Elevated Bone Turnover Markers after Risk-Reducing Salpingo-Oophorectomy in Women at Increased Risk for Breast and Ovarian Cancer

Abstract Purpose/Introduction: The aim of this study was to determine relationship of the bone markers levels with the fracture risk and treatment monitoring in patients with osteoporosis. Bone markers may point out to on specific aspects of bone quality, detecting changes of bone mineral density, thus providing prognostic perspective and accounting for a substantial proportion of fracture risk reduction.Methods: The case-control study comprised data from 55 patients undergoing evaluation for osteoporosis at Medicus Universalis Polyclinic in Krusevac. Densitometric findings, P1NP, CTX and osteocalcin levels were determined in all patients twice – at the first assessment and 6 months after. While 30 patients took no medical therapy, 25 of them were treated with ibandronate. Results: No convincing difference in densitometric measurements between patients with and without prevalent fractures were noted, while mean osteocalcin and P1NP levels were significantly lower (p<0.05) in osteoporotic patients who suffered fractures. A significant correlation between those bone turnover markers and T-score was established, especially in the second measurement and in patients treated with ibandronate.Conclusion: In postmenopausal women and individuals with low BMD, the presence of increased bone turnover markers suggests an increased risk of fractures. Furthermore, these metabolic markers are useful in the monitoring of patients receiving antiresorptive therapy, wherein fast decline of their levels indicate favorable course. Their determination after 6 months offers the remarkable advantage in assessing the effectiveness of medical treatment comparing to 12–24 months required to document changes by BMD.

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The effect of hormone therapy on breast density following risk-reducing salpingo-oophorectomy in women with an increased risk for breast and ovarian cancer

Menopause ◽

10.1097/gme.0000000000001844 ◽

2021 ◽

Vol Publish Ahead of Print ◽

Author(s):

Mark van Barele ◽

Chistien C.M. Buis ◽

Monique M.A. Brood-van Zanten ◽

H. (Lena) C. van Doorn ◽

Katja N. Gaarenstroom ◽

...

Keyword(s):

Ovarian Cancer ◽

Hormone Therapy ◽

Breast Density ◽

Breast And Ovarian Cancer ◽

Increased Risk ◽

Risk Reducing

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Physiological Factors of Female Runners With and Without Stress Fracture Histories: A Pilot Study

Sports Health A Multidisciplinary Approach ◽

10.1177/1941738120919331 ◽

2020 ◽

Vol 12 (4) ◽

pp. 334-340

Author(s):

Therese E. Johnston ◽

Colleen Dempsey ◽

Frances Gilman ◽

Ryan Tomlinson ◽

Ann-Katrin Jacketti ◽

...

Keyword(s):

Risk Factors ◽

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Mineral Density ◽

Physiological Factors ◽

Physiological Factor ◽

Increased Risk ◽

Turnover Markers

Background: Female runners are at increased risk of stress fractures (SFs) compared with men. Literature is lacking with regard to best practice for preventing and treating SFs in women. The purpose of the study was to compare physiological measures and running-related factors between women of various ages and running abilities with and without a history of running-related SFs. Hypothesis: Women with and without SF histories will differ with regard to medical and menstrual history, bone health, body composition, nutrition, and running history. Study Design: Prospective cohort study. Level of Evidence: Level 2. Methods: A total of 20 female runners with SF histories were matched based on age and running distance with 20 women without SF histories. Data included medical, menstrual, running, injury, and nutritional histories; blood histology related to nutritional, hormonal, and bone-related risk factors; and bone density, fat, and lean tissue using dual energy x-ray absorptiometry. Paired t tests were used to examine differences between women with and without SF histories, and Spearmen correlations were conducted to examine relationships between physiological factors. Results: Women with SF histories had lower hip bone mineral density compared with women without SF histories ( P < 0.05). SF history was moderately correlated with menstrual changes during increased training times ( r = 0.580; P < 0.0001) but was not correlated with any other physiological factor. There was a moderate correlation within the SF group ( r = 0.65; P = 0.004) for bone markers for resorption and formation both increasing, indicating increased bone turnover. Conclusion: Female runners with low hip bone mineral density, menstrual changes during peak training, and elevated bone turnover markers may be at increased risk of SF. Clinical Relevance: Female runners need routine screening for risks associated with SF occurrence. As bone mineral density and bone turnover markers are not routinely assessed in this population, important risk factors may be missed.

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Hydroxycoumarin Scopoletin Inhibits Bone Loss through Enhancing Induction of Bone Turnover Markers in a Mouse Model of Type 2 Diabetes

Biomedicines ◽

10.3390/biomedicines9060648 ◽

2021 ◽

Vol 9 (6) ◽

pp. 648

Author(s):

Eun-Jung Lee ◽

Woojin Na ◽

Min-Kyung Kang ◽

Yun-Ho Kim ◽

Dong-Yeon Kim ◽

...

