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Li W, Zhang Z, Li Y, Wu Z, Wang C, Huang Z, Ye B, Jiang X, Yang X, Shi X. Effects of total flavonoids of Rhizoma Drynariae on biochemical indicators of bone metabolism: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1443235. [PMID: 39359242 PMCID: PMC11445651 DOI: 10.3389/fphar.2024.1443235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 08/23/2024] [Indexed: 10/04/2024] Open
Abstract
Background Evidence shows that the total flavonoids of Rhizoma Drynariae (TFRD) can improve bone mineral density (BMD). However, there is no evidence to summarize the improvement of biochemical indicators of bone metabolism (BIBM). Methods The PubMed, Web of Science, Cochrane Library, Embase, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, Chongqing VIP Information Database (VIP) and SinoMed were searched from inception to 6 May 2024. The final included studies performed meta-analyses using RevMan 5.3. Results Nine randomized controlled trials (RCTs) were ultimately included. The TFRD group had higher bone gla protein (BGP) and type I procollagen-N-propeptide (PINP) compared to the Other therapies (WMD: 5.11; 95% CI: 3.37, 6.84; p < 0.00001; WMD: 13.89; 95% CI: 11.81, 15.97; p < 0.00001). The tartrate-resistant acid phosphatase (TRACP) decreased significantly (WMD: -1.34; 95% CI: -1.62, -1.06; p < 0.00001). The alkaline phosphatase (ALP) increased significantly (WMD: 7.47; 95% CI: 6.29, 8.66; p < 0.00001). There were no significant differences in serum calcium (SC) or serum phosphorus (SP) levels between the TFRD and control groups (WMD: 0.08; 95% CI: -0.04, 0.20; p = 0.17; WMD: 0.02; 95% CI: -0.02, 0.05; p = 0.36). Conclusion TFRD can stimulate bone formation and prevent bone resorption in osteoporosis (OP) patients, but it has no effect on SC and SP. Systematic Review Registration https://www.crd.york.ac.uk/PROSPERO/.
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Affiliation(s)
- Wei Li
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zechen Zhang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuyi Li
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhenyu Wu
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Chengjie Wang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zhen Huang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Baisheng Ye
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xin Jiang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaolong Yang
- The Second School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xiaolin Shi
- Department of Orthopaedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Zhang ZZ, Hu TT, Wang Y, Zhu XN, Liu Y, Gao L, Zhang ZK, Gao EP, Zhang W, Zheng YL. Preliminary study on the effect of lumbar axial rotation on bone mineral density measured by DXA and QCT. Sci Rep 2024; 14:20417. [PMID: 39223229 PMCID: PMC11368918 DOI: 10.1038/s41598-024-71229-1] [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: 02/29/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024] Open
Abstract
Currently, the relationship between axial rotation of the vertebrae and bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and quantitative computed tomography (QCT) remains controversial. The aim of this study is to quantitatively assess the effect of vertebral rotation on volumetric bone mineral density (v-BMD) and areal bone mineral density (a-BMD), further to propose the corrected strategies. To achieve this, a phantom, which was rotated from 0° to 25° in 5° increments, was utilized. Bone mineral content (BMC), a-BMD, v-BMD, and projected area (p-AREA) were measured. The Kruskal-Wallis non-parametric test or one-way ANOVA was used to examine the differences in variables between the different groups. The Pearson and Spearman correlation was used to test the relationships between quantitative parameters and rotated angles. Linear regression analysis was used to evaluate the relationship between angles and quantitative parameters. The findings indicate that, as the angle increased, a-BMD and v-BMD decreased (P < 0.001) , and the p-AREA increased (P < 0.001), but the BMC stays constant. The rotated angle was negative correlated (r = - 0.925, P < 0.001) with a-BMD and v-BMD (r = - 0.880, P < 0.001), positive (r = 0.930, P = < 0.001) correlated with p-AREA. The linear regression analysis showed that a-BMD = 0.808-0.01 × Angle and v-BMD = 151.808-1.588 × Angle. This study showed that, axial rotation might lead to a lower measured for a-BMD and v-BMD, it should be modified. This gives clinicians some insights into how to deal with osteoporosis in scoliosis patients. It's essential for clinicians to incorporate these findings into their diagnostic processes to prevent potential misdiagnosis and over-treatment of osteoporosis.
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Affiliation(s)
- Zu-Zhuo Zhang
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Ting-Ting Hu
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Yan Wang
- Department of Endocrinology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Xiao-Na Zhu
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Ying Liu
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Lei Gao
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Ze-Kun Zhang
- Department of Radiology, Hebei Provincial Hospital of Chinese Medicine, The First Affiliated Hospital of Hebei University of Chinese Medicine, Shijiazhuang, 050011, Hebei, China
| | - En-Peng Gao
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China
| | - Wei Zhang
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China.
| | - Yong-Li Zheng
- Department of Radiology, Hebei Medical University Third Hospital, No. 139 Ziqiang Road, Qiaoxi District, Shijiazhuang, 050051, Hebei, China.
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Moonkum N, Withayanuluck T, Somarungsan A, Sichai N, Wongsiri A, Chawkhaodin W, Ruengdach P, Boonsuk P, Pukdeeyorng M, Tochaikul G. Osteopenia and Osteoporosis Screening Detection: Calcaneal Quantitative Ultrasound with and without Calibration Factor Comparison to Gold Standard Dual X-ray Absorptiometry. J Clin Densitom 2024; 27:101470. [PMID: 38342001 DOI: 10.1016/j.jocd.2024.101470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 12/25/2023] [Accepted: 01/18/2024] [Indexed: 02/13/2024]
Abstract
BACKGROUND osteoporosis is a worldwide major health problem that normally diagnosed in advanced stages. So, an early detection at preclinical stage is now an interesting issue. A key factor to early diagnosis the disease is the used of noninvasive bone densitometry. Dual energy x-ray absorptiometry (DXA) is the gold standard techniques for the proposed. However, the high cost, non-widely available and exposed to ionizing radiation are still a drawback of the machine. Therefore, a cheaper, smaller and non-ionizing device such quantitative ultrasound (QUS) is now a favor alternative method, but the possibility of used QUS measurement instead of DXA is still limited due to their uncertainties. So, the aim of our study was to calibrated the QUS with the DXA to allowing the possible to establish a calibration factor (CF) to improve the measured value closer to the standard method. METHODOLOGY 135 healthy men and women aged 30-88 years were recruited for lumbar spine/femoral neck DXA and calcaneal QUS scanning. The Pearson's correlation between T- and Z-score from the two systems were studied. Moreover, the sensitivity, specificity and percentage of diagnosed accuracy for both with and without CF were calculated. RESULTS The significant correlation between the two systems showed a positive trajectory in highly correlation (r = 0.784-0.899). Analyses showed a higher sensitivity, specificity and reduced the misdiagnosed rates when applied the CF in QUS values. CONCLUSIONS QUS results showed a significantly correlated with DXA results for both lumbar spine and femoral neck sites with some percentage differences. These differences can be reduced by applied an individual specific machine CF to improve a QUS results. As identification of high risk of osteopenia and osteoporosis to reduce the demand of DXA propose, using a QUS alternative method can be a reliable that provide a cheaper and lack of ionizing radiation.
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Affiliation(s)
- Nutthapong Moonkum
- Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand
| | | | - Arun Somarungsan
- Department of Radiology, Paolo Kaset Hospital, Bangkok 10900, Thailand
| | - Naphondej Sichai
- Department of Radiology, Paolo Kaset Hospital, Bangkok 10900, Thailand
| | - Arisa Wongsiri
- Department of Radiology, Paolo Kaset Hospital, Bangkok 10900, Thailand
| | - Witchayada Chawkhaodin
- Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand
| | - Podjana Ruengdach
- Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand
| | - Pasinee Boonsuk
- Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand
| | - Marut Pukdeeyorng
- Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand
| | - Gunjanaporn Tochaikul
- Faculty of Radiological Technology, Rangsit University, 52/347 Lak Hok, Mueang Pathum Thani District, Pathumthani 12000, Thailand.
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Aguirre AO, Soliman MAR, Kuo CC, Ruggiero N, Im J, Khan A, Lim J, Nyabuto E, Smolar DE, Mullin JP, Pollina J. Comparative Analysis of the 3 Cervical Vertebral Bone Quality (C-VBQ) Score Methodologies and Their Correlations to the Lumbar Vertebral Bone Quality (VBQ) Score. World Neurosurg 2024; 183:e321-e327. [PMID: 38143028 DOI: 10.1016/j.wneu.2023.12.095] [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: 11/10/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVE Common complications after spinal fusion, such as pseudoarthrosis, cage subsidence, or instrumentation failure, are affected by patients' bone quality. The cervical-vertebral bone quality (C-VBQ) score, a magnetic resonance imaging (MRI)-based adaption of the lumbar vertebral bone quality (VBQ) score, was developed by 3 separate research groups simultaneously to evaluate bone quality in cervical spinal fusion patients. We present the first analysis comparing these scoring methods to the well-validated VBQ score. METHODS A retrospective analysis of data for consecutive patients who underwent spine surgery at a single institution was completed. The VBQ score was calculated using the Ehresman et al. METHOD The C-VBQ scores, named according to placement of the region of interest within the cerebral spinal fluid, were calculated separately using the methods of Soliman et al. (C2-VBQ), Razzouk et al. (C5-VBQ), and Huang et al. (T1-VBQ). Linear regression models were utilized to evaluate correlations to the VBQ score. RESULTS A total of 105 patients were identified (mean age, 57.0 ± 11.9 years; women, 50.5%). Mean scores were C2-VBQ, 2.37 ± 0.55; C5-VBQ, 2.36 ± 0.61; and T1-VBQ, 2.64 ± 0.68. The C-VBQ scores for the C2 level were significantly higher than those for the C3-C6 levels (3.18 ± 0.96 vs. 2.63 ± 0.77, P < 0.001), whereas the C7 level was found to have significantly lower C-VBQ scores (2.42 ± 0.78 vs. 2.63 ± 0.77, P = 0.04). The C2-VBQ (r = 0.63) score had the strongest correlation to the VBQ score, compared to C5-VBQ (r = 0.41) and T1-VBQ (r = 0.43) (P < 0.001). CONCLUSIONS This study demonstrates that the C2-VBQ had the strongest correlation to the lumbar VBQ score among all C-VBQ scores.
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Affiliation(s)
- Alexander O Aguirre
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Mohamed A R Soliman
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA; Department of Neurosurgery, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Cathleen C Kuo
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Nicco Ruggiero
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Justin Im
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA
| | - Asham Khan
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Jaims Lim
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Elizabeth Nyabuto
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - David E Smolar
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - Jeffrey P Mullin
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA
| | - John Pollina
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, USA; Department of Neurosurgery, Buffalo General Medical Center, Kaleida Health, Buffalo, New York, USA.
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5
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Saisirivechakun P, Mahakkanukrauh A, Pongchaiyakul C, Boonya-Ussadorn T, Narongroeknawin P, Pakchotanon R, Assavatanabodee P, Chaiamnuay S. Prevalence of low trabecular bone score and its association with disease severity and activity in patients with axial spondyloarthritis. Sci Rep 2023; 13:16258. [PMID: 37758825 PMCID: PMC10533482 DOI: 10.1038/s41598-023-43321-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Accepted: 09/22/2023] [Indexed: 09/29/2023] Open
Abstract
Axial spondyloarthritis (axSpA) increases the risk of osteoporosis and vertebral fractures. Bone mineral density (BMD) measured by dual X-ray absorptiometry (DXA) has limitations in axSpA patients. Trabecular bone score (TBS) indirectly assesses bone microarchitecture and can be used to predict fracture risk. However, few studies have investigated the role of TBS in axSpA patients. The objective of this study were to compare TBS between axSpA patients and 1:1 sex- and age-matched healthy volunteers and determine factors associated with low TBS in axSpA patients. A cross-sectional study was conducted in two tertiary-care hospitals. A total of 137 axSpA patients and healthy volunteers were enrolled. Demographics, disease characteristics, and risk factors for osteoporosis were recorded. TBS, BMD at the lumbar spine, hip, and vertebral fractures were assessed by DXA. Low TBS was defined as a TBS value < 1.230. Factors associated with low TBS were examined by logistic regression. Most patients were male (75.9%) and tested positive for HLA-B27 (88.3%). The mean (SD) age was 42.8 (12.0) years. The mean (SD) of TBS in the axSpA patients was lower than those in the healthy volunteers [1.402 (0.107) vs 1.440 (0.086), respectively; p = 0.002]. The mean (SD) of lumbar BMD in the axSpA patients was higher than in healthy volunteers [1.186 (0.212) vs 1.087 (0.124), p < 0.001], whereas the mean (SD) of femoral neck BMD in the axSpA group was lower than that in the healthy volunteers [0.867 (0.136) vs 0.904 (0.155), p = 0.038]. Disease severity as indicated by sacroiliac joint fusion and a high ASDAS score were associated with low TBS with the odds ratios (95% confidence interval) of 11.8 (1.2-115.4) and 5.2 (1.6-16.9), respectively. In conclusion, axSpA patients had a higher prevalence of low TBS than healthy volunteers. Sacroiliac joint fusion and a high ASDAS score were associated with low TBS.
