Bone isoenzyme of serum alkaline phosphatase and serum inorganic phosphate in metabolic bone disease of prematurity

2000 ◽  
Vol 89 (7) ◽  
pp. 867-873 ◽  
Author(s):  
MC Backström ◽  
T Kouri ◽  
A-L Kuusela ◽  
H Sievänen ◽  
A-M Koivisto ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Disease ◽  
Inorganic Phosphate ◽  
Metabolic Bone Disease ◽  
Serum Alkaline Phosphatase ◽  
Metabolic Bone ◽  
Serum Inorganic Phosphate

scholarly journals Modified Serum ALP Values and Timing of Apparition of Knee Epiphyseal Ossification Centers in Preterm Infants with Cholestasis and Risk of Concomitant Metabolic Bone Disease of Prematurity

Nutrients ◽  
2020 ◽  
Vol 12 (12) ◽  
pp. 3854
Author(s):  
Sandra Llorente-Pelayo ◽  
Pablo Docio ◽  
Bernardo A. Lavín-Gómez ◽  
María T. García-Unzueta ◽  
Isabel de las Cuevas ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Preterm Infants ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Serum Alkaline Phosphatase ◽  
Bone Mineralization ◽  
Ultrasound Monitoring ◽  
Metabolic Bone ◽  
Ossification Centers ◽  
Preterm Newborns

The usefulness of serum alkaline phosphatase (ALP) and phosphorous in screening and monitoring of metabolic bone disease of prematurity (MBDP) still has some limitations, especially in preterm infants with concomitant conditions such as cholestasis. We aimed to assess a modification of serum ALP (M-ALP) as a biomarker for MBDP in preterm infants, and the use of ultrasound monitoring for the apparition of knee ossification centers as marker of bone mineralization. Biochemical and clinical registers were taken from 94 preterm newborns <32 weeks. A significant correlation existed between serum ALP and direct bilirubin (DB), expressed by the regression equation: M-ALP (IU/L) = 302.1 + 96.9 (DB (mg/dL)). The ratio ALP/M-ALP > 1 was demonstrated to be more specific (87.5%) in the diagnosis of MBDP than the cut-off value of serum ALP > 500 IU/L (62.5%). ALP/M-ALP > 1 showed 100% sensitivity and specificity for the diagnosis of MBDP, and a good correlation with specific bone ALP (B-ALP). Patients with the knee nucleus by post-menstrual week 37 had lower B-ALP compared to patients with no nucleus, and no patients with MBDP presented the nucleus by the 40th week. In the absence of reliable specific B-ALP, reinterpreting serum ALP values by M-ALP plus monitoring of knee ossification centers contribute to better management of MBDP in preterm infants with cholestasis.

scholarly journals Screening of Serum Alkaline Phosphatase and Phosphate Helps Early Detection of Metabolic Bone Disease in Extremely Low Birth Weight Infants

2021 ◽  
Vol 9 ◽  
Author(s):  
Hui Zhang ◽  
Qiong Jia ◽  
Meihua Piao ◽  
Yanmei Chang ◽  
Jinghui Zhang ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Birth Weight ◽  
Early Detection ◽  
Gestational Age ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Serum Alkaline Phosphatase ◽  
Extremely Low Birth Weight ◽  
Metabolic Bone ◽  
Male Sex

