Study of procollagen type1 nitrogenous propeptides (P1NP) in reproductive female.

A study of 109 female volunteers in good health and reproductive life, the mean age was 38.5 years, the volunteers had no intake of any kind of medicine before blood examination. The mean value of PINP is 44.57 ng/ml, standard deviation= 19.91, standard error= 1.9 with 95% confident interval = 40.79 to 48.35 ng/ml The PINP is a bone formation marker which is secreted by osteoblast, the advantage of the present study was helping the evaluation of bone status after bone forming agents therapy. In addition PINP showed the status of bone turnover when compared to bone resorption marker (CTx).

Clinical study of efficacy of hydroxyapatite.

The cleaved part of collagen during collagen formation was secreted into the circulation. The present study used this remnant part of collagen called procollagen type 1 propeptide at carboxyl terminal (PICP) as a bone formation marker Clinical study of efficacy of hydroxyapatite tablet (800 mg) in 47 menopausal women with bone resorption marker, (CTx) below 0.330 ng/ml. and their general condition is healthy. All cases were free of medication at least one month before the present study. After one month, the mean of PICP was 1452.28 ng/ml SD = 625.58 which is significantly higher than the mean of baseline control, 930.98 ng/ml SD=477.44 (p=0.0001).

Application of Gabapentin in Thai women with menopausal syndrome.

Application of 100 mg. three times a day of Gabapentin group, 70 women to relieve menopausal syndrome with the following symptoms:Paresthesia,sweating, hot flushes in a comparative study with the amitriptyline group, 52 women 10 mg once daily. Analysis of data was done by Chi square which assumed that the Gabapentin is superior to amitripyline as accept alternative hypothesis (Ha) and other reject null hypothesis(H0) assumed both have the same action. The result of Chi square showed that the value of calculated Chi square (39.32) is higher than Table Chi square (6.63) at p < 0.01 so the authors have to accept that Ha means that Gabapentin therapy is more significantly effective than amitripyline(p < 0.01). In addition, the present study showed that the number need to treat (NNT) of Gabapentin =2.

Serum concentration of undercarboxylated osteocalcin and the risk of osteoporosis in thai elderly women.

The elevation of undercarboxylated osteocalcin (ucOC) means vitamin K insufficiency is significantly increased in elderly women, and is associated with high skeletal turnover, low BMD, and increased risk of osteoporotic fracture. The objective of the present study was to find out the level of ucOC and the prevalence of vitamin K deficiency in elderly Thai women. The upper limit of normal premenopausal ucOC level was 2.314 ng/ml, represented the cut-off level for vitamin K deficiency, 39.1% of elderly women had serum ucOC concentration above this level. Women with high serum ucOC level had a significantly lower BMD of ultradistal radius, distal 1/3 of radius and 25(OH)D level, higher serum PTH and alkaline phosphatase activity than women with a normal ucOC (p<0.05). Serum ucOC was correlated positively with PTH (r = 0.411, p< 0.001), modest negatively with serum 25(OH)D (r = -0.17, p= 0.013). The ucOC level of urbanized elderly was higher than that of rural elderly. It was concluded that vitamin K deficiency is one of the risks of osteoporosis with high prevalence in the Thai elderly especially urbanized ones, the supplement of vitamin K should be recommended in Thai osteoporotic patients especially the urbanized elderly.

Level of undercarboxylated osteocalcin in reproductive Thai females.

Osteocalcin is a vitamin K dependent protein requiring vitamin K as a cofactor for the enzyme gamma glutamyl carboxylase which converts the glutamate residues at 17, 21, 24 position of the molecule into gamma carboxyglutamate or Gla residues.The carboxylation makes immature osteocalcin or undercarboxylated osteocalcin (ucOC) into mature osteocalcin which enhances calcium binding in bone. The level of undercarboxylated osteocalcin is recognized as a marker of vitamin K2 bone.The level of undercarboxylated osteocalcin is recognized as a marker of vitamin K2 in blood necessary for this process. Mature osteocalcin has a higher affinity for hydroxyapatite than undercarboxylated osteocalcin. Foreign studies have shown that ucOC level is increased in elderly women and postmenopausal women in comparison with young, healthy, reproductive women and level of ucOC is also the marker to predict the risk of hip fracture. The standard value of undercarboxylated osteocalcin in Thai women is not available. The aim of the present study was to find the level of ucOC in reproductive Thai females. 357 healthy female volunteers who had regular menstruation, 20-50 years of age, average age 38.5 years old. The volunteers had no intake of any kind of medicine affecting bone metabolism before blood examination. The mean value of undercarboxylated osteocalcin is 2.69 ng/ml, median is 2.10_ng/ml standard deviation = 2.02,_standard error = 0.107 with 95% confident interval = 2.485 to 2.906 ng/ml. In the authors previous pilot study in elderly and postmenopausal women, the authors found that the mean of ucOC in Thai elderly and postmenopausal women was higher than that of reproductive women.

Monitoring of Risedronate by biochemical bone markers in clinical practice.

The study of trend of Risedronate 10 mg/day in menopausal women with a high level of resorptive bone marker (Betacrosslaps, CTx) by the following bone markers:Bone alkaline phosphatase (formation marker) total alkaline phosphatase (TAlP), NMID osteocalcin, undercarboxylated osteocalcin (UcOC) and procollagen type 1 carboxyl propeptides (PICP). Risedronate does not suppress bone resorption deeply that enhances the bone recovers quickly after withdrawal. The level of undercarboxylated osteocalcin was increased after one year of treatment; it may be a sign of vitamin K2 deficiency. The bone alkaline phosphatase was decreased at the end of 12 months and Procollagen type 1 carboxyl propeptides (PICP) of twelfth month changed significantly compared to the sixth months of treatment (p=0.001) The once week 70 mg/week group also changed of CTx the same as daily dose group.