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Issue title: Bone Health in Children with Special Health Care Needs
Article type: Research Article
Authors: Stevenson, David A. | Rudser, Kyle | Kunin-Batson, Alicia | Fung, Ellen B. | Viskochil, David | Shapiro, Elsa | Orchard, Paul J. | Whitley, Chester B. | Polgreen, Lynda E.
Affiliations: Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, UT, USA | Division of Biostatistics, University of Minnesota, Minneapolis, MN, USA | Department of Pediatrics, University of Minnesota, Minneapolis, MN, USA | Children's Hospital and Research Center, Oakland, CA, USA
Note: [] Corresponding author: David A. Stevenson, Division of Medical Genetics, University of Utah, 2C412 SOM, SLC, UT 84132, USA. Tel.: +1 801 581 8943; Fax: +1 801 585 7252; E-mail: david.stevenson@hsc.utah.edu
Abstract: PURPOSE: Skeletal disease causes significant morbidity in mucopolysaccharidoses (MPS), and bone remodeling processes in MPS have not been well characterized. The objective of this study was to determine if biomarkers of bone turnover are abnormal in children with specific MPS disorders (i.e. MSP-I, MPS-II, and MPS-VI) compared to healthy children. METHODS: A cross-sectional study was performed of serum biomarkers of bone formation (bone-specific alkaline phosphatase [BSAP], osteocalcin) and urine biomarkers of bone resorption (pyridinoline, deoxypyridinoline) in MPS and healthy controls. Measures of physical function and pain were obtained using the Children's Health Questionnaire (CHQ). RESULTS: The cohort consisted of 39 children with MPS (MPS-I=26; MPS-II=11; MPS-VI=4) and 51 healthy children. Adjusting for sex and Tanner stage group, MPS individuals had statistically significant increases for osteocalcin (p< 0.001), with trends toward higher BSAP (p=0.054) and urinary pyridinoline (p=0.084). These biomarkers were not significantly associated with CHQ bodily pain and physical-function scores. CONCLUSION: Osteocalcin was increased in children with MPS disorders, with trends for increases in BSAP and urinary pyridinoline, suggesting that bone remodeling is altered in children with MPS. Future studies to assess the ability of these biomarkers to quantify and monitor MPS skeletal disease in response to therapy are needed.
Keywords: Bone, lysosomal storage diseases, mucopolysaccharidosis, dysostosis multiplex
DOI: 10.3233/PRM-140285
Journal: Journal of Pediatric Rehabilitation Medicine, vol. 7, no. 2, pp. 159-165, 2014
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