Use of bone biochemical markers with dual-energy x-ray absorptiometry for early determination of bone loss in persons with spinal cord injury

moun, Laurent Ma; Couret, I.; Micallef, Jean‐Paul; Péruchon, E.; Mariano‐Goulart, Denis; Rossi, Michel; Leroux, Jean‐Paul; Ohanna, F

doi:10.1053/meta.2002.34013

Cited by 77 publications

(48 citation statements)

References 27 publications

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“…This finding explains the minimal bone loss in the femoral region (1% in the femoral neck) determined by DEXA in the acute period. The study by Maimoun et al (17), performed on 7 patients with acute and complete SCI, supported this finding. In that study, they concluded that it would not be possible to determine the BMD changes in the early period of SCI by using DEXA.…”

Section: Discussionmentioning

confidence: 70%

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Evaluation of Bone Mineral Density in Patients With Spinal Cord Injury

Kaya¹,

Aybay²,

Özel³

et al. 2006

The Journal of Spinal Cord Medicine

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Background/Objective: This study was performed to evaluate the bone mineral density (BMD) values in patients with spinal cord injury (SCI) and determine the effects of the level, severity, and duration of the neurological lesion and spasticity on BMD values.Methods: A total of 75 patients with traumatic SCI and a healthy control group of 39 people were included in the study. The BMD values of the lumbar spine and 4 different regions of the hip (femoral neck, Ward's triangle, trochanter, and femoral shaft) of all cases were measured using dual energy x-ray absorptiometry. The biochemical markers were also analyzed. Results:The BMD values in all measured regions were found to be decreased in patients compared with that of controls. The level and severity of the lesion and the spasticity did not significantly affect BMD values in the regions analyzed. The BMD values of the hip decreased as the duration of SCI increased. The levels of plasma phosphorus and alkaline phosphatase, calcium in 24-hour urine samples, and the calcium/creatinine ratio in spot urines were found to be significantly higher in the patient group.Conclusion: All patients with SCI had lower BMD values than controls. The level and severity of SCI and spasticity did not significantly affect BMD values. The BMD values of the hip decreased as the duration of SCI increased.

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Section: Discussionmentioning

confidence: 70%

“…The suppressed plasma PTH levels might be related to the increased bone resorption followed by increased plasma phosphorus level. In some studies, hypercalciuria and suppressed PTH levels were found, whereas plasma calcium levels were normal in patients with SCI during the acute period (17,18).…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Bone Mineral Density in Patients With Spinal Cord Injury

Kaya¹,

Aybay²,

Özel³

et al. 2006

The Journal of Spinal Cord Medicine

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“…Spaceflight decreases trabecular indices of bone formation in the iliac crest of monkeys [37,38], and human astronauts experience an imbalance in bone resorption and bone formation during spaceflight [2,39], which probably causes the cortical bone loss that is observed after 4-6 months in space [40,41]. Similarly, patients with acute spinal cord injury (< 6 months postinjury) experience increased bone resorption and increased urinary calcium excretion, which likely explains why spinal cord injury patients lose bone structural properties and demonstrate increased rates of bone fracture [12,16,42,43]. In contrast, we showed decreased turnover with balanced formation and resorption in hibernating grizzly bear femurs (Table 4) which reduced porosity and maintained bone geometrical and mechanical properties during hibernation (Tables 3 and 4, Figure 5C, D).…”

Section: Discussionmentioning

confidence: 99%

Decreased bone turnover with balanced resorption and formation prevent cortical bone loss during disuse (hibernation) in grizzly bears (Ursus arctos horribilis)

