Bone Alkaline Phosphatase Levels Research Articles

Osteoprotective effect of extract from Panax ginseng in ovariectomized rats

This study was carried out to investigate the effects of the Panax ginseng extract on serum level of hormones from osteoporosis induced ovariectomized rats. Two month-old rats were ovariectomized (OVX), remained untreated for 8 weeks, and were subsequently administered P. ginseng (200 mg/kg) every day for 8 weeks. We examined the effects of treated P. ginseng every 10 days on ovariectomy-related changes in Insulin-like Growth Factors (IGF), Insulin-like Growth Factor binding protein-3 (IGBF-3), Estrogen, Calcium, and Phosporus After 8 weeks serum levels of IGF-I, -II, and IGFBP-3 were heigher after P. ginseng extract treatment on OVX rats as compared to the other two groups (p < 0.05). Bone alkaline phosphatase levels were increased through P. ginseng extract treatment in OVX rats compared to the other two groups. There were no differences between OVX and P. ginseng extract treated OVX rats in serum levels of estrogen, but estrogen levels for the sham group were higher than for the other two groups. P. ginseng extract is increased to serum levels of IGFs and IGFBP-3 of osteoporosis induced by ovariectomized rats. Thus, the results reveal that the P. ginseng extract is a possible role for improvement of osteoporosis induced-ovariectomized rats and has a great potential as an alternative tool for the treatment of osteoporosis.

Study on levels of serum phosphorus, bone alkaline phosphatase and 25-hydroxyvitamin D in preterm infants with very low birth weight

To compare the levels of serum phosphorus, bone alkaline phosphatase and 25-hydroxyvitamin D3 in preterm infants with very low birth weight, and provide evidence for early screening, prevention of metabolic bone disease in preterm infants. A total of 110 newborns who met the inclusion criteria were selected in pediatric ward in our hospital. The case group included 60 preterm infants with very low birth weight and control group included 50 full term infants. Fasting blood were taken from the subjects at week 1, 4, and 12 respectively, and ELISA was conducted to quantitatively detect the serum levels of phosphorus, bone alkaline phosphatase and 25-hydroxyvitamin D. The increase of serum 25-hydroxyvitamin D₃in case group was smaller than that in control group; the levels of serum phosphorus had no significant difference between two groups. In case group, the level of bone alkaline phosphatase increased at week 1, 4, and 12, and the 25-hydroxyvitamin D₃level had significant difference at week 12 (P<0.05). The abnormal rate of 25-hydroxyvitamin D3 level was 26.7% for case group and 0% for control group. There were significant differences between case group and control group in levels of bone alkaline phosphatase and 25-hydroxyvitamin D₃, suggesting that detecting the serum levels of bone alkaline phosphatase and 25-hydroxyvitamin D3 would facilitate the early diagnosis of metabolic bone disease in preterm infants.

Wnt3a-producing fibroblasts in ovariectomy-induced osteoporosis in a rat model

We investigated the effect of in vitro cultured Wnt3a-producing fibroblasts on positive bone balance and regeneration of the osteopenic skeleton. Thirty-six female Wistar rats (250–300 g, aged 12 weeks) were randomized into three groups: a control group (sham-operated), ovariectomy (OVX) group, and OVX with Wnt-cell injection (OVX with Wnt) group. Wnt3a-producing fibroblasts were injected into the lateral tail vein at 2 and 4 weeks after OVX. Both tibias were removed at 5, 6, 7, and 8 weeks after OVX, and pathological and micro-CT evaluations were performed. We also evaluated β-catenin expression by immunohistochemical staining. For bone metabolism detection, we evaluated the expression of bone alkaline phosphatase (BALP), osteocalcin, and C-telopeptide of collagen type I. Bone mineral density, trabecular bone volume, trabecular number, trabecular thickness were higher, while trabecular seperation was lower, in the OVX with Wnt group than in the OVX group. BALP and osteocalcin levels were significantly higher in the OVX with Wnt group compared to the control and OVX groups. β-catenin expression was significantly lower in the OVX group than in the other two groups. Based on these results, we hypothesized that Wnt3a-producing fibroblasts may be effective for the induction of bone formation.

