[Indices of mechanical strength of the distal radius in healthy women and women with Colles fracture]. / Wskazniki wytrzymalosci mechanicznej dystalnego odcinka kosci promieniowej u kobiet zdrowych i ze zlamaniem typu Collesa.

Wrist fractures (Colles) are one of the most frequently observed osteoporotic fractures in postmenopausal women. The aim of our study was the comparison of mechanical properties of distal radius of women with Colles fracture using a Stratec XCT 960 peripheral quantitative computed tomography (pQCT) in relation to age-pair controls without a wrist fracture. Using the pQCT method for estimation of SSI (Strength Strain Index), we found significant differences of SSI values in Colles subjects. In clinical practice, pQCT offers new diagnostic tools which cannot be provided by conventional densitometric methods.

[Age-related changes of densitometric and strength parameters evaluated with QCT method in healthy women]. / Zwiazane z wiekiem zmiany wartosci parametrów densytometrycznych i wytrzymalosciowych wyznaczonych u zdrowych kobiet metoda pQCT.

In the present study the age-related changes of pQCT values in normal Polish women were examined. The volumetric bone mineral density, trabecular density, cortical density and Strength Strain Index was measured using peripheral quantitative computed tomography (Stratec XCT 960) in 459 healthy women aged 18-60 years. Bone mineral measurement of the distal and proximal radius may be useful in evaluation of age-related bone loss, fracture risk and for diagnosis of osteoporosis.

[Difficulties in the interpretation of bone densitometric measurements]. / Trudnosci w interpretacji badania densytometrycznego.

In evaluation of the densitometric measurements the most popular presentation of results is a form of t-score or z-score values. T-score is a result of bone mineral density (BMD) in SD below a peak bone mass and z-score is a figure in SD below the values of BMD of healthy individuals of the same age and sex. Osteoporosis is diagnosed if t-score is more than -2.5 ranges from -1.0 to -2.5. Z-score has less value in diagnosis of osteoporosis. The value of different densitometric techniques depends on age of the subject and a past history of fractures. In subjects below 65 yrs the best technique is DEXA (dual energy X ray absorptiometry) and the spine is the site of measurement. In subjects above 65 yrs the best site to measure BMD is the hip. Previous fractures at the site of measurement (vertebral crush fractures), osteoarthritis, kyphosis, could change the values of BMD (overestimate them), and there is a need for a very careful and critical interpretation of BMD results.

Pyridinium crosslinks of collagen as a marker of bone resorption rates in children and adolescents: normal values and clinical application.

The aim of our study was to establish normal values of urinary pyridinoline (Pyr) and deoxypyridinoline (DPyr) excretion for children aged 3-18 years, examine the biological variability of the marker, and assess its clinical value for pediatric patients with growth hormone deficiency. Pyr and DPyr was measured in first void urine samples from 692 healthy subjects (340 boys, 352 girls) by high-performance liquid chromatography. At sampling, age, body height, and weight was recorded for all individuals. Short-term variability in crosslinks excretion was examined in four healthy children. The clinical value of the marker was studied in seven patients with growth hormone (GH) deficiency. In childhood, crosslinks excretion exceeded normal adult values by about fivefold and declined during puberty. In the age range of 13-18 years, gender-related differences in Pyr and DPyr levels were observed, presumably resulting from the earlier onset of puberty in girls. Urinary levels of Pyr and DPyr were highly correlated both in males and females. Pyr/DPyr ratio was significantly higher in adolescents than children, suggesting enhanced release of Pyr from extraosseous sources. In both genders, neither age nor anthropometric variables showed a linear effect on crosslinks excretion. The range of within-subject, short-term variability in urinary Pyr and DPyr was relatively high (CV: 6%-21%), indicating that single measurements of crosslinks excretion may not adequately reflect bone resorption rates in children. Pyr and DPyr levels were significantly lower in GH-deficient patients and normalized during human growth hormone (hGH) therapy. Significant correlations between growth velocity (GV) and crosslinks levels were found, but individual prediction of GV increment during hGH treatment may be inaccurate. Pyr/DPyr ratio was not related to GV. It is concluded that measurement of urinary Pyr and DPyr excretion in children may be a valuable tool to assess bone resorption rates in population-based studies. In individual patients, however, only qualitative evaluation of disease severity and response to treatment seems justified.

