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Serum levels of type I procollagen carboxy-terminal propeptide in a sample of elderly, institutionalized women
424 “Bone metabolism in adults witth serious neurological lesions: a preliminary studyVl. C.R.Lucchini+,E.A.Gidoni++,M.landi++ clungarno Colombo,44 - C.E.& “&To-rigiani”C.R.I. L Florence In order to study osteoarticular pai? and in view of physiotherapic treatment and choice of aids, bone metabolism was studied in adults with severe neurological lesions. IQaterials:iO subjects 7 males and 3 femeles,I&37years aged. 6 of them suffer from immobilitation’syndrome. 9 patients are affected by cerebral palsy and present:-hypostural severe form (?VJV,-dystonic tetraparetic palsy (NO4) - spastic tetraparetic palsy (NO2). I patient presents a lesion of spinal cord with paraparesis. 7 subjects have dyspagy.A patient is obese. No spontaneous fractures. Methods: total body (TB), lumbar spine (LI-L4 BJlD (g/cm2) was studied by DZXA (LUNAR DPX-X-RAI Bone Densitometer).Be observed serum calcium, phosphorus,GLA-protejn,alkaline-phosfatases and isoenzymee, parathormone ana urine calcium,phosphorus, and hydroxyproline.Data were assumed as normal if higher than 90s of age matched normal values.Results:we obtained nolma1 values in 4 patients of whom only I has the imnobilitation syndrome.Othe- c patient; ha3 pathclogicsl values. Ve trinck that it may be possible osteopenia is one of the main oauses of pain in this kind of patients other- data will be presented.
426
mineral the treatment bone p.c.Befora and after photon usin d s:ng!e den-,lty 18?!?Di was measured nandunlndnt or, the the l’lt3 distal densl!ometer at ur ine s31np1?L. and 24-hour I‘_v:t;n9 b!ocj radius. w,ere a:~ ch:air.od to dctc-n:ne msr4e’S of col!ec::on ,..el P t.eccrdo: j,r Ing bzne I’Iwo~~~,: ~w,.No sidP effects <,r,e and col’rc!at ,o17 w+:nwn CT to-catnwIt.D ne:;at:ve 10 group 2 1n 9r3u, 1 dW both BY!? w.i $3 e,: Ident remained Ir=,!.h3,p’O.l)51. In zJ:.cup I GrD patlents
unchanged after one year of treatment whereas :n gl’oup 2 BPI’J slcjniflcantly decreaseo (pt0.01 I .Gloctie,nrcal Lnchanged irq group mxi e!‘: of bow turncver remalnEb 2;1n group 1 a significant reductl?n (p/O.r)l) In 5@rum levels of tartrate-resIStant acid phosphatase (TwPJ reflect levels TRAP serum obServed.Since was usteaclas(. rcllable speak
in
they
actlvlty Index
of
bone
favour
of
Furthor
bone
osteoporosis,most activity.
SERUM LEVELS OF ‘TYPE 1 PROCOLLAGEN CAREOXY-TERRINAL PROPEPTIDE IN A SAMPLE OF ELDERLY, INSTITUTJONALIZED WOMEN.
