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Comparative Pharmacokinetic Study of 5 Active Ingredients after Oral Administration of Zuogui Pill in Osteoporotic Rats with Different Syndrome Types. Int J Anal Chem 2023; 2023:1473878. [PMID: 36998619 PMCID: PMC10045483 DOI: 10.1155/2023/1473878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/07/2023] [Accepted: 02/15/2023] [Indexed: 03/02/2023] Open
Abstract
Zuogui Pill is a kidney-yin-tonifying formula in traditional Chinese medicine that is widely used to manage osteoporosis with kidney-yin-deficiency in China. Herein, an efficient and accurate high-performance liquid chromatography-tandem mass spectrometry method was developed to determine the concentrations of 5 bioactive compounds in rat plasma following oral administration of Zuogui Pill. Because drug absorption and distribution differ under physiological and pathological conditions, the established method was used to quantify blood components and dynamic change in osteoporotic rats with different syndrome types. Moreover, integrated pharmacokinetic study was conducted to describe the overall pharmacokinetic characteristics of traditional Chinese medicine. The results showed that the absorption, distribution, and metabolism of Zuogui Pill varied widely under different states. The bioavailability of most active components showed significant advantages in osteoporotic rats with kidney-yin-deficiency, which corresponds to the opinion that Zuogui Pill has the effect of nourishing kidney-yin. It is hoped that this finding could interpret the pharmacodynamic substances and mechanism of Zuogui Pill in the treatment of osteoporosis with kidney-yin-deficiency.
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Lee YS, Park SJ, Lee JY, Choi E, Kim BJ. Benefits of lumican on human bone health: clinical evidence using bone marrow aspirates. Korean J Intern Med 2022; 37:821-829. [PMID: 35468703 PMCID: PMC9271722 DOI: 10.3904/kjim.2022.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 03/22/2022] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND/AIMS Lumican, a small leucine-rich proteoglycan, has shown osteoprotective effects by synchronously stimulating bone formation and suppressing bone resorption. To clarify the role of lumican in human bone metabolism, the association between lumican concentrations and osteoporosis-related phenotypes was evaluated using bone marrow (BM) samples directly reflecting local microenvironments. METHODS BM aspirates were obtained from 77 patients during hip surgery for either fragility hip fractures (HF) (n = 29) or osteoarthritis (n = 48) and centrifuged. Concentrations of lumican and biochemical bone markers in BM supernatants were measured using enzyme linked immunosorbent assays. RESULTS After considering confounders, lumican concentrations in BM supernatants were 16.9% lower in patients with HF than in controls, with each increase in the standard deviation of lumican concentration being associated with a 61% lower likelihood of HF. The odds ratios for HF decreased linearly with increasing lumican tertiles in BM, with the odds of having fragility HF markedly lower in participants in the highest than in the lowest lumican tertile. Higher lumican level correlated significantly with higher femur neck bone mineral density and higher bone-specific alkaline phosphatase levels, but not with tartrate-resistant acid phosphatase 5b concentrations, in BM supernatants. CONCLUSION These data clinically validate previous in vitro and animal experiments showing the beneficial roles of lumican for bone homeostasis and suggest that lumican may contribute to a reduction in fracture risk in humans mainly through its stimulation of bone formation.
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Affiliation(s)
- Yun Sun Lee
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul,
Korea
| | - So Jeong Park
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul,
Korea
| | - Jin Young Lee
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul,
Korea
| | - Eunah Choi
- Asan Institute for Life Sciences, University of Ulsan College of Medicine, Seoul,
Korea
| | - Beom-Jun Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul,
Korea
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3
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Lumican Inhibits Osteoclastogenesis and Bone Resorption by Suppressing Akt Activity. Int J Mol Sci 2021; 22:ijms22094717. [PMID: 33946862 PMCID: PMC8124849 DOI: 10.3390/ijms22094717] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 12/24/2022] Open
Abstract
Lumican, a ubiquitously expressed small leucine-rich proteoglycan, has been utilized in diverse biological functions. Recent experiments demonstrated that lumican stimulates preosteoblast viability and differentiation, leading to bone formation. To further understand the role of lumican in bone metabolism, we investigated its effects on osteoclast biology. Lumican inhibited both osteoclast differentiation and in vitro bone resorption in a dose-dependent manner. Consistent with this, lumican markedly decreased the expression of osteoclastogenesis markers. Moreover, the migration and fusion of preosteoclasts and the resorptive activity per osteoclast were significantly reduced in the presence of lumican, indicating that this protein affects most stages of osteoclastogenesis. Among RANKL-dependent pathways, lumican inhibited Akt but not MAP kinases such as JNK, p38, and ERK. Importantly, co-treatment with an Akt activator almost completely reversed the effect of lumican on osteoclast differentiation. Taken together, our findings revealed that lumican inhibits osteoclastogenesis by suppressing Akt activity. Thus, lumican plays an osteoprotective role by simultaneously increasing bone formation and decreasing bone resorption, suggesting that it represents a dual-action therapeutic target for osteoporosis.
