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Lewiecki EM, Betah D, Humbert L, Libanati C, Oates M, Shi Y, Winzenrieth R, Ferrari S, Omura F. 3D-modeling from hip DXA shows improved bone structure with romosozumab followed by denosumab or alendronate. J Bone Miner Res 2024; 39:473-483. [PMID: 38477808 DOI: 10.1093/jbmr/zjae028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 11/22/2023] [Accepted: 12/15/2024] [Indexed: 03/14/2024]
Abstract
Romosozumab treatment in women with postmenopausal osteoporosis increases bone formation while decreasing bone resorption, resulting in large BMD gains to reduce fracture risk within 1 yr. DXA-based 3D modeling of the hip was used to assess estimated changes in cortical and trabecular bone parameters and map the distribution of 3D changes in bone parameters over time in patients from 2 randomized controlled clinical trials: FRAME (romosozumab vs placebo followed by denosumab) and ARCH (romosozumab vs alendronate followed by alendronate). For each study, data from a subset of ~200 women per treatment group who had TH DXA scans at baseline and months 12 and 24 and had provided consent for future research were analyzed post hoc. 3D-SHAPER software v2.11 (3D-SHAPER Medical) was used to generate patient-specific 3D models from TH DXA scans. Percentage changes from baseline to months 12 and 24 in areal BMD (aBMD), integral volumetric BMD (vBMD), cortical thickness, cortical vBMD, cortical surface BMD (sBMD), and trabecular vBMD were evaluated. Data from 377 women from FRAME (placebo, 190; romosozumab, 187) and 368 women from ARCH (alendronate, 185; romosozumab, 183) with evaluable 3D assessments at baseline and months 12 and 24 were analyzed. At month 12, treatment with romosozumab vs placebo in FRAME and romosozumab vs alendronate in ARCH resulted in greater increases in aBMD, integral vBMD, cortical thickness, cortical vBMD, cortical sBMD, and trabecular vBMD (P < .05 for all). At month 24, cumulative gains in all parameters were greater in the romosozumab-to-denosumab vs placebo-to-denosumab sequence and romosozumab-to-alendronate vs alendronate-to-alendronate sequence (P < .05 for all). 3D-SHAPER analysis provides a novel technique for estimating changes in cortical and trabecular parameters from standard hip DXA images. These data add to the accumulating evidence that romosozumab improves hip bone density and structure, thereby contributing to the antifracture efficacy of the drug.
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Affiliation(s)
- E Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, 300 Oak St NE, Albuquerque, NM 87106, United States
| | - Donald Betah
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, United States
| | - Ludovic Humbert
- 3D-SHAPER Medical, Rambla de Catalunya, 53, 4-H, Eixample, 08007 Barcelona, Spain
| | - Cesar Libanati
- UCB Pharma, Allée de la Recherche, 60, Brussels B-1070, Belgium
| | - Mary Oates
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, United States
| | - Yifei Shi
- Amgen Inc., One Amgen Center Drive, Thousand Oaks, CA 91320, United States
| | - Renaud Winzenrieth
- 3D-SHAPER Medical, Rambla de Catalunya, 53, 4-H, Eixample, 08007 Barcelona, Spain
| | - Serge Ferrari
- Division of Bone Diseases, University Hospital of Geneva, Geneva 1211, Switzerland
| | - Fumitoshi Omura
- Koenji Orthopedics Clinic, 4-29-2, Koenji minami, Suginami-ku, Tokyo, 166-0003, Japan
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Blay R, Flores LE, Kupzyk K, Waltman N, Lappe J, Mack L, Bilek L. Twelve-month resistance and impact exercise program or risedronate provides a relative benefit to hip bone structure in postmenopausal women: results from a randomized controlled trial. Osteoporos Int 2024; 35:877-891. [PMID: 38368307 DOI: 10.1007/s00198-023-07008-x] [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: 01/16/2023] [Accepted: 12/19/2023] [Indexed: 02/19/2024]
Abstract
Bone strength estimates are important for fracture prevention. This study compared bone strength changes in postmenopausal women with low bone mass who were assigned to 12 months of exercise, a bone medication, or control. Exercise and bone medications benefited structure at the hip. Structure should be considered in fracture prevention research. PURPOSE Exercise and bisphosphonates reduce fracture risk, but their impact on estimates of bone strength remains uncertain. This study compared changes in tibial bone strength using peripheral quantitative computed tomography (pQCT) and hip structure analysis (HSA) outcomes from dual-energy X-ray absorptiometry (DXA) scans in postmenopausal women with low bone mass assigned to 12 months of exercise, risedronate, or control. METHODS In this RCT, 276 postmenopausal women within 6 years of menopause were randomly assigned to three groups: exercise (92), risedronate (91), or control (93). Exercise included weighted jogging and progressive resistance exercises; risedronate treatment was 150 mg monthly; all groups received calcium and vitamin D. pQCT and DXA images were obtained at baseline and 6 and 12 months and compared between groups over time. RESULTS Participants had a mean (± SD) age of 54.5 (± 3.2) years with an average of 36.7 (± 40.7) months postmenopause. No significant differences were found between groups for the change in pQCT outcomes (volumetric bone mineral density, area, and strength estimates). At 12 months, mean percent differences (95% CI) in HSA measures between exercise and controls were as follows: intertrochanteric, cross-sectional area 2.25% (0.28, 4.12) (p = .03), cross-sectional moment of inertia (CSMI) 5.67% (1.47, 9.87) (p < .01), and section modulus (SM) 4.38% (1.02, 7.74) (p = .01), and narrow neck, average cortical thickness 2.37% (-0.08, 4.83) (p = .031). Mean percent differences (95% CI) in HSA measures between risedronate and control were as follows: intertrochanteric, CSMI 4.28% (-0.24, 8.81) (p = .03) and SM 3.35% (-0.21, 6.91) (p = .03), and shaft, subperiosteal width 0.82% (0.05, 1.58) (p = .047), CSMI 2.53% (0.88, 4.18) (p = .004), and SM 1.57% (0.34, 2.8) (p = .008). Exercise maintained neck-shaft angle compared to both control 1.27% (0.13, 2.41) (p = .04) and risedronate 1.31% (0.23, 2.39) (p = .03). All other differences for changes in HSA outcomes over time were not significantly different between the exercise and risedronate groups. CONCLUSION Exercise and bisphosphonates may influence structural and strength estimates at the hip, but not at peripheral sites (tibia). Neither exercise nor bisphosphonates were found to be superior in improving estimates of hip bone strength.
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Affiliation(s)
- R Blay
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA
| | - L E Flores
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - K Kupzyk
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - N Waltman
- College of Nursing, University of Nebraska Medical Center, Omaha, NE, USA
| | - J Lappe
- Creighton Osteoporosis Research Center, Omaha, NE, USA
| | - L Mack
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - L Bilek
- College of Allied Health Professions, University of Nebraska Medical Center, Omaha, NE, USA.
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Lane NE, Betah D, Deignan C, Oates M, Wang Z, Timoshanko J, Khan AA, Binkley N. Effect of Romosozumab Treatment in Postmenopausal Women With Osteoporosis and Knee Osteoarthritis: Results From a Substudy of a Phase 3 Clinical Trial. ACR Open Rheumatol 2024; 6:43-51. [PMID: 37985218 PMCID: PMC10789302 DOI: 10.1002/acr2.11619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 09/02/2023] [Accepted: 09/05/2023] [Indexed: 11/22/2023] Open
Abstract
OBJECTIVE Romosozumab is a bone-forming agent approved for osteoporosis treatment. Here we report results of the protocol-specified, noninferiority osteoarthritis substudy of the fracture study in postmenopausal women with osteoporosis (FRAME), which evaluated the effect of romosozumab versus placebo on knee osteoarthritis in patients with a clinical history of osteoarthritis. METHODS Women in FRAME with a history of knee osteoarthritis were eligible for enrollment in the osteoarthritis substudy; key inclusion criteria were osteoarthritis-related signal knee pain, morning stiffness lasting less than 30 minutes, knee crepitus, and knee osteoarthritis confirmed by x-ray within 12 months. The protocol-specified outcomes were change from baseline through month 12 in the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score, incidence of worsening knee osteoarthritis, and treatment-emergent adverse events (TEAEs) with romosozumab versus placebo. In a post hoc analysis, percentage change from baseline to month 12 in bone mineral density (BMD) was assessed. RESULTS Of 7180 women in FRAME, 347 participated in the osteoarthritis substudy (placebo, 177; romosozumab, 170). At month 12, no significant difference in progression of knee osteoarthritis was observed with romosozumab versus placebo (least squares mean total WOMAC score: -2.2 vs. -1.3; P = 0.71). Incidence of worsening symptoms of knee osteoarthritis was comparable between romosozumab (17.1%) and placebo (20.5%) (odds ratio 0.9 [95% confidence interval: 0.5, 1.7]; P = 0.69). Incidence of TEAEs of osteoarthritis was numerically lower with romosozumab (13 [7.7%]) versus placebo (21 [12.0%]). BMD gains were higher with romosozumab. CONCLUSION Romosozumab treatment did not impact knee pain or function in postmenopausal women with osteoporosis and knee osteoarthritis and resulted in significant BMD gains in these women.
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Sebro R, De la Garza-Ramos C, Peterson JJ. Detecting whether L1 or other lumbar levels would be excluded from DXA bone mineral density analysis during opportunistic CT screening for osteoporosis using machine learning. Int J Comput Assist Radiol Surg 2023; 18:2261-2272. [PMID: 37219803 DOI: 10.1007/s11548-023-02910-5] [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: 08/23/2022] [Accepted: 04/04/2023] [Indexed: 05/24/2023]
Abstract
PURPOSE One or more vertebrae are sometimes excluded from dual-energy X-ray absorptiometry (DXA) analysis if the bone mineral density (BMD) T-score estimates are not consistent with the other lumbar vertebrae BMD T-score estimates. The goal of this study was to build a machine learning framework to identify which vertebrae would be excluded from DXA analysis based on the computed tomography (CT) attenuation of the vertebrae. METHODS Retrospective review of 995 patients (69.0% female) aged 50 years or greater with CT scans of the abdomen/pelvis and DXA within 1 year of each other. Volumetric semi-automated segmentation of each vertebral body was performed using 3D-Slicer to obtain the CT attenuation of each vertebra. Radiomic features based on the CT attenuation of the lumbar vertebrae were created. The data were randomly split into training/validation (90%) and test datasets (10%). We used two multivariate machine learning models: a support vector machine (SVM) and a neural net (NN) to predict which vertebra(e) were excluded from DXA analysis. RESULTS L1, L2, L3, and L4 were excluded from DXA in 8.7% (87/995), 9.9% (99/995), 32.3% (321/995), and 42.6% (424/995) patients, respectively. The SVM had a higher area under the curve (AUC = 0.803) than the NN (AUC = 0.589) for predicting whether L1 would be excluded from DXA analysis (P = 0.015) in the test dataset. The SVM was better than the NN for predicting whether L2 (AUC = 0.757 compared to AUC = 0.478), L3 (AUC = 0.699 compared to AUC = 0.555), or L4 (AUC = 0.751 compared to AUC = 0.639) were excluded from DXA analysis. CONCLUSIONS Machine learning algorithms could be used to identify which lumbar vertebrae would be excluded from DXA analysis and should not be used for opportunistic CT screening analysis. The SVM was better than the NN for identifying which lumbar vertebra should not be used for opportunistic CT screening analysis.
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Affiliation(s)
- Ronnie Sebro
- Department of Radiology, Mayo Clinic, Jacksonville, FL, 32224, USA.
- Center for Augmented Intelligence, Mayo Clinic, Jacksonville, FL, 32224, USA.
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Craven BC, Cirnigliaro CM, Carbone LD, Tsang P, Morse LR. The Pathophysiology, Identification and Management of Fracture Risk, Sublesional Osteoporosis and Fracture among Adults with Spinal Cord Injury. J Pers Med 2023; 13:966. [PMID: 37373955 DOI: 10.3390/jpm13060966] [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: 04/25/2023] [Revised: 05/26/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND The prevention of lower extremity fractures and fracture-related morbidity and mortality is a critical component of health services for adults living with chronic spinal cord injury (SCI). METHODS Established best practices and guideline recommendations are articulated in recent international consensus documents from the International Society of Clinical Densitometry, the Paralyzed Veterans of America Consortium for Spinal Cord Medicine and the Orthopedic Trauma Association. RESULTS This review is a synthesis of the aforementioned consensus documents, which highlight the pathophysiology of lower extremity bone mineral density (BMD) decline after acute SCI. The role and actions treating clinicians should take to screen, diagnose and initiate the appropriate treatment of established low bone mass/osteoporosis of the hip, distal femur or proximal tibia regions associated with moderate or high fracture risk or diagnose and manage a lower extremity fracture among adults with chronic SCI are articulated. Guidance regarding the prescription of dietary calcium, vitamin D supplements, rehabilitation interventions (passive standing, functional electrical stimulation (FES) or neuromuscular electrical stimulation (NMES)) to modify bone mass and/or anti-resorptive drug therapy (Alendronate, Denosumab, or Zoledronic Acid) is provided. In the event of lower extremity fracture, the need for timely orthopedic consultation for fracture diagnosis and interprofessional care following definitive fracture management to prevent health complications (venous thromboembolism, pressure injury, and autonomic dysreflexia) and rehabilitation interventions to return the individual to his/her pre-fracture functional abilities is emphasized. CONCLUSIONS Interprofessional care teams should use recent consensus publications to drive sustained practice change to mitigate fracture incidence and fracture-related morbidity and mortality among adults with chronic SCI.
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Affiliation(s)
- Beverley Catharine Craven
- KITE Research Institute, 520 Sutherland Dr, Toronto, ON M4G 3V9, Canada
- Faculty of Medicine, University of Toronto, Medical Sciences Building, 1 King's College Cir, Toronto, ON M5S 1A8, Canada
| | - Christopher M Cirnigliaro
- Department of Veterans Affairs Rehabilitation, Research, and Development Service, Spinal Cord Damage Research Center, Bronx, NY 10468, USA
| | - Laura D Carbone
- Department of Medicine: Rheumatology, Medical College of Georgia, Augusta University, 1120 15th St, Augusta, GA 30912, USA
| | - Philemon Tsang
- KITE Research Institute, 520 Sutherland Dr, Toronto, ON M4G 3V9, Canada
| | - Leslie R Morse
- Department of Rehabilitation Medicine, University of Minnesota, 500 Harvard St SE, Minneapolis, MN 55455, USA
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Wang M, Li H, Tang J, Xi Y, Chen S, Liu M. Effect of simvastatin on osteogenesis of the extremity bones in aging rats. Connect Tissue Res 2023; 64:64-74. [PMID: 35816110 DOI: 10.1080/03008207.2022.2094790] [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: 02/03/2023]
Abstract
PURPOSE Simvastatin is a prodrug of the potent 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor. The main purpose of the current study is to assess the accurate function of simvastatin on osteoporosis of extremity bones in aging rats. MATERIALS AND METHODS Fifty 15-month-old SD rats were divided into five groups (four simvastatin groups and one control group). The rats in four simvastatin groups were fed with different doses of simvastatin (5, 10, 20, and 40 mg/kg/d, respectively) for 3 months, whereas the rats in control group were fed the equal physiological saline. Calcium (Ca), phosphorus (P), and the lipid spectrum in serum were measured. Biochemical markers of bone metabolism, osteocalcin (OC), and tartrate-resistant acid phosphatase (Trap-5b), were analyzed using ELISA. The content of adipocytes in bone marrow was analyzed by histological staining. Finally, the bone quality of the femur and tibia were evaluated using dual-energy X-ray absorptiometry (DEXA), peri-quantity CT (pQCT), and the 3-point bending biomechanical test. RESULTS Simvastatin reduced serum triglycerides (TG), and 10 mg/kg/d of simvastatin significantly reduced the content of adipocytes in bone marrow compared to the control group. However, statistically significant differences between the simvastatin groups and the control group were not found in the CA, P, OC, Trap-5b, or the evaluation indexes of bone quality from DEXA, pQCT, and biomechanical tests. CONCLUSION Simvastatin could not prevent osteoporosis of the extremity bones in aging rats.
