scholarly journals Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients.

1996 ◽  
Vol 7 (3) ◽  
pp. 506-512
Author(s):  
P Ureña ◽  
M Hruby ◽  
A Ferreira ◽  
K S Ang ◽  
M C de Vernejoul
Keyword(s):  
Alkaline Phosphatase ◽  
Bone Formation ◽  
Bone Turnover ◽  
Bone Disease ◽  
Formation Rate ◽  
Bone Alkaline Phosphatase ◽  
Hemodialysis Patients ◽  
High Turnover ◽  
Bone Formation Rate ◽  
Markers Of Bone Turnover

Plasma total versus bone alkaline phosphatase as markers of bone turnover in hemodialysis patients. Plasma bone-specific alkaline phosphatase (bAP) has been demonstrated to be more reliable than total alkaline phosphatases (tAP) in providing information about bone turnover in patients with metabolic bone diseases. This study surveyed 42 hemodialysis patients who underwent a systematic transiliac bone biopsy for histomorphometry study. Plasma bAP was determined by using a new immunoassay (Tandem-R Ostase, Hybritech, Liège, Belgium). Plasma bAP values were compared with those of two other plasma markers of bone metabolism, namely tAP and intact parathyroid hormone (iPTH), for the correlations with bone histomorphometric parameters. Patients with high-turnover bone disease (HTBD) (N = 32) had significantly higher plasma bAP levels than patients with normal or low bone turnover (N/LTBD) (N = 10) (66.9 +/- 63.5 ng/mL versus 10.8 +/- 4.2 ng/mL, respectively). Bone formation and resorption were highly correlated in these patients, and plasma bAP levels were positively correlated with bone resorption parameters, including osteoclast surface (r = 0.39, P < 0.0001) and osteoclast number/mm2 (r = 0.36, P < 0.001), and with bone formation parameters, osteoblast surface (r = 0.50, P < 0.005), and bone formation rate (r = 0.91, P < 0.0001). The bone formation rate was better correlated with plasma bAP levels than with either plasma tAP or iPTH concentrations. Plasma bAP level equal or higher than 20 ng/mL, either alone or combined with plasma iPTH of 200 pg/mL, had the highest sensitivity, specificity, and predictability values for the diagnosis of high-turnover bone disease, and formally excluded patients with normal or LTBD. In conclusion, plasma bAP can be measured with a reliable immunoassay in hemodialysis patients. It represents a highly sensitive and specific biochemical marker of skeletal remodeling in these patients. Therefore, both serum iPTH and bAP are complementary in diagnoses of the type of renal osteodystrophy.

scholarly journals SO07118F-SODIUM FLUORIDE POSITRON EMISSION TOMOGRAPHY AND BONE HISTOMORPHOMETRY - COMPARISON BETWEEN ONLY BONE TURNOVER -BASED AND EXPERT EVALUATION -BASED CLASSIFICATION OF RENAL OSTEODYSTROPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Louise Caroline Aaltonen ◽  
Niina Koivuviita ◽  
Marko Seppänen ◽  
Inari Burton ◽  
Heikki Kröger ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Renal Osteodystrophy ◽  
Bone Disease ◽  
Bone Biopsy ◽  
Formation Rate ◽  
Adynamic Bone Disease ◽  
High Turnover ◽  
Bone Formation Rate ◽  
Adynamic Bone

Abstract Background and Aims The diagnosis and the differentiation of renal osteodystrophy (ROD) are challenging. Bone biopsy is the golden standard, but it is invasive and not available in every center. Bone turnover rate is defined by bone formation rate and/or activation frequency. Adynamic bone disease is defined as low turnover bone with reduced osteoblast- and osteoclast activities. Hyperparahyreoid bone disease or osteitis fibrosa is defined as high turnover bone with osteoclast- and osteoblast activities and fibrosis. 18F- Sodium Fluoride positron emission tomography (18F-NaF PET) is a noninvasive imaging technique that allows assessment of regional bone turnover. The aim was to assess how well bone turnover –based classification of ROD correlates with the classification determined by an expert histomorphometrist (HK), and how these correlate with 18F-NaF PET analysis Method A total of 24 dialysis patients underwent a 18F-NaF PET scan. Fluoride activity was measured at the anterior iliac crest and in the lumbar region. An iliac crest bone biopsy was obtained within 4 weeks from the PET-scan. The diagnosis of bone histomorphometry was determined based on turnover-mineralization-volume (TMV) classification. Firstly, bone turnover was assessed using bone formation rate and activation frequency. Secondly, also other histomorphometric parameters (eg. osteoid volume, osteoid surface, resorption surface, mineralized surface, osteoblast and osteoclast surfaces and peritrabecular fibrosis) were also taking into account for classification of ROD by a histomorphometrist. Results Based on bone turnover parameters only, 12% of the patients had high turnover and 64% low turnover. When the diagnosis of renal osteodystrophy was made by a histomorphometrist, 40% had hyperparathyreoid bone/osteitis fibrosa and 24% adynamic bone disease or ostemalasia. 18F-NaF PET´s sensitivity to recognize hyperparathyreoid bone disease was 80% end specificity 100% (cut-of value 0.055).18F-NaF PET´s sensitivity to recognize adynamic bone disease was 100% and specificity 61% (cut-of value of fluoride-activity 0.038) Conclusion 18F-NaF PET works well as a diagnostic tool, when the diagnosis of ROD is based on the histopathological evaluation. It remains unknown how variations in normal bone turnover rate can be detected in CKD patients by 18F-NaF PET and if treatment decisions of ROD can be made only based on bone turnover.

