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Kozior M, Demehin OA, Ryan MM, O’Connell S, Jakeman PM. The Temporal Change in Ionised Calcium, Parathyroid Hormone and Bone Metabolism Following Ingestion of a Plant-Sourced Marine Mineral + Protein Isolate in Healthy Young Adults. Nutrients 2024; 16:3110. [PMID: 39339710 PMCID: PMC11434972 DOI: 10.3390/nu16183110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2024] [Revised: 09/11/2024] [Accepted: 09/13/2024] [Indexed: 09/30/2024] Open
Abstract
Background: An increase in plant-sourced (PS) nutrient intake is promoted in support of a sustainable diet. PS dietary minerals and proteins have bioactive properties that can affect bone health and the risk of fracture. Methods: In a group randomised, cross-over design, this study evaluated the post-ingestion temporal pattern of change in arterialised ionised calcium (iCa), parathyroid hormone (PTH), C-terminal crosslinked telopeptide of type I collagen (CTX) and procollagen type 1 amino-terminal propeptide (P1NP) for 4 h following ingestion of a novel supplement (SUPP) containing a PS marine multi-mineral + PS protein isolate. A diurnally matched intake of mineral water was used as a control (CON). Results: Compared to baseline, the change in iCa concentration was 0.022 (95% CI, 0.006 to 0.038, p = 0.011) mmol/l greater in SUPP than CON, resulting in a -4.214 (95% CI, -8.244 to -0.183, p = 0.042) pg/mL mean reduction in PTH, a -0.64 (95% CI, -0.199 to -0.008, p = 0.029) ng/mL decrease in the biomarker of bone resorption, CTX, and no change in the biomarker of bone formation, P1NP. Conclusions: When used as a dietary supplement, or incorporated into a food matrix, the promotion of PS marine multi-mineral and PS protein isolates may contribute to a more sustainable diet and overall bone health.
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Affiliation(s)
- Marta Kozior
- Food, Diet and Nutrition, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
| | - Olusoji Aboyeji Demehin
- Marigot Research Centre, Sycamore Court, V92 N6C8 Tralee, Ireland; (O.A.D.); (M.M.R.); (S.O.)
| | - Michelle Mary Ryan
- Marigot Research Centre, Sycamore Court, V92 N6C8 Tralee, Ireland; (O.A.D.); (M.M.R.); (S.O.)
| | - Shane O’Connell
- Marigot Research Centre, Sycamore Court, V92 N6C8 Tralee, Ireland; (O.A.D.); (M.M.R.); (S.O.)
- Shannon Applied Technology Centre, Munster Technological University, Clash, V92 CX88 Tralee, Ireland
| | - Philip Michael Jakeman
- Food, Diet and Nutrition, Health Research Institute, University of Limerick, V94 T9PX Limerick, Ireland;
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Hansen D, Bressendorff I, Nordholm A, Møller AS, Klausen T, Jørgensen N. Circadian rhythm of markers of bone turnover in patients with chronic kidney disease. Bone Rep 2022; 16:101593. [PMID: 35663376 PMCID: PMC9157017 DOI: 10.1016/j.bonr.2022.101593] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Revised: 05/08/2022] [Accepted: 05/23/2022] [Indexed: 11/15/2022] Open
Abstract
Patients with chronic kidney disease (CKD) have a high risk of bone fractures. A circadian rhythmicity in turnover and mineralization of bone appears to be of importance for bone health. In CKD disturbances in the circadian rhythm of various functions has been demonstrated and indeed the circadian rhythm in the mineral metabolism is disturbed. The aim of the present study was to compare the circadian rhythm of bone turnover markers in ten patients with CKD to ten healthy controls. Bone turnover markers (C-terminal telopeptide of type I collagen, tartrate-resistant acid phosphatase 5b, N-terminal propeptide of type I procollagen, bone alkaline phosphatase and osteocalcin) were measured every third hour for 24 h. All bone turnover markers displayed a significant circadian rhythm in both groups and there were no significant differences in the rhythmicity between the two groups (no group*time interaction). As expected, due to the reduced renal clearance, the overall level of C-terminal telopeptide of type I collagen and osteocalcin was higher in CKD compared to the healthy controls. The present study suggests that disturbances in the circadian rhythm of bone turnover do not explain the metabolic bone disease and increased risk of fractures in CKD.
