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Relationship between Bone Specific Alkaline Phosphatase, Osteocalcin and Age in Osteoporotic Women
No full textBackground: Osteoporosis is a serious disabiliting disease and a leading cause of fractures, especially in postmenopausal women.
Several serum markers of bone metabolism have been investigated,
but their pattern over age and gender in the general population
is unclear. The objective of this study was to examine the
relationship between bone formation markers osteocalcin (OC),
bone specific alkaline phosphatase (bALP) and age in postmenopausal
women with osteoporosis. Patients and Methods: The study population was obtained from a
cohort of 236 postmenopausal women who underwent osteodensitometry
using dual energy X-ray absorptiometry with measurement
of bone mineral density (BMD). Forty-eight (20.3%)
patients (median age 62, range 49-76 years) with osteoporosis (Tscore
< -2.5 SD) were enrolled in the study. There were 17 (35%)
patients aged 49-59 years (Group A), and 31 (65%) patients aged
over 59 years (Group B).
Results: PTH (76.0±13.1 vs. 81.9±13.9 ng/L), calcium (2.23±0.41
vs. 2.32±0.56 mmol/L), and creatinine (68.1±15.2 vs. 71.0±26.1
μmol/L) serum levels did not differ significantly (p=NS) between
Groups (A vs. B). In Group B patients, both OC (28.5±17.8 vs.
46.2±19.3 ng/mL; p=0.003), and bALP (57.3±12.4 vs. 66.4±8.7 U/
L; p=0.005) were higher, while the serum concentration of estradiol
(78.1±18.6 vs. 66.7±17.8 pmol/L; p=0.001) was lower. Moreover,
a significant relationship between age and both OC (r=0.39,
p=0.008) and bALP (r=0.31, p=0.009) was found only in Group B
patients, but there was no relationship (p=NS) with BMD.
Conclusion: In postmenopausal women the increase of bone formation
markers later in life may be an expression of increased
bone turnover, which is partially the cause of osteoporosis, while
the role of estrogen is still unclear
Arterial blood pressure and its relationship with serum calcium and PTH in elderly men with primary hyperparathyroidism.
No full textBone mineral density and bone formation markers in patients with insulin-dependent diabetes mellitus
No full textQuantitative ultrasound technology in the assessment of bone status in primary hyperparathyroidism
No full textFemoral and lumbar spine BMD changes in patients with primary hyperparathyroidism: Different improvements following successful parathyroidectomy in male and female patients
No full textIntroduction. The aim of this study was to analyze the femoral neck and lumbar spine BMD changes in patients with PHPT following successful PTx, and to correlate the results with the age and sex of the patients.
Patients and Methods. Thirty-nine patients (median age 57 years, range 23-76) with confirmed PHPT underwent both femoral and lumbar (L2-L4 region) spine osteodensitometry using a dual-energy X-ray absorptiometry. Patients were divided into three groups: Group A (12 premenopausal women, mean age 44.1±9.0 years), Group B (16 postmenopausal women, mean age 64.2±6.9 years; p=0.00, Student's t-test), and Group C (11 men, mean age 54.1±14.8 years; p=NS in respect of women's age). None of the Group B patients had received estrogen replacement therapy at any time, and no Group A patient had used oral contraceptives. Preoperative s-alkaline phosphatase (ALP), s-bone-ALP, s-osteocalcin, and s-PTH 1-88 levels did not differ significantly (p=NS) among the three groups. In Group A patients s-creatinine levels (A=86.50±15.89, B=85.06±22.49, C=83.82±17.85 mmol/L; p=0.016) were lower, whereas s-calcium levels (A=2.94±0.24, B=2.80±0.17, C=2.92±0.25 mmol/L; p=0.012), L2-L4 BMD values (A=0.8588±0.0781, B=0.7301±0.1363, C=0.8002±0.1465 g/cm2; p=0.007), and trochanteric BMD values A=0.5871±0.0964, B=0.5213±0.2117, C=0.6865±0.9703 g/cm2; p=0.023) were higher.
Results. At short-term (mean 13 months, range 9-15 months) follow-up following successful PTx all biochemical parameters were normal with significant (p<0.05) differences in respect of the preoperative values. Overall, ostoperative BMD values improved between 4.77% and 11.48% (median 6.37%). Significant differences were found only in Group A (L2-L4=0.8588±0.0781 vs 0.9575±0.1063, p=0.016; femoral neck=0.6056±0.1217 vs 0.722±0.1382, p=0.039; total hip: 0.7415±0.1424 vs 0.8890±0.1267, p=0-013) and in Group C patients (L2-L4=0.8002±0.1465 vs 0.9411±0.137, p=0.023). No difference (p=NS) was foundin Group B patients.
