Carboxyterminal Telopeptide Of Type Research Articles

Markers of bone turnover and biomechanical properties of the third metacarpal bone of growing pigs subjected to the different dietary phosphorus and calcium content

Abstract Eighteen weaned piglets were subjected to deficiency, adequate or excess of dietary phosphorus and calcium (group C−50, C and C+50, respectively) during growth from 33 to 110 day of age. However, the ratio of calcium/digestible phosphorus in all feeds was the same and consistent with the nutritional recommendation. Performance, bone growth, concentration of osteocalcin (OC) and carboxyterminal telopeptide of type I collagen (CTX-I), densitometry, geometry and mechanical properties of the 3rd metacarpal bone were measured. Growth rate and final body weight did not differ between C and C+50 animals, however, they grew approximately 5.9% faster and were heavier by about 4.0% than C−50 pigs. In turn, mass and length of bones were similar in C−50 and C+50 groups, however, they were approximately 11% lighter and 4% shorter compared to C pigs. Serum content of OC took the following order: C−50 < C < C+50 group (P<0.01). Content of CTX-I did not differ between C and C+50 animals, however they were lower by 36% (P<0.01) than in the C−50 pigs. All measured geometry parameters (cortical wall thickness, cross section area and cortical index) did not differ between C and C+50 pigs and were higher than in C−50 pigs (P<0.01). Bones of C−50 pigs contained less minerals than bones of the C and C+50 pigs (5.24 g vs mean 6.14 g, P<0.01). The 3rd metacarpal bone mineral density (g/cm2) was the lowest in pigs in group C−50, higher in pigs in group C, and the highest in animals in group C+50 (0.398, 0.431 and 0.475, respectively, P<0.01). Maximum strength of bones was similar in the C and C+50 pigs, however it was 13% greater (P<0.01) compared to C−50 animals. In turn, elastic strength and elastic deflection did not differ between the C and C−50 animals and were over 20% lower (P<0.01) than in the C+50 pigs. Whereas, there was no significant difference between groups in bone stiffness (mean 27.13 mm). The results of the present study proved that even a strong excess of phosphorus and calcium content in the diet for growing pigs is inadvisable and does not improve performance and bones parameters. While excessively lowering the dietary phosphorus and calcium concentration (e.g. to reduce environmental pollution) may adversely affect growth rate and bone characteristics.

Prenatal but not continued postpartum vitamin D supplementation reduces maternal bone resorption as measured by C-terminal telopeptide of type 1 collagen without effects on other biomarkers of bone metabolism

Vitamin D is a key regulator of bone mineral homeostasis and may modulate maternal bone health during pregnancy and postpartum. Using previously-collected data from the Maternal Vitamin D for Infant Growth (MDIG) trial in Dhaka, Bangladesh, we aimed to investigate the effects of prenatal and postpartum vitamin D3 supplementation on circulating biomarkers of bone formation and resorption at delivery and 6 months postpartum. MDIG trial participants were randomized to receive a prenatal;postpartum regimen of placebo or vitamin D3 (IU/week) as either 0;0 (Group A), 4200;0 (B), 16,800;0 (C), 28,000;0 (D) or 28,000;28,000 (E) from 17 to 24 weeks' gestation to 6 months postpartum. As this sub-study was not pre-planned, the study sample included MDIG participants who had data for at least 1 biomarker of interest at delivery or 6 months postpartum, with a corresponding baseline measurement (n = 690; 53 % of 1300 enrolled trial participants). Biomarkers related to bone turnover were measured in maternal venous blood samples collected at enrolment, delivery, and 6 months postpartum: osteoprotegerin (OPG), osteocalcin (OC), receptor activator nuclear factor kappa-B ligand (RANKL), fibroblast growth factor 23 (FGF23), procollagen type 1 N-terminal propeptide, (P1NP) and carboxy terminal telopeptide of type 1 collagen (CTx). Supplementation effects were expressed as percent differences between each vitamin D group and placebo with 95 % confidence intervals (95 % CI). Of 690 participants, 64 % had 25-hydroxyvitamin D concentrations (25OHD) <30 nmol/L and 94 % had 25OHD < 50 nmol/L at trial enrolment. At delivery, mean CTx concentrations were 27 % lower in group E versus placebo (95 % CI: −38, −13; P < 0.001), adjusting for enrolment concentrations. However, at 6 months postpartum, CTx concentrations were not statistically different in group E versus placebo (14 %; 95 % CI: −5.3, 37; P = 0.168), adjusting for delivery CTx concentrations. Effects on other biomarkers at delivery or postpartum were not statistically significant. In conclusion, prenatal high-dose vitamin D supplementation reduced bone resorption during pregnancy, albeit by only one biomarker, and without evidence of a sustained effect in the postpartum period. However, further evidence is needed to substantiate potential maternal bone health benefits of vitamin D in the postpartum period.

