Biochemical Markers Of Bone Metabolism Research Articles

Effects of Treatment Model on Bone Metabolism in Patients with Severe Hemophilia A

Improving bone health and preventing osteoporosis is an essential approach for hemophilia patients. Regarding precautions, the treatment model may affect bone health. To detect the effect of a treatment model (prophylaxis/on-demand treatment) on bone metabolism in patients with severe hemophilia A was the primary aim of this study. The biochemical markers of bone metabolism and bone mineral density were obtained from the patients enrolled in the study. No statistically significant differences were found between the groups due to the limitations of the prophylaxis group, such as adaptation problems, personal differences, and type of prophylaxis.

Effects of Treatment Model on Bone Metabolism in Patients with Severe Hemophilia A

Improving bone health and preventing osteoporosis is an essential approach for hemophilia patients. Regarding precautions, the treatment model may affect bone health. To detect the effect of a treatment model (prophylaxis/on-demand treatment) on bone metabolism in patients with severe hemophilia A was the primary aim of this study. The biochemical markers of bone metabolism and bone mineral density were obtained from the patients enrolled in the study. No statistically significant differences were found between the groups due to the limitations of the prophylaxis group, such as adaptation problems, personal differences, and type of prophylaxis.

Iron status is associated with tibial structure and vitamin D metabolites in healthy young men

The influence of iron on collagen synthesis and vitamin D metabolism has implications for bone health. This cross-sectional observational study investigated associations between markers of iron status and tibial structure, vitamin D metabolites, and circulating biochemical markers of bone metabolism in young healthy men. A total of 343 male British Army recruits participated (age 22 ± 3 y, height 1.77 ± 0.06 m, body mass 75.5 ± 10.1 kg). Circulating biochemical markers of iron status, vitamin D metabolites, and bone metabolism, and tibial structure and density by high-resolution peripheral quantitative computed tomography scans (HRpQCT) were measured in participants during week 1 of basic military training. Associations between markers of iron status and HRpQCT outcomes, bone metabolism, and vitamin D metabolites were tested, controlling for age, height, lean body mass, and childhood exercise volume. Higher ferritin was associated with higher total, trabecular, and cortical volumetric bone mineral density, trabecular volume, cortical area and thickness, stiffness, and failure load (all p ≤ 0.037). Higher soluble transferrin receptor (sTfR) was associated with lower trabecular number, and higher trabecular thickness and separation, cortical thickness, and cortical pore diameter (all p ≤ 0.033). Higher haemoglobin was associated with higher cortical thickness (p = 0.043). Higher ferritin was associated with lower βCTX, PINP, total 25(OH)D, and total 24,25(OH)2D, and higher 1,25(OH)2D:24,25(OH)2D ratio (all p ≤ 0.029). Higher sTfR was associated with higher PINP, total 25(OH)D, and total 24,25(OH)2D (all p ≤ 0.025). The greater density, size, and strength of the tibia, and lower circulating concentrations of markers of bone resorption and formation with better iron stores (higher ferritin) are likely as a result of the direct role of iron in collagen synthesis.

DYNAMICS OF BIOCHEMICAL MARKERS OF HUMORAL IMMUNITY AND METABOLISM IN MANDIBULAR BONE TISSUE UNDER INFLUENCE ON REPARATIVE OSTEOGENESIS

