Assessment of bone metabolism in children in conditions of the strontium biogeochemical province

Introduction. Excessive strontium entry into the body in a specific biochemical province creates elevated risks of diseases of the musculoskeletal system.

The purpose of the study. To assess the state of bone metabolism in children living in the strontium biogeochemical province.

Materials and methods. We examined by performing clinical examination of one hundred fifty six 5–10 years children (45.5% boys and 54.5% girls) (the observation group). They were exposed to strontium in drinking water in doses reaching 1.2 maximum permissible concentration. The reference group was made of 192 children (45.8% boys and 54.2% girls) who drank water conforming to hygienic requirements fixed in the sanitary legislation. We assessed strontium levels in biological media (blood and urine). Bone metabolism was examined relying on such indicators as phosphor and calcium metabolism, synthesis and resorption of bone tissues, regulation of osteoclastogenesis in blood serum, levels of hormones and vitamin D responsible for regulation of calcium metabolism.

Results. Children resided in a strontium biogeochemical province had elevated strontium levels in blood and urine. We established 2.2 times higher likelihood of deforming dorsopathy and constitutional changes for the exposed children. Also, children with strontium contamination in biological media were established to have slower formation of bone tissues that became obvious through lower N-osteocalcin levels and less active bone isozyme of alkaline phosphatase in 37.9% of cases. Resorptive processes in bones tended to be activated in the exposed children and it involved lower levels of tartrate-resistant acid phosphatase in 84.2 of cases, lower osteoprotegerin levels in 37.2%, and elevated levels of C-terminal telopeptides and Ampli-sRANKL in 40.4–43.4% of the exposed children. Likelihood of elevated bone tissue resorption was established to be 2.9 times higher for the children with strontium contamination in biological media.

Research limitations. The study included children aged 5–10 years.

Conclusion. Changes in bone metabolism in children living in a strontium biogeochemical province can facilitate early development of osteopenia and diseases of the musculoskeletal system.

Compliance with ethical standards: The clinical examination was carried out in accordance with the ethical principles of the Declaration of Helsinki (as amended in 2013) and the National Standard of the Russian Federation GOST-R 52379–2005 "Good Clinical Practice" (ICH E6 GCP), approved by the Ethics Committee of the Federal Scientific Center for Medical and Preventive Health Risk Management Technologies (protocol No. 3, 29.01.2013). The legal representatives of the children signed a voluntary informed consent for the examination in advance.

Contribution of the authors:
Maklakova O.A. — study concept and design, data collection and analysis, statistical analysis, writing and editing the text;
Shtina I.E. — data collection and analysis, statistical analysis, writing the text;
Valina S.L. — data collection and analysis, editing the text.
All co-authors — approval of the final version of the article, responsibility for the integrity of all parts of the article.

Acknowledgment. The study had no financial support.

Conflict of interest. The authors declare no conflict of interest.

Received: April 4, 2024 / Accepted: October 3, 2024 / Published: December 28, 2024