Endocrine Abstracts

Introduction: Vitamin D has a potentially beneficial role in insulin resistance, but there is a lack of evidence in elderly. We report preliminary results of an ongoing study that investigated the effect vitamin D replacement treatment (12 weeks) on insulin resistance and metabolic parameters in elderly people with normal glucose tolerance.Methods/design: The study’s eligibility criteria were body mass index <30.0 kg/m2, creatinine le...

Introduction: Fibroblast growth factor 23 (FGF23) and PTH have been identified as major players in the bone-parathyroid-kidney axis controlling phosphate homeostasis. In patients with primary hyperparathyroidism (PHPT) data on the relationship between PTH and FGF23 are scarce and not always concordant.Objective: The aim of our study was to evaluate whether the relationship between PTH and FGF23 was altered in patients with primary hyperparathyroidism and...

Introduction: The aim of this study was to investigate whether monthly ibandronate improves hip bone mineral density (BMD) to the same degree as weekly risedronate in osteoporotic elderly.Material and methods: Eighty-one older adults with osteoporosis, age ranging from 65 to 95 years (mean: 77.5 years) were completed the study. Patients were treated either ibandronate 150 mg once monthly (n=56) and risedronate 35 mg once weekly (n=25). Chan...

BMI over 30 kg/m2 is associated with lowest risk for osteoporosis and hip fracture in both sex. Increased body fat mass is followed with greater hip fracture risk, independently of BMI.Aim: Evaluate risk for osteoporosis in postmenopausal female with BMI 25–29.9 kg/m2 and influence of body fat mass on mineral bone density in overweight women.Material and methods: One hundred postmenopausal female, age 48&...

Obese subjects have lower risk for osteoporosis than normal weight people. Body mass index over 33 kg/m2 is associated with lowest risk for hip fracture in both sexes.Aim: Investigate overweight influence on bone mineral density of hip bone and lumbar spine in overweight postmenopausal women.Material and methods: Postmenopausal women N=100, without co-morbidity, 48–88 years of age, divided in two groups: grou...

At patients with premature ovarian failure, follicular endowment is very low and therefore is deficient ovarian hormonogenesis. As the number of follicles is lower, the lifetime of the ovary is reduced, representing a clinical spectrum from total or partial absence of pubertal sexualisation by early onset climacteric. The disruption of ovarian hormones that control bone homeostasis, is disturb-training report bone resorption with decreased bone mass and osteoporosis.<p cla...

Aim: The aim of this study was to assess the implications of TRACP-5b (bone tartrate-resistant acid phosphatase izoform-5b), BAP (bone alkaline phophatase) BGP (bone Gla protein) and E2(estradiol) in bone remodelling process, in osteoporotic postmenopausal women.Material and method: The study comprised two groups of women with postmenopausal osteoporosis (with different degrees of estrogenic deprivation): group I (n=48, estrogenic deprivation &#60...

Background: It is recognized worldwide that the endocrine diseases lead among the causes of secondary osteoporosis. Based on many studies there was established the frequency of osteoporosis during the thyroid disorders, diabetes mellitus, hypercorticism. The most obscure in this line is the metabolic syndrome. The study of bone mineral density index during the metabolic syndrome is interesting from the aspect that until now the obesity has been considered to be the prevention ...

Background: Primary hyperparathyroidism (PHPT) affects mainly cortical bone. It is thought that PTH indirectly regulates the activity of osteoclasts by means of the osteoprotegerin/ligand of the receptor activator of nuclear factor-κβ (OPG/RANKL) system. Several studies have confirmed that OPG and RANKL loci are determinants of bone mineral density (BMD) in the general population. The aim of this study is to analyze the relationship between fractures and BMD and the ...

Background: Vitamin D deficiency is common worldwide. No homogenous reference values have yet been established and no studies of values have been done in Spain involving a large number of participants.Objective: To study the population concentrations of vitamin D in a representative sample of the Spanish population.Subjects/methods: The study involved two cohorts from Spain, the Asturias Study and the Pizarra Study, which are two p...

