BACKGROUND: Leptin is known to affect bone metabolism both centrally and peripherally. This study was performed to investigate the relationship between leptin and bone mineral density(BMD) in healthy premenopausal and postmenopausal Korean women. METHODS: 140 women were recruited for a routine health check-up. Anthro-pometric and biochemical data were checked as usual. BMDs were measured by dual x-ray absorptiometry of the spine and femur in 67 premenopausal women and 73 postmenopausal women, in addition to their serum leptin levels. RESULTS: Serum leptin level showed no correlation with BMD in premenopausal women, but there was a positive correlation betwen serum leptin and spinal BMD in postmenopausal women(r=0.468, p<0.001). After the correcting for age, body mass index, and duration of menopause, the serum leptin level and BMD still showed a positive correlation(r=0.217, p=0.088) although weak. The women in the lowest quartile of serum leptin level showed significantly lower lumbar and femoral neck BMD. CONCLUSION: Leptin level seems to have a weak relationship with BMD showing different features in premenopausal and postmenopausal women.
Absorptiometry, Photon ; Body Mass Index ; Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Leptin* ; Menopause ; Metabolism ; Spine

OBJECTIVE: To investigate the significance of detecting serum complement C3 and C4 in patients with multiple myeloma (MM) and to explore its correlation with myeloma bone disease (MBD). METHODS: The levels of serum complement C3 and C4 in 69 MM patients and 30 healthy people were examined by scatter nephelometry. The bone density of L1-4 vertebral body, bilateral femoral neck and bilateral hip joints were measured by dual energy bone density meter (DXA). RESULTS: The levels of serum complement C3 and C4 in MM patients significantly increased in comparison with that in healthy people (P＜0.01). The patients in advanced clinical stage exhibited a higher levels of C3 and C4 than those in stable stage (P＜0.01). In addition, the patients with grade C of MBD had a higher levels of serum complement C3 and C4 than those in patients with grade A and B of MBD (P＜0.01). The levels of serum complement C3 and C4 in MM patients negatively correlated with bone density in L1-4 vertebral body, bilateral femoral necks and hip joints. The correlation coefficients were r=-0.938, r=-0.659, r=-0.745, r=-0.748, r=-0.596 in complement C3 and r=-0.908, r=-0.623, r=-0.710, r=-0.714, r=-0.595 in complement C4, respectively. CONCLUSION The levels of complement C3 and C4 positively correlate with the severity of bone disease and bone density in MM patients, which suggests that complement C3 and C4 plays important roles in the development of MBD. The levels of serum C3 and C4 may be the sensitive biomarkers of MBD.
Biomarkers ; Complement C3 ; metabolism ; Complement C4 ; metabolism ; Femur Neck ; Humans ; Multiple Myeloma

PURPOSE:Effects of IDDM on bone mineral metabolism are still in controversy. Some reported that bone mineral density in IDDM had inverse relationship with HbA1c, some reported that spine BMD was normal while femur BMD was decreased. Others reported that increased urinary calcium excretion in IDDM induced early trabecular bone mineral loss. We studied the correlation of BMD with diabetic control and body measurements. METHODS:In sixteen IDDM patients, using dual energy X-ray absorptiometry, BMD was measured in lumbar spine as trabecular bone and femur neck as cortical bone. Z-score of BMD was obtained by comparing age and sex matched control data. Correlations between BMD and diabetic control parameters (HbA1c, duration of IDDM) and body measurements were calculated. RESULTS:The body measurements were in normal range in all IDDM patients, the duration of IDDM was 38.4+/-24.0months, HbA1c was in good control state (7.69+/-1.53%), and urinary Ca/creatinine ratio was not increased. The Z-score of BMD was not decreased statistically (lumbar spine: -0.255, femur neck: -0.404), and the Z-score had no correlationship with body measurements and diabetic control parameters. CONCLUSIONS:In well controlled childhood IDDM, BMD was not decreased significantly.
Absorptiometry, Photon ; Bone Density* ; Calcium ; Diabetes Mellitus, Type 1* ; Femur ; Femur Neck ; Humans ; Metabolism ; Reference Values ; Spine

