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Kocabas GU, Yurekli BS, Simsir IY, Ozgur S, Aksit M, Bozkaya G. Assessment of osteoprotegerin and RANKL levels and several cardiovascular risk scoring systems in acromegaly. Hormones (Athens) 2024; 23:81-88. [PMID: 37981618 DOI: 10.1007/s42000-023-00509-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 11/09/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE The OPG/RANKL (osteoprotegerin/receptor activator of nuclear factor kappa-B) system, which plays a crucial role in bone metabolism, is also associated with vascular calcification. Acromegaly is characterized by excessive secretion of growth hormone and insulin-like growth factor, and studies have demonstrated an elevated risk of cardiovascular disease in individuals with acromegaly. In this study, our objective was to investigate the relationship between OPG/RANKL and various cardiovascular risk scoring systems. METHODS We recruited 44 consecutive acromegaly patients and 41 healthy controls with a similar age and gender distribution for this study. RESULTS While RANKL levels were significantly higher in the acromegaly group compared to the controls, OPG levels were not found to be significantly different between the two groups. Furthermore, within the acromegaly group, RANKL levels were significantly higher in patients with active acromegaly compared to those with controlled acromegaly. Osteoprotegerin levels showed a positive correlation with the Framingham risk score (FRS) in the acromegaly group. Linear regression analysis revealed an association of OPG with FRS (adjusted R2 value of 21.7%). CONCLUSION OPG and RANKL may serve as potential markers for assessment of cardiovascular calcification and prediction of the cardiovascular risk status in acromegalic patients.
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Affiliation(s)
- Gokcen Unal Kocabas
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey.
| | - Banu Sarer Yurekli
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ilgin Yildirim Simsir
- Division of Endocrinology and Metabolism Disorders, Department of Internal Medicine, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Su Ozgur
- Ege University Translational Pulmonary Research Center, Regional Hub for Cancer Registration in North Africa, Central and Western Asia, WHO/IARC GICR, Izmir, Turkey
| | - Murat Aksit
- Department of Medical Biochemistry, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Giray Bozkaya
- Department of Medical Biochemistry, Bozyaka Training and Research Hospital, Izmir, Turkey
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Fang J, Zhang X, Chen X, Wang Z, Zheng S, Cheng Y, Liu S, Hao L. The role of insulin-like growth factor-1 in bone remodeling: A review. Int J Biol Macromol 2023; 238:124125. [PMID: 36948334 DOI: 10.1016/j.ijbiomac.2023.124125] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 03/15/2023] [Accepted: 03/17/2023] [Indexed: 03/24/2023]
Abstract
Insulin-like growth factor (IGF)-1 is a polypeptide hormone with vital biological functions in bone cells. The abnormal expression of IGF-1 has a serious effect on bone growth, particularly bone remodeling. Evidence from animal models and human disease suggested that both IGF-1 deficiency and excess cause changes in bone remodeling equilibrium, resulting in profound alterations in bone mass and development. Here, we first introduced the functions and mechanisms of the members of IGFs in bone. Subsequently, the critical role of IGF-1 in the process of bone remodeling were emphasized from the aspects of bone resorption and bone formation respectively. This review explains the mechanism of IGF-1 in maintaining bone mass and bone homeostasis to a certain extent and provides a theoretical basis for further research.
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Affiliation(s)
- Jiayuan Fang
- College of Animal Science, Jilin University, Changchun 130062, China
| | - Xunming Zhang
- College of Animal Science, Jilin University, Changchun 130062, China
| | - Xi Chen
- College of Animal Science, Jilin University, Changchun 130062, China
| | - Zhaoguo Wang
- College of Animal Science, Jilin University, Changchun 130062, China
| | - Shuo Zheng
- College of Animal Science, Jilin University, Changchun 130062, China
| | - Yunyun Cheng
- College of Public Health, Jilin University, Changchun 130061, China
| | - Songcai Liu
- College of Animal Science, Jilin University, Changchun 130062, China
| | - Linlin Hao
- College of Animal Science, Jilin University, Changchun 130062, China.
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Dissociation of Bone Resorption and Formation in Spaceflight and Simulated Microgravity: Potential Role of Myokines and Osteokines? Biomedicines 2022; 10:biomedicines10020342. [PMID: 35203551 PMCID: PMC8961781 DOI: 10.3390/biomedicines10020342] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 01/27/2022] [Accepted: 01/28/2022] [Indexed: 11/16/2022] Open
Abstract
The dissociation of bone formation and resorption is an important physiological process during spaceflight. It also occurs during local skeletal unloading or immobilization, such as in people with neuromuscular disorders or those who are on bed rest. Under these conditions, the physiological systems of the human body are perturbed down to the cellular level. Through the absence of mechanical stimuli, the musculoskeletal system and, predominantly, the postural skeletal muscles are largely affected. Despite in-flight exercise countermeasures, muscle wasting and bone loss occur, which are associated with spaceflight duration. Nevertheless, countermeasures can be effective, especially by preventing muscle wasting to rescue both postural and dynamic as well as muscle performance. Thus far, it is largely unknown how changes in bone microarchitecture evolve over the long term in the absence of a gravity vector and whether bone loss incurred in space or following the return to the Earth fully recovers or partly persists. In this review, we highlight the different mechanisms and factors that regulate the humoral crosstalk between the muscle and the bone. Further we focus on the interplay between currently known myokines and osteokines and their mutual regulation.
