1
|
Shoung A, Shoung N, Hii R, Nerlekar N, Ebeling PR, Rodríguez AJ. Electrocardiogram Changes Following Intravenous Bisphosphonate Infusion: A Systematic Review and Meta-Analysis. J Bone Miner Res 2023; 38:1679-1688. [PMID: 37681243 DOI: 10.1002/jbmr.4911] [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: 05/24/2023] [Revised: 08/06/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
Bisphosphonates are first-line treatments for several bone and mineral disorders. Studies have reported an increased incidence of serious atrial fibrillation in patients receiving bisphosphonates; however, uncertainty remains as to whether electrical disturbances are precipitated by bisphosphonates. We aimed to review the literature for studies reporting electrocardiogram (ECG) findings in patients receiving intravenous bisphosphonates for any indication. We searched MEDLINE and EMBASE from inception until January 14, 2023, for studies reporting ECG parameters after intravenous bisphosphonate infusion. We excluded studies that only reported atrial fibrillation. Study quality was assessed using the Newcastle-Ottawa scale. Continuous data were meta-analyzed if reported in at least two studies. Random-effects models were fitted and reported as standardized mean difference (SMD) with 95% confidence intervals (95% CIs). We found 1083 unique records, of which 11 met our inclusion and exclusion criteria. Studies had a low to low/moderate risk of bias. Six prospective cohort studies were included in the meta-analysis. Five studies used zoledronic acid, whereas one study used pamidronate. Most studies (n = 4) were conducted in postmenopausal women with osteoporosis, one study was conducted in patients with bone metastases, and one study in children with osteoporosis secondary to cerebral palsy. Study populations ranged from n = 15 to n = 116. Heart rate-corrected QT (QTc) was significantly longer post-infusion (SMD = 0.46 ms [95% CI 0.80 to 0.11]; n = 67 patients, k = 2 studies, τ2 = 0). There were no differences in heart rate, P wave (maximum), P wave (minimum), P wave dispersion, PR interval, QRS duration, QTc, QTc (maximum), QTc (minimum), and QTc dispersion. The correlation between pre- and post-infusion QTc was not significant (p = 0.93). Overall, there is a weak association between intravenous bisphosphonate infusion and a QTc interval prolongation. However, there is insufficient evidence to support an association between intravenous bisphosphonate and any ECG variable changes, which may precipitate atrial fibrillation. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Alex Shoung
- School of Medicine, Griffith University, Southport, Australia
- Sunshine Coast University Hospital, Birtinya, Australia
| | - Nicholas Shoung
- School of Medicine, Griffith University, Southport, Australia
- Department of Diabetes and Endocrinology, St Vincent's Hospital, Darlinghurst, Australia
- St Vincent's Clinical School, University of New South Wales, Darlinghurst, Australia
| | - Rachael Hii
- Department of Medicine, Monash University, Clayton, Australia
| | - Nitesh Nerlekar
- Department of Medicine, Monash University, Clayton, Australia
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical Centre, Clayton, Australia
- Monash Cardiovascular Research Centre, Monash University and Monash Heart, Monash Health, Clayton, Australia
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical Centre, Clayton, Australia
- Department of Endocrinology, Monash Health, Clayton, Victoria, Australia
| | - Alexander J Rodríguez
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Monash Medical Centre, Clayton, Australia
- Disorders of Mineralisation Research Group, School of Clinical Sciences, Faculty of Medicine, Edith Cowan University, Joondalup, Australia
| |
Collapse
|
2
|
Lee S, Kim JH, Jeon YK, Lee JS, Kim K, Hwang SK, Kim JH, Goh TS, Kim YH. Effect of adipokine and ghrelin levels on BMD and fracture risk: an updated systematic review and meta-analysis. Front Endocrinol (Lausanne) 2023; 14:1044039. [PMID: 37181034 PMCID: PMC10171108 DOI: 10.3389/fendo.2023.1044039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Context Circulating adipokines and ghrelin affect bone remodeling by regulating the activation and differentiation of osteoblasts and osteoclasts. Although the correlation between adipokines, ghrelin, and bone mineral density (BMD) has been studied over the decades, its correlations are still controversial. Accordingly, an updated meta-analysis with new findings is needed. Objective This study aimed to explore the impact of serum adipokine and ghrelin levels on BMD and osteoporotic fractures through a meta-analysis. Data sources Studies published till October 2020 in Medline, Embase, and the Cochrane Library were reviewed. Study selection We included studies that measured at least one serum adipokine level and BMD or fracture risk in healthy individuals. We excluded studies with one or more of the following: patients less than 18 years old, patients with comorbidities, who had undergone metabolic treatment, obese patients, patients with high physical activities, and a study that did not distinguish sex or menopausal status. Data extraction We extracted the data that include the correlation coefficient between adipokines (leptin, adiponectin, and resistin) and ghrelin and BMD, fracture risk by osteoporotic status from eligible studies. Data synthesis A meta-analysis of the pooled correlations between adipokines and BMD was performed, demonstrating that the correlation between leptin and BMD was prominent in postmenopausal women. In most cases, adiponectin levels were inversely correlated with BMD. A meta-analysis was conducted by pooling the mean differences in adipokine levels according to the osteoporotic status. In postmenopausal women, significantly lower leptin (SMD = -0.88) and higher adiponectin (SMD = 0.94) levels were seen in the osteoporosis group than in the control group. By predicting fracture risk, higher leptin levels were associated with lower fracture risk (HR = 0.68), whereas higher adiponectin levels were associated with an increased fracture risk in men (HR = 1.94) and incident vertebral fracture in postmenopausal women (HR = 1.18). Conclusions Serum adipokines levels can utilize to predict osteoporotic status and fracture risk of patients. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021224855, identifier CRD42021224855.
