Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury
Study Design Prospective observational study. Purpose To evaluate bone turnover markers (BTMs) in individuals with acute spinal cord injury (SCI) and to compare the results with those of healthy controls and postmenopausal females. Overview of Literature SCI significantly impacts bone health. Change...
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Spine Society
2020-02-01
|
| Series: | Asian Spine Journal |
| Subjects: | |
| Online Access: | http://asianspinejournal.org/upload/pdf/asj-2019-0004.pdf |
| _version_ | 1811274179382607872 |
|---|---|
| author | Prince Thakkar Naveen B. Prakash George Tharion Sahana Shetty Thomas V. Paul Joseph Bondu Bijesh Yadav |
| author_facet | Prince Thakkar Naveen B. Prakash George Tharion Sahana Shetty Thomas V. Paul Joseph Bondu Bijesh Yadav |
| author_sort | Prince Thakkar |
| collection | DOAJ |
| description | Study Design Prospective observational study. Purpose To evaluate bone turnover markers (BTMs) in individuals with acute spinal cord injury (SCI) and to compare the results with those of healthy controls and postmenopausal females. Overview of Literature SCI significantly impacts bone health. Change in bone mineral density appears 6 months after SCI and rapid bone loss during the acute phase is often underestimated, resulting in osteoporosis and a high risk of sublesional fractures. However, few studies have evaluated BTMs in the Indian SCI population. Despite a high risk of fracture, there are no guidelines for the diagnosis, monitoring, and management of SCI-induced osteoporosis. Methods Twenty patients within 1 month of traumatic SCI who had been admitted to a tertiary care rehabilitation center were included in this study. Serum BTMs, C telopeptide (CTX) as a bone resorption marker, and osteocalcin as a bone formation marker, were serially measured at baseline, and 3 and 6 months after SCI. BTMs of SCI patients were compared with those of a control group of age-matched healthy males, premenopausal females, and a vulnerable group of postmenopausal females. Results BTMs were significantly elevated in patients with SCI, with maximum levels observed at the 3rd month of injury. At baseline, the bone resorption marker CTX was approximately 3 times higher in SCI patients than in the control male population and premenopausal females, and about double that of postmenopausal females. The rise in the bone formation marker was marginal in comparison to that of the bone resorption marker. BTMs were persistently elevated and did not reach the normative range until the 6th month of SCI. Conclusions Raised bone resorption markers in comparison to bone formation markers indicate hyper-resorption-related bone loss following acute SCI. Markedly elevated bone resorption markers in the SCI population, compared with those in control and vulnerable groups, emphasize the need for early bone health monitoring and management. |
| first_indexed | 2024-04-12T23:14:14Z |
| format | Article |
| id | doaj.art-b084b143afe3490bb4c5d8ebd83d82b5 |
| institution | Directory Open Access Journal |
| issn | 1976-1902 1976-7846 |
| language | English |
| last_indexed | 2024-04-12T23:14:14Z |
| publishDate | 2020-02-01 |
| publisher | Korean Spine Society |
| record_format | Article |
| series | Asian Spine Journal |
| spelling | doaj.art-b084b143afe3490bb4c5d8ebd83d82b52022-12-22T03:12:44ZengKorean Spine SocietyAsian Spine Journal1976-19021976-78462020-02-011419710510.31616/asj.2019.00041127Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord InjuryPrince Thakkar0Naveen B. Prakash1George Tharion2Sahana Shetty3Thomas V. Paul4Joseph Bondu5Bijesh Yadav6 Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India Department of Physical Medicine and Rehabilitation, Christian Medical College, Vellore, India Department of Endocrinology, Christian Medical College, Vellore, India Department of Endocrinology, Christian Medical College, Vellore, India Department of Clinical Biochemistry, Christian Medical College, Vellore, India Department of Biostatistics, Christian Medical College, Vellore, IndiaStudy Design Prospective observational study. Purpose To evaluate bone turnover markers (BTMs) in individuals with acute spinal cord injury (SCI) and to compare the results with those of healthy controls and postmenopausal females. Overview of Literature SCI significantly impacts bone health. Change in bone mineral density appears 6 months after SCI and rapid bone loss during the acute phase is often underestimated, resulting in osteoporosis and a high risk of sublesional fractures. However, few studies have evaluated BTMs in the Indian SCI population. Despite a high risk of fracture, there are no guidelines for the diagnosis, monitoring, and management of SCI-induced osteoporosis. Methods Twenty patients within 1 month of traumatic SCI who had been admitted to a tertiary care rehabilitation center were included in this study. Serum BTMs, C telopeptide (CTX) as a bone resorption marker, and osteocalcin as a bone formation marker, were serially measured at baseline, and 3 and 6 months after SCI. BTMs of SCI patients were compared with those of a control group of age-matched healthy males, premenopausal females, and a vulnerable group of postmenopausal females. Results BTMs were significantly elevated in patients with SCI, with maximum levels observed at the 3rd month of injury. At baseline, the bone resorption marker CTX was approximately 3 times higher in SCI patients than in the control male population and premenopausal females, and about double that of postmenopausal females. The rise in the bone formation marker was marginal in comparison to that of the bone resorption marker. BTMs were persistently elevated and did not reach the normative range until the 6th month of SCI. Conclusions Raised bone resorption markers in comparison to bone formation markers indicate hyper-resorption-related bone loss following acute SCI. Markedly elevated bone resorption markers in the SCI population, compared with those in control and vulnerable groups, emphasize the need for early bone health monitoring and management.http://asianspinejournal.org/upload/pdf/asj-2019-0004.pdfspinal cord injuriesbone remodelingbone turnover markersc telopeptideosteocalcinosteoporosis |
| spellingShingle | Prince Thakkar Naveen B. Prakash George Tharion Sahana Shetty Thomas V. Paul Joseph Bondu Bijesh Yadav Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury Asian Spine Journal spinal cord injuries bone remodeling bone turnover markers c telopeptide osteocalcin osteoporosis |
| title | Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury |
| title_full | Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury |
| title_fullStr | Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury |
| title_full_unstemmed | Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury |
| title_short | Evaluating Bone Loss with Bone Turnover Markers Following Acute Spinal Cord Injury |
| title_sort | evaluating bone loss with bone turnover markers following acute spinal cord injury |
| topic | spinal cord injuries bone remodeling bone turnover markers c telopeptide osteocalcin osteoporosis |
| url | http://asianspinejournal.org/upload/pdf/asj-2019-0004.pdf |
| work_keys_str_mv | AT princethakkar evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury AT naveenbprakash evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury AT georgetharion evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury AT sahanashetty evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury AT thomasvpaul evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury AT josephbondu evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury AT bijeshyadav evaluatingbonelosswithboneturnovermarkersfollowingacutespinalcordinjury |