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Rahmati M, Haffner M, Lee MA, Leach JK, Saiz AM. The critical impact of traumatic muscle loss on fracture healing: Basic science and clinical aspects. J Orthop Res 2024; 42:249-258. [PMID: 37990953 DOI: 10.1002/jor.25746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Revised: 10/05/2023] [Accepted: 11/20/2023] [Indexed: 11/23/2023]
Abstract
Musculoskeletal trauma, specifically fractures, is a leading cause of patient morbidity and disability worldwide. In approximately 20% of cases with fracture and related traumatic muscle loss, bone healing is impaired leading to fracture nonunion. Over the past few years, several studies have demonstrated that bone and the surrounding muscle tissue interact not only anatomically and mechanically but also through biochemical pathways and mediators. Severe damage to the surrounding musculature at the fracture site causes an insufficiency in muscle-derived osteoprogenitor cells that are crucial for fracture healing. As an endocrine tissue, skeletal muscle produces many myokines that act on different bone cells, such as osteoblasts, osteoclasts, osteocytes, and mesenchymal stem cells. Investigating how muscle influences fracture healing at cellular, molecular, and hormonal levels provides translational therapeutic solutions to this clinical challenge. This review provides an overview about the contributions of surrounding muscle tissue in directing fracture healing. The focus of the review is on describing the interactions between bone and muscle in both healthy and fractured environments. We discuss current progress in identifying the bone-muscle molecular pathways and strategies to harness these pathways as cues for accelerating fracture healing. In addition, we review the existing challenges and research opportunities in the field.
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Affiliation(s)
- Maryam Rahmati
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA
| | - Max Haffner
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA
| | - Mark A Lee
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA
| | - Jonathan Kent Leach
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA
- Department of Biomedical Engineering, University of California, Davis, Davis, California, USA
| | - Augustine M Saiz
- Department of Orthopaedic Surgery, University of California, Davis, Sacramento, California, USA
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Wang Y, Ma W, Pu J, Chen F. Interrelationships between sarcopenia, bone turnover markers and low bone mineral density in patients on hemodialysis. Ren Fail 2023; 45:2200846. [PMID: 37122165 PMCID: PMC10134952 DOI: 10.1080/0886022x.2023.2200846] [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: 05/02/2023] Open
Abstract
BACKGROUND Hemodialysis (HD) patients are at risk for sarcopenia (SP) and bone loss, which may impact falls and bone fragility and lead to poor prognosis. Patients with HD and those with osteoporosis (OP) are still underdiagnosed and untreated. The aims of the present study were to evaluate the factors that affect bone mineral density (BMD) loss in HD patients, and explore traditional and novel approaches to manage chronic kidney disease-mineral-bone disorder (CKD-MBD). METHODS Patients who underwent regular HD at the First Affiliated Hospital of Soochow University were retrospectively evaluated. According to the WHO osteoporosis criteria, patients were categorized into three groups: normal BMD, osteopenia, and osteoporosis. Demographic and clinical data, skeletal muscle mass, and bone turnover markers(BTM) were compared between the three groups. The correlation between bone density and muscle mass was calculated, and related risk factors were analyzed. RESULTS This study enrolled 130 HD patients, 36 patients were diagnosed with sarcopenia (27.7%), 44 patients were diagnosed with osteopenia (33.8%), 19 patients were diagnosed with osteoporosis (14.6%), and 23 patients were diagnosed with osteosarcopenia (17.7%). The SMI was positively correlated with the BMD of the lumbar spine (r = 0.23, p < 0.01) and femoral neck (r = 0.22, p < 0.05). In ordinal logistic regression analysis, the odds ratio (OR) for low BMD was high for patients with sarcopenia (OR = 5.894, 95% CI 1.592-21.830, p < 0.01), older age (OR = 1.095, 95% CI 1.041-1.153, p < 0.001), higher TRACP-5b levels (OR = 1.597, 95% CI 1.230-2.072, p < 0.01), and lower 25-OH vitamin D levels (OR = 0.631, 95% CI 0.544-0.733, p < 0.001). CONCLUSION The preservation of skeletal muscle mass could be important to prevent a BMD decrease in HD patients. Adequate intake of vitamin D and control of TRACP-5b levels will help reduce the occurrence and progression of osteopenia/sarcopenia in HD patients.
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Affiliation(s)
- Yilin Wang
- The Blood Purification Center, The First Affiliated Hospital of Soochow University, Suzhou, P. R. China
| | - Wenxia Ma
- Quality Management Dept, The First Affiliated Hospital of Soochow University, Suzhou, P. R. China
| | - Jianhong Pu
- The Center of Health Management, The First Affiliated Hospital of Soochow University, Suzhou, P. R. China
| | - Fengling Chen
- The Blood Purification Center, The First Affiliated Hospital of Soochow University, Suzhou, P. R. China
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Mielke MM, Kapoor E, Geske JR, Fields JA, LeBrasseur NK, Morrow MM, Winham SJ, Faubion LL, Castillo AM, Hofrenning EI, Bailey KR, Rocca WA, Kantarci K. Long-term effects of premenopausal bilateral oophorectomy with or without hysterectomy on physical aging and chronic medical conditions. Menopause 2023; 30:1090-1097. [PMID: 37699239 PMCID: PMC10615715 DOI: 10.1097/gme.0000000000002254] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
OBJECTIVE We examined the long-term effects of premenopausal bilateral oophorectomy (PBO) with or without concurrent or preceding hysterectomy on physical and cognitive function and on odds of chronic conditions. METHODS We enrolled 274 women with PBO with or without concurrent or preceding hysterectomy and 240 referents aged 55 years and older who were residents of Olmsted County, MN as of the PBO or index date. Chronic conditions were assessed via medical record abstraction. Cognitive diagnoses were based on neurocognitive testing. A physical function assessment included measures of strength and mobility. Multivariable regression models compared characteristics for women with PBO <46 years, PBO 46-49 years, and referent women with adjustments for age and other confounders. RESULTS The clinical visits (median age, 67 years) were a median of 22 years after the PBO or index date. Of 274 women with PBO, 161 (59%) were <46 years at PBO and 113 (41%) were 46-49 years. Compared with referents, women with a history of PBO <46 years had increased odds of arthritis (odds ratio [OR], 1.64; 95% confidence interval [CI], 1.06-2.55), asthma (OR, 1.74; 95% CI, 1.03-2.93), obstructive sleep apnea (OR, 2.00; 95% CI, 1.23-3.26), and bone fractures (OR, 2.86; 95% CI, 1.17-6.98), and walked a shorter mean distance on a 6-minute walk test ( b = -18.43; P = 0.034). Compared with referents, women with a history of PBO at age 46-49 years had increased odds of arthritis (OR, 1.92; 95% CI, 1.16-3.18) and obstructive sleep apnea (OR, 2.21; 95% CI, 1.33-3.66). There were no significant differences in cognitive status in women with PBO compared with referents. CONCLUSIONS Women with a history of PBO with or without concurrent or preceding hysterectomy, especially at age <46 years, have more chronic conditions in late mid-life compared with referents.
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Affiliation(s)
- Michelle M. Mielke
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Ekta Kapoor
- Mayo Clinic Center for Women’s Health, Mayo Clinic, Rochester, MN
- Women’s Health Research Center, Mayo Clinic, Rochester, MN
- Division of General Internal Medicine, Mayo Clinic, Rochester, MN
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN
| | - Jennifer R. Geske
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Julie A. Fields
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | - Nathan K. LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic, Rochester, MN
- Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN
| | - Melissa M. Morrow
- University of Texas Medical Branch, Department of Nutrition, Metabolism & Rehabilitation Sciences, Galveston, TX
| | - Stacey J. Winham
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Anna M. Castillo
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | | | - Kent R. Bailey
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
| | - Walter A. Rocca
- Women’s Health Research Center, Mayo Clinic, Rochester, MN
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN
- Department of Neurology, Mayo Clinic, Rochester, MN
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Barr RD, Inglis D, Athale U, Farncombe T, Gordon CL. The Influence of Body Composition on Bone Health in Long-term Survivors of Acute Lymphoblastic Leukemia in Childhood and Adolescence: Analyses by Dual-energy Radiograph Absorptiometry and Peripheral Quantitative Computed Tomography. J Pediatr Hematol Oncol 2022; 44:423-431. [PMID: 35482464 DOI: 10.1097/mph.0000000000002470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/12/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The normal interrelationship of body composition with bone health is less clear in the context of disease. Survivors of acute lymphoblastic leukemia (ALL) exhibit sarcopenic obesity and osteopenia. The impact of body composition on bone health in such survivors was examined. SUBJECTS AND METHODS Survivors of ALL (N=74), >10 years from diagnosis, underwent dual-energy radiograph absorptiometry and peripheral quantitative computed tomography. RESULTS Whole-body bone mineral content (WB BMC) Z scores were greater in males than females, but WB BMC indices (WB BMC/height 2 ) were comparable (0.74±0.125 and 0.72±0.069, respectively). WB BMC index (I) and fat-free mass index correlated significantly with trabecular bone mineral density, only in males. Fat mass index and appendicular lean mass index showed no such correlations. WB BMCI and fat-free mass index also correlated, again predominantly in males, with measures of strength in both trabecular and cortical bone. WB BMCI also correlated strongly with trabecular number, thickness, and hole size, also only in males. CONCLUSIONS The results point to the need for enhancing muscle mass, measured by appendicular lean mass index, while reducing fat mass and maintaining good bone mineralization in long-term survivors of ALL to ensure the integrity of healthy bones.
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Affiliation(s)
| | - Dean Inglis
- Canadian Longitudinal Study on Aging, Department of Health Research Methods, Evidence, and Impact, McMaster University
| | | | - Troy Farncombe
- Department of Nuclear Medicine, Hamilton Health Sciences Corporation, Hamilton, ON, Canada
| | - Christopher L Gordon
- Department of Nuclear Medicine, Hamilton Health Sciences Corporation, Hamilton, ON, Canada
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Chen F, Li Q, Chen Y, Wei Y, Liang J, Song Y, Shi L, Wang J, Mao L, Zhang B, Zhang Z. Association of the gut microbiota and fecal short-chain fatty acids with skeletal muscle mass and strength in children. FASEB J 2021; 36:e22109. [PMID: 34941012 DOI: 10.1096/fj.202002697rrr] [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: 12/11/2020] [Revised: 11/26/2021] [Accepted: 12/06/2021] [Indexed: 12/11/2022]
Abstract
We aimed to investigate whether the gut microbiota and fecal short-chain fatty acids (SCFAs) are associated with skeletal muscle mass and strength in healthy Chinese children aged 6-9 years. In this study, 412 children were enrolled. 16S rRNA gene sequencing was used to characterize the gut microbiota compositions. Fecal SCFAs were quantified using high-performance liquid chromatography. Dual X-ray absorptiometry was used to measure the total body lean soft tissue mass (TSM), total body fat mass (TBF), appendicular skeletal muscle mass (ASM), and appendicular fat mass (AFM). TSM/height2 (TSMI), ASM/height2 (ASMI), TSM/weight (TSMR), ASM/weight (ASMR), and the ratio of TSM/TBF and ASM/AFM were calculated. Handgrip strength (HGS) was measured using the Jamar® Plus+ Hand Dynamometer. A multiple regression analysis after adjustment for covariates and multiple test correction showed some operational taxonomic units in partial least squares models identified by Multivariate methods with Unbiased Variable selection analysis such as genera of Faecalibacterium, Lachnospira, Lachnospiraceae_ND3007_group, and Lachnospiraceae_UCG-004 were positively correlated with at least one measure of TSM, TSMI, ASM, ASMI, and ASMI Z-score (β: 0.103-0.143, pFDR : .008-.032) but negatively correlated with at least one measure of TSMR, TSM/TBF, ASMR, ASM/AFM, and ASMR Z-score (β: -0.185 to 0.124, pFDR = .008-.045). Children with higher fecal butyric acid, acetic acid, and total SCFA levels exhibited higher TSM, ASM, TSMI, ASMI, and ASMI Z-score and lower TSM/TBF, ASM/AFM, TSMR, ASMR, and ASMR Z-score. However, after additional adjustment for TBF or body mass index, only the associations for Faecalitalea and Pyramidobacter still existed. Mediation analysis suggested that total body fat significantly mediated 66.3%-95.3% of the estimated association of microbiota and SCFAs with TSM, ASM, and ASMI Z-score. Our results suggest that the associations of gut microbiota and SCFAs with skeletal muscle quality in children may largely depend upon on total body fat content.
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Affiliation(s)
- Fengyan Chen
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Qing Li
- Department of Dietetics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ying Chen
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Yuanhuan Wei
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China.,Department of Clinical Nutrition, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, China
| | - Jingjing Liang
- Department of Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Yanyan Song
- Department of Child Health Care, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China
| | - Linna Shi
- Department of Dietetics, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jue Wang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Limei Mao
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
| | - Bo Zhang
- Food Safety and Health Research Center, School of Public Health, Southern Medical University, Guangzhou, China
| | - Zheqing Zhang
- Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou, China
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Gries KJ, Zysik VS, Jobe TK, Griffin N, Leeds BP, Lowery JW. Muscle-derived factors influencing bone metabolism. Semin Cell Dev Biol 2021; 123:57-63. [PMID: 34756782 DOI: 10.1016/j.semcdb.2021.10.009] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/28/2021] [Accepted: 10/20/2021] [Indexed: 12/11/2022]
Abstract
A significant amount of attention has been brought to the endocrine-like function of skeletal muscle on various tissues, particularly with bone. Several lines of investigation indicate that the physiology of both bone and muscle systems may be regulated by a given stimulus, such as exercise, aging, and inactivity. Moreover, emerging evidence indicates that bone is heavily influenced by soluble factors derived from skeletal muscle (i.e., muscle-to-bone communication). The purpose of this review is to discuss the regulation of bone remodeling (formation and/or resorption) through skeletal muscle-derived cytokines (hereafter myokines) including the anti-inflammatory cytokine METRNL and pro-inflammatory cytokines (e.g., TNF-α, IL-6, FGF-2 and others). Our goal is to highlight possible therapeutic opportunities to improve muscle and bone health in aging.
