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Ge Y, Jia Z, Zhao S, Zhang W, Shi X, Xie R, Gong Y, Sheng J, van 't Hof RJ, Yang J, Han C, Hu X, Wang Y, Wu Y, Li C, Wang M. Mitigating lead-induced osteoporosis: The role of butyrate in gut-bone axis restoration. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 283:116943. [PMID: 39216219 DOI: 10.1016/j.ecoenv.2024.116943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2024] [Revised: 08/22/2024] [Accepted: 08/23/2024] [Indexed: 09/04/2024]
Abstract
Lead (Pb) is an environmentally widespread bone toxic pollutant, contributes to the development of osteoporosis. Butyric acid, mainly produced by the fermentation of indigestible dietary fiber by gut microbiota, plays a pivotal role in the maintenance of bone homeostasis. However, the effects of butyric acids on the Pb induced osteoporosis have not yet been elucidated. In this study, our results showed that Pb exposure was negatively related to the abundance of butyric acid, in the Pb-exposed population and Pb-exposed mice. Pb exposure caused gut microbiota disorders, resulting in the decline of butyric acid-producing bacteria, such as Butyrivibrio_crossotus, Clostridium_sp._JN9, and the butyrate-producing enzymes through the acetyl-CoA pathway. Moreover, results from the NHANES data suggested that dietary intake of butyrate was associated with a reduced risk of osteoporosis in lead-burdened populations, particularly among men or participants aged 18-60 years. In addition, butyrate supplementation in mice with chronic Pb exposure improved the bone microarchitectures, repaired intestinal damage, upregulated the proportion of Treg cells. Taken together, these results demonstrated that chronic Pb exposure disturbs the gut-bone axis, which can be restored by butyric acid supplement. Our results suggest that butyrate supplementation is a possible therapeutic strategy for lead-induced bone toxicity.
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Affiliation(s)
- Yuqiu Ge
- MOE Medical Basic Research Innovation Center for Gut Microbiota and Chronic Diseases, Wuxi School of medicine, Jiangnan University, China; Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China; Public Health Research Center, Jiangnan University, Wuxi, Jiangsu, China
| | - Zhongtang Jia
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Shiting Zhao
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - WenChao Zhang
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Xian Shi
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Ruijin Xie
- Affiliated Hospital of Jiangnan University, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yan Gong
- Department of Occupational Medicine, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, China
| | - Jixiang Sheng
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Rob J van 't Hof
- Institute of Ageing and Chronic Disease, University of Liverpool, United Kingdom
| | - Jiatao Yang
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Chunqing Han
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Xiping Hu
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yafeng Wang
- Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China
| | - Yu Wu
- MOE Medical Basic Research Innovation Center for Gut Microbiota and Chronic Diseases, Wuxi School of medicine, Jiangnan University, China; Lab of Modern Environmental Toxicology, School of Public Health Research, Wuxi School of Medicine, Jiangnan University, Wuxi, Jiangsu, China; Public Health Research Center, Jiangnan University, Wuxi, Jiangsu, China.
| | - Chunping Li
- Department of Occupational Medicine, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, China.
| | - Miaomiao Wang
- Department of Occupational Medicine, Wuxi Center for Disease Control and Prevention, Wuxi, Jiangsu, China.
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Voltan G, Di Giovannantonio G, Carretta G, Vianello S, Contessa C, Veronese N, Brandi ML. A novel case-finding strategy based on artificial intelligence for the systematic identification and management of individuals with osteoporosis or at varying risk of fragility fracture. Arch Osteoporos 2024; 19:45. [PMID: 38816562 DOI: 10.1007/s11657-024-01403-5] [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: 11/16/2023] [Accepted: 05/13/2024] [Indexed: 06/01/2024]
Abstract
An artificial intelligence-based case-finding strategy has been developed to systematically identify individuals with osteoporosis or at varying risk of fragility fracture. This strategy has the potential to close the critical care gap in osteoporosis treatment in primary care, thereby lessening the societal burden imposed by fragility fractures. BACKGROUND Osteoporotic fractures represent a major cause of morbidity and, in older adults, a precursor of disability, loss of independence, poor quality of life and premature death. Despite the detrimental health impact, osteoporosis remains largely underdiagnosed and undertreated worldwide. Subjects at risk for osteoporosis-related fractures are identified either via organised screening or case finding. In the absence of a population-based screening policy, subjects at high risk of fragility fractures are opportunistically identified when a fracture occurs or because of other clinical risk factors (CRFs) for osteoporotic fracture and areal bone mineral density (aBMD) measured by dual-energy X-ray absorptiometry (DXA). PURPOSE This paper describes the development of a novel case-finding strategy, named Osteoporosis Diagnostic and Therapeutic Pathway (ODTP), which enables to identify subjects with osteoporosis or at varying risk of fragility fracture. This strategy is based on a specifically designed software tool, named "Bone Fragility Query" (BFQ), which analyses the electronic health record (EHR) databases of General Practitioners (GPs) to systematically identify individuals who should be prescribed DXA-BMD measurement, vertebral fracture assessment (VFA) and anti-osteoporosis medications (AOM). CONCLUSIONS The ODTP through BFQ tool is a feasible, convenient and time-saving osteoporosis model of care for GPs during routine clinical practice. It enables GPs to shift their focus from what to do (clinical guidelines) to how to do it in the primary health care setting. It also allows a systematic approach to primary and secondary prevention of fragility fractures, thereby overcoming clinical inertia and contributing to closing the gap between evidence and practice for the management of osteoporosis in primary care.
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Affiliation(s)
- Gianpaolo Voltan
- Centre for Metabolic Bone Diseases, Health Authority of Venice Province, Noale, Venice, Italy.
