CHANGES OF BIOCHEMICAL MARKERS OF BONE METABOLISM IN HIP JOINT OSTEOTOMY
The purpose of this study was to define the changes in serum calcium (Ca), inorganic phosphorus (P), total and bone-type alkaline phosphatase (ALP), osteocalcin (OC) and calcitonin (CT) after osteotomy, and to know the bone metabolic properties during the early period of bone healing. The subjects w...
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| Published in | Journal of The Showa Medical Association Vol. 60; no. 2; pp. 241 - 247 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English Japanese |
| Published |
The Showa University Society
2000
昭和大学学士会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0037-4342 2185-0976 |
| DOI | 10.14930/jsma1939.60.241 |
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| Abstract | The purpose of this study was to define the changes in serum calcium (Ca), inorganic phosphorus (P), total and bone-type alkaline phosphatase (ALP), osteocalcin (OC) and calcitonin (CT) after osteotomy, and to know the bone metabolic properties during the early period of bone healing. The subjects were 11 cases (1 male and 10 female, 16-61 years, mean age: 39.6 years) who underwent osteotomy of the hip joint. Samples of venous blood were taken before and on days 3, 7, 14, 21 and 28 after the operation. Ca, P and total ALP activity were measured by the recommended methods, and bone-type ALP (B-ALP) activity was measured by electrophoresis. OC was measured by radioimmunoassay and CT was measured by a newly developed chemiluminescent immunoassay. Ca concentration decreased, reaching the lowest value by day 3 and returned to the pre-operative value by day 14. P concentration decreased, reaching the lowest value by day 3 and increased significantly by day 21. B-ALP activity fell by day 7 and started to increase to day 21. OC concentration significantly decreased by day 3 and then increased throughout the period. In contrast, CT concentration rose during the first 3 days and decreased week by week. According to the rise of B-ALP, osteoblast activity can be accelerated on about day 7 after osteotomy. The changes of OC and CT reflected the bone resorption and formation at the fracture site. Further investigations are required to determine the clinical significance of biochemical markers to estimate the prognosis of healing after bone fracture. |
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| AbstractList | The purpose of this study was to define the changes in serum calcium (Ca), inorganic phosphorus (P), total and bone-type alkaline phosphatase (ALP), osteocalcin (OC) and calcitonin (CT) after osteotomy, and to know the bone metabolic properties during the early period of bone healing. The subjects were 11 cases (1 male and 10 female, 16-61 years, mean age: 39.6 years) who underwent osteotomy of the hip joint. Samples of venous blood were taken before and on days 3, 7, 14, 21 and 28 after the operation. Ca, P and total ALP activity were measured by the recommended methods, and bone-type ALP (B-ALP) activity was measured by electrophoresis. OC was measured by radioimmunoassay and CT was measured by a newly developed chemiluminescent immunoassay. Ca concentration decreased, reaching the lowest value by day 3 and returned to the pre-operative value by day 14. P concentration decreased, reaching the lowest value by day 3 and increased significantly by day 21. B-ALP activity fell by day 7 and started to increase to day 21. OC concentration significantly decreased by day 3 and then increased throughout the period. In contrast, CT concentration rose during the first 3 days and decreased week by week. According to the rise of B-ALP, osteoblast activity can be accelerated on about day 7 after osteotomy. The changes of OC and CT reflected the bone resorption and formation at the fracture site. Further investigations are required to determine the clinical significance of biochemical markers to estimate the prognosis of healing after bone fracture.
