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Fuchs CJ, Trommelen J, Weijzen MEG, Smeets JSJ, van Kranenburg J, Verdijk LB, van Loon LJC. Becoming a World Champion Powerlifter at 71 Years of Age: It Is Never Too Late to Start Exercising. Int J Sport Nutr Exerc Metab 2024; 34:223-231. [PMID: 38458181 DOI: 10.1123/ijsnem.2023-0230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 02/06/2024] [Accepted: 02/06/2024] [Indexed: 03/10/2024]
Abstract
This case study assessed body composition, muscle strength, cardiorespiratory fitness, and metabolic health of the present female world champion powerlifter in the 70+ age category who started resistance exercise training at 63 years of age with no prior experience with structured exercise training. Measures of body composition (magnetic resonance imaging, computed tomography, and dual-energy X-ray absorptiometry scanning, leg volume); strength (one-repetition maximum leg press and extension, maximum voluntary contraction, and handgrip strength); physical function (short physical performance battery); cardiorespiratory fitness (peak oxygen consumption); and metabolic health (oral glucose tolerance test) were assessed. In addition, a muscle biopsy was collected to assess muscle fiber type distribution and cross-sectional area (CSA). Where possible, data were compared with previously (un)published sex- and age-matched data using z scores. Skeletal muscle mass index was calculated by dividing limb muscle mass by height squared. Data from the control groups are expressed as mean ± 95% confidence interval. Our participant (age: 71 years; body mass: 64.5 kg; body mass index: 27.6 kg/m2) reported a good bone mineral density of 1.09 g/cm2 (T score between -1 and +1) and very low values of abdominal and organ body fat (i.e., between 20% and 70% lower compared with a reference group of postmenopausal women). In addition, she showed a 33% greater skeletal muscle mass index when compared with healthy, older female control subjects (7.9 vs. 5.9 [5.7-6.2] kg/m2; n = 61) as well as 37% greater muscle quadriceps CSA (63.8 vs. 46.6 [44.5-48.7] cm2; n = 48) and 46% greater Type II muscle fiber CSA (4,536 vs. 3,097 [2,707-3,488] μm2; n = 19). Absolute leg press muscle strength was 36% greater (190 vs. 140 [132-147] kg; n = 30) and handgrip strength was 33% greater (33 vs. 25 [23-26] kg; n = 48) when compared with healthy, age-matched controls. In conclusion, even for resistance exercise naïve individuals, starting exercise at an advanced age can lead to improvements in body composition and muscle strength allowing older adults to reduce the risk for developing metabolic syndrome, live independently, and even compete at a world class level.
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Affiliation(s)
- Cas J Fuchs
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Jorn Trommelen
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Michelle E G Weijzen
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Joey S J Smeets
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Janneau van Kranenburg
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Lex B Verdijk
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
| | - Luc J C van Loon
- Department of Human Biology, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center+ (MUMC+), Maastricht, the Netherlands
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Ghattas YS, Zeblisky P, Cassinat J, Aceto M, Spindler KP, Cannada LK. Pickleball-Related Fractures in the United States From 2002 to 2022: An Analysis Using the NEISS Database. Orthop J Sports Med 2024; 12:23259671241255674. [PMID: 38881851 PMCID: PMC11179465 DOI: 10.1177/23259671241255674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 02/02/2024] [Indexed: 06/18/2024] Open
Abstract
Background Pickleball is one of the fastest-growing sports in the United States, with more than an 11-fold increase in injuries from 2010 to 2019. Purpose To (1) determine the prevalence and demographic variables associated with pickleball-related fractures among patients evaluated at emergency departments in the United States between 2002 and 2022 and (2) identify variables influencing patient disposition status. Study Design Descriptive epidemiology study. Methods The US Consumer Product Safety and Commission's publicly available database, the National Electronic Injury Surveillance System (NEISS), was used in this study. Analyses consisted of descriptive statistics for fracture prevalence and demographic variables as well as univariate analysis for disposition status (discharged home vs hospital admission). Results A total of 397 pickleball-related fractures were recorded between 2002 and 2022, which indicated a 90-fold increase in our study period. Based on weighted national average of NEISS sampling, this equated to approximately 5400 fractures annually. Players who sustained pickleball fractures were primarily aged >60 years (n = 344 [87%]; P < .001) and female (n = 273 [69%]; P < .001). Most fractures involved the upper extremity (n = 262 [66%]; P < .001), with the most common ones involving the radius (n = 79 [30%]), humerus (n = 22 [8%]), and ulna (n = 8 [3%]). Fractures were due most commonly to falls (n = 365 [92%]; P < .001) and occurred in the winter months (n = 142 [36%]; P < .001). There was a significant difference in disposition status, with most patients discharged (n = 320 [81%] vs n = 77 [19%] for hospital admission; P < .001). Univariate analysis revealed that age >60 years, male sex, and fractures to the trunk and lower extremity all led to significantly increased odds of being admitted (odds ratios: 2.27, 2.31, 2.89, and 13.8, respectively). Conclusion Between 2002 and 2022, there was a 90-fold increase in pickleball-related fractures. Most fractures were of the upper extremity after a fall in women aged >60 years. Despite female fracture predominance, men were 2.3 times more likely to be admitted after sustaining a fracture.
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Affiliation(s)
- Yasmine S Ghattas
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Peter Zeblisky
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Joshua Cassinat
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Matthew Aceto
- University of Central Florida College of Medicine, Orlando, Florida, USA
| | - Kurt P Spindler
- Cleveland Clinic Florida, Sports Medicine, Weston, Florida, USA
| | - Lisa K Cannada
- University of Central Florida College of Medicine, Orlando, Florida, USA
- Novant Health, Charlotte, North Carolina, USA
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Ellington M, Hibberd O, Aylwin C. Fat intravasation, fat emboli and fat embolism syndrome in adult major trauma patients with intraosseous catheters: a systematic review. BMJ Mil Health 2024:e002645. [PMID: 38760078 DOI: 10.1136/military-2023-002645] [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: 12/17/2023] [Accepted: 04/07/2024] [Indexed: 05/19/2024]
Abstract
INTRODUCTION Intraosseous (IO) administration of medication, fluids and blood products is accepted practice for critically injured patients in whom intravenous access is not immediately available. However, there are concerns that high intramedullary pressures resulting from IO infusion may cause bone marrow intravasation and subsequent fat embolisation. The aim of this systematic review is to synthesise the existing evidence describing fat intravasation, fat embolism and fat embolism syndrome (FES) following IO infusion. METHODS A systematic search of CINAHL, MEDLINE and Embase was undertaken using the search terms "intraosseous", "fat embolism", "fat intravasation" and "fat embolism syndrome". Two authors independently screened abstracts and full texts, against eligibility criteria and assessed risk of bias. A grey literature search (including references) was undertaken. Inclusion criteria were: all human and animal studies reporting novel data on IO-associated fat emboli. This systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. RESULTS 22 papers were identified from the search, with a further 5 found from reference lists. N=7 full papers met inclusion criteria. These papers were all translational animal studies. The overall risk of bias was high. Studies demonstrated that fat intravasation and fat embolisation are near universal after IO infusion, but of uncertain clinical significance. The initial IO flush appears to cause the highest intramedullary pressure and highest chance of fat intravasation and embolisation. No conclusions could be drawn on FES. CONCLUSIONS IO catheters remain a useful intervention in the armamentarium of trauma clinicians. Although their use is widely accepted, there is a paucity of evidence investigating fat embolisation in IO infusions. Despite this, pulmonary fat emboli after IO infusion are very common. The existing data are of low quality with a high risk of bias. More research is needed to address this important subject. PROSPERO REGISTRATION NUMBER CRD42023399333.
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Affiliation(s)
- Matt Ellington
- Department of Haematology, University of Cambridge, Cambridge, UK
- 254 MMR, Royal Army Medical Corps, Cambridge, UK
| | - O Hibberd
- Blizard Institute, Centre for Trauma Sciences, Queen Mary University of London, London, UK
- Emergency and Urgent Care Research in Cambridge (EURECA), PACE Section, Department of Medicine, University of Cambridge, Cambridge, UK
| | - C Aylwin
- Blizard Institute, Centre for Trauma Sciences, Queen Mary University of London, London, UK
- Centre for Trauma Sciences, Blizard Institute, QMUL, London, UK
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Aitken T, Tiong MK, Talbot AS, Ruderman I, Nicholls KM. The Effect of Fabry Disease Therapy on Bone Mineral Density. Diseases 2024; 12:102. [PMID: 38785757 PMCID: PMC11120203 DOI: 10.3390/diseases12050102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Revised: 05/10/2024] [Accepted: 05/10/2024] [Indexed: 05/25/2024] Open
Abstract
Fabry disease (FD) is an X-linked lysosomal storage disorder, characterised by the cellular accumulation of globotriaosylceramide due to impaired alpha-galactosidase A enzyme activity. FD may manifest with multisystem pathology, including reduced bone mineral density (BMD). Registry data suggest that the introduction of Fabry-specific therapies (enzyme replacement therapy or chaperone therapy) has led to significant improvements in overall patient outcomes; however, there are limited data on the impact on bone density. The aim of this study was to describe the effect of Fabry-specific therapies on longitudinal changes in bone mineral density (BMD) in FD. We performed a retrospective observational study analysing bone densitometry (DXA) in patients with genetically confirmed FD. Patients were grouped based on the use of Fabry-specific therapies. The between-group longitudinal change in BMD Z-score was analysed using linear mixed effects models. A total of 88 FD patients were analysed (50 untreated; 38 treated). The mean age at first DXA was 38.5 years in the untreated group (84% female) and 43.7 years in the treated group (34% female). There was no significant longitudinal between-group difference in the BMD Z-score at the lumbar spine. However, the Z-score per year at the total hip (β = -0.105, p < 0.001) and femoral neck (β = -0.081, p = 0.001) was significantly lower over time in the treated than the untreated group. This may reflect those receiving therapy having a more severe underlying disease. Nevertheless, this suggests that Fabry-specific therapies do not reverse all disease mechanisms and that the additional management of BMD may be required in this patient population.
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Affiliation(s)
- Tess Aitken
- Department of Nephrology, The Royal Melbourne Hospital, Parkville 3050, Australia
| | - Mark K. Tiong
- Department of Nephrology, The Royal Melbourne Hospital, Parkville 3050, Australia
- Department of Medicine (RMH), The University of Melbourne, Parkville 3010, Australia
| | - Andrew S. Talbot
- Department of Nephrology, The Royal Melbourne Hospital, Parkville 3050, Australia
| | - Irene Ruderman
- Department of Nephrology, The Royal Melbourne Hospital, Parkville 3050, Australia
- Department of Medicine (RMH), The University of Melbourne, Parkville 3010, Australia
| | - Kathleen M. Nicholls
- Department of Nephrology, The Royal Melbourne Hospital, Parkville 3050, Australia
- Department of Medicine (RMH), The University of Melbourne, Parkville 3010, Australia
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Gaemelke T, Laustsen C, Feys P, Folkestad L, Andersen MS, Jørgensen NR, Jørgensen ML, Jespersen SN, Ringgaard S, Eskildsen SF, Dalgas U, Hvid LG. Effects of power training in older patients with multiple sclerosis on neurodegeneration, neuromuscular function, and physical function. A study protocol for the "power training in older multiple sclerosis patients (PoTOMS) randomized control trial. Contemp Clin Trials Commun 2024; 38:101279. [PMID: 38444875 PMCID: PMC10912361 DOI: 10.1016/j.conctc.2024.101279] [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: 10/23/2023] [Revised: 01/24/2024] [Accepted: 02/17/2024] [Indexed: 03/07/2024] Open
Abstract
Introduction Approximately one-third of all persons with multiple sclerosis (pwMS) are older, i.e., having an age ≥60 years. Whilst ageing and MS separately elicit deteriorating effects on brain morphology, neuromuscular function, and physical function, the combination of ageing and MS may pose a particular challenge. To counteract such detrimental changes, power training (i.e., a type of resistance exercise focusing on moderate-to-high loading at maximal intended movement velocity) presents itself as a viable and highly effective solution. Power training is known to positively impact physical function, neuromuscular function, as well as brain morphology. Existing evidence is promising but limited to young and middle-aged pwMS, with the effects of power training remaining to be elucidated in older pwMS. Methods The presented 'Power Training in Older MS patients (PoTOMS)' trial is a national, multi-center, parallel-group, randomized controlled trial. The trial compares 24 weeks of usual care(n = 30) to 24 weeks of usual care and power training (n = 30). The primary outcome is whole brain atrophy rate. The secondary outcomes include changes in brain micro and macro structures, neuromuscular function, physical function, cognitive function, bone health, and patient-reported outcomes. Ethics and dissemination The presented study is approved by The Regional Ethics Committee (reference number 1-10-72-222-20) and registered at the Danish Data Protection Agency (reference number 2016-051-000001). All study findings will be published in scientific peer-reviewed journals and presented at relevant scientific conferences independent of the results. The www.clinicaltrials.gov identifier is NCT04762342.
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Affiliation(s)
- Tobias Gaemelke
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christoffer Laustsen
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Peter Feys
- REVAL, Rehabilitation Research Center, BIOMED, Biomedical Research Institute, Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital and University of Southern Denmark, Odense, Denmark
| | | | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Sune Nørhøj Jespersen
- Department of Physics and Astronomy, Aarhus University, Aarhus, Denmark
- Center of Functionally Integrative Neuroscience and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Steffen Ringgaard
- The MR Research Center, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Simon F. Eskildsen
- Center of Functionally Integrative Neuroscience and MINDLab, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Ulrik Dalgas
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Lars G. Hvid
- Exercise Biology, Department of Public Health, Aarhus University, Aarhus, Denmark
- The Danish MS Hospitals, Ry and Haslev, Denmark
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Khodadadi F, Bagheri SR, Ahmadi S, Rahmatinezhad M, Arjmandnia F, Abdi A, Alimohammadi E. The association between menopausal status and clinical outcomes of female patients with carpal tunnel release: a retrospective observational study. Int J Neurosci 2024; 134:318-322. [PMID: 35815446 DOI: 10.1080/00207454.2022.2100783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/07/2022] [Accepted: 06/23/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND The relationship between menopausal status and clinical outcomes of female patients with carpal tunnel release (CTR) has been not clearly investigated. This study aimed to evaluate the clinical outcomes of CTR among women with different menopausal statuses. METHODS Two hundred-eighteen consecutive female patients with carpal tunnel syndrome (CTS) who underwent surgery at our hospital between May 2016 and May 2020 were included in this study. Based on whether subjects had undergone menopause before surgery, they were divided into three groups: the premenopausal group, the early postmenopausal group (less than 10 years since menopause) and the late postmenopausal group (more than 10 years since menopause). The clinical outcome was assessed before surgery and at six-month postoperative visits using the Boston Carpal Tunnel Questionnaire (BCTQ). RESULTS There were 86 patients in the premenopausal group, 70 patients in the early postmenopausal group and 62 patients in the late postmenopausal group. All the groups showed significant improvements in their Symptom Severity Scale (SSS) and Functional Status Scale (FSS) compared with preoperative scores. Although, there was a significant difference between the groups based and post-surgical SSS and FSS (p < 0.05). Patients in the postmenopausal group had less improvement in SSS and FSS in comparison with those in the other groups (p < 0.05). CONCLUSIONS Our results showed that all the groups had significant improvement in their SSS and FSS. However, the clinical outcomes were poorer in late postmenopausal patients than in premenopausal or early postmenopausal patients. These findings can be used in pre-operative counseling and interpretation of outcomes in women with CTR.
