Quantitative ultrasound (QUS): a useful tool for monitoring bone health in preterm infants?
Preterm infants are at risk of osteopenia and metabolic bone disease (MBD) of prematurity. There is a need for simple, reliable methods to detect and monitor this condition.


OBJECTIVE
The aims were first to describe longitudinal changes in speed of sound (SOS) measured using quantitative ultrasound (QUS; Sunlight Omnisense, Israel) in preterm neonates: and second to determine whether SOS predicts the development of MBD.


METHODS
SOS was measured in the tibia in 99 preterm infants (mean (SD)) gestation 29.7 (3.6) weeks; birthweight 1340 (550) g, with longitudinal measurements in 75. SOS z-scores were generated for gestation and sex. Clinical data were recorded.


RESULTS
Baseline SOS (but not SOS z-score) was positively associated with gestational age. SOS and SOS z-score fell with age. In multivariate models, peak ALP, minimum phosphate concentrations and markers of illness severity were not predictors of the fall in SOS z-score, and baseline SOS measurements did not predict the development of high peak ALP or low phosphate.


CONCLUSIONS
Speed of sound measurements fell with age in all infants, but we found no evidence that this measurement could predict biochemical indicators of MBD. We cannot exclude the possibility that this technique could be useful in monitoring the response to interventions designed to improve bone health in this population.
Fewtrell
M S
MS
MRC Childhood Nutrition Research Centre, UCL Institute of Child Health, London, UK. m.fewtrell@ich.ucl.ac.uk
Loh
K L
KL
Chomtho
S
S
Kennedy
K
K
Hawdon
J
J
Khakoo
A
A
D000469:Alkaline Phosphatase / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001835:Body Weight; D001851:Bone Diseases, Metabolic / Q000097:blood / Q000000981:diagnostic imaging*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000097:blood / Q000000981:diagnostic imaging*; D008297:Male; D010710:Phosphates / Q000097:blood; D011237:Predictive Value of Tests; D012737:Sex Factors; D013977:Tibia / Q000000981:diagnostic imaging; D014463:Ultrasonography / Q000379:methods
D015415:Biomarkers; D010710:Phosphates; D000469:Alkaline Phosphatase