Endocrinology and Metabolism

Original Article

Bone Metabolism
Efficacy of a Once-Monthly Pill Containing Ibandronate and Cholecalciferol on the Levels of 25-Hydroxyvitamin D and Bone Markers in Postmenopausal Women with Osteoporosis: In-Jin Cho, Ho-Yeon Chung, Sung-Woon Kim, Jae-Won Lee, Tae-Won Lee, Hye-Soon Kim, Sin-Gon Kim, Han Seok Choi, Sung-Hee Choi, Chan Soo Shin, Ki-Won Oh, Yong-Ki Min, Jung-Min Koh, Yumie Rhee, Dong-Won Byun, Yoon-Sok Chung, Jeong Hyun Park, Dong Jin Chung, Minho Shong, Eun-Gyoung Hong, Chang Beom Lee, Ki Hyun Baek, Moo-Il Kang; Endocrinol Metab. 2015;30(3):272-279. Published online December 9, 2014; DOI: https://doi.org/10.3803/EnM.2015.30.3.272

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Background

The present study evaluated the efficacy of a combination of ibandronate and cholecalciferol on the restoration of the levels of 25-hydroxyvitamin D (25[OH]D) and various bone markers in postmenopausal women with osteoporosis.

Methods

This was a randomized, double-blind, active-controlled, prospective 16-week clinical trial conducted in 20 different hospitals. A total of 201 postmenopausal women with osteoporosis were assigned randomly to one of two groups: the IBN group, which received a once-monthly pill containing 150 mg ibandronate (n=99), or the IBN+ group, which received a once-monthly pill containing 150 mg ibandronate and 24,000 IU cholecalciferol (n=102). Serum levels of 25(OH)D, parathyroid hormone (PTH), and various bone markers were assessed at baseline and at the end of a 16-week treatment period.

Results

After 16 weeks of treatment, the mean serum levels of 25(OH)D significantly increased from 21.0 to 25.3 ng/mL in the IBN+ group but significantly decreased from 20.6 to 17.4 ng/mL in the IBN group. Additionally, both groups exhibited significant increases in mean serum levels of PTH but significant decreases in serum levels of bone-specific alkaline phosphatase and C-telopeptide of type 1 collagen (CTX) at 16 weeks; no significant differences were observed between the groups. However, in subjects with a vitamin D deficiency, IBN+ treatment resulted in a significant decrease in serum CTX levels compared with IBN treatment.

Conclusion

The present findings demonstrate that a once-monthly pill containing ibandronate and cholecalciferol may be useful for the amelioration of vitamin D deficiency in patients with postmenopausal osteoporosis. Moreover, this treatment combination effectively decreased serum levels of resorption markers, especially in subjects with a vitamin D deficiency, over the 16-week treatment period.

Citations

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Effect of vitamin D supplementation or fortification on bone turnover markers in women: a systematic review and meta-analysis
Nasrin Nasimi, Sanaz Jamshidi, Aida Askari, Nazanin Zolfaghari, Erfan Sadeghi, Mehran Nouri, Nick Bellissimo, Shiva Faghih
British Journal of Nutrition.2024; : 1. CrossRef
Quality of life and patient satisfaction with raloxifene/cholecalciferol combination therapy in postmenopausal women
Dong-Yun Lee, Yoon-Sok Chung
Scientific Reports.2022;[Epub] CrossRef
Efficacy of risedronate with cholecalciferol on bone mineral density in Korean patients with osteoporosis
So Young Park, Moo-Il Kang, Hyung Moo Park, Yumie Rhee, Seong Hwan Moon, Hyun Koo Yoon, Jung-Min Koh, Jae Suk Chang, In Joo Kim, Ye Yeon Won, Ye Soo Park, Hoon Choi, Chan Soo Shin, Taek Rim Yoon, Sung-Cheol Yun, Ho-Yeon Chung
Archives of Osteoporosis.2020;[Epub] CrossRef
Efficacy and safety of vitamin D3 B.O.N intramuscular injection in Korean adults with vitamin D deficiency
Han Seok Choi, Yoon-Sok Chung, Yong Jun Choi, Da Hea Seo, Sung-Kil Lim
Osteoporosis and Sarcopenia.2016; 2(4): 228. CrossRef
Pharmacologic treatment of osteoporosis
Yong-Ki Min
Journal of the Korean Medical Association.2016; 59(11): 847. CrossRef

