scholarly journals Prevalence of Vertebral Fractures and Serum Sclerostin Levels in Acromegaly

2021 ◽  
Author(s):  
Meliha Melin Uygur ◽  
Dilek Dereli Yazici ◽  
Onur Buğdayci ◽  
Dilek Gogas Yavuz
Keyword(s):  
Bone Turnover ◽  
Vertebral Fractures ◽  
Treatment Modality ◽  
Gamma Knife Radiosurgery ◽  
Binary Logistic Regression ◽  
Control Group ◽  
Binary Logistic Regression Analysis ◽  
Mineral Density ◽  
Control Subjects ◽  
Markers Of Bone Turnover

Abstract ObjectiveAn increased prevalence of vertebral fractures (VFs) has been reported in previous studies. The aim of this study was to evaluate the association between bone mineral density (BMD), bone turnover markers, serum sclerostin levels, and vertebral fractures (VFs) in acromegaly patients. We also evaluated the effects of gonadal status, disease activity, treatment modality, age, sex, and body mass index (BMI) on skeletal endpoints.DesignCase-control study.Patients and measurementsSeventy acromegaly patients (M/F:36/34, mean age 45,5±11,9 years) and 70 controls (M/F:31/39; mean age 45.66±11.9 years) were included. VFs, BMD, calcium metabolism, markers of bone turnover, and sclerostin levels were evaluated. BMD was measured by dual-energy X-ray absorptiometry (Hologic QDR 4500). Conventional lateral radiography of the spine was performed and the Genant method was used for the assessment of fractures of T4–L5 vertebrae.ResultsThe prevalence of vertebral fractures was higher in acromegalic patients as compared with the control group (72.9% vs. 20%; p<0.001). Serum phosphate (P) levels (3.46±0.59 mg/dl vs. 3.11±0.44 mg/dl; p<0.001) and b-cross laps (CTx) levels (0.47 µg/l, range 0.04-2.38 vs. 0.28 µg/l, range 0.11-0.80; p<0.001) were significantly higher in acromegaly patients than control subjects. Serum sclerostin levels were similar between either acromegaly patients and control subjects or acromegaly patients with VF and without VF. In the means of treatment modality, VFs were more frequent in patients treated with adjuvant gamma-knife radiosurgery (GKS) (p=0.07). In the binary logistic regression analysis, the age of the acromegaly patients, the presence of hypogonadism, and GKS treatment were the factors significantly correlated with the occurrence of spinal fractures.ConclusionThe prevalence of VFs in patients with acromegaly is higher than in control subjects. Since advanced age, the presence of hypogonadism and GKS treatment were the factors predicting VFs in acromegaly; radiological evaluations should be considered as an emerging tool especially in those patients. Although markers of bone turnover elevated in acromegaly, they were not useful for the prediction of fractures. Serum sclerostin levels showed no discrepancy between the two groups and further studies are required for assessment of sclerostin role in this form of secondary osteoporosis.

scholarly journals The threshold of bone mineral density for vertebral fractures in female patients with primary hyperparathyroidism

2005 ◽  
Vol 153 (3) ◽  
pp. 373-378 ◽  
Author(s):  
Hiroshi Kaji ◽  
Mika Yamauchi ◽  
Kazuo Chihara ◽  
Toshitsugu Sugimoto
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Primary Hyperparathyroidism ◽  
Bone Mineral ◽  
Vertebral Fractures ◽  
Control Group ◽  
Mineral Density ◽  
Female Patients ◽  
Control Subjects

