determined diseases of the connective tissue and the findings of blood and urine tests are present, the nutrition of the child should be corrected, i.e. meat broths, meat products, products from highgrade flour, semolina, milk products with a high fat content should be excluded.