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Berger MB, Cohen DJ, Levit MM, Puetzer JL, Boyan BD, Schwartz Z. Hydrophilic implants generated using a low-cost dielectric barrier discharge plasma device at the time of placement exhibit increased osseointegration in an animal pre-clinical study: An effect that is sex-dependent. Dent Mater 2022; 38:632-645. [PMID: 35184898 PMCID: PMC9123943 DOI: 10.1016/j.dental.2022.02.002] [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] [Received: 11/29/2021] [Accepted: 02/08/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Increased wettability of titanium and titanium alloy surfaces due to processing and storage methods increases osteoprogenitor cell differentiation and osseointegration compared to microroughness alone. Implants that are exposed to air have a hydrophobic surface due to adsorption of atmospheric hydrocarbons, which can limit overall implant success. Dielectric barrier discharge plasma (DBD) is one method to increase surface hydrophilicity. Although current DBD methods yield a hydrophilic surface, adsorbed hydrocarbons rapidly restore hydrophobicity. We demonstrated that application of DBD to implants previously packaged in a vacuum, generates a hydrophilic surface that supports osteoblastic differentiation in vitro and this can be done immediately prior to use. In the present study, we tested the hypothesis that DBD treatment to alter surface wettability at the time of implant placement will improve osseointegration in vivo. MATERIALS AND METHODS Twenty male and sixteen female rabbits were used in a preclinical trans-axial femur model of osseointegration. Control and DBD treatment implants were inserted randomized per hind limb in each rabbit (1 implant/hind-limb). At 6 weeks post-surgery, bone-to-implant contact, adjacent bone volume, and torque to failure were assessed by micro-CT, calcified histology, and mechanical testing. RESULTS DBD plasma treatment of vacuum-sealed implants increased surface wettability and did not change surface chemistry or roughness. Peak torque and torsional energy, and bone-to-implant contact increased with DBD treatment in males. In contrast, female rabbits showed increased osseointegration equal to DBD treated male implants regardless of DBD plasma treatment. CONCLUSION DBD treatment is an effective method to enhance osseointegration by increasing surface wettability; however, this response is sex dependent. In healthy female patients, DBD treatment may not be necessary but in older patients or patients with compromised bone, this treatment could be an effective measure to ensure implant success.
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Affiliation(s)
- Michael B Berger
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA
| | - D Joshua Cohen
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA
| | - Michael M Levit
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA
| | - Jennifer L Puetzer
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA
| | - Barbara D Boyan
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA; Wallace H. Coulter Department of Biomedical Engineering at the Georgia Institute of Technology and Emory University, 313 Ferst Drive, Atlanta, GA 30332, USA.
| | - Zvi Schwartz
- Department of Biomedical Engineering, Virginia Commonwealth University, 601 W. Main Street, Richmond, VA 23284, USA; Department of Periodontology, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX 78229, USA
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Prosperi S, Chiarelli F. Early and precocious puberty during the COVID-19 pandemic. Front Endocrinol (Lausanne) 2022; 13:1107911. [PMID: 36699035 PMCID: PMC9868951 DOI: 10.3389/fendo.2022.1107911] [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: 11/25/2022] [Accepted: 12/19/2022] [Indexed: 01/12/2023] Open
Abstract
During the year 2020, the COVID-19 pandemic rapidly became a severe health emergency worldwide. In order to contrast the spread of the novel SARS-CoV-2, many countries implemented extraordinary restrictive measures, such as a strict lockdown and school closures. The pandemic had a great impact on children and adolescents' daily life, leading to a much more sedentary lifestyle, to larger use of electronic devices and to an increase in stress-related symptoms. These conspicuous changes acted as disruptors of children's normal development. Since the beginning of the pandemic, many studies reported an increase in the number of precocious puberty cases as well as a faster progression rate of puberty itself, if compared to the pre-pandemic years. In this review, our aim was to evaluate the incidence of new cases of early and precocious puberty during the COVID-19 pandemic, analyzing variations in the timing of puberty and in pubertal progression rate, and to investigate the role of environmental and lifestyle factors during the pandemic in modulating the physiopathology of pubertal development. While a direct effect of SARS-CoV-2 infection remains, at the moment, a remote hypothesis, both physical and psychological factors related to the pandemic seem to have a role in triggering GnRH pulsatile secretion leading to earlier pubertal onset. It is indeed important to stress the need to clarify the exact role of COVID-19 in early pubertal onset comparing data from all over the world; long-term comprehensive studies are also pivotal to explain whether this phenomenon will continue while we resume pre-pandemic habits.
