Rohana J, Hasmawati J, Zulkifli S Z
Department of Paediatrics, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Kuala Lumpur 56000, Malaysia.
Singapore Med J. 2007 Mar;48(3):191-4.
We report part of the findings of a study conducted to determine the correlation between bone mineral content (BMC) and biochemical bone markers in very low birth weight (VLBW) infants.
This was a cross-sectional study, carried out between August 2001 and June 2004 in the neonatal intensive care unit of Hospital Universiti Kebangsaan Malaysia. Whole body BMC was measured by dual energy X-ray absorptiometry in 41 VLBW infants.
The mean BMC/kg body weight was 25.8 (standard deviation [SD] 11.2) g per kg. The BMC of these infants had significant negative correlation with their birth weight (r equals -0.31, p-value equals 0.048). There was no significant difference in the mean BMC between different races and gender. The infants were divided into two groups based on the course of prematurity: "non-complicated" and "complicated" groups because of the lack of "healthy reference population" data for normal BMC values in premature infants. The "non-complicated" group (30) had received ventilator assistance for less than seven days, tolerated full enteral nutrition before the age of two weeks, had no sepsis or necrotising enterocolitis and did not receive regular diuretic or steroid treatment. The cut-off level for a desirable BMC per kg in VLBW infants was obtained from a value corresponding to one SD below the mean of the "non-complicated" group, i.e., 17.4 g per kg. Eight (19.6 percent) infants had BMC less than this value. Multilinear regression analysis of demographical characteristics, maternal factors, neonatal complications and nutrition received revealed that heavier birth weight (p-value equals 0.007) and longer duration of parenteral nutrition (p-value equals 0.03) were associated with lower BMC.
VLBW infants who required parenteral nutrition for longer periods were at higher risk to having poorer bone mineralisation.
我们报告了一项为确定极低出生体重(VLBW)婴儿骨矿物质含量(BMC)与生化骨标志物之间的相关性而开展的研究的部分结果。
这是一项横断面研究,于2001年8月至2004年6月在马来西亚国立大学医院新生儿重症监护病房进行。采用双能X线吸收法测量了41例VLBW婴儿的全身BMC。
平均每千克体重的BMC为25.8(标准差[SD]11.2)克/千克。这些婴儿的BMC与其出生体重呈显著负相关(r = -0.31,p值 = 0.048)。不同种族和性别的平均BMC无显著差异。由于缺乏早产儿正常BMC值的“健康参考人群”数据,根据早产病程将婴儿分为两组:“非复杂”组和“复杂”组。“非复杂”组(30例)接受呼吸机辅助治疗少于7天,在2周龄前耐受全肠内营养,无败血症或坏死性小肠结肠炎,未接受常规利尿剂或类固醇治疗。VLBW婴儿每千克理想BMC的截断水平取自低于“非复杂”组均值一个标准差的值,即17.4克/千克。8例(19.6%)婴儿的BMC低于此值。对人口统计学特征、母亲因素、新生儿并发症和所接受的营养进行多线性回归分析显示,出生体重较重(p值 = 0.007)和肠外营养持续时间较长(p值 = 0.03)与较低的BMC相关。
需要较长时间肠外营养的VLBW婴儿发生骨矿化较差的风险较高。