Bone maturation in extremely low birth weight infants in relation to birth weight and endocrine parameters

Abstract

Modern intensive care techniques have led to higher survival rates of extremely low birth weight infants (ELBW, birth weight <1,000 g). Previous studies have suggested a link between abnormal birth parameters and subsequent endocrine disturbances, but a possible impact on bone maturation during childhood has not been studied. ELBW children were studied (mean chronological age (CA), 6.01 years; range, 4.5-8.2). Skeletal maturation was assessed according to Greulich and Pyle (8). Bone age (BA) was defined as retarded when DeltaBA-CA was < -1 SD and accelerated when DeltaBA-CA was >+1 SD. BA was either retarded or accelerated in 15 patients (24.6%). Twenty-one of 61 radiograms (34.4%) showed a discordant BA with a marked gender difference (14/24 boys; 7/37 girls). DeltaBA-CA correlated significantly with BMI (r = 0.36; p = 0.005) and height SDS (r = 0.35; p = 0.006). We found significant correlations between BA and androgens. Insulin-like growth factor binding protein-1 (IGFBP-1), which decreases in insulin-resistant individuals, correlated negatively with BA. In conclusion, bone maturation in ELBW children is correlative with height and weight. It is modulated by a variety of metabolic factors, including IGFBP-1 and androgens. Bone age, together with height and weight catch-up, can thus possibly serve as early indicators of insulin resistance later in life.

Impact of Early Nutrition on Body Composition in Children Aged 9.5 Years Born with Extremely Low Birth Weight

“…Subjects with chronic or syndromal disorders or with handicaps after severe intraventricular hemorrhages or necrotizing enterocolitis were excluded. For more details see [ 11 ].…”

Increased Steroid Excretion in Children with Extremely Low Birth Weight at a Median Age of 9.8 years

“…The original study [26] included 52 of the 178 ELBW infants born between 1999 and 2002 (29 female, 23 male, all Caucasian) at our University Children's Hospital in Bonn and enrolled there in a preterm follow-up programme. The Ethics Committee of the University Hospital in Bonn approved the study.…”

The Association between Bone Age Advancement and Insulin Resistance in Prepubertal Obese Children

“…There are a few reports on the factors that affect skeletal maturation in obese subjects. Adrenal androgen such as dehydroepiandrosterone sulfate (DHEAS) was positive correlated with adiposity in prepubertal children [17,18]. Sopher et al [4] reported that obesity was highly correlated with greater BA divided by chronological age (CA), and DHEAS was associated with advanced BA in prepubertal obese children and children with premature adrenarche.…”