Markers Of Bone Metabolism In Children Research Articles

Comparative Analysis of Myokines and Bone Metabolism Markers in Prepubertal Vegetarian and Omnivorous Children.

The role of bone and muscle as endocrine organs may be important contributing factors for children's growth and development. Myokines, secreted by muscle cells, play a role in regulating bone metabolism, either directly or indirectly. Conversely, markers of bone metabolism, reflecting the balance between bone formation and bone resorption, can also influence myokine secretion. This study investigated a panel of serum myokines and their relationships with bone metabolism markers in children following vegetarian and omnivorous diets. A cohort of sixty-eight healthy prepubertal children, comprising 44 vegetarians and 24 omnivores, participated in this study. Anthropometric measurements, dietary assessments, and biochemical analyses were conducted. To evaluate the serum concentrations of bone markers and myokines, an enzyme-linked immunosorbent assay (ELISA) was used. The studied children did not differ regarding their serum myokine levels, except for a higher concentration of decorin in the vegetarian group (p = 0.020). The vegetarians demonstrated distinct pattern of bone metabolism markers compared to the omnivores, with lower levels of N-terminal propeptide of type I procollagen (P1NP) (p = 0.001) and elevated levels of C-terminal telopeptide of type I collagen (CTX-I) (p = 0.018). Consequently, the P1NP/CTX-I ratio was significantly decreased in the vegetarians. The children following a vegetarian diet showed impaired bone metabolism with reduced bone formation and increased bone resorption. Higher levels of decorin, a myokine involved in collagen fibrillogenesis and essential for tissue structure and function, may suggest a potential compensatory mechanism contributing to maintaining bone homeostasis in vegetarians. The observed significant positive correlations between myostatin and bone metabolism markers, including P1NP and soluble receptor activator of nuclear factor kappa-B ligand (sRANKL), suggest an interplay between muscle and bone metabolism, potentially through the RANK/RANKL/OPG signaling pathway.

Dietary Intake and Circulating Amino Acid Concentrations in Relation with Bone Metabolism Markers in Children Following Vegetarian and Omnivorous Diets.

Scientific studies reported that most vegetarians meet the total protein requirements; however, little is known about their amino acid intakes. We aimed to assess dietary intake and serum amino acid levels in relation to bone metabolism markers in prepubertal children on vegetarian and traditional diets. Data from 51 vegetarian and 25 omnivorous children aged 4-9 years were analyzed. Dietary intake of macro- and micronutrients were assessed using the nutritional program Dieta 5®. Serum amino acid analysis was performed using high-pressure liquid chromatography technique, 25-hydroxyvitamin D and parathormone-electrochemiluminescent immunoassay, and bone metabolism markers, albumin, and prealbumin levels using enzyme-linked immunosorbent assay. Vegetarian children had a significantly lower intake of protein and amino acids with median differences of about 30-50% compared to omnivores. Concentrations of four amino acids (valine, lysine, leucine, isoleucine) in serum varied significantly by diet groups and were lower by 10-15% in vegetarians than meat-eaters. Vegetarian children also had lower (p < 0.001) serum albumin levels compared to omnivores. Among bone markers, they had higher (p < 0.05) levels of C-terminal telopeptide of collagen type I (CTX-I) than omnivores. Correlation patterns between amino acids and bone metabolism markers differed in the vegetarian and omnivore groups. Out of bone markers, especially osteoprotegerin was positively correlated with several amino acids, such as tryptophan, alanine, aspartate, glutamine, and serine, and ornithine in vegetarians. Vegetarian children consumed apparently sufficient but lower protein and amino acids compared to omnivores. In circulation these differences were less marked than in the diet. Significantly lower amino acid intake and serum levels of valine, lysine, leucine, and isoleucine as well as the observed correlations between serum amino acids and biochemical bone marker levels indicated the relations between diet, protein quality, and bone metabolism.