The scientific and practical significance of our study lies in the application of various therapeutic measures aimed at accelerating the processes of reparative osteogenesis in the presence of perforated defects in the bone tissue of the mandible using hydroxyapatite-containing osteotropic material “Biomin GT bone graft» and thymaline (injections into the surrounding soft tissues) analyzed in our article.
 The aim of the study is to investigate the dynamics of secretory immunoglobulin A content and activity of acid and alkaline phosphatases in the oral fluid of rats under the conditions of influence on the processes of reparative osteogenesis when filling the bone defect with osteotropic material and injecting thymaline into the surrounding soft tissues at different study periods.
 Materials and methods. Experimental studies were conducted on 30 mature WAG population rats weighing 160-180 g, which were divided into five groups. The control group consisted of 6 intact rats, the first group included rats with a simulated hole defect of the mandible, the second group included rats with a simulated hole defect followed by closure of the bone defect with hydroxyapatite-containing osteotropic material, the third group included rats with a mandibular defect after thymaline injections into the surrounding soft tissues, and the fourth group included animals with a defect after filling the bone defect with osteotropic material and injections of thymaline into the surrounding soft tissues. The concentration of sIgA in the oral fluid of rats was determined by enzyme-linked immunosorbent assay using «The IgA Saliva ELISA kit» (Diametra, Italy). The activity of alkaline (ALP) and acid phosphatase (AP) in the biomaterial was measured using a set of reagents “Granum» Ukraine, Kharkiv. The optical density was measured using a STAT-FAX 303+ immunoenzyme analyzer.
 Results and discussion. A decrease in the content of sIgA in the oral fluid of rats of groups I-IV was found both on day 3 and day 7 of the study compared with the control group. On the 14th day, an increase (by 16.7%) in the content of sIgA in the oral fluid of rats of group IV was determined compared to the first group. The content of sIgA in the oral fluid of rats of groups I and III remained below the control by 29.6%, 32.7%, 29.9%, respectively. On the 28th day, only in rats of group IV, sIgA exceeded the value of its content in rats of the control group and was 52.6% higher compared to rats of group I. On the 3rd day, an increase in the activity of ALP from 102% to 111%, respectively, was observed in the oral fluid of rats of groups I-IV compared to intact animals. On the 7th day, the greatest (18.9%) decrease in the activity of ALP was observed in the oral fluid of rats of group IV; on the 14th day, only rats of group IV showed a decrease in the activity of ALP (by 38.1%) compared to the 3rd day. On the 28th day, a decrease in the activity of ALP (by 43.12%) was observed in the oral fluid of rats of group IV compared to day 3 and was equal to the control. On the third day, there was an increase in the activity of AP in the oral fluid of all rats. When comparing the values of AP activity in the oral fluid of rats of groups I and IV, a difference of 17.3% was determined. In rats of group IV on day 14: 25.6% decrease in AP activity compared to day 3 of the study, although it differed from the control group. However, statistically significant decrease in AP activity was observed in rats of group IV compared to groups I-III.
 Conclusions. In rats with a simulated mandibular perforation defect on the third and seventh days of observation, a deficiency of sIgA in the oral fluid was observed, indicating a decrease in the functioning of the humoral link of local immunity. In rats of group IV, on the 14th and 28th day of the study, the sIgA content was normalized. There is an activation of reparative osteogenesis in the bone tissue of the mandible in rats with a simulated hole defect under the conditions of its subsequent closure with hydroxyapatite-containing osteotropic material and injections of thymaline into the surrounding soft tissues. The determination of biochemical markers of bone metabolism, in particular alkaline and acid phosphatase in the oral fluid in mandibular fractures, can be used in clinical practice to improve the efficiency of diagnosing reparative osteogenesis in the jaw bones.

Effect of acute resistance exercise on bone turnover in young adults before and after concurrent resistance and interval training.

Weight-bearing physical activity can stimulate bone adaptation. This investigation explored the effect of an acute bout of resistance exercise before and after resistance+interval training on circulating biomarkers of bone metabolism and muscle-bone crosstalk. Healthy young male and female participants (n = 21 male, 28 ± 4 years; n = 17 female, 27 ± 5 years) performed a 6 × 10 squat test (75% 1RM) before and after a 12-week resistance+interval training program. Before and after completion of the training program, blood samples were collected at rest, immediately postexercise, and 2 h postexercise. Blood samples were analyzed for βCTX, P1NP, sclerostin, osteocalcin, IGF-1, and irisin. Significant effects of acute exercise (main effect of time) were observed as increases in concentrations of IGF-1, irisin, osteocalcin, and P1NP from rest to postexercise. A sex*time interaction indicated a greater decline in βCTX concentration from rest to 2 h postexercise and a greater increase in sclerostin concentration from rest to immediately postexercise in male compared with female participants. Sex differences (main effect of sex) were also observed for irisin and P1NP concentrations. In summary, changes in concentrations of biochemical markers of bone metabolism and muscle-bone crosstalk were observed in males and females after an acute bout of resistance exercise and following 12 weeks of resistance+interval training.