骨折治癒での骨代謝マーカーの変動モデルとして, 股関節疾患に対する骨切術 (股関節臼蓋形成不全に対する寛骨臼回転骨切術, 特発性大腿骨頭壊死に対する大腿骨回転骨切術) の手術前後における骨代謝マーカーの変動を検討した.症例は寛骨臼回転骨切術: 8例, 大腿骨回転骨切術: 3例の計11例である.今回検討したのは, 血清カルシウム, 無機リン, アルカリ性ホスファターゼ (ALP) , 骨型ALPなど日常的に測定されている骨代謝マーカーに加えて, オステオカルシンとカルシトニンを測定し, 手術前から術後3, 7, 14, 21, 28日まで追跡した.血清カルシウムは, 術後3日目に術前値の90.3±1.5% (平均値±標準誤差) と最低値になった後に漸増し, 14日目に100.1±2.0%と術前値に復する経過であった.一方, 無機リンは術後3日目に73.3±6.1%とカルシウムと比較して異常低値になった後漸増し, 14日目には109.3±5.5%となり, 21日目には115.1±4.5%とリバウンド的に術前値より高値となる経過であった.また, 骨型ALPは術後3日目に80.2±5.4%まで低下した後, 7日目より上昇し, 21日目には術前値の160.5±26.2%, 28日目には134.0±118.4%と上昇が認められ, 骨芽細胞の増殖は術後7日目頃からおこることが示唆された.特異的骨代謝マーカーであるオステオカルシンは術後3日目に術前値の60.6±6.2%にまで低下したものが14日日には100.9±9.0%と術前値に復した後漸増し, 21日目に108.2±10.7%, 28日目には131.0±12.2%と上昇が持続する経過であった.一方カルシトニンは, 術後3日目に1499.3±571.2%と著明に上昇した後漸減し, 14日目には317.2±93.8%, 21日目には282.8±107.2%, 28日目には264.4±94.5%と漸減する変動であった.骨切術による生体反応としては, 骨吸収を抑制し, 骨新生を促進することが必要であり, カルシトニンとオステオカルシンの変動はこれらを良く反映していることが確認できた. The purpose of this study was to define the changes in serum calcium (Ca), inorganic phosphorus (P), total and bone-type alkaline phosphatase (ALP), osteocalcin (OC) and calcitonin (CT) after osteotomy, and to know the bone metabolic properties during the early period of bone healing. The subjects were 11 cases (1 male and 10 female, 16-61 years, mean age: 39.6 years) who underwent osteotomy of the hip joint. Samples of venous blood were taken before and on days 3, 7, 14, 21 and 28 after the operation. Ca, P and total ALP activity were measured by the recommended methods, and bone-type ALP (B-ALP) activity was measured by electrophoresis. OC was measured by radioimmunoassay and CT was measured by a newly developed chemiluminescent immunoassay. Ca concentration decreased, reaching the lowest value by day 3 and returned to the pre-operative value by day 14. P concentration decreased, reaching the lowest value by day 3 and increased significantly by day 21. B-ALP activity fell by day 7 and started to increase to day 21. OC concentration significantly decreased by day 3 and then increased throughout the period. In contrast, CT concentration rose during the first 3 days and decreased week by week. According to the rise of B-ALP, osteoblast activity can be accelerated on about day 7 after osteotomy. The changes of OC and CT reflected the bone resorption and formation at the fracture site. Further investigations are required to determine the clinical significance of biochemical markers to estimate the prognosis of healing after bone fracture. |
| Author | MIKUMO, Hitoshi HIRAIZUMI, Yutaka TAKAGI, Yasushi HOSINO, Yushi |
| Author_FL | 星野 雄志 高木 康 平泉 裕 三雲 仁 |
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| References | 6) Joerring S and Jensen LT: Changes in collagen metabolites in serum after cemented hip and knee arthroplasty. Arch Orthop Trauma Surg 112: 139-141, 1993. 5) Ohnishi T, Takahashi M, Kushida K, et al: Changes of biochemical markers during fracture healing. Arch Orthop Trauma Surg 118: 126-130, 1998. 10) Guilloteau D, Perdrisot R, Calmettes C, et al: Diagnosis of medullary carcinoma of the thyroid (MCT) by calcitonin assay using monoclonal antibodies: Criteria for the pentagastrin stimulation test in hereditary MCT. J Clin Endocrinol Metab 71: 1064-1067, 1990. 