Metatropic dysplasia is associated with increased fracture risk and increased markers of bone turnover

2015 ◽  
Author(s):  
Michael Bober ◽  
Angela Duker ◽  
Megan Carney ◽  
Colleen Ditro ◽  
Kenneth Rogers ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Fracture Risk ◽  
Markers Of Bone Turnover ◽  
Metatropic Dysplasia

Relationship Between Changes in Biochemical Markers of Bone Turnover and BMD to Predict Vertebral Fracture Risk

2003 ◽  
Vol 19 (3) ◽  
pp. 394-401 ◽  
Author(s):  
Somnath Sarkar ◽  
Jean-Yves Reginster ◽  
Gerald G Crans ◽  
Adolfo Diez-Perez ◽  
Karen V Pinette ◽  
...  
Keyword(s):  
Vertebral Fracture ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Biochemical Markers ◽  
Vertebral Fracture Risk ◽  
Markers Of Bone Turnover

scholarly journals Biomarkers of bone health and osteoporosis risk

2008 ◽  
Vol 67 (2) ◽  
pp. 157-162 ◽  
Author(s):  
Richard Eastell ◽  
Rosemary A. Hannon
Keyword(s):  
Bone Turnover ◽  
Fracture Risk ◽  
Risk Reduction ◽  
Hormone Replacement ◽  
Osteoporosis Treatment ◽  
Bone Alkaline Phosphatase ◽  
Type I ◽  
Mineral Density ◽  
Markers Of Bone Turnover ◽  
Fracture Risk Reduction

The assay features of biochemical markers of bone turnover have markedly improved in the past few years. The most sensitive and specific markers of bone formation include serum bone alkaline phosphatase, total osteocalcin (including the intact molecule and the large N-mid fragment) and the procollagen type I N-terminal propeptide assay. Among the various markers of bone resorption, measurements of the urinary excretion of N- and C-terminal cross-linked telopeptides) and of serum C-terminal cross-linked telopeptides are the most sensitive and specific. Markers of bone turnover can be used to predict the rate of bone loss in post-menopausal women and can also be used to assess the risk of fractures. In osteoporosis-treatment studies (with alendronate, risedronate, raloxifene) markers of bone turnover appear even more strongly associated with fracture risk reduction than bone mineral density (BMD). These observations support the use of markers of bone turnover as surrogates for fracture risk reduction, perhaps even more so than BMD. Bone markers can also be used to monitor the efficacy of antiresorptive therapy such as hormone-replacement therapy, raloxifene and bisphosphonates in individual patients. Furthermore, they have also proved to be helpful in monitoring the response to nutritional interventions and have the advantage over BMD in that they provide information about mechanism of effect and changes are often observed much more rapidly.

scholarly journals Is it possible to predict a risk of osteoporosis in patients with juvenile idiopathic arthritis? A study of serum levels of markers of bone turnover

2018 ◽  
Vol 65 (2) ◽  
pp. 297-302 ◽  
Author(s):  
Marta Janicka-Szczepaniak ◽  
Krzysztof Orczyk ◽  
Katarzyna Szymbor ◽  
Danuta Chlebna-Sokół ◽  
Elzbieta Smolewska
Keyword(s):  
Alkaline Phosphatase ◽  
Juvenile Idiopathic Arthritis ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Serum Levels ◽  
Bone Alkaline Phosphatase ◽  
Common Finding ◽  
Treatment Needs ◽  
Mineral Density ◽  
Markers Of Bone Turnover

