Urinary Hydroxyproline Levels Research Articles

VALUE OF BONE REMODELLING MARKERS IN MANDIBULAR FRACTURE PATIENTS BY GENDER AND BONE MINERAL DENSITY

Numerous studies have shown that fractures of the mandible are the most common injuries of the facial skeleton. The high incidence of such fractures is due to the anatomical and physiological characteristics of the mandible, as well as a variety of local and general causes. Disturbances in the structural-functional properties of bone tissue can occur as a result of internal and external influences and provide a favorable background for the development of fractures in various locations, including the mandible. A large number of regulatory factors of a nervous, humoral and immune nature, the presence of inflammation as an obligatory (first) phase of reparative regeneration after bone damage, dictate the need for an in-depth study of the structuralfunctional state of bone tissue in patients with traumatic injuries of the mandible, through the improvement of diagnostic and therapeutic methods. The aim of the study is to analyze the levels of bone remodeling markers in the oral fluid of patients with traumatic lesions of the mandible according to sex and BMD status compared with those of practically healthy control subjects (without general somatic and dental diseases). Materials and methods. The study is based on the results of laboratory tests on 151 people (main group) with mandibular fractures and 30 people (control group) without general somatic and dental diseases. The study included patients of both sexes aged 18-44 years: 92 (60,93%) male and 59 (39,07%) female patients. The levels of total calcium (Ca) and inorganic phosphorus (P) in the oral fluid were determined by photometric methods using commercial kits from «Filisit-Diagnostics» (Ukraine). The activity of alkaline phosphatase and acid phosphatase in oral fluid was determined by the kinetic method with n-nitrophenol phosphate. Oxyproline excretion was determined in daily urine using the Cobas test system (Roshe Diagnostics, Germany). Statistical processing of the study results was performed using Microsoft Excel and Statistics software packages for the statistical analysis of biomedical research data. Results and discussion. As a result of the studies, it was found that in men with osteoporosis, the levels of P in oral fluid were not significantly different from those in the control group, p>0,05. At the same time, the remaining values of bone remodeling markers in biological fluids were characterized by a pronounced imbalance, namely an increase in Ca content by 92,85%, p<0,01, p1<0,05, Ca/P ratio by 2,8 times, p, p1<0,01, AP activity by 89,48%, p<0,01, p1>0,05, ALP by 56,34%, p<0,05, p1>0,05, and urinary hydroxyproline level by 54,09%, p, p1<0,01, compared with the same data in the control group. In women with osteoporotic mandibular fractures, the values of all the parameters studied were significantly different from those of the control group. Thus, we found an increase in the oral fluid content of Ca – by 102,38%, p, p1<0,05, Ca/P ratio – by 3,5 times, p, p1<0,01, AP activity – by 99,06%, p, p1<0,01, ALP – by 65,15%, p, p1<0,01 against a decrease in the value of P – by 42,31%, p, p1<0,05, compared to the data of the control group. At the same time, in this subgroup of women there was an increase in urinary hydroxyproline by 58,26%, p, p1<0,01, compared to the data in the control group. Conclusions. Thus, analysis of bone remodeling marker levels showed that in patients with mandibular fractures due to destruction of the bone matrix as a result of trauma, there was an increase in osteoresorption activity that depended on the structural-functional state of the patients' bone tissue and was more pronounced in women.

