Endocrine Abstracts

Background: The delayed puberty is defined by absence of secondary sexual characters until the age of 16 or lack of puberty development until the limit of +2DS in regard to the age when the puberty begin normal at considered population. After the major factor implied in delayed puberty ethiology, can be distinguished three mechanisms: hypothalamic, hypophyseal and gonadal. It is recognized the fact that the osteoporosis process is, in the first place, dependent and interdepend...

Backgound: ESRD is associated with reduce bone mineral density compared with aged-matched healthy population. DXA is the standard noninvasive method to assess BMD. It is expensive, needs special equipment, X ray exposure, movement of the patients. QUS is inexpensive, mobile, easy to perform, radiation free, recognize for screening abilities and risk fracture prediction in normal population. This study assessed the ability of QUS versus DXA in determine BMD in haemodialised pop...

Objective: Cinacalcet, a calcimimetic that reduces parathyroid hormone (PTH) secretion and serum calcium (S-Ca) levels by increasing the sensitivity of calcium-sensing receptors has been introduced for the treatment of patients with persistent or recurrent primary hyperparathyroidism (PHPT). Within a prospective, non-interventional cohort study we identified patients with newly diagnosed PHPT who have been started on cinacalcet. Patient characteristics, treatment indications a...

Introduction: Persistent or intractable PHPT can lead to neuromuscular and psychiatric symptoms and may increase the long-term risk for cardiovascular disease and fractures. Cinacalcet (Mimpara/Sensipar) represents an innovative treatment option for this small group of patients, as it directly acts on the calcium sensing receptors on cell surfaces, reducing the severity of hypercalcemia.Purpose: To estimate the UK budget impact of cinacalcet in patients ...

Objective: The Swiss Primary HyperParaThyroidism (PHPT) Cohort Study is an ongoing, prospective, non-interventional project collecting clinical, densitometric, biochemical and outcome data in patients with PHPT. The aims are to describe the profile of these patients particularly neurobehavioral and cognitive symptoms, changes in calcium and PTH over time and treatment modalities.Methods: Patients newly diagnosed with PHPT and with high serum calcium leve...

Introduction: The relationship between diabetes mellitus (DM) and osteoporosis is controversial. Both Type 1 DM and Type 2 DM have been associated with higher risk of fractures, whereas BMD is increased in Type 2 and decreased in Type 1 DM. In primary hyperparathyroidism (PHPT) a higher prevalence of Type 2 DM has been found but the influence of DM on BMD is unknown.Subjects and methods: In a consecutive series of 262 patients with PHPT (age, mean±S...

Aims: End stage renal disease is associated with disorders of calcium and phosphate metabolism that favor the loss of bone mass.Kidney transplant may alter this unbalance restoring bone mass. Nevertheless, recent studies showed that 48 months after transplant, the loss of bone mass still is superior to general population. Post-transplant corticosteroid therapy is considered the main responsible for the loss of bone mass.The authors...

Pseudohypoparathyroidism (PHP) is a term applied to a heterogeneous group of disorders whose common feature is resistance to parathyroid hormone. Most of the PHP forms are caused by defects in GNAS: PHP-Ia (characterized by PTH and TSH resistance with Albright Hereditary Osteodystrophy) is caused by heterozygous inactivating mutations in those exons of GNAS encoding the α subunit of the stimulatory G-protein, and the autosomal dominant form of PHP-Ib (PTH an...

Introduction: Acromegaly is associated with skeletal changes that are characterized by appositional bone growth, increased bone dimensions and increased bone turnover. PTH is an important regulator of bone remodeling and its anabolic action requires the presence of GH. The strong correlation found between PTH concentrations and bone turnover markers in active and treated acromegaly has led to the suggestion, that the effect of GH on bone turnover may be mediated by PTH. Succes...

Introduction: There is increasing evidence suggesting that adiponectin plays a role in the regulation of bone metabolism. We have studied the changes in the circulating concentration of adiponectin in lean and obese post-menopausal women with and without osteoporosis and its association with a marker of bone formation – type 1 procollagen amino-terminal pro-peptide (P1NP) and a marker of bone resorption – type 1 collagen C-telopeptide (βCTX).<p class="abstex...

