Damage of bone metabolism and osteoporosis in testicular cancer patients

5052 Background: Improved survival of testicular cancer (TC) patients leads to rising of interest on late toxicity. Treatment-related bone loss is well recognized in breast and prostate cancer, but there has been little information in long-term survivors from other tumors. The aim of the study was to assign the damage of bone metabolism in TC patients. Materials: Bone mineral density (BMD) was measured by dual energy photon x-ray absorptiometry in the lumbar spine and hips. BMD was classified as osteopenia (T score ranging from -1 to -2,5) and osteoporosis (T score less -2,5). C-terminal cross-linked telopeptides of type I collagen (CTX) were measured using ELISA. Additionally serum total testosterone was measured. Comparison was made with matched control data. Relationships between baseline characteristics (age, treatment type and time from orchiectomy) and BMD were assessed using univariate and multivariate analysis tools. Results: We included 257 patients in the study (17 - 72 yrs old, median: 36 yrs) who were treated for GCT since 1982. 29 (11%) of them had bilateral orchiectomy (OE) due to bilateral TC. 23% of pts were treated by OE alone, 17% by subsequent radiotherapy of para-aortic field and 59% by subsequent chemotherapy. Median time since the OE was 4 years (1–36 yrs). Pts after bilateral OE had significantly lower BMD comparing with pts with unilateral OE. We didn’t find any differences between TC pts and matched control data regarding incidence of osteopenia and CTX, but the incidence of osteoporosis was considerably higher in TC pts. The incidence of osteoporosis appeared to increase with age and slightly correlated with time since OE, particularly after 10 years after OE. Type of therapy did not prove to have significant impact on the appearance of osteoporosis. Serum testosterone level did not correlate with BMD. Conclusion: The long term survivors from GCP have significantly higher risk of osteoporosis than healthy matched population. No significant financial relationships to disclose.

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Damage of hormonal function and bone metabolism in long-term survivors of testicular cancer

Neoplasma ◽

10.4149/neo_2009_06_473 ◽

2009 ◽

Vol 56 (6) ◽

pp. 473-479 ◽

Cited By ~ 22

Author(s):

M. ONDRUSOVA ◽

D. ONDRUS ◽

L. DUSEK ◽

B. SPANIKOVA

Keyword(s):

Testicular Cancer ◽

Bone Metabolism ◽

Hormonal Function ◽

Long Term Survivors

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Testosterone Deficiency and Bone Metabolism Damage in Testicular Cancer Survivors

American Journal of Men s Health ◽

10.1177/1557988316661986 ◽

2016 ◽

Vol 12 (3) ◽

pp. 628-633 ◽

Cited By ~ 8

Author(s):

Martina Ondrusova ◽

Beata Spanikova ◽

Katarina Sevcikova ◽

Dalibor Ondrus

Keyword(s):

Testicular Cancer ◽

Type I Collagen ◽

Total Testosterone ◽

Type I ◽

Mineral Density ◽

Cross Sectional ◽

Therapeutic Modalities ◽

Unilateral Disease

The aim of the study was to investigate the influence of therapeutic modalities and sexual hormone levels on changes in bone mineral density (BMD) in testicular cancer (TC) survivors. In a cross-sectional descriptive, long-term follow-up study, a total of 1,249 long-term TC survivors were evaluated according to treatment modality: orchiectomy (OE) only, OE + chemotherapy (CT), or OE + radiotherapy (RT). Luteinizing hormone (LH), total testosterone (TST), marker of bone resorption (β-carboxyl-terminal cross-linking telopeptide of type I collagen—CTx), and BMD were evaluated. Standard statistical techniques were used to test the differences between groups of patients. TST decrease was observed in 46/313 TC survivors after OE alone, in 103/665 after OE + CT, and in 66/271 after OE + RT. LH increase was observed in 23/313 TC survivors after OE alone, in 154/665 after OE + CT, and in 43/271 after OE + RT. CTx increase was observed in 116/313 TC survivors after OE alone, in 324/665 after OE + CT, and in 82/271 after OE + RT. Osteopenia/osteoporosis occurred in 136/313 TC survivors after OE alone, in 298/665 after OE + CT, and in 139/271 after OE + RT. TC survivors after RT have statistically significant decreased TST levels, increased LH and nonsignificant worse BMD (osteopenia/osteoporosis) in comparison with TC survivors after OE alone or CT. TST decrease and LH increase were statistically significant, more frequently observed in patients with osteopenia/osteoporosis. Examination of TST is an important part of follow-up in TC survivors with bilateral as well as unilateral disease. The important part of standard examination algorithm should be also the osteological examination of TC survivors mainly in patients with androgen deficiency.

