Biochemical markers of bone turnover in children with clinical bone fragility

AbstractThe role of biochemical bone turnover markers (BTMs) in assessing low bone mass and monitoring bisphosphonate treatment in pediatric patients with clinical bone fragility is not well established. The aim of the study was to examine the correlations of BTMs and the bone mineral density (BMD), and evaluate the effects of bisphosphonates therapy on BTMs in children with clinical bone fragility.Clinical data of 115 patients with clinical bone fragility (mean age 9.7±5.8 years), 102 of whom received bisphosphonates, were studied. Serum alkaline phosphatase (ALP), osteocalcin (OC), urine pyridinoline (PD) and deoxypyridinoline (DPD), BMD at baseline and subsequent years were analyzed.There was a significant negative correlation between urine PD and lumbar BMD (slope=–0.29, p<0.001). There were no correlations between BTMs and lumbar BMD Z-score. There was a significant positive correlation between serum OC and serum ALP, urine PD and DPD (p<0.001). Serum OC, urine PD and DPD index, as expressed as measured value/upper limit of normal value for age, decreased during the first 3 years of bisphosphonate therapy.In children with clinical bone fragility, BTMs correlated with each other, but not with lumbar BMD Z-score. While they were not reliable predictors of degree of low BMD, the bone markers showed suppression during bisphosphonate therapy and may be helpful in monitoring the response to therapy.

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Bone Mineral Density and Bone Turnover Markers Under Bisphosphonate Therapy Used in the First Year After Liver Transplantation

Annals of Transplantation ◽

10.12659/aot.895413 ◽

2016 ◽

Vol 21 ◽

pp. 241-249 ◽

Cited By ~ 2

Author(s):

Ewa Nowacka-Cieciura ◽

Anna Sadowska ◽

Marek Pacholczyk ◽

Andrzej Chmura ◽

Olga Tronina ◽

...

Keyword(s):

Bone Mineral Density ◽

Liver Transplantation ◽

Bone Turnover ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Bisphosphonate Therapy ◽

First Year ◽

Mineral Density ◽

Turnover Markers

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Phenytoin and sodium valproate but not levetiracetam induce bone alterations in female mice

Canadian Journal of Physiology and Pharmacology ◽

10.1139/cjpp-2013-0504 ◽

2014 ◽

Vol 92 (6) ◽

pp. 507-511 ◽

Cited By ~ 6

Author(s):

Md. Jamir Anwar ◽

K.V. Radhakrishna ◽

Divya Vohora

Keyword(s):

Bone Turnover ◽

Sodium Valproate ◽

Plasma Concentrations ◽

Lumbar Vertebrae ◽

Mineral Density ◽

Female Mice ◽

Markers Of Bone Turnover ◽

Bone Changes ◽

Clinical Consequences ◽

Turnover Markers

Adverse effects on the bone are amongst the potentially adverse clinical consequences with antiepileptic drugs (AEDs). This study compared the effects of 3 AEDs (phenytoin (PHT), sodium valproate (SVP), and levetiracetam (LTM)) on the bones of a Swiss strain of albino female mice. Drugs were administered daily for 4 months at doses that produced plasma concentrations corresponding to the clinically relevant therapeutic ranges. PHT and SVP (but not LTM) significantly lowered the bone mineral density (BMD) of lumbar vertebrae (L2–L4) as evaluated by dual-energy X-ray absorptiometry (DEXA) scan. The findings were supported by histopathology of vertebral (lumbar) bone and analysis of bone turnover markers. While both PHT and SVP reduced alkaline phosphatase (ALP) and hydroxyproline (HxP) in lumbar vertebrae, and elevated tartarate-resistant acid phosphatase (TRAP) and urinary excretion of calcium, LTM did not affect any of these markers of bone turnover, indicating that the drug might be a safer option in female epileptic patients prone to bone changes.

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Monthly intravenous alendronate treatment can maintain bone strength in osteogenesis imperfecta patients following cyclical pamidronate treatment

Journal of Pediatric Endocrinology and Metabolism ◽

10.1515/jpem-2020-0071 ◽

2020 ◽

Vol 33 (11) ◽

pp. 1391-1397

Author(s):

Daisuke Harada ◽

Hiroko Kashiwagi ◽

Kaoru Ueyama ◽

Kyoko Oriyama ◽

Yuki Hanioka ◽

...

Keyword(s):

