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Biomedical subjects

P Pietschmann

Publications and source records attributed to P Pietschmann.

At least 91 records · Page 5Linked to original sources

Increased serum osteocalcin levels in patients with lactase deficiency.

Serum levels of osteocalcin, a noncollagenous bone matrix protein, have been found to be a specific biochemical parameter of bone formation. In the literature in subjects with osteoporosis, an increased incidence of lactase deficiency has been described. We therefore determined the serum levels of osteocalcin in 10 patients with lactase deficiency and in 20 control subjects by radioimmunoassay. The patients with lactase deficiency were dietary treated and had a very low daily calcium intake. Serum osteocalcin levels were significantly higher in the patients with lactase deficiency than in the control subjects. In contrast, serum levels of parathyroid hormone, alkaline phosphatase, calcium, and phosphorus were not statistically different in the two groups. Our data suggest an increased rate of bone turnover in patients with lactase deficiency on a low calcium diet; possibly calcium supplementation is indicated in dietary-treated patients with lactase deficiency.

Adult↗

[Osteocalcin].

The serum levels of osteocalcin, a 49 amino acid bone matrix protein have been found to represent a specific biochemical parameter of bone formation. The serum osteocalcin levels are influenced by age, sex and the time of blood sampling. In various studies on osteoporosis, endocrinopathies and other diseases which might be associated with bone disorders, the determination of serum osteocalcin levels has been proved to be an interesting research tool. However, further studies are necessary to clarify, whether the measurement of serum osteocalcin levels should be recommended in general clinical praxis.

Age Factors↗

Decreased serum osteocalcin levels in patients with liver cirrhosis.

Serum levels of osteocalcin (OC) have been found to be a specific biochemical parameter of bone formation. We measured serum levels of osteocalcin, parathyroid hormone (PTH) and 25-hydroxyvitamin D (25(OH)D) in 49 patients with liver cirrhosis, who are known to have an increased prevalence of metabolic bone disease, and a matched control group (n = 35). Serum levels of OC were significantly decreased in the patients with liver cirrhosis when compared to control subjects (P less than 0.001). Serum levels of 25(OH)D were decreased (P less than 0.001), whereas no statistical difference was found between the serum levels of PTH in the patients with liver cirrhosis and those of the controls. In a subgroup of 23 patients with cirrhosis of the liver and 34 control subjects, the bone mineral content (BMC) of the non-dominant forearm was determined by single photon absorptiometry. BMC was significantly lower in the patient with liver cirrhosis than the control subjects (P less than 0.04). Our data demonstrate vitamin D deficiency, decreased bone formation and a decreased BMC in patients with liver cirrhosis.

Bone Density↗

Increased serum osteocalcin levels in elderly females with vitamin D deficiency.

Serum levels of osteocalcin (OC), a 49 amino acid bone matrix protein, have been found to be a biochemical parameter of bone formation. In order to study bone metabolism in aging subjects we measured serum levels of OC, parathyroid hormone (PTH) and 25 hydroxy-vitamin D (25 OH Vit D) in 36 institutionalized elderly females (age range: 80-93 years) and in 21 premenopausal control subjects. Serum levels of 25 OH Vit D were significantly decreased in the elderly subjects (p less than 0.0001), whereas serum levels of OC and PTH were significantly higher in the elderly subjects than in the controls (p less than 0.0025 and p less than 0.0001, respectively). Serum OC levels correlated significantly with the serum PTH levels (p less than 0.009). Our data demonstrate that in elderly females with vitamin-D deficiency secondary hyperparathyroidism is associated with increased serum OC levels indicating an increased bone formation; these conditions might contribute to the bone disease of geriatric patients.

Aged↗

Increased growth hormone responses to growth hormone releasing hormone and thyrotropin releasing hormone in patients with metastatic testicular cancer.

In 16 patients with metastatic testicular cancer and 10 age matched male control subjects growth hormone (GH) responses to growth hormone releasing hormone (GHRH; 1 microgram/kg body weight iv.) and thyrotropin releasing hormone (TRH; 200 micrograms iv.) were measured. Basal GH levels and GH levels following stimulation with GHRH or TRH were significantly increased in cancer patients compared to control subjects. 9 patients with testicular cancer were studied both in the stage of metastatic disease and after they had reached a complete remission. In complete remission GH responses to GHRH tended to decrease but the differences did not reach statistical significance. Our data suggest an alteration of hypothalamic and/or pituitary regulation of GH secretion in patients with metastatic testicular cancer.

Adult↗

A circadian rhythm of serum osteocalcin levels in postmenopausal osteoporosis.