Дисплазія сполучної тканини як провокуючий фактор важкості пієлонефриту в дітей

Актуальність. Останніми десятиріччями все більшу увагу привертає патологія різних органів і систем людини, асоційована з дисплазією сполучної тканини (ДСТ), через часте формування на її фоні патології різних систем організму, зокрема з боку нирок. Мета дослідження — з’ясування ролі недиференційованої дисплазії сполучної тканини (НДСТ) у важкості перебігу пієлонефриту (ПН) у дітей та пошук можливих молекулярно­генетичних маркерів, асоційованих із порушенням фібрилогенезу в дітей із різними варіантами перебігу ПН. Матеріали та методи. Обстежено 60 дітей із ПН. За результатами катамнестичного спостереження вони були розподілені на 2 групи: І — 30 дітей із хронічним пієлонефритом (ХрПН), у катамнезі яких діагностувались 3 епізоди рецидиву ПН і більше впродовж 2 років, ІІ — 30 дітей із ПН, в яких впродовж 2 років не відмічалось рецидивів ПН. Контрольну групу становили 42 здорові дитини. Дітям проводилося рутинне обстеження, встановлювались клініко­лабораторні маркери порушення фібрилогенезу (фенотипові ознаки ДСТ, вміст оксипроліну (Оп) у плазмі крові та сечі) та молекулярно­генетичне тестування локусів ТТ та СТ поліморфного локусу rs565470 гена COL4A2 та локусів AA та AG поліморфного локусу rs605143 гена колагену COL4A1. Результати. У дітей із ХрПН вірогідно частіше відмічались фенотипові ознаки недиференційованої дисплазії сполучної тканини порівняно з даними дітей із гострим ПН (ГПН). Практично у всіх обстежених із ХрПН були вірогідно підвищені показники вільної та зв’язаної фракцій Оп у плазмі крові (47,14 ± 0,03 мкмоль/л та 40,08 ± 0,03 мкмоль/л відповідно), вірогідно відрізняючись від даних дітей із ГПН (17,65 ± 0,01 мкмоль/л та 17,22 ± 0,02 мкмоль/л), серед яких ці показники були підвищені тільки у 12,0 та 16,0 % дітей відповідно. У 97,0 % дітей із ХрПН визначався підвищений рівень Оп у сечі, що перевищувало частоту його виділення із сечею в дітей із ГПН (10 %). Установлена вірогідна вища частота «дикого» генотипу АА — rs605143 гена колагену COL4A1 у дітей із ХрПн порівняно з даними осіб загальнопопуляційної контрольної групи (21,4 проти 4,8 %, p < 0,05). Розрахунки показали, що носійство цього генотипу в п’ять разів збільшує ризик розвитку ХрПН (OR 5,105, 95% CI 0,12–0,87), а наявність у дитини генотипу ТТ поліморфного локусу rs565470 гена колагену COL4A2 зменшує ризик розвитку рецидивування ПН (OR 0,14, 95% CI 0,02–1,19). Висновки. Наявність НДСТ у дитини відіграє важливу роль у процесі хронізації пієлонефриту, тому наявність ознак НДСТ є прогностично неблагополучною. З метою прогнозування генетично детермінованої схильності до хронізації ПН рекомендується проведення молекулярно­генетичного тестування генотипів AA та AG поліморфного локусу rs605143 гена колагену COL4A1 та генотипів ТТ та ТС поліморфного локусу rs565470 гена колагену COL4A2.

Study of bone turnover markers – Alkaline phosphatase and urinary hydroxyproline in postmenopausal women

Osteoporosis is a major cause for morbidity in elderly and is further accentuated by the low levels of estrogen in postmenopausal women. Recognition of bone changes early by estimating the levels of bone turnover markers in the post menopausal women in comparison with pre menopausal women would aidin decreasing the disability caused due to fracture.To find the difference between the levels of ALP and urinary hydroxyproline in pre menopausal and postmenopausal women. In our study 45 post menopausal women and 45 premenopausal women attending the OPD for different reasons were recruited and after obtaining informedconsent, blood sample and urine samples were collected. Alkaline phosphatase (ALP) was estimated inserum sample and Hydroxy proline levels were estimated in the urine sample. Both the serum ALP and urinary hydroxyproline levels were significantly (p<0.001) elevated in postmenopausal women. Bone turnover markers play a role in assessing the bone health in post menopausal women and also aid in prognosis when an individual is on bone formation drugs.

Evaluation of urinary hydroxyproline and creatinine level in patients with benign mandibular odontogenic tumor.

