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Gajewska J, Chełchowska M, Rowicka G, Klemarczyk W, Głąb-Jabłońska E, Ambroszkiewicz J. Assessment of Biochemical Bone Turnover Markers in Polish Healthy Children and Adolescents. JOURNAL OF MOTHER AND CHILD 2024; 28:14-22. [PMID: 38639100 PMCID: PMC11027035 DOI: 10.34763/jmotherandchild.20242801.d-23-00105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 02/09/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Assessing bone turnover in paediatric populations is crucial for understanding the physiological changes occurring during skeletal development and identifying potential abnormalities. The objective of this study was to assess osteocalcin (OC), bone alkaline phosphatase (BALP), and C-terminal telopeptide of type I collagen (CTX-I) levels reflecting bone formation and resorption for age and sex in Polish healthy children and adolescents. MATERIALS AND METHODS A total of 355 healthy normal-weight children and adolescents (46.5% girls) aged 1-18 years old were recruited. Total body less head (TBLH) and spine L1-L4 were used in children to assess bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). Bone marker concentrations were determined by immunoenzymatic methods. RESULTS Bone marker levels in girls and boys started with higher values in the first year of life and subsequently decreased until reaching a nadir during the prepubertal period. The pubertal peak values of bone markers were reached at 11-13 years old in boys and at 9-11 years old in girls. After puberty, the adolescents showed a gradual decline in bone marker concentrations to the values observed in adults. We found positive correlations between OC level and TBLH-BMD (r = 0.329, p = 0.002), TBLH-BMD Z-score (r = 0.245, p = 0.023), and L1-L4 BMD (r = 0.280, p = 0.009) in the prepubertal group. CONCLUSIONS We showed serum levels of bone turnover markers-BALP, OC, and CTX-I-in relation to age and sex in healthy Polish children and adolescents. The age intervals of these markers for girls and boys aged 1-18 years old may be clinically useful in the assessment of bone metabolism in individuals with skeletal disorders.
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Affiliation(s)
- Joanna Gajewska
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Warsaw01-211, Kasprzaka 17a, Poland
| | - Magdalena Chełchowska
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Warsaw01-211, Kasprzaka 17a, Poland
| | - Grażyna Rowicka
- Department of Nutrition, Institute of Mother and Child, Warsaw01-211, Kasprzaka 17aPoland
| | - Witold Klemarczyk
- Department of Nutrition, Institute of Mother and Child, Warsaw01-211, Kasprzaka 17aPoland
| | - Ewa Głąb-Jabłońska
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Warsaw01-211, Kasprzaka 17a, Poland
| | - Jadwiga Ambroszkiewicz
- Department of Screening Tests and Metabolic Diagnostics, Institute of Mother and Child, Warsaw01-211, Kasprzaka 17a, Poland
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Ladang A, Rauch F, Delvin E, Cavalier E. Bone Turnover Markers in Children: From Laboratory Challenges to Clinical Interpretation. Calcif Tissue Int 2023; 112:218-232. [PMID: 35243530 DOI: 10.1007/s00223-022-00964-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/17/2022] [Indexed: 01/25/2023]
Abstract
Bone turnover markers (BTMs) have been developed many years ago to study, in combination with imaging techniques, bone remodeling in adults. In children and adolescents, bone metabolism differs from adults since it implies both growth and bone remodeling, suggesting an age- and gender-dependent BTM concentration. Therefore, specific studies have evaluated BTMs in not only physiological but also pathological conditions. However, in pediatrics, the use of BTMs in clinical practice is still limited due to these many children-related specificities. This review will discuss about physiological levels of BTMs as well as their modifications under pathological conditions in children and adolescents. A focus is also given on analytical and clinical challenges that restrain BTM usefulness in pediatrics.
