Children and adults who suffer severe burn injuries develop abnormalities in bone and mineral metabolism. The most prominent of these is a reduction in bone formation. Events occurring immediately following burn injury that are likely contributors to the reduced bone formation include an increase in endogenous glucocorticoid production, functional growth hormone deficiency, hypoparathyroidism, and interoperative immobilization. The proinflammatory cytokines interleukin-1 β and interleukin-6 may also contribute. To date, the effects of burn injury on bone formation have been equivocal. However, the major reduction in bone formation without any consistent change in resorption suggests an uncoupling of formation and resorption. A consequence of this is lumbar spine bone loss as detected by dual-energy X-ray absorptiometry by 6 wk postburn. In both cross-sectional and longitudinal studies, the initial low bone density remains decreased in relation to unburned age-matched peers. The reduced bone density increases the risk for postburn fractures and for reduced peak bone mass, increasing the risk of these patients for adult-onset osteoporosis.
- Bone loss
- Growth hormone
ASJC Scopus subject areas
- Endocrinology, Diabetes and Metabolism
- Orthopedics and Sports Medicine
- Radiology Nuclear Medicine and imaging