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Affiliation(s)
- Foziyeh Khodadadi
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Seyed Reza Bagheri
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
| | - Samane Ahmadi
- Imam Reza hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Maryam Rahmatinezhad
- Department of anesthesiology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Alireza Abdi
- Imam Reza hospital, Nursing and midwifery school, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Ehsan Alimohammadi
- Department of neurosurgery, Kermanshah University of Medical Sciences, Imam Reza hospital, Kermanshah, Iran
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Ono R, Katsumata A, Fujikawa Y, Takahira E, Yamamoto T, Kanamura N. Sex differences and age-related changes in the mandibular alveolar bone mineral density using a computer-aided measurement system for intraoral radiography. Sci Rep 2024; 14:7386. [PMID: 38548856 PMCID: PMC10979020 DOI: 10.1038/s41598-024-57805-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Accepted: 03/21/2024] [Indexed: 04/01/2024] Open
Abstract
This study aimed to conduct a cross-sectional data analysis of the alveolar bone mineral density (al-BMD) in 225 patients of various ages and different sexes. The al-BMD value in the mandibular incisor region was calculated using a computer-aided measurement system (DentalSCOPE) for intraoral radiography. All participants with intact teeth (101 males and 124 females; age range, 25-89 years) were divided into three age-segregated groups (25-49, 50-74, and > 75 years). Statistical differences were evaluated using the Mann-Whitney U or Kruskal-Wallis test. Males exhibited significantly greater al-BMD than females (p < 0.001). The highest means were observed in the 25-49 age group, regardless of sex (1007.90 mg/cm2 in males, 910.90 mg/cm2 in females). A 9.8% decrease in al-BMD was observed with the increase in age in males (25-49 to 50-74 years; p = 0.004); however, no further changes were seen thereafter. In females, a decreasing trend was seen throughout the lifespan, with values reaching up to 76.0% of the initial peak value (p < 0.001). Similar to other skeletal sites, the alveolar bone exhibits sex differences and undergoes a reduction in BMD via the normal aging process.
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Affiliation(s)
- Ryutaro Ono
- Department of Dental Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan.
- Department of Oral and Maxillofacial Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Akitoshi Katsumata
- Department of Oral Radiology, Asahi University School of Dentistry, Gifu, Japan
| | - Yumi Fujikawa
- Department of Dental Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
- Department of Oral and Maxillofacial Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Emi Takahira
- Department of Dental Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
- Department of Oral and Maxillofacial Surgery, North Medical Center, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Toshiro Yamamoto
- Department of Dental Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Narisato Kanamura
- Department of Dental Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, 602-8566, Japan
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Llop M, Gratacós J, Moreno M, Arevalo Salaet M, Calvet J, Berenguer-Llergo A, Dougados M, Molto A, López-Medina C. Sex differential impact of comorbidities in spondyloarthritis: data from COMOSPA study. RMD Open 2024; 10:e003776. [PMID: 38296312 PMCID: PMC10836353 DOI: 10.1136/rmdopen-2023-003776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 01/09/2024] [Indexed: 02/05/2024] Open
Abstract
OBJECTIVES To describe and compare the prevalence of comorbidities in female and male patients with spondyloarthritis (SpA) and to assess whether comorbidities had a different impact on disease outcomes in male and female patients. METHODS This is a post hoc analysis of the COMOrbidities in SPondyloArthritis study. Differences in comorbidities regarding sex were assessed using logistic regression models. Comorbidities were evaluated for their impact on disease outcomes (Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score (ASDAS), Bath Ankylosing Spondylitis Functional Index, European health-related quality of life questionnaire) with linear models, which included sex and comorbidity as explanatory variables and their interaction. Age and treatment with biological synthetic disease-modifying antirheumatic drugs were included as confounders. RESULTS We included 3982 patients with SpA (65% male, mean age 43.6 years). Male and female patients with SpA exhibited similar comorbidity profiles, except for a low prevalence of fibromyalgia in males and a higher prevalence of certain cardiovascular risk factors in males (hypertension, dyslipidaemia, renal impairment and ischaemic heart disease). Comorbidities, especially fibromyalgia, correlated with higher disease activity, decreased physical function and reduced health-related quality of life in both sexes. Some comorbidities exhibited sex-specific associations with disease outcomes. Peptic ulcers and high waist circumference had a greater impact on disease activity in females (with a higher impact in BASDAI than in ASDAS). In contrast, osteoporosis had a more pronounced effect on physical function in male patients. CONCLUSIONS Comorbidities exert distinct influences on disease activity, physical function and health-related quality of life in male and female patients with SpA. Understanding these sex-specific effects is crucial for improving SpA management, emphasising the importance of assessing disease activity using ASDAS when comorbidities are present to mitigate sex-related disparities in disease assessment.
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Affiliation(s)
- Maria Llop
- Rheumatology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Jordi Gratacós
- Rheumatology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
- Medicine department Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Mireia Moreno
- Rheumatology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Marta Arevalo Salaet
- Rheumatology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Joan Calvet
- Rheumatology Department, Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | - Antoni Berenguer-Llergo
- Biostatistics and Bioinformatics Rheumatology Department, Institut d'Investigació i Innovació Parc Taulí I3PT, Sabadell, Spain
| | | | - Anna Molto
- Rheumatology, Hospital Cochin, Paris, France
- ECAMO team - INSERM (U1153) - Center of Research in Epidemiology and Statistics (CRESS) - Université Paris-Cité, Paris, France
| | - Clementina López-Medina
- Rheumatology Department, Hospital Universitario Reina Sofía/IMIBIC/Universidad de Córdoba, Córdoba, Spain
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Carletti A, Gavaia PJ, Cancela ML, Laizé V. Metabolic bone disorders and the promise of marine osteoactive compounds. Cell Mol Life Sci 2023; 81:11. [PMID: 38117357 PMCID: PMC10733242 DOI: 10.1007/s00018-023-05033-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 10/12/2023] [Accepted: 11/05/2023] [Indexed: 12/21/2023]
Abstract
Metabolic bone disorders and associated fragility fractures are major causes of disability and mortality worldwide and place an important financial burden on the global health systems. These disorders result from an unbalance between bone anabolic and resorptive processes and are characterized by different pathophysiological mechanisms. Drugs are available to treat bone metabolic pathologies, but they are either poorly effective or associated with undesired side effects that limit their use. The molecular mechanism underlying the most common metabolic bone disorders, and the availability, efficacy, and limitations of therapeutic options currently available are discussed here. A source for the unmet need of novel drugs to treat metabolic bone disorders is marine organisms, which produce natural osteoactive compounds of high pharmaceutical potential. In this review, we have inventoried the marine osteoactive compounds (MOCs) currently identified and spotted the groups of marine organisms with potential for MOC production. Finally, we briefly examine the availability of in vivo screening and validation tools for the study of MOCs.
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Affiliation(s)
- Alessio Carletti
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Faro, Portugal
- Department of Developmental Genetics, Max Planck Institute for Heart and Lung Research, Bad Nauheim, Germany
| | - Paulo Jorge Gavaia
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Faro, Portugal
- Associação Oceano Verde (GreenCoLab), Faro, Portugal
| | - Maria Leonor Cancela
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal
- Faculty of Medicine and Biomedical Sciences (FMCB), University of Algarve, Faro, Portugal
- Algarve Biomedical Center (ABC), University of Algarve, Faro, Portugal
| | - Vincent Laizé
- Centre of Marine Sciences (CCMAR), University of Algarve, Faro, Portugal.
- Collaborative Laboratory for Sustainable and Smart Aquaculture (S2AQUAcoLAB), Olhão, Portugal.
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Desai S, Lång P, Näreoja T, Windahl SH, Andersson G. RANKL-dependent osteoclast differentiation and gene expression in bone marrow-derived cells from adult mice is sexually dimorphic. Bone Rep 2023; 19:101697. [PMID: 37485233 PMCID: PMC10359713 DOI: 10.1016/j.bonr.2023.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 07/25/2023] Open
Abstract
Sex-specific differences in bone integrity and properties are associated with age as well as the number and activity of cells involved in bone remodeling. The aim of this study was to investigate sex-specific differences in adhesion, proliferation, and differentiation of mouse bone marrow derived cells into osteoclasts. The adherent fraction of bone marrow- derived cells from 12-week-old male and female C57BL/6J mice were assessed for their adhesion, proliferation, and receptor activator of nuclear factor κB (RANKL)-induced differentiation into osteoclasts. Female bone marrow derived macrophages (BMDMs) displayed higher adhesion and proliferation ratio upon macrophage colony stimulating factor (M-CSF) (day 0) and M-CSF + RANKL (day 4) treatment, respectively. On the contrary, male BMDMs differentiated more efficiently into osteoclasts upon RANKL-treatment compared to females (day 5). To further understand these sex-specific differences at the gene expression level, BMDMs treated with M-CSF (day 0) and M-CSF + RANKL (day 4), were assessed for their differential expression of genes through RNA sequencing. M-CSF treatment resulted in 1106 differentially expressed genes, while RANKL-treatment gave 473 differentially expressed genes. Integrin, adhesion, and proliferation-associated genes were elevated in the M-CSF-treated female BMDMs. RANKL-treatment further enhanced the expression of the proliferation- associated genes, and of genes associated with inhibition of osteoclast differentiation in the females, while RANK-signaling-associated genes were upregulated in males. In conclusion, BMDM adhesion, proliferation and differentiation into osteoclasts are sex-specific and may be directed by the PI3K-Akt signaling pathway for proliferation, and the colony stimulating factor 1-receptor and the RANKLsignaling pathway for the differentiation.
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Affiliation(s)
- Suchita Desai
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Pernilla Lång
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Tuomas Näreoja
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
- Department of Life Technologies, University of Turku, Finland
| | - Sara H. Windahl
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Göran Andersson
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
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11
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Liu D, Kadri A, Hernando D, Binkley N, Anderson PA. MRI-based vertebral bone quality score: relationship with age and reproducibility. Osteoporos Int 2023; 34:2077-2086. [PMID: 37640844 DOI: 10.1007/s00198-023-06893-6] [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: 04/24/2023] [Accepted: 08/17/2023] [Indexed: 08/31/2023]
Abstract
Vertebral bone quality (VBQ) score is an opportunistic measure of bone mineral density using routine preoperative MRI in spine surgery. VBQ score positively correlates with age and is reproducible across serial scans. However, extrinsic factors, including MRI machine and protocol, affect the VBQ score and must be standardized. PURPOSE The purposes of this study were to determine whether VBQ score increased with age and whether VBQ remained consistent across serial MRI studies obtained within 3 months. METHODS This retrospective study evaluated 136 patients, age 20-69, who received two T1-weighted lumbar MRI within 3 months of each other between January 2011 and December 2021. VBQ(L1-4) score was calculated as the quotient of L1-L4 signal intensity (SI) and L3 cerebral spinal fluid (CSF) SI. VBQ(L1) score was calculated as the quotient of L1 SI and L1 CSF SI. Regression analysis was performed to determine correlation of VBQ(L1-4) score with age. Coefficient of variation (CV) was used to determine reproducibility between VBQ(L1-4) scores from serial MRI scans. RESULTS One hundred thirty-six patients (mean ± SD age 44.9 ± 12.5 years; 53.7% female) were included in this study. Extrinsic factors affecting the VBQ score included patient age, MRI relaxation time, and specific MRI machine. When controlling for MRI relaxation/echo time, the VBQ(L1-4) score was positively correlated with age and had excellent reproducibility in serial MRI with CV of 0.169. There was excellent agreement (ICC > 0.9) of VBQ scores derived from the two formulas, VBQ(L1) and VBQ(L1-4). CONCLUSION Extrinsic factors, including MRI technical factors and age, can impact the VBQ(L1-4) score and must be considered when using this tool to estimate bone mineral density (BMD). VBQ(L1-4) score was positively correlated with age. Reproducibility of the VBQ(L1-4) score across serial MRI is excellent especially when controlling for technical factors, supporting use of the VBQ score in estimating BMD. The VBQ(L1) score was a reliable alternative to the VBQ(L1-4) score.
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Affiliation(s)
- Daniel Liu
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792-3252, USA.
| | - Aamir Kadri
- Department of Orthopaedic Surgery and Sports Medicine, University of Kentucky College of Medicine, Lexington, KY, USA
| | - Diego Hernando
- Department of Radiology and Medical Physics, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Neil Binkley
- Osteoporosis Clinical Research Program, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Paul A Anderson
- Department of Orthopedics and Rehabilitation, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave, Madison, WI, 53792-3252, USA
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12
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Florence GE, Oosthuyse T, Bosch AN. Skeletal site-specific effects of jump training on bone mineral density in adults: a systematic review and meta-analysis. J Sports Sci 2023; 41:2063-2076. [PMID: 38305252 DOI: 10.1080/02640414.2024.2312052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 01/19/2024] [Indexed: 02/03/2024]
Abstract
Preserving or preventing declines in bone mineral density (BMD) is imperative. As jumping is a high-impact bone-loading action, this meta-analysis evaluated the efficacy of jump training to improve BMD and bone turnover relative to non-jumping controls in men and women > 18 years, following Preferred Reported Items for Systematic Reviews and Meta-Analysis guidelines. PubMed and COCHRANE Library databases were searched until February 2022. Fifteen articles (19 jumping-trials) met the predetermined search criteria. Eighteen trials were included for BMD data (n = 666 participants). There was a significant small-moderate effect of jumping on femoral neck BMD (%mean difference: 95%CI, +1.50%: 0.83%; 2.17%, p < 0.0001), that remained significant after sub-analysis by age for both younger (+1.81%: 0.98%; 2.65%) and older adults (+1.03%: 0.02%; 2.03%). BMD of total hip (+1.26%: 0.56%; 1.96% vs + 0.06%: -0.96%; 1.08%), and trochanter (+0.84%: 0.20%; 1.48% vs -0.16%: -1.08%; 0.76%) increased significantly with jump training only in younger adults and non-significantly at the lumbar spine (+0.84%: -0.02%; 1.7% vs -0.09%: -0.96%; 0.77%) only in younger but not older adults, respectively. The BMD response to jump training appears to be site-specific, with the highest sensitivity at the femoral neck. No dose-response effect suggests moderate certainty of a gain in femoral neck BMD when performing the median jump-load of 50 jumps four times weekly.
