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Perut F, Roncuzzi L, Gómez-Barrena E, Baldini N. Association between Bone Turnover Markers and Fracture Healing in Long Bone Non-Union: A Systematic Review. J Clin Med 2024; 13:2333. [PMID: 38673606 PMCID: PMC11051214 DOI: 10.3390/jcm13082333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/15/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Fracture healing is a very complex and well-orchestrated regenerative process involving many cell types and molecular pathways. Despite the high efficiency of this process, unsatisfying healing outcomes, such as non-union, occur for approximately 5-10% of long bone fractures. Although there is an obvious need to identify markers to monitor the healing process and to predict a potential failure in callus formation to heal the fracture, circulating bone turnover markers' (BTMs) utility as biomarkers in association with radiographic and clinical examination still lacks evidence so far. Methods: A systematic review on the association between BTMs changes and fracture healing in long bone non-union was performed following PRISMA guidelines. The research papers were identified via the PubMed, Cochrane, Cinahl, Web of Science, Scopus, and Embase databases. Studies in which the failure of fracture healing was associated with osteoporosis or genetic disorders were not included. Results: A total of 172 studies were collected and, given the inclusion criteria, 14 manuscripts were included in this review. Changes in circulating BTMs levels were detected during the healing process and across groups (healed vs. non-union patients and healthy vs. patients with non-union). However, we found high heterogeneity in patients' characteristics (fracture site, gender, and age) and in sample scheduling, which made it impossible to perform a meta-analysis. Conclusions: Clinical findings and radiographic features remain the two important components of non-union diagnosis so far. We suggest improving blood sample standardization and clinical data collection in future research to lay the foundations for the effective use of BTMs as tools for diagnosing non-union.
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Affiliation(s)
- Francesca Perut
- Biomedical Science and Technologies and Nanobiotechnology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (L.R.); (N.B.)
| | - Laura Roncuzzi
- Biomedical Science and Technologies and Nanobiotechnology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (L.R.); (N.B.)
| | - Enrique Gómez-Barrena
- Department of Orthopedic Surgery and Traumatology, Hospital Universitario La Paz-IdiPAZ, 28046 Madrid, Spain;
- Facultad de Medicina, Universidad Autónoma de Madrid, 28029 Madrid, Spain
| | - Nicola Baldini
- Biomedical Science and Technologies and Nanobiotechnology Laboratory, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy; (L.R.); (N.B.)
- Department of Biomedical and Neuromotor Sciences, University of Bologna, 40136 Bologna, Italy
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Filella X, Guañabens N. Clinical use of bone markers: a challenge to variability. ADVANCES IN LABORATORY MEDICINE 2024; 5:7-14. [PMID: 38634081 PMCID: PMC11019881 DOI: 10.1515/almed-2023-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/22/2023] [Indexed: 04/19/2024]
Abstract
Bone markers are a group of substances released into circulation during bone formation and/or resorption. These substances can be measured in blood and urine to obtain information about metabolic bone disorders. This review provides an insight into factors influencing bone marker variability and describes different approaches to minimize variability and interpret results appropriately. Variability in bone marker concentrations results from biological and analytical variability across assays. Other influencing factors include gender, age, physical exercise, circadian rhythm, and diet. The multiplicity of influencing factors hinders the establishment of accurate reference values. Gaining a deep understanding of bone marker variability is the first step to ascertain their clinical usefulness. Bone marker variability can be minimized by controlling as many variables as it is possible and through the standardization of patient preparation and sample collection and handling.
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Affiliation(s)
- Xavier Filella
- Servicio de Bioquímica y Genética Molecular (CDB), Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Núria Guañabens
- Servicio de Reumatología, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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3
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Filella X, Guañabens N. Utilidad clínica de los biomarcadores óseos: un desafío a la variabilidad. ADVANCES IN LABORATORY MEDICINE 2024; 5:15-23. [PMID: 38634078 PMCID: PMC11019885 DOI: 10.1515/almed-2023-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/22/2023] [Indexed: 04/19/2024]
Abstract
Los biomarcadores óseos son un conjunto de sustancias que son liberadas a la circulación sanguínea durante el proceso de formación y/o resorción ósea y que podemos medir en sangre y orina para obtener información sobre los trastornos metabólicos del hueso. La revisión traza una perspectiva sobre los factores que influyen en la variabilidad de los biomarcadores óseos y describe los aspectos a considerar para reducirla al máximo e interpretar los resultados de manera adecuada. La variabilidad que podemos observar en la concentración de los biomarcadores óseos engloba diversos aspectos que abarcan desde su variabilidad biológica y la variabilidad de los ensayos empleados en su medida hasta la variabilidad derivada de la influencia de numerosos factores, entre los cuales el sexo, la edad, el ejercicio, su ritmo circadiano o la dieta. Todo ello se refleja en la dificultad de establecer valores de referencia precisos. El conocimiento de esta variabilidad es el primer desafío que debe afrontar su empleo en la práctica clínica. Es necesario minimizar la variabilidad de los biomarcadores óseos controlando el máximo de variables que sea posible, así como estandarizando la preparación del paciente antes de la toma de las muestras, así como su obtención y manejo.
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Affiliation(s)
- Xavier Filella
- Servicio de Bioquímica y Genética Molecular (CDB), Hospital Clinic, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, España
| | - Núria Guañabens
- Servicio de Reumatología, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, España
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4
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Tiwari JP. Osteoporosis in Renal Disease. Indian J Orthop 2023; 57:192-199. [PMID: 38107809 PMCID: PMC10721758 DOI: 10.1007/s43465-023-01021-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 10/09/2023] [Indexed: 12/19/2023]
Abstract
Introduction Osteoporosis is a disorder characterized by decreased bone mass and skeletal fragility with increased fracture risk. Chronic kidney disease presents with wide range of bone metabolic disorders, including osteoporosis. Osteoporosis prevalence is high in early stages of CKD; whereas in late stages, it coexists with renal osteodystrophy. Risk factors Risk factors for osteoporosis include advancing age, low bone mineral density (BMD), glucocorticoid therapy, smoking, alcohol intake, etc. Diagnosis The diagnosis of osteoporosis in renal disease is made after assessment of BMD, in addition to exclusion of chronic kidney disease-mineral bone disorder (CKD-MBD), eliciting history of prior fragility fractures and relevant laboratory investigations. Management The treatment of osteoporosis varies with the different stages of CKD, with management in stages 1-3 being similar to the general population. Special emphasis must be laid on prevention of fractures as well.
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Affiliation(s)
- Jai Prakash Tiwari
- Department of Nephrology, Goa Medical College, Bambolim, Goa 403202 India
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Lu AX, Lin Y, Li J, Liu JX, Yan CH, Zhang L. Effects of food-borne docosahexaenoic acid supplementation on bone lead mobilisation, mitochondrial function and serum metabolomics in pre-pregnancy lead-exposed lactating rats. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 337:122613. [PMID: 37757928 DOI: 10.1016/j.envpol.2023.122613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 09/01/2023] [Accepted: 09/22/2023] [Indexed: 09/29/2023]
Abstract
Large bone lead (Pb) resulting from high environmental exposure during childhood is an important source of endogenous Pb during pregnancy and lactation. Docosahexaenoic acid (DHA) attenuates Pb toxicity, however, the effect of DHA on bone Pb mobilisation during lactation has not been investigated. We aimed to study the effects of DHA supplementation during pregnancy and lactation on bone Pb mobilisation during lactation and its potential mechanisms. Weaning female rats were randomly divided into control (0.05% sodium acetate) and Pb-exposed (0.05% Pb acetate) groups, after a 4-week exposure by ad libitum drinking and a subsequent 4-week washout period, all female rats were mated with healthy males until pregnancy. Then exposed rats were randomly divided into Pb and Pb + DHA groups, and the latter was given a 0.14% DHA diet, while the remaining groups were given normal feed until the end of lactation. Pb and calcium levels, bone microarchitecture, bone turnover markers, mitochondrial function and serum metabolomics were analyzed. The results showed that higher blood and bone Pb levels were observed in the Pb group compared to the control, and there was a significant negative correlation between blood and bone Pb. Also, Pb increased trabecular bone loss along with slightly elevated serum C-telopeptide of type I collagen (CTX-I) levels. However, DHA reduced CTX-I levels and improved trabecular bone microarchitecture. Metabolomics showed that Pb affected mitochondrial function, which was further demonstrated in bone tissue by significant reductions in ATP levels, Na+-K+-ATPase, Ca2+-Mg2+-ATPase and CAT activities, and elevated levels of MDA, IL-1β and IL-18. However, these alterations were partially mitigated by DHA. In conclusion, DHA supplementation during pregnancy and lactation improved bone Pb mobilisation and mitochondrial dysfunction in lactating rats induced by pre-pregnancy Pb exposure, providing potential means of mitigating bone Pb mobilisation levels during lactation, but the mechanism still needs further study.
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Affiliation(s)
- An-Xin Lu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Yin Lin
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Jing Li
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Jun-Xia Liu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Chong-Huai Yan
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China; Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Lin Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China.
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Yoo H, Park K. Association between Phytochemical Index and Osteoporosis in Women: A Prospective Cohort Study in Korea. Nutrients 2023; 15:nu15071605. [PMID: 37049447 PMCID: PMC10097207 DOI: 10.3390/nu15071605] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/29/2023] Open
Abstract
Osteoporosis is a prevalent issue among postmenopausal women, who have a higher incidence of the condition than men. This study aimed to examine the relationship between phytochemical-rich food intake and osteoporosis incidence in premenopausal and postmenopausal women. The data analyzed included 4600 women aged 40–69 who were free of osteoporosis at baseline, with dietary intake evaluated through a semi-quantitative food frequency questionnaire and osteoporosis prevalence determined using interviewer-administered questionnaires and bone mineral density tests. The phytochemical index (PI) was calculated to reflect the intake levels of phytochemical-rich foods. Postmenopausal women in the highest PI quartile had a 16% lower risk of osteoporosis (95% confidence interval (CI): 0.71 to 0.99, p for trend = 0.02) than those in the lowest quartile, while no significant association was observed among premenopausal women (hazard ratio: 0.98, 95% CI: 0.78 to 1.24, p for trend = 0.8). These findings suggest that consuming phytochemical-rich foods may have a protective effect against osteoporosis in postmenopausal women, offering valuable scientific insights. However, additional research is needed to validate these findings using biochemical data. Overall, this study highlights the potential of dietary interventions to reduce the risk of osteoporosis in postmenopausal women.
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Ponzano M, Wiest MJ, Coleman A, Newton E, Pakosh M, Patsakos EM, Magnuson DSK, Giangregorio LM, Craven BC. The use of alkaline phosphatase as a bone turnover marker after spinal cord injury: A scoping review of human and animal studies. J Spinal Cord Med 2023; 46:167-180. [PMID: 34935593 PMCID: PMC9987745 DOI: 10.1080/10790268.2021.1977905] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Serum alkaline phosphatase (ALP) is measured as an indicator of bone or liver disease. Bone-specific alkaline phosphatase (B-ALP) is an isoform of ALP found in the bone tissue which can predict fractures and heterotopic ossification. OBJECTIVE The aim of this scoping review was to explore the current use of ALP and B-ALP in studies using humans or animal models of SCI, and to identify ways to advance future research using ALP and B-ALP as a bone marker after SCI. RESULTS HUMAN STUDIES: 42 studies were included. The evidence regarding changes or differences in ALP levels in individuals with SCI compared to controls is conflicting. For example, a negative correlation between B-ALP and total femur BMD was observed in only one of three studies examining the association. B-ALP seemed to increase after administration of teriparatide, and to decrease after treatment with denosumab. The effects of exercise on ALP and B-ALP levels are heterogeneous and depend on the type of exercise performed. ANIMAL STUDIES: 11 studies were included. There is uncertainty regarding the response of ALP or B-ALP levels after SCI; levels increased after some interventions, including vibration protocols, curcumin supplementation, cycles in electromagnetic field or hyperbaric chamber. Calcitonin or bisphosphonate administration did not affect ALP levels. CONCLUSION Researchers are encouraged to measure the bone-specific isoform of ALP rather than total ALP in future studies in humans of animal models of SCI.
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Affiliation(s)
- Matteo Ponzano
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, Canada
| | - Matheus J Wiest
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - André Coleman
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Emily Newton
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada
| | - Maureen Pakosh
- Library & Information Services, University Health Network, Toronto Rehabilitation Institute, Toronto, Canada
| | - Eleni M Patsakos
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - David S K Magnuson
- Kentucky Spinal Cord Injury Research Center, University of Louisville, Louisville, Kentucky, USA
| | - Lora M Giangregorio
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, Canada.,Schlegel-UW Research Institute for Aging, Waterloo, Canada
| | - B Catharine Craven
- KITE - Toronto Rehabilitation Institute, University Health Network, Toronto, Canada.,Department of Kinesiology, University of Waterloo, Waterloo, Canada.,Rehabilitation Sciences Institute, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.,Department of Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
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8
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Timon R, Martinez-Guardado I, Brocherie F. Effects of Intermittent Normobaric Hypoxia on Health-Related Outcomes in Healthy Older Adults: A Systematic Review. SPORTS MEDICINE - OPEN 2023; 9:19. [PMID: 36843041 PMCID: PMC9968673 DOI: 10.1186/s40798-023-00560-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 02/05/2023] [Indexed: 02/27/2023]
Abstract
BACKGROUND Aging is a degenerative process that is associated with an increased risk of diseases. Intermittent hypoxia has been investigated in reference to performance and health-related functions enhancement. This systematic review aimed to summarize the effect of either passive or active intermittent normobaric hypoxic interventions compared with normoxia on health-related outcomes in healthy older adults. METHODS Relevant studies were searched from PubMed and Web of Science databases in accordance with PRISMA guidelines (since their inceptions up until August 9, 2022) using the following inclusion criteria: (1) randomized controlled trials, clinical trials and pilot studies; (2) Studies involving humans aged > 50 years old and without any chronic diseases diagnosed; (3) interventions based on in vivo intermittent systemic normobaric hypoxia exposure; (4) articles focusing on the analysis of health-related outcomes (body composition, metabolic, bone, cardiovascular, functional fitness or quality of life). Cochrane Collaboration recommendations were used to assess the risk of bias. RESULTS From 509 articles initially found, 17 studies were included. All interventions were performed in moderate normobaric hypoxia, with three studies using passive exposure, and the others combining intermittent hypoxia with training protocols (i.e., using resistance-, whole body vibration- or aerobic-based exercise). CONCLUSIONS Computed results indicate a limited effect of passive/active intermittent hypoxia (ranging 4-24 weeks, 2-4 days/week, 16-120 min/session, 13-16% of fraction of inspired oxygen or 75-85% of peripheral oxygen saturation) compared to similar intervention in normoxia on body composition, functional fitness, cardiovascular and bone health in healthy older (50-75 years old) adults. Only in specific settings (i.e., intermediate- or long-term interventions with high intensity/volume training sessions repeated at least 3 days per week), may intermittent hypoxia elicit beneficial effects. Further research is needed to determine the dose-response of passive/active intermittent hypoxia in the elderly. TRIAL REGISTRATION SYSTEMATIC REVIEW REGISTRATION PROSPERO 2022 CRD42022338648.