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Affiliation(s)
- Mengran Wang
- Department of Orthopedics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Haowei Li
- Department of Orthopedics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Jiaxin Tang
- Department of Orthopedics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yue Xi
- Department of Orthopedics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Shiyi Chen
- Department of Orthopedics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Ming Liu
- Department of Orthopedics, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, Shanghai, China
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Devlin MJ, Eick GN, Snodgrass JJ. The utility of dried blood spot measurement of bone turnover markers in biological anthropology. Am J Hum Biol 2022; 34:e23816. [PMID: 36214251 PMCID: PMC9787861 DOI: 10.1002/ajhb.23816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Bone is a dynamic organ under continual turnover influenced by life history stage, energy dynamics, diet, climate, and disease. Bone turnover data have enormous potential in biological anthropology for testing evolutionary and biocultural hypotheses, yet few studies have integrated these biomarkers. In the present article we systematically review the current availability, future viability, and applicability of measuring bone turnover markers (BTMs) in dried blood spot (DBS) samples obtained from finger prick whole blood. METHODS Our review considers clinical and public health relevance, biomarker stability in DBS, assay availability, and cost. We consider biomarkers of bone formation such as osteocalcin (bone matrix protein), PINP (N-terminal propeptide of type I collagen), and alkaline phosphatase (osteoblast enzyme), as well as biomarkers of bone resorption such as CTX (marker of collagen breakdown) and TRACP5b (tartrate-resistant acid phosphatase 5b; osteoclast enzyme). RESULTS Two BTMs have been validated for DBS: osteocalcin (formation) and TRACP5b (resorption). Prime candidates for future development are CTX and PINP, the formation and resorption markers used for clinical monitoring of response to osteoporosis treatment. CONCLUSION BTMs are a field-friendly technique for longitudinal monitoring of skeletal biology during growth, reproduction and aging, combining minimized risk to study participants with maximized ease of sample storage and transport. This combination allows new insights into the effects of energy availability, disease, and physical activity level on bone, and questions about bone gain and loss across life history and in response to environmental factors; these issues are important in human biology, paleoanthropology, bioarchaeology, and forensic anthropology.
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Affiliation(s)
- Maureen J. Devlin
- Department of AnthropologyUniversity of MichiganAnn ArborMichiganUSA
| | - Geeta N. Eick
- Global Health Biomarker Laboratory, Department of AnthropologyUniversity of OregonEugeneOregonUSA
| | - J. Josh Snodgrass
- Global Health Biomarker Laboratory, Department of AnthropologyUniversity of OregonEugeneOregonUSA,Center for Global HealthUniversity of OregonEugeneOregonUSA,Invited Faculty, Global Station for Indigenous Studies & Cultural DiversityHokkaido UniversitySapparoHokkaidoJapan
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Todorov G, Brook S, Quah Qin Xian N, Von Widekind S, Freudenthal B, Comninos AN. Comparison of fracture risk calculators in elderly fallers: a hospital-based cross-sectional study. BMJ Open 2022; 12:e060282. [PMID: 35820750 PMCID: PMC9274535 DOI: 10.1136/bmjopen-2021-060282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/29/2022] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE Elderly patients presenting with falls are known to carry an extremely high risk of future fragility fractures. Current osteoporosis guidelines recommend using fracture risk calculators such as FRAX, QFracture or Garvan to guide management. However, they differ considerably in their inputs and may therefore provide contrasting risk estimations in certain individuals. In this study, we compare these risk calculators in a high-risk cohort of elderly patients admitted to hospital with falls. DESIGN Hospital-based cross-sectional study. SETTING Secondary care, London, UK. PARTICIPANTS Data from 120 consecutive elderly patients who had falls presenting to a single hospital over 4 months were collected. 10-year major and hip fracture risks were calculated using FRAX, QFracture and Garvan. 1-year major and hip fracture risks from QFracture were assessed against prospective incidence of fracture. RESULTS Median 10-year major fracture risk was: FRAX 19.5%, QFracture 26.0%, Garvan 32.5%. Median 10-year hip fracture risk was: FRAX 9.6%, QFracture 21.1%, Garvan 6.5%. Correlation between FRAX and QFracture was r=0.672 for major, r=0.676 for hip fracture (both p<0.0001); FRAX and Garvan r=0.778 (p<0.0001) for major, r=0.128 (p=0.206) for hip fracture; QFracture and Garvan r=0.658 (p<0.0001) for major, r=0.318 (p<0.001) for hip fracture. QFracture 1-year predicted major and hip fracture rates were 1.8% and 1.2%, respectively, compared with actual rates of 2.1% and 0%, respectively. CONCLUSIONS Although strong correlations between calculators were observed in the study cohort, there were differences of up to 13% between estimated risks. QFracture captured several elderly-specific inputs not considered by other calculators and so projected higher fracture risk than the other calculators. QFracture provided 1-year fracture risks that were comparable with the prospective observed fracture incidence in the cohort. This study has important clinical implications for the use of fracture risk calculators to guide treatment decisions, particularly in the high-risk cohort of elderly patients admitted to hospital following falls.
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Affiliation(s)
- Georgi Todorov
- Department of Medicine for the Elderly, West Middlesex University Hospital, Isleworth, UK
| | - Susan Brook
- Department of Medicine for the Elderly, Imperial College Healthcare NHS Trust, London, UK
| | | | - Sophia Von Widekind
- Department of Acute Medicine, Imperial College Healthcare NHS Trust, London, UK
| | - Bernard Freudenthal
- Endocrine Bone Unit, Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
- Section of Endocrinology & Investigative Medicine, Imperial College London, London, UK
| | - Alexander N Comninos
- Endocrine Bone Unit, Department of Endocrinology, Imperial College Healthcare NHS Trust, London, UK
- Section of Endocrinology & Investigative Medicine, Imperial College London, London, UK
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Garibaldi N, Besio R, Dalgleish R, Villani S, Barnes AM, Marini JC, Forlino A. Dissecting the phenotypic variability of osteogenesis imperfecta. Dis Model Mech 2022; 15:275408. [PMID: 35575034 PMCID: PMC9150118 DOI: 10.1242/dmm.049398] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 03/16/2022] [Indexed: 12/24/2022] Open
Abstract
Osteogenesis imperfecta (OI) is a heterogeneous family of collagen type I-related diseases characterized by bone fragility. OI is most commonly caused by single-nucleotide substitutions that replace glycine residues or exon splicing defects in the COL1A1 and COL1A2 genes that encode the α1(I) and α2(I) collagen chains. Mutant collagen is partially retained intracellularly, impairing cell homeostasis. Upon secretion, it assembles in disorganized fibrils, altering mineralization. OI is characterized by a wide range of clinical outcomes, even in the presence of identical sequence variants. Given the heterotrimeric nature of collagen I, its amino acid composition and the peculiarity of its folding, several causes may underlie the phenotypic variability of OI. A deep analysis of entries regarding glycine and splice site collagen substitution of the largest publicly available patient database reveals a higher risk of lethal phenotype for carriers of variants in α1(I) than in α2(I) chain. However, splice site variants are predominantly associated with lethal phenotype when they occur in COL1A2. In addition, lethality is increased when mutations occur in regions of importance for extracellular matrix interactions. Both extracellular and intracellular determinants of OI clinical severity are discussed in light of the findings from in vitro and in vivo OI models. Combined with meticulous tracking of clinical cases via a publicly available database, the available OI animal models have proven to be a unique tool to shed light on new modulators of phenotype determination for this rare heterogeneous disease.
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Affiliation(s)
- Nadia Garibaldi
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, 27100 Pavia, Italy
| | - Roberta Besio
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, 27100 Pavia, Italy
| | - Raymond Dalgleish
- Department of Genetics and Genome Biology, University of Leicester, Leicester LE1 7RH, United Kingdom
| | - Simona Villani
- Department of Public Health and Experimental and Forensic Medicine, Unit of Biostatistics and Clinical Epidemiology, University of Pavia, 27100 Pavia, Italy
| | - Aileen M Barnes
- Section on Heritable Disorders of Bone and Extracellular Matrix, NICHD, NIH, 20892 Bethesda, MD, USA
| | - Joan C Marini
- Section on Heritable Disorders of Bone and Extracellular Matrix, NICHD, NIH, 20892 Bethesda, MD, USA
| | - Antonella Forlino
- Department of Molecular Medicine, Biochemistry Unit, University of Pavia, 27100 Pavia, Italy
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Effective Spatial Resolution of Photon Counting CT for Imaging of Trabecular Structures is Superior to Conventional Clinical CT and Similar to High Resolution Peripheral CT. Invest Radiol 2022; 57:620-626. [PMID: 35318968 DOI: 10.1097/rli.0000000000000873] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Photon counting computed tomography (PCCT) might offer an effective spatial resolution that is significantly improved compared with conventional state-of-the-art computed tomography (CT) and even provide a microstructural level of detail similar to high-resolution peripheral CT (HR-pQCT). The aim of this study was to evaluate the volumetric effective spatial resolution of clinically approved PCCT as an alternative to HR-pQCT for ex vivo or preclinical high-resolution imaging of bone microstructure. MATERIALS AND METHODS The experiment contained 5 human vertebrae embedded in epoxy resin, which were scanned 3 times each, and on 3 different clinical CT scanners: a PCCT (Naeotom Alpha), a dual-energy CT (Somatom Force [SF]), and a single-energy CT (Somatom Sensation 40 [S40]), all manufactured by Siemens Healthineers (Erlangen, Germany). Scans were performed with a tube voltage of 120 kVp and, to provide maximum scan performance and minimum noise deterioration, with exposures of 1500 mAs (SF), 2400 mAs (S40), and 4500 mAs (PCCT) and low slice increments of 0.1 (PCCT) and 0.3 mm (SF, S40). Images were reconstructed with sharp and very sharp bone kernels, Br68 and Br76 (PCCT), Br64 (SF), and B65s and B75h (S40). Ground truth information was obtained from an XtremeCT scanner (Scanco, Brüttisellen, Switzerland). Voxel-wise comparison was performed after registration, calibration, and resampling of the volumes to isotropic voxel size of 0.164 mm. Three-dimensional point spread- and modulation-transfer functions were calculated with Wiener's deconvolution in the anatomical trabecular structure, allowing optimum estimation of device- and kernel-specific smoothing properties as well as specimen-related diffraction effects on the measurement. RESULTS At high contrast (modulation transfer function [MTF] of 10%), radial effective resolutions of PCCT were 10.5 lp/cm (minimum resolvable object size 476 μm) for kernel Br68 and 16.9 lp/cm (295 μm) for kernel Br76. At low contrast (MTF 5%), radial effective spatial resolutions were 10.8 lp/cm (464 μm) for kernel Br68 and 30.5 lp/cm (164 μm) for kernel Br76. Axial effective resolutions of PCCT for both kernels were between 27.0 (185 μm) and 29.9 lp/cm (167 μm). Spatial resolutions with kernel Br76 might possibly be still higher but were technically limited by the isotropic voxel size of 164 μm. The effective volumetric resolutions of PCCT with kernel Br76 ranged between 61.9 (MTF 10%) and 222.4 (MTF 5%) elements per cubic mm. Photon counting CT improved the effective volumetric resolution by factor 5.5 (MTF 10%) and 18 (MTF 5%) compared with SF and by a factor of 8.7 (MTF 10%) and 20 (MTF 5%) compared with S40. Photon counting CT allowed obtaining similar structural information as HR-pQCT. CONCLUSIONS The effective spatial resolution of PCCT in trabecular bone imaging was comparable with that of HR-pQCT and more than 5 times higher compared with conventional CT. For ex vivo samples and when patient radiation dose can be neglected, PCCT allows imaging bone microstructure at a preclinical level of detail.
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Holubiac IȘ, Leuciuc FV, Crăciun DM, Dobrescu T. Effect of Strength Training Protocol on Bone Mineral Density for Postmenopausal Women with Osteopenia/Osteoporosis Assessed by Dual-Energy X-ray Absorptiometry (DEXA). SENSORS (BASEL, SWITZERLAND) 2022; 22:s22051904. [PMID: 35271050 PMCID: PMC8915025 DOI: 10.3390/s22051904] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 05/09/2023]
Abstract
This study aims to introduce a resistance training protocol (6 repetitions × 70% of 1 maximum repetition (1RM), followed by 6 repetitions × 50% of 1RM within the same set) specifically designed for postmenopausal women with osteopenia/osteoporosis and monitor the effect of the protocol on bone mineral density (BMD) in the lumbar spine, assessed by dual-energy X-ray absorptiometry (DEXA). The subjects included in the study were 29 postmenopausal women (56.5 ± 2.8 years) with osteopenia or osteoporosis; they were separated into two groups: the experimental group (n = 15), in which the subjects participated in the strength training protocol for a period of 6 months; and the control group (n = 14), in which the subjects did not take part in any physical activity. BMD in the lumbar spine was measured by DEXA. The measurements were performed at the beginning and end of the study. A statistically significant increase (Δ% = 1.82%) in BMD was observed at the end of the study for the exercise group (0.778 ± 0.042 at baseline vs. 0.792 ± 0.046 after 6 months, p = 0.018, 95% CI [-0.025, -0.003]); while an increase was observed for the control group (Δ% = 0.14%), the difference was not statistically significant (0.762 ± 0.057 at baseline vs. 0.763 ± 0.059, p = 0.85, 95% CI [-0.013, 0.011]). In conclusion, our strength training protocol seems to be effective in increasing BMD among women with osteopenia/osteoporosis and represents an affordable strategy for preventing future bone loss.
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Affiliation(s)
- Iulian Ștefan Holubiac
- Department of Physical Education and Sport, Stefan cel Mare University, 720229 Suceava, Romania; (I.Ș.H.); (D.M.C.)
| | - Florin Valentin Leuciuc
- Department of Physical Education and Sport, Stefan cel Mare University, 720229 Suceava, Romania; (I.Ș.H.); (D.M.C.)
