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Serum Osteocalcin in Pediatric Osteogenesis Imperfecta: Impact of Disease Type and Bisphosphonate Therapy

Jakub Krzysztof Nowicki1, Elżbieta Jakubowska-Pietkiewicz1

  • 1Department of Pediatrics, Neonatal Pathology and Metabolic Bone Diseases, Medical University of Lodz, Sporna 36/50, 91-738 Lodz, Poland.

International Journal of Molecular Sciences
|August 28, 2025
PubMed

Insights

Serum osteocalcin levels are elevated in children with osteogenesis imperfecta (OI). Type 3 OI and pamidronate treatment reduce osteocalcin, an important bone formation marker.

Area of Science:

  • Pediatric Endocrinology
  • Bone Metabolism
  • Genetic Disorders

Background:

  • Osteogenesis imperfecta (OI) is a group of genetic disorders characterized by fragile bones.
  • Serum osteocalcin is a marker of bone formation, but its behavior in pediatric OI patients undergoing bisphosphonate treatment is not fully understood.

Purpose of the Study:

  • To investigate factors influencing serum osteocalcin levels in children with OI treated with intravenous sodium pamidronate.
  • To determine the role of osteocalcin assessment in managing pediatric OI.

Main Methods:

  • Retrospective analysis of 61 pediatric patients (ages 2-18) with OI types 1 or 3.
  • Collected data included demographics, fracture history, serum osteocalcin, alkaline phosphatase, 25(OH)D3, creatinine, and DXA BMD z-scores.
  • Analyzed the relationship between osteocalcin levels and OI type, pamidronate treatment, and other clinical factors.

Main Results:

  • Osteocalcin levels were higher in OI patients compared to age- and sex-matched references.
  • Patients with OI type 3 had significantly lower osteocalcin than type 1.
  • Increased pamidronate treatment frequency correlated with reduced osteocalcin levels.
  • OI type was the strongest predictor of osteocalcin concentration; BMD and fracture frequency were not related.

Conclusions:

  • Osteocalcin is elevated in pediatric OI but decreases with pamidronate therapy.
  • OI type is a key determinant of osteocalcin levels.
  • Osteocalcin measurement is valuable at the start of bisphosphonate treatment for pediatric OI.

Keywords:
bonechildrenosteocalcinosteogenesis imperfecta

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