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Affiliation(s)
- D. Hansen
- Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Denmark
| | - I. Bressendorff
- Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - A. Nordholm
- Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
- Department of Nephrology, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Astrid Sand Møller
- Department of Nephrology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - T.W. Klausen
- Department of Hematology, Copenhagen University Hospital - Herlev and Gentofte, Copenhagen, Denmark
| | - N.R. Jørgensen
- Institute of Clinical Medicine, University of Copenhagen, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital – Rigshospitalet Glostrup, Copenhagen, Denmark
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3
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Circadian control of the secretory pathway maintains collagen homeostasis. Nat Cell Biol 2020; 22:74-86. [DOI: 10.1038/s41556-019-0441-z] [Citation(s) in RCA: 92] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 11/22/2019] [Indexed: 12/30/2022]
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Temporal Change in Biomarkers of Bone Turnover Following Late Evening Ingestion of a Calcium-Fortified, Milk-Based Protein Matrix in Postmenopausal Women with Osteopenia. Nutrients 2019; 11:nu11061413. [PMID: 31234587 PMCID: PMC6627915 DOI: 10.3390/nu11061413] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/18/2019] [Accepted: 06/19/2019] [Indexed: 11/16/2022] Open
Abstract
The diurnal rhythm of bone remodeling suggests nocturnal dietary intervention to be most effective. This study investigated the effect of bedtime ingestion of a calcium-fortified, milk-derived protein matrix (MBPM) or maltodextrin (CON) on acute (0–4 h) blood and 24-h urinary change in biomarkers of bone remodeling in postmenopausal women with osteopenia. In CON, participants received 804 ± 52 mg calcium, 8.2 ± 3.2 µg vitamin D and 1.3 ± 0.2 g/kg BM protein per day. MBPM increased calcium intake to 1679 ± 196 mg, vitamin D to 9.2 ± 3.1 µg and protein to 1.6 ± 0.2 g/kg BM. Serum C-terminal cross-linked telopeptide of type I collagen (CTX) and procollagen type 1 amino-terminal propeptide (P1NP), and urinary N-telopeptide cross-links of type I collagen (NTX), pyridinoline (PYD) and deoxypyridinoline (DPD) was measured. Analyzed by AUC and compared to CON, a −32% lower CTX (p = 0.011, d = 0.83) and 24% (p = 0.52, d = 0.2) increase in P1NP was observed for MBPM. Mean total 24 h NTX excreted in MBPM was −10% (p = 0.035) lower than CON. Urinary PYD and DPD were unaffected by treatment. This study demonstrates the acute effects of bedtime ingestion of a calcium-fortified, milk-based protein matrix on bone remodeling.
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Redmond J, Fulford AJ, Jarjou L, Zhou B, Prentice A, Schoenmakers I. Diurnal Rhythms of Bone Turnover Markers in Three Ethnic Groups. J Clin Endocrinol Metab 2016; 101:3222-30. [PMID: 27294326 PMCID: PMC4971334 DOI: 10.1210/jc.2016-1183] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
CONTEXT Ethnic groups differ in fragility fracture risk and bone metabolism. Differences in diurnal rhythms (DRs) of bone turnover and PTH may play a role. OBJECTIVE We investigated the DRs of plasma bone turnover markers (BTMs), PTH, and 1,25(OH)2D in three groups with pronounced differences in bone metabolism and plasma PTH. PARTICIPANTS Healthy Gambian, Chinese, and white British adults (ages 60-75 years; 30 per country). INTERVENTIONS Observational study with sample collection every 4 hours for 24 hours. MAIN OUTCOMES Levels of plasma C-terminal telopeptide of type I collagen, procollagen type-1 N-propeptide, N-mid osteocalcin, bone alkaline phosphatase, PTH, and 1,25-dihydroxyvitamin D were measured. DRs were analyzed with random-effects Fourier regression and cross-correlation and regression analyses to assess associations between DRs and fasting and 24-hour means of BTMs and PTH. RESULTS Concentrations of BTMs, PTH, and 1,25-dihydroxyvitamin D were higher in Gambians compared to other groups (P < .05). The DRs were significant for all variables and groups (P < .03) and were unimodal, with a nocturnal peak and a daytime nadir for BTMs, whereas PTH had two peaks. The DRs of BTMs and PTH were significantly cross-correlated for all groups (P < .05). There was a significant positive association between C-terminal telopeptide of type I collagen and PTH in the British and Gambian groups (P = .03), but not the Chinese group. CONCLUSIONS Despite ethnic differences in plasma BTMs and PTH, DRs were similar. This indicates that alteration of rhythmicity and loss of coupling of bone resorption and formation associated with an elevated PTH in other studies may not uniformly occur across different populations and needs to be considered in the interpretation of PTH as a risk factor of increased bone loss.
