151
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Shields CN, Solasz S, Gonzalez LJ, Tong Y, Konda SR, Egol KA. Outpatient lower extremity fracture surgery: should we be concerned? EUROPEAN JOURNAL OF ORTHOPAEDIC SURGERY AND TRAUMATOLOGY 2021; 32:719-723. [PMID: 34101006 DOI: 10.1007/s00590-021-03029-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 04/09/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE With rising healthcare costs and insurance push against non-emergent hospital admission, lower extremity fracture treatment is shifting toward outpatient procedures over inpatient hospitalizations. This study compares outcomes for fractures treated as inpatient versus outpatient. METHODS We conducted a retrospective review of lower extremity fracture patients. We collected demographics, injury information, hospital course, and complication data. Length of stay was categorized as "inpatient" and "outpatient" based a 24-h hospital stay cutoff. Data analysis included differences between cohorts with regards to readmissions and complications. RESULTS We identified 229 patients who met inclusion criteria. Inpatient versus outpatient status was predictive of in-hospital complications; however, inpatient versus outpatient status did not predict 1-year readmission. CONCLUSION Outpatient surgery is safe and effective. As the population increases and ages, low-risk surgeries should be considered for outpatient rather than inpatient stays to lower costs, save resources, and reduce complications.
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Affiliation(s)
- Charlotte N Shields
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA
| | - Sara Solasz
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA
| | - Leah J Gonzalez
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA
| | - Yixuan Tong
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA
| | | | - Kenneth A Egol
- Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Medical Center, 301 E 17th Street, New York, NY, 10003, USA. .,Jamaica Hospital Medical Center, Queens, NY, USA.
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152
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Seasonal Variation and Global Public Interest in the Internet Searches for Osteoporosis. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6663559. [PMID: 34189139 PMCID: PMC8195644 DOI: 10.1155/2021/6663559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 03/01/2021] [Accepted: 03/18/2021] [Indexed: 12/01/2022]
Abstract
Background To ascertain the seasonal pattern and global public interest in osteoporosis by evaluating search term popularity changes of the disease over a decade. Methods We applied Google Trends to retrieve search popularity scores for the term “osteoporosis” between January 01, 2004, and December 31, 2019. Cosinor analyses were conducted to examine the seasonality of osteoporosis, and analysis on osteoporosis-related topics including hot topics and rising-related topics was also performed. Results The cosinor analyses demonstrated a statistically significant seasonal variation in relative search volume of the “osteoporosis” in the world (p = 0.0083), USA (p < 0.001), UK (p < 0.001), Canada (p < 0.001), Ireland (p < 0.001), Australia (p < 0.001), and New Zealand (p < 0.001), with a peak in the late winter months and trough in the summer months. The peaks in late winter and valley in summer presented an approximately 6-month difference between hemispheres. The top 11 rising topics were denosumab, FRAX, hypocalcaemia, zoledronic acid, ibandronic acid, osteomyelitis, osteopenia, osteoarthritis, bone, calcium, and bone density. Conclusions Google search query volumes related to osteoporosis follow strong seasonal patterns with late winter peaks and summer troughs. Further studies aimed at elucidating the possible mechanisms behind seasonality in osteoporosis are needed. Moreover, Internet data including the top rising topics may alert physicians to strengthen the propaganda of osteoporosis timely, so as to further promote the development of public health interventions.
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153
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Ferreira AC, Mendes M, Silva C, Cotovio P, Aires I, Navarro D, Caeiro F, Salvador R, Correia B, Cabral G, Nolasco F, Ferreira A. Bone densitometry versus bone histomorphometry in renal transplanted patients: a cross-sectional study. Transpl Int 2021; 34:1065-1073. [PMID: 33909300 DOI: 10.1111/tri.13888] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 03/23/2021] [Accepted: 04/14/2021] [Indexed: 11/28/2022]
Abstract
Bone loss leads to increase risk of fractures in renal transplantation. The aim of this study was to analyse the relationship between bone densitometry (DXA) findings, bone histomorphometry and bone-related molecules 1-year after renal transplantation. We performed a cross-sectional study of de novo renal transplanted patients that agreed to perform a bone biopsy and a DXA examination 1 year after transplantation. All patients underwent a laboratory evaluation, bone biopsy, DXA examination and cardiac CT 1 year after transplantation. 67 patients were included, 16 had a normal examination, and 18 patients were classified as having osteoporosis by DXA. Correlations between bone mineral density and T-scores of total femur and femoral neck were the ones that best correlated with bone volume assessed by a bone biopsy. The sensitivity of DXA for osteoporosis diagnosis was 47.0%, and the specificity was 81.2%. The positive predictive value was 50.0%, and the negative predictive value (NPV) was 80.0%. DXA parameters also correlated with klotho and sclerostin serum levels. In this population, a normal examination excluded the presence of osteoporosis, helping in identifying patients that would not benefit from therapy. Overall, densitometry in total femur and femoral neck correlated well with bone volume measured by bone biopsy.
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Affiliation(s)
- Ana Carina Ferreira
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal.,Nova Medical School, Lisbon, Portugal
| | - Marco Mendes
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal
| | - Cecília Silva
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal
| | - Patrícia Cotovio
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal
| | - Inês Aires
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal.,Nova Medical School, Lisbon, Portugal
| | - David Navarro
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal
| | - Fernando Caeiro
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal
| | - Rute Salvador
- Tissue Repair and Inflammation Lab, CEDOC, Lisbon, Portugal
| | - Bruna Correia
- Tissue Repair and Inflammation Lab, CEDOC, Lisbon, Portugal
| | | | - Fernando Nolasco
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal.,Nova Medical School, Lisbon, Portugal
| | - Aníbal Ferreira
- Nephrology Department, Hospital Curry Cabral, CHULC, Lisbon, Portugal.,Nova Medical School, Lisbon, Portugal
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154
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Seong I, Jeon I. Non-operative Treatment of Osteoporotic Thoracolumbar Extension-distraction Fracture Using Teriparatide in Elderly Female Patient with Severe Osteoporosis under Inoperable Condition: A Case Report. Korean J Neurotrauma 2021; 17:70-74. [PMID: 33981647 PMCID: PMC8093024 DOI: 10.13004/kjnt.2021.17.e8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/02/2021] [Accepted: 04/07/2021] [Indexed: 11/15/2022] Open
Abstract
Vertebral extension-distraction fractures are a type of unstable fracture and require surgical stabilization with instrumentation. Unfortunately, in elderly patients with severe osteoporosis, poor bone quality can be related to postoperative pseudo-arthrosis and instability. Teriparatide is known as an effective anabolic agent for bone healing, union, and managing osteoporosis. In this report, we describe a rare case of extension-distraction thoracolumbar fractures in 86-year-old female patient with severe osteoporosis, which was treated conservatively. The patient was inoperable due to the presence of concomitant cardiopulmonary problems and the patients' old age. She had poor bone quality on bone mineral densitometry (-6.7, lumbar spine) but no neurologic deficits. As conservative treatment, bedrest and pain control were first performed for three weeks along with the use of teriparatide for 6-month and supplementation of calcium and vitamin D. Afterwards, sitting and standing with wearable orthoses were gradually implemented. After 1 year, the patient achieved bone fusion and was able to walk by herself, and there was radiological correction of the initial segmental lordotic curvature and disappearance of the intravertebral gap caused by the extension-distraction fracture.
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Affiliation(s)
- Insu Seong
- Department of Neurosurgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea
| | - Ikchan Jeon
- Department of Neurosurgery, Yeungnam University Hospital, Yeungnam University College of Medicine, Daegu, Korea
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155
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Robertsson C, Sävendahl L, Cardemil C. Primary chronic osteomyelitis of the jaw: Rapid improvement after hormonal suppression in a girl with precocious puberty. Bone Rep 2021; 14:101089. [PMID: 34026952 PMCID: PMC8131392 DOI: 10.1016/j.bonr.2021.101089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Revised: 04/09/2021] [Accepted: 05/01/2021] [Indexed: 11/11/2022] Open
Abstract
Primary chronic osteomyelitis (PCO) of the jaw is a non-infectious, inflammatory state of the jawbone of unknown etiology. In recurrent periods, these patients often exhibit swelling of the cheek, impaired ability to open their mouth as well as pain. Available treatments today include anti-inflammatory or antiresorptive drugs, hyperbaric oxygen, surgical decortication or resection followed by reconstruction where none of them have been described to lead to restored anatomy and complete relief of symptoms. We here report the unexpected complete regression of all clinical symptoms of PCO within three months after initiating pubertal suppression therapy with a gonadotropin-releasing hormone analogue in a 9-year-old girl with PCO of the jaw and early onset of pubertal development. Radiology of the jawbone confirmed complete PCO remission when performed 18 months after starting the hormone suppression therapy. To our knowledge, total regression of PCO in such a short period of time has not been described earlier suggesting an effect of the anti-hormonal therapy per se. In this case report, we discuss possible underlying mechanisms and hypothesize that anti-hormonal treatment could be a potential effective treatment in patients with PCO of the jaw.
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Affiliation(s)
- Caroline Robertsson
- Unit of Cranio- & Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden
| | - Lars Sävendahl
- Unit of Pediatric Endocrinology, Karolinska University Hospital, Stockholm, Sweden.,Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Carina Cardemil
- Unit of Cranio- & Maxillofacial Surgery, Karolinska University Hospital, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.,Department of Biomaterials, Institute of Clinical Sciences, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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156
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Histone modifications centric-regulation in osteogenic differentiation. Cell Death Dis 2021; 7:91. [PMID: 33941771 PMCID: PMC8093204 DOI: 10.1038/s41420-021-00472-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 03/21/2021] [Accepted: 04/07/2021] [Indexed: 02/03/2023]
Abstract
Histone modification critically contributes to the epigenetic control of gene expression by changing the configuration of chromatin and modifying the access of transcription factors to gene promoters. Recently, we observed that histone acetylation and crotonylation mediated the expression of endocytosis-related genes and tumor-related immune checkpoint genes by regulating the enrichment of signal transducer and activator of transcription 3 on these gene promoters in Alzheimer's disease and tumorigenesis, suggesting that histone modification plays an important role in disease development. Furthermore, studies performed in the past decade revealed that histone modifications affect osteogenic differentiation by regulating the expression of osteogenic marker genes. In this review, we summarize and discuss the histone modification-centric regulation of osteogenic gene expression. This review improves the understanding of the role of histone modifications in osteogenic differentiation and describes its potential as a therapeutic target for osteogenic differentiation-related diseases.
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157
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Briot K, Schott AM, Sanchez JP, Chauny JV, Samama P, Désaméricq G. High persistence over two years with denosumab among postmenopausal women with osteoporosis in France: A prospective cohort study. Bone 2021; 146:115890. [PMID: 33610904 DOI: 10.1016/j.bone.2021.115890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 01/13/2021] [Accepted: 02/13/2021] [Indexed: 12/19/2022]
Abstract
PURPOSE To assess the 12 and 24-month persistence with denosumab in postmenopausal women with osteoporosis in real-world clinical practice in France, and to describe characteristics and management of these patients. METHODS This prospective, multicenter cohort study evaluated persistence with denosumab at 12 months (primary endpoint) and 24 months (secondary endpoint), defined as at least 2 or 4 injections respectively, and time elapsed between 2 consecutive injections did not exceed 6 months +8 weeks. Other endpoints included patients' characteristics at baseline, medical history, concomitant and previous treatments, and incidence of adverse drug reactions (ADR), serious adverse events and fractures. RESULTS 478 patients were enrolled by 86 physicians between June 2015 and February 2016. The mean follow-up was 28 months. Mean age was 72 years and 91% of patients had been previously treated for osteoporosis. The persistence with denosumab was 86% (95%CI: 83%-89%) at 12 months and 72% (95%CI: 68%-76%) at 24 months. Using the Kaplan-Meier estimates, the persistence probability over time was 86% at 12 months and 76% at 24 months. During the study, 78 patients discontinued therapy. No multiple vertebral fractures were reported upon discontinuation. ADR were reported for 55 patients, 4 being serious, and 27 patients discontinued denosumab due to an ADR. Among patients who received at least one injection, 10 died. None of the deaths were attributable to denosumab. CONCLUSION Persistence with denosumab at 12 and 24 months was high, and the treatment was well tolerated among postmenopausal women with osteoporosis treated in routine clinical practice in France.
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Affiliation(s)
- Karine Briot
- Department of Rheumatology, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, Paris, France
| | - Anne-Marie Schott
- Universite Claude Bernard Lyon 1, EA 7425 HeSPeR, Hospices Civils de Lyon, Pôle de Santé Publique, Lyon, France
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158
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Wallimann A, Hildebrand M, Groeger D, Stanic B, Akdis CA, Zeiter S, Richards RG, Moriarty TF, O'Mahony L, Thompson K. An Exopolysaccharide Produced by Bifidobacterium longum 35624® Inhibits Osteoclast Formation via a TLR2-Dependent Mechanism. Calcif Tissue Int 2021; 108:654-666. [PMID: 33388801 DOI: 10.1007/s00223-020-00790-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 12/04/2020] [Indexed: 02/01/2023]
Abstract
The probiotic Bifidobacterium longum subsp. longum 35624® (B. longum 35624®), with its surface exopolysaccharide (EPS624), has previously been demonstrated to induce immunoregulatory responses in the host and may, therefore, be a novel approach to prevent bone loss in inflammatory conditions such as post-menopausal osteoporosis (PMO). The aim of this study was to investigate the effect of EPS624 on osteoclast and osteoblast differentiation and to assess the potential of B. longum 35624® to prevent bone loss in vivo. In vitro cell assays were used to assess the impact of EPS624 on osteoclast and osteoblast differentiation. The potential of two probiotic B. longum 35624® strains, including an EPS-deficient strain, for preventing ovariectomy (Ovx)-induced bone loss was assessed in a murine model. EPS624 prevented osteoclast formation from murine bone marrow precursors under both normal and TNFα-induced inflammatory conditions and modestly increased mineralized matrix deposition in osteogenic cell cultures. However, in the presence of an anti-TLR2 blocking antibody, or in MyD88-/- osteoclast precursors, the inhibitory effect of EPS624 on osteoclast formation was diminished or completely prevented, respectively. Moreover, EPS624 induced IL-10 production in osteoclast precursors in a TLR2-dependent manner, although IL-10 was dispensable in the EPS624-mediated inhibition of osteoclast formation. In addition, EPS624-producing B. longum 35624® partially prevented bone loss in Ovx mice when administered by oral gavage. This study introduced EPS624 as a potential anti-resorptive therapy, although optimal in vivo delivery of the probiotic strain for treating low-grade inflammatory diseases such as PMO remains to be determined.