Keyword(s):

Type 2 Diabetes ◽

Bone Loss ◽

Mouse Model ◽

Bone Turnover ◽

Bone Remodeling ◽

Bone Turnover Markers ◽

Elevated Serum ◽

Increased Risk ◽

Turnover Markers

Diabetes induces bone deterioration, which leads to increased risk of fracture, osteopenia, and osteoporosis. Thus, diabetes-associated bone fragility has been recognized as a diabetic complication. However, the pathophysiological effects of hyperglycemia on bone turnover remain unclear. Literature evidence demonstrates that anti-diabetic medications increase the risk of fractures in individuals with type 2 diabetes. Scopoletin is a naturally occurring hydroxycoumarin potentially exhibiting anti-inflammatory and antioxidant activities and ameliorating insulin resistance as an anti-diabetic agent. However, little is known regarding the effects of scopoletin on the impairment of bone remodeling that is caused by diabetes. The aim of this study was to identify that scopoletin was capable of inhibiting the impairment of bone remodeling and turnover in a mouse model of type 2 diabetes. Submicromolar scopoletin accelerated the formation TRAP-positive multinucleated osteoclasts (40.0 vs. 105.1%) and actin ring structures impaired by 33 mM glucose. Further, 1–20 μM scopoletin enhanced bone resorption and the induction of matrix-degrading enzymes in diabetic osteoclasts. The oral administration of 10 mg/kg scopoletin elevated serum RANKL/OPG ratio and osteocalcin level reduced in db/db mice along with an increase in BMD by ~6–14%; however, it was not effective in lowering blood glucose and hemoglobin glycation. In addition, the supplementation of scopoletin elevated the formation of trabecular bones and collagen fibers in femoral epiphysis and metaphysis with a thicker epiphyseal plate and cortical bones. Furthermore, 1–20 μM scopoletin enhanced ALP activity (4.39 vs. 7.02 nmol p-nitrophenyl phosphate/min/mg protein) and deposits of mineralized bone nodules in cultured osteoblasts reduced by 33 mM glucose. The treatment of diabetic osteoblasts with scopoletin stimulated the cellular induction of BMP-2 and osteopontin and Runx2 transcription. Accordingly, the administration of scopoletin protected mice from type 2 diabetes-associated bone loss through boosting bone remodeling via the robust induction of bone turnover markers of both osteoclasts and osteoblasts. These findings suggest that scopoletin could be a potential osteoprotective agent for the treatment of diabetes-associated bone loss and fractures.

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Effectiveness of Risk-Reducing Salpingo-Oophorectomy in Preventing Ovarian Cancer in a High-Risk French Canadian Population

International Journal of Gynecological Cancer ◽

10.1097/igc.0b013e318257b936 ◽

2012 ◽

Vol 22 (6) ◽

pp. 974-978 ◽

Cited By ~ 6

Author(s):

Omar Moreira Bacha ◽

Jean Gregoire ◽

Katherine Grondin ◽

Maria Isabel Edelweiss ◽

Rachel Laframboise ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

High Risk ◽

Fallopian Tube ◽

French Canadian ◽

Breast And Ovarian Cancer ◽

Surgical Morbidity ◽

Canadian Population ◽

Increased Risk ◽

Risk Reducing

BackgroundWomen with germ line BRCA1 or BRCA2 mutations have a marked increased risk of breast and ovarian cancer compared with the general population, whereas risk-reducing salpingo-oophorectomy (RRSO) significantly lowers the incidence of these cancers. The objective of this study was to review the clinical and pathological characteristics of a French Canadian population undergoing RRSO. Surgical morbidity was also evaluated.Materials and MethodsFrom December 1999 to December 2009, all women who underwent RRSO at our institution were identified. Medical records were retrospectively reviewed. Descriptive statistics, the Fischer exact test, and the Student t test were used for analysis.ResultsDuring the study period, RRSO was performed on 119 women. Mean age at surgery was 49 years (35–72 years), and 63 patients (53%) were premenopausal. Sixty-two women (52%) had a history of in situ or invasive breast cancer. BRCA1 and BRCA2 mutations were present in 34 patients (29%) and 42 patients (35%), respectively, whereas 43 patients (36%) were considered to have an increased risk of breast and ovarian cancer, despite a personal genetic test, which was either negative (n = 23) or unknown because the patient declined genetic testing (n = 20). Most patients with a uterus in place had a complementary hysterectomy (65%). Six complications occurred (3 hematomas, 2 cardiac arrhythmias, and 1 cystotomy). In one patient (0.8%), a high-grade stage II ovarian cancer was discovered at the time of surgery. Fallopian tube atypias were identified on final pathology in 8 cases (6.7%). After a median follow-up of 22 months, 4 women (3.4%) developed breast cancer and one woman (0.8%) developed peritoneal cancer.ConclusionsRisk-reducing salpingo-oophorectomy is highly effective in preventing ovarian, fallopian tube, and breast cancers in a high-risk French Canadian population; and the surgical morbidity is low.