| | | | | | | | | | - Nicola Veronese
- Geriatrics Section, Department of Internal Medicine, University of Palermo, Palermo, Italy
| | - Maria Luisa Brandi
- Vita-Salute San Raffaele University, Milan, Italy
- Fragility Fractures Observatory, Florence, Italy
- Italian Bone Diseases Research Foundation, Florence, Italy
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Weiss MB, Syed SA, Whiteson HZ, Hirani R, Etienne M, Tiwari RK. Navigating Post-Traumatic Osteoporosis: A Comprehensive Review of Epidemiology, Pathophysiology, Diagnosis, Treatment, and Future Directions. Life (Basel) 2024; 14:561. [PMID: 38792583 PMCID: PMC11122478 DOI: 10.3390/life14050561] [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: 03/11/2024] [Revised: 04/14/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024] Open
Abstract
Post-traumatic osteoporosis (PTO) presents a significant challenge in clinical practice, characterized by demineralization and decreased skeletal integrity following severe traumatic injuries. This literature review manuscript addresses the knowledge gaps surrounding PTO, encompassing its epidemiology, pathophysiology, risk factors, diagnosis, treatment, prognosis, and future directions. This review emphasizes the complexity of the etiology of PTO, highlighting the dysregulation of biomineralization processes, inflammatory cytokine involvement, hormonal imbalances, glucocorticoid effects, vitamin D deficiency, and disuse osteoporosis. Moreover, it underscores the importance of multidisciplinary approaches for risk mitigation and advocates for improved diagnostic strategies to differentiate PTO from other musculoskeletal pathologies. This manuscript discusses various treatment modalities, including pharmacotherapy, dietary management, and physical rehabilitation, while also acknowledging the limited evidence on their long-term effectiveness and outcomes in PTO patients. Future directions in research are outlined, emphasizing the need for a deeper understanding of the molecular mechanisms underlying PTO and the evaluation of treatment strategies' efficacy. Overall, this review provides a comprehensive overview of PTO and highlights avenues for future investigation to enhance clinical management and patient outcomes.
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Affiliation(s)
- Matthew B. Weiss
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA (H.Z.W.); (R.H.); (M.E.)
| | - Shoaib A. Syed
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA (H.Z.W.); (R.H.); (M.E.)
| | - Harris Z. Whiteson
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA (H.Z.W.); (R.H.); (M.E.)
| | - Rahim Hirani
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA (H.Z.W.); (R.H.); (M.E.)
- Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA
| | - Mill Etienne
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA (H.Z.W.); (R.H.); (M.E.)
- Department of Neurology, New York Medical College, Valhalla, NY 10595, USA
| | - Raj K. Tiwari
- School of Medicine, New York Medical College, Valhalla, NY 10595, USA (H.Z.W.); (R.H.); (M.E.)
- Graduate School of Biomedical Sciences, New York Medical College, Valhalla, NY 10595, USA
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Hou X, Zhang N, Chen S, Guo L, Yu Y, Wei Z, Liu J, Wu S, Tian F. Association of life's essential 8 and risk of fragility fractures: A large cohort study. J Orthop Res 2024; 42:798-805. [PMID: 37804221 DOI: 10.1002/jor.25708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Revised: 08/29/2023] [Accepted: 10/05/2023] [Indexed: 10/09/2023]
Abstract
Cardiovascular health (CVH) score is not only associated with cardiovascular diseases, but also some disorders in other systems. This study aims to investigate the association between CVH score and the risk of fragility fractures. The analysis enrolled 89,464 participants at baseline in Kailuan study initiated in 2006-2007. All participants were then followed up every 2 years and the incidence of fragility fractures was recorded annually. A total CVH score was classified as low (0-49 points), moderate (50-79 points), and ideal (80-100 points). The primary outcome was incident fragility fractures before December 31, 2021. Kaplan-Meier was used to estimate cumulative incidence. Multivariable adjusted Cox proportional hazards regression models and time-dependent Cox hazards regression models were used to estimate fragility fracture hazard ratios (aHR) and 95% confidence intervals (95% CI). After 13.98 ± 2.84 years of follow-up, a total of 1534 cases of fragility fractures were identified, with an incidence density of 1.23 per 1000 person-years. Compared with the low CVH group, the risk of fragility fractures was significantly lower in moderate (aHR = 0.78, 95% CI: 0.66-0.92) and ideal CVH groups (aHR = 0.65, 95% CI: 0.51-0.83), particularly in the age <60 group (aHR = 0.72, 95% CI: 0.59-0.88; aHR= 0.55, 95% CI: 0.41-0.73, respectively). Time-dependent Cox hazards regression models, sensitivity analysis, and death competition model confirmed the reliability of these findings. The ideal CVH score is associated with a decreased risk of fragility fractures. With the increase of CVH score, the risk of fragility fracture decreases.
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Affiliation(s)
- Xiaoli Hou
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Nan Zhang
- Department of Orthopedics, Kailuan General Hospital, Tangshan, China
| | - Shuohua Chen
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Lu Guo
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Yaohui Yu
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Zhihao Wei
- School of Public Health, North China University of Science and Technology, Tangshan, China
| | - Jiayin Liu
- Second Hospital of Tangshan, Tangshan, China
| | - Shouling Wu
- Department of Cardiology, Kailuan General Hospital, Tangshan, China
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Tangshan, China
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Jeong C, Lee CH, Lee Y, Seo J, Wang W, Park KH, Oh E, Cho Y, Park C, Son YJ, Yoon Park JH, Kang H, Lee KW. Ulmus macrocarpa Hance trunk bark extracts inhibit RANKL-induced osteoclast differentiation and prevent ovariectomy-induced osteoporosis in mice. JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117285. [PMID: 37839769 DOI: 10.1016/j.jep.2023.117285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 10/17/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Ulmus macrocarpa Hance (UmH) bark has been traditionally utilized for medicinal purposes. The bark extract of this plant has diverse health benefits, and its potential role in enhancing bone health is of distinct interest, particularly when considering the substantial health and economic implications of bone-related pathologies, such as osteoporosis. Despite the compelling theoretical implications of UmH bark in fortifying bone health, no definitive evidence at the in vivo level is currently available, thus highlighting the innovative and as-yet-unexplored potential of this field of study. AIM OF THE STUDY Primarily, our study aims to conduct a meticulous analysis of the disparity in the concentration of active compounds in the UmH root bark (Umrb) and trunk bark (Umtb) extracts and confirm UmH bark's efficacy in enhancing bone health in vivo, illuminating the cellular mechanisms involved. MATERIALS AND METHODS The Umrb and Umtb extracts were subjected to component analysis using high-performance liquid chromatography and then assessed for their inhibitory effects on osteoclast differentiation through the TRAP assay. An ovariectomized (OVX) mouse model replicates postmenopausal conditions commonly associated with osteoporosis. Micro-CT was used to analyze bone structure parameters, and enzyme-linked immunosorbent assay and staining were used to assess bone formation markers and osteoclast activity. Furthermore, this study investigated the impact of the extract on the expression of pivotal proteins and genes involved in bone formation and resorption using mouse bone marrow-derived macrophages (BMMs). RESULTS The findings of our study reveal a significant discrepancy in the concentration of active constituents between Umrb and Umtb, establishing Umtb as a superior source for promoting bone health. I addition, a standardized pilot-scale procedure was conducted for credibility. The bone health benefits of Umtb were verified using an OVX model. This validation involved the assessment of various parameters, including BMD, BV/TV, and BS/TV, using micro-CT imaging. Additionally, the activation of osteoblasts was evaluated by Umtb by measuring specific factors such as ALP, OCN, OPG in blood samples and through IHC staining. In the same investigations, diminished levels of osteoclast differentiation factors, such as TRAP, NFATc1, were also observed. The observed patterns exhibited consistency in vitro BMM investigations. CONCLUSIONS Through verification at both in vitro levels using BMMs and in vivo levels using the OVX-induced mouse model, our research demonstrates that Umtb is a more effective means of improving bone health in comparison to Umrb. These findings pave the way for developing health-functional foods or botanical drugs targeting osteoporosis and other bone-related disorders and enhance the prospects for future research extensions, including clinical studies, in extract applications.
