Pyridinium crosslinks of collagen as a marker of bone resorption rates in children and adolescents: Normal values and clinical application

Marowska, Joanna; Kobylińska, Maria; Lukaszkiewicz, J; Tałajko, A; Rymkiewicz-Kluczyńska, B; Lorenc, R

doi:10.1016/s8756-3282(96)00284-0

Cited by 46 publications

(48 citation statements)

References 37 publications

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“…However, the impact of other factors such as parity, maternal diseases, and infant's sex on bone turnover in the premature infant are yet to be identified. In this study we used serum concentration of carboxy terminal propeptide of type I procollagen (PICP) in cord blood, as a marker of fetal bone formation (6 -8), and pyridinoline (Pyd) excretion in urine as a biomarker of bone resorption (9,10).…”

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Gestational Age, Sex and Maternal Parity Correlate with Bone Turnover in Premature Infants

et al. 2005

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Factors affecting bone turnover in premature infants are not entirely clear but certainly are different from those influencing bones of adults and children. To identify fetal and maternal factors that might influence bone turnover, we prospectively studied 50 infants (30 preterm and 20 full-term) born at Ain Shams University Obstetric Hospital in Cairo, Egypt. Maternal parity and medical history and infant's weight, gestational age, gender and anthropometrical measurements were recorded. Cord blood samples were collected and serum type I collagen Cterminal propeptide (PICP) was assessed as a marker for fetal bone formation. First morning urine samples were collected and pyridinoline cross-links of collagen (Pyd) were measured as an index for bone resorption. Serum PICP was higher in premature infants when compared with full-term infants (73.30 Ϯ 15.1 versus 64.3 Ϯ 14.7, p ϭ 0.022) and was higher in male premature infants when compared with females (81.64 Ϯ 9.06 versus 66.0 Ϯ 15.7, p ϭ 0.018). In a multiple regression model using Throughout life, bone is constantly resorbed and new bone is formed. Both modeling and remodeling occur during skeletal growth. Bone modeling results in linear growth and remodeling allows expansion of bone circumference and mineral deposition. Five to twenty percent of the bone mass is actively remodeled by about two million bone remodeling units in the human skeleton at any given time (1,2). The rate of bone turnover in adults differs from children and neonates. In addition, factors affecting such process in adults do not necessarily influence children or neonates (3,4). Premature infants represent a unique vulnerable population, in which bone growth and mineral acquisition are critical. The relation of bone turnover with gestational age and birth weight has been well described (5). However, the impact of other factors such as parity, maternal diseases, and infant's sex on bone turnover in the premature infant are yet to be identified. In this study we used serum concentration of carboxy terminal propeptide of type I procollagen (PICP) in cord blood, as a marker of fetal bone formation (6 -8), and pyridinoline (Pyd) excretion in urine as a biomarker of bone resorption (9,10). PATIENTS AND METHODSPatients. Fifty appropriate-for-gestational-age infants were included in this study. Thirty preterm and twenty term infants were prospectively enrolled. Infants with history of perinatal asphyxia, maternal fever, rupture of amniotic membranes Ͼ18 h, congenital anomalies, liver diseases, and inherited metabolic or genetic disorders were excluded from the study. The study was approved by the institutional review board and parental consents were obtained. Maternal history including maternal age, parity and diabetes mellitus. Length of gestation was estimated using the date of last menstrual period, early antenatal ultrasound when available and the new Ballard scoring system (11). All anthropometrical measurements were done by the same doctor on admission and were plotted against gestational age (1...

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confidence: 99%

Gestational Age, Sex and Maternal Parity Correlate with Bone Turnover in Premature Infants

et al. 2005

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“…Nevertheless, bone turnover markers do appear to have clinical utility in children (Szulc et al, 2000). They predict longitudinal growth in infants up to 18 months of age (Lieuw-A-Fa et al, 1995) and children 4 -18 y (Rauch et al, 1994) as well as response to growth hormone supplementation in children (Marowska et al, 1996), suggesting that they may be a valid short-term marker of bone changes. Furthermore, animal models have suggested that the mechanism by which isoflavones prevent bone loss is by suppression of bone turnover (Ishida et al, 1998;Tsutsumi, 1995).…”

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confidence: 99%

A randomized controlled trial of phytoestrogen supplementation, growth and bone turnover in adolescent males

et al. 2003

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Objective: To assess the effect of phytoestrogens on bone turnover and growth in adolescent boys. Design: Randomized double-blind placebo-controlled trial. Setting: Single school in northwest Tasmania. Participants: Adolescent boys (treatment n ¼ 69, placebo n ¼ 59, mean age 16.8 y). Interventions: Six weeks of isoflavone supplementation (Novasoy, 50 mg daily of isoflavone equivalents). Bone turnover markers (bone specific alkaline phosphatase (BAP) and pyridinoline creatinine ratio (PYR)) were measured at baseline and follow-up. Results: Despite marked increases in urinary genistein and daidzein in the treatment arm (both P < 0.001), there were no significant differences in BAP, PYR or short-term height or weight change. This applied to both intention-to-treat and per protocol analysis. Neither was there a significant correlation between urinary genistein and daidzein levels and BAP or PYR. Conclusions: Phytoestrogen supplementation to the level of usual Japanese dietary intake has no measurable effect on bone turnover in adolescent boys. Longer-term studies of bone density may be desirable but it is unlikely that there will be a large effect in either girls or boys given the lower endogenous oestrogen levels in boys.