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Affiliation(s)
- Gabriella E Florence
- Institute of Sport and Exercise Medicine, Division of Orthopaedic Surgery, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg, South Africa
| | - Tanja Oosthuyse
- School of Physiology, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
- Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
| | - Andrew N Bosch
- Health through Physical Activity, Lifestyle and Sport Research Centre, Division of Physiological Sciences, Department of Human Biology, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa
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13
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Wan Y, Hu C, Hou Y, Si C, Zhao Q, Wang Z, Wang L, Guo X. OPG gene-modified adipose-derived stem cells improve bone formation around implants in osteoporotic rat maxillae. Heliyon 2023; 9:e19474. [PMID: 37817994 PMCID: PMC10560787 DOI: 10.1016/j.heliyon.2023.e19474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 08/14/2023] [Accepted: 08/23/2023] [Indexed: 10/12/2023] Open
Abstract
Background Osteoporosis is a significant barrier to the use of dental implants in the elderly for the treatment of tooth defects. Adipose derived stem cells (ADSCs) have demonstrated extensive potential for tissue repair and regeneration. The present study aimed to investigate the effectiveness of ADSCs engineered to express high levels of osteoprotegerin (OPG) for the treatment of bone loss in implant dentistry caused by estrogen deficiency. Methods A rat model of osteoporosis was established through double oophorectomy, and the rats were treated by gene modified cells Adv-OPG-ADSCs. The effects of the treatment on maxilla tissue changes were evaluated using HE staining and micro-CT. Additionally, ALP and TRAP staining were used to assess osteoblast and osteoclast alterations. Finally, the changes in related osteoblast and osteoclast indicators were measured by RT-qPCR, Western blot, and ELISA. Results The successfully generated high-OPG-expressing ADSCs led to increase of cell viability, proliferation, and osteoblast differentiation. Treatment with Adv-OPG-ADSCs significantly ameliorated maxillary morphology, trabecular volume reduction, and bone mineral density decline in the model of estrogen-deficient maxillary implant dentistry. Furthermore, the treatment was beneficial to promoting the generation of osteoblasts and inhibiting the generation of osteoclast. Adv-OPG-ADSCs increased OPG, ALP, OCN, and Runx-2 expressions in the maxilla while suppressing RANKL expression, and also increased the concentration of COL I and PINP, as well as decreased the concentration of CTX-1. Conclusion Adv-OPG-ADSCs promote the formation of osteoblasts and inhibit the generation of osteoclasts, thereby inhibiting bone absorption, facilitating bone formation, and promoting the repair of maxillary bone after dental implantation in the presence of osteoporosis-related complications, especially in the setting of estrogen deficiency, providing scientific basis for the application of Adv-OPG-ADSCs in the treatment of implant related osteoporosis.
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Affiliation(s)
| | | | - Yongjie Hou
- General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Chenchen Si
- General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Qian Zhao
- General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Zhenzhen Wang
- General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Liyuan Wang
- General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
| | - Xiaoqian Guo
- General Hospital of Ningxia Medical University, Yinchuan, 750004, Ningxia, China
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14
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Choi JY, Yang YM. Analysis of the association between osteoporosis and muscle strength in Korean adults: a national cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:97. [PMID: 37700322 PMCID: PMC10498644 DOI: 10.1186/s41043-023-00443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND This study aimed to examine the associations between osteoporosis and hand grip strength (HGS), a surrogate marker of muscular strength, among Korean adults stratified by body mass index (BMI), age, and renal function. METHODS This study was conducted using the data obtained from the Korea National Health and Nutrition Examination Survey 2015-2019, a cross-sectional and nationally representative survey performed by the Korea Centers for Diseases Control and Prevention. RESULTS Of the 26,855 subjects included in this study, those with low muscle strength (LMS) and normal muscle strength were showed in 4,135 (15.4%) and 22,720 (84.6%) subjects, respectively. The osteoporotic subjects had a higher prevalence rate for LMS than those without osteoporosis after adjusting for age [odds ratio (OR), 1.684; 95% confidence interval (CI), 1.500-1.890). The subjects with osteoporosis and BMI < 18.5 kg/m2 also had a higher prevalence rate for LMS after adjusting for age compared to those with non-osteoporosis and BMI < 18.5 kg/m2 (OR, 1.872; 95% CI, 1.043-3.359). Compared to the non-osteoporotic subjects with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2, those with osteoporosis and eGFR ≥ 60 mL/min/1.73 m2 had a higher prevalence rate for LMS after controlling for age and sex (OR, 1.630; 95% CI, 1.427-1.862). CONCLUSIONS The results showed that osteoporosis was likely to contribute to an increased prevalence rate of LMS in terms of HGS. Aging, BMI, and renal function also had significant effects on the association between osteoporosis and LMS. This association is likely to assist in developing better strategies to estimate bone health in clinical or public health practice.
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Affiliation(s)
- Ji-Young Choi
- Department of Food and Nutrition, College of Natural Science and Public Health and Safety, Chosun University, Gwangju, Republic of Korea
| | - Young-Mo Yang
- Department of Pharmacy, College of Pharmacy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea.
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15
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Abstract
Most women worldwide experience menopausal symptoms during the menopause transition or postmenopause. Vasomotor symptoms are most pronounced during the first four to seven years but can persist for more than a decade, and genitourinary symptoms tend to be progressive. Although the hallmark symptoms are hot flashes, night sweats, disrupted sleep, and genitourinary discomfort, other common symptoms and conditions are mood fluctuations, cognitive changes, low sexual desire, bone loss, increase in abdominal fat, and adverse changes in metabolic health. These symptoms and signs can occur in any combination or sequence, and the link to menopause may even be elusive. Estrogen based hormonal therapies are the most effective treatments for many of the symptoms and, in the absence of contraindications to treatment, have a generally favorable benefit:risk ratio for women below age 60 and within 10 years of the onset of menopause. Non-hormonal treatment options are also available. Although a symptom driven treatment approach with individualized decision making can improve health and quality of life for midlife women, menopausal symptoms remain substantially undertreated by healthcare providers.
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Affiliation(s)
- Erin R Duralde
- Division of Women's Health, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Talia H Sobel
- Division of Women's Health Internal Medicine, Mayo Clinic Arizona, Scottsdale, AZ, USA
| | - JoAnn E Manson
- Harvard Medical School, Boston, MA, USA
- Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
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16
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Sun Z, Shi J, Yang C, Chen X, Chu J, Chen J, Wang Y, Zhu C, Xu J, Tang G, Shao S. Identification and evaluation of circulating exosomal miRNAs for the diagnosis of postmenopausal osteoporosis. J Orthop Surg Res 2023; 18:533. [PMID: 37496029 PMCID: PMC10373377 DOI: 10.1186/s13018-023-04020-z] [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: 05/16/2023] [Accepted: 07/14/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Postmenopausal osteoporosis (PMOP) is a common condition that leads to a loss of bone density and an increased risk of fractures in women. Recent evidence suggests that exosomal miRNAs are involved in regulating bone development and osteogenesis. However, exosomal miRNAs as biomarkers for PMOP diagnosis have not been systematically evaluated. In this study, we aim to identify PMOP-associated circulating exosomal miRNAs and evaluate their diagnostic performance. METHODS We performed next-generation sequencing and bioinformatics analysis of plasma exosomal miRNAs from 12 PMOP patients and 12 non-osteoporosis controls to identify PMOP-associated exosomal miRNAs, and then validated them in an independent natural community cohort with 26 PMOP patients and 21 non-osteoporosis controls. Exosomes were isolated with the size exclusion chromatography method from the plasma of elder postmenopausal women. The plasma exosomal miRNA profiles were characterized in PMOP paired with controls with next-generation sequencing. Potential plasma exosomal miRNAs were validated by qRT-PCR in the validation cohort, and their performance in diagnosing PMOP was systematically evaluated with the receiver operating characteristic curve. RESULTS Twenty-seven miRNAs were identified as differentially expressed in PMOP versus controls in sequencing data, of which six exosomal miRNAs (miR-196-5p, miR-224-5p, miR320d, miR-34a-5p, miR-9-5p, and miR-98-5p) were confirmed to be differentially expressed in PMOP patients by qRT-PCR in the validation cohort. The three miRNAs combination (miR-34a-5p + miR-9-5p + miR-98-5p) demonstrated the best diagnostic performance, with an AUC = 0.734. In addition, the number of pregnancies was found to be an independent risk factor that can improve the performance of exosomal miRNAs in diagnosing PMOP. CONCLUSIONS These results suggested that the plasma exosomal miRNAs had the potential to serve as noninvasive diagnostic biomarkers for PMOP.
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Affiliation(s)
- Zhibang Sun
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Junjie Shi
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Chenyang Yang
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Xukun Chen
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Jiaqi Chu
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Jing Chen
- Department of R&D, Echo Biotech Co., Ltd, Beijing, People's Republic of China
| | - Yuan Wang
- Department of R&D, Echo Biotech Co., Ltd, Beijing, People's Republic of China
| | - Chenxin Zhu
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Jinze Xu
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Guozhen Tang
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China
| | - Song Shao
- Department of Orthopedics, The Lu'an Affiliated Hospital of Anhui Medical University, Lu'an, People's Republic of China.
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Fan J, Liu T, Dong X, Sun S, Zhang H, Yang C, Yin X, Liao B, Li X. Effect of Zoledronic Acid on the Vertebral Body Bone Mineral Density After Instrumented Intervertebral Fusion in Postmenopausal Women With Osteoporosis. Global Spine J 2023; 13:1280-1285. [PMID: 34212769 PMCID: PMC10416581 DOI: 10.1177/21925682211027833] [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: 11/16/2022] Open
Abstract
STUDY DESIGN Retrospective cohort study. OBJECTIVES To evaluate the effect of zoledronic acid, an anti-osteoporosis treatment, during the perioperative period on vertebral body bone mineral density (BMD) after spinal fusion surgery in postmenopausal women with osteoporosis. METHODS The medical records of postmenopausal patients with osteoporosis who underwent instrumented intervertebral fusion for lumbar degenerative disease between July 2016 and May 2018 were reviewed. Patients with comorbidities or condition which might affect bone metabolism were excluded. Forty-six patients did not receive anti-osteoporosis treatment before surgery and during the postoperative follow-up (untreated group). Another 46 patients who was treated with zoledronic acid perioperatively were matched for age and body mass index to patients in the untreated group. Preoperative and postoperative dual-energy X-ray absorptiometry (DEXA) records and lumbar BMD values of the involved spinal segments and of the cephalad levels, as well as of the femoral neck were recorded. RESULTS A significant decrease of cephalad vertebral BMD values was observed in the untreated group (-11.47%, P < 0.001), with a slight decrease of the femoral neck (-1.28%, P > 0.05). Zoledronic acid prevented rapid bone loss after instrumented intervertebral fusion surgery, with a bone loss in the cephalad levels of -0.76 ± 4.71% compared to -11.47 ± 16.45% in the untreated group (P < 0.001). while the change in BMD of the femoral neck in the treated group was 1.52 ± 5.88% compared to -1.28 ± 6.58% in the untreated group (P = 0.036). CONCLUSIONS Perioperative zoledronic acid treatment may offer protection against a significant decrease in BMD of cephalad vertebrae after spinal fusion surgery among postmenopausal women with osteoporosis.
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Affiliation(s)
- Junjun Fan
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
- Department of Orthopedics, Xijing Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Tao Liu
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
- State Key Laboratory of Cancer Biology, Biotechnology Center, School of Pharmacy, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xin Dong
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Siguo Sun
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Hongtao Zhang
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Chunbao Yang
- Department of Orthopedics, 985 hospital of PLA, Taiyuan, Shanxi, China
| | - Xin Yin
- Department of Orthopedics, the fourth medical center of PLAGH, Beijing, China
| | - Bo Liao
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Xiaoxiang Li
- Department of Orthopedics, Tangdu Hospital, The Fourth Military Medical University, Xi’an, Shaanxi, China
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Ellington M, Walker I, Barnard E. Red cell haemolysis secondary to intraosseous (IO) blood transfusion in adult patients with major trauma: a systematic review. BMJ Mil Health 2023:military-2023-002378. [PMID: 37236652 DOI: 10.1136/military-2023-002378] [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: 02/15/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023]
Abstract
INTRODUCTION Intraosseous (IO) administration of medications and blood products is accepted practice in major trauma when intravenous access is not immediately available. However, there is a concern that the high infusion pressures required for IO transfusion may increase the risk of red cell haemolysis and its associated complications. The aim of this systematic review is to synthesise the existing evidence describing the risks of red cell haemolysis in IO blood transfusion. METHODS We undertook a systematic search of MEDLINE, CINAHL and EMBASE using the search terms: "intraosseous transfusion" and "haemolysis". Two authors independently screened abstracts, and reviewed full-text articles against the inclusion criteria. Reference lists of included studies were reviewed and a grey literature search undertaken. Studies were assessed for risk of bias. Inclusion criteria were: all human and animal study types that reported novel data on IO-associated red cell haemolysis. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline was used. RESULTS Twenty-three abstracts were identified; n=9 full papers met the inclusion criteria. No further studies were identified from reference lists or grey literature. These papers included: seven large animal translational studies, a prospective and a retrospective human study. The overall risk of bias was high. One animal study with good translatability to adult patients with trauma demonstrated haemolysis. Other animal studies had methodological constraints that limit their human applicability. No haemolysis was observed in low-density flat bones (sternum), whereas haemolysis was reported in long bones (humerus, tibia). IO infusion using a three-way tap was associated with haemolysis. Conversely, pressure bag transfusion was not associated with haemolysis, but this method may result in insufficient flow rates for effective resuscitation. CONCLUSIONS There is a paucity of high-quality evidence surrounding the risks of red cell haemolysis in IO blood transfusion. However, evidence from one study suggests that the likelihood is increased by use of a three-way tap to administer blood transfusion to young adult male patients with trauma. Further research is needed to address this important clinical question. PROSPERO REGISTRATION NUMBER CRD42022318902.