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Affiliation(s)
- Rafael Timon
- Sport Sciences Faculty, Universidad de Extremadura, Av/ Universidad s/n, 10004, Cáceres, Spain.
| | - Ismael Martinez-Guardado
- grid.464701.00000 0001 0674 2310BRABE Group. Faculty of Life and Nature Sciences, Universidad de Nebrija, Madrid, Spain
| | - Franck Brocherie
- grid.418501.90000 0001 2163 2398Laboratory Sport, Expertise and Performance (EA 7370), French Institute of Sport (INSEP), Paris, France
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Tai TW, Huang CF, Huang HK, Yang RS, Chen JF, Cheng TT, Chen FP, Chen CH, Chang YF, Hung WC, Han DS, Chan DC, Tsai CC, Chen IW, Chan WP, Chang HJ, Hwang JS, Wu CH. Clinical practice guidelines for the prevention and treatment of osteoporosis in Taiwan: 2022 update. J Formos Med Assoc 2023; 122 Suppl 1:S4-S13. [PMID: 36781371 DOI: 10.1016/j.jfma.2023.01.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 01/15/2023] [Accepted: 01/17/2023] [Indexed: 02/13/2023] Open
Abstract
Osteoporosis greatly increases the risk of fractures. Osteoporotic fractures negatively impact quality of life, increase the burden of care, and increase mortality. Taiwan is an area with a high prevalence of osteoporosis. This updated summary of guidelines has been developed by experts of the Taiwan Osteoporosis Association with the intention of reducing the risks of osteoporotic fractures and improving the quality of care for patients with osteoporosis. The updated guidelines compile the latest evidence to provide clinicians and other healthcare professionals with practical recommendations for the prevention, diagnosis, and management of osteoporosis under clinical settings in Taiwan.
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Affiliation(s)
- Ta-Wei Tai
- Department of Orthopedics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Skeleton Materials and Biocompatibility Core Lab, Research Center of Clinical Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Chun-Feng Huang
- Division of Family Medicine, En Chu Kong Hospital, New Taipei City, Taiwan; Faculty of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Leisure Services Management, Chaoyang University of Technology, Taichung, Taiwan
| | - Huei-Kai Huang
- Department of Family Medicine, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Rong-Sen Yang
- Department of Orthopedics, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Jung-Fu Chen
- Division of Metabolism and Endocrinology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tien-Tsai Cheng
- Division of Rheumatology, Allergy, And Immunology, Chang Gung University and Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - Fang-Ping Chen
- Department of Obstetrics and Gynecology, Osteoporosis Prevention and Treatment Center, Keelung Chang Gung Memorial Hospital, Keelung, Taiwan; Department of Medicine, College of Medicine, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan
| | - Chung-Hwan Chen
- Orthopaedic Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Regeneration Medicine and Cell Therapy Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan; Department of Orthopedics, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan; Musculoskeletal Regeneration Research Center, Kaohsiung Medical University, Kaohsiung, Taiwan; Institute of Medical Science and Technology, National Sun Yat-Sen University, Kaohsiung, Taiwan; Graduate Institute of Animal Vaccine Technology, College of Veterinary Medicine, National Pingtung University of Science and Technology, Pingtung, Taiwan; Graduate Institute of Materials Engineering, College of Engineering, National Pingtung University of Science and Technology, Pingtung, Taiwan
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Wei-Chieh Hung
- Department of Family Medicine, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan
| | - Der-Sheng Han
- Department of Physical Medicine and Rehabilitation, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital BeiHu Branch, Taipei, Taiwan
| | - Ding-Cheng Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Ching-Chou Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan
| | - I-Wen Chen
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan City, Taiwan
| | - Wing P Chan
- Department of Radiology, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Radiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | | | - Jawl-Shan Hwang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Taoyuan City, Taiwan.
| | - Chih-Hsing Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Gerontology, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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10
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Chen CA, Chiu PY, Huang TH, Ho NYJ, Kao FC, Tsai TT. Quantitative lateral flow immunoassay for rapid detection of procollagen type I N-terminal propeptide in the monitoring of osteoporosis treatment. Anal Chim Acta 2023; 1239:340695. [PMID: 36628763 DOI: 10.1016/j.aca.2022.340695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 11/01/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022]
Abstract
Appropriate follow-up after treatment initiation in patients with osteoporosis is challenging. Serum biomarkers may offer more efficient monitoring of bone mineral density (BMD) than the currently used dual X-ray absorptiometry; however, significant changes in BMD often occur over at least 12 months. During teriparatide treatment for osteoporosis, monitoring with markers such as procollagen type I propeptide (PINP), which is derived from osteoblasts, can provide clinically useful information for disease management. However, rapid and cost-effective methods for detecting serum PINP are lacking, necessitating a point-of-care test (POCT) for enhanced follow-up efficiency in osteoporosis management. For the quantitative detection of PINP, we developed a high-sensitivity lateral flow immunoassay with a stacking pad (sLFIA). We established a calibration equation based on the test line/control line ratio obtained from our PINP sLFIA results of various nonspiked serum samples to calculate the PINP concentrations in 40 serum samples and compared the result with those obtained using a fully automated electrochemiluminescence immunoassay. PINP concentrations between these two methods exhibited excellent correlation (R = 0.991). In addition, we assessed the serum PINP concentrations of patients with osteoporosis treated with teriparatide. At the 3-month follow-up, their PINP levels were nearly twice as high as those at baseline, thus implying that our method can be used for osteoporosis treatment monitoring. Our findings thus indicate that the PINP sLFIA can serve as a POCT for monitoring medication response and managing osteoporosis.
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Affiliation(s)
- Chung-An Chen
- Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Ping-Yeh Chiu
- Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Tse-Hao Huang
- Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Natalie Yi-Ju Ho
- Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Fu-Cheng Kao
- Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
| | - Tsung-Ting Tsai
- Department of Orthopaedic Surgery, Spine Section and Bone and Joint Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; School of Medicine, Chang Gung University, Taoyuan, Taiwan.
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11
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Guo H, An Z, Wang N, Ge S, Cai J, Yu S, Zhou Y, Ying R, Zha K, Gu T, Zhao Y, Lu Y. Diabetes Mellitus Type 2 Patients with Abdominal Obesity Are Prone to Osteodysfunction: A Cross-Sectional Study. J Diabetes Res 2023; 2023:3872126. [PMID: 37102159 PMCID: PMC10125752 DOI: 10.1155/2023/3872126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/31/2023] [Accepted: 03/31/2023] [Indexed: 04/28/2023] Open
Abstract
Introduction The interaction between diabetes, obesity, and bone metabolism was drawing increasing public attention. However, the osteometabolic changes in diabetes mellitus type 2 (T2DM) patients with abdominal obesity have not been fully revealed. This study is aimed at investigating the association between abdominal obesity indices and bone turnover markers among T2DM participants. Methods 4351 subjects were involved in the METAL study. Abdominal obesity indices included neck, waist, and hip circumference, visceral adiposity index (VAI), lipid accumulation product (LAP), waist-to-hip ratio (WHR), and Chinese visceral adiposity index (CVAI). They were applied to elucidate the nexus between β-C-terminal telopeptide (β-CTX), osteocalcin (OC), and intact N-terminal propeptide of type I collagen (P1NP). Results Abdominal obesity indices were strongly negatively associated with β-CTX and OC. Among males, five indices were negatively correlated with β-CTX (BMI, WC, LAP, WHR, and CVAI) and OC (BMI, NC, WC, WHR, and CVAI). There were no significant associations with P1NP. Among females, all eight indices were negatively associated with β-CTX. Seven indices were negatively related to OC (BMI, NC, WC, HC, LAP, WHR, and CVAI). The VAI was negatively correlated with P1NP. Conclusions The present study demonstrated that in T2DM, abdominal obesity had an obviously negative correlation with bone metabolism. Abdominal obesity indices were significantly negatively associated with skeletal destruction (β-CTX) and formation (OC). In routine clinical practice, these easily obtained indices could be used as a preliminary screening method and relevant factors for osteodysfunction incidence risk at no additional cost and may be of particular value for postmenopausal women in T2DM populations.
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Affiliation(s)
- Hui Guo
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Zengmei An
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaohong Ge
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Jian Cai
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Shiyan Yu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhou
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Rong Ying
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Kexi Zha
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Tao Gu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yan Zhao
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Optimal Serum 25(OH)D Level and Vitamin D Intake in Young Korean Women. Nutrients 2022; 14:nu14224845. [PMID: 36432534 PMCID: PMC9698687 DOI: 10.3390/nu14224845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 11/13/2022] [Accepted: 11/14/2022] [Indexed: 11/18/2022] Open
Abstract
Vitamin D status is essential for preventing bone disease. Young Korean women have the highest vitamin D deficiency prevalence compared with other demographic groups. This study aimed to establish the optimal vitamin D intake level for maintaining an adequate serum 25-hydroxyvitamin D (25[OH]D) level by season in young Korean women (mean age: 23.1 years). Each participant (wintertime, n = 101; summertime, n = 117) completed a lifestyle survey, dietary record, bone mineral density, and biochemical tests. Seasonal factors impacting 25(OH)D were identified, vitamin D intake for sufficient 25(OH)D levels was calculated, and the relationship between 25(OH)D and intact parathyroid hormone (iPTH) was analyzed. During summertime, 25(OH)D levels were higher than in wintertime (17.9 vs. 15.0 ng/mL). A 1 µg/1000 kcal increase in vitamin D intake increased 25(OH)D levels by 0.170 ng/mL in wintertime and 0.149 ng/mL in summertime. iPTH levels reached a theoretical plateau corresponding to an 18.4 ng/mL 25(OH)D level. The vitamin D intake threshold for maintaining 25(OH)D levels at ≥20 and ≥18.4 ng/mL was ≥10.97 μg/day. For a sufficient level of 25(OH)D in young Korean women, increasing summertime UV irradiation time and increasing vitamin D supplements and vitamin D-containing foods throughout the year is beneficial.
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13
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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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14
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Perreault M, Mottola MF, Atkinson SA, Phillips S, Hutton E, Wahoush O, Xie F, Thabane L, Bracken K, Mottola M, Manzin J. Individualized high dairy protein + walking program supports bone health in pregnancy: a randomized controlled trial. Am J Clin Nutr 2022; 116:887-896. [PMID: 35759368 DOI: 10.1093/ajcn/nqac182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 05/03/2022] [Accepted: 06/24/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Pregnancy induces bone mineral mobilization, which may be further compromised if diet and physical activity are suboptimal. OBJECTIVES We aimed to determine the effects of a Nutrition + Exercise intervention during pregnancy on maternal calciotropic and bone biomarker profiles throughout pregnancy and the postpartum. METHODS In the Be Healthy in Pregnancy (BHIP) randomized controlled trial, 203 of 225 participants who consented to the bone health substudy were, randomly assigned at 12-17 weeks gestation to receive either usual care (control) or a structured and monitored Nutrition + Exercise plan (intervention) providing an individualized high dairy protein diet and a walking program throughout pregnancy. Maternal serum total procollagen type 1 N-terminal propeptide (P1NP; bone formation), C-terminal telopeptide of type I collagen (CTX; bone resorption), and insulin-like growth factor-1 (IGF-1) were measured by ELISA, and vitamin D metabolites by ultra-performance LC tandem MS at early and late pregnancy, 6 mo postpartum, and in cord blood. RESULTS In 187 participants completing all measures, significantly higher intakes were observed in the intervention than in the control group for total protein (P < 0.0001), protein intake from dairy foods (P < 0.0001), and calcium (P < 0.0001), whereas vitamin D intake was similar between treatment groups in both the second and third trimesters. The intervention group had significantly lower serum CTX at end of pregnancy (mean ± SD: 0.78 ± 0.31 ng/mL; n = 91 compared with 0.89 ± 0.33 ng/mL; n = 96, P = 0.034) and in cord serum (0.58 ± 0.13 ng/mL; n = 31 compared with 0.69 ± 0.18 ng/mL; n = 22, P < 0.025). Serum concentrations of P1NP rose significantly (P < 0.02) from early pregnancy to 6 mo postpartum for the intervention group only. Serum 25-hydroxyvitamin D status was >50 nmol/L for 97% of all participants. CONCLUSIONS Higher maternal dietary protein and calcium intakes than usual care in concert with normal vitamin D status minimized bone resorption and maintained bone formation and may protect bone health during pregnancy.This trial was registered at clinicaltrials.gov as NCT01689961.
