title: Effects of early postnatal dexamethasone therapy on calcium homeostasis and bone growth in preterm infants with respiratory distress syndrome.
abstract: The effects of dexamethasone therapy on calcium homeostasis and bone growth were evaluated in 49 infants (24 placebo and 25 dexamethasone) who participated in a double-blind trial of early dexamethasone therapy for the prevention of chronic lung disease. Dexamethasone (0.25 mg kg(-1) b.i.d. on d 1-7; 0.12 mg kg(-1) b.i.d. on d 8-14; 0.05 mg kg(-1) b.i.d. on d 15-21; 0.02 mg kg(-1) b.i.d. on d 22-28) or saline placebo was given i.v. Serum calcium (Ca), phosphorus (P) and parathyroid hormone (PTH), and the corresponding urinary excretion of calcium (FECa) and phosphorus (FEP) were measured on d 2, 3, 7, 10, 14, 21 and 28 after starting the study. Radiographic evaluations of bone growth were also evaluated. Infants in the dexamethasone group had significantly higher PTH on d 2 (p < 0.01), 7 and 14 (p < 0.05) than infants in the placebo group. The dexamethasone-treated infants also had significantly higher FEP on d 2, 7 and 14 (p < 0.05) and lower FECa on d 7 and 14 (p < 0.05) than control infants. There was no significant difference between the groups in bone growth during the study. It was concluded that early dexamethasone therapy causes a transient elevation in PTH without apparent change in bone growth. The long-term effect remains to be evaluated further.
authors.affiliation: Department of Pediatrics, National Cheng-Kung University Hospital, Tainan, Taiwan, ROC.
authors.forename: Y J
authors.initials: YJ
authors.lastname: Lin
authors.forename: T F
authors.initials: TF
authors.lastname: Yeh
authors.forename: H C
authors.initials: HC
authors.lastname: Lin
authors.forename: J M
authors.initials: JM
authors.lastname: Wu
authors.forename: C H
authors.initials: CH
authors.lastname: Lin
authors.forename: C Y
authors.initials: CY
authors.lastname: Yu
mesh_terms: D000367:Age Factors; D001846:Bone Development / Q000187:drug effects*; D002118:Calcium / Q000502:physiology*; D003907:Dexamethasone / Q000494:pharmacology* / Q000627:therapeutic use; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids / Q000494:pharmacology* / Q000627:therapeutic use; D006706:Homeostasis / Q000187:drug effects*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D010281:Parathyroid Hormone / Q000097:blood; D012127:Respiratory Distress Syndrome, Newborn / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids; D010281:Parathyroid Hormone; D003907:Dexamethasone; D002118:Calcium