scholarly journals SAT-395 Correlations Between Biochemical Parameters and Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHP) Patients

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lívia Marcela Santos ◽  
Monique Nakayama Ohe ◽  
Sthefanie Giovanna Pallone ◽  
Ilda Sizue Kunii ◽  
Renata Elen Costa Silva ◽  
...  
Keyword(s):  
Vitamin D ◽  
Trabecular Bone ◽  
Vitamin D Deficiency ◽  
Negative Correlation ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
Control Group ◽  
Total Calcium ◽  
Mineral Density ◽  
Positive Correlation

Abstract Background: Vitamin D deficiency is common among PHP patients. While data are limited, some studies suggest that vitamin D deficiency may exacerbates skeletal disease in PHP. TBS is a software-based method for assessment of trabecular bone structure of the spine, based on analysis of pixels obtained in dual energy x-ray absorptiometry (DXA) images. The aim of this study was to evaluate TBS, vitamin D status, clinical and laboratorial measurements in a PHP group of patients in a search for a more accurate bone fragility test for risk assessment in this group of patients. Methods: From June/2017 to January/2019, patients who met the criteria for PHP diagnosis were included in this study. Control group was composed by age and sex-matched healthy individuals. Overall, 64 PHP and 63 controls were enrolled. Bone mineral density (BMD) measured by DXA (Hologic QDR 4500) at the lumbar spine, total hip, femoral neck, and TBS values (InSight™) were determined in both groups. Total and ionized calcium, PTH, 25-hydroxyvitamin D (25(OH)D), creatinine, alkaline phosphatase, P1NP and CTX were measured. None were in use of Vitamin D supplementation. Results: As expected, PHP patients had lower BMD values than controls in all sites (p<0.0001). TBS measurements were also reduced in PHP patients compared to controls (1233 vs 1280, p=0.0444). TBS values were inversely correlated with total calcium (CaT) and phosphorus measurements were positively correlated in the PHP patients. 25(OH)D measurements didn’t differ between groups (PHP 22.5 vs. controls 19.8 ng/mL, p=0.1699). There was a positive correlation between 25(OH)D and TBS in both PHP and controls (r= 0,3088, p= 0,0138 and r= 0,3708, p= 0,003 respectively). Considering individuals with vitamin D deficiency (25(OH)D levels <=20 ng/mL), a negative correlation between TBS and CaT measurements among PHP patients (r= -0,4391, p=0,0172) was observeed, while in controls there was a positive correlation between TBS and 25(OH)D (r= 0,3504, p= 0,0362). Conclusion: Serum total calcium presents negative correlation and phosphorus a positive one with TBS in PHP patients. We also found a correlation between TBS and 25(OH)D, both in PHP and in controls. 25(OH)D <=20 ng/mL is an independent risk factor determining degraded TBS among PHP patients and controls.

scholarly journals SAT-405 Trabecular Bone Score (TBS) in Primary Hyperparathyroidism (PHP): A Useful Tool?

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Lívia Marcela Santos ◽  
Monique Nakayama Ohe ◽  
Sthefanie Giovanna Pallone ◽  
Ilda Sizue Kunii ◽  
Renata Elen Costa Silva ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Primary Hyperparathyroidism ◽  
Trabecular Bone ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
Assessment Method ◽  
Bone Fragility ◽  
Control Group ◽  
Mineral Density ◽  
Roc Curve Analysis

Abstract Background: PHP is a common disorder, and regardless of being an asymptomatic entity, often leads to bone loss and osteoporosis. TBS is a software-based assessment method of trabecular bone structure of the spine based on the analysis of pixels in dual energy x-ray absorptiometry (DXA) images. The aim of this study was to evaluate TBS measurements in combination with DXA values by searching for more accurate bone fragility risk assessment among PHP patients. Methods: From June/2017 to January/2019, all patients who met the criteria for PHP diagnosis prior to surgery were selected to take part in this study. Control group was composed by non-family related healthy volunteers. Bone mineral density (BMD) by DXA (DXA; Hologic QDR 4500) at the lumbar spine, total hip, femoral neck, distal third of the non-dominant radius and TBS values by InSight were determined in 64 PHP patients and 63 controls. Total and ionized calcium, PTH, 25-hydroxyvitamin D (25(OH)D), creatinine, alkaline phosphatase, P1NP and CTX were measured in all patients and control group. Results: Primary hyperparathyroidism patients presented significant lower BMD values in all evaluated sites compared to controls. TBS measurements were also statistically different among PHP patients and controls (mean TBS PHP=1233 vs TBS controls= 1280, p=0.044). Patients and controls didn’t differ in age, sex, menopausal state or BMI (body mass index). Osteoporosis diagnosis by DXA analysis was observed in 50% of PHP patients and in 26.6% of controls. Self-reported or image-diagnosed fracture occurred in 15 PHP (23.4%) patients and in 11 (17.5%) controls. Among these fractures, vertebral fracture account for 9 (14%) in PHP group and 4 (6.3%) in controls. ROC curve analysis showed that the TBS value < 1187 is associated to significant high risk of vertebral fracture (sensibility 87.5%, specificity 67.3%) among PHP patients. Conclusion: TBS, used as a complement to DXA measurements, is a useful tool to better assess fragility risk among PHP patients.

