scholarly journals Obesity and Bone Loss at Menopause: The Role of Sclerostin

Diagnostics ◽  
2021 ◽  
Vol 11 (10) ◽  
pp. 1914
Author(s):  
Paolo Marzullo ◽  
Chiara Mele ◽  
Stefania Mai ◽  
Antonio Nardone ◽  
Massimo Scacchi ◽  
...  
Keyword(s):  
Body Composition ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Health ◽  
Bone Turnover Markers ◽  
Turnover Markers ◽  
Total Body

Background. Peripheral fat tissue is known to positively influence bone health. However, evidence exists that the risk of non-vertebral fractures can be increased in postmenopausal women with obesity as compared to healthy controls. The role of sclerostin, the SOST gene protein product, and body composition in this condition is unknown. Methods. We studied 28 severely obese premenopausal (age, 44.7 ± 3.9 years; BMI, 46.0 ± 4.2 kg/m2) and 28 BMI-matched post-menopausal women (age, 55.5 ± 3.8 years; BMI, 46.1 ± 4.8 kg/m2) thorough analysis of bone density (BMD) and body composition by dual X-ray absorptiometry (DXA), bone turnover markers, sclerostin serum concentration, glucose metabolism, and a panel of hormones relating to bone health. Results. Postmenopausal women harbored increased levels of the bone turnover markers CTX and NTX, while sclerostin levels were non-significantly higher as compared to premenopausal women. There were no differences in somatotroph, thyroid and adrenal hormone across menopause. Values of lumbar spine BMD were comparable between groups. By contrast, menopause was associated with lower BMD values at the hip (p < 0.001), femoral neck (p < 0.0001), and total skeleton (p < 0.005). In multivariate regression analysis, sclerostin was the strongest predictor of lumbar spine BMD (p < 0.01), while menopausal status significantly predicted BMD at total hip (p < 0.01), femoral neck (p < 0.001) and total body (p < 0.05). Finally, lean body mass emerged as the strongest predictor of total body BMD (p < 0.01). Conclusions. Our findings suggest a protective effect of obesity on lumbar spine and total body BMD at menopause possibly through mechanisms relating to lean body mass. Given the mild difference in sclerostin levels between pre- and postmenopausal women, its potential actions in obesity require further investigation.

scholarly journals Bone Mineral Density and Turnover After Sleeve Gastrectomy and Gastric Bypass: A Randomized Controlled Trial (Oseberg)

2020 ◽  
Author(s):  
Dag Hofsø ◽  
Thor Olav Widerøe Hillestad ◽  
Erling Halvorsen ◽  
Farhat Fatima ◽  
Line Kristin Johnson ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Gastric Bypass ◽  
Sleeve Gastrectomy ◽  
Lumbar Spine ◽  
Femoral Neck ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Mineral Density ◽  
Turnover Markers

Abstract Context Bariatric surgery, particularly Roux-en-Y gastric bypass (RYGB), is associated with an increased risk of osteoporotic fractures. It is unknown whether RYGB or sleeve gastrectomy (SG) have different effects on bone health. Objective To compare changes in bone mineral density and markers of bone turnover 1 year after SG and RYGB. Design, Setting, Patients, and Interventions Randomized, triple-blind, single-center trial at a tertiary care center in Norway. The primary outcome was diabetes remission. Patients with severe obesity and type 2 diabetes were randomized and allocated (1:1) to SG or RYGB. Main Outcome Measures Changes in areal bone mineral density (aBMD) and bone turnover markers. Results Femoral neck, total hip, and lumbar spine aBMD, but not total body aBMD, decreased significantly more after RYGB (n = 44) than after SG (n = 48) (mean [95% confidence interval] between group differences -2.8% [-4.7 to -0.8], -3.0% [-5.0 to -0.9], -4.2% [-6.4 to -2.1], and -0.5% [-1.6 to 0.6], respectively). The increase in procollagen type 1 N-terminal propeptide (P1NP) and C-telopeptide of type I collagen (CTX-1) were approximately 100% higher after RYGB than after SG (between group difference at 1 year, both P &lt; 0.001). The changes in femoral neck, total hip, and lumbar spine aBMDs and the changes in P1NP and CTX-1 were independently associated with the surgical procedure (all P &lt; 0.05) and not weight change. Conclusions Roux-en-Y gastric bypass was associated with a greater reduction in aBMD and a greater increase in bone turnover markers compared with SG. This finding could suggest greater skeletal fragility after RYGB.

scholarly journals Serumβ-Catenin Levels Associated with the Ratio of RANKL/OPG in Patients with Postmenopausal Osteoporosis

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Xiao-Juan Xu ◽  
Lin Shen ◽  
Yan-Ping Yang ◽  
Rui Zhu ◽  
Bo Shuai ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Postmenopausal Women ◽  
Postmenopausal Osteoporosis ◽  
Bone Turnover Markers ◽  
Enzyme Linked Immunosorbent Assay ◽  
Functional Communication ◽  
Mineral Density ◽  
Wnt Pathways ◽  
Turnover Markers