THU605 Impact Of Abnormal Circadian Cortisol Secretion On Bone Metabolism In Patients With Mild Autonomous Cortisol Secretion

Abstract Disclosure: J. Saini: None. R. Nathani: None. S. Singh: None. V. Fell: None. E. Atkinson: None. S. Achenbach: None. S. Khosla: None. I. Bancos: None. Background: Previous studies reported that both cortisol secretion and bone metabolism biomarkers follow a circadian pattern of secretion. Patients with mild autonomous cortisol secretion (MACS) demonstrate an increased risk of fractures. As most patients with MACS do not have increased cortisol production, we hypothesized that abnormal circadian cortisol secretion is associated with impaired bone metabolism. Objective: To compare the circadian secretory pattern of bone metabolism biomarkers in relation to cortisol circadian secretion in patients with MACS versus referent subjects. Methods: We conducted a pilot cross-sectional study of patients with MACS and referent subjects. MACS was diagnosed in patients with adrenal adenomas based on an abnormal 1 mg dexamethasone suppression test (cortisol &amp;gt;1.8 mcg/dL). Referent subjects with available abdominal imaging within 5 years and adrenal disorder were recruited from the community. Participants were admitted to the clinical research unit for blood sampling every 2 hours over 24h period. Measurements included total and free cortisol, calcium, parathyroid hormone (PTH), osteocalcin, amino-terminal propeptide type 1 collagen (PINP), and carboxy-terminal telopeptide of type 1 collagen (CTX). Subjects with disorders or medication affecting bone metabolism were excluded. Time periods of blood draw were categorized into the morning (6 to 12 hours), afternoon (14-18 hours) and night (20-2 hours). Delta (morning measurements/afternoon measurements) was calculated. Results: Subjects included 12 patients with MACS (median age 57, IQR 48-67, 83% women) and 10 referent subjects (median age 57, IQR 50-63, 80% women). The 24-hour area under the curve for total (10342 vs 9090 mcg/dL, p=0.468) and free cortisol (437 vs 329 mcg/dL, p=0.086) was no different between patients with MACS and referent subjects. However, the mean night total (6.7 vs 4.3 mcg/dL, p=0.056) and free cortisol (0.2 vs 0.1 mcg/dL, p=0.035) was higher in MACS vs referent subjects. The area under the curve for calcium, phosphorus, CTX, osteocalcin and PINP were similar between patients and referent subjects, however, the area under the curve for PTH was higher in patients vs referent subjects (mean 64179 vs 42602 pg/mL, p=0.021). Both delta total cortisol (mean 8.6 vs 5.5, p=0.01) and delta PTH (mean -1.5 vs 4.2, p=0.051) was higher in referent subjects vs patients with MACS. Conclusion: When compared to referent subjects, patients with MACS have similar 24-hour cortisol production but demonstrate an increase in night-time cortisol secretion and a blunting of diurnal cortisol (lower morning/afternoon cortisol). Patients with MACS have higher PTH production overall, as well as an abnormal diurnal PTH secretion. Noted abnormalities in PTH may contribute to the MACS-associated impairment in bone health. Presentation: Thursday, June 15, 2023

Assessment of connective tissue metabolism in patients with head and neck malignancies treated with radiotherapy.

&lt;br&gt;&lt;b&gt;Introduction:&lt;/b&gt; Despite the use of highly specialized irradiation techniques in the treatment of head and neck tumors, it is still impossible to selectively destroy cancer cells without damaging normal structures, including connective tissue cells.&lt;/br&gt; &lt;br&gt;&lt;b&gt;Aim:&lt;/b&gt; The aim of the study was to analyze the concentration of degradation markers such as collagen type I (carboxyterminal telopeptide of type I collagen; ICTP) and elastin (elastin-derived peptides; EDPs) as well as selected metalloproteinases (MMP-1, MMP-2, MMP-9) in patients with head and neck malignancies undergoing radiotherapy.&lt;/br&gt; &lt;br&gt;&lt;b&gt;Material and methods:&lt;/b&gt; The test group consisted of 56 men, who underwent radical or palliative radiotherapy. The concentrations of ICTP, EDPs, MMP-1, MMP-2, MMP-9 were determined in three blood samples collected from patients prior to radiotherapy, immediately after its completion and 3 months after the therapy.&lt;/br&gt; &lt;br&gt;&lt;b&gt;Results&lt;/b&gt;: Both radical and palliative radiotherapy contribute to a significant increase in the concentration of EDPs. At the time of healing of post-irradiation lesions, the level of EDPs was reduced in both groups. The ICTP concentration was not affected by radiotherapy. No significant differences were observed in the concentration of MMP-1 and MMP-2 before and after radiotherapy. Radical radiotherapy caused a statistically significant late reduction in the concentration of MMP-9. The lowest concentrations of MMP-1, MMP-2, MMP-9 in the serum of patients qualified for palliative radiotherapy were recorded in a samples collected three months post-irradiation.&lt;/br&gt; &lt;br&gt;&lt;b&gt;Conclusions:&lt;/b&gt; The degradation markers of key extracellular matrix structural proteins may be helpful tools in the objective assessment of radiation-induced injuries to the connective tissue.&lt;/br&gt.

