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Amini M, Reisinger A, Synek A, Hirtler L, Pahr D. The predictive ability of a QCT-FE model of the proximal femoral stiffness under multiple load cases is strongly influenced by experimental uncertainties. J Mech Behav Biomed Mater 2023; 139:105664. [PMID: 36657193 DOI: 10.1016/j.jmbbm.2023.105664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/03/2023] [Accepted: 01/05/2023] [Indexed: 01/11/2023]
Abstract
Despite significant improvements in terms of the predictive ability of Quantitative Computed Tomography based Finite Element (QCT-FE) models in estimating femoral strength (fracture load and stiffness), no substantial clinical adoption of this method has taken place to date. Narrowing the wide variability of FE results by standardizing the methodology and validation protocols, as well as reducing the uncertainties in the FEA process have been proposed as routes towards improved reliability. The aim of this study was to: First, validate a QCT-FE model of proximal femoral stiffness in multiple stance load cases, and second, using a parametric approach, determine the influence of select experimental and modeling parameters on the predictive ability of our model. Ten fresh frozen human femoral samples were tested in neutral stance, 15° adducted and 15° abducted load cases. Voxel-based linear-elastic QCT-FE models of the samples were generated to predict the models' stiffness values in all load cases. The base FE models were validated against the experimental results using linear regression. Thirty six deviated models were created using the minimum and maximum values of experiment-based "plausible range" for 18 parameters in 4 categories of embedding, loading, material, and segmentation. The predictive ability of the models were compared in terms of the coefficient of determination (R2) of the linear regression between the measured and predicted stiffness values in all load cases. Our model was capable of capturing 90% of the variation in the experimental stiffness of the samples in neutral stance position (R2 = 0.9, concordance correlation coefficient (CCC) = 0.93, percent root mean squared error (RMSE%) = 8.4%, slope and intercept not significantly different from unity and zero, respectively). Embedding and loading categories strongly affected the predictive ability of the models with an average percent difference in R2 of 4.36% ± 2.77 and 2.96% ± 1.69 for the stance-neutral load case, respectively. The performance of the models were significantly different in adducted and abducted load cases with their R2 dropping to 71% and 70%, respectively. Similarly, off-axes load cases were affected by the parameters differently compared to the neutral load case, with the loading parameter category imposing more than 10% difference on their R2, larger than all other categories. We also showed that automatically selecting the best performing plausible value for each parameter and each sample would result in a perfectly linear correlation (R2> 0.99) between the "tuned" model's predicted stiffness and experimental results. Based on our results, high sensitivity of the model performance to experimental parameters requires extra diligence in modeling the embedding geometry and the loading angles since these sources of uncertainty could dwarf the effects of material modeling and image processing parameters. The results of this study could help in improving the robustness of the QCT-FE models of proximal femur by limiting the uncertainties in the experimental and modeling steps.
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Affiliation(s)
- Morteza Amini
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Getreidemarkt 9, 1060, Vienna, Austria.
| | - Andreas Reisinger
- Division Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria.
| | - Alexander Synek
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Getreidemarkt 9, 1060, Vienna, Austria.
| | - Lena Hirtler
- Center for Anatomy and Cell Biology, Medical University of Vienna, Währinger Straße 13, 1090, Vienna, Austria.
| | - Dieter Pahr
- Institute of Lightweight Design and Structural Biomechanics, TU Wien, Getreidemarkt 9, 1060, Vienna, Austria; Division Biomechanics, Karl Landsteiner University of Health Sciences, Dr.-Karl-Dorrek-Straße 30, 3500 Krems an der Donau, Austria.
