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Vol. 54. Núm. 3.
Páginas 290-296 (Marzo 2001)
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Vol. 54. Núm. 3.
Páginas 290-296 (Marzo 2001)
Acceso a texto completo
Concentraciones de calcio y de marcadores de remodelamiento óseo en sangre de cordón umbilical y en orina del recién nacido en el parto
Concentrations of calcium and bone remodeling biomarkers in umbilical cord blood and urine of newborn infants during delivery
Visitas
...
A. de Toro Salasa,
Autor para correspondencia
med009753@nacom.es

Correspondencia: Ximénez de Enciso, 22, 1.° B. 41004 Sevilla
, J.L. Dueñas Díeza, E. de Jaime Revueltab
a Servicios de Ginecología. Hospital Universitario Virgen de la Macarena. Sevilla
b Servicios de Pediatría. Hospital Universitario Virgen de la Macarena. Sevilla
Información del artículo
Objetivo

Evaluar las concentraciones de calcio, fósforo, paratormona (PTH), osteocalcina y fosfatasa alcalina en sangre de cordón umbilical y de las piridinolinas urinarias junto con el cálculo del cociente piridinolinas/creatinina, con el fin de estimar, indirectamente, el proceso de remodelamiento óseo fetal, comparando los valores de estos marcadores con los obtenidos de la madre durante el parto y el tercer trimestre de gestación

Pacientes y métodos

Se estudiaron los valores séricos de calcio, fósforo,PTH, osteocalcina, fosfatasa alcalina y de piridinolinas en orina, y se procedió al cálculo del cociente piridinolinas/creatinina en 38 gestantes normales durante los últimos 2 meses de gestación y durante el parto. Se obtuvieron muestras de sangre de la vena umbilical durante el período del alumbramiento, y de orina de los mismos recién nacidos en las primeras 24 h puerperales para determinar estos parámetros

Resultados

El valor del calcio en la sangre de cordón fue superior al obtenido en sangre materna durante el parto. Las concentraciones de PTH en sangre de cordón fueron muy inferiores a las obtenidas en sangre materna, las de fosfatasa alcalina fueron similares y las de osteocalcina, superiores.El valor medio de las piridinolinas en orina del recién nacido fue muy superior a los obtenidos en la madre durante el tercer trimestre del embarazo y en el parto

Conclusión

El recién nacido es hipercalcémico respecto a la madreen el momento del parto y presenta un estado de hipoparatiroidismo relativo. En general, los marcadores de remodelamiento óseo presentan unos valores más elevados en el recién nacido que en la madre, mostrando una alta tasa de remodelamiento óseo

Palabras clave:
Osteocalcina
Piridinolinas
Gestación
Parto
Cordón umbilical
Objective

To evaluate calcium, phosphorus, parathormone (PTH),osteocalcin, and alkaline phosphatase concentrations in cord blood, pyridinoline concentrations in urine, and the pyridinoline/creatinine ratio in order to indirectly assess late bone remodeling in the newborn by comparing concentrations of these substances with those in the mother during the third trimester and delivery

Patients and methods

Calcium, phosphorus, PTH, osteocalcin, and alkaline phosphatase levels in cord blood, pyridinolines in urine and the pyridinoline/creatinine ratio were evaluated in 38 healthy pregnant women during the last two months of pregnancy and during delivery. To determine concentrations of these substances, samples from vein umbilical cord blood were obtained immediately after birth and urine samples were obtained from the neonates within 24 hours of delivery

Results

The mean calcium concentration in cord blood was higher than maternal values during delivery. Concentrations of PTH in cord blood were much lower than those in maternal blood during pregnancy, alkaline phosphatase levels were similar, and osteocalcin levels were higher. Mean urine pyridinoline concentrations in the neonates were much higher than those in the mother during the third trimester and delivery

Conclusion

During delivery newborn infants are hypercalcemic compared with their mothers, presenting a state of relative hypoparathyroidism. Concentrations of remodeling biomarkers are higher in the newborn than in the mother, revealing a higher rate of bone turnover in the fetus