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Affiliation(s)
- Aurélie Ladang
- Clinical Chemistry Department, CHU de Liège, Liège, Belgium.
| | - Frank Rauch
- Shriners Hospital for Children, McGill University, Montreal, Canada
| | - Edgard Delvin
- Centre & Department of Biochemistry, Ste-Justine University Hospital Research, Université de Montréal, Montreal, Canada
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Relationships between Body Weight Status and Serum Levels of Adipokine, Myokine and Bone Metabolism Parameters in Healthy Normal Weight and Thin Children. J Clin Med 2022; 11:jcm11144013. [PMID: 35887780 PMCID: PMC9320693 DOI: 10.3390/jcm11144013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 07/05/2022] [Accepted: 07/08/2022] [Indexed: 02/06/2023] Open
Abstract
Optimal body weight and body composition for age are relevant to child development and healthy life. Changes in lean mass and fat mass as well as its distribution are associated with alterations in the secretion of myokines and adipokines by muscle and adipose tissues. These factors are very important for bone health. The aim of the study was to assess serum leptin, adiponectin, resistin, visfatin and omentin as adipokines and myostatin and irisin as myokines with regard to their associations with bone parameters in healthy normal weight and thin children. We studied 81 healthy prepubertal children (aged 5 to 9 years) divided into three groups: group A—35 children with a BMI z-score between +1 and −1 SD; group B—36 children with a BMI z-score between −1 and −2 SD; and group C—10 thin children with a BMI z-score of <−2 SD. We observed significantly (p < 0.001) lower fat mass, fat/lean mass ratio and bone mineral density (BMD) across weight status with the lowest values in the group of thin children. We noticed significantly (p < 0.05) lower concentrations of 25-hydroxyvitamin D, resistin and high-molecular-weight (HMW) adiponectin but higher levels of myostatin as the BMI z-score deceased. We found that BMI and leptin levels were directly correlated with fat mass, lean mass, bone mineral content (BMC) and BMD. Resistin levels were negatively associated with lean mass, while visfatin concentrations were positively related to total BMD. In healthy prepubertal children there were differences in body composition and in bone mineral density across decreasing BMI status. We suggest that changes in serum myostatin and 25-hydroxyvitamin D levels may play a role in bone status of thin children. Moreover, significant relations between adipokines and bone parameters may confirm crosstalk between fat tissue and bone in these children.
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Cao B, Liu M, Luo Q, Wang Q, Liu M, Liang X, Wu D, Li W, Su C, Chen J, Gong C. The Effect of BMI, Age, Gender, and Pubertal Stage on Bone Turnover Markers in Chinese Children and Adolescents. Front Endocrinol (Lausanne) 2022; 13:880418. [PMID: 35769079 PMCID: PMC9234688 DOI: 10.3389/fendo.2022.880418] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/22/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To ascertain the associations of serum bone turnover markers (BTMs) levels with body mass index (BMI) in Chinese children and adolescents, and whether the influence of BMI, age, pubertal stage on BTMs varied by gender. METHODS A total of 500 students (180 controls and 320 children and adolescents with overweight/obesity) aged 9-14 years were randomly selected from the Chinese National Survey on Students Constitution and Health Cohort. Serum levels of BTMs, including bone formation marker bone alkaline phosphatase (BAP), collagen type 1 C-terminal propeptide (CICP), and bone resorption markers C-terminal telopeptide of type-I collagen (CTX) were determined by commercial enzyme-linked immunosorbent assay kits. The associations among BMI, age, gender, pubertal stage, and BTMs were analyzed. RESULTS Serum levels of CICP and CTX in overweight/obese children and adolescents were lower than those in controls (p<0.05). Moreover, after subgroup analysis stratified by gender, the decreased serum CICP and CTX levels in overweight/obese children and adolescents were observed only in boys (p<0.05). After adjustment of age and pubertal stage, there was a negative correlation between serum BAP and BMI in both boys and girls (p<0.05). However, the correlations between serum CICP, CTX levels, and BMI were significant in boys but not in girls. Serum BAP and CICP levels were independently correlated with BMI, age, gender, and pubertal stage, while CTX levels were independently correlated with BMI, age, and gender (p<0.05). BAP, CICP, and CTX levels showed a clear age, gender, and pubertal stage dependence with significantly higher values in boys (p<0.05). CONCLUSIONS Our findings support the associations between serum BTMs levels and BMI in Chinese children and adolescents, and suggest age, gender, and pubertal stage differences in this relationship that warrant future studies.
