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Collagen X Biomarker (CXM), Linear Growth, and Bone Development in a Vitamin D Intervention Study in Infants
Helena H Hauta-Alus1,2,3,4, Elisa M Holmlund-Suila1,2, Saara M Valkama1,2
1Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
Insights
Collagen X biomarker (CXM) shows a weak association with linear growth in infants under 12 months. However, CXM reliably tracks growth velocity in the second year of life, suggesting its utility increases with age.
Area of Science:
- Pediatric Endocrinology
- Biomarker Research
- Growth and Development
Background:
- Collagen X biomarker (CXM) is a proposed indicator of linear growth velocity.
- Limited data exists on CXM's role in early childhood growth.
- Vitamin D supplementation may influence growth and bone development.
Purpose of the Study:
- To investigate the relationship between CXM and linear growth rate in early childhood.
- To assess CXM's association with bone development parameters.
- To examine potential modifying effects of vitamin D supplementation on CXM and growth.
Main Methods:
- Analysis of 276 infants from the Vitamin D Intervention in Infants (VIDI) study.
- CXM and length measurements at 12 and 24 months.
- pQCT measurements of tibial bone parameters (BMC, vBMD, CSA, PMI, PsC) at 12 and 24 months.
- Calculation of linear growth as length velocity and growth rate (SD unit).
Main Results:
- CXM showed a significant association with linear growth over the 2-year follow-up (p=0.041), but not with bone development (p=0.53).
- Higher vitamin D supplementation (30 μg/d) with high CXM levels correlated with accelerated growth at 12 months.
- CXM's association with length velocity and growth rate strengthened significantly by 24 months (p=0.002).
Conclusions:
- CXM may not be a reliable biomarker for linear growth from birth to 12 months.
- The correlation between CXM and growth velocity improves notably during the second year of life.
- Vitamin D supplementation might interact with CXM in influencing infant growth velocity.
Abstract:
Collagen X biomarker (CXM) is suggested to be a biomarker of linear growth velocity. However, early childhood data are limited. This study examines the relationship of CXM to the linear growth rate and bone development, including the possible modifying effects of vitamin D supplementation. We analyzed a cohort of 276 term-born children participating in the Vitamin D Intervention in Infants (VIDI) study. Infants received 10 μg/d (group-10) or 30 μg/d (group-30) vitamin D3 supplementation for the first 2 years of life. CXM and length were measured at 12 and 24 months of age. Tibial bone mineral content (BMC), volumetric bone mineral density (vBMD), cross-sectional area (CSA), polar moment of inertia (PMI), and periosteal circumference (PsC) were measured using peripheral quantitative computed tomography (pQCT) at 12 and 24 months. We calculated linear growth as length velocity (cm/year) and the growth rate in length (SD unit). The mean (SD) CXM values were 40.2 (17.4) ng/mL at 12 months and 38.1 (12.0) ng/mL at 24 months of age (p = 0.12). CXM associated with linear growth during the 2-year follow-up (p = 0.041) but not with bone (p = 0.53). Infants in group-30 in the highest tertile of CXM exhibited an accelerated mean growth rate in length compared with the intermediate tertile (mean difference [95% CI] -0.50 [-0.98, -0.01] SD unit, p = 0.044) but not in the group-10 (p = 0.062) at 12 months. Linear association of CXM and growth rate until 12 months was weak, but at 24 months CXM associated with both length velocity (B for 1 increment of √CXM [95% CI] 0.32 [0.12, 0.52] cm/yr, p = 0.002) and growth rate in length (0.20 [0.08, 0.32] SD unit, p = 0.002). To conclude, CXM may not reliably reflect linear growth from birth to 12 months of age, but its correlation with growth velocity improves during the second year of life. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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