title: Effects of intermittent parathyroid hormone administration on bone mineralization density in iliac crest biopsies from patients with osteoporosis: a paired study before and after treatment.
abstract: Anabolic effects of PTH have been observed at several skeletal sites in humans by dual x-ray absorptiometry without differentiating between an actual increase in bone volume and an increase in mineral content within already established bone. The present study addressed this issue by evaluating the bone mineralization density distribution of iliac crest bone biopsies before and after PTH treatment for 18-36 months in men and women with osteoporosis using quantitative backscattered electron imaging. In cortical bone, pairwise comparison of the two biopsies before and after treatment revealed a reduction in the typical calcium concentration in men (-3.32%; P = 0.02, by paired t test), but no change in women, and the heterogeneity of mineralization increased in both males and females [+18.80% (P = 0.09) and +18.14% (P = 0.005), respectively]. In cancellous bone, there was no change in the typical calcium concentration, but there was a greater heterogeneity of mineralization in both men and women [+19.65% (P = 0.02) and +21.59% (P = 0.056), respectively] due to newly formed bone matrix. Small angle x-ray scattering performed on a subgroup of subjects revealed normal collagen/mineral structure. The findings confirm the observations that PTH stimulates skeletal remodeling, resulting in an increased percentage of newly formed bone matrix of lower mineral density.
authors.affiliation: Ludwig Boltzmann Institute of Osteology and Fourth Medical Department, Hanusch Hospital and UKH Meidling, A-1140 Vienna, Austria.
authors.forename: Barbara M
authors.initials: BM
authors.lastname: Misof
authors.forename: Paul
authors.initials: P
authors.lastname: Roschger
authors.forename: Felicia
authors.initials: F
authors.lastname: Cosman
authors.forename: Etah S
authors.initials: ES
authors.lastname: Kurland
authors.forename: Walter
authors.initials: W
authors.lastname: Tesch
authors.forename: Phaedra
authors.initials: P
authors.lastname: Messmer
authors.forename: David W
authors.initials: DW
authors.lastname: Dempster
authors.forename: Jeri
authors.initials: J
authors.lastname: Nieves
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Shane
authors.forename: Peter
authors.initials: P
authors.lastname: Fratzl
authors.forename: Klaus
authors.initials: K
authors.lastname: Klaushofer
authors.forename: John
authors.initials: J
authors.lastname: Bilezikian
authors.forename: Robert
authors.initials: R
authors.lastname: Lindsay
mesh_terms: D015502:Absorptiometry, Photon; D001706:Biopsy; D015519:Bone Density / Q000187:drug effects*; D002118:Calcium / Q000097:blood; D005260:Female; D006801:Humans; D007085:Ilium; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000188:drug therapy*; D010281:Parathyroid Hormone / Q000008:administration & dosage*; D012542:Scattering, Radiation
chemical_list: D010281:Parathyroid Hormone; D002118:Calcium