Quantitative Ultrasound as a Biomarker Tool in Newborn Infants for the Bone
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Early nutrition and adequate growth can influence future adult health. Nonetheless, recommended nutrient intakes, which can affect growth and bone health, are rarely achieved in preterm infants during the first weeks of life. Peak fetal accretion of bone growth occurs during the last trimester of gestation, and preterm infants are exposed to a higher risk of developing metabolic bone disease with an increased bone fragility, a higher fracture risk, and a long-term reduced linear growth and childhood height. MBD has consequences either in the medium or long term. In the medium term, fractures are reported in 10% of VLBWI, and in the long term, children who were born prematurely had a decreased weight and height at the age of 7–8 years, and compared to controls they had a lower bone mineral content. Monitoring bone growth has become mandatory in neonatology. Quantitative ultrasound technique is an inexpensive, portable, noninvasive, and radiation-free method of evaluating bone status and can be applied to monitor premature bone health.
Most of the studies, by applying QUS, report a positive correlation of bone status with gestational age but an inverse correlation with postconceptional age. Former preterm has lower bone growth at term compared to term infants suggesting that perinatal factors after birth are still limiting preterm bone health.
There are no established guidelines on the timing of monitoring bone disease in preterms, and different monitoring protocols are suggested.
QUS, though it is necessary to establish universal normative values, could be an easy, painless, and rapidly performing method to monitor patient bone health from birth till infanthood. Further studies are necessary to evaluate the influence of perinatal factors on long-term bone health.
KeywordsBone development Early nutrition Metabolic bone disease Neonatology Preterm newborns Quantitative ultrasound
List of Abbreviations
Bone transmission time
Clinical risk index for babies
Dual-energy X-ray absorptiometry
Extremely low birth weight infant
Metacarpal speed of sound
Metacarpal bone transmission time
Metabolic bone disease
Total parenteral nutrition
Very low birth weight infant
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