scholarly journals KORELASI KADAR CRP, TNF-α DAN BONE MINERAL DENSITY DENGAN CARBOXYTERMINAL CROSSLINKED TELOPEPTIDE TYPE I OF COLLAGEN DI PENDERITA ARTRITIS REUMATOID

Author(s):  
Kusworini Handono ◽  
BP Putra Suryana ◽  
Sulistyorini Sulistyorini

Rheumatoid Arthritis (RA) is a systemic autoimmune disease accompanied by decreasing bone mass density and ultimately leads toosteoporosis. The cause of decreased bone mass density is still unknown, but the inflammation has been suspected as an important factor.The correlation between the severity of inflammation with the decrease in bone mass density in Indonesian RA patients has not been muchstudied. The purpose of this study was to know the assessment in the correlation between levels of C-reactive protein (CRP), Tumour NecrosisFactor-α (TNFα) and bone mineral density (BMD) with bone resorption marker CTx-1 β-Cross Laps in premenopausal RA patients.Thisobservational study using cross sectional design, was carried out in the Rheumatology Clinic and Central Laboratory of RSSA, Malang fromAugust 2009 until October 2010. All 47 RA patients were diagnosed according to revised of the 1997 American College of Rheumatology(ACR). Measurement of CRP levels uses turbidimetry method, TNF-α and CTX-1 β-Cross Laps levels using ELISA methods and the measurementof BMD using DEXA. The results of this study showed mean levels of CRP were 4.288±1.775 g/L, TNF-α were 322.077±275.248 pg/mLand CTX-1 β-Cross Laps were 0.588±0.139 ng mL. The correlation of CRP and TNF-α levels with CTX-1 β-Cross Laps level were r=0.5832,p=0.453 and r=0.615, p=0.041. Correlation of CTX-1 β-Cross Laps level and Femoral Neck BMD was r=–0.469, p=0.143 and r=0.248,p=0.799 for L average BMD. There was no correlation between CRP level and BMD results with bone resorption marker CTX-1 β-Cross Laps,but there is a significant correlation between high levels of TNFα with CTX-1 β-Cross Laps. It seems that TNF-α appears to be contributed tothe decrease of bone mass density in RA patients.

2017 ◽  
Vol 3 (4) ◽  
pp. 200
Author(s):  
Nadia Ayu Mulansari ◽  
Nanang Sukmana ◽  
Bambang Setyohadi ◽  
Siti Setiati

Pendahuluan. Tingginya angka kejadian HIV/AIDS pada usia muda yang mencapai 50% dari total kasus HIV/AIDS di Indonesia menjadi permasalahan yang serius, khususnya terkait kualitas hidup pasien. Selain infeksi oportunistik, keadaan osteopenia dan juga osteoporosis sering ditemukan pada pasien dengan HIV/AIDS. Namun demikian, penelitian mengenai gambaran massa tulang pada pasien HIV/AIDS di Indonesia sampai saat ini belum didapatkan.Metode. Studi potong lintang dilakukan pada pasien dewasa dengan infeksi HIV naif antiretroviral di Rumah Sakit dr. Cipto Mangunkusumo (RSCM) Jakarta pada Februari-Mei 2008. Pemeriksaan bone mineral density (BMD) dilakukan dengan menggunakan DXA scanning. Hasil. Berdasarkan pemeriksaan BMD didapatkan sebanyak 29,3% subjek ostopenia, 1,3% osteoporosis dan sisanya normal. Osteopenia/osteoporosis didapatkan lebih besar pada subjek yang mengonsumsi alkohol, merokok, hitung limfosit CD4+ <200 sel/mm3 dan IMT<18,5 dengan proporsi masing-masing secara berturut-turut yaitu 53,6%; 36,9%; 35,5%; dan 37,6%. Lama infeksi HIV pada penelitian ini tidak menunjukkan hasil yang berbeda.Simpulan. Didapatkan keadaan osteopenia dan osteoporosis pada pasien dengan HIV/AIDS. Pada pasien HIV/AIDS dengan riwayat merokok, konsumsi alkohol, hitung limfosit CD4+ <200 sel/mm3 dam IMT rendah, didapatkan angka osteopenia/osteoporosis yang lebih tinggi.Kata kunci: HIV, naif antiretroviral, osteopenia/osteoporosis Bone Mass Density in HIV/AIDS PatientsIntroduction. Indonesia has a high incidence of young HIV-positive population which is 20-29 years of age is in the highest group (50%). For this reason, it is important to make a better quality of life for them. Unfortunately, beside all the opportunistic infection, it was proved that osteopenia/osteoporosis has become a new emerging metabolic condition for HIV-infected patients. There is still no study about the description of bone mass density in HIV/AIDS patients in Indonesia. Methods. A cross sectional study was conducted in a total of 75 HIV-seropositive antiretroviral-naïve patients. Bone mineral density (BMD) was determined by dual energy X-ray absorptiometry in lumbar spine. Results. Seventy-five subjects had been recruited. Low BMD was found in 29.3% HIV-seropositive patients with osteopenia and 1,3% with osteoporosis. There was a higher number of osteopenia/osteoporosis in subjects who consume alcohol, smoking, lymphocyte CD4 <200 cells/mm3 and low body mass index (BMI). Duration of infection did not show any differences in both HIV with osteopenia/osteoporosis and subjects with normal bone condition. Conclusions. Osteopenia and osteoporosis were found in patients with HIV/AIDS in RSCM with lower bone density in subjects who consumed alcohol, smoke, lymphocyte CD4 <200 cells/mm3 and low BMI. Keywords: HIV, antiretroviral naïve, osteopenia/osteoporosis 


