Growth velocity and plasma alkaline phosphatase activity in the preterm infant

James, Janet; Mayne, Philip; Barnes, I.; Kovar, I Z

doi:10.1016/0378-3782(85)90116-1

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…Nevertheless, when grossly elevated, plasma alkaline phosphatase activity in neonates is predominantly of bone origin18 and there are abundant data to show that its activity is usually increased during frank metabolic bone disease, often exceeding the maximum adult value several fold.1'13-1619-2 It is increased when bone mineral intake is inadequate and growth is slowed.2 7 23-26 Many workers have regarded raised plasma alkaline phosphatase activity as an important indicator of metabolic bone disease,1' 16 21 2 and in particular when sequential monitoring is undertaken.16 Conversely, a reduction in plasma alkaline phosphatase activity has been observed during catch up growth following periods of slow growth in preterm infants. 8 Our data add further weight to the view that high plasma alkaline phosphatase activity is associated with bone mineral substrate deficiency. In a randomised comparison infants fed human milk had significantly higher plasma alkaline phosphatase activity than those receiving a formula providing twice the calcium and phosphorus contents of breast milk (fig 1).…”

Section: Discussionsupporting

confidence: 61%

High alkaline phosphatase activity and growth in preterm neonates.

Lucas

Brooke

Baker

et al. 1989

Archives of Disease in Childhood

152

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SUMMARY In a study on 857 infants born preterm, high peak plasma alkaline phosphatase activity was independently related to slower growth rate in the neonatal period, and to a highly significant reduction in attained length at 9 months and 18 months post term. At 18 months the deficit in body length associated with peak neonatal plasma alkaline phosphase activity of 1200 IU/l or more was 1 6 cm (95% confidence interval 0-9 to 2-3 cm) after adjusting for confounding factors. The strength and magnitude of this association between high plasma alkaline phosphase activity and body length was greater than that for any other factor identified, including the infant's sex and the presence of fetal growth retardation. Data are presented that support the view that the high plasma alkaline phosphatase activity reflected early bone mineral substrate deficiency resulting in metabolic bone disease.We speculate that even silent early bone disease may interfere with the control of subsequent linear growth and emphasise the potential importance of providing preterm infants, especially those fed human milk, with adequate substrate for bone mineralisation.

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Section: Discussionsupporting

confidence: 61%

High alkaline phosphatase activity and growth in preterm neonates.

Lucas

Brooke

Baker

et al. 1989

Archives of Disease in Childhood

152

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“…However the reduced enzyme activity reflects to a certain deposition rate where the ratio of Ca level of the transmembrane vesicles with the P levels of bone tissue is always steady (15). Although in the current literature there are studies that suggest that ALP is not a reliable biochemical biomarker of bone metabolism in premature neonates (15)(16)(17), however it used until nowadays to identify premature infants with bone metabolic disorders (1,6,11,18). We concluded that gestational week and less the body weight is a factor in the assessment of biochemical markers of bone metabolism in healthy premature neonates.…”

Section: Clinical Cases In Mineral and Bone Metabolism 2017; 14(2):16mentioning

confidence: 99%

Clinical-laboratory findings of bone metabolism in healthy premature and full-term neonates: preliminary results

Dokos

Tsakalidis

Manaridou

et al. 2017

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SummaryPremature infants are a major risk group for bone metabolic disorders. The purpose of this study is to clarify certain aspects of bone metabolism in healthy preterm and fullterm neonates. Forty neonates (20 preterm and 20 fullterm) were the material of the study. For each neonate demographic data (gender, gestational week) and anthropometric data (body weight) were recorded. Blood samples were collected and biochemical markers of bone metabolism (serum ALP, Ca, P, Mg) were immediately estimated. According to the results there is a statistically significant difference in average ALP of preterm neonates compared to full term neonates. Slightly higher values of Ca, P, Mg occurred in premature neonates while there was a statistically significant difference in the weeks of gestation and body weights between the two groups. It is typical in premature neonates the decrease in levels of ALP by the weeks of gestation and the stable levels of Ca. Gestational week seems to positively affect P and Mg levels in preterm neonates. Conclusively from our study's results arises that the week of gestation and not so much the body weight influence the alterations of bone biochemical biomarkers in healthy premature newborns. It seems that very premature neonates have high levels of serum ALP in decompensation of lower levels of Mg and P from all the newborns in this study. Therefore in very premature neonates, it is recommended to estimate serum ALP, Mg and P for assessment of bone turnover.

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“…The degree of osteopenia is inversely related to birth weight and gestational age and the prevalence of osteopenia is estimated to be 50% in infants born at extreme low birth weight (ELBW) with a high fracture rate [2,10]. Severe morbidity during the neonatal period, development of bronchopulmonary dysplasia (BPD), chronic treatment with diuretics and steroids, the need for total parenteral nutrition and prolonged immobility further increase the risk of bone demineralisation [4].…”

Section: Introductionmentioning

confidence: 99%