Biochemical markers of bone turnover in girls during puberty

Blumsohn, Aubrey; Hannon, Rosemary A.; Wrate, Robert M.; Barton, J R; AI-Dehaimi, Abdul Wahed; Colwell, A.; Eastell, Richard

doi:10.1111/j.1365-2265.1994.tb03019.x

Cited by 191 publications

(127 citation statements)

References 33 publications

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“…(8,(22)(23)(24)(25) Although prior studies have demonstrated that biomarkers of bone metabolism were positively correlated with growth velocity, (7,24) these studies were limited to correlations between biomarkers and growth velocity without consideration of the independent effects of pubertal maturation, bone mass, and bone accrual on biomarker levels. Our data in healthy controls demonstrates that Tanner stage, sex, WB-BMC, height velocity, and WB-BMC accrual rates were all significant and independent determinants of bone biomarker levels during childhood and adolescence.…”

Section: Discussionmentioning

confidence: 99%

Interpretation of Biomarkers of Bone Metabolism in Children: Impact of Growth Velocity and Body Size in Healthy Children and Chronic Disease

Tuchman

Thayu

Shults

et al. 2008

The Journal of Pediatrics

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Objectives-To determine the effects of growth, maturation, and whole body bone mineral content (WB-BMC) accrual on biomarkers of bone formation [bone specific alkaline phosphatase (BSAP)] and resorption [urine deoxypyridinoline/creatinine (DPD)] in healthy children and children with Crohn's disease.Study design-BSAP and DPD were measured at baseline, and growth and dual energy x-ray absorptiometry (DXA) WB-BMC were measured at baseline and six months in 202 controls and 110 subjects with Crohn's disease, ages 5 to 21 years. Multivariable linear regression identified determinants of biomarkers in controls and subjects with Crohn's disease.Results-In controls, BSAP and DPD were significantly and independently associated with sex, Tanner stage, WB-BMC, height velocity, and WB-BMC accrual rates; these covariates explained 77-80% of the variability in bone biomarkers. Subjects with Crohn's disease had lower height-forage (p < 0.001) and WB-BMC-for-height (p < 0.05), compared with controls. Crohn's disease was associated with lower BSAP (p < 0.001) and greater DPD (p < 0.001), independent of growth, maturation, baseline WB-BMC, and WB-BMC accrual, compared with controls.Conclusions-These data illustrate the potential confounding effects of growth and WB-BMC on bone metabolism biomarkers in children. After adjustment for these effects, Crohn's disease was associated with lower biomarkers of bone formation and greater bone resorption. KeywordsCrohn's disease; height velocity; bone-specific alkaline phosphatase; urine deoxypyridinoline; dual energy x-ray absorptiometry; bone mineral content Corresponding/Reprint request author: Shamir Tuchman MD, MPH, Division of Pediatric Nephrology, Department of Pediatrics, The Children' s Hospital of Philadelphia, 34 th and Civic Center Blvd., Philadelphia, PA 19104, pH: (215) 590-2449, fax: (215) 590-3705, email: E-mail: tuchman@email.chop.edu. Edited by TW and WFB Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.The authors declare no conflicts of interest. Serum levels of biomarkers of bone formation were significantly reduced in children with newly diagnosed Crohn's disease, and biomarkers of bone resorption were variably reduced in comparison with controls; thus, bone remodeling may be suppressed in incident Crohn's disease due to a primary impairment in bone formation. (9) The accompanying editorial suggested that these findings support the use of anabolic agents as opposed to anti-resorptive agents in childhood Crohn's disease.(10) However, low overall bone mass (i.e. reduced numbers of osteoblasts and osteoclasts) and reduced ...

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Section: Discussionmentioning

confidence: 99%

Interpretation of Biomarkers of Bone Metabolism in Children: Impact of Growth Velocity and Body Size in Healthy Children and Chronic Disease

Tuchman

Thayu

Shults

et al. 2008

The Journal of Pediatrics

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“…8 Mean concentration of RANKL in the groups of girls studied for bone formation to assess osteoblastic activity. Both markers are increased in metabolic bone diseases with increased bone or osteoid formation including osteopenia, osteoporosis, as well as in adolescent idiopathic scoliosis [39][40][41][42][43][44].…”

Section: Discussionmentioning

confidence: 99%

Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis

Kulis

Goździalska

Drąg

et al. 2015

International Orthopaedics (SICOT)