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Affiliation(s)
- Kevin J Gries
- Program in Exercise & Sports Science, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA; Bone & Muscle Research Group, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA; Division of Biomedical Science, Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222, USA.
| | - Victoria S Zysik
- Bone & Muscle Research Group, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA; Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222, USA
| | - Tyler K Jobe
- Program in Exercise & Sports Science, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA
| | - Nicole Griffin
- Bone & Muscle Research Group, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA; Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222, USA
| | - Benjamin P Leeds
- Bone & Muscle Research Group, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA; Division of Clinical Affairs, Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222, USA
| | - Jonathan W Lowery
- Bone & Muscle Research Group, Marian University, 3200 Cold Spring Road, Indianapolis, IN 46222, USA; Division of Biomedical Science, Marian University College of Osteopathic Medicine, 3200 Cold Spring Road, Indianapolis, IN 46222, USA
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Caplliure-Llopis J, Escrivá D, Benlloch M, de la Rubia Ortí JE, Estrela JM, Barrios C. Poor Bone Quality in Patients With Amyotrophic Lateral Sclerosis. Front Neurol 2021; 11:599216. [PMID: 33391162 PMCID: PMC7775537 DOI: 10.3389/fneur.2020.599216] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/23/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: Musculoskeletal functional deterioration in Amyotrophic lateral sclerosis (ALS) is associated with an increase in bone fractures. The purpose of this study was to evaluate the influence of sex, ALS type, on bone quality in patients with ALS compared to healthy controls. The impact on bone health of the clinical status and some metabolic parameters was also analyzed in ALS patients. Methods: A series of 33 voluntary patients with ALS, and 66 healthy individuals matched in sex and age underwent assessment of bone mass quality using quantitative ultrasound (QUS) of the calcaneus. Ultrasonic broadband attenuation (BUA), the speed of sound (SOS), stiffness index and T-score were measured. Bone mineral density (BMD) was estimated using standard equations. Apart from fat and muscle mass percentage determinations, clinical baseline measures in ALS patients included ALSFRS-R score, Barthel index for activities of daily living, pulmonary function measured using FVC, and muscular strength assessed by a modified MRC grading scale. Laboratory tests included serum calcium, 25-HO-cholecalciferol (Vitamin D), alkaline phosphatase (ALP), T4 and TSH. Results: All bone parameters evaluated were statistically significant lower in ALS patients than in healthy controls. ALS females showed significantly lower bone parameters than healthy females. According to the estimated BMD, there were 25 ALS patients (75.8%) and 36 (54.5%) healthy individuals showing an osteoporotic profile (BMD <0.700 g/cm2). Only 16.7% of the ALS females had T-scores indicative of healthy bones. There was no correlation between any of the clinical parameters analyzed and the bone QUS measurements. Vitamin D and TSH levels positively correlated with all the bone parameters. Conclusions: This study confirms that ALS patients, particularly females, exhibited deteriorated bone health as compared to healthy individuals. These structural bone changes were independent of ALS subtype and clinical status. Bone health in ALS patients seems to be related to certain metabolic parameters such as Vitamin D and TSH levels.
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Affiliation(s)
- Jordi Caplliure-Llopis
- School of Doctorate, Valencia Catholic University, Valencia, Spain.,Primary Care Services, La Ribera University Hospital, Alzira, Spain
| | - Dolores Escrivá
- Intensive Care Unit, La Fe Polytechnic and University Hospital, Valencia, Spain
| | - María Benlloch
- Department of Anatomy and Physiology, School of Medicine and Health Sciences, Valencia Catholic University, Valencia, Spain
| | - José Enrique de la Rubia Ortí
- Department of Anatomy and Physiology, School of Medicine and Health Sciences, Valencia Catholic University, Valencia, Spain
| | | | - Carlos Barrios
- Institute of Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain
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Huang P, Luo K, Xu J, Huang W, Yin W, Xiao M, Wang Y, Ding M, Huang X. Sarcopenia as a Risk Factor for Future Hip Fracture: A Meta-Analysis of Prospective Cohort Studies. J Nutr Health Aging 2021; 25:183-188. [PMID: 33491032 DOI: 10.1007/s12603-020-1474-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE Our study aims to determine whether sarcopenia is a predictive factor of future hip fractures. DESIGN Systematic review and meta-analysis. Set: We searched for potentially suitable articles in PubMed, Cochrane library, Medline and EMBASE from inception to March 2020. The quality of the research was assessed by the Newcastle-Ottawa Scale (NOS). Finally, a meta-analysis was conducted with the Stata software. PARTICIPANTS Older community-dwelling residents. MEASUREMENTS Hip fracture due to sarcopenia. RESULTS We retrieved 2129 studies through our search strategy, and five studies with 23,359 individuals were analyzed in our pooled analyses. Sarcopenia increases the risk of future hip fractures with a pooled hazard ratio (HR) of 1.42 (95% CI: 1.18-1.71, P <0.001, I2 = 37.7%). In addition, in subgroup analyses based on different definitions of sarcopenia, sarcopenia was associated with the risk of future hip fractures with the Asian Working Group for Sarcopenia (AWGS) criteria with a pooled HR of 2.13(95% CI: 1.33-3.43). When subgroup analyses were conducted by sex, sarcopenia was associated with the risk for future hip fractures in females with pooled HRs of 1.69 (95% CI: 1.18-2.43). Sarcopenia was associated with the risk of future hip fractures in the group with a follow-up period of more than 5 years, with a pooled HR of 1.32 (95% CI: 1.08-1.61), and in the group with a follow-up period of less than 5 years, with a pooled HR of 2.13 (95% CI: 1.33-3.43). CONCLUSIONS Sarcopenia could significantly increase the risk of future hip fracture in old people; thus, it is necessary to prevent hip fractures in individuals with sarcopenia.
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Affiliation(s)
- P Huang
- Mei Ding, Medical College Road, Ganzhou City, Jiangxi Province 341000, China, E-mail address:. Xiaofeng Huang, E-mail address :
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9
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Muscle deficits with normal bone microarchitecture and geometry in young adults with well-controlled childhood-onset Crohn's disease. Eur J Gastroenterol Hepatol 2020; 32:1497-1506. [PMID: 32675776 DOI: 10.1097/meg.0000000000001838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Muscle-bone deficits are common in pediatric Crohn's disease; however, few studies have assessed long-term musculoskeletal outcomes in adults with childhood-onset Crohn's disease. This study assessed the prevalence of musculoskeletal deficits in young adults with childhood-onset Crohn's disease compared with healthy controls. METHODS High-resolution MRI and MR spectroscopy were used to assess bone microarchitecture, cortical geometry and muscle area, and adiposity at distal femur and bone marrow adiposity (BMA) at lumbar spine. Muscle function and biomarkers of the muscle-bone unit were also assessed. RESULTS Twenty-seven adults with Crohn's disease with median (range) age 23.2 years (18.0, 36.1) and 27 age and sex-matched controls were recruited. Trabecular microarchitecture, cortical geometry and BMA were not different between Crohn's disease and controls (P > 0.05 for all). Muscle area was lower (P = 0.01) and muscle fat fraction was higher (P = 0.04) at the distal femur in Crohn's disease compared to controls. Crohn's disease participants had lower grip strength [-4.3 kg (95% confidence interval (CI), -6.8 to -1.8), P = 0.001] and relative muscle power [-5.0 W/kg (95% CI, -8.8 to -1.2), P = 0.01]. Crohn's disease activity scores negatively associated with trabecular bone volume (r = -0.40, P = 0.04) and muscle area (r = -0.41, P = 0.03). CONCLUSION Young adults with well-controlled Crohn's disease managed with contemporary therapies did not display abnormal bone microarchitecture or geometry at the distal femur but exhibited muscle deficits. The observed muscle deficits may predispose to musculoskeletal morbidity in future and interventions to improve muscle mass and function warrant investigation.
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Ohde D, Walz M, Walz C, Noce A, Brenmoehl J, Langhammer M, Hoeflich A. Sex-Specific Control of Muscle Mass: Elevated IGFBP Proteolysis and Reductions of IGF-1 Levels Are Associated with Substantial Loss of Carcass Weight in Male DU6PxIGFBP-2 Transgenic Mice. Cells 2020; 9:cells9102174. [PMID: 32993096 PMCID: PMC7600981 DOI: 10.3390/cells9102174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 09/18/2020] [Accepted: 09/25/2020] [Indexed: 11/16/2022] Open
Abstract
In farmed animals, carcass weight represents an important economic trait. Since we had demonstrated that IGFBP-2 represents a potent inhibitor of muscle accretion in inbred mice, we wanted to quantify the inhibitory effects of IGFBP-2 under conditions of elevated protein mass in growth selected non-inbred mice (DU6P). Therefore, we crossed male DU6P mice with female IGFBP-2 transgenic mice. Male IGFBP-2 transgenic offspring (DU6P/IGFBP-2) were characterized by more than 20% reductions of carcass mass compared to male non-transgenic littermates. The carcass mass in males was also significantly lower (p < 0.001) than in transgenic female DU6P/IGFBP-2 mice, which showed a reduction of less than 10% (p < 0.05) compared to non-transgenic female DU6P/IGFBP-2 mice. Although transgene expression was elevated in the muscle of both sexes (p < 0.001), serum levels were normal in female, but significantly reduced in male transgenic DU6P/IGFBP-2 mice (p < 0.001). In this group, also IGFBP-3 and IGFBP-4 were significantly reduced in the circulation (p < 0.01). Particularly in male transgenic mice, we were able to identify proteolytic activity against recombinant IGFBP-2 included in diluted serum. IGFBP-proteolysis in males correlated with massive reductions of IGF-1 in serum samples and the presence of elevated levels of IGFBP-2 fragments. From our data, we conclude that elevated tissue expression of IGFBP-2 is an essential effector of muscle accretion and may block more than 20% of carcass mass. However, in the circulation, intact IGFBP-2 contained no reliable biomarker content. Notably, for the estimation of breeding values in meat-producing animal species, monitoring of IGFBP-2 expression in muscle appears to be supported by the present study in a model system.
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Affiliation(s)
- Daniela Ohde
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (D.O.); (M.W.); (C.W.); (A.N.); (J.B.)
| | - Michael Walz
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (D.O.); (M.W.); (C.W.); (A.N.); (J.B.)
| | - Christina Walz
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (D.O.); (M.W.); (C.W.); (A.N.); (J.B.)
| | - Antonia Noce
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (D.O.); (M.W.); (C.W.); (A.N.); (J.B.)
| | - Julia Brenmoehl
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (D.O.); (M.W.); (C.W.); (A.N.); (J.B.)
| | - Martina Langhammer
- Institute of Genetics and Biometry, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany;
| | - Andreas Hoeflich
- Institute of Genome Biology, Leibniz-Institute for Farm Animal Biology (FBN), 18196 Dummerstorf, Germany; (D.O.); (M.W.); (C.W.); (A.N.); (J.B.)
- Correspondence: ; Tel.: +49-38208-68744
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Invernizzi M, de Sire A, Carda S, Venetis K, Renò F, Cisari C, Fusco N. Bone Muscle Crosstalk in Spinal Cord Injuries: Pathophysiology and Implications for Patients' Quality of Life. Curr Osteoporos Rep 2020; 18:422-431. [PMID: 32519284 DOI: 10.1007/s11914-020-00601-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW The goal of this review is to provide a comprehensive overview of (i) bone and muscle tissue modifications pathophysiology in spinal cord injury (SCI), (ii) experimental data on the physiopathological mechanisms underpinning these modifications and their similarities with the aging process, and (iii) potential clinical implications in the management of the disabling sequelae of SCI. RECENT FINDINGS Several studies attempted to describe the biology underpinning the links between bone and muscle tissues in the setting of highly disabling conditions, such as osteoporosis, sarcopenia, and neurodegenerative disorders, although these bidirectional connections remain still unclear. SCI could be considered an in vivo paradigmatic model of the bone muscle interactions in unloading conditions that might be expanded in the field of neurodegenerative disorders or cancer studies. Future studies should take into consideration the newer insights into bone muscle crosstalk in order to develop multitargeted and therapeutic interventions.
