title: Biochemical markers of bone turnover in children with clinical bone fragility.
abstract: BACKGROUND
  The role of biochemical bone turnover markers (BTMs) in assessing low bone mass and monitoring bisphosphonate treatment in pediatric patients with clinical bone fragility is not well established. The aim of the study was to examine the correlations of BTMs and the bone mineral density (BMD), and evaluate the effects of bisphosphonates therapy on BTMs in children with clinical bone fragility.
  
  
  METHODS
  Clinical data of 115 patients with clinical bone fragility (mean age 9.7±5.8 years), 102 of whom received bisphosphonates, were studied. Serum alkaline phosphatase (ALP), osteocalcin (OC), urine pyridinoline (PD) and deoxypyridinoline (DPD), BMD at baseline and subsequent years were analyzed.
  
  
  RESULTS
  There was a significant negative correlation between urine PD and lumbar BMD (slope=-0.29, p<0.001). There were no correlations between BTMs and lumbar BMD Z-score. There was a significant positive correlation between serum OC and serum ALP, urine PD and DPD (p<0.001). Serum OC, urine PD and DPD index, as expressed as measured value/upper limit of normal value for age, decreased during the first 3 years of bisphosphonate therapy.
  
  
  CONCLUSIONS
  In children with clinical bone fragility, BTMs correlated with each other, but not with lumbar BMD Z-score. While they were not reliable predictors of degree of low BMD, the bone markers showed suppression during bisphosphonate therapy and may be helpful in monitoring the response to therapy.
authors.forename: Sasigarn A
authors.initials: SA
authors.lastname: Bowden
authors.forename: Chiazor I
authors.initials: CI
authors.lastname: Akusoba
authors.forename: John R
authors.initials: JR
authors.lastname: Hayes
authors.forename: John D
authors.initials: JD
authors.lastname: Mahan
mesh_terms: D000293:Adolescent; D015415:Biomarkers / Q000032:analysis; D015519:Bone Density; D001851:Bone Diseases, Metabolic / Q000188:drug therapy; D016723:Bone Remodeling / Q000187:drug effects; D002648:Child; D002675:Child, Preschool; D004164:Diphosphonates / Q000627:therapeutic use; D005260:Female; D006801:Humans; D008297:Male
chemical_list: D015415:Biomarkers; D004164:Diphosphonates