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Cancellous and cortical bone architecture and turnover at the iliac crest of postmenopausal osteoporotic women treated with parathyroid hormone 1-84.
Bone. 2009 Jan; 44(1):113-9.BONE

Abstract

Treatment with parathyroid hormone [PTH(1-84)] increases lumbar spine bone mineral density and decreases vertebral fractures, but its effects on bone microarchitecture are unknown. We obtained iliac crest biopsies from postmenopausal osteoporotic women given placebo (n=8) or 100 microg PTH(1-84) for 18 (n=8) or 24 (n=7) months to assess cancellous and cortical bone formation and structure. At 18 months, cancellous bone volume (BV/TV) measured by microcomputed tomography and histomorphometry was 45-48% higher in subjects treated with PTH(1-84) versus placebo, a result of higher trabecular number (Tb.N) and thickness. The higher Tb.N appeared to result from intratrabecular tunneling. Connectivity density was higher and structure model index was lower, indicating a better connected and more plate-like trabecular architecture. Cancellous bone formation rate (BFR) was 2-fold higher in PTH(1-84)-treated subjects, primarily because of greater mineralizing surface. Osteoblast and osteoid surfaces were a nonsignificant 58% and 35%, respectively, higher with PTH(1-84) treatment. Osteoclast and eroded surface were unaffected by PTH(1-84). There were no effects of PTH(1-84) treatment on cortical thickness, or endocortical or periosteal BFR, but cortical porosity tended to be higher. Although cancellous BFR was lower at 24 than at 18 months, measures of cancellous and cortical bone structure were similar at both timepoints. The bone produced by PTH(1-84) had normal lamellar structure and mineralization with no abnormal histology. In conclusion, when compared with placebo, treatment of osteoporotic women with PTH(1-84) was associated with higher BV/TV and trabecular connectivity, with a more plate-like architecture, all consistent with the lower vertebral fracture incidence.

Authors+Show Affiliations

Osteoporosis Research Center, Creighton University, Omaha, NE 68131, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

18983947

Citation

Recker, R R., et al. "Cancellous and Cortical Bone Architecture and Turnover at the Iliac Crest of Postmenopausal Osteoporotic Women Treated With Parathyroid Hormone 1-84." Bone, vol. 44, no. 1, 2009, pp. 113-9.
Recker RR, Bare SP, Smith SY, et al. Cancellous and cortical bone architecture and turnover at the iliac crest of postmenopausal osteoporotic women treated with parathyroid hormone 1-84. Bone. 2009;44(1):113-9.
Recker, R. R., Bare, S. P., Smith, S. Y., Varela, A., Miller, M. A., Morris, S. A., & Fox, J. (2009). Cancellous and cortical bone architecture and turnover at the iliac crest of postmenopausal osteoporotic women treated with parathyroid hormone 1-84. Bone, 44(1), 113-9. https://doi.org/10.1016/j.bone.2008.09.019
Recker RR, et al. Cancellous and Cortical Bone Architecture and Turnover at the Iliac Crest of Postmenopausal Osteoporotic Women Treated With Parathyroid Hormone 1-84. Bone. 2009;44(1):113-9. PubMed PMID: 18983947.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cancellous and cortical bone architecture and turnover at the iliac crest of postmenopausal osteoporotic women treated with parathyroid hormone 1-84. AU - Recker,R R, AU - Bare,S P, AU - Smith,S Y, AU - Varela,A, AU - Miller,M A, AU - Morris,S A, AU - Fox,J, Y1 - 2008/10/17/ PY - 2007/08/16/received PY - 2008/09/12/revised PY - 2008/09/22/accepted PY - 2008/11/6/pubmed PY - 2009/1/29/medline PY - 2008/11/6/entrez SP - 113 EP - 9 JF - Bone JO - Bone VL - 44 IS - 1 N2 - Treatment with parathyroid hormone [PTH(1-84)] increases lumbar spine bone mineral density and decreases vertebral fractures, but its effects on bone microarchitecture are unknown. We obtained iliac crest biopsies from postmenopausal osteoporotic women given placebo (n=8) or 100 microg PTH(1-84) for 18 (n=8) or 24 (n=7) months to assess cancellous and cortical bone formation and structure. At 18 months, cancellous bone volume (BV/TV) measured by microcomputed tomography and histomorphometry was 45-48% higher in subjects treated with PTH(1-84) versus placebo, a result of higher trabecular number (Tb.N) and thickness. The higher Tb.N appeared to result from intratrabecular tunneling. Connectivity density was higher and structure model index was lower, indicating a better connected and more plate-like trabecular architecture. Cancellous bone formation rate (BFR) was 2-fold higher in PTH(1-84)-treated subjects, primarily because of greater mineralizing surface. Osteoblast and osteoid surfaces were a nonsignificant 58% and 35%, respectively, higher with PTH(1-84) treatment. Osteoclast and eroded surface were unaffected by PTH(1-84). There were no effects of PTH(1-84) treatment on cortical thickness, or endocortical or periosteal BFR, but cortical porosity tended to be higher. Although cancellous BFR was lower at 24 than at 18 months, measures of cancellous and cortical bone structure were similar at both timepoints. The bone produced by PTH(1-84) had normal lamellar structure and mineralization with no abnormal histology. In conclusion, when compared with placebo, treatment of osteoporotic women with PTH(1-84) was associated with higher BV/TV and trabecular connectivity, with a more plate-like architecture, all consistent with the lower vertebral fracture incidence. SN - 1873-2763 UR - https://www.unboundmedicine.com/medline/citation/18983947/Cancellous_and_cortical_bone_architecture_and_turnover_at_the_iliac_crest_of_postmenopausal_osteoporotic_women_treated_with_parathyroid_hormone_1_84_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S8756-3282(08)00811-9 DB - PRIME DP - Unbound Medicine ER -