Bone Mineral Density and Markers of Bone Turnover in Boys with Constitutional Delay of Growth and Puberty

Abstract

It has been suggested that poor growth in childhood or puberty might be a correctable determinant of osteoporosis. To assess the effect of the growth and puberty delay on bone metabolism, we measured bone mineral density (BMD) and markers of bone turnover in 41 boys with constitutional delay of growth and puberty. Total body (TB) and lumbar spine (LS) BMD were measured by dual-energy x-ray absorptiometry. Serum osteocalcin, total alkaline phosphatase, and urinary deoxypyridinoline cross-links as markers of bone turnover were evaluated. BMD was decreased by at least 1 sd in TB in 23 boys (56%) and in LS in 27 boys (66%). After adjustment of BMD for bone age, TB was decreased in 11 boys (27%) and LS in 13 boys (32%). Bone age and chronological age significantly correlated with areal and volumetric BMD. The significant increments of height, weight, TB, and LS BMD between the consecutive pubertal stages were reported. Mean alkaline phosphatase, osteocalcin, and deoxypyridinoline were within reference ranges and showed no differences between pubertal stages. In conclusion, in boys with constitutional delay of growth and puberty, bone turnover is normal, and BMD increases in a manner similar to healthy children.

Catch up in bone acquisition in young adult men with late normal puberty

“…(8)(9)(10) A study including boys (8-18 years of age) with constitutional delay of growth and puberty found that BMD, measured with dualenergy X-ray absorptiometry (DXA), adjusted for bone age increased throughout pubertal stages in a similar manner as in healthy children. (11) Less is known about how adult BMD in men is affected by variations in pubertal timing within the normal range. We have earlier reported, in the Gothenburg Osteoporosis and Obesity (GOOD) study of 19-year-old males in Sweden, that late but normal puberty was associated with lower BMD and previous fracture in a cross-sectional study.…”

Predictors of low bone mass in postmenopausal Japanese women: a questionnaire-based study

“…Bone-type alkaline phosphatase is often used as a representative bone metabolism marker related to bone formation (Frost et al 2004;Iba et al 2004;de Papp et al 2007). Deoxypyridinoline (DPD) is often used as a bone metabolism marker related to bone resorption (Kitatani et al 2003;Krupa and Miazgowski 2005;Millet et al 2005). Bone metabolism markers are measured in blood or urine samples.…”

Assessment of bone turnover markers and bone mineral density in normal short boys

“…On the contrary, in a pediatric study, BMD and bone turnover markers (serum osteocalcin, total alkaline phosphatase, and urinary D-pyd) were evaluated in 41 boys with CDGP between stages I-IV of puberty and authors reported that in boys with CDGP, like normal boys, BMD adjusted for bone age increases parallel to the stages of puberty, and the most significant BMD increments took place between stages III and IV. They recommended that in boys with CDGP, bone turnover was similar with that of healthy children (7). In a study from Italy, 21 adult men with CDGP and 12 healthy men as a control group were compared.…”

“…This is suggested as a risk factor for development of osteopenia and bone fractures (1)(2)(3)(4)(5). Contrarily, some authors indicated that bone remodeling-related biochemical parameters of cases with CDGP are not different than normal values, therefore, their bone mineral density (BMD) and fracture risks remain unchanged (6)(7)(8).…”