Objective: Sex steroids play an important role in the maintenance of bone health. However, there is limited information on the association between sex hormones and age-related bone loss in men. Our objective was to study the relationship between sex steroid levels and the changes accompanying aging process, including bone mineral density (BMD), muscle strength and body composition in elderly Egyptian men.Methods: Free testosterone (FT), estradiol (E...

The transcription factors Runx2 and osterix (Osx), which are known as downstream genes in BMP2 pathway, are essential for osteoblast differentiation and bone formation. Runx2 expression is normal in Osx null mice, but Osx is not expressed in Runx2 null mice, indicating that Osx acts as a downstream of Runx2. Here, we questioned whether or not all bones could be formed by BMP2–Runx2–Osx pathway or unknown their own gene axis. To answer this question, we first analyzed...

Rat and mice bones in vivo and their derived cell cultures in vitro respond sex-specifically to gonadal steroids (GS) by stimulating DNA synthesis (DNA) and the specific activity of creatine kinase (CK; a hormone receptor response marker). Similar results were demonstrated in cultured human male or female-derived bone cells (Obs); female Obs responded only to estradiol-17β (E2) whereas male Obs responded only to dihydrotestosterone (DHT) by stimul...

Introduction: Recent data suggest a reciprocal influence between bone and energy metabolism. Mediators have been identified as osteocalcin (OC), which stimulates insulin (IRI) secretion and activity and IRI as bone anabolic factor. Primary hyperparathyroidism (PHPT) stimulates bone turnover, induces osteoporosis and is associated with increased IRI resistance. A positive relationship between OC and IRI sensitivity has been found in PHPT, but no data exist on the relationship b...

Introduction: Although incidentalomas in endocrine glands such as pituitary, adrenal or thyroid are well defined, parathyroid incidentaloma is a rare concept. In this study, we aimed to determine the prevalence of suspicious parathyroid lesions and true parathyroid incidentalomas in patients referred for thyroid ultrasonography (US) and investigate the possible factors that might cause inadvertent suspicion of a parathyroid adenoma.Methods: Patients susp...

Introduction: Persistent hyperparathyroidism is reported to occur in 0–6% of cases after initial surgery for sporadic primary hyperparathyroidism (PHPT). The management of these cases is complex, however, with a poor cure rate despite repeated surgery. The aim of our study was to identify the challenges and pitfalls encountered in the management of a series of patients with persistent hyperparathyroidism after initial parathyroidectomy.Patients and ...

Best of all, the primary hyperparathyroidism (PHPT) should already be disclosed in the asymptomatic stage. The authors of this contribution are participating in a longitudinal study, which is focused on several aspects of asymptomatic PHPT. The study has been in progress in the Czech Republic at the two tertiary endocrinology centers. Previously we had attempted to verify the assumption that the presence of a chronic disease results in more frequent contact of the patient with...

We have previously reported, that cultured female- derived human Osteoblats (hObs) responded to DT56a (Femarelle). Since the skeletal protective effects of estrogens are not discernible in diabetic women, we sought to test the effects of DT56a on hObs grown in high glucose concentration in the growth medium (HG) as compared to estradiol-17β (E2). We used the stimulation of creatine kinase specific activity (CK), and 3[H] thymidine incorporation into ...

Background and aims: The aim was to compare calcium homeostasis indexes in diabetic and non-diabetic patients with or without fractures.Materials and methods: We examined 62 postmenopausal women with type 2 diabetes mellitus (DM), 32 of them had bone fracture within last month. The control group included 54 non-diabetic women, 25 within a group were recently fractured. Groups were comparable in body mass index, age, duration of menopause and calcium inta...

To evaluate vitamin D levels in relapsing remitting (RR) and secondary progressive (SP) courses of multiple sclerosis (MS) and to evaluate correlations between vitamin D and clinical features of disease progression, in a southern Italy population. 63 (41 RR and 22 SP) ‘naive’ MS patients (47 females, 16 males aged 37.7±5.7 years) and 63 healthy controls were enrolled. Patients were assessed through clinical, magnetic resonance imaging (MRI) and laboratory invest...

