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Perinatal serum bone Gla-protein and vitamin D metabolites in preterm and fullterm neonates
Insights
Serum 1,25-dihydroxyvitamin D levels in neonates help regulate calcium homeostasis. Bone Gla-protein may indicate bone growth in premature infants, suggesting adaptation to life outside the womb.
Area of Science:
- Neonatal physiology
- Mineral metabolism
- Endocrinology
Background:
- Neonatal hypocalcemia is common, but its cause (adaptation vs. imbalanced homeostasis) is unclear.
- Vitamin D metabolites and bone formation markers are crucial for understanding mineral balance.
- Previous research has not fully elucidated the dynamics of these markers in early neonatal life.
Purpose of the Study:
- To compare serum levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D [1,25-(OH)2D], and bone Gla-protein (BGP) in fullterm and preterm neonates.
- To investigate the relationship between these markers and calcium homeostasis during the first month of life.
- To assess the potential of BGP as a marker for bone growth in premature infants.
Main Methods:
- Serum samples collected from mothers, and neonates (cord blood, days 1, 5, 30).
- Measurements included 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D [1,25-(OH)2D], and bone Gla-protein (BGP).
- Comparative analysis between fullterm and preterm neonates, and with maternal levels.
Main Results:
- Maternal 1,25-(OH)2D was higher in mothers of preterm infants; maternal BGP was lower than in nonpregnant women.
- Neonatal BGP levels were significantly elevated at birth compared to adults, increasing further in fullterm infants.
- Serum 1,25-(OH)2D levels in neonates varied, with higher concentrations observed in preterm infants by day 30; no sustained correlation with BGP was found.
Conclusions:
- Changes in 1,25-dihydroxyvitamin D [1,25-(OH)2D] support its role in the perinatal adaptation of calcium homeostasis.
- Bone Gla-protein (BGP) shows potential as a marker for monitoring bone growth in premature neonates.
- These findings contribute to understanding mineral homeostasis and bone development in newborns.
Abstract:
Whether the hypocalcemia often found in premature neonates results from an adaptation to extrauterine life or an expression of imbalanced mineral homeostasis has yet to be established. We compared serum levels of 25-hydroxyvitamin D, 1,25-dihydroxyvitamin D [1,25-(OH)2D], and bone Gla-protein (BGP), a specific marker of bone formation during the first month of life in fullterm and preterm neonates. Measurements were performed in cord blood and on days 1, 5, and 30 of life. In maternal blood, mean serum 1,25-(OH)2D concentrations were higher in the mothers of premature than in those of fullterm neonates, and serum BGP concentrations were lower than those in nonpregnant women. In cord blood mean serum BGP levels were 2-3 times higher than in adults. Serum BGP increased significantly on days 5 and 30 in fullterm infants. In preterm infants, and increase was found only on day 30. Mean serum 25-hydroxyvitamin D and 1,25-(OH)2D concentrations were lower in neonates than in mothers, but not different in fullterm and preterm neonates. In fullterm infants serum 1,25-(OH)2D increased rapidly from birth to day 5 and decreased on day 30. The pattern was similar in preterm infants, but 1,25-(OH)2D was higher than in fullterm infants on day 30. No sustained correlation between serum BGP and 1,25-(OH)2D levels was found. These data support the contention that changes in 1,25-(OH)2D reflect the perinatal equilibration of calcium homeostasis. Serum BGP may be a potential marker of bone growth in premature neonates.