Biomedical subjects

K Kushida

Publications and source records attributed to K Kushida.

At least 55 records · Page 3Linked to original sources

PubMed1999

The degree of osteoporosis in patients with vertebral fracture and patients with hip fracture: relationship to incidence of vertebral fracture.

The most typical fracture that occurs in osteoporotic patients is a vertebral fracture, whereas hip fractures are thought to occur in the most severe osteoporotic patients. The purpose of this study was to compare the degree of osteoporosis between patients with vertebral fractures and patients with hip fracture by examining bone mineral density, biochemical markers of bone metabolism, and the incidence of vertebral fractures. Subjects were 50 female patients with vertebral fractures (VX) and 60 female patients with hip fracture (HX). Bone mineral densities (BMD) of the lumbar spine, femoral neck (Neck), and one-third of the radius were determined by DXA. Total and bone alkaline phosphatase, osteocalcin, N-MID osteocalcin, PICP, free deoxypyridinoline, and CTx were measured. All z-scores of BMD in the three areas of VX and HX patients were negative, meaning those BMDs were lower in VX and HX than a decade-matched normal reference. The z-score of Neck BMD was significantly lower in HX than in VX. Deoxypyridinoline and CTx were significantly higher in HX than in VX. N-MID osteocalcin was significantly lower in HX than in VX. VX and HX patients were divided into four subgroups according to the number of their vertebral fractures: VX, with a single fracture; VX, with multiple fractures; HX, without vertebral fractures: and HX, with vertebral fractures. VX with multiple fractures and HX with vertebral fractures had lower z-scores at all skeletal sites. HX with vertebral fractures had the lowest median z-score at spine and Neck, whereas HX without vertebral fractures had a low z-score only at Neck compared to VX with a single fracture. There was no significant difference in markers among the subgroups. The number of vertebral fractures was negatively correlated with z-scores of BMD at all three sites. We concluded that uncoupling between bone formation and resorption is greater in hip fractures than in vertebral fractures. Vertebral fractures are associated with general osteopenia of the total skeleton. We suggest that there are two types of osteoporosis in patients with hip fractures: one is that the bone mass of the femoral neck is specifically reduced, and the other is a terminal stage of osteoporosis which follows osteoporosis with vertebral fractures.

Aged↗

PubMed1999

Measurements of urinary nonisomerized form of type I collagen degradation products (alpha-CTx) in aging, menopause, and osteoporosis with fractures.

We have evaluated the effect of aging, menopause, and osteoporosis on the measurements of urinary nonisomerized form of type I collagen degradation products (alpha-CTx). In 18 children, 86 premenopausal healthy women, 144 postmenopausal healthy women, 74 patients with vertebral fractures and 61 patients with hip fractures, alpha-CTx excretions were measured by a RIA. The age-related changes of alpha-CTx in healthy females show that the values were extremely high before the age of 16 years and decreased between ages 16 and 29, and that after the age of 40 years, the values tended to increase and to vary widely with age. In menopause, alpha-CTx in postmenopausal subjects was significantly higher than those in premenopausal subjects. There was no significant correlation between alpha-CTx and years since menopause in 102 postmenopausal subjects. Alpha-CTx in the vertebral fracture group were higher than those in the postmenopause group, but not significantly. Alpha-CTx in the hip fracture group were significantly higher than those in postmenopause and vertebral fracture groups. In age-matched comparisons, the values of the patients with vertebral fracture and the patients with hip fracture were significantly higher than those of corresponded age-matched postmenopausal women. Alpha-CTx well reflects an increase of bone resorption associated with bone modeling at childhood and high bone resorption after the menopause and higher bone resorption in osteoporotic patients with fractures.

Adolescent↗

PubMed1999

Risk factors for vertebral fractures in renal osteodystrophy.

