scholarly journals Treatment of Glucocorticoid-Induced Osteoporosis with Bisphosphonates Alone, Vitamin D Alone or a Combination Treatment in Eastern Asians: A Meta-Analysis

2019 ◽  
Vol 25 (14) ◽  
pp. 1653-1662
Author(s):  
Junjie Wang ◽  
Hongzhuo Li
Keyword(s):  
Vitamin D ◽  
Femoral Neck ◽  
Combination Treatment ◽  
Type I Collagen ◽  
Meta Analysis ◽  
Type I ◽  
Mineral Density ◽  
Bone Specific Alkaline Phosphatase ◽  
Asian Populations ◽  
Significant Difference

Background: Glucocorticoid (GC)-induced osteoporosis and fractures have become a serious problem for Eastern Asians. Bisphosphonates (BPs), vitamin D and a combination treatment are effective methods to prevent and treat GC-induced osteoporosis. Objective: The study aimed to compare the efficacy of BPs, vitamin D and a combination treatment for preventing and managing GC-induced osteoporosis in Eastern Asians. Methods: A comprehensive search in the PubMed, EMBASE, Web of Science and Cochrane CENTRAL databases was undertaken for randomized controlled trials (RCTs) on the effect of BPs, vitamin D and the combination treatment on GCs-induced osteoporosis in Eastern Asian populations. Primary outcome measures were the change in bone mineral density (BMD) and bone turnover markers. The final search was performed in March 2019. Results: Nine RCTs were included. A total of 545 patients met the inclusion criteria. Compared with vitamin D, BPs and the combination treatment significantly alleviated osteoporosis of the spine and femoral neck in Eastern Asians with GC-induced osteoporosis. At the same time, the change in serum bone-specific alkaline phosphatase (BAP) and serum C-telopeptide of type I collagen (CTX) levels was observed to be significantly less with BPs and the combination treatment with vitamin D alone. No significant difference was found between BPs and the combination treatment in the markers mentioned above. Conclusion: Compared with vitamin D alone, BPs alone and the combination treatment were significantly effective on Eastern Asians with GC-induced osteoporosis. Compared with the combination treatment, BPs alone were observed to be effective enough to increase the BMDs of the spine and femoral neck on both sides and thus prevent GC-induced osteoporosis in Eastern Asians.

scholarly journals Evaluation of bone mineral density (BMD) and indicators of bone turnover in patients with hemophilia

2018 ◽  
Vol 18 (2) ◽  
pp. 206-210 ◽  
Author(s):  
Mehmet Dagli ◽  
Ali Kutlucan ◽  
Sedat Abusoglu ◽  
Abdulkadir Basturk ◽  
Mehmet Sozen ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Formation ◽  
Bone Mass ◽  
Bone Mineral ◽  
Type I ◽  
Healthy Controls ◽  
Mineral Density ◽  
Lymphocyte Ratio ◽  
Significant Difference

A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment.

scholarly journals Head-to-head comparisons of bisphosphonates and teriparatide in osteoporosis: a meta-analysis

2017 ◽  
pp. E146-E157 ◽  
Author(s):  
Chun-Lin Liu ◽  
Han-Chung Lee ◽  
Chun-Chung Chen ◽  
Der-Yang Cho
Keyword(s):  
Lumbar Spine ◽  
Femoral Neck ◽  
Treatment Effectiveness ◽  
Meta Analysis ◽  
Mineral Density ◽  
Total Hip ◽  
Nonvertebral Fractures ◽  
Post Menopausal Osteoporosis ◽  
Significant Difference ◽  
Post Menopausal

Purpose: This meta-analysis aimed to compare the efficacy and safety of teriparatide vs. bisphosphonates in the management of osteoporosis. Methods: A total of 1,967 patients from eight randomized controlled trials were analyzed; outcomes included bone mineral density (BMD) of the femoral neck, total hip and lumbar spine, vertebral and nonvertebral fractures and any adverse event. A subgroup analysis of treatment effectiveness was performed according to the etiology of osteoporosis; i.e., glucocorticoid-induced osteoporosis (GIO) vs. post-menopausal osteoporosis (PO). Results: Teriparatide increased the BMD of the lumbar spine, femoral neck and total hip to a greater extent than bisphosphonates. Patients treated with teriparatide also had a lower risk of vertebral fractures compared with bisphosphonates; however, no difference in risk of nonvertebral fractures (or adverse events) was found. GIO subgroups showed larger increases in BMD of the lumbar spine, total hip and femoral neck in patients treated with teriparatide compared with bisphosphonates. The PO subgroup showed larger increases in BMD of the lumbar spine in patients treated with teriparatide compared with bisphosphonates. Patients in the GIO subgroup (but not the PO subgroup) were less likely to suffer a vertebral fracture on teriparatide as compared with bisphosphonates. In contrast, no significant difference in the percentage of nonvertebral fractures was noted between the two types of treatment for either subgroup. Conclusion: Teriparatide significantly increased the BMD of lumbar spine, total hip and femoral neck, particularly in GIO-induced osteoporosis. Teriparatide did not lower the risk of nonvertebral fractures when compared with bisphosphonates.

