Editorial
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Methodol. Sep 26, 2015; 5(3): 115-121
Published online Sep 26, 2015. doi: 10.5662/wjm.v5.i3.115
Metabolic bone disease in the preterm infant: Current state and future directions
Moghis Ur Rehman, Hassib Narchi
Moghis Ur Rehman, Department of Pediatrics, Tawam Hospital, Al Ain, PO Box 15258, United Arab Emirates
Hassib Narchi, Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates
Author contributions: Both Ur Rehman M and Narchi H have made substantial contributions to the conception and design of the editorial, drafting the article or making critical revisions related to important intellectual content of the manuscript and final approval of the version of the article to be published.
Conflict-of-interest statement: The authors have no commercial, personal, political, intellectual, or religious conflict-of-interest to report in relation to this work.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Hassib Narchi, Professor, Department of Pediatrics, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, PO Box 17666, United Arab Emirates. hassib.narchi@uaeu.ac.ae
Telephone: +971-3-7137414 Fax: +971-3-7672022
Received: January 19, 2015
Peer-review started: January 20, 2015
First decision: March 6, 2015
Revised: July 1, 2015
Accepted: August 4, 2015
Article in press: August 7, 2015
Published online: September 26, 2015
Processing time: 239 Days and 23.4 Hours
Abstract

Neonatal osteopenia is an important area of interest for neonatologists due to continuing increased survival of preterm infants. It can occur in high-risk infants such as preterm infants, infants on long-term diuretics or corticosteroids, and those with neuromuscular disorders. Complications such as rickets, pathological fractures, impaired respiratory function and poor growth in childhood can develop and may be the first clinical evidence of the condition. It is important for neonatologists managing such high-risk patients to regularly monitor biochemical markers for evidence of abnormal bone turnover and inadequate mineral intake in order to detect the early phases of impaired bone mineralization. Dual-energy X-ray absorptiometry has become an increasingly used research tool for assessing bone mineral density in children and neonates, but more studies are still needed before it can be used as a useful clinical tool. Prevention and early detection of osteopenia are key to the successful management of this condition and oral phosphate supplements should be started as soon as is feasible.

Keywords: Premature; Osteopenia; Bone metabolism; Calcium; Alkaline phosphatase; Phosphorus; Nutrition

Core tip: Osteopenia of prematurity remains an important challenge in neonatal medicine due to continuing increased survival of preterm infants. The risk is higher with long-term diuretics or corticosteroids. It is important when managing such infants to regularly monitor biochemical markers for evidence of abnormal bone turnover and inadequate mineral intake. Dual-energy X-ray absorptiometry is increasingly used in research for assessing bone mass density in neonates. Prevention and early detection of osteopenia are key to the successful management of this condition and oral phosphate supplements should be started as soon as it is feasible.