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Affiliation(s)
- Jean Redmond
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Anthony J Fulford
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Landing Jarjou
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Bo Zhou
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Ann Prentice
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
| | - Inez Schoenmakers
- Medical Research Council (MRC) Human Nutrition Research (J.R., A.P., I.S.), Cambridge CB1 9NL, United Kingdom; MRC Keneba (A.J.F., L.J., A.P.), Banjul, The Gambia; MRC International Nutrition Group (A.J.F.), London School of Hygiene & Tropical Medicine, London WC1E 7HT, United Kingdom; and Department of Public Health (B.Z.), Shenyang Medical College, Shenyang 110034, People's Republic of China
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Bahijri SM, Ajabnoor GM, Borai A, Al-Aama JY, Chrousos GP. Effect of Ramadan fasting in Saudi Arabia on serum bone profile and immunoglobulins. Ther Adv Endocrinol Metab 2015; 6:223-32. [PMID: 26445645 PMCID: PMC4579416 DOI: 10.1177/2042018815594527] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Each year Muslims fast from dawn to sunset for 1 month (Ramadan). In Saudi Arabia, the sleep-wake cycle during Ramadan is severely disturbed and is associated with abolition of the circadian cortisol rhythm, exposing Saudis to continuously increased cortisol levels, which may influence the immune response. In addition to cortisol, sleep and fasting affect the secretion of parathyroid hormone (PTH) and hence bone metabolism. METHODS Our objective was to investigate the effect of Ramadan type fasting on secretory patterns of PTH, markers of bone metabolism, and serum immunoglobulins. Blood samples from healthy young volunteers were collected at 9 a.m. and 9 p.m. (± 1 hour) before (Shaban) and 2 weeks into Ramadan. Calcium, phosphorus, magnesium, albumin, alkaline phosphatase, 25-OH vitamin D, intact PTH (iPTH), and immunoglobulin (Ig) A, M and G were measured. RESULTS During Ramadan, evening-adjusted calcium was higher (p = 0.036) and phosphate lower (p < 0.001) than the corresponding morning value. Moreover, the Ramadan mean morning phosphate was higher and the evening level lower was than Shabaan values (p = 0.010 and p <0.001, respectively), while mean iPTH level was decreased compared with the morning value (p = 0.001), and the evening mean during Shabaan (p = 0.029). Mean IgG concentration was significantly lower during Ramadan (p = 0.003 and p = 0.021 for morning and evening, respectively). CONCLUSIONS Changes in dietary practices during Ramadan modulated PTH secretion to a pattern which might be beneficial to bone health. Combined effects of fasting and disturbed sleep led to a noted decrease in IgG level. Therefore, a possible beneficial effect of fasting on bone turnover is combined with decreased immune response.