Objective. To demonstrate the role of Wnt/β-catenin canonical pathway in postmenopausal osteoporosis by evaluating serumβ-catenin levels in patients with postmenopausal osteoporosis and analyzing their possible relationship with serum OPG, RANKL, the ratio of RANKL/OPG, sclerostin, and bone turnover markers.Methods. 480 patients with postmenopausal osteoporosis and 170 healthy postmenopausal women were enrolled in the study. Serumβ-catenin, OPG, RANKL, and sclerostin levels were measured by enzyme-linked immunosorbent assay. Bone status was assessed by measuring bone mineral density and bone turnover markers. Estradiol levels were also detected.Results. Serumβ-catenin levels were lower in postmenopausal osteoporotic women compared to nonosteoporotic postmenopausal women (26.26±14.81versus39.33±5.47 pg/mL,P<0.001). Serumβ-catenin was positively correlated with osteoprotegerin (r=0.232,P<0.001) and negatively correlated with the ratio of RANKL/OPG, body mass index, and sclerostin (r=-0.128,P=0.005;r=-0.117,P=0.010;r=-0.400,P<0.001, resp.) in patients with postmenopausal osteoporosis.Conclusion. The results indicate that lower serumβ-catenin and concomitantly higher ratio of RANKL/OPG may be involved in the pathogenesis of postmenopausal osteoporosis. Functional communication between RANKL/RANK/OPG system and Wnt pathways plays an important role in postmenopausal osteoporosis.

scholarly journals Genetic polymorphisms and their influence on therapeutic response to alendronate-a pilot study

2019 ◽  
Vol 10 (Vol.10, No.3) ◽  
pp. 243-251
Author(s):  
Alina Deniza CIUBEAN ◽  
Laszlo IRSAY ◽  
Rodica Ana UNGUR ◽  
Viorela Mihaela CIORTEA ◽  
Ileana Monica BORDA ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Lumbar Spine ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Type I Collagen ◽  
Type I ◽  
Mineral Density ◽  
Turnover Markers

Introduction: Osteoporosis has a strong genetic contribution, and several genes have been shown to influence bone mineral density. Variants in the human genome are considered important causes of differences in drug responses observed in clinical practice. In terms of bone mineral density, about 26–53% of patients do not respond to amino-bisphosphonate therapies, of which alendronate is the most widely used. Material and method: The current study is prospective, observational, analytical, longitudinal and cohort type. It included 25 postmenopausal women treated with alendronate for 1 year. Bone mineral density at lumbar spine and proximal femur was measured and bone turnover markers (C-terminal telopeptide of type I collagen and procollagen 1N-terminal propeptide) were evaluated at 0 and 12 months of treatment. Six single nucleotide polymorphisms in osteoporosis-candidate genes were genotyped (FDPS rs2297480, LRP5 rs3736228, SOST rs1234612, VKORC1 rs9934438, GGPS1 rs10925503 and RANKL rs2277439). Treatment response was evaluated by percentage changes in bone mineral density and bone turnover markers. Results: The heterozygous CT of FDPS rs2297480 showed lower increases in BMD values in the lumbar spine region and the homozygous CC of the GGPS1 rs10925503 showed lower increases in terms of BMD at the total hip region. No association was found for LRP5 rs3736228, SOST rs1234612, VKORC1 rs9934438 and RANKL rs2277439. Conclusions: Romanian postmenopausal women with osteoporosis carrying the CT genotype of FDPS rs2297480 or the CC genotype of GGPS1 rs10925503 could have an unsatisfactory response to alendronate treatment. Key words: osteoporosis; genetic polymorphism; alendronate; bone mineral density; bone turnover markers,

scholarly journals The Effects of Season-Long Vitamin D Supplementation on Collegiate Swimmers and Divers

2013 ◽  
Vol 23 (5) ◽  
pp. 431-440 ◽  
Author(s):  
Regina M. Lewis ◽  
Maja Redzic ◽  
D. Travis Thomas
Keyword(s):  
Vitamin D ◽  
Body Composition ◽  
Bone Turnover ◽  
Inflammatory Cytokines ◽  
Bone Turnover Markers ◽  
Female Athletes ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Turnover Markers ◽  
Total Body

