Abnormal bone turnover in monoclonal gammopathy of undetermined significance: analyses of type I collagen telopeptide, osteocalcin, bone-specific alkaline phosphatase and propeptides of type I and type III procollagens

Abstract Context: Patients with congenital adrenal hyperplasia (CAH) receive glucocorticoids as replacement therapy. Glucocorticoid therapy is the most frequent cause of drug-induced osteoporosis. Objective: The objective of the study was to evaluate bone mineral density (BMD) and bone metabolism in CAH patients. Design: This was a cross-sectional observational study. Setting: The study was conducted at a referral center for pediatric endocrinology. Patients and Other Participants: Thirty young patients with the classical form of CAH (aged 16.4–29.7 yr) treated with glucocorticoid from diagnosis (duration of treatment 16.4–29.5 yr) and 138 healthy controls (aged 16.0–30.0 yr) were enrolled. Main Outcome Measures: BMD was measured in the lumbar spine and whole body by dual-energy x-ray absorptiometry. Bone formation and resorption rates were estimated by serum measurements of bone-specific alkaline phosphatase and C-terminal telopeptide of type I collagen, respectively. Results: CAH patients were shorter than controls (women −6.8 and men −13.3 cm). Therefore, several methods were used to account for the effect of this difference on bone measurements. Whole-body BMD measurements were significantly lower, compared with controls (P < 0.03), after controlling for height (on average −2.5% in females and −9.3% in male patients). No differences were found in lumbar spine measurements. Bone-specific alkaline phosphatase and C-terminal telopeptide of type I collagen serum concentrations were higher in CAH patients than control subjects (P < 0.04). BMD measurements and bone metabolism markers did not correlate with the actual glucocorticoid dose or mean dose over the previous 7 yr. Conclusions: Young adult patients with the classical form of CAH have decreased bone density values, compared with healthy controls. This may put them at risk of developing osteoporosis early in life.

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Determination and biological relevance of serum cross-linked type I collagen N-telopeptide and bone-specific alkaline phosphatase in breast metastatic cancer

Journal of Pharmaceutical and Biomedical Analysis ◽

10.1016/s0731-7085(03)00567-3 ◽

2004 ◽

Vol 34 (4) ◽

pp. 827-832 ◽

Cited By ~ 28

Author(s):

I. Kanakis ◽

M. Nikolaou ◽

D. Pectasides ◽

C. Kiamouris ◽

N.K. Karamanos

Keyword(s):

Alkaline Phosphatase ◽

Type I Collagen ◽

Metastatic Cancer ◽

Type I ◽

Specific Alkaline Phosphatase ◽

Bone Specific Alkaline Phosphatase ◽

Biological Relevance

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Effects of Soy Isoflavones on Markers of Bone Turnover in Premenopausal and Postmenopausal Women*

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.85.9.6787 ◽

2000 ◽

Vol 85 (9) ◽

pp. 3043-3048 ◽

Cited By ~ 2

Author(s):

Kerry E. Wangen ◽

Alison M. Duncan ◽

Barb E. Merz-Demlow ◽

Xia Xu ◽

Robert Marcus ◽

...

Keyword(s):

Alkaline Phosphatase ◽

Bone Turnover ◽

Postmenopausal Women ◽

Soy Isoflavones ◽

Type I ◽

Small Magnitude ◽

Specific Alkaline Phosphatase ◽

Bone Specific Alkaline Phosphatase ◽

Markers Of Bone Turnover ◽

Cross Links

Abstract Soy isoflavones are hypothesized to exert hormonal effects in women and thus may play a role in bone metabolism throughout life. In 2 randomized, cross-over studies, 14 pre- and 17 postmenopausal women were given 3 soy protein isolates containing different amounts of isoflavones [control, 0.13; low isoflavone (low-iso), 1.00; and high-iso, 2.01 mg/kg body wt·day, averaging 8, 65, and 130 mg/day, respectively], for over 3 months each. Food records, blood samples, and 24-h urine collections were obtained throughout the studies. The endpoints evaluated included plasma or serum concentrations of bone-specific alkaline phosphatase, osteocalcin, insulin-like growth factor-I (IGFI), IGF binding protein-3 (IGFBP3), and urine concentrations of deoxypyridinoline cross-links and carboxy-terminal telopeptide of type I collagen. In premenopausal women, IGFI and IGFBP3 concentrations were increased by the low-iso diet, and deoxypyridinoline cross-links was increased by both the low- and high-iso diets during certain phases of the menstrual cycle. In postmenopausal women, bone-specific alkaline phosphatase was decreased by both the low- and high-iso diets, and there were trends toward decreased osteocalcin, IGFI, and IGFBP3 concentrations with increasing isoflavone consumption. Although soy isoflavones do affect markers of bone turnover, the changes observed were of small magnitude and not likely to be clinically relevant. These data do not support the hypothesis that dietary isoflavones per se exert beneficial effects on bone turnover in women.

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