The excretion of collagen cross-links in malnourished children and their subsequent recovery - abstract

ABSTRACT

Pyridinoline (PYD) and deoxypridinoline (DYP) molecules cross-link the collagen in bone and cartilage. They are neither re-used in the body nor found in the collagen of any other organ. We have measured the urinary excretion rate of these cross-links in 46 severely malnourished boys to assess their skeletal turnover and to relate the output to the subsequent rate of growth in height. The children were 12 +/- 6mo, -3.6 +/- 1.6 SD units height-for-age and -2.4 +/- 0.9 SD units weight for height. Their excretion when malnourished and after recovery was 11.4 +/- 5.3 (mal, X +/- DS) and 32.3 +/- 10.8 (rec) of PYD and, 2.7 +/- 1.5 (mal) and 7.5 +/- 3.0 (rec) of DYP (all nmol .h-1 .m-ý). This indicates that skeletal turnover is much less in the malnourished than the recovered child. Comparison with Italian control data indicates that there is depressed skeletal metabolism in malnutrition. There was a significant relationship between the cross-link excretion, age and weight-for-height and the rate of height gain in the subsequent month by multiple regression analysis. These three factors - age, degree of wasting amd skeletal turnover accounted for 44 percent of the variance in the subsequent height velocity of the children. It may be possible to use PYD and DYP to assess therapeutic intervention designed to alleviate stunting(AU)