4P - Influence of anthracycline- and/or taxane-based chemotherapy on bone metabolism of patients with primary breast cancer

Background: Cancer therapy-induced bone loss (CTIBL) is well-known sequela of adjuvant endocrine therapy in postmenopausal patients (pts) with primary breast cancer (PBC). Pts exposed to chemotherapy (Ctx) with alkylators for lymphoma/leukemia own a high risk of premature CTIBL which as in premenopausal PBC pts may be mainly an indirect endocrine effect of Ctx. In contrast, data on direct effects of modern perioperative Ctx on bone metabolism are limited. This retrospective study was initiated to gain more detailed insights into the influence of perioperative anthracycline (A)- and/or taxane (T)-based Ctx on bone turnover of pts with pre- and postmenopausal PBC.Methods: A total of 109 pts (premenopausal: 49; postmenopausal: 60) receiving neoadjuvant or adjuvant A- and/or T-based Ctx were included. Serum markers of bone metabolism including C-telopeptide of type I collagen (ICTP) indicating the osteoclast activity, N-propeptide of type I collagen (P1NP) indicating the osteoblast activity, and bone alkaline phosphatase (BALP) were determined at baseline and prior to each subsequent Ctx cycle (C) up to C6. Changes of ICTP, P1NP, and BALP over time were analyzed by repeated-measure ANOVA.Results: A total of 600 Ctx cycles were analyzed. Baseline levels of ICTP, P1NP, and BALP were significantly higher in post- versus premenopausal pts. ICTP and BALP did not significantly change during Ctx. Both an increase of ICTP from baseline until C6 in premenopausal pts and a decrease in postmenopausal pts did not reach statistical significance. In contrast, P1NP significantly declined in postmenopausal pts from baseline to C6 (p = 0.0152). In premenopausal pts, P1NP declined from baseline to C3 and then increased until C6. These changes were highly significant (p = 0.0024).Conclusion: Our study demonstrates that A- and/or T-based Ctx for PBC exhibits direct effects on bone metabolism. In postmenopausal pts, Ctx was associated with a sustained suppression of osteoblast activity. In premenopausal pts, early osteoclast suppression completely recovered during C4-6. Whether these effects will translate into an increased risk to further develop CTIBL needs to be clarified by long-term observations.Disclosure: All authors have declared no conflicts of interest. Background: Cancer therapy-induced bone loss (CTIBL) is well-known sequela of adjuvant endocrine therapy in postmenopausal patients (pts) with primary breast cancer (PBC). Pts exposed to chemotherapy (Ctx) with alkylators for lymphoma/leukemia own a high risk of premature CTIBL which as in premenopausal PBC pts may be mainly an indirect endocrine effect of Ctx. In contrast, data on direct effects of modern perioperative Ctx on bone metabolism are limited. This retrospective study was initiated to gain more detailed insights into the influence of perioperative anthracycline (A)- and/or taxane (T)-based Ctx on bone turnover of pts with pre- and postmenopausal PBC. Methods: A total of 109 pts (premenopausal: 49; postmenopausal: 60) receiving neoadjuvant or adjuvant A- and/or T-based Ctx were included. Serum markers of bone metabolism including C-telopeptide of type I collagen (ICTP) indicating the osteoclast activity, N-propeptide of type I collagen (P1NP) indicating the osteoblast activity, and bone alkaline phosphatase (BALP) were determined at baseline and prior to each subsequent Ctx cycle (C) up to C6. Changes of ICTP, P1NP, and BALP over time were analyzed by repeated-measure ANOVA. Results: A total of 600 Ctx cycles were analyzed. Baseline levels of ICTP, P1NP, and BALP were significantly higher in post- versus premenopausal pts. ICTP and BALP did not significantly change during Ctx. Both an increase of ICTP from baseline until C6 in premenopausal pts and a decrease in postmenopausal pts did not reach statistical significance. In contrast, P1NP significantly declined in postmenopausal pts from baseline to C6 (p = 0.0152). In premenopausal pts, P1NP declined from baseline to C3 and then increased until C6. These changes were highly significant (p = 0.0024). Conclusion: Our study demonstrates that A- and/or T-based Ctx for PBC exhibits direct effects on bone metabolism. In postmenopausal pts, Ctx was associated with a sustained suppression of osteoblast activity. In premenopausal pts, early osteoclast suppression completely recovered during C4-6. Whether these effects will translate into an increased risk to further develop CTIBL needs to be clarified by long-term observations. Disclosure: All authors have declared no conflicts of interest.

