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Monteiro HL, Antunes M, Sarmento M, Quental C, Folgado J. Influence of age-related bone density changes on primary stability in stemless shoulder arthroplasty: a multi-implant finite element study. J Shoulder Elbow Surg 2024:S1058-2746(24)00403-8. [PMID: 38851525 DOI: 10.1016/j.jse.2024.04.013] [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: 01/08/2024] [Revised: 04/02/2024] [Accepted: 04/08/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Stemless implants were introduced to prevent some of the stem-related complications associated with the total shoulder arthroplasty. Although general requirements for receiving these implants include good bone quality conditions, little knowledge exists about how bone quality affects implant performance. The goal of this study was to evaluate the influence of age-induced changes in bone density, as a metric of bone quality, in the primary stability of five anatomic stemless shoulder implants using three-dimensional finite element (FE) models. METHODS The implant designs considered were based on the Global Icon, Sidus, Simpliciti, SMR, and Inhance stemless implants. Shoulder arthroplasties were virtually simulated in Solidworks. The density distributions of 20 subjects from two age groups, 20-40 and 60-80 years old, were retrieved from medical image data and integrated into three-dimensional FE models of a single humerus geometry, developed in Abaqus, to avoid confounding factors associated with geometric characteristics. For the designs which do not have a solid collar covering the entire bone surface, ie, the Sidus, Simpliciti, SMR, and Inhance implants, contact and noncontact conditions between the humeral head component and bone were considered. Primary stability was evaluated through the assessment of micromotions at the bone-implant interface considering eight load cases related to rehabilitation activities and demanding tasks. Three research variables, considering 20 μm, 50 μm, and 150 μm as thresholds for osseointegration, were used for a statistical analysis of the results. RESULTS The decreased bone density registered for the 60-80 age group led to larger micromotions at the bone-implant interface when compared to the 20-40 age group. The Global Icon-based and Inhance-based designs were the least sensitive to bone density, whereas the Sidus-based design was the most sensitive to bone density. The establishment of contact between the humeral head component and bone for the implants that do not have a solid collar led to decreased micromotions. DISCUSSION Although the age-induced decline in bone density led to increased micromotions in the FE models, some stemless shoulder implants presented good overall performance regardless of the osseointegration threshold considered, suggesting that age alone may not be a contraindication to anatomic total shoulder arthroplasty. If only primary stability is considered, the results suggested superior performance for the Global Icon-based and Inhance-based designs. Moreover, the humeral head component should contact the resected bone surface when feasible. Further investigation is necessary to combine these results with the long-term performance of the implants and allow more precise recommendations.
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Affiliation(s)
- Helena Líbano Monteiro
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal, Lisbon, Portugal
| | - Madalena Antunes
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal, Lisbon, Portugal
| | | | - Carlos Quental
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal, Lisbon, Portugal.
| | - João Folgado
- IDMEC, Instituto Superior Técnico, Universidade de Lisboa, Lisbon, Portugal, Lisbon, Portugal
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Ibrahim A, Jiang Z, Shirvani K, Dalili A, Abdel Hamid Z. A Novel Viscoelastic Deformation Mechanism Uncovered during Vickers Hardness Study of Bone. J Funct Biomater 2024; 15:87. [PMID: 38667544 PMCID: PMC11051036 DOI: 10.3390/jfb15040087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Revised: 03/26/2024] [Accepted: 03/29/2024] [Indexed: 04/28/2024] Open
Abstract
This study investigates the viscoelastic deformation mechanisms of bone as a response to Vickers hardness indentation. We utilized advanced high-resolution scanning electron microscopy (SEM) to investigate a distinct deformation pattern that originates from the indentation site within the bone matrix. The focus of our research was to analyze a unique deformation mechanism observed in bone tissue, which has been colloquially termed as "screw-like" due to its resemblance to a screw thread when viewed under an optical microscope. The primary goals of this research are to investigate the distinctive characteristics of the "screw-like" deformation pattern and to determine how the microstructure of bone influences the initiation and control of this mechanism. These patterns, emerging during the dwell period of indentation, underscore the viscoelastic nature of bone, indicating its propensity for energy dissipation and microstructural reconfiguration under load. This study uncovered a direct correlation between the length of the "screw-like" deformation and the duration of the indentation dwell time, providing quantifiable evidence of the bone's viscoelastic behavior. This finding is pivotal in understanding the mechanical properties of bone, including its fracture toughness, as it relates to the complex interplay of factors such as energy dissipation, microstructural reinforcement, and stress distribution. Furthermore, this study discusses the implications of viscoelastic properties on the bone's ability to resist mechanical challenges, underscoring the significance of viscoelasticity in bone research.
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Affiliation(s)
- Ahmed Ibrahim
- Mechanical Engineering Department, Farmingdale State College, Farmingdale, NY 11735, USA; (K.S.); (A.D.)
| | - Zhenting Jiang
- The Department of Earth & Planetary Sciences, Yale University, New Haven, CT 06511, USA;
| | - Khosro Shirvani
- Mechanical Engineering Department, Farmingdale State College, Farmingdale, NY 11735, USA; (K.S.); (A.D.)
| | - Alireza Dalili
- Mechanical Engineering Department, Farmingdale State College, Farmingdale, NY 11735, USA; (K.S.); (A.D.)
| | - Z. Abdel Hamid
- Central Metallurgical Research and Development Institute, Helwan 11421, Egypt;
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Binney N. Reference-Class Problems Are Real: Health-Adjusted Reference Classes and Low Bone Mineral Density. THE JOURNAL OF MEDICINE AND PHILOSOPHY 2024; 49:128-146. [PMID: 38418083 PMCID: PMC10938540 DOI: 10.1093/jmp/jhae005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024] Open
Abstract
Elselijn Kingma argues that Christopher Boorse's biostatistical theory (the BST) does not show how the reference classes it uses are objective and naturalistic. Recently, philosophers of medicine have attempted to rebut Kingma's concerns. I argue that these rebuttals are theoretically unconvincing, and that there are clear examples of physicians adjusting their reference classes according to their prior knowledge of health and disease. I focus on the use of age-adjusted reference classes to diagnose low bone mineral density in children. In addition to using the BST's age, sex, and species, physicians also choose to use other factors to define reference classes, such as pubertal status, bone age, body size, and muscle mass. I show that physicians calibrate the reference classes they use according to their prior knowledge of health and disease. Reference classes are also chosen for pragmatic reasons, such as to predict fragility fractures.
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Reiner E, Weston F, Pleshko N, Querido W. Application of Optical Photothermal Infrared (O-PTIR) Spectroscopy for Assessment of Bone Composition at the Submicron Scale. APPLIED SPECTROSCOPY 2023; 77:1311-1324. [PMID: 37774686 DOI: 10.1177/00037028231201427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/01/2023]
Abstract
The molecular basis of bone structure and strength is mineralized collagen fibrils at the submicron scale (∼500 nm). Recent advances in optical photothermal infrared (O-PTIR) spectroscopy allow the investigation of bone composition with unprecedented submicron spatial resolution, which may provide new insights into factors contributing to underlying bone function. Here, we investigated (i) whether O-PTIR-derived spectral parameters correlated to standard attenuated total reflection (ATR) Fourier transform infrared spectroscopy spectral data and (ii) whether O-PTIR-derived spectral parameters, including heterogeneity of tissue, contribute to the prediction of proximal femoral bone stiffness. Analysis of serially demineralized bone powders showed a significant correlation (r = 0.96) between mineral content quantified using ATR and O-PTIR spectroscopy, indicating the validity of this technique in assessing bone mineralization. Using femoral neck sections, the principal component analysis showed that differences between O-PTIR and ATR spectra were primarily attributable to the phosphate ion (PO4) absorbance band, which was typically shifter toward higher wavenumbers in O-PTIR spectra. Additionally, significant correlations were found between hydrogen phosphate (HPO4) content (r = 0.75) and carbonate (CO3) content (r = 0.66) quantified using ATR and O-PTIR spectroscopy, strengthening the validity of this method to assess bone mineral composition. O-PTIR imaging of individual trabeculae at 500 nm pixel resolution illustrated differences in submicron composition in the femoral neck from bones with different stiffness. O-PTIR analysis showed a significant negative correlation (r = -0.71) between bone stiffness and mineral maturity, reflective of newly formed bone being an important contributor to bone function. Finally, partial least squares regression analysis showed that combining multiple O-PTIR parameters (HPO4 content and heterogeneity, collagen integrity, and CO3 content) could significantly predict proximal femoral stiffness (R2 = 0.74, error = 9.7%) more accurately than using ATR parameters. Additionally, we describe new findings in the effects of bone tissue orientation in the O-PTIR spectra. Overall, this study highlights a new application of O-PTIR spectroscopy that may provide new insights into molecular-level factors underlying bone mechanical competence.
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Affiliation(s)
- Emily Reiner
- Department of Bioengineering, Temple University, Philadelphia, PA, USA
| | - Frank Weston
- Photothermal Spectroscopy Corporation, Santa Barbara, CA, USA
| | - Nancy Pleshko
- Department of Bioengineering, Temple University, Philadelphia, PA, USA
| | - William Querido
- Department of Bioengineering, Temple University, Philadelphia, PA, USA
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Hasegawa M, Tanaka R, Zhong J, Kobayashi M, Manabe A, Shibata Y. Deciphering load attenuation mechanisms of the dentin-enamel junction: Insights from a viscoelastic constitutive model. Acta Biomater 2023; 171:193-201. [PMID: 37669711 DOI: 10.1016/j.actbio.2023.08.050] [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: 05/29/2023] [Revised: 08/03/2023] [Accepted: 08/24/2023] [Indexed: 09/07/2023]
Abstract
A considerable material discontinuity between the enamel and dentin might jeopardize the tooth's mechanical durability over time without the attenuation of the dentin-enamel junction (DEJ). However, the critical loading transmission mechanism at the DEJ remains understudied. This study aimed to define the extent and effective width of the DEJ, along with its mechanical competence. The presence of DEJ interphase layer was identified using a motif analysis based on the ion beam-transmission electron microscopy coupled with nanoindentation modulus mapping. For each region, nanoindentation load-displacement curves were recorded and mathematically analyzed using an appropriate viscoelastic constitutive model. The time-course of indenter penetration (creep) behavior of the tooth tissues can be mathematically approximated by the Kelvin-Voigt model in series, which determined the visco-contribution to the overall mechanical responses. Therefore, the elastic-plastic contribution can be distinguished from the overall mechanical responses of the tooth after subtracting the visco-contributions. During the loading period, the enamel behavior was dominated by elastic-plastic responses, while both the dentin and DEJ showed pronounced viscoelastic responses. The instantaneous modulus of the DEJ, which was measured by eliminating viscoelastic behavior from the raw load-displacement curve, was almost double that of the dentin. The DEJ was stiffer than the dentin, but it exhibited large viscoelastic motion even at the initial loading stage. This study revealed that the load attenuation competence of the DEJ, which involves extra energy expenditure, is mainly associated with its viscoelasticity. The mathematical analysis proposed here, performed on the nanoindentation creep behavior, could potentially augment the existing knowledge on hard-tissue biomechanics. STATEMENT OF SIGNIFICANCE: In this study, we undertake a rigorous mechanical characterization of the dentin-enamel junction (DEJ) using an advanced nanoindentation technique coupled with a pertinent viscoelastic constitutive model. Our approach unveils the substantial viscoelastic contribution of the DEJ during the initial indentation loading phase and offers an elaborate delineation of the DEJ interphase layer through sophisticated image analysis. These insights significantly augment our understanding of tooth durability. Importantly, our innovative mathematical analysis of creep behavior introduces a novel approach with profound implications for future research in the expansive field of hard-tissue biomechanics. The pioneering methodologies and findings presented in this work hold substantial potential to invigorate progress in biomaterials research and fuel further explorations into the functionality of biological tissues.
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Affiliation(s)
- Masataka Hasegawa
- Department of Conservative Dentistry, Division of Aesthetic Dentistry and Clinical Cariology, Showa University Graduate School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Reina Tanaka
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan.
| | - Jingxiao Zhong
- School of Aerospace, Mechanical and Mechatronic Engineering, The University of Sydney, Sydney NSW, 2006, Australia
| | - Mikihiro Kobayashi
- Department of Conservative Dentistry, Division of Aesthetic Dentistry and Clinical Cariology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Atsufumi Manabe
- Department of Conservative Dentistry, Division of Aesthetic Dentistry and Clinical Cariology, Showa University School of Dentistry, 2-1-1 Kitasenzoku, Ohta-ku, Tokyo 145-8515, Japan
| | - Yo Shibata
- Department of Biomaterials and Engineering, Showa University School of Dentistry, 1-5-8 Hatanodai, Shinagawa-ku, Tokyo 142-8555, Japan
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Lo JC, Yang W, Park-Sigal JJ, Ott SM. Osteoporosis and Fracture Risk among Older US Asian Adults. Curr Osteoporos Rep 2023; 21:592-608. [PMID: 37542683 PMCID: PMC10858302 DOI: 10.1007/s11914-023-00805-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/06/2023] [Indexed: 08/07/2023]
Abstract
PURPOSE OF REVIEW This review summarizes the current knowledge regarding osteoporosis and fracture among older US Asian adults. RECENT FINDINGS Asian adults have lower (areal) bone density than non-Hispanic White adults and thus are more likely to be diagnosed and treated for osteoporosis, despite their lower risk of hip fracture. The latter may relate to favorable characteristics in hip geometry, volumetric bone density, and bone microarchitecture; lower risk of falls; and other clinical factors. The fracture risk calculator FRAX accounts for the lower risk of hip fracture among US Asian adults. However, data on major osteoporotic fracture risk remain limited. Fracture rates also vary by Asian subgroup, which may have implications for fracture risk assessment. Furthermore, among women receiving bisphosphonate drugs, Asian race is a risk factor for atypical femur fracture, an uncommon complication associated with treatment duration. Recent clinical trial efficacy data pertaining to lower bisphosphonate doses and longer dosing intervals may be relevant for Asian adults. More research is needed to inform osteoporosis care of US Asian adults, including risk-benefit considerations and the optimal duration of bisphosphonate treatment. Greater evidence-based guidance for primary fracture prevention among US Asian adults will ensure health equity in the prevention of osteoporotic fractures.
