Abstract

BackgroundOur aim was to determinate bone mineral density (BMD), levels of biochemical markers and cytokines in children with chronic hepatitis B treated with interferon (IFN)-alpha and to investigate effect of IFN-alpha therapy on these variables. To the best of our knowledge, this is first study carried out about BMD and cytokine levels in pediatric patients with chronic hepatitis B treated with IFN-alpha.MethodsBMD, levels of parathyroid hormone (PTH), osteocalcin, C-terminal cross-linking telopeptide of type I collagen (CTX), calcium, alkaline phosphates (ALP), cytokines as TNF-alpha, interleukin (IL)-1β, IL-2r, IL-6, and IL-8 were studied in 54 children with chronic hepatitis B (4–15 years old) treated with interferon alone (n = 19) or in combination with lamivudine (n = 35) for six months and as controls in 50 age-matched healthy children.ResultsThere was no significant difference in respect to serum IL-1β, TNF-α and osteocalcin levels while serum IL-2r (p = 0.002), IL-6 (p = 0.001), IL-8 (p = 0.013), PTH (p = 0.029), and CTX (p = 0.021) levels were higher in children with chronic hepatitis B than in healthy controls. BMD of femur neck (p = 0.012) and trochanter (p = 0.046) in patients were higher than in healthy controls. There was a statistically significant correlation between serum IL-1β and osteocalcin (r = -0.355, p < 0.01); between serum IL-8 and CTX levels (r = 0.372, p = 0.01), and ALP (r = 0.361, p = 0.01); between serum ALP and femur neck BMD (r = 0.303, p = 0.05), and trochanter BMD (r = 0.365, p = 0.01); between spine BMD and IL-2R (r = -0.330, p < 0.05).ConclusionIn conclusion, our study suggest that BMD of femur, serum IL-2r, IL-6, IL-8, PTH, and CTX levels were higher in children with chronic hepatitis B treated with IFN-alpha alone or combination with lamivudine than in healthy children. High femur BMD measurements found in patients may suggest that IFN-alpha therapy in children with chronic hepatitis B could contribute indirectly to prevent from hip osteoporosis. Additionally, further investigations on effects of IFN-alpha for bone structure in children should be performed in the future.

Highlights

  • Our aim was to determinate bone mineral density (BMD), levels of biochemical markers and cytokine in children with chronic hepatitis B treated with IFN-alpha and to investigate effect of IFN-alpha therapy on these variables

  • While serum IL-2r (p = 0.002), IL-6 (p = 0.001), IL-8 (p = 0.013), parathyroid hormone (PTH) (p = 0.029), and C-terminal cross-linking telopeptide of type I collagen (CTX) (p = 0.021) levels were higher in children with chronic hepatitis B than in healthy controls, there was no significant different in respect to serum IL-1β, TNF-α and osteocalcin levels

  • While serum PTH and CTX levels were higher in children with chronic hepatitis B than in healthy controls, there was no significant different in respect to serum osteocalcin and alkaline phosphates (ALP) levels

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Summary

Introduction

Our aim was to determinate bone mineral density (BMD), levels of biochemical markers and cytokines in children with chronic hepatitis B treated with interferon (IFN)-alpha and to investigate effect of IFN-alpha therapy on these variables. To the best of our knowledge, this is first study carried out about BMD and cytokine levels in pediatric patients with chronic hepatitis B treated with IFN-alpha. Bone development during childhood and adolescence is a key determinant of adult skeleton health. A reduced bone mass is associated with increased fracture risk in adults as well as in children. Peak bone mass, which is reached by early adulthood, serves as a bone reserve for the remainder of life, childhood and adolescence are crucial periods for bone development. Patients with cirrhosis are living longer, an increasing proportion of such patients are found to have bone disease [4]

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