Negative effect of serotonin–norepinephrine reuptake inhibitor therapy on rat bone tissue after orchidectomy

Our goal was to determine if venlafaxine has a negative effect on bone metabolism.Rats were divided into three groups. The sham-operated control group (SHAM), the control group after orchidectomy (ORX), and the experimental group after orchidectomy received venlafaxine (VEN ORX) in standard laboratory diet (SLD) for 12 weeks. Bone mineral content (BMC) was measured by dual energy X-ray absorptiometry (DXA). Bone marker concentrations of carboxy-terminal cross-linking telopeptide of type I collagen (CTX-I), osteoprotegerin (OPG), amino-terminal propeptide of procollagen type I (P1NP), bone alkaline phosphatase (BALP), sclerostin and bone morphogenetic protein 2 (BMP-2) were examined in bone homogenate. The femurs were used for biomechanical testing.Compared to the ORX group we found lower BMD in the diaphysis area of the femur in the VEN ORX group, suggesting a preferential effect on cortical bone. Of the bone metabolism markers, there was significant decrease (ORX control group versus VEN ORX experimental group) in BALP levels and increase in sclerostin and CTX-I levels, suggesting a decrease in osteoid synthesis and increased bone resorption.The results suggest that the prolonged use of venlafaxine may have a negative effect on bone metabolism. Further studies are warranted to establish whether venlafaxine may have a clinically significant adverse effect on bone.

Effect of Mirtazapine on Rat Bone Tissue after Orchidectomy

Objective: Our study aimed to investigate the effect of mirtazapine on bone metabolism in the orchidectomized rat model. Methods: Rats were divided into three groups. A sham-operated control group (SHAM group) and a control group after orchidectomy (ORX group) received the standard laboratory diet (SLD). An experimental group after orchidectomy (ORX MIRTA group) received SLD enriched with mirtazapine for 12 weeks. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry. Bone marker concentrations of osteoprotegerin (OPG), amino-terminal propeptide of procollagen type I, bone alkaline phosphatase (BALP), sclerostin and bone morphogenetic protein 2 were examined in bone homogenate. The femurs were used for biomechanical testing. Results: Compared with the control ORX group, we found a lower BMD in the ORX MIRTA group. The differences were statistically significant, although not in the lumbar vertebrae. BMD was lower in the MIRTA group, suggesting a preferential effect on cortical bone. However, although the thickness of the diaphyseal cortical bone was not different, the fragility in the femoral neck area was statistically significantly different between the groups in biomechanical testing. Regarding the bone metabolism markers, there was a significant decrease in OPG and BALP levels, suggesting a reduction in osteoid synthesis. Conclusions: The results suggest that prolonged use of mirtazapine may have a negative effect on the synthesis of bone and on its mechanical strength, especially in the femoral neck. Further studies are warranted to establish whether mirtazapine may have a clinically significant adverse effect on bone exclusively in the model of gonadectomized rats, or whether the effect occurs also in the model of gonadally intact animals and in respective human models.

Effects of silk fibroin hydrolysate on bone metabolism in ovariectomized rats

This study aimed to investigate the effects of silk fibroin on bone metabolism in ovariectomized rats. A total of 30 Sprague-Dawley rats were randomized into sham-operated (SHAM), ovariectomized control (OVX), alendronate (OVX+ALEN, 10 mg/kg body weight/d), low silk fibroin (OVX+SF100, 100 mg/kg body weight/d), and high silk fibroin (OVX+SF300, 300 mg/kg body weight/d) groups. All the rats were fed by gavage for 12 wk. At the end of 12 wk, blood and urine were collected for analysis of bone turnover markers, and bone mineral density (BMD) was measured by micro-computed tomography. The results show that the OVX group (p < 0.05) displayed the highest mean body weight gain. Among the five groups, serum levels of bone alkaline phosphatase (ALP) and urine levels of deoxypyridinoline (DPD) were highest in the OVX group (p < 0.05). Bone ALP levels in the ALEN group were significantly lower than that of the silk-treated groups. On the other hand, DPD levels were not significantly different between the ALEN and silk-fibroin-treated groups ( p < 0.05). The trabecular BMD was significantly higher in the ALEN and silk-treated groups compared to the OVX group ( p < 0.05). In conclusion, this study showed that silk fibroin has similar effects as alendronate, which is used in osteoporosis medication. Therefore silk fibroin might be a new candidate for the prevention and treatment of osteoporosis in patients.

Bone Regeneration Is Promoted by Orally Administered Bovine Lactoferrin in a Rabbit Tibial Distraction Osteogenesis Model.