BackgroundOdontogenic tumors are relatively common oro‐facial tumors seen in our environment with challenges encountered with management in terms of inadequate infrastructure and high cost of treatment. They are often associated with bone resorption with concomitant collagen degradation and excretion of their by‐products in serum or urine. The aim of this present study was to evaluate urinary hydroxyproline level in patients with benign mandibular odontogenic tumors.Materials and methodsTwenty‐two consecutive patients with histologically diagnosed mandibular odontogenic tumors were recruited. Twenty‐two controls who matched the study group for sex and age were also recruited. The study group had CT‐Scan of their lesions done. All participants were required to fast 12 hours overnight and their early morning second void urine collected between 7 a.m and 8 a.m. The collected urine samples were stored frozen at −20°C until analysis. Colorimetric method of analysis of urinary hydroxyproline and creatinine were done using Biovision hydroxyproline kit and Randox creatinine kit, respectively. The results were recorded as urinary hydroxyproline alone (μg/μl) and as urinary hydroxyproline/creatinine ratio.ResultsThe mean age of the participants was 28.45 ± 6.8 years. The mean duration of the tumors in the study group was 5.9 ± 4.4 years. A mean urinary hydroxyproline/ creatinine ratio of 0.081 ± 0.129 was noted in the study group as compared to 0.016 ± 0.006 that was noted among healthy Nigerian who served as controls in the study.ConclusionThere was a significant increase in urinary hydroxyproline level in patients with odontogenic tumors when compared with healthy Nigerians.

A Preliminary estimation of baseline urinary hydroxyproline/creatinine levels in a study population of healthy Nigerians

Background: Hydroxyproline is one of the biochemical markers that can be measured objectively as an indicator of normal biological processes or pathological processes. It is usually raised in disease conditions that are associated with bone resorption. Aim: To determine the urinary hydroxyproline/creatinine levels in a study population of healthy Nigerians. Methods: This study recruited 22 consenting participants who served as control for another study at the University of Nigeria Teaching Hospital (UNTH) Ituku-Ozalla, Enugu. All participants were required to fast for at least 12 hours overnight and their early morning second void urine collected between 7am and 8am. The collected urine samples were stored frozen at -20oC until analysis. Colorimetric method of analysis of urinary hydroxyproline and creatinine were done using Biovisionhydroxyproline kit and Randoxcreatinine kit respectively. Bivariate analysis was conducted on the collated data using statistical package of social science (SPSS) version 19. The results were recorded as urinary hydroxyproline alone (μg/μL) and as urinary hydroxyproline/creatinine ratio. Results: The mean urinary hydroxyproline level of 0.020±0.013μg/μL and urinary hydroxyproline/ creatinine ratio of 0.016±0.006 were noted for healthy Nigerians. Conclusions: The urinary hydroxyproline levels in the study population of healthy Nigerians are within normal values reported in other healthy populations.

The Relationship Among Bone Mineral Density, Bone Biomarkers and Vitamin D Levels in Patients with Parkinson's Disease.

Idiopathic Parkinson's disease (IPD) is the most common age-related neurodegenerative movement disorder. It causes a decrease and deceleration in movements. It may also lead to loss of bone mineral density, vi-tamin D deficiency, falls and fractures due to various factors. As indicated in our study, determining the prevalence of osteopenia and osteoporosis in IPD is important to determine complications. Thirty patients with IPD and 30 age-matched control subjects were included in the study. The bone mineral density (BMD) measurements of the participants were taken from the lumbar spine (L1-4) and double femur regions using the dual energy X-ray absorptiometry device. Serum 25 (OH) vitamin D, alkaline phosphatase, parathormone, osteocalcin, prolidase and urine hydroxyproline levels were measured. The femur total BMD and serum 25 (OH) vitamin D levels were lower in the patients with IPD than in the control group (p > 0.05). The serum prolidase and urinary hydroxyproline levels were higher in the IPD group relative to the control group (p < 0.05). The frequency of osteoporosis and osteopenia was significantly higher in the IPD group than in the control group (p < 0.05). Patients with Parkinson's disease tend to have lower vitamin D levels than those with a similar age without Parkinson's disease. Vitamin D levels are usually associated with BMD in people with Parkinson's disease, but administering vitamin D does not improve BMD. Cross-sectional studies suggest a correlation between vitamin D levels and the severity of symptoms of Parkinson's disease. Decreased exposure to sunlight due to immobilisation and reduced vitamin D intake by diet may lead to vitamin D deficiency and low BMD. There is a negative correlation among the duration of disease, disease severity, number of falls, parathormone level and serum vitamin D level in people with Parkinson's disease. Consequently, vitamin D levels may be low in Parkinson's disease patients. Therefore, patients with Parkinson's disease should be checked for vitamin D and osteoporosis by considering the risk of hip fracture, fall from a height and high risk of osteoporosis.