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Affiliation(s)
- Marco Invernizzi
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy.
| | - Alessandro de Sire
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
- Rehabilitation Unit, "Mons. L. Novarese" Hospital, Moncrivello, Vercelli, Italy
| | - Stefano Carda
- Neuropsychology and Neurorehabilitation Service, Department of Clinical Neuroscience, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Konstantinos Venetis
- Ph.D. Program in Translational Medicine, University of Milan, Milan, Italy
- Division of Pathology, IRCCS European Institute of Oncology (IEO), Milan, Italy
| | - Filippo Renò
- Innovative Research Laboratory for Wound Healing, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
| | - Carlo Cisari
- Physical and Rehabilitative Medicine, Department of Health Sciences, University of Eastern Piedmont, Novara, Italy
- Physical Medicine and Rehabilitation Unit, University Hospital "Maggiore della Carità", Novara, Italy
| | - Nicola Fusco
- Division of Pathology, IRCCS European Institute of Oncology (IEO), Milan, Italy
- Department of Oncology and Hemato-Oncology, University of Milan, Milan, Italy
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12
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Using smartphone accelerometer data to obtain scientific mechanical-biological descriptors of resistance exercise training. PLoS One 2020; 15:e0235156. [PMID: 32667945 PMCID: PMC7363108 DOI: 10.1371/journal.pone.0235156] [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: 12/05/2019] [Accepted: 06/09/2020] [Indexed: 02/07/2023] Open
Abstract
Background Single repetition, contraction-phase specific and total time-under-tension (TUT) are crucial mechano-biological descriptors associated with distinct morphological, molecular and metabolic muscular adaptations in response to exercise, rehabilitation and/or fighting sarcopenia. However, to date, no simple, reliable and valid method has been developed to measure these descriptors. Objective In this study we aimed to test whether accelerometer data obtained from a standard smartphone placed on the weight stack can be used to extract single repetition, contraction-phase specific and total TUT. Methods Twenty-two participants performed two sets of ten repetitions of their 60% one repetition maximum with a self-paced velocity on nine commonly used resistance exercise machines. Two identical smartphones were attached on the resistance exercise weight stacks and recorded all user-exerted accelerations. An algorithm extracted the number of repetitions, single repetition, contraction-phase specific and total TUT. All exercises were video-recorded. The TUT determined from the algorithmically-derived mechano-biological descriptors was compared with the video recordings that served as the gold standard. The agreement between the methods was examined using Limits of Agreement (LoA). The association was calculated using the Pearson correlation coefficients and interrater reliability was determined using the intraclass correlation coefficient (ICC 2.1). Results The error rate of the algorithmic detection of single repetitions derived from two smartphones accelerometers was 0.16%. Comparing algorithmically-derived, contraction-phase specific TUT against video, showed a high degree of correlation (r>0.93) for all exercise machines. Agreement between the two methods was high on all exercise machines as follows: LoA ranged from -0.3 to 0.3 seconds for single repetition TUT (0.1% of mean TUT), from -0.6 to 0.3 seconds for concentric contraction TUT (7.1% of mean TUT), from -0.3 to 0.5 seconds for eccentric contraction TUT (4.1% of mean TUT) and from -1.9 to 1.1 seconds for total TUT (0.5% of mean TUT). Interrater reliability for single repetition, contraction-phase specific TUT was high (ICC > 0.99). Conclusion Data from smartphone accelerometer derived resistance exercise can be used to validly and reliably extract crucial mechano-biological descriptors. Moreover, the presented multi-analytical algorithmic approach enables researchers and clinicians to reliably and validly report missing mechano-biological descriptors.
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Di Monaco M, Castiglioni C, Bardesono F, Milano E, Massazza G. Sarcopenia, osteoporosis and the burden of prevalent vertebral fractures: a cross-sectional study of 350 women with hip fracture. Eur J Phys Rehabil Med 2020; 56:184-190. [PMID: 32052946 DOI: 10.23736/s1973-9087.20.05991-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The concurrent presence of sarcopenia and osteoporosis may enhance fracture risk. AIM The aim of this study was to evaluate the association between sarcopenia, osteoporosis, or the concurrent presence of both the conditions (osteosarcopenia) and the burden (number and severity) of vertebral fractures in women with hip fracture. DESIGN Cross-sectional study. SETTING Division of Physical and Rehabilitation Medicine. POPULATION We studied 350 women with subacute hip fracture. METHODS Lateral radiographs of the spine were taken 18.2±4.5 days after fracture occurrence and the Spine Deformity Index (SDI) was calculated. Body composition was assessed by dual-energy X-ray absorptiometry. Low muscle mass was identified with appendicular lean mass <15.02 kg and low bone mineral density with a femoral T-Score <-2.5. RESULTS The presence of sarcopenia (P=0.033) and osteoporosis (P=0.032) was associated with the SDI scores independently of each other and independently of age, percentage of body fat and hip-fracture type. The 350 women were categorized into 3 groups according to the absence of both osteoporosis and sarcopenia (N.=25), presence of either osteoporosis or sarcopenia (N.=95) or presence of osteosarcopenia (N.=230). We found a significant difference in SDI scores across the 3 groups: χ2 (2, N.=350) = 15.29; P<0.001. The categorization of the 350 women into the 3 groups was associated with the SDI scores (P=0.001) independently of age, percentage of body fat and hip-fracture type. CONCLUSIONS Both osteoporosis and sarcopenia were independently associated with the burden of prevalent vertebral fractures in women with hip fracture. The concurrent presence of sarcopenia and osteoporosis was associated with a higher SDI Score than the presence of only one of the 2 conditions. CLINICAL REHABILITATION IMPACT Subjects with both low bone mass and low muscle mass should be considered at particularly high risk for vertebral fractures. Interventions targeting both the components of the muscle-bone unit, including exercise, nutrition, and possibly new medications, should be investigated to optimize fracture prevention.
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Affiliation(s)
- Marco Di Monaco
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Opera San Camillo Foundation, Turin, Italy -
| | - Carlotta Castiglioni
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Opera San Camillo Foundation, Turin, Italy
| | - Francesca Bardesono
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
| | - Edoardo Milano
- Osteoporosis Research Center, Division of Physical and Rehabilitation Medicine, Presidio Sanitario San Camillo, Opera San Camillo Foundation, Turin, Italy
| | - Giuseppe Massazza
- Division of Physical and Rehabilitation Medicine, Department of Surgical Sciences, University of Turin, Turin, Italy
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Leonard MB, Wehrli FW, Ziolkowski SL, Billig E, Long J, Nickolas TL, Magland JF, Nihtianova S, Zemel BS, Herskovitz R, Rajapakse CS. A multi-imaging modality study of bone density, bone structure and the muscle - bone unit in end-stage renal disease. Bone 2019; 127:271-279. [PMID: 31158505 DOI: 10.1016/j.bone.2019.05.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 05/16/2019] [Accepted: 05/16/2019] [Indexed: 01/10/2023]
Abstract
End stage renal disease (ESRD) is associated with sarcopenia and skeletal fragility. The objectives of this cross-sectional study were to (1) characterize body composition, bone mineral density (BMD) and bone structure in hemodialysis patients compared with controls, (2) assess whether DXA areal BMD (aBMD) correlates with peripheral quantitative CT (pQCT) measures of volumetric BMD (vBMD), cortical dimensions and MRI measures of trabecular microarchitecture, and (3) determine the magnitude of bone deficits in ESRD after adjustment for muscle mass. Thirty ESRD participants, ages 25 to 64 years, were compared with 403 controls for DXA and pQCT outcomes and 104 controls for MRI outcomes; results were expressed as race- and sex- specific Z-scores relative to age. DXA appendicular lean mass index (ALMI kg/m2) and total hip, femoral neck, ultradistal and 1/3rd radius aBMD were significantly lower in ESRD, vs. controls (all p < 0.01). pQCT trabecular vBMD (p < 0.01), cortical vBMD (p < 0.001) and cortical thickness (due to a greater endosteal circumference, p < 0.02) and MRI measures of trabecular number, trabecular thickness, and whole bone stiffness were lower (all p < 0.01) in ESRD, vs. controls. ALMI was positively associated with total hip, femoral neck, ultradistal radius and 1/3rd radius aBMD and with tibia cortical thickness (R = 0.46 to 0.64). Adjustment for ALMI significantly attenuated bone deficits at these sites: e.g. mean femoral neck aBMD was 0.79 SD lower in ESRD, compared with controls and this was attenuated to 0.33 with adjustment for ALMI. In multivariate models within the dialysis participants, pQCT trabecular vBMD and cortical area Z-scores were significant and independently (all p < 0.02) associated with DXA femoral neck, total hip, and ultradistal radius aBMD Z-scores. Cortical vBMD (p = 0.01) and cortical area (p < 0.001) Z-scores were significantly and independently associated with 1/3rd radius areal aBMD Z-scores (R2 = 0.62). These data demonstrate that DXA aBMD captures deficits in trabecular and cortical vBMD and cortical area. The strong associations with ALMI, as an index of skeletal muscle, highlight the importance of considering the role of sarcopenia in skeletal fragility in patients with ESRD.
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Affiliation(s)
- Mary B Leonard
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, United States of America; Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America.
| | - Felix W Wehrli
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Susan L Ziolkowski
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Erica Billig
- Department of Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Jin Long
- Department of Medicine, Stanford University School of Medicine, Stanford, CA, United States of America
| | - Thomas L Nickolas
- Department of Medicine, Columbia University, New York, NY, United States of America
| | - Jeremy F Magland
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Snejana Nihtianova
- Susanne M. Glasscock School of Continuing Studies, Rice University, Houston, TX, United States of America
| | - Babette S Zemel
- Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Rita Herskovitz
- Department of Pediatrics, The Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Chamith S Rajapakse
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, United States of America; Department of Orthopaedic Surgery, University of Pennsylvania, Philadelphia, PA, United States of America
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15
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Paik JM, Rosen HN, Katz JN, Rosner BA, Rimm EB, Gordon CM, Curhan GC. BMI, Waist Circumference, and Risk of Incident Vertebral Fracture in Women. Obesity (Silver Spring) 2019; 27:1513-1519. [PMID: 31318497 PMCID: PMC6707901 DOI: 10.1002/oby.22555] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 05/10/2019] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The study aimed to investigate the association between BMI, waist circumference, and vertebral fracture (VF) risk in women. METHODS This prospective study was conducted in 54,934 Nurses' Health Study participants. BMI was assessed biennially, and waist circumference was assessed in the year 2000. Self-reports of VF were confirmed by record review. BMI reflects lean body mass, and waist circumference reflects abdominal adiposity when included in the same regression model. RESULTS This study included 536 VF cases (2002 to 2014). Compared with women with BMI of 21.0 to 24.9 kg/m2 , the multivariable-adjusted relative risk (RR) of VF for women with BMI ≥ 32.0 was 0.84 (95% CI: 0.61-1.14; Ptrend = 0.08). After further adjustment for waist circumference, the multivariable-adjusted RR of VF for women with BMI ≥ 32.0 was 0.70 (95% CI: 0.49-0.98; Ptrend = 0.003). Compared with women with waist circumference < 71.0 cm, the multivariable-adjusted RR of VF for women with waist circumference ≥ 108.0 cm was 1.76 (95% CI: 1.06-2.92; Ptrend = 0.01), and after further adjustment for BMI, the multivariable-adjusted RR of VF was 2.49 (95% CI: 1.44-4.33; Ptrend < 0.001). CONCLUSIONS Greater lean body mass was independently associated with lower VF risk. Larger waist circumference was independently associated with higher VF risk. These findings suggest that fat distribution is an important predictor of VF and that avoiding central adiposity, as well as maintaining muscle mass, may potentially confer reduced risk of VF in older women.
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Affiliation(s)
- Julie M Paik
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Harold N Rosen
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Endocrinology Division, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Jeffrey N Katz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Rheumatology Division, Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Orthopedic Surgery, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Bernard A Rosner
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Eric B Rimm
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
| | - Catherine M Gordon
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
- Division of Adolescent/Young Adult Medicine, Boston Children's Hospital, Boston, Massachusetts, USA
| | - Gary C Curhan
- Channing Division of Network Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Harvard University, Boston, Massachusetts, USA
- Harvard Medical School, Harvard University, Boston, Massachusetts, USA
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16
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Li G, Zhang L, Wang D, AIQudsy L, Jiang JX, Xu H, Shang P. Muscle-bone crosstalk and potential therapies for sarco-osteoporosis. J Cell Biochem 2019; 120:14262-14273. [PMID: 31106446 DOI: 10.1002/jcb.28946] [Citation(s) in RCA: 92] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2019] [Revised: 04/15/2019] [Accepted: 04/18/2019] [Indexed: 12/17/2022]
Abstract
The nature of muscle-bone crosstalk has been historically considered to be only mechanical, where the muscle is the load applier while bone provides the attachment sites. However, this dogma has been challenged with the emerging notion that bone and muscle act as secretory endocrine organs affect the function of each other. Biochemical crosstalk occurs through myokines such as myostatin, irisin, interleukin (IL)-6, IL-7, IL-15, insulin-like growth factor-1, fibroblast growth factor (FGF)-2, and β-aminoisobutyric acid and through bone-derived factors including FGF23, prostaglandin E2 , transforming growth factor β, osteocalcin, and sclerostin. Aside from the biochemical and mechanical interaction, additional factors including aging, circadian rhythm, nervous system network, nutrition intake, and exosomes also have effects on bone-muscle crosstalk. Here, we summarize the current research progress in the area, which may be conductive to identify potential novel therapies for the osteoporosis and sarcopenia, especially when they develop in parallel.
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Affiliation(s)
- GuoBin Li
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Lan Zhang
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - DongEn Wang
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Luban AIQudsy
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Jean X Jiang
- Department of Biochemistry and Structural Biology, University of Texas Health Science Center, San Antonio, Texas
| | - HuiYun Xu
- Key Laboratory for Space Bioscience and Biotechnology, School of Life Sciences, Northwestern Polytechnical University, Xi'an, Shaanxi, China
| | - Peng Shang
- Research & Development Institute in Shenzhen, Northwestern Polytechnical University, Shenzhen, Guangdong, China
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17
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Wong RMY, Wong H, Zhang N, Chow SKH, Chau WW, Wang J, Chim YN, Leung KS, Cheung WH. The relationship between sarcopenia and fragility fracture-a systematic review. Osteoporos Int 2019; 30:541-553. [PMID: 30610245 DOI: 10.1007/s00198-018-04828-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 14.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 12/21/2018] [Indexed: 12/11/2022]
Abstract
Sarcopenia is a common geriatric syndrome characterized by progressive decrease of muscle mass and function leading to an increased risk of physical disability, poor quality of life, and mortality. Increasing evidence shows that sarcopenia is related with fragility fractures. This systematic review aimed to summarize the following: (1) the prevalence of sarcopenia in patients with fragility fracture and (2) the associated risk factors for fragility fracture in patients with sarcopenia. Literature search was conducted in PubMed and Cochrane databases. Studies with the prevalence of sarcopenia in elderly patients with fragility fracture and associated risk factors in patients with sarcopenia were included. A total of 15 papers were included, with 10 reporting sarcopenia prevalence, and 5 on fracture risk in patients with sarcopenia. The prevalence of sarcopenia after fracture ranged from 12.4 to 95% in males and 18.3 to 64% in females. The prevalence of sarcopenia in elderly patients with fragility fracture was high, especially in men. Two studies showed that sarcopenia was a risk factor for fragility fracture when associated with low bone mineral density (BMD) but only in men. Caution should be taken for male patients with sarcopenia and low BMD, which is related to significantly increased risk of fractures. There is a pressing need for further research on sarcopenia and its risk on fragility fracture to better understand the relationship, pathophysiology, and mechanisms, which may shed light on potential interventions to improve clinical outcomes.
