Ebru CANDA, Nermin TANSUĞ, BETÜL ERSOY, CEVVAL ULMAN, Yeşim BÜLBÜL

Determination of Vitamin D Metabolism and Bone Strength by Quantitative Ultrasound in Term Newborns

INTRODUCTION: Insufficient intake of vitamin D negatively effects bone mineralization and turnover. Changes in mothers’ bone turnover during pregnancy effects bone mineral composition of the fetus. The aim of this study was to evaluate the factors, biochemical markers and bone structure assessed by quantitative ultrasonography effecting vitamin D metabolism. METHODS: Ninety term newborn and their mothers included in the study. Serum levels of Ca, P, alkaline phosphatase (ALP), bone ALP (BALP), 1,25(OH)2D, 25(OH)D, parathyroid hormone (PTH), and osteocalcine levels were analyzed from the serums of mothers. Quantitative ultrasound from the tibial bone was performed for all infants during the first 96 hours RESULTS: Mean values for 25(OH)D and 1,25(OH)2D were within normal ranges in mothers. Mean blood Ca levels of the newborns was 10.1 ±0.6 mg/dl, and mean P levels of the newborns was 6.2±1 mg/dl. Serum 25(OH)D values were high in mother who used vitamin D supplementation (P=0.02), PTH values were high and osteocalcine values were low in mothers who did not used vitamin D supplementation (P=0.02 and P=0.03, respectively). PTH values were low in newborns whose mothers did not received vitamin D supplementation (P=0.004). 25(OH)D values were high in mothers who received Ca supplementation (P=0.009). SOS values of newborns were 3127±107 (range, 2900-3389), and mean Z scores were 0.3±0.7 (range, -1.4 - 2.6). DISCUSSION AND CONCLUSION: Significant correlation was observed between the SOS scores and Ca and ALP values of the newborns. Assessment of the structure of bone with quantitative ultrasound is a noninvasive and practical method.

Anne ve Term Bebeklerin Vitamin D ve Kalsiyum Metabolizmasının Değerlendirilmesi ve Bebeklerin Kemik Gücünün Kantitatiif Ultrason ile Tayini

GİRİŞ ve AMAÇ: Yetersiz D vitamin alımı kemik mineralizasyonunu ve döngüsünü olumsuz etkilemektedir. Gebelikte annenin kemik döngüsü üzerindeki değişiklikler fetusun kemik mineral içeriğinde değişikliğe neden olmaktadır. Bu çalışmada fetal kemik minerilizasyonu üzerinde belirleyici olan D vitamin metabolizmasını etkileyen faktörler, biyokimyasal kemik göstergeleri ve yenidoğanlarda kantitatif ultrason ile değerlendirilen kemik yapısı arasındaki ilişkinin saptanması amaçlanmıştır. YÖNTEM ve GEREÇLER: Celal Bayar Üniversitesi Tıp Fakültesi Hastanesinde doğan 90 term bebek ve annesi çalışmaya alındı. Serum kalsiyum, fosfor, alkalen fosfataz, kemik alkalen fosfataz, 1,25(OH)2D, 25(OH)D, paratiroid hormone ve osteokalsin düzeyleri ölçüldü. Yaşamın ilk 96 saati içinde kantitatif ultrason cihazı ile tibial ölçümleri yapıldı. BULGULAR: Annelerin ortalama 25(OH)D ve 1,25(OH)2D düzeyleri normal sınırlarda saptandı. Yenidoğanlarda ölçülen ortalama Ca düzeyleri ortalama 10.1 ±0.6 mg/dl, P düzeyleri 6.2±1 mg/dl saptandı. D vitamini desteği almayan annelerde serum 25 (OH)D değerleri yüksek (p = 0.02), D vitamini desteği almayan annelerde PTH değerleri yüksek ve osteokalsin değerleri düşük bulundu (sırasıyla P = 0.02 ve p = 0.03). Anneleri D vitamini desteği almayan yenidoğanlarda PTH değerleri daha düşüktü (P= 0.004). Ca takviyesi yapılan annelerde 25 (OH) D değeri yüksekti (P = 0.009). Yenidoğanların SOS değerleri 3127 ± 107 (2900-3389), ortalama Z skoru 0.3 ± 0.7 (-1.4 - 2.6) idi. TARTIŞMA ve SONUÇ: Yenidoğanların SOS skorları ile Ca ve ALP değerleri arasında anlamlı korelasyon gözlendi. Kemik yapısının kantitatif ultrason ile değerlendirilmesi, invaziv olmayan ve pratik bir yöntemdir.

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