Hyperparathyroidism Clinical Trial
Official title:
Association Between Serum Periostin Levels and Cortical Porosity in Patients With Secondary Hyperparathyroidism
Based on the evidence that periostin is specifically involved in intra-cortical remodeling
control, our working hypothesis is that assessment of its concentration in the serum would
be helpful in identifying patients with severe cortical porosity, a critical parameter in
bone fragility. Periostin expression by osteoblasts and osteocytes is part of the bone
cortical response to anabolic stimuli such as mechanical strain or intermittent increase in
parathyroid hormone. However, it remains unknown whether this expression may participate as
well to mechanisms that will lead to exaggerated intra-cortical remodeling and subsequent
bone loss.
In rare clinical situations in which trans-iliac bone biopsies will be necessary to better
understand their bone status in addition to densitometry and biological bone markers
assessment, specific analyses using immune-staining techniques will be performed on the bone
sample. Data from routine follow-up every six months will be also collected in this specific
sub-group.
High resolution peripheral quantitative computerized tomography (HR-pQCT) gives the
opportunity of performing a virtual bone biopsy providing information on trabecular and
cortical microarchitecture in vivo. These microarchitectural parameters allow a more
accurate evaluation of the alteration of the bone structure and therefore of the fracture
risk as compared to current tools used in clinical practice such as densitometry. However,
the availability of such HRpQCT facilities is limited and there is on-going development on
the best way of measuring porosity for example. The definition of a biological profile
including key proteins such as periostin and sclerostin involved in porosity mechanisms is
therefore of great interest. A better understanding of the relationship between bone matrix
components and parathyroid hormone effects also appears as critical. Follow-up of routine
evaluation parameters reflecting bone status in a subgroup of specific patients could also
provide new and additional information.
n/a
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Basic Science
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