Biomedical subjects

P Rødbro

Publications and source records attributed to P Rødbro.

At least 37 records · Page 2Linked to original sources

PubMed1986

The role of serum concentrations of sex steroids and bone turnover in the development and occurrence of postmenopausal osteoporosis.

It has been debated whether postmenopausal osteoporosis is characterized by high or low bone turnover and whether circulating levels of sex steroids contribute to the occurrence of osteoporotic fractures. We examined 154 70-year-old women with or without osteoporotic fractures, and 178 early postmenopausal women with a "rapid" or a "slow" bone loss. In all participants, we determined markers of bone formation (serum alkaline phosphatase (AP) and serum bone Gla protein (BGP)), markers of bone resorption (fasting urinary calcium/creatinine (FU Ca/Cr) and hydroxyproline/creatinine (FU Hpr/Cr)), and serum estrone (E1), estradiol (E2), androstenedione (A), and fat mass. The 70-year-old women with osteoporotic fractures had significantly elevated AP (P less than 0.001), BGP (P less than 0.001), and FU Hpr/Cr (P less than 0.001) compared with the group without fractures. In the group of early postmenopausal women, the "rapid" bone losers had significantly increased FU Hpr/Cr (P less than 0.001) and FU Ca/Cr (P less than 0.001). E1, E2, A, and the fat mass did not differ in the groups with and without osteoporotic fractures, whereas the "rapid" bone losers had significantly lower E1 (P less than 0.05), E2 (P less than 0.05), and fat mass (P less than 0.01) than the "slow" bone losers. It is concluded that patients with manifest osteoporosis and early postmenopausal women with a rapid bone loss have increased biochemical markers of bone turnover. Moreover, the present study demonstrates that early postmenopausal women with an "excessive" bone loss have significantly decreased serum estrogens, whereas it is not possible to detect low estrogens in women with osteoporotic fractures.

Aged↗

PubMed1986

Oestrogen-progestogen replacement therapy changes body composition in early post-menopausal women.

Changes in body composition were investigated in a group of 136 post-menopausal women treated for at least 1 yr with combined oestrogen-progestogen therapy at three different doses, or a placebo. The body composition changes were evaluated using the urinary creatinine excretion rate as an indicator of lean body mass, and the changes in daily creatinine excretion were related to the changes in serum oestradiol and oestrone. The urinary creatinine excretion rate was significantly increased (P less than 0.001) in the group receiving high-dose hormones, and the urinary creatinine/body weight ratio was significantly increased (P less than 0.05) in all treated groups as compared with the placebo-group. The body weight remained unchanged in all groups. The relationships between the changes in daily creatinine excretion and the changes in serum oestradiol and serum oestrone were both significant (P less than 0.05). The present study suggests that high-dose post-menopausal hormone therapy changes the body composition by increasing the muscle mass and that, since the body weight remains unchanged, a proportionate decrease in the fat mass seems to occur.

Adult↗

PubMed1986

Different metabolism of vitamin D2/D3 in epileptic patients treated with phenobarbitone/phenytoin.

Serum concentrations of vitamin D metabolites were measured before and during treatment with either vitamin D2 or vitamin D3, 4000 IU per day for 24 weeks, in 22 epileptic outpatients receiving phenobarbitone/phenytoin. The serum concentration of total 1,25(OH)2D did not change during the treatment period in any of the treatment groups. On the other hand, in the vitamin D2 group, serum 25(OH)D2, total 25(OH)D, and 24,25(OH)2D increased significantly during the trial, whereas serum concentrations of the vitamin D3 metabolites were unchanged. In the vitamin D3 group, serum concentrations of the vitamin D3 metabolites increased significantly, whereas the vitamin D3 metabolite levels remained unchanged. However, vitamin D3 treatment resulted in a 2-4-fold greater increase in serum concentrations compared to vitamin D2 treatment. Treatment with vitamin D2 and vitamin D3 in the same dose in IU results in considerably different serum concentrations of the vitamin D metabolites.

24,25-Dihydroxyvitamin D 3↗

PubMed1986

Serum concentration of vitamin D metabolites during treatment with vitamin D2 and D3 in normal premenopausal women.

Serum concentrations of vitamin D metabolites were measured in 19 healthy premenopausal women before and during treatment with 4000 IU per day of either vitamin D2 or vitamin D3 for 8 weeks. Vitamin D2 treatment increased the serum concentration of 25(OH)D2, but a corresponding decrease in 25(OH)D3 resulted in an unchanged value for total 25(OH)D. The serum concentration of the D3 dihydroxy metabolites was also significantly decreased. Vitamin D3 treatment increased the serum concentrations of 25(OH)D3 and D3 dihydroxy metabolites. The serum concentration of 1,25(OH)2D did not change in either of the treatment groups. We conclude that vitamin D2 and vitamin D3 given in the same doses in international units have a different effect on the serum concentration of vitamin D metabolites and biochemical indices of calcium metabolism.