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Purpose In order to verify the potential association between the aetiopathogenesis of adolescent idiopathic scoliosis (AIS) and the process of sexual maturation, we determined the concentrations of oestrogens in pre-and postmenarcheal girls affected by this condition. AIS, occurring mostly in pubescent girls, is one of the most frequent forms of faulty posture. Therefore, it was assumed that the multifactorial pathomechanism of AIS involves significant deficiency of oestrogens. Methods The diagnosis of AIS was established on the basis of physical examination and analyses of radiograms. Concentrations of FSH, LH, oestrogens, progesterone, osteocalcin and RANKL were determined by ELISA. The activity of alkaline phosphatase (AP) was measured by kinetic method. The study included pre-and postmenarcheal girls with AIS and corresponding groups of scoliosis-free controls. Results In premenarcheal scoliotic girls, the levels of FSH, LH and oestradiol were lower; the levels of progesterone, oestrone and oestriol were higher; and the concentrations of oestrone and oestriol were similar compared to premenarcheal controls. Higher levels of RANKL, osteocalcin and AP were observed in premenarcheal adolescents with AIS compared to controls. The concentrations of FSH, LH, oestradiol, and progesterone in postmenarcheal girls with scoliosis were lower, oestrone were slightly lower and oestriol did not differ compared with the control group. Significantly higher levels of RANKL, osteoc alcin an d A P w ere o bserv ed i n postmenarcheal scoliotic adolescents compared with controls. Conclusions There is an interdependence between the concentration of oestradiol and development of scoliosis. Determination of estradiol may have diagnostic value in the screening of spinal pathologies associated with AIS.

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“…Clearly, measurement of the bone isoform is likely to provide better information about osteoblast function than total AP. 6 The most important performance characteristic of bone AP (BAP) assays, is the ability to quantitate BAP within the reference range, in the face of varying levels of the liver isoform. The liver and bone isoforms differ in terms of heat stability, urea sensitivity, electrophoretic mobility, immunoreactivity and affinity for wheat-germ lectin, and methods based on these differences have been used to quantitate these isoforms in serum.…”

Section: Bone Alkaline Phosphatasementioning

confidence: 99%

The Performance and Utility of Biochemical Markers of Bone Turnover: Do We Know Enough to Use Them in Clinical Practice?

Blumsohn

Eastell

1997

Ann Clin Biochem

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Additional key phrases: osteoporosis; telopeptides of type I collagen; deoxypyridinoline; evidencebased medicineSeveral new biochemical techniques to assess bone turnover have been developed over the last decade. I These techniques are divided into those which are believed to reflect either the rate of bone formation or the rate of bone resorption (Table I).The validity of marker of bone turnover can be considered in different ways ( Table 2). The distinction between these different aspects of validity is important, because it leads to rather different interpretations of what is meant by a valid test. Markers of bone turnover are clearly useful in population-based epidemiological studies, and in therapeutic research studies. However, the routine clinical use of these measurements has been enthusiastically advocated, despite uncertainty about exactly how they should be used, or whether they can be relied upon to provide useful information in clinical practice. In any particular clinical context, it is necessary to decide: (I) which analyte to measure; (2) how to measure it; (3) when to measure it; (4) how the sample should be collected; and (5) how to interpret the result.To assess the clinical validity of markers of bone turnover, we need a clear understanding of exactly what information the measurements are intended to provide. Although traditional markers of bone turnover (total alkaline phosphatase, tartrate resistant acid phosphatase and hydroxyproline) are non-specific indicators of bone turnover, they may be as reliable as more specific measurements when bone turnover is markedly elevated, as in severe Paget's disease of'bone.? The main potential clinical use of new markers is to identify apparently healthy subjects at risk of future osteoporosis, and to monitor the effect of antiresorptive drug therapy. Crucial requirements for these new analytes are therefore that they should be able to: (I) rank healthy subjects with regard to their turnover status: and (2) distinguish between individual subjects in terms of their response to antiresorptive therapy. SELECTED ANALYTICAL ISSUESThe relevant biochemistry and the availability of particular assays have been reviewed elsewhere, 1 and only a few selected issues will be considered here. For convenience, markers have been divided into those which are related to bone collagen metabolism, and those which are not.Markers of bone formation related to collagen metabolism These include procollagen type I C-terminal propeptide (PICP) and procollagen type I N-terminal propeptide (PINP) released into the circulation during the conversion of procollagen to collagen. Theoretically, the production of both these analytes should parallel the production of type I collagen, and they should therefore, perform similarly.In most clinical models, PICP appears to be much less sensitive and specific than bone alkaline phosphatase or osteocalcin.l" This non-specificity is likely to be due to contribution from tissues other than bone, as well as variable metabolic clearance. Type I coll...

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Biochemical markers of bone turnover in girls during puberty

Cited by 191 publications

References 33 publications

Interpretation of Biomarkers of Bone Metabolism in Children: Impact of Growth Velocity and Body Size in Healthy Children and Chronic Disease

Interpretation of Biomarkers of Bone Metabolism in Children: Impact of Growth Velocity and Body Size in Healthy Children and Chronic Disease

Participation of sex hormones in multifactorial pathogenesis of adolescent idiopathic scoliosis

The Performance and Utility of Biochemical Markers of Bone Turnover: Do We Know Enough to Use Them in Clinical Practice?

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