• Gabriela Katharina Muschitz, Elisabeth Schwabegger, Roland Kocijan, Andreas Baierl, Hervé Moussalli, Alexandra Fochtmann, Stefanie Nickl, Ines Tinhofer, Judith Haschka, Heinrich Resch, Thomas Rath, Peter Pietschmann, and Christian Muschitz.
• Division of Plastic and Reconstructive Surgery (G.K.M., A.F., S.N., I.T., T.R.), Department of Surgery, and Department of Pathophysiology and Allergy Research (P.P.), Center for Pathophysiology, Infectiology and Immunology, The Medical University of Vienna, and Department of Statistics and Operations Research (A.B.), The University of Vienna, 1090 Vienna, Austria; Department of Plastic, Reconstructive and Aesthetic Surgery (E.S.), The Medical University Innsbruck, 6020 Innsbruck, Austria; St. Vincent Hospital (R.K., H.M., J.H., H.R., C.M.), Medical Department II, Academic Teaching Hospital of The Medical University of Vienna, and Karl Landsteiner Institute for Gastroenterology and Rheumatology (H.R.), 1060 Vienna, Austria.
• J. Clin. Endocrinol. Metab. 2016 Apr 1; 101 (4): 1506-15.

ContextSevere burn injury causes a massive stress response, consecutively heightened serum levels of acute phase proteins, cortisol, and catecholamines with accompanying disturbance in calcium metabolism.ObjectiveEvaluation of early and prolonged changes of serum bone turnover markers (BTMs) and regulators of bone metabolism.DesignLongitudinal observational design.SettingUniversity clinic.PatientsA total of 32 male patients with a median age of 40.5 years and a median burned total body surface area of 40% (83% patients with full thickness burn injury).InterventionsNone.Main Outcome MeasuresComparison of changes of BTM/regulators of bone metabolism in the early (d 2–7) and prolonged (d 7–56) phases after trauma.ResultsAll investigated BTM/regulators significantly changed. During the early phase, pronounced increases were observed for serum type 1 collagen cross-linked C-telopeptide, intact N-terminal propeptide of type I procollagen, sclerostin, Dickkopf-1, bone-specific alkaline phosphatase, fibroblast growth factor 23, and intact parathyroid hormone levels, whereas 25-hydroxyvitamin D, albumin, serum, and ionized calcium levels decreased. Changes of osteoprotegerin, osteocalcin, and phosphate were less pronounced but remained significant. In the prolonged phase, changes of intact N-terminal propeptide of type I procollagen were most pronounced, followed by elevated sclerostin, osteocalcin, bone-specific alkaline phosphatase, and lesser changes for albumin levels. Calcium and ionized calcium levels tardily increased and remained within the limit of normal. In contrast, levels of intact parathyroid hormone, fibroblast growth factor 23, C-reactive protein, and to a lesser extent serum type 1 collagen cross-linked C-telopeptide and phosphate levels declined significantly during this phase of investigation.ConclusionsOngoing changes of BTM and regulators of bone metabolism suggest alterations in bone metabolism with a likely adverse influence on bone quality and structure in male patients with severe burn injuries.

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