Adult↗

PubMed1986

Reliability for an imaging test: evaluation of scintigraphy to reveal liver state in gastrointestinal cancer.

In 185 consecutive, surgical patients with suspected or proven gastrointestinal cancer a preoperative liver scintigraphy was performed; liver metastases were bioptically verified in 28 patients. A seven-class descriptive system was used for blind classification of the scintigraphies according to conferential consensus. Two years later (with the knowledge of the verified incidence of metastatic liver disease) the scintigraphies were reclassified. Considering the verified state of the patients, the latter classification was substantially improved. Probability for metastatic disease increased with more abnormal class label. At best, reliability for a twice interpreted scintigraphy as a binary test to denote the true state of the liver was 92 percent. The best cut-off level for diagnostic purposes yields a probability of 1.00 for an abnormal scintigraphy to denote liver metastases, accepting that 54 percent of patients with liver metastases were not found. For screening purposes, at best, a probability of 0.98 for a normal scintigraphy to denote no liver metastases was noted; thus, 83 percent of patients with normal liver state were missed. In conclusion, we find the liver scintigraphy classification system useful to find or exclude metastases in the test population and we think the procedure applied could be useful as a vehicle to report test results for any imaging modality.

Gastrointestinal Neoplasms↗

PubMed1986

Reproducibility of an imaging test: evaluation of dual liver scintigraphy by a long-term procedure.

A seven-class classification system for liver scintigraphy was developed to find or exclude metastases in a clinically defined population with gastrointestinal tumours. Scintigraphy was performed twice in fifty patients a few days apart. During a period of three years each scintigraphy was classified thrice as a consensus between two experienced observers at six occasions placed on three separate days. No substantial change in classification was seen whether the same scintigraphy was interpreted twice in a day or three years apart, although considerable uncertainty was seen in interpretation of near-normal scintigraphies. In dual scintigraphies, a significant lower reproducibility was noted--directly visualized in 10 percent of the patients--indicating that a recorded difference does not necessarily reflect a change in patient situation. We think the applied procedure may be valuable for evaluation of any imaging system for clinical use.

Gastrointestinal Neoplasms↗

PubMed1985

Cigarette smoking, serum estrogens, and bone loss during hormone-replacement therapy early after menopause.

To elucidate the effect of smoking on estrogen metabolism, we examined 136 postmenopausal women treated for one year with one of three different doses of combined estrogen-progestogen or placebo. The women were grouped according to smoking status, and serum levels of estrone and estradiol were measured before and after treatment. The results showed reduced levels of both estrogens in smokers as compared with nonsmokers in all three dosage groups. This reduction was most pronounced in the high-dose group (4 mg of estradiol), in which the serum levels of estrone and estradiol in smokers were only 50 per cent of those in nonsmokers (P less than 0.001 and less than 0.05, respectively). In contrast, no significant changes could be demonstrated in the corresponding placebo groups. Moreover, it was possible to demonstrate significant inverse correlations between the number of cigarettes smoked daily and the changes in the levels of serum estrone and estradiol, respectively, (P less than 0.001). This study suggests that an increased hepatic metabolism of estrogens results in lower estrogen levels among postmenopausal smokers. This may contribute to the reported risk of osteoporosis among smokers.

Adult↗

PubMed1985

Uncoupling of bone formation and resorption by combined oestrogen and progestagen therapy in postmenopausal osteoporosis.

10 healthy early postmenopausal women were treated with oestrogen and progestagen for two cycles of 28 days. Serum alkaline phosphatase and bone Gla protein increased during progestagen administration, whereas urinary excretion of calcium and hydroxyproline fell significantly during treatment, independently of progestagen intake. Thus, bone formation increases when progestagen is added to oestrogen treatment, whereas bone resorption may be kept constantly low during oestrogen plus progestagen treatment, leading to a positive calcium balance. This makes possible effective treatment of postmenopausal osteoporosis--treatment of elderly postmenopausal women with substantial bone loss before their bones have fractured or when they have just started to fracture. This study design can be used for easy and rapid screening of potential drugs for the prevention and treatment of postmenopausal bone loss.

Bone Development↗

PubMed1985

Familial hypocalciuric hypercalcaemia. II. Intestinal calcium absorption and vitamin D metabolism.

We compared intestinal calcium absorption, measured by a single isotope technique, and serum concentrations of vitamin D metabolites in ten patients with familial hypocalciuric hypercalcaemia (FHH) and ten age- and sex-matched healthy controls. Our results showed no significant differences in intestinal calcium absorption or in serum concentrations of vitamin D metabolites. There was a significant correlation between serum concentrations of PTH, measured with one of our assays, and 1,25(OH)2D. We conclude that neither increased intestinal calcium absorption nor altered vitamin D metabolism plays a part in the hypercalcaemia of FHH.