It was previously shown that patients with primary hyperparathyroidism (PHPT) are insulin resistant.Aim: The aim of our study was to evaluate the effect of surgical treatment on glucose tolerance, insulin secretion and sensitivity (SI) in patients with PHPT.Material and methods: In 26 patients with PHPT (age: 57.15±9.54 years, BMI 26.00±4.55 kg/m2, PTH 276.61±64.83 ng/l, Calcium 2.95±0.19 mmol/l)) AIR...

According to the novel concept bone remodeling is centrally regulated (CNS). Leptin the adipocyte derived hormone acts on hypothalamus and by increasing sympathetic activity acts on osteoblasts to regulate bone formation. In patients with schizophrenia several factors have influence on bone metabolism. Schizophrenia per se, as a disease of central nervous system is associated with increased occurence of osteoporosis. Hyperprolactinemia as consequence of antipsychotic tr...

Association between anorexia nerviosa (AN) and low bone mass has been demonstrated. Bone loss associated with AN involve hormonal and nutritional impairments, though their exact contribution is not clearly established. We compare bone mass in AN patients with women of similar weight with no criteria for anorexia nervosa, and a third group of healthy, normal-weight, age-matched women. The study included 48 patients with AN (DSM-IV criteria), 22 healthy eumenorrheic women with l...

Aim: Thyroid hormones play an important role in bone remodeling. The aim of the study was to evaluate the changes of bone markers and osteoprotegerin (OPG)/sRANK-L levels during follow-up in a group of patients with thyroid cancer.Material and methods: Twenty euthyroid women with the diagnosis of differentiated thyroid cancer were enrolled to the study (39.25±13.46 years, 6 postmenopausal) before thyroidectomy. Samples were collected before the oper...

Refractory or severe hypercalcemia is important clinical problem as it can lead to serious complications such as arrhythmias, acute or chronic pancreatitis, gastric ulcer, water and electrolyte balance disturbances, osteoporosis, psychoses and even to hypercalcemic crisis. Most often it is diagnosed in parathyroid cancer (PC). It is also observed in benign primary hyperparathyroidism (HPTH) in case of difficulties with adenoma’s localization. Routinely treatment includes ...

Background: Idiopatic hypogonadotropic hypogonadism is a congenital abnormality due to GnRH deficiency which is associated with severe osteoporosis. Testosterone replacement has been shown to improve the loss in the bone mass. The aim of the present retrospective analysis was to measure the effect of human chorionic gonadotropin treatment on the improvement of bone mineral density.Methods: A total number of 96 young male (mean age 21±3.7 years) pati...

Introduction: Fibroblast growth factor (FGF)-23 is a peptid, released from bone tissue and osteogenic cells. Phosphatonins regulate phosphate homeostasis in some phosphate wasting disorders such as X-linked hypophosphatemia, otozomal dominant hypophosphatemic rickets, and tumor-induced osteomalacia.FGF-23 is a possible phosphatonin: it regulates phosphate homeostasis by PTH independent actions.Objective: In the present study, we ai...

In thalassemic patients individual values of BMD measured by traditional DEXA are lower than those determined by QCT. The reason for this discrepancy is still controversial.Aim: To investigate bone features in a large group of thalassemic patients, compared with patients with anorexia nervosa, also characterized by precocious osteoporosis.Study design: Forty-six adult thalassemic subjects and 25 anorectic women were studied. In all...

Hyperprolactinemia may lead to bone loss, both due to hypogonadism and other hormonal disturbances.Aim: Aim of the study was the analysis of influences of hormonal profiles associated with hyperprolactinemia on bone mineral density (BMD) and bone turnover in women with hyperprolactinemia of various origin. The subjects were 32 patients with prolactinoma, 43 ones with functional hyperprolactinemia and 29 healthy controls. All of them were studied BMD (lum...

Teriparatide (TPTD – recombinant human parathyroid hormone 1–34) markedly increases bone mineral density (BMD) and reduces fracture risk. Sequential treatment with an antiresorptive agent is believed to preserve or further increase BMD. Strontium ranelate (SR) is thought to uncouple bone remodeling resulting in increased BMD and reduced fracture risk. In this prospective study, we aimed to evaluate the effect of SR on BMD in women with established osteoporosis previo...

Aim/hypothesis: Chronic renal failure maintenance hemodialysis (HD) patients are at risk for low bone mineral density (BMD) and fractures. Parathyroid hormone (iPTH) plays a pivotal role in the pathophysiology of uremic bone disease, but in healthy population body weight and particularly body composition are more important determinants of bone mass.Patients and methods: We studied BMD (results were recorded as g/cm2) and T score using D...