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Affiliation(s)
- Joan C Lo
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA, 94612, USA.
- The Permanente Medical Group, Oakland, CA, USA.
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
| | - Wei Yang
- The Permanente Medical Group, Oakland, CA, USA
- Department of Endocrinology, Kaiser Permanente San Jose Medical Center, San Jose, CA, USA
| | - Jennifer J Park-Sigal
- The Permanente Medical Group, Oakland, CA, USA
- Department of Endocrinology, Kaiser Permanente South San Francisco Medical Center, South San Francisco, CA, USA
| | - Susan M Ott
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
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A Review of 3D Polymeric Scaffolds for Bone Tissue Engineering: Principles, Fabrication Techniques, Immunomodulatory Roles, and Challenges. Bioengineering (Basel) 2023; 10:bioengineering10020204. [PMID: 36829698 PMCID: PMC9952306 DOI: 10.3390/bioengineering10020204] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/29/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
Over the last few years, biopolymers have attracted great interest in tissue engineering and regenerative medicine due to the great diversity of their chemical, mechanical, and physical properties for the fabrication of 3D scaffolds. This review is devoted to recent advances in synthetic and natural polymeric 3D scaffolds for bone tissue engineering (BTE) and regenerative therapies. The review comprehensively discusses the implications of biological macromolecules, structure, and composition of polymeric scaffolds used in BTE. Various approaches to fabricating 3D BTE scaffolds are discussed, including solvent casting and particle leaching, freeze-drying, thermally induced phase separation, gas foaming, electrospinning, and sol-gel techniques. Rapid prototyping technologies such as stereolithography, fused deposition modeling, selective laser sintering, and 3D bioprinting are also covered. The immunomodulatory roles of polymeric scaffolds utilized for BTE applications are discussed. In addition, the features and challenges of 3D polymer scaffolds fabricated using advanced additive manufacturing technologies (rapid prototyping) are addressed and compared to conventional subtractive manufacturing techniques. Finally, the challenges of applying scaffold-based BTE treatments in practice are discussed in-depth.
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Yamakawa Y, Yamamoto N, Tomita Y, Noda T, Inoue T, Matsumoto T, Kawasaki K, Ozaki T. Coronal shear fractures of the femoral neck: a comparison with basicervical fractures. Eur J Trauma Emerg Surg 2023; 49:419-430. [PMID: 35978044 DOI: 10.1007/s00068-022-02079-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 08/08/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE We propose coronal shear fracture of the femoral neck (CSFF) as a new type of fracture that differs from a basicervical fracture. This study aimed to present the incidence of CSFF and compare its clinical characteristics and outcomes with those of basicervical fractures. METHODS In this multicenter retrospective cohort study, 2207 patients with hip fractures were identified using computed tomography (CT), 17 and 27 patients were diagnosed with CSFF (CSFF group) and basicervical fractures (basicervical fracture group), respectively. The primary outcome was reoperation, while the secondary outcomes were postoperative radiographic findings, ambulatory ability, and 1-year mortality rate. These outcomes were compared between the two groups. We also conducted diagnostic reliability tests for these fractures using the Cohen's kappa coefficient. RESULTS The incidence of CSFF and basicervical fractures in the 2207 patients were 0.77% and 1.22%, respectively. The inter-and intra-observer agreements for the diagnosis were almost perfect. The comorbidity score was significantly higher in the CSFF group than in the basicervical fracture group. No reoperations occurred in both groups. There were no significant intergroup differences in the postoperative radiographic findings. The 1-year mortality rate was higher in the CSFF group than in the basicervical fracture group (38.5% vs. 5.3%; odds ratio: 11.9, 95% CI: 1.2-118.5; p = 0.025). CONCLUSION This study presents the definition and incidence of CSFF with a high diagnostic reliability. Patients with CSFF had similar reoperation rate postoperative radiographic outcomes to basicervical fractures, while 1-year mortality rate was high.
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Affiliation(s)
- Yasuaki Yamakawa
- Department of Orthopedic Surgery, Kochi Health Sciences Center, Kochi, Japan
| | - Norio Yamamoto
- Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan. .,Systematic Review Workshop Peer Support Group (SRWS-PSG), Osaka, Japan.
| | - Yosuke Tomita
- Department of Physical Therapy, Faculty of Health Care, Takasaki University of Health and Welfare, Gunma, Japan
| | - Tomoyuki Noda
- Department of Orthopaedic Surgery and Traumatology, Kawasaki Medical School General Medical Center, Okayama, Japan
| | - Tomoo Inoue
- Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Toshiyuki Matsumoto
- Department of Orthopedic Surgery, Kochi Health Sciences Center, Kochi, Japan
| | - Keisuke Kawasaki
- Department of Orthopedic Surgery, Kagawa Prefectural Central Hospital, 1-2-1, Asahi-machi, Takamatsu, Kagawa, 760-8557, Japan
| | - Toshifumi Ozaki
- Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Science, Okayama, Japan
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9
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Clinical Applications of PET in Evaluating the Aging Spine. PET Clin 2023; 18:39-47. [DOI: 10.1016/j.cpet.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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The potential anti-osteoporotic effect of exercise-induced increased preptin level in ovariectomized rats. Anat Sci Int 2023; 98:22-35. [PMID: 35507276 DOI: 10.1007/s12565-022-00666-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 04/03/2022] [Indexed: 01/20/2023]
Abstract
Osteoporosis increases bone fragility and fractures. Preptin hormone is regulated by moderate exercise training and increases bone formation. Therefore, this study was conducted to see how estradiol administration and moderate exercise training affected osteoporotic changes in ovariectomized (OVX) rats. To achieve this aim, 36 healthy adult female Wistar albino rats were randomized into Sham, OVX, ovariectomized estradiol-treated (OVX + E) (OVX + E rats were treated using subcutaneous estradiol benzoate 2.5 μg/kg body weight/day), ovariectomized practicing moderate exercise training, ovariectomized estradiol-treated and practiced a moderate exercise training, and ovariectomized alendronate-treated (OVX + Alen) (OVX + Alen rats were treated orally with alendronate 3 mg/kg body weight/week) groups. Alendronate was used as a standard anti-osteoporotic drug. Moderate exercise training, including therapy with estradiol and alendronate for OVX rats began on the fourth week and lasted for six weeks. Results showed that OVX rats had estrogen and preptin deficiency in serum. These deficiencies were associated with a significant increase in bone resorption biomarkers (urinary deoxypyridinoline and hydroxyproline), and bone formation biomarkers (serum osteocalcin and bone-specific alkaline phosphatase). Also, serum pro-inflammatory cytokines (tumor necrosis factor alpha and interleukin-6) were increased, while bone osteopontin (OPN) expression was decreased. Subsequently, the osteoporotic alterations were verified based on histopathological changes. From the results, estradiol therapy and moderate exercise training significantly improved these findings to the same extent as that of the standard alendronate treatment. Therefore, through their anti-inflammatory properties, increasing bone OPN expression, and regulating serum preptin; estradiol therapy and moderate exercise training can reduce osteoporotic alterations in OVX rats. Thus, combined estradiol therapy and moderate exercise training could be a promising potential therapeutic protocol to reduce postmenopausal osteoporosis. Also, targeting serum preptin and bone osteopontin regulation could have a critical role in the treatment of postmenopausal osteoporosis.
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11
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Palomo T, Muszkat P, Weiler FG, Dreyer P, Brandão CMA, Silva BC. Update on trabecular bone score. ARCHIVES OF ENDOCRINOLOGY AND METABOLISM 2022; 66:694-706. [PMID: 36382759 PMCID: PMC10118821 DOI: 10.20945/2359-3997000000559] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Trabecular bone score (TBS) is an indirect and noninvasive measure of bone quality. A low TBS indicates degraded bone microarchitecture, predicts osteoporotic fracture, and is partially independent of clinical risk factors and bone mineral density (BMD). There is substantial evidence supporting the use of TBS to assess vertebral, hip, and major osteoporotic fracture risk in postmenopausal women, as well as to assess hip and major osteoporotic fracture risk in men aged > 50 years. TBS complements BMD information and can be used to adjust the FRAX (Fracture Risk Assessment) score to improve risk stratification. While TBS should not be used to monitor antiresorptive therapy, it may be potentially useful for monitoring anabolic therapy. There is also a growing body of evidence indicating that TBS is particularly useful as an adjunct to BMD for fracture risk assessment in conditions associated with increased fracture risk, such as type-2 diabetes, chronic corticosteroid excess, and other conditions wherein BMD readings are often misleading. The interference of abdominal soft tissue thickness (STT) on TBS should also be considered when interpreting these findings because image noise can impact TBS evaluation. A new TBS software version based on an algorithm that accounts for STT rather than BMI seems to correct this technical limitation and is under development. In this paper, we review the current state of TBS, its technical aspects, and its evolving role in the assessment and management of several clinical conditions.
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12
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Barr RD, Inglis D, Athale U, Farncombe T, Gordon CL. The Influence of Body Composition on Bone Health in Long-term Survivors of Acute Lymphoblastic Leukemia in Childhood and Adolescence: Analyses by Dual-energy Radiograph Absorptiometry and Peripheral Quantitative Computed Tomography. J Pediatr Hematol Oncol 2022; 44:423-431. [PMID: 35482464 DOI: 10.1097/mph.0000000000002470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 03/12/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND The normal interrelationship of body composition with bone health is less clear in the context of disease. Survivors of acute lymphoblastic leukemia (ALL) exhibit sarcopenic obesity and osteopenia. The impact of body composition on bone health in such survivors was examined. SUBJECTS AND METHODS Survivors of ALL (N=74), >10 years from diagnosis, underwent dual-energy radiograph absorptiometry and peripheral quantitative computed tomography. RESULTS Whole-body bone mineral content (WB BMC) Z scores were greater in males than females, but WB BMC indices (WB BMC/height 2 ) were comparable (0.74±0.125 and 0.72±0.069, respectively). WB BMC index (I) and fat-free mass index correlated significantly with trabecular bone mineral density, only in males. Fat mass index and appendicular lean mass index showed no such correlations. WB BMCI and fat-free mass index also correlated, again predominantly in males, with measures of strength in both trabecular and cortical bone. WB BMCI also correlated strongly with trabecular number, thickness, and hole size, also only in males. CONCLUSIONS The results point to the need for enhancing muscle mass, measured by appendicular lean mass index, while reducing fat mass and maintaining good bone mineralization in long-term survivors of ALL to ensure the integrity of healthy bones.
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Affiliation(s)
| | - Dean Inglis
- Canadian Longitudinal Study on Aging, Department of Health Research Methods, Evidence, and Impact, McMaster University
| | | | - Troy Farncombe
- Department of Nuclear Medicine, Hamilton Health Sciences Corporation, Hamilton, ON, Canada
| | - Christopher L Gordon
- Department of Nuclear Medicine, Hamilton Health Sciences Corporation, Hamilton, ON, Canada
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13
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Iolascon G, Paoletta M, Liguori S, Gimigliano F, Moretti A. Bone fragility: conceptual framework, therapeutic implications, and COVID-19-related issues. Ther Adv Musculoskelet Dis 2022; 14:1759720X221133429. [PMID: 36317067 PMCID: PMC9614590 DOI: 10.1177/1759720x221133429] [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: 06/29/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022] Open
Abstract
Bone fragility is the susceptibility to fracture even for common loads because of structural, architectural, or material alterations of bone tissue that result in poor bone strength. In osteoporosis, quantitative and qualitative changes in density, geometry, and micro-architecture modify the internal stress state predisposing to fragility fractures. Bone fragility substantially depends on the structural behavior related to the size and shape of the bone characterized by different responses in the load-deformation curve and on the material behavior that reflects the intrinsic material properties of the bone itself, such as yield and fatigue. From a clinical perspective, the measurement of bone density by DXA remains the gold standard for defining the risk of fragility fracture in all population groups. However, non-quantitative parameters, such as macro-architecture, geometry, tissue material properties, and microcracks accumulation can modify the bone's mechanical strength. This review provides an overview of the role of different contributors to bone fragility and how these factors might be influenced by the use of anti-osteoporotic drugs and by the COVID-19 pandemic.
