Summary
The decoupling of bone formation and bone resorption causes an insidious bone loss that is responsible for the negative skeletal balance in the frequent form of low turnover osteoporosis. The reduction of bone formation can hardly be verified by clinical methods.
Osteocalcin, a non-collagenous bone protein, has proved to be a useful new indicator of bone formation. To establish its predictable value, plasma levels of osteocalcin were compared to conventional serological data of bone turnover and to histomorphometric parameters of iliac crest trabecular bone.
In cases of osteoporosis with normal bone turnover activity (as confirmed by histomorphometry) no differences were observed in any of our laboratory data including osteocalcin. However, there was a significant lower mean serum level of osteocalcin in a group of patients with histomorphometrically proven low turnover osteoporosis in comparison to those with normal bone turnover. Serum levels of osteocalcin below 2.0 ng/ml seem to indicate a low turnover in the individual case of osteoporosis while this is unlikely when serum levels above 6.0 ng/ml are measured (according to our RIA).
Similar content being viewed by others
Abbreviations
- OC:
-
Osteocalcin
- TBV:
-
trabekuläres Knochenvolumen
- ROV:
-
relatives Osteoidvolumen
- ROS:
-
relative Osteoidoberfläche
- RRS:
-
relative Resorptionsoberfläche
Literatur
Abbasi R, Hodgen GD (1986) Predicting the predisposition to osteoporosis. Gonadotropin — releasing hormone antagonist for acute estrogen deficiency test. JAMA 255:1600–1604
Brown JP, Delmas PD, Malaval L, Edouard C, Chapuy MC, Meunier PJ (1984) Serum bone gla-protein: a specific marker for bone formation in postmenopausal osteoporosis. Lancet I:1091–1093
Burkhardt R (1966) Technische Verbesserungen und Anwendungsbereiche der Histo-Biopsie von Knochenmark und Knochen. Klin Wochenschr 44:326–334
Christiansen C, Riis BJ, Nilas L, Rodbro P, Deftos L (1985) Uncoupling of bone formation and resorption by combined oestrogen and progestagen therapy in postmenopausal osteoporosis. Lancet II:800–801
Dambacher MA, Ittner J, Rüegsegger P (1986) Osteoporose — Pathogenese, Prophylaxe, Therapie. Internist 27:206–213
Dambacher MA (1982) Praktische Osteologie. Thieme, Stuttgart New York, S 98–103
Delling G (1985) Generalisierte Osteopathien. In: Remmele W (Hrsg) Pathologie, Bd. 4, Springer, Berlin Heidelberg New York Tokyo, S 689–707
Delmas PD, Wahner HW, Mann KG, Riggs BL (1983) Assessment of bone turnover in postmenopausal osteoporosis by measurement of serum Gla-protein. J Lab Clin Med 102:470–476
Gundberg CM, Lian JB, Gallop PM, Steinberg JJ (1983) Urinary gamma-carboxyglutamic acid and serum osteocalcin as bone markers. Studies in osteoporosis and Paget's disease. J Clin Endocr 57:1221–1225
Gundberg CM, Cole DEC, Lian JB, Reade TM, Gallop PM (1983) Serum osteocalcin in the treatment of inherited rickets with 1.25-dihydroxy-vitamin D3. J Clin Endocrinol Metab 56:1063–1067
Kruse HP, Kuhlencordt F (1984) Grundzüge der Osteologie. Springer, Berlin Heidelberg New York Tokyo, S 47–50
Mazzuoli G, Minisola S, Valtorta C, Antonelli R, Tabolli S, Bigi F (1985) Changes in mineral content and biochemical bone markers at the menopause. Isr J Med Sciences 21:875–877
Minne H (1986) Therapie von Knochenstoffwechselerkrankungen. Symposium, Hannover
Parfitt AM (1982) The coupling of bone formation to bone resorption: A critical analysis of the concept and of its relevance to the pathogenesis of osteoporosis. Metab Bone Dis Rel Res 4:1–12
Podenphant J, Christiansen C, Catherwood BD, Deftos LJ (1984) Serum bone gla protein variations during estrogen and calcium prophylaxis of postmenopausal women. Calc Tiss Int 36:536–540
Price PA, Parthemore JG, Deftos LJ (1980) New biochemical marker for bone metabolism. J Clin Invest 66:878–883
Raisz L, Smith J (1985) Prevention and therapy of osteoporosis. Rational Diag Therapy 19:1–8
Reid IR, Ibbertson HK (1986) Calcium supplements in the prevention of steroid-induced osteoporosis. Amer J Clin Nutr 44:287–290
Revell PA (1985) Pathology of Bone. Springer, Berlin Heidelberg New York Tokyo, S 97–100
Ringe JD, Wahner HW (1986) Früherkennung der Osteoporose. Heutiger Stand der nicht-invasiven Meßmethoden des Knochenmineralgehaltes. DMW 111:954–958
Slovik DM, Gundberg CM, Neer RM, Lian JB (1984) Clinical evaluation of bone turnover by serum osteocalcin measurements in a hospital setting. J Clin Endocr 59:228–230
Spencer H, Kramer L (1986) NIH consensus conference Osteoporosis. Factors contributing to osteoporosis. J Nutr 116:316–321
Stracke H, Schatz Ch, Pralle H, Ullmann J, Schatz H (1985) Osteocalcin, ein Marker bei Erkrankungen mit erhöhtem Knochenumsatz. Dtsch Med Wochenschr 38:1442–1446
Zerwekh JE, Sakhaee K, Pak CYC (1985) Short-term 1.25-dihydroxyvitamin D3 administration raises serum osteocalcin in patients with postmenopausal osteoporosis. J Clin Endocrinol Metab 60:615–617
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stracke, H., Schulz, A., Weber, U. et al. Osteocalcin und Knochenhistologie bei Osteoporose. Klin Wochenschr 65, 1095–1100 (1987). https://doi.org/10.1007/BF01736116
Received:
Revised:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01736116