[Determining sclerostin level in healthy men]

MOLNÁR Zsuzsanna1, WAMWAKI John1, PETHŐ Zsófia2, KALINA Edit1, FÖLDESI Róza1, BALOGH Ádám3, ANTAL-SZALMÁS Péter1, BHATTOA Harjit Pál1

MAY 30, 2014

LAM KID - 2014;4(02)

[The aim of this study is to evaluate the relationship of serum sclerostin levels with age, cystatin C, bone mineral density (BMD) and biochemical markers of bone turnover in healthy Hungarian men over 50 years of age. We determined serum levels of sclerostin and examined its relationship with age, cystatin C, osteocalcin, C-terminal telopeptides of type-I collagen, procollagen type 1 amino-terminal propeptide, 25- hydroxyvitamin D, parathyroid hormone, and L1-L4 (LS) and femur neck (FN) BMD data available from 194 randomly selected ambulatory men belonging to the HunMen cohort. In the study population as a whole (n=194; age (median, range): 59 (51-81) years), statistically significant correlation was found between sclerostin and age (r=0.211; p=0.003), cystatin C (r=0.246; p=0.001), FN-BMD (r=0.147; p=0.041) and LS BMD (r=0.169; p=0.019). Compared with middle-aged men (age: ≤ 59 years, n=98), elderly men (age > 59 years, n=96) had significantly higher serum sclerostin levels (67.8±15.9 pmol/l vs. 63.5±14; p=0.047). Among men with normal (T score >-1,0) FN-BMD, the elderly had significantly higher serum sclerostin levels as compared with the middle-aged (70.4±17 pmol/l vs. 63.9±11.5 pmol/l; p=0.019). Furthermore, among the elderly men cystatin C was the only significant predictor of serum sclerostin levels (standardized regression coefficient (béta) = 0,487; p<0,001). Our results show that in the studied healthy elderly cohort sclerostin levels significantly increase with age, along with the deterioration of kidney function as determined by plasma cystatin C levels. ]


  1. Debreceni Egyetem, Orvos- és Egészségügyi Központ, Laboratóriumi Medicina Intézet
  2. Debreceni Egyetem, Orvos- és Egészségügyi Központ, Reumatológiai Tanszék
  3. Regionális Osteoporosis Centrum, Szülészeti és Nôgyógyászati Klinika



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[Recognition of the characteristics of arthritis is crucial for making a correct diagnosis. Several aspects of the history and physical examination could help the diagnosis, such as the mode of onset (acute, insidious), duration of symptoms (self-limiting, chronic), number of affected joints (mono-, oligo-, polyarthritis), distribution of joint involvement (symmetrical, asymmetrical), localisation of affected joints (axial, peripherial) and sequence of involvement (additive, migratory, intermittent). Other important aspects for the correct diagnosis are the characteristics of the patient (gender, age, family history) and the presence or absence of extra-articular features of disease. The articular pattern may change with time in the course of a disease, and the single clinical pattern of joint disease may correspond to more than one diagnosis. Evidence of some distinct articular patterns may limit the spectrum of diagnostic options and reduces unnecessary diagnostic testing. The diagnostic process may require the addition of laboratory examination, imaging techniques, and other tests to refine the analysis. In this article, we report a case where joint punction and histological elucidation was necessary to make the correct diagnosis, because a syndrome of acute, destructive sterile arthritis mimicking articular infection might be present in a variety of joint disorders. In this paper, we highlight those characteristics that are distinctive for particular rheumatological disorders, in order to help starting treatment early.. In a substantial number of patients the cause of the diseases remains undetermined. However, a detailed anamnesis and physical examination remain the cornerstone of a diagnostic evaluation.]


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[In rheumatoid arthritis, the inflammation and damage of multiple joints can lead to generalised osteoporosis. This process is mostly mediaated by cells and cytokines that are also important for maintaining inflammation, by inhibiting bone formation as well as stimulating bone resorption. Data from the literature show that biological therapies that effectively decrease inflammation can also stimulate bone formation and inhibit bone resorption. This results in an increased bone density and bone protection, which is highly important to prevent subseqent fractures.]

