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Article: Pregnancy- and lactation-related osteoporosis: an important topic also for rheumatologists.

Misiorowski, Waldemar

2023 Volume 61, Issue 4, Page(s) 223–224

Language	English
Publishing date	2023-08-31
Publishing country	Poland
Document type	Editorial
ZDB-ID	604151-6
ISSN	0034-6233
ISSN	0034-6233
DOI	10.5114/reum/171597
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Article: Osteoporosis in men.

Misiorowski, Waldemar

Przeglad menopauzalny = Menopause review

2017 Volume 16, Issue 2, Page(s) 70–73

Abstract: Osteoporotic fractures are the leading cause of morbidity and mortality among aging men. 30% of all hip fractures occur in men, and mortality resulting from not only the hip fracture, but also the spine and other major osteoporotic fractures, is ... ...

Abstract	Osteoporotic fractures are the leading cause of morbidity and mortality among aging men. 30% of all hip fractures occur in men, and mortality resulting from not only the hip fracture, but also the spine and other major osteoporotic fractures, is significantly higher in men than in women. As in women, hypogonadism is the best documented risk factor for developing osteoporosis in men. In older men, testosterone levels are negatively correlated with the risk of fractures, and it seems that this age-related testosterone deficiency should not be considered as one of the many causes of secondary osteoporosis, rather one of the major and most important mechanisms of senile osteoporosis. Acute hypogonadism induced by ablation treatment for prostate cancer (surgical or pharmacological castration, antiandrogen therapy) is associated with an extremely high risk of fracture. Other documented causes of bone loss in men are cigarette smoking and alcohol abuse, and a number of diseases that require corticosteroid treatment. Pharmacotherapy of osteoporosis should be recommended to all men with a diagnosed osteoporotic fracture and all men with a high 10-year absolute fracture risk (FRAX
Language	English
Publishing date	2017-06-30
Publishing country	Poland
Document type	Journal Article ; Review
ZDB-ID	2596140-8
ISSN	2299-0038 ; 1643-8876
ISSN (online)	2299-0038
ISSN	1643-8876
DOI	10.5114/pm.2017.68596
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Article ; Online: Osteoporosis in men

Waldemar Misiorowski

Menopause Review, Vol 16, Iss 2, Pp 70-

2017 Volume 73

Abstract	Osteoporotic fractures are the leading cause of morbidity and mortality among aging men. 30% of all hip fractures occur in men, and mortality resulting from not only the hip fracture, but also the spine and other major osteoporotic fractures, is significantly higher in men than in women. As in women, hypogonadism is the best documented risk factor for developing osteoporosis in men. In older men, testosterone levels are negatively correlated with the risk of fractures, and it seems that this age-related testosterone deficiency should not be considered as one of the many causes of secondary osteoporosis, rather one of the major and most important mechanisms of senile osteoporosis. Acute hypogonadism induced by ablation treatment for prostate cancer (surgical or pharmacological castration, antiandrogen therapy) is associated with an extremely high risk of fracture. Other documented causes of bone loss in men are cigarette smoking and alcohol abuse, and a number of diseases that require corticosteroid treatment. Pharmacotherapy of osteoporosis should be recommended to all men with a diagnosed osteoporotic fracture and all men with a high 10-year absolute fracture risk (FRAXTM). Not all drugs registered for the treatment of postmenopausal osteoporosis have been registered for the treatment of osteoporosis in men, and others have not been the subject of long-term and costly clinical trials required for such registration. The risk reduction of new fractures was documented only for treatment with zoledronic acid. Risedronate, strontium ranelate, teriparatide, and denosumab in men increase in bone mineral density comparable to that seen in postmenopausal women.
Keywords	male osteoporosis ; hypogonadism ; fracture risk ; treatment ; Medicine ; R
Subject code	610
Language	English
Publishing date	2017-06-01T00:00:00Z
Publisher	Termedia Publishing House
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Osteitis Fibrosa Cystica.

Misiorowski, Waldemar / Bilezikian, John P

JBMR plus

2020 Volume 4, Issue 9, Page(s) e10403

Abstract: Osteitis fibrosa cystica is a rare presentation of both primary and secondary hyperparathyroidism. In this perspective, we provide a historical backdrop to this form of parathyroid disease and contend that this clinical presentation of excess parathyroid ...

