URINARY MARKERS TO INDEX SKELETAL GROWTH

在正畸中，青少年生长发育调整的时机是一个 治疗成功的重要决定因素。治疗结果取决于 不同发育阶段骨生长速度的变化 成熟。然而，目前还不存在用于测量的可靠标记 骨发育阶段的变化。这项研究的目的是探索 尿中特异性骨胶原代谢物作为临床诊断标记物的研究 正畸治疗的时机。具体目标是：1)相互关联 尿羟基吡啶酚(HP)和赖氨酰吡啶酚(LP) 排泄量与面部骨骼生长速度，2)提供诊断 确定个人青春期成熟阶段的决策规则， 3)评价面部矫形治疗的疗效。 治疗开始时的HP和LP排泄功能。 设计了一项前瞻性队列研究，其中尿样、面部和 每月收集青少年的体格发育测量数据。 基础。从这些数据中，面部生长速度之间的相关性 尿幽门螺杆菌/肌酐和脂蛋白/肌酐排泄率将 使用广义估计方程进行了研究。不同 青春期的成熟阶段将由身高来决定 将使用三次样条线进行平滑的生长速度曲线 方法。将使用Logistic来构建诊断决策规则 判别分析在成熟期个体分类中的应用 使用HP和LP排泄量、年龄和性别。 队列的一个子组将由接受治疗的患者组成 配合下颌矫形矫治器。治疗的结果将是 作为幽门螺杆菌尿排泄量的函数进行评估 LP在治疗开始时。 潜在的临床意义是所提出的尿液标志物 将允许正畸医生花时间进行生长干预以获得最佳 治疗结果。

In orthodontics, timing of growth modification in adolescents is an important determinant of treatment success. Treatment results depend on the rates of bone growth which vary during different stages of maturation. However, currently no reliable markers exist for measuring changes in bone growth stages. The purpose of this study is to explore the use of specific urinary metabolites of bone collagen as markers for timing of orthodontic treatment. The specific aims are 1) to correlate urinary hydroxylysyl-pyridinoline (HP) and lysyl-pyridinoline (LP) excretion with facial bone growth velocity, 2) to provide a diagnostic decision rule to determine an individual's adolescent maturational stage, and 3) to evaluate the outcome of facial orthopaedic treatment as a function of the HP and LP excretion at the start of treatment. A prospective cohort study is designed in which urine samples, facial and statural growth measurements are gathered from adolescents on a monthly basis. From these data, the correlation between facial growth velocity and urinary HP/creatinine and LP/creatinine excretion ratios will be investigated using generalized estimating equations. Different adolescent maturational stages will be derived from the statural height growth velocity curves which will be smoothed using a cubic spline method. A diagnostic decision rule will be constructed using logistic discriminant analysis to classify individuals in maturational stages using HP and LP excretion, age and sex. A subgroup of the cohort will be comprised of patients that are treated with mandibular orthopaedic appliance. The results of treatment will be evaluated as a function of the quantity of urinary excretion of HP and LP at the start of treatment. The potential clinical implication is that the proposed urinary markers would allow orthodontists to time growth intervention to obtain optimum treatment results.