OBJECTIVES: Abnormalities of bone metabolism could be followed in gastrectomized patients as a late complication. Nowadays, many biochemical and radiologic measurements are applied to detect these abnormalities. The aim of our study is to determine the valuable parameter as an appropriate screening test during long-term follow-up periods and define the usefulness of new biochemical markers for bone metabolism by comparing with traditional markers. METHODS: Fifteen patients who had undergone partial gastrectomy were chosen randomly and fifteen healthy controls were compared. Then, several biochemical and radiologic tests were measured. We excluded subjects who proved to have other causes of bone metabolism abnormalities. Ten patients and 10 controls were finally selected. RESULTS: Comparing the data with those of a corresponding control group, the lumbar bone density measured by quantitative computed tomography (QCT) was statistically significantly lower in the patient group (p +ADw- 0.01). The urinary deoxypyridinoline, a biochemical marker for bone resorption, was statistically higher in the patient group (p +ADw- 0.025). Osteocalcin, Procollagen I C-terminal peptide (PICP) and Type I collagen C-terminal telopeptide (ICTP) were slightly but not significantly higher in the patient group. The serum parathyroid hormone (PTH) and 25-hydroxy vitamin D levels were similar in both groups. CONCLUSION: We could suggest that urinary deoxypyridinoline and QCT are appropriate parameters as screening tests for the detection of bone metabolism abnormalities in gastrectomized patients during long-term follow-up. Urinary deoxypyridinoline may be a simple and rapid test which could replace cumbersome 24-hour urinary hydroxyproline.
Absorptiometry, Photon ; Adult ; Biological Markers/analysis ; Bone Density/physiology+ACo- ; Bone Diseases, Metabolic/etiology+ACo- ; Bone Diseases, Metabolic/diagnosis ; Bone Diseases, Metabolic/blood ; Comparative Study ; Gastrectomy/methods ; Gastrectomy/adverse effects+ACo- ; Human ; Male ; Middle Age ; Reference Values ; Sensitivity and Specificity

Vitamin K is the cofactor for the hepatic carboxylation of glutamic acid residues in a number of proteins including the procoagulants factors ll, Vll, lX, and X. The role of vitamin K in normal bone function is not fully understood. Inherited deficiency of vitamin K dependent coagulation factors is a rare bleeding disorder reported only in a few patients. Here we present an 18-month old child who presented with osteopeni due to inherited vitamin K deficiency. While the patient had high bone specific alkaline phosphatase and parathyroid hormone levels and low osteocalcin and bone mineral density values, with the regular supplementation of vitamin K all the mentioned parameters returned to normal values.
Bone Density ; Bone Diseases, Metabolic/etiology ; Human ; Infant ; Male ; Osteocalcin/blood ; Prothrombin Time ; Vitamin K Deficiency/blood/complications/*genetics

Bleeding disorders, including hemophilia, can be seen in every ethnic population in the world. Among various bleeding disorders, reduced bone density has been addressed in hemophilia A. In recent years, there has been an increasing interest in addressing osteopenia and osteoporosis in hemophilia A. There is little or no study about the possible susceptibility of other individuals with bleeding disorders to reduced bone density. Questions have been raised about the role of blood coagulation factors in bone mineralization. This review provides new insight and ideas for further survey in the field of bleeding disorders and reduced bone density.
Blood Coagulation Factors ; Bone Density* ; Bone Diseases, Metabolic ; Calcification, Physiologic ; Hemophilia A ; Hemophilia B ; Hemorrhage* ; Osteoporosis ; von Willebrand Diseases

DM is a systemic disease with many complications. One of them, diabetic osteopenia is important sequelae and many authors reported reduced bone mass in diabetic rats. However, in mandible, study has been rare because of its anatomical limits. So the objective of this study was to investigate bony change in mandible of diabetic rats. Thirty-two adult rats were used in this study. Half of them were male and female respectively. In sixteen rats, streptozotocin was injected intraperitoneally to induce DM and the serum glucose concentration was checked to ensure the induction of DM prior to the time of sacrifice. At 1, 2, 3, 4, 6, 8, 12, 16weeks, control group and diabetic group rats were sacrificed respectively. And then bone mineral density of mandibles and femurs of the rats was measured using dual energy X-ray absorptiometry(DEXA). In addition serum osteocalcin and urine deoxypyridinoline were measured as markers of bone formation and resoption respectively. Mandibular and femoral bone density in streptozotocin induced rats was decreased with significance statistically after 4 weeks from injection. In mandible, comparing with femur, bone density was moderately decreased. The alveolar bone in mandible was more decreased bone density than the whole body in the mandible From these results, bone mineral density decreased in uncontrolled diabetic group with time, and especially alveolar bone was more destructive in the mandible. So authors think that consideration of reduced bone mineral density is necessary in dental procedure.
Adult ; Animals ; Blood Glucose ; Bone Density* ; Bone Diseases, Metabolic ; Female ; Femur ; Humans ; Male ; Mandible* ; Osteocalcin ; Osteogenesis ; Osteoporosis ; Rats* ; Streptozocin

