Biomedical subjects

Boonsong Ongphiphadhanakul

Publications and source records attributed to Boonsong Ongphiphadhanakul.

13 recordsLinked to original sources

PubMed2006

Relationship of body composition and circulatory adiponectin to bone mineral density in young premenopausal women.

OBJECTIVE: Adiponectin is a recently discovered hormone secreted by adipocytes. Adiponectin plays an important role in the regulation of insulin sensitivity as well as the propensity to inflammation and atherosclerosis. In the present study, the authors explore the relationship between adiponectin and bone mass in premenopausal women. The relationship of fat mass compared to lean body mass to bone mass was also investigated MATERIAL AND METHOD: Two hundred premenopausal women aged between 20 and 40 years were studied. Bone mineral density (BMD) was measured at L2-4 and femoral neck by dual-energy X-ray absorptiometry (DEXA). Serum adiponectin concentrations were measured by radioimmunoassay. RESULTS: At the lumbar spines, factors associated with BMD were age (p < 0.01) and lean body mass (p < 0.001). No independent association with fat mass was demonstrated Likewise, at the femoral neck, only lean body mass was related to BMD (p < 0. 01). In terms of the relation of serum adiponectin to BMD, no association of serum adiponectin to BMD at the lumbar spines or femoral neck was found CONCLUSION: Altogether, the present findings do not suggest the independent role of adiponectin in the accrual of bone mass in females, although such a role still cannot be excluded in men or postmenopausal women.

Adiponectin↗

PubMed2005

Exogenous subclinical hyperthyroidism during adolescence: effect on peak bone mass.

BACKGROUND: Chronic subclinical hyperthyroidism induced by suppressive doses of L-thyroxine (L-T4) therapy, so-called exogenous subclinical hyperthyroidism, may cause diminished bone mass in postmenopausal women. The effect of subclinical hyperthyroidism during childhood and adolescence on peak bone mass, however, has not been evaluated. OBJECTIVE: To determine whether exogenous subclinical hyperthyroidism during adolescence, the period of critical bone mass acquisition, would reduce peak bone mass. PATIENTS AND METHODS: Eighteen female adolescents and young adults with Hashimoto's thyroiditis and euthyroid goiter (aged 22.4 +/- 4.4 years) who had been treated with suppressive doses of L-T4, 127.5 +/- 23.7 microg/day, during adolescence (age at onset of subclinical hyperthyroidism, 14.2 +/- 1.5 years) for 6.3 +/- 3.4 years were enrolled in the study. Twenty-nine healthy female volunteers matched for age, weight, height and body mass index served as the controls. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry. RESULTS: BMD of the lumbar spine, radius, Ward's triangle and total body were comparable in the two groups. In contrast, BMD of the femoral neck, trochanter and shaft of patients was slightly higher than those of controls. There were no correlations between BMD values and clinical parameters. CONCLUSION: Exogenous subclinical hyperthyroidism during adolescence has no demonstrable detrimental effect on peak bone mass attainment.

Adolescent↗

PubMed2005

Capillary blood beta-hydroxybutyrate measurement by reagent strip in diagnosing diabetic ketoacidosis.

OBJECTIVE: To compare blood beta-hydroxybutyrate (beta-OHB) levels measured by reagent strip with serum ketone levels assessed by the nitroprusside reaction in diagnosing diabetic ketoacidosis (DKA). DESIGN: Prospective study of DKA in 19 Thai diabetic patients from September 2001 until August 2002. SETTING: A university hospital. PATIENTS: Nineteen patients with DKA and ten patients with metabolic acidosis from other causes. INTERVENTIONS: Capillary blood alpha-OHB was measured by a blood ketone meter (MediSense Optium). Concurrently, serum ketone was measured semiquantitatively by nitroprusside reaction (Ketostix, N-multistix, and Labstix). MAIN OUTCOME MEASURE: Sensitivity, specificity, and ROC curve of both methods in diagnosing DKA. RESULT: Mean age +/- SD of DKA patients was 45.6 +/- 16.95 years. Plasma glucose was 675.25 +/- 188.15 mg/dL, arterial blood pH 7.19 +/- 0.12, anion gap and serum bicarbonate 29.93 +/- 4.90 and 8 +/- 3.35 mmol/L. Serum ketone was moderately to markedly positive in most cases. Capillary beta-OHB ranged from 2.4 to >6 mmol/L. The sensitivity and specificity of serum ketone by nitroprusside reaction in diagnosing DKA were 95% and 100%. The sensitivity and specificity of capillary beta-OHB was 90% and 100% respectively. The areas under ROC curves of serum ketone and capillary beta-OHB were 0.975 and 0.950 (NS) respectively. CONCLUSION: Serum ketone and blood beta-OHB measurement are equally effective in diagnosing DKA among uncomplicated cases.

