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Hilkens L, Bons J, Nyakayiru J, van Loon LJC, van Dijk JW. A single bout of jumping exercise does not modulate serum markers of bone formation or bone resorption throughout a 24 h period. Bone 2024; 188:117216. [PMID: 39074570 DOI: 10.1016/j.bone.2024.117216] [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: 05/23/2024] [Revised: 07/11/2024] [Accepted: 07/26/2024] [Indexed: 07/31/2024]
Abstract
INTRODUCTION This randomized, cross-over trial assessed the effect of a single bout of high-impact exercise on serum markers of bone formation and bone resorption over a 24 h period. METHODS Twenty healthy males and females performed a single bout of brief jumping exercise (EXC) or no exercise (CON), 55 min following consumption of a standard breakfast. Blood markers of bone formation (P1NP) and bone resorption (CTX-I) were assessed before (t = 0 h) and over a 5 h period after breakfast, and following 24 h of post-exercise recovery (t = 24 h). RESULTS Serum CTX-I concentrations decreased during the 5 h postprandial period (time-effect, P < 0.001) with no differences between conditions (time x condition, P = 0.14). After a ~ 16 % decline during the first 30 min following breakfast, serum P1NP concentrations gradually returned to baseline values during the 5 h postprandial period, with no differences in the overall response between conditions (time-effect, P < 0.001; time x condition, P = 0.25). Fasted serum CTX-I concentrations decreased from 0.33 ± 0.15 and 0.35 ± 0.15 ng/mL at baseline, to 0.31 ± 0.13 and 0.31 ± 0.16 ng/mL at t = 24 h in CON and EXC, respectively, with no differences between conditions (time-effect, P < 0.01; time x condition, P = 0.70). Fasted serum P1NP concentrations did not change from baseline to t = 24 h in both CON (baseline: 76 ± 27 ng/mL, t = 24 h: 79 ± 26 ng/mL) and EXC (baseline: 80 ± 24 ng/mL, t = 24 h: 77 ± 29 ng/mL; time-effect, P = 0.89), with no differences between conditions (time x condition, P = 0.22). CONCLUSION High-impact exercise does not modulate the concentrations of the serum marker of bone formation P1NP and the serum marker of bone resorption CTX-I throughout a 24 h recovery period in healthy adults.
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Affiliation(s)
- Luuk Hilkens
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Judith Bons
- Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | | | - Luc J C van Loon
- Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Jan-Willem van Dijk
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands.
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Stables R, Anderson L, Sale C, Hannon MP, Dunn R, Tang JCY, Fraser WD, Costello NB, Close GL, Morton JP. Training with reduced carbohydrate availability affects markers of bone resorption and formation in male academy soccer players from the English Premier League. Eur J Appl Physiol 2024:10.1007/s00421-024-05574-4. [PMID: 39154306 DOI: 10.1007/s00421-024-05574-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Accepted: 08/05/2024] [Indexed: 08/19/2024]
Abstract
PURPOSE To test the hypothesis that training with reduced carbohydrate (CHO) availability increases bone resorption in adolescent soccer players. METHODS In a randomised crossover design, ten male players (age: 17.4 ± 0.8 years) from an English Premier League academy completed an acute 90-min field-based training session (occurring between 10:30-12:00) in conditions of high (TRAIN HIGH; 1.5 g.kg-1, 60 g, 1.5 g.kg-1 and 1.5 g.kg-1 consumed at 08:00, during training, 12:30 and 13:30, respectively) or low CHO availability (TRAIN LOW; 0 g.kg-1). Participants also completed a non-exercise trial (REST) under identical dietary conditions to TRAIN LOW. Venous blood samples were obtained at 08:30, 10:30, 12:30 and 14:30 for assessment of bone resorption (βCTX), bone formation (PINP) and calcium metabolism (PTH and ACa). RESULTS External training load did not differ (all P > 0.05) between TRAIN HIGH and TRAIN LOW, as evident for total distance (5.6 ± 0.8; 5.5 ± 0.1 km), average speed (81 ± 9; 85 ± 12 m.min-1) and high-speed running (350 ± 239; 270 ± 89 m). Area under the curve for both βCTX and PINP was significantly greater (P < 0.01 and P = 0.03) in TRAIN LOW versus TRAIN HIGH, whilst no differences in PTH or ACa (P = 0.11 and P = 0.89) were observed between all three trials. CONCLUSION CHO restriction before, during and after an acute soccer training session increased bone (re)modelling markers in academy players. Despite acute anabolic effects of bone formation, the long-term consequence of bone resorption may impair skeletal development and increase injury risk during growth and maturation.
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Affiliation(s)
- Reuben Stables
- Research Institute for Sport and Exercise Sciences (RISES), Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | - Liam Anderson
- School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK
| | - Craig Sale
- Department of Sport and Exercise Sciences, Manchester Metropolitan University Institute of Sport, 99 Oxford Road, Manchester, UK
| | - Marcus P Hannon
- Research Institute for Sport and Exercise Sciences (RISES), Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | - Rachel Dunn
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK
- Departments of Clinical Biochemistry, Diabetes and Endocrinology, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
| | - Jonathan C Y Tang
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK
- Departments of Clinical Biochemistry, Diabetes and Endocrinology, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
| | - William D Fraser
- Bioanalytical Facility, Norwich Medical School, University of East Anglia, Norwich, UK
- Departments of Clinical Biochemistry, Diabetes and Endocrinology, Norfolk and Norwich University Hospital NHS Foundation Trust, Colney Lane, Norwich, UK
| | - Nessan B Costello
- Carnegie Faculty, Institute for Sport, Physical Activity and Leisure, Leeds Beckett University, Leeds, UK
| | - Graeme L Close
- Research Institute for Sport and Exercise Sciences (RISES), Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK
| | - James P Morton
- Research Institute for Sport and Exercise Sciences (RISES), Liverpool John Moores University, Byrom Street, Liverpool, L3 3AF, UK.
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Bouvard B, Mabilleau G. Gut hormones and bone homeostasis: potential therapeutic implications. Nat Rev Endocrinol 2024:10.1038/s41574-024-01000-z. [PMID: 38858581 DOI: 10.1038/s41574-024-01000-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/14/2024] [Indexed: 06/12/2024]
Abstract
Bone resorption follows a circadian rhythm, with a marked reduction in circulating markers of resorption (such as carboxy-terminal telopeptide region of collagen type I in serum) in the postprandial period. Several gut hormones, including glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP1) and GLP2, have been linked to this effect in humans and rodent models. These hormones are secreted from enteroendocrine cells in the gastrointestinal tract in response to a variety of stimuli and effect a wide range of physiological processes within and outside the gut. Single GLP1, dual GLP1-GIP or GLP1-glucagon and triple GLP1-GIP-glucagon receptor agonists have been developed for the treatment of type 2 diabetes mellitus and obesity. In addition, single GIP, GLP1 and GLP2 analogues have been investigated in preclinical studies as novel therapeutics to improve bone strength in bone fragility disorders. Dual GIP-GLP2 analogues have been developed that show therapeutic promise for bone fragility in preclinical studies and seem to exert considerable activity at the bone material level. This Review summarizes the evidence of the action of gut hormones on bone homeostasis and physiology.
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Affiliation(s)
- Béatrice Bouvard
- Univ Angers, Nantes Université, ONIRIS, Inserm, RMeS UMR 1229, Angers, France
- CHU Angers, Service de Rhumatologie, Angers, France
| | - Guillaume Mabilleau
- Univ Angers, Nantes Université, ONIRIS, Inserm, RMeS UMR 1229, Angers, France.
- CHU Angers, Departement de Pathologie Cellulaire et Tissulaire, Angers, France.
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Shimoda M, Sato Y, Abe K, Masunaga N, Tsukabe M, Yoshinami T, Sota Y, Miyake T, Tanei T, Shimazu K. Prognostic value of serum tartrate‑resistant acid phosphatase‑5b for bone metastasis in patients with resectable breast cancer. Oncol Lett 2024; 27:250. [PMID: 38638841 PMCID: PMC11024733 DOI: 10.3892/ol.2024.14383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Accepted: 03/12/2024] [Indexed: 04/20/2024] Open
Abstract
Bone metastasis significantly affects the quality of life of patients with metastatic breast cancer, and can shorten overall survival. Identifying patients with early-stage breast cancer at high risk for bone metastasis and preventing bone metastasis may lead to a better quality of life and prolonged survival. The present study investigated whether serum tartrate-resistant acid phosphatase-5b (TRACP-5b), a bone turnover marker, can be a prognostic factor for bone metastasis. Female patients who underwent resectable breast surgery between May 2002 and August 2006 were consecutively investigated. A total of 304 patients with a median follow-up of 3,722 days were retrospectively analyzed. TRACP-5b levels in sera prepared from patients' blood drawn preoperatively without any presurgical treatments were measured using an enzyme-linked immunosorbent assay. The cutoff of TRACP-5b levels, in order to separate patients into high and low TRACP-5b groups, was set at median (347 mU/dl). The associations of clinicopathological factors, including TRACP-5b, with bone metastasis-free interval (BMFI), which was defined as the duration between surgery and the diagnosis of bone metastasis at any time point, were examined. Multivariate analysis of various clinicopathological features revealed that lymph node metastasis and histological grade were independent factors associated with BMFI (P=0.017 and 0.030, respectively). In patients with node-positive breast cancer (n=114), a high TRACP-5b level and a high grade were significantly and independently associated with worse BMFI (log-rank P=0.041 and 0.011, respectively). In conclusion, these findings indicated that TRACP-5b may predict bone metastasis in patients with node-positive breast cancer.
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Affiliation(s)
- Masafumi Shimoda
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Yasufumi Sato
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Kaori Abe
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Nanae Masunaga
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Masami Tsukabe
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Tetsuhiro Yoshinami
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Yoshiaki Sota
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Tomohiro Miyake
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Tomonori Tanei
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
| | - Kenzo Shimazu
- Department of Breast and Endocrine Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565-0871, Japan
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Shieh A, Karlamangla AS, Gossiel F, Eastell R, Greendale GA. Changes in Collagen Type I C-Telopeptide and Procollagen Type I N-Terminal Propeptide During the Menopause Transition. J Clin Endocrinol Metab 2024; 109:1580-1589. [PMID: 38087944 PMCID: PMC11099485 DOI: 10.1210/clinem/dgad727] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 11/26/2023] [Accepted: 12/08/2023] [Indexed: 02/12/2024]
Abstract
CONTEXT Collagen type I C-telopeptide (CTX) and procollagen type I N-terminal propeptide (PINP) are reference bone resorption and formation markers, respectively. OBJECTIVE To characterize CTX and PINP trajectories across the menopause transition (MT). METHODS This 18-year longitudinal analysis of a community-based cohort from the Study of Women's Health Across the Nation included 541 women (126 Black, 90 Chinese, 87 Japanese, 238 White) who transitioned from pre- to postmenopause. Multivariable mixed effects regression fit piecewise linear models of CTX or PINP relative to years from final menstrual period (FMP); covariates were race/ethnicity, body mass index (BMI), and age at FMP. In the referent participant (White, 52.46 years at FMP, BMI 27.12 kg/m2), CTX and PINP were stable until 3 years pre-FMP (premenopause). During the MT (3 years before to 3 years after the FMP), CTX and PINP increased 10.3% (P < .0001) and 7.5% (P < .0001) per year, respectively; MT-related gains totaled 61.9% for CTX and 45.2% for PINP. Starting 3 years post-FMP (postmenopause), CTX and PINP decreased 3.1% (P < .0001) and 2.9% (P < .0001) per year, respectively. Compared with the White participants, during the MT, Chinese participants had larger gains in CTX (P = .01), and Japanese women experienced greater increases in CTX (P < .0001) and PINP (P = .02). In postmenopause, CTX (P = .01) and PINP (P = .01) rose more in Japanese relative to White women. CONCLUSION CTX and PINP are stable in premenopause, increase during the MT, and decrease in postmenopause. During the MT and postmenopause, bone turnover change rates vary by race/ethnicity.
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Affiliation(s)
- Albert Shieh
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | - Arun S Karlamangla
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
| | - Fatma Gossiel
- Department of Oncology and Metabolism, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield S5 7AU, UK
| | - Richard Eastell
- Department of Oncology and Metabolism, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield S5 7AU, UK
| | - Gail A Greendale
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, CA 90095, USA
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Arakil N, Akhund SA, Elaasser B, Mohammad KS. Intersecting Paths: Unraveling the Complex Journey of Cancer to Bone Metastasis. Biomedicines 2024; 12:1075. [PMID: 38791037 PMCID: PMC11117796 DOI: 10.3390/biomedicines12051075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/27/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
The phenomenon of bone metastases presents a significant challenge within the context of advanced cancer treatments, particularly pertaining to breast, prostate, and lung cancers. These metastatic occurrences stem from the dissemination of cancerous cells into the bone, thereby interrupting the equilibrium between osteoblasts and osteoclasts. Such disruption results in skeletal complications, adversely affecting patient morbidity and quality of life. This review discusses the intricate interplay between cancer cells and the bone microenvironment, positing the bone not merely as a passive recipient of metastatic cells but as an active contributor to cancer progression through its distinctive biochemical and cellular makeup. A thorough examination of bone structure and the dynamics of bone remodeling is undertaken, elucidating how metastatic cancer cells exploit these processes. This review explores the genetic and molecular pathways that underpin the onset and development of bone metastases. Particular emphasis is placed on the roles of cytokines and growth factors in facilitating osteoclastogenesis and influencing osteoblast activity. Additionally, this paper offers a meticulous critique of current diagnostic methodologies, ranging from conventional radiography to advanced molecular imaging techniques, and discusses the implications of a nuanced understanding of bone metastasis biology for therapeutic intervention. This includes the development of targeted therapies and strategies for managing bone pain and other skeletal-related events. Moreover, this review underscores the imperative of ongoing research efforts aimed at identifying novel therapeutic targets and refining management approaches for bone metastases. It advocates for a multidisciplinary strategy that integrates advancements in medical oncology and radiology with insights derived from molecular biology and genetics, to enhance prognostic outcomes and the quality of life for patients afflicted by this debilitating condition. In summary, bone metastases constitute a complex issue that demands a comprehensive and informed approach to treatment. This article contributes to the ongoing discourse by consolidating existing knowledge and identifying avenues for future investigation, with the overarching objective of ameliorating patient care in the domain of oncology.
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Affiliation(s)
| | | | | | - Khalid S. Mohammad
- Department of Anatomy, College of Medicine, Alfaisal University, Riyadh 1153, Saudi Arabia; (N.A.); (S.A.A.); (B.E.)
