Changes In Bone Health Research Articles

Supplemental fish oil decreases urinary excretion of a marker of bone resorption in healthy adults

Background Incorporation of fish oil (FO) into the diet of rodents has been shown to result in positive changes in bone health. Currently it is poorly understood if FO has the same effects on bone health in humans. The purpose of this study was to determine the effects of supplemental FO on levels of urinary N-terminal cross-linked telopeptide (NTx), which is a marker of bone breakdown, and how this is related to the morning levels of salivary cortisol and urinary excretion of interleukin 6 (IL-6).

Bone-marker levels in patients with prostate cancer: potential correlations with outcomes

The skeleton is typically the first site of metastasis in patients with prostate cancer, and bone metastases can result in severe bone pain and potentially debilitating fractures. Although bone scans are a reliable means of assessing osteoblastic lesions, tools for monitoring early changes in bone health are lacking. Biochemical markers of bone turnover might fulfill this unmet need. Correlative studies have suggested that bone-marker levels may have utility in assessing disease progression and response to bone-directed therapy. Elevated levels of the markers, N-telopeptide of type I collagen and bone-specific alkaline phosphatase, are associated with higher rates of death and skeletal-related events in the bone metastasis setting. Marker levels also correlate with response to zoledronic acid treatment, and similar data with the investigational agent, denosumab, are emerging. Changes in bone-marker levels reflect alterations in skeletal homeostasis and can provide important insights into bone disease progression and response to bone-directed therapy in patients with prostate cancer. More mature data from currently ongoing clinical trials will provide further insight on the utility of marker assessments as an adjunct to established monitoring methods in prostate cancer.

Changes in bone health and skeletal-related events following implementation of a multidisciplinary consensus statement guiding surveillance and treatment of men undergoing androgen deprivation therapy for prostate cancer

Purpose. Androgen deprivation therapy (ADT) is a cornerstone for inhibiting progression of prostate cancer (CAP) and improving survival. After previously establishing that men with CAP treated with ADT at our institution had significant skeletal morbidity, we evaluate the effectiveness of a multidisciplinary consensus statement (MCS) to improve outcomes.Materials and methods. We reviewed the records of men treated with ADT in our clinic. Only 38% of men had BMD studies, and 81% of those men had bone loss. Twenty-four percent of men had skeletal-related events (SREs). A minority of men were being treated for bone loss. We decided not to initiate therapy soon enough, and implemented an MCS to guide surveillance and treatment.Results. Four years after implementing the MCS, half of the men were still being treated with ADT and the average treatment length doubled. Significantly more men were being screened, bone loss remained stable, and there was a trend towards decreased SREs. Significantly more men were being treated for bone loss.Conclusions. After implementing an MCS we show stable bone mineral density and a trend towards decreased SREs despite doubling of the treatment length. We document significant improvement in our practice pattern.

The effect of tai chi chuan on bone remodeling and cytokines among breast cancer survivors: A feasibility trial

9610 Background: Weight-bearing exercise may slow the rate of bone loss associated with breast cancer treatment. The purpose of this study is to determine the effect of tai chi chuan (TCC) on bone health, as measured by the changes in the levels of bone resorption and bone formation. This study also aimed to investigate whether changes in bone health were correlated with growth and inflammation markers that serve as regulators of bone cell function. Methods: Female patients (N=16) who completed treatment for breast cancer within the past 30 months were randomly assigned to either the TCC group or the psycho-educational support group without exercise (ST) for 60 minutes, three times a week for a period of 12 weeks. Serum levels of bone resorption (N-telopeptides of type I collagen; NTx) and bone formation (bone specific alkaline phosphatase; BAP) were determined by ELISA at baseline and post-intervention. Using validated methods, a bone remodeling index (BRI) was calculated from levels of NTx and BAP. In addition, pre- and post-intervention levels of insulin-like growth factor binding protein 1 (IGFBP-1) and interleukin-2 (IL-2), markers associated with excessive bone resorption, were measured. Lastly, levels of interleukin-6 (IL-6), believed to enhance bone formation, were measured at both pre- and post-intervention. Results: ANCOVA analyses demonstrated that survivors in the TCC group experienced a greater increase in bone remodeling than those in the ST group (Δ BRITCC=1.6 vs Δ BRIST=0.2; p=0.04). All correlations were determined by Pearson's correlation coefficients. IGFBP-1 was negatively correlated with increasing bone remodeling levels (r=-0.43, p=0.14). IL-2 was also negatively correlated with increasing bone remodeling levels (r=-0.35, p=0.24). IL-6 was positively correlated with increasing bone remodeling levels (r=0.69, p=0.01). Conclusions: This pilot study suggests that TCC has positive effects on bone remodeling through changes in growth and inflammation factors that regulate bone cell function. A larger, more definitive trial examining the influence of TCC on bone remodeling is warranted. Funding: Sally Schindel Cone and R25 CA102618 No significant financial relationships to disclose.

Postnatal “Speed of Sound” Decline in Preterm Infants: An Exploratory Study

"Speed of sound" (SOS), measured by quantitative ultrasound, is a noninvasive method of assessing bone status. At expected term and 1, 2, and 3 months of corrected age, bone status and body fat mass were assessed by quantitative ultrasound and by an air-displacement system in 53 preterm infants to explore whether longitudinal changes in bone health were influenced by body fat mass. SOS decreased within the first month of corrected age. Body fat mass increased significantly. No correlation between SOS and body fat mass was found. SOS was not influenced by changes in body fat mass. The decline in SOS may be ascribed to bone structure factors.

Longitudinal changes in bone health as assessed by the speed of sound in very low birth weight preterm infants

Longitudinal changes in bone health as assessed by the speed of sound in very low birth weight preterm infants

Longitudinal changes in bone health as assessed by the speed of sound in very low birth weight preterm infants

To assess longitudinal changes in speed of sound (SOS) in very low birth weight (VLBW) infants and investigate the relationship with markers of osteopathy of prematurity (OP) and clinical illness. Twenty-five infants were recruited. Eighteen infants, median gestation 27 weeks (range 24-32), median birth weight 957 g (range 625-1500 g), had serial scans. SOS was measured at both tibiae weekly until 35 to 37 weeks corrected gestational age (CGA). Initial median SOS standard deviation score (SDS) (Z) score was -0.07 (range-1.3-1.3). SOS correlated with gestation (r, 0.8, P<.005), and birth weight (r, 0.67, P<.005.) SOS fell from a median of 2923 m/s (2672-3107) at birth to 2802 m/s (2502-2991) at 35 to 37 weeks CGA (P<.05). This fall was greater in the 24- to 27-week gestation cohort with a median reduction of 2.2 SDS (1.6, 4.0) compared with 1.3 SDS (0.8-2.2) in those>28 weeks (P<.05). There was a negative correlation between SOS, at the end of the study, peak serum alkaline phosphatase (ALP) (r, 0.6, P<.05), CRIB (Clinical Risk Index for Babies)/CRIB II scores (both r, 0.6, P<.05), and duration of total parenteral nutrition (TPN) (r, 0.58, P<.05.) Although tibial SOS was within the expected range at birth, there was a subsequent failure to gain SOS, and this was most marked in infants of a lower gestation.