Bone Loss During the Acute Stage Following Burn Injury

Abstract

The aim of this study was to investigate the effect of burn injury on bone metabolism and bone densitometry in the early period. Twenty-one patients with >25% total body surface area (TBSA) burns and 20 healthy controls participated. TBSA burned, ambulation, and functional status were recorded. After 30 days, we measured bone mineral densities of the L1-L4 vertebrae, the left distal forearm, and the left proximal femur in the patients. At 1 and 4 weeks after the burn, changes in bone turnover were assessed in patients by changes in deoxypyridinoline levels in the urine and osteocalcin in the serum and compared with the values of control group. In patients, Z-scores < -1 were found in 71.42% of left distal forearm, 23.80% of left proximal femur, and in 42.85% of L1-L4 vertebrae measurements. No significant correlations existed between Z-scores and TBSA, Functional Ambulation Scale, or Functional Independent Measure. When compared with controls, there was no statistically significant decrease of osteocalcin (a marker of bone formation) levels in patients 1 and 4 weeks after burn injury. However, when compared with controls, a statistically significant difference was found regarding deoxypyridinoline (a marker for bone resorption) in patients 1 and 4 weeks after burn injury (P < .001 and P < .001, respectively). Decreases in bone mineral density occurred during the first month following burn injury, which seemed to be linked with increases in bone resorption during this period. No correlation existed between reduction in bone mineral density and functional status.