Response

Thyroid
Response: Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes (Endocrinol Metab 2013;28:110-8, Dong Jun Lim et al.): Dong Jun Lim, Ki Hyun Baek; Endocrinol Metab. 2013;28(3):243-244. Published online September 13, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.3.243

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Calcification Patterns in Papillary Thyroid Carcinoma are Associated with Changes in Thyroid Hormones and Coronary Artery Calcification
Jeonghoon Ha, Jeongmin Lee, Kwanhoon Jo, Jeong-Sun Han, Min-Hee Kim, Chan Jung, Moo Kang, Bong Cha, Dong-Jun Lim
Journal of Clinical Medicine.2018; 7(8): 183. CrossRef

Original Article

Thyroid
Natural Course of Cytologically Benign Thyroid Nodules: Observation of Ultrasonographic Changes: Dong Jun Lim, Jee Young Kim, Ki Hyun Baek, Mee Kyoung Kim, Woo Chan Park, Jong Min Lee, Moo Il Kang, Bong Yun Cha; Endocrinol Metab. 2013;28(2):110-118. Published online June 18, 2013; DOI: https://doi.org/10.3803/EnM.2013.28.2.110

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Background

The natural course of cytologically benign thyroid nodules remains unclear. The aim of this study was to evaluate whether ultrasonographic (US) changes are associated with changes in nodule volume during follow-up.

Methods

We retrospectively reviewed over 4 years of clinical records of patients with benign thyroid nodules as confirmed by fine needle aspiration (FNA). In total, 186 patients with 202 benign thyroid nodules were included for study. We assessed for changes in nodule volume and examined the cystic portion of the nodule as well as four US features (echogenicity, margin, calcification pattern, and shape).

Results

During follow-up (mean, 21.7±10.7 months) and using 50% as a cutoff value, nodule volumes increased in 11.8%, exhibited no change in 79.9%, and decreased in 8.3% of patients. Proportion of nodules demonstrating at least one US change was 20.8% (42/202). The most common US changes (in descending order of frequency) were cystic change, margin change, and calcification pattern change. Nodule shape and echogenicity rarely changed. Increased nodule volume was not significantly associated with any US features or with the number of FNAs but was associated with younger age at time of diagnosis.

Conclusion

Although a portion of thyroid nodules confirmed as benign showed US changes or volume changes during the follow-up period, these findings may only represent the natural course of benign nodules. Frequent follow-up with US might be needed for only a small number of cases with suspicious US findings.

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Naykky Singh Ospina, Spyridoula Maraka, Ana Espinosa DeYcaza, Derek O'Keeffe, Juan P. Brito, Michael R. Gionfriddo, M. Regina Castro, John C. Morris, Patricia Erwin, Victor M. Montori
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Claudius Falch, Steffen Axt, Bettina Scuffi, Alfred Koenigsrainer, Andreas Kirschniak, Sven Muller
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Retractions of Publication

Retraction: Relationship between Circulating Osteoprotegerin and Cardiovascular Risk Factors in Women.: Ki Won Oh, Eun Joo Yun, Eun Sook Oh, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Cheol Young Park, Moon Ki Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2008;23(1):69. Published online February 1, 2008

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Retraction: Relationship between Serum Leptin, Adiponectin, Resistin and Ghrelin Levels, and Bone Mineral Density in Men.: Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2008;23(1):68. Published online February 1, 2008

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Retraction: Relationship between Serum Osteoprotegerin-Receptor Activator of NF-kappaB Ligand Levels and Bone Mineral Metabolism in Men.: Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Moo Il Kang, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2008;23(1):67. Published online February 1, 2008

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Case Report

A Case of Graves' Disease Associated with Systemic Sclerosis.: Yune Jeong Lee, Mee Kyoung Kim, Dong Jun Lim, Ki Hoon Hur, Ki Hyun Baek, Moo Il Kang, Chul Soo Cho, Kwang Woo Lee, Gyeong Sin Park; J Korean Endocr Soc. 2007;22(3):220-224. Published online June 1, 2007; DOI: https://doi.org/10.3803/jkes.2007.22.3.220

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Abstract PDF

Systemic sclerosis is associated with a broad spectrum of autoimmune thyroid diseases. The association between systemic scleroderma and hypothyroidism is well established. However, there have been very few reports concerning the association between hyperthyroidism and systemic scleroderma. We experienced a patient with Graves' disease who presented with muscle weakness and the patient was finally diagnosed with systemic sclerosis via pathological examination of the muscle. We describe here a rare case of systemic sclerosis associated with Graves` disease.

