Endocrine Abstracts

The requirement for Sestimibi imaging of the parathyroid glands has increased over recent years, partly due to advances in surgical techniques and the need for accurate pre-operative localisation. We audited sestimibi imaging to ensure efficient and appropriate use of this tool in the face of increasing demand. Over two and a half years 128 scans were identified by Nuclear Medicine. We obtained biochemistry and operative status for these using the hospital patient administrati...

PTH has been reported to enhance steroid secretion in vitro from human adrenocortical cells and some reports indicate an increased cortisol secretion in patients with PHPT that normalizes after surgery. Thus, the possible stimulatory effect of PTH on cortisol secretion could contribute to the impairment of bone status in primary hyperparathyroidism (PHPT). The aim of this study was to evaluate the relationship between parameters of adrenal function, bone metabolism and ...

Pain due to bone metastases can be relieved by local radiotherapy (RT). The mechanism of pain relief by RT has not been fully elucidated. Inhibition of bone resorption has been proposed as a possible mechanism. Osteoprotegrin (OPG) has been shown to block behaviours indicative of pain in mice with bone metastases and to diminish bone destruction (Honore et al., 2000, Nature Medicine 6; 521–8).The aim of this study was to evaluate serum OPG le...

Aims: The clinical and radiological observation of patients with diabetic osteoarthropathy (DOAP) was carried out with the aim of determining the most significant factors in type 1 and type 2 diabetes mellitus (DM) patients.Methods and materials: Anamnesis, clinical and radiological data were analsed in 28 DOAP patients. The patients were divided into two groups according to the type of diabetes: group 1 included 14 patients with type 1 DM (mean age 37.8...

In elderly subjects the mortality rate after hip fractures ranges from 18 to 33% within one year; among survivors, 40% did not return to the previous level of functional ability. The aim of this study was to evaluate the longitudinal changes of some markers of bone metabolism in relation to functional and nutritional status.Thirthy-seven subjects aged more 70y with a new vertebral or hip fracture were admitted to the study. Thirthy age-matched and not fr...

Objectives: To characterize the possible role of the osteoprotegerin (OPG) and receptor activator of NF-κB ligand (RANKL) system in thalassemia-related bone loss.Background: Osteoporosis represents an important cause of morbidity in patients with β-thalassemia major and its aetiology is multifactorial.Methods: Serum concentrations of OPG, RANKL, markers of bone turnover and lumbar spine bone mineral density (BMD) were mea...

Aim of the study: Our study was designed to determine the possible role of phytoestrogens with minerals Ca, Mg, Zn and vitamins D, C, K in the reduction of bone mass lost in postmenopausal women.Subjects and methods: The study population consisted of 86 nonsmoking 60…80 years old women. Their bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) region L2-L4. The osteoporosis had been diagnosed (T-score by DXA was &#8722...

Osteoporosis has a strong genetic component and is a common side-effect in patients with long-term glucocorticoid (GC) treatment. Vitamin D plays an important role in bone metabolism, and polymorphisms in its receptor (VDR) gene have been implicated in the pathogenesis of osteoporosis. On the other hand, variability in the sensitivity to GCs, due to polymorphic variants of the glucocorticoid receptor (GR) gene was observed in patients treated with GCs, both with regard to the ...

Background: Type1 diabetes is associated with reduction in Bone mineral density (BMD). It is thought, that metabolic abnormalities associated with type 1 diabetes alter the BMD, but the pathologic mechanisms of reduced bone mass are not fully understood.Objective: The aim of our study was to reveal whether the metabolic control affects bone mass in patients with type 1 diabetes.Materials and Methods: We studied 80 patients (45 -mal...

In developmental studies of mice lacking T3-receptor alpha (TRa0/0) and beta (TRb−/−) we demonstrated delayed endochondral ossification, reduced mineralisation and short stature in TRa0/0 mice, despite euthyroidism. In contrast, TRb−/− mice, which display thyroid hormone resistance with elevated T4 and T3 levels, have advanced ossification, increased mineralisation and accelerated growth. T3-target gene studie...

Adult Growth Hormone Deficiency (AGHD) is associated with osteoporosis. PTH is secreted in a circadian rhythm and temporal fluctuations in PTH concentration, particularly at night, appear to be important in the regulation of bone turnover. Serum phosphate is an important determinant of PTH, with changes in phosphate preceding fluctuations in PTH concentration. We examined the difference in PTH and phosphate circadian rhythmicity in AGHD patients with normal and reduced bone mi...

Adult Growth Hormone Deficiency (AGHD) is associated with reduced bone mineral density (BMD) and bone turnover. Abnormalities in PTH circadian rhythmicity, including blunted nocturnal rise in PTH concentration have been reported in AGHD and may underlie the pathogenesis of osteoporosis. Serum phosphate is an important regulator of PTH, with changes in phosphate concentration preceding fluctuations in PTH. We examined the effect of oral phosphate therapy on PTH circadian rhythm...