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Affiliation(s)
- R M Y Wong
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - H Wong
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - N Zhang
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - S K H Chow
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
- The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, People's Republic of China
| | - W W Chau
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - J Wang
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - Y N Chim
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - K S Leung
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China
| | - W H Cheung
- Department of Orthopaedics and Traumatology, 5/F, Clinical Sciences Building, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong, SAR, China.
- The CUHK-ACC Space Medicine Centre on Health Maintenance of Musculoskeletal System, The Chinese University of Hong Kong Shenzhen Research Institute, Shenzhen, People's Republic of China.
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Wagner P, Chapurlat R, Ecochard R, Szulc P. Low Muscle Strength and Mass Is Associated With the Accelerated Decline of Bone Microarchitecture at the Distal Radius in Older Men: the Prospective STRAMBO Study. J Bone Miner Res 2018; 33:1630-1640. [PMID: 29734464 DOI: 10.1002/jbmr.3456] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 04/11/2018] [Accepted: 04/22/2018] [Indexed: 12/19/2022]
Abstract
Low muscle mass and strength are associated with poor bone microarchitecture. We studied the association of muscle mass and strength with changes in bone microarchitecture of distal radius in 821 older men during an 8-year prospective follow-up. Bone microarchitecture was assessed by high resolution peripheral quantitative computed tomography (XtremeCT-1, Scanco) at baseline, then after 4 and 8 years. Relative appendicular lean mass of the upper limbs (RALM-u.l.) was calculated as DXA-measured lean mass of upper limbs divided by (height)2 . Relative grip strength was calculated as grip strength divided by height. Decrease in bone mineral content (BMC), total volumetric bone mineral density (Tt.vBMD), cortical thickness (Ct.Th), cortical area (Ct.Ar) and cortical vBMD (Ct.vBMD) accelerated with age. Trabecular area (Tb.Ar) expansion and trabecular bone deterioration accelerated with age. Men in the first RALM-u.l. quartile had more rapid loss of BMC, Tt.vBMD, Ct.Th, Ct.vBMD and Ct.Ar vs. the highest quartile. They had more rapid increase in Tb.Ar. Men in the lowest quartile of grip strength had greater decrease in BMC, Tt.vBMD, Ct.Th, Ct.vBMD, Ct.Ar, and greater increase in Tb.Ar vs. the highest quartile. In the models including ALM-u.l. and grip strength (not corrected for height), both muscle-related variables were associated with more rapid bone microarchitectural deterioration (slightly more so for grip strength). Trabecular vBMD (Tb.vBMD) and Central.Tb.vBMD increased in men having higher muscle mass and strength. Trends in trabecular number and thickness did not differ across the groups in all the analyses. Thus, in men, aging-related deterioration of bone microarchitecture was most rapid after the age of 80. Low grip strength (and slightly more weakly low RALM-u.l.) is associated with the more rapid decrease in Tt.vBMD and cortical variables, and with greater Tb.Ar expansion. In conclusion, dynapenia and sarcopenia contribute to the deterioration of bone microarchitecture in older men. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Philippe Wagner
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
| | - René Ecochard
- Department of Health Biostatistics, UMR CNRS 5558, University of Lyon, Lyon, France
| | - Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hôpital Edouard Herriot, Lyon, France
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19
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Chalhoub D, Boudreau R, Greenspan S, Newman AB, Zmuda J, Frank-Wilson AW, Nagaraj N, Hoffman AR, Lane NE, Stefanick ML, Barrett-Connor E, Dam T, Cawthon PM, Orwoll ES, Cauley JA. Associations Between Lean Mass, Muscle Strength and Power, and Skeletal Size, Density and Strength in Older Men. J Bone Miner Res 2018; 33:1612-1621. [PMID: 29701926 PMCID: PMC6266871 DOI: 10.1002/jbmr.3458] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 04/17/2018] [Accepted: 04/22/2018] [Indexed: 11/06/2022]
Abstract
Studies examining the relationship between muscle parameters and bone strength have not included multiple muscle measurements and/or both central and peripheral skeletal parameters. The purpose of this study was to explore the relationship between lean mass, muscle strength and power, and skeletal size, bone density, and bone strength. We studied the association between appendicular lean mass (ALM), grip strength, and leg power, and central quantitative computed tomography (QCT) parameters in 2857 men aged 65 years or older; peripheral QCT was available on a subset (n = 786). ALM, grip strength, and leg power were measured by dual-energy X-ray absorptiometry (DXA), Jamar dynamometer, and the Nottingham Power Rig, respectively. Multivariable models adjusting for potential confounders including age, race, study site, BMI, and muscle measurements were developed and least squares means were generated from linear regression models. For the multivariable model, percent differences of bone parameters between lowest (Q1) and highest quartiles (Q4) of ALM, grip strength, and leg power were reported. ALM was significantly associated with central and peripheral QCT parameters: percent higher values (Q4 versus Q1) ranging from 3.3% (cortical volumetric bone mineral density [vBMD] of the femoral neck) to 31% (vertebral strength index of the spine). Grip strength was only significantly associated with radial parameters: percent higher values (Q4 versus Q1) ranging from 2.5% (periosteal circumference) to 7.5% (33% axial strength index [SSIx]). Leg power was associated with vertebral strength and lower cross-sectional area with percent lower values (Q4 versus Q1) of -11.9% and -2.7%, respectively. In older men, stronger associations were observed for ALM compared to muscle strength and power. Longitudinal studies are needed to examine the relationship between independent changes in muscle measurements and skeletal size, density and strength. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Didier Chalhoub
- Intramural Research Program, Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Robert Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Susan Greenspan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Joseph Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew W Frank-Wilson
- Intramural Research Program, Laboratory of Epidemiology, and Population Sciences, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Nayana Nagaraj
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Andrew R Hoffman
- Department of Endocrinology, Stanford University School of Medicine, CA, USA
| | - Nancy E Lane
- Center for Musculoskeletal Health, University of California, Davis School of Medicine, Davis, CA, USA
| | - Marcia L Stefanick
- Department of Endocrinology, Stanford University School of Medicine, CA, USA
| | - Elizabeth Barrett-Connor
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA
| | - Tien Dam
- Division of Epidemiology, Department of Family and Preventive Medicine, University of California, San Diego, La Jolla, CA, USA.,Division of Geriatrics and Aging, Columbia University, New York, NY, USA
| | - Peggy M Cawthon
- Research Institute, San Francisco Coordinating Center, California Pacific Medical Center, San Francisco, CA, USA
| | - Eric S Orwoll
- School of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
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20
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Patel HP, Dawson A, Westbury LD, Hasnaoui G, Syddall HE, Shaw S, Sayer AA, Cooper C, Dennison EM. Muscle Mass, Muscle Morphology and Bone Health Among Community-Dwelling Older Men: Findings from the Hertfordshire Sarcopenia Study (HSS). Calcif Tissue Int 2018; 103:35-43. [PMID: 29372275 PMCID: PMC6010484 DOI: 10.1007/s00223-018-0388-2] [Citation(s) in RCA: 10] [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: 10/11/2017] [Accepted: 01/04/2018] [Indexed: 12/21/2022]
Abstract
Sarcopenia and osteoporosis are associated with poor health outcomes in older people. Relationships between muscle and bone have typically been reported at a functional or macroscopic level. The aims of this study were to describe the relationships between muscle morphology and bone health among participants of the Hertfordshire Sarcopenia Study (HSS). 105 older men, mean age 72.5 (SD 2.5) years, were recruited into the HSS. Whole body lean mass as well as appendicular lean mass, lumbar spine and femoral neck bone mineral content (BMC) and bone mineral density (BMD) were obtained through dual-energy X-ray absorptiometry scanning. Percutaneous biopsy of the vastus lateralis was performed successfully in 99 participants. Image analysis was used to determine the muscle morphology variables of slow-twitch (type I) and fast-twitch (type II) myofibre area, myofibre density, capillary and satellite cell (SC) density. There were strong relationships between whole and appendicular lean body mass in relation to femoral neck BMC and BMD (r ≥ 0.43, p < 0.001). Type II fibre area was associated with both femoral neck BMC (r = 0.27, p = 0.01) and BMD (r = 0.26, p = 0.01) with relationships robust to adjustment for age and height. In unadjusted analysis, SC density was associated with whole body area (r = 0.30, p = 0.011) and both BMC (r = 0.26, p = 0.031) and area (r = 0.29, p = 0.017) of the femoral neck. We have demonstrated associations between BMC and changes in muscle at a cellular level predominantly involving type II myofibres. Interventions targeted at improving muscle mass, function and quality may improve overall musculoskeletal health. Larger studies that include women are needed to explore these relationships further.
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Affiliation(s)
- H. P. Patel
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
- 0000 0004 1936 9297grid.5491.9Academic Geriatric Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- grid.430506.4National Institute for Health Research Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, SO16 6YD UK
| | - A. Dawson
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - L. D. Westbury
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - G. Hasnaoui
- 0000 0004 1936 9297grid.5491.9Academic Geriatric Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
| | - H. E. Syddall
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - S. Shaw
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
| | - A. A. Sayer
- 0000 0004 1936 9297grid.5491.9Academic Geriatric Medicine, University of Southampton, Tremona Road, Southampton, SO16 6YD UK
- AGE Research Group, Institute of Neuroscience, Newcastle, UK
- 0000 0001 0462 7212grid.1006.7NIHR Newcastle Biomedical Research Centre, Newcastle upon-Tyne NHS Foundation Trust and Newcastle University, Newcastle, UK
| | - C. Cooper
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
- 0000 0004 1936 8948grid.4991.5National Institute for Health Research Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - E. M. Dennison
- 0000 0004 1936 9297grid.5491.9MRC Lifecourse Epidemiology Unit, University Hospital Southampton, University of Southampton, Tremona Road, Mail point 95, Southampton, SO16 6YD UK
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Clemmons DR. Role of IGF-binding proteins in regulating IGF responses to changes in metabolism. J Mol Endocrinol 2018; 61:T139-T169. [PMID: 29563157 DOI: 10.1530/jme-18-0016] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 03/21/2018] [Indexed: 12/22/2022]
Abstract
The IGF-binding protein family contains six members that share significant structural homology. Their principal function is to regulate the actions of IGF1 and IGF2. These proteins are present in plasma and extracellular fluids and regulate access of both IGF1 and II to the type I IGF receptor. Additionally, they have functions that are independent of their ability to bind IGFs. Each protein is regulated independently of IGF1 and IGF2, and this provides an important mechanism by which other hormones and physiologic variables can regulate IGF actions indirectly. Several members of the family are sensitive to changes in intermediary metabolism. Specifically the presence of obesity/insulin resistance can significantly alter the expression of these proteins. Similarly changes in nutrition or catabolism can alter their synthesis and degradation. Multiple hormones such as glucocorticoids, androgens, estrogen and insulin regulate IGFBP synthesis and bioavailability. In addition to their ability to regulate IGF access to receptors these proteins can bind to distinct cell surface proteins or proteins in extracellular matrix and several cellular functions are influenced by these interactions. IGFBPs can be transported intracellularly and interact with nuclear proteins to alter cellular physiology. In pathophysiologic states, there is significant dysregulation between the changes in IGFBP synthesis and bioavailability and changes in IGF1 and IGF2. These discordant changes can lead to marked alterations in IGF action. Although binding protein physiology and pathophysiology are complex, experimental results have provided an important avenue for understanding how IGF actions are regulated in a variety of physiologic and pathophysiologic conditions.
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Affiliation(s)
- David R Clemmons
- Department of MedicineUNC School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
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22
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Pomeroy E, Mushrif-Tripathy V, Kulkarni B, Kinra S, Stock JT, Cole TJ, Shirley MK, Wells JCK. Estimating body mass and composition from proximal femur dimensions using dual energy x-ray absorptiometry. ARCHAEOLOGICAL AND ANTHROPOLOGICAL SCIENCES 2018; 11:2167-2179. [PMID: 31565085 PMCID: PMC6743672 DOI: 10.1007/s12520-018-0665-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/15/2018] [Accepted: 06/04/2018] [Indexed: 06/10/2023]
Abstract
Body mass prediction from the skeleton most commonly employs femoral head diameter (FHD). However, theoretical predictions and empirical data suggest the relationship between mass and FHD is strongest in young adults, that bone dimensions reflect lean mass better than body or fat mass and that other femoral measurements may be superior. Here, we generate prediction equations for body mass and its components using femoral head, neck and proximal shaft diameters and body composition data derived from dual-energy x-ray absorptiometry (DXA) scans of young adults (n = 155, 77 females and 78 males, mean age 22.7 ± 1.3 years) from the Andhra Pradesh Children and Parents Study, Hyderabad, India. Sex-specific regression of log-transformed data on femoral measurements predicted lean mass with smaller standard errors of estimate (SEEs) than body mass (12-14% and 16-17% respectively), while none of the femoral measurements were significant predictors of fat mass. Subtrochanteric mediolateral shaft diameter gave lower SEEs for lean mass in both sexes and for body mass in males than FHD, while FHD was a better predictor of body mass in women. Our results provide further evidence that lean mass is more closely related to proximal femur dimensions than body or fat mass and that proximal shaft diameter is a better predictor than FHD of lean but not always body mass. The mechanisms underlying these relationships have implications for selecting the most appropriate measurement and reference sample for estimating body or lean mass, which also depend on the question under investigation.
