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Tian Y, Ming J. The role of circadian rhythm in osteoporosis; a review. Front Cell Dev Biol 2022; 10:960456. [PMID: 36238690 PMCID: PMC9550872 DOI: 10.3389/fcell.2022.960456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/15/2022] [Indexed: 11/16/2022] Open
Abstract
Osteoporosis is characterized by a high incidence rate, with significant effects on people’s lives. The underlying mechanisms are complex, with no treatments for the condition. Recent studies have indicated that melatonin can be used to treat osteoporosis by promoting osteoblast proliferation and differentiation, and inhibiting osteoclast differentiation. Specifically, in vivo mechanisms are initiated by stabilizing biological rhythms in bone tissue. In healthy organisms, these biological rhythms are present in bone tissue, and are characterized by bone formation during the day, and bone resorption at night. When this rhythm is disrupted, osteoporosis occurs. Thus, taking appropriate medication at different times of the day could produce different effects on osteoporosis rhythms. In this review, we characterized these processes, and provided treatments and management strategies for individuals with osteoporosis.
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Salivary IGF-1 and Alkaline Phosphatase-Based Modeling for Skeletal Maturity Prediction in Orthodontic Patients. BIOMED RESEARCH INTERNATIONAL 2022; 2022:2390865. [PMID: 35097113 PMCID: PMC8799341 DOI: 10.1155/2022/2390865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 01/04/2022] [Indexed: 11/17/2022]
Abstract
Results A strong positive correlation was found between CA and cervical stages (r = 0.836, P < 0.001). Based on the regression model analysis, the model which combined IGF-1, ALP, and CA provided the best prediction at P < 0.001 with McFadden's pseudo R2 value of 0.552 for cervical stage prediction and 0.646 for growth phase prediction. In particular, its predictive ability for the prepubertal, pubertal, and postpubertal growth phases was 95%, 80%, and 90%, respectively. Conclusions A new model with the combination of salivary IGF-1 and ALP with CA can be used as a less invasive method to determine the cervical stage and also growth phase with high predictive ability in healthy subjects.
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Winter EM, Kooijman S, Appelman-Dijkstra NM, Meijer OC, Rensen PC, Schilperoort M. Chronobiology and Chronotherapy of Osteoporosis. JBMR Plus 2021; 5:e10504. [PMID: 34693186 PMCID: PMC8520066 DOI: 10.1002/jbm4.10504] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 03/31/2021] [Accepted: 04/10/2021] [Indexed: 12/31/2022] Open
Abstract
Physiological circadian (ie, 24-hour) rhythms are critical for bone health. Animal studies have shown that genes involved in the intrinsic molecular clock demonstrate potent circadian expression patterns in bone and that genetic disruption of these clock genes results in a disturbed bone structure and quality. More importantly, circulating markers of bone remodeling show diurnal variation in mice as well as humans, and circadian disruption by, eg, working night shifts is associated with the bone remodeling disorder osteoporosis. In this review, we provide an overview of the current literature on rhythmic bone remodeling and its underlying mechanisms and identify critical knowledge gaps. In addition, we discuss novel (chrono)therapeutic strategies to reduce osteoporosis by utilizing our knowledge on circadian regulation of bone. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Elizabeth M Winter
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands.,Department of Medicine, Center for Bone Quality Leiden University Medical Center Leiden The Netherlands
| | - Sander Kooijman
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
| | - Natasha M Appelman-Dijkstra
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands.,Department of Medicine, Center for Bone Quality Leiden University Medical Center Leiden The Netherlands
| | - Onno C Meijer
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
| | - Patrick Cn Rensen
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
| | - Maaike Schilperoort
- Department of Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine Leiden The Netherlands
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Walton JC, Walker WH, Bumgarner JR, Meléndez-Fernández OH, Liu JA, Hughes HL, Kaper AL, Nelson RJ. Circadian Variation in Efficacy of Medications. Clin Pharmacol Ther 2020; 109:1457-1488. [PMID: 33025623 DOI: 10.1002/cpt.2073] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 09/13/2020] [Indexed: 12/22/2022]
Abstract
Although much has been learned about circadian clocks and rhythms over the past few decades, translation of this foundational science underlying the temporal regulation of physiology and behavior to clinical applications has been slow. Indeed, acceptance of the modern study of circadian rhythms has been blunted because the phenomenology of cyclic changes had to counteract the 20th century dogma of homeostasis in the biological sciences and medicine. We are providing this review of clinical data to highlight the emerging awareness of circadian variation in efficacy of medications for physicians, clinicians, and pharmacists. We are suggesting that gold-standard double-blind clinical studies should be conducted to determine the best time of day for optimal effectiveness of medications; also, we suggest that time of day should be tracked and reported as an important biological variable in ongoing clinical studies hereafter. Furthermore, we emphasize that time of day is, and should be considered, a key biological variable in research design similar to sex. In common with biomedical research data that have been historically strongly skewed toward the male sex, most pharmaceutical data have been skewed toward morning dosing without strong evidence that this is the optimal time of efficacy.