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Affiliation(s)
- Maude Perreault
- Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada
| | - Michelle F Mottola
- School of Kinesiology and Department of Anatomy & Cell Biology, Western University, London, Ontario, Canada.,Children's Health Research Institute, Western University, London, Ontario, Canada
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15
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The Impact of an Adapted Physical Activity Program on Bone Turnover, Physical Performance and Fear of Falling in Osteoporotic Women with Vertebral Fractures: A Quasi-Experimental Pilot Study. Biomedicines 2022; 10:biomedicines10102467. [PMID: 36289729 PMCID: PMC9598604 DOI: 10.3390/biomedicines10102467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 09/27/2022] [Accepted: 09/28/2022] [Indexed: 11/19/2022] Open
Abstract
Physical activity has been indicated as a potential strategy to counteract osteoporosis (OP). This study of post-menopausal women with osteoporotic vertebral fractures investigated the effect of an adapted physical activity (APA) program on two serum bone turnover biomarkers (Bone Alkaline Phosphatase, B-ALP and C-terminal telopeptide of type 1 collagen, CTX-1), functional capacity (6-Minutes Walking Test, 6MWT), and risk and fear of falls (Tinetti and Falls Efficacy scale). The APA group (n = 12) performed a 1-h group session twice per week for 6 months whereas the control group (n = 9) was asked to maintain their current lifestyle. The exercise program did not affect the serum concentrations of B-ALP and CTX-1 biomarkers measured at the baseline and after 6 months in women of the APA group. Moreover, at the end of intervention no significant differences in serum concentrations for either biomarker was observed between the two study groups. Interestingly, when compared to the control group, women in the APA group showed significant improvement in the functional capacity measures by 6MWT (p = 0.037) and a decrease of the risk and fear of falls as indicated by the Tinetti test (p = 0.043). Based on these findings, exercise could provide new perspectives for the care and management of OP.
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16
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Current use of bone turnover markers in the management of osteoporosis. Clin Biochem 2022; 109-110:1-10. [PMID: 36096182 DOI: 10.1016/j.clinbiochem.2022.09.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 08/31/2022] [Accepted: 09/01/2022] [Indexed: 11/21/2022]
Abstract
The adult bone is continuously being remodelled to repair microdamage, preserve bone strength and mechanical competence as well as maintain calcium homeostasis. Bone turnover markers are products of osteoblasts (bone formation markers) and osteoclasts (bone resorption markers) providing a dynamic assessment of remodelling (turnover). Resorption-specific bone turnover markers are typically degradation products of bone collagen molecules (N- [NTX] and C-telopeptide cross-linked type 1 collagen [CTX]), which are released into the circulation and excreted in urine; or enzymatic activities reflecting osteoclastic resorption, tartrate-resistant acid phosphatase [TRACP]. Formation-specific bone turnover markers embrace different osteoblastic activities: type 1 collagen synthesis (Procollagen type I N- propeptide [PINP]), osteoblast enzymes (bone-specific alkaline phosphatase [BALP]), or bone matrix proteins [osteocalcin]. Among individuals not receiving osteoporosis treatment, resorption and formation markers are tightly linked and highly correlated (r= 0.6-0.8). Significant biological variability was reported in the past, but these issues have been greatly improved with automated assays and attention to pre-analytical and analytical factors that are known to influence bone turnover marker levels. Bone turnover markers are not useful in the diagnosis of osteoporosis, the individual prediction of bone loss, fracture, or rare complications, or in the selection of pharmacological treatment. Despite remaining issues with reference intervals and assays harmonization, bone turnover markers have proven to be useful in elucidating the pharmacodynamics and effectiveness of osteoporosis medications in clinical trials. As an alternative to BMD testing, BTMs may be useful to monitor osteoporosis therapies.
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17
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Guo H, Sui C, Ge S, Cai J, Lin D, Guo Y, Wang N, Zhou Y, Ying R, Zha K, Gu T, Zhao Y, Lu Y, An Z. Positive association of glucagon with bone turnover markers in type 2 diabetes: A cross-sectional study. Diabetes Metab Res Rev 2022; 38:e3550. [PMID: 35621313 DOI: 10.1002/dmrr.3550] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 02/09/2022] [Accepted: 03/24/2022] [Indexed: 11/12/2022]
Abstract
AIMS The osteo-metabolic changes in type 2 diabetes (T2D) patients are intricate and have not been fully revealed. It is not clear whether glucagon is entirely harmful in the pathogenesis of diabetes or a possible endocrine counter-regulation mechanism to reverse some abnormal bone metabolism. This study aimed to investigate the association between glucagon and bone turnover markers (BTMs) in T2D patients. METHODS A total of 3984 T2D participants were involved in a cross-sectional study in Shanghai, China. Serum glucagon was measured to elucidate its associations with intact N-terminal propeptide of type I collagen (P1NP), osteocalcin (OC), and β-C-terminal telopeptide (β-CTX). Glucagon was detected with a radioimmunoassay. Propeptide of type I collagen, OC, and β-CTX were detected using chemiluminescence. The diagnosis of T2D was based on American Diabetes Association criteria. RESULTS The concentration of glucagon was positively correlated with two BTMs [OC-β: 0.034, 95% CI: 0.004, 0.051, p = 0.024; CTX-β: 0.035, 95% CI: 0.004, 0.062, p = 0.024]. The result of P1NP was [P1NP-regression coefficient (β): 0.027, 95% CI: -0.003, 0.049, p = 0.083]. In the glucagon tertiles, P for trend of the BTMs is [P1NP: 0.031; OC: 0.038; CTX: 0.020], respectively. CONCLUSIONS Glucagon had a positive effect on bone metabolism. The concentrations of the three BTMs increased as glucagon concentrations rose. This implied that glucagon might speed up skeletal remodelling, accelerate osteogenesis, and promote the formation of mature bone tissue. At the same time, the osteoclastic process was also accelerated, providing raw materials for osteogenesis to preserve the dynamic balance. In view of the successful use of single-molecule as well as dual/triple agonists, it would be feasible to develop a preparation that would reduce osteoporosis in diabetic patients.
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Affiliation(s)
- Hui Guo
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Chunhua Sui
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shaohong Ge
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Jian Cai
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Dongping Lin
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuyu Guo
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ningjian Wang
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ying Zhou
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Rong Ying
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Kexi Zha
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Tao Gu
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yan Zhao
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
| | - Yingli Lu
- Institute and Department of Endocrinology and Metabolism, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zengmei An
- Institute and Department of Endocrinology and Metabolism, Huangpu Branch of Shanghai Ninth People's Hospital, Shanghai, China
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18
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de Oliveira JAGT, Neves MD, Sampaio GFS, Constantino CJL, Nakagaki WR. Analysis of the effects of turmeric and symbiotic consumption on bones of rats submitted to the use of dexamethasone. Life Sci 2022; 304:120690. [DOI: 10.1016/j.lfs.2022.120690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/01/2022] [Accepted: 06/01/2022] [Indexed: 10/18/2022]
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Intermittent Hypoxia as a Therapeutic Tool to Improve Health Parameters in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095339. [PMID: 35564732 PMCID: PMC9103404 DOI: 10.3390/ijerph19095339] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 12/23/2022]
Abstract
Aging is associated with metabolic alterations, and with a loss of strength, muscle and bone mass. Moderate intermittent hypoxia has been proposed as a new tool to enhance health-related function. The aim of this study was to evaluate the effect of moderate intermittent hypoxia exposures on parameters related to cardiovascular and bone health in older adults. A total of 38 healthy older adults (aged 65-75 years) were divided into two groups: control group (C), and hypoxia group (H) that was subjected to an intermittent hypoxia exposure (at simulated altitude of 2500 m asl) during a 24-week period (3 days/week). Body composition, blood pressure, metabolic parameters (Cholesterol, triglycerides and glucose), C-reactive protein (CRP), vascular cell adhesion molecule-1 (VCAM-1), interleukin 8 (IL-8), interleukin 10 (IL-10), N-terminal propeptide of type I procollagen (PINP) and beta C-terminal telopeptide of collagen bone formation (b-CTX) were analyzed before and after the intervention. A repeated measures analysis of variance was performed to evaluate between-group differences. The results showed that the hypoxia group achieved after the intervention a decrease in fat mass, CRP (pro-inflammatory biomarker) and b-CTX (bone resorption biomarker), as well as an increase in PINP (bone formation biomarker). In conclusion, the intermittent hypoxia might be a useful therapeutic tool to deal with problems associated with aging, such as the increase in body fat, the loss of bone mass or low-grade inflammation.
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20
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McClung MR, Kagan R, Graham S, Bernick B, Mirkin S, Constantine G. Effects of E2/P4 oral capsules on bone turnover in women with vasomotor symptoms. Menopause 2022; 29:304-308. [PMID: 35213517 PMCID: PMC8862769 DOI: 10.1097/gme.0000000000001915] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 10/11/2021] [Accepted: 10/11/2021] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To evaluate bone turnover markers (BTM) in the REPLENISH trial (NCT01942668). METHODS REPLENISH evaluated oral estradiol/progesterone (E2/P4) for the treatment of moderate to severe vasomotor symptoms (VMS) in postmenopausal women with a uterus. Eligible women for this analysis had ≥50 moderate to severe VMS/wk, were <5 years since last menstrual period, and had BTM measurements at baseline, and months 6 and 12. Percent changes for three BTM (bone-specific alkaline phosphatase [BSAP], C-terminal telopeptide of type I collagen [CTX-1], and N-terminal propeptide of type I procollagen [P1NP]) assessed by immunoassay methods were evaluated from baseline to months 6 and 12 for the 1 mg E2/100 mg P4, 0.5 mg E2/100 mg P4, and placebo groups. RESULTS A total of 157 women (40-61 y, 69% White) were analyzed. Mean baseline values ranged from 14.0 to 14.3 U/L for BSAP, 0.34 to 0.39 ng/mL for CTX-1, and 76.9 to 79.3 ng/mL for PINP. Mean differences in percent change from baseline for both E2/P4 doses versus placebo significantly decreased at months 6 and 12 and ranged from -8% to -16% for BSAP (all, P < 0.05), -30% to -41% for CTX-1 (all, P ≤ 0.001), and -14% to -29% for PINP (all, P < 0.01). CONCLUSIONS REPLENISH data provide support for a potential skeletal benefit of E2/P4 when it is used for the treatment of moderate to severe VMS. Further studies are warranted.
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Affiliation(s)
- Michael R. McClung
- Oregon Osteoporosis Center, Portland, OR
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Risa Kagan
- University of California, San Francisco and Sutter East Bay Medical Foundation, Berkeley, CA
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21
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Li M, Yang S, Song J, Fu T, Liang P, Gao Z, Tang J, Guo L. Different grinding speeds affect induced regeneration capacity of human treated dentin matrix. J Biomed Mater Res B Appl Biomater 2021; 110:755-767. [PMID: 34637601 DOI: 10.1002/jbm.b.34954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Revised: 09/18/2021] [Accepted: 09/29/2021] [Indexed: 11/07/2022]
Abstract
Human-treated dentin matrix (hTDM) is a biomaterial scaffold, which can induce implant cells to differentiate into odontoblasts and then form neo-dentin. However, hTDM with long storage or prepared by high-speed handpiece would not to form neo-dentin. In this research, we developed two fresh hTDM with different grinding speeds, which were low-speed hTDM (LTDM) with maximum speed of 500 rpm and high-speed hTDM (HTDM) with a speed of 3,80,000 rpm. Here, we aim to understand whether there were induced regeneration capacity differences between LTDM and HTDM. Scanning electron microscope showed that DFCs grew well on both materials, but the morphology of DFCs and the extracellular matrix was different. Especially, the secreted extracellular matrixes on the inner surface of LTDM were regular morphology and ordered arrangement around the dentin tubules. The transcription-quantitative polymerase chain reaction (qRT-PCR), western blot and immunofluorescence assay showed that the dentin markers DSPP and DMP-1 were about 2× greater in DFCs induced by LTDM than by HTDM, and osteogenic marker BSP was about 2× greater in DFCs induced by HTDM than by LTDM. Histological examinations of the harvested grafts observed the formation of neo-tissue were different, and there were neo-dentin formed on the inner surface of LTDM and neo-cementum formed on the outer surface of HTDM. In summary, it found that the induction abilities of LTDM and HTDM are different, and the dentin matrix is directional. This study lays a necessary foundation for searching the key factors of dentin regeneration in future.
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Affiliation(s)
- Min Li
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.,Department of Medical Cosmetology, Suining Central Hospital, Suining, China.,Department of Stomatology, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Sen Yang
- Stomatology Center, Suining Central Hospital, Suining, China
| | - Jinlin Song
- Chongqing Medical University Stomatology College, Chongqing, China.,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Tiwei Fu
- Chongqing Medical University Stomatology College, Chongqing, China.,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Panpan Liang
- Chongqing Medical University Stomatology College, Chongqing, China.,Chongqing Key Laboratory for Oral Diseases and Biomedical Sciences, Chongqing, China.,Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Chongqing, China
| | - Zhi Gao
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jing Tang
- Department of Stomatology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lijuan Guo
- Department of Medical Cosmetology, Suining Central Hospital, Suining, China
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22
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Mangano KM, Noel SE, Dawson-Hughes B, Tucker KL. Sufficient Plasma Vitamin C Is Related to Greater Bone Mineral Density among Postmenopausal Women from the Boston Puerto Rican Health Study. J Nutr 2021; 151:3764-3772. [PMID: 34510185 PMCID: PMC8643605 DOI: 10.1093/jn/nxab291] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 07/23/2021] [Accepted: 08/06/2021] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Vitamin C may benefit bone as an antioxidant. OBJECTIVES This cross-sectional study evaluated associations between dietary, supplemental, and plasma vitamin C with bone mineral density (BMD) among Puerto Rican adults. METHODS Diet was assessed by food-frequency questionnaire (n = 902); plasma vitamin C, measured in fasting blood (n = 809), was categorized as sufficient (≥50 μmol/L), insufficient (20-49 μmol/L), or low (<20 μmol/L). Associations between vitamin C and BMD (measured by DXA) were tested, with false discovery rate correction for multiple comparisons, and interactions by smoking, sex, and estrogen status. Least-squares mean BMDs were compared across tertiles of diet and plasma vitamin C. RESULTS Participants' mean age was 59 ± 7 y (range: 46-78 y), 72% were women, mean dietary vitamin C was 95 ± 62 mg/d, and plasma vitamin C ranged from 1.7 to 125 μmol/L. No associations were observed between dietary vitamin C and BMD (P-value range: 0.48-0.96). BMD did not differ by vitamin C supplement use (P-value range: 0.07-0.29). Total femur BMD was higher (P = 0.04) among plasma vitamin C-sufficient participants (mean: 1.06; 95% CI: 1.035, 1.076 g/cm2) compared with low plasma vitamin C participants (1.026; 0.999, 1.052 g/cm2) in adjusted models. Findings at the trochanter were similar (P = 0.04). Postmenopausal women without estrogen therapy, with sufficient plasma vitamin C, showed greater total femur BMD (1.004 ± 0.014 g/cm2) compared to those with low plasma vitamin C (0.955 ± 0.017 g/cm2; P = 0.001). Similar findings were observed at the trochanter (P < 0.001). No significant associations were observed among premenopausal women or those with estrogen therapy or men. Interactions with smoking status were not significant. CONCLUSIONS Dietary vitamin C was not associated with BMD. Low plasma vitamin C, compared with sufficiency, was associated with lower hip BMD, particularly among postmenopausal women without estrogen therapy. Future research is needed to determine whether vitamin C status is associated with change in BMD or reduction in fracture risk.