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Affiliation(s)
- Emma Pomeroy
- School of Natural Sciences and Psychology, Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF UK
| | | | | | - Sanjay Kinra
- Department of Non-communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Jay T. Stock
- ADaPt Project, PAVE Research Group, Department of Archaeology and Anthropology, University of Cambridge, Cambridge, UK
| | - Tim J. Cole
- UCL Great Ormond Street Institute of Child Health, UCL, London, UK
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Yang J, Hong N, Shim JS, Rhee Y, Kim HC. Association of Insulin Resistance with Lower Bone Volume and Strength Index of the Proximal Femur in Nondiabetic Postmenopausal Women. J Bone Metab 2018; 25:123-132. [PMID: 29900162 PMCID: PMC5995762 DOI: 10.11005/jbm.2018.25.2.123] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 05/15/2018] [Accepted: 05/17/2018] [Indexed: 12/29/2022] Open
Abstract
Background Type 2 diabetes mellitus is associated with an increased risk of osteoporotic fracture despite relatively preserved bone mineral density (BMD). Although this paradox might be attributed to the influence of insulin resistance (IR) on bone structure and material properties, the association of IR with femur bone geometry and strength indices remains unclear. Methods Using data from the Cardiovascular and Metabolic Disease Etiology Research Center cohort study, we conducted a cross-sectional analysis among nondiabetic postmenopausal women. IR was estimated using the homeostasis model assessment of IR (HOMA-IR). Compartment-specific volumetric BMD (vBMD) and bone volume of proximal femur were measured using quantitative computed tomography. The compressive strength index (CSI), section modulus (Z), and buckling ratio of the femoral neck were calculated as bone strength indices. Results Among 1,008 subjects (mean age, 57.3 years; body mass index [BMI], 23.6 kg/m2), BMI, waist circumference, and vBMD of the femoral neck and total hip increased in a linear trend from the lowest (<1.37) to highest (≥2.27) HOMA-IR quartile (P<0.05 for all). The HOMA-IR showed an independent negative association with total bone volume (standardized β=−0.12), cortical volume (β=−0.05), CSI (β=−0.013), and Z (β=−0.017; P<0.05 for all) of the femoral neck after adjustment for age, weight, height, physical activity, and vitamin D and high-sensitivity C-reactive protein levels. However, the association between HOMA-IR and vBMD was attenuated in the adjusted model (femoral neck, β=0.94; P=0.548). Conclusions Elevated HOMA-IR was associated with lower cortical bone volume and bone strength indices in nondiabetic postmenopausal women, independent of age and body size.
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Affiliation(s)
- Jaewon Yang
- Department of Public Health, Yonsei University Graduate School, Seoul, Korea
| | - Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jee-Seon Shim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Cardiovascular and Metabolic Diseases Etiology Research Center, Yonsei University College of Medicine, Seoul, Korea.,Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Korea
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Pomeroy E, Macintosh A, Wells JC, Cole TJ, Stock JT. Relationship between body mass, lean mass, fat mass, and limb bone cross-sectional geometry: Implications for estimating body mass and physique from the skeleton. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2018; 166:56-69. [PMID: 29344931 PMCID: PMC6178563 DOI: 10.1002/ajpa.23398] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/16/2017] [Accepted: 12/18/2017] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Estimating body mass from skeletal dimensions is widely practiced, but methods for estimating its components (lean and fat mass) are poorly developed. The ability to estimate these characteristics would offer new insights into the evolution of body composition and its variation relative to past and present health. This study investigates the potential of long bone cross-sectional properties as predictors of body, lean, and fat mass. MATERIALS AND METHODS Humerus, femur and tibia midshaft cross-sectional properties were measured by peripheral quantitative computed tomography in sample of young adult women (n = 105) characterized by a range of activity levels. Body composition was estimated from bioimpedance analysis. RESULTS Lean mass correlated most strongly with both upper and lower limb bone properties (r values up to 0.74), while fat mass showed weak correlations (r ≤ 0.29). Estimation equations generated from tibial midshaft properties indicated that lean mass could be estimated relatively reliably, with some improvement using logged data and including bone length in the models (minimum standard error of estimate = 8.9%). Body mass prediction was less reliable and fat mass only poorly predicted (standard errors of estimate ≥11.9% and >33%, respectively). DISCUSSION Lean mass can be predicted more reliably than body mass from limb bone cross-sectional properties. The results highlight the potential for studying evolutionary trends in lean mass from skeletal remains, and have implications for understanding the relationship between bone morphology and body mass or composition.
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Affiliation(s)
- Emma Pomeroy
- School of Natural Sciences and PsychologyLiverpool John Moores UniversityLiverpool, L3 3AFUnited Kingdom
| | - Alison Macintosh
- ADaPt Project, PAVE Research Group, Department of Archaeology and AnthropologyUniversity of CambridgeCambridge, CB2 3QGUnited Kingdom
| | - Jonathan C.K. Wells
- UCL Great Ormond Street Institute of Child HealthLondon, WC1N 1EHUnited Kingdom
| | - Tim J. Cole
- UCL Great Ormond Street Institute of Child HealthLondon, WC1N 1EHUnited Kingdom
| | - Jay T. Stock
- ADaPt Project, PAVE Research Group, Department of Archaeology and AnthropologyUniversity of CambridgeCambridge, CB2 3QGUnited Kingdom
- Department of AnthropologyUniversity of Western OntarioLondonOntario, N6A 3K7Canada
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25
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The temporospatial pattern of energy metabolism coordinates the interactions between the bones and other organ systems. J Oral Biosci 2018. [DOI: 10.1016/j.job.2017.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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26
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Self-reported protein intake and properties of bone in community-dwelling older individuals. Arch Osteoporos 2018; 13:10. [PMID: 29388047 PMCID: PMC5846856 DOI: 10.1007/s11657-018-0421-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Accepted: 12/21/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study revealed that a quick and simple estimation of protein intake was related to measures of bone density and area in 70-year-old individuals. Furthermore, these associations were mediated by muscle mass when investigating peripheral measurement sites such as arms and legs. PURPOSE Recent evidence suggests that dietary protein is beneficial for bone health in older individuals, but less is known about the influence of muscle mass on this relationship. This cross-sectional study aimed to investigate associations among protein intake, bone health, and muscle mass in 2332 men and women aged 70 years. METHODS Volumetric bone mineral density of the radius and tibia was measured using peripheral quantitative computed tomography. Using dual-energy X-ray absorptiometry, we measured areal bone mineral density (aBMD) at the L1-L4 vertebrae, radius, and femoral neck, together with appendicular lean mass. Participants reported their average meal size and proportion of meat/fish intake. Associations were investigated using multiple linear regression models, adjusted for multiple covariates. RESULTS Self-reported protein intake was associated with aBMD of the femoral neck (β = 0.082) and L1-L4 vertebrae (β = 0.063) in men (both p < 0.05) after adjusting for multiple covariates, including appendicular muscle mass. No significant association was detected among women. In addition, protein intake was associated with tibial cortical area (β = 0.08), periosteal circumference (β = 0.072), radial aBMD (β = 0.064), and trabecular area (β = 0.078) in men (all p < 0.05), although these associations were attenuated after adjustment for appendicular muscle mass (all p > 0.05). CONCLUSION Self-reported protein intake was associated with bone properties in 70-year-old men. The strength of these associations in peripheral bone sites may be partially mediated by muscle mass from protein intake.
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Wang H, Yi J, Li X, Xiao Y, Dhakal K, Zhou J. ALS-associated mutation SOD1 G93A leads to abnormal mitochondrial dynamics in osteocytes. Bone 2018; 106:126-138. [PMID: 29030231 PMCID: PMC5718158 DOI: 10.1016/j.bone.2017.10.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2017] [Revised: 10/05/2017] [Accepted: 10/09/2017] [Indexed: 12/13/2022]
Abstract
While the death of motor neuron is a pathological hallmark of amyotrophic lateral sclerosis (ALS), defects in other cell types or organs may also actively contribute to ALS disease progression. ALS patients experience progressive skeletal muscle wasting that may not only exacerbate neuronal degeneration, but likely has a significant impact on bone function. In our previous published study, we have discovered severe bone loss in an ALS mouse model with overexpression of ALS-associated mutation SOD1G93A (G93A). Here we further provide a mechanistic understanding of the bone loss in ALS animal and cellular models. Combining mitochondrial fluorescent indicators and confocal live cell imaging, we discovered abnormalities in mitochondrial network and dynamics in primary osteocytes derived from the same ALS mouse model G93A. Those mitochondrial defects occur in ALS mice after the onset of neuromuscular symptoms, indicating that mitochondria in bone cells respond to muscle atrophy during ALS disease progression. To examine whether ALS mutation has a direct contribution to mitochondrial dysfunction independent of muscle atrophy, we evaluated mitochondrial morphology and motility in cultured osteocytes (MLO-Y4) with overexpression of mitochondrial targeted SOD1G93A. Compared with osteocytes overexpressing the wild type SOD1 as a control, the SOD1G93A osteocytes showed similar defects in mitochondrial network and dynamic as that of the primary osteocytes derived from the ALS mouse model. In addition, we further discovered that overexpression of SOD1G93A enhanced the expression level of dynamin-related protein 1 (Drp1), a key protein promoting mitochondrial fission activity, and reduced the expression level of optic atrophy protein 1 (OPA1), a key protein related to mitochondrial fusion. A specific mitochondrial fission inhibitor (Mdivi-1) partially reversed the effect of SOD1G93A on mitochondrial network and dynamics, indicating that SOD1G93A likely promotes mitochondrial fission, but suppresses the fusion activity. Our data provide the first evidence that mitochondria show abnormality in osteocytes derived from an ALS mouse model. The accumulation of mutant SOD1G93A protein inside mitochondria directly causes dysfunction in mitochondrial dynamics in cultured MLO-Y4 osteocytes. In addition, the ALS mutation SOD1G93A-mediated dysfunction in mitochondrial dynamics is associated with an enhanced apoptosis in osteocytes, which could be a potential mechanism underlying the bone loss during ALS progression.
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Affiliation(s)
- Huan Wang
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Jianxun Yi
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Xuejun Li
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Yajuan Xiao
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Kamal Dhakal
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA
| | - Jingsong Zhou
- Kansas City University of Medicine and Bioscience, Kansas City, MO, USA.
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Abstract
PURPOSE OF REVIEW This review assembles recent understanding of the profound loss of muscle and bone in spinal cord injury (SCI). It is important to try to understand these changes, and the context in which they occur, because of their impact on the wellbeing of SC-injured individuals, and the urgent need for viable preventative therapies. RECENT FINDINGS Recent research provides new understanding of the effects of age and systemic factors on the response of bone to loading, of relevance to attempts to provide load therapy for bone in SCI. The rapidly growing dataset describing the biochemical crosstalk between bone and muscle, and the cell and molecular biology of myokines signalling to bone and osteokines regulating muscle metabolism and mass, is reviewed. The ways in which this crosstalk may be altered in SCI is summarised. Therapeutic approaches to the catabolic changes in muscle and bone in SCI require a holistic understanding of their unique mechanical and biochemical context.
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Affiliation(s)
- Jillian M Clark
- Discipline of Orthopaedics and Trauma, The University of Adelaide, North Terrace, Adelaide, South Australia, 5000, Australia.
| | - David M Findlay
- Discipline of Orthopaedics and Trauma, The University of Adelaide, North Terrace, Adelaide, South Australia, 5000, Australia
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Hart N, Nimphius S, Rantalainen T, Ireland A, Siafarikas A, Newton R. Mechanical basis of bone strength: influence of bone material, bone structure and muscle action. JOURNAL OF MUSCULOSKELETAL & NEURONAL INTERACTIONS 2017; 17:114-139. [PMID: 28860414 PMCID: PMC5601257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Accepted: 05/19/2017] [Indexed: 11/09/2022]
Abstract
This review summarises current understanding of how bone is sculpted through adaptive processes, designed to meet the mechanical challenges it faces in everyday life and athletic pursuits, serving as an update for clinicians, researchers and physical therapists. Bone's ability to resist fracture under the large muscle and locomotory forces it experiences during movement and in falls or collisions is dependent on its established mechanical properties, determined by bone's complex and multidimensional material and structural organisation. At all levels, bone is highly adaptive to habitual loading, regulating its structure according to components of its loading regime and mechanical environment, inclusive of strain magnitude, rate, frequency, distribution and deformation mode. Indeed, the greatest forces habitually applied to bone arise from muscular contractions, and the past two decades have seen substantial advances in our understanding of how these forces shape bone throughout life. Herein, we also highlight the limitations of in vivo methods to assess and understand bone collagen, and bone mineral at the material or tissue level. The inability to easily measure or closely regulate applied strain in humans is identified, limiting the translation of animal studies to human populations, and our exploration of how components of mechanical loading regimes influence mechanoadaptation.
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Affiliation(s)
- N.H. Hart
- Exercise Medicine Research Institute, Edith Cowan University, Perth, W.A., Australia
- Western Australian Bone Research Collaboration, Perth, W.A., Australia
| | - S. Nimphius
- Western Australian Bone Research Collaboration, Perth, W.A., Australia
- Centre for Exercise and Sport Science Research, Edith Cowan University, Perth, W.A., Australia
| | - T. Rantalainen
- Western Australian Bone Research Collaboration, Perth, W.A., Australia
- School of Exercise and Nutrition Sciences, Deakin University, Melbourne, VIC, Australia
| | - A. Ireland
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - A. Siafarikas
- Western Australian Bone Research Collaboration, Perth, W.A., Australia
- Department of Endocrinology, Princess Margaret Hospital, Perth, W.A., Australia
- School of Paediatrics and Child Health, University of Western Australia, Perth, W.A., Australia
- Institute of Health Research, University of Notre Dame Australia, Perth, W.A., Australia
| | - R.U. Newton
- Exercise Medicine Research Institute, Edith Cowan University, Perth, W.A., Australia
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Verroken C, Pieters W, Beddeleem L, Goemaere S, Zmierczak HG, Shadid S, Kaufman JM, Lapauw B. Cortical Bone Size Deficit in Adult Patients With Type 1 Diabetes Mellitus. J Clin Endocrinol Metab 2017; 102:2887-2895. [PMID: 28531321 DOI: 10.1210/jc.2017-00620] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2017] [Accepted: 05/15/2017] [Indexed: 01/01/2023]
Abstract
CONTEXT The increased fracture risk associated with type 1 diabetes mellitus (T1DM) remains unexplained by traditional risk factors such as low areal bone mineral density (aBMD). Nonetheless, few data exist on other determinants of bone strength in T1DM, including volumetric bone mineral density (vBMD) and bone geometry. OBJECTIVE We compared areal and volumetric bone parameters and cortical bone geometry in adult T1DM patients and sex- and age-matched controls. DESIGN Cross-sectional study including 64 adult T1DM patients (38 men; mean age, 41.1 ± 8.1 years) and 63 sex- and age-matched controls. MAIN OUTCOME MEASURES Areal bone parameters using dual-energy X-ray absorptiometry; volumetric bone parameters and cortical bone geometry using peripheral quantitative computed tomography. RESULTS T1DM was associated with lower aBMD at the total body, femoral neck, and total hip; lower trabecular vBMD at the distal radius; and higher cortical but lower total vBMD at the radial shaft. In addition, subjects with T1DM had a similar periosteal but larger endosteal circumference, smaller cortical thickness, and lower cortical over total bone area ratio. Differences in bone parameters could not be explained by differences in bone turnover markers or body composition, but cortical area was inversely associated with glycemic variability and long-term glycemic control. CONCLUSIONS Besides decreased aBMD and trabecular vBMD, adult T1DM patients present with a cortical bone size deficit, which may contribute to their increased fracture risk. This deficit is mainly situated at the endosteal envelope, suggesting imbalanced remodeling rather than compromised modeling processes as the underlying mechanism.