Conclusions: At short-term follow-up PTx did not result in a significant increase of BMD in postmenopausal patients with PHPT, suggesting the need of estrogenhormones in complete bone remodeling
Relationship between serum N-telopeptide and bone alkaline phosphatase and their diagnostic value in patients with breast cancer and bone metastases
No full textBackground: Breast cancer (BC) is the most common cancer in women, and the bone is the first site of distant metastases in patients with BC. Bone lysis induced by cancer cells invading the bone, promotes degradation ofmineralmatrix, and represents one of themechanisms of cancer-induced hypercalcemia. Bone metastases (BMs) are usually detected by skeletal X-ray and whole body bone scintigraphy, which visualizes areas of increased osteoblastic activity but lacks specificity. Several urinary and serummarkers are altered inpatientswith BMs. The aim of this study was to assess the usefulness of two serum markers of bone remodelling in patients with BC and BMs. Patients andmethods: We studied 59 women (median age 61 years, range 47–70) with BC: 28 patients with confirmed BMs (GroupA), and 31 age-matched (60.0± 6.6 vs. 61.0±5.5 years; p=0.54) patients without BMs (Group B). Serum levels of bone resorption marker cross-linked amino-terminal telopeptide of type I collegen (NTx), and bone formation marker bone alkaline phosphatase (BAP) were measured in both groups by enzymelinked immunosorbent assay. Results: NTx (35.1±7.2 vs. 25.3±3.2 nM BCE), and BAP (54.0±5.7 vs. 39.6±6.4 U/L) serum levels were significantly (p<0.001) different between groups (Avs. B). A significant (R=−0.85, p<0.001), and a weak (R=−0.53, p=0.002) inverse correlation between age and TNx were found in Groups A and B, respectively. Therewas no correlation between age and BAP (R=−0.31, p=0.11; R=0.027, p=0.88), and between NTx and BAP (R=0.40, p=0.037; R=0.10, p=0.58). Using a cut-off value of 30 (TNx) and 50 (BAP), the sensitivity, specificity, and accuracywere 67.86% (OR=30.61, 95% CI 5.95–157.45), 93.55%, and 81.4% (TNx), and 75.0% (OR=43.50, 95% CI 8.91–230.81), 93.55% and 84.7% (BAP), respectively. Conclusions: In patients with BC both NTx and BAP are specific bone remodelling markers, but their usefulness is limited in early diagnosis of BMs
Quantitative Ultrasound Technology in Evaluating Bone Status and Osteoporosis in Patients with Cushing's Syndrome
No full textOsteoporosis is a major feature of Cushing’s syndrome (CS),
and fragility fractures may be the first sign of the disease. The aim of this
study was to evaluate the ability of quantitative ultrasound technology
(QUS) in diagnosing osteoporosis in patients with CS. Sixty-three consecutive
patients (mean age 38.6 ± 13.0 years), 13 (20.6%) men and 50
(79.4%) women, with confirmed CS underwent both dual-energy X-ray
densitometry (DXA) and QUS. Two groups of patients were selected:
group A, 23 patients, T-score –2 SD or less (bone mineral density [BMD]
femoral neck ≤ 695 g/cm2), and group B, 40 patients, T-score above –2
SD. Age (42±12 vs. 37±13 years) and 24-h free urinary cortisol (499±
345 vs. 469 ± 319 g/day) did not differ significantly (P = NS) between
groups, while the body mass index did (24.3 ± 4.1 vs. 28.1 ± 4.6, P =
0.002). Unlike DXA, QUS values did not differ significantly (P = NS)
between groups. Moreover, in the overall population, as well as in a single
group, there was no correlation (R< 0.5, P = NS) between QUS and
DXA parameters. In conclusion, in our study QUS was not able to differentiate
osteoporotic patients from those with normal BMD measured
by DXA, and thus QUS technology should not be used to discriminate
between osteopenic and nonosteopenic patients with CS
Clinical and biochemical features of primary hyperparathyroidism in the elderly. A retrospective study in 139 patients who underwent parathyroidectomy
No full textBone mineral density and bone remodelling markers osteocalcin and alkaline phosphatase in patients with Stage IV breast cancer
