Alkaline phosphatase: changes in serum levels after a fracture.

Sharland, D. E.; Overstall, P. W.

doi:10.1136/bmj.1.6113.620

Cited by 19 publications

(8 citation statements)

References 1 publication

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“…The endpoint of the increase is not known but a return to the initial value should be expected when the primary remodeling period, with high activity, has passed. This is in accordance with earlier studies of the alkaline phosphatase reaction to trauma, which is less specific but nevertheless increases during fracture healing but later returns to normal [30,31]. As we did not find, in these investigated women, any correlation to the time elapsed from fracture or the number of sustained fractures, we assume that the immediate metabolic reactions to the fracture and the healing period is over.…”

Section: Discussionsupporting

confidence: 93%

Serum osteocalcin and fracture susceptibility in elderly women

et al. 1993

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The purpose of this investigation was to evaluate the bone turnover by using bone metabolic markers in relation to previous fracture history and independent of bone mass. Patients and controls were recruited from a population-based study of 193 women, all living in the same city and aged 60, 70, and 80 years. The bone mineral content (BMC) was measured bilaterally in the distal forearm by single-photon absorptiometry (SPA). At the same time, serum samples were obtained for biochemical analysis. Of the 193 women, we identified 26 with at least one major fracture during the past few years. Each of these 26 women with a certified recent previous fracture was individually matched with a woman from the same study group of equal BMC and age but without a fracture history. In the two groups, the serum samples were analyzed for osteocalcin, C-terminal procollagen peptide (P1CP), alkaline phosphatase, bone-specific alkaline phosphatase, calcium, phosphate, and albumin. The serum concentration of osteocalcin was 20% lower in the women with a previous fracture than in the controls (P = 0.03). The other markers of bone formation gave similar values in the two groups. There was a significant correlation between the osteocalcin and P1CP concentrations (P = 0.001). Our findings indicate that the susceptibility to fractures independent of factors such as age and BMC may be related to a decreased bone turnover.

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Section: Discussionsupporting

confidence: 93%

Serum osteocalcin and fracture susceptibility in elderly women

et al. 1993

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“…An increase of the osteocalcin level 1 week after hip fracture has been described by Thompson et al [32] and a continued increase should be expected of the formation variables osteocalcin and alkaline phosphatase as a reaction to the fracture healing. This is in accordance with earlier studies of the osteocalcin [33] and alkaline phosphatase changes after fracture [34][35][36].…”

Section: Discussionsupporting

confidence: 92%

Impairment of bone turnover in elderly women with hip fracture

et al. 1993

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Hip fracture is one of the most severe consequences of osteoporosis affecting aged women. However, abnormalities of bone turnover responsible for bone loss in this condition have not been clearly defined. To further evaluate the bone metabolic status of women sustaining hip fracture, we have prospectively measured serum osteocalcin as a marker of bone formation and urinary excretion of pyridinoline (Pyr) and deoxypyridinoline (D-pyr) cross-links as markers of bone collagen degradation in 174 independently living women (80 +/- 8 years) within a few hours after a hip fracture. Comparison was made with 77 age-matched controls (80 +/- 5 years) and 17 premenopausal women (39 +/- 3 years). In addition 15 of the patients were followed with daily measurements during the first postoperative week. At the time of admission osteocalcin was 20% lower in the fractured women compared to the elderly controls (7.6 +/- 3.8 vs. 9.5 +/- 4.5 ng/ml, P = 0.001). Pyr and D-pyr were 36% and 40% higher, respectively (P = 0.0001), than in elderly controls and 85% and 76% higher than in premenopausal controls (P = 0.0001). Serum osteocalcin did not correlate with the cortisol level measured at the same time (r = 0.03, ns), nor with serum albumin and creatinine. Serum osteocalcin remained unchanged within 18 hours after fracture, whereafter it progressively decreased until the third postoperative day. No correlation was noted between the excretion of pyridinoline cross-links and the time elapsed from fracture.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Moreover, concomitant administration of pharmacologic doses of vitamin D may also contribute to increased bone resorption. (29) Resorption must further weaken already weak osteoporotic bone, at least until subsequent bone formation fills in the resorption lacunae. Unfortunately, fluorideinduced osteoid, although usually plentiful, mineralizes slowly'!'…”

Section: Discussionmentioning

confidence: 99%

Journal of Bone and Mineral Research

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et al. 1990

Journal of Bone and Mineral Research

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We attempted to identify risk factors for the development of lower limb stress fractures during fluoride therapy for osteoporosis (OP). We compared 18 patients who developed 41 such fractures (26 periarticular, 6 femoral neck, 5 long bone shaft, 1 greater trochanter and 3 pubic rami fractures) during fluoride therapy, with 24 similarly treated patients who did not develop stress fractures. Treatment consisted of sodium fluoride 0.99 mg/kg per day, elemental calcium 1 g/day, and vitamin D. We obtained a previous fracture history, annual radiographs of the spine (fractures), hands (metacarpal cortical index, MCI) and pelvis (Singh index, femoral cortical index), three-monthly serum fluoride and alkaline phosphatase levels, and pretreatment transiliac bone biopsies (routine histomorphometry). The stress fracture group was found to have, before treatment: lower MCI (p less than 0.05), lower trabecular bone volume (p less than 0.05), a lower number of trabeculae (p less than 0.05), greater trabecular separation (p less than 0.05), less extensive eroded surfaces (p less than 0.05), a lower double/single tetracycline label ratio (p less than 0.05); and during treatment: more new spinal fractures (p less than 0.05) and higher serum alkaline phosphatase levels (p less than 0.01). We conclude that stress fracture patients had more severe trabecular and cortical OP and possibly a poorer bone-forming capacity before therapy than patients without stress fractures. We suspect that fluoride therapy may temporarily further weaken bone and so lead to stress fractures in severely osteoporotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

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Alkaline phosphatase: changes in serum levels after a fracture.

Cited by 19 publications

References 1 publication

Serum osteocalcin and fracture susceptibility in elderly women

Serum osteocalcin and fracture susceptibility in elderly women

Impairment of bone turnover in elderly women with hip fracture

Journal of Bone and Mineral Research

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