Search PubMed⌕ Search

Biomedical subjects

C Christiansen

Publications and source records attributed to C Christiansen.

At least 325 records · Page 18Linked to original sources

Changes in soft tissue body composition and plasma lipid metabolism during nandrolone decanoate therapy in postmenopausal osteoporotic women.

Thirty-nine osteoporotic (prior spine or Colles' fracture) but otherwise healthy postmenopausal women were allocated to receive blindly either 50 mg nandrolone decanoate (ND) intramuscularly or placebo injections every 3 weeks for 1 year. Thirty-six women (92%) completed the study. ND treatment resulted in an increase in non-osseous lean weight and a corresponding decrease in fat mass (measured by dual photon absorptiometry). A 20% increase in the 24-hour urinary creatinine excretion indicated that the increase in non-osseous lean weight was caused mainly by an increase in muscle mass. With regard to serum lipids and lipoproteins, ND treatment slightly decreased high density lipoprotein (HDL) cholesterol without significantly affecting total cholesterol, low density lipoprotein (LDL) cholesterol or triglycerides. In conclusion, treatment with ND changes the soft tissue composition in osteoporotic postmenopausal women towards a leaner and more muscular body.

Adipose Tissue↗

Estrogen/gestagen therapy changes soft tissue body composition in postmenopausal women.

The long-term effect of percutaneous and oral estrogen replacement therapy on soft tissue body composition was examined in a two-year, placebo-controlled study with 110 early postmenopausal women. The women were allocated to four treatment groups: (1) oral cyclical combination of estradiol valerate and cyproterone acetate, (2) oral placebo, (3) percutaneous 17 beta-estradiol, supplemented by oral progesterone during the second year, or (4) percutaneous placebo cream. Total-body lean body mass (LBM) and fat mass (FM) were measured by dual photon (153Gd) absorptiometry once a year, and the fat layer in the distal forearm (FATarm) was measured every 3 months by single photon (125I) absorptiometry. Both hormone therapies prevented an increase in FATarm, as observed in the placebo groups. A similar pattern was seen for FM, body weight, and skin-fold thickness (measured once a year by mechanical calipers), whereas LBM was unaffected by the therapy. Hormonal replacement therapy prevents the age-related increase in body fat observed after the menopause.

Adipose Tissue↗

Measurement of the subcutaneous fat in the distal forearm by single photon absorptiometry.

The influence of subcutaneous fat on single photon (125I) absorptiometry (SPA) measurement of bone mineral content of the distal forearm was investigated. A fat correction model was tested by measurements on eight lean subjects with different amounts of porcine fat around their forearm, and further validated from measurements on 128 females. In addition, it is shown that the fat content in the distal forearm can be measured by SPA with a short-term precision at 1.9% in an obese subject and that it correlates well with total body fat (r2 = .7) measured by dual photon absorptiometry, skinfold thickness (r2 = .5), and body mass index (r2 = .6). By using this method in a double-blind placebo-controlled trial, hormonal substitutional therapy significantly decreased the forearm fat content without affecting the body weight in postmenopausal osteoporotic women.

Adipose Tissue↗

Treatment of postmenopausal osteoporosis: is the anabolic steroid nandrolone decanoate a candidate?

Thirty-nine postmenopausal women (aged 55-75 years) with at least one osteoporotic fracture were allocated to one year of treatment with the anabolic steroid nandrolone decanoate (50 mg i.m. every 3 weeks) or placebo injection. Both groups also received a daily intake of 500 mg calcium. Thirty-six women (92%) completed the study. In the nandrolone decanoate-treated group the fat corrected bone mineral content in the proximal part of the distal forearm (measured by single photon absorptiometry) showed a significant increase of 3% compared with placebo (P less than 0.01), and the same tendency was seen in the bone mineral content of the distal part of the distal forearm and density of the lumbar spine (measured by dual photon absorptiometry). However, this did not reach significance. In the placebo group all bone mineral measurements remained unchanged. The biochemical estimates of bone formation (plasma bone Gla protein (BGP), serum alkaline phosphatase) and whole body retention (WBR) of 99mTc-diphosphonates were not statistically significantly changed by the nandrolone decanoate therapy. We conclude that treatment with nandrolone decanoate does increase the bone mineral content; however, this may not be due to a direct increase in bone formation. The mechanism may theoretically be a combination of decreased bone resorption and increased muscle mass, which both play a beneficial role in conserving bone.

