Universität zu Köln

Shi, Lijie, Sanchez-Guijo, Alberto, Hartmann, Michaela F., Schoenau, Eckhard, Esche, Jonas, Wudy, Stefan A. and Remer, Thomas (2015). Higher Glucocorticoid Secretion in the Physiological Range Is Associated With Lower Bone Strength at the Proximal Radius in Healthy Children: Importance of Protein Intake Adjustment. J. Bone Miner. Res., 30 (2). S. 240 - 249. HOBOKEN: WILEY-BLACKWELL. ISSN 1523-4681

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Abstract

Whether higher production of glucocorticoids (GCs) within the physiological range may already be affecting bone status in healthy children is unknown. Because dietary protein intake affects both bone and GCs, we examined the association of urinary measures of glucocorticoid status and cortical bone in healthy non-obese children, after particularly controlling for protein intake. Proximal forearm bone parameters were measured by peripheral quantitative computed tomography (pQCT). Subjects studied (n=175, 87 males, aged 6 to 18 years) had two 24-hour urine samples collected: the first sample at 1 year before bone measurement, and the second sample at the time of bone measurement. Major urinary GC metabolites were measured by mass spectrometry and summed to assess daily adrenal GC secretion (Sigma C21). Urinary free cortisol (UFF) and cortisone (UFE) were summed to assess potentially bioactive free GCs (UFF+UFE). After controlling for several covariates and especially urinary nitrogen (the biomarker of protein intake) cortisol secretion Sigma C21 was inversely associated with all analyzed pQCT measures of bone quality. Sigma C21 also predicted a higher endosteal and lower periosteal circumference, explaining both a smaller cortical area and (together with lower BMD) a lower strength-strain-index (SSI). UFF+UFE, UFE itself, and a urinary metabolite-estimate of 11beta-hydroxysteroid dehydrogenase type1 (11beta-HSD1) activity showed corresponding reciprocal associations (p<0.05) with BMD and bone mineral content, but not with SSI and bone geometry variables. In conclusion, higher GC levels, even within the physiological range, appear to exert negative influences on bone modeling and remodeling already during growth. Our physiological data also suggest a relevant role of cortisone as the direct source for intracrine-generated cortisol by bone cell 11beta-HSD1. (c) 2014 American Society for Bone and Mineral Research.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Shi, Lijie UNSPECIFIED UNSPECIFIED UNSPECIFIED Sanchez-Guijo, Alberto UNSPECIFIED UNSPECIFIED UNSPECIFIED Hartmann, Michaela F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoenau, Eckhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Esche, Jonas UNSPECIFIED UNSPECIFIED UNSPECIFIED Wudy, Stefan A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Remer, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-413387
DOI:	10.1002/jbmr.2347
Journal or Publication Title:	J. Bone Miner. Res.
Volume:	30
Number:	2
Page Range:	S. 240 - 249
Date:	2015
Publisher:	WILEY-BLACKWELL
Place of Publication:	HOBOKEN
ISSN:	1523-4681
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language 11-BETA-HYDROXYSTEROID DEHYDROGENASE TYPE-1; RENAL ACID LOAD; URINARY FREE CORTISOL; GROWTH-FACTOR-I; MINERAL DENSITY; PREMENOPAUSAL WOMEN; CUSHINGS-SYNDROME; INDUCED OSTEOPOROSIS; ELDERLY-MEN; OSTEOBLAST DIFFERENTIATION Multiple languages Endocrinology & Metabolism Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/41338