Lactoferrin, an iron-binding glycoprotein which belongs to the transferrin family, has been shown to promote bone growth. However, reports regarding effects of lactoferrin on bone regeneration during distraction osteogenesis are limited. Our study was designed to investigate the effect of bovine lactoferrin treatment on bone formation of the distracted callus. We asked whether bovine lactoferrin enhances bone formation of the distraction callus as determined by (1) radiographic and histologic appearances; (2) dual-energy x-ray absorptiometry (DXA) analysis of bone mineral composition and bone mineral density; (3) micro-CT measures of trabecular architecture; and (4) biomechanical strength of the healing bone. Additionally, serology, reverse transcription (RT)-PCR, and immunohistochemistry were used to explore the possible mechanisms of bovine lactoferrin use on bone formation during distraction osteogenesis. Unilateral tibial osteodistraction was performed on 80 New Zealand White rabbits with a distraction rate of 1 mm per day for 10 days. Animals then were divided randomly into two groups: (1) vehicle and (2) bovine lactoferrin. At 4 and 8 weeks after completion of distraction, the animals were sacrificed. Lengthened tibias and serum samples were obtained and subjected to radiologic, DXA, micro-CT, histologic, and biomechanical examinations, and serum, RT-PCR and immunohistochemical analyses. Radiologic, DXA, micro-CT, histologic, and biomechanical examinations indicated that bovine lactoferrin treatment not only accelerated bone formation at early stages of distraction osteogenesis but also promoted bone consolidation at late stages. The ultimate force of the distracted calluses was increased by 37% (118.8 ± 6.65 N in the lactoferrin group and 86.5 ± 5.47 N in the vehicle group; p < 0.001) and 84% (384.8 ± 18.4 N in the lactoferrin group and 209.0 ± 15.2 N in the vehicle group; p < 0.001) at 4 and 8 weeks, respectively. Moreover, serum analysis showed that bovine lactoferrin treatment significantly increased serum levels of bone alkaline phosphatase and decreased serum levels of tartrate resistant acid phosphatase 5b. In addition, RT-PCR and immunohistochemical analyses suggested that bovine lactoferrin treatment induced a lower receptor activator of nuclear factor-kappaB (RANK) ligand/osteoprotegerin (RANKL/OPG) ratio in the distracted callus. The results of our study suggest that bovine lactoferrin treatment could promote bone regeneration during distraction osteogenesis in the rabbit. The results indicate that the OPG/RANKL/RANK system might be a major mechanism for increased bone formation and decreased bone resorption in distraction osteogenesis with bovine lactoferrin treatment. Oral administration of bovine lactoferrin may provide a feasible approach for promoting osteogenesis during distraction osteogenesis.

Quantitative analysis of factors influencing tissue-engineered bone formation by detecting the expression levels of alkaline phosphatase and bone γ-carboxyglutamate protein 2.

Bone tissue engineering is a promising alternative approach that permits the efficient reconstruction of bone defects. There are four elements involved in bone tissue engineering technology, including the seed cells, growth factors, scaffolds and culture environment. The aim of the present study was to evaluate the effect of these factors on bone formation in tissue engineering technology by analyzing the expression of osteogenetic markers using polymerase chain reaction (PCR). Bone marrow mesenchymal stem cells (BMSCs) were extracted from the bone marrow of the bilateral tibial platform of New Zealand white rabbits. In addition, platelet-rich plasma (PRP) samples were prepared from blood extracted from the ear vein of the rabbits. A perfusion bioreactor was used to provide the culture environment, and β-tricalcium phosphate (β-TCP) was used to build the scaffolds. The β-TCP scaffolds were divided into five groups and each group was treated with a different combination of the factors. Next, the composites were implanted into the rabbits. After three months, the expression levels of the new bone formation markers, alkaline phosphatase and bone γ-carboxyglutamate protein 2, were detected using quantitative reverse transcription-PCR analysis. The expression levels of the markers in the experimental groups were higher compared with the negative control group. Comparisons between the experimental groups also revealed statistical significance. Scanning electron microscopy revealed good adhesion and distribution of the BMSCs on the β-TCP scaffold. In conclusion, the PCR results indicated that PRP, BMSCs and the bioreactor exhibited a promoting effect on bone formation.

Associations between IGF-I, IGF-binding proteins and bone turnover markers in prepubertal obese children.

To assess the relationships between components of the growth hormone axis, body composition, and bone markers in obese children. We determined the levels of bone alkaline phosphatase (BALP), C-terminal telopeptide of type I collagen (CTX-I), insulin-like growth factor-I (IGF-I), and IGF-binding proteins (IGFBPs) by immunoenzymatic methods, and body composition by dual-energy X-ray absorptiometry in 45 obese and 20 non-obese children. IGF-I and functional IGFBP-3 levels, IGF-I/total IGFBP-3, and functional IGFBP-3/total IGFBP-3 molar ratios were significantly higher in obese patients than in controls. Multivariate regression analysis in obese patients showed significant associations of BALP with IGF-I (p=0.047) and percent of body fat mass (p=0.002). The relationship of IGF-I and functional IGFBP-3 to BALP may support the concept of IGF-I influence on accelerated bone formation process in obesity. Moreover, IGF-I and percentage of body fat mass may be significant predictors of BALP in obese during the prepubertal period.

