The Relevance of Osteoclastic and Osteoblastic Activity Markers Follow-Up in Patients on Antiresorptive Osteoporosis Treatment

Association between systemic inflammatory response index and bone turnover markers in Chinese patients with osteoporotic fractures: a retrospective cross-sectional study

Background

The systemic inflammatory response index (SIRI) is a novel composite biomarker of inflammation. However, there is limited information on its use in the context of osteoporotic fractures. Hence, this study aimed to investigate the association between baseline SIRI values and bone turnover markers (BTMs) in Chinese patients diagnosed with osteoporotic fractures (OPFs), to offer a more precise method for assessing bone health and inflammation in clinical settings.

Methods

A retrospective cross-sectional study was conducted on 3,558 hospitalized patients with OPFs who required surgery or hospitalization at the First People's Hospital of Kunshan City from January 2017 to July 2022. Baseline measurements of SIRI, β-CTX (beta-C-terminal telopeptide of type I collagen), and P1NP (procollagen type I N-terminal propeptide) were obtained. The analyses were adjusted for variables, including age, sex, body mass index (BMI), and other initial laboratory and clinical findings. Furthermore, multivariable logistic regression, smooth curve fitting, and threshold analysis were also performed.

Results

The results revealed a negative correlation between baseline SIRI values and both β-CTX and P1NP levels. After adjusting for covariates in the regression analysis, each unit increase in SIRI was found to be inked to a reduction of 0.04 (β = -0.04; 95% confidence interval [CI], -0.05 to -0.03; with p-value <0.001) in β-CTX levels and a decrease of 3.77 (β = 3.77; 95% CI, 5.07 to 2.47; with p-value <0.001) in P1NP levels. Furthermore, a curvilinear relationship and threshold effect were also identified. Turning points were identified at SIRI values of 1.41 and 1.63 on the adjusted smooth curve.

Conclusion

The results showed a negative correlation between the baseline SIRI value and β-CTX level, as well as the level of P1NP. This suggests a possible link between the systemic inflammatory response and reduced bone metabolism. If these findings are verified, SIRI has the potential to function as a predictive indicator for BTMs. Nevertheless, additional research is necessary to verify these findings.

Association of osteoporosis and skeletal muscle loss with serum type I collagen carboxyl-terminal peptide β glypeptide: A cross-sectional study in elder Chinese population

Type I collagen carboxyl-terminal peptide β (β-CTX) increases in osteoporosis. The study aimed to explore the relationship between serum β-CTX and the risk of osteoporosis as well as sarcopenia in Chinese elderly inpatients. Around 228 patients whose age >65 years were recruited in this cross-sectional study. Dual-energy X-ray scanning was used to access skeletal muscle and bone mass. Serum concentration of β-CTX as well as the prevalence of osteoporosis were significantly higher in low skeletal muscle index (SMI) group than that in the normal SMI group (P < 0.05). Serum β-CTX levels negatively correlated with SMI and bone mass (P < 0.05). Total muscle mass, appendicular skeletal muscle mass, SMI, total bone mass, and bone mass at various sites including the limbs, spine, and pelvis decreased significantly, and the prevalence of low SMI increased with the increase of the quartiles of β-CTX. Higher serum β-CTX had an increased risk of low SMI and osteoporosis (P < 0.05). Summarily, with increasing serum β-CTX levels, both muscle and bone mass decreased in Chinese elderly inpatients. Serum β-CTX was positively associated with the risk of not only osteoporosis but also skeletal muscle loss.

The relationship between FOSB and SOCS3 gene polymorphisms and the susceptibility to periodontitis and osteopenia in the Chinese population