24 Hours Urinary Hydroxyproline - A Noninvasive, Cost-Effective and Early Biochemical Marker Which May be Used to Screen the Osteoporotic Lesion in Postmenopausal Women

Introduction: Osteoporosis results due increased rate of bone turnover. It has multifactorial etiology and most common in women after menopause. Objective: The current study was aimed to assess the rate of bone turnover towards detection of osteoporotic changes by measuring 24 hours urinary hydroxyproline which is an early as well as non- invasive biochemical bone marker. Methods: Urinary hydroxyproline was measured in 40 postmenopausal women and compared with similar number of premenopausal women as controls. Results: 24 hours urinary hydroxyproline levels were significantly higher (p&lt;0.001) in postmenopausal women than premenopausal groups. This indicates a higher rate of bone turnover suggesting osteoporotic changes. 24 hour urinary hydroxyproline is also positively correlated (r= 0.934) with age. Conclusion: The present study suggests that measurement of 24 hours urinary hydroxyproline which is a cost-effective and non- invasive technique, may be used for screening and early detection of osteoporotic changes in women of postmenopausal age group.DOI: http://dx.doi.org/10.3126/ajms.v6i4.11853 Asian Journal of Medical Sciences Vol.6(4) 2015 21-24

A comparative study between the effect of 17-β estradiol and antioxidants combination on some menopausal changes in oophorectomised rats

As oxidative stress is proposed to be responsible for many of the menopause associated disorders, antioxidants may play an important role in this situation. The aim of this work was to compare between the effects of oestrogen replacement therapy and antioxidant supplements of vitamin C and low dose of vitamin A on some menopause associated changes in oophorectomised rats. Forty albino female rats were divided into 4 groups: normal control group, oophorectomised group, oophorectomised group treated with 17-β estradiol (oophorectomised + E 2 ) and oophorectomised group treated with vitamins (oophorectomised + vit).The following were measured: total antioxidant (TAO) and malondialdehyde (MDA), lipid profile, serum insulin, glucose and homeostasis model assessment-insulin resistance (HOMA-IR), bone specific alkaline phosphatase (BALP), urinary hydroxyproline, weight gain and visceral fat. A positive correlation was found between MDA and low density lipoprotein-cholesterol (LDL) ( r = 0.694 and P = 0.000), HOMA-IR ( r = 0.691 and P = 0.000.) and BALP ( r = 0.563 and P = 0.000) and urinary hydroxyproline level ( r = 0.761 and P = 0.000). Those results denoted that OS might be a cause of dyslipidemia, insulin resistance and osteoporosis associated with menopause. Both E 2 and vitamins in oophorectomised rats led to a significant decrease in MDA ( F = 33.402, P = 0.000), weight gain, visceral fat ( F = 7.589, p = 0.000 and F = 3.748, P = .019, respectively), cholesterol ( F = 40.748, P = 0.0001), LDL cholesterol ( F = 55.168, P = 0.0001), and significant increase in HDL ( F = 18.393, P = 0.0001) and TAO levels ( F = 14.781, P = 0.000) compared to oophorectomised rats. Also, both treatments led to a significant decrease of HOMA-IR ( F = 18.933, P = 0.000, respectively), BALP ( F = 13.202, P = 0.000) and urinary hydroxylproline ( F = 220.012, P = 0.000). An interesting finding was detected where oophorectomised rats showed a decrease in triglyceride level which was significantly increased by E 2 administration whereas antioxidant administration produced no change ( F = 34.267, P = 0.0001). Our results denote similar effects of both E 2 and antioxidant’ supplements (vitamin C and low dose vitamin A) administration in surgically induced menopause in rats regarding oxidative stress, weight gain, atherogenic lipid profile changes, insulin sensitivity and bone turnover. However differences between preclinical and clinical studies must be taken into consideration especially when moving from animal studies to clinical trials.