We determined the prevalence of vertebral fractures in hemodialysis (HD) patients, investigated whether low bone mineral density (BMD) is predictive of vertebral fracture, and evaluated the effect of serum intact parathyroid hormone (iPTH) and alkaline phosphatase (ALP) levels on vertebral fracture. One hundred eighty-seven male HD patients were assessed for vertebral fractures, and lumbar-spine and total-body BMD were measured by dual-energy x-ray absorptiometory. Thirty-nine patients (20.9%) had vertebral fractures. Each standard deviation (SD) decrease in lumbar-spine BMD increased the age-adjusted odds ratio of vertebral fracture 2.0 times (95% confidence interval [CI], 1.4 to 2.0) and 1.6 times (95% CI, 1.1 to 1.6) for total-body BMD. The area under the receiver operating characteristic curve for lumbar-spine BMD was significantly greater than that for total-body BMD (P < 0.05). Patients with serum iPTH levels in the lowest tertile had a 2.4-fold greater risk for vertebral fracture than those in the middle tertile and a 1.6-fold greater risk than those in the highest tertile (P < 0.05). When the two criteria of lowest tertile of serum iPTH level and highest tertile of serum ALP level were combined, the prevalence of vertebral fractures was the greatest. Similarly, when the lowest tertile of serum iPTH level and lowest tertile of serum ALP level were combined, the prevalence was the second greatest among the combined groups according to tertiles of serum iPTH and ALP levels. We conclude that low lumbar-spine BMD might be a sensitive predictor of vertebral fracture in HD patients, and patients with relatively low iPTH levels would have a greater risk for vertebral fracture than those with hyperparathyroidism.

Absorptiometry, Photon↗

PubMed1999

Bone turnover and cortical bone mineral density in the distal radius in patients with hyperthyroidism being treated with antithyroid drugs for various periods of time.

OBJECTIVE: Whether patients, who have lost bone mass, can be restored to age-matched control levels by some means is still controversial. We investigated how the thyroid status after antithyroid drug therapy for various periods of time affects bone metabolism in patients with hyperthyroidism by assessing currently used biochemical markers of bone turnover and distal radius bone mineral density (BMD). DESIGN AND PATIENTS: The biochemical markers of bone turnover and BMD at the distal one third of the radius were measured in 79 women with hyperthyroidism treated with antithyroid drugs for various periods of time. The patients were divided into two groups according to thyroid function at the time of study: a hyperthyroid group (serum thyroid stimulating hormone (TSH) < 0.4 mU/l) and an euthyroid group (TSH 0.4-4.0 mU/l). Second, each group was further divided according to the duration of therapy: short-term (less than 3 years) and long-term (3 or more years). MEASUREMENTS: Urinary type I collagen degradation products (CTx) were measured by the CrossLapsTM ELISA kit. Urinary pyridinoline (Pyr) and deoxypyridinoline (Dpyr) were measured by high performance liquid chromatography (HPLC) after acid hydrolysis. Serum N-mid osteocalcin (OCN-mid) was measured by a recently developed enzyme-linked immunosorbent assay. Serum alkaline phosphatase (ALP) was determined by routine laboratory methods. Bone mineral density (BMD) at the distal one third of the radius was measured using dual energy X-ray absorptiometry (DEXA; DCS-600EX, Aloka, Tokyo). RESULTS: There were statistically significant positive correlations of FT3 and FT4 with the biochemical markers of bone turnover. There were significant negative correlations between the biochemical markers and BMD only in patients undergoing long-term therapy. In a comparison between hyperthyroid and euthyroid groups based on duration of treatment (long-term and short-term), and in a comparison without regard for length of treatment (all patients), it was evident that ALP and CTx levels were significantly higher in the hyperthyroid than in the euthyroid groups. Significantly lower BMD Z-scores in the hyperthyroid group compared to those in the euthyroid group were observed only in patients undergoing long-term therapy. CONCLUSIONS: Urinary type I collagen degradation products were a sensitive marker for evaluating the bone turnover in patients with hyperthyroidism. Our data suggested that it might be important to control the levels of TSH within normal ranges during long-term antithyroid drug therapy in order to prevent bone loss.

Adult↗

PubMed1999

Comparison of the concentrations of pentosidine in the synovial fluid, serum and urine of patients with rheumatoid arthritis and osteoarthritis.