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Affiliation(s)
- Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Wout Pieters
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Loïc Beddeleem
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hans-Georg Zmierczak
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
| | - Samyah Shadid
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jean-Marc Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, 9000 Ghent, Belgium
- Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
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Verroken C, Zmierczak HG, Goemaere S, Kaufman JM, Lapauw B. Insulin Resistance Is Associated With Smaller Cortical Bone Size in Nondiabetic Men at the Age of Peak Bone Mass. J Clin Endocrinol Metab 2017; 102:1807-1815. [PMID: 28001453 DOI: 10.1210/jc.2016-3609] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Accepted: 12/19/2016] [Indexed: 01/27/2023]
Abstract
CONTEXT In type 2 diabetes mellitus, fracture risk is increased despite preserved areal bone mineral density. Although this apparent paradox may in part be explained by insulin resistance affecting bone structure and/or material properties, few studies have investigated the association between insulin resistance and bone geometry. OBJECTIVE We aimed to explore this association in a cohort of nondiabetic men at the age of peak bone mass. DESIGN, SETTING, AND PARTICIPANTS Nine hundred ninety-six nondiabetic men aged 25 to 45 years were recruited in a cross-sectional, population-based sibling pair study at a university research center. MAIN OUTCOME MEASURES Insulin resistance was evaluated using the homeostasis model assessment of insulin resistance (HOMA-IR), with insulin and glucose measured from fasting serum samples. Bone geometry was assessed using peripheral quantitative computed tomography at the distal radius and the radial and tibial shafts. RESULTS In age-, height-, and weight-adjusted analyses, HOMA-IR was inversely associated with trabecular area at the distal radius and with cortical area, periosteal and endosteal circumference, and polar strength strain index at the radial and tibial shafts (β ≤ -0.13, P < 0.001). These associations remained essentially unchanged after additional adjustment for dual-energy X-ray absorptiometry-derived body composition, bone turnover markers, muscle size or function measurements, or adiponectin, leptin, insulin-like growth factor 1, or sex steroid levels. CONCLUSION In this cohort of nondiabetic men at the age of peak bone mass, insulin resistance is inversely associated with trabecular and cortical bone size. These associations persist after adjustment for body composition, muscle size or function, or sex steroid levels, suggesting an independent effect of insulin resistance on bone geometry.
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Affiliation(s)
- Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Hans-Georg Zmierczak
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Jean-Marc Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, 9000 Ghent, Belgium
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Cianferotti L, Bertoldo F, Carini M, Kanis JA, Lapini A, Longo N, Martorana G, Mirone V, Reginster JY, Rizzoli R, Brandi ML. The prevention of fragility fractures in patients with non-metastatic prostate cancer: a position statement by the international osteoporosis foundation. Oncotarget 2017; 8:75646-75663. [PMID: 29088899 PMCID: PMC5650454 DOI: 10.18632/oncotarget.17980] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 04/20/2017] [Indexed: 12/13/2022] Open
Abstract
Androgen deprivation therapy is commonly employed for the treatment of non-metastatic prostate cancer as primary or adjuvant treatment. The skeleton is greatly compromised in men with prostate cancer during androgen deprivation therapy because of the lack of androgens and estrogens, which are trophic factors for bone. Men receiving androgen deprivation therapy sustain variable degrees of bone loss with an increased risk of fragility fractures. Several bone antiresorptive agents have been tested in randomized controlled trials in these patients. Oral bisphosphonates, such as alendronate and risedronate, and intravenous bisphosphonates, such as pamidronate and zoledronic acid, have been shown to increase bone density and decrease the risk of fractures in men receiving androgen deprivation therapy. Denosumab, a fully monoclonal antibody that inhibits osteoclastic-mediated bone resorption, is also effective in increasing bone mineral density and reducing fracture rates in these patients. The assessment of fracture risk, T-score and/or the evaluation of prevalent fragility fractures are mandatory for the selection of patients who will benefit from antiresorptive therapy. In the future, new agents modulating bone turnover and skeletal muscle metabolism will be available for testing in these subjects.
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Affiliation(s)
- Luisella Cianferotti
- Department of Surgery and Translational Medicine, University of Florence, University Hospital of Florence, Florence, Italy
| | | | - Marco Carini
- Department of Urology, University of Florence, University Hospital of Florence, Largo Brambilla Florence, Italy
| | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, United Kingdom
| | - Alberto Lapini
- Department of Urology, University of Florence, University Hospital of Florence, Largo Brambilla Florence, Italy
| | - Nicola Longo
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Giuseppe Martorana
- Department of Urology, S Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Vincenzo Mirone
- Department of Urology, University of Naples Federico II, Naples, Italy
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liege, CHU Sart-Tilman, Liege, Belgium
| | - Rene Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University of Florence, University Hospital of Florence, Florence, Italy
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Guo B, Zhang ZK, Liang C, Li J, Liu J, Lu A, Zhang BT, Zhang G. Molecular Communication from Skeletal Muscle to Bone: A Review for Muscle-Derived Myokines Regulating Bone Metabolism. Calcif Tissue Int 2017; 100:184-192. [PMID: 27830278 DOI: 10.1007/s00223-016-0209-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 11/01/2016] [Indexed: 01/26/2023]
Abstract
Besides the mechanical loading-dependent paradigm, skeletal muscle also serves as an endocrine organ capable of secreting cytokines to modulate bone metabolism. In this review, we focused on reviewing the myokines involved in communication from skeletal muscle to bone, i.e. (1) myostatin and myostatin-binding proteins including follistatin and decorin, (2) interleukins including interleukin-6 (IL-6), interleukin-7 (IL-7) and interleukin-15 (IL-15), (3) insulin-like growth factor 1 (IGF-1) and its binding proteins, (4) other myokines including PGC-1α-irisin system and osteoglycin (OGN). To better understand the molecular communication from skeletal muscle to bone, we have summarized the recent advances in muscle-derived cytokines regulating bone metabolism in this review.
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Affiliation(s)
- Baosheng Guo
- Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Zong-Kang Zhang
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Chao Liang
- Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Jie Li
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Jin Liu
- Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China
| | - Aiping Lu
- Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.
| | - Bao-Ting Zhang
- School of Chinese Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Ge Zhang
- Institute for Advancing Translational Medicine in Bone and Joint Diseases, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong SAR, China.
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Zymbal V, Janz KF, Baptista F. Sexual dimorphism in bone–muscle relationship in young adults. J Sports Sci 2016; 35:2433-2438. [DOI: 10.1080/02640414.2016.1273535] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Vera Zymbal
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
| | - Kathleen F. Janz
- Department of Health and Human Physiology and Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Fátima Baptista
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Lisbon, Portugal
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Bruno E, Roveda E, Vitale J, Montaruli A, Berrino F, Villarini A, Venturelli E, Gargano G, Galasso L, Caumo A, Carandente F, Pasanisi P. Effect of aerobic exercise intervention on markers of insulin resistance in breast cancer women. Eur J Cancer Care (Engl) 2016; 27:e12617. [DOI: 10.1111/ecc.12617] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2016] [Indexed: 12/20/2022]
Affiliation(s)
- E. Bruno
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - E. Roveda
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - J. Vitale
- IRCCS Istituto Ortopedico Galeazzi; Milan Italy
| | - A. Montaruli
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - F. Berrino
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - A. Villarini
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - E. Venturelli
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - G. Gargano
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
| | - L. Galasso
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - A. Caumo
- Research Centre of Metabolism; IRCCS Policlinico San Donato Milanese; Milan Italy
| | - F. Carandente
- Department of Biomedical Sciences for Health; University of Milan; Milan Italy
| | - P. Pasanisi
- Department of Predictive & Preventive Medicine; Fondazione IRCCS Istituto Nazionale dei Tumori; Milan Italy
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Hars M, Biver E, Chevalley T, Herrmann F, Rizzoli R, Ferrari S, Trombetti A. Low Lean Mass Predicts Incident Fractures Independently From FRAX: a Prospective Cohort Study of Recent Retirees. J Bone Miner Res 2016; 31:2048-2056. [PMID: 27253633 DOI: 10.1002/jbmr.2878] [Citation(s) in RCA: 70] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2016] [Revised: 05/17/2016] [Accepted: 05/28/2016] [Indexed: 12/25/2022]
Abstract
Whether low muscle mass predisposes to fracture is still poorly understood. In the diagnosis of sarcopenia, different thresholds for low lean mass have been proposed but comparative data for these criteria against hard outcomes such as fractures are lacking. This study aimed to investigate the prevalence of low lean mass according to different thresholds used in operational definitions of sarcopenia and their association with 3-year fracture incidence in a cohort of healthy 63- to 67-year-old community dwellers. In a longitudinal analysis of 913 participants (mean age 65.0 ± 1.4 years) enrolled in the Geneva Retirees Cohort (GERICO) study, lean mass was assessed by dual-energy X-ray absorptiometry (DXA), and low trauma clinical fracture incidence was recorded over a 3-year period. Prevalence of low lean mass ranged from 3.5% to 20.2% according to the threshold applied. During a follow-up of 3.4 ± 0.9 years, 40 (4.4%) participants sustained at least one low trauma fracture. After multivariate adjustment including Fracture Risk Assessment Tool (FRAX) probability with femoral neck bone mineral density (BMD), low lean mass, as defined by Baumgartner thresholds, was associated with higher fracture risk (odds ratio [OR], 2.32; 95% CI, 1.04 to 5.18; p = 0.040). It also added significant predictive value beyond FRAX (likelihood ratio test for nested models, 4.28; p < 0.039). No significant association was found for other definition thresholds. The coexistence of sarcopenia and a T-score <-2.5 at spine or hip was associated with a 3.39-fold (95% CI, 1.54 to 7.46; p = 0.002) increase in low trauma fracture risk. In conclusion, low lean mass, as defined by the Baumgartner thresholds, is a predictor of incident fractures in a large cohort of healthy 65-year-old community dwellers, independently of FRAX probability. The increased risk is related to the threshold for low lean mass selected. These findings suggest that identification of sarcopenia should be considered in fracture risk assessment beyond usual risk factors. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Mélany Hars
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Emmanuel Biver
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Thierry Chevalley
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - François Herrmann
- Division of Geriatrics, Department of Internal Medicine Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Thônex, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Serge Ferrari
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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38
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Laurent MR, Dubois V, Claessens F, Verschueren SMP, Vanderschueren D, Gielen E, Jardí F. Muscle-bone interactions: From experimental models to the clinic? A critical update. Mol Cell Endocrinol 2016; 432:14-36. [PMID: 26506009 DOI: 10.1016/j.mce.2015.10.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 10/13/2015] [Accepted: 10/20/2015] [Indexed: 02/06/2023]
Abstract
Bone is a biomechanical tissue shaped by forces from muscles and gravitation. Simultaneous bone and muscle decay and dysfunction (osteosarcopenia or sarco-osteoporosis) is seen in ageing, numerous clinical situations including after stroke or paralysis, in neuromuscular dystrophies, glucocorticoid excess, or in association with vitamin D, growth hormone/insulin like growth factor or sex steroid deficiency, as well as in spaceflight. Physical exercise may be beneficial in these situations, but further work is still needed to translate acceptable and effective biomechanical interventions like vibration therapy from animal models to humans. Novel antiresorptive and anabolic therapies are emerging for osteoporosis as well as drugs for sarcopenia, cancer cachexia or muscle wasting disorders, including antibodies against myostatin or activin receptor type IIA and IIB (e.g. bimagrumab). Ideally, increasing muscle mass would increase muscle strength and restore bone loss from disuse. However, the classical view that muscle is unidirectionally dominant over bone via mechanical loading is overly simplistic. Indeed, recent studies indicate a role for neuronal regulation of not only muscle but also bone metabolism, bone signaling pathways like receptor activator of nuclear factor kappa-B ligand (RANKL) implicated in muscle biology, myokines affecting bone and possible bone-to-muscle communication. Moreover, pharmacological strategies inducing isolated myocyte hypertrophy may not translate into increased muscle power because tendons, connective tissue, neurons and energy metabolism need to adapt as well. We aim here to critically review key musculoskeletal molecular pathways involved in mechanoregulation and their effect on the bone-muscle unit as a whole, as well as preclinical and emerging clinical evidence regarding the effects of sarcopenia therapies on osteoporosis and vice versa.