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Affiliation(s)
- Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Marco Paoletta
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, 80138 Naples, Italy
| | - Sara Liguori
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Francesca Gimigliano
- Department of Mental and Physical Health and Preventive Medicine, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, University of Campania ‘Luigi Vanvitelli’, Naples, Italy
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14
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Tabassum A, Chainchel Singh MK, Ibrahim N, Ramanarayanan S, Mohd Yusof MYP. Quantifications of Mandibular Trabecular Bone Microstructure Using Cone Beam Computed Tomography for Age Estimation: A Preliminary Study. BIOLOGY 2022; 11:1521. [PMID: 36290424 PMCID: PMC9598395 DOI: 10.3390/biology11101521] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 10/10/2022] [Accepted: 10/12/2022] [Indexed: 11/23/2022]
Abstract
The aim of this study is two-fold: first, to correlate the values for each of the trabecular bone microstructure (TBM) parameters to the individual’s chronological age and sex, thereby facilitating the assessment of potential age and sex-related changes in trabecular bone microstructure parameters in the mandible; and second, to quantify the trabecular microstructural parameters in relation to chronological age. Twenty cone-beam computed tomographic (CBCT) scans were retrieved retrospectively from a database of adult patients with ages ranging in age from 22 to 43 years. In the mandible, the volume of interest included the inter-dental space between the second mandibular premolar and the first mandibular molar, as well as the trabecular space beneath and between the apices. Using the AnalyzeDirect 14.0 software, the DICOM images of CBCT scans were pre-processed, transformed, segmented using a novel semi-automatic threshold-guided method, and quantified. In addition, TBM parameters were derived, and statistical analysis was conducted using a Pearson correlation test with two tails. All parameters exhibited no statistically significant differences (p > 0.05) between chronological age and sex. Statistically significant negative correlations were found between Tb. N (r = −0.489), BS/TV (r = −0.527), and chronological age (p = 0.029 and p = 0.017, respectively). Only Tb. N and BS/TV exhibited an inverse relationship with chronological age. Numerous studies have quantified the trabecular architecture of the jaw bones, but none have found a correlation between the quantified trabecular parameters and chronological age. The digital imprints produced by radiographic imaging can serve as biological profiles for data collection.
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Affiliation(s)
- Arshiya Tabassum
- Center for Oral and Maxillofacial Diagnostics and Medicine Studies, Faculty of Dentistry, Universiti Teknologi MARA Selangor, Sungai Buloh 47000, Selangor, Malaysia
| | - Mansharan Kaur Chainchel Singh
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA Selangor, Sungai Buloh 47000, Selangor, Malaysia
| | - Norliza Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur 50603, Federal Territory of Kuala Lumpur, Malaysia
| | - Subramaniam Ramanarayanan
- Department of Public Health Dentistry, Indira Gandhi Institute of Dental Sciences, Nellikuzhi P.O., Kothamangalam, Kerala 686691, India
| | - Mohd Yusmiaidil Putera Mohd Yusof
- Institute of Pathology, Laboratory and Forensic Medicine (I-PPerForM), Universiti Teknologi MARA Selangor, Sungai Buloh 47000, Selangor, Malaysia
- Department of Forensic Odontology, Faculty of Dental Medicine, Universitas Airlangga, Surabaya, Jawa Timur 60132, Indonesia
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15
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Kuhn F, Clausing RJ, Stiller A, Fonseca Ulloa CA, Foelsch C, Rickert M, Jahnke A. Determination of E-modulus of cancellous bone derived from human humeri and validation of plotted single trabeculae: Development of a standardized humerus bone model. J Orthop 2022; 33:48-54. [PMID: 35855729 PMCID: PMC9287625 DOI: 10.1016/j.jor.2022.07.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/23/2022] [Accepted: 07/07/2022] [Indexed: 10/17/2022] Open
Abstract
Background Evaluation of the mechanical behavior of the microstructure of cancellous bone seems important for the understanding of the mechanical behavior of bone. Prevention and treatment of fragility fractures due to osteoporosis is a major challenge according to ageing population. A bone model might help to assess fracture risk. Measurement of single trabeculae of bone should give further information compared with bone densitometry alone. This study measures the mechanical properties of single cancellous trabeculae derived from human proximal humerus. Methods 34 single trabeculae dissected from human humeral heads were measured and evaluated mechanically. Trabeculae were fixed on microscope slides and geometrical data were reported during axial rotation of the specimens to measure the transverse section using computer aided design (CAD). The samples were subjected to a two-point bending test and were loaded with a measure-stamp at a defined distance. Force and deflection were measured by high-resolution sensors. The E-modulus was then calculated in combination with finite elements method simulation (FEM), using the previously obtained CAD-Data. Results The average E-modulus from 34 valid measurements of human humeral trabeculae was 1678 MPa with a range from 829 to 3396 MPa, which is consistent with existing literature. The planned additional validation of the measurement method using manufactured three-dimensional synthetic trabeculae with known mechanical properties showed an average elastic modulus of single trabeculae of 51.5 MPa, being two dimensions lower than the value reported in the datasheet of the plastic. Conclusion This newly developed, time and cost-efficient procedure allows the measurement of E-modulus in single trabeculae. Measurement of mechanic parameters of single trabeculae might give insights on mechanic behavior of bone and be relevant for the research of systemic bone diseases, complementing the existing data on bone-mineral-density. Further examination of single trabeculae of human cancellous bone should give an insight on the mechanical behavior of bone also considering systemic bone diseases.
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Affiliation(s)
- Florian Kuhn
- Laboratory of Biomechanics, Department of Orthopaedics and Orthopaedic Surgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - Rasmus Johannes Clausing
- Laboratory of Biomechanics, Department of Orthopaedics and Orthopaedic Surgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - Alexander Stiller
- Laboratory of Biomechanics, Department of Orthopaedics and Orthopaedic Surgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - Carlos Alfonso Fonseca Ulloa
- Laboratory of Biomechanics, Department of Orthopaedics and Orthopaedic Surgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
| | - Christian Foelsch
- Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Klinikstraße 33, 35392, Giessen, Germany
| | - Markus Rickert
- Department of Orthopaedics and Orthopaedic Surgery, University Hospital Giessen and Marburg (UKGM), Klinikstraße 33, 35392, Giessen, Germany
| | - Alexander Jahnke
- Laboratory of Biomechanics, Department of Orthopaedics and Orthopaedic Surgery, Justus-Liebig-University Giessen, Klinikstrasse 29, 35392, Giessen, Germany
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16
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Vitamin D and the Kidney: Two Players, One Console. Int J Mol Sci 2022; 23:ijms23169135. [PMID: 36012412 PMCID: PMC9409427 DOI: 10.3390/ijms23169135] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Revised: 08/08/2022] [Accepted: 08/11/2022] [Indexed: 01/08/2023] Open
Abstract
Vitamin D belongs to the group of liposoluble steroids mainly involved in bone metabolism by modulating calcium and phosphorus absorption or reabsorption at various levels, as well as parathyroid hormone production. Recent evidence has shown the extra-bone effects of vitamin D, including glucose homeostasis, cardiovascular protection, and anti-inflammatory and antiproliferative effects. This narrative review provides an overall view of vitamin D’s role in different settings, with a special focus on chronic kidney disease and kidney transplant.
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17
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Bailey S, Stadelmann MA, Zysset PK, Vashishth D, Alkalay RN. Influence of Metastatic Bone Lesion Type and Tumor Origin on Human Vertebral Bone Architecture, Matrix Quality, and Mechanical Properties. J Bone Miner Res 2022; 37:896-907. [PMID: 35253282 PMCID: PMC9158727 DOI: 10.1002/jbmr.4539] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/19/2021] [Accepted: 01/26/2022] [Indexed: 11/10/2022]
Abstract
Metastatic spine disease is incurable, causing increased vertebral fracture risk and severe patient morbidity. Here, we demonstrate that osteolytic, osteosclerotic, and mixed bone metastasis uniquely modify human vertebral bone architecture and quality, affecting vertebral strength and stiffness. Multivariable analysis showed bone metastasis type dominates vertebral strength and stiffness changes, with neither age nor gender having an independent effect. In osteolytic vertebrae, bone architecture rarefaction, lower tissue mineral content and connectivity, and accumulation of advanced glycation end-products (AGEs) affected low vertebral strength and stiffness. In osteosclerotic vertebrae, high trabecular number and thickness but low AGEs, suggesting a high degree of bone remodeling, yielded high vertebral strength. Our study found that bone metastasis from prostate and breast primary cancers differentially impacted the osteosclerotic bone microenvironment, yielding altered bone architecture and accumulation of AGEs. These findings indicate that therapeutic approaches should target the restoration of bone structural integrity. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Stacyann Bailey
- Department of Biomedical Engineering, University of Massachusetts Amherst, Amherst, MA
| | - Marc A. Stadelmann
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland
| | - Philippe K. Zysset
- ARTORG Center for Biomedical Engineering Research, University of Bern, Freiburgstrasse 3, 3010 Bern, Switzerland
| | - Deepak Vashishth
- Center for Biotechnology and Interdisciplinary Studies, Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY
| | - Ron N. Alkalay
- Center for Advanced Orthopedic Studies, Department of Orthopedic Surgery, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
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18
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The Influence of Nesfatin-1 on Bone Metabolism Markers Concentration, Densitometric, Tomographic and Mechanical Parameters of Skeletal System of Rats in the Conditions of Established Osteopenia. Animals (Basel) 2022; 12:ani12050654. [PMID: 35268222 PMCID: PMC8909152 DOI: 10.3390/ani12050654] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 02/28/2022] [Accepted: 03/03/2022] [Indexed: 12/02/2022] Open
Abstract
Simple Summary Nesfatin-1 is an adipokine with little known effect on the skeletal system. In this study, we examined the effect of 8-wk administration of nesfatin-1 on densitometric, tomographic, and mechanical parameters of bones, as well as the concentration of bone metabolism markers in rats with experimentally induced established osteopenia. Abstract Our study aimed to evaluate the impact of nesfatin-1 administration on bone metabolism and properties in established osteopenia in ovariectomized female rats. In total, 21 female Wistar rats were assigned to two groups: sham-operated (SHAM, n = 7) and ovariectomized (OVA, n = 14). After 12 weeks of osteopenia induction in the OVA females, the animals were given i.p. physiological saline (OVA, n = 7) or 2 µg/kg body weight of nesfatin-1(NES, n = 7) for the next 8 weeks. The SHAM animals received physiological saline at the same time. Final body weight, total bone mineral density and content of the skeleton were estimated. Then, isolated femora and tibias were subjected to densitometric, tomographic, and mechanical tests. Bone metabolism markers, i.e., osteocalcin, bone specific alkaline phosphatase (bALP), and crosslinked N-terminal telopeptide of type I collagen (NTx) were determined in serum using an ELISA kit. Ovariectomy led to negative changes in bone metabolism associated with increased resorption, thus diminishing the densitometric, tomographic, and mechanical parameters. In turn, the administration of nesfatin-1 led to an increase in the value of the majority of the tested parameters of bones. The lowest bALP concentration and the highest NTx concentration were found in the OVA females. The bALP concentration was significantly higher after nesfatin-1 administration in comparison to the OVA rats. In conclusion, the results indicate that nesfatin-1 treatment limits bone loss, preserves bone architecture, and increases bone strength in condition of established osteopenia.
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19
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Hofbauer LC, Busse B, Eastell R, Ferrari S, Frost M, Müller R, Burden AM, Rivadeneira F, Napoli N, Rauner M. Bone fragility in diabetes: novel concepts and clinical implications. Lancet Diabetes Endocrinol 2022; 10:207-220. [PMID: 35101185 DOI: 10.1016/s2213-8587(21)00347-8] [Citation(s) in RCA: 130] [Impact Index Per Article: 65.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 12/09/2021] [Accepted: 12/09/2021] [Indexed: 12/12/2022]
Abstract
Increased fracture risk represents an emerging and severe complication of diabetes. The resulting prolonged immobility and hospitalisations can lead to substantial morbidity and mortality. In type 1 diabetes, bone mass and bone strength are reduced, resulting in up to a five-times greater risk of fractures throughout life. In type 2 diabetes, fracture risk is increased despite a normal bone mass. Conventional dual-energy x-ray absorptiometry might underestimate fracture risk, but can be improved by applying specific adjustments. Bone fragility in diabetes can result from cellular abnormalities, matrix interactions, immune and vascular changes, and musculoskeletal maladaptation to chronic hyperglycaemia. This Review summarises how the bone microenvironment responds to type 1 and type 2 diabetes, and the mechanisms underlying fragility fractures. We describe the value of novel imaging technologies and the clinical utility of biomarkers, and discuss current and future therapeutic approaches that protect bone health in people with diabetes.
