Osteocalcin In Patients Research Articles

Metabolic activity of bone tissue osteoblasts in patients with chronic pancreatitis

Objective — to investigate the level and role of osteocalcin in patients with chronic pancreatitis, to determine the dependence of changes in this indicator on the vitamin D receptor gene. Materials and methods. Examinations involved 70 patients with chronic pancreatitis (CP), who formed the main group. Women (46 or 66.4%) prevailed in this group. The age of the patients was from 29 to 43 years, the mean age 33.2±2.1 years. Control group consisted of 78 practically healthy subjects. The groups were comparable in terms of age and gender ratio. The diagnostic search included the study of the polymorphism of vitamin D receptor (VDR) gene and the biochemical marker of bone tissue, osteocalcin. Their possible effects on the course of the disease and the formation of complications have been investigated. Results. In the process of determining the VDR gene polymorphism, the significant difference was found in the distribution of gene alleles (χ2=30.08, df=4; p <0.01). According to the results of genetic testing, both groups of patients were divided into three subgroups: 1st subgroup (bb‑genotype carriers), 2nd subgroup (Bb‑genotype carriers), 3rd subgroup (BB‑genotype carriers). In the control group, the distribution was as follows: 27 (38.6%), 34 (48.6%) and 9 (12.8%) patients, in the main group — 13 (18.5%), 30 (42.8%) and 27 (38.7%) patients. With the presence of CP, there was a change in the distribution of alleles towards the BB genotype of the VDR gene, which was associated with a higher risk of osteoporosis. 35 (50.0%) patients with CP and 3 (3.8%) individuals from the control group had a history of bone fractures (p <0.01). In CP, the average osteocalcin level was 22.20±2.53 ng/ml, 27 (38.6%) patients had normal levels, 15 (55.6%) of them had the Bb genotype, 7 (25.9%) — genotype BB, in 5 (18.5%) — genotype bb. A decrease in the level of osteocalcin below the norm (to 12.7±1.87 ng/ml) was registered in 4 (5.7%) patients, of which 2 (50.0%) had the BB genotype, 1 (25.0%) — Bb genotype, another 1 (25.0%) — bb genotype. A higher than normal level of osteocalcin (45.1±23.24 ng/ml) was recorded in 39 (55.7%) patients of the main group, of which 18 (43.6%) had the BB genotype, 14 (35.9%) — Bb genotype, 7 (20.5%) — bb genotype. Conclusions. The course of CP in most cases is accompanied by an increase in osteocalcin levels, which can be considered as an indicator of a violation of the mineral density of bone tissue. Changes in the ratio of genotypes of the VDR gene are registered in patients with CP, which gives reason to assume a violation of the absorption of vitamin D due to genetic aberrations. In the majority of patients with CP, in the presence of an unfavorable genotype (BB) of the VDR gene, an increase in the content of osteocalcin is observed, which can be explained by one of the ways of the formation of osteoporotic conditions — a violation of the differentiation of osteoblasts. Chronic pancreatitis can be considered as an unfavorable nosology that provokes interference in bone metabolism with a high probability of formation of osteoporotic conditions, which requires early diagnosis and prevention of complications.

Evaluation of the Level and Polymorphism of the Osteocalcin Gene in Patients with Rheumatoid Arthritis

The hormone is known as the bone protein γ-carboxyglutamic acid. The hormone belongs to the family of proteins that depend on vitamin K, as this vitamin is a catalyst in the formation of (γ-carboxylation) that determines its attraction to the bone matrix and calcium, and this contributes to the formation of bones. Moreover, the non-carboxylated form of the hormone that exerts hormonal properties and is also involved in glucose and energy metabolism, stimulates osteoblasts to secrete insulin directly and indirectly from the pancreas through the synthesis of glucagon-like-peptide 1 GLP-1 From the small intestine this enhances insulin sensitivity in fat cells and muscle cells. This property may have an effect on bone mineralization and may lead to a change in bone quality and an increased risk of fractures.
 The aim of the study is to evaluate the level of osteocalcin in patients with rheumatoid arthritis in comparison with the healthy ones and its relationship with the enzymes (GSH, CP, SOD), and to detect the gene encoding the hormone osteocalcin in the disease and to find the relationship between the hormone osteocalcin and vital variables.
 Blood samples were collected from (30) healthy people (15) males and (15) females, their ages ranged from (25-60) years and (30) patients from (19) males and (11) females in a hospital Salah Al-Din General and Al-Sharqat General Hospital, and the analyzes were measured in the central laboratory of the hospital, which were examined by the specialist doctor.
 This study showed that the levels of OC in the blood serum of people with rheumatoid arthritis is statistically higher compared to the healthy ones, and a significant decrease in the level of GSH for patients compared with the healthy ones, and a significant increase in the level of CP and the level of SOD for patients compared with the healthy ones, and there is a positive correlation between the level of OC and the level of CP And a negative relationship between OC level, GSH level and SOD level. It was revealed that there were significant differences at the level of probability (P<0.01) of repeating the allele for the OC gene between the group of patients and the healthy ones, where the value of the repeating of the mutated C allele increased and the level of the normal T allele decreased within the group of patients compared to the healthy ones.