Bone Turnover ◽

Osteogenesis Imperfecta ◽

Bone Strength ◽

Bone Turnover Markers ◽

Bone Fragility ◽

Mineral Density ◽

Before And After ◽

Alendronate Treatment ◽

Z Scores ◽

Turnover Markers

AbstractObjectivesOsteogenesis imperfecta (OI) is a skeletal dysplasia characterized by recurrent fractures due to congenital bone fragility. The only bisphosphonate approved for OI in Japan is pamidronate (PAM). To investigate whether monthly intravenous alendronate (ALN) infusions can maintain bone strength in OI children following cyclical PAM treatment.MethodsA prospective and non-inferiority study was conducted. Eight school-age OI patients aged 8.5±2.0 years who were treated with cyclical PAM for 6.0±2.3 years were enrolled and switched to monthly intravenous ALN (0.030 mg/kg/month). Changes in L1-4 bone mineral density (BMD) Z-scores, fracture rates, and bone turnover markers for 12 months were analyzed.ResultsAverage BMD Z-scores were −3.0±1.9, −2.9±2.0, and −2.2±2.0 in 12 months before enrollment, at enrollment, and after 12 months of ALN treatment, respectively. BMD Z-scores increased significantly during treatment with both PAM and ALN (p=0.012), and the effect of ALN was not inferior to that of PAM (p=0.67). There was no change in fracture rates (p=0.86) and bone turnover markers during the 12 months before and after enrollment. Additionally, ALN showed no remarkable side effects.ConclusionsOur results suggest that monthly intravenous ALN can maintain bone strength after primary usage of cyclical PAM. We concluded that monthly intravenous ALN as a maintenance treatment following cyclical PAM administration can be an option for OI children.

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Effects of oligofructose-enriched inulin on intestinal absorption of calcium and magnesium and bone turnover markers in postmenopausal women

British Journal Of Nutrition ◽

10.1017/s000711450733674x ◽

2007 ◽

Vol 97 (2) ◽

pp. 365-372 ◽

Cited By ~ 100

Author(s):

Leah Holloway ◽

Sharon Moynihan ◽

Steven A. Abrams ◽

Kyla Kent ◽

Andrew R. Hsu ◽

...

Keyword(s):

Bone Mineral Density ◽

Bone Loss ◽

Bone Turnover ◽

Postmenopausal Women ◽

Bone Mineral ◽

Bone Turnover Markers ◽

Spine Bone Mineral Density ◽

Mineral Density ◽

Markers Of Bone Turnover ◽

Turnover Markers

Deficiency of oestrogen at menopause decreases intestinal Ca absorption, contributing to a negative Ca balance and bone loss. Mg deficiency has also been associated with bone loss. The purpose of the present investigation was to test the hypothesis that treatment with a spray-dried mixture of chicory oligofructose and long-chain inulin (Synergy1; SYN1) would increase the absorption of both Ca and Mg and alter markers of bone turnover. Fifteen postmenopausal women (72·2 (sd6·4) years) were treated with SYN1 or placebo for 6 weeks using a double-blind, placebo-controlled, cross-over design. Fractional Ca and Mg absorption were measured using dual-tracer stable isotopes before and after treatment. Bone turnover markers were measured at baseline, 3 and 6 weeks. Fractional absorption of Ca and Mg increased following SYN1 compared with placebo (P < 0·05). Bone resorption (by urinary deoxypyridinoline cross-links) was greater than baseline at 6 weeks of active treatment (P < 0·05). Bone formation (by serum osteocalcin) showed an upward trend at 3 weeks and an increase following 6 weeks of SYN1 (P < 0·05). Closer examination revealed a variation in response, with two-thirds of the subjects showing increased absorption with SYN1.Post hocanalyses demonstrated that positive responders had significantly lower lumbar spine bone mineral density than non-responders (dual X-ray absorptiometry 0·887 ± 0·102v.1·104 ± 0·121 g/cm2;P < 0·01), and changes in bone turnover markers occurred only in responders. These results suggest that 6 weeks of SYN1 can improve mineral absorption and impact markers of bone turnover in postmenopausal women. Further research is needed to determine why a greater response was found in women with lower initial spine bone mineral density.

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Use of Bone Turnover Markers in Clinical Osteoporosis Assessment in Women: Current Issues and Future Options

Women s Health ◽

10.2217/whe.11.74 ◽

2011 ◽

Vol 7 (6) ◽

pp. 689-698 ◽

Cited By ~ 11

Author(s):

K Henriksen ◽

DJ Leeming ◽

C Christiansen ◽

MA Karsdal

Keyword(s):

High Risk ◽

Bone Turnover ◽

Bone Quality ◽

Bone Turnover Markers ◽

Biochemical Markers ◽

Metabolic Diseases ◽

Mineral Density ◽

Dual Emission ◽

Markers Of Bone Turnover ◽

Turnover Markers

Monitoring bone turnover of the adult and aging skeleton is essential for optimal treatment of bone metabolic diseases, such as postmenopausal osteoporosis. Diagnosis of osteoporosis is based solely on dual-emission x-ray absorptiometry-based measurements of bone mineral density. However, within the last 20 years, biochemical markers of bone turnover have been implemented to a larger degree, and especially within the field of drug development. Numerous clinical studies have underscored that the markers have promise in terms of predicting patients at high risk of losing bone, future fracture events and importantly also the fracture efficacy of drugs in development. Furthermore, while classical methods often require years to monitor the changes, the bone turnover markers do so within a shorter time span. The aims of this article are to provide an update on the different biochemical markers of bone turnover, and to give an overview of their applications in epidemiological and clinical research especially in women. The main emphasis will be on their utility in clinical trials testing the efficacy of drugs for the treatment of osteoporosis, and their ability to supplement bone mass measurements. Finally, recent evidence suggests that biochemical markers may provide information on bone age that may indirectly relate to bone quality, and this is discussed together with future possibilities for measuring bone quality using bone turnover markers. In summary, a more targeted use of biomarkers could assist in the identification of high-risk patients, the process of drug discovery and monitoring of the efficacy of osteoporosis treatment in clinical settings.

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