AIMTo explore the characteristics of the urinary excretion in the elderly patients and to offer some advice for the prevention and treatment of hyponatremia in the elderly patients.

METHODS42 inpatients aged over 80 were divided into tow groups according to their creatinine clearance rate (CCR). Meanwhile, 24 patients aged 45-59 and 31 patients aged 60-79 were chosen as the control groups. All patients were examined 24h urinary electrolytes and CCR.

RESULTS(1) The CCR in the elderly group was lower than in the middle-aged and old group and the 24 h urinary sodium excretion was accordingly diminished than the two groups. 24 h urinary sodium excretion in CCR abnormal group was also diminished than in CCR normal group. The urinary sodium excretion was not linearly correlate with the CCR in middle-aged group and old group but was linearly correlate in the elderly group. (2) The elderly patients' capability of holding blood sodium and excreting potassium was declined in the CCR normal group. But the urinary excretion of sodium, potassium and phosphonium were all diminished in CCR abnormal group. (3) All patients' sodium intake was higher than the criteria made by China Hypertension Association.

CONCLUSIONTheir urinary sodium excretion is linearly correlate with CCR. Urinary sodium excretion is increased when the elderly patients' renal function is relative normal but when the renal function is severely damaged, urinary sodium excretion is diminished.

Age Factors ; Aged ; Aged, 80 and over ; Calcium ; urine ; Coronary Disease ; urine ; Creatinine ; metabolism ; Humans ; Male ; Middle Aged ; Potassium ; urine ; Sodium ; urine

OBJECTIVETo study the effect of different extracts of Alisma orientalis on urinary calcium oxalate stone formation in rats and to identify the effective constituents.

METHODDifferent extracts were administered through a stomach tube to rats of different groups with renal calcium oxalate stones induced by ethylene glycol (EG) and ammonium chloride (AC).

RESULTIn the rats administered with ethyl acetate elution of ethyl acetate extract, blood Cr, BUN, renal tissue calcium content, urinary calcium excretion and crystals deposition in renal tissue were significantly lower than those of the stone formation group.

CONCLUSIONThe ethyl acetate elution of ethyl acetate fraction extract of Alisma orientalis can significantly inhibit urinary calcium oxalate stone formation in rats and be the most effective constituent of Alisma orientalis.

Alisma ; chemistry ; Ammonium Chloride ; Animals ; Blood Urea Nitrogen ; Calcium ; metabolism ; Calcium Oxalate ; urine ; Creatinine ; blood ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Ethylene Glycol ; Kidney ; metabolism ; Kidney Calculi ; chemically induced ; metabolism ; prevention & control ; Magnesium ; metabolism ; urine ; Male ; Rats ; Rats, Wistar

OBJECTIVETo compare the curative effects of primary osteoporosis treated with heat-sensitive point moxibustion and Gaitianli (Oyster Shell and Calcium Carbonate Chewable) tablets for oral administration and explore the treatment mechanism.

METHODSSixty cases of primary osteoporosis were randomly divided into a heat-sensitive point moxibustion group (moxibustion group) and a Gaitianli tablets group (medication group), 30 cases in each group. In the moxibustion group, the heat sensitized points were searched around Zusanli (ST 36), Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4) and treated by heat-sensitive point moxibustion; in medication group, Gaitianli tablets were taken by oral administration, 3 pills for once and 3 times a day. The curative effects, bone mineral density (BMD), alkaline phosphatase (S-AKP) and urinary calcium to creatinine ratio (U-Ca/Cr) in both groups were observed before and after treatment.

RESULTSThe total effective rate was 86.7% (26/30) in moxibustion group, superior to that of 76.7% (23/30) in medication group (P < 0.05). After treatment, the BMD of lumbar vertebrae (L2-L4) mean was improved (P < 0.05), and the S-AKP and U-Ca/Cr were reduced (all P < 0.05); in medi cation group, the indexes above were no obvious changes (all P > 0.05).