Association of bone turnover markers with glucose metabolism in type 2 diabetes mellitus

Introduction and Aim: Type 2 diabetes mellitus (Type 2 DM) subjects are at increased risk of fracture due to poor bone quality contributing to diabetic skeletal fragility. This study provides an understanding of the relationship between bone turnover markers (BTM) and glucose metabolism in Type 2 DM. Materials and Methods: One hundred types 2 diabetics and one hundred controls participated in this case control study. Serum FBS, osteocalcin, alkaline phosphatase (ALP), CTx (C- terminal cross linked telopeptide of type 1 collagen), HOMA-IR and HOMA-B was measured. Association between BTM and FBS, HOMA-IR and HOMA-B was studied. Comparison was done by Student’s t test. The correlation was established using Pearson's correlation test. P value less than 0.05 was used to determine statistical significance. Results: Mean levels of FBS, ALP and HOMA-IR were higher and mean levels of osteocalcin, CTx and HOMA-B were decreased in diabetics when compared to controls. Osteocalcin levels showed significant negative correlation with FBS, ALP, HOMA-B and HOMA-IR. CTx levels were negatively correlated with ALP and FBS. Conclusion: Early identification of decrease in bone mass in diabetic patients may be helpful in preventing bone loss and future fracture risks. Monitoring for diabetes associated with osteopenia is essential. The biochemical markers of bone metabolism can detect even small changes in the bone turnover, thus identifying diabetics who may become osteoporosis-prone.

Rapid Establishment and Validation of an Experimental Model of Osteoporosis for Implant-Bone Analysis.

Osteoporosis is an increasingly prevalent disease. The development of an osteoporosis-like experimental animal model is of great importance for the study of peri-implant osteogenesis in osteoporosis. The present authors aimed to establish a rapid modeling method of osteoporotic rabbits for implant-bone analysis and validate whether the models can affect the implant osseointegration. The present study included 29 female New Zealand rabbits (age: 5 to 6 months). Two rabbits were lost during anesthetization. Of the remaining 27 rabbits, 18 received an ovariectomy, with 9 receiving dexamethasone injections for 8 weeks (OVX+D group) and 9 receiving equivalent-volume saline injections (OVX group). As a control group, the remaining 9 rabbits were sham-operated and received an equivalent volume of normal saline (SHAM group). Then, serum biochemical markers of bone metabolism were detected and densitometric measurements were performed. Implants were then placed in the tibias of each rabbit. Bone samples (including implants) were obtained after 4, 8, and 12 weeks of healing and were subjected to histologic and histomorphometric analyses. The results showed that the OVX+D group experienced a 32% reduction in bone mineral density (BMD) from baseline. The BMD of the OVX+D group was significantly lower than that of the SHAM and OVX groups. Moreover, alkaline phosphatase (ALP) blood concentrations of in the OVX+D group were increased significantly. The osteoporotic rabbits exhibited marked decreases in osseointegration, characterized by slowed bone formation and decreased bone-to-implant contact (BIC). The combination of an ovariectomy and dexamethasone injections could experimentally induce osteoporosis in rabbits in the short term, which can be used as an appropriate animal model to study the osseointegration of implants under osteoporosis.

Both epilepsy and anti-seizure medications affect bone metabolism in children with self-limited epilepsy with centrotemporal spikes.

