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Relationships between biochemical bone turnover markers, season, and inflammatory status indices in prepubertal
1Elsie Widdowson Laboratory, MRC Human Nutrition Research, Fulbourn Road, Cambridge CB1 9NL, United Kingdom.
Insights
Childhood bone growth in developing countries is affected by seasonal food availability and illness. This study found that inflammation markers were high, reducing bone collagen synthesis and turnover in Gambian boys.
Area of Science:
- Pediatric Endocrinology
- Nutritional Biochemistry
- Growth and Development
Background:
- Childhood growth, including bone development, is influenced by seasonal variations in food and illness, particularly in developing nations.
- Inflammation is common in these settings and can impact metabolic processes.
Purpose of the Study:
- To investigate seasonal changes in serum markers of bone metabolism (procollagen type I N propeptide [P1NP], serum C-terminal telopeptide of type 1 collagen [S-CTX]).
- To examine the relationship between bone metabolism markers and serum inflammation markers (alpha(1)- antichymotrypsin [ACT], C-reactive protein [CRP], sialic acid).
- To assess these markers in prepubertal Gambian boys across different seasons.
Main Methods:
- Serum samples were collected from prepubertal Gambian boys in August (mid-rainy season), October (late rainy season), and April (late dry season).
- Measurements included bone markers (P1NP, S-CTX) and inflammation markers (ACT, CRP, sialic acid).
- Statistical analysis explored seasonal variations and correlations between bone and inflammation markers.
Main Results:
- High prevalence of elevated inflammatory markers (ACT, CRP, sialic acid) was observed across all seasons, peaking in the rainy season.
- Serum C-terminal telopeptide of type 1 collagen (S-CTX) was highest in August (rainy season); P1NP showed no seasonal variation.
- Inverse relationships were found between bone markers and acute phase reactants, notably between P1NP and ACT or sialic acid.
Conclusions:
- Bone collagen synthesis and turnover are reduced in the presence of inflammation in rural Gambian boys.
- Biochemical markers can serve as valuable indicators of infection and growth faltering episodes at single time points.
Abstract:
Seasonal and interindividual differences in food availability and illnesses cause variations in growth, including bone growth, in children in developing countries. We investigated seasonal differences in biochemical (serum) markers of bone metabolism and relationships between these markers (procollagen type I N propeptide [P1NP], serum C-terminal telopeptide of type 1 collagen [S-CTX]) and serum markers of inflammation (alpha(1)- antichymotrypsin [ACT], C-reactive protein [CRP], sialic acid) in prepubertal Gambian boys. Three seasonal time points were chosen: August, mid-rainy season; October, late rainy season (both are associated with decreased food supply, increased prevalence of infection, reduced weight gain, and stunting); and April, late dry season, when environmental conditions are better and rates of weight gain are higher. The prevalence of raised inflammatory markers was high: 29% of ACT values >0.40 g/L in August, 42% >0.40 g/L in October, and 18% >0.40 g/L in April. Of CRP values, 92-96% were >0.47 mg/L and 30%, 46%, and 18% were >3.95 mg/L in August, October, and April, respectively. Also, 42-52% of sialic acid values were >648 mg/L. Of the bone markers, S-CTX exhibited the highest values in August; P1NP did not vary with season. Inverse relationships between each bone marker and the acute phase markers occurred, with the strongest relationships between P1NP and ACT or sialic acid. We conclude that bone collagen synthesis and turnover are reduced during inflammation in rural Gambian boys. Biochemical indices can provide powerful, single-time point evidence of infection and growth-faltering episodes.
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