Calcium↗

PubMed1985

Different metabolism of vitamin D2 and vitamin D3 in epileptic patients on carbamazepine.

Serum concentrations of vitamin D metabolites were measured in 30 epileptic outpatients on monotherapy with carbamazepine before and during treatment with either vitamin D2 or vitamin D3, 4000 IU per day for 24 weeks. Vitamin D2 treatment increased the serum concentration of 25OHD2, but a corresponding decrease in 25OHD3 resulted in an unchanged serum value of total 25OHD. Vitamin D3 treatment increased the serum concentration of 25OHD3. The resulting serum level of 25OHD was consequently twice the level of that in the D2-treated group. The serum concentrations of the dihydroxy metabolites showed a similar difference between the 2 treatment groups. We conclude that treatment with vitamins D2 and D3 in the same doses produces considerably different serum concentrations of vitamin D metabolites. If the present findings can be extrapolated to normal subjects, it is important to consider more carefully which D-vitamin should be used, both with regard to therapy and supplementation.

Adult↗

PubMed1985

Serum concentrations of vitamin D metabolites in different degrees of impaired renal function. Estimation of renal and extrarenal secretion rate of 24,25-dihydroxyvitamin D.

The serum levels of 25-hydroxycholecalciferol, 24,25-dihydroxycholecalciferol, and 1,25-dihydroxycholecalciferol were measured simultaneously in three groups of adults with different renal function: normal (n = 24), glomerular filtration rate (GFR) greater than 70 ml/min; moderately decreased (n = 15), GFR 5-35 ml/min, and severely decreased (n = 27), GFR less than 5 ml/min. 25-hydroxycholecalciferol was normal in both patient groups with decreased renal function. 1,25-dihydroxycholecalciferol was halved in the group with moderately decreased renal function (p less than 0.01) and severely decreased (almost undetectable) in the group with severely decreased renal function (p less than 0.01). In contrast, 24,25-dihydroxycholecalciferol was normal in the group with moderately decreased renal function and only halved (p less than 0.05) in the group with severely decreased renal function. These findings suggest extrarenal C-24 hydroxylase activity which may be stimulated by decreasing renal function, thus decreasing renal C-24 hydroxylase activity.

24,25-Dihydroxyvitamin D 3↗

PubMed1985

Bone mineral loss during centre and home haemodialysis. Influence of vitamin D metabolites and serum parathyroid hormone.

Twenty-seven patients on chronic haemodialysis were investigated for a mean of 4.8 years (3.0-6.5 years). Mean bone mineral content fell constantly and similarly at a rate of three to four per cent per year in both centre (n = 14) and home (n = 13) haemodialysis patients. Mean serum values of 25(OH)D3 (normal), 24,25(OH)2D3 (decreased to half the normal level and 1,25(OH)2D3 (severely decreased and almost non-detectable) were similar in patients with a rapid bone mineral content loss (greater than 10%/3 years) and a slow bone mineral loss (less than 10%/3 years). Mean serum parathyroid hormone was markedly elevated, but significantly higher (about twice the level) in the 'rapid losers' than in the 'slow losers'; whereas the two groups did not differ with regard to mean serum concentrations of calcium, phosphate and alkaline phosphatase.

Adult↗

PubMed1984

Calcium supplementation and postmenopausal bone loss.

A series of 103 early postmenopausal women completed a questionnaire about their dietary calcium intake and were then divided into three groups: those with an intake below 550 mg/day, those with an intake between 550 and 1150 mg/day, and those with an intake above 1150 mg/day. Thereafter they were given a daily supplement of 500 mg calcium for two years and had their bone mineral content measured every three months. Any changes found were taken as an estimate of bone calcium balance. All three groups showed a similar fall in bone mineral content over the two years, indicating that a calcium intake of 1000-2000 g daily is ineffective in preventing bone loss in the early menopause.

Bone and Bones↗

PubMed1984

Serum vitamin D metabolites in younger and elderly postmenopausal women.

Previous investigations have suggested that a lower-than-normal serum 1,25(OH)2D is found in elderly women with postmenopausal osteoporosis. We examined the fundamental aspects of this theory by investigating serum vitamin D metabolites in four representative samples of Caucasian women. These included 44 early postmenopausal women divided into two subgroups: fast bone losers, that is, bone loss greater than 3%/year (n = 20), and "physiological" bone loss (n = 24); and 28 70-year-old women divided into two subgroups: with and without osteoporotic fractures. Serum 1,25(OH)2D concentrations were virtually the same in all groups thus contradicting the previous reports of low 1,25(OH)2D in elderly women. Furthermore, mean 25OHD and 24,25(OH)2D did not differ between the groups. We conclude that 1,25(OH)2D is unlikely to be significant in the development or treatment of a majority of women with postmenopausal osteoporosis.