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Affiliation(s)
- Chanhyeok Jeong
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Chang Hyung Lee
- Bio-MAX Institute, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Yongjin Lee
- Department of Pharmacy, Sunchon National University, Suncheon, 57922, Republic of Korea.
| | - Jiwon Seo
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Weihong Wang
- Laboratory of Marine Drugs, School of Earth and Environmental Sciences, NS-80, Seoul National University, Seoul, 08826, Republic of Korea; Research Institute of Oceanography, Seoul National University, NS-80, Seoul, 08826, Republic of Korea.
| | - Kyu-Hyung Park
- Laboratory of Marine Drugs, School of Earth and Environmental Sciences, NS-80, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Eunseok Oh
- Laboratory of Marine Drugs, School of Earth and Environmental Sciences, NS-80, Seoul National University, Seoul, 08826, Republic of Korea; Research Institute of Oceanography, Seoul National University, NS-80, Seoul, 08826, Republic of Korea.
| | - Youbin Cho
- Laboratory of Marine Drugs, School of Earth and Environmental Sciences, NS-80, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Chanyoon Park
- Bio-MAX Institute, Seoul National University, Seoul, 08826, Republic of Korea; Laboratory of Marine Drugs, School of Earth and Environmental Sciences, NS-80, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Young-Jin Son
- Department of Pharmacy, Sunchon National University, Suncheon, 57922, Republic of Korea.
| | - Jung Han Yoon Park
- Bio-MAX Institute, Seoul National University, Seoul, 08826, Republic of Korea.
| | - Heonjoong Kang
- Bio-MAX Institute, Seoul National University, Seoul, 08826, Republic of Korea; Laboratory of Marine Drugs, School of Earth and Environmental Sciences, NS-80, Seoul National University, Seoul, 08826, Republic of Korea; Research Institute of Oceanography, Seoul National University, NS-80, Seoul, 08826, Republic of Korea; Interdisciplinary Graduate Program in Genetic Engineering, Seoul National University, NS-80, Seoul, 08826, Republic of Korea.
| | - Ki Won Lee
- Department of Agricultural Biotechnology and Research Institute of Agriculture and Life Sciences, Seoul National University, Seoul, 08826, Republic of Korea; Bio-MAX Institute, Seoul National University, Seoul, 08826, Republic of Korea; Advanced Institutes of Convergence Technology, Seoul National University, Suwon, 16229, Republic of Korea; Institutes of Green Bio Science & Technology, Seoul National University, Pyeongchang, 25354, Republic of Korea; Department of Agricultural Biotechnology and Center for Food and Bio Convergence, Seoul National. University, Seoul, 08826, Republic of Korea.
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Küçükçiloğlu Y, Şekeroğlu B, Adalı T, Şentürk N. Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models. Diagn Interv Radiol 2024; 30:9-20. [PMID: 37309886 PMCID: PMC10773174 DOI: 10.4274/dir.2023.232116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 05/06/2023] [Indexed: 06/14/2023]
Abstract
PURPOSE Osteoporosis is the systematic degeneration of the human skeleton, with consequences ranging from a reduced quality of life to mortality. Therefore, the prediction of osteoporosis reduces risks and supports patients in taking precautions. Deep-learning and specific models achieve highly accurate results using different imaging modalities. The primary purpose of this research was to develop unimodal and multimodal deep-learning-based diagnostic models to predict bone mineral loss of the lumbar vertebrae using magnetic resonance (MR) and computed tomography (CT) imaging. METHODS Patients who received both lumbar dual-energy X-ray absorptiometry (DEXA) and MRI (n = 120) or CT (n = 100) examinations were included in this study. Unimodal and multimodal convolutional neural networks (CNNs) with dual blocks were proposed to predict osteoporosis using lumbar vertebrae MR and CT examinations in separate and combined datasets. Bone mineral density values obtained by DEXA were used as reference data. The proposed models were compared with a CNN model and six benchmark pre-trained deep-learning models. RESULTS The proposed unimodal model obtained 96.54%, 98.84%, and 96.76% balanced accuracy for MRI, CT, and combined datasets, respectively, while the multimodal model achieved 98.90% balanced accuracy in 5-fold cross-validation experiments. Furthermore, the models obtained 95.68%-97.91% accuracy with a hold-out validation dataset. In addition, comparative experiments demonstrated that the proposed models yielded superior results by providing more effective feature extraction in dual blocks to predict osteoporosis. CONCLUSION This study demonstrated that osteoporosis was accurately predicted by the proposed models using both MR and CT images, and a multimodal approach improved the prediction of osteoporosis. With further research involving prospective studies with a larger number of patients, there may be an opportunity to implement these technologies into clinical practice.
