Bone Mineral Density According to Dual Energy X-ray Absorptiometry is Associated with Serial Serum Alkaline Phosphatase Level in Extremely Low Birth Weight Infants at Dischargeopen access
- Authors
- Lee, Jin; Park, Hyun-Kyung; Kim, Ja Hye; Choi, Yun Young; Lee, Hyun Ju
- Issue Date
- Jun-2017
- Publisher
- ELSEVIER TAIWAN
- Keywords
- bone mineral density; dual energy x-ray absorptiometry; premature infants
- Citation
- PEDIATRICS AND NEONATOLOGY, v.58, no.3, pp.251 - 257
- Indexed
- SCIE
SCOPUS
- Journal Title
- PEDIATRICS AND NEONATOLOGY
- Volume
- 58
- Number
- 3
- Start Page
- 251
- End Page
- 257
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/152275
- DOI
- 10.1016/j.pedneo.2016.05.005
- ISSN
- 1875-9572
- Abstract
- Background: To examine bone mineral density in extremely low birth weight infants at discharge and investigate whether serial measurements of serum alkaline phosphatase (ALP) and phosphate can predict bone mineralization. Methods: The individuals were 70 preterm infants. Serum calcium, phosphate, and ALP were measured at weekly intervals during admission in extremely low birth weight infants (mean gestational age, 25.3 +/- 2.1 weeks; birth weight, 812.8 +/- 141.1 g). Bone mineral apparent density (BMAD) of the lumbar spine was prospectively evaluated by dual energy X-ray absorptiometry at discharge (n = 70). Results: BMAD was classified as poor (< 25th percentile) at < 0.014 g/cm(3), fair (25th-75th percentile) at < 0.014-0.021 g/cm(3), and good (> 75th percentile) at > 0.021 g/cm(3), based on the distribution of BMAD values in infants with noncomplicated courses of prematurity (n = 43). In a further multivariate analysis, the number of total parenteral nutrition days, phosphate at 2 postnatal weeks and 3 postnatal weeks, and ALP at 4 postnatal weeks and 5 postnatal weeks had an impact on bone mineral density at the lumbar spine, independent of gestational age and body weight. Peak ALP activities exceeding 650 IU/L revealed low bone mineral density with 80% sensitivity and 64% specificity (AUC, 0.70; p = 0.005). Conclusion: Serial measurements of serum ALP and phosphate are associated with decreased bone mineralization by dual energy X-ray absorptiometry at discharge in extremely low birth weight infants.
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