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Affiliation(s)
- Lorenz C Hofbauer
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine III, and Center for Healthy Aging, University Medical Center, Technische Universität Dresden, Dresden, Germany.
| | - Björn Busse
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Richard Eastell
- Department of Oncology and Metabolism, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - Serge Ferrari
- Service and Laboratory of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
| | - Morten Frost
- Molecular Endocrinology Laboratory and Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
| | - Ralph Müller
- Institute of Biomechanics, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Andrea M Burden
- Institute of Pharmaceutical Sciences, Department of Chemistry and Applied Biosciences, ETH Zurich, Zurich, Switzerland
| | | | - Nicola Napoli
- RU of Endocrinology and Diabetes, Campus Bio-Medico University of Rome and Fondazione Policlinico Campus Bio-Medico, Rome, Italy; Division of Bone and Mineral Diseases, Washington University in St Louis, St Louis, MO, USA
| | - Martina Rauner
- Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine III, and Center for Healthy Aging, University Medical Center, Technische Universität Dresden, Dresden, Germany
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20
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Huang M, Xu S, Liu L, Zhang M, Guo J, Yuan Y, Xu J, Chen X, Zou J. m6A Methylation Regulates Osteoblastic Differentiation and Bone Remodeling. Front Cell Dev Biol 2022; 9:783322. [PMID: 34993198 PMCID: PMC8724434 DOI: 10.3389/fcell.2021.783322] [Citation(s) in RCA: 39] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/06/2021] [Indexed: 01/15/2023] Open
Abstract
Osteoporosis is a prevalent bone disease of the aging population, which is characterized by a decrease in bone mass because of the imbalance of bone metabolism. Although the prevention and treatment of osteoporosis have been explored by different researchers, the mechanisms underlying osteoporosis are not clear exactly. N6 methyladenosine (m6A) is a methylated adenosine nucleotide, which functions through its interaction with the proteins called “writers,” “readers” and “erasers.” The epigenetic regulation of m6A has been demonstrated to affect mRNA processing, nuclear export, translation, and splicing. At the cellular level, m6A modification has been known to affect cell proliferation, differentiation, and apoptosis of bone-related cells, such as bone marrow mesenchymal stem cells (BMSC), osteoblasts, and osteoclasts by regulating the expression of ALP, Runx2, Osterix, VEGF, and other related genes. Furthermore, PTH/Pth1r, PI3K‐Akt, Wnt/β‐Catenin, and other signaling pathways, which play important roles in the regulation of bone homeostasis, are also regulated by m6A. Thus, m6A modification may provide a new approach for osteoporosis treatment. The key roles of m6A modification in the regulation of bone health and osteoporosis are reviewed here in this article.
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Affiliation(s)
- Mei Huang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.,School of Sports Science, Wenzhou Medical University, Wenzhou, China
| | - Shaozhe Xu
- School of Sports Science, Wenzhou Medical University, Wenzhou, China
| | - Lifei Liu
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Miao Zhang
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Jianmin Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
| | - Yu Yuan
- School of Kinesiology, Shanghai University of Sport, Shanghai, China.,School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Jiake Xu
- School of Biomedical Sciences, University of Western Australia, Perth, WA, Australia
| | - Xi Chen
- School of Sports Science, Wenzhou Medical University, Wenzhou, China
| | - Jun Zou
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
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21
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Malluche HH, Chen J, Lima F, Liu LJ, Monier-Faugere MC, Pienkowski D. Bone Quality and Fractures in Women With Osteoporosis Treated With Bisphosphonates for 1 to 14 Years. JBMR Plus 2021; 5:e10549. [PMID: 34761151 PMCID: PMC8567493 DOI: 10.1002/jbm4.10549] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 07/26/2021] [Accepted: 08/17/2021] [Indexed: 11/09/2022] Open
Abstract
Oral bisphosphonates are the primary medication for osteoporosis, but concerns exist regarding potential bone-quality changes or low-energy fractures. This cross-sectional study used artificial intelligence methods to analyze relationships among bisphosphonate treatment duration, a wide variety of bone-quality parameters, and low-energy fractures. Fourier transform infrared spectroscopy and histomorphometry quantified bone-quality parameters in 67 osteoporotic women treated with oral bisphosphonates for 1 to 14 years. Artificial intelligence methods established two models relating bisphosphonate treatment duration to bone-quality changes and to low-energy clinical fractures. The model relating bisphosphonate treatment duration to bone quality demonstrated optimal performance when treatment durations of 1 to 8 years were separated from treatment durations of 9 to 14 years. This may be due to a change in relationship of bone-quality parameters with treatment duration. This model also showed that the effects of bisphosphonate treatment duration were most highly correlated with changes in means and standard deviations of infrared spectroscopically derived mineral and matrix parameters and histomorphometric bone turnover parameters. A second model related treatment duration to bone fracture in all 22 patients who fractured while on treatment with bisphosphonates for more than 8 years. This second model showed that bisphosphonate treatment duration, not hip bone mineral density (BMD), was the most strongly correlated parameter to these low-energy bone fractures. Application of artificial intelligence enabled analysis of large quantities of structural, cellular, mineral, and matrix bone-quality parameters to determine relationships with long-term oral bisphosphonate treatment and fracture. Infrared spectroscopy provides clinically relevant bone-quality information of which bone mineral purity is among the most relevant. Nine or more years of bisphosphonate treatment was associated with abnormal bone mineral purity, matrix abnormalities, and low-energy fractures. These data justify limiting bisphosphonate treatment duration to 8 years. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Hartmut H Malluche
- Division of Nephrology, Bone & Mineral Metabolism, Department of Internal Medicine University of Kentucky Lexington KY USA
| | - Jin Chen
- Division of Biomedical Informatics, Department of Internal Medicine University of Kentucky Lexington KY USA.,Department of Computer Science University of Kentucky Lexington KY USA
| | - Florence Lima
- Division of Nephrology, Bone & Mineral Metabolism, Department of Internal Medicine University of Kentucky Lexington KY USA
| | - Lucas J Liu
- Department of Computer Science University of Kentucky Lexington KY USA
| | - Marie-Claude Monier-Faugere
- Division of Nephrology, Bone & Mineral Metabolism, Department of Internal Medicine University of Kentucky Lexington KY USA
| | - David Pienkowski
- F. Joseph Halcomb III, MD Department of Biomedical Engineering University of Kentucky Lexington KY USA
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22
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Koeppe J, Katthagen JC, Rischen R, Freistuehler M, Faldum A, Raschke MJ, Stolberg-Stolberg J. Male Sex Is Associated with Higher Mortality and Increased Risk for Complications after Surgical Treatment of Proximal Humeral Fractures. J Clin Med 2021; 10:2500. [PMID: 34198778 PMCID: PMC8201359 DOI: 10.3390/jcm10112500] [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: 05/12/2021] [Revised: 05/27/2021] [Accepted: 06/03/2021] [Indexed: 12/20/2022] Open
Abstract
AIMS The best surgical treatment of multi-fragmentary proximal humeral fractures in the elderly is a highly controversial topic. The aim of this study is to assess for sex-related differences regarding mortality and complications after reverse total shoulder arthroplasty (RTSA) and locking plate fixation (LPF). PATIENTS AND METHODS All patients from the largest German healthcare insurance (26.5 million policy holders) above the age of 65 years that were treated with LPF or RTSA after a multi-fragmentary proximal humerus fracture between January 2010 and September 2018 were included. Multivariable Cox regression models were used to assess the association of sex with overall survival, major adverse events and surgical complications. RESULTS A total of 8264 (15%) men and 45,707 (85%) women were followed up for a median time of 52 months. After 8 years, male patients showed significantly higher rates for death (65.8%; 95% CI 63.9-67.5% vs. 51.1%; 95% CI 50.3-51.9%; p < 0.001) and major adverse events (75.5%; 95% CI 73.8-77.1% vs. 61.7%; 95% CI 60.9-62.5%; p < 0.001). With regard to surgical complications, after adjustment of patient risk profiles, there were no differences between females and males after LPF (p > 0.05), whereas men showed a significantly increased risk after RTSA (HR 1.86; 95% CI 1.56-2.22; p < 0.001) with more revision surgeries performed (HR 1.76, 95% CI 1.46-2.12; p < 0.001) compared to women. CONCLUSION The male sex is an independent risk factor for death and major adverse events after both LPF and RTSA. An increased risk for surgical complications after RTSA suggests that male patients benefit more from LPF. Sex should be considered before making treatment decisions.
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Affiliation(s)
- Jeanette Koeppe
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstrasse 56, 48149 Muenster, Germany; (J.K.); (A.F.)
| | - J. Christoph Katthagen
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149 Muenster, Germany; (J.C.K.); (M.J.R.)
| | - Robert Rischen
- Clinic for Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, 48149 Muenster, Germany;
| | - Moritz Freistuehler
- Medical Management Division—Medical Controlling, University Hospital Muenster, Niels-Stensen-Straße 8, 48149 Muenster, Germany;
| | - Andreas Faldum
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstrasse 56, 48149 Muenster, Germany; (J.K.); (A.F.)
| | - Michael J. Raschke
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149 Muenster, Germany; (J.C.K.); (M.J.R.)
| | - Josef Stolberg-Stolberg
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, 48149 Muenster, Germany; (J.C.K.); (M.J.R.)
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23
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Ayubcha C, Raynor WY, Borja AJ, Seraj SM, Rojulpote C, Werner TJ, Revheim ME, Rajapakse CS, Alavi A. Magnetic resonance imaging-based partial volume-corrected 18F-sodium fluoride positron emission tomography in the femoral neck. Nucl Med Commun 2021; 42:416-420. [PMID: 33306627 DOI: 10.1097/mnm.0000000000001344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES 18F-sodium fluoride (NaF) is a radiotracer used in PET that reflects calcium metabolism and osteoblastic activity. In this study, we assessed the construct validity of a novel application of global assessment to measure NaF uptake in the femoral neck as a method of evaluating physiologic changes in osteoblastic metabolism with age. METHODS Whole-body NaF-PET/computed tomography (CT) images and MRI of 24 male patients with a history of nonmetastatic prostate cancer between the ages of 36 and 82 years (67.8 ± 9.6) were analyzed. A region of interest delineated the entire femoral neck on the PET/CT image to determine the mean standardized uptake value (SUVmean). Correction for the partial volume effect was performed by measuring the volume of inert yellow bone marrow by MRI segmentation. Multiple linear regression was used to assess the relationship of uptake with age and body weight. RESULTS The SUVmean with and without partial volume correction decreased with respect to age (P = 0.001 and P = 0.002, respectively). Body weight was not significantly related to any measured PET parameter. CONCLUSION Our results support the use of global NaF uptake with magnetic resonance-derived partial volume correction in the femoral neck. Because osteoblastic metabolism is known to decrease with normal aging, the observed decrease in NaF uptake constitutes evidence for convergent validity, indicating that the proposed methodology likely reflects systemic osteoblastic activity. Future studies of this methodology are warranted in other instances of varying osteoblastic activity such as in metabolic bone diseases and for the evaluation of therapy targeting osteoblastic metabolism.
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Affiliation(s)
- Cyrus Ayubcha
- Department of Radiology, Hospital of the University of Pennsylvania
| | - William Y Raynor
- Department of Radiology, Hospital of the University of Pennsylvania
- Department of Medicine, Drexel University College of Medicine
| | - Austin J Borja
- Department of Radiology, Hospital of the University of Pennsylvania
- Department of Orthopedic Surgery, Hospital of the University of Pennsylvania
- Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Siavash M Seraj
- Department of Radiology, Hospital of the University of Pennsylvania
| | | | - Thomas J Werner
- Department of Radiology, Hospital of the University of Pennsylvania
| | - Mona-Elisabeth Revheim
- Department of Radiology, Hospital of the University of Pennsylvania
- Division for Radiology and Nuclear Medicine, Oslo University Hospital
- Department of Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Chamith S Rajapakse
- Department of Radiology, Hospital of the University of Pennsylvania
- Department of Orthopedic Surgery, Hospital of the University of Pennsylvania
| | - Abass Alavi
- Department of Radiology, Hospital of the University of Pennsylvania
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24
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Rufus-Membere P, Holloway-Kew KL, Diez-Perez A, Kotowicz MA, Pasco JA. Associations between Bone Material Strength Index, Calcaneal Quantitative Ultrasound, and Bone Mineral Density in Men. J Endocr Soc 2021; 5:bvaa179. [PMID: 33728389 PMCID: PMC7940167 DOI: 10.1210/jendso/bvaa179] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES Impact micro-indentation (IMI) measures bone material strength index (BMSi) in vivo. This study investigated how IMI is associated with calcaneal quantitative ultrasound and bone densitometry parameters in men. METHODS BMSi was measured on the tibial plateau using the OsteoProbe in 377 men (age 33-96 years) from the Geelong Osteoporosis Study. Broadband ultrasound attenuation (BUA), speed of sound (SOS), and stiffness index (SI) were assessed at the calcaneus using an ultrasonometer. Areal BMD was measured at several skeletal sites using dual-energy x-ray absorptiometry. Linear associations between parameters were tested using Pearson's correlation. Multivariable regression techniques were used to determine associations between BMSi and other measures of bone, independent of confounders. RESULTS BMSi was negatively correlated with age (r = -0.171, P = .001), weight (r = -0.100, P = .052), and body mass index (r = -0.187, P = .001), and positively with height (r = +0.109, P = .034). There was some evidence to support a positive association between BMSi and BUA (β = 0.052, P = .037), SOS (β = 0.013, P = .144), and SI (β = 0.036, P = .051). After age adjustment, this association was attenuated. No correlations were observed between BMSi and BMD at any skeletal site (r values ranged from -0.006 to +0.079, all P ≥ .13). CONCLUSION There was a small positive association between BMSi and quantitative ultrasound (QUS) parameters, which were not independent of age. No associations were detected between BMSi and BMD. This suggests that BMSi and QUS are capturing common age-dependent properties of bone. Further research on the utility of IMI alone and complementary to conventional bone testing methods for predicting fracture risk is warranted.
