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By Tessa Rajak and David Noy

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Extra info for Archisynagogoi: Office, Title and Social Status in the Greco-Jewish Synagogue

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In men, diurnal variation is similar for different bone resorption markers. Variation of bone formation is lower – 5 to 20%. Mechanisms that govern circadian variability of BTM are not known. Food consumption accentuates circadian variation of bone resorption, whereas fasting significantly attenuates the circadian pattern probably due to the increased secretion of glucagon-like peptide-2 which is stimulated by food intake [52]. It suggests that the circadian variation of bone resorption is only partly inherent and, to a major extent, determined by the exogenous nutritional regulation.

In these persons, adjustment of the urinary excretion of bone resorption markers for urinary creatinine may falsely increase their levels. Ethanol withdrawal results in a progressive normalization of bone turnover rate [62]. The actions of alcohol on bone include the following potential mechanisms: a direct effect of ethanol on bone cells, undernourishment, hepatic cirrhosis, hypogonadism, vitamin D deficiency, hypercortisolemia [63]. Any one or combination of these discrete mechanisms could be responsible for negative calcium balance in alcoholism.

Such a strategy has recently been applied to define a serum biomarker profile which was able to differentiate postmenopausal women with high or low bone turnover [47]. Ultimately, such strategies may result in identifying a panel of a few independent markers which, when combined, may improve the sensitivity and specificity to detect patients at high fracture risk. Multiplex automated technologies allowing the simultaneous measurement of these biochemical markers in a low sample volume will then be required for easy use.

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Archisynagogoi: Office, Title and Social Status in the Greco-Jewish Synagogue by Tessa Rajak and David Noy

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