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Changes in bone metabolism associated with exposure to industrial vibration

Russian Journal of Occupational Health and Industrial Ecology ◽

10.31089/1026-9428-2019-59-9-766-767 ◽

2020 ◽

pp. 766-766

Author(s):

A. V. Sukhova ◽

E. N. Kryuchkova

Keyword(s):

Bone Mineral Density ◽

Alkaline Phosphatase ◽

Bone Resorption ◽

Bone Formation ◽

Bone Metabolism ◽

Biochemical Markers ◽

Mineral Density ◽

Local Vibration ◽

Markers Of Bone Formation

The influence of general and local vibration on bone remodeling processes is investigated. The interrelations between the long - term exposure of industrial vibration and indicators of bone mineral density (T-and Z-criteria), biochemical markers of bone formation (osteocalcin, alkaline phosphatase) and bone resorption (ionized calcium, calcium/creatinine) were established.

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Effects of denosumab in Japanese rheumatoid arthritis patients treated with conventional anti-rheumatic drugs: 36-month extension of a phase 3 study

The Journal of Rheumatology ◽

10.3899/jrheum.201376 ◽

2021 ◽

pp. jrheum.201376

Author(s):

Yoshiya Tanaka ◽

Tsutomu Takeuchi ◽

Satoshi Soen ◽

Hisashi Yamanaka ◽

Toshiyuki Yoneda ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Type I Collagen ◽

Joint Destruction ◽

Term Treatment ◽

Drug Discontinuation ◽

Type I ◽

Mineral Density ◽

Phase 3 ◽

Long Term Treatment

Objective To evaluate safety and efficacy of long-term denosumab 60 mg every 6 (Q6M) or 3 months (Q3M) in rheumatoid arthritis (RA) patients. Methods This 12-month, randomised, double-blind, placebo-controlled, multicentre phase 3 trial with an open-label extension period from 12 to 36 months (DESIRABLE) enrolled Japanese RA patients treated with placebo for 12 months then denosumab Q6M (P/Q6M) or denosumab Q3M (P/Q3M); denosumab Q6M for 36 months (Q6M/Q6M); or denosumab Q3M for 36 months (Q3M/Q3M). Efficacy was assessed by van der Heijde modified total Sharp (mTSS), bone erosion (ES), and joint space narrowing (JSN) scores. Results Long-term treatment better maintained mTSS and ES suppression in the P/Q3M and Q3M/Q3M versus P/Q6M and Q6M/Q6M groups; changes from baseline in total mTSS at 36 months were 2.8 (standard error 0.4), 1.7 (0.3), 3.0 (0.4), and 2.4 (0.3), respectively; corresponding changes in ES were 1.3 (0.2), 0.4 (0.2), 1.4 (0.2), and 1.1 (0.2). No JSN effect was observed. Bone mineral density consistently increased in all groups after denosumab initiation, regardless of concomitant glucocorticoid administration. Serum C-telopeptide of type I collagen decreased rapidly at 1-month post-denosumab administration (both in the initial 12- month [Q3M, Q6M groups] and long-term treatment [P/Q3M, P/Q6M groups] phases). Adverse event incidence leading to study drug discontinuation was similar across treatment groups. Conclusion Denosumab treatment maintained inhibition of progression of joint destruction up to 36 months. Based on effects on ES progression, higher dosing frequency at an earlier treatment stage may be needed to optimise treatment. Denosumab was generally well tolerated.

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Long term effect of oral testosterone substitution therapy on bone mineral density and hormone profil in patients with bilateral testicular cancer

European Journal of Cancer ◽

10.1016/s0959-8049(01)81316-2 ◽

2001 ◽

Vol 37 ◽

pp. S224-S225

Author(s):

J. Horti ◽

A. Petranyi ◽

S. Forgacs ◽

I. Bodrogi

Keyword(s):

Bone Mineral Density ◽

Testicular Cancer ◽

Bone Mineral ◽

Term Effect ◽

Substitution Therapy ◽

Mineral Density ◽

Long Term Effect ◽

Testosterone Substitution

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P1621VITAMIN D SUPPLEMENTATION: CHANGES IN BONE MINERAL DENSITY IN KIDNEY TRANSPLANT PATIENTS WITH LONG TERM DURATION OF THE GRAFT

Nephrology Dialysis Transplantation ◽

10.1093/ndt/gfaa143.p1621 ◽

2020 ◽

Vol 35 (Supplement_3) ◽

Author(s):

Yuri Battaglia ◽

Michele Provenzano ◽

Francesco Tondolo ◽

Antonio Bellasi ◽

Pasquale Esposito ◽

...

