Université Paris Descartes and AP-HP, Hôpital Bicêtre, Unité d'Endocrinologie Pédiatrique, Le Kremlin Bicêtre, Paris, France.
Bone Marrow Transplant. 2010 Mar;45(3):437-41. doi: 10.1038/bmt.2009.198. Epub 2009 Aug 17.
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.
全身照射（TBI）可导致身材矮小，原因是生长激素（GH）减少和骨骼异常。为了评估骨形成（骨钙素和 I 型前胶原氨基端前肽，P1NP）和吸收（羧基端肽，CTX）标志物的血浆浓度，在接受过 6.6±0.4 岁时接受过 TBI 的患者（n=65）中进行了评估在 9.8±0.4 岁时。接受单次 10 Gy 或分次 12 Gy TBI 的患者具有相似的特征，除了单次 10 Gy 组的血浆胰岛素样生长因子（IGF-1）较低。有 7 人骨钙素较低，2 人 CTX 较高。骨标志物（zs）呈正相关（骨钙素与 P1NP，rho=0.42，P=0.0007；骨钙素与 CTX，rho=0.3，P<0.02），但 P1NP 与 CTX 无相关性。血浆骨钙素和 CTX 与血浆 IGF-1 呈正相关，但与 GH 第一年的生长速度无关（n=28）。成人身高为-2.5±0.2 个标准差（n=49）。那些年轻时接受照射（P=0.0002）或接受单次 TBI 的人，在 TBI 和成人身高之间损失了更多的身高。大多数 TBI 患者的骨形成和吸收标志物正常。因此，骨转换受损可能不是导致他们身材矮小和对 GH 反应不良的原因。
