Urinary excretion of pyridinium cross-links of collagen in infancy

This cross-sectional study evaluated urinary excretion of pyridinium cross-links of collagen, specific markers of ongoing bone resorption, in infants aged 1 week to 7 months and examined the relationship between urinary cross-links and individual renal function. Spot urines from a total of 100 infants were analyzed. The collagen cross-links, pyridinoline (Pyd) and deoxypyridinoline (D-Pyd), were assayed by fluorescence detection after high- performance liquid chromatography (HPLC). β₂-Microglobulin (β₂M), an index of renal tubular function, was determined by radioimmunoassay. In healthy term infants, urinary collagen cross-links were several times higher than the reported data for older children, with peak values seen at 1 month of age. Excretion of Pyd and D-Pyd was also markedly elevated in 1-month-old preterm infants, despite poor somatic growth. Such high excretion of collagen cross-links probably reflects the state of accelerated bone turnover in infancy. The postnatal change in the cross-links was different from that in urinary β₂M, and the values obtained did not correlate with β₂M in either term or preterm infants. These results indicate that cross-link excretion is not influenced directly by individual renal function.