Key words:
Osteocalcin
Pyridinolines
Pregnancy
Delivery
Umbilical cord
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Bibliografía
[1.]
G. Siddharth, L.K. Kamath, A.F. Kelley, F. Smith, C.H. Smith.
Transport and binding in calcium uptake by microvillous membrane of human placenta.
Am J Physiol, 262 (1992), pp. 789-794
[2.]
A.D. Care.
Calcium homeostasis in the fetus.
J Dev Physiol, 2 (1980), pp. 85-99
[3.]
J.W. Pike, L.L. Gooze, M.R. Haussler.
Biochemical evidence for 1-25-dihydroxyvitamin-D receptor macromolecules in parathiroid, pancreatic, pituitary, and placental tissues.
Life Sci, 26 (1980), pp. 407-414
[4.]
R. Bromagge, H. DeLuca.
Placental transport of calcium and phosphorus is not regulated by vitamin D.
Am J Physiol, 246 (1984), pp. 526-529
[5.]
R.M. Pitkin.
Calcium metabolism in pregnancy and the perinatal period: a review.
Am J Obstet Gynecol, 151 (1985), pp. 99-109
[6.]
G.J. Fisher, L.K. Kelley, C.H. Smith.
ATP-dependent calcium transport across basal plasma membranes of human placental trophoblast.
Am J Physiol, 252 (1987), pp. 38-46
[7.]
L.H. Allen.
Calcium bioavailability and absortion: a review.
Am J Clin Nutr, 35 (1982), pp. 783-808
[8.]
R. Santamaría, F. García, L. Cabero, I. Mújica.
Modificaciones de diversos parámetros de función renal durante el parto.
Prog Obstet Gin, 36 (1993), pp. 118-127
[9.]
Y. Fujisawa, K. Kida, K. Terada, N. Hirai, K. Yamashita.
Transient late neonatal hypocalcemia with high serum parathyroid hormone.
J Pediatr Endocrinol Metab, 10 (1997), pp. 433-436
[10.]
P. Wieland, J.A. Fisher, U. Treschel.
Perinatal parathyroid hormone, vitamin D metabolites, and calcitonin in man.
Am J Physiol, 239 (1980), pp. 385-390
[11.]
L.S. Hillman, S. Rojanasathit, E. Slatopolsky, J.G. Haddad.
Serial measurement of serum calcium, magnesium, parathyroid hormone, calcitonin, and 25-OHD in premature and term infants during the first week of life.
Pediatr Res, 11 (1977), pp. 739-744
[12.]
E.E. Delvin, F.H. Glorieux, B.L. Salle, L. David, J.P. Varenne.
Control of vitamin D metabolism in preterm infants: feto-maternal relationships.
Arch Dis Child, 57 (1982), pp. 754-757
[13.]
R.M. Pitkin, D.P. Cruikshank, C.W. Schauberger, W.A. Reynolds, G.A. Williams, G.K. Hargis.
Fetal calciotropic hormones and neonatal calcium homeostasis.
Pediatrics, 66 (1980), pp. 77-82
[14.]
Y. Hirota, I. Miyakawa, T. Anai.
Parathyroid hormone-related protein levels in maternal and cord blood.
Am J Obstet Gynecol, 177 (1997), pp. 702-706
[15.]
L.S. Hillman, N. Hoff, J. Walgate, J.G. Haddad.
Serum calcitonin concentrations in premature infants during the first 12 weeks of life.
Calcif Tissue Int, 34 (1982), pp. 470-473
[16.]
L.S. Hillman, J.G. Haddad.
Perinatal vitamin D metabolism. III Factors influencing late gestational human serum 25-hydroxyvitamin D.
Am J Obstet Gynecol, 125 (1975), pp. 196-200
[17.]
N.A. Cross, L.S. Hillman, S.H. Allen, G.F. Krause, E.N. Vieira.
Calcium homeostasis and bone metabolism during pregnancy, lactation and postweaning: a longitudinal study.
Am J Clin Nutr, 61 (1995), pp. 514-523
[18.]
P. Urena, M.C. De Vernejoul, K.S. Ang, A. Ferreira, M. Hruby.
Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients.
J Am Soc Nephrol, 7 (1996), pp. 506-512
[19.]
L.S. Zhou, G.F. Zhang, M.C. Zheng.
Bone metabolism in pregnant women.
Chung Hua Fu Chan Ko Tsa Chih, 29 (1994), pp. 157-158
[20.]
S.J. Gallacher, W.D. Fraser, O.J. Owens, F.J. Dryburgh, F.C. Logue, A. Jenkins.
Changes in calciotrophic hormones and biochemical markers of bone turnover in normal human pregnancy.
Eur J Endocrinol, 131 (1994), pp. 369-374
[21.]
A. Saxe, S. Dean, G. Gibson, M.R. Pandian, J. Levy.
Parathyroid hormone and parathyroid hormone-related peptide in venous umbilical cord blood of healthy neonates.
J Perinat Med, 25 (1997), pp. 288-291
[22.]
S.M. Handwerker, B.T. Altura, K.Y. Jones, B.M. Altura.
Maternal-fetal transfer of ionized serum magnesium during the stress of labor and delivery: a human study.
J Am Coll Nutr, 14 (1995), pp. 376-381
[23.]
T. Root, A. Gruskin, R.M. Reber, A. Stopa, G. Duckett.