Introduction: Amino-Bisphosphonates (N-BPs) are potent inhibitors of the bone resorption, they inhibit enzymes of the intracellular mevalonate pathway required for prenylation of different important signaling proteins. In order to study the genetic basis of the variability in therapy response we have analysed the polymorphism of farnesyl pyrophosphate-synthase (FDPS) gene in 234 postmenopausal Danish women treated with N-BPs for 1 and 2 years.Methods: Th...

Background and aim: Parathyroid hormone (PTH) measurement is critical to evaluate bone status in patients with chronic renal failure as adynamic bone (AB) and bone with a high turnover (HTB) require different therapeutic options. Since the 2nd generation PTH assays recognise a non 1–84 PTH fragment in addition to the intact 1–84 PTH, a new assay defined as 3rd generation has been commercialised. The aim of this study was to evaluate, in dialysed patients, the rate of...

To determine our adherence to the Consensus Development Conference on the Management of Asymptomatic Primary Hyperparathyroidism (2002) guidelines, we audited the management of all patients referred to our endocrine unit with the diagnosis of primary hyperparathyroidism during January 2003 to December 2004.Overall 36 patients were referred. 32 were females and the mean age was 64 years.19 patients were Caucasians, 8 were Asians and 9 patients were of Afr...

During the past thirty years bone biopsy has been used as an invasive diagnostic and research investigation of bone structure and metabolism. Bone biopsy parameters are used to assess both bone mass and bone quality. This study aimed to establish the value of routine qualitative bone biopsy evaluation in subjects with unclear primary osteoporosis. One-hundred seventy patients (73 men and 97 women), aged 54.29±0.95 years, were included in the study. The diagnosis was based...

Aims: To assess factors associated with excess rates of fractures in women with Turner’s syndrome.Settings: Adult Turner Clinic.Outcome measures: Bone fracture history, oestrogen, growth hormone, oxandrolone and thyroxine therapies, anthropometry, calcium, vitamin D, parathyroid hormone and karyotype, hearing impairment, spinal bone mineral density (BMD). This study was approved by Ethical Committee.Resu...

Recently, since the lives of patients with chronic renal failure have prolonged considerably, the importance of prevention and treatment of metabolic bone disease which inevitably develops in this group, has become better appreciated.The aim of this study was to evaluate the relation between bone mineral density (BMD) and specific markers of bone turnover in haemodialysis (HD) population.A cross-sectional study involving 40 HD pati...

Abnormal growth patterns are commonly observed in children suffering from chronic inflammatory diseases. These disorders are associated with the increased production of pro-inflammatory cytokines, which inhibit growth plate chondrocyte dynamics. Ceramide, a sphingosine-based lipid second messenger, mediates many of the actions of pro-inflammatory cytokines. Ceramide inhibits IGF-1 signalling and induces apoptosis in numerous cell types. This study determined the effects of C2-...

We report a retrospective study of 50 cases of primary hyperparathyroidism (10 men and 40 women, mean age: 49 years) collected between 1975 and 2004. At the time of diagnosis, 44% of patients had bone disease, renal manifestations were present in 17 cases (34%).Parathyroidectomy is a safe and effective approach of primary hyperparathyroidism treatment. The management of persistent or recurrent hyperparathyroidism is explained by the fact that parathyroid...

Introduction: Results of many studies indicate that the BsmI and FokI polymorphisms in the VDR gene may influence bone tissue metabolism and may be useful in means of identifying patients at greater risk of osteoporosis.Aim of the study: To determine frequency of polymorphic variants of VDR gene (BsmI and FokI) and its relationship to phenotypic features characterizing bone status (BMD).Materials and methods: 176 randomly selected ...

Hypophosphatemic rickets is an X-linked dominant inherited bone disorder, characterized by renal phosphate wasting, inappropriately normal to low vitamin D serum levels and severe skeletal and dental defects from early childhood. Inactivating mutations in the PHEX gene (phosphate regulating gene with homologies to endopeptidases on the X-chromosome) have been identified as the underlying cause, although the pathomechanism is unknown. The PHEX gene encodes a membrane-bound meta...

Primary hyperparathyroidism (PHP) and growth hormone deficiency (GHD) are both associated with alterations of bone metabolism.GH secretion is frequently impaired in PHP patients; thus GH/IGF-I system alterations could be involved in the pathogenesis of osteoporosis.In the present study 50 post-menopausal women with PHP were evaluated by GH response to GH-releasing hormone (GHRH)+arginine (ARG) test and femoral neck bone mineral den...

