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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Main Authors: 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
Format: Article
Language:English
Published: MDPI AG 2025-03-01
Series:Diagnostics
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Online Access:https://www.mdpi.com/2075-4418/15/5/630
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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.
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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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