Assessment of the prevalence of anemia in patients with primary hyperparathyroidism: a single-center observational study

The combination of primary hyperparathyroidism (PHPT) with anemia was first described in 1931. It remains unclear whether PHPT is the direct cause of anemia, or it develops due to PHPT's complications. The frequency of PHPT--associated anemia in the Russian population is unknown. To assess the prevalence of anemia in patients with PHPT admitted to the Department of Parathyroid Glands Pathology in the Endocrinology Research Centre from January 2017 to August 2020. The study included patients with PHPT over 18 years old. A single-center observational one-stage one-sample uncontrolled study was carried out. We analyzed laboratory and instrumental data obtained during inpatient examination in accordance with the standards of medical care. Statistical analysis was performed using Statistica 13 (StatSoft, USA) and SPSS (IBM, USA) software packages. The study included 327 patients with PHPT, 28 (9%) men and 299 (91%) women. The median age was 59 years [51; 66]. 26 patients (8%) with anemia were identified. Statistically significant differences between patients with and without anemia were found only in the GFR. Comparison of patients with and without anemia didn't reveal any significant differences in the incidence of PHPT's complications.Significant differences in serum hemoglobin concentration and average hemoglobin concentration in erythrocytes were revealed between patients with and without vertebrae fractures. In the group of patients without compression fractures these parameters were higher.In the subgroup of patients with total calcium concentration above 3 mmol/L and PTH above 3 normal values, the incidence of anemia reached 21% (95% CI: 10%; 35%). Within this group we revealed tendencies to higher levels of PTH, ionized calcium and osteocalcin in patients with anemia. In general, there was no correlation between hypercalcemia, the degree of PTH elevation and the presence of anemia in patients with PHPT. However, in the subgroup of patients with severe hypercalcemia, there was a relationship between the concentration of PTH, ionized calcium and the presence of anemia. In patients with PHPT and vertebral fractures, significantly lower concentrations of blood hemoglobin and hemoglobin in erythrocytes were observed.

Оценка распространенности анемий у пациентов с первичным гиперпаратиреозом: одноцентровое обсервационное исследование

BACKGROUND : The combination of primary hyperparathyroidism (PHPT) with anemia was first described in 1931. It remains unclear whether PHPT is the direct cause of anemia, or it develops due to PHPT’s complications. The frequency of PHPT-­associated anemia in the Russian population is unknown. AIM : To assess the prevalence of anemia in patients with PHPT admitted to the Department of Parathyroid Glands Pathology in the Endocrinology Research Centre from January 2017 to August 2020. MATERIALS AND METHODS : The study included patients with PHPT over 18 years old. A single-center observational one-stage one-sample uncontrolled study was carried out. We analyzed laboratory and instrumental data obtained during inpatient examination in accordance with the standards of medical care. Statistical analysis was performed using Statistica 13 (StatSoft, USA) and SPSS (IBM, USA) software packages. RESULTS : The study included 327 patients with PHPT, 28 (9%) men and 299 (91%) women. The median age was 59 years [51; 66]. 26 patients (8%) with anemia were identified. Statistically significant differences between patients with and without anemia were found only in the GFR. Comparison of patients with and without anemia didn’t reveal any significant differences in the incidence of PHPT’s complications. Significant differences in serum hemoglobin concentration and average hemoglobin concentration in erythrocytes were revealed between patients with and without vertebrae fractures. In the group of patients without compression fractures these parameters were higher. In the subgroup of patients with total calcium concentration above 3 mmol/L and PTH above 3 normal values, the incidence of anemia reached 21% (95% CI: 10%; 35%). Within this group we revealed tendencies to higher levels of PTH, ionized calcium and osteocalcin in patients with anemia. CONCLUSION : In general, there was no correlation between hypercalcemia, the degree of PTH elevation and the presence of anemia in patients with PHPT. However, in the subgroup of patients with severe hypercalcemia, there was a relationship between the concentration of PTH, ionized calcium and the presence of anemia. In patients with PHPT and vertebral fractures, significantly lower concentrations of blood hemoglobin and hemoglobin in erythrocytes were observed.