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Song C, Zhu M, Zheng R, Hu Y, Li R, Zhu G, Chen L, Xiong F. Analysis of bone mass and its relationship with body composition in school-aged children and adolescents based on stage of puberty and site specificity: A retrospective case-control study. Medicine (Baltimore) 2019; 98:e14005. [PMID: 30813124 PMCID: PMC6408102 DOI: 10.1097/md.0000000000014005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The aim of this study was to better understand the relationship of bone mass with body composition based on different stages of puberty and to illuminate the contribution of site-specific fat mass and lean mass (FM and LM) compared with bone mass in school-aged children and adolescents in Chongqing, China.A total of 1179 healthy subjects of both sexes were recruited. Bone mineral content (BMC), bone mineral density (BMD), bone area, and both FM and LM were measured by dual-energy X-ray absorptiometry (DXA). The fat mass and lean mass indexes (FMI and LMI, respectively) were calculated as the FM (kg) and LM (kg) divided by the height in meters squared, respectively.Most of the bone mass indicators were significantly higher for postpubertal boys than for girls at the same stage (P < .001). The proportion of subjects with normal bone mass increased, while the proportion of subjects with osteopenia and osteoporosis decreased with increased body weight regardless of gender and puberty stage (P < .01). FM and LM were significantly positively related to bone mass regardless of gender and puberty stage (P < .0001). FMI and LMI were significantly positively related to bone mass in most conditions (P < .05 and P < .0001, respectively). Four components of the FM and LM were linearly and significantly associated with BMD and BMC for TB and TBHL. Among them, the head fat mass and head lean mass showed the greatest statistical contribution.In the process of assessing bone status, we recommend measuring fat and lean masses, including the fat and lean masses of the head.
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Affiliation(s)
- Cui Song
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
| | - Min Zhu
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
| | - Rongfei Zheng
- Endocrinology Departments, Shenzhen Children's Hospital, Shenzhen, P.R. China
| | - Yujuan Hu
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
| | - Rong Li
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
| | - Gaohui Zhu
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
| | - Long Chen
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
| | - Feng Xiong
- Department of Endocrine and Genetic Metabolism Disease, Children's Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders
- China International Science and Technology Cooperation Base of Child Development and Critical Disorders, Chongqing Key Laboratory of Pediatrics, Chongqing
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Berger MB, Cohen DJ, Olivares-Navarrete R, Williams JK, Cochran DL, Boyan BD, Schwartz Z. Human osteoblasts exhibit sexual dimorphism in their response to estrogen on microstructured titanium surfaces. Biol Sex Differ 2018; 9:30. [PMID: 29970177 PMCID: PMC6029108 DOI: 10.1186/s13293-018-0190-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/25/2018] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Osseointegration is dependent on the implant surface, surrounding bone quality, and the systemic host environment, which can differ in male and female patients. Titanium (Ti) implants with microstructured surfaces exhibit greater pullout strength when compared to smooth-surfaced implants and exhibit enhanced osteogenic cellular responses in vitro. Previous studies showed that 1α,25-dihydroxyvitamin D3 [1α,25(OH)2D3] has a greater effect on rat osteoblast differentiation on microstructured Ti compared to smooth Ti surfaces and tissue culture polystyrene (TCPS). The stimulatory effect of 17β-estradiol (E2) on differentiation is observed in female osteoblasts on micro-rough Ti, but it is not known if male osteoblasts behave similarly in response to E2 and microtopography. This study assessed whether human male and female osteoblasts exhibit sex-specific differences in response to E2 and 1α,25(OH)2D3 when cultured on microstructured Ti surfaces. METHODS Osteoblasts from three male and three female human donors were cultured on Ti discs with varying surface profiles: a smooth pretreatment (PT), a coarse grit-blasted/acid-etched (SLA), and an SLA surface having undergone modification in a nitrogen environment and stored in saline to maintain hydrophilicity (modSLA). Cells cultured on these surfaces were treated with E2 or 1α,25(OH)2D3. RESULTS Male and female human osteoblasts responded similarly to microstructure although there were donor-specific differences; cell number decreased, and osteocalcin (OCN), osteoprotegerin (OPG), and latent and active transforming growth factor 1 increased on SLA and modSLA compared to TCPS. Female osteoblasts had higher alkaline phosphatase activity and OCN production than male counterparts but produced less OPG. Both sexes responded similarly to 1α,25(OH)2D3. E2 treatment reduced cell number and increased osteoblast differentiation and factor production only in female cells. CONCLUSIONS Male and female human osteoblasts respond similarly to microstructure and 1α,25(OH)2D3 but exhibit sexual dimorphism in substrate-dependent responses to E2. E2 affected female osteoblasts, suggesting that signaling is sex-specific and surface-dependent. Donor osteoblasts varied in response, demonstrating the need to test multiple donors when examining human samples. Understanding how male and female cells respond to orthopedic biomaterials will enable greater predictability post-implantation as well as therapies that are more patient-specific.
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Affiliation(s)
- Michael B Berger
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA
| | - David J Cohen
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA
| | - Rene Olivares-Navarrete
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA
| | | | - David L Cochran
- Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
| | - Barbara D Boyan
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA. .,Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, Atlanta, GA, 30332, USA.