Background: CLDN14 gene encodes a protein involved in regulation of paracellular permeability or ion transport at epithelial tight junctions as in the nephron. C allele of the rs219780 SNP of CLDN14 gene has been associated with high levels of PTH and with low bone mineral density (BMD) in women. Our aim is to study the relationship between rs219780 SNP of CLDN14 and fractures, renal lithiasis and bone mineral density in patients with primary hyperparathyr...

Bilateral cervical exploration has been the gold standard in parathyroid surgery. Nowadays, the preoperative localization procedures have facilitated the minimally invasive surgery. This study aims to analyze the influence of thyroid disease in Tc99m-sestamibi scintigraphy (MIBI) results.A series of 154 patients with PHP who underwent parathyroidectomy was reviewed. Patients were divided into two groups: group 1 (G1, 58 patients) with thyroid diseases, a...

Multiple myeloma is a hematologic malignancy characterized by osteolytic bone destruction which follows the increased osteoclastic resorption of bone that is not accompanied by increased bone formation. This can lead to bone pain, diffuse osteopenia, focal lytic lesions, pathologic fractures, spinal cord compression, and hypercalcemia, so it is evident that osteolytic bone disease is a major cause of morbidity and mortality in patients with multiple myeloma. Long-term monthly ...

Aim: To investigate factors associated with low bone mineral density (BMD) in type-1 diabetic (T1D) patients.Patients and methods: One hundred and seventy-five eugonadal T1D patients (age 32.8±8.4 years, diabetes duration 13.0±8.4 years) were studied. Body mass index (BMI), daily insulin dose (DID), age at diagnosis (AgeD), presence of diabetic complications, glomerular filtration rate (GFR), HbA1c, and BMD at lumbar spine (LS) and femur (F) by...

Aim: Hypocalcemia is a common problem after parathyroidectomy but is generally transient. In some cases the postoperative hypocalcemia is severe and prolonged despite normal or even elevated levels of parathyroid hormone (PTH). This phenomenon, called the hungry bone syndrome (HBS), occurs due to sudden withdrawal of PTH leading to a marked net increase in bone uptake of Ca, P, and Mg. We aimed to evaluate predictive factors for HBS development after parathyroidectomy.<p c...

Risk for vertebral fractures (VFx), the most common osteoporotic fractures, is a heritable complex trait. No genome-wide association studies (GWAS) searching for genetic susceptibility factors for VFx have been reported. We performed a GWAS for VFx in a population-based study of Dutch elderly. Thoracolumbar spine radiographs were scored for osteoporotic VFx using the McCloskey/Kanis method. Genetic data was available in 329 VFx cases and 2666 controls. We tested 2 543 887 impu...

Obesity was considered to be a protective condition against osteoporosis. New studies suggest that visceral obesity is associated with low BMD and a higher risk for fracture. Patients with diabetes mellitus, although they do not have a lower BMD, have a higher fracture risk, probably due to the lower bone turn over.Aim: The aim of the study was to evaluate bone metabolism in connection with hormonal profile in postmenopausal women with metabolic syndrome...

Introduction: In postmenopausal women the rate of bone remodeling increases. Trace elements are known to influence bone metabolism. The aim of the study was to assess serum concentrations of some elements in pre- and postmenopausal women with and without osteopenia.Methods: Serum concentrations of magnesium, copper, cadmium and vanadium were measured by inductively coupled plasma atomic emission spectroscopy in 51 postmenopausal women (19 women with oste...

Introduction: Fahr’s syndrome in characterized by bilateral calcifications in basal ganglia, dentate nucleus and semioval center. Its clinical manifestations are a rigid hypokinetic syndrome, mood disorders and cognitive impairment. The most frequent aetiology of this syndrome is, together with idiopatic causes and congenital infections, calcium disorders, mainly primary hypoparathyroidism, accounting for up to 80% of all causes.Case report: A 57-ye...

