Abstract
Bone diseases represent an increasing health burden worldwide, and basic research remains necessary to better understand the complexity of these pathologies and to improve and expand existing prevention and treatment approaches. In the present study, 216 bone samples from the caput femoris and collum femoris of 108 patients with degenerative or dysplastic coxarthrosis, hip fracture, or osteonecrosis were evaluated for the proportion of trabecular bone (TB) and expression of parathyroid hormone (PTH) type 1 receptor (PTH1R), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL). Serum levels of PTH, OPG, soluble RANKL (sRANKL), alkaline phosphatase (AP), osteocalcin, total procollagen type-1 intact N-terminal propeptide (TP1NP), tartrate-resistant acid phosphatase type 5b (TRAP5b), sclerostin, and C-telopeptide of type-1 collagen (ICTP) were also determined. Age was positively correlated with serum levels of PTH, OPG, and sclerostin but negatively associated with TB and sRANKL. Women exhibited less TB, lower sclerostin and ICTP, and higher TRAP5b. Impaired kidney function was associated with shorter bone decalcification time, less TB, lower sRANKL, and higher serum PTH, OPG, and sclerostin. Furthermore, correlations were observed between bone PTH1R and OPG expression and between serum PTH, OPG, and AP. There were also positive correlations between serum OPG and TP1NP; serum OPG and sclerostin; serum AP, osteocalcin, and TRAP5b; and serum sclerostin and ICTP. Serum OPG was negatively associated with sRANKL. In summary, clear relationships between specific bone metabolism markers were observed, and distinct influences of age, sex, and kidney function, thus underscoring their suitability as diagnostic or prognostic markers.
Highlights
Bone diseases, such as osteoporosis, represent one of the major health problems worldwide
While previous studies have been in agreement regarding the expression of PTH type 1 receptor (PTH1R), OPG or receptor activator of nuclear factor kappa-B ligand (RANKL) on osteoblasts and osteocytes [5, 9, 12, 15,16,17,18,19,20,21,22,23,24,25,26,27,28], literature data are contradictory regarding their expression on osteoclasts
Parameters of bone metabolism in a series of orthopaedic patients unchanged with age. These findings suggest that changes in OPG expression, leading to a secondary imbalance between OPG and RANKL expression, are predominantly responsible for bone loss in the ageing skeleton
Summary
Bone diseases, such as osteoporosis, represent one of the major health problems worldwide. They are especially common in the elderly but may affect people of any age [1,2,3]. Parameters of bone metabolism in a series of orthopaedic patients hormone type 1 receptor; RANKL, receptor activator of nuclear factor kappa-B ligand; rsp, Spearman correlation coefficient; TB, trabecular bone; TP1NP, total procollagen type-1 intact Nterminal propeptide; TRAP5b, tartrate-resistant acid phosphatase type 5b. To pain and deformity, fractures are a major complication of bone disease, leading to increased morbidity, reduced quality of life, and even death. The care of patients with bone diseases is very costly to society, and expenses will continue to rise as the frequency of bone diseases increases in the future with the anticipated growth of the elderly population. Despite modern prophylaxis and treatment options, basic research efforts are still necessary to better understand the complex pathologies of different bone diseases and to improve and expand treatment approaches
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