Clinical Studies Using a Highly Sensitive Radioimmunoassay for Mid-Region and Carboxy Terminus of Parathyroid Hormone in Normal, Hypo-and Hypercalcemic States

Fukase, Masaaki; Fujita, Takeshi; Matsumoto, Toshio; Ogata, Etsuro; Iijima, Takashi; Takezawa, Junichi; Saitô, Kenichi; Ishige, Hideyuki; Fujimoto, Masao

doi:10.1507/endocrine1927.65.8_807

Cited by 28 publications

(11 citation statements)

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“…The data were adjusted with urinary creatinine concentration for the exception of aberration which was induced by urine volume. In addition to these markers, measurements were taken of serum calcium (Ca) by the orthocresolphthalein complexone (OCPC) method [17], serum phosphorus (P) by direct determination of molybdic acid [18], serum alkaline phosphatase (AlP) by the paranitrophenol (PNP) substrate method [19], and the serum level of high sensitive parathyroid hormone (PTH) by RIA [20]. The range of measurement in healthy adults were serum Oc 3.1-12.7 ng/ml; urinary Dpd 2.1-5.4 nMol/liter ⅐ Cr; serum Ca 4.1-5.0 mEq/liter; serum P 2.5-4.5 mg/dl; serum AlP 74-223 U/liter; and serum PTH 74-273 pg/ml.…”

Section: Measurement Of Biochemical Markers (Bm) For Bone Metabolismmentioning

confidence: 99%

Acute Alteration in Bone Mineral Density and Biochemical Markers for Bone Metabolism in Nephrotic Patients Receiving High-Dose Glucocorticoid and One-Cycle Etidronate Therapy

Fujita

Satomura

Hidaka

et al. 2000

Calcified Tissue International

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It is widely known that glucocorticoids induce and accelerate osteoporosis. High-dose glucocorticoids are administrated daily to patients in the acute phase of nephrotic syndrome. It could be inferred that high-dose glucocorticoids rapidly decrease patients' basal bone mineral density (BMD) and this accelerates the natural progress of osteoporosis associated with aging or menopause. Nine nephrotic patients (male/female: 5/4) without previous prednisolone administration were chosen to measure BMD and the level of the markers for bone turnover before and after treatment for 3 months (total prednisolone administration: 4.5 +/- 0.0 g). Twenty-three patients under remission with prednisolone administration (male/female: 14/9) were included in the long-term treatment group. Patients in this group whose %YAM in the lateral lumbar spine was less than 89% were classified into a low BMD group (n = 10, male/female: 3/7). They were administered etidronate disodium at 200 mg/day for 14 days. BMD and % of young adult mean (YAM) in the lumbar spine (L2-L4 in lateral objection) and other regions were measured by dual-energy X-ray absorptiometry. As markers of bone metabolism, the urinary level of deoxypyridinoline (Dpd) was determined to evaluate osteogenesis, and serum osteocalcin was measured to evaluate bone resorption. BMD of the lumbar spine significantly decreased in the 3-month treatment group (752 +/- 96 mg/cm(2), 7 +/- 4% reduction) compared with the pretreatment group (810 +/- 85 mg/cm(2)). BMD in the long-term treatment group decreased continuously (683 +/- 135 mg/cm(2)). No significant differences were noted in other measurement sites. BMD in the etidronate treatment group increased significantly (597 +/- 55 mg/cm(2)) compared with the pretreatment group (549 +/- 76 mg/cm(2)). Etidronate did not change BMD at the sites with a normal BMD. Among the biochemical markers (BM) examined, the urinary level of Dpd (nMol/liter. Cr) significantly increased in the 3-month treatment group (8.6 +/- 5.1 nMol/liter.Cr) compared with the pretreatment group (5.8 +/- 2.0 nMol/liter. Cr). No significant differences were seen in the BMs measured in the long-term treatment group. The urinary Dpd level of the etidronate treatment group decreased (3.9 +/- 1.4 nMol/liter. Cr) compared with the pretreatment group. These data indicate that etidronate could improve the accelerated bone resorption. In conclusion, high-dose glucocorticoid therapy causes rapid bone resorption and accelerates the natural progress of osteoporosis associated with aging or menopause. Etidronate administration prevents the progress of osteoporosis in nephrotic patients. Preventive treatment should be performed when the estimated BMD in 3 months falls below the baseline by more than 7 +/- 4%, reaching the therapeutic range.

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Section: Measurement Of Biochemical Markers (Bm) For Bone Metabolismmentioning

confidence: 99%

Acute Alteration in Bone Mineral Density and Biochemical Markers for Bone Metabolism in Nephrotic Patients Receiving High-Dose Glucocorticoid and One-Cycle Etidronate Therapy

Fujita

Satomura

Hidaka

et al. 2000

Calcified Tissue International

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“…The coefficient of variation for tHcy was 2.26% for the within-assay precision (n=7) and 2.96% for the between-assay precision (n=10). The same blood and serum samples from all dialyzed subjects were used to monitor other risk factors for vascular disease, including concentrations of total and high-density lipoprotein cholesterol (HDL-C), triglyceride, lipoprotein(a), uric acid, calcium, inorganic phosphate, and parathyroid hormone (Yamasa method 14 ).…”

Section: Biochemical Analysismentioning

confidence: 99%

Association Between Plasma Homocysteine Concentration and Carotid Atherosclerosis in Hemodialysis Patients