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The effect of monthly Ibandronate on bone mineral density and bone turnover markers in patients with hemophilia A or B and increased risk for fracture

Endocrine Abstracts ◽

10.1530/endoabs.32.p92 ◽

2013 ◽

Author(s):

Panagiotis Anagnostis ◽

Tomoleon-Achilleas Vyzantiadis ◽

Maria Charizopoulou ◽

Fotini Adamidou ◽

Spyridon Karras ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Hemophilia A ◽

Mineral Density ◽

Increased Risk ◽

Turnover Markers

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The Impact of Mild Autonomous Cortisol Secretion on Bone Turnover Markers

The Journal of Clinical Endocrinology & Metabolism ◽

10.1210/clinem/dgaa120 ◽

2020 ◽

Vol 105 (5) ◽

pp. 1469-1477 ◽

Cited By ~ 1

Author(s):

Shobana Athimulam ◽

Danae Delivanis ◽

Melinda Thomas ◽

William F Young ◽

Sundeep Khosla ◽

...

Keyword(s):

Bone Turnover ◽

Bone Metabolism ◽

Bone Turnover Markers ◽

Cushing Syndrome ◽

Adrenal Tumors ◽

Cortisol Secretion ◽

Increased Risk ◽

Autonomous Cortisol Secretion ◽

Turnover Markers ◽

The Impact

Abstract Context Several studies have reported increased risk of fragility fractures in patients with mild autonomous cortisol secretion (MACS), discordant to the degree of bone density deterioration. Objective To evaluate the effect of MACS on bone metabolism in patients with adrenal adenomas. Design Cross-sectional study with prospective enrollment, 2014-2019 Setting Referral center. Patients 213 patients with adrenal adenomas: 22 Cushing syndrome (CS), 92 MACS and 99 nonfunctioning adrenal tumors (NFAT). Main Outcome Measures Osteocalcin, procollagen I intact N-terminal (PINP), C-terminal telopeptide (CTX), sclerostin. Results Patients with CS demonstrated lower markers of bone formation compared with patients with MACS and NFAT (CS vs MACS vs NFAT: mean osteocalcin 14.8 vs 20.1 vs 21.3 ng/mL [P < 0.0001]; mean PINP 34.8 vs 48.7 vs 48.5 µg/L [P = 0.003]). Severity of cortisol excess was inversely associated with sclerostin (CS vs MACS vs NFAT: mean sclerostin 419 vs 538 vs 624 ng/L, [P < 0.0001]). In a multivariable model of age, sex, body mass index, cortisol, and bone turnover markers, sclerostin was a significant predictor of low bone mass in patients with MACS (OR 0.63 [CI 95%, 0.40–0.98] for each 100 ng/L of sclerostin increase). After adrenalectomy, osteocalcin, CTX, and sclerostin increased by a mean difference of 6.3 ng/mL, 0.12 ng/mL, and 171 pg/mL (P = 0.02 for all), respectively. Conclusions Lower sclerostin level in patients with MACS reflects a reduction in osteocyte function or number associated with exposure to chronic cortisol excess. Increase in bone turnover markers after adrenalectomy suggests restoration of favorable bone metabolism.

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Relationship between Serum Total Cholesterol Level and Serum Biochemical Bone Turnover Markers in Healthy Pre- and Postmenopausal Women

BioMed Research International ◽

10.1155/2014/398397 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 9

Author(s):

Tae-Dong Jeong ◽

Woochang Lee ◽

Sung-Eun Choi ◽

Jae Seung Kim ◽

Hong-Kyu Kim ◽

...

Keyword(s):

Cardiovascular Disease ◽

Bone Turnover ◽

Lipid Profile ◽

Total Cholesterol ◽

Bone Turnover Markers ◽

Premenopausal Women ◽

Cholesterol Concentration ◽

Mineral Density ◽

Increased Risk ◽

Turnover Markers

Background. The presence of common risk factors suggests that there is a relationship between osteoporosis and cardiovascular disease, possibly via dyslipidemia and inflammation. We investigated the relationships among the lipid profile, the inflammation marker high-sensitivity C-reactive protein (hsCRP), bone turnover markers, and bone mineral density (BMD) to assess the correlation between osteoporosis and cardiovascular disease and identify factors predicting osteoporosis.Methods. The study included 759 Korean women older than 20 years of age. The BMD, serum lipid profile, and levels of hsCRP, cross-linked C-terminal peptide (CTX), and osteocalcin were measured. We compared the serum biomarkers between groups with normal and low BMD and assessed the correlations between the levels of bone turnover markers and the lipid profile and hsCRP level.Results. The concentrations of CTX, osteocalcin, and total cholesterol were significantly higher in the low BMD group than in the normal BMD group in premenopausal women group. However, hsCRP was not correlated with these parameters. Multivariate logistic regression analysis revealed that TC (OR, 1.647; 95% CI, 1.190–2.279) and osteocalcin (OR, 1.044; 95% CI, 1.002–1.088) had an increased risk of low BMD in premenopausal women.Conclusions. These results indicate that total cholesterol concentration is correlated with the levels of bone turnover markers, suggesting that it might predict osteoporosis in premenopausal women.

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