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Affiliation(s)
- James C Walton
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - William H Walker
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Jacob R Bumgarner
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - O Hecmarie Meléndez-Fernández
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Jennifer A Liu
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Heather L Hughes
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Alexis L Kaper
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Randy J Nelson
- Department of Neuroscience, Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
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Bone turnover markers in serum but not in saliva correlate with bone mineral density. Sci Rep 2020; 10:11550. [PMID: 32665632 PMCID: PMC7360752 DOI: 10.1038/s41598-020-68442-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Accepted: 06/10/2020] [Indexed: 02/07/2023] Open
Abstract
Saliva was proposed as a diagnostic tool for systemic diseases. Here we determined the correlation of bone turnover markers in saliva, bone turnover markers in serum and bone mineral density in postmenopausal osteoporotic and healthy women. Forty postmenopausal osteoporotic and 40 age-matched healthy non-osteoporotic females were recruited for this case–control study. Serum and stimulated saliva levels of osteocalcin, N-terminal propeptide of type I collagen, bone-specific alkaline phosphatase and cross-linked-C-telopeptide of type I collagen were determined. Bone mineral density of the lumbar spine, proximal femur, and total hip were obtained. We show that osteocalcin and cross-linked-C-telopeptide of type I collagen (CTX) reached detectable levels in saliva while N-terminal propeptide of type I collagen and alkaline phosphatase were close or below the detection limit. Serum levels of bone turnover markers were significantly higher than saliva levels. Correlation analysis revealed a strong correlation of serum osteocalcin and, to a lesser extent, also serum CTX values with bone mineral density in lumbar spine, femoral neck, or total hip, respectively. There was, however, no significant correlation of bone mineral density with the respective bone turnover markers in saliva. There was a trend that saliva osteocalcin correlates with femoral neck (p = 0.16) or total hip (p = 0.06). There was also no association between serum and saliva bone turnover markers. This study reveals that saliva cannot replace the withdrawal of serum to evaluate bone metabolism.
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Clarke MW, Black LJ, Hart PH, Jones AP, Palmer DJ, Siafarikas A, Lucas RM, Gorman S. The challenges of developing and optimising an assay to measure 25-hydroxyvitamin D in saliva. J Steroid Biochem Mol Biol 2019; 194:105437. [PMID: 31352025 DOI: 10.1016/j.jsbmb.2019.105437] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 05/29/2019] [Accepted: 07/24/2019] [Indexed: 12/12/2022]
Abstract
Accurately detecting vitamin D deficiency (defined as concentration in blood of 25-hydroxyvitamin D (25(OH)D), <20 ng/mL) is important for both clinicians and researchers. Drawing blood may be difficult in some populations, such as infants and children. We thus explored the development of a method to measure 25(OH)D concentrations in saliva, using a liquid chromatography tandem mass spectrometry (LC-MS/MS) assay. Using 25(OH)D3 standards spiked into synthetic saliva, we generated a standard curve with high correlation (r = 0.999, Pearson's); the intra-assay and inter-assay variation were ≤3.2% and ≤13.2% (CV%), respectively. Passive collection of saliva via drooling into glass or polypropylene tubes yielded higher levels of 25(OH)D3 than chewing on a synthetic swab. Chewing gum for at least 4 min reduced saliva levels of 25(OH)D3. Differences in the levels of 25(OH)D3 in saliva between the passive drooling and stimulated swab-chewing methods were normalised by adjusting for measured levels of vitamin D binding protein in saliva. Freezing samples immediately, or after 24 h of refrigeration did not affect 25(OH)D3 levels. When saliva levels of 25(OH)D3 were averaged from samples collected daily for three consecutive days, for which an additional centrifugation step was performed after samples were defrosted (to remove mucin), there was a positive (but non-significant) correlation between 25(OH)D3 levels in saliva and serum (r = 0.57, p = 0.24, Pearson's) with significant correlations (r ≥ 0.88, p < 0.05) observed after further adjusting for saliva flow rate. The time of day of the collection made little difference to 25(OH)D3 levels measured in saliva. In conclusion, we have developed an LC-MS/MS assay that accurately measures saliva 25(OH)D3 levels, which correlated with serum levels. However, for a measurement that correlates with serum 25(OH)D it may be necessary to average results from saliva collected on three consecutive days, and adjust for differences in saliva flow rate. This would increase costs, and combined with the processing requirements for samples, could limit the applicability of this assay to large cohort and field studies.
