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Published on: January 29, 2018
Assessment of Biochemical Bone Turnover Markers and Bone Mineral Density in Thin and Normal-Weight Children
Jadwiga Ambroszkiewicz1, Joanna Gajewska1, Grazyna Rowicka2
11 Screening Department, Institute of Mother and Child, Warsaw, Poland.
Insights
Thin children exhibit poorer bone health, with higher bone resorption and lower bone mineral density. This suggests that undercarboxylated osteocalcin (uc-OC) and increased CTX levels contribute to impaired bone turnover in childhood thinness.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism
- Nutritional Science
Background:
- Thinness in early childhood is under-researched despite potential long-term health implications.
- Bone health and development are critical during childhood for lifelong well-being.
Purpose of the Study:
- To evaluate bone status in thin versus normal-weight children.
- To compare bone mineral density (BMD), bone mineral content (BMC), and biochemical bone turnover markers, including specific osteocalcin forms (carboxylated and undercarboxylated).
Main Methods:
- Study included 80 prepubertal children, divided into thin (n=40) and normal-weight (n=40) groups based on BMI.
- Bone mineral density (BMD) and bone mineral content (BMC) were measured using dual-energy x-ray absorptiometry.
- Serum levels of CTX (bone resorption marker), total osteocalcin (OC), carboxylated osteocalcin (c-OC), and undercarboxylated osteocalcin (uc-OC) were quantified via ELISA.
Main Results:
- Thin children showed significantly higher bone resorption marker CTX compared to normal-weight children.
- While total osteocalcin levels were similar, thin children had higher uc-OC and a lower c-OC/uc-OC ratio.
- Thin children exhibited significantly decreased total BMD and BMC compared to their normal-weight peers.
Conclusions:
- Increased CTX and uc-OC concentrations in thin children may indicate disturbances in bone turnover.
- These biochemical markers and reduced bone mineral density suggest compromised bone health in thin prepubertal children.
- Further research is needed to understand the long-term consequences of childhood thinness on skeletal health.
Abstract:
Objective There is scant research examining the prevalence of thinness in early childhood, despite its potential negative consequences for health and development across the life course. The objective of this study was to assess bone status through measurement of bone mineral density and biochemical bone turnover markers, with special attention paid to carboxylated (c-OC) as well as undercarboxylated (uc-OC) forms of osteocalcin, in the groups of thin and normal-weight children. Design The study included 80 healthy prepubertal children (median age 7.0 years), who were divided (according to Cole's international cutoffs) into 2 subgroups: thin children ( n = 40, body mass index [BMI] = 13.5 kg/m2) and normal-weight children ( n = 40, BMI = 16.1 kg/m2). Bone mineral density (BMD) and bone mineral content (BMC) were assessed by dual-energy x-ray absorptiometry method. Serum concentrations of C-terminal telopeptide of collagen type I (CTX), total osteocalcin (OC), and c-OC, and uc-OC forms of osteocalcin were determined using enzyme-linked immunosorbent assays. Results In thin children, we observed higher levels of bone resorption marker CTX compared with normal-weight peers. Total osteocalcin concentrations were comparable in both groups of children; however, in thin children we observed higher median values of uc-OC (34.40 vs. 29.30 ng/mL, P < 0.05) and similar c-OC levels (25.65 vs. 28.80 ng/mL). The ratio of c-OC to uc-OC was significantly lower ( P < 0.05) in thin than in normal-weight children. Total BMD and BMC were significantly decreased ( P < 0.0001) in thin children compared with normal-weight peers (0.724 ± 0.092 vs. 0.815 ± 0.060 g/cm2 and 602.7 ± 159.2 vs. 818.2 ± 220.1 g, respectively). Conclusion Increased concentrations of CTX and uc-OC might lead to disturbances in bone turnover and a decrease in bone mineral density in thin children.
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