Effects of a 20-week concurrent training program on bone metabolism in elderly women / Efecto de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores

The present study evaluated the effect of a 20-week concurrent training program on bone metabolism in elderly women. The sample consisted of 51 elderly women living in the municipality of Muriaé (MG), distributed into two groups: a concurrent training group (CTG = 25), with an average age of 69.44 ± 6.82 years, and a control group (CG = 26), with mean age of 68.30 ± 6.34 years. Biophysical parameters were determined based on weight, height and body mass index. Bone metabolism was assessed by collecting second-morning urine samples before and after intervention to analyze levels of the biochemical marker deoxypyridinoline (DPD), which quantifies bone resorption. Results: The results showed a post-intervention decline in DPD content in the GTC when compared to controls (p = 0.007) and an improvement in the variables weight, BMI and DPD between the GTC and GC (p = 0.000). Conclusion: Concurrent training was efficient in improving bone metabolism in the elderly population studied.

El presente estudio evaluó los efectos de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores. La muestra fue compuesta por 51 mujeres adultas mayores, residentes en el municipio de Muriaé (MG), voluntarias, distribuidas en dos grupos, un grupo participó en entrenamiento concurrente (GTC=25), con una edad media de 69,44±6,82 años y un grupo control (GC=26) con una media de 68,30±6,34 años. Los parámetros biofísicos se determinaron por medio del peso corporal, la estatura e índice de masa corporal. Para la evaluación del metabolismo óseo, se realizó la recolección de la orina matinal en el pre y post-test, utilizando como reactivo el marcador bioquímico de deoxipiridinolina (DPD) que cuantifica la reabsorción ósea. Los resultados mostraron una reducción en la concentración de DPD en el GTC cuando se compararon los grupos (p = 0,007) y la mejora de las variables, peso corporal, IMC y DPD entre el GTC y el GC en el post-test (p = 0,000). Se percibe que el entrenamiento concurrente, para las mujeres adultas mayores fue eficiente en la mejoría de las condiciones de salud del metabolismo óseo.

Effect of low level laser therapy on local bone resorption during orthodontic treatment: a randomized controlled trial / Efecto del laser terapéutico en la reabsorción osea local durante tratamientos de ortodoncia: un ensayo clínico aleatoriamente controlado

The aim of this study was to assess whether the application of low-level laser therapy (LLLT) during the first stage of orthodontic treatment has an effect on local bone resorption and is detectable at the systemic level by measuring deoxypyridinoline levels (Pyrilinks) in urine. This was a randomized (1:1), double-blind, active-controlled, parallel-group trial. 28 adult patients who were going to start orthodontic treatment were randomly divided into the control group (n: 13) and the experimental group (n: 15), the latter of which received LLLT. All of the subjects underwent testing of urine samples: the first one on the day before the beginning of orthodontic treatment (T0), and the second one 5 days after bracket placement to measure Pyrilinks values (Dpd/Cr) in urine. Group differences were evaluated with Student's paired t-test. At the beginning of the study, the Pyrilinks were in the normal range for 53.57 % of the patients, and 46.43 % had elevated values according to the normal ranges. Only taking into account the normal values at (T0), the average Pyrilinks for control group (T0) were 5.75± 1.20 nM/mM, (T1): 6.02±3.00 nM/mM. For experimental group, (T0) was 5.71± 0.72, and it was 6.63± 0.73 in (T1).There were no significant differences in the Pyrilinks changes. (p= 0.75). In the experimental group levels raised statistically significant (p = 0.009). LLLT on patients starting orthodontic treatment with normal Pyrilinks levels have a statistically significant increment on their levels 5 days post irradiation.

