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Liu S, Pang Q, Guan W, Yu F, Wang O, Li M, Xing X, Yu W, Jiang Y, Xia W. Association of serum osteocalcin with bone microarchitecture and muscle mass in Beijing community-dwelling postmenopausal women. Endocrine 2024; 84:236-244. [PMID: 38206435 DOI: 10.1007/s12020-023-03668-1] [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: 08/27/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND Osteoporosis is a systemic skeletal disease with increasing bone fragility and prone to fracture. Osteocalcin (OC), as the most abundant non collagen in bone matrix, has been extensively used in clinic as a biochemical marker of osteogenesis. Two forms of OC were stated on circulation, including carboxylated osteocalcin (cOC) and undercarboxylated osteocalcin (ucOC). OC was not only involved in bone mineralization, but also in the regulation of muscle function. OBJECTIVE This study explored the relationship between serum OC, cOC, ucOC levels and bone mineral density (BMD), bone microarchitecture, muscle mass and physical activity in Chinese postmenopausal women. METHOD 216 community-dwelling postmenopausal women were randomized enrolled. All subjects completed biochemical measurements, including serum β-isomer of C-terminal telopeptides of type I collagen (β-CTX), N-terminal propeptide of type 1 procollagen (P1NP), alkaline phosphatase (ALP), OC, cOC and ucOC. They completed X-ray absorptiometry (DXA) scan to measure BMD, appendicular lean mass (ALM) and trabecular bone score (TBS). They completed high resolution peripheral quantitative CT (HR-pQCT) to assess peripheral bone microarchitectures. RESULTS Serum OC, cOC and ucOC were elevated in osteoporosis postmenopausal women. In bone geometry, serum ucOC was positively related with total bone area (Tt.Ar) and trabecular area(Tb.Ar). In bone volumetric density, serum OC and ucOC were negatively associated with total volume bone mineral density (Tt.vBMD) and trabecular volume bone mineral density (Tb.vBMD). In bone microarchitecture, serum OC and ucOC were negatively correlative with Tb.N and Tb.BV/TV, and were positively correlated with Tb.Sp. Serum OC and ucOC were positively associated with Tb.1/N.SD. Serum OC was negatively related with Tb.Th. Serum ucOC was positively associated with ALM. The high level of serum OC was the risk factor of osteoporosis. ALM was the protective factor for osteoporosis. CONCLUSION All forms of serum OC were negatively associated with BMD. Serum OC and ucOC mainly influenced microstructure of trabecular bone in peripheral skeletons. Serum ucOC participated in modulating both bone microstructure and muscle mass.
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Affiliation(s)
- Shuying Liu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Qianqian Pang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Wenmin Guan
- Department of Radiology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Fan Yu
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Ou Wang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Mei Li
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Xiaoping Xing
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Wei Yu
- Department of Radiology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China
| | - Yan Jiang
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China.
| | - Weibo Xia
- Department of Endocrinology, Key Laboratory of Endocrinology, National Health Commission, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, 100730, Beijing, China.
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Liebich G, Lamy O, Aubry-Rozier B, Gonzalez-Rodriguez E. Maintenance of bone resorption markers in the low premenopausal range during the year following denosumab discontinuation is associated to bone density preservation. The ReoLaus study. Bone 2023; 172:116764. [PMID: 37062514 DOI: 10.1016/j.bone.2023.116764] [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: 12/22/2022] [Revised: 03/17/2023] [Accepted: 04/11/2023] [Indexed: 04/18/2023]
Abstract
PURPOSE Denosumab discontinuation (DD) is associated with serum C-terminal X-linked telopeptides (sCTX) increase, bone mineral density (BMD) loss and vertebral fractures (VFs) risk increase. We compared clinical characteristics of women losing or not lumbar spine (LS) BMD one-year after DD, and their sCTX values at different time-points. METHODS We included women from the ReoLaus cohort having received ≥2 denosumab 60 mg injections, with three BMD measurements on the same device (before (DXA1), at the end of denosumab treatment (DXA2), and one-year after (DXA3)) and sCTX measured at different time-points. Losers (LS DXA3-DXA2 > 2.8 %) and stable groups were compared. RESULTS 63 postmenopausal women were included (mean age 64.2 ± 9.1 years, 7.9 ± 2.7 denosumab injections). 19 months after last denosumab injection, 65 % had lost LS BMD. Losers were younger, had lower BMD and higher sCTX before denosumab, received more injections and gained more BMD under denosumab, and had higher sCTX after DD. Same proportion of patients received bisphosphonates in both groups, but 11 (all in losers group) received ≥1 zoledronate infusion. Three women developed VFs in the losers group (none in the stable). Mean sCTX at 10 and 19 months were 590 ± 372 versus 221 ± 101, and 598 ± 324 versus 293 ± 157 ng/l, respectively (premenopausal range < 573 ng/l, p < 0.01 for both). LS BMD loss and sCTX levels measured at 10 and 19 months were correlated (r2 = 0.29, p = 0.10, and r2 = 0.16, p < 0.005). CONCLUSION Maintenance of BMD gained with denosumab is associated with sCTX in the low premenopausal range after DD. Whether this could be achieved by regular sCTX monitoring and adjustment of bisphosphonates doses or frequency administration needs to be confirmed by further studies.