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Affiliation(s)
- Yasemin Küçükçiloğlu
- Near East University Faculty of Medicine, Department of Radiology, Nicosia, Cyprus
- Near East University, Center of Excellence, Tissue Engineering and Biomaterials Research Center, Nicosia, Cyprus
| | - Boran Şekeroğlu
- Near East University, Applied Artificial Intelligence Research Center, Nicosia, Cyprus
| | - Terin Adalı
- Near East University, Center of Excellence, Tissue Engineering and Biomaterials Research Center, Nicosia, Cyprus
- Near East University Faculty of Engineering, Department of Biomedical Engineering, Nicosia, Cyprus
- Sabancı University, Nanotechnology Research and Application Center, İstanbul, Turkey
| | - Niyazi Şentürk
- Near East University, Center of Excellence, Tissue Engineering and Biomaterials Research Center, Nicosia, Cyprus
- Near East University Faculty of Engineering, Department of Biomedical Engineering, Nicosia, Cyprus
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Jha SS, Srivastava A, Kambhampati SBS, Elhence A. Introduction to Osteoporosis, Osteomalacia, and Fragility Fractures. Indian J Orthop 2023; 57:25-32. [PMID: 38107821 PMCID: PMC10721584 DOI: 10.1007/s43465-023-01015-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Accepted: 09/28/2023] [Indexed: 12/19/2023]
Abstract
Background Osteoporosis is a disease of the bones leading to decreased bone mineral density, leading to fragility fractures. This article is an overview of osteoporosis, osteomalacia and fragility fractures and serves as an introductory article for this special issue on osteoporosis. Methods This is a short, comprehensive account of the given conditions with concepts and a review from the recent literature. The authors provide relevant references from the literature in the bibliography. The sections herein have also been deliberated in the meetings of experts of osteoporosis. Results An overview of osteoporosis, osteomalacia and fragility fractures is provided, including definitions and summaries of aetiology, pathophysiology, diagnosis, prevention, and management. A detailed account of some of these topics will be provided in subsequent chapters. Conclusion Osteoporosis is a silent disease with the potential to cause significant morbidity and mortality if not detected early. It is important to differentiate from and diagnose associated osteomalacia to provide accurate therapy. It is also important to identify the type of fragility fractures and initiate treatment for bone strengthening to prevent subsequent fractures.
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Uemura K, Otake Y, Takashima K, Hamada H, Imagama T, Takao M, Sakai T, Sato Y, Okada S, Sugano N. Development and validation of an open-source tool for opportunistic screening of osteoporosis from hip CT images. Bone Joint Res 2023; 12:590-597. [PMID: 37728034 PMCID: PMC10509772 DOI: 10.1302/2046-3758.129.bjr-2023-0115.r1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/21/2023] Open
Abstract
Aims This study aimed to develop and validate a fully automated system that quantifies proximal femoral bone mineral density (BMD) from CT images. Methods The study analyzed 978 pairs of hip CT and dual-energy X-ray absorptiometry (DXA) measurements of the proximal femur (DXA-BMD) collected from three institutions. From the CT images, the femur and a calibration phantom were automatically segmented using previously trained deep-learning models. The Hounsfield units of each voxel were converted into density (mg/cm3). Then, a deep-learning model trained by manual landmark selection of 315 cases was developed to select the landmarks at the proximal femur to rotate the CT volume to the neutral position. Finally, the CT volume of the femur was projected onto the coronal plane, and the areal BMD of the proximal femur (CT-aBMD) was quantified. CT-aBMD correlated to DXA-BMD, and a receiver operating characteristic (ROC) analysis quantified the accuracy in diagnosing osteoporosis. Results CT-aBMD was successfully measured in 976/978 hips (99.8%). A significant correlation was found between CT-aBMD and DXA-BMD (r = 0.941; p < 0.001). In the ROC analysis, the area under the curve to diagnose osteoporosis was 0.976. The diagnostic sensitivity and specificity were 88.9% and 96%, respectively, with the cutoff set at 0.625 g/cm2. Conclusion Accurate DXA-BMD measurements and diagnosis of osteoporosis were performed from CT images using the system developed herein. As the models are open-source, clinicians can use the proposed system to screen osteoporosis and determine the surgical strategy for hip surgery.
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Affiliation(s)
- Keisuke Uemura
- Department of Orthopaedic Medical Engineering, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Yoshito Otake
- Division of Information Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
| | - Kazuma Takashima
- Department of Orthopaedics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Hidetoshi Hamada
- Department of Orthopaedic Medical Engineering, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Takashi Imagama
- Department of Orthopaedics, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Masaki Takao
- Department of Bone and Joint Surgery, Graduate School of Medicine, Ehime University, Toon, Japan
| | - Takashi Sakai
- Department of Orthopaedics, Graduate School of Medicine, Yamaguchi University, Ube, Japan
| | - Yoshinobu Sato
- Division of Information Science, Graduate School of Science and Technology, Nara Institute of Science and Technology, Ikoma, Japan
| | - Seiji Okada
- Department of Orthopaedics, Graduate School of Medicine, Osaka University, Suita, Japan
| | - Nobuhiko Sugano
- Department of Orthopaedic Medical Engineering, Graduate School of Medicine, Osaka University, Suita, Japan
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Avgerinou C, Petersen I, Clegg A, West RM, Osborn D, Walters K. Trends in incidence of recorded diagnosis of osteoporosis, osteopenia, and fragility fractures in people aged 50 years and above: retrospective cohort study using UK primary care data. Osteoporos Int 2023:10.1007/s00198-023-06739-1. [PMID: 37162537 PMCID: PMC10382342 DOI: 10.1007/s00198-023-06739-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/29/2023] [Indexed: 05/11/2023]
Abstract
This study used primary care data to estimate the incidence of recorded diagnosis of osteoporosis, osteopenia, and fragility fracture in the UK during 2000-2018 accounting for age, sex, calendar year and social deprivation. More than 3 million people aged 50-99 years were included. We found that men living in the most deprived areas had a 45% higher risk of being diagnosed with osteoporosis and 50% higher risk of fragility fracture compared to men living in the least deprived areas. PURPOSE a) To estimate the incidence trends of a recorded diagnosis of osteoporosis, osteopenia, and fragility fracture in the UK over time; b) to describe differences according to age, sex, and social deprivation. METHODS This is a longitudinal population-based cohort study using routinely collected primary care data obtained via IQVIA Medical Research Database (IMRD). All patients aged 50-99 years registered with a practice participating in THIN (The Health Improvement Network) between 2000-2018 were included. The first recorded diagnosis of osteoporosis, osteopenia, or fragility fracture was used to estimate incidence rates (IR) per 10,000 person-years at risk. Poisson regression was used to provide Incidence Rate Ratios (IRR) adjusted by age, sex, social deprivation, calendar year, and practice effect. RESULTS The year-specific adjusted IRR of recorded osteoporosis was highest in 2009 in women [IRR 1.44(95%CI 1.38-1.50)], whereas in men it was highest in 2013-2014 [IRR 1.94(95%CI 1.72-2.18)] compared to 2000. The year-specific adjusted IRR of fragility fracture was highest in 2012 in women [IRR 1.77(95%CI 1.69-1.85)], whereas in men it was highest in 2013 [IRR 1.64(95%CI 1.51-1.78)] compared to 2000. Men in the most deprived areas had a higher risk of being diagnosed with osteoporosis [IRR 1.45(95%CI 1.38-1.53)], osteopenia [IRR 1.17(95%CI 1.09-1.26)], and fragility fracture [IRR 1.50(95%CI 1.44-1.56)] compared to those living in the least deprived areas, but smaller differences were seen in women. CONCLUSION Use of fracture risk assessment tools may enhance the detection of osteoporosis cases in primary care. Further research is needed on the effect of social deprivation on diagnosis of osteoporosis and fractures.