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Affiliation(s)
- Suhard M. Bahijri
- Department of Clinical Biochemistry, Faculty of Medicine, Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, PO Box 4873, Jeddah 21412, Saudi Arabia
| | - Ghada M. Ajabnoor
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Anwar Borai
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, King Abdulaziz Medical City, Jeddah, Saudi Arabia
| | - Jumana Y. Al-Aama
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- Department of Genetic Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
- Princess Al-Jawhara Al Brahim Center of Excellence in Research of Hereditary Disorders
| | - George P. Chrousos
- Saudi Diabetes Research Group, King Fahd Medical Research Center, King Abdulaziz University, Jeddah, Saudi Arabia
- First Department of Pediatrics, University of Athens Medical School, ‘Aghia Sophia’ Children’s Hospital, Athens, Greece
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Jenkins N, Black M, Paul E, Pasco JA, Kotowicz MA, Schneider HG. Age-related reference intervals for bone turnover markers from an Australian reference population. Bone 2013; 55:271-6. [PMID: 23603243 DOI: 10.1016/j.bone.2013.04.003] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2012] [Revised: 03/22/2013] [Accepted: 04/04/2013] [Indexed: 11/17/2022]
Abstract
BACKGROUND This study was performed to establish age-related serum reference intervals for procollagen type I N-propeptide (P1NP) and type I collagen C-telopeptide (CTx) in the Australian population. METHODS Fasting sera from 1143 males (mean age 60 years; range 20-97 years) and 1246 females (mean age 53 years; range 20-93 years) who participated in the Geelong Osteoporosis Study were analysed for CTx and P1NP using the automated Roche Modular Analytics E170 analyser. RESULTS Optimal age-related reference intervals were based on the central 90% of the distribution. The male CTx reference interval was divided into three age groups. For men aged 25 to 40 years, the interval was 170-600 ng/L; 40 to 60 years, the interval was 130-600 ng/L; and for men aged greater 60 years the interval was 100-600 ng/L. For P1NP the male reference interval was 15-80 μg/L for men aged between 25 to 70 years. In men greater than 70 years of age values were higher possibly due to increased bone turnover. High values are frequently seen for both CTx and P1NP in males aged younger than 25 years. This is probably due to bone growth that is not completely finalised. The female CTx reference interval was divided into four age groups. For women aged less than 30 years, the interval was 150-800 ng/L; 30-39 years, the interval was 100-700 ng/L; 40-49 years, the interval was 100-600 ng/L; and for women aged 50 years or more the interval was 100-700 ng/L. The female P1NP reference interval was divided into four age groups. For women aged less than 30 years, the interval was 25-90 μg/L; 30-39 years, the interval was 15-80 μg/L; 40-49 years, the interval was 15-60 μg/L; and for women aged 50-69 years the interval was 15-75 μg/L. In women greater than 70 years of age values were higher possibly due to increased bone turnover. CONCLUSION Values obtained from this large study provide sound age-related reference intervals for serum P1NP and CTx values in the Australian population.
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Affiliation(s)
- N Jenkins
- Clinical Biochemistry Unit, Alfred Pathology Service, Melbourne, Australia.
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8
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Coleman R, Brown J, Terpos E, Lipton A, Smith MR, Cook R, Major P. Bone markers and their prognostic value in metastatic bone disease: clinical evidence and future directions. Cancer Treat Rev 2008; 34:629-39. [PMID: 18579314 DOI: 10.1016/j.ctrv.2008.05.001] [Citation(s) in RCA: 95] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 05/02/2008] [Indexed: 12/31/2022]
Abstract
BACKGROUND Bone metastases are prevalent among patients with advanced solid tumors. Metastatic bone disease alters bone homeostasis, resulting in reduced bone integrity and, consequently, increased skeletal complications. Biochemical markers of bone metabolism may meet an unmet need for useful, noninvasive, and sensitive surrogate information for following patients' skeletal health. MATERIALS AND METHODS Data for this review were identified by searches of PubMed, and references from relevant articles using the search terms "bone markers" or individual bone marker nomenclature, "cancer," and "metastases." Abstracts and reports from meetings were included only when they related directly to previously published work. Only papers published in English between 1990 and 2007 were included. RESULTS Recent retrospective analyses with bisphosphonates, and particularly with zoledronic acid, have shown significant correlations between biochemical markers of bone metabolism levels and clinical outcomes, especially for bone resorption markers. Clinical results for biochemical markers of bone formation and resorption and other emerging markers of bone metabolism including bone sialoprotein, receptor-activator of nuclear factor-kappaB ligand, osteoprotegerin, and other markers are presented. However, biochemical markers of bone metabolism are not yet an established surrogate endpoint for treatment efficacy. CONCLUSIONS Biochemical markers of bone metabolism may allow physicians to identify which patients with metastatic bone disease are at high risk for skeletal-related events or death and who may be responding to therapy. Prospective randomized clinical trials are underway to further assess the utility of markers of bone metabolism in patients with bone metastases.
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Affiliation(s)
- Robert Coleman
- Academic Unit of Clinical Oncology, Cancer Research Centre, Weston Park Hospital, Sheffield S10 2SJ, UK.