| | - Zvi Schwartz
- Department of Biomedical Engineering, College of Engineering, Virginia Commonwealth University, 601 West Main Street, Richmond, VA, 23284-3068, USA.,Department of Periodontics, University of Texas Health Science Center at San Antonio, San Antonio, TX, 78229, USA
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Alyahya KO. Vitamin D levels in schoolchildren: a cross-sectional study in Kuwait. BMC Pediatr 2017; 17:213. [PMID: 29273017 PMCID: PMC5741933 DOI: 10.1186/s12887-017-0963-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Accepted: 12/08/2017] [Indexed: 03/14/2023] Open
Abstract
Background Ongoing studies in the Middle East, particularly in the Arabian Gulf countries, have reported extremely low levels of serum vitamin D across age and gender. In Kuwait, vitamin D deficiency is prevalent in adolescent girls and in adult women. A number of risk factors have been reported, among which gender, age, and obesity are a few. Because adequate vitamin D status is necessary to promote bone mineral accrual in childhood, and because low vitamin D levels have been associated with a wide range of health problems, there is concern that growing children with low vitamin D may be at higher risk for developing diseases. The aim of this study was to assess vitamin D levels in elementary schoolchildren. Methods Kuwaiti schoolchildren were recruited and assessed for their serum vitamin D, 25(OH)D, parathyroid hormone (PTH) and adjusted serum calcium (adj-Ca). Anthropometric measurements and data on lifestyle and health status were recorded during an interview. Results In a total of 199 schoolchildren, median (IQR) age was 8.5 (7.0–9.5 years), 25(OH)D was 30 (22–39 nmol/L), PTH was 4.7 (3.8–5.9 pmol/L), and adj-Ca was 2.39 (2.33–2.44 mmol/L). Boys had higher levels of 25(OH)D (18.3% vs 6.6% had levels ≥50 nmol/L) and lower levels of PTH (94.6% vs 80.2% had levels <7 pmol/L) than girls. Significant risk factors for 25(OH)D levels <25 nmol/L included being ≤8.5 years old (OR 4.95, 95% CI: 1.92–12.74), having PTH ≥7 pmol/L (OR 2.28, 95% CI: 1.17–4.46), being female (OR 2.44, 95% CI: 1.22–4.88), and being overweight or obese (OR 2.18, 95% CI: 1.11–4.26). Conclusions The results show relatively low levels of 25(OH)D in young schoolchildren in Kuwait, with lower levels in girls. Given the association of 25(OH)D with a wide range of ailments, it is necessary to further examine the causes and risk factors of low vitamin D in this age group to prevent associated health problems.
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Affiliation(s)
- Khulood Othman Alyahya
- Science Department, College of Basic Education, Public Authority for Applied Education and Training (PAAET), Ardhyia, Kuwait.
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Kang MJ, Hong HS, Chung SJ, Lee YA, Shin CH, Yang SW. Body composition and bone density reference data for Korean children, adolescents, and young adults according to age and sex: results of the 2009-2010 Korean National Health and Nutrition Examination Survey (KNHANES). J Bone Miner Metab 2016; 34:429-39. [PMID: 26056024 DOI: 10.1007/s00774-015-0686-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2014] [Accepted: 05/09/2015] [Indexed: 10/23/2022]
Abstract
We established the timing of peak bone mass acquisition and body composition maturation and provide an age- and sex-specific body composition and bone density reference database using dual-energy X-ray absorptiometry in Korean subjects 10-25 years of age. Reference percentiles and curves were developed for bone mineral content (BMC), bone mineral density (BMD) of the whole body, the lumbar spine, and the femoral neck, and for fat mass (FM) and lean mass (LM) of 1969 healthy participants (982 males) who participated in the 2009-2010 Korean National Health and Nutrition Examination Survey. Additionally, bone mineral apparent density (BMAD), FM index, and LM index were calculated to adjust for body size. BMC and BMD at all skeletal sites as well as LM increased with age, reaching plateaus at 17-20 years of age in females and 20-23 years of age in males. The femoral neck was the first to reach a bone mass plateau, followed by the lumbar spine and then the whole body. Spine BMAD increased with age in both sexes, but femoral and whole-body BMAD remained the same over time. Females displayed a dramatic increase in FM during puberty, but the FM of males decreased until mid-puberty. These findings indicate that bone health and body composition should be monitored using a normal reference database until the late second to early third decade of life, when statural growth and somatic maturation are completed.
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Affiliation(s)
- Min Jae Kang
- Department of Pediatrics, Hallym University Sacred Heart Hospital, Anyang, 431-796, Korea
| | - Hyun Sook Hong
- Medical Research Collaborating Center, Seoul National University Hospital, Seoul, 110-769, Korea
| | - Seung Joon Chung
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 110-744, Korea
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 110-744, Korea.
| | - Choong Ho Shin
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 110-744, Korea
| | - Sei Won Yang
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, 110-744, Korea
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Sanwalka N, Khadilkar A, Chiplonkar S, Khatod K, Phadke N, Khadilkar V. Influence of Vitamin D Receptor Gene Fok1 Polymorphism on Bone Mass Accrual Post Calcium and Vitamin D Supplementation. Indian J Pediatr 2015; 82:985-90. [PMID: 25972288 DOI: 10.1007/s12098-015-1783-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Accepted: 04/27/2015] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To examine the association of vitamin D receptor (VDR) gene polymorphisms of the Fok1 locus on bone mass accrual in Indian girls used to a low calcium intake. METHODS An intervention trial was undertaken in 102 girls aged 8-16 y, attending a state run school in Pune city, India. All girls received 500 mg calcium daily and 30,000 IU of vitamin D3 quarterly for one year. Dietary calcium intake was evaluated. Bone mineral content (BMC), bone area (BA) and bone mineral density (BMD) were measured at total body using Dual Energy X-ray Absorptiometry (Lunar DPX-PRO). Polymorphisms of the Fok1 locus of the vitamin D Receptor (VDR) gene were detected using SYBR Green quantitative polymerase chain reaction. RESULTS The prevalence of Fok1 polymorphism was 43.1% (Ff), 9.8% (ff) and 47.1% (FF). At baseline, FF genotype had significantly lower BMD as compared to ff and Ff genotype (p < 0.05). At baseline, majority of girls (82.4%) were hypocalcemic with low calcium intake. Post-supplementation, FF genotype had significantly lower bone mass as compared to ff and Ff genotype. Significant increase in BMC [Ff (17.9%); ff (18.1%); FF (17.4%)], and BMD [Ff (5.4 %); ff (6.3%); FF (4.8%)] was observed post supplementation (p value < 0.05), though percentage increase in BMC and BMD was similar for three Fok1 polymorphisms (p > 0.1). CONCLUSIONS VDR gene polymorphism, as defined by Fok1 genotype had no positive influence on bone mass accrual in response to calcium supplementation.
