Role of Biochemical Markers of Bone Turnover as Prognostic Indicator of Successful Osteoporosis Therapy

in BONE (2008), 42

Most of the currently available anti-osteoporosis medications promptly and significantly influence the rate of bone turnover. Biochemical markers of bone turnover now provide a high sensitivity to change ... [more ▼]

Most of the currently available anti-osteoporosis medications promptly and significantly influence the rate of bone turnover. Biochemical markers of bone turnover now provide a high sensitivity to change, allowing the detection of these bone turnover changes within a couple of weeks. Since the anti-fracture efficacy of inhibitors of bone resorption or stimulators of bone formation appears to be largely independent of baseline bone turnover, biochemical markers do not appear to play a significant role in the selection of one particular drug, for an individual patient. However, there are consistent data showing that short-term changes in biochemical markers of bone turnover may be significant predictors of future changes in bone mineral density or fracture reduction, hence suggesting that bone turnover markers play a significant role in the monitoring of anti-osteoporosis therapy. [less ▲]

Effets d'une perfusion unique d'acide zolédronique 5 mg versus risédronate (5 mg/jour) sur le remodelage osseux sur 1 an chez des patients avec ostéroporose cortisonique

in Revue du Rhumatisme (2008), 75

A cross-sectional evaluation of adiponectin plasma levels in patients with schizophrenia and schizoaffective disorder.

in Schizophrenia Research (2008), 106(2-3), 308-14

BACKGROUND: In recent years, several studies showed increased rates of hyperglycaemia, diabetes, dyslipidemia, metabolic syndrome as well as cardiovascular disease in schizophrenic patients. The ... [more ▼]

BACKGROUND: In recent years, several studies showed increased rates of hyperglycaemia, diabetes, dyslipidemia, metabolic syndrome as well as cardiovascular disease in schizophrenic patients. The underlying mechanism, however, is poorly understood. Adiponectin is a recently identified adipocyte-derived protein, with low adiponectin levels being associated with metabolic abnormalities such as obesity, insulin resistance and type 2 diabetes. METHODS: Fasting adiponectin levels were assessed in a cross-sectional sample of 386 patients with schizophrenia or schizoaffective disorder. All patients were on monotherapy of second-generation antipsychotics (SGA) and underwent an extensive metabolic screening including an oral glucose tolerance test (OGTT). RESULTS: Adiponectin plasma levels were inversely correlated with BMI, and differed significantly between patients with normal weight, overweight or obesity (p<0.05). Patients who met criteria for the metabolic syndrome, according to adapted National Cholesterol Educational Program - Adult Treatment Panel criteria (NCEP-ATP III) (29.3%), had significantly lower adiponectin levels than patients not meeting metabolic syndrome criteria (p<0.0001). Patients without glucose abnormalities (78%) had significantly higher adiponectin levels than patients with diabetes (5.7%) (p<0.05). After controlling for components of metabolic syndrome and sex, antipsychotic medication independently influenced adiponectin levels (p<0.0001), with the lowest mean levels in patients on clozapine and olanzapine. CONCLUSIONS: Adiponectin levels in schizophrenic patients mirror what is observed in the general population, with the lowest levels in the most metabolically comprised subjects. However, antipsychotic medication may also influence adiponectin regulation independently, a finding that should be confirmed in longitudinal studies. [less ▲]

Prevalence of vitamin D inadequacy in European postmenopausal women

in Current Medical Research & Opinion (2007), 23(8), 1939-1944

Objective: Inadequate vitamin D level is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to ... [more ▼]

Objective: Inadequate vitamin D level is associated with secondary hyperparathyroidism and increased bone turnover and bone loss, which in turn increases fracture risk. The objective of this study is to assess the prevalence of inadequate serum vitamin D levels in postmenopausal European women. There are no clear international agreements on what constitutes a level of vitamin D inadequacy, but recent publications suggest that the circulating level of vitamin D should be over 80 nmol/L or at least between 50 and 80 nmol/L. Material and methods: Assessment of 25-hydroxyvitamin D [25(OH)D] was performed in 8532 European postmenopausal women with osteoporosis or osteopenia. European countries included France, Belgium, Denmark, Italy, Poland, Hungary, United Kingdom, Spain and Germany. Two cut-offs of 25(OH)D inadequacy were fixed < 80 nmol/L and < 50 nmol/L. Results: Mean (SD) age of the patients was 74.2 (7.1) years, body mass index was 25.7 (4.1)kg/m(2). Level of 25(OH)D was 61.0 (27.2) nmol/L. There was a highly significant difference of 25(OH)D level across European countries (p < 0.0001). The lowest level of 25(OH)D was found in France [51.5 (26.1) nmol/L] and the highest in Spain [85.2 (33.3) nmol/L]. In the whole study population, the prevalence of 25(OH)D inadequacy was 79.6% and 32.1 % when considering cut-offs of 80 and 50 nmol/L, respectively and when considering patients aged less than 65 years, the prevalence reached 86% (cut-off of 80 nmol/L) and 45% (cutoff of 50 nmol/L). Conclusion: This study indicates a high prevalence of vitamin D [25(OH)D] inadequacy in European postmenopausal women. The prevalence could be even higher in some particular countries. A greater awareness of the importance of vitamin D inadequacy is needed to address this public health problem. [less ▲]