Sleep characteristics and parameters of bone turnover and strength in the adult population: results from the Study of Health in Pomerania-TREND.

Poor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania-TREND underwent laboratory-based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino-terminal propeptide of type 1 procollagen (P1NP) and carboxy-terminal telopeptide of type 1 collagen (CTX) were measured. Cross-sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea-hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound-based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health.

Референтные уровни карбокситерминального телопептида коллагена I типа в сыворотке крови у жителей Украины разного возраста и пола

Целью исследования является определение референтного уровня карбокситерминального телопептида коллагена I типа (β-CTX) в сыворотке крови у практически здоровых мужчин и женщин разного возраста, проживающих на территории Украины. Материалы и методы. В исследование были включены 4754 лица в возрасте 20–89 лет (4123 женщины (средний возраст — 59,6 ± 13,6 года) и 631 мужчина (средний возраст — 49,5 ± 16,3 года)). Всех участников распределили по возрасту на 7 групп по десятилетиям (от 20 до 89 лет), и три возрастные группы — 40–49, 50–59 и 60–69 лет — дополнительно разделили на подгруппы по пятилетиям. Также распределение пациентов проводили по геронтологической классификации возраста на 4 группы: молодой возраст — 20–44 года, средний — 45–59 лет, пожилой — 60–74 года и старческий возраст — 75–89 лет. Концентрацию β-CTX определяли в сыворотке крови методом электрохемилюминесцентного иммуноанализа ECLIA на анализаторе Сobas e 411. Результаты. Определено достоверное влияние возраста на вариабельность β-CTX в сыворотке крови: достоверное повышение уровня β-CTX с возрастом у женщин (p &lt; 0,00001) и снижение у мужчин (p &lt; 0,00001). Достоверно более низкий уровень β-CTX обнаружили у женщин в возрасте 20–29 (p &lt; 0,00001) и 30–39 лет (p &lt; 0,00001) по сравнению с мужчинами данного возраста. Однако у женщин 65–69 лет (p = 0,001) выявили достоверно более высокий уровень β-CTX в сыворотке крови по сравнению с мужчинами этой же возрастной группы. Выводы. Обнаружили связь уровня β-CTX в сыворотке крови с возрастом: у мужчин он достоверно снижается с возрастом, у женщин — достоверно повышается. У молодых мужчин в возрасте 20–44 года и женщин в возрасте 65–69 лет концентрация β-CTX была достоверно выше по сравнению с лицами противоположного пола этого же возраста. Полученные нами результаты в отношении уровня β-CTX у практически здоровых лиц разного возраста, проживающих на территории нашей страны, могут быть использованы как референтные показатели для населения Украины.

Уровни маркеров метаболизма костной ткани (N-терминального пропептида проколлагена I типа и β-терминального телопептида коллагена I типа) у жителей Украины в зависимости от пола и возраста