EFFECTS OF BISPHOSPHONATES ON OSTEOPOROSIS INDUCED BY DUCHENNE MUSCULAR DYSTROPHY: A PROSPECTIVE STUDY

2020 ◽  
Vol 26 (12) ◽  
pp. 1477-1485
Author(s):  
Wen-bin Zheng ◽  
Yi Dai ◽  
Jing Hu ◽  
Di-chen Zhao ◽  
Ou Wang ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Alkaline Phosphatase ◽  
Duchenne Muscular Dystrophy ◽  
Zoledronic Acid ◽  
Muscular Dystrophy ◽  
Bone Mineral ◽  
Type I Collagen ◽  
Type I ◽  
Mineral Density

Objective: Duchenne muscular dystrophy (DMD) is a severe X-linked progressive neuromuscular disease that brings a significantly increased risk of osteoporosis and bone fractures. We prospectively evaluated the effects of oral and intravenous bisphosphonates on the bones of children with DMD. Methods: This study included a total of 52 children with DMD. They were divided into zoledronic acid (ZOL), alendronate (ALN), and control groups according to bone mineral density (BMD) and history of fragility fractures. For 2 years, all patients took calcium, vitamin D, and calcitriol. Meanwhile, 17 patients received infusions of ZOL, and 18 patients received ALN. BMD, serum levels of alkaline phosphatase (ALP) and the cross-linked C-telopeptide of type I collagen (β-CTX) were evaluated. Results: After 24 months of treatment, the percentage changes in lumbar spine BMD were 23.2 ± 9.7% and 23.6 ± 8.8% in the ZOL and ALN groups (all P<.01 vs. baseline). The increases did not differ between the ZOL and ALN groups, but were significantly larger than those of the control group ( P<.01). Serum β-CTX and ALP levels, respectively, were decreased by 44.4 ± 18.0% and 31.9 ± 26.7% in the ZOL group and by 36.0 ± 20.3% and 25.8 ± 14.4% in the ALN group (all P<.01 vs. baseline). Conclusion: Zoledronic acid and alendronate had similar protective effects to increase bone mineral density and reduce bone resorption in children with DMD, which were superior to treatment of calcium, vitamin D, and calcitriol. Abbreviations: 25OHD = 25 hydroxyvitamin D; ALN = alendro-nate; ALP = alkaline phosphatase; ALT = alanine aminotransferase; BMD = bone mineral density; BP = bisphosphonate; Ca = calcium; β-CTX = cross-linked C-telopeptide of type I collagen; DMD = Duchenne muscular dystrophy; FN = femoral neck; GC = glucocorticoid; LS = lumbar spine; ZOL = zoledronic acid

scholarly journals Reduced Bone Mineral Density and Increased Bone Metabolism Rate in Young Adult Patients with 21-Hydroxylase Deficiency

2006 ◽  
Vol 91 (11) ◽  
pp. 4453-4458 ◽  
Author(s):  
Mariateresa Sciannamblo ◽  
Gianni Russo ◽  
Debora Cuccato ◽  
Giuseppe Chiumello ◽  
Stefano Mora
Keyword(s):  
Bone Mineral Density ◽  
Alkaline Phosphatase ◽  
Bone Metabolism ◽  
Type I Collagen ◽  
Whole Body ◽  
Type I ◽  
Healthy Controls ◽  
Mineral Density ◽  
Specific Alkaline Phosphatase ◽  
Bone Specific Alkaline Phosphatase

