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Biochemical markers of bone turnover
P M Crofton1, H F Stirling, E Schönau
1Department of Paediatric Biochemistry, Royal Hospital for Sick Children, Edinburgh, UK.
Hormone Research
|January 1, 1996
Summary
Bone turnover markers, including procollagen type I C-terminal propeptide and bone alkaline phosphatase (BALP), effectively track growth in children. These markers reveal changes during growth hormone therapy, chemotherapy, and corticosteroid treatment.
Area of Science:
- Pediatrics
- Endocrinology
- Biochemistry
Background:
- Assessing bone turnover and growth in children is crucial for monitoring development and treatment efficacy.
- Biochemical markers offer a non-invasive method to evaluate bone metabolism.
- Existing methods may not fully capture dynamic changes in pediatric bone health.
Purpose of the Study:
- To evaluate the utility of procollagen type I C-terminal propeptide, type I collagen cross-linked telopeptide, and bone alkaline phosphatase (BALP) in assessing pediatric bone turnover and growth.
- To correlate changes in BALP with height velocity in children treated with growth hormone.
- To examine the impact of chemotherapy and corticosteroid treatment on bone metabolism markers in children.
Main Methods:
- Study 1: Assessed 50 short normal children treated with growth hormone or placebo, measuring delta BALP and height velocity.
- Study 2: Monitored 12 children with acute lymphoblastic leukemia during chemotherapy, analyzing collagen peptides, BALP, and leg length velocity.
- Study 3: Compared 14 premature infants treated with high-dose dexamethasone to 25 non-steroid-treated infants, measuring collagen peptides, weight, and leg length.
Main Results:
- In growth hormone-treated children, delta BALP strongly correlated with height velocity response.
- Chemotherapy in leukemia patients induced significant changes in bone markers and growth velocity, with suppression and catch-up phases.
- Dexamethasone treatment in infants led to rapid decreases in collagen peptides, weight loss, and leg shrinkage, followed by recovery during steroid weaning.
Conclusions:
- Procollagen type I C-terminal propeptide and BALP are valuable tools for monitoring bone turnover and growth responses in pediatric patients undergoing various treatments.
- These markers can detect significant alterations in bone metabolism during growth hormone therapy, chemotherapy, and corticosteroid administration.
- The findings support the use of these biochemical markers for personalized pediatric care and treatment adjustments.