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Affiliation(s)
- Christina Avgerinou
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
| | - Irene Petersen
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Andrew Clegg
- Academic Unit for Ageing and Stroke Research, Bradford Institute for Health Research, University of Leeds, Leeds, UK
| | - Robert M West
- Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - David Osborn
- Division of Psychiatry, University College London, Leeds, UK
- Camden and Islington NHS Foundation Trust, London, UK
| | - Kate Walters
- Department of Primary Care and Population Health, University College London, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
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10
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The neuroprotective and antidiabetic effects of trigonelline: A review of signaling pathways and molecular mechanisms. Biochimie 2023; 206:93-104. [PMID: 36257493 DOI: 10.1016/j.biochi.2022.10.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 08/07/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022]
Abstract
The global epidemic of diabetes has brought heavy pressure on public health. New effective anti-diabetes strategies are urgently needed. Trigonelline is the main component of fenugreek, which has been proved to have a good therapeutic effect on diabetes and diabetic complications. Trigonelline achieves amelioration of diabetes, the mechanisms of which include the modulation of insulin secretion, a reduction in oxidative stress, and the improvement of glucose tolerance and insulin resistance. Besides, trigonelline has been reported to be a neuroprotective agent against many neurologic diseases including Alzheimer's disease, Parkinson's disease, stroke, and depression. Concerning the potential therapeutic effects of trigonelline, comprehensive clinical trials are warranted to evaluate this valuable molecule.
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11
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Han BX, Yan SS, Yu Han, Xu Q, Zhao QG, Ma XL, Ni JJ, Zhang L, Pei YF. Causal Effects of Plasma Proteome on Osteoporosis and Osteoarthritis. Calcif Tissue Int 2023; 112:350-358. [PMID: 36576504 DOI: 10.1007/s00223-022-01049-w] [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: 06/19/2022] [Accepted: 12/13/2022] [Indexed: 12/29/2022]
Abstract
The two-sample Mendelian randomization (MR) study revealed a causal association of plasma proteins with osteoporosis (OP) and osteoarthritis (OA). Bone mineral density (BMD) is the gold standard for the clinical assessment of OP. Recent studies have shown that plasma proteins play an essential role in the regulation of bone development. However, the causal association of plasma proteins with BMD and OA remains unclear. We estimated the effects of 2889 plasma proteins on 2 BMD phenotypes and 6 OA phenotypes using two-sample MR analysis based on the genome-wide association study summary statistics. Then, we performed sensitivity analysis and reverse-direction MR analysis to evaluate the robustness of the MR analysis results, followed by gene ontology (GO) enrichment analysis and KEGG pathway analysis to explore the functional relevance of the identified plasma proteins. Overall, we observed a total of 257 protein-estimated heel BMD associations, 17 protein-total-body BMD associations, 2 protein-all-OA associations, and 2 protein-knee-OA associations at PFDR < 0.05. Reverse-direction MR analysis demonstrated that there was little evidence of the causal association of BMD and OA with plasma proteins. GO enrichment analysis and KEGG pathway analysis identified multiple pathways, which may be involved in the development of OP and OA. Our findings recognized plasma proteins that could be used to regulate changes in OP and OA, thus, providing new insights into protein-mediated mechanisms of bone development.
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Affiliation(s)
- Bai-Xue Han
- Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, Jiangsu Province, People's Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
| | - Shan-Shan Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, Jiangsu Province, People's Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
| | - Yu Han
- Laboratory of Molecular Neuropathology, Jiangsu Key Laboratory of Neuropsychiatric Diseases and College of Pharmaceutical Sciences, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
| | - Qian Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, Jiangsu Province, People's Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
| | - Qi-Gang Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, Jiangsu Province, People's Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
| | - Xin-Ling Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, Jiangsu Province, People's Republic of China
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
| | - Jing-Jing Ni
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China
- Center for Genetic Epidemiology and Genomics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, JiangSu Province, People's Republic of China
| | - Lei Zhang
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China.
- Center for Genetic Epidemiology and Genomics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, JiangSu Province, People's Republic of China.
| | - Yu-Fang Pei
- Department of Epidemiology and Biostatistics, School of Public Health, Suzhou Medical College of Soochow University, 199 Ren-Ai Rd., SuZhou City, 215123, Jiangsu Province, People's Republic of China.
- Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Suzhou Medical College of Soochow University, SuZhou, Jiangsu, People's Republic of China.
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12
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Tao J, Yan Z, Huang W, Feng T. Seropositive for hepatitis B and C viruses is associated with the risk of decreased bone mineral density in adults: An analysis of studies from the NHANES database. Front Med (Lausanne) 2023; 10:1120083. [PMID: 37035336 PMCID: PMC10073499 DOI: 10.3389/fmed.2023.1120083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
Background Some studies had reported that patients with viral hepatitis are at increased risk of reduced bone mineral density and even osteoporosis. However, the interaction between reduced bone mineral density (BMD) and viral hepatitis remains inconclusive. Therefore, our study collected hepatitis test results and bone mineral density from respondents in the NHANES database. The aim of this study was to investigate whether there is an association between hepatitis and a decrease in bone mineral density. Methods The respondents with both hepatitis- and BMD-related indicators from the NHANES database in the United States from 2005-2010, 2013-2014, to 2017-2020 were collected for this study. BMD were compared between respondents who were positive and negative for respondents related to hepatitis B and C. BMD was measured using dual-energy X-ray absorptiometry of the femur and lumbar spine. Finally, multiple regression analysis was performed between hepatitis B surface antigen (HBsAg) and hepatitis C RNA (HCV-RNA) and BMD in the respondents. Results A total of 15,642 respondents were included in the hepatitis B surface antigen-related survey. Of these, 1,217 respondents were positive for hepatitis B surface antigen. A total of 5111 hepatitis C RNA-related responders were included. Hepatitis C RNA-positive had 268 respondents. According to the results of the multiple regression analysis, the femoral BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.018 (-0.026, -0.009) (P < 0.01). Moreover, spinal BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.020 (-0.030, -0.010) (P < 0.01). According to the results of multiple regression analysis for hepatitis C RNA, HCV-RNA (+) respondents had significantly lower BMD compared to HCV-RNA (-) respondents: -0.043 (-0.059, -0.026) (P < 0.01). Conclusion During the analysis of respondents in the NHANES database in the United States, positive tests for hepatitis B surface antigen and hepatitis C RNA were found to be associated with a reduction in BMD. Positive serology for these hepatitis indicators may increase the risk of reduced BMD. Of course, this conclusion still needs to be further confirmed by more large clinical trials.