CONCLUSIONThe therapeutic effect of primary osteoporosis treated with heat-sensitive point moxibustion is superior to that with Gaitianli tablets for oral administration. The mechanism is restraining bone resorption, increasing bone strength, keeping balance of bone metabolism, in order to increase bone mineral density and improve the clinical symptoms.

Acupuncture Points ; Aged ; Alkaline Phosphatase ; blood ; Bone Density ; Calcium ; urine ; Creatinine ; urine ; Female ; Humans ; Male ; Middle Aged ; Moxibustion ; methods ; Osteoporosis ; metabolism ; therapy

BACKGROUND: High oral intake of sodium is known to increase urinary calcium excretion in hypercalciuria and renal-stone formers, and there is well-documented correlation between urinary sodium and calcium excretion in 24-hour urine collections from normal subjects and postmenopausal women. The present study was aimed to investigate relationship between urinary sodium excretion and bone mineral metabolism of climacteric women in Korea. METHODS: We measured 24-hour urinary sodium, calcium, and creatinine level; serum osteocalcin level, serum alkaline phosphatase (ALP) level, serum follicular stimulating hormone (FSH) level; urine deoxypyridinoline (DPD) level; and bone mineral density (BMD) in 430 climacteric women in Korea (331 postmenopausal and 99 premenopausal women). RESULTS: The postmenopausal women had higher (p<0.05) value for mean urinary sodium to creatinine ratio of 0.225+/-0.078 mmol/mg vs. 0.209+/-0.061 mmol/mg and higher (p<0.001) value for mean urinary calcium to creatinine ratio of 0.261+/-0.125 mg/mg vs. 0.209+/-0.081 mg/mg than the premenopausal women. Significant positive correlation was noted between urinary sodium to creatinine ratio and urinary calcium to creatinine ratio (r=0.426, p<0.001). Negative correlation was found between urinary sodium to creatinine ratio and femur neck BMD (r=-0.099, p<0.05). Although urinary sodium to creatinine ratio was not significantly correlated to serum FSH level (r=0.066, p=0.088), serum ALP level (r=0.067, p=0.083), urine DPD level (r=0.077, p=0.056), and lumbar BMD (r=-0.067, p=0.083), but there is a weak trend in it. CONCLUSION: There is not only an increase in urinary sodium excretion at postmenopausal women, but also an increase in the urinary calcium excretion. It seems that subjects with a high urinary sodium excretion show a higher urinary calcium excretion that may have some effect on bone mineral metabolism. However, further studies are required to establish whether urinary sodium excretion have a direct effect on bone mineral metabolism of climacteric women in Korea.
Alkaline Phosphatase ; Bone Density ; Calcium ; Climacteric* ; Creatinine ; Female ; Femur Neck ; Humans ; Hypercalciuria ; Korea* ; Metabolism* ; Osteocalcin ; Sodium* ; Urine Specimen Collection

