A W van der Eerden

Publications (2)8.57 Total impact

• Article: Circulating sclerostin levels are decreased in patients with endogenous hypercortisolism and increase after treatment.

  A H van Lierop, A W van der Eerden, N A T Hamdy, A R Hermus, M den Heijer, S E Papapoulos
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  ABSTRACT: Context: Increased bone fragility is a frequent complication of hypercortisolism due predominantly to suppression of bone formation. Sclerostin is an osteocyte-produced negative regulator of bone formation, which is up-regulated by glucocorticoids in mice. Objective: Our objective was to assess the effect of endogenous hypercortisolism on circulating sclerostin and bone turnover in humans. Design: We measured sclerostin, β-C-terminal telopeptide, amino-terminal propeptide of type 1 procollagen, and fibroblast growth factor 23 in blood samples of 21 patients with endogenous hypercortisolism and 21 age- and gender-matched controls. In 12 patients, measurements were repeated at various time intervals after successful surgical treatment (transsphenoidal surgery or adrenalectomy). Results: Plasma sclerostin levels were significantly decreased in patients compared with controls (112 ± 49 vs. 207 ± 48 pg/ml, P < 0.001). In the 12 patients who were evaluated after surgical treatment, sclerostin levels increased from 121.4 ± 46.5 to 175.8 ± 78.5 pg/ml (P = 0.003). These changes in plasma sclerostin levels were accompanied by significant increases in levels of fibroblast growth factor 23 (from 44.2 ± 12.2 to 84.0 ± 58.8 pg/ml, P = 0.017) and of the bone turnover markers amino-terminal propeptide of type 1 procollagen (from 31.7 ±18.2 to 94.2 ± 92.2 ng/ml, P = 0.037) and β-C-terminal telopeptide (from 134.2 ± 44 to 409.2 ± 285 pg/ml, P = 0.005). Conclusions: Contrary to the findings in mice, circulating sclerostin is decreased in patients with chronic endogenous hypercortisolism and increases after treatment. These findings suggest that in humans, chronic exposure to glucocorticoids affects the number or function of osteocytes rather than the production of sclerostin.
  The Journal of clinical endocrinology and metabolism 07/2012; 97(10):E1953-7. · 6.50 Impact Factor
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  Available from: njmonline.nl

  Article: Cushing's syndrome and bone mineral density: lowest Z scores in young patients.

  A W van der Eerden, M den Heijer, W J Oyen, A R Hermus
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  ABSTRACT: Patients with Cushing's syndrome have a high prevalence of osteoporotic fractures. Little is known about factors determining bone mineral density (BMD) in these patients. To evaluate which factors influence BMD at the time of diagnosis of Cushing's syndrome. In 77 consecutive patients with Cushing's syndrome with a median age of 41.1 (interquartile range 31.1 to 52.2) years we measured BMD of the lumbar spine and the femoral neck at the time of diagnosis. From the medical records we obtained information on possible predictors of BMD. We compared BMD with a reference population by means of the Z score. Adjustment for other variables than age and sex was made with linear regression models. Patients with Cushing's syndrome had a low Z score in both the lumbar spine (-1.07 SD (95% CI -1.43 to -0.71 SD )) and in the femoral neck (-0.81 SD (95% CI -1.06 to -0.55 SD )). 82% of patients had osteopenia at one or both sites (T score lower than -1 SD ), including 31% with osteoporosis (T score -2.5 SD or lower). The main determinant of the Z score at both sites and for both sexes was age. Z score increased by about 0.4 SD per decade. 81% of patients.
  The Netherlands Journal of Medicine 05/2007; 65(4):137-41. · 2.07 Impact Factor