scholarly journals A Prospective Study on Critical Illness and Changes in Bone Turnover in Adult Patients

2022 ◽  
Author(s):  
Gemma Marcucci ◽  
Morena Cozzolino ◽  
Mirko Duradoni ◽  
Simone Parri ◽  
Caterina Fossi ◽  
...  
Keyword(s):  
Critical Illness ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Bone Turnover Marker ◽  
Positive Association ◽  
Hypovitaminosis D ◽  
Adult Survivors ◽  
Mineral Density ◽  
Severity Scores ◽  
A Prospective Study

Critical illness has been recognized to acutely influence bone metabolism and, consequently, bone mineral density. The main purpose of this study was to describe bone metabolism changes in adult survivors of critical illness in the attempt to correlate changes with severity scores. It is an open, prospective, observational, monocentric study on patients admitted to the ICU was conducted, evaluating bone metabolism at baseline (within 72 hours of ICU admission), 6 months, and 12 months. Fifty-nine patients admitted to the ICU (63% males), mean age 58 ± 16 years, were enrolled. Of these, 20 patients (34%) completed the one-year follow up. At baseline, bone resorption showed an increase, which was maintained at 6 months, with normalization at 12 months. Patients showed, in a majority of cases, hypovitaminosis D with hyperparathyroidism at baseline with subsequent normalization. A trend towards a correlation was described between severity scores and serum 25(OH) vitamin D and bone turnover marker levels. These results contribute to the confirmation of a positive association between critical illness requiring ICU and bone metabolism changes. This study poses the bases for further studies to evaluate bone health in ICU patients.

scholarly journals Persistent Increase in Bone Turnover in Graves’ Patients with Subclinical Hyperthyroidism

2000 ◽  
Vol 85 (11) ◽  
pp. 4157-4161 ◽  
Author(s):  
Yasuro Kumeda ◽  
Masaaki Inaba ◽  
Hideki Tahara ◽  
Yasuko Kurioka ◽  
Tetsuro Ishikawa ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Bone Metabolism ◽  
Antithyroid Drug ◽  
Significant Negative Correlation ◽  
Bone Alkaline Phosphatase ◽  
Mineral Density ◽  
Free T4 ◽  
Bone Formation Markers ◽  
Significant Attenuation ◽  
Group B

Hyperthyroid patients exhibit accelerated bone loss by increased bone turnover, and normalization of thyroid function is associated with a significant attenuation of increased bone turnover, followed by an increase in bone mineral density. However, of patients with Graves’ disease (GD) maintained on antithyroid drug (ATD) treatment, some exhibit persistent suppression of TSH long after normalization of their serum free T3 (FT3) and free T4 (FT4) levels. The aim of this study was to examine whether bone metabolism is still enhanced in TSH-suppressed premenopausal GD patients with normal FT3 and FT4 levels after ATD therapy (n = 19) compared with that in TSH-normal premenopausal GD patients (n = 30), and to evaluate the relationship between serum TSH receptor antibody (TRAb), an indicator of disease activity of GD, and various biochemical markers of bone metabolism. No difference was found between the two groups in serum Ca, phosphorus, or intact PTH, or in urinary Ca excretion. Serum bone alkaline phosphatase (B-ALP), bone formation markers, and urinary excretions of pyridinoline (U-PYD) and deoxypyridinoline (U-DPD), which are bone resorption markers, were significantly higher in the TSH-suppression group than in the TSH-normal group (B-ALP, P < 0.05; U-PYD, P < 0.001; U-DPD, P < 0.001). For the group of all GD patients enrolled in this study, TSH, but neither FT3 nor FT4, exhibited a significant negative correlation with B-ALP (r = −0.300; P < 0.05), U-PYD (r= −0.389; P < 0.05), and U-DPD (r = −0.446; P < 0.05), whereas TRAb exhibited a highly positive and significant correlation with B-ALP (r = 0.566; P < 0.0001), U-PYD (r = 0.491; P < 0.001), and U-DPD (r = 0.549; P < 0.0001). Even in GD patients with normal TSH, serum TRAb was positively correlated with B-ALP (r = 0.638; P < 0.001), U-PYD (r = 0.638; P < 0.001), and U-DPD (r = 0.641; P < 0.001). In conclusion, it is important to achieve normal TSH levels during ATD therapy to normalize bone turnover. TRAb was not only a useful marker for GD activity, but was also a very sensitive marker for bone metabolism in GD patients during ATD treatment.

