Bone turnover in hyperthyroidism before and after thyrostatic management.

Hyperthyroidism is associated with enhanced osteoblastic and osteoclastic activity, and patients frequently have low bone mineral density and high bone turnover. The aim of this study was to examine the bone formation and resorption markers trend in 12 female patients, before and after normalization of thyroid activity. The following measurements were made at baseline and 1 and 6 months after hormone normalization induced by methimazole treatment: total alkaline phosphatase (ALP), bone alkaline phosphatase (BALP), collagen type C-terminal propeptide (PICP), osteocalcin (BGP), telopeptide (ICTP), urinary-hydroxyproline/urinary creatinine (uOHP/uCreat), urinary calcium/urinary creatinine (uCa/uCreat) and deoxypyridinoline crosslinks (D-Pyr).

[Synthetic salmon calcitonin suppositories for the short-term treatment of involutive osteoporosis].

Intramuscular and intranasal synthetic salmon calcitonin (sCT) has long been used in the treatment of involutional osteoporosis. A new suppository formulation was developed and many studies demonstrated that rectally administered sCT is efficacious and well tolerated. Thirty postmenopausal women, who had a bone mineral density at the lumbar spine below the mean of age-matched women, were enrolled in this study.

Metabolic markers for the early diagnosis of postmenopausal osteoporosis.

We performed a cross-sectional study in 147 women, 41 in premenopausal age and 106 in menopause for 1-5 years: bone mineral density (BMD) at the distal radius and annual bone loss (as shown by plasma alkaline phosphatase and osteocalcin levels, and by calcium/creatinine and hydroxyproline/creatinine in the second urine of the morning) were evaluated. A significant reduction of BMD with a significant increase of bone loss was observed with increasing duration of menopause. Furthermore, when the women were subdivided into two groups according to annual bone loss (over or under 1.

[Gamma-ray bone densitometry and evaluation of the patient at risk for osteoporosis].

After having briefly illustrated the main theories of photonic ray bone densitometry, the authors describe the various techniques used to evaluate bone mass and bone mineral density as accurately and precisely as possible both at an appendicular level and at lumbar and femoral sites. Since these data only provide a static measurement and are unable to provide information regarding bone mass evolution in time, a method is illustrated which is theoretically capable of identifying high risk subjects, namely those who, on the basis of simple blood and urine tests for some biochemical parameters, are likely to undergo a significant reduction in bone mass in the future. Lastly, the paper reports the preliminary results of a study carried out in immediately post-menopausal women in whom rapid loss of bone mass was followed by a greater reduction in bone mineral density measured at an appendicular level.

Effect of testosterone on bone in hypogonadal males.

Bone mineral content (BMC) and testosterone levels were evaluated and compared in 10 hypogonadal males and 10 normal, age-matched controls. In 6 of the subjects an investigation was also carried out into the effects of testosterone administration on lumbar BMC, calcitonin (CT) response to hypercalcaemia, osteocalcin (BGP) and the fasting urinary calcium/creatinine and hydroxyproline/creatinine ratios. Our results confirm that male hypogonadism is characterized by a low BMC and that testosterone administration is able to improve this parameter and to increase both basal BGP and CT response to hypercalcaemia.

Influence of estrogens on calcitonin secretion.

In this study we investigated the calcitonin (CT) pattern both in basal conditions and after calcium infusion before and one month after oophorectomy in 17 premenopausal women. In addition, 13 oophorectomized women were randomly allocated to two groups, one given hormone replacement treatment and the other untreated, and CT response to hypercalcemia was reevaluated one year later. CT response to calcium infusion was significant only before oophorectomy and one year after estrogen-progestogen treatment, whereas there was no response one month after oophorectomy or after one year without hormone replacement therapy.

[Photon densitometry in the diagnosis of osteoporosis].

The increased average life expectancy of the inhabitants of industrialised countries has led to a marked increase in degenerative pathologies, including osteoporosis. This has made it necessary to elaborate instrumental tests capable of identifying risk subjects in order to intervene as quickly as possible using appropriate prophylactic and therapeutic measures. Single and dual photon ray densitometry represents the first correct approach to quantitatively assess bone mineral content.