Citations

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Systemic Sclerosis Associated with Non-small Cell Lung Cancer and Papillary Thyroid Cancer: Case Report and Literature Review
Ho Jae Kim, Jung Joo Kim, Hee Jung Park, Yong Tai Kim
The Korean Journal of Medicine.2017; 92(3): 316. CrossRef

Original Article

The Effect of Oxidative Stress on the Proliferation and Differentiation of Human Bone Marrow Stromal Cell-Derived Osteoblasts.: Eun Sook Oh, Ki Hyun Baek, Won Young Lee, Ki Won Oh, Hye Soo Kim, Je Ho Han, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Moo Il Kang; J Korean Endocr Soc. 2006;21(3):222-232. Published online June 1, 2006; DOI: https://doi.org/10.3803/jkes.2006.21.3.222

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Abstract PDF

BACKGROUND
The objectives of our study were to assess the effects of oxidative stress on the proliferation, differentiation and apoptosis of human bone marrow stromal cell (BMSC)-derived osteoblasts and to explore pathways by which osteoblast cell apoptosis was induced. METHODS: Mononuclear cells including BMSCs were cultured to osteoblastic lineage. Different doses of hydrogen peroxide (H2O2) were added to the culture media. The colony forming units-fibroblastic (CFU-Fs) were stained with crystal violet and alkaline phosphatase (ALP). The MTT assay was done to see the effect of H2O2 on cell viability. The effect of H2O2 on osteocalcin gene expression was determined by RT-PCR. The matrix calcification measurement was performed. FACS analysis was performed to determine the osteoblasts apoptosis. Caspase-3, -8 and 9 activity assay and cytochrome c release were measured. RESULTS: The size and number of ALP (+) CFU-Fs were also decreased by H2O2 treatment. When compared with the control group, H2O2 significantly decreased the total number of cells of each culture well during MTT assay. H2O2 significantly diminished expression of osteocalcin mRNA. N-acetylcystein (NAC) blocked the diminution of cell viability and the inhibition of osteocalcin mRNA expression by H2O2. H2O2 reduced matrix calcification. FACS analysis revealed H2O2 increased percentage of apoptotic cells. Addition of H2O2 resulted in the increase of caspase-9 and -3 activity but not caspase-8, and release of cytochrome c to the cytosol. CONCLUSION: These data suggest that, in primary human BMSCs, oxidative stress inhibits proliferation of stromal cells and inhibits the differentiation to osteoblastic lineage. In addition, oxidative stress induces apoptosis of human BMSC-derived osteoblasts and this may be mediated by mitochondrial pathway of apoptotic signal.

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Antioxidaitve and Differentiation Effects of Artemisia capillaris T. Extract on Hydrogen Peroxide-induced Oxidative Damage of MC3T3-E1 Osteoblast Cells
Jee-Eun Seo, Eun-Sun Hwang, Gun-Hee Kim
Journal of the Korean Society of Food Science and Nutrition.2011; 40(11): 1532. CrossRef

Editorial

Sequential and Combination Therapy using Parathyroid Hormone for Osteoporosis.: Ki Hyun Baek; J Korean Endocr Soc. 2005;20(4):319-322. Published online August 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.4.319

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Abstract PDF

No Abstract available.