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FTY720 Attenuates LPS-Induced Inflammatory Bone Loss by Inhibiting Osteoclastogenesis via the NF- κB and HDAC4/ATF Pathways. J Immunol Res 2023; 2023:8571649. [PMID: 36644540 PMCID: PMC9839404 DOI: 10.1155/2023/8571649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 12/14/2022] [Accepted: 12/22/2022] [Indexed: 01/07/2023] Open
Abstract
Osteoclast (OC) abnormalities lead to many osteolytic diseases, such as osteoporosis, inflammatory bone erosion, and tumor-induced osteolysis. Exploring effective strategies to remediate OCs dysregulation is essential. FTY720, also known as fingolimod, has been approved for the treatment of multiple sclerosis and has anti-inflammatory and immunosuppressive effects. Here, we found that FTY720 inhibited osteoclastogenesis and OC function by inhibiting nuclear factor kappa-B (NF-κB) signaling. Interestingly, we also found that FTY720 inhibited osteoclastogenesis by upregulating histone deacetylase 4 (HDAC4) expression levels and downregulating activating transcription factor 4 (ATF4) expression levels. In vivo, FTY720 treatment prevented lipopolysaccharide- (LPS-) induced calvarial osteolysis and significantly reduced the number of tartrate-resistant acid phosphatase- (TRAP-) positive OCs. Taken together, these results demonstrate that FTY720 can inhibit osteoclastogenesis and ameliorate inflammation-induced bone loss. Which may provide evidence of a new therapeutic target for skeletal diseases caused by OC abnormalities.
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Loundagin LL, Bredbenner TL, Jepsen KJ, Edwards WB. Bringing Mechanical Context to Image-Based Measurements of Bone Integrity. Curr Osteoporos Rep 2021; 19:542-552. [PMID: 34269975 DOI: 10.1007/s11914-021-00700-z] [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] [Accepted: 06/11/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE OF REVIEW Image-based measurements of bone integrity are used to estimate failure properties and clinical fracture risk. This paper (1) reviews recent imaging studies that have enhanced our understanding of the mechanical pathways to bone fracture and (2) discusses the influence that inter-individual differences in image-based measurements may have on the clinical assessment of fracture risk RECENT FINDINGS: Increased tissue mineralization is associated with improved bone strength but reduced fracture toughness. Trabecular architecture that is important for fatigue resistance is less important for bone strength. The influence of porosity on bone failure properties is heavily dependent on pore location and size. The interaction of various characteristics, such as bone area and mineral content, can further complicate their influence on bone failure properties. What is beneficial for bone strength is not always beneficial for bone toughness or fatigue resistance. Additionally, given the large amount of imaging data that is clinically available, there is a need to develop effective translational strategies to better interpret non-invasive measurements of bone integrity.
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Affiliation(s)
- Lindsay L Loundagin
- Department of Anatomy, Physiology and Pharmacology, University of Saskatchewan, 105 Administration Place, Saskatoon, SK, S7N 5A2, Canada
| | - Todd L Bredbenner
- Department of Mechanical and Aerospace Engineering, University of Colorado Colorado Springs, Colorado Springs, CO, USA
| | - Karl J Jepsen
- Department of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA
- Biomedical Engineering, University of Michigan, Ann Arbor, MI, USA
| | - W Brent Edwards
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, 2500 University Dr. NW, Calgary, Alberta, T2N 1N4, Canada.
- McCaig Institute for Bone and Joint Health, University of Calgary, HRIC 3A08, 3280 Hospital Drive NW, Calgary, Alberta, T2N 4Z6, Canada.
