OBJECTIVETo investigate the correlation between serum levels of follicle-stimulating hormone (FSH) and total procollagen I N-terminal propeptide (TP1NP) in perimenopausal women.

METHODSTotal 274 women aged 33~60 y with perimenopausal period were enrolled in this study. Serum levels of FSH and TP1NP were detected by electrochemiluminescence.

RESULTSIn 274 perimenopausal women, the average level of TP1NP was (48.99±20.31) ng/mL, which was positively correlated with FSH level (r=0.159, P=0.009). In 40-50 age group, TP1NP level in women with FSH<40 mIU/mL was lower than that in those with FSH≥40mIU/mL [(35.05±18.11) ng/mL vs (51.33±24.67) ng/mL; t=-2.954, P=0.004]. However, in <40 and 50-60 age groups, there were no significant differences in TP1NP levels between patients with FSH<40 mIU/mL and those with FSH≥40 mIU/mL (t=-0.063, P=0.950; t=1.177, P=0.242). Multiple linear regression analysis showed that standardized coefficients of age variable was 0.047 (P=0.448) and standardized coefficients of FSH variable was 0.146 (P=0.019).

CONCLUSIONTP1NP levels showed a certain correlation with FSH in perimenopausal women, especially for women aged 40-50, indicating that high FSH levels may be important factors for osteoporosis in postmenopausal women.

Adult ; Female ; Follicle Stimulating Hormone ; blood ; Humans ; Middle Aged ; Peptide Fragments ; blood ; Perimenopause ; blood ; Procollagen ; blood

Osteoporosis is a major health problem worldwide, and is projected to increase exponentially due to the aging of the population. The absolute fracture risk in individual subjects is calculated by the use of algorithms which include bone mineral density (BMD), age, gender, history of prior fracture and other risk factors. This review describes the laboratory investigations into osteoporosis which include serum calcium, phosphate, creatinine, alkaline phosphatase and 25-hydroxyvitamin D and, additionally in men, testosterone. Parathyroid hormone (PTH) is measured in patients with abnormal serum calcium to determine its cause. Other laboratory investigations such as thyroid function testing, screening for multiple myeloma, and screening for Cushing's syndrome, are performed if indicated. Measurement of bone turnover markers (BTMs) is currently not included in algorithms for fracture risk calculations due to the lack of data. However, BTMs may be useful for monitoring osteoporosis treatment. Further studies of the reference BTMs serum carboxy terminal telopeptide of collagen type I (s-CTX) and serum procollagen type I N-terminal propeptide (s-PINP) in fracture risk prediction and in monitoring various treatments for osteoporosis may help expedite their inclusion in routine clinical practice.
Algorithms ; Biological Markers/*blood ; Clinical Laboratory Techniques ; Collagen Type I/blood ; Fractures, Bone/prevention & control ; Humans ; Osteoporosis/*diagnosis ; Peptide Fragments/blood ; Peptides/blood ; Procollagen/blood

OBJECTIVETo investigate the correlation of gestational age (GA) with carboxyterminal propeptide of type I procollagen (PICP), deoxypyridinoline (DPD), and bone sound of speed (SOS) in appropriate-for-gestational-age (AGA) neonates, as well as the relationship between bone turnover markers and bone SOS.

METHODSSixty-five AGA neonates were included in the study. The neonates were divided into three groups: preterm infant (GA ≤3 4 weeks, 14 cases), late preterm infant (34 weeksblood was collected within 7 days after birth to measure blood PICP concentration. Urine was collected to measure urinary DPD and creatinine (Cr) levels. Omnisense 7000P ultrasound bone sonometer was applied to measure the SOS of the left tibia in all cases within 7 days after birth.

RESULTSThere were significant differences in GA (F=140.199, P<0.001), birth weight (F=47.042, P<0.001), birth length (F=46.877, P<0.001), and PI (F=11.898, P<0.001) between the three groups; the higher the GA, the higher the birth weigh, birth length, and PI. There were significant differences in PICP (F=30.384, P<0.001), DPD/Cr (F=21.761, P<0.001), and SOS (F=20.052, P<0.001) between the three groups; the higher the GA, the lower the PICP and DPD/Cr and the higher the bone SOS. PICP and DPD/Cr were negatively correlated with GA, birth weight and bone SOS (P<0.01), while bone SOS was positively correlated with GA and birth weight (P<0.01), which still held true after adjustment for GA and birth weight.

CONCLUSIONSAmong AGA neonates, bone turnover markers are negatively correlated with GA, birth weight and bone SOS. High bone turnover is bad for bone health in AGA neonates.

