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

卷:12

MaríaT. García-Unzueta¹  BernardoA. Lavín-Gómez¹  Luis de la Rubia²  Isabel de las Cuevas³  MaríaJ. Cabero-Pérez⁴  Sandra Llorente-Pelayo⁴  Domingo González-Lamuño⁴  Pablo Docio⁴ 

[1] Biochemical Department, University Hospital Marqués de Valdecilla—Research Institute Valdecilla (IDIVAL), 39008 Santander, Spain;

[2] Departmento de Ciencias Médicas y Quirúrgicas, University of Cantabria, 39005 Santander, Spain;

[3] Neonatology Unit, Pediatric Department, University Hospital Marqués de Valdecilla—Research Institute Valdecilla (IDIVAL), 39008 Santander, Spain;

[4] Pediatric Department, University Hospital Marqués de Valdecilla—Research Institute Valdecilla (IDIVAL), 39008 Santander, Spain;

关键词: metabolic bone disease;    prematurity;    osteopenia;    rickets;    cholestasis;    alkaline phosphatase;   

DOI  :  10.3390/nu12123854

来源: DOAJ

【 摘 要 】

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.

【 授权许可】

Unknown