PARTICULAR OF THE BONE METABOLISM IN CHILDREN WITH THE EXTREMITIES’ FRACTURES

Abstract

35 children with extremities’ long bones fractures of the different localization were examined. The medium age (10.5 ± 2.0) years. The control group consisted of 35 healthy children: without pathology of the supporting-motor apparatus, medium age 10.5 ± 3.0. The single study of the systemic and ionized calci-um, phosphorus, magnesium and alkaline concentration and phosphatase’s activity in the blood serum was realized using automatic analyzers «Cobas 6000 SWA» (Roche Diagnostics, Switzerland). The forming and bone resorption process activity was appreciated according to the P1NP (N-terminal propeptide of type I collagen) content in the blood serum, osteocalcin аnd β-СrossLaps (β-isomerized carboxy-terminal cross-linking region of type I collagen) on the modular platform «Cobas 6000 SWA» (Roche Diagnostics,Switzerland). The mineral turnover’s regulation was determined by parathyroid hor-mone, thyrocalcitonin and 25(ОН)-D3 in the blood serum. The growth process activity was determined by content of the somatotropic hormone in the blood serum. Osteocalcin and somatotropic hormone de-termination was done by analyzer «Immulite One» (USА). The statistical processing of the obtained results was carried out with application program package Statistica 6.0 for Windows. The distribution normalcy control was performed using the Kolmogorov-Smirnov's test. Data were presented as Ме ( LQ – UQ ), where Ме is median, ( LQ – UQ ) is interquartile dis-persion. To reveal the differences between groups concerning quantitative readings the Mann–Whitney and Craskell–Wallace tests were used. The disparities were counted as statistically significant in р < 0.05. The correlation analysis was carried out by means of Spearman criterion. Children with extremities’ long bones fractures demonstrated the decrease of the bony tissue synthesis markers P1NP and calcium ions in the blood serum that speaks for the relative predominance of the resorptive activity of the bony tissue against the hypocalcaemia. There was the increase of the parathyroid hormone and somatotropic hormone levels in the blood serum in children with fractures on the back of the absence of the correlation relationship between these values and bony markers that seems to be the return of the disorders of the endocrine control of the bone-mineral turnover. The deceleration of the bony tissue synthesis may be connected with hypocalcaemia conditioned by vitamin D deficit received for most of the examined children. On the other side, rickets D is usually the cause of the secondary hyperparathyroidism that can lead to the bony resorption elevation as a whole, osteomalacia progressing and bone mass decrease and increase of the bone’s fracture risk. The up-to-date diagnostics, treatment and prophylaxis of the vitamin D deficit states in children allow to decrease the osteopenia frequency and to reveal the tendency to the fractures.