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Affiliation(s)
- Alexandra Wallimann
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Maria Hildebrand
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland
| | - David Groeger
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Precision Biotics Group Ltd, 4400 Cork Airport Business Park, Kinsale Road, Cork, Ireland
| | - Barbara Stanic
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland
| | - Cezmi A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
| | - Stephan Zeiter
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland
| | - R Geoff Richards
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland
| | - T Fintan Moriarty
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland
| | - Liam O'Mahony
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Davos, Switzerland
- Departments of Medicine and Microbiology, APC Microbiome Ireland, University College Cork, College Road, Cork, Ireland
| | - Keith Thompson
- AO Research Institute Davos, Clavadelerstrasse 8, 7270, Davos Platz, Switzerland.
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159
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Tang C, Zhang W, Li H, Li L, Li Z, Cai A, Wang L, Shi D, Yan B. CNN-based qualitative detection of bone mineral density via diagnostic CT slices for osteoporosis screening. Osteoporos Int 2021; 32:971-979. [PMID: 33165630 DOI: 10.1007/s00198-020-05673-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Abstract
UNLABELLED The features extracted from diagnostic computed tomography (CT) slices were used to qualitatively detect bone mineral density (BMD) through neural network models, and the evaluation results indicated that it may be a promising approach to perform osteoporosis screening in clinical practice. INTRODUCTION The purpose of this study is to design a novelty diagnostic method for osteoporosis screening by using the convolutional neural network (CNN), which can be incorporated into the procedure of routine CT diagnostic in medical examination thereby improving the osteoporosis diagnosis and reducing the patient burden. METHODS The proposed CNN-based method mainly comprises two functional modules to perform qualitative detection of BMD by analyzing the diagnostic 2D CT slice. The first functional module aims to locate and segment the ROI of diagnostic 2D CT slice, called Mark-Segmentation-Network (MS-Net). The second functional module is used to determine the category of BMD by the features of ROI, called BMD-Classification-Network (BMDC-Net). The diagnostic 2D CT slice of pedicle level in lumbar vertebrae (L1) was selected from 3D CT image in our experiments firstly. Then, the trained MS-Net can get the mark image of input original 2D CT slice, thereby obtain the segmentation image. Finally, the trained BMDC-Net can obtain the probability value of normal bone mass, low bone mass, and osteoporosis by inputting the segmentation image. On the basis of network results, the radiologists can provide preliminary qualitative diagnosis results of BMD. RESULTS Training of the network was performed on diagnostic 2D CT slices of 150 patients. The network was tested on 63 patients. Each patient corresponds to a 2D CT slice. The proposed MS-Net has an excellent segmentation precision on the shape preservation of different lumbar vertebra. The dice index (DI), pixel accuracy (PA), and intersection over union (IOU) of segmentation results are greater than 0.8. The proposed BMDC-Net achieved an accuracy of 76.65% and an area under the receiver operating characteristic curve of 0.9167. CONCLUSIONS This study proposed a novel method for qualitative detection of BMD via diagnostic CT slices and it has great potential in clinical applications for osteoporosis screening. The method can potentially reduce the manual burden to radiologists and diagnostic cost to patients.
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Affiliation(s)
- C Tang
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China
| | - W Zhang
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China
| | - H Li
- Department of Radiology in Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - L Li
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China
| | - Z Li
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China
| | - A Cai
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China
| | - L Wang
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China
| | - D Shi
- Department of Radiology in Henan Provincial People's Hospital, Zhengzhou, Henan Province, China
| | - B Yan
- PLA Strategy Support Force Information Engineering University, No.62 Science Avenue, Zhengzhou, Henan Province, China.
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160
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Xue C, Pan W, Lu X, Guo J, Xu G, Sheng Y, Yuan G, Zhao N, Sun J, Guo X, Wang M, Li H, Du P, An L, Han X. Effects of compound deer bone extract on osteoporosis model mice and intestinal microflora. J Food Biochem 2021; 45:e13740. [PMID: 33904182 DOI: 10.1111/jfbc.13740] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 04/01/2021] [Accepted: 04/05/2021] [Indexed: 12/26/2022]
Abstract
The preventive and therapeutic mechanisms of CDBE on osteoporosis were studied by observing the serum bone-related biochemical indicators, bone trabecular micro-structure and intestinal flora in ovariectomized osteoporosis model mice, in order to provide a scientific theoretical basis for the further study on the effect of CDBE on osteoporosis, and the prevention and treatment of osteoporosis with clinical traditional Chinese medicines. The components in CDBE were detected by UHPLC-MS. A mouse osteoporosis model was established by the bilateral ovariectomy in female ICR mice. The biochemical indicators related to osteoporosis were detected, the right proximal tibia was scanned by Micro-CT, the intestinal microflora in the colon contents were examined, and the changes of microflora were taken as the main target to evaluate the effect of CDBE on the intestinal microflora in the model mice. A total of 16 compounds were obtained by the combined application of UHPLC-MS. CDBE could significantly increase the contents of E2, Ca2+ , CT, HyP, OCN, FOXP3, P1NP and CTX-II, in the model mice. CDBE could significantly improve the trabecular micro-structure, Tb.N, Tb.Sp, SMI and Conn.D. CDBE could make the intestinal flora of osteoporosis model mice tend to healthy mice in species and quantity. CDBE can improve the symptoms of postmenopausal osteoporosis in mice, with a positive effect on the intestinal flora of postmenopausal mice. Its mechanism of regulating the symptoms of osteoporosis may be related to the regulation of bone-related biochemical indicators in the serum of mice. PRACTICAL APPLICATIONS: This research has a positive impact on the development of functional food with anti-osteoporosis in the future.
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Affiliation(s)
- Chuang Xue
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Wang Pan
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Xuechun Lu
- Department of Hematology, General Hospital of the Chinese People's Liberation Army, Beijing, China
| | - Jingru Guo
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Guangyu Xu
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Yu Sheng
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Guangxin Yuan
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Nanxi Zhao
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Jingbo Sun
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Xiao Guo
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Manli Wang
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Hongyu Li
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Peige Du
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Liping An
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
| | - Xiao Han
- Department of Pharmaceutical Analysis, College of Pharmacy, Beihua University, Jilin, China
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161
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Chen Y, Zhu J, Zhou Y, Peng J, Wang B. Efficacy and Safety of Denosumab in Osteoporosis or Low Bone Mineral Density Postmenopausal Women. Front Pharmacol 2021; 12:588095. [PMID: 33935694 PMCID: PMC8080120 DOI: 10.3389/fphar.2021.588095] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Denosumab, a human monoclonal antibody, acts against the receptor activator of nuclear factor-κB ligand and is a promising antiresorptive agent in patients with osteoporosis. This study aimed to update the efficacy and safety of denosumab vs. placebo in osteoporosis or low bone mineral density (BMD) postmenopausal women. PubMed, Embase, Cochrane library, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) reporting the efficacy and safety data of denosumab vs. placebo in osteoporosis or low BMD postmenopausal women. A random-effects model was used to calculate pooled weight mean differences (WMDs) or relative risks (RRs) with corresponding 95% confidence intervals (CIs) for treatment effectiveness of denosumab vs. placebo. Eleven RCTs including 12,013 postmenopausal women with osteoporosis or low BMD were preferred for the final meta-analysis. The summary results indicated that the percentage change of BMD in the denosumab group was greater than that of BMD in placebo at 1/3 radius (WMD: 3.43; 95%CI: 3.24–3.62; p < 0.001), femoral neck (WMD: 3.05; 95%CI: 1.78–4.33; p < 0.001), lumbar spine (WMD: 6.25; 95%CI: 4.59–7.92; p < 0.001), total hip (WMD: 4.36; 95%CI: 4.07–4.66; p < 0.001), trochanter (WMD: 6.00; 95%CI: 5.95–6.05; p < 0.001), and total body (WMD: 3.20; 95%CI: 2.03–4.38; p < 0.001). Moreover, denosumab therapy significantly reduced the risk of clinical fractures (RR: 0.57; 95%CI: 0.51–0.63; p < 0.001), nonvertebral fracture (RR: 0.83; 95%CI: 0.70–0.97; p = 0.018), vertebral fracture (RR: 0.32; 95%CI: 0.25–0.40; p < 0.001), and hip fracture (RR: 0.61; 95%CI: 0.37–0.98; p = 0.042). Finally, denosumab did not cause excess risks of adverse events. These findings suggested that postmenopausal women receiving denosumab had increased BMDs and reduced fractures at various sites without inducing any adverse events.
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Affiliation(s)
- Yi Chen
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jun Zhu
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yiqin Zhou
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jinhui Peng
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Bo Wang
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
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Riar S, Feasel AL, Aghajafari F, Frohlich D, Symonds CJ, Kline GA, Billington EO. Comparison of 2 fracture risk estimation processes in Alberta: a cross-sectional chart review. CMAJ Open 2021; 9:E711-E717. [PMID: 34162663 PMCID: PMC8248580 DOI: 10.9778/cmajo.20200207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND In Canada, decisions regarding osteoporosis pharmacotherapy are based on estimated 10-year risk of osteoporotic fracture. We aimed to determine how frequently 2 common approaches (Canadian Association of Radiologists and Osteoporosis Canada [CAROC] tool and Fracture Risk Assessment Tool [FRAX]) produced different estimates and to seek possible explanations for differences. METHODS We conducted a cross-sectional chart review at a tertiary osteoporosis centre (Dr. David Hanley Osteoporosis Centre in Calgary). Included patients were women referred for consideration of osteoporosis pharmacotherapy who attended a consultation between 2016 and 2019 and whose charts contained 10-year osteoporotic fracture risk estimates using both the CAROC tool (based on bone mineral density [BMD] results) and FRAX (based on BMD results and clinically assessed fracture risk factors). Risk estimates provided on BMD reports (calculated with CAROC) and generated through osteoporosis clinic consultation (calculated with FRAX, including BMD) were categorized as low (< 10.0%), moderate (10.0%-19.9%) or high (≥ 20.0%). Estimates were considered discordant when they placed the patient in different risk categories. RESULTS Of 190 patients evaluated, 99 (52.1%) had discordant risk estimates. Although a similar proportion were considered high risk by BMD reports using the CAROC tool (17.9%) and clinic charts using FRAX (19.5%), the 2 methods identified different patients as being high risk. Around the crucial high-risk (20.0%) treatment threshold, discordance was present in 37 patients (19.5%, 95% confidence interval [CI] 14.5%-25.7%); discordance around the moderate-risk (10.0%) threshold was present in 69 (36.3%, 95% CI 29.5%-43.2%) patients. Disagreement regarding fracture history between BMD reports and clinic charts was observed in 19.8% of patients. INTERPRETATION Fracture risk estimates on BMD reports (using the CAROC tool) and those calculated in the clinical setting (using FRAX) frequently result in different risk classification. Osteoporosis treatment decisions may differ in up to half of patients depending on which estimate is used, highlighting the need for a consistent and accurate assessment process for fracture risk.
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Affiliation(s)
- Shivraj Riar
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta
| | - A Lynn Feasel
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta
| | - Fariba Aghajafari
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta
| | - Dean Frohlich
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta
| | - Christopher J Symonds
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta
| | - Greg A Kline
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta
| | - Emma O Billington
- Division of Endocrinology & Metabolism (Riar, Symonds, Kline, Billington), Cumming School of Medicine, University of Calgary; Dr. David Hanley Osteoporosis Centre (Feasel, Symonds, Kline, Billington), Alberta Health Services; Departments of Family Medicine and Community Health Sciences (Aghajafari), Cumming School of Medicine, and Department of Radiology (Frohlich), University of Calgary, Alta.
