impact of type 2 diabetes mellitus on bone mass and bone turnover in postmenopausal females

Objectives: Osteoporosis is a prevalent bone disease characterized by a decrease in bone mass and altered bone architecture leading to increased fracture risk. The present study aimed at evaluation of the impact of type 2 diabetes mellitus [T[2]DM] on bone mass and the status of bone turnover in postmenopausal females

Methodology: In this cross sectional study we evaluated bone turnover and bone mineral density [BMD] in 39 postmenopausal T[2]DM and 25 non-diabetic postmenopausal females. We measured serum levels of calcium, phosphate, osteocalcin, bone specific alkaline phosphatase [BS-ALP] and urinary excretion of c-terminal telopeptide cross links/creatinine ratio while BMD was evaluated by dual energy x-ray absorptiometry [DEXA]

Results: We found significantly higher BMD values for lumbar spine in the patients' group, [0.828 g/cm[2] for the study group and 0.720 g/cm[2] for controls]. Levels of, BS-ALP, osteocalcin and c-terminal telopeptide cross links/creatinine ratio were significantly lower in the diabetic subjects [68.667U/L, 3.856 ng/ml and 4.157 mg/mg creatinine respectively in the patient group versus 94.640 UL, 7.472 ng/ml and 5.851 mg/mg creatinine in the control group]

Conclusion: Our results suggested protective effect of T2DM on bone mass of lumbar spine together with decreased bone turnover in postmenopausal females

Serum high sensitivity c-reactive protein as an approach to assess disease activity in hand osteoarthritis

Objective: To measure serum level of high sensitivity C-reactive protein [hs CRP] in patients with hand osteoarthritis [OA] and to correlate this level with the activity of the disease as detected by bone scintigraphy of both hands

Methodology: The study included 59 patients with hand OA, J6 non erosive OA [non EOA] and 23 erosive OA [EOA]. All patients were subjected to full medical history taking, thorough general clinical examination and clinical examination of hand joints, plain x-ray and bone scintigraphy of both hands. Serum level of hs CRP was measured by particle enhanced immunoturbidimetric method

Results: Serum level of hs CRP was significantly higher in patients with EOA [6. 74 +/- 0.52 mg/L] than in non EOA patients [5.38 +/- 0.58 mg/L]. There was a statistically highly significant difference between both groups as regards the number of scintigraphically positive joints. There was also a significant correlation between hs CRP and the number of clinically affected joints within each group. The correlation between hs CRP and scintigraphically affected joint count was highly significant in EOA patients only. The radiological joint count did not correlate with hs CRP in either group

Conclusion: Higher serum level of hs CRP in EOA may indicate the presence of an inflammatory element in this type of OA. The positive correlation between the level of hs CRP and the count of scintigraphically affected hand joints in EOA demonstrates that it can be used as a feasible test to assess disease activity

Evidence of cerebral hypoperfusion with [99m]tc HMPAO SPECT in Egyptian scleroderma patients

The aim of this study was to investigate regional cerebral blood flow [rCBF] with 99mTc-hexamethyl-propylenamine oxine [HMPAO] single photon emission computed tomography [SPECT] in a group of 22 patients affected with systemic sclerosis [SSc]. The SPECT findings were correlated with clinical data and MRI whenever possible. The study was conducted on 22 Egyptian SSc patients in comparison to ten healthy age-matched controls. Subjects affected with concomitant diseases that might interfere with the interpretation of the SPECT results were excluded. SPECT findings were correlated with clinical data, magnetic resonance imaging [MRI] of the brain and magnetic resonance angiography if available. Twelve SSc patients [54.5%] showed cerebral hypoperfusion, focal in 8 [66.7%] patients and diffuse hypoperfusion in 4 [33.3%] patients at the SPECT analysis. MRI was available in 15 patients and was shown to be altered in five of them [33.3%]. Magnetic resonance angiography [MRA] was normal in those five patients except one. No significant differences were found between the group of SSc patients showing hypoperfusion and those showing a normal SPECT scan regarding age, the duration of disease and damage of other organs typically involved in the disease. Focal or diffuse cerebral hypoperfusion was found with SPECT in more than half of the neurologically asymptomatic SSc patients. SPECT was more sensitive in reflecting changes of cerebral blood flow than MRI. The hypoperfusion was not linked to ageing and possibly reflects the cerebral location of the microangiopathic process characterizing the disease