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Affiliation(s)
- Pannarat Saisirivechakun
- Rheumatic Diseases Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Ajanee Mahakkanukrauh
- Division of Rheumatology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Chatlert Pongchaiyakul
- Division of Endocrinology and Metabolism, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - Trirat Boonya-Ussadorn
- Division of Nuclear Medicine, Department of Radiology, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - Pongthorn Narongroeknawin
- Rheumatic Diseases Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Rattapol Pakchotanon
- Rheumatic Diseases Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Paijit Assavatanabodee
- Rheumatic Diseases Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Ratchathewi District, Bangkok, 10400, Thailand
| | - Sumapa Chaiamnuay
- Rheumatic Diseases Unit, Department of Internal Medicine, Phramongkutklao Hospital and College of Medicine, 315 Ratchawithi Road, Ratchathewi District, Bangkok, 10400, Thailand.
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Heimes D, Becker P, Pabst A, Smeets R, Kraus A, Hartmann A, Sagheb K, Kämmerer PW. How does dental implant macrogeometry affect primary implant stability? A narrative review. Int J Implant Dent 2023; 9:20. [PMID: 37405709 DOI: 10.1186/s40729-023-00485-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 06/21/2023] [Indexed: 07/06/2023] Open
Abstract
PURPOSE The macrogeometry of a dental implant plays a decisive role in its primary stability. A larger diameter, a conical shape, and a roughened surface increase the contact area of the implant with the surrounding bone and thus improve primary stability. This is considered the basis for successful implant osseointegration that different factors, such as implant design, can influence. This narrative review aims to critically review macro-geometric features affecting the primary stability of dental implants. METHODS For this review, a comprehensive literature search and review of relevant studies was conducted based on formulating a research question, searching the literature using keywords and electronic databases such as PubMed, Embase, and Cochrane Library to search for relevant studies. These studies were screened and selected, the study quality was assessed, data were extracted, the results were summarized, and conclusions were drawn. RESULTS The macrogeometry of a dental implant includes its surface characteristics, size, and shape, all of which play a critical role in its primary stability. At the time of placement, the initial stability of an implant is determined by its contact area with the surrounding bone. Larger diameter and a conical shape of an implant result in a larger contact area and better primary stability. But the linear relationship between implant length and primary stability ends at 12 mm. CONCLUSIONS Several factors must be considered when choosing the ideal implant geometry, including local factors such as the condition of the bone and soft tissues at the implant site and systemic and patient-specific factors such as osteoporosis, diabetes, or autoimmune diseases. These factors can affect the success of the implant procedure and the long-term stability of an implant. By considering these factors, the surgeon can ensure the greatest possible therapeutic success and minimize the risk of implant failure.
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Affiliation(s)
- Diana Heimes
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany.
| | - Philipp Becker
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstraße 170, 56072, Koblenz, Germany
| | - Andreas Pabst
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Department of Oral and Maxillofacial Surgery, Federal Armed Forces Hospital, Rübenacherstraße 170, 56072, Koblenz, Germany
| | - Ralf Smeets
- Department of Oral and Maxillofacial Surgery, University Medical Center Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Germany
- Department of Oral and Maxillofacial Surgery, Division of "Regenerative Orofacial Medicine", University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Annika Kraus
- Department of Prosthetic Dentistry, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Amely Hartmann
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
- Private Practice for Oral Surgery, Echterdinger Straße 7, 70794, Filderstadt, Germany
| | - Keyvan Sagheb
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
| | - Peer W Kämmerer
- Department of Oral and Maxillofacial Surgery, University Medical Center Mainz, Augustusplatz 2, 55131, Mainz, Germany
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Huang JW, Fang WH, Chen WL. Detrimental Association Between Blood Cadmium Concentration and Trabecular Bone Score. Biol Trace Elem Res 2023; 201:82-89. [PMID: 35137281 DOI: 10.1007/s12011-022-03143-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/29/2022] [Indexed: 01/11/2023]
Abstract
Osteoporosis has been recognized as a significant cause of disability in the elderly leading to heavy socioeconomic burden. Current measurements such as dual-energy X-ray absorptiometry (DEXA) and bone mineral density (BMD) have limitations. In contrast, trabecular bone score (TBS) is an emerging tool for bone quality assessment. The objective of our study was to investigate the relationship between TBS and trace elements (cadmium and lead). We analyzed all subjects from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey (NHANES) dataset and included a total of 8,244 participants in our study; 49.4% of the enrolled subjects were male. We used blood cadmium (Cd) and lead (Pb) concentrations to define environmental exposure. The main variables were TBS and BMD. Other significant demographic features were included as covariates and later adjusted using linear regression models to determine the association between TBS and four quartiles based on the blood trace element concentrations with or without sex differences. The fully adjusted regression model revealed a negative relationship between TBS and blood cadmium (B-Cd) significant for both males and females (both p < 0.05). The β-coefficient for males was -0.009 (95% confidence intervals (CI): (-0.015 to -0.004)) and -0.019 for female (95% CI: (-0.024 to -0.013)). We also found a dose-dependent relationship between TBS and B-Cd for both sexes (both trend's p < 0.05). Our study concluded that TBS could measure Cd-related bone quality deterioration for both males and females.
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Affiliation(s)
- Jun-Wei Huang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wen-Hui Fang
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China
| | - Wei-Liang Chen
- Division of Family Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan, Republic of China.
- Division of Geriatric Medicine, Department of Family and Community Medicine, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Number 325, Section 2, Chang-gong Rd, Nei-Hu District, 114, Taipei, Taiwan, Republic of China.
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Republic of China.
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Asynchronous calibration of quantitative computed tomography bone mineral density assessment for opportunistic osteoporosis screening: phantom-based validation and parameter influence evaluation. Sci Rep 2022; 12:20729. [PMID: 36456574 PMCID: PMC9715650 DOI: 10.1038/s41598-022-24546-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 11/16/2022] [Indexed: 12/03/2022] Open
Abstract
Asynchronous calibration could allow opportunistic screening based on routine CT for early osteoporosis detection. In this phantom study, a bone mineral density (BMD) calibration phantom and multi-energy CT (MECT) phantom were imaged on eight different CT scanners with multiple tube voltages (80-150 kVp) and image reconstruction settings (e.g. soft/hard kernel). Reference values for asynchronous BMD estimation were calculated from the BMD-phantom and validated with six calcium composite inserts of the MECT-phantom with known ground truth. Relative errors/changes in estimated BMD were calculated and investigated for influence of tube voltage, CT scanner and reconstruction setting. Reference values for 282 acquisitions were determined, resulting in an average relative error between calculated BMD and ground truth of - 9.2% ± 14.0% with a strong correlation (R2 = 0.99; p < 0.0001). Tube voltage and CT scanner had a significant effect on calculated BMD (p < 0.0001), with relative differences in BMD of 3.8% ± 28.2% when adapting reference values for tube voltage, - 5.6% ± 9.2% for CT scanner and 0.2% ± 0.2% for reconstruction setting, respectively. Differences in BMD were small when using reference values from a different CT scanner of the same model (0.0% ± 1.4%). Asynchronous phantom-based calibration is feasible for opportunistic BMD assessment based on CT images with reference values adapted for tube voltage and CT scanner model.
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Hasenbein I, Sachse A, Hortschansky P, Schmuck KD, Horbert V, Anders C, Lehmann T, Huber R, Maslaris A, Layher F, Braun C, Roth A, Plöger F, Kinne RW. Single Application of Low-Dose, Hydroxyapatite-Bound BMP-2 or GDF-5 Induces Long-Term Bone Formation and Biomechanical Stabilization of a Bone Defect in a Senile Sheep Lumbar Osteopenia Model. Biomedicines 2022; 10:513. [PMID: 35203721 PMCID: PMC8962316 DOI: 10.3390/biomedicines10020513] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 12/13/2022] Open
Abstract
Effects of hydroxyapatite (HA) particles with bone morphogenetic BMP-2 or GDF-5 were compared in sheep lumbar osteopenia; in vitro release in phosphate-buffered saline (PBS) or sheep serum was assessed by ELISA. Lumbar (L) vertebral bone defects (Ø 3.5 mm) were generated in aged, osteopenic female sheep (n = 72; 9.00 ± 0.11 years; mean ± SEM). Treatment was: (a) HA particles (2.5 mg; L5); or (b) particles coated with BMP-2 (1 µg; 10 µg) or GDF-5 (5 µg; 50 µg; L4; all groups n = 6). Untouched vertebrae (L3) served as controls. Three and nine months post-therapy, bone formation was assessed by osteodensitometry, histomorphometry, and biomechanical testing. Cumulative 14-day BMP release was high in serum (76-100%), but max. 1.4% in PBS. In vivo induction of bone formation by HA particles with either growth factor was shown by: (i) significantly increased bone volume, trabecular and cortical thickness (overall increase HA + BMP vs. control close to the injection channel 71%, 110%, and 37%, respectively); (ii) partial significant effects for bone mineral density, bone formation, and compressive strength (increase 17%; 9 months; GDF-5). Treatment effects were not dose-dependent. Combined HA and BMPs (single low-dose) highly augment long-term bone formation and biomechanical stabilization in sheep lumbar osteopenia. Thus, carrier-bound BMP doses 20,000-fold to 1000-fold lower than previously applied appear suitable for spinal fusion/bone regeneration and improved treatment safety.
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Affiliation(s)
- Ines Hasenbein
- Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany; (I.H.); (A.S.); (V.H.); (A.M.); (F.L.)
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany;
| | - André Sachse
- Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany; (I.H.); (A.S.); (V.H.); (A.M.); (F.L.)
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany;
| | - Peter Hortschansky
- Leibniz Institute for Natural Product Research and Infection Biology (Leibniz-HKI), 07745 Jena, Germany;
| | - Klaus D. Schmuck
- Johnson & Johnson Medical GmbH, DePuySynthes, 22851 Norderstedt, Germany;
| | - Victoria Horbert
- Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany; (I.H.); (A.S.); (V.H.); (A.M.); (F.L.)
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany;
| | - Christoph Anders
- Division of Motor Research, Pathophysiology and Biomechanics, Experimental Trauma Surgery, Department for Hand, Reconstructive, and Trauma Surgery, Jena University Hospital, 07743 Jena, Germany;
| | - Thomas Lehmann
- Institute of Medical Statistics, Computer Sciences and Data Sciences, Jena University Hospital, 07743 Jena, Germany;
| | - René Huber
- Institute of Clinical Chemistry, Hannover Medical School, 30625 Hannover, Germany;
| | - Alexander Maslaris
- Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany; (I.H.); (A.S.); (V.H.); (A.M.); (F.L.)
| | - Frank Layher
- Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany; (I.H.); (A.S.); (V.H.); (A.M.); (F.L.)
| | - Christina Braun
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany;
| | - Andreas Roth
- Bereich Endoprothetik/Orthopädie, Klinik für Orthopädie, Unfallchirurgie und Plastische Chirurgie, Uniklinik Leipzig AöR, 04103 Leipzig, Germany;
| | - Frank Plöger
- BIOPHARM GmbH, Czernyring 22, 69115 Heidelberg, Germany;
| | - Raimund W. Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkliniken Eisenberg GmbH, 07607 Eisenberg, Germany;
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10
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Kim KY, Kim KM. Similarities and differences between bone quality parameters, trabecular bone score and femur geometry. PLoS One 2022; 17:e0260924. [PMID: 35015756 PMCID: PMC8751997 DOI: 10.1371/journal.pone.0260924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Accepted: 11/22/2021] [Indexed: 11/25/2022] Open
Abstract
Bone quality is a critical factor that, along with bone quantity, determines bone strength. Image-based parameters are used for assessing bone quality non-invasively. The trabecular bone score (TBS) is used to assess quality of trabecular bone and femur geometry for cortical bone. Little is known about the associations between these two bone quality parameters and whether they show differences in the relationships with age and body mass index (BMI). We investigated the associations between the trabecular bone score (TBS) and femur cortical geometry. Areal bone mineral density (BMD) was assessed using dual energy X-ray absorptiometry (DXA) and the TBS was assessed using iNsight software and, femur geometry using APEX (Hologic). A total of 452 men and 517 women aged 50 years and older with no medical history of a condition affecting bone metabolism were included. Z-scores for TBS and cortical thickness were calculated using the age-specific mean and SD for each parameter. A ‘discrepancy group’ was defined as patients whose absolute Z-score difference between TBS and cortical thickness was > 1 point. TBS and cortical thickness correlated negatively with age both in men and women, but the associations were stronger in women. Regarding the associations with BMI, TBS provided significant negative correlation with BMI in the range of BMI > 25 kg/m2. By contrast, cortical thickness correlated positively with BMI for all BMI ranges. These bone quality-related parameters, TBS and cortical thickness, significantly correlated, but discordance between these two parameters was observed in about one-third of the men and women (32.7% and 33.4%, respectively). Conclusively, image-based bone quality parameters for trabecular and cortical bone exhibit both similarities and differences in terms of their associations with age and BMI. These different profiles in TBS and FN cortical thickness might results in different risk profiles for the vertebral fractures or hip fractures in a certain percentage of people.
