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Matejek T, Zapletalova B, Stranik J, Zaloudkova L, Palicka V. Reference values of parathyroid hormone in very low birth weight infants. Ann Clin Biochem 2024; 61:372-385. [PMID: 38520177 DOI: 10.1177/00045632241245942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/25/2024]
Abstract
PURPOSE The primary goal was to estimate reference values of parathyroid hormone (PTH) in very low birth weight infants without severe neonatal morbidity. A secondary objective was to assess the relationship between PTH serum levels and selected laboratory markers of bone metabolism. METHODS Ninety two infants with birth weight less than 1500 g met the inclusion criteria of the study. Serum levels of PTH, 25-hydroxyvitamin-D [25(OH)D], C3-epi-25(OH)D, total calcium, phosphorus, and alkaline phosphatase, and urinary levels of calcium, phosphorus, and creatinine were examined on day 14 and subsequently every 2 weeks until discharge. RESULTS Of the total 167 serum samples examined for PTH levels in infants without 25(OH)D deficiency the estimated range was 0.9-11.9 pmol/l (8.5-112.3 pg/mL). During the first month, no statistically significant correlation was observed between PTH level and that of 25(OH)D, C3-epimers of 25(OH)D, S-Ca, S-P, or ALP, nor with urinary excretion of calcium and phosphorus. From the second month of life, there was a moderately significant correlation between PTH and 25(OH)D (Rho = -0.40, P =< .001), between PTH and calcium/creatinine ratio (Rho = -0.56, P = < .001), and between PTH and phosphorus/creatinine ratio (Rho = 0.51, P = < .001). CONCLUSIONS The physiological range for PTH levels for preterm neonates without 25(OH)D deficiency was estimated as 0.9-11.9 pmol/l (8.5-112.3 pg/mL). It seems that elevation of serum PTH above this range can be considered as hyperparathyroidism in very low birth weight infants.
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Affiliation(s)
- Tomas Matejek
- Department of Paediatrics, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Bara Zapletalova
- Department of Paediatrics, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Jaroslav Stranik
- Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Lenka Zaloudkova
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
| | - Vladimir Palicka
- Institute of Clinical Biochemistry and Diagnostics, Faculty of Medicine Hradec Kralove, University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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Cerar S, Vurzer L, Šalamon AS, Kornhauser Cerar L, Trdan M, Robek D, Perme T, Biček A, Oblak A, Marc J, Černe D, Erčulj V, Grosek Š. Diagnostics of Metabolic Bone Disease in Extremely Preterm Infants-Clinical Applicability of Bone Turnover Biochemical Markers and Quantitative Ultrasound. CHILDREN (BASEL, SWITZERLAND) 2024; 11:784. [PMID: 39062233 PMCID: PMC11275004 DOI: 10.3390/children11070784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Revised: 06/11/2024] [Accepted: 06/25/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Significant improvement in neonatal care has enabled increasing survival of preterm infants. Metabolic bone disease of prematurity is often overlooked due to other comorbidities of preterm birth. The best approach is screening and prevention of the disease in high-risk infants such as preterm infants. AIM We followed up the clinical, radiological, and serum biochemical markers of metabolic bone disease in extremely preterm infants (<28 weeks of gestation). The clinical applicability and validation of C-terminal telopeptide of type I collagen (CTX-I) as a novel bone turnover marker were assessed. Standard and novel biochemical bone turnover markers and quantitative ultrasound were compared. METHOD Patients' data were collected from medical records. Assessments of calcium, phosphate, alkaline phosphatase, bone-alkaline phosphatase, CTX-I, and quantitative ultrasound were prospectively performed twice in 42 extremely preterm infants at postmenstrual ages of 30-32 weeks and 36-40 weeks. Bone mineral density was measured by quantitative ultrasound. CONCLUSION Phosphate, alkaline phosphatase, bone alkaline phosphatase, calcium, or ionized calcium are not related to gestational age, but bone mineral density, measured by quantitative ultrasound, is related. There is no correlation between standard and novel biochemical markers and quantitative ultrasound for the identification of metabolic bone disease.
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Affiliation(s)
- Sandra Cerar
- Department of Neonatology, Division of Paediatrics, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia; (S.C.); (A.S.Š.)
| | - Lara Vurzer
- Department of Paediatrics, Community Health Centre Ljubljana, 1000 Ljubljana, Slovenia;
| | - Aneta Soltirovska Šalamon
- Department of Neonatology, Division of Paediatrics, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia; (S.C.); (A.S.Š.)