PURPOSE: To find out the possible role of 1,25(OH)2 vitamin D3 [1,25(OH)2D3] and parathyroid hormone (PTH) as intrinsic factors in urinary calcium stone formers (SFs), we investigated their relationship with serum and urinary biochemical parameters. MATERIALS AND METHODS: A total of 326 calcium SFs (male: 204, female: 122) were enrolled and underwent outpatient metabolic evaluations including 1,25(OH)2D3 and PTH as well as serum and 24-hour urinary biochemical parameters. As control, 163 age- and sex-matched (2:1) individuals (non-SFs) who have never urinary stone episode were included. RESULTS: 1,25(OH)2D3 level was positively correlated with urinary calcium excretion (r=0.347, p<0.001). The hypercalciuric group and recurrent SFs had higher serum 1,25(OH)2D3 levels than the normocalciuric group (p<0.001) and first SFs (p=0.050). In the adjusted multiple linear regression analysis, serum 1,25(OH)2D3 level (beta=0.259, p<0.001) and serum PTH level (beta=-0.160, p<0.001) were significantly correlated with urinary calcium excretion. The patients in highest tertile of 1,25(OH)2D3 had a more than 3.1 fold risk of hypercalciuria than those in the lowest tertile (odds ratio=3.14, 95% confidence interval: 1.431-6.888, p=0.004). No correlation was observed between PTH and 1,25(OH)2D3 (R=0.005, p=0.929) in calcium SFs, while a negative correlation was found in controls (R=-0.269, p=0.001). CONCLUSION: 1,25(OH)2D3 was closely correlated with urinary calcium excretion, and high 1,25(OH)2D3 levels were detected in the hypercalciuric group and in recurrent SFs. However, 1,25(OH)2D3 was not correlated with PTH in calcium SFs. These findings suggest that 1,25(OH)2D3 might be important intrinsic factor for altered calcium regulation in SFs.
Adult ; Calcium/metabolism/*urine ; Female ; Humans ; Kidney Calculi ; Linear Models ; Male ; Middle Aged ; Multivariate Analysis ; Odds Ratio ; Parathyroid Hormone/blood/*physiology/urine ; Vitamin D/*analogs & derivatives/blood/physiology/urine

OBJECTIVETo compare therapeutic effects of warm needle moxibustion and medication on osteoporosis and to study the mechanism.

METHODSForty cases were randomly divided into an acupuncture group and a medication group, 20 cases in each group. The acupuncture group was treated by warm needle moxibustion at Dazhu (BL 11), Ganshu (BL 18), Shenshu (BL 23), Zusanli (ST 36), Yanglingquan (GB 34) etc. once other day, for 3 months; and the medication group was treated by oral administration of tablet Caltrate with Vit D2 for 3 months. The changes of bone mass density (BMD), estradiol (E2), osteocalcin (bone growth protein, BGP), urine calcium/creatinine (Ca/Cr) in the two groups before and after treatment and therapeutic effects were investigated.

RESULTSAfter treatment, BMD significantly increased (P<0.05, P<0.01) in the acupuncture group and did not signifi cantly changed in the medication group (P>0.05) with a significant difference between the two groups (P<0.05). After treatment E2 level significantly increased as compared with before treatment in both of groups (P<0.01); after treatment BGP significantly decreased as compared with before treatment in both of groups (P<0.01); after treatment Ca/Cr significantly decreased as compared with before treatment in the acupuncture group (P<0.05) ; af ter treatment, there were significant differences in BGP and Ca/Cr between the two groups (P<0.05 or P<0.01). The clinically controlled rate in the acupuncture group and in the medication group were 35.0%, 5.0%, respectively, the therapeutic effect of the acupuncture group being better than that of the medication group (P<0.01).

CONCLUSIONThe therapeutic effect of warm needle moxibustion on osteoporosis is better than that of oral administration of tablet Caltrate with Vit D2 and it can increase levels of hormones and delay bone loss. It is an effective method for preventing and treating postmenopausal osteoporosis.

Acupuncture Points ; Aged ; Bone Density ; Bone and Bones ; metabolism ; physiopathology ; Calcium ; urine ; Creatinine ; urine ; Estradiol ; metabolism ; Female ; Humans ; Middle Aged ; Moxibustion ; Osteocalcin ; metabolism ; Osteoporosis, Postmenopausal ; drug therapy ; metabolism ; physiopathology ; therapy

OBJECTIVETo investigate the effects of the decoction of Rhizoma Dioscorea septemlobae (RD) on the bone metabolism in ovariectomized rats.

METHODThirty female, 3-month-old Wistar rats without pregnancy and deliver were randomly divided into 6 groups: sham (sham-operation), ovariectomy (OVX), OVX + diethylstilbestrol, OVX + high dose RD (4 g x kg(-1) x d(-1)), OVX + middle dose RD (2 g x kg(-1) x d(-1)) and OVX + low dose RD (1 g x kg(-1) x d(-1)) (n = 5 in every group). After 12-week period of continuous treatment, the urinary samples and blood samples were collected for the determination of serum estrodiol (E2), calcium (Ca), phosphorus (P), bone glaprotein (BGP), alkaline phosphatase (ALP), urinary calcium/creatinine (Ca/Cr), phosphorus/ creatinine (P/Cr) and deoxypyridioline/creatinine (DPD/Cr). The uteri were removed and weighed. The bone mineral density (BMD) and the biomechanical parameters of the femur of the rats in every group were determined, respectively.

