scholarly journals Effects of anti-osteoporosis therapy on plasma aldosterone and renin

2020 ◽  
Vol 21 (2) ◽  
pp. 147032032092887
Author(s):  
Qingfen Hu ◽  
Kangla Liao ◽  
Longwei Zhang ◽  
Xiaoyu Shu ◽  
Zhixin Xu ◽  
...  
Keyword(s):  
Parathyroid Hormone ◽  
Femoral Neck ◽  
Postmenopausal Osteoporosis ◽  
Plasma Renin ◽  
Osteoporosis Treatment ◽  
Plasma Aldosterone ◽  
Mineral Density ◽  
Osteoporosis Therapy ◽  
Plasma Aldosterone Concentration ◽  
T Score

Objective: This study aimed to investigate the effect of anti-osteoporosis therapy on plasma aldosterone concentration (PAC), plasma renin concentration (PRC) and the aldosterone/renin ratio (ARR) in patients with postmenopausal osteoporosis. Methods: In 60 patients with postmenopausal osteoporosis, bone mineral density (BMD), PAC and PRC were measured before and after treatment with alendronate (70 mg/week, n=22) or recombinant human parathyroid hormone (20 μg/day, n=35) for 48 weeks. Results: PAC was negatively correlated with the T-score of lumbar spine BMD and femoral neck BMD (lumbar r=−0.386, p<0.01; femoral neck r=−0.262, p<0.05). With the improvement in lumbar BMD after anti-osteoporosis treatment (T-score −3.4±0.5 vs. –3.1 ±0.4, p<0.0001), PAC decreased from 182.8±53.2 to 143.7±68.6 pg/mL ( p<0.0001), PRC increased from 7.8±11.6 to 39.2±50.0 μIU/mL ( p<0.0001) and the ARR decreased from 74.8±75.2 to 13.1±17.1 pg/μIU ( p<0.0001). At baseline, 58% (35/60) of the patients had an ARR >37 pg/μIU, and the proportion decreased to 8% (5/57) after treatment. Conclusion: Treatment with alendronate or parathyroid hormone causes decreased PAC and increased PRC, resulting in a decreased ARR in postmenopausal women with osteoporosis.

scholarly journals Under-Recognition of Fractures as Osteoporosis Indicators

Geriatrics ◽  
2019 ◽  
Vol 4 (1) ◽  
pp. 9 ◽  
Author(s):  
Violet S. Lagari ◽  
Fatima Al-Yatama ◽  
Gracielena Rodriguez ◽  
Hara R. Berger ◽  
Silvina Levis
Keyword(s):  
Older Adults ◽  
Osteoporotic Fractures ◽  
Osteoporosis Treatment ◽  
Mineral Density ◽  
Osteoporosis Therapy ◽  
Diagnosis Of Osteoporosis ◽  
International Classification Of Disease ◽  
T Score ◽  
Traumatic Fracture ◽  
Receive Treatment

After the first fracture, the risk of subsequent fractures increases significantly. Medical treatment can reduce the risk of a second fracture by about 50%, but many older adults do not receive osteoporosis medication following their first fracture. This observational study aimed to understand primary care management patterns of older adults after osteoporotic fractures at the Miami Veterans Affairs (VA) Healthcare System. A retrospective review of 219 fracture cases selected by International Classification of Disease (ICD-9) codes between October 2015 and September 2016 identified 114 individuals age ≥50 years who had a non-traumatic fracture code entered in their medical record for the first time. Among them, 72 (63%) did not undergo a bone mineral density (BMD) test or receive treatment in the 12 months following their fracture. Of the 40 individuals who had a BMD test post-fracture, 17 (100%) received or were considered for anti-osteoporosis treatment if their T-score indicated osteoporosis (T-score ≤−2.5), but only 8/23 (35%) if the T-score was >−2.5. Physicians are more likely to prescribe osteoporosis therapy based on a BMD T-score diagnosis of osteoporosis, rather than a clinical diagnosis of osteoporosis based on a low-trauma fracture. A change in practice patterns is necessary to decrease the incidence of fractures.