Paget's Disease in Mandible: A Rare Occurrence in an Indian Sub-Continent.

Female patient aged 50-year-old reported an extra oral swelling of lower jaw since 7 months. Broadening and widening of lower third of the face, with thick & incompetent lower lip seen [Table/Fig-1]. Swelling was nontender in the anterior alveolar bone with expanded cortical plates & no mobility of tooth felt after palpation [Table/Fig-2]. Orthopantomogram (OPG) showed irregular radiolucent areas with interspersed radio opacities confined to the anterior and body of mandible, hypercementosis of lower anterior teeth and resorption of roots [Table/Fig-3]. CT scan showed enlarged entire mandible with irregular intra medullary lytic lesion suggestive of fibrous dysplasia/ Paget’s disease [Table/Fig-4]. Incisional biopsy showed features of PD. The presence of irregular areas of bone formation with osteoblastic rimming of bone seen with haematoxylin and eosin stain at 10x and 20x magnifications [Table/Fig-5a,b]. The haematoxyphilic reversal lines seen within most of the areas of bone formation with vascular fibrous connective tissue with amount of inflammatory cell infiltrate at 10X and 20X magnifications [Table/Fig-6a,b]. Whole body bone scintigraphy performed using injection of 20m Ci Tc-99m MDP confirming increased tracer uptake in the mandible only [Table/Fig-7]. Mild increase in alkaline phosphatase (173 IU/L) seen. Based on these facts diagnosis of PD rendered and referred to an endocrinologist for medical management. Treatment was started with Tab. Risedronic acid 35mg orally once every day for two months. Posttreatment scintigraphy showed decreased tracer uptake in the mandible suggestive of good response to treatment [Table/Fig-8]. Patient followed up for more than 20 months successfully. Every six months patient asked for further follow up. [Table/Fig-1]: Pre-treatment frontal photograph showing facial asymmetry [Table/Fig-2]: Pre-treatment Intraoral view showing expanded cortical plates [Table/Fig-3]: Orthopantomogram showing irregular radiolucent areas with inter­spersed radio opacities [Table/Fig-4]: Computerised tomography scan of axial view of mandible showing irregular intra medullary lytic lesion [Table/Fig-5a&b]: Haematoxylin and eosin staining of Biopsy specimen at 10X & 20X magnification showing irregular areas of bone formation respectively [Table/Fig-6a&b]: Microscopic picture of biopsy specimen showing haematoxyphilic reversal lines with fibrous vascular connective tissue. At 10X & 20 X magnification respectively [Table/Fig-7]: Pretreatment bone scintigraphy showing increased tracer uptake [Table/Fig-8]: Post-treatment bone scintigraphy showing reduced tracer uptake PD is disorder of the skeleton results in enlarged & deformed bones. PD showed predilection of male-to-female (3:2) ratio. PD is rare in India, China and Malaysia [1]. Some studies suggested an association of Vitamin D deficiency [2] & viral infection inclusion bodies resembling paramyxovirus nucleocapsid particles in Paget’s osteoclasts [3]. It may present as a coincident with hyperparathyroidism. The bone shows ground glass appearance during early osteolytic stage, later during osteoblastic stage bone gives ‘cotton wool ’ appearance on X-ray film [3]. Pulp chambers of tooth may be calcified, loss of lamina dura and hypercementosis of roots seen [4]. On the other hand during lytic phase of PD root resorption may occur associated with loosening of teeth [5]. Diagnosis is based on clinical, radiographic, bone scintigraphy and histologic features. Deformity involving skull or bowing of long bones which may result in fracture and neurological signs like deafness, cranial nerve palsies and even neoplastic transformation should be examined by plain radiographs [6]. The biochemical values of total plasma alkaline phosphatase activity is elevated in 85% of patients with untreated PD [7] but in our case marginal increase seen. Management mainly aimed at symptomatic (pain control) and specific treatment (Calcitonin, Bisphosphonates). Intravenous bisphosphonates pamidronate, oral alendronate, oral residronate [8] normalize high levels of bone alkaline phosphatase. In our patient residronate 30mg/day for 2months was advised followed by whole body bone scan which showed marked decrease uptake of isotope and biochemical values are within normal limits. Residronate appeared to have excellent safety profile and well-tolerated [8]. PD is considered to be very rare in Indian subcontinent. Its typical clinical features when it involves the maxillofacial region should lead to a high degree of suspicion to arrive at a diagnosis with unknown aetiology. Residronate appeared to have excellent results. Physicians should be aware of the potential for hypocalcemia when patients with polyostotic PD and markedly elevated indicators of bone remodelling are initiated with powerful anti-resorptive therapy.