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Affiliation(s)
- Jiasheng Tao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zijian Yan
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wenmian Huang
- Affiliated Stomatological Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Tao Feng
- Department of Orthopedics, Nantong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, China
- *Correspondence: Tao Feng
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13
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Geusens P, Appelman-Dijkstra NM, Zillikens MC, Willems H, Lems WF, van den Bergh J. How to implement guidelines and models of care. Best Pract Res Clin Rheumatol 2022; 36:101759. [PMID: 35729036 DOI: 10.1016/j.berh.2022.101759] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
In subjects older than 50 years, the presence of clinical risk factors (CRFs) for fractures or a recent fracture is the cornerstone for case finding. In patients who are clinically at high short- and long-term risk of fractures (those with a recent clinical fracture or with multiple CRFs), further assessment with bone mineral density (BMD) measurement using dual-energy absorptiometry (DXA), imaging of the spine, fall risk evaluation and laboratory examination contributes to treatment decisions according to the height and modifiability of fracture risk. Treatment is available with anti-resorptive and anabolic drugs, and from the start of treatment a lifelong strategy is needed to decide about continuous, intermittent, and sequential therapy. Implementation of guidelines requires further initiatives for improving case finding, public awareness about osteoporosis and national policies on reimbursement of assessment and therapy.
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Affiliation(s)
- Piet Geusens
- Department of Rheumatology, Maastricht University, Minderbroedersberg 4-6, 6211 LK Maastricht, Netherlands.
| | - Natasha M Appelman-Dijkstra
- Department of Internal Medicine-Endocrinology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, Netherlands.
| | - M Carola Zillikens
- Department of Internal Medicine, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD, Rotterdam, Netherlands.
| | - Hanna Willems
- Department of Geriatrics, Amsterdam University Medical Center, De Boelelaan 1117 1081 HV Amsterdam, Netherlands.
| | - Willem F Lems
- Department of Rheumatology, Amsterdam University Medical Center, De Boelelaan 1117 1081 HV Amsterdam, Netherlands.
| | - Joop van den Bergh
- Department of Internal Medicine, VieCuri Medisch Cenrum, Tegelseweg 210, 5912 BL Venlo, Netherlands.
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14
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Schoeb M, Winter EM, Malgo F, Schipper IB, van der Wal RJP, Papapoulos SE, Appelman-Dijkstra NM. Bone material strength index as measured by in vivo impact microindentation is normal in subjects with high-energy trauma fractures. Osteoporos Int 2022; 33:1511-1519. [PMID: 35307747 PMCID: PMC9187533 DOI: 10.1007/s00198-022-06368-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 02/28/2022] [Indexed: 11/25/2022]
Abstract
UNLABELLED Bone material properties were assessed using impact microindentation in patients with high-energy trauma fractures. Compared to patients with low-energy trauma fractures, bone material strength index was significantly higher in patients with high-energy trauma fractures, and did not differ between patients with osteopenia and those with osteoporosis within each trauma group. INTRODUCTION Impact microindentation (IMI) is a technique to assess tissue-level properties of bone at the tibia. Bone material strength index (BMSi), measured by IMI, is decreased in patients with low-energy trauma fractures, independently of areal bone mineral density (aBMD), but there is no information about BMSi in patients with high-energy trauma fractures. In the present study, we evaluated tissue-level properties of bone with IMI in patients with high-energy trauma fractures. METHODS BMSi was measured 3.0 months (IQR 2.0-5.8) after the fracture in 40 patients with high-energy trauma and 40 age- and gender-matched controls with low-energy trauma fractures using the OsteoProbe® device. RESULTS Mean age of high- and low-energy trauma patients was 57.7 ± 9.1 and 57.2 ± 7.7 years, respectively (p = 0.78). Fracture types were comparable in high- vs low-energy trauma patients. Lumbar spine (LS)-aBMD, but not femoral neck (FN)-aBMD, was higher in high- than in low-energy trauma patients (LS 0.96 ± 0.13 vs 0.89 ± 0.13 g/cm2, p = 0.02; FN 0.75 ± 0.09 vs 0.72 ± 0.09 g/cm2, p = 0.09). BMSi was significantly higher in high- than in low-energy trauma patients (84.4 ± 5.0 vs 78.0 ± 4.6, p = 0.001), also after adjusting for aBMD (p = 0.003). In addition, BMSi did not differ between patients with osteopenia and those with osteoporosis within each trauma group. CONCLUSION Our data demonstrate that BMSi and LS-aBMD, but not FN-aBMD, are significantly higher in high-energy trauma patients compared to matched controls with similar fractures from low-energy trauma. Further studies of non-osteoporotic patients with high-energy trauma fracture with measurements of BMSi are warranted to determine whether IMI might help in identifying those with reduced bone strength.
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Affiliation(s)
- M Schoeb
- LUMC Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - E M Winter
- LUMC Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - F Malgo
- LUMC Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - I B Schipper
- Center for Bone Quality, Department of Trauma Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - R J P van der Wal
- Center for Bone Quality, Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands
| | - S E Papapoulos
- LUMC Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands
| | - N M Appelman-Dijkstra
- LUMC Center for Bone Quality, Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, 2300 RC, Leiden, The Netherlands.
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15
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Wang W, Jeong C, Lee Y, Park C, Oh E, Park KH, Cho Y, Kang E, Lee J, Cho YJ, Park JHY, Son YJ, Lee KW, Kang H. Flavonoid Glycosides from Ulmus macrocarpa Inhibit Osteoclast Differentiation via the Downregulation of NFATc1. ACS OMEGA 2022; 7:4840-4849. [PMID: 35187304 PMCID: PMC8851653 DOI: 10.1021/acsomega.1c05305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/21/2022] [Indexed: 06/14/2023]
Abstract
The aim of this study was to isolate and identify chemical components with osteoclast differentiation inhibitory activity from Ulmus macrocarpa Hance bark. Spectroscopic analyses, including nuclear magnetic resonance (NMR) and electronic circular dichroism (ECD), resulted in the unequivocal elucidation of active compounds such as (2S)-naringenin-6-C-β-d-glucopyranoside (1), (2R)-naringenin-6-C-β-d-glucopyranoside (2), (2R,3S)-catechin-7-O-β-d-xylopyranoside (3), (2R,3S)-catechin-7-O-β-d-apiofuranoside (6), (2R,3R)-taxifolin-6-C-β-d-glucopyranoside (7), and (2S,3S)-taxifolin-6-C-β-d-glucopyranoside (8). Mechanistically, the compounds may exhibit osteoclast differentiation inhibitory activity via the downregulation of NFATc1, a master regulator involved in osteoclast formation. This is the first report of their inhibitory activities on the receptor activator of nuclear factor κB ligand (RANKL)-induced osteoclast differentiation in murine bone marrow-derived macrophages. These findings provide further scientific evidence for the rational application of the genus Ulmus for the amelioration or treatment of osteopenic diseases.
