Broad application prospects of bone turnover markers in pediatrics

Abstract

Background: Bone turnover markers (BTMs) have been studied for application in clinical medicine. However, BTMs in children are challenging, and few studies explore these BTMs in children. The application of BTMs is complicated mainly due to pre-analytical factors, variable reference intervals of age- and sex-related BTMs for adolescents and children in different regions and laboratories. Therefore, laboratory testing of BTMs is critical for understanding pediatric bone development and metabolism, which provides additional information about bone development and diseases.

Methods: Literature search was conducted using the MeSH term "child" combined with the terms that bone turnover markers such as "osteocalcin," "Procollagen type I N-terminal propeptide," "procollagen type I C-terminal propeptide," "osteocalcin," "N-terminal cross-linked telopeptide," and "C-terminal cross-linked telopeptide," Several databases including Web of Science, Google Scholar, and PubMed were searched to obtain the relevant studies.

Results: BTMs represent the combined effects of skeletal development, growth, and remodeling in children, which can be used in clinical pediatrics to assist in the diagnosis and prognosis of bone metabolic disorders.

Conclusion: BTMs are clearly helpful for diagnosis and monitoring of bone growth and development as well as bone metabolic disorders.

Keywords: ALP; CTX; PINP; bone turnover markers; clinical utility; metabolic disease; osteocalcin; pediatrics.

FIGURE 1

Biochemical markers of bone remodeling. BAP, bone alkaline phosphatase; CTX, C‐terminal cross‐linked telopeptide; DPD, deoxypyridinoline; NTX, N‐terminal cross‐linked telopeptide; OC, osteocalcin; PICP, procollagen type I C‐terminal propeptide; PINP, procollagen type I N‐terminal propeptide; PYD, pyridinoline.