Osteoprotective effect of extract from &amp;lt;i&amp;gt;Achyranthes&amp;lt;/i&amp;gt; japonica in ovariectomized rats

This study was carried out to investigate the effects of the Achyrantes japonica (A. japonica) extract on serum level of hormones from osteoporosis induced ovariectomized rats. Two month-old rats were ovariectomized (OVX), remained untreated for 8 weeks, and were subsequently administered A. japonica (300 mg/kg) every day for 8 weeks. We examined the effects of treated A. japonica every 10 days on ovariectomy-related changes in Insulin-like Growth Factors (IGF), Insulin-like Growth Factor binding protein-3 (IGBF-3), Estrogen, Calcium, and Phosporus. After 8 weeks, the serum levels of IGF-I, -II, and IGFBP-3 were higher presented as compared to the other two groups (P< 0.05), in the A. japonica extract treatment on OVX rats. Bone alkaline phosphatase levels were increased through A. japonica extract treatment in OVX rats compared to the other two groups. There were no differences between OVX and A. japonica extract treated OVX rats in serum levels of estrogen, but estrogen levels for the sham group were higher than for the other two groups. A. japonica extract is increased to serum levels of IGFs and IGFBP-3 of osteoporosis induced by ovariectomized rats. Thus, the results reveal that the A. japonica extract is a possible role for improvement of osteoporosis induced-ovariectomized rats and has a great potential as an alternative tool for the treatment of osteoporosis.

Adipose tissue-derived stem cells in the ovariectomy-induced postmenopausal osteoporosis rat model

This study investigated the efficacy of adult adipose tissue-derived stem cells in restoring bone using an osteoporotic rat model. Thirty-six female Wistar rats (250–300 g, 12 weeks) were randomized into three equal groups: SHAM group (sham-operated), ovariectomy-induced (OVX) group and OVX with stem cell injection group (OVX with stem). Femur extraction and blood sampling were performed at 5, 6, 7 and 8 weeks. The proximal femoral metaphysis was scanned by micro-CT and evaluated for changes in various histomorphometric parameters. β-catenin expression was determined using H&E and immunohistochemistry. Bone metabolism was assessed using measurements of C-telopeptide of collagen type I (CTX), osteocalcin, and bone alkaline phosphatase (BALP). There was a trend for an increase in the bone mineral density (BMD), bone volume/trabecular bone volume (BV/TV) and trabecular number (Tb.N) in the OVX with stem group as compared with the OVX group, and decrease in the OVX with stem group as compared with SHAM group. The trabecular thickness (Tb.Th) and trabecular separation (Tb.Sp) of the OVX group were increased compared with those values in the SHAM and OVX with stem group. BALP levels were higher in the OVX group as compared with that in the other two groups and osteocalcin levels were highest in the SHAM group and slightly increased in the OVX with stem group as compared with the OVX group. This study may help us gain an understanding of the role of MSCs in the pathophysiology and treatment of osteoporosis.

Markers of Bone Metabolism in Obese Individuals Undergoing Laparoscopic Sleeve Gastrectomy.

Besides its advantages, bariatric surgery implicates a risk of nutritional deficiencies, which might result in impaired bone metabolism. We assessed the effect of laparoscopic sleeve gastrectomy (LSG) on blood markers of bone metabolism in obese patients during a 3-year observation period. In 39 obese patients (29 women, 10 men, mean BMI 51.8 ± 6.8 kg/m(2)) undergoing LSG, we measured blood concentrations of 25-hydroxyvitamin D (25(OH)D), calcium, parathyroid hormone (PTH), bone alkaline phosphatase (BAP), and N-telopeptides crosslinks (NTx) before LSG and up to 3 years postoperatively. Vitamin D and calcium supplementations were recorded. LSG caused an excess weight loss (EWL) of 54 ± 20 % after 3 years. Before surgery, we found decreased levels of 25(OH)D and calcium in 80 and 5 % of the subjects, respectively, while increased levels of PTH, BAP, and NTx were found in 39, 28, and 21 %, respectively. Mean levels of NTx and the prevalence of elevated levels of NTx increased within 2 years (p < 0.001 and p < 0.01). Neither mean blood concentrations of 25(OH)D, calcium, PTH, and BAP nor relative prevalence of deficiencies regarding these markers changed during the study period. The supplementation rates of calcium and vitamin D increased postoperatively. Morbid obesity is associated with pronounced changes of markers of bone metabolism; LSG did neither aggravate nor ameliorate vitamin D metabolism within a 3-year time period, but led to increased bone resorption 2 years postoperatively. Routine supplementation of calcium and vitamin D is not likely sufficient to compensate the obesity-associated deficiencies in bone metabolism.

