Alteration of Bone Metabolism Markers According to the Progression of Puberty / 소아과

ABSTRACT

PURPOSE: The object of this study is to evaluate bone metabolism in healthy adolescents according to the progression of puberty. METHODS: Forty boys(13.9+/-1.7 years) and 42 girls(12.1+/-1.6 years) were classified by Tanner stage (TS) and bone age. Serum levels of osteocalcin(OC) and bone specific alkaline phosphatase(BALP) were measured as bone formation markers. Serum level of C-terminal telopeptide of type I collagen (ICTP) and urinary N-terminal telopeptide of type I collagen(NTx) concentrations adjusted by creatinine concentrations were measured as bone resorption markers. Serum or urine levels of bone turnover markers in each pubertal development group and bone age group were analysed. RESULTS: In boys, BALP and OC levels increased to peak levels significantly(P<0.05), and decreased significantly(P<0.05) from the peak levels to the levels at TS 5. ICTP and NTx levels seemed to increase to peak levels and to decrease from the peak levels to the levels at TS 5. But there were no significant differences except decreasing NTx levels. All showed peak levels between 13 and 15 years of bone age. In comparison with each TS group, BALP and OC levels were significantly different(P<0.05) between each TS group, but ICTP and NTx were not. In girls, the levels of all bone markers seemed to increase to peak levels without significance, and then decrease significantly(P< 0.05). All showed peak levels between 11 and 13 years of bone age. All except ICTP level were significantly different between each TS group(P<0.05). CONCLUSION: The bone metabolism seems to increase as progression of puberty, and to decrease during late puberty. Bone formation markers levels change more actively, rather than bone resorption markers levels during puberty. And the increment of bone formation in early puberty is more significant in boys rather than in girls.