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Im C, Li N, Moon W, Liu Q, Morton LM, Leisenring WM, Howell RM, Chow EJ, Sklar CA, Wilson CL, Wang Z, Sapkota Y, Chemaitilly W, Ness KK, Hudson MM, Robison LL, Bhatia S, Armstrong GT, Yasui Y. Genome-wide Association Studies Reveal Novel Locus With Sex-/Therapy-Specific Fracture Risk Effects in Childhood Cancer Survivors. J Bone Miner Res 2021; 36:685-695. [PMID: 33338273 PMCID: PMC8044050 DOI: 10.1002/jbmr.4234] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 12/18/2022]
Abstract
Childhood cancer survivors treated with radiation therapy (RT) and osteotoxic chemotherapies are at increased risk for fractures. However, understanding of how genetic and clinical susceptibility factors jointly contribute to fracture risk among survivors is limited. To address this gap, we conducted genome-wide association studies of fracture risk after cancer diagnosis in 2453 participants of European ancestry from the Childhood Cancer Survivor Study (CCSS) with 930 incident fractures using Cox regression models (ie, time-to-event analysis) and prioritized sex- and treatment-stratified genetic associations. We performed replication analyses in 1417 survivors of European ancestry with 652 incident fractures from the St. Jude Lifetime Cohort Study (SJLIFE). In discovery, we identified a genome-wide significant (p < 5 × 10-8 ) fracture risk locus, 16p13.3 (HAGHL), among female CCSS survivors (n = 1289) with strong evidence of sex-specific effects (psex-heterogeneity < 7 × 10-6 ). Combining discovery and replication data, rs1406815 showed the strongest association (hazard ratio [HR] = 1.43, p = 8.2 × 10-9 ; n = 1935 women) at this locus. In treatment-stratified analyses in the discovery cohort, the association between rs1406815 and fracture risk among female survivors with no RT exposures was weak (HR = 1.22, 95% confidence interval [CI] 0.95-1.57, p = 0.11) but increased substantially among those with greater head/neck RT doses (any RT: HR = 1.88, 95% CI 1.54-2.28, p = 2.4 × 10-10 ; >36 Gray only: HR = 3.79, 95% CI 1.95-7.34, p = 8.2 × 10-5 ). These head/neck RT-specific HAGHL single-nucleotide polymorphism (SNP) effects were replicated in female SJLIFE survivors. In silico bioinformatics analyses suggest these fracture risk alleles regulate HAGHL gene expression and related bone resorption pathways. Genetic risk profiles integrating this locus may help identify female survivors who would benefit from targeted interventions to reduce fracture risk. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Cindy Im
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Nan Li
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Wonjong Moon
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Qi Liu
- School of Public Health, University of Alberta, Edmonton, Canada
| | - Lindsay M Morton
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, MD, USA
| | - Wendy M Leisenring
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Rebecca M Howell
- Department of Radiation Physic, MD Anderson Cancer Center, Houston, TX, USA
| | - Eric J Chow
- Clinical Research Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Charles A Sklar
- Department of Pediatrics, Memorial Sloan Kettering Cancer Center, NY, New York, USA
| | - Carmen L Wilson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Zhaoming Wang
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Computational Biology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yadav Sapkota
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Wassim Chemaitilly
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Division of Endocrinology, Department of Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Smita Bhatia
- Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Gregory T Armstrong
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Yutaka Yasui
- School of Public Health, University of Alberta, Edmonton, Canada.,Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, TN, USA
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Preyer O, Concin H, Nagel G, Zitt E, Ulmer H, Brozek W. Serum uric acid is associated with incident hip fractures in women and men - Results from a large Austrian population-based cohort study. Maturitas 2021; 148:46-53. [PMID: 33836935 DOI: 10.1016/j.maturitas.2021.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 01/22/2021] [Accepted: 03/03/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Serum markers that can be used to estimate the risk of bone fractures are rare, and findings for one candidate marker, uric acid, are heterogeneous. Our aim was to investigate the potential of serum uric acid (SUA) to predict hip fractures occurring in people aged 50 years and over. STUDY DESIGN During a medical prevention program over the period 1985-2005 in Vorarlberg, baseline data were collected on SUA levels and covariates (age, BMI, blood pressure, smoking status, diabetes, triglycerides and cholesterol) from 185,397 individuals, of whom 42,488 women and 35,908 men met the inclusion criteria of this population-based cohort study. Information on incident cancer and end-stage kidney disease was acquired from registries. MAIN OUTCOME MEASURE Incident hip fracture occurring in participants aged 50 years and over during the observation period 2003-2013. RESULTS SUA was associated with a rise in female hip fracture risk by 6% per unit increase (HR 1.06, 95 %-CI 1.01-1.10), and risk in the highest vs. lowest SUA quartile was significantly increased (HR 1.17, 95 %-CI 1.01-1.35), but not at hyperuricemic (>5.7 mg/dl) vs. normouricemic (≤5.7 mg/dl) levels. In men, hip fracture risk rose by 15 % per unit increase (HR 1.15, 95 %-CI 1.08-1.22), and risk was significantly higher in the highest vs. lowest SUA quartile (HR 1.50, 95 %-CI 1.17-1.91) as well as at hyperuricemic (>7.0 mg/dl) vs. normouricemic (≤7.0 mg/dl) levels (HR 1.48, 95 %-CI 1.19-1.84). CONCLUSIONS Our results link SUA with increased risk of hip fractures, particularly in men.
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Affiliation(s)
- Oliver Preyer
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Hans Concin
- Agency for Preventive and Social Medicine, Bregenz, Austria
| | - Gabriele Nagel
- Agency for Preventive and Social Medicine, Bregenz, Austria; Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany
| | - Emanuel Zitt
- Agency for Preventive and Social Medicine, Bregenz, Austria; Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Academic Teaching Hospital Feldkirch, Feldkirch, Austria; Department of Nephrology and Dialysis, Academic Teaching Hospital Feldkirch, Feldkirch, Austria
| | - Hanno Ulmer
- Agency for Preventive and Social Medicine, Bregenz, Austria; Department of Medical Statistics, Informatics and Health Economics, Innsbruck Medical University, Innsbruck, Austria
| | - Wolfgang Brozek
- Agency for Preventive and Social Medicine, Bregenz, Austria.
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165
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Lim HK, Ha HI, Park SY, Han J. Prediction of femoral osteoporosis using machine-learning analysis with radiomics features and abdomen-pelvic CT: A retrospective single center preliminary study. PLoS One 2021; 16:e0247330. [PMID: 33661911 PMCID: PMC7932154 DOI: 10.1371/journal.pone.0247330] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/04/2021] [Indexed: 12/31/2022] Open
Abstract
Background Osteoporosis has increased and developed into a serious public health concern worldwide. Despite the high prevalence, osteoporosis is silent before major fragility fracture and the osteoporosis screening rate is low. Abdomen-pelvic CT (APCT) is one of the most widely conducted medical tests. Artificial intelligence and radiomics analysis have recently been spotlighted. This is the first study to evaluate the prediction performance of femoral osteoporosis using machine-learning analysis with radiomics features and APCT. Materials and methods 500 patients (M: F = 70:430; mean age, 66.5 ± 11.8yrs; range, 50–96 years) underwent both dual-energy X-ray absorptiometry and APCT within 1 month. The volume of interest of the left proximal femur was extracted and 41 radiomics features were calculated using 3D volume of interest analysis. Top 10 importance radiomic features were selected by the intraclass correlation coefficient and random forest feature selection. Study cohort was randomly divided into 70% of the samples as the training cohort and the remaining 30% of the sample as the validation cohort. Prediction performance of machine-learning analysis was calculated using diagnostic test and comparison of area under the curve (AUC) of receiver operating characteristic curve analysis was performed between training and validation cohorts. Results The osteoporosis prevalence of this study cohort was 20.8%. The prediction performance of the machine-learning analysis to diagnose osteoporosis in the training and validation cohorts were as follows; accuracy, 92.9% vs. 92.7%; sensitivity, 86.6% vs. 80.0%; specificity, 94.5% vs. 95.8%; positive predictive value, 78.4% vs. 82.8%; and negative predictive value, 96.7% vs. 95.0%. The AUC to predict osteoporosis in the training and validation cohorts were 95.9% [95% confidence interval (CI), 93.7%-98.1%] and 96.0% [95% CI, 93.2%-98.8%], respectively, without significant differences (P = 0.962). Conclusion Prediction performance of femoral osteoporosis using machine-learning analysis with radiomics features and APCT showed high validity with more than 93% accuracy, specificity, and negative predictive value.
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Affiliation(s)
- Hyun Kyung Lim
- Department of Radiology, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | - Hong Il Ha
- Department of Radiology, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Republic of Korea
- * E-mail:
| | - Sun-Young Park
- Department of Radiology, Hallym University Sacred Heart Hospital, Anyang-si, Gyeonggi-do, Republic of Korea
| | - Junhee Han
- Department of Statistics and Data Science Convergence Research Center, Hallym University, Chuncheon-si, Gangwon-do, Republic of Korea
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166
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Ohlsson C, Lawenius L, Andersson A, Gustafsson K, Wu J, Lagerquist M, Movérare-Skrtic S, Islander U, Sjögren K. Mild stimulatory effect of a probiotic mix on bone mass when treatment is initiated 1.5 weeks after ovariectomy in mice. Am J Physiol Endocrinol Metab 2021; 320:E591-E597. [PMID: 33522399 DOI: 10.1152/ajpendo.00412.2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Studies in humans and rodents show that probiotic bacteria can protect from bone loss caused by sex steroid deficiency. We showed earlier that a mixture of three probiotic bacteria, Lacticaseibacillus paracasei DSM13434, Lactiplantibacillus plantarum DSM 15312, and DSM 15313 (L. mix), protects mice from ovariectomy (ovx)-induced bone loss when treatment was started 2 wk before sham and ovx surgery. In addition, the same probiotic treatment protected against lumbar spine bone loss in early postmenopausal women. In the present study, we wanted to evaluate the therapeutic potential of L. mix by starting treatment 1.5 wk after ovx when most of the rapid bone loss as a result of estrogen deficiency has already occurred. Treatment with L. mix for 5.5 wk increased the trabecular thickness but not the trabecular number in the proximal metaphyseal region of tibia compared with vehicle treatment. Cortical thickness and cortical area of the middiaphyseal part of the tibia were significantly decreased in ovx mice but not in L. mix-treated ovx mice. The bone-protective effects of L. mix in ovx mice were associated with a protection against ovx-induced reduction of the frequency of regulatory T-cells and of the expression of Tgfβ in the bone marrow. In conclusion, the probiotic L. mix exerted a mild stimulatory effect on trabecular and cortical bone width when treatment is initiated 1.5 wk after ovariectomy in mice. This effect was associated with effects on bone-protecting regulatory T-cells. The results suggest that L. mix may exert beneficial effects on bone mass when treatment is started after ovariectomy.NEW & NOTEWORTHY The probiotic L. mix exerted a mild stimulatory effect on trabecular and cortical bone width when treatment is initiated 1.5 wk after ovariectomy in mice. This effect was associated with effects on bone-protecting regulatory T-cells. The results suggest that L. mix may exert beneficial effects on bone mass when treatment is started after ovariectomy.
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Affiliation(s)
- Claes Ohlsson
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Drug Treatment, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Lina Lawenius
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Annica Andersson
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Rheumatology and Inflammation Research, Institute of Medicine, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Karin Gustafsson
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Jianyao Wu
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Marie Lagerquist
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Sofia Movérare-Skrtic
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Ulrika Islander
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Krefting Research Centre, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
| | - Klara Sjögren
- Department of Internal Medicine and Clinical Nutrition, Centre for Bone and Arthritis Research, Institute of Medicine, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
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167
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Lems WF, Paccou J, Zhang J, Fuggle NR, Chandran M, Harvey NC, Cooper C, Javaid K, Ferrari S, Akesson KE. Vertebral fracture: epidemiology, impact and use of DXA vertebral fracture assessment in fracture liaison services. Osteoporos Int 2021; 32:399-411. [PMID: 33475820 PMCID: PMC7929949 DOI: 10.1007/s00198-020-05804-3] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 12/16/2020] [Indexed: 02/07/2023]
Abstract
Vertebral fractures are independent risk factors for vertebral and nonvertebral fractures. Since vertebral fractures are often missed, the relatively new introduction of vertebral fracture assessment (VFA) for imaging of the lateral spine during DXA-measurement of the spine and hips may contribute to detect vertebral fractures. We advocate performing a VFA in all patients with a recent fracture visiting a fracture liaison service (FLS). Fracture liaison services (FLS) are important service models for delivering secondary fracture prevention for older adults presenting with a fragility fracture. While commonly age, clinical risk factors (including fracture site and number of prior fracture) and BMD play a crucial role in determining fracture risk and indications for treatment with antiosteoporosis medications, prevalent vertebral fractures usually remain undetected. However, vertebral fractures are important independent risk factors for future vertebral and nonvertebral fractures. A development of the DXA technology, vertebral fracture assessment (VFA), allows for assessment of the lateral spine during the regular DXA bone mineral density measurement of the lumbar spine and hips. Recent approaches to the stratification of antiosteoporosis medication type according to baseline fracture risk, and differences by age in the indication for treatment by prior fracture mean that additional information from VFA may influence initiation and type of treatment. Furthermore, knowledge of baseline vertebral fractures allows reliable definition of incident vertebral fracture events during treatment, which may modify the approach to therapy. In this manuscript, we will discuss the epidemiology and clinical significance of vertebral fractures, the different methods of detecting vertebral fractures, and the rationale for, and implications of, use of VFA routinely in FLS. • Vertebral fracture assessment is a tool available on modern DXA instruments and has proven ability to detect vertebral fractures, the majority of which occur without a fall and without the signs and symptoms of an acute fracture. • Most osteoporosis guidelines internationally suggest that treatment with antiosteoporosis medications should be considered for older individuals (e.g., 65 years +) with a recent low trauma fracture without the need for DXA. • Younger individuals postfracture may be risk-assessed on the basis of FRAX® probability including DXA and associated treatment thresholds. • Future fracture risk is markedly influenced by both site, number, severity, and recency of prior fracture; awareness of baseline vertebral fractures facilitates definition of true incident vertebral fracture events occurring during antiosteoporosis treatment. • Detection of previously clinically silent vertebral fractures, defining site of prior fracture, might alter treatment decisions in younger or older FLS patients, consistent with recent IOF-ESCEO guidance on baseline-risk-stratified therapy, and provides a reliable baseline from which to define new, potentially therapy-altering, vertebral fracture events.