Abstract	Osteitis fibrosa cystica is a rare presentation of both primary and secondary hyperparathyroidism. In this perspective, we provide a historical backdrop to this form of parathyroid disease and contend that this clinical presentation of excess parathyroid hormone, particularly in primary hyperparathyroidism, is still seen today. In view of its rarity and the way it typically presents, the diagnosis of metastatic cancer is often the first diagnostic impression. © 2020 The Authors.
Language	English
Publishing date	2020-09-07
Publishing country	England
Document type	Journal Article
ISSN	2473-4039
ISSN (online)	2473-4039
DOI	10.1002/jbm4.10403
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Article: Persistent hypercalcaemia associated with two pathogenic variants in the

Leszczyńska, Dorota / Szatko, Alicja / Latocha, Julia / Kochman, Magdalena / Duchnowska, Maria / Wójcicka, Anna / Misiorowski, Waldemar / Zgliczyníski, Wojciech / Glinicki, Piotr

Frontiers in endocrinology

2024 Volume 15, Page(s) 1355916

Abstract: Introduction: 24-Hydroxylase, encoded by the : Aim of the study: We report a rare case of an adult with primary hyperparathyroidism and loss-of-function mutations in the : Case presentation: We report the case of a 58-year-old woman diagnosed ... ...

Abstract	Introduction: 24-Hydroxylase, encoded by the Aim of the study: We report a rare case of an adult with primary hyperparathyroidism and loss-of-function mutations in the Case presentation: We report the case of a 58-year-old woman diagnosed initially with primary hyperparathyroidism. Preoperatively, the suspected mass adjoining the upper pole of the left lobe of the thyroid gland was found via ultrasonography and confirmed by 99mTc scintigraphy and biopsy as the parathyroid gland. The patient underwent parathyroidectomy (a histopathology report revealed parathyroid adenoma), which led to normocalcaemia. After 10 months, vitamin D supplementation was introduced due to deficiency, and the calcium level remained within the reference range. Two years later, biochemical tests showed recurrence of hypercalcaemia with suppressed parathyroid hormone levels and elevated 1,25(OH) Conclusions: The diagnostic process for hypercalcaemia becomes complicated when multiple causes of hypercalcaemia coexist. The measurement of vitamin D metabolites using LC-MS/MS may help to identify carriers of
MeSH term(s)	Humans ; Hypercalcemia/genetics ; Female ; Middle Aged ; Vitamin D3 24-Hydroxylase/genetics ; Parathyroid Neoplasms/genetics ; Parathyroid Neoplasms/complications ; Parathyroid Neoplasms/surgery ; Parathyroid Neoplasms/pathology ; Adenoma/genetics ; Adenoma/complications ; Adenoma/pathology ; Mutation ; Parathyroidectomy
Chemical Substances	Vitamin D3 24-Hydroxylase (EC 1.14.15.16) ; CYP24A1 protein, human (EC 1.14.15.16)
Language	English
Publishing date	2024-04-11
Publishing country	Switzerland
Document type	Case Reports ; Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	2592084-4
ISSN	1664-2392
ISSN	1664-2392
DOI	10.3389/fendo.2024.1355916
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Article ; Online: Management of hypoparathyroidism: a Position Statement of the Expert Group of the Polish Society of Endocrinology.

Misiorowski, Waldemar / Dedecjus, Marek / Konstantynowicz, Jerzy / Zygmunt, Arkadiusz / Kos-Kudła, Beata / Lewiński, Andrzej / Ruchała, Marek / Zgliczyński, Wojciech

Endokrynologia Polska

2023 Volume 74, Issue 5, Page(s) 447–467

Abstract: Over the past few years, there have been significant advances in our understanding of hypoparathyroidism (HypoPT) in terms of its epidemiology, clinical presentation, etiology, and skeletal and renal complications. Moreover, the available treatment ... ...

