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Wiromrat P, Namphaisan P, Wongsurawat N, Panamonta O, Nasomyont N. Elevated bone turnover markers predict bone mineral density accrual in adolescents with 21-hydroxylase deficiency. Clin Endocrinol (Oxf) 2023; 99:462-469. [PMID: 35941818 DOI: 10.1111/cen.14809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 07/25/2022] [Accepted: 08/02/2022] [Indexed: 11/29/2022]
Abstract
CONTEXT Prognostic biomarkers for monitoring bone health in adolescents with 21-hydroxylase deficiency (21OHD) are needed. OBJECTIVES To assess associations between concentrations of baseline bone turnover markers (BTMs) including osteocalcin (OC) and type-I collagen C-terminal telopeptide (CTX) and changes in lumbar spine bone mineral density (LSBMD) in adolescents with classic 21OHD. DESIGNS AND PATIENTS A retrospective-prospective study of 33 adolescents with classic 21OHD who had baseline data for LSBMD, bone age (BA), and BTM concentrations. METHODS BTM concentrations were converted into z-scores according to BA. We measured LSBMD at the follow-up study visit and calculated the annual percentage change in LSBMD (%∆LSBMD). RESULTS At baseline, participants (55% female, 79% Tanner 5) had mean (±SD) age of 14.6 ± 3.6 years, BA 16.7 ± 2.9 years, and average glucocorticoid (GC) dose 17.3 ± 5.6 mg/m2 /day of hydrocortisone equivalent. The mean follow-up duration was 14.4 ± 5.6 months. Median (Q1-Q3) %∆LSBMD was 3.6% (0-8.5)/year. %∆LSBMD was similar among genders or 21OHD subtypes. Prednisolone versus hydrocortisone replacement resulted in lower %∆LSBMD (p = .004). %∆LSBMD was increased across tertiles of CTX z-score (p = .014). %∆LSBMD correlated negatively with GC dose (p = .01) and positively with CTX and OC z-scores (p < .01). In regression analyses, only CTX z-score positively associated with %∆LSBMD (p = .003), adjusting for sex, BA, body mass index, testosterone, 25-hydroxyvitamin D, and GC type and dose. CONCLUSIONS Higher GC dose and the use of prednisolone were associated with decreased LSBMD accrual in adolescents with 21OHD. CTX z-score independently associated with LSBMD accrual, suggesting its potential for prognostic bone biomarker.
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Affiliation(s)
- Pattara Wiromrat
- Section of Endocrinology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Phanpaphorn Namphaisan
- Section of Endocrinology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nantaporn Wongsurawat
- Section of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Ouyporn Panamonta
- Section of Endocrinology, Department of Pediatrics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Nat Nasomyont
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center and Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Sandel AA, Negrey JD, Arponen M, Clark IR, Clift JB, Reddy RB, Ivaska KK. The evolution of the adolescent growth spurt: Urinary biomarkers of bone turnover in wild chimpanzees (Pan troglodytes). J Hum Evol 2023; 177:103341. [PMID: 36905703 DOI: 10.1016/j.jhevol.2023.103341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 02/01/2023] [Accepted: 02/01/2023] [Indexed: 03/11/2023]
Abstract
Life history theory addresses how organisms balance development and reproduction. Mammals usually invest considerable energy into growth in infancy, and they do so incrementally less until reaching adult body size, when they shift energy to reproduction. Humans are unusual in having a long adolescence when energy is invested in both reproduction and growth, including rapid skeletal growth around puberty. Although many primates, especially in captivity, experience accelerated growth in mass around puberty, it remains unclear whether this represents skeletal growth. Without data on skeletal growth in nonhuman primates, anthropologists have often assumed the adolescent growth spurt is uniquely human, and hypotheses for its evolution have focused on other uniquely human traits. The lack of data is largely due to methodological difficulties of assessing skeletal growth in wild primates. Here, we use two urinary markers of bone turnover-osteocalcin and collagen-to study skeletal growth in a large, cross-sectional sample of wild chimpanzees (Pan troglodytes) at Ngogo, Kibale National Park, Uganda. For both bone turnover markers, we found a nonlinear effect of age, which was largely driven by males. For male chimpanzees, values for osteocalcin and collagen peaked at age 9.4 years and 10.8 years, respectively, which corresponds to early and middle adolescence. Notably, collagen values increased from 4.5 to 9 years, suggesting faster growth during early adolescence compared to late infancy. Biomarker levels plateaued at 20 years in both sexes, suggesting skeletal growth continues until then. Additional data, notably on females and infants of both sexes, are needed, as are longitudinal samples. However, our cross-sectional analysis suggests an adolescent growth spurt in the skeleton of chimpanzees, especially for males. Biologists should avoid claiming that the adolescent growth spurt is uniquely human, and hypotheses for the patterns of human growth should consider variation in our primate relatives.