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Affiliation(s)
- Neha Sanwalka
- Department of Nutrition and Biostatistics, NutriCanvas, Mumbai, India
| | - Anuradha Khadilkar
- Department of Growth and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Old Building Basement, 32, Sassoon Road, Pune, Maharashtra, 411001, India.
| | - Shashi Chiplonkar
- Department of Growth and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Old Building Basement, 32, Sassoon Road, Pune, Maharashtra, 411001, India
| | - Kavita Khatod
- Department of Molecular Diagnostics, GenePath Diagnostics, Pune, India
| | - Nikhil Phadke
- Department of Molecular Diagnostics, GenePath Diagnostics, Pune, India
| | - Vaman Khadilkar
- Department of Growth and Endocrine, Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Old Building Basement, 32, Sassoon Road, Pune, Maharashtra, 411001, India
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Bonura F. Prevention, Screening, and Management of Osteoporosis: An Overview of the Current Strategies. Postgrad Med 2015; 121:5-17. [DOI: 10.3810/pgm.2009.07.2021] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Sanwalka N, Khadilkar A, Chiplonkar S, Khatod K, Phadke N, Khadilkar V. Vitamin D receptor gene polymorphisms and bone mass indices in post-menarchal Indian adolescent girls. J Bone Miner Metab 2013; 31:108-15. [PMID: 23081732 DOI: 10.1007/s00774-012-0390-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2011] [Accepted: 09/10/2012] [Indexed: 01/23/2023]
Abstract
To study the association between vitamin D receptor (VDR) gene polymorphisms and bone mass indices in adolescent girls, a cross-sectional study was conducted in 120 post-menarchal girls aged 15-18 years in Pune city, India. Serum levels of ionised calcium, inorganic phosphorous, parathyroid hormone and 25-hydroxy vitamin-D were measured. Bone mineral content (BMC), bone area (BA) and bone mineral density (BMD) were measured at total body (TB), lumbar spine (LS) and left femoral neck (FN) using dual energy X-ray absorptiometry. Polymorphisms of the VDR gene at the Fok1 and Bsm1 loci were detected using SYBR Green quantitative polymerase chain reaction. The overall distribution of genotypes at the Bsm1 locus in this study was 33.3 % Bb, 29.2 % bb and 37.5 % BB while that for the Fok1 locus was 44.2 % Ff, 7.5 % ff and 48.3 % FF. There were no significant differences in the blood parameters when classified according to Bsm1 or Fok1 genotypes. Subjects with BB genotype have significantly higher mean TBBMC, TBBA, TBBMD and LSBMD than Bb and bb (p < 0.05) and showed a tendency for association with LSBMC and LSBA (p < 0.1). Subjects with Ff genotype showed a tendency for association with left FNBMC and FNBA (p < 0.1). Bsm1 genotype did not show an association with FN bone indices whereas Fok1 genotype did not show association with TB or LS bone indices. In conclusion, the present study demonstrates VDR gene polymorphism, defined by Bsm1 genotype, has an influence on total body and lumbar spine bone mass indices in post-menarchal Indian girls.
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Affiliation(s)
- Neha Sanwalka
- Interdisciplinary School of Health Sciences, University of Pune, Pune, India
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Khadilkar AV, Sanwalka NJ, Kadam NS, Chiplonkar SA, Khadilkar VV, Mughal MZ. Poor bone health in underprivileged Indian girls: an effect of low bone mass accrual during puberty. Bone 2012; 50:1048-53. [PMID: 22370248 DOI: 10.1016/j.bone.2012.01.028] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2011] [Revised: 12/16/2011] [Accepted: 01/23/2012] [Indexed: 01/14/2023]
Abstract
A socio-economic gradient exists for most reasons of morbidity and mortality including delayed puberty in lower (LSES) as compared to higher (HSES) socio-economic stratum and puberty is an important factor affecting bone status in children and adolescents. Thus, a cross-sectional study was conducted on 195 age-matched pairs of girls (8-17years) from LSES and HSES in Pune City, India to assess the hypothesis that socio-economic factors working through late puberty would have a negative association with bone status of adolescents. Height, weight and Tanner stage were assessed. Total body bone mineral content (TBBMC), total body bone area (TBBA), total body bone mineral density (TBBMD), lean body mass (LBM) and total body fat mass (TBFM) were measured using GE Lunar DPX Pro Pencil Beam DXA (Wisconsin, USA) scanner. Mean TBBMC (1172±434g), TBBA (1351±356cm(2)), TBBMD (0.846±0.104g/cm(2)), LBM (21,622±5306g) and TBFM (7746±5194g) in LSES girls were significantly lower than that of HSES girls [TBBMC (1483±525g), TBBA (1533±380cm(2)), TBBMD (0.942±0.119g/cm(2)), LBM (24,308±5829g) and TBFM (12,196±7404g)] (p<0.01). There was a significant effect of age and puberty on all bone parameters. The differences in TBBMC, TBBA, LBM and TBFM between the 2 socio-economic strata at Tanner stage I were not significant (p>0.1) whereas there were significant differences in these parameters from Tanner stages II to V (p<0.05). The percentage difference between LSES and HSES girls in TBBMC, TBBA, TBBMD, LBM and TBFM was 3.4%, 0%, 3.7%, 0.2% and 17.3% respectively at Tanner stage I which increased to 19.1%, 9.7%, 10.4%, 8.8% and 31.2% respectively at Tanner stage V. In conclusion, our results suggest that pubertal years may provide a window of opportunity to promote bone health in adolescent girls from the lower socio-economic stratum.