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Affiliation(s)
- Bingyan Cao
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Meijuan Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Qipeng Luo
- Department of Pain Medicine, Peking University Third Hospital, Beijing, China
| | - Qiao Wang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Min Liu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Xuejun Liang
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Di Wu
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Wenjing Li
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Chang Su
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Jiajia Chen
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
| | - Chunxiu Gong
- Department of Endocrinology, Genetics and Metabolism, Beijing Children’s Hospital, Capital Medical University, National Center for Children’s Health, Beijing, China
- *Correspondence: Chunxiu Gong,
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Kim SH, Choi YJ, Ahn MB, Cho WK, Cho KS, Jung MH, Suh BK. Associations between Sclerostin and Anthropometric and Metabolic Parameters in Children and Adolescents. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8090788. [PMID: 34572220 PMCID: PMC8467097 DOI: 10.3390/children8090788] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/16/2021] [Accepted: 09/08/2021] [Indexed: 01/04/2023]
Abstract
(1) Background: Bone plays an important role in the regulation of the systemic glucose and energy metabolism. Sclerostin, secreted by osteocytes, is an inhibitor of the Wnt/β–catenin bone metabolic pathway, and is involved in osteoporosis and metabolic disease. The aim of this study was to investigate the relationship between sclerostin and anthropometric and metabolic parameters in children and adolescents with obesity or who are overweight. (2) Methods: This study included 63 children and adolescents (20 obese, 11 overweight and 32 healthy control subjects). We evaluated the correlation between serum sclerostin and anthropometric parameters, metabolic parameters related to glucose (homeostasis model assessment of insulin resistance [HOMA–IR]), lipid, and bone metabolism (osteocalcin and 25-hydroxy vitamin D). (3) Results: Sclerostin and osteocalcin levels did not differ between obese and control groups. Sclerostin level was higher in boys than in girls (median 20.7 vs. 18.9 pmol/L, respectively; p = 0.04). In all subjects, sclerostin levels were negatively correlated with fasting insulin (r = −0.26; p = 0.04) and HOMA–IR (r = −0.28; p = 0.03), and positively correlated with serum concentrations of triglycerides (r = 0.29; p = 0.04), alkaline phosphatase (r = 0.41; p = 0.002), and osteocalcin (r = 0.33; p = 0.008). In obese patients, sclerostin levels were correlated negatively with fasting glucose (r = −0.49; p = 0.03) and HOMA–IR (r = −0.48; p = 0.03) and positively correlated with triglyceride levels (r = 0.53; p = 0.02). In the healthy control, sclerostin levels were correlated negatively with fasting insulin levels (r = −0.61; p < 0.001) and HOMA–IR (r = −0.36; p = 0.04). After adjusting for age, sex, and height SDS, a negative correlation between sclerostin and HOMA–IR was found (r = −0.39; p = 0.003) in all of the subjects. This association was more evident in obese patients (r = −0.60; p = 0.01) than in healthy controls (r = −0.39; p = 0.047). (4) Conclusions: Among children and adolescents with obesity, serum sclerostin was negatively correlated with HOMA–IR. Further studies are needed to clarify the mechanisms involved to understand how sclerostin affects the glucose metabolism.
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Affiliation(s)
- Shin-Hee Kim
- Department of Medicine, Graduate School, Kyung Hee University, Seoul 02447, Korea;
| | - Yun Jung Choi
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.J.C.); (M.B.A.); (W.K.C.); (K.S.C.); (B.-K.S.)
| | - Moon Bae Ahn
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.J.C.); (M.B.A.); (W.K.C.); (K.S.C.); (B.-K.S.)
| | - Won Kyoung Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.J.C.); (M.B.A.); (W.K.C.); (K.S.C.); (B.-K.S.)
| | - Kyoung Soon Cho
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.J.C.); (M.B.A.); (W.K.C.); (K.S.C.); (B.-K.S.)
| | - Min Ho Jung
- Department of Pediatrics, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Korea
- Correspondence: ; Tel.: +82-2-3779-1131; Fax: +82-2-783-2589
| | - Byung-Kyu Suh
- Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Korea; (Y.J.C.); (M.B.A.); (W.K.C.); (K.S.C.); (B.-K.S.)