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Griffin JS, Dent SC, Berger SM. Pathways linking activity, adiposity, and inflammation to bone mineral density in women and men from NHANES 2007 to 2010. Am J Hum Biol 2021; 33:e23583. [PMID: 33645876 DOI: 10.1002/ajhb.23583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 02/07/2021] [Accepted: 02/08/2021] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Age, sedentary activity, central adiposity, and inflammation have all been independently associated with bone mineral density (BMD). We assessed how the effects of sedentary activity and central adiposity on BMD of the lumbar spine and femoral neck change across early to late adulthood and whether these relationships are mediated by inflammation. METHODS We analyzed data from 7135 women and men 20 years of age and older from NHANES 2007 to 2010. Anthropometrics, sedentary activity (min/day), serum CRP (mg/dl), and BMD (gm/cm2 measured by DXA scans) at the femoral neck and lumbar spine. Data were compared by age and sex groups and through causal mediation analysis. RESULTS The effect of waist circumference on BMD was significantly mediated by serum CRP at both skeletal sites in men and at the femoral neck in women. Sedentary activity did not have a direct relationship to BMD but was mediated by waist circumference in men. Least square means differed significantly by sex and age groups with a general age-related decline in BMD at both skeletal sites. CONCLUSIONS We found that central adiposity, independent of overall body size and composition as measured through BMI, has an inverse relationship with BMD that is mediated by serum CRP. In addition, the negative impact of increased sedentism acted through changes in central adiposity (waist circumference) but only in men. Although low bone density and osteoporosis are often considered degenerative diseases that primarily impact postmenopausal women, our findings show that sedentary activity and central adiposity impact bone density beginning in early adulthood in both women and men.
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Affiliation(s)
- Jacob S Griffin
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sophia C Dent
- Department of Anthropology, Appalachian State University, Boone, North Carolina, USA
| | - Steph M Berger
- Department of Anthropology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Xu X, Tang Y, Lang Y, Liu Y, Cheng W, Xu H, Liu Y. Oral Exposure to ZnO Nanoparticles Disrupt the Structure of Bone in Young Rats via the OPG/RANK/RANKL/IGF-1 Pathway. Int J Nanomedicine 2020; 15:9657-9668. [PMID: 33299310 PMCID: PMC7721121 DOI: 10.2147/ijn.s275553] [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] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 11/10/2020] [Indexed: 01/04/2023] Open
Abstract
Purpose To evaluate the effects of ZnO NPs on bone growth in rats and explore the possible mechanisms of action. Materials and Methods Three-week-old male rats received ultrapure water or 68, 203, and 610 mg/kg zinc oxide nanoparticles (ZnO NPs) for 28 days, orally. Results The high-dosage groups caused significant differences in weight growth rate, body length, and tibia length (P<0.05), all decreasing with increased ZnO NP dosage. There were no significant differences in body mass index (BMI) (P>0.05). The zinc concentration in liver and bone tissue increased significantly with increased ZnO NP dosage (P<0.05). Clearly increased aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels were observed in the 610 mg/kg ZnO NP group (P>0.05), whereas alkaline phosphatase (ALP) increased in the 610 mg/kg ZnO NP group (P<0.05). Significant differences in insulin-like growth factor type 1 (IGF-1) levels and a decrease in calcium (Ca) levels were observed in 203 and 610 mg/kg ZnO NP groups (P<0.05). Phosphorus (P) levels increased and the Ca/P ratio decreased in the 610 mg/kg ZnO NP group (P<0.05). Micro-computed tomography (micro-CT) of the tibia demonstrated signs of osteoporosis, such as decreased bone density, little trabecular bone structure and reduced cortical bone thickness. Micro-CT data further demonstrated significantly decreased bone mineral density (BMD), trabecular number (Tb.N), and relative bone volume (BV/TV) with increasing dosage of ZnO NPs. Osteoprotegerin (OPG) expression and the ratio of OPG to receptor activator of nuclear factor-κB ligand (RANKL) were statistically lower in the 610 mg/kg ZnO NP group (P<0.05), whereas RANKL expression did not change significantly (P>0.05). Conclusion We infer that ZnO NPs affect bone growth in young rats directly or indirectly by altering IGF-1 levels. Overall, the results indicate that ZnO NPs promote osteoclast activity and increase bone loss through the OPG/RANK/RANKL/IGF-1 pathway.
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Affiliation(s)
- Xinyue Xu
- Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, People's Republic of China
| | - Yizhou Tang
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, People's Republic of China
| | - Yuanyuan Lang
- Medical Imaging Center, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, People's Republic of China
| | - Yanling Liu
- Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, People's Republic of China
| | - Wenshu Cheng
- Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, People's Republic of China
| | - Hengyi Xu
- State Key Laboratory of Food Science and Technology, Nanchang University, Nanchang 330047, People's Republic of China
| | - Yang Liu
- Department of Pediatrics, The Second Affiliated Hospital of Nanchang University, Nanchang 330006, People's Republic of China
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Bielecka-Dabrowa A, Ebner N, Dos Santos MR, Ishida J, Hasenfuss G, von Haehling S. Cachexia, muscle wasting, and frailty in cardiovascular disease. Eur J Heart Fail 2020; 22:2314-2326. [PMID: 32949422 DOI: 10.1002/ejhf.2011] [Citation(s) in RCA: 78] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022] Open
Abstract
The last several years have seen increasing interest in understanding cachexia, muscle wasting, and physical frailty across the broad spectrum of patients with cardiovascular illnesses. This interest originally started in the field of heart failure, but has recently been extended to other areas such as atrial fibrillation, coronary artery disease, peripheral artery disease as well as to patients after cardiac surgery or transcatheter aortic valve implantation. Tissue wasting and frailty are prevalent among many of the affected patients. The ageing process itself and concomitant cardiovascular illness decrease lean mass while fat mass is relatively preserved, making elderly patients particularly prone to develop wasting syndromes and frailty. The aim of this review is to provide an overview of the available knowledge of body wasting and physical frailty in patients with cardiovascular illness, particularly focussing on patients with heart failure in whom most of the available data have been gathered. In addition, mechanisms of wasting and possible therapeutic targets are discussed.