Aged↗

Long-term and withdrawal effects of two different oestrogen-progestogen combinations on lipid and lipoprotein profiles in post-menopausal women.

Serum lipids and lipoproteins were studied in 86 healthy post-menopausal women at 3-monthly intervals throughout 2 yr of treatment with cyclic oestradiol valerate plus cyproterone acetate (E2V + CPA), continuous 17 beta-oestradiol plus norethisterone acetate (E2 + NETA), or placebo. Withdrawal effects were also investigated. Serum oestrogen levels were similar following the 2 hormone regimens. Serum total and low-density-lipoprotein (LDL) cholesterol were significantly reduced by 5-8% during cyclic E2V + CPA therapy and by 15-20% during continuous E2 + NETA treatment. The concentrations remained significantly reduced throughout the 2 yr of treatment. Virtually no changes were observed in the placebo group. High-density-lipoprotein (HDL) cholesterol concentrations were significantly reduced in relation to pretreatment values during the first year of continuous E2 + NETA therapy, but were not significantly different from the levels in the cyclic E2V + CPA or the placebo groups. Serum triglyceride levels remained almost constant in all the groups. Withdrawal of hormone therapy resulted in steep increases in total and LDL-cholesterol, the levels returning to pretreatment values. A similar increase in HDL-cholesterol was observed in the E2 + NETA group, following withdrawal. Vaginal bleeding episodes were experienced by all the women receiving the E2V + CPA regimen and they occurred regularly in 63% of the women. Fifty-two (52) percent of the women receiving E2 + NETA did not bleed at all. The results of the present study suggest that the continuous addition of NETA may enhance the oestrogen-induced changes in total and LDL-cholesterol, whereas only minor changes in the oestrogen-induced effects on these variables are produced by the cyclic addition of CPA. However, in the case of HDL-cholesterol, the antagonistic effect of CPA seems to be moderate in comparison with that of NETA.

Cholesterol, HDL↗

Nandrolone decanoate treatment of post-menopausal osteoporosis for 2 years and effects of withdrawal.

This study investigated the effects of nandrolone decanoate (ND) therapy (50 mg i.m. every 3 or 4 wk) on bone mass and soft tissue body composition in post-menopausal women. Twenty-two (22) women were followed up over a period of 30 mth, during which they received ND therapy for 12-24 mth and were treatment-free for the other 6-18 mth. While they were receiving treatment forearm bone mineral content (BMC) and lean body mass (LBM) increased, whereas fat mass (FM) decreased. After withdrawal of ND therapy the BMC, LBM and FM values all tended to return to pretreatment levels. Serum high-density-lipoprotein cholesterol showed a non-significant decrease, while serum low-density-lipoprotein cholesterol and serum total cholesterol remained unchanged during therapy. It was concluded that ND therapy can achieve an increase in BMC in post-menopausal women, but this is maintained only for as long as therapy is continued.

Aged↗

Influence of soft tissue body composition on bone mass and metabolism.

Total body bone mineral (TBBM), lean body mass (LBM), and fat mass (FM) were measured by dual photon 153Gd absorptiometry in four female groups: (a) 27 patients with hip fracture; (b) 40 patients with spinal crush fracture; (c) 17 patients with osteoarthrosis, and (d) 26 healthy postmenopausal women. TBBM was significantly decreased in the two osteoporotic groups. The FM tended to be smaller in the two osteoporotic groups and larger in the osteoarthrotic group compared to the control group, whereas, LBM was virtually equal in all four groups. A significant negative correlation (p less than 0.01) was found between fasting urinary calcium corrected for creatinine and FM, whereas no relation between plasma bone Gla protein and FM could be demonstrated. We conclude that an increased fat mass after the menopause decreases bone resorption without a corresponding decrease in bone formation.