McGee

Maki

Johnson

et al. 2008

Bone

102

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Disuse uncouples bone formation from resorption, leading to increased porosity, decreased bone geometrical properties, and decreased bone mineral content which compromises bone mechanical properties and increases fracture risk. However, black bear bone properties are not adversely affected by aging despite annual periods of disuse (i.e., hibernation), which suggests that bears either prevent bone loss during disuse or lose bone and subsequently recover it at a faster rate than other animals. Here we show decreased cortical bone turnover during hibernation with balanced formation and resorption in grizzly bear femurs. Hibernating grizzly bear femurs were less porous and more mineralized, and did not demonstrate any changes in cortical bone geometry or whole bone mechanical properties compared to active grizzly bear femurs. The activation frequency of intracortical remodeling was 75% lower during hibernation than during periods of physical activity, but the normalized mineral apposition rate was unchanged. These data indicate bone turnover decreases during hibernation, but osteons continue to refill at normal rates. There were no changes in regional variation of porosity, geometry, or remodeling indices in femurs from hibernating bears, indicating that hibernation did not preferentially affect one region of the cortex. Thus, grizzly bears prevent bone loss during disuse by decreasing bone turnover and maintaining balanced formation and resorption, which preserves bone structure and strength. These results support the idea that bears possess a biological mechanism to prevent disuse osteoporosis.

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“…This is supported by a biochemical profile characterized by increased urinary excretion of N-and C-telopeptide (NTx and CTx; markers of bone resorption) and calcium, suppressed parathyroid hormone (PTH) and 1,25-dihydroxyvitamin D 3 (1,25-D) levels, and decreased osteocalcin levels (a marker of bone formation) as early as 9 to 14 days after SCI (3,4,(10)(11)(12). Subsequently, there is a mild increase in bone formation (13,14), but elevated markers of bone resorption peak at 10 to 16 weeks (14).…”

Section: Introductionmentioning

confidence: 99%

“…These biochemical markers correlate with continued loss of unloaded cortical bone and persist for at least 10 years after injury, well beyond densitometric homeostasis at 16 months, beyond which there may still be a downward trend (15). Thus, it has been postulated that biochemical markers of bone resorption are sensitive indicators of fracture risk (12,16).…”

Section: Introductionmentioning

confidence: 99%

Effect of a Convenient Single 90-mg Pamidronate Dose on Biochemical Markers of Bone Metabolism in Patients With Acute Spinal Cord Injury

Mechanick

Liu

Nierman

et al. 2006

The Journal of Spinal Cord Medicine

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Background/Objective: To describe the biochemical and adverse effects of a convenient single 90 mg pamidronate dose in patients with acute spinal cord injury (SCI) and compare these effects with those observed in a previous similar study using a 30 mg/d 3 3-day pamidronate dosing regimen.Study Design: Retrospective cohort study.Setting: University-based rehabilitation center in New York City.Methods: A total of 32 patients with SCI were evaluated for biochemical response and adverse events associated with pamidronate therapy. All patients were screened at or near admission for acute rehabilitation, received calcium (1,000 mg daily) and calcitriol (0.25 lg daily) therapy daily, and on day 4, received a single dose of pamidronate, 90 mg by intravenous infusion, over 4 hours. Serum calcium and phosphate levels were closely monitored, and 2 weeks after pamidronate, biochemical bone markers were re-evaluated.Results: Responses of biochemical markers of bone resorption (N-telopeptide and 24-hour urinary calcium excretion) to pamidronate 90 mg were consistent with an antiresorptive effect, although less than that observed with a 30 mg/d 3 3-day pamidronate dosing regimen. The frequency of hypocalcemia was greater, and hypophosphatemia was less than the 30 mg/d 3 3-day pamidronate dosing regimen. Fever was more frequent (78%) with the 90-mg single dose of pamidronate compared with the 30 mg/d 3 3-day pamidronate dosing regimen (20%).Conclusions: Single-dose pamidronate 90 mg is effective at reducing biochemical markers of bone hyperresorption in patients with acute SCI but is associated with a greater incidence of fever compared with a 30 mg/d 3 3-day dosing regimen.

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Use of bone biochemical markers with dual-energy x-ray absorptiometry for early determination of bone loss in persons with spinal cord injury

Cited by 77 publications

References 27 publications

Evaluation of Bone Mineral Density in Patients With Spinal Cord Injury

Evaluation of Bone Mineral Density in Patients With Spinal Cord Injury

Decreased bone turnover with balanced resorption and formation prevent cortical bone loss during disuse (hibernation) in grizzly bears (Ursus arctos horribilis)

Effect of a Convenient Single 90-mg Pamidronate Dose on Biochemical Markers of Bone Metabolism in Patients With Acute Spinal Cord Injury

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