scholarly journals ROLE OF VITAMIN D IN ETIOPATHOGENESIS AND METABOLIC ABNORMALITIES SEEN IN POLYCYSTIC OVARIAN SYNDROME

2019 ◽  
pp. 215-219
Author(s):  
SURANKITA SUKUL ◽  
JYOTIRMAYEE BAHINIPATI ◽  
ASHOK KUMAR DAS
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Negative Correlation ◽  
Biochemical Parameters ◽  
Polycystic Ovarian Syndrome ◽  
Serum Insulin ◽  
Control Group ◽  
Insulin Metabolism ◽  
Ovarian Syndrome

Objective: Polycystic ovarian syndrome (PCOS) is a common cause of ovarian dysfunction in women in reproductive age group. It is now the leading cause of infertility among premenopausal women. PCOS women usually suffer from metabolic disturbances and insulin resistance (IR). Vitamin D has shown a significant role in glucose and insulin metabolism. Correlation studies have been done to examine the role of vitamin D in PCOS. However, still, Vitamin D status in PCOS remains varied. This study is an attempt to find out the association of Vitamin D with etiopathogenesis and metabolic risk factors seen in PCOS. Methods: Hundred subjects (50 PCOS and 50 age-matched normal control) were recruited for the study. Difference in biochemical parameters in PCOS women and normal group was measured, and association of Vitamin D with etiological and biochemical parameters in PCOS was seen. Results: There was a significant (p<0.001) increase in body mass index, serum insulin, fasting blood sugar (FBS), serum cholesterol, triglyceride, and low-density lipoprotein in PCOS. IR was observed in PCOS cases (homeostatic model assessment for β-cell function and IR = 6.40±1.96) compared to the control group (2.43±0.53). Serum 25(OH) Vitamin D3 was significantly decreased in PCOS (9.04±2.60 ng/ml) compared to control group (20.06±3.28 ng/ml). Negative correlation of serum Vitamin D was found with FBS, serum insulin, IR, HI, and serum testosterone. Vitamin D with metabolic parameters also showed a statistically significant negative correlation. Conclusion: Vitamin D deficiency may be a common comorbid manifestation of PCOS. Hence, Vitamin D supplementation may decrease the potential risk of morbidity and mortality associated with PCOS. However, further studies are needed which should include assessment of Vitamin D in women at various stages of PCOS to enhance the temporal order of Vitamin D deficiency in relation to PCOS.

BONE REMODELING MARKERS AS PREDICTORS OF BONE METABOLIC CHANGES IN MALES WITH DIABETIC OSTEOPATHY

2020 ◽  
Vol 58 (3) ◽  
pp. 290-293
Author(s):  
S. S. Safarova ◽  
S. S. Safarova
Keyword(s):  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Bone Remodeling ◽  
Control Group ◽  
Mineral Density ◽  
Amino Terminal ◽  
Bone Remodeling Markers ◽  
History Of ◽  
Male Patients

Diabetic osteopathy is one of the little studied complications of diabetes mellitus (DM), which leads to common lowtrauma fractures and, as a consequence, disability and death. The level of insulin is connected with bone functional and morphological changes followed by decreased bone mineral density (BMD) in the early stages of diabetic osteopathy. Objective: to study bone morphofunctional properties in males with type 1 and 2 DM (T1DM and T2DM). Subjects and methods. Examinations were made in 41 male patients with T1DM and 52 male patients with T2DM without a history of fractures. Their age varied from 40 to 70 years (mean age, 55.8±0.7 years and 58.4±0.9 years, respectively). A control group consisted of 34 patients (mean age, 55.9±0.9 years) without a history of DM. Patients with other endocrine disorders, end-stage complications, or chronic liver and kidney diseases were excluded from the investigation. BMD was determined by dual-energy X-ray absorptiometry (DXA). Serum bone remodeling markers (procollagen type 1 amino-terminal propeptide and C-terminal telopeptide), as well as 25(OH)D, parathyrin, insulin, glycated hemoglobin (HbA1c), and electrolytes (Ca2+, P+) were evaluated. Results and discussion. An association of BMD with renal function, HbA1c, and body mass index was observed in patients with T2DM. In the T1MD group, BMD was closely related to insulin deficiency and was significantly lower than that in the control group. In patients with vitamin D deficiency, BMD was significantly lower than in those with normal vitamin D levels (p<0.05). The patients with T1DM displayed both a decrease in BMD (p<0.05) and a pronounced change in the levels of bone markers (p<0.05). Those with T2DM had impaired bone remodeling processes, which was determined by the level of these markers (p<0.05) and observed in the presence of normal BMD due to the complex pathophysiology of the underlying disease. Conclusion. Vitamin D deficiency, insufficient and decreased insulin sensitivity, hyperglycemia, and overweight are important causes of osteopathy in patients with DM. The markers of bone remodeling may become promising indicators for diagnosing osteopathy, but additional studies are needed to elaborate recommendations for their use in routine practice in order to predict and prevent this complication of DM.