- Correspondence:
| | - Daniela Maria Crăciun
- Department of Physical Education and Sport, Stefan cel Mare University, 720229 Suceava, Romania; (I.Ș.H.); (D.M.C.)
| | - Tatiana Dobrescu
- Department of Physical Education and Sport Performance, Vasile Alecsandri University, 600115 Bacau, Romania;
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Medeleanu M, Vali R, Sadeghpour S, Moineddin R, Doria AS. A systematic review and meta-analysis of pediatric normative peripheral quantitative computed tomography data. Bone Rep 2021; 15:101103. [PMID: 34377749 PMCID: PMC8327482 DOI: 10.1016/j.bonr.2021.101103] [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: 02/10/2021] [Revised: 06/15/2021] [Accepted: 06/28/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Peripheral-quantitative computed tomography (pQCT) provides an intriguing diagnostic alternative to dual-energy X-ray absorptiometry (DXA) since it can measure 3D bone geometry and differentiate between the cortical and trabecular bone compartments. OBJECTIVE To investigate and summarize the methods of pQCT image acquisition of in children, adolescents and/or young adults (up to age 20) and to aggregate the published normative pQCT data. EVIDENCE ACQUISITION A literature search was conducted in MEDLINE and EMBASE from 1947 to December 2020. Quality of the included articles was assessed using Standards for Reporting of Diagnostic Accuracy (STARD) scoring system and United States Preventative Services Task Force (USPSTF) Study Design Categorization. Seven articles, encompassing a total of 2134 participants, were aggregated in the meta-analysis. Due to dissimilar age groups and scan sites, only seven pQCT parameters of the 4% radius, 4% tibia and 38% tibia were analyzed in this meta-analysis. EVIDENCE SYNTHESIS The overall fixed-effect estimates of trabecular vBMD of the 4% radius were: 207.16 (201.46, 212.86), mg/cm3 in 8 to 9 year-old girls, 210.42 (201.91, 218.93)in 10 to 12 year-old girls, 226.99 (222.45, 231.54) in 12 to 13 year-old girls, 259.97 (254.85, 265.10) in 12 to 13 year-old boys and 171.55 (163.41,179.69) in 16 to 18 year-old girls. 21 of 54 (38.9%) primary papers received a 'good' STARD quality of reporting score (<90 and 70 ≥ %) (mean STARD score of all articles = 69.4%). The primary articles of this review had a 'good' level USPSTF study design categorization. However, most of the normative data in these articles were non-comparable and non-aggregable due to a lack of standardization of reference lines, acquisition parameters and/or age at acquisition. CONCLUSION There is not sufficient evidence to suggest that pQCT is appropriately suited for use in the pediatric clinical setting. Normative pediatric data must be systematically derived for pQCT should it ever be a modality that is used outside of research. CLINICAL IMPACT We demonstrate the need for normative pQCT reference data and for clinical guidelines that standardize pediatric acquisition parameters and delineate its use in pediatric settings.
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Affiliation(s)
- Maria Medeleanu
- Department of Physiology, Faculty of Medicine, University of Toronto, Canada
- Translational Medicine, Hospital for Sick Children, Canada
| | - Reza Vali
- Department of Physiology, Faculty of Medicine, University of Toronto, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical imaging, University of Toronto, Canada
| | | | - Rahim Moineddin
- Biostatistics Division, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Andrea S. Doria
- Department of Physiology, Faculty of Medicine, University of Toronto, Canada
- Department of Diagnostic Imaging, Hospital for Sick Children and Department of Medical imaging, University of Toronto, Canada
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Brown JP, Engelke K, Keaveny TM, Chines A, Chapurlat R, Foldes AJ, Nogues X, Civitelli R, De Villiers T, Massari F, Zerbini CAF, Wang Z, Oates MK, Recknor C, Libanati C. Romosozumab improves lumbar spine bone mass and bone strength parameters relative to alendronate in postmenopausal women: results from the Active-Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk (ARCH) trial. J Bone Miner Res 2021; 36:2139-2152. [PMID: 34190361 PMCID: PMC9292813 DOI: 10.1002/jbmr.4409] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 06/16/2021] [Accepted: 06/25/2021] [Indexed: 01/20/2023]
Abstract
The Active-Controlled Fracture Study in Postmenopausal Women With Osteoporosis at High Risk (ARCH) trial (NCT01631214; https://clinicaltrials.gov/ct2/show/NCT01631214) showed that romosozumab for 1 year followed by alendronate led to larger areal bone mineral density (aBMD) gains and superior fracture risk reduction versus alendronate alone. aBMD correlates with bone strength but does not capture all determinants of bone strength that might be differentially affected by various osteoporosis therapeutic agents. We therefore used quantitative computed tomography (QCT) and finite element analysis (FEA) to assess changes in lumbar spine volumetric bone mineral density (vBMD), bone volume, bone mineral content (BMC), and bone strength with romosozumab versus alendronate in a subset of ARCH patients. In ARCH, 4093 postmenopausal women with severe osteoporosis received monthly romosozumab 210 mg sc or weekly oral alendronate 70 mg for 12 months, followed by open-label weekly oral alendronate 70 mg for ≥12 months. Of these, 90 (49 romosozumab, 41 alendronate) enrolled in the QCT/FEA imaging substudy. QCT scans at baseline and at months 6, 12, and 24 were assessed to determine changes in integral (total), cortical, and trabecular lumbar spine vBMD and corresponding bone strength by FEA. Additional outcomes assessed include changes in aBMD, bone volume, and BMC. Romosozumab caused greater gains in lumbar spine integral, cortical, and trabecular vBMD and BMC than alendronate at months 6 and 12, with the greater gains maintained upon transition to alendronate through month 24. These improvements were accompanied by significantly greater increases in FEA bone strength (p < 0.001 at all time points). Most newly formed bone was accrued in the cortical compartment, with romosozumab showing larger absolute BMC gains than alendronate (p < 0.001 at all time points). In conclusion, romosozumab significantly improved bone mass and bone strength parameters at the lumbar spine compared with alendronate. These results are consistent with greater vertebral fracture risk reduction observed with romosozumab versus alendronate in ARCH and provide insights into structural determinants of this differential treatment effect. © 2021 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)
- Jacques P Brown
- Centre Hospitalier Universitaire (CHU) de Québec Research Centre, Department of Medicine, Rheumatology Division, Laval University, Quebec City, Québec, Canada
| | - Klaus Engelke
- Bioclinica, Hamburg, Germany.,Department of Medicine 3, Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Tony M Keaveny
- Departments of Mechanical Engineering and Bioengineering, University of California Berkeley, Berkeley, California, USA
| | | | - Roland Chapurlat
- Institut National de la Santé et de la Recherche Médicale (INSERM) Unités Mixtes de Recherche (UMR) 1033, Université de Lyon, Hôpital E Herriot, Lyon, France
| | - A Joseph Foldes
- Osteoporosis Center, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Xavier Nogues
- Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Centro de Investigación Biomédica en Red Fragilidad y Envejecimiento Saludable (CIBERFES), Autonomous University of Barcelona, Barcelona, Spain
| | - Roberto Civitelli
- Musculoskeletal Research Center, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Tobias De Villiers
- Department of Obstetrics and Gynaecology, Stellenbosch University, Stellenbosch, South Africa
| | - Fabio Massari
- Instituto de Diagnóstico e Investigaciones Metabólicas, Buenos Aires, Argentina
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McCaskie CJ, Sim M, Newton RU, Hart NH. Lower-limb injury in elite Australian football: A narrative review of kinanthropometric and physical risk factors. Phys Ther Sport 2021; 52:69-80. [PMID: 34418589 DOI: 10.1016/j.ptsp.2021.08.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 08/09/2021] [Accepted: 08/10/2021] [Indexed: 12/23/2022]
Abstract
OBJECTIVE This review aims to provide a succinct and critical analysis of the current physical and mechanical demands of elite Australian football while examining lower-limb injury and the associated physical and kinanthropometric risk factors. METHODS MEDLINE, PubMed, Web of Science and SPORTSDiscus electronic databases were searched for studies that investigated the playing demands, injury trends, and physical and kinanthropometric injury risk factors of elite Australian football. Articles from similar team sports including soccer and rugby (union and league) were also included. RESULTS While the physical demands of elite AF have steadied over the past decade, injury rates continue to rise with more than two-thirds of all injuries affecting the lower-limbs. Body composition and musculoskeletal morphological assessments are regularly adopted in many sporting settings with current research suggesting high and low body mass are both associated with heightened injury risk. However, more extensive investigations are required to determine whether the proportions of muscle and fat are linked. Repeated assessment of musculoskeletal morphology may also provide further insight into stress fracture rates. CONCLUSIONS While kinanthropometric and physical attributes are highly valued within elite sporting environments, establishing a deeper connection with injury may provide practitioners with more insight into current injury trends.
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Affiliation(s)
- Callum J McCaskie
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, 270 Joondalup Drive, Joondalup, WA, 6027, Australia.
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, 270 Joondalup Drive, Joondalup, WA, 6027, Australia; Institute of Nutrition Research, Edith Cowan University, 270 Joondalup Drive, Joondalup, WA, 6027, Perth, Australia.
| | - Robert U Newton
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, 270 Joondalup Drive, Joondalup, WA, 6027, Australia; Exercise Medicine Research Institute, Edith Cowan University, Building 21, 270 Joondalup Drive, Joondalup, WA, 6027, Perth, Australia.
| | - Nicolas H Hart
- School of Medical and Health Sciences, Edith Cowan University, Perth, WA, 270 Joondalup Drive, Joondalup, WA, 6027, Australia; Exercise Medicine Research Institute, Edith Cowan University, Building 21, 270 Joondalup Drive, Joondalup, WA, 6027, Perth, Australia.
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Colleluori G, Aguirre L, Napoli N, Qualls C, Villareal DT, Armamento-Villareal R. Testosterone Therapy Effects on Bone Mass and Turnover in Hypogonadal Men with Type 2 Diabetes. J Clin Endocrinol Metab 2021; 106:e3058-e3068. [PMID: 33735389 PMCID: PMC8599870 DOI: 10.1210/clinem/dgab181] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2020] [Indexed: 12/21/2022]
Abstract
CONTEXT Male hypogonadism is associated with low bone mineral density (BMD) and increased fragility fracture risk. Patients with type 2 diabetes (T2D) have relatively higher BMD, but greater fracture risk. OBJECTIVE Evaluate the skeletal response to testosterone therapy in hypogonadal men with T2D compared with hypogonadal men without T2D. METHODS Single arm, open-label clinical trial (NCT01378299) involving 105 men (40-74 years old), with average morning testosterone <300 ng/dL. Subjects were injected intramuscularly with testosterone cypionate (200 mg) every 2 weeks for 18 months. Testosterone and estradiol were assessed by liquid chromatography/mass spectrometry; serum C-terminal telopeptide of type I collagen (CTX), osteocalcin and sclerostin by enzyme-linked immunosorbent assay; glycated hemoglobin (HbA1c) by high-performance liquid chromatography, areal BMD (aBMD) and body composition by dual-energy x-ray absorptiometry; tibial volumetric BMD (vBMD) and bone geometry by peripheral quantitative computed tomography. RESULTS Among our population of hypogonadal men, 49 had T2D and 56 were non-T2D. After 18 months of testosterone therapy, there were no differences in circulating testosterone and estradiol between the groups. Hypogonadal men with T2D had increased osteocalcin, reflecting increased osteoblast activity, compared with non-T2D men (P < .01). T2D men increased lumbar spine aBMD (P < .05), total area at 38% tibia (P < .01) and periosteal and endosteal circumferences at the same site (P < .01 for both). T2D men had reduced tibial vBMD (P < .01), but preserved bone mineral content (P = .01). Changes in HbA1c or body composition were similar between the 2 groups. CONCLUSION Testosterone therapy results in greater improvements in the skeletal health of hypogonadal men with T2D than their nondiabetic counterparts.
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Affiliation(s)
- Georgia Colleluori
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston 77030, TX, USA
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, , Houston 77030, TX, USA
- Current Affiliation: Georgia Colleluori, Marche Polytechnic University, Department of Experimental and Clinical Medicine, Center of Obesity, via Tronto 10A, 60020, Ancona, Italy
| | - Lina Aguirre
- New Mexico VA Health Care System, Albuquerque, NM 87108, USA
| | - Nicola Napoli
- Department of Endocrinology and Diabetes, Campus Biomedico University, Via Alvaro del Portillo Rome, Italy
| | - Clifford Qualls
- Division of Mathematics and Statistics, University of New Mexico School of Medicine, Albuquerque, NM 87108, USA
| | - Dennis T Villareal
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston 77030, TX, USA
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, , Houston 77030, TX, USA
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes and Metabolism, Baylor College of Medicine, Houston 77030, TX, USA
- Center for Translational Research on Inflammatory Diseases, Michael E. DeBakey VA Medical Center, , Houston 77030, TX, USA
- Correspondence: Reina Armamento-Villareal, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA.
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16
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O'Leary TJ, Rice HM, Greeves JP. Biomechanical Basis of Predicting and Preventing Lower Limb Stress Fractures During Arduous Training. Curr Osteoporos Rep 2021; 19:308-317. [PMID: 33635518 DOI: 10.1007/s11914-021-00671-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/12/2021] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Stress fractures at weight-bearing sites, particularly the tibia, are common in military recruits and athletes. This review presents recent findings from human imaging and biomechanics studies aimed at predicting and preventing stress fractures. RECENT FINDINGS Peripheral quantitative computed tomography (pQCT) provides evidence that cortical bone geometry (tibial width and area) is associated with tibial stress fracture risk during weight-bearing exercise. The contribution of bone trabecular microarchitecture, cortical porosity, and bone material properties in the pathophysiology of stress fractures is less clear, but high-resolution pQCT and new techniques such as impact microindentation may improve our understanding of the role of microarchitecture and material properties in stress fracture prediction. Military studies demonstrate osteogenic outcomes from high impact, repetitive tibial loading during training. Kinetic and kinematic characteristics may influence stress fracture risk, but there is no evidence that interventions to modify biomechanics can reduce the incidence of stress fracture. Strategies to promote adaptive bone formation, in combination with improved techniques to assess bone strength, present exciting opportunities for future research to prevent stress fractures.
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Affiliation(s)
- Thomas J O'Leary
- Army Health and Performance Research, Army Headquarters, Andover, Hampshire, UK
- Division of Surgery and Interventional Science, UCL, London, UK
| | - Hannah M Rice
- Sport and Health Sciences, University of Exeter, Exeter, UK
| | - Julie P Greeves
- Army Health and Performance Research, Army Headquarters, Andover, Hampshire, UK.
- Division of Surgery and Interventional Science, UCL, London, UK.
- Norwich Medical School, University of East Anglia, Norwich, UK.