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“…Discrepant data may be explained by the fact that subjects (AN and CO) in the Soyka study were substantially younger (mean age between 15 and 16 y) than in Stefanis' (23 -28 y) and ours (24 -26 y). Urinary Dpd is a marker of growth in normal children (Branca et al, 2002) and adolescents (Rauch et al, 1996) which experiences a dramatic increase around puberty (Marowska et al, 1996) to progressively decrease until reaching adult values by age 20 y (Vesper et al, 2002). Thus, menstruating controls in the Soyka study were likely to show higher growth velocity than amenorrheic AN patients both being in pubertal ages, and therefore higher Dpd excretion if bone resorption in AN patients had not been increased for other reasons.…”

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confidence: 99%

Bone resorption in anorexia nervosa and rehabilitated patients

et al. 2003

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Objective: To assess the impact of anorexia nervosa and that of nutritional rehabilitation on bone resorption. Design: Cross-sectional, observational study. Setting: Rome, Italy Subjects: Twenty-eight female patients affected by anorexia nervosa (AN, BMI 17.0 kg=m 2 ), 18 females rehabilitated from anorexia nervosa and weight-stable for at least 6 months (RE, BMI ! 18.5 kg=m 2 ) and 34 age-and sex-matched healthy controls (CO, BMI ! 18.5 kg=m 2 ). Among AN patients, 16 were affected by the 'restrictive' (ANr) and 12 by the 'purging' type (ANp) of anorexia nervosa. Method: Body weight, height and skeletal diameters were measured on each individual. The skeletal mass (SKM) was predicted from the skeletal diameters of the elbow, wrist, knee and ankle, using the equation of Martin. Twenty-four-hour urinary excretion of pyridinium crosslinks of collagen (pyridinoline (Pyd) and deoxypyridinoline (Dpd)) and creatinine was assessed by reversed-phase HPLC with fluorimetric detection after solid-phase extraction and by the Jaffé-method with deproteinization, respectively. Results: Twenty-four-hour urinary output of Pyd and Dpd was not significantly different between AN and CO when expressed in absolute values, but AN showed higher bone resorption than CO when Pyd and Dpd excretion was adjusted by either creatinine (P < 0.0000) or the SKM (P < 0.05). Within the AN group, urinary excretion of both cross-links was significantly and consistently higher in ANp compared with ANr (P < 0.05). However, these differences disappeared when crosslink output was adjusted either by urinary creatinine or SKM. RE subjects showed no differences in bone resorption with the AN group despite weight gain, being crosslink excretion consistently elevated compared to controls (Pyd: P < 0.01 by creatinine and P < 0.05 by SKM; Dpd: P < 0.01 by creatinine and P < 0.05 by SKM). Conclusion: Bone resorption is elevated in anorexia nervosa and different strategies for low-weight maintenance do not seem to have a differential impact. Increased bone resorption persists in subjects with past diagnosis of anorexia nervosa despite rehabilitation lasting more than 6 months. This finding indicates that bone mass and turnover should be monitored in anorexia nervosa patients and ex-patients well beyond recovery of normal body mass. Further investigation is warranted to examine the long-term effect of such prolonged increase in bone turnover at a young age. Sponsorship: Dr. Valtueña is supported by a Marie Curie Fellowship from the European Commission (Contact no. HPMF-CT-1999-00192). European Journal of Clinical Nutrition (2003) 57, 260 -265. doi:10.1038=sj.ejcn.1601527 Keywords: anorexia nervosa; 'purging' anorexia; restrictive anorexia; pyridinoline; deoxypyridinoline; nutritional rehabilitation *Correspondence: F Branca, Human Nutrition Unit, National Institute for Food and Nutrition Research, Via Ardeatina 546, 00179 Roma, Italy. E-mail: f.branca@agora.it Guarantor: Dr. Francesco Branca. Contributors: SV was responsible for the analysis of the data and th...

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Pyridinium crosslinks of collagen as a marker of bone resorption rates in children and adolescents: Normal values and clinical application

Cited by 46 publications

References 37 publications

Gestational Age, Sex and Maternal Parity Correlate with Bone Turnover in Premature Infants

Gestational Age, Sex and Maternal Parity Correlate with Bone Turnover in Premature Infants

A randomized controlled trial of phytoestrogen supplementation, growth and bone turnover in adolescent males

Bone resorption in anorexia nervosa and rehabilitated patients

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