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Abstract: The usefulness of serum alkaline phosphatase (ALP) and phosphorous in screening and monitoring of metabolic bone disease of prematurity (MBDP) still has some limitations, especially in preterm infants with concomitant conditions such as cholestasis. We aimed to assess a modification of serum ALP (M-ALP) as a biomarker for MBDP in preterm infants, and the use of ultrasound monitoring for the apparition of knee ossification centers as marker of bone mineralization. Biochemical and clinical registers were taken from 94 preterm newborns <32 weeks. A significant correlation existed between serum ALP and direct bilirubin (DB), expressed by the regression equation: M-ALP (IU/L) = 302.1 + 96.9 (DB (mg/dL)). The ratio ALP/M-ALP > 1 was demonstrated to be more specific (87.5%) in the diagnosis of MBDP than the cut-off value of serum ALP > 500 IU/L (62.5%). ALP/M-ALP > 1 showed 100% sensitivity and specificity for the diagnosis of MBDP, and a good correlation with specific bone ALP (B-ALP). Patients with the knee nucleus by post-menstrual week 37 had lower B-ALP compared to patients with no nucleus, and no patients with MBDP presented the nucleus by the 40th week. In the absence of reliable specific B-ALP, reinterpreting serum ALP values by M-ALP plus monitoring of knee ossification centers contribute to better management of MBDP in preterm infants with cholestasis.
Fuente: Nutrients . 2020 Dec 17;12(12):3854.
Publisher: MDPI
Year of publication: 2020
No. of pages: 15
Publication type: Article
DOI: 10.3390/nu12123854
ISSN: 2072-6643
Publication Url: https://doi.org/10.3390/nu12123854
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SANDRA LLORENTE PELAYO
PABLO DOCIO PEREZ
BERNARDO ALIO LAVIN GOMEZ
MARIA TERESA GARCIA UNZUETA
MARIA ISABEL DE LAS CUEVAS TERAN
LUIS RAMON DE LA RUBIA FERNANDEZ
MARIA JESUS CABERO PEREZ
DOMINGO GONZALEZ-LAMUÑO LEGUINA
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