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Affiliation(s)
- W F Lems
- Amsterdam UMC, VU University Medical Center, Amsterdam, The Netherlands.
| | - J Paccou
- Department of Rheumatology, Univ. Lille, CHU Lille, MABLab ULR 4490, 59000, Lille, France
| | - J Zhang
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - N R Fuggle
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - M Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Nuffield Department of Orthopaedics, Rheumatology and Orthopaedic Sciences, University of Oxford, Oxford, UK
| | - K Javaid
- Nuffield Department of Orthopaedics, Rheumatology and Orthopaedic Sciences, University of Oxford, Oxford, UK
| | - S Ferrari
- Clinical Service and Research Laboratory of Bone Diseases, Hôpitaux Universitaires de Genève, Geneva, Switzerland
| | - K E Akesson
- Department of Clinical Sciences and Department of Orthopaedics, Skane University Hospital, Lund University, Malmö, Sweden
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168
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AlHajri L, Ayoub A, Ahmed H, AlMulla M. Effect of Vitamin K2 Alone or in Combination on Various Bone Turnover Markers Amongst Postmenopausal Females. J Bone Metab 2021; 28:11-26. [PMID: 33730780 PMCID: PMC7973400 DOI: 10.11005/jbm.2021.28.1.11] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Accepted: 01/28/2021] [Indexed: 11/27/2022] Open
Abstract
Background Osteoporosis is common in postmenopausal women. Some studies have demonstrated the usefulness of vitamin K through the action of bone-specific proteins and osteoblast and osteoclast activities. However, no systematic review had explored this aspect in postmenopausal women. Hence, this systematic review aimed to explore the effect of vitamin K2 alone or in combination with other agents (vitamin D3 or calcium) on various bone turnover markers (BTMs) and bone mineral density (BMD) in postmenopausal women. Methods MEDLINE, ScienceDirect, PubMed, and Google Scholar were searched to identify relevant studies using specific inclusion criteria. Data extraction and quality assessment were carried out using standardized tests, and the results were narratively synthesized and presented in the form of tables. Results Vitamin K2 was beneficial in inducing an improvement or preventing deterioration, as evidenced by the BMD and osteocalcin (OC), undercarboxylated OC (ucOC), carboxylated OC (cOC), and γ-carboxylated OC levels. However, its effect was not conclusive when procollagen type 1 N-terminal propeptide, carboxyterminal propeptide of type I procollagen, C-terminal telopeptide of type I collagen, bone alkaline phosphatase, deoxypyridinoline, and N-terminal telopeptide levels (NTX) and ucOC:cOC or cOC:ucOC, and NTX:creatinine ratios were examined. Conclusions Vitamin K2 supplementation combined with vitamin D and calcium was found to be advantageous. However, vitamin K2 supplementation cannot replace the existing treatment options. In addition, vitamin K2 should be used with caution, considering its interactions with food and other drugs.
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Affiliation(s)
- Lamia AlHajri
- Department of Health Sciences and Pharmacy, Higher Colleges of Technology, Dubai, United Arab Emirates.,Department of Health Research, Lancaster University, Lancaster, UK
| | - Amna Ayoub
- United Arab Emirates University, Al Ain, United Arab Emirates
| | - Hessa Ahmed
- Department of Health Sciences and Pharmacy, Higher Colleges of Technology, Dubai, United Arab Emirates
| | - Marwa AlMulla
- Department of Health Sciences and Pharmacy, Higher Colleges of Technology, Dubai, United Arab Emirates
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169
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Ouyang Y, Chen S, Wan T, Zheng G, Sun G. The effects of teriparatide and bisphosphonates on new fractures in postmenopausal women with osteoporosis: A protocol for systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e24839. [PMID: 33607854 PMCID: PMC7899820 DOI: 10.1097/md.0000000000024839] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 12/22/2020] [Accepted: 01/26/2021] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND To systematically evaluate the efficacy of teriparatide and bisphosphonates in preventing fractures in postmenopausal women with osteoporosis. MATERIALS AND METHODS We performed a systematic search of PubMed, Embase, and the Cochrane Library for randomized controlled trials (RCTs) that compared teriparatide and bisphosphonates for osteoporosis treatment. Searches were performed without language restrictions and included studies from beginning of time to March 2019. Two authors independently screened and extracted the selected article. The quality of the included studies was evaluated using the Cochrane system evaluation method. Data were extracted and analysed using RevMan 5.2 software. RESULTS Nine RCTs were included for a total of 2990 postmenopausal women with osteoporosis. Of these, 1515 patients were treated with teriparatide and 1475 were treated with bisphosphonates. After pooling the data of 9 studies, there were significant differences between teriparatide and bisphosphonates [relative risk (RR): 0.61, 95% confidence interval (CI) (0.51, 0.74)] in the prevention of fractures according to different follow-up durations (P < .05), whatever alendronate [RR: 0.51, 95% CI (0.27, 0.95)] and other bisphosphonates [RR: 0.63, 95% CI (0.51, 0.77)]. In addition, we found significant differences between teriparatide and bisphosphonates in the prevention of vertebral fractures [RR: 0.47, 95% CI (0.35, 0.64)] and non-vertebral fractures [RR: 0.76, 95% CI (0.58,0.99)]. There were no significant differences in adverse effects between teriparatide and bisphosphonates [RR: 0.89, 95% CI (0.76, 1.03)]. CONCLUSIONS Based on the results of our meta-analysis, teriparatide was better than bisphosphonates in preventing fractures in postmenopausal women with osteoporosis both in the short-term and long-term follow-up periods. Teriparatide was superior to bisphosphonates in preventing vertebral and non-vertebral fractures. These drugs did not differ in terms of their adverse effects. More high-quality studies are needed to compare other factors such as costs and adverse reactions.
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Affiliation(s)
| | - ShuiLin Chen
- The Fourth Affiliated Hospital of Nanchang University
| | | | | | - GuiCai Sun
- The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
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170
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Golinelli D, Boetto E, Mazzotti A, Rosa S, Rucci P, Berti E, Ugolini C, Fantini MP. Cost Determinants of Continuum-Care Episodes for Hip Fracture. Health Serv Insights 2021; 14:1178632921991122. [PMID: 33642863 PMCID: PMC7894600 DOI: 10.1177/1178632921991122] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 01/08/2021] [Indexed: 11/17/2022] Open
Abstract
Many factors affect the healthcare costs and outcomes in patients with hip fracture (HF). Through the construction of a Continuum-Care Episode (CCE), we investigated the costs of CCEs for HF and their determinants. We used data extracted from administrative databases of 5094 consecutive elderly patients hospitalized in 2017 in Emilia Romagna, Italy, to evaluate the overall costs of the CCE. We calculated the acute and post-acute costs from the date of the hospital admission to the end of the CCE. The determinants of costs by type of surgical intervention (total hip replacement, partial hip replacement, open reduction, and internal fixation) were investigated using generalized linear regression models. Regardless of the type of surgical intervention, hospital bed-based rehabilitation in public or private healthcare facilities either followed by rehabilitation in a community hospital/temporary nursing home beds or not were the strongest determinants of costs, while rehabilitation in intermediate care facilities alone was associated with lower costs. CCE's cost and its variability is mainly related to the rehabilitation setting. Cost-wise, intermediate care resulted to be an appropriate setting for providing post-acute rehabilitation for HF, representing the one associated with lower overall costs. Intermediate care organizational setting should be privileged when planning integrated care HF pathways.
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Affiliation(s)
- Davide Golinelli
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum–University of Bologna, Italy
| | - Erik Boetto
- School of Hygiene and Preventive Medicine, Alma Mater Studiorum–University of Bologna, Italy
| | - Antonio Mazzotti
- 1st Orthopedic and Traumatologic Clinic, IRCCS–Istituto Ortopedico Rizzoli, Bologna, Italy
| | - Simona Rosa
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum–University of Bologna, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum–University of Bologna, Italy
| | - Elena Berti
- Regional Agency for Health and Social Care, Emilia-Romagna Region - ASSR, Bologna, Italy
| | - Cristina Ugolini
- Department of Economics and CRIFSP-School of Advanced Studies in Health Policy, University of Bologna, Italy
| | - Maria Pia Fantini
- Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum–University of Bologna, Italy
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171
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Xu Y, Wu Q. Trends in osteoporosis and mean bone density among type 2 diabetes patients in the US from 2005 to 2014. Sci Rep 2021; 11:3693. [PMID: 33580184 PMCID: PMC7881186 DOI: 10.1038/s41598-021-83263-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Abstract
This study aimed to examine how bone health changed among T2DM patients in the past decade. Continuous National Health and Nutrition Examination Survey (NHANES) data from 2005-2006 to 2013-2014 were analyzed to examine the trends of bone mineral density (BMD) and the prevalence trends of osteoporosis osteopenia among T2DM patients and non-diabetic people aged 40 years and older. The age- and BMI-adjusted mean BMD of the femur neck for the four NHANES cycles decreased linearly in both T2DM patients and non-diabetic people (both Plinear trend ≤ 0.009). Among women with T2DM, the mean BMD in 2013-2014 was significantly lower than that in 2005-2006, even after adjusting for multiple covariates. During 2005-2014, the prevalence of osteoporosis among T2DM patients and non-diabetic people increased but with no significant linear trend (both Plinear trend > 0.05), while the prevalence of osteopenia in the two populations increased linearly (both Plinear trend < 0.04). Age- and BMI-adjusted mean BMD decreased in 2013-2014 in patients with T2DM and non-diabetic people, while the prevalence of osteoporosis and osteopenia increased in both groups.
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Affiliation(s)
- Yingke Xu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA
- Nevada Institute of Personalized Medicine, College of Science, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA
| | - Qing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA.
- Nevada Institute of Personalized Medicine, College of Science, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA.
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172
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Zhao X, Cui P, Hu G, Wang C, Jiang L, Zhao J, Xu J, Zhang X. PIP5k1β controls bone homeostasis through modulating both osteoclast and osteoblast differentiation. J Mol Cell Biol 2021; 12:55-70. [PMID: 30986855 PMCID: PMC7052985 DOI: 10.1093/jmcb/mjz028] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2018] [Revised: 11/16/2018] [Accepted: 12/21/2018] [Indexed: 02/07/2023] Open
Abstract
PIP5k1β is crucial to the generation of phosphotidylinosotol (4, 5)P2. PIP5k1β participates in numerous cellular activities, such as B cell and platelet activation, cell phagocytosis and endocytosis, cell apoptosis, and cytoskeletal organization. In the present work, we aimed to examine the function of PIP5k1β in osteoclastogenesis and osteogenesis to provide promising strategies for osteoporosis prevention and treatment. We discovered that PIP5k1β deletion in mice resulted in obvious bone loss and that PIP5k1β was highly expressed during both osteoclast and osteoblast differentiation. Deletion of the gene was found to enhance the proliferation and migration of bone marrow-derived macrophage-like cells to promote osteoclast differentiation. PIP5k1β-/- osteoclasts exhibited normal cytoskeleton architecture but stronger resorption activity. PIP5k1β deficiency also promoted activation of mitogen-activated kinase and Akt signaling, enhanced TRAF6 and c-Fos expression, facilitated the expression and nuclear translocation of NFATC1, and upregulated Grb2 expression, thereby accelerating osteoclast differentiation and function. Finally, PIP5k1β enhanced osteoblast differentiation by upregulating master gene expression through triggering smad1/5/8 signaling. Therefore, PIP5k1β modulates bone homeostasis and remodeling.
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Affiliation(s)
- Xiaoying Zhao
- Department of Orthopedic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200025, China
| | - Penglei Cui
- Department of Orthopedic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Guoli Hu
- Department of Orthopedic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200025, China
| | - Chuandong Wang
- Department of Orthopedic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China
| | - Lei Jiang
- Key Laboratory of Tibetan Medicine Research, Northwest Plateau Institute of Biology, Chinese Academy of Sciences, Xining 810001, China
| | - Jingyu Zhao
- Department of Orthopedic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200025, China
| | - Jiake Xu
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Western Australia, 6009, Australia
| | - Xiaoling Zhang
- Department of Orthopedic Surgery, Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200092, China.,The Key Laboratory of Stem Cell Biology, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai 200025, China
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173
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Abstract
PURPOSE OF REVIEW Much of what we know about dietary patterns (DPs) and bone is derived from cross-sectional studies in adults. Given, establishing healthy bones during childhood serves as a blueprint for adult bone, it is important to better understand the role of DPs on pediatric bone. The purpose of this review is to determine if DPs influence bone strength in children. RECENT FINDINGS The majority of studies investigating the role of DPs on pediatric bone are cross-sectional in design and examine data-derived "a posterori" DPs. Overall, the DPs characterized by high intakes of fruits and vegetables demonstrated positive effects on pediatric bone. Results from both "a posteriori" and "a priori" DPs approaches in children suggests that DPs dominated by the intake of fruits and vegetables might be beneficial for pediatric bone. Future studies may consider "a priori" DPs interventions to better understand relationship between DPs and pediatric bone.
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Affiliation(s)
- Lauren M Coheley
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA.
| | - Richard D Lewis
- Department of Foods and Nutrition, The University of Georgia, 279 Dawson Hall, 305 Sanford Drive, Athens, GA, USA
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174
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Effects of High-Impact Weight-Bearing Exercise on Bone Mineral Density and Bone Metabolism in Middle-Aged Premenopausal Women: A Randomized Controlled Trial. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11020846] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
This study examined the effects of high-impact weight-bearing exercise on bone mineral density (BMD) and bone metabolic markers in middle-aged premenopausal women. Forty middle-aged premenopausal women were initially enrolled, but thirty-one participants (40.34 ± 3.69 years) completed in the study. The subjects were randomly divided into two groups including the high-impact weight-bearing exercise group (HWE, n = 14) and control group (CON, n = 17). The HWE group participated in the exercise for 50 min a day, three days per week for four months, while the CON group maintained their regular lifestyle. The HWE program included 10 different high-impact weight-bearing exercises such as jumping and running. BMD was measured using DXA (Hologic, QDR 4500W, Marlborough, MA, USA). The bone metabolic markers including serum 25-(OH) D, intact parathyroid hormone (PTH), osteoprotegerin (OPG), osteopontin (OPN), receptor activator of nuclear factor κB ligand (RANKL), osteocalcin (OC), C-terminal telopeptide of type 1 collagen (CTX), and calcium were analyzed. The results showed that the BMDs of femur, lumbar, and forearm did not significantly change during the intervention period in both the HWE and CON groups. A significant decrease in bone formation markers such as OC (F = 10.514, p = 0.003, ηp2 = 0.266) and an increase in bone resorption marker including CTX (F = 8.768, p = 0.006, ηp2 = 0.232) were found only in the CON group, while these values did not change in the HWE group. There was a significant increase in serum 25-(OH) D (F = 4.451, p = 0.044, ηp2 = 0.133) in the HWE group. Our findings suggest that four months of HWE is not sufficient to improve BMD and bone metabolic markers, but this impact exercise program may prevent the age-associated changes in bone turnover markers in middle-aged premenopausal women.