Prevalence of Vitamin D Deficiency in Patients With Talar Osteochondral Lesions

2018 ◽  
Vol 39 (4) ◽  
pp. 471-478 ◽  
Author(s):  
Jessica J. M. Telleria ◽  
Lauren V. Ready ◽  
Eric M. Bluman ◽  
Christopher P. Chiodo ◽  
Jeremy T. Smith
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Vitamin D Deficiency ◽  
Health Care Providers ◽  
Hypovitaminosis D ◽  
Control Group ◽  
Osteochondral Lesions ◽  
Care Providers ◽  
Mineral Density ◽  
Level Of Evidence

Background: Vitamin D deficiency affects over 1 billion people worldwide and is common in foot and ankle patients. The prevalence in those with osteochondral lesions of the talus (OLTs) is unknown. This study identified the prevalence and risk factors for hypovitaminosis D in patients with an OLT. Methods: Serum 25(OH)D levels were obtained from patients presenting with an OLT from May to November during 2007 to 2016. Hypovitaminosis D was defined as 25(OH)D less than 30 ng/mL (75 nmol/L). Patients presenting with an acute ankle sprain (AS) during the same months served as a control group. Specific medical risk factors for hypovitaminosis D were recorded. The final OLT population included 46 patients (31 women [67.4%]; mean [SD] age 43.6 [14.8] years). The comparison AS group had 40 patients (32 women [80.0%]; mean [SD] age 56.2 [13.0] years). Results: The mean (SD) 25(OH)D in the OLT and AS cohorts were 31.2 (12.6) ng/mL and 37.1 (13.5) ng/mL, respectively ( P = .039). Hypovitaminosis D was identified in 54% of the OLT population and 28% of the AS population ( P = .012). Conclusion: Hypovitaminosis D is intimately related to decreased bone mineral density. This study identified a significantly higher rate of hypovitaminosis D in patients with an OLT compared to a cohort of AS patients. These findings suggest that when patients present with an OLT, health care providers should consider evaluating for and treating hypovitaminosis D. Level of Evidence: Level III, comparative study.

Trabecular Bone Score (TBS) in Clinical Practice – Rewiev

2018 ◽  
Vol 20 (5) ◽  
pp. 347-359 ◽  
Author(s):  
Maja Warzecha ◽  
Edward Czerwiński ◽  
Jarosław Amarowicz ◽  
Małgorzata Berwecka
Keyword(s):  
Risk Assessment ◽  
Differential Diagnosis ◽  
Clinical Practice ◽  
Fracture Risk ◽  
Trabecular Bone ◽  
Bone Structure ◽  
Trabecular Bone Score ◽  
World Health ◽  
Secondary Osteoporosis ◽  
Mineral Density

Bone mineral density (BMD) assessment is the basic method for assessing fracture risk and diagnosing osteoporosis according to the World Health Organization (WHO). Osteoporosis is diagnosed when the T-score at the proximal femur or spine is T≤-2.5; however, 70% of fractures occur in patients who do not fulfil this criterion. As BMD alone does not adequately predict fracture risk, additional methods supporting risk assessment are needed [3,4]. In 2012, the US Food and Drug Administration (FDA) adopted the Trabecular Bone Score (TBS) as another diagnostic method for osteoporosis. The aim of this study is to evaluate the use of TBS in clinical practice with particular attention to fracture risk assessment, differential diagnosis and assessment of treatment outcomes in patients suffering from primary or secondary osteoporosis. Literature analysis points to the increasing use of TBS in clinical practice. It has been found that, in different subjects with the same BMD, structural bone health is better differentiated using TBS. Additionally, it is valuable to use the DXA along with TBS analysis for improved prediction of fracture risk. Indirect assessment of bone structure with TBS is also helpful in assessing the effect of medications. In conclusion, TBS analysis is a valuable tool in the assessment of bone fracture risk and in the differential diagnosis of structural bone disorders in secondary osteoporosis.