1) Enhorn TA: The cell and molecular biology of fracture healing. Clin On hop 355 (Suppl) S7-21, 1998. 3) 川口浩, 松本俊夫, 黒川高秀, ほか: Monoclonal抗体を用いたtwo-site immunoradiometric assay (IRMA) による血清BGP濃度の測定. ホルモンと臨床38: 1291-1296, 1990. 4) 山下泉, 宮津誠, 加茂裕樹, ほか: 高位脛骨骨切り術後の骨代謝における活性型VitaminDの投与効果. 日整会誌67: 804-815, 1993. 8) Price PA, Parthemore JG and Def tos LJ: New biochemical markers for bone formation. J Clin Invest 66: 878-883, 1980. 2) Suzuki H: Calcitonin levels in normal individuals with new highly sensitive chemiluminescent enzyme immunoassay. J Clin Lab Anal 12: 218-222, 1998. 11) Lindholm TS: Effects of 1α-hydroxycholeca lciferol on osteoporotic changes induced by calcium deficiency in bone fractures in adult rats. J Trauma 18: 336-339, 1987. 9) Delmas PD, Stenner D, Wahner HW, et al: Increase in serum bone γ-carboxyglutamic acid protein with aging in women. J Clin Invest 71: 1316-1321, 1983. 7) Joerring S, Krogsgaard M, Wilbek H, et al: Collagen turnover after tibial fracture. Arch Orthop Trauma Surg 113: 334-336, 1994. |
| References_xml | – reference: 4) 山下泉, 宮津誠, 加茂裕樹, ほか: 高位脛骨骨切り術後の骨代謝における活性型VitaminDの投与効果. 日整会誌67: 804-815, 1993. – reference: 2) Suzuki H: Calcitonin levels in normal individuals with new highly sensitive chemiluminescent enzyme immunoassay. J Clin Lab Anal 12: 218-222, 1998. – reference: 11) Lindholm TS: Effects of 1α-hydroxycholeca lciferol on osteoporotic changes induced by calcium deficiency in bone fractures in adult rats. J Trauma 18: 336-339, 1987. – reference: 5) Ohnishi T, Takahashi M, Kushida K, et al: Changes of biochemical markers during fracture healing. Arch Orthop Trauma Surg 118: 126-130, 1998. – reference: 10) Guilloteau D, Perdrisot R, Calmettes C, et al: Diagnosis of medullary carcinoma of the thyroid (MCT) by calcitonin assay using monoclonal antibodies: Criteria for the pentagastrin stimulation test in hereditary MCT. J Clin Endocrinol Metab 71: 1064-1067, 1990. – reference: 7) Joerring S, Krogsgaard M, Wilbek H, et al: Collagen turnover after tibial fracture. Arch Orthop Trauma Surg 113: 334-336, 1994. – reference: 8) Price PA, Parthemore JG and Def tos LJ: New biochemical markers for bone formation. J Clin Invest 66: 878-883, 1980. – reference: 1) Enhorn TA: The cell and molecular biology of fracture healing. Clin On hop 355 (Suppl) S7-21, 1998. – reference: 3) 川口浩, 松本俊夫, 黒川高秀, ほか: Monoclonal抗体を用いたtwo-site immunoradiometric assay (IRMA) による血清BGP濃度の測定. ホルモンと臨床38: 1291-1296, 1990. – reference: 6) Joerring S and Jensen LT: Changes in collagen metabolites in serum after cemented hip and knee arthroplasty. Arch Orthop Trauma Surg 112: 139-141, 1993. – reference: 9) Delmas PD, Stenner D, Wahner HW, et al: Increase in serum bone γ-carboxyglutamic acid protein with aging in women. J Clin Invest 71: 1316-1321, 1983. |
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| SubjectTerms | bone metabolic marker calcitonin coxarthrosis osteocalcin osteotomy オステオカルシン カルシトニン 股関節症 骨代謝マーカー 骨切術 |
| Title | CHANGES OF BIOCHEMICAL MARKERS OF BONE METABOLISM IN HIP JOINT OSTEOTOMY |
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