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Affiliation(s)
- Giovanni Liebich
- Faculty of Biology and Medicine, Lausanne University, 1015 Lausanne, Switzerland
| | - Olivier Lamy
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland; Service of Internal Medicine, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Bérengère Aubry-Rozier
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland
| | - Elena Gonzalez-Rodriguez
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and University of Lausanne, 1011 Lausanne, Switzerland.
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Bai L, Li J, Ren C, Wang M, Yang F, Li Q, Zhao J, Zhang P. Cortex or cancellous-which is early for the decrease of bone content for vertebral body in health? Endocrine 2022; 78:597-604. [PMID: 36136287 DOI: 10.1007/s12020-022-03194-6] [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: 05/27/2022] [Accepted: 09/03/2022] [Indexed: 11/03/2022]
Abstract
OBJECTIVE To obtain the cortex and cancellous parameter of the vertebral bone of healthy subjects using QCT. To explore which is earlier or faster for bone loss with age. MATERIALS AND METHODS 733 physical examiners underwent chest low-dose CT examination were recruited, from April 1, 2021 to October 1, 2021. QCT sequence was used to obtain the bone mineral density of T12-L2 vertebral body without additional radiation. The mass and area of vertebral cortex and cancellous at the central level of L2 vertebral body were measured. The age -related characteristics of vertebral cortex and cancellous between male and female was analyzed and compared. RESULTS The vBMD of T12-L2 vertebral body decreased with age. Significant differences were found in volumetric bone mineral density (vBMD) of T12-L2 vertebral body. For female, significant differences were found in bone content involving cortical mass, cancellous mass, cortical area, cancellous area, cortical mass/cancellous mass and cortical area/cancellous area in different age groups, respectively. The cortical mass decreased with age in female. The cancellous mass of female increased and then decreased with peak at 31-40 y. The cortical area of female decreased gradually before 71 y. The cancellous area of female increased and then decreased with peak at 51-60 y. The values of mass ratio and area ratio in female showed a slowly downward trend with age. Significant differences of bone content between non-menopausal and menopausal women were found except the cancellous mass. For male, no significant differences were found in all parameters of bone content. CONCLUSION The changes of vertebral BMD, bone content of cortex and cancellous have different characteristics in different age. The change of cortex in female maybe earlier and faster than that of cancellous, especially in menopausal women.
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Affiliation(s)
- Lin Bai
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Jujia Li
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Congcong Ren
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Ming Wang
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Fan Yang
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Qian Li
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China
| | - Jian Zhao
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
| | - Ping Zhang
- Department of Radiology, Hebei Province Biomechanical Key Laboratory of Orthopedics, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, Hebei, China.