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175
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Blázquez Cabrera JA, Sosa Henriquez M, Diaz-Curiel M, Sánchez Molini P, Arranz Garcia F, Montoya MJ, Filgueira J, Olmos JM, Coco-Martín MB, Castrillón JLP. Profile of patients who consult with internists for an osteoporosis assessment: The OSTEOMED registry. Rev Clin Esp 2021; 221:9-17. [PMID: 33998484 DOI: 10.1016/j.rceng.2020.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Accepted: 06/05/2020] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND OBJECTIVES Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently. MATERIAL AND METHODS Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors. RESULTS In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; p<.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; p<.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; p<.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%). CONCLUSIONS These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.
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Affiliation(s)
| | - M Sosa Henriquez
- Servicio de Medicina Interna, Hospital Universitario Insular, Las Palmas de Gran Canaria, Las Palmas, Spain
| | - M Diaz-Curiel
- Servicio de Medicina Interna, Fundación Jiménez Díaz, Madrid, Spain
| | - P Sánchez Molini
- Servicio de Medicina Interna, Hospital de la Princesa, Madrid, Spain
| | - F Arranz Garcia
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, Spain
| | - M J Montoya
- Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, Spain
| | - J Filgueira
- Servicio de Medicina Interna, Hospital Universitario Gregorio Marañón, Madrid, Spain
| | - J M Olmos
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, Spain
| | - M B Coco-Martín
- Grupo de Investigación en Neurociencias Clínicas Aplicadas, Universidad de Valladolid, Valladolid, Spain
| | - J L Pérez Castrillón
- Servicio de Medicina Interna, Hospital Universitario Río Hortega, Valladolid, Spain.
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176
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Ahn KH, Lee Y, Sohn TY, Kim DY, Ryu M, Gym H, Lee S. Association between Relative Handgrip Strength and Osteoporosis in Older Women: The Korea National Health and Nutrition Examination Survey 2014-2018. Ann Geriatr Med Res 2021; 24:243-251. [PMID: 33389972 PMCID: PMC7781960 DOI: 10.4235/agmr.20.0076] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 12/18/2020] [Indexed: 02/03/2023] Open
Abstract
Background While handgrip strength is associated with osteoporosis in the older population and muscle weakness is related to a reduction in bone mineral density, no study has yet assessed the association between relative hand grip strength (RHGS) and osteoporosis in the older Korean population. This study assessed the associations between RHGS and osteoporosis in Korean older women aged over 60 years. Methods We used data of 4,179 older women from the Korea National Health and Nutrition Examination Survey (KNHANES) from 2014 to 2018. We applied binomial logistic regression to identify an association between RHGS and osteoporosis while controlling for other covariates such as age; socioeconomic status; smoking behavior; alcohol consumption, laboratory test results; and the prevalence of hypertension, diabetes mellitus, thyroid disease, and obesity. Results RHGS was significantly associated with osteoporosis of the left hand in older Korean women. RHGS levels 2 and 4 of the left hand showed an inverse association with the prevalence of osteoporosis in female participants aged 60–69 years (odds ratio [OR]=0.637; 95% confidence interval [CI], 0.452–0.898; p=0.010; and OR=0.496; 95% CI, 0.258–0.956; p=0.036, respectively) but not in those aged over 70 years and in the right hand. Conclusion osteoporosis was significantly associated with left-hand RHGS in 60–69-year-old women, and the osteoporosis risks decreased by approximately 36.3% and 50.4% in women with RHGS levels 2 and 4, respectively. RHGS may be used to predict osteoporosis in pre-clinical settings such as public health care institutes.
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Affiliation(s)
- Kwang-Ho Ahn
- Uijeongbu Seoul-Chuk Hospital, Uijeongbu, Korea.,Institute on Aging, Ajou University Medical Center, Suwon, Korea
| | - Yunhwan Lee
- Institute on Aging, Ajou University Medical Center, Suwon, Korea.,Department of Preventive Medicine and Public Health, Ajou University School of Medicine, Suwon, Korea
| | - Tae-Yong Sohn
- Department of u-Health Service Administration, Yuhan University, Bucheon, Korea
| | | | - Mikyung Ryu
- Institute on Aging, Ajou University Medical Center, Suwon, Korea.,Department of Sports and Health Science, College of Human-Centered Convergence, Kyonggi University, Suwon, Korea
| | - Ho Gym
- Department of BBKO Research Center, BBKO Co. Ltd., Seoul, Korea.,Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Sol Lee
- Department of BBKO Research Center, BBKO Co. Ltd., Seoul, Korea.,Department of Health Policy and Management, Korea University, Seoul, Korea
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177
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Xia SL, Ma ZY, Wang B, Guo SY, Zhou XX, Gao F. The Association between Tea Consumption and the Risk of Fracture: A Dose-Response Meta-Analysis of Prospective Cohort Studies. J Nutr Health Aging 2021; 25:1046-1052. [PMID: 34725660 DOI: 10.1007/s12603-021-1677-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Inconsistent results exist on the role of tea consumption on subsequent risk of fracture. A dose-response meta-analysis was therefore conducted to assess the association of tea consumption with the risk of fracture based on prospective cohort studies. METHODS The electronic databases of PubMed, Embase, and the Cochrane library were systematically searched to identify prospective cohort studies from inception until September 2020. The categories of high versus low and dose-response meta-analyses for tea consumption on the risk of fracture were calculated using the random-effects model. Eight prospective cohort studies recruited 774,134 individuals selected for the final meta-analysis. RESULTS An increment of 1 cup in tea consumption was not associated with the risk of fracture [relative risk (RR), 0.98; 95% confidence interval (CI), 0.96-1.00; P = 0.102]. Moreover, the highest tea consumption category was associated with a reduced risk of fracture (RR, 0.93; 95% CI, 0.88-0.98; P = 0.005). Furthermore, heavy (RR, 0.91; 95% CI, 0.85-0.98; P = 0.008) and mild (RR, 0.97; 95% CI, 0.94-1.00; P = 0.046) tea consumption were associated with lower risk of fracture. However, moderate tea consumption was not associated with the risk of fracture (RR, 0.98; 95% CI, 0.94-1.02; P = 0.281). CONCLUSION This study found that increased tea consumption may provide a protective role in the risk of fracture. The benefits of tea consumption should be further explored according to the characteristics of the individuals.
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Affiliation(s)
- S-L Xia
- Feng Gao, 1500 Zhoupu Zhouyuan Road, Pudong New Area, Shanghai 201318, China, Tel: 86-021-68135590, of Missouri Sinclair School of Nursing, Columbia, USA,
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178
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Bäcker HC, Wu CH, Maniglio M, Wittekindt S, Hardt S, Perka C. Epidemiology of proximal femoral fractures. J Clin Orthop Trauma 2021; 12:161-165. [PMID: 33716441 PMCID: PMC7920330 DOI: 10.1016/j.jcot.2020.07.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 05/14/2020] [Accepted: 07/02/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION With increasing age, the incidence of proximal femoral fractures increases steadily. Although the different treatments are investigated frequently, little is known about the seasonal variation and predisposing factors. The purpose of this study is to investigate the epidemiology, the impact of femoroacetabular impingement, as well as the presence of osteoarthritis. METHODS We performed a retrospective review of all patients with pertrochanteric, lateral and medial femoral neck fractures between 2012 and 2019. Inclusion criteria consisted of patients older than 18 years old who presented with isolated proximal femoral fractures without any congenital or hereditary deformity. For analysis, we assessed the demographics, season at time of accident, Kellgren-Lawrence score and corner edge (CE) angle. RESULTS In total, 187 patients were identified at a mean age of 75.1 ± 12.9 years old. Females consisted of 54.5% of this cohort. Most commonly, patients tend to present in winter with pertrochanteric fractures whereas no seasonal variation was found for medial femoral neck fractures. Significant correlations between season and age (regression coefficient -0.050 ± 0.021; p < 0.05) were identified. In medial neck fractures, the Gardner score was lower and Kellgren-Lawrence score higher for both female than males (p < 0.05). Patients with lateral neck fractures were significantly younger at 68.6 ± 12.5 years old (p < 0.05). In pertrochanteric fractures, the Kellgren-Lawrence score was significantly higher at 2.1 ± 0.8 (p < 0.05) with higher CE angle at 43.0 ± 7.6° (p = 0.14). CONCLUSION With increasing incidences of proximal femoral fractures, it is essential to recognize potential risk factors. This allows for development of new guidelines and algorithm that can aid in diagnosis, prevention, and education for patients.
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Affiliation(s)
- Henrik C. Bäcker
- Department of Orthopaedic Surgery and Traumatology, Charité Berlin, UniversityHospital Berlin, Berlin, Germany,Corresponding author. Charité Berlin, UniversityHospital Berlin, Berlin, Germany.
| | - Chia H. Wu
- Department of Orthopedics & Sports Medicine, Baylor College of Medicine Medical Center, Houston, TX, USA
| | - Mauro Maniglio
- Department of Orthopaedics and Traumatology, HFR Fribourg Hopital Cantonal, Fribourg, Switzerland
| | - Sophie Wittekindt
- Department of Orthopaedic Surgery and Traumatology, Charité Berlin, UniversityHospital Berlin, Berlin, Germany
| | - Sebastian Hardt
- Department of Orthopaedic Surgery and Traumatology, Charité Berlin, UniversityHospital Berlin, Berlin, Germany
| | - Carsten Perka
- Department of Orthopaedic Surgery and Traumatology, Charité Berlin, UniversityHospital Berlin, Berlin, Germany
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179
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Gennari L, Merlotti D, Figura N, Mingiano C, Franci MB, Lucani B, Picchioni T, Alessandri M, Campagna MS, Gonnelli S, Bianciardi S, Materozzi M, Caffarelli C, Gonnelli S, Nuti R. Infection by CagA-Positive Helicobacter pylori Strains and Bone Fragility: A Prospective Cohort Study. J Bone Miner Res 2021; 36:80-89. [PMID: 32790186 DOI: 10.1002/jbmr.4162] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2020] [Revised: 07/31/2020] [Accepted: 08/05/2020] [Indexed: 02/06/2023]
Abstract
Helicobacter pylori (HP) infection is a common and persistent disorder acting as a major cofactor for the development of upper gastrointestinal diseases and several extraintestinal disorders including osteoporosis. However, no prospective study assessed the effects of HP on bone health and fracture risk. We performed a HP screening in a population-based cohort of 1149 adults followed prospectively for up to 11 years. The presence of HP infection was assessed by serologic testing for serum antibodies to HP and the cytotoxin associated gene-A (CagA). The prevalence of HP infection did not differ among individuals with normal bone mineral density (BMD), osteoporosis, and osteopenia. However, HP infection by CagA-positive strains was significantly increased in osteoporotic (30%) and osteopenic (26%) patients respect to subjects with normal BMD (21%). Moreover, anti-CagA antibody levels were significantly and negatively associated with lumbar and femoral BMD. Consistent with these associations, patients affected by CagA-positive strains had a more than fivefold increased risk to sustain a clinical vertebral fracture (HR 5.27; 95% CI, 2.23-12.63; p < .0001) and a double risk to sustain a nonvertebral incident fracture (HR 2.09; 95% CI, 1.27-2.46; p < .005). Reduced estrogen and ghrelin levels, together with an impaired bone turnover balance after the meal were also observed in carriers of CagA-positive HP infection. HP infection by strains expressing CagA may be considered a risk factor for osteoporosis and fractures. Further studies are required to clarify in more detail the underlying pathogenetic mechanisms of this association. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Luigi Gennari
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Daniela Merlotti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Natale Figura
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Christian Mingiano
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Beatrice Franci
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Barbara Lucani
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Tommaso Picchioni
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Mario Alessandri
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Stella Campagna
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Sara Gonnelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Simone Bianciardi
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Maria Materozzi
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy.,Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - Carla Caffarelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Stefano Gonnelli
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
| | - Ranuccio Nuti
- Department of Medicine, Surgery and Neurosciences, University of Siena, Siena, Italy
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Sollmann N, Becherucci EA, Boehm C, Husseini ME, Ruschke S, Burian E, Kirschke JS, Link TM, Subburaj K, Karampinos DC, Krug R, Baum T, Dieckmeyer M. Texture Analysis Using CT and Chemical Shift Encoding-Based Water-Fat MRI Can Improve Differentiation Between Patients With and Without Osteoporotic Vertebral Fractures. Front Endocrinol (Lausanne) 2021; 12:778537. [PMID: 35058878 PMCID: PMC8763669 DOI: 10.3389/fendo.2021.778537] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Accepted: 12/06/2021] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Osteoporosis is a highly prevalent skeletal disease that frequently entails vertebral fractures. Areal bone mineral density (BMD) derived from dual-energy X-ray absorptiometry (DXA) is the reference standard, but has well-known limitations. Texture analysis can provide surrogate markers of tissue microstructure based on computed tomography (CT) or magnetic resonance imaging (MRI) data of the spine, thus potentially improving fracture risk estimation beyond areal BMD. However, it is largely unknown whether MRI-derived texture analysis can predict volumetric BMD (vBMD), or whether a model incorporating texture analysis based on CT and MRI may be capable of differentiating between patients with and without osteoporotic vertebral fractures. MATERIALS AND METHODS Twenty-six patients (15 females, median age: 73 years, 11 patients showing at least one osteoporotic vertebral fracture) who had CT and 3-Tesla chemical shift encoding-based water-fat MRI (CSE-MRI) available were analyzed. In total, 171 vertebral bodies of the thoracolumbar spine were segmented using an automatic convolutional neural network (CNN)-based framework, followed by extraction of integral and trabecular vBMD using CT data. For CSE-MRI, manual segmentation of vertebral bodies and consecutive extraction of the mean proton density fat fraction (PDFF) and T2* was performed. First-order, second-order, and higher-order texture features were derived from texture analysis using CT and CSE-MRI data. Stepwise multivariate linear regression models were computed using integral vBMD and fracture status as dependent variables. RESULTS Patients with osteoporotic vertebral fractures showed significantly lower integral and trabecular vBMD when compared to patients without fractures (p<0.001). For the model with integral vBMD as the dependent variable, T2* combined with three PDFF-based texture features explained 40% of the variance (adjusted R2[Ra2] = 0.40; p<0.001). Furthermore, regarding the differentiation between patients with and without osteoporotic vertebral fractures, a model including texture features from CT and CSE-MRI data showed better performance than a model based on integral vBMD and PDFF only ( Ra2 = 0.47 vs. Ra2 = 0.81; included texture features in the final model: integral vBMD, CT_Short-run_emphasis, CT_Varianceglobal, and PDFF_Variance). CONCLUSION Using texture analysis for spine CT and CSE-MRI can facilitate the differentiation between patients with and without osteoporotic vertebral fractures, implicating that future fracture prediction in osteoporosis may be improved.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- *Correspondence: Nico Sollmann,
| | - Edoardo A. Becherucci
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Christof Boehm
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Malek El Husseini
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Stefan Ruschke
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas M. Link
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD) Pillar, Singapore University of Technology and Design (SUTD), Singapore, Singapore
- Changi General Hospital, Singapore, Singapore
| | - Dimitrios C. Karampinos
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Roland Krug
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, CA, United States
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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181
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Larsson BAM, Johansson L, Johansson H, Axelsson KF, Harvey N, Vandenput L, Magnusson P, McCloskey E, Liu E, Kanis JA, Sundh D, Lorentzon M. The timed up and go test predicts fracture risk in older women independently of clinical risk factors and bone mineral density. Osteoporos Int 2021; 32:75-84. [PMID: 33089354 PMCID: PMC7755867 DOI: 10.1007/s00198-020-05681-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 10/09/2020] [Indexed: 12/12/2022]
Abstract
The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. In older women, TUG time predicts the risk of major osteoporotic fracture and hip fracture independently of clinical risk factors and bone mineral density, and has a substantial impact on fracture probabilities. INTRODUCTION The timed up and go (TUG) test measures physical performance and predicts falls in the elderly. A slow TUG has been associated with an increased fracture risk, but it is unclear whether the association is independent of clinical risk factors and bone mineral density (BMD). The aim of this study was to investigate if TUG time was associated with fracture risk independently of clinical risk factors and BMD and to determine its impact on fracture probabilities in older women. METHODS A standardized questionnaire was used to assess information regarding clinical risk factors in the large population-based SUPERB study of 3028 older women (75-80 years). At baseline, the TUG test was performed and BMD measured with DXA. The association between TUG time and the risk of hip fracture and major osteoporotic fracture (MOF) was examined using an extension of Poisson regression. RESULTS Fracture incidence increased steeply with increasing TUG time up to 12 s and subsequently started to level off. A slow TUG time was therefore defined as TUG > 12 s, a cutoff level then used in Cox models to study the association between slow TUG and fracture risk. A slow TUG time was associated with an increased risk of fracture (MOF 2.39 [1.80-3.18] and hip fracture 2.96 [1.62-5.40]). These associations were slightly attenuated but remained significant after adjustment for clinical risk factors and femoral neck BMD. Depending on BMD, the 4-year fracture probability of MOF increased by a factor of 1.5-1.9 in a 75-year-old woman with slow TUG (> 12 s). CONCLUSION The TUG time predicts the risk of MOF and hip fracture independently of clinical risk factors and BMD and has a substantial impact on fracture probabilities, indicating that inclusion of the TUG test in patient evaluation should be considered in order to improve fracture prediction in older women.