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Jackson BF, Blumsohn A, Goodship AE, Wilson AM, Price JS. Circadian variation in biochemical markers of bone cell activity and insulin-like growth factor-I in two-year-old horses. J Anim Sci 2004; 81:2804-10. [PMID: 14601884 DOI: 10.2527/2003.81112804x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Studies in humans have found circadian changes to be one of the most important sources of controllable preanalytical variability when evaluating bone cell activity using biochemical markers. It remains unclear whether similar circadian changes influence bone marker concentrations in the horse. The aim of this study was to characterize changes in serum concentrations of three biochemical markers of bone cell activity over a 24-h period in six 2-yr-old Thoroughbred mares, and to determine circadian variability in IGF-I, which regulates bone turnover. Three bone markers were measured in serum: osteocalcin, a marker of bone formation, the carboxy-terminal propeptide of type-I collagen (a marker of bone formation), and the carboxy-terminal telopeptide of type-I collagen (a marker of bone resorption). Data were analyzed using the cosinor technique, which fits a 24-h cycle to each dataset. A significant circadian rhythm was observed for osteocalcin (P = 0.028), with an estimated amplitude of 7.6% of the mean (95% confidence interval 1.3% to 16.3%), and an estimated peak time of 0900. However, the observed rhythm for the carboxy-terminal telopeptide of type-I collagen (amplitude = 7.4%) was not significant (P = 0.067), and there were no significant changes in concentrations of the carboxy-terminal propeptide of type-I collagen over the 24-h study period (P = 0.44). There was a small but significant circadian rhythm for IGF-I (P = 0.04), with an estimated amplitude of 3.4% (95% confidence interval 0.2 to 7.1%) and peak at 1730. Further studies are now required to determine the potential association between circadian changes in IGF-I and osteocalcin in the horse. Although no significant circadian variation was found in concentrations of the car-boxy-terminal propeptide of type-I collagen and the carboxy-terminal telopeptide of type-I collagen, this may in part be a result of the age of the animals that were still skeletally immature. Future studies should aim to determine whether these markers develop a circadian rhythm at a later age when growth is complete. In the meantime, consistency in time of sampling should continue to be considered best practice when measuring biochemical markers of bone turnover in the horse.
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Affiliation(s)
- B F Jackson
- Department of Veterinary Basic Sciences, The Royal Veterinary College, London NW1 0TU, UK
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Abstract
Routine assessment of the skeleton's response to disease and injury traditionally has consisted of plain-film radiography supplemented with advanced imaging techniques, such as computed tomography, magnetic resonance imaging, nuclear scintigraphy, and bone densitometry. Although these techniques provide increased sensitivity as compared with radiography, they still are limited by the fact that they can only document the net results of past skeletal activity. In contrast, serum and urinary biomarkers of bone formation and resorption provide near real-time information about bone cell activity. In this review, I describe the scientific rationale behind the use of these markers in humans and detail the efforts that have been made to adapt this technology to veterinary medicine and animal research. Commercial assay kits that are applicable to different animal species are described, and the potential limitations of the technology are discussed. The goal of this review is to provide clinical pathologists and researchers with the information needed to decide whether the use of bone markers is likely to be helpful and to select the most appropriate marker (or panel of markers) to answer a particular question.
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Affiliation(s)
- M J Allen
- Department of Orthopedic Surgery, State University of New York Upstate Medical University, Syracuse 13210, USA.
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11
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Qvist P, Christgau S, Pedersen BJ, Schlemmer A, Christiansen C. Circadian variation in the serum concentration of C-terminal telopeptide of type I collagen (serum CTx): effects of gender, age, menopausal status, posture, daylight, serum cortisol, and fasting. Bone 2002; 31:57-61. [PMID: 12110413 DOI: 10.1016/s8756-3282(02)00791-3] [Citation(s) in RCA: 217] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We examined the diurnal variation in serum concentration of C-terminal telopeptide of type I collagen (serum CrossLaps, sCTx) under various conditions. The studies included a total of 100 individuals. Blood samples were collected every 3 h over 27 h. sCTx levels varied over the 24 h with a maximum at about 05:00 in the morning and a minimum of about 14:00 in the afternoon. The variation had a magnitude of about +/-40% around the 24 h mean and was similar in premenopausal and early and late postmenopausal women with normal and low bone mass. Furthermore, it was not affected by 5 days of bed-rest, by absence of a normal diurnal variation in cortisol production, or by absence of a normal light cycle (blindness). Nasal salmon calcitonin, an antiresorptive drug used for treatment of osteoporosis, was not able to break the circadian pattern whether the treatment was administered in the morning or the evening. The only parameter that showed a pronounced influence on the circadian variation was fasting, which reduced the variation significantly to about one fourth. From a practical point of view the results of this study demonstrate that samples for sCTx should be taken in the fasting state.
