Koo W W, Walters J, Bush A J, Chesney R W, Carlson S E
Department of Pediatrics, University of Tennessee-Memphis, USA.
J Bone Miner Res. 1996 Jul;11(7):997-102. doi: 10.1002/jbmr.5650110717.
We studied bone mineral status using dual-energy X-ray absorptiometry (DXA) on 150 singleton newborn infants with birth weights 1002-3990 g and gestational ages (GA) 27-42 weeks. Eighty-five infants were preterm (< 38 weeks), and 79 infants were low birth weight (< or = 2500 g). In addition, we aimed to determined the predictive value of anthropometric measurements, race, and gender on variability in bone mineral status. Data were acquired using a whole body DXA scanner with a pediatric platform. Scan analyses were performed with software version V5.64P. Results showed a highly significant (p < 0.001 for all comparisons) correlation among the continuous independent variables, gestational age, birth weight, study weight, study bare weight, and study length, and between independent and each of the dependent variables, total body bone mineral content (TB BMC), TB area, and TB bone mineral density (TB BMD). The best single determinant of bone mineral status is body weight, accounting for 95% of TB BMC and TB area and for 86% of TB BMD variation. Body length was the only additional significant predictor of TB area. Inclusion of postnatal age (during the first week after birth), race, gender, or season, either individually or in combination, failed to improve bone mineral status explanation. By term (GA 38-42 weeks, birth weight 2700-3990 g), the mean TB BMC was 68.2 g, TB area 307.6 cm2, and TB BMD 0.221 g/cm2. We conclude that DXA can be performed even in small preterm infants during the newborn period. Our results can be used as a basis for further studies in physiologic and pathologic situations that might affect bone mineralization in infants.
我们采用双能X线吸收法（DXA）对150例单胎新生儿进行了骨矿物质状况研究，这些新生儿出生体重为1002 - 3990克，胎龄（GA）为27 - 42周。其中85例为早产儿（< 38周），79例为低出生体重儿（≤ 2500克）。此外，我们旨在确定人体测量指标、种族和性别对骨矿物质状况变异性的预测价值。数据通过配备儿科平台的全身DXA扫描仪获取。使用软件版本V5.64P进行扫描分析。结果显示，连续自变量胎龄、出生体重、研究体重、研究裸体重和研究身长之间，以及自变量与每个因变量全身骨矿物质含量（TB BMC）、TB面积和TB骨矿物质密度（TB BMD）之间均存在高度显著相关性（所有比较p < 0.001）。骨矿物质状况的最佳单一决定因素是体重，它解释了95%的TB BMC和TB面积变异以及86%的TB BMD变异。身长是TB面积的唯一另外一个显著预测因素。单独或联合纳入出生后年龄（出生后第一周内）、种族、性别或季节，均未能改善对骨矿物质状况的解释。足月时（GA 38 - 42周，出生体重2700 - 3990克），平均TB BMC为68.2克，TB面积为307.6平方厘米，TB BMD为0.221克/平方厘米。我们得出结论，即使在新生儿期的小早产儿中也可进行DXA检查。我们的结果可作为进一步研究可能影响婴儿骨矿化的生理和病理情况的基础。