I.Santi.M.Monti.G.Verdel.R.Acclnnl+r,C.Otto~~no,c p c.-urlI1 UGer idtr :c lnct1tut2 PlO Pllborgo Trivulzlo;+Dlvislon PC Endocri~alogy;*tClln. Phys:ologv Institute.Dsp.N~9ua~~~a,V~lan,Italy. As type I procol Iagen carboxy-termlna! propeptlde (PICP) 15 prodr;ced by the osteob!dSts at a rate tiblch 1s equimolar with the rat.? of bore colla9en syct.heS15, and because it 1s not incorporated into the bone matrl4, serum level of PICP might be a valuable marker oC bone formation. We measured in a sample of b2 women (median age 83 yrs,range 55-94) with a duration of ~nSt~tut.iOnall2atlOn of 6Q months (loedlan) the se!‘um PICP Ieve: (dohble antlbocy RIA; Interand intraassay C’J were 3.W 3nd 57, respectlLelyl.Moreover, serum calcium tear, phcsphcrcus (PI ,tota1 alLa!:i,e phnsphat3ae (A?), parathyroib hormone IPTq), csteocalcin (E!GF), tartrate-resls?ant aci: phosp%tasa (TRAP:, urlrary h,jdroryproline 13kP/;r), Cd !Ca’Cr, and P were measured. Bane denslth (ED1 wdS ~meaiurw at
and l/l0 of I/3 radiuS by abscrptiometry. StatiStiCal analrsis
c:,q,e of the
pt.oton
results VUS~~ performed with Gpearm.Ir f-dnk anaIysis.PICP levels were directly correlated with AP (r=O.W, p /O.OiI,BGP (r=3.3b,p~C.Olland TRAP (r-0.30, p’O.OSldnd lnve-sely vll:h Ca (r--0.29, p”J.Oc,,. Furt?e~mo~.e,@ foLr,d t I: .I t RP !evels w&r-e car -e:.iCe;: w:t!II 1r EC (r--O.3j,~*C.O11. BtP l1’=‘>.26, o’Cl.‘X~. wIll (-=,.:.3V. p. 3.1):: and UW=/Cr (I.=~J.~?. 7 :C.l,“j. EGP ICVCIL i”E’ P correlated with ED 11121 lr=-0.X, g*‘O.O:I,GP Ir=-.;.Z’L,
\r=-0.32, (I-:-?.?$, p(o.05; aqd C.iiCI_ conclusion, our finoings suggk?st that 5erum PICP may be useful to sr,secs bore turnover.
p
427
NASAL SPRAY SALNONCALCITONlN IN THE TRERTIIENT OF M.Monti. G.Verde*, SENILE OSTEOPOROSIS. I.Santi. Inet:lute Pi0 G.Sensalari, E.Cunietti. Geriatric Endocrino!ogy, *Division Of Trivulzio, Albcrgo Osp.Niguarda, Milan, Italy. d” Nasal spray salmon calcitznrn tC71 may represent oztecpcl-osi_; tool in senile effective therapeutic actioll CP bunt its potent inhibitory owinq to and e*1sy toler~blllt~, rfxorptlon, §dfetq, sood admlnlstratlon. Thus,@ eva!uatsd the effect of one elcfel- :y gl’aul: of treatment in a year CT eeni le women affected inskLtiatlorali:ed by o~t~9pcros~5. Twenty-four patients were randomized to treatment with either CT,100 U! daily in two pkffes in thecrening .for three clcles of 91) days, divided by 30 or placebo (group 2).&l! days of interval (group 11, partecipants received dally supplement of 1 gr.calclum
preventing
425
have
been
propowd
as
resorptlon.Thus,these the
105s
probably
a
ef fes
t iveness
of
resLll!s CT I”
in
patlents
with
sen:le
by
reducing
osteoclrlst
METABOL;TC AND CLINICAL EFFECTS OF IPRIFLWONE IN PATIENTS )I‘Illi WSTMENOPAUSALOSTEDPOROSIS: A DDUBLEBLIND PLACEBO CDNTRDLLEDSTUDY. L.Bufalino*, D.Aqnusdei, C.Gennari. Institute of Internal Medicine, University of Siena. Italy. *Clinical 9esearch Departmen?, Chiesi Farmaceutici, Parms. Italy. A recent multicenter clinical study demonstrated that iprifiavone (IP) is sble to increase bone msss in patients with established postmenopausal osteoporosis (PMO). Here we present a preliminary report of a Z-year multicenter clinics1 study performed in order to evaluate the efficacy and tolerability of IP in PMO. The study was conducted according to a double blind, placebo controlled, parallel design. A first group of 134 patients (Group I), from 13 italian centers, with PM0 was randomly divided into 2 groups and treated with oral IP (600 mg/d) or placebo (Pl). All patients received an oral Ca supple134 patients completed 6-month and, to ;;t”,’ ( 1 g/d). , 34 patients completed l-year of the study. Bone mineral density (BMD) of the distal radius, measured by DPA, serum osteocalcin (BGP), and urinary hydroxyprol ine excretion (HOP/Cr), were measured before and after 6 and 12 months. In another group of 46 patients (Group II), EMDwas evaluated by DEXA of the lumbar spine. Results on BMD are sunrmarized in the following table: Group Treatment BMD 12m (0%) BMD6m (D%) +B.S% (n=16) I (D?A) IP +4.3% (n=69) -1.0% (n=65) -2.0% (n=la) Pl _---II (DexA) IP +1.2% (n=23) -----1.0% (n=23) Pl In the Group I, after 6 and 12 months, the difference in BMD between IP end Pl resulted statistically significant (~(6.05; AWVA). IP determined a progressive reduction of HOP/Cr and after 6 months the difference between rne two groups of treatment resulted significant (~(0.05; ANOVA). Although not significantly, BGP decreased only in the IP The drug was well tolerated and the treated patients. patients’ compliance to the oral treatment resulted exthis study indicate that IP is cellent. The results of able to increase bone mass mainly by inhibiting bone resorption. However, these encouraging preliminary results the end of the 2-year study Peneed to be confirmed at riod.