Keyword(s):

Bone Mineral Density ◽

Vitamin D ◽

Vitamin D Deficiency ◽

Kidney Transplant ◽

Bone Mineral ◽

Categorical Variables ◽

Z Score ◽

Mineral Density ◽

T Score

Abstract Background and Aims In the medical literature, several studies have linked bone mineral density (BMD) with vitamin D deficiency in kidney transplant patients (KTRs). However, in spite of the fact that ergocalciferol, cholecalciferol and calcifediol reduce parathyroid hormone (PTH) and improves calcium levels, their effects on the bone mineral density (BMD) in KTRs remain undefined. In consideration of the lack of data available, we aim at investigating the effect of inactive form of vitamin D supplementation on the BMD over a follow-up period up to 2 year, in a real-life cohort of long-term kidney transplant(KT). Method This study was carried out in KTRs who were followed up in a Nephrology Unit. Exclusion criteria were parathyroidectomy, therapy with bisphosphonate, previous history of bone fractures. Demographic, clinical and immunosuppressive agents were collected. Based on 25-OH-D levels, KTRs were classified as suffering from deficiency (< 30 ng/mL). BMD was evaluated at lumbar vertebral bodies (LV) and right femoral hip (FH) by a single operator, using a standard dual energy X-ray absorptiometry. According to WHO criteria, results were expressed as T-score (standard deviation [SD] relative to young healthy adults), and Z-score (SD relative to age-matched controls). Osteoporosis and osteopenia were defined as T score ≤ −2.5 SD and T score < −1 and > −2.5 SD, respectively. Laboratory data, 25-OH-D, and BMD were measured at baseline and after 24 months of supplementation therapy. Vitamin D deficiency was corrected using standard treatment strategy recommended for general population. Continuous variables were expressed as mean ± SD whereas categorical variables as percentage. The Student’s t test and chi-square test were used to compare to compare continuous and categorical variables, respectively. For before and after comparisons of continuous variables, the paired t-test or one-sample Wilcoxon signed rank test were used based on variable’s distribution. Results Data pertaining to 111 out of 133 consecutive outpatients were collected, of whom most were males (69.4%), no-smokers (89.1%) and treated with glucocorticoids (84%). The mean age was 53.9±11.6 years and months after transplant was 161.6±128.3. No statistical differences were found among patients with normal BMD, osteopenia or osteoporosis at LV and FH in terms of age at transplant, gender distribution, time on dialysis, BMI and eGFR, serum calcium, serum phosphate, 25-OH-D and iPTH. At baseline, 25-OH-D was 13.9±7.2 ng/ml and the prevalence of osteopenia/osteoporosis was 40.9% (T-Score -1.69±0.37; Z-score -1.16±1.09) and 21.8 % (T-Score -3.15±0.50; Z-score -2.27±0.58) at LV; 55.3 % (T-Score -1.8±0.46; Z-score -0.84±0.633) and 14 % (T-Score -2.83±0.39; Z-score -1.65±0.49) at FH. After 27.6±3.7 months of therapy with cholecalciferol at mean dose of 13.396±7.537 UI at week, 25-OH-D values increased to 29.4±9.4 ng/ml (p<0.0001) while no statistically significant changes were found in Z-score and T-score at both sites, except for a mild improvement in lumbar vertebral Z-score, reaching −0.82± 0.7 (p = 0.06) in KTRs with osteopenia Conclusion Our study showed BMD remained stable after up to 2 years of inactive vitamin D therapy in long-term kidney transplant with vitamin D deficiency. A mild increase in Z-score was observed in the L-spine. Further designated studies should be conducted to demonstrate the effect of vitamin D on BMD.

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Effect of Vitamin E Isoforms on Bone Metabolism in C57BL/6 J Mice Fed a High Fat Diet

Current Developments in Nutrition ◽

10.1093/cdn/nzaa067_022 ◽

2020 ◽

Vol 4 (Supplement_2) ◽

pp. 1795-1795

Author(s):

Chen Du ◽

Gina Tran ◽

Victorine Imrhan ◽

Chandan Prasad ◽

Parakat Vijayagopal ◽

...

