Feeding and Bone Turnover in Gastric Bypass

Context: Roux-en-Y gastric bypass (RYGB) is associated with high bone turnover. In healthy subjects, feeding causes acute reduction of bone resorption, which is regulated by several intestinal and pancreatic peptides. Objective: Our objective was to assess bone turnover after feeding in patients with RYGB. Design and Setting: This was a cross-sectional case-control study at a university hospital. Participants: Fifteen postmenopausal women who underwent RYGB 7.4 ± 4.1 years previously were matched by age and body mass index with 15 nonoperated women (controls). Main Outcomes: Serum PTH, calcium, phosphorus, insulin, carboxy telopeptide (CTX), procollagen type I N-terminal propeptide (P1NP), and glucagon-like peptide 2 (GLP-2) were measured while fasting and after a standard meal (SM). Results: The fasting calcium, phosphorus, and PTH were similar in both groups and exhibited similar decreases after an SM. The fasting CTX level was higher in the RYGB than in the control group (0.589 ± 0.18 vs 0.382 ± 0.11 ng/mL; P < .05) and fell to a nadir of 42.2% of the basal value in the RYGB and 53.9% in controls (P < .05). The fasting and postprandial P1NP levels were similar in both groups and fell to a nadir of 85.8% in the RYGB and 89.3% in controls. Insulin and GLP-2 levels were similar during fasting in both groups. RYGB patients had exaggerated postprandial insulin and GLP-2 response compared with the controls with the insulin and GLP-2 area under the curve being significantly higher in the RYGB group. There was a significant negative correlation between the peak of insulin levels and the CTX changes. Conclusion: The acute reduction in bone resorption after feeding is preserved in RYGB and is even higher than in nonoperated subjects. This phenomenon is related to the increase of postprandial levels of insulin. These findings suggest a bone-protecting mechanism in RYGB that may counteract the elevated bone resorption that occurs during fasting.

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Low Dose Estrogen and Calcium Have an Additive Effect on Bone Resorption in Older Women1

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jcem.84.1.5416 ◽

1999 ◽

Vol 84 (1) ◽

pp. 179-183

Author(s):

K. M. Prestwood ◽

D. L. Thompson ◽

A. M. Kenny ◽

M. J. Seibel ◽

C. C. Pilbeam ◽

...

Keyword(s):

Bone Resorption ◽

Bone Formation ◽

Bone Turnover ◽

Older Women ◽

Low Dose ◽

Type I Collagen ◽

Control Group ◽

Type I ◽

Markers Of Bone Formation ◽

Markers Of Bone Resorption

Previous studies have shown that treatment with estrogen or calcium decreases bone turnover in older women. The mechanisms by which estrogen and calcium exert their effects are probably different. We therefore examined the possibility of an additive or synergistic effect of combined treatment with calcium and low dose estrogen on bone turnover in older women, using biochemical markers. Thirty-one healthy women over 70 yr of age were randomized to 12 weeks of treatment with either micronized 17β-estradiol [0.5 mg/day Estrace (E2)] or 1500 mg/day elemental calcium, given as carbonate plus vitamin D (800 IU/day; Ca+D). At the end of the initial 12-week treatment period, both groups received both Ca+D and E2 for an additional 12 weeks. Eleven older women were followed for 36 weeks without any treatment and served as a control group. Serum and urine were collected at baseline, at 12 and 24 weeks on treatment, and at 12 weeks after treatment was terminated for measurement of biochemical markers of bone turnover. Markers of bone formation were bone alkaline phosphatase, osteocalcin, and type I procollagen peptide; markers of bone resorption were urinary cross-linked C-telopeptides and N-telopeptides of type I collagen, serum cross-linked N-telopeptides of type I collagen, urinary free deoxypyridinoline cross-links, and serum bone sialoprotein. Repeated measures ANOVA was used to determine changes in bone turnover measures over time by group. All markers of bone resorption decreased with initial treatment and decreased further with combination therapy (P < 0.001). Markers of bone formation decreased with Ca+D treatment, but not with E2 alone; there was no additional effect of combination therapy on formation markers compared to Ca+D alone. Neither markers of formation nor resorption changed in the control group. These results suggest that there is an additive effect of low dose estrogen and calcium on bone resorption, but not on bone formation, in older women. Thus, the combination of low dose estrogen plus calcium is likely to be more effective in older women than either treatment alone.