scholarly journals POS1018 IMPORTANCE OF LATERAL SPINE VIEW IN DXA BONE DENSITOMETRY IN PATIENTS WITH SPONDYLOARTHRITIS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 776.3-777
Author(s):  
S. Miri ◽  
H. Ferjani ◽  
K. Maatallah ◽  
A. Kasraoui ◽  
D. Kaffel ◽  
...  
Keyword(s):  
Femoral Neck ◽  
Structural Changes ◽  
Age Of Onset ◽  
Posterior Part ◽  
Lateral View ◽  
Mineral Density ◽  
Lateral Spine ◽  
Male Predominance ◽  
T Score ◽  
The Mean

Background:Osteoporosis is an increasingly important health problem among patients with spondyloarthritis (SPA). The Measure of Bone Mineral Density BMD is routinely carried out in an anteroposterior (AP) view of the spine. However, the syndesmophytes, ligaments calcifications, and the posterior part of vertebrae affect AP scanning. A lateral spine view is a more sensitive tool in assessing bone loss in trabecular bone.Objectives:We aimed to evaluate the association between lateral lumbar DXA and syndesmophyte grading in patients with SPA.Methods:We conducted a retrospective study including 75 patients with SPA. Bone density of the hip and lumbar spine was measured with a GE Lunar Prodigy Advance Bone Densitometer equipment. All patients had lumbar lateral, AP, and proximal femur DXA scans. The T-score, which measures the difference between a patient’s BMD and young-normal subjects, was computed and age-matched.Results:The mean age of the patients was 36±11 years. Male predominance was noted with a sex ratio of 4.76. The mean BMI was 25±5 kg/m2. Eight percent were obese. Fifty-two percent had Vitamin D deficiency.Forty-eight percent of the patients had axial SPA, while 52% had axial and peripheral symptoms.The mean age of onset was 27±7 years. Fifty-two percent of the patients had high inflammatory biomarkers. The BASDAI, ASDAS-VS, and ASDAS-CRP mean levels were respectively: 3.5±2.4, 3.1±0.9, and 3±0.8. The mean BASRI and mass were respectively 8 + 4.8 and 16.4 + 19.4. Analyses of T-score values obtained over the femoral neck revealed osteoporosis in 18.7% of the cases and osteopenia in 32% of the cases. On the other hand, analyses of AP, spine views revealed osteoporosis in 25.3% and osteopenia in 45.3% of patients (p=0.028, r=0.254). We detected the highest percentage of osteoporosis in lateral lumbar view and T-scores matched more closely with femoral neck values; osteoporosis in 29.3%, and osteopenia in 22.7% of the patients (p<10-3, r=0.562). BMD measured in AP, and lateral views were in good agreement (p<10-3, p=0.592). Age was inversely but not significantly associated with BMD in lateral (p=0.442, r=-0.09), AP (p=0.319, r=-0.117) and femoral neck projections (p=0.179, r=-0.157). Femoral neck BMD was associated with the activity of SPA (ASDAS vs (p=0.027, r= -0.295), and the mobility limitation BASMI (p=0.032, r= -0.247). Coxitis, BASRI, or mSASS were independent of BMD.Conclusion:We conclude that spine lateral view in DXA accurately measures BMD exceeding the AP spine views and femoral neck values. Therefore, structural changes do not affect this measurementDisclosure of Interests:None declared.

Renin, aldosterone, electrolyte, and cortisol responses to hypoxic decompression

1977 ◽  
Vol 43 (3) ◽  
pp. 421-424 ◽  
Author(s):  
J. R. Sutton ◽  
G. W. Viol ◽  
G. W. Gray ◽  
M. McFadden ◽  
P. M. Keane
Keyword(s):  
Plasma Renin Activity ◽  
Plasma Cortisol ◽  
Acute Mountain Sickness ◽  
Plasma Renin ◽  
Plasma Aldosterone ◽  
Renin Activity ◽  
Plasma Sodium ◽  
Plasma Aldosterone Concentration ◽  
Urinary Potassium ◽  
Mountain Sickness