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Affiliation(s)
- Anuradha V Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
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Khadilkar AV, Sanwalka NJ, Chiplonkar SA, Khadilkar VV, Mughal MZ. Normative data and percentile curves for Dual Energy X-ray Absorptiometry in healthy Indian girls and boys aged 5-17 years. Bone 2011; 48:810-9. [PMID: 21182992 DOI: 10.1016/j.bone.2010.12.013] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2010] [Revised: 12/10/2010] [Accepted: 12/14/2010] [Indexed: 10/18/2022]
Abstract
For the correct interpretation of Dual Energy X-ray Absorptiometry (DXA) measurements in children, the use of age, gender, height, weight and ethnicity specific reference data is crucially important. In the absence of such a database for Indian children, the present study aimed to provide gender and age specific data on bone parameters and reference percentile curves for the assessment of bone status in 5-17 year old Indian boys and girls. A cross sectional study was conducted from May 2006 to July 2010 on 920 (480 boys) apparently healthy children from schools and colleges in Pune City, India. The GE-Lunar DPX Pro Pencil Beam DXA scanner was used to measure bone mineral content (BMC [g]), bone area (BA [cm(2)]) and bone mineral density (BMD [g/cm(2)]) at total body, lumbar spine and left femur. Reference percentile curves by age were derived separately for boys and girls for the total body BMC (TBBMC), total body BA (TBBA), lumbar spine bone mineral apparent density (BMAD [g/cm(3)]), and left femoral neck BMAD. We have also presented percentile curves for TBBA for height, TBBMC for TBBA, LBM for height and TBBMC for LBM for normalizing bone data for Indian children. Mean TBBMC, TBBA and TBBMD were expressed by age groups and Tanner stages for boys and girls separately. The average increase in TBBMC and TBBA with age was of the order of 8 to 12% at each age group. After 16 years of age, TBBMC and TBBA were significantly higher in boys than in girls (p<0.01). Maximal increase in TBBMD occurred around the age of 13 years in girls and three years later in boys. Reference data provided may be used for the clinical assessment of bone status of Indian children and adolescents.
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Affiliation(s)
- Anuradha V Khadilkar
- Hirabai Cowasji Jehangir Medical Research Institute, Jehangir Hospital, Pune, India.
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Olivares-Navarrete R, Hyzy SL, Chaudhri RA, Zhao G, Boyan BD, Schwartz Z. Sex dependent regulation of osteoblast response to implant surface properties by systemic hormones. Biol Sex Differ 2010; 1:4. [PMID: 21208469 PMCID: PMC3010104 DOI: 10.1186/2042-6410-1-4] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2010] [Accepted: 11/04/2010] [Indexed: 12/01/2022] Open
Abstract
Background Osseointegration depends on the implant surface, bone quality and the local and systemic host environment, which can differ in male and female patients. This study was undertaken in order to determine if male and female cells respond differently to titanium surfaces that have micron-scale roughness and if interactions of calciotropic hormones [1α,25(OH)2D3 and 17β-oestradiol (E2)] and microstructured surfaces on osteoblasts are sex dependent. Methods Osteoblasts from 6-week old Sprague-Dawley rats were cultured on tissue culture polystyrene (TCPS) or on titanium (Ti) disks with two different surface topographies, a smooth pretreated (PT) surface and a coarse grit-blasted/acid-etched (SLA) surface, and treated with 1α,25(OH)2D3, E2, or E2 conjugated to bovine serum albumin (E2-BSA). Results Male and female cells responded similarly to Ti microstructure with respect to cell number and levels of osteocalcin, transforming growth factor-β1, osteoprotegerin and prostaglandin E2 in their conditioned media, exhibiting a more differentiated phenotype on SLA than on PT or TCPS. E2 and E2-BSA increased differentiation and local factor production, an effect that was microstructure dependent and found only in female osteoblasts. 1α,25(OH)2D3 increased osteoblast differentiation and local factor production in female and male cells, but the effect was more robust in male cells. Conclusions Male and female rat osteoblasts respond similarly to surface microstructure but exhibit sexual dimorphism in substrate-dependent responses to systemic hormones. Oestrogen affected only female cells while 1α,25(OH)2D3 had a greater effect on male cells. These results suggest that successful osseointegration in males and females may depend on the implant surface design and correct levels of calciotropic hormones.
