URINARY MARKERS TO INDEX SKELETAL GROWTH

在儿科学中，青少年生长调节的时机是一个重要因素。 治疗成功的重要决定因素。 治疗结果取决于 骨生长的速度在不同的阶段变化， 成熟 然而，目前没有可靠的标记用于测量 骨生长阶段的变化。 本研究旨在探讨 骨胶原蛋白的特定尿代谢物作为以下指标的用途： 正畸治疗的时机。 具体目标是：（1） 尿羟赖氨酰吡啶啉（HP）和赖氨酰吡啶啉（LP） 排泄与面骨生长速度，2）提供诊断 决定规则，以确定一个人的青春期成熟阶段， 和3）评估面部矫形治疗的结果， 治疗开始时HP和LP排泄的功能。 设计了一项前瞻性队列研究，其中尿液样本、面部和 每个月从青少年中收集一次身高测量数据， 基础 从这些数据来看，面部生长速度与 尿HP/肌酐和LP/肌酐排泄率将 使用广义估计方程进行研究。 不同 青少年的成熟阶段将从身高推导出来 生长速度曲线，将使用三次样条进行平滑 法 诊断决策规则将使用逻辑 判别分析，对成熟阶段的个体进行分类 使用HP和LP排泄物，年龄和性别。 队列的亚组将由接受治疗的患者组成， 下颌骨矫形器 治疗的结果将是 作为HP尿排泄量的函数进行评价， 治疗开始时的LP。 潜在的临床意义是，所提出的尿液标记物 将允许益生菌生长干预的时间，以获得最佳的 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.