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Jeon W, Harrison JM, Stanforth PR, Griffin L. Bone Mineral Density Differences Across Female Olympic Lifters, Power Lifters, and Soccer Players. J Strength Cond Res 2021; 35:638-643. [PMID: 33587547 DOI: 10.1519/jsc.0000000000003944] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
ABSTRACT Jeon, W, Harrison, JM, Stanforth, PR, and Griffin, L. Bone mineral density differences across female Olympic lifters, power lifters, and soccer players. J Strength Cond Res 35(3): 638-643, 2021-Athletic training improves bone mineral density (BMD) through repeated mechanical loading. The location, intensity, and direction of applied mechanical pressure play an important role in determining BMD, making some sports more advantageous at improving BMD at specific regions. Thirty-seven (10 power lifters [PL], 8 Olympic lifters [OL], 8 soccer players [SP], and 11 recreationally active [RA]) women participated in a cross-sectional study. We measured lumbar spine (L1-L4), femoral neck, total-body BMD, and overall body composition (total fat mass, lean mass, percent body fat) with dual-energy x-ray absorptiometry. All athletic groups had greater total BMD than RA (p = 0.01 [PL]; p < 0.001 [OL]; p = 0.01 [SP]). Olympic lifters had the highest total BMD than all other athletic groups. Olympic lifters had the significantly greater total BMD than PL (p = 0.018), but there was no difference in total BMD between PL and SP. As compared with RA, OL showed greater BMD at both the total lumbar spine (p = 0.002) and the femoral neck (p = 0.007), whereas PL showed greater BMD only for the total lumbar spine (p = 0.019) and SP showed greater BMD only for the femoral neck (p = 0.002). Olympic-style lifting includes both high-impact and odd-impact loading modalities that are associated with the highest BMD at both the lumbar spine and femoral neck.
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Affiliation(s)
- Woohyoung Jeon
- Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, Texas
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18
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Hughes JM, Castellani CM, Popp KL, Guerriere KI, Matheny RW, Nindl BC, Bouxsein ML. The Central Role of Osteocytes in the Four Adaptive Pathways of Bone's Mechanostat. Exerc Sport Sci Rev 2020; 48:140-148. [PMID: 32568926 DOI: 10.1249/jes.0000000000000225] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
We review evidence supporting an updated mechanostat model in bone that highlights the central role of osteocytes within bone's four mechanoadaptive pathways: 1) formation modeling and 2) targeted remodeling, which occur with heightened mechanical loading, 3) resorption modeling, and 4) disuse-mediated remodeling, which occur with disuse. These four pathways regulate whole-bone stiffness in response to changing mechanical demands.
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Affiliation(s)
- Julie M Hughes
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick
| | - Colleen M Castellani
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick
| | | | - Katelyn I Guerriere
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick
| | - Ronald W Matheny
- Military Performance Division, United States Army Research Institute of Environmental Medicine, Natick
| | - Bradley C Nindl
- Neuromuscular Research Laboratory/Warrior Human Performance Research Center, Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA
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Bland VL, Heatherington-Rauth M, Howe C, Going SB, Bea JW. Association of objectively measured physical activity and bone health in children and adolescents: a systematic review and narrative synthesis. Osteoporos Int 2020; 31:1865-1894. [PMID: 32542544 DOI: 10.1007/s00198-020-05485-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 06/01/2020] [Indexed: 12/11/2022]
Abstract
The influence of day-to-day physical activity on bone in adolescence has not been well characterized. Forty articles were identified that assessed the relationship between accelerometry-derived physical activity and bone outcomes in adolescents. Physical activity was positively associated with bone strength in peri-pubertal males, with less consistent evidence in females. Physical activity (PA) is recommended to optimize bone development in childhood and adolescence; however, the influence of day-to-day PA on bone development is not well defined. The aim of this review was to describe the current evidence for objectively measured PA on bone outcomes in healthy children and adolescents. MEDLINE, Embase, Cochrane Library, Scopus, Web of Science, CINAHL, PsycInfo, and ClinicalTrials.gov were searched for relevant articles up to April 2020. Studies assessing the relationship between accelerometry-derived PA and bone outcomes in adolescents (6-18 years old) were included. Two reviewers independently screened studies for eligibility, extracted data, and rated study quality. Forty articles met inclusion criteria (25 cross-sectional, 15 longitudinal). There was significant heterogeneity in accelerometry methodology and bone outcomes measured. Studies in males indicated a significant, positive relationship between moderate to vigorous PA (MVPA) and bone outcomes at the hip and femur, particularly during the peri-pubertal years. The results for MVPA and bone outcomes in females were mixed. There was a paucity of longitudinal studies using pQCT and a lack of data regarding how light PA and/or impact activity influences bone outcomes. The current evidence suggests that objectively measured MVPA is positively associated with bone outcomes in children and adolescents, especially in males. However, inconsistencies in methodology make it difficult to determine the amount and type of PA that leads to favorable bone outcomes. Given that the majority of research has been conducted in Caucasian adolescents, further research is needed in minority populations.
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Affiliation(s)
- V L Bland
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA.
| | - M Heatherington-Rauth
- Exercise and Health Laboratory, CIPER, Faculdade de Motricidade Humana, Universidade de Lisboa, Estrada da Costa, 1499-002, Cruz-Quebrada, Portugal
| | - C Howe
- University of Arizona Health Sciences Library, University of Arizona, 1501 N Campbell Ave, Tucson, AZ, 85724, USA
| | - S B Going
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
| | - J W Bea
- Department of Nutritional Sciences, University of Arizona, 1177 E 4th St, Tucson, AZ, 85721, USA
- University of Arizona Cancer Center, 3838 N Campbell Ave, Tucson, AZ, 85719, USA
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Aquino M, DiMenna FJ, Petrizzo J, Otto RM, Wygand J. Power training improves bone mineral density and fall risk for a postmenopausal woman with a history of osteoporosis and increased risk of falling: A case report. J Bodyw Mov Ther 2020; 24:44-49. [PMID: 32826007 DOI: 10.1016/j.jbmt.2020.02.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 02/15/2020] [Accepted: 02/24/2020] [Indexed: 11/26/2022]
Abstract
The purpose of this case study was to assess the degree to which a 12-month power-based resistance-training program improved bone mineral density (BMD) and fall risk for a 70-year-old postmenopausal woman with osteoporosis and increased risk of falling. After an eight-week strength-development phase, we had the patient perform 44 weeks of resistance training with maximal force mobilization by instructing her to complete as many repetitions as possible during each 60-s set. We used dual-energy X-ray absorptiometry (DEXA) to assess BMD and Dynamic Gait Index (DGI) to assess fall risk before and after the intervention. Post compared to pre-training testing indicated an increase in BMD in the lumbar spine (24%) and femoral neck (29%) resulting in changes in T-score of 0.7 and 0.4 SD, respectively. Testing also revealed a seven-point change in DGI which improved her status to "safe ambulator." After a 12-month period of power training, BMD was increased and fall risk was reduced for a postmenopausal woman with osteoporosis and increased risk of falling.
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Affiliation(s)
- Michele Aquino
- Department of Health and Sport Sciences, Adelphi University, New York, USA.
| | - Fred J DiMenna
- Department of Health and Sport Sciences, Adelphi University, New York, USA; Division of Endocrinology, Diabetes and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, 10025, USA; Teachers College, Department of Biobehavioral Sciences, Columbia University, New York, USA
| | - John Petrizzo
- Department of Health and Sport Sciences, Adelphi University, New York, USA
| | - Robert M Otto
- Department of Health and Sport Sciences, Adelphi University, New York, USA
| | - John Wygand
- Department of Health and Sport Sciences, Adelphi University, New York, USA
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Geometric and "True" Densitometric Characteristics of Bones in Athletes with Stress Fracture and Menstrual Disturbances: A Systematic Review. Sports Med 2020; 49:1059-1078. [PMID: 31041601 DOI: 10.1007/s40279-019-01109-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND Stress fractures can lead to short- and long-term consequences, impacting participation in sport and general health. Recognizing which skeletal characteristics render bones susceptible to stress fracture may aid stress-fracture prevention. Menstrual disturbances among exercising women are a known risk factor for stress fracture; therefore, assessing skeletal commonalities between women with stress fractures and women with menstrual disturbances may increase our understanding of why menstrual disturbances put athletes at greater risk for stress fracture. Three-dimensional (3D) bone imaging tools provide detailed information about volumetric bone mineral density (vBMD) and bone structure that cannot be obtained using traditional two-dimensional (2D) techniques. OBJECTIVES This systematic review serves to: (1) evaluate the current literature available on vBMD, bone geometry, and bone structure in exercising women with menstrual disturbances and exercising women with stress fractures, and (2) assess the common skeletal characteristics between both conditions. Our aim is to reveal bone properties beyond 2D areal BMD that may indicate increased susceptibility to stress fracture among exercising women with menstrual disturbances. SEARCH METHODS A search of the PubMed/Medline database was completed in May 2018. ELIGIBILITY CRITERIA Eligible articles included those that reported vBMD, bone geometry, or bone structure obtained from 3D imaging techniques or estimated from 2D imaging techniques. Only studies conducted in premenopausal exercising women and girls who had a stress fracture, a menstrual disturbance, or both were included. RESULTS Twenty-four articles met the inclusion criteria. Bone area and cortical thickness at the tibia were identified as altered both in women with menstrual disturbances and in women with stress fractures; however, there was inconsistency in the results observed for all bone parameters. The majority of skeletal parameters of the lower extremities were not significantly different between exercising women with and without stress fractures and between those with and without menstrual disturbances. DISCUSSION Most studies were moderate or low quality based on study design, and only one article combined both conditions to explore vBMD and bone geometry in athletes with menstrual disturbances and a history of stress fracture. These findings highlight the need for more skeletal research on the intersection of these health conditions in exercising women. The lack of observed differences in skeletal parameters suggests that risk factors other than bone geometry and structure may be the primary causes of stress fracture in these women.
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Bernau M, Schrott J, Schwanitz S, Kreuzer LS, Scholz AM. "Sex" and body region effects on bone mineralization in male pigs. Arch Anim Breed 2020; 63:103-111. [PMID: 32318622 PMCID: PMC7163300 DOI: 10.5194/aab-63-103-2020] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 03/02/2020] [Indexed: 11/30/2022] Open
Abstract
Lameness in pigs is one of the major reasons for culling and early losses in
pigs. This can be linked to osteoporosis due to pathologic alterations in
bone mineral density (BMD) or bone mineral content (BMC) and may also be
linked to the sex. Dealing with the ban on piglet castration without
anaesthesia in Germany 2021, we have three male “sex” types: entire
boars (EB), immunocastrated boars (IB), and surgically castrated boars (SB).
The hypothesis of the present study is that BMC or BMD varies between different
male sex types. If sex has an effect on bone mineralization
(BMC or BMD) and if this affects leg health, it could result in more lameness
and problems during fattening in the negatively affected sex type. The
present study evaluated bone mineralization (in terms of BMD and BMC) and
body composition traits using dual-energy X-ray absorptiometry (DXA) three
times during growth at 30, 50, and 90 kg live body weight. Nine body regions
were analysed for bone mineral traits and compared for different male sex
types and the fattening season. Significant differences were found
regarding BMD (and BMC) among EB, IB, and SB for whole-body BMD (BMC).
Additionally significant differences were found in the front and lower hind
limbs, where SB showed a significantly higher BMD compared to EB, with IB
in between. Additionally regional differences were detected among the groups.
Further studies are needed to evaluate the effect of these differences in
bone mineralization on leg health.
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Affiliation(s)
- Maren Bernau
- Livestock Center Oberschleissheim of the Veterinary Faculty, Ludwig-Maximilians-Universität München, St. Hubertusstrasse 12, 85764 Oberschleissheim, Germany.,Faculty of Agriculture, Economics and Management, Nuertingen-Geislingen University, Neckarsteige 6-10, 72622 Nürtingen, Germany
| | - Juliane Schrott
- Livestock Center Oberschleissheim of the Veterinary Faculty, Ludwig-Maximilians-Universität München, St. Hubertusstrasse 12, 85764 Oberschleissheim, Germany
| | - Sebastian Schwanitz
- Livestock Center Oberschleissheim of the Veterinary Faculty, Ludwig-Maximilians-Universität München, St. Hubertusstrasse 12, 85764 Oberschleissheim, Germany
| | - Lena Sophie Kreuzer
- Livestock Center Oberschleissheim of the Veterinary Faculty, Ludwig-Maximilians-Universität München, St. Hubertusstrasse 12, 85764 Oberschleissheim, Germany
| | - Armin Manfred Scholz
- Livestock Center Oberschleissheim of the Veterinary Faculty, Ludwig-Maximilians-Universität München, St. Hubertusstrasse 12, 85764 Oberschleissheim, Germany
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Chang R, Ma X, Jiang Y, Huang D, Chen X, Zhang M, Hao D. Percentage fat fraction in magnetic resonance imaging: upgrading the osteoporosis-detecting parameter. BMC Med Imaging 2020; 20:30. [PMID: 32183731 PMCID: PMC7079407 DOI: 10.1186/s12880-020-00423-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 02/10/2020] [Indexed: 02/05/2023] Open
Abstract
Background Osteoporosis (OP) is a systemic metabolic bone disorder identified as an essential health issue worldwide. Orthopedic imaging approaches were commonly used with some limitations. Thus, our study aimed to investigate the diagnostic value of magnetic resonance spectroscopy (1-H MRS) and m-Dixon-Quant in OP. Methods A total of 76 subjects were enrolled in the study and bone mineral density (BMD) was measured using quantitative computed tomography (QCT). Then, the subjects were divided into three groups according to BMD: normal control group, osteopenia group and OP group. The following parameters were recorded for each patient: gender, age, height, body weight, waist circumference, and hip circumference. Further, the fat fraction percentage (FF%) values were determined by 1-H MRS and m-Dixon-Quant methods. Results In both 1-H MRS and magnetic resonance Imaging (MRI) m-Dixon-Quant, the FF% exhibited a negative correlation with BMD (P < 0.05). The FF% value of the OP group was significantly higher than that of the control group (P < 0.05). In addition, the FF% value in the m-Dixon scans was positively related to age, while BMD showed a negative linear relationship with age (P < 0.0001). Further, females had a significantly higher FF% value compared to males (P < 0.01), and height was correlated with BMD (P < 0.05) but not with FF% (P > 0.05). Conclusions MRI investigations especially FF% value in the m-Dixon-Quant imaging system is correlated with OP. Its diagnostic value remains to be demonstrated on a large prospective cohort of patients. Besides, parameters such as age, gender, and height are important factors for predicting and diagnosing OP.
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Affiliation(s)
- Rong Chang
- Department of Medical Imaging, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Xiaowen Ma
- Department of Medical Imaging, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Yonghong Jiang
- Department of Medical Imaging, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Dageng Huang
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Xiujin Chen
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China
| | - Ming Zhang
- Department of Medical Imaging, First Affiliated Hospital, Medical College Xi'an Jiaotong University, Xi'an, 710061, China.
| | - Dingjun Hao
- Department of Orthopedics, Honghui Hospital, Xi'an Jiaotong University College of Medicine, Xi'an, 710054, China.
