Use of bone biochemical markers with dual-energy x-ray absorptiometry for early determination of bone loss in persons with spinal cord injury
Laurent Maïmoun [MEDLINE LOOKUP]
Isabelle Couret [MEDLINE LOOKUP]
Jean-Paul Micallef [MEDLINE LOOKUP]
Edouard Peruchon [MEDLINE LOOKUP]
Denis Mariano-Goulart [MEDLINE LOOKUP]
Jean-Louis Leroux [MEDLINE LOOKUP]
Freddy Ohanna [MEDLINE LOOKUP]

Abstract TOP

Our cross-sectional study aimed at the early determination of changes in bone metabolism in terms of bone mineral density (BMD) and bone turnover in persons with complete spinal cord injury (SCI) during the acute phase of paraplegia. Combined dual-energy x-ray absorptiometry (DXA) and specific biochemical markers of bone turnover were used to determine bone metabolism. Seven persons with SCI (age, 31.3 ± 9.5 years) who had sustained injury an average of 3 months earlier (103 ± 10.8 days) were compared with 10 able-bodied controls (27.5 ± 4.3 years). Four paraplegics and 3 quadriplegics composed the SCI group. BMD was measured by DXA, while bone turnover was evaluated by serum osteocalcin (OC), bone alkaline phosphatase (B-ALP), and serum and urinary type I collagen C-telopeptide (CTXs and CTXu). Regional BMD (proximal femur, lumbar spine, radius, lower limb) was similar in the 2 groups except in the upper limb (P < .05). CTXs and CTXu were significantly higher in SCI [P < .01 and P < .001, respectively), whereas among the bone formation markers used, only serum OC was affected by immobilization [P < .05). The SCI group developed hypercalciuria [0.76 ± 0.37 v 0.35 ± 0.14), whereas calcemia was normal [2.42 ± 0.09 v 2.31 ± 0.10). Intact parathyroid hormone [iPTH) and 1.25 [OH)2 vitamin D levels were suppressed in persons with SCI [P < .001) by 80.6% and 66%, respectively. In conclusion, it was not possible to detect any variation in BMD from the DXA technique at this early stage of demineralization, but the sensitivity and early response of the biochemical markers strongly suggested their usefulness for the early identification of persons with SCI at risk of severe osteoporosis.
Copyright 2002, Elsevier Science (USA). All rights reserved.

Publishing and Reprint Information TOP

From the Centre Propara, Montpellier; Service de Médecine Nucléaire, CHU Lapeyronie, Montpellier; UPRES EA 701, Laboratoire des Interactions, Département de Physiologie, Faculté de Médecine, Montpellier; INSERM Montpellier; and the Service de Rhumatologie, CHU Caremeau, Nîmes, France.
Submitted April 23, 2001.

Accepted February 26, 2002.
Supported by Grant No. ET8-227 from the Fondation de l'Avenir.

Address reprint requests to Laurent Maïmoun, MD, Centre Propara, Parc Euromedecine, 263 rue de la Caducée, 34195 Montpellier, France.

Copyright 2002, Elsevier Science (USA). All rights reserved.



[This message was edited by Wise Young on Aug 25, 2002 at 09:30 AM.]