Absorptiometry, Photon↗

Antagonism of diazepam sedation by flumazenil.

Forty adult patients undergoing elective surgery, anaesthetized with diazepam, alfentanil and nitrous oxide in oxygen, and paralysed with atracurium were given flumazenil or placebo i.v. in a double-blind randomized study to assess the efficacy of flumazenil. Awake state, heart rate, arterial pressure, rate of ventilation and arterial blood-gas values were measured at 0, 5, 30, 120 and 240 min after administration of flumazenil or placebo. Flumazenil was found to antagonize the sedative effects of diazepam; there was no resedation within the time of observation. There were no intergroup differences in any of the other measured variables. A median dose of diazepam 0.33 mg kg-1 during surgery lasting a median of 98 min was antagonized by a median dose of flumazenil 0.35 mg. No side effects related to flumazenil were observed.

Aged↗

Nasal calcitonin for treatment of established osteoporosis.

Thirty-seven women with established osteoporosis completed a one-year double-blind, placebo-controlled study with the primary aim of examining the effect of nasal salmon calcitonin (200 IU daily) on bone and calcium metabolism. All the women received a daily calcium supplement of 500 mg. For comparison we also report data from an age-matched group of healthy women who did not receive calcium supplementation. The bone mineral measured in the forearm (single photon absorptiometry) and spine (dual photon absorptiometry) showed a similar pattern during treatment. The calcitonin group (n = 17) did not lose bone mineral in comparison with the placebo (n = 20) and the control groups (n = 19) (P less than 0.01). The biochemical estimates of both bone resorption and bone formation decreased highly significantly in the calcitonin group (P less than 0.001) and were unchanged in the control group, whereas the placebo (calcium) group showed intermediate values. Neither subjective nor objective side-effects occurred in any of the groups. We conclude that nasal calcitonin is a realistic treatment of established osteoporosis.

Administration, Intranasal↗

The pathophysiology of peri- and postmenopausal bone loss.

Changes in sex hormones and bone turnover were studied longitudinally in 31 women aged 47-54 years who were approaching the menopause. Every 6 weeks for 2-3 years, hormones and biochemical estimates of the bone turnover were determined and the bone mass was measured at two forearm sites by single photon absorptiometry. Spinal bone mass was measured every 6 months. The bone turnover was normal in women aged 47-54 years with regular menstruation, whereas the estimates of bone resorption were high in the women with irregular menstruation. In nine women, who reached the menopause during the study, bone resorption increased significantly, whereas bone formation showed only a small increase. When the results of the nine women were combined with those of 50 women, who had passed a natural menopause within the preceding 3.5 years, the bone resorption indices reached their peak within the first postmenopausal year, whereas bone formation increased until 1.5-2 years after the last menstrual cycle. At the ultradistal forearm site the rate of bone loss was maximal (5% per year) immediately after the menopause and subsequently declined, which suggests that trabecular bone is more sensitive than cortical bone to changes in bone turnover. Spinal bone loss was identical in late peri- and early postmenopausal women. We conclude that bone resorption starts to increase during the last perimenopausal years, with a beginning acceleration in bone loss, which then becomes sharp after the menopause. The changes are related to the decline in oestrogens, but other mechanisms may also play a role.

Aged↗

Body composition measurement by dual photon absorptiometry: comparison with body density and total body potassium measurements.

Body composition was measured in 29 healthy adults (12 men and 17 women) by three different methods: Dual photon (153Gd) absorptiometry (DPA), body density measurements (BD) and measurements of total body potassium (TBK). Correlation and regression analysis with the body fat percentage (Fat%) measured by the three different methods gave r values between 0.83 and 0.90 and SEEs between 4.0 and 6.0 (Fat%). We conclude that DPA provides a new method of measuring body composition with precision and accuracy errors in the same range as the more established methods.