2017 ◽  
Vol 3 (1) ◽  
pp. 43
Author(s):  
Sri Lestari ◽  
Rini Widyaningrum

The relationship of anterior mandible trabecular area with bone mass density of lumbar spine for early detection of osteoporosis. Bone mineral density is an indicator of osteoporosis, including the bone mineral density of lumbar spine. The decrease of lumbar spine bone mass density will cause an alteration in another site, including the mandibular. The aim of this research is to determine the predictor of lumbar spine bone mineral density using trabecular bone image of anterior mandible on periapical radiographs. The research was conducted by extracting the area fraction at mandible trabecular bone using digital periapical radiograph from 25 subjects. Canny edge detection was used in digital image processing for each radiograph. The regions of interest were selected from the image obtained by canny edge detection, so that the area fraction could be measured. A linier regression test was applied to determine a relationship between the area fractions of mandible trabecular bone with the bone mineral density of lumbar spine. The result of linear regression test showed that the area fraction of mandible trabecular bone had a moderate negative correlation with bone mass density of lumbar spine (α = 0.046; R = -0.403). The direction of the correlation was negative (b = -0.145). The area fraction of mandible trabecular bone on periapical radiographs could be used as the predictor for bone mass density of lumbar spine.ABSTRAKKepadatan tulang merupakan indikator osteoporosis, salah satu diantaranya adalah kepadatan tulang pada lumbar spine. Penurunan kepadatan tulang pada lumbar spine mempengaruhi kondisi tulang lain, termasuk tulang rahang bawah (mandibula). Tujuan penelitian ini adalah untuk menentukan prediktor densitas mineral tulang menggunakan citra radiograf periapikal tulang trabekula pada regio anterior rahang bawah. Penelitian dilakukan dengan ekstraksi fraksi area tulang trabekula mandibula yang tercitrakan pada radiograf periapikal digital dari 25 subjek. Pengolahan citra digital pada radiograf periapikal dilakukan dengan menggunakan metode deteksi tepi canny terhadap masing-masing citra radiograf. Region of Interest diseleksi dari citra hasil deteksi canny, sehingga dapat dilakukan pengukuran fraksi area. Uji regresi linier dilakukan untuk mengetahui hubungan antara nilai fraksi area trabekula mandibula dengan tingkat kepadatan tulang pada lumbar spine. Hasil uji regresi linier menunjukkan bahwa nilai fraksi area trabekula mandibula berkorelasi negatif dengan kepadatan tulang dengan kekuatan sedang (α = 0,046; R = -0,403). Adapun arah korelasi antara nilai fraksi area trabekula mandibula dengan kepadatan tulang adalah negatif (b = -0,145). Fraksi area tulang trabekula pada citra radiograf periapikal dapat digunakan sebagai prediktor kepadatan tulang pada lumbar spine.


2012 ◽  
Vol 2012 ◽  
pp. 1-4 ◽  
Author(s):  
Ibrahim Aslan ◽  
Duran Canatan ◽  
Nihal Balta ◽  
Gulizar Kacar ◽  
Cengaver Dorak ◽  
...  

