Impaired Development of Bone Mineral Density During Chemotherapy: A Prospective Analysis of 46 Children Newly Diagnosed with Cancer
| Autor: | Heikki Kröger, Pekka Riikonen, Jukka S. Jurvelin, Markku Parviainen, Pekka Arikoski, Raimo Voutilainen, Jorma Komulainen |
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| Rok vydání: | 1999 |
| Předmět: |
Male
Peak bone mass medicine.medical_specialty Adolescent Drug-Related Side Effects and Adverse Reactions Bone disease Endocrinology Diabetes and Metabolism Osteocalcin Osteoporosis Urology Collagen Type I Bone resorption Bone remodeling Calcification Physiologic N-terminal telopeptide Bone Density Neoplasms Internal medicine medicine Humans Orthopedics and Sports Medicine Longitudinal Studies Bone Resorption Child Finland Bone mineral Minerals business.industry medicine.disease Peptide Fragments Osteopenia Bone Diseases Metabolic Endocrinology Child Preschool Female Collagen Peptides business Procollagen |
| Zdroj: | Journal of Bone and Mineral Research. 14:2002-2009 |
| ISSN: | 0884-0431 |
| Popis: | Osteopenia and osteoporosis are becoming increasingly recognized in children with cancer, though reasons for these changes are poorly understood. The purpose of the present study was to evaluate longitudinal changes in bone mineral density (BMD) and bone turnover in newly diagnosed children with a malignancy. Lumbar spine (L2-L4) and femoral neck bone mineral density (BMDareal, g/cm2) was measured by dual-energy X-ray absorptiometry in 46 children (age 2.9-16.0, median 8.0 years; 15 leukemias, 12 lymphomas, 19 solid tumors) at diagnosis, and after 6 months from the baseline. The apparent volumetric bone mineral density (BMDvol) was calculated to minimize the effect of bone size on BMD. Serum levels of osteocalcin (OC), type I collagen carboxy-terminal propeptide (PICP), and type I collagen carboxy-terminal telopeptide (ICTP) were analyzed at diagnosis, and during a 6-month follow-up. A significant decrease in lumbar BMDvol (-2.1%, p < 0.05), and in femoral BMDareal (-9.9%, p = 0.0001) and BMDvol (-8.5%, p = 0.0001) was observed after 6 months when compared with baseline measurements. The markers of bone formation (PICP, OC) were significantly decreased, and the marker of bone resorption (ICTP) was significantly increased at diagnosis as compared with normal values. By the end the follow-up, the levels of PICP and OC were normalized, whereas the level of ICTP continued to increase indicating that there was a negative balance in bone turnover. A deficient accumulation of bone mass might predispose children with a malignancy to impaired development of peak bone mass. A controlled study determining the benefits of an early intervention on bone turnover should be considered in these patients. |
| Databáze: | OpenAIRE |
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