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Bone turnover markers and bone mineral density in children with haemophilia
A Tlacuilo-Parra1, J Villela-Rodríguez, R Garibaldi-Covarrubias
1UMAE Hospital de Pediatria, Centro Medico Nacional de Occidente IMSS, Guadalajara, México. albtlacuilo@yahoo.com
Insights
Children with haemophilia and low bone mineral density (BMD) show lower osteocalcin levels, indicating reduced bone formation. Bone resorption markers did not differ between groups.
Area of Science:
- Pediatric Endocrinology
- Hematology
- Bone Biology
Background:
- Childhood bone modeling involves osteoblastic and osteoclastic activity.
- Bone turnover markers correlate with growth and height velocity.
- Children with haemophilia may have altered bone health.
Purpose of the Study:
- To compare serum bone turnover markers in children with haemophilia and normal vs. low bone mineral density (BMD).
Main Methods:
- Cross-sectional study of 69 children with haemophilia.
- Assessed lumbar spine BMD using dual X-ray absorptiometry (DXA) and Z-scores.
- Measured serum osteocalcin (bone formation) and C-telopeptide of type I collagen (bone resorption) via ELISA.
Main Results:
- Children with low BMD had significantly lower mean BMD (0.558 ± 0.12 g cm⁻²) compared to normal BMD (0.656 ± 0.15 g cm⁻²).
- Osteocalcin levels were significantly lower in the low BMD group (7.06 ± 2.17 ng μL⁻¹) versus the normal BMD group (9.29 ± 4.97 ng μL⁻¹).
- No significant differences in C-telopeptide levels were observed between groups (P = 0.169).
Conclusions:
- Diminished osteoblastic bone formation activity, indicated by low osteocalcin, is associated with low BMD in children with haemophilia.
- Bone resorption markers do not differ between children with haemophilia with normal or low BMD.
- Osteocalcin levels account for 10% of the variation in lumbar spine Z-score.
Abstract:
During childhood growth, bone undergoes modelling involving separate osteoblastic and osteoclastic processes. Markers of bone turnover circulate at high concentrations, parallel the childhood growth curve and correlate with height velocity. The aim of this study was to compare serum markers of bone turnover in children with haemophilia and normal bone mineral density (BMD) vs. those with low BMD. In a cross-sectional study, 69 children with haemophilia were evaluated, 45 children with normal spine BMD vs. 24 with low BMD. Lumbar spine BMD was determined using dual X-ray absorptiometry and Z-scores were calculated. Serum samples of markers of bone turnover, osteocalcin (bone formation) and C-telopeptide of type I collagen (bone resorption) were measured using ELISA. The mean BMD (g cm(-2) ) in the normal group was 0.656 ± 0.15 vs. 0.558 ± 0.12 in those with low BMD (P = 0.007), osteocalcin levels in children with normal BMD were 9.29 ± 4.97 vs. 7.06 ± 2.17 ng μL(-1) in the low BMD group (P = 0.012). C-telopeptide levels in the normal group were 1.06 ± 1.4 vs. 0.74 ± 0.3 ng mL(-1) in the low BMD group (P = 0.169). Our results showed that low osteocalcin levels predominated in the group with low BMD, which indicates a diminished osteoblastic bone formation activity while there were no differences with regard to bone resorption markers. Moreover, osteocalcin levels explain 10% of the variation of lumbar spine Z-score.
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