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Affiliation(s)
- B A M Larsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - L Johansson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Orthopaedics, Sahlgrenska University Hospital, Mölndal, Sweden
| | - H Johansson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - K F Axelsson
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Orthopaedic Surgery, Skaraborg Hospital, Skövde, Sweden
| | - N Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK
| | - L Vandenput
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Centre for Bone and Arthritis Research, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - P Magnusson
- Department of Clinical Chemistry, and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - E McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
- MRC and Arthritis Research UK Centre for Integrated Research in Musculoskeletal Ageing, Mellanby Centre for Bone Research, University of Sheffield, Sheffield, UK
| | - E Liu
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - J A Kanis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - D Sundh
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - M Lorentzon
- Geriatric Medicine, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden.
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia.
- Region Västra Götaland, Department of Geriatric Medicine, Sahlgrenska University Hospital, 43180, Mölndal, Sweden.
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182
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Blázquez Cabrera JA, Sosa Henriquez M, Diaz-Curiel M, Sánchez Molini P, Arranz Garcia F, Montoya MJ, Filgueira J, Olmos JM, Coco-Martín MB, Castrillón JLP. Profile of patients who visit medical internists for an osteoporosis assessment: The OSTEOMED registry. Rev Clin Esp 2021; 221:9-17. [PMID: 32682689 DOI: 10.1016/j.rce.2020.06.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 12/21/2022]
Abstract
BACKGROUND AND OBJECTIVES Osteoporosis is considered a generalised skeletal disorder in which there is impaired bone resistance, which predisposes the individual to a greater risk of fracture. The aim of this cross-sectional study was to collect and present data on the main clinical characteristics of patients who consult medical internists in Spain. Understanding these characteristics can help in implementing action plans to improve these patients' care more effectively and efficiently. MATERIAL AND METHODS Through an analysis of the Osteoporosis in Internal Medicine (OSTEOMED) registry, this study presents the main clinical characteristics of patients with osteoporosis who attended internal medicine consultations in 23 Spanish hospital centres between 2012 and 2017. We analysed the reasons for the consultations, the densitometric values, the presence of comorbidities, the prescribed treatment and other lifestyle-related factors. RESULTS In total, 2024 patients with osteoporosis were assessed (89.87% women, 10.13% men). The patients' mean age was 64.1±12.1 years (women, 64.7±11.5 years; men, 61.2±14.2 years). There was no significant difference between the sexes in their history of recent falls (9.1% and 6.7%); however, there were significant differences in the daily intake of calcium from milk products (553.8±332.6mg for women vs. 450.2±303.3mg for men; P<.001) and in the secondary causes of osteoporosis (13% of men vs. 6.5% of women; P<.001). In the sample, there were 404 fractures (20%), with a notable number of confirmed vertebral fractures (17.2%, 35.6% in men vs. 15.2% in women; P<.001). A large portion of the patients did not undergo the indicated treatment and presented low levels of physical activity and sun exposure. A significant percentage of the patients presented associated comorbidities, the most common of which were hypertension (32%) and dyslipidaemia (28%). CONCLUSIONS These results define the profile of patients with osteoporosis who attend internal medicine consultations in Spain. The results also show the multisystemic character of this condition, which, along with its high prevalence, determine that the specific internal medicine consultations dedicated to managing the condition are the appropriate place for caring for these patients.
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Affiliation(s)
| | - M Sosa Henriquez
- Servicio de Medicina Interna, Hospital Universitario Insular, Las Palmas de Gran Canaria, Las Palmas, España
| | - M Diaz-Curiel
- Servicio de Medicina Interna, Fundación Jiménez Díaz, Madrid, España
| | - P Sánchez Molini
- Servicio de Medicina Interna, Hospital de la Princesa, Madrid, España
| | - F Arranz Garcia
- Servicio de Medicina Interna, Hospital Clínico San Carlos, Madrid, España
| | - M J Montoya
- Servicio de Medicina Interna, Hospital Universitario Virgen Macarena, Sevilla, España
| | - J Filgueira
- Servicio de Medicina Interna, Hospital Universitario Gregorio Marañón, Madrid, España
| | - J M Olmos
- Servicio de Medicina Interna, Hospital Universitario Marqués de Valdecilla, Santander, Cantabria, España
| | - M B Coco-Martín
- Grupo de Investigación en Neurociencias Clínicas Aplicadas, Universidad de Valladolid, Valladolid, España
| | - J L Pérez Castrillón
- Servicio de Medicina Interna. Hospital Universitario Río Hortega, Valladolid, España.
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183
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Takeda K, Koyama S, Shomoto K, Ushiroyama K, Naoi Y, Nagai T, Sakurai H, Kanada Y, Tanabe S. The effect of gait training with low-intensity neuromuscular electrical stimulation of hip abductor muscles in two patients following surgery for hip fracture: Two case reports. Physiother Theory Pract 2020; 38:1553-1563. [PMID: 33355512 DOI: 10.1080/09593985.2020.1864798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background: The rate of force development (RFD) is an indicator of muscle strength. A previous study reported that the RFD of hip abductor muscles was increased by neuromuscular electrical stimulation (NMES) to gluteus medius (GM) during gait in healthy adults. However, the effects for patients following femoral head replacement for hip fracture are unclear.Purpose: The aim of this case report was to investigate the effects of gait training with sub-motor threshold NMES on RFD of hip abductor muscles in two patients following femoral head replacement for hip fracture compared to gait training without NMES.Case description: Two elderly patients following femoral head replacement for hip fracture received both interventions of gait training with sub-motor threshold NMES to GM and without NMES. Intervention phases involved 14 sessions each, for 28 sessions total.Outcomes: The RFD of hip abductor muscles, maximum walking speed, six-minute walk distance (6MWD), Berg Balance Scale, one-leg standing time (OLST), functional independence measure, and Numeric Pain Rating Scale (NPRS) were used as outcome measures. In both patients, RFD, 6MWD, OLST, and NPRS were improved by gait training with NMES compared to without NMES.Conclusion: Our results suggest the potential of NMES as a treatment methodology for these two patients undergoing femoral head replacement for hip fracture.
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Affiliation(s)
- Kazuya Takeda
- Department of Rehabilitation, Kawamura Hospital, Akutami, Japan
| | - Soichiro Koyama
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Koji Shomoto
- Department of Physical Therapy, Faculty of Health Science, Kio University, Koryo, Japan
| | | | - Yuki Naoi
- Department of Rehabilitation, Kawamura Hospital, Akutami, Japan
| | - Tomoko Nagai
- Department of Rehabilitation, Kawamura Hospital, Akutami, Japan
| | - Hiroaki Sakurai
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Yoshikiyo Kanada
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
| | - Shigeo Tanabe
- Faculty of Rehabilitation, School of Health Sciences, Fujita Health University, Toyoake, Japan
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184
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Kwok TSH, Sutton M, Yang Ye J, Pereira D, Chandran V, Gladman DD. Prevalence and factors associated with osteoporosis and bone mineral density testing in psoriatic arthritis. Arthritis Care Res (Hoboken) 2020; 74:1006-1012. [PMID: 33326187 DOI: 10.1002/acr.24538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 10/17/2020] [Accepted: 12/10/2020] [Indexed: 11/09/2022]
Abstract
OBJECTIVES To determine bone mineral density (BMD) in psoriatic arthritis (PsA) patients, factors associated with undergoing BMD testing, and the effect of PsA clinical activity on BMD. METHODS Patients attending the University of Toronto PsA Clinic with a BMD from cohort inception to January 2019 were included. Descriptive statistics summarized lumbar spine, femoral neck and total hip T-scores. Cox proportional hazard regression identified predictors for BMD testing. Logistic regression analysis determined odds of having normal (T-score ≥ -1.0) versus osteoporotic range BMD (T-score ≤ -2.5). A multi-state model determined factors associated with BMD state changes over time. RESULTS Of the 1479 patients, 214 had BMDs. Mean T-scores at the lumbar spine, femoral neck and total hip were -0.30±0.32, -1.10±1.04 and -0.45±0.42 respectively. Osteopenia and osteoporosis occurred in 45.27% and 12.94% of patients. Increasing age, menopause, elevated acute phase reactants, biologic, methotrexate and systemic glucocorticoid use were associated with a higher chance of undergoing BMD testing. Increased BMI and biologic use were associated with a lower chance of having osteoporotic range BMD. In multi-state analysis, polyarthritis may portend lower BMDs over time, although this did not achieve statistical significance due to low patient numbers. CONCLUSIONS The prevalence of osteopenia and osteoporosis in the PsA cohort were similar to the general population. Clinicians are using osteoporosis risk factors and PsA disease severity markers to select patients for BMD testing. Polyarticular disease may portend worse BMDs. Biologic use and increased BMI appear to have a protective effect.
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Affiliation(s)
- Timothy S H Kwok
- Department of Medicine Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto
| | - Mitchell Sutton
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Justine Yang Ye
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Daniel Pereira
- Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Vinod Chandran
- Department of Medicine Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Krembil Research Institute, University Health Network.,Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Institute of Medical Science, University of Toronto, Ontario, Canada, Toronto
| | - Dafna D Gladman
- Department of Medicine Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Centre for Prognosis Studies in the Rheumatic Diseases, Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada.,Schroeder Arthritis Institute, Krembil Research Institute, University Health Network.,Division of Rheumatology, Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Ontario, Canada, Toronto.,Institute of Medical Science, University of Toronto, Ontario, Canada, Toronto
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185
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Drug-Eluting Biodegradable Implants for the Sustained Release of Bisphosphonates. Polymers (Basel) 2020; 12:polym12122930. [PMID: 33297466 PMCID: PMC7762379 DOI: 10.3390/polym12122930] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 12/04/2020] [Accepted: 12/04/2020] [Indexed: 11/16/2022] Open
Abstract
Despite being one of the first-line treatments for osteoporosis, the bisphosphonate drug class exhibits an extremely low oral bioavailability (<1%) due to poor absorption from the gastrointestinal tract. To overcome this, and to explore the potential for sustained drug release, bioerodible poly(lactic acid) (PLA) and poly(D,L-lactide-co-glycolide) (PLGA) implants loaded with the bisphosphonate alendronate sodium (ALN) were prepared via hot-melt extrusion. The rate of drug release in vitro was modulated by tailoring the ratio of lactide to glycolide in the polymer and by altering the ALN-loading of the implants. All investigated implants exhibited sustained ALN release in vitro between 25 to 130 days, where implants of greater glycolide composition and higher ALN-loadings released ALN more rapidly. All PLGA implants demonstrated a sigmoidal release profile, characterised by an initial surface dissolution phase, followed by a period of zero-order drug diffusion, then relaxation or erosion of the polymer chains that caused accelerated release over the subsequent days. Contrastingly, the PLA implants demonstrated a logarithmic release profile, characterised by a gradual decrease in ALN release over time.
