EARLY MODIFICATIONS OF BIOCHEMICAL MARKERS OF BONE METABOLISM IN SPINAL-CORD INJURY PATIENTS A PRELIMINARY-STUDY

Spinal cord injury is associated with the development of a rapid and s evere osteoporosis which might reflect uncoupling between bone formati on and resorption, A prospective study was made in 6 spinal cord injur y patients followed up to 2-3 months after onset with various markers of a) bone formation: osteocalcin and C-terminal peptide of type I pro collagen, b) bone resorption: pyridinolines and C-terminal telopeptide of type I collagen, c) connective tissue metabolism: amino-terminal p ropeptide of type LU collagen (PIIINP), Preliminary results show that early after onset, bone formation was depressed as compared to dramati cally increased bone resorption. Low bone formation rate lasted two we eks before it began to raise, while bone resorption showed a continuou s tendency to increase, The dramatic increase in PIIINP levels might r epresent some attempt of bone to repair, This paper describes the evol ution of various biochemical markers of bone and connective tissue met abolism after onset of paralysis and critically reviews the use of tho se markers in patients with spinal cord injury.