Остеопонтин та остеокальцин при раку легенів

Актуальність. Рак легенів (РЛ) займає лідуючу позицію в структурі онкологічної захворюваності та є однією з провідних причин смерті від онкозахворювань. Пошук ефективних підходів до оцінки перебігу РЛ з використанням інформативних критеріїв є актуальним завданням сучасної онкології. РЛ зазвичай перебігає з підвищеним рівнем у крові остеопонтину (ОР) та остеокальцину (ОС), що має прогностичну значущість у рамках виживання хворих. Сироватковий вміст цих остеоонкомаркерів прямо асоціюється з наявністю у хворих метастазів і з високими темпами прогресування захворювання, але ці дані вимагають подальшого уточнення. Мета дослідження: оцінити клініко-патогенетичну й прогностичну значущість ОР та ОС у хворих із різними варіантами перебігу РЛ. Матеріали та методи. Обстежено 115 хворих на РЛ віком від 24 до 80 років (у середньому 58 років), серед яких було 78 % чоловіків і 22 % жінок. Жоден пацієнт раніше не був прооперований із приводу РЛ і до обстеження не отримував радіохіміотерапію. Дрібноклітинний гістологічний варіант РЛ встановлений у 17 % від числа хворих, недрібноклітинний — у 83 %. Імуноферментним аналізом вивчали в сироватці крові показники ОР, ОС і судинного ендотеліального фактору росту (VEGF). Результати. У хворих на РЛ збільшуються в сироватці крові показники онкоостеоасоційованих маркерів OP та OC, що спостерігається відповідно в 99 і 98 % випадків. Зміни ОР і ОС пов’язані з формою захворювання, гістологічним його варіантом, ступенем диференціації, інтегральною тяжкістю перебігу РЛ, характером ускладнень первинної пухлини й особливостями метастазування. Високий рівень маркерів у крові мало впливає на трирічне виживання пацієнтів, а прогнознегативними критеріями відносно перебігу РЛ є параметри ОР. Показники ОР і ОС у крові між собою прямо корелюють, а вміст ОР, окрім того, має позитивні співвідношення з таким пухлинним маркером, як VEGF, що належить до стимуляторів неоангіогенезу. Метастатичне ураження скелету й розвиток порушень мозкового кровообігу внаслідок подальшої радіохіміотерапії прямо пов’язані з високою концентрацією в крові ОР, який також є чинником ризику інших ускладнень лікування. Висновки. Підвищені рівні в крові ОР і ОС мають важливе клініко-патогенетичне значення при РЛ, а вивчення показників цих остеоонкомаркерів сприятиме ранній діагностиці окремих ознак перебігу захворювання, підвищенню якості оцінки метастазування в кістково-суглобовий апарат і прогнозуванню можливих ускладнень радіохіміотерапії.

Coronary artery calcinosis and metabolic disorders in Chernobyl accident responders

Relevance. Atherocalcinosis is a prognostically unfavorable pathology that is often found in the general population and, especially, in the liquidators of the consequences of the accident at the Chernobyl nuclear power plant. Its pathogenesis has not been sufficiently studied, as well as its treatment.Intention: To establish relationship between the severity of coronary artery calcinosis and biomarkers of inflammation, bone metabolism and vascular calcification in liquidators of the consequences of Chernobyl accident at a remote period. Methodology. The study group was made up of 90 liquidators of the consequences of the Chernobyl accident – men aged 40 to 78 years, the median – 59 years, at the time of participation in emergency recovery work they were from 18 to 53 years old. Proteins of inflammation, osteocalcin, mineral metabolism, osteopontin, osteoprotegerin, fetuin A in patients’ blood serum were analyzed. Expression of coronary vessel calcinosis was evaluated on the basis of multispiral computed tomography data with determination of calcium index by Agatston method, peculiarities of bone mineral density change depending on cardiac calcinosis severity in persons who participated in the aftermath of Chernobyl accident suffering from atherosclerosis.Results and Discussion. Liquidators of the consequences of the Chernobyl accident with reduced bone mineral density were more likely to have a high and extremely high degree of coronary artery calcinosis (65 %) than patients without osteopenia (49 %). The serum level of osteocalcin in patients with reduced bone mineral density was significantly greater than in the subgroup with unchanged bone mineral density. It has been established that in liquidators of the consequences of the Chernobyl accident, inflammation with high values of C-reactive protein and leptin in the blood was associated with reduced fetuin A levels. In the liquidators of the consequences of the accident at the Chernobyl nuclear power plant with a calcium index of more than 400 points, osteoprotegerin was statistically significantly higher, and the level of fetuin was statistically significantly lower than in other patients.Conclusion. Changes in calcium metabolism and bone mineral metabolism as well as systemic inflammation are closely related to the change in the calcium index in liquidators of the consequences of the Chernobyl accident with coronary heart disease and, along with instrumental diagnostic methods, may reflect the degree and severity of vascular injury. In addition, the study of the mechanisms of formation of cardiac calcinosis is extremely important due to the fact that they can be targets for pharmacological intervention, the effects of which will change the nature of atherosclerosis progression.

