Presentació

OSCAT (Grup de Treball d’Osteoporosi de la Societat Catalana de Reumatologia) està format per un grup de reumatòlegs socis de l’SCR amb interès per la patologia metabòlica òssia.

Objectius del Grup de treball d’OSCAT

Els objectius principals del grup són la recerca i la formació en el camp de l’osteoporosi i altres malalties metabòliques òssies, afavorint els projectes multicèntrics i els cursos formatius, especialment dirigits a residents de Reumatologia.

El grup també té l’objectiu de facilitar les relacions entre centres i entre investigadors.

Junta coordinadora d’OsCat

Activitats

Producció científica del Grup

Abstract

At present, data comparing the quantification methods for measurement of free vitamin D (direct assay [direct 25-OHDF] and estimated by calculation [calculated 25-OHDF]), are scarce. The aim of this study was to analyse the concordance between these two methods of 25-OHDF analysis (direct vs. calculated).

METHODS:

Serum values of total 25-OHD (25-OHDT), vitamin D binding protein (DBP) (by R&D Systems ELISA), calculated 25-OHDF (by DBP, albumin and 25-OHDT) and direct 25-OHDF (by DIAsource ELISA) were analysed in 173 healthy women (aged 35-45years). Assessment of concordance was evaluated by the Bland-Altman plot and the total deviation index (TDI).

RESULTS:

The mean values of calculated and direct 25-OHDF in these subjects were 5.27±2.5 and 3.83±1.01pg/mL, respectively. We found significantly lower values of 25-OHDF on comparing subjects with and without vitamin D deficiency, independently of the method used. The total deviation index evaluated by the Bland-Altman plot showed low concordance for both measurements. Only low 25-OHDF levels were concordant.

CONCLUSIONS:

This study shows that the concordance between these two methods of 25-OHDF analysis is low and has a concentration dependent bias. Further studies are necessary to clarify the reference values and the indications for 25-OHDF measurement.

PMID:29056531   DOI:10.1016/j.cca.2017.10.016

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Abstract

Determination of different forms of 25-OHD (total, free and bioavailable) in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency.

INTRODUCTION:

Determination of 25-OH vitamin D serum levels (25-OHD) constitutes the method of choice for evaluating vitamin D deficiency. However, vitamin D-binding protein (DBP) may modulate its bioavailability thereby affecting correct evaluation of 25-OHD status. We analysed the impact of the determination of 25-OHD (total, free and bioavailable) on the evaluation its biologic activity (estimated by serum PTH determination) in healthy young women.

METHODS:

173 premenopausal women (aged 35-45 yrs.) were included. We analysed serum values of total 25-OHD (25-OHDT), DBP, albumin, PTH and bone formation (PINP,OC) and resorption (NTx,CTx) markers. Free(25-OHDF) and bioavailable (25-OHDB) serum 25-OHD levels were estimated by DBP and albumin determinations and also directly by ELISA (25-OHDF-2). We analysed threshold PTH values for the different forms of 25-OHD and the correlations and differences according to 25-OHDT levels <20 ng/ml.

RESULTS:

62% of subjects had 25-OHD values <20 ng/ml and also had significantly lower 25-OHDF and 25-OHDB values, with no significant differences in bone markers and PTH values. The PTH threshold value was similar for all forms of 25-OHD (∼70 pg/ml). Women with PTH values >70 had lower 25-OHDT (15.4 ± 1.4 vs. 18.3 ± 2.7, p < 0.05) and 25OHDB values (1.7 ± 0.2 vs. 2.2 ± 0.09, p < 0.05). The different forms of 25OHD were significantly intercorrelated, with marginal correlations between PTH and 25-OHDT (r = -0.136, p = 0.082).

CONCLUSIONS:

Determination of different forms of 25-OHD in healthy young women does not offer additional advantages over standard 25-OHDT for evaluating vitamin D deficiency. In these subjects 25-OHDT values <15 ng/ml would be more appropriate for defining this deficiency.

PMID:28466136  DOI:10.1007/s00198-017-4062-8

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Abstract

BACKGROUND:

The aims of this study were to establish robust reference intervals and to investigate the factors influencing bone turnover markers (BTMs) in healthy premenopausal Spanish women.

METHODS:

A total of 184 women (35-45 years) from 13 centers in Catalonia were analyzed. Blood and second void urine samples were collected between 8 a.m. and 10 a.m. after an overnight fast. Serum procollagen type I amino-terminal propeptide (PINP) and serum cross-linked C-terminal telopeptide of type I collagen (CTX-I) were measured by two automated assays (Roche and IDS), bone alkaline phosphatase (bone ALP) by ELISA, osteocalcin (OC) by IRMA and urinary NTX-I by ELISA. PTH and 25-hydroxyvitamin D (25OHD) levels were measured. All participants completed a questionnaire on lifestyle factors.

RESULTS:

Reference intervals were: PINP: 22.7-63.1 and 21.8-65.5 μg/L, bone ALP: 6.0-13.6 μg/L, OC: 8.0-23.0 μg/L, CTX-I: 137-484 and 109-544 ng/L and NTX-I: 19.6-68.9 nM/mM. Oral contraceptive pills (OCPs) influenced PINP (p=0.007), and low body mass index (BMI) was associated with higher BTMs except for bone ALP. Women under 40 had higher median values of most BTMs. CTX-I was influenced by calcium intake (p=0.010) and PTH (p=0.007). 25OHD levels did not influence BTMs. Concordance between the two automated assays for PINP and particularly CTX-I was poor.

CONCLUSIONS:

Robust reference intervals for BTMs in a Southern European country are provided. The effects of OCPs and BMI on their levels are significant, whilst serum 25OHD levels did not influence BTMs. Age, calcium intake, BMI and PTH influenced CTX-I. The two automated assays for measuring PINP and CTX-I are not interchangeable.

PMID: 26088062 DOI:10.1515/cclm-2015-0162

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Abstract

OBJECTIVE:

The aim of this study was to quantify the incidence of all clinical fractures, including traumatic and fragility fractures, in patients aged 50 years and older, and to describe their distribution by fracture location, sex and age.

METHODS:

The incidence of clinical fractures at 10 hospitals in Catalonia, with a reference population of 3 155 000 inhabitants, was studied. For 1 week, from 30 May to 5 June 2016, we reviewed the discharge reports of the Traumatology section of the Emergency Department to identify all fractures diagnosed in patients [1]50 years of age. As a validation technique, data collection was carried out for 1 year at one of the centres, from 1 December 2015 to 30 November 2016. The fracture incidence, including the 95% CI, was estimated for the entire sample and grouped by fracture type, location, sex and age.

RESULTS:

A total of 283 fractures were identified. Seventy per cent were in women, with a mean age of 72 years. The overall fracture incidence was 11.28 per 1000 person-years (95% CI: 11.10, 1.46), with an incidence of traumatic and fragility fractures of 4.15 (95% CI: 4.04, 4.26) and 7.13 per 1000 person-years (95% CI: 6.99, 7.28), respectively. The incidence of fractures observed in the validation sample coincided with that estimated for the whole of Catalonia. The most common fragility fractures were of the hip, forearm, humerus and vertebrae.

CONCLUSIONS:

The results of this study are the first to estimate the incidence of clinical fragility fractures in Spain, grouped by location, age and sex.

DOI: 10.1093/rap/rkaa050

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