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Makino A, Hasegawa T, Yamamoto T, Takagi H, Takahashi Y, Miyakoshi N, Amizuka N. Abaloparatide promotes bone repair of vertebral defects in ovariectomized rats by increasing bone formation. Bone 2024; 182:117056. [PMID: 38402920 DOI: 10.1016/j.bone.2024.117056] [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: 11/29/2023] [Revised: 02/07/2024] [Accepted: 02/19/2024] [Indexed: 02/27/2024]
Abstract
Osteoporotic vertebral fracture (OVF) is the most common type of osteoporotic fracture and is associated with immobility and mortality. Bone anabolic agents, such as abaloparatide (ABL), are usually administered to patients with OVF to prevent subsequent fractures. Although several studies have shown that bone anabolic agents promote healing of long bone fractures, there is little evidence of their healing effect on vertebral bone fractures. In the present study, we investigated the effect of ABL on vertebral bone defects using ovariectomized (OVX) rats with vertebral body drill-hole defects, an animal model of OVF. Eight-week-old female Sprague-Dawley rats were subjected to OVX, followed by the 32-36 days of bone depletion period, once-daily subcutaneous ABL was administered to OVX rats at a dose of 30 μg/kg for a maximum of 6 weeks from the day of the vertebral defect surgery. We found that ABL significantly increased bone mineral content and improved trabecular structural parameters at the vertebral defect site. Moreover, ABL significantly increased bone strength of the defected vertebrae. Bone histochemical analysis revealed formation of thick trabecular bone networks at the defect site after ABL administration, consistent with an improvement in trabecular structural parameters by ABL. ABL increased ALPase- and PHOSPHO1-positive osteoblastic cells and ALPase/PCNA double-positive cells, indicating enhanced preosteoblast proliferation as well as bone formation at the defect site. On the other hand, ABL did not affect the number of cathepsin K-positive osteoclasts per bone surface, suggesting that ABL did not promote excessive bone resorption. Our findings suggest that ABL is useful not only for preventing secondary vertebral fractures but also for promoting bone healing in OVF.
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Affiliation(s)
- Akito Makino
- Pharmacology Research Department, Teijin Pharma Limited, Tokyo, Japan.
| | - Tomoka Hasegawa
- Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Tomomaya Yamamoto
- Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
| | - Hideko Takagi
- Pharmacology Research Department, Teijin Pharma Limited, Tokyo, Japan
| | | | - Naohisa Miyakoshi
- Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Norio Amizuka
- Developmental Biology of Hard Tissue, Graduate School of Dental Medicine, Hokkaido University, Sapporo, Japan
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Liu H, Xiao H, Lin S, Zhou H, Cheng Y, Xie B, Xu D. Effect of gut hormones on bone metabolism and their possible mechanisms in the treatment of osteoporosis. Front Pharmacol 2024; 15:1372399. [PMID: 38725663 PMCID: PMC11079205 DOI: 10.3389/fphar.2024.1372399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 03/25/2024] [Indexed: 05/12/2024] Open
Abstract
Bone is a highly dynamic organ that changes with the daily circadian rhythm. During the day, bone resorption is suppressed due to eating, while it increases at night. This circadian rhythm of the skeleton is regulated by gut hormones. Until now, gut hormones that have been found to affect skeletal homeostasis include glucagon-like peptide-1 (GLP-1), glucagon-like peptide-2 (GLP-2), glucose-dependent insulinotropic polypeptide (GIP), and peptide YY (PYY), which exerts its effects by binding to its cognate receptors (GLP-1R, GLP-2R, GIPR, and Y1R). Several studies have shown that GLP-1, GLP-2, and GIP all inhibit bone resorption, while GIP also promotes bone formation. Notably, PYY has a strong bone resorption-promoting effect. In addition, gut microbiota (GM) plays an important role in maintaining bone homeostasis. This review outlines the roles of GLP-1, GLP-2, GIP, and PYY in bone metabolism and discusses the roles of gut hormones and the GM in regulating bone homeostasis and their potential mechanisms.
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Affiliation(s)
- Hongyu Liu
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Institute of Traditional Chinese Medicine and New Pharmacy Development, Guangdong Medical University, Dongguan, China
| | - Huimin Xiao
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Institute of Traditional Chinese Medicine and New Pharmacy Development, Guangdong Medical University, Dongguan, China
| | - Sufen Lin
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Institute of Traditional Chinese Medicine and New Pharmacy Development, Guangdong Medical University, Dongguan, China
| | - Huan Zhou
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Institute of Traditional Chinese Medicine and New Pharmacy Development, Guangdong Medical University, Dongguan, China
| | - Yizhao Cheng
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Institute of Traditional Chinese Medicine and New Pharmacy Development, Guangdong Medical University, Dongguan, China
| | - Baocheng Xie
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Department of Pharmacy, The 10th Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, China
| | - Daohua Xu
- Guangdong Key Laboratory for Research and Development of Natural Drugs, Dongguan Key Laboratory of Traditional Chinese Medicine and New Pharmaceutical Development, School of Pharmacy, Guangdong Medical University, Dongguan, China
- Institute of Traditional Chinese Medicine and New Pharmacy Development, Guangdong Medical University, Dongguan, China
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Berggren SS, Dahlgren J, Andersson O, Bergman S, Roswall J. Reference limits for osteocalcin in infancy and early childhood: A longitudinal birth cohort study. Clin Endocrinol (Oxf) 2024; 100:399-407. [PMID: 38385947 DOI: 10.1111/cen.15036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 01/26/2024] [Accepted: 02/08/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE The longitudinal variations in serum levels of the hormone osteocalcin is largely unknown during infancy and early childhood. Our aim was to establish reference limits for total serum osteocalcin during specific time points from birth until 5 years of age and present those in the context of sex, breastfeeding practices and gestational age (GA). DESIGN Blood samples from 551 Swedish children were analysed at birth, 4, 12, 36 and 60 months of age. Total serum osteocalcin was measured using the IDS-iSYS N-MID Osteocalcin assay technique. Information about the mother, birth, anthropometrics and a food diary were collected. RESULTS Sex-specific and age-specific reference limits were established for the five time points. The median osteocalcin levels over time were 40.8, 90.0, 67.8, 62.2 and 80.9 μg/L for boys and 38.1, 95.5, 78.3, 73.9 and 92.6 μg/L for girls. Lower GA was associated to higher osteocalcin at birth, and ongoing breastfeeding was associated to higher osteocalcin levels. CONCLUSION Osteocalcin followed a wavelike pattern with low levels in the umbilical cord and a postnatal peak during the first year which then declined and rose again by the age of five. Knowledge of this wavelike pattern and association to factors as sex, breastfeeding and GA may help clinicians to interpret individual osteocalcin levels and guide in future research.
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Affiliation(s)
- Sara S Berggren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Health Center Hyltebruk, Hyltebruk, Halland, Sweden
| | - Jovanna Dahlgren
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Västra Götalandregion, Queen Silvia Children's Hospital, Lund, Sweden
| | - Ola Andersson
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Stefan Bergman
- Department of Public Health and Community Medicine, Primary Health Care Unit, University of Gothenburg, Gothenburg, Sweden
- Spenshult Research and Development Centre, Halmstad, Sweden
| | - Josefine Roswall
- Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Department of Pediatrics, Halland Hospital Halmstad, Halmstad, Sweden
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Filella X, Guañabens N. Clinical use of bone markers: a challenge to variability. ADVANCES IN LABORATORY MEDICINE 2024; 5:7-14. [PMID: 38634081 PMCID: PMC11019881 DOI: 10.1515/almed-2023-0092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/22/2023] [Indexed: 04/19/2024]
Abstract
Bone markers are a group of substances released into circulation during bone formation and/or resorption. These substances can be measured in blood and urine to obtain information about metabolic bone disorders. This review provides an insight into factors influencing bone marker variability and describes different approaches to minimize variability and interpret results appropriately. Variability in bone marker concentrations results from biological and analytical variability across assays. Other influencing factors include gender, age, physical exercise, circadian rhythm, and diet. The multiplicity of influencing factors hinders the establishment of accurate reference values. Gaining a deep understanding of bone marker variability is the first step to ascertain their clinical usefulness. Bone marker variability can be minimized by controlling as many variables as it is possible and through the standardization of patient preparation and sample collection and handling.
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Affiliation(s)
- Xavier Filella
- Servicio de Bioquímica y Genética Molecular (CDB), Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - Núria Guañabens
- Servicio de Reumatología, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, Spain
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Filella X, Guañabens N. Utilidad clínica de los biomarcadores óseos: un desafío a la variabilidad. ADVANCES IN LABORATORY MEDICINE 2024; 5:15-23. [PMID: 38634078 PMCID: PMC11019885 DOI: 10.1515/almed-2023-0041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 06/22/2023] [Indexed: 04/19/2024]
Abstract
Los biomarcadores óseos son un conjunto de sustancias que son liberadas a la circulación sanguínea durante el proceso de formación y/o resorción ósea y que podemos medir en sangre y orina para obtener información sobre los trastornos metabólicos del hueso. La revisión traza una perspectiva sobre los factores que influyen en la variabilidad de los biomarcadores óseos y describe los aspectos a considerar para reducirla al máximo e interpretar los resultados de manera adecuada. La variabilidad que podemos observar en la concentración de los biomarcadores óseos engloba diversos aspectos que abarcan desde su variabilidad biológica y la variabilidad de los ensayos empleados en su medida hasta la variabilidad derivada de la influencia de numerosos factores, entre los cuales el sexo, la edad, el ejercicio, su ritmo circadiano o la dieta. Todo ello se refleja en la dificultad de establecer valores de referencia precisos. El conocimiento de esta variabilidad es el primer desafío que debe afrontar su empleo en la práctica clínica. Es necesario minimizar la variabilidad de los biomarcadores óseos controlando el máximo de variables que sea posible, así como estandarizando la preparación del paciente antes de la toma de las muestras, así como su obtención y manejo.
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Affiliation(s)
- Xavier Filella
- Servicio de Bioquímica y Genética Molecular (CDB), Hospital Clinic, IDIBAPS, Hospital Clínic de Barcelona, Barcelona, España
| | - Núria Guañabens
- Servicio de Reumatología, Hospital Clinic, IDIBAPS, Universitat de Barcelona, Barcelona, España
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Hughes L, Centner C. Idiosyncratic bone responses to blood flow restriction exercise: new insights and future directions. J Appl Physiol (1985) 2024; 136:283-297. [PMID: 37994414 PMCID: PMC11212818 DOI: 10.1152/japplphysiol.00723.2022] [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: 11/28/2022] [Revised: 11/14/2023] [Accepted: 11/21/2023] [Indexed: 11/24/2023] Open
Abstract
Applying blood flow restriction (BFR) during low-load exercise induces beneficial adaptations of the myotendinous and neuromuscular systems. Despite the low mechanical tension, BFR exercise facilitates a localized hypoxic environment and increase in metabolic stress, widely regarded as the primary stimulus for tissue adaptations. First evidence indicates that low-load BFR exercise is effective in promoting an osteogenic response in bone, although this has previously been postulated to adapt primarily during high-impact weight-bearing exercise. Besides studies investigating the acute response of bone biomarkers following BFR exercise, first long-term trials demonstrate beneficial adaptations in bone in both healthy and clinical populations. Despite the increasing number of studies, the physiological mechanisms are largely unknown. Moreover, heterogeneity in methodological approaches such as biomarkers of bone metabolism measured, participant and study characteristics, and time course of measurement renders it difficult to formulate accurate conclusions. Furthermore, incongruity in the methods of BFR application (e.g., cuff pressure) limits the comparability of datasets and thus hinders generalizability of study findings. Appropriate use of biomarkers, effective BFR application, and befitting study design have the potential to progress knowledge on the acute and chronic response of bone to BFR exercise and contribute toward the development of a novel strategy to protect or enhance bone health. Therefore, the purpose of the present synthesis review is to 1) evaluate current mechanistic evidence; 2) discuss and offer explanations for similar and contrasting data findings; and 3) create a methodological framework for future mechanistic and applied research.
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Affiliation(s)
- Luke Hughes
- Department of Sport Exercise & Rehabilitation, Northumbria University, Newcastle upon Tyne, United Kingdom
| | - Christoph Centner
- Department of Sport and Sport Science, University of Freiburg, Freiburg, Germany
- Praxisklinik Rennbahn, Muttenz, Switzerland
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Hilkens L, Boerboom M, van Schijndel N, Bons J, van Loon LJC, van Dijk JW. Bone turnover following high-impact exercise is not modulated by collagen supplementation in young men: A randomized cross-over trial. Bone 2023; 170:116705. [PMID: 36804484 DOI: 10.1016/j.bone.2023.116705] [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: 10/10/2022] [Revised: 01/23/2023] [Accepted: 02/10/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION We assessed whether collagen supplementation augments the effects of high-impact exercise on bone turnover and whether a higher exercise frequency results in a greater benefit for bone metabolism. METHODS In this randomized, cross-over trial, 14 healthy males (age 24 ± 4 y, BMI 22.0 ± 2.1 kg/m2) performed 5-min of high-impact exercise once (JUMP+PLA and JUMP+COL) or twice daily (JUMP2+COL2) during a 3-day intervention period, separated by a 10-day wash out period. One hour before every exercise bout participants ingested 20 g hydrolysed collagen (JUMP+COL and JUMP2+COL2) or a placebo control (JUMP+PLA). Blood markers of bone formation (P1NP) and resorption (CTXI) were assessed in the fasted state before the ingestion of the initial test drinks and 24, 48, and 72 h thereafter. In JUMP+PLA and JUMP+COL, additional blood samples were collected in the postprandial state at 1, 2, 3, 4, 5 and 13 h after ingestion of the test drink. RESULTS In the postprandial state, serum P1NP concentrations decreased marginally from 99 ± 37 to 93 ± 33 ng/mL in JUMP+COL, and from 97 ± 32 to 92 ± 31 ng/mL in JUMP+PLA, with P1NP levels having returned to baseline levels after 13 h (time-effect, P = 0.053). No differences in serum P1NP concentrations were observed between JUMP+PLA and JUMP+COL (time x treatment, P = 0.58). Serum CTX-I concentrations showed a ~ 50 % decline (time, P < 0.001) in the postprandial state in JUMP+COL (0.9 ± 0.3 to 0.4 ± 0.2 ng/mL) and JUMP+PLA (0.9 ± 0.3 to 0.4 ± 0.2 ng/mL), with no differences between treatments (time x treatment, P = 0.17). Fasted serum P1NP concentrations increased ~8 % by daily jumping exercise (time-effect, P < 0.01), with no differences between treatments (time x treatment, P = 0.71). Fasted serum CTX-I concentrations did not change over time (time-effect, P = 0.41) and did not differ between treatments (time x treatment, P = 0.58). CONCLUSIONS Five minutes of high-impact exercise performed daily stimulates bone formation during a 3-day intervention period. This was indicated by an increase in fasted serum P1NP concentrations, rather than an acute increase in post-exercise serum P1NP concentrations. Collagen supplementation or an increase in exercise frequency does not further increase serum P1NP concentrations. The bone resorption marker CTX-I was not affected by daily short-duration high-impact exercise with or without concurrent collagen supplementation.
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Affiliation(s)
- Luuk Hilkens
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Marleen Boerboom
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Nick van Schijndel
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands
| | - Judith Bons
- Central Diagnostic Laboratory, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Luc J C van Loon
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands; Department of Human Biology, NUTRIM, Maastricht University Medical Centre+, Maastricht, the Netherlands
| | - Jan-Willem van Dijk
- School of Sport and Exercise, HAN University of Applied Sciences, Nijmegen, the Netherlands.