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Affiliation(s)
- Rene Olivares-Navarrete
- Institute for Bioengineering and Bioscience, Georgia Institute of Technology, 315 Ferst Drive, Atlanta, GA, USA.
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14
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El-Soud NHA, . MMY, . MAM, . YAK. Obesity in Children and Adolescents: Effect on Bone Mineral Content and Density. JOURNAL OF MEDICAL SCIENCES 2006. [DOI: 10.3923/jms.2006.786.792] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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15
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Zadik Z, Sinai T, Borondukov E, Zung A, Yaniv I, Reifen R. Longitudinal monitoring of bone accretion measured by quantitative multi-site ultrasound (QUS) of bones in patients with delayed puberty (a pilot study). Osteoporos Int 2005; 16:1036-41. [PMID: 15616757 DOI: 10.1007/s00198-004-1795-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2004] [Accepted: 10/07/2004] [Indexed: 11/25/2022]
Abstract
OBJECTIVE to compare the effect of anabolic agents on bone accretion in boys with constitutional delay of puberty (CGDP). RATIONALE it has been suggested that an appropriate timing of puberty is necessary for normal bone mineral density (BMD) acquisition. Proper bone development during childhood is the key factor in achieving higher peak bone mass during middle age, which may not be achievable in CGDP children, and thereby osteoporosis may appear at an earlier age then expected. PATIENTS AND METHODS 45 boys with CGDP aged 14-16 years were monitored longitudinally, every 3 months over 12 months with Sunlight Omnisense, a quantitative ultrasound device (Tel Aviv, Israel). The apparatus is a multi-site bone sonometer that obtains axial Speed of Sound (SOS). Based on a reference database obtained on n=1,085 (490 boys) 0-18 years, a normative curve was determined. Fifteen (14-16 years old) of the CGDP patients were treated with I.M. testovirone depot 100 mg monthly for 6 months, 15 (14-16 years old) were treated with oxandrolone 5 mg/m(2) daily for 6 months, and 15 (14-16 years old) were in an observation group. RESULTS whereas the quantitative ultrasound (QUS) Z-score had shown some increase over time in CGDP-treated patients, an increase was found in tibia Z-score from -0.5(-0.64, -0.36) to -0.4(-0.54, -0.26) and from -0.52(-0.67, -0.38) to -0.31(-0.44, -0.11) in the testosterone and oxandrolone-treated groups, respectively, [median (25%, 75%)]. An increase in radius Z-score from -0.52(-0.65, -0.25) to -0.4(-0.54, -0.15) and from -0.51(-0.61, -0.21) to -0.37(-0.47, -0.07) in the testosterone- and oxandrolone-treated groups respectively [median (25%,75%)]. Z-score SOS decreased in the observation group -0.5(-0.66, -0.3) to -0.69(-0.85, -0.54) and -0.5(-0.59, -0.41) to -0.81(-0.95, -0.55) in tibia (P = 0.032) and radius (P = 0.029), respectively. Despite the fact that QUS remained in the normative range in all patients, a clear deterioration was demonstrated in untreated CGDP patients. CONCLUSION longitudinal follow-up of patients with CGDP may detect an early pattern of deterioration of bone mass.
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Affiliation(s)
- Zvi Zadik
- The Pediatric Endocrine Unit, Kaplan Medical Center, Hadassah Medical School, 76100 Rehovot, Israel.
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16
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Maric N, Popovic V, Jasovic-Gasic M, Pilipovic N, van Os J. Cumulative exposure to estrogen and psychosis: a peak bone mass, case-control study in first-episode psychosis. Schizophr Res 2005; 73:351-5. [PMID: 15653281 DOI: 10.1016/j.schres.2004.07.016] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2004] [Revised: 07/24/2004] [Accepted: 07/24/2004] [Indexed: 10/26/2022]
Abstract
The organizational structural effects of estrogen may be cumulative and permanent by impacting on neurodevelopment, giving rise to "neuroprotective" effects and eventually reduction of psychosis risk. Reduction in bone mineral density (BMD, in g/cm2), as a biological marker of reduced cumulative exposure to estrogen, may be a marker of increased psychosis risk. A sample of 19 first-episode female psychosis patients with minimal previous antipsychotic exposure (mean 10 weeks) and 20 female controls underwent advanced fan-beam dual X-ray absorptiometry (DXA) to assess lumbal spine BMD of the region of L1-L4. Mean BMD was around one standard deviation lower in patients (1.13, S.D.=0.10) than in controls (1.25, S.D.=0.12; p=0.0021), and 84% of patients scored below the median value of the controls (OR=5.3, 95% CI: 1.2, 24.2). The results are compatible with the hypothesis that psychosis in women may be associated causally with a reduced protective effect of estrogen over the course of development.