Introduction: Body weight is positively correlated to bone mineral density. The exact mechanism is unclear but gravity may be one of the involved factors. Adipocytokines (leptin and adiponectin), secreted by the adipose tissue, are involved in bone turnover. We investigated the influence of body weight, body composition, and adipocytokines upon bone mass in pre and postmenopausal women.Design: Cross-sectional study including six groups of 8 to 16 healthy...

Introduction: There are many reports that vascular and/or heart valve calcification is good predictor for low bone mineral density. I investigated whether benign calcification of breast can also well predict low bone mineral density.Methods/design: I have reviewed and analyzed the records of 91 women with age more than 50 years old among patients examined bone mineral density and breast mammography from January through December 2010. The lowest value of ...

Objective: To evaluate Vitamin D levels and bone metabolism in adult patients with cystic fibrosis (CF).Patients and methods: One hundred patients with CF (53 F, 47 M; age 29±8 years). and 100 healthy controls were enrolled. Patients were assessed through clinical, and laboratory investigations. Evaluation of serum 25 hydroxy vitamin D (25OHD), vertebral fractures (quantitative morphometric analysis) and bone mineral density (BMD) at lumbar spine an...

Wnt signaling through low-density lipoprotein receptor-related protein 5 (LRP5) is an important determinant of bone mass regulation. Polymorphisms in the LRP5 gene have been associated with either osteoporotic phenotypes or normal bone mineral density (BMD) variation.Objective: To explore the influence of two LRP5 single nucleotide polymorphisms (SNPs) A1330V and V667M on BMD and serum levels of osteoprotegerin (OPG), receptor activator of nuclear factor...

Introduction: In Romania, the prevalence of postmenopausal osteoporosis in urban centers was estimated by a study in 2007 to be 16.5%. Using alendronate we are increasing bone mineral density and reducing bone turn-over in women with postmenopausal osteoporosis.Materials and methods: There were examined 55 postmenopausal women with osteoporosis (average age 62±4.5 years). Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometer ...

Aim: To evaluate the effect of risedronate vs ibandronate in treatment of systemic osteoporosis in postmenopausal women.Materials and methods: We examined 57 postmenopausal women with systemic osteoporosis (average age 61±3.5 years). Bone mineral density (BMD) was determined by dual-energy X-ray absorptiometer (HOLOGIC Delphi W; SN 7044909) on lumbar spine. Examination was performed before the onset of treatment and after a period of 1, 2 and 3 year...

Objective: Evaluate cinacalcet use and effect based on follow-up within a cohort study of recently diagnosed Primary Hyperparathyroidism (PHPT) patients. Characteristics, treatment indications and biochemical data are presented with measures of cinacalcet efficacy and safety.Methods: The Swiss Primary Hyperparathyroidism Cohort Study is a prospective, non-interventional project to collect clinical, biochemical and outcome data in patients with PHPT initi...

Objective: To study if people with diabetes mellitus (DM) have increased risk of fracture.Methods: The study population consisted of 29 512 people aged 50 years or more. There were 1981 diabetic patients among them. The records of the local trauma clinic for two-year period were analyzed.Results: Women with DM had fewer fractures during two years than women without DM (relative risk 0.43; 95% confidence interval 0.30–0.61). Th...

Background: Osteoporosis is considered to be an important cause of morbidity in patients with β-thalassemia major. Despite recent advances in the identification of the molecular pathways involved in the thalassemia-induced osteoporosis, less is known about the responses of the thalassemic skeleton to various physiological and pathological conditions. The aim of the present study was to evaluate the postprandial response of bone turnover, which is an important component of...

Introduction and aim: Primary hyperparathyroidism (PHP) is the most frequent endocrine abnormality in MEN1 affecting about 100% of cases and inducing severe bone and kidney complications. Although surgery represents the only curative approach in MEN1 PHP, novel drugs are now available to effectively control PHP. The objective of this study was to show the recent changes in clinical presentation and therapeutic approach in MEN1-related PHP occurred in the last years.<p clas...