Abstract	Over the past few years, there have been significant advances in our understanding of hypoparathyroidism (HypoPT) in terms of its epidemiology, clinical presentation, etiology, and skeletal and renal complications. Moreover, the available treatment options for HypoPT have changed. This position statement of the Expert Group of the Polish Society of Endocrinology summarizes the current state of knowledge and provides recommendations for optimal management to assist clinicians in the diagnosis, treatment, and monitoring of HypoPT in Poland. The specific aspects of HypoPT management in children, pregnant and lactating women, and patients with chronic kidney disease are also discussed. HypoPT is a rare disorder characterized by hypocalcemia and the lack or deficiency of parathyroid hormone (PTH). Hypoparathyroidism can be associated with complications, including nephrocalcinosis, nephrolithiasis, renal insufficiency, cataract, seizures, cardiac arrhythmia, depression, and an increased risk of infection. Minimizing complications of HypoPT requires careful evaluation and close monitoring of laboratory parameters. Conventional management of HypoPT has focused on maintaining serum calcium levels using oral calcium and active vitamin D. However, this approach is limited because it does not restore normal PTH function, is often associated with inadequate biochemical control, and raises concerns as to long-term side effects. HypoPT is the only classic endocrine insufficiency that is not commonly treated with the substitution of the missing hormone. Recently, recombinant human PTH(1-84) has become available, offering hope that the use of the missing hormone in the treatment of HypoPT will help achieve better control and reduce the risk of complications. However, this treatment is currently unavailable in Poland.
MeSH term(s)	Child ; Humans ; Female ; Calcium/therapeutic use ; Poland ; Lactation ; Parathyroid Hormone ; Hypoparathyroidism/diagnosis ; Hypoparathyroidism/drug therapy ; Hypocalcemia
Chemical Substances	Calcium (SY7Q814VUP) ; Parathyroid Hormone
Language	English
Publishing date	2023-10-30
Publishing country	Poland
Document type	Journal Article
ZDB-ID	419270-9
ISSN	2299-8306 ; 0423-104X
ISSN (online)	2299-8306
ISSN	0423-104X
DOI	10.5603/ep.96950
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Article: Parathyroid hormone and its analogues--molecular mechanisms of action and efficacy in osteoporosis therapy.

Misiorowski, Waldemar

Endokrynologia Polska

2011 Volume 62, Issue 1, Page(s) 73–78

Abstract: Most medical agents currently applied in osteoporosis therapy act by inhibiting bone resorption and reducing bone remodelling, i.e. they inhibit the process of bone mass loss by suppressing bone resorption processes. These drugs provide an ideal ... ...

Abstract	Most medical agents currently applied in osteoporosis therapy act by inhibiting bone resorption and reducing bone remodelling, i.e. they inhibit the process of bone mass loss by suppressing bone resorption processes. These drugs provide an ideal therapeutic option to prevent osteoporosis progression. They however have a rather limited usefulness when the disease has already reached its advanced stages with distinctive bone architecture lesions. The fracture risk reduction rate, achieved in the course of anti-resorptive therapy, is insufficient for patients with severe osteoporosis to stop the downward spiral of their quality of life (QoL) with a simultaneously increasing threat of premature death. The activity of the N-terminal fragment of 1-34 human parathormone (teriparatide - 1-34 rhPTH), a parathyroid hormone (PTH) analogue obtained via genetic engineering , is expressed by increased bone metabolism, while promoting new bone tissue formation by stimulating the activity of osteoblasts more than that of osteoclasts. The anabolic activity of PTH includes both its direct effect on the osteoblast cell line, and its indirect actions exerted via its regulatory effects on selected growth factors, e.g. IGF-1 or sclerostin. However, the molecular mechanisms responsible for the actual anabolic effects of PTH remain mostly still unclear. Clinical studies have demonstrated that therapeutic protocols with the application of PTH analogues provide an effective protection against all osteoporotic fracture types in post-menopausal women and in elderly men with advanced osteoporosis. Particular hopes are pinned on the possibility of applying PTH in the therapy of post-steroid osteoporosis, mainly to suppress bone formation, the most important pathological process in this regard. The relatively short therapy period with a PTH analogue (24 months) should then be replaced and continued by anti-resorptive treatment.
MeSH term(s)	Bone Density Conservation Agents/therapeutic use ; Female ; Humans ; Male ; Osteoporosis/drug therapy ; Osteoporosis, Postmenopausal/drug therapy ; Parathyroid Hormone/analogs & derivatives ; Parathyroid Hormone/therapeutic use
Chemical Substances	Bone Density Conservation Agents ; Parathyroid Hormone
Language	English
Publishing date	2011-01
Publishing country	Poland
Document type	Journal Article ; Review
ZDB-ID	419270-9
ISSN	0423-104X
ISSN	0423-104X
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Article ; Online: Parathormon i jego analogi - mechanizmy molekularne działania a skuteczność w leczeniu osteoporozy.