181
426
mineral the treatment bone p.c.Befora and after photon usin d s:ng!e den-,lty 18?!?Di was measured nandunlndnt or, the the l’lt3 distal densl!ometer at ur ine s31np1?L. and 24-hour I‘_v:t;n9 b!ocj radius. w,ere a:~ ch:air.od to dctc-n:ne msr4e’S of col!ec::on ,..el P t.eccrdo: j,r Ing bzne I’Iwo~~~,: ~w,.No sidP effects <,r,e and col’rc!at ,o17 w+:nwn CT to-catnwIt.D ne:;at:ve 10 group 2 1n 9r3u, 1 dW both BY!? w.i $3 e,: Ident remained Ir=,!.h3,p’O.l)51. In zJ:.cup I GrD patlents
unchanged after one year of treatment whereas :n gl’oup 2 BPI’J slcjniflcantly decreaseo (pt0.01 I .Gloctie,nrcal Lnchanged irq group mxi e!‘: of bow turncver remalnEb 2;1n group 1 a significant reductl?n (p/O.r)l) In 5@rum levels of tartrate-resIStant acid phosphatase (TwPJ reflect levels TRAP serum obServed.Since was usteaclas(. rcllable speak
in
they
actlvlty Index
of
bone
favour
of
Furthor
bone
osteoporosis,most activity.
SERUM LEVELS OF ‘TYPE 1 PROCOLLAGEN CAREOXY-TERRINAL PROPEPTIDE IN A SAMPLE OF ELDERLY, INSTITUTJONALIZED WOMEN.
I.Santi.M.Monti.G.Verdel.R.Acclnnl+r,C.Otto~~no,c p c.-urlI1 UGer idtr :c lnct1tut2 PlO Pllborgo Trivulzlo;+Dlvislon PC Endocri~alogy;*tClln. Phys:ologv Institute.Dsp.N~9ua~~~a,V~lan,Italy. As type I procol Iagen carboxy-termlna! propeptlde (PICP) 15 prodr;ced by the osteob!dSts at a rate tiblch 1s equimolar with the rat.? of bore colla9en syct.heS15, and because it 1s not incorporated into the bone matrl4, serum level of PICP might be a valuable marker oC bone formation. We measured in a sample of b2 women (median age 83 yrs,range 55-94) with a duration of ~nSt~tut.iOnall2atlOn of 6Q months (loedlan) the se!‘um PICP Ieve: (dohble antlbocy RIA; Interand intraassay C’J were 3.W 3nd 57, respectlLelyl.Moreover, serum calcium tear, phcsphcrcus (PI ,tota1 alLa!:i,e phnsphat3ae (A?), parathyroib hormone IPTq), csteocalcin (E!GF), tartrate-resls?ant aci: phosp%tasa (TRAP:, urlrary h,jdroryproline 13kP/;r), Cd !Ca’Cr, and P were measured. Bane denslth (ED1 wdS ~meaiurw at
and l/l0 of I/3 radiuS by abscrptiometry. StatiStiCal analrsis
c:,q,e of the
pt.oton
results VUS~~ performed with Gpearm.Ir f-dnk anaIysis.PICP levels were directly correlated with AP (r=O.W, p /O.OiI,BGP (r=3.3b,p~C.Olland TRAP (r-0.30, p’O.OSldnd lnve-sely vll:h Ca (r--0.29, p”J.Oc,,. Furt?e~mo~.e,@ foLr,d t I: .I t RP !evels w&r-e car -e:.iCe;: w:t!II 1r EC (r--O.3j,~*C.O11. BtP l1’=‘>.26, o’Cl.‘X~. wIll (-=,.:.3V. p. 3.1):: and UW=/Cr (I.=~J.~?. 7 :C.l,“j. EGP ICVCIL i”E’ P correlated with ED 11121 lr=-0.X, g*‘O.O:I,GP Ir=-.;.Z’L,
\r=-0.32, (I-:-?.?$, p(o.05; aqd C.iiCI_ conclusion, our finoings suggk?st that 5erum PICP may be useful to sr,secs bore turnover.