OBJECTIVE: Pentosidine, an advanced glycation end product (AGE), has recently been observed to be elevated in rheumatoid arthritis (RA). The aim was to elucidate which pentosidine levels, i.e. in serum, synovial fluid or urine, are more related to the disease status of RA. METHODS: We measured levels of pentosidine in serum, synovial fluid or urine in RA compared with osteoarthritis (OA), and examined the relationship between pentosidine and RA disease activity. Subjects were 20 patients with RA and 22 patients with OA. RESULTS: In total RA and OA patients combined, there was a significant correlation between pentosidine in serum, synovial fluid and urine. Pentosidine in serum and synovial fluid was significantly higher in RA than in OA. In RA, there were significant correlations between pentosidine in serum and synovial fluid and C-reactive protein, Lansbury index (LI) and erythrocyte sedimentation rate. CONCLUSIONS: These results demonstrate that pentosidine levels in body fluids correlated with each other, and pentosidine in serum and in synovial fluid is associated with the systemic inflammatory activity of RA. Higher or similar concentrations of pentosidine in serum compared with synovial fluids indicate that the elevated pentosidine levels in serum in RA are not derived from the synovial fluid, but from an increase in the formation of pentosidine in the whole body in RA. Among body fluids, serum pentosidine was the superior indicator for RA disease status.

Adult↗

PubMed1999

Comparison of free and peptide-bound pyridinoline cross-links excretion in rheumatoid arthritis and osteoarthritis.

OBJECTIVE: To investigate urinary fractions of free and peptide forms of pyridinoline cross-links in arthritis. PATIENTS AND METHODS: The free and total forms of pyridinoline (Pyr) and deoxypyridinoline (Dpyr) were measured by high-performance liquid chromatography (HPLC) in 30 pre-menopausal and 22 post-menopausal normal women, 38 women with rheumatoid arthritis (RA) and 62 women with osteoarthritis (OA). Peptide forms were calculated as total minus free. Free Dpyr and peptide form were also measured by deoxypyridinoline and carboxy-terminal telopeptide of type I collagen (CTx) immunoassays. RESULTS: In normal women, all fractions of Pyr and Dpyr and immunoassays were elevated in post-menopause compared to pre-menopause. In post-menopausal normal women, the free form increased more than the peptide form. In RA, an increase in the fractions of Pyr was greater than Dpyr. Peptide and total cross-links correlated with the disease activity of RA and they were elevated in RA patients with high disease activity. Free Dpyr and CTx were significantly lower in OA than in normal women. Peptide and total Pyr and Dpyr, and immunoassayed Dpyr were significantly higher in the radiographic later stage of OA than in the early stage of OA. CONCLUSIONS: The menopause, RA and OA may have different effects on the urinary excretion of free and peptide-bound pyridinoline cross-links.

Amino Acids↗

PubMed1999

Measurement of matrix metalloproteinases (MMPs) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in patients with knee osteoarthritis: comparison with generalized osteoarthritis.

OBJECTIVES: To compare plasma levels of matrix metalloproteinase (MMP)-3, MMP-9 and tissue inhibitor of metalloproteinases-1 (TIMP-1) between patients with knee osteoarthritis and normal subjects, to investigate whether the degree of knee joint involvement is related to those measurements, and to compare patients with and without generalized osteoarthritis. METHODS: Eighty-three women with knee osteoarthritis (OA patients) were studied. Plasma levels of MMP-3, MMP-9 and TIMP-1 were measured by enzyme immunoassays. Knee and hand radiographs were taken of all patients. The joints of the knee and hand were graded from 0 to 4 according to Kellgren and Lawrence criteria. All OA patients were divided into a generalized OA (GOA) group (n = 37) and a knee OA (KOA) group (n = 46) according to Doherty's criteria. MMPs and TIMP were also measured in 19 normal subjects. RESULTS: Plasma levels of MMP-3 and TIMP-1 were significantly higher in OA patients than in normal subjects. In contrast, MMP-9 was lower in OA patients than in normal subjects. Plasma levels of MMP-3 and MMP-9 were not influenced by the grade of knee OA. TIMP-1 was influenced by the grade of knee OA. Plasma levels of MMP-3 were significantly elevated in GOA compared to KOA. In contrast, there were no significant differences in plasma levels of MMP-9 and TIMP-1 between GOA and KOA. CONCLUSION: Since the plasma level of MMP-3 in GOA was higher than that in KOA patients, it may be a superior indicator for whole-joint degeneration.