Lead exposure is a risk for worsening bone mineral density in middle-aged male workers

Objective: Lead exposure linked to osteoporosis in women. However, there is no direct evidence whether lead exposure has effects on bone metabolism in middle-aged male subjects. Therefore, the present study investigated the relationship between bone mineral densitometry measurements, bone markers, endocrine hormones and blood lead levels.Material and methods: The present study included lead exposure patients (n: 30) and control subjects (n: 32). We recorded information on patient demographics and risk factors of osteoporosis. Blood lead levels were evaluated using Varian AA 240Z atomic absorption spectrophotometry. Bone mineral density measurements were measured using dual-energy X-ray absorptiometry.Results: Each lumbar T and Z scores in the lead exposure group were lower than the control group. There were no significant differences in femur neck and femur total T and Z scores between two groups. Blood lead levels were also negatively correlated with lumbar 2-4 T score, total lumbar T score, lumbar 2-4 Z score and total lumbar Z score. Urinary hydroxyproline and urinary deoxypyridinoline levels in the lead exposure group were significantly higher compared to controls. Blood lead levels were strong, positively correlated with urinary deoxypyridinoline. Endocrine hormone levels and 1,25-dihydroxy-vitamin D3 levels were comparable between lead exposure and control group.Conclusion: Lead exposure in male workers is an important factor for deterioration in bone mineral density. We should be screening blood lead levels and history of lead exposure in male osteoporosis.

Suppression of NF-κB p65 nuclear translocation and tumor necrosis factor-α by Pongamia pinnata seed extract in adjuvant-induced arthritis

Pongamia pinnata is a plant known for its therapeutic usage in Indian traditional medicine. Despite the controversy regarding toxic flavonoid and erucic acid content, the seed of this plant is consumed in tribal medicine and its oil is used in Ayurveda to treat psoriasis and arthritis. This study explored the potential anti-arthritic effects of a P. pinnata seed (hexane) extract (PSE) at non-lethal doses in an adjuvant-induced arthritic rat model; possible mechanisms of any observed effects were also explored. After establishing the lethal doses arising from oral exposure to the extract, the material was administered per os daily at two doses (0.3 g/kg/day; 0.5 g/kg/day) to arthritic rats. Other rats received indomethacin or vehicle (control). Treatments were performed for a total of 14 days. One day after the final exposure, the rats were euthanized to permit harvest of various cells, blood, and tissues for analyses. Paw diameter and tissue myeloperoxidase activity in the paws were evaluated as indices for edema and neutrophil infiltration into the tissue. The severity of arthritis in the experimental rats was assessed via measures of urinary hydroxyproline (HP) and glucosamine, and of serum pro-inflammatory TNFα and anti-inflammatory IL-10. The extent of NF-κB p65 nuclear translocation in peritoneal macrophages harvested from naïve rats and then treated in vitro was also assessed. The results indicated that exposure to PSE significantly decreased paw diameter, tissue myeloperoxidase level, and levels of urinary HP and glucosamine, as well as of serum TNFα and IL-10 in adjuvant-injected (arthritic) rats. In vitro PSE treatment also resulted in a marked inhibition of NF-κB p65 nuclear translocation in primary cultures of peritoneal macrophages. Thus, PSE appears to be able to prevent experimental arthritis, in part, by helping to maintain the balance between pro- and anti-inflammatory cytokines and by inhibiting NF-κB activation.

Metabolomics evaluation of hydroxyproline as a potential marker of melamine and cyanuric acid nephrotoxicity in male and female Fischer F344 rats

Following kidney failure in domesticated pets in the US and kidney issues requiring hospitalization with some deaths in children in China, investigators determined the cause was adulteration of pet foods and baby formula with melamine. It has since been noted that exposure of rats to melamine and cyanuric acid forms melamine cyanurate crystals in the kidney leading to acute nephrotoxicity. This metabolomics study aimed to identify biomarkers of melamine and cyanuric acid-induced renal injury. Male and female Fischer 344 rats were fed a diet fortified with varying doses of melamine and cyanuric acid for 28days. Analysis of urinary amino acids showed hydroxyproline was increased in both sexes in a manner consistent with the clinical chemistry and histopathology data; most prominent when total urine output was taken into account. Furthermore, rats with the highest levels of urinary hydroxyproline were the only rats that exhibited fibrosis within the kidney. Clinical chemistry and histopathology indicated male rats were slightly more affected than female rats following dosing with the 120 and 180ppm formulations; hydroxyproline excretion also supports this finding. Hydroxyproline may be a noninvasive urinary biomarker for detection of acute kidney injury potentially associated with kidney fibrosis.