p
427
NASAL SPRAY SALNONCALCITONlN IN THE TRERTIIENT OF M.Monti. G.Verde*, SENILE OSTEOPOROSIS. I.Santi. Inet:lute Pi0 G.Sensalari, E.Cunietti. Geriatric Endocrino!ogy, *Division Of Trivulzio, Albcrgo Osp.Niguarda, Milan, Italy. d” Nasal spray salmon calcitznrn tC71 may represent oztecpcl-osi_; tool in senile effective therapeutic actioll CP bunt its potent inhibitory owinq to and e*1sy toler~blllt~, rfxorptlon, §dfetq, sood admlnlstratlon. Thus,@ eva!uatsd the effect of one elcfel- :y gl’aul: of treatment in a year CT eeni le women affected inskLtiatlorali:ed by o~t~9pcros~5. Twenty-four patients were randomized to treatment with either CT,100 U! daily in two pkffes in thecrening .for three clcles of 91) days, divided by 30 or placebo (group 2).&l! days of interval (group 11, partecipants received dally supplement of 1 gr.calclum
preventing
425
have
been
propowd
as
resorptlon.Thus,these the
105s
probably
a
ef fes
t iveness
of
resLll!s CT I”
in
patlents
with
sen:le
by
reducing
osteoclrlst
METABOL;TC AND CLINICAL EFFECTS OF IPRIFLWONE IN PATIENTS )I‘Illi WSTMENOPAUSALOSTEDPOROSIS: A DDUBLEBLIND PLACEBO CDNTRDLLEDSTUDY. L.Bufalino*, D.Aqnusdei, C.Gennari. Institute of Internal Medicine, University of Siena. Italy. *Clinical 9esearch Departmen?, Chiesi Farmaceutici, Parms. Italy. A recent multicenter clinical study demonstrated that iprifiavone (IP) is sble to increase bone msss in patients with established postmenopausal osteoporosis (PMO). Here we present a preliminary report of a Z-year multicenter clinics1 study performed in order to evaluate the efficacy and tolerability of IP in PMO. The study was conducted according to a double blind, placebo controlled, parallel design. A first group of 134 patients (Group I), from 13 italian centers, with PM0 was randomly divided into 2 groups and treated with oral IP (600 mg/d) or placebo (Pl). All patients received an oral Ca supple134 patients completed 6-month and, to ;;t”,’ ( 1 g/d). , 34 patients completed l-year of the study. Bone mineral density (BMD) of the distal radius, measured by DPA, serum osteocalcin (BGP), and urinary hydroxyprol ine excretion (HOP/Cr), were measured before and after 6 and 12 months. In another group of 46 patients (Group II), EMDwas evaluated by DEXA of the lumbar spine. Results on BMD are sunrmarized in the following table: Group Treatment BMD 12m (0%) BMD6m (D%) +B.S% (n=16) I (D?A) IP +4.3% (n=69) -1.0% (n=65) -2.0% (n=la) Pl _---II (DexA) IP +1.2% (n=23) -----1.0% (n=23) Pl In the Group I, after 6 and 12 months, the difference in BMD between IP end Pl resulted statistically significant (~(6.05; AWVA). IP determined a progressive reduction of HOP/Cr and after 6 months the difference between rne two groups of treatment resulted significant (~(0.05; ANOVA). Although not significantly, BGP decreased only in the IP The drug was well tolerated and the treated patients. patients’ compliance to the oral treatment resulted exthis study indicate that IP is cellent. The results of able to increase bone mass mainly by inhibiting bone resorption. However, these encouraging preliminary results the end of the 2-year study Peneed to be confirmed at riod.
181