Levels of carboxylated and undercarboxylated osteocalcin in patients with type 2 diabetes

Introduction: Osteocalcin (OC) is a bone-derived protein that undergoes vitamin K-dependent carboxylation. The undercarboxylated form of the protein (ucOC) is released in the circulation during the process of bone resorption. Experimental studies on mice and rats have revealed that ucOC is involved in the regulation of energy homeostasis, linking in this way the bone, pancreas, and adipose tissue metabolism. Experimental studies suggest no hormonal role for the carboxylated form (cOC) of the protein. Aim: In the current study we aimed to examine the levels of OC in its carboxylated and undercarboxylated form in patients with type 2 diabetes and control subjects, and to compare the vitamin K status between the two groups. Materials and Methods: The present cross-sectional study involved a sample of 46 adults type 2 diabetes patients and a control group of 19 individuals. The carboxylated and undercarboxylated forms of OC were measured in serum by using highly sensitive sandwich-type enzyme immunoassay kits. Vitamin K status was evaluated by the ratio ucOC/cOC. Student’s two-tailed unpaired t-test was used to compare the groups. Results: UcOC and cOC serum levels were significantly lower in patients with type 2 diabetes compared to controls. We found no difference in the vitamin K status between the groups. Conclusion: Our results show that OC might be involved in the regulation of carbohydrate metabolism. In humans, it appears that the carboxylation state might not be essential for the hormonal role of the protein as in mice and rats.

Показники кісткового ремоделювання у хворих на цукровий діабет 2-го типу з різним конституційно-метаболічним фенотипом

SummaryIntroduction. According to the latest data, osteocalcin – hormonally active productof bone tissue – plays an active role in the humoral control of homeostatic processes. Inparticular, osteocalcin was shown to regulate sensitivity of peripheral tissues to insulin,carbohydrate metabolism, transport and deposition of lipids.An inverse correlations were found between the level of osteocalcin and the degreeof insulin resistance, levels of glucose, insulin and adipokines, manifestation of themetabolic syndrome, visceral obesity, type 2 diabetes, cardiovascular risk. Osteocalcinmay be a significant factor of regulation of energy processes and formation of certainconstitutional and metabolic phenotypic characteristics of the organism, in particular interms of regional distribution and metabolic activity of adipose tissue.Purpose of the study was to study the relationship between the level of osteocalcinand constitutionally-metabolic phenotypic traits.Materials and methods. 44 patients with type 2 diabetes over 50 years old wereallocated into 3 groups by the serum osteocalcin level. Anthropometric measurements(height, weight, waist circumference), determining of insulin resistance degree (HOMAIR), lipid spectrum were carried out. Visceral adiposity index (VAI) was calculated byempirical formulas for men and women, which includes body mass index, waistcircumference, blood level of triglycerides, and high density lipoprotein. The controlgroup included 23 people of the same age without diabetes.Results. In the groups 1–3 of men osteocalcin levels were: <2.0 ng/ml;(2.75±0.21) ng/ml; (5.3±0.39) ng/ml, respectively. In the groups 1–3 of women:<2.0 ng/ml; (2.91±0,15) ng/ml; (6.01±0,56) ng/ml. In all groups of diabetic patientsmean osteocalcin levels were significantly lower than in control subjects withoutdiabetes (in men (10.78±1.08) ng/ml; in women (8.12±1.03) ng/ml; p<0.05).Reducing of osteocalcin level in subjects with type 2 diabetes was associated with asignificant increase in the degree of insulin resistance. Especially high values ofHOMA-IR were observed in patients of group 1 with low osteocalcin levels (HOMA-IRin men (7.25±1.04); in women (8.25±1.45)), comparing with high osteocalcin group 3(in men (4.23±0.87); in women (2.78±0.34); p<0.05).It was found that the decrease of osteocalcin in groups of men with type 2 diabetes wasaccompanied by a significant increase in VAI (in men groups 1–3: (4.21±1.09); (3.05±0.38);(1.43±0.27); p<0.05; in women groups 1–3: (4.86±1.17); (3.15±0.58); (2.75±0.53)).Increase of VAI characterizes the worsening of morphological and functional characteristicsof adipose tissue. In women, such changes were not significant.Our results show the relationship between slowing of osteosynthesis andconstitutional manifestations and metabolic disorders, which in turn are associated withphenotypic changes in patients with type 2 diabetes.Conclusions. Reduction of serum osteocalcin in patients with type 2 diabetesoccurred in parallel with the strengthening of insulin resistance, visceral obesity, anddyslipidemia. The visceral obesity index, which includes both humoral andanthropometric parameters, was more precise and standardized parameter for revealingof constitutional and metabolic phenotypic changes as compared with the waistcircumference.

