Ohiwerei et al, J Biomed & App Sci FUD (2023) 2:2
Keywords: Alkaline phosphatase, collagen, fracture, hydroxyproline, serum calcium, serum creatinine
2024-06-28 DOI: JOBASFUD_2024_3_1_002
Background: Fracture healing is an extremely complex interaction of cells, biological pathways, and molecules. Interference with any of these pathways or proteins either promotes or, more likely, decreases fracture healing. The inflammatory response is certainly one of the initiating factors for bone healing; this phase is a critical period characterized by low oxygen tension, impaired perfusion, and migration of a wide array of cells and the release of active molecules. When searching for biochemical bone markers, molecules in bone of connective tissue origin that may be detected in plasma and/or urine are being targeted; as they provide a dynamic view of the remodeling process of bone. Bone turnover markers (BTMs) are a product of bone cell activity. They are a series of protein or protein derivative biomarkers released during bone remodeling by osteoblasts or osteoclasts. Bone resorption markers are related to osteoclast resorption of the matrix and include tartrate-resistant acid phosphatase and degradation products of type I collagen, especially urinary hydroxyproline (OHPr), etc. Aim of the Study: The aim of the study is to investigate early detection of fracture healing disturbances among patients with fractures. Materials and Methods: A total number of fifty (50) male subjects aged between 20 and 45 were used in the study. They were divided into two groups of 25 people each (control and test groups). OHPr was determined using an automated method based on Stegmann-Staeder’s method as modified by Utevskaya and Persky, and serum calcium concentrations by O-cresol phthalein complexone method. Serum creatinine (Cr) was estimated by modified Jaffe’s method; and alkaline phosphatase by enzymatic method. Results: It was found that biosynthesis of collagen in the 6th week period of healing increased due to an increase in (OHPr) content, which subsequently decreased to normal reference interval at the 9th week. Serum alkaline phosphatase activity in healing fractures increased significantly during the first two weeks of the healing process and subsequently decreased to normal reference interval at the 9th week. At the same time, serum calcium increased up to the 3rd week after fracture and then returned to normal level within the next weeks of fracture. There was no significant change in creatinine levels across the weeks. Conclusion: The increase in the biosynthesis of collagen protein during the healing period was due to the increase in the content of its index marker, hydroxyproline. Serum alkaline phosphatase activity in healing fractures increased significantly and subsequently decreased to normal reference interval. At the same time, serum calcium increased after fracture and then returned to normal level within the next weeks of fracture. There was no significant change in creatinine, which could be due to reduced GFR.