Primary hyperparathyroidism is an autonomous form of hyperparathyroidism, whose characteristics are: increased secretion of parathyroid hormone with clinical signs of hypercalcemic syndrome and various organ lesions, including bones.Case report: A 51-year-old Caucasian female presented with walking difficulties, polyuria, polydipsia, palpitations and headaches. Examination showed thoracic spine hyperkyphosis with consecutive chest deformity, staggered wa...

Introduction: The most common localization of parathyroid glands is behind the thyroid gland poles. According to different authors ectopic localization is present in 37–45.7%.Case report: Caucasian male, 31 years old, with elevated serum calcium was sent to an endocrinologist after pyelolithotothomy. He has the history of ulcerative colitis treated with anti-inflammatory therapy. Laboratory analysis: total serum calcium: 2.85 mmol/l, phosphorus: 0.6...

Osteoporosis is a chronic noninfectious disease, which changes the structure and mineral density of bones, causing fractures after small trauma, deformities and disability. Every minute two breakages happen, due to osteoporosis. Thyroid gland disfunction could disturb the bone remodelling process.The aim of this study is to check the bone quality in females suffering from thyroid diseases. This prospective study included 164 women of the average age of 7...

An adequate intestinal uptake of calcium is critical for the maintenance of calcium homeostasis during pregnancy and lactation. We previously found in rat models of end-stage renal disease that dietary fructose reduces intestinal calcium absorption and perturbs kidney morphology. Despite the dramatic rise in fructose consumption and the evidence of its deleterious effects for adult health, there is no information about fructose effects on maternal health and pregnancy outcomes...

Background: Skeletal changes including demineralization have been reported in WD. The exact mechanism originating these changes isn’t completely understood but some authors have proposed a link to vitamin D (VitD) metabolism.Aim: To investigate the prevalence of demineralization in a cohort of WD patients and correlate it with VitD status and severity of hepatic and neurological involvement.Methods: Thirty-five patients (17 ma...

Background: The optimal surgical technique in patients with refractory renal hyperparathyroidism (RHP) on hemodialysis for end stage renal disease is still a point of debates.The high percentage of recurrences after standard surgical procedures, i.e. subtotal parathyroidectomy (SPtx) and total parathyroidectomy with autotransplantation (TPtx+At) reactualised the practice of total parathyroidectomy (TPtx).Patients and methods: Forty...

Introduction: Vitamin D deficiency has been frequently observed in the elderly population. Improving vitamin D status may be an important modifiable risk factor to reduce fractures; however, adherence to daily supplementation is poor. We tested whether oral administration of an alcoholic solution of vitamin D3, 200 000 IU every 4 months in elderly could assure an optimal serum 25(OH)D concentration of 80–120 nmol/l.Method: We enrolled 50 ...

Recurrent primary hyperparathyroidism (RPHPT) is defined as hypercalcemia occurring after 6 months of normocalcemia following initial operation. The aim of this study was to analyze our experience in RPHPT.Between 1980 and 2010 33 patients (1.2%) with primary hyperparathyroidism (HPT1) were reoperated in our tertiary referral centre for recurrence of disease: 24 adenomectomies, six subtotal parathyroidectomies, two total parathyroidectomies with autotran...

Vitamin D is synthesized in the skin. Low vitamin D levels have been observed in African Americans. However, the relationship between vitamin D and skin color has not been completely evaluated.The aim was to study the relationship between dark skin color and vitamin D levels in healthy individuals.Vitamin D (25(OH)D3) levels were measured in 15 dark skinned individuals. All subjects were immigrants, having migrated to Gr...

BACKGROUND: Different dosing protocols have been used for vitamin D supplementation, but there has been a lack of comparative data among them. This clinical trial study was aimed to compare the efficacy of two different regimens of vitamin D supplements on serum 25(OH) D3 level, at the end of a 3 months therapy period. DESIGN: 84 cases of vitamin D deficiency or insufficiency who did not meet exclusion criteria were randomized to two different vitamin ...