Aged↗

PubMed1999

Biochemical markers of bone turnover do not decline after menopause in healthy women.

OBJECTIVES: To investigate the duration of high bone turnover after menopause in normal healthy women. DESIGN: Study recruited from three screening studies for health care in the elderly held in the area of Hamamatsu city. SETTING: Department of Orthopaedic Surgery, Hospital at Hamamatsu University School of Medicine, Hamamatsu. PARTICIPANTS: Ninety-two healthy postmenopausal women aged 47-81 years and 18 premenopausal women. MAIN OUTCOME MEASURES: Bone mass was determined by densitometry of the spine and the os calcis, or by ultrasound of the os calcis. Biochemical markers of bone turnover were measured including total and bone-specific alkaline phosphatase, osteocalcin, C-terminal propeptide of type I procollagen, free deoxypyridinoline and urinary degredation products of type I collagen. RESULTS: All markers except the C-terminal propeptide of type I procollagen were significantly higher in early postmenopausal women than in premenopausal women. Postmenopausal women were divided into four groups according to years since menopause. There was no difference in biochemical markers among those women in whom years since menopause were 1 to 5, 6 to 15, 16 to 25 and >26. There were no correlations between biochemical markers and age in postmenopausal women. When the postmenopausal women were divided into three groups according to t-scores of bone mass, there was no significant difference in the biochemical markers among the groups. CONCLUSIONS: High bone turnover occuring after menopause lasts for >25 years during the postmenopausal period.

Aged↗

PubMed1999

[A case of advanced retroperitoneal dedifferentiated liposarcoma treated effectively with high-dose ifosfamide].

We report a case of retroperitoneal dedifferentiated liposarcoma treated effectively with high-dose ifosfamide. A 59-year-old man received tumorectomy and right nephrectomy for the retroperitoneal liposarcoma. Twenty-two months after the operation, the liver metastasis was resected incompletely. Three months later, right pleural, retroperitoneal and peritoneal metastases appeared. With 6 cycles of high-dose ifosfamide therapy these tumors were reduced partially. Ten cycles of this chemotherapy were administered. These tumors showed regrowth at 14 months after administration of high dose ifosfamide. The combination chemotherapy of ifosfamide and doxorubicine or etoposide was not effective after regrowth of the tumors.

Antineoplastic Agents, Alkylating↗

PubMed1999

[Therapeutic use of vitamin D and its analogues for rickets and osteomalacia].

Recently, It has become clear that the mutant gene in X-linked hypophosphatemic rickets, vitamin D dependent rickets type I, and vitamin D dependent rickets type II were identified and they were caused by the disorder in the activation of vitamin D and the intracellular defect in vitamin D receptor. In this paper, the pathophysiology in various type of rickets or osteomalacia and the treatment by vitamin D agents were reported. So far, 1, alpha-(OH) D3 and 1, 25-(OH)2D3 have been effectively used as the treatment of these disease. However, vitamin D poisoning caused by these agents is still a serious issue for the treatment. In the near future, more effective treatment using genetic engineering is expected to treat the disorder of phosphate metabolism in X-linked hypophosphatemic rickets.

Female↗

PubMed1999

[Promotion of home medical care and ways to provide medicines to patients at home].

The Medicare Security Law and Fee Schedule for Medical Services have undergone revisions in accordance with the changes in society, and these were introduced on the premise that home medical care be promoted. If home medical care is promoted, it is expected that a considerable proportion of persons who are now hospitalized and depend heavily on medicare will be transferred home, partly because of the shortening of the maximum insured hospitalization time. Thus, it will become necessary to provide medicines including injectables such as TPN to patients at home. Generally speaking, medicines for patients at home are provided by nearby pharmacists based on prescriptions written by the physician in charge of a patient. However, with regard to injectables such as TPN that require aseptic environments for preparation, such requirements can not yet be met satisfactorily owing to a shortage of sufficient provisions at pharmacies and of sufficient technical skills on the part of pharmacists. Currently, there are only 27 pharmacies which are officially recognized as being sufficiently equipped to prepare injectables in aseptic environments, and pharmacists who actually prepare TPN drugs in aseptic environments account for about one third of this number. The current number of pharmacists will obviously not meet the demand for medicines from patients at home, which will undergo a sharp rise in the near future. Accordingly, it is essential to increase the number of pharmacists nationwide who are sufficiently equipped to manage injectables such as TPN in aseptic conditions.