Responses of plasma renin activity, plasma aldosterone, plasma cortisol, and plasma electrolyte concentration and urinary electrolyte and aldosterone excretion were studied in four men during hypoxic decompression to a stimulated altitude of 4,760 m in a pressure chamber. Three of the four subjects developed significant acute mountain sickness. Plasma sodium and potassium concentrations were unchanged. No significant change in plasma renin activity was observed, but values tended to fall. Plasma aldosterone concentration was depressed while plasma cortisol was elevated and diurnal variation lost. Urinary sodium excretion was unchanged, but urinary potassium and aldosterone excretion were decreased. The decrease in plasma and urinary aldosterone and urinary potassium in the absence of change in plasma renin activity or plasma potassium is of uncertain origin. It is unlikely to be due to a decrease in adrenocorticotropin secretion since plasma cortisol rose during the same time. None of the changes could be causally implicated in the development of acute mountain sickness although the increase in plasma cortisol was greatest in the most ill.

scholarly journals BMD status of Postmenopausal Women in relation with BMI: A study with 93 cases

2016 ◽  
Vol 17 (2) ◽  
pp. 138-141
Author(s):  
Samira Sharmin ◽  
Mabubul Haque ◽  
Syedur Rahman Miah ◽  
Md Mahbub Ur Rahman ◽  
Jasmine Ara Haque ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Postmenopausal Women ◽  
Lumbar Vertebrae ◽  
The Body ◽  
Mineral Density ◽  
Cross Sectional ◽  
T Score ◽  
Minimal Trauma ◽  
The Mean

Objectives: Low bone mass is a common disorder in elderly population which predisposes to fracture with minimal trauma. This study was performed to find out the association between the Body Mass Index (BMI) and Bone Mineral Density (BMD) in postmenopausal women.Materials and Methods: This cross sectional study was carried out at Institute of Nuclear Medicine and Allied Sciences Comilla and Mitford, Dhaka over a period of 12 months from January 2013 to December 2013. A total 93 postmenopausal women were enrolled for this study. All postmenopausal women underwent a BMD scan of femoral neck and lumbar vertebrae using a Dual Energy X-ray Absorptiometry (DEXA). Participants were categorized into three groups according to their age and BMI. BMD were expressed base on T-score according to WHO criteria. The relation among BMI, age and BMD were assessed.Results: The results of this study showed that the mean age of the study group was 57.13±7.49 years with range of 46 to 75 years. The most postmenopausal women were in age group 55-65years. The mean BMI of the study subjects were 24.18±5.08 kg/m2 with a range of 15.62 to 36.20 kg/m2. Among 93 subjects osteopenia was greater at lumbar spine (45.2%) with T-score mean±SD-1.83±0.33 and osteoporosis at femoral neck (51.6%) with T-score mean ±SD-3.36±-0.67. Pearson’s correlation coefficient test showed inverse relationship between age and BMD both lumbar spine (r = -0.301, p = 0.003) and femoral neck (r = -0.303, p=0.003) whereas the positive relation between BMI and BMD both at lumbar spine (r=0.338, p=0.001) and femoral neck (r =0.343, p=0.001). These showed that with advancing age, BMD decreases and the risk of osteoporosis increases and with increasing BMI, BMD increases and risk of osteoporosis decreases.Conclusion: The findings of this study portrait that aging and low BMI are risk factors associated with bone loss. So preventive measure should be taken for high risk post menopausal women.Bangladesh J. Nuclear Med. 17(2): 138-141, July 2014

scholarly journals Risk factors for decreased bone mineral density in men with type 2 diabetes.

2021 ◽  
Vol 23 (5) ◽  
pp. 424-433
Author(s):  
Olga N. Fazullina ◽  
Anton I. Korbut ◽  
Maksim V. Dashkin ◽  
Vadim V. Klimontov
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Fat Mass ◽  
Free Testosterone ◽  
Mineral Density ◽  
T Score ◽  
25 Oh Vitamin D