Amino Acids ; blood ; Birth Weight ; Bone Density ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Male ; Peptide Fragments ; blood ; Procollagen ; blood ; Tibia ; diagnostic imaging ; Ultrasonography

OBJECTIVETo investigate the effect of spironolactone on left ventricular remodeling (LVRM) in patients with acute myocardial infarction.

METHODSIn this multicentric, randomized, controlled study, spironolactone 40 mg/d was randomly administered in addition to the routine treatment for patients with AMI. During the 6 months the serum PIIINP, BNP and echocardiography were examined in all patients to assess myocardial fibrosis, LV function and volume.

RESULTSA total of 88 AMI patients entered the study came from 4 hospitals in Shijiazhuang. There were 43 patients with anterior MI and 45 with inferior MI. In anterior MI group 23 patients received spironolactone and 20 accepted the routine treatment. In inferior MI group 23 received spironolactone and 22 accepted the routine treatment. In anterior MI group: (1) At 3rd, 6th month PIIINP and BNP serum levels were significantly lower in the spironolactone group compared with those in control group [PIIINP (260.2 +/- 59.9) vs (328.0 +/- 70.3) ng/L, P = 0.001, (197.1 +/- 46.3) vs (266.7 +/- 52.4) ng/L, P < 0.001], [BNP (347.4 +/- 84.0) vs (430.1 +/- 62.9) ng/L, P < 0.001, (243.7 +/- 79.7) vs (334.6 +/- 62.8) ng/L, P < 0.001]; (2) There were smaller LVEDD and LVESD in spironolactone group compared with those in control group after 6 months intervention [(51.0 +/- 5.5) vs (55.6 +/- 4.5) mm, P = 0.005, (35.7 +/- 4.6) vs (39.1 +/- 5.6) mm, P = 0.046]. However, in inferior MI group: (1) There were no significant differences in PIIINP and BNP values between the two groups after 6 months intervention; (2) There were no significant differences in the LVEDD, LVESD, LVEF after 6 months treatment.

CONCLUSION(1) In patients with anterior MI, spironolactone combined with the routine treatment could inhibit myocardial fibrosis and left ventricular dilation and prevent LVRM. (2) In patients with inferior MI, no significant difference in prevention of LVRM was found between the spironolactone combined with the routine treatment and the routine treatment alone.

Female ; Humans ; Male ; Myocardial Infarction ; drug therapy ; physiopathology ; Myocardial Revascularization ; Natriuretic Peptide, Brain ; blood ; Peptide Fragments ; blood ; Procollagen ; blood ; Spironolactone ; therapeutic use ; Ventricular Remodeling ; drug effects

OBJECTIVESTo study the relationship between serum levels of hyaluronic acid (HA), type III procollagen (PCIII), laminin (LN), type IV collagen (IV-C) and hepatic fibrosis and to determine their value in clinical practice.

METHODS2600 serum samples from chronic hepatitis patients were assayed for fibrosis indexes including HA, PCIII, LN and IV-C with RIA. Liver biopsy was performed in 280 of those patients and the biopsy material was examined histopathologically. The inflammation grade of the liver, stage of fibrosis and degree of chronic hepatitis were recorded and were compared with fibrotic indexes.

RESULTSAmong 2600 chronic hepatitis patients, every fibrotic index had a significant correlation with the inflammation grade, fibrosis staging and the degree of chronic hepatitis (P < 0.01). The coefficient correlation of the results of histopathological examinations to HA was 0.544, 0.548 and 0.468 respectively, that to PCIII, 0.495, 0.424 and 0.335, that to LN, 0.214, 0.204 and 0.184, and that to IV-C, 0.406, 0.404 and 0.412, respectively.

CONCLUSIONSSerum fibrosis indexes are fairly well correlated with the inflammation grade of the liver, fibrosis staging and the degree of chronic hepatitis. However, as diagnostic markers, they should be considered in combination with liver function tests, ultrasonography and clinical manifestations.

Adolescent ; Adult ; Aged ; Collagen Type III ; blood ; Collagen Type IV ; blood ; Female ; Hepatitis, Chronic ; blood ; diagnosis ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Liver Cirrhosis ; blood ; diagnosis ; Male ; Middle Aged ; Procollagen ; blood ; Prognosis

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

OBJECTIVESTo study the quantitative relationship between the levels of serum liver fibrosis markers and fibrosis stages of liver tissues in patients with chronic hepatic diseases.

METHODSIn 118 patients with chronic hepatitis, fatty liver or cirrhosis, their Serum levels of LN, HA, PCIII and CIV were investigated by EIA and their liver histological changes were studied. The relationship between the levels of serum LN, HA, PCIII and CIV and the degrees of liver tissue fibrosis was analyzed quantitatively by using the SPSS11.0.