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Affiliation(s)
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Bess Dawson-Hughes
- Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, Center for Population Health, Zuckerberg College of Health Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Effects of Extracellular Osteoanabolic Agents on the Endogenous Response of Osteoblastic Cells. Cells 2021; 10:cells10092383. [PMID: 34572032 PMCID: PMC8471159 DOI: 10.3390/cells10092383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 08/31/2021] [Accepted: 09/07/2021] [Indexed: 12/27/2022] Open
Abstract
The complex multidimensional skeletal organization can adapt its structure in accordance with external contexts, demonstrating excellent self-renewal capacity. Thus, optimal extracellular environmental properties are critical for bone regeneration and inextricably linked to the mechanical and biological states of bone. It is interesting to note that the microstructure of bone depends not only on genetic determinants (which control the bone remodeling loop through autocrine and paracrine signals) but also, more importantly, on the continuous response of cells to external mechanical cues. In particular, bone cells sense mechanical signals such as shear, tensile, loading and vibration, and once activated, they react by regulating bone anabolism. Although several specific surrounding conditions needed for osteoblast cells to specifically augment bone formation have been empirically discovered, most of the underlying biomechanical cellular processes underneath remain largely unknown. Nevertheless, exogenous stimuli of endogenous osteogenesis can be applied to promote the mineral apposition rate, bone formation, bone mass and bone strength, as well as expediting fracture repair and bone regeneration. The following review summarizes the latest studies related to the proliferation and differentiation of osteoblastic cells, enhanced by mechanical forces or supplemental signaling factors (such as trace metals, nutraceuticals, vitamins and exosomes), providing a thorough overview of the exogenous osteogenic agents which can be exploited to modulate and influence the mechanically induced anabolism of bone. Furthermore, this review aims to discuss the emerging role of extracellular stimuli in skeletal metabolism as well as their potential roles and provide new perspectives for the treatment of bone disorders.
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Current Lack of Evidence for an Effect of Physical Activity Intervention Combined with Pharmacological Treatment on Bone Turnover Biomarkers in People with Osteopenia and Osteoporosis: A Systematic Review. J Clin Med 2021; 10:jcm10153442. [PMID: 34362225 PMCID: PMC8348888 DOI: 10.3390/jcm10153442] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 07/31/2021] [Accepted: 07/31/2021] [Indexed: 12/12/2022] Open
Abstract
The process of bone loss occurs silently and progressively with age, often appearing as osteopenia or osteoporosis or related fractures. Given the rapid raise in disease burden and socio-economic costs of these conditions worldwide, drug therapy combined with physical activity can be a useful strategy and bone biomarkers, can represent a useful evaluation tool to assess their effects. The objective of this systematic review, conducted according to PRISMA statement, was to investigate the effects of physical activity interventions combined with drug treatments on bone biomarkers in people with osteopenia and osteoporosis. Through PubMed, Cochrane, Cinahl, Embase, Trip, a comprehensive literature search was performed. Each study's quality was assessed according to the Cochrane risk-of-bias tool. Out of 582 identified articles, 50 full texts were screened. Only one matched the eligibility criteria. The study, scored as high quality, showed, in both experimental and control groups, an increase of CTX and P1NP bone biomarkers, without statistically significant differences. Based on available evidence, no exhaustive conclusion can be drawn. However, this systematic review critically analyses the literature, highlighting the knowledge gap on combined treatments efficacy assessed by bone biomarkers. Moreover, an outlook is provided for the planning of future studies.
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Pencina KM, Burnett AL, Storer TW, Guo W, Li Z, Kibel AS, Huang G, Blouin M, Berry DL, Basaria S, Bhasin S. A Selective Androgen Receptor Modulator (OPK-88004) in Prostate Cancer Survivors: A Randomized Trial. J Clin Endocrinol Metab 2021; 106:2171-2186. [PMID: 34019661 PMCID: PMC8277210 DOI: 10.1210/clinem/dgab361] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND Androgen deficiency is common among prostate cancer survivors, but many guidelines consider history of prostate cancer a contraindication for testosterone replacement. We determined the safety and efficacy of a selective androgen receptor modulator (OPK-88004) in symptomatic, testosterone-deficient men who had undergone radical prostatectomy for low-grade, organ-confined prostate cancer. METHODS In this placebo-controlled, randomized, double-blind trial, 114 men, ≥19 years of age, who had undergone radical prostatectomy for low-grade, organ-localized prostate cancer, undetectable PSA (<0.1 ng/mL) for ≥2 years after radical prostatectomy and testosterone deficiency were randomized in stages to placebo or 1, 5, or 15 mg OPK-88004 daily for 12 weeks. Outcomes included PSA recurrence, sexual activity, sexual desire, erectile function, body composition, muscle strength and physical function measures, mood, fatigue, and bone markers. RESULTS Participants were on average 67.5 years of age and had severe sexual dysfunction (mean erectile function and sexual desire domain scores 7.3 and 14.6, respectively). No participant experienced PSA recurrence or erythrocytosis. OPK-88004 was associated with a dose-related increase in whole-body (P < 0.001) and appendicular (P < 0.001) lean mass and a significantly greater decrease in percent body fat (P < 0.001) and serum alkaline phosphatase (P < 0.001) than placebo. Changes in sexual activity, sexual desire, erectile function, mood, fatigue, physical performance, and bone markers did not differ among groups (P = 0.73). CONCLUSIONS Administration of OPK-88004 was safe and not associated with PSA recurrence in androgen-deficient men who had undergone radical prostatectomy for organ-confined prostate cancer. OPK-88004 increased lean body mass and decreased fat mass but did not improve sexual symptoms or physical performance.
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Affiliation(s)
- Karol M Pencina
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Arthur L Burnett
- Department of Urology, The Johns Hopkins University School of Medicine, The James Buchanan Brady Urological Institute, Baltimore, MD, USA
| | - Thomas W Storer
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Wen Guo
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Zhuoying Li
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Adam S Kibel
- Division of Urology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Grace Huang
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Michelle Blouin
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Donna L Berry
- Department of Biobehavioral Nursing and Health Informatics, University of Washington, Seattle, WA, USA
| | - Shehzad Basaria
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
| | - Shalender Bhasin
- Research Program in Men’s Health: Aging and Metabolism, Claude D. Pepper Older Americans Independence Center, Brigham and Women’s Hospital, Boston, MA, USA
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Metabolic Phenotypes and Step by Step Evolution of Type 2 Diabetes: A New Paradigm. Biomedicines 2021; 9:biomedicines9070800. [PMID: 34356863 PMCID: PMC8301386 DOI: 10.3390/biomedicines9070800] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 01/18/2023] Open
Abstract
Unlike bolus insulin secretion mechanisms, basal insulin secretion is poorly understood. It is essential to elucidate these mechanisms in non-hyperinsulinaemia healthy persons. This establishes a baseline for investigation into pathologies where these processes are dysregulated, such as in type 2 diabetes (T2DM), cardiovascular disease (CVD), certain cancers and dementias. Chronic hyperinsulinaemia enforces glucose fueling, depleting the NAD+ dependent antioxidant activity that increases mitochondrial reactive oxygen species (mtROS). Consequently, beta-cell mitochondria increase uncoupling protein expression, which decreases the mitochondrial ATP surge generation capacity, impairing bolus mediated insulin exocytosis. Excessive ROS increases the Drp1:Mfn2 ratio, increasing mitochondrial fission, which increases mtROS; endoplasmic reticulum-stress and impaired calcium homeostasis ensues. Healthy individuals in habitual ketosis have significantly lower glucagon and insulin levels than T2DM individuals. As beta-hydroxybutyrate rises, hepatic gluconeogenesis and glycogenolysis supply extra-hepatic glucose needs, and osteocalcin synthesis/release increases. We propose insulin’s primary role is regulating beta-hydroxybutyrate synthesis, while the role of bone regulates glucose uptake sensitivity via osteocalcin. Osteocalcin regulates the alpha-cell glucagon secretory profile via glucagon-like peptide-1 and serotonin, and beta-hydroxybutyrate synthesis via regulating basal insulin levels. Establishing metabolic phenotypes aids in resolving basal insulin secretion regulation, enabling elucidation of the pathological changes that occur and progress into chronic diseases associated with ageing.
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Abstract
Bone turnover markers fill a clinical need that improves comprehensive care of metabolic bone health and osteoporosis. Creating a standard process for drawing them that reduces modifiable variability improves their precision and clinical usefulness. Creating a standard process for interpreting them by applying statistical significance improves their clinical applicability. Understanding what causes them to increase and decrease can help elucidate secondary causes of osteoporosis. Monitoring them can assess patient adherence to therapy for a silent disease that will progressively become louder with an aging global population.
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Affiliation(s)
- Sumeet Jain
- Division of Endocrinology and Metabolism, Department of Medicine, Rush University Medical Center, 1725 West Harrison Street, Suite 250, Chicago, IL 60612, USA.
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Turoń-Skrzypińska A, Dutkiewicz G, Marchelek-Myśliwiec M, Rył A, Dziedziejko V, Safranow K, Ciechanowski K, Rotter I. Physical Activity versus Sclerostin and Interleukin 6 Concentration in Patients Receiving Renal Replacement Therapy by Hemodialysis. Risk Manag Healthc Policy 2020; 13:1467-1475. [PMID: 32982505 PMCID: PMC7490095 DOI: 10.2147/rmhp.s255780] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 07/22/2020] [Indexed: 01/04/2023] Open
Abstract
Introduction Chronic kidney disease and renal replacement therapy are associated with reduced motor activity, which may result in the presence of mineral bone disorders and an increase in inflammation markers. The aim of the study was to assess the relationship between the performance of daily physical activity, expressed in the number of steps performed by patients undergoing hemodialysis and the concentration of selected biochemical parameters (SCL, IL-6). Patients and Methods The study group (B) involved 33 patients aged 59.8 ± 9.8 years from the dialysis station at the Department of Nephrology, Transplantology and Internal Medicine PUM. In group B, interventions considering an increase in physical activity expressed in the number of steps were introduced. Group C consisted of 30 people aged 54.9 (9.37), with GFR over 60 mL/min/1.73m. Physical activity was measured with pedometers. Anthropometric and biochemical parameters were assessed at baseline, after the third and sixth month of the study. Descriptive statistics, intergroup comparisons using Mann–Whitney U test and Spearman correlation analysis were performed. The level of significance was set at p≤0.005. Results A relationship between IL-6 concentration and the number of steps in group B after three months of intervention was demonstrated. In group C, the concentration of SCL and IL-6 decreased with the increase in the number of steps taken. Only in group C the waist circumference decreased with the increase of the number of steps performed. Conclusion Patients receiving renal replacement therapy by hemodialysis showed significantly lower physical activity compared to people without kidney disease. Performing bigger number of steps can lower interleukin 6 levels in hemodialysis patients.
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Affiliation(s)
- Agnieszka Turoń-Skrzypińska
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University, Szczecin 71-210, Poland
| | - Grażyna Dutkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin 70-111, Poland
| | | | - Aleksandra Rył
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University, Szczecin 71-210, Poland
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin 70-111, Poland
| | - Krzysztof Safranow
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, Szczecin 70-111, Poland
| | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, Szczecin 70-111, Poland
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University, Szczecin 71-210, Poland
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Zhang X, Huang F, Chen X, Wu X, Zhu J. Ginsenoside Rg3 attenuates ovariectomy-induced osteoporosis via AMPK/mTOR signaling pathway. Drug Dev Res 2020; 81:875-884. [PMID: 32898934 DOI: 10.1002/ddr.21705] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 05/11/2020] [Accepted: 05/30/2020] [Indexed: 01/06/2023]
Abstract
Ginsenoside Rg3, a ginsenoside isolated from Panax ginseng, can regulate autophagy via AMP-activated protein kinase/mammalian target of rapamycin (AMPK/mTOR) signaling pathway. AMPK/mTOR signaling and autophagy have been reported to be involved in osteogenesis. Here, the effect of Rg3 on ovariectomy (OVX)-induced osteoporosis is explored. In vivo, rats were treated with 20 mg/kg Rg3 after OVX and the body weight (BW) was monitored. Bone mineral density (BMD), hematoxylin-eosin staining of femur tissues, osteogenesis, autophagy, and AMPK/mTOR signaling were analyzed. In vitro, MC3T3-E1 cells were treated with 0, 1, 5, 10, 20, and 100 μmol/L Rg3. 10 and 20 μmol/L Rg3, which had no significant effect on cell viability and significantly affected AMPK/mTOR signaling, were chosen for further analysis. Then osteogenic differentiation was induced with Rg3 or/and AMPK inhibitor (Compound C). AMPK/mTOR signaling, autophagy, osteogenic differentiation, and mineralization by Alizarin Red staining were analyzed. The expression or activity of AMPK/mTOR signaling-related proteins, autophagy markers, and osteogenesis markers was measured by western blotting or commercial kits, and cell viability by cell counting kit-8 assay kits. Rg3 significantly alleviated OVX-induced BW increases, BMD declines and histological changes of femur tissues, promoted osteogenesis, autophagy, and AMPK signaling, but inhibited mTOR signaling in vivo. Moreover, Rg3 significantly enhanced AMPK signaling, autophagy, osteogenic differentiation, and mineralization, but suppressed mTOR signaling in vitro. However, Compound C significantly reversed Rg3-induced alterations in vitro, indicating that Rg3 regulated autophagy, osteogenic differentiation, and mineralization via AMPK/mTOR signaling. Hence, it was speculated that Rg3 might attenuate OVX-induced osteoporosis via AMPK/mTOR signaling pathway.