Целью исследования является определение уровня N-терминального пропептида проколлагена I типа (PINP) и карбокситерминального телопептида коллагена I типа (β-CTX) и их взаимосвязи в сыворотке крови у здорового населения Украины разного возраста и пола. Материалы и методы. В исследование было включено 3850 человек в возрасте 20–89 лет (3351 женщина (средний возраст 59,05 ± 13,89 года) и 499 мужчин (49,17 ± 15,8 года)). Всех участников распределили по возрасту в соответствии с геронтологической классификацией на 4 группы: молодой возраст — 20–44 года, средний — 45–59 лет, пожилой — 60–74 года и старческий возраст — 75–89 лет, а также на 7 групп по десятилетиям: от 20 до 89 лет. Концентрацию β-CTX и PINP в сыворотке крови определяли методом электрохемилюминесцентного иммуно­анализа ECLIA на анализаторе cobas e 411. Результаты. Выявлено достоверное влияние возраста на вариабельность β-CTX и PINP у мужчин (F = 6,64, р &lt; 0,001, и F = 4,93, р &lt; 0,001) и женщин (F = 16,17, р &lt; 0,001, и F = 10,46, р &lt; 0,001). У женщин по критерию Шеффе обнаружили достоверно более высокий уровень β-CTX в группе 80–89 лет по сравнению с группами 20–29 лет (р = 0,01), 30–39 лет (р &lt; 0,001), 40–49 лет (р &lt; 0,001), 50–59 лет (0,52 ± 0,27, р = 0,002), 60–69 лет (р = 0,001) и 70–79 лет (р = 0,04). Показатели PINP в группе 80–89 лет также были достоверно выше в сравнении с группами 30–39 лет (р &lt; 0,001), 40–49 лет (р &lt; 0,001), 50–59 лет (р = 0,009), 60–69 лет (р = 0,002) и 70–79 лет (р = 0,02). У мужчин обнаружили достоверное снижение концентрации β-CTX в группах: 30–39 лет (р = 0,02), 40–49 лет (р &lt; 0,001), 50–59 лет (р = 0,01) и 60–69 лет (р = 0,001) в сравнении с группой 20–29 лет. Уровень PINP был достоверно ниже в группах 40–49 лет (р &lt; 0,001) и 50–59 лет (р = 0,03) в сравнении с группой 20–29 лет. По результатам исследования, коэффициент корреляции между показателями концентрации PINP и β-CTX изменяется в зависимости от возраста и пола. Самые высокие коэффициенты корреляции среди обоих полов наблюдались в возрастных группах 40–49 (женщины: r = 0,74; мужчины: r = 0,64) и 50–59 (женщины: r = 0,74; мужчины: r = 0,66) лет; низкие коэффициенты корреляции у женщин наблюдались в возрастной группе 20–29 (r = 0,63) и 70–79 (r = 0,65) лет; у мужчин (r = 0,53) в возрасте 20–29 и 70–79 лет. Выводы. Выявлено достоверное влияние возраста на вариабельность β-CTX и PINP в сыворотке крови у мужчин и женщин. Наиболее высокая корреляционная связь между концентрациями β-CTX и PINP наблюдалась в группах 40–49 и 50–59 лет среди обоих полов. Полученные результаты могут быть использованы у практически здоровых мужчин и женщин Украины как референтные, а в будущем будут необходимыми для изучения метаболизма костной ткани при вторичном остеопорозе и его осложнениях.

Pancreatic Iron and Bone Health in Thalassemia Major

Background. It has been shown that serum ferritin and heart iron content are good indicators of bone mineral density (BMD) in patients with beta thalassemia major (TM). In the present study we explored for the first time the relationship between pancreatic iron and BMD and bone markers in TM.Methods. We considered 135 TM patients (68 M, mean age 37.79±7.74 years) enrolled in the MIOT (Myocardial Iron Overload in Thalassemia) Network. BMDs of the lumbar vertebrae (L1-L4) and femoral neck were measured by dual X-ray absorptiometry (DEXA) and were expressed as T-scores. Pancreatic iron overload was quantified by the T2* Magnetic Resonance Imaging (MRI) technique. Blood samples were collected for the measurement of bone formation markers (procollagen 1 amino-terminal propeptide-P1NP, osteocalcin and bone-specific-BAP alkaline phosphatise), bone resorption marker (carboxy-terminal telopeptide of type I collagen-CTX), calcium, and vitamin D.Results. Pancreatic T2* values were significantly associated to lumbar T-scores (R=0.207, P=0.017) as well as to femoral T-scores (R=0.242, P=0.005). The correlations remained significant also in patients without diabetes. Pancreatic iron (global pancreas T2*<26 ms) was detected in 8 patients. Patients with pancreatic iron showed significant lower lumbar T-scores (-2.61±0.89 vs -1.60±0.89; P=0.031) as well as femoral T-scores (-2.12±1.17 vs -1.03±0.97; P=0.009) and 7 of them (87.6%) had lumbar and femoral T-scores indicating osteopathy (osteopenia or osteoporosis).As regards as the markers, pancreatic T2* values were negatively correlated to BAP (R=-0.196 P=0.031) and positively correlated to vitamin D (R=0.220, P=0.014).Conclusion. A significant correlation, although not strong, was detected between pancreatic iron overload and bone disease. From a different point of view, our results support the role of endocrinopathies in thalassemic osteopathy and underline the critical role of a multi-disciplinary intervention in preventing bone complications. DisclosuresPepe:Chiesi Farmaceutici and ApoPharma Inc.: Other: Alessia Pepe is the PI of the MIOT project, that receives no profit support from Chiesi Farmaceutici S.p.A. and ApoPharma Inc.

Growth Hormone As Antiaging Factor in Old Bones.

Aging induces changes in bone. Growth hormone (GH) is reduced by aging, and age-related changes observed in old bones might be due to a decrease in the GH/insulin-like growth factor-I (IGF-I) axis. GH administration on aged individuals is controversial. This study aimed to assess the effect of systemic GH treatment on bone properties, bone metabolism, and bone mineral density (BMD) in long bone of old rats. Aged Wistar rats were treated with GH at a dose of 2 mg/kg/day during 10 weeks. Plasma osteocalcin, IGF-I, and carboxy-terminal telopeptide of type I collagen levels were measured. Cross-sectional bone areas and BMD were measured by morphometric and densitometric analysis, respectively. Femora were analyzed by three point-bending testing. t-Test was used for statistical evaluation. p < 0.05 was considered to be significant. Significantly enhanced bone area, at the expense of the cortical area, was found in treated rats. The densitometric analysis showed 11% higher BMD in the experimental group. Significantly higher bone flexural modulus, stiffness, and ultimate load were observed in the treated rats. Plasma osteocalcin and IGF-I levels were significantly increased in the treated group, while the resorption marker concentration remained unchanged. Within the limitations of this experimental study, systemic GH administration has shown to enhance biomechanical properties, BMD, cortical mass, and plasma IGF-I and osteocalcin in old treated rats, compared to the control group; consequently, GH could be considered as an alternative therapy against age-related changes in the bone.

