International Journal of Travel Medicine and Global Health

International Journal of Travel Medicine and Global Health

Treatment of Osteopenic Menopause Women as a Public Health Problem with Nasal Calcitonin; an Original Study on Follow up Markers

Authors
Bita Najafian 1
Majid Shohrati 2
Amin Saburi 1
Zahra Abbasi 3
Gholam-Hossein Alishiri 4
Noushin Bayat 4
1 Pediatrics Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
2 Chemical Injuries Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
3 Tehran Medical Branch, Islamic Azad University, Tehran, Iran
4 Internal Medicine Department, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, Iran
Abstract
Introduction: Various therapeutic options such as Calcitonin are suggested for patients with low bone density. However, the efficacy remains uncertain in all patients. C-telopeptide of type I collagen (CTx) is the authentic bone marker which is recently used to assess the bone turnover. This study aimed at revealing the therapeutic effects of Calcitonin on osteopenic women via serum CTx and assessment of other biochemical markers.

Methods: we conducted a before-after clinical trial on menopause women with low bone mineral density (bone mineral density score less than 1.5 SD of peak bone mass) attending Baqiyatallah hospital clinic. They received 200 IU Calcitonin nasal spray, calcium (1000 mg) and vitamin D (400 IU). Then the serum CTx and other laboratory parameters were compared after a 6 months treatment. The data was analyzed using SPSS ver.16, paired T-test and regression model.

Results: The study population included 115 menopause women with the mean age of 58.75 ± 8.15 years. The CTx amount decreased significantly compared with that of the baseline level (3.203 ± 2.24 vs. 2.497 ± 1.657 Pmol/lit, P <0.001). Also, Bone Mineral Densitometry of spine increased significantly from 0.834±0.112 to 0.852±0.122 (P =0.003). Serum levels of PTH, Ca, AST, ALT and alkaline phosphatase total had also changed insignificantly (P >0.05).