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Affiliation(s)
- Weihong Wang
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
- Research
Institute of Oceanography, Seoul National
University, NS-80, Seoul 08826, Korea
| | - Chanhyeok Jeong
- Department
of Agricultural Biotechnology and Research Institute of Agriculture
and Life Sciences, Seoul National University, Seoul 08826, Korea
| | - Yongjin Lee
- Department
of Pharmacy, Sunchon National University, 315 Maegok-dong, Suncheon, Jeollanam-do 57922, Korea
| | - Chanyoon Park
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
- Interdisciplinary
Graduate Program in Genetic Engineering, Seoul National University, NS-80, Seoul 08826, Korea
| | - Eunseok Oh
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
| | - Kyu-Hyung Park
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
| | - Youbin Cho
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
| | - Eunmo Kang
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
| | - JunI Lee
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
| | - Yeon-Jin Cho
- Bio-MAX Institute, Seoul National
University, Seoul 08826, Korea
| | - Jung Han Yoon Park
- Department
of Agricultural Biotechnology and Research Institute of Agriculture
and Life Sciences, Seoul National University, Seoul 08826, Korea
- Advanced
Institutes of Convergence Technology, Seoul
National University, Suwon 16229, Korea
| | - Young-Jin Son
- Department
of Pharmacy, Sunchon National University, 315 Maegok-dong, Suncheon, Jeollanam-do 57922, Korea
| | - Ki Won Lee
- Department
of Agricultural Biotechnology and Research Institute of Agriculture
and Life Sciences, Seoul National University, Seoul 08826, Korea
- Bio-MAX Institute, Seoul National
University, Seoul 08826, Korea
- Advanced
Institutes of Convergence Technology, Seoul
National University, Suwon 16229, Korea
| | - Heonjoong Kang
- Laboratory
of Marine Drugs, School of Earth and Environmental Sciences, Seoul National University, Seoul 08826, Korea
- Research
Institute of Oceanography, Seoul National
University, NS-80, Seoul 08826, Korea
- Interdisciplinary
Graduate Program in Genetic Engineering, Seoul National University, NS-80, Seoul 08826, Korea
- Bio-MAX Institute, Seoul National
University, Seoul 08826, Korea
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16
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Development of an open-source measurement system to assess the areal bone mineral density of the proximal femur from clinical CT images. Arch Osteoporos 2022; 17:17. [PMID: 35038079 DOI: 10.1007/s11657-022-01063-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 01/07/2022] [Indexed: 02/08/2023]
Abstract
Commercial software is generally needed to measure the areal bone mineral density (aBMD) of the proximal femur from clinical computed tomography (CT) images. This study developed and verified an open-source reproducible system to quantify CT-aBMD to screen osteoporosis using clinical CT images. PURPOSE For existing CT images acquired for various reasons other than osteoporosis, it might be beneficial to estimate areal BMD as assessed by dual-energy X-ray absorptiometry (DXA-based BMD) to ascertain the bone status based on DXA. In this study, we aimed to (1) develop an open-source reproducible measurement system to quantify DXA-based BMD from CT images and (2) validate its accuracy. METHODS This study analyzed 75 pairs of hip CT and DXA images of women that were acquired for the preoperative assessment of total hip arthroplasty. From the CT images, the femur and a calibration phantom were automatically segmented using pre-trained codes/models available at https://github.com/keisuke-uemura . The proximal femoral region was isolated by manually selected landmarks and was projected onto the coronal plane to measure the areal density (CT-aHU). The calibration phantom was employed to convert the CT-aHU into CT-aBMD. Each parameter was correlated with DXA-based BMD, and the residual errors of CT images to estimate the T-scores in DXA were calculated using the standard error of estimate (SEE). RESULTS The correlation coefficients of DXA-based BMD with CT-aHU and CT-aBMD were 0.947 and 0.950, respectively (both p < 0.001). The SEE for quantifying the T-scores in DXA were 0.51 and 0.50 for CT-aHU and CT-aBMD, respectively. CONCLUSION With the method developed herein, CT permits estimation of the DXA-based BMD of the proximal femur within the standard DXA total hip region of interest with an SEE of 0.5 in T-scores. The radiation dose for CT acquisition needs consideration; therefore, our data do not provide a rationale for performing CT for screening osteoporosis. However, on CT images already acquired for clinical indications other than osteoporosis, researchers may use this open-source system to investigate osteoporosis status through the estimated DXA-based BMD of the proximal femur.
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17
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Yang X, Ye J, Cheng B, Cheng S, Liu L, Meng P, Liang C, Yao Y, Wen Y, Zhang Z, Li C, Zhang H, Chen Y, Zhang J, Pan C, Jia Y, Zhang F. Evaluating the associations of adult heel BMD with birth weight and growth parameters at age 10 in UK Biobank cohort. Bone 2021; 152:116038. [PMID: 34118445 DOI: 10.1016/j.bone.2021.116038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/25/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study was aimed to evaluate the associations of adult heel bone mineral density (BMD) with birth weight and growth parameters at the age of ten years. METHODS The analysis data (97178-178,494 subjects) was derived from the UK Biobank cohort. Birth weight, comparative body size and height size at the age of ten years were determined by self-report. The heel BMD was estimated by the Quantitative Ultrasound Index through the calcaneus. Linear regression analysis was applied to test the associations of adult heel BMD with birth weight and growth parameters at the age of ten years, respectively. Age, sex, body mass index and 10 principle components (PC) of population structure were used as covariates in the regression analysis of total samples. In sex-specific analysis, age, body mass index and 10 PC were used as covariates. RESULTS We observed significant associations of heel BMD with birth weight (b = -0.020, P = 1.974 × 10-13), comparative body size (b = 0.020, P = 2.539 × 10-6) and comparative height size (b = -0.020, P = 5.892 × 10-11) at the age of ten years in total samples. In females, birth weight (b = -0.040, P = 2.870 × 10-24) and comparative height size (b = -0.040, P = 2.034 × 10-20) were statistically associated with adult heel BMD. In males, comparative body size appeared to be associated with adult heel BMD (b = 0.030, P = 1.590 × 10-7). CONCLUSION Our study results support the predictive effects of birth weight and growth parameters at the age of ten years on adult heel BMD. We also observed sex-specific association between adult heel BMD and growth parameters at the age of ten years.