scholarly journals Is it possible to predict a risk of osteoporosis in patients with juvenile idiopathic arthritis? A study of serum levels of markers of bone turnover

2018 ◽  
Vol 65 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Marta Janicka-Szczepaniak ◽  
Krzysztof Orczyk ◽  
Katarzyna Szymbor ◽  
Danuta Chlebna-Sokół ◽  
Elzbieta Smolewska
Keyword(s):  
Alkaline Phosphatase ◽  
Juvenile Idiopathic Arthritis ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Serum Levels ◽  
Bone Alkaline Phosphatase ◽  
Common Finding ◽  
Treatment Needs ◽  
Mineral Density ◽  
Markers Of Bone Turnover

Background: Low bone mineral density is a common finding in children with systemic connective tissue diseases, including juvenile idiopathic arthritis (JIA). The influence of the ongoing process of bone remodeling on the disease course merits further investigation. The aim of the study was to assess the clinical relevance of markers of bone turnover and their potential role as predictors of higher fracture risk and, by extension, risk of osteoporosis.Materials and methods: Blood samples were collected from 59 patients diagnosed with JIA in order to determine serum levels of the following markers of bone turnover: Beta-Crosslaps, osteocalcin, bone alkaline phosphatase, osteoprotegerin and receptor activator for nuclear factor kappa-B ligand. The values were analyzed with laboratory parameters and results of dual X-ray absorptiometry (DXA).Results: Osteoprotegerin and bone alkaline phosphatase levels were age-dependent. Beta‑Crosslaps values were significantly higher in patients with positive JADAS27 score (p=0.0410). Osteoprotegerin levels were higher in patients treated with biological agentsthan only withdisease-modifying anti-rheumatic drugs (p=0.0273). There was no relation between markers of bone turnover and sex, DXA results, dosage of glucocorticosteroids and disease duration.Conclusions:Authors postulate performing DXA measurements every 6 months in patients with higher disease activity. The potential lower fracture risk in children with JIA within biological treatment needs future assessment. Age- and sex-adjusted reference rates of markers of bone turnover for Central Europe need to be developed in order to assess individual values properly.

Attenuated bone aluminum deposition in nonuremic beagles with reduced bone remodeling

1990 ◽  
Vol 258 (4) ◽  
pp. E576-E581
Author(s):  
L. D. Quarles
Keyword(s):  
Parathyroid Hormone ◽  
Bone Formation ◽  
Bone Turnover ◽  
Bone Remodeling ◽  
Aluminum Chloride ◽  
Formation Rate ◽  
Bone Formation Rate ◽  
Osteoid Surface ◽  
Aluminum Accumulation ◽  
Aluminum Deposition