Effects of competitive physical activity on serum irisin levels and bone turnover markers

BackgroundIrisin, a myokine, is a polypeptide derived from the cleavage of the extracellular domain of fibronectin domain-containing protein 5, a receptor that is present on different tissues (skeletal muscle, pericardium, myocardium, and brain), whose functions are not yet fully defined.PurposeThe main aim of our study was to evaluate the effect of competitive physical activity on serum irisin levels and bone turnover markers.MethodsFifteen male footballers and an equal number of subjects of the same age and gender, but with a predominantly sedentary lifestyle, had their serum levels of irisin and bone turnover markers measured. Bone mineral status was evaluated in both groups by quantitative bone ultrasound of the calcaneus. In addition, only in footballers, biochemical analyses were repeated after 3 months.ResultsWe did not observe significant differences in the serum levels of calcium, phosphorus, and parathyroid hormone between the two groups. The footballers had significantly higher quantitative bone ultrasound, 25-OH vitamin D, and creatinine values than the controls. There were also no significant differences in the bone alkaline phosphatase, carboxy-terminal telopeptide of type I collagen, osteoprotegerin, sclerostin or Dkk-1 values, while the irisin levels (+ 89%, p < 0.001) and RANKL were significantly higher in the footballers compared to those in the controls.ConclusionOur study shows that footballers have significantly higher serum irisin values than the general population. Irisin could be the "trait d’union" between bone health and physical activity.

Differential effects of abaloparatide and teriparatide on hip cortical volumetric BMD by DXA-based 3D modeling

SummaryIn postmenopausal osteoporotic women in ACTIVE, abaloparatide reduced fracture risk and increased areal bone mineral density (BMD) more than teriparatide at the hip and wrist. DXA-based 3D modeling showed significantly greater increases in hip cortical volumetric BMD with abaloparatide versus teriparatide. This may explain differences reported in aBMD by DXA.IntroductionIn ACTIVE, abaloparatide (ABL) increased bone mineral density (BMD) shown by dual-energy X-ray absorptiometry (DXA) while reducing fracture incidence in postmenopausal osteoporotic women. Changes in DXA BMD with ABL, 80 μg, were significantly greater than with open-label teriparatide (TPTD), 20 μg, at cortical sites including total hip, femoral neck, and 1/3 distal radius. The purpose of this study was to better understand the relative effects of ABL and TPTD on cortical and cancellous compartments in the proximal femur.MethodsHip DXA images from a subset of randomly selected patients in the ACTIVE trial (n = 250/arm) were retrospectively analyzed using three-dimensional modeling methods (3D-SHAPER software) to evaluate changes from baseline at months 6 and 18.ResultsSimilar significant increases in trabecular volumetric BMD (vBMD, + 9%) and cortical thickness (+ 1.5%) were observed with ABL and TPTD by 3D-DXA at 18 months. In contrast, only ABL significantly increased cortical vBMD versus baseline (+ 1.3%), and changes in both cortical vBMD and cortical surface BMD were significantly greater with ABL versus TPTD. In the TPTD group, changes in cortical vBMD were inversely correlated with changes in serum CTX (carboxy-terminal telopeptide of type I collagen) and PINP (procollagen type I N-terminal propeptide), suggesting that higher bone turnover may have attenuated cortical gains.ConclusionThese results suggest previously reported differences in areal BMD increases between ABL and TPTD may be due to differential effects on cortical vBMD. Further studies are warranted to investigate how these differences affect therapeutic impact on hip strength in postmenopausal women with osteoporosis.

Bone turnover markers to assess jawbone quality prior to dental implant treatment: a case-control study

BackgroundBone quality is as important as bone mineral density in terms of bone strength. Bone turnover markers (BTMs) are clinical indicators of bone quality. In implant dentistry, bone quality is considered equivalent to bone density on radiographic assessments. The purpose of this study was to determine whether the BTM values are reflected in jawbone condition by evaluating the relationship at baseline and during follow-up in patients with prosthodontic implants.Computed tomography (CT) scans were obtained and BTM (osteocalcin, bone-specific alkaline phosphatase, pyridinoline cross-linked carboxyterminal telopeptide of type I collagen, and crosslinked N-telopeptide of type I collagen) levels in blood samples were measured in partially edentulous eighteen patients before implant surgery. During the follow-up observation after implant surgery, marginal bone loss (MBL) was measured on dental radiography. We investigated the relationship between the presence of BTM abnormalities and radiographic bone density.ResultsMore women than men had abnormal BTM values. Bone turnover was accelerated in the group of women with abnormal BTM values. The density of cancellous bone at the implant placement site was significantly lower in the patients with abnormally high BTM values than in their counterparts with BTM values in the normal range.ConclusionsFemale patients who undergo implant treatments may have reduced bone quality; evaluations of bone strength will require assessments of both BTMs and the density of cancellous bone.