El objetivo de este trabajo fue evaluar si la aplicación de la terapia láser de bajo nivel (TLBN) durante la primera etapa del tratamiento ortodóncico tiene un efecto sobre la resorción ósea local y es detectable a nivel sistémico midiendo los niveles de desoxipiridinolina en la orina. Se trató de un ensayo aleatorizado (1:1), doble ciego, controlado de forma activa y paralelo. 28 pacientes adultos que iban a iniciar el tratamiento de ortodoncia se dividieron al azar en el grupo control (n: 13) y el grupo experimental (n: 15), el último de los cuales recibió TLBN. Todos los sujetos fueron sometidos a pruebas de muestras de orina: la primera en el día anterior al inicio del tratamiento ortodóncico (T0) y la segunda 5 días después de la colocación del bracket para medir los valores de Pyrilinks (Dpd / Cr) en la orina. Las diferencias grupales se evaluaron con la prueba t de Student pareada. Al inicio del estudio, los Pyrilinks estaban en el rango normal para 53,57 % de los pacientes, y 46,43 % tenían valores elevados según los rangos normales. Sólo teniendo en cuenta los valores normales en (T0), los Pyrilinks medios para el grupo de control (T0) fueron 5,75 ± 1,20 nM / mM, (T1): 6,02 ± 3,00 nM / mM. Para el grupo experimental, (T0) fue de 5,71 ± 0,72, y fue de 6,63 ± 0,73 en (T1). No hubo diferencias significativas en los cambios de Pyrilinks. (P = 0,75). En el grupo experimental los niveles aumentaron estadísticamente (p = 0,009). LLLT en los pacientes que comienzan el tratamiento ortodóncico con niveles normales de Pyrilinks tienen un incremento estadísticamente significativo en sus niveles 5 días después de la irradiación.

High dietary calcium intake decreases bone mobilization during pregnancy in humans / Alto consumo de calcio en la dieta, disminuye la movilización ósea durante el embarazo en seres humanos

Calcium metabolism of the mother is modified during pregnancy because of the mineralization of the fetus skeleton. OBJECTIVE: To evaluate the association of calcium intake and bone demineralization during pregnancy. MATERIAL AND METHODS: At each trimester of pregnancy a validated food frequency intake questionnaire was administered to assess individual daily calcium intake in a cohort of 206 pregnant women, residents of Mexico City. Samples of urine were collected to measure levels of the cross-linked N-telopeptide of type I collagen (NTx), which is a biomarker of bone resorption. The association between calcium ingestion and bone resorption was analyzed using random effects models; non-linear associations were explored using generalized additive models. RESULTS: Progressive increases in NTx levels were observed during pregnancy; with mean and standard deviation (SD) values during the first, second and third trimester of 76.50 (SD=38), 101.02 (SD=48.86) and 144.83 (SD=61.33) nmol BCE/mmol creatinine, respectively. Higher dietary calcium intake was associated with lower bone resorption (β=-0.015; p<0.05). The association between age and NTx showed a non-linear trend with an inflexion point around 33 years: increase in maternal age below that point was associated with a decrease in bone resorption, while in older women the increase in age was associated with an increased resorption. CONCLUSIONS: Our results suggest that calcium ingestion, specifically from dairy products, reduces bone resorption during pregnancy. For each 300mg (a glass of milk) of calcium intake there is an estimated reduction in NTx level of 4.8 nmol BCE/mmol of creatinine (p<0.05).

El metabolismo de calcio es modificado durante el embarazo debido a la mineralización del esqueleto del feto. OBJETIVO: Evaluar la asociación entre la ingesta de calcio y la desmineralización ósea durante el embarazo. MATERIAL Y MÉTODOS: Se administró un Cuestionario de Frecuencia de Consumo de alimentos en cada trimestre del embarazo para evaluar el consumo de calcio en una cohorte de 206 mujeres residentes de la Ciudad de México. Se recolectaron muestras de orina para medir los niveles de N-telopéptido de colágeno tipo I (NTx), biomarcador de resorción. Se hicieron modelos de efectos aleatorios; se estudiaron asociaciones no lineales utilizando modelos aditivos generalizados. RESULTADOS: Se observó aumento progresivo en los niveles de NTx durante el embarazo. El mayor consumo de calcio se asoció con una menor resorción ósea (β=- 0.015, p<0,05). CONCLUSIONES: Los resultados sugieren que la ingestión de calcio reduce la resorción ósea en el embarazo.

