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or mandible in patients under chronic bisphosphonate therapy
Abstracts / Bone 47 (2010) S72–S241
eventually developed OP over 10 years, whereas only 2 (2.9%) women in the normal group did. Cox's proportional hazard analysis was performed to assess whether the occurrence of OP is affected by the presence of osteopenia after adjusting for age and weight. The analysis revealed that the presence of osteopenia significantly increased the risk of OP (hazard ratio (HR), 17.8; 95% confidence interval (CI) 40.1–79.4; p = 0.000). This tendency was also observed at the site of femoral neck (HR, 16.9; 95% CI, 2.17–131.7; p = 0.007). Osteopenia at L2–4 increased the risk of morphometric vertebral fractures over 10 years, but the increase was not significant (odds ratio, 5.61; 95% CI, 0.46–68.7; p = 0.18). Conclusion: Osteopenia significantly increases the risk of OP in women. Disclosure of Interest: None declared Keywords: osteoporotic fractures, prognosis of osteopenia, risk factors doi:10.1016/j.bone.2010.04.450
PP315 Dietary calcium content influences body composition and bone markers of obese (beta O) growing rats A. Weisstaub1, E. Hernandez2, G.G. Pellegrini2,3, C. Marotte2,3, M.L. de Portela1, M.M. Gonzales Chaves2,3, S.N. Zeni2,3,4,* 1 Nutrition, Fac.Biochemistry, Bs.As., Argentina 2 Clinical Hospital, Osteopaties Section, UBA, Argentina 3 CONICET, Bs.As., Argentina 4 Oral Biochemistry, Fac.Dentistry, Bs.As., Argentina According to recent literature, osteoporosis and obesity are interrelated. On these bases we had compared the effect of feeding different dietary calcium (Ca) levels on body weight (BW) and composition and its relationship to bone metabolism, in genetically modified obese (β) rats during growth. Rats were mated and fed diets varying Ca content: high: 0.9% (βH); normal: 0.5% (βN); low: 0.2% (βL). A Wistar group was run simultaneously (W) as control and fed a diet according to AIN'93. At weanling, the male pups continued feeding the same diet till 50 days of age. At the end of the experience, body composition, bone alkaline phosphatase (BAP), BGP and CTX (ELISA) were evaluated. Results (mean ± SD): Food intake was similar in all groups. BW was lower in βH vs. βN and βH groups (162 ± 18 vs. 217 ± 31 221 ± 37g; p < 0.01). In β groups ashes content (g/100 g) increased as dietary Ca content increases (1.88 ± 0.26; 2.42 ± 0.24, 2.51 ± 0.21; p < 0.03) without reaching W values (2.71 ± 0.21). Lipids% was higher in βL and βN (14.7 ± 1.3 and 13.6 ± 2.7) vs. W (10.9 ± 2.6) and βH (12.6 ± 2.2) (p < 0.05). BAP (IU/L) did not show differences among β groups (186 ± 27, 193 ± 39 and 184 ± 30), being higher vs. W (67.8 ± 10.0). BGP (ug/ml) exhibit an inverse correlation with dietary Ca level in β (447 ± 45, 375 ± 46 and 279 ± 73), being lower than W (825 ± 106) (p < 0.01). CTX (mg/ml) did not show differences between W (88 ± 16) and βH (87 ± 4) which were higher vs βN and βL (69 ± 12 and 70 ± 3, respectively) (p < 0.01). Conclusions: The increase in dietary Ca content seems to decrease BW and body lipids content and to increase mineral content of β rats. These findings together with changes in bone markers suggest an imbalance in bone metabolism related to adipose tissue. This abstract is part of C. Marote PhD. UBACyT B 091. Disclosure of Interest: None declared Keywords: obese rats - dietary calcium content-bone-fat doi:10.1016/j.bone.2010.04.451
S191
PP316 Bone resorption in osteonecrosis (ON) of the jaw and/or mandible in patients under chronic bisphosphonate therapy S. Picardo1, E. Rey1, G. Pellegrini2, S.N. Zeni2,3,4,* 1 Surgery and Traumatology Buco-Maxillo-Facial II, Fac. Dentistry, Bs.As., Argentina 2 Clinical Hospital, Osteopaties Section, UBA, Argentina 3 Biochemistry, Fac. Dentistry. UBA, Bs. As, Argentina 4 CONICET, Bs. As, Argentina Bisphosphonates (BPs) induce marked inhibition of bone resorption, particularly by intravenous infusion. They are used to treat osteoporosis (OP) or advance-stage cancer involving skeletal metastasis and hypercalcemia of malignancy. Although the pathogenesis of ON of the jaw is not understood yet, several papers suggest that BPs may play a role in its development. In the present report we describe our experience in patients who received treatment with BPs and subsequently developed ON in the jaw and/or mandible. Since 2007, a man and 26 women (65 ± 9 years) with ON diagnosis under BPs treatment (mean ± SD: 64.5 ± 9.0 month) were referred to Oralmaxillofacial Dep, Fac. Dentistry. UBA, by Bs.As. Suburban Hospitals. BPs were received for OP (67%) or oncologic treatments (33%): multiple mieloma; metastatatic breast cancer, metastatic ovary cancer. 