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Mendes DAB, Coelho MCA, Gehrke B, de Pinho LKJ, Cardoso Lima LF, Paranhos-Neto F, de Mendonça LMC, Farias MLF, Madeira M. Microarchitectural parameters and bone mineral density in patients with tumour-induced osteomalacia by HR-pQCT and DXA. Clin Endocrinol (Oxf) 2021; 95:587-594. [PMID: 34043830 DOI: 10.1111/cen.14533] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 05/17/2021] [Accepted: 05/23/2021] [Indexed: 11/29/2022]
Abstract
INTRODUCTION Tumour-induced osteomalacia (TIO) is a rare paraneoplastic condition characterised by decreased tubular phosphate reabsorption. The purpose of this study is to evaluate bone mineral density (BMD) and microarchitecture in six TIO patients, compared with 18 healthy controls. METHODS Volumetric BMD and microarchitecture were evaluated by high-resolution peripheral quantitative computed tomography (HR-pQCT), and areal BMD by dual-energy X-ray absorptiometry (DXA). Differences between groups were significant for p < .05. RESULTS All TIO subjects were healthy until the development of diffuse bone pain and multiple skeletal fractures and deformities. At baseline, sPi and TmPi/GFR were low and patients were on vitamin D and phosphate replacement at the study. Compared with controls, TIO patients had lower aBMD at lumbar spine and hip, and lower vBMD at trabecular, cortical and entire bone, at distal radius (R) and distal tibia (T): trabecular vBMD (R = 118.3 × 177.1; T = 72.3 × 161.3 gHA/cm3 ); cortical vBMD (R = 782.3 × 866.5; T = 789.1 × 900.9 gHA/cm3 ); total region vBMD (R = 234.5 × 317; T = 167.1 × 295.8 gHA/cm3 ). Bone microarchitecture was very heterogeneous among patients and significantly different from controls: lower cortical thickness (R = 0.59 × 0.80; T = 0.90 × 1.31 mm), bone volume-to-total volume ratio (R = 0.09 × 0.14; T = 0.06 × 0.13) and Tb.N (R = 1.46 × 2.10; T = 0.93 × 1.96 mm-1 ) and also higher Tb.Sp (R = 0.70 × 0.41; T = 1.28 × 0.45 mm) and Tb.1/N.SD (R = 0.42 × 0.18; T = 0.87 × 0.20 mm). CONCLUSION In this original study of TIO patients, DXA and HR-pQCT evaluation identified lower areal and volumetric BMD and severely impaired microarchitecture at cortical and trabecular bones, which probably contribute to bone fragility and fractures.
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Affiliation(s)
- Danielle A B Mendes
- Endocrinology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria C A Coelho
- Endocrinology Division, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Bárbara Gehrke
- Endocrinology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Endocrinology Division, Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
- Postgraduate Program in Clinical and Experimental Pathophysiology (FISCLINEX), Faculty of Medical Sciences, State University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Leandro K J de Pinho
- Endocrinology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Luis F Cardoso Lima
- Nuclear Engineering Program, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Francisco Paranhos-Neto
- Endocrinology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Laura M C de Mendonça
- Rheumatology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - M L Fleiuss Farias
- Endocrinology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
| | - Miguel Madeira
- Endocrinology Division, Federal University of Rio de Janeiro, Rio de Janeiro, Rio de Janeiro, Brazil
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Chiba K, Suetoshi R, Cretin D, Arai T, Kawajiri T, Okayama A, Tsuji S, Okazaki N, Osaki M, Yoh K. Development of a QUS Device to Evaluate Deterioration of Cortical Bone: Verification by HR-pQCT and Measurements in Healthy Individuals and Dialysis Patients. J Clin Densitom 2021; 24:94-105. [PMID: 32224102 DOI: 10.1016/j.jocd.2020.02.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 02/07/2020] [Accepted: 02/11/2020] [Indexed: 01/15/2023]
Abstract
INTRODUCTION The objectives of this study were to identify what is reflected in cortical speed of sound (cSOS) measured by a cortical quantitative ultrasound (cortical QUS) device we have developed, and to investigate cSOS measurements in healthy individuals and dialysis patients. METHODS The cSOS and the SOS were measured by cortical QUS and conventional QUS in 20 volunteers, and the correlations between these measurements and areal bone mineral density measured by dual-energy X-ray absorptiometry and bone microstructural parameters on high-resolution peripheral quantitative computed tomography were analyzed. The cSOS and the SOS were measured in 91 young adults (47 men, 44 women), 64 elderly people (30 men, 33 women), and 64 dialysis patients (33 men, 31 women). The period of hemodialysis and intact parathyroid hormoneevels were also investigated in the dialysis patients. RESULTS cSOS was correlated with cortical tissue mineral density (tibia: r = 0.74, radius: r = 0.72) on high-resolution peripheral quantitative computed tomography, reflecting the degree of minaralization and microporosity of cortical bone. There was no correlation with the thickness of cortical bone, suggesting that it measured the bone quality rather than bone mass. Elderly women had lower cSOS than young adults (3865 ± 74 vs 3971 ± 63 m/s, p < 0.01). Many of dialysis patients showed very low cSOS and it was related to higher intact parathyroid hormone levels (male: ß = -0.67, female: ß = -0.60). CONCLUSIONS Our cortical QUS device is capable of evaluating the qualitative degradation of cortical bone, which cannot be assessed by conventional QUS, and its use in combination with conventional QUS may provide a better understanding of fracture risk.
