特邀小型评论 早产儿代谢性骨病:概述与实践建议。

IF 2.6 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Monica Grover, Ambika P Ashraf, Sasigarn A Bowden, Andrew Calabria, Alicia Diaz-Thomas, Sowmya Krishnan, Jennifer L Miller, Marie-Eve Robinson, Linda A DiMeglio
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引用次数: 0

摘要

早产儿代谢性骨病(MBDP)是指早产儿因产前和产后钙(Ca)和磷酸盐(PO4)摄入不足而导致骨骼矿化不足。严重的 MBDP 可导致佝偻病和骨折。尽管新生儿营养学取得了进步,但由于矿物质在胎儿期补充不足,早产儿仍普遍存在钙、磷、镁缺乏症。此外,新生儿科医生和儿科内分泌医生在监测和治疗 MBDP 的最佳实践方面仍存在很大的知识差距。预防和治疗 MBDP 可避免佝偻病或病理性骨折等严重后果。通过一级实验室筛查,测量血清钙、磷和碱性磷酸酶以识别高危婴儿,是产后监测早期识别 MBDP 的最佳方法。如果这些化验结果异常,包括评估甲状旁腺激素和/或磷酸盐的肾小管再吸收在内的进一步研究有助于区分主要病因是钙缺乏还是 PO4 缺乏,从而指导适当的矿物质补充剂治疗。需要对预防和治疗 MBDP 的最佳矿物质补充剂进行更多研究,以改善长期骨骼健康结果,并为未来的治疗指南提供更全面的证据基础。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Invited Mini Review Metabolic Bone Disease of Prematurity: Overview and Practice Recommendations.

Metabolic bone disease of prematurity (MBDP) is defined by undermineralization of the preterm infant skeleton arising from inadequate prenatal and postnatal calcium (Ca) and phosphate (PO4) accretion. Severe MBDP can be associated with rickets and fractures. Despite advances in neonatal nutrition, MBDP remains prevalent in premature infants due to inadequate mineral accretion ex-utero. There also remain significant knowledge gaps regarding best practices for monitoring and treatment of MBDP among neonatologists and pediatric endocrinologists. Preventing and treating MBDP can prevent serious consequences including rickets or pathologic fractures. Postnatal monitoring to facilitate early recognition of MBDP is best done by first-tier laboratory screening by measuring serum calcium, phosphorus, and alkaline phosphatase to identify infants at risk. If these labs are abnormal, further studies including assessing parathyroid hormone and/or tubular resorption of phosphate can help differentiate between Ca and PO4 deficiency as primary etiologies to guide appropriate treatment with mineral supplements. Additional research into optimal mineral supplementation for the prevention and treatment of MBDP is needed to improve long-term bone health outcomes and provide a fuller evidence base for future treatment guidelines.

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来源期刊
Hormone Research in Paediatrics
Hormone Research in Paediatrics ENDOCRINOLOGY & METABOLISM-PEDIATRICS
CiteScore
4.90
自引率
6.20%
发文量
88
审稿时长
4-8 weeks
期刊介绍: The mission of ''Hormone Research in Paediatrics'' is to improve the care of children with endocrine disorders by promoting basic and clinical knowledge. The journal facilitates the dissemination of information through original papers, mini reviews, clinical guidelines and papers on novel insights from clinical practice. Periodic editorials from outstanding paediatric endocrinologists address the main published novelties by critically reviewing the major strengths and weaknesses of the studies.
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