Z-scores of bone turnover markers calculated from new established sex- and age-specific reference curves are associated to future change in BMD in children and adolescents

Rand, Michael Schønemann; Diemar, Sarah Seberg; Møllehave, Line Tang; Heidemann, Malene; Thuesen, Betina H.; Petersen, Jørgen Holm; Johannesen, Jesper; Schou, Anders; Wedderkopp, Niels; Mølgaard, Christian; Jørgensen, Niklas Rye

doi:10.1016/j.bone.2022.116641

Cited by 6 publications

(2 citation statements)

References 31 publications

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“…The two-sample t test was used to assess statistically signi cant differences. years in girls and 13-14 years in boys [10]. Aksnes and Aarskog demonstrated that the two quotients of 25(OH)D and 24,25(OH)2D are inversely associated with 1,25(OH)2D status during puberty pointing to a higher Vitamin D requirement [11].…”

Section: Methodsmentioning

confidence: 98%

Seasonal, Age- and Sex-dependent Variations in Serum Vitamin D Concentrations in Children and Adolescents and their Relevance for Future Health

Hower¹,

Novo

2023

Preprint

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Except for the first year of life, when infants are fully supplemented with 400 IU vitamin D, we found seasonal and age-dependent vitamin D distribution patterns for all age groups. The age groups between 2 and 9 years (grouped in 2-3, 4-5, 6-7, and 8-9 years) showed a positive deviation, and the age groups between 10-15 years showed a negative deviation from the mean curve over all age groups. The time frame between 10-15 years is associated with puberty, and the lower serum concentrations may indicate a higher conversion rate of 25(OH)-vitamin D into 1,25(OH)2 vitamin D. The pubertal decrease in serum vitamin D concentrations between boys and girls differs significantly in time, length, and magnitude. As puberty starts and ends earlier in girls than in boys, this difference may suggest that puberty is possibly among others a causal factor for the observed drop in serum vitamin D concentrations. Vitamin D deficiency especially in critical growth periods may hamper bone and immune health which has so far not been sufficiently considered. The dilemma of multiple factors and their influence on distribution curves can probably only be solved by using machine learning programs, which may be better suited to take multiple determinants into account to provide reliable data to achieve adequate Vitamin D supplementation. The associations among sunshine exposure, D supplementation and serum vitamin D concentrations are well known. Guidelines for dietary intake and serum concentrations are intended to limit the population risk of vitamin D deficiency. Present recommendations have been widely unsuccessful in achieving vitamin D sufficiency in childhood, adolescence and adulthood. Specific age-dependent seasonal D distribution curves do not exist, but they would allow an evidence-based estimate of vitamin D requirements for boys and girls in different stages of development. In a secondary analysis of the first wave (May 2003-May 2006) of the nationwide representative German KiGGS Study (Study on the Health of Children and Adolescents in Germany), we reanalysed data from 10,015 participants to investigate the seasonal variations in serum vitamin D concentrations for children and adolescents within two-year age intervals to increase our understanding of the relationship between serum vitamin D concentrations and child development in both sexes.

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Section: Methodsmentioning

confidence: 98%

Seasonal, Age- and Sex-dependent Variations in Serum Vitamin D Concentrations in Children and Adolescents and their Relevance for Future Health

Hower¹,

Novo

2023

Preprint

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“…Bone resorption markers must be interpreted according to the patient’s age. Young adults are characterised by active bone remodelling and physiologic increases in BTMs [ 101 , 102 ]. Additionally, elevated BTMs are observed after a recent fracture.…”

Section: Evaluation Of Early-onset Osteoporosismentioning

confidence: 99%

Bone fragility and osteoporosis in children and young adults

Formosa,

Christou,

Mäkitie

2023

J Endocrinol Invest

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Osteoporosis is a metabolic bone disorder which increases fragility fracture risk. Elderly individuals, especially postmenopausal women, are particularly susceptible to osteoporosis. Although rare, osteoporosis in children and young adults is becoming increasingly evident, highlighting the need for timely diagnosis, management and follow-up. Early-onset osteoporosis is defined as the presence of a low BMD (Z-score of ≤ −2.0 in individuals aged < 20 years; T-score of ≤ −2.5 in those aged between 20 to 50 years) accompanied by a clinically significant fracture history, or the presence of low-energy vertebral compression fractures even in the absence of osteoporosis. Affected children and young adults should undergo a thorough diagnostic workup, including collection of clinical history, radiography, biochemical investigation and possibly bone biopsy. Once secondary factors and comorbidities are excluded, genetic testing should be considered to determine the possibility of an underlying monogenic cause. Defects in genes related to type I collagen biosynthesis are the commonest contributors of primary osteoporosis, followed by loss-of-function variants in genes encoding key regulatory proteins of canonical WNT signalling (specifically LRP5 and WNT1), the actin-binding plastin-3 protein (encoded by PLS3) resulting in X-linked osteoporosis, and the more recent sphingomyelin synthase 2 (encoded by SGMS2) which is critical for signal transduction affecting sphingomyelin metabolism. Despite these discoveries, genetic causes and underlying mechanisms in early-onset osteoporosis remain largely unknown, and if no causal gene is identified, early-onset osteoporosis is deemed idiopathic. This calls for further research to unravel the molecular mechanisms driving early-onset osteoporosis that consequently will aid in patient management and individualised targeted therapy.

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