Clinical application of biochemical markers of bone turnover / Marcadores bioquímicos da remodelação óssea

With the ageing population in most countries, disorders of bone and mineral metabolism are becoming increasingly relevant to every day clinical practice. Consequently, the interest in, and the need for effective measures to be used in the screening, diagnosis and follow-up of such pathologies have markedly grown. Together with clinical and imaging techniques, biochemical tests play an important role in the assessment and differential diagnosis of metabolic bone disease. In recent years, the isolation and characterisation of cellular and extracellular components of the skeletal matrix have resulted in the development of molecular markers that are considered to reflect either bone formation or bone resorption. These biochemical indices are non-invasive, comparatively inexpensive and, when applied and interpreted correctly, helpful tools in the diagnostic and therapeutic assessment of metabolic bone disease. This review provides an overview of the current evidence regarding the clinical use of biochemical markers of bone remodelling in bone disease, with an emphasis on osteoporosis.

Tendo em vista o crescimento da população idosa na maioria dos países, os distúrbios do metabolismo ósseo e mineral estão tornando-se cada vez mais relevantes na prática clínica diária. Conseqüentemente, o interesse e a necessidade de medidas efetivas para serem usadas no rastreamento, diagnóstico e seguimento de tais patologias vêm crescendo acentuadamente. Além da avaliação clínica e de técnicas de imagens, os marcadores bioquímicos desempenham um importante papel na avaliação e diagnóstico das doenças ósseas metabólicas. Recentemente, a melhor caracterização dos componentes intracelulares e extracelulares da matriz óssea resultou no desenvolvimento dos marcadores moleculares, os quais refletem tanto a formação como a reabsorção óssea. Estes marcadores bioquímicos não são invasivos e comparativamente são de mais baixo custo, e quando aplicados e interpretados corretamente são instrumentos úteis no diagnóstico e tratamento das doenças ósseas metabólicas. Esta revisão abordará evidências atuais, levando em consideração o uso clínico dos marcadores bioquímicos da remodelação óssea nas doenças metabólicas ósseas, com ênfase na osteoporose.

Effect of hormone replacement therapy on the bone mass and urinary excretion of pyridinium cross-links

CONTEXT: The menopause accelerates bone loss and is associated with an increased bone turnover. Bone formation may be evaluated by several biochemical markers. However, the establishment of an accurate marker for bone resorption has been more difficult to achieve. OBJECTIVE: To study the effect of hormone replacement therapy (HRT) on bone mass and on the markers of bone resorption: urinary excretion of pyridinoline and deoxypyridinoline. DESIGN: Cohort correlational study. SETTING: Academic referral center. SAMPLE: 53 post-menopausal women, aged 48-58 years. MAIN MEASUREMENTS: Urinary pyr and d-pyr were measured in fasting urine samples by spectrofluorometry after high performance liquid chromatography and corrected for creatinine excretion measured before treatment and after 1, 2, 4 and 12 months. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DEXA) before treatment and after 12 months of HRT. RESULTS: The BMD after HRT was about 4.7 percent (P < 0.0004); 2 percent (P < 0.002); and 3 percent (P < 0.01) higher than the basal values in lumbar spine, neck and trochanter respectively. There were no significant correlations between pyridinium cross-links and age, weight, menopause duration and BMD. The decrease in pyr and d-pyr was progressive after HRT, reaching 28.9 percent (P < 0.0002), and 42 percent (P < 0.0002) respectively after 1 year. CONCLUSIONS: Urinary pyridinoline and deoxypyridinoline excretion decreases early in hormone replacement therapy, reflecting a decrease in the bone resorption rate, and no correlation was observed with the bone mass evaluated by densitometry

Reference value for urinary deoxypyridinoline as a specific marker for measuring bone resorption in Thais.

In the next century, the increasing number of elderly and rising healthcare costs will bring with it metabolic bone problems, particularly osteoporosis. Deoxypyridinoline: Dpd in urine is a sensitive and specific marker for screening and monitoring of bone resorption in a variety of diseases affecting bone turnover and in risk groups especially in the postmenopause. The reference value among aging (21-60 years) of a healthy well defined group was studied by collecting the urine between 700-1000 hours and using the ELISA technique to determine the level of Dpd. The reference value of Dpd in 113 males and 298 females 1.3-6.5 and 1.5-6.9 nm Dpd/nm Creatinine respectively. The level of Dpd in females was significantly higher than in males at p < 0.028. However, the average value of deoxypyridinoline in postmenopause was higher than premenopause but not different at p = 0.05. There are many factors which influence the results so the overall reference value is only a guideline for screening in bone resorption.