Biochemical markers of bone turnover in children with clinical bone fragility

Abstract

Background: The role of biochemical bone turnover markers (BTMs) in assessing low bone mass and monitoring bisphosphonate treatment in pediatric patients with clinical bone fragility is not well established. The aim of the study was to examine the correlations of BTMs and the bone mineral density (BMD), and evaluate the effects of bisphosphonates therapy on BTMs in children with clinical bone fragility. Methods: Clinical data of 115 patients with clinical bone fragility (mean age 9.7±5.8 years), 102 of whom received bisphosphonates, were studied. Serum alkaline phosphatase (ALP), osteocalcin (OC), urine pyridinoline (PD) and deoxypyridinoline (DPD), BMD at baseline and subsequent years were analyzed. Results: There was a significant negative correlation between urine PD and lumbar BMD (slope = -0.29, p < 0.001). There were no correlations between BTMs and lumbar BMD Z-score. There was a significant positive correlation between serum OC and serum ALP, urine PD and DPD (p < 0.001). Serum OC, urine PD and DPD index, as expressed as measured value/upper limit of normal value for age, decreased during the first 3 years of bisphosphonate therapy. Conclusions: In children with clinical bone fragility, BTMs correlated with each other, but not with lumbar BMD Z-score. While they were not reliable predictors of degree of low BMD, the bone markers showed suppression during bisphosphonate therapy and may be helpful in monitoring the response to therapy.

Decreased markers of bone turnover in children and adolescents with type 1 diabetes

“…The relationship between BMD and BTM in children and adolescents with T1D has previously been investigated in a few publications and most of these could not demonstrate significant associations between BMD and BTM . In children and adolescents without T1D, the results have been more ambiguous . None of the above previously published studies have investigated the association between BTM and BMD using Z‐scores for the BTM.…”

Osteokalsin düzeylerinin adölesandaki büyüme atağını izleme ve büyüme potansiyelini belirlemedeki önemi

“…[1] Serum osteokalsin düzeyi yüksek kemik dönüşümü ile karakterize durumlarda artar, büyüme atağının (Growth Spurt) gerçekleştiği puberte buna iyi bir örnektir. [2][3][4] Adölesandaki en önemli değişimlerden biri hızlı fiziksel büyümedir. Boyca büyüme hızındaki artış kızlarda 10, erkeklerde 12 yaşta başlayarak kızlarda cinsel gelişme evresi 3 veya 12 yaşta, erkeklerde cinsel gelişme evresi 4 veya 14 yaşta doruk noktasına (Peak Height Velocity) ulaşır, daha sonra hız giderek azalır ve büyüme sonlanır.…”

The Clinical and Biochemical Predictors of Bone Mass in Preterm Infants

“…This correlation corresponded with an observed OC level decrease and body length increase during the study period. Nevertheless, serum OC level, CTx, PINP do not correlate with BMD in children with clinical bone fragility [41, 42]. Similarly, Litmanovitz et al found that changes in the biochemical markers could not predict the changes in bone strength assessed by quantitative ultrasound [43].…”