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Affiliation(s)
- Pamela Rufus-Membere
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, Geelong, VIC, Australia
| | - Kara L Holloway-Kew
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, Geelong, VIC, Australia
| | - Adolfo Diez-Perez
- Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Mark A Kotowicz
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, Geelong, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
| | - Julie A Pasco
- Deakin University, IMPACT – Institute for Mental and Physical Health and Clinical Translation, Geelong, VIC, Australia
- Department of Medicine-Western Health, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- Barwon Health, Geelong, VIC, Australia
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Quantitative and qualitative bone imaging: A review of synchrotron radiation microtomography analysis in bone research. J Mech Behav Biomed Mater 2020; 110:103887. [DOI: 10.1016/j.jmbbm.2020.103887] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 04/13/2020] [Accepted: 05/25/2020] [Indexed: 01/07/2023]
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de Clauser L, Santana-Varela S, Wood JN, Sikandar S. Physiologic osteoclasts are not sufficient to induce skeletal pain in mice. Eur J Pain 2020; 25:199-212. [PMID: 32955748 PMCID: PMC8436750 DOI: 10.1002/ejp.1662] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 08/21/2020] [Accepted: 09/13/2020] [Indexed: 12/18/2022]
Abstract
Background Increased bone resorption is driven by augmented osteoclast activity in pathological states of the bone, including osteoporosis, fracture and metastatic bone cancer. Pain is a frequent co‐morbidity in bone pathologies and adequate pain management is necessary for symptomatic relief. Bone cancer is associated with severe skeletal pain and dysregulated bone remodelling, while increased osteoclast activity and bone pain are also observed in osteoporosis and during fracture repair. However, the effects of altered osteoclast activity and bone resorption on nociceptive processing of bone afferents remain unclear. Methods This study investigates whether physiologic osteoclasts and resulting changes in bone resorption can induce skeletal pain. We first assessed correlation between changes in bone microarchitecture (through µCT) and skeletal pain using standardized behavioural phenotyping assays in a mouse model of metastatic bone cancer. We then investigated whether increased activity of physiologic osteoclasts, and the associated bone resorption, is sufficient to induce skeletal pain using mouse models of localized and widespread bone resorption following administration of exogenous receptor activator of nuclear factor kappa‐B ligand (RANKL). Results Our data demonstrates that mice with bone cancer exhibit progressive pain behaviours that correlate with increased bone resorption at the tumour site. Systemic RANKL injections enhance osteoclast activity and associated bone resorption, without producing any changes in motor function or pain behaviours at both early and late timepoints. Conclusion These findings suggest that activation of homeostatic osteoclasts alone is not sufficient to induce skeletal pain in mice. Significance statement The role of osteoclasts in peripheral sensitization of sensory neurones is not fully understood. This study reports on the direct link between oestrogen‐independent osteoclast activation and skeletal pain. Administration of exogenous receptor activator of nuclear factor kappa‐B ligand (RANKL) increases bone resorption, but does not produce pro‐nociceptive changes in behavioural pain thresholds. Our data demonstrates that physiologic osteoclasts are not essential for skeletal pain behaviours.
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Affiliation(s)
- Larissa de Clauser
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London, UK.,Wolfson Centre for Age-Related Diseases, Institute of Psychiatry, Psychology and Neuroscience (IoPPN), King's College London, London, UK
| | - Sonia Santana-Varela
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London, UK
| | - John N Wood
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London, UK
| | - Shafaq Sikandar
- Molecular Nociception Group, Wolfson Institute for Biomedical Research, University College London, London, UK.,William Harvey Research Institute, Barts and the London School of Medicine & Dentistry, Mary University of London, London, UK
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Hsu CY, Chen LR, Chen KH. Osteoporosis in Patients with Chronic Kidney Diseases: A Systemic Review. Int J Mol Sci 2020; 21:E6846. [PMID: 32961953 PMCID: PMC7555655 DOI: 10.3390/ijms21186846] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 09/13/2020] [Accepted: 09/16/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic kidney disease (CKD) is associated with the development of mineral bone disorder (MBD), osteoporosis, and fragility fractures. Among CKD patients, adynamic bone disease or low bone turnover is the most common type of renal osteodystrophy. The consequences of CKD-MBD include increased fracture risk, greater morbidity, and mortality. Thus, the goal is to prevent the occurrences of fractures by means of alleviating CKD-induced MBD and treating subsequent osteoporosis. Changes in mineral and humoral metabolism as well as bone structure develop early in the course of CKD. CKD-MBD includes abnormalities of calcium, phosphorus, PTH, and/or vitamin D; abnormalities in bone turnover, mineralization, volume, linear growth, or strength; and/or vascular or other soft tissue calcification. In patients with CKD-MBD, using either DXA or FRAX to screen fracture risk should be considered. Biomarkers such as bALP and iPTH may assist to assess bone turnover. Before initiating an antiresorptive or anabolic agent to treat osteoporosis in CKD patients, lifestyle modifications, such as exercise, calcium, and vitamin D supplementation, smoking cessation, and avoidance of excessive alcohol intake are important. Managing hyperphosphatemia and SHPT are also crucial. Understanding the complex pathogenesis of CKD-MBD is crucial in improving one's short- and long-term outcomes. Treatment strategies for CKD-associated osteoporosis should be patient-centered to determine the type of renal osteodystrophy. This review focuses on the mechanism, evaluation and management of patients with CKD-MBD. However, further studies are needed to explore more details regarding the underlying pathophysiology and to assess the safety and efficacy of agents for treating CKD-MBD.
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Affiliation(s)
- Chia-Yu Hsu
- Department of Rehabilitation Medicine, Ten-Chan General Hospital, Zhongli, Taoyuan 320, Taiwan;
- Department of Biomedical Engineering, Chung Yuan Christian University, Taoyuan 320, Taiwan
| | - Li-Ru Chen
- Department of Physical Medicine and Rehabilitation, Mackay Memorial Hospital, Taipei 104, Taiwan;
- Department of Mechanical Engineering, National Chiao-Tung University, Hsinchu 300, Taiwan
| | - Kuo-Hu Chen
- Department of Obstetrics and Gynecology, Taipei Tzu-Chi Hospital, The Buddhist Tzu-Chi Medical Foundation, Taipei 231, Taiwan
- Department of Medicine, School of Medicine, Tzu-Chi University, Hualien 970, Taiwan
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Rehberg M, Azim M, Martakis K, Winzenrieth R, Hoyer-Kuhn H, Schoenau E, Semler O, Duran I. Bone Microarchitecture Assessed by Trabecular Bone Score Is Independent of Mobility Level or Height in Pediatric Patients with Cerebral Palsy. J Bone Miner Res 2020; 35:1685-1694. [PMID: 32395832 DOI: 10.1002/jbmr.4047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 04/29/2020] [Accepted: 05/04/2020] [Indexed: 12/27/2022]
Abstract
Bone strength and fracture risk do not only depend on bone density, but also on bone structure. The trabecular bone score (TBS) evaluates homogeneity of bone microarchitecture indirectly by measuring gray-level variations of two-dimensional (2D) DXA images. Although TBS is well-established for adults, there have been only few publications in pediatrics. In this monocentric retrospective analysis, we investigated TBS in children and adolescents with cerebral palsy (CP), a patient group vulnerable to low bone mineral mass due to impaired mobility. The influence of different parameters on TBS and areal BMD (aBMD) were evaluated, as well as the relationship between TBS and aBMD. We compared TBS values of our study population to a reference population. A total of 472 lumbar spine-dual-energy X-ray absorptiometry (LS-DXA) scans of children and adolescents with CP (205 female), aged between 4 and 18 years, were analyzed. The DXA-scans were part of the routine examination. The children had no records of fractures or specific bone diseases. Our study population with CP had similar TBS as the reference population. TBS did not increase with age until an inflection point at 10 years in females, and 12 years in males. Girls had significantly higher TBS than boys (p = .049) and pubertal girls aged 8 to 13 years had significantly higher TBS than prepubertal girls (p = .009). TBS standard deviation score for age (SDS-TBS) and aBMD Z-scores correlated weakly (p < .001; R = 0.276 [males], R = 0.284 [females]). Other than for aBMD Z-scores, SDS-TBS was not influenced by age-adjusted height Z-scores and there was no significant difference in SDS-TBS when grouped by mobility levels, using the Gross Motor Function Classification System (GMFCS). Our results indicate that children with CP have a similar homogeneous distribution of trabecular microarchitecture as controls. Puberty initiation appears to be essential for increase of TBS with age and for sex differences. TBS seems less influenced by body composition, height, and mobility than aBMD. © 2020 The Authors. Journal of Bone and Mineral Research published by American Society for Bone and Mineral Research.
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Affiliation(s)
- Mirko Rehberg
- Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
| | - Manuela Azim
- Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
| | - Kyriakos Martakis
- Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany.,Department for Pediatric Neurology, Social Pediatrics and Epileptology, Justus-Liebig University Giessen and University Hospital of Giessen and Marburg (UKGM), Giessen, Germany.,Department of International Health, School Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Renaud Winzenrieth
- R&D Department, Medimaps Société par Actions Simplifiée Unipersonnelle (SASU), Merignac, France
| | - Heike Hoyer-Kuhn
- Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany
| | - Eckhard Schoenau
- Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany.,Center of Prevention and Rehabilitation, University Hospital Cologne, Cologne, Germany
| | - Oliver Semler
- Department of Pediatrics, University of Cologne, Medical Faculty and University Hospital, Cologne, Germany.,Cologne Centre for Rare Skeletal Dysplasia in Childhood, University Hospital Cologne, Cologne, Germany
| | - Ibrahim Duran
- Center of Prevention and Rehabilitation, University Hospital Cologne, Cologne, Germany
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Asif MK, Ibrahim N, Sivarajan S, Heng Khiang Teh N, Chek Wey M. Osseous evidence behind micro-osteoperforation technique in accelerating orthodontic tooth movement: A 3-month study. Am J Orthod Dentofacial Orthop 2020; 158:579-586.e1. [PMID: 32826123 DOI: 10.1016/j.ajodo.2019.09.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 09/01/2019] [Accepted: 09/01/2019] [Indexed: 12/20/2022]
Abstract
INTRODUCTION The study aimed to investigate the effects of micro-osteoperforations (MOPs) on the mandibular bone volume/tissue volume (BV/TV) ratio changes and the rate of orthodontic tooth movement using cone-beam computed tomography images. Another objective was to evaluate the effects of MOP frequency intervals (4 weeks, 8 weeks, and 12 weeks) on the BV/TV ratio and rate of tooth movement. METHODS In 24 participants, 140-200 g of force was applied for mandibular canine retraction. Three MOPs were made according to the scheduled intervals of the 3 different groups: group 1 (MOP 4 weeks), group 2 (MOP 8 weeks), and group 3 (MOP 12 weeks) directly at the mandibular buccal cortical bone of extracted first premolars sites. Cone-beam computed tomography scans were obtained at the 12th week after MOP application. Computed tomography Analyzer software (version 1.11.0.0; Skyscan, Kontich, Belgium) was used to compute the trabecular alveolar BV/TV ratio. RESULTS A significant difference was observed in the rate of canine movement between control and MOP. Paired t test analysis showed a significant difference (P = 0.001) in the mean BV/TV ratio between control and MOP sides in all the frequency intervals groups. However, the difference was significant only in group 1 (P = 0.014). A strong negative correlation (r = -0.86) was observed between the rate of canine tooth movement and the BV/TV ratio at the MOP side for group 1 and all frequency intervals together (r = -0.42). CONCLUSIONS The rate of orthodontic tooth movement can be accelerated by the MOP technique with frequently repeated MOPs throughout the treatment.
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Affiliation(s)
- Muhammad Khan Asif
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliza Ibrahim
- Department of Oral and Maxillofacial Clinical Sciences, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Saritha Sivarajan
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Ng Heng Khiang Teh
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia
| | - Mang Chek Wey
- Department of Pediatric Dentistry and Orthodontics, Faculty of Dentistry, University of Malaya, Kuala Lumpur, Malaysia.
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Raterman HG, Bultink IE, Lems WF. Osteoporosis in patients with rheumatoid arthritis: an update in epidemiology, pathogenesis, and fracture prevention. Expert Opin Pharmacother 2020; 21:1725-1737. [PMID: 32605401 DOI: 10.1080/14656566.2020.1787381] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
INTRODUCTION Rheumatoid arthritis (RA) is a chronic disabling disease characterized by a symmetrical articular involvement due to ongoing joint inflammation, if left insufficiently treated. Local and generalized bone loss is one of the main extra-articular complications of RA and leads to an increased risk for fragility fractures, which further impair functional ability, quality of life, and life expectancy. Therefore, there is an urgent need for good fracture risk management in the vulnerable RA patient. AREAS COVERED The authors review: the epidemiology and pathophysiology (i.e. risk factors) of osteoporosis (OP), fracture, and vertebral fracture risk assessment, the effects of anti-rheumatic drugs on bone loss, pharmacological treatment of OP in RA including both bisphosphonates (BP) and newer drugs including anti-resorptives and osteoanabolic treatment options. EXPERT OPINION Patients with active RA have elevated bone resorption and local bone loss. Moreover, these patients are at increased risk for generalized bone loss, vertebral and non-vertebral fractures. Since general risk factors (such as low BMI, fall risk) and RA-related factors play a role, optimal fracture prevention in RA patients is based on optimal diagnostics based on both of these factors, and on the use of adequate non-medical and medical treatment options.
