Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis
<b>Background/Objective</b>: With increasing cases of osteoporosis in children and adolescents, the need for timely diagnosis, management, and follow-up has become important. This study aimed to determine whether bone turnover markers (BTMs), particularly serum bone-specific alkaline pho...
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2025-03-01
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| author | Eunha Bae Soo Yeun Sim Su Jin Park Sung Eun Kim Seulki Kim Shin-Hee Kim Won Kyoung Cho Kyoung Soon Cho Min Ho Jung Byung-Kyu Suh Moon Bae Ahn |
| author_facet | Eunha Bae Soo Yeun Sim Su Jin Park Sung Eun Kim Seulki Kim Shin-Hee Kim Won Kyoung Cho Kyoung Soon Cho Min Ho Jung Byung-Kyu Suh Moon Bae Ahn |
| author_sort | Eunha Bae |
| collection | DOAJ |
| description | <b>Background/Objective</b>: With increasing cases of osteoporosis in children and adolescents, the need for timely diagnosis, management, and follow-up has become important. This study aimed to determine whether bone turnover markers (BTMs), particularly serum bone-specific alkaline phosphatase (BsALP) and serum C-telopeptide of collagen type 1 (CTx), accurately reflect BMD. <b>Methods</b>: In this retrospective study, 280 post-puberty males and females who were previously diagnosed with hemato-oncologic, rheumatic, gastrointestinal, and endocrinologic diseases at a single tertiary care center were reviewed. The association between the lumbar spine bone mineral density (LSBMD) Z-scores and BTMs, such as BsALP and CTx, were assessed. The LSBMD was measured in the anterior–posterior direction using DXA, and BTMs were determined using the blood samples obtained. <b>Results</b>: Of the 280 patients, 95 were male (33.9%), and the mean age was 15.4 <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mo>±</mo></semantics></math></inline-formula> 2.07 years. With multivariate regression analysis, LSBMD Z-scores and BsALP showed a negative correlation with <i>p</i> < 0.007, while CTx was not statistically significant. The logistic regression models showed that after adjusting for underlying diseases and sex, as BsALP increased, the probability of LSBMD Z-score being ≤−2 increased with an odds ratio of 1.043 (<i>p</i> = 0.048). When comparing BTMs with vertebral fracture while adjusting for underlying diseases and sex, as BsALP increased, the probability of vertebral fracture increased with an odds ratio of 1.035 (<i>p</i> = 0.005). <b>Conclusions</b>: The positive correlation between BsALP and LSBMD Z-scores being ≤−2, as well as with vertebral fracture after adjusting for underlying diseases and sex, suggests the possible application of BsALP as a predictor of bone health in patients. |
| format | Article |
| id | doaj-art-23e166b4236c40e39d418e80e52169ee |
| institution | DOAJ |
| issn | 2075-4418 |
| language | English |
| publishDate | 2025-03-01 |
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| spelling | doaj-art-23e166b4236c40e39d418e80e52169ee2025-08-20T02:58:58ZengMDPI AGDiagnostics2075-44182025-03-0115563010.3390/diagnostics15050630Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary OsteoporosisEunha Bae0Soo Yeun Sim1Su Jin Park2Sung Eun Kim3Seulki Kim4Shin-Hee Kim5Won Kyoung Cho6Kyoung Soon Cho7Min Ho Jung8Byung-Kyu Suh9Moon Bae Ahn10Department of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of KoreaDepartment of Pediatrics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea<b>Background/Objective</b>: With increasing cases of osteoporosis in children and adolescents, the need for timely diagnosis, management, and follow-up has become important. This study aimed to determine whether bone turnover markers (BTMs), particularly serum bone-specific alkaline phosphatase (BsALP) and serum C-telopeptide of collagen type 1 (CTx), accurately reflect BMD. <b>Methods</b>: In this retrospective study, 280 post-puberty males and females who were previously diagnosed with hemato-oncologic, rheumatic, gastrointestinal, and endocrinologic diseases at a single tertiary care center were reviewed. The association between the lumbar spine bone mineral density (LSBMD) Z-scores and BTMs, such as BsALP and CTx, were assessed. The LSBMD was measured in the anterior–posterior direction using DXA, and BTMs were determined using the blood samples obtained. <b>Results</b>: Of the 280 patients, 95 were male (33.9%), and the mean age was 15.4 <inline-formula><math xmlns="http://www.w3.org/1998/Math/MathML" display="inline"><semantics><mo>±</mo></semantics></math></inline-formula> 2.07 years. With multivariate regression analysis, LSBMD Z-scores and BsALP showed a negative correlation with <i>p</i> < 0.007, while CTx was not statistically significant. The logistic regression models showed that after adjusting for underlying diseases and sex, as BsALP increased, the probability of LSBMD Z-score being ≤−2 increased with an odds ratio of 1.043 (<i>p</i> = 0.048). When comparing BTMs with vertebral fracture while adjusting for underlying diseases and sex, as BsALP increased, the probability of vertebral fracture increased with an odds ratio of 1.035 (<i>p</i> = 0.005). <b>Conclusions</b>: The positive correlation between BsALP and LSBMD Z-scores being ≤−2, as well as with vertebral fracture after adjusting for underlying diseases and sex, suggests the possible application of BsALP as a predictor of bone health in patients.https://www.mdpi.com/2075-4418/15/5/630bone turnover markersbone-specific alkaline phosphatasechildrenadolescentssecondary osteoporosislumbar spine bone mineral density |
| spellingShingle | Eunha Bae Soo Yeun Sim Su Jin Park Sung Eun Kim Seulki Kim Shin-Hee Kim Won Kyoung Cho Kyoung Soon Cho Min Ho Jung Byung-Kyu Suh Moon Bae Ahn Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis Diagnostics bone turnover markers bone-specific alkaline phosphatase children adolescents secondary osteoporosis lumbar spine bone mineral density |
| title | Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis |
| title_full | Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis |
| title_fullStr | Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis |
| title_full_unstemmed | Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis |
| title_short | Bone-Specific Alkaline Phosphatase as a Complementary Diagnostic Marker for the Assessment of Children and Adolescents with Secondary Osteoporosis |
| title_sort | bone specific alkaline phosphatase as a complementary diagnostic marker for the assessment of children and adolescents with secondary osteoporosis |
| topic | bone turnover markers bone-specific alkaline phosphatase children adolescents secondary osteoporosis lumbar spine bone mineral density |
| url | https://www.mdpi.com/2075-4418/15/5/630 |
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