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Gregory A K, Daniel T H. Bone Turnover Markers for Assessment of Anti-Resorptive Effect in Clinical Practice: A Good Idea Meets the Problem of Measurement Uncertainty. Clin Biochem 2023; 116:100-104. [PMID: 37084998 DOI: 10.1016/j.clinbiochem.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 04/15/2023] [Accepted: 04/17/2023] [Indexed: 04/23/2023]
Abstract
OBJECTIVES Bone turnover markers (BTM) are measures for understanding the effect of anti-resorptives upon osteoclast activity. Post-hoc trial data suggests reduction in BTM of 40% may represent a target for defining appropriate response to therapy. We modeled clinical application of this target threshold in an individual patient setting where assay measurement uncertainty and biological variation are included. DESIGN Using serum C-telo-peptide (ß-CTX), we constructed hypothetical scenarios of ß-CTX measurement pre and post bisphosphonate therapy. Using typical ß-CTX assay characteristics (analytical coefficient of variation, CV 5.0%) and published intra-individual ß-CTX data for post-menopausal women (CV 18.0%), we calculated the post-therapy ß-CTX that must be seen on single repeat measure for 95% confidence that the observed result was ≥40% below baseline. Sensitivity analyses considered greater and lesser variations in the combined sources of variation. RESULTS The one-tailed 95% reference change value for any detectable therapeutic decrease in ß-CTX was 22%. However, to have 95% confidence of having achieved a reduction ≥ 40%, an observed ß-CTX decrease of ≥56% is required. Larger decreases are needed for scenarios of greater analytical or intra-individual variation. CONCLUSIONS Although population data suggest a ß-CTX decrease of 40% is commensurate with adequate therapeutic response to anti-resorptives, application to an individual patient where measurement and natural variation are present is problematic. ß-CTX decreases much greater than 40% are required to be confident of having achieved the optimal treatment response. It is uncertain whether this is a legitimate change to be expected in all individual patients and therefore clinical application of this threshold is uncertain.
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Affiliation(s)
- Kline Gregory A
- Division of Endocrinology, Faculty of Medicine, Cumming School of Medicine, University of Calgary.
| | - Holmes Daniel T
- Department of Pathology and Laboratory Medicine, St. Paul's Hospital, Vancouver, BC, Canada; The University of British Columbia Department of Pathology and Laboratory
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15
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Maagensen H, Helsted MM, Gasbjerg LS, Vilsbøll T, Knop FK. The Gut-Bone Axis in Diabetes. Curr Osteoporos Rep 2023; 21:21-31. [PMID: 36441432 DOI: 10.1007/s11914-022-00767-2] [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] [Accepted: 11/03/2022] [Indexed: 11/29/2022]
Abstract
PURPOSE OF REVIEW To describe recent advances in the understanding of how gut-derived hormones regulate bone homeostasis in humans with emphasis on pathophysiological and therapeutic perspectives in diabetes. RECENT FINDINGS The gut-derived incretin hormone glucose-dependent insulinotropic polypeptide (GIP) is important for postprandial suppression of bone resorption. The other incretin hormone, glucagon-like peptide 1 (GLP-1), as well as the intestinotrophic glucagon-like peptide 2 (GLP-2) has been shown to suppress bone resorption in pharmacological concentrations, but the role of the endogenous hormones in bone homeostasis is uncertain. For ambiguous reasons, both patients with type 1 and type 2 diabetes have increased fracture risk. In diabetes, the suppressive effect of endogenous GIP on bone resorption seems preserved, while the effect of GLP-2 remains unexplored both pharmacologically and physiologically. GLP-1 receptor agonists, used for the treatment of type 2 diabetes and obesity, may reduce bone loss, but results are inconsistent. GIP is an important physiological suppressor of postprandial bone resorption, while GLP-1 and GLP-2 may also exert bone-preserving effects when used pharmacologically. A better understanding of the actions of these gut hormones on bone homeostasis in patients with diabetes may lead to new strategies for the prevention and treatment of skeletal frailty related to diabetes.
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Affiliation(s)
- Henrik Maagensen
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
- Center for Clinical Metabolic Research, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 7, 3rd floor, DK-2900, Hellerup, Denmark
| | - Mads M Helsted
- Center for Clinical Metabolic Research, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 7, 3rd floor, DK-2900, Hellerup, Denmark
| | - Lærke S Gasbjerg
- Center for Clinical Metabolic Research, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 7, 3rd floor, DK-2900, Hellerup, Denmark
- Department of Biomedical Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Tina Vilsbøll
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark
- Center for Clinical Metabolic Research, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 7, 3rd floor, DK-2900, Hellerup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Filip K Knop
- Clinical Research, Copenhagen University Hospital-Steno Diabetes Center Copenhagen, Herlev, Denmark.
- Center for Clinical Metabolic Research, Copenhagen University Hospital-Herlev and Gentofte, Gentofte Hospitalsvej 7, 3rd floor, DK-2900, Hellerup, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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Chusyd DE, Brown JL, Golzarri-Arroyo L, Dickinson SL, Kraus VB, Siegal-Willott J, Griffin TM, Huebner JL, Edwards KL, Allison DB, Austad SN. RELATIONSHIP BETWEEN REPRODUCTIVE AND BONE BIOMARKERS AND OSTEOARTHRITIS IN ZOO ASIAN ( ELEPHAS MAXIMUS) AND AFRICAN ( LOXODONTA AFRICANA) ELEPHANTS. J Zoo Wildl Med 2023; 53:801-810. [PMID: 36640083 PMCID: PMC10150656 DOI: 10.1638/2021-0080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 01/09/2023] Open
Abstract
Osteoarthritis (OA) is common in zoo Asian (Elephas maximus) and African (Loxodonta africana) elephants. This study investigated the relationship between confirmed or suspected OA with ovarian cyclicity, gonadotropins, progestagens, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and collagen type I (CTX-I) in zoo elephants. In Asian elephants, odds of having confirmed or suspected OA decreased with cycling (OR = 0.22, P = 0.016; OR = 0.29, P = 0.020, respectively), however, not when adjusted for age (odds ratio [OR] = 0.31, P = 0.112; OR = 0.58, P = 0.369, respectively). In African elephants, none of the models between confirmed OA and cycling status were significant (P > 0.060), while the odds of having suspected OA decreased with cycling (OR = 0.12, P = 0.001), even after adjusting for age (OR = 0.15, P = 0.005). Progestagens (Asian elephants P > 0.096; African elephants P > 0.415), LH (Asian P > 0.129; African P > 0.359), and FSH (Asian P > 0.738; African P > 0.231) did not differ with confirmed or suspected OA status, unadjusted. CTX-I concentrations were not related to OA status (P > 0.655). This study concluded hormonal changes may not have a strong impact on OA, so additional investigation into other serologic biomarkers is warranted.
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Affiliation(s)
- Daniella E Chusyd
- Department of Nutrition Sciences, University of Alabama at Birmingham, Birmingham, AL 35233, USA,
- Nutrition Obesity Research Center, University of Alabama at Birmingham, AL 35294, USA
| | - Janine L Brown
- Center for Species Survival, Smithsonian Conservation Biology Institute, Front Royal, VA 22630, USA
| | - Lilian Golzarri-Arroyo
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Stephanie L Dickinson
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Virginia B Kraus
- Division of Rheumatology, Departments of Medicine, Pathology, and Orthopedic Surgery, Duke University, Durham, NC 22701, USA
- Duke Molecular Physiology Institute, Duke University, Durham, NC 22701, USA
| | - Jessica Siegal-Willott
- United States Department of Agriculture, Animal and Plant Health Inspection Service, Riverdale, MD 20737, USA
| | - Timothy M Griffin
- Oklahoma Medical Research Foundation, Oklahoma City, OK 73104, USA
- Veterans Affairs Medical Center, Oklahoma City, OK 73104, USA
- University of Oklahoma Health Sciences Center, Oklahoma City, OK 73104, USA
| | - Janet L Huebner
- Duke Molecular Physiology Institute, Duke University, Durham, NC 22701, USA
| | - Katie L Edwards
- Center for Species Survival, Smithsonian Conservation Biology Institute, Front Royal, VA 22630, USA
| | - David B Allison
- Department of Epidemiology and Biostatistics, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Steven N Austad
- Nutrition Obesity Research Center, University of Alabama at Birmingham, AL 35294, USA
- Nathan Shock Center, University of Alabama at Birmingham, AL 35294, USA
- Biology Department, University of Alabama at Birmingham, Birmingham, AL 35233, USA
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Schini M, Vilaca T, Gossiel F, Salam S, Eastell R. Bone Turnover Markers: Basic Biology to Clinical Applications. Endocr Rev 2022; 44:417-473. [PMID: 36510335 PMCID: PMC10166271 DOI: 10.1210/endrev/bnac031] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 11/26/2022] [Accepted: 12/05/2022] [Indexed: 12/15/2022]
Abstract
Bone turnover markers (BTMs) are used widely, in both research and clinical practice. In the last 20 years, much experience has been gained in measurement and interpretation of these markers, which include commonly used bone formation markers bone alkaline phosphatase, osteocalcin, and procollagen I N-propeptide; and commonly used resorption markers serum C-telopeptides of type I collagen, urinary N-telopeptides of type I collagen and tartrate resistant acid phosphatase type 5b. BTMs are usually measured by enzyme-linked immunosorbent assay or automated immunoassay. Sources contributing to BTM variability include uncontrollable components (e.g., age, gender, ethnicity) and controllable components, particularly relating to collection conditions (e.g., fasting/feeding state, and timing relative to circadian rhythms, menstrual cycling, and exercise). Pregnancy, season, drugs, and recent fracture(s) can also affect BTMs. BTMs correlate with other methods of assessing bone turnover, such as bone biopsies and radiotracer kinetics; and can usefully contribute to diagnosis and management of several diseases such as osteoporosis, osteomalacia, Paget's disease, fibrous dysplasia, hypophosphatasia, primary hyperparathyroidism, and chronic kidney disease-mineral bone disorder.
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Affiliation(s)
- Marian Schini
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Tatiane Vilaca
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Fatma Gossiel
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Syazrah Salam
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.,Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Richard Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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Impact of radiotherapy on bone health in women with rectal cancer - A prospective cohort study. Eur J Surg Oncol 2022; 48:2509-2517. [PMID: 35786532 DOI: 10.1016/j.ejso.2022.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 06/19/2022] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Pelvic radiotherapy (RT) increases the risk of pelvic insufficiency fractures. The aim was to investigate if RT is associated with changes in serum bone biomarkers in women with rectal cancer, and to examine the incidence of radiation-induced bone injuries and the association with bone biomarkers. MATERIAL AND METHODS Women diagnosed with rectal cancer stage I-III, planned for abdominal surgery ± preoperative (chemo) RT, were prospectively included and followed one year. Serum bone biomarkers comprised sclerostin (regulatory of bone formation), CTX (resorption), BALP and PINP (formation). A subgroup was investigated with annual pelvic magnetic resonance imaging (MRI). The association between RT and bone biomarkers was explored in regression models. RESULTS Of 134 included women, 104 had surgery with preoperative RT. The formation markers BALP and PINP increased from baseline to one year in the RT-exposed group (p < 0.001, longitudinal comparison). In the adjusted regression analysis, the mean increase in PINP was higher in the RT-exposed than the unexposed group (17.6 (3.6-31.5) μg/L, p = 0.013). Sclerostin and CTX did not change within groups nor differed between groups. Radiation-induced injuries were detected in 16 (42%) of 38 women with available MRI. At one year, BALP was higher among women with than without bone injuries (p = 0.018, cross-sectional comparison). CONCLUSIONS Preoperative RT was associated with an increase in the formation marker PINP, which could represent bone recovery following RT-induced injuries, commonly observed in participants evaluated with MRI. These findings should be further explored in larger prospective studies on bone health in rectal cancer patients.
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Devlin MJ, Eick GN, Snodgrass JJ. The utility of dried blood spot measurement of bone turnover markers in biological anthropology. Am J Hum Biol 2022; 34:e23816. [PMID: 36214251 PMCID: PMC9787861 DOI: 10.1002/ajhb.23816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 01/25/2023] Open
Abstract
OBJECTIVES Bone is a dynamic organ under continual turnover influenced by life history stage, energy dynamics, diet, climate, and disease. Bone turnover data have enormous potential in biological anthropology for testing evolutionary and biocultural hypotheses, yet few studies have integrated these biomarkers. In the present article we systematically review the current availability, future viability, and applicability of measuring bone turnover markers (BTMs) in dried blood spot (DBS) samples obtained from finger prick whole blood. METHODS Our review considers clinical and public health relevance, biomarker stability in DBS, assay availability, and cost. We consider biomarkers of bone formation such as osteocalcin (bone matrix protein), PINP (N-terminal propeptide of type I collagen), and alkaline phosphatase (osteoblast enzyme), as well as biomarkers of bone resorption such as CTX (marker of collagen breakdown) and TRACP5b (tartrate-resistant acid phosphatase 5b; osteoclast enzyme). RESULTS Two BTMs have been validated for DBS: osteocalcin (formation) and TRACP5b (resorption). Prime candidates for future development are CTX and PINP, the formation and resorption markers used for clinical monitoring of response to osteoporosis treatment. CONCLUSION BTMs are a field-friendly technique for longitudinal monitoring of skeletal biology during growth, reproduction and aging, combining minimized risk to study participants with maximized ease of sample storage and transport. This combination allows new insights into the effects of energy availability, disease, and physical activity level on bone, and questions about bone gain and loss across life history and in response to environmental factors; these issues are important in human biology, paleoanthropology, bioarchaeology, and forensic anthropology.
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Affiliation(s)
- Maureen J. Devlin
- Department of AnthropologyUniversity of MichiganAnn ArborMichiganUSA
| | - Geeta N. Eick
- Global Health Biomarker Laboratory, Department of AnthropologyUniversity of OregonEugeneOregonUSA
| | - J. Josh Snodgrass
- Global Health Biomarker Laboratory, Department of AnthropologyUniversity of OregonEugeneOregonUSA,Center for Global HealthUniversity of OregonEugeneOregonUSA,Invited Faculty, Global Station for Indigenous Studies & Cultural DiversityHokkaido UniversitySapparoHokkaidoJapan
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20
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Haines MS, Kimball A, Meenaghan E, Santoso K, Colling C, Singhal V, Ebrahimi S, Gleysteen S, Schneider M, Ciotti L, Belfer P, Eddy KT, Misra M, Miller KK. Denosumab increases spine bone density in women with anorexia nervosa: a randomized clinical trial. Eur J Endocrinol 2022; 187:697-708. [PMID: 36134902 PMCID: PMC9746654 DOI: 10.1530/eje-22-0248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 09/21/2022] [Indexed: 12/15/2022]
Abstract
Objective Anorexia nervosa is complicated by high bone resorption, low bone mineral density (BMD), and increased fracture risk. We investigated whether off-label antiresorptive therapy with denosumab increases BMD in women with anorexia nervosa. Design Twelve-month, randomized, double-blind, placebo-controlled study. Methods Thirty ambulatory women with anorexia nervosa and areal BMD (aBMD) T-score <-1.0 at ≥1 sites were randomized to 12 months of denosumab (60 mg subcutaneously q6 months)(n = 20) or placebo (n = 10). Primary end point was postero-anterior (PA) lumbar spine aBMD by dual-energy x-ray absorptiometry. Secondary end points included femoral neck aBMD, tibia and radius volumetric BMD and bone microarchitecture by high-resolution peripheral quantitative CT, tibia and radius failure load by finite element analysis (FEA), and markers of bone turnover. Results Baseline mean (±s.d.) age (29 ± 8 (denosumab) vs 29 ± 7 years (placebo)), BMI (19.0 ± 1.7 vs 18.0 ± 2.0 kg/m2), and aBMD (PA spine Z-score -1.6±1.1 vs -1.7±1.4) were similar between groups. PA lumbar spine aBMD increased in the denosumab vs placebo group over 12 months (P = 0.009). The mean (95% CI) increase in PA lumbar spine aBMD was 5.5 (3.8-7.2)% in the denosumab group and 2.2 (-0.3-4.7)% in the placebo group. The change in femoral neck aBMD was similar between groups. Radial trabecular number increased, radial trabecular separation decreased, and tibial cortical porosity decreased in the denosumab vs placebo group (P ≤ 0.006). Serum C-terminal telopeptide of type I collagen and procollagen type I N-terminal propeptide decreased in the denosumab vs placebo group (P < 0.0001). Denosumab was well tolerated. Conclusions Twelve months of antiresorptive therapy with denosumab reduced bone turnover and increased spine aBMD, the skeletal site most severely affected in women with anorexia nervosa.