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Affiliation(s)
- Aaron A Sandel
- Department of Anthropology, University of Texas at Austin, WCP 4.102, 2201 Speedway Stop C3200, Austin, TX 78712, USA; Primate Ethology and Endocrinology Lab, University of Texas at Austin, 2201 Speedway Stop C3200, Austin, TX 78712, USA.
| | - Jacob D Negrey
- School of Human Evolution and Social Change, Arizona State University, 900 S. Cady Mall, Tempe, AZ 85281, USA; Department of Pathology/Section on Comparative Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, USA
| | - Milja Arponen
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
| | - Isabelle R Clark
- Department of Anthropology, University of Texas at Austin, WCP 4.102, 2201 Speedway Stop C3200, Austin, TX 78712, USA; Primate Ethology and Endocrinology Lab, University of Texas at Austin, 2201 Speedway Stop C3200, Austin, TX 78712, USA
| | - Jeremy B Clift
- Department of Psychological Science, University of Arkansas, 216 Memorial Hall, Fayetteville, AR 72701, USA
| | - Rachna B Reddy
- Department of Human Evolutionary Biology, Harvard University, 11 Divinity Ave, Cambridge, MA 02138, USA; Department of Psychology, Harvard University, 33 Kirkland St, Cambridge, MA 02138, USA; Department of Evolutionary Anthropology, Duke University, 104 Biological Sciences, Durham, NC 27708, USA
| | - Kaisa K Ivaska
- Institute of Biomedicine, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
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Rand MS, Diemar SS, Møllehave LT, Heidemann M, Thuesen BH, Petersen JH, Johannesen J, Schou AJ, Wedderkopp N, Mølgaard C, Jørgensen NR. Z-scores of bone turnover markers calculated from new established sex- and age-specific reference curves are associated to future change in BMD in children and adolescents. Bone 2023; 167:116641. [PMID: 36481707 DOI: 10.1016/j.bone.2022.116641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/01/2022] [Accepted: 12/01/2022] [Indexed: 12/12/2022]
Affiliation(s)
- Michael Schønemann Rand
- Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark.
