Related Experiment Video

Updated: Jun 30, 2026

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts
07:56

Scanning Skeletal Remains for Bone Mineral Density in Forensic Contexts

Published on: January 29, 2018

Risk factors associated with the development of metabolic bone disease in infants admitted to the pediatric intensive

Elsa Salmonson1, Flavia M Wehrle2, Aziz Chaouch3

  • 1Division of Pediatric Endocrinology and Diabetology, University Children's Hospital Zurich, University of Zurich, Zurich, Switzerland.

Early Human Development
|June 28, 2026
PubMed

Insights

Metabolic bone disease (MBD) affects nearly half of critically ill infants in the ICU. Parenteral nutrition and corticosteroids are key risk factors for MBD development in this vulnerable population.

Area of Science:

  • Pediatrics
  • Intensive Care Medicine
  • Pediatric Endocrinology

Background:

  • Critically ill infants in the intensive care unit (ICU) face a heightened risk of developing metabolic bone disease (MBD).
  • MBD in infants can manifest as osteopenia and fractures, complicating recovery and increasing mortality.
  • Early identification and management of MBD risk factors are crucial for improving outcomes in pediatric critical care.

Purpose of the Study:

  • To determine the prevalence of MBD in infants admitted to the ICU.
  • To identify independent risk factors associated with MBD development in this cohort.
  • To inform targeted interventions for MBD prevention in critically ill infants.

Main Methods:

  • Retrospective analysis of 208 infants (<12 months) admitted to a pediatric ICU for over 4 weeks.
  • MBD diagnosis based on radiographic evidence of osteopenia and/or fractures.
  • Multivariable logistic regression used to identify independent risk factors for MBD.

Main Results:

  • Nearly half of the infants (48.6%) showed radiological evidence of MBD, with 7.9% experiencing fractures.
  • Infants with MBD had a significantly higher mortality rate (18.8%) compared to those without (2.8%).
  • Parenteral nutrition (aOR 2.81) and corticosteroids (aOR 2.96) were independently associated with MBD development.

Conclusions:

  • Metabolic bone disease is highly prevalent in critically ill infants within the ICU setting.
  • Exposure to parenteral nutrition and corticosteroids significantly increases the risk of MBD.
  • Targeted screening and preventive strategies are essential for MBD in at-risk pediatric ICU patients.
Abstract

Keywords:
Congenital heart diseaseCorticosteroidsCritical illnessInfantsParenteral nutrition

Related Concept Videos

Bone Disorders01:29

Bone Disorders

Aging and its effect on bone remodeling is the most common cause of bone disorders. In young and healthy people, bone deposition and resorption happen at an equal rate to maintain optimal bone health.
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...
Inborn Errors of Metabolism01:20

Inborn Errors of Metabolism

Phenylketonuria (PKU) is a protein metabolism disorder characterized by high blood levels of the amino acid phenylalanine. This results from a mutation in the gene responsible for phenylalanine hydroxylase, an enzyme that converts phenylalanine into tyrosine. When this enzyme is deficient, phenylalanine builds up in the blood, leading to symptoms such as vomiting, rashes, seizures, growth deficiency, and severe mental retardation. An early diagnosis and a diet restricting phenylalanine intake...
Overview of Protein Metabolism01:21

Overview of Protein Metabolism

Proteins are broken down into amino acids during digestion. Unlike fats and carbohydrates, which are stored for later use, proteins are not. Instead, amino acids are either used to produce ATP through oxidation or contribute to the creation of new proteins for the growth and repair of the body. Any surplus amino acids from the diet are converted into glucose or triglycerides rather than excreted.
Amino acids play various roles in the body once they are absorbed into cells. They are restructured...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Role of Vitamins in Maintaining Bone Health01:25

Role of Vitamins in Maintaining Bone Health

The growth and maintenance of bone are regulated by a combination of nutritional factors, including vitamins, such as vitamin A, B12, C, D, and K.
Vitamin A
Vitamin A is involved in the process of bone remodeling. Retinoic acid, the active metabolite of Vitamin A, has nuclear receptors in osteoblasts and osteoclasts, which are involved in bone remodeling.
Vitamin B12
Vitamin B12 acts as a cofactor during the formation of osteoblast-related proteins, such as osteocalcin. Vitamin B12 plays a role...
Chronic Kidney Disease II: Clinical Manifestations01:24

Chronic Kidney Disease II: Clinical Manifestations

Chronic Kidney Disease (CKD) progressively impairs multiple body systems due to the accumulation of uremic toxins, which disrupt cellular functions across various organs.Neurologic symptomsNeurologic symptoms often arise early in CKD, as uremic toxin buildup drives changes in cognitive and motor functions. Patients frequently experience fatigue, headache, confusion, difficulty concentrating, and, in severe cases, seizures. Peripheral neuropathy commonly manifests as burning sensations in the...