Bone development and the IGF1 axis in preterm infants given massage intervention.

按摩干预下早产儿的骨骼发育和 IGF1 轴。

基本信息

批准号：
7994798
负责人：
Shannon L Haley
金额：
$ 5.7万
依托单位：
UNIVERSITY OF UTAH
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-12-01 至 2012-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7994798
关键词：
Acids Air Alkaline Phosphatase Autonomic nervous system Basic Science Binding Binding Proteins Biochemical Biochemical Markers Biological Availability Biological Markers Blinded Blood specimen Body Composition Body measure procedure Bone Density Bone Development Bone Growth Bone Mineral Contents Bone Resorption Child Childhood Clinical Clinical Research Clinical Trials Complementary Medicine Complementary and alternative medicine Data Development Doctor of Philosophy Dual-Energy X-Ray Absorptiometry Endocrine Equilibrium Evaluation Exhibits Fracture Funding Goals Growth Growth and Development function Health Health Personnel Hormones Hydrocortisone IGFBP1 gene IGFBP3 gene Infant Insulin-Like Growth Factor I Insulin-Like Growth-Factor Binding Protein 1 Intervention K-Series Research Career Programs Knowledge Life Long-Term Effects Longitudinal Studies Manuals Massage Measurement Measures Medical Mentorship Methods Morbidity - disease rate Movement National Center for Complementary and Alternative Medicine National Research Service Awards Neonatal Neonatal Intensive Care Units Neurosecretory Systems Nutritional Occupations Osteocalcin Osteogenesis Physiologic calcification Plasma Plethysmography Pregnancy Premature Birth Premature Infant Protocols documentation Randomized Research Research Personnel Research Training Risk Sampling Somatomedins Speed Spottings Stress Supplementation Testing Time Training United States National Institutes of Health Weight Gain bone bone health bone strength career crosslink design experience heart rate variability improved in utero intervention effect knowledge base longitudinal design nutrition peer postnatal premature prospective public health relevance quantitative ultrasound research study response sound tibia urinary

项目摘要

DESCRIPTION (provided by applicant): Infants born prematurely (<37 weeks gestation) experience delayed growth and sub-optimal bone mineralization that continues into childhood. Long-term effects of delayed bone mineralization include shorter stature and a higher rate of fracture than full term peers. Evidence suggests that Developmental Massage Therapy (DMT) that includes massage and kinesthetic movement may promote bone mineralization and improve postnatal growth. The purpose of this study is to provide career training and identify the response associated with DMT treatment on bone growth in preterm infants. This research will examine three specific aims to identify the 1) effects of DMT on bone mineral content and bone strength 2) effects of DMT on biomarkers for bone formation/resorption and their relationship with measures of bone mineralization and strength in Specific Aim 1, and 3) relationship of DMT with the levels and bioavailability of Insulin like growth factor (IGF1). We predict that infant DMT will result in improved bone mineral content (DEXA) and bone strength (tibia speed of sound), greater levels of bone formation biomarkers (osteocalcin & bone specific alkaline phosphotase) and lower levels of bone resorption markers (urinary pyridinium crosslink) in association with increased bone density and strength, and alterations of IGF1 binding proteins in the IGF1 axis that increase IGF1 bioavailability. This clinical study has a prospective, blinded, longitudinal design. Premature infants between 29 4/7 and 32 3/7 weeks gestation are randomized to either daily DMT or control treatments. DMT consisted of massage therapy with kinesthetic movement twice daily while the infant is in the NICU. Control treatment includes everything but DMT. Weekly measurements during intervention are taken at multiple time points during a period of accelerated postnatal maturation, growth, and development. The longitudinal design provides a stronger understanding of the modulating effects of DMT on postnatal growth and bone mineralization in premature infants and increases the statistical power of the analysis. PUBLIC HEALTH RELEVANCE: Infants born prematurely (<37 weeks gestation) experience delayed growth and sub-optimal bone mineralization that continues into childhood. Additional long-term effects of delayed bone mineralization include shorter stature and a higher rate of fracture than full term peers. Evidence suggests that developmental massage therapy (DMT) that includes massage and kinesthetic movement may promote bone mineralization and postnatal growth.

描述（由申请人提供）：婴儿过早出生的婴儿（妊娠37周）经验延迟生长和持续到童年时期的亚地区骨矿化。延迟骨骼矿化的长期影响包括较短的身材和比全学期同伴更高的断裂率。有证据表明，包括按摩和运动觉运动在内的发展按摩疗法（DMT）可以促进骨矿化并改善产后生长。这项研究的目的是提供职业培训，并确定与早产儿骨骼生长有关的DMT治疗相关的反应。这项研究将研究三个特定目的，以确定DMT对骨矿物质含量和骨强度的影响2）DMT对生物标志物对骨形成/吸收的影响及其与特定目的的骨矿化和强度的关系1）和3）DMT与胰岛素类似生长因子的水平和生物利用度（IGF1）的关系。我们预测，婴儿DMT将导致骨矿物质含量（DEXA）和骨骼强度（胫骨速度），骨形成更高的生物标志物（骨钙素和骨骼特异性碱性磷酸酶）和较低的骨吸收标记（尿中吡啶昆虫）交叉链接）与IGF1轴中IGF1结合蛋白的骨密度和强度增加以及增加IGF1生物利用度的变化。这项临床研究具有前瞻性，盲目的纵向设计。 29 4/7至32 3/7周妊娠之间的早产婴儿被随机分为每日DMT或对照治疗。 DMT包括每天两次的按摩疗法，而婴儿在NICU中。控制治疗包括除DMT以外的所有内容。在产后成熟，生长和发育的加速期间，在干预过程中的每周测量在多个时间点进行。纵向设计提供了对DMT对早产婴儿产后生长和骨矿化的调节作用的更深入的了解，并增加了分析的统计能力。公共卫生相关性：婴儿过早出生（<37周妊娠）经验延迟生长和持续到童年时期的次优骨矿化。延迟骨矿化的额外长期影响包括较短的身材和比全学期同伴更高的断裂率。有证据表明，包括按摩和运动觉运动在内的发展按摩疗法（DMT）可能会促进骨矿化和产后生长。