Quantitative ultrasound measurements of bone speed of sound in premature infants

Nemet, Damir; Dolfin, Tzipora; Wolach, Baruch; Eliakim, Alon

doi:10.1007/s004310100849

Cited by 81 publications

(69 citation statements)

References 16 publications

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“…39 Although urinary excretion of calcium and phosphate were not related to QUS in our study, AP correlated inversely with QUS, which confirms reports applying both QUS and DXA that found AP to predict reduced bone density with a sensitivity of 88% and a specificity of 71%. 14,15,40,41 The lack of correlation between AP or QUS and serum levels of calcium or phosphate in our patients is most likely due to the stringent regulation of these two minerals by a complex endocrine system to keep their serum levelFessential for many organ functionsFwithin normal limits. As expected, several risk factors for reduced bone formation showed a relevant influence on QUS, that is, the duration of parenteral nutrition or mechanical ventilation and the treatment with diuretics or corticosteroids.…”

Section: Discussionmentioning

confidence: 79%

“…Our data also confirm previous studies that reported a correlation of bone quality with gestational age and birth weight both by DXA [23][24][25][26] and QUS. [9][10][11][12][13][14][15]27,28 Multivariate analysis confirmed postconceptional age as the most relevant predictor of bone quality. Body weight was the strongest predictor of QUS in the most immature infants but lost its significance in term neonates.…”

Section: Discussionmentioning

confidence: 80%

“…8 Although QUS is now widely used in adults and represents a relatively established method for evaluating bone mineral status in the context of diagnosing osteoporosis, QUS has only been employed in mostly small study samples of newborn infants and children. [9][10][11][12][13][14][15][16][17] However, none of these studies provide longitudinal data in regular intervals on QUS measurements in preterm infants simultaneously accounting for growth changes and increase of soft tissue. Therefore, we initiated a trial for the evaluation of QUS following both preterm and term infants in predefined intervals until the age of 17 months.…”

Section: Introductionmentioning

confidence: 99%

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Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

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Objective: As 80% of intrauterine bone mineralization takes place during the last trimester of pregnancy, preterm infants should be supplemented postnatally with optimal doses of calcium, phosphate and vitamin D. Calcium and phosphate excretion in the urine may be used to monitor individual mineral requirements, but are sometimes difficult to interpret. The objective of this study was to assess the value of quantitative ultrasound (QUS) for the analysis of bone status in neonates.Study Design: All admissions to three independent tertiary neonatal intensive care units were studied. In 172 preterm and term infants with a gestational age between 23 and 42 weeks (mean 33.8 ± 5.0) and a birth weight from 405 to 5130 g (mean 2132±1091 g) bone status was evaluated prospectively by quantitative ultrasound velocity using a standardized protocol. Infants were followed in regular intervals up to their first discharge home. While measurements were conducted in weekly intervals initially (n ¼ 55), 2-week intervals were regarded as sufficient thereafter due to limited changes in QUS values within the shorter period. Infants with a birth weight below 1500 g were followed during outpatient visits until up to 17 months of age.Result: The intra-individual day-to-day reproducibility was 0.62%. QUSvalues from the first week of life correlated significantly with gestational age and birth weight (r ¼ 0.5 and r ¼ 0.6; P<0.001). Small-forgestational-age infants showed lower values for QUS than appropriate-forgestational-age infants allowing for their gestational age. Follow-up measurements correlated positively with age and weight during the week of measurement (r ¼ 0.2 and r ¼ 0.4; P ¼ 0.001). Comparing bone quality at 40 weeks of age in infants born at term versus infants born at 24 to 28 weeks, preterm infants showed significantly lower QUS than term infants (P<.0001).There was a significant correlation of QUS with serum alkaline phosphatase (P ¼ 0.003), the supplementation with calcium, phosphate and vitamin D (P< 0.001 each), as well as risk factors for a reduced bone mineralization. No correlation was found between QUS and calcium or phosphate concentration in serum or urine.Conclusion: QUS is a highly reproducible, easily applicable and radiation-free technique that can be used to monitor bone quality in individual newborns. Further prospective randomized-trials are necessary to evaluate, if therapeutic interventions based on QUS are able to prevent osteopenia of prematurity.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 80%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound for the assessment of bone quality in preterm and term infants

Rack

Janni

et al. 2011

J Perinatol

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“…Since then, a quantitative ultrasound instrument has been developed and marketed, that allows measuring bone SOS in small infants on a routine basis. 6 Using this instrument, we have recently developed standard curves of neonatal bone SOS in appropriately grown, singleton infants ranging in gestational age from 25 to 42 weeks. 7 We designed this study in order to measure the ultrasound bone velocity of LGA InDMs.…”

Section: Introductionmentioning

confidence: 99%

Decreased Bone Ultrasound Velocity in Large-for-Gestational-Age Infants

et al. 2003

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BACKGROUND:Bone speed of sound is a measure of bone breakability. There are few reports on bone mineral content in large for gestational age infants; most of them in infants of diabetic mothers. There are no data on bone speed of sound in large for gestational age infants of nondiabetic mothers. OBJECTIVE:To test the hypothesis that large for gestational age infants of nondiabetic mothers have lower bone speed of sound than appropriate for gestational age infants. DESIGN/METHODS:Bone speed of sound was measured within the first 96 hours of life at the right tibial midshaft in 25 singleton large for gestational age infants of non diabetic mothers and compared to appropriate for gestational age controls. RESULTS:Bone speed of sound measured in large for gestational age infants of nondiabetic mothers was lower than in controls.CONCLUSIONS: Large for gestational age infants of nondiabetic mothers have lower bone speed of sound than controls.

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“…[10][11][12] The two methods can yield divergent results. Studies that used either DEXA [13][14][15][16][17] or tibial QUS [18][19][20][21] report lower indices of bone strength and mineral content in preterm infants versus infants born at term. However, studies that used DEXA or tibial QUS to compare bone status of SGA versus AGA newborn infants yield different results.…”

Section: Introductionmentioning

confidence: 99%

Bone ultrasound velocity in small- versus appropriate-for-gestational age preterm infants

2007

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Objective: To compare bone status of small-for-gestational age (SGA) versus appropriate-for-gestational age (AGA) newborn preterm infants.Study Design: Tibial speed of sound (SOS) was measured in 144 infants categorized as SGA or AGA using the reference tables of Lubchenco et al. and Alexander et al.Result: By the Lubchenco tables, 22% of infants were SGA and 75% were AGA. The mean gestational ages of SGA and AGA were similar (33.3±2.6 and 32.5±2.4 weeks, respectively, P ¼ 0.09); however, SGA infant birth weights were lower (1329±392 and 1829±481 g, respectively, P<0.001). SOS values were higher for SGA versus AGA infants (3098±135 and 3003±122 m/s, respectively. P<0.001). Use of the Alexander tables yielded a twofold increase in the percent of infants categorized as SGA; SOS values remained significantly greater for SGA infants (P<0.001). Conclusion:Higher tibial SOS values in SGA versus AGA infants indicate greater bone strength.

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Quantitative ultrasound measurements of bone speed of sound in premature infants

Cited by 81 publications

References 16 publications

Ultrasound for the assessment of bone quality in preterm and term infants

Ultrasound for the assessment of bone quality in preterm and term infants

Decreased Bone Ultrasound Velocity in Large-for-Gestational-Age Infants

Bone ultrasound velocity in small- versus appropriate-for-gestational age preterm infants

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