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Relationship between bone mineral content and bone turnover markers, sex hormones and calciotropic hormones in pre- and early pubertal children

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Abstract

Summary

We investigated associations between bone mineral content (BMC) and bone-related biomarkers (BM) in pre-and early pubertal children of both sexes. In this population, we found that bone turnover markers explain a small part of BMC variance.

Introduction

It is still debated whether BM including bone turnover markers (BTM), sex hormones and calciotropic (including cortisol) hormones provide information on BMC changes during growth.

Methods

Three hundred fifty-seven girls and boys aged 6 to 13 years were included in this study. BM was measured at baseline and BMC twice at 9 months and 4 years using DXA. Relationship between BMs was assessed using principal component analysis (PCA). BM was tested in its ability to explain BMC variation by using structural equation modelling (SEM) on cross-sectional data. Longitudinal data were used to further assess the association between BM and BMC variables.

Results

BMC and all BMs, except calciotropic hormones, increased with age. PCA in BM revealed a three-factor solution (BTM, sex hormones and calciotropic hormones). In the SEM, age accounted for 61% and BTM for 1.2% of variance in BMC (cross-sectional). Neither sex nor calciotropic hormones were BMC explanatory variables. In the longitudinal models (with single BM as explanatory variables), BMC, age and sex at baseline accounted for 79–81% and 70–75% in BMC variance at 9 months and 4 years later, respectively. P1NP was consistently associated with BMC.

Conclusion

BMC strongly tracks in pre- and early pubertal children. In this study, only a small part of BMC variance was explained by single BTM at the beginning of pubertal growth.

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Abbreviations

BM:

Biomarkers (including all markers measured in the blood)

BTM:

Bone turnover marker

CORT:

Cortisol

CTX:

C-terminal telopeptide

DHEAS:

Dehydroepiandrosterone sulphate

DXA:

Dual-energy X-ray absorptiometry

E2 :

Estradiol

FN:

Femoral neck

LS:

Lumbar spine

OCN :

Osteocalcin

25(OH)D:

25-Hydroxy vitamin D/calcifediol

PCA:

Principal component analysis

P1NP :

N-terminal propeptide

PROGE:

Progesterone

PTH:

Intact parathyroid hormone

SEM:

Structural equation modelling

SHBG:

Sex hormone-binding globulin

TEST:

Testosterone

WB:

Whole body

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Acknowledgements

We sincerely thank all children, teachers and parents for taking part in the study. We greatly appreciate the help of Giulio Conicella, Chantal Genet and Claude Kränzlin for their competent help in the bone measurements. We thank the foundation AETAS, Switzerland, for the use of their DXA-bus, the Swiss Heart Foundation for financial support of the current study and the funders of the initial study (KISS) including the Federal Council of Sports, Magglingen, Switzerland (grant number SWI05-013), and the Swiss National Foundation (grant number PMPDB-114401). And finally, also thanks to Erin Ashley West for proof-reading the manuscript.

Funding

This study was funded by the Swiss Heart Foundation. Funding for the initial trial (Effect of a general school-based physical activity intervention on bone mineral content and density) was provided by Swiss Federal Office of Sports and the Swiss National Science Foundation.

Author information

Authors and Affiliations

  1. Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Hirschengraben 84, 8001, Zürich, Switzerland

    S. J. Zürcher & S. Kriemler

  2. Personality Psychology, Differential Psychology and Personality Assessment (PDD), University of Bern, Bern, Switzerland

    N. Borter

  3. Division of Endocrinology, Diabetes, Metabolism and Bone Research, University Hospital Basel, and Endonet, Basel, Switzerland

    M. Kränzlin

  4. Department of Laboratory Medicine, Kantonsspital Aarau, Aarau, Switzerland

    P. Neyer

  5. Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland

    U. Meyer

  6. Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland

    R. Rizzoli

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  1. S. J. Zürcher
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Correspondence to S. Kriemler.

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ESM 1

Fig. 1 appendix. Study flow diagram: relation between bone mineral content and bone turnover markers, sex hormones and calciotropic hormones in pre- and early pubertal children (PPTX 35 kb)

Appendix

Appendix

Table 4 Percentile distribution (5th, 50th and 95th percentile) of biomarkers (SI units) by sex and different age groups at baseline (T0)
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Table 5 Results of different structural equation models using different sets of predictors (models a, b, c, d and e) explaining variability of BMC by calciotropic hormones, sex hormones, bone turnover markers and age (n = 309)
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Zürcher, S.J., Borter, N., Kränzlin, M. et al. Relationship between bone mineral content and bone turnover markers, sex hormones and calciotropic hormones in pre- and early pubertal children. Osteoporos Int 31, 335–349 (2020). https://doi.org/10.1007/s00198-019-05180-7

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