RESULTThe coefficient of uteri in every dose group of OVX + RD was significantly higher than that in the OVX group (P < 0.01). The concentration of serum ALP, BGP and urinary DPD/Cr, Ca/Cr in the OVX group was significantly higher than that in the sham group (P < 0.05), respectively, However, that in the every dose of OVX + RD was lower than that in the OVX group, respectively. There was no significan difference in the concentration of serum Ca, P and urinary P/Cr in every group, respectively. The bone mineral density (BMD) in the OVX group was (0.032 +/- 0.007) g x cm(-2) and was significantly lower than that in the sham group (P < 0.01). However, the value in the group of every dose OVX + RD was significantly higher than that in the OVX group (P < 0.05, P < 0.01), respectively. The maximum loading, deflection and the maximum strain of the femur in the OVX group were (125.78 +/- 15.48) N, (1.87 +/- 0.22) mm, (9.34 +/- 1.10) % and were significantly lower than those in the sham group (P < 0.05, P < 0.01), respectively. The maximum loading and maximum stress were increased in different extent in the every dose group of OVX + RD, respectively.

CONCLUSIONThe decoction of RD can inhibit bone absorption, decline bone turnover and improve the loss of bone in ovariectomized rats.

Alkaline Phosphatase ; blood ; Animals ; Bone Density ; drug effects ; Bone Remodeling ; drug effects ; Bone Resorption ; blood ; physiopathology ; urine ; Calcium ; urine ; Creatinine ; urine ; Dioscorea ; chemistry ; Drugs, Chinese Herbal ; isolation & purification ; pharmacology ; Estradiol ; blood ; Female ; Femur ; drug effects ; metabolism ; physiopathology ; Osteocalcin ; blood ; Osteoporosis ; blood ; physiopathology ; urine ; Ovariectomy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Wistar ; Weight-Bearing

OBJECTIVETo investigate the effect of Rongshi granule on osteopontin(OPN) expression.

METHODThe urlisthiasis rats were induced by ethylene glycol (EG) and ammonium chloride, the control group rats were non-treated, and the Rongshi granule groups (low-dose group, middle-dose group and high-dose group) were administered Rongshi granule in addition to EG and ammonium chloride in 21 days. Pooled 24 h urine samples from each group were collected weekly with the use of metabolic cages, the concentration of uric calcium and oxalic acid were respectively measured by EDTA and photoelectric colorimetric method. Eight animals from each group were killed at 0, 7, 14, and 21 days, kidneys were histologic examinaed and immunohistochemical staining.

RESULTThe expression of kidney osteopontin in model group was obviously higher than that of control group (P <0.01), and was up to the highest at 21 days with 1.4 times (0.281 3/0.201 8) of the control group. The expression of kidney osteopontin in all of the Rongshi granule groups were lower than those of model group (P < 0.05), with an obvious dose-dependent manner. The degree of the kidney calcium oxalate crystal of the rats in all the Rongshi granule groups was much lower than that of model group, and the uric calcium and oxalic acid were much lower than those of model group (P < 0.01).

CONCLUSIONThe Rongshi granule could inhibit the expression of osteopontin in rat urolithiasis model.

