Diagnostics of Metabolic Bone Disease in Extremely Preterm Infants—Clinical Applicability of Bone Turnover Biochemical Markers and Quantitative Ultrasound
Sandra Cerar,
Lara Vurzer,
Aneta Soltirovska Šalamon,
Lilijana Kornhauser Cerar,
Matevž Trdan,
Domen Robek,
Tina Perme,
Ajda Biček,
Adrijana Oblak,
Janja Marc,
Darko Černe,
Vanja Erčulj,
Štefan Grosek
Affiliations
Sandra Cerar
Department of Neonatology, Division of Paediatrics, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
Lara Vurzer
Department of Paediatrics, Community Health Centre Ljubljana, 1000 Ljubljana, Slovenia
Aneta Soltirovska Šalamon
Department of Neonatology, Division of Paediatrics, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
Lilijana Kornhauser Cerar
Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Matevž Trdan
Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Domen Robek
Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Tina Perme
Neonatology Section, Department of Perinatology, Division of Gynaecology and Obstetrics, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Ajda Biček
Department of Nuclear Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Adrijana Oblak
Department of Nuclear Medicine, University Medical Centre Ljubljana, 1000 Ljubljana, Slovenia
Janja Marc
Faculty of Pharmacy, Department of Clinical Biochemistry, University of Ljubljana, 1000 Ljubljana, Slovenia
Darko Černe
Faculty of Pharmacy, Department of Clinical Biochemistry, University of Ljubljana, 1000 Ljubljana, Slovenia
Vanja Erčulj
Faculty of Criminal Justice and Security, University of Maribor, 1000 Ljubljana, Slovenia
Štefan Grosek
Faculty of Medicine, University of Ljubljana, 1000 Ljubljana, Slovenia
Background: Significant improvement in neonatal care has enabled increasing survival of preterm infants. Metabolic bone disease of prematurity is often overlooked due to other comorbidities of preterm birth. The best approach is screening and prevention of the disease in high-risk infants such as preterm infants. Aim: We followed up the clinical, radiological, and serum biochemical markers of metabolic bone disease in extremely preterm infants (<28 weeks of gestation). The clinical applicability and validation of C-terminal telopeptide of type I collagen (CTX-I) as a novel bone turnover marker were assessed. Standard and novel biochemical bone turnover markers and quantitative ultrasound were compared. Method: Patients’ data were collected from medical records. Assessments of calcium, phosphate, alkaline phosphatase, bone-alkaline phosphatase, CTX-I, and quantitative ultrasound were prospectively performed twice in 42 extremely preterm infants at postmenstrual ages of 30–32 weeks and 36–40 weeks. Bone mineral density was measured by quantitative ultrasound. Conclusion: Phosphate, alkaline phosphatase, bone alkaline phosphatase, calcium, or ionized calcium are not related to gestational age, but bone mineral density, measured by quantitative ultrasound, is related. There is no correlation between standard and novel biochemical markers and quantitative ultrasound for the identification of metabolic bone disease.