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Affiliation(s)
- Xiaonan Zhang
- Department of Orthopaedics and Traumatology, Shenzhen University General Hospital, Shenzhen, 518055, People's Republic of China.,Guangdong Key Laboratory for Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, Health Science Center, Shenzhen University, Shenzhen, 518060, People's Republic of China
| | - Fenglan Huang
- Department of Endocrine and Metabolism, Shenzhen University General Hospital, Shenzhen, 518060, People's Republic of China
| | - Xiaoyong Chen
- Department of Orthopaedics and Traumatology, Shenzhen University General Hospital, Shenzhen, 518055, People's Republic of China
| | - Xiaoqing Wu
- Department of Orthopaedics and Traumatology, Shenzhen University General Hospital, Shenzhen, 518055, People's Republic of China
| | - Jinyu Zhu
- Department of Orthopaedics and Traumatology, Shenzhen University General Hospital, Shenzhen, 518055, People's Republic of China
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Noel SE, Mangano KM, Mattei J, Griffith JL, Dawson-Hughes B, Bigornia S, Tucker KL. Dietary Approaches to Stop Hypertension, Mediterranean, and Alternative Healthy Eating indices are associated with bone health among Puerto Rican adults from the Boston Puerto Rican Osteoporosis Study. Am J Clin Nutr 2020; 111:1267-1277. [PMID: 32386194 PMCID: PMC7266690 DOI: 10.1093/ajcn/nqaa090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 04/07/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Conflicting results on associations between dietary quality and bone have been noted across populations, and this has been understudied in Puerto Ricans, a population at higher risk of osteoporosis than previously appreciated. OBJECTIVE To compare cross-sectional associations between 3 dietary quality indices [Dietary Approaches to Stop Hypertension (DASH), Alternative Health Eating Index (AHEI-2010), and Mediterranean Diet Score (MeDS)] with bone outcomes. METHOD Participants (n = 865-896) from the Boston Puerto Rican Osteoporosis Study (BPROS) with complete bone and dietary data were included. Indices were calculated from validated food frequency data. Bone mineral density (BMD) was measured using DXA. Associations between dietary indices (z-scores) and their individual components with BMD and osteoporosis were tested with ANCOVA and logistic regression, respectively, at the lumbar spine and femoral neck, stratified by male, premenopausal women, and postmenopausal women. RESULTS Participants were 59.9 y ± 7.6 y and mostly female (71%). Among postmenopausal women not taking estrogen, DASH (score: 11-38) was associated with higher trochanter (0.026 ± 0.006 g/cm2, P <0.001), femoral neck (0.022 ± 0.006 g/cm2, P <0.001), total hip (0.029 ± 0.006 g/cm2, P <0.001), and lumbar spine BMD (0.025 ± 0.007 g/cm2, P = 0.001). AHEI (score: 25-86) was also associated with spine and all hip sites (P <0.02), whereas MeDS (0-9) was associated only with total hip (P = 0.01) and trochanter BMD (P = 0.007) in postmenopausal women. All indices were associated with a lower likelihood of osteoporosis (OR from 0.54 to 0.75). None of the results were significant for men or premenopausal women. CONCLUSIONS Although all appeared protective, DASH was more positively associated with BMD than AHEI or MeDS in postmenopausal women not taking estrogen. Methodological differences across scores suggest that a bone-specific index that builds on existing indices and that can be used to address dietary differences across cultural and ethnic minority populations should be considered.
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA,Address correspondence to SEN (e-mail: )
| | - Kelsey M Mangano
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
| | - Josiemer Mattei
- Department of Nutrition, Harvard TH Chan School of Public Health, Harvard University, Boston, MA, USA
| | - John L Griffith
- Department of Health Sciences, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Bess Dawson-Hughes
- Jean Mayer US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Sherman Bigornia
- Department of Agriculture, Nutrition, and Food Systems, University of New Hampshire Durham, Durham, MA, USA
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA
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Senay A, Perreault S, Delisle J, Morin SN, Fernandes JC. Performance of a Fracture Liaison Service in an Orthopaedic Setting: A Report of Key Indicators and Improvement of Longitudinal Outcomes. J Bone Joint Surg Am 2020; 102:486-494. [PMID: 31714470 DOI: 10.2106/jbjs.19.00185] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Many Fracture Liaison Services (FLSs) have been successfully implemented, but very few incorporate systematic longitudinal follow-up. The objective of this study was to report on the performance of such an FLS using key performance indicators and longitudinal clinical outcomes. METHODS An FLS was implemented in 2 outpatient orthopaedic clinics. Men and women who were ≥40 years of age and had a recent fragility fracture were recruited. Participants were evaluated, treated when appropriate, and systematically followed over a 2-year period. Clinical data including chart review and questionnaires were collected. Medical services and hospitalization claims data were retrieved from administrative databases. The primary outcomes were the following key performance indicators: the numbers of investigated and treated patients, follow-up attendance, and the incidence of subsequent fractures. Secondary outcomes were the changes in bone turnover markers and quality of life, physical capacity, and pain scores between baseline and follow-up visits. RESULTS A total of 532 subjects with a mean age of 63.4 years were recruited; 85.7% were female. Bone mineral density results were collected for 472 subjects (88.7%) and a prescription for anti-osteoporosis medication was given to 86.6% of patients. Overall, 83.6% of patients attended at least 1 follow-up visit. The subsequent fracture incidence rate was 2.6 per 100 person-years (23 fractures). The mean level of type-I collagen C-telopeptide (CTX-1), a bone resorption marker, decreased >35%. Clinically important improvements of functional capacity scores (by 14.4% to 63.7%) and pain level (by 19.3% to 35.7%) were observed over time; however, the increase in quality-of-life scores was not clinically important (by 3% to 15.2%). CONCLUSIONS In this FLS, the rates of investigation, treatment, and participation were >80% over a 2-year period. The subsequent fragility fracture incidence rate was <3 per 100 person-years. These results suggest that an intensive FLS model of care, with a systematic longitudinal follow-up, is effective. A randomized controlled trial is needed to support these results. LEVEL OF EVIDENCE Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
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Affiliation(s)
- Andréa Senay
- Faculties of Pharmacy (A.S. and S.P.) and Medicine (J.C.F.), Université de Montréal, Montréal, Québec, Canada.,CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada
| | - Sylvie Perreault
- Faculties of Pharmacy (A.S. and S.P.) and Medicine (J.C.F.), Université de Montréal, Montréal, Québec, Canada
| | - Josée Delisle
- CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital Jean-Talon, Montréal, Montréal, Québec, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Center for Outcomes and Evaluation, Montréal, Québec, Canada
| | - Julio C Fernandes
- Faculties of Pharmacy (A.S. and S.P.) and Medicine (J.C.F.), Université de Montréal, Montréal, Québec, Canada.,CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital du Sacré-Coeur de Montréal, Montréal, Québec, Canada.,CIUSSS du Nord-de-l'Île-de-Montréal, Hôpital Jean-Talon, Montréal, Montréal, Québec, Canada
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Zheng JS, Ruan HR, Shuang-Qiu, Jing-Nie, Hou KW, Rui-Wu. Therapeutic Effects of Revascularisation on the Healing of Free Bone Grafts in Dogs. J Vet Res 2020; 64:175-180. [PMID: 32258815 PMCID: PMC7105986 DOI: 10.2478/jvetres-2020-0023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 03/02/2020] [Indexed: 11/20/2022] Open
Abstract
INTRODUCTION The therapeutic effect of subcutaneous embedding and revascularisation on the repair of canine bone defects caused by open fracture was examined. MATERIAL AND METHODS A total of 12 adult beagle dogs were randomly split into a control group (group C) and a test group (group T). A section of the radius was removed from each dog under general anaesthesia and the deficit supported by an orthopaedic implant. Group T had the section surgically implanted next to the blood vessel-rich saphenous vein and Group C had it cryopreserved at -80°C. After eight weeks, the bone was surgically implanted back into the matching radial deficit. Bone healing was evaluated by gross morphological and X-ray examinations, post-mortem histology, and successive blood measurements of key bone biochemical markers. RESULTS At 12 weeks, the bone healing boundary was disappearing more quickly in group T dogs than in their group C counterparts. X-ray and histological examinations showed that the cortical repair of group T subjects was complete and the bony plate arrangement was more regular than that in group C. The levels of bone biochemical markers also proved that the healing state of group T was better. CONCLUSION The results showed that the degree of healing, osteoclast activity, and bone formation status of group T were better than those of group C, proving that the vascularised bone graft had a significantly shorter healing time than the cryopreserved bone graft.
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Affiliation(s)
- Jia-San Zheng
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University Daqing High-tech Industrial Development Zone, Daqing, 163319, People’s Republic of China
| | - Hong-Ri Ruan
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University Daqing High-tech Industrial Development Zone, Daqing, 163319, People’s Republic of China
| | - Shuang-Qiu
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University Daqing High-tech Industrial Development Zone, Daqing, 163319, People’s Republic of China
| | - Jing-Nie
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University Daqing High-tech Industrial Development Zone, Daqing, 163319, People’s Republic of China
| | - Kai-Wen Hou
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University Daqing High-tech Industrial Development Zone, Daqing, 163319, People’s Republic of China
| | - Rui-Wu
- College of Animal Science and Veterinary Medicine, Heilongjiang Bayi Agricultural University Daqing High-tech Industrial Development Zone, Daqing, 163319, People’s Republic of China
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Correlation between Urine N-Terminal Telopeptide and Fourier Transform Infrared Spectroscopy Parameters: A Preliminary Study. J Osteoporos 2020; 2020:5725086. [PMID: 32095227 PMCID: PMC7036120 DOI: 10.1155/2020/5725086] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 01/21/2020] [Indexed: 11/17/2022] Open
Abstract
N-terminal telopeptide (NTX) is a bone resorption marker that is commonly referenced in clinical practice. Bone remodeling is also associated with changes in mineral components. Fourier transform infrared spectroscopy (FTIR) is utilized in the assessment of bone material properties and some parameters are reported to have associations with bone remodeling. The aim of this cross-sectional study is to investigate the relationship between uNTX levels and FTIR parameters, utilizing prospectively collected study data for patients who underwent lumbar fusion surgery. Bone specimens were taken from iliac crest (IC) and vertebrae (V). Cortical (C) and trabecular (T) bones were separately analyzed. 22 patients (mean age 60.0 years (35.9-73.3), male : female 9 : 13) were included in the final analysis. Women showed significantly higher uNTX levels (male : female, median [range] 21.0 [11.0-39.0] : 36.0 [15.0-74.0] nM·BCE/mM, p=0.033). Among women, a significant positive correlation was observed between uNTX and mineral-to-matrix ratio in IC-C. Among men, uNTX demonstrated significant negative correlation with collagen crosslinks (XLR: ratio of mature to immature collagen crosslinks) in IC-C, V-T, and V-C. In addition, uNTX was positively correlated with acid phosphate substitution (HPO4, a parameter of new bone formation) in IC-C, IC-T, and V-C. After age adjustment, HPO4 in IC-T and V-C among men showed significant positive associations with uNTX (IC-T: p=0.018, R 2 = 0.544; V-C: p=0.007, R 2 = 0.672). We found associations between FTIR parameters and uNTX in men, but not in women. The correlations between uNTX and FTIR parameters in men might suggest a better balance of bone breakdown (uNTX) and new bone formation (FTIR parameters: XLR, HPO4) than in women.
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Marini S, Barone G, Masini A, Dallolio L, Bragonzoni L, Longobucco Y, Maffei F. The Effect of Physical Activity on Bone Biomarkers in People With Osteoporosis: A Systematic Review. Front Endocrinol (Lausanne) 2020; 11:585689. [PMID: 33193098 PMCID: PMC7644859 DOI: 10.3389/fendo.2020.585689] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 10/05/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Bone imbalance between anabolic and catabolic processes at the level of remodeling unit due to the prevalence of resorbing activity, represents a health problem of aging. The consequence is the negative balance of bone turnover that can lead to osteoporosis. Physical activity (PA) can play a central role in the comprehensive management of osteoporosis, since it induces the anabolism of bone tissue. Bone turnover biomarkers, reflecting the cellular activity linked to bone metabolism, can represent an evaluation tool to assess the efficacy of PA in the osteoporotic population. The aim of this systematic review, conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement, was to investigate the effects of PA interventions on bone biomarkers in people with osteoporosis. METHODS A comprehensive literature search of electronic databases was conducted through PubMed, Cochrane, Cinahl, Embase, Trip, to find randomized controlled trials (RCTs) investigating the topic of PA and bone turnover biomarkers in the osteoporosis population. In accordance with the Cochrane risk-of-bias tool, the quality of each study was assessed. RESULTS Out of 992 identified articles, 136 full texts were screened. Only three RTCs matched the eligibility criteria. In one study, sub-maximal aerobic exercise improved Bone-specific alkaline phosphatase (bone formation biomarker) and Amino-terminal Crosslinked Telopeptide of type 1 collagen (bone resorption biomarker) in osteoporotic women. The other two studies showed a positive effect on total alkaline phosphatase (a non-specific bone formation biomarker) in women with osteoporosis. CONCLUSION The systematic review revealed possible exercise benefits in terms of improving bone formation and decreasing bone resorption biomarkers in the osteoporotic population. However, these results should be interpreted with caution, especially due to the limited number and poor quality of the studies included. Further research is needed to estimate the influence of PA on bone biomarkers in the osteoporosis management.
