Assesment of bone mineral density and markers of bone turnover in normal short stature children

It is still being discussed if there is a risk of osteopenia and broken bone children who have constitutional delay of growth and puberty (CDGP). This project has been planned to evaluate the density of bone minerals and biochemical indicators of bone metabolism of prepubertal male boys who have familial short stature(FSS) and CDGP.31 children between 6-11 years who have been observed as CDGP, 22 children who have been observed as familial short stature and 27 healthy boy in control group have been included in this research. All patients were male and in prepubertal stage. Serum calcium (Ca) , phosphore (P), alkaline phosphatase (ALP) , osteocalcin (OC), parathormone (PTH) , 25 OH Vitamin D, osteoprotegerin (OPG) , level of deoksipiridinolin (D-pyd) in urinary relation have been researched via DEXA method in the level of lumbar vertebra density of bone minerals between CDGP, FSS and control group.There is no meaningful difference in average and median of calcium phosphore, alkaline phosphatase , parathormone and osteoprotogerin of FSS, CDGP and control group according to parameters from laboratory (p>0.05). While level of 25 OH Vit D in FSS is meaningfully higher than that in control group, differences between FSS and CDGP (p 00.887) and between CDGP and control (p=0.311) are not meaningful. Median of osteokalsin of the children in control group is smaller than the ones in familial and structural short stature. While there is no difference in the level of deoksipiridinolin in urine in FSS and CDGP (z=1.826; p=0.068) and familial and control (Z=0.628; p=0.530) groups; it is higher meaningfully in the CDGP group (Z=2.582; p=0.010). Bone mineral density(BMD) Z score is meaningfully quite low in CDGP when compared with control group (p<0.001). Average Z score of density of bone mineral is similar in the groups of familial and control(p=0.111). It has been observed that there is a direct relation between Z score density of mineral of bone and daily calcium intake (r=0.758; p<0.001). While the link between osteoprotogerin and Z score of bone mineral density children who have familial short stature is reverse, and there is no link found between CDGP and Z score of bone mineral density in control group. There is no link found between Z score of bone mineral density and deoxypyridinoline of urine and 25 OH Vit D. In the children whose bone age is ? 8, Z score median of bone mineral density has been found quite high when compared with familial short stature group statistics. (Z=2.188; p=0.026) Among other parameters , there is no difference in FSS and CDGP. There has beeen found a medium and reverse relation between levels of deoksipiridinolin of urine and osteoprotegerin in the age group of above bone age 8 in the CDGP group. (r=-0.528; p=0.008).As a consequent; bone mineral density in CDGP group has been found low when compared with FSS and control group. The question ?May there be also an effect of nutritional short stature? has been raised in minds because Ca intake in CDGP group was lower than others. Also since level of deoxypyridinoline in urine is so high; inclination to osteoporosis which starts in prepuberty stage , is believed to be increased with delay of puberty.