Drug Prescriptions↗

PubMed1998

Inhibition of nitric oxide formation and superoxide generation during reduction of LY83583 by neuronal nitric oxide synthase.

6-Anilino-5,8-quinolinedione (LY83583) has been widely used as an agent to reduce levels of nitric oxide (NO)-dependent cGMP in tissues. We report here that suppression of NO formation and production of superoxide during enzymatic reduction of LY83583 by neuronal NO synthase appeared to be potentially involved in the pharmacological action caused by LY83583. LY83583 suppressed neuronal NO synthase activity of 20,000 x g rat cerebellar supernatant preparation in a concentration-dependent manner (IC50 value = 12.9 microM). A kinetic study revealed that LY83583 is a competitive inhibitor with respect to NADPH, with a Ki value of 2.57 microM. With purified neuronal NO synthase it was found that LY83583 was a potent inhibitor of NO formation by the enzyme and served as efficient substrate for reduction with a specific activity of 173 nmol of NADPH oxidized per mg of protein per minute. The reductase activity was stimulated about 19.8-fold by addition of CaCl2/calmodulin, indicating that the presence of CaCl2/calmodulin is essential to express maximal activity of LY83583 reduction. Although LY83583 was a good substrate for both NADPH-cytochrome P450 reductase (P450 reductase) and DT-diaphorase, these flavin enzymes-catalyzed reductions of LY83583 were less than the neuronal NO synthase-mediated reduction in the presence of CaCl2/calmodulin. Enzymatic generation of superoxide during reduction of LY83583 by neuronal NO synthase, P450 reductase or DT-diaphorase was confirmed by electron spin resonance (ESR) experiments. Thus the present results indicate that a benzoquinone derivative LY83583 appears to interact with the P450 reductase domain on neuronal NO synthase, resulting in inhibition of NO formation and superoxide generation, which is involved in suppression of intracellular cGMP content.

Aminoquinolines↗

PubMed1998

Reduced susceptibility to collagen-induced arthritis in mice deficient in IFN-gamma receptor.

Collagen-induced arthritis (CIA) is an arthritic model that was developed after immunization with type II collagen (CII). Apparently, contradictory results have been reported regarding the role of IFN-gamma in the development of CIA. Therefore, we employed IFN-gamma R-deficient mice to study the role of IFN-gamma. To introduce the CIA susceptibility gene (H-2q), IFN-gamma R-deficient (H-2b/b/IFN-gamma R-/-) mice were mated with DBA/1 (H-2q/q/IFN-gamma R+/+) mice; next, the F1 mice were interbred to yield F2 offspring bearing different combinations of H-2 (H-2q/q, H-2q/b, and H-2b/b) and IFN-gamma R (IFN-gamma R+/+, IFN-gamma R+/-, and IFN-gamma R-/-) genes. Although the H-2q allele appeared to confer susceptibility to CIA, mice that were homozygous for the IFN-gamma R mutation showed a substantially decreased incidence and severity of CIA. The CII-specific IgG levels of serum samples, which are known to be involved in the development of CIA, were remarkably reduced in IFN-gamma R-/- mice. Furthermore, the anti-CII IgG2a levels controlled by IFN-gamma R were significantly reduced in IFN-gamma R-/- F2 mice compared with those seen in IFN-gamma R+/+ and IFN-gamma R+/- mice, although the levels of all IgG subclass Abs examined were lower in IFN-gamma R-/- mice than in IFN-gamma R+/+ mice. No clear evidence of the imbalance of Th1/Th2 cytokines was observed in CII-immunized, IFN-gamma R-deficient mice. Taken together, these results suggest that IFN-gamma exacerbates CIA by affecting, at least, levels of CII-specific IgG Ab rather than the imbalance of Th1/Th2 cells.