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Messina C, Piodi LP, Rinaudo L, Buonomenna C, Sconfienza LM, Vergani L, Ulivieri FM. Reproducibility of DXA-based bone strain index and the influence of body mass: an in vivo study. Radiol Med 2019; 125:313-318. [PMID: 31883053 DOI: 10.1007/s11547-019-01118-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2019] [Accepted: 11/28/2019] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Bone strain index (BSI) is a dual-energy X-ray absorptiometry (DXA)-derived index of bone strength obtained from lumbar densitometric scan. We estimated the reproducibility of BSI in healthy women with different body mass index. METHODS We enrolled postmenopausal women (mean age ± SD: 66 ± 10 years) divided into three groups (A, B and C) according to body mass index (BMI: < 25; 25-29.9; ≥ 30 kg/m2) and two groups (D and E) according to waist circumference (WC: ≤ 88; > 88 cm), each of 30 subjects. They underwent two DXA examinations with in-between repositioning, according to the International Society for Clinical Densitometry guidelines for precision estimation. Bone mineral density (BMD) and BSI were expressed as g/cm2 and absolute value, respectively. The coefficient of variation (CoV) was calculated as the ratio between root-mean-square standard deviation and mean; least significant change percentage (LSC%) as 2.77 × CoV; reproducibility as the complement to 100% LSC. RESULTS BSI increased proportionally to BMI and WC and significantly in group C compared to B and A (p = 0.032 and 0.006, respectively). BSI was significantly higher in E compared to D (p = 0.017), whereas no differences were observed in BMD. Although BSI reproducibility was slightly lower in group C (89%), the differences were not significant between all groups. BMD reproducibility did not significantly differ between all groups. CONCLUSIONS BSI reproducibility was significantly lower than that of BMD and decreased proportionally to BMI and WC increase. This reduction of BSI reproducibility was more pronounced in patients with BMI ≥ 30 and WC > 88, as expected, being BSI a parameter sensible to weight.
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Affiliation(s)
- Carmelo Messina
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal, 36, 20100, Milan, Italy
| | - Luca Petruccio Piodi
- Gastroenterologia ed Endoscopia Digestiva, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy
| | - Luca Rinaudo
- TECHNOLOGIC Srl, Lungo Dora Voghera 34/36, 10153, Turin, Italy
| | - Ciriaco Buonomenna
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono 7, 20122, Milan, Italy
| | - Luca Maria Sconfienza
- IRCCS Istituto Ortopedico Galeazzi, Via Riccardo Galeazzi 4, 20161, Milan, Italy.,Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano, Via Pascal, 36, 20100, Milan, Italy
| | - Laura Vergani
- Dipartimento di Ingegneria Meccanica, Politecnico di Milano, Via Giuseppe La Masa 1, 20156, Milan, Italy
| | - Fabio Massimo Ulivieri
- Medicina Nucleare, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Via Francesco Sforza 35, 20122, Milan, Italy.
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Comparative evaluation of bone microstructure in alveolar cleft repair by cone beam CT: influence of different autologous donor sites and additional application of β-tricalcium phosphate. Clin Oral Investig 2019; 24:2789-2797. [PMID: 31707628 DOI: 10.1007/s00784-019-03142-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Accepted: 10/30/2019] [Indexed: 10/25/2022]
Abstract
OBJECTIVES This study used cone beam computed tomography (CBCT) images to comparatively evaluate the three-dimensional microstructural features of reconstructed bone bridge based on the bone harvesting site and the presence/absence of artificial bone material, as well as the features of regenerated bone tissue after bone harvesting from mandibular symphysis in secondary alveolar bone grafting (SABG) for patients with cleft lip, with or without cleft palate. MATERIALS AND METHODS Thirty-one patients were divided into three groups in which SABG was performed by autologous bone harvesting from iliac crest (IC), mandibular symphysis (MS), or MS combined with β-TCP granules (MS+TCP). The microstructural trabecular bone parameters (TBPs) and bone structure indexes (SIs) were analyzed using datasets of CBCT images taken before and after SABG. RESULTS TBPs showed differences between IC and MS groups (P < 0.05), resulting in greater values of bone volume density (P < 0.05) and inferior value of TBPf (P = 0.070) in IC group compared with MS group. Using MS+TCP or filling β-TCP granules into donor site significantly improved reconstructed or regenerated BV/TV and Tb.Th (P < 0.05) compared with group without β-TCP. CONCLUSIONS Microstructural characteristics of reconstructed bone bridge were dependent on the donor site of bone harvesting; using an absorbable bone conductive material improved bone quality and increased bone volume density. CLINICAL RELEVANCE Application of β-TCP granules as a partial alternative with autologous bone from mandibular symphysis could obtain comparable outcomes in the microstructure of bone bridge to SABG with autologous iliac crest.
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26
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Grover K, Hu M, Lin L, Muir J, Qin YX. Functional disuse initiates medullary endosteal micro-architectural impairment in cortical bone characterized by nanoindentation. J Bone Miner Metab 2019; 37:1048-1057. [PMID: 31292723 DOI: 10.1007/s00774-019-01011-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 05/16/2019] [Indexed: 01/22/2023]
Abstract
In this study, we evaluated the effect of functional disuse-induced bone remodeling on its mechanical properties, individually at periosteum and medullary endosteum regions of the cortical bone. Left middle tibiae were obtained from 5-month-old female Sprague-Dawley rats for the baseline control as well as hindlimb suspended (disuse) groups. Micro-nano-mechanical elastic moduli (at lateral region) was evaluated along axial (Z), circumferential (C) and radial (R) orientations using nanoindentation. Results indicated an anisotropic microstructure with axial orientation having the highest and radial orientation with the lowest moduli at periosteum and medullary endosteum for both baseline control as well as disuse groups. Between the groups: at periosteum, an insignificant difference was evaluated for each of the orientations (p > 0.05) and at endosteum, a significant decrease of elastic moduli in the radial (p < 0.0001), circumferential (p < 0.001) and statistically insignificant difference in axial (p > 0.05) orientation. For the moduli ratios between groups: at periosteum, only significant difference in the Z/R (p < 0.05) anisotropy ratio, whereas at endosteum, a statistically significant difference in Z/C (p < 0.001), and Z/R (p < 0.001), as well as C/R (p < 0.05) anisotropy ratios, was evaluated. The results suggested initial bone remodeling impaired bone micro-architecture predominantly at the medullary endosteum with possible alterations in the geometric orientations of collagen and mineral phases inside the bone. The findings could be significant for studying the mechanotransduction pathways involved in maintaining the bone micro-architecture and possibly have high clinical significance for drug use against impairment from functional disuse.
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Affiliation(s)
- Kartikey Grover
- Department of Biomedical Engineering, SUNY Stony Brook University, 215 Bioengineering Building, Stony Brook, New York, 11794, USA
| | - Minyi Hu
- Department of Biomedical Engineering, SUNY Stony Brook University, 215 Bioengineering Building, Stony Brook, New York, 11794, USA
| | - Liangjun Lin
- Department of Biomedical Engineering, SUNY Stony Brook University, 215 Bioengineering Building, Stony Brook, New York, 11794, USA
| | - Jesse Muir
- Department of Biomedical Engineering, SUNY Stony Brook University, 215 Bioengineering Building, Stony Brook, New York, 11794, USA
| | - Yi-Xian Qin
- Department of Biomedical Engineering, SUNY Stony Brook University, 215 Bioengineering Building, Stony Brook, New York, 11794, USA.
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27
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Schoell SL, Beavers KM, Beavers DP, Lenchik L, Marsh AP, Rejeski WJ, Stitzel JD, Weaver AA. Prediction of lumbar vertebral body compressive strength of overweight and obese older adults using morphed subject-specific finite-element models to evaluate the effects of weight loss. Aging Clin Exp Res 2019; 31:491-501. [PMID: 30043314 DOI: 10.1007/s40520-018-1010-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Accepted: 07/13/2018] [Indexed: 12/23/2022]
Abstract
BACKGROUND Diet and exercise can promote weight loss in older adults; however, there is potential to increase fracture risk due to loss of bone mineral density (BMD) known to accompany weight loss. Weight loss effects on measures of bone quality and strength are currently unknown. AIMS The purpose of this study is to develop subject-specific finite-element (FE) models of the lumbar spine and study the effect of intentional weight loss on bone strength in a pilot data set. METHODS Computed tomography (CT) scans of the lumbar spine of 30 overweight and obese (mean BMI = 29.7 ± 3.9 kg/m2), older adults (mean age = 65.9 ± 4.6 years) undergoing an 18-month intentional weight loss intervention were obtained at baseline and post-intervention. Measures of volumetric BMD (vBMD) and variable cortical thickness were derived from each subject CT scan. Development of the subject-specific FE models of the lumbar spine involved model morphing techniques to accelerate the development of the models. vBMD-derived material properties and cortical thickness measures were directly mapped to baseline and post-intervention models. Bone strength was estimated through simulation of a quasi-static uniaxial compression test. RESULTS From baseline to 18-month post-weight loss intervention, there were statistically significant decreases in estimated bone strength (6.5% decrease; p < 0.05). Adjusting for baseline bone measures and gender revealed no statistically significant correlations between weight change and change in vBMD, cortical thickness, or bone strength. CONCLUSION Integration of CT-based measures and FE models with conventional areal BMD can improve the understanding of the effects of intentional weight loss on bone health.
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Affiliation(s)
- Samantha L Schoell
- Department of Biomedical Engineering, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Kristen M Beavers
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Daniel P Beavers
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Leon Lenchik
- Department of Radiology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Anthony P Marsh
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - W Jack Rejeski
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Joel D Stitzel
- Department of Biomedical Engineering, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Ashley A Weaver
- Department of Biomedical Engineering, Medical Center Blvd, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
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Nijhuis WH, Eastwood DM, Allgrove J, Hvid I, Weinans HH, Bank RA, Sakkers RJ. Current concepts in osteogenesis imperfecta: bone structure, biomechanics and medical management. J Child Orthop 2019; 13:1-11. [PMID: 30838070 PMCID: PMC6376438 DOI: 10.1302/1863-2548.13.180190] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
The majority of patients with osteogenesis imperfecta (OI) have mutations in the COL1A1 or COL1A2 gene, which has consequences for the composition of the bone matrix and bone architecture. The mutations result in overmodified collagen molecules, thinner collagen fibres and hypermineralization of bone tissue at a bone matrix level. Trabecular bone in OI is characterized by a lower trabecular number and connectivity as well as a lower trabecular thickness and volumetric bone mass. Cortical bone shows a decreased cortical thickness with less mechanical anisotropy and an increased pore percentage as a result of increased osteocyte lacunae and vascular porosity. Most OI patients have mutations at different locations in the COL1 gene. Disease severity in OI is probably partly determined by the nature of the primary collagen defect and its location with respect to the C-terminus of the collagen protein. The overall bone biomechanics result in a relatively weak and brittle structure. Since this is a result of all of the above-mentioned factors as well as their interactions, there is considerable variation between patients, and accurate prediction on bone strength in the individual patient with OI is difficult. Current treatment of OI focuses on adequate vitamin-D levels and interventions in the bone turnover cycle with bisphosphonates. Bisphosphonates increase bone mineral density, but the evidence on improvement of clinical status remains limited. Effects of newer drugs such as antibodies against RANKL and sclerostin are currently under investigation. This paper was written under the guidance of the Study Group Genetics and Metabolic Diseases of the European Paediatric Orthopaedic Society.
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Affiliation(s)
- W. H. Nijhuis
- Department of Orthopaedic Surgery, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, The Netherlands
| | - D. M. Eastwood
- Department of Orthopaedic Surgery, Great Ormond Street Hospital, London, United Kingdom
| | - J. Allgrove
- Department of Endocrinology, Great Ormond Street Hospital, London, United Kingdom
| | - I. Hvid
- Department of Orthopaedic Surgery, Oslo University Hospital, Norway
| | - H. H. Weinans
- Department of Orthopaedic Surgery, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, The Netherlands and Technical University, Delft, The Netherlands
| | - R. A. Bank
- Department of Pathology and Medical Biology, University Medical Centre Groningen, The Netherlands
| | - R. J. Sakkers
- Department of Orthopaedic Surgery, University Medical Centre Utrecht, Wilhelmina Children’s Hospital, The Netherlands, Correspondence should be sent to R. Sakkers, MD, PhD, Department of Orthopaedic Surgery University Medical Centre Utrecht, Wilhelmina Children’s Hospital, Lundlaan 6, 3548EA Utrecht, The Netherlands. E-mail:
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Fourier Transform Infrared Spectroscopy of Bone Tissue: Bone Quality Assessment in Preclinical and Clinical Applications of Osteoporosis and Fragility Fracture. Clin Rev Bone Miner Metab 2019. [DOI: 10.1007/s12018-018-9255-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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30
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Zhu M, Hao G, Xing J, Hu S, Geng D, Zhang W, Wang Q, Hu C, Wang X. Bone marrow adipose amount influences vertebral bone strength. Exp Ther Med 2018; 17:689-694. [PMID: 30651851 PMCID: PMC6307407 DOI: 10.3892/etm.2018.7003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 11/08/2018] [Indexed: 11/06/2022] Open
Abstract
Association of bone marrow adipose and microstructure with bone strength in osteoporotic rats using MR Dixon analysis and micro-CT was evaluated. A total of 40 female Sprague-Dawley rats (6-month-old) were divided randomly into sham-operated (SHAM, n=20) group and ovariectomized (OVX, n=20) group. Fat fraction (FF) was measured by two-point Dixon method with MR imaging at the baseline, 4th, 8th and 12th week, respectively. After sacrifice by anesthesia, the fifth lumbar vertebrae bone was sampled for micro-CT scanning. The biomechanical analysis was also performed. FF in osteoporotic rats significantly increases with time, which correlates with bone microstructure parameters. Compared with biomechanical test, FF showed negative correlation with break stress and elastic modulus. It also suggested that loss of bone mass was accompanied with the increase of adipose tissue content in vertebrae bone marrow. The impairment of bone strength leads to the risk of brittle fracture. In conclusion, the bone marrow adipose amount obtained by MR Dixon and microstructure by micro-CT correlates to bone strength in osteoporotic rats.
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Affiliation(s)
- Mo Zhu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Guangyu Hao
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Jianming Xing
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Su Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Dechun Geng
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Wen Zhang
- Department of Orthopedic, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Qianqian Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Chunhong Hu
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
| | - Ximing Wang
- Department of Radiology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu 215006, P.R. China
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Kaiser J, Allaire B, Fein PM, Lu D, Jarraya M, Guermazi A, Demissie S, Samelson EJ, Bouxsein ML, Morgan EF. Correspondence between bone mineral density and intervertebral disc degeneration across age and sex. Arch Osteoporos 2018; 13:123. [PMID: 30421154 PMCID: PMC6291246 DOI: 10.1007/s11657-018-0538-1] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Accepted: 10/24/2018] [Indexed: 02/03/2023]
Abstract
The distribution of bone tissue within the vertebra can modulate vertebral strength independently of average density and may change with age and disc degeneration. Our results show that the age-associated decrease in bone density is spatially non-uniform and associated with disc health, suggesting a mechanistic interplay between disc and vertebra. PURPOSE While the decline of bone mineral density (BMD) in the aging spine is well established, the extent to which age influences BMD distribution within the vertebra is less clear. Measures of regional BMD (rBMD) may improve predictions of vertebral strength and suggest how vertebrae might adapt with intervertebral disc degeneration. Thus, we aimed to assess how rBMD values were associated with age, sex, and disc height loss (DHL). METHODS We measured rBMD in the L3 vertebra of 377 participants from the Framingham Heart Study (41-83 years, 181 M/196 F). Integral (Int.BMD) and trabecular BMD (Tb.BMD) were measured from QCT images. rBMD ratios (anterior/posterior, superior/mid-transverse, inferior/mid-transverse, and central/outer) were calculated from the centrum. A radiologist assigned a DHL severity score to adjacent intervertebral discs (L2-L3 and L3-L4). RESULTS Int.BMD and Tb.BMD were both associated with age, though the decrease across age was greater in women (Int.BMD, - 2.6 mg/cm3 per year; Tb.BMD, - 2.6 mg/cm3 per year) than men (Int.BMD, - 0.5 mg/cm3 per year; Tb.BMD, - 1.2 mg/cm3 per year). The central/outer (- 0.027/decade) and superior/mid-transverse (- 0.018/decade) rBMD ratios were negatively associated with age, with similar trends in men and women. Higher Int.BMD or Tb.BMD was associated with increased odds of DHL after adjusting for age and sex. Low central/outer ratio and high anterior/poster and superior/mid-transverse ratios were also associated with increased odds of DHL. CONCLUSIONS Our results indicate that the distribution of bone within the L3 vertebra is different across age, but not between sexes, and is associated with disc degeneration.