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Affiliation(s)
- Melanie S Haines
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Allison Kimball
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Erinne Meenaghan
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Kate Santoso
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Caitlin Colling
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Vibha Singhal
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Pediatric Endocrinology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Seda Ebrahimi
- Cambridge Eating Disorder Center, Cambridge, Massachusetts, USA
| | - Suzanne Gleysteen
- Harvard Medical School, Boston, Massachusetts, USA
- Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
| | - Marcie Schneider
- Greenwich Adolescent & Young Adult Medicine, Greenwich, Connecticut, USA
| | - Lori Ciotti
- The Renfrew Center, Boston, Massachusetts, USA
| | - Perry Belfer
- Harvard Medical School, Boston, Massachusetts, USA
- Newton-Wellesley Eating Disorders & Behavioral Medicine, Brookline, Massachusetts, USA
- McLean Hospital, Belmont, Massachusetts, USA
| | - Kamryn T Eddy
- Harvard Medical School, Boston, Massachusetts, USA
- Eating Disorders Clinical and Research Program, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Madhusmita Misra
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
- Division of Pediatric Endocrinology, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Karen K Miller
- Neuroendocrine Unit, Massachusetts General Hospital, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
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Perri G, Hill TR, Mathers JC, Walsh JS, Gossiel F, Winther K, Frölich J, Folkestad L, Cold S, Eastell R. Long-Term Selenium-Yeast Supplementation Does Not Affect Bone Turnover Markers: A Randomized Placebo-Controlled Trial. J Bone Miner Res 2022; 37:2165-2173. [PMID: 36093566 PMCID: PMC10087503 DOI: 10.1002/jbmr.4703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/01/2022] [Accepted: 09/05/2022] [Indexed: 11/08/2022]
Abstract
Higher selenium status has been associated with lower bone turnover markers (BTM) in epidemiological studies. However, the long-term impact of selenium supplementation on BTMs has not been studied. We investigated the effects of selenium supplementation on BTMs including osteocalcin (OC), procollagen type I N-terminal propeptide (PINP), collagen type I cross-linked C-telopeptide (CTX), and bone alkaline phosphatase (BALP) in the short (6 months) and long term (5 years). A total of 481 Danish men and women (60-74 years) were randomized to receive placebo-yeast versus 100, 200, or 300 μg selenium as selenium-enriched yeast daily for 5 years. Plasma selenium concentration was measured using inductively coupled plasma mass spectrometry, and BTMs were measured in nonfasted samples at baseline, 6 months, and 5 years. Data were analyzed by ANCOVA to investigate the shape of the dose-response relationships. Covariates included age, body mass index, baseline selenium status, baseline BTM, smoking, alcohol, supplement use, and medication. Plasma selenium concentration (mean 86.5 μg/d at baseline) increased significantly with increasing selenium supplementation to 152.6, 209.1, and 253.7 μg/L after 6 months and remained elevated at 5 years (158.4, 222.4, and 275.9 μg/L for 100, 200, and 300 μg supplemental selenium/d, respectively (p < 0.001)). There was no change in plasma selenium concentration in the placebo-treated group. There was no significant effect of selenium supplementation on OC (6 months p = 0.37; 5 years p = 0.63), PINP (6 months p = 0.37; 5 years p = 0.79), CTX (6 months p = 0.91; 5 years p = 0.58) or BALP (6 months p = 0.17; 5 years p = 0.53). The relatively replete baseline selenium status in the study participants may explain this lack of effect. Testing in more deficient populations may provide further insights into the impact of selenium supplementation on bone health. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Giorgia Perri
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Tom R Hill
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - John C Mathers
- Human Nutrition Research Centre, Centre for Healthier Lives, Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jennifer S Walsh
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Fatma Gossiel
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Kristian Winther
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.,Centre for Diabetes, Academic Specialist Centre, Stockholm, Sweden.,Department of Molecular Medicine and Surgery, Karolinska Institute, Solna, Sweden
| | - Jacob Frölich
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Lars Folkestad
- Department of Endocrinology, Odense University Hospital, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Søren Cold
- Department of Oncology, Odense University Hospital, Odense, Denmark
| | - Richard Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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22
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Bønløkke SE, Rand MS, Haddock B, Arup S, Smith CD, Jensen JEB, Schwarz P, Hovind P, Oturai PS, Jensen LT, Møller S, Eiken P, Rubin KH, Hitz MF, Abrahamsen B, Jørgensen NR. Baseline bone turnover marker levels can predict change in bone mineral density during antiresorptive treatment in osteoporotic patients: the Copenhagen bone turnover marker study. Osteoporos Int 2022; 33:2155-2164. [PMID: 35729342 DOI: 10.1007/s00198-022-06457-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 05/31/2022] [Indexed: 11/25/2022]
Abstract
UNLABELLED Anti-resorptive osteoporosis treatment might be more effective in patients with high bone turnover. In this registry study including clinical data, high pre-treatment bone turnover measured with biochemical markers was correlated with higher bone mineral density increases. Bone turnover markers may be useful tools to identify patients benefitting most from anti-resorptive treatment. INTRODUCTION In randomized, controlled trials of bisphosphonates, high pre-treatment levels of bone turnover markers (BTM) were associated with a larger increase in bone mineral density (BMD). The purpose of this study was to examine this correlation in a real-world setting. METHODS In this registry-based cohort study of osteoporosis patients (n = 158) receiving antiresorptive therapy, the association between pre-treatment levels of plasma C-telopeptide of type I Collagen (CTX) and/or N-terminal propeptide of type I procollagen (PINP) and change in bone mineral density (BMD) at lumbar spine, total hip, and femoral neck upon treatment was examined. Patients were grouped according to their pre-treatment BTM levels, defined as values above and below the geometric mean for premenopausal women. RESULTS Pre-treatment CTX correlated with annual increase in total hip BMD, where patients with CTX above the geometric mean experienced a larger annual increase in BMD (p = 0.008) than patients with CTX below the geometric mean. The numerical pre-treatment level of CTX showed a similar correlation at all three skeletal sites (total hip (p = 0.03), femoral neck (p = 0.04), and lumbar spine (p = 0.0003)). A similar association was found for PINP where pre-treatment levels of PINP above the geometric mean correlated with a larger annual increase in BMD for total hip (p = 0.02) and lumbar spine (p = 0.006). CONCLUSION Measurement of pre-treatment BTM levels predicts osteoporosis patients' response to antiresorptive treatment. Patients with high pre-treatment levels of CTX and/or PINP benefit more from antiresorptive treatment with larger increases in BMD than patients with lower pre-treatment levels.
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Affiliation(s)
- S E Bønløkke
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - M S Rand
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - B Haddock
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - S Arup
- Medical Department, National Research Center for Bone Health, Zealand University Hospital Køge, Køge, Denmark
| | - C D Smith
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - J E B Jensen
- Department of Endocrinology, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - P Schwarz
- Department of Endocrinology, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - P Hovind
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - P S Oturai
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark
| | - L T Jensen
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Herlev, Herlev, Denmark
| | - S Møller
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Physiology and Nuclear Medicine, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - P Eiken
- Department of Endocrinology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark
| | - K H Rubin
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- OPEN - Open Patient Data Explorative Network, Odense University Hospital, Odense, Denmark
| | - M F Hitz
- Medical Department, National Research Center for Bone Health, Zealand University Hospital Køge, Køge, Denmark
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - B Abrahamsen
- Research Unit OPEN, Department of Clinical Research, University of Southern Denmark, Odense, Denmark
- Department of Medicine, Holbæk Hospital, Holbæk, Denmark
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - N R Jørgensen
- Department of Clinical Biochemistry, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
- Institute of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
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23
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Zhang Y, Huang X, Li C, Zhang J, Yu X, Li Y, Zhou W, Yu F. Broad application prospects of bone turnover markers in pediatrics. J Clin Lab Anal 2022; 36:e24656. [PMID: 35949006 PMCID: PMC9459349 DOI: 10.1002/jcla.24656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 07/29/2022] [Accepted: 08/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Bone turnover markers (BTMs) have been studied for application in clinical medicine. However, BTMs in children are challenging, and few studies explore these BTMs in children. The application of BTMs is complicated mainly due to pre-analytical factors, variable reference intervals of age- and sex-related BTMs for adolescents and children in different regions and laboratories. Therefore, laboratory testing of BTMs is critical for understanding pediatric bone development and metabolism, which provides additional information about bone development and diseases. METHODS Literature search was conducted using the MeSH term "child" combined with the terms that bone turnover markers such as "osteocalcin," "Procollagen type I N-terminal propeptide," "procollagen type I C-terminal propeptide," "osteocalcin," "N-terminal cross-linked telopeptide," and "C-terminal cross-linked telopeptide," Several databases including Web of Science, Google Scholar, and PubMed were searched to obtain the relevant studies. RESULTS BTMs represent the combined effects of skeletal development, growth, and remodeling in children, which can be used in clinical pediatrics to assist in the diagnosis and prognosis of bone metabolic disorders. CONCLUSION BTMs are clearly helpful for diagnosis and monitoring of bone growth and development as well as bone metabolic disorders.
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Affiliation(s)
- Yiduo Zhang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xiaocui Huang
- Chengdu Jinjiang District Maternal and Child Healthcare Hospital, Chengdu, China
| | - Chao Li
- Chengdu Jinjiang District Maternal and Child Healthcare Hospital, Chengdu, China
| | - Jing Zhang
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Xingnan Yu
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Ye Li
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Wenjie Zhou
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
| | - Fan Yu
- Department of Laboratory Medicine, West China Second University Hospital, Sichuan University, Chengdu, China.,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, China
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24
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Guzman A, Kurgan N, Moniz SC, McCarthy SF, Sale C, Logan-Sprenger H, Elliott-Sale KJ, Hazell TJ, Klentrou P. Menstrual Cycle Related Fluctuations in Circulating Markers of Bone Metabolism at Rest and in Response to Running in Eumenorrheic Females. Calcif Tissue Int 2022; 111:124-136. [PMID: 35429247 DOI: 10.1007/s00223-022-00970-4] [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: 12/24/2021] [Accepted: 03/10/2022] [Indexed: 11/02/2022]
Abstract
This study examined potential fluctuations in bone metabolic markers across the menstrual cycle both at rest and after a 30-min bout of continuous running at 80% of V̇O2max. Resting and post-exercise (0, 30, 90 min) sclerostin, parathyroid hormone (PTH), carboxy-terminal cross-linking telopeptide of type I collagen (β-CTXI), and procollagen type 1 N propeptide (PINP) were assessed in 10 eumenorrheic women (age: 21 ± 3 y, BMI: 23.2 ± 3.0 kg.m2) during the mid- to late-follicular (FP: day 8.0 ± 1.4) and mid-luteal (LP: day 22.0 ± 2.5) phases of the menstrual cycle. Ovulation was determined using ovulation kits and daily measurement of oral body temperature upon awakening. Menstrual cycle phase was subsequently confirmed by measurement of plasma estradiol and progesterone. On average, resting estradiol concentrations increased from 46.3 ± 8.9 pg·mL-1 in the FP to 67.3 ± 23.4 pg·mL-1 in the LP (p = 0.015), and resting progesterone increased from 4.12 ± 2.36 ng·mL-1 in the FP to 11.86 ± 4.49 ng·mL-1 in the LP (p < 0.001). At rest, there were no differences between menstrual cycle phases in sclerostin (FP: 260.1 ± 135.0 pg·mL-1; LP: 303.5 ± 99.9 pg·mL-1; p = 0.765), PTH (FP: 0.96 ± 0.64 pmol·L-1; LP: 0.79 ± 0.44 pmol·L-1; p = 0.568), β-CTXI (FP: 243.1 ± 158.0 ng·L-1; LP: 202.4 ± 92.3 ng·L-1; p = 0.198), and PINP (FP: 53.6 ± 8.9 μg·L-1; LP: 66.2 ± 20.2 μg·L-1; p = 0.093). Main effects for time (p < 0.05) were shown in sclerostin, PTH, β-CTXI and PINP, without phase or interaction effects. Sclerostin increased from pre- to immediately post-exercise (45%; p = 0.007), and so did PTH (43%; p = 0.011), both returning to resting concentrations 30 min post-exercise. β-CTXI decreased from pre- to post-exercise (20%; p = 0.027) and was still below its pre-exercise concentrations at 90 min post-exercise (17%; p = 0.013). PINP increased immediately post-exercise (29%; p < 0.001), returning to resting concentrations at 30 min post-exercise. These results demonstrate no effect of menstrual cycle phase on resting bone marker concentrations or on the bone metabolic marker response to intense exercise.
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Affiliation(s)
- Anne Guzman
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada
| | - Sara C Moniz
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Seth F McCarthy
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Craig Sale
- SHAPE Research Centre, Nottingham Trent University, Nottingham, UK
| | | | | | - Tom J Hazell
- Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Brock University, St. Catharines, ON, Canada.
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25
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Knych HK, Finno CJ, Katzman S, Ryan D, McKemie DS, Kass PH, Arthur RM. Clodronate detection and effects on markers of bone resorption are prolonged following a single administration to horses. Equine Vet J 2022. [DOI: 10.1111/evj.13866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 07/10/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Heather K. Knych
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine University of California Davis CA USA
- Department of Molecular Biosciences, School of Veterinary Medicine University of California Davis CA USA
| | - Carrie J. Finno
- Department of Population Health and Reproduction, School of Veterinary Medicine University of California Davis CA USA
| | - Scott Katzman
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine University of California Davis CA USA
| | - Declan Ryan
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine University of California Davis CA USA
| | - Daniel S. McKemie
- K.L. Maddy Equine Analytical Pharmacology Laboratory, School of Veterinary Medicine University of California Davis CA USA
| | - Philip H. Kass
- Department of Molecular Biosciences, School of Veterinary Medicine University of California Davis CA USA
| | - Rick M. Arthur
- School of Veterinary Medicine University of California Davis CA USA
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26
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Gossiel F, Ugur A, Peel NFA, Walsh JS, Eastell R. The clinical utility of TRACP-5b to monitor anti-resorptive treatments of osteoporosis. Osteoporos Int 2022; 33:1357-1363. [PMID: 35102444 DOI: 10.1007/s00198-022-06311-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 01/17/2022] [Indexed: 11/24/2022]
Abstract
UNLABELLED TRACP-5b can be used to monitor the response of treatments in osteoporosis. We investigated the effect of feeding on levels of TRACP-5b and how these markers perform in a clinical setting. After feeding, there was no effect on levels TRACP-5b. It has similar diagnostic accuracy to CTX and PINP. INTRODUCTION Bone turnover markers (BTMs) can be used to monitor response to osteoporosis treatment. However, some are affected by food intake and are not suitable to measure in a clinical setting. An assay is available which is capable of detecting the active isoform 5b of tartrate resistance acid phosphatase (TRACP-5b) and it may have minimal biological variation. Our aims were to investigate the effect of feeding on levels of TRACP-5b and compare this to CTX and PINP and then to compare the diagnostic accuracy of TRACP-5b to CTX and PINP in patients with osteoporosis given commonly used treatments. METHODS Eighteen patients were recruited to investigate the effect of feeding on BTMs. Ninety-seven patients (74 females and 23 males) receiving 5 mg annual intra-venous zoledronate (mean age 70) and 97 patients receiving no treatment were recruited as group-matched controls. Sixteen patients receiving 60 mg subcutaneous denosumab every 6 months, (mean age 76) and 16 matched controls were recruited. Seventy-six patients were receiving oral bisphosphonates: 70 mg alendronate weekly, 35 mg risedronate and 150 mg monthly ibandronate (4%). Thirty of these patients had BMD measured at the total hip and lumbar spine. An estimate of compliance was not determined. Eighty patients receiving no treatment were recruited as group-matched controls. TRACP-5b (ELISA, Nittobo) and CTX and PINP were measured in serum in the non-fasting state between 0800 and 1700. RESULTS After feeding, there was no effect on levels TRACP-5b and significant reductions in CTX and PINP, 29% and 10%, respectively (p < 0.001). In the zoledronate and denosumab groups, there were no differences in the areas under the curves (AUCs) between TRACP-5b, PINP and CTX. In the oral bisphosphonates group, the AUCs between TRACP-5b and PINP and TRACP-5b and CTX were significantly different, p < 0.01 and p = 0.001, respectively. TRACP-5b was negatively correlated with BMD. CONCLUSION TRACP-5b is not affected by food intake, unlike CTX and PINP. All three BTMs correlate with change in BMD at the lumbar spine and total hip. TRACP-5b has similar diagnostic accuracy to CTX and PINP with commonly used treatments for osteoporosis with the exception of oral bisphosphonate therapy.