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Affiliation(s)
- Agata Bielecka-Dabrowa
- Department of Cardiology and Congenital Diseases of Adults, Polish Mother's Memorial Hospital Research Institute (PMMHRI), Lodz, Poland.,Department of Hypertension, Chair of Nephrology and Hypertension, Medical University of Lodz, Lodz, Poland
| | - Nicole Ebner
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | | | - Junishi Ishida
- Department of Cardiovascular Medicine, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Gerd Hasenfuss
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
| | - Stephan von Haehling
- Department of Cardiology and Pneumology, University of Göttingen Medical Center, Göttingen, Germany.,German Center for Cardiovascular Research (DZHK), Partner Site Göttingen, Göttingen, Germany
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Comprehensive assessment of tissue and serum parameters of bone metabolism in a series of orthopaedic patients. PLoS One 2019; 14:e0227133. [PMID: 31881044 PMCID: PMC6934299 DOI: 10.1371/journal.pone.0227133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 12/11/2019] [Indexed: 12/21/2022] Open
Abstract
Bone diseases represent an increasing health burden worldwide, and basic research remains necessary to better understand the complexity of these pathologies and to improve and expand existing prevention and treatment approaches. In the present study, 216 bone samples from the caput femoris and collum femoris of 108 patients with degenerative or dysplastic coxarthrosis, hip fracture, or osteonecrosis were evaluated for the proportion of trabecular bone (TB) and expression of parathyroid hormone (PTH) type 1 receptor (PTH1R), osteoprotegerin (OPG), and receptor activator of nuclear factor kappa-B ligand (RANKL). Serum levels of PTH, OPG, soluble RANKL (sRANKL), alkaline phosphatase (AP), osteocalcin, total procollagen type-1 intact N-terminal propeptide (TP1NP), tartrate-resistant acid phosphatase type 5b (TRAP5b), sclerostin, and C-telopeptide of type-1 collagen (ICTP) were also determined. Age was positively correlated with serum levels of PTH, OPG, and sclerostin but negatively associated with TB and sRANKL. Women exhibited less TB, lower sclerostin and ICTP, and higher TRAP5b. Impaired kidney function was associated with shorter bone decalcification time, less TB, lower sRANKL, and higher serum PTH, OPG, and sclerostin. Furthermore, correlations were observed between bone PTH1R and OPG expression and between serum PTH, OPG, and AP. There were also positive correlations between serum OPG and TP1NP; serum OPG and sclerostin; serum AP, osteocalcin, and TRAP5b; and serum sclerostin and ICTP. Serum OPG was negatively associated with sRANKL. In summary, clear relationships between specific bone metabolism markers were observed, and distinct influences of age, sex, and kidney function, thus underscoring their suitability as diagnostic or prognostic markers.
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Liu H, Zhu R, Wang L, Liu C, Ma R, Qi B, Chen B, Li L, Guo Y, Shi S, Jia Q, Niu J, Zhao D, Mo F, Gao S, Zhang D. Radix Salviae miltiorrhizae
improves bone microstructure and strength through Wnt/β-catenin and osteoprotegerin/receptor activator for nuclear factor-κB ligand/cathepsin K signaling in ovariectomized rats. Phytother Res 2018; 32:2487-2500. [DOI: 10.1002/ptr.6188] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 07/16/2018] [Accepted: 08/13/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Haixia Liu
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Ruyuan Zhu
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Lili Wang
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
- Chinese Materia Medica School; Beijing University of Chinese Medicine; Beijing China
| | - Chenyue Liu
- Chinese Materia Medica School; Beijing University of Chinese Medicine; Beijing China
| | - Rufeng Ma
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Guang'anmen Hospital; China Academy of Chinese Medical Sciences; Beijing China
| | - Bowen Qi
- Chinese Materia Medica School; Beijing University of Chinese Medicine; Beijing China
| | - Beibei Chen
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Lin Li
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Yubo Guo
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- The Third Affiliated Clinical Hospital; Beijing University of Chinese Medicine; Beijing China
| | - Shepo Shi
- Chinese Materia Medica School; Beijing University of Chinese Medicine; Beijing China
| | - Qiangqiang Jia
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Jianzhao Niu
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Dandan Zhao
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Fangfang Mo
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Sihua Gao
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
| | - Dongwei Zhang
- Diabetes Research Center; Beijing University of Chinese Medicine; Beijing China
- Traditional Chinese Medicine School; Beijing University of Chinese Medicine; Beijing China
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Abstract
Prenatal hypoxia causes intrauterine growth retardation. It is unclear whether/how hypoxia affects the bone in fetal and offspring life. This study showed that prenatal hypoxia retarded fetal skeletal growth in rats, inhibited extracellular matrix (ECM) synthesis and down-regulated of insulin-like growth factor 1 (IGF1) signaling in fetal growth plate chondrocytes in vivo and in vitro. In addition, ovariectomized (OVX) was used for study of postmenopausal osteoporosis. Compared with the control, OVX offspring in prenatal hypoxic group showed an enhanced osteoporosis in the femurs, associated with reduced proteoglycan and IGF1 signaling. The results indicated prenatal hypoxia not only delayed fetal skeletal growth, but also increased OVX-induced osteoporosis in the elder offspring probably through down-regulated IGF1 signaling and inhibition of ECM synthesis, providing important information of prenatal hypoxia on functional and molecular bone growth and metabolism in fetal and offspring.