Bone metabolism can be influenced by a range of factors. We selected children with self-limited epilepsy with centrotemporal spikes (SeLECTS) and lifestyles similar to those of healthy children to control for the confounding factors that may influence bone metabolism. We aimed to identify the specific effects of epilepsy and/or anti-seizure medications (ASMs) on bone metabolism. Patients with SeLECTS were divided into an untreated group and a monotherapy group, and the third group was a healthy control group. We determined the levels of various biochemical markers of bone metabolism, including procollagen type I nitrogenous propeptide (PINP), alkaline phosphatase (ALP), osteocalcin (OC), collagen type I cross-linked C-telopeptide (CTX), calcium, magnesium, phosphorus, parathyroid hormone (PTH), and vitamin D3 (VD3 ). A total of 1487 patients (from 19 centers) were diagnosed with SeLECTS; 1032 were analyzed, including 117 patients who did not receive any ASMs (untreated group), 643 patients who received only one ASM (monotherapy group), and 272 children in the healthy control group. Except for VD3 , other bone metabolism of the three groups were different (p < .001). Bone metabolism was significantly lower in the untreated group than the healthy control group (p < .05). There were significant differences between the monotherapy and healthy control group in the level of many markers. However, when comparing the monotherapy and untreated groups, the results were different; oxcarbazepine, levetiracetam, and topiramate had no significant effect on bone metabolism. Phosphorus and magnesium were significantly lower in the valproic acid group than the untreated group (adjusted p < .05, Cliff's delta .282-.768). CTX was significantly higher in the lamotrigine group than in the untreated group (adjusted p = .012, Cliff's delta = .316). Epilepsy can affect many aspects of bone metabolism. After controlling epilepsy and other confounders that affect bone metabolism, we found that the effects of ASMs on bone metabolism differed. Oxcarbazepine, levetiracetam, and topiramate did not affect bone metabolism, and lamotrigine corrected some of the abnormal markers of bone metabolism in patients with epilepsy.

Bone fractures in children with celiac disease: analysis of clinical and anthropometric measurements and bone metabolism markers

Introduction. Abnormal bone remodelling process is one of the clinical manifestations of celiac disease, which increases the risk of developing osteopenia conditions, including bone fractures. The median age for the first fracture is similar in celiac disease and in the general population, but the incidence is higher in patients with celiac disease.Aim. To compare clinical and anamnestic characteristics, anthropometric measurements and laboratory test results in celiac children and adolescents with and without bone fractures.Materials and methods. A total of 151 children aged 1-17 years were included in the study. Patients were divided into two groups: those who had fractures in their lifetime - 21 (13.9%) children and those who had no fractures - 130 (86.1%) children. Results. The frequency of fractures among the patients included in the study was 13.9%, while among children with vitamin D deficiency fractures were reported 2.7 times more often than among children with its optimal level (p = 0.019).Vitamin D deficiency was detected in 20 (95.2%) children with fractures, and levels of 30 ng/ml or higher were found in 1 (4.8%) child. In the group of patients without fractures, the 25(OH)D optimal level was observed in 43 (33.1%) cases.It was found that patients with fractures had a significantly lower osteocalcin level than children without fractures - 26.9 (15.6; 32.9) ng/ml (p &lt; 0.001), and children with fractures had C-terminal telopeptide level 1.9 times higher than the group of children without fractures (p = 0.01). The median PTH concentration in children with fractures was 34.6 (19.6; 54.7) pg/ml, whereas in children without fractures it was 24.2 (17.1; 39.5) pg/ml (p = 0.1).Conclusion. Due to elevated PTH level and severe vitamin D deficiency, a predominance of osteoresorption over osteosynthesis was observed in children with celiac disease and fractures of tubular bones. It is important to maintain a 25(OH)D optimal level and monitor biochemical markers of bone metabolism in patients with celiac disease to assess the processes of bone formation and resorption.