Keyword(s):

Vitamin E ◽

Bone Loss ◽

Bone Metabolism ◽

Bone Mineral ◽

High Fat Diet ◽

Alpha Tocopherol ◽

Type I ◽

High Fat ◽

Mineral Density ◽

Gamma Tocopherol

Abstract Objectives The purpose of this study was to compare the effects of alpha tocopherol, gamma tocopherol, and the combination of alpha and gamma tocopherols on bone mineral density (BMD), bone mineral content (BMC), and bone metabolism in C57BL/6 J mice fed a high-fat diet. Methods A total of 75 male C57BL/6 mice were randomized to either a low fat diet (LFD) with 6% fat, a high fat diet (HFD) with 20% fat, HFD supplemented with alpha tocopherol (AT), gamma tocopherol (GT), or the combination of AT and GT. LFD and HFD were provided to corresponding groups of mice without vitamin E isoform supplements for 15 weeks to induce bone loss. At the end of the 15 weeks, AT, GT, and a combination of AT and GT were added to 3 of the HFD groups and fed for 10 weeks. LFD group and one of the HFD groups were continued on the same diet for another 10 weeks without additional supplements. All mice were euthanized at the end of the 25 weeks period. Left and right fibula bones were excised, cleaned, and scanned using the Lunar PIXImus dual-energy x-ray absorptiometry (DEXA) densitometer to assess BMD, BMC, lean tissue, and fat tissue content. Serum biomarkers of bone metabolism were evaluated post euthanization. Results HFD resulted in significantly lower fibular BMD and higher tibial bone fat content in comparison to LFD. Animals in the HFD supplemented with GT, but not AT, showed significantly reduced effect of HFD in lowering BMD. Additionally, in the group fed HFD supplemented with GT, a significantly higher concentration of alkaline phosphatase (ALP) and N-terminal propeptide of type I procollagen (PINP) were noted, compared to LFD. This may be indicative of increased bone formation resulting from GT incorporated into the HFD diet. Conclusions The findings of the study suggest that different isoforms of vitamin E affect bone density and bone metabolism differently. Within the different isoforms of vitamin E, gamma tocopherol may have protective effects in bone, especially in the situation of high fat diet induced bone loss. Further examination of the mechanistic action of vitamin E isoforms on skeletal health is warranted. Funding Sources Texas Woman's University.

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Zhuang-Gu-Fang Treats Osteoporosis in Ovariectomized Rats by Increasing the Osteogenesis-Related Factors Leptin, Ghrelin, and PYY

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/8164064 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Yuanjin Chen ◽

Rui Bai ◽

Wenhui Chen ◽

Shuanglei Li ◽

Yunxia Jiang

Keyword(s):

Bone Metabolism ◽

Therapeutic Effect ◽

Wistar Rats ◽

Dose Group ◽

Bone Structure ◽

Ovariectomized Rats ◽

Type I ◽

Mineral Density ◽

Related Factors ◽

Expression Levels

Zhuang-Gu-Fang is a Chinese medicinal compound mixture, which is mainly composed of traditional remedies like the Epimedium Herb, Astragalus, and Eucommia among many others. The study is aimed at investigating the therapeutic effect of Zhuang-Gu-Fang in ovariectomized rats. Fifty six-month-old Wistar rats were randomly selected and divided into 5 groups (n = 10), namely, model group, positive group, low-dose Chinese medicine group, medium-dose group, and high-dose group. Another 10 sham operation Wistar rats were taken as a negative control group. After 3 months of intervention, the bone mineral density (BMD), procollagen type I N-peptide (PINP), beta C-terminal cross-linked telopeptides of type I collagen carboxyl-terminal peptide (β-CTX), Leptin, Ghrelin, and Peptide YY (PYY) of each group were measured. Besides, the ultrastructure of bone structure and osteoblasts was also observed by transmission electron microscopy. Western blot method was used to detect the expression levels of Leptin and Ghrelin in bone tissue, and RT-PCR detected the mRNA expression levels of Leptin and Ghrelin. BMD test indicated that Zhuang-Gu-Fang could effectively prevent the loss of tibia bone in ovariectomized rats. Histomorphology analysis showed that Zhuang-Gu-Fang could preserve trabecular bone structure integrity and improve osteoblast ultrastructure. Notably, the study found out that Zhuang-Gu-Fang worked through balancing the bone metabolism via increasing bone formation/resorption ratio. Additionally, Zhuang-Gu-Fang highlighted the recovery effects in multiple levels of osteogenesis- and osteanagenesis-related factors Leptin, Ghrelin, and PYY. Conclusively, the study proved the therapeutic potential of the Zhuang-Gu-Fang for postmenopausal osteoporosis (PMOP) and further revealed that its therapeutic effect was related to the balance of bone metabolism and the recovery effects of bone-related factors Leptin, Ghrelin, and PYY.

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