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Mohammad Rahimi GR, Niyazi A, Alaee S. The effect of exercise training on osteocalcin, adipocytokines, and insulin resistance: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 2021; 32:213-224. [PMID: 32803318 DOI: 10.1007/s00198-020-05592-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 08/07/2020] [Indexed: 02/07/2023]
Abstract
Recently, it has been reported that osteocalcin (OC), in particular its undercarboxylated (ucOC) form, is not only a bone remodeling marker but also an active hormone that intercedes glucose metabolism in humans. This study aimed to determine the impact of an exercise intervention on ucOC, adiponectin, leptin, and insulin resistance (measured by HOMA-IR). PubMed, CINAHL, Medline, Google Scholar, and Scopus databases and reference lists of included studies were searched. Twenty-two randomized controlled trials (RCTs) of exercise training impact in adults were included in the analysis. Results showed an overall significant increase in serum ucOC (MD: 0.15 ng/ml; 95% CI: 0.05 to 0.25) and adiponectin (MD: 2.83 mg/ml; 95% CI: 1.67 to 3.98), a significant decline in leptin (MD: - 4.89 pg/ml; 95% CI: - 6.94 to - 2.84), fasting glucose (MD: - 2.29 mg/dl; 95% CI: - 4.04 to - 0.54), fasting insulin (MD, - 8.90 μIU/ml; 95% CI: - 13.81 to - 3.98), and HOMA-IR (MD: - 1.96; 95% CI: - 3.11 to - 0.80). However, after removal of studies that had prescribed a balanced diet along with exercise intervention, total OC (TOC) levels also increased in the exercise group compared with the control group (MD: 0.36 ng/ml; 95% CI: 0.07 to 0.65). Our findings demonstrate that exercise-induced increases in ucOC are the probable cause of increased adiponectin. Additionally, increases in ucOC itself are probably due to changes in leptin levels and other factors, rather than its direct impact on bone and its osteoblastic activity. Further studies are required to clarify the mechanisms underlying the impact of exercise training on ucOC, adipocytokines, and insulin resistance.
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Affiliation(s)
- Gh R Mohammad Rahimi
- Department of Sports Sciences, Vahdat Institute of Higher Education, Torbat-e-Jam, Iran.
| | | | - S Alaee
- Department of Physical Education, Islamic Azad University, Neyshabur Branch, Neyshabur, Iran
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Fintini D, Cianfarani S, Cofini M, Andreoletti A, Ubertini GM, Cappa M, Manco M. The Bones of Children With Obesity. Front Endocrinol (Lausanne) 2020; 11:200. [PMID: 32390939 PMCID: PMC7193990 DOI: 10.3389/fendo.2020.00200] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
Excess adiposity in childhood may affect bone development, ultimately leading to bone frailty. Previous reports showing an increased rate of extremity fractures in children with obesity support this fear. On the other hand, there is also evidence suggesting that bone mineral content is higher in obese children than in normal weight peers. Both adipocytes and osteoblasts derive from multipotent mesenchymal stem cells (MSCs) and obesity drives the differentiation of MSCs toward adipocytes at the expense of osteoblast differentiation. Furthermore, adipocytes in bone marrow microenvironment release a number of pro-inflammatory and immunomodulatory molecules that up-regulate formation and activation of osteoclasts, thus favoring bone frailty. On the other hand, body adiposity represents a mechanical load, which is beneficial for bone accrual. In this frame, bone quality, and structure result from the balance of inflammatory and mechanical stimuli. Diet, physical activity and the hormonal milieu at puberty play a pivotal role on this balance. In this review, we will address the question whether the bone of obese children and adolescents is unhealthy in comparison with normal-weight peers and discuss mechanisms underlying the differences in bone quality and structure. We anticipate that many biases and confounders affect the clinical studies conducted so far and preclude us from achieving robust conclusions. Sample-size, lack of adequate controls, heterogeneity of study designs are the major drawbacks of the existing reports. Due to the increased body size of children with obesity, dual energy absorptiometry might overestimate bone mineral density in these individuals. Magnetic resonance imaging, peripheral quantitative CT (pQCT) scanning and high-resolution pQCT are promising techniques for the accurate estimate of bone mineral content in obese children. Moreover, no longitudinal study on the risk of incident osteoporosis in early adulthood of children and adolescents with obesity is available. Finally, we will address emerging dietary issues (i.e., the likely benefits for the bone health of polyunsaturated fatty acids and polyphenols) since an healthy diet (i.e., the Mediterranean diet) with balanced intake of certain nutrients associated with physical activity remain the cornerstones for achieving an adequate bone accrual in young individuals regardless of their adiposity degree.