Background: One of the major complications developed by patients with end stage renal disease (ESRD) is secondary hyperparathyroidism (SHPT), due to hypocalcaemia, hyperphosphatemia and 1,25(OH)2D deficiency with parathyroid hyperplasia and high PTH levels as earliest changes, which may require parathyroidectomy (PTX).Study design and objectives: This study aimed to evaluate the indications, the particularities and outcomes post-PTX of patient...

The two main subtypes of pseudohypoparathyroidism (PHP), PHP-Ia and -Ib, are caused by mutations in GNAS exons 1–13 and methylation defects in the imprinted GNAS cluster, respectively. PHP-Ia patients show Albright hereditary osteodystrophy (AHO) and resistance toward multiple hormones (PTH/TSH/GHRH/gonadotropins), whereas PHP-Ib patients classically display hormone resistance limited to PTH and TSH. Incoming data suggest that the two diseases share more genetic and clini...

Subtotal parathyroidectomy (SPX) and total parathyroidectomy with autotransplantion (TPXAT) are adequate techniques in treatment of secondary hyperparathyroidism (HPT2) in hemodialysed patients with identical results. Reinterventions required for persistence or recurrence of HPT2 may seem easy after TPXAT: no redo-surgery in the cervical area and removal of grafts in the forearm under local anaesthesia. The aim of this study was to analyze our results of reiterative surgery in...

Introduction: The training year of elite athletes is characterized by different kind and intensities of workload implying different level of metabolic responses of the skeletal tissue, assessable by measuring serum levels biochemical markers.Methods: Fourteen top-level female skiers, from the Italian Women’s Alpine Ski Team (slalom and giant slalom), were tested at the end of the relative rest period (T1), the pre-competitive season (T2) and the com...

Primary hyperparathyroidism (PHPT) is the third most frequent endocrine disorder and has a variable clinical presentation. Asymptomatic PHPT became the predominant form of the disease with increase of it’s incidence after the introduction of automated serum calcium measurement in North America and Europe. Data from Russia is lacking.Aim: To present the clinical profile of PHPT in Russia.Materials and methods: This retrospectiv...

Introduction: Parathyroid hormone (PTH) secretion is regulated by the concentration of extracellular ionized calcium. The calcium sensing receptors (CaSR) of parathyroid chief cells play a central role in calcium homeostasis. Their activity is reduced by calcimimetics, the compounds that directly increase the sensitivity of CaSR to extracellular ionized calcium. Cinacalcet hydrochloride, an oral calcimimetic, is indicated in treatment of primary hyperparathyroidism (PHP), for ...

Introduction: The quantitative ultrasound (QUS) is an useful tool in the evaluation of the fragility fracture risk.Aim and study design: We performed the QUS fragility fracture risk groups (valided by the golden standard DXA) by a unifactorial analyze including the bone markers.Method: The cut offs used were: SI≤59U (high risk), SI≥83U (low risk), and medium risk with SI between 59 and 83U. The QUS analyze was performed...

Background: The presence of functional ACTH receptors (MC2R) on osteoblasts and fact, that their activation lead to the proliferation of osteoblasts is consistent with the presence of receptors for another anterior pituitary hormones (FSH and TSH) on bone cells. Does ACTH directly regulate bone? Is it possible, that this is another hormone of a novel regulatory axis, pituitary-bone axis, in which hormones bypass traditional endocrine targets to regulate bone mass directly? Sup...

Introduction: There is accumulating evidence on the favourable effects of some statins on bone and mineral metabolism. Although some studies have reported drop of serum 25-hydroxyvitamin D levels in subjects receiving statin therapy, comparative studies evaluating various statins in prospective randomized design is lacking. Our purpose is to compare the effects of variable doses of rosuvastatin and atorvastatin on serum 25-hydoxyvitamin D levels adjusted for seasons.<p cla...