| | - Sarah Seberg Diemar
- Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark
| | - Line Tang Møllehave
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Malene Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense, Denmark
| | - Betina Heinsbæk Thuesen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000 Frederiksberg, Denmark
| | - Jørgen Holm Petersen
- Department of Biostatistics, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark
| | - Jesper Johannesen
- Department of Children and Adolescents, Copenhagen University Hospital Herlev, Borgmester Ib Juuls Vej 1, 2730 Herlev, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark; Steno Diabetes Center Copenhagen, Borgmester Ib Juuls vej 83, 2730 Herlev, Denmark
| | - Anders J Schou
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense, Denmark
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Centre of Research in Childhood Health, Department of Regional Health Research, University of Southern Denmark, Campusvej 55, 5000 Odense, Denmark; Department of Orthopaedics, Hospital of Southwest Jutland, Finsensgade 35, 6700 Esbjerg, Denmark
| | - Christian Mølgaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense, Denmark; Clinical Institute, University of Southern Denmark, Campusvej 55, 5000 Odense, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark
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Fujita Y, Kouda K, Ohara K, Nakamura H, Iki M. Maternal pre-pregnancy underweight is associated with underweight and low bone mass in school-aged children. J Bone Miner Metab 2020; 38:878-884. [PMID: 32661733 DOI: 10.1007/s00774-020-01121-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 06/16/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION A number of studies have reported that pre-pregnancy overweight status is associated with offspring obesity, yet only a few studies have examined pre-pregnancy underweight status as it associates with offspring health. The aim of the present study was to assess the effect of pre-pregnancy underweight status in a mother on health outcomes in her offspring. To this end, the primary outcome examined in the present study was underweight status in the offspring, with a secondary outcome of offspring low bone mass. MATERIALS AND METHODS The present retrospective cohort study, conducted from 2008 to 2011, targeted a source population of all students registered as fifth-graders at three public elementary schools in Hamamatsu and Fukuroi cities. Maternal height and weight before and after pregnancy and offspring weight and height at birth were obtained from the Maternal and Child Health Handbook. Offspring weight and height at age 10 years were measured using standard procedures. Offspring total body less head (TBLH) bone mineral content (BMC) was determined with a dual-energy X-ray absorptiometry scanner. RESULTS Pre-pregnancy underweight status was found to be associated with an increased risk of an underweight status in female offspring (OR = 2.88, 95% CI 1.06-7.81). Offspring TBLH BMC in the underweight mother group was significantly lower than that in the non-underweight mother group. CONCLUSIONS We determined that pre-pregnancy underweight status was more likely to lead to an underweight status and low TBLH BMC in school-aged offspring.
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Affiliation(s)
- Yuki Fujita
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan.
| | - Katsuyasu Kouda
- Department of Hygiene and Public Health, Kansai Medical University, Hirakata, Osaka, 573-1010, Japan
| | - Kumiko Ohara
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
| | - Harunobu Nakamura
- Department of Health Promotion and Education, Graduate School of Human Development and Environment, Kobe University, Kobe, 657-8501, Japan
| | - Masayuki Iki
- Department of Public Health, Kindai University Faculty of Medicine, 377-2 Oono-Higashi, Osaka-Sayama, Osaka, 589-8511, Japan
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Rønne MS, Heidemann M, Lylloff L, Schou AJ, Tarp J, Bugge A, Laursen JO, Jørgensen NR, Husby S, Wedderkopp N, Mølgaard C. Bone mass development is sensitive to insulin resistance in adolescent boys. Bone 2019; 122:1-7. [PMID: 30738213 DOI: 10.1016/j.bone.2019.02.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2018] [Revised: 01/29/2019] [Accepted: 02/05/2019] [Indexed: 12/27/2022]
Abstract
PURPOSE Insulin resistance may exert a negative influence on bone mass in childhood and adolescence. The objective was to assess the association between insulin resistance and total body less head (TBLH) bone mineral content (BMC) and to investigate whether body composition, physical activity or osteocalcin levels may influence this association. METHODS A longitudinal study with follow-up over more than 6 years was performed and included 562 apparently healthy participants with a mean age of 9.6 years at baseline. Participants underwent DXA scanning at baseline. At the two follow-ups, participants had performed another DXA scanning, had blood samples taken for fasting insulin, glucose and osteocalcin and had physical activity measured with an accelerometer. HOMA-IR was calculated as an index of insulin resistance. RESULTS HOMA-IR was negatively associated with TBLH BMC in boys at follow-ups (β = -31.4, p < 0.001) after adjustment for maturity, height, bone area, and baseline level of TBLH BMC. The negative association remained almost unchanged after further adjustments for body composition and physical activity. No association between HOMA-IR and TBLH BMC was found in girls. CONCLUSION Insulin resistance may be detrimental for bone development through puberty in boys independent of body composition and the level of physical activity.