Effect of Antiresorptive Therapy on Urinary Hydroxyproline in Postmenopausal Osteoporosis

Osteoporosis becomes a serious health threat for older postmenopausal women by predisposing them to an increased risk of fracture. Osteoporosis and associated fractures are an important cause of morbidity and mortality. Special attention is being paid to early detection, management, and treatment of postmenopausal osteoporosis in women. Biochemical markers can enable dynamic and rapid measurement of total body skeletal metabolism and will be clinically useful in the management of postmenopausal osteoporosis women (PMO) and also for assessing the effects of antiresorptive therapy. With this view, we planned to assess osteoclastic activity by determining urinary hydroxyproline in osteoporotic women. The aim of this study is to measure urinary hydroxyproline (expressed as mg of hydroxyproline/g of creatinine) and serum ascorbic acid in postmenopausal women with osteoporosis and without osteoporosis. These biochemical parameters were determined 3months post antiresorptive therapy (alendronate+calcium+vitamin D) in postmenopausal osteoporosis patients. 60 postmenopausal women with osteoporosis in the age group 45-60years and 60 healthy postmenopausal women (normal bone mineral density) in the same age group were included in the study. Urinary hydroxyproline levels were significantly increased (P<0.001) in PMO at baseline level as compared to control group. These levels were decreased significantly (P<0.001) post therapy in PMO patients. Serum vitamin C levels were significantly decreased (P<0.001) in PMO patients at baseline level as compared to controls. No significant change occurred of serum vitamin C level post therapy. Raised excretion of hydroxyproline at the baseline level might be due to increased degradation of collagen type I from the bone matrix in osteoporosis. Breakdown of collagen seems to be lowered as reflected by lowering of hydroxyproline excretion post antiresorptive therapy. Alteration in the concentration of this marker can be very well utilized to monitor the effectiveness of therapy. Thus simple, direct urinary assay to measure bone resorption is very useful in monitoring the therapy in PMO and may become an integral part of the management of osteoporosis.

Antioxidative role of selected herbs against ethanol induced liver injury in rats

The purpose of this study was to know the hepatotoxicity of ethanol in laboratory rats Rattus rattus and to observe the individual and combined phytotherapeutic role of five herbs viz. Arctium lappa, Curcuma longa, Piper longum, Plumbago zeylanica and Terminalia chebula through biochemical and histopathological parameters. Ethanol is commonly used as solvent, pharmaceutical, drugs and alcohol abuse. Lipidperoxidation, glutathione content, urinary hydroxyproline, collagen and histopathological studies showed hepatotoxicity of 1 ml/kg bodyweight dose of ethanol and protective role of 100 mg/kg body weight dose of herbs. Histopathological changes observed in the liver of rats after ethanol treatment showed hepatitis, collagenesis, fatty infiltration, sclerosis, perilobular necrosis, cytoplasmic degeneration, enlarged bile canaliculi, hydropic degeneration, focal necrosis, binucleated hepatocytes and nuclear degeneration. Mild cytoplasmic degeneration, necrosis, collagenesis and hepatocytes regenerations were observed in rats treated with same dose of ethanol and herbal combination.Ethanol treatment decreased the glutathione content, increased tissue malondialdehyde and collagen content, thus causing tissue injury and liver collagenesis. Urinary hydroxyproline level and biochemical parameters also showed the protective role of herbs against ethanol induced toxicity. Herbal combination i. e. 100ml/kg body weight from the mixture of five herbs given orally was found more effective than their individual role. Herbs and plants contain aromatic substances, secondary metabolites, alkaloids and polyphenols which act as antioxidant thus showing protective role.

Serum Leptin and Bone Mineral Density in Hemodialysis Patients with or without Liver Diseases