Evaluation of serum level of the vascular endothelial growth factor and osteocalcin in patients with ankylosing spondylitis

Evaluation of serum level of the vascular endothelial growth factor and osteocalcin in patients with ankylosing spondylitis

Hormonal and Mineral Imbalance Effect on Bone Resorption in Predialysis Iraqi Patients with Chronic Kidney Disease

Introduction: Chronic kidney disease mineral bone disorder is a metabolic bone disease present in almost all uremic patients. The aim of this research to indicate the stage of chronic kidney disease (CKD) that affect the bone metabolism that leading to the mineral and hormonal imbalance by studying the relationship among osteocalcin , glomerular filtration rate (GFR), parathyroid hormone, calcium and phosphorus levels in the blood. Method: The study included 52 patients with predialysis chronic kidney disease stage 3-5 and 40 apparently healthy relatives accompanying the patients. Glomerular filtration rate (GFR) was calculated for each patient. Renal function tests, including serum levels of urea, creatinine, a biochemical marker of bone metabolism: osteocalcin (OSN), calcium, phosphorus, and parathyroid hormone (PTH), were measured for each participant. Results: Serum urea and creatinine levels were significantly higher in CKD patients Than that of apparently healthy control. There is significantly higher serum parathyroid hormone, serum phosphorus, serum osteocalcin (P&lt;0.01, P&lt;0.01, P&lt;0.01 respectively) in CKD patients than that of the healthy control group. While low serum calcium level in CKD patients as compared to the corresponding group (P&lt;0.01). Conclusion: Hyperphosphatemia and hypocalcemia in the end stage of predialysis CKD patients lead to increase parathyroid hormone secretion, which causes high bone turnover characterized by significantly high serum osteocalcin in these patients. Parathyroid hormone and osteocalcin were used as a biomarker for the development of bone and mineral disorders in predialysis CKD patients.

The role of osteocalcin in mechanism of Steroid induced diabetes mellitus

Steroids induced diabetes (SID), may be due to either insulin resistance (IR) or beta cell dysfunction or combination of both. Several studies have established that these effects of steroids may be mediated by an osteoblast derived protein called osteocalcin (OC). However, this effect has been described only in diabetic patients and has not been studied in SID patients. A prospective observational cohort study was designed to evaluate the correlation between serum OC level and blood glucose profile, in patients on steroids. Out of a total of 88 subjects who were on steroid therapy, 42(47.7%) subjects had their blood sugar levels in the diabetic range. Based on the glycemic status, subjects were divided into three groups, namely, normoglycemic, pre-diabetes and diabetes. The patients who developed SID were older than normoglycemic (mean age 43.15 vs 39.27years). The age (r=-0.105 p=0.5), BMI (r=-0.3 p= 0.07) and abdominal obesity (r=-0.32 p=0.04) were negatively correlated with serum osteocalcin in diabetes group. Serum osteocalcin level decreased as dose of steroid increased in all three groups (normogylcemic r=-0.701 p=0.004 prediabetes r=-0.3 p=0.07 diabetes -0.362 p=0.04). Fasting plasma glucose (r=-0.319 p=0.04), Fasting insulin (r=-0.10 p=0.5) and IR (r=-0.194 p=0.212) were increased with decrease in OC in patients in diabetes group. Decrease in serum osteocalcin level with increase in glycemic parameters in steroid induced diabetes group, point to have a new role in mechanism of steroid induced diabetes. This may be a novel target to discover drugs that can maintain the OC levels so that the effect of steroids on blood sugar level can be minimised.

Serum osteocalcin level in end-stage renal disease patients on maintenance hemodialysis after parathyroidectomy in relation to parathyroid hormone level

BackgroundParathyroidectomy (PTX) is an effective treatment for refractory hyperparathyroidism in end-stage renal disease (ESRD) patients on maintenance hemodialysis (MHD). However, adynamic bone disease, a possible complication, is associated with persistent bone pain and increased fracture risk. Osteocalcin (OC) is a bone formation marker, produced by osteoblasts, stimulated by parathyroid hormone and active vitamin D, associated with overall survival. Late changes in its level after PTX need to be evaluated.AimThe aim of this study was to determine serum OC and its relation to intact parathyroid hormone (iPTH) in patients on MHD with and without a history of PTX.Patients and methodsThis case–control study was conducted on 50 patients with ESRD on MHD, subdivided into two groups (group I and group II), according to the history of PTX. Patients having diabetic mellitus or autoimmune disease were excluded. Patients were inquired about manifestations of bone disease. Serum concentrations of ionized total calcium, magnesium, phosphorus, alkaline phosphatase (ALP), iPTH, and OC (by ELISA) were determined. Serum OC concentration was also measured in the samples of 20 healthy participants (group III) to evaluate its reference value.ResultsBone fracture was present in nine patients with or without PTX, with no significant difference from the other patients, as regards the studied parameters. Patients with ESRD on MHD had a significantly higher serum OC level than controls (P<0.001). Serum OC in patients who underwent PTX, and with adynamic bone disease (iPTH<150 pg/ml) (group IA), was significantly lower than that in the corresponding subgroup without PTX (group 2A) (P=0.001); similarly, the two subgroups were different, as regards serum ALP (P<0.001) and serum iPTH (P<0.001). There were significant positive correlations between serum OC and total ALP and iPTH in the total patient sample (P<0.001 and <0.001, respectively).ConclusionAdynamic bone disease after PTX in patients on MHD in comparison with those who have not undergone PTX is associated with a lower level of bone formation marker OC.