Distal Tibial Bone Properties and Bone Stress Injury Risk in Young Men Undergoing Arduous Physical Training

Trabecular microarchitecture contributes to bone strength, but its role in bone stress injury (BSI) risk in young healthy adults is unclear. Tibial volumetric BMD (vBMD), geometry, and microarchitecture, whole-body areal BMD, lean and fat mass, biochemical markers of bone metabolism, aerobic fitness, and muscle strength and power were measured in 201 British Army male infantry recruits (age 20.7 [4.3] years, BMI 24.0 ± 2.7 kg·m2) in week one of basic training. Tibial scans were performed at the ultra-distal site, 22.5 mm from the distal endplate of the non-dominant leg using High Resolution Peripheral Quantitative Computed Tomography (XtremeCT, Scanco Medical AG, Switzerland). Binary logistic regression analysis was performed to identify associations with lower body BSI confirmed by MRI. 20 recruits (10.0%) were diagnosed with a lower body BSI. Pre-injured participants had lower cortical area, stiffness and estimated failure load (p = 0.029, 0.012 and 0.011 respectively) but tibial vBMD, geometry, and microarchitecture were not associated with BSI incidence when controlling for age, total body mass, lean body mass, height, total 25(OH)D, 2.4-km run time, peak power output and maximum dynamic lift strength. Infantry Regiment (OR 9.3 [95%CI, 2.6, 33.4]) Parachute versus Line Infantry, (p ≤ 0.001) and 2.4-km best effort run time (1.06 [95%CI, 1.02, 1.10], p < 0.033) were significant predictors. Intrinsic risk factors, including ultradistal tibial density, geometry, and microarchitecture, were not associated with lower body BSI during arduous infantry training. The ninefold increased risk of BSI in the Parachute Regiment compared with Line Infantry suggests that injury propensity is primarily a function of training load and risk factors are population-specific.

Bone Mineral Density in Adult Patients with Type 1 Diabetes Mellitus Assessed by Both DXA and QCT.

Bone mineral density (BMD) was measured in uncomplicated young adult patients with type 1 diabetes mellitus (T1DM) and sex- and age-matched controls, using both dual X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) to investigate their diagnostic ability in detecting abnormal values in these patients. 118 patients with T1DM (65 females, mean age 30.12 ± 8.78 years) and 94 sex- and age-matched controls were studied. BMD was assessed in all participants by DXA and QCT at lumbar spine (LS). Biochemical markers of bone metabolism were also measured. T1DM was associated with lower BMD at L1-L3 vertebrae measured by both DXA and QCT and lower bone turnover compared to sex- and age-matched controls. In T1DM subjects, QCT detected more patients with abnormal BMD values compared to DXA. BMI and HbA1c levels were the only determinants of BMD. Bone turnover markers were lower in patients with longer duration of diabetes. QCT provides a higher sensitivity compared to DXA in detecting abnormal BMD values in patients with uncomplicated T1DM. In these patients, the diabetes-related decreased BMD may be present early, before it is detected by DXA, the clinical gold standard for BMD measurements, and before the presence of any other diabetes complications, stressing the importance of an early intervention for fracture prevention.

Evaluation of biochemical markers of bone metabolism in patients with secondary hyperparathyroidism and chronic kidney disease

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Prevalence of Osteoporosis in Cirrhosis: A Systematic Review and Meta-Analysis.