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Affiliation(s)
- Kyong Young Kim
- Department of Internal Medicine, Gyeongsang National University Changwon Hospital, Changwon, South Korea
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, South Korea
- Division of Endocrinology, Department of Internal Medicine, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, Republic of Korea
- * E-mail:
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11
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Anderson F, Payne C, Pannier L, Pethick D, Gardner G. The potential for dual energy X-ray absorptiometry to predict lamb eating quality. Meat Sci 2021; 181:108434. [DOI: 10.1016/j.meatsci.2021.108434] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 11/25/2022]
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12
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常 艳, 林 新, 张 蓉, 刘 喜, 童 笑, 陈 平, 封 志. Expert consensus on clinical management of metabolic bone disease of prematurity (2021). ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:761-772. [PMID: 34511163 PMCID: PMC8428920 DOI: 10.7499/j.issn.1008-8830.2105152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 06/29/2021] [Indexed: 11/21/2022]
Abstract
Metabolic bone disease of prematurity (MBDP) is a systemic bone disease with a reduction in bone mineral content due to disorder of calcium and phosphorus metabolism. There is still a lack of in-depth research and systematic understanding of MBDP in China, and there are many irregularities in clinical management of this disease. Based on relevant studies in China and overseas, Grading of Recommendations Assessment, Development and Evaluation was used to develop the expert consensus on the clinical management of MBDP, which provides recommendations from the following five aspects: high-risk factors, screening/diagnosis, prevention, treatment, and post-discharge follow-up of MBDP, so as to provide relevant practitioners with recommendations on the clinical management of MBDP to reduce the incidence rate of MBDP and improve its short- and long-term prognosis.
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Affiliation(s)
| | - 新祝 林
- 厦门大学附属妇女儿童医院/厦门市妇幼保健院新生儿科, 福建厦门 361003
| | | | - 喜红 刘
- 广州市妇女儿童医疗中心 临床营养科,广东广州 510623
| | | | - 平洋 陈
- 中南大学湘雅二医院儿童医学中心新生儿专科,湖南长沙410011
| | - 志纯 封
- 解放军总医院第七医学中心八一儿童医院新生儿科北京100700
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13
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Jia X, Zhu H, Li G, Lan M, Li X, Huang M, Xu W, Wu S. Anti-osteoporotic effects of alisol C 23-acetate via osteoclastogenesis inhibition. Biomed Pharmacother 2021; 137:111321. [PMID: 33524783 DOI: 10.1016/j.biopha.2021.111321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 12/28/2020] [Accepted: 01/21/2021] [Indexed: 12/21/2022] Open
Abstract
Alismatis rhizoma (AR) is the dried rhizome of Alisma orientale (Sam.) Juz. (Alismataceae). This traditional Chinese formula is diuretic, hypoglycemic, and hypolipidemic. Alisol C 23-acetate (AC23A) from AR is anti-inflammatory and ameliorates certain metabolic diseases. However, the mechanism by which AC23A mitigates osteoporosis is unknown. The present study investigated the anti-osteoporotic effects of AC23A in vivo and in vitro. In an ovariectomized (OVX) rat model, AC23A ameliorated OVX-induced organ coefficients and trabecular bone loss. In OVX rats, AC23A treatment lowered serum TRAP5b, CTK, β-CTX, TNF-α, IL-6, and IL-1β, raised serum E2, and did not significantly change serum OCN or BALP. AC23A inhibited osteoclast formation in a rat co-culture system without affecting osteoblast activity. RANK (receptor activator of nuclear factor kappaB) signaling channels are vital osteoclastogenesis transcription elements. AC23A inhibited RANK ligand (RANKL)-induced TRAP, c-Fos, MMP9, NFATc1, and CTK expression and JNK phosphorylation. Therefore, AC23A is anti-osteoclastogenic in vitro and in vivo by inhibiting RANKL-induced osteoclast differentiation and function. Moreover, AC23A could help prevent or limit osteoclast-mediated bone diseases by inhibiting osteoclastogenesis.
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Affiliation(s)
- Xiaokang Jia
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China; Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China; Centre of Biomedical Research & Development, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Huaichang Zhu
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Gaopan Li
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Mengliu Lan
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Xiaoyan Li
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Mingqing Huang
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China; Centre of Biomedical Research & Development, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Wen Xu
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China; Centre of Biomedical Research & Development, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
| | - Shuisheng Wu
- College of Pharmacy, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China; Centre of Biomedical Research & Development, Fujian University of Traditional Chinese Medicine, Fuzhou, 350122, China.
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14
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Sebro R, Ashok SS. A Statistical Approach Regarding the Diagnosis of Osteoporosis and Osteopenia From DXA: Are We Underdiagnosing Osteoporosis? JBMR Plus 2021; 5:e10444. [PMID: 33615110 PMCID: PMC7872343 DOI: 10.1002/jbm4.10444] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 09/23/2020] [Accepted: 10/06/2020] [Indexed: 11/06/2022] Open
Abstract
Osteoporosis and osteopenia are diagnosed most commonly by evaluating the lowest T‐score of BMD measurements, typically taken at three sites: the L1‐L4 lumbar spine, femoral neck, and total hip. This study aimed to evaluate the effect of using all three BMD measurements and multivariate statistical theory to evaluate how the diagnoses of osteoporosis and osteopenia change in simulation studies and in real data. First, it was found that the T‐scores from these three BMD measurements rarely give concordant diagnoses using the same World Health Organization (WHO) and International Society for Clinical Densitometry (ISCD) guidelines, so that the diagnosis strongly depends on the BMD sites measured. Next, strong correlations were found between the BMD measurements at different sites within the same person, which resulted in increased congruence/concordance between the diagnoses obtained from the BMD T‐scores. Multivariate statistical theory was used to show that the joint distribution of the BMD T‐scores at different sites follows a multivariate t distribution and found that the marginal distribution of any BMD T‐score follows a univariate t distribution. Confidence ellipsoids were derived that are equivalent to the univariate WHO/ISCD thresholds for osteoporosis (T‐score ≤−2.5) and osteopenia (−2.5 < T‐score <−1). The study found that more patients are diagnosed with osteoporosis using the multivariate version of the WHO/ISCD guidelines rather than the current WHO/ISCD guidelines in both real data and simulation studies. Diagnoses of osteoporosis using the statistics derived method were also associated with higher FRAX (fracture risk assessment tool) probabilities of major osteoporotic (p = 0.001) and hip fractures (p = 2.2 × 10−6). In conclusion, this study shows that considering all three BMD T‐scores is potentially more informative than using the single lowest BMD T‐score. © 2020 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)
- Ronnie Sebro
- Department of Radiology University of Pennsylvania Philadelphia PA USA.,Department of Orthopaedic Surgery University of Pennsylvania Philadelphia PA USA.,Department of Genetics University of Pennsylvania Philadelphia PA USA.,Department of Biostatistics, Epidemiology and Informatics University of Pennsylvania Philadelphia PA USA
| | - S Sharon Ashok
- Department of Radiology University of Pennsylvania Philadelphia PA USA
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15
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Gutierrez-Buey G, Restituto P, Botella S, Monreal I, Colina I, Rodríguez-Fraile M, Calleja A, Varo N. Trabecular bone score and bone remodelling markers identify perimenopausal women at high risk of bone loss. Clin Endocrinol (Oxf) 2019; 91:391-399. [PMID: 31141196 DOI: 10.1111/cen.14042] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 05/22/2019] [Accepted: 05/28/2019] [Indexed: 01/26/2023]
Abstract
CONTEXT Bone loss is accelerated in the late perimenopause and early menopause. The date of the final menstrual period cannot be stated until 1 year after it has ended, and at that time, most of the rapid bone loss phase will have elapsed. Therefore, early detection of bone loss is crucial. OBJECTIVES To evaluate the utility of bone turnover markers (BTM) to identify the women who are more likely to lose more bone mass during the transition to menopause and quantify the loss of bone quality measured by trabecular bone score (TBS). DESIGN, PATIENTS AND SETTING Sixty-four healthy premenopausal women, mean age between 44 and 57 years old, were enrolled and followed up for 5 years. Clinical features, lifestyle, bone densitometry, TBS and BTM (CTX, P1NP and osteocalcin) were measured at baseline and follow-up. RESULTS All women had densitometrically normal bone at the time of enrolment. After 5 years, 48.4% had normal bone mineral density, 45.8% low bone mass and 6.3% osteoporosis. Women with osteopenia/osteoporosis at follow-up had higher CTX and P1NP at enrolment compared with women with densitometrically normal bone. The areas under the curve for the prediction of low bone mass or osteoporosis were 0.69 (P = 0.011) for P1NP, 0.69 for CTX (P = 0.013) and 0.77 (P 0.001) for OC. A significant correlation was found between P1NP increase after 5 years and the decrease in lumbar bone density (r = -0.383, P = 0.002). At baseline, 7 (10.9%) women had deteriorated microarchitecture (TBS < 1.3). Three of these women developed osteoporosis and four osteopenia at follow-up. CONCLUSIONS Women with higher P1NP and CTX and lower TBS at baseline had lower BMD in the transition to menopause suggesting these novel tools could have potential use in identifying women at high risk of rapidly decreasing bone mass.
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Affiliation(s)
| | | | - Sonsoles Botella
- Endocrinology Department, Complejo Hospitalario de Navarra, Pamplona, Spain
| | - Ignacio Monreal
- Clinical Chemistry, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Inmaculada Colina
- Internal Medicine Department, Clínica Universidad de Navarra, Pamplona, Spain
| | | | - Amparo Calleja
- Endocrinology Department, Clínica Universidad de Navarra, Pamplona, Spain
| | - Nerea Varo
- Clinical Chemistry, Clínica Universidad de Navarra, Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
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16
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Hussain A, Lee RJ, Graff JN, Halabi S. The evolution and understanding of skeletal complication endpoints in clinical trials of tumors with metastasis to the bone. Crit Rev Oncol Hematol 2019; 139:108-116. [PMID: 31170574 DOI: 10.1016/j.critrevonc.2019.04.020] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/15/2019] [Accepted: 04/22/2019] [Indexed: 01/06/2023] Open
Abstract
Bone metastases are a frequent complication of solid tumors, leading to significant skeletal sequelae that negatively impact quality of life and survival. Prevention and management of skeletal-related complications are critical treatment goals in oncology. Endpoints used in clinical trials to evaluate skeletal-related complications have evolved. In contrast to single measures of bone health, contemporary clinical trial endpoints reflect composite measures of skeletal-related complications, and increasingly also survival. In addition, key symptomatic components, which are more reflective of quality of life and the patient experience, are being incorporated. Given the evolution and resulting diversity of the endpoints being used in pivotal trials, it is becoming increasingly relevant to clarify the utility and the potential clinical impact of these measures not only within the context of trials but also in the real-world setting. Here, we describe the development and evolution of skeletal endpoints used in trials, and discuss their clinical relevance.
