The effect of bisphosphosphonates on bone turnover and bone balance in postmenopausal women with osteoporosis: The T-score bone marker approach in the TRIO study

Bone ◽  
2020 ◽  
Vol 131 ◽  
pp. 115158 ◽  
Author(s):  
F. Gossiel ◽  
M.A. Paggiosi ◽  
K.E. Naylor ◽  
E.V. McCloskey ◽  
J. Walsh ◽  
...  
Keyword(s):  
Bone Turnover ◽  
Postmenopausal Women ◽  
Bone Marker ◽  
T Score

scholarly journals The comparative efficiency of denosumab treatment in patients with postmenopausal osteoporosis, primary hyperparathyroidism and glucocorticoid-induced osteoporosis in real clinical practice

2021 ◽  
Vol 23 (1) ◽  
pp. 4-13
Author(s):  
Liudmila Ya. Rozhinskaya ◽  
Sofya A. Gronskaia ◽  
Elizaveta O. Mamedova ◽  
Zhanna E. Belaya ◽  
Galina A. Melnichenko
Keyword(s):  
Clinical Practice ◽  
Femoral Neck ◽  
Primary Hyperparathyroidism ◽  
Bone Turnover ◽  
Postmenopausal Women ◽  
Serum Calcium ◽  
T Score ◽  
Median Increase ◽  
Male To Female ◽  
Denosumab Treatment

Background: Denosumab is a highly effective and safe first-line treatment for osteoporosis. Primary hyperparathyroidism is a prevalent condition found in patients with osteoporosis. However, data regarding effectiveness of denosumab treatment in patients with PHPT are scarce. Aims: To estimate the comparative effects of denosumab to treat postmenopausal osteoporosis (PMO) and osteoporosis caused by primary hyperparathyroidism (PHPT) or glucocorticoid-induced osteoporosis (GIOP) in postmenopausal women in routine clinical practice. Materials and methods: Retrospective study based on the medical card records. Patients over 50 years of age with verified osteoporosis (based on bone mineral density (BMD) T-score ≤ -2.5 SD and/or low-trauma fracture), who had at least 3 denosumab injections were included in the study. Results: 162 patients were included and divided into three groups according to the etiology of osteoporosis. The first group consisted of postmenopausal women with osteoporosis (PMO) [(n=85); median age 70 [64;78]]. Patients with glucocorticoid-induced osteoporosis (GIOP) were enrolled in the second group [(n=16); male to female ratio =1:15; median age 60 [57,8; 66,3]]. The third group consisted of patients with PHPT and osteoporosis [(n=61); male to female=2:59; median age 68 [63; 75]]. Among all patients, denosumab treatment significantly increased BMD and decreased serum levels of calcium and CTx compared with baseline. PMO: the median increase in BMD according to the T-score was L1-L4 0,6 (p<0,001), femoral neck 0,2 (p<0,001); serum calcium -0,04 (p=0,004). PHPT: the median increase in BMD according to the T-score was L1-L4 0,6 (p<0,001), femoral neck 0,2 (p<0,001); radius 33% 0,25 (p=0,002), serum calcium -0,04 (p<0,001). In patients with GIOP, denosumab increased BMD in the lumbar spine L1-L4 0,5 (p=0,004). There was no difference in BMD increase or in levels of bone turnover suppression between the groups. A marked decline in levels of serum calcium was noted among patients with GFR less than 60 ml / min / 1.73 m2 (median Δ Са serum=0,24 p<0,001), compared to patients without CKD (median Δ Са serum=0,08 p<0,001).Conclusion: Denosumab treatment is similarly effective for increasing BMD and decreasing bone turnover markers in patients with PMO and PHPT among postmenopausal women. The hypocalciemic effect of denosumab is most significant in subjects with PHPT.

scholarly journals Multimarker method in the study of laboratory predictors of vascular wall elasticity as the basis for the development of a personalized approach to the treatment of socially significant diseases

2021 ◽  
Vol 28 (Supplement_1) ◽  
Author(s):  
T Petelina ◽  
K Avdeeva ◽  
N Musikhina ◽  
L Gapon ◽  
S Bykova ◽  
...  
Keyword(s):  
Vitamin D ◽  
Parathyroid Hormone ◽  
Postmenopausal Women ◽  
Ldl Cholesterol ◽  
Blood Pressure Monitoring ◽  
Vascular Inflammation ◽  
Fold Increase ◽  
Endothelin 1 ◽  
T Score ◽  
Markers Of Inflammation

Abstract Funding Acknowledgements Type of funding sources: None. Aim To investigate the role of markers of vascular inflammation, vitamin D, parathyroid hormone as predictors of increased pulse-wave velocity (PWV) and degenerative bone changes in postmenopausal women with arterial hypertension (AH). Methods 164 females were examined. Gr.1 included 42 healthy individuals, Gr.2 - 58 patients with AH and Gr.3 - 64 postmenopausal women with AH and osteoporosis. Parameters of blood pressure monitoring; PWV, osteodensitometry (T-Score); inflammatory markers: hsCRP, TNFα, homocysteine, IL-1β, 6, 8, endothelin-1; lipid profile parameters; sex and parathyroid hormones, vitamin D  were measured. Results In Gr.3 excess levels of PWV, hsCRP, homocysteine, IL8, total cholesterol, LDL cholesterol, endothelin-1 and parathyroid hormone was detected with decrease in the level of sex hormones and vitamin D. Besides, negative correlations of T-Score with age, PWV, duration of menopause, IL-6, hsCRP were registered; positive correlations between PWV with IL6, LDL cholesterol, hsCRP, endothelin-1, DBP variability were found. The logistic regression method revealed the main markers that affect increase of PWV, such as hsCRP and endothelin-1.Rise of each marker by unit of measurement leads to increase in PWV by 1.3 times and 2.4%, respectively. In Gr.2 increase in PWV level of more than 12.05 m/s was associated with 3.8-fold increase in the risk of osteoporosis. In Gr.3 increase in PWV level on 1 m/s was associated with 6 fold increase in the risk of osteoporosis. Conclusions Elevated levels of PWV are associated with markers of inflammation, levels of parathyroid hormone, vitamin D, T-Score and may be part of the pathogenesis of the cardiovascular continuum in postmenopausal women, which will require an individual approach to the treatment of AH with comorbid metabolic disorders.

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