Abstract Context: Patients with congenital adrenal hyperplasia (CAH) receive glucocorticoids as replacement therapy. Glucocorticoid therapy is the most frequent cause of drug-induced osteoporosis. Objective: The objective of the study was to evaluate bone mineral density (BMD) and bone metabolism in CAH patients. Design: This was a cross-sectional observational study. Setting: The study was conducted at a referral center for pediatric endocrinology. Patients and Other Participants: Thirty young patients with the classical form of CAH (aged 16.4–29.7 yr) treated with glucocorticoid from diagnosis (duration of treatment 16.4–29.5 yr) and 138 healthy controls (aged 16.0–30.0 yr) were enrolled. Main Outcome Measures: BMD was measured in the lumbar spine and whole body by dual-energy x-ray absorptiometry. Bone formation and resorption rates were estimated by serum measurements of bone-specific alkaline phosphatase and C-terminal telopeptide of type I collagen, respectively. Results: CAH patients were shorter than controls (women −6.8 and men −13.3 cm). Therefore, several methods were used to account for the effect of this difference on bone measurements. Whole-body BMD measurements were significantly lower, compared with controls (P &lt; 0.03), after controlling for height (on average −2.5% in females and −9.3% in male patients). No differences were found in lumbar spine measurements. Bone-specific alkaline phosphatase and C-terminal telopeptide of type I collagen serum concentrations were higher in CAH patients than control subjects (P &lt; 0.04). BMD measurements and bone metabolism markers did not correlate with the actual glucocorticoid dose or mean dose over the previous 7 yr. Conclusions: Young adult patients with the classical form of CAH have decreased bone density values, compared with healthy controls. This may put them at risk of developing osteoporosis early in life.

scholarly journals EFFECT OF LOVASTATIN NANO DRUG DELIVERY SYSTEM ON BONE MINERAL DENSITY (BMD) AND BIOMECHANICAL PROPERTIES OF TIBIA BONES OF WISTAR RATS

2019 ◽  
pp. 42-48
Author(s):  
RAMANDEEP KAUR ◽  
Makula Ajitha
Keyword(s):  
Wistar Rats ◽  
Type I Collagen ◽  
Biomechanical Properties ◽  
Type I ◽  
Mineral Density ◽  
Bone Specific Alkaline Phosphatase ◽  
Type I Procollagen ◽  
Nanoemulsion Gel ◽  
Male Wistar Rats

Objective: In the present study, transdermal nanoemulsion (NE) gel of lovastatin was investigated for its anti-osteoporosis effect on the long bones of rat i.e. tibia. Methods: Male wistar rats (n=30, weighing 180-200g) were taken for this study and grouped as: 1) control (normal saline daily), 2) Dex (dexamethasone sodium; 25 mg/kg subcutaneously twice a week), 3) Dex+LNG5 (lovastatin nanoemulsion gel; 5 mg/kg/d transdermally daily), 4) Dex+LNG10 (lovastatin nanoemulsion gel; 10 mg/kg/d transdermally daily), and 5) Dex+ALN (alendronate sodium; 0.03 mg/kg/d orally daily). All the treatments were carried out for 60 d. At the end of the experiment, all animals were anesthetized using diethyl ether and collected blood samples from retro-orbital venous plexus of rats in dry eppendorf tubes followed by the sacrifice of animals by cervical dislocation method and collected tibia bones of both the legs for analysis. Results: Bone formation biomarkers (OC: osteocalcin, b-ALP: bone-specific alkaline phosphatase, PINP: N-terminal propeptides of type I procollagen) were significantly improved and resorption biomarkers (CTx: C-terminal cross-linking telopeptides of type-I collagen, TRAcP5b: isoform 5b of tartarate resistant acid phosphatase) were significantly reduced in the LNG5 (p<0.05) and LNG10 (p<0.05) treatment groups when compared to Dex. In vivo anti-osteoporotic results demonstrated the formation of new bone in osteoporotic rat tibias. Biomechanical strength testing demonstrated increased load-bearing capacity of rat tibias in the treated animals in comparison with the osteoporotic group (p<0.05 for LNG5 and p<0.01 for LNG10). Conclusion: Thus, the transdermal NE gel formulation of lovastatin demonstrated the greater potential for the treatment of osteoporosis.

scholarly journals Association between serum vitamin B6concentration and risk of osteoporosis in the middle-aged and older people in China: a cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e028129 ◽  
Author(s):  
Jing Wang ◽  
Lin Chen ◽  
Yan Zhang ◽  
Chen-guang Li ◽  
Hao Zhang ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Type I Collagen ◽  
Bone Turnover Marker ◽  
Serum Vitamin ◽  
Type I ◽  
Hormone Concentration ◽  
Mineral Density ◽  
Cross Sectional ◽  
25 Hydroxy Vitamin D

