The study of bone turnover biochemical markers in delayed puberty
Iulia Bistriceanu1, Aurora Covei4, Elena Neacsu2, Ionut Vasile3, Magda Elvira Preda1 & Marian Bistriceanu2
Background: The delayed puberty is defined by absence of secondary sexual characters until the age of 16 or lack of puberty development until the limit of +2DS in regard to the age when the puberty begin normal at considered population. After the major factor implied in delayed puberty ethiology, can be distinguished three mechanisms: hypothalamic, hypophyseal and gonadal. It is recognized the fact that the osteoporosis process is, in the first place, dependent and interdependent by the deficiency of one or of all sexual hormones, arised during the ontogenesis process.
Methods: Have been included in the study 26 cases with delayed puberty, with ages between 12 and 35 years old, where 14 cases (53.85%) with hypergonadotroph hypogonadism (female Turner syndrome 10 cases; Klinefelter 4 cases) and 12 cases (46.15%) with hypogonadotroph hypogonadism (hypophyseal dwarfism with sexual infantilism 3 cases; functional adipose-genital syndrome 7 cases; tumor-like hypophyseal insufficiency 2 cases). Was evaluated the plasmatic level of the 2 markers of bone turnover (osteocalcine and CrossLap) trough ELISA method. The measuring of the bone mineral density was made by dual absorption with X-rays.
Results: Were identified trough DXA, 10 cases (38.46%) with osteoporosis, where the osteocalcine values (29.4112.96 ng/ml) and CrossLap (0.1971.768 ng/ml) were comparable with those of women in postmenopausal period, 6 cases (23.08%) with osteopenia, and at 10 cases (38.46%). T score value and of biochemical markers were in normal limits.
Conclusions: The paperwork is suggesting two major objectives in therapeutically strategy of existent osteoporosis/osteopenia at delayed puberty cases: precocious diagnosis of gonadal insufficiency, in the purpose of some prophylaxis measures for bone modifications beginning from pre-pubertal, for insuring the stabilization or amounting of bone mass corresponding to sex and age; therapeutically solution associates estro-progestative/androgenic substitution with antiresorbtion or proformation medication.