Purpose: PTH (parathyroid hormone) level is a useful index for prediction of hypocalcemia after thyroidectomy. The fast results are required for an early diagnosis of hypocalcemia. In this study, we evaluated the PTH change according to incubation time, and investigated the usefulness of hypocalcemia diagnosis of PTH results in early incubation time. Materials and Methods: The subjects were 131 patients who had taken the PTH test from July to August in 2009. All experiments were used IRMA method. PTH value were evaluated with the correlation between precision (10 times repeat) and recovery rate and at 0.5, 3, 6 and $18{\pm}2$ (below overnight) hours following incubation time. Data analysis was investigated with relationship of the sensitivity, specificity, PPV (positive predictive value) and accuracy. Results: The correlation was time-dependent with levels reaching $R^2$=0.987 at 0.5 hours, $R^2$=0.993 at 3 hours and $R^2$=0.996 at 6 hours compare to overnight levels. The precision (%CV${\pm}$SD) were $15.92{\pm}15.54$ at 0.5 hours, $6.91{\pm}7.38$ at 3 hours, $4.30{\pm}4.69$ at 6 hours and $4.59{\pm}2.59$ at overnight. The recovery rate (%Mean${\pm}$SD) were $96.8{\pm}5.44$ at 0.5 hours, $102.6{\pm}4.35$ at 3 hours, $100.7{\pm}2.56$ at 6 hours and $102.2{\pm}5.98$ at overnight. When 15 pg/ml of overnight density was set up as criteria, we measured the sensitivity, specificity and PPV, accuracy at 0.5, 3, 6 hours. The sensitivity was shown to 97.5% at all times. The specificity was 96.0% at 0.5 hours, 100% at 3 hours and 92.3% at 6 hours for control, respectively. The PPV was 86.6% at 0.5 hours, 100% at 3 hours and 92.8% at 6 hours. The accuracy was shown to 84.7% at 0.5 hours, 97.5% at 3 hours and 90.6% at 6 hours. These data were accompanied by a corresponding PTH value of overnight incubation time, which significantly correlated with early time results. Conclusion: The values of PTH at 3 hours has favorable the rate of concordance of 94.1% and may be useful for prediction of hypocalcemia, and it responses to overnight incubation PTH values. Therefore, This method may be an attractive alternative to proper treatment to stop symptom revelation by giving a calcium agent to the patient.
This study was conducted to examine whether bone mineral density changes in 55 young Korean college women aged 19 to 26 years over 2 years and nutritional and biochemical factors are related. Bone mineral density (BMD) was measured in the spine (LS), femoral neck (FN), ward's triangle (WT), and femoral trochanter (FT) by dual energy X-ray absorptiometry three times at one-year intervals. Serum osteocalcin (OC), parathyroid hormone (PTH), and urinary cross-linked N-teleopeptides of type collagen (NTx) were measured. Dietary intake was assessed 8 times with 24-hour recall method. Physical activity (PA) was obtained by questionnaire and body fat content was measured by bioelectrical impedance analysis at baseline and after 2 years. Analyses were performed on 34 subjects with all three BMD measurements. The BMDs at the lumbar spine gradually increased over 2 years, while the BMDs of three sites at the femur were sustained or increased. The mean OC, PTH had a similar pattern with the change of BMD at the femur. The mean NTx decreased over 2 years but was still higher than those in other studies. BMI, body fat, vitamin A and zinc intake had a significant correlation with LS-BMD. Femur, PTH, body fat, vitamin A, vitamin B$_2$and calcium intake had a significant correlation with WT-BMD and was mostly influenced by diet. By multiple regression analysis, it was shown that the significant factors affecting the LS-BMD were BMI and vitamin A intake and those affecting FN and WT were age, BMI, PTH and calcium intake. These results indicate that some Korean women still experience increases in BMD and that this was associated with PTH and vitamin A and calcium intake. Therefore, proper diet and diet management is needed to increase changes in BMD among college women.