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Affiliation(s)
- Matt Ellington
- Anaesthetic Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Division of Anaesthesia, University of Cambridge, Cambridge, UK
| | - I Walker
- Haematology Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
- Department of Haematology, University of Cambridge, Cambridge, UK
| | - E Barnard
- Academic Department of Military Emergency Medicine, Royal Centre for Defence Medicine (Research and Clinical Innovation), Birmingham, UK
- Emergency Department, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
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Shahen VA, Schindeler A, Rybchyn MS, Girgis CM, Mulholland B, Mason RS, Levinger I, Brennan-Speranza TC. Rescue of High Glucose Impairment of Cultured Human Osteoblasts Using Cinacalcet and Parathyroid Hormone. Calcif Tissue Int 2023; 112:452-462. [PMID: 36754901 PMCID: PMC10025212 DOI: 10.1007/s00223-023-01062-7] [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: 09/11/2022] [Accepted: 01/16/2023] [Indexed: 02/10/2023]
Abstract
Patients with type 2 diabetes mellitus (T2DM) experience a higher risk of fractures despite paradoxically exhibiting normal to high bone mineral density (BMD). This has drawn into question the applicability to T2DM of conventional fracture reduction treatments that aim to retain BMD. In a primary human osteoblast culture system, high glucose levels (25 mM) impaired cell proliferation and matrix mineralization compared to physiological glucose levels (5 mM). Treatment with parathyroid hormone (PTH, 10 nM), a bone anabolic agent, and cinacalcet (CN, 1 µM), a calcimimetic able to target the Ca2+-sensing receptor (CaSR), were tested for their effects on proliferation and differentiation. Strikingly, CN+PTH co-treatment was shown to promote cell growth and matrix mineralization under both physiological and high glucose conditions. CN+PTH reduced apoptosis by 0.9-fold/0.4-fold as measured by Caspase-3 activity assay, increased alkaline phosphatase (ALP) expression by 1.5-fold/twofold, increased the ratio of nuclear factor κ-B ligand (RANKL) to osteoprotegerin (OPG) by 2.1-fold/1.6-fold, and increased CaSR expression by 1.7-fold/4.6-fold (physiological glucose/high glucose). Collectively, these findings indicate a potential for CN+PTH combination therapy as a method to ameliorate the negative impact of chronic high blood glucose on bone remodeling.
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Affiliation(s)
- V A Shahen
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - A Schindeler
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Bioengineering & Molecular Medicine Laboratory, The Children's Hospital at Westmead and the, Westmead Institute for Medical Research, Westmead, NSW, 2006, Australia
| | - M S Rybchyn
- School of Chemical Engineering, University of New South Wales, Sydney, NSW, 2033, Australia
| | - C M Girgis
- Sydney Medical School, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
- Department of Diabetes and Endocrinology, Westmead Hospital, Sydney, Australia
- Department of Endocrinology, Royal North Shore Hospital, Sydney, Australia
| | - B Mulholland
- Graduate School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - R S Mason
- School of Life and Environmental Sciences, Faculty of Science, University of Sydney, Sydney, NSW, 2006, Australia
| | - I Levinger
- Institute for Health and Sport (IHES), Victoria University, Melbourne, VIC, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), University of Melbourne and Western Health, St Albans, VIC, Australia
| | - T C Brennan-Speranza
- School of Medical Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
- School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
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Boileau M, Routier E, Pouvelle A, Lambotte O, Robert C. Tenofovir-induced osteoporosis fracture in a patient using PrEP: A pitfall for the oncologist. Eur J Cancer 2023; 182:53-56. [PMID: 36739633 DOI: 10.1016/j.ejca.2022.12.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 12/31/2022] [Indexed: 01/11/2023]
Affiliation(s)
- Marie Boileau
- CHU de Lille, Service de Dermatologie, F-59000 Lille, France; Univ Lille, F-59000, Lille, France; Dermatology Unit, Department of Medicine, Gustave Roussy Cancer Campus, France.
| | - Emilie Routier
- Dermatology Unit, Department of Medicine, Gustave Roussy Cancer Campus, France
| | - Arnaud Pouvelle
- Department of Interventional Radiology, Gustave Roussy Cancer Campus, France
| | - Olivier Lambotte
- Université Paris Saclay, AP-HP, Department of Internal Medicine & Clinical Immunology, Bicêtre Hospital, Inserm, CEA, UMR1184, Le Kremlin-Bicêtre, France
| | - Caroline Robert
- Dermatology Unit, Department of Medicine, Gustave Roussy Cancer Campus, France; University Paris-Saclay, Kremlin-Bicêtre, France; INSERM Unit U981, France.
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21
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Cobb LH, Bailey VO, Liu YF, Teixido MT, Rizk HG. Relationship of vitamin D levels with clinical presentation and recurrence of BPPV in a Southeastern United States institution. Auris Nasus Larynx 2023; 50:70-80. [PMID: 35659787 DOI: 10.1016/j.anl.2022.05.011] [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: 02/09/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine the relationship of 25hydroxyvitamin D serum levels with BPPV incidence and recurrence rates. METHODS A retrospective cross-sectional, case-controlled study with follow-up phone survey was performed on patients diagnosed with BPPV between 05/2017-05/2020, who had available 25hydroxyvitamin D serology. Patients were seen at a multidisciplinary, vestibular-focused, neurotology clinic at a tertiary referral center. Controls consisted of subjects from the National Health and Nutrition Examination Survey (NHANES), and a locoregional age, sex, and race-matched group of patients from our institution. RESULTS Our BPPV cohort consisted of 173 patients (mean age 66.2 ± 11.8 years), who were predominately female (75.7%) and Caucasian (76.3%). Almost all age subgroups (BPPV, NHANES, and locoregional groups) ≤60 years old had insufficient levels of vitamin D. However, the overall BPPV cohort had a significantly higher vitamin D level than the NHANES control (31.4 ± 16.5 v. 26.0 ± 11.2 ng/mL, d=0.474 [0.323, 0.626]). There was no significant difference when compared to the overall locoregional control (31.4 ± 20.5 ng/mL). Migraines were significantly correlated to increased BPPV recurrence rates on univariate (beta=0.927, p=0.037, 95% CI: [0.057, 1.798]) and multiple regression analyses (beta=0.231, 95% CI: [0.024, 2.029], p=0.045). Furthermore, patients with BPPV recurrences had significantly lower levels of vitamin D at initial presentation when compared to patients with no recurrences (29.0 ± 12.0 v. 37.6 ± 18.3 ng/mL, d=0.571[0.139,1.001]). CONCLUSION Many BPPV patients in our cohort had insufficient vitamin D levels, and patients with BPPV recurrences had insufficient and significantly lower vitamin D levels than those without. As a readily available and affordable supplement, vitamin D may be used as an adjunct treatment but prospective studies should be done to confirm if it can prevent or reduce recurrence.
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Affiliation(s)
- Leah H Cobb
- Department of Otolaryngology; Medical University of South Carolina, Charleston, SC, USA
| | - Victoria O Bailey
- Department of Otolaryngology; Medical University of South Carolina, Charleston, SC, USA
| | - Yuan F Liu
- Department of Otolaryngology, Head and Neck Surgery, Loma Linda University Health, Loma Linda, CA, USA
| | - Michael T Teixido
- Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA, USA
| | - Habib G Rizk
- Department of Otolaryngology; Medical University of South Carolina, Charleston, SC, USA.
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22
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Factors associated with an increased risk of developing postoperative symptomatic lumbar spondylolisthesis after decompression surgery: an explorative two-centre international cohort study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2023; 32:462-474. [PMID: 36308544 DOI: 10.1007/s00586-022-07403-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 08/26/2022] [Accepted: 09/23/2022] [Indexed: 11/06/2022]
Abstract
PURPOSE Symptomatic lumbar spinal stenosis can be treated with decompression surgery. A recent review reported that, after decompression surgery, 1.6-32.0% of patients develop postoperative symptomatic spondylolisthesis and may therefore be indicated for lumbar fusion surgery. The latter can be more challenging due to the altered anatomy and scar tissue. It remains unclear why some patients get recurrent neurological complaints due to postoperative symptomatic spondylolisthesis, though some associations have been suggested. This study explores the association between key demographic, biological and radiological factors and postoperative symptomatic spondylolisthesis after lumbar decompression. METHODS This retrospective cohort study included patients who had undergone lumbar spinal decompression surgery between January 2014 and December 2016 at one of two Spine Centres in the Netherlands or Switzerland and had a follow-up of two years. Patient characteristics, details of the surgical procedure and recurrent neurological complaints were retrieved from patient files. Preoperative MRI scans and conventional radiograms (CRs) of the lumbar spine were evaluated for multiple morphological characteristics. Postoperative spondylolisthesis was evaluated on postoperative MRI scans. For variables assessed on a whole patient basis, patients with and without postoperative symptomatic spondylolisthesis were compared. For variables assessed on the basis of the operated segment(s), surgical levels that did or did not develop postoperative spondylolisthesis were compared. Univariable and multivariable logistic regression analyses were used to identify associations with postoperative symptomatic spondylolisthesis. RESULTS Seven hundred and sixteen patients with 1094 surgical levels were included in the analyses. (In total, 300 patients had undergone multilevel surgery.) ICCs for intraobserver and interobserver reliability of CR and MRI variables ranged between 0.81 and 0.99 and 0.67 and 0.97, respectively. In total, 66 of 716 included patients suffered from postoperative symptomatic spondylolisthesis (9.2%). Multivariable regression analyses of patient-basis variables showed that being female [odds ratio (OR) 1.2, 95%CI 1.07-3.09] was associated with postoperative symptomatic spondylolisthesis. Higher BMI (OR 0.93, 95%CI 0.88-0.99) was associated with a lower probability of having postoperative symptomatic spondylolisthesis. Multivariable regression analyses of surgical level-basis variables showed that levels with preoperative spondylolisthesis (OR 17.30, 95%CI 10.27-29.07) and the level of surgery, most importantly level L4L5 compared with levels L1L3 (OR 2.80, 95%CI 0.78-10.08), were associated with postoperative symptomatic spondylolisthesis; greater facet joint angles (i.e. less sagittal-oriented facets) were associated with a lower probability of postoperative symptomatic spondylolisthesis (OR 0.97, 95%CI 0.95-0.99). CONCLUSION Being female was associated with a higher probability of having postoperative symptomatic spondylolisthesis, while having a higher BMI was associated with a lower probability. When looking at factors related to postoperative symptomatic spondylolisthesis at the surgical level, preoperative spondylolisthesis, more sagittal orientated facet angles and surgical level (most significantly level L4L5 compared to levels L1L3) showed significant associations. These associations could be used as a basis for devising patient selection criteria, stratifying patients or performing subgroup analyses in future studies regarding decompression surgery with or without fusion.
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23
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Resmi SL, Hashim V, Mohammed J, Dileep PN. Bone Mineral Density Prediction from CT Image: A Novel Approach using ANN. Appl Bionics Biomech 2023; 2023:1123953. [PMID: 37153753 PMCID: PMC10162883 DOI: 10.1155/2023/1123953] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 02/25/2023] [Accepted: 03/25/2023] [Indexed: 05/10/2023] Open
Abstract
Background Though treatable, osteoporosis continues as a substantially underdiagnosed and undertreated condition. Bone mineral density (BMD) monitoring will definitely aid in the prediction and prevention of medical emergencies arising from osteoporosis. Although quantitative computed tomography (QCT) is one of the most widely accepted tools for measuring BMD, it lacks the contribution of bone architecture in predicting BMD, which is significant as aging progresses. This paper presents an innovative approach for the prediction of BMD incorporating bone architecture that involves no extra cost, time, and exposure to severe radiation. Methods In this approach, the BMD is predicted using clinical CT scan images taken for other indications based on image processing and artificial neural network (ANN). The network used in this study is a standard backpropagation neural network having five input neurons with one hidden layer having 40 neurons with a tan-sigmoidal activation function. The Digital Imaging and Communications in Medicine (DICOM) image properties extracted from QCT of human skull and femur bone of rabbit that are closely associated with the BMD are used as input parameters of the ANN. The density value of the bone which is computed from the Hounsfield units of QCT scan image through phantom calibration is used as the target value for training the network. Results The ANN model predicts the density values using the image properties from the clinical CT of the same rabbit femur bone and is compared with the density value computed from QCT scan. The correlation coefficient between predicted BMD and QCT density valued to 0.883. The proposed network can assist clinicians in identifying early stage of osteoporosis and devise suitable strategies to improve BMD with no additional cost.
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Affiliation(s)
- S. L. Resmi
- Department of Mechanical Engineering, TKM College of Engineering, Kollam, Kerala, India
| | - V. Hashim
- Department of Mechanical Engineering, TKM College of Engineering, Kollam, Kerala, India
| | - Jesna Mohammed
- Department of Mechanical Engineering, TKM College of Engineering, Kollam, Kerala, India
| | - P. N. Dileep
- Department of Mechanical Engineering, TKM College of Engineering, Kollam, Kerala, India
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24
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Matur F, Ülgen Y. The complex impedance phase angle of dominant arm: a useful parameter in bone mineral density (BMD) assessment of group 1 post-menopausal women. Med Biol Eng Comput 2023; 61:25-32. [PMID: 36306050 DOI: 10.1007/s11517-022-02669-y] [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: 03/01/2022] [Accepted: 09/17/2022] [Indexed: 01/07/2023]
Abstract
For widespread osteoporosis (OP) screening, portable and cost-effective screening devices are needed. With 45 menopaused women, when body mass index was below 30 kg.m- 2, the phase angle (PhA) of complex bioimpedance at 5 kHz, measured from the dominant arm, was correlated with dual-energy X-ray absorptiometry (DEXA) measured central bone mineral densities (BMD), for total hip r = 0.493 and for total lumbar r = 0.411, P< 0.05, and the strength of correlation decreased with increasing measurement frequencies. ANOVA tests showed that, below 15 kHz, PhA was a descriptive marker for bone mineral deficiency. By correlating to hip and lumbar bone mineral densities simultaneously, the dominant arm segment PhA was superior to the characteristic frequency fc of the body impedance spectroscopy (BIS) and the PhA of whole-body impedance measurements, of the earlier research works. Due to its medium correlation strength with central BMDs, a PhA measuring device could be considered as a complementary tool to the gold standard (DEXA), for OP screening of group 1 post-menopausal women only. For group 2, with 44 subjects with body mass indices over 30 kg.m- 2, i.e., obese population, the PhA was not correlated with BMD and was no longer a descriptive marker for reduced BMD.
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Affiliation(s)
- Fırat Matur
- Canon Eurasia, Kozyatağı, Değirmen Sk. Nida Kule İş Merkezi No:18 D:10, 34742, Istanbul, Turkey.
| | - Yekta Ülgen
- Bahçeşehir University, Yıldız, Çırağan Cd., 34349 Beşiktaş, Istanbul, Turkey
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25
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Stowers JM, Black AT, Kavanagh AM, Mata KDL, Eshetu T. Bone Density by Specific Anatomic Location Using Hounsfield Samples of the Lower Extremity: A Multi-center Retrospective Analysis. J Foot Ankle Surg 2022; 62:80-84. [PMID: 35738992 DOI: 10.1053/j.jfas.2022.05.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/01/2022] [Accepted: 05/06/2022] [Indexed: 02/03/2023]
Abstract
Understanding bone mineral density and its effects on patient outcomes is a useful tool for lower extremity surgeons. Historically, dual-energy X-ray absorptiometry scans have been the gold standard for quantifying bone mineral density. In this study, we look at an indirect way to measure bone mineral density using Hounsfield units on computed tomography. The aim of this study is to establish normal physiological Hounsfield ranges in specific bones of the foot by analyzing Hounsfield unit measurements and determining associated factors. We hypothesize that there will be a difference in density based on age, sex, and anatomic location. Patient data from January 2010 to January 2020 were retrospectively analyzed from 2 institutions. Nine anatomic locations (calcaneus, talar body, talar head, navicular, cuboid, medial cuneiform, head of first and fifth metatarsal, and base of first proximal phalanx) were measured for bone mineral density averages. In total, 137 patients were evaluated (71 males, 66 females) with an average age of 54 years. Significant differences in density were found between the 9 anatomic locations. Age was confirmed to be a significant covariate with inverse relation to Hounsfield units, p < .001. There were no density differences between sexes at any of the locations, except the talar head, p < .001. This is the first study to our knowledge to establish normal physiological ranges of bone density on computed tomography for specific anatomic locations of the foot. This quantitative approach to bone density and the established effect of age, sex, and location is pivotal for diagnostic and preoperative planning.