Background: Thyroid-stimulating hormone (TSH) might influence bone mineral density (BMD) through its regulation of the thyroid hormones thyroxine (T4) and triiodthyronine (T3). Direct effect of TSH on bone turnover, mediated through its receptors on both osteoblast and osteoclast precursors, has been suggested. We wanted to explore the relationship between serum TSH, fT4 and BMD in women with different TSH levels after a long-term observation of thyroid function and bone statu...

Adiponectin and leptin have been described as potential contributors to bone metabolism. The effect of anticatabolic drugs on these adipokines and their relationship with bone metabolism have not been clearly clarified.Aims: (1) Evaluate adiponectin and leptin levels in osteoporosic postmenopausal women and their relationship with BMD, bone turnover and osteoclastogenesis markers. (2) Analyze changes on adiponectin and leptin levels after treatment with ...

The strong link between bone mass and body composition is widely recognized but only few studies were selectively performed on healthy subjects with body mass index within normal limits. We aimed to evaluate the influence of body composition on bone mass in apparently healthy young non-obese men and women (n=40). To reveal the effect of menopausal transition on the fat mass content, fat mass distribution and fat mass-bone mineral density relationship we compared body co...

Thyroid hormones play an important role in bone metabolism. The potential action of prolonged levothyroxine therapy on bone mass reduction is stil a matter of debate.The aim of our one year prospective study was to elucidate whether longterm suppressive thyroid hormone therapy in patient with differentiated thyroid cancer (DTC) affects bone metabolism, osteoprotegerin (OPG) and soluble receptor activator of nuclear factor kβ ligand (sRANK-L) and is ...

Introduction: Severe vitamin D deficiency is very common in northern Europe. It is not limited to the elderly, but occurs in a large variety of subjects. Colecalciferol dosing guidelines for rapid correction of vitamin D deficiency are not available.Objective: To assess the optimal Colecalciferol dose regimen, based on body weight, for rapid correction of vitamin D deficiency, in a variety of subjects.Materials and methods: One hun...

Introduction: Osteoporotic hip fracture is one of the serious complications of bone loss. These fractures constitute almost 20% of orthopedics wards admissions. Due to lack of precise statistical data of osteoporotic hip fracture rates in IRAN, and absence of previous investigations regarding the problem in Tabriz (a large city in north west of IRAN), we planed a study to survey frequency of this epidemic in over 50 years old residents of Tabriz.Material...

Background: Primary hyperparathyroidism (PHP) is associated with increased rates of cardiovascular (CV) risk. Moreover, it is not fully clear whether surgery can attenuate CV risk. The intima-media thickness (IMT) of carotid vessels is considered a marker of atherosclerosis and CV events.Aim: Of the study was to evaluate IMT and some metabolic parameters in PHP patients.Subjects: Of 56 subjects were studied. Patients were divided i...

Low concentrations of vitamin D leads to secondary hiperparathyroidism, bone loss, and an increase of osteoporotic fractures in populations at risk. Adequate vitamin D and calcium intake is considered an essential component of postmenopausal osteoporosis management. Several epidemiological studies have assessed the prevalence of low serum vitamin D concentrations, indicating that vitamin D inadequacy (<30 ng/ml) is a problem world-wide.Aims: To evalu...

Objective: It was previously shown that primary hyperparathyroidism (PHPT) might induce impaired renal function and chronic renal failure. The aim of our study was to evaluate the effect of surgical treatment on parameters of calcium and phosphate renal metabolism and renal function in patients with PHPT.Material and methods: In 26 patients with PHPT (age: 57.15±9.54 years, BMI 26.00±4.55 kg/m2, PTH 276.61±64.83 ng/l, Calcium 2....

The aim of this study was to determine the relationship between biochemical parameters, parathyroid adenoma volume, and bone mineral density with respect to intact parathyroid hormone (iPTH) levels in patients with primary hyperparathyroidism. Data were collected retrospectively from patients with primary hyperparathyroidism who were diagnosed and followed-up at our clinic between 2004 and 2008. Forty-eight (female/male=42/6) patients with a mean age of 52.8±13.1 (range 2...

Hypovitaminosis D is frequent in population over 65 years age, producing a secondary hyperparathyroidism, increase the bone remodeling, bone loss and osteoporotic fractures, loss of the muscle force.Daily dose of 0.5 μg alfacalcidol was effectively in improved muscle strength in elderly and reduced falls. The bisphosphonates have been shown to increase Bone Mineral Density (BMD) and reduce bone turnover in postmenopausal osteoporosis. The combined a...