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Affiliation(s)
- A Hussain
- University of Maryland, School of Medicine, Marlene and Stuart Greenebaum Cancer Center, and Baltimore VA Medical Center, Baltimore, MD, USA.
| | - R J Lee
- Massachusetts General Hospital Cancer Center, Boston, MA, USA
| | - J N Graff
- Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA
| | - S Halabi
- Duke University Medical Center, Durham, NC, USA
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17
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Mehta SD, Sebro R. Random forest classifiers aid in the detection of incidental osteoblastic osseous metastases in DEXA studies. Int J Comput Assist Radiol Surg 2019; 14:903-909. [PMID: 30852715 DOI: 10.1007/s11548-019-01933-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 03/04/2019] [Indexed: 11/30/2022]
Abstract
PURPOSE Dual-energy X-ray absorptiometry (DEXA) studies are used for screening patients for low bone mineral density (BMD). Patients with breast and prostate cancer are often treated with hormone-altering drugs that result in low BMD. These patients may have incidental osteoblastic metastases of the spine that may be detected on screening DEXA studies. The aim of this pilot study is to assess whether random forest classifiers or support vector machines can identify patients with incidental osteoblastic metastases of the spine from screening DEXA studies and to evaluate which technique is better. METHODS We retrospectively reviewed the DEXA studies from 200 patients (155 normal control patients and 45 patients with osteoblastic metastases of one or more lumbar vertebral bodies from L1 to L4). The dataset was split into training (80%) and validation (20%) datasets. The optimal random forest (RF) and support vector machine (SVM) classifiers were obtained. Receiver-operator-characteristic curves were compared with DeLong's test. RESULTS The sensitivity, specificity, accuracy and area under the curve (AUC) of the optimal RF classifier were 77.8%, 100.0%, 98.0% and 0.889, respectively, in the validation dataset. The sensitivity, specificity, accuracy and AUC of the optimal SVM classifier were 33.3%, 96.8%, 82.5% and 0.651 in the validation dataset. The RF classifier was significantly better than the SVM classifier (P = 0.008). Only 7 of the 45 patients with osteoblastic metastases (15.6%) were prospectively identified by the radiologist interpreting the study. CONCLUSIONS RF classifiers can be used as a useful adjunct to identify incidental lumbar spine osteoblastic metastases in screening DEXA studies.
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Affiliation(s)
- Samir D Mehta
- Department of Radiology, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, USA
| | - Ronnie Sebro
- Department of Radiology, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, USA. .,Department of Orthopedic Surgery, University of Pennsylvania, 3737 Market Street, Philadelphia, PA, 19104, USA. .,Department of Genetics, University of Pennsylvania, 421 Marie Curie Blvd, Philadelphia, PA, 19104, USA. .,Department of Epidemiology and Biostatistics, University of Pennsylvania, 421 Marie Curie Blvd, Philadelphia, PA, 19104, USA.
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18
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Cho CS, Jeong HS, Kim IY, Jung GW, Ku BH, Park DC, Moon SB, Cho HR, Bashir KMI, Ku SK, Choi JS. Anti-osteoporotic effects of mixed compositions of extracellular polymers isolated from Aureobasidium pullulans and Textoria morbifera in ovariectomized mice. BMC COMPLEMENTARY AND ALTERNATIVE MEDICINE 2018; 18:295. [PMID: 30400922 PMCID: PMC6220464 DOI: 10.1186/s12906-018-2362-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Accepted: 10/25/2018] [Indexed: 12/26/2022]
Abstract
Background Extracellular polymeric substances isolated from Aureobasidium pullulans (EAP), containing specifically 13% β-1,3/1,6-glucan, have shown various favorable bone-preserving effects. Textoria morbifera Nakai (TM) tree has been used as an ingredient in traditional medicine and tea for various pharmacological purposes. Thus, the present study was aimed to examine the synergistic anti-osteoporotic potential of mixtures containing different proportions of EAP and TM compared with that of the single formulations of each herbal extract using bilateral ovariectomized (OVX) mice, a renowned rodent model for studying human osteoporosis. Methods Thirty five days after bilateral-OVX surgery, 9 combinations of EAP:TM (ratios = 1:1, 1:3, 1:5, 1:7, 1:9, 3:1, 5:1, 7:1, 9:1) and single separate formulations of EAP or TM were supplied orally, once a day for 35 days at a final concentration of 200 mg/kg. Variations in body weight gains during the experimental periods, as well as femur weights, bone mineral density (BMD), bone strength (failure load), and mineral content (calcium [Ca] and inorganic phosphorus [IP]) following sacrifice were measured. Furthermore, histomorphometric and histological profile analyses of serum biochemical parameters (osteocalcin content and bone specific alkaline phosphatase [bALP] activity) were conducted following sacrifice. Femurs histomorphometric analyses were also conducted for bone resorption, structure and mass. The results for the mixed formulations of EAP:TM and separate formulations were compared with those of risedronate sodium (RES). Results The EAP:TM (3:1) formulation synergistically enhanced the anti-osteoporotic potential of individual EAP or TM formulations, possibly due to enhanced variety of the active ingredients. Furthermore, the effects of EAP:TM were comparable to those of RES (2.5 mg/kg) treatment. Conclusion The results of this study suggest that, the EAP:TM (3:1) combination might act as a new pharmaceutical agent and/or health functional food substance for curing osteoporosis in menopausal women. Electronic supplementary material The online version of this article (10.1186/s12906-018-2362-y) contains supplementary material, which is available to authorized users.
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19
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Anti-Osteoporotic Effects of Polysaccharides Isolated from Persimmon Leaves via Osteoclastogenesis Inhibition. Nutrients 2018; 10:nu10070901. [PMID: 30011853 PMCID: PMC6073770 DOI: 10.3390/nu10070901] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/09/2018] [Accepted: 07/11/2018] [Indexed: 12/11/2022] Open
Abstract
Persimmon (Diospyros kaki L.f.) leaves have traditionally been used as a phytomedicine, in health beverages to treat cardiovascular and respiratory disease and to promote maternal health in East Asia. In particular, polysaccharides from persimmon are known to have anti-coagulant, anti-oxidant, and immune-stimulatory activities. However, their beneficial effects against osteoporosis have not been reported. In the present study, we investigated the anti-osteoporotic effects of polysaccharides from persimmon leaves (PLE0) using an in vivo model of ovariectomy (OVX)-induced bone loss and an in vitro system of receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclast differentiation. In the OVX mouse model, PLE0 remarkably improved OVX-induced trabecular bone loss by suppressing osteoclast activity. In primary bone marrow-derived macrophages (BMMs), PLE0 dose-dependently inhibited osteoclast differentiation. In addition, PLE0 down-regulated RANKL-induced activation of mitogen-activated protein kinases (MAPKs) such as p38, ERK, and JNK resulting in suppression of nuclear factor of activated T cells cytoplasmic 1 (NFATc1) expression. Our results indicate that PLE0 has anti-osteoporotic effects in OVX-induced bone loss via inhibition of osteoclast differentiation. Taken together, PLE0 from persimmon may prevent postmenopausal bone loss and osteoporotic bone fragility.
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20
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Cho CS, Jeong HS, Kim IY, Jung GW, Ku BH, Park DC, Moon SB, Cho HR, Ku SK, Choi JS. Antiosteoporotic effects of 3:1 (g/g) mixed formulation of exopolymers purified fromAureobasidium pullulansSM-2001 andDendropanax morbiferaleaf extracts in ovariectomized rats. J Food Biochem 2018. [DOI: 10.1111/jfbc.12548] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Chang-Soo Cho
- Hurim Hwangchil Co., Ltd., 907-11, Gyeongseo-dearo, Hoengcheon-myeon; Hadong-gun Gyeongsangnam-do 52320 Republic of Korea
| | - Hye-Seong Jeong
- Hurim Hwangchil Co., Ltd., 907-11, Gyeongseo-dearo, Hoengcheon-myeon; Hadong-gun Gyeongsangnam-do 52320 Republic of Korea
| | - In-Young Kim
- Hurim Hwangchil Co., Ltd., 907-11, Gyeongseo-dearo, Hoengcheon-myeon; Hadong-gun Gyeongsangnam-do 52320 Republic of Korea
| | - Go-Woon Jung
- Glucan Corp., #305 Marine Bio-Industry Development Center, 7 Hoenggye-gil; Busan 46048 Republic of Korea
| | - Bon-Hwa Ku
- Glucan Corp., #305 Marine Bio-Industry Development Center, 7 Hoenggye-gil; Busan 46048 Republic of Korea
| | - Dong-Chan Park
- Glucan Corp., #305 Marine Bio-Industry Development Center, 7 Hoenggye-gil; Busan 46048 Republic of Korea
| | - Seung-Bae Moon
- Glucan Corp., #305 Marine Bio-Industry Development Center, 7 Hoenggye-gil; Busan 46048 Republic of Korea
| | - Hyung-Rae Cho
- Glucan Corp., #305 Marine Bio-Industry Development Center, 7 Hoenggye-gil; Busan 46048 Republic of Korea
| | - Sae Kwang Ku
- Department of Anatomy and Histology, College of Korean Medicine; Daegu Haany University, 1, Hanuidae-ro; Gyeongsan-si Gyeongsangbuk-do 38610 Republic of Korea
| | - Jae-Suk Choi
- Major in Food Biotechnology, Division of Bioindustry, College of Medical and Life Sciences; Silla University, 140, Baegyang-daero 700beon-gil; Busan 46958 Republic of Korea
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The GDF5 mutant BB-1 enhances the bone formation induced by an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2018; 18:357-369. [PMID: 29031993 DOI: 10.1016/j.spinee.2017.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 09/15/2017] [Accepted: 10/02/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Targeted delivery of osteoinductive bone morphogenetic proteins (eg, GDF5) in bioresorbable calcium phosphate cement (CPC), potentially suitable for vertebroplasty and kyphoplasty of osteoporotic vertebral fractures, may be required to counteract augmented local bone catabolism and to support complete bone regeneration. The biologically optimized GDF5 mutant BB-1 may represent an attractive drug candidate for this purpose. PURPOSE The aim of the current study was to test an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming CPC containing low-dose BB-1 in a sheep lumbar osteopenia model. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and were filled with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of BB-1 (L5; CPC+fibers+BB-1; 5, 100, and 500 µg BB-1; n=6 each). The results were compared with those of untouched controls (L1). Three and 9 months after the operation, structural and functional effects of the CPC (±BB-1) were analyzed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (BV/TV) (assessed by micro-CT and histomorphometry), trabecular thickness (Tb.Th), and trabecular number (Tb.N); (3) bone formation, that is, osteoid volume/bone volume (OV/BV), osteoid surface/bone surface (OS/BS), osteoid thickness, mineralizing surface/bone surface (MS/BS), mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), CPC+fibers (L4) and/or CPC+fibers+BB-1 (L5) significantly improved all parameters of bone formation, bone resorption, and bone structure. These effects were observed at 3 and 9 months, but were less pronounced for some parameters at 9 months. Compared with CPC without BB-1, additional significant effects of BB-1 were demonstrated for BMD, bone structure (BV/TV, Tb.Th, and Tb.N), and bone formation (OS/BS and MS/BS). The BB-1 effects on bone formation at 3 and 9 months were dose dependent, with 100 µg as the potentially optimal dosage. CONCLUSIONS BB-1 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. A single local dose as low as 100 µg BB-1 was sufficient to augment middle- to long-term bone formation. A CPC containing the novel GDF5 mutant BB-1 may thus represent an alternative to the bioinert, supraphysiologically stiff polymethylmethacrylate cement presently used to treat osteoporotic vertebral fractures by vertebroplasty and kyphoplasty.
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GDF5 significantly augments the bone formation induced by an injectable, PLGA fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2017. [PMID: 28642196 DOI: 10.1016/j.spinee.2017.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Biodegradable calcium phosphate cement (CPC) represents a promising option for the surgical treatment of osteoporotic vertebral fractures. Because of augmented local bone catabolism, however, additional targeted delivery of bone morphogenetic proteins with the CPC may be needed to promote rapid and complete bone regeneration. PURPOSE In the present study, an injectable, poly(l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing the bone morphogenetic protein GDF5 was tested in a sheep lumbar osteopenia model. STUDY DESIGN/SETTING This is a prospective experimental animal study. METHODS Defined bone defects (diameter 5 mm) were placed in aged, osteopenic female sheep. Defects were treated with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of GDF5 (L5; CPC+fibers+GDF5; 1, 5, 100, and 500 µg GDF5; n=5 or 6 each). The results were compared with those of untouched controls (L1). Three and 9 months postoperation, structural and functional effects of the CPC (±GDF5) were assessed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography and histomorphometry), trabecular thickness, and trabecular number; (3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralized surface/bone surface, mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), both CPC+fibers (L4) and CPC+fibers+GDF5 (L5) numerically or significantly improved all parameters of bone formation, bone resorption, and bone structure. These significant effects were observed both at 3 and 9 months, but for some parameters they were less pronounced at 9 months. Compared with CPC without GDF5, additional significant effects of CPC with GDF5 were demonstrated for BMD and parameters of bone formation and structure (bone volume/total volume, trabecular thickness, and trabecular number, as well as mineralized surface/bone surface). The GDF5 effects were dose-dependent (predominantly in the 5-100 µg range) at 3 and 9 months. CONCLUSIONS GDF5 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. The results indicated that a local dose as low as ≤100 µg GDF5 may be sufficient to augment middle to long-term bone formation. The novel CPC+GDF5 combination may thus qualify as an alternative to the bioinert, supraphysiologically stiff poly(methyl methacrylate) cement currently applied for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures.