ObjectiveTo determine the relationship between serum vitamin B6(Vit B6) concentration and the status of bone mineral density and identify the relationship between serum Vit B6 and bone metabolism parameters in middle-aged and older people in China.DesignThe present study was a cross-sectional study within the framework of an ongoing prospective population-based cohort study.Setting and participantsA total of 1829 residents (men ≥50 years and women ≥45 years) from two subdistricts were recruited from July 2015 to February 2016 in Shanghai, China.MeasuresRecruited residents were grouped (control, osteopenia and osteoporosis) according to their lumbar spine bone mineral density, measured through dual-energy X-ray absorptiometry. Serum Vit B6concentrations, bone turnover marker concentrations and calcium and phosphorus metabolism parameters were assessed.ResultsNo significant linear trend between serum Vit B6concentrations and lumbar bone mass was observed in the men. In the women, the average osteoporosis risk was 61% higher at serum Vit B6concentrations of <19.2 μg/L than at those of >26.9 μg/L (OR 1.61, 95% CI 1.00 to 2.58). However, there was no significance after controlling of serum 25-hydroxy-vitamin D concentration and parathyroid hormone concentration, respectively. In the osteoporotic women, the serum Vit B6concentration was significantly negatively correlated to concentrations of bone turnover marker including N-terminal propeptide of type I collagen, β-C-terminal telopeptide of type I collagen and osteocalcin. It was also positively related to the serum 25-hydroxy-vitamin D concentration and inversely related to the serum parathyroid hormone concentration.ConclusionsA relatively low serum Vit B6concentration, even in the normal range, may be a risk factor for osteoporosis in postmenopausal women, which is dependent on serum 25-hydroxy-vitamin D concentration and parathyroid hormone concentration.Trial registration numberNCT02958020; Post-results.

scholarly journals Complex assessment of bone mineral density, fracture risk, vitamin D status, and bone metabolism in Hungarian systemic sclerosis patients

2019 ◽  
Vol 21 (1) ◽  
Author(s):  
Ágnes Horváth ◽  
Edit Végh ◽  
Anita Pusztai ◽  
Zsófia Pethő ◽  
Attila Hamar ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Systemic Sclerosis ◽  
Femoral Neck ◽  
Bone Mineral ◽  
Digital Ulcers ◽  
Type I ◽  
Mineral Density ◽  
Amino Terminal ◽  
Cortical Density

Abstract Objective We wished to determine bone alterations in systemic sclerosis (SSc) patients by conventional densitometry (DXA), peripheral quantitative computed tomography (pQCT), and bone biomarkers. Methods We included 44 SSc patients and 33 age-matched healthy controls. Lumbar spine and femoral neck bone mineral density (BMD) was assessed by DXA. Volumetric BMD was measured by pQCT at the radius. FRAX, 25-hydroxyvitamin-D3 (25-OH-D3), parathyroid hormone, osteocalcin, C-terminal collagen telopeptide, and procollagen type I amino-terminal propeptide were also assessed. Results SSc patients had lower L2–4 BMD (0.880 ± 0.108 vs. 0.996 ± 0.181 g/cm2; p = 0.019) and femoral neck (FN) BMD (0.786 ± 0.134 vs. 0.910 ± 0.090 g/cm2; p = 0.007) by DXA. In SSc vs. controls, pQCT indicated lower mean cortical (328.03 ± 103.32 vs. 487.06 ± 42.45 mg/cm3; p < 0.001) and trabecular density (150.93 ± 61.91 vs. 184.76 ± 33.03 mg/cm3; p = 0.037). Vitamin D3 deficiency was more common in SSc vs. controls (60.0% vs. 39.3%; p = 0.003). L2–4 (p = 0.002) and FN BMD (p = 0.015) positively correlated with BMI. pQCT assessments confirmed an inverse correlation between pulmonary manifestation and total (p = 0.024), trabecular (p = 0.035), and cortical density (p = 0.015). Anti-Scl70 positivity inversely correlated with pQCT total density (p = 0.015) and the presence of digital ulcers with cortical density (p = 0.001). We also found that vertebral and FN BMD as determined by DXA significantly correlated with pQCT total, trabecular, and cortical density (p < 0.05). Conclusion The results of our study suggest that bone loss in SSc patients may be associated with lower BMI, anti-Scl70 positivity, and the presence of pulmonary manifestations and digital ulcers. Both DXA and pQCT are appropriate tools to evaluate the bone alterations in SSc patients.

