© 2002 Archives of Disease in Childhood Fetal and Neonatal Edition
ORIGINAL ARTICLE
Changes in markers of bone metabolism during dexamethasone treatment for chronic lung disease in preterm infants
1 Department of Paediatrics, Prince of Wales Hospital, Chinese University of Hong Kong
2 Department of Chemical Pathology
3 Centre for Clinical Trials and Epidemiological Research
Correspondence to:
Correspondence to:
Professor Ng, Department of Paediatrics, Level 6, Clinical Science Building, Prince of Wales Hospital, Shatin, NT, Hong Kong;
pakcheungng{at}cuhk.edu.hk
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.
Keywords: bone; growth; alkaline phosphatase; osteocalcin; corticosteroid
Abbreviations: BALP, bone specific alkaline phosphatase; Dpd, deoxypyridinoline; VLBW, very low birth weight; BPD, bronchopulmonary dysplasia
CiteULike 
Complore 
Connotea 
Del.icio.us 
Digg 
Reddit 
Technorati What's this?
- Full Text
- Full Text (PDF)
- Submit a response
- Alert me when this article is cited
- Alert me when eLetters are posted
- Alert me if a correction is posted
- Citation Map
Services
- Email this link to a friend
- Similar articles in ADC Online
- Similar articles in PubMed
- Add article to my folders
- Download to citation manager
- Request Permissions
Citing Articles
Google Scholar
PubMed
Topic Collections
Bookmark with
Register for free content
The full back archive is now available for all BMJ Journals. Institutional subscribers may access the entire archive as part of their subscription. Personal subscribers will also have access to all content when logged in. Non-subscribers who register have free access to all articles published before 2006 right back to volume 1 issue 1. Register here to access the free archive of all BMJ Journals.
Don't forget to sign up for content alerts so you keep up to date with all the articles as they are published.
