Stigson Lennart, Kistner Anna, Sigurdsson Jon, Engström Eva, Magnusson Per, Hellström Ann, Swolin-Eide Diana
Department of Pediatrics, Institute for Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
The Sahlgrenska Center for Pediatric Ophthalmology Research, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Göteborg University, Göteborg, Sweden.
Pediatr Res. 2014 Apr;75(4):544-50. doi: 10.1038/pr.2014.4. Epub 2013 Jan 17.
Children born prematurely may be at risk of developing osteopenia. This study investigated whether insulin-like growth factors (IGFs) in the early postnatal period influence bone mass and body composition in prematurely born children.
A total of 74 control (gestational age >36 wk; n = 37) and preterm (gestational age <32 wk; n = 37) infants were investigated (mean age ± SD: 4.59 ± 0.31 y). Bone mineral density, body composition, and markers of bone and mineral metabolism were investigated in relation to postnatal IGF levels.
After adjusting for confounders, we found no differences in bone mass, but significantly less lean mass, increased fat mass, and increased osteocalcin levels in ex-preterm infants. Forward stepwise multiple analysis revealed that higher late postnatal IGF-II levels predict lumbar spine bone mineral content (P < 0.05) and lean mass (P < 0.05). When the birth weight standard deviation score was included in the analysis, higher early postnatal IGF-I levels predicted both lumbar spine bone mineral density and bone mineral content (P < 0.05). Higher early postnatal IGF binding protein-3 (P < 0.01) predicted increased fat mass at 4-y follow-up.
Ex-preterm children have normal bone mass but different body composition compared with full-term controls. Higher early IGF-I and late postnatal IGF-II concentrations are positive predictors of lumbar spine bone mass.
早产出生的儿童可能有发生骨质减少的风险。本研究调查了出生后早期的胰岛素样生长因子（IGF）是否会影响早产儿童的骨量和身体成分。
共对74名对照（胎龄>36周；n = 37）和早产（胎龄<32周；n = 37）婴儿进行了研究（平均年龄±标准差：4.59±0.31岁）。研究了骨矿物质密度、身体成分以及骨和矿物质代谢标志物与出生后IGF水平的关系。
在对混杂因素进行校正后，我们发现早产儿童的骨量没有差异，但瘦体重显著减少、脂肪量增加且骨钙素水平升高。向前逐步多元分析显示，出生后晚期较高的IGF-II水平可预测腰椎骨矿物质含量（P<0.05）和瘦体重（P<0.05）。当分析中纳入出生体重标准差评分时，出生后早期较高的IGF-I水平可预测腰椎骨矿物质密度和骨矿物质含量（P<0.05）。出生后早期较高的IGF结合蛋白-3水平（P<0.01）可预测4年随访时脂肪量增加。
与足月对照相比，早产儿童骨量正常但身体成分不同。出生后早期较高的IGF-I和晚期较高的IGF-II浓度是腰椎骨量的阳性预测指标。