Introduction: Single adenoma is the most frequent cause of Primary hyperparathyroidism (HPT1). Surgical excision has a high success rate, particularly when associated with a fast intraoperative intact parathyroid hormone assay (PTHi).Aim: Evaluate the success rate of primary hyperparathyroidism surgery in our unit.Methods: Descriptive study of the last 33 consecutive HPT1 patients who undertook surgery, 27 of which with PTHi. The P...

Background: Although the decline in sex steroid levels, particularly estradiol, may be largely responsible for age-related bone loss and osteoporotic fractures in older women, the insulin-like growth factor (IGF) system may also play a key role. This study aimed at evaluating the relation between the secretory status of growth hormone (GH) with the bone mineral content (BMC) in postmenopausal women.Methods and materials: In a descriptive cross-sectional ...

There have been few epidemiologic studies on vitamin D status in postmenopausal women of Middle East countries.The purpose of this study was to investigate the 25-hydroxyvitamin D levels in postmenopausal women of Iran. By using the records of the local household registry, a sample of 300 subjects was drawn by simple random sampling. Serum 25-hydroxyvitamin D levels were determined with full automated chemiluminescent immunoassay. In addition, the study ...

Introduction: A newborn baby boy of a family of Asian origin with an uncommon, but logical diagnosis.Case: Of 8 days old, term baby boy. Normal pregnancy, spontaneous delivery, uncomplicated postnatal period. On day 5, jerking movements of the whole body. Fully breastfed, not feeding well lately. Medical and neurological clinical examination normal. Tonic-clonic epileptic fit during the 1 h of admission.Blood results: Calcium 1.48 ...

Background: Bone metabolism is affected in hemodialysed patients (HD) and PTH plays central role. Additionally leptin which is increased in renal failure may be linked with bone metabolism. We investigated the BMD and bone metabolism in comparison with serum PTH, 25OHD3 and leptin in HD patients.Methods: We measured in 37 HD patients bone alkaline phosphatase (bSAP), NTx, PTH, 25OHD3 and leptin. We evaluated BMI and BMD in lumbar spine (LS) and in femora...

Introduction: Hypocalcaemia is a rare presentation of thyrotoxicosis. We describe a patient with severe life-threatening hypocalcaemia and suggest pathogenic mechanisms.Case report: A 66-year old lady with long-standing insulin-treated type 2 diabetes presented acutely with generalised weakness and a collapse at home. Prior to admission, she had been treated for an infected neuro-ischaemic plantar ulcer with broad-spectrum antibiotics. She had developed ...

Introduction: Some recent data indicates that high levels of homocysteine (Hcy) can be independent risk factor for osteoporosis and fractures in elderly. There are few explanations how homocysteine influence bone resorption and probably modify effect of therapy for osteoporosis. 1. Hcy interferes with collagen cross-linking. 2. High levels of Hcy specially stimulate resorptive activity of osteoclasts in vitro. 3. Hcy interfere bisphosphonates binding to hydroxyapatite.<...

Introduction: The combined influence of risk factors on osteoporosis being known, the problem whether it is correctly identified and quantified arises, aiming to the improvement of populational screening. The correct judgment related to osteoporotic pathology refers to fracture risk assessment.Materials and methods: We investigated 2149 women aged 20–91, without treatment for osteoporosis, for anthropometric, anamnestic and bone densitometry feature...

Objective: It was previously shown that patients with primary hyperparathyroidism (PHPT) have atherogenic dyslipidaemia. The aim of our study was to evaluate the effect of surgical treatment on lipid levels in patients with PHPT.Material and methods: In 26 patients with PHPT (age: 57.15±9.54 years, BMI 26.00±4.55 kg/m2, PTH 276.61±64.83 ng/l, Calcium 2.95±0.19 mmol/l) Total cholesterol (TC), HDL-C, LDL-C, triglyceride (TG),...

Background: There is increasing body of evidence suggesting for low vitamin D levels in humans. The levels of vitamin D in nonselect populations of Europe, Middle East, Asia and Latin America had been repeatedly shown to be as low as 20-30 μg/l.Aim: The aim of our study was to examine serum 25-hydroxyvitamin D [25-(OH)D] levels in young healthy premenopausal women in Slovak population.Subjects and methods: The participants (<i...