Associations of plasma YKL-40 concentrations with heel ultrasound parameters and bone turnover markers in the general adult population.

YKL-40, also known as chitinase-3-like protein 1, is a new proinflammatory biomarker, that might play a role in tissue remodeling and bone resorption. Here we evaluated the associations of the YKL-40 plasma concentration with heel ultrasound parameters and bone turnover markers (BTMs) in adult men and women from the general population. We tested for a causal role of YKL-40 on bone metabolism using published single nucleotide polymorphisms (SNPs) with consequences for YKL-40 expression and function. Data were obtained from two population-based cohorts: the Study of Health in Pomerania (SHIP) and SHIP-Trend. Quantitative ultrasound (QUS) measurements at the heel were performed and bone turnover was assessed by measurement of intact amino-terminal propeptide of type I procollagen (PINP) and carboxy-terminal telopeptide of type I collagen (CTX). Associations between the YKL-40 plasma concentration and the QUS-based parameters, bone turnover marker (BTM) concentrations and 44 SNPs, including the lead SNP rs4950928, were evaluated in 382 subjects. Furthermore, we assessed the associations between the same SNPs and the QUS-based parameters (n=5777) or the BTM concentrations (n=7190). Sex-specific linear regression models adjusted for a comprehensive panel of interfering covariantes revealed statistically significant inverse associations between YKL-40 and all QUS-based parameters as well as positive associations with CTX in women. The rs4950928 polymorphism was associated with YKL-40 in men and women but none of the tested SNPs was associated with the QUS-based parameters or the BTMs after correction for multiple testing. Plasma YKL-40 concentrations are associated with QUS-based parameters as well as CTX concentrations in women but these associations are probably not causal.

Bone Metabolism in Patients Treated for Depression.

Background: Depression and osteoporosis are severe public health problems. There are conflicting findings regarding the influence of depression on bone metabolism. The aim of the presented study was to compare bone turnover markers and vitamin D levels between patients treated for depression and healthy controls. Patients and Methods: We determined a concentration of osteocalcin, carboxy-terminal telopeptide of type I collagen (β-CTX), 25-hydroxyvitamin D (25OHD) and 1,25(OH)2D3 in 99 patients, aged 46.9 ± 11 years, treated for depression, as well as in 45 healthy subjects. Depressive status was determined with the Hamilton Depression Scale (HDRS). Results: In patients treated for depression, we demonstrated significantly lower osteocalcin concentrations (p < 0.03) and higher concentration of β-CTX (result on the border of significance; p = 0.08). Those relationship were stronger in women. The level of 25OHD and 1,25(OH)2D3 did not differ significantly between the examined groups. We observed a negative correlation between the 25OHD and HDRS score after treatment in all patients treated for depression and in subgroups of women and subjects with recurrent depression. Conclusions: Our results indicate that depression is related to disturbances in bone metabolism, especially in women and patients with recurrent depression, suggesting its role in context of osteoporosis development.

Mineral bone disorder and osteoporosis in hemodialysis patients

BackgroundBone disease is common in patients undergoing hemodialysis. It is the result of bone turnover abnormalities and the decrease of bone mineral density (BMD). We aimed to determine the usefulness of serum bone turnover markers and BMD measurement by dual-energy x-ray absorptiometry (DXA) in hemodialysis patients.MethodsWe conducted a cross-sectional study including 90 hemodialysis for more than 12 months. Bone mineral density was assessed by DXA. Peripheral blood samples were obtained from each patient before dialysis in a fasting state within a week of the DXA. Biochemical variables of calcium and phosphate were measured. One bone formation marker (bone-specific alkaline phosphatase (bAP), one bone resorption marker (carboxy-terminal telopeptides of type 1 collagen (CTX)) were measured. Total alkaline phosphatase (TAP), intact parathyroid hormone (PTH) and fibroblast growth factor 23 (FGF23) which is a bone-derived hormone were also measured.ResultsCTX values were 6.25 times higher than the normal limit of the assay. Bone alkaline phosphatase levels were less than 10 ng/mL in 28.8% of cases. 23% of patients have osteoporosis and 45% have osteopenia. Femoral BMD had negative correlations with age and PTH levels. FGF23 levels were significantly increased in patients with osteoporosis affecting the lumbar. The levels of bAP and CTX showed a positive correlation. Both circulating bAP and CTX levels showed also positive correlations with PTH levels. Fractures, observed in 12.2% of cases, were associated with low PTH values and the existence of osteoporosis.ConclusionsOur study showed that osteoporosis and fracture are common in dialysis patients. The reduced BMD was associated with advanced age and elevated levels of PTH. Markers of bone turnover and FGF23 may play a role in the diagnosis of bone disease in hemodialysis patients. DXA measurement is necessary for the monitoring for bone loss.