Research advances in the application of bone metabolic markers in children's diseases associated with growth and development

The incidence of children's growth and development diseases such as rickets, obesity, dwarfism and precocious puberty has increased year by year recently. The occurrence and development of these diseases are often closely related to children's malnutrition and endocrine disorders. Plenty of studies have indicated that bone is not only the structural scaffold of human body, but also an important endocrine and hormone target organ. As a series of substances closely related to bone formation and bone resorption, the levels of bone metabolic markers have been confirmed to change in the course of many children's growth and development diseases. The characteristics, classification and application of bone metabolism markers in children's growth and development related diseases was summarized and commented in this article in order to provide reference for the prevention, early diagnosis and treatment effect monitoring of children's growth and development diseases.

Rapid Hypercalciuria Induction With Bone Formation Marker Reduction During Immobilization in Children

ObjectiveTo prospectively examine the occurrence of hypercalciuria and changes in bone metabolite markers in pediatric patients during immobilization. MethodsIn total, 13 children with an orthopedic disease requiring immobilization longer than 2 weeks were enrolled. Blood samples were collected after breakfast. Urine samples were collected at the second voiding after waking. The urine calcium/creatinine (Ca/Cr) ratio and various bone metabolite parameters were measured before and every 1 to 4 weeks after the start of immobilization. ResultsThe median patient age was 7 years with a range of 2 to 13 years. Orthopedic diseases in the patients were dislocated hip joint (N = 7), slipped capital femoral epiphysis (N = 2), etc. The urine Ca/Cr ratio increased significantly within a week after immobilization (P < .01) and continued to increase for 2 more weeks. Once immobilization ended, the urine Ca/Cr ratio gradually decreased and returned to the normal range approximately 6 weeks after mobility was achieved (P < .01). Serum alkaline phosphatase (ALP) and bone-specific ALP significantly decreased after immobilization began (P < .01). After immobilization ended, the serum ALP returned to preimmobilization levels in 2 to 4 weeks (P < .01). Serum N-terminal telopeptides did not change significantly during immobilization. ConclusionThe urine Ca/Cr ratio immediately increased after immobilization. In contrast to adults, bone formation markers in children decreased during immobilization, whereas bone resorption markers did not increase. To our knowledge, this study is the first to examine bone metabolism markers in children during immobilization.

Evaluation of bone mineral density and bone metabolism markers in children diagnosed as celiac disease

Amaç: Çölyak hastalığında kalsiyum ve D vitamini eksikliğine bağlı metabolik kemik hastalığı en sık ekstraintestinal semptomlardan biridir. Bu çalışmada, çölyak hastalığı olan çocuklarda tanı esnasında kemik mineral yoğunluğunun değerlendirilmesi ve kemik mineral metabolizmasıyla ilişkili faktörlerin değerlendirilmesi amaçlandı.Gereç ve Yöntemler: Çalışmaya hastanemiz çocuk gastroenteroloji bölümünde Aralık 2015-Aralık 2019 tarihleri arasında çölyak hastalığı tanısı alan 43 çocuk hasta alındı. Retrospektif olarak hastaların klinik, antropometrik, patolojik ve laboratuar özellikleri [kalsiyum, fosfor, alkalenfosfataz (ALP), parathormon (PTH), 25-OH vitamin D düzeyleri] incelendi. Tanıda Dual Energy X-Ray Absorptiometry (DEXA) yöntemi ile ölçülmüş olan lumbal (L1-L4) kemik mineral yoğunluğu düzeyleri değerlendirilerek kronolojik yaşa ve boy yaşına göre Z-skorları hesaplandı. Bulgular: Ortalama yaşları 9,9±4,8 (2,5-17,7) yıl olan 43 hastanın (34 kız/9 erkek) verileri değerlendirildi. %30,2’si (n=13) 0-6 yaş, %30,2’si (n=13) 7-11 yaş aralığında ve % 39,5’i (n=17) 11 yaş üzerindeydi. Yaşa göre KMY Z-skoru -0,83±1,1 (-3,6-1,6), boy yaşına göre KMY Z-skoru -0,18±1,1 (-3,6-1,8) saptandı. Hastaların %51,2’sinde (n=22) yaşa göre KMY Z-skoru&amp;gt;-1, %34,9’unda (n=15) -1 ve -2 arasında ve %14’ünde (n=6) &amp;lt;-2 saptandı. Yaşa göre KMY Z-skorunun&amp;lt;-2 olma oranı 11 yaştan büyük çocuklarda anlamı olarak yüksekti (p&amp;lt;0,001). Hastaların KMY Z-skorları ile serum D vitamini, kalsiyum, fosfor, ALP ve PTH düzeyleri arasında ilişki saptanmadı (p&amp;gt;0,050). Sonuç: Çölyak hastalarında tanı yaşının gecikmesi kemik mineral yoğunluğunu olumsuz etkilemektedir. Erken yaşta tanı konulması kemik mineral kaybını engeller ve osteopeni/osteoporoz gelişmiş olan hastalarda tedavi olanağı sağlayarak morbiditeyi azaltır.

