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Bone formation and resorption markers at 7 years of age: Relations with growth and bone mineralization
Teresa Monjardino1, Poliana Silva1, Joana Amaro1
1EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal.
Insights
Bone formation and resorption markers like total alkaline phosphatase (tALP) were assessed in 7-year-olds. tALP correlated with height and weight status, but other markers showed limited correlation with growth or bone density.
Area of Science:
- Pediatric Endocrinology
- Bone Metabolism Research
- Growth and Development Studies
Background:
- Bone turnover markers are crucial for understanding skeletal health in children.
- Limited data exists on bone formation and resorption markers in healthy prepubertal populations.
- Assessing these markers alongside anthropometric and bone density measures can provide insights into growth patterns.
Purpose of the Study:
- To describe bone formation and resorption markers (total alkaline phosphatase [tALP], osteocalcin [OC], and β-isomerized C-terminal telopeptides of type I collagen [β-CTx]) in healthy 7-year-old children.
- To evaluate the correlations between these bone markers and anthropometric growth parameters (height, weight, BMI, weight gain trajectories).
- To investigate the relationship between bone markers and bone mineral content (BMC) and areal bone mineral density (aBMD).
Main Methods:
- A cohort of 395 7-year-old children from the Generation XXI cohort was studied.
- Serum concentrations of tALP, OC, and β-CTx were measured from fasting venous blood samples.
- Bone mineral content (BMC) and areal bone mineral density (aBMD) were assessed using dual-energy X-ray absorptiometry (DXA).
- Gender-specific reference intervals were established, and correlation analyses (Pearson and partial) were performed.
Main Results:
- Total alkaline phosphatase (tALP) showed a positive correlation with height and was higher in overweight children and those with above-average weight gain during infancy.
- Osteocalcin (OC) and β-CTx did not correlate with anthropometric growth measures.
- In girls, OC demonstrated a slight correlation with subtotal BMC and aBMD, and lumbar spine aBMD. tALP and β-CTx were not correlated with DXA-derived bone measures.
Conclusions:
- This study provides reference data for bone turnover markers in 7-year-old children.
- Bone metabolism markers measured at a single time point have limited utility in describing overall anthropometric growth and bone status in healthy prepubertal children.
- Further research may be needed to understand the longitudinal relationship between bone markers and skeletal development.
Purpose:
We aimed to describe bone formation and resorption markers in generally healthy prepubertal children using total alkaline phosphatase (tALP), osteocalcin (OC) and β-isomerized C-terminal telopeptides of type I collagen (β-CTx) serum concentrations and to estimate markers' correlations with anthropometric growth (height, weight, body mass index and trajectories of weight gain) as well as bone mineral content (BMC) and areal density (aBMD).
Methods:
We assessed 395 7-year-old children from the Generation XXI cohort with tALP, OC and β-CTx concentrations determined from a fasting venous blood sample and BMC/aBMD measured by dual-energy X-ray absorptiometry. Gender-specific reference intervals for tALP, OC and β-CTx in 7-year-old children were established by calculating the 2.5th and 97.5th percentiles. Pearson and partial correlation coefficients (controlling for sex, age, body size and season) between bone markers and growth measures were computed.
Results:
tALP increased with height (rpartial controlled for sex = 0.26, 95%CI: 0.17, 0.35), was higher in overweight than in healthy weight children, and in children who gained weight above average during infancy. No correlations were found between OC or β-CTx and growth. In girls, OC was slightly correlated with subtotal BMC (rpartial = 0.22, 95%CI: 0.08, 0.35), subtotal aBMD (rpartial = 0.20, 95%CI: 0.06, 0.33) and lumbar spine aBMD (rpartial = 0.23, 95%CI: 0.09, 0.36). tALP and β-CTx were not correlated with any of the DXA-derived bone measures.
Conclusion:
This study contributed to the description of bone turnover at 7 years of age and suggested that bone metabolism markers measured in a single point in time have limited ability to describe anthropometric growth and overall bone status in generally healthy prepubertal children.
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