Monitoring alendronate therapy for osteoporosis.

Alendronate is an antiresorptive therapy for osteoporosis and results in a decrease in bone turnover. To choose the optimal measurement for monitoring this therapy, the size of the change needs to be compared with the variability of the measurement. We studied 26 women with postmenopausal osteoporosis (bone mineral density [BMD] T score < -2.

Serum galactosyl hydroxylysine as a biochemical marker of bone resorption.

Background: Serum-based biochemical markers of bone resorption may provide better clinical information than urinary markers because direct comparison with serum markers of bone formation is possible and because the within-subject variability of serum markers may be lower. We describe a method for the measurement of free beta-1-galactosyl-O-hydroxylysine (Gal-Hyl) in serum.

Methods: The assay used preliminary ultrafiltration of serum, dansylation, and separation by reversed-phase HPLC with fluorescence detection.

Bone turnover in preterm infants.

Total parenteral nutrition is associated with osteopenia in preterm infants. Insufficient calcium and phosphate are likely causes: aluminum contamination is another possible contributing factor as this adversely affects bone formation and mineralization. The study was designed to evaluate changes in biochemical markers of bone turnover in 22 preterm infants receiving total parenteral nutrition in comparison with 19 term infants.

Bone mass and muscle strength in female college athletes (runners and swimmers).

Objective: To determine whether female college athletes had increased muscle strength and bone mass in comparison with age-matched nonathletic female subjects and, if so, whether participation in weight-bearing versus non-weight-bearing exercise made a difference.

Material And Methods: We performed a comparative statistical analysis of the bone mineral density (BMD) of the total body, lumbar spine, and femoral neck, maximal oxygen uptake (VO2max), muscle strength, and level of physical activity in 21 runners, 22 swimmers, and 20 control subjects. The study participants were female college students, 18 to 24 years old, who had had more than 8 normal menstrual cycles during the past year.

A UK Consensus Group on management of glucocorticoid-induced osteoporosis: an update.

In the UK, over 250 000 patients take continuous oral glucocorticoids (GCs), yet no more than 14% receive any therapy to prevent bone loss, a major complication of GC treatment. Bone loss is rapid, particularly in the first year, and fracture risk may double. This review, based wherever possible on clinical evidence, aims to provide easy-to-use guidance with wide applicability.

A longitudinal study of bone gain in pubertal girls: anthropometric and biochemical correlates.

The aim of this longitudinal study was to investigate the factors associated with bone mineral acquisition in pubertal girls. Subjects were 37 healthy, Caucasian girls aged 12.1 years (SD 0.

Effects of estrogen therapy of postmenopausal women on cytokines measured in peripheral blood.

Estrogen replacement therapy (ERT) is known to prevent bone loss following the menopause, but the mechanism for this is unclear. Estrogen may suppress the secretion of certain bone-resorbing cytokines. The aim of this study was to assess the effect of ERT on the levels of cytokines measured in peripheral blood.

Response of biochemical markers of bone turnover to hormone replacement therapy: impact of biological variability.

Biochemical markers of bone turnover may be useful to monitor patients taking hormone replacement therapy (HRT). The aim of this study was to assess the utility of markers in monitoring HRT by comparing the response of a large panel of markers to HRT with their within subject variability. We measured the response of markers to transdermal estradiol in 11 postmenopausal women over 24 weeks.

Bone loss around 2 different types of hip prostheses.

Dual energy x-ray absorptiometry (DXA) allows the measurement of bone mineral density (BMD) around an uncemented hip prosthesis. The aims of this study were: 1) to determine the reproducibility of periprosthetic BMD measurements; 2) to delineate the time course of bone loss that occurs after insertion of a hip prosthesis; and 3) to compare the bone loss around two different types of hip prosthesis. We studied 20 patients: 11 had Bateman and 9 had porous-coated anatomic prostheses inserted.

Management of male osteoporosis: report of the UK Consensus Group.

Although osteoporosis is generally regarded as a disease of women, up to 30% of hip fractures and 20% of vertebral fractures occur in men. Risk factors for osteoporotic fractures in men include low body mass index, smoking, high alcohol consumption, corticosteroid therapy, physical inactivity, diseases that predispose to low bone mass, and conditions increasing the risk of falls. The key drugs and diseases that definitely produce a decrease in bone mineral density (BMD) and/or an increase in fracture rate in men are long-term corticosteroid use, hypogonadism, alcoholism and transplantation.

Mechanisms of bone loss after cardiac transplantation.

To determine the mechanism of bone loss after cardiac transplantation (CTX), we studied 50 men 0.5-47 months after CTX (ages 18-64 years) who received prednisolone and cyclosporin to prevent rejection, and 40 healthy men as controls (ages 20-70 years). We measured bone mineral density (BMD) using dual-energy X-ray absorptiometry (DXA), bone resorption using urinary cross-linked N-terminal telopepides of type I collagen (NTx), and bone formation using osteocalcin (BGP) and bone alkaline phosphatase (BAP).