24,25-Dihydroxyvitamin D 3↗

PubMed1984

Mineral loss in cortical and trabecular bone during high-dose prednisone treatment.

To evaluate the effect of prednisone and triple treatment (sodium fluoride, calcium, and vitamin D) on trabecular and cortical bone serial bone mineral content (BMC) measurements were made at a metaphyseal (BMCD) and diaphyseal (BMCP) site on the forearm on 31 consecutive and previously bone-healthy patients scheduled for at least 24 weeks high-dose prednisone treatment. The patients were randomized into two further treatment groups: group I (n = 16) received prednisone plus triple treatment and group II (n = 15) received only prednisone. The two groups were similar with regard to age, sex, prednisone dose, and initial BMC. During 24 weeks treatment, BMCD (partially representing trabecular bone) and BMCP (mainly representing cortical bone) fell significantly and similarly, demonstrating that there is no preventive effect on bone mineral loss on the triple regimen. The BMC fall after 12 weeks was significantly more pronounced for metaphyseal (partially trabecular) than for diaphyseal (cortical) bone, whereas the values did not differ significantly after 24 weeks; this indicates a greater sensitivity to the hormone treatment of trabecular bone. In the entire group, the fall in BMC correlated positively with individual prednisone dose, significant at the diaphyseal site (r = 0.39, P less than 0.05), but not at the metaphyseal site (r = 0.31, P = 0.08). It is concluded that corticosteroid-induced osteopenia is a diffuse bone disease which affects trabecular as well as cortical bone, suggesting that BMC measured on the forearm reflects changes in bone mineral at other locations.

Adult↗

PubMed1984

Serum alkaline phosphatase during hormone treatment in early postmenopausal women. A model for establishing optimal prophylaxis and treatment in postmenopausal osteoporosis.

We propose a new model for use in establishing optimal treatment of postmenopausal osteoporosis. When hydroxyproline is taken as an estimate of bone resorption and alkaline phosphatase (ALP) of bone formation, the model indicates that the difference between hydroxyproline and ALP is reflected in the negative calcium balance, and thus the decline in bone mineral content (BMC). Since BMC increases during oestrogen treatment in postmenopausal women, in whom ALP declines gradually, it is postulated that this only happens because of a rapid decline in hydroxyproline. This decline together with BMC, must be dose-related since changes in ALP are uncorrelated to the oestrogen dose. This model fits the generally accepted opinion that the effect of oestrogen on bone loss in postmenopausal osteoporosis is limited, declines with age, and is dose-related. The model indicates that oestrogen treatment should be introduced early after the menopause in order to obtain the optimum prophylactic effect.

Adult↗

PubMed1984

Effect of 1,25-dihydroxyvitamin D3 on biochemical indices of bone turnover in postmenopausal women.

Bone metabolism was estimated by serum alkaline phosphatase (index of bone formation) and fasting urinary excretions of calcium and hydroxyproline (indices of bone resorption) in a group of early postmenopausal women and a group of 70-year-old women, during 12 months' treatment with 1,25-dihydroxycholecalciferol (1,25(OH)2D3), and compared to oestrogen/gestagen treatment or placebo treatment. The groups treated with 1,25(OH)2D3 did not show any change in bone metabolism, neither in bone resorption nor in bone formation, during the treatment period when compared to the placebo group, whereas treatment with female hormones decreased both bone resorption and bone formation.

Aged↗

PubMed1984

Does oestriol add to the beneficial effect of combined hormonal prophylaxis against early postmenopausal osteoporosis?

Sixty-nine healthy women in the early menopause were assessed in terms of calcium metabolism, coronary risk factors, Kupperman index, and various serum hormones before and during replacement therapy with 17 beta-oestradiol plus oestriol and norethisterone acetate. The patients were followed for 1 year, and the daily doses used were: 17 beta-oestradiol: 2 mg from day 1 to day 22, 1 mg from day 23 to day 28; oestriol: 1 mg from day 1 to day 22, 0.5 mg from day 23 to day 28; and norethisterone acetate: 1 mg from day 13 to day 22. Group A (n = 22) received 17 beta-oestradiol and norethisterone acetate; group B (n = 20) received 17 beta-oestradiol plus oestriol and norethisterone acetate and group C (n = 23) received a placebo. The responses in groups A and B were similar with no significant difference between the two therapy regimens. The results suggest that in the dose given, oestriol does not add significantly to the beneficial effect of combined hormonal prophylaxis against early postmenopausal osteoporosis.

Calcium↗