Metabolic bone disease of prematurity and secondary hyperparathyroidism

Lothe, Ashish; Sinn, John; Stone, M Van

doi:10.1111/j.1440-1754.2011.02019.x

Cited by 29 publications

(20 citation statements)

References 17 publications

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“…Consequently, elevation of ALP suggests biliary obstruction only after bone disease is excluded 32 , 36 . Thus, the metabolic bone disease, usually referred to as osteopenia of prematurity, should be considered a likely confounder when evaluating serum ALP in premature infants 33 , 37 – 39 . In our study, the exact incidence of osteopenia of prematurity cannot be calculated because specific investigation was not routinely performed.…”

Section: Discussionmentioning

confidence: 92%

Cholestasis, Bronchopulmonary Dysplasia, and Lipid Profile in Preterm Infants Receiving MCT/ω‐3–PUFA–Containing or Soybean‐Based Lipid Emulsions

et al. 2012

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Section: Discussionmentioning

confidence: 92%

Cholestasis, Bronchopulmonary Dysplasia, and Lipid Profile in Preterm Infants Receiving MCT/ω‐3–PUFA–Containing or Soybean‐Based Lipid Emulsions

et al. 2012

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“…In recent studies, we could find this pathology in slightly more than half of the newborns (NB) with less than 28 weeks of gestational age (GA) or newborn's weight (NBW) less than 1000 grams, and 1 of every 4-5 children under 1500 grams 9,10 . It is closely associated with GA, NBW, and the type of feeding with delayed enteral inputs and with the severity of the total process.…”

Section: Introductionmentioning

confidence: 99%

Factores de riesgo y marcadores bioquímicos de la enfermedad metabólica ósea del recién nacido prematuro

Ramón

Espuelas

Calmarza

et al. 2017

Rev. chil. pediatr.

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Background: Metabolic bone disease (MBD) of prematurity is a complication of multifactorial aetiology, which has been increasing, due to progressive decrease in mortality of preterm newborns. The aim of the study was to analyze risk factors of severe MBD and its analytical markers. Patients and Method: Retrospective study involving preterm infants less than 32 weeks gestational age and/or weight less tan 1,500 g born between january 2012 and december 2014. Comparison was made according to the presence of severe MBD. Results: 139 patients were recruited. Mean value of 25(OH)D3 was 70.68 ± 25.20 nmol/L, being higher in patients born in spring-summer than in autumn-winter (80.94 ± 25.33 vs 61.13 ± 21.07; p = 0.000). Levels of 25(OH)D3 were similar in patients with severe MBD compared with the rest of patients (65.61 ± 26.49 vs 72.07 ± 24.89, P = 0.283). Higher levels of alkaline phosphatase (AP, IU/L ) (1314.19 ± 506.67 vs 476.56 ± 188.85; p = 0.000) were found in these patients. Cutoff point of AP 796.5 IU/L (S 95.2%, specificity 92.4%) was calculated by ROC curve. The risk factors most associated to severe EMO were restricted fetal growth, birth weight, duration of ventilation therapy and parenteral nutrition. Conclusions: AP levels were the best marker of severe MBD development. EMO risk increases with the number of risk factors and lower levels of 25(OH) D3. Levels of 25(OH)D3 higher than 70nmol/L appear to protect from the development of severe MBD, even in patients with multiple risk factors.

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“…It is more likely that an elevated iPTH level in our patients resulted rather from insufficient calcium intake/absorption than their vitamin D status, insofar as we found less serum calcium in the lower BMC group, while there were no differences in the serum 25OHD level between the groups. A decreasing iPTH level during oral calcium supplementation means a higher probability of calcium deficiency in preterm infants with an elevated iPTH [28, 31]. On the other hand, a higher vitamin D intake in preterm infants fed mineral-enriched postdischarge formula is associated with increased bone accretion.…”

Section: Discussionmentioning

confidence: 99%

The Clinical and Biochemical Predictors of Bone Mass in Preterm Infants

et al. 2016

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BackgroundMetabolic bone disease of prematurity still occurs in preterm infants, although a significant improvement in neonatal care has been observed in recent decades. Dual-energy X-ray absorptiometry (DXA) is the precise technique for assessing bone mineral content (BMC) in preterm infants, but is not widely available.AimTo investigate the clinical and biochemical parameters, including bone metabolism markers as potential predictors of BMC, in preterm infants up to 3 months corrected age (CA).Materials and MethodsCa-P homeostasis, iPTH, 25-hydroxyvitamin D, osteocalcin, N-terminal propeptide, cross-linked C-telopeptide and amino-terminal pro C-type natriuretic peptide and the DXA scans were prospectively performed in 184 preterm infants (≤ 34 weeks’ gestation) between term age and 3 mo CA. Lower bone mass was defined as BMC below or equal to respective median value for the whole study group, rounded to the nearest whole number.ResultsThe appropriate quality DXA scans were available for 160 infants (87%) examined at term and for 130 (71%) tested at 3 mo CA. Higher iPTH level was the only independent predictor of lower BMC at term, whereas lower BMC at 3 mo CA was associated both with lower urinary phosphate excretion and higher serum osteocalcin level. ROC analysis showed that iPTH >43.6 pg/mL provided 40% sensitivity and 88% specificity in identification of preterm infants with lower BMC at term. In turn, urinary phosphate excretion (TRP>97% or UP/Cr ≤0.74 mg/mg) and serum osteocalcin >172 ng/mL provided 40% sensitivity and 93% specificity in identification of infants with decreased BMC at 3 mo CA.ConclusionSerum iPTH might to be a simple predictor of reduced BMC in preterm infants at term age, but urinary phosphate excretion and serum osteocalcin might predict reduced BMC at 3 mo CA. These results represent a promising diagnostic tool based on simple, widely available biochemical measurements for bone mass assessment in preterm infants.

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Metabolic bone disease of prematurity and secondary hyperparathyroidism

Cited by 29 publications

References 17 publications

Cholestasis, Bronchopulmonary Dysplasia, and Lipid Profile in Preterm Infants Receiving MCT/ω‐3–PUFA–Containing or Soybean‐Based Lipid Emulsions

Cholestasis, Bronchopulmonary Dysplasia, and Lipid Profile in Preterm Infants Receiving MCT/ω‐3–PUFA–Containing or Soybean‐Based Lipid Emulsions

Factores de riesgo y marcadores bioquímicos de la enfermedad metabólica ósea del recién nacido prematuro

The Clinical and Biochemical Predictors of Bone Mass in Preterm Infants

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