Relationships between biochemical and symptomatic response in a double-blind randomised trial of pamidronate for metastatic bone disease.

Purpose: The aim of this study was to evaluate pamidronate for bone pain in a randomised double-blind trial and to evaluate the contribution of new markers of bone resorption in patients with bone metastases.

Patients And Methods: Fifty-two patients with painful bone metastases were randomised to receive a two-hour infusion of pamidronate 120 mg or an identical infusion of saline. Four weeks later, all patients received pamidronate 120 mg.

Phosphate supplementation in young men: lack of effect on calcium homeostasis and bone turnover.

Objective: To examine the effect of phosphate supplements on calcium homeostasis and bone turnover in young men.

Design: Study 1 was a randomised, controlled, cross-over trial of 1000 mg elemental phosphate given for one week, with a standard diet of 800 mg/d each of calcium and phosphorus. Study 2 was an escalating dose study of 0, 1000, 1500 and 2000 mg/d elemental phosphate, each given for one week, with a standard diet of 1000 mg/d each of calcium and phosphate.

Milk intake and bone mineral acquisition in adolescent girls: randomised, controlled intervention trial.

Objectives: To investigate the effect of milk supplementation on total body bone mineral acquisition in adolescent girls.

Design: 18 month, open randomised intervention trial.

Subjects: 82 white girls aged 12.

The value of biochemical markers of bone turnover in osteoporosis.

A number of biochemical markers of bone turnover have been described and these reflect the activity of osteoblasts (bone formation) or osteoclasts (bone resorption). These markers have the following advantages for the measurement of bone turnover: (1) they are noninvasive; (2) inexpensive; (3) can be repeated on many occasions; (4) and reflect bone cell activity in the entire skeleton. They have disadvantages: (1) they do not provide information about the work of individual cells; (2) they do not reflect the process of mineralization; and (3) their levels may be affected by the rate of clearance.

The effect of dietary sodium on calcium metabolism in premenopausal and postmenopausal women.

Objective: To investigate the effects of high and low sodium diets on urinary calcium, bone turnover and calcium absorption in pre and postmenopausal women.

Design: Experimental, prospective and longitudinal study.

Setting: Samples were taken at the hospital and the diets were followed at home.

Longitudinal changes of bone mineral density and bone turnover in postmenopausal women on thyroxine.

Objective: The skeletal risks of subclinical hyperthyroidism in postmenopausal women on replacement thyroxine remain controversial. The aims of this study were to determine (1) the relationship between bone turnover and TSH levels and (2) whether reduction of thyroxine (T4) dose in postmenopausal women who have suppressed TSH levels is beneficial to bone mineral density (BMD) and bone turnover.

Design: A prospective study over 2 years of post-menopausal women treated with T4 with an age- and sex-matched healthy control group.

Glucocorticoid replacement therapy: are patients over treated and does it matter?

Background And Objectives: Adequate assessment of patients on glucocorticoid replacement therapy is of great importance to avoid the consequences of under or over treatment, but no simple test is available for this. The aims of this study were (1) to assess adequacy of glucocorticoid replacement in hypoadrenal patients, (2) to correlate serum cortisol levels (cortisol day curve) with 24-hour urine free cortisol excretion and (3) to assess the impact of glucocorticoid dose optimization on markers of bone formation and bone resorption.

Design: Cross-sectional study of current replacement therapy and a prospective study of the effect of dose alteration on bone turnover markers.

Treatment of isolated hypogonadotropic hypogonadism effect on bone mineral density and bone turnover.

Isolated hypogonadotropic hypogonadism (IHH) presents with delayed puberty in the late teens or early twenties, with a period of testosterone deficiency during active growth. The aims of the study were to determine 1) whether long term treatment of IHH results in normalization of bone density (BMD) and bone turnover, and 2) whether BMD and bone turnover respond to increasing doses of hCG. We studied 10 men, aged 26-46 yr, with IHH who were treated with hCG or testosterone esters (Sustanon) for 2-22 yr, with age at the start of treatment between 17-29 yr, and 10 age- and body weight-matched normal men as a control group.

Biochemical markers of bone resorption compared with estimates of bone resorption from radiotracer kinetic studies in osteoporosis.

The pyridinium cross-links of collagen pyridinoline (Pyd) and deoxypyridinoline (Dpd) are released during bone resorption and are neither metabolized nor absorbed from the diet. The aim of this study was to validate their use in osteoporosis. We studied 19 women with osteoporosis and estimated the bone resorption rate from a combined calcium balance/kinetics technique without (R) and with partial (R(H)) and "complete" (Res) correction for long-term exchange.