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Chen YC, Zhang L, Li EN, Ding LX, Zhang GA, Hou Y, Yuan W. Association of the insulin-like growth factor-1 single nucleotide polymorphisms rs35767, rs2288377, and rs5742612 with osteoporosis risk: A meta-analysis. Medicine (Baltimore) 2017; 96:e9231. [PMID: 29390475 PMCID: PMC5758177 DOI: 10.1097/md.0000000000009231] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Insulin-like growth factor-1 (IGF-1) plays an important role in the regulation of bone formation and mineralization. We aimed to perform a meta-analysis to assess the association of three IGF-1 single nucleotide polymorphisms (SNPs) rs35767, rs2288377, and rs5742612 with osteoporosis risk. METHODS A systematic search of PubMed, Web of Science, Embase, Medline, Scopus, CNKI, and Wanfang databases was conducted. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using a fixed effects model. RESULTS Four Chinese case-control studies with a total of 2807 participants were included in this meta-analysis. The results revealed an association between rs35767 and osteoporosis risk in all study subjects (women and men) in dominant (OR 1.32, 95% CI 1.13-1.53, P < .001), recessive (OR 1.73, 95% CI 1.35-2.21, P < .001), homozygote (OR 1.89, 95% CI 1.46-2.45, P < .001), and allelic (OR 1.31, 95% CI 1.18-1.47, P < .001) models. Subgroup analysis according to gender showed that rs35767 was associated with osteoporosis risk in women under dominant (OR 1.29, 95% CI 1.08-1.54, P = .005), recessive (OR 1.59, 95% CI 1.19-2.12, P = .002), homozygote (OR 1.73, 95% CI 1.28-2.34, P < .001), and allelic (OR 1.28, 95% CI 1.12-1.47, P < .001) models. Meta-analysis did not find associations of rs2288377 and rs5742612 with osteoporosis risk. There was no evidence of between-study heterogeneity and publication bias. CONCLUSION Our results suggest that rs35767 is associated with osteoporosis risk in Chinese, whereas there is no association of rs2288377 and rs5742612 with osteoporosis risk.
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Affiliation(s)
- Ying-Chun Chen
- Department of Spine Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
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Rucker K, de Sá LBPC, Arbex AK. Growth Hormone Replacement Therapy in Patients without Adult Growth Hormone Deficiency: What Answers Do We Have So Far? Health (London) 2017. [DOI: 10.4236/health.2017.95057] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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12
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Ekbote VH, Khadilkar VV, Khadilkar AV, Mughal Z, Chiplonkar SA, Palande SA, Phanse-Gupte SS, Patwardhan VG, Shilvant DS. Relationship of insulin-like growth factor 1 and bone parameters in 7-15 years old apparently, healthy Indian children. Indian J Endocrinol Metab 2015; 19:770-774. [PMID: 26693426 PMCID: PMC4673804 DOI: 10.4103/2230-8210.167549] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Growth hormone through insulin-like growth factor 1 (IGF-1) plays an important role in both bone growth and mineralization. This cross-sectional study was carried out to evaluate the relationship between serum IGF-1 concentrations and dual energy X-ray (DXA) measured whole body less head bone area (BA), lean body mass (LBM), and bone mineral content (BMC). METHODS One hundred and nineteen children (boys = 70, age = 7.3-15.6 years) were studied for their anthropometric parameters by standard methods and bone and body composition by DXA. Their fasting serum IGF-1 concentrations were assessed by enzyme-linked immunosorbent assay and Z-scores were calculated using available reference data. Bone and body composition parameter Z-scores were calculated using ethnic reference data. RESULTS Mean age of the boys and girls was similar (11.5 ± 1.8 years). The mean serum IGF-1concentrations and IGF-1 Z-scores were similar (P > 0.1) between boys and girls and were of the order of (302.3 ± 140.0 and - 1.4 ± 1.1, respectively). The LBM for age and BA for age Z-score was greater in children with IGF-1 Z-score > median than children with IGF-1 Z-score < median. The mean BMC for age Z-scores were 0.4 ± 0.9 and - 0.2 ± 0.8 in children with above and below the median of IGF-1 Z-score (P > 0.1). CONCLUSION Serum IGF-1 levels were more strongly associated with BA and LBM, suggesting that its effect on bone is greater with respect to periosteal bone acquisition and through its effect on muscle mass.