Sakurabayashi¹,

Fujimoto

Takaesu³

et al. 1999

Jpn Circ J

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Ultrasonography to Calculate Carotid Maximum IMTB-mode ultrasonography of the extracranial carotid artery was performed with a high-resolution, real-time scanner equipped with a 7.5-MHz imaging transducer (SSD 650 CL, Aloka, Tokyo, Japan). One trained physician, who was blinded with regard to the subjects' clinical Jpn Circ J 1999; 63: 692 -696 (Received March 19, 1999; revised manuscript received June 2, 1999; accepted June 10, 1999 Accelerated atherosclerosis is a major risk for uremic patients undergoing long-term hemodialysis. Because hyperhomocysteinemia may influence this condition, 168 such patients were examined for a possible association between plasma total homocysteine concentration (tHcy) and conventional cardiovascular risk factors. Generalized atherosclerosis was indicated by excessive intimal-medial wall thickness (IMT) of the extracranial carotid artery as measured by B-mode ultrasonography. The results documented tHcy in these patients of 33.0±16.9 mol/L, a significantly higher amount than that of healthy subjects (11.0±3.1 mol/L, p<0.0001). The patients' carotid maximum IMT was 1.79±1.16 mm. In multiple regression analyses with forward elimination procedure, carotid maximum IMT was clearly related to age (r=0.417, p<0.0001), systolic blood pressure (r=0.262, p=0.0043), smoking (r=0.177, p=0.0076), duration of hemodialysis (r=0.083, p=0.0045), and tHcy (r=0.195, p=0.0021). These 5 factors accounted for 36.0% of the variation in carotid maximum IMT. Factors determined as unrelated were male gender, diastolic blood pressure, body mass index, total and HDL cholesterol, triglyceride, lipoprotein(a), uric acid, calcium, inorganic phosphate, and parathyroid hormone. Therefore hyperhomocysteinemia, along with advanced age, systolic hypertension and smoking aggravates atherosclerosis in chronic uremic patients. (Jpn Circ J 1999; 63: 692 -696)

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“…The calcium, phosphate, creatinine, and highly sensitive plasma PTH (HS-PTH) levels were determined from the serum samples. The HS-PTH level was measured by the double antibody method (PTH kit, Yamasa Shoyu Co., Choshi, Chiba, Japan) [10,12].…”

Section: Eh Testmentioning

confidence: 99%

Abnormal calcium metabolism in myotonic dystrophy as shown by the Ellsworth-Howard test and its relation to CTG triplet repeat length

Kinoshita

Komori

Ohtake

et al. 1997

Journal of Neurology

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Myotonic dystrophy (DM) is an autosomal dominant disorder characterized by peculiar clinical features. Its molecular basis is the unstable expansion of a CTG triplet repeat in the gene encoding myotonin protein kinase (Mt-PK), the nucleotide sequence of which has extensive homology to the cyclic AMP (cAMP)-dependent protein kinase gene. Extensive efforts have been made to clarify the signal transduction pathway in which the responsible gene operates, but confirming evidence has yet to be obtained. Because some symptoms in DM are similar to those in hypoparathyroidism, we divided 24 DM patients into two groups on the basis of their serum calcium levels; Group 1, those with normocalcemia (11 patients), and group 2, those with hypocalcemia (13 patients). The highly sensitive parathyroid hormone (HS-PTH) plasma levels in group 1 were within normal limits, whereas those in group 2 were abnormally high. Laboratory findings for the group 2 patients resembled those for pseudohypoparathyroidism (PHP), whereas those for group 1 patients were normal. The Ellsworth-Howard (EH) test was used to determine which type of PHP the group 2 patients belonged to. Both the phosphaturic (delta P) and urinary cAMP (UcAMP) responses were estimated. The delta P responses in group 2 were significantly lower than those in group 1, but their UcAMP responses did not differ. This is evidence that group 2 patients had PHP type II, whereas group 1 patients were normal. We also investigated whether the disease severity differed between the groups. Cataracts, ectopic calcifications, and ossifications, which are associated with PHP, were more frequent in group 2. In addition, the mean IQ in that group was significantly lower. Clinically, the group 2 signs agreed well with those of PHP, whereas for group 1 there was only a slight similarity. These results are additional evidence that the patients in group 2 have abnormal calcium metabolism, the abnormality being in the postadenylate cyclase-cAMP pathway in the renal tubular cells. The degree of (CTG)n expansion, the so-called expanded DNA fragment (EF) size, was determined by standard Southern blot analysis. The allelic EF sizes in both groups were greater than in the healthy controls. Moreover, those in group 2 were significantly longer than those in group 1. We therefore investigated whether EF size is correlated with the serum calcium and plasma PTH levels, the delta P responses in the EH test, and IQ. All these items were significantly correlated with EF size. Our findings show that the expanded DNA fragment size in DM is correlated with the degree of abnormal calcium metabolism.

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Clinical Studies Using a Highly Sensitive Radioimmunoassay for Mid-Region and Carboxy Terminus of Parathyroid Hormone in Normal, Hypo-and Hypercalcemic States

Cited by 28 publications

References 0 publications

Acute Alteration in Bone Mineral Density and Biochemical Markers for Bone Metabolism in Nephrotic Patients Receiving High-Dose Glucocorticoid and One-Cycle Etidronate Therapy

Acute Alteration in Bone Mineral Density and Biochemical Markers for Bone Metabolism in Nephrotic Patients Receiving High-Dose Glucocorticoid and One-Cycle Etidronate Therapy

Association Between Plasma Homocysteine Concentration and Carotid Atherosclerosis in Hemodialysis Patients

Abnormal calcium metabolism in myotonic dystrophy as shown by the Ellsworth-Howard test and its relation to CTG triplet repeat length

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