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Affiliation(s)
- Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yao Yao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
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Soen S, Kaku M, Okubo N, Touzeni S, Saito K, Kobayashi M. Epidemiology of glucocorticoid-induced osteoporosis and management of associated fracture risk in Japan. J Bone Miner Metab 2021; 39:1019-1030. [PMID: 34125296 DOI: 10.1007/s00774-021-01236-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 05/05/2021] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Glucocorticoid-induced osteoporosis (GIOP) is associated with a high fracture risk. Practice guidelines by the Japanese Society for Bone and Mineral Research in 2014 recommend bone densitometry and appropriate treatment to reduce this risk. The study objectives were to describe characteristics of GIOP patients in Japan and to evaluate their management in a subgroup of patients without comorbid cancer. MATERIALS AND METHODS This retrospective cohort study was performed using the Medical Data Vision (MDV) database from Japan. Adult patients initiating oral glucocorticoid treatment with a total GIOP risk score ≥ 3, based on the 2014 practice guideline, identified between 2009 and 2019 were eligible. A subgroup of patients without any cancer diagnosis was also identified. Data were extracted on demographics, concurrent medical conditions, use of bone densitometry, and osteoporosis treatment. RESULTS 25,569 patients were eligible, of whom 12,227 had a confirmed cancer diagnosis. Mean age was 68.5 years and 12,356 patients (48.3%) were women. Concurrent medical conditions of interest were documented in 14,887 patients, most frequently rheumatoid arthritis (n = 4185) and asthma (n = 3085). Yearly bone densitometry was performed in 6.5% (n = 865) of the cancer-free subgroup; 51.8% (n = 6905) were prescribed an osteoporosis treatment, most frequently bisphosphonates (n = 5132; 74.3%). Between 2011 and 2018, rates of densitometry were stable, whereas prescription rates increased from 40.0 to 51.8%. CONCLUSION In spite of publication of guidelines for GIOP management, there is an important treatment gap in their application in everyday practice. For this reason, public health measures to increase physician awareness of GIOP are needed.
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Affiliation(s)
- Satoshi Soen
- Soen Orthopaedics, Osteoporosis and Rheumatology Clinic, Kobe, Japan
| | - Miki Kaku
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan.
| | - Naoki Okubo
- Data Intelligence Department, Digital Transformation Management Division, Daiichi Sankyo Co. Ltd, Tokyo, Japan
| | - Salsabil Touzeni
- Health Economics and Outcomes Research, Creativ-Ceutical, Tunis, Tunisia
| | - Kengo Saito
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan
| | - Makiko Kobayashi
- Primary Medical Science Department, Medical Affairs Division, Japan Business Unit, Daiichi Sankyo Co. Ltd, 3-5-1, Nihonbashi Honcho, Chuo-ku, Tokyo, Japan
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19
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Diao X, Wang L, Zhou Y, Bi Y, Zhou K, Song L. The mechanism of Epimedin B in treating osteoporosis as revealed by RNA sequencing-based analysis. Basic Clin Pharmacol Toxicol 2021; 129:450-461. [PMID: 34491615 DOI: 10.1111/bcpt.13657] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 08/25/2021] [Accepted: 08/25/2021] [Indexed: 12/13/2022]
Abstract
With the ageing of populations, the management of osteoporosis is a priority of society in general. Epimedin B, a major ingredient of Herba Epimedii, which has the advantages of high content and hypotoxicity has been proved to be effective in preventing osteoporosis in vitro. However, the efficacy and mechanism of Epimedin B on osteoporosis in vivo have not been well elucidated yet. This study aimed to investigate the effects and the potential mechanisms of 8-week repeated oral administration of Epimedin B (10 and 20 mg/kg/day) on a mouse osteoporosis model. Effects of Epimedin B were evaluated by examinations of serum bone turnover markers, bone mineral density, bone microstructure parameters and histopathological section. Epimedin B significantly rose N-terminal propeptide of type I procollagen (P1NP) and dropped C-telopeptide of type I collagen (CTX1). Connectivity density (Conn.D) increased significantly while structure model index (DA) decreased significantly after treated by Epimedin B. Meanwhile, Epimedin B administration significantly increased the number of trabecular bones while significantly decreased the gap between them. Overall, Epimedin B showed beneficial effects on osteoporosis. Furthermore, RNA sequencing-based analysis revealed 5 significantly down-regulated transcripts and 107 significantly up-regulated transcripts between the Epimedin B administration group and the model group. These transcripts were mapped to 15 pathways by KEGG enrichment analysis, of which PI3K-Akt signalling pathway, MAPK signalling pathway and PPAR signalling pathway were most connected to osteoporosis. To conclude, Epimedin B is effective in treating osteoporosis in mice via regulating PI3K-Akt, MAPK and PPAR signalling pathway.
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Affiliation(s)
- Xinyue Diao
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Liwen Wang
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yating Zhou
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Yanan Bi
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Kun Zhou
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Tianjin Key Laboratory of Chinese Medicine Pharmacology, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
| | - Lei Song
- Institute of Traditional Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,Tianjin Key Laboratory of Chinese Medicine Pharmacology, Tianjin University of Traditional Chinese Medicine, Tianjin, China.,State Key Laboratory of Component-Based Chinese Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China
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20
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Abstract
Osteoporosis is an incurable chronic condition, like heart disease, diabetes, or hypertension. A large gap currently exists in the primary prevention of fractures, and studies show that an estimated 80% to 90% of adults do not receive appropriate osteoporosis management even in the secondary prevention setting. Case finding strategies have been developed and effective pharmacological interventions are available. This publication addresses how best to use the pharmacological options available for postmenopausal osteoporosis to provide lifelong fracture protection in patients at high and very high risk of fracture. The benefit of osteoporosis therapies far outweighs the rare risks.
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Affiliation(s)
- Jacques P Brown
- Division of Rheumatology, Department of Medicine, Laval University, Quebec City, QC, Canada
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