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Affiliation(s)
- Veena H. Ekbote
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Vaman V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Anuradha V. Khadilkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Zulf Mughal
- Department of Paediatric Endocrinology, Royal Manchester Children's Hospital, Manchester, M13 9WL, UK
| | - Shashi A. Chiplonkar
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Sonal A. Palande
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Supriya S. Phanse-Gupte
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Vivek G. Patwardhan
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
| | - Dhanashri S. Shilvant
- Growth and Endocrine Unit, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, Maharashtra, India
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Girgis CM. Integrated therapies for osteoporosis and sarcopenia: from signaling pathways to clinical trials. Calcif Tissue Int 2015; 96:243-55. [PMID: 25633430 DOI: 10.1007/s00223-015-9956-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 01/15/2015] [Indexed: 12/15/2022]
Abstract
Sarcopenia and osteoporosis are two sides of the same coin. They represent different aspects of the same age-related process of musculoskeletal atrophy and together culminate in falls, fractures, deconditioning, and increased mortality in older individuals. However, the current therapeutic approach to the prevention of minimal trauma fracture is unilateral and focuses solely on bone. In theory, an integrated approach that recognizes the interaction between muscle and bone could break the vicious cycle of their combined involution and more effectively minimize falls/fractures. In this review, signaling pathways and cross-talk mechanisms that integrate bone/muscle, and the emergence of novel therapies that exploit these pathways to target osteoporosis/sarcopenia will be discussed. In broad terms, these agents act on nuclear receptors (e.g., VDR, AR) or transmembrane receptors (e.g., activins, GH/IGF-1) expressed in muscle and bone, and seek to alter biologic responses to musculoskeletal aging, loading, and injury. Challenges in the development of these dual bone-muscle therapies, early clinical trials examining their safety/efficacy, and novel targets that hold promise in the reversal of musculoskeletal aging will be discussed.
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Affiliation(s)
- Christian M Girgis
- Westmead Millennium Institute for Medical Research, 176 Hawkesbury Rd, Westmead, NSW, Australia,
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Elkazaz AY, Salama K. The effect of oral contraceptive different patterns of use on circulating IGF-1 and bone mineral density in healthy premenopausal women. Endocrine 2015; 48:272-8. [PMID: 24861474 DOI: 10.1007/s12020-014-0290-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2013] [Accepted: 05/05/2014] [Indexed: 11/30/2022]
Abstract
Both insulin-like growth factor-1(IGF-1) and oral contraceptive (OC) use have been linked to premenopausal breast and colorectal cancers, osteoporosis and cardiovascular disease. Understanding the effects of different patterns of use of OC on IGF-1 levels and bone mineral density (BMD) may offer insight into its influence on osteoporosis. We conducted a cross-sectional study, which included 135 women, who were then divided into three groups: Group A who were OC current users, 41 women; Group B who never use OC, 51 women; and Group C who were past users of OC, 41 women. Each patient completed a questionnaire on demographic parameters, marital state history and contraception history including duration of use and type of contraceptive pills or used method. Lower-end radius, proximal femur and lumbar spine BMD were measured by dual-energy X-ray absorptiometry. IGF-1 was assessed with chemiluminescent immunometric assay. The three groups were similar in total body T value of BMD (with slight better results in past users than the other two groups but it was statistically insignificant difference), and past users showed significantly higher BMD values compared to current users at spine, femur and forearm. Nonusers also had better BMD values compared to current users (spine and forearm BMD). Among past users, the mean level of circulating IGF-1 was higher than the other two groups and that difference was statistically significant. Past OC use and/or nonuse has a more favorable impact on BMD compared to current use and that this relationship is in part mediated by IGF-1. Hence, it appears that OC use is beneficial to BMD if used in the past and then discontinued or if never used at all compared to current use.
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Affiliation(s)
- Amany Y Elkazaz
- Department of Medical Biochemistry, Faculty of Medicine, Suez Canal University, Ismailia, Egypt,
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15
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Abstract
Musculoskeletal diseases are highly prevalent with staggering annual health care costs across the globe. The combined wasting of muscle (sarcopenia) and bone (osteoporosis)-both in normal aging and pathologic states-can lead to vastly compounded risk for fracture in patients. Until now, our therapeutic approach to the prevention of such fractures has focused solely on bone, but our increasing understanding of the interconnected biology of muscle and bone has begun to shift our treatment paradigm for musculoskeletal disease. Targeting pathways that centrally regulate both bone and muscle (eg, GH/IGF-1, sex steroids, etc.) and newly emerging pathways that might facilitate communication between these 2 tissues (eg, activin/myostatin) might allow a greater therapeutic benefit and/or previously unanticipated means by which to treat these frail patients and prevent fracture. In this review, we will discuss a number of therapies currently under development that aim to treat musculoskeletal disease in precisely such a holistic fashion.