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Gunnella F, Kunisch E, Bungartz M, Maenz S, Horbert V, Xin L, Mika J, Borowski J, Bischoff S, Schubert H, Hortschansky P, Sachse A, Illerhaus B, Günster J, Bossert J, Jandt KD, Plöger F, Kinne RW, Brinkmann O. Low-dose BMP-2 is sufficient to enhance the bone formation induced by an injectable, PLGA fiber-reinforced, brushite-forming cement in a sheep defect model of lumbar osteopenia. Spine J 2017; 17:1699-1711. [PMID: 28619686 DOI: 10.1016/j.spinee.2017.06.005] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 05/23/2017] [Accepted: 06/08/2017] [Indexed: 02/03/2023]
Abstract
BACKGROUND CONTEXT Bioresorbable calcium phosphate cement (CPC) may be suitable for vertebroplasty/kyphoplasty of osteoporotic vertebral fractures. However, additional targeted delivery of osteoinductive bone morphogenetic proteins (BMPs) in the CPC may be required to counteract the augmented local bone catabolism and support complete bone regeneration. PURPOSE This study aimed at testing an injectable, poly (l-lactide-co-glycolide) acid (PLGA) fiber-reinforced, brushite-forming cement (CPC) containing low-dose bone morphogenetic protein BMP-2 in a sheep lumbar osteopenia model. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Bone defects (diameter 5 mm) were generated in aged, osteopenic female sheep and filled with fiber-reinforced CPC alone (L4; CPC+fibers) or with CPC containing different dosages of BMP-2 (L5; CPC+fibers+BMP-2; 1, 5, 100, and 500 µg BMP-2; n=5 or 6 each). The results were compared with those of untouched controls (L1). Three and 9 months after the operation, structural and functional effects of the CPC (±BMP-2) were analyzed ex vivo by measuring (1) bone mineral density (BMD); (2) bone structure, that is, bone volume/total volume (assessed by micro-computed tomography [micro-CT] and histomorphometry), trabecular thickness, and trabecular number; (3) bone formation, that is, osteoid volume/bone volume, osteoid surface/bone surface, osteoid thickness, mineralizing surface/bone surface, mineral apposition rate, and bone formation rate/bone surface; (4) bone resorption, that is, eroded surface/bone surface; and (5) compressive strength. RESULTS Compared with untouched controls (L1), CPC+fibers (L4) and/or CPC+fibers+BMP-2 (L5) significantly improved all parameters of bone formation, bone resorption, and bone structure. These effects were observed at 3 and 9 months, but were less pronounced for some parameters at 9 months. Compared with CPC without BMP-2, additional significant effects of BMP-2 were demonstrated for bone structure (bone volume/total volume, trabecular thickness, trabecular number) and formation (osteoid surface/bone surface and mineralizing surface/bone surface), as well as for the compressive strength. The BMP-2 effects on bone formation at 3 and 9 months were dose-dependent, with 5-100 µg as the optimal dosage. CONCLUSIONS BMP-2 significantly enhanced the bone formation induced by a PLGA fiber-reinforced CPC in sheep lumbar osteopenia. A single local dose as low as ≤100 µg BMP-2 was sufficient to augment middle to long-term bone formation. The novel CPC+BMP-2 may thus represent an alternative to the bioinert, supraphysiologically stiff polymethylmethacrylate cement presently used to treat osteoporotic vertebral fractures by vertebroplasty/kyphoplasty.
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Affiliation(s)
- Francesca Gunnella
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Elke Kunisch
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Matthias Bungartz
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany; Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Stefan Maenz
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldtstr. 10, 07743 Jena, Germany
| | - Victoria Horbert
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Long Xin
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Joerg Mika
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Juliane Borowski
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Peter Hortschansky
- Leibniz-Institute for Natural Products Research and Infection Biology - Hans-Knoell-Institute, Beutenbergstr. 11a, 07745 Jena, Germany
| | - Andre Sachse
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
| | - Bernhard Illerhaus
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Straße 23, 07743 Jena, Germany
| | - Jens Günster
- BAM Bundesanstalt für Materialforschung und -prüfung (BAM), Unter den Eichen 44-46, 12203 Berlin; Germany
| | - Jörg Bossert
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, 07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldtstr. 10, 07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, 07743 Jena, Germany
| | - Frank Plöger
- BIOPHARM GmbH, Handelsstrasse 15, 69214 Eppelheim, Germany
| | - Raimund W Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany.
| | - Olaf Brinkmann
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany; Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str. 81, 07607 Eisenberg, Germany
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Normal range of BMD in proximal tibia as a different skeletal site at women. North Clin Istanb 2017; 3:201-208. [PMID: 28275752 PMCID: PMC5336625 DOI: 10.14744/nci.2016.95866] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 12/20/2016] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE: Osteoporosis is progressive metabolic bone disease that decreases bone density and features deterioration of bone structure. Dual-energy X-ray absorptiometry (DXA) is commonly used and reliable method to measure bone mineral density (BMD). Aim of this study was to determine normal ranges of BMD in left proximal tibia. METHODS: Fifty-five females were included in this study. BMD was measured at the lumbar spine and the left proximal tibia using DXA. BMD value of subregions in the left proximal tibia was significantly correlated with BMD value of the total lumbar spine (r=0.111–0.766). New average BMD values of the left proximal tibia were calculated according to age using linear regression formula, leading to average BMD value for the total lumbar spine (L1-L4) in normal population. New simulated T-scores for proximal subregions of the tibia were then calculated. RESULTS: T-scores for proximal subregions were not different from T-scores of total lumbar spine (p>0.05). CONCLUSION: It was concluded that proximal tibia is an ideal region for measurement of BMD in osteoporosis.
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Anti-climacterium effects of pomegranate concentrated solutions in ovariectomized ddY mice. Exp Ther Med 2017; 13:1249-1266. [PMID: 28413464 DOI: 10.3892/etm.2017.4109] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2015] [Accepted: 10/05/2016] [Indexed: 12/14/2022] Open
Abstract
In the present study, the complex anti-climacterium potential of standardized pomegranate concentrated solution (PCS) was investigated using bilateral ovariectomy (OVX) female ddY mice. Changes in body weight and gain during experimental periods, food consumption, serum estradiol levels, total body and abdominal fat densities, abdominal fat pads, and uterus weights were observed, along with the histopathology of abdominal fat pads and uterus for anti-obesity and estrogenic effects. In addition, liver weights, serum aspartate aminotransferase (AST), alanine aminotransferase (ALT) levels, and histopathological inspections were performed to explore the hepato-protective effects. Serum total cholesterol (TC), low density lipoprotein (LDL), high density lipoprotein, and triglyceride (TG) levels were monitored for hypolipidemic effects with total body and femur mean bone mineral density (BMD), right femur wet, dry and ash weights, strength, serum osteocalcin, bone-specific alkaline phosphatase (bALP) contents, and histological and histomorphometrical analyses for anti-osteoporosis activity. As a result of OVX, notable increases in body weight and gains, food consumption, abdominal fat mass densities, weights of abdominal fat pads deposited in the abdominal cavity, and serum AST, ALT, TC, LDL, TG, and osteocalcin levels were observed, along with decreases in the uterus, liver, and femur weights, mean total body and femur BMD, femur strength, serum bALP, and estradiol levels. In addition, marked hypertrophic alterations in adipocytes located in the deposited abdominal fat pads, liver steatosis, uterine disused atrophic changes, and decreases in bone mass and structures of the femur were also observed in OVX control mice with significant increases in bone resorption markers based on histopathological and histomorphometrical analysis. However, these estrogen-deficient climacterium symptoms were significantly (P<0.05 or P<0.01) inhibited after 84 days of continuous treatment with estradiol and PCS (1, 2 and 4 ml/kg), respectively. The present results suggested that PCS was able to effectively inhibit or refine the climacterium symptoms, including obesity, hyperlipidemia, hepatic steatosis, and osteoporosis, induced by OVX in ddY mice.
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Effects of Recombinant Human Growth Hormone for Osteoporosis: Systematic Review and Meta-Analysis. Can J Aging 2017; 36:41-54. [PMID: 28069090 DOI: 10.1017/s0714980816000696] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Our objective was to evaluate the efficacy of recombinant human growth hormone (GH) on bone mineral density (BMD) in persons age 50 and older, with normal pituitary function, with or at risk for developing osteoporosis. We systematically reviewed randomized clinical trials (RCTs), searching six databases, and conducted meta-analyses to examine GH effects on BMD of the lumbar spine and femoral neck. Data for fracture incidence, bone metabolism biomarkers, and adverse events were also extracted and analysed. Thirteen RCTs met the eligibility criteria. Pooled effect sizes suggested no significant GH effect on BMD. Pooled effect sizes were largest, but nonsignificant, when compared to placebo. GH had a significant effect on several bone metabolism biomarkers. A significantly higher rate of adverse events was observed in the GH groups. Meta-analysis of RCTs suggests that GH treatment for persons with or at risk for developing osteoporosis results in very small, nonsignificant increases in BMD.
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Bungartz M, Maenz S, Kunisch E, Horbert V, Xin L, Gunnella F, Mika J, Borowski J, Bischoff S, Schubert H, Sachse A, Illerhaus B, Günster J, Bossert J, Jandt KD, Kinne RW, Brinkmann O. First-time systematic postoperative clinical assessment of a minimally invasive approach for lumbar ventrolateral vertebroplasty in the large animal model sheep. Spine J 2016; 16:1263-1275. [PMID: 27345746 DOI: 10.1016/j.spinee.2016.06.015] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2016] [Revised: 05/20/2016] [Accepted: 06/21/2016] [Indexed: 02/06/2023]
Abstract
BACKGROUND CONTEXT Large animal models are highly recommended for meaningful preclinical studies, including the optimization of cement augmentation for vertebral body defects by vertebroplasty/kyphoplasty. PURPOSE The aim of this study was to perform a systematic characterization of a strictly minimally invasive in vivo large animal model for lumbar ventrolateral vertebroplasty. STUDY DESIGN/ SETTING This is a prospective experimental animal study. METHODS Lumbar defects (diameter 5 mm; depth approximately 14 mm) were created by a ventrolateral percutaneous approach in aged, osteopenic, female sheep (40 Merino sheep; 6-9 years; 68-110 kg). L1 remained untouched, L2 was left with an empty defect, and L3 carried a defect injected with a brushite-forming calcium phosphate cement (CPC). Trauma/functional impairment, surgical techniques (including drill sleeve and working canula with stop), reproducibility, bone defects, cement filling, and functional cement augmentation were documented by intraoperative incision-to-suture time and X-ray, postoperative trauma/impairment scores, and ex vivo osteodensitometry, microcomputed tomography (CT), histology, static/fluorescence histomorphometry, and biomechanical testing. RESULTS Minimally invasive vertebroplasty resulted in short operation times (28±2 minutes; mean±standard error of the mean) and X-ray exposure (1.59±0.12 minutes), very limited local trauma (score 0.00±0.00 at 24 hours), short postoperative recovery (2.95±0.29 hours), and rapid decrease of the postoperative impairment score to 0 (3.28±0.36 hours). Reproducible defect creation and cement filling were documented by intraoperative X-ray and ex vivo conventional/micro-CT. Vertebral cement augmentation and osteoconductivity of the CPC was verified by osteodensitometry (CPC>control), micro-CT (CPC>control and empty defect), histology/static histomorphometry (CPC>control and empty defect), fluorescence histomorphometry (CPC>control; all p<.05 for 3 and 9 months), and compressive strength measurements (CPC numerically higher than control; 102% for 3 months and 110% for 9 months). CONCLUSIONS This first-time systematic clinical assessment of a minimally invasive, ventrolateral, lumbar vertebroplasty model in aged, osteopenic sheep resulted in short operation times, rapid postoperative recovery, and high experimental reproducibility. This model represents an optimal basis for standardized evaluation of future studies on vertebral augmentation with resorbable and osteoconductive CPC.