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Affiliation(s)
- Danilo Fintini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
- *Correspondence: Danilo Fintini
| | - Stefano Cianfarani
- Diabetes and Growth Disorders Unit, Dipartimento Pediatrico Universitario Ospedaliero Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Marta Cofini
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Angela Andreoletti
- Pediatric Resident, Pediatric Clinic, University of Brescia, Brescia, Italy
| | - Grazia Maria Ubertini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Marco Cappa
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Bambino Gesù Children's Hospital, Rome, Italy
- Melania Manco
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Salgueiro M, Stribos M, Zhang LF, Stevens M, Awad ME, Elsalanty M. Value of pre-operative CTX serum levels in the prediction of medication-related osteonecrosis of the jaw (MRONJ): a retrospective clinical study. EPMA J 2019; 10:21-29. [PMID: 30984311 PMCID: PMC6459452 DOI: 10.1007/s13167-019-0160-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2018] [Accepted: 01/11/2019] [Indexed: 12/21/2022]
Abstract
OBJECTIVES The low incidence yet severe presentation of medication-related osteonecrosis of the jaw (MRONJ) makes it necessary to develop reliable predictive and preventive strategies. This study explored the value of pre-operative carboxy-terminal collagen crosslinks (CTX) serum level in the prediction of osteonecrosis-related complications in patients on bisphosphonate therapy. PATIENTS AND METHODS We examined patient records over 4 years (a total of 137 patients). Biometric data were extracted, in addition to type of treatment, CTX levels, drug holiday, procedure, complications, and co-morbidities. Non-parametric Wilcoxon two-sample tests were used to test the effect of initial CTX level in IV or PO and whether it was predictive of complications. Two independent proportion tests were used for testing the two different complication incident rates before or after the drug holiday. RESULTS A total of 93 patients were included in the study, of whom 88.17% were female. A total of 11 patients were receiving IV bisphosphonates at the time of initial presentation, 82 oral bisphosphonates. Out of 64 patients who underwent invasive dental procedure (IDP) before a drug holiday, eight were on IV bisphosphonates. Three patients in this group experienced osteonecrosis-related complications (37.5%). Out of the remaining 56 patients on oral bisphosphonates, four (7.14%) developed complications, significantly lower than the IV bisphosphonate group (p = 0.0364). On the other hand, of the 34 patients placed on a drug holiday prior to IDP, only one subject developed complications related to osteonecrosis. Five subjects who had operations both before and after drug holiday did not experience any complications. No statistical difference was detected in complication rates based on initial CTX level (above versus below 150 pg/ml), gender, comorbidities, or total duration of bisphosphonate treatment (p = 0.2675). The sensitivity and specificity of CTX cutoff of 150 pg/ml in predicting osteonecrosis were 37.5% and 57.7, respectively. CONCLUSIONS Serum levels of CTX by itself are not reliable as a predictive or preventive measure for such complications. Our data also suggested that a drug holiday of 5 months was not helpful in preventing osteonecrosis-related complications in patients on intravenous bisphosphonates. Further studies are urgently needed to develop adequate predictive and preventive strategies of MRONJ.
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Affiliation(s)
- Martin Salgueiro
- Oral and Maxillofacial Surgery Department, Dental College of Georgia, Augusta University, Augusta, GA USA
| | - Michael Stribos
- Medical Student, Medical College of Georgia, Augusta University, Augusta, GA USA
| | - Li Fang Zhang
- Department of Biostatistics and Epidemiology, Medical College of Georgia, Augusta University, Augusta, GA USA
| | - Mark Stevens
- Oral and Maxillofacial Surgery Department, Dental College of Georgia, Augusta University, Augusta, GA USA
| | - Mohamed E. Awad
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA USA
| | - Mohammed Elsalanty
- Department of Oral Biology and Diagnostic Sciences, Dental College of Georgia, Augusta University, Augusta, GA USA
- Department of Oral Biology, Dental College of Dentistry, Augusta University, 1120 15th Street, Room #2404E, Augusta, GA 30809 USA
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