Citations

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Effects of the Pharmacopuncture in Animal Models for Treatment of Osteoporosis: A Review of Animal Study Reports Published in Korea
Jung-min Kim, Soo-min Choi, Hee-Duk An
Journal of Korean Medicine Rehabilitation.2016; 26(2): 75. CrossRef

Original Articles

The Effects of Osteoprotegerin Polymorphism on Bone Mineral Metabolism in Korean Women with Perimenopause.: Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Moo Il Kang, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2005;20(3):204-215. Published online June 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.3.204

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Abstract PDF: BACKGROUND
Osteoprotegerin(OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of the NF-kappaB ligand(RANKL), and has also been shown to be an important inhibitor of osteoclastogenesis in animal models. However, the relationship between OPG gene polymorphism and female bone stati in human populations is unclear. In this study, the relationship between OPG gene polymorphisms and bone mineral metabolism in healthy Korean women was investigated. METHODS: We observed 251 healthy women(mean age, 51.3+/-6.9 yr). The serum OPG concentrations were determined using ELISA, and the biochemical markers of bone turnover and FSH measured using standard methods. The bone mineral densities at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. The A163G, G209A, T245G and T950C polymorphisms of the OPG gene were analyzed by allelic discrimination using the 5 nuclease polymerase chain reaction assay. RESULTS: The lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group(A163G, 0.98+/-0.14g/cm2[GG+GA] vs. 1.05+/- 0.15g/cm2[AA], P =0.070; T245G, 0.97+/-0.13g/cm2[GG+GT] vs. 1.04+/-0.15g/cm2[TT], P=0.056). In the linkage of polymorphisms A163G and T245G, the lumbar spine BMD of premenopausal women was marginally decreased in the variant allele group compared to the wild type group([AATT] vs. [AGTG+AGGG+GGTG+GGGG]: 1.04+/-0.15 vs. 0.97+/- 0.13; P=0.072). However, there were no differences in the serum OPG levels and bone turnover markers among the different genotypes. CONCLUSION: The A163G and T245G polymorphisms of the OPG gene were observed to be marginally associated with the lumbar spine BMD in healthy premenopausal Korean women, but further studies will be needed to clarify this relationship

The Changes in the Serum RANKL and OPG levels after Bone Marrow Transplantation: Association with Bone Mineral Metabolism.: Hyun Jung Tae, Ki Hyun Baek, Eun Sook Oh, Ki Won Oh, Won Young Lee, Hye Soo Kim, Je Ho Han, Bong Yun Cha, Kwang Woo Lee, Ho Young Son, Sung Koo Kang, Choon Choo Kim, Moo Il Kang; J Korean Endocr Soc. 2005;20(1):40-51. Published online February 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.1.40

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Abstract PDF: BACKGROUND
The loss of bone mass is usually detected after bone marrow transplantation(BMT), particularly during the early post-transplant period. We recently reported that enhanced bone resorption following BMT was related to both the steroid dose and increase in IL-6. It was also suggested damage of the marrow microenvironment due to myeloablation and changes in bone growth factors contribute to post-BMT bone loss. Recently, the interactions of OPG and RANKL have been reported to be crucial in osteoclastogenesis and therefore in bone homeostasis. There are few data on the changes in RANKL/OPG status during the post-BMT period. This study investigated the changes in the levels of RANKL and OPG during the post-BMT period, and also assessed whether the changes in these cytokine levels actually influenced bone turnover and post-BMT bone loss. METHODS: We prospectively investigated 110 patients undergoing allogenic BMT and analyzed 36 (32.4+/-1.3 years, 17 men and 19 women) where DEXA was performed before and 1 year after the BMT. The serum bone turnover marker levels were measured before and 1, 2, 3, 4 and 12 wks, 6 Ms, and 1 yr after the BMT. The serum sRANKL and OPG levels were measured in all patients before and 1, 3 and 12 wks after the BMT. RESULTS: The mean bone losses in the lumbar spine and total proximal femur, which were calculated as the percent change from the baseline to 1 yr, were 5.2(P<0.01) and 11.6%(P<0.01), respectively. The mean serum ICTP, a bone resorption marker, increased progressively until 3 and 6 months after the BMT, but decreased gradually thereafter, reaching the basal values after 1 year. The serum osteocalcin levels decreased progressively until 3 wks after the BMT, then increased transiently at 3 and 6 Ms, but returned to the basal level by 1 yr. The serum sRANKL and OPG levels had increased significantly by weeks 1 and 3 compared with the baseline(P<0.01), but decreased at 3 months. The sRANKL/OPG ratio increased progressively until 3 weeks, but then decreased to the basal values. During the observation period, the percent changes from the baseline in the serum RANKL levels and RANKL/OPG ratio showed positive correlations with the percent changes from the baseline serum ICTP levels. Patients with higher RANKL levels and RANKL/OPG ratio during the early post-BMT period lost more bone mass at the lumbar spine. CONCLUSION: In conclusion, dynamic changes in the sRANKL and OPG levels were observed during the immediate post-BMT period, which were related to a decrease in bone formation and loss of L-spine BMD during the year following the BMT. Taken together, these results suggest that increased sRANKL levels and sRANKL/OPG ratios could be involved in a negative balance in bone metabolism following BMT.

