Abstract
Bone loss and the serum markers of bone metabolism were studied in 22 patients with primary hyperparathyroidism and 108 patients with renal hyperparathyroidism. The parameters of bone loss were bone mineral density in the distal radius and lumbar vertebrae, measured by dual energy X-ray absorptiometry, and bone mass index (ΣGS/D) and the metacarpal index, in the second metacarpal bone, measured by the digital image processing method. Alkaline phosphatase (AIP), intact osteocalcin (OC), and the carboxyterminal propeptide of type I procollagen (PICP) were measured as serum markers of bone formation, while tartrate-resistant acid phsophatase (TRACP) and the carboxyterminal pyridinoline cross-linked telopeptide of type I collagen (ICTP) were measured as serum markers of bone resorption. Bone loss and elevated markers of bone metabolism were observed both in patients with skeletal symptoms and in those without. Furthermore, the decrease in the cortical bone mass was more predominant than that of the trabecular bone. As markers of bone formation, AIP and OC seemed to be more sensitive than PICP, and as markers of bone resorption, ICTP appeared to be more sensitive than TRACP. Thus, a close correlation was observed between bone loss and the markers of bone formation and resorption.
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References
Katagiri M, Harada T (1994) Surgical treatment for secondary hyperparathyroidism in Japan: A questionnaire survey of cases between 1982 and 1991. Endocrinology 11:157–166 (in Japanese)
Nussbaum SR, Zahradnik RJ, Lavigne JR, Brennan GL, Nozawa-Ung K, Kim LY, Keutmann HT, Wang CA, Potts JT Jr, Segre GV (1987) Highly sensitive two-site immunoradiometric assay of parathyrin, and its clinical utility in evaluating patients with hypercalcemia. Clin Chem 33:1364–1367
Fukunaga M (1992) Study for a standardization of bone mineral density in lumbar vertebrae in Japanese by dual energy X-Ray absorptiometry. 1992 Report, vol. 2, Longevity Science Research Project, sponsored by Ministry of Public Health and Welfare, Tokyo, pp 402–405
Hayashi Y, Yamamoto K, Fukunaga M, Ishibashi T, Takahashi K, Nishii Y (1990) Assessment of bone mass by image analysis of metacarpal bone roentgenograms: A quantitative digital image processing (DIP) method. Radiat Med 8:173–178
Kasai J, Takahashi Y, Ishibashi T, Fukushima M, Nishii Y (1989) Investigation of the age- and sex-matched values in the analysis with DIP (Digital Image Processing) method using X-ray film of the hand. J Bone Miner Metab 7:272 (in Japanese)
Kawaguchi H (1990) Serum levels of BGP determined by two-site immunoradiometric assay (IRMA) using monoclonal antibodies. Clin Endocrinol 38:1291–1296 (in Japanese)
Melkko J, Niemi S, Risteli L, Risteli J (1990) Radioimmunoassay of the carboxyterminal propeptide of human type I procollagen. Clin Chem 36:1328–1332
Risteli J, Elomaa I, Niemi S, Novamo A, Risteli L (1993) Radioimmunoassay for the pyridinoline cross-linked carboxyterminal telopeptide of type I collagen: A new serum marker of bone collagen degradation. Clin Chem 39:635–640
Sartoris DJ, Sommer FG, Kosek J, Gies A, Carter D (1985) Dual-energy projection radiography in the evaluation of femoral neck strength, density, and mineralization. Invest Radiol 20:476–485
Ott SM (1991) Methods of determining bone mass. J Bone Miner Res 6 [Suppl 2]:71–76
Fukunaga M, Tomomitsu T, Ono S, Otsuka N, Nagai K, Morita K, Imai H, Miyake M, Katagiri M (1993) Quantification of bone mineral in the vertebral body and whole body skeleton with a newly developed dual energy X-ray absorptiometric system using a multi-detector array. Kawasaki Med J 19:65–76
Shane E, de la Cruz L, Ott SM (1988) Photon absorptiometry and bone histomorphometry show preferential loss of cortical bone in renal patients. J Bone Miner Res 3 [Suppl 1]: Abstract 105
Price PA, Parthemore JG, Deftos LJ (1980) New biochemical marker for bone metabolism. Measurement by radioimmunoassay of bone Gla protein in the plasma of normal subjects and patients with bone disease. J Clin Invest 66:878–883