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Low calcium intake is associated with increased bone resorption in postmenopausal Japanese women: Yokogoshi Study

Public Health Nutrition ◽

10.1017/s1368980009005084 ◽

2009 ◽

Vol 12 (12) ◽

pp. 2366-2370 ◽

Cited By ~ 8

Author(s):

Kazutoshi Nakamura ◽

Toshiko Saito ◽

Akihiro Yoshihara ◽

Miki Ishikawa ◽

Yasuo Tsuchiya ◽

...

Keyword(s):

Bone Resorption ◽

Bone Turnover ◽

Bone Metabolism ◽

Type I Collagen ◽

Community Setting ◽

Serum Markers ◽

Japanese Women ◽

Type I ◽

Cross Sectional ◽

Markers Of Bone Turnover

AbstractObjectiveLow Ca intake is common among Japanese women, but its effect on bone metabolism has not been fully elucidated. The aim of the present study was to determine the relationship between Ca intake and serum markers of bone turnover in postmenopausal Japanese women.DesignA cross-sectional study.SettingA community setting.SubjectsSubjects were 595 home-dwelling postmenopausal Japanese women. Ca intake was assessed by a validated FFQ. Serum type I collagen cross-linked N-telopeptides (NTX) and osteocalcin were measured as markers of bone turnover. The relationships between demographic characteristics, lifestyles, serum Ca, vitamin D and intact serum parathyroid hormone and bone turnover were also assessed.ResultsThe average age of the subjects was 64·5 (sd 5·8) years and the mean Ca intake was 527 (sd 160) mg/d. Ca intake was significantly associated with serum NTX (P = 0·0104), but not with serum osteocalcin. Mean serum NTX concentration in the lowest quartile of Ca intake (<417 mg/d) was significantly higher than in the fourth, referent quartile. Among these Japanese postmenopausal women, very low Ca intake (less than ∼400 mg/d) was associated with increased bone resorption but not bone formation.ConclusionsIncreased bone resorption may be one mechanism by which this Ca-depleted population normalizes bone metabolism and prevents osteoporosis.

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Serum Sclerostin and Bone Turnover in Latent Autoimmune Diabetes in Adults

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/jc.2017-02274 ◽

2018 ◽

Vol 103 (5) ◽

pp. 1921-1928 ◽

Cited By ~ 17

Author(s):

Nicola Napoli ◽

Rocky Strollo ◽

Giuseppe Defeudis ◽

Gaetano Leto ◽

Chiara Moretti ◽

...

Keyword(s):

Bone Resorption ◽

Bone Formation ◽

Bone Turnover ◽

Type I Collagen ◽

Autoimmune Diabetes ◽

Positive Trend ◽

Type I ◽

Cross Sectional ◽

Latent Autoimmune Diabetes

Abstract Purpose Bone formation is impaired in both type 1 diabetes and type 2 diabetes (T2D), whereas sclerostin, an antagonist of bone formation, is increased in T2D only. No data are available on latent autoimmune diabetes in adults (LADA), an autoimmune type of diabetes that may clinically resemble T2D at diagnosis. We evaluated serum sclerostin and bone turnover markers in LADA compared with those in T2D and whether metabolic syndrome (MetS) affects sclerostin in T2D or LADA. Methods This cross-sectional study included 98 patients with T2D and 89 with LADA from the Action LADA and Non Insulin Requiring Autoimmune Diabetes cohorts. Patients were further divided according to MetS status. Nondiabetic participants (n = 53) were used as controls. Serum sclerostin, bone formation (pro-collagen type 1 N-terminal propeptide [P1NP]), and bone resorption (C-terminal telopeptide of type I collagen [CTX]) were analyzed. Results Patients with T2D had higher sclerostin than did those with LADA [P = 0.0008, adjusted for sex and body mass index (BMI)], even when analysis was restricted to patients with MetS (adjusted P = 0.03). Analysis of T2D and LADA groups separately showed that sclerostin was similar between those with and those without MetS. However, a positive trend between sclerostin and number of MetS features was seen with T2D (P for trend = 0.001) but not with LADA. Patients with T2D or LADA had lower CTX than did controls (P = 0.0003) and did not have significantly reduced P1NP. Sclerostin was unrelated to age or hemoglobin A1c but was correlated with BMI (ρ = 0.29; P = 0.0001), high-density lipoprotein (ρ = −0.23; P = 0.003), triglycerides (ρ = 0.19; P = 0.002), and time since diagnosis (ρ = 0.32; P < 0.0001). Conclusions Patients with LADA presented lower bone resorption than did controls, similar to patients with T2D. Sclerostin is increased in T2D but not in LADA, suggesting possible roles on bone metabolism in T2D only.

