Plasma alkaline phosphatase activity in rickets of prematurity

Area of Science:

• Neonatal Medicine
• Biochemistry
• Pediatric Endocrinology

Background:

• Plasma alkaline phosphatase (ALP) is a key enzyme in bone metabolism.
• Establishing normal ranges for ALP in neonates is crucial for identifying metabolic bone disease.
• Rickets of prematurity is a significant concern in low birth weight infants.

Purpose of the Study:

• To determine normal plasma alkaline phosphatase ranges in neonates based on gestational age.
• To investigate the correlation between plasma ALP activity and radiological signs of bone disease in preterm infants.
• To assess the utility of plasma ALP in screening and monitoring rickets of prematurity.

Main Methods:

• Measured plasma alkaline phosphatase activity in 349 infants (5-10 days old) across different gestational ages.
• Sequentially analyzed plasma calcium, phosphate, and ALP in 51 preterm infants (<1500g birth weight).
• Correlated ALP levels with radiological findings including osteoporosis and metaphyseal/periosteal changes.

Main Results:

• Significant differences in plasma ALP activity were observed between term and preterm infants.
• Highest ALP values were associated with shorter gestational lengths.
• A significant correlation was found between elevated plasma ALP and radiological evidence of bone abnormalities.

Conclusions:

• Plasma alkaline phosphatase levels vary significantly with gestational age in newborns.
• Elevated plasma ALP is a valuable indicator of rickets of prematurity.
• Plasma ALP can be effectively used for screening and monitoring bone health in preterm infants.