Response of serum carboxylated and undercarboxylated osteocalcin to alendronate monotherapy and combined therapy with vitamin K2 in postmenopausal women.

Alendronate decreases the risk of femoral neck fracture by suppressing bone turnover, and also decreases the serum total osteocalcin level. A low serum carboxylated osteocalcin level or high undercarboxylated osteocalcin level could be risk factors for femoral neck fracture. Vitamin K mediates the carboxylation of osteocalcin, but the effect of alendronate therapy with or without vitamin K(2) supplementation remains unknown. Forty-eight postmenopausal women were enrolled in a 1-year prospective randomized trial and assigned to alendronate monotherapy (5 mg/day) (group A, n = 26) or vitamin K(2) (45 mg/day) plus alendronate (5 mg/day) (group AK, n = 22). Bone mineral density was measured by dual-energy X-ray absorptiometry at 0 and 12 months; bone turnover parameters were measured at 0, 3, and 12 months. Four patients discontinued alendronate therapy, and we analyzed the remaining 44 patients (23 in group A and 21 in group AK) who completed 1 year of treatment. Alendronate decreased undercarboxylated osteocalcin; carboxylated osteocalcin was not affected. Addition of vitamin K(2) enhanced the decrease of undercarboxylated osteocalcin levels and led to a greater increase of femoral neck bone mineral density. Alendronate monotherapy does not decrease carboxylation of osteocalcin, and combination of vitamin K(2) and alendronate brings further benefits on both osteocalcin carboxylation and BMD of femoral neck in postmenopausal women with osteoporosis.

Effects of nutritional supplementation on bone mineral status of children with rheumatic diseases receiving corticosteroid therapy.

OBJECTIVE: Because children with rheumatic disease receiving longterm corticosteroids are at high risk for developing osteoporosis, we attempted to determine whether nutritional supplementation would improve bone status in this group of children. METHODS: In a crossover design study, 10 corticosteroid treated children with rheumatic disease and osteoporosis received calcium and vitamin D supplementation for 6 months to determine their effect on bone density. They were then studied for 6 months without added nutrition supplements. The mean age was 13.1 years with a mean duration of disease of 4.2 years. Six patients had juvenile rheumatoid arthritis, 2 had systemic lupus erythematosus and 2 had mixed connective tissue disease. These children obtained a minimum of 1 g of calcium and 400 IU of vitamin D daily from diet and added supplements. Dual photon absorptiometry, laboratory and dietary data were obtained at baseline, 6 months, and one year. RESULTS: Spinal bone density significantly improved with supplementation. Osteocalcin values remained low throughout the study. CONCLUSION: Our results suggest some children with rheumatic disease receiving corticosteroids would benefit from calcium and vitamin D supplementation.

The changes of bone gamma-carboxyglutamic acid-containing protein in bone and serum of developing chick.

The changes of bone gamma-carboxyglutamic acid-containing protein (BGP) levels in bone and serum were studied in relation to those in calcium metabolism using chick embryos and chicks aged from 13 days' incubation to 8 weeks old. Chick BGP was determined by radioimmunoassay using antiserum to purified chick BGP. BGP levels in bone and serum increased significantly at hatching and then decreased until 3-5 days of age. Thereafter, BGP levels in bone and serum increased gradually until 8 weeks of age. These changes of BGP levels were well correlated with those of serum calcium and inorganic phosphorus concentrations, serum alkaline phosphatase activity and bone calcium content. The molecular size of increased serum BGP at hatching was not different from that of bone BGP. These results suggest that BGP plays a role in hatching and bone formation during chick development.

Effect of aging and castration on the changes in the levels of bone gamma-carboxyglutamic acid-containing protein in bone and serum of female rat.

Using female rats from 2 to 64 weeks old, the changes in bone gamma-carboxyglutamic acid-containing protein (BGP) levels in bone and serum were studied in relation to the changes in calcium metabolism during aging. Intestinal calcium transport, serum phosphorus level, bone origin serum alkaline phosphatase activity and serum BGP content were high in rapidly growing animals and then decreased with aging. Serum BGP content correlated well to bone origin serum alkaline phosphatase activity. Bone density, bone ash content and bone BGP content increased during aging. Bone BGP content was correlated to bone density which indicates the level of bone calcification. Moreover, the effect of castration on calcium metabolism and bone and serum BGP contents were observed in young (10 weeks old) and aged (40 weeks old) female rat at 12 and 24 weeks after operation. Intestinal calcium transport in ovariectomized rat was significantly lower than in sham operated rat. Serum phosphorus level and serum BGP content were increased in castrated female rat. However, serum calcium level and bone origin serum alkaline phosphatase activity did not show a significant change in castrated female rat. Bone density was significantly decreased in aged rat at 24 weeks after operation. During aging or castration, serum BGP content changed more than bone BGP content. The determination of change in serum BGP levels in various disorders of calcium metabolism would be very informative in future study.