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Response of biochemical markers of bone turnover to oral glucose load in diseases that affect bone metabolism

Acta Endocrinologica ◽

10.1530/eje-11-0128 ◽

2011 ◽

Vol 164 (6) ◽

pp. 1035-1041 ◽

Cited By ~ 16

Author(s):

Maria P Yavropoulou ◽

Konstantinos Tomos ◽

Xanthippi Tsekmekidou ◽

Olympia Anastasiou ◽

Pantelis Zebekakis ◽

...

Keyword(s):

Bone Resorption ◽

Bone Turnover ◽

Bone Metabolism ◽

Bone Turnover Markers ◽

Physiological Response ◽

Control Group ◽

Oral Glucose ◽

Type I ◽

Turnover Markers ◽

Affect Bone Metabolism

ObjectivePostprandial suppression of bone resorption is considered one of the main contributors in the circadian rhythm of bone turnover markers. The aim of this study was to investigate this physiological response of bone tissue in diseases that affect bone metabolism.Patients and methodsIn this study, 118 patients (45 hypothyroid, 40 hyperthyroid, and 33 β-thalassemic patients) and 78 healthy individuals matched for age and body mass index were included. An oral glucose test (75 g glucose) was performed after overnight fasting. Serum levels of procollagen type-I N-terminal propeptide (P1NP), β-C-terminal telopeptide of type I collagen (β-CTX), and osteocalcin were assayed at 0, 60, and 120 min.ResultsBaseline values of bone turnover markers were significantly elevated in hyperthyroid and β-thalassemic patients but not in hypothyroid patients compared with the control group. After oral glucose, the levels of β-CTX but not P1NP or osteocalcin were significantly suppressed in all groups (mean change from baseline is 46.9% for β-CTX, 7.9% for P1NP, and 8% for osteocalcin). The percentage change from baseline for β-CTX was significantly augmented in hypothyroidism (52 vs 42%, P=0.009).ConclusionThe preservation or even augmentation of postprandial suppression of bone resorption in diseases that affect bone metabolism through distinct pathogenetic mechanisms suggests the importance of this physiological response to nutrients for the general homeostasis and functional integrity of the skeleton.

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Effect of Vitamin E Supplement on Bone Turnover Markers in Postmenopausal Osteopenic Women: A Double-Blind, Randomized, Placebo-Controlled Trial

Nutrients ◽

10.3390/nu13124226 ◽

2021 ◽

Vol 13 (12) ◽

pp. 4226

Author(s):

Sakda Arj-Ong Vallibhakara ◽

Katanyuta Nakpalat ◽

Areepan Sophonsritsuk ◽

Chananya Tantitham ◽

Orawin Vallibhakara

Keyword(s):

Placebo Group ◽

Vitamin E ◽

Bone Resorption ◽

Bone Turnover ◽

Bone Remodeling ◽

Controlled Trial ◽

Control Group ◽

Bone Resorption Marker ◽

Type I ◽

Significant Difference

Vitamin E is a strong anti-oxidative stress agent that affects the bone remodeling process. This study evaluates the effect of mixed-tocopherol supplements on bone remodeling in postmenopausal osteopenic women. A double-blinded, randomized, placebo-controlled trial study was designed to measure the effect of mixed-tocopherol on the bone turnover marker after 12 weeks of supplementation. All 52 osteopenic postmenopausal women were enrolled and allocated into two groups. The intervention group received mixed-tocopherol 400 IU/day, while the control group received placebo tablets. Fifty-two participants completed 12 weeks of follow-up. Under an intention-to-treat analysis, vitamin E produced a significant difference in the mean bone resorption marker (serum C-terminal telopeptide of type I collagen (CTX)) compared with the placebo group (−0.003 ± 0.09 and 0.121 ± 0.15, respectively (p < 0.001)). In the placebo group, the CTX had increased by 35.3% at 12 weeks of supplementation versus baseline (p < 0.001), while, in the vitamin E group, there was no significant change of bone resorption marker (p < 0.898). In conclusion, vitamin E (mixed-tocopherol) supplementation in postmenopausal osteopenic women may have a preventive effect on bone loss through anti-resorptive activity.