scholarly journals Serum and Urinary Osteocalcin in Healthy 7- to 19-Year-Old Finnish Children and Adolescents

2021 ◽  
Vol 9 ◽  
Author(s):  
Päivi M. Paldánius ◽  
Kaisa K. Ivaska ◽  
Outi Mäkitie ◽  
Heli Viljakainen
Keyword(s):  
Body Composition ◽  
Bone Turnover ◽  
Children And Adolescents ◽  
Bone Turnover Marker ◽  
High Growth ◽  
Reference Intervals ◽  
Normative Values ◽  
Specific Reference ◽  
Mineral Density ◽  
The Impact

Children and adolescents have high bone turnover marker (BTM) levels due to high growth velocity and rapid bone turnover. Pediatric normative values for BTMs reflecting bone formation and resorption are vital for timely assessment of healthy bone turnover, investigating skeletal diseases, or monitoring treatment outcomes. Optimally, clinically feasible measurement protocols for BTMs would be validated and measurable in both urine and serum. We aimed to (a) establish sex- and age-specific reference intervals for urinary and serum total and carboxylated osteocalcin (OC) in 7- to 19-year-old healthy Finnish children and adolescents (n = 172), (b) validate these against standardized serum and urinary BTMs, and (c) assess the impact of anthropometry, pubertal status, and body composition on the OC values. All OC values in addition to other BTMs increased with puberty and correlated with pubertal growth, which occurred and declined earlier in girls than in boys. The mean serum total and carboxylated OC and urinary OC values and percentiles for sex-specific age categories and pubertal stages were established. Correlation between serum and urinary OC was weak, especially in younger boys, but improved with increasing age. The independent determinants for OC varied, the urinary OC being the most robust while age, height, weight, and plasma parathyroid hormone (PTH) influenced serum total and carboxylated OC values. Body composition parameters had no influence on any of the OC values. In children and adolescents, circulating and urinary OC reflect more accurately growth status than bone mineral density (BMD) or body composition. Thus, validity of OC, similar to other BTMs, as a single marker of bone turnover, remains limited. Yet, serum and urinary OC similarly to other BTMs provide a valuable supplementary tool when assessing longitudinal changes in bone health with repeat measurements, in combination with other clinically relevant parameters.

scholarly journals Relationships Between Thyroid Hormones, Insulin-Like Growth Factor-1 and Antioxidant Levels in Hypothalamic Amenorrhea and Impact on Bone Metabolism

2019 ◽  
Vol 51 (05) ◽  
pp. 302-308
Author(s):  
Antonio Mancini ◽  
Edoardo Vergani ◽  
Carmine Bruno ◽  
Angelina Barini ◽  
Andrea Silvestrini ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Bone Metabolism ◽  
Bone Alkaline Phosphatase ◽  
Antioxidant Systems ◽  
Special Focus ◽  
Mineral Density ◽  
Hypothalamic Amenorrhea ◽  
Low T3 ◽  
Group A ◽  
The Impact

