Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 6:16:1568981.
doi: 10.3389/fendo.2025.1568981. eCollection 2025.

Bone biomarkers in post-polio clinic patients

Seyed Pezhman Madani  1 , Richard Kremer  2   3 , Ami Grunbaum  2   3   4 , Shaddam Bagmar  1 , Andrea Benedetti  5 , Daria A Trojan  1
Affiliations

Bone biomarkers in post-polio clinic patients

Seyed Pezhman Madani et al. Front Endocrinol (Lausanne). .

Abstract

Introduction: Osteoporosis is common in post-polio clinic patients, and is reported in 30%to 50% of middle-aged individuals with previous polio. The levels of bone biomarkers (calcium regulating hormones, bone metabolism markers, and bone turnover markers), and the response of bone turnover markers to bisphosphonates is unknown in post-polio patients with osteoporosis.

Objectives: 1) To describe serum levels of bone biomarkers in post-polio clinic patients with osteoporosis and compare these levels to those in controls with osteoporosis without neurological disease. 2) To examine the change in serum levels of bone biomarkers in post-polio patients following at least six months of treatment with bisphosphonates and compare these changes to controls.

Methods: We conducted a retrospective chart review of Post-Polio and Bone Metabolism Clinic charts of our center. Patients without osteoporosis, and incomplete lab data were excluded. For the second objective, patients untreated with bisphosphonates were excluded.

Results: Mean age and proportion of females were similar in post-polio patients (n=25) and controls (n=31) (66.3 ± 8.1 vs 66.2 ± 10.9 years, 52% vs 61%). Mean baseline serum levels of calcium, calcium regulating hormones [parathyroid hormone (PTH), 25-hydroxy Vitamin D), and serum bone turnover makers (sBTM's; osteocalcin, C-telopeptide, non-specific alkaline phosphatase (ALP)] were normal. PTH (4.4 ± 1.7 vs 5.5 ± 2.3 pmol/L, p=0.05), ALP (63.9 ± 15.8 vs 76.2 ± 26.7 U/L, p=0.04), osteocalcin (18.3 ± 8.8 vs 26.9 ± 8.4 ng/ml, p<0.01), and C-telopeptide (0.35 ± 0.2 vs 0.55 ± 0.21 microgram/L, p=0.01) were significantly lower in post-polio patients. After ≥ six months of treatment with bisphosphonates, sBTM's declined significantly in both groups, with a significantly greater reduction in controls for osteocalcin (p<0.01) and C-telopeptide (p=0.02).

Conclusions: While mean levels of all evaluated bone biomarkers were normal, PTH and sBTMs were significantly lower in post-polio patients with osteoporosis compared to controls, indicating reduced bone turnover. With bisphosphonate treatment, osteocalcin and C-telopeptide declined significantly in both groups, but significantly more in controls than in post-polio patients. These results indicate that BTM's could be useful for monitoring treatment response in post-polio patients.

Keywords: C-telopeptide; bisphosphonates; osteocalcin; osteoporosis; poliomyelitis.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision.

References

    1. Trojan DA, Cashman NR. Post-poliomyelitis syndrome. Muscle Nerve. (2005) 31:6–19. doi: 10.1002/mus.20259 - DOI - PubMed
    1. Baj A, Colombo M, Headley JL, McFarlane JR, Liethof MA, Toniolo A. Post-poliomyelitis syndrome as a possible viral disease. Int J Infect Dis. (2015) 35:107–16. doi: 10.1016/j.ijid.2015.04.018 - DOI - PubMed
    1. Lo JK, Robinson LR. Post-polio syndrome and the late effects of poliomyelitis: Part 2. treatment, management, and prognosis. Muscle Nerve. (2018) 58:760–9. doi: 10.1002/mus.26167 - DOI - PubMed
    1. Mohammad AF, Khan KA, Galvin L, Hardiman O, O’Connell PG. High incidence of osteoporosis and fractures in an aging post-polio population. Eur Neurol. (2009) 62:369–74. doi: 10.1159/000242444 - DOI - PubMed
    1. Chang KH, Tseng SH, Lin YC, Lai CH, Hsiao WT, Chen SC. The relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous poliomyelitis. Disabil Health J. (2015) 8:284–9. doi: 10.1016/j.dhjo.2014.09.011 - DOI - PubMed

MeSH terms

LinkOut - more resources