ABSTRACT
OBJECTIVES: To define cut off values of bone mineral density (BMD), measured at different forearm sites by single photon absorptiometry, that discriminated postmenopausal women who have had fractures from those who have not, in order to provide an index of fracture risk for screening purposes. METHODS: BMD values were measured at distal third radius (DTR) and ultradistal radius (UDR) sites in two groups of postmenopausal women. Group 1 (n = 398) had not suffered fractures, and group 2 (n = 354) had appendicular fractures. Results were evaluated using receiver operating characteristic (ROC) curves. RESULTS: BMD values were significantly greater (p < 0.001) at both sites in group 1. Weight was lower in group 2 than in group 1 (p < 0.001). The BMD cut off value was 0.596 g/cm2 at DTR (sensitivity 63%, specificity 72%), and 0.310 g/cm2 at UDR (sensitivity 80%, specificity 80%). Values of area under ROC curves estimated for UDR were greater than for those DTR (p < 0.001). CONCLUSION: For screening purposes the BMD cut off value of 0.310 g/cm2 at the UDR may be useful in identifying women at high risk of fracture in an unselected postmenopausal population. BMD measured at UDR appeared to have a better predictive value than that at DTR.
Subject(s)
Bone Density , Fractures, Bone/etiology , Osteoporosis, Postmenopausal/diagnosis , Radius/physiopathology , Absorptiometry, Photon , Adult , Aged , Aged, 80 and over , Female , Fractures, Bone/physiopathology , Humans , Middle Aged , Osteoporosis, Postmenopausal/complications , Osteoporosis, Postmenopausal/physiopathology , ROC Curve , Risk Factors , Sensitivity and SpecificityABSTRACT
Circulating monomeric human calcitonin (hCT-M), parathyroid hormone, osteocalcin, alkaline phosphatase, urinary hydroxyproline, corrected serum calcium and inorganic phosphate were measured in 49 multiple myeloma patients and 49 matched controls. In patients with Durie-Salmon stage III disease hCT-M levels (16.9 +/- 5.8 ng/l, mean +/- SD) were significantly higher than controls and stage I patients (P less than 0.01), and correlated directly with corrected serum calcium (r = 0.74; P less than 0.001). In the same subgroup 14 of 15 patients had plasma hCT-M concentrations higher than the mean + 2SD of the controls. The calcium infusion test induced an increase of hCT-M in normocalcemic patients which was significantly greater in patients with advanced disease than in either controls or stage I patients. These findings suggest that hCT-M may be a biochemical index of bone resorption and disease activity in myeloma patients with osteolysis. In fact, its plasma concentrations were elevated in a large proportion (93%) of patients with severe bone involvement, and correlated directly with serum calcium. Moreover, our findings suggest the presence of a calcitonin-dependent calcium homeostatic mechanism, that protects against hypercalcemia due to tumor osteolysis.
Subject(s)
Biomarkers, Tumor/blood , Calcitonin/blood , Multiple Myeloma/blood , Osteolysis/blood , Adult , Aged , Aged, 80 and over , Alkaline Phosphatase/blood , Calcium/blood , Female , Humans , Hydroxyproline/urine , Male , Middle Aged , Multiple Myeloma/complications , Osteocalcin/blood , Osteolysis/etiologyABSTRACT
We measured serum tartrate-resistant acid phosphatase (TRAP) activity in 120 healthy subjects and 35 patients with multiple myeloma as well as urinary hydroxyproline excretion in the myeloma patients. Young subjects (0-18 years) showed higher TRAP levels (ANOVA p less than 0.01) compared with the other age classes due to the more active bone remodelling processes associated with growth. Myeloma patients with bone lytic lesions (MM+) showed higher serum TRAP values than controls (p less than 0.01). Hydroxyproline excretion was higher in MM+ patients but the difference between patients with and without bone lesions was not statistically significant. Our data suggest that serum TRAP activity may be a suitable, simple biochemical test to assess bone turnover in patients with multiple myeloma but that its clinical usefulness as a marker of bone resorption needs further evaluation.
Subject(s)
Acid Phosphatase/blood , Biomarkers, Tumor/blood , Bone Resorption/enzymology , Multiple Myeloma/enzymology , Neoplasm Proteins/blood , Adolescent , Adult , Aged , Aged, 80 and over , Bone Resorption/etiology , Bone Resorption/urine , Child , Child, Preschool , Female , Humans , Hydroxyproline/urine , Infant , Infant, Newborn , Male , Middle Aged , Multiple Myeloma/complications , Multiple Myeloma/urine , Predictive Value of TestsABSTRACT
Concentrations of total serum N-acetyl-neuraminic acid, carcinoembryonic antigen, ferritin, lactate dehydrogenase, creatine phosphokinase and total proteins were measured in both tumor drainage blood (axillary vein) and in peripheral blood taken during surgery from 44 breast cancer patients. There were no significant differences in any of the markers between mean values in peripheral and tumor drainage blood, between cancer patients and healthy controls, between patients with or without axillary lymph node metastases, or according to the site of breast mass.