The prevalence of osteoporosis in individuals with cirrhosis varies based on the diagnostic approach and etiology of the underlying liver disease. This systematic review aims to evaluate the prevalence of osteoporosis in individuals with cirrhosis. Electronic databases were searched for studies reporting the prevalence of osteoporosis among patients with cirrhosis. The primary outcome was the presence of osteoporosis, as determined by a dual-energy x-ray absorptiometry (DEXA) scan. Secondary outcomes were levels of biochemical markers of bone metabolism, including calcium, vitamin D, phosphorus, and parathormone (PTH) levels. A cohort of 836 patients from 10 studies was included in the final analysis. The pooled rate of osteoporosis was 14.80% (95% CI: 14.19-15.49). Pooled levels of biochemical markers of bone metabolism were as follows: calcium 9.09 mg/dL (95% CI: 8.73-9.45), 25-hydroxyvitamin D (25-OH vitamin D) 15.41 ng/mL (95% CI: 14.79-16.03), phosphorus 15.41 mg/dL (95% CI: 2.99-3.51), and PTH 26.58 pg/mL (95% CI: 25.45-27.71). Pooled levels of liver biochemistries were: bilirubin 3.04 mg/dL (95% CI: 2.84-3.25), aspartate aminotransferase (AST) 65.35 U/L (95% CI: 61.39-69.31), alanine aminotransferase (ALT) 50.17 U/L (95% CI: 46.18-54.10), alkaline phosphatase 133.31 U/L (95% CI: 124.89-141.73), and albumin 3.25 g/dL (95% CI: 3.05-3.45). Cirrhosis appears to be associated with an increased risk for osteoporosis, with a pooled prevalence of 15%. This can include men and individuals younger than 50 years of age, a cohort not typically considered to be at an increased risk of osteoporosis.Levels of 25-hydroxyvitamin D and insulin-like growth factor-1 (IGF-1) were also significantly low.Further studies are required to evaluate the risk of osteoporosis based on the etiology and stage of cirrhosis, especially in younger males, to incorporate this into future prediction models for fragility fractures.

The Superiority of Zoledronic Acid Over Risedronate for Paget's Disease: A 16-Year Experience at a Single Institution.

Introduction Bisphosphonates are considered to be the treatment of choice for patients with active Paget's disease. The aim of this study was to record and assess the therapeutic effect in response to a single intravenousinfusion of5mg zoledronic acid or oral risedronate. Methods A retrospective observational study was conducted of 89 patients in Greek patients with active Paget's disease from a tertiary hospital in North Greece. Patients were treated with either a single intravenous infusion of 5mg zoledronic acid (1st group, n=46) or 30mg of risedronate per day for 60 days (2nd group, n=43). All patients received 1000mg of calcium and 400-800IU of calciferol daily. The primary outcome measure was to record the therapeutic response defined as the control of patients' symptoms and normalization of the biochemical markers of bone metabolism. The secondary outcome measures included the patient's quality of life which was evaluated by the questionnaire SF-36 and adverse events. Results Forty patients from the zoledronic acid group and 38 patients from the risedronate group, who reported pain at the beginning of the study, showed a significant degree of clinical improvement. All the patients in our study showed a therapeutic response at six months while the remission was persistent at 36 months. There was a statistically significant difference between pre-treatment basal results and values at the sixthand 36th months of treatment (p<0.001) between the two groups. Conclusion The study demonstrated the superiority of zoledronic acid over risedronate in patients with active Paget's disease.

Methods for assessing the effectiveness of using bone morphogenetic proteins in spondylodesis

BACKGROUND: Today, growth factors, in particular bone morphogenetic proteins in the composition of osteoplastic materials, are widely used to accelerate bone tissue regeneration after injuries or diseases of the musculoskeletal system. There are various methods for evaluating the effectiveness of using these proteins, in particular, the methods for medical imaging and determining specific markers. Bone loss often occurs after trauma or injury, including surgery. Rapid impairment of bone formation and increased bone resorption, as reflected by biochemical markers of bone metabolism, may cause this bone loss. Therefore, the detection of these markers in patients after spinal fusion using bone morphogenetic proteins is important in assessing the effectiveness of this therapy at various stages of observation in the postoperative period. However, due to the widespread use of bone morphogenetic proteins, their therapeutic efficacy can increasingly be seen in everyday radiological practice. X-ray or computed tomography is usually used to assess the effectiveness of the surgical intervention. Magnetic resonance imaging may be a useful adjunct, however, postoperative magnetic resonance imaging analysis is vulnerable to hardware artifacts. Although there is extensive data in the literature on the outcomes of surgical interventions for spondylodesis using bone morphogenetic proteins, radiographic data and data on the detection of specific markers and their use are scarce.&#x0D; AIM: In this study, we will discuss the current knowledge about existing and possible methods for evaluating the effectiveness of the use of bone morphogenetic proteins in spondylodesis.&#x0D; MATERIALS AND METHODS: Using PubMed, Embase, the Cochrane Database, and Google Scholar, we conducted a comprehensive literature search demonstrating possible methods for evaluating the effectiveness of bone morphogenetic proteins in spondylodesis.&#x0D; RESULTS: This study presents various methods for determining the effectiveness of the use of bone morphogenetic proteins in spondylodesis. In addition, the results of preclinical and clinical studies, which analyzed the effectiveness of the use of bone morphogenetic proteins, have been analyzed.&#x0D; CONCLUSIONS: To identify the effectiveness of bone morphogenetic proteins in spondylodesis further preclinical and clinical studies are required.