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Affiliation(s)
- Ko Chiba
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
| | | | - Dorian Cretin
- Research and Innovation Center, Furuno Electric Co., Ltd
| | - Tatsuo Arai
- Research and Innovation Center, Furuno Electric Co., Ltd
| | | | | | - Shotaro Tsuji
- Department of Orthopaedic Surgery, Hyogo College of Medicine
| | - Narihiro Okazaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Makoto Osaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Ohs N, Collins CJ, Atkins PR. Validation of HR-pQCT against micro-CT for morphometric and biomechanical analyses: A review. Bone Rep 2020; 13:100711. [PMID: 33392364 PMCID: PMC7772687 DOI: 10.1016/j.bonr.2020.100711] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 07/29/2020] [Accepted: 08/19/2020] [Indexed: 12/26/2022] Open
Abstract
High-resolution peripheral quantitative computed-tomography (HR-pQCT) has the potential to become a powerful clinical assessment and diagnostic tool. Given the recent improvements in image resolution, from 82 to 61 μm, this technology may be used to accurately quantify in vivo bone microarchitecture, a key biomarker of degenerative bone diseases. However, computational methods to assess bone microarchitecture were developed for micro computed tomography (micro-CT), a higher-resolution technology only available for ex vivo studies, and validation of these computational analysis techniques against the gold-standard micro-CT has been inconsistent and incomplete. Herein, we review methods for segmentation of bone compartments and microstructure, quantification of bone morphology, and estimation of mechanical strength using finite-element analysis, highlighting the need throughout for improved standardization across the field. Studies have relied on homogenous datasets for validation, which does not allow for robust comparisons between methods. Consequently, the adaptation and validation of novel segmentation approaches has been slow to non-existent, with most studies still using the manufacturer's segmentation for morphometric analysis despite the existence of better performing alternative approaches. The promising accuracy of HR-pQCT for capturing morphometric indices is overshadowed by considerable variability in outcomes between studies. For finite element analysis (FEA) methods, the use of disparate material models and FEA tools has led to a fragmented ability to assess mechanical bone strength with HR-pQCT. Further, the scarcity of studies comparing 62 μm HR-pQCT to the gold standard micro-CT leaves the validation of this imaging modality incomplete. This review revealed that without standardization, the capabilities of HR-pQCT cannot be adequately assessed. The need for a public, extendable, heterogeneous dataset of HR-pQCT and corresponding gold-standard micro-CT images, which would allow HR-pQCT users to benchmark existing and novel methods and select optimal methods depending on the scientific question and data at hand, is now evident. With more recent advancements in HR-pQCT, the community must learn from its past and provide properly validated technologies to ensure that HR-pQCT can truly provide value in patient diagnosis and care.