3-Hydroxybutyric Acid↗

PubMed2005

Association of circulating leptin with bone mineral density in males and females.

Leptin, a hormone produced by fat cells, possesses several physiological functions not limited to energy balance. Recently, leptin has been shown to inhibit bone formation through its action at the hypothalamus. In the present study, the authors explored the association of leptin with bone mineral density (BMD) in men and women according to menopausal status. Subjects consisted of 75 men, 51 premenopausal women and 63 postmenopausal women aged 20-80 years. All were healthy and did not take medication which may affect bone metabolism. BMD was measured at L2-4 and femoral neck by DEXA. Serum leptin concentrations were measured by radioimmunoassay. Serum leptin in males was independently related to BMD at L2-4 (r = -0.36, p < 0.05) and the femoral neck (r = -0.32, p < 0.05) in a multiple linear regression model with age, body mass index (BMI), serum free testosterone, estradiol and leptin as independent variables. In premenopausal women, serum leptin correlated negatively to L2-4 (r = -0.29, p < 0.01) and femoral neck BMD (r = -0.29, p < 0.05) independently of age and BMI. However, in postmenopausal women, no association of leptin with BMD was found after controlling for age and BMI. The authors concluded that circulating leptin is negatively associated with BMD in men and premenopausal women, but not in postmenopausal women. The negative associations found in both premenopausal women and men in the present study strengthen the notion that leptin may inhibit bone formation during the accumulation of bone mass early in life

Adult↗

PubMed2004

Efficacy of intermittent low dose alendronate in Thai postmenopausal osteoporosis.

Alendronate has been proven to be effective in the prevention and treatment of postmenopausal osteoporosis with the recommended daily dose of 10 mg. However, a constraining requirement for dosing limited its general acceptance in treatment. Since alendronate is potent and has a long half-life, weekly administration of alendronate in lower total doses might be safer and more convenient. The purpose of this study was to determine the efficacy of low dose once-weekly 20 mg alendronate in Thai postmenopausal women with osteoporosis. Thirty-nine postmenopausal women with osteoporosis received alendronate 20 mg once a week plus 750 mg elemental calcium daily. Bone mineral density (BMD) was measured by dual energy X-ray absorptiometry (DXA) at baseline and 6 and 12 months after treatment. Serum C-terminal telopeptide of type I collagen (CTx-I) was measured by electrochemiluminescence immunoassay at baseline and 3 months after treatment. By the end of 1 year, once weekly 20 mg alendronate significantly increased vertebral BMD (+6.2%, p < 0.001 vs baseline) from baseline whereas there was a reduction of 60.7% in serum CTx-I at 3 months. However, the BMD at femur did not increase significantly (+0.64%). Conclusion. Low-dose intermittent once-weekly 20 mg alendronate was effective, cost saving and had a good safety profile in increasing vertebral BMD and stabilizing BMD at the femoral neck in postmenopausal osteoporosis.

Absorptiometry, Photon↗

PubMed2003

The implication of assessing a polymorphism in estrogen receptor alpha gene in the risk assessment of osteoporosis using a screening tool for osteoporosis in Asians.

Both genetic and environmental factors interact to determine bone mass and the risk for developing postmenopausal osteoporosis. Recently, an Asian-specific tool, the Osteoporosis Self-Assessment Tool for Asians (OSTA), has been developed to assess the risk of osteoporosis in women. An index is calculated by multiplying the difference in body weight in kilograms and age in years by 0.2 and disregarding the decimal digits. The risk of osteoporosis is classified as high, intermediate or low according to the OSTA index less than -4, -4 to -1 and greater than -1. In the present study we examined how a single nucleotide polymorphism (SNP) in exon 8 of the estrogen receptor alpha (ERalpha) gene affected the predictive value of the OSTA index. Subjects consisted of 358 postmenopausal women who were at least 55 years old. BMDs were measured by DXA, and the SNP in the ERalpha gene was assessed by PCR-RFLP. When considering both the OSTA index and ERalpha genotype in a logistic regression model, it was found that both the OSTA index and the ERalpha genotype independently contributed to the risk of osteoporosis. The odds ratios were 1.58 (95% CI 1.26-1.91) and 2.51 (95% CI 1.42-4.44) for one unit decrement in the OSTA index and each copy of the A allele of the ERalpha genotype, respectively. The joint effect conformed more to a multiplicative model of interaction than an additive model. This suggests that persons with the high-risk genotype are at far greater risk of developing osteoporosis with advancing age or decreasing body weight, the two variables from which the OSTA index is derived. Targeting preventive measures for osteoporosis subjects with risk factors and also disease-susceptibility alleles is likely to be more cost effective.