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Affiliation(s)
- Christian M Girgis
- Garvan Institute of Medical Research, 384 Victoria St, Darlinghurst, Sydney NSW, Australia,
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16
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Authors' response. Am J Orthod Dentofacial Orthop 2013; 143:447-8. [PMID: 23561401 DOI: 10.1016/j.ajodo.2013.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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17
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Moghadasi M, Siavashpour S. The effect of 12 weeks of resistance training on hormones of bone formation in young sedentary women. Eur J Appl Physiol 2012; 113:25-32. [PMID: 22562545 DOI: 10.1007/s00421-012-2410-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2011] [Accepted: 04/18/2012] [Indexed: 10/28/2022]
Abstract
Physical activity has been proposed as one strategy to enhance bone mineral acquisition; however, the basic mechanisms of this effect are not fully understood. The purpose of this study was to investigate the effect of 12 weeks of resistance training on hormones of bone formation in young sedentary women. Twenty sedentary females (aged 25.3 ± 3.2 years; ±SD) volunteered to participate in this study. The subjects were randomly assigned to a training group (n = 10) or control group (n = 10). Subjects executed eight resistance exercises selected to stress the major muscle groups in the following order: chest press, leg extension, shoulder press, leg curls, latissimus pull down, leg press, arm curls, and triceps extension. Resistance training consisted of 50-60 min of circuit weight training per day, 3 days a week, for 12 weeks. This training was circularly performed in eight stations and included two to four sets with 8-12 maximal repetitions at 65-80 % of one-repetition maximum in each station. After 12 weeks, the training group had a significant increase (P < 0.05) in the growth hormone, estrogen, parathyroid hormone and testosterone compared to the control group. The results showed that insulin-like growth factor I levels did not change significantly in response to resistance training. In conclusion, the results suggest that resistance training with specific intensity and duration utilized in this study increases the hormones of bone formation in young sedentary women.
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Affiliation(s)
- Mehrzad Moghadasi
- Department of Exercise Physiology, Shiraz Branch, Islamic Azad University, Shiraz, Iran.
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18
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Peng KY, Horng LY, Sung HC, Huang HC, Wu RT. Antiosteoporotic Activity of Dioscorea alata L. cv. Phyto through Driving Mesenchymal Stem Cells Differentiation for Bone Formation. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2011; 2011:712892. [PMID: 21760825 PMCID: PMC3132482 DOI: 10.1155/2011/712892] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/15/2010] [Revised: 01/22/2011] [Accepted: 03/17/2011] [Indexed: 11/17/2022]
Abstract
The aim of this study was to evaluate the effect of an ethanol extract of the rhizomes of Dioscorea alata L. cv. Phyto, Dispo85E, on bone formation and to investigate the mechanisms involved. Our results showed that Dispo85E increased the activity of alkaline phosphatase (ALP) and bone nodule formation in primary bone marrow cultures. In addition, Dispo85E stimulated pluripotent C3H10T1/2 stem cells to differentiate into osteoblasts rather than adipocytes. Our in vivo data indicated that Dispo85E promotes osteoblastogenesis by increasing ALP activity and bone nodule formation in both intact and ovariectomized (OVX) mice. Microcomputed tomography (μCT) analysis also showed that Dispo85E ameliorates the deterioration of trabecular bone mineral density (tBMD), trabecular bone volume/total volume (BV/TV), and trabecular bone number (Tb.N) in OVX mice. Our results suggested that Dispo85E is a botanical drug with a novel mechanism that drives the lineage-specific differentiation of bone marrow stromal cells and is a candidate drug for osteoporosis therapy.
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Affiliation(s)
- Kang-Yung Peng
- Institute of Biopharmaceutical Science, School of Pharmaceutical Science, National Yang-Ming University, Taipei City 112, Taiwan
| | - Lin-Yea Horng
- Research Center for Drug Discovery, National Yang-Ming University, Taipei City 112, Taiwan
| | - Hui-Ching Sung
- Research Center for Drug Discovery, National Yang-Ming University, Taipei City 112, Taiwan
| | - Hui-Chuan Huang
- Institute of Biopharmaceutical Science, School of Pharmaceutical Science, National Yang-Ming University, Taipei City 112, Taiwan
| | - Rong-Tsun Wu
- Institute of Biopharmaceutical Science, School of Pharmaceutical Science, National Yang-Ming University, Taipei City 112, Taiwan
- Research Center for Drug Discovery, National Yang-Ming University, Taipei City 112, Taiwan
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Trouvin AP, Goëb V. Receptor activator of nuclear factor-κB ligand and osteoprotegerin: maintaining the balance to prevent bone loss. Clin Interv Aging 2010; 5:345-54. [PMID: 21228900 PMCID: PMC3010170 DOI: 10.2147/cia.s10153] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2010] [Indexed: 12/30/2022] Open
Abstract
Bone remodeling requires a precise balance between resorption and formation. It is a complex process that involves numerous factors: hormones, growth factors, vitamins, and cytokines, and notably osteoprotegerin (OPG) and receptor activator for nuclear factor-κB (RANK) ligand. The signaling pathway OPG/RANK/RANKL is key to regulation for maintaining the balance between the activity of osteoblasts and osteoclasts in order to prevent bone loss and ensure a normal bone turnover. In this review, the RANK/RANKL/OPG pathway is described. The multiple interactions of various factors (hormones, cytokines, growth factors, and vitamins) with the OPG/RANK/RANKL pathway are also commented on. Finally, the effects of denosumab, a human monoclonal antibody that binds to RANKL and thereby inhibits the activation of osteoclasts, and of strontium ranelate are also described. Indeed, these two new drugs afford appreciable assistance in daily care practice, helping to prevent bone loss in patients with osteoporosis.