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Affiliation(s)
- Nicholas Ohs
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
| | | | - Penny R. Atkins
- Institute for Biomechanics, ETH Zurich, Zurich, Switzerland
- Department of Osteoporosis, Inselspital, Bern, Switzerland
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Bui M, Zebaze R, Li S, Hopper JL, Bjørnerem Å. Are the Relationships of Lean Mass and Fat Mass With Bone Microarchitecture Causal or Due to Familial Confounders? A Novel Study of Adult Female Twin Pairs. JBMR Plus 2020; 4:e10386. [PMID: 32995689 PMCID: PMC7507375 DOI: 10.1002/jbm4.10386] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Revised: 06/12/2020] [Accepted: 06/24/2020] [Indexed: 12/26/2022] Open
Abstract
It is not known whether the relationships of lean mass (LM) and fat mass (FM) with bone microarchitecture and geometry are causal and/or are because of confounders, including familial confounders arising from genetic and environment effects shared by relatives. We tested the hypotheses that: (i) LM is associated with cortical bone traits, (ii) FM is associated with trabecular bone traits, and (iii) these relationships of LM and FM with bone microarchitecture and geometry have a causal component. Total body composition was quantified for 98 monozygotic (MZ) and 54 dizygotic (DZ) white female twin pairs aged 31 to 77 years. Microarchitecture at the distal tibia and distal radius was quantified using HRpQCT and StrAx software. We applied the Inference about Causation through Examination of FAmiliaL CONfounding (ICE FALCON) method. Within‐individuals, distal tibia total bone area, cortical area, cortical thickness, and trabecular number were positively associated with LM (standardized regression coefficient (β) = 0.13 to 0.43; all p < 0.05); porosity of the inner transitional zone (ITZ) was negatively associated with LM (β = −0.22; p < 0.01). Trabecular number was positively associated with FM (β = 0.40; p < 0.001), and trabecular thickness was negatively associated with FM (β = −0.27; p < 0.001). For porosity of ITZ and trabecular number, the cross‐pair cross‐trait association with LM was significant before and after adjustment for the within‐individual association with LM (all ps < 0.05). For trabecular number, the cross‐pair cross‐trait association with FM was significant before and after adjustment for the within‐individual association with FM (p < 0.01). There were no significant changes in these cross‐pair cross‐trait associations after adjustment for the within‐individual association (p = 0.06 to 0.99). Similar results were found for distal radius measures. We conclude that there was no evidence that the relationships of LM and FM with bone microarchitecture and geometry are causal; they must in part due to by familial confounders affecting both bone architecture and body composition. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Minh Bui
- Centre for Epidemiology and Biostatistics, School of Population and Global Health University of Melbourne Melbourne Victoria Australia
| | - Roger Zebaze
- Department of Medicine, School of Clinical Sciences Monash University Melbourne Victoria Australia
| | - Shuai Li
- Centre for Epidemiology and Biostatistics, School of Population and Global Health University of Melbourne Melbourne Victoria Australia.,Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care University of Cambridge Cambridge UK
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, School of Population and Global Health University of Melbourne Melbourne Victoria Australia
| | - Åshild Bjørnerem
- Department of Clinical Medicine UiT - The Arctic University of Norway Tromsø Norway.,Department of Obstetrics and Gynecology University Hospital of North Norway Tromsø Norway
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He T, Cui L, Niu N, Wang F, Miao H, Zhao H, Gao X, Liu C, Yu F, Jiang Y, Wang O, Li M, Xing X, Zhou D, Li J, Cao X, Xia W. Bone mineral density and bone microarchitecture in a cohort of patients with Erdheim-Chester Disease. Orphanet J Rare Dis 2020; 15:236. [PMID: 32887616 PMCID: PMC7487812 DOI: 10.1186/s13023-020-01518-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 08/24/2020] [Indexed: 02/07/2023] Open
Abstract