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[Bone metabolism and the 10-year probability of hip fracture and a major osteoporotic fracture using the country specific FRAX algorithm in men with type 2 diabetes mellitus]


[Objectives: Was to evaluate 10-year probability of hip fracture and a major osteoporotic fracture using the FRAX algorithm, vitamin D status, bone mineral density (BMD) and biochemical markers of bone turnover in men over 50 years of age with type 2 diabetes (T2DM). We compared FRAX-predicted 10-year fracture probability, levels of 25-hydroxyvitamin D (25-OH-D), markers of bone turnover and bone mineral density at L1-L4 (LS) and femur neck (FN) in 68 men with T2DM with an age- and gender-matched group (n=68). The mean (range) age of the T2DM group was 61.4 (51-78) years. The prevalence of hypovitaminosis D (25-OH-D <75 nmol/L) was 59%. The mean (range) FRAX hip fracture and FRAX major osteoporotic fracture was 0.7 (0-2.8)% and 3.2 (0-8.5)%, respectively. BMD at the FN (0.974 gm/cm2 vs. 0.915 gm/cm2; p = 0.008) and LS (1.221 gm/cm2 vs. 1.068 gm/cm2; p < 0.001) was significantly higher in the T2DM cohort as compared to the healthy age matched males. 25-OH-vitamin D (67.7 nmol/L vs.79.8 nmol/L; p < 0.001), crosslaps (0.19 μg/L vs. 0.24 μg/L; p = 0.004) and osteocalcin (13.3 μg/L vs. 15.7 μg/L; p = 0.004) were significantly lower in the T2DM group. There was no difference in FRAX-related fracture probability between the two groups. The increased BMD in T2DM and the lack of inclusion of T2DM as a risk factor in the FRAX algorithm are probable explanations for the discordance between literature-observed and FRAX-related fracture probabilities.]

Lege Artis Medicinae

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GYŐRFFY Zsuzsa, IMOLA Sándor, CSOBOTH Csilla, KOPP Mária

[BACKGROUND - Whereas the scientific literature regarding physical abuse primarily focuses on female victims, few studies have been performed on the childhood abuse of men. The aim of our study was to examine the potential effects of childhood physical abuse of men on adult mental health status. METHODS - Data of 4675 male participants of the Hungarostudy nation-wide representative survey were analyzed. RESULTS - Altogether almost 13% of our study group reported physical abuse by a parent or other significant person. Compared with men who did not report abuse, depression, suicidal thoughts and attempts were significantly more common among abused men. Smoking, alcohol- and drugabuse, anxiety disorders and sleeping disorders also had a higher occurence. Moreover, we established that abused men had a significantly greater risk of marital distress and were more likely to have fewer children. Interpretation of the results in a multivariate model indicated that physical abuse is a determinate and independent risk factor of depression, suicidal thoughts and attempts, smoking habits and alcohol abuse. CONCLUSIONS - Our results underline that childhood physical abuse can have a significant effect on numerous mental disorders and maladaptive behaviours in adulthood. However, the deeper understanding of the relationship between physical abuse and mental disorders necessitates further studies.]


[New approaches to the treatment of osteoporosis]


[Osteoporosis is a significant health care problem, and its treatment is of major interest. Despite of the wide spectrum of therapeutical modalities, the effective cure for all forms of this condition has not yet been developed. For this reason, the focus is on the development of new pharmacological approaches. The RANK/RANKL/OPG system discovered one and a half decades ago provides a tool for the neutralization of the osteoclast-stimulating RANKL by the use of monoclonal antibodies. Catepsin-K inhibitors offer another pathway for the inhibition of bone degradation. Anti-sclerostin and anti-Dkk-1 antibodies may stimulate bone formation by the release of Wnt signal transduction system. Other administration methods for PTH analogs, new generations of selective estrogen receptor modulators and antibodies against vitronectin receptors as well as potential new drug targets will enable us to fight bone loss more efficiently.]