Excess bone aluminum accumulates in uremic subjects after parathyroidectomy. To evaluate whether decreased bone remodeling caused by parathyroidectomy augments bone aluminum deposition, we administered aluminum chloride (0.75 mg/kg iv 3 times/wk) or vehicle to thyroparathyroidectomized (TPTX) and sham-operated (Sham) nonuremic beagles for 8 wk. TPTX alone effectively lowered plasma parathyroid hormone concentrations (8.2 +/- 2.8 vs. 27 +/- 2.2 pg/ml) and consequently suppressed bone remodeling, as evidenced by the diminished resorptive surface (0.8 +/- 0.3 vs. 4.0 +/- 0.5%), osteoid surface (0.5 +/- 0.2 vs. 13.3 +/- 2.3%), and bone formation rate (1.8 +/- 0.6 vs. 15.5 +/- 2.2%/yr) compared with untreated Shams. Aluminum treatment resulted in no further suppression of bone remodeling in TPTX dogs and did not cause osteomalacia. Aluminum-treated TPTX dogs, however, accumulated much less total bone (28.1 +/- 4.5 micrograms/g) and surface aluminum (3.8 +2- 1.4%) than similarly treated Shams (61.4 +/- 5.6 micrograms/g; 12.2 +/- 2.7%, respectively) despite displaying higher plasma aluminum concentrations (1,209 +/- 330 vs. 181 +/- 18 micrograms/l). These observations illustrate that diminished bone turnover retards rather than augments bone aluminum accumulation. Thus bone aluminum deposition after parathyroidectomy in uremic subjects is not likely to be the result of passive aluminum accumulation on inactive bone surfaces. Further studies are needed to determine whether factors, such as prior bone aluminum accumulation and/or the degree of preexistent hyperosteoidosis, modulate aluminum accumulation after parathyroidectomy.

1,25(OH)2D3 acts as a bone-forming agent in the hormone-independent senescence-accelerated mouse (SAM-P/6)

2005 ◽  
Vol 288 (4) ◽  
pp. E723-E730 ◽  
Author(s):  
Gustavo Duque ◽  
Michael Macoritto ◽  
Natalie Dion ◽  
Louis-Georges Ste-Marie ◽  
Richard Kremer
Keyword(s):  
Bone Formation ◽  
Bone Turnover ◽  
Bone Marrow Cells ◽  
Formation Rate ◽  
Mineral Density ◽  
Bone Formation Rate ◽  
Senile Osteoporosis ◽  
Dihydroxyvitamin D ◽  
Bone Formation Markers

Recent studies suggest that vitamin D signaling regulates bone formation. However, the overall effect of 1,25-dihydroxyvitamin D3 [1,25(OH)2D3] on bone turnover in vivo is still unclear. In this study, our aim was to examine the effect of 1,25(OH)2D3 on bone turnover in SAM-P/6, a hormone-independent mouse model of senile osteoporosis characterized by a decrease in bone formation. Male and female 4-mo-old SAM-P/6 mice were treated with 1,25(OH)2D3 (18 pmol/24 h) or vehicle for a period of 6 wk, and a group of age- and sex-matched nonosteoporotic animals was used as control. Bone mineral density (BMD) at the lumbar spine increased rapidly by >30 ± 5% ( P < 0.001) in 1,25(OH)2D3-treated SAM-P/6 animals, whereas BMD decreased significantly by 18 ± 2% ( P < 0.01) in vehicle-treated SAM-P/6 animals and remained stable in control animals during the same period. Static and dynamic bone histomorphometry indicated that 1,25(OH)2D3 significantly increased bone volume and other parameters of bone quality as well as subperiosteal bone formation rate compared with vehicle-treated SAM-P/6 mice. However, no effect on trabecular bone formation was observed. This was accompanied by a marked decrease in the number of osteoclasts and eroded surfaces. A significant increase in circulating bone formation markers and a decrease in bone resorption markers was also observed. Finally, bone marrow cells, obtained from 1,25(OH)2D3-treated animals and cultured in the absence of 1,25(OH)2D3, differentiated more intensely into osteoblasts compared with those derived from vehicle-treated mice cultured in the same conditions. Taken together, these findings demonstrate that 1,25(OH)2D3 acts simultaneously on bone formation and resorption to prevent the development of senile osteoporosis.

Histomorphometric assessment of bone turnover in uraemic patients: comparison between activation frequency and bone formation rate

2001 ◽  
Vol 38 (6) ◽  
pp. 571-583 ◽  
Author(s):  
P Ballanti ◽  
G Coen ◽  
S Mazzaferro ◽  
F Taggi ◽  
M Giustini ◽  
...  
Keyword(s):  
Bone Formation ◽  
Bone Turnover ◽  
Formation Rate ◽  
Bone Formation Rate

scholarly journals P0885THE RELATIONSHIP BETWEEN BONE REGULATORY MARKERS AND BONE TURNOVER IN RENAL OSTEODYSTROPHY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Syazrah Salam ◽  
Orla Gallagher ◽  
Fatma Gossiel ◽  
Arif Khwaja ◽  
Richard Eastell
Keyword(s):  
Bone Formation ◽  
Bone Turnover ◽  
Renal Osteodystrophy ◽  
Bone Biopsy ◽  
Formation Rate ◽  
Tartrate Resistant Acid Phosphatase ◽  
Bone Resorption Marker ◽  
Bone Formation Rate ◽  
Bone Formation Markers ◽  
The Relationship

