acid-phosphatase and Parathyroid-Neoplasms

This study was carried out in order to evaluate clinical usefulness of cross-linked N-telopeptides (NTx) of type I collagen determination, in patients with primary hyperparathyroidism. Twenty-six consecutive patients (6 males and 20 females, aged 56.3 +/- 15.0, SD, yrs) with primary hyperparathyroidism were studied in basal conditions and, ten of them, after surgical cure of the disease. Cross-linked collagen peptides were measured by enzyme-linked immunosorbent assay and conventional markers of bone turnover according to standard procedures. Bone densitometry at the lumbar spine and proximal femur was performed using dual-energy X-ray absorptiometry. Bone mineral density, was also assessed at the junction of the distal and middle third of the radius and at the ultradistal radius of the non-dominant arm by a dual photon densitometer. Mean urinary NTx values (194.2 +/- 121.9 pmoles bone collagen equivalents/mumoles creatinine) were significantly higher (p < 0.001) in respect to those found in normal subjects. The mean increase of Z score values of both serum tartrate resistant acid phosphatase activity (1.4 +/- 1.8) and the fasting hydroxyproline/creatinine ratio (1.45 +/- 2.0) was significantly lower (p < 0.02) in respect to that of NTx Z score values (3.3 +/- 3.3); the latter values were not significantly different than mean Z score values of serum osteocalcin (4.0 +/- 3.9), serum alkaline phosphatase activity (2.6 +/- 2.6) and urinary calcium/creatinine ratio (3.2 +/- 3.3). We found a significant inverse correlation between NTx values and both lumbar spine (p < 0.01) and ultradistal radius bone mineral density (p < 0.05); a modest inverse correlation was also observed between serum tartrate resistant acid phosphatase activity and lumbar spine bone mineral density (p < 0.04). Following successful adenoma removal, the percentage decrease of both NTx and hydroxyproline was similar in patients with increased bone turnover rate; major discrepancies were observed in patients with normal values of NTx, the telopeptide reduction being greater than that of hydroxyproline. Finally, in a hypercalcemic patient with metastatic parathyroid cancer, telopeptide excretion was shown to be more sensitive in respect to urinary hydroxyproline when evaluating the effects of antiresorptive therapy. Our results seem to indicate that amongst the markers with good sensitivity, NTx is the only one that is inversely related with bone mineral density at two different skeletal sites

Topics: Absorptiometry, Photon; Acid Phosphatase; Adenoma; Adult; Aged; Alkaline Phosphatase; Bone Density; Bone Resorption; Calcium; Collagen; Collagen Type I; Creatinine; Enzyme-Linked Immunosorbent Assay; Female; Humans; Hydroxyproline; Hyperparathyroidism; Male; Middle Aged; Osteocalcin; Parathyroid Neoplasms; Peptides; Tartrates

Bone loss and the serum markers of bone metabolism were studied in 22 patients with primary hyperparathyroidism and 108 patients with renal hyperparathyroidism. The parameters of bone loss were bone mineral density in the distal radius and lumbar vertebrae, measured by dual energy X-ray absorptiometry, and bone mass index (sigma GS/D) and the metacarpal index, in the second metacarpal bone, measured by the digital image processing method. Alkaline phosphatase (AIP), intact osteocalcin (OC), and the carboxyterminal propeptide of type I procollagen (PICP) were measured as serum markers of bone formation, while tartrate-resistant acid phosphatase (TRACP) and the carboxyterminal pyridinoline cross-linked telopeptide of type I collagen (ICTP) were measured as serum markers of bone resorption. Bone loss and elevated markers of bone metabolism were observed both in patients with skeletal symptoms and in those without. Furthermore, the decrease in the cortical bone mass was more predominant than that of the trabecular bone. As markers of bone formation, AIP and OC seemed to be more sensitive than PICP, and as markers of bone resorption, ICTP appeared to be more sensitive than TRACP. Thus, a close correlation was observed between bone loss and the markers of bone formation and resorption.

Topics: Acid Phosphatase; Adenoma; Alkaline Phosphatase; Biomarkers, Tumor; Bone and Bones; Bone Density; Bone Resorption; Chronic Kidney Disease-Mineral and Bone Disorder; Female; Humans; Hyperparathyroidism; Isoenzymes; Male; Middle Aged; Osteocalcin; Parathyroid Neoplasms; Procollagen; Tartrate-Resistant Acid Phosphatase

Altogether 184 patients with bone, renal or mixed hyperparathyroidism (HPT) presenting primarily were examined for blood levels of parathyroid hormone and indirect indicators of parathyroid function. None of the indices (calcium concentration, phosphorus level, serum activity of acid and alkaline phosphatase, oxyproline excretion with urine, etc.) was changed. The commonest biochemical signs of primary HPT were hypercalcemia, hypersecretion of parathyroid hormone, hyperoxyprolinuria. Biochemical indices deviations occurred more often and were more profound in bone primary HPT and parathyroid adenomas.

Topics: Acid Phosphatase; Adenoma; Alkaline Phosphatase; Calcium; Humans; Hydroxyproline; Hyperparathyroidism; Parathyroid Hormone; Parathyroid Neoplasms; Phosphorus; Radioimmunoassay

Acid-phosphatase-rich granules, separate from the parathyroid-hormone-containing secretory granules, have been demonstrated in the normal, adenomatous and primary hyperplastic human parathyroid glands. These granules are thought to represent lysosomes which are derived from the Golgi region. In the normal glands these granules are postulated to be associated with involution of the cell organelles during the normal secretory cycle. In the adenomatous and hyperplastic glands evidence is presented that these lysosomes are associated with the destruction of secretary granules and parthyroid hormone.

Topics: Acid Phosphatase; Adenoma; Extracellular Space; Golgi Apparatus; Humans; Hyperplasia; Lysosomes; Parathyroid Diseases; Parathyroid Glands; Parathyroid Neoplasms

Topics: Acid Phosphatase; Adenoma; Adult; Alkaline Phosphatase; Chromatography, Thin Layer; Edetic Acid; Electrophoresis; Epithelium; Female; Gels; Humans; Hydrogen-Ion Concentration; Hyperparathyroidism; Isoenzymes; Middle Aged; Parathyroid Neoplasms; Starch; Tartrates

Topics: Acid Phosphatase; Alkaline Phosphatase; Anuria; Fractures, Spontaneous; Humans; Hyperparathyroidism; Osteitis Fibrosa Cystica; Parathyroid Neoplasms; Pathology; Postoperative Care; Postoperative Complications; Radiography; Surgical Procedures, Operative