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Kim BJ, Lee SH, Koh JM. Potential Biomarkers to Improve the Prediction of Osteoporotic Fractures. Endocrinol Metab (Seoul) 2020; 35:55-63. [PMID: 32207264 PMCID: PMC7090300 DOI: 10.3803/enm.2020.35.1.55] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/03/2019] [Accepted: 12/31/2019] [Indexed: 12/27/2022] Open
Abstract
Osteoporotic fracture (OF) is associated with high disability and morbidity rates. The burden of OF may be reduced by early identification of subjects who are vulnerable to fracture. Although the current fracture risk assessment model includes clinical risk factors (CRFs) and bone mineral density (BMD), its overall ability to identify individuals at high risk for fracture remains suboptimal. Efforts have therefore been made to identify potential biomarkers that can predict the risk of OF, independent of or combined with CRFs and BMD. This review highlights the emerging biomarkers of bone metabolism, including sphongosine-1-phosphate, leucine-rich repeat-containing 17, macrophage migration inhibitory factor, sclerostin, receptor activator of nuclear factor-κB ligand, and periostin, and the importance of biomarker risk score, generated by combining these markers, in enhancing the accuracy of fracture prediction.
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Affiliation(s)
- Beom Jun Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
| | - Seung Hun Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jung Min Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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Ryu KJ, Park H, Park JS, Lee YW, Kim SY, Kim H, Jeong Y, Kim YJ, Yi KW, Shin JH, Hur JY, Kim T. Vasomotor Symptoms: More Than Temporary Menopausal Symptoms. J Menopausal Med 2020; 26:147-153. [PMID: 33423402 PMCID: PMC7797223 DOI: 10.6118/jmm.20030] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 10/05/2020] [Indexed: 01/10/2023] Open
Abstract
Vasomotor symptoms (VMS), such as hot flashes and night sweating, are classic menopausal symptoms experienced by a majority of perimenopausal and postmenopausal women. VMS have received a great deal of attention due to their relationship with cardiometabolic risk. Further, accumulating evidence indicates that VMS are associated with an increased risk of several chronic diseases, including metabolic syndrome, type 2 diabetes mellitus, nonalcoholic fatty liver diseases, and osteoporosis in perimenopausal and postmenopausal women. These findings suggest VMS as biomarkers of impaired cardiometabolic conditions rather than just temporary symptoms in menopausal women, warranting further studies to confirm the casual relationship of VMS with these diseases and the exact underlying mechanism in this context.
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Affiliation(s)
- Ki Jin Ryu
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Hyuntae Park
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea.
| | | | - Yeon Woo Lee
- Korea University College of Medicine, Seoul, Korea
| | | | - Hayun Kim
- Korea University College of Medicine, Seoul, Korea
| | - Youngmi Jeong
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Yong Jin Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Kyong Wook Yi
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Jung Ho Shin
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Jun Young Hur
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
| | - Tak Kim
- Department of Obstetrics and Gynecology, Korea University College of Medicine, Seoul, Korea
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Ha J, Lee JM, Lim Y, Kim MK, Kwon HS, Song KH, Jeon HM, Kang MI, Baek KH. Effect of bisphosphonate on the prevention of bone loss in patients with gastric cancer after gastrectomy: A randomized controlled trial. Bone 2020; 130:115138. [PMID: 31706052 DOI: 10.1016/j.bone.2019.115138] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/31/2019] [Accepted: 11/01/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Bone loss is highly prevalent after gastrectomy in gastric cancer patients. Therefore, the efficacy of medical treatment should be evaluated in patients undergoing gastrectomy. METHODS We conducted an unblinded, randomized controlled trial of patients who underwent gastrectomy to treat gastric cancer. The intention-to-treat participants (n = 107) were randomly assigned to receive either alendronate at a weekly dose of 70 mg and daily elemental calcium (500 mg) with cholecalciferol (1000 IU) or daily elemental calcium (500 mg) with cholecalciferol (1000 IU) only. The primary endpoint was defined by the changes in bone mineral density of four measurement sites: the lumbar spine, femur neck, total hip, and trochanter. Changes in bone turnover markers, osteocalcin and collagen I carboxyterminal telopeptide were also observed. RESULTS At baseline, there were no differences between the two groups in bone mineral density. In the lumbar spine and trochanter, there were no significant percentage changes compared with the baseline in the alendronate group, but a significant decrease was noted in the control group (p < 0.001 for both lumbar spine and trochanter). In the femur neck and total hip, a larger decrease was observed compared with the baseline in the control group (p < 0.001 for both femur neck and total hip). Significant percentage increases in serum osteocalcin compared with baseline were noted in the control group (p for trend <0.001), but there was no change in the alendronate group (p for trend = 0.713). Collagen I carboxyterminal telopeptide significantly declined in the alendronate group over 12 months (p for trend <0.001). CONCLUSIONS Prevention and treatment with bisphosphonate effectively reduces bone loss by suppressing bone resorption in gastric cancer patients undergoing gastrectomy.