Background: Extremely low birth weight (ELBW, &lt;1,000 g) infants have a high risk of metabolic bone disease (MBD). Because of the late appearance of radiological signs, diagnosis of MBD in ELBW infants might be delayed, and its prevalence underestimated in this group of patients. This study adopted serial screening of serum alkaline phosphatase (ALP) and phosphate (P) of ELBW infants to determine whether such screening is helpful for the early detection of MBD.Materials and Methods: We performed a retrospective study of preterm infants with a gestational age ≤ 31 weeks and birth weight &lt;1,000 g. MBD was absent (ALP ≤500 IU/L), mild (ALP &gt;500 IU/L, P ≥4.5 mg/dL), and severe (ALP &gt;500 IU/L, P &lt;4.5 mg/dL); MBD was divided into early MBD (≤4 weeks after birth) and late MBD (&gt;4 weeks after birth) according to the time of onset.Results: A total of 142 ELBW infants were included, with a median gestational age of 28.1 (26.5–29.7) weeks and a median birth weight of 875 (818–950) g. Seventy-three cases of MBD were diagnosed, and the total prevalence was 51.4% (mild MBD, 10.6%; and severe MBD, 40.8%). Male sex, breastfeeding, and sepsis would increase the risk of severe MBD. Most MBD in ELBW infants occurred at 3–4 weeks after birth. Sixty-two percent (45/73) of infants were diagnosed as having early MBD, which are diagnosed earlier than late MBD [24 (21–26) vs. 39 (36–41), t = −7.161; P &lt; 0.001]. Male sex [odds ratio (OR), 2.86; 95% confidence interval (CI), 1.07–7.64; P = 0.036], initial high ALP levels (OR, 1.02; 95% CI, 1.01–1.03; P &lt; 0.001), and breastfeeding (OR, 5.97; 95% CI, 1.01–25.12; P = 0.049) are independent risk factors for the development of early MBD.Conclusion: The risk of MBD among ELBW infants is very high. Most cases occurred early and were severe. Male sex, initial high ALP levels, and breastfeeding are closely related to the increased risk of early MBD. Serial screening of serum ALP and P helps early detection of MBD; it is recommended to start biochemical screening for ELBW infants 2 weeks after birth and monitor their biochemical markers weekly.

Concurrent Assays of Circulating Bone Gla-Protein and Bone Alkaline Phosphatase: Effects of Sex, Age, and Metabolic Bone Disease*

1988 ◽  
Vol 66 (5) ◽  
pp. 951-957 ◽  
Author(s):  
RALPH J. DUDA ◽  
JOHN F. O’BRIEN ◽  
JERRY A. KATZMANN ◽  
JAMES M. PETERSON ◽  
KENNETH G. MANN ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Bone Alkaline Phosphatase ◽  
Bone Gla Protein ◽  
Metabolic Bone

scholarly journals Posttranslational Heterogeneity of Bone Alkaline Phosphatase in Metabolic Bone Disease

1994 ◽  
Vol 32 (9) ◽  
Author(s):  
M. R. Langlois ◽  
J. R. Delanghe ◽  
J. M. Kaufman ◽  
M. L. De Buyzere ◽  
M. J. Hoecke ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Bone Alkaline Phosphatase ◽  
Metabolic Bone

Comparison of Intact Parathyroid Hormone, Alkaline Phosphatase, Phosphate Levels for Diagnosing Severe Metabolic Bone Disease in Infants with Severe Bronchopulmonary Dysplasia

2017 ◽  
Vol 34 (12) ◽  
pp. 1199-1204 ◽  
Author(s):  
Erin Tkach ◽  
Ammie White ◽  
Kevin Dysart ◽  
Brenda Waber ◽  
Ursula Nawab ◽  
...  
Keyword(s):  
Alkaline Phosphatase ◽  
Parathyroid Hormone ◽  
Bronchopulmonary Dysplasia ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Very Low Birth Weight ◽  
Area Under The Curve ◽  
Intact Parathyroid Hormone ◽  
Vlbw Infants ◽  
Metabolic Bone

Objective We compared the accuracy of serum intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and phosphate (phos) levels for diagnosing severe metabolic bone disease (MBD) in very low-birth-weight (VLBW) infants with severe bronchopulmonary dysplasia (BPD). Study Design Retrospective analysis of VLBW infants with severe BPD admitted between 2010 and 2012 and with ≥ 1 iPTH, ALP, and phos level collected within a similar 72-hour period. MBD severity was classified by serial radiography. Results Laboratory values were available for 65 infants, of whom 24 (36.9%) developed severe MBD. A maximum ALP > 660 IU/L was the most accurate for diagnosing severe MBD (area under the curve: 88.4%; 95% confidence interval [CI]: 77.2–94.5%). Maximum iPTH was the least accurate (optimal cut point > 130 pg/mL; area under the curve: 70.5%; 95% CI: 58.2–81.4). Conclusion Maximum ALP was more accurate than iPTH or phos for diagnosing severe MBD among preterm infants with severe BPD.