Conclusion: Nasal spray of Calcitonin could be effective on the progression of osteoporosis by decreasing bone tissue turnover and improving the bone density. Further controlled-studies with a larger sample size and a longer duration of follow up are recommended.
Keywords
Bone Density
Osteoporosis
Calcitonin
Biological Markers
  1. Genant H, Cooper C, Poor G, Reid I, Ehrlich G, Kanis J, et al. Interim report and recommendation of the World Health Organization task-force for the osteoporosis. Osteoporos Int. 1999;10(4):259-64.
  2. Ofluoglu D, Karadag-Saygi E, Canbulat C, Hakan Gunduz O, KUL-Panza E, Akyuz G. Early effect of nasal salmon calcitonin on the bone marker Crosslaps. Rheumatol Int. 2006;26(4):288-91.
  3. Weiss M, Ben-Shlomo A, Hagag P, Rapoport M. Reference database for bone speed of sound measurement by novel quantitative multi-site ultrasound device. Osteoporos Int. 2000;11(8):688-96.
  4. M.Blake G, Fogelman I. Bone densitometry and the diagnosis of osteoporosis. Seminars in Nuclear Medicine. 2001;31(1):69-81.
  5. Kanis J, Delmas P, Burckhardt P, Cooper C, Torgerson D. Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int. 1997;7(4):390-406.
  6. Brown J, Josse R, Scientific Advisory Council of the Osteoporosis Society of Canada. 2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada. CMAJ 2002;12(167(10 Suppl)):S1-34.
  7. Herrmann M, Seibel M. The amino- and carboxyterminal cross-linked telopeptides of collagen type I, NTX-I and CTX-I: A comparative review. Clinica Chimica Acta. 2008;393(2):57-75.
  8. Chesnut C, Silverman S, Andriano K,  Genant H, Gimona A, Harris S, et al. A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the Prevent Recurrence of Osteoporotic Fractures Study. PROOF Study Group. Am J Med. 2000;109(4):267-76.
  9. Huusko T, Karppi P, Kautiainen H, Suominen H, Avikainen V, Sulkava R. Randomized, double-blind, clinically controlled trial of intranasal calcitonin treatment in patients with hip fracture. Calcif Tissue Int. 2002;71(6):478-84.
  10. Trovas G, Lyritis G, Galanos A, Raptou P, Constantelou E. A randomized trial of nasal spray salmon calcitonin in men with idiopathic osteoporosis: effects on bone mineral density and bone markers. J Bone Miner Res. 2002;17(3):521-7.
  11. Ellerington M, Hillard T, Whitcroft S, Marsh M, Lees B, Banks L, et al. Intranasal salmon calcitonin for the prevention and treatment of postmenopausal osteoporosis. Calcif Tissue Int. 1996;59:6-11.
  12. Srivastava AK, Libanati C, Hohmann O, Kriegman A, Baylink DJ. Acute effects of calcitonin nasal spray on serum C-telopeptide of type 1 collagen (CTx) levels in elderly osteopenic women with increased bone turnover. Calcif Tissue Int. 2004;75(6):477-81.
  13. Patni R. Normal BMD values for Indian females aged 20-80 years. J Midlife Health. 2010;1(2):70-3.
  14. Acharya S, Srivastava A, Sen IB. Osteoporosis in Indian women aged 40–60 years. Arch Osteoporos. 2010;5:83-9.
  15. Sanchez-Riera L, Wilson N, Kamalaraj N, Nolla JM, Kok C, Li Y, et al. Osteoporosis and fragility fractures. Best Practice & Research Clinical Rheumatology. 2010;24(6):793-810.
  16. Brixen K, Abrahamsen B, Kassem M. Prevention and treatment of osteoporosis in women. Current Obstetrics & Gynaecology. 2005;15:251-8.
  17. Bliuc D, Nguyen N, Milch V, Nguyen TV, Eisman JA, Center JR. Mortality risk associated with low-trauma osteoporotic fracture and subsequent fracture in men and women. JAMA. 2009;301(5):513-21.
  18. Nguyen N, Center J, Eisman J, Nguyen T. Bone loss, weight loss, and weight fluctuation predict mortality risk in elderly men and women. J Bone Miner Res. 2007;22(8):1147-54.
  19. Mehta N, Malootian A, Gilligan J. Calcitonin for osteoporosis and bone pain. Curr Pharm Des. 2003;9(32):2659-76.
  20. Delmas P, Eastell R, Garnero P, Seibel MJ, Stepan J; Committee of Scientific Advisors of the International Osteoporosis Foundation. The use of biochemical markers of bone turnover in osteoporosis. Committee of Scientific Advisors of the International Osteoporosis Foundation. Osteoporos Int. 2000;11 Suppl 6:S2-17.
  21. Wekre LL, Eriksen EF, Falch JA. Bone mass, bone markers and prevalence of fractures in adults with osteogenesis imperfecta. Arch Osteoporos. 2011;6(1-2):31-8.
  22. Tankó L, Bagger Y, Alexandersen P, Devogelaer J, Reginster J, Chick R, et al. Safety and efficacy of a novel salmon calcitonin (sCT) technology-based oral formulation in healthy postmenopausal women: acute and 3-month effects on biomarkers of bone turnover. J Bone Miner Res. 2004;19(9):1531-8.
  23. Kaskani E, Lyritis G, Kosmidis C, Galanos A, Andypas G, Chorianopoulos K, et al. Effect of intermittent administration of 200 IU intranasal salmon calcitonin and low doses of 1alpha (OH) vitamin D3 on bone mineral density of the lumbar spine and hip region and biochemical bone markers in women with postmenopausal osteoporosis: a pilot study. Clin Rheumatol. 2005;24(3):232-8.
  24. Bayat N, Shohrati M , Saburi A, Abbasi Z, Alishiri Gh , Najafian B. Effects of calcitonin nasal spray on serum bone resorptive marker CTX and other laboratory findings in osteopenic menopausal women: a clinical trial. Tehran Univ Med J. 2012;70(4):236-41

International Journal of Travel Medicine and Global Health
Volume 2, Issue 3 - Serial Number 6
Summer 2014
Pages 101-105

  • Receive Date 04 July 2014
  • Revise Date 25 July 2014
  • Accept Date 01 August 2014