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Affiliation(s)
- Michaël R Laurent
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium; Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium.
| | - Vanessa Dubois
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Frank Claessens
- Laboratory of Molecular Endocrinology, Department of Cellular and Molecular Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Sabine M P Verschueren
- Research Group for Musculoskeletal Rehabilitation, Department of Rehabilitation Science, KU Leuven, 3000 Leuven, Belgium
| | - Dirk Vanderschueren
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
| | - Evelien Gielen
- Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium; Centre for Metabolic Bone Diseases, University Hospitals Leuven, 3000 Leuven, Belgium
| | - Ferran Jardí
- Clinical and Experimental Endocrinology, Department of Clinical and Experimental Medicine, KU Leuven, 3000 Leuven, Belgium
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39
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Effects of myokines on bone. BONEKEY REPORTS 2016; 5:826. [PMID: 27579164 DOI: 10.1038/bonekey.2016.48] [Citation(s) in RCA: 91] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 05/01/2016] [Indexed: 12/22/2022]
Abstract
The links between muscle and bone have been recently examined because of the increasing number of patients with osteoporosis and sarcopenia. Myokines are skeletal muscle-derived humoral cytokines and growth factors, which exert physiological and pathological functions in various distant organs, including the regulation of glucose, energy and bone metabolism. Myostatin is a crucial myokine, the expression of which is mainly limited to muscle tissues. The inhibition of myostatin signaling increases bone remodeling, bone mass and muscle mass, and it may provide a target for the treatment of both sarcopenia and osteoporosis. As myostatin is involved in osteoclast formation and bone destruction in rheumatoid arthritis, myostatin may be a target myokine for the treatment of accelerated bone resorption and joint destruction in rheumatoid arthritis. Numerous other myokines, including transforming growth factor-β, follistatin, insulin-like growth factor-I, fibroblast growth factor-2, osteoglycin, FAM5C, irisin, interleukin (IL)-6, leukemia inhibitory factor, IL-7, IL-15, monocyte chemoattractant protein-1, ciliary neurotrophic factor, osteonectin and matrix metalloproteinase 2, also affect bone cells in various manners. However, the effects of myokines on bone metabolism are largely unknown. Further research is expected to clarify the interaction between muscle and bone, which may lead to greater diagnosis and the development of the treatment for muscle and bone disorders, such as osteoporosis and sarcopenia.
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40
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Schafer MJ, Atkinson EJ, Vanderboom PM, Kotajarvi B, White TA, Moore MM, Bruce CJ, Greason KL, Suri RM, Khosla S, Miller JD, Bergen HR, LeBrasseur NK. Quantification of GDF11 and Myostatin in Human Aging and Cardiovascular Disease. Cell Metab 2016; 23:1207-1215. [PMID: 27304512 PMCID: PMC4913514 DOI: 10.1016/j.cmet.2016.05.023] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/01/2016] [Accepted: 05/31/2016] [Indexed: 01/08/2023]
Abstract
Growth and differentiation factor 11 (GDF11) is a transforming growth factor β superfamily member with a controversial role in aging processes. We have developed a highly specific LC-MS/MS assay to quantify GDF11, resolved from its homolog, myostatin (MSTN), based on unique amino acid sequence features. Here, we demonstrate that MSTN, but not GDF11, declines in healthy men throughout aging. Neither GDF11 nor MSTN levels differ as a function of age in healthy women. In an independent cohort of older adults with severe aortic stenosis, we show that individuals with higher GDF11 were more likely to be frail and have diabetes or prior cardiac conditions. Following valve replacement surgery, higher GDF11 at surgical baseline was associated with rehospitalization and multiple adverse events. Cumulatively, our results show that GDF11 levels do not decline throughout aging but are associated with comorbidity, frailty, and greater operative risk in older adults with cardiovascular disease.
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Affiliation(s)
- Marissa J Schafer
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Elizabeth J Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Patrick M Vanderboom
- Medical Genome Facility-Proteomics Core, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Brian Kotajarvi
- Center for Clinical and Translational Sciences, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Thomas A White
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Matthew M Moore
- Center for Innovation, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Charles J Bruce
- Division of Cardiovascular Diseases, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Kevin L Greason
- Division of Cardiovascular Surgery, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Rakesh M Suri
- Division of Cardiovascular Surgery, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Sundeep Khosla
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Center for Clinical and Translational Sciences, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Division of Endocrinology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Jordan D Miller
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Division of Cardiovascular Surgery, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - H Robert Bergen
- Medical Genome Facility-Proteomics Core, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, Rochester, MN 55905, USA
| | - Nathan K LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905, USA; Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, Rochester, MN 55905, USA.
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Almirol EA, Chi LY, Khurana B, Hurwitz S, Bluman EM, Chiodo C, Matzkin E, Baima J, LeBoff MS. Short-term effects of teriparatide versus placebo on bone biomarkers, structure, and fracture healing in women with lower-extremity stress fractures: A pilot study. JOURNAL OF CLINICAL AND TRANSLATIONAL ENDOCRINOLOGY 2016; 5:7-14. [PMID: 29067229 PMCID: PMC5644467 DOI: 10.1016/j.jcte.2016.05.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 05/15/2016] [Accepted: 05/17/2016] [Indexed: 12/11/2022]
Abstract
AIMS In this pilot, placebo-controlled study, we evaluated whether brief administration of teriparatide (TPTD) in premenopausal women with lower-extremity stress fractures would increase markers of bone formation in advance of bone resorption, improve bone structure, and hasten fracture healing according to magnetic resonance imaging (MRI). METHODS Premenopausal women with acute lower-extremity stress fractures were randomized to injection of TPTD 20-µg subcutaneous (s.c.) (n = 6) or placebo s.c. (n = 7) for 8 weeks. Biomarkers for bone formation N-terminal propeptide of type I procollagen (P1NP) and osteocalcin (OC) and resorption collagen type-1 cross-linked C-telopeptide (CTX) and collagen type 1 cross-linked N-telopeptide (NTX) were measured at baseline, 4 and 8 weeks. The area between the percent change of P1NP and CTX over study duration is defined as the anabolic window. To assess structural changes, peripheral quantitative computed topography (pQCT) was measured at baseline, 8 and 12 weeks at the unaffected tibia and distal radius. The MRI of the affected bone assessed stress fracture healing at baseline and 8 weeks. RESULTS After 8 weeks of treatment, bone biomarkers P1NP and OC increased more in the TPTD- versus placebo-treated group (both p ≤ 0.01), resulting in a marked anabolic window (p ≤ 0.05). Results from pQCT demonstrated that TPTD-treated women showed a larger cortical area and thickness compared to placebo at the weight bearing tibial site, while placebo-treated women had a greater total tibia and cortical density. No changes at the radial sites were observed between groups. According to MRI, 83.3% of the TPTD- and 57.1% of the placebo-treated group had improved or healed stress fractures (p = 0.18). CONCLUSIONS In this randomized, pilot study, brief administration of TPTD showed anabolic effects that TPTD may help hasten fracture healing in premenopausal women with lower-extremity stress fractures. Larger prospective studies are warranted to determine the effects of TPTD treatment on stress fracture healing in premenopausal women.
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Affiliation(s)
| | - Lisa Y Chi
- Department of Medicine, Brigham and Women's Hospital, USA
| | - Bharti Khurana
- Harvard Medical School, Boston, MA, USA.,Department of Radiology, Brigham and Women's Hospital, USA
| | - Shelley Hurwitz
- Department of Medicine, Brigham and Women's Hospital, USA.,Harvard Medical School, Boston, MA, USA
| | - Eric M Bluman
- Department of Orthopedic Surgery, Brigham and Women's Hospital, USA
| | - Christopher Chiodo
- Harvard Medical School, Boston, MA, USA.,Department of Orthopedic Surgery, Brigham and Women's Hospital, USA
| | - Elizabeth Matzkin
- Harvard Medical School, Boston, MA, USA.,Department of Orthopedic Surgery, Brigham and Women's Hospital, USA
| | - Jennifer Baima
- Division of Physical Medicine and Rehabilitation, UMass Memorial Medical Center, Worcester, MA 01605, USA
| | - Meryl S LeBoff
- Department of Medicine, Brigham and Women's Hospital, USA.,Harvard Medical School, Boston, MA, USA
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42
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Verroken C, Zmierczak HG, Goemaere S, Kaufman JM, Lapauw B. Association of Jumping Mechanography-Derived Indices of Muscle Function with Tibial Cortical Bone Geometry. Calcif Tissue Int 2016; 98:446-55. [PMID: 26671019 DOI: 10.1007/s00223-015-0094-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/25/2015] [Indexed: 10/22/2022]
Abstract
Jumping mechanography has been developed to estimate maximum voluntary muscle forces. This study assessed associations of jumping mechanography-derived force and power measurements with tibial cortical bone geometry, compared to other estimates of muscle mass, size, and function. Healthy men (n = 181; 25-45 years) were recruited in a cross-sectional, population-based sibling-pair study. Muscle parameters include isokinetic peak torque of the quadriceps, DXA-derived leg lean mass, mechanography-derived peak jump force and power, and pQCT-derived mid-tibial (66 %) muscle cross-sectional area (CSA). Mid-tibial cortical bone parameters were assessed by pQCT. In age, height, and weight-adjusted analyses, jump force and power correlated positively with cortical bone area, cortical thickness, and polar strength-strain index (SSIp) (β = 0.23-0.34, p ≤ 0.001 for force; β = 0.25-0.30, p ≤ 0.007 for power) and inversely with endosteal circumference adjusted for periosteal circumference (ECPC) (β = -0.16, p < 0.001 for force; β = -0.13, p = 0.007 for power). Force but not power correlated with cortical over total bone area ratio (β = 0.25, p = 0.002). Whereas leg lean mass correlated with all cortical parameters except cortical over total bone area ratio (β = 0.25-0.62, p ≤ 0.004), muscle CSA only correlated with cortical bone area, periosteal circumference, and SSIp (β = 0.21-0.26, p ≤ 0.001), and quadriceps torque showed no significant correlations with the bone parameters. Multivariate models indicated that leg lean mass was independently associated with overall bone size and strength reflected by periosteal and endosteal circumference and SSIp (β = 0.32-0.55, p ≤ 0.004), whereas jump force was independently associated with cortical bone size reflected by ECPC, cortical thickness, and cortical over total bone area ratio (β = 0.13-0.28; p ≤ 0.002). These data indicate that jumping mechanography provides relevant information about the relationship of muscle with bone geometry.
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Affiliation(s)
- Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium.
| | - Hans-Georg Zmierczak
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
| | - Jean-Marc Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Department of Endocrinology, Ghent University Hospital, De Pintelaan 185, 9K12IE, 9000, Ghent, Belgium
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Abstract
PURPOSE OF REVIEW We provide an update of bone health in trans persons on cross-sex hormonal therapy. This drastic hormonal reversal will have direct but also indirect effects on bone, through body composition changes. RECENT FINDINGS Recent evidence suggests that trans women, even before the start of any hormonal intervention, already have a lower bone mass, a higher frequency of osteoporosis, and a smaller bone size vs. natal men. During cross-sex hormonal treatment, bone mass was maintained or gained in trans women. In trans men, bone metabolism seemed to increase during short-term testosterone therapy, but no major changes have been found in bone density. On long-term testosterone therapy, larger cortical bone size was observed in trans men vs. natal women. SUMMARY Follow-up of bone health and osteoporosis prevention in trans persons is important. We advise active assessment of osteoporosis risk factors including the (previous) use of hormonal therapy. Based on this risk profile and the intended therapy, bone densitometry may be indicated. Long-term use of antiandrogens or gonadotropin-releasing hormone agonists alone should be monitored as trans women may have low bone mass, even prior to treatment. Therapy compliance with the cross-sex hormones is of major concern, especially after gonadectomy. Large-scaled, multicenter, and long-term research is needed to determine a well tolerated dosage of cross-sex hormonal treatment, also in elderly trans persons.
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Affiliation(s)
- Eva Van Caenegem
- aDepartment of Endocrinology bCenter for Sexology and Gender, Ghent University Hospital, Ghent, Belgium
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Bajaj D, Allerton BM, Kirby JT, Miller F, Rowe DA, Pohlig RT, Modlesky CM. Muscle volume is related to trabecular and cortical bone architecture in typically developing children. Bone 2015; 81:217-227. [PMID: 26187197 PMCID: PMC5912953 DOI: 10.1016/j.bone.2015.07.014] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2014] [Revised: 05/15/2015] [Accepted: 07/13/2015] [Indexed: 11/22/2022]
Abstract
INTRODUCTION Muscle is strongly related to cortical bone architecture in children; however, the relationship between muscle volume and trabecular bone architecture is poorly studied. The aim of this study was to determine if muscle volume is related to trabecular bone architecture in children and if the relationship is different than the relationship between muscle volume and cortical bone architecture. MATERIALS AND METHODS Forty typically developing children (20 boys and 20 girls; 6 to 12y) were included in the study. Measures of trabecular bone architecture [i.e., apparent trabecular bone volume to total volume (appBV/TV), trabecular number (appTb.N), trabecular thickness (appTb.Th) and trabecular separation (appTb.Sp)] in the distal femur, cortical bone architecture [cortical volume, total volume, section modulus (Z) and polar moment of inertia (J)] in the midfemur, muscle volume in the midthigh and femur length were assessed using magnetic resonance imaging. Total physical activity and moderate-to-vigorous physical activity were assessed using an accelerometer-based activity monitor worn around the waist for four days. Calcium intake was assessed using diet records. Relationships among the measures were tested using multiple linear regression analysis. RESULTS Muscle volume was moderately-to-strongly related to measures of trabecular bone architecture [appBV/TV (r=0.81), appTb.N (r=0.53), appTb.Th (r=0.67), appTb.Sp (r=-0.71); all p<0.001] but more strongly related to measures of cortical bone architecture [cortical volume (r=0.96), total volume (r=0.94), Z (r=0.94) and J (r=0.92; all p<0.001)]. Similar relationships were observed between femur length and measures of trabecular (p<0.01) and cortical (p<0.001) bone architecture. Sex, physical activity and calcium intake were not related to any measure of bone architecture (p>0.05). Because muscle volume and femur length were strongly related (r=0.91, p<0.001), muscle volume was scaled for femur length (muscle volume/femur length(2.77)). When muscle volume/femur length(2.77) was included in a regression model with femur length, sex, physical activity and calcium intake, muscle volume/femur length(2.77) was a significant predictor of appBV/TV, appTb.Th and appTb.Sp (partial r=0.44 to 0.49, p<0.05) and all measures of cortical bone architecture (partial r=0.47 to 0.54; p<0.01). CONCLUSIONS The findings suggest that muscle volume in the midthigh is related to trabecular bone architecture in the distal femur of typically developing children. The relationship is weaker than the relationship between muscle volume in the midthigh and cortical bone architecture in the midfemur, but the discrepancy is driven, in large part, by the greater dependence of cortical bone architecture measures on femur length.
