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
| Autor: | Pablo Docio, Luis de la Rubia, María T. García-Unzueta, Isabel de las Cuevas, María J Cabero-Perez, Domingo González-Lamuño, Bernardo A. Lavín-Gómez, Sandra Llorente-Pelayo |
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| Přispěvatelé: | Universidad de Cantabria |
| Rok vydání: | 2020 |
| Předmět: |
Male
Time Factors Epiphyseal Ossification Centers Metabolic Bone Disease Infant Premature Diseases Gastroenterology Cohort Studies 0302 clinical medicine Osteogenesis rickets Growth Plate Prospective Studies 030212 general & internal medicine Ultrasonography Nutrition and Dietetics Cholestasis musculoskeletal neural and ocular physiology musculoskeletal system Alkaline phosphatase Biomarker (medicine) Female metabolic bone disease medicine.symptom Prematurity alkaline phosphatase lcsh:Nutrition. Foods and food supply Infant Premature Rickets Risk musculoskeletal diseases medicine.medical_specialty lcsh:TX341-641 Sensitivity and Specificity digestive system Article Metabolic bone disease 03 medical and health sciences stomatognathic system 030225 pediatrics Internal medicine medicine Animals Humans Knee Retrospective Studies Bone Specific Alkaline Phosphatase Ossification business.industry Osteopenia prematurity Infant Reproducibility of Results medicine.disease Alkaline Phosphatase Bone Diseases Metabolic osteopenia Spain Concomitant business cholestasis Biomarkers Food Science |
| Zdroj: | Nutrients . 2020 Dec 17;12(12):3854. UCrea Repositorio Abierto de la Universidad de Cantabria instname Nutrients, Vol 12, Iss 3854, p 3854 (2020) Nutrients Volume 12 Issue 12 Universidad de Cantabria (UC) |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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