The physiological and neuroendocrine functions of the pineal gland hormone, melatonin and its therapeutic potential critically depend on the understanding of its target sites and its mechanism of action. There is evidence that melatonin promoted osteoblast differentiation and mineralization in MC3T3-E1 (mouse preosteoblast) and rat osteoblast-like osteosarcoma 17/2.8 cells. Our group set up an experimental model of mouse osteoblast culture. As a marker specific for osteoblast ...

Introduction: The beneficial effect of GH replacement on bone in AGHD patients is mediated by improvements in target organ sensitivity to PTH and phosphocalcium metabolism. In aging women with established osteoporosis, GH and IGF-1 concentrations are lower and administration of GH has been shown to increase bone turnover and BMD, but the mechanisms remain unclear.Methods: Fourteen postmenopausal women (63.4±2.1 years; mean BMD T score ± ...

Calcium and Vitamin D deficiency is a common cause of falls and fracture and supplementation with 1 g of calcium and 800 IU of vitamin D is commonly recommended.However, the serum level of 25 OHD that defines deficiency is controversial, and the 25 OHD level required to normalise serum parathyroid hormone (PTH)-in the presence of normal calcium- is often used. In this study we set out to explore how effective is 1 g of calcium and 800 IU of vitamin D in ...

When used to treat inflammatory disease therapeutic glucocorticoids (GCs) cause rapid bone loss. However clinical studies suggest that in patients without inflammation GCs have little impact on the skeleton. The mechanism by which inflammation magnifies the effects of GCs is unknown. We have proposed that intracellular GC generation (inactive cortisone/prednisone to active cortisol/prednisolone conversion) via the 11 beta-hydroxysteroid dehydrogenase type 1 (11b-HSD1) enzyme d...

Introduction: Osteoporosis in males is an underdiagnosed condition. It is considered to be of secondary pathogenesis in up to 60% of cases. In order to establish rational flow charts for the diagnosis and management of osteoporosis in men solid data seem to be necessary about the incidence of certain underlying diseases.Methods: In a prospective screening for hormonal alterations we analysed 65 patients with male osteoporosis according to laboratory para...

Overt hypercortisolism causes reduction in bone mass and density. The effects of subclinical Cushing’s syndrome (SCS) on bone markers and structure are still debated. We therefore studied 56 patients with adrenal incidentaloma: group A=35 (20 F 15 M, age 43–79, mean 64.6±1.5; BMI 29.9±0.9 kg/m2) without evidence of hypercortisolism, and group B=21 (10 F 11 M, age 51–76, mean 63.4±1.9, BMI 28.0±1.2 kg/m2) with SCS (i.e. w...

Aim of this 2-year, prospective, randomized study is to compare the effect of parathyroidectomy (PTX) vs no treatment in patients with asymptomatic primary hyperparathyroidism (PHPT), who didn’t meet the 1991 NIH criteria for surgery. The study was approved by our local Ethical Committee. The primary endpoint was the change in lumbar spine bone mineral density (BMD); secondary endpoints were BMD changes at femur and distal radius, markers of bone turnover, quality ...

A 57 year old Caucasian woman complained of severe back pain and arthralgia of large joints. Her arthralgia gradually got worse and she also noticed proximal muscle weakness. Blood tests showed normal CRP but elevated alkaline phosphatase of 521 iu/l with normal Gamma GT. Phosphate was low at 0.75 mmol/l with normal corrected calcium of 2.6 mmol/l. A DEXA scan suggested osteoporosis (Spine T −2.5). Isotope bone scan revealed increased activity in the right tibia and plai...

Aims: The Observational Study of Severe Osteoporosis (OSSO) is a 12-month, European, prospective study aiming to assess the changes in Health Related Quality of Life (HRQoL) of women with osteoporosis (OP) and an inadequate clinical response to antiresorptive (AR) medications.Methods: In Greece, 263 of 271 (97%) patients (pts) with severe OP met the inclusion criteria. The study population was assigned to1of 2 groups according to one or more of the follo...

Aim: This study was to investigate the protective effect of grape procyanidins on ethanol and carbon tetrachloride induced cell damages in MC3T3-E1 osteoblast-like cells.Methods: Normal MC3T3-E1 osteoblast-like cells and cells damaged by ethanol or carbon tetrachloride were incubated with different doses of grape procyanidins for 24 hours. Cell TNF alpha mRNA expression and apoptotic DNA fragmentation were subsequently determined using in situ hyb...

Osteoporosis and associated fractures are the most common and debilitating complication of glucocorticoid use. The use of alternative anti-inflammatory agents without the catabolic and deleterious skeletal side-effects of glucocorticoids is needed. Dehydroepiandrosterone (DHEA) may have immunomodulatory as well as positive effects on bone. To further our understanding of the mechanisms of action of DHEA, as a steroid-sparing agent, we investigated and compared the effects of D...