AbstractReduced bone mineral density (BMD) in Functional Hypothalamic Amenorrhea (FHA) is mainly related to hypoestrogenism, but other hormonal derangement (reduced conversion of T4–T3 and GH resistance) can play a role. These hormones are involved in antioxidant systems regulation. We evaluated the impact of hormonal alterations, with special focus on low T3 and IGF-1 levels, on antioxidant systems as a link with osteoporosis in FHA. Forty-three FHA patients, 15–34 years, with BMI range 17.3–23.4 kg/m2, were divided in 2 groups according to fT3 levels; group A (n=22), low fT3 (<2.4 pg/ml) and group B (n=21), normal fT3 (≥ 2.4 pg/ml). We evaluated hormonal parameters (fT3, fT4, TSH, IGF-1, FSH, LH, estradiol, DHEAS, testosterone, cortisol), bone metabolism (calcium, phosphorus, 25-OH Vitamin D, PTH, β-crosslaps, bone alkaline phosphatase) and total antioxidant capacity (TAC), expressed as LAG (latency time in radical species appearance using spectrophotometric method). BMD was assessed by DEXA. Group A patients exhibited significantly lower levels of IGF-1 (159.76±14.79 vs. 220.05±15.25 ng/ml) and osteocalcin (17.51±1.14 vs. 21.49±1.56 ng/ml); LAG values were significantly higher in A (66.33±1.74 s) vs. B (54.62±1.74 s). A significant direct correlation was found between both IGF-1 and fT3 with osteocalcin (r²=0.22, p=0.0049 and r²=0.34, p=0.0001, respectively). No difference in LAG between groups according to IGF-1 were found. These data show a correlation between altered bone turnover and low fT3, which is highly prevalent in FHA. Low fT3 levels may contribute to reduced BMD. Oxidative stress could be the link underlying different bone turnover pattern and endocrine dysfunction in FHA.

scholarly journals Recreational football improves bone mineral density and bone turnover marker profile in elderly men

2014 ◽  
Vol 24 ◽  
pp. 98-104 ◽  
Author(s):  
E. W. Helge ◽  
T. R. Andersen ◽  
J. F. Schmidt ◽  
N. R. Jørgensen ◽  
T. Hornstrup ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Marker ◽  
Mineral Density ◽  
Elderly Men ◽  
Marker Profile

Bone Mineral Density and Biochemical Markers of Bone Metabolism in Women Engaging in Recreational Horseback Riding

2016 ◽  
Vol 13 (5) ◽  
pp. 520-524 ◽  
Author(s):  
Agnieszka Kaczmarek ◽  
Alicja Nowak ◽  
Piotr Leszczynski
Keyword(s):  
Physical Activity ◽  
Bone Mineral Density ◽  
Bone Mass ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Horseback Riding ◽  
Mineral Density ◽  
Turnover Markers

Background:An increased occurrence of lifestyle-related diseases such as osteoporosis indicates the necessity for taking preventive action, including regularly engaging in physical activity. The aim of the study was to assess the areal bone mineral density (aBMD) and bone turnover markers levels in young adult women engaging in recreational horseback riding and to determine the relationship between training characteristics and bone metabolism indices.Methods:The study involved 43 women: 23 equestrians and 20 age- and body mass index–matched controls. The hip and spine aBMD and serum levels of the bone turnover markers: osteocalcin and collagen type I cross-linked C-telopeptide were measured.Results:No significant differences were found in somatic features, concentrations of bone turnover markers, or bone mass variables. Correlation analysis of the equestrian participants showed significant relationship between body mass and BMDL1–L4 (P < .05) as well as between BMI and BMDL1–L4 (P ≤ .01) and z-score L1–L4 (P < .05).Conclusions:The study showed no differences in bone mass and levels of bone metabolic indices between groups of women practicing horseback riding at the recreational level and subjects who do not participate in frequent systematic physical activity. No relationship between training characteristics and bone turnover markers were found.

scholarly journals Effects of a 'Drug Holiday' on Bone Mineral Density and Bone Turnover Marker During Bisphosphonate Therapy

2013 ◽  
Vol 20 (1) ◽  
pp. 31 ◽  
Author(s):  
Sung Yeol Kong ◽  
Dae Young Kim ◽  
Eun Jin Han ◽  
So Young Park ◽  
Chang Hoon Yim ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Marker ◽  
Bisphosphonate Therapy ◽  
Drug Holiday ◽  
Mineral Density

scholarly journals Spine bone texture assessed by trabecular bone score (TBS) in active and controlled acromegaly: a prospective study

2021 ◽  
Author(s):  
E Sala ◽  
E Malchiodi ◽  
G Carosi ◽  
E Verrua ◽  
E Cairoli ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Trabecular Bone ◽  
Bone Quality ◽  
Trabecular Bone Score ◽  
Bone Microarchitecture ◽  
Normal Density ◽  
Mineral Density ◽  
Gh Secretion ◽  
And Gender ◽  
A Prospective Study

