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Citation
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Muschitz GK, Schwabegger E, Kocijan R, Baierl A, Moussalli H, Fochtmann A, Nickl S, Tinhofer I, Haschka J, Resch H, Rath T, Pietschmann P, Muschitz C. J. Clin. Endocrinol. Metab. 2016; 101(4): 1506-1515. |
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Abstract
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CONTEXT: Severe burn injury causes a massive stress response, consecutively heightened serum levels of acute phase proteins, cortisol and catecholamines with accompanying disturbance in calcium metabolism.
OBJECTIVE: Evaluation of early and prolonged changes of serum bone turnover markers (BTM) and regulators of bone metabolism.
DESIGN: Longitudinal observational design. SETTING: University clinic. PATIENTS: 32 male patients with a median age of 40.5 years and a median burned total body surface area (TBSA) of 40% (83% patients with full thickness burn injury). INTERVENTIONS: None. MAIN OUTCOME MEASURES: Comparison of changes of BTM/regulators of bone metabolism in the early (days 2 - 7) and prolonged (days 7 - 56) phases after trauma.
RESULTS: All investigated BTM/regulators significantly changed. During the early phase pronounced increases were observed for CTX, P1NP, sclerostin, DKK-1, BALP, FGF23 and iPTH levels, whereas 25-OH vitamin D, albumin, serum and ionized calcium levels decreased. Changes of OPG, OCN and phosphate were less pronounced, but remained significant. In the prolonged phase, changes of P1NP were most pronounced, followed by elevated sclerostin, OCN, BALP, and lesser changes for albumin levels. Calcium and ionized calcium levels tardily increased and remained within the limit of normal. In contrast levels of iPTH, FGF23, CRP and to a lesser extent CTX and phosphate levels, declined significantly during this phase of investigation.
CONCLUSIONS: Ongoing changes of BTM and regulators of bone metabolism suggest alterations in bone metabolism with a likely adverse influence on bone quality and structure in male patients with severe burn injuries.
Language: en |