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Affiliation(s)
- Jered M Stowers
- Fellowship Trained Foot and Ankle Surgeon, Foot and Ankle Specialists of Central Ohio, Columbus, OH.
| | - Alexandra T Black
- Fellowship Trained Foot and Ankle Surgeon, Foot and Ankle Specialists of Central Ohio, Columbus, OH
| | - Amber M Kavanagh
- Senior Resident Physician, Department of Plastics Surgery, MedStar Georgetown University Hospital, Washington, DC
| | - Karla De La Mata
- Resident Physician, Department of Podiatric Surgery, Northwell Lenox Hill Hospital, New York, NY
| | - Tefera Eshetu
- Biostatistician, Department of Plastics Surgery, MedStar Georgetown University Hospital, Washington, DC
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26
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Clements M, Heffernan M, Ward M, Hoey L, Doherty LC, Hack Mendes R, Clarke MM, Hughes CF, Love I, Murphy S, McDermott E, Grehan J, McCann A, McAnena LB, Strain JJ, Brennan L, McNulty H. A 2-Year Randomized Controlled Trial With Low-Dose B-Vitamin Supplementation Shows Benefits on Bone Mineral Density in Adults With Lower B12 Status. J Bone Miner Res 2022; 37:2443-2455. [PMID: 36128889 PMCID: PMC10092614 DOI: 10.1002/jbmr.4709] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 01/19/2023]
Abstract
Folate, vitamins B12, B6, and riboflavin are required for one-carbon metabolism and may affect bone health, but no previous randomized trial has investigated all four nutrients in this context. We investigated the effect of low-dose B-vitamins for 2 years on bone mineral density (BMD) in a dual-centered, 2-year randomized controlled trial (RCT) in adults aged ≥50 years. Eligible participants not consuming B-vitamin supplements or fortified foods >4 times weekly were randomized to receive daily either combined folic acid (200 μg), vitamin B12 (10 μg), vitamin B6 (10 mg), and riboflavin (5 mg), or "active" placebo, whereby both the intervention and placebo groups received vitamin D (10 μg). BMD was assessed before and after intervention using dual-energy X-ray absorptiometry (DXA) scanning of the total hip, femoral neck, and lumbar spine (L1 to L4). Of 205 eligible participants randomized, 167 completed the trial in full. B-vitamin intervention resulted in increases in serum folate (p < 0.001), serum B12 (p < 0.001), and plasma pyridoxal-5-phosphate (p < 0.001) and decreases in functional biomarkers of B-vitamin status, erythrocyte glutathione reductase activation coefficient (p < 0.001), serum methylmalonic acid (MMA; p < 0.001), and serum total homocysteine (p < 0.001). B-vitamin intervention had no overall effect on BMD, which declined in both treatment groups by approximately 1% (ranging from -0.7% to -1.4%). However, in participants with lower baseline B12 status (serum B12 <246 pmol/L or MMA ≥0.22 μmol/L), B-vitamin intervention reduced the 2-year BMD decline versus placebo: adjusted mean (95% confidence interval [CI]) change of -0.003 (-0.008, 0.002) versus -0.015 (-0.021, -0.010) g/cm2 at the total hip and -0.004 (-0.010, 0.001) versus -0.013 (-0.018, -0.007) g/cm2 at the femoral neck. In conclusion, the findings indicate that although low-dose B-vitamin intervention for 2 years had no overall effect on BMD, improving B-vitamin status appears to have specific benefits for bone health in adults with lower B12 status. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Michelle M Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Ingrid Love
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Shauna Murphy
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Eilish McDermott
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jennifer Grehan
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Liadhan B McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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27
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Do antihypertensive medications effect the mandibular cortical bone thickness? A study using cone beam computed tomography images. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:687-694. [PMID: 36241600 DOI: 10.1016/j.oooo.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to measure the association between antihypertensive medication use and mandibular cortical thickness. STUDY DESIGN This retrospective cross-sectional study was comprised of a study sample of 169 patients aged 40 to 69. Cone beam computed tomography scans were examined. The buccal cortical thickness of the mandibular ramus was measured. Participants were separated into the control or study group based on use of antihypertensive medications. The predictor variable was the use of antihypertensive medications. The primary outcome variable was cortical thickness of the mandible. Age was identified as a covariate affecting the outcome variable. The data was analyzed with a one-way analysis of covariance (ANCOVA) to remove the effect of age on the outcome variable. The groups were subdivided based on the sex of the patient. RESULTS The study sample was composed of 169 patients with a mean age of 52.1, and 54% were female. There were 67 patients in the antihypertensive group (39.6%). A mean difference of 0.21 mm was found (P = .0010, 95% CI 0.09, 0.34 mm). The difference persisted after adjusting for age with one-way ANCOVA testing (P < .001). CONCLUSIONS This study suggests that there may be an association between antihypertensive use and mandibular cortical thickness. Age may be an effect modifier with the effect increasing in older patients.
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28
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Rowbotham SK, Mole CG, Tieppo D, Blaszkowska M, Cordner S, Blau S. Reference measurements for average human neurocranial bone density to inform head trauma interpretations. AUST J FORENSIC SCI 2022. [DOI: 10.1080/00450618.2022.2141320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Samantha K Rowbotham
- Victorian Institute of Forensic Medicine, Melbourne, Australia
- Department of Forensic Medicine, Monash University, Melbourne, Australia
| | - Calvin G Mole
- Department of Pathology, Division of Forensic Medicine and Toxicology, University of Cape Town, Cape Town, South Africa
| | - Diana Tieppo
- Department of Forensic Medicine, Monash University, Melbourne, Australia
| | - Magda Blaszkowska
- Centre for Forensic Anthropology, University of Western Australia, Perth, Australia
| | - Stephen Cordner
- Victorian Institute of Forensic Medicine, Melbourne, Australia
- Department of Forensic Medicine, Monash University, Melbourne, Australia
| | - Soren Blau
- Victorian Institute of Forensic Medicine, Melbourne, Australia
- Department of Forensic Medicine, Monash University, Melbourne, Australia
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29
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Kitagawa T, Hiraya K, Denda T, Yamamoto S. A comparison of different exercise intensities for improving bone mineral density in postmenopausal women with osteoporosis: A systematic review and meta-analysis. Bone Rep 2022; 17:101631. [PMID: 36310762 PMCID: PMC9615132 DOI: 10.1016/j.bonr.2022.101631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 10/08/2022] [Accepted: 10/20/2022] [Indexed: 11/21/2022] Open
Abstract
Objective This study aimed to compare the effects of moderate- and high-intensity resistance and impact training (MiRIT and HiRIT, respectively) on changes in bone mineral density (BMD) in postmenopausal women with osteoporosis. Methods Randomized controlled trials that compared the intervention effects of MiRIT and HiRIT were used as selection criteria to assess study patients with osteoporosis or an osteoporotic condition. Database searches were conducted on August 25, 2022, using CENTRAL, PubMed, CINAHL Web of Science, EMBASE, and MEDLINE. A risk of bias assessment was performed using Revised Cochrane risk of bias tool for the assessment of randomized controlled trials. Point estimates and 95 % confidence intervals of change in BMD derived using dual-energy X-ray absorptiometry were collected as outcomes, and a meta-analysis was performed using the amount of change in BMD before and after the intervention. Adverse event data were also collected. Results The search yielded six studies (391 patients, mean age 53–65 years) that met the inclusion criteria. The intervention duration ranged from 24 weeks to 13 months. Compared with the MiRIT group, the HiRIT group showed significantly improved BMD of the lumbar spine (standardized mean difference 2.37 [0.10–4.65]). However, a high degree of heterogeneity was observed for three studies (154 patients, I2 = 98 %). Almost all studies reported minimal adverse events. The certainty of evidence was extremely low because of the risk of bias, inconsistency among studies, and imprecision in terms of sample size. Conclusion Postmenopausal women with osteoporosis may achieve more significantly improved lumbar spine BMD with HiRIT than with MiRIT. The effects of moderate versus high-intensity training on bone mineral density in postmenopausal woman were compared. High-intensity training would be more beneficial for improving bone mineral density of the lumbar spine than moderate one. Almost all studies reported minimal adverse events. However, the lack of certainty associated with the evidence should be considered for clinical application.
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Key Words
- BMD, bone mineral density;
- Bone mineral density
- CI, confidence interval
- Exercise
- FN, femoral neck
- HiRIT, high-intensity resistance and impact training
- LS, lumbar spine
- Meta-analysis
- MiRIT, moderate-intensity resistance and impact training
- Osteoporosis
- Postmenopausal women
- RCT, randomized controlled trial
- RM, repetition maximum
- Resistance training
- SMD, standardized mean difference
- aBMD, areal bone mineral density
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Affiliation(s)
- Takashi Kitagawa
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, Japan,Corresponding author.
| | - Kaede Hiraya
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, Japan
| | - Takumi Denda
- Department of Physical Therapy, School of Health Sciences, Shinshu University, Matsumoto, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
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30
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Pleić N, Brdar D, Gunjača I, Babić Leko M, Torlak V, Punda A, Polašek O, Hayward C, Zemunik T. Thyroid Hormones Are Not Associated with Plasma Osteocalcin Levels in Adult Population with Normal Thyroid Function. Metabolites 2022; 12:metabo12080719. [PMID: 36005591 PMCID: PMC9412351 DOI: 10.3390/metabo12080719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 02/05/2023] Open
Abstract
Thyroid hormones (THs) play an indispensable role in skeletal development and bone remodeling. Some studies have reported associations of THs with serum osteocalcin (OC) levels, but the results are quite inconsistent and the molecular mechanism of their simultaneous or interdependent activity on bone is almost unknown. Therefore, the aim of this study was to determine the possible associations of plasma THs with plasma OC levels and the possible mediating effect of OC on the relationship between THs and bone mineral density (BMD). For this purpose, out of the initial 1981 participants, we selected healthy euthyroid participants controlled for available confounding factors that can affect thyroid function and bone metabolism (N = 694). Given our results, we could not confirm any associations of THs with plasma OC levels nor the mediating effect of OC on the relationship between THs and BMD in euthyroid population. In the group of women controlled for menopause status (N = 396), we found a significant negative association of body mass index (BMI) with OC levels (β = −0.14, p = 0.03). We also found a negative association of free triiodothyronine (fT3) (β = −0.01, p = 0.02) and age (β = −0.003, p < 0.001) with BMD, and a positive association of BMI (β = 0.004, p < 0.001) and male gender (β = 0.1, p < 0.001) with BMD. In addition, we found significantly higher plasma OC levels and lower values of BMD in postmenopausal euthyroid women compared with premenopausal euthyroid women. In our opinion, the results of previous studies suggesting an association between circulating THs and serum OC levels may be influenced by an inconsistent selection of participants and the influence of confounding factors.
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Affiliation(s)
- Nikolina Pleić
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
| | - Dubravka Brdar
- Department of Nuclear Medicine, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Ivana Gunjača
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
| | - Mirjana Babić Leko
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
| | - Vesela Torlak
- Department of Nuclear Medicine, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Ante Punda
- Department of Nuclear Medicine, University Hospital Split, Spinčićeva 1, 21000 Split, Croatia
| | - Ozren Polašek
- Department of Public Health, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
| | - Caroline Hayward
- MRC Human Genetics Unit, Institute of Genetics and Cancer, University of Edinburgh, Edinburgh EH4 2XU, UK
| | - Tatijana Zemunik
- Department of Medical Biology, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia
- Correspondence:
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Hayden AC, Binkley N, Krueger D, Bernatz JT, Kadri A, Anderson PA. Effect of degeneration on bone mineral density, trabecular bone score and CT Hounsfield unit measurements in a spine surgery patient population. Osteoporos Int 2022; 33:1775-1782. [PMID: 35554615 DOI: 10.1007/s00198-022-06407-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 04/15/2022] [Indexed: 10/18/2022]
Abstract
UNLABELLED This study investigated the impact of spinal degeneration on bone mineral density (BMD), trabecular bone score (TBS), and CT Hounsfield units in an at-risk population. We found that BMD was increased by degeneration, whereas TBS and HU were unaffected. These findings support that TBS is not adversely affected by spinal degeneration. INTRODUCTION This study evaluated the impact of spinal degeneration on BMD and TBS measured by dual-energy x-ray absorptiometry (DXA) and on CT HU in a spine surgery patient population. METHODS A retrospective study of 63 patients referred for consideration of spine surgery or with history of spine surgery was performed. Patients were included if a DXA scan and a CT containing the lumbar spine were obtained within 18 months of each other. DXA data were collected and analyzed by vertebral level. Individual vertebrae were assessed for degenerative changes by qualitative evaluation of the anterior and posterior elements using CT. Degeneration scores were compared to BMD T-scores, TBS and CT HU at individual vertebral levels L1-4, and after applying International Society for Clinical Densitometry (ISCD) criteria for excluding vertebrae from diagnostic consideration. RESULTS Mean patient age and BMI were 67.2 years and 27.8 kg/m2, respectively; 79.4% were female. Mean (SD) lowest T-scores of the hip, spine, and lowest overall T-score were - 1.3 (1.4), - 1.7 (0.9), and - 1.9 (1.0), respectively. Osteoporosis was present by T-score in 38% and osteopenia in 52%; 10% had a history of osteoporotic fracture. The mean degeneration score of individual vertebrae was 4.1 on a 0-6 scale. T-score correlated moderately with degeneration score (Spearman's rho 0.484, p < 0.001), whereas TBS and HU were unrelated. ISCD excluded vertebrae had a higher degeneration score than included vertebrae (p = < 0.001). CONCLUSIONS In a spine surgery population, TBS and CT HU values are unrelated to degeneration score and thus appear unaffected by lumbar vertebral degenerative changes. Additionally, these data support the ISCD criteria for vertebral exclusion.
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Affiliation(s)
- A C Hayden
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - N Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - D Krueger
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - J T Bernatz
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - A Kadri
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
| | - P A Anderson
- Department of Orthopedics Surgery and Rehabilitation, University of Wisconsin, UWMF Centennial Bldg, 1685 Highland Ave, 6th floor, Madison, WI, 53705-2281, USA.