Collapse
Affiliation(s)
- Seoyul Lee
- Department of Physiology, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jeong Hun Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- College of Nursing, Pusan National University, Yangsan, Republic of Korea
| | - Yun Kyung Jeon
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Internal Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Jung Sub Lee
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Orthopaedic Surgery, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Keunyoung Kim
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Nuclear Medicine, School of Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Sun-Kyung Hwang
- College of Nursing, Pusan National University, Yangsan, Republic of Korea
| | - Jae Ho Kim
- Department of Physiology, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
| | - Tae Sik Goh
- Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Orthopaedic Surgery, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- *Correspondence: Yun Hak Kim, ; Tae Sik Goh,
| | - Yun Hak Kim
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan, Republic of Korea
- Department of Anatomy, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- Department of Biomedical Informatics, School of Medicine, Pusan National University, Yangsan, Republic of Korea
- *Correspondence: Yun Hak Kim, ; Tae Sik Goh,
| |
Collapse
|
3
|
Szabó A, Janovszky Á, Pócs L, Boros M. The periosteal microcirculation in health and disease: An update on clinical significance. Microvasc Res 2017; 110:5-13. [DOI: 10.1016/j.mvr.2016.11.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Revised: 11/18/2016] [Accepted: 11/18/2016] [Indexed: 11/28/2022]
|
4
|
Dai SQ, Yu LP, Shi X, Wu H, Shao P, Yin GY, Wei YZ. Serotonin regulates osteoblast proliferation and function in vitro. ACTA ACUST UNITED AC 2014; 47:759-65. [PMID: 25098615 PMCID: PMC4143203 DOI: 10.1590/1414-431x20143565] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2013] [Accepted: 05/22/2014] [Indexed: 11/22/2022]
Abstract
The monoamine serotonin (5-hydroxytryptamine, 5-HT), a well-known neurotransmitter,
also has important functions outside the central nervous system. The objective of
this study was to investigate the role of 5-HT in the proliferation, differentiation,
and function of osteoblasts in vitro. We treated rat primary
calvarial osteoblasts with various concentrations of 5-HT (1 nM to 10 µM) and
assessed the rate of osteoblast proliferation, expression levels of
osteoblast-specific proteins and genes, and the ability to form mineralized nodules.
Next, we detected which 5-HT receptor subtypes were expressed in rat osteoblasts at
different stages of osteoblast differentiation. We found that 5-HT could inhibit
osteoblast proliferation, differentiation, and mineralization at low concentrations,
but this inhibitory effect was mitigated at relatively high concentrations. Six of
the 5-HT receptor subtypes (5-HT1A, 5-HT1B, 5-HT1D,
5-HT2A, 5-HT2B, and 5-HT2C) were found to exist
in rat osteoblasts. Of these, 5-HT2A and 5-HT1B receptors had
the highest expression levels, at both early and late stages of differentiation. Our
results indicated that 5-HT can regulate osteoblast proliferation and function
in vitro.
Collapse
Affiliation(s)
- S Q Dai
- Department of Orthopedic Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - L P Yu
- Department of Orthopedic Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - X Shi
- Department of Obstetrics and Gynecology, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - H Wu
- Emergency Department, The First Affiliated Hospital, Soochow University, Suzhou, China
| | - P Shao
- Department of Orthopedic Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - G Y Yin
- Department of Orthopedic Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Y Z Wei
- Department of Orthopedic Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| |
Collapse
|
5
|
Kassi G, Papamichael K, Papaioannou G, Giagourta I, Thanou S, Triantaphyllopoulou M, Zapanti E, Papandroulaki F, Ktena V, Karga H. Cytokines and Insulin Resistance after Zoledronic Acid-Induced Acute Phase Response. Immunol Invest 2014; 43:544-55. [DOI: 10.3109/08820139.2014.892510] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
6
|
Liu Y, Song CY, Wu SS, Liang QH, Yuan LQ, Liao EY. Novel adipokines and bone metabolism. Int J Endocrinol 2013; 2013:895045. [PMID: 23431296 PMCID: PMC3575660 DOI: 10.1155/2013/895045] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2012] [Accepted: 01/02/2013] [Indexed: 01/25/2023] Open
Abstract
Osteoporosis is a serious social issue nowadays. Both the high morbidity and its common complication osteoporotic fracture load a heavy burden on the whole society. The adipose tissue is the biggest endocrinology organ that has a different function on the bone. The adipocytes are differentiated from the same cell lineage with osteoblast, and they can secrete multiple adipokines with various functions on bone remolding. Recently, several novel adipokines have been identified and investigated thoroughly. In this paper, we would like to highlight the complicated relation between the bone metabolism and the novel adipokines, and it may provide us with a new target for prediction and treatment of osteoporosis.
Collapse
Affiliation(s)
- Yuan Liu
- Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
- Geriatric Department, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Cheng-Yuan Song
- Neurology Department, Xiangya Hospital, Central South University, Changsha 410008, Hunan, China
| | - Shan-Shan Wu
- Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Qiu-Hua Liang
- Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
| | - Ling-Qing Yuan
- Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
- *Ling-Qing Yuan:
| | - Er-Yuan Liao
- Institute of Metabolism and Endocrinology, Second Xiangya Hospital, Central South University, Changsha 410011, Hunan, China
- *Er-Yuan Liao: and
| |
Collapse
|