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Affiliation(s)
- Jarred Kaiser
- Department of Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA, 02215, USA.
| | - Brett Allaire
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Paul M Fein
- Department of Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA, 02215, USA
| | - Darlene Lu
- Department of Biostatistics, Boston University, Boston, MA, USA
| | - Mohamed Jarraya
- Boston University School of Medicine, Boston, MA, USA
- Department of Radiology, Mercy Catholic Medical Center, Darby, PA, USA
| | - Ali Guermazi
- Boston University School of Medicine, Boston, MA, USA
| | | | - Elizabeth J Samelson
- Institute for Aging Research, Hebrew Senior Life, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Mary L Bouxsein
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Dept of Orthopedic Surgery, Harvard Medical School, Boston, MA, USA
| | - Elise F Morgan
- Department of Mechanical Engineering, Boston University, 110 Cummington Street, Boston, MA, 02215, USA
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32
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Solitro GF, Mainnemare F, Amirouche F, Mehta A. A novel technique with reduced computed tomography exposure to predict vertebral compression fracture: a finite element study based on rat vertebrae. Med Biol Eng Comput 2018; 57:795-805. [PMID: 30402789 DOI: 10.1007/s11517-018-1918-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 10/21/2018] [Indexed: 10/27/2022]
Abstract
Vertebral compression fractures are a significant clinical issue with an annual incidence of approximately 750,000 cases in the USA alone. Mechanical properties of vertebrae are successfully evaluated through finite element (FE) models based on vertebrae CT. However, clinical drawbacks associated to radiation transmission encouraged to explore the possibility to use selected or reduced portions of the vertebra. The objective of our study was to develop a new procedure to predict vertebral compression fracture from sub-volumes. We reconstructed rat vertebras from micro-CT of thoracic and lumbar groups. Each vertebra was partitioned into three sub-volumes of different axial thickness. FE simulating compression tests were performed on each model to evaluate their failure load and stiffness. Using a power function, a high correlation was found for stiffness and strength. The sub-volume with three fifths thickness had a failure load of 180.7 ± 19.2 N for thoracic and of 209.5 ± 27.4 N for the lumbar vertebra. These values were not significantly different from the values found for the entire vertebra (p > 0.05). Based on our findings, failure loads and stiffnesses obtained with reduced CT scans can be successfully used to predict full vertebral failure. This sub-region analysis and power relationship suggests that one can limit radiation exposure to patients when bone characterization is needed. Graphical abstract Estimated mechanical properties in relation to the extent of the computed tomography reconstruction.
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Affiliation(s)
- Giovanni F Solitro
- Department of Orthopaedics, University of Illinois at Chicago, 835 S. Wolcott Avenue, Room E270, Chicago, IL, 60612, USA.,Department of Orthopaedic Surgery, Louisiana State University Health Science Center of Shreveport, 1501 Kings Hwy, Room 3-317, Shreveport, LA, 71104, USA
| | - Florian Mainnemare
- Department of Mechanical Engineering, ENS Cachan, Université Paris-Saclay, 61 Avenue du Président Wilson, 94235, Cachan, France
| | - Farid Amirouche
- Department of Orthopaedics, University of Illinois at Chicago, 835 S. Wolcott Avenue, Room E270, Chicago, IL, 60612, USA.
| | - Ankit Mehta
- Department of Neurosurgery, University of Illinois at Chicago, 912 S Wood St, Chicago, IL, USA
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Fatima N, Zaman MU, Saleem S, Hameed N, Bano J. Discordant interpretation of serial bone mineral density measurements by dual-energy X-ray absorptiometry using vendor's and institutional least significant changes: Serious impact on decision-making. World J Nucl Med 2018; 17:236-240. [PMID: 30505220 PMCID: PMC6216730 DOI: 10.4103/wjnm.wjnm_69_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Meaningful change in bone mineral density (BMD) should be equal or higher than institutional least significant change (LSC). But some facilities use vendor's LSC which is discouraged by International Society for Clinical Densitometry (ISCD). The aim of this study was to find the impact of scan interpretation upon interval BMD changes using vendors and institutional LSCs. This prospective study was conducted at Joint Commission International-accredited facility of Pakistan from April–June 2017 using Hologic Discovery-A scanner. As per ISCD recommendations, precision error and LSC of two technologists were measured. Serial BMD changes such as deterioration or improvement interpreted based on vendor's and institutional LSCs were compared. Serial BMD changes in 102 patients were included, having a mean age, male:female ratio, and mean body mass index of 63 years, 94%:06%, and 29.274 kg/m2, respectively. Mean menopausal age was 47 years and mean duration between two dual X-ray absorptiometry (DXA) studies was 3 years. BMD changes over hip were found significant in 55% and 53% cases against vendor's and institutional LSCs, respectively (nonsignificant discordance in 2%). BMD changes using vendor's and institutional LSCs were found significant over L1-4 (62% vs. 46%; discordance: 14%) and distal forearm (77% vs. 35%; discordance: 41%), respectively. Interpretations based on vendor's LSCs revealed significantly overestimated deterioration over forearm and improvement over L1-4 BMD values. We conclude that vendor's provided LSC for interpretation of serial DXA is misleading and has a significant negative impact upon patients' management. Every DXA facility must use its own LSC as per ISCD guidelines. Furthermore, ISCD must consider publishing cutoff values for LSC for distal forearm measurement.
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Affiliation(s)
- Nosheen Fatima
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Maseeh Uz Zaman
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Sadaf Saleem
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Noureen Hameed
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Jamila Bano
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
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Szulc P, Boutroy S, Chapurlat R. Prediction of Fractures in Men Using Bone Microarchitectural Parameters Assessed by High-Resolution Peripheral Quantitative Computed Tomography-The Prospective STRAMBO Study. J Bone Miner Res 2018; 33:1470-1479. [PMID: 29694676 DOI: 10.1002/jbmr.3451] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/09/2018] [Accepted: 04/15/2018] [Indexed: 12/31/2022]
Abstract
Areal bone mineral density (aBMD) poorly identifies men at high fracture risk. Our aim was to assess prediction of fractures in men by bone microarchitectural measures. At baseline, 825 men aged 60 to 87 years had the assessment of bone microarchitecture at distal radius and distal tibia by high-resolution peripheral QCT (HR-pQCT; XtremeCT-I, Scanco Medical, Brüttisellen, Switzerland). Bone strength was estimated by micro-finite element analysis. During the prospective 8-year follow-up, 105 men sustained fractures (59 vertebral fractures in 49 men and 70 nonvertebral fractures in 68 men). After adjustment for age, body mass index (BMI), prior falls, and fractures, most HR-pQCT measures at both skeletal sites predicted fractures. After further adjustment for aBMD, low distal radius trabecular number (Tb.N) was most strongly associated with higher fracture risk (hazard ratio [HR] = 1.63 per SD, 95% confidence interval [CI] 1.31-2.03, p < 0.001). In similar models, low Tb.N was associated with higher risk of major osteoporotic fracture (HR = 1.80 per SD, p < 0.001), vertebral fracture (HR = 1.78 per SD, p < 0.01) and nonvertebral fracture (HR = 1.46 per SD, p < 0.01). In comparison with the reference model (age, BMI, falls, fractures, aBMD), the adjustment for distal radius Tb.N increased the estimated fracture probability in men who sustained fractures versus those who did not have ones (difference = 4.1%, 95% CI 1.9-6.3%, p < 0.001). However, the adjustment for distal radius Tb.N did not increase the area under the curve (AUC, p = 0.37). Similar results were found for distal radius trabecular separation (Tb.Sp) and connectivity density (Conn. D). They were predictive of all fracture types and increased the estimated fracture risk, but not AUC, in men who had incident fractures. Thus, poor distal radius trabecular microarchitecture is predictive of fracture after adjustment for age, BMI, falls, fractures, and aBMD. Although distal radius Tb.N, Conn. D, and Tb.Sp improve the discrimination between men who will or who will not have fracture, they do not provide clinically relevant improvement of fracture prediction in older men. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Stéphanie Boutroy
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, Lyon, France
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Cosman F, Crittenden DB, Ferrari S, Khan A, Lane NE, Lippuner K, Matsumoto T, Milmont CE, Libanati C, Grauer A. FRAME Study: The Foundation Effect of Building Bone With 1 Year of Romosozumab Leads to Continued Lower Fracture Risk After Transition to Denosumab. J Bone Miner Res 2018; 33:1219-1226. [PMID: 29573473 DOI: 10.1002/jbmr.3427] [Citation(s) in RCA: 84] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Revised: 03/08/2018] [Accepted: 03/15/2018] [Indexed: 11/06/2022]
Abstract
Romosozumab is a bone-forming agent with a dual effect of increasing bone formation and decreasing bone resorption. In FRActure study in postmenopausal woMen with ostEoporosis (FRAME), postmenopausal women with osteoporosis received romosozumab 210 mg s.c. or placebo once monthly for 12 months, followed by denosumab 60 mg s.c. once every 6 months in both groups for 12 months. One year of romosozumab increased spine and hip BMD by 13% and 7%, respectively, and reduced vertebral and clinical fractures with persistent fracture risk reduction upon transition to denosumab over 24 months. Here, we further characterize the BMD gains with romosozumab by quantifying the percentages of patients who responded at varying magnitudes; report the mean T-score changes from baseline over the 2-year study and contrast these results with the long-term BMD gains seen with denosumab during Fracture REduction Evaluation of Denosumab in Osteoporosis every 6 Months (FREEDOM) and its Extension studies; and assess fracture incidence rates in year 2, when all patients received denosumab. Among 7180 patients (n = 3591 placebo, n = 3589 romosozumab), most romosozumab-treated patients experienced ≥3% gains in BMD from baseline at month 12 (spine, 96%; hip, 78%) compared with placebo (spine, 22%; hip, 16%). For romosozumab patients, mean absolute T-score increases at the spine and hip were 0.88 and 0.32, respectively, at 12 months (placebo: 0.03 and 0.01) and 1.11 and 0.45 at 24 months (placebo-to-denosumab: 0.38 and 0.17), with the 2-year gains approximating the effect of 7 years of continuous denosumab administration. Patients receiving romosozumab versus placebo in year 1 had significantly fewer vertebral fractures in year 2 (81% relative reduction; p < 0.001), with fewer fractures consistently observed across other fracture categories. The data support the clinical benefit of rebuilding the skeletal foundation with romosozumab before transitioning to antiresorptive therapy. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Felicia Cosman
- Helen Hayes Hospital, West Haverstraw, NY, USA.,College of Physician and Surgeons, Columbia University, New York, NY, USA
| | | | | | - Aliya Khan
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - Nancy E Lane
- Center for Musculoskeletal Health, UC Davis Medical Center, UC Davis, Sacramento, CA, USA
| | - Kurt Lippuner
- Department of Osteoporosis, Bern University Hospital, University of Bern, Switzerland
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36
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Time to rethink the use of bone biopsy to prevent fractures in patients with chronic kidney disease. Curr Opin Nephrol Hypertens 2018; 27:243-250. [DOI: 10.1097/mnh.0000000000000418] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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37
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West SL, Rajapakse CS, Rayner T, Miller R, Slinger MA, Wells GD. The reproducibility of measuring trabecular bone parameters using a commercially available high-resolution magnetic resonance imaging approach: A pilot study. Bone Rep 2018; 8:180-186. [PMID: 29955637 PMCID: PMC6020268 DOI: 10.1016/j.bonr.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2017] [Revised: 04/09/2018] [Accepted: 04/23/2018] [Indexed: 02/02/2023] Open
Abstract
Bone imaging is currently the best non-invasive way to assess changes to bone associated with aging or chronic disease. However, common imaging techniques such as dual energy x-ray absorptiometry are associated with limitations. Magnetic resonance imaging (MRI) is a radiation-free technique that can measure bone microarchitecture. However, published MRI bone assessment protocols use specialized MRI coils and sequences and therefore have limited transferability across institutions. We developed a protocol on a Siemens 3 Tesla MRI machine, using a commercially available coil (Siemens 15 CH knee coil), and manufacturer supplied sequences to acquire images at the tibia. We tested the reproducibility of the FSE and the GE Axial sequences and hypothesized that both would generate reproducible trabecular bone parameters. Eight healthy adults (age 25.5 ± 5.4 years) completed three measurements of each MRI sequence at the tibia. Each of the images was processed for 8 different bone parameters (such as volumetric bone volume fraction). We computed the coefficient of variation (CV) and intraclass correlation coefficients (ICC) to assess reproducibility and reliability. Both sequences resulted in trabecular parameters that were reproducible (CV <5% for most) and reliable (ICC >80% for all). Our study is one of the first to report that a commercially available MRI protocol can result in reproducible data, and is significant as MRI may be an accessible method to measure bone microarchitecture in clinical or research environments. This technique requires further testing, including validation and evaluation in other populations. Trabecular bone is difficult to measure using commercial MRI techniques Reproducibility of a MRI protocol measuring trabecular bone was assessed Tibia trabecular bone was reproducible using a knee coil and a FSE Axial sequence Tibia trabecular bone was reproducible using a knee coil and a GE Axial sequence
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Affiliation(s)
- Sarah L West
- Department of Biology, Trent/Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada.,Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Chamith S Rajapakse
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Tammy Rayner
- Radiology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Rhiannon Miller
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Michelle A Slinger
- Department of Radiology, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.,Department of Orthopaedic Surgery, University of Pennsylvania School of Medicine, Philadelphia, PA, USA
| | - Greg D Wells
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.,Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Ontario, Canada
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Alomari AH, Wille ML, Langton CM. Bone volume fraction and structural parameters for estimation of mechanical stiffness and failure load of human cancellous bone samples; in-vitro comparison of ultrasound transit time spectroscopy and X-ray μCT. Bone 2018; 107:145-153. [PMID: 29198979 DOI: 10.1016/j.bone.2017.11.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/07/2017] [Accepted: 11/29/2017] [Indexed: 11/30/2022]
Abstract
Conventional mechanical testing is the 'gold standard' for assessing the stiffness (N mm-1) and strength (MPa) of bone, although it is not applicable in-vivo since it is inherently invasive and destructive. The mechanical integrity of a bone is determined by its quantity and quality; being related primarily to bone density and structure respectively. Several non-destructive, non-invasive, in-vivo techniques have been developed and clinically implemented to estimate bone density, both areal (dual-energy X-ray absorptiometry (DXA)) and volumetric (quantitative computed tomography (QCT)). Quantitative ultrasound (QUS) parameters of velocity and attenuation are dependent upon both bone quantity and bone quality, although it has not been possible to date to transpose one particular QUS parameter into separate estimates of quantity and quality. It has recently been shown that ultrasound transit time spectroscopy (UTTS) may provide an accurate estimate of bone density and hence quantity. We hypothesised that UTTS also has the potential to provide an estimate of bone structure and hence quality. In this in-vitro study, 16 human femoral bone samples were tested utilising three techniques; UTTS, micro computed tomography (μCT), and mechanical testing. UTTS was utilised to estimate bone volume fraction (BV/TV) and two novel structural parameters, inter-quartile range of the derived transit time (UTTS-IQR) and the transit time of maximum proportion of sonic-rays (TTMP). μCT was utilised to derive BV/TV along with several bone structure parameters. A destructive mechanical test was utilised to measure the stiffness and strength (failure load) of the bone samples. BV/TV was calculated from the derived transit time spectrum (TTS); the correlation coefficient (R2) with μCT-BV/TV was 0.885. For predicting mechanical stiffness and strength, BV/TV derived by both μCT and UTTS provided the strongest correlation with mechanical stiffness (R2=0.567 and 0.618 respectively) and mechanical strength (R2=0.747 and 0.736 respectively). When respective structural parameters were incorporated to BV/TV, multiple regression analysis indicated that none of the μCT histomorphometric parameters could improve the prediction of mechanical stiffness and strength, while for UTTS, adding TTMP to BV/TV increased the prediction of mechanical stiffness to R2=0.711 and strength to R2=0.827. It is therefore envisaged that UTTS may have the ability to estimate BV/TV along with providing an improved prediction of osteoporotic fracture risk, within routine clinical practice in the future.