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Affiliation(s)
- Sofia Marini
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, Rimini, Italy
| | - Giuseppe Barone
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, Rimini, Italy
| | - Alice Masini
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
- *Correspondence: Alice Masini,
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - Laura Bragonzoni
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, Rimini, Italy
| | - Yari Longobucco
- Clinical and Experimental Medicine Unit, Department of Medicine and Surgery, University of Parma, Parma, Italy
| | - Francesca Maffei
- Department of Life Quality Studies, University of Bologna, Campus of Rimini, Rimini, Italy
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Turon-Skrzypinska A, Dutkiewicz G, Marchelek-Mysliwiec M, Dziedziejko V, Ciechanowski K, Ryl A, Rotter I. Assessment of Sclerostin and Interleukin 6 Levels and Selected Anthropometric Parameters in Patients Receiving Hemodialysis Replacement Therapy-Pilot Study. MEDICINA (KAUNAS, LITHUANIA) 2019; 55:E784. [PMID: 31847451 PMCID: PMC6955865 DOI: 10.3390/medicina55120784] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 12/03/2019] [Accepted: 12/11/2019] [Indexed: 12/26/2022]
Abstract
Background and Objectives: Chronic kidney disease (CKD) is an important public health problem associated with, e.g., progressive renal insufficiency, bone mineral disorders, and increased inflammatory marker levels. The objective of this study was to compare selected biochemical parameters and to evaluate potential correlations between selected anthropometric parameters and levels of sclerostin and interleukin 6 (IL-6) in blood plasma. Materials and Methods: The study group consisted of 34 patients aged 59.8 ± 9.8 years, receiving hemodialysis therapy. The control group consisted of 31 individuals aged 55.4 ± 9.37 years, presenting with GFR (glomerular filtration rate) of more than 60 mL/min/1.73 m2. Selected anthropometric and biochemical parameters were assessed at baseline, as well as 3 and 6 months into the study. Statistical analyses were performed using the Statistica 2014 software package (StatSoft, Inc.Tulsa, OK, USA). Analyses included descriptive statistics, intergroup comparisons using the Mann-Whitney U-test or the Kruskal-Wallis test, and Spearman's correlation analysis. The significance level was set at p ≤ 0.005. Results: At all measurement time points, i.e., at baseline, at month 3, and at month 6, the IL-6 levels in the study group were significantly higher than those in the control group. No correlations were observed in the study group between SCL or IL-6 levels and anthropometric parameters such as body weight, body mass index (BMI), or waist circumference. Conclusions: Patients receiving hemodialysis replacement therapy present with significantly higher levels of IL-6 in their blood. Anthropometric parameters (body weight, BMI, and waist circumference) have no impact on sclerostin and IL-6 levels in patients undergoing hemodialysis therapy. The results obtained are satisfactory, and the research will be continued.
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Affiliation(s)
- Agnieszka Turon-Skrzypinska
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.R.); (I.R.)
| | - Grazyna Dutkiewicz
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111Szczecin, Poland; (G.D.); (M.M.-M.); (K.C.)
| | - Malgorzata Marchelek-Mysliwiec
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111Szczecin, Poland; (G.D.); (M.M.-M.); (K.C.)
| | - Violetta Dziedziejko
- Department of Biochemistry and Medical Chemistry, Pomeranian Medical University, 70-111 Szczecin, Poland;
| | - Kazimierz Ciechanowski
- Department of Nephrology, Transplantology and Internal Medicine, Pomeranian Medical University, 70-111Szczecin, Poland; (G.D.); (M.M.-M.); (K.C.)
| | - Aleksandra Ryl
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.R.); (I.R.)
| | - Iwona Rotter
- Department of Medical Rehabilitation and Clinical Rehabilitation, Pomeranian Medical University, 71-210 Szczecin, Poland; (A.R.); (I.R.)
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Mo H, Zhang N, Li H, Li F, Pu R. Beneficial effects of Cuscuta chinensis extract on glucocorticoid-induced osteoporosis through modulation of RANKL/OPG signals. ACTA ACUST UNITED AC 2019; 52:e8754. [PMID: 31826180 PMCID: PMC6903142 DOI: 10.1590/1414-431x20198754] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Accepted: 09/18/2019] [Indexed: 12/16/2022]
Abstract
Cuscuta chinensis Lam. (Convolvulaceae) is an important herbal medicine widely used to improve sexual function, treat osteoporosis, and prevent aging, and has been reported to exhibit anti-osteoporotic effects in vitro. However, the activity of Cuscuta chinensis Lam. on glucocorticoid-induced osteoporosis still remains unclear. The present study aimed to assess the protective effect and the underlying mechanism of action of Cuscuta chinensis extract (CCE) against glucocorticoid-induced osteoporosis in vivo. Sprague-Dawley rats were randomly divided into four groups as follows: control group, osteoporosis group, and 2 CCE-treated osteoporosis groups (100 mg·kg-1·day-1). Blood samples and femur bones were collected for immunohistochemistry, biochemical, mRNA expression, and western blot analysis. HPLC analysis revealed that chlorogenic acid, quercetin, and hyperin were the major constituents of CCE. The results indicated that CCE increased bone length, bone weight, and bone mineral density and suppressed dexamethasone (DEX)-induced reduction in body weight. In addition, TRAP staining indicated that CCE reduced osteoclasts in DEX-induced osteoporosis rats. Mechanistically, CCE treatment alleviated the increase of bone resorption markers and the decline of osteogenic markers, which might be partially mediated by regulation of RANKL/OPG and RunX2 pathways. These results suggest that CCE showed promising effects in the protection against glucocorticoid-induced osteoporosis through protecting osteoblasts and suppressing osteoclastogenesis.
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Affiliation(s)
- Hui Mo
- Department of Nuclear Medicine, Maoming People's Hospital, Maoming, Guangdong, China
| | - Ning Zhang
- Department of Nuclear Medicine, Maoming People's Hospital, Maoming, Guangdong, China
| | - Huifu Li
- Department of Nuclear Medicine, Maoming People's Hospital, Maoming, Guangdong, China
| | - Fan Li
- Department of Nuclear Medicine, Maoming People's Hospital, Maoming, Guangdong, China
| | - Rong Pu
- Clinical Laboratory of the Third People's Hospital of Dongguan City, Dongguan, Guangdong, China
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Ahn SH, Park SY, Yoo JI, Chung YJ, Jeon YK, Yoon BH, Kim HY, Lee SH, Lee J, Hong S. Use of Bone Turnover Markers in Clinical Practice for the Management of Osteoporosis in Korea: From the Survey on the Prescription Pattern of Bone Turnover Markers. J Bone Metab 2019; 26:271-277. [PMID: 31832393 PMCID: PMC6901689 DOI: 10.11005/jbm.2019.26.4.271] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/27/2019] [Accepted: 11/28/2019] [Indexed: 11/23/2022] Open
Abstract
Background There has been interest in the clinical potential of bone turnover markers (BTMs) as tools both for assessing fracture risk and for monitoring treatment. However, the practical use of BTMs has been limited by their biological variability and difficulties in the interpretation of results. We investigated the current situation of application of BTMs by clinicians in Korea for the management of osteoporosis through a survey asking the patterns of BTMs prescription in clinical practice. Methods The survey was conducted online using the “google survey” by the BTM committee authorized by the Korean Society for Bone and Mineral Research. Results Total 108 clinicians responded the survey. Most of the respondents prescribed BTMs (80.6%) when they prescribed anti-osteoporotic medications (AOMs). The most frequently prescribed bone resorption and formation markers were serum C-terminal telopeptide of type I collagen (90.7%) and osteocalcin (65.1%), respectively. BTMs were mostly prescribed before starting AOMs (90.8%) and used for the purpose of evaluating treatment response (74.4%). Treatment response and compliance to AOMs were evaluated according to the change of absolute value of BTMs (55.1%). The respondents complained difficulties in the interpretation of BTMs (33.3%), the choice of proper BTMs (17.2%), and the proper sample preparation and handling (13.8%). Conclusions In Korea, most of clinicians recognized the benefit of BTMs in the management of osteoporosis. However, there are limitations in the broad use of these markers in clinical practice. Therefore, a clear recommendation for BTM in Korea enhances their use in clinical practice.
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Affiliation(s)
- Seong Hee Ahn
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
| | - So Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kyung Hee University Hospital, Seoul, Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Gyeongsang National University Hospital, Jinju, Korea
| | - Youn-Jee Chung
- Department of Obstetrics and Gynecology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yun Kyung Jeon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Pusan National University Hospital, Busan, Korea
| | - Byung-Ho Yoon
- Department of Orthopaedic Surgery, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ha Young Kim
- Division of Endocrinology, Department of Internal Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
| | - Seung Hun Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jehoon Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seongbin Hong
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon, Korea
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Ross RD, Shah RC, Leurgans S, Bottiglieri T, Wilson RS, Sumner DR. Circulating Dkk1 and TRAIL Are Associated With Cognitive Decline in Community-Dwelling, Older Adults With Cognitive Concerns. J Gerontol A Biol Sci Med Sci 2019; 73:1688-1694. [PMID: 29432613 DOI: 10.1093/gerona/glx252] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Indexed: 12/22/2022] Open
Abstract
Background Osteoporosis and Alzheimer's disease are common diseases of aging that would seem to be unrelated, but may be linked through the influence of bone-derived signals on brain function. The aim of the current study is to investigate the relationship between circulating levels of bone-related biomarkers and cognition. Methods The population included 103 community-dwelling older individuals with memory concerns but without cognitive impairment. A global cognition summary measure was collected at baseline and 6, 12, and 18 months post-enrollment by converting raw scores from 19 cognitive function tests to z-scores and averaging. Baseline plasma concentrations of bone-related biomarkers, including undercarboxylated, carboxylated, and total osteocalcin, parathyroid hormone, C-terminal telopeptide of collagen 1 (CTX-1), procollagen type 1 amino-terminal propeptide, osteoprotegrin, osteopontin, Dickkopf WNT signaling pathway inhibitor 1 (Dkk1), sclerostin, and amyloid β peptides (Aβ40 and Aβ42), were measured. Results Using sex, age, and education-adjusted mixed-effects models, we found that baseline levels of TNF-related apoptosis-inducing ligand (TRAIL; p < .001), Dkk1 (p = .014), and CTX-1 (p = .046) were related to the annual rate of change of global cognition over the 18 month follow-up. In cognitive domain-specific analysis, baseline TRAIL was found to be positively related to the annual rate of change in episodic (p < .001) and working memory (p = .016), and baseline Dkk1 was positively related to semantic memory (p = .027) and negatively related to working memory (p = .016). Conclusions These results further confirm the link between bone and brain health and suggest that circulating levels of bone-related biomarkers may have diagnostic potential to predict worsening cognition.
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Affiliation(s)
- Ryan D Ross
- Department of Cell and Molecular Medicine, Rush University Medical Center, Chicago, Illinois
| | - Raj C Shah
- Department of Family Medicine, Rush University Medical Center, Chicago, Illinois.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Sue Leurgans
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | | | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Dale Rick Sumner
- Department of Cell and Molecular Medicine, Rush University Medical Center, Chicago, Illinois.,Department of Orthopedic Surgery, Rush University Medical Center, Chicago, Illinois
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Jääskeläinen A, Jukkola A, Risteli J, Haapasaari KM, Karihtala P. Elevated preoperative serum levels of collagen I carboxyterminal telopeptide predict better outcome in early-stage luminal-B-like (HER2-negative) and triple-negative subtypes of breast cancer. Tumour Biol 2019; 41:1010428319847081. [PMID: 31122159 DOI: 10.1177/1010428319847081] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Type 1 collagen is an important part of the extracellular matrix and changes in its metabolism and distribution are essential in breast cancer induction and progression. Serum concentrations of type 1 collagen synthesis (aminoterminal propeptide (PINP)) and degradation markers (carboxyterminal telopeptide (ICTP)) have previously been studied in early and metastatic breast cancer, but no data are available on specific breast cancer subtypes. We assayed 662 preoperative serum samples for PINP and ICTP and 109 postoperative serum samples for ICTP. The results were linked to prospectively collected clinical data and the cases were divided into breast cancer subtypes for survival analyses. The concentrations of both pre- and postoperative ICTP serum levels increased linearly from ductal in situ carcinoma to stage I-II tumors, stage III tumors, and finally to those with concomitant primary metastases (preoperative ICTP, p = 0.009; postoperative ICTP, p = 0.016). High-preoperative ICTP levels were associated with better breast cancer-specific survival in connection with luminal-B-like (HER2-negative) tumors (p = 0.017), which was confirmed in Cox regression analysis (relative risk = 3.127; 95% confidence interval = 1.081-9.049, p = 0.035), when T-class (relative risk = 4.049; 95% confidence interval = 1.263-12.981; p = 0.019) and nodal status (relative risk = 3.896; 95% confidence interval = 1.088-13.959; p = 0.037) were included in the analysis. In patients with triple-negative breast cancer, a high-preoperative ICTP level was a significant predictor of local relapse-free survival in univariate (p = 0.0020) and multivariate analyses (relative risk = 13.04; 95% confidence interval = 1.354-125.5; p = 0.026; for T-class, relative risk = 2.128 and 95% confidence interval = 0.297-15.23; p = 0.452; for N-class, relative risk = 0.332 and 95% confidence interval = 0.033-3.307; p = 0.347). A preoperatively elevated serum ICTP level appears to be an important marker of better prognosis in triple-negative breast cancer and luminal-B-like (HER2-negative) subtypes.