To elucidate the relationship among the levels of nutrients intake, bone mineral density (BMD) and the urinary biochemical markers of bone metabolism, this survey is conducted with 225 postmenopausal women over 50 years of age. The urinary biochemical markers including deoxypyridinoline (DPD) and Ca excretion were measured. Bone mineral densities of lumbar spine (L2-L4), femoral neck, ward's triangle and trochanter were measured with dual-energy X-ray absorptiometry and the nutrient intake data obtained by 24 hr recall method. Mean age of all subjects was 64.8 years old, and the BMDs of the subjects were 0.86 g/cm2 (lumbar spine), 0.60 g/cm2 (femoral neck), 0.49 g/cm2 (trochanter), and 0.41 g/cm2 (ward's triangle). The results were compared among 3 groups with different nutrient intake levels classified by the percentage of Dietary Reference Intakes (DRIs) for Koreans as follows: low < 75% DRIs, 75% DRI < or = adequate < 125% DRIs, high > or = 125% DRIs. Bone mineral density of adequate protein intake group was significantly higher than those of low and high protein intake groups (p < 0.05). Urinary DPD excretion was lowest in protein and calcium adequate intake groups (p < 0.05, p < 0.05), respectively. In relation to urinary Ca excretion, it is revealed to be considerably lower in the groups taking protein and vitamin C adequate intake (p < 0.05, p < 0.05). The percent DRI of protein and calcium were positively correlated with the BMD of the femoral neck after adjusted age (p < 0.05, p < 0.05). These results showed that there are probably some relationships between nutrient intake levels and urinary biochemical markers. For postmenopausal women with adequate nutrition expecially protein, calcium and vitamin C, has an important role to postpone bone resorption and to prevent the decrease of bone density.
Absorptiometry, Photon ; Ascorbic Acid ; Biomarkers ; Bone Density* ; Bone Resorption ; Calcium ; Female ; Femur ; Femur Neck ; Humans ; Metabolism ; Recommended Dietary Allowances ; Spine

Wilson's disease (WD) is a rare inherited disorder of copper metabolism. It chiefly has hepatic, neurological and ophthalmic manifestations. Although osteoporosis, rickets and early arthritis are common features of WD, they are under-recognized. Musculoskeletal manifestations very rarely lead to diagnosis of the disease. Here we present a case of a 12-year-old girl who presented with a 3-month-old pathological fracture of neck of femur. WD was diagnosed on investigating the cause of the pathological fracture, which was managed by performing a conventional McMurray's intertrochanteric osteotomy. At 6 months follow up, fracture had united and patient was able to ambulate with support. WD can be a rare cause of pathological fracture. A high index of suspicion must be maintained in patients of pathological fracture presenting with associated neuropsychiatric or hepatic manifestations.
Arthritis ; Child ; Copper ; Diagnosis* ; Female ; Femur ; Femur Neck* ; Follow-Up Studies ; Fractures, Spontaneous* ; Hepatolenticular Degeneration* ; Humans ; Infant ; Metabolism ; Neck ; Osteoporosis ; Osteotomy ; Rickets

OBJECTIVE: Because bone metabolic changes progress from initial stage of stoke, early prevention and treatment have been important. Isoflavone has been proved to be effective in post-menopausal osteoporosis. Therefore the authors used a stroke rat model and evaluated the effects of isoflavone on bone metabolism from initial stage of stroke. METHOD: Female Sprague-Dawley rats were randomly divided into 2 separate groups; a stroke without isoflavone supplement group and stroke with isoflavone supplement group. The bone mineral density (BMD) in 4th and 5th lumbar vertebrae were measured at the day before stroke, 11th and 18th days after the stroke. The BMD in excised distal femur and proximal tibia and the maximum load of emur neck and tibia shaft were measured at 18th days after the stroke. RESULTS: On the 18th day after stroke, BMD of stroke with isoflavone group was significantly higher than that of stroke without isoflavone group in 4th and 5th lumbar vertebrae and distal femur. The maximum load of stroke with isoflavone group was significantly higher than that of stroke without isoflavone group in femur neck. CONCLUSION: The results suggested that isoflavone supplement in stroke rat had beneficial effect on bone metabolism from the initial stage of stroke.
Animals ; Bone Density* ; Female ; Femur ; Femur Neck ; Humans ; Lumbar Vertebrae ; Metabolism ; Models, Animal ; Neck ; Osteoporosis ; Osteoporosis, Postmenopausal ; Rats* ; Rats, Sprague-Dawley ; Stroke* ; Tibia