Background: Low bone mineral density is a common finding in children with systemic connective tissue diseases, including juvenile idiopathic arthritis (JIA). The influence of the ongoing process of bone remodeling on the disease course merits further investigation. The aim of the study was to assess the clinical relevance of markers of bone turnover and their potential role as predictors of higher fracture risk and, by extension, risk of osteoporosis.Materials and methods: Blood samples were collected from 59 patients diagnosed with JIA in order to determine serum levels of the following markers of bone turnover: Beta-Crosslaps, osteocalcin, bone alkaline phosphatase, osteoprotegerin and receptor activator for nuclear factor kappa-B ligand. The values were analyzed with laboratory parameters and results of dual X-ray absorptiometry (DXA).Results: Osteoprotegerin and bone alkaline phosphatase levels were age-dependent. Beta‑Crosslaps values were significantly higher in patients with positive JADAS27 score (p=0.0410). Osteoprotegerin levels were higher in patients treated with biological agentsthan only withdisease-modifying anti-rheumatic drugs (p=0.0273). There was no relation between markers of bone turnover and sex, DXA results, dosage of glucocorticosteroids and disease duration.Conclusions:Authors postulate performing DXA measurements every 6 months in patients with higher disease activity. The potential lower fracture risk in children with JIA within biological treatment needs future assessment. Age- and sex-adjusted reference rates of markers of bone turnover for Central Europe need to be developed in order to assess individual values properly.

scholarly journals Hip and Nonvertebral Fracture Prediction in Nursing Home Patients: Role of Bone Ultrasound and Bone Marker Measurements

2007 ◽  
Vol 92 (5) ◽  
pp. 1678-1686 ◽  
Author(s):  
Harald Dobnig ◽  
Jutta Claudia Piswanger-Sölkner ◽  
Barbara Obermayer-Pietsch ◽  
Andreas Tiran ◽  
Andrea Strele ◽  
...  
Keyword(s):  
Nursing Home ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Hip Fractures ◽  
Nonvertebral Fracture ◽  
Bone Ultrasound ◽  
Nonvertebral Fractures ◽  
Nursing Home Patients ◽  
Markers Of Bone Turnover ◽  
Ultrasound Measurements

Abstract Context: Absolute fracture risk in nursing home patients is the highest among the communities studied. Screening for high-risk patients in such an environment is usually difficult. Objective: The objective was to investigate whether quantitative bone ultrasound measurements and/or markers of bone turnover/metabolism help in predicting which patients will incur hip or nonvertebral fractures. Design, Setting, and Participants: In this prospective study, mobile teams enrolled 1664 female patients from 95 nursing homes in Austria. Main Outcome Measures: Calcaneal stiffness (n = 1117), radial speed of sound (SOS) (n = 1332), and phalangeal SOS (n = 1498) measurements were performed at baseline. Serum samples (n = 960) were analyzed for serum calcium and phosphate, 25 hydroxyvitamin D, PTH, osteocalcin, C-terminal telopeptide crosslinks, and osteoprotegerin (OPG). Patients were prospectively followed for hip and other nonvertebral fractures for 2 yr. Results: A total of 117 hip fractures and 269 nonvertebral fractures developed during a mean observation period of 2 yr. Prevalence of vitamin D deficiency and secondary hyperparathyroidism was high. A history of a past fracture was significantly associated with a hazard ratio (HR) of 1.47 (95% confidence interval, 1.01–2.15) and 1.65 (1.26–2.16) for the development of hip and nonvertebral fractures, respectively. Cox regression analysis revealed a multivariate adjusted elevation in both hip [HR 1.30 (1.12–1.43)] and nonvertebral [HR 1.14 (1.02–1.25)] fracture risk for each sd decrease in calcaneal stiffness. Patients in the lowest quartile for calcaneal stiffness Z-score had 2.5 and 1.2 times higher rates of hip and nonvertebral fractures when compared with patients in the highest quartile. Fracture rates were not statistically associated with baseline radial or phalangeal SOS measurements or with serum osteocalcin, C-terminal telopeptide crosslinks, and OPG concentrations. When adjusted for bone mass, higher serum OPG levels were associated with fewer hip as well as nonvertebral fractures [HR 0.85 (0.73–0.99) and 0.89 (0.80–0.99) per increment of 1]. Higher serum phosphate levels indicated an increased hip [HR 1.54 (1.07–2.21)] and nonvertebral fracture risk [HR 1.40 (1.10–1.78) per increase of 1 mg/dl]. Body mass index was protective of hip fractures [HR 0.94 (0.90–0.98) per increase of 1] as well as medication with acetylsalicylic acid [HR 0.59 (0.36–0.95) for hip and 0.72 (0.52–0.99) for nonvertebral fractures]. In contrast, current use of glucocorticoids [HR 5.65 (1.77–18.0)] and opiates [HR 1.85 (1.18–2.92)] exerted a negative effect on prospective hip fracture risk. Conclusion: Calcaneal stiffness measurements proved to be useful in predicting hip fractures and to a lesser extent nonvertebral fractures in nursing home residents. Radial and phalangeal bone ultrasound measurements and baseline markers of bone turnover, however, were not indicative of future fracture risk in this population.

