Small-for-gestational-age preterm-born infants already have lower bone mass during early infancy

Lagemaat, Monique van de; Rotteveel, Joost; Weissenbruch, Mirjam M. van; Lafeber, Harrie N.

doi:10.1016/j.bone.2012.06.017

Cited by 20 publications

(16 citation statements)

References 41 publications

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“…Bone remodeling, the continuous process of bone formation and resorption, can be assessed and monitored by biochemical markers of bone turnover (1). Many studies have found that ex-preterm infants are shorter, lighter, and have lower bone mass (2-5) than their full-term peers, and ex-preterm infants who are small for gestational age at birth seem to have the most risk (6). However, several studies have found that the bone mass in ex-preterm infants is appropriate for their body size (7,8) and one study proposed that bone mineral density (BMD) in very-low-birth-weight infants is normalized at 2 y of age (9).…”

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confidence: 99%

Bone and fat mass in relation to postnatal levels of insulin-like growth factors in prematurely born children at 4 y of age

et al. 2014

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Background: Children born prematurely may be at risk of developing osteopenia. This study investigated whether insulin-like growth factors (IGFs) in the early postnatal period influence bone mass and body composition in prematurely born children. Methods: A total of 74 control (gestational age >36 wk; n = 37) and preterm (gestational age <32 wk; n = 37) infants were investigated (mean age ± SD: 4.59 ± 0.31 y). Bone mineral density, body composition, and markers of bone and mineral metabolism were investigated in relation to postnatal IGF levels. results: After adjusting for confounders, we found no differences in bone mass, but significantly less lean mass, increased fat mass, and increased osteocalcin levels in ex-preterm infants. Forward stepwise multiple analysis revealed that higher late postnatal IGF-II levels predict lumbar spine bone mineral content (P < 0.05) and lean mass (P < 0.05). When the birth weight standard deviation score was included in the analysis, higher early postnatal IGF-I levels predicted both lumbar spine bone mineral density and bone mineral content (P < 0.05). Higher early postnatal IGF binding protein-3 (P < 0.01) predicted increased fat mass at 4-y follow-up. conclusion: Ex-preterm children have normal bone mass but different body composition compared with full-term controls. Higher early IGF-I and late postnatal IGF-II concentrations are positive predictors of lumbar spine bone mass. c hildren's bone health is an important issue with lifelong importance. Many factors and medical conditions are associated with an increased risk of a bone mineral disorder and future skeletal problems, including genetics, mechanical loading, activity level, longitudinal growth, puberty, hormones, cytokines, and nutritional status. Peak bone mass is achieved during early adulthood and serves as the "bone bank" for the remainder of life. Bone remodeling, the continuous process of bone formation and resorption, can be assessed and monitored by biochemical markers of bone turnover (1). Many studies have found that ex-preterm infants are shorter, lighter, and have lower bone mass (2-5) than their full-term peers, and ex-preterm infants who are small for gestational age at birth seem to have the most risk (6). However, several studies have found that the bone mass in ex-preterm infants is appropriate for their body size (7,8) and one study proposed that bone mineral density (BMD) in very-low-birth-weight infants is normalized at 2 y of age (9). During adolescence, children who were born prematurely do not have different bone mineral content (BMC ) (10) or BMD (11) (adjusted for height and weight) in comparison with normal-weight children born at full term. Supplementation with early diet benefits short-time growth and BMD. Positive outcomes of an early special diet have been shown on body composition and fat mass during the first 2 y of life, but the long-term effects on BMD and other morbidities are not yet known (12).In full-term newborn infants, umbilical cord serum insulinlike growth factor (IGF)-I and ...

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Bone and fat mass in relation to postnatal levels of insulin-like growth factors in prematurely born children at 4 y of age

et al. 2014

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“…A positive association between birth weight and bone mass was clear among the children, but was unclear among adolescents and weak among adults [18, 19]. Infants born small for their gestational age are also at a higher risk of MBD, and reduced BMC which might persist up to 6 mo CA or even longer [17, 20]. However, in our study the impact of intrauterine growth retardation on BMC is seen only at term—not at 3 mo CA.…”

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confidence: 58%

The Clinical and Biochemical Predictors of Bone Mass in Preterm Infants

et al. 2016

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BackgroundMetabolic bone disease of prematurity still occurs in preterm infants, although a significant improvement in neonatal care has been observed in recent decades. Dual-energy X-ray absorptiometry (DXA) is the precise technique for assessing bone mineral content (BMC) in preterm infants, but is not widely available.AimTo investigate the clinical and biochemical parameters, including bone metabolism markers as potential predictors of BMC, in preterm infants up to 3 months corrected age (CA).Materials and MethodsCa-P homeostasis, iPTH, 25-hydroxyvitamin D, osteocalcin, N-terminal propeptide, cross-linked C-telopeptide and amino-terminal pro C-type natriuretic peptide and the DXA scans were prospectively performed in 184 preterm infants (≤ 34 weeks’ gestation) between term age and 3 mo CA. Lower bone mass was defined as BMC below or equal to respective median value for the whole study group, rounded to the nearest whole number.ResultsThe appropriate quality DXA scans were available for 160 infants (87%) examined at term and for 130 (71%) tested at 3 mo CA. Higher iPTH level was the only independent predictor of lower BMC at term, whereas lower BMC at 3 mo CA was associated both with lower urinary phosphate excretion and higher serum osteocalcin level. ROC analysis showed that iPTH >43.6 pg/mL provided 40% sensitivity and 88% specificity in identification of preterm infants with lower BMC at term. In turn, urinary phosphate excretion (TRP>97% or UP/Cr ≤0.74 mg/mg) and serum osteocalcin >172 ng/mL provided 40% sensitivity and 93% specificity in identification of infants with decreased BMC at 3 mo CA.ConclusionSerum iPTH might to be a simple predictor of reduced BMC in preterm infants at term age, but urinary phosphate excretion and serum osteocalcin might predict reduced BMC at 3 mo CA. These results represent a promising diagnostic tool based on simple, widely available biochemical measurements for bone mass assessment in preterm infants.

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“…In line with these findings, preterm infants born small for Review gestational age had decreased bone accretion at 6 mo corrected age. In addition, 20 y olds who were born preterm, especially those small for gestational age, had decreased bone mineral density and were shorter compared to term controls (35,36). Interestingly, however, others found normal bone mass in 4-yold children who were born preterm (9).…”

Section: The Role Of Igf I In Growth and Body Compositionmentioning

confidence: 98%

Dietary proteins and IGF I levels in preterm infants: determinants of growth, body composition, and neurodevelopment

2014

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Small-for-gestational-age preterm-born infants already have lower bone mass during early infancy

Cited by 20 publications

References 41 publications

Bone and fat mass in relation to postnatal levels of insulin-like growth factors in prematurely born children at 4 y of age

Bone and fat mass in relation to postnatal levels of insulin-like growth factors in prematurely born children at 4 y of age

The Clinical and Biochemical Predictors of Bone Mass in Preterm Infants

Dietary proteins and IGF I levels in preterm infants: determinants of growth, body composition, and neurodevelopment

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