Related Experiment Video
Updated: Sep 24, 2025
Modeling Encephalopathy of Prematurity Using Prenatal Hypoxia-ischemia with Intra-amniotic Lipopolysaccharide in Rats
Published on: November 20, 2015
Factors Affecting Metabolic Bone Disease of Prematurity: Is Hypothyroxinemia Included?
Mesut Dursun1,2,2, Bahar Ozcabi3, Mehmet Sariaydin4
1Division of Neonatology, Department of Pediatrics, Memorial Bahcelievler Hospital, Istanbul, Turkey.
Insights
Transient hypothyroxinemia of prematurity (THOP) does not appear to be a risk factor for metabolic bone disease of prematurity (MBD) in very low birth weight infants. MBD is a complex condition influenced by multiple factors, not solely thyroid hormone levels.
Area of Science:
- Neonatology
- Pediatric Endocrinology
- Biochemistry
Background:
- Metabolic bone disease of prematurity (MBD) is a significant concern in very low birth weight infants.
- The relationship between transient hypothyroxinemia of prematurity (THOP) and MBD is not well-established.
- Understanding risk factors for MBD is crucial for improving outcomes in premature infants.
Purpose of the Study:
- To investigate the association between THOP and MBD in very low birth weight infants.
- To identify other potential risk factors contributing to the development of MBD.
- To clarify the role of THOP in the pathogenesis of MBD.
Main Methods:
- Retrospective analysis of medical records for infants born at <30 weeks gestational age and <1500 g birth weight.
- Diagnosis of MBD based on alkaline phosphatase (ALP) levels >500 IU/L at 4-6 weeks postnatal age.
- Comparison of demographic, clinical, and laboratory data between infants with and without MBD, and with and without THOP.
Main Results:
- The incidence of MBD was 16.5% and THOP was 56.5%.
- Infants with MBD had significantly lower gestational age and birth weight, longer parenteral nutrition duration, and higher rates of bronchopulmonary dysplasia and postnatal steroid use.
- No significant difference in THOP was observed between infants with and without MBD, and multivariate analysis did not identify specific risk factors for MBD.
Conclusions:
- Metabolic bone disease of prematurity is a multifactorial condition.
- Transient hypothyroxinemia of prematurity is not identified as a risk factor for the development of MBD in this cohort.
- Further research may be needed to fully elucidate the complex etiology of MBD.
Objectives:
The association between transient hypothyroxinemia of prematurity (THOP) and metabolic bone disease of prematurity (MBD) is not clearly known. We aimed to evaluate the effects of THOP and other risk factors on MBD in very low birth weight infants.
Methods:
This study included infants born at <30 weeks gestational age and <1500 g birth weight who were hospitalized between July 2016 and December 2019. The following information was obtained from medical records: Demographic characteristics; clinical follow-up data; morbidities; initial thyroid function tests; and calcium (Ca), phosphorus (P), and alkaline phosphatase (ALP) levels at postnatal 4-6 weeks. Newborns with an ALP level >500 IU/L were diagnosed with MBD. Patients without MBD were defined as Group 1 and patients with MBD were defined as Group 2.
Results:
Our study enrolled 145 infants who met the inclusion criteria. The incidences of MBD and THOP were 16.5% and 56.5%, respectively. Gestational age and birth weight were significantly lower in Group 2 than in Group 1. It was observed that these infants received total parenteral nutrition for a longer period of time and had a longer transition period to full enteral feeding. In addition, duration of non-invasive mechanical ventilation, duration of oxygen treatment, frequencies of moderate-severe bronchopulmonary dysplasia, and postnatal steroid use were found to be significantly higher in babies in Group 2 compared to babies in Group 1. There was no significant difference between the groups in terms of THOP. However, multivariate logistic regression analysis revealed no risk factors for the development of MBD. The presence of MBD and Ca, P, and ALP levels did not differ significantly between patients with and without THOP.
Conclusion:
Our study reveals that MBD is a multifactorial disease and THOP is not a risk factor for the development of MBD.
Related Concept Videos
01:17Hormones and Bone Tissue
Hormones That Influence Osteoblasts and/or Maintain the Matrix
Several hormones are necessary for controlling bone growth and maintaining the bone matrix. The pituitary gland secretes growth hormone (GH), which, as its name implies, controls bone growth. This happens in several ways: first, it triggers chondrocyte...
01:29Bone Disorders
Bone deposition is also affected by the levels of sex hormones like estrogen and testosterone that promote osteoblast activity and bone matrix synthesis. When the level of these hormones decreases due to aging, it causes a reduction in bone deposition. As a result, bone resorption by osteoclasts...
01:18Functions of Thyroid Hormones
TH is indispensable for the normal development and maturation of the skeletal, muscular, and nervous systems during fetal and childhood growth. It facilitates bone mineral turnover and regulates protein synthesis in developing tissues, contributing significantly to overall growth and...
01:29Factors Affecting Protein-Drug Binding: Patient-Related Factors
Age stands as a key determinant in protein-drug binding. Neonates, characterized by low albumin content, experience heightened concentrations of unbound drugs such as phenytoin and...
01:20Inborn Errors of Metabolism
01:24Factors Affecting Erythropoiesis
Several factors influence the erythrocyte production rate, with tissue oxygen level being among the most critical. Intense exercise or high altitudes can cause tissue hypoxia, which triggers the kidneys to release more erythropoietin (EPO) into the bloodstream.
EPO then...