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Affiliation(s)
- Michael W Clarke
- Metabolomics Australia, Centre for Microscopy, Characterisation and Analysis, University of Western Australia, Perth, Australia
| | - Lucinda J Black
- Telethon Kids Institute, University of Western Australia, Perth, Australia; School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Prue H Hart
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Anderson P Jones
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Debra J Palmer
- Telethon Kids Institute, University of Western Australia, Perth, Australia
| | - Aris Siafarikas
- Telethon Kids Institute, University of Western Australia, Perth, Australia; Department of Endocrinology and Diabetes, Perth Children's Hospital, Perth, Australia; Medical School, Division of Paediatrics, University of Western Australia, Perth, Australia; Institute for Health Research, University of Notre Dame, Fremantle, Australia
| | - Robyn M Lucas
- National Centre for Epidemiology and Population Health, Research School of Population Health, Australian National University, Canberra, Australian Capital Territory, Australia; Centre for Ophthalmology and Visual Science, University of Western Australia, Perth, Australia
| | - Shelley Gorman
- Telethon Kids Institute, University of Western Australia, Perth, Australia.
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St Hilaire MA, Rahman SA, Gooley JJ, Witt-Enderby PA, Lockley SW. Relationship between melatonin and bone resorption rhythms in premenopausal women. J Bone Miner Metab 2019; 37:60-71. [PMID: 29318392 DOI: 10.1007/s00774-017-0896-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 12/14/2017] [Indexed: 12/31/2022]
Abstract
Although evidence exists for a daily rhythm in bone metabolism, the contribution of factors such as melatonin levels, the light-dark cycle, and the sleep-wake cycle is difficult to differentiate given their highly correlated time courses. To examine these influences on bone resorption, we collected 48-h sequential urine samples under both ambulatory (8-h sleep:16-h wake) and constant routine (CR) (constant wake, posture, nutrition and dim light) conditions from 20 healthy premenopausal women. Urinary 6-sulphatoxymelatonin (aMT6s; ng/h) and the bone resorption marker amino-terminal cross-linked collagen I telopeptide (NTx; bone collagen equivalents nM/h) were assayed and fit by cosinor models to determine significant 24-h rhythms and acrophase. Most participants had significant 24-h aMT6s rhythms during both ambulatory and CR conditions (95 and 85%, respectively), but fewer had significant 24-h NTx rhythms (70 and 70%, respectively). Among individuals with significant rhythms, mean (± SD) aMT6s acrophase times were 3:57 ± 1:50 and 3:43 ± 1:25 h under ambulatory and CR conditions, respectively, and 23:44 ± 5:55 and 3:06 ± 5:15 h, respectively, for NTx. Mean 24-h levels of both aMT6s and NTx were significantly higher during CR compared with ambulatory conditions (p < 0.0001 and p = 0.03, respectively). Menstrual phase (follicular versus luteal) had no impact on aMT6s or NTx timing or 24-h levels. This study confirms an endogenous circadian rhythm in NTx with a night-time peak when measured under CR conditions, but also confirms that environmental factors such as the sleep-wake or light-dark cycles, posture or meal timing affects overall concentrations and peak timing under ambulatory conditions, the significance of which remains unclear.
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Affiliation(s)
- Melissa A St Hilaire
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue BLI-438, Boston, MA, 02115, USA.
- Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue BLI-438, Boston, MA, 02115, USA.