BACKGROUND/AIMS: Although trials have suggested an association between osteoporosis and cardiovascular disease (CVD), the relationship between fracture risk and cardiovascular disease is not well defined. Here, we examined whether subjects with a higher risk of fracture also share an increased likelihood of developing CVD. METHODS: This study included 477 subjects; patients with a history of diabetes, chronic hepatopathy, nephritic syndrome, or any cardiovascular diseases were excluded. We used dual energy X-ray absorptiometry to assess the bone mineral density (BMD) of the lumbar spine and femur, and calculated fracture risk based on the Fracture Risk Assessment (FRAX) score. The Framingham risk score (FRS) was used to estimate cardiovascular risk. RESULTS: Of the 477 subjects, 222 had osteopenia and 150 had osteoporosis; the remaining 105 had a normal BMD. In men, no significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure, low-density lipoprotein, high-density lipoprotein (HDL), and triglyceride (TG) between groups. Men with osteoporosis were generally older, and had significantly higher total cholesterol (TC). In women, age and FRS were significantly higher in the osteoporosis group. In the multivariate analysis, age, SBP, TC, HDL, TG, and FRAX were all significantly associated with FRS. CONCLUSIONS: These data suggest that patients with a higher risk of fracture are also at greater risk of developing CVD, indicating a possible mechanistic link between CVD and osteoporosis.
Absorptiometry, Photon ; Blood Pressure ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Cholesterol ; Female ; Femur ; Humans ; Lipoproteins ; Male ; Multivariate Analysis ; Osteoporosis ; Risk Assessment* ; Spine ; Triglycerides

OBJECTIVES: This study was carried out to investigate bone mineral density (BMD), blood pressure, age and biochemical index and nutrient intakes, and to analyze the relationship between BMD, blood pressure, biochemical index, nutrient intakes of Korean women. METHODS: The study subjects were 499 women with a age range of 30-79 years living in Seoul and Kyunggi area who participated in 2011 KNHANES. The study subjects were divided into 5 age groups: 30 years (145), 40 years (110), 50 years (102), 60 years (85) and 70 years (57), and 3 BMD groups: normal 258 (50.4%), osteopenia 163 (32.9%) and osteoporosis 78 (16.7%). RESULTS: The average waist circumference, BMI and body fat increased with age, but fat free mass decreased with age. Average BMD and T-score was decreased from 0.84, 0.74 g/cm2 in 30 years to 0.05, -1.05 g/cm2 in 70 years. The rates of osteopenia and osteoporosis increased significantly 22% in 30~40 years, 47% in 50 years and 56% in 60~70 years. Systolic blood pressure and cholesterol were significantly increased with age. The rates of hypertension was significantly increased 2.1% in 30 years, 30.4% in 50 years 89.5% in 70 years. Average nutrient intakes such as protein, calcium, iron, vitamin A and C were significantly decreased with age. There were significant negative correlations between age and calcium, systolic blood pressure, triglyceride. CONCLUSIONS: In this study, we found the risk of osteoporosis and hypertension were significantly increase with over 50 years age. Calcium and protein intake decreased with age. Therefore, in order to prevent osteoporosis and hypertension, adult women need to be educated regarding the importance of protein, calcium and other nutrients in their diet.
Adipose Tissue ; Adult ; Blood Pressure ; Bone Density* ; Bone Diseases, Metabolic ; Calcium ; Cholesterol ; Diet ; Female ; Gyeonggi-do ; Humans ; Hypertension ; Iron ; Osteoporosis ; Seoul ; Triglycerides ; Vitamin A ; Waist Circumference

This study was carried out to investigate bone mineral density (BMD), blood pressure, calcium, sodium intake and related biochemical variables, and to analyze the relationship between BMD, and blood pressure, physical characteristics, nutrient intakes of Korean adult women. The study subjects were 30~80years old, 513 women living in Seoul and Kyunggi area who participated in 2011 KNHANES. The study subjects were divided into three BMD groups; normal, n = 259 (50.4%), osteopenia, n = 169 (32.9%), and osteoporosis, n = 85 (16.7%). Average height and weight and fat free mass decreased with a decrease in BMD. Average BMD of normal, osteopenia, osteoporosis were 0.87, 0.79, 0.70 g/cm2, and T-score were 0.42, -0.66, -1.62, respectively. Higher systolic blood pressure, alkaline phosphatase, and triglyceride were significantly associated with a decrease in the BMD. The rates of hypertension were significantly increased from normal to osteoporosis. i.e. 18.5% in normal, 34.3% in osteopenia and 63.5% in osteoporosis. Average nutrientintakes such as protein, fat, calcium, phosphorus, iron, sodium, potassium, vitamin A, vitamin B, vitamin B2, and vitamin C were significantly lower in subjects with lower BMD.n. Average calcium intake of normal, osteopernia and osteoporosis were 528.50, 416.96, 389.56 mg, respectively. There were significant negative correlations between calcium, phosphorus and age, systolic blood pressure, triglyceride. Also, there were negative correlation systolic blood pressure (incomplete sentence). In this study, we found low BMD according to low calcium intake increase the risk of osteoporosis and hypertension rather than sodium intake, also calcium intake decreased with increase age. Therefore, in order to prevent osteoporosis and hypertension, subjects need to be educated regarding the importance of calcium nutrients in diet.
Adult ; Alkaline Phosphatase ; Ascorbic Acid ; Blood Pressure ; Bone Density ; Bone Diseases, Metabolic ; Calcium ; Diet ; Female ; Humans ; Hypertension ; Iron ; Osteoporosis ; Phosphorus ; Potassium ; Riboflavin ; Sodium ; Vitamin A ; Vitamins