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Effect of cachexia on bone turnover in cancer patients: a case-control study

BMC Cancer ◽

10.1186/s12885-021-08518-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Hannes Zwickl ◽

Elisabeth Zwickl-Traxler ◽

Alexander Haushofer ◽

Josef Seier ◽

Klaus Podar ◽

...

Keyword(s):

Weight Loss ◽

Body Composition ◽

Bone Resorption ◽

Bone Turnover ◽

Bone Metastases ◽

Cancer Patients ◽

Bone Remodeling ◽

Control Group ◽

Type I ◽

Laboratory Parameters

Abstract Background Increased bone turnover is frequently observed in advanced cancer and predominantly related to bone metastases or therapy. Cachexia represents an important cause of morbidity and mortality in cancer patients. Key features are weight loss, muscle wasting and chronic inflammation, which induce profound metabolic changes in several organs, including the bone. However, whether cachexia contributes to abnormal bone metabolism in cancer patients is unknown. Aim of the present study was to determine the potential correlation of bone turnover markers with body composition and laboratory parameters in treatment-naïve cancer patients. Methods In this cross-sectional study we measured the levels of carboxy terminal telopeptide of collagen (CTX), an indicator of bone resorption, as well as osteocalcin (Ocn) and procollagen type I N-terminal propeptide (PINP), indicators of bone formation, in 52 cancer patients and correlated with body composition and laboratory parameters. Univariate and multivariate logistic analysis were performed to identify determinants of negative bone remodeling balance, estimated by CTX/Ocn and CTX/PINP ratio. Results Based on weight loss, body mass index and muscle mass, patients were divided into a cachectic (59.6%) and a control (40.4%) group. After correcting for the presence of bone metastases, our results showed a significant upregulation of CTX in cachectic patients compared to non-cachectic cancer patients (median 0.38 vs 0.27 ng/mL, p < 0.05), with no difference in Ocn and PINP levels (mean 14 vs. 16 ng/ml, p = 0.2 and median 32 vs. 26 μg/L, p = 0.5, respectively). In addition, the CTX/Ocn and the CTX/PINP ratio were indicative of bone resorption in 68% and 60% of cachexia patients, respectively (vs. 20% and 31% in the control group, p = 0.002 and p = 0.06). The main determinants of the unbalanced bone turnover were hypoalbuminemia for the CTX/Ocn ratio (OR 19.8, p < 0.01) and high CRP for the CTX/PINP ratio (OR 5.3, p < 0.01) in the multivariate regression analysis. Conclusions CTX is substantially higher in cachectic patients compared to non-cachectic oncological patients and hypoalbuminemia as well as elevated CRP concentrations are independent predictors of a negative bone remodeling balance in cancer patients. These results strongly indicate that cachexia correlates with exacerbated bone turnover in cancer.

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Prevalence of Thyroid Diseases in an Occupationally Radiation Exposed Group: A Cross-Sectional Study in a University Hospital of Southern Italy

Endocrine Metabolic & Immune Disorders - Drug Targets ◽

10.2174/1871530318666181102114627 ◽

2019 ◽

Vol 19 (6) ◽

pp. 803-808 ◽

Cited By ~ 1

Author(s):

Luigi Vimercati ◽

Luigi De Maria ◽

Francesca Mansi ◽

Antonio Caputi ◽

Giovanni M. Ferri ◽

...