The overall purpose of this study was to investigate the effects of level of isoflavones supplementation on bone metabolism in growing female rats. Forty-five rats divided into three groups; Control, l/2IF, and lIF. Serum osteocalcin and alkaline phosphatase (ALP) activity, urinary deoxypyridinoline (DPD) crosslinks value were measured to monitor bone formation and resorption at the ninth week after feeding. Hormones related to bone metabolism were determined, included parathyroid hormone (PTH) , calcitonin, estradiol, growth hormone and insulin-like growth factor I (IGF-I). The results of this study were as follows: the isoflavones intake level did not affect weight gain, mean food intake and food efficiency ratio. The serum concentration of osteocalcin and the activity ofALP were not significantly different by different levels of isoflavones supplementation. The urinary DPD crosslinks value was not significantly different by different levels ofisoflavones supplementation. There were no significant differences in serum PTH, estradiol and IGFI among all groups. However, calcitonin was shown significantly higher in the groups of lIF and l/2IF than control group. And growth hormone was shown significantly higher in the groups of lIF than control group. (Korean J Nutr 2008; 41(3): 199~205)
The purpose of this study was to investigate nutrient intake and bone status in rural postmenopausal women in Korea. Ten postmenopausal women in An-Sung area participated in this study and they were divided into two groups ; women in group I had been postmenopausal for 4 years or less and those in group II had been postmenopausal for 5 years or more before the present study began. Their environmental factors and dietary intakes were surveyed through the personal interviews. Serum levels of calcium, phosphorus, parathyroid hormone(PTH), estradiol and urinary Ca, P, creatinine, hydroxyproline levels were measured from December 4 to December 27 in 1993. The reults of this study are summarized as follows : Average ages of group I and II were 54.8 and 57.2 years. Average menopausal ages of group I and II were 50.8 and 47.3 years. The nutrient intakes of subjects were higher than recommended dietary allowances(RDA) except calorie, protein, calcium, and vitamin A. The nutrient status did not show any significant difference between group I and II. Serum levels of Ca, P, PTH, estradiol and urinary P, creatinine excretion did not show any significant difference between group I and II, and all levels were in normal range. Urinary Ca excretion(p<0.05) and hydroxyproline excretion(p<0.01) were significantly lower in group I than in group II. Urinary Ca/creatinine(Ca/cr) and hydroxyproline/creatinine(Hpr/cr) rations were significantly higher in group II than in group I(p<0.01. And Hpr/cr levels of group I were in normal range, but most of subjects in group II were higher than 0.017 indicating sign of osteoporosis. Correlations between parameters showed that serum PTH adn urinary Ca, Ca/cr levels were positive related (p<0.01), and the years of the after menopausal year and urinary Hpr/cr was also positive related(p<0.05). The present results suggests that it is difficult to protect postmenopausal women's bone destruction having Korean usual diets. Therefore, to prevent osteoporosis with aging, minimizing the hormonal changes in postmenopausal women is needed as well as Ca supplementation and proper exercise before menopause begins.
It has been more than three decades since the first assay assessing circulating 25 (OH)D in human subjects was performed That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25 (OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25 (OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400 IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25 (OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25 (OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of 25 (OH)D$\leq$30 ng/mL. In certain cases, such as pregnancy and lactation, significantly higher circulating 25 (OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.
Proceedings of the Korean Nutrition Society Conference
/
2004.11a
/
pp.22-33
/
2004
It has been more than three decades since the first assay assessing circulating 25(OH)D in human subjects was performed. That publication as well as several that followed it defined 'normal' nutritional vitamin D status in human populations. Recently, the wisdom by which 'normal' circulating 25(OH)D levels in human subjects were assigned in the past has come under question. It appears that sampling human subjects, who appear to be free from disease, and assessing 'normal' circulating 25(OH)D levels by plotting a Gaussian distribution is grossly inaccurate. There are many reasons why this method is inaccurate, including race, lifestyle habits, sunscreen usage, age, latitude, and inappropriately low dietary recommendations for vitamin D. For instance, a 400IU/day. AI for vitamin D is insignificant when one considers that a 10-15 minute whole body exposure to peak summer sun will generate and release up to 20,000 IU vitamin $D_3$ into the circulation. Recent studies, which orally administered up to 10,000 IU/day vitamin $D_3$ to human subjects for several months, have successfully elevated circulating 25(OH)D levels to those observed in individuals from sun-rich environments. Further, we are now able to accurately assess sufficient circulating 25(OH)D levels utilizing specific biomarkers instead of guessing what an adequate level is. These biomarkers include intact parathyroid hormone (PTH), calcium absorption, bone mineral density (BMD), insulin resistance and pancreatic beta cell function. Using the data from these biomarkers, vitamin D deficiency should be defined as circulating levels of $25(OH)D{\leq}30ng/mL$. In certain cases, such as pregnancy and lactation, significantly higher circulating 25(OH)D levels would almost certainly be beneficial to both the mother and recipient fetus/infant.
Kim, Jung-Sook;Kim, Ji-Hyeon;Ha, Soo-Min;Hynn, Su-Jin;Yoon, Byeong-Kon;Kim, Do-Yeon
Journal of the Korean Applied Science and Technology
/
v.35
no.2
/
pp.519-531
/
2018
The purpose of this study was to investigate the effects of combined exercise program on short physical performance battery, bone mineral density and parathyroid hormone levels in elderly women. This study subjects were 22 elderly female volunteers, aged 65-75 years and they divided into the combined exercise group(n=11) and the "no exercise" control group(n=11). The combined exercise included the line dance program performed twice per week for 60 minutes and the resistance exercise program performed once per week during 12 weeks. Exercise intensity was progressively increased from RPE "fairly light" to "slightly hard" (from 11 to 14). The findings of this study were as follows; Short physical performance battery(Balance test, gait speed, and rising from a chair five times) and bone mineral density (lumbar spine L2~L4 bone densities, and the T-score) were significantly increased after 12 weeks in the exercise group compared to the baseline. The PTH level was significantly decreased in the exercise group compared to the baseline. In conclusion, regular and continuous physical activity was effective for improving short physical performance and had a positive effect on bone mineral density and parathyroid hormone. With aging, women have decreased muscle strength and bone density and therefore, it is strongly recommended that women need to carry out continuous physical activity to prevent disease and ensure a healthy retirement.