The aim is to analyze the relationship and significance of the FOS, FOSB, Suppressors of cytokine signaling (SOCS), and hypoxia-inducible factor 1 (HIF1) gene loci and their polymorphisms with periodontitis and osteopenia in the Chinese population. In this case-control study, data on questionnaires, periodontal examination, bone mineral density, and FOS, FOSB, SOCS3, and HIF1 gene loci and their polymorphisms were obtained from 474 participants. The data were analyzed using the analysis of variance, Kruskal-Wallis test, χ² test, and logistic regression. The incidence of osteopenia was significantly increased in patients with periodontitis compared to controls (58.6 vs. 34.4%, P < 0.001). Accordingly, the risk was increased 2.21-fold compared with controls (95% CI 2.09-4.95). Osteopenia patients had a significantly higher risk of periodontitis than patients with normal bone density (OR = 3.22, 95% CI 2.09-4.94). There were significant positive associations between FOSB and SOCS3 polymorphisms and periodontitis and osteopenia susceptibility. Individuals carrying the G/G genotype of the FOSB gene rs708905 locus had an increased risk of periodontitis (OR = 5.06, 95% CI 2.36-10.86) and osteopenia (OR = 3.26, 95% CI 1.34-7.96). Compared with the C/C genotype, the A/A genotype of the FOSB rs8105114 locus was associated with a significantly higher risk of periodontitis (OR = 2.14, 95% CI 1.02-4.53) and osteopenia (OR = 2.85, 95% CI 1.12-7.22). Compared with the A/A genotype, the risk of periodontitis in the G/G genotype of the SOCS3 rs7207782 locus was increased 3.10-fold (P < 0.001), and the risk of osteopenia was increased 2.01-fold (P = 0.023). There was a bidirectional relationship between periodontitis and osteopenia. The rs708905 G/G and rs8105114 A/A genotypes of FOSB and the rs7207782 G/G genotype of SOCS3 were risk factors for both periodontitis and osteopenia in the Chinese population, which could increase knowledge about disease‑specific and cross‑disease genetic pattern.

Does spinal sagittal imbalance lead to future vertebral compression fractures in osteoporosis patients?

BACKGROUND CONTEXT

Many risk factors for osteoporotic vertebral compression fractures (OVCFs) have been reported. However, there are few reports on the relationship between spine sagittal parameters in patients with osteoporosis.

PURPOSE

To explore whether: spinal sagittal imbalance is associated with future vertebral compression fractures in osteoporosis patients; spinal sagittal parameters in patients with osteoporosis can predict the occurrence of vertebral compression fractures.

STUDY DESIGN

A retrospective cohort study.

PATIENT SAMPLE

Patients with osteoporosis.

OUTCOME MEASURES

Occurrence of OVCFs during the follow-up period.

METHODS

From January 2017 to October 2019, eligible patients with osteoporosis at the initial visit were enrolled. They were followed up to November 1, 2020. Based on whether OVCFs occurred during the follow-up, the patients were divided into two groups: the experimental group (vertebral compression fracture group) and the control group (no vertebral compression fracture group). Intragroup analysis was performed as follows: Pearson and Spearman correlation coefficients were used to calculate the correlation between each parameter. Intergroup analysis was performed as follows. For categorical variables, the chi-square test was used; for normally distributed continuous variables, an independent sample t-test was used; and for non-normally distributed variables, a two-sample nonparametric test was used. Binary logistic regression analysis and receiver operating characteristic (ROC) curves were used to determine independent risk factors and critical values, respectively.

RESULTS

A total of 340 patients with osteoporosis were enrolled. The longest and shortest follow-up periods were 44 months and 12 months, respectively, with an average of 25.2±10.2 months. There were significant differences in age, bone mineral density (femur and lumbar), smoking history, medication treatment regularity, Thoracolumbar Kyphosis (TLK), Pelvic Tilt (PT), C7-S1 Sagittal Vertical Axis (C7-S1 SVA), and C2-7 Sagittal Vertical Axis (C2-7 SVA) between the experimental and control groups. There were no significant differences in sex, body mass index (BMI), alcohol consumption history, hypertension, diabetes, coronary heart disease, family history of osteoporosis, physical activity, Thoracic Kyphosis (TK), Lumbar Lordosis (LL), Pelvic Incidence (PI), Sacral Slope (SS), C2-C7 Cobb Angle (CL), T1 slope (T1S) or blood parameters. Through binary logistic regression analysis, we found that BMD, medication treatment regularity and C7-S1 SVA were independent risk factors for future vertebral compression fractures. According to the ROC curve, the prediction accuracy of C7-S1 SVA was the highest. Through the calculation of critical values, we found that when C7-S1 SVA was more than 3.81 cm, future OVCFs were more likely to occur, and for every 1cm increase in C7-S1 SVA, the incidence of future OVCFs would increase by 0.324 times (p<.001, OR=1.324). Through intragroup analysis, we further found that C7-S1 SVA was positively correlated with the percentage of vertebral body wedging.

CONCLUSIONS

For patients with osteoporosis, a C7-S1 SVA more than 3.81cm is significantly associated with a greater risk for vertebral compression fractures in the future.