| | - Shadab A Rahman
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue BLI-438, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue BLI-438, Boston, MA, 02115, USA
| | - Joshua J Gooley
- Programme in Neuroscience and Behavioural Disorders, Duke-National University of Singapore Medical School, 8 College Road, Singapore, 169857, Singapore
| | - Paula A Witt-Enderby
- Division of Pharmaceutical, Administrative and Social Sciences, Duquesne University School of Pharmacy, 600 Forbes Avenue, Pittsburgh, PA, 15282, USA
| | - Steven W Lockley
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, 221 Longwood Avenue BLI-438, Boston, MA, 02115, USA
- Division of Sleep Medicine, Harvard Medical School, 221 Longwood Avenue BLI-438, Boston, MA, 02115, USA
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Emerging role of circadian rhythm in bone remodeling. J Mol Med (Berl) 2018; 97:19-24. [PMID: 30446776 DOI: 10.1007/s00109-018-1723-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 11/07/2018] [Accepted: 11/09/2018] [Indexed: 12/31/2022]
Abstract
The 24-h rhythm of behavioral and physiological processes is a typical biological phenomenon regulated by a group of circadian rhythm genes. Dysfunction of the circadian rhythm can cause a wide range of problems, such as cancer and metabolic diseases. In recent decades, increased understanding of the roles of circadian rhythm genes in the bone remodeling process have been documented, including osteoblastic bone formation, osteoclastic bone resorption, and osteoblast/osteoclast communication. A timely review of the current findings may help to facilitate the new field of circadian rhythmic bone remodeling research. Targeted pharmacological modulation of circadian rhythm genes is a possible therapeutic approach through which to overcome bone remodeling problems in the future.
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Insights into the Role of Circadian Rhythms in Bone Metabolism: A Promising Intervention Target? BIOMED RESEARCH INTERNATIONAL 2018; 2018:9156478. [PMID: 30363685 PMCID: PMC6180976 DOI: 10.1155/2018/9156478] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2018] [Accepted: 09/09/2018] [Indexed: 11/18/2022]
Abstract
Numerous physiological processes of mammals, including bone metabolism, are regulated by the circadian clock system, which consists of a central regulator, the suprachiasmatic nucleus (SCN), and the peripheral oscillators of the BMAL1/CLOCK-PERs/CRYs system. Various bone turnover markers and bone metabolism-regulating hormones such as melatonin and parathyroid hormone (PTH) display diurnal rhythmicity. According to previous research, disruption of the circadian clock due to shift work, sleep restriction, or clock gene knockout is associated with osteoporosis or other abnormal bone metabolism, showing the importance of the circadian clock system for maintaining homeostasis of bone metabolism. Moreover, common causes of osteoporosis, including postmenopausal status and aging, are associated with changes in the circadian clock. In our previous research, we found that agonism of the circadian regulators REV-ERBs inhibits osteoclast differentiation and ameliorates ovariectomy-induced bone loss in mice, suggesting that clock genes may be promising intervention targets for abnormal bone metabolism. Moreover, osteoporosis interventions at different time points can provide varying degrees of bone protection, showing the importance of accounting for circadian rhythms for optimal curative effects in clinical treatment of osteoporosis. In this review, we summarize current knowledge about circadian rhythms and bone metabolism.
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Janovszky Á, Vereb T, Szabó A, Piffkó J. [Current approaches for early detection and treatment of medication-related osteonecrosis of jaw]. Orv Hetil 2014; 155:1960-6. [PMID: 25434516 DOI: 10.1556/oh.2014.30046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Owing to the increased life expectancy, the incidence of rheumatoid disorders and oncologic cases with bone metastasis has dramatically increased. Despite the beneficial effects of the applied antiresorptive and antiangiogenic drugs (e.g. bisphosphonates), serious side effects such as jaw osteonecrosis may also develop. The aim of the authors was to summarize present knowledge about the possibilities of prevention and treatment in medication-related osteonecrosis of the jaw. Based on literature data, currently used detection methods for medication-related osteonecrosis of the jaw (including their advantages and limitations) are summarized. In addition, novel trends of surgical and adjuvant therapeutic approaches are also reviewed. The authors conclude that possibilities of prevention and efficacy of therapeutic interventions in this disorder are still limited possibly due to an incomplete knowledge of the underlying pathomechanism. An interdisciplinary cooperation for prevention and attentive monitoring in order to decrease the incidence of iatrogenic oral and maxillofacial complications seems to be particularly important.