scholarly journals Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

2021 ◽  
Vol 9 (B) ◽  
pp. 1625-1632
Author(s):  
Maged A. El Wakeel ◽  
Ghada M. El-Kassas ◽  
Shaimaa A. Hashem ◽  
Hasanin M. Hasanin ◽  
Walaa H. Ali ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Negative Correlation ◽  
Serum Biomarkers ◽  
Control Group ◽  
Z Score ◽  
Positive Correlation ◽  
Egyptian Children ◽  
Environmental Enteric Dysfunction ◽  
Z Scores

BACKGROUND: Environmental enteric dysfunction (EED) is a chronic subclinical condition, contributed to limited sources and poor countries. EED pathology is concerned with small intestine structure and function, which affect the macronutrients and micronutrients absorption with consequent growth faltering. AIM: This study aimed to evaluate some serum biomarkers involved in EED and determine their association with stunting and faltering growth in children; zonulin, endotoxin core antibody (EndoCAb), high-sensitive C-reactive protein (hsCRP), alpha-1-acid glycoprotein (AGP), and tumor necrosis factor (TNF), serum iron, and Vitamins A and D. PATIENTS AND METHODS: This case–control study enrolled 105 children aged from 1 to 10 years old, having weight-for-age z-scores and height-for-age z-scores (WAZ or HAZ) ranging from −1.5 to −2. They were compared with control group consisted of 100 children having WAZ or HAZ > −1 of matched age and sex. Assessment of serum markers levels of enteric dysfunction (zonulin and EndoCAb), markers of systemic inflammation (Hs CRP and AGP), along with serum micronutrients (vitamin A, vitamin D and iron) in children with malnutrition in comparison to controls. RESULTS: There was a highly significant decrease as regarding the anthropometric measurements; weight, height, BMI, and arm circumference. Moreover, significant increase in serum zonulin, EndoCAb, HsCRP, and AGP and highly significant decrease of serum Vitamin D and iron in cases group as compared to control group. Height Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D. Weight Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D and Vitamin A. Regression analysis noted increase of zonulin and α1AGP as high associative markers with height Z score affection, however, increase of zonulin was high associative markers with weight Z score affection. CONCLUSION: Faltering growth is associated with elevated serum systemic markers of intestinal inflammation (HsCRP and α1AGP). EED may be a cause of faltering growth.

scholarly journals Serum Biomarkers of Environmental Enteric Dysfunction and Growth Perspective in Egyptian Children

2020 ◽  
Vol 8 (T2) ◽  
pp. 246-253
Author(s):  
Maged El Wakeel ◽  
Ghada El-Kassas ◽  
Shimaa Hashem ◽  
Hasanin Mohamed ◽  
Walaa Ali ◽  
...  
Keyword(s):  
Vitamin D ◽  
Vitamin A ◽  
Negative Correlation ◽  
Serum Biomarkers ◽  
Control Group ◽  
Z Score ◽  
Positive Correlation ◽  
Egyptian Children ◽  
Environmental Enteric Dysfunction ◽  
Z Scores

BACKGROUND: Environmental enteric dysfunction (EED) is a chronic subclinical condition, contributed to limited sources and poor countries. EED pathology is concerned with small intestine structure and function, which affect the macronutrients and micronutrients absorption with consequent growth faltering. AIM: This study aimed to evaluate some serum biomarkers involved in EED and determine their association with stunting and faltering growth in children; zonulin, endotoxin core antibody (EndoCAb), high-sensitive C-reactive protein (hsCRP), alpha-1-acid glycoprotein (AGP), and tumor necrosis factor (TNF), serum iron, and Vitamins A and D. PATIENTS AND METHODS: This case–control study enrolled 105 children aged from 1 to 10 years old, having weight-for-age z-scores and height-for-age z-scores (WAZ or HAZ) ranging from −1.5 to −2. They were compared with control group consisted of 100 children having WAZ or HAZ > −1 of matched age and sex. Assessment of serum markers levels of enteric dysfunction (zonulin and EndoCAb), markers of systemic inflammation (Hs CRP and AGP), along with serum micronutrients (vitamin A, vitamin D and iron) in children with malnutrition in comparison to controls. RESULTS: There was a highly significant decrease as regarding the anthropometric measurements; weight, height, BMI, and arm circumference. Moreover, significant increase in serum zonulin, EndoCAb, HsCRP, and AGP and highly significant decrease of serum Vitamin D and iron in cases group as compared to control group. Height Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D. Weight Z score showed negative correlation with zonulin, HsCRP, and AGP and positive correlation with Vitamin D and Vitamin A. Regression analysis noted increase of zonulin and α1AGP as high associative markers with height Z score affection, however, increase of zonulin was high associative markers with weight Z score affection. CONCLUSION: Faltering growth is associated with elevated serum systemic markers of intestinal inflammation (HsCRP and α1AGP). EED may be a cause of faltering growth.

