Comparison of Intact Parathyroid Hormone, Alkaline Phosphatase, Phosphate Levels for Diagnosing Severe Metabolic Bone Disease in Infants with Severe Bronchopulmonary Dysplasia

Erin K. Tkach; Ammie M. White; Kevin C. Dysart; Brenda Waber; Ursula S. Nawab; Huayan Zhang; Erik A. Jensen

doi:10.1055/s-0037-1602419

American Journal of Perinatology, Inhaltsverzeichnis

Am J Perinatol 2017; 34(12): 1199-1204
DOI: 10.1055/s-0037-1602419

Original Article

Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comparison of Intact Parathyroid Hormone, Alkaline Phosphatase, Phosphate Levels for Diagnosing Severe Metabolic Bone Disease in Infants with Severe Bronchopulmonary Dysplasia

Erin K. Tkach

¹Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Ammie M. White

²Division of Radiology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Kevin C. Dysart

¹Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Brenda Waber

¹Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Ursula S. Nawab

¹Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Huayan Zhang

¹Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

,

Erik A. Jensen

¹Division of Neonatology, Department of Pediatrics, University of Pennsylvania, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania

› Institutsangaben

Abstract

Objective We compared the accuracy of serum intact parathyroid hormone (iPTH), alkaline phosphatase (ALP), and phosphate (phos) levels for diagnosing severe metabolic bone disease (MBD) in very low-birth-weight (VLBW) infants with severe bronchopulmonary dysplasia (BPD).

Study Design Retrospective analysis of VLBW infants with severe BPD admitted between 2010 and 2012 and with ≥ 1 iPTH, ALP, and phos level collected within a similar 72-hour period. MBD severity was classified by serial radiography.

Results Laboratory values were available for 65 infants, of whom 24 (36.9%) developed severe MBD. A maximum ALP > 660 IU/L was the most accurate for diagnosing severe MBD (area under the curve: 88.4%; 95% confidence interval [CI]: 77.2–94.5%). Maximum iPTH was the least accurate (optimal cut point > 130 pg/mL; area under the curve: 70.5%; 95% CI: 58.2–81.4).

Conclusion Maximum ALP was more accurate than iPTH or phos for diagnosing severe MBD among preterm infants with severe BPD.

Keywords

bronchopulmonary dysplasia - metabolic bone disease - alkaline phosphatase - phosphate - intact parathyroid hormone

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