Review Article

Official Positions of the International Society for Clinical Densitometry.: Ki Hyun Baek, Moo Il Kang; J Korean Endocr Soc. 2005;20(1):1-7. Published online February 1, 2005; DOI: https://doi.org/10.3803/jkes.2005.20.1.1

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Abstract PDF

No abstract available.

Citations

Citations to this article as recorded by

Dietary factors affecting bone mineral density in Korean rural postmenopausal women
Jeong Sook Choe, Eun Mi Ahn, Sung Ok Kwon, Young Hee Park, Jinyoung Lee
Korean Journal of Nutrition.2012; 45(5): 470. CrossRef

Original Articles

Relationship between Circulating Osteoprotegerin and Cardiovascular Risk Factors in Women.: Ki Won Oh, Eun Joo Yun, Eun Sook Oh, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Cheol Young Park, Moon Ki Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2005;20(1):52-63. Published online February 1, 2005

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Abstract PDF: BACKGROUND
Osteoprotegerin(OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of NF-B ligand(RANKL). OPG has been shown to be an important inhibitor of osteoclastogenesis and arterial calcification in animal models. Recently, OPG has been proposed as a link molecule between osteoporosis and arterial calcification. However, the relationship between circulating OPG levels and cardiovascular disease in human populations is unclear. Thus, the aim of this study was to investigate the relationship between circulating OPG levels and cardiovascular risk factors in women. METHODS: The subjects were 286 women, with a mean age of 51.5 yr. The blood pressure, body mass index(BMI) and waist to hip ratio(WHR) were examined and the serum concentrations of OPG determined by ELISA. The fasting glucose levels, serum lipid profiles and follicle stimulating hormone (FSH) were measured by standard methods. RESULTS: A significant association was observed between the serum OPG levels, age and WHR(r=0.134, P<0.05). Also, the serum OPG levels were significantly correlated with the serum total cholesterol and low density lipoprotein cholesterol levels(r=0.175, P<0.01; r=0.176, P<0.01). Conversely, there was a nonsignificant relationship between the serum OPG levels, blood pressure and fasting glucose levels. The mean serum OPG levels were found to be about 11% greater in post-than premenopausal women(mean+/-SD, 1358.5+/-380.0 vs. 1228.8+/-407.7pg/mL, respectively(P<0.001). There was a significant association between the serum OPG and serum FSH levels(r=0.176, P<0.01). CONCLUSION: In conclusion, our data show that the levels of circulating OPG are partially associated with the cardiovascular risk factors and female hormonal status in healthy women. These data suggest that OPG may be an important paracrine factor of cardiovascular disease in human female populations.

