Abstract
Rapid bone loss after orthoptic cardiac transplantation (OHTX) is a major problem; however, the mechanisms are poorly understood. To investigate these mechanisms we measured biochemical and hormonal indices of bone turnover serially in 25 patients (21 men, 4 women) after OHTX. Serum osteocalcin was reduced immediately post-OHTX (2.2±0.5 ng/ml) but rose significantly by 6 and 12 months (14.1±2.5 and 15.7±2.2 respectively). Bone resorption indices (urinary hydroxyproline/creatinine and calcium/creatinine ratios) were increased immediately post-OHTX but fell by 6 months. Serum testosterone was reduced in males but recovered towards normal values by 6–12 months. Regression analysis showed lumbar bone loss was predicted independently by the change in both serum osteocalcin and testosterone. The data suggest that bone loss post-OHTX is due to a combination of accelerated turnover and hypogonadism.
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Sambrook, P.N., Kelly, P.J., Fontana, D. et al. Mechanisms of rapid bone loss following cardiac transplantation. Osteoporosis Int 4, 273–276 (1994). https://doi.org/10.1007/BF01623351
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DOI: https://doi.org/10.1007/BF01623351