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Affiliation(s)
- Ágnes Janovszky
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Arc-, Állcsont- és Szájsebészeti Klinika Szeged Kálvária sgt. 57. 6725
| | - Tamás Vereb
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Arc-, Állcsont- és Szájsebészeti Klinika Szeged Kálvária sgt. 57. 6725
| | - Andrea Szabó
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Sebészeti Műtéttani Intézet Szeged
| | - József Piffkó
- Szegedi Tudományegyetem, Szent-Györgyi Albert Klinikai Központ, Általános Orvostudományi Kar Arc-, Állcsont- és Szájsebészeti Klinika Szeged Kálvária sgt. 57. 6725
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Antonenko O, Bryk G, Brito G, Pellegrini G, Zeni SN. Oral health in young women having a low calcium and vitamin D nutritional status. Clin Oral Investig 2014; 19:1199-206. [DOI: 10.1007/s00784-014-1343-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2014] [Accepted: 10/20/2014] [Indexed: 12/14/2022]
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Michelsen J, Wallaschofski H, Friedrich N, Spielhagen C, Rettig R, Ittermann T, Nauck M, Hannemann A. Reference intervals for serum concentrations of three bone turnover markers for men and women. Bone 2013; 57:399-404. [PMID: 24076251 DOI: 10.1016/j.bone.2013.09.010] [Citation(s) in RCA: 80] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2013] [Revised: 09/10/2013] [Accepted: 09/17/2013] [Indexed: 01/23/2023]
Abstract
OBJECTIVE Bone turnover markers (BTMs) reflect the metabolic activity of bone tissue and can be used to monitor osteoporosis therapy. To adequately interpret BTMs, method-specific reference intervals are needed. We aimed to determine reference intervals for serum concentrations of intact amino-terminal propeptide of type I procollagen (PINP), bone-specific alkaline phosphatase (BAP) and carboxy-terminal telopeptide of type I collagen (CTX). MATERIAL AND METHODS We established a healthy reference population of 1107 men as well as 382 pre- and 450 postmenopausal women, who participated in the first follow-up of the Study of Health in Pomerania. Serum PINP, BAP and CTX concentrations were measured on the IDS-iSYS Automated System (Immunodiagnostic Systems, Frankfurt am Main, Germany). The reference interval was defined as the central 95% range. We determined age-specific reference intervals for PINP, BAP, and CTX for men by quantile regression. Reference intervals for women were age-independent. RESULTS Reference intervals for men for PINP and CTX decreased with age (25-29year-old men: PINP 31.1-95.9ng/mL, CTX 0.12-0.83ng/mL; 75-79year-old men: PINP 15.7-68.1ng/mL, CTX 0.05-0.58ng/mL). The reference interval for men for BAP did not significantly change with age (25-29year-old men: 7.4-27.7ng/mL; 75-79year-old men: 7.6-24.4ng/mL). The reference intervals for 30-54year-old premenopausal women were: PINP 19.3-76.3ng/mL, BAP 6.0-22.7ng/mL, and CTX 0.05-0.67ng/mL. The reference intervals for 50-79year-old postmenopausal women were: PINP 18.2-102.3ng/mL, BAP 8.1-31.6ng/mL, and CTX 0.09-1.05ng/mL. CONCLUSION An intensively characterized, large reference population free of bone-related diseases allowed us to determine robust reference intervals for serum concentrations of PINP, BAP and CTX. Our normative data may aid to interpret bone turnover in adult men and pre- and postmenopausal women.
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Affiliation(s)
- J Michelsen
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
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Dhima M, Salinas TJ, Wermers RA, Weaver AL, Koka S. Preference changes of adult outpatients for giving saliva, urine and blood for clinical testing after actual sample collection. J Prosthodont Res 2013; 57:51-6. [PMID: 23376012 DOI: 10.1016/j.jpor.2012.09.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Revised: 07/17/2012] [Accepted: 09/10/2012] [Indexed: 10/27/2022]
Abstract
PURPOSE Patients' preferences of the type of sample collections for clinical testing are currently unknown. The aims of this study were: (1) to assess patients' preferences of three types of samples for clinical testing (saliva, urine and blood) both before and after collection and (2) to assess whether prior experiences with collection of saliva impacted patients responses. METHODS Adult outpatients underwent collection of one sample each of saliva, urine and blood. Patients' perceptions of comfort, convenience and easiness were assessed in pre-collection and post-collection questionnaires. RESULTS Post-collection, patients' endorsement of saliva as being the "most comfortable" and "most convenient" significantly declined (pre vs. post, 61.5% vs. 37.5% and 73.1% vs. 42.3%). However, saliva was still endorsed as the "most convenient" post-collection (compared to urine 33.7% and blood 24.0%). Although not statistically significant, the proportion of patients who changed their response in terms of what sample was "easiest to collect at home" was considerably higher in the group with vs. without prior experience giving saliva (54.6% vs. 32.6%, p=0.19 Fisher's exact test). CONCLUSIONS Overall, saliva remained as the most highly preferred sample to donate despite a decline in patients' preferences of saliva donation after sample collection. The results of the study are promising for future widespread patient acceptance of saliva as a diagnostic fluid.
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Affiliation(s)
- Matilda Dhima
- Department of Dental Specialties, Division of Prosthetic and Esthetic Dentistry, Mayo Clinic, Rochester, MN 55905, United States.
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