Adult↗

The effect of hemiplegia on bone mass and soft tissue body composition.

The content of bone mineral (BMC), lean tissue, and fat tissue were measured by single and dual photon absorptiometry in both the paretic and the non-paretic limbs of 15 patients, hemiplegic due to cerebrovascular accident 23-38 weeks earlier. Compared with the non-paretic arm, the paretic arm had approximately 10% lower (P less than 0.01) BMC. This difference was largest at the measuring site with the highest ratio of trabecular to compact bone. The paretic leg had a 4% (P less than 0.001) lower BMC than the non-paretic leg. For both the arms and the legs, the lean content was lower (P less than 0.05) and the fat content higher (P less than 0.01) in the paretic than in the non-paretic. This was relatively more pronounced in the arms than in the legs. We conclude that partial immobilization, owing to paresis after a cerebrovascular accident, results in characteristic changes in the affected limbs, with a marked decrease in the content of bone and lean tissue and a pronounced increase in fatty tissue.

Adipose Tissue↗

Metabolism of vitamin D2 and vitamin D3 in patients on anticonvulsant therapy.

We examined the effect of short-term treatment with pharmacological doses of vitamin D2 or vitamin D3 on the serum concentration of 1,25(OH)2D metabolites in epileptic patients on chronic anticonvulsant drug therapy. Nine patients were studied before and after treatment with vitamin D2 4000 IU daily for 24 weeks and 10 before and after treatment with vitamin D3 in the same dose. Before treatment the serum concentrations of 1,25(OH)2D and 25(OH)D were significantly lower in epileptics than in normal subjects (P less than 0.01). Vitamin D2 treatment increased the serum concentration of 1,25(OH)2D2, but a corresponding decrease in 1,25(OH)2D3 resulted in an unchanged serum concentration of total 1,25(OH)2D. The serum concentration of 25(OH)D2 and 25(OH)D increased significantly, whereas there was a small decrease in 25(OH)D3. Vitamin D3 treatment did not change the serum concentration of 1,25(OH)2D3 whereas serum 25(OH)D3 increased significantly. The correlation between the serum ratio of 1,25(OH)2D2/1,25(OH)2D3 and 25(OH)D2/25(OH)D3 estimated on vitamin D2-treated epileptic patients and normal subjects was highly significant (P less than 0.01). The data indicate that the serum concentration of 1,25(OH)2D2 and 1,25(OH)2D3 are directly proportional to the amount of their precursors 25(OH)D2 and 25(OH)D3 and that the concentration of total 1,25(OH)2D is tightly regulated.

25-Hydroxyvitamin D 2↗

Discrepancy between serum concentrations of 1,25-dihydroxyvitamin D metabolites measured by radio-immunoassay and thymus radioreceptor assay during vitamin D2 treatment.

A radio-immunoassay (RIA) for determination of 1,25-dihydroxycholecalciferol (1,25(OH)2D3) and 1,25-dihydroxyergocalciferol (1,25(OH)2D2) in serum was compared with a competitive protein binding assay using calf thymus receptor to clarify the comparability of measurements in subjects treated with either vitamin D2 or vitamin D3 (4000 IU per day for 8 weeks). Before and during treatment with vitamin D3 the two assay techniques were concordant, but during vitamin D2 treatment the serum concentrations of 1,25(OH)2D2 and 1,25(OH)2D3 were higher when measured by RIA. The study demonstrates that during vitamin D2 treatment unknown compounds, recognized only by the antiserum, co-elute with 1,25(OH)2D2 and 1,25(OH)2D3 in high pressure liquid chromatography. It can be concluded that the radio-immunoassay used here cannot replace the calf thymus receptor assay.

Adult↗

Regional bone mineral in healthy and osteoporotic women: a cross-sectional study.