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Wang S, Wang S, Wang X, Xu Y, Zhang X, Han Y, Yan H, Liu L, Wang L, Ye H, Li X. Effects of Icariin on Modulating Gut Microbiota and Regulating Metabolite Alterations to Prevent Bone Loss in Ovariectomized Rat Model. Front Endocrinol (Lausanne) 2022; 13:874849. [PMID: 35399950 PMCID: PMC8988140 DOI: 10.3389/fendo.2022.874849] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
Postmenopausal osteoporosis (PMOP) is an estrogen deficiency-induced bone loss, which has been shown an association with an altered gut microbiota (GM). Gut microbiota-bone axis has been recognized as a crucial mediator for bone homeostasis. Icariin (ICA) is an effective agent to delay bone loss by regulating the bone homeostasis. Thus, we hypothesize that ICA can prevent bone loss by modulating GM and regulating metabolite alterations. The effects of ICA on bone metabolism improvement in ovariectomized (OVX) rats and their relationships with the GM and fecal metabolites were investigated. Micro-computed tomography (micro-CT) and hematoxylin-eosin (HE) staining showed a typical bone boss in OVX group, while ICA or estradiol (E2) administration exhibited positive effects on bone micro-architecture improvement. The GM such as Actinobacteria, Gammaproteobacteria, Erysipelotrichi, Erysipelotrichales, Enterobacteriales, Actinomycetales, Ruminococcus and Oscillospira significantly correlated to serum bone Gla-protein (BGP), receptor activator of nuclear factor-κB (RANK), receptor activator of nuclear factor-κB ligand (RANKL), osteoprotegerin (OPG) and tartrate resistant acid phosphatase (TRACP). Further t-test revealed a substantial variation of the GM and fecal metabolites in different treatments. Among them, Lachnoclostridium, Butyricimonas, Rikenella, Paraprevolla, Adlercreutzia, Enterorhabdus, Anaerovorax, Allobaculum, Elusimicrobium, Lactococcus, Globicatella and Lactobacillus were probably the key microbial communities driving the change of bile acid, amino acid and fatty acid, thereby leading to an improvement of PMOP. The significant up-regulation of L-Saccharopine, 1-Aminocyclohexadieneacid and linoleic acid after ICA administration suggested important contributions of amino acid and fatty acid metabolisms in the prevention and treatment of PMOP. Taken together, our study has provided new perspectives to better understand the effects of ICA on PMOP improvement by regulating GM and the associated fecal metabolites. Our findings contribute to develop ICA as a potential therapy for PMOP.
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Affiliation(s)
- Shanshan Wang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Shengjie Wang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xiaoning Wang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yunteng Xu
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xin Zhang
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Yidan Han
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hui Yan
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Basic Discipline Laboratory of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Linglong Liu
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Basic Discipline Laboratory of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Lili Wang
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Hongzhi Ye
- Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
| | - Xihai Li
- College of Integrative Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, China
- Key Laboratory of Fujian University of Traditional Chinese Medicine, Fuzhou, China
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Li Y, Tseng WJ, de Bakker CMJ, Zhao H, Chung R, Liu XS. Peak trabecular bone microstructure predicts rate of estrogen-deficiency-induced bone loss in rats. Bone 2021; 145:115862. [PMID: 33493654 PMCID: PMC7920939 DOI: 10.1016/j.bone.2021.115862] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 12/31/2020] [Accepted: 01/19/2021] [Indexed: 01/11/2023]
Abstract
Postmenopausal osteoporosis affects a large number of women worldwide. Reduced estrogen levels during menopause lead to accelerated bone remodeling, resulting in low bone mass and increased fracture risk. Both peak bone mass and the rate of bone loss are important predictors of postmenopausal osteoporosis risk. However, whether peak bone mass and/or bone microstructure directly influence the rate of bone loss following menopause remains unclear. Our study aimed to establish the relationship between peak bone mass/microstructure and the rate of bone loss in response to estrogen deficiency following ovariectomy (OVX) surgery in rats of homogeneous background by tracking the skeletal changes using in vivo micro-computed tomography (μCT) and three-dimensional (3D) image registrations. Linear regression analyses demonstrated that the peak bone microstructure, but not peak bone mass, was highly predictive of the rate of OVX-induced bone loss. In particular, the baseline trabecular thickness was found to have the highest correlation with the degree of OVX-induced bone loss and trabecular stiffness reduction. Given the same bone mass, the rats with thicker baseline trabeculae had a lower rate of trabecular microstructure and stiffness deterioration after OVX. Moreover, further evaluation to track the changes within each individual trabecula via our novel individual trabecular dynamics (ITD) analysis suggested that a trabecular network with thicker trabeculae is less likely to disconnect or perforate in response to estrogen deficiency, resulting a lower degree of bone loss. Taken together, these findings indicate that the rate of estrogen-deficiency-induced bone loss could be predicted by peak bone microstructure, most notably the trabecular thickness. Given the same bone mass, a trabecular bone phenotype with thin trabeculae may be a risk factor toward accelerated postmenopausal bone loss.
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Affiliation(s)
- Yihan Li
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Wei-Ju Tseng
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Chantal M J de Bakker
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States; Department of Radiology, Cumming School of Medicine, McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, Canada.
| | - Hongbo Zhao
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - Rebecca Chung
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
| | - X Sherry Liu
- McKay Orthopaedic Research Laboratory, Department of Orthopaedic Surgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States.