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Affiliation(s)
- F Gossiel
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK.
- The Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
| | - A Ugur
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - N F A Peel
- Sheffield Teaching Hospitals NHS Trust, Sheffield, UK
| | - J S Walsh
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - R Eastell
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
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27
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Prowting JL, Skelly LE, Kurgan N, Fraschetti EC, Klentrou P, Josse AR. Acute Effects of Milk vs. Carbohydrate on Bone Turnover Biomarkers Following Loading Exercise in Young Adult Females. Front Nutr 2022; 9:840973. [PMID: 35571916 PMCID: PMC9101466 DOI: 10.3389/fnut.2022.840973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 04/07/2022] [Indexed: 11/17/2022] Open
Abstract
Dairy products and impact exercise have previously been identified to be independently beneficial for bone mineral properties, however, it is unknown how the combination of these two osteogenic interventions may alter acute bone turnover. Using a randomized crossover design, we compared the acute effects of consuming milk vs. an isoenergetic carbohydrate control beverage on bone biomarkers following loading exercise. Thirteen healthy female participants (Age = 20.3 ± 2.3y; BMI = 21.0 ± 1.1 kg/m2) consumed either 550 mL of 0% skim white milk (MILK) or 52.7 g of maltodextrin in 550 mL of water (CHO), both 5 min and 1 h following completion of a combined plyometric (198 impacts) and resistance exercise (3-4 sets/exercise, 8-12 reps/set, ∼75% 1-RM) bout. Venous blood samples were obtained pre-exercise, and 15 min, 75 min, 24 h and 48 h post-exercise to assess serum concentrations of bone resorption biomarkers, specifically carboxyl-terminal crosslinking telopeptide of type I collagen (CTX), receptor activator nuclear factor kappa-β ligand (RANKL), and sclerostin (SOST), as well as bone formation biomarkers, specifically osteoprotegerin (OPG) and osteocalcin (OC). When absolute biomarker concentrations were examined, there were no interaction or group effects for any biomarker, however, there were main time effects (p < 0.05) for RANKL, SOST, and OC, which were lower, and the OPG: OPG/RANKL ratio, which was higher at 75 min post-exercise compared with baseline in both conditions. In addition to assessing absolute biomarker concentrations at specific timepoints, we also evaluated the relative (% change) cumulative post-exercise response (75 min to 48 h) using an area under the curve (AUC) analysis. This analysis showed that the relative post-exercise CTX response was significantly lower in the MILK compared to the CHO condition (p = 0.03), with no differences observed in the other biomarkers. These results show that while milk does not appear to alter absolute concentrations of bone biomarkers compared to CHO, it may attenuate relative post-exercise bone resorption (i.e., blunt the usual catabolic response to exercise).
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Affiliation(s)
- Joel L. Prowting
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Lauren E. Skelly
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Nigel Kurgan
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Faculty of Applied Health Sciences, Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - Emily C. Fraschetti
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Panagiota Klentrou
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Faculty of Applied Health Sciences, Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
| | - Andrea R. Josse
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
- Department of Kinesiology, Faculty of Applied Health Sciences, Brock University, St. Catharines, ON, Canada
- Faculty of Applied Health Sciences, Centre for Bone and Muscle Health, Brock University, St. Catharines, ON, Canada
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28
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Schou A, Jørgensen NR, Maro VP, Kilonzo K, Ramaiya K, Sironga J, Jensen AK, Christensen DL, Schwarz P. The circadian rhythm of calcium and bone homeostasis in Maasai. Am J Hum Biol 2022; 34:e23756. [PMID: 35481615 PMCID: PMC9539595 DOI: 10.1002/ajhb.23756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Revised: 04/04/2022] [Accepted: 04/13/2022] [Indexed: 11/09/2022] Open
Abstract
OBJECTIVES Ethnic groups differ in prevalence of calcium-related diseases. Differences in the physiology and the endogenous circadian rhythm (CR) of calcium and bone homeostasis may play a role. Thus, we aimed to investigate details of CR pattern in calcium and bone homeostasis in East African Maasai. METHODS Ten clinically healthy adult Maasai men and women from Tanzania were examined. Blood samples were collected every 2nd hour for 24 h. Serum levels of total calcium, albumin, parathyroid hormone (PTH), 25(OH)D, creatinine, C-terminal telopeptide (CTX), bone-specific alkaline phosphatase (BSAP), procollagen type 1 N-terminal propeptide (P1NP), and osteocalcin were measured. Circadian patterns were derived from graphic curves of medians, and rhythmicity was assessed with Fourier analysis. RESULTS PTH-levels varied over the 24 h exhibiting a bimodal pattern. Nadir level corresponded to 65% of total 24-h mean. CTX and P1NP showed 24-h variations with a morning nadir and nocturnal peak with nadir levels corresponding to 23% and 79% of the 24-h mean, respectively. Albumin-corrected calcium level was held in a narrow range and alterations were corresponding to alterations in PTH. There was no distinct pattern in 24-h variations of 25(OH)D, creatinine, osteocalcin, or BSAP. CONCLUSIONS All participants showed pronounced 24-h variations in PTH and bone turnover markers CTX and P1NP. These findings support that Maasai participants included in this study have typical patterns of CR in calcium and bone homeostasis consistent with findings from other ethnic populations.
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Affiliation(s)
- Anne Schou
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark
| | - Niklas Rye Jørgensen
- Department of Clinical Biochemistry, Rigshospitalet Glostrup, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Venance Phillip Maro
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Kajiru Kilonzo
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Kaushik Ramaiya
- Department of Internal Medicine, Shree Hindu Mandal Hospital, Dar es Salaam, Tanzania
| | - Joseph Sironga
- Department of Internal Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.,Department of Internal Medicine, Monduli District Hospital, Monduli, Tanzania
| | - Andreas Kryger Jensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dirk Lund Christensen
- Department of Public Health, Global Health Section, University of Copenhagen, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter Schwarz
- Diabetes and Bone-Metabolic Research Unit, Department of Endocrinology, Rigshospitalet, Copenhagen, Denmark.,Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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29
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Borgen TT, Solberg LB, Lauritzen T, Apalset EM, Bjørnerem Å, Eriksen EF. Target Values and Daytime Variation of Bone Turnover Markers in Monitoring Osteoporosis Treatment after Fractures. JBMR Plus 2022; 6:e10633. [PMID: 35720666 PMCID: PMC9189911 DOI: 10.1002/jbm4.10633] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 04/14/2022] [Accepted: 04/19/2022] [Indexed: 11/06/2022] Open
Abstract
The serum bone turnover markers (BTM) procollagen type 1 N‐terminal propeptide (P1NP) and C‐terminal cross‐linking telopeptide of type 1 collagen (CTX) are recommended for monitoring adherence and response of antiresorptive drugs (ARD). BTM are elevated about 1 year after fracture and therefore BTM target values are most convenient in ARD treatment follow‐up of fracture patients. In this prospective cohort study, we explored the cut‐off values of P1NP and CTX showing the best discriminating ability with respect to adherence and treatment effects, reflected in bone mineral density (BMD) changes. Furthermore, we explored the ability of BTM to predict subsequent fractures and BTM variation during daytime in patients using ARD or not. After a fragility fracture, 228 consenting patients (82.2% women) were evaluated for ARD indication and followed for a mean of 4.6 years (SD 0.5 years). BMD was measured at baseline and after 2 years. Serum BTM were measured after 1 or 2 years. The largest area under the curve (AUC) for discrimination of patients taking ARD or not was shown for P1NP <30 μg/L and CTX <0.25 μg/L. AUC for discrimination of patients with >2% gain in BMD (lumbar spine and total hip) was largest at cut‐off values for P1NP <30 μg/L and CTX <0.25 μg/L. Higher P1NP was associated with increased fracture risk in patients using ARD (hazard ratio [HR]logP1NP = 15.0; 95% confidence interval [CI] 2.7–83.3), p = 0.002. P1NP and CTX were stable during daytime, except in those patients not taking ARD, where CTX decreased by 21% per hour during daytime. In conclusion, P1NP <30 μg/L and CTX <0.25 μg/L yield the best discrimination between patients taking and not taking ARD and the best prediction of BMD gains after 2 years. Furthermore, higher P1NP is associated with increased fracture risk in patients on ARD. BTM can be measured at any time during the day in patients on ARD. © 2022 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)
- Tove T Borgen
- Department of Rheumatology Vestre Viken Hospital Trust, Drammen Hospital Drammen Norway
| | - Lene B Solberg
- Division of Orthopedic Surgery Oslo University Hospital Oslo Norway
| | - Trine Lauritzen
- Department of Laboratory Medicine Vestre Viken Hospital Trust, Drammen Hospital Drammen Norway
- Department of Clinical Medicine University of Oslo Oslo Norway
| | - Ellen M. Apalset
- Bergen group of Epidemiology and Biomarkers in Rheumatic Disease, Department of Rheumatology Haukeland University Hospital Bergen Norway
- Department of Global Public Health and Primary Care University of Bergen Bergen Norway
| | - Åshild Bjørnerem
- Department of Clinical Medicine UiT ‐ The Arctic University of Norway Tromsø Norway
- Department of Obstetrics and Gynecology University Hospital of North Norway Tromsø Norway
- Norwegian Research Centre for Women's Health, Oslo University Hospital Oslo Norway
| | - Erik F Eriksen
- Department of Endocrinology Morbid Obesity and Preventive Medicine, Oslo University Hospital Oslo Norway
- Department of Odontology University of Oslo Oslo Norway
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Li W, Lai K, Chopra N, Zheng Z, Das A, Diwan AD. Gut-disc axis: A cause of intervertebral disc degeneration and low back pain? 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 2022; 31:917-925. [PMID: 35286474 DOI: 10.1007/s00586-022-07152-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 01/29/2022] [Accepted: 02/10/2022] [Indexed: 02/07/2023]
Abstract
PURPOSE Low back pain (LBP), a widely prevalent and costly disease around the world, is mainly caused by intervertebral disc (IVD) degeneration (IDD). Although numerous factors may trigger this degenerative process, microbiome dysbiosis has recently been implicated as one of the likely causes. However, the exact relationship between the microbiome and IDD is not well understood. This review summarizes the potential mechanisms and discusses microbiome dysbiosis's possible influence on IDD and LBP. METHODS Prospective literature review. RESULTS Alterations in microbiome composition and host responses to the microbiota causing pathological bone development and involution, led to the concept of gut-bone marrow axis and gut-bone axis. Moreover, the concept of the gut-disc axis was also proposed to explain the microbiome's role in IDD and LBP. According to the existing evidence, the microbiome could be an important factor for inducing and aggravating IDD through changing or regulating the outside and inside microenvironment of the IVD. Three potential mechanisms by which the gut microbiota can induce IVD and cause LBP are: (1) translocation of the bacteria across the gut epithelial barrier and into the IVD, (2) regulation of the mucosal and systemic immune system, and (3) regulation of nutrient absorption and metabolites formation at the gut epithelium and its diffusion into the IVD. Furthermore, to investigate whether IVD is initiated by pathogenic bacteria and establish the correlation between the presence of certain microbial groups with the disease in question, microbiome diversity analysis based on16S rRNA data can be used to characterise stool/blood microbiota from IVD patients. CONCLUSION Future studies on microbiome, fungi and viruses in IDD is necessary to revolutionize our thinking about their possible role in the development of IVD diseases. Furthermore, we believe that inflammation inhibition and interruption of amplification of cascade reaction in IVD by targeting the gut and IVD microbiome is worthwhile for the treatment of IDD and LBP. LEVEL OF EVIDENCE I Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.
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Affiliation(s)
- Wentian Li
- Spine Labs, St. George & Sutherland Clinical School, University of New South Wales, Kogarah, NSW, 2217, Australia
| | - Kaitao Lai
- Charles Perkins Centre, School of Medical Sciences, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Neha Chopra
- Spine Service, St. George Private Hospital, Kogarah, NSW, 2217, Australia
| | - Zhaomin Zheng
- Spine Labs, St. George & Sutherland Clinical School, University of New South Wales, Kogarah, NSW, 2217, Australia
- Department of Spine Surgery, The First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Abhirup Das
- Spine Labs, St. George & Sutherland Clinical School, University of New South Wales, Kogarah, NSW, 2217, Australia.
- Spine Service, St. George Private Hospital, Kogarah, NSW, 2217, Australia.
| | - Ashish D Diwan
- Spine Labs, St. George & Sutherland Clinical School, University of New South Wales, Kogarah, NSW, 2217, Australia
- Spine Service, St. George Private Hospital, Kogarah, NSW, 2217, Australia
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Sheftel CM, Sartori LC, Hunt ER, Manuel RSJ, Bell AM, Domingues RR, Wake LA, Scharpf BR, Vezina CM, Charles JF, Hernandez LL. Peripartal treatment with low-dose sertraline accelerates mammary gland involution and has minimal effects on maternal and offspring bone. Physiol Rep 2022; 10:e15204. [PMID: 35234346 PMCID: PMC8889862 DOI: 10.14814/phy2.15204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022] Open
Abstract
Women mobilize up to 10% of their bone mass during lactation to provide milk calcium. About 8%–13% of mothers use selective serotonin reuptake inhibitors (SSRI) to treat peripartum depression, but SSRIs independently decrease bone mass. Previously, peripartal use of the SSRI fluoxetine reduced maternal bone mass sustained post‐weaning and reduced offspring bone length. To determine whether these effects were fluoxetine‐specific or consistent across SSRI compounds, we examined maternal and offspring bone health using the most prescribed SSRI, sertraline. C57BL/6 mice were given 10 mg/kg/day sertraline, from the beginning of pregnancy through the end of lactation. Simultaneously, we treated nulliparous females on the same days as the primiparous groups, resulting in age‐matched nulliparous groups. Dams were euthanized at lactation day 10 (peak lactation, n = 7 vehicle; n = 9 sertraline), lactation day 21 (weaning, n = 9 vehicle; n = 9 sertraline), or 3m post‐weaning (n = 10 vehicle; n = 10 sertraline) for analysis. Offspring were euthanized at peak lactation or weaning for analysis. We determined that peripartum sertraline treatment decreased maternal circulating calcium concentrations across the treatment period, which was also seen in nulliparous treated females. Sertraline reduced the bone formation marker, procollagen 1 intact N‐terminal propeptide, and tended to reduce maternal BV/TV at 3m post‐weaning but did not impact maternal or offspring bone health otherwise. Similarly, sertraline did not reduce nulliparous female bone mass. However, sertraline reduced immunofluorescence staining of the tight junction protein, zona occludens in the mammary gland, and altered alveoli morphology, suggesting sertraline may accelerate mammary gland involution. These findings indicate that peripartum sertraline treatment may be a safer SSRI for maternal and offspring bone rather than fluoxetine.
