title: Bone maturation in extremely low birth weight infants in relation to birth weight and endocrine parameters.
abstract: Modern intensive care techniques have led to higher survival rates of extremely low birth weight infants (ELBW, birth weight <1,000 g). Previous studies have suggested a link between abnormal birth parameters and subsequent endocrine disturbances, but a possible impact on bone maturation during childhood has not been studied. ELBW children were studied (mean chronological age (CA), 6.01 years; range, 4.5-8.2). Skeletal maturation was assessed according to Greulich and Pyle (8). Bone age (BA) was defined as retarded when DeltaBA-CA was < -1 SD and accelerated when DeltaBA-CA was >+1 SD. BA was either retarded or accelerated in 15 patients (24.6%). Twenty-one of 61 radiograms (34.4%) showed a discordant BA with a marked gender difference (14/24 boys; 7/37 girls). DeltaBA-CA correlated significantly with BMI (r = 0.36; p = 0.005) and height SDS (r = 0.35; p = 0.006). We found significant correlations between BA and androgens. Insulin-like growth factor binding protein-1 (IGFBP-1), which decreases in insulin-resistant individuals, correlated negatively with BA. In conclusion, bone maturation in ELBW children is correlative with height and weight. It is modulated by a variety of metabolic factors, including IGFBP-1 and androgens. Bone age, together with height and weight catch-up, can thus possibly serve as early indicators of insulin resistance later in life.
authors.affiliation: Department of Pediatrics, University of Bonn, Adenauerallee 119, 53113 Bonn, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Stutte
authors.forename: Joachim
authors.initials: J
authors.lastname: Woelfle
authors.forename: Marc
authors.initials: M
authors.lastname: Born
authors.forename: Peter
authors.initials: P
authors.lastname: Bartmann
authors.forename: Bettina C
authors.initials: BC
authors.lastname: Gohlke
mesh_terms: D000365:Age Determination by Skeleton; D001724:Birth Weight; D015992:Body Mass Index; D001846:Bone Development / Q000502:physiology*; D002648:Child; D019314:Dehydroepiandrosterone Sulfate / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D052577:Infant, Extremely Low Birth Weight / Q000097:blood / Q000502:physiology*; D007231:Infant, Newborn; D007333:Insulin Resistance / Q000502:physiology; D018970:Insulin-Like Growth Factor Binding Protein 1 / Q000097:blood*; D008297:Male; D012737:Sex Factors
chemical_list: C032231:IGFBP1 protein, human; D018970:Insulin-Like Growth Factor Binding Protein 1; D019314:Dehydroepiandrosterone Sulfate