Keyword(s):

Ionizing Radiation ◽

Healthcare Workers ◽

Southern Italy ◽

Cross Sectional Study ◽

Thyroid Diseases ◽

University Hospital ◽

Control Group ◽

Sectional Study ◽

Cross Sectional ◽

Exposed Workers

Background: Thyroid diseases occur more frequently in people exposed to ionizing radiation, but the relationship between occupational exposure to ionizing radiation and thyroid pathologies still remains unclear. Objective: To evaluate the prevalence of thyroid diseases in healthcare workers exposed to low-level ionizing radiation compared with a control group working at the University Hospital of Bari, Southern Italy, and living in the same geographical area, characterized by mild iodine deficiency. Methods: We ran a cross-sectional study to investigate whether healthcare workers exposed to ionizing radiation had a higher prevalence of thyroid diseases. Four hundred and forty-four exposed healthcare workers (241 more exposed, or “A Category”, and 203 less exposed, or “B Category”) and 614 nonexposed healthcare workers were enrolled during a routine examination at the Occupational Health Unit. They were asked to fill in an anamnestic questionnaire and undergo a physical examination, serum determination of fT3, fT4 and TSH, anti-TPO ab and anti-TG ab and ultrasound neck scan. Thyroid nodules were submitted to fine needle aspiration biopsy when indicated. Results: The prevalence of thyroid diseases was statistically higher in the exposed workers compared to controls (40% vs 29%, adPR 1.65; IC95% 1.34-2.07). In particular, the thyroid nodularity prevalence in the exposed group was approximately twice as high as that in the controls (29% vs 13%; adPR 2.83; IC95% 2.12-3.8). No statistically significant association was found between exposure to ionizing radiation and other thyroid diseases. Conclusion: In our study, mild ionizing radiation-exposed healthcare workers had a statistically higher prevalence of thyroid diseases than the control group. The results are likely due to a closer and more meticulous health surveillance programme carried out in the ionising radiation-exposed workers, allowing them to identify thyroid alterations earlier than non-exposed health staff.

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The changes in bone turnover markers of female systemic lupus erythematousus patients without glucocorticoid

Lupus ◽

10.1177/09612033211000126 ◽

2021 ◽

Vol 30 (6) ◽

pp. 965-971

Author(s):

Wang Tianle ◽

Zhang Yingying ◽

Hong Baojian ◽

Gu Juanfang ◽

Wang Hongzhi ◽

...

Keyword(s):

Bone Resorption ◽

Bone Formation ◽

Bone Turnover ◽

Bone Metabolism ◽

Bone Turnover Markers ◽

Control Group ◽

Bone Resorption Marker ◽

Amino Terminal ◽

Normal People ◽

Turnover Markers

Objectives SLE is a chronic autoimmune disease, which can affect the level of bone metabolism and increase the risk of osteoporosis and fracture. The purpose of this research is to study the effect of SLE on bone turnover markers without the influence of glucocorticoids. Methods A total of 865 female subjects were recruited from Zhejiang Provincial People’s Hospital and the First Hospital of Jiaxing, including 391 SLE patients without the influence of glucocorticoids and 474 non-SLE people. We detected Bone turnover markers including amino-terminal propeptide of type 1 procollagen (P1NP), C-terminal turnover of β - I collagen (β-CTX), N-terminal midfragment of osteocalcin (NMID) and 25(OH)D, and analyzed the difference in Bone turnover markers between the SLE group and the control group, as well as the influence of age and season on bone metabolism in female SLE patients. Results In the SLE group, the average age was 43.93±13.95 years old. In the control group, the average age was 44.84±11.42 years old. There was no difference between the two groups (t = 1.03, P = 0.30). P1NP, NMID and 25(OH)D in the SLE group were significantly lower than those in the control group (Z = 8.44, p < 0.001; Z = 14.41, p < 0.001; Z = 2.19, p = 0.029), and β-CTX in the SLE group was significantly higher than that in the control group (Z = 2.61, p = 0.009). In addition, the levers of β-CTX, NMID, P1NP and 25(OH)D in older SLE female patients were statistically significantly higher than those in younger (ρ = 0.104, p = 0.041; ρ = 0.223, p < 0.001; ρ = 0.105, p = 0.038; ρ = 0.289, p < 0.001). Moreover, β-CTX reached a high value in summer and PINP reached a low value in winter. Conclusion The bone formation markers of female SLE patients without glucocorticoid were lower than those of normal people and the bone resorption marker was higher than that of normal people. The 25 (OH) D of female SLE patients without glucocorticoid was lower than that of normal people. The risk of osteoporosis and fracture may be higher in elderly women with SLE. The bone resorption level of female SLE patients is high in summer and the bone formation level is low in winter.