Diversity of Gut Microbiota Affecting Serum Level of Undercarboxylated Osteocalcin in Patients with Crohn's Disease.

Several reports have indicated a possible link between decreasing plasma levels of vitamin K and bone mineral density. It has been suggested that intestinal bacteria contribute to maintenance of vitamin K. Several factors are involved in the reduction of vitamin K in patients with Crohn’s disease (CD). We aimed to assess the relationship between gut microbiota and alternative indicators of vitamin K deficiency in patients with CD. We collected the feces of 26 patients with clinically inactive CD. We extracted 16S rRNA from the intestinal bacteria in the feces and amplified it by polymerase chain reaction. The generated polymerase chain reaction product was analyzed using a 16S metagenomic approach by Illumina Miseq platform. Serum undercarboxylated osteocalcin concentration was used as an alternative indicator of vitamin K deficiency. There was a significant negative correlation between serum undercarboxylated osteocalcin and mean Chao1 index in cases of low activity. The diversity of the gut microbiota was significantly lower, and Ruminococcaceae and Lachnospiraceae were significantly decreased in the vitamin K-deficient group in comparison to the vitamin K-normal group. Taken together, these data suggested the significance of investigating the gut microbiota even in patients with clinically inactive CD for improving patients’ vitamin K status.

Undercarboxylated osteocalcin in patients with newly diagnosed type 2 diabetes after blood glucose regulation.

Undercarboxylated osteocalcin in patients with newly diagnosed type 2 diabetes after blood glucose regulation.

Effect of parathyroidectomy on osteopontin and undercarboxylated osteocalcin in patients with primary hyperparathyroidism

ABSTRACT Purpose: Surgical treatment for primary hyperparathyroidism (PHPT) improves bone metabolism. Osteocalcin (OC) and its undercarboxylated form (ucOC) are associated with bone and energy metabolism. Osteopontin (OPN), a multifunctional protein expressed in bone, is involved in resorption, along with β-carboxyl-terminal cross-linking telopeptide of type 1 collagen (β-CTX), and osteoprotegerin (OPG). Our aim was to investigate these biomarkers of bone metabolism in patients with PHPT. Methods: We examined 30 individuals with PHPT, in a clinical research facility, before and 1 month following parathyroidectomy. Circulating levels of OC, ucOC, OPN, β-CTX, and OPG were examined as bone biomarkers along with inflammatory markers (e.g., interleukin-6 [IL-6], lipocalin-2), insulin resistance (i.e., homeostasis model assessment for insulin resistance [HOMA-IR]), adiposity (i.e., leptin, adiponectin), PTH, calcium, 25-hydroxyvitamin D, creatinine, and demographics. Results: Participants (27 females/3 males) were 60 ± 9 (mean±SD) years old. There was a significant reduction of ucOC (7.9 ± 5.1 [median±SIQR] vs. 6.6 ± 3.7 ng/mL, p = 0.022) and OPN (75.4 ± 14.5 vs. 54.5 ± 9.2 ng/mL, p < 0.001) pre- versus post-parathyroidectomy. There were no univariate differences postoperatively for IL-6, HOMA-IR, leptin, or adiponectin. Regression analysis showed that postoperative levels of adiponectin, IL-6, and OPN were significantly associated with ucOC, while adjusting for PTH and albumin corrected calcium levels (model R 2 = 0.610, p = 0.001). With OPN as the dependent variable, higher adiponectin and lower ucOC were significantly associated with lower OPN levels postoperatively (model R 2 = 0.505, p = 0.010). Conclusion: The lower 1-month postoperative OPN and ucOC levels in PHPT seem to indicate reduced bone resorption. Decreased ucOC levels may also suggest lower energy demands postoperatively.

THE MARKERS OF BONE METABOLISM AND SYSTEM INFLAMMATION IN PATIENTS WITH OSTEOARTHRITIS DEPENDING ON BODY MASS, THE INFLUENCE OF SYMPTOMATIC SLOW ACTING DRUGS