Animals↗

PubMed1998

Outcomes for patients undergoing one or more total hip and knee arthroplasties.

Either total hip arthroplasty (THA), total knee arthroplasty (TKA) or both were performed in 105 patients from 1981 to 1994. These patients were experiencing severe joint destruction in the lower extremities due to rheumatoid arthritis (RA). These patients were followed for more than 2 years after their last operation. Eighty-six patients were alive and 19 patients had died at the time of follow-up. The 86 living patients were divided into four groups based on the number of replaced joints. Their pre- and postoperative conditions, including such factors as pain, mobility and disability for the quality of life (QOL), were compared. All of the four groups showed some reduction in pain and disability, and an improvement in ambulation after the operations. The 19 deceased patients were classified into two groups, one including those with multiple (three or four) arthroplasties and the other, those with only a small number (one or two). The mean age at death was lower (55.7+/-6.2 years) in patients with multiple arthroplasties than that (69.1+/-7.5 years) in patients with only a small number of arthroplasties. Secondary diseases from RA, such as amyloidosis, spinal injury and pulmonary fibrosis, were found to be the primary cause of death in patients with multiple arthroplasties. The most important finding in this study is that although RA patients with multiple arthroplasties in the lower extremities improved their QOL, they were still afflicted with secondary diseases derived from RA and experienced complications that could shorten their lifespan.

Adult↗

PubMed1998

Urinary excretion of type I collagen degradation products in healthy women and osteoporotic patients with vertebral and hip fractures.

We have evaluated both the effect of normal aging and menopause on urinary CrossLapstrade mark (u-CTx) excretion and the bone resorption status by u-CTx in patients with vertebral fracture and hip fracture. In 246 healthy women, 76 patients with vertebral fracture, and 63 patients with hip fracture, u-CTx excretion was measured by ELISA. The age-related changes of u-CTx in healthy females reflected the marked increase of bone resorption associated with modeling at childhood. The values in the subgroups of postmenopausal women 1-3 years since menopause and </=10 years since menopause were significantly higher than those in the subgroups of premenopausal adult women. The values in the vertebral fracture group were significantly higher than those in the premenopause group, but not those in the postmenopause groups. The values in the hip fracture group were significantly higher than those in the other groups. Of the 70 postmenopausal subjects aged 45-64 years, 43% had u-CTx values more than 2 SD above premenopausal mean. The corresponding values in the patients with vertebral fracture and those with hip fracture were 58% and 64%, respectively. This marker reflects well the increase of bone resorption associated with bone modeling at childhood and with high bone turnover after menopause. The excretions in the patients with hip fracture were much higher than those in the age-matched subjects and also higher than those in the patients with vertebral fracture. These findings indicate that the abnormality of bone resorption in the patients with hip fracture is more severe than in the patients with vertebral fracture.

Adolescent↗

PubMed1998

The less potent estrogenic effect of tamoxifen on bone in ovariectomized rats with established osteopenia.

The longitudinal effects of tamoxifen (TAM) treatment on bone metabolism, spinal bone mineral density (BMD), and bone mineral content (BMC) were compared with those of estrogen in ovariectomized (OVX) rats with established osteopenia. The 6-month-old rats were divided into Sham (n = 8) and OVX (n = 24) groups. First, the OVX rats were allowed to lose bone for 6 weeks. Six weeks after ovariectomy they were divided into three groups: (1) OVX rats treated with solvent vehicle (OVX+Vehicle), (2) OVX rats injected with TAM subcutaneously six times a week at a dosage of 1.0 mg/kg body weight (OVX+TAM), (3) OVX rats injected with 17-beta estradiol subcutaneously six times a week at a dosage of 0.1 mg/kg body weight (OVX+ET). The longitudinal effects of TAM and estrogen on bone were studied by dual energy X-ray absorptiometry (DXA) and biochemical markers including urinary pyridinoline (Pyr) and deoxypyridinoline (Dpyr). Ovariectomy resulted in a significant increase in urinary Pyr, Dpyr, and a significant decrease in spine BMD and BMC. TAM treatment completely inhibited the further bone loss in OVX rats with established osteopenia, however, estrogen increased spine BMD and BMC significantly compared with OVX+Vehicle, OVX+TAM, and baseline of treatment. Both TAM and estrogen treatment decreased urinary Pyr and Dpyr significantly in OVX rats. Our findings indicate that TAM acts as an estrogen agonist with respect to effects on spine BMD, BMC, and bone resorption in OVX rats with established osteopenia, but fails to restore spine BMD and BMC to the extent observed with estrogen in this study.