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Affiliation(s)
- Ali Hamed Alomari
- Science & Engineering Faculty and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia; The University College in Al-Qunfudah, Umm Al-Qura University, Saudi Arabia
| | - Marie-Luise Wille
- Science & Engineering Faculty and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Christian M Langton
- Science & Engineering Faculty and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Laboratory of Ultrasonic Electronics, Doshisha University, Kyotanabe, Japan.
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Jovanovic M, Schmidt FN, Guterman-Ram G, Khayyeri H, Hiram-Bab S, Orenbuch A, Katchkovsky S, Aflalo A, Isaksson H, Busse B, Jähn K, Levaot N. Perturbed bone composition and integrity with disorganized osteoblast function in zinc receptor/Gpr39-deficient mice. FASEB J 2018; 32:2507-2518. [PMID: 29295862 DOI: 10.1096/fj.201700661rr] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Changes in bone matrix composition are frequently found with bone diseases and may be associated with increased fracture risk. Bone is rich in the trace element zinc. Zinc was established to play a significant role in the growth, development, and maintenance of healthy bones; however, the mechanisms underlying zinc effects on the integrity of the skeleton are poorly understood. Here, we show that the zinc receptor (ZnR)/Gpr39 is required for normal bone matrix deposition by osteoblasts. Initial analysis showed that Gpr39-deficient ( Gpr39-/-) mice had weaker bones as a result of altered bone composition. Fourier transform infrared spectroscopy analysis showed high mineral-to-matrix ratios in the bones of Gpr39-/- mice. Histologic analysis showed abnormally high numbers of active osteoblasts but normal osteoclast numbers on the surfaces of bones from Gpr39-/- mice. Furthermore, Gpr39-/- osteoblasts had disorganized matrix deposition in vitro with cultures exhibiting abnormally low collagen and high mineral contents, findings that demonstrate a cell-intrinsic role for ZnR/Gpr39 in these cells. We show that both collagen synthesis and deposition by Gpr39-/- osteoblasts are perturbed. Finally, the expression of the zinc transporter Zip13 and a disintegrin and metalloproteinase with thrombospondin motifs family of zinc-dependent metalloproteases that regulate collagen processing was downregulated in Gpr39-/- osteoblasts. Altogether, our results suggest that zinc sensing by ZnR/Gpr39 affects the expression levels of zinc-dependent enzymes in osteoblasts and regulates collagen processing and deposition.-Jovanovic, M., Schmidt, F. N., Guterman-Ram, G., Khayyeri, H., Hiram-Bab, S., Orenbuch, A., Katchkovsky, S., Aflalo, A., Isaksson, H., Busse, B., Jähn, K., Levaot, N. Perturbed bone composition and integrity with disorganized osteoblast function in zinc receptor/Gpr39-deficient mice.
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Affiliation(s)
- Milena Jovanovic
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Felix N Schmidt
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Gali Guterman-Ram
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hanifeh Khayyeri
- Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - Sahar Hiram-Bab
- Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and
| | - Ayelet Orenbuch
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Svetlana Katchkovsky
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Anastasia Aflalo
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hanna Isaksson
- Department of Biomedical Engineering, Faculty of Engineering, Lund University, Lund, Sweden
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Katharina Jähn
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Noam Levaot
- Department of Physiology and Cell Biology, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.,Regenerative Medicine and Stem Cell Research Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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40
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Mitchell DM, Caksa S, Yuan A, Bouxsein ML, Misra M, Burnett-Bowie SAM. Trabecular Bone Morphology Correlates With Skeletal Maturity and Body Composition in Healthy Adolescent Girls. J Clin Endocrinol Metab 2018; 103:336-345. [PMID: 29121215 PMCID: PMC5761494 DOI: 10.1210/jc.2017-01785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 11/02/2017] [Indexed: 12/28/2022]
Abstract
Context Growth in healthy children is associated with changes in bone density and microarchitecture. Trabecular morphology is an additional important determinant of bone strength, but little is currently known about trabecular morphology in healthy young people. Objective To investigate associations of trabecular morphology with increasing maturity and with body composition in healthy girls. Design Cross-sectional study. Setting Academic research center. Participants Eighty-six healthy girls aged 9 to 18 years. Main Outcome Measures High-resolution peripheral quantitative computed tomography and individual trabecula segmentation were used to assess volumetric bone density, microarchitecture, and trabecular morphology (plate-like vs rod-like) at the distal radius and tibia. Results Plate-like bone volume divided by total volume (pBV/TV) increased statistically significantly at the tibia (R = 0.41, P < 0.001), whereas rod-like BV/TV (rBV/TV) decreased statistically significantly at both the radius and tibia (R = -0.34, P = 0.003 and R = -0.28, P = 0.008, respectively) with increasing bone age. In multivariable models, lean mass positively correlated with pBV/TV and plate number at the radius and with plate thickness at both sites. In contrast, fat mass negatively correlated with plate thickness at the tibia and plate surface at both sites. In addition, fat mass positively correlated with rBV/TV and number at the tibia. pBV/TV at both the distal radius and tibia was positively correlated with spine bone mineral density. Conclusions Increasing maturity across late childhood and adolescence is associated with changes in trabecular morphology anticipated to contribute to bone strength. Body composition correlates with trabecular morphology, suggesting that muscle mass and adiposity in youth may contribute to long-term skeletal health.
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Affiliation(s)
- Deborah M Mitchell
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Signe Caksa
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Amy Yuan
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Mary L Bouxsein
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Center for Advanced Orthopaedic Studies, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, Massachusetts
| | - Madhusmita Misra
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Pediatric Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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Peres-Ueno MJ, Stringhetta-Garcia CT, Castoldi RC, Ozaki GAT, Chaves-Neto AH, Dornelles RCM, Louzada MJQ. Model of hindlimb unloading in adult female rats: Characterizing bone physicochemical, microstructural, and biomechanical properties. PLoS One 2017; 12:e0189121. [PMID: 29228060 PMCID: PMC5724829 DOI: 10.1371/journal.pone.0189121] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Accepted: 11/20/2017] [Indexed: 11/18/2022] Open
Abstract
Prolonged bedrest and microgravity induce alterations to bone, leading to bone fragility and compromising the quality of life. In this study, we characterized the physicochemical changes, microstructure, and biomechanics of the femurs of female adult rats in response to hindlimb unloading for 21 days. Twenty 6-month-old Wistar female rats were distributed into control (CON) and hindlimb unloading (HLU) groups. Analysis the in vivo bone mineral density (BMD) by dual energy x-ray absorptiometry (DXA) from the femurs was performed at the beginning and end of the experiment; plasma levels of calcium, phosphorus, and alkaline phosphatase, tartrate-resistant acid phosphatase activity, assessed by spectrophotometry, and estradiol, measured by enzyme-linked immunosorbent assay, was performed after the experiment. We evaluated changes in the trabecular and cortical structure of the femur, after disuse, by micro-computed tomography with high resolution, for analysis of cortical porosity, Raman spectroscopy to measure the amount of physicochemical properties, and the biomechanical test to estimate the changes in biomechanical properties. Our results demonstrated that, after 21 days, HLU animals had decreased femoral BMD, deteriorated bone microarchitecture, particularly in the cortical compartment, with changes in the physicochemical properties and porosity, and reduced deformation capacity of the bone and resistance to the bone stresses. Nevertheless, this study showed the critical role of mechanical stimulation in maintaining the structure of the skeleton in female adults and that disuse, even for a few days, leads to microscopic changes in the structure of the bone matrix, which increases the risk of fracture.
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Affiliation(s)
- Melise Jacon Peres-Ueno
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- * E-mail:
| | - Camila Tami Stringhetta-Garcia
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Robson Chacon Castoldi
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, UNICAMP-Univ. Estadual de Campinas, Campinas, São Paulo, Brazil
| | - Guilherme Akio Tamura Ozaki
- Department of Orthopedics and Traumatology, Faculty of Medical Sciences, UNICAMP-Univ. Estadual de Campinas, Campinas, São Paulo, Brazil
| | | | - Rita Cássia Menegati Dornelles
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
- Department of Basic Sciences, School of Dentistry, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
| | - Mário Jefferson Quirino Louzada
- Programa de Pós-Graduação Multicêntrico em Ciências Fisiológicas, SBFis, São Paulo State University (UNESP), Araçatuba, São Paulo, Brazil
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Cortical and trabecular morphology is altered in the limb bones of mice artificially selected for faster skeletal growth. Sci Rep 2017; 7:10527. [PMID: 28874773 PMCID: PMC5585176 DOI: 10.1038/s41598-017-10317-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 08/07/2017] [Indexed: 12/26/2022] Open
Abstract
Bone strength is influenced by mineral density and macro- and microstructure. Research into factors that contribute to bone morphology and strength has focused on genetic, environmental and morphological factors (e.g., body mass index), but little is known regarding the impact of rates of skeletal elongation on adult skeletal morphology and strength. Using micro-CT, we examined the impact of rates of skeletal elongation on bone cortical and trabecular morphology, and on rates of estrogen-dependent bone loss in the tibia in CD-1 mice, and in mice with accelerated skeletal growth (Longshanks). Groups of adult mice (n = 7/group) were subjected to ovariectomy or sham surgeries, scanned for 6 weeks, and indices of bone morphology were collected. Results show that Longshanks mice had significantly less trabecular bone at skeletal maturity, characterized by fewer, thinner trabeculae, and furthermore lost trabecular bone more slowly in response to ovariectomy. Artificial selection for rapid skeletal growth relative to somatic growth thus had a significant impact on trabecular bone morphology in Longshanks. Our data do not unequivocally demonstrate a causal relationship between rapid bone growth and reduced trabecular bone quality, but suggest that rapid linear bone growth may influence the risk of cancellous bone fragility.
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Zhang L, Chen X, Wu J, Yuan Y, Guo J, Biswas S, Li B, Zou J. The effects of different intensities of exercise and active vitamin D on mouse bone mass and bone strength. J Bone Miner Metab 2017; 35:265-277. [PMID: 27357401 DOI: 10.1007/s00774-016-0764-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 05/05/2016] [Indexed: 02/07/2023]
Abstract
Physical exercise is beneficial to bone health. However, little is known how different intensities of exercise affect bone mass and strength. In the present study, we used young mice to study the effects of different intensities of exercise on bone mass and bone strength in comparison to pharmacological doses of active vitamin D (calcitriol). We found that only the medium level of exercise tested showed a positive effect on bone mineral density, trabecular bone volume, and bone strength, which are attributable to a decrease in bone resorption and an increase in bone formation, with the latter being accompanied by an increase in the number of osteogenic mesenchymal stem cells in the bone marrow. Calcitriol increases bone volume and bone strength, yet the combination of calcitriol and medium-intensity exercise did not further improve bone mass or strength. Moreover, calcitriol also showed some protective effect on the bone in mice with high levels of exercise. These results indicate that exercise at medium intensity increases bone mass and strength via affecting both bone formation and resorption and that its beneficial effects on bone mass cannot be further improved by calcitriol.
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Affiliation(s)
- Lingli Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Xi Chen
- School of Sports Science, Wenzhou Medical University, Wenzhou, 325035, China
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Juanni Wu
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Yu Yuan
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Jianmin Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai, 200438, China
| | - Soma Biswas
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Bio-X Institutes, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
- School of Pharmacy, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Baojie Li
- Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders, Bio-X Institutes, Ministry of Education, Shanghai Jiao Tong University, Shanghai, 200240, China
| | - Jun Zou
- Scientific Research Department, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China.
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Patsch JM, Rasul S, Huber FA, Leitner K, Thomas A, Kocijan R, Boutroy S, Weber M, Resch H, Kainberger F, Schüller-Weidekamm C, Kautzky-Willer A. Similarities in trabecular hypertrophy with site-specific differences in cortical morphology between men and women with type 2 diabetes mellitus. PLoS One 2017; 12:e0174664. [PMID: 28384358 PMCID: PMC5383225 DOI: 10.1371/journal.pone.0174664] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2016] [Accepted: 03/13/2017] [Indexed: 01/13/2023] Open
Abstract
The goal of our study was to investigate interactions between sex and type 2 diabetes mellitus (T2DM) with regard to morphology of the peripheral skeleton. We recruited 85 subjects (mean age, 57±11.4 years): women with and without T2DM (n = 17; n = 16); and men with and without T2DM (n = 26; n = 26). All patients underwent high-resolution, peripheral, quantitative, computed tomography (HR-pQCT) imaging of the ultradistal radius (UR) and tibia (UT). Local bone geometry, bone mineral density (BMD), and bone microarchitecture were obtained by quantitative analysis of HR-pQCT images. To reduce the amount of data and avoid multi-collinearity, we performed a factor-analysis of HR-pQCT parameters. Based on factor weight, trabecular BMD, trabecular number, cortical thickness, cortical BMD, and total area were chosen for post-hoc analyses. At the radius and tibia, diabetic men and women exhibited trabecular hypertrophy, with a significant positive main effect of T2DM on trabecular number. At the radius, cortical thickness was higher in diabetic subjects (+20.1%, p = 0.003). Interestingly, there was a statistical trend that suggested attenuation of tibial cortical hypertrophy in diabetic men (cortical thickness, pinteraction = 0.052). Moreover, we found an expected sexual dichotomy, with higher trabecular BMD, Tb.N, cortical BMD, Ct.Th, and total area in men than in women (p≤ 0.003) at both measurement sites. Our results suggest that skeletal hypertrophy associated with T2DM is present in men and women, but appears attenuated at the tibial cortex in men.