Relationship between Serum Leptin, Adiponectin, Resistin and Ghrelin Levels, and Bone Mineral Density in Men.: Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Kun Ho Yoon, Moo Il Kang, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2004;19(4):379-392. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Fat mass is an important determinant of bone mineral density (BMD), but the mechanism involved in this relationship is uncertain. Several lines of evidence have suggested the effects of fat mass on BMD may be mediated by hormonal factors, with the principal candidates being serum sex hormones, insulin, leptin and adiponectin. Thus, the aim of this study was to investigate the relationship between the serum adipocytokine and ghrelin levels, and BMD in men. METHODS: Eighty men, aged 42~70 (mean age, 54.5 yr), were selected as the study subjects. The serum concentrations of leptin and ghrelin were measured with RIA, the adiponectin with ELISA and the resistin with EIA. The serum concentrations of estradiol, total testosterone and the biochemical markers of bone turnover were measured by standard methods. The BMD at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. RESULTS: The serum leptin level was found to correlate to the BMI, waist to hip ratio (WHR), blood pressure, fasting blood sugar, serum fasting insulin, total cholesterol, triglyceride and calcium levels. Although the serum leptin level was not significantly correlated to the serum estradiol level, it did show a weak trend. The serum adiponectin level were correlated to the BMI, WHR and serum fasting insulin level; and the resistin to serum total cholesterol and low density lipoprotein cholesterol levels; ghrelin to age, WHR and serum triglyceride levels. A significant negative correlation was observed between the serum resistin level and lumbar spine BMD. Also, there was a significant negative correlation between the serum leptin level and lumbar spine BMD. The above correlations were observed only when the BMI and the serum estradiol and insulin levels were included as independent variables in the regression analysis model. The serum adiponectin level was not significantly correlated with the BMD, either in the presence or absence of the BMI and serum insulin level. CONCLUSION: The serum adipocytokine level was observed to be partly associated with the BMD in men. Therefore, these data suggest that leptin and resistin may play roles in the bone mineral metabolism in men. Further studies are needed to larify this relationship

Relationship between Serum Osteoprotegerin-Receptor Activator of NF-kappaB Ligand Levels and Bone Mineral Metabolism in Men.: Ki Won Oh, Eun Joo Yun, Eun Jung Rhee, Won Young Lee, Ki Hyun Baek, Moo Il Kang, Cheol Young Park, Sung Hee Ihm, Moon Gi Choi, Hyung Joon Yoo, Sung Woo Park; J Korean Endocr Soc. 2004;19(4):332-345. Published online August 1, 2004

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Abstract PDF: BACKGROUND
Osteoporosis is a growing health problem, not only in women, but in men also. Sex hormones and insulin-like growth factor-I (IGF-I) have been shown to be the major determinant in male bone metabolism. Osteoprotegerin (OPG) is a recently identified cytokine, which acts as a decoy receptor for the receptor activator of the NF- B ligand (RANKL). OPG and RANKL have been shown to be important regulators of osteoclastogenesis in animal models. The relationship between the OPG-RANKL system and male bone status in human populations is unclear. The aim of this study was to investigate the relationship between circulating the OPG-RANKL system and bone mineral metabolism in 80 Korean men. METHODS: The subjects of this study were 80 men aged between 42 and 70 (mean age, 54.5 yr). The serum concentrations of OPG and RANKL were measured by ELISA. The serum concentrations of estradiol, total testosterone, IGF-I and biochemical markers of bone turnover were measured by standard methods. The bone mineral densites (BMD) at the lumbar spine and femoral neck were measured by dual energy x-ray absorptiometry. RESULTS: A significant correlation was observed between the serum OPG/RANKL ratios and osteocalcin levels (r=-0.229, p<0.05). The serum OPG levels were significantly correlated to the femoral neck BMD (r=-0.227, p<0.05). The mean value of the serum OPG was found to be greater in patients with osteoporosis at the femoral neck (mean SD, 4.72.1 pmol/L) than in subjects with a normal BMD (3.30.9 pmol/L, p<0.05). The serum RANKL/OPG ratios were significantly positively correlated to the serum estradiol level (r=0.401, p<0.001). Also, there was a significant negative correlation between the serum OPG and estradiol levels (r=-0.288, p<0.05). In a multiple regression analysis, the BMI, serum OPG and RANKL levels, and the serum IGF-I level were identified as significant predictors of the femoral neck BMD. In another multiple regression analysis, only the serum estradiol level was identified as a significant predictor of the serum OPG level. CONCLUSION: In conclusion, our data show that the serum OPG and RANKL levels are partly associated with bone mineral metabolism, and are related to the endogenous estrogen levels in human male populations. Therefore, the possibility exists that the OPG-RANKL system may be a mediator of the estradiol in male bone metabolism. However, there have been few study published on the relation between the serum OPG and estradiol levels in men. Further studies are needed to clarify this relationship

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