ArticlePediatric research2026
Daily clinical markers in metabolic bone disease of prematurity.
Article in Pediatric research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundMonitoring the condition of infants' bone metabolism timely and providing tailor-made appropriate supplementation are important to prevent severe metabolic bone disease of prematurity. This study aimed to clarify the characteristics of daily clinical markers in infants with hyperparathyroidism under management based on the clinical guidelines.
methodsA single-center, retrospective study was performed at Kyoto University Hospital. Infants born at ≤37 weeks of gestation with a birth weight <2500 g were enrolled. Serum calcium and phosphorus concentrations, the urinary calcium to creatinine ratio (Ur Ca/Cre), and the percent tubular reabsorption rate of phosphorus (%TRP) were analyzed in relation to elevated serum intact parathyroid hormone (iPTH) concentrations (>100 pg/mL).
resultsOne hundred ninety-four infants (366 data points) were analyzed. Most infants with iPTH concentrations >100 pg/mL had serum calcium concentrations <9.8 mg/dL and/or serum phosphorus concentrations <6.5 mg/dL. Most infants with iPTH concentrations >100 pg/mL had Ur Ca/Cre <0.67 and/or %TRP < 94%.
conclusionIn preterm infants, iPTH concentrations can be elevated, even when daily clinical indicators are within the normal range in children or adults. These thresholds of daily clinical indicators may be useful for assessing bone metabolism timely and can help provide tailor-made management. IMPACT: We clarified the characteristics of daily clinical indicators in infants with hyperparathyroidism (iPTH >100 pg/mL) under management based on the clinical guidelines. The cutoff values using the Youden index of serum calcium and phosphorus concentrations, Ur Ca/Cre, and %TRP were 9.8 mg/dL, 6.5 mg/dL, 0.67, and 94%, respectively. Most infants with hyperparathyroidism had serum calcium concentrations <9.8 mg/dL and/or serum phosphorus concentrations <6.5 mg/dL. Most infants with hyperparathyroidism had Ur Ca/Cre <0.67 and/or %TRP < 94%. In preterm infants, iPTH can be elevated, even when daily clinical indicators are within the normal range in children or adults.
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