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Effect of glucocorticoids on bone Gla protein values--BGP as a good marker of osteoporosis
1Department of Pediatrics, School of Medicine, University of Occupational and Environmental Health, Kitakyushu, Japan.
Insights
Preventing corticosteroid-induced osteoporosis in children is crucial. This study shows serum Bone Gla protein (BGP) can be a useful marker for early detection of this condition in pediatric patients.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism
- Pharmacology
Background:
- Corticosteroids (CS) can induce osteoporosis, especially in children, by inhibiting osteoblasts.
- Bone Gla protein (BGP) is a marker of bone formation produced by osteoblasts.
- Identifying reliable markers for CS-induced osteoporosis is essential for early intervention.
Purpose of the Study:
- To evaluate the utility of serum Bone Gla protein (BGP) as a biomarker for corticosteroid (CS)-induced osteoporosis in pediatric patients.
- To investigate the relationship between long-term prednisolone (PSL) use, serum BGP levels, and growth suppression in children.
Main Methods:
- Serum BGP levels were measured in 24 pediatric patients receiving long-term prednisolone (PSL) and correlated with their growth rates.
- Serum BGP levels were also determined in 167 healthy children and 16 healthy adults for reference.
- Normal BGP levels in healthy children were established, showing peaks at age 15 for boys and 11 for girls.
Main Results:
- Pediatric patients treated with >0.25 mg/kg/day of PSL exhibited significantly decreased serum BGP levels.
- Height growth was markedly suppressed in pediatric patients with reduced serum BGP levels.
- Serum BGP levels in healthy children peaked at ages 15 (boys) and 11 (girls).
Conclusions:
- Serum BGP measurement is a valuable tool for the early detection of corticosteroid-induced osteoporosis in children.
- Decreased serum BGP levels in pediatric patients correlate with significant growth suppression due to long-term CS treatment.
- BGP serves as a sensitive indicator of impaired bone formation in children undergoing corticosteroid therapy.
Abstract:
It is important to prevent corticosteroid(CS)-induced osteoporosis, particularly in children. One of the mechanisms is a direct inhibitory effect of CS on osteoblasts. Bone Gla protein (BGP) is produced in osteoblasts, and the serum level of BGP reflects the bone formation rate. The aim of this study is to examine the usefulness of BGP as a marker of CS-induced osteoporosis. In the present study, serum levels of 24 pediatric patients who were given prednisolone (PSL) for long periods were studied in relation to their growth rate. Serum BGP was also determined in 167 healthy children and 16 adults. In healthy children, BGP levels reached a peak at the age of 15 years in boys and 11 years in girls. In patients who were given more than 0.25 mg/kg/day PSL, serum BGP levels were significantly decreased and height growth was remarkably suppressed. In conclusion, the measurement of serum BGP is useful for early detection of CS-induced osteoporosis.