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Affiliation(s)
- Hennie G Raterman
- Department of Rheumatology, North West Clinics , Alkmaar, The Netherlands
| | - Irene Em Bultink
- Department of Rheumatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Rheumatology and Immunology Center , Amsterdam, The Netherlands
| | - Willem F Lems
- Department of Rheumatology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Rheumatology and Immunology Center , Amsterdam, The Netherlands.,Department of Rheumatology, Amsterdam Rheumatology and Immunology Center , Amsterdam, The Netherlands
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Xie W, Li F, Han Y, Qin Y, Wang Y, Chi X, Xiao J, Li Z. Neuropeptide Y1 receptor antagonist promotes osteoporosis and microdamage repair and enhances osteogenic differentiation of bone marrow stem cells via cAMP/PKA/CREB pathway. Aging (Albany NY) 2020; 12:8120-8136. [PMID: 32381754 PMCID: PMC7244071 DOI: 10.18632/aging.103129] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/30/2020] [Indexed: 12/15/2022]
Abstract
Osteoporosis is a common metabolic bone disorder in the elderly population. The accumulation of bone microdamage is a critical factor of osteoporotic fracture. Neuropeptide Y (NPY) has been reported to regulated bone metabolism through Y1 receptor (Y1R). In this study the effects and mechanisms of Y1R antagonist on prevention for osteoporosis were characterized. In the clinical experiment, compared with osteoarthritis (OA), osteoporosis (OP) showed significant osteoporotic bone microstructure and accumulation of bone microdamage. NPY and Y1R immunoreactivity in bone were stronger in OP group, and were both correlated with bone volume fraction (BV/TV). In vivo experiment, Y1R antagonist significantly improved osteoporotic microstructure in the ovariectomized (OVX) rats. And Y1R antagonist promoted RUNX2, OPG and inhibit RANKL, MMP9 in bone marrow. In vitro cell culture experiment, NPY inhibited osteogenesis, elevated RANKL/OPG ratio and downregulated the expression of cAMP, p-PKAs and p-CREB in BMSCs, treated with Y1R antagonist or 8-Bromo-cAMP could inhibit the effects of NPY. Together, Y1R antagonist improved the bone microstructure and reduced bone microdamage in OVX rats. NPY-Y1R could inhibit osteoblast differentiation of BMSCs via cAMP/PKA/CREB pathway. Our findings highlight the regulation of NPY-Y1R in bone metabolism as a potential therapy strategy for the prevention of osteoporosis and osteoporotic fracture.
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Affiliation(s)
- Weixin Xie
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.,Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Fan Li
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China.,Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yi Han
- Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yi Qin
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Yuan Wang
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Xiaoying Chi
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Jie Xiao
- Department of Anesthesiology, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
| | - Zhanchun Li
- Department of Orthopaedic Surgery, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai 200127, China
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Pharmacological Management of Osteoporosis in Rheumatoid Arthritis Patients: A Review of the Literature and Practical Guide. Drugs Aging 2020; 36:1061-1072. [PMID: 31541358 PMCID: PMC6884430 DOI: 10.1007/s40266-019-00714-4] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Rheumatoid arthritis (RA) is a chronic disabling disease that is associated with increased localized and generalized osteoporosis (OP). Previous studies estimated that approximately one-third of the RA population experience bone loss. Moreover, RA patients suffer from a doubled fracture incidence depending on several clinical factors, such as disease severity, age, glucocorticoid (GC) use, and immobility. As OP fractures are related to impaired quality of life and increased mortality rates, OP has an enormous impact on global health status. Therefore, there is an urgent need for a holistic approach in daily clinical practice. In other words, both OP- and RA-related factors should be taken into account in treatment guidelines for OP in RA. First, to determine the actual fracture risk, dual-energy X-ray absorptiometry (DXA), including vertebral fracture assessment (VFA) and calculation of the 10-year fracture risk with FRAX®, should be performed. In case of high fracture risk, calcium and vitamin D should be supplemented alongside anti-osteoporotic treatment. Importantly, RA treatment should be optimal, aiming at low disease activity or remission. Moreover, GC treatment should be at the lowest possible dose. In this way, good fracture risk management will lead to fracture risk reduction in RA patients. This review provides a practical guide for clinicians regarding pharmacological treatment options in RA patients with OP, taking into account both osteoporotic-related factors and factors related to RA.
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Castro BBAD, Carmo WB, Oliveira RSMF, Peters VM, Jorgetti V, Custodio MR, Sanders-Pinheiro H. Digital radiography as an alternative method in the evaluation of bone density in uremic rats. J Bras Nefrol 2020; 42:8-17. [PMID: 31419270 PMCID: PMC7213932 DOI: 10.1590/2175-8239-jbn-2019-0008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 04/24/2019] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Digital radiography (DRx) may provide a suitable alternative to investigate mineral and bone disorder (MBD) and loss of bone density (BD) in rodent models of chronic kidney disease (CKD). The objective of this study was to use DRx to evaluate BD in CKD rats, and to evaluate the correlation between DRx findings and serum MBD markers and bone histomorphometry. METHODS Uremia was induced by feeding Wistar rats an adenine-enriched diet (0.75% for 4 weeks/0.10% for 3 weeks); outcomes were compared to a control group at experimental weeks 3, 4, and 7. The following biochemical markers were measured: creatinine clearance (CrC), phosphate (P), calcium (Ca), fractional excretion of P (FeP), alkaline phosphatase (ALP), fibroblast growth factor-23 (FGF-23), and parathyroid hormone (PTH). DRx imaging was performed and histomorphometry analysis was conducted using the left femur. RESULTS As expected, at week 7, uremic rats presented with reduced CrC and higher levels of P, FeP, and ALP compared to controls. DRx confirmed the lower BD in uremic animals (0.57±0.07 vs. 0.68 ± 0.06 a.u.; p = 0.016) compared to controls at the end of week 7, when MBD was more prominent. A severe form of high-turnover bone disease accompanied these biochemical changes. BD measured on DRx correlated to P (r=-0.81; p = 0.002), ALP (r = -0.69, p = 0.01), PTH (r = -0.83, p = 0.01), OS/BS (r = -0.70; p = 0.02), and ObS/BS (r = -0.70; p = 0.02). CONCLUSION BD quantified by DRx was associated with the typical complications of MBD in CKD and showed to be viable in the evaluation of bone alterations in CKD.
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Affiliation(s)
- Bárbara Bruna Abreu de Castro
- Núcleo de Experimentação Animal, Laboratório de Nefrologia Experimental, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Wander Barros Carmo
- Núcleo de Experimentação Animal, Laboratório de Nefrologia Experimental, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | | | - Vera Maria Peters
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
| | - Vanda Jorgetti
- Laboratório de Fisiopatologia Renal, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Melani Ribeiro Custodio
- Laboratório de Fisiopatologia Renal, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Helady Sanders-Pinheiro
- Núcleo de Experimentação Animal, Laboratório de Nefrologia Experimental, Universidade Federal de Juiz de Fora, Juiz de Fora, MG, Brasil
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Sun S, Sun L, Kang Y, Tang L, Qin YX, Ta D. Therapeutic Effects of Low-Intensity Pulsed Ultrasound on Osteoporosis in Ovariectomized Rats: Intensity-Dependent Study. ULTRASOUND IN MEDICINE & BIOLOGY 2020; 46:108-121. [PMID: 31587953 DOI: 10.1016/j.ultrasmedbio.2019.08.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 08/13/2019] [Accepted: 08/30/2019] [Indexed: 06/10/2023]
Abstract
This study investigated the effects of low-intensity pulsed ultrasound (LIPUS) of different spatial-average-temporal-average intensity (ISATA) ranging from 15-150 mW/cm2 on the treatment of osteoporosis in ovariectomized rats. Healthy 3-mo-old female Sprague-Dawley rats were randomly divided into nine groups (n = 12 per group): sham-ovariectomy (OVX) control group, OVX control group and OVX groups treated with LIPUS at seven different intensities (ISATA: 15, 30, 50, 75, 100, 125 and 150 mW/cm2, respectively). LIPUS was applied to bilateral femurs 12 wk post-OVX for 20 min/d for 6 wk. Micro-computed tomography, biomechanical tests, serum biochemical analysis and grip strength tests were performed to evaluate the therapeutic effects of LIPUS at different intensities. Results revealed that LIPUS intensity yielded strong correlations with bone mineral density and bone microstructure (R2 = 0.57-0.83) and bone mechanical strength (R2 = 0.80-0.97), and that the intensity of 150 mW/cm2, instead of the 30 mW/cm2 widely used in bone fracture healing, was most effective in maintaining bone mass among all the LIPUS signals between 15 and 150 mW/cm2. This suggests that higher ultrasound intensity (i.e., 150 mW/cm2) may be more effective than lower intensity in mitigation of osteopenia and osteoporosis.
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Affiliation(s)
- Shuxin Sun
- Department of Electronic Engineering, Fudan University, Shanghai, China
| | - Lijun Sun
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, China
| | - Yiting Kang
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, China
| | - Liang Tang
- Institute of Sports Biology, Shaanxi Normal University, Xi'an, China
| | - Yi-Xian Qin
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, New York, USA
| | - Dean Ta
- Department of Electronic Engineering, Fudan University, Shanghai, China; State Key Laboratory of ASIC and System, Fudan University, Shanghai, China; Key Laboratory of Medical Imaging Computing and Computer Assisted Intervention (MICCAI) of Shanghai, Shanghai, China.
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Shitole P, Gupta A, Ghosh R. Fracture Mechanism and Fracture Toughness at the Interface between Cortical and Cancellous bone. J Biomech Eng 2019; 141:2737109. [PMID: 31233094 DOI: 10.1115/1.4044093] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Indexed: 11/08/2022]
Abstract
Objective The micro-structure at the interface of cortical and cancellous bone is quite complicated. The fracture mechanism at this location is necessary for understanding the comprehensive fracture of whole bone. The goal of this study is to identify fracture toughness in terms of J integral and fracture mechanism at the interface between cortical and cancellous bone. Materials and Methods For this purpose, single edge notch bend (SENB) specimens were prepared from bovine proximal femur according to ASTM-E399 standard. Bone samples were prepared such that half of the sample width consist of cortical bone and other half of the width was cancellous bone; this interfacial bone is referred as corticellous bone. Elastic-plastic fracture mechanics was used to measure fracture toughness. The J integral (both elastic and plastic) was used to quantify the fracture toughness. Results The plastic part of J integral value (Jpl) of corticellous specimen was 9310 Jm-2, and shown to be 27 times of the J integral of the elastic part (Jel), 341 Jm-2. The total J integral of the corticellous bone was found to be 9651 Jm-2, which is close to two times of the cortical bone, 4731 Jm-2. Conclusions Present study observed that, J integral of corticellous bone is higher than cortical bone since, more energy is required for plastic deformation of corticellous bone due to crack branches and slowdown at the interface between cortical and cancellous bone.
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Affiliation(s)
- Pankaj Shitole
- Research Scholar School of Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, Himachal Pradesh, India - 175005
| | - Arpan Gupta
- Assistant Professor School of Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, Himachal Pradesh, India - 175005
| | - Rajesh Ghosh
- Assistant Professor School of Engineering, Indian Institute of Technology Mandi, Kamand, Mandi, Himachal Pradesh, India - 175005
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Beck‐Cormier S, Lelliott CJ, Logan JG, Lafont DT, Merametdjian L, Leitch VD, Butterfield NC, Protheroe HJ, Croucher PI, Baldock PA, Gaultier‐Lintia A, Maugars Y, Nicolas G, Banse C, Normant S, Magne N, Gérardin E, Bon N, Sourice S, Guicheux J, Beck L, Williams GR, Bassett JHD. Slc20a2, Encoding the Phosphate Transporter PiT2, Is an Important Genetic Determinant of Bone Quality and Strength. J Bone Miner Res 2019; 34:1101-1114. [PMID: 30721528 PMCID: PMC6618161 DOI: 10.1002/jbmr.3691] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Revised: 01/22/2019] [Accepted: 01/26/2019] [Indexed: 12/25/2022]
Abstract
Osteoporosis is characterized by low bone mineral density (BMD) and fragility fracture and affects over 200 million people worldwide. Bone quality describes the material properties that contribute to strength independently of BMD, and its quantitative analysis is a major priority in osteoporosis research. Tissue mineralization is a fundamental process requiring calcium and phosphate transporters. Here we identify impaired bone quality and strength in Slc20a2-/- mice lacking the phosphate transporter SLC20A2. Juveniles had abnormal endochondral and intramembranous ossification, decreased mineral accrual, and short stature. Adults exhibited only small reductions in bone mass and mineralization but a profound impairment of bone strength. Bone quality was severely impaired in Slc20a2-/- mice: yield load (-2.3 SD), maximum load (-1.7 SD), and stiffness (-2.7 SD) were all below values predicted from their bone mineral content as determined in a cohort of 320 wild-type controls. These studies identify Slc20a2 as a physiological regulator of tissue mineralization and highlight its critical role in the determination of bone quality and strength. © 2019 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.