Aim. To assess the levels of markers of the bone synthesis and system inflammation in patients with osteoarthritis (OA) in combination with obesity and their dynamic under the influence of basic treatment. Materials and methods. The research included 40 women with OA, 46–78 years old (mean age – 59,8±1,5 years). Duration of the disease varied from 3 to 36 years (mean duration – 10,0±1,1 years). Mean body mass index (BMI) among patients was 30,6±0,7 [22,3; 39,5]kg/m2, according to which patients were divided in 3 groups: patients with OA without obesity (n=17), patients with OA with 1 degree of obesity (n=14), patients with OA with 2 degree of obesity (n=9). The level of osteochondral metabolism was assessed using quantitative measuring of the levels of procollagen IC-terminal propeptide (РІСР), (Cloud-CloneCorp. “procollagen IC-Terminal Propeptide”, USA) and osteocalcin (Roche Diagnostics «N-MID Osteocalcin», Switzerland) on analyzer «ELECSYS 2010» by the method of immune-enzyme analysis; the level of the system inflammation was assessed by the level of C-reactive protein (CRP) by the method of immunoturbidimetry. The clinical efficacy was assessed by the dynamics of intensity levels of pain syndromes at physical load and at rest by the visual-analogue scale (VAS). The measuring of РІСР, osteocalcin and CRP levels and also the assessment of clinical efficacy as to the decrease of pain syndrome were carried out twice – at the beginning and at the end of observation. The period of observation is 2 months. Results. The presence of direct correlation between РІСР and BMI (r=0,62; р=0,008) among patients with OA in combination with the normal body weight was established at the research, whereas among patients with OA in combination with obesity the analogous correlation was demonstrated between SRP and BMI (r=0,43; р=0,04) on the background of correlation of PICP and OC levels (r=0,46; р=0,03). Obesity in patients with OA was associated with the reliably higher levels of pain at both rest and physical load from the side of knee joints, with maximal intensity of the pain syndrome among patients with OA and 1 degree of obesity. Statistical analysis did not reveal the reliable dependence of РІСР and OC in patients with OA from the initial CRP level on the background of tendency to the higher РІСР level and lower OC level among patients with initially increased CRP level comparing with ones with normal CRP level. The therapy with basic preparations at OA during 2 months among patients with OA with increased CRP level led to the reliable decrease of РІСР level (р=0,0076) and the tendency to increase of OC level (р˃0,05), without the reliably significant difference between the initial and final РІСР and OC levels among patients with OA and normal CRP level. At the end of observation period the maximal analgesic effect was demonstrated as to the articulate pain at rest from the side of knee joints (р˂0,001) among patients with OA, who received diacerein, with clinically comparable effect from the side of other aticulate zones (р˂0,05), that was associated with reliable decrease of CRP level (р=0,013). Discussion. The received results testify that the control of the system inflammation level at OA is a target not only relative to the decrease of pain syndrome but also conditions the stable state of subchondral bone (SCB), providing the compensation of processes of destruction and synthesis in bone tissue. The significance of procollagen IC-terminal propeptide (РІСР) and osteocalcin (OC) as the markers of bone synthesis that are able to reflect metabolic processes in SCB at OA, and also the discordant influence of CRP level on PICP level at the relative stability of OC level were demonstrated at the research. The received results allow consider the inflammatory process at OA as a target for preservance of the bone tissue, conditioning the expedience of taking into account the ability of OA basic preparations to realize the control influence on the level of system inflammation. Diacerein that in ESCEO recommendations (2014) is related to the preparations of the 1 step of treatment of patients with OA provides the control on inflammation and stability of osteocalcin level that testifies to the balance of catabolic processes in SCB. Conclusions. At OA the levels of procollagen IC-terminal propeptide (РІСР) and osteocalcin (OC) were not associated with obesity and did not depend on the initial CRP level at the presence of correlation between РІСР level and BMI among patients with OA with the normal body weight and BMI and CRP level among patients with OA in combination with obesity. The absence of reliable dynamics from РІСР side and maintenance of the stable OC level on the background of the reliable anti-inflammatory effect at using diacerein in patients with OA can testify to the compensatory adequacy of reparation processes in SCB.

Bone mineral density change in patients with hyperthyroidism after (131)I therapy: a Meta-analysis

Objective To review the influence of 131I therapy on bone mineral density(BMD) in patients with hyperthyroidism. Methods Published articles of prospective randomized controlled study, clinical controlled study or case-control study on BMD change in patients with hyperthyroidism after 131I therapy were selected from PubMed, the Excerpta Media Database (Embase), Cochrane library, Chinese Journal Full-text Database, Wanfang Database, Vip Database and Chinese Biomedical Literature Database. Data from the date of database establishment to October 2015 were all reviewed. The languages were restricted to English and Chinese. Meta-analysis was performed with RevMan 5.3. Results Thirteen trials with a total of 668 hyperthyroidism patients were included. The meta-analysis showed that BMD of the lumbar spine, hip joint, femoral neck and osteocalcin were significantly improved after 131I therapy. The weighted mean difference(WMD) for BMD of the lumbar spine was 0.07 (95% CI: 0.04-0.11), P=0.000 2; that of the hip joint and the femoral neck was 0.13(95% CI: 0.09-0.16) and 0.05(95% CI: 0.03-0.06), respectively(both P<0.01). The standardized mean difference (SMD) of osteocalcin was -1.20(95% CI: -1.43--0.97) with P<0.01. Furthermore, the improvements were time dependent within the 2 years′ follow-up. Conclusions 131I therapy improves the BMD and osteocalcin in patients with hyperthyroidism in a time dependent manner within 2 years′ follow-up. Key words: Hyperthyroidism; Bone density; Radiotherapy; Iodine radioisotopes; Meta-analysis

Mitral annular calcification and the serum osteocalcin level in patients with chronic kidney disease

