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The effect of teriparatide on serum Dickkopf-1 levels in postmenopausal women with established osteoporosis

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Summary Objective 

Parathyroid hormone increases the differentiation of osteoblast precursors through canonical wingless (Wnt) signalling, resulting in an osteoanabolic effect. We aimed to evaluate serum levels of the Wnt-inhibitor Dickkopf-1 (Dkk-1) in postmenopausal women with established osteoporosis and their changes with teriparatide (TPTD – human recombinant PTH 1–34). Design and patients 

A total of 31 postmenopausal Caucasian women with established osteoporosis (mean age 66·3 ± 1·4 years) received daily injections of 20 μg TPTD for 18 months. Follow-up was continued for another 6 months after treatment discontinuation (total duration of treatment 24 months). Measurements 

Serum samples for total calcium (Ca), intact PTH (iPTH), bone-specific alkaline phosphatase, C-terminal cross-linking telopeptide of type 1 collagen (CTx) and Dkk-1 were obtained at baseline, and at 6, 18 and 24 months after TPTD initiation. Lumbar spine bone mineral density (BMD) was measured before and after 18 months of TPTD treatment. A total of 16 age- and gender-matched healthy controls were also analysed at baseline. Results 

Serum Dkk-1 levels at baseline were significantly higher in osteoporotic women compared with that in controls (P <0·002). Dkk-1 increased significantly during TPTD administration (P <0·044) and decreased to baseline 6 months after TPTD discontinuation. Dkk-1 change was positively correlated to Ca (r =0·530, P =0·004) and negatively correlated to iPTH change (r = −0·398, P =0·040). There was no correlation between Dkk-1 and BMD changes. Conclusions 

Our data suggest that Dkk-1 levels are increased in women with postmenopausal osteoporosis. TPTD therapy results in further increase of Dkk-1 that may be compensative to TPTD-induced enhanced Wnt signalling.
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Document Type: Research Article

Affiliations: 1: Department of Endocrinology, 424 General Military Hospital, Thessaloniki, Greece 2: Second Department of Internal Medicine, Aristotle University of Thessaloniki, Hippokration General Hospital, Thessaloniki, Greece 3: Department of Endocrinology, Hippokration General Hospital, Thessaloniki, Greece 4: Department of Medical Research, 251 General Air Force Hospital, Athens, Greece

Publication date: June 1, 2010

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