Bone and Collagen Markers in Preterm Infants: Relationship with Growth and Bone Mineral Content over the First 10 Weeks of Life

Crofton, Patricia M.; Shrivastava, A.; Wade, James B.; Stephen, Rhona; Kelnar, Christopher J. H.; Lyon, Andrew; McIntosh, Neil

doi:10.1203/00006450-199911000-00015

Cited by 53 publications

(42 citation statements)

References 28 publications

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“…Serum BAP, a surrogate marker of bone formation, is strongly related to BMC accretion in premature VLBW infants. 25 We observed a relatively constant serum BAP levels from baseline to 4 weeks in MOM and OT infants, but a significant decrease in CTL infants. Urine Pyd, a surrogate marker for bone resorption was unchanged for all groups.…”

Section: Discussionmentioning

confidence: 51%

“…Bone speed of sound (SOS, m s À1 ) is measured by quantitative ultrasound, is a Physical activity and bone mass in premature infants LJ Moyer-Mileur et al surrogate for bone strength, and decreases significantly during the first 3 months of life in prematurely born infants. 25,26 The decrease in bone SOS is thought to reflect expansion of BA coupled with delayed mineralization during rapid postnatal growth. 26 Recently, Litmanovitz et al 27 reported tibia bone SOS was maintained in infants randomized to a daily physical activity regimen, whereas CTL infants experienced a significant decrease in bone SOS.…”

Section: Discussionmentioning

confidence: 99%

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Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

et al. 2008

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Objective: To determine if physical activity delivered by an infant's mother would be as effective in promoting bone mineral acquisition in preterm very low birth weight (VLBW) infants as the same intervention administered by a trained therapist.Patients and methods: Preterm VLBW infants were randomized to receive daily physical activity administered by the infant's mother (MOM, n ¼ 11) or a trained therapist (OT, n ¼ 11), or control (n ¼ 11). Physical activity consisted of range of motion movements against passive resistance to all extremities for 5 to 10 min daily. All infants were fed mother's milk with fortification to 24 kcal oz À1 . Dual energy x-ray of the forearm bone area (BA, cm 2 ), mineral content (BMC, g), and density (BMD, g/cm 2 ) and measurement of bone formation (bone-specific alkaline phosphatase, BAP) and resorption (urine pyridinium crosslinks of collagen, Pyd) were obtained at study entry and at 2.0 kg of body weight.Result: Forearm BA and BMC gains were greater in MOM and OT infants compared to the control infants despite similar postnatal growth rate and nutrient intake. Serum BAP levels decreased in controls but remained unchanged in MOM and OT infants. Urine Pyd levels were similar at baseline to 2.0 kg for all groups. These findings suggest greater bone growth and mineral acquisition in MOM and OT infants than control infants. Conclusion:This study demonstrates that a physical activity program administered by the infant's own mother is as equally effective as therapist-administered physical activity in promoting greater bone growth and mineral acquisition in preterm VLBW infants.

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Section: Discussionmentioning

confidence: 51%

Section: Discussionmentioning

confidence: 99%

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

et al. 2008

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“…Pyridinoline (Pyd), measured in urine, reflects whole body collagen degradation (excluding that in skin) whereas deoxypyridinoline (Dpd) is thought to be more specific for bone collagen. We have already demonstrated that in preterm infants not treated with glucocorticoids, PICP and P3NP increase after birth, whereas ICTP decreases, reflecting postnatal growth (13). P3NP was correlated with rate of weight and length gain in these infants, whereas PICP was highly correlated with bone mineral content.…”

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confidence: 97%

Effects of Dexamethasone Treatment on Bone and Collagen Turnover in Preterm Infants with Chronic Lung Disease

et al. 2000

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Dexamethasone is used commonly in the treatment of chronic lung disease of prematurity, but there are concerns about possible deleterious effects on growth and bone. Our aim in this study was to examine the effects of dexamethasone treatment on bone and collagen turnover in preterm infants. Bone-specific alkaline phosphatase, the C-terminal propeptide of type I collagen (PICP, reflecting whole-body type I collagen synthesis), and the Nterminal propeptide of type III procollagen (P3NP, reflecting soft tissue collagen turnover), together with the C-terminal telopeptide of type I collagen (ICTP), urinary pyridinoline (Pyd), and deoxypyridinoline (all markers of collagen breakdown) were measured at weekly intervals over the first 12 wk of life in 14 preterm infants with chronic lung disease treated with dexamethasone. Results were expressed as SD scores relative to preterm control infants not treated with dexamethasone. PICP, P3NP, ICTP, and Pyd all showed marked decreases (Ϫ2.1 to Ϫ3.7 SD scores) during the first week of treatment (p Ͻ 0.001), returning to pretreatment levels after stopping dexamethasone. In the group as a whole, these collagen markers were negatively correlated with dexamethasone dose (p Ͻ 0.0001); negative correlations were also seen in most individual babies, although the slopes of individual regression lines varied by a factor of 2. Weight gain at 12 wk was correlated with PICP, expressed as the mean SD score over 12 wk for each baby, (r ϭ 0.69, p Ͻ 0.01) but not with other markers or cumulative dose of dexamethasone. We conclude that dexamethasone markedly suppressed collagen turnover in preterm infants in a dose-dependent fashion, although some babies were more affected than others. The degree of suppression of type I collagen synthesis was a strong independent predictor of overall weight gain over the first 12 wk of life. Steroids are used commonly in the management of preterm infants with developing chronic lung disease (CLD). Dexamethasone has been shown to improve pulmonary compliance and help to wean infants from the ventilator, but there are concerns about side effects (1-3). Glucocorticoids impair growth and bone formation in children (4 -8). We and others have demonstrated that infants treated with dexamethasone have short-term reductions in linear growth, weight velocity, radial length velocity, and bone mineralization compared with those not so treated (9 -11). We have also demonstrated that these infants have reduced calcium absorption and retention, and reduced phosphate retention, compared with infants who did not receive steroids (11).Biochemical markers of bone and soft tissue turnover may give insight into the dynamic effects of therapeutic interventions on bone and growth (12). For the present study, we chose a panel of markers that would reflect various aspects of bone and soft tissue turnover and that have already been validated as markers of growth in older children and as markers of bone formation and resorption by histomorphometry and calcium kinetic studies in adults (1...

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“…Most of the previous studies reported the incidences of osteopenia of prematurity was as high as up to 25-75%. 2,3 Osteopenia of prematurity refers to the hypomineralized skeleton of the premature infant compared to that of the normal fetal skeleton resulting from inadequate in-utero accretion of minerals. Their bone mineral content at term corrected age has been found to be 25-70% lower than in term.…”

Section: Introductionmentioning

confidence: 99%

Osteopenia in Premature Infants and Effect of Supplementation

Afroz

Chowdhury

Hoque

et al. 2017

Bangladesh J Child Health

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Bone and Collagen Markers in Preterm Infants: Relationship with Growth and Bone Mineral Content over the First 10 Weeks of Life

Cited by 53 publications

References 28 publications

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

Maternal-administered physical activity enhances bone mineral acquisition in premature very low birth weight infants

Effects of Dexamethasone Treatment on Bone and Collagen Turnover in Preterm Infants with Chronic Lung Disease

Osteopenia in Premature Infants and Effect of Supplementation

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