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Buettmann EG, Goldscheitter GM, Hoppock GA, Friedman MA, Suva LJ, Donahue HJ. Similarities Between Disuse and Age-Induced Bone Loss. J Bone Miner Res 2022; 37:1417-1434. [PMID: 35773785 PMCID: PMC9378610 DOI: 10.1002/jbmr.4643] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/07/2022]
Abstract
Disuse and aging are known risk factors associated with low bone mass and quality deterioration, resulting in increased fracture risk. Indeed, current and emerging evidence implicate a large number of shared skeletal manifestations between disuse and aging scenarios. This review provides a detailed overview of current preclinical models of musculoskeletal disuse and the clinical scenarios they seek to recapitulate. We also explore and summarize the major similarities between bone loss after extreme disuse and advanced aging at multiple length scales, including at the organ/tissue, cellular, and molecular level. Specifically, shared structural and material alterations of bone loss are presented between disuse and aging, including preferential loss of bone at cancellous sites, cortical thinning, and loss of bone strength due to enhanced fragility. At the cellular level bone loss is accompanied, during disuse and aging, by increased bone resorption, decreased formation, and enhanced adipogenesis due to altered gap junction intercellular communication, WNT/β-catenin and RANKL/OPG signaling. Major differences between extreme short-term disuse and aging are discussed, including anatomical specificity, differences in bone turnover rates, periosteal modeling, and the influence of subject sex and genetic variability. The examination also identifies potential shared mechanisms underlying bone loss in aging and disuse that warrant further study such as collagen cross-linking, advanced glycation end products/receptor for advanced glycation end products (AGE-RAGE) signaling, reactive oxygen species (ROS) and nuclear factor κB (NF-κB) signaling, cellular senescence, and altered lacunar-canalicular connectivity (mechanosensation). Understanding the shared structural alterations, changes in bone cell function, and molecular mechanisms common to both extreme disuse and aging are paramount to discovering therapies to combat both age-related and disuse-induced osteoporosis. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Evan G Buettmann
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Galen M Goldscheitter
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabriel A Hoppock
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael A Friedman
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Larry J Suva
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Henry J Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
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Kondou H, Bandou R, Ichioka H, Idota N, Matsunari R, Kawamoto M, Ikegaya H. Estimating the age at death for forensic cases using quantitative computed tomography. Forensic Sci Int 2022; 337:111367. [PMID: 35738134 DOI: 10.1016/j.forsciint.2022.111367] [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: 12/02/2021] [Revised: 05/06/2022] [Accepted: 06/13/2022] [Indexed: 11/17/2022]
Abstract
Estimation of the age at death is an important task for forensic scientists. Although the correlation between age and bone mineral density is already known, including for cadavers, to our knowledge, there are no published studies on age estimation with quantitative computed tomography. Quantitative computed tomography can be used to measure bone mineral density based on the mean computed tomography value of the cancellous bone. As this value cannot be calculated in putrefied cases, we modified quantitative computed tomography to calculate the bone mineral density from regions of the bone with mean computed tomography values of 50-350 Hounsfield units. We aimed to examine whether this method could be used for age estimation. We examined 171 male and 106 female cadavers, some of which were putrefied. We performed univariate linear regression analysis for age at death and bone mineral density. The resultant intercept, slope, and root mean square error were 91.3, - 0.20 (p < 0.0001), and 11.4, respectively, for male cadavers, and 96.1, - 0.23 (p < 0.0001), and 11.0, respectively, for female cadavers. We evaluated this regression formula by using 10-fold cross-validation, resulting in a coefficient of determination of 0.33 for male cadavers and 0.42 for female cadavers. The modified quantitative computed tomography method may be of assistance in estimating age at death, even in putrefied cases.
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Affiliation(s)
- Hiroki Kondou
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Risa Bandou
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hiroaki Ichioka
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Nozomi Idota
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Ryota Matsunari
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Masataka Kawamoto
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan
| | - Hiroshi Ikegaya
- Department of Forensic Medicine, Graduate School of Medicine, Kyoto Prefectural University of Medicine, 465 Kajiicho, Kawaramachi-dori Hirokoji-agaru, Kamigyo-ku, Kyoto, 602-8566, Japan.
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Abstract
Life expectancy of people living with HIV (PLWH) is now close to that of the HIV-uninfected population. As a result, age-related comorbidities, including osteoporosis, are increasing in PLWH. This narrative review describes the epidemiology of bone fragility in PLWH, changes of bone features over the course of HIV infection and their determinants, as well as the available evidence regarding the management of osteoporosis in PLWH. The risk of fracture is higher and increases about 10 years earlier compared to the general population. The classical risk factors of bone fragility are very widespread and are major determinants of bone health in this population. The majority of bone loss occurs during virus replication and during immune reconstitution at antiretroviral therapies (ART) initiation, which both increase osteoclast activity. Abnormalities in bone formation and mineralization have also been shown in histomorphometric studies in untreated PLWH. Measurement of bone mineral density (BMD) is the first line tool for assessing fracture risk in postmenopausal women, men above 50 years, and other HIV-infected patients with clinical risk factors for osteoporosis. FRAX underestimates fracture probability in PLWH. In case of indication for anti-osteoporotic drug, bisphosphonates remain the reference option. Calcium and vitamin D supplementation should be considered as ART initiation, since it may attenuate bone loss at this stage. Bone-protective ART regimens improve BMD compared to other regimens, but to a lesser extent than bisphosphonate, and without available data on their influence on the incidence of fracture.
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Affiliation(s)
- Emmanuel Biver
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, 4 Rue Gabrielle Perret-Gentil, 1205, Geneva, Switzerland.
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Objectively assessed physiological, physical, and cognitive function along with patient-reported outcomes during the first 2 years of Alemtuzumab treatment in multiple sclerosis: a prospective observational study. J Neurol 2022; 269:4895-4908. [PMID: 35482080 DOI: 10.1007/s00415-022-11134-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 04/07/2022] [Accepted: 04/08/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION In persons with multiple sclerosis (pwMS), little evidence exist on the effects of Alemtuzumab on physiological, physical, and cognitive function along with patient-reported outcomes, despite these domains are being rated as highly important. Therefore, our purpose was to perform a prospective observational study to examine these outlined outcomes during the first two years of Alemtuzumab treatment in pwMS. METHODS In n = 17 relapsing-remitting pwMS, physiological function [body composition; bone mineral content; muscle strength; aerobic capacity], physical function [6-min walk test (6MWT, primary outcome); timed 25 ft walk test (T25FWT); six spot step test (SSST); 9-step stair ascend (9SSA); timed up and go test (TUG); 5 × sit to stand test (5STS)], cognitive function [selective reminding test (SRT); symbol digit modalities test (SDMT)], and patient-reported outcomes [multiple sclerosis impact scale-29 (MSIS29); 12-item multiple sclerosis walking scale (MSWS12); modified fatigue impact scale (MFIS); hospital anxiety and depression scale (HADS)] were assessed prior to Alemtuzumab treatment initiation as well as 3, 6, 12, and 24 months into the treatment. RESULTS Improvements were observed at 24-month follow-up in T25FWT (+ 8%), SSST (+ 10%), SDMT (+ 5.2 points, 53% improved more than the clinical cut-off score) and SRT, whereas the primary outcome 6MWT, and all other remaining outcomes, remained stable throughout the Alemtuzumab treatment period. CONCLUSION The present findings suggest that Alemtuzumab treatment in relapsing-remitting pwMS can improve certain domains of physical function (short distance walking) and cognitive function (processing speed, memory), and furthermore stabilize physiological and physical function along with patient-reported outcomes. TRIAL REGISTRATION Registered at clinicaltrials.gov: NCT03806387.
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Dimet-Wiley A, Golovko G, Watowich SJ. One-Year Postfracture Mortality Rate in Older Adults With Hip Fractures Relative to Other Lower Extremity Fractures: Retrospective Cohort Study. JMIR Aging 2022; 5:e32683. [PMID: 35293865 PMCID: PMC8968577 DOI: 10.2196/32683] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 11/03/2021] [Accepted: 12/02/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Hip fracture in older adults is tied to increased mortality risk. Deconvolution of the mortality risk specific to hip fracture from that of various other fracture types has not been performed in recent hip fracture studies but is critical to determining current unmet needs for therapeutic intervention. OBJECTIVE This study examined whether hip fracture increases the 1-year postfracture mortality rate relative to several other fracture types and determined whether dementia or type 2 diabetes (T2D) exacerbates postfracture mortality risk. METHODS TriNetX Diamond Network data were used to identify patients with a single event of fracture of the hip, the upper humerus, or several regions near and distal to the hip occurring from 60 to 89 years of age from 2010 to 2019. Propensity score matching, Kaplan-Meier, and hazard ratio analyses were performed for all fracture groupings relative to hip fracture. One-year postfracture mortality rates in elderly populations with dementia or T2D were established. RESULTS One-year mortality rates following hip fracture consistently exceeded all other lower extremity fracture groupings as well as the upper humerus. Survival probabilities were significantly lower in the hip fracture groups, even after propensity score matching was performed on cohorts for a variety of broad categories of characteristics. Dementia in younger elderly cohorts acted synergistically with hip fracture to exacerbate the 1-year mortality risk. T2D did not exacerbate the 1-year mortality risk beyond mere additive effects. CONCLUSIONS Elderly patients with hip fracture have a significantly decreased survival probability. Greatly increased 1-year mortality rates following hip fracture may arise from differences in bone quality, bone density, trauma, concomitant fractures, postfracture treatments or diagnoses, restoration of prefracture mobility, or a combination thereof. The synergistic effect of dementia may suggest detrimental mechanistic or behavioral combinations for these 2 comorbidities. Renewed efforts should focus on modulating the mechanisms behind this heightened mortality risk, with particular attention to mobility and comorbid dementia.
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Affiliation(s)
- Andrea Dimet-Wiley
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, United States
| | - George Golovko
- Department of Pharmacology and Toxicology, University of Texas Medical Branch, Galveston, TX, United States
| | - Stanley J Watowich
- Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, Galveston, TX, United States
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Sebro R, De la Garza-Ramos C. Machine Learning for Opportunistic Screening for Osteoporosis from CT Scans of the Wrist and Forearm. Diagnostics (Basel) 2022; 12:diagnostics12030691. [PMID: 35328244 PMCID: PMC8947723 DOI: 10.3390/diagnostics12030691] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/04/2022] [Accepted: 03/08/2022] [Indexed: 02/06/2023] Open
Abstract
Background: We investigated whether opportunistic screening for osteoporosis can be done from computed tomography (CT) scans of the wrist/forearm using machine learning. Methods: A retrospective study of 196 patients aged 50 years or greater who underwent CT scans of the wrist/forearm and dual-energy X-ray absorptiometry (DEXA) scans within 12 months of each other was performed. Volumetric segmentation of the forearm, carpal, and metacarpal bones was performed to obtain the mean CT attenuation of each bone. The correlations of the CT attenuations of each of the wrist/forearm bones and their correlations to the DEXA measurements were calculated. The study was divided into training/validation (n = 96) and test (n = 100) datasets. The performance of multivariable support vector machines (SVMs) was evaluated in the test dataset and compared to the CT attenuation of the distal third of the radial shaft (radius 33%). Results: There were positive correlations between each of the CT attenuations of the wrist/forearm bones, and with DEXA measurements. A threshold hamate CT attenuation of 170.2 Hounsfield units had a sensitivity of 69.2% and a specificity of 77.1% for identifying patients with osteoporosis. The radial-basis-function (RBF) kernel SVM (AUC = 0.818) was the best for predicting osteoporosis with a higher AUC than other models and better than the radius 33% (AUC = 0.576) (p = 0.020). Conclusions: Opportunistic screening for osteoporosis could be performed using CT scans of the wrist/forearm. Multivariable machine learning techniques, such as SVM with RBF kernels, that use data from multiple bones were more accurate than using the CT attenuation of a single bone.
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Affiliation(s)
- Ronnie Sebro
- Mayo Clinic Florida, Department of Radiology, Jacksonville, FL 32224, USA;
- Center for Augmented Intelligence, Mayo Clinic Florida, Department of Radiology, Jacksonville, FL 32224, USA
- Correspondence: ; Tel.: +1-904-953-2000
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Rathnayake N, Rathnayake H, Lekamwasam S. Age-Related Trends in Body Composition among Women Aged 20-80 Years: A Cross-Sectional Study. J Obes 2022; 2022:4767793. [PMID: 35154825 PMCID: PMC8828324 DOI: 10.1155/2022/4767793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 11/27/2021] [Accepted: 01/06/2022] [Indexed: 11/24/2022] Open
Abstract
The determinants of body composition are likely to vary geographically due to the diversity of genetic and environmental factors between populations. Age-related trends in body composition in a population help understanding the health issues that are linked with different body compartments. In general, such studies are scarce in the South Asian region and this cross-sectional study examined the age-related trends in body composition in a selected group of healthy women aged 20-80 years in Sri Lanka. The study included randomly selected 784 healthy women aged 20-80 years from the Southern province, Sri Lanka. Women were divided into five age groups: 20-29 years (n = 79), 30-39 years (n = 144), 40-49 years (n = 185), 50-59 years (n = 281), and ≥60 years (n = 85). Total body bone mineral density (TBBMD, g/cm2), total body bone mineral content (TBBMC, g), total body fat mass (TBFM, kg), and total body lean mass (TBLM, kg) were measured with central-type dual-energy X-ray absorptiometry (DXA). Multivariate analysis of variance with Bonferroni post hoc test was performed. The age-related trends of TBBMD and TBBMC were similar with a peak in 40-49-year age group. Between 50 and 59 and ≥60 age categories, TBBMD and TBBMC showed a rapid decline: 16% and 23%, respectively. The rate of TBBMD decline was 0.008 g/cm2 per year after 50 years. TBFM increased by 14% between age categories 20-29 and 40-49 years and remained unchanged after 49 years. TBLM increased by 15% between age groups 20-29 and 40-49 years and then decreased by 13% between age categories 50-59 and ≥60 years. Of the 13% decrease in TBLM after 50 years, 9% loss occurred after 59 years. The trends observed help to understand the occurrence of diseases linked with body composition.
