Decreased Cortical Bone Density and Mechanical Strength with Associated Elevated Bone Turnover Markers at Peri-pubertal Peak Height Velocity: a Cross-sectional and Longitudinal Cohort Study of 396 Girls with Adolescent Idiopathic Scoliosis

Overview

Journal Osteoporos Int

Specialties Endocrinology
Orthopedics

Date 2021 Oct 13

PMID 34643755

Citations 2

Authors

K G Yang

W Y W Lee

A L H Hung

V W Y Hung

M F Tang

T F Leung

A P S Kong

J C Y Cheng

T P Lam

Affiliations

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Abstract

Introduction: As part of the studies related to aetiopathogenesis of AIS, we assessed bone qualities, bone mechanical strength and bone turnover markers (BTMs) focusing at the peri-pubertal period and PHV in AIS girls.

Methods: 396 AIS girls in two separate cohorts were studied. Skeletal maturity was assessed using the validated thumb ossification composite index (TOCI). Bone qualities and strength were evaluated with high-resolution peripheral quantitative computed tomography (HR-pQCT) and finite element analysis (FEA).

Results: Cohort-A included 179 girls (11.95 ± 0.95 years old). Girls at TOCI-4 had numerically the highest height velocity (0.71 ± 0.24 cm/month) corresponding to the PHV. Subjects at TOCI-4 had lower cortical volumetric BMD (672.36 ± 39.07 mg/mm), cortical thickness (0.68 ± 0.08 mm) and apparent modulus (1601.54 ± 243.75 N/mm) than: (a) those at TOCI-1-3 (724.99 ± 32.09 mg/mm (p < 0.001), 0.79 ± 0.11 mm (p < 0.001) and 1910.88 ± 374.75 N/mm (p < 0.001), respectively) and (b) those at TOCI-8 (732.28 ± 53.75 mg/mm (p < 0.001), 0.84 ± 0.14 mm (p < 0.001), 1889.11 ± 419.37 N/mm (p < 0.001), respectively). Cohort-B included 217 girls (12.22 ± 0.89 years old). Subjects at TOCI-4 had higher levels of C-terminal telopeptide of type 1 collagen (1524.70 ± 271.10 pg/L) and procollagen type 1 N-terminal propeptide (941.12 ± 161.39 µg/L) than those at TOCI-8 (845.71 ± 478.55 pg/L (p < 0.001) and 370.08 ± 197.04 µg/L (p < 0.001), respectively).

Conclusion: AIS girls had decreased cortical bone density and bone mechanical strength with elevated BTMs at PHV. Coupling of PHV with decreased cortical and FEA parameters could provide the link to the previously reported observation that low BMD could contribute as one of the prognostic factors for curve progression that mostly occurs during PHV in AIS.

Citing Articles

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More Prevalent and Severe Low Bone-Mineral Density in Boys with Severe Adolescent Idiopathic Scoliosis Than Girls: A Retrospective Study of 798 Surgical Patients.

Wu Z, Zhu X, Xu L, Liu Z, Feng Z, Hung V J Clin Med. 2023; 12(8).

PMID: 37109327 PMC: 10143180. DOI: 10.3390/jcm12082991.

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