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Affiliation(s)
- P Qvist
- Osteometer Biotech A/S, Herlev, Denmark
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12
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Bjarnason NH, Henriksen EEG, Alexandersen P, Christgau S, Henriksen DB, Christiansen C. Mechanism of circadian variation in bone resorption. Bone 2002; 30:307-13. [PMID: 11792602 DOI: 10.1016/s8756-3282(01)00662-7] [Citation(s) in RCA: 175] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The diurnal variation in bone resorption markers is poorly understood and may contain essential information about regulation of bone resorption. To explore the acute regulation of bone resorption we studied bone turnover in 14 postmenopausal women during a randomized, crossover, 24 h study of oral glucose tolerance test (OGTT), normal diet, or fasting. Whereas fasting counteracted variation in bone resorption, as measured by serum C-telopeptide fragments of collagen type 1 degradation (s-CTx), OGTT and normal diet induced a 50% reduction (p < 0.001) over 2 h. For OGTT, s-CTx reverted to baseline levels after 6 h, and for normal diet s-CTx remained suppressed during the afternoon and returned to baseline overnight. Repeated OGTT at 8:00 A.M. and 8:00 P.M. in nine postmenopausal women demonstrated that identical reductions in s-CTx could be obtained at both timepoints with an intermediate return to baseline between tests. A 2 h randomized, crossover study of OGTT and fasting in 23 men and premenopausal women similarly revealed a 50% decrease in s-CTx. A randomized, crossover 2 h study of insulin tolerance test compared with fasting in six men and premenopausal women demonstrated a 20%-30% decrease in s-CTx (p < 0.01-0.05). Nine hour follow-up of ten healthy individuals during a crossover experiment of OGTT, protein, and fat intake revealed a comparable 50% reduction in s-CTx, but distinct profiles of serum glucose and serum insulin. Bone resorption was reduced by intake of food, glucose, fat, and protein and counteracted by fasting, and this seems to have been be independent of age and gender. Both exogenous and endogenous insulin stimulation tests induced a reduction in bone resorption, but this was only partial when compared with the reduction observed during food intake.
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Affiliation(s)
- N H Bjarnason
- Center for Clinical and Basic Research, Ballerup, Denmark.
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13
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Schlemmer A, Hassager C, Alexandersen P, Fledelius C, Pedersen BJ, Kristensen IO, Christiansen C. Circadian variation in bone resorption is not related to serum cortisol. Bone 1997; 21:83-8. [PMID: 9213012 DOI: 10.1016/s8756-3282(97)00039-2] [Citation(s) in RCA: 40] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Serum osteocalcin, serum procollagen type I carboxyterminal propeptide (sPICP), and the urinary excretion of pyridinium crosslinks (biochemical markers of bone formation and resorption) all exhibit a circadian variation with a peak during the night. This study was performed to investigate the influence of the endogenous circadian rhythm in cortisol on the biochemical markers of bone turnover. Participants included 11 patients substituted with hydrocortisone due to either hypopituitarism (n = 7) or bilateral adrenalectomy (n = 4). Their daily tablet intake of hydrocortisone was divided in four equal doses in order to abrogate the known circadian variation in cortisol. 24 healthy postmenopausal women served as controls. The study design was performed over 24 h, with blood samples taken every 3 h, and urine collected in 3 h aliquots. Urinary pyridinium crosslinks (Pyr/ Cr, D-Pyr/Cr), serum osteocalcin (sOC), and serum PICP were measured. Patients without a circadian variation in cortisol had normal circadian variation in the urinary excretion of pyridinium crosslinks and sPICP, but no circadian rhythm in serum osteocalcin. We conclude that the etiology of the circadian rhythm in the biochemical markers of bone turnover is still unknown. This study indicates that the circadian variation in sOC can be controlled by the endogenous circadian variation in serum cortisol, whereas this hormone does not control the circadian variation in either the serum PICP or the urinary excretion in pyridinium crosslinks.
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Affiliation(s)
- A Schlemmer
- Center for Clinical and Basic Research, Ballerup, Denmark
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