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Affiliation(s)
- Matthias Bungartz
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle," Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany; Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany.
| | - Stefan Maenz
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, D-07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, D-07743 Jena, Germany
| | - Elke Kunisch
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Victoria Horbert
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Long Xin
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Francesca Gunnella
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Joerg Mika
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Juliane Borowski
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Sabine Bischoff
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Str. 23, D-07743 Jena, Germany
| | - Harald Schubert
- Institute of Laboratory Animal Sciences and Welfare, Jena University Hospital, Dornburger Str. 23, D-07743 Jena, Germany
| | - Andre Sachse
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle," Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Bernhard Illerhaus
- BAM Bundesanstalt für Materialforschung und - prüfung (BAM), Unter den Eichen 87, D-12205 Berlin, Germany
| | - Jens Günster
- BAM Bundesanstalt für Materialforschung und - prüfung (BAM), Unter den Eichen 87, D-12205 Berlin, Germany
| | - Jörg Bossert
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, D-07743 Jena, Germany
| | - Klaus D Jandt
- Chair of Materials Science, Otto Schott Institute of Materials Research, Friedrich Schiller University Jena, Löbdergraben 32, D-07743 Jena, Germany; Jena School for Microbial Communication (JSMC), Friedrich Schiller University Jena, Neugasse 23, D-07743 Jena, Germany; Jena Center for Soft Matter (JCSM), Friedrich Schiller University Jena, Humboldstr. 10, D-07743 Jena, Germany
| | - Raimund W Kinne
- Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
| | - Olaf Brinkmann
- Chair of Orthopedics, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle," Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany; Experimental Rheumatology Unit, Department of Orthopedics, Jena University Hospital, Waldkrankenhaus "Rudolf Elle", Klosterlausnitzer Str 81, D-07607 Eisenberg, Germany
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Selection of the Optimal Herbal Compositions of Red Clover and Pomegranate According to Their Protective Effect against Climacteric Symptoms in Ovariectomized Mice. Nutrients 2016; 8:nu8080447. [PMID: 27455321 PMCID: PMC4997362 DOI: 10.3390/nu8080447] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 02/07/2023] Open
Abstract
This study aimed to ascertain the optimal range of red clover dry extracts (RC) and dried pomegranate concentrate powder (PCP) to induce anti-climacteric effects. Thus, the dose ranges showing protective effect of mixed formulae consisting of RC and PCP were examined in ovariectomized mice. At 28 days after bilateral ovariectomy (OVX), mixed herbal compositions (RC:PCP = 1:1, 1:2, 1:4, 1:8, 2:1, 4:1, and 8:1) were administered orally, at 120 mg/kg once daily for 84 days. We evaluated that RC and PCP mixture attenuate OVX-caused obesity, hyperlipidemia, hepatic steatosis, and osteoporosis. Compared to OVX-induced control mice, body weight and abdominal fat weight in OVX-induced mice were significantly decreased, concomitantly with increase of uterus weight by RC:PCP mixture. Additionally, significant increases in serum estradiol levels were observed in all RC:PCP-treated mice. RC:PCP mixture also showed protective effect against OVX-induced hyperlipidemia, hepatic steatosis. Total body and femur mean bone mineral density (BMD), osteocalcin, bALP contents were effectively increased by RC:PCP mixture. Taken together, RC:PCP mixture (2:1, 1:1, and 4:1) has remarkable protective effects against the changes induced by OVX. In particular, RC:PCP mixture (2:1) shows the strongest effect and may be considered as a potential protective agent against climacteric symptoms.
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Jung MY, Kim JW, Kim KY, Choi SH, Ku SK. Polycan, a β-glucan from Aureobasidium pullulans SM-2001, mitigates ovariectomy-induced osteoporosis in rats. Exp Ther Med 2016; 12:1251-1262. [PMID: 27588046 PMCID: PMC4998138 DOI: 10.3892/etm.2016.3485] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Accepted: 11/05/2015] [Indexed: 01/16/2023] Open
Abstract
The present study aimed to investigate the protective effects of Polycan, a β-glucan from Aureobasidium pullulans SM-2001, in a rat model of ovariectomy-induced osteoporosis. Ovariectomized (OVX) rats were orally administered 31.25, 62.5 or 125 mg/kg/day Polycan for 126 days, and alterations in body weight, bone mineral content, bone mineral density, failure load, histological profiles and histomorphometric indices were analyzed. In particular, serum levels of osteocalcin, bone-specific alkaline phosphatase (bALP), calcium and phosphorus, and the urine deoxypyridinoline/creatinine ratio, were measured. Furthermore, the femur, tibia and lumbar vertebrae were harvested from all rats, and histomorphometrical analyses were conducted in order to assess the mass and structure of the bones, and the rates of bone resorption and formation. One group of rats was treated with alendronate, which served as the reference drug. The results of the present study suggested that Polycan treatment was able to inhibit ovariectomy-induced alterations in bone resorption and turnover in a dose-dependent manner. In addition, the serum expression levels of bALP and all histomorphometrical indices for bone formation were markedly increased in the Polycan-treated groups. These results indicated that Polycan was able to preserve bone mass and strength, and increase the rate of bone formation in OVX rats; thus suggesting that Polycan may be considered a potential effective anti-osteoporosis agent.
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Affiliation(s)
- Mi Young Jung
- Department of Anatomy and Histology, College of Oriental Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do 712-715, Republic of Korea
| | - Joo Wan Kim
- Glucan Corp. Research Institute, Marine Bio-Industry Development Center, Busan 619-912, Republic of Korea
| | - Ki Young Kim
- Glucan Corp. Research Institute, Marine Bio-Industry Development Center, Busan 619-912, Republic of Korea
| | - Seong Hun Choi
- Department of Anatomy and Histology, College of Oriental Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do 712-715, Republic of Korea
| | - Sae Kwang Ku
- Department of Anatomy and Histology, College of Oriental Medicine, Daegu Haany University, Gyeongsan-si, Gyeongsangbuk-do 712-715, Republic of Korea
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Zong Y, Tang Y, Xue Y, Ding H, Li Z, He D, Zhao Y, Wang P. Depression is associated with increased incidence of osteoporotic thoracolumbar fracture in postmenopausal women: a prospective study. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2015; 25:3418-3423. [PMID: 26002355 DOI: 10.1007/s00586-015-4033-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/24/2014] [Revised: 05/13/2015] [Accepted: 05/14/2015] [Indexed: 01/08/2023]
Abstract
PROPOSE To determine whether depression in postmenopausal women with osteoporosis is associated with an increased risk of thoracolumbar fragility fracture. METHODS Postmenopausal women with osteoporosis and without prior vertebral fracture history who were seen at our institution from January 2006 to January 2010 (n = 1397) were divided into depression group (n = 494) and depression-free group (n = 903). After at least 4 years the incidence of thoracolumbar osteoporotic vertebral fracture was compared between the groups. For those who developed vertebral fracture, quality of life over the subsequent 2 months and fracture pain in the subsequent 2 weeks were compared. Depression was assessed with the 21-item Beck Depression Inventory, pain intensity with the visual analogue scale and quality of life with the Medical Outcomes Study 36-item Short-Form Survey. RESULTS The incidence of thoracolumbar fractures among women with continuous depression was higher than the group without depression (35.43 vs. 25.14 %, respectively; (P < 0.05). Osteoporotic thoracolumbar fractures were associated with significantly lower quality of life scores in women with depression than in those without depression (P < 0.05). Fracture pain was experienced by a higher percentage of patients with continuous depression than by those without depression (44.00 vs. 27.31 %; P < 0.05). CONCLUSION Depression is associated with a higher risk of thoracolumbar fracture, with more fracture pain and with lower quality of life in the 2 months following fracture.
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Affiliation(s)
- Yaqi Zong
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China
| | - Yanming Tang
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China
| | - Yuan Xue
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China.
| | - Huairong Ding
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China
| | - Zhiyang Li
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China
| | - Dong He
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China
| | - Ying Zhao
- Tianjin Medical University, Qixiangtai Road No.22, Heping District, Tianjin, 300070, China
| | - Pei Wang
- Department of Orthopaedics Surgery, Tianjin Medical University General Hospital, Anshan Road No.154, Heping District, Tianjin, 300052, China
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Dried pomegranate potentiates anti-osteoporotic and anti-obesity activities of red clover dry extracts in ovariectomized rats. Nutrients 2015; 7:2622-47. [PMID: 25912038 PMCID: PMC4425164 DOI: 10.3390/nu7042622] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/10/2015] [Accepted: 04/02/2015] [Indexed: 12/19/2022] Open
Abstract
Red clover (RC) shows potential activity against menopausal symptoms and pomegranates have antioxidative and beneficial effects on postmenopausal symptoms; thus, we investigated whether the anti-climacteric activity of RC could be enhanced by the addition of dried pomegranate concentrate powder (PCP) extracts in ovariectomized (OVX) rats. Regarding the anti-osteoporotic effects, bone mineral density increased significantly in OVX induced rats treated with 60 and 120 mg/kg of an RC:PCP 2:1 mixture, respectively, compared with OVX control rats. Additionally, femoral, tibia, and L4 bone resorption was decreased in OVX induced control rats treated with the RC:PCP 2:1 mixture (60 and 120 mg/kg), respectively, compared with OVX control rats. Regarding anti-obesity effects, the OVX induced rats treated with 60 and 120 mg/kg of the RC:PCP 2:1 mixture showed a decrease in total fat pad thickness, the mean diameters of adipocytes and the body weights gain compared with OVX induced control rats. The estradiol and bone-specific alkaline phosphatase levels were significantly increased in OVX induced rats treated with the RC:PCP 2:1 mixture (120 mg/kg) compared with OVX induced control rats, also, the uterine atrophy was significantly inhibited in 60 and 120 mg/kg of the RC:PCP 2:1 mixture treatment compared with OVX control rats. In conclusion, our results indicate that PCP enhanced the anti-climacteric effects of RC in OVX rats. The RC:PCP 2:1 mixture used in this study may be a promising new potent and protective agent for relieving climacteric symptoms.
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Choi JS, Kim JW, Kim KY, Cho HR, Choi IS, Ku SK. Antiosteoporotic effects of Polycan in combination with calcium lactate-gluconate in ovariectomized rats. Exp Ther Med 2014; 8:957-967. [PMID: 25120630 PMCID: PMC4113539 DOI: 10.3892/etm.2014.1793] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Accepted: 02/26/2014] [Indexed: 12/19/2022] Open
Abstract
The aim of the present study was to investigate the optimum composition of Polycan (β-glucan complex) and calcium lactate-gluconate (CaLG) that exhibited the most beneficial effects in ovariectomy (OVX)-induced osteoporotic rats. Polycan and CaLG single formulas (100 mg/kg each), and three doses (50, 100 and 200 mg/kg) of three mixed formulas [polycan:CaLG (PCLG)=1:99, 5:95 and 10:90] were orally administered once a day for 84 days. The effects of the test materials were compared with those of a risedronate sodium-treated group. OVX resulted in an increase in body weight, decreased bone formation, elevated serum osteocalcin levels and urine deoxypyridinoline/creatinine ratio, as well as decreased serum bone-specific alkaline phosphatase levels, femur indices, bone mineral content, bone mineral density and failure load. However, these OVX-induced osteoporotic changes markedly decreased following the administration of the test materials. Continuous oral treatment of Polycan or CaLG single formulas and the PCLG mixed formulas preserved bone mass and strength. The PCLG 10:90 mixed formula exhibited the most favorable synergistic antiosteoporotic effects in the OVX-induced osteoporotic rats as compared with equal doses of the Polycan or CaLG single formulas.