Background and objective: Primary hyperparathyroidism (pHPT) is one of the causal diseases that induce secondary osteoporosis. Although patients with pHPT have reduced bone mineral density (BMD) especially at the cortical bone, there have been controversies about risk of fracture. Moreover, no reports have been available about the threshold of BMD for fractures in pHPT patients. Methods: BMD values were measured by dual-energy x-ray absorptiometry at lumbar spine, femoral neck and distal one third of radius. Various indices were compared in 116 female pHPT patients and 716 control subjects. Moreover, we analyzed relationship between the cut-off values of BMD and the prevalence of vertebral fractures in pHPT and control subjects. Results: The prevalence of subjects with vertebral fractures was lower in pHPT patients, compared with that of control subjects. Age and body height were significantly higher and lower in pHPT women with vertebral fractures, respectively. Lumbar spine BMD was significantly lower in pHPT women with vertebral fractures, presumably due to their increased age. There were no differences in femoral neck and radius BMD or in bone metabolic indices between pHPT women with and without vertebral fractures. On the other hand, age-matched BMD was not significantly different between both groups at any measured site. Cut-off values of BMD at lumbar spine and femoral neck were lower in postmenopausal pHPT patients, compared with those of the postmenopausal control group. Moreover, cut-off values of BMD at radius was much lower in postmenopausal pHPT patients, compared with those of the postmenopausal control group (pHPT vs control (g/cm2): 0.670 vs 0.706 at lumbar spine; 0.549 vs 0.570 at femoral; 0.394 vs 0.474 at radius). Sensitivity and specificity of vertebral fractures was lower in pHPT patients, compared with those in control group. Conclusions: The present cross-sectional study demonstrated that thresholds of BMD for vertebral fractures were lower especially at radial bone in female patients with pHPT, compared with those in the control group.

scholarly journals High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly

2011 ◽  
Vol 164 (4) ◽  
pp. 475-483 ◽  
Author(s):  
M J E Wassenaar ◽  
N R Biermasz ◽  
N A T Hamdy ◽  
M C Zillikens ◽  
J B J van Meurs ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Disease Control ◽  
Vertebral Fractures ◽  
Mineral Density ◽  
Markers Of Bone Turnover ◽  
High Prevalence

ObjectiveTo establish the prevalence of osteoporosis, vertebral fractures (VFs), and non-VFs in acromegaly patients with long-term controlled disease and factors potentially influencing fracture risk.DesignCase–control study.Patients and measurementsEighty-nine patients (46% male, mean age: 58 years) were included. We studied VFs and non-VFs, bone mineral density (BMD), and markers of bone turnover. In 48 patients, BMD assessment was also obtained 7 years prior to the current study. To compare VF prevalence, data from a sample of the Dutch population (n=3469) were used.ResultsVF prevalence was 59% (men 64% and women 54%), significantly increased when compared with controls (odds ratio up to 6.5), and independent of the duration of disease control, BMD, markers of bone turnover, and acromegalic disease characteristics. Mean number of VFs per patient was 3.4±0.3 (range 1–8). There was no relationship between the number and severity of fractures, parameters of bone turnover, and follow-up BMD measurements. BMD did not change during prolongation of follow-up by 7 years of controlled acromegaly.ConclusionThere is a very high prevalence of VFs in acromegaly patients with long-term controlled disease, independently of BMD. In view of the significant morbidity and mortality associated with VFs in general and the inability of BMD to predict fracture risk in acromegalic patients, we propose to include VF assessment, for example by lateral conventional radiographs of the spine in the screening of patients with acromegaly, both at diagnosis and during follow-up after establishment of disease control.

Osteoprotegerin, RANKL and bone turnover in postmenopausal osteoporosis

2011 ◽  
Vol 64 (4) ◽  
pp. 354-357 ◽  
Author(s):  
Suhair Jabbar ◽  
John Drury ◽  
John N Fordham ◽  
Harish K Datta ◽  
Roger M Francis ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Postmenopausal Women ◽  
Postmenopausal Osteoporosis ◽  
Biochemical Markers ◽  
Critical Role ◽  
Mineral Density ◽  
Cross Sectional ◽  
Control Subjects ◽  
Markers Of Bone Turnover ◽  
Circulating Levels