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Affiliation(s)
- Celeste M Sheftel
- Molecular and Cellular Pharmacology Training Program, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Luma C Sartori
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emily R Hunt
- Department of Orthopedic Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Robbie S J Manuel
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Autumn M Bell
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Rafael R Domingues
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Lella A Wake
- Department of Orthopedic Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Brandon R Scharpf
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Chad M Vezina
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julia F Charles
- Department of Orthopedic Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Laura L Hernandez
- Molecular and Cellular Pharmacology Training Program, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Stunes AK, Brobakken CL, Sujan MAJ, Aagård N, Brevig MS, Wang E, Syversen U, Mosti MP. Acute Effects of Strength and Endurance Training on Bone Turnover Markers in Young Adults and Elderly Men. Front Endocrinol (Lausanne) 2022; 13:915241. [PMID: 35846315 PMCID: PMC9279869 DOI: 10.3389/fendo.2022.915241] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
CONTEXT Exercise is recognized as an important strategy to prevent bone loss, but its acute effects on bone turnover markers (BTMs) and related markers remain uncertain. OBJECTIVE To assess the acute effects of two different exercise modes on BTMs and related markers in young adults of both sexes and elderly men. DESIGN SETTING PARTICIPANTS This was a three-group crossover within-subjects design study with a total of 53 participants-19 young women (aged 22-30), 20 young men (aged 21-30 years), and 14 elderly men (aged 63-74 years)-performing two different exercise sessions [strength training (ST) and high-intensity interval training (HIIT)] separated by 2 weeks, in a supervised laboratory setting. MAIN OUTCOME MEASURES Plasma volume-corrected serum measurements of the BTMs C-terminal telopeptide of type 1 collagen (CTX-I) and procollagen of type 1 N-terminal propeptide (P1NP), total osteocalcin (OC), sclerostin, and lipocalin-2 (LCN2) at baseline, immediately after, and 3 and 24 h after each of the two exercise modes were performed. RESULTS AND CONCLUSION Analyses revealed sex- and age-dependent differences in BTMs and related bone markers at baseline and time-, sex-, and age-dependent differences in response to exercise. No differences between exercise modes were observed for BTM response except for sclerostin in young men and LCN2 in elderly men. An acute, transient, and uniform increase in P1NP/CTX-1 ratio was found in young participants, demonstrating that beneficial skeletal effects on bone metabolism can be attained through both aerobic endurance and resistance exercise, although this effect seems to be attenuated with age. The acute effects of exercise on bone-related biomarkers were generally blunted after 24 h, suggesting that persistent alterations following prolonged exercise interventions should be assessed at later time points.
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Affiliation(s)
- Astrid Kamilla Stunes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Clinic, St. Olavs University Hospital, Trondheim, Norway
- *Correspondence: Astrid Kamilla Stunes, orcid.org/0000-0003-1074-5199
| | - Cathrine Langlie Brobakken
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Md Abu Jafar Sujan
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Norun Aagård
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Myworkout, Medical Rehabilitation Clinic, Trondheim, Norway
| | - Martin Siksjø Brevig
- Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Eivind Wang
- Faculty of Health and Social Sciences, Molde University College, Molde, Norway
- Department of Psychosis and Rehabilitation, Psychiatry Clinic, St. Olavs University Hospital, Trondheim, Norway
| | - Unni Syversen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Endocrinology, St. Olavs University Hospital, Trondheim, Norway
| | - Mats Peder Mosti
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Medical Clinic, St. Olavs University Hospital, Trondheim, Norway
- Department of Research and Development, Clinic of Substance Use and Addiction Medicine, St. Olavs University Hospital, Trondheim, Norway
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Kloukos D, Mavrogonatou E, Kletsas D, Makras P, Koukos G, Stavropoulos A, Katsaros C. Bone turnover markers in gingival crevicular fluid and blood serum of patients with fixed orthodontic appliances. Eur J Orthod 2021; 44:412-419. [PMID: 34878106 DOI: 10.1093/ejo/cjab077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
AIM Bone remodelling can be followed through the bone turnover markers (BTMs). Aim of the present study was to record the fluctuation of an osteoclastic and an osteoblastic BTM [C-terminal telopeptide of type I collagen (CTX) and N-terminal pro-peptide of type I pro-collagen (PINP), respectively] in both the gingival crevicular fluid (GCF) and the serum of orthodontic patients before and after the initial application of orthodontic forces. MATERIALS AND METHODS Twenty-one Caucasian patients were prospectively evaluated. GCF and blood samples were collected in order to measure the selected biomarkers by ELISA at three time-points: exactly before, 5 days, and 14 days after bonding of the appliances. Standardized sample handling and patient preparation procedures were adopted in order to reduce pre-analytical variability. RESULTS GCF and serum CTX levels were found to be independent of age, although higher in the serum of female subjects. PINP levels were found higher in the serum of patients ≥25 years old, as well as in the GCF of males. A positive correlation between serum and GCF baseline PINP levels was observed. LIMITATIONS The effect of orthodontic treatment on bone remodelling might not be absolutely representative of the local bone microenvironment as the levels of the specific BTMs where measured within the GCF of the lower front teeth. CONCLUSIONS This is the first time PINP and CTX have been evaluated in the GCF and serum of orthodontic patients with fixed appliances. No statistically significant alterations of CTX and PINP levels in the GCF and the serum of patients were recorded over time during the initial stages of orthodontic treatment.
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Affiliation(s)
- Dimitrios Kloukos
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland.,Department of Orthodontics and Dentofacial Orthopedics, 251 Hellenic Air Force & VA General Hospital, Athens, Greece.,Department of Periodontology, Faculty of Odontology, Malmö University, Sweden
| | - Eleni Mavrogonatou
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences & Applications, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Dimitris Kletsas
- Laboratory of Cell Proliferation and Ageing, Institute of Biosciences & Applications, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Polyzois Makras
- Department of Endocrinology and Diabetes, 251 Hellenic Air Force & VA General Hospital, Athens, Greece.,Department of Medical Research, 251 Hellenic Air Force & VA General Hospital, Athens, Greece
| | - George Koukos
- Department of Periodontology, 251 Hellenic Air Force & VA General Hospital, Athens, Greece
| | - Andreas Stavropoulos
- Department of Periodontology, Faculty of Odontology, Malmö University, Sweden.,Division of Conservative Dentistry and Periodontology, University Clinic of Dentistry, Medical University of Vienna, Vienna, Austria
| | - Christos Katsaros
- Department of Orthodontics and Dentofacial Orthopedics, University of Bern, Switzerland
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Martínez-Noguera FJ, Alcaraz PE, Ortolano-Ríos R, Dufour S, Marín-Pagán C. Professional cyclists have lower levels of bone markers than amateurs. Is there a risk of osteoporosis in cyclist? Bone 2021; 153:116102. [PMID: 34245935 DOI: 10.1016/j.bone.2021.116102] [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: 02/07/2021] [Revised: 06/02/2021] [Accepted: 06/30/2021] [Indexed: 10/20/2022]
Abstract
Currently, there is a greater number of amateurs that practice cycling. However, there is no clear evidence regarding bone health in amateur cyclists compared to professional cyclists, as the latter has shown to have lower bone mineral content and density. Therefore, the aim of this study was to identify the differences in bone variables between professional (PRO) and amateur (AMA) road cyclists, and to see if these differences were related to differences in cycling performance. A parallel trial was carried out with 15 AMA and 10 PRO cyclists. All cyclists visited the laboratory twice: 1) in a fasted state, body composition measured by dual-energy X-ray absorptiometry (DXA) and 2) physiological variables measured using an incremental test until exhaustion. Significantly lower values were found in bone mineral density, bone mineral content and fat free mass in PRO compared to AMA (p < 0.05). In addition, significantly higher power was produced in ventilatory thresholds 1 and 2 (VT1 and VT2) and VO2MAX in PRO compared to AMA (p < 0.05). Overall, PRO cyclists had lower values in bone health and muscle mass but better results in performance compared to AMA.
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Affiliation(s)
| | - Pedro E Alcaraz
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain.
| | - Raquel Ortolano-Ríos
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain
| | - Stéphane Dufour
- University of Strasbourg, Faculty of Medicine, Translational Medicine Federation (FMTS), UR 3072, France; University of Strasbourg, Faculty of Sport Sciences, France.
| | - Cristian Marín-Pagán
- Research Center for High Performance Sport, Catholic University of Murcia, Murcia, Spain.
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Abstract
Bone fragility fractures remain an important worldwide health and economic problem due to increased morbidity and mortality. The current methods for predicting fractures are largely based on the measurement of bone mineral density and the utilization of mathematical risk calculators based on clinical risk factors for bone fragility. Despite these approaches, many bone fractures remain undiagnosed. Therefore, current research is focused on the identification of new factors such as bone turnover markers (BTM) for risk calculation. BTM are a group of proteins and peptides released during bone remodeling that can be found in serum or urine. They derive from bone resorptive and formative processes mediated by osteoclasts and osteoblasts, respectively. Potential use of BTM in monitoring these phenomenon and therefore bone fracture risk is limited by physiologic and pathophysiologic factors that influence BTM. These limitations in predicting fractures explain why their inclusion in clinical guidelines remains limited despite the large number of studies examining BTM.
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Affiliation(s)
- Lisa Di Medio
- Department of Surgery and Translational Medicine, University Hospital of Florence, Florence, Italy.
| | - Maria Luisa Brandi
- Department of Surgery and Translational Medicine, University Hospital of Florence, Florence, Italy
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Zheng Q, Kernozek T, Daoud-Gray A, Borer KT. Anabolic Bone Stimulus Requires a Pre-Exercise Meal and 45-Minute Walking Impulse of Suprathreshold Speed-Enhanced Momentum to Prevent or Mitigate Postmenopausal Osteoporosis within Circadian Constraints. Nutrients 2021; 13:nu13113727. [PMID: 34835982 PMCID: PMC8620686 DOI: 10.3390/nu13113727] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 01/22/2023] Open
Abstract
Osteoporosis currently afflicts 8 million postmenopausal women in the US, increasing the risk of bone fractures and morbidity, and reducing overall quality of life. We sought to define moderate exercise protocols that can prevent postmenopausal osteoporosis. Our previous findings singled out higher walking speed and pre-exercise meals as necessary for suppression of bone resorption and increasing of markers of bone formation. Since both studies were amenable to alternate biomechanical, nutritional, and circadian interpretations, we sought to determine the relative importance of higher speed, momentum, speed-enhanced load, duration of impulse, and meal timing on osteogenic response. We hypothesized that: (1) 20 min of exercise one hour after eating is sufficient to suppress bone resorption as much as a 40-min impulse and that two 20 min exercise bouts separated by 7 h would double the anabolic effect; (2) early morning exercise performed after eating will be as effective as mid-day exercise for anabolic outcome; and (3) the 08:00 h 40-min. exercise uphill would be as osteogenic as the 40-min exercise downhill. Healthy postmenopausal women, 8 each, were assigned to a no-exercise condition (SED) or to 40- or 20-min exercise bouts, spaced 7 h apart, for walking uphill (40 Up and 20 Up) or downhill (40 Down and 20 Down) to produce differences in biomechanical variables. Exercise was initiated at 08:00 h one hour after eating in 40-min groups, and also 7 h later, two hours after the midday meal, in 20-min groups. Measurements were made of CICP (c-terminal peptide of type I collagen), osteocalcin (OC), and bone-specific alkaline phosphatase (BALP), markers of bone formation, and of the bone resorptive marker CTX (c-terminal telopeptide of type 1 collagen). The osteogenic ratios CICP/CTX, OC/CTX, and BALP/CTX were calculated. Only the 40-min downhill exercise of suprathreshold speed-enhanced momentum, increased the three osteogenic ratios, demonstrating the necessity of a 40-min, and inadequacy of a 20-min, exercise impulse. The failure of anabolic outcome in 40-min uphill exercise was attributed to a sustained elevation of PTH concentration, as its high morning elevation enhances the CTX circadian rhythm. We conclude that postmenopausal osteoporosis can be prevented or mitigated in sedentary women by 45 min of morning exercise of suprathreshold speed-enhanced increased momentum performed shortly after a meal while walking on level ground, or by 40-min downhill, but not 40-min uphill, exercise to avoid circadian PTH oversecretion. The principal stimulus for the anabolic effect is exercise, but the prerequisite for a pre-exercise meal demonstrates the requirement for nutrient facilitation.
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Affiliation(s)
- Qingyun Zheng
- School of Kinesiology, The University of Michigan, Ann Arbor, MI 48109, USA; (A.D.-G.); (K.T.B.)
- School of Physical Education, Henan University, Kaifeng 475004, China
- Correspondence: ; Tel.: +86-138-4915-1204
| | - Thomas Kernozek
- Physical Therapy Program, Department of Health Professions, University of Wisconsin-La Crosse, La Crosse, WI 54601, USA;
| | - Adam Daoud-Gray
- School of Kinesiology, The University of Michigan, Ann Arbor, MI 48109, USA; (A.D.-G.); (K.T.B.)
| | - Katarina T. Borer
- School of Kinesiology, The University of Michigan, Ann Arbor, MI 48109, USA; (A.D.-G.); (K.T.B.)
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Vatrasresth J, Suwan A, Panyakhamlerd K. Effects of early estradiol valerate administration on bone turnover markers in surgically induced menopausal women. BMC WOMENS HEALTH 2021; 21:363. [PMID: 34645447 PMCID: PMC8515676 DOI: 10.1186/s12905-021-01508-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 10/05/2021] [Indexed: 03/20/2023]
Abstract
Background Compared with a natural process, surgically induced menopausal women have a higher bone loss rate. This study aims to evaluate early treatment with estradiol valerate on bone turnover markers after surgically induced menopause. Methods This prospective study included 41 pre and perimenopausal women who underwent hysterectomy with oophorectomy for benign gynecologic conditions. Two weeks after the operation, all participants were assessed for menopausal hormone therapy (MHT) indications. Estrogen therapy was prescribed for those who had indications and accepted treatment (hormone treatment group). The others who had no MHT indication were allocated to the no-treatment group. Serum CTX and P1NP levels at preoperative and 12 weeks postoperative were measured and set as the primary outcome. Within the same group, serum CTX and P1NP before and after surgical menopause were analyzed using Wilcoxon signed-rank test. ANCOVA was used to compare serum CTX and P1NP at 12 weeks after surgical menopause between the two groups. Spearman's rank correlation coefficient analysis analyzed the correlation between age and baseline bone turnover markers. A p-value of < 0.05 was considered statistically significant. Results At 12 weeks after surgery, there were no significant differences in serum CTX and P1NP levels in the hormone treatment group compared to baseline. In contrast, serum CTX and P1NP levels were significantly elevated among women who did not receive hormone treatment (p-value < 0.001 and 0.002, respectively). Serum CTX and P1NP at 12 weeks were significantly different between the two groups (p-value < 0.001 and 0.004, respectively). Conclusion Early estrogen administration with oral estradiol valerate could significantly suppress the high bone remodeling in surgically induced menopausal women. Trial registration Thai Clinical Trial Registry identification number TCTR20190808004, retrospective registered since 2019-08-08. http://www.thaiclinicaltrials.org/show/TCTR20190808004.
