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

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

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

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

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

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

BACKGROUND: Biochemical markers have been proposed as sensitive indicators of high bone turnover and for monitoring response to osteoporosis treatment. We conducted a retrospective study to investigate the pattern of biochemical markers of bone metabolism (urinary deoxypryridinoline(D PYD), serum osteocalcin) across menopausal transition in women. METHODS: We measured the urinary excretion of D PYD, serum osteocalcin and BMD in 44 premenopausal and age matched 44 postmenopausal women who visited a tertiary hospital from May 1, 1997 to July 31, 1997. Each values between premenopausal and postmenopausal women were anaysed with paired t-tests. Pearson's correlation coefficients were performed to assess the relationships between the three values. RESULTS: Urinary excretion of D-PYD in postmenopausal women (12.103+/-2.27 nM/mM creatinine) was higher than in premenopausal women (9.322+/-2.53 nM/mM creatinine) (P<0.05). Serum osteocalcin in postmenopausal women (12.8698+/-3.1 ng/ml) was higher than in premenopausal women (9.0949+/-2.7 ng/ml) (P<0.01). BMD in postmenopausal women (0.9979+/-0.1863 g/cm2) was lower than in postmenopausal women (1.1845+/-0.1591 g/cm2) (P<0.01). The serum osteocalcin level was positively correlated with D-PYD (r=0.547, p<0.01). Urine excretion of D-PYD was negatively correlated with BMD (r= 0.36, p<0.01). Serum osteocalcin was negatively correlated with BMD (r= 0.427, P<0.01). CONCLUSION: Urinary D-PYD excretion and serum osteocalcin were increased, but BMD was decreased significantly in postmenopausal women. Urinary D-PYD, serum osteocalcin, and BMD were significantly correlated with each other in women.
Biomarkers ; Bone Density ; Female ; Humans ; Menopause ; Metabolism ; Osteocalcin* ; Osteoporosis ; Retrospective Studies ; Tertiary Care Centers

PURPOSE: While treating 14 phenylketonuria(PKU) patients, we evaluated bone density, changes in bone age, andbony changes such as spiculation or metaphyseal widening. MATERIALS AND METHODS: A total of 14 PKU patients agedbetween 1 month and 14 years(mean, 6.4 years) were under dietary treatment. Eight and eleven patients underwentradiography of the left hand and wrist and bone densitometry(BMD) of the lumbar spine, respectively. The resultswere reviewed with regard to abnormal bony changes, delayed bone age, and osteopenia. Patients were assigned toeither the early or late treatment group, depending on whether or not dietary therapy was started before 3 monthsof age. Those in whom a blood phenylalanine level of under 10 mg/dl was maintained were assigned to the 'goodcontrol' group; others were classified as 'variable control'. The findings of radiographs of the left hand andlumbar BMD were evaluated in relation to the time of dietary therapy, and adequacy of treatment. RESULTS: Onlumbar BMD, four of 11 patients (36%) showed reduced bone density of more than 1 S.D. None of the 11 who underwentradiography of the left hand showed bony abnormalities such as spiculation or metaphyseal widening. In four of the11, bone age was less than chronological age by at least one year. According to Fisher's exact test there was norelation between delayed bone age , osteoporosis and the time and adequacy of dietary therapy (p >0.05). CONCLUSION: None of the 14 PKU patients who underwent dietary therapy had bony abnormalities such as spiculationor metaphyseal widening. In four of the 11, bone age was at least one year less than chronological age, and onlumbar BMD, osteoporosis was seen. For the evaluation of bone change in PKU patients, plain radiography and BMDare thus complementary.
Bone Density ; Bone Diseases, Metabolic ; Hand ; Humans ; Metabolism ; Osteoporosis ; Phenylalanine ; Phenylketonurias* ; Radiography ; Spine ; Wrist