Impact of Skeletal Maturation on Bone Metabolism Biomarkers and Bone Mineral Density in Healthy Brazilian Adolescents
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Bone biomarkers
Bone mineral density
Bone age



Submitted : 2023-03-21
Accepted : 2023-04-05
Published : 2023-04-20


This study was conducted to evaluate the behavior of biomarkers in the bone formation and resorption in Brazilian adolescents according to their biological maturation. Eighty-seven volunteers were selected and divided into three groups according to their bone age (BIA); 10-12 years (n=25), 13-15 years (n=36) and 16-18 years (n=26). Few parameters and biomarkers such as, the weight (kg), height (m), body mass index (kg/m2), 3-day calcium intake (mg/day), assessment of pubertal events by Tanner criteria, levels of the biomarkers [osteocalcin (OC) (ng/mL), bone alkaline phosphatase (FAO) (U/L), and serum carboxy–terminal telopeptide (S–CTx) (ng/mL)] and their correlation with bone mineral density (BMD) (g/cm2) were measured by dual–energy X–ray attenuation of the lumbar spine, proximal femur and total body in each volunteer. The results showed that, all the biomarkers have similar behaviors, showing a higher median value for 13 to 15 years (FAO=154.71 U/L, OC=43.0 ng/mL, S–CTx=2.09 ng/mL; p<0.01) at the pubertal stage G4, and the median is decreased with the advancing IO and sexual maturation level. Additionally, the biomarker levels showed a parallelism with a peak velocity in the stature level, and interestingly, the training biomarkers indicated a negative correlation with BMD where high BMD values correlated with the low biomarker values. In conclusion, this is the first study were conducted in Brazilian adolescents with strict, and careful inclusion and exclusion criteria to assess the correlation between the bone markers and BMD against the indicators of biological maturation. The results of this study may help to understand and monitor the bone turnover and bone metabolism respectively.