Bhandari V, Fall P, Raisz L, Rowe J
Department of Pediatrics, University of Connecticut Health Center, Farmington, USA.
Am J Perinatol. 1999;16(7):339-49. doi: 10.1055/s-2007-993882.
Identification of a biochemical marker of growth in low birth weight (LBW) infants would be of benefit to rapidly assess the effects of illness and/or therapeutic intervention. The aims of the present study were (1) to measure serially the C-terminal fragment of type I procollagen (PICP), bone-specific alkaline phosphatase (BSAP), and osteocalcin (OC) in LBW infants during the first 6 weeks of life; (2) to correlate the changes in PICP, BSAP, and OC with the changes in weight; and (3) to evaluate PICP levels as a marker for bronchopulmonary dysplasia (BPD). Premature neonates (< or =36 weeks of gestation) had cord blood and then weekly blood samples taken from up to 6 weeks after birth. Daily changes in weight were recorded. Measurements of serum PICP, BSAP, and OC were done in duplicate by immunoassay. In a subset population (25-30 weeks), PICP levels in the first 4 weeks of life were evaluated as a marker for subsequent development of BPD. A total of 77 infants had serum PICP and BSAP measured. The mean (+/- SEM) gestational ages of all the infants were 30.4 (+/-0.3) weeks and birth weights 1477 (+/-55) g. Fifteen infants also had measurements of OC done. In these 15 infants, change in weight was correlated significantly with PICP (p<0.0001), but not with either BSAP (p = 0.8) or OC measurements (p = 0.9). In appropriate for gestational age (AGA) infants (n = 66), the PICP values decreased from the cord blood values to the week 1 measurement, coinciding with the fall in weight over the same time period. BSAP values, on the other hand, continued to increase from birth onwards. Over the first 6 weeks of postnatal life in these infants, change in weight had a stronger positive correlation with PICP (R2 = 0.43, p<0.0001) than BSAP (R2 = 0.03, p<0.01). In the subset population, PICP levels at week 4 were significantly lower (p<0.04) in those infants who subsequently developed BPD. PICP measurements are correlated with somatic growth in premature infants and could be used as a biochemical marker in infants who develop BPD.
鉴定低出生体重（LBW）婴儿生长的生化标志物将有助于快速评估疾病和/或治疗干预的效果。本研究的目的是：（1）在出生后的前6周内对LBW婴儿的I型前胶原C端片段（PICP）、骨特异性碱性磷酸酶（BSAP）和骨钙素（OC）进行连续测量；（2）将PICP、BSAP和OC的变化与体重变化进行关联；（3）评估PICP水平作为支气管肺发育不良（BPD）的标志物。早产新生儿（胎龄≤36周）出生时采集脐血，然后在出生后直至6周每周采集血样。记录每日体重变化。血清PICP、BSAP和OC的测量采用免疫测定法重复进行。在一个亚组人群（胎龄25 - 30周）中，评估出生后前4周的PICP水平作为后续BPD发生的标志物。共有77名婴儿测量了血清PICP和BSAP。所有婴儿的平均（±标准误）胎龄为30.4（±0.3）周，出生体重为1477（±55）g。15名婴儿还测量了OC。在这15名婴儿中，体重变化与PICP显著相关（p<0.0001），但与BSAP（p = 0.8）或OC测量值（p = 0.9）均无相关性。在适于胎龄（AGA）婴儿（n = 66）中，PICP值从脐血值降至第1周测量值，与同一时期体重下降一致。另一方面，BSAP值从出生起持续升高。在这些婴儿出生后的前6周内，体重变化与PICP的正相关性（R2 = 0.43，p<0.0001）强于与BSAP的相关性（R2 = 0.03，p<0.01）。在亚组人群中，随后发生BPD的婴儿在第4周时PICP水平显著较低（p<0.04）。PICP测量与早产儿的身体生长相关，可作为发生BPD婴儿的生化标志物。