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Affiliation(s)
- Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Jung-Min Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
| | - Yejee Lim
- Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, Republic of Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Hyuk-Sang Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Ki-Ho Song
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Hae Myung Jeon
- Department of Surgery, Uijeongbu St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Moo Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea
| | - Ki-Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Republic of Korea.
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Znorko B, Oksztulska-Kolanek E, Michałowska M, Kamiński T, Pawlak K. Does the OPG/RANKL system contribute to the bone-vascular axis in chronic kidney disease? A systematic review. Adv Med Sci 2017; 62:52-64. [PMID: 28189120 DOI: 10.1016/j.advms.2016.08.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 08/20/2016] [Accepted: 08/29/2016] [Indexed: 02/07/2023]
Abstract
Vascular calcification (VC) is highly prevalent in patients with chronic kidney disease (CKD) and is strongly associated with cardiovascular mortality and morbidity. Accumulating evidence over the past decade has challenged the hypothesis of close interaction between bone and VC what raises the possibility of a common underlying pathophysiological mechanism. Lately, bone regulatory proteins such as: osteoprotegerin (OPG) and Receptor Activator for Nuclear Factor κB Ligand (RANKL) has attracted attention of researchers as a possible key mediators of bone-vascular calcification imbalance. The literature search was carried out using the MEDLINE/PubMed database and a combination of keywords and MeSH terms, and only papers published since January 2005 to July 2016 were selected. The search resulted in 562 potential articles. After selection according to the eligibility criteria, 107 studies fulfilled were included (102 full texts and 5 was case reports). OPG and RANKL plays essential role in the regulation of bone metabolism and may be regarded as a possible link between VC, bone and mineral metabolism in CKD patients. Further studies are required to determine the diagnostic significance of these proteins in evaluation of progression and severity of VC process in CKD patients. Finally, the efficacy and safety, especially in regard to VC, of anti-RANKL therapy in CKD patients requires well-designed prospective, randomized trials.
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Affiliation(s)
- Beata Znorko
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Bialystok, Poland
| | - Ewa Oksztulska-Kolanek
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Bialystok, Poland
| | | | - Tomasz Kamiński
- Department of Pharmacodynamics, Medical University of Bialystok, Bialystok, Poland
| | - Krystyna Pawlak
- Department of Monitored Pharmacotherapy, Medical University of Bialystok, Bialystok, Poland.