Ammonium Chloride ; Animals ; Calcium ; urine ; Calcium Oxalate ; metabolism ; Dose-Response Relationship, Drug ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Ethylene Glycol ; Female ; Kidney ; metabolism ; Kidney Calculi ; chemically induced ; metabolism ; Male ; Osteopontin ; metabolism ; Oxalic Acid ; urine ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley

To elucidate the changes in bone turnover during pregnancy and puerperium, we measured serially the levels of serum osteocalcin and urine deoxypyridinoline (Dpy) as markers of bone formation and bone resorption, respectively, in 22 healthy women with normal pregnancy. Nineteen non-pregnant women served as control. The Dpy levels increased significantly at 16 weeks of pregnancy and remained elevated thereafter. The levels of osteocalcin, however, were significantly decreased at 16 weeks of pregnancy and elevated later at 6 weeks postpartum. Bone turnover ratio (Dpy/osteocalcin) continued to rise during pregnancy, but returned to control levels 6 weeks after delivery. Dpy levels and bone turnover ratio during puerperium tended to be higher in 17 breast-feeding women than those of 5 exclusive bottle-feeders. In conclusion, bone resorption begins to increase from the second trimester of pregnancy and calcium release from bone tissue might play a major role in calcium homeostasis during the whole period of pregnancy as well as during lactation.
Adult ; Amino Acids/urine ; Analysis of Variance ; Biological Markers* ; Bone Resorption/physiopathology* ; Calcium/metabolism ; Female ; Human ; Lactation/physiology ; Osteocalcin/blood ; Osteoporosis/physiopathology* ; Pregnancy ; Pregnancy Complications/physiopathology* ; Puerperium/physiology*

OBJECTIVETo observe the efficacy and safety of Yigu capsule (YGC), a Chinese herbal compound preparation, in treating postmenopausal osteoporosis (PMO) and to explore its possible mechanism.

METHODSThe clinical study was conducted in a prospective, randomized, double blinded method lasting for 6 months with placebo and positive control. Two hundred and ten PMO patients with confirmed diagnosis were assigned into the YGC group, the calciferol group and the placebo group. Besides being administered element calcium, they were treated with YGC, calciferol capsule and placebo capsule respectively. And such symptoms as newly found fracture and ostealgia, bone mineral density (BMD) of the 2nd-4th lumbar vertebrae (L(2-4)) and upper femur, blood and urinary indexes for bone metabolism, sex hormone level and adverse reaction that occurred in patients were observed.

RESULTSIn the YGC group, the total effective rate was 95.50%, with no new occurrence of fractures, which was significantly better than that in the other two groups (P < 0.05). Moreover, in the YGC group, the increase rate of BMD was 9.83% in L(2-4), 4.09% in femoral neck, 4.60% in Wards triangle, 3.00% in greater trochanter, which was also better than that in the placebo group (P < 0.05, P < 0.01). As compared with the placebo group, levels in the YGC group of urinary oxyproline hydroxyproline/creatinine, urinary calcium/creatinine were significantly lower, serum and bone alkaline phosphatase, osteocalcin, estradiol and estradiol/testosterone were significantly higher, but no difference was shown in the comparison of testosterone level. In the observation period, no abnormality in blood or urine routine, liver or renal function was found. Only mild, transient gastro-intestinal response occurred in individual patients, but it did not affect the treatment.

CONCLUSIONYGC could treat PMO effectively, as it could obviously increase the BMD of lumbar vertebrae and coxafemoral bone, elevate the alleviating rate of ostealgia and incessant motion time, yet causing no newly found compressive fracture of vertebrae, or and any related adverse reaction. YGC could not only promote the formation, but also inhibit the absorption of bone as well as increase the sex hormone level. Therefore, it is a pure Chinese herbal compound preparation worthy of further research and development.

Administration, Oral ; Aged ; Amidohydrolases ; urine ; Bone Density ; drug effects ; Bone and Bones ; drug effects ; metabolism ; Calcium ; administration & dosage ; blood ; urine ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Female ; Fractures, Bone ; epidemiology ; prevention & control ; Gonadal Steroid Hormones ; blood ; Humans ; Hydroxyproline ; urine ; Incidence ; Middle Aged ; Osteoporosis, Postmenopausal ; drug therapy ; metabolism ; Prospective Studies ; Treatment Outcome