Acute uncoupling of bone turnover in children following severe burn injury 1817

Burn injury of ≥ 40% total body surface area(TBSA) results in long-term reduction of bone mineral density(J Pediatr 1995; 126: 252). Bone formation is reduced but measurements of bone

resorption have been equivocal(Bone 1995; 17: 455). We measured biochemical markers of bone formation(serum osteocalcin) and resorption(24h urine N-telopeptide of type I collagen(NTx))

within 48hr of admission for burns ≥ 40%TBSA in order to determine whether bone resorption was significantly altered immediately post-burn. We studied 9 children, 6M, 3F, ages 0.8-13 yr.

Serum osteocalcin, determined by EIA was 6.8 ± 3.4(SD)ng/ml, range 2.2-11 with normal for age of 18-42. These levels were 43± 26% of the LOWER limit of normal for age, while urine

NTx/creatinine was 801 ± 544(mu)mol/mmol, range 376-2167. These levels are 143 ± 36% of the UPPER limit of normal. Simultaneous measurements of the resorptive cytokines, interleukin-1(beta)

and-6, were 4.6± 3.1 pg/ml(n=7) and 249 ± 183 pg/ml, respectively. These levels are approximately 5 and 250 times the upper limit of normal. These data suggest that bone resorption occurs

acutely post-burn and before the patients are immobilized to any significant degree. The mechanism(s) causing the uncoupling of formation and resorption are unclear, but this phenomenon may

initiate the process of post-burn bone loss. AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Pediatrics, Univ Texas Med Branch, Galveston, Texas, USA Gordon L Klein, Craig B Langman, Dawn E

Sailer & David N Herndon * Nephrology, Children's Memorial Hospital and Northwestern Univ Med School, Chicago, Illinois, USA Gordon L Klein, Craig B Langman, Dawn E Sailer & 

David N Herndon * Nephrology, Children's Memorial Hospital and Northwestern Univ Med School, Chicago, Illinois, USA Gordon L Klein, Craig B Langman, Dawn E Sailer & David N Herndon

* Surgery, Univ Texas Med Branch and Shriners Burns Institute, Galveston, Texas, USA Gordon L Klein, Craig B Langman, Dawn E Sailer & David N Herndon Authors * Gordon L Klein View author

publications You can also search for this author inPubMed Google Scholar * Craig B Langman View author publications You can also search for this author inPubMed Google Scholar * Dawn E

Sailer View author publications You can also search for this author inPubMed Google Scholar * David N Herndon View author publications You can also search for this author inPubMed Google

Scholar ADDITIONAL INFORMATION Funded by Shriners Hospitals for Children (8770, GLK) RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Klein, G., Langman,

C., Sailer, D. _et al._ Acute Uncoupling of Bone Turnover in Children following Severe Burn Injury 1817. _Pediatr Res_ 43 (Suppl 4), 310 (1998).

https://doi.org/10.1203/00006450-199804001-01840 Download citation * Issue Date: 01 April 1998 * DOI: https://doi.org/10.1203/00006450-199804001-01840 SHARE THIS ARTICLE Anyone you share the

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