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Tetsunaga T, Tetsunaga T, Nishida K, Tanaka M, Sugimoto Y, Takigawa T, Takei Y, Ozaki T. Denosumab and alendronate treatment in patients with back pain due to fresh osteoporotic vertebral fractures. J Orthop Sci 2017; 22:230-236. [PMID: 28087216 DOI: 10.1016/j.jos.2016.11.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 11/23/2016] [Accepted: 11/26/2016] [Indexed: 02/09/2023]
Abstract
INTRODUCTION Denosumab specifically inhibits the receptor activator for nuclear factor-kappa B ligand (RANKL), and prevents osteoporotic fractures. Several reports have analyzed the effects of denosumab and alendronate alone on bone mineral density (BMD) or reduction of fracture risk. The objective of this study was to analyze the effects of antiresorptive osteoporosis pharmacotherapy on pain relief in patients with fresh vertebral fracture. METHODS This retrospective, single-center study included 80 patients (10 males, 70 females) with fresh osteoporotic vertebral fractures treated using denosumab at a dose of 60 mg subcutaneously every 6 months (40 patients) or alendronate at a dose of 35 mg orally every week (40 patients) for 6 months in our hospital. The mean age of subjects was 77 years (range, 55-92 years). The primary outcome was duration of back pain. Secondary outcomes included changes in BMD, serum type 1 collagen cross-linked N-telopeptide (NTX), and serum N-terminal propeptide of type 1 collagen (P1NP) from baseline to 6 months. Pain catastrophizing due to back pain was assessed using the Pain Catastrophizing Scale (PCS). The incidences of further vertebral fracture and adverse events were also assessed. RESULTS Pain relief was obtained at a mean of 3.3 weeks with denosumab and 5.4 weeks with alendronate. Pain relief was achieved significantly earlier with denosumab than with alendronate. At 6 months, change in BMD was higher with denosumab (6.1%) than with alendronate (0.8%). No significant differences in changes in NTX and P1NP were observed between groups. Scores for PCS were significantly lower for denosumab than for alendronate. The incidence of further vertebral fractures was 5% with denosumab and 10% with alendronate. Adverse event rates were similar between groups. CONCLUSIONS Denosumab enabled earlier pain relief than alendronate and avoided catastrophizing in patients with osteoporotic vertebral fractures after 6 months of treatment.
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Affiliation(s)
- Tomoko Tetsunaga
- Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan; Department of Orthopaedic Surgery, Kurashiki Municipal Hospital, 2-39, Kojima-Ekimae, Kurashiki 711-0921, Japan
| | - Tomonori Tetsunaga
- Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan.
| | - Keiichiro Nishida
- Department of Human Morphology, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Masato Tanaka
- Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Yoshihisa Sugimoto
- Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Tomoyuki Takigawa
- Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
| | - Yoshitaka Takei
- Department of Orthopaedic Surgery, Kurashiki Municipal Hospital, 2-39, Kojima-Ekimae, Kurashiki 711-0921, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University, 2-5-1 Shikata-cho, Kitaku, Okayama 700-8558, Japan
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Conservative management of osteoporotic vertebral fractures: an update. Eur J Trauma Emerg Surg 2016; 43:19-26. [DOI: 10.1007/s00068-016-0747-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2016] [Accepted: 11/29/2016] [Indexed: 12/14/2022]
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10
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Festuccia F, Jafari MT, Moioli A, Fofi C, Barberi S, Amendola S, Sciacchitano S, Punzo G, Menè P. Safety and efficacy of denosumab in osteoporotic hemodialysed patients. J Nephrol 2016; 30:271-279. [PMID: 27394428 DOI: 10.1007/s40620-016-0334-1] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Accepted: 06/28/2016] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS In elderly subjects, renal insufficiency and osteoporosis often coexist with high risk of fracture and elevated socio-economic burden. Today a large number of effective anti-osteoporotic drugs are available but generally they are contraindicated in patients with chronic kidney disease (CKD) because of their progressive accumulation. Denosumab, instead, does not require dose adjustments for different degrees of renal impairment so it can be a valid treatment in osteoporotic patients with CKD. Limited data are available in the literature concerning the use of denosumab in hemodialysis (HD). The aim of our study was, therefore, to study the efficacy and tolerability of this drug in this particular subset of patients. METHODS We retrospectively reviewed the charts of 12 osteoporotic HD patients who received a single 60-mg subcutaneous dose of denosumab every 6 months for an observation period of 24 months. Serum electrolyte, markers of bone turnover and quantitative ultrasound (QUS) were evaluated. RESULTS Over 24 months, we observed a gradual improvement of bone metabolism: β-CrossLaps from 2567.08 ± 1264 to 1492.5 ± 1182.5 pg/ml; bone alkaline phosphatase (BALP) from 33.5 ± 28.8 to 11.8 ± 3.7 mcg/l, and of QUS index (T-score from -5.33 ± 1.58 to -4.84 ± 1.2; risk of fracture from 13.9 ± 4.7 to 11.07 ± 5.3 %). Few cases of hypocalcemia were detected, more significant after the first and second injection, but with careful monitoring of serum calcium and rapid therapy adjustment we could easily manage serum Ca levels. CONCLUSIONS Our pilot experience highlights the safety and efficacy of denosumab in the treatment of osteoporosis in HD patients, potentially supporting its use to reduce the burden of fractures in this patient population.