Strontium ranelate decreases vertebral fracture risk whatever the level of pretreatment bone turnover markers

in Calcified Tissue International (2007, May), 80(Suppl.1), 29-30

Prevalence of vitamin D inadequacy is high in European postmenopausal women

in Osteoporosis International (2007, March), 18(Suppl.1), 124

Dissociation between bone formation and bone resorption evidenced by changes in biochemical markers of bone turnover in patients treated with strontium ranelate

in Osteoporosis International (2007, March), 18(Suppl.1), 125

Biochemical markers of bone turnover confirm the dual mode of action of strontium ranelate: increase in bone formation and decrease in bone resorption

in Arthritis and Rheumatism (2006, November), 54(Suppl), 590

Evaluation of different bone markers in hemodialyzed patients

in Clinica Chimica Acta (2006), 371(1-2), 107-111

Background: Routinely, nephrologists rely on different biochemical markers like intact PTH (iPTH), bone-specific alkaline phosphatase (BALP), plasmatic calcium and phosphate. The aim of the present study ... [more ▼]

Background: Routinely, nephrologists rely on different biochemical markers like intact PTH (iPTH), bone-specific alkaline phosphatase (BALP), plasmatic calcium and phosphate. The aim of the present study was to evaluate different other bone markers like N-terminal propeptide of type I procollagen (PINP), active isoform 5b of the tartrate-resistant acid phosphatase (TRAP 5b) and beta-crossLaps (R) (CTXS) as well as full-length PTH (wPTH), presumed non-(1-84) PTH, and their ratio in the diagnosis of renal osteodystrophy with high and low turnover. We also determined 25 hydroxyvitamin D (25VTD), 1-25 dihydroxyvitamin D and homocystein (HCY). Methods: We performed those parameters on 73 patients with end-stage renal disease according to the manufacturers' instructions. Results: There were very strong correlations between the bone markers concentrations, particularly between BALP and PINP (r=0.953). We did not observe any correlation between the ratio whole PTH/non-(1-84) PTH and any of the usual bone markers. This ratio was significantly (p < 0.05) higher in low and high bone turnover patients than in normal patients according to the K/DOQI. We found a correlation between low levels of 25VTD and high levels of HCY Conclusions: BALP offers the best clinical and analytical profile as the easier marker of choice in hemodiallyzed patients for the diagnosis of bone disease. (c) 2006 Elsevier B.V All rights reserved. [less ▲]

Comprehensive therapy in osteoporosis using a single drug: From ADFR to strontium ranelate

in Current Medicinal Chemistry (2006), 13(13), 1585-1590

In vitro, strontium ranelate increases collagen and non-collagenic proteins synthesis by mature osteoblast enriched cells. The effects of strontium ranelate on bone formation were confirmed as the drug ... [more ▼]

In vitro, strontium ranelate increases collagen and non-collagenic proteins synthesis by mature osteoblast enriched cells. The effects of strontium ranelate on bone formation were confirmed as the drug enhanced preosteoblastic cell replication. In the isolated rat osteoclast, a preincubation of bone slices with strontium ranclate induced a dose-dependent inhibition of the bone resorbing activity of treated rat osteoclast. Strontium ranelate dose-dependently inhibited preosteoclast differentiation. In a phase 11 dose ranging trial Strontium ranclate (500 mg. 1000 mg, 2000 mg/day) or placebo were given to 353 postmenopausal women with prevalent vertebral osteoporosis. At the conclusion of this 2-year study. the annual increase in lumbar BMD of the group receiving 2000 mg of strontium ranclate was + 7.3%. a significant increase in bone alkaline phosphatase, over a 6-month period and a significant decrease in N-telopeptide crosslinks throughout the 2-year period were seen. During the second year of treatment, the dose of 2000 mg was associated with a 44% reduction in the number of patients experiencing a new vertebral deformity. The primary analysis of the SOTI study, evaluatine the effect of strontium ranelate 2000 mg on vertebral fracture rates, revealed a 41% reduction in the relative risk of patient experiencing a first new vertebral fracture with strontium ranelate throughout the 3-year study. The TROPOS study showed a significant reduction in the risk of experiencing a first non-vertebral fracture by 16% in the group treated with strontium ranclate throughout the 3-year study. A reduction in the risk of experiencing a hip fracture by 36% was also demonstrated in the patients at high risk of hip fracture (age >= 74 years and Femoral Neck T score <=-2.4 according to NHANES normative value). [less ▲]