Osteoporosis and beta-thalassemia major: role of the IGF-I/IGFBP-III axis
| Autor: | G. Denuzzo, Anna Meo, Antonino Lasco, Agostino Gaudio, Alessandra Crisafulli, Nancy Morabito, Nicola Frisina |
|---|---|
| Rok vydání: | 2002 |
| Předmět: |
Adult
Male Deoxypyridinoline medicine.medical_specialty Bone disease Hormone Replacement Therapy Endocrinology Diabetes and Metabolism Osteoporosis Medroxyprogesterone Acetate Deferoxamine Iron Chelating Agents Bone resorption Bone and Bones Bone remodeling chemistry.chemical_compound Endocrinology Bone Density Reference Values Internal medicine Methyltestosterone medicine Humans Insulin-Like Growth Factor I Femoral neck Lumbar Vertebrae biology business.industry Femur Neck Estrogen Replacement Therapy beta-Thalassemia medicine.disease Osteopenia medicine.anatomical_structure Cross-Sectional Studies Insulin-Like Growth Factor Binding Protein 3 chemistry Osteocalcin biology.protein Female business Biomarkers |
| Zdroj: | Scopus-Elsevier |
| ISSN: | 0391-4097 |
| Popis: | Patients with beta-thalassaemia major are susceptible to osteopenia due to several factors which interfere with bone remodeling. It is known that bone metabolism and skeletal consolidation result from a complex sequence of hormonal changes, where the concerted actions of GH, IGF-I and sex hormones and their receptors, are responsible for the timing and attainment of skeletal consolidation. IGF-I and the corresponding binding protein (IGFBP-III), markers of bone metabolism and lumbar and femoral neck BMD were measured in 28 adult patients, undergoing hormonal replacement and chelation therapy and a hypertransfusion program, with beta-thalassaemia major (12 males with mean age 22.5+/-3.1 and 16 females with mean age 27.5+/-8.2), and in 28 healthy volunteers matched for age, anthropometric features and sex to the patients. BMD values, both at lumbar and femoral neck level were significantly lower (p0.001 and p0.05) by 18.7 and 4.2% respectively, in patients than in the controls. Markers of bone resorption [pyridinoline (Pyr) 78.1+/-15.7 vs 47.5+/-11.2 pmol/pmol urinary creatinine, p0.001 and deoxypyridinoline (D-Pyr) 21.9+/-3.5 vs 14.5+/-5.4 pmol/ micromol urinary creatinine, p0.001] were higher in patients than in controls, whereas the marker of bone formation was slightly lower [osteocalcin (BGP) 3.8+/-0.6 vs 4.6+/-1.7 pmol/ml, p0.05]. Plasma levels of IGF-I (21.07+/-5.12 vs 35.25+/-8.33 nmol/ml, p0.001) and IGF binding protein III (IGFBP-III) (1.9+/-0.4 vs 2.5+/-0.1 mg/ml, p0.001) were lower in patients than in controls and positively correlated with BMD L2-L4 (r=0.57, p0.05 and r=0.47, p0.05 respectively), BMD neck (r=0.40, p0.05 and r=0.34, p0.05 respectively) and BGP (r=0.52, p0.05 and r=0.34, p0.05 respectively). Our beta-thalassaemic patients, in spite of normalizing hemoglobin levels, adequate hormone replacement and chelation therapies, showed osteopenia and an unbalanced bone turnover with an increased resorptive phase and a decreased formation phase probably correlated to low levels of IGF-I and IGFBP-III observed in our study. |
| Databáze: | OpenAIRE |
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