Aged↗

PubMed2003

Effect of alendronate on bone mineral density and bone turnover in Thai postmenopausal osteoporosis.

Alendronate has recently been approved for the prevention and treatment of postmenopausal osteoporosis, and its efficacy has been demonstrated in many Western countries. Our present study was performed to evaluate the effect of alendronate on bone mineral density (BMD) and its tolerability in Thais. Eighty postmenopausal women with osteoporosis participated in this study. After giving informed consent, the subjects were randomly allocated either 10 mg alendronate or placebo in a double-blind fashion. All patients received a supplement of 500 mg elemental calcium daily. BMD at the lumbar spine, femoral neck, and distal forearm was measured at baseline and 6 and 12 months after treatment. Biochemical markers of bone resorption were determined at baseline and 6 months after treatment. Baseline characteristics were similar in both alendronate- and placebo-treated groups. Ten subjects discontinued the study. Of 70 subjects, 32 received 10 mg alendronate daily and the remaining subjects received placebo. At 1 year, BMD in the alendronate-treated group had increased from baseline by 9.2%, 4.6%, and 3.1% at lumbar spine, femoral neck, and distal forearm, respectively. These percentages were greater than those in controls (4.1%, 0.6%, and 1.0%, respectively). Urinary N-terminal telopeptide (NTx)-I and serum C-terminal telopeptide (CTx)-I levels decreased in both groups after 6 months of treatment. However, more reduction was demonstrated in the alendronate-treated group (71.9% vs. 28.4%, P < 0.01, and 84.7% vs. 33.1%, P < 0.01, respectively). Compliance with treatment and drug tolerability were good in both alendronate and placebo groups. We concluded that treatment with alendronate 10 mg daily for Thai postmenopausal women with osteoporosis significantly increased BMD at all skeletal sites and reduced biochemical markers of bone resorption. It was well tolerated without any serious side effects.

Aged↗

PubMed2003

Genetic polymorphisms of estrogen receptor-alpha: possible implications for targeted osteoporosis therapy.

Genetic factors play an important role in the determination of bone mass and osteoporosis. A number of candidate genes have been implicated in osteoporosis, including genes encoding type 1 collagen, vitamin D receptor, estrogen receptor-alpha (ERalpha), and others. A number of association studies have been performed with single nucleotide polymorphisms in the ERalpha gene to assess their relation with bone mineral density in pre- and postmenopausal women, as well as the rate of bone loss after menopause and skeletal response to estrogen administration. The polymorphisms studied thus far mostly involved intronic polymorphisms in intron 1. Other less frequently studied polymorphisms include those in exons 1, 4, and 8. Although most studies demonstrated associations with various bone-related parameters, the results are still disputed. Assessing genetic factors including ERalpha polymorphisms, if their significances are confirmed, can be helpful in targeting preventive measures to individuals with higher risk of developing osteoporosis and render the preventive effort more cost-effective. Moreover, pharmacogenetically, it may help identify postmenopausal women who tend to have better skeletal responses after estrogen replacement. It is not known, however, if patients who possess favorable polymorphisms in terms of skeletal responsiveness will also have an undesirably higher risk of adverse effects. This issue needs to be further investigated before clinical decisions based on the balance between benefits and risks can be made.

Animals↗

PubMed2002

Risk of calcium oxalate nephrolithiasis in postmenopausal women supplemented with calcium or combined calcium and estrogen.