scholarly journals Bone condition in children with juvenile idiopathic arthritis

2021 ◽  
pp. 45-52
Author(s):  
N.S. Shevchenko ◽  
◽  
L.F. Bogmat ◽  
Yu.V. Khadzhinova ◽  
◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Juvenile Idiopathic Arthritis ◽  
Parathyroid Hormone ◽  
Disease Activity ◽  
Vitamin D Deficiency ◽  
Bone Tissue ◽  
Control Group ◽  
Mineral Density ◽  
Calcium And Phosphorus

Osteopenia (osteopenic syndrome) and osteoporosis (OP) are among the frequent and highly disabling conditions that accompany the development of rheumatic diseases (RD), including juvenile idiopathic arthritis (JIA). Changes in the requirements for the diagnosis and treatment of children with JIA according to the treatment strategy to achieve the goal (treat to target) have led to a decrease in the frequency of development and manifestations of OP in patients with RD. The condition of bone tissue in children with JIA, against the background of modern therapy and in conditions of widespread vitamin D deficiency requires further study. Purpose — to study bone mineral density (BMD) in children with JIA in modern disease management and to identify adverse factors for the development of OP among clinical signs. Materials and methods. We examined 35 children with JIA aged 7 to 17 years, mostly female (77.1%), with oligo (25.7)%, poly (60.0%) and undifferentiated (14.3%) option, 53.4% of whom have not yet received basic therapy. All patients underwent BMD by dual-energy X-ray absorptiometry on a bone densitometer Explorer QD W (Hologic), parathyroid hormone (PTH), 25-hydroxyvitamin D [25(OH)D], total and ionized calcium and phosphorus in syvo. The control group consisted of 12 healthy children of the same age with a normal level of 25(OH)D. Results. The mean level of vitamin D in the serum of children in the main group was 20.41±1.35 ng/ml, which was significantly lower than in the control group (30.03±2.53 ng/ml, p<0.05); the frequency of low levels of vitamin D reached 88.57%. The content of calcium and phosphorus in the blood did not deviate from the normative values, despite the widespread deficiency of vitamin D. 98.37% of patients had normal PTH values, the average level in the blood was 30.43±0.90 pg/ml. The content of PTH was the highest in non-differential arthritis (34.33±1.80 pg/ml), the lowest in the oligoarticular variant (28.36±1.43 pg/ml, p<0.05). PTH concentrations correlated with vitamin D levels (r=-0.41; p<0.05) and were independent of patient gender and disease activity. The frequency of decreased BMD was 28.57% of the surveyed children. The prevalence of osteopenia was the same in different variants of arthritis and did not depend on the sex and age of patients, positivity in the RF. Osteopenic syndrome was significantly more common in ANA-positive JIA than in ANA-negative variant (46.15% vs. 18.18%; pϕ<0.05). The condition of bone tissue (Z-criteria) depended on BMI (r=0.33; p<0.05), disease activity on the JADAS scale (r=0.35; p<0.04), the number of active joints (r=0.34; p<0.05); ANA level (r=-0.34; p<0.05). In the group of children with osteopenic syndrome, BMD correlated with the duration of the disease (r=-0.67; p<0.05), the number of active joints (r=-0.62; p<0.05), the level of blood phosphorus 0.74; p<0.05) and the sum of points on the JADAS scale (r=0.59; p<0.05). In the group of children with preserved BMD, the spectrum of correlations was supplemented by indicators of vitamin D status (r=-0.33; p<0.05) and BMI (r=-0.40; p<0.05). Conclusions. In children with JIA, the incidence of osteopenia is 28.57% with vitamin D deficiency in 88.57% of patients, preserved levels of total calcium, phosphorus and PTH in the blood. Decreased BMD in the early stages of JIA is associated with a younger age of patients and the age of onset of the disease, increased prevalence of joint syndrome, inflammatory and serological activity of the disease, ionized calcium and blood phosphorus, PTH levels and decreased vitamin D (р<0,001). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: bone mineral density; juvenile idiopathic arthritis; osteopenia; 25-OH-vitamin D; parathyroid hormone.

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