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β-Hydroxy β-methylbutyryl-coenzyme A (HMB-CoA), also known as 3-hydroxyisovaleryl-CoA, is a metabolite of L-leucine that is produced in the human body. [1] [2] Its immediate precursors are β-hydroxy β-methylbutyric acid (HMB) and β-methylcrotonoyl-CoA (MC-CoA).
β-Hydroxy β-methylbutyric acid [note 1] (HMB), otherwise known as its conjugate base, β-hydroxy β-methylbutyrate, is a naturally produced substance in humans that is used as a dietary supplement and as an ingredient in certain medical foods that are intended to promote wound healing and provide nutritional support for people with muscle wasting due to cancer or HIV/AIDS.
It has 41% homology to parathyroid hormone (PTH) (1-34) and 76% homology to parathyroid hormone-related protein (PTHrP) (1-34). [11] It works as an anabolic agent for the bone, through selective activation of the parathyroid hormone 1 receptor (PTH1R), a G protein-coupled receptor (GPCR) expressed in the osteoblasts and osteocytes.
The FAST 1 device consists of multiple needles in a probe that penetrates the manubrium once manual pressure is applied. [16] The Bone Injection Gun (BIG) device is a small, plastic, disposable, spring-loaded device that has a trigger that shoots the IO needle into the IO insertion site, which is more than likely in the proximal tibia. [16]
In those with postmenopausal osteoporosis denosumab decreases the risk of fractures but increases the risk of infection. [19] A 2013 review concluded that it is a reasonable treatment for postmenopausal osteoporosis. [20] A 2017 review did not find benefit in males. [21]
As of 2010 "The results of clinical studies of adjuvant treatment on early-stage hormone-receptor-positive breast-cancer patients under hormonal treatment – especially with the bisphosphonate zoledronic acid – caused excitement because they demonstrated an additive effect on decreasing disease relapses at bone or other sites.
In large studies, women taking bisphosphonates for osteoporosis have had unusual fractures ("bisphosphonate fractures") in the femur (thigh bone) in the shaft (diaphysis or sub-trochanteric region) of the bone, rather than at the femoral neck, which is the most common site of fracture. However, these fractures are rare (12 in 14,195 women ...
It is an effective anabolic (promoting bone formation) agent [15] used in the treatment of some forms of osteoporosis. [13] [16] Teriparatide is a recombinant human parathyroid hormone analog (PTH 1-34). [13] It has an identical sequence to the 34 N-terminal amino acids of the 84-amino acid human parathyroid hormone. [13]
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