Necrotizing enterocolitis increases the bone resorption in premature infants

Çakır, Murat; Mungan, İlke; Karahan, Caner; Çan, Gamze; Ökten, Ayşenur

doi:10.1016/j.earlhumdev.2005.10.015

Cited by 17 publications

(16 citation statements)

References 21 publications

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“…In this study, we measured N-MID of OC and found no significant changes in it between infected group and non-infected group. Similarly, an earlier study also showed unchanged levels of OC between the neonates with and without infection 23. Whether this result indicates that makers for bone formation are more sensitive than those bone turnover makers in assessing illness severity is currently unknown.…”

Section: Discussionmentioning

confidence: 69%

“…Previous studies have shown increased OCLs activity in septic mice and premature infants with necrotizing enterocolitis 10, 23, 32, 33, but Cakir et al 24 found no significant difference in CTX between the neonates with some kinds of bacterial sepsis and with some diseases such as respiratory distress syndrome, congenital heart disease, pneumothorax or neonatal pneumonia. In this study, we also found no significant changes in CTX levels between the infected and non-infected groups.…”

Section: Discussionmentioning

confidence: 94%

“…Previous studies in mice revealed that some stress situations, such as bleeding and inflammation, could affect the activities of OBs and OCLs 20. Several clinical studies also found that inflammation could influence the functions of OBs and OCLs in adults and children 21-23. Therefore, we hypothesized that bone metabolism biomarkers can reflect the illness severity of infected neonates.…”

Section: Introductionmentioning

confidence: 95%

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Serum Bone Alkaline Phosphatase in Assessing Illness Severity of Infected Neonates in the Neonatal Intensive Care Unit

Zhang¹,

Xue²,

Zhu³

et al. 2012

Int. J. Biol. Sci.

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Background: Infections can influence bone metabolism of neonates, which may lead to changes in some bone metabolism biomarkers. The purpose of this study was to determine whether serum bone alkaline phosphatase (BALP), osteocalcin (OC) and beta carboxy-terminal peptide of type I collagen (CTX), as specific biomarkers of bone metabolism, can be used to assess the severity of neonatal infections.Methods: Sixty-three neonates in the NICU were enrolled in this study. The neonates were divided into infected group (n=33) and non-infected group (n=30). The scores for neonatal acute physiology-perinatal extension II (SNAPPE-II) were calculated and interleukin-6 (IL-6), procalcitonin (PCT), BALP, OC and CTX were measured among the neonates with or without infections, and among the infected neonates before and after treatment.Results: The serum BALP levels were lower in the infected group than that in the non-infected group (p<0.01). The serum BALP levels increased markedly in the infected neonates after treatment (p<0.01). The serum BALP levels were also inversely correlated with SNAPPE-II of infected neonates before and after treatment (r=-0.56, p<0.05; r=-0.37, p<0.05, respectively). In infected neonates, the differences between serum BALP levels before and after treatment were inversely correlated with those of IL-6 levels (p<0.05). There were no significant changes in the OC, CTX and PCT levels in the infected or non-infected group before and after treatment.Conclusion: Our data suggest that serum BALP level might be used as a marker for assessing the severity of illness in infected neonates.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 95%

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Serum Bone Alkaline Phosphatase in Assessing Illness Severity of Infected Neonates in the Neonatal Intensive Care Unit

Zhang¹,

Xue²,

Zhu³

et al. 2012

Int. J. Biol. Sci.

