Bone markers after total body irradiation in childhood.
Total body irradiation (TBI) can cause short stature because of decreased growth hormone (GH) and skeletal abnormalities. To evaluate the plasma concentrations of markers of bone formation (osteocalcin and procollagen type 1 amino-terminal propeptide, P1NP) and resorption (carboxy-terminal telopeptide, CTX), in patients (n=65) who had been given TBI at 6.6+/-0.4 years were evaluated at 9.8+/-0.4 years. Patients given single 10 Gy or fractionated 12 Gy TBI had similar characteristics, except that plasma insulin-like growth factor (IGF-1) was lower in those given a single 10 Gy. Seven had lower osteocalcin and two had higher CTX than controls. Bone markers (as zs) were positively correlated (osteocalcin with P1NP, rho=0.42, P=0.0007; osteocalcin with CTX, rho=0.3, P<0.02), but not P1NP with CTX. Plasma osteocalcin and CTX were also positively correlated with plasma IGF-1, but not with growth rate during the first year on GH (n=28). Adult height was -2.5+/-0.2 s.d.s. (n=49). Those irradiated when young (P=0.0002) or given single TBI lost more height between TBI and adult height. Most TBI patients had normal bone formation and resorption markers. Thus, impaired bone turnover is probably not the cause of their short stature and poor response to GH.
Couto-Silva
A-C
AC
Université Paris Descartes and AP-HP, Hôpital Bicêtre, Unité d'Endocrinologie Pédiatrique, Le Kremlin Bicêtre, Paris, France.
Trivin
C
C
Espérou
H
H
Michon
J
J
Baruchel
A
A
Souberbielle
J-C
JC
Brauner
R
R
D015415:Biomarkers / Q000097:blood; D001827:Body Height / Q000187:drug effects / Q000528:radiation effects; D001846:Bone Development / Q000528:radiation effects; D016723:Bone Remodeling / Q000187:drug effects / Q000528:radiation effects; D001842:Bone and Bones / Q000187:drug effects / Q000378:metabolism* / Q000528:radiation effects*; D016022:Case-Control Studies; D002648:Child; D024042:Collagen Type I / Q000097:blood; D006130:Growth Disorders / Q000097:blood / Q000209:etiology; D018380:Hematopoietic Stem Cell Transplantation; D019382:Human Growth Hormone / Q000627:therapeutic use; D006801:Humans; D015675:Osteocalcin / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010455:Peptides / Q000097:blood; D011347:Procollagen / Q000097:blood; D011994:Recombinant Proteins / Q000627:therapeutic use; D014916:Whole-Body Irradiation / Q000009:adverse effects*
D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; D011994:Recombinant Proteins; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D015675:Osteocalcin; D019382:Human Growth Hormone