Misiorowski, Waldemar

Endokrynologia Polska

2011 Volume 62 Suppl 2, Page(s) 32–36

Title translation	Parathyroid hormone and its analogues - molecular mechanisms of action and efficacy of osteoporosis therapy.
Abstract	Most medical agents currently applied in osteoporosis therapy act by inhibiting bone resorption and reducing bone remodelling, i.e. they inhibit the process of bone mass loss by suppressing bone resorption processes. These drugs provide an ideal therapeutic option to prevent osteoporosis progression. They however have a rather limited usefulness when the disease has already reached its advanced stages with distinctive bone architecture lesions. The fracture risk reduction rate, achieved in the course of anti-resorptive therapy, is insufficient for patients with severe osteoporosis to stop the downward spiral of their quality of life (QoL) with a simultaneously increasing threat of premature death. The activity of the N-terminal fragment of 1-34 human parathormone (teriparatide - 1-34 rhPTH), a parathyroid hormone (PTH) analogue obtained via genetic engineering , is expressed by increased bone metabolism, while promoting new bone tissue formation by stimulating the activity of osteoblasts more than that of osteoclasts. The anabolic activity of PTH includes both its direct effect on the osteoblast cell line, and its indirect actions exerted via its regulatory effects on selected growth factors, e.g. IGF-1 or sclerostin. However, the molecular mechanisms responsible for the actual anabolic effects of PTH remain mostly still unclear. Clinical studies have demonstrated that therapeutic protocols with the application of PTH analogues provide an effective protection against all osteoporotic fracture types in post-menopausal women and in elderly men with advanced osteoporosis. Particular hopes are pinned on the possibility of applying PTH in the therapy of post-steroid osteoporosis, mainly to suppress bone formation, the most important pathological process in this regard. The relatively short therapy period with a PTH analogue (24 months) should then be replaced and continued by anti-resorptive treatment.
MeSH term(s)	Bone Density/drug effects ; Bone Density Conservation Agents/pharmacology ; Humans ; Osteoporosis/drug therapy ; Osteoporosis/physiopathology ; Parathyroid Hormone/analogs & derivatives ; Parathyroid Hormone/pharmacology ; Randomized Controlled Trials as Topic ; Severity of Illness Index ; Teriparatide/pharmacology
Chemical Substances	Bone Density Conservation Agents ; Parathyroid Hormone ; Teriparatide (10T9CSU89I)
Language	Polish
Publishing date	2011
Publishing country	Poland
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	419270-9
ISSN	2299-8306 ; 0423-104X
ISSN (online)	2299-8306
ISSN	0423-104X
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Article ; Online: Cinacalcet as symptomatic treatment of hypercalcaemia in primary hyperparathyroidism prior to surgery.

Misiorowski, Waldemar / Zgliczyński, Wojciech

Endokrynologia Polska

2017 Volume 68, Issue 3, Page(s) 306–310

Abstract: Intriduction: The aim of presented study was to assess the efficacy of cinacalcet in reducing serum calcium concentrations in primary hyperparathyroid (PHPT) patients with hypercalcaemia exceeding 12.5 mg/dL, awaiting parathyroidectomy.: Material and ... ...

Abstract	Intriduction: The aim of presented study was to assess the efficacy of cinacalcet in reducing serum calcium concentrations in primary hyperparathyroid (PHPT) patients with hypercalcaemia exceeding 12.5 mg/dL, awaiting parathyroidectomy. Material and methods: The study included 23 patients with PHPT with hypercalcaemia > 12.5 mg/dL, qualified for surgery. We recorded clinical and biochemical data at baseline, and after every week of treatment. We also monitored adverse events. Cinacalcet was adminis-tered in increasing doses until the corrected serum calcium concentration was 11.3 mg/dL or less, the patient reached the highest possible dosage of 90 mg four times daily, or the patient experienced an adverse event that precluded further dosage increases. Results: The primary end point of reduction in corrected serum calcium concentration to 11.3 mg/dL was achieved in 19 patients (83%), and normocalcaemia (S-Ca < 10.3 mg/dL) was achieved in 55% of patients. The medication was usually well tolerated (83.4%). Most common adverse events were nausea and vomiting, especially at the beginning of therapy; however, only one patient withdrew from the study because of adverse events. Conclusion: Cinacalcet rapidly reduced serum calcium in PHPT patients with severe hypercalcaemia and can be useful as a short-term pretreatment prior to surgery, allowing the completion of diagnostics and safe awaiting for operation.
MeSH term(s)	Adult ; Aged ; Calcimimetic Agents/administration & dosage ; Calcimimetic Agents/adverse effects ; Calcimimetic Agents/pharmacology ; Calcimimetic Agents/therapeutic use ; Calcium/blood ; Cinacalcet/administration & dosage ; Cinacalcet/adverse effects ; Cinacalcet/pharmacology ; Cinacalcet/therapeutic use ; Female ; Humans ; Hypercalcemia/drug therapy ; Hypercalcemia/etiology ; Hyperparathyroidism, Primary/complications ; Male ; Middle Aged ; Parathyroid Hormone/blood
Chemical Substances	Calcimimetic Agents ; Parathyroid Hormone ; Calcium (SY7Q814VUP) ; Cinacalcet (UAZ6V7728S)
Language	English
Publishing date	2017-06-23
Publishing country	Poland
Document type	Journal Article
ZDB-ID	419270-9
ISSN	2299-8306 ; 0423-104X
ISSN (online)	2299-8306
ISSN	0423-104X
DOI	10.5603/EP.2017.0023
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Article ; Online: The Effect of a Single High Dose of Vitamin D on Serum Levels of Its Metabolites in the Elderly.

