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Parathyroid hormone as a marker for metabolic bone disease of prematurity

Journal of Perinatology volume 34, pages 787–791 (2014)Cite this article

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A Corrigendum to this article was published on 29 July 2015

Abstract

Objective:

To compare parathyroid hormone to alkaline phosphatase as a serologic marker for metabolic bone disease (MBD) in preterm infants.

Study Design:

An 18-month prospective observational study in neonates with birth weight <1250 g. Simultaneous serum parathyroid hormone (PTH), alkaline phosphatase (ALP), calcium (Ca) and phosphorus (P) were measured at scheduled intervals during hospitalization. At 6 weeks of age, MBD was evaluated using knee radiographs. Comparisons were analyzed using multivariate logistic regression, receiver operating characteristic (ROC) curves, χ2 and Student t-test.

Result:

Fourty-nine infants were included in the study: 7 with severe and 42 with mild MBD. Using ROC curves, at 660 U l−1 ALP had a sensitivity of 29% and specificity of 93% for severe MBD, while a cutoff point of 180 mg dl−1 gave PTH a sensitivity of 71% and specificity of 88%. Infants with severe bone disease had a lower birth weight, 21-day serum P, an increased use of glucocorticoids and caffeine, and more likely to have major neonatal morbidities.

Conclusion:

PTH is an early marker with better sensitivity than ALP in screening for MBD. At 3 weeks chronologic age, a PTH level >180 mg dl−1 or a P level <4.6 mg dl−1 yielded a sensitivity of 100% and specificity of 94% for severe MBD.

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Acknowledgements

We thank the team of neonatal care providers at UTMB.

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Authors and Affiliations

  1. Department of Pediatrics, University of Texas Health Science Center, San Antonio, TX, USA

    A Moreira & C Blanco

  2. Department of Pediatrics, University of Texas Medical Branch, Galveston, TX, USA

    L Swischuk, M Malloy & C Geary

  3. Marian University, Fond du Lac, WI, USA

    D Mudd

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  1. A Moreira
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Correspondence to A Moreira.

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Moreira, A., Swischuk, L., Malloy, M. et al. Parathyroid hormone as a marker for metabolic bone disease of prematurity. J Perinatol 34, 787–791 (2014). https://doi.org/10.1038/jp.2014.97

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