Korpysz Alicja, Jaworski Maciej, Skorupa Ewa, Szalecki Mieczysław, Walczak Mieczysław, Petriczko Elżbieta
Department of Endocrinology and Diabetology, "The Children Memorial Health" Institute, 04-736 Warsaw, Poland.
Department of Biochemistry, "The Children Memorial Health" Institute, 04-736 Warsaw, Poland.
Biomedicines. 2024 Aug 21;12(8):1919. doi: 10.3390/biomedicines12081919.
Growth hormone therapy (GHT) can improve growth velocity and final height, but can also accelerate the process of bone growth, which is related to structural bone modeling in both formation and resorption. This study evaluated the capacity of bone turnover markers to predict early growth response to one year of GHT in short stature children born small for gestational age (SGA). This study included 25 prepubertal children born SGA. We estimated P1NP (N-terminal procollagen type 1), CTX (C-terminal telopeptide of collagen type 1), P3NP (N-terminal procollagen type 3), NT-pro-CNP (amino-terminal C-type natriuretic peptide) and Ca-P metabolism using standard ECLIA (electrochemiluminescence), RIA (radioimmunoassay), and ELISA (enzyme-linked immunosorbent assay) methods. A statistically significant increase in bone resorption markers (CTX) was found at both 6 and 12 months. P1NP bone markers were increased at 6 months and after 12 months of therapy. The P3NP marker for collagen synthesis also increased after 12 months of therapy. We obtained significant increases in phosphorus levels at 6 and 12 months, and similar ALP (alkaline phosphatase) increases. We found a significant correlation between height (cm) and CTX after 6-12 months, as well as a P1NP/height (SD) correlation after 12 months. Calcium levels significantly correlated with height (SD) after 12 months. We found strong reactions of bone resorption and bone formation markers during growth hormone therapy, which may determine their selection as predictors of GHT outcome in children born SGA. However, the issue requires further research.
生长激素疗法（GHT）可提高生长速度和最终身高，但也会加速骨骼生长过程，这与骨骼在形成和吸收方面的结构建模有关。本研究评估了骨转换标志物预测小于胎龄儿（SGA）出生的身材矮小儿童对一年GHT早期生长反应的能力。本研究纳入了25名青春期前SGA出生的儿童。我们使用标准电化学发光免疫分析（ECLIA）、放射免疫分析（RIA）和酶联免疫吸附测定（ELISA）方法估计了I型前胶原N端前肽（P1NP）、I型胶原C端肽（CTX）、III型前胶原N端前肽（P3NP）、氨基末端C型利钠肽（NT-pro-CNP）以及钙磷代谢情况。在6个月和12个月时均发现骨吸收标志物（CTX）有统计学意义的升高。P1NP骨标志物在6个月时及治疗12个月后升高。治疗12个月后，胶原合成标志物P3NP也升高。我们在6个月和12个月时磷水平显著升高，碱性磷酸酶（ALP）也有类似升高。我们发现6 - 12个月后身高（厘米）与CTX之间存在显著相关性，以及12个月后P1NP/身高（标准差）之间存在相关性。12个月后钙水平与身高（标准差）显著相关。我们发现在生长激素治疗期间骨吸收和骨形成标志物有强烈反应，这可能决定它们可作为SGA出生儿童GHT结局预测指标的选择。然而，这个问题需要进一步研究。