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Affiliation(s)
- Maria Sode Rønne
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark.
| | - Malene Heidemann
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark
| | - Louise Lylloff
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; Department of Clinical Biochemistry, Hospital Unit West, Gl. Landevej 61, 7400 Herning, Denmark
| | - Anders J Schou
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark
| | - Jakob Tarp
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark
| | - Anna Bugge
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Physiotherapy and Occupational Therapy, University College Copenhagen, Sigurdsgade 26, 2200 København N, Denmark
| | - Jens Ole Laursen
- Emergency Department, Hospital of South Jutland, Kresten Philipsens Vej 15, 6200 Aabenraa, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Glostrup, Valdemar Hansens Vej 1-23, 2600 Glostrup, Denmark; OPEN, Odense Patient data Explorative Network, Department of Clinical Research, University of Southern Denmark, J.B.Winsløws Vej 9 A, 3, 5000 Odense C, Denmark
| | - Steffen Husby
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark
| | - Niels Wedderkopp
- Research Unit for Exercise Epidemiology, Research in Childhood Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230 Odense M, Denmark; Department of Orthopaedics, Hospital of Southwestern Denmark, Finsensgade 34, 6700 Esbjerg, Denmark
| | - Christian Mølgaard
- Hans Christian Andersen Children's Hospital, Odense University Hospital, Kløvervænget 23C, 5000 Odense C, Denmark; Department of Clinical Research, University of Southern Denmark, Winsløwparken 19, 3, 5000 Odense C, Denmark; Department of Nutrition, Exercise and Sports, University of Copenhagen, Nørre Allé 51, 2200 København N, Denmark
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Di Iorgi N, Maruca K, Patti G, Mora S. Update on bone density measurements and their interpretation in children and adolescents. Best Pract Res Clin Endocrinol Metab 2018; 32:477-498. [PMID: 30086870 DOI: 10.1016/j.beem.2018.06.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Following the increased awareness about the central role of the pediatric age in building bone for life, clinicians face more than ever the necessity of assessing bone health in pediatric subjects at risk for early bone mass derangements or in healthy children, in order to optimize their bone mass accrual and prevent osteoporosis. Although the diagnosis of osteoporosis is not made solely upon bone mineral density measurements during growth, such determination can be very useful in the follow-up of pediatric patients with primary and secondary osteoporosis. The ideal instrument would give information on the mineral content and density of the bone, and on its architecture. It should be able to perform the measurements on the skeletal sites where fractures are more frequent, and it should be minimally invasive, accurate, precise and rapid. Unfortunately, none of the techniques currently utilized fulfills all requirements. In the present review, we focus on the pediatric use of dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), peripheral QCT (pQCT), and magnetic resonance imaging (MRI), highlighting advantages and limits for their use and providing indications for bone densitometry interpretation and of vertebral fractures diagnosis in pediatric subjects.
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Affiliation(s)
- Natascia Di Iorgi
- Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
| | - Katia Maruca
- Pediatric Bone Densitormetry Service and Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Institute, Milano, Italy
| | - Giuseppa Patti
- Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy
| | - Stefano Mora
- Pediatric Bone Densitormetry Service and Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Institute, Milano, Italy.
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Yoon J, Kim DJ, Sung HH, Jo YK. Analysis of Bone Mineral Density according to Hemoglobin in University Students. KOREAN JOURNAL OF CLINICAL LABORATORY SCIENCE 2016. [DOI: 10.15324/kjcls.2016.48.4.296] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Joon Yoon
- Department of Radiologic Technology, Dongnam Health University, Suwon 16328, Korea
| | - Dai-Joong Kim
- Department of Laboratory Medicine, Bundang Jesaeng Hospital, Seongnam 13590, Korea
| | - Hyun-Ho Sung
- Department of Clinical Laboratory Science, Dongnam Health University, Suwon 16328, Korea
| | - Yoon-Kyung Jo
- Department of Clinical Laboratory Science, Dongnam Health University, Suwon 16328, Korea
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