OBJECTIVES: The purpose of this study was to investigate the influences of interruption and reinitiation of monthly minodronate therapy on the bone mineral density (BMD) and bone metabolism markers in postmenopausal women with osteoporosis. METHODS: Study patients were included if they had been administered monthly minodronate therapy for ≥6 months, interrupted the therapy, and reinitiated the therapy for ≥12 months. The BMD and bone metabolism markers were assessed at 4 time points: initiation, interruption, reinitiation and 1 year after reinitiation of therapy. RESULTS: A total of 23 patients were enrolled. The mean monthly minodronate treatment period was 23.8 ± 12.9 months following a mean interruption period of 11.9 ± 5.4 months. Once increased by monthly minodronate treatment for 2 years on average, the BMD of lumbar spine and radius did not significantly decrease even after an interruption for 1 year on average. However, the BMD of the femoral neck did decrease after interruption. The BMD of the lumbar spine and radius increased further after 1 year of monthly minodronate retreatment. The BMD of the femoral neck did not change. Once decreased after the treatment for an average of 2 years followed by an interruption for 1 year, bone metabolism markers increased gradually but did not recover to baseline levels. A potent suppressive effect on bone resorption was noted. The change rate was greater for the bone formation marker procollagen 1 N-terminal propeptide. CONCLUSIONS: Monthly minodronate treatment increases BMD and reduces bone metabolism markers. The effect lessens after treatment interruptions, and can be restored by retreatment.
Bone Density ; Bone Resorption ; Female ; Femur Neck ; Humans ; Metabolism ; Osteogenesis ; Osteoporosis ; Procollagen ; Radius ; Retreatment ; Spine

OBJECTIVETo observe the sequential changes in biomechanical competence of the femoral neck and marrow cavity of the proximal femur in ovariectomized rats.

METHODSBone mineral density (BMD) and biomechanical properties of the femoral neck and the structural dimension of the proximal femur were measured 0, 3, 6, 9, 12, 15, 18, 21 weeks after ovariectomy (OVX) or sham operation (Sham) in 6-month-old female SD rats.

RESULTSThe BMD of femoral neck in OVX rats was significantly lower than that in Sham group 6 weeks after operation, (0.195 +/-0.028) g/mm(2) vs (0.225 +/-0.036) g/mm(2) (P=0.03). Nine weeks after operation,the failure load of femoral neck decreased about 10% in OVX group to that in Sham group, (89.6 +/-7.7)N vs (96.7 +/-7.5)N (P=0.05). The medullary cavity of proximal femur started to show difference 15 weeks after operation (3.834 +/-0.115)mm(2) vs (3.713 +/-0.114) mm(2) (P=0.03).

CONCLUSIONBMD loss after ovariectomy is associated with a medullary expansion in proximal femur and biomechanical strength deterioration in femoral neck, which might be an important factor of prostheses loosening in the postmenopausal osteoporotic women.

Animals ; Arthroplasty, Replacement, Hip ; Biomechanical Phenomena ; Bone Density ; Female ; Femur ; metabolism ; Femur Neck ; metabolism ; Humans ; Osteoporosis, Postmenopausal ; Ovariectomy ; Prosthesis Failure ; Random Allocation ; Rats ; Rats, Sprague-Dawley