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Affiliation(s)
- Jarika Vatrasresth
- Reproductive Medicine Division, Departments of Obstetrics and Gynecology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 Rama IV Rd. Pathum Wan, Pathum Wan District, Bangkok, 10330, Thailand
| | - Ammarin Suwan
- Reproductive Medicine Division, Departments of Obstetrics and Gynecology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 Rama IV Rd. Pathum Wan, Pathum Wan District, Bangkok, 10330, Thailand. .,Gender, Sexual and Climacteric Medicine Division, Departments of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand.
| | - Krasean Panyakhamlerd
- Reproductive Medicine Division, Departments of Obstetrics and Gynecology, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Chulalongkorn University, 1873 Rama IV Rd. Pathum Wan, Pathum Wan District, Bangkok, 10330, Thailand.,Gender, Sexual and Climacteric Medicine Division, Departments of Obstetrics and Gynecology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Center of Excellence in Transgender Health, Chulalongkorn University, Bangkok, Thailand
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Associations between Postprandial Gut Hormones and Markers of Bone Remodeling. Nutrients 2021; 13:nu13093197. [PMID: 34579074 PMCID: PMC8467604 DOI: 10.3390/nu13093197] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 09/06/2021] [Accepted: 09/10/2021] [Indexed: 01/31/2023] Open
Abstract
Gut-derived hormones have been suggested to play a role in bone homeostasis following food intake, although the associations are highly complex and not fully understood. In a randomized, two-day cross-over study on 14 healthy individuals, we performed postprandial time-course studies to examine the associations of the bone remodeling markers carboxyl-terminal collagen type I crosslinks (CTX) and procollagen type 1 N-terminal propeptide (P1NP) with the gut hormones glucose-dependent insulinotropic polypeptide (GIP), glucagon-like peptide 1 (GLP-1), and peptide YY (PYY) using two different meal types-a standardized mixed meal (498 kcal) or a granola bar (260 kcal). Plasma concentrations of total GIP, total GLP-1, total PYY, CTX, and P1NP were measured up to 240 min after meal intake, and the incremental area under the curve (iAUC) for each marker was calculated. The iAUC of CTX and P1NP were used to assess associations with the iAUC of GIP, GLP-1, and PYY in linear mixed effect models adjusted for meal type. CTX was positively associated with GIP and GLP-1, and it was inversely associated with PYY (all p < 0.001). No associations of P1NP with GIP or GLP-1 and PYY were found. In conclusion, the postprandial responses of the gut hormones GIP, GLP-1, and PYY are associated with the bone resorption marker CTX, supporting a link between gut hormones and bone homeostasis following food intake.
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Proia P, Amato A, Drid P, Korovljev D, Vasto S, Baldassano S. The Impact of Diet and Physical Activity on Bone Health in Children and Adolescents. Front Endocrinol (Lausanne) 2021; 12:704647. [PMID: 34589054 PMCID: PMC8473684 DOI: 10.3389/fendo.2021.704647] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 08/13/2021] [Indexed: 12/15/2022] Open
Abstract
There is growing recognition of the role of diet and physical activity in modulating bone mineral density, bone mineral content, and remodeling, which in turn can impact bone health later in life. Adequate nutrient composition could influence bone health and help to maximize peak bone mass. Therefore, children's nutrition may have lifelong consequences. Also, physical activity, adequate in volume or intensity, may have positive consequences on bone mineral content and density and may preserve bone loss in adulthood. Most of the literature that exists for children, about diet and physical activity on bone health, has been translated from studies conducted in adults. Thus, there are still many unanswered questions about what type of diet and physical activity may positively influence skeletal development. This review focuses on bone requirements in terms of nutrients and physical activity in childhood and adolescence to promote bone health. It explores the contemporary scientific literature that analyzes the impact of diet together with the typology and timing of physical activity that could be more appropriate depending on whether they are children and adolescents to assure an optimal skeleton formation. A description of the role of parathyroid hormone (PTH) and gut hormones (gastric inhibitory peptide (GIP), glucagon-like peptide (GLP)-1, and GLP-2) as potential candidates in this interaction to promote bone health is also presented.
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Affiliation(s)
- Patrizia Proia
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Alessandra Amato
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Darinka Korovljev
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Sonya Vasto
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
| | - Sara Baldassano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, Palermo, Italy
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Hansen MS, Frost M. Alliances of the gut and bone axis. Semin Cell Dev Biol 2021; 123:74-81. [PMID: 34303607 DOI: 10.1016/j.semcdb.2021.06.024] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 06/27/2021] [Accepted: 06/28/2021] [Indexed: 12/12/2022]
Abstract
Gut hormones secreted from enteroendocrine cells following nutrient ingestion modulate metabolic processes including glucose homeostasis and food intake, and several of these gut hormones are involved in the regulation of the energy demanding process of bone remodelling. Here, we review the gut hormones considered or known to be involved in the gut-bone crosstalk and their role in orchestrating adaptions of bone formation and resorption as demonstrated in cellular and physiological experiments and clinical trials. Understanding the physiology and pathophysiology of the gut-bone axis may identify adverse effects of investigational drugs aimed to treat metabolic diseases such as type 2 diabetes and obesity and new therapeutic candidates for the treatment of bone diseases.
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Affiliation(s)
- Morten Steen Hansen
- Molecular Endocrinology Laboratory (KMEB), Department of Endocrinology, Odense University Hospital, DK-5000 Odense, Denmark
| | - Morten Frost
- Molecular Endocrinology Laboratory (KMEB), Department of Endocrinology, Odense University Hospital, DK-5000 Odense, Denmark.
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Kreitman A, Schneider SH, Hao L, Schlussel Y, Bello NT, Shapses SA. Reduced postprandial bone resorption and greater rise in GLP-1 in overweight and obese individuals after an α-glucosidase inhibitor: a double-blinded randomized crossover trial. Osteoporos Int 2021; 32:1379-1386. [PMID: 33432459 DOI: 10.1007/s00198-020-05791-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Accepted: 12/07/2020] [Indexed: 12/13/2022]
Abstract
UNLABELLED When taken with a meal, α-glucosidase inhibitors (α-GI) reduce the rise in postprandial glucose and increase glucagon-like peptide-1 (GLP-1), and this may lower bone turnover. In this study, a salacinol-type α-GI increased GLP-1 and markedly reduced postprandial bone resorption compared to placebo, suggesting it could have implications for bone health. INTRODUCTION Animal and clinical trials indicate that α-glucosidase inhibitors attenuate postprandial glycemic indices and increase secretion of GLP-1. In addition, GLP-1 acts on bone by inhibiting resorption. The goal in this study was to determine if a salacinol α-GI alters postprandial bone turnover and can be explained by changes in serum GLP-1. METHODS In this double-blind, placebo-controlled crossover study, healthy overweight/obese adults (body mass index 29.0 ± 3.8 kg/m2; 21-59 years; n = 21) received a fixed breakfast and, in random order, were administered Salacia chinensis (SC; 500 mg) or placebo. A fasting blood sample was taken before and at regular intervals for 3 h after the meal. Serum was measured for bone turnover markers, C-terminal telopeptide of type I collagen (CTX) and osteocalcin, and for glycemic indices and gut peptides. RESULTS Compared to placebo, SC attenuated the bone resorption marker, CTX, at 60, 90, and 120 min (p < 0.05) after the meal, and decreased osteocalcin, at 180 min (p < 0.05). As expected, SC attenuated the postprandial rise in glucose compared with placebo, whereas GLP-1 was increased at 60 min (p < 0.05) with SC. Serum GLP-1 explained 41% of the variance for change in postprandial CTX (p < 0.05). CONCLUSION This study indicates that attenuating postprandial glycemic indices, with an α-GI, markedly decreases postprandial bone resorption and can be explained by the rise in GLP-1. Future studies should determine whether longer term α-GI use benefits bone health.
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Affiliation(s)
- A Kreitman
- Department of Nutritional Sciences, Rutgers University, 59 Dudley RD, New Brunswick, NJ, 08901, USA
| | - S H Schneider
- Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Rutgers-Robert Wood Johnson University Hospital, New Brunswick, NJ, 08901, USA
- NJ-Institute of Food, Nutrition and Health, New Brunswick, NJ, 08901, USA
| | - L Hao
- Department of Nutritional Sciences, Rutgers University, 59 Dudley RD, New Brunswick, NJ, 08901, USA
- NJ-Institute of Food, Nutrition and Health, New Brunswick, NJ, 08901, USA
| | - Y Schlussel
- Department of Nutritional Sciences, Rutgers University, 59 Dudley RD, New Brunswick, NJ, 08901, USA
| | - N T Bello
- NJ-Institute of Food, Nutrition and Health, New Brunswick, NJ, 08901, USA
- Department of Animal Sciences, Rutgers University, New Brunswick, NJ, 08901, USA
| | - S A Shapses
- Department of Nutritional Sciences, Rutgers University, 59 Dudley RD, New Brunswick, NJ, 08901, USA.
- Department of Medicine, Division of Endocrinology, Metabolism and Nutrition, Rutgers-Robert Wood Johnson University Hospital, New Brunswick, NJ, 08901, USA.
- NJ-Institute of Food, Nutrition and Health, New Brunswick, NJ, 08901, USA.
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Kikuchi W, Ichihara K, Mori K, Shimizu Y. Biological sources of variations of tartrate-resistant acid phosphatase 5b in a healthy Japanese population. Ann Clin Biochem 2021; 58:358-367. [PMID: 33715446 PMCID: PMC8258717 DOI: 10.1177/00045632211003941] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Tartrate-resistant acid phosphatase 5b (TRACP5b) is a bone resorption marker that is mainly used in clinical management of osteoporosis. For proper interpretations of test results for serum TRACP5b, we explored their biological sources of variation, esp. age-related changes, and associations with other bone-related markers in healthy Japanese adults. METHODS During the 2009 East-Southeast Asian multicentre study for determination of reference intervals, 72 major laboratory tests were measured by centralized assays in 3541 well-defined healthy volunteers. The current study included 1980 test results in Japanese subjects for five bone-related markers: TRACP5b, bone alkaline phosphatase, intact parathyroid hormone, calcium and inorganic phosphate. Information on sources of variation, including body mass index, smoking habits and ABO-blood group, were obtained from a health status questionnaire. RESULTS Gender-specific profiles of age-related changes were observed for each parameter. Increased values starting from 40 years of age in females were most prominent for TRACP5b, followed by bone alkaline phosphatase and inorganic phosphate. TRACP5b in males decreased with body mass index, bone alkaline phosphatase and TRACP5b were higher in blood type-O subjects, especially in males. TRACPT5b was closely correlated with bone alkaline phosphatase, and moderately correlated with adjusted calcium and inorganic phosphate, especially in females aged ≥45 years. Reference intervals for each analyte were determined parametrically based on gender and age. CONCLUSIONS This study elucidated sources of variation of TRACP5b and related bone markers in healthy Japanese subjects and demonstrated a specific age profile for each marker. These results are of relevance for better clinical usage and interpretations of serum levels of bone markers.
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Affiliation(s)
- Wataru Kikuchi
- Research and Development Headquarters, Nitto Boseki Co., Ltd, Koriyama, Japan
| | - Kiyoshi Ichihara
- Department of Clinical Laboratory Sciences, Faculty of Health Sciences, Yamaguchi University Graduate School of Medicine, Ube, Japan
| | - Kazuo Mori
- Scientific & Technical Affairs Department, Nittobo Medical Co., Ltd, Tokyo, Japan
| | - Yoshihisa Shimizu
- Department of Medical Life Science, Faculty of Medical Bioscience, Kyushu University of Health and Welfare, Nobeoka, Japan
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Abstract
Bone turnover markers fill a clinical need that improves comprehensive care of metabolic bone health and osteoporosis. Creating a standard process for drawing them that reduces modifiable variability improves their precision and clinical usefulness. Creating a standard process for interpreting them by applying statistical significance improves their clinical applicability. Understanding what causes them to increase and decrease can help elucidate secondary causes of osteoporosis. Monitoring them can assess patient adherence to therapy for a silent disease that will progressively become louder with an aging global population.
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Affiliation(s)
- Sumeet Jain
- Division of Endocrinology and Metabolism, Department of Medicine, Rush University Medical Center, 1725 West Harrison Street, Suite 250, Chicago, IL 60612, USA.
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Donat A, Knapstein PR, Jiang S, Baranowsky A, Ballhause TM, Frosch KH, Keller J. Glucose Metabolism in Osteoblasts in Healthy and Pathophysiological Conditions. Int J Mol Sci 2021; 22:ijms22084120. [PMID: 33923498 PMCID: PMC8073638 DOI: 10.3390/ijms22084120] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 04/11/2021] [Accepted: 04/14/2021] [Indexed: 01/01/2023] Open
Abstract
Bone tissue in vertebrates is essential to performing movements, to protecting internal organs and to regulating calcium homeostasis. Moreover, bone has also been suggested to contribute to whole-body physiology as an endocrine organ, affecting male fertility; brain development and cognition; and glucose metabolism. A main determinant of bone quality is the constant remodeling carried out by osteoblasts and osteoclasts, a process consuming vast amounts of energy. In turn, clinical conditions associated with impaired glucose metabolism, including type I and type II diabetes and anorexia nervosa, are associated with impaired bone turnover. As osteoblasts are required for collagen synthesis and matrix mineralization, they represent one of the most important targets for pharmacological augmentation of bone mass. To fulfill their function, osteoblasts primarily utilize glucose through aerobic glycolysis, a process which is regulated by various molecular switches and generates adenosine triphosphate rapidly. In this regard, researchers have been investigating the complex processes of energy utilization in osteoblasts in recent years, not only to improve bone turnover in metabolic disease, but also to identify novel treatment options for primary bone diseases. This review focuses on the metabolism of glucose in osteoblasts in physiological and pathophysiological conditions.
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Amato A, Proia P, Caldara GF, Alongi A, Ferrantelli V, Baldassano S. Analysis of Body Perception, Preworkout Meal Habits and Bone Resorption in Child Gymnasts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18042184. [PMID: 33672264 PMCID: PMC7926894 DOI: 10.3390/ijerph18042184] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 12/13/2022]
Abstract
The beneficial effects of physical activity on body image perception and bone are debated among artistic gymnasts. Gymnasts seem to be at greater risk of developing body dissatisfaction, eating disorders and osteoporosis due to inadequate nutrition and attention to the appearance of the body. The objective of this work was to investigate the association between the artistic gymnast and a more favorable body image compared to their sedentary peers and if a preworkout high-carbohydrate meal (HCM; 300 kcal, 88% carbohydrates, 9% protein, 3% fat) or high-protein meal (HPM; 300 kcal, 55% carbohydrates, 31% protein, 13% fat) is able to attenuate bone resorption in young rhythmic gymnasts. Twenty-eight preadolescent female gymnasts were examined. Self-esteem tests were used to analyze body image perception. Preworkout eating habits were examined by short food frequency questions (FFQ) validated for children. The biomarker of the bone resorption C-terminal telopeptide region of collagen type 1 (CTX) was measured in the urine (fasting, postmeal and postworkout). Gymnasts reported higher satisfaction with their body appearance compared to sedentary peers. Of the gymnasts, 30% did not have a preworkout meal regularly, and the timing of the consumption was variable. Bone resorption was decreased by the HCM, consumed 90 min before the training, with respect to the HPM. The study suggests that playing artistic gymnastics is associated with a positive body self-perception in a child. The variability in preworkout meal frequency and timing need attention to prevent inadequate eating habits in light of the ability of the HCM to reduce acute bone resorption.