The serum levels of osteocalcin, a 49 amino acid bone matrix protein, have been found to be a specific biochemical parameter of bone formation. The aim of our study was to assess the variability of serum osteocalcin and parathyroid hormone levels in postmenopausal osteoporosis. In 16 patients with postmenopausal osteoporosis, serum levels of osteocalcin and parathyroid hormone were determined in 4-hourly intervals by radioimmunoassay. Whereas the serum parathyroid hormone levels were similar throughout the day, the serum osteocalcin levels showed a circadian rhythm, with lowest levels in the morning and maximal levels during the night. These findings might suggest a circadian variation of bone formation in patients with postmenopausal osteoporosis.

Aged↗

Effects of one-year hormone replacement therapy on peripheral bone mineral content in patients with osteoporotic spine fractures.

A double-blind, placebo-controlled study on 31 patients with osteoporotic spine fractures was performed in order to assess the effects of one-year cyclical estrogen/gestagen replacement therapy (Trisequens, Novo) on peripheral bone mineral content and bone turnover. Bone mineral content was measured by single-photon absorptiometry with 125I before, and 6 and 12 months after start of therapy. Calcium, phosphate, alkaline phosphatase, parathyroid hormone, calcidiol, calcitonin and 2-hour urinary hydroxyproline excretion were measured to evaluate bone turnover. After 12 months, forearm bone mineral content showed a significant increase (p less than 0.02) in the treatment group, whereas in the control group no statistically significant change in peripheral bone mass was observed. Parameters of bone metabolism showed a decrease in hydroxyproline excretion (p less than 0.02) as well as alkaline phosphatase (p less than 0.01) and no changes in parathyroid hormone, calcidiol, and calcitonin. These results demonstrate that one-year cyclical estrogen/gestagen replacement therapy improves peripheral bone mineral content measured by single-photon absorptiometry. This effect appears to be induced by an inhibition of bone resorption.

Alkaline Phosphatase↗

Broadband ultrasound attenuation: a new diagnostic method in osteoporosis.

Broadband ultrasound attenuation (BUA) measurements of the calcaneus, single-photon absorptiometry (SPA) of the nondominant distal forearm, and quantitative CT (QCT) of the lumbar spine were performed in 37 women with osteoporotic vertebral fractures and 23 female control subjects of similar age distribution to assess the usefulness of sonography in detecting axial osteopenia. In the women with osteoporotic vertebral fractures, all three measuring methods showed significantly reduced values (SPA: p less than .05; QCT: p less than .0001; BUA: p less than .05) compared with those in the control subjects. In addition, for all subjects, a significant positive correlation was found between BUA and QCT (tau = 0.25, p less than .005) and between SPA and QCT (tau = 0.34, p less than .0001). These results suggest that BUA, a simple method that is radiation-free, is a valuable tool in the management of osteoporosis.

Aged↗

Peripheral bone mineral content in patients with fatty liver and hepatic cirrhosis.

The aim of our study was to determine peripheral bone mineral content (BMC) and serum osteocalcin (OC) levels in two groups of patients with fatty liver and hepatic cirrhosis as compared with a control group comprising healthy subjects. Group I consisted of 18 male patients (mean age, 51 years) with hepatic steatosis, group II included 23 men (mean age, 52 years) with hepatic cirrhosis. In all patients diagnosis was established with ultrasonic examination of the liver; 18 patients in group II underwent additional blind liver biopsies. The control group consisted of 23 subjects. Analysis of variance showed marked differences between the three groups (p less than 0.001). Peripheral BMC was significantly lower in patients with liver cirrhosis (BMC, 46.8 U) than in both patients with fatty liver (BMC, 54.7 U) and the control group (BMC, 60.7 U). However, no statistically significant differences in BMC values occurred between patients with hepatic steatosis and the controls. Serum osteocalcin levels followed a pattern similar to that of BMC values. A statistically significant decrease in osteocalcin values was found in the liver cirrhosis group (OC, 3.9 ng/ml) compared with the control group (OC, 6.6 ng/ml) and with the patients with hepatic steatosis (OC, 6.2 ng/ml). According to these results, clearly reduced BMC and decreased OC levels are found in patients with chronic alcoholic liver disease. However, these reductions are essentially influenced by the extent of morphologic changes in liver structure.

Adult↗

Serum osteocalcin levels in breast cancer patients.