Amino Acids↗

PubMed1998

Changes of biochemical markers during fracture healing.

The aim of this study was to evaluate the changes of biochemical markers during fracture healing in patients with osteoporosis. The study included 26 patients; 9 underwent hip hemiarthroplasty (mean age +/- SD: 71.0 +/- 10.2 years, group EN) for femoral neck fractures. 7 underwent osteosynthesis (75.3 +/- 8.2 years, group OS) for trochanteric fractures, and 10 subjects had spinal compression fractures (68.2 +/- 12.0 years, group CO). No operative procedures were performed in group CO. Urinary pyridinoline (Pyr), deoxypyridinoline (Dpyr) by high performance liquid chromatography (HPLC), Crosslaps by both enzyme-linked immunosorbent assay (ELISA) and radioimmunoassay (RIA) (CTx-ELISA and CTx-RIA) and serum N-terminal mid-fragment osteocalcin (OCN-Mid) by ELISA were analyzed at the time of admission and at weeks 1, 2, 4, 8 and 24 after operation or, in the case of group CO, after admission. As a whole, bone resorption markers started to increase from week 1, with various peak values between weeks 4 and 8 depending upon the particular marker, but returned to the initial vales at week 24. OCN-Mid started to increase from week 8 and remained at elevated levels at week 24. In groups EN and OS, bone resorption markers changed in the same manner as they did as a whole group. OCN-Mid did not change in group EN, although it increased significantly from week 8 in group OS. No biochemical markers changed significantly in group CO. In conclusion, bone resorption was accelerated at an early stage due to acute osteonecrosis or bed rest, followed by bone formation due to callus or mechanical stress later on. As far as bone resorption markers are concerned, 24 weeks are enough to eliminate the effect of fracture.

Aged↗

PubMed1998

Circadian variation of urinary type I collagen crosslinked C-telopeptide and free and peptide-bound forms of pyridinium crosslinks.

This study was performed to investigate the circadian variation of urinary CrossLaps (CTx), which was the type I collagen peptide released during bone matrix degradation, and peptide-bound and free forms of urinary pyridinium crosslinks. Urine was obtained during the 24 h of the study in seven separate collections as follows: from 23:00 h to the first void (FV) followed by FV at 11:00, 11:00-14:00, 14:00-17:00, 17:00-20:00, 20:00-23:00, and 23:00 h to FV the next morning. Total, free, and peptide-bound pyridinoline (Pyr) and deoxypyridinoline (Dpyr) excretion measured by high-performance liquid chromatography (HPLC) and CTx measured by enzyme-linked immunosorbent assay in nine premenopausal women aged 22-40 years and nine osteoporotic women aged 65-83 years was analyzed. Among three parameters of Pyr measured by HPLC, a significant day and night difference was found only in total Pyr (21.9% higher at night than during the day in premenopausal women and 24.0% in osteoporotic women, whereas no significant day and night variation was found in free and peptide-bound Pyr in either group. In contrast, total and peptide-bound Dpyr were significantly (37.9% and 66.9%) higher at night than those during the day in premenopausal women (38.0%) and osteoporotic women (48.8%). For free Dpyr, there were no day and night differences in the two groups. The day and night variances were significantly greater in peptide-bound Dpyr than with total Dpyr in both groups. In urinary CTx, a significant circadian variation with a peak at night and a nadir at 17:00 h was found (p < 0.0001) (premenopausal was 54.0% higher at night than during the day; osteoporotic was 38.4%. In conclusion, urinary CTx represented remarkable circadian variation compared with urinary pyridinium crosslinks measured by HPLC. Furthermore, free pyridinium crosslinks did not undergo a circadian variation. Peptide-bound crosslinks might contribute mostly to the circadian variation of total excretion of pyridinium crosslinks.

Adult↗