The purpose of this 6-month randomized, placebo-controlled trial was to determine the effect of season-long (September–March) vitamin D supplementation on changes in vitamin D status, which is measured as 25(OH) D, body composition, inflammation, and frequency of illness and injury. Forty-five male and female athletes were randomized to 4,000 IU vitamin D (n = 23) or placebo (n = 22). Bone turnover markers (NTx and BSAP), 25(OH)D, and inflammatory cytokines (TNF-alpha, IL-6, and IL1-β) were measured at baseline, midpoint, and endpoint. Body composition was assessed by DXA and injury and illness data were collected. All athletes had sufficient 25(OH)D (> 32 ng/ml) at baseline (mean: 57 ng/ml). At midpoint and endpoint, 13% and 16% of the total sample had 25(OH)D < 32 ng/ml, respectively. 25(OH)D was not positively correlated with bone mineral density (BMD) in the total body, proximal dual femur, or lumbar spine. In men, total body (p = .04) and trunk (p = .04) mineral-free lean mass (MFL) were positively correlated with 25(OH)D. In women, right femoral neck BMD (p = .02) was positively correlated with 25(OH)D. 25(OH)D did not correlate with changes in bone turnover markers or inflammatory cytokines. Illness (n = 1) and injury (n = 13) were not related to 25(OH)D; however, 77% of injuries coincided with decreases in 25(OH)D. Our data suggests that 4,000 IU vitamin D supplementation is an inexpensive intervention that effectively increased 25(OH)D, which was positively correlated to bone measures in the proximal dual femur and MFL. Future studies with larger sample sizes and improved supplement compliance are needed to expand our understanding of the effects of vitamin D supplementation in athletes.

Postoperative Zoledronic Acid for Osteoporosis in Primary Hyperparathyroidism: a Randomized Placebo-controlled Study

2021 ◽  
Author(s):  
E M Ryhänen ◽  
A M Koski ◽  
Eliisa Löyttyniemi ◽  
M J Valimaki ◽  
Ulla Kiviniemi ◽  
...  
Keyword(s):  
Lumbar Spine ◽  
Zoledronic Acid ◽  
Femoral Neck ◽  
Primary Hyperparathyroidism ◽  
Bone Turnover ◽  
Bone Turnover Markers ◽  
Controlled Study ◽  
Mineral Density ◽  
Turnover Markers

Objective: In primary hyperparathyroidism (PHPT) with osteoporosis, bone mineral density (BMD) improves after parathyroidectomy. It is unclear whether combining surgery with postoperative bisphosphonate treatment can further improve bone health. Design: This randomized, placebo-controlled study compared the effects of surgery alone and surgery combined with zoledronic acid on bone metabolism in PHPT with osteoporosis. Methods: Fifty-six patients (f/m 47/9, mean age 68.4 years) with PHPT and osteoporosis were randomized 1–3 months after parathyroidectomy to receive a two-year treatment of zoledronic acid or placebo. Dual-energy X-ray absorptiometry (DXA) and bone turnover markers (N-terminal propeptide of type 1 procollagen, C-terminal telopeptide of type 1 collagen, and alkaline phosphatase) were measured annually during the 2-year follow-up. Results: Two years after parathyroidectomy, BMD was significantly higher in the zoledronic acid (ZOL) group compared with the placebo (PBO) group at the femoral neck (P = 0.045 for Z-score) and lumbar spine (P = 0.039 and 0.017 for T- and Z-scores, respectively). Bone turnover markers were significantly lower in the ZOL group (P < 0.001 for all markers). Of the 18 patients who had received bisphosphonates for >1 year before surgery, BMD improved significantly in the ZOL group both in the femoral neck and lumbar spine (N = 10; all P < 0.001–0.01) but in the PBO group only in the lumbar spine (N = 8, P = 0.03), (P= 0.08-0.95 for between-group changes). Conclusion: BMD increases after parathyroidectomy both with and without zoledronic acid but the increase is significantly higher with postoperative zoledronic acid.

scholarly journals Serum 25-OH Vitamin D in relation to Bone Mineral Density and Bone Turnover

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Nicola Napoli ◽  
Rocky Strollo ◽  
Delia Sprini ◽  
Ernesto Maddaloni ◽  
Giovam Battista Rini ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Femoral Neck ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Mineral Density ◽  
Serum 25Ohd ◽  
Turnover Markers

It is unclear which vitamin D status is optimal for bone health. In this study, we aimed to assess cutoffs of 25-hydroxyvitamin D (25OHD) derived by the literature (20, 25, or 30 ng/mL) in relation to bone turnover and bone mineral density (BMD). Serum 25OHD, PTH, osteocalcin, bone alkaline phosphatase, and C-telopeptide were measured in 274 consecutive postmenopausal women. BMD of the lumbar spine (L1–L4) and of femoral neck were also evaluated. 50 patients had normal BMD, while 124 had osteopenia and 100 had osteoporosis. 37.6%, 56.2%, and 70.8% subjects had serum 25OHD lower than 20, 25, or 30 ng/mL, respectively. No differences in bone turnover markers were found when comparing patients with low 25OHD defined according to the different cutoffs. However, a cutoff of 25 ng/mL appeared to differentiate better than a cutoff of 30 ng/mL in those subjects with reduced femoral neck BMD. The PTH plateau occurred at 25OHD levels of 26–30 ng/mL. In conclusion, vitamin D deficiency is common in Sicilian postmenopausal women and it may be associated with low BMD and increased bone turnover markers. Further studies are needed to better define the right cutoff for normal vitamin D levels in postmenopausal women.

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