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186
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Stieglitz J, Hooper PL, Trumble BC, Kaplan H, Gurven MD. Productivity loss associated with functional disability in a contemporary small-scale subsistence population. eLife 2020; 9:e62883. [PMID: 33259289 PMCID: PMC7744098 DOI: 10.7554/elife.62883] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 11/30/2020] [Indexed: 12/27/2022] Open
Abstract
In comparative cross-species perspective, humans experience unique physical impairments with potentially large consequences. Quantifying the burden of impairment in subsistence populations is critical for understanding selection pressures underlying strategies that minimize risk of production deficits. We examine among forager-horticulturalists whether compromised bone strength (indicated by fracture and lower bone mineral density, BMD) is associated with subsistence task cessation. We also estimate the magnitude of productivity losses associated with compromised bone strength. Fracture is associated with cessation of hunting, tree chopping, and walking long distances, but not tool manufacture. Age-specific productivity losses from hunting cessation associated with fracture and lower BMD are substantial: ~397 lost kcals/day, with expected future losses of up to 1.9 million kcals (22% of expected production). Productivity loss is thus substantial for high strength and endurance tasks. Determining the extent to which impairment obstructs productivity in contemporary subsistence populations improves our ability to infer past consequences of impairment.
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Affiliation(s)
- Jonathan Stieglitz
- Université Toulouse 1 CapitoleToulouseFrance
- Institute for Advanced Study in ToulouseToulouseFrance
| | - Paul L Hooper
- Economic Science Institute, Chapman University, 1 University DriveOrangeUnited States
| | - Benjamin C Trumble
- Center for Evolution and Medicine, Life Sciences C, Arizona State UniversityTempeUnited States
- School of Human Evolution and Social Change, Arizona State UniversityTempeUnited States
| | - Hillard Kaplan
- Economic Science Institute, Chapman University, 1 University DriveOrangeUnited States
| | - Michael D Gurven
- Department of Anthropology, University of California, Santa BarbaraSanta BarbaraUnited States
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187
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Fibronectin 1 activates WNT/β-catenin signaling to induce osteogenic differentiation via integrin β1 interaction. J Transl Med 2020; 100:1494-1502. [PMID: 32561820 DOI: 10.1038/s41374-020-0451-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 06/03/2020] [Accepted: 06/04/2020] [Indexed: 02/06/2023] Open
Abstract
Osteoporosis (OP) is a systemic skeletal disease leading to fragility fractures and is a major health issue globally. WNT/β-catenin signaling regulates bone-remodeling processes and plays vital roles in OP development. However, the underlying regulatory mechanisms behind WNT/β-catenin signaling in OP requires clarification, as further studies are required to identify novel alternate therapeutic agents to improve OP. Here we report that fibronectin 1 (FN-1) promoted differentiation and mineralization of osteoblasts by activating WNT/β-catenin pathway, in cultured pre-osteoblasts. With isobaric tags for relative and absolute quantitation labeling proteomics analysis, we investigated protein changes in bone samples from OP patients and normal controls. FN-1 accumulated in osteoblasts in bone samples from OP patients and age-related OP mice compared to control group. In addition, we observed that integrin β1 (ITGB1) acts as an indispensable signaling molecule for the interplay between FN-1 and β-catenin, and that FN-1 expression increased, but ITGB1 expression decreased in osteoblasts during OP progression. Therefore, our study reveals a novel explanation for WNT/β-catenin pathway inactivation in OP pathology. Supplying of FN-1 and ITGB1 may provide a potential therapeutic strategy in improving bone formation during OP.
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188
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Park E, Kim J, Jin HS, Choi CW, Choi TH, Choi S, Huh D, Jeong SY. Scopolin Attenuates Osteoporotic Bone Loss in Ovariectomized Mice. Nutrients 2020; 12:nu12113565. [PMID: 33233714 PMCID: PMC7699886 DOI: 10.3390/nu12113565] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 11/17/2020] [Accepted: 11/18/2020] [Indexed: 11/29/2022] Open
Abstract
Bone remodeling is a renewal process regulated by bone synthesis (osteoblasts) and bone destruction (osteoclasts). A previous study demonstrated that Lycii radicis cortex (LRC) extract inhibited ovariectomized (OVX)-induced bone loss in mice. This study investigated the anti-osteoporotic effects of bioactive constituent(s) from the LRC extract. The effective compound(s) were screened, and a single compound, scopolin, which acts as a phytoalexin, was chosen as a candidate component. Scopolin treatment enhanced alkaline phosphatase activity and increased mineralized nodule formation in MC3T3-E1 pre-osteoblastic cells. However, osteoclast differentiation in primary-cultured monocytes was reduced by treatment with scopolin. Consistently, scopolin treatment increased osteoblast differentiation in the co-culture of monocytes (osteoclasts) and MC3T3-E1 (osteoblast) cells. Scopolin treatment prevented bone mineral density loss in OVX-induced osteoporotic mice. These results suggest that scopolin could be a therapeutic bioactive constituent for the treatment and prevention of osteoporosis.
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Affiliation(s)
- Eunkuk Park
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, Korea; (E.P.); (J.K.)
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon 16499, Korea
| | - Jeonghyun Kim
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, Korea; (E.P.); (J.K.)
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon 16499, Korea
| | - Hyun-Seok Jin
- Department of Biomedical Laboratory Science, College of Life and Health Sciences, Hoseo University, Asan 31499, Korea;
| | - Chun Whan Choi
- Natural Products Research Institute, Gyeonggi Institute of Science & Technology Promotion, Suwon 16229, Korea;
| | - Tae Hyun Choi
- Department of Molecular Imaging, Korea Institute of Radiological and Medical Sciences, Seoul 01812, Korea;
| | - Sangho Choi
- International Biological Material Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon 34141, Korea;
| | - Dam Huh
- Dongwoodang Pharmacy Co. Ltd., Yeongchen 38819, Korea;
| | - Seon-Yong Jeong
- Department of Medical Genetics, Ajou University School of Medicine, Suwon 16499, Korea; (E.P.); (J.K.)
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon 16499, Korea
- Correspondence: ; Tel.: +82-31-219-4520
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189
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State of Fragility Fractures Management during the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217732. [PMID: 33105834 PMCID: PMC7672624 DOI: 10.3390/ijerph17217732] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 10/12/2020] [Accepted: 10/21/2020] [Indexed: 01/08/2023]
Abstract
Osteoporosis is a public health concern all over the world. As a chronic condition, it generally requires prolonged medical interventions to limit the risks of further bone loss, impaired skeletal integrity and the onset of fractures. This problem is further complicated by the fact that the abrupt cessation of some therapies may be associated with an increased risk of harm. It is in this context that the COVID-19 pandemic has caused an unprecedented disruption to the provision of healthcare worldwide, exceeding our worst expectations in terms of the number of lives lost and the rapidity at which consolidated economies and healthcare systems are being significantly damaged. In this review, we assessed the challenges and strategies used in the management of osteoporosis and fragility fracture care during the COVID-19 pandemic. We also examined the available evidence and provided clinical recommendations that will require reassessment as the worldwide response to COVID-19 evolves.
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190
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Changes in physical activity and risk of fracture: a Korean nationwide population-based cohort study. Sci Rep 2020; 10:16266. [PMID: 33004986 PMCID: PMC7531000 DOI: 10.1038/s41598-020-73495-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 09/11/2020] [Indexed: 12/04/2022] Open
Abstract
Physical activity (PA) is one of the most important modifiable factors associated with fracture risk. However, the association between interval changes in PA and the risk of fracture remains unknown. We investigated the risk of fracture development according to interval changes in PA in middle aged and older individuals. In this nationwide cohort study of adults aged ≥ 40 years, more than 4.9 million individuals without fractures within the last year who underwent two consecutive national health screenings in Korea from 2009 to 2012 were identified. The risk of fracture between 2013 and 2016 according to interval changes in regular PA was prospectively analyzed. Compared to individuals with a continuous lack of PA, those with a decrease in PA (0.41/1000 person-years (PY) decrease in incidence rate (IR); adjusted hazard ratio (aHR) 0.975; 95% confidence interval (CI) 0.964–0.987), increase in PA (1.8/1000 PY decrease in IR; aHR 0.948; 95% CI 0.937–0.959), and continuous PA (3.58/1000 PY decrease in IR; aHR 0.888; 95% CI 0.875–0.901) had a significantly reduced risk of fracture. Interval changes in regular PA were associated with risk of fracture. Individuals who engaged in continuous regular PA exhibited the maximum protective benefit against fracture.
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191
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Rey-Rodriguez MM, Vazquez-Gamez MA, Giner M, Garrachón-Vallo F, Fernández-López L, Colmenero MA, Montoya-García MJ. Incidence, morbidity and mortality of hip fractures over a period of 20 years in a health area of Southern Spain. BMJ Open 2020; 10:e037101. [PMID: 32973058 PMCID: PMC7517558 DOI: 10.1136/bmjopen-2020-037101] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVE To evaluate the incidence of osteoporotic hip fracture in the Macarena Health Area (Seville). SETTING AND PARTICIPANTS This was a prospective observational study that collected all osteoporotic hip fractures that occurred between March 2013 and February 2014 at the Clinical Unit of Traumatology and Orthopaedics. All cases collected during the first 6 months of the study were followed for 1 year after the occurrence of the event. OUTCOME MEASURES We evaluated the incidence of osteoporotic hip fractures in the Macarena Health Area (Seville) from 1 March 2013 to 28 February 2014, and we compared the incidence with that in 2 previous studies carried out with the same methodology in 1994 and 2006. Furthermore, we calculated the morbidity and degree of disability 1 year after the fracture occurred and determined mortality and the associated factors. RESULTS The overall incidence was 228 per 100 000 individuals/year (95% CI 204.5 to 251.6), and the incidence was higher in women than in men. In women, the incidence rate decreased in all age groups over time, while in men, the incidence rate increased. The mortality rate 1 year after the episode was 27.2%. The factors associated with overall mortality were a body mass index below 25 kg/m2, renal failure and low plasma proteins. CONCLUSIONS Our results show a high incidence of osteoporotic hip fracture that is increasing in men, and in men it is associated with a higher mortality than in women. There is room to improve the modifiable factors associated with mortality and the available rehabilitation interventions to reduce the disability associated with these fractures.
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Affiliation(s)
| | - M A Vazquez-Gamez
- Medicine Department, Universidad de Sevilla Facultad de Medicina, Sevilla, Spain
| | - Mercè Giner
- Citología e Histología Normal y Patológica, Universidad de Sevilla Facultad de Medicina, Sevilla, Spain
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192
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Shuai Y, Liao L, Su X, Sha N, Li X, Wu Y, Jing H, Kuang H, Deng Z, Li Y, Jin Y. Circulating microRNAs in serum as novel biomarkers for osteoporosis: a case-control study. Ther Adv Musculoskelet Dis 2020; 12:1759720X20953331. [PMID: 33029202 PMCID: PMC7522822 DOI: 10.1177/1759720x20953331] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 08/05/2020] [Indexed: 02/05/2023] Open
Abstract
AIMS Osteoporosis is underdiagnosed because of the lack of a convenient diagnostic method. Circulating microRNAs (miRNAs) emerge as novel biomarkers for disease diagnosis. Here, we conducted a case-control study that included a total of 448 serum samples collected from 182 healthy participants, 132 osteopenia participants, and 134 osteoporosis patients. METHODS Circulating miRNAs dysregulated during osteoporosis were screened and analyzed in three randomly determined sub-cohorts: the discovery cohort identified 22 candidate miRNAs; the training cohort tested the candidate miRNAs and constructed Index 1, comprising five miRNAs by logistic regression, and Index 2, comprising four miRNAs, was developed by linear combination. RESULTS Both indices were tested in the validation cohort and showed statistically significant results in distinguishing osteoporosis patients from healthy and osteopenic patients. Moreover, Index 1 also showed improved performance over traditional bone turnover biomarkers type I pro-collagen (tPINP) and type I collagen (β-CTx). CONCLUSION In conclusion, circulating miRNAs are potential biomarkers for osteoporosis. The diagnostic panel of circulating miRNAs could be a complementary method for dual-energy X-ray absorptiometry (DXA) in mass screening and routine examination to enhance the osteoporosis detection rate.
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Affiliation(s)
- Yi Shuai
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Li Liao
- State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Xiaoxia Su
- State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Nanxi Sha
- Department of Health Medical Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Xiaobo Li
- Department of Health Medical Center, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi 710032, China
| | - Yutao Wu
- State Key Laboratory of Oral Disease, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Huan Jing
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Huijuan Kuang
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Zhihong Deng
- Xi'an Institute of Tissue Engineering and Regenerative Medicine, Xi'an, Shaanxi 710032, China
| | - Yongqi Li
- Department of Pediatric, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yan Jin
- State Key Laboratory of Military Stomatology and National Clinical Research Center for Oral Diseases and Shaanxi International Joint Research Center for Oral Diseases, Center for Tissue Engineering, School of Stomatology, Fourth Military Medical University, 145# West Changle Road, Xi'an, Shaanxi 710032, China
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193
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Undertreatment of osteoporosis following hip fracture: a retrospective, observational study in Singapore. Arch Osteoporos 2020; 15:141. [PMID: 32918196 DOI: 10.1007/s11657-020-00816-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Accepted: 09/01/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Undertreatment of osteoporosis after hip fracture increases the risk of death, disability, recurrent osteoporotic fractures, and financial burden. Only half were compliant with osteoporosis medications. Elderly patients were less persistent and compliant to treatment. Denosumab was associated with a higher proportion of days covered by osteoporosis medications than oral bisphosphonates. PURPOSE The aim of this study was to identify factors that contributed to the initiation of osteoporosis medications following hip fracture as well as the compliance and persistence to osteoporosis medications. METHODS Clinical data of 532 patients older than 50 years old admitted for surgical fixation of hip fractures were reviewed. Three hundred forty-seven had sufficient data for analysis after excluding patients with non-fragility fractures. Prescription for any osteoporosis medication in the year following hip fracture as well as compliance to treatment was evaluated. RESULTS Only 40.3% of patients were prescribed with osteoporosis medication within 1 year post-hip fracture. Females (p = 0.020) performing dual-energy x-ray absorptiometry scan (p < 0.001) and 25 hydroxyvitamin D levels testing post-hip fracture (p < 0.027) were independent determinants of increased likelihood of being prescribed with osteoporosis medication. Patients with proportion of days covered (PDC) ≥ 0.8 (or 80% of days covered in a year) were defined as compliant. Overall, only 49.7% of the patients were compliant with osteoporosis medications. Elderly patients aged 70-79 years (p = 0.002) and males (p = 0.017) were less persistent with osteoporosis treatment when compared with patients aged < 69 years and females. The compliance was poorer in patients aged 70-79 years (p = 0.026) as compared with those under 69 years of age. Statistically significant difference (p = 0.032) was observed between mean PDC of oral bisphosphonates (0.66) and denosumab (0.83). Only 39.3% of patients were persistent with treatment at 1 year. CONCLUSION Our findings demonstrate the urgent need to increase awareness through a structured protocol of osteoporosis treatment. A multi-disciplinary Fracture Liaison Service should be set up to ensure compliance to osteoporosis medication post-hip fracture.