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Affiliation(s)
- Anniina Jääskeläinen
- 1 Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
- 2 Department of Pathology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Arja Jukkola
- 3 Department of Oncology, Tampere University Hospital, Tampere, Finland
| | - Juha Risteli
- 4 Department of Clinical Chemistry, Medical Research Center Oulu, University of Oulu, Oulu, Finland
- 5 Northern Finland Laboratory Centre (NordLab), Oulu University Hospital, Oulu, Finland
| | - Kirsi-Maria Haapasaari
- 2 Department of Pathology, Medical Research Center Oulu, Oulu University Hospital, Oulu, Finland
| | - Peeter Karihtala
- 1 Department of Oncology and Radiotherapy, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
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Cousminer DL, McCormack SE, Mitchell JA, Chesi A, Kindler JM, Kelly A, Voight BF, Kalkwarf HJ, Lappe JM, Shepherd JA, Oberfield SE, Gilsanz V, Zemel BS, Grant SFA. Postmenopausal osteoporotic fracture-associated COLIA1 variant impacts bone accretion in girls. Bone 2019; 121:221-226. [PMID: 30711642 PMCID: PMC6800229 DOI: 10.1016/j.bone.2019.01.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 01/17/2019] [Accepted: 01/29/2019] [Indexed: 11/15/2022]
Abstract
Over the past two decades, a low frequency variant (rs1800012) within the first intron of the type I collagen alpha 1 (COLIA1) gene has been implicated in lower areal BMD (aBMD) and increased risk of osteoporotic fracture. This association is particularly strong in postmenopausal women, in whom net bone loss arises in the context of high bone turnover. High bone turnover also accompanies childhood linear growth; however, the role of rs1800012 in this stage of net bone accretion is less well understood. Thus, we assessed the association between rs1800012 and aBMD and bone mineral content (BMC) Z-scores for the 1/3 distal radius, lumbar spine, total hip, and femoral neck total body less head in the Bone Mineral Density in Childhood Study, a mixed-longitudinal cohort of children and adolescents (total n = 804 girls and 771 boys; n = 19 girls and 22 boys with the TT genotype). Mixed effects modeling, stratified by sex, was used to test for associations between rs1800012 and aBMD or BMC Z-scores and for pubertal stage interactions. Separately, SITAR growth modeling of aBMD and BMC in subjects with longitudinal data reduced the complex longitudinal bone accrual curves into three parameters representing a-size, b-timing, and c-velocity. We tested for differences in these three parameters by rs1800012 genotype using t-tests. Girls with the TT genotype had significantly lower aBMD and BMC Z-scores prior to puberty completion (e.g. spine aBMD-Z P-interaction = 1.0 × 10-6), but this association was attenuated post-puberty. SITAR models revealed that TT girls began pubertal bone accrual later (b-timing; e.g. total hip BMC, P = 0.03). BMC and aBMD Z-scores also increased across puberty in TT homozygous boys. Our data, along with previous findings in post-menopausal women, suggest that rs1800012 principally affects female bone density during periods of high turnover. Insights into the genetics of bone gain and loss may be masked during the relatively quiescent state in mid-adulthood, and discovery efforts should focus on early and late life.
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Affiliation(s)
- Diana L Cousminer
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; Department of Genetics, University of Pennsylvania, Philadelphia, PA, United States of America; Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America.
| | - Shana E McCormack
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Jonathan A Mitchell
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Alessandra Chesi
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; Department of Genetics, University of Pennsylvania, Philadelphia, PA, United States of America; Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Joseph M Kindler
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Andrea Kelly
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; Division of Endocrinology and Diabetes, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Benjamin F Voight
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, United States of America; Department of Systems Pharmacology and Translation Therapeutics, University of Pennsylvania, Philadelphia, PA, United States of America; Institute of Translational Medicine and Therapeutics, University of Pennsylvania, Philadelphia, PA, United States of America
| | - Heidi J Kalkwarf
- Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, United States of America
| | - Joan M Lappe
- Division of Endocrinology, Department of Medicine, Creighton University, Omaha, NB, United States of America
| | - John A Shepherd
- University of Hawaii Cancer Center, Honolulu, HI, United States of America
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Diabetes, and Metabolism, Department of Pediatrics, Columbia University Medical Center, New York, NY, United States of America
| | - Vicente Gilsanz
- Department of Radiology, Children's Hospital Los Angeles, Los Angeles, LA, United States of America
| | - Babette S Zemel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States of America; Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, United States of America
| | - Struan F A Grant
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America; Department of Genetics, University of Pennsylvania, Philadelphia, PA, United States of America; Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, United States of America.
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Liu Y, Liu X, R Lewis J, Brock K, C Brennan-Speranza T, Teixeira-Pinto A. Relationship between serum osteocalcin/undercarboxylated osteocalcin and type 2 diabetes: a systematic review/meta-analysis study protocol. BMJ Open 2019; 9:e023918. [PMID: 30862632 PMCID: PMC6429918 DOI: 10.1136/bmjopen-2018-023918] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION The global burden of type 2 diabetes (T2DM) is steadily increasing. Experimental studies have demonstrated that a novel hormone secreted by bone cells, osteocalcin (OC), can stimulate beta-cell proliferation and improve insulin sensitivity in mice. Observational studies in humans have investigated the relationship between OC and metabolic parameters, and T2DM. Importantly, few studies have reported on the undercarboxylated form of OC (ucOC), which is the putative active form of OC suggested to affect glucose metabolism. OBJECTIVES We will conduct a systematic review and meta-analysis to: (1) compare the levels of serum OC and ucOC between T2DM and normal glucose-tolerant controls (NGC); (2) investigate the risk ratios between serum OC and ucOC, and T2DM; (3) determine the correlation coefficient between OC and ucOC and fasting insulin levels, homeostatic model assessment-insulin resistance, haemoglobin A1c and fasting glucose levels and (4) explore potential sources of between-study heterogeneity. The secondary objective is to compare the serum OC and ucOC between pre-diabetes (PD) and NGC and between T2DM and PD. HODS AND ANALYSIS This study will report items in line with the guidelines outlined in preferred reporting items for systematic reviews and meta-analysis of observational studies in epidemiology. We will include observational studies (cohort, case-control and cross-sectional studies) and intervention studies with baseline data. Three databases (MEDLINE, EMBASE and SCOPUS) will be searched from inception until July 2018 without language restrictions. Two reviewers will independently screen the titles and abstracts and conduct a full-text assessment to identify eligible studies. Discrepancies will be resolved by consensus with a third reviewer. The risk of bias assessment will be conducted by two reviewers independently based on the Newcastle-Ottawa Scale. Potential sources of between-study heterogeneity will be tested using meta-regression/subgroup analyses. Contour-enhanced funnel plots and Egger's test will be used to identify potential publication bias. ETHICS AND DISSEMINATION Formal ethical approval is not required. We will disseminate the results to a peer-reviewed publication and conference presentation. PROSPERO REGISTRATION NUMBER CRD42017073127.
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Affiliation(s)
- Yihui Liu
- Centre for Kidney Research, Children's Hospital, Westmead, New South Wales, Australia
- School Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Xiaoying Liu
- School Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
| | - Joshua R Lewis
- Centre for Kidney Research, Children's Hospital, Westmead, New South Wales, Australia
- School of Medicine, Faculty of Medicine and Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Kaye Brock
- School of Medical Sciences, University of Sydney, Camperdown, New South Wales, Australia
| | | | - Armando Teixeira-Pinto
- Centre for Kidney Research, Children's Hospital, Westmead, New South Wales, Australia
- School Public Health, Faculty of Medicine and Health, University of Sydney, Camperdown, New South Wales, Australia
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42
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Senay A, Perreault S, Delisle J, Morin SN, Raynauld JP, Banica A, Troyanov Y, Beaumont P, Jodoin A, Laflamme GY, Leduc S, Mac-Thiong JM, Nguyen H, Ranger P, Rouleau DM, Fernandes JC. Rationale, study design, and descriptive data of the Lucky Bone™ Fracture Liaison Service. Arch Osteoporos 2019; 14:19. [PMID: 30756193 DOI: 10.1007/s11657-019-0571-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 01/27/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED The study design of a multidisciplinary Fracture Liaison Service (2-year follow-up) aiming to optimize fragility fracture management in an outpatient setting is presented. Patient characteristics, investigation, and treatment initiation data at baseline were recorded. Results corroborate the care gap in osteoporosis management, reinforcing the need for secondary fracture prevention programs. PURPOSE This paper describes the study design, implementation, and baseline characteristics of a multidisciplinary Fracture Liaison Service (FLS) in Quebec (Canada). METHODS A FLS was implemented as a prospective cohort study. After identification, fracture risk was assessed and patients were started on treatment or referred, according to guidelines and risk assessment. Thereafter, patients were systematically followed over 2 years. Clinical data (fractures, bone density, blood testing (bone turnover markers), quality of life, physical disability) as well as administrative data (pharmacological, health services, hospitalization) was collected. Baseline descriptive data was analyzed and presented. RESULTS Of 542 recruited participants, 532 underwent baseline assessment (85.7% female, mean age 63.4 years). Overall, 29.7% of participants either withdrew from the study or were lost to follow-up. Almost 27% were referred to a specialist, while > 70% received anti-osteoporosis medication prescriptions through the FLS at baseline. Mean femoral T-score was - 1.6 ± 1.0 and vertebral T-score was - 1.7 ± 1.4. Nearly 19% of subjects reported being under anti-osteoporosis medication at the time of incident fracture. Thirty-three percent of participants reported a prior fracture history, of which 29.7% reported being given anti-osteoporosis therapy. Most fracture sites were to the wrist and ankle, while < 19% were hip/femur or vertebral fractures. CONCLUSIONS These results highlight the important care gap in fragility fracture management and reinforce the need for secondary fracture prevention programs. This prospective study will allow the evaluation of key performance indicators for outpatient clinic-based FLS, such as medication usage, by combining prospective clinical and administrative data.
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Affiliation(s)
- Andréa Senay
- Faculty of Pharmacy, Université de Montréal, 2900 bl. Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada
| | - Sylvie Perreault
- Faculty of Pharmacy, Université de Montréal, 2900 bl. Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada.,Sanofi Aventis endowment Research Chair in Optimal Drug Use, Université de Montréal, Montreal, Canada
| | - Josée Delisle
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada.,CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada
| | - Suzanne N Morin
- McGill University Health Centre, Montreal General Hospital, 1650 Cedar avenue, Room B2.118, Montreal, QC, H3G 1A4, Canada
| | - Jean-Pierre Raynauld
- Institut de rhumatologie de Montréal, 1551 rue Ontario est, Montreal, QC, H2L 1S6, Canada
| | - Andreea Banica
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada.,CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada
| | - Yves Troyanov
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada
| | - Pierre Beaumont
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada
| | - Alain Jodoin
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada
| | - G Yves Laflamme
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada.,CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada
| | - Stéphane Leduc
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada.,CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada
| | - Jean-Marc Mac-Thiong
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada
| | - Hai Nguyen
- CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada
| | - Pierre Ranger
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada.,CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada
| | - Dominique M Rouleau
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada
| | - Julio C Fernandes
- CIUSSS Nord de l'Ile de Montréal, Hôpital du Sacré-Coeur de Montréal, 5400 bl. Gouin ouest, Montreal, QC, H4J 1C5, Canada. .,CIUSSS Nord de l'Ile de Montréal, Hôpital Jean-Talon, 1385 rue Jean-Talon est, Montreal, QC, H2E 1S6, Canada. .,Faculty of Medicine, Université de Montréal, 2900 bl. Edouard-Montpetit, Montreal, QC, H3T 1J4, Canada. .,Chaire de recherche en orthopédie de l'UdeM au CIUSS NIM, 5400 boul. Gouin ouest, Montreal, QC, H4J 1C5, Canada.
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Eriksson R, Broberg BV, Ishøy PL, Bak N, Andersen UB, Jørgensen NR, Knop FK, Ebdrup BH. Bone Status in Obese, Non-diabetic, Antipsychotic-Treated Patients, and Effects of the Glucagon-Like Peptide-1 Receptor Agonist Exenatide on Bone Turnover Markers and Bone Mineral Density. Front Psychiatry 2019; 9:781. [PMID: 30745885 PMCID: PMC6360839 DOI: 10.3389/fpsyt.2018.00781] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2018] [Accepted: 12/27/2018] [Indexed: 01/14/2023] Open
Abstract
Background: Low bone mineral density (BMD) may constitute an underestimated comorbidity in schizophrenia patients undergoing long-term antipsychotic treatment. Glucagon-like peptide 1 (GLP-1) receptor agonists are antidiabetic drugs, which may also affect bone turnover. Methods: In planned secondary analyses of a 3 months, double-blind, randomized, placebo-controlled trial (n = 45), we explored effects of the GLP-1 receptor agonist exenatide 2 mg once-weekly (n = 23), or placebo (n = 22) on bone turnover markers (BTMs) and BMD in chronic, obese, antipsychotic-treated patients with schizophrenia spectrum disorder. Baseline BTMs were compared to sex- and age-adjusted reference values from a Danish population cohort, and T- and Z-scores were calculated for BMD. Results: In women (n = 24), all baseline BTM measurements of procollagen type I N-terminal propeptide (PINP) and C-terminal cross-linking telopeptide of type I collagen (CTX) were within reference values. In men (n = 21), 5% displayed lower PINP and 14% displayed lower CTX. One patient displayed BMD Z-score < -2, and 23% of patients (17% of women and 29% of men) displayed -2.5 < T-scores < -1 indicating osteopenia, but none had osteoporosis. After treatment, PINP decreased at trend level significance (P = 0.05), and body mass index BMD increased for L2-L4 (P = 0.016). No changes in bone markers were significant after correction for mean prolactin levels. Conclusions: Sex- and age-adjusted measures of bone status in chronic, obese, antipsychotic-treated patients appeared comparable to the reference population. Subtle changes in bone markers during 3 months exenatide treatment may suggest beneficial effects of GLP-1 receptor agonists on bone status in antipsychotic-treated patients, and further studies should consider the potential influence of prolactin.