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
| | - Lilijana Kornhauser Cerar
- Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (L.K.C.); (M.T.); (D.R.); (T.P.)
| | - Matevž Trdan
- Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (L.K.C.); (M.T.); (D.R.); (T.P.)
| | - Domen Robek
- Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (L.K.C.); (M.T.); (D.R.); (T.P.)
| | - Tina Perme
- Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (L.K.C.); (M.T.); (D.R.); (T.P.)
| | - Ajda Biček
- Department of Nuclear Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia (A.O.)
| | - Adrijana Oblak
- Department of Nuclear Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia (A.O.)
| | - Janja Marc
- Faculty of Pharmacy, Department of Clinical Biochemistry, University of Ljubljana, 1000 Ljubljana, Slovenia; (J.M.); (D.Č.)
- Clinical Institute for Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Darko Černe
- Faculty of Pharmacy, Department of Clinical Biochemistry, University of Ljubljana, 1000 Ljubljana, Slovenia; (J.M.); (D.Č.)
- Clinical Institute for Clinical Chemistry and Biochemistry, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
| | - Vanja Erčulj
- Faculty of Criminal Justice and Security, University of Maribor, 1000 Ljubljana, Slovenia;
| | - Štefan Grosek
- Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
- Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia; (L.K.C.); (M.T.); (D.R.); (T.P.)
- Department of Paediatric Intensive Care, Division of Paediatrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
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Chen YW, Chang YJ, Chen LJ, Lee CH, Hsiao CC, Chen JY, Chen HN. Neurodevelopment Outcomes in Very-Low-Birth-Weight Infants with Metabolic Bone Disease at 2 Years of Age. CHILDREN (BASEL, SWITZERLAND) 2024; 11:76. [PMID: 38255389 PMCID: PMC10814392 DOI: 10.3390/children11010076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Revised: 01/04/2024] [Accepted: 01/06/2024] [Indexed: 01/24/2024]
Abstract
Metabolic bone disease (MBD) predominantly affects preterm infants, particularly very-low-birth-weight (VLBW) infants weighing <1500 g. However, there are limited reports on MBD and neurodevelopmental outcomes. This study aimed to analyze the risk factors for MBD and understand its impact on neurodevelopmental outcomes at 2 years of corrected age. Overall, 749 VLBW infants weighing <1350 g at birth were enrolled. Exclusion criteria were major congenital abnormalities, chromosomal abnormalities, and loss of follow-up on the Bayley Scales of Infant Development, Third Edition (BSID-III) test at 24 months of corrected age. Infants were retrospectively assessed by a trained case manager using the BSID-III test at 6, 12, and 24 months old. Infants were categorized as with or without MBD according to radiographic signs. Of those enrolled, 97 VLBW infants were diagnosed with MBD, compared to 362 VLBW infants without MBD. The proportion of infants that completed three follow-ups was 86%. At the assessment at 2 years of age, infants with MBD had lower and more significant differences in motor, language, and cognitive composites. MBD is associated with poor neurodevelopmental outcomes in cognitive, motor, and language composites for VLBW infants at 24 months of corrected age.
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Affiliation(s)
- Yu-Wen Chen
- Department of Neonatology, Changhua Christian Children’s Hospital, No. 320, Xuguang Road, Changhua City 500010, Taiwan
| | - Yu-Jun Chang
- Big Data Center, Changhua Christian Hospital, No. 135, Nanxiao Street, Changhua City 500209, Taiwan
| | - Lih-Ju Chen
- Department of Neonatology, Changhua Christian Children’s Hospital, No. 320, Xuguang Road, Changhua City 500010, Taiwan
| | - Cheng-Han Lee
- Department of Neonatology, Changhua Christian Children’s Hospital, No. 320, Xuguang Road, Changhua City 500010, Taiwan
| | - Chien-Chou Hsiao
- Department of Neonatology, Changhua Christian Children’s Hospital, No. 320, Xuguang Road, Changhua City 500010, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, No. 145, Xingda Road, South District, Taichung City 402202, Taiwan
| | - Jia-Yuh Chen
- Department of Neonatology, Changhua Christian Children’s Hospital, No. 320, Xuguang Road, Changhua City 500010, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, No. 145, Xingda Road, South District, Taichung City 402202, Taiwan
| | - Hsiao-Neng Chen
- Department of Neonatology, Changhua Christian Children’s Hospital, No. 320, Xuguang Road, Changhua City 500010, Taiwan
- School of Medicine, Chung-Sun Medical University, No. 110, Sec. 1, Jianguo N. Road, South District, Taichung City 402306, Taiwan
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