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The relationship between circulating hormone levels, bone turnover markers and skeletal development in healthy boys
Thiberiu Banica1, Sara Vandewalle1, Hans-Georg Zmierczak1
1Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, Ghent, Belgium.
Insights
Bone development in boys during puberty is complex. Hormonal changes and bone markers peak at different stages, showing varied associations with skeletal growth depending on maturation and site.
Area of Science:
- Pediatric Endocrinology
- Bone Biology
- Growth and Development
Background:
- Puberty involves significant skeletal changes driven by hormonal shifts.
- Understanding the interplay between bone turnover, signaling pathways, and growth factors is crucial for assessing skeletal development.
Purpose of the Study:
- To investigate peri-pubertal changes in bone turnover markers, Wnt-signaling markers, insulin-like growth factor-1 (IGF-1), and sex steroids.
- To determine how these markers reflect skeletal development in boys during puberty.
Main Methods:
- A longitudinal study of 118 boys (ages 5.1-17.3 years) with repeated measurements over two years.
- Assessed serum levels of bone turnover markers, IGF-1, Wnt-signaling proteins (osteoprotegerin, sclerostin, dickkopf-1), and sex steroids.
- Utilized dual-energy X-ray absorptiometry (DXA) and peripheral quantitative computed tomography (pQCT) for bone measurements; Tanner staging for pubertal assessment.
Main Results:
- Sex steroids and IGF-1 levels, along with bone mass and size, increased with advancing Tanner stages.
- Bone turnover markers and sclerostin peaked in mid-puberty, then declined.
- Associations between bone markers, sex steroids, and skeletal parameters were significant but varied by pubertal stage and skeletal site.
Conclusions:
- Serum levels of sex steroids, IGF-1, and bone metabolism markers correlate with skeletal development in boys.
- Skeletal development and hormonal associations are nonlinear and depend on maturation stage and skeletal site.
Introduction:
This study investigates peri-pubertal changes in bone turnover markers, Wnt-signalling markers, insulin-like growth factor-1 (IGF-1) and sex steroid levels, and how they reflect skeletal development in peri-pubertal boys.
Materials And Methods:
Population-based study in 118 peri-pubertal boys from the NINIOS cohort (age range at baseline 5.1-17.3 years) with repeated measurements at baseline and after two years. Serum levels of the classical bone turnover markers (BTM) procollagen type 1 N-terminal propeptide and carboxy-terminal collagen crosslinks, as well as sex-hormone binding globulin, IGF-1, osteoprotegerin, sclerostin and dickkopf-1 were measured using immunoassays. Sex steroids (estradiol, testosterone, and androstenedione) were measured using mass spectrometry and free fractions calculated. Dual energy x-ray absorptiometry was used for bone measurements at the lumbar spine and whole body. Volumetric bone parameters and bone geometry at the proximal and distal radius were assessed by peripheral QCT. Pubertal development was categorized based on Tanner staging.
Results:
During puberty, sex steroid and IGF-1-levels along with most parameters of bone mass and bone size increased every next Tanner stage. In contrast, classical bone turnover markers and sclerostin peaked around mid-puberty, with subsequent declines towards adult values in late puberty. Especially classical BTM and sex steroid levels showed consistent associations with areal and volumetric bone parameters and bone geometry. However, observed associations differed markedly according to pubertal stage and skeletal site.
Conclusion:
Serum levels of sex steroids, IGF-1 and bone metabolism markers reflect skeletal development in peri-pubertal boys. However, skeletal development during puberty is nonlinear, and the relations between skeletal indices and hormonal parameters are nonlinear as well, and dependent on the respective maturation stage and skeletal site.
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