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Affiliation(s)
- Sarah Beck‐Cormier
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Université de NantesUnité de Formation et de Recherche (UFR) OdontologieNantesFrance
| | | | - John G Logan
- Molecular Endocrinology LaboratoryDepartment of MedicineImperial College LondonLondonUK
| | | | - Laure Merametdjian
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Université de NantesUnité de Formation et de Recherche (UFR) OdontologieNantesFrance
- Centre Hospitalier Universitaire (CHU) NantesPôles Hospitalo‐Universitaires (PHU4) ‐ Ostéo‐articulaire ‐ Tête et Cou ‐ Odontologie ‐ Neurochirurgie ‐ Neuro‐traumatologie (OTONN)NantesFrance
| | - Victoria D Leitch
- Molecular Endocrinology LaboratoryDepartment of MedicineImperial College LondonLondonUK
| | - Natalie C Butterfield
- Molecular Endocrinology LaboratoryDepartment of MedicineImperial College LondonLondonUK
| | - Hayley J Protheroe
- Molecular Endocrinology LaboratoryDepartment of MedicineImperial College LondonLondonUK
| | - Peter I Croucher
- The Garvan Institute of Medical ResearchSydneyNSWAustralia
- St Vincent's Clinical School, Faculty of MedicineUniversity of New South Wales (UNSW) AustraliaSydneyNSWAustralia
| | - Paul A Baldock
- The Garvan Institute of Medical ResearchSydneyNSWAustralia
- St Vincent's Clinical School, Faculty of MedicineUniversity of New South Wales (UNSW) AustraliaSydneyNSWAustralia
| | | | - Yves Maugars
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Centre Hospitalier Universitaire (CHU) NantesPôles Hospitalo‐Universitaires (PHU4) ‐ Ostéo‐articulaire ‐ Tête et Cou ‐ Odontologie ‐ Neurochirurgie ‐ Neuro‐traumatologie (OTONN)NantesFrance
| | - Gael Nicolas
- INSERM U1245Université de Rouen Normandie (UNIROUEN)RouenFrance
- Department of GeneticsRouen University HospitalRouenFrance
- Centre National de Référence pour les Malades Alzheimer Jeunes (CNR‐MAJ)Normandy Center for Genomic and Personalized MedicineRouenFrance
| | | | | | - Nicolas Magne
- Department of NeuroradiologyRouen University HospitalRouenFrance
| | | | - Nina Bon
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Université de NantesUnité de Formation et de Recherche (UFR) OdontologieNantesFrance
| | - Sophie Sourice
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Université de NantesUnité de Formation et de Recherche (UFR) OdontologieNantesFrance
| | - Jérôme Guicheux
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Université de NantesUnité de Formation et de Recherche (UFR) OdontologieNantesFrance
- Centre Hospitalier Universitaire (CHU) NantesPôles Hospitalo‐Universitaires (PHU4) ‐ Ostéo‐articulaire ‐ Tête et Cou ‐ Odontologie ‐ Neurochirurgie ‐ Neuro‐traumatologie (OTONN)NantesFrance
| | - Laurent Beck
- INSERM, UMR 1229, Regenerative Medicine and Skeleton (RMeS), Université de Nantes, École Nationale Vétérinaire, Agroalimentaire et de l'AlimentationNantes‐Atlantique (ONIRIS)NantesFrance
- Université de NantesUnité de Formation et de Recherche (UFR) OdontologieNantesFrance
| | - Graham R Williams
- Molecular Endocrinology LaboratoryDepartment of MedicineImperial College LondonLondonUK
| | - J H Duncan Bassett
- Molecular Endocrinology LaboratoryDepartment of MedicineImperial College LondonLondonUK
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Cosman MN, Britz HM, Rolian C. Selection for longer limbs in mice increases bone stiffness and brittleness, but does not alter bending strength. ACTA ACUST UNITED AC 2019; 222:jeb.203125. [PMID: 31043455 DOI: 10.1242/jeb.203125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/24/2019] [Indexed: 12/14/2022]
Abstract
The ability of a bone to withstand loads depends on its structural and material properties. These tend to differ among species with different modes of locomotion, reflecting their unique loading patterns. The evolution of derived limb morphologies, such as the long limbs associated with jumping, may compromise overall bone strength. We evaluated bone mechanical properties in the Longshanks mouse, which was selectively bred for increased tibia length relative to body mass. We combined analyses of 3D shape and cross-sectional geometry of the tibia, with mechanical testing and bone composition assays, to compare bone strength, elastic properties and mineral composition in Longshanks mice and randomly bred controls. Our data show that, despite being more slender, cortical geometry and predicted bending strength of the Longshanks tibia were similar to controls. In whole bone bending tests, measures of bone bending strength were similar across groups; however, Longshanks tibiae were significantly more rigid, more brittle, and required less than half the energy to fracture. Tissue-level elastic properties were also altered in Longshanks mice, but the bones did not differ from the control in water content, ash content or density. These results indicate that while Longshanks bones are as strong as control tibiae, selection for increased tibia length has altered its elastic properties, possibly through changes in organic bony matrix composition. We conclude that selection for certain limb morphologies, and/or selection for rapid skeletal growth, can lead to tissue-level changes that can increase the risk of skeletal fracture, which in turn may favor the correlated evolution of compensatory mechanisms to mitigate increased fracture risk, such as delayed skeletal maturity.
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Affiliation(s)
- Miranda N Cosman
- Department of Anthropology, University of Michigan, 101 West Hall 1085 S. University Ave, Ann Arbor, MI 48109, United States
| | - Hayley M Britz
- Department of Cell Biology and Anatomy, Cumming School or Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada.,McCaig Institute for Bone and Joint Health, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
| | - Campbell Rolian
- McCaig Institute for Bone and Joint Health, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada .,Department of Comparative Biology and Experimental Medicine, Faculty of Veterinary Medicine, University of Calgary, 3330 Hospital Drive NW, Calgary, Alberta, T2N 4N1, Canada
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39
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Nanomechanical characterization of time-dependent deformation/recovery on human dentin caused by radiation-induced glycation. J Mech Behav Biomed Mater 2019; 90:248-255. [DOI: 10.1016/j.jmbbm.2018.10.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 10/01/2018] [Accepted: 10/04/2018] [Indexed: 01/05/2023]
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40
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Fourier Transform Infrared Spectroscopy of Bone Tissue: Bone Quality Assessment in Preclinical and Clinical Applications of Osteoporosis and Fragility Fracture. Clin Rev Bone Miner Metab 2019. [DOI: 10.1007/s12018-018-9255-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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41
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Scanlan J, Li FF, Umnova O, Rakoczy G, Lövey N, Scanlan P. Detection of Osteoporosis from Percussion Responses Using an Electronic Stethoscope and Machine Learning. Bioengineering (Basel) 2018; 5:bioengineering5040107. [PMID: 30563076 PMCID: PMC6316453 DOI: 10.3390/bioengineering5040107] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Revised: 11/26/2018] [Accepted: 12/03/2018] [Indexed: 11/16/2022] Open
Abstract
Osteoporosis is an asymptomatic bone condition that affects a large proportion of the elderly population around the world, resulting in increased bone fragility and increased risk of fracture. Previous studies had shown that the vibroacoustic response of bone can indicate the quality of the bone condition. Therefore, the aim of the authors’ project is to develop a new method to exploit this phenomenon to improve detection of osteoporosis in individuals. In this paper a method is described that uses a reflex hammer to exert testing stimuli on a patient’s tibia and an electronic stethoscope to acquire the impulse responses. The signals are processed as mel frequency cepstrum coefficients and passed through an artificial neural network to determine the likelihood of osteoporosis from the tibia’s impulse responses. Following some discussions of the mechanism and procedure, this paper details the signal acquisition using the stethoscope and the subsequent signal processing and the statistical machine learning algorithm. Pilot testing with 12 patients achieved over 80% sensitivity with a false positive rate below 30% and accuracies in the region of 70%. An extended dataset of 110 patients achieved an error rate of 30% with some room for improvement in the algorithm. By using common clinical apparatus and strategic machine learning, this method might be suitable as a large population screening test for the early diagnosis of osteoporosis, thus avoiding secondary complications.
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Affiliation(s)
- Jamie Scanlan
- The School of Computing, Science & Engineering, Newton Building, University of Salford, Salford, Greater Manchester M5 4WT, UK.
| | - Francis F Li
- The School of Computing, Science & Engineering, Newton Building, University of Salford, Salford, Greater Manchester M5 4WT, UK.
| | - Olga Umnova
- The School of Computing, Science & Engineering, Newton Building, University of Salford, Salford, Greater Manchester M5 4WT, UK.
| | - Gyorgy Rakoczy
- The School of Computing, Science & Engineering, Newton Building, University of Salford, Salford, Greater Manchester M5 4WT, UK.
| | - Nóra Lövey
- Warrington Hospital, Lovely Lane, Warrington, Cheshire WA5 1QG, UK.
| | - Pascal Scanlan
- Taybank Medical Centre, 10 Robertson Street, Dundee, DD4 6EL, UK.
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42
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Agnew AM, Murach MM, Dominguez VM, Sreedhar A, Misicka E, Harden A, Bolte JH, Kang YS, Stammen J, Moorhouse K. Sources of Variability in Structural Bending Response of Pediatric and Adult Human Ribs in Dynamic Frontal Impacts. STAPP CAR CRASH JOURNAL 2018; 62:119-192. [PMID: 30608995 DOI: 10.4271/2018-22-0004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Despite safety advances, thoracic injuries in motor vehicle crashes remain a significant source of morbidity and mortality, and rib fractures are the most prevalent of thoracic injuries. The objective of this study was to explore sources of variation in rib structural properties in order to identify sources of differential risk of rib fracture between vehicle occupants. A hierarchical model was employed to quantify the effects of demographic differences and rib geometry on structural properties including stiffness, force, displacement, and energy at failure and yield. Three-hundred forty-seven mid-level ribs from 182 individual anatomical donors were dynamically (~2 m/s) tested to failure in a simplified bending scenario mimicking a frontal thoracic impact. Individuals ranged in age from 4 - 108 years (mean 53 ± 23 years) and included 59 females and 123 males of diverse body sizes. Age, sex, body size, aBMD, whole rib geometry and cross-sectional geometry were explored as predictors of rib structural properties. Measures of cross-sectional rib size (Tt.Ar), bone quantity (Ct.Ar), and bone distribution (Z) generally explained more variation than any other predictors, and were further improved when normalized by rib length (e.g., robustness and WBSI). Cortical thickness (Ct.Th) was not found to be a useful predictor. Rib level predictors performed better than individual level predictors. These findings moderately explain differential risk for rib fracture and with additional exploration of the rib's role in thoracic response, may be able contribute to ATD and HBM development and alterations in addition to improvements to thoracic injury criteria and scaling methods.
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Affiliation(s)
- Amanda M Agnew
- Injury Biomechanics Research Center, The Ohio State University
| | | | | | | | - Elina Misicka
- Injury Biomechanics Research Center, The Ohio State University
| | - Angela Harden
- Injury Biomechanics Research Center, The Ohio State University
| | - John H Bolte
- Injury Biomechanics Research Center, The Ohio State University
| | - Yun-Seok Kang
- Injury Biomechanics Research Center, The Ohio State University
| | - Jason Stammen
- National Highway Traffic Safety Administration, Vehicle Research and Test Center
| | - Kevin Moorhouse
- National Highway Traffic Safety Administration, Vehicle Research and Test Center
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Furukawa T, Matsunaga S, Morioka T, Nakano T, Abe S, Yoshinari M, Yajima Y. Study on bone quality in the human mandible-Alignment of biological apatite crystallites. J Biomed Mater Res B Appl Biomater 2018; 107:838-846. [PMID: 30296354 DOI: 10.1002/jbm.b.34180] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 05/18/2018] [Accepted: 05/28/2018] [Indexed: 11/09/2022]
Abstract
The importance of considering bone quality during oral implant treatment is increasingly being recognized. Assessment of bone quality in response to changes in the jaw bone is extremely important when planning treatment. The present study analyzed biological apatite (BAp) crystallites, a bone quality factor, in order to investigate crystallographic anisotropy in dentate and edentulous human mandibles. Using mandibular samples from Japanese adult cadavers, a region of interest was established comprising cortical bone in the central incisors. Samples were classified into five morphological categories based on the extent of bone resorption. Bone mineral density (BMD) was measured and diffraction intensity ratios were calculated using a microbeam X-ray diffraction system. While no differences were observed in BMD, differences were observed in BAp crystallite alignment between the measurement points. In the alveolar region, samples with residual alveolar bone showed strong alignment in the occlusal direction, while samples with marked alveolar bone resorption had preferential alignment in the mesiodistal direction. The present findings suggest that tooth loss and the extent of alveolar bone resorption affects bone quality in the mandible. © 2018 Wiley Periodicals, Inc. J. Biomed. Mater. Res. Part B: 2018. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater 107B: 838-846, 2019.