Biochemical markers of bone metabolism in the diagnosis of mineral and bone disorders associated with chronic kidney disease

The diagnostic possibilities of using biochemical markers of bone metabolism in patients with secondary hyperparathyroidism (SHPT) and chronic kidney disease (CKD) have not yet been properly evaluated.We analyzed indicators of bone mineral density according to double X-ray absorptiometry, as well as biochemical markers of bone metabolism (OC, CTx, ALP), incl. using a neural network algorithm, in 452 patients with various stages of CKD and in 60 persons of the comparison group (control).It has been established that the levels of biochemical markers of bone metabolism in patients with CKD progressively increase with aggravation of renal failure, and are interrelated with PTH and the presence of SHPT, as well as with the presence of osteoporosis. Estimation of OC, CTx, ALP can be used as a source of additional information about the state of bone metabolism in patients with SHPT and CKD. It should be taken into account that in patients with CKD 4–5, the levels of OC, CTx significantly exceed those in a healthy population, due to both an increase in bone metabolism and a slowdown in the process of degradation and elimination of these markers.Using a neural network algorithm, we proposed reference intervals for these indicators depending on the stage of CKD. The data obtained are the basis for the development of recommendations for the diagnosis of osteopathy in SHPT and CKD, as well as multifactorial prevention and correction of this pathology. Only a comprehensive assessment of the state of the bone will make it possible to objectively assess its condition and choose an effective and safe way to correct the identified violations.

Natural stable calcium isotope ratios: a new gold standard for bone balance?

Bone calcium balance is the net gain, loss, or equilibrium of calcium moving to and from bone, which reflects bone balance. There are currently no clinically available tools for measuring real-time bone balance. In this issue, Shroff etal. demonstrate the use of natural stable calcium isotope ratios as a novel biomarker of bone balance in children with chronic kidney disease on dialysis that is highly repeatable and associated with radiological and biochemical markers of bone metabolism.

Effect of simvastatin on osteogenesis of the extremity bones in aging rats

ABSTRACT Purpose Simvastatin is a prodrug of the potent 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor. The main purpose of the current study is to assess the accurate function of simvastatin on osteoporosis of extremity bones in aging rats. Materials and methods Fifty 15-month-old SD rats were divided into five groups (four simvastatin groups and one control group). The rats in four simvastatin groups were fed with different doses of simvastatin (5, 10, 20, and 40 mg/kg/d, respectively) for 3 months, whereas the rats in control group were fed the equal physiological saline. Calcium (Ca), phosphorus (P), and the lipid spectrum in serum were measured. Biochemical markers of bone metabolism, osteocalcin (OC), and tartrate-resistant acid phosphatase (Trap-5b), were analyzed using ELISA. The content of adipocytes in bone marrow was analyzed by histological staining. Finally, the bone quality of the femur and tibia were evaluated using dual-energy X-ray absorptiometry (DEXA), peri-quantity CT (pQCT), and the 3-point bending biomechanical test. Results Simvastatin reduced serum triglycerides (TG), and 10 mg/kg/d of simvastatin significantly reduced the content of adipocytes in bone marrow compared to the control group. However, statistically significant differences between the simvastatin groups and the control group were not found in the CA, P, OC, Trap-5b, or the evaluation indexes of bone quality from DEXA, pQCT, and biomechanical tests. Conclusion Simvastatin could not prevent osteoporosis of the extremity bones in aging rats.