Leptin is a hormone secreted by adipocytes that plays an important role in regulating appetite and energy expenditure. Our aim was to evaluate serum leptin level in hemodialysis (HD) patients with or without chronic liver disease (CLD) and study the relationship between serum leptin level and bone mineral density in these groups of patients. we recruited 20 healthy volunteers as controls (group I), 20 patients on regular HD with normal liver function (group II), 20 CLD patients with normal kidney function (group III) and 20 patients on regular HD with CLD (group IV). We measured serum calcium, phosphorus, parathyroid hormone (PTH), total alkaline phosphatase (ALP), serum leptin, 24-hours urinary hydroxyproline and bone mineral density (BMD) of the lumber spine and femoral neck by DEXA scan. Serum leptin level was significantly higher (p < 0.001) in HD patients and CLD patients compared to controls. Its level was also significantly elevated in HD patients without liver disease (group II) compared to patients with CLD who had no renal failure (group III). Urinary hydroxyproline level was increased in both HD patients and CLD patients. We detected a positive correlation between serum leptin level and urinary hydroxyproline in all patient groups. There was a significant decrease in BMD in HD and CLD patients. BMD was significantly lower in HD patients without CLD compared to HD patients with CLD. There was a significant negative correlation between serum leptin level and BMD in CLD patients without renal disease but not in other groups (r = - 0.6, P = 0.01). Serum leptin is elevated in HD patients with or without liver disease and in CLD patients. Serum leptin level is inversely correlated with BMD in CLD patients without renal disease.

Osteoporosis transitoria de cadera y gestación

Transient osteoporosis of the hip (TOH) is a rare disorder of unknown etiology, characterized by acute, progressive disabling pain in the hip without prior trauma. This disease is more common among middle-aged men and during the third trimester of pregnancy. Laboratory values are normal, except for erythrocyte sedimentation rate and urinary hydroxyproline levels, which can be elevated. Radiologic findings consist of demineralization of the femoral head, but are only apparent after a window of 4-6 weeks. Magnetic resonance imaging has been proven to be the most accurate test for an early diagnosis, which can be important to avoid potential complications such as pathological fractures. Both clinical and radiological signs of TOH usually resolve spontaneously at 6-8 months. Treatment consists of analgesics and restricted weight bearing of the affected limb. Calcitonin may be used as an analgesic and to shorten disease duration. Bisphosphonates are another alternative. We report a case of severe bilateral TOH in a pregnant woman.

Hydroxyproline Levels in Young Adults Undergoing Muscular Stretching and Neural Mobilization

Hydroxyproline Levels in Young Adults Undergoing Muscular Stretching and Neural MobilizationThis study aimed to assess the acute effect of stretching and neural mobilization on urinary hydroxyproline (HP) levels in young adults. The sample, composed of physical therapy students from Teresina (PI), was divided into three groups: a neural mobilization group (NMG; n=15; age=22±3 years; BMI=24.75±3.09); a static stretching group (SSG; n=15; age=23±4 years; BMI: 25±4.33) and a control group (CG; n=15; age: 24±4 years; BMI: 23.91±3.09). The NMG underwent neural mobilization of the sciatic nerve while engaged in hip flexion with knee extension in a direct, oscillatory and strenuous manner for 60 seconds. The SSG performed passive static stretching, which consisted of the maintenance of a high amplitude posture, without exceeding the limits of the movement, for a period of tension ranging from four to six seconds. Urinary HP was evaluated at the baseline and 24 hours after the intervention using the colorimetric method. Repeated measures ANOVA showed significant intragroup increases in the NMG (Δ7.38 mg/24h; p=0.0001) and the SSG (Δ=3.47 mg/24h; p=0.002) and inter-group increases in the NMG (Δ%=118.89%) when compared to the SSG (Δ%=60.32%; p=0.006) and the CG (Δ%=-0.91%; p=0.0001). These results indicate that the NMG worked with tension beyond the ordinary amplitude arches of articular movement, thus causing a restructuring of collagen.

Anti-arthritic activity of Indian monocellate cobra (Naja kaouthia) venom on adjuvant induced arthritis

The Indian Monocellate Cobra venom (NKV) showed anti-arthritic activity over FCA induced arthritis in male albino rats. NKV treatment (1/20th & 1/10th MLD doses x 13 days, i.p.) showed significant restoration in paw & ankle volume, paw weight. Urinary hydroxyproline, glucosamine, serum ACP, ALP and IL-10 level were restored significantly, due to NKV treatment, as compared with arthritic rats. NKV also showed significant protection against arthritis induced oxidative damages. Thus this study confirmed the scientific validation behind ancient belief and use of snake venom in arthritis as mentioned in Ayurveda.