Bone marrow culture systems are widely used to differentiate osteoclast-like cells in vitro using several osteotropic hormones. In this study, we isolated and cultured the mouse bone marrow cells with or without some osteotropic hormones such as parathyroid hormone(PTH), prostaglandin $E_2(PGE_2)$ and $l,25(OH)_2-vitamin$$D_3$(Vit. $D_3$). We confirmed the formation of osteoclast-like cells morphologically and functionally by the expression of tartrate-resistant acid phosphatase(TRAP) and by their capability to resorb dentin slices. We also studied the effects of transforming growth $factor-{\beta}(TGF-{\beta})$ and epidermal growth factor(EGF) on the Vit. $D_3-induced$ osteoclast-like cell formation. In control, a few multinucleated cells were formed whereas PTH and $PGE_2$ increased the number of multinucleated cells. PTH, $PGE_2$ and Vit. $D_3$ induced the formation of TRAP-positive multinucleated cells. After culture of mouse bone marrow cells on the dentin slices with or without osteotropic hormones, giant cells with diverse morphology were found on the dentin slices under the scanning electronmicroscopy. After removing the attached cells, resorption pits were identified on the dentin slices, and the shape of resorption pits was variable. EGF increased the osteoclast-like cell formation induced by Vit. $D_3$, however, $TGF-{\beta}$ showed biphasic effect, which at low concentration, increased and at high concentration, decreased the osteoclast-like cell formation induced by Vit. $D_3$.
To study the effects of the age and the dietary protein content on Ca metabolism male rats of 1 month 6 month 12 month of age were fed experimental diets containing 5%, 15% or 50% casein for 4 weeks. Food and ca intake were higher in old rats and in high protein groups. The weight ash and Ca contents of femur and tibia were higher in old rats. The higher dietary protein level resulted in higher skeletal weigh ash and Ca contents. But high protein diet(50% casein) lead to reduced bone mineral density(ash/dry bone weight) and Ca density(Ca/dry bone weight) in 1 month old rats. Low protein diet(5% casein) on the other hand reduced the bone growth even though the bone density was higher in this group. The ill effect of low protein diet was not evident in 12 month old rats. Glomerular filteration rate(GFR) and urinary Ca excretionincreased with age and with dietary protein level especially in 12 month old rats. Serum immunoreactive parathyroid hormone(iPTH) level tended to be higher in aged rats but was not affected by dietary protein level except 1 month old rats where 50% protein group showed significantly higher value. This study showed that the dietary protein level seemed to have different effect on Ca metabo-lism in rats of different age., The low bone density in the high protein group of growing rats may be due to the higher iPTH level and increased urinary Ca. The dietary protein level however had no effects on the bone composition in aged rats even though the higher urinary Ca excretion. In conclusion this study suggests that high protein intake from young may lead to less peak bone mass and to increase the bone loss in later years, which would increase the risk for osteporosis.
This study was carried out to compare the relationship between biochemical indices and bone mineral density (BMD) in 50 pre-menopausal and 50 post-menopausal women. The subjects were divided into normal and risk groups according to their bone status, as determined by T-scores of the lumbar spine and femur. The average T-score of the lumbar spine was higher (p<0.05) in pre-menopausal women ($0.42{\pm}0.18$) than post-menopausal women ($-0.08{\pm}0.21$). Serum levels of HDL-cholesterol, P, and Fe were significantly higher in the risk group than the normal group in pre-menopausal women (p<0.05). Serum levels of total protein, globulin, alkaline phosphatase (ALP), and osteocalcin were lower in the risk group than the normal group, whereas the level of estrogen was higher in the normal group than the risk group in post-menopausal women (p<0.05). In pre-menopausal women, P was positively correlated with Ca (p<0.01), and ALP was positively correlated with osteocalcin (p<0.01) and parathyroid hormone (PTH) (p<0.05). Further, insulin-like growth factor-I (IGF-I) was negatively correlated with the vitamin $25(OH)D_3$ and vitamin K (p<0.05). In post- menopausal women, the Ca was positively correlated with vitamin $25(OH)D_3$ (p<0.05) and vitamin K (p<0.01), and P was positively correlated with vitamin K (p<0.01), Ca (p<0.01), and IGF-I (p<0.05) and negatively correlated with PTH (p<0.05). IGF-I was negatively correlated with PTH (p<0.01) and estrogen (p<0.05), and ALP was positively correlated with osteocalcin (p<0.01) and negatively correlated with vitamin K and estrogen (p<0.05). In pre-menopausal women, the lumbar spine BMD was positively correlated with vitamin K level (p<0.01) and negatively correlated with P level (p<0.05). In post-menopausal women, the femur BMD was positively correlated with estrogen level and negatively correlated with PTH leves (p<0.05). These results suggest that vitamin K and P levels are associated with bone health in pre-menopausal women, and estrogen and PTH levels are associated with bone health in post-menopausal women.
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