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Affiliation(s)
- Francescaromana Festuccia
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. .,Division of Nephrology, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
| | - Maryam Tayefeh Jafari
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy
| | - Alessandra Moioli
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy. .,Division of Nephrology, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy.
| | - Claudia Fofi
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.,Division of Nephrology, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Simona Barberi
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.,Division of Nephrology, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Stefano Amendola
- Section of Endocrinology and Diabetology, Ospedale Israelitico, Rome, Italy
| | - Salvatore Sciacchitano
- Department of Clinical and Molecular Medicine, Sapienza University of Rome, Policlinico Umberto I, Rome, Italy.,Laboratory of Biomedical Research, Niccolò Cusano University Foundation, Rome, Italy
| | - Giorgio Punzo
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.,Division of Nephrology, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
| | - Paolo Menè
- Nephrology and Dialysis Unit, Department of Clinical and Molecular Medicine, Sapienza University of Rome, Sant'Andrea Hospital, Rome, Italy.,Division of Nephrology, Sant'Andrea University Hospital, Via di Grottarossa 1035-1039, 00189, Rome, Italy
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11
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Vasomotor symptoms and osteoporosis in Korean postmenopausal women. Maturitas 2016; 87:27-32. [PMID: 27013285 DOI: 10.1016/j.maturitas.2016.02.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/05/2016] [Accepted: 02/10/2016] [Indexed: 11/21/2022]
Abstract
OBJECTIVES This study examined the relationships between vasomotor symptoms (VMS), bone mineral density (BMD) and osteoporosis in postmenopausal women. STUDY DESIGN A cross-sectional study was conducted of 1390 postmenopausal Korean women aged 45-65 years who attended a routine health check-up at a single institution. Their results on the Menopause Rating Scale were used to assess VMS, and moderate, severe, and very severe VMS were combined into moderate-to-severe VMS. MAIN OUTCOME MEASURES The relationships of VMS with BMD and osteoporosis in the lumbar spine and femoral neck bone were analyzed by multivariate regression analyses. RESULTS The mean age of all participants was 54.63 ± 4.78 years. Four hundred seventy-one (33.9%) women reported mild VMS and 344 (24.7%) reported moderate-to-severe VMS. Osteoporosis was newly diagnosed in 156 (11.2%) women. BMD levels were not significantly different among the no/mild/moderate-to-severe VMS groups, despite the significant differences in the prevalence of osteoporosis in the femoral neck bone. Women with mild VMS and those with moderate-to-severe VMS had a lower BMD than women without VMS after adjustment for age, years since menopause, years of reproductive age, BMI, insulin resistance, smoking, alcohol, steroids use, exercise, previous fracture and parental history of hip fracture. And moderate-to-severe VMS was significantly associated with the risk of osteoporosis in the femoral neck bone (OR = 2.97, 95% CI = 1.41-6.26) and in the lumbar spine (OR = 1.93, 95% CI = 1.09-3.40). CONCLUSIONS VMS are associated with decreased BMD, and moderate-to-severe VMS in particular are independently associated with the risk of osteoporosis in otherwise healthy postmenopausal Korean women.
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12
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Selga J, Nuñez JH, Minguell J, Lalanza M, Garrido M. Simultaneous bilateral atypical femoral fracture in a patient receiving denosumab: case report and literature review. Osteoporos Int 2016; 27:827-32. [PMID: 26501556 DOI: 10.1007/s00198-015-3355-z] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 09/29/2015] [Indexed: 11/26/2022]
Abstract
Osteoporosis remains a chronic and common disease associated with high medical costs. Pharmacological therapy has shown to be a good strategy to significantly reduce fracture risk. While literary evidence for bone protection in the short and medium term is strongly in it's favor, there are concerns about long-term treatment with antiresorptive drugs. Increased risk of atypical femoral fractures (AFFs) have been demonstrated in several studies following the long-term use of bisphosphonate. Denosumab offers an alternative approach to the treatment of osteoporosis, however, it is also an antiresorptive drug. We present a case of simultaneous bilateral atypical femoral fractures in a patient with denosumab treatment. These findings highlight the need to reevaluate the optimal antiresorptive therapy duration, as well as the safety of transition from bisphosphonates to denosumab and the need for continued monitoring in the prevention of AFFs.
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13
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Hwang YC. Sulfonylurea: Personalized Medicine for Type 2 Diabetes. Endocrinol Metab (Seoul) 2015; 30:467-8. [PMID: 26790382 PMCID: PMC4722399 DOI: 10.3803/enm.2015.30.4.467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- You Cheol Hwang
- Division of Endocrinology and Metabolism, Department of Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
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14
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