No full textBackground: Metastatic breast cancer (BC) is a severe disease, which frequently involves the bone. Direct bone resorption by lytic metastases, together with the action of local osteolytic factors, such as parathyroid hormone-related protein, is the mechanism causing malignancy-related hypercalcemia. Total alkaline phosphatase (AP) is a widely used test in metastatic bone disease, while osteocalcin is a specific marker whenever resorption and formation are uncoupled. In all patients with bone metastases (BMs), fracture risk identification has become an important aspect, especially in those who underwent hormone therapy. Thus, an evidence-based algorithm is needed to assess the risk and provide the correct therapy. The aim of this study was to evaluate the relationship between BAP, osteocalcin, and bone mineral density (BMD) in patients with Stage IV BC. Patients and methods: A series of 21 (median age 64 years, range 56–70 years) postmenopausal women with BC and confirmed BMs (Group A) underwent lumbar spine measurement of BMD using dual-energy Xray absorptiometry (DXA). Twenty-five age-matched women with Stage I–II BC represented the control group (Group B). Serum calcium, PTH, creatinine, and other routine biochemical parameters were normal in all patients. Results: Both serum AP (51.2±4.8 U/L vs. 39.6±5.4 U/L, p<0.001), and BMD (0.794±0.114 vs. 0.864±0.103 g/ cm2, p=0.03) were significantly different between Groups (A vs. B), while osteocalcin serum levels (25.1±9.1 vs. 27.5±7.2 ng/mL, p=0.32) did not differ. In Group A patients no correlations between BMD and both osteocalcin (R=−0.39, p=0.08) and BAP (R=−0.42, p=0.06), and between age and AP (R=0.37, p=0.10) were found, while there was a strong relationship between osteocalcin and both AP (R=−0.58, p=0.006) and age (R=0.47, p=0.03). No correlation (p=NS) was found in the control group. Conclusions: Inwomen with BC and metastatic bone defects, both bone remodelling marker measurement and DXA may be useful to identify patients at risk of pathologic fractures
Femoral and lumbar spine BMD changes in patients with primary hyperparathyroidism. Different improvement following successful parathyroidectomy in male and female patients
No full textIntroduction.
The aim of this study was to analyze the femoral neck and lumbar spine BMD changes in patients with PHPT following successful PTx, and to correlate the results with the age and sex of the patients.
Patients and Methods.
Thirty-nine patients (median age 57 years, range 23-76) with confirmed PHPT underwent both femoral neck and lumbar (L2-L4 region) spine osteodensitometry using a dual-energy X-ray absorptiometry. Patients were divided into three groups: Group A (12 premenopausal women, mean age 44.1 +/- 9.0 years), Group B (16 postmenopausal women, mean age 64.2 +/- 6.9 years; p=0.00), and Group C (11 men, mean age 54.1 +/- 14.8 years; p=NS in respect of women’s age). None of the Group B patients had received estrogen replacement therapy at any time, and no Group A patient had used oral contraceptives. Preoperative s-alkaline phosphatase (ALP), s-bone-ALP, s-osteocalcin, and s-PTH 1-88 levels did not differ significantly (p=NS) among the three groups. In Group A patients s-creatinine levels were lower (p=0.016), whereas s-calcium levels (A=2.94 +/- 0.24, B=2.80 +/- 0.17, C=2.92 +/- 0.25 mmol/L; p=0.012), L2-L4 BMD values (A=0.8588 +/- 0.0781, B=0.7301 +/- 0.1363, C=0.8002 +/- 0.1465 g/cm2; p=0.007), and trochanteric BMD values (A=0.5871 +/- 0.0964, B=0.5213 +/- 0.2117, C=0.6865 +/- 0.9703 g/cm2; p=0.023) were higher.
Results.
At short-term (mean 13 months, range 9-15 months) follow-up following successful PTx all biochemical parameters were normal with significant (p<0.05) differences in respect of the preoperative values. Overall postoperative BMD values improved between 4.77% and 11.48% (median 6.37%). Significant differences were found only in Group A (L2-L4=0.8588 +/- 0.0781 vs 0.9575 +/- 0.1063, p=0.016; femoral neck=0.6056 +/- 0.1217 vs 0.722 +/- 0.1382, p=0.039; total hip: 0.7415 +/- 0.1424 vs 0.8890 +/- 0.1267, p=0-013) and in Group C patients (0.8002 +/- 0.1465 vs 0.9411 +/- 0.137, p=0.023).
Conclusions: In patients with PHPT, at long-term follow-up, BMD of the lumbar spine significantly improves after PTx in premenopausal women, suggesting a higher bone sensitivity to serum PTH normalization
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