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Affiliation(s)
- Nirmala Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka
| | - Hasanga Rathnayake
- Department of Biochemistry, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Sarath Lekamwasam
- Population Health Research Centre, Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
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Diaz-Lopez KDJ, Caire-Juvera G. Interventions to Improve Bone Mineral Density, Muscle Mass and Fat Mass among Breast Cancer Survivors. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022; 41:94-106. [PMID: 33570477 DOI: 10.1080/07315724.2020.1833791] [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: 08/13/2020] [Revised: 10/04/2020] [Accepted: 10/04/2020] [Indexed: 10/22/2022]
Abstract
Survivors of breast cancer (BC) are at increased risk of chronic diseases due to factors such as low bone mineral density (BMD) and loss of muscle mass (MM) coupled with increased fat mass (FM). It is important to know that healthy behaviors can mitigate the risk of these complications. A narrative review was performed using PubMed and ScienceDirect to identify diet and physical activity (PA) interventions aimed at improving BMD, MM, and/or FM in female BC survivors. Data from 2000 to 2018 were used and 17 diet and/or PA interventions were identified. The duration of interventions was from 3 weeks until 24 months, the smallest sample was 26 women, and the largest was 223. The ranging age of participants was from 46 to 64 years. Studies with a longer duration, in-person modality and/or that used behavioral models showed better results. In BMD, the best results in spine were observed at 24 months in a face-to-face intervention (increase of 3.08%). Regarding MM, the greatest increase was at 26 weeks under Cognitive Behavioral Therapy (CBT) in person (43.8 ± 8.7 to 44.7 ± 8.4 kg, p = 0.04). This approach also showed the greatest decrease in FM from 36.7 to 31.2 kg in 4 months (p ≤ 0.01). Improving BMD and MM and preventing the increase of FM is a challenge for public health. More studies are needed to improve BMD among BC survivors and consider strategies that have yielded better results to promote healthy changes.Key teaching pointsBreast cancer survivors are at increased risk for low bone mineral density, loss of muscle mass, and increased fat mass due to the treatments received; the adoption of a healthy diet and physical activity can mitigate these complications.Of the 17 studies included, 8 used the face-to-face modality, 7 combined face-to-face with phone calls and two studies used only phone calls and email; studies that used the face-to-face modality showed better results.For bone mineral density, the best results were observed in spine at 24 months (increase of 3.08%) in a face-to-face intervention.The greatest increase in muscle mass (43.8 to 44.7 kg) was at 26 weeks in a physical activity intervention; the larger amount of fat mass loss was 5.5 kg in a diet and physical activity intervention. Both results were obtained using the Cognitive Behavioral Therapy (CBT) in person.Lifestyle interventions to maintain or improve bone mineral density, muscle mass and fat mass are effective at least for one of these three variables.
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Jo JY, Lee YJ, Seo HK, Kang MJ, Cho IA, Choi WJ, Kim SC, Cho MC. Vitamin D Status and Bone Health in Postmenopausal Women Working in Greenhouses. J Menopausal Med 2022; 28:70-77. [PMID: 36070872 PMCID: PMC9452596 DOI: 10.6118/jmm.21033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 11/30/2022] Open
Abstract
Objectives Greenhouse workers synthesize less vitamin D because ultraviolet light is blocked by the vinyl that covers the greenhouses. This study aimed to investigate the vitamin D status and bone health of postmenopausal women working in greenhouses. Methods This observational study enrolled women living in urban (n = 70, group 1) and rural areas (n = 91, group 2) and those working in greenhouses (n = 112, group 3). Serum levels of total and bioavailable 25-hydroxy-vitamin D [25(OH)D] and vitamin D binding protein were measured. T-scores of the lumbar spine and femur neck were measured by dual-energy X-ray absorptionetry. Results Heights were shorter in group 2 and group 3 than in group 1. Bioavailable 25(OH)D levels were higher and T-scores of the spine and femur were lower in both group 2 and 3 than in group 1. T-scores of the femur in group 3 were lower than those in group 2. The linear regression analysis showed that levels of bioavailable 25(OH)D significantly correlated with the spine T-scores but not with the femur T-scores. The prevalence of spinal osteoporosis was higher in both groups 2 and 3 compared to group 1. Group 3 demonstrated greater femur osteoporosis compared to groups 1 and 2. Conclusions Vitamin D plays an important role in spinal bone health. Moreover, working conditions are likely to play an important role in femur bone health. Therefore, appropriate working conditions and nutrition are paramount to improve bone health in postmenopausal women working in greenhouses.
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Affiliation(s)
- Jae Yoon Jo
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea
| | - Yeon Jee Lee
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea
| | - Hyun Kyoung Seo
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea
| | - Min Ji Kang
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea
| | - In Ae Cho
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Won Jun Choi
- Department of Obstetrics and Gynecology, Gyeongsang National University Hospital, Jinju, Korea
- Department of Obstetrics and Gynecology, Gyeongsang National University College of Medicine, Jinju, Korea
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
| | - Seung Chan Kim
- Biostatistics Cooperation Center, Gyeongsang National University Hospital, Jinju, Korea
| | - Min-Chul Cho
- Institute of Health Sciences, Gyeongsang National University, Jinju, Korea
- Department of Laboratory Medicine, Gyeongsang National University Hospital, Jinju, Korea
- Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
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Feng S, Wang H, Yan Y, Su X, Ao J, Chen W. Regulatory SNP of RREB1 is Associated With Bone Mineral Density in Chinese Postmenopausal Osteoporosis Patients. Front Genet 2021; 12:756957. [PMID: 34868232 PMCID: PMC8637614 DOI: 10.3389/fgene.2021.756957] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 10/21/2021] [Indexed: 11/13/2022] Open
Abstract
Postmenopausal osteoporosis (PMO) is the most common bone disorder in elderly Chinese women. Although genetic factors have been shown to have a pivotal role in PMO, studies on genetic loci associated with PMO in Chinese individuals are still lacking. We aimed to identify SNPs that contribute to PMO in Chinese individuals by conducting a genome-wide association study (GWAS). Bone mineral density (BMD) of postmenopausal Chinese women was assessed. Participants with T-score < -2.5 standard deviations (n = 341) were recruited and divided into a discovery group (n = 150) and a replication group (n = 191). GWAS was performed, with T-score as the quantitative trait, using linear regression. Our results revealed that an SNP cluster upstream of RREB1 showed a trend of association with BMD in Chinese PMO patients. The leading SNP of the cluster was rs475011 (p combined = 1.15 × 10-6, beta = 0.51), which is a splicing quantitative trait locus (sQTL) of RREB1. This association was further supported by data from the UK Biobank (UKBB; p = 9.56 × 10-12). The high BMD-associated allele G of rs475011 is related to a high intron excision ratio. This SNP may increase BMD by upregulating mature RREB1 mRNA, based on data from the Genotype-Tissue Expression (GTEx) database. We identified BMD-associated SNPs that regulate RREB1 in Chinese PMO patients. Future functional experiments are needed to further link rs475011, RREB1, and PMO in Chinese individuals.
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Affiliation(s)
- Shuo Feng
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Han Wang
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Yumeng Yan
- Key Laboratory for Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
| | - Xin Su
- Beijing GuardianHealth Technology Co., Ltd., Beijing, China
| | - Jintao Ao
- Department of Spine Surgery, Beijing Jishuitan Hospital, Beijing, China
| | - Wei Chen
- Key Laboratory for Biomechanics and Mechanobiology, Ministry of Education, Beijing Advanced Innovation Centre for Biomedical Engineering, School of Biological Science and Medical Engineering, Beihang University, Beijing, China
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42
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Nejatian MM, Sobhi S, Sanchez BN, Linn K, Manning L, Soh SC, Hiew J, Ritter JC, Yeap BB, Hamilton EJ. Reduction in femoral neck and total hip bone mineral density following hospitalisation for diabetes-related foot ulceration. Sci Rep 2021; 11:22742. [PMID: 34815495 PMCID: PMC8611081 DOI: 10.1038/s41598-021-02233-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Accepted: 11/08/2021] [Indexed: 11/09/2022] Open
Abstract
Management of diabetes-related foot ulceration (DFU) includes pressure offloading resulting in a period of reduced activity. The metabolic effects of this are unknown. This study aims to investigate changes in bone mineral density (BMD) and body composition 12 weeks after hospitalisation for DFU. A longitudinal, prospective, observational study of 22 people hospitalised for DFU was conducted. Total body, lumbar spine, hip and forearm BMD, and total lean and fat mass were measured by dual-energy X-ray absorptiometry (DXA) during and 12 weeks after hospitalisation for DFU. Significant losses in total hip BMD of the ipsilateral limb (- 1.7%, p < 0.001), total hip BMD of the contralateral limb (- 1.4%, p = 0.005), femoral neck BMD of the ipsilateral limb (- 2.8%, p < 0.001) and femoral neck BMD of the contralateral limb (- 2.2%, p = 0.008) were observed after 12 weeks. Lumbar spine and forearm BMD were unchanged. HbA1c improved from 75 mmol/mol (9.2%) to 64 mmol/mol (8.0%) (p = 0.002). No significant changes to lean and fat mass were demonstrated. Total hip and femoral neck BMD decreased bilaterally 12 weeks after hospitalisation for DFU. Future research is required to confirm the persistence and clinical implications of these losses.
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Affiliation(s)
- Marcel M Nejatian
- Medical School, The University of Western Australia, Perth, Australia
| | - Salar Sobhi
- Medical School, The University of Western Australia, Perth, Australia
| | - Blake N Sanchez
- Medical School, The University of Western Australia, Perth, Australia
| | - Kathryn Linn
- Department of Nuclear Medicine, Fiona Stanley Hospital, Perth, Australia
| | - Laurens Manning
- Medical School, The University of Western Australia, Perth, Australia.,Infectious Diseases Department, Fiona Stanley Hospital, Perth, Australia.,Multidisciplinary Diabetes Foot Unit, Fiona Stanley Hospital, Perth, Australia
| | - Shuen-Chyn Soh
- Medical School, The University of Western Australia, Perth, Australia
| | - Jonathan Hiew
- Multidisciplinary Diabetes Foot Unit, Fiona Stanley Hospital, Perth, Australia.,Department of Podiatry, Fiona Stanley Hospital, Perth, Australia
| | - J Carsten Ritter
- Multidisciplinary Diabetes Foot Unit, Fiona Stanley Hospital, Perth, Australia.,Department of Vascular Surgery, Fiona Stanley Hospital, Perth, Australia.,Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Bu B Yeap
- Medical School, The University of Western Australia, Perth, Australia.,Multidisciplinary Diabetes Foot Unit, Fiona Stanley Hospital, Perth, Australia.,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, CD-09, 11 Robin Warren Drive, Murdoch, Perth, 6150, Australia
| | - Emma J Hamilton
- Medical School, The University of Western Australia, Perth, Australia. .,Multidisciplinary Diabetes Foot Unit, Fiona Stanley Hospital, Perth, Australia. .,Department of Endocrinology and Diabetes, Fiona Stanley Hospital, CD-09, 11 Robin Warren Drive, Murdoch, Perth, 6150, Australia.
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43
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Frisoli A, Paes AT, Kimura AD, Azevedo E, Ambrosio V. Measuring forearm bone density instead of lumbar spine bone density improves the sensitivity of diagnosing osteoporosis in older adults with cardiovascular diseases: Data from SARCOS study. Bone Rep 2021; 15:101134. [PMID: 34660851 PMCID: PMC8502712 DOI: 10.1016/j.bonr.2021.101134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 09/24/2021] [Accepted: 09/26/2021] [Indexed: 11/11/2022] Open
Abstract
Introduction In older individuals with cardiovascular diseases, it has been challenging to diagnose osteoporosis due to aortic calcification and degenerative processes in the spine of older adults, especially in very old adults. Aim To assess whether the distal forearm BMD with the proximal femur BMD has greater sensitivity for the diagnosis of osteoporosis than the lumbar spine BMD with the proximal femur BMD. Methods We evaluated 515 older adults with cardiovascular disease from the SARCOS study and stratified them into under and over 80-year-old age groups and according to gender. Two diagnostic criteria were used to assess osteoporosis, SPF (lumbar spine and proximal femur BMD) and DFF (distal forearm and proximal femur BMD), which were compared with the multiple bone sites (MS) criteria (lumbar spine, distal radius, femoral neck, and total femur BMD). Results 43.9% were aged ≥80 years. Osteoporosis by SPF was diagnosed in 34% (n = 175), by DFF in 42.2% (n = 216), and by MS in 46.8% (n = 241). The characteristics of the three groups were similar. For every 100 older individuals with osteoporosis based on MS, 27 were not diagnosed by the SPF, and nine were not diagnosed by DFF (p = 0.001). The SPF did not diagnose osteoporosis in 23/100 in older adults aged <80 years, while DFF did not diagnose 16/100 (p.ns). In adults aged ≥80 years, the SPF did not identify osteoporosis in 31/100 older adults, while the DFF failed to identify it in only 5/100 (p < 0.001). In men and women aged ≥80 years, DFF showed higher sensitivity for the diagnosis of osteoporosis compared to the SPF criterion. Conclusion In the elderly population with cardiovascular disease evaluated in our study, the use of distal forearm BMD instead of lumbar spine BMD, associated with proximal femur BMD, showed higher sensitivity for the diagnosis of osteoporosis, regardless of gender, and especially among the very older adults. Diagnosis of osteoporosis (OP) in the elderly with cardiovascular disease is challenging. We evaluated the sensitivity of distal forearm (DF) BMD vs. lumbar spine (LS) BMD. LS BMD did not diagnose OP in 27/100, and DF BMD in 9/100 (p = 0.001). LS BMD did not identify OP in 31/100, and DF BMD in 5/100 (p < 0.001) aged ≥80 years. DF BMD showed higher sensitivity for diagnosing osteoporosis, regardless of gender.