Brown JP, Delmas PD, Malaval L, Edouard C, Chapuy MC, Meunier PJ (1984) Serum bone Gla-protein: A specific marker for bone formation in postmenopausal osteoporosis. Lancet I:1091–1095
Ljunghall S, Haellgren R, Rastad J (1985) Serum osteocalcin levels in normal subjects and patients with primary hyperparathyroidism. Expl Clin Endocrinol 86:218–222
Delmas PD, Demiaux B, Malaval L, Chapuy MC, Edouard C, Meunier J (1986) Serum bone gamma carboxyglutamic acid-containing protein in primary hyperparathyroidism and in hypercalcemia. J Clin Invest 77:985–991
Stepan JJ, Lachmanova J, Strakova M, Pacovsky V (1987) Serum osteocalcin, bone alkaline phosphatase isoenzyme, and plasma tartrate resistant acid phosphatase in patients on chronic maintenance hemodialysis. Bone Miner 3:177–183
Price PA, Williamson MK, Lothringer JW (1981) Origin of the vitamin K-dependent bone protein found in plasma and its clearance by kidney and bone. J Biol Chem 256:12760–12766
Delmas PD, Wilson DM, Mann KG, Riggs BL (1983) Effect of renal function on plasma levels of bone Gla-protein. J Clin Endocrinol Metab 57:1028–1030
Simon LS, Krane SM (1983) Procollagen extension peptides as markers of collagen synthesis. In: Frame B, Potts JT Jr (eds) Clinical disorders of bone and mineral metabolism. Excerpta Medica, Amsterdam
Simon LS, Krane SM, Wortman PD, Krane IM, Kovitz KL (1984) Serum levels of type I and III procollagen fragments in Paget's disease of bone. J Clin Endocrinol Metab 58:110–120
Parfitt AM, Simon LS, Villanueva AR, Krane SM (1987) Procollagen type I carboxy-terminal extension peptide in serum as a marker of collagen biosynthesis in bone. Correlation with iliac bone formation rates and comparison with total alkaline phosphatase. J Bone Miner Res 2:427–436
Hassager C, Jensen LT, Johansen JS, Riis BJ, Melkko J, Podenphant J, Risteli L, Christiansen C, Risteli J (1991) The carboxy-terminal propeptide of type I procollagen in serum as a marker of bone formation: The effect of nandrolone decanoate and female sex hormones. Metabolism 40:205–208
Saggese G, Bertelloni S, Baroncelli GI, Nero GD (1992) Serum levels of carboxyterminal propeptide of type I procollagen in healthy children from 1st year of life to adulthood and in metabolic bone diseases. Eur J Pediatr 151:764–768
Eriksen EF, Charles P, Melsen, F, Mosekilde L, Risteli L, Risteli J (1993) Serum markers of type I collagen formation and degradation in metabolic bone disease: Correlation with bone histomorphometry. J Bone Miner Res 8:127–132
Hassager C, Risteli J, Risteli L, Jensen SB, Christiansen C (1992) Diurnal variation in serum markers of type I collagen synthesis and degradation in healthy premenopausal women. J Bone Miner Res 7:1307–1311
Elomaa I, Virkkunen P, Risteli L, Risteli J (1992) Serum concentration of the cross-linked carboxyterminal telopeptide of Type I collagen (ICTP) is a useful prognostic indicator in multiple myeloma. Br J Cancer 66:337–341
Minkin C (1982) Bone acid phosphatase: Tartrate-resistant acid phosphatase as a marker of osteoclast function. Calcif Tissue Int 34:285–290
Stepan JJ, Silinkova-Malkova E, Havranek T, Formankova J, Zichova M, Lachmanova J, Strakova M, Broulik P, Pacovsky V (1983) Relationship of plasma tartrate resistant acid phosphatase to the bone isoenzyme of serum alkaline phosphatase in hyperparathyroidism. Clinica Chemica Acta 133:189–200
de la Piedra C, Torres R, Rapado A, Curiel MD, Castro N (1989) Serum tartrate-resistant acid phosphatase and bone mineral content in postmenopausal osteoporosis. Calcif Tissue Int 45:58–60
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Katagiri, M., Ohtawa, T., Fukunaga, M. et al. Evaluation of bone loss and the serum markers of bone metabolism in patients with hyperparathyroidism. Surg Today 25, 598–604 (1995). https://doi.org/10.1007/BF00311432
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DOI: https://doi.org/10.1007/BF00311432