Osteoporosis and a metabolic syndrome

S170

Abstracts

and total body bone mineral content, soft tissue composition (Hologic 4500A, software version 5.73); peripheral quantitative computed tomography measures (pQCT; Stratec XCT 3000) of the radius and tibia; serum hormones and bone turnover markers; health-related questionnaires; blood pressure and anthropometry. 84 patients [51 male (mean age (± SD); 43.5 y (± 17.8)) and 33 female (41.2 y (± 17.1))] were enrolled, randomized and had their 3 month assessment. The measures at this assessment did not differ significantly between groups. 70 patients underwent repeat assessments at 15 months (40 LEV, 30 older AED group). At this assessment there were increases (compared to 3 months) in the older AED group in weight (p = 0.039), BMI (p = 0.035), % abdominal fat (p = 0.013) and leptin (p = 0.032) and a decrease in cortisol (p = 0.043); these measures did not change significantly in the LEV group. Femoral neck aBMD (0.8%, p b 0.001; 1.0%, p b 0.001) and forearm aBMD (1.4%, p b 0.001; 1.0%, p = 0.015) decreased significantly in the LEV and older AED groups respectively. Radial trabecular BMD decreased in both groups (LEV – 2.3%, p = 0.005; older AEDs – 2.9%, p = 0.001). Serum βCTX decreased by 13% (p = 0.021) in the LEV group while βCTX (16%, p = 0.028) and P1NP (21%, p = 0.008) both decreased in the older AED group. Use of both LEV and older AEDs was associated with significant bone loss over 1 year and a modest reduction in bone turnover, raising the possibility of impaired osteoblast function analogous to the effect of ageing. Older AEDs but not LEV caused adverse effects on weight and body composition. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: J. Wark Grant / Research Support from UCB PHARMA, T. Hakami: None Declared, T. O'Brien Grant / Research Support from UCB PHARMA, M. Sakellarides : None Declared, J. Christie: None Declared, S. Kantor : None Declared, M. Todaro: None Declared, A. Gorelik: None Declared, M. Seibel Grant / Research Support from UCB PHARMA, S. Petty: None Declared.

doi:10.1016/j.bone.2012.02.532

PP344 Osteoporosis and a metabolic syndrome L. Kilasonia⁎, N. Kirvalidze, L. Lagvilava, N. Rusia, T. Burtchuladze, L. Pertaia Rheumatology, "MEDULLA" Clinic, Tiblisi, Georgia Abstract: Objective: A large number of studies have defined the frequency of secondary osteoporosis connected with a thyroid gland diseases, diabetes and hypercorticism. Interleikin-6 (IL-6) intense excretion, which is followed by the increase of osteoclast activity and bone losses, has been revealed in the case of insulin resistance. However, in the case of a metabolic syndrome, the bone mineral density is also interesting in that sense that if obesity was supposed as a preventive factor of osteoporosis, nowadays it is considered as a risk factor. Materials and Methods: 90 women with a metabolic syndrome (MS) aged from 25 to 50 have been examined. Body mass index (BMI), variations of fat distribution and complications following obesity have been marked in the diagnosis. All patients underwent per oral glucose tolerant tests; fasting plasma glucose test; fasting immunorheactive insulin level before and after loading with glucose, has also been determined by means of Caro index.We have studied lipid change index of all patients. As a result of our research we divided the patients into 3 groups: 34 patients with the diagnose of a full metabolic syndrome (30.7%) 27 patients with an MS diagnose without carbohydrate exchange disorder (30%) 29 patients with an MS diagnose without dislipidemia (39.3%) Diagnosis of osteoporosis has been carried out with the help of dual energetic absorptive densitometry (Hologic 1000). A bone mineral density has been measured in lumbar spine, in the proximal part of a femoral neck and in the forearm distal part. Result: The results proved to be interesting not only from the point of revealing the frequency of osteoporosis in the case of MS, but also from the point of a rhetoric link which is supposed to be between obesity and a low mineral density. A low mineral density (T ≤ -2, 5) has been marked in 45% of 90 patients (mainly in a femoral neck and a forearm distal part). An osteopenic syndrome (T ≤ - 2.0) has been revealed among 11 patients, mainly in those parts of the skeleton which are presented by cortical bones. Conclusion: Quite often a bone low mineral density has been revealed in the cases of MS with a hyperinsulinemic clinical course. We could not reveal a correlative link between a BMS index and a dislipidemic level. Obesity not only does not excludes osteoporosis in the cases of MS, but even more, it correlates with the seriousness of MS. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None Declared.