BackgroundOsteoprotegerin (OPG) and receptor activator of nuclear factor κ B ligand (RANKL) play a critical role in the regulation of bone turnover, but the relative importance of these two cytokines in the pathogenesis of postmenopausal osteoporosis is controversial.AimTo investigate the relationship between circulating levels of OPG, RANKL, bone turnover and bone mineral density (BMD) in postmenopausal women.MethodsA cross-sectional study of 185 women with osteoporosis and 185 age- and sex-matched control subjects was undertaken. Measurements were made of plasma OPG, RANKL, interleukin-6 (IL-6), sex steroids, calciotropic hormones, biochemical markers of bone turnover, BMD and anthropometry. Health questionnaires were administered.ResultsPlasma RANKL was significantly higher (p<0.0001) in women with osteoporosis (0.66±0.67 pmol/l) than in control subjects (0.37±0.38 pmol/l), as was plasma OPG (18.70±9.70 pmol/l in women with osteoporosis, 10.44±5.85 pmol/l in control subjects; p<0.0001). OPG/RANKL ratio was higher in women with osteoporosis (51.3) than in control subjects (36.6). The women with osteoporosis also had significantly higher biochemical markers of bone turnover, IL-6 and parathyroid hormone and lower 25-hydroxyvitamin D and oestradiol than the control subjects. Multiple regression analysis showed that lumbar spine and femoral neck BMD in postmenopausal women were best predicted by OPG and RANKL, giving an R2 value of 15.5% and 14.9%, respectively.ConclusionsThis study indicates that the circulating levels of OPG and RANKL are inversely related to BMD and contribute to the development of osteoporosis in postmenopausal women.

scholarly journals Effect of Denosumab on Bone Mineral Density and Markers of Bone Turnover among Postmenopausal Women with Osteoporosis

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
A. Sánchez ◽  
L. R. Brun ◽  
H. Salerni ◽  
P. R. Costanzo ◽  
D. González ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Control Group ◽  
Bone Resorption Marker ◽  
Similar Response ◽  
Mineral Density ◽  
Turnover Markers

The aim of this study was to evaluate the effect of denosumab (Dmab) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of Dmab in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 425 postmenopausal women treated with Dmab for 1 year in clinical practice conditions in specialized centers from Argentina. Participants were also divided according to previous bisphosphonate treatment into BP-naïve and BP-prior. A control group of patients treated with BP not switched to Dmab matched by sex, age, and body mass index was used. Data are expressed as mean ± SEM. After 1 year of treatment with Dmab the bone formation markers total alkaline phosphatase and osteocalcin were significantly decreased (23.36% and 43.97%, resp.), as was the bone resorption marker s-CTX (69.61%). Significant increases in BMD were observed at the lumbar spine, femoral neck, and total hip without differences between BP-naïve and BP-prior. A better BMD response was found in BP-prior group compared with BP treated patients not switched to Dmab.Conclusion. Dmab treatment increased BMD and decreased bone turnover markers in the whole group, with similar response in BP-naïve and BP-prior patients. A better BMD response in BP-prior patients versus BP treated patients not switched to Dmab was observed.

Circulating Biomarkers Related to Osteocyte and Calcium Homeostasis between Postmenopausal Women with and without Osteoporosis

2021 ◽  
Vol 21 ◽  
Author(s):  
Chin Yi Chan ◽  
Shaanthana Subramaniam ◽  
Norazlina Mohamed ◽  
Norliza Muhammad ◽  
Fitri Fareez Ramli ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Postmenopausal Women ◽  
Calcium Homeostasis ◽  
Bone Cells ◽  
Control Group ◽  
Protein Markers ◽  
Mineral Density ◽  
Hydroxyvitamin D ◽  
Hip Bmd ◽  
Turnover Markers