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Affiliation(s)
- Nadja Maric
- Institute of Psychiatry, University Clinical Centre, Belgrade, Serbia and Montenegro
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17
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Yilmaz D, Ersoy B, Bilgin E, Gümüşer G, Onur E, Pinar ED. Bone mineral density in girls and boys at different pubertal stages: relation with gonadal steroids, bone formation markers, and growth parameters. J Bone Miner Metab 2005; 23:476-82. [PMID: 16261455 DOI: 10.1007/s00774-005-0631-6] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2005] [Accepted: 06/03/2005] [Indexed: 11/24/2022]
Abstract
Puberty has a key role in bone development. During puberty, several nutritional and hormonal factors play a major role in this process. The aim of this study was to determine the changes in areal bone mineral density (BMD), gonadal steroids, bone formation markers, and growth parameters in healthy Turkish pubertal girls and boys at different pubertal stages. In additional, we aimed to detect the relationship between BMD, sex steroids, and growth parameters, and to reveal the most important determinant of BMD in the pubertal period. BMD of the lumbar spine and total body was performed by dual-energy X-ray absorptiometry (Lunar DPX series) in 174 healthy pubertal children (91 girls, 83 boys), aged 11-15 years. Height and weight were measured. Pubertal stages were assesed. Bone formation markers and gonadal steroids were measured. BMD values significantly increased until stage IV in girls. In boys, BMD values also increased during puberty (P < 0.05), but it was significantly higher in stage IV compared with that in other pubertal stages (P < 0.01). Testosterone levels increased until stage IV in both sexes, particularly in boys. Estrogen levels significantly increased during puberty in girls, whereas it was significantly higher at stage IV in boys (P < 0.001). Bone-specific alkaline phosphatase (BAP) level was higher in early and midpuberty, and decreased in late puberty in girls (P < 0.001). BAP level was higher in stage IV in boys. Osteocalcin level was shown not to change significantly in pubertal stages. There was a modest correlation between BMD values and estrogen and testosterone levels in boys. In girls, there was a correlation between BMD values and estrogen levels only (P < 0.05). Weight was significantly associated with BMD in both sexes (P < 0.05). Estrogen had a significant influence on BMD in boys and girls. In conclusion, bone mass increased throughout puberty in both sexes. Peak bone mass was not achieved in girls, but was obtained at stage IV in boys. Bone formation markers were good predictors of bone mass in girls, but not in boys. Estrogen level made the greatest contribution to bone mineral acquisition in boys and girls. The achievement of peak bone mass was sustained by estrogen in boys. The major independent determinant of BMD in both sexes was weight.
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Affiliation(s)
- Dilek Yilmaz
- Department of Pediatrics, School of Medicine, Celal Bayar University, Manisa, Turkey
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18
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Kanazawa S, Kojima M, Koyama S, Arisaka O. Effect of Testosterone on Bone Mineral Gain: Observations of Male Patients with Growth Hormone Deficiency and Normal Gonadotropin Secretion. Clin Pediatr Endocrinol 2004; 13:79-82. [PMID: 24790302 PMCID: PMC4004918 DOI: 10.1297/cpe.13.79] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2003] [Accepted: 03/05/2004] [Indexed: 11/25/2022] Open
Affiliation(s)
- Sanae Kanazawa
- Department of Pediatrics, Dokkyo University School of Medicine
| | - Megumi Kojima
- Department of Pediatrics, Dokkyo University School of Medicine
| | - Satomi Koyama
- Department of Pediatrics, Dokkyo University School of Medicine
| | - Osamu Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine
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19
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Frank GR. Role of estrogen and androgen in pubertal skeletal physiology. MEDICAL AND PEDIATRIC ONCOLOGY 2003; 41:217-21. [PMID: 12868122 DOI: 10.1002/mpo.10340] [Citation(s) in RCA: 75] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Since both estrogen and androgen are present in each sex, it has been difficult to discern the exact role that each sex steroid plays in skeletal physiology. However, studying clinical syndromes in which there is either only estrogen or androgen action has allowed us to gain insight into the unique role that each sex steroid plays in the growing skeleton. In complete androgen insensitivity syndrome (AIS) the only functional sex steroid receptor is that for estrogen. Effected XY females have a pubertal growth spurt that is typical of normal females, both in magnitude and timing. Individuals with AIS have a mild reduction in bone density but it is difficult to distinguish whether this is the result of androgen resistance or estrogen deficiency. These observations suggest that estrogen action only is sufficient to induce a normal pubertal growth spurt, epiphyseal maturation, and near normal bone mineral accretion in women. Until recently, the skeletal effects of estrogen were not thought to be of importance in the male. Conventional wisdom dictated that, in the male, testosterone mediated these skeletal changes. The notion that estrogen is of little importance in the male has been challenged by the recent discovery of two human syndromes in which estrogen action is lacking. In males with either estrogen resistance (inability to respond to circulating estrogen) or aromatase deficiency (inability to synthesize estradiol), as a result of the lack of estrogen action, a pubertal growth spurt does not appear to occur. Furthermore, complete epiphyseal maturation does not take place allowing for continued growth in adulthood and resultant tall stature. Finally normal bone mineral accretion does not take place resulting in severe osteoporosis. These findings indicate that estrogen plays a critical role in skeletal physiology of males as well as females.
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Affiliation(s)
- Graeme R Frank
- Division of Endocrinology, Department of Pediatrics, Schneider Children's Hospital, New Hyde Park, New York 11040, USA.