scholarly journals Oxidative Stress and Bone Resorption Interplay as a Possible Trigger for Postmenopausal Osteoporosis

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Carlo Cervellati ◽  
Gloria Bonaccorsi ◽  
Eleonora Cremonini ◽  
Arianna Romani ◽  
Enrica Fila ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Lumbar Spine ◽  
Bone Resorption ◽  
Postmenopausal Osteoporosis ◽  
Type I Collagen ◽  
Serum Levels ◽  
Type I ◽  
Bone Homeostasis ◽  
Mineral Density ◽  
Bone Specific Alkaline Phosphatase

The underlying mechanism in postmenopausal osteoporosis (PO) is an imbalance between bone resorption and formation. This study was conducted to investigate whether oxidative stress (OxS) might have a role in this derangement of bone homeostasis. In a sample of 167 postmenopausal women, we found that increased serum levels of a lipid peroxidation marker, hydroperoxides, were negatively and independently associated with decreasedbone mineral density(BMD) in total body (r=-0.192,P<0.05), lumbar spine (r=-0.282,P<0.01), and total hip (r=-0.282,P<0.05), as well as with increased bone resorption rate (r=0.233,P<0.05), as assessed by the serum concentration of C-terminal telopeptide of type I collagen (CTX-1). On the contrary, the OxS marker failed to be correlated with the serum levels of bone-specific alkaline phosphatase (BAP), that is, elective marker of bone formation. Importantly, multiple regression analysis revealed that hydroperoxides is a determinant factor for the statistical association between lumbar spine BMD and CTX-1 levels. Taken together, our data suggest that OxS might mediate, by enhancing bone resorption, the uncoupling of bone turnover that underlies PO development.

BONE MASS RECOVERY OF OSTEOPENIC VITAMIN D INSUFFICIENT RATS FROM STRONTIUM RANELATE TREATMENT: DOES THE RESPONSE DEPEND ON VITAMIN D NUTRITIONAL STATUS OR ON SOURCE OF VITAMIN D (D2 VERSUS D3)?

2010 ◽  
Vol 13 (03) ◽  
pp. 95-108
Author(s):  
Macarena M. S. Gonzales Chaves ◽  
Clarisa Marote ◽  
Gretel G. Pellegrini ◽  
Andrés Pighin ◽  
Maria C. de Landeta ◽  
...  
Keyword(s):  
Vitamin D ◽  
Bone Mass ◽  
Bone Mineral ◽  
Strontium Ranelate ◽  
Type I Collagen ◽  
Body Weight Gain ◽  
Type I ◽  
Mineral Density ◽  
Study Results ◽  
Mass Recovery

It was investigated if Vitamin D (Vit D) status or source (Vitamin D2 vs. Vitamin D3) interferes with bone mass recovery from strontium ranelate (SrRa) treatment of rats with Vit D insufficiency and established osteopenia. Osteopenic and Vit D insufficient rats were divided in groups to complete a 105-day period. First experiment: The rats were fed with diets that only varied in Vit D (100 vs. 0 IU%) and/or SrRa (0 vs. 900 mg/kg/day) content. A SHAM group received Vit D throughout the experience. Second experiment: Rats were divided into groups and received Vit D2 or Vit D3 through diet and SrRa by gavages in a fasting state. Two SHAM groups received Vit D2 or Vit D3 throughout the study. Results: Levels of 25-hydroxyvitamin 25OHD were reduced in groups lacking dietary Vit D (p < 0.001). Independently of Vit D status or source, SrRa did not affect body weight gain or bone alkaline phosphatase levels; osteocalcin and C-terminal telopeptide of type I collagen levels were reduced (p < 0.05) and bone Sr content was increased (p < 0.0001). Although no improvement in biomechanical parameters was observed, total skeletal bone mineral content and proximal tibial bone mineral density were increased (p < 0.05). There was a reduction in the trabecular number and an increase in the trabecular surface and bone volume without reaching SHAM levels. Conclusion: This is the first study that examined SrRa effects in an osteopenic vitamin D–insufficient experimental model. Under our experimental conditions, SrRa increased bone Sr content independently of Vit D status or source; however, no evidence of an anabolic or antifracture effect was found, and only a slight decrease in some bone resorption parameters was observed.

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