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Affiliation(s)
- Janina M. Patsch
- Department of Biomedical Imaging and Image-Guided Therapy, Division of General Radiology and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
- * E-mail:
| | - Sazan Rasul
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Nuclear Medicine, Medical University of Vienna, Vienna, Austria
| | - Florian A. Huber
- Department of Biomedical Imaging and Image-Guided Therapy, Division of General Radiology and Pediatric Radiology, Medical University of Vienna, Vienna, Austria
| | - Karoline Leitner
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Anita Thomas
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
| | - Roland Kocijan
- Department of Internal Medicine II, Karl Landsteiner Institute for Rheumatology and Gastroenterology, St. Vincent Hospital Vienna, Vienna, Austria
| | | | - Michael Weber
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Heinrich Resch
- Department of Internal Medicine II, Karl Landsteiner Institute for Rheumatology and Gastroenterology, St. Vincent Hospital Vienna, Vienna, Austria
| | - Franz Kainberger
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Claudia Schüller-Weidekamm
- Department of Biomedical Imaging and Image-Guided Therapy, Division of Neuroradiology and Musculoskeletal Radiology, Medical University of Vienna, Vienna, Austria
| | - Alexandra Kautzky-Willer
- Department of Internal Medicine III, Division of Endocrinology and Metabolism, Gender Medicine Unit, Medical University of Vienna, Vienna, Austria
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Roszko KL, Bi R, Gorvin CM, Bräuner-Osborne H, Xiong XF, Inoue A, Thakker RV, Strømgaard K, Gardella T, Mannstadt M. Knockin mouse with mutant G α11 mimics human inherited hypocalcemia and is rescued by pharmacologic inhibitors. JCI Insight 2017; 2:e91079. [PMID: 28194446 PMCID: PMC5291736 DOI: 10.1172/jci.insight.91079] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Heterotrimeric G proteins play critical roles in transducing extracellular signals generated by 7-transmembrane domain receptors. Somatic gain-of-function mutations in G protein α subunits are associated with a variety of diseases. Recently, we identified gain-of-function mutations in Gα11 in patients with autosomal-dominant hypocalcemia type 2 (ADH2), an inherited disorder of hypocalcemia, low parathyroid hormone (PTH), and hyperphosphatemia. We have generated knockin mice harboring the point mutation GNA11 c.C178T (p.Arg60Cys) identified in ADH2 patients. The mutant mice faithfully replicated human ADH2. They also exhibited low bone mineral density and increased skin pigmentation. Treatment with NPS 2143, a negative allosteric modulator of the calcium-sensing receptor (CASR), increased PTH and calcium concentrations in WT and mutant mice, suggesting that the gain-of-function effect of GNA11R6OC is partly dependent on coupling to the CASR. Treatment with the Gα11/q-specific inhibitor YM-254890 increased blood calcium in heterozygous but not in homozygous GNA11R60C mice, consistent with published crystal structure data showing that Arg60 forms a critical contact with YM-254890. This animal model of ADH2 provides insights into molecular mechanism of this G protein-related disease and potential paths toward new lines of therapy.
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Affiliation(s)
- Kelly L Roszko
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Ruiye Bi
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
- West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Caroline M Gorvin
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, England, United Kingdom
| | - Hans Bräuner-Osborne
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Xiao-Feng Xiong
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Asuka Inoue
- Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
- Japan Science and Technology Agency (JST), Precursory Research for Embryonic Science and Technology (PRESTO), Kawaguchi, Saitama, Japan
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Churchill Hospital, Oxford, England, United Kingdom
| | - Kristian Strømgaard
- Department of Drug Design and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - Thomas Gardella
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Michael Mannstadt
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
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Durosier-Izart C, Biver E, Merminod F, van Rietbergen B, Chevalley T, Herrmann FR, Ferrari SL, Rizzoli R. Peripheral skeleton bone strength is positively correlated with total and dairy protein intakes in healthy postmenopausal women. Am J Clin Nutr 2017; 105:513-525. [PMID: 28077378 DOI: 10.3945/ajcn.116.134676] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 12/05/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Bone mineral content (BMC) and bone mineral density (BMD) are positively correlated with dietary protein intakes, which account for 1-8% of BMC and BMD variances. However, the relation between bone strength and microstructure, which are variables that are not captured by areal bone mineral density (aBMD), and dietary protein intakes, particularly from specific dietary sources, has not been clearly established. OBJECTIVE We investigated the association between the peripheral skeleton-predicted failure load and stiffness, bone microstructure, and dietary protein intakes from various origins (animal, divided into dairy and nondairy, and vegetable origins) in healthy postmenopausal women. DESIGN In a cross-sectional study in 746 Caucasian women aged 65.0 ± 1.4 y, we measured the aBMD with the use of dual-energy X-ray absorptiometry, the distal radius and tibia bone microstructures with the use of high-resolution peripheral quantitative computerized tomography, and bone strength with the use of a finite element analysis, and we evaluated dietary protein and calcium with the use of a validated food-frequency questionnaire. RESULTS Mean dietary calcium and protein intakes were greater than recommended amounts for this class of age. The predicted failure load and stiffness at the distal radius and tibia were positively associated with total, animal, and dairy protein intakes but not with vegetable protein intake. Failure load differences were accompanied by modifications of the aBMD and of cortical and trabecular bone microstructures. The associations remained statistically significant after adjustment for weight, height, physical activity, menopause duration, calcium intake, and the interaction between calcium and protein intake. A principal component analysis of the volumetric BMD and bone microstructure indicated that trabecular bone mainly contributed to the positive association between protein intakes and bone strength. CONCLUSIONS These results, which were recorded in a very homogeneous population of healthy postmenopausal women, indicate that there is a beneficial effect of animal and dairy protein intakes on bone strength and microstructure. Specifically, there is a positive association between the bone failure load and stiffness of the peripheral skeleton and dietary protein intake, which is mainly related to changes in the trabecular microstructure. This trial was registered at www.controlled-trials.com as ISRCTN11865958.
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Affiliation(s)
- Claire Durosier-Izart
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Emmanuel Biver
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Fanny Merminod
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Bert van Rietbergen
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, Netherlands; and
| | - Thierry Chevalley
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - François R Herrmann
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.,Division of Geriatrics, Department of Internal Medicine, Rehabilitation and Geriatrics, Geneva University Hospitals and University of Geneva, Geneva, Switzerland
| | - Serge L Ferrari
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Department of Internal Medicine Specialties, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland;
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Z Movassagh E, Kontulainen S, Baxter-Jones ADG, Whiting S, Szafron M, Papadimitropoulos M, Vatanparast H. Are milk and alternatives and fruit and vegetable intakes during adolescence associated with cortical and trabecular bone structure, density, and strength in adulthood? Osteoporos Int 2017; 28:609-619. [PMID: 27699440 DOI: 10.1007/s00198-016-3775-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/12/2016] [Indexed: 01/11/2023]
Abstract
UNLABELLED We investigated the impact of food group intake during adolescence on bone structure and strength during adulthood. In females, we found a beneficial effect of adolescent milk and alternatives and fruit and vegetable intake on adult radius shaft and distal tibia bone structure, respectively. No association was observed in males. INTRODUCTION The purpose of this study was to investigate whether adolescents with high intake of milk and alternatives (M&A) or fruit and vegetables (F&V) had better adult bone structure and strength compared to those with low intake levels. METHODS We analyzed data from 47 males and 69 females enrolled in the Pediatric Bone Mineral Accrual Study (PBMAS 1991-2011), who had one peripheral quantitative computed tomography scan at age 29 ± 2 years. We measured radius and tibia shaft total area (ToA), cortical area (CoA), cortical content (CoC), cortical density, bone strength (SSIp), and muscle area, as well as distal radius and tibia ToA, total density, trabecular area, trabecular content, trabecular density, and bone strength (BSIc). Sequential 24-h recalls were used to assess M&A and F&V intake; participants were grouped for their mean intake during adolescence (low = bottom quartile, moderate = middle quartiles, high = top quartile) and were compared using multivariate analysis of covariance while adjusting for adult height, muscle area, physical activity, energy and calcium intake and adolescent energy intake, and physical activity. RESULTS Females with high M&A intake compared to low M&A intake group (mean 3.8 vs. 1.3 servings/day, respectively) had greater adult ToA (14 %, p < 0.05), CoA (15 %, p < 0.01), and CoC (16 %, p < 0.01) at radius shaft. Females with moderate F&V intake compared to low F&V intake group (mean 3.7 vs. 2.1 servings/day, respectively) had greater adult ToA (8.5 %, p < 0.05) at distal tibia. CONCLUSION Higher intake of M&A or F&V during adolescence had a long-term beneficial effect on bone structure in females, an association not observed in males.
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Affiliation(s)
- E Z Movassagh
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada
| | - S Kontulainen
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
| | - A D G Baxter-Jones
- College of Kinesiology, University of Saskatchewan, 87 Campus Drive, Saskatoon, SK, S7N5B2, Canada
- College of Graduate Studies and Research, University of Saskatchewan, 105 Administration place, Saskatoon, SK, S7N 5A2, Canada
| | - S Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada
| | - M Szafron
- School of Public Health, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 5E5, Canada
| | - M Papadimitropoulos
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada
| | - H Vatanparast
- College of Pharmacy and Nutrition, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 2Z4, Canada.
- School of Public Health, University of Saskatchewan, 104 Clinic place, Saskatoon, SK, S7N 5E5, Canada.
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Anitha D, Thomas B, Jan KS, Subburaj K. Risk of vertebral compression fractures in multiple myeloma patients: A finite-element study. Medicine (Baltimore) 2017; 96:e5825. [PMID: 28079810 PMCID: PMC5266172 DOI: 10.1097/md.0000000000005825] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to develop and validate a finite element (FE) model to predict vertebral bone strength in vitro using multidetector computed tomography (MDCT) images in multiple myeloma (MM) patients, to serve as a complementing tool to assess fracture risk. In addition, it also aims to differentiate MM patients with and without vertebral compression fractures (VCFs) by performing FE analysis on vertebra segments (T1-L5) obtained from in vivo routine MDCT imaging scans. MDCT-based FE models were developed from the in vitro vertebrae samples and were then applied to the in vivo vertebrae segments of MM patients (n = 4) after validation. Predicted fracture load using FE models correlated significantly with experimentally measured failure load (r = 0.85, P < 0.001). Interestingly, an erratic behavior was observed in patients with fractures (n = 2) and a more gradual change in FE-predicted strength values in patients without fractures (n = 2). Severe geometric deformations were also observed in models that have already attained fractures. Since BMD is not a reliable parameter for fracture risk prediction in MM subjects, it is necessary to use advanced tools such as FE analysis to predict individual fracture risk. If peaks are observed between adjacent segments in an MM patient, it can be safe to conclude that the spine is experiencing regions of structural instability. Such an FE visualization may have therapeutic consequences to prevent MM associated vertebral fractures.
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Affiliation(s)
- D. Anitha
- Engineering Product Development (EPD), Singapore University of Technology and Design (SUTD), Singapore
| | - Baum Thomas
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Kirschke S. Jan
- Department of Radiology, Klinikum rechts der Isar, Technische Universitaet Muenchen, Muenchen, Germany
| | - Karupppasamy Subburaj
- Engineering Product Development (EPD), Singapore University of Technology and Design (SUTD), Singapore
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Wittkowske C, Reilly GC, Lacroix D, Perrault CM. In Vitro Bone Cell Models: Impact of Fluid Shear Stress on Bone Formation. Front Bioeng Biotechnol 2016; 4:87. [PMID: 27896266 PMCID: PMC5108781 DOI: 10.3389/fbioe.2016.00087] [Citation(s) in RCA: 162] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2016] [Accepted: 10/25/2016] [Indexed: 01/06/2023] Open
Abstract
This review describes the role of bone cells and their surrounding matrix in maintaining bone strength through the process of bone remodeling. Subsequently, this work focusses on how bone formation is guided by mechanical forces and fluid shear stress in particular. It has been demonstrated that mechanical stimulation is an important regulator of bone metabolism. Shear stress generated by interstitial fluid flow in the lacunar-canalicular network influences maintenance and healing of bone tissue. Fluid flow is primarily caused by compressive loading of bone as a result of physical activity. Changes in loading, e.g., due to extended periods of bed rest or microgravity in space are associated with altered bone remodeling and formation in vivo. In vitro, it has been reported that bone cells respond to fluid shear stress by releasing osteogenic signaling factors, such as nitric oxide, and prostaglandins. This work focusses on the application of in vitro models to study the effects of fluid flow on bone cell signaling, collagen deposition, and matrix mineralization. Particular attention is given to in vitro set-ups, which allow long-term cell culture and the application of low fluid shear stress. In addition, this review explores what mechanisms influence the orientation of collagen fibers, which determine the anisotropic properties of bone. A better understanding of these mechanisms could facilitate the design of improved tissue-engineered bone implants or more effective bone disease models.
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Affiliation(s)
- Claudia Wittkowske
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Gwendolen C Reilly
- INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK; Department of Material Science, University of Sheffield, Sheffield, UK
| | - Damien Lacroix
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
| | - Cecile M Perrault
- Department of Mechanical Engineering, University of Sheffield, Sheffield, UK; INSIGNEO Institute for in silico Medicine, University of Sheffield, Sheffield, UK
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50
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Long T, Tang T, Hao Y, Zhu Z, Shao L, Liu M. Effect of simvastatin on osteogenesis of the lumbar vertebrae in ovariectomized rats. Exp Ther Med 2016; 12:3951-3957. [PMID: 28105128 PMCID: PMC5228519 DOI: 10.3892/etm.2016.3904] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Accepted: 08/05/2016] [Indexed: 02/06/2023] Open
Abstract
The aim of the present study was to assess the role of simvastatin on osteoporosis of the vertebrae by examining the effect of simvastatin on the osteogenesis of the lumbar vertebra in ovariectomized (OVX) rats. A total of 60 6-month-old female Sprague Dawley rats were divided into one sham group and five ovariectomized groups, consisting of four simvastatin groups and one control group. Four dosages of simvastatin (5, 10, 20 and 40 mg/kg/d) were administered by gavage for three months. L4 vertebrae were examined by dual-energy X-ray absorptiometry (DEXA) and peripheral quantitative computed tomography (pQCT) to determine the mineral apposition rate (MAR). L5 vertebrae were examined using a compression biomechanical test. Although the measurements from DEXA, pQCT and MAR, and the biomechanical parameters in the OVX + simvastatin rats were higher than those for the OVX + vehicle group, no significant differences were detected. Therefore, simvastatin may not improve osteogenesis of the lumbar vertebra in OVX rats or prevent osteoporosis of the spinal vertebrae.
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Affiliation(s)
- Teng Long
- Orthopedic Implant Central Lab, Orthopedic Department, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200011, P.R. China
| | - Tingting Tang
- Orthopedic Implant Central Lab, Orthopedic Department, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200011, P.R. China
| | - Yongqiang Hao
- Orthopedic Implant Central Lab, Orthopedic Department, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200011, P.R. China
| | - Zhenan Zhu
- Orthopedic Implant Central Lab, Orthopedic Department, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200011, P.R. China
| | - Litian Shao
- School of Mathematics and Information Science, Shanghai Lixin University of Commerce, Shanghai 201620, P.R. China
| | - Ming Liu
- Orthopedic Implant Central Lab, Orthopedic Department, Shanghai Ninth People's Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200011, P.R. China
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