OBJECTIVETo investigate the clinical value of serum total procollagen type 1 aminoterminal propeptide (total P1NP), cross-linked C-terminal telopeptide of type I collagen (β-CTX) and 25(OH)D3 detection in evaluating the risks of fragile hip fracture in elderly patients with osteoporosis.

METHODSSerum levels of total P1NP, β-CTX and 25(OH)D3 was measured in 68 elderly osteoporotic patients with fragile hip fracture and 68 age- and gender-matched osteoporotic controls without fragile hip fracture. In both groups, bone mineral density (BMD) was detected with dual X-ray absorptiometry.

RESULTSThe serum levels of total P1NP and β-CTX were significantly higher and 25(OH)D3 level was significantly lower in fragile hip fracture group than in the control group (P<0.05), but the two groups showed no significant difference in lumbar or total hip BMD. Bivariate correlation analysis suggested that in fragile hip fracture group, serum 25(OH)D3 level was positively, while serum total P1NP and β-CTX levels were inversely correlated with lumbar and total hip BMD (P<0.05). In control group, 25(OH)D3 was not related to lumbar or total hip BMD, and serum total P1NP and β-CTX levels were inversely correlated with total hip BMD (P<0.05) but not related to lumbar BMD.

CONCLUSIONIn osteoporotic elderly patients with close BMD levels, high serum levels of total P1NP and β-CTX and low serum levels of 25(OH)D3 might independently indicate high fragile hip fracture risk, and detection of the three markers can help identify high-risk individuals.

Aged ; Aged, 80 and over ; Biomarkers ; blood ; Bone Density ; Calcifediol ; blood ; Collagen Type I ; blood ; Female ; Hip Fractures ; blood ; diagnosis ; etiology ; Humans ; Male ; Osteoporosis ; complications ; diagnosis ; Osteoporosis, Postmenopausal ; blood ; diagnosis ; Peptides ; blood ; Procollagen ; blood

BACKGROUND: We aimed to investigate the diagnostic utility of osteocalcin (OC), undercarboxylated osteocalcin (ucOC), and alkaline phosphatase (ALP) in pre- and postmenopausal women for femoral neck, L1-4, and L2-4 bone mineral density (BMD) values by taking into consideration their age, body mass index (BMI), and menopausal status. METHODS: Premenopausal (N=40) and postmenopausal cases (N=42) were classified as 25-34 or 35-45 yr of age and within the first 5 yr or 5 yr or more after the onset of menopause, respectively. RESULTS: Among the groups, statistical differences were found for age, BMI, OC, ucOC, ALP, femoral neck BMD, L1-4 BMD, and L2-4 BMD. The highest serum OC, ucOC, and ALP levels were observed in cases within the first 5 yr after the onset of menopause, probably due to a more rapid bone turnover rate. The best predictors for the femoral neck osteoporosis were ALP, OC, and calcium (areas under the ROC curve [AUC]=0.882, 0.829, and 0.761, respectively), and those for L1-4 and L2-4 osteoporosis were OC, ALP, and ucOC (AUC=0.949, 0.873, and 0.845; and 0.866, 0.819, and 0.814, respectively). Multiple logistic regression analysis revealed that the most discriminative parameter for osteoporosis was OC. CONCLUSIONS: These results indicate that serum OC levels, with or without ucOC and ALP, may be useful to monitor follow-up changes that currently cannot be assessed with BMD and to diagnose femoral neck, L1-4 spine, and L2-4 spine osteoporosis.
Adult ; Aged ; Alkaline Phosphatase/*blood ; Body Mass Index ; Bone Density ; Discriminant Analysis ; Female ; Follow-Up Studies ; Humans ; Logistic Models ; Middle Aged ; Osteocalcin/*blood ; Osteoporosis/blood/*diagnosis ; Osteoporosis, Postmenopausal/blood/diagnosis ; Postmenopause ; Premenopause

OBJECTIVETo investigate whether blood stasis is one of the main causes in the pathogenesis of postmenopausal osteoporosis.

METHODSThe clinical manifestation of blood stasis syndrome were comprehensively scored in sixty postmenopausal osteoporosis patients, their vascular endothelial function and platelet activating capacity were also detected, and compared with those in 30 healthy women as control.

RESULTSThe molecular indexes as vascular endothelial function and platelet activating capacity, as well as comprehensive scores of clinical manifestation of blood stasis syndrome in postmenopausal osteoporosis patients were significantly different to those of healthy women (P < 0.05, P < 0.01).

CONCLUSIONThere is objective molecular pathologic change of blood stasis syndrome in postmenopausal osteoporosis. Blood stasis plays an important role in pathogenesis of postmenopausal osteoporosis.

Aged ; Blood Viscosity ; Diagnosis, Differential ; Endothelium, Vascular ; physiopathology ; Female ; Hemorheology ; Humans ; Medicine, Chinese Traditional ; Middle Aged ; Osteoporosis, Postmenopausal ; blood ; etiology ; Platelet Activation ; physiology

PURPOSE: Up to 71% of South Korean postmenopausal women have vitamin D deficiency {serum 25-hydroxyvitamin D [25(OH) D] level <50 nmol/L}. Data on vitamin D supplementation was collected during the screening phase of an efficacy/safety study of denosumab in Korean postmenopausal women with osteoporosis. This report describes the effect of vitamin D supplementation on repletion to 25(OH)D levels ≥50 nmol/L in Korean postmenopausal women with osteoporosis. MATERIALS AND METHODS: Vitamin D levels of Korean postmenopausal women (60-90 years old) were measured by extracting 25(OH)D2 and 25(OH)D3 from serum samples via protein precipitation and using liquid chromatography with tandem mass spectrometry detection. Calibration curves were constructed from the mass chromatograms to obtain total vitamin D levels. Subjects with serum 25(OH)D levels <50 nmol/L were supplemented with 1000 IU of vitamin D tablets during the 2.5-month-long screening period. Dose, frequency, and duration were determined by the investigator. If repletion was achieved (≥50 nmol/L) on retest, subjects were eligible to be rescreened for study entry. RESULTS: Of 371 subjects screened, 191 (52%) required vitamin D supplementation, and 88% (168 of 191) were successfully repleted. More than half of the subjects (58%) who were successfully repleted received doses of 2000 IU daily. The mean time to successful repletion was 31 days (standard deviation 8.4 days; range 11-48 days). CONCLUSION: Supplementation with daily median doses of 2000 IU vitamin D successfully repleted 88% of Korean postmenopausal women with osteoporosis within 48 days to a serum vitamin D level of 50 nmol/L.
Aged ; Aged, 80 and over ; *Asian Continental Ancestry Group ; Bone Density Conservation Agents/*therapeutic use ; *Dietary Supplements ; Double-Blind Method ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal/*complications/drug therapy/ethnology ; Postmenopause/blood ; Republic of Korea ; Vitamin D/analogs & derivatives/blood/*therapeutic use ; Vitamin D Deficiency/diagnosis/*drug therapy/ethnology