OBJECTIVES: To assess the extent of generalized osteoporosis in Korean rheumatoid arthritis patients and evaluate the importance of disease activity, duration of disease, menopausal status, corticosteroid use and markers of bone metabolism. METHODS: Bone mineral density was measured by dual energy x-ray absorptiometry (DEXA) at 3 locations in 134 rheumatoid arthritis patients, aged 21~80 (57 premenopausal and 66 postmenopausal patients). Markers of bone metabolism were measured and assessed in relation to the disease activity and corticosteroid use. RESULTS: The mean age of the study population was 49 years and mean age of the menopause was 48.1+/-3.6 years. Decreased bone mineral density was observed at all 3 locations measured in the study population (Z-score -0.36, -0.14 and -0.66 for BMD of L-spine, femoral neck and femur Ward? triangle respectively). Fifty nine percent of the patients showed osteopenia (T-score <-1) and 13.4% showed T-score lower than -2.5. The best independent predictors of bone mass (stepweise multiple regression analysis) was body mass index, cortocosteroid use, and CRP in premenopausal patients and years post menopause, age, alkaline phosphatase and rheumatoid factor in postmenopausal patients. Urinary excretion of deoxypyridinoline was increased in both pre- and postmonopausal RA patients while serum osteocalcin level was normal in both groups. Deoxypyridinoline level was significantly correlated with CRP in premenopausal RA patients. CONCLUSION: Generalized osteoporosis is also prevalent in Korean rheumatoid arthritis patients. Bone metabolism appears to be uncoupled. Deoxypyridinoline correlated best with CRP and thus can provide a rational approach for selecting and treating patients with RA to reduce the risk of osteoporotic fracture.
Absorptiometry, Photon ; Alkaline Phosphatase ; Arthritis, Rheumatoid* ; Body Mass Index ; Bone Density ; Bone Diseases, Metabolic ; Female ; Femur ; Femur Neck ; Humans ; Menopause ; Metabolism ; Osteocalcin ; Osteoporosis* ; Osteoporotic Fractures ; Postmenopause ; Rheumatoid Factor

PURPOSE: Estrogen deficiency causes sexual infantilism in Turner syndrome, which could decrease the bone mineral density(BMD) since birth. This decreased BMD might be contributed by the decreased growth hormone(GH) secretion. To improve the decreased BMD, estrogen therapy is recommended, especially after the pubertal age, but estrogen therpay during childhood can accelerate the epiphyseal fusion, resulting in shorter final height. There is a possibility that GH therapy not only ameliorates the final height, but also improve the decreased BMD, because GH is known to be involved in the normal bone metabolism. We observed whether GH therapy, given to improve the growth velocity, can change the BMD in the girls with Turner syndrome. METHODS: Thirteen prepubertal girls with Turner syndrome, who were confirmed by clinical and chromosomal examinations, were given GH(1 U/kg/week, daily, subcutaneous) for one year. During GH therapy, BMDs were mesured by DEXA(dual energy X-ray absorptiometry at trochanter and lumbar spine between the second and fourth vertebra. Growth velocity significantly increased during GH therapy and bone age were significantly advanced during this period. RESULTS: 1) The BMD of femur neck was significantly increased from 0.59+/-0.09 gm/cm2 before therapy to 0.73+/-0.07 gm/cm2 and 0.81+/-0.06 gm/cm2 at 6 and 12 months of therapy, respectively(p<0.01, Fig. 2). 2) The BMD of 2nd lumbar spine did not change during GH therapy. 3) The BMD of 3rd lumbar spine was decreased with marginal significance from 0.73+/-0.09 gm/cm2 before therapy to 0.66+/-0.09 gm/cm2, 0.65+/-0.05 gm/cm2 after 6 and 12 months of therapy, respectively(p=0.05). 4) The BMD of 4th lumbar spine was significantly decreased from 0.75+/-0.06 gm/cm2 before therapy to 0.69+/-0.10 gm/cm2, 0.64+/-0.08 gm/cm2 after 6 and 12 months of therapy, respectively(p<0.01, Fig. 2). 5) There was no significant correlation between the changes of the BMD and Bone or chronological age at initial GH therapy. Conclusion : The positive effect on BMD of GH therapy seems to be dependent on the specific area of skeletal system, where GH might exerts its effect, regardless of the existence of estrogen effect. The BMDs of another areas of skeletal system, where GH does not exert its effect, did not change with GH therapy and rather decreased by probably unknown mechanisms and GH therapy. These unknown mechanisms partially might involve the estrogen defect on BMD, This should be remained to be clarified with more patients and longer duration of study.
Absorptiometry, Photon ; Bone Density* ; Estrogens ; Female* ; Femur ; Femur Neck ; Human Growth Hormone* ; Humans ; Humans* ; Metabolism ; Parturition ; Sexual Infantilism ; Spine ; Turner Syndrome*