Effects of quercetin on the dentin resistance to erosion

Objective To evaluate the effects of quercetin on dentin resistance to erosion and provide evidence-based recommendations for the prevention and therapy of dental erosion. Methods One hundred and twenty-eight dentin samples were prepared from 50 extracted human wisdom teeth (collected from Department of Oral Surgery, School and Hospital of Stomatology). Ninety-six samples were randomly divided into 8 groups using the following different soaking solutions: deionized water, ethanol (control groups), 12.300 mg/L sodium fluoride, 0.120 mg/L chlorhexidine, 0.183 mg/L epigallocatechin gallate (EGCG), and 0.075, 0.150 and 0.300 mg/L quercetin. In each group, twelve specimen was prepared. Before daily acid challenge, the samples were immersed in the respective solutions for 2 min, rinsed with deionized water, and immersed in artificial saliva for 2 h. The samples were then subjected to 4 cycles of in vitro acid challenges. This protocol was applied for 7 d. The surface microhardness (SMH) and surface profiles were measured before and after erosion using the surface microhardness tester and contact profilometry, respectively. The change in surface profiles and reduction in SMH were used to calculate the substance loss and reduction percentage of SMH (SMH%) respectively. Scanning electron microscope (SEM) images were taken to observe the surface morphology of the samples. Additionally, another thirty two samples were divided into 8 groups (n=4) as mentioned above. The specimens were treated with 10% phosphoric acid and desiccated, immersed in the respective solutions for 2 min, rinsed, and immersed in the artificial saliva at 37 ℃ for 7 d. The content of cross-linked carboxyterminal telopeptide of type Ⅰ collagen (ICTP) in the soaking solutions were measure quantitatively. Results Compared with the control groups, the application of chlorhexidine, quercetin, and EGCG were effective in preventing the surface softening and substance loss of human dentin after erosion. More specifically, the specimens treated with 0.300 mg/L quercetin exhibited the lowest SMH% [(8.75±4.95)%], the lowest surface substance loss [(2.26±1.16) μm], and the lowest contents of ICTP in the soaking solution [(5.72±0.88) ng], showing significant differences to the chlorhexidine and EGCG treated samples (P 0.05). However, the specimens treated with 0.300 mg/L quercetin exhibited significantly lower SMH% than those treated with the other two concentrations of quercetin (P<0.05). Conclusions Within the limitations of the current study, immersion in the quercetin solution is effective in improving the dentin resistance to erosion by inhibiting the dentinal MMP. Among all the concentrations tested, 0.300 mg/L quercetin showed the best performance. Key words: Quercetin; Acid etching, dental; Tissue inhibitor of metalloproteinases; Dentin

The tendency of reduced periodontal destruction in acromegalic patients showing similar inflammatory status with periodontitis patients

Evaluate periodontal status of acromegalics through clinical and biochemical variables. Demographics, hormone and metabolic variables, periodontal variables, gingival crevicular fluid (GCF) volume, and content data were collected from 30 patients with acromegaly, 30 patients with periodontitis, and 20 healthy subjects and comparatively analyzed. GH differences between acromegaly (2.56 ± 4.86) and periodontitis (0.53 ± 0.95) (p < 0.001) were statistically significant. IGF-1 was lowest at periodontitis (113.31 ± 45.01) and lower (152.11 ± 45.56) at healthy group compared with acromegalics (220.38 ± 167.62) (p < 0.05). GH and IGF-1 had positive correlation (p < 0.05). IGF-1 and CAL had negative (p < 0.01) correlation except healthy group that showed the same correlation at the opposite direction (p < 0.05). Besides similar plaque and gingival indices with periodontitis, acromegalics showed relatively less CAL and GCF volume but except CAL, all their periodontal variables were higher than healthy subjects. GCF GH and prolactin showed higher values in acromegalics while healthy subjects showed relatively high interleukin-1, -10 and carboxyterminal telopeptide of type I collagen compared with others. Acromegalics have a tendency of slowed periodontal destruction with an influence of GH and IGF-1 to the inflammation- and collage metabolism-related mechanisms rather than bone-associated ones. However, this information must be confirmed with further studies exploring the mechanisms possibly bonded to others.