[Quantitative computerized tomography of peripheral body parts (pQCT)--results of measurements in healthy women from the Polish population]. / Ilosciowa tomografia komputerowa obwodowych czesci ciala (pQCT)-- wyniki pomiar-ow u zdrowych kobiet w populacji Polskiej.

The authors present a new method in densitometry-quantitative computerized tomography of peripheral body parts (pQCT). It takes into account the volume of measured bones expressing the results as density in physical sense, and makes possible differentation of internal bone structure with a very low exposure (up to 6 mrem for a complete measurement). The authors have begun also work on gathering reference data for the Polish population and they present the preliminary results of measurements in an initial group of 97 women.

[Comparison of bone density in various skeletal parts in women during peri and postmenopause with previous Colles fracture]. / Porównanie gestosci masy kostnej w róznych miejscach szkieletu u kobiet w okresie peri i postmenopauzalnym z przebytym zlamaniem Collesa.

Forearm fracture of Colles type is one of the most frequently observed osteoporotic fractures in women in postmenopausal period. It is proved that the group of women who had Celles fractures (n = 63) has lower bone mineral density in all measured sites except hip comparing to the controls (n = 53). Osteopenia found involves trabecular bone. Women with previous forearm fracture can be treated as the group of increased risk for spine and femoral neck fracture in the future.

[Evaluation of bone density using the DEXA method and ultrasonography in women after menopause during treatment with vitamin D]. / Ocena gestosci masy kostnej metoda DEXA i ultradzwiekowa u kobiet po menopauzie w przebiegu leczenia witamina D.

A new group of drugs-oestrogen agonists-antagonists (tamoxifen and raloxifen) is discussed. In view of their potentially favourable effects on the bone and lipids and lacking unfavourable action on the uterus and mammary gland, after successful completion of clinical studies, these preparations may be possibly important for the prophylaxis and treatment of osteoporosis.

[Evaluation of bone mass in children in a national sample of the population]. / Ocena masy kostnej u dzieci w krajowej próbie populacyjnej.

Dual energy X-ray absorptiometry (DEXA) was used to measure a mean bone mineral density (BMD) and bone mineral content (BMC) in total body and lumbar spine (L2-L4--BMD; L2-L4--BMC) in a group of 306 healthy children of both sexes, aged between 6 and 18 years. Step-wise increase in BMD in peripubertal age was noted. A degree of an increase in BMD at the age of 10 and 16 years was higher in boys than in girls. Bone mineral density of the spine was lower in the Polish population than that in USA. A high degree correlation between densitometric measurements and calendar age, and body height and weight was noted.

[Dynamics of the course of idiopathic juvenile osteoporosis]. / Dynamika przebiegu idiopatycznego osteoporozy mlodzienczej.

Clinical course of the idiopathic juvenile osteoporosis (IJO) was monitored in the group of 45 patients of both sexes with diagnosed disease, verified during follow-up period. The aim of the study was to evaluate the relationship between clinical symptoms and the results of biochemical, anthropometric, and densitometric measurements. An analysis of the obtained data enabled to distinguish the acute and chronic IJO phases. Evolution of the acute phase into chronic one was manifested by the cessation of pain and pathological gait stereotype, normalization of muscular strength, anthropometric parameters and urinary Pyr and DPyr excretion, as well as improvement in bone density. Hypercalciuria and increased urinary excretion of Pyr and DPyr, observed in the acute phase of IJO, may indicate that bone resorption exceeded bone formation. Tendency to maintain of alkaline phosphatase activity within lower limits of the normal values with slight increase during an improvement of densitometric parameters suggested transient osteoblast dysfunction.