Expressions and clinical significance of serum bone Gla-protein, bone alkaline phosphatase and C-terminal telopeptide of type I collagen in bone metabolism of patients with osteoporosis.

Objective:This study aimed to evaluate the expressions and clinical significance of bone Gla-protein (BGP), bone alkaline phosphatase (B-ALP) and C-terminal telopeptide of type I collagen (CTX) in patients with osteoporosis (OP), and to provide evidence for developing individualized treatment plans.Methods: Seventy-two OP patients in our hospital were selected as an OP group, and another 72 healthy subjects were used as a control group. Their BGP, B-ALP and CTX levels as well as bone mineral density (BMD) values were measured. The correlations between BGP, B-ALP and CTX levels and BMD values were determined.Results:The BGP level of the OP group [(5.61±5.52) ng/ml] was significantly higher than that of the control group (P<0.05), but the levels of B-ALP and CTX did not differ significantly (P>0.05). The BMD values of femoral neck and Ward's triangle in the OP group were negatively correlated with the B-ALP levels (P<0.05). For women OP patients, the BMD values of femoral neck and Ward's triangle were also negatively correlated with the B-ALP levels (P<0.05). The BMD of femoral neck in the control group was negatively correlated with the CTX level (P<0.05).Conclusion:Determining BGP, B-ALP and CTX levels can evaluate the bone metabolism degree, which provides evidence for clinical typing of OP and developing treatment strategies.

PS-094 The Levels Of Bone Alkaline Phosphatase And Human Epidermal Growth Factor Receptor-2 In Patients With Osteosarcoma

Background and aims Osteosarcoma (OS) is a primary malignant bone tumour, deriving from primitive bone-forming mesenchyme and characterised by the production of osteoid tissue or immature bone. The importance of bone alkaline phosphatase (BALP) and human epidermal growth factor receptor-2 (HER-2) as prognostic markers is still discussed. The aim of this study was to investigate serum levels of BALP and HER-2 in patients with OS during clinical treatment. Methods We studied 22 patients (5 girls, 17 boys) at the age 7–20 years with osteosarcoma treated at the Institute of Mother and Child in Warsaw. All patients were evaluated for the serum levels of BALP and HER-2 before treatment onset, during pre- and postoperative chemotherapy and after termination of treatment. Healthy children (n = 22) were the reference group. The levels of BALP and HER-2 were measured using immunoenzymatic methods. Results The values of BALP and HER-2 proteins were higher (p Conclusions Our results demonstrate different pattern of BALP and HER-2 proteins during clinical treatment. However, low values of both markers during therapy may characterise remission of disease and favourable prognosis for patients with OS. Further longitudinal studies are necessary to confirm the prognostic values of BALP and HER-2 proteins in this group of patients.

Osteoporosis and FRAX risk in patients with liver cirrhosis

BackgroundHepatic osteodystrophy is any bone disease in patients with chronic liver disease. To measure bone mineral density (BMD) T-score by bone densitometry (BD) is used, classifying the disease in osteopenia, osteoporosis and severe osteoporosis. There are not criteria for monitoring and detection of osteodystrophy in cases of non-cholestasic cirrhosis. To determine the risk of fracture at 10 years, Fracture Risk Assessment Tool (FRAX), could be useful. ObjectivesDetermine the frequency of hepatic osteodystrophy in cirrhotic patients according to BD and FRAX and identify associated risk factors. Patients and methodsAn observational, analytic, cross-sectional study. We included cirrhotic patients with report of DO and FRAX. Results52 patients were included, 38 were female (73.1%). The mean age was 12.29±55.46 year-old, MELD 4.14±11.71. In cholestatic etiology Mayo Score was 2.9±3.31. The BMD was 0.756±0.1896mg/ cm 2 and T-score -2.34±1.0. Of all patients, 26 (50%) had ranges of osteopenia and 21 (40.4%) of osteoporosis. Fracture risk with FRAX 10-year was 7.77±6,713, and when we added the value of T-score fracture risk was 13.72±12. Higher prevalence of cholestatic diseases in women and viral etiology in men (P=0.006) was observed. There was significant relationship between cholestatic etiology T-score, alkaline phosphatase, and elderly and FRAXS with T-score (P=<0.05). Vitamin D was lower in patients with cholestatic liver disease (P=0.047) and a trend towards lower value of FRAX in patients with cholestatic liver disease was observed. ConclusionsThe frequency of osteoporosis or osteopenia is 90.4% in Mexican patients with liver cirrhosis of different etiologies. The decreased levels of bone alkaline phosphatase and 25-hydroxyvitamin-D were correlated with the risk of bone disease in patients with liver cirrhosis.