Abstract Purpose Acromegalic patients have an increased vertebral fracture (VFx) risk due to bone quality reduction, independently of bone mineral density (BMD). Aim of the study is to describe bone quality in acromegaly, measured by Trabecular bone score (TBS), a non-invasive index for assessing bone microarchitecture. Methods We collected data of 18 patients (13 F, age 56.2±15 years) newly diagnosed with acromegaly. Thirty-six age-and gender matched healthy controls were also recruited. Pituitary function, bone and calcium-phosphorous metabolism, and BMD at spine and femur and TBS (by dual-X-ray absorptiometry) were assessed in acromegalic patients at diagnosis and 12 months after the achievement of IGF-1 normalization. Results At diagnosis, BMD and the VFx prevalence were comparable between patients and controls (28.3 ± 5.9 vs 27.6 ± 3.7 and 11% vs 8.3%), while TBS was significantly lower in acromegalic patients (1.20±0.13 vs 1.30±0.06; p&lt;0.001) and CTX and osteocalcin were significantly higher compared to controls (707±365.7 vs 371±104.1 pg/ml; p=0.001 and 31.6 ± 15.4 vs 17.0 ± 5.7 ng/ml; p=0.001 respectively). One year after IGF-1 normalization, a significant reduction of bone turnover indexes in the group of acromegalic patients surgically cured (osteocalcin decreased of 61.2%, CTX decreased of 60.3%) compared to the ones controlled by medical therapy was observed (osteocalcin decreased of 39%, CTX decreased of 40.7%; p= 0.01 and p=0.001, respectively). Despite these findings, no TBS or BMD variations were observed. Conclusions Acromegalic patients have an impaired bone quality despite normal density. Achieving normal GH secretion rapidly leads to the normalization of bone turnover.

scholarly journals Bone mineral density and bone metabolism in postmenopausal women with type 2 diabetes in a Chinese community: a cross-sectional study

2020 ◽  
Author(s):  
Wu Han ◽  
Yufan Zhang ◽  
Wenbin Zhou ◽  
Jing Dai ◽  
Tao Yao ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Formation ◽  
Bone Turnover ◽  
Bone Metabolism ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Mineral Density ◽  
Osteoporosis Fracture

Abstract AMI: There is growing evidence of a complex interaction between T2DM and osteoporosis. The purpose of this study was to further study the relationship between BTMs and fasting blood glucose (FBG) in postmenopausal patients with type 2 diabetes and to analyze the effect of hyperglycemia on bone metabolism. Methods: Six hundred and twelve (612) postmenopausal women were included, including one hundred and seven (107) subjects with T2DM and five hundred and five (505) subjects without diabetes. BMD was measured by DXA (dual-energy X-ray absorptiometry). Markers of bone formation (P1NP) and resorption ( CTX ) were quantified. Results: Compared to controls, postmenopausal women with diabetes had a higher prevalence of previous osteoporosis fracture (27.1% vs. 17.4% for diabetic and nondiabetic women, respectively) and a higher BMD. The P1NP level in women with T2DM was 49.451 ng/ml, while in N-DM individuals, it was 58.633 ng/ml, (p = 0.017). The CTX level in women with T2DM was 0.325 ng/ml, while in N-DM individuals, it was 0.412 ng/ml (p=0.039). In addition, P1NP was significantly negatively associated with age (β=-0.590; p= 0.002) and FBG (β=-1.950; p = 0.035). CTX was negatively associated with FBG (β=-0.029; p = 0.015). Conclusions: T2DM was associated with higher BMD and paradoxically, with an increased risk of fracture. Postmenopausal women with T2DM had lower bone turnover than controls. With increased levels of FBG, bone formation and bone resorption were reduced, and the overall bone turnover level was reduced. Keywords Type 2 diabetes mellitus · Bone mineral density · Bone turnover markers · Osteoporosis fracture

Sign in / Sign up

Export Citation Format

Share Document