Cesare Verdoia

Osteoprotegerin: A valid new marker of bone turnover in post-menopausal osteoporosis?

An increase of setum osteoprotegerin has been found in post-menopausal women, that is positively correlated with age and bone markers, negatively with bone mass. In 25 post-menopausal women (mean age, 63±8 years) we measured serum levels of osteoprotegerin, total and bone alkaline phosphatase, osteocalcin, urinary deoxypyridinoline and bone mineral density of the lumbar spine and femur.Osteoprotegerin and bone markers did not differ from range of normal values. Bone mineral density appeared markedly reduced both at the spine and the femur.A significant correlation between osteoprotegerin and age, duration of menopause, osteocalcin and bone alkaline phosphatase was found. No correlation was found between osteoprotegerin and bone mineral density in all measured skeletal sites. In conclusion, osteoprotegerin does not appear to be an interesting parameter for the evaluation of bone turnover in post-menopausal osteoporosis.

High-intensity exercise in female athletes: effects on bone mass and body composition

We investigated bone mass and body composition in young healthy athletic women in order to determine the influence of high-impact physical activity on bone, fat and lean mass. In a case-control study, we studied 68 healthy women, aged 18–45 years, divided in two groups (age and body mass index matched): 39 sedentary women and 29 professional karate athletes. Family and medical histories and information on habits and dietary patterns were collected through a self-administered questionnaire. Bone mineral density (BMD, g/cm2) of whole body, lumbar spine and proximal femur was measured by means of dual energy X-ray absorptiometry (Hologic QDR 4500A scanner; Hologic,Waltham, USA; version 8.26). Total and subregional fat and lean whole body masses were also measured (grams). Significantly higher femoral and total body bone masses were found in active women compared to sedentary women (total femur: 1.00±0.09 vs. 0.95±0.10 g/cm2, p<0.05; femoral neck: 0.94±0.11 vs. 0.87±0.11, p<0.05; trochanter: 0.77±0.10 vs. 0.70±0.08, p=0.002; intertrochanter: 1.17±0.09 vs. 1.11±0.12, p<0.05; total body: 1.19±0.06 vs. 1.14±0.08, p<0.05). Active women also had lower fat mass (total: 16510±4430 vs. 20736±7883 g, p=0.007; limbs: 9952±2779 vs. 11888±4147, p=0.027; trunk: 5807±1970 vs. 8325±4113 p=0.001) and higher limb lean mass (15574±2124 vs. 14532±2034 g, p=0.05). A significantly lower calcium intake was registered in active women. Oral contraceptive use appeared to significantly increase femoral bone density. Physical activity increased bone mass in young active women, and this effect seemed to be superior to that of dietary calcium intake.

Usefulness of osteoprotegerin in assessing responses to neridronate treatment in Paget's disease of bone

Osteoprotegerin (OPG) is a protein that inhibits of osteoclastogenesis. The aim this study was to evaluate the response of serum OPG levels to neridronate treatment in patients with Pagets disease of bone resistant to previous therapy. Nine patients (4 men) affected by active Paget’s disease of bone (6 polyostotic, 3 monostotic) not responsive to clodronate were studied. Serum OPG, osteocalcin, total and bone isoenzyme of alkaline phosphatase (AP and BAP, respectively), and urinary deoxypyridinoline (DPD) were measured before and 5 months after neridronate treatment (100 mg/day, i.v. for two days). A scintigraphic activity index (SAI) was also calculated before treatment. Mean baseline OPG levels were within normal values and were not significantly different 5 months after neridronate treatment. In contrast, there were significant reductions in AP (41.9%, p<0.02) and BAP (38.8%, p<0.04). Serum OPG levels correlated with DPD (r=0.925) and SAI (r=0.689). Although OPG is an important regulator of bone metabolism, in our series of already treated patients it was not a sensitive marker for diagnosing Pagets disease and for monitoring the response to pharmacological treatment, whereas AP and BAP confirmed their clinical usefulness. This preliminary study requires confirmation by a study with a larger population.