BACKGROUND: Recent studies showed that postmenopausal women lost less bone mass when supplemented with calcium or estrogen therapy. However, the safety of the treatments in terms of the risk of calcium oxalate stone formation is unknown. We therefore conducted this study to determine the alteration in calcium oxalate supersaturation after calcium supplement or after combined calcium and estrogen therapy in postmenopausal osteoporotic women. METHODS: Fifty-six postmenopausal women were enrolled in this study. All subjects were more than 10 years postmenopausal with vertebral or femoral osteoporosis by bone mineral density criteria. They were randomly allocated to receive either 625 mg of calcium carbonate (250 mg of elemental calcium) at the end of a meal three times a day (group A, n=26) or calcium carbonate in the same manner plus 0.625 mg/day of conjugated equine estrogen and 5 mg medrogestone acetate from day 1-12 each month (group B, n=30). The age (mean +/- S.E.M.) was 66.3 +/- 1.2 and 65.1 +/- 1.1 years, weight 54.1 +/- 1.2 and 55.3 +/- 2.1 kg, in group A and group B, respectively. Urine specimens (24-h) were collected at baseline and 3 months after treatment for the determination of calcium oxalate saturation by using Tiselius's index (AP(CaOx)) and calcium/citrate ratio. RESULTS: After 3 months of treatment, there was no significant alteration from baseline for urinary excretion of calcium, citrate and oxalate. Urinary phosphate excretion was significantly reduced (6.3 +/- 0.7 vs. 5.1 +/- 0.7 mmol/day for group A and 8.2 +/- 0.9 vs. 5.8 +/- 0.7 mmol/day for group B, P<0.05), whereas net alkaline absorption was significantly elevated (10.1 +/- 3.6 vs. 20.1 +/- 4.4 meq/day for group A and 4.8 +/- 3.2 vs. 19.9 +/- 3.6 meq/day for group B, P<0.05). Calcium/citrate ratio and AP(CaOx) determined at baseline were not different from the corresponding values after treatment in both groups; calcium/citrate: 10.1 +/- 3.1 vs. 10.1 +/- 2.5 for group A and 9.3 +/- 1.8 vs. 11.9 +/- 2.5 for group B and AP(CaOx): 1.1 +/- 0.1 vs. 1.3 +/- 0.2 for group A and 1.2 +/- 0.2 vs. 1.1 +/- 0.1 for group B. There were eight and nine patients with high AP(CaOx), or >2, at baseline and after treatment, respectively. CONCLUSIONS: Calcium supplement with a meal or combined calcium supplement and estrogen therapy is not associated with a significant increased risk of calcium oxalate stone formation in the majority of postmenopausal osteoporotic patients. Determination of urinary saturation for calcium oxalate after calcium and estrogen supplements, especially at the initial phase of treatment, may be helpful in the avoidance of nephrolithiasis.

Aged↗

PubMed2002

Bone histology and bone mineral density after correction of acidosis in distal renal tubular acidosis.

BACKGROUND: The association between chronic metabolic acidosis and alterations in bone cell functions has been demonstrated in vitro and in animal studies. However, the causal role of acidosis and the effects of alkaline therapy on bone histology and bone mineral density in chronic metabolic acidosis have never been systematically demonstrated in humans. This study was conducted to examine the alterations in bone mineral density and bone histology before and after correction of acidosis among patients with distal renal tubular acidosis (dRTA) METHODS: Correction of metabolic acidosis by potassium citrate was done in non-azotemic dRTA patients, 6 females and 4 males, who had never received long-term alkaline therapy before enrolling into this study. Blood chemistries, serum intact parathyroid hormone, and 24-hour urine collection for the determination of urinary calcium, phosphate, sodium, potassium, bone mineral density determination, and transiliac bone biopsy were done in all patients at baseline and after one year of potassium citrate therapy. RESULTS: Significant elevations in serum bicarbonate (16.5 +/- 3.0 vs. 24.6 +/- 2.8 mEq/L, P < 0.05) and urinary potassium excretion (35.2 +/- 7.9 vs. 55.4 +/-3.5 mEq/L, P < 0.05) were observed after potassium citrate therapy. No significant alterations in other serum and urine electrolytes were found after the therapy. Serum intact parathyroid hormone level was also significantly elevated after one year of treatment (12.8 +/- 7.3 vs. 26.2 +/- 8.7 pg/mL, P < 0.05). Bone formation rate was significantly suppressed at baseline and was normalized by the treatment (0.02 +/- 0.02 vs. 0.06 +/- 0.03 microm(3)/microm(2)/day, P < 0.05). There were non-significant elevations in trabecular bone volume, osteoblastic and osteoclastic numbers. Bone mineral densities in dRTA patients were also significantly decreased below normal values in most studied areas at baseline and were significantly elevated at the trochanter of femur (0.677 +/- 0.136 vs. 0.748 +/- 0.144 g/c m(2), P < 0.05) and total femur (0.898 +/- 0.166 vs. 0.976 +/- 0.154 g/c m(2), P < 0.05) after the treatment. CONCLUSIONS: This study demonstrates that alkaline therapy corrects abnormal bone cell function and elevates bone mineral density in dRTA patients, indicating the causal role of acidosis in the alterations of bone cell functions and reduction in bone mineral density. Parathyroid gland activity also may be involved in the adaptation of the body to chronic metabolic acidosis.