Biochemical Markers of Bone Turnover and Fracture Prediction

2003 ◽  
Vol 9 (1) ◽  
pp. 10-16 ◽  
Author(s):  
Rosemary A Hannon ◽  
Richard Eastell
Keyword(s):  
Bone Mineral Density ◽  
Bone Resorption ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Bone Mineral ◽  
Biochemical Markers ◽  
Mineral Density ◽  
Risk Of Fracture ◽  
Increased Risk ◽  
Markers Of Bone Turnover

Low bone mineral density is a strong risk factor for fractures in the older woman. Biochemical markers of bone turnover may predict fracture risk independently of bone mineral density. High levels of bone resorption markers are associated with increased risk of fracture in both retrospective and prospective studies, although the evidence for bone formation markers and fracture risk is equivocal. For example, the risk of fracture is increased up to two-fold in women with elevated levels of several markers of bone resorption. Prediction models have been developed to predict the 10–year risk of fracture using bone mineral density and biochemical markers of bone turnover and these could prove very useful in clinical practice.

scholarly journals High prevalence of vertebral fractures despite normal bone mineral density in patients with long-term controlled acromegaly

2011 ◽  
Vol 164 (4) ◽  
pp. 475-483 ◽  
Author(s):  
M J E Wassenaar ◽  
N R Biermasz ◽  
N A T Hamdy ◽  
M C Zillikens ◽  
J B J van Meurs ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Turnover ◽  
Fracture Risk ◽  
Disease Control ◽  
Vertebral Fractures ◽  
Mineral Density ◽  
Markers Of Bone Turnover ◽  
High Prevalence

ObjectiveTo establish the prevalence of osteoporosis, vertebral fractures (VFs), and non-VFs in acromegaly patients with long-term controlled disease and factors potentially influencing fracture risk.DesignCase–control study.Patients and measurementsEighty-nine patients (46% male, mean age: 58 years) were included. We studied VFs and non-VFs, bone mineral density (BMD), and markers of bone turnover. In 48 patients, BMD assessment was also obtained 7 years prior to the current study. To compare VF prevalence, data from a sample of the Dutch population (n=3469) were used.ResultsVF prevalence was 59% (men 64% and women 54%), significantly increased when compared with controls (odds ratio up to 6.5), and independent of the duration of disease control, BMD, markers of bone turnover, and acromegalic disease characteristics. Mean number of VFs per patient was 3.4±0.3 (range 1–8). There was no relationship between the number and severity of fractures, parameters of bone turnover, and follow-up BMD measurements. BMD did not change during prolongation of follow-up by 7 years of controlled acromegaly.ConclusionThere is a very high prevalence of VFs in acromegaly patients with long-term controlled disease, independently of BMD. In view of the significant morbidity and mortality associated with VFs in general and the inability of BMD to predict fracture risk in acromegalic patients, we propose to include VF assessment, for example by lateral conventional radiographs of the spine in the screening of patients with acromegaly, both at diagnosis and during follow-up after establishment of disease control.

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