PMC3333459_01
Radiographs and MR images of the lumbar spine - lateral views before treatment.. Notes: Radiographs of the lumbar spine did not show any obvious vertebral fractures (morphometric fractures) in the lumbar spine. However, T1-weighted MR images identified low-intensity areas and T2-weighted and STIR MR images identified high-intensity areas at the L2 and L5 vertebral bodies.. Abbreviations: MR, magnetic resonance; STIR, short-tau inversion-recovery.
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Although radiographs of the lumbar spine did not show any obvious vertebral (morphometric) fractures in the lumbar spine, magnetic resonance imaging detected clinical vertebral fractures at the L2 and L5 spine (Figure 1).
Changes in lumbar spine BMD.. Notes: The lumbar spine BMD increased from the baseline value. The increase in the lumbar spine BMD after 5 years of treatment with alfacalcidol was 21.4%.. Abbreviation: BMD, bone mineral density.
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The lumbar spine BMD increased from the baseline value (Figure 2) and reached 0.906 g/cm2, corresponding to 92% of the age-matched control.
Changes in serum calcium, phosphorus, ALP, and intact PTH.. Notes: The serum ALP levels tended to decrease, and the serum intact PTH levels tended to increase from the baseline values. The serum levels of calcium and phosphorus stayed within the normal ranges. The decrease in the serum ALP levels after 5 years of treatment with alfacalcidol was 59.8%. The increase in the serum intact PTH level was 220%.. Abbreviations: ALP, alkaline phosphatase; PTH, parathyroid hormone.
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Figures 3 and 4 show changes in biochemical markers.
Changes in bone turnover markers.. Notes: The serum BAP levels and urinary NTX levels tended to decrease from the baseline values. The decrease in the serum BAP levels and the urinary NTX levels after 5 years of treatment with alfacalcidol were 75.7% and 58.3%, respectively.. Abbreviations: BAP, bone-specific alkaline phosphatase; NTX, cross-linked N-terminal telopeptides of type I collagen.
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Figures 3 and 4 show changes in biochemical markers.
Radiographs of the thoracic and lumbar spine - lateral views after 5 years of treatment.. Notes: After 5 years of alfacalcidol treatment, radiographs of the thoracic and lumbar spine revealed no evidence of new thoracic or lumbar vertebral fractures, and the L2 and L5 vertebral fractures had healed.
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At 5 years, radiographs of the thoracic and lumbar spine revealed no evidence of new thoracic or lumbar morphometric vertebral fractures, and the L2 and L5 vertebral fractures had healed with small height loss of the vertebral bodies (Figure 5).