Acidosis, Renal Tubular↗

PubMed2002

[Osteoporosis in Thailand].

Osteoporosis is a health problem which is becoming more prevalent in Thailand. A number of differences compared to Caucasian populations, however, exist which include the burden and the diagnosis of osteoporosis, genetics of osteoporosis, vitamin D status and calcium intake. Thai postmenopausal women suffer less hip fractures despite lower bone mineral density (BMD). Other environmental or genetic factor are likely to play modulatory role on the determination of osteoporotic fractures besides BMD. Distal renal tubular acidosis is prevalent in certain parts of Thailand. The disorder in which low BMD is a clinical feature needs to be excluded before the diagnosis of osteoporosis based on bone densitometry can be made. Genetic factors play important role in the determination of osteoporosis and osteoporotic fractures. The cohort of genes involved in osteoporosis and their impact are likely to be different among populations with different ethnic background. Besides genetic factors, environmental factors such as calcium intake and vitamin status are also crucial. Thailand is situated in a geographic area with abundant sunlight exposure and vitamin D deficiency is not commonly found in our elderly who are still active and ambulatory. Due to adequate vitamin D status, favorable vitamin D receptor genotype and less urinary calcium loss because of smaller body built, the optimal calcium in Thais may not be as high as that recommended in Caucasians.

English Abstract↗

PubMedDate not supplied

Community pharmacy-based implementation and evaluation of an osteoporosis self-assessment tool for Asians.

OBJECTIVES: To implement an osteoporosis screening and referral program in community pharmacies and evaluate the use of the Osteoporosis Self-Assessment Tool for Asians (OSTA) as the screening instrument. DESIGN: Uncontrolled study. SETTING: Three community pharmacies in Bangkok, Thailand. PATIENTS: 51 women aged 50 years or older without prior diagnosis of osteoporosis; three community pharmacists; six hospital-based physicians. INTERVENTION: OSTA assessment by community pharmacists of the risks of osteoporosis in patients; counseling of patients about diet and exercise; referral of patients at high risk (OSTA index value less than -4) to hospitals where pharmacists had made arrangements in advance; and assessment of satisfaction and opinions of participating patients and physicians. RESULTS: Of the 51 patients, 32 (62.7%) were categorized as low risk (OSTA index value > -1) and 19 (37.3%) as intermediate risk (OSTA index value range, -4 to -1). The majority of patients (97%) were satisfied with the program and the knowledge gained. Even though no high-risk patients were identified and referred for medical care, all six participating physicians agreed with having risk assessment service in community pharmacies and the prearranged referral system, and five of six physicians believed that OSTA results were valuable in the management of osteoporosis. CONCLUSION: Community pharmacy-based osteoporosis risk assessment services using OSTA were well accepted by the patients and participating physicians. Public health benefits may result from the provision of osteoporosis risk screening services in community pharmacies in Thailand and other Asian countries.

Community Pharmacy Services↗

PubMedDate not supplied

Lack of association of VDR polymorphisms with Thai prostate cancer as compared with benign prostate hyperplasia and controls.

While still relatively low as compared to rates in the Western world, prostate cancer is on the increase in Asia, presumably due to change in dietary and other lifestyle factors. One risk factor is reported to be vitamin D (VD) and therefore the function of its receptor (VDR) could be of importance. In the present study polymorphims with functional significance in the Bsm, Apa 1 and Taq 1 genes were therefore compared in 28 prostate cancer (CaP), 44 benign prostate hyperplasia (BPH) and 30 control cases in Thailand. None demonstrated any significant variation in distribution within these three groups and therefore we conclude that vitamin D may not be major risk factor for prostate cancer in this population. However, there is considerable variation in the distribution frequencies from country to country and this, combined with differences in sun exposure, means that the results may not be extrapolated to the general case.

Age Distribution↗