Metabolismo fosfocálcico y factores litogénicos en pacientes con fractura osteoporótica / Calcium and phosphorus metabolism and lithogenic factors in patients with osteoporotic fracture

Objetivos: Demostrar la presencia de alteraciones del metabolismo del fósforo y calcio y la presencia de factores litogénicos en orina de pacientes con fractura osteoporótica sin litiasis previamente conocida. Material y métodos: Se incluyen 67 pacientes con fractura osteoporótica tratados quirúrgicamente en un servicio de traumatología. Se incluyen pacientes con fractura osteoporótica demostrada por la zona de la fractura, mecanismo de fractura y presencia de osteoporosis en la densitometría ósea. Se analiza el metabolismo fosfocálcico, el estudio de calciuria, la oxaluria, la citraturia y la uricosuria de 24 h. Se compara entre los pacientes con hipercalciuria versus normocalciuria la presencia de alteraciones del metabolismo fosfocálcico. Resultados: Doce hombres y 55 mujeres incluidos con edad media de 68,8 ± 14,5 años. El IMC medio fue de 27,4 ± 4,1 kg/m2. Presentan hipercalciuria el 42% de los pacientes, hiperoxaluria el 34% de los pacientes, hipocitraturia el 34% de los pacientes e hiperuricosuria el 7% de los pacientes. Al comparar los pacientes con hipercalciuria versus normocalciuria únicamente hay diferencias estadísticamente significativas en el calcio/creatinina en ayunas (0,17 versus 0,08; p < 0,0001). Conclusión: Los pacientes con fractura osteoporótica presentan diversos factores litogénicos en la orina, fundamentalmente hipercalciuria, siendo siempre de ayunas

Objectives: To demonstrate the attendance of mineral metabolism disorders and lithogenic factors in patients’ urine with osteoporotic fracture without previously known stones Material and methods: 67 patients with osteoporotic fractures surgically treated in trauma service are included. The area of the fracture site, fracture mechanism and the presence of osteoporosis were the factors taken into account to diagnose osteoporotic fracture. Mineral metabolism, calciuria, oxaluria, uricosuria and citraturia in 24 hours urine were analyzed. The presence of abnormal calcium and phosphorus metabolism was proved comparing hypercalciuria patients with normocalciuria ones. Results: 12 men and 55 women with mean age 68.8 ± 14.5 years old were included. Mean Body Mass Index (BMI) was 27.4 ± 4.1 kg/m2. 42% of patients showed hypercalciuria, 34% hyperoxaluria, 34% hypocitraturia and 7% hyperuricosuria. Statistically significant differences were observed only in fasting calcium/creatinine ratio (0.17 vs. 0.08; P < .0001) when comparing patients with hypercalciuria with those with normocalciuria. Conclusions: Patients with osteoporotic fractures show different lithogenic factors in urine, mainly hypercalciuria, always in fasting conditions

Calcium and phosphorus metabolism and lithogenic factors in patients with osteoporotic fracture.

OBJECTIVES: To demonstrate the attendance of mineral metabolism disorders and lithogenic factors in patients' urine with osteoporotic fracture without previously known stones MATERIAL AND METHODS: 67 patients with osteoporotic fractures surgically treated in trauma service are included. The area of the fracture site, fracture mechanism and the presence of osteoporosis were the factors taken into account to diagnose osteoporotic fracture. Mineral metabolism, calciuria, oxaluria, uricosuria and citraturia in 24hours urine were analyzed. The presence of abnormal calcium and phosphorus metabolism was proved comparing hypercalciuria patients with normocalciuria ones. RESULTS: 12 men and 55 women with mean age 68.8±14.5 years old were included. Mean Body Mass Index (BMI) was 27.4±4.1kg/m2. 42% of patients showed hypercalciuria, 34% hyperoxaluria, 34% hypocitraturia and 7% hyperuricosuria. Statistically significant differences were observed only in fasting calcium/creatinine ratio (0.17 vs. 0.08; P<.0001) when comparing patients with hypercalciuria with those with normocalciuria. CONCLUSIONS: Patients with osteoporotic fractures show different lithogenic factors in urine, mainly hypercalciuria, always in fasting conditions.

Comparative activities of the S-enantiomer and racemic forms of equol on bone fragility in ovariectomized mice.

We compared the effects of the S-enantiomer and racemic forms of equol on bone using ovariectomized (OVX) mice. Femoral bone mineral density and bone strength decreased in the OVX mice, but not in OVX mice administered 0.5 mg/d S-equol. This, however, did not hold for racemic equol. Serum and urine S-equol concentrations were higher in the mice administered S-equol than in those administered racemic equol. These results suggest that the inhibitory effects of S-equol on bone fragility in OVX mice are greater than those of racemic equol.

Biochemical markers of bone turnover as predictors of osteoporosis and osteoporotic fractures in men and women: 10-year follow-up of the Taiji cohort.

We aimed to assess the capacity of biochemical markers of bone turnover (BTMs) to predict bone loss, osteoporosis (OP), and osteoporotic fractures. We randomly selected 400 individuals (age 40-79 years in 1993; 50 of each gender and age stratum) from a list of registered residents. In the years 1993, 1996, 2000, and 2003, bone mineral density (BMD) of the spine and hip were measured by dual-energy X-ray absorptiometry. The BTMs assessed at baseline were serum intact osteocalcin (OC), total OC, bone-specific alkaline phosphatase, C-terminal propeptide of type I procollagen, N-terminal propeptide of type I procollagen (PINP), C-terminal cross-linking telopeptide of type I collagen generated by matrix metalloproteinase, C-terminal cross-linking telopeptide of type I collagen (beta-CTX), N-terminal cross-linking telopeptide of type I collagen (NTX), urinary pyridinoline, and deoxypyridinoline (DPD). For 307 completers, multivariate analysis after adjusting for confounders revealed that serum PINP levels in men [hazard ratio (HR) 2.80, P < 0.05] and serum PINP (HR 1.65, P < 0.05), beta-CTX (HR 1.80, P < 0.001), NTX (HR 1.96, P < 0.01), and urinary DPD levels (HR 1.40, P < 0.05) in women were significantly related to the occurrence of spinal OP. In addition to adjustment for the baseline status of BMD, i.e., osteopenia or normal range, PINP, beta-CTX, and NTX in women could significantly predict the future occurrence of spinal OP. BTMs were not significant predictors of bone loss, femoral OP, or osteoporotic fractures. In conclusion, various BTMs in women can predict the occurrence of spinal OP.