The serum levels of osteocalcin, a 49-amino-acid bone-matrix protein, which is a biochemical parameter of bone formation, were measured in 61 patients with breast cancer. Breast cancer patients were subdivided as follows: (a) Patients in complete remission; (b) patients with visceral metastases (without bone metastases); (c) patients with bone metastases (with or without visceral metastases). Serum osteocalcin levels were significantly higher in patients with bone metastases than in patients in complete remission (P less than 0.005). When osteocalcin levels of patients with bone metastases were compared with those of an age-matched control group, serum osteocalcin levels were higher in the patients with bone metastases; however, the differences did not reach statistical significance. Serum osteocalcin levels of patients with visceral metastases (without bone metastases) were significantly lower than in control subjects (P less than 0.02). Our data demonstrate that serum osteocalcin levels are higher in breast cancer patients with bone metastases than in patients in remission. Bone formation, as reflected by serum osteocalcin levels, is decreased in breast cancer patients with visceral metastases.

Alkaline Phosphatase↗

Estimated long-term effect of calcitonin treatment in acute osteoporotic spine fractures.

A 12-month prospective controlled study was conducted in 28 patients with acute osteoporotic spine fractures to evaluate and compare the effect of calcitonin treatment and cyclical hormone replacement therapy on forearm bone mineral content (BMC) and bone turnover. We established two treatment groups and a control group of women with postmenopausal osteoporosis (n = 28). Group A (n = 10) received 100 U of calcitonin by subcutaneous self-application on alternate days and oral calcium (Ca) for 6-8 weeks. Group B (n = 10) received cyclical estrogen/gestagen replacement therapy over 12 months and oral calcium. The control group (n = 8) received analgetic treatment and 500 mg Ca daily. BMC was measured by single photon absorptiometry (SPA) with I 125 before and 6 and 12 months after the onset of the therapies. Ca, phosphorus (P), alkaline phosphatase, and 2-hour urinary OH-proline excretion were measured to classify bone turnover. One year after the onset of the two therapies, forearm BMC measured by SPA showed a significant increase in the group under hormone replacement therapy (P less than 0.025) as well as in the calcitonin group (P less than 0.05), although the latter underwent treatment only over a short period (6-8 weeks). In the same period, BMC decreased significantly in the control group (P less than 0.025). These results demonstrate that short-term calcitonin treatment over 6-8 weeks is as effective as long-term hormone replacement therapy, both therapies increasing forearm BMC measured by SPA.

Aged↗

Serum osteocalcin concentrations in patients with rheumatoid arthritis.

Osteocalcin is a non-collagenous bone matrix protein which is released into the circulation and can be measured by radioimmunoassay. Recent studies indicate that serum osteocalcin concentrations are a marker of bone formation. Because bone demineralisation is a common finding in patients with rheumatoid arthritis (RA) the serum osteocalcin concentrations and, in addition, the serum concentrations of 25-hydroxyvitamin D, parathyroid hormone, and calcitonin were measured in 29 patients with RA and in 30 control subjects. Whereas serum osteocalcin concentrations were similar in patients with RA and in control subjects, serum 25-hydroxyvitamin D concentrations were significantly decreased in patients with RA. Serum concentrations of parathyroid hormone and calcitonin in patients with RA and in control subjects were not statistically different. The normal osteocalcin concentrations in patients with RA suggest a normal rate of bone formation in these patients.

Arthritis, Rheumatoid↗

Serum osteocalcin levels in diabetes mellitus: analysis of the type of diabetes and microvascular complications.

Recent studies indicate that serum levels of osteocalcin, a 49-aminoacid bone matrix protein, are a biochemical marker of bone formation. In order to study bone metabolism in diabetes mellitus, in 28 patients with Type 1 (insulin-dependent) diabetes mellitus, in 38 patients with Type 2 (non-insulin-dependent) diabetes mellitus and two control groups, matched for Type 1 and Type 2 diabetic patients, respectively, serum levels of osteocalcin, parathyroid hormone and 25 hydroxy vitamin D were measured by radioimmunoassay. Whereas in Type 1 diabetic patients and control subjects serum levels of osteocalcin and 25 hydroxy vitamin D were not statistically different, serum osteocalcin and 25 hydroxy vitamin D levels were significantly decreased in Type 2 diabetic patients when compared with corresponding control subjects (p less than 0.03 and p less than 0.001, respectively). Independent of the type of diabetes, serum parathyroid hormone levels were comparable in diabetic patients and matched control subjects. Serum osteocalcin levels were significantly lower in Type 1 diabetic patients with retinopathy and/or proteinuria than in Type 1 diabetic patients without microangiopathy (p less than 0.05). Whereas serum parathyroid hormone levels in Type 2 diabetic patients with retinopathy and/or proteinuria were significantly increased (p less than 0.02), 25 hydroxy vitamin D levels were decreased (p less than 0.02) when compared with Type 2 diabetic patients without microangiopathy. Our data give evidence of a vitamin D deficiency and a decreased bone formation in patients with Type 2 diabetes mellitus. In Type 1 diabetes mellitus bone formation as reflected by serum osteocalcin levels is influenced by the presence or absence of microangiopathic complications.

