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.
Status | Completed |
Enrollment | 22 |
Est. completion date | April 2016 |
Est. primary completion date | April 2016 |
Accepts healthy volunteers | No |
Gender | Both |
Age group | 18 Years and older |
Eligibility |
Inclusion Criteria: - Hyperparathyroidism defined by a parathyroid hormone serum level above 65 ng/ml, secondary to Chronic Kidney Disease (CKD) ou vitamin D deficiency Exclusion Criteria: - Concurrent bone disease (such as Paget's disease, osteomalacia), - Other endocrinopathy having an impact on bone metabolism (such as Cushing, hyperthyroidism, severe hypogonadism (except menopause)), - Current or previous bisphosphonate treatment. - Transplantation - parathyroidectomy - Life expectancy less than 3 months. - Lack of study understanding. - Lack of agreement. - Under legal control. |
Intervention Model: Single Group Assignment, Masking: Open Label, Primary Purpose: Basic Science
Country | Name | City | State |
---|---|---|---|
France | CHU de SAINT-ETIENNE | Saint-etienne |
Lead Sponsor | Collaborator |
---|---|
Centre Hospitalier Universitaire de Saint Etienne | University Hospital, Geneva |
France,
Type | Measure | Description | Time frame | Safety issue |
---|---|---|---|---|
Primary | Correlation between periostin level and cortical porosity | Correlation between periostin serum level (ng/ml) and cortical porosity. Cortical porosity (%) is measured by HR-pQCT | day 1 | No |
Secondary | Correlation between periostin level and other trabecular and cortical microarchitectural parameters (composite outcome) | Correlation between periostin serum level (ng/ml) and other trabecular and cortical microarchitectural parameters. Cortical microarchitectural parameters are a composite measure measured by HR-pQCT. The measures are : Total volumetric mineral density (mg/ccm HA), Trabecular volumetric mineral density (mg/ccm HA), Cortical volumetric mineral density (mg/ccm HA), Number of bone trabeculae (1/mm), Trabecular thickness (mm), Cortical thickness (mm), Trabecular spacing (mm) o Trabecular distribution (mm) |
day 1 | No |
Secondary | Correlation between parathyroid hormon level and other trabecular and cortical microarchitectural parameters (composite outcome) | Correlation between parathyroid hormon serum level (pg/ml) and other trabecular and cortical microarchitectural parameters. Cortical microarchitectural parameters are a composite measure measured by HR-pQCT. The measures are : Total volumetric mineral density (mg/ccm HA), Trabecular volumetric mineral density (mg/ccm HA), Cortical volumetric mineral density (mg/ccm HA), Number of bone trabeculae (1/mm), Trabecular thickness (mm), Cortical thickness (mm), Trabecular spacing (mm) o Trabecular distribution (mm) |
day 1 | No |
Secondary | Correlation between Sclerostin serum level and cortical porosity | Correlation between Sclerostin serum level (ng/ml) and cortical porosity.Cortical porosity (%) is measured by HR-pQCT. | Day 1 | No |
Secondary | Correlation between parathyroid hormon level and cortical porosity | Correlation between parathyroid hormon serum level (pg/ml) and cortical porosity.Cortical porosity (%) is measured by HR-pQCT. | Day 1 | No |
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