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Bone Biomarkers in Intrauterine Growth Restriction

  • Despina D. Briana
  • Ariadne Malamitsi-PuchnerEmail author
Reference work entry
  • 832 Downloads
Part of the Biomarkers in Disease: Methods, Discoveries and Applications book series (BDMDA)

Abstract

Bone tissue is subject to remodeling during the lifetime of an individual. Through a continuous remodeling cycle, old bone is resorbed by osteoclasts with the formation of cavities that are subsequently filled by osteoblasts, which induce bone formation. Fetal life is associated with a high rate of skeletal growth and intense bone modeling activity. Both fetal and neonatal calcium and bone metabolism are uniquely adapted to meet the specific needs of these developmental periods. The fetus must actively receive sufficient calcium across the placenta to meet the large demands of the rapidly mineralizing skeleton, whereas the neonate must quickly adjust to loss of placental calcium transport, while continuing to undergo rapid skeletal growth. Biochemical markers of bone turnover are reliable indices for measuring changes of bone formation and resorption, reflecting the dynamics of bone metabolism at the cellular level. Due to limitations in the application of bone densitometry during the perinatal period, bone biomarkers are effective alternatives to estimate bone turnover. There is considerable evidence that impaired fetal skeletal growth predisposes to late-onset disorders and an accelerated rate of bone loss during later life. As for other adult diseases, intrauterine growth restriction (IUGR) is considered a risk factor for altered bone growth and osteoporosis development. This notion appears to be confirmed by animal data. However, this is less clear in human IUGR neonates. Some studies show a relationship of fetal growth with bone mineral density (BMD), whereas others do not. Similarly, reports determining bone biomarkers provide evidence of unaltered bone metabolism in IUGR fetuses/neonates, although data are not consistent.

Keywords

Intrauterine growth restriction Fetus Neonate Osteoporosis Bone turnover Biochemical markers 

List of Abbreviations

AGA

Appropriate for gestational age

ALP

Alkaline phosphatase

BALP

Bone-specific alkaline phosphatase

BMC

Bone mineral content

BMD

Bone mineral density

Glu-OC

Undercarboxylated osteocalcin

ICTP

Cross-linked carboxyl terminal telopeptide of type I collagen

IUGR

Intrauterine growth restriction

NTx

N-telopeptide of type 1 collagen

OC

Osteocalcin

OPG

Osteoprotegerin

PICP

Carboxy-terminal propeptide of type I collagen

PINP

Amino-terminal propeptide of type I collagen

PTH

Parathormone

RANKL

Receptor activator of nuclear factor-kB ligand

SGA

Small for gestational age

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Copyright information

© Springer Science+Business Media Dordrecht 2017

Authors and Affiliations

  1. 1.Department of NeonatologyAthens University Medical SchoolAthensGreece

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