RESULTSA correlation between the levels of serum LN, HA, PCIII and CIV and the histologically assessed grades of inflammatory activity was found (r = 0.394, 0.449, 0.443, 0.351, respectively, P <0.01). The correlation between the levels of serum LN, HA, PCIII and CIV and the histological assessed stages of liver fibrosis was strong (r = 0.456, 0.564, 0.476, 0.421 respectively, P <0.01). The levels of serum LN, HA, PCIII and CIV of the patients with a stage 2 liver fibrosis were 110 ng/ml, 110 ng/ml, 100 ng/ml and 70 ng/ml respectively, with sensibilities of diagnosing stage 2 liver fibrosis at 70%, 79%, 79% and 74% respectively. Their specificities in diagnosing stage 2 liver fibrosis were 68%, 72%, 64% and 73% respectively. The levels of LN, HA, PCIII and CIV in serum of these patients diagnosing cut-off value in stage 4 liver fibrosis (early cirrhosis) were 130 ng/ml, 140 ng/ml, 120 ng/ml and 70 ng/ml respectively. Their sensibility of diagnosing liver cirrhosis was 79%, 93%, 79% and 86% respectively. Their specificity of diagnosing liver cirrhosis was 66%, 82%, 72% and 61% respectively. As shown by the ROC curves in these patients, differentiating patients with cirrhosis or without cirrhosis, serum HA level was more valuable than LN, PCIII, CIV (the areas under the curves = 0.938 vs 0.775, 0.787, 0.791 ) When serum HA was higher than 190 ng/ml, the veracity of diagnosing liver cirrhosis was 93%.

CONCLUSIONSThere is a certain quantitative relationship between the levels of LN, HA, PCIII and CIV in serum and the degrees of liver tissue fibrosis. The level of HA in serum is an important reference datum for early diagnosing liver cirrhosis.

Adolescent ; Adult ; Aged ; Child ; Fatty Liver ; blood ; complications ; Female ; Hepatitis, Chronic ; blood ; complications ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Liver ; pathology ; Liver Cirrhosis ; blood ; etiology ; pathology ; Male ; Middle Aged ; Procollagen ; blood

BACKGROUNDSclerostin, expressed exclusively by osteocytes, is a negative regulator of bone formation. To gain insights into the action of sclerostin in postmenopausal osteoporosis, we evaluated serum sclerostin levels in postmenopausal women and investigated its possible associations with bone turnover markers in patients with postmenopausal osteoporosis.

METHODSWe detected serum sclerostin, and measured lumbar spine bone mineral density in 650 Chinese postmenopausal women. We also assessed serum levels of β-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin, 25-hydroxyvitamin D, and estradiol.

RESULTSSerum sclerostin levels were lower in postmenopausal osteoporotic women compared with non-osteoporotic postmenopausal women ((38.79 ± 7.43) vs. (52.86 ± 6.69) pmol/L, P < 0.001). Serum sclerostin was positively correlated with lumbar spine bone mineral density (r = 0.391, P < 0.001) and weakly negatively correlated with β-isomerized C-terminal crosslinking of type I collagen, intact N-terminal propeptide of type I collagen, N-mid fragment of osteocalcin (r = -0.225, P < 0.001; r = -0.091, P = 0.046; r = -0.108, P = 0.018; respectively) in postmenopausal osteoporosis. There was no significant association of serum sclerostin with age, body mass index, 25-hydroxyvitamin D, and estradiol (r = -0.004, P = 0.926; r = 0.067, P = 0.143; r = 0.063, P = 0.165; r = -0.045, P = 0.324; respectively).

CONCLUSIONSclerostin may be involved in the pathogenesis of postmenopausal osteoporosis and may play a role in bone turnover.

Aged ; Bone Density ; Bone Morphogenetic Proteins ; blood ; Bone Remodeling ; Collagen Type I ; blood ; Female ; Genetic Markers ; Humans ; Lumbar Vertebrae ; Middle Aged ; Osteoporosis, Postmenopausal ; blood ; metabolism ; Peptide Fragments ; blood ; Peptides ; blood ; Procollagen ; blood

OBJECTIVETo explore the dynamic change in biochemical markers of bone turnover in preterm infants and the effect of early parenteral calcium supply.

METHODSForty preterm infants were divided into parenteral calcium supply group and control group. Blood and urine samples were collected at 24 h and 11 d after birth. Serum osteocalcin (OC) was measured with ELISA, serum carboxyterminal telopeptide type I collagen (ICTP) with radioimmunoassay, serum alkaline phosphatase (AKP), calcium, phosphate, and urine calcium, phosphate, creatinine with automatic biochemical analyzer. Blood samples were also collected from 22 term infants as control. Calcium gluconate (10%, 4 ml/kg x d(-1)) was administered intravenously in parenteral calcium supply group.