[Postmenopausal and senile osteoporosis. Prevention or therapy?].

Pharmacological treatments of osteoporosis can improve bone mineral content, but are not able to restore trabecular bone structure in presence of microfractures. It is therefore necessary to carry out at the right moment some preventive actions to increase peak bone mass in premenopausal age: adequate calcium intake, systematic physical activity and, if necessary, oestrogen administration before menopause are correct prophylactic measures against osteoporosis; moreover risk factors identification allows to perform a preliminary screening. Serial bone absorptiometry at lumbar level is able to identify fast losers women by means of integrating densitometric data and some metabolic results.

[Effect on phospho-calcium metabolism of testosterone administration in hypogonadal males].

Many authors have shown that osteoporosis is an important complication in male hypogonadism, due to the chronic lack of androgens; but in hypogonadal males the pathogenesis of osteopenia isn't completely explained. In this work we examined in 10 hypogonadal males (4 with Klinefelter's Syndrome and 6 with Hypogonadotropic Hypogonadism) lumbar bone mineral content (BMC) and the effects of testosterone (Sustanon) administration on BMC and other phosphocalcium parameters. We evidenced lower BMC levels in hypogonadal subjects if compared to those observed in the control age-matched group; moreover after 3 months of treatment a statistically significant increment of plasma bone gla protein, calcitonin and lumbar BMC was observed.

Vertebral bone loss in menopause.

A direct correlation between loss of ovarian function and reduction of bone mass is well established. The incidence of fractures sharply increases with age starting from the menopause. Therefore, it is very important to know the rate of bone loss occurring after menopause, at both trabecular and cortical levels.

Calcitonin and lumbar bone mineral content during oestrogen-progestogen administration in post-menopausal women.

It now appears to be accepted that oestrogens and progestogens can help to prevent post-menopausal bone loss. This study accordingly evaluated vertebral bone mineral content (BMC) patterns and changes in calcitonin (CT) secretion in 12 women who had been ovariectomized in the previous 6 mth and in 12 others who had had a natural menopause, all of whom received oestrogen-progestogen replacement therapy for 12 mth. We also studied 12 oophorectomized and 21 normal-menopause women who did not receive any treatment and hence constituted the corresponding control groups.

[Clinical problems of osteoporosis].

In this paper we summarize the main problems connected with the diagnosis of primary osteoporosis, after evidencing the remarkable social importance of the disease, linked to the great increase of aged population; finally the pathogenetic hypotheses more documented are described. From a diagnostic point of view common laboratory investigations are not mostly able to provide sufficient significant informations; recently the dosage of osteocalcin as index of osteoblastic activity and as marker of bone turnover has been suggested. Mainly traditional radiology does not provide sufficient information about the real demineralization rate, while the radiogrammometry can offer sufficiently reliable indications about bone mineral content.

Diagnostic notes--lumbar BMC reproducibility as evaluated by means of dual photon absorptiometry.

Three evaluations of lumbar bone mineral content (BMC) were carried out at different times at intervals of a few days in 10 normal volunteers aged between 18 and 60. The dual photon absorptiometry technique was employed (using gadolinium-153 as radioactive isotope). Data on 20 subjects aged from 23 to 62 were recorded on magnetic tape and processed ten times by the same operator.

Osteoporosis in type II diabetes.

Double photon absorptiometry comparison was done of lumbar bone mineral content (BMC) values in 40 women with well-compensated non-insulin-dependent diabetes mellitus (type II) and on dietary and/or oral hypoglycemic treatment, and 35 age-matched non-diabetic women, to determine the presence and degree of osteoporosis in this type of diabetes by means of a highly precise and sensitive method. No difference between the two groups was noted as regards blood calcium, phosphorus, PTH and thyrocalcitonin, and urinary calcium and phosphorus. BMC, on the other hand, was significantly lower in the diabetics, both in L2,L3,L4 and in L4 alone.