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Affiliation(s)
- Jae-Suk Choi
- RIS Center, Industry-Academic Cooperation Foundation, Silla University, Busan 702-701, Republic of Korea
| | - Joo Wan Kim
- Glucan Corporation Research Institute, Marine Bio-Industry Development Center, Busan 619-912, Republic of Korea
| | - Ki Young Kim
- Glucan Corporation Research Institute, Marine Bio-Industry Development Center, Busan 619-912, Republic of Korea
| | - Hyung-Rae Cho
- Glucan Corporation Research Institute, Marine Bio-Industry Development Center, Busan 619-912, Republic of Korea
| | - In Soon Choi
- RIS Center, Industry-Academic Cooperation Foundation, Silla University, Busan 702-701, Republic of Korea ; Department of Biological Science, Silla University, Busan 702-701, Republic of Korea
| | - Sae Kwang Ku
- Department of Anatomy and Histology, College of Oriental Medicine, Daegu Haany University, Gyeongsan 712-715, Republic of Korea
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Using an Assessment Tool to Identify Risk of Osteopenia in Infants and Prevent Fractures. Jt Comm J Qual Patient Saf 2013; 39:228-32. [DOI: 10.1016/s1553-7250(13)39030-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Intensive electrical stimulation attenuates femoral bone loss in acute spinal cord injury. PM R 2011; 2:1080-7. [PMID: 21145519 DOI: 10.1016/j.pmrj.2010.08.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2010] [Revised: 07/31/2010] [Accepted: 08/08/2010] [Indexed: 01/30/2023]
Abstract
OBJECTIVE To determine whether intensive electrical stimulation (ES) can reduce femoral bone mineral density (BMD) loss in acute spinal cord injury (SCI). DESIGN Randomized controlled trial. SETTING Inpatient rehabilitation hospital. PARTICIPANTS Twenty-six subjects with C4 to T12 American Spinal Injury Association Impairment Scale A or B SCI less than 12 weeks postinjury. METHODS The control group received usual rehabilitative care and the intervention group received usual care plus 1 hour of ES over the quadriceps 5 days per week for 6 weeks. MAIN OUTCOME MEASUREMENTS Outcome measurements were collected at baseline, postintervention (interim), and 3 months postinjury (follow-up), and included dual energy x-ray absorptiometry, serum osteocalcin (OC), and urinary N-telopeptide (NTx). RESULTS In the control group, there was increasing BMD loss with distance from the spine (lumbar -1.88%, hip -12.25%, distal femur -15.15%, proximal tibia -17.40%). This trend was attenuated over the distal femur in the ES group (lumbar -1.29%, hip -14.45%, distal femur -7.40%, proximal tibia -12.31%). NTx increased over the 3 assessments in controls ([mean ± standard deviation] 115.00 ± 34.10, 154.86 ± 70.41, and 171.33 ± 75.8 nmol/mmol creatinine) compared with the ES group (160.56 ± 140.06, 216.71 ± 128.40, and 154.67 ± 69.12 nmol/mmol creatinine)-all of which were elevated compared with the reference range, and the differences between the 2 groups were not significant. Osteocalcin levels markedly decreased in the control group (12.90 ± 7.30, 24.00 ± 4.29, and 6.40 ± 7.28 μg/L) to subnormal levels, and remained stable and in the normal range in the ES group (13.80 ± 7.64, 11.86 ± 6.77, and 14.80 ± 12.91 μg/L), although differences between the groups were not significant. CONCLUSIONS Lower extremity BMD loss increases with distance from the spine. An intensive lower extremity ES program may attenuate BMD loss locally after acute motor complete SCI, although it is unknown whether these benefits are maintained in the long term.
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Fiber Bragg grating sensor for monitoring bone decalcification. Orthop Traumatol Surg Res 2010; 96:646-51. [PMID: 20801730 DOI: 10.1016/j.otsr.2010.04.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2009] [Revised: 12/24/2009] [Accepted: 04/19/2010] [Indexed: 02/02/2023]
Abstract
INTRODUCTION Estimation of decalcification is a vital tool to discern bone health. Different techniques are used for its quantitative measurement, e.g. DEXA, QCT & QUS. All these techniques, although noninvasive, suffer from limitations such as radiation exposure and inaccurate values. Recently, fiber optic techniques are fast emerging for medical applications owing to their various attractive features like immunity to EMI/RFI, geometric versatility, chemical inertness, etc. MATERIAL AND METHODS The effect of decalcification on strain response of a goat tibia was investigated in vitro using fiber Bragg grating (FBG) sensing technique. The bone was strained by using three-point bending technique and corresponding Bragg wavelength shifts were recorded. Two similar bone samples from the same animal were taken and one was partially decalcified. Strain response of decalcified and untreated bone was taken concurrently to monitor the effects of calcium loss and that of degradation with time. RESULTS AND CONCLUSION The strain generated for same stress increased with greater degree of decalcification and a steep increase occurred after 2g calcium loss, indicating the onset of damage. The strain response, therefore gives a direct indication of the degree of calcium present in the bone. LEVEL OF EVIDENCE Level III.
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Dagistan S, Bilge OM. Comparison of antegonial index, mental index, panoramic mandibular index and mandibular cortical index values in the panoramic radiographs of normal males and male patients with osteoporosis. Dentomaxillofac Radiol 2010; 39:290-4. [PMID: 20587653 DOI: 10.1259/dmfr/46589325] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim of the study was to compare the values of the antegonial index (AI), mental index (MI), panoramic mandibular index (PMI) and mandibular cortical index (MCI) in the panoramic radiographs of normal males and male patients with osteoporosis. METHODS In panoramic radiographs obtained from 40 male individuals (20 normal and 20 with osteoporosis), the mean was calculated for MI, AI, PMI and MCI index values measured in the right and left mandibles. The MI, AI and PMI index values were evaluated using the paired t-test, and MCI values were analysed using the chi(2) test. RESULTS MI (P < 0.001), AI (P < 0.01) and PMI (P < 0.05) values were significantly smaller in the group with osteoporosis; however, MCI (P > 0.05) was not significantly different. CONCLUSION MI, PMI and AI values, as radiomorphometric indices, were found to be smaller among male patients with osteoporosis, compared with normal patients in this study. It is suggested that these indices, used as an ancillary method in the diagnosis of osteoporosis in women, could also be useful for male patients. Further studies, of larger groups are needed on this subject, including of the MCI, which in this study showed no significant difference.
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Affiliation(s)
- S Dagistan
- Department of Oral Diagnosis and Radiology, Faculty of Dentistry, Ataturk University, Erzurum 25240, Turkey.
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Kostovski E, Iversen PO, Hjeltnes N. [Complications of chronic spinal cord injury]. TIDSSKRIFT FOR DEN NORSKE LEGEFORENING 2010; 130:1242-5. [PMID: 20567276 DOI: 10.4045/tidsskr.09.0055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
Abstract
BACKGROUND A spinal cord injury changes body composition and metabolism over time. The main purpose of this article is to provide an overview of what is known about these changes and the consequences of those in the chronic phase, long after the acute injury. MATERIAL AND METHODS The article is based on own research and clinical experience, as well as a non-systematic search in the PubMed database. RESULTS The following has been documented for people with spinal cord injury: reduced bone and muscle mass, altered composition of muscle fibre, marked increase of body fat, decreased sensitivity to insulin and leptin and an increased activity in inflammatory signalling pathways. Changes are also demonstrated in hemostatic mechanisms and immune system. INTERPRETATION Changes in metabolism and hormonal regulation in people with spinal cord injury, may increase the risk of osteoporosis, obesity, cardiovascular disease and type 2 diabetes. Changed body composition and inflammatory activity may contribute to the higher incidence of cardiovascular disease and diabetes/metabolic syndrome, although other important risk factors (such as obesity and high blood pressure) may be absent. It has not been documented that changes in haemostatic mechanisms and the immune system are associated with the increased incidence of thromboembolic complications, severe infections or certain types of cancer.
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Affiliation(s)
- Emil Kostovski
- Forskningsavdelingen, Sunnaas sykehus, 1450 Nesoddtangen, Norway.
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Abstract
Major depressive disorder has been associated with low bone mineral density. The strength of this association, however, varies greatly among studies; the direction of the causative link is still controversial, and the etiology remains unclear. We aimed to confirm this association, assess its magnitude and estimate its clinical relevancy. A total of 535 articles were initially identified and the research synthesis was based on 33 qualified articles. Of these, 25 articles (or 76%) showed an inverse relationship between major depression or minor depression or depressive symptoms and bone mineral density or bone turnover. Meta-analysis could be performed on 20 of the initially selected 33 articles. Standardized weighted differences in mean AP spine, total femur and femoral neck bone mineral density, each from at least 10 studies, were computed in g/cm (2) and transformed into percent differences. At each site, bone mass was lower in subjects with depression as compared to controls: AP spine bone mineral density was 4.73% lower (95% CI -7.28% to -2.19%, p<0.0001; n=16 studies), total femur bone mineral density was 3.53% lower (95% CI -5.66% to -1.41%, p<0.001; n=13 studies), and femoral neck bone mineral density was 7.32% lower (95% CI -10.67% to -3.96%; p<0.0005; n=8 studies). In conclusion, major depressive disorder was associated with lower bone mineral density at the AP spine, femoral neck, and total femur. The deficits in bone mineral density in subjects with depression are of clinical significance and likely to increase fracture risk over the lifetime of these subjects.
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Seo BI, Joo SJ, Park JH, Roh SS, Kim SM, Choi HS, Ku SK. The Anti-osteoporotic Effect of Aqueous Extracts of Gastrodiae Rhizoma In Vitro and In Vivo. ACTA ACUST UNITED AC 2010. [DOI: 10.1248/jhs.56.422] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- Bu Il Seo
- Department of Herbology, College of Oriental Medicine, Daegu Haany University
| | - Seok Joong Joo
- Department of Herbology, College of Oriental Medicine, Daegu Haany University
| | - Ji Ha Park
- Department of Herbology, College of Oriental Medicine, Daegu Haany University
| | - Seong Soo Roh
- Department of Herbology, College of Oriental Medicine, Daegu Haany University
| | - Seong Mo Kim
- Department of Korean Internal Medicine, College of Oriental Medicine, Daegu Haany University
| | - Hong Sik Choi
- Department of Korean Internal Medicine, College of Oriental Medicine, Daegu Haany University
| | - Sae Kwang Ku
- Department of Histology and Anatomy, College of Oriental Medicine, Daegu Haany University
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Cizza G, Primma S, Csako G. Depression as a risk factor for osteoporosis. Trends Endocrinol Metab 2009; 20:367-73. [PMID: 19747841 PMCID: PMC2764354 DOI: 10.1016/j.tem.2009.05.003] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2009] [Revised: 05/01/2009] [Accepted: 05/01/2009] [Indexed: 11/18/2022]
Abstract
Osteoporosis is a major public health threat. Multiple studies have reported an association between depression and low bone mineral density, but a causal link between these two conditions is disputed. Here we review the endocrine and immune alterations secondary to depression that might affect bone mass. We also discuss the possible role of poor lifestyle in the etiology of osteoporosis in subjects with depression and the potential effect of antidepressants on bone loss. We propose that depression induces bone loss and osteoporotic fractures, primarily via specific immune and endocrine mechanisms, while poor lifestyle habits and use of specific antidepressants are potential contributory factors.
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Affiliation(s)
- Giovanni Cizza
- Clinical Endocrine Section, Clinical Endocrinology Branch, NIDDK, NIH, DHHS, USA.
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Cakur B, Dagistan S, Sahin A, Harorli A, Yilmaz A. Reliability of mandibular cortical index and mandibular bone mineral density in the detection of osteoporotic women. Dentomaxillofac Radiol 2009; 38:255-61. [PMID: 19474252 DOI: 10.1259/dmfr/22559806] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Measuring the bone mineral density (BMD) of the femur and lumbar vertebrae has been the traditional method for determining osteoporosis in women. In this study, we tried to determine the relationships between mandibular dual-energy X-ray absorptiometry (m-DXA) values obtained with a new methodology, mandibular cortical index (MCI), total BMD values of the femur and lumbar vertebrae in 80 women with osteoporosis determined by DXA in conformity with T-score thresholds, as defined by the World Health Organization (WHO). METHODS m-DXA and panoramic radiography were performed on 80 women with osteoporosis. m-DXA was calculated by manual analysis of DXA scans. MCI was determined by the appearance of the mandibles on panoramic radiographs. DXA measurements of the skeletal BMD (femur and lumbar vertebras) and MCI values were also calculated. Correlations between these variables were assessed. RESULTS Although there were no correlations between skeletal BMD (total BMD values of the femur and lumbar vertebras) and mandibular measurements (mDXA and MCI), we found that there was a significant correlation between the skeletal BMDs (r = 0.355, P = 0.001). CONCLUSIONS It is concluded that no significant correlations were found between the mandibular and non-mandibular measures in women with osteoporosis.
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Affiliation(s)
- B Cakur
- Department of Oral Diagnosis and Oral Radiology, Atatürk University, Turkey.
