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Bone Biomarkers in Intrauterine Growth Restriction

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Book cover Biomarkers in Bone Disease

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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.

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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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Authors and Affiliations

  1. Department of Neonatology, Athens University Medical School, 24, Al. Papagou Street, 14122, Athens, Greece

    Despina D. Briana & Ariadne Malamitsi-Puchner

Authors
  1. Despina D. Briana
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  2. Ariadne Malamitsi-Puchner
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Correspondence to Ariadne Malamitsi-Puchner .

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Editors and Affiliations

  1. Department of Biomedical Sciences, Faculty of Science and Technology, University of Westminster, London, United Kingdom

    Vinood B. Patel

  2. Department of Nutrition and Dietetics, Division of Diabetes and Nutritional Sciences, Faculty of Life Sciences and Medicine, King’s College London, London, United Kingdom

    Victor R. Preedy

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Briana, D.D., Malamitsi-Puchner, A. (2017). Bone Biomarkers in Intrauterine Growth Restriction. In: Patel, V., Preedy, V. (eds) Biomarkers in Bone Disease. Biomarkers in Disease: Methods, Discoveries and Applications. Springer, Dordrecht. https://doi.org/10.1007/978-94-007-7693-7_30

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