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Affiliation(s)
- Takehiro Furukawa
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
| | - Satoru Matsunaga
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Toshiyuki Morioka
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Removable Partial Prosthodontics, Tokyo Dental College, Tokyo, Japan
| | - Takayoshi Nakano
- Division of Materials & Manufacturing Science, Graduate School of Engineering, Osaka University, Osaka, Japan
| | - Shinichi Abe
- Department of Anatomy, Tokyo Dental College, Tokyo, Japan
| | - Masao Yoshinari
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan
| | - Yasutomo Yajima
- Oral Health Science Center, Tokyo Dental College, Tokyo, Japan.,Department of Oral and Maxillofacial Implantology, Tokyo Dental College, Tokyo, Japan
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Andronowski JM, Crowder C, Soto Martinez M. Recent advancements in the analysis of bone microstructure: New dimensions in forensic anthropology. Forensic Sci Res 2018; 3:278-293. [PMID: 30788447 PMCID: PMC6374927 DOI: 10.1080/20961790.2018.1483294] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Accepted: 05/30/2018] [Indexed: 10/29/2022] Open
Abstract
Bone is a mechanically active, three-dimensionally (3D) complex, and dynamic tissue that changes in structure over the human lifespan. Bone tissue exists and remodels in 3D and changes over time, introducing a fourth dimension. The products of the remodelling process, secondary and fragmentary osteons, have been studied substantially using traditional two-dimensional (2D) techniques. As a result, much has been learned regarding the biological information encrypted in the histomorphology of bone, yielding a wealth of information relating to skeletal structure and function. Three-dimensional imaging modalities, however, hold the potential to provide a much more comprehensive understanding of bone microarchitecture. The visualization and analysis of bone using high-resolution 3D imaging will improve current understandings of bone biology and have numerous applications in both biological anthropology and biomedicine. Through recent technological advancements, we can hone current anthropological applications of the analysis of bone microstructure and accelerate research into the third and fourth dimensional realms. This review will explore the methodological approaches used historically by anthropologists to assess cortical bone microstructure, spanning from histology to current ex vivo imaging modalities, discuss the growing capabilities of in vivo imaging, and conclude with an introduction of novel non-histological modalities for investigating bone quality.
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45
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Tavera Ruiz CG, De La Torre-Ibarra MH, Flores-Moreno JM, Frausto-Reyes C, Santoyo FM. Cortical bone quality affectations and their strength impact analysis using holographic interferometry. BIOMEDICAL OPTICS EXPRESS 2018; 9:4818-4833. [PMID: 30319905 PMCID: PMC6179407 DOI: 10.1364/boe.9.004818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Revised: 08/08/2018] [Accepted: 08/09/2018] [Indexed: 06/08/2023]
Abstract
It is now accepted that bone strength is a complex property determined mainly by three factors: quantity, quality and turnover of the bone itself. Most of the patients who experience fractures due to fragility could never develop affectations related to bone mass density (i.e. osteoporosis). In this work, the effect of secondary bone strength affectations are analyzed by simulating the degradation of one or more principal components (organic and inorganic) while they are inspected with a nondestructive optical technique. From the results obtained, a strong correlation among the hydroxyapatite, collagen and water is found that determines the bone strength.
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Affiliation(s)
- Cesar G. Tavera Ruiz
- Centro de Investigaciones en Óptica, Loma Del Bosque 115, León Guanajuato C.P. 37150, México
| | - Manuel H. De La Torre-Ibarra
- Centro de Investigaciones en Óptica - Unidad Aguascalientes, Prol. Constitución 607, Fracc. Reserva Loma Bonita, Aguascalientes, Ags, C.P. 20200, México
| | - J. M. Flores-Moreno
- Centro de Investigaciones en Óptica, Loma Del Bosque 115, León Guanajuato C.P. 37150, México
| | - Claudio Frausto-Reyes
- Centro de Investigaciones en Óptica - Unidad Aguascalientes, Prol. Constitución 607, Fracc. Reserva Loma Bonita, Aguascalientes, Ags, C.P. 20200, México
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Abstract
PURPOSE OF REVIEW This review examines recent literature regarding the clinical management of fragility fractures, provides insight into new practice patterns, and discusses controversies in current management. RECENT FINDINGS There are declining rates of osteoporosis management following initial fragility fracture. Management of osteoporotic fractures via a multidisciplinary team reduces secondary fracture incidence and improves overall osteoporotic care. Anabolic agents (abaloparatide and teriparatide) are effective adjuvants to fracture repair, and have shown positive results in cases of re-fracture in spite of medical management (i.e., bisphosphonates). For AO 31-A1 and A2 intertrochanteric hip fractures (non-reverse obliquity), no clinical advantage of intramedullary fixation over the sliding hip screw (SHS) has been proven; SHS is more cost-effective. As fragility fracture incidence continues to rise, orthopedic surgeons must play a more central role in the care of osteoporotic patients. Initiation of pharmacologic intervention is key to preventing subsequent fragility fractures, and may play a supportive role in initial fracture healing. While the media bombards patients with complications of medical therapy (atypical femur fractures, osteonecrosis of jaw, myocardial infarction), providers need to understand and communicate the low incidence of these complications compared with consequences of not initiating medical therapy.
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Affiliation(s)
- Adam Z Khan
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Richard D Rames
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA
| | - Anna N Miller
- Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, MO, USA.
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47
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Dirkes RK, Richard MW, Meers GM, Butteiger DN, Krul ES, Thyfault JP, Rector RS, Hinton PS. Soy Protein Isolate Suppresses Bone Resorption and Improves Trabecular Microarchitecture in Spontaneously Hyperphagic, Rapidly Growing Male OLETF Rats. Curr Dev Nutr 2018; 2:nzy010. [PMID: 30019033 PMCID: PMC6041976 DOI: 10.1093/cdn/nzy010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 12/27/2017] [Accepted: 01/18/2018] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Traditionally, milk proteins have been recommended for skeletal health; recently, soy proteins have emerged as popular alternatives. Excess adiposity appears detrimental to skeletal health, as obese adolescents have increased fracture rates compared with healthy controls. However, soy protein effects on skeletal health during excess adiposity remain unknown. OBJECTIVE The study objective was to examine the effects of isocaloric diets containing milk protein isolate (MPI), soy protein isolate (SPI), or a 50/50 combination (MIX) as the sole protein source on metabolic health indicators and bone outcomes in rapidly growing, hyperphagic, male Otsuka Long Evans Tokushima Fatty (OLETF) rats. METHODS OLETF rats, aged 4 wk, were randomly assigned to 3 treatment groups (MPI, SPI, or MIX, n = 20 per group) and provided with access to experimental diets ad libitum for 16 wk. RESULTS Body mass did not differ between the groups, but SPI had lower percentage body fat than MPI (P = 0.026). Insulin was lower in MPI than in MIX (P = 0.033) or SPI (P = 0.044), but fasting blood glucose was not different between the groups. SPI significantly reduced serum cholesterol compared with MPI (P = 0.001) and MIX (P = 0.002). N-terminal propeptide of type I collagen (P1NP) was higher in MIX than MPI (P = 0.05); C-terminal telopeptide of type 1 collagen (CTx) was higher in MPI than SPI (P < 0.001) and MIX (P < 0.001); the P1NP to CTx ratio was significantly higher in SPI and MIX than in MPI (P < 0.001). Trabecular separation was reduced in SPI compared with MPI (P = 0.030) and MIX (P = 0.008); trabecular number was increased in SPI compared with MIX (P = 0.038). No differences were seen in cortical geometry and biomechanical properties. CONCLUSIONS In the context of excess adiposity, soy- and milk-based proteins have comparable effects on cortical bone geometry and biomechanical properties, whereas soy-based proteins favorably affect the trabecular microarchitecture, and the combination of both proteins may offer additional benefits to bone remodeling in rapidly growing male OLETF rats.
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Affiliation(s)
- Rebecca K Dirkes
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Matthew W Richard
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Grace M Meers
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | | | | | - John P Thyfault
- University of Kansas Medical Center and Kansas City VA, Kansas City, MO
| | - R Scott Rector
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
| | - Pamela S Hinton
- Department of Nutrition and Exercise Physiology, University of Missouri, Columbia, MO
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Structure-based development of an osteoprotegerin-like glycopeptide that blocks RANKL/RANK interactions and reduces ovariectomy-induced bone loss in mice. Eur J Med Chem 2018; 145:661-672. [DOI: 10.1016/j.ejmech.2018.01.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2017] [Revised: 01/03/2018] [Accepted: 01/08/2018] [Indexed: 01/08/2023]
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Magat G, Ozcan Sener S. Evaluation of trabecular pattern of mandible using fractal dimension, bone area fraction, and gray scale value: comparison of cone-beam computed tomography and panoramic radiography. Oral Radiol 2018; 35:35-42. [PMID: 30484179 DOI: 10.1007/s11282-018-0316-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/30/2017] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study was performed to compare the fractal dimension (FD), bone area fraction (BAF), and gray scale value (GSV) on digital panoramic radiography (DPR) and cross-sectional cone-beam computed tomography (CBCT) using image analysis and to determine whether a relationship exists among parameters associated with bone quality. METHODS Thirty edentulous human hemimandibles were scanned by DPR and CBCT. Ninety regions of interest (ROIs) were evaluated on DPR and CBCT images to calculate the FD and BAF. The GSV of the ROI on CBCT was also calculated. RESULTS Statistically significant differences were observed in the FD values of the ROIs between DPR and CBCT (p = 0.002) and in the BAF values of ROIs between DPR and CBCT (p = 0.017). The Spearman's correlation test revealed a statistically significant high correlation between the FD and BAF values of the ROIs on DPR and between the FD and BAF values of the ROIs on CBCT (p < 0.01). No significant correlations were observed between the GSVs of ROIs on CBCT and the FD values of ROIs on DPR, the BAF values of ROIs on DPR, the FD values of ROIs on CBCT, and the BAF values of ROIs on CBCT (p > 0.05). CONCLUSIONS The GSV did not support the FD and BAF. Additionally, DPR and CBCT did not have similar image quality for assessing the FD, BAF, and GSV. In evaluating the trabecular structure, the use of panoramic radiographs should be continued because the image resolution of CBCT is lower and its generalized dose is higher than that of panoramic radiography. These results may serve as a reference for clinical practitioners using dental CBCT to analyze the trabecular structures of alveolar bones.
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Affiliation(s)
- Guldane Magat
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Necmettin Erbakan University, Karaciğan Mahallesi, No:A, Ankara Cd., No:74, 42050, Karatay/Konya, Turkey.
| | - Sevgi Ozcan Sener
- Faculty of Dentistry, Department of Oral and Maxillofacial Radiology, Necmettin Erbakan University, Karaciğan Mahallesi, No:A, Ankara Cd., No:74, 42050, Karatay/Konya, Turkey
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Anar C, Yüksel Yavuz M, Güldaval F, Varol Y, Kalenci D. Assessment of osteoporosis using the FRAX method and the importance of vitamin D levels in COPD patients. Multidiscip Respir Med 2018; 13:1. [PMID: 29318009 PMCID: PMC5756431 DOI: 10.1186/s40248-017-0116-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Accepted: 12/01/2017] [Indexed: 01/09/2023] Open
Abstract
Background The aim of this paper was to evaluate the availability of FRAX for assessing osteoporosis risk, and to demonstrate the importance of vitamin D levels in COPD patients. Methods Fourty-six males who fulfilled the COPD diagnostic criteria defined by GOLD were included. Age, race, BMI, physical activity frequency, smoking and dietary habits, age at COPD diagnosis, disease duration, fractures history, and medications use were determined. Levels of 25(OH)D were detected. BMD was measured by DXA at lumbar spine, femoral neck, and entire femur, and classified according to ISCD. FRAX score was calculated. Control group was composed of 40 non-smoker individuals without previous history of pulmonary diseases. Results 25(OH)D levels were significantly different between patients and controls. In the COPD group, a statistically significant difference in vitamin D levels was detected among the A, B, C, and D grades, while no such significant differences in FRAX scores were detected. 25(OH)D levels were significantly low in COPD patients with disease exacerbations and hospitalizations in the previous one year. No correlation was detected between vitamin D levels and the FRAX score. A positive correlation was observed between vitamin D levels and T-score. FRAX scores were higher and vitamin D levels were lower in osteoporotic COPD patients than in non-osteoporotic COPD patients. Conclusion Using FRAX for assessing osteoporosis in COPD can reduce fracture risk and allow adequate treatment. Since vitamin D levels are related to exacerbations and hospitalizations, vitamin D supplementation may be needed in COPD patients, especially in those with high FRAX scores.
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Affiliation(s)
- Ceyda Anar
- Department of Chest Diseases, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Gaziler Cad. No: 331, 35110 İzmir, Turkey
| | - Melike Yüksel Yavuz
- Department of Chest Diseases, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Gaziler Cad. No: 331, 35110 İzmir, Turkey
| | - Filiz Güldaval
- Department of Chest Diseases, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Gaziler Cad. No: 331, 35110 İzmir, Turkey
| | - Yelda Varol
- Department of Chest Diseases, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, Gaziler Cad. No: 331, 35110 İzmir, Turkey
| | - Dilek Kalenci
- Department of Biochemistry, İzmir Dr. Suat Seren Chest Diseases and Surgery Training Research Hospital, İzmir, Turkey
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