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42
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Sioka C, Bougias C, Papadopoulos A, Fotopoulos A. Is osteoporosis in postmenopausal female patients related to previous pregnancies and/or miscarriages? Climacteric 2009; 10:381-5. [PMID: 17852140 DOI: 10.1080/13697130701627040] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To investigate if osteopenia and osteoporosis in postmenopausal female patients are related to previous pregnancies and/or miscarriages. PATIENTS AND METHODS We studied 81 postmenopausal female patients, 40 with osteopenia or osteoporosis and 41 without osteopenia or osteoporosis, carefully matched for age (control group). In the two groups, the presence or not of osteopenia, osteoporosis, or both, were analyzed and compared with the number of childbirths and/or miscarriages. RESULTS Overall, no statistical difference was found among the 40 patients with one, two, three or more than three childbirths and osteopenia or osteoporosis compared with the control group (p=0.5363, p=0.5782, p=0.0763, p=0.1931, respectively). Similarly, no differences were found between the osteopenia/osteoporosis group and the control group in relation to previous one, two, three or more than three miscarriages. When both childbirths and miscarriages were added together (three, four, five, six, more than six), again no statistical difference was found between the osteopenia/osteoporosis group and the control group. CONCLUSIONS In postmenopausal women, the obstetric history of previous childbirths and/or miscarriages, independent of the number, did not seem to be a risk factor for osteopenia or osteoporosis.
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Affiliation(s)
- C Sioka
- Department of Nuclear Medicine, University Hospital of Ioannina, Ioannina, Greece
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Abstract
UNLABELLED Premature infants are at significant risk of reduced bone mineral content (BMC) and subsequent osteopenia. There are currently no standard practices regarding screening, investigation or treatment of this condition. We present a case report and findings of a national survey of 36 level 2 and 3 neonatal units (72% response rate). The findings showed widely disparate practice regarding screening, prevention and treatment. We summarize the tests currently available for osteopenia and suggest guidelines for management of the at risk group. CONCLUSION Our survey confirms inconsistent practices regarding management of infants at risk of osteopenia of prematurity. Investigations and treatments available are summarized together with a guideline for management of this susceptible group of infants.
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Affiliation(s)
- C M Harrison
- Department of Neonatology, Leeds Teaching Hospitals Trust, Leeds, UK.
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Han SY, Lee JR, Kwon YK, Jo MJ, Park SJ, Kim SC, Lee HS, Ku SK. Ostreae Testa prevent ovariectomy-induced bone loss in mice by osteoblast activations. JOURNAL OF ETHNOPHARMACOLOGY 2007; 114:400-5. [PMID: 17905549 DOI: 10.1016/j.jep.2007.08.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/02/2007] [Revised: 08/04/2007] [Accepted: 08/14/2007] [Indexed: 05/17/2023]
Abstract
AIM OF THE STUDY The anti-osteoporotic effect of heated powder of Ostreae Testa (hPOT), a powder of oyster shell-Ostrea gigas Thumb (Ostrediae) was observed in vitro and in vivo. MATERIALS AND METHODS The effects on proliferation and alkaline phosphatase activity of primary osteoblasts, bone nodule formation, pit formation of osteoclasts and osteoclastogenesis were observed in vitro, and to observe the in vivo efficacy hPOT was orally administered once a day for 28 days to bilateral ovariectomy-induced osteoporosis mice at 125, 250 and 500mg/kg (of body weight). RESULTS Although hPOT did not influence the pit formation and the number of multinucleated osteoclast-like cells, osteoclastogenesis, it enhanced the proliferation of primary osteoblasts, differentiation (ALP activity) and bone nodule formation of osteoblast in vitro. The estrogen-deficient osteoporotic changes were dramatically prevented by hPOT treatment except for osteoclasts/bone perimeter. CONCLUSIONS In conclusion, hPOT prevents OVX-induced osteoporosis through osteoblasts activation effects.
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Affiliation(s)
- Sang Yeob Han
- College of Oriental Medicine, Daegu Haany University, Gyeongsan 712-715, Republic of Korea
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Shin HD, Yang KJ, Park BR, Son CW, Jang HJ, Ku SK. Antiosteoporotic effect of Polycan, β-glucan from Aureobasidium, in ovariectomized osteoporotic mice. Nutrition 2007; 23:853-60. [PMID: 17884343 DOI: 10.1016/j.nut.2007.08.011] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Revised: 05/07/2007] [Accepted: 08/19/2007] [Indexed: 11/25/2022]
Abstract
OBJECTIVE We investigated the anti-osteoporotic effects of Polycan, a beta-glucan from Aureobasidium pullulans, in ovariectomized mice at doses of 31.25, 62.5, and 125 mg/kg. METHODS Polycan was administered orally once a day for 28 d to bilateral ovariectomized mice, beginning 4 wk after surgery. Changes in body weight, bone weight, bone mineral content, bone mineral density, failure load, histologic profiles, and histomorphometric analyses were determined, in addition to serum osteocalcin, calcium, and phosphorus levels. Alendronate was used as a reference drug. RESULTS Polycan significantly and dose-dependently suppressed decreases in bone weight, bone mineral content, failure load, bone mineral density, and serum calcium and phosphorus levels and the increase in serum osteocalcin levels. In addition, Polycan significantly suppressed decreases in histomorphometric parameters such as volume, length, and thickness of trabecular bone and thickness of cortical bone and the increase in osteoclast cells in the femur and tibia. CONCLUSION Although the effects of Polycan were generally modest and smaller than those of alendronate, the effects on cortical bone thickness were more favorable for Polycan than for alendronate. In addition, Polycan exhibited favorable effects on ovariectomy-induced osteoporosis. However, more long-term studies are needed to confirm the effects of Polycan on osteoporosis.
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Affiliation(s)
- Hyun Dong Shin
- Glucan Corp. Research Institute, Marine Biotechnology Center, Gwaebop-dong, Sasanggu, Busan, Republic of Korea
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Evaluation of the patient positioning during DXA measurements in daily clinical practice. Clin Rheumatol 2007; 27:713-5. [DOI: 10.1007/s10067-007-0773-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2007] [Revised: 09/24/2007] [Accepted: 10/02/2007] [Indexed: 10/22/2022]
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Pappou IP, Girardi FP, Sandhu HS, Parvataneni HK, Cammisa FP, Schneider R, Frelinghuysen P, Lane JM. Discordantly high spinal bone mineral density values in patients with adult lumbar scoliosis. Spine (Phila Pa 1976) 2006; 31:1614-20. [PMID: 16778698 DOI: 10.1097/01.brs.0000222030.32171.5f] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective study. OBJECTIVE The purposes of this study were: 1) to investigate the validity of bone mineral density measurements with DEXA in patients with adult lumbar scoliosis and 2) to investigate the association between osteoporosis and adult lumbar scoliosis. SUMMARY OF BACKGROUND DATA Osteoporosis and lumbar degenerative scoliosis are phenomena encountered with increased frequency in aging, often concurrently. It has been suggested that scoliosis predisposes to osteoporosis, but degenerative scoliosis could falsely elevate spinal bone mineral density measurements. METHODS The feasibility of measuring Cobb's angle in DEXA scans was established in 48 surgical candidates with standing anteroposterior lumbar radiographs and supine DEXA scans. Charts and radiographs of 454 consecutive adult patients evaluated at an osteoporosis center were reviewed thereafter. The association between age, lumbar curve, and various bone density measurements was investigated. Bone density measurements between nonscoliotic and scoliotic patients with and without a history of adolescent scoliosis were compared. RESULTS Cobb's angle on DEXA scan was measured with an error of 4 degrees and correlated highly with the plain lumbar radiographs. The prevalence of scoliosis was 9.47% in this cohort of patients. Advancing age was associated with an increase in osteoporosis in both scoliotic and nonscoliotic patients. Scoliotic patients demonstrated increased spinal bone mineral density (BMD) measurements compared with nonscoliotic patients, resulting in discrepancies between hip and spine BMD values. This discrepancy correlated with aging and curve magnitude (up to 30% for curves of 43 degrees ). Scoliotic patients demonstrated significantly lower hip BMD values than nonscoliotic. Curve magnitude did not correlate with severity of osteoporosis. CONCLUSIONS Cobb's angle measurements on DEXA scans are reliable and comparable to conventional radiographs. Spinal BMD values are less valuable for monitoring osteoporosis than hip values in scoliotic patients; an increasing discrepancy with age was noted. Scoliotic patients exhibited discordantly high spinal BMD values, despite significant hip osteoporosis. The discrepancy correlated with aging and curve magnitude. Scoliosis was common among the osteoporotic population (9.47%). Lumbar scoliosis is a useful clinical marker for osteoporosis, irrespective of scoliosis history and magnitude. Viable alternatives for osteoporosis evaluation of adult patients with lumbar scoliosis are hip DEXA values, in conjunction with other BMD measurements.
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Mylonakis A, Hadjidakis D, Katsavochristos P, Androulakis II, Sfakianakis M, Raptis SA. Discrepancies between vertebral bone density values: The least dense vertebra. Maturitas 2006; 53:476-82. [PMID: 16203114 DOI: 10.1016/j.maturitas.2005.08.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2005] [Revised: 08/01/2005] [Accepted: 08/09/2005] [Indexed: 11/22/2022]
Abstract
Vertebral bone mineral density (BMD) measurements by DXA are considered reliable indicators of local fracture risk in the absence of radiographic deformities. The clinical evaluation of one individual vertebra presenting a BMD value significantly less than the others is attempted in this study. For a period of 30 months, BMD measurements of L1-L4 vertebrae and femoral neck (FN) were performed by DXA in 817 postmenopausal women, aged under 65 years, with a BMI less than 33 kg/m(2). In 204 (25%) of these women (group A), the least dense vertebra (LDV) presented a BMD value lower than 92.4% from the immediate denser vertebra. The remaining 613 women comprised group B. Women with X-ray proven vertebral degenerative lesions or deformities were excluded from the study. Among the four measured vertebrae, L1 was the most frequent LDV (47%), whilst L3 was the most rare (2%). Absolute and age-adjusted BMD values of L1-L4 and FN, as well as the proportions of osteopenic or osteoporotic women, did not differ significantly between the two groups. A significant positive correlation was observed between either L1-L4 or LDV and FN BMD values in both groups, but stepwise multiple regression analysis revealed that in group A the LDV did not participate in the model explaining the variability of the FN BMD values. In group B, the least dense vertebra was the only variable participating in the respective model (adjusted-R(2) = 37.7%). It is concluded that in a significant proportion of relatively young postmenopausal women, a wide variance of BMD values exists between individual vertebral BMD values without radiographic background. L1 was the most frequent LDV and L3 the most rare. In such cases, the evaluation of the least dense vertebra seems to offer an alternative estimation of vertebral bone mass, instead of mean L1-L4.
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Affiliation(s)
- A Mylonakis
- 2nd Department of Internal Medicine-Propaedeutic, Research Institute and Diabetes Center, Athens University, Attikon and Evgenidion University Hospitals, Athens, Greece.
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Seo BI, Ku SK, Cha EM, Park JH, Kim JD, Choi HY, Lee HS. Effect of Mornidae Radix extracts on experimental osteoporosis in sciatic neurectomized mice. Phytother Res 2005; 19:231-8. [PMID: 15934024 DOI: 10.1002/ptr.1683] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The preventive and therapeutic effects of aqueous extracts of Mornidae Radix (MR) were observed in sciatic neurectomized mice, a disused osteoporotic model. The right hind limbs of 80 mice were neurectomized and 20 mice were sham-operated and served as a sham control. Then 50, 100 and 200 mg/kg of MR extracts were dosed 3 days after neurectomy for 6 weeks in the prevention study and were dosed 2 weeks after neurectomy for 12 weeks for the therapeutic study. After dosing with the MR extracts, the thickness of the hind limbs, tibia failure load, tibia bone mineral density (BMD), serum osteocalcin levels, tibia calcium (Ca) and phosphorus (P) contents were monitored with histomorphometrical changes of the tibia. In both the prevention and therapeutic studies, the MR extracts significantly and dose-dependently suppressed the decrease in hind limb thickness, tibia failure load, BMD, tibia Ca and P contents with an increase in serum osteoclacin levels. In addition, the MR extracts also significantly and dose-dependently suppressed the decrease in histomorphometrical parameters of the tibia such as volume, length and thickness of trabecular bone and thickness of cortical bone with an increase in osteoclast cells in both the prevention and therapeutic studies. Based on these results, the MR extracts may act as both a suppressor of bone resorption and an enhancer of bone formation in vivo and may have some favorable effects for preventing and treating the osteoporosis induced by sciatic neurectomy.
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Affiliation(s)
- Bu Il Seo
- College of Oriental Medicine, Daegu Haany University, Gyeongsan, 712-715, Republic of Korea
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