Aim. We assessed the bone mineral density and related parameters in nine adults, thirty-eight pubertal, prepubertal totally forty-seven patients with thalassemia major living in Antalya, Turkey.Materials and Methods. We measured height and pubertal staging in last five years by six-month intervals. Average ferritin and hemoglobin concentrations were calculated for last three years. The levels of hydroxyproline, calcium, phosphorus, and creatinine were measured in 24 h urine, and those of parathormone, IGF 1, osteocalcine, alkaline phosphatase, calcium, ionized calcium, magnesium, phosphorus, creatine, blood glucose, thyroid stimulating hormone, alanine transaminase, and aspartate transaminase were determined in serum, and also the bone mineral density was measured.Results. The average L1–L4 bone mass density was27.1±10.1 g cm−2; the average bone mineral content was0.65 ± 0.11 g. of the patients with a Z-score under 2.5. A moderate relationship was found between the bone mass density age and height. Subjects in low pubertal staging and short stature (<3% percentile) have significantly lower bone mass densitiesP<0.001.Conclusion. he prevalence of osteoporosis is high in patients with thalassemia major, possibly related to delayed puberty.


2018 ◽  
Vol 18 (2) ◽  
pp. 206-210 ◽  
Author(s):  
Mehmet Dagli ◽  
Ali Kutlucan ◽  
Sedat Abusoglu ◽  
Abdulkadir Basturk ◽  
Mehmet Sozen ◽  
...  

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.


Cartilage ◽  
2017 ◽  
Vol 9 (3) ◽  
pp. 255-262 ◽  
Author(s):  
Jadwiga Ambroszkiewicz ◽  
Joanna Gajewska ◽  
Grazyna Rowicka ◽  
Witold Klemarczyk ◽  
Magdalena Chelchowska

Objective There is scant research examining the prevalence of thinness in early childhood, despite its potential negative consequences for health and development across the life course. The objective of this study was to assess bone status through measurement of bone mineral density and biochemical bone turnover markers, with special attention paid to carboxylated (c-OC) as well as undercarboxylated (uc-OC) forms of osteocalcin, in the groups of thin and normal-weight children. Design The study included 80 healthy prepubertal children (median age 7.0 years), who were divided (according to Cole’s international cutoffs) into 2 subgroups: thin children ( n = 40, body mass index [BMI] = 13.5 kg/m2) and normal-weight children ( n = 40, BMI = 16.1 kg/m2). Bone mineral density (BMD) and bone mineral content (BMC) were assessed by dual-energy x-ray absorptiometry method. Serum concentrations of C-terminal telopeptide of collagen type I (CTX), total osteocalcin (OC), and c-OC, and uc-OC forms of osteocalcin were determined using enzyme-linked immunosorbent assays. Results In thin children, we observed higher levels of bone resorption marker CTX compared with normal-weight peers. Total osteocalcin concentrations were comparable in both groups of children; however, in thin children we observed higher median values of uc-OC (34.40 vs. 29.30 ng/mL, P < 0.05) and similar c-OC levels (25.65 vs. 28.80 ng/mL). The ratio of c-OC to uc-OC was significantly lower ( P < 0.05) in thin than in normal-weight children. Total BMD and BMC were significantly decreased ( P < 0.0001) in thin children compared with normal-weight peers (0.724 ± 0.092 vs. 0.815 ± 0.060 g/cm2 and 602.7 ± 159.2 vs. 818.2 ± 220.1 g, respectively). Conclusion Increased concentrations of CTX and uc-OC might lead to disturbances in bone turnover and a decrease in bone mineral density in thin children.


2001 ◽  
Vol 91 (4) ◽  
pp. 1663-1668 ◽  
Author(s):  
K. J. Hart ◽  
J. M. Shaw ◽  
E. Vajda ◽  
M. Hegsted ◽  
S. C. Miller

Weight-bearing exercise is traditionally recommended for improving bone health in postmenopausal women. Effects of swim exercise were studied as an alternative to weight-bearing exercise in ovariectomized rats. Rats in a swim group (Sw, n = 8) swam for 12 wk, 5 days/wk for 60 min per session. A control group (Con, n = 9) engaged in no structured exercise. Femurs were analyzed for bone mineral density and for bone mineral content by dual energy X-ray absorptiometry, biomechanical properties by three-point bending (Instron), and bone structure and formation by histomorphometry. Food intake did not differ among groups. Final body weights were significantly lower in Sw compared with Con ( P< 0.05). Swimmers had significantly greater femoral shaft bone mineral density and content ( P < 0.05) compared with Con. Femurs of the Sw group had greater mechanical properties ( P< 0.05) compared with Con. Histomorphometric data were significantly better in the Sw group compared with Con after the 12-wk intervention ( P < 0.05). In conclusion, data from this study demonstrate some beneficial effects of swim exercise on bone structure, turnover, and strength.