Background Erdheim-Chester Disease (ECD) is a rare type of non-Langerhans histiocytosis. Skeletal structures are affected in over 95% ECD patients. Due to the lack of proper imaging assessment tools, the alteration of bone microarchitecture in ECD has not been well studied. High-resolution peripheral quantitative computed tomography (HR-pQCT) is a newly developed assessment of bone mineral density and bone microarchitecture. Methods We performed a cross-sectional study with 13 patients diagnosed with ECD in Peking Union Medical College Hospital between October 2018 and June 2019. The diagnosis of ECD was based on typical pathological findings in the context of appropriate clinical and radiological manifestations. Bone geometry, volumetric bone mineral density and bone microarchitecture of those ECD patients were assessed using HR-pQCT at the non-dominant distal radius and distal tibia. Those HR-pQCT parameters were then compared to an ongoing population-based database of HR-pQCT for Mainland Chinese. Results As a result, remarkable heterogeneity of osteosclerosis in the HR-pQCT images was found in ECD patients, ranging from apparent normal structure, scattered thickening of trabecula, to homogenous consolidation. In terms of quantitative measurements, total volumetric BMD (383.50 mg/cm3, 1.352 times of normal mean, p = 0.023) of the tibia differed significantly in ECD patients, due to the increased trabecular volumetric BMD (291 mg/cm3, 2.058 times of normal mean, p = 0.003). The increased trabecular volumetric BMD of tibia was associated with remarkably increased number of trabecula (1.7/mm, 1.455 times of normal mean, p = 0.002) and increased thickness of trabecula (0.37 mm, 1.466 times of normal mean, p = 0.003). These differences could be due to the existence of dense bone interposed in the trabecula. Conclusion This study is the first to assess the volumetric bone mineral density and bone microstructure with HR-pQCT in a cohort of ECD patients and indicated that the application of HR-pQCT may help to reveal the nature of bone lesions in the disease.
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Affiliation(s)
- Tianhua He
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Lijia Cui
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Na Niu
- Department of Nuclear Medicine, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Fengdan Wang
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Huilei Miao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Hao Zhao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xuemin Gao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Chang Liu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Fan Yu
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Yan Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Ou Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Mei Li
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xiaoping Xing
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Daobin Zhou
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Jian Li
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China
| | - Xinxin Cao
- Department of Hematology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, Ministry of Health, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 100730, China.
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Vieth R. Weaker bones and white skin as adaptions to improve anthropological "fitness" for northern environments. Osteoporos Int 2020; 31:617-624. [PMID: 31696275 PMCID: PMC7075826 DOI: 10.1007/s00198-019-05167-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 09/11/2019] [Indexed: 01/12/2023]
Abstract
The vitamin D paradox relates to the lower risk of osteoporosis in people of sub-Saharan African ancestry (Blacks) compared with people of European ancestry (Whites). The paradox implies that for bone health, Blacks require less vitamin D and calcium than Whites do. Why should populations that migrated northward out of Africa have ended up needing more vitamin D than tropical Blacks? Human skin color became lighter away from the tropics to permit greater skin penetration of the UVB light that generates vitamin D. Lack of vitamin D impairs intestinal calcium absorption and limits the amount of calcium that can deposit into the protein matrix of bone, causing rickets or osteomalacia. These can cause cephalopelvic disproportion and death in childbirth. Whiter skin was more fit for reproduction in UV-light restricted environments, but natural selection was also driven by the phenotype of bone per se. Bone formation starts with the deposition of bone-matrix proteins. Mineralization of the matrix happens more slowly, and it stiffens bone. If vitamin D and/or calcium supplies are marginal, larger bones will not be as fully mineralized as smaller bones. For the same amount of mineral, unmineralized or partially mineralized bone is more easily deformed than fully mineralized bone. The evidence leads to the hypothesis that to minimize the soft bone that causes pelvic deformation, a decrease in amount of bone, along with more rapid mineralization of osteoid improved reproductive fitness in Whites. Adaptation of bone biology for reproductive fitness in response to the environmental stress of limited availability of vitamin D and calcium came at the cost of greater risk of osteoporosis later in life.
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Affiliation(s)
- R Vieth
- Department of Laboratory Medicine and Pathobiology, and Department of Nutritional Sciences, Faculty of Medicine, University of Toronto, Medical Sciences Building, 5th Floor, Room 5253A 1 King's College Circle, Toronto, Ontario, M5S 1A8, Canada.
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