BACKGROUND: Type 2 diabetes and osteoporosis are widespread diseases in the middle-aged and elderly people. Most studies of osteoporosis in patients with type 2 diabetes have been performed in women; meantime risk factors for lowering bone mineral density (BMD) in men have been little studied.AIMS: to identify risk factors for decreased BMD at the lumbar spine, femoral neck and forearm in men with type 2 diabetes.METHODS: Eighty two men from 50 to 75 years old, with duration of diabetes for at least one year, were included in the study. Individuals with known risk factors for secondary osteoporosis were not included. Twenty-three men with normal BMD having no diabetes or obesity were acted as control. The T-score at the lumbar spine, femoral neck and forearm of a non-dominant arm, as well as body composition parameters, were evaluated by dual-energy X-ray absorptiometry. The levels of hormones that affect bone metabolism (parathyroid hormone, free testosterone, 25-OH vitamin D) were measured in blood serum by ELISA. Risk factors for reducing BMD were identified using multivariate regression analysis and receiver operating characteristic (ROC) curves.RESULTS: Among patients with diabetes, 49 individuals had normal BMD and 33 showed decreased T-score values (<-1 SD). Free testosterone <5.92 pg/ml was predictor for decreased BMD at the lumbar spine (OR=4.4, p=0.04). For femoral neck, the risk factors were body weight <95.5 kg (OR=2.8, p=0.04), total fat mass <27 kg (OR=3.3, p=0.03), truncal fat mass<17.5 kg(OR=4.5, p=0.006), android (central abdominal) fat mass <3.2 kg(OR=4.0, p=0.01), gynoid (hip) fat mass <3.5 kg(OR=3.3, p=0.02), and lean mass <59 kg(OR=3.0, p=0.04). Risk factors for reduced BMD at the forearm were diabetes duration>15.5 years (OR=3.7, p=0.03) and HbA1c <8.15% (OR=3.8, p=0.03). Parathyroid hormone and 25-OH-vitamin D did not predict BMD independently.CONCLUSIONS: In men with type 2 diabetes, low free testosterone is a risk factor for decreased BMD in the lumbar spine, and diabetes duration is a risk factor for decreased BMD in the forearm. The presence of obesity is associated with an increase in BMD in the femoral neck; a high HbA1c is associated with an increase in BMD in the forearm.

Role of the pituitary in the effects of tonin on adrenal secretion of the rat

1983 ◽  
Vol 61 (3) ◽  
pp. 201-206 ◽  
Author(s):  
Ernesto L. Schiffrin ◽  
Raul Garcia ◽  
Jolanta Gutkowska ◽  
Jacques Genest
Keyword(s):  
Plasma Renin ◽  
Plasma Corticosterone ◽  
Plasma Aldosterone ◽  
High Rate ◽  
Pituitary Hormone ◽  
Plasma Aldosterone Concentration ◽  
Plasma Angiotensin ◽  
Hypophysectomized Rats ◽  
Adrenal Secretion

Chronically catheterized conscious rats were infused intravenously with tonin at 2.4 and 12 μg∙kg−1∙min−1 for 2 h. Plasma aldosterone concentration (PAC) at the end of the experiment was 11.2 ± 2.4 ng% in controls, 8.5 ± 2.8 ng% in rats infused with tonin at the lower rate, and 26.2 ± 3.6 ng% (p < 0.01 vs. controls) in rats infused at the higher rate. Plasma corticosterone (PC) was significantly higher (p < 0.05) in the group infused at the high rate while plasma renin activity (PRA) was significantly reduced in this group of rats. Plasma angiotensin II (AII) concentration was similar in all three groups. PAC was elevated after tonin infusion in the presence of AII blockade. PAC in conscious sodium-depleted rats infused with tonin was not significantly changed, but PRA was significantly reduced (p < 0.01). In chronically hypophysectomized rats, PAC remained unchanged by tonin infusion. The failure of tonin to stimulate aldosterone in hypophysectomized animals indicates a role of a pituitary hormone (probably ACTH) in the effect of tonin on adrenal secretion.