Does idiopathic hypercalciuria affect bone metabolism during childhood? A prospective case-control study.

A limited number of studies have evaluated biochemical bone metabolism markers in children with idiopathic hypercalciuria, which in adults has been linked with osteopenia. Our aim was to investigate in children with idiopathic hypercalciuria biochemical markers of bone formation and resorption and the osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kB ligand (sRANKL) system which is involved in the osteoclastogenesis process. A prospective study was conducted on 50 children with idiopathic hypercalciuria and 50 healthy age-, sex-, and Tanner stage-matched control subjects. Following the diagnosis, patients were requested to follow a 3-month dietary recommendation for idiopathic hypercalciuria. In patients, at diagnosis and at 3months of follow-up, and in controls, bone-related hormones and serum/urine biochemical parameters were studied. The bone formation markers (total ALP and osteocalcin) and the bone resorption markers (β-Crosslaps) and the OPG and sRANKL levels were determined. No differences were found in the bone formation markers or OPG and sRANKL between the children with idiopathic hypercalciuria and controls. The β-Crosslaps and the β-Crosslaps/osteocalcin ratio were higher in the patients at diagnosis than in controls (p = 0.019 and p = 0.029, respectively), with a trend to decrease after the 3-month dietary intervention. The initially increased 24-h urinary Ca in the patients decreased after the 3-month dietary intervention (p = 0.002). Children with idiopathic hypercalciuria had biochemical markers compatible with normal bone formation but increased bone resorption. After a 3-month dietary intervention, the trend observed towards decrease in the serum β-Crosslaps may reflect a beneficial response.

Decreased bone mineral density and alteration in biochemical bone metabolism markers in children affected by bone tumors after completion of therapy.

The aim of this study was to assess bone mineral density (BMD) and biochemical bone metabolism markers in patients with bone tumors after anti-cancer treatment. The study included 27 patients (median age 15 years) with malignant bone tumors and 27 healthy children. In all subjects, BMD and body composition were measured by dual-energy x-ray absorptiometry. Serum bone markers were determined by immunoenzymatic assays. After completion of treatment, patients with bone tumors had significantly decreased total and lumbar spine BMD. We observed lower calcium and vitamin Dlevels in patients and comparable values of bone turnover markers (carboxyterminal telopeptide of collagen type I- CTX, bone alkaline phosphatase - BALP and osteocalcin - OC) in both groups of children. However, the level of carboxylated osteocalcin (cOC) was significantly lower (p<0.01) and undercarboxylated OC (ucOC) was higher (p<0.05) in patients than in controls. Additionally, we observed similar values of anthropometric parameters in the subgroups of patients treated with methotrexate (MTX) or without MTX. In patients treated without MTX we found lower (p<0.05) ratio of cOC/ucOC, lower vitamin Dlevel and higher CTX concentrations. Patients with bone tumors after anticancer treatment had decreased bone mineral density and alterations in bone metabolism markers with potential decrease in bone formation. bone cancer survivors, bone mineral density, bone formation markers, bone resorption markers, methotrexate.