Changes in markers of bone metabolism during dexamethasone treatment for chronic lung disease in preterm infants
Changes in markers of bone metabolism during dexamethasone treatment for chronic lung disease in preterm infants
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DOI：
10.1136/fn.86.1.f49
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发表时间：
2002-01-01
影响因子：
4.4
通讯作者：
Lee, SY
中科院分区：
文献类型：
--
作者：
Ng, PC;Lam, CWK;Lee, SY
目的：为了解早产儿出生后早期血、尿骨代谢指标的变化，探讨全身性皮质类固醇激素对早产儿骨代谢的影响，采用骨特异性碱性磷酸酶（BALP）和骨钙素（OCa）测定方法，观察早产儿出生后早期血、尿骨代谢指标的变化。通过监测肌酐校正的尿脱氧吡啶啉（Dpd）浓度来测量骨吸收。在地塞米松疗程开始前（Td-pre）、开始后3周（Td-end）、结束后2周（Td-post 2）和4周（Td-post 4）采集皮质类固醇治疗婴儿（n = 19）的血液和尿液样本。未治疗组（n = 30）在出生后第3周（Twk-3）、第6周（Twk-6）、第8周（Twk-8）和第10周（Twk-10）采集标本。与治疗前相比，尿Dpd浓度在治疗结束时没有显著下降。但与未治疗组相比，Twk-6时尿Dpd浓度明显降低。小腿长度的增加率显着高于非治疗组之间的第3周和第6周比在相应的时期在地塞米松治疗的皮质类固醇group.Conclusion：全身性皮质类固醇引起明显的抑制血清BALP和骨钙素，在较小的程度上，尿DPD。结果提示皮质类固醇主要通过减少骨形成抑制骨生长。
Aim: To characterise the change in serum and urinary bone markers in the early postnatal period, and to assess the effect of systemic corticosteroid on bone metabolism in preterm infants.Methods: Bone formation was quantified by measurement of serum concentrations of bone specific alkaline phosphatase (BALP) and osteocalcin. Bone resorption was measured by monitoring creatinine adjusted urinary deoxypyridinoline (Dpd) concentration. Blood and urinary samples were collected from corticosteroid treated infants (n = 19) immediately before the start (Td-pre), three weeks after the start (Td-end), and two (Td-post2) and four weeks (Td-post4) after the end of the dexamethasone course. Untreated patients (n = 30) had specimens taken at week 3 (Twk-3), 6 (Twk-6), 8 (Twk-8), and 10 (Twk-10) of postnatal age.Results: Serum concentrations of BALP and osteocalcin at Td-end were significantly lower than pretreatment levels and the levels at the corresponding time point (Twk-6) of the non-treatment group. In contrast, urinary Dpd concentration at Td-end was not significantly decreased compared with the pretreatment level. However, it was significantly lower than the urinary Dpd concentration at Twk-6 of the non-treatment group. The rate of increase in lower leg length was significantly higher in the non-treatment group between weeks 3 and 6 than in the corresponding period during dexamethasone treatment in the corticosteroid group.Conclusion: Systemic corticosteroid causes appreciable suppression of serum BALP and osteocalcin and, to a lesser extent, urinary Dpd. The results suggest that corticosteroid inhibits bone growth mainly by decreasing bone formation.