RESULTAt 24 h, serum AKP, ICTP [(147.86+/- 44.87)IU, (57.36+/- 6.34)micro g/L] in preterm infants were significantly higher than those [(147.86+/- 44.87)IU, (57.36+/- 6.34)micro g/L] in term infants, and negatively correlated with gestational age and birth weight (r =-0.528, P<0.01; -0.614, P< 0.01), but serum OC [(648.77+/- 238.89) nmol/L] in preterm infants was lower than that [(851.68+/- 238.69)nmol/L] of term infants, and positively correlated with gestational age and birth weight (r=0.359, P< 0.05; 0.376, P< 0.01). At 11 day, serum OC [947.25+/- 335.47)nmol/L] in preterm infants was markedly elevated and reached the level of term infants [(941.65+/- 297.28)nmol/L], but serum ICTP [(65.44+/- 6.24)micro g/L] in preterm infants was higher than that [(57.10+/- 3.48)micro g/L] in term infants all along. Serum AKP [(246.00+/-66.64)IU] in parenteral calcium supply group was higher than that [(206.53+/- 53.9)IU] in the control group. There were no significantly differences in serum OC and ICTP between parenteral calcium supply group and the control group. Calcium in serum and urine was elevated, phosphate in serum and urine was reduced in the parenteral calcium supply group. Urine analysis and kidney ultrasounds were normal.

CONCLUSIONThere is active bone formation and bone resorption in preterms as compared with terms. Alone parenteral calcium supply during early life can not increase formation of bone protein or decrease degradation of bone collagen, but can elevate serum calcium and urine calcium levels. Hematuria and renal calcification were not found in short duration.

Alkaline Phosphatase ; blood ; Bone and Bones ; metabolism ; Calcium ; administration & dosage ; blood ; urine ; Collagen Type I ; Female ; Humans ; Infant, Newborn ; Infant, Premature ; Injections, Intravenous ; Male ; Osteocalcin ; blood ; Peptide Fragments ; blood ; Peptides ; Procollagen ; blood

OBJECTIVETo evaluate the diagnostic value of liver fibrosis markers and ultrasonic examination for determining compensated liver cirrhosis in patients with chronic hepatitis B, and screen applicable non-invasive diagnostic marker for compensated liver cirrhosis.

METHODSSerum hyaluronic acid (HA), Type III procollagen (PCIII), laminin (LN) and Type IV collagen (CIV) were measured from 350 patients with chronic hepatitis B, who were also detected with liver biopsy and ultrasonography. To determine the cut-off value of every serum liver fibrosis marker for diagnosing compensated liver cirrhosis, data was analysed with clinical epidemiology methods. Then evaluated and compared all the markers.

RESULTS85 out of 350 patients were diagnosed as compensated liver cirrhosis by liver biopsy, and 81 had liver cirrhosis images by ultrasonic examination. HA achieved the biggest area under the ROC curve. The cut-off values with best sensitivity and accuracy of HA, PCIII, LN and CIV were 154.35 microg/L, 198.44 microg/L, 137.58 microg/L and 100.80 microg/L respectively. The related diagnostic sensitivities of HA, PCIII, LN and CIV were 82.4%, 63.5%, 57.3% and 70.6%, specificities were 79.3%, 54.0%, 56.8%, 68.3%, and accuracies were 80.0%, 56.3%, 56.9%, 68.9%, respectively. Parallel tests could increase the diagnostic sensitivity, but decreased specificity and accuracy accordingly. Compared with other non-invasive diagnostic methods, HA was the best marker (mu > or =1.814, P<0.05). The level of HA at 119.17 microg/L was suitable for determining compensated cirrhosis, with a 87.1% sensitivity, 67.6% specificity, 72.3% accuracy, 46.25% positive predictive value and 94.7% negative predictive value.

CONCLUSIONAmong the non-invasive serum diagnostic markers for liver fibrosis and ultrasonic examination for cirrhosis image, HA is the best marker for diagnosing compensated liver cirrhosis.

Adolescent ; Adult ; Biomarkers ; blood ; Child ; Collagen Type IV ; blood ; Female ; Hepatitis B, Chronic ; complications ; Humans ; Hyaluronic Acid ; blood ; Laminin ; blood ; Liver Cirrhosis ; diagnosis ; etiology ; Male ; Middle Aged ; Procollagen ; blood