Neurology ◽  
2001 ◽  
Vol 57 (3) ◽  
pp. 445-449 ◽  
Author(s):  
Y. Sato ◽  
I. Kondo ◽  
S. Ishida ◽  
H. Motooka ◽  
K. Takayama ◽  
...  

Background: Bone loss and hypovitaminosis D are reported in patients taking antiepileptic drugs, but little is known about changes in bone and calcium metabolism from valproic acid (VPA).Objective: To assess the relationship of VPA to bone mass and calcium metabolism in 40 adults with epilepsy on long-term VPA monotherapy, 40 age- and sex-matched epileptic patients taking phenytoin (PHT), and 40 healthy control subjects. Bone mineral density (BMD) of the second metacarpal was determined as T- and Z-scores.Results: BMD reduction from control values was 14% (12% in men, 16% in women) with VPA and 13% (12% in men, 15% in women) with PHT. Among patients on VPA, nine (23%) had T-scores below −2.5 SD, suggesting osteoporosis; 15 (37%) had T-scores between −1 and −2.5 SD, suggesting osteopenia. Serum concentrations of calcium were significantly higher with VPA than in PHT or control groups. Serum concentrations of bone Gla protein (a bone formation marker) and pyridinoline cross-linked carboxy-terminal telopeptide of type I collagen (ICTP; a bone resorption marker) associated with either drug significantly exceeded control values. Z-scores for BMD in the VPA group correlated negatively with calcium and ICTP. High ICTP correlated positively with ionized calcium, implying that increased bone resorption caused the latter.Conclusion: Long-term VPA monotherapy can increase bone resorption, leading to decreased BMD.


Author(s):  
Rini Widyaningrum ◽  
Sri Lestari ◽  
Ferry Jie

<span>Osteoporosis is a systemic skeletal disease. Parameter from any bone site in the body has possibility to be developed as a predictor of osteoporosis. The alteration in the mandible trabecular bone is visible in periapical radiographs. The aim of this study was to correlate the area parameter and the integrated density of periapical radiograph with bone mineral density. Image analysis of periapical radiograph i.e. measurement of area parameter and integrated density was done on Region of Interest (ROI) by using canny edge detection method. Result of this study showed that the area parameter has asignificant (α&lt;0.05) negative correlation with the bone mass density (BMD) of the lumbar spine (r = -0.371) and T-score of the lumbar spine (r = -0.383). The linear regression test showed that the area parameter only can be used to predict T-score of the lumbar spine (F=5.822, α&lt;0.05). The integrated density showed a significant (α &lt; 0.05) negative correlation with T-score of hip (r = -0.332) and T-score of lumbar spine (r = -0.377). It can be concluded that the area parameter can be used as one of input parameters for computer-aided system of osteoporosis early detection by using periapical radiograph.</span>


2005 ◽  
Vol 12 (4) ◽  
pp. 973-981 ◽  
Author(s):  
J L Reverter ◽  
S Holgado ◽  
N Alonso ◽  
I Salinas ◽  
M L Granada ◽  
...  

The effect of subclinical hyperthyroidism on bone mineral density is controversial and could be significant in patients with differentiated thyroid carcinoma who receive suppressive doses of levothyroxine (LT4). To ascertain whether prolonged treatment with LT4 to suppress thyrotropin had a deleterious effect on bone mineral density and/or calcium metabolism in patients thyroidectomized for differentiated thyroid cancer we have performed a cross-sectional study in a group of 88 women (mean ± SD age: 51 ± 12 years) treated with LT4 after near-total thyroidectomy and in a control group of 88 healthy women (51 ± 11 years) matched for body mass index and menopausal status. We determined calcium metabolism parameters, bone turnover marker N-telopeptide and bone mass density by dual-energy X-ray absorptiometry. No differences were found between patients and controls in calcium metabolism parameters or N-telopeptide except for PTH, which was significantly increased in controls. No differences were found between groups in bone mineral density in femoral neck (0.971 ± 0.148 gr/cm2 vs 0.956 ± 0.130 gr/cm2 in patients and controls respectively, P = 0.5). In lumbar spine, bone mineral density values were lower in controls than in patients (1.058 ± 0.329 gr/cm2 vs 1.155 ± 0.224 gr/cm2 respectively, P<0.05). When premenopausal (n = 44) and postmenopausal (n = 44) patients were compared with their respective controls, bone mineral density was similar both in femoral neck and lumbar spine. The proportion of women with normal bone mass density, osteopenia and osteoporosis in patient and control groups was similar in pre- and postmenopausal women. In conclusion, long-term suppressive LT4 treatment does not appear to affect skeletal integrity in women with differentiated thyroid carcinoma.


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