25 patients had ON signs (bone exposed; inflammation; osteomyelitis; delay healing; oral mucosal changes; sequester): maxilla 42% and jaw 58%. Two patients were discarded for not presenting inflammatory signs post-invasive dental procedures. Most of the cases occurred after an invasive dental procedure such as: dental extractions; implants; endodontic treatments) but approximately a 20% occurred spontaneously. A total of 18 patients were treated only whit one BPs, in decreasing order: Alendronate (AL); Zolendronate (ZOL); Pamidronate (PAM) and Risendronate (RIS): the remaining patients were treated with two BPs: PAM/ZOL 3; ALE/ZOL 1; ALE/PAM 1 and ALE/ Ibandronate 1. Serum C-terminal of telopeptide type I collagen (CTX) (ELISA, Nordic Bioscience Diag. A/S) was in the lowest level of reference (251-761): (mean ± SD) 258.3 ± 62.4 μg/L. Conclusion: These findings, according to literature reports, suggest that BPs and the very low bony renewal capacity may contribute to pathogenesis of ON. Although most of the cases develope in oncological patients, as demonstrated in the present study, it could be also identified in osteoporotic patients who should also be carefully followed by preventive oral care before beginning BPs treatment. This paper is part of the S Picardo PhD. Disclosure of Interest: None declared Keywords: osteonecrosis - Jaw - mandible - bone turnover doi:10.1016/j.bone.2010.04.452
PP317 Changes in bone mineral density during anti-TNF aplha therapy in psoriatic arthritis patients C. Ancuta1,*, E. Ancuta2, C. Iordache1, R. Chirieac1 1 GR.T.Popa University of Medicine and Pharmacy, Iasi, Romania 2 Research Unit, Cuza-Voda Hospital, Iasi, Romania Background: secondary osteoporosis related to increase in proinflammatory cytokines activity (IL-1, TNF alpha), medication (such as methotrexate) and impaired exercise, has been well recognized as a common complication of psoriatic arthritis (PsA). Aims: to assess both generalized (spine and hip) and local (hand) changes in bone mineral density (BMD) and bone metabolism markers in poly-articular PsA patients (pts) receiving anti-TNF alpha therapy.
eventually developed OP over 10 years, whereas only 2 (2.9%) women in the normal group did. Cox's proportional hazard analysis was performed to assess whether the occurrence of OP is affected by the presence of osteopenia after adjusting for age and weight. The analysis revealed that the presence of osteopenia significantly increased the risk of OP (hazard ratio (HR), 17.8; 95% confidence interval (CI) 40.1–79.4; p = 0.000). This tendency was also observed at the site of femoral neck (HR, 16.9; 95% CI, 2.17–131.7; p = 0.007). Osteopenia at L2–4 increased the risk of morphometric vertebral fractures over 10 years, but the increase was not significant (odds ratio, 5.61; 95% CI, 0.46–68.7; p = 0.18). Conclusion: Osteopenia significantly increases the risk of OP in women. Disclosure of Interest: None declared Keywords: osteoporotic fractures, prognosis of osteopenia, risk factors doi:10.1016/j.bone.2010.04.450
PP315 Dietary calcium content influences body composition and bone markers of obese (beta O) growing rats A. Weisstaub1, E. Hernandez2, G.G. Pellegrini2,3, C. Marotte2,3, M.L. de Portela1, M.M. Gonzales Chaves2,3, S.N. Zeni2,3,4,* 1 Nutrition, Fac.Biochemistry, Bs.As., Argentina 2 Clinical Hospital, Osteopaties Section, UBA, Argentina 3 CONICET, Bs.As., Argentina 4 Oral Biochemistry, Fac.Dentistry, Bs.As., Argentina According to recent literature, osteoporosis and obesity are interrelated. On these bases we had compared the effect of feeding different dietary calcium (Ca) levels on body weight (BW) and composition and its relationship to bone metabolism, in genetically modified obese (β) rats during growth. Rats were mated and fed diets varying Ca content: high: 0.9% (βH); normal: 0.5% (βN); low: 0.2% (βL). A Wistar group was run simultaneously (W) as control and fed a diet according to AIN'93. At weanling, the male pups continued feeding the same diet till 50 days of age. At the end of the experience, body composition, bone alkaline phosphatase (BAP), BGP and CTX (ELISA) were evaluated. Results (mean ± SD): Food intake was similar in all groups. BW was lower in βH vs. βN and βH groups (162 ± 18 vs. 217 ± 31 221 ± 37g; p < 0.01). In β groups