[Certain changes in mineral metabolism of patients with osteoarthrosis and osteoporosis under the influence of combined treatment].

Disturbances of calcium and phosphorus metabolism in patients with articular disorders are gender-dependent and related to the presence of osteoporosis. Concomitant abnormalities in collagen synthesis are more pronounced in women than in men and especially in patients with osteoporosis, in agreement with their altered hormonal status. Combined balneo-physiotherapeutic treatment including mid-wavelength ultraviolet irradiation partially normalizes calcium and phosphorus metabolism but fails to significantly decrease the enhanced activity of alkaline phospatase and elevated blood oxyproline level that collectively account for the low regenerative potential of osteoblasts.

Electromagnetic fields in the treatment of postmenopausal osteoporosis: an experimental study conducted by densitometric, dry ash weight and metabolic analysis of bone tissue.

The authors conducted an experimental study on 32 female rats which had been castrated at 10 months of age in order to verify the ability of pulsating electromagnetic fields to prevent osteoporosis induced by surgical menopause. Two different values of intensity of PEMFs were used: 30 G and 70 G. After 4 months of treatment the following testing was done: monophotonic bone densitometry of the lumbar spine, quantitative measurement of the dry ash weight of the femurs, and hematochemical tests to evaluate bone metabolism. The experimental study showed that the PEMFs supplied at 30 Gauss were capable of slowing down the loss of bone mass, while the PEMFs supplied at 70 Gauss obstructed bone decay, providing values for Bone Mineral Density and dry ash weight which were very similar to those observed in the non-castrated control group. Hematochemical tests did not reveal significant variations between the two groups.

The effect of short-term low-energy ultraviolet B irradiation on bone mineral density and bone turnover markers in postmenopausal women with osteoporosis: a randomized single-blinded controlled clinical trial.

INTRODUCTION: The importance of vitamin D on bone health and osteoporosis was studied by many researchers. The main role of the Vitamin D is to absorb calcium and phosphate and increase bone mineralization. Older people are at an increased risk of the inadequate vitamin D production in the skin because of lower sun exposure and reduced ability of the skin to synthesize vitamin D. OBJECTIVE: The aim of this clinical trial was to evaluate the efficacy and tolerability of short-term (2 weeks) low energy UVB irradiation in postmenopausal women with osteoporosis using bone mineral density and bone turnover markers. METHODS: A three-month, single-blinded, randomized, placebo-controlled clinical trial was conducted at the University hospital in Daegu, Republic of Korea. Fifty-two postmenopausal Korean women (older than 65 years) with osteoporosis were randomly allocated to have either low energy UVB or placebo for 30 minutes a day for two weeks of treatment during winter. Laboratory analysis and physical examination before and 4, 8 and 12 weeks after treatment were carried out and BMD was measured before and 8 and 12 weeks after treatment. The effects of time and treatment interaction between these two groups were evaluated by repeated-measure two-factor analysis, and subgroup analysis was performed to examine UVB effect on the vitamin D insufficient group [serum 25(OH)D3 concentration < 30 ng/mL]. RESULTS: In vitamin D insufficient group, the effect of UVB irradiation on vitamin D and bone ALP as well as additional benefit on bone formation was confirmed. The vitamin D insufficient group showed statistically significant increment in serum 25(OH)D3 compared with the normal group (p < 0.05). However, there was no significant difference between two groups in the other bone turnover markers, such as serum calcium, PTH-C, serum osteocalcin, serum CTX and BMD. CONCLUSION: Low-energy-short-term UVB radiation for postmenopausal women may be of use in vitamin D synthesis. There was a modest benefit in change of bone ALP especially in women with the insufficient vitamin D.

UVB radiation and its role in the treatment of postmenopausal women with osteoporosis.

In humans, the serum concentration of parathyroid hormone (PTH) is higher in winter than in summer. The increase of PTH can be suppressed by oral vitamin D supplements, which is considered beneficial to those with osteoporosis. The present study investigates whether this effect can also be achieved by serial ultraviolet (UV) irradiation of the skin. In total, 34 women suffering from postmenopausal osteoporosis were included in the open trial. In late winter, 20 patients were irradiated with a spectrum containing UVB, eight times over a period of 4 weeks. The serum concentrations of 25-hydroxyvitamin D [25(OH)D], 1,25-dihydroxyvitamin D [1,25(OH)2D], PTH, osteocalcin, alkaline phosphatase (AP), calcium and phosphorus were measured before the first, and 2 days after the last, dose of radiation. The data were compared to the controls (n = 14, no UV exposure), who were evaluated once at the start of the study and then again 4 weeks later. After UV irradiation the level of 25(OH)D was increased, whilst that of PTH remained unchanged. The serum level of osteocalcin decreased in the control group, but did not change in the group of women who had been exposed to UV radiation. The present study of osteoporotic women does not confirm previous findings in studies of healthy volunteers i.e. that PTH can be suppressed by exposure to UVB radiation in winter. Further studies are required to specify whether there are subgroups of osteoporotic people who may benefit from exposure to UVB radiation during winter.