Serum osteocalcin – A biochemical marker for pubertal growth assessment

Growth evaluation methods have made great strides in the shift from radiologic to non-radiologic biomarkers. Osteocalcin (OC), a bone protein, has been reportedly used as a biomarker for osteoblastic bone formation. The present study aimed at evaluation of serum OC in Class II skeletal patterns for accurate assessment of pubertal growth spurt to facilitate functional jaw orthopedics during the growth period. Eighty subjects, comprising 38 males and 42 females with skeletal Class II malocclusion in the age range of 11–18 years, were recruited for the study. Human serum OC was quantitatively assessed with enzyme-linked immunosorbent assay. The cervical vertebral stages were assessed from lateral cephalograms. Statistical analysis for gender-wise comparison of mean serum levels of OC at each cervical stage (CS) and in the intervals of the CSs was carried out using Kruskal–Wallis test and for intergroup comparisons, Mann–Whitney U-test with Bonferroni’s correction was done. Gender-wise comparison of mean serum OC levels revealed that it was highest in CS2 in both males (72.24 ng/mL) and females (74.71 ng/mL) with another discernible peak in CS5 in males (66.82 ng/mL) and in CS6 in females (63.78 ng/mL), exhibiting thereby a circadian rhythm in bone modeling during the entire adolescent growth spurt. Despite a pre-pubertal and a late pubertal spike in both the genders, the mean OC serum levels actually exhibited a circadian rhythmicity across all the CSs, exhorting thereby the importance of bone remodeling during the complete circumpubertal growth period.