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Biomarkers in Body Fluids as Indicators of Skeletal Maturity: A Systematic Review and Meta-analysis
Priyanka Kapoor1,2, Rajiv Balachandran3, Aman Chowdhry1,4
1School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India.
Rambam Maimonides Medical Journal
|September 5, 2023
Summary
Biomarkers like insulin-like growth factor-1 (IGF-1) and alkaline phosphatase (ALP) in bodily fluids show potential for assessing skeletal maturation. Peak IGF-1 and BALP correlate with pubertal growth spurts in both sexes.
Area of Science:
- Biochemistry
- Orthodontics
- Endocrinology
Background:
- Skeletal maturation assessment is crucial in orthodontics and pediatric dentistry.
- Current methods rely on radiographic indices, which involve radiation exposure.
- Identifying non-invasive biomarkers for skeletal maturation is a significant research area.
Purpose of the Study:
- To critically evaluate the evidence for biomarkers in various body fluids (serum, GCF, saliva, urine) for skeletal maturation assessment.
- To compare the efficacy of these biomarkers against standard radiographic indices.
Main Methods:
- A comprehensive literature search was conducted across multiple databases.
- Studies were screened for biomarkers in body fluids used for skeletal maturation assessment.
- Quality assessment using QUADAS-2 and meta-analysis were performed on eligible studies.
Main Results:
- 33 studies met inclusion criteria, analyzing biomarkers like IGF-1, ALP, BALP, DHEAS, DBP, PTHrP, osteocalcin, and serotransferrin.
- Significant increases in IGF-1, DBP, ALP, osteocalcin, TF, and BALP were observed during puberty.
- Meta-analysis showed significant differences in IGF-1 levels between pubertal growth stages.
Conclusions:
- Peak serum IGF-1 and BALP levels correlate with pubertal growth spurts in both sexes.
- Peak GCF ALP levels correlate with pubertal spurt in a combined sample.
- Standardized protocols for biofluid collection and methodology are recommended for future research.
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