No abstract available.
Biomarkers* ; Metabolism* ; Osteoporosis*

Secondary osteoporosis resulting from specific clinical disorders may be potentially reversible, and thus continuous efforts to find and adequately treat the secondary causes of skeletal fragility are critical to ameliorate fracture risk and to avoid unnecessary treatment with anti-osteoporotic drugs. Among the hyperfunctional adrenal masses, Cushing's syndrome, pheochromocytoma, and primary aldosteronism are receiving particularly great attention due to their high morbidity and mortality mainly by increasing cardiovascular risk. Interestingly, there is accumulating experimental and clinical evidence that adrenal hormones may have direct detrimental effects on bone metabolism as well. Thus, the present review discusses the possibility of adrenal disorders, especially focusing on pheochromocytoma and primary aldosteronism, as secondary causes of osteoporosis.
Cushing Syndrome ; Hyperaldosteronism ; Metabolism ; Mortality ; Osteoporosis ; Pheochromocytoma

OBJECTIVES: The aim of this study was to examine the efficacy, safety, and adherence of ibandronate (IBN) treatment with or without vitamin D supplementation for 3 years in Japanese women with postmenopausal osteoporosis. METHODS: This prospective investigation included 27 patients treated with IBN alone (monotherapy group) and 29 patients receiving IBN and alfacalcidol (ALF) (combination group). Bone metabolism and bone mineral density (BMD) were measured before and at 18, 24, 30, and 36 months of therapy. Treatment discontinuation and fracture occurrence were assessed as well. RESULTS: Lumbar 1–4 BMD (L-BMD) was significantly increased in the monotherapy and combination groups by 3.9% and 7.2%, respectively, at 36 months, with significant gains in total hip BMD (H-BMD) of 3.7% and 4.9%, respectively. There were significant differences in L-BMD improvement between the groups at 18, 24, and 30 months (P < 0.05) and at 36 months (P < 0.01). Compared with pretreatment levels, the percentage changes of L-BMD and H-BMD were significant at all time points in the combination group and at all points apart from L-BMD at 36 months in the monotherapy group. In the monotherapy group, 14 patients dropped out during 3 years and 2 vertebral fractures occurred during the first year. In the combination group, 16 cases dropped out during 3 years and 1 nonvertebral fracture was noted during the first year. CONCLUSIONS: Our findings suggest that combination therapy of IBN and vitamin D is superior to monotherapy with regard to L-BMD improvements for 3 years, with both groups showing comparable safety and adherence to treatment.
Asian Continental Ancestry Group ; Bone Density ; Compliance ; Female ; Hip ; Humans ; Metabolism ; Osteoporosis ; Osteoporosis, Postmenopausal ; Prospective Studies ; Vitamin D

There are various causes for male osteoporosis. The low testosterone level is one of the important reasons. Androgen does not only play an important role in gaining the peak bone mass and maintaining the bone mass, but also has an intimate correlation with the bone loss with ageing. Androgen affects osteoblasts through androgen receptors. Various local cell factors play regulating roles. The partial testosterone replacement therapy in aging men could elevate the bone mass density, but the advantages and the disadvantages should be observed further. The function of the estrogen in male osteoporosis is being noted as well.
Age Factors ; Hormone Replacement Therapy ; Humans ; Male ; Osteoporosis ; drug therapy ; metabolism ; Testosterone ; metabolism ; therapeutic use

OBJECTIVETo observe the clinical effectiveness of warm needling combined with element calcium on postmenopausal osteoporosis, and to explore its action mechanism.

METHODSEighty-five postmenopausal patients were randomly divided into an observation group (43 cases) and a control group (42 cases). Both the two groups were treated with oral administration of caltrate-D tablet, 600 mg per day, once a day before sleep for one year. Patients in the observation group were treated with warm needling at Dazhu (BL 11), Shenshu (BL 23), Xuan-zhong (GB 39), once a day; 30 days of treatment were taken as a course, and totally 4 courses were given with an interval of 60 days between courses. The bone mineral density (BMD) of the lumbar vertebra and hip joint, and the level of serum bone gla protein (S-BGP) and hydroxyproline/creatinine (Hyp/Cr) were observed before and after treatment in the two groups.

RESULTS(1)After treatment, the BMD in the observation group was significantly increased [lumbar vertebra (0. 811±0. 024) g/cm2 vs (0. 892±0.019) g/cm2, femoral neck (0. 512±0.014) g/cm2 vs (0. 554±0. 015) g/cm2, femoral trochanter (0. 716±0. 028) g/cm2 vs (0.769±0.026) g/cm2, Ward's trigonum (0. 590±0. 013) g/cm2 vs (0. 660±0. 017) g/cm2, all P<0. 05)]; the improvement in the observation group was more significant than that in the control group (all P<0. 05). (2)After treatment, the index of bone metabolism in the control group was increased, and the serum S-BGP, the Hyp/Cr in the control group were higher than those in the observation group (both P<0. 05).

CONCLUSIONThe treatment of warm needling combined with element calcium on postmenopausal osteoporosis is significant, which is likely to be achieved by reducing the bone metabolism of postmenopausal patients.

Acupuncture Therapy ; Bone Density ; Calcium ; metabolism ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; physiopathology ; therapy

OBJECTIVETo understand the effects of low-frequency pulsed electromagnetic fields (PEMFs) on chronic bony pain, bone mineral density (BMD), bone strength and biochemical markers of bone metabolism in the patients of osteoporosis.

DATA SOURCESUsing the key words "pulsed electromagnetic fields" and "osteoporosis", we searched the PubMed for related studies published in English from January 1996 to December 2007. We also searched the China National Knowledge Infrastructure (CNKI) for studies published in Chinese from January 1996 to December 2007.