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Affiliation(s)
| | - Vincent Goëb
- Department of Rheumatology, Rouen University Hospital, Rouen, France
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Wagner D, Fahrleitner-Pammer A. Levels of osteoprotegerin (OPG) and receptor activator for nuclear factor kappa B ligand (RANKL) in serum: are they of any help? Wien Med Wochenschr 2010; 160:452-7. [PMID: 20714810 DOI: 10.1007/s10354-010-0818-x] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2010] [Accepted: 05/05/2010] [Indexed: 12/14/2022]
Abstract
The coupling of bone formation and resorption is mediated through the OPG/RANK/RANKL system. OPG and RANKL are mainly produced by osteoblasts but also a variety of other tissues. The binding of RANKL to RANK, its natural receptor which is expressed by osteoclasts, accelerates bone resorption. OPG acts as decoy receptor and prevents the interaction of RANKL with RANK and therefore leads to a decrease in activity, survival and proliferation of osteoclasts. Since assays for measurements of serum OPG and RANKL have become commercially available, intense research focused on serum OPG/RANKL levels in context with underlying disease, age, co-morbidities, bone density, and fractures has derived. This review aims to provide an overview if and to which extent serum OPG and RANKL levels may reflect bone metabolism in patients with osteoporosis and metabolic bone disease.
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Affiliation(s)
- Doris Wagner
- Department of Surgery, Medical University of Graz, Graz, Austria
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Kung AWC, Xiao SM, Cherny S, Li GHY, Gao Y, Tso G, Lau KS, Luk KDK, Liu JM, Cui B, Zhang MJ, Zhang ZL, He JW, Yue H, Xia WB, Luo LM, He SL, Kiel DP, Karasik D, Hsu YH, Cupples LA, Demissie S, Styrkarsdottir U, Halldorsson BV, Sigurdsson G, Thorsteinsdottir U, Stefansson K, Richards JB, Zhai G, Soranzo N, Valdes A, Spector TD, Sham PC. Association of JAG1 with bone mineral density and osteoporotic fractures: a genome-wide association study and follow-up replication studies. Am J Hum Genet 2010; 86:229-39. [PMID: 20096396 DOI: 10.1016/j.ajhg.2009.12.014] [Citation(s) in RCA: 141] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2009] [Revised: 12/18/2009] [Accepted: 12/23/2009] [Indexed: 11/18/2022] Open
Abstract
Bone mineral density (BMD), a diagnostic parameter for osteoporosis and a clinical predictor of fracture, is a polygenic trait with high heritability. To identify genetic variants that influence BMD in different ethnic groups, we performed a genome-wide association study (GWAS) on 800 unrelated Southern Chinese women with extreme BMD and carried out follow-up replication studies in six independent study populations of European descent and Asian populations including 18,098 subjects. In the meta-analysis, rs2273061 of the Jagged1 (JAG1) gene was associated with high BMD (p = 5.27 x 10(-8) for lumbar spine [LS] and p = 4.15 x 10(-5) for femoral neck [FN], n = 18,898). This SNP was further found to be associated with the low risk of osteoporotic fracture (p = 0.009, OR = 0.7, 95% CI 0.57-0.93, n = 1881). Region-wide and haplotype analysis showed that the strongest association evidence was from the linkage disequilibrium block 5, which included rs2273061 of the JAG1 gene (p = 8.52 x 10(-9) for LS and 3.47 x 10(-5) at FN). To assess the function of identified variants, an electrophoretic mobility shift assay demonstrated the binding of c-Myc to the "G" but not "A" allele of rs2273061. A mRNA expression study in both human bone-derived cells and peripheral blood mononuclear cells confirmed association of the high BMD-related allele G of rs2273061 with higher JAG1 expression. Our results identify the JAG1 gene as a candidate for BMD regulation in different ethnic groups, and it is a potential key factor for fracture pathogenesis.
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Affiliation(s)
- Annie W C Kung
- Department of Medicine, Research Centre of Heart, Brain, Hormone & Healthy Aging, Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Ostadrahimi A, Moradi T, Zarghami N, Shoja MM. Correlates of serum leptin and insulin-like growth factor-I concentrations in normal weight and overweight/obese Iranian women. J Womens Health (Larchmt) 2009; 17:1389-97. [PMID: 18771389 DOI: 10.1089/jwh.2007.0736] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Leptin and insulin-like growth factor-I (IGF-I) are two interrelated hormones that are implicated in the development or progression of coronary artery disease (CAD) and some cancers. The aim of this study was to investigate the relation between serum leptin and total IGF-I concentrations and to identify their correlations with age or anthropometric and body composition variables in healthy normal weight and overweight/obese Iranian women. METHODS The percent of body fat (BF%), fat mass (FM), fat-free mass (FFM), and waist/hip ratio (WHR) were determined in 51 healthy normal weight (body mass index [BMI] 18.5-24.9 kg/m(2)) and 50 overweight/obese (BMI > or = 25 kg/m(2)) Iranian reproductive-age women. Serum leptin and total IGF-I concentrations were measured by double-antibody sandwich assay and enzyme-linked immunosorbent assay (ELISA), respectively. Statistical analysis was performed by Mann-Whitney U test and Spearman's rank-correlation test. Multivariate linear regression analysis was performed with ranked-transformed data to obtain partial correlation coefficient. RESULTS In this group of healthy, premenopausal Iranian women, variance of serum leptin concentration was independently explained by FM (partial rho = 0.295, p < 0.01), and variance of the total IGF-I concentration was explained by age (partial rho = -0.214, p = 0.037) and BMI (partial rho = 0.229, p = 0.026). Overweight/obese women had higher leptin and total IGF-I concentrations than normal weight women (p < 0.01). The serum leptin and total IGF-I concentrations were differentially correlated with age and anthropometric and body composition variables in the two groups. Whereas in normal weight women, leptin was negatively related to BMI (partial rho = -0.356, p = 0.015), in overweight/obese women, BMI, BF%, and FM independently contributed to the serum leptin variability (partial rho = 0.370, p = 0.013; partial rho = -0.320, p = 0.034; partial rho = 0.421, p < 0.01, respectively). There was a weak association between age and total IGF-I concentration in normal weight women, which did not reach statistical significance (partial rho = -0.255, p = 0.091). None of the variables was associated with the total IGF-I in overweight/obese women (p > 0.05). CONCLUSIONS Although the studied anthropometric and body composition variables could explain approximately half of the leptin variance in Iranian women, they explained only a small proportion of total IGF-I variability. Our results indicated that the serum leptin and total IGF-I concentrations are differentially regulated in healthy normal weight and overweight/obese Iranian women.