Transient hyperphosphatasemia in a child with autosomal recessive vitamin D dependency.

1986 ◽  
Vol 32 (7) ◽  
pp. 1418-1419 ◽  
Author(s):  
D E Cole
Keyword(s):  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Phosphatase Activity ◽  
Alkaline Phosphatase Activity ◽  
Bone Disease ◽  
Autosomal Recessive ◽  
Metabolic Bone Disease ◽  
Extensive Investigation ◽  
Asymptomatic Children ◽  
Metabolic Bone

Abstract The case of a 4.5-year-old girl with autosomal recessive vitamin D dependency is described. Although she had been effectively treated since one month postpartum with 1 alpha-hydroxycholecalciferol [1 alpha(OH)D3, alfacalcidol], her mean alkaline phosphatase (EC 3.1.3.1) activity in serum increased to 3680 U/L from a stable value [335 (SD 50) U/L; n = 12] within three weeks, then returned to baseline over the ensuing four months. Transient hyperphosphatasemia was diagnosed. Extensive investigation of an isolated episodic increase in alkaline phosphatase activity is as superfluous in the child with adequately treated metabolic bone disease as it is in other healthy and asymptomatic children.

scholarly journals Doença Metabólica Óssea da Prematuridade em Recém-Nascidos de Muito Baixo Peso: Estudo Observacional Retrospetivo

2019 ◽  
Vol 32 (7-8) ◽  
pp. 536
Author(s):  
Raquel Costa ◽  
Catarina Franco ◽  
Nádia Santos ◽  
Patrícia Maio ◽  
Filipa Vieira ◽  
...  
Keyword(s):  
Birth Weight ◽  
Gestational Age ◽  
Bone Disease ◽  
Low Birthweight ◽  
Metabolic Bone Disease ◽  
Serum Alkaline Phosphatase ◽  
Bone Matrix ◽  
Very Low Birthweight ◽  
Convenience Sample ◽  
Metabolic Bone

Introduction: Metabolic bone disease of prematurity consists in a decrease of bone matrix mineral content, in comparison with the level expected for gestational age. Screening of this condition is based on serum alkaline phosphatase and phosphate levels. The aim of this study is to evaluate the prevalence of metabolic bone disease of prematurity, to assess the aspects associated with a higher risk of this disease and to describe the growth of newborns with birth weight below 1500 g and metabolic bone disease of prematurity.Material and Methods: Observational, retrospective, multicenter and descriptive study in three neonatal intensive care units in Portugal, from May 1st 2016 to April 30th 2017. A convenience sample of very low birthweight newborns was obtained. Demographic, clinical, and laboratory variables were described in newborns with and without metabolic bone disease of prematurity.Results: A total of 53 newborns were included in this study: 30 males, 16 with gestational age ≤ 28 weeks. Five cases of metabolic bone disease of prematurity were diagnosed. In this group, the majority of patients was male and presented a lower gestational age and birth weight, in comparison with the group without metabolic bone disease of prematurity. The average duration of parenteral nutrition was higher in newborns with metabolic bone disease of prematurity and the calcium/phosphate ratio was lower than the recommended values. Growth was similar in both groups. No patient with metabolic bone disease of prematurity underwent physical rehabilitation.Discussion: The prevalence of metabolic bone disease of prematurity was 9.43%, which is lower than what is described in the literature. However, only 50% of newborns completed the screening according to the recommendations. The main risk factors identified concur with the literature.Conclusion: Metabolic bone disease of prematurity is a frequent but underdiagnosed comorbidity in very low birthweight newborns. It is essential to screen newborns at risk for this condition, using biochemical markers, as well as structure nutritional interventions and physical stimulation in order to avoid short and long-term consequences of this disease.

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