LAM KID

[The results of the Ca-Intake.hu study - Calcium supplementation as a part of basic therapy of osteoporosis is more than a routine step]

LAKATOS Péter, SPEER Gábor, DOMBAI Péter, ZAJZON Gergely

DECEMBER 23, 2011

LAM KID - 2011;1(03)

[Calcium intake is considered the base therapy of osteoporosis treatment. It is known that in case of inadequate calcium intake, specific anti-osteoporotic drugs are inefficient. In the present study, we aimed to investigate the alimentary and supplementary calcium intake among Hungarian osteoporotic patients, using a nationwide representative survey. Patients with osteoporosis were enrolled in the study. We determined the total alimentary calcium intake and the average supplementary dose. In some cases, total calcium intake was lower than recommended, in other cases it was significantly higher than that. In some cases, bone density showed a positive correlation with calcium intake. Vitamin D supplementation complied with current recommendations.]

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[Vitamin D determination: preanalytical and analytical points of view]

BHATTOA Harjit Pál

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[PAGE OF THE HUNGARIAN SOCIETY OF OSTEOPOROSIS AND OSTEOARTHROLOGY]

LAM KID

[The pathogenic and clinical significance of the RANK-RANKL-osteoprotegerin system in rheumatoid arthritis]

SZENTPÉTERY Ágnes, VÁNCSA Andrea, SZABÓ Zoltán, SZEKANECZ Zoltán

[Rheumatoid arthritis (RA) is characterised by increased local and generalised bone resorption, which manifests in the develoment of marginal erosions and generalised osteoporosis, respectively. An increasing number of data suggest that lymphocytes, proinflammatory cytokines and other mediators involved in inflammation contribute to arthritic bone resorption. Therefore, the term ‘osteoimmunology’ has also become widely used. In RA, Receptor Activator of Nuclear Factor kappa B (RANK) and its ligand (RANKL) play a crucial role in bone resorption. These proteins, which belong to the tumor necrosis factor a (TNF-a) receptor and TNF ligand superfamilies, respectively, activate osteoclasts while interacting with T cells, synovial fibroblasts and other cytokines (e.g. IL-1, IL-17), which results in bone resorption. Osteoprotegerin (OPG) is a decoy receptor that also belongs to the TNF receptor family and inhibits RANK-RANKL interactions. There is increased RANKL production and decreased OPG production in RA. The interaction of RANKL with IL-17 is particularly important. Regarding therapy, sulfasalazine, methotrexate and biological agents, especially TNF inhibitors suppress RANKL-mediated bone resorption and thus the development of joint erosions. RANKL-RANK interaction can be directly inhibited by recombinant OPG or anti-RANKL antibody (denosumab). Among these agents, denosumab gave promising results in experiments performed in animal models of arthritis. These were followed by a phase II human RA trial, which proved that denosumab decreased MRI erosion scores in RA.]

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[Personal genome - brave new world?]

KÓSA János Pál

LAM KID

[The relationship of coronary heart disease and bone from a different point of view: is lumbar vertebral density a positive predictor of coronary heart disease in women?]

KISS József, BUDAY BARBARA, LITERÁTI Nagy Botond, FALUKÖZI József, FOGARASSY György, APRÓ Dezső, VECSEI Istvánné, FÉK A. Attila, VERESS Gábor, KORÁNYI LÁSZLÓ

[BACKGROUND - A number of international data demonstrate the relationship between cardiovascular disease and bone density, osteoporosis and osteopenia. It is possible that bone formation/remodeling and vascular calcification are influenced by common pathogenetic factors (adipocytokines, inflammatory processes). Our aim was to assess this relationship among Hungarian patients. PATIENTS AND METHODS - We examined 82 patients (49 men and 33 women). The patients underwent a DEXA measurement and fasting blood sampling with full metabolic profiling within one month following an elective coronarography. Coronary state was characterised by the Gensini-score. RESULTS - Femur neck T-score values showed significant decreases in the CHD+ group (patients having at least one significant coronary stenosis), compared with the CHD- group (patients with no history of significant coronary stenosis) (-0.22 vs. -0.85, p<0.05) when the two genders were examined together. In women, lumbar BMD showed a significant positive correlation (r=+0.37, p=0.03), and the levels of adiponectin and HDL-cholesterol showed significant negative correlations (r=-0.311, p=0.04, és r=-0.38, p=0.03) with the Gensini-score. Neither the HOMA-index that characterises insulin resistance, nor the majority of conventional lipid and lipoprotein risk factors showed any association with the severity of coronary heart disease. CONCLUSION - On the basis of our results, the relationships between femur and lumbar regions and coronary heart disease are opposite in nature, which is probably explained by the different regulatory mechanisms in these two regions. Adiponectin may have an important role in the regulation of this relationship, which is independent of insulin resistance.]

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