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.
Absorptiometry, Photon ; American Heart Association ; Blood Pressure ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Exercise ; Female ; Femur ; Health Promotion ; Humans ; Lipoproteins ; Lumbar Vertebrae ; Menopause ; Obesity ; Osteoporosis ; Reference Values ; Risk Factors

PURPOSE: This study explored the relationships among obesity, bone mineral density, and cardiovascular risks in post-menopausal women. METHODS: One hundred post-menopausal women were recruited via convenience sampling from osteoporosis prevention program participants who were living in a metropolitan city in September 2006. Obesity was evaluated by body mass index, bone mineral density measured by DEXA scan, and cardiovascular risk factors assessed by a guideline of American Heart Association. RESULTS: Seventy-two percent of women were either in the osteopenia or osteoporosis group, while 28% were in normal range in lumbar vertebrae. Obese women had greater bone mineral density in lumbar (F=3.31, p=.040) and femur (F=4.72, p=.011). Variables for cardiovascular risks were significantly different for high density lipoprotein (F=7.51, p=.001), systolic blood pressure (F=5.21, p=.007), and in percent of 10-year cardiovascular disease risk according to obesity. CONCLUSION: Post-menopausal women are at risk for obesity, osteoporosis, and cardiovascular disease. In order to prevent these conditions, nursing interventions such as resistance and aerobic exercise that reduces body weight and bone loss, increases high density lipoprotein, and reduces systolic blood pressure, should be proposed continually through health promotion programs for postmenopausal women.
Absorptiometry, Photon ; American Heart Association ; Blood Pressure ; Body Mass Index ; Body Weight ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Exercise ; Female ; Femur ; Health Promotion ; Humans ; Lipoproteins ; Lumbar Vertebrae ; Menopause ; Obesity ; Osteoporosis ; Reference Values ; Risk Factors

BACKGROUND: Secondary hyperparathyroidism is a common complication of chronic renal failure. The only reliable method for distinguishing patients with high turnover from those with low turnover bone disease is bone histomorphometric study, but its clinical utility is restricted. Because of its invasive nature, efforts have been made to predict indirectly the type and severity of this metabolic bone disease by serologic assays. This study was undertaken to evaluate the determinants and clinical significance of intact parathyroid hormone(iPTH) in end-stage renal disease patients on regular hemodialysis. METHODS: Ninety-eight patients on regular hemodialysis patients were included in this study. Laboratory data included blood urea nitrogen, serum creatinine, albumin, calcium, phosphate, alkaline phosphatase and iPTH. Serum iPTH was checked by immunoradiometric assay. We also evaluated age, sex and underlying renal diseases. RESULTS: The mean age was 50.3+/-13.8 years, duration of dialysis 42.7+/-40.1 months, duration of follow-up 38.3+/-10.9 months. Thirty patients had an iPTH level more than three times of normal (> or =195 pg/mL). Patients with iPTH level of > or =195 pg/mL had longer duration of dialysis, younger age, lower incidence of diabetes, higher serum creatinine, albumin, alkaline phosphatase, lower calcium and arterial HCO3- concentration. In patients with iPTH level of <195 pg/mL, there was significant correlation between serum iPTH and calcium level(r=-0.43, p<0.001), whereas there was no significant correlation in those with iPTH level of > or =195 pg/mL. CONCLUSION: In patients with iPTH level of > or =195 pg/mL (three times of normal level), normal calcium-parathyroid feedback mechanism are not maintained. Serum iPTH level seems to be affected by nourishment, age, acidosis and the presence of diabetes.
Acidosis ; Age Factors ; Albumins ; Alkaline Phosphatase ; Blood Urea Nitrogen ; Bone Diseases ; Bone Diseases, Metabolic ; Calcium ; Creatinine ; Dialysis ; Follow-Up Studies ; Humans ; Hyperparathyroidism, Secondary ; Immunoradiometric Assay ; Incidence ; Kidney Failure, Chronic ; Parathyroid Hormone* ; Renal Dialysis*