Laboratory of Pediatric Endocrinology, BoNetwork, San Raffaele Scientific Institute, 20132 Milan, Italy.
J Bone Miner Metab. 2009;27(6):721-6. doi: 10.1007/s00774-009-0092-4. Epub 2009 May 20.
Bones undergo intensive modeling during growth, a process involving both formation and resorption processes. Bone formation can be accurately monitored by measurements of bone-specific alkaline phosphatase (BAP) in serum. The lack of appropriate reference values has hampered the use of BAP in pediatric subjects. The purposes of the present study were to verify the effect of age, gender, and puberty on BAP concentration in healthy children, and to generate reference curves. Morning blood samples were collected from 239 healthy children and adolescents (113 boys), aged 4.5-20.9 years. Anthropometric measurements and pubertal stage were recorded. Blood samples were also obtained from 37 healthy young adults (13 men), aged 21.5-30.2 years. BAP concentration varied significantly with age, showing a peak at age 10-12 years in girls and 12-14 years in boys. Prepubertal concentration of BAP was six- to sevenfold higher than in healthy adults. We observed significantly higher BAP values at the beginning of puberty (stage II) compared to prepubertal stage in both sexes. The effect of puberty was independent from age and gender. We demonstrated that BAP serum concentration varies with age in children and adolescents, and we provided equations to calculate reference values. Because BAP concentrations vary markedly according to the pubertal stage, the values of BAP obtained in single patients should be compared to reference considering not only age and sex, but also the stage of pubertal development.
骨骼在生长过程中经历了密集的重塑，这个过程涉及形成和吸收过程。通过测量血清中骨特异性碱性磷酸酶（BAP）可以准确监测骨形成。由于缺乏适当的参考值，BAP 在儿科患者中的应用受到了阻碍。本研究的目的是验证年龄、性别和青春期对健康儿童 BAP 浓度的影响，并生成参考曲线。采集了 239 名健康儿童和青少年（113 名男性）的清晨血样，年龄 4.5-20.9 岁。记录了人体测量学指标和青春期分期。还采集了 37 名健康年轻成年人（13 名男性）的清晨血样，年龄 21.5-30.2 岁。BAP 浓度随年龄变化显著，女性在 10-12 岁、男性在 12-14 岁时达到峰值。青春期前 BAP 浓度比健康成年人高 6-7 倍。我们观察到，在两性中，与青春期前阶段相比，青春期开始（Ⅱ期）的 BAP 值显著升高。青春期的影响独立于年龄和性别。我们证明了 BAP 血清浓度在儿童和青少年中随年龄变化，并且提供了计算参考值的方程。由于 BAP 浓度根据青春期阶段有很大差异，因此在单个患者中获得的 BAP 值应根据参考值进行比较，不仅要考虑年龄和性别，还要考虑青春期发育阶段。