Objective: To examine different methods of analysing bone health and body composition in children and examine the relationships between these methods.Method: In a LREC approved cross-sectional study, DXA was used to assess bone mineral content (BMC) (at total body (TB), lumbar spine (LS), femur (F) and femoral neck (FN)), cross-sectional moment of inertia (CSMI) at the proximal femur and body composition (defined as Lean mass (LM) and Fat mass (FM)) in 6...

The aim of the present study was to compare the assessment of BMD measured either by DEXA or by QUS in patients with AI. We evaluated 40 patients with AI, who underwent an evaluation of hypothalamic-pituitary-adrenal (HPA) axis function and bone densitometry measured either by DEXA (Hologic QDR 4500 W) at lumbar spine and at femur or QUS (Achilles Express) at the right foot. Subclinical Cushing’s syndrome (SCS) was defined as abnormal response to at least 2 standard tests...

Background: Many Endocrinologists believe that preoperative localisation/lateralization in patients undergoing initial neck exploration for primary hyperparathyroidism is unimportant because of high cure rate in the hands of experienced surgeons. Tcm-MIBI imaging has a sensitivity of 70 to 95% in localizing parathyroid tumors. Ultrasonography has lower sensitivity but is noninvasive and relatively cheap. Unilateral surgical exploration has potential benefits including reduced ...

Human studies have suggested that local glucocorticoid (GC) generation within osteoblasts plays a critical role in bone loss seen during aging, in response to inflammation and treatment with GCs. Human osteoblasts express the enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) that converts inactive GCs (cortisone, dehydrocorticosterone, prednisone) to their active counterparts (cortisol, corticosterone, prednisolone). Enzyme expression increases with age, in r...

Growth hormone deficiency (GHD) in adulthood has been associated with increased central adiposity, reduced lean body mass, increased cardiovascular risk, reduced bone mineral density with increased fracture risk and decreased quality of life. GH replacement might improve these alterations.We evaluated the long-term metabolic effects of GH replacement on bone metabolism and body composition of 24 GHD patients (20 males, mean age 38±11 years, 20 adult...

Primary hyperparathyroidism (PHP) is a common endocrine condition. The associated metabolic abnormalities are usually amenable to surgical treatment (PTX). Although it is generally believed that such treatment will reduce the risk of long-term complications this has not been demonstrated in a clinical trial and the current treatment guidelines are based on consensus. In order to assess the effect of parathyroidectomy on two of the most common complications of PHP, renal stones...

Primary hyperparathyroidism is characterized by abnormal PTH secretion from one or more hyperfunctioning parathyroids and hypercalcemia. PTH exerts a catabolic effect on the cortical bone resulting in the osteitis fibrosa cystica. Two patients were referred to us after destroyed surgery for brown tumors mistaken for primitive bone tumors.A 59 years old man was referred to emergency department for a pathologic fracture of the left hip. The X-ray showed a ...

The nitrogen-containing bisphosphonate Risedronate have been shown to reduce the risk of both spine and nonspine fractures by reducing bone turnover, increasing bone mass and improving bone strength.Objective: To study the effects of once-weekly Risedronate on bone turnover markers in osteoporotic patients after three month of treatment.Patients and methods: Study group included 50 osteoporotic patients (3 males and 47 females), me...

Acromegaly is associated with various skeletal deformities and in some cases with bone deterioration. The aim of the study was to assess the skeletal status using quantitative ultrasound (QUS) in patients suffering from acromegaly. A group of 38 patients with acromegaly (27 women and 11 men) in mean age of 57.21±9.85 y in various gonadal status was compared with a control group matched for sex, age and body mass. QUS measurements at hand phalanges were performed with DBM ...

Mesenchymal stem cells (MSC) are developed for cell based therapeutic strategies and undergo cellular stress during ex vivo procedures. Reactive oxygen species (ROS) of environmental and cellular origin are involved in redox signaling, cumulative cell damage, senescence and tumor development. Selenium independent (superoxide dismutases 1 and 2 (SOD1 and SOD2) and catalase (CAT)) and selenium dependent (glutathione peroxidases (GPx), thioredoxin reductases (TrxR)) enzyme...

UO-44 is a novel protein of unknown function which was described in uterus, medium-size ovarian follicles, oviduct and pancreas of different mammalian species. Using differential display analysis in preimplantation rat uteri, Chen et al. 1999 cloned and described it as an estradiol responsive gene named estrogen regulated gene 1 (ERG-1). Subsequent characterization showed that its expression was modified through pregnancy. The human ortholog (HuUO-44) was cloned and cha...

The nitrogen-containing bisphosphonate Risedronate have been shown to reduce the risk of both spine and nonspine fractures by reducing bone turnover, increasing bone mass and improving bone strength.Objective: To study the effects of once-weekly Risedronate on bone turnover markers in osteoporotic patients after three month of treatment.Patients and methods: Study group included 50 osteoporotic patients (3 males and 47 females), me...