Changes in Bone Mineral Density After Parathyroidectomy and Their Relations With Biochemical Markers of Bone Metabolism.

To measure total type 1 serum amino-terminal propeptide procollagen (t-P1NP), β- type 1 cross-linked C-terminal telopeptide collagen (β-CTX), N-terminal osteocalcin (OC), and 25-(OH)-VD3 levels before parathyroidectomy (PTX) in patients with PHPT, and correlate these measurements with bone mineral density (BMD) changes at 1-year post-PTX. Patients with primary hyperparathyroidism (PHPT) were followed from diagnosis to 12months after surgery. Serum levels of calcium, parathyroid hormone (PTH), vitamin 25-(OH)-VD3, OC, β-CTX, t-P1NP, and BMD were measured before and 1year after surgery. One year after PTX, mean BMD increased by 25.7, 27.7, and 33.5% in the lumbar spine (L1-L4), femoral neck (FN), and greater trochanter (GT), respectively. Percent BMD change 1-year post-PTX was significant correlated with preoperative levels of β-CTX (L1-L4: r = 0.41, P < 0.0001; FN: r = 0.54, P = 0.0003; GT: r = 0.46, P = 0.0029), t-P1NP (L1-L4: r = 0.58, P < 0.0001; FN: r = 0.73, P < 0.0001; GT: r = 0.65, P < 0.0001), 25-(OH)-VD3 (L1-L4: r = -0.33, P = 0.034; FN: r = -0.48, P = 0.002; GT: r = -0.52, P = 0.0007), and OC (L1-L4: r = 0.49, P = 0.0013; FN: r = 0.55, P = 0.0002; GT: r = 0.47, P = 0.002). Preoperative levels of turnover markers and BMD improvements were significantly correlated in patients with PHPT 1 year after PTX.

Effect of verapamil on bone mass, microstructure and mechanical properties in type 2 diabetes mellitus rats

BackgroundVerapamil was mainly used to treat hypertension, cardiovascular disease, inflammation and improve blood glucose in patients with diabetes, but its effects on bone mass, microstructure and mechanical properties were unclear. This study described the effects of verapamil on bone mass, microstructure, macro and nano mechanical properties in type 2 diabetic rats.MethodsRat models of type 2 diabetes were treated with verapamil at doses of 4, 12, 24 and 48 mg/kg/day by gavage respectively, twice a day. After 12 weeks, all rats were sacrificed under general anesthesia. Blood glucose, blood lipid, renal function and biochemical markers of bone metabolism were obtained by serum analysis, Micro-CT scanning was used to assess the microstructure parameters of cancellous bone of femoral head, three-point bending test was used to measure maximum load and elastic modulus of femoral shaft, and nano-indentation tests were used to measure indentation moduli and hardnesses of longitudinal cortical bone in femoral shaft, longitudinal and transverse cancellous bones in femoral head.ResultsCompared with T2DM group, transverse indentation moduli of cancellous bones in VER 24 group, longitudinal and transverse indentation moduli and hardnesses of cancellous bones in VER 48 group were significantly increased (p < 0.05). Furthermore, the effects of verapamil on blood glucoses, microstructures and mechanical properties in type 2 diabetic rats were dependent on drug dose. Starting from verapamil dose of 12 mg/kg/day, with dose increasing, the concentrations of P1NP, BMD, BV/TV, Tb. Th, Tb. N, maximum loads, elastic moduli, indentation moduli and hardnesses of femurs in rats in treatment group increased gradually, the concentrations of CTX-1 decreased gradually, but these parameters did not return to the level of the corresponding parameters of normal rats. Verapamil (48 mg/kg/day) had the best therapeutic effect.ConclusionVerapamil treatment (24, 48 mg/kg/day) significantly affected nano mechanical properties of the femurs, and tended to improve bone microstructures and macro mechanical properties of the femurs, which provided guidance for the selection of verapamil dose in the treatment of type 2 diabetic patients.