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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Mericq, Veronica / Toppari, Jorma

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Volume 32, Issue 1


The effect of thyroid functions on osteopenia of prematurity in preterm infants

Ufuk Çakır
  • Corresponding author
  • Division of Neonatology, Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Altıntag, Ankara, Turkey
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Cuneyt Tayman
  • Division of Neonatology, Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Altıntag, Ankara, Turkey
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-12-04 | DOI: https://doi.org/10.1515/jpem-2018-0429



It is known that thyroid hormones have effects on bone development. In particular, the effect of thyroid hormones on osteopenia of prematurity (OOP) has not been examined in preterm infants. Our study aimed to examine the relationship between OOP and congenital hypothyroidism (CH) in preterm infants.


Very low birth weight infants (VLBW, <1500 g) were included in the study. Thyroid-stimulating hormone (TSH) and free thyroxine (fT4) levels were measured on postnatal day 5. Serum calcium, phosphorus and alkaline phosphatase (ALP) levels were studied as standard screening parameters for OOP at postnatal week 4. Patients with serum ALP level >700 IU/L were included in the OOP group. We intended to figure out the relationship between OOP and CH in infants.


In our study, OOP frequency was 14.9% among 543 VLBW infants. There was no statistically significant difference between groups with and without CH (21.7% and 14.8%, respectively) in terms of OOP (p=0.632). Gestational age (GA) was significantly lower in infants with diagnosed OOP (p<0.001, p<0.001, respectively). In addition, the prevalence rates of mothers with preeclampsia, small for gestational age (SGA), respiratory support requirement, late-onset neonatal sepsis (LOS), bronchopulmonary dysplasia (BPD) and full enteral feeding time were found to be higher in the OOP group (p<0.05).


We found that thyroid hormones had no effect on OOP in preterm infants. Therefore, future randomized controlled studies as well as long-term outcome studies are warranted on this topic.

Keywords: congenital hypothyroidism; osteopenia of prematurity; thyroid function tests; very low birth weight preterm


  • 1.

    Ali E, Rockman-Greenberg C, Moffatt M, Narvey M, Reed M, et al. Caffeine is a risk factor for osteopenia of prematurity in preterm infants: a cohort study. BMC Pediatr 2018;18:9.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 2.

    Abdallah EA, Said RN, Mosallam DS, Moawad EM, Kamal NM, et al. Serial serum alkaline phosphatase as an early biomarker for osteopenia of prematurity. Medicine (Baltimore) 2016;95:e4837.PubMedWeb of ScienceCrossrefGoogle Scholar

  • 3.

    Rustico SE, Calabria AC, Garber SJ. Metabolic bone disease of prematurity. J Clin Transl Endocrinol 2014;1:85–91.PubMedGoogle Scholar

  • 4.

    Chin LK, Doan J, Teoh YS, Stewart A, Forrest P, et al. Outcomes of standardised approach to metabolic bone disease of prematurity. J Paediatr Child Health 2018;54:665–70.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 5.

    Williams GR, Bassett JH. Thyroid diseases and bone health. J Endocrinol Invest 2018;41:99–109.Web of ScienceCrossrefPubMedGoogle Scholar

  • 6.

    Bassett JH, Williams GR. Role of thyroid hormones in skeletal development and bone maintenance. Endocr Rev 2016;37:135–87.Web of ScienceCrossrefPubMedGoogle Scholar

  • 7.

    Reddy PA, Harinarayan CV, Sachan A, Suresh V, Rajagopal G. Bone disease in thyrotoxicosis. Indian J Med Res 2012;135:277–86.PubMedGoogle Scholar

  • 8.

    Medeiros-Neto GA. [Osteopenia and treatment with L-thyroxine]. Rev Assoc Med Bras (1992). 1995;41:34–6.PubMedGoogle Scholar

  • 9.

    Chiesa A, Prieto L, Mendez V, Papendieck P, Calcagno Mde L, et al. Prevalence and etiology of congenital hypothyroidism detected through an argentine neonatal screening program (1997–2010). Horm Res Paediatr 2013;80:185–92.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 10.

    Olivieri A, Fazzini C, Medda E; Italian Study Group for Congenital Hypothyroidism. Multiple factors influencing the incidence of congenital hypothyroidism detected by neonatal screening. Horm Res Paediatr 2015;83:86–93.CrossrefWeb of SciencePubMedGoogle Scholar

  • 11.

    Hung YL, Chen PC, Jeng SF, Hsieh CJ, Peng SS, et al. Serial measurements of serum alkaline phosphatase for early prediction of osteopaenia in preterm infants. J Paediatr Child Health 2011;47:134–9.Web of ScienceCrossrefPubMedGoogle Scholar

  • 12.

