Prospective, controlled clinical trials in postmenopausal osteoporosis typically compare effects of an active drug with placebo in addition to vitamin D and calcium supplementation in both treatment arms. While clinical benefits are documented, the effect of this supplementation in the placebo arm and in clinical practice on bone material composition properties is unknown. The purpose of the present study was to evaluate these bone quality indices (specifically mineral/matrix, nanoporosity, glycosaminoglycan content, mineral maturity/crystallinity, and pyridinoline content) in patients that either received long-term vitamin D (400-1200IU) and calcium (1.0-1.5g) supplementation, or did not. We have analyzed by Raman microspectroscopy the bone forming trabecular surfaces of iliac crest in pre-treatment samples of a teriparatide study and the endpoint biopsies of the control arm obtained from the HORIZON trial. In general, the mineral/matrix ratio and the glycosaminoglycan (GAG) content was higher while nanoporosity, (a surrogate for tissue water content), the mineral maturity/crystallinity (MMC) and the pyridinoline (Pyd) content was lower in patients without long-term supplementation. Moreover, all indices were significantly dependent on tissue age. In conclusion, vitamin D and calcium supplementation is associated with altered mineral and organic matrix properties.

• Klíčová slova
• Bone quality, Calcium, Postmenopausal osteoporosis, Raman spectroscopy, Vitamin D,
• MeSH
• aminokyseliny metabolismus   MeSH
• analýza rozptylu MeSH
• fyziologická kalcifikace účinky léků   MeSH
• glykosaminoglykany metabolismus   MeSH
• kostní matrix účinky léků   metabolismus   MeSH
• lidé MeSH
• nanočástice chemie   MeSH
• poréznost MeSH
• postmenopauzální osteoporóza farmakoterapie   patofyziologie   MeSH
• potravní doplňky * MeSH
• Ramanova spektroskopie MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vápník farmakologie   terapeutické užití   MeSH
• vitamin D farmakologie   terapeutické užití   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• aminokyseliny MeSH
• glykosaminoglykany MeSH
• pyridinoline MeSH Prohlížeč
• vápník MeSH
• vitamin D MeSH

SUMMARY: The level of increased bone formation after 24 months of treatment with teriparatide (rhPTH (1-34), TPTD) is similar in patients who were either treatment-naïve (TN) or had lower bone turnover initially due to previous alendronate (ALN) therapy. INTRODUCTION: Bone anabolic effects of TPTD in postmenopausal women with osteoporosis may be blunted during the initial phase after switching from ALN to TPTD. To explore the long-term implications, we examined histomorphometric and biochemical markers of bone turnover of patients on TPTD therapy after long-term ALN treatment. METHODS: Paired biopsies were obtained after tetracycline double labeling at baseline and after 24 months of TPTD treatment from 29 ALN-pretreated (64.5 ± 16.4 months) and 16 TN patients. Biochemical markers were measured at baseline, during the treatment, or at study end. RESULTS: Compared with the baseline, after 24-month TPTD, activation frequency (Ac.F.) and osteoid surface (OS) increased in both groups: 0.11-0.34 cycles per year, 3.96-9.8% in the ALN-pretreated group and 0.19-0.33 cycles per year, 6.2-11.3% (p < 0.05) in the TN group, respectively. Biochemical and histomorphometric markers correlated positively both at baseline and endpoint. Serum amino terminal propeptide of type I procollagen (PINP) correlated with Ac.F. (r = 0.57, p < 0.001 and r = 0.48, p < 0.01) and OS (r = 0.51, p < 0.01 and r = 0.56, p < 0.01) at baseline and endpoint, respectively. Following 3 months of treatment, increases in biochemical markers like PINP predicted the increase in Ac.F. (r = 0.52, p < 0.01) and OS (r = 0.54, p < 0.01) after 24 months. CONCLUSIONS: The increased level of formation is similar in patients who were either TN or had lower bone turnover initially due to previous ALN therapy. Elevated bone formation in postmenopausal women with osteoporosis was sustained over a 24-month period by TPTD. Biochemical markers of bone formation are a good surrogate for the assessment of TPTD effects.

• MeSH
• alendronát terapeutické užití   MeSH
• bederní obratle patofyziologie   MeSH
• biologické markery krev   MeSH
• biopsie MeSH
• dospělí MeSH
• inhibitory kostní resorpce terapeutické užití   MeSH
• kostní denzita účinky léků   MeSH
• krček femuru patofyziologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• náhrada léků MeSH
• osteogeneze účinky léků   MeSH
• postmenopauzální osteoporóza farmakoterapie   patologie   patofyziologie   MeSH
• remodelace kosti účinky léků   MeSH
• senioři MeSH
• teriparatid terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky kontrolované MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Názvy látek
• alendronát MeSH
• biologické markery MeSH
• inhibitory kostní resorpce MeSH
• teriparatid MeSH

Long-term estrogen deficiency after menopause is responsible for different disorders, which not only make the quality of life in the older age worse but also are the major causes of women's mortality. It is especially the case for cardiovascular disease, osteoporosis and dementia. The risk for these disorders can significantly be reduced by hormone replacement therapy (HRT). Unfortunately, the mean duration of the postmenopausal administration of HRT is too short to demonstrate its efficacy in preventing the mentioned diseases. In this review the new therapeutic possibilities are discussed, called selective estrogen receptor modulators (SERMs). These structurally heterogeneous compounds interact with estrogen receptors and act as either estrogen-agonists or--antagonists according to the type of organ and physiological context (i.e., dose, target tissue and hormone concentration in the tissue). The evaluation of the effects of these compounds led to the better understanding of both antiestrogens and the whole steroid signaling system. The research of the clinical properties of SERM showed their potential benefit in the long-term care of the women in their non-reproductive period of life and demonstrated the possibility to overcome some drawbacks of HRT.

• MeSH
• antagonisté estrogenu farmakologie   MeSH
• demence prevence a kontrola   MeSH
• estrogenní substituční terapie MeSH
• estrogeny agonisté   MeSH
• kardiovaskulární nemoci prevence a kontrola   MeSH
• lidé MeSH
• menopauza * MeSH
• postmenopauzální osteoporóza prevence a kontrola   MeSH
• receptory pro estrogeny účinky léků   MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• antagonisté estrogenu MeSH
• estrogeny MeSH
• receptory pro estrogeny MeSH