Effect of Prenatal and Postpartum Vitamin D Supplementation on Circulating Biomarkers of Maternal Bone Metabolism (P24-048-19)

ObjectivesTo estimate the dose-dependent effect of prenatal and postpartum vitamin D supplementation on circulating concentrations of biomarkers of maternal bone formation (osteoprotegerin [OPG], osteocalcin [OC], procollagen type 1 amino-terminal propeptide [P1NP], and OPG/RANKL ratio), bone resorption (receptor activator nuclear factor kappa-β ligand [RANKL], and carboxyterminal telopeptide of type 1 collagen [CTX]), and general markers of bone metabolism (fibroblast growth factor 23 [FGF23]), in a pregnancy cohort in Dhaka, Bangladesh. MethodsThis study is a sub-study of the Maternal Vitamin D for Infant Growth trial, a randomized controlled trial in which women were enrolled at 17–24 weeks gestation and randomized to one of five weekly oral vitamin D3 supplements or placebo regimens during pregnancy and up to 6 months postpartum: group A (placebo), group B (4200 IU/week), group C (16,800 IU/week), group D (28,000 IU/week), group E (28,000 IU/week during pregnancy and postpartum). Postpartum, all groups other than group E received placebo. Maternal venous blood samples were collected from MDIG participants at enrolment, delivery and 6 months postpartum. Concentrations of FGF23, CTX, and P1NP were determined using ELISAs and OPG, OC, and RANKL concentrations were determined using a Luminex/Millipore magnetic beads kit. For each biomarker (n range, 344 to 606), linear regression was used to compare each treatment group versus the placebo group adjusting for baseline concentrations. For delivery time point analyses, treatment groups D and E (same prenatal vitamin D dose) were combined, while in postpartum analyses the two groups were separated to estimate the postpartum effect. ResultsAt delivery and 6 months postpartum, there were no significant differences in OPG, OC, OPG/RANKL, RANKL, and FGF23 concentrations between each treatment group versus the placebo group (Table 1 and Table 2). ConclusionsVitamin D supplementation during the 2ndhalf of pregnancy and up to 6 months postpartum had no effect on markers of bone formation or resorption. Analyses for CTX are underway and will also be presented. Funding SourcesBill and Melinda Gates Foundation. Supporting Tables, Images and/or Graphs▪▪▪

The Effect Insulin Therapy and Metformin on Osteoporosis in Diabetic Post-Menopausal Iraqi Women

The aim of this study is to evaluate the effects of insulin therapy and metformin on osteoporosis (OP) in diabetic post-menopausal women. In this study, 200 individuals, aged (50–73) year. Control and patients were divided to four groups, each group containing 50 patients. Group (CG) were healthy post-menopausal, group (OP) were post-menopausal with OP, group (T2D insulin) were post-menopausal with diabetic and treated insulin once daily and group (T2D-metformin) were post-menopausal with diabetic and treated metformin (500 mg) twice daily. The results revealed that fasting blood glucose (F.B.G), hemostatic model assessment-insulin resistance (HOMO-IR), and bone mineral density (BMD) demonstrated a significant different in (T2D-insulin and T2D-metformin) group comparison with (OP) group. Serum insulin demonstrated a significant increase in (T2D-insulin) group comparison with (OP) group, While a significant reduce in (T2D-metfomin) group comparison with (OP) group. Whereas, the osteocalcin (OC) and carboxy-terminal telopeptides of type I collagen (CTXI) was a significant reduce in (T2D-insulin and T2D-metformin) group comparison with (OP) group. The final concluded that insulin therapy increases bone turnover biomarkers more than metformin therapy.

Reveromycin A Inhibits Bone Loss in Ovariectomized Mice

Background and objectives: Reveromycin A inhibits bone metastasis of lung cancer cells in natural killer cell-depleted immunodeficient mice with increasing apoptosis of osteoclasts. This knowledge suggests that reveromycin A is a potent inhibitor for osteoclasts in vivo. To determine the activity of bone loss in acute estrogen deficiency, we studied ovariectomized mice treated with reveromycin A. Materials and Methods: Eight-week-old female C57BL/6 mice were either ovariectomized or sham-operated. Reveromycin A was continuously administered for the first 2 weeks (Group RA) or the last 2 weeks (Group RP) using a subcutaneous mini osmotic pump. Mice were sacrificed 4 weeks after surgery. Inhibition was detected by images as well as serum carboxyterminal telopeptide of type I collagen (CTX). Results: BMD reduction in the RA group was significantly inhibited and was comparable with that in the sham group. In contrast, the RP group failed to inhibit BMD reduction. The plasma CTX level at the 28th day of the experiment was significantly increased in the RP and OVX groups compared with that in the sham group, while the increase was inhibited in the RA group. Morphometric analysis revealed that absorption of trabecular bone was strongly inhibited in the RA group. Conclusion: The inhibitory effects of reveromycin A administered immediately after ovariectomy was the most effective at the early phase of bone loss than at the later stage. A new reagent that inhibits bone loss in acute estrogen deficiency might be a new tool to experimentally study osteoporosis and may have clinical implications.