title: Bone markers during acute burn care: Relevance to clinical practice?
abstract: OBJECTIVE
  Bone changes are increasingly described after burn. How bone markers could help to detect early bone changes or to screen burn patients at higher risk of demineralization is still not made clear. We performed an observational study assessing the changes in serum bone markers after moderate burn.
  
  
  METHODS
  Adults admitted in the first 24h following burn extended on >10% body surface area were included. Serum levels of collagen type 1 cross-linked C-telopeptide (CTX), tartrate-resistant acid phosphatase 5b (TRAP), type 1 procollagen N-terminal (P1NP) and bone alkaline phosphatase (b-ALP) were measured at admission and every week during the first month. Data are expressed as median [min-max].
  
  
  RESULTS
  Bone markers were measured in 20 patients: 18 men, 2 women (including one post-menopausal). Age was 46 [19-86] years old, burn surface area reached 15 [7-85] %. Twelve patients completed the study. All biomarkers mainly remained into normal ranges during evolution. A huge variability was observed regarding biomarkers evolution. Patient's evolution was not linear and could fluctuate from a decrease to an increase of blood concentrations. There was not necessarily a consistency between the two formation or the two resorption markers. Variations observed between two consecutive measurements were lesser than the accepted critical difference in almost one third of the cases.
  
  
  CONCLUSIONS
  Considering available data, role and interest of bone markers in management of burn related bone disease remain unclear.
authors: Burn Centre and General Intensive Care Department, University of Liège, University Hospital, Sart-Tilman, Liège, Belgium. Electronic address: afrousseau@chu.ulg.ac.be.
authors: Anne-Françoise
authors: AF
authors: Rousseau
authors: Burn Centre and General Intensive Care Department, University of Liège, University Hospital, Sart-Tilman, Liège, Belgium.
authors: Pierre
authors: P
authors: Damas
authors: Nephrology Department University of Liège, University Hospital, Sart-Tilman, Liège, Belgium.
authors: Pierre
authors: P
authors: Delanaye
authors: Clinical Chemistry Department, University of Liège, University Hospital, Sart-Tilman, Liège, Belgium.
authors: Etienne
authors: E
authors: Cavalier
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000469:Alkaline Phosphatase / Q000097:blood*; D015415:Biomarkers / Q000097:blood; D001830:Body Surface Area; D016723:Bone Remodeling; D001842:Bone and Bones / Q000378:metabolism; D002056:Burns / Q000097:blood*; D015331:Cohort Studies; D024042:Collagen Type I / Q000097:blood*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010281:Parathyroid Hormone / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D010455:Peptides / Q000097:blood*; D011347:Procollagen / Q000097:blood*; D000071681:Tartrate-Resistant Acid Phosphatase / Q000097:blood*; D014807:Vitamin D / Q000031:analogs & derivatives / Q000097:blood; D055815:Young Adult
chemical_list: D015415:Biomarkers; D024042:Collagen Type I; D010281:Parathyroid Hormone; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C047202:procollagen Type I N-terminal peptide; D014807:Vitamin D; C104450:25-hydroxyvitamin D; C548267:ALPL protein, human; D000469:Alkaline Phosphatase; C000605510:ACP5 protein, human; D000071681:Tartrate-Resistant Acid Phosphatase
keywords: Bone markers; Bone turnover; Burns