Regional bone mineral content and density (BMC and BMD) was measured in six regions (head, arms, chest, spine, pelvis, and legs) using dual photon 153Gd absorptiometry (DPA) in 128 healthy women aged 21-77 years, and in 45 women presenting with Colles' fracture (mean age 65 years), 46 women with vertebral crush or wedge fracture (mean age 68 years), and 27 women with femoral neck-fracture (mean age 74 years). The age-related normal bone loss was generalized, uniformly distributed, and best described by a combination of a premenopausal linear and a postmenopausal exponential regression in all six regions. Looking at BMD, the overall expected bone loss from age 20 to age 80 was approximately 20% in all the regions. When the fracture patients were examined, we found also generalized bone deficit as the prominent feature, amounting to about 20% of the premenopausal level for Colles' and spinal fractures, and about 25% for femoral neck-fracture. However, there was a regional bias in the fracture patients, as the Colles' and spinal fracture patients had a preferential reduction in spinal and pelvic BMD, whereas the patients with femoral neck-fracture had a preferential reduction in pelvic and leg BMD. We conclude that age-related and osteoporotic bone loss is generalized. Furthermore, we propose that regional differences in osteoporotic bone loss are brought about by a simple biological variability of the range of (i) relative amount of trabecular and cortical bone, (ii) rate of loss in the two types of bone tissue, and (iii) time of onset of trabecular relative to cortical bone loss.

Absorptiometry, Photon↗

Discriminative ability of total body bone-mineral measured by dual photon absorptiometry.

We investigated the discriminative ability of total body bone-mineral expressed as the total body bone-density (TBBD) measured by dual photon absorptiometry (DPA) in 79 healthy premenopausal women, 27 healthy postmenopausal women, and 120 female osteoporotic fracture patients presenting with either Colles' fracture, vertebral fracture or femoral neck-fracture. TBBD was compared to the bone-mineral density of the lumbar spine (BMDspine) also measured by DPA, and to the bone-mineral content of the forearms (BMCforearm) measured by single photon absorptiometry (SPA). TBBD, BMDspine and BMCforearm showed that all the fracture patient groups had significantly reduced bone-mass. Using receiver operating characteristic (ROC) analysis, we found that TBBD had a tendency towards better discriminative ability than BMDspine or BMCforearm with regard to the discrimination between healthy premenopausal women and the three types of osteoporotic fractures (not significant in spinal fracture patients). BMCforearm had an intermediate position, whereas BMDspine had the smallest discriminative ability. TBBD also discriminated better between healthy postmenopausal women and hip-fracture patients than BMDspine or BMCforearm, whereas there was no significant difference between the three methods regarding the discrimination between the healthy postmenopausal women and the Colles' and spinal fracture patients. We conclude that the TBBD measurement by DPA has a discriminative potential which is better than the local spine or forearm measurements.

Absorptiometry, Photon↗

The measurement of secretory endometrial protein PP14 in serum from postmenopausal women receiving unopposed estrogen or continuously combined estrogen/progestogen.

A highly sensitive radioimmunoassay was developed to measure the low serum concentrations of the endometrial secretory placenta protein 14 (PP14) in postmenopausal women. The assay was established by selecting optimum reaction conditions for radioactive labelling of PP14, combined with simple procedures for the purification of the labelled PP14. The PP14 assay was used in 2 groups of healthy, early postmenopausal women blindly receiving either estrogen monotherapy (n = 20, placebo n = 25) or continuously combined estrogen/progestogen therapy (n = 20, placebo n = 23). Neither of these regimens is believed to produce secretory endometrium. During the 12 months of estrogen monotherapy, serum PP14 (S-PP14) remained unchanged at 4.9 micrograms/l, when compared with placebo. Treatment with continuously combined estrogen/progestogen showed a small but significant increase in S-PP14 from 5.3 micrograms/l to 7.2 micrograms/l at 3 months. S-PP14 remained at this slightly elevated level throughout the treatment period of 24 months. Three months after hormone withdrawal, S-PP14 had returned to the pretreatment level. We suggest that S-PP14 might be a useful marker of secretory endometrium.

Drug Combinations↗