doi:10.1016/j.bone.2012.02.533

PP345 Reduced trabecular bone score in patients with OI type 1 compared with healthy controls L. Folkestada,b,c,⁎, J.D. Haldd, S. Hansena,c, J. Gramb, B.L. Langdahld, B. Abrahamsene,f, K. Brixena,c a Department of Endocrinology, Odense University Hospital, Odense, Denmark b Department of Endocrinology, Hospital of Southwest Denmark, Esbjerg, Denmark c Institute of Clinical Research, University of Southern Denmark, Odense, Denmark d Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus University Hospital, Aarhus, Denmark e Department of Internal Medicine, Gentofte Hospital, Gentofte, Denmark f Institute of Clinical Research, Odense University Hospital, Odense, Denmark Abstract: Objectives: Patients with OI have increased susceptibility to bone fractures due to decreased bone strength. Bone mineral density (BMD) is often decreased in patients with OI, however, the impact of other determinants of bone strength are less well explored. Trabecular Bone Score (TBS) is a novel method to estimate cancellous bone structure at the lumbar spine by analysing the greyscale properties of 2D images from Dual Energy X-ray Absorptiometry (DXA) scans. We therefore compared TBS at the lumbar spine in patients with OI type 1 with healthy age- and gender-matched controls. Methods: Patients with OI were recruited through our clinical database and through the Danish OI Patient Society. Healthy, age- and gender-matched controls were recruited through the central personal registry through random invitation by letter. BMD at the lumbar spine (L1–L4) was measured using a Hologic Discovery densitometer. TBS was assessed for L1–L4 using the TBS Insight software. Groups were compared using a Wilcoxon Matched-Pairs SignedRanks test. Results: In a total of 33 patients DXA scans were available for analysis. Four patients were excluded for technical reasons (TBS could not be calculated by the software). Thus, 20 female and 9 male patients aged 46 ± 17 years (mean ± SD) and 20 female and 9 male controls aged 46 ± 17 years were included in the analyses. Body height was significantly lower in the patients compared with the controls (158.8± 9.5 vs 169.8± 10.1 cm, p = 0.002). We found a numerically higher BMI and lower body surface area in the patients with OI compared with the controls, but these differences were non-significant. BMD was significantly lower in the OI group compared with the healthy control group (0.877 g/cm2 [0.771–0.963 g/cm2] (median [range: 25–75 percentiles]) vs 0.960 g/cm2 [0.891–1.029 g/cm2] p = 0.01). We found significantly lower TBS in the OI group compared to the healthy controls (1.290 mm− 1 [1.162–1,329 mm− 1] vs 1.334 [1.229–1.397] p = 0.05). Conclusion: We found a significantly decreased TBS in the lumbar spine, in patients with type 1 OI compared with healthy controls. This indicates a decreased mean trabecular thickness and volume fraction of cancellous bone. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared.

doi:10.1016/j.bone.2012.02.534

PP346 BMD improvements after operation for primary hyperparathyroidism L. Roligheda,⁎, P. Vestergaardb, L. Heickendorffc, T. Sikjaerb, L. Rejnmarkb, L. Mosekildeb, P. Christiansena a Department of Surgery P, Aarhus University Hospital, Aarhus C, Denmark b Department of Endocrinology MEA, Aarhus University Hospital, Aarhus C, Denmark c Department of Clinical Biochemistry, Aarhus University Hospital, Aarhus C, Denmark Abstract: Background: In primary hyperparathyroidism (PHPT) one of the arguments for operation is decreased BMD in the spine, hip or forearm. However, it can be an option to observe patients without surgery in mild or asymptomatic cases. The objective was to measure postoperative BMD in PHPT and to investigate BMD changes and relations with clinical and biochemical variables. Methods: Analysis of a historic consecutive cohort of 236 PHPT patients where DXA scans (pre- and one year postoperatively), clinical data (age, sex, height and weight) and biochemical data (PTH, 25hydroxy-vitamin D (25OHD), ionized calcium (iCa) and creatinine) were available. Results: Included patients had a mean age of 60 years (range 19–86) and 192 (81%) were women. Mean values (range) for biochemical data were: PTH 12.7 pmol/l (5.1; 63), iCa 1.47 mmol/l (1.33; 1.89), creatinine 78 μmol (32; 206) and 25OHD 64 nmol/l (18; 195). Compared with a preoperative DXA scan, postoperative BMD increased 3.4% (95%CI 2.8; 4.0) in the spine. In a multiple regression model the BMD increase was positively associated with preoperative PTH values (β 0.001, 2p 0.02) and no other clinical or biochemical