A familial tendency for developing inguinal hernias: study of a single family

Inguinal hernias are the most common abdominal wall rupture, and the predisposing factors to hernia formation include a familial tendency, connective tissue and lung diseases, smoking and prostatism. The aim of this study is to discuss the familial tendency for hernia in 5 members of a family of 11 people. To our knowledge, no other large family with inguinal hernias has been reported in the English literature. This study presents the surgical procedures and follow-up results of right inguinal hernias seen in 5 of 11 members from one family. Age, sex, body mass index (BMI), biochemical parameters, type of hernia and surgical procedure, and follow-up results were evaluated retrospectively. This study included five patients (three males, two females) presenting with right direct inguinal hernias. The initial symptoms began at an average age of 18.2 years (range 15-22), and the mean BMI of the patients was 20.6 kg/m(2) (range 19.3-22.1). Three underwent hernia repairs with polypropylene surgical mesh and two with polyglactin-polypropylene composite mesh (Vypro II). The patients' blood vitamin C levels were lower than those of the other family members, while their 24-h urinary hydroxyproline levels were higher. The patients were followed for an average of 16.4 months (range 3-33 months). No complications developed during follow-up. The occurrence of the same type of hernia in more than one family member and the altered biochemical results indicate that the hernias may have resulted from a familial connective tissue disease. In patients with hernias, if a familial tendency is suspected, a detailed examination for connective tissue diseases may help to confirm the diagnosis.

Effects of sparfloxacin on CNS functions and urinary hydroxyproline in mice

Sparfloxacin is a widely prescribed drug for various infections. In the present study, sparfloxacin, at two doses, 25 and 50 mg kg −1 was screened on seven neurological and neurobehavioural parameters in mice. In addition, a chronic study was performed to measure the grip strength of the animal to simulate tendon damage and corresponding hydroxyproline levels were determined in mice urine. Increasing current electroshock test (ICES), pentylenetetrazole (PTZ)-induced seizures, forced swim test (FST), passive avoidance response (PAR), spontaneous alternation behaviour (SAB) and elevated plus maze (EPM) were used for studying the acute effects of sparfloxacin while ICES, grip strength test (GST) and urinary hydroxyproline estimations were done for studying its chronic effects. The results indicate a proconvulsive potential of sparfloxacin on the ICES test (when administered for 21 days) and on PTZ when administered for 4 days. Further sparfloxacin (50 mg kg −1 × 4 days) exhibited anxiety like effects on EPM while mood and memory remained unaffected. Sparfloxacin 50 mg kg −1 reduced the grip strength of mice after 2 weeks while both 25 and 50 mg kg −1 reduced the same after 3 weeks. On urinary hydroxyproline, sparfloxacin 25 mg kg −1 significantly increased the levels after 3 weeks of treatment. At 50 mg kg −1, an elevation was evident from the first week onwards. In conclusion, sparfloxacin produced proconvulsant and anxiogenic effects in mice and was devoid of effects on mood and memory. On chronic treatment, it reduced grip strength and caused an elevation in urinary hydroxyproline levels.

Effects of Soy Isoflavone and/or Estrogen Treatments on Bone Metabolism in Ovariectomized Rats

This study investigated whether soy isoflavone intake, with or without estrogen treatment, can reduce postmenopausal bone loss, and whether soy isoflavones can be an alternative for estrogen replacement therapy using a postmenopausal osteoporotic rat model in which ovariectomized female rats were fed a low calcium, high fat diet. Nine-week-old female Sprague-Dawley rats were ovariectomized and then fed low (0.1%) calcium diets with or without soy isoflavone supplementation (80 or 160 ppm) for 6 weeks. Some ovariectomized rats were fed the same diets but also injected with estrogen (10 microg/kg of body weight) subcutaneously. Serum calcium and phosphate levels were normal in all rats. Serum alkaline phosphatase activities were not affected by the treatments. Serum tartrate-resistant acid phosphatase activities and urinary hydroxyproline levels were not different between experimental groups. Bone mineral (calcium and phosphorus) contents were increased in the rats supplemented with 80 ppm soy isoflavone or the rats treated with only estrogen without soy isoflavone. Therefore, the effect of 80 ppm soy isoflavone supplementation was the same as estrogen injection, but there was no beneficial effect from combining soy isoflavones and estrogen injections. When 160 ppm soy isoflavone was used, the benefits were lessened or disappeared altogether. These results suggest that appropriate soy isoflavone supplementation prevents postmenopausal bone loss without estrogen injection and may have efficacy as an alternative to estrogen therapy.