THE ROLE OF BIOCHEMICAL MARKERS IN BONE METABOLISM IN CHILDREN AND ADOLESCENTS. LITERATURE REVIEW

Abstract

Background. Skeletal health is of paramount importance during childhood and adolescence, as it directly influences growth, development, and overall quality of life. Individuals who do not achieve optimal bone mass during these critical periods are at risk of developing osteoporosis, even if they do not experience accelerated bone loss in adulthood. In recent years, biochemical markers have become valuable tools for assessing bone metabolism and turnover. However, interpreting these results remains challenging, as measurements fluctuate based on factors such as age, pubertal stage, growth rate, mineral accumulation, hormonal regulation, nutritional status, circadian and diurnal variations, tissue specificity, and the sensitivity and specificity of analytical methods. Serum markers of bone formation include bone-specific alkaline phosphatase, osteocalcin, and the C- and N-terminal propeptides of type I collagen. Urinary markers of bone resorption include degradation products of type I collagen such as pyridinoline (PYD), deoxypyridinoline (D-PYD), and the Cand N-terminal telopeptides of type I collagen (CTX and NTX).Therefore, it is essential to establish reference values that account for age and sex in each pediatric population, considering their specific climatic conditions and lifestyle factors. Aim. To analyze the literature on the role of bone turnover markers and their reference values in children. Search Strategy: A systematic search was conducted in the PubMed and Google Scholar databases using the following keywords: "bone metabolism markers," "osteopenic syndrome in children," "osteoporosis diagnosis," "C-terminal telopeptide," and "reference values of bone metabolism markers." The search was limited to studies published in English over the past 10 years. 40 sources were reviewed. Discussion. An analysis of the literature indicates that quantitative values of osteocalcin, C-terminal telopeptide of type I collagen, N-terminal propeptide of type I procollagen, and alkaline phosphatase in the blood of healthy children and adolescents from different countries vary considerably and exhibit gender-specific differences. Conclusion. A review of the literature underscores the importance of assessing bone metabolism markers in pediatric populations. Age-specific reference intervals for these markers, taking into account ethnic, gender, and geographic variations, are clinically significant for evaluating bone metabolism in children and adolescents.