UMAE Hospital de Pediatria, Centro Medico Nacional de Occidente IMSS, Guadalajara, México.
Haemophilia. 2011 Jul;17(4):657-61. doi: 10.1111/j.1365-2516.2010.02439.x. Epub 2010 Dec 1.
During childhood growth, bone undergoes modelling involving separate osteoblastic and osteoclastic processes. Markers of bone turnover circulate at high concentrations, parallel the childhood growth curve and correlate with height velocity. The aim of this study was to compare serum markers of bone turnover in children with haemophilia and normal bone mineral density (BMD) vs. those with low BMD. In a cross-sectional study, 69 children with haemophilia were evaluated, 45 children with normal spine BMD vs. 24 with low BMD. Lumbar spine BMD was determined using dual X-ray absorptiometry and Z-scores were calculated. Serum samples of markers of bone turnover, osteocalcin (bone formation) and C-telopeptide of type I collagen (bone resorption) were measured using ELISA. The mean BMD (g cm(-2) ) in the normal group was 0.656 ± 0.15 vs. 0.558 ± 0.12 in those with low BMD (P = 0.007), osteocalcin levels in children with normal BMD were 9.29 ± 4.97 vs. 7.06 ± 2.17 ng μL(-1) in the low BMD group (P = 0.012). C-telopeptide levels in the normal group were 1.06 ± 1.4 vs. 0.74 ± 0.3 ng mL(-1) in the low BMD group (P = 0.169). Our results showed that low osteocalcin levels predominated in the group with low BMD, which indicates a diminished osteoblastic bone formation activity while there were no differences with regard to bone resorption markers. Moreover, osteocalcin levels explain 10% of the variation of lumbar spine Z-score.
在儿童生长过程中，骨骼经历了涉及单独成骨细胞和破骨细胞过程的建模。骨转换标志物以高浓度循环，与儿童生长曲线平行，并与身高速度相关。本研究的目的是比较患有血友病且骨矿物质密度（BMD）正常的儿童与 BMD 较低的儿童的骨转换血清标志物。在一项横断面研究中，评估了 69 名血友病儿童，45 名脊柱 BMD 正常的儿童与 24 名 BMD 较低的儿童。使用双能 X 线吸收法测定腰椎 BMD，并计算 Z 评分。使用 ELISA 测定骨转换标志物、骨钙素（骨形成）和 I 型胶原 C 端肽（骨吸收）的血清样本。正常组的平均 BMD（g cm(-2)）为 0.656 ± 0.15，而 BMD 较低组为 0.558 ± 0.12（P = 0.007），正常 BMD 组的骨钙素水平为 9.29 ± 4.97，BMD 较低组为 7.06 ± 2.17 ng μL(-1)（P = 0.012）。正常组的 C 端肽水平为 1.06 ± 1.4，而 BMD 较低组为 0.74 ± 0.3 ng mL(-1)（P = 0.169）。我们的结果表明，低 BMD 组中低骨钙素水平为主，表明成骨细胞骨形成活性降低，而骨吸收标志物无差异。此外，骨钙素水平解释了腰椎 Z 评分变化的 10%。