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“…Compared with these results, Eliakim et al [27] reported that neonatal sepsis in premature infants was not correlated with biochemical prove of diminished bone turnover. Nevertheless, Cakir et al [28] reported positive correlation between NEC and increased bone resorption in premature infants, which might be related to the reduced glucagon like peptide-2 levels, an intestinal hormone that is chiefly secreted from the distal small intestine.…”

Section: Discussionmentioning

confidence: 99%

Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity

Abdallah¹,

Said²,

Mosallam³

et al. 2016

Medicine

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Metabolic bone disease of prematurity is a condition characterized by reduction in bone mineral content (osteopenia). It is a problem faced by very low birth weight (VLBW) infants because of lack of fetal mineralization during the last trimester. Our aim was to assess serum alkaline phosphatase (ALP) level as an early biomarker for osteopenia in premature infants and to estimate an optimal cutoff value of serum ALP at which osteopenia is detected radiologically in premature newborns.This prospective study was conducted on a cohort of 120 newborn infants of both sex of ≤34 weeks’ gestational age and <1500 g birth weight. Two blood samples, from each infant on at least 2 consecutive weeks, were reported for calcium, phosphorus, and ALP. Evidence of osteopenia was evaluated radiologically by performing wrist/knee x-ray.Sixteen infants (13.3%) had evidence of osteopenia in x-ray, whereas 104 infants (86.7%) were nonosteopenic and all the osteopenic infants were <1000-g birth weight. Birth weight and gestational age were significantly inversely related to serum ALP levels. Both samples showed statistically significantly higher mean ALP level in osteopenic than nonosteopenics (P < 0.001, and P < 0.001 respectively). There was no constant value of serum ALP related to radiologic evidence of osteopenia. However, the optimal cutoff value of serum ALP at which osteopenia is detected is 500 IU/L with 100% sensitivity and 80.77% specificity.High levels of ALP can be considered a reliable biomarker to predict the status of bone mineralization and the need for radiological evaluation in premature infants particularly those <1000-g birth weight and <32 weeks’ gestation.

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“…Factors commonly thought to relate to rickets of prematurity include mismatch of postnatal intake of minerals compared to intrauterine mineral transfer, low bone loading effects in the NICU, intrauterine growth restriction, chorioamnionitis, steroids, methylxanthines and diuretic usage and necrotizing enterocolitis (7-10, 14-16). Inadequate mineral nutrient (calcium and phosphorous) intake appears to play a major role in causing rickets of prematurity (10, 17).…”

Section: Discussionmentioning

confidence: 99%

High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

et al. 2012

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Risk factors for rickets of prematurity have not been re-examined since introduction of high mineral formula, particularly in ELBW infants. We analyzed the incidence and the risk factors of rickets in extremely low birth weight (ELBW) infants. As a retrospective case-control study from 2004 to 2008, risk factors were analyzed in 24 patients with rickets versus 31 patients without. The frequency of rickets in ELBW infants was 24/55 (44%). Infants with rickets were diagnosed at 48.2 ± 16.1 days of age, and improved by 85.3 ± 25.3 days. By radiologic evaluation, 29% were grade 1 rickets, 58% grade 2 and 13% grade 3. In univariate analysis, infants with rickets had significantly higher incidence of patent ductus arteriosus, parenteral nutrition associated cholestasis (PNAC), severe PNAC and moderate/severe bronchopulmonary dysplasia (BPD). In multiple regression analysis, after adjustment for gestation and birth weight, rickets significantly correlated with severe PNAC and with moderate/severe BPD. Serum peak alkaline phosphatase levels were significantly elevated in rickets (P < 0.001). In ELBW infants, the incidence of rickets of prematurity remains high and the incidence of severe PNAC and moderate/severe BPD was significantly increased 18 and 3 times, respectively.

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Necrotizing enterocolitis increases the bone resorption in premature infants

Cited by 17 publications

References 21 publications

Serum Bone Alkaline Phosphatase in Assessing Illness Severity of Infected Neonates in the Neonatal Intensive Care Unit

Serum Bone Alkaline Phosphatase in Assessing Illness Severity of Infected Neonates in the Neonatal Intensive Care Unit

Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity

High Incidence of Rickets in Extremely Low Birth Weight Infants with Severe Parenteral Nutrition-Associated Cholestasis and Bronchopulmonary Dysplasia

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