Serum concentrations of parathyroid hormone in infants, children, and adolescents.
Pediatrics, 85 (1974), pp. 329-336
[24.]
Y. Hirota, I. Miyakawa, T. Anai.
Parathyroid hormone-related protein levels in maternal and cord blood.
Am J Obstet Gynecol, 177 (1997), pp. 702-706
[25.]
E. Bucht, O. Torring, E. Rian, B. Granberg, K. Bremme, H. Rong.
Midmolecular parathyroid hormone-related peptide in serum during pregnancy, lactation and in umbilical cord blood.
Eur J Endocrinol, 132 (1995), pp. 438-443
[26.]
A. Prentice.
Maternal calcium requirements during pregnancy and lactation.
Am J Clin Nutr, 59 (1994), pp. 477-483
[27.]
L. Raman, K. Rajalakshmi, K.A.V.R. Krishnamashari, G. Sastry.
Effect of calcium supplementation to undernourished mothers during pregnancy on the bone density of the neonates.
Am J Clin Nutr, 31 (1978), pp. 466-469
[28.]
W.B. Pittard, K.M. Geddes, T.C. Hulsey, B.W. Hollis.
Osteocalcin, skeletal alkaline phosphatase, and bone mineral content in very low birth weight infants: a longitudinal assessment.
Pediatr Res, 31 (1992), pp. 181-185
[29.]
W.L. Chiang, C.B. Liu, S.P. Chanlai.
Total body bone mineral content in small-for-gestational-age, appropriate- for-gestational-age, large-for-gestational-age term infants and appropriate-for-gestational-age preterm infants.
Chung Hua I Hsueh Tsa Chih (Taipei), 56 (1995), pp. 109-114
[30.]
K. Ozono, M. Yamagata, T. Michigami, S. Nakajima, N. Sakai, G. Cai.
Identification of novel missense mutations (Phe310Leu and Gly439Arg) in a neonatal case of hypophosphatasia.
J Clin Endocrinol Metab, 81 (1996), pp. 4458-4461
[31.]
W.W. Koo, P. Succop, K.M. Hambidge.
Serum alkaline phosphatase and serum zinc concentrations in preterm infants with rickets and fractures.
Am J Dis Child, 143 (1989), pp. 1342-1345
[32.]
O. Alatas, P. Ozalp, M. Inal, B. Tekin, E. Alatas, O. Colak.
Osteocalcin metabolism in late fetal life: fetal and maternal osteocalcin levels.
Clin Chim Acta, 239 (1995), pp. 179-183
[33.]
J. Verhaeghe, K. Allewaert, E. Van Herck, R. Van Bree, F.A. Van Assche, R. Bouillon.
1,25-Dihydroxyvitamin D3 and osteocalcin in maternal and fetal guinea pigs.
Bone Miner, 26 (1994), pp. 261-273
[34.]
P.D. Delmas, F.H. Glorieux, E.E. Delvin, B.L. Salle, I. Melki.
Perinatal serum bone Gla-protein and vitamin D metabolites in preterm and fullterm neonates.
J Clin Endocrinol Metab, 65 (1987), pp. 588-591
[35.]
C.E. Fiore, G. Di Stefano, M. Romeo, L.S. Malatino, D.R. Grimaldi, R. Foti.
Calcium-induced serum Bone Gla Protein variations in preterm newborns.
J Endocrinol Invest, 10 (1987), pp. 443-446
[36.]
M.E. Martinez, P. Catalan, A. Lisbona, M.J. Sanchez-Cabezudo, F. Pallardo, I. Jans.
Serum osteocalcin concentrations in diabetic pregnant women and their newborns.
Horm Metab Res, 26 (1994), pp. 338-342
[37.]
J. Verhaeghe, R. Vouillon, E. Van Herck.
Umbilical cord osteocalcin in normal pregnancies and pregnancies complicated by fetal growth retardation or diabetes mellitus.
Biol Neonate, 68 (1995), pp. 377-383
[38.]
T. Yasumizu, J. Kato.
Concentrations of serum markers of type I collagen synthesis and degradation and serum osteocalcin in maternal and umbilical circulation.
Endocr J, 43 (1996), pp. 191-195
[39.]
H. Tsukahara, M. Takeuchi, K. Fujisawa, M. Miura, K. Hata, K. Yamamoto.
High-turnover osteopenia in preterm infants: determination of urinary pyridinium cross-links of collagen.
Metabolism, 47 (1998), pp. 333-335
[40.]
R. Namgung, R.C. Tsang, C. Lee, D.G. Han, M.L. Ho, R.I. Sierra.
Low total body bone mineral content and high bone resorption in Korean winter-born versus summer born newborn infants.
J Pediatr, 132 (1998), pp. 421-425
[41.]
K.E. Naylor, R. Eastell, K.E. Shattuck, A.C. Alfrey, G.L. Klein.
Bone turnover in preterm infants.
Pediatr Res, 45 (1999), pp. 363-366
[42.]
R. Namgung, R.C. Tsang, R.I. Sierra, M.L. Ho.
Normal serum indices of bone collagen biosynthesis and degradation in small for gestational age infants.
J Pediatr Gastroenterol Nutr, 23 (1996), pp. 224-228
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