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Affiliation(s)
- Alberto Frisoli
- Geriatric Cardiology Clinic, Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.,Elderly Vulnerability Disease Research Group - Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Angela T Paes
- Statistics Department, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Amanda Diniz Kimura
- Geriatric Cardiology Clinic, Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.,Elderly Vulnerability Disease Research Group - Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Elaine Azevedo
- Geriatric Cardiology Clinic, Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil.,Elderly Vulnerability Disease Research Group - Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
| | - Valdir Ambrosio
- Geriatric Cardiology Clinic, Cardiology Division, Escola Paulista de Medicina, Universidade Federal de São Paulo, Brazil
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Lauterlein JJL, Gossiel F, Weigl M, Eastell R, Hackl M, Hermann P, Bollerslev J, Frost M. Development of the Bone Phenotype and microRNA Profile in Adults With Low-Density Lipoprotein Receptor-Related Protein 5-High Bone Mass (LRP5-HBM) Disease. JBMR Plus 2021; 5:e10534. [PMID: 34532618 PMCID: PMC8441296 DOI: 10.1002/jbm4.10534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 07/07/2021] [Accepted: 07/19/2021] [Indexed: 12/01/2022] Open
Abstract
Pathogenic variants in the Wnt‐pathway co‐receptor low‐density lipoprotein (LDL) receptor‐related protein 5 (LRP5) cause high bone mass (LRP5‐HBM) due to insensitivity to the endogenous antagonist of Wnt‐signaling. Although indicating incessant progression of BMD and biomarkers reflecting bone formation, this has not been confirmed in individuals with LRP5‐HBM. We investigated how the LRP5‐HBM bone phenotype changes with age in adults and is associated with quantitative changes of bone turnover markers and bone‐related microRNAs (miRNAs) in the circulation. Whole body, lumbar spine, total hip, and femoral neck areal BMD (aBMD) and radial and tibial bone microarchitecture and geometry were assessed using DXA and HR‐pQCT scans of 15 individuals with LRP5‐HBMT253I (11 women; median age 51 years; range, 19 to 85 years) with a time interval between scans of 5.8 years (range, 4.9 to 7.6 years). Fasting P1NP and CTX were measured in 14 LRP5‐HBMT253I individuals and age‐, sex‐, and body mass index (BMI)‐matched controls, and 187 preselected miRNAs were quantified using qPCR in 12 individuals and age‐, sex‐, and BMI‐matched controls. DXA and HR‐pQCT scans were assessed in subjects who had reached peak bone mass (aged >25 years, n = 12). Femoral neck aBMD decreased by 0.8%/year (p = 0.01) and total hip by 0.3%/year, and radial volumetric BMD (vBMD) increased 0.3%/year (p = 0.03). Differences in bone turnover markers at follow‐up were not observed. Compared to controls, 11 of the 178 detectable miRNAs were downregulated and none upregulated in LRP5‐HBM individuals, and five of the downregulated miRNAs are reported to be involved in Wnt‐signaling. Bone loss at the hip in LRP5‐HBM individuals demonstrates that the bone phenotype does not uniformly progress with age. Differentially expressed miRNAs may reflect changes in the regulation of bone turnover and balance in LRP5‐HBM individuals. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Jens-Jacob Lindegaard Lauterlein
- Department of Endocrinology and Metabolism Odense University Hospital Odense Denmark.,Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Fatma Gossiel
- Department of Oncology and Metabolism University of Sheffield Sheffield UK
| | | | - Richard Eastell
- Department of Oncology and Metabolism University of Sheffield Sheffield UK
| | | | - Pernille Hermann
- Department of Endocrinology and Metabolism Odense University Hospital Odense Denmark.,Department of Clinical Research University of Southern Denmark Odense Denmark
| | - Jens Bollerslev
- Department of Endocrinology Rikshospitalet Oslo Norway.,Faculty of Medicine University of Oslo Oslo Norway
| | - Morten Frost
- Department of Endocrinology and Metabolism Odense University Hospital Odense Denmark.,Department of Clinical Research University of Southern Denmark Odense Denmark.,Steno Diabetes Centre Odense Odense University Hospital Odense Denmark
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45
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Wang XJ, Liu H, He JB, Gong Q, Hong Y, Rong X, Ding C, Wang BY, Yang Y, Meng Y. Is there a difference in the outcomes of anterior cervical discectomy and fusion among female patients with different menopausal statuses? J Orthop Surg Res 2021; 16:518. [PMID: 34416892 PMCID: PMC8377952 DOI: 10.1186/s13018-021-02673-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 08/11/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The surgical outcomes of anterior cervical discectomy and fusion (ACDF) in female patients according to menopausal status remain unclear. The objective of this study was to investigate the differences in these outcomes among female patients with different menopausal statuses. METHODS Ninety-one patients undergoing single-level or consecutive two-level ACDF with a minimum 12-month postoperative follow-up were included in this study. There were 38 patients in the premenopausal group, 28 patients in the early postmenopausal group, and 25 patients in the late postmenopausal group. The clinical outcomes were evaluated by means of the neck disability index (NDI) scores, Japanese Orthopedic Association (JOA) scores, and visual analog scale (VAS) scores. Radiological parameters included cervical lordosis (CL), the functional spinal unit (FSU) angle, range of motion (ROM) of the total cervical spine, ROM of the FSU, anterior and posterior FSU height, implant subsidence, adjacent segment degeneration (ASD), and Hounsfield unit (HU) values. RESULTS All groups showed significant improvements in their JOA, VAS, and NDI scores (P < 0.05). The differences in preoperative and final follow-up CL, ROM of C2-7, FSU angle, and ROM of FSU were not statistically significant among the three groups (P > 0.05). The anterior FSU height loss rate showed a significant difference (P = 0.043), while there was no difference in the posterior FSU height loss rate (P = 0.072). The fusion rates in the early and late postmenopausal groups were consistently lower than those in the premenopausal group during the follow-up period. All patients had satisfactory outcomes at the final follow-up. CONCLUSION There were no significant differences in clinical or other related outcomes of single-level or consecutive two-level ACDF in the long term among female patients with different menopausal statuses. However, the early bony fusion rates and anterior FSU height loss rates were poorer in late postmenopausal patients than in premenopausal or early postmenopausal patients. Hence, importance should be attached to the protection of late postmenopausal patients in the early postoperative period to guarantee solid bony fusion.
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Affiliation(s)
- Xing-Jin Wang
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Hao Liu
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China.
| | - Jun-Bo He
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Quan Gong
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Ying Hong
- Department of Operation Room, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Xin Rong
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Chen Ding
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Bei-Yu Wang
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yi Yang
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
| | - Yang Meng
- Department of Orthopaedic Surgery, West China Hospital, Sichuan University, No. 37 Guo Xue Xiang, Chengdu, 610041, Sichuan, China
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Tanphiriyakun T, Rojanasthien S, Khumrin P. Bone mineral density response prediction following osteoporosis treatment using machine learning to aid personalized therapy. Sci Rep 2021; 11:13811. [PMID: 34226589 PMCID: PMC8257695 DOI: 10.1038/s41598-021-93152-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 06/22/2021] [Indexed: 11/09/2022] Open
Abstract
Osteoporosis is a global health problem for ageing populations. The goals of osteoporosis treatment are to improve bone mineral density (BMD) and prevent fractures. One major obstacle that remains a great challenge to achieve the goals is how to select the best treatment regimen for individual patients. We developed a computational model from 8981 clinical variables, including demographic data, diagnoses, laboratory results, medications, and initial BMD results, taken from 10-year period of electronic medical records to predict BMD response after treatment. We trained 7 machine learning models with 13,562 osteoporosis treatment instances [comprising 5080 (37.46%) inadequate treatment responses and 8482 (62.54%) adequate responses] and selected the best model (Random Forests with area under the receiver operating curve of 0.70, accuracy of 0.69, precision of 0.70, and recall of 0.89) to individually predict treatment responses of 11 therapeutic regimens, then selected the best predicted regimen to compare with the actual regimen. The results showed that the average treatment response of the recommended regimens was 9.54% higher than the actual regimens. In summary, our novel approach using a machine learning-based decision support system is capable of predicting BMD response after osteoporosis treatment and personalising the most appropriate treatment regimen for an individual patient.
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Affiliation(s)
- Thiraphat Tanphiriyakun
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Biomedical Informatics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Sattaya Rojanasthien
- Department of Orthopaedics, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Piyapong Khumrin
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Biomedical Informatics Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Shieh A, Karlamangla AS, Huang MH, Han W, Greendale GA. Faster Lumbar Spine Bone Loss in Midlife Predicts Subsequent Fracture Independent of Starting Bone Mineral Density. J Clin Endocrinol Metab 2021; 106:e2491-e2501. [PMID: 33903908 PMCID: PMC8208668 DOI: 10.1210/clinem/dgab279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Bone mineral density (BMD) decreases rapidly during menopause transition (MT), and continues to decline in postmenopause. OBJECTIVE This work aims to examine whether faster BMD loss during the combined MT and early postmenopause is associated with incident fracture, independent of starting BMD, before the MT. METHODS The Study of Women's Health Across the Nation, a longitudinal cohort study, included 451 women, initially premenopausal or early perimenopausal, and those transitioned to postmenopause. Main outcome measures included time to first fracture after early postmenopause. RESULTS In Cox proportional hazards regression, adjusted for age, body mass index, race/ethnicity, study site, use of vitamin D and calcium supplements, and use of bone-detrimental or -beneficial medications, each SD decrement in lumbar spine (LS) BMD before MT was associated with a 78% increment in fracture hazard (P = .007). Each 1% per year faster decline in LS BMD was related to a 56% greater fracture hazard (P = .04). Rate of LS BMD decline predicted future fracture, independent of starting BMD. Women with a starting LS BMD below the sample median, and an LS BMD decline rate faster than the sample median had a 2.7-fold greater fracture hazard (P = .03). At the femoral neck, neither starting BMD nor rate of BMD decline was associated with fracture. CONCLUSION At the LS, starting BMD before the MT and rate of decline during the combined MT and early postmenopause are independent risk factors for fracture. Women with a below-median starting LS BMD and a faster-than-median LS BMD decline have the greatest fracture risk.
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Affiliation(s)
- Albert Shieh
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
- Correspondence: Albert Shieh, MD, UCLA Division of Geriatrics, 10945 Le Conte Ave, Suites 2339 to 2345, Los Angeles, CA 90095-1687, USA.
| | - Arun S Karlamangla
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Mei-Hua Huang
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Weijuan Han
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
| | - Gail A Greendale
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, California, USA
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Stevens K, Hultin H, Hellman P, Sundbom M. Low bone mineral density following gastric bypass is not explained by lifestyle and lack of exercise. BMC Surg 2021; 21:282. [PMID: 34088293 PMCID: PMC8178896 DOI: 10.1186/s12893-021-01281-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2021] [Accepted: 05/25/2021] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Bariatric surgery, Roux-en-Y gastric bypass (RYGBP) in particular, is associated with weight loss as well as low bone mineral density. Bone mineral density relies upon multiple factors, some of which are lifestyle factors. The aim of this study was to compare lifestyle factors in order to eliminate them as culprits of the suspected difference in BMD in RYGBP operated and controls. MATERIALS AND METHODS Study participants included 71 RYGBP-operated women (42.3 years, BMI 33.1 kg/m2) and 94 controls (32.4 years, BMI 23.9 kg/m2). Each completed a DEXA scan, as well as survey of lifestyle factors (e.g. physical activity in daily life, corticosteroid use, and calcium intake). All study participants were premenopausal Caucasian women living in the same area. Blood samples were taken in RYGBP-patients. RESULTS BMD was significantly lower in RYGBP, femoral neck 0.98 vs. 1.04 g/cm2 compared to controls, despite higher BMI (present and at 20 years of age) and similar physical activity and calcium intake. In a multivariate analysis, increased time since surgery and age were negatively associated with BMD of the femoral neck and total hip in RYGBP patients. CONCLUSION Despite similar lifestyle, RYGBP was followed by a lower BMD compared to controls. Thus, the reduced BMD in RYGBP cannot be explained, seemingly nor prevented, by lifestyle factors. As the reduction in BMD was associated with time since surgery, strict follow-up is a lifelong necessity after bariatric surgery, and especially important in younger bariatric patients.
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Affiliation(s)
- Katharina Stevens
- Department of Surgical Sciences, Uppsala University, Entrance 70, University Hospital, 751 85, Uppsala, Sweden.
| | - Hella Hultin
- Department of Surgical Sciences, Uppsala University, Entrance 70, University Hospital, 751 85, Uppsala, Sweden
| | - Per Hellman
- Department of Surgical Sciences, Uppsala University, Entrance 70, University Hospital, 751 85, Uppsala, Sweden
| | - Magnus Sundbom
- Department of Surgical Sciences, Uppsala University, Entrance 70, University Hospital, 751 85, Uppsala, Sweden
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Chuang TL, Koo M, Chuang MH, Wang YF. Bone Mineral Density and Hemoglobin Levels: Opposite Associations in Younger and Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105495. [PMID: 34065536 PMCID: PMC8161311 DOI: 10.3390/ijerph18105495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023]
Abstract
This cross-sectional, retrospective medical record review study aimed to investigate the association between hemoglobin levels and bone mineral density (BMD) in adult women. Medical records obtained from general health examinations conducted from June 2014 to July 2020 at a regional hospital in southern Taiwan were reviewed. Anthropometric and laboratory data were recorded. BMD of the lumbar spine and bilateral femoral neck regions was assessed by dual energy X-ray absorptiometry. Linear regression analysis was used to assess the association between BMD and hemoglobin level with and without adjusting for other anthropometric and laboratory data. The study included 9606 female patients with a mean age of 55.9 years. Of these, 2756 (28.7%) were aged ≤ 50 years and 6850 (71.3%) were aged > 50 years. Results from multiple linear regression analysis showed that hemoglobin and femoral and lumbar spine BMD were significantly correlated. A higher hemoglobin level was significantly associated with a lower BMD level in females aged ≤ 50 years, but with a higher BMD level in those aged > 50 years. Given the relationship between bone metabolism and hematopoiesis, additional research is needed to elucidate the association between hemoglobin and BMD levels in different age groups, particularly in premenopausal and perimenopausal women.
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Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622401, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien 973302, Taiwan;
| | - Mei-Hua Chuang
- Faculty of Pharmacy, National Yang-Ming University, Taipei 112304, Taiwan;
- Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622401, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622401, Taiwan
- Correspondence: ; Tel.: +886-5-2648000 (ext. 5700)
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50
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Qu Z, Yang F, Yan Y, Hong J, Wang W, Li S, Jiang G, Yan S. Relationship between Serum Nutritional Factors and Bone Mineral Density: A Mendelian Randomization Study. J Clin Endocrinol Metab 2021; 106:e2434-e2443. [PMID: 33581692 DOI: 10.1210/clinem/dgab085] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Indexed: 12/19/2022]
Abstract
PURPOSE Multiple risk factors have been implicated in the development of osteoporosis. This study examined potential associations between serum nutritional factors and bone mineral density (BMD). METHODS Six nutritional factors were selected as exposures. Outcomes included total body BMD (n = 66 945); BMD at the forearm (FA), femoral neck (FN) and lumbar spine (LS) (n = 8143, n = 32 735, and n = 28 498, respectively); estimated heel BMD (HL eBMD) (n = 394 929); and HL eBMD stratified by sex (n = 206 496). A 2-sample Mendelian randomization approach was adopted to estimate the association between serum nutritional factors and BMD. The threshold for adjusted P value was 1.39 × 10-3. RESULTS Serum calcium levels were inversely associated with LS BMD (effect = -0.55; 95% CI, -0.86 to -0.24; P = 0.001), whereas serum selenium levels were positively correlated with HL eBMD (effect = 0.22; 95% CI, 0.10 to 0.33; P = 1.70 × 10-4). Regarding nominal significance, there was a positive association between serum selenium levels and FA BMD. Nominally significant results were also obtained for serum retinol as well as vitamin E levels and HL eBMD. Moreover, sex-specific effects of serum retinol and vitamin E levels on BMD were observed in men. CONCLUSION Serum calcium and selenium levels influence BMD at specific skeletal sites. This implies that these nutritional factors play crucial roles in bone metabolism.
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Affiliation(s)
- Zihao Qu
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Fangkun Yang
- Department of Cardiology, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yishang Yan
- The Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Jianqiao Hong
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Wei Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Sihao Li
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Guangyao Jiang
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
| | - Shigui Yan
- Department of Orthopedic Surgery, The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Orthopedic Research Institute of Zhejiang University, Hangzhou, Zhejiang, China
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