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Karlamangla AS, Shieh A, Greendale GA. Hormones and bone loss across the menopause transition. VITAMINS AND HORMONES 2021; 115:401-417. [PMID: 33706956 DOI: 10.1016/bs.vh.2020.12.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The menopause transition is a critical period for bone health in women, with rapid losses in bone mass and strength occurring over an approximately 3-year window bracketing the date of the final menstrual period. The onset of the rapid bone loss phase is preceded by large changes in sex steroid hormones, measurements of which may be clinically useful in predicting the onset of the rapid loss phase and identifying the women who will lose the most bone mass during this rapid bone loss phase. Here we summarize recent and new findings related to the ability of sex hormone levels to (1) determine if a woman in her 5th decade of life is about to enter or has already entered the rapid phase of bone loss, and (2) if she will lose more than the average amount of bone mass over the menopause transition.
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Affiliation(s)
- Arun S Karlamangla
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States.
| | - Albert Shieh
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
| | - Gail A Greendale
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, United States
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Hu Y, Wang L, Zhao Z, Lu W, Fan J, Gao B, Luo Z, Jie Q, Shi X, Yang L. Cytokines CCL2 and CXCL1 may be potential novel predictors of early bone loss. Mol Med Rep 2020; 22:4716-4724. [PMID: 33173955 PMCID: PMC7646868 DOI: 10.3892/mmr.2020.11543] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 06/18/2020] [Indexed: 12/23/2022] Open
Abstract
Osteoporosis is a common disorder characterized by decreased bone mineral density (BMD) and increased fracture risk. The current techniques detect real-time BMD precisely but do not provide adequate information to predict early bone loss. If bone loss could be diagnosed and predicted early, severe osteoporosis and unexpected fractures could be prevented, allowing for an improved quality of life for individuals. In the present study, an ovariectomized rat model of bone loss was established and the serum levels of 78 potential cytokines were determined using a protein array. The BMD of ovariectomized rats was dynamically measured by micro-CT and the early stage of bone loss was defined at the fourth week after surgery. The expression of several serum protein cytokines was indicated to be altered in the ovariectomized rats during an 8-week time-course of bone loss. Linear regression analysis revealed that the serum levels of C-C motif chemokine ligand 2 (CCL2, also known as monocyte chemoattractant protein 1) and C-X-C motif chemokine ligand 1 (CXCL1) were significantly associated with a reduction in BMD. The significance of these two factors in indicating bone mass reduction was further verified by analyzing serum samples from 24 patients with BMD using ELISA and performing a linear regression analysis. The serum levels of CCL2 and CXCL1 were inversely correlated with the bone mass. Therefore, the cytokines CCL2 and CXCL1 may be potential novel predictors of early bone loss and may be clinically relevant for the early diagnosis and prevention of osteoporosis.
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Affiliation(s)
- Yaqian Hu
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Long Wang
- Department of Orthopaedics, Chinese PLA General Hospital, Beijing 100853, P.R. China
| | - Zhuojie Zhao
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Weiguang Lu
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Jing Fan
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Bo Gao
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Zhuojing Luo
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Qiang Jie
- Department of Orthopedic Surgery, Honghui Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi 710049, P.R. China
| | - Xiaojuan Shi
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
| | - Liu Yang
- Department of Orthopedic Surgery, Xijing Hospital, The Fourth Military Medical University, Xi'an, Shaanxi 710032, P.R. China
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Pepe J, Body JJ, Hadji P, McCloskey E, Meier C, Obermayer-Pietsch B, Palermo A, Tsourdi E, Zillikens MC, Langdahl B, Ferrari S. Osteoporosis in Premenopausal Women: A Clinical Narrative Review by the ECTS and the IOF. J Clin Endocrinol Metab 2020; 105:5846185. [PMID: 32453819 DOI: 10.1210/clinem/dgaa306] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Accepted: 05/20/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Consensus regarding diagnosis and management of osteoporosis in premenopausal women (PW) is still lacking due to few studies carried out in this population. DESIGN The European Calcified Tissue Society and the International Osteoporosis Foundation convened a working group to produce an updated review of literature published after 2017 on this topic. RESULTS Fragility fractures in PW are rare and mostly due to secondary osteoporosis (ie, in presence of an underlying disease such as hormonal, inflammatory, or digestive disorders). In absence of another disorder, low bone mineral density (BMD) together with fragility fractures qualifies as idiopathic osteoporosis. In contrast, low BMD alone does not necessarily represent osteoporosis in absence of bone microarchitectural abnormalities. BMD increases in PW with osteoporosis when the underlying disease is treated. For example, in celiac disease, an increase of 9% in radius trabecular volumetric density was achieved after 1 year of gluten-free diet, while anti-tumor necrosis factor alpha improved BMD in PW with inflammatory bowel diseases. In amenorrhea, including anorexia nervosa, appropriately delivered estrogen replacement therapy can also improve BMD. Alternatively, antiresorptive or anabolic therapy has been shown to improve BMD in a variety of conditions, the range of improvement (3%-16%) depending on skeletal site and the nature of the secondary cause. No studies were powered to demonstrate fracture reduction. The effects of bisphosphonates in childbearing women have been scantly studied and caution is needed. CONCLUSION The majority of PW with osteoporosis have an underlying disease. Specific therapy of these diseases, as well as antiresorptive and anabolic drugs, improve BMD, but without evidence of fracture reduction.
