Changes in the serum growth factors and osteoprotegerin after bone marrow transplantation: impact on bone and mineral metabolism.
The loss of bone mass often occurs after bone marrow transplantation (BMT), particularly during the early posttransplant period. There are few reports on the role of growth factors and osteoprotegerin (OPG) in the post-BMT bone loss. This study prospectively investigated 110 patients undergoing BMT and analyzed 36 patients who had dual-energy x-ray absorptiometry performed before BMT and 1 yr after BMT. The biochemical markers of bone formation and resorption were measured at the short-term intervals during the year-long follow-up. The serum IGF-I, IGF binding protein (IGFBP)-3, fibroblast growth factor-2, macrophage-colony stimulating factor (M-CSF), and OPG levels were measured before and 1 wk, 3 wk, and 3 months after BMT. The mean bone loss in the lumbar spine and the total proximal femur, which was calculated as the percent change from the baseline to the level at 1 yr, was 5.2% (P < 0.05) and 11.6% (P < 0.01), respectively. During the immediate post-BMT period, bone formation decreased, whereas bone resorption increased, which was indicated by the biochemical markers of bone turnover. The serum IGF-I levels also decreased progressively until 3 wk and then increased to the basal values at 3 months. The serum IGFBP-3 levels decreased progressively until 3 months. The serum fibroblast growth factor-2 levels decreased to the nadir at 1 wk and gradually recovered to the basal values at 3 months. The serum M-CSF levels increased immediately after BMT, which declined to its baseline level by 3 months. The serum OPG levels increased progressively, reached a peak at 3 weeks, and declined thereafter. There were significant correlations between the IGF-I and osteocalcin levels before BMT and at 3 wk after BMT (r = 0.45, P < 0.01; r = 0.54, P < 0.01). During the observation period, the serum IGFBP-3 and M-CSF levels showed positive correlations with the osteocalcin and serum collagen I carboxyl-terminal telopeptide levels, respectively. Although statistically not significant, the OPG levels tended to be positively associated with the serum collagen I carboxyl-terminal telopeptide levels. Significant correlations were observed between the percent changes from the baseline to 1 yr in the bone mineral density at the proximal femur and the serum IGF-I levels at 3 wk and 3 months after BMT (r = 0.52, P < 0.01; r = 0.41, P < 0.05).
Department of Internal Medicine,The Catholic University of Korea, College of Medicine, Seoul 150-010, Korea.
Ki Hyun
KH
Baek
Won Young
WY
Lee
Ki Won
KW
Oh
Hye Soo
HS
Kim
Je Ho
JH
Han
Moo Il
MI
Kang
Bong Yun
BY
Cha
Kwang Woo
KW
Lee
Ho Young
HY
Son
Sung Koo
SK
Kang
Choon Choo
CC
Kim
D000328:Adult; D015415:Biomarkers; D015519:Bone Density; D016026:Bone Marrow Transplantation; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism*; D005260:Female; D016222:Fibroblast Growth Factor 2 / Q000097:blood; D006023:Glycoproteins / Q000097:blood*; D006133:Growth Substances / Q000097:blood*; D006801:Humans; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D016173:Macrophage Colony-Stimulating Factor / Q000097:blood; D008297:Male; D053244:Osteoprotegerin; D011446:Prospective Studies; D018160:Receptors, Cytoplasmic and Nuclear / Q000097:blood*; D018124:Receptors, Tumor Necrosis Factor
D015415:Biomarkers; D006023:Glycoproteins; D006133:Growth Substances; D018972:Insulin-Like Growth Factor Binding Protein 3; D053244:Osteoprotegerin; D018160:Receptors, Cytoplasmic and Nuclear; D018124:Receptors, Tumor Necrosis Factor; C506030:TNFRSF11B protein, human; D016222:Fibroblast Growth Factor 2; D007334:Insulin-Like Growth Factor I; D016173:Macrophage Colony-Stimulating Factor