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Affiliation(s)
- Alessandra Amato
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, 90128 Palermo, Italy; (A.A.); (P.P.)
| | - Patrizia Proia
- Department of Psychological, Pedagogical and Educational Sciences, Sport and Exercise Sciences Research Unit, University of Palermo, 90128 Palermo, Italy; (A.A.); (P.P.)
| | - Gaetano Felice Caldara
- Istituto Zooprofilattico Sperimentale della Sicilia, 90129 Palermo, Italy; (G.F.C.); (A.A.); (V.F.)
- Department of Sciences for Health Promotion and Mother and Child Care “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy
| | - Angelina Alongi
- Istituto Zooprofilattico Sperimentale della Sicilia, 90129 Palermo, Italy; (G.F.C.); (A.A.); (V.F.)
| | - Vincenzo Ferrantelli
- Istituto Zooprofilattico Sperimentale della Sicilia, 90129 Palermo, Italy; (G.F.C.); (A.A.); (V.F.)
| | - Sara Baldassano
- Department of Biological, Chemical and Pharmaceutical Sciences and Technologies (STEBICEF), University of Palermo, 90128 Palermo, Italy
- Correspondence:
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Gillett MJ, Vasikaran SD, Inderjeeth CA. The Role of PINP in Diagnosis and Management of Metabolic Bone Disease. Clin Biochem Rev 2021; 42:3-10. [PMID: 34305208 PMCID: PMC8252919 DOI: 10.33176/aacb-20-0001] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Serum procollagen type I N-propeptide (PINP) is designated the reference marker of bone formation in osteoporosis; the reference marker for resorption is C-terminal telopeptide of type I collagen (CTX). PINP has very low circadian and biological variation, is not affected by food intake, and is very stable in serum after venepuncture. The two automated commercial assays for PINP provide similar results in subjects with normal renal function, allowing reference intervals to be used interchangeably. Bone turnover markers (BTM) are currently not recommended for fracture risk assessment and therefore not included in fracture risk calculators. In the management of osteoporosis, the main utility of BTM including PINP is for monitoring therapy, both antiresorptive as well as anabolic agents; monitoring is thought to help improve adherence. PINP as well as CTX may also be used in assessing offset of drug action following a pause in bisphosphonate therapy, to help decide when to re-instate therapy, or following cessation of denosumab therapy to assess efficacy of follow-on bisphosphonate therapy. PINP may also be used in the diagnosis of Paget's disease of bone as well as in monitoring response to therapy and for recurrence. Although BTM other than bone alkaline phosphatase are currently not recommended for use in metabolic bone disease of chronic kidney disease, PINP measured by assays specific to the intact molecule has potential in this condition. Further studies are needed to examine this area, as well as in malignant bone disease.
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Affiliation(s)
- Melissa J Gillett
- Department of Clinical Biochemistry, PathWest Fiona Stanley Hospital, Murdoch, WA 6150
- Western Diagnostic Pathology, Jandakot, WA 6164
| | - Samuel D Vasikaran
- Department of Clinical Biochemistry, PathWest Fiona Stanley Hospital, Murdoch, WA 6150
| | - Charles A Inderjeeth
- Medical School, University Western Australia, Nedlands, WA 6009
- Departments of Geriatric Medicine and Rheumatology, North Metropolitan Health Service, Nedlands, WA 6009, Australia
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Lauterlein JJL, Hermann P, Konrad T, Wolf P, Nilsson P, Sánchez RG, Ferrannini E, Balkau B, Højlund K, Frost M. Serum sclerostin and glucose homeostasis: No association in healthy men. Cross-sectional and prospective data from the EGIR-RISC study. Bone 2021; 143:115681. [PMID: 33035729 DOI: 10.1016/j.bone.2020.115681] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 01/24/2023]
Abstract
INTRODUCTION Sclerostin, an inhibitor of bone formation, has emerged as a potential negative regulator of glucose homeostasis. We aimed to investigate if serum sclerostin associates with insulin sensitivity, beta cell function, prediabetes or metabolic syndrome in healthy men. MATERIALS AND METHODS Serum sclerostin was measured in basal and insulin-stimulated samples from 526 men without diabetes from the RISC cohort study. An OGTT was performed at baseline and after 3 years. An IVGTT and a hyperinsulinaemic-euglycaemic clamp were performed at baseline. Insulin sensitivity was estimated by the oral glucose sensitivity index (OGIS) and the M-value relative to insulin levels. Beta cell function was assessed by the acute and total insulin secretion (ISRtot) and by beta cell glucose sensitivity. RESULTS Serum sclerostin levels correlated positively with age but were similar in individuals with (n = 69) and without (n = 457) prediabetes or the metabolic syndrome. Serum sclerostin was associated with measures of neither insulin sensitivity nor beta cell function at baseline in age-adjusted analyses including all participants. However, baseline serum sclerostin correlated inversely with OGIS at follow-up in men without prediabetes (B: -0.29 (-0.57, -0.01) p = 0.045), and inversely with beta cell glucose sensitivity in men with prediabetes (B: -13.3 (-26.3, -0.2) p = 0.046). Associations between serum sclerostin and 3-year changes in measures of glucose homeostasis were not observed. Acute hyperinsulinemia suppressed serum sclerostin (p = 0.02), and this reduction correlated with OGIS and ISRtot. CONCLUSIONS Overall, serum sclerostin was not associated with prediabetes, insulin sensitivity or insulin secretion in healthy men. The inverse relationship between serum sclerostin and insulin sensitivity at follow-up was weak and likely not of clinical relevance. The ability of insulin to reduce sclerostin, possibly promoting bone formation, needs to be clarified.
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Affiliation(s)
| | - Pernille Hermann
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Thomas Konrad
- Institute for Metabolic Research, Goethe University, Frankfurt am Main, Germany
| | - Peter Wolf
- Division of Endocrinology and Metabolism, Department of Internal Medicine III, Medical University of Vienna, Austria
| | - Peter Nilsson
- Department of Clinical Sciences, Clinical Research Center, Lund University, Malmö, Sweden; Department of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | | | | | - Beverley Balkau
- Clinical Epidemiology, Université Paris-Saclay, UVSQ, Inserm, CESP, 94807 Villejuif, France
| | - Kurt Højlund
- Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
| | - Morten Frost
- Department of Endocrinology, Odense University Hospital, Odense, Denmark; Steno Diabetes Centre Odense, Odense University Hospital, Odense, Denmark
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Dolan E, Dumas A, Keane KM, Bestetti G, Freitas LHM, Gualano B, Kohrt W, Kelley GA, Pereira RMR, Sale C, Swinton P. The influence of acute exercise on bone biomarkers: protocol for a systematic review with meta-analysis. Syst Rev 2020; 9:291. [PMID: 33308281 PMCID: PMC7733242 DOI: 10.1186/s13643-020-01551-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 11/30/2020] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Bone is a plastic tissue that is responsive to its physical environment. As a result, exercise interventions represent a potential means to influence the bone. However, little is currently known about how various exercise and participant characteristics interact to influence bone metabolism. Acute, controlled, interventions provide an in vivo model through which the acute bone response to exercise can be investigated, typically by monitoring circulating bone biomarkers. Currently, substantial heterogeneity in factors such as study design, quality, exercise, and participant characteristics render it difficult to synthesize and evaluate the available evidence. Using a systematic review and meta-analytic approach, the aim of this investigation is to quantify the effect of an acute exercise bout on circulating bone biomarkers as well as examine the potential factors that may moderate this response, e.g., variation in participant, exercise, and sampling characteristics. METHODS This protocol was designed in accordance with the PRISMA-P guidelines. Seven databases (MEDLINE, Embase, Sport Discus, Cochrane CENTRAL, PEDro, LILACS, and Ibec) will be systematically searched and supplemented by a secondary screening of the reference lists of all included articles. The PICOS (Population, Intervention, Comparator, Outcomes and Study Design) approach was used to guide the determination of the eligibility criteria. Participants of any age, sex, training, or health status will be considered for inclusion. We will select studies that have measured the bone biomarker response before and after an acute exercise session. All biomarkers considered to represent the bone metabolism will be considered for inclusion, and sensitivity analyses will be conducted using reference biomarkers for the measurement of bone resorption and formation (namely β-CTX-1 and P1NP). Multi-level, meta-regression models within a Bayesian framework will be used to explore the main effect of acute exercise on bone biomarkers as well as potential moderating factors. The risk of bias for each individual study will be evaluated using a modified version of the Downs and Black checklist while certainty in resultant outcomes will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach. DISCUSSION A better understanding of the bone metabolic response to an acute bout of exercise has the potential to advance our understanding of the mechanisms through which this stimulus impacts bone metabolism, including factors that may moderate this response. Additionally, we will identify current gaps in the evidence base and provide recommendations to inform future research. SYSTEMATIC REVIEW REGISTRATION This protocol was prospectively registered in the Open Science Framework Registry ( https://osf.io/6f8dz ).
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Affiliation(s)
- E Dolan
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.
| | - A Dumas
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - K M Keane
- Department of Sport, Exercise and Rehabilitation, Northumbria University, Newcastle upon Tyne, UK
| | - G Bestetti
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - L H M Freitas
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil
| | - B Gualano
- Applied Physiology and Nutrition Research Group, School of Physical Education and Sport; Faculdade de Medicina FMUSP, University of Sao Paulo, Sao Paulo, Brazil.,Food Research Centre, University of São Paulo, Sao Paulo, SP, Brazil
| | - W Kohrt
- Centre for Women's Health Research, School of Medicine, University of Colorado, Aurora, USA
| | - G A Kelley
- Department of Biostatistics, West Virginia University, Morgantown, USA
| | - R M R Pereira
- Bone Metabolism Laboratory, Rheumatology Division, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil
| | - C Sale
- Musculoskeletal Physiology Research Group, Sport, Health and Performance Enhancement (SHAPE) Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, UK
| | - P Swinton
- School of Health Sciences, Robert Gordon University, Aberdeen, UK
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Dolan E, Varley I, Ackerman KE, Pereira RMR, Elliott-Sale KJ, Sale C. The Bone Metabolic Response to Exercise and Nutrition. Exerc Sport Sci Rev 2020; 48:49-58. [PMID: 31913188 DOI: 10.1249/jes.0000000000000215] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Bone (re)modeling markers can help determine how the bone responds to different types, intensities, and durations of exercise. They also might help predict those at risk of bone injury. We synthesized evidence on the acute and chronic bone metabolic responses to exercise, along with how nutritional factors can moderate this response. Recommendations to optimize future research efforts are made.
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Affiliation(s)
| | - Ian Varley
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Kathryn E Ackerman
- Division of Sports Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA
| | - Rosa Maria R Pereira
- Rheumatology Division, Hospital das Clinicas HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Kirsty Jayne Elliott-Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
| | - Craig Sale
- Musculoskeletal Physiology Research Group, Sport, Health, and Performance Enhancement Research Centre, School of Science and Technology, Nottingham Trent University, Nottingham, United Kingdom
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Cavalier E, Lukas P, Bottani M, Aarsand AK, Ceriotti F, Coşkun A, Díaz-Garzón J, Fernàndez-Calle P, Guerra E, Locatelli M, Sandberg S, Carobene A. European Biological Variation Study (EuBIVAS): within- and between-subject biological variation estimates of β-isomerized C-terminal telopeptide of type I collagen (β-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin, intact fibroblast growth factor 23 and uncarboxylated-unphosphorylated matrix-Gla protein-a cooperation between the EFLM Working Group on Biological Variation and the International Osteoporosis Foundation-International Federation of Clinical Chemistry Committee on Bone Metabolism. Osteoporos Int 2020; 31:1461-1470. [PMID: 32270253 DOI: 10.1007/s00198-020-05362-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Accepted: 02/19/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED We have calculated the biological variation (BV) of different bone metabolism biomarkers on a large, well-described cohort of subjects. BV is important to calculate reference change value (or least significant change) which allows evaluating if the difference observed between two consecutive measurements in a patient is biologically significant or not. INTRODUCTION Within-subject (CVI) and between-subject (CVG) biological variation (BV) estimates are essential in determining both analytical performance specifications (APS) and reference change values (RCV). Previously published estimates of BV for bone metabolism biomarkers are generally not compliant with the most up-to-date quality criteria for BV studies. We calculated the BV and RCV for different bone metabolism markers, namely β-isomerized C-terminal telopeptide of type I collagen (β-CTX), N-terminal propeptide of type I collagen (PINP), osteocalcin (OC), intact fibroblast growth factor 23 (iFGF-23), and uncarboxylated-unphosphorylated Matrix-Gla Protein (uCuP-MGP) using samples from the European Biological Variation Study (EuBIVAS). METHODS In the EuBIVAS, 91 subjects were recruited from six European laboratories. Fasting blood samples were obtained weekly for ten consecutive weeks. The samples were run in duplicate on IDS iSYS or DiaSorin Liaison instruments. The results were subjected to outlier and variance homogeneity analysis before CV-ANOVA was used to obtain the BV estimates. RESULTS We found no effect of gender upon the CVI estimates. The following CVI estimates with 95% confidence intervals (95% CI) were obtained: β-CTX 15.1% (14.4-16.0%), PINP 8.8% (8.4-9.3%), OC 8.9% (8.5-9.4%), iFGF23 13.9% (13.2-14.7%), and uCuP-MGP 6.9% (6.1-7.3%). CONCLUSIONS The EuBIVAS has provided updated BV estimates for bone markers, including iFGF23, which have not been previously published, facilitating the improved follow-up of patients being treated for metabolic bone disease.
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Affiliation(s)
- E Cavalier
- Department of Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium.
- International Federation of Clinical Chemistry-International Osteoporosis Foundation Committee for Bone Markers, Milan, Italy.
| | - P Lukas
- Department of Clinical Chemistry, University of Liège, CHU de Liège, 4000, Liège, Belgium
| | - M Bottani
- IRCCS Istituto Ortopedico Galeazzi, Laboratory of Experimental Biochemistry & Molecular Biology, Milan, Italy
| | - A K Aarsand
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
| | - F Ceriotti
- Clinical Laboratory, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy
| | - A Coşkun
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- School of Medicine, Acibadem Mehmet Ali Aydinlar University, Atasehir, Istanbul, Turkey
| | - J Díaz-Garzón
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Quality Analytical Commission of Spanish Society of Laboratory Medicine (SEQC-ML), Hospital Universitario La Paz, Madrid, Spain
| | - P Fernàndez-Calle
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Quality Analytical Commission of Spanish Society of Laboratory Medicine (SEQC-ML), Hospital Universitario La Paz, Madrid, Spain
| | - E Guerra
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | - M Locatelli
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
| | - S Sandberg
- Department of Medical Biochemistry and Pharmacology, Haukeland University Hospital, Bergen, Norway
- Norwegian Organization for Quality Improvement of Laboratory Examinations (Noklus), Haraldsplass Deaconess Hospital, Bergen, Norway
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway
| | - A Carobene
- Biological Variation Working Group, European Federation of Clinical Chemistry and Laboratory Medicine, Milan, Italy
- Laboratory Medicine, Ospedale San Raffaele, Milan, Italy
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