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Affiliation(s)
- Jessica Pepe
- Department of Clinical, Internal, Anesthesiology and Cardiovascular Sciences, "Sapienza" University of Rome, Italy
| | - Jean-Jacques Body
- Department of Medicine, CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - Peyman Hadji
- Frankfurt Center of Bone Health, Frankfurt, Germany and Philipps-University of Marburg, Marburg, Germany
| | - Eugene McCloskey
- Centre for Integrated Research in Musculoskleetal Ageing, Mellanby Centre for Bone Research, Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Christian Meier
- Division of Endocrinology, Diabetology and Metabolism, University Hospital and University of Basel, Basel, Switzerland
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Diabetology, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Andrea Palermo
- Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Elena Tsourdi
- Department of Medicine III, Technische Universität Dresden Medical Center, Dresden, Germany
- Center for Healthy Aging, Technische Universität Dresden Medical Center, Dresden, Germany
| | - M Carola Zillikens
- Bone Center, Department of Internal Medicine, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - Bente Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Serge Ferrari
- Service of Bone Diseases, Geneva University Hospital and Faculty of Medicine, Geneva, Switzerland
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Role of Secreted Frizzled-Related Protein 1 and Tumor Necrosis Factor- α (TNF- α) in Bone Loss of Patients with Rheumatoid Arthritis. Int J Rheumatol 2020; 2020:9149762. [PMID: 32190056 PMCID: PMC7068142 DOI: 10.1155/2020/9149762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Revised: 02/02/2020] [Accepted: 02/04/2020] [Indexed: 12/12/2022] Open
Abstract
Bone loss is one of the emerging extra-articular manifestations of rheumatoid arthritis. TNF-α is the main inflammatory cytokine that can directly increase bone resorption. However, its role in bone formation is still unknown, especially related to secreted frizzled-related protein 1 (SFRP-1), an osteoblast inhibitor. This study examines the correlation between TNF-α and SFRP-1, with a bone turn over marker (CTX and P1NP). This is a cross-sectional study with 38 subjects of premenopausal female patients with RA. This study found that 60.6% of the patients were in remission or low disease activity. The median of TNF-α was 10.6 pg/mL, mean of SFRP-1 was 9.29 ng/mL, mean of CTX was 2.74 ng/mL, and the median of P1NP was 34.04 pg/ml. There is positive correlation between TNF-α and P1NP (r = 0.363, p = 0.026), also between SFRP-1 and P1NP (r = 0.341; p = 0.036). A low level of TNF-𝛼, high level of SFRP-1, high level of CTX, and low level of P1NP in this study indicate a high bone turn over process, with dominant resorption activity in premenopausal female patients with RA.
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Mohamad NV, Ima-Nirwana S, Chin KY. Are Oxidative Stress and Inflammation Mediators of Bone Loss Due to Estrogen Deficiency? A Review of Current Evidence. Endocr Metab Immune Disord Drug Targets 2020; 20:1478-1487. [PMID: 32496996 PMCID: PMC8383467 DOI: 10.2174/1871530320666200604160614] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 02/15/2020] [Accepted: 03/30/2020] [Indexed: 12/16/2022]
Abstract
Osteoporosis is one of the major health issues associated with menopause-related estrogen deficiency. Various reports suggest that the hormonal changes related to menopausal transition may lead to the derangement of redox homeostasis and ultimately oxidative stress. Estrogen deficiency and oxidative stress may enhance the expression of genes involved in inflammation. All these factors may contribute, in synergy, to the development of postmenopausal osteoporosis. Previous studies suggest that estrogen may act as an antioxidant to protect the bone against oxidative stress, and as an antiinflammatory agent in suppressing pro-inflammatory and pro-osteoclastic cytokines. Thus, the focus of the current review is to examine the relationship between estrogen deficiency, oxidative stress and inflammation, and the impacts of these phenomena on skeletal health in postmenopausal women.
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Affiliation(s)
- Nur-Vaizura Mohamad
- Department of Pharmacology, Faculty of Medicine, The National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Faculty of Medicine, The National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, The National University of Malaysia Medical Centre, Kuala Lumpur, Malaysia
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