Sub Topic | Secondary Topic: Biotherapeutics and Biotechnology - Biomarkers | Analytical Qualification and Validation
Authors: Kayla Bateman, Roseman University (Main Author); Casey Luu, Roseman University; Prashanti Bollu, Roseman University; Manas Mandal, Roseman University (Presenting Author)
Presenting Author: Manas Mandal
Purpose: Determination of an individual’s skeletal maturation status coinciding with pubertal growth spurt is clinically important in the diagnosis and treatment planning of orthodontic patients. A radiographic image of the craniofacial skeleton determining cervical vertebral maturational stages (CVMS) is routinely used by orthodontists. Yet, CVMS reliability is questionable and limited with subjective observation and staging, that also lacks the ability to determine the intensity and cessation of growth spurt of an individual. Bio-markers such as insulin-like growth factor-1 (IGF-1), estradiol and testosterone play a key role in regulating puberty, growth spurt and skeletal maturation. The purpose of this study is to find correlation/association of salivary IGF-1 (sIGF-1) with CVMS generated via cone beam computed tomography (CBCT). Secondary objective of this study is to correlate age, height and weight of the patient with CVMS.
Methods: A cross-sectional research study was initiated after IRB approval that included patients from Roseman University of Health Sciences Orthodontic Clinic of age 8-25 years. A customized medical questionnaire and informed consent and/or assent were completed. Patient’s age, height and weight were recorded at the initial records appointment. Cephalometric radiographs via CBCT (Fig 1) were graded for CVMS by two observers independently at two different time points. Saliva samples were obtained using the passive drool technique and kept frozen at -80 0C until analyzed by enzyme-linked immunosorbent assay (ELISA) to determine the concentration of IGF-1. Analysis of variance (ANOVA) and linear regression were used to determine the association between sIGF-1, age, height, and weight of the patient.
Results: 105 subjects were included in the study with 60 female (mean age 13.1±3.1 years) and 45 male (mean age 14.5±2.9 years) patients. Distribution of CVMS (Fig 2) in male patients differed significantly from female patients in stages III (male 20%, female 28%), IV (male 30%, female 13%) and V (male 11%, female 20%). Mean chronological age of male patients was slightly higher than female patients in individual category of CVMS and also increase in mean chronological age was observed in both male and female patients along with higher CVMS, demonstrating an increase in skeletal maturation. The mean sIGF-1 concentration for males was 892 pg/mL and for females 1089.4 pg/mL. A weak correlation was observed between chronological age and sIGF-1in males (r=0.233, p=0.129) and females (r=0.062, p=0.637), which were not statistically significant. Overall, the mean sIGF-1 concentration increased with skeletal maturation (CVMS IV) in male patients, while in female patients, a peak was observed in CVMS III. sIGF-1 concentration peaked around age 13.5 year for male and 12.5 year for females that coincided with CVMS III in both genders. A strong and significant correlation of height and age was observed in male (r=0.767, p<0.01) and female (r=0.653), p<0.01) patients that corresponded well with CVMS I-IV.
Conclusion: Salivary biomarker such as IGF-1can be useful to determine skeletal maturation in orthodontic patients. Higher CVMS correlated with increase in age in both sexes and female patients attained earlier skeletal maturation compared to male patients. Increase in patient height correlated with increase in age and CVMS.
See attached abstract pdf for images.