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Is suicidal ideation associated with allergic asthma and allergic rhinitis?

Jornal Brasileiro de Pneumologia ◽

10.1590/s1806-37562017000000129 ◽

2018 ◽

Vol 44 (1) ◽

pp. 31-35 ◽

Cited By ~ 2

Author(s):

Martín Bedolla-Barajas ◽

Norma Angélica Pulido-Guillén ◽

Bolívar Vivar-Aburto ◽

Jaime Morales-Romero ◽

José Raúl Ortiz-Peregrina ◽

...

Keyword(s):

Allergic Rhinitis ◽

Suicidal Ideation ◽

Allergic Asthma ◽

Allergic Diseases ◽

Cross Sectional Study ◽

University Hospital ◽

Control Group ◽

Healthy Controls ◽

Cross Sectional ◽

And Control

ABSTRACT Objective: To investigate whether there is an association between suicidal ideation (SI) and allergic diseases in adults. Methods: This was a comparative cross-sectional study involving individuals ranging from 20 to 50 years of age recruited from a university hospital in the city of Guadalajara, Mexico. We included patients with a confirmed diagnosis of allergic asthma, those with a confirmed diagnosis of allergic rhinitis, and healthy controls. All subjects completed the Beck Depression Inventory-II (BDI-II), which includes an item that evaluates the presence of suicidal thoughts or desires within the last two weeks, in order to identify SI. Results: The sample comprised 115 patients with allergic asthma, 111 patients with allergic rhinitis, and 96 healthy controls. The number of individuals identified with SI in the three groups were, respectively, 17 (14.8%), 13 (11.7%), and 8 (8.3%). Regarding the presence of SI, no statistically significant association was found in the allergic asthma group (OR = 1.98; 95% CI: 0.78-4.64; p = 0.154) or in the allergic rhinitis group (OR = 1.46; 95% CI: 0.58-3.68; p = 0.424) when they were compared with the control group. However, the presence of depression was associated with SI in the three groups: allergic asthma (OR = 12.36; 95% CI: 2.67-57.15; p = 0.001); allergic rhinitis (OR = 6.20; 95% CI: 1.66-23.14; p = 0.006); and control (OR = 21.0; 95% CI: 3.75-117.36; p < 0,001). Conclusions: In comparison with the control group, no association was found between SI and the groups with allergic diseases. In contrast, there was association between SI and depression in the three groups.

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Recurrent Miscarriage and Consanguinity among Omani Women– A Cross Sectional Study

Gynecology & Reproductive Health ◽

10.33425/2639-9342.1141 ◽

2021 ◽

Vol 5 (1) ◽

Author(s):

Fatma Al Hoqani ◽

Wadha Al Ghafri ◽

Saneya El tayeb ◽

Yahya Al Farsi ◽

Vaidyanathan Gowri

Keyword(s):

Recurrent Miscarriage ◽

Cross Sectional Study ◽

University Hospital ◽

Control Group ◽

P Value ◽

Cross Sectional ◽

Recurrent Miscarriages ◽

Sultan Qaboos University ◽

Chi Squared ◽

History Of

Objective: to determine the prevalence of explained and unexplained recurrent miscarriages (RM) and to find out if there is a significant relationship between recurrent miscarriages and consanguinity. Methods: A cross sectional in which the cases group included all women with RM attending the outpatient clinic at Sultan Qaboos University Hospital from July 2006 to April 2012 and the controls group included women with no history of RM after matching them with cases for age (case to control ratio was 1:1). The main outcome measures were the prevalence of consanguinity in women with or without recurrent miscarriages. Results: During study period a total of 290 women with RM were seen. Of which, 150 (51.7%) women had unexplained RM. Control group with no history of RM were 300 women. Consanguinity rate among cases (49.5%) %) was less than the controls (52.7 %%). Both first cousin and second cousin marriages were more common in the controls than the cases and it was not statistically significant (p value 0.476, chi squared test). Conclusion: In this study we found that more than half of RM cases were unexplained and there was no significant association between RM and consanguinity.

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