ashes content (g/100 g) increased as dietary Ca content increases (1.88 ± 0.26; 2.42 ± 0.24, 2.51 ± 0.21; p < 0.03) without reaching W values (2.71 ± 0.21). Lipids% was higher in βL and βN (14.7 ± 1.3 and 13.6 ± 2.7) vs. W (10.9 ± 2.6) and βH (12.6 ± 2.2) (p < 0.05). BAP (IU/L) did not show differences among β groups (186 ± 27, 193 ± 39 and 184 ± 30), being higher vs. W (67.8 ± 10.0). BGP (ug/ml) exhibit an inverse correlation with dietary Ca level in β (447 ± 45, 375 ± 46 and 279 ± 73), being lower than W (825 ± 106) (p < 0.01). CTX (mg/ml) did not show differences between W (88 ± 16) and βH (87 ± 4) which were higher vs βN and βL (69 ± 12 and 70 ± 3, respectively) (p < 0.01). Conclusions: The increase in dietary Ca content seems to decrease BW and body lipids content and to increase mineral content of β rats. These findings together with changes in bone markers suggest an imbalance in bone metabolism related to adipose tissue. This abstract is part of C. Marote PhD. UBACyT B 091. Disclosure of Interest: None declared Keywords: obese rats - dietary calcium content-bone-fat doi:10.1016/j.bone.2010.04.451
S191
PP316 Bone resorption in osteonecrosis (ON) of the jaw and/or mandible in patients under chronic bisphosphonate therapy S. Picardo1, E. Rey1, G. Pellegrini2, S.N. Zeni2,3,4,* 1 Surgery and Traumatology Buco-Maxillo-Facial II, Fac. Dentistry, Bs.As., Argentina 2 Clinical Hospital, Osteopaties Section, UBA, Argentina 3 Biochemistry, Fac. Dentistry. UBA, Bs. As, Argentina 4 CONICET, Bs. As, Argentina Bisphosphonates (BPs) induce marked inhibition of bone resorption, particularly by intravenous infusion. They are used to treat osteoporosis (OP) or advance-stage cancer involving skeletal metastasis and hypercalcemia of malignancy. Although the pathogenesis of ON of the jaw is not understood yet, several papers suggest that BPs may play a role in its development. In the present report we describe our experience in patients who received treatment with BPs and subsequently developed ON in the jaw and/or mandible. Since 2007, a man and 26 women (65 ± 9 years) with ON diagnosis under BPs treatment (mean ± SD: 64.5 ± 9.0 month) were referred to Oralmaxillofacial Dep, Fac. Dentistry. UBA, by Bs.As. Suburban Hospitals. BPs were received for OP (67%) or oncologic treatments (33%): multiple mieloma; metastatatic breast cancer, metastatic ovary cancer. 25 patients had ON signs (bone exposed; inflammation; osteomyelitis; delay healing; oral mucosal changes; sequester): maxilla 42% and jaw 58%. Two patients were discarded for not presenting inflammatory signs post-invasive dental procedures. Most of the cases occurred after an invasive dental procedure such as: dental extractions; implants; endodontic treatments) but approximately a 20% occurred spontaneously. A total of 18 patients were treated only whit one BPs, in decreasing order: Alendronate (AL); Zolendronate (ZOL); Pamidronate (PAM) and Risendronate (RIS): the remaining patients were treated with two BPs: PAM/ZOL 3; ALE/ZOL 1; ALE/PAM 1 and ALE/ Ibandronate 1. Serum C-terminal of telopeptide type I collagen (CTX) (ELISA, Nordic Bioscience Diag. A/S) was in the lowest level of reference (251-761): (mean ± SD) 258.3 ± 62.4 μg/L. Conclusion: These findings, according to literature reports, suggest that BPs and the very low bony renewal capacity may contribute to pathogenesis of ON. Although most of the cases develope in oncological patients, as demonstrated in the present study, it could be also identified in osteoporotic patients who should also be carefully followed by preventive oral care before beginning BPs treatment. This paper is part of the S Picardo PhD. Disclosure of Interest: None declared Keywords: osteonecrosis - Jaw - mandible - bone turnover doi:10.1016/j.bone.2010.04.452
PP317 Changes in bone mineral density during anti-TNF aplha therapy in psoriatic arthritis patients C. Ancuta1,*, E. Ancuta2, C. Iordache1, R. Chirieac1 1 GR.T.Popa University of Medicine and Pharmacy, Iasi, Romania 2 Research Unit, Cuza-Voda Hospital, Iasi, Romania Background: secondary osteoporosis related to increase in proinflammatory cytokines activity (IL-1, TNF alpha), medication (such as methotrexate) and impaired exercise, has been well recognized as a common complication of psoriatic arthritis (PsA). Aims: to assess both generalized (spine and hip) and local (hand) changes in bone mineral density (BMD) and bone metabolism markers in poly-articular PsA patients (pts) receiving anti-TNF alpha therapy.