    Agostoni C, Buonocore G, Carnielli VP, De Curtis M, Darmaun D, et al. ESPGHAN Committee on Nutrition. Enteral nutrient supply for preterm infants: commentary from the European Society of Paediatric Gastroenterology, Hepatology and Nutrition Committee on Nutrition. J Pediatr Gastroenterol Nutr J 2010;50:85–91.CrossrefGoogle Scholar

  • 13.

    Fenton TR. A new growth chart for preterm babies: Babson and Benda’s chart updated with recent data and new format. BMC Pediatr 2003;16:3–13.Google Scholar

  • 14.

    Dargaville PA, Gerber A, Johansson S, De Paoli AG, Kamlin CO, et al. Australian and New Zealand neonatal network. Incidence and outcome of CPAP failure in preterm infants. Pediatrics 2016;138:e20153985.PubMedCrossrefGoogle Scholar

  • 15.

    Northway Jr WH, Rosan RC, Porter DY. Pulmonary disease following respirator therapy of hyaline-membrane disease. Bronchopulmonary dysplasia. N Engl J Med 1967;276:357e68.Google Scholar

  • 16.

    Papile LA, Burstein J, Burstein R, Koffler H. Incidence and evolution of subependymal and intraventricular hemorrhage: a study of infants with birth weights less than 1,500 gm. J Pediatr 1978;92:529e34.Google Scholar

  • 17.

    Bell MJ, Ternberg JL, Feigin RD, Keating JP, Marshall R, et al. Neonatal necrotizing enterocolitis. Therapeutic decision based upon clinical staging. An Surg 1978;187:1–7.CrossrefGoogle Scholar

  • 18.

    Terrin G, Conte F, Scipione A, Bacchio E, Conti MG, et al. Efficacy of paracetamol for the treatment of patent ductus arteriosus in preterm neonates. Ital J Pediatr 2014;40:21.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 19.

    Pieltain C, de Halleux V, Senterre T, Rigo J. Prematurity and bone health. World Rev Nutr Diet 2013;106:181–8.PubMedGoogle Scholar

  • 20.

    Stalnaker KA, Poskey GA. Osteopenia of prematurity: does physical activity improve bone mineralization in preterm infants? Neonatal Netw 2016;35:95–104.CrossrefWeb of SciencePubMedGoogle Scholar

  • 21.

    Lee JH, Kim SW, Jeon GW, Sin JB. Thyroid dysfunction in very low birth weight preterm infants. Korean J Pediatr 2015;58:224–9.PubMedCrossrefGoogle Scholar

  • 22.

    Vigone MC, Caiulo S, Di Frenna M, Ghirardello S, Corbetta C, et al. Evolution of thyroid function in preterm infants detected by screening for congenital hypothyroidism. J Pediatr 2014;164:1296–302.PubMedCrossrefGoogle Scholar

  • 23.

    Ko YJ, Kim JY, Lee J, Song HJ, Kim JY, et al. Levothyroxine dose and fracture risk according to the osteoporosis status in elderly women. J Prev Med Public Health 2014;47:36–46.CrossrefPubMedGoogle Scholar

  • 24.

    Lee SJ, Kim KM, Lee EY, Song MK, Kang DR, et al. Low normal TSH levels are associated with impaired BMD and hip geometry in the elderly. Aging Dis 2016;7:734–43.PubMedCrossrefWeb of ScienceGoogle Scholar

  • 25.

    Ding B, Zhang Y, Li Q, Hu Y, Tao XJ, et al. Low thyroid stimulating hormone levels are associated with low bone mineral density in femoral neck in elderly women. Arch Med Res 2016;47:310–4.CrossrefPubMedWeb of ScienceGoogle Scholar

  • 26.

    Van Rijn LE, Pop VJ, Williams GR. Low bone mineral density is related to high physiological levels of free thyroxine in peri-menopausal women. Eur J Endocrinol 2014;170:461–8.CrossrefWeb of SciencePubMedGoogle Scholar

  • 27.

    Kachui A, Tabatabaizadeh SM, Iraj B, Rezvanian H, Feizi A. Evaluation of bone density, serum total and ionized calcium, alkaline phosphatase and 25-hydroxy vitamin D in papillary thyroid carcinoma, and their relationship with TSH suppression by levothyroxine. Adv Biomed Res 2017;6:4.Google Scholar

About the article

Corresponding author: Ufuk Çakır, MD, Division of Neonatology, Zekai Tahir Burak Women’s Health Training and Research Hospital, Faculty of Medicine, University of Health Sciences, Altıntag, Ankara, Turkey, Phone: +90 505 8581781, Fax: +90 312 2315781

Received: 2018-10-05

Accepted: 2018-11-11

Published Online: 2018-12-04

Published in Print: 2019-01-28

Author contributions: Concept, design and data collection or processing: Ufuk Cakir. Data analysis and interpretation: Cuneyt Tayman. Literature search: Ufuk Cakir and Cuneyt Tayman. Writing: Ufuk Cakir and Cuneyt Tayman.

Research funding: None declared.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 32, Issue 1, Pages 65–70, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2018-0429.

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