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194
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Tang J, Yu H, Wang Y, Duan G, Wang B, Li W, Zhu Z. microRNA-199a counteracts glucocorticoid inhibition of bone marrow mesenchymal stem cell osteogenic differentiation through regulation of Klotho expression in vitro. Cell Biol Int 2020; 44:2532-2540. [PMID: 32869899 DOI: 10.1002/cbin.11460] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 08/11/2020] [Accepted: 08/30/2020] [Indexed: 11/11/2022]
Abstract
Osteogenic differentiation (OD) of bone marrow mesenchymal stem cells (BMSCs) is critically important for mitigation of osteoporosis. Glucocorticoids (GCs) are extensively used for treating chronic inflammation, although long-term exposure to GCs is capable of triggering osteoporosis. microRNAs (miRNAs) have been reported to play a critical role in bone diseases. In the present study, we treated BMSCs with dexamethasone (DEX) during OD to stimulate GC-mediated osteoporosis. Microarray and quantitative polymerase chain reaction (Q-PCR) assays demonstrated that miR-199a was upregulated during OD of BMSCs, while DEX treatment caused a significant reduction in miR-199a. Alkaline phosphatase (ALP) activity, Alizarin red (AR) staining, and Q-PCR were applied to assess the role of miRNA-199a overexpression in DEX-triggered OD inhibition. miR-199a was able to rescue OD and ALP activity, which were inhibited by DEX. Additionally, we observed that ALP, BMP2, COL1A1, and Runx2 were increased after transfection of miRNA-199a mimics. Furthermore, we confirmed that miRNA-199a facilitates OD of BMSCs through direct inhibition of Klotho protein and messenger RNA expression affecting the downstream fibroblast growth factor receptor 1/extracellular-signal-regulated kinase and Janus kinase 1/signal transducer and activator of transcription 1 pathways. This study indicates that miR-199a plays a critical role in preventing GC-mediated osteoblast differentiation and may function as a promising miRNA biomarker for osteoporosis.
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Affiliation(s)
- Jinshan Tang
- Department of Orthopedics, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China.,Department of Orthopedics, The Second People's Hospital of Huai'an, Huai'an, Jiangsu, China
| | - Huaixi Yu
- Department of Orthopedics, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China.,Department of Orthopedics, The Second People's Hospital of Huai'an, Huai'an, Jiangsu, China
| | - Yunqing Wang
- Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Gang Duan
- Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Bin Wang
- Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Wenbo Li
- Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Ziqiang Zhu
- Department of Orthopedics, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou, Jiangsu, China
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195
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Kim JM, Lin C, Stavre Z, Greenblatt MB, Shim JH. Osteoblast-Osteoclast Communication and Bone Homeostasis. Cells 2020; 9:E2073. [PMID: 32927921 PMCID: PMC7564526 DOI: 10.3390/cells9092073] [Citation(s) in RCA: 475] [Impact Index Per Article: 118.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 12/23/2022] Open
Abstract
Bone remodeling is tightly regulated by a cross-talk between bone-forming osteoblasts and bone-resorbing osteoclasts. Osteoblasts and osteoclasts communicate with each other to regulate cellular behavior, survival and differentiation through direct cell-to-cell contact or through secretory proteins. A direct interaction between osteoblasts and osteoclasts allows bidirectional transduction of activation signals through EFNB2-EPHB4, FASL-FAS or SEMA3A-NRP1, regulating differentiation and survival of osteoblasts or osteoclasts. Alternatively, osteoblasts produce a range of different secretory molecules, including M-CSF, RANKL/OPG, WNT5A, and WNT16, that promote or suppress osteoclast differentiation and development. Osteoclasts also influence osteoblast formation and differentiation through secretion of soluble factors, including S1P, SEMA4D, CTHRC1 and C3. Here we review the current knowledge regarding membrane bound- and soluble factors governing cross-talk between osteoblasts and osteoclasts.
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Affiliation(s)
- Jung-Min Kim
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (J.-M.K.); (C.L.); (Z.S.)
| | - Chujiao Lin
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (J.-M.K.); (C.L.); (Z.S.)
| | - Zheni Stavre
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (J.-M.K.); (C.L.); (Z.S.)
| | - Matthew B. Greenblatt
- Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY 10065, USA;
| | - Jae-Hyuck Shim
- Division of Rheumatology, Department of Medicine, University of Massachusetts Medical School, Worcester, MA 01605, USA; (J.-M.K.); (C.L.); (Z.S.)
- Li Weibo Institute for Rare Diseases Research, University of Massachusetts Medical School, Worcester, MA 01605, USA
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196
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Zhao Y, Li Z, Jiang Y, Liu H, Feng Y, Wang Z, Liu H, Wang J, Yang B, Lin Q. Bioinspired mineral hydrogels as nanocomposite scaffolds for the promotion of osteogenic marker expression and the induction of bone regeneration in osteoporosis. Acta Biomater 2020; 113:614-626. [PMID: 32565370 DOI: 10.1016/j.actbio.2020.06.024] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/09/2020] [Accepted: 06/12/2020] [Indexed: 12/14/2022]
Abstract
Osteoporosis is one of the most prevalent age-related diseases worldwide and is characterized by a systemic deterioration of bone strength (bone mineral density and bone quality) with a resulting increase in fragility fractures. Due to the complex osteoporotic pathological environment, it is a huge challenge to induce bone regeneration under osteoporosis conditions. In this study, we successfully nanoengineer a bioinspired mineralized hydrogel from the supramolecular assembly of nano-hydroxyapatite, sodium carbonate, and polyacrylic acid, termed as CHAp-PAA. The resultant nanocomposite hydrogels can maintain their initial morphology and mechanical properties under physiological conditions, while exhibiting good primary stability, biocompatibility, bioactivity, and osteoconductivity. We demonstrate that this optimized hydrogel scaffold has shown superior performance for bone marrow stem cells (BMSCs) proliferation, differentiation, and extracellular matrix production in vitro. Remarkably, the mineralized CHAp-PAA hydrogels could be used as scaffolds for the critical-sized bone defect (6.0 mm diameter and 10.0 mm depth) in the osteoporotic rabbit model. Without the delivery of additional therapeutic agents or stem cells, these CHAp-PAA hydrogel scaffolds can improve bone ingrowth and accelerate new bone formation even in complex osteoporotic pathological environments. Therefore, this work presents a type of bioinspired multifunctional mineral hydrogel that offers an alternative strategy to manage osteoporosis. STATEMENT OF SIGNIFICANCE.
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197
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Characteristics and outcomes of osteoporotic hip fractures: treatment gaps in a tertiary care center in Riyadh, Saudi Arabia. Aging Clin Exp Res 2020; 32:1689-1695. [PMID: 31643073 DOI: 10.1007/s40520-019-01377-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 10/05/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Hip fracture is the most clinically devastating and economically important complication of osteoporosis. Pain, suffering, loss of mobility and independence are some of the devastating consequences of hip fractures. The present study aimed to determine the main characteristics and outcomes of patients with osteoporotic hip fracture and treatment gaps at King Abdulaziz Medical City (KAMC), Riyadh, Saudi Arabia. METHODS This is a single-center, retrospective cohort study analyzing charts of patients > 45 years who were admitted for hip fracture secondary to low-grade trauma from 2008 to 2012. RESULTS A total of 264 patients (50.4% males and 49.6% females) were included. The most common fracture types were trochanter (49%) and femoral neck (46%). History of falls was documented in 115 (43.6%) patients. Bone mineral density (BMD) was assessed in only 41 (15.5%) patients. Majority underwent surgery (92%). Surgical complications occurred in 15 (5.7%) patients and medical complications in 21 (7.9%) patients. Vitamin D and calcium were the most common medications, but given only to 45 (17%) patients. Bone mineral density (BMD) assessment was significantly more frequent post-surgery than pre-surgery (p = 0.03). Very few patients received osteoporosis-specific therapy. F ollow-up revealed that 62 (23.5%) patients died 1 year after surgery. CONCLUSION These present findings warrant urgent reassessment of clinical care and treatments provided to patients with osteoporotic hip fractures to prevent recurrent fractures. The introduction of Fracture Liaison Service (FLS) in institutions caring for patients with hip fractures as internationally recommended will definitely change the current status of care.
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198
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Effect of exercise interventions in the early phase to improve physical function after hip fracture – A systematic review and meta-analysis. Physiotherapy 2020; 108:90-97. [DOI: 10.1016/j.physio.2020.04.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Indexed: 01/06/2023]
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199
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Vertebral stiffness measured via tomosynthesis-based digital volume correlation is strongly correlated with reference values from micro-CT-based DVC. Med Eng Phys 2020; 84:169-173. [PMID: 32977915 DOI: 10.1016/j.medengphy.2020.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/03/2020] [Accepted: 08/24/2020] [Indexed: 11/21/2022]
Abstract
Digital tomosynthesis (DTS) is a clinically available modality that allows imaging of a patient's spine in supine and standing positions. The purpose of this study was to establish the extent to which vertebral displacement and stiffness derived from DTS-based digital volume correlation (DTS-DVC) are correlated with those from a reference method, i.e., microcomputed tomography-based DVC (μCT-DVC). T11 vertebral bodies from 11 cadaveric donors were DTS imaged twice in a nonloaded state and once under a fixed load level approximating upper body weight. The same vertebrae were µCT imaged in nonloaded and loaded states (40 μm voxel size). Vertebral displacements were calculated at each voxel using DVC with pairs of nonloaded and loaded images, from which endplate-to-endplate axial displacement (DDVC) and vertebral stiffness (SDVC) were calculated. Both DDVC and SDVC demonstrated strong positive correlations between DTS-DVC and μCT-DVC, with correlations being stronger when vertebral displacement was calculated using the median (R2=0.80; p<0.0002 and R2=0.93; p<0.0001, respectively) rather than average displacement (R2=0.63; p<0.004 and R2=0.69; p<0.002, respectively). In conclusion, the demonstrated relationship of DTS-DVC with the μCT standard supports further development of a biomechanics-based clinical assessment of vertebral bone quality using the DTS-DVC technique.
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200
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Wu J, Wang C, Li GF, Tang ET, Zheng Q. Quantitative prediction of bone mineral density by using bone turnover markers in response to antiresorptive agents in postmenopausal osteoporosis: A model-based meta-analysis. Br J Clin Pharmacol 2020; 87:1175-1186. [PMID: 32692857 DOI: 10.1111/bcp.14487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 06/26/2020] [Accepted: 07/06/2020] [Indexed: 01/12/2023] Open
Abstract
AIMS This study aimed to predict time course of bone mineral density (BMD) by using corresponding response of bone turnover markers (BTMs) in women with postmenopausal osteoporosis under antiresorptive treatments. METHODS Data were extracted from literature searches in accessible public database. Time courses of percent change from baseline in serum C-telopeptide of type 1 collagen (sCTX) and N-telopeptide of type 1 collagen were described by complex exponential onset models. The relationship between BTM changes and BMD changes at lumbar spine and total hip was described using a multiscale indirect response model. RESULTS The dataset included 41 eligible published trials of 5 US-approved antiresorptive agents (alendronate, ibandronate, risedronate, zoledronic acid and denosumab), containing over 28 800 women with postmenopausal osteoporosis. The time courses of BTM changes for different drugs were differentiated by maximal effect and onset rate in developed model, while sCTX responses to zoledronic acid and denosumab were captured by another model formation. Furthermore, asynchronous relationship between BTMs and BMD was described by a bone remodelling-based semimechanistic model, including zero-order production and first-order elimination induced by N-telopeptide of type 1 collagen and sCTX, separately. After external and informative validations, the developed models were able to predict BMD increase using 1-year data. CONCLUSION This exploratory analysis built a quantitative framework linking BTMs and BMD among antiresorptive agents, as well as a modelling approach to enhance comprehension of dynamic relationship between early and later endpoints among agents in a certain mechanism of action. Moreover, the developed models can offer predictions of BMD from BTMs supporting early drug development.
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Affiliation(s)
- Junyi Wu
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Clinical Pharmacology, Amgen Asia R&D Center, Shanghai, China
| | - Chen Wang
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Clinical Pharmacology, Amgen Asia R&D Center, Shanghai, China.,Clinical Pharmacology, China R&D and Medical Affairs, Janssen Research & Development, Shanghai, China
| | - Guo-Fu Li
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China.,Subei People's Hospital, Yangzhou University, Yangzhou, Jiangsu, China
| | - En-Tzu Tang
- Biostatistics, Amgen Asia R&D Center, Shanghai, China
| | - Qingshan Zheng
- Center for Drug Clinical Research, Shanghai University of Traditional Chinese Medicine, Shanghai, China
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