Korakaki Eftichia, Gourgiotis Dimitrios, Aligizakis Agisilaos, Manoura Antonia, Hatzidaki Eleftheria, Giahnakis Emmanuel, Marmarinos Antonios, Kalmanti Maria, Giannakopoulou Christina
Department of Neonatology, University of Crete, 37 Atlantithos St., 71305 Heraklion, Greece.
J Bone Miner Metab. 2007;25(3):172-8. doi: 10.1007/s00774-006-0742-8. Epub 2007 Apr 20.
Although the beneficial effects of antenatally administered glucocorticoids are well documented, data on the potential of adverse consequences are limited. The objective of this study was to determine the effects of antenatally administered glucocorticoids on biochemical markers of bone metabolism of 55 preterm infants with a gestational age of 24-34 weeks who were enrolled in the study. Neonates were divided into two groups according to antenatal exposure to corticosteroids. There were no significant differences between the groups in clinical characteristics and anthropometric variables. We studied blood levels of osteocalcin (OC), carboxy-terminal propeptide of type I procollagen (PICP), and carboxy-terminal telopeptide of type I collagen (ICTP) at the time of delivery, on postnatal day 10, and at 2 and 4 months of life. Comparing the groups, we found statistically significant reduction in PICP levels at birth in corticosteroid-exposed neonates (P < 0.05). The levels of bone markers increased progressively on the first days of life. There were no significant differences between groups in bone markers at 10 days or at 2 and 4 months of life. We found no significant difference for bone markers between groups of infants exposed to single or repeated maternal corticosteroid treatments. In summary, antenatal glucocorticoid treatments are suggested to have a negative impact on fetal bone formation as reflected by low PICP levels at birth. However, this negative effect on bone markers seems to be a temporary effect that subsides on the first days of life and afterward.
尽管产前给予糖皮质激素的有益效果已有充分记录，但关于其潜在不良后果的数据有限。本研究的目的是确定产前给予糖皮质激素对55例胎龄为24 - 34周的早产婴儿骨代谢生化标志物的影响，这些婴儿被纳入研究。根据产前是否接触糖皮质激素将新生儿分为两组。两组在临床特征和人体测量变量方面无显著差异。我们在分娩时、出生后第10天以及出生后2个月和4个月时研究了骨钙素（OC）、I型前胶原羧基末端前肽（PICP）和I型胶原羧基末端肽（ICTP）的血药浓度。比较两组，我们发现暴露于糖皮质激素的新生儿出生时PICP水平有统计学意义的降低（P < 0.05）。骨标志物水平在出生后的头几天逐渐升高。两组在出生后10天、2个月和4个月时的骨标志物水平无显著差异。我们发现，暴露于单次或重复母体糖皮质激素治疗的婴儿组之间的骨标志物无显著差异。总之，产前糖皮质激素治疗被认为对胎儿骨形成有负面影响，这在出生时低PICP水平中得到体现。然而，这种对骨标志物的负面影响似乎是一种暂时的影响，在出生后的头几天及之后会消退。