[Evaluation of reproducibility and precision of ultrasonic measurements of the calcaneus for diagnosing osteopenia]. / Ocena powtarzalnosci i dokladnosci pomiarów ultradzwiekowych kosci pietowej w diagnostyce osteopenii.

The study aimed at evaluating precision of ultrasound measurements of mineral bone density of the calcaneus, and evaluating correlation between the obtained results with those measured with single photon absorptiometry (SPA) and DEXA in different skeletal sites. In 24 healthy individuals and 44 patients with osteoporosis SOS, BUA, calcaneus stiffness index, spine bone mineral density (L2-L4), femoral neck and calcaneal bone mineral densities were measured with DEXA technique whereas BMD in distal radial bone was measured with SPA. Very good precision of ultrasound measurements--better for SOS (CV = 0.12%), worse for BUA (CV = 1.64%) due to repositioning--was achieved. Statistically significant correlation between ultrasound and DEXA measurements of BMD in calcaneus bone (r = 0.90), and significant but worse correlations with BMD measurements for the spine (r = 0.43), femoral bone neck (r = 0.53), and 1/3 radius, (r = 0.51) were achieved. Ultrasound measurements of bone mineral density have low error of repeatability and good accuracy, enabling to discriminate healthy individuals from osteoporosis patients.

[Bone density in axial and peripheral skeleton and mineral density of the entire body as an age dependent factor in a population sample of healthy women]. / Gestosc masy kostnej w szkielecie osiowym i obwodowym oraz gestosc mineralna calego ciala w zaleznosci od wieku w próbce populacyjnej zdrowych kobiet.

Bone mineral density has been measured with dual energy X-ray absorptiometry (DEXA) in both axial and peripheral skeleton of 208 randomly selected healthy women aged between 20 and 80 years. Examined women have been stratified into the age groups of every 10 years. Bone mineral density has been measured in lumbar spine L2-L4 (AP), L2-L3 (Lat.) and proximal femur together with total body mineral density in every examined woman. The obtained results are considered reference values for the Polish population.

[Pyridinoline and deoxypyridinoline excretion in urine of healthy children--dependence on age]. / Wydalanie pirydynoliny i dezoksypirydynoliny w moczu dzieci zdrowych--zaleznosc od wieku.

Pyridinoline (Pyr) and deoxypyridinoline (DPyr) are crosslinking compounds of bone collagen. Their urinary excretion is considered to be the first sensitive and specific marker of bone resorption in a number of metabolic bone diseases in adults. Application of crosslinks measurements to evaluate bone turnover rate in pediatric patients is so far limited because of lack of reference values. Therefore, the aim of our study was to determine urinary excretion of Pyr and DPyr in healthy children aged 3-18 yrs, and to evaluate the possible relationship between the levels of both compounds and body height, weight, BMC, and BMD. Pyr and DPyr levels were determined in first void urine samples obtained from 249 children (124 boys, 125 girls). Urine aliquots were hydrolysed, Pyr and DPyr extracted on CF1 cellulose, and analysed by HPLC with fluorimetric detection. Bone mineral content (BMC) and density (BMD) were measured with Lunar DPX-L apparatus in 205 children (104 boys, 101 girls) from the same population, aged over 5.5 yrs. In prepubertal children, a tendency towards lowering of urinary Pyr and DPyr levels with advancing age was shown. At puberty, urinary excretion of both crosslinks markedly decreased. This phenomenon was observed at various calendar age in girls as compared to boys, reflecting sex-dependent differences. Significant negative correlation (p < 0.0001) between urinary Pyr and DPyr levels and calendar age, body height and weight, BMC and BMD, were also found. The obtained results suggest that references values for Pyr and DPyr excretion in growing children should be related to calendar age, sex, and--in case of adolescents--phase of puberty.