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Affiliation(s)
- Robert Eriksson
- Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Disease Systems Biology, Faculty of Health and Medical Sciences, Novo Nordisk Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark
| | - Brian V. Broberg
- Center for Neuropsychiatric Schizophrenia Research, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Pelle L. Ishøy
- Center for Neuropsychiatric Schizophrenia Research, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Nikolaj Bak
- Center for Neuropsychiatric Schizophrenia Research, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
| | - Ulrik B. Andersen
- Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark
| | - Niklas R. Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Glostrup, Denmark
- Odense Patient Data Explorative Network, Odense University Hospital, Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Filip K. Knop
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Clinical Metabolic Physiology, Steno Diabetes Center Copenhagen, Gentofte Hospital, Hellerup, Denmark
- Faculty of Health and Medical Sciences, The Novo Nordisk Foundation Center for Basic Metabolic Research, University of Copenhagen, Copenhagen, Denmark
| | - Bjørn H. Ebdrup
- Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Center for Neuropsychiatric Schizophrenia Research, Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Centre Glostrup, Copenhagen University Hospital, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Abstract
PURPOSE OF REVIEW Osteoporosis is a common public health problem that is often undertreated and underdiagnosed. The clinical management of osteoporosis is often reactionary to devastating fracture events. Bone turnover markers may improve the ease and rapidity at which osteoporosis is monitored and treated. Bone turnover markers are biochemical byproducts of bone formation or bone resorption. The clinical use of bone turnover markers is limited by significant preanalytical variability. Effective interpretation of bone turnover markers requires a detailed understanding of the variables that can affect their responses to osteoporosis treatment and monitoring. RECENT FINDINGS Progress is continuously being made on the standardization of bone turnover markers. The literature on the response of bone turnover markers to unique clinical situations is expanding. Data for evidence-based reference intervals for bone turnover markers has increased. Variables that affect the appropriate timing of lab draws like diurnal variation, postprandial status, exercise and alcohol use have been described. Studies examining the expected response of bone turnover markers to treatments of osteoporosis and other medications that affect bone health continue to increase. SUMMARY Bone turnover markers have clinical utility in the comprehensive evaluation of osteoporosis. When interpreted with caution and with a good understanding of their natural variability, bone turnover markers provide information that supplements osteoporosis management and provides useful clinical information about conditions that alter bone turnover.
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Affiliation(s)
- Sumeet Jain
- Loyola University Medical Center, Maywood, Illinois, USA
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45
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Ornstrup MJ, Kjær TN, Harsløf T, Jørgensen NR, Pedersen SB, Langdahl BL. Comparison of bone turnover markers in peripheral blood and bone marrow aspirate. Bone 2018; 116:315-320. [PMID: 30176391 DOI: 10.1016/j.bone.2018.08.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 08/16/2018] [Accepted: 08/30/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Bone remodeling takes place in the bone marrow environment. We investigated if levels of bone turnover markers (BTMs) differ between bone marrow and peripheral blood, if the bone marrow is an independent compartment, and how well the measurements in bone marrow correlate with bone mineral density. METHODS Sixty-six men participated in a placebo controlled study designed to evaluate the effect of 16 weeks supplementation with resveratrol on bone mineral density and BTM. Bone marrow aspirates and blood samples were drawn at baseline and at week 16. Procollagen I N-terminal propeptide (PINP), C-terminal telopeptide of type I collagen (CTx), osteocalcin, bone specific alkaline phosphatase (BAP), and osteoprogeterin (OPG) were analyzed. Bland-Altman analysis was used to compare measurements across compartment to detect possible systematic or proportional differences. Paired t-test was performed if no proportional difference was revealed at the difference vs concentration plot. RESULTS Measurements of PINP, CTx, and BAP differed proportionally between compartments depending on concentration; at low concentrations absolute values were only slightly different, while at higher average concentrations the levels were much higher in bone marrow than blood. Osteocalcin measures in bone marrow were systematically and significantly lower than in blood (mean ± SD; 14.4 μg/L ± 5.3 μg/L versus 21.7 μg/L ± 6.0 μg/L respectively, p < 0.001). OPG measures were comparable between compartments (p = 0.69). CTx and OPG measured in blood were negatively associated with lumbar spine BMD (β = -0.22, p = 0.05 and β = -0.02, p = 0.02, respectively), whereas both markers measured in bone marrow were not (p = 0.60 and p = 0.50 respectively). None of the BTMs, bone marrow or blood, were associated with total hip BMD. DISCUSSION The levels of most BTMs differed significantly between bone marrow and peripheral blood, while OPG was comparable. Levels of PINP, CTx, and BAP differed between compartments depending on concentration, suggesting bone marrow to represent a compartment separate from the general circulation. Unexpectedly, osteocalcin was lower in the marrow, a gradient that was independent of concentration. BTMs measured in bone marrow did not show any association with bone mineral density. Although further studies are needed to investigate potential explanatory causes of the differences, BTMs in bone marrow do not seem to contribute further to fracture risk assessment.
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Affiliation(s)
- M J Ornstrup
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark.
| | - T N Kjær
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark
| | - T Harsløf
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark
| | - N R Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Denmark; OPEN, Odense Patient data Explorative Network, Odense University Hospital/Institute of Clinical Research, University of Southern Denmark, Denmark
| | - S B Pedersen
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
| | - B L Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Denmark; Department of Clinical Medicine, Aarhus University, Denmark
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46
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Zivna H, Gradošová I, Zivny P, Cermakova E, Palicka V. Effects of Amlodipine on Bone Metabolism in Orchidectomised Spontaneously Hypertensive Rats. Pharmacology 2018; 102:67-73. [PMID: 29898457 DOI: 10.1159/000489666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 04/24/2018] [Indexed: 11/19/2022]
Abstract
Spontaneously hypertensive rats (SHR) represent a model of essential hypertension. We studied the effect of amlodipine (AML) on bone markers, bone mineral density (BMD), and biomechanical properties of osteopenic bone induced by orchidectomy in male SHR. Rats were allocated to 3 groups and were sacrificed after 12 weeks: sham-operated control; orchidectomised control; and orchidectomised receiving a diet supplemented with AML. Indicators of bone turnover were assessed in bone homogenate, BMD was measured by dual energy X-ray absorptiometry, and the femurs were subjected to biomechanical testing. Long-term AML administration does not have a negative impact on bone metabolism and density in male SHR.
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Affiliation(s)
- Helena Zivna
- Radioisotope Laboratories and Vivarium, Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Iveta Gradošová
- Radioisotope Laboratories and Vivarium, Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic.,Institute of Clinical Biochemistry and Diagnostics, Medical Faculty and University Hospital, Hradec Kralove, Czech Republic
| | - Pavel Zivny
- Institute of Clinical Biochemistry and Diagnostics, Medical Faculty and University Hospital, Hradec Kralove, Czech Republic
| | - Eva Cermakova
- Computer Technology Center, Faculty of Medicine, Charles University, Hradec Kralove, Czech Republic
| | - Vladimir Palicka
- Institute of Clinical Biochemistry and Diagnostics, Medical Faculty and University Hospital, Hradec Kralove, Czech Republic
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Dagli M, Kutlucan A, Abusoglu S, Basturk A, Sozen M, Kutlucan L, Unlu A, Yilmaz F. Evaluation of bone mineral density (BMD) and indicators of bone turnover in patients with hemophilia. Bosn J Basic Med Sci 2018; 18:206-210. [PMID: 29236646 DOI: 10.17305/bjbms.2018.2335] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 10/10/2017] [Accepted: 10/10/2017] [Indexed: 11/16/2022] Open
Abstract
A decrease in bone mass is observed in hemophilic patients. The aim of this study was to evaluate bone mineral density (BMD), parathyroid hormone (PTH), 25-hydroxy vitamin D (vitamin D), and a bone formation and resorption marker, procollagen type I N-terminal propeptide (PINP) and urinary N-terminal telopeptide (uNTX) respectively, in hemophilic patients and healthy controls. Laboratory parameters related to the pathogenesis of bone loss such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were also evaluated. Thirty-five men over 18 years of age, with severe hemophilia (A and B) and receiving secondary prophylaxis, were included in the study. The same number of age-, sex-, and ethnicity-matched healthy controls were evaluated. Anthropometric, biochemical, and hormonal parameters were determined in both groups. No significant difference in anthropometric parameters was found between the two groups. The BMD was low in 34% of hemophilic patients. Vitamin D, calcium, and free testosterone levels were significantly lower (p < 0.001, p = 0.011, p < 0.001, respectively), while PTH, PINP, and activated partial thromboplastin time (aPTT) levels were significantly higher (p < 0.014, p = 0.043, p < 0.001, respectively), in hemophilic patients compared to controls. There was no significant difference between the two groups in NLR, PLR, phosphorus, thyroid-stimulating hormone, and uNTX level. The reduction of bone mass in hemophilic patients may be evaluated using the markers of bone formation and resorption, enabling early detection and timely treatment.
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Affiliation(s)
- Mehmet Dagli
- Department of Internal Medicine, Faculty of Medicine, Selcuk University, Konya, Turkey.
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van den Broek DHN, Geddes RF, Williams TL, Chang YM, Elliott J, Jepson RE. Calcitonin Response to Naturally Occurring Ionized Hypercalcemia in Cats with Chronic Kidney Disease. J Vet Intern Med 2018; 32:727-735. [PMID: 29469976 PMCID: PMC5867022 DOI: 10.1111/jvim.15051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 11/29/2017] [Accepted: 01/05/2018] [Indexed: 12/27/2022] Open
Abstract
Background Hypercalcemia is commonly associated with chronic kidney disease (CKD) in cats. Objectives To explore the calcitonin response to naturally occurring ionized hypercalcemia in cats with azotemic CKD, and to assess the relationship of plasma calcitonin with ionized calcium, alkaline phosphatase (ALP), and urinary calcium excretion. Animals Thirty‐three client‐owned cats with azotemic CKD and ionized hypercalcemia from first opinion practice. Methods Cohort study. Calcitonin was measured with an immunoradiometric assay in heparinized plasma. Simple correlations were assessed with Kendall's rank correlation, and the within‐subject correlations of calcitonin with ionized calcium and other clinicopathological variables were calculated with a bivariate linear mixed effects model. Results Calcitonin concentrations above the lower limit of detection (>1.2 pg/mL; range, 1.7–87.2 pg/mL) were observed in 11 of 33 hypercalcemic cats (responders). Blood ionized calcium concentration did not differ significantly between responders (median, 1.59 [1.46, 1.66] mmol/L) and nonresponders (median, 1.48 [1.43, 1.65] mmol/L; P = 0.22). No evidence was found for calcitonin and ionized calcium to correlate between cats (τb = 0.14; P = 0.31; n = 33), but significant positive correlation was evident within individual responders over time (within‐subject correlation coefficient [rwithin], 0.83; 95% confidence interval [CI], 0.63–0.92). Calcitonin correlated negatively over time with plasma ALP (rwithin, −0.55; 95% CI, −0.79 to −0.16). Conclusions and Clinical Importance Calcitonin does not appear to have an important role in calcium metabolism in cats with CKD.
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Affiliation(s)
- D H N van den Broek
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - R F Geddes
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
| | - T L Williams
- Department of Veterinary Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Y-M Chang
- Research Support Office, Royal Veterinary College, University of London, London, United Kingdom
| | - J Elliott
- Department of Comparative Biomedical Sciences, Royal Veterinary College, University of London, London, United Kingdom
| | - R E Jepson
- Department of Clinical Science and Services, Royal Veterinary College, University of London, London, United Kingdom
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49
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Bone turnover, calcium homeostasis, and vitamin D status in Danish vegans. Eur J Clin Nutr 2018; 72:1046-1054. [DOI: 10.1038/s41430-017-0081-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 11/08/2017] [Accepted: 12/18/2017] [Indexed: 12/11/2022]
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50
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Craven BC, Giangregorio LM, Alavinia SM, Blencowe LA, Desai N, Hitzig SL, Masani K, Popovic MR. Evaluating the efficacy of functional electrical stimulation therapy assisted walking after chronic motor incomplete spinal cord injury: effects on bone biomarkers and bone strength. J Spinal Cord Med 2017; 40:748-758. [PMID: 28929919 PMCID: PMC5778938 DOI: 10.1080/10790268.2017.1368961] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVES To determine the efficacy of functional electrical stimulation therapy assisted walking (FES-T) compared to a conventional aerobic and resistance training (CONV) with respect to bone biomarkers and lower extremity bone strength outcomes among adults with chronic motor incomplete spinal cord injury (SCI). DESIGN Parallel group randomized controlled trial ( www.clinicaltrials.gov - NCT0020196819). Site: Tertiary academic rehabilitation centre in Canada. METHODS Adults with chronic (≥18 months) motor incomplete SCI (C2-T12 AIS C-D) were consented and randomized to FES-T or CONV training for 45 minutes thrice-weekly for 4 months. Osteocalcin (OC), β-cross laps (CTX) and sclerostin were assessed at baseline, and 4 months. Similarly, total hip, distal femur and proximal tibia region bone mineral density (BMD) via DXA (4500A, Hologic Inc. Waltham, MA, USA) and tibia bone quality via pQCT (Stratec XCT-2000, Mezintecknik, Pforzheim, Germany) were assessed at baseline, 4, and 12 months. Between group differences were analyzed using repeated measures general linear models. RESULTS Thirty-four participants (17 FES-T, 17 CONV) consented and were randomized, 27 participants completed the 4-month intervention and 12-month outcome assessments. Participants in the FES-T arm had a decrease in CTX and a significant increase in OC at intervention completion (P<0.05). Significant biomarker changes were not observed in the CONV group. No within or between group differences from baseline were observed in sclerostin or bone strength. CONCLUSIONS Four months of FES-T improved bone turnover (increase in OC and decrease in CTX) but not bone strength among individuals with chronic SCI. Future, long term FES-T may augment lower extremity bone strength.
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Affiliation(s)
- B. Catharine Craven
- Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada,Department of Medcine, University of Toronto, Toronto, ON, Canada,University of Waterloo, Waterloo, ON, Canada,Correspondence to: B. Catharine Craven, BA, MD, MSc, FRCPC, University Health Network, Toronto Rehab, Lyndhurst Centre, 206J-520 Sutherland Drive, Toronto, ON M4G 3V9 Canada.
| | - Lora M. Giangregorio
- Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada,University of Waterloo, Waterloo, ON, Canada
| | | | | | - Naaz Desai
- Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada
| | - Sander L. Hitzig
- Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada,Sunnybrook Research Institute - Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Kei Masani
- Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada,Institute of Biomaterials and Biomedical Engineering BBME, University of Toronto, Toronto, ON, Canada
| | - Milos R. Popovic
- Toronto Rehabilitation Institute - UHN, Toronto, ON, Canada,Institute of Biomaterials and Biomedical Engineering BBME, University of Toronto, Toronto, ON, Canada
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