Renin, Angiotensin and Aldosterone in Human Pregnancy and the Menstrual Cycle

1971 ◽  
Vol 16 (3) ◽  
pp. 183-196 ◽  
Author(s):  
J. I. S. Robertson ◽  
R. J. Weir ◽  
G. O. Düsterdieck ◽  
R. Fraser ◽  
M. Tree
Keyword(s):  
Angiotensin Ii ◽  
Plasma Renin ◽  
Normal Pregnancy ◽  
Maternal Plasma ◽  
Plasma Aldosterone ◽  
Sodium Depletion ◽  
Aldosterone Secretion ◽  
Renin Substrate ◽  
Plasma Aldosterone Concentration ◽  
In Pregnancy

Aldosterone secretion is frequently, although not invariably, increased above the normal non-pregnant range in normal pregnancy. Substantial increases in plasma aldosterone concentration have also been demonstrated as early as the sixteenth week. In pregnancy, aldosterone secretion rate responds in the usual way to changes in sodium intake. Plasma renin concentration is frequently, but not invariably, raised above the normal non-pregnant range. Plasma renin-substrate is consistently raised in pregnancy. Plasma angiotensin II has also been shown usually to be raised in a series of pregnant women. A significant positive correlation has been shown between the maternal plasma aldosterone concentration and the product of the concurrent plasma renin and renin-substrate concentrations. This suggests that the increased plasma aldosterone in pregnancy is the consequence of an increase in circulating angiotensin II, which in turn is related to the level of both renin and its substrate in maternal blood. For these reasons, estimations of renin activity in pregnancy are of dubious value. The increased renin, angiotensin and aldosterone concentrations may represent a tendency to maternal sodium depletion, probably mainly a consequence of the increased glomerular filtration rate. It is possible that the nausea and other symptoms of early pregnancy may be a consequence of this tendency to sodium depletion, with its attendant hormonal changes. In ‘pre-eclampsia’, renin and aldosterone values are generally slightly lower than in normal pregnancy. Human chorion can apparently synthesize renin independently of the kidney. The physiological significance of this remains at present obscure, but it seems unlikely that this source contributes much, if at all, to the often elevated maternal plasma renin. Plasma renin, renin-activity and angiotensin II concentrations, and aldosterone secretion are increased in the luteal phase of the menstrual cycle.

Inflammatory Markers as a Predictor of Postmenopausal Osteoporosis

2021 ◽  
Author(s):  
Asma Al Salmani ◽  
Asma Al Shidhani ◽  
Nouf M Al-Alawi ◽  
Arwa A Al Sulaimi ◽  
Maha A Al-Hashemi
Keyword(s):  
Bone Mineral Density ◽  
Postmenopausal Osteoporosis ◽  
Bone Mineral ◽  
Inflammatory Markers ◽  
Neutrophil To Lymphocyte Ratio ◽  
Mineral Density ◽  
Platelet To Lymphocyte Ratio ◽  
Lymphocyte Ratio ◽  
T Score ◽  
Inflammatory Status

Objectives: Postmenopausal osteoporosis is a progressive metabolic bone disease resulting from estrogen deficiency. However, due to the silent nature of the disease, there is an urgent need for a simple, early predictive marker. This study, conducted between January 2017 to December 2019, aimed to assess the potential of three factors—specifically, the neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-to-lymphocyte ratio (PLR)—as inflammatory markers of bone mineral density (BMD) loss. Methods: A retrospective cross-sectional study was conducted among 450 postmenopausal Omani women undergoing dual-energy X-ray absorptiometry at the Sultan Qaboos University Hospital, Muscat, Oman. Participants were allocated into groups based on lumbar spine BMD t-score values. A receiver-operating characteristic curve was used to find the area under the curve (AUC). Multivariate logistic regression was performed to identify independent predictors of low BMD. Results: A total of 65 (14.4%), 164 (36.4%), and 221 (49.1%) women were allocated to the control, osteopenia, and osteoporosis groups, respectively. No significant differences in PLR, MLR, and NLR values were observed based on group allocation. BMD t-score values were reversely correlated with age (P = 0.007) and PLR (P = 0.004), and positively correlated with body mass index (BMI) (P <0.001). The AUC was 0.59. However, the only independent predictors of low BMD were age (>65 years) and BMI (<25 kg/m2). Conclusion: None of the three inflammatory biomarkers studied were found to be useful prognostic indicators of bone loss. Further research is recommended to reject or support theories regarding the role of inflammatory status in the pathogenesis. Keywords: inflammatory markers, neutrophil-to-lymphocyte ratio, monocyte-to-lymphocyte ratio, platelet-to-lymphocyte ratio, Bone mineral density, osteoporosis

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