Decline in bone mineral density in children

Abstract

Bone mineral density decline is one of the significant problems in pediatrics due to the high prevalence of this pathology, the peculiarities of its course in childhood, and the necessity for early detection of changes in bone mineral density to prevent fractures. Osteoporosis is a multifactorial metabolic disease of the skeleton characterized by low bone mass, microarchitectural deterioration of bone tissue, and increased bone fragility and brittleness. Objective. To highlight current diagnostic approaches for early detection of bone mineral density decline in children and adolescents. A review of the available medical literature was conducted. The basic pathogenetic mechanisms of bone mineral density disorders and osteoporosis development were presented. Current diagnostic approaches were considered, namely the main laboratory and instrumental markers of osteoporosis in children, including changes in Z-score of more than 2 SD (according to bone densitometry), the level of biochemical markers of resorption and bone tissue formation (c-terminal telopeptide, oxyproline, osteocalcin, acid and alkaline phosphatase, etc.), and questionnaires. Conclusion. New diagnostic algorithms will allow targeted prevention and treatment of bone mineral density decline in high-risk patients at an early stage, preventing the development of pathological fractures. Key words: hypovitaminosis D, densitometry, bone metabolism markers, bone mineral density, osteoporosis, polymorphism