Background: The currently available bone turnover markers are mostly derived from osteoblasts or osteoclasts. Protein markers derived from osteocytes, the most abundant bone cells that can regulate bone turnover activities by other cells, are less explored. Objective: This study aimed to compare the circulating markers of osteocytes and calcium homeostasis between Malaysian postmenopausal women with and without osteoporosis. Method: Postmenopausal women with (n=20) or without osteoporosis (n=20) as determined by dual-energy X-ray absorptiometry were randomly drawn from a bone health cohort. Their fasting blood was collected and assayed by a multiplex immunoassay panel. Results: The results showed that osteoprotegerin and sclerostin levels were significantly lower among postmenopausal women with osteoporosis than the normal control. No significant differences in other markers were observed between the two groups. Sclerostin level correlated positively with spine bone mineral density (BMD), while 25-hydroxyvitamin D correlated negatively with hip BMD in the control group. No significant correlation was observed between other markers with spine or hip BMD. Conclusion: These data provide an insight into the possible roles of osteocyte markers, especially osteoprotegerin and sclerostin in classifying subjects with osteoporosis. However, the lack of association between these markers and BMD indicates that osteoporosis is a complex and multifactorial condition.

scholarly journals A Comparison of the Effects of Raloxifene and Estrogen on Bone in Postmenopausal Women1

2000 ◽  
Vol 85 (6) ◽  
pp. 2197-2202
Author(s):  
Karen M. Prestwood ◽  
Michele Gunness ◽  
Douglas B. Muchmore ◽  
Yili Lu ◽  
Mayme Wong ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Biochemical Markers ◽  
Mineral Density ◽  
Bone Formation Rate ◽  
Markers Of Bone Turnover ◽  
Bone Biopsies ◽  
Hip Bmd ◽  
Total Body

Raloxifene HCl, a selective estrogen receptor modulator, has been shown to increase bone mineral density (BMD) and decrease biochemical markers of bone turnover in postmenopausal women without stimulatory effects on the breast and uterus. However, it is not known whether the changes in BMD and bone turnover are associated with changes at the tissue level, nor how changes with raloxifene compare with estrogen. In this randomized, double blind study, we evaluated the effects of raloxifene (Evista, 60 mg/day) or conjugated equine estrogens (CEE; Premarin, 0.625 mg/day) on bone architecture, bone turnover, and BMD. Iliac crest bone biopsies were obtained at baseline and at the end of the study after double tetracycline labeling and were analyzed for standard histomorphometric indexes. Serum and urinary biochemical markers of bone turnover were measured at baseline and at 4, 10, 18, and 24 weeks of treatment. Total body, lumbar spine, and hip BMD were measured at baseline and at the end of the study by dual energy x-ray absorptiometry. Activation frequency and bone formation rate/bone volume were significantly decreased from baseline in the CEE, but not in the raloxifene, group. Bone mineralization did not change in either group. Most markers of bone resorption and formation decreased in both groups, but to a greater degree in the CEE group (P &lt; .05). Total body and lumbar spine BMD increased from baseline in both groups, with a greater increase in the CEE group (P&lt; 0.05). Hip BMD significantly increased from baseline in the raloxifene group, but the change was not different from that in the CEE group. These results suggest that raloxifene reduces bone turnover and increases bone density, although to a lesser extent than CEE. Thus, raloxifene is an alternative to CEE for the prevention and treatment of osteoporosis in postmenopausal women.

scholarly journals Relationship among dietary estimates of net endogenous acid production, bone mineral density and biochemical markers of bone turnover in an Iranian general population

Bone ◽  
2009 ◽  
Vol 45 (5) ◽  
pp. 876-881 ◽  
Author(s):  
Alireza Rahbar ◽  
Bagher Larijani ◽  
Iraj Nabipour ◽  
Mohamad Mehdi Mohamadi ◽  
Kamran Mirzaee ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
General Population ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Acid Production ◽  
Biochemical Markers ◽  
Mineral Density ◽  
Net Endogenous Acid Production ◽  
Markers Of Bone Turnover
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