TY - JOUR
T1 - Metabolic bone disease in preterm infants
T2 - Relationship between radiologic grading in the wrist and serum biochemical markers
AU - You, S. K.
AU - Lee, J. E.
AU - Lee, S. M.
AU - Cho, H. H.
N1 - Publisher Copyright:
© 2017 Éditions françaises de radiologie
PY - 2017/11
Y1 - 2017/11
N2 - Purpose To assess the relationship between radiographic findings of metabolic bone disease (MBD) and serum biochemical markers in preterm infants. Materials and methods A total of 159 preterm infants were included in this study. Two readers reviewed the wrist radiography for grading according to MBD severity. We recorded the levels of alkaline phosphatase (ALP) and phosphorous (P) immediately after birth, on the same day of the first wrist radiography (ALP-s, P-s), the highest/lowest ALP/P levels before the first wrist radiography (ALP-hb/P-lb) and during follow-up (ALP-h/P-l). For analysis, the patients were first subdivided into 4 groups according to MBD severity, and were then divided into 2 groups according to MBD presence or absence. Results Of the 159 patients, 94, 39, 19, and 7 infants were classified into grades 0,1, 2, and 3. Analysis according to severity showed that ALP-s, ALP-hb, and ALP-h differed between grades 0–1 and 2–3 (all P < 0.001); P-lb differed between grades 0 and 2 (P = 0.001); and P-l differed between grades 0 and 2 or 3 (P < 0.001 or P = 0.001). Moreover, ALP-s, ALP-hb, ALP-h, P-s, P-lb, and P-l differed according to the presence or absence of MBD (P < 0.001). ALP-h showed the largest area under the curve value (0.752, 95% confidence interval = 0.676–0.828, P < 0.001). The optimal cut-off value of ALP-h was 473.5 U/L. The sensitivity and specificity were 81.5% and 47.9%. ALP-h was measured at 6.9 ± 5.3 weeks after birth. Conclusion Taking the wrist radiography with reference to an ALP level measured at around 6.9 weeks after birth could be helpful for screening of MBD in preterm infants, unless a fracture is clinically suspected.
AB - Purpose To assess the relationship between radiographic findings of metabolic bone disease (MBD) and serum biochemical markers in preterm infants. Materials and methods A total of 159 preterm infants were included in this study. Two readers reviewed the wrist radiography for grading according to MBD severity. We recorded the levels of alkaline phosphatase (ALP) and phosphorous (P) immediately after birth, on the same day of the first wrist radiography (ALP-s, P-s), the highest/lowest ALP/P levels before the first wrist radiography (ALP-hb/P-lb) and during follow-up (ALP-h/P-l). For analysis, the patients were first subdivided into 4 groups according to MBD severity, and were then divided into 2 groups according to MBD presence or absence. Results Of the 159 patients, 94, 39, 19, and 7 infants were classified into grades 0,1, 2, and 3. Analysis according to severity showed that ALP-s, ALP-hb, and ALP-h differed between grades 0–1 and 2–3 (all P < 0.001); P-lb differed between grades 0 and 2 (P = 0.001); and P-l differed between grades 0 and 2 or 3 (P < 0.001 or P = 0.001). Moreover, ALP-s, ALP-hb, ALP-h, P-s, P-lb, and P-l differed according to the presence or absence of MBD (P < 0.001). ALP-h showed the largest area under the curve value (0.752, 95% confidence interval = 0.676–0.828, P < 0.001). The optimal cut-off value of ALP-h was 473.5 U/L. The sensitivity and specificity were 81.5% and 47.9%. ALP-h was measured at 6.9 ± 5.3 weeks after birth. Conclusion Taking the wrist radiography with reference to an ALP level measured at around 6.9 weeks after birth could be helpful for screening of MBD in preterm infants, unless a fracture is clinically suspected.
KW - Alkaline phosphatase
KW - Metabolic bone disease
KW - Preterm infant
KW - Radiographs
KW - Wrist
UR - http://www.scopus.com/inward/record.url?scp=85033550951&partnerID=8YFLogxK
U2 - 10.1016/j.diii.2017.06.008
DO - 10.1016/j.diii.2017.06.008
M3 - Article
C2 - 28734779
AN - SCOPUS:85033550951
SN - 2211-5684
VL - 98
SP - 785
EP - 791
JO - Diagnostic and Interventional Imaging
JF - Diagnostic and Interventional Imaging
IS - 11
ER -