Leszczyńska, Dorota / Szatko, Alicja / Kowalski, Konrad / Raczkiewicz, Dorota / Ostrowska, Magdalena / Misiorowski, Waldemar / Zgliczyński, Wojciech / Glinicki, Piotr

Frontiers in bioscience (Landmark edition)

2022 Volume 27, Issue 10, Page(s) 289

Abstract: Background: Vitamin D is a dietary micronutrient responsible for calcium and phosphorus metabolism and multiple extraskeletal actions. The assessment of vitamin D status is commonly based on measurement of 25(OH)D total concentration in serum. However, ... ...

Abstract	Background: Vitamin D is a dietary micronutrient responsible for calcium and phosphorus metabolism and multiple extraskeletal actions. The assessment of vitamin D status is commonly based on measurement of 25(OH)D total concentration in serum. However, the usage of liquid chromatography with tandem mass spectrometry (LC-MS/MS) technique allows to reliably assess a panel of vitamin D metabolites in serum or plasma, which may help to investigate the metabolic paths of vitamin D, especially in populations at risk of deficiency. Methods: A randomized, two-arms, open study was conducted on 58 patients (28 female and 30 male; aged from 61 to 96 years old). The primary aim was to assess the effects of a single, high, oral dose of vitamin D3 (120,000 IU) on serum 25(OH)D3, 25(OH)D2, 24,25(OH)2D3, 3-epi-25(OH)D3, 1,25(OH)2D3, 24,25(OH)2D3/25(OH)D3 ratio, and 25(OH)D3/3-epi-25(OH)D3 ratio concentration (measured by LC-MS/MS) at baseline, 3 days and 7 days after administration, compared to control group. The secondary aim was assessment of influence of percentage of fat tissue on serum metabolites of vitamin D and their changes after bolus dose. Results: 56.6% study group attained a serum 25(OH)D3 concentration >30 ng/mL. All subjects, except for one patient achieved a serum 25(OH)D3 concentration >20 ng/mL after administration. No one exceed reference value of vitamin D (30-50 ng/mL). Among participants who received vitamin D3 there were significant increase in 25(OH)D3, 3-epi-25(OH)D3, 1,25(OH)2D3, 24,25(OH)2D3 on 3rd day after administration. 24,25(OH)2D3 concentration gradually grew, achieving the highest concentration on 7th day. The percentage increase of 25(OH)D3 was negatively correlated with baseline 25(OH)D3 (r = -0.688, Conclusions: High dose of vitamin D rapidly increases 25(OH)D3 concentration in the elderly patients. The response to the bolus of vitamin D includes activation of 3-epimerase, followed by production of 24,25(OH)2D3, which protects from excessive increase of active form of vitamin D.
MeSH term(s)	Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged ; Calcium ; Cholecalciferol ; Chromatography, Liquid/methods ; Tandem Mass Spectrometry/methods ; Vitamin D
Chemical Substances	Calcium (SY7Q814VUP) ; Cholecalciferol (1C6V77QF41) ; Vitamin D (1406-16-2)
Language	English
Publishing date	2022-11-07
Publishing country	Singapore
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2704569-9
ISSN	2768-6698 ; 2768-6698
ISSN (online)	2768-6698
ISSN	2768-6698
DOI	10.31083/j.fbl2710289
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