The effect of calcitonin and growth hormone on urinary deoxypyridinoline levels in burned patients

Reduced bone formation and bone loss have been documented in patients following burn injury. Urinary deoxypyridinoline (DPD) is accepted as a marker of collagen breakdown activity. Because calcitonin (CT) diminishes bone resorption and growth hormone (GH) increases bone formation and density in GH-deficient patients, we studied the short-term effects of CT and GH on urinary DPD levels in burned patients. In 30 patients with severe burns, urinary DPD levels were investigated for 3 days following hospitalisation. Then the patients were divided into 3 groups of 10. In the CT group, CT 100 U was injected subcutaneously daily for 5 days. In the GH group, GH 0.1 mg/kg was injected subcutaneously three times in a week. In the control group, isotonic saline solution 0.1 mg/kg was injected subcutaneously three times in a week. In all groups, following the last dose of the agents, urinary DPD levels were investigated for 3 days again. Mean burn size and age were not significantly different between the groups. Urinary DPD level obtained in the early period was 16.5 ± 3.1 nM in the CT group, 10.4 ± 5.3 nM in the GH group and 18.6 ± 2.7 nM in the control group. There were no statistical differences among the groups (P> 0.5, for all). Urinary DPD level obtained in the late period was 4.5 ± 1.0 nM in the CT group, 14.4 ± 5.9 nM in the GH group and 36.6 ± 2.1 nM in the control group. The differences between the CT group and control group, the CT group and GH group and the GH group and control group were statistically significant (P< 0.001, P< 0.01, P< 0.01, respectively). In the comparison of early and late urinary DPD levels, a significant decrease was only obtained in the CT group (P< 0.001, z:6.5). In the other 2 groups, DPD levels increased in the late period. We concluded that GH is not effective in decreasing urinary DPD levels. On the contrary, CT was found to very effective in decreasing urinary DPD levels. This decrease in urinary DPD levels may be associated with diminished bone loss