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Affiliation(s)
- Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University (Medical Sciences), Tabriz, Iran
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Giustina A, Mazziotti G, Canalis E. Growth hormone, insulin-like growth factors, and the skeleton. Endocr Rev 2008; 29:535-59. [PMID: 18436706 PMCID: PMC2726838 DOI: 10.1210/er.2007-0036] [Citation(s) in RCA: 548] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2007] [Accepted: 04/03/2008] [Indexed: 12/18/2022]
Abstract
GH and IGF-I are important regulators of bone homeostasis and are central to the achievement of normal longitudinal bone growth and bone mass. Although GH may act directly on skeletal cells, most of its effects are mediated by IGF-I, which is present in the systemic circulation and is synthesized by peripheral tissues. The availability of IGF-I is regulated by IGF binding proteins. IGF-I enhances the differentiated function of the osteoblast and bone formation. Adult GH deficiency causes low bone turnover osteoporosis with high risk of vertebral and nonvertebral fractures, and the low bone mass can be partially reversed by GH replacement. Acromegaly is characterized by high bone turnover, which can lead to bone loss and vertebral fractures, particularly in patients with coexistent hypogonadism. GH and IGF-I secretion are decreased in aging individuals, and abnormalities in the GH/IGF-I axis play a role in the pathogenesis of the osteoporosis of anorexia nervosa and after glucocorticoid exposure.
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Affiliation(s)
- Andrea Giustina
- Department of Medical and Surgical Sciences, University of Brescia, Brescia, Italy.
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Liu JM, Zhao HY, Ning G, Chen Y, Zhang LZ, Sun LH, Zhao YJ, Xu MY, Chen JL. IGF-1 as an early marker for low bone mass or osteoporosis in premenopausal and postmenopausal women. J Bone Miner Metab 2008; 26:159-64. [PMID: 18301972 DOI: 10.1007/s00774-007-0799-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2007] [Accepted: 07/13/2007] [Indexed: 10/22/2022]
Abstract
To find out which of the following parameters-serum levels of insulin-like growth factor 1 (IGF-1), osteoprotegerin (OPG), leptin, osteocalcin (OC), and urinary excretion of N-terminal telopeptide of type I collagen (NTx), can be used as an early marker for osteopenia/osteoporosis in women diagnosed by dual-energy X-ray absorptiometry (DXA), 282 premenopausal and 222 postmenopausal women aged 20-75 years were investigated by the measurement of bone mineral densities (BMDs) at lumbar spine (LS) and femoral neck (FN) by DXA, together with serum concentrations of IGF-1, OPG, leptin, OC, and urinary NTx. The characteristics of the earliest marker(s) were tested with the receiver operating characteristic (ROC) analysis. The area under the curve (AUC), sensitivity, and specificity parameters were determined. It was revealed that serum levels of IGF-1 and leptin changed the earliest, with both markers significantly decreasing (P < 0.0001) or increasing (P = 0.020), respectively, at age 30. However, in ROC analysis, IGF-1 was the only early parameter that had the capacity to differentiate the low bone mass/osteoporosis women from the normal ones (P < 0.0001). If the serum level of IGF-1 at 1.5 SD below its peak was adopted as a cutoff point, it could identify women with low bone mass/osteoporosis with a sensitivity of 73% and specificity of 67%. In the premenopausal women subgroup analysis, the low bone mass women (30/282, 10.6%) were older (38.2 +/- 1.7 vs. 34.5 +/- 0.5 years; P = 0.026), with lower serum levels of IGF-1 (215.1 +/- 22.4 vs. 278.8 +/- 9.4 ng/ml; P = 0.02) and less lean mass (33.1 +/- 0.6 vs. 34.8 +/- 0.2 kg; P = 0.010) than the normal ones. After controlling for age, the serum level of IGF-1 had a weak, but still significant, positive correlation with lean mass (r = 0.17, P < 0.001). In conclusion, measurement of serum IGF-1 in young women may help in the early identification of those at risk for developing low bone mass and osteoporosis.
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Affiliation(s)
- Jian-min Liu
- Department of Endocrine and Metabolic Diseases, Rui-jin Hospital, Shanghai Jiao-tong University Medical School, 197 Shanghai Rui-jin Er Road, Shanghai 200025, China
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