Biochemical markers of bone metabolism in breast cancer.

The relationship between biochemical markers of bone resorption (C-terminal telopeptide, deoxypyridinoline, tartrate-resistant acid phosphatase 5b) and osteosynthesis (bone alkaline phosphatase) and clinical manifestations of bone metastases were studied in 239 patients with breast cancer with and without signs of bone involvement. High levels of C-terminal telopeptide and bone alkaline phosphatase were associated with poor prognosis: more severe skeletal complications and lesser survival values. These biochemical markers can be used for prognosis and optimization of therapy for bone metastases in patients with breast cancer.

Pre-transplantation and post-transplantation serum bone alkaline phosphatase levels in renal transplant patients

Bone Alkaline Phosphatase (BAP) reflects the biosynthetic activity of the osteoblasts. End-stage renal disease and renal transplantation have effects on bone metabolism. The aim of this study was to evaluate serum BAP levels in pre-transplantation (pre-tx) and post-transplantation (post-tx) samples obtained from patients who underwent a renal transplantation. Forty end-stage renal disease patients (16 male and 24 female) undergoing transplantation and 40 healthy individuals (20 female and 20 male) volunteered for this study. The serum samples were obtained before the onset of immunosuppressive treatment and two months after renal transplantation. Serum BAP levels were measured by Ostease Kit (Beckman Coulter, California, USA) at DXI 800 immunoassay autoanalyzer. There were significant differences between control group and pre-tx group (p=0.015) and between control group and post-x group (P<0.001). The serum BAP levels were lower in the post-tx group than that of the control group the control group, but this difference was not statistically significant (p=0.023). These results suggest that osteoblast activity is suppressed during chronic renal failure and transplantation worsens osteoblastic inactivity, thus causing to enter a non-dynamic state the bone. BAP may be a useful parameter for assessing the metabolic status of bone before and after renal transplantation.

Determinants of vitamin D levels in children, adolescents, and young adults with juvenile idiopathic arthritis.

Deficiency of 25-hydroxyvitamin D [25(OH)D] is reported to be common in patients with rheumatoid arthritis (RA); data in patients with juvenile idiopathic arthritis (JIA) are inconsistent. We assessed serum 25(OH)D in children, adolescents and young adults with JIA, in order to identify the risk factors for vitamin D deficiency in patients with JIA. We evaluated 152 patients with JIA: 115 female, 37 male, mean age 16.2 ± 7.4 yrs; evaluated by onset type, 96 had oligoarticular, 35 polyarticular, 7 systemic, and 14 enthesitis-related arthritis (ERA). Patients were compared with a control group matched for sex and age. All patients and controls underwent laboratory tests of plasma 25(OH)D, parathyroid hormone (PTH), calcium, phosphorus, and bone alkaline phosphatase levels, and dual-energy x-ray absorptiometry examination. Patients with JIA showed significantly reduced 25(OH)D levels compared to controls (p < 0.001), even divided into subtypes (oligoarticular, p < 0.05; polyarticular, p < 0.005; systemic, p < 0.001; ERA, p < 0.005). Patients with active disease and/or frequent relapses had significantly reduced 25(OH)D levels compared to patients with no active disease and no frequent flares (p < 0.005, respectively). Nevertheless, JIA patients had significantly higher PTH levels compared to controls (p < 0.0001). JIA patients with 25(OH)D deficiency showed a significantly lower bone mineral apparent density than those with normal 25(OH)D levels (p < 0.001). JIA patients have reduced 25(OH)D and higher PTH values. This may explain at least in part why JIA patients, despite more effective current drugs, do not achieve bone-normal condition over time. JIA patients with more severe disease could require higher supplementation of vitamin D to maintain normal 25(OH)D serum levels. Longterm studies are needed to investigate the relationship between serum 25(OH)D levels and disease activity in JIA.