Abstract Background and Aims Renal osteodystrophy is common in advanced chronic kidney disease (CKD) patients and is characterized by abnormal bone turnover and mineralization. Parathyroid hormone (PTH) increases bone turnover through osteoblast and osteoclast activation. Osteoprotegerin (OPG) is a decoy receptor of receptor activator of nuclear factor kappa-β ligand and thus, inhibits osteoclast maturation. Meanwhile, sclerostin is an inhibitor of the Wnt signalling pathway and thus, inhibits osteoblast maturation. We aimed to assess the relationship between these bone regulatory markers and bone turnover as assessed by bone histomorphometry and bone turnover markers (BTMs). Method We recruited 43 CKD patients with eGFR&lt;30ml/min/1.73m2 or on dialysis. Fasting serum samples were analysed using Immunodiagnostic Systems automated assays (Boldon, UK) for intact PTH (iPTH) and BTMs such as bone alkaline phosphatase (bALP) and intact procollagen type 1 N-terminal propeptide (intact PINP) which are bone formation markers, and tartrate-resistant acid phosphatase 5b (TRAP5b) which is a bone resorption marker. OPG and sclerostin were analysed using manual ELISA by Biomedica (Vienna, Austria). Trans-iliac bone biopsy was performed after tetracycline labelling. Bone samples were analysed using quantitative histomorphometry. Normal bone turnover was defined as bone formation rate/bone surface (BFR/BS) of 18 - 38µm3/µm2/year. Spearman rank correlation was used to test the relationship between the variables. Results Median BFR/BS was 32.12 (IQR 17.76 – 48.25) um3/um2/year. 26% of patients had low and 40% had high bone turnover. iPTH and OPG were positively correlated with BFR/BS (rho = 0.42, p&lt;0.01 and rho = 0.36, p&lt;0.05 respectively). Sclerostin was not correlated with BFR/BS. Furthermore, sclerostin did not correlate with bALP and intact PINP whereas OPG correlated with TRAP5b (rho = 0.43, p&lt;0.01). iPTH correlated with bALP (rho = 0.62, p&lt;0.001), intact PINP (rho = 0.62, p&lt;0.001) and TRAP5b (rho = 0.50, p = 0.001). Conclusion Circulating levels of iPTH and OPG were modestly associated with bone turnover but sclerostin was not. There are likely to be bone regulators other than iPTH, OPG and sclerostin which regulate bone turnover in renal osteodystrophy.

scholarly journals Bone markers and osteoporosis

2004 ◽  
Vol 23 (3) ◽  
pp. 221-228 ◽  
Author(s):  
Kaya Emerk
Keyword(s):  
Bone Resorption ◽  
Bone Formation ◽  
Bone Turnover ◽  
Biochemical Markers ◽  
Alcohol Intake ◽  
Bone Markers ◽  
Bone Alkaline Phosphatase ◽  
Low Concentrations ◽  
Trabecular Microstructure ◽  
Markers Of Bone Turnover

Diagnosis of a given disease is often the first step to a successful therapy. The use of biochemical markers of bone turnover in osteoporosis is becoming more important due to their capacity to give early information. Many of the new markers are proteins, peptides, or other large biomolecules, usually present at very low concentrations. Bone is a living, growing tissue that turns over at a rate of about 10% a year. It is lergely made up of collagen, that gives the bone its tensile strength and framework, and calcium phosphate, mineralized complex that hardens the framework. After age 24, bone resorption slowly begins to happen faster than bone formation. Bone loss is most rapid in women in the first few year after menopause but continues into the postmenopausal years. Loss although much slowly, also happens in men. In addition to bone porosity, the bone strength is determined by the trabecular microstructure in wich osteoclastic, and osteoblastic activities play an important role. Osteoporosis develops when bone resorption occurs too rapidly and bone formation fails to keep up. Risk factors for osteoporosis involves age, gender, ethnicity, use of certain drugs, exercise, smoking Vit D deficiency, Ca intake, sex hormones, alcohol intake etc. Mineralization markers are serum osteocalcin, bone alkaline phosphatase, serum prokollagen I extention peptides. Markers for the resorption of bone on the other hand are urine N-telopeptide crosslinks, urine deoxy-piridinoline, urine hydroxyproline, tartarate dependent acid phosphatase and Catepsin K. Biochemical markers of bone turnover should be used with BMD for diagnosis.

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