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.

scholarly journals Metabolic bone disease in preterm infants.

1985 ◽  
Vol 60 (7) ◽  
pp. 682-685 ◽  
Author(s):  
O G Brooke ◽  
A Lucas
Keyword(s):  
Preterm Infants ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Metabolic Bone

scholarly journals A Study of the Relationship Between Cystatin C and Metabolic Bone Disease in Preterm Infants

2018 ◽  
Vol 10 (2) ◽  
pp. 119-124
Author(s):  
Sabriye Korkut ◽  
Şeyma Memur ◽  
Hülya Halis ◽  
Osman Baştuğ ◽  
Levent Korkmaz ◽  
...  
Keyword(s):  
Preterm Infants ◽  
Cystatin C ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Metabolic Bone ◽  
The Relationship

scholarly journals Comparison of prevalence and characteristics of fractures in term and preterm infants in the first 3 years of life

2020 ◽  
Author(s):  
Liting Tong ◽  
Sarita Pooranawattanakul ◽  
Jaya Sujatha Gopal-Kothandapani ◽  
Amaka C. Offiah
Keyword(s):  
Emergency Department ◽  
Birth Weight ◽  
Linear Regression ◽  
Low Birth Weight ◽  
Preterm Infants ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Categorical Variables ◽  
Metabolic Bone ◽  
Significant Difference

Abstract Background Preterm infants may be more vulnerable to fractures due to various factors, including metabolic bone disease, but an increased risk of fractures up to the age of 2 is unproven. Objective To compare fracture patterns in premature and full-term children in the first 3 years of life. Materials and methods A retrospective study was conducted. We excluded any child who returned with the same injury, with known metabolic bone disease, with any disease or condition known to reduce bone density, who received any medication known to affect Vitamin D metabolism within 3 months of enrollment or who had fractures post-surgery/resuscitation. Variables such as the number of fractures sustained each year, age of presentation to the Emergency Department and mechanism of injury were compared between the preterm and term groups using statistical analysis (χ2 and Fisher exact test for categorical variables and Student’s t-test for continuous variables). Simple linear regression was performed on the total number of fractures sustained by age 3. Results Forty-four children with fractures were included. Of these, none were born extremely preterm, 24 (55%) were preterm, and 20 (45%) were born at term. Mean gestational ages of the preterm and term groups were 32 weeks 3 days and 39 weeks 6 days, respectively. There were no extremely low birth weight or very low birth weight children. There was no significant difference in the number of fractures sustained yearly, the age of presentation to the Emergency Department or the site of fracture between preterm and term groups. Linear regression showed that the total number of fractures sustained by age 3 years was unrelated to prematurity status, gender or birth weight category. Conclusion No significant difference in fracture number or pattern was identified.

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 Metabolic Bone Disease and Bone Mineral Density in Very Preterm Infants

2014 ◽  
Vol 164 (3) ◽  
pp. 499-504 ◽  
Author(s):  
Josep Figueras-Aloy ◽  
Enriqueta Álvarez-Domínguez ◽  
José M. Pérez-Fernández ◽  
Gloria Moretones-Suñol ◽  
Sergi Vidal-Sicart ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Preterm Infants ◽  
Bone Mineral ◽  
Bone Disease ◽  
Metabolic Bone Disease ◽  
Mineral Density ◽  
Very Preterm Infants ◽  
Very Preterm ◽  
Metabolic Bone
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