Biochemical Markers of Bone Turnover

Abstract

Three studies to evaluate procollagen type I C-terminal propeptide, type I collagen cross-linked telopeptide and bone alkaline phosphatase (BALP) in the assessment of bone turnover and growth in children are presented. (1) In 50 short normal children treated with placebo or growth hormone, ΔBALP after 3 months of treatment was highly correlated with height velocity response after 1 year (r = 0.67, p < 0.0001). (2) In 12 children with acute lymphoblastic leukaemia, marked changes in collagen peptides, BALP, and lower leg length velocity were seen during the first 6 months of chemotherapy. Suppression occurred during induction and the two intensification phases, with catch-up during the intervening phase (paired t-tests, p < 0.001). (3) Fourteen babies (birthweight < 1,500 g) treated with high-dose dexamethasone for bronchopulmonary dysplasia were compared with 25 non-steroid-treated babies < 1,500 g. Both collagen peptides decreased rapidly and dramatically (mean decreases 41-68%) after dexamethasone was started, accompanied by weight loss and lower leg shrinkage and followed by recovery during steroid weaning.

Effect of growth hormone therapy on bone metabolism of growth hormone deficient children

“…Increment in ALP after 3 months has been recently reported to highly correlate with HV after 1 year in normal variant short children receiving GH treatment [5]. The timing of the 3 months' sample may have in¯uenced which markers gave the best prediction, as PICP* and ICTP** in that study responded earlier than ALP to GH therapy [6]. In our study the best correlation between increment in HV and change in ALP was observed at 6 months, whereas the best correlation between increment of HV and change in TPO 4 /GFR was shown at 1 month.…”

Skeletal morbidity in childhood acute lymphoblastic leukaemia

“…10,11 Low concentrations of the bone collagen degradation peptide, carboxyterminal telopeptide of type I collagen (ICTP), have also been demonstrated. 11 These findings indicate that the leukaemic disease process is associated with a low bone turnover state.…”

Early Life Factors Predict Abnormal Growth and Bone Accretion at Prepuberty in Former Premature Infants With/Without Neonatal Dexamethasone Exposure

“…Preterm BPD infants who were treated with DEX demonstrated impaired growth, with a lower whole body fat and lean mass than healthy term infants during the first year of life (6). Compared with nonsteroid-treated VLBW control infants, the VLBW infants treated with DEX for BPD also showed lower weight and shrinkage of the lower leg length (7). In our previous studies in both VLBW infants (8,9) and infant piglets (1,10), growth in weight, length, and bone mass was compromised by DEX administration in early life, although in the human infants the effects of BPD and ventilatory history may also contribute.…”