Objective: To determine the relationships between inflammatory mediators, mitral annular calcification (MAC), and osteocalcin in patients with chronic kidney disease (CKD). Materials and methods: Echocardiographic data for 60 patients diagnosed as CKD were retrospectively evaluated. The patients were divided into 2 groups; patients with MAC (MAC+ group) and patients without MAC (MAC− group). The relationships between biochemical markers—including osteocalcin—and MAC were evaluated. Results: The study included 19 female and 41 male patients. In all, 29 patients were MAC+ and 31 were MAC−. High-sensitive C-reactive protein (hsCRP) and osteocalcin levels were significantly higher in the MAC+ group (p < 0.05). The eGFR was lower, serum calcitonin (we could not obtain calcitonin data for 15 patients), Ca, PO4, CaxPO4, the erythrocyte sedimentation rate, red cell distribution width, the neutrophil/Lymphocyte rate, and PTH were higher in the MAC+ group; however, the differences between the groups were not significant (p > 0.05). The mitral E/A ratio, mitral peak Ea velocity, tricuspid E/A ratio, hsCRP, and the osteocalcin level were strongly correlated with MAC. Multivariate logistic regression analysis showed that only the osteocalcin level and mitral E/A ratio were independent variables, each with an independent effect on MAC. Conclusion: CKD patients in the MAC+ group had higher osteocalcin levels than those in the MAC− group, and left ventricular diastolic dysfunction was more common in the MAC+ group.

Lipoprotein-Associated Phospholipase A2 Is Increased in Patients with Impaired Bone Density

Summary Background: Increased levels of lipoprotein-associated phospholipase A2 are associated with atherosclerosis, and may contribute to cardiac disease. The aim of this study was to analyze serum levels of lipoprotein phospholipase A2 (Lp-PLA2) in patients with impaired bone resorption and correlate the findings with markers of bone metabolism (osteocalcin) and other biochemical markers (cholesterol, low density lipoprotein, triacylglycerols). Methods: Serum Lp-PLA2 was measured by a turbidimetric method in a group of currently treated 85 patients with impaired bone resorption and in a control group of 46 healthy individuals. Serum triacylglycerols was measured by the electrochemiluminescence immunoassay. Cholesterol, low density lipoprotein and triacylglycerols were measured by commercially available enzymatic assays. Bone density was investigated by dual energy X-ray densitometry performed on the lower spine and hips. Results: Concentrations of LP-PLA2 were significantly elevated in the patients with bone resorption compared to the control group of healthy individuals (225 ng/mL vs. 192 ng/mL, p&gt;0.001) with the highest difference in patients with a T score below –2.5 SD (227 vs. 192 ng/mL). Serum levels of Lp-PLA2 also negatively correlated with decreased levels of serum osteocalcin in patients, and a significant difference in Lp-PLA2 (p=0.02) levels was observed between the control group and group with low levels of osteocalcin. Elevated Lp-PLA2 levels were significantly associated with the therapeutic procedures used, but not with age, gender and concentration of lipids. Conclusions: Lipoprotein-associated phospholipase A2 seems to play an important role also in bone metabolism.

Vitamin K deficiency evaluated by serum levels of undercarboxylated osteocalcin in patients with anorexia nervosa with bone loss

Osteoporosis is a chief complication in patients with anorexia nervosa. Serum levels of undercarboxylated osteocalcin reflect serum and bone vitamin K deficiency. We investigated vitamin K status in patients with anorexia nervosa to help establish prevention and treatment recommendations for osteoporosis. Fifty-four female amenorrheic patients with anorexia nervosa (29 restricting-type and 25 binge eating/purging type) (age, 28.0 (26.7-31.1) (mean (95% CI)) years; body mass index, 14.8 (14.1-15.5) kg/m(2), duration of illness; 107.3 (88.5-126.0) months) and 15 age-matched healthy females were included in this study. We measured serum levels of undercarboxylated osteocalcin, biochemical and nutritional markers, and bone metabolic markers. Dietary vitamin K intake was evaluated by a questionnaire. Lumbar bone mineral density and T-scores in patients with anorexia nervosa were 0.756 (0.721-0.790) g/cm(2) and -2.4 (-2.1 to -2.7), respectively, indicating bone loss. Serum levels of undercarboxylated osteocalcin in patients with anorexia nervosa were significantly higher than those of controls. The 17% of restricting type and 40% of binge eating/purging type anorexia nervosa patients, serum levels of undercarboxylated osteocalcin were higher than 4.5 ng/ml and were diagnosed with vitamin K deficiency. Serum levels of undercarboxylated osteocalcin correlated significantly and negatively with vitamin K intake in patients with anorexia nervosa. Patients with anorexia nervosa had vitamin K deficiency. Since a supplement of vitamin K might be effective for maintaining bone quality, we provide recommendations regarding vitamin K intake for prevention and treatment of osteoporosis in patients with AN.