STUDY SELECTION

INCLUSION CRITERIA(1) all articles which referred to the effects of low-frequency pulsed magnetic fields on osteoporosis either in primary osteoporosis or secondary osteoporosis; (2) either observational studies or randomized controlled studies.

EXCLUSION CRITERIA(1) articles on experimental studies about osteoporosis; (2) repetitive studies; (3) case reports; (4) meta analysis.

RESULTSTotally 111 related articles were collected, 101 of them were published in Chinese, 10 were in English. Thirty-four were included and the remaining 84 were excluded.

CONCLUSIONSLow-frequency PEMFs relieves the pain of primary osteoporosis quickly and efficiently, enhances bone formation and increases BMD of secondary osteoporosis. But the effects of PEMFs on bone mineral density of primary osteoporosis and bone resorption were controversial.

Bone Density ; Bone and Bones ; metabolism ; Chronic Disease ; Electromagnetic Fields ; Humans ; Osteoporosis ; metabolism ; radiotherapy ; Pain ; radiotherapy ; Spinal Cord Injuries ; metabolism

To investigate the effect of hyperprolactinemia (HPLN) on bone mineral density (BMD), 21 previously treated hyprolactinemic amenorrheic women and 16 healthy, normally menstruating women were studied. Dualphoton absorptiometry was employed to specifically measure BMD at several sites in each of these women. Serum prolactin (PRL) along with LH, FSH, and estradiol (E2) had been measured by radioimmunoassay before treatment. Although all measured sites (vertebral body femur neck, Ward's triangle, and trochanter) showed lower BMDs in the study control group, only BMD at Ward's traingle, but no at the three other sites, was noted to be statistically significant in the study group compared with the control. There was no significant correlation between BMD and the patient's age, duration of amenorrhea, E2, and prolactin levels. Difference in BMD according to therapeutic modality was analyzed in these patients after treatment: transsphenoidal adenodectomy (TSA) with or without subsequent bromocriptine (Bx) (TSA +/- Bx) proved better in preserving BMD than TSA combined with postoperative radiotheraphy (RT) and Bx (TSA+RT+Bx), or Bx alone.
Adult ; Age Factors ; Bone and Bones/*metabolism ; Female ; Human ; Hyperprolactinemia/complications/*metabolism/therapy ; Minerals/*metabolism ; Osteoporosis/etiology ; Radionuclide Imaging

Cytokine has been postulated to play a role in the pathogenesis of post-menopausal osteoporosis. To test this hypothesis we measured circulating levels of IL-1, IL-6,IL-8 and TNF-alpha in 98 post-menopausal women (30 age matched normal and 68 osteoporotic) with no vertebral fractures. Although the cytokine levels of patients were found in normal cut off values, the difference in cytokine levels between patients and controls was statistically significant for IL-1 and IL-8 (p < 0.01). In osteoporotic patients, none of the cytokines correlated with lumbar, femoral (neck) and total hip bone mineral densities and also with body mass index (p > 0.01). In conclusion, we were unable to demonstrate abnormalities of cytokines affecting bone resorption in peripheral serum of women with post-menopausal osteoporosis. However increased production of these cytokines may occur in the local environment of bone.
Bone Resorption ; metabolism ; Case-Control Studies ; Cytokines ; blood ; metabolism ; Female ; Humans ; Middle Aged ; Osteoporosis, Postmenopausal ; metabolism ; Postmenopause ; physiology

Large, randomized, controlled trials have demonstrated the efficacy of bisphosphonates (BP) in terms of improving bone mineral density (BMD) and reducing fracture risk. Consequently, bisphosphonates are used widely in the treatment of osteoporosis. Recently, however, several safety issues regarding the long-term use of BP, especially BP-related osteonecrosis of the jaws and atypical fractures, have been noted and have emerged as a limitation of their clinical use. Although the absolute risk is very small, the risks could increase with the long-term use of BP. The anti-fracture efficacy of BP is not sustained after treatment for 5-10 years. Therefore, recommendations suggest that a drug holiday be considered after 5 years of treatment for patients at low risk of fracture. However, as the individual fracture risk varies, the treatment duration should be based on individual clinical risk factors and bone metabolism status. Moreover, recommendations regarding monitoring after discontinuing and reinitiating BP await further studies.
Bone Density ; Diphosphonates ; Holidays ; Humans ; Jaw ; Metabolism ; Osteonecrosis ; Osteoporosis ; Risk Factors

OBJECTIVE: To evaluate the effects of estrogen replacement therapy and pamidronate on the bone metabolism in the postmenopausal women. METHODS: This prospective randomized clinical trial examined the effects of oral pamidronate and conjugated equine estrogen, in combination and seperately, on biochemical markers of bone turnover in 140 women with low bone mass. Treatment included pamidronate (group I, n=50), or conjugated equine estrogen (group II, n=50), conjugated equine estrogen plus alendronate (group III, n=40) for 12 months. Biochemical markers of bone turnover were also measured at months 6 and 12 months. RESULTS: Serum osteocalcin and urinary deoxypyridinoline in Group I, Group II and Group III decreased signifiantly at 12 months of treatment (p<0.05). But total alkaline phosphatase decreased significantly during the treatment in Group III, but not in Group I and Group II. CONCLUSION: The combined treatment with pamidronate and conjugated equine estrogen is more effective in postmenopausal women with osteoporosis by decreasing bone biochemical markers.
Alendronate ; Alkaline Phosphatase ; Biomarkers ; Estrogen Replacement Therapy* ; Estrogens* ; Female ; Humans ; Metabolism* ; Osteocalcin ; Osteoporosis ; Postmenopause ; Prospective Studies