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Affiliation(s)
- Deepti Bajaj
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Brianne M Allerton
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Joshua T Kirby
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA
| | - Freeman Miller
- Department of Orthopedics, Nemours AI duPont Hospital for Children, Wilmington, DE 19803, USA
| | - David A Rowe
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow G1 1XQ, UK
| | - Ryan T Pohlig
- Biostatistics Core Facility, University of Delaware, Newark, DE 19713, USA
| | - Christopher M Modlesky
- Department of Kinesiology and Applied Physiology, University of Delaware, Newark, DE 19713, USA.
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DeMambro VE, Le PT, Guntur AR, Maridas DE, Canalis E, Nagano K, Baron R, Clemmons DR, Rosen CJ. Igfbp2 Deletion in Ovariectomized Mice Enhances Energy Expenditure but Accelerates Bone Loss. Endocrinology 2015; 156:4129-40. [PMID: 26230658 PMCID: PMC4606757 DOI: 10.1210/en.2014-1452] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Previously, we reported sexually dimorphic bone mass and body composition phenotypes in Igfbp2(-/-) mice (-/-), where male mice exhibited decreased bone and increased fat mass, whereas female mice displayed increased bone but no changes in fat mass. To investigate the interaction between IGF-binding protein (IGFBP)-2 and estrogen, we subjected Igfbp2 -/- and +/+ female mice to ovariectomy (OVX) or sham surgery at 8 weeks of age. At 20 weeks of age, mice underwent metabolic cage analysis and insulin tolerance tests before killing. At harvest, femurs were collected for microcomputed tomography, serum for protein levels, brown adipose tissue (BAT) and inguinal white adipose tissue (IWAT) adipose depots for histology, gene expression, and mitochondrial respiration analysis of whole tissue. In +/+ mice, serum IGFBP-2 dropped 30% with OVX. In the absence of IGFBP-2, OVX had no effect on preformed BAT; however, there was significant "browning" of the IWAT depot coinciding with less weight gain, increased insulin sensitivity, lower intraabdominal fat, and increased bone loss due to higher resorption and lower formation. Likewise, after OVX, energy expenditure, physical activity and BAT mitochondrial respiration were decreased less in the OVX-/- compared with OVX+/+. Mitochondrial respiration of IWAT was reduced in OVX+/+ yet remained unchanged in OVX-/- mice. These changes were associated with significant increases in Fgf21 and Foxc2 expression, 2 proteins known for their insulin sensitizing and browning of WAT effects. We conclude that estrogen deficiency has a profound effect on body and bone composition in the absence of IGFBP-2 and may be related to changes in fibroblast growth factor 21.
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Affiliation(s)
- Victoria E DeMambro
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - Phuong T Le
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - Anyonya R Guntur
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - David E Maridas
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - Ernesto Canalis
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - Kenichi Nagano
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - Roland Baron
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - David R Clemmons
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
| | - Clifford J Rosen
- Maine Medical Center Research Institute (V.E.M., P.T.L., A.R.G., D.E.M., C.J.R.), Scarborough, Maine 04074; Departments of Orthopedic Surgery and Medicine (E.C.), University of Connecticut Health Center, Farmington, Connecticut 06032; Department of Medicine (K.N., R.B.), Harvard Medical School and Department of Oral Medicine, Infection and Immunity, Harvard School of Dental Medicine, Harvard University, Boston, Massachusetts 02115; and University of North Carolina (D.R.C.), Chapel Hill, North Carolina 27514
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Abstract
Amyotrophic lateral sclerosis (ALS), also called Lou Gehrig's disease, is a fatal neuromuscular disorder characterized by degeneration of motor neurons and by skeletal muscle atrophy. Although the death of motor neurons is a pathological hallmark of ALS, the potential role of other organs in disease progression remains to be elucidated. Skeletal muscle and bone are the two largest organs in the human body. They are responsible not only for locomotion but also for maintaining whole body normal metabolism and homeostasis. Patients with ALS display severe muscle atrophy, which may reflect intrinsic defects in mitochondrial respiratory function and calcium (Ca) signaling in muscle fibers, in addition to the role of axonal withdrawal associated with ALS progression. Incidence of fractures is high in ALS patients, indicating there are potential bone defects in individuals with this condition. There is a lifelong interaction between skeletal muscle and bone. The severe muscle degeneration that occurs during ALS progression may potentially have a significant impact on bone function, and the defective bone may also contribute significantly to neuromuscular degeneration in the course of the disease. Due to the nature of the rapid and severe neuromuscular symptoms, a majority of studies on ALS have focused on neurodegeneration. Just a few studies have explored the possible contribution of muscle defects, even fewer on bone defects, and fewer still on possible muscle-bone crosstalk in ALS. This review article discusses current studies on bone defects and potential defects in muscle-bone crosstalk in ALS.
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Affiliation(s)
- Jingsong Zhou
- Department of Physiology, Kansas City University of Medicine and Biosciences, 1750 Independence Ave., Kansas City, MO, 64106, USA,
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Chalhoub D, Cawthon PM, Ensrud KE, Stefanick ML, Kado DM, Boudreau R, Greenspan S, Newman AB, Zmuda J, Orwoll ES, Cauley JA. Risk of Nonspine Fractures in Older Adults with Sarcopenia, Low Bone Mass, or Both. J Am Geriatr Soc 2015; 63:1733-40. [PMID: 26310882 DOI: 10.1111/jgs.13605] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To test the hypothesis that men and women with low bone mineral density (BMD) and sarcopenia have a higher risk of fracture than those with only one or neither conditions. DESIGN The Osteoporotic Fractures in Men Study and the Study of Osteoporotic Fractures in women are prospective observational studies with a mean follow up of 9 (2000-2012) and 8 years (1997-2009), respectively. SETTING U.S. clinical centers. PARTICIPANTS Men (n = 5,544; mean age 73.7) and women (n = 1,114; mean age 77.6) aged 65 and older, able to walk without assistance, and without bilateral hip replacement. MEASUREMENTS Sarcopenia was defined as low appendicular lean mass plus slowness or weakness and low BMD according to the World Health Organization definition of a T-score less than -1.0. Participants were classified as having normal BMD and no sarcopenia (3,367 men, 308 women), sarcopenia only (79 men, 48 women), low BMD only (1,986 men, 626 women), and low BMD and sarcopenia (112 men, 132 women). RESULTS Men with low BMD and sarcopenia (hazard ratio (HR)=3.79, 95% confidence interval (CI)=2.65-5.41) and men with low BMD only (HR=1.67, 95% CI=1.45-1.93) but not men with sarcopenia only (HR=1.14, 95% CI=0.62-2.09) had greater risk of fracture than men with normal BMD and no sarcopenia. Women with low BMD and sarcopenia (HR=2.27, 95% CI=1.37-3.76) and women with low BMD alone (HR=2.62, 95% CI=1.74-3.95), but not women with only sarcopenia, had greater risk of fracture than women with normal BMD and no sarcopenia. CONCLUSION Men with low BMD and sarcopenia are at especially high risk of fracture. Sarcopenia alone did not increase fracture risk in either group.
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Affiliation(s)
- Didier Chalhoub
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peggy M Cawthon
- California Pacific Medical Center, San Francisco, California
| | - Kristine E Ensrud
- Division of Epidemiology and Community Health, Department of Medicine, University of Minnesot aand Minneapolis VA Health Care System, Minneapolis, Minnesota
| | | | - Deborah M Kado
- University of California at San Diego, La Jolla, California
| | - Robert Boudreau
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Susan Greenspan
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Anne B Newman
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joseph Zmuda
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Eric S Orwoll
- Oregon Health & Sciences University, Portland, Oregon
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania
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Bergen HR, Farr JN, Vanderboom PM, Atkinson EJ, White TA, Singh RJ, Khosla S, LeBrasseur NK. Myostatin as a mediator of sarcopenia versus homeostatic regulator of muscle mass: insights using a new mass spectrometry-based assay. Skelet Muscle 2015; 5:21. [PMID: 26180626 PMCID: PMC4502935 DOI: 10.1186/s13395-015-0047-5] [Citation(s) in RCA: 85] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Accepted: 05/29/2015] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Myostatin is a protein synthesized and secreted by skeletal muscle that negatively regulates muscle mass. The extent to which circulating myostatin levels change in the context of aging is controversial, largely due to methodological barriers. METHODS We developed a specific and sensitive liquid chromatography with tandem mass spectrometry (LC-MS/MS) assay to measure concentrations of myostatin and two of its key inhibitors, follistatin-related gene (FLRG) protein and growth and serum protein-1 (GASP-1) in 80 younger (<40 years), 80 older (>65 years), and 80 sarcopenic older women and men. RESULTS Older women had 34 % higher circulating concentrations of myostatin than younger women. Per unit of lean mass, both older and sarcopenic older women had >23 % higher myostatin levels than younger women. By contrast, younger men had higher myostatin concentrations than older men with and without sarcopenia. Younger men had approximately twofold higher concentrations of myostatin than younger women; however, older women and sarcopenic older women had significantly higher relative myostatin levels than the corresponding groups of men. In both sexes, sarcopenic older subjects had the highest concentrations of FLRG. Circulating concentrations of myostatin exhibited positive, but not robust, correlations with relative muscle mass in both sexes. CONCLUSIONS Our data suggest that myostatin may contribute to the higher prevalence of sarcopenia in women but acts as a homeostatic regulator of muscle mass in men. Moreover, this new LC-MS/MS-based approach offers a means to determine the extent to which myostatin serves as a biomarker of muscle health in diverse conditions of muscle loss and deterioration.
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Affiliation(s)
- H Robert Bergen
- Department of Biochemistry and Molecular Biology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA.,Medical Genome Facility-Proteomics Core, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Joshua N Farr
- Division of Endocrinology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905 USA.,Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Patrick M Vanderboom
- Medical Genome Facility-Proteomics Core, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Elizabeth J Atkinson
- Division of Biomedical Statistics and Informatics, Department of Health Sciences Research, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Thomas A White
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Ravinder J Singh
- Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Sundeep Khosla
- Division of Endocrinology, Department of Medicine, Mayo Clinic College of Medicine, Rochester, MN 55905 USA.,Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905 USA
| | - Nathan K LeBrasseur
- Robert and Arlene Kogod Center on Aging, Mayo Clinic College of Medicine, Rochester, MN 55905 USA.,Department of Physical Medicine and Rehabilitation, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905 USA
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Abstract
PURPOSE OF REVIEW Androgen deprivation therapy (ADT) remains a common treatment for prostate cancer, even in the nonmetastatic setting and in scenarios without evidence of efficacy. Increasing attention has focused on its adverse effects, of which bone disease in the form of osteoporosis and fractures has been one of the major concerns. Recently published articles are reviewed, focusing on ADT effects on bone and management of ADT-associated bone disease. RECENT FINDINGS A range of strategies directed at ADT-associated bone disease are available, including antiresorptive agents such as denosumab and bisphosphonates, as well as complementary approaches such as calcium and vitamin D supplementation, exercise regimens, and multifaceted interventions incorporating several approaches. Most interventions used bone mineral density as a surrogate outcome, despite compelling evidence that it inadequately captures fracture risk. SUMMARY The antiresorptive agents are clearly able to preserve bone mineral density in men on ADT, whereas other approaches have modest to no benefits. Unfortunately, despite intense research interest in this area, no approach has yet demonstrated a definitive and convincing reduction in clinically relevant fracture outcomes. This emphasizes the importance of restricting the use of ADT to settings in which its benefits are clearly established, in order to limit unnecessary complications.
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50
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Weight lifting and appendicular skeletal muscle mass among breast cancer survivors: a randomized controlled trial. Breast Cancer Res Treat 2015; 151:385-92. [PMID: 25935584 DOI: 10.1007/s10549-015-3409-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2015] [Accepted: 04/25/2015] [Indexed: 12/25/2022]
Abstract
Low appendicular skeletal muscle mass (ASMM) is associated with premature mortality, hyperinsulinemia, frailty, disability, and low bone mineral density. We explored the potential efficacy of slowly progressive weight lifting to attenuate the decline of ASMM among breast cancer survivors by conducting a post hoc analysis of data from the Physical Activity and Lymphedema trial. Between October 2005 and August 2008, we conducted a single-blind, randomized controlled trial of twice weekly slowly progressive weight lifting or standard care among 295 non-metastatic breast cancer survivors. ASMM was quantified using dual-energy X-ray absorptiometry. Changes in ASMM were evaluated from baseline to 12 months between the weight lifting and control groups using repeated measures linear mixed effects regression models. Over 12 months, participants in the weight lifting group experienced attenuated declines in muscle mass compared to the control group, as reflected by relative ASMM (-0.01 ± 0.02 kg/m(2) vs -0.08 ± 0.03 kg/m(2); P = 0.041) and absolute ASMM (-0.02 ± 0.06 kg vs -0.22 ± 0.07 kg; P = 0.038), respectively. Weight lifting did not alter other body composition outcomes including body mass index, total body mass, body fat percentage, and fat mass compared to the control group. Weight lifting significantly increased upper and lower body muscle strength compared to the control group. The intervention was well tolerated with no serious adverse events related to weight lifting. Slowly progressive weight lifting attenuated the decline of ASMM among breast cancer survivors compared to standard care over 12 months. These data are hypothesis generating. Future studies should examine the efficacy of weight lifting to improve distal health outcomes among breast cancer survivors.
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