Adult↗

Serum concentrations of laminin P1 in diabetics with advanced nephropathy.

In 97 patients with type I diabetes mellitus, 155 patients with type II diabetes mellitus, and two matched control groups, serum concentrations of laminin P1, a non-collagenous component of basement membranes, were determined by radioimmunoassay to see whether laminin P1 might be a valuable indicator of microangiopathic complications in diabetics. Independent of the type of diabetes, serum laminin concentrations in patients without nephropathy or with early renal damage as assessed by microalbuminuria were comparable with those of the control subjects. Patients with macroproteinuria or with renal insufficiency had significantly increased serum laminin P1 concentrations. Diabetic retinopathy was not found to influence serum laminin P1 concentrations. These data indicate that serum laminin P1 concentrations are increased in advanced diabetic nephropathy.

Adult↗

Decreased serum osteocalcin levels in phenprocoumon-treated patients.

Osteocalcin (OC) is a noncollagenous bone matrix protein containing gamma-carboxyglutamic acid, the synthesis of which is vitamin K dependent. Serum OC levels are generally believed to reflect the de novo synthesis of OC by osteoblasts and thus reflect bone formation. We measured serum OC levels by RIA in 48 patients receiving phenprocoumon anticoagulant treatment, which inhibits the posttranscriptional synthesis of gamma-carboxyglutamic acid, and in 22 matched normal subjects. The median serum OC level in the patients receiving phenprocoumon therapy was significantly lower than that in the normal subjects (P less than 0.0001). In 27 patients receiving anticoagulant therapy and in 21 normal subjects the proportion of noncarboxylated OC to total OC also was determined. The proportion of OC that was noncarboxylated was significantly higher in the patients receiving phenprocoumon therapy than in the normal subjects (P less than 0.0001). We conclude that OC carboxylation is impaired in patients receiving oral anticoagulant therapy. The decreased total OC levels in patients receiving phenprocoumon treatment might result from decreased bone formation, although these patients do not have symptoms of bone disease.

4-Hydroxycoumarins↗

The effect of pirenzepine on growth hormone and blood glucose levels in type I diabetes mellitus. A controlled study in patients on basal bolus insulin treatment.

Increased GH levels in Type I diabetes mellitus have been implicated in the pathogenesis of metabolic complications such as the so-called dawn phenomenon. GH secretion is under control of cholinergic mechanisms. In 21 Type I diabetic patients the effect of oral administration of the anticholinergic drug pirenzepine in addition to intensive insulin therapy on GH and blood glucose levels was studied. At 21.30, 08.00 and 12.00 h, all patients received in random order 50 mg of pirenzepine or placebo po. Blood for determination of GH, blood glucose, cortisol and C-peptide levels were obtained at 3-h intervals. Serum levels of plasma glucose and GH were significantly lower under pirenzepine than under placebo (P less than 0.05 and P less than 0.01, respectively). Serum levels of cortisol, free insulin and C-peptide were comparable on the test and the control day. Our data indicate that in Type I diabetes mellitus the anticholinergic drug pirenzepine is effective in decreasing both GH and blood glucose levels.

Administration, Oral↗

Effect of growth hormone releasing hormone on growth hormone secretion in type 2 (non-insulin-dependent) diabetes mellitus.

Growth hormone levels following an intravenous bolus injection of 1 micrograms/kg body weight growth hormone releasing hormone were measured in 21 non-obese and 26 obese patients with Type 2 (non-insulin-dependent) diabetes mellitus and in 13 control subjects. Growth hormone responses in non-obese Type 2 diabetic patients were not statistically different from control subjects. However, obese Type 2 diabetic patients had significantly decreased growth hormone responses to growth hormone releasing hormone when compared with non-obese Type 2 diabetic patients (p less than 0.02). In 9 Type 2 diabetic patients growth hormone releasing hormone tests were performed both during hyperglycaemia and after metabolic improvement by insulin treatment. Growth hormone responses before and after insulin treatment were not statistically different. Our data demonstrate that growth hormone responses to growth hormone releasing hormone in non-obese Type 2 diabetic patients do not differ significantly from control subjects; obesity blunts growth hormone responses to growth hormone releasing hormone in Type 2 diabetes mellitus; and growth hormone responses following growth hormone releasing hormone administration in Type 2 diabetes mellitus are not influenced by the state of metabolic control.

Aged↗