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20
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Abstract
Among the main areas of progress in osteoporosis research during the last decade or so are the general recognition that this condition, which is the cause of so much pain in the elderly population, has its antecedents in childhood and the identification of the structural basis accounting for much of the differences in bone strength among humans. Nevertheless, current understanding of the bone mineral accrual process is far from complete. The search for genes that regulate bone mass acquisition is ongoing, and current results are not sufficient to identify subjects at risk. However, there is solid evidence that BMD measurements can be helpful for the selection of subjects that presumably would benefit from preventive interventions. The questions regarding the type of preventive interventions, their magnitude, and duration remain unanswered. Carefully designed controlled trials are needed. Nevertheless, previous experience indicates that weight-bearing activity and possibly calcium supplements are beneficial if they are begun during childhood and preferably before the onset of puberty. Modification of unhealthy lifestyles and increments in exercise or calcium assumption are logical interventions that should be implemented to improve bone mass gains in all children and adolescents who are at risk of failing to achieve an optimal peak bone mass.
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Affiliation(s)
- Stefano Mora
- Laboratory of Pediatric Endocrinology, Scientific Institute H San Raffaele, Milan, Italy
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21
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van der Sluis IM, de Ridder MAJ, Boot AM, Krenning EP, de Muinck Keizer-Schrama SMPF. Reference data for bone density and body composition measured with dual energy x ray absorptiometry in white children and young adults. Arch Dis Child 2002; 87:341-7; discussion 341-7. [PMID: 12244017 PMCID: PMC1763043 DOI: 10.1136/adc.87.4.341] [Citation(s) in RCA: 240] [Impact Index Per Article: 10.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To obtain normative data on bone mineral density and body composition measured with dual energy x ray absorptiometry (DXA) from early childhood to young adulthood. METHODS Cross sectional results from 444 healthy white volunteers (4-20 years) in the Netherlands were combined with the results from 198 children who agreed to participate in the follow up study approximately four years later. DXA (Lunar, DPXL) of lumbar spine and total body was performed to assess bone density and body composition. RESULTS Bone density and lean body mass (LBM) increased with age. Maximal increase in bone density and LBM occurred around the age of 13 years in girls and approximately two years later in boys. Bone density of total body and lumbar spine showed an ongoing slight increase in the third decade. Mean fat percentage in boys remained at 10.5% throughout childhood, but increased in girls. CONCLUSIONS Most of the skeletal mass in lumbar spine and total body is reached before the end of the second decade, with a slight increase thereafter. This study provides reference values for bone density and body composition measured with DXA for children and young adults.
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Affiliation(s)
- I M van der Sluis
- Dept of Paediatrics, Subdivision of Endocrinology, Erasmus University Rotterdam, Rotterdam, Netherlands.
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22
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Abstract
The predominant influences on fetal growth are maternal and placental factors. Post-natal growth is regulated by a complex interaction between genetic, environmental and hormonal influences. The role of the growth hormone insulin-like growth factor (GH-IGF) system is explored, including the emerging role of IGF-2 in fetal growth. Increasing understanding of the genetics of overgrowth and short stature syndromes is contributing greatly to basic understanding of growth regulation. A range of prenatal overgrowth syndromes is discussed, including those associated with neonatal hyperinsulinism and hypoglycaemia.Post-natal overgrowth may be caused by a diverse range of normal variant conditions, endocrine disorders, chromosomal abnormalities and other genetic syndromes. An approach to diagnosis is presented and major conditions discussed in detail. Sex-steroid therapy for height limitation continues to be a controversial area with uncertainty about height prediction, benefits achieved and possible long-term side-effects.
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Affiliation(s)
- Geoffrey Ambler
- The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW, Australia
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23
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Decker R, Partsch CJ, Sippell WG. Combined treatment with testosterone (T) and ethinylestradiol (EE2) in constitutionally tall boys: is treatment with T plus EE2 more effective in reducing final height in tall boys than T alone? J Clin Endocrinol Metab 2002; 87:1634-9. [PMID: 11932294 DOI: 10.1210/jcem.87.4.8361] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
Estrogens have been shown to rapidly inhibit longitudinal growth in tall boys. To antagonize the initial growth accelerating effect of T, 41 boys with an initial height prediction in excess of 203 cm were treated prospectively with either T enanthate (TE) 250 mg/wk im in combination with ethinylestradiol (EE2) 0.1 mg/d taken orally for the first 5.8 +/- 0.47 wk (mean +/- SE) of treatment (group 1, n = 20) or with TE alone (group 2, n = 21). Patients were randomized to one or the other treatment regimen. Mean (+/-SE) predicted adult height was 206.8 +/- 0.7 cm in group 1 and 206.4 +/- 0.8 cm in group 2. Total duration of treatment was 16.1 +/- 0.8 months and 14.0 +/- 1.2 months in group 1 and 2, respectively (NS). EE2-induced side effects in group 1 (gynecomastia) were limited and fully reversible. No negative long-term sequelae were found at final height with respect to hypothalamic-pituitary-gonadal axis activity and to testis volumes. Although there was a tendency to a lower initial growth velocity measured by knemometry in group 1 (0.30 +/- 0.05 vs. 0.38 +/- 0.05 mm/wk, NS), final height did not differ in both study groups (195.0 +/- 0.8 cm in group 1, 194.6 +/- 0.8 cm in group 2). Similarly, height reduction (initial predicted adult height minus final height) was not significantly different between the two groups (12.0 +/- 0.9 cm in group 1, 11.7 +/- 0.9 cm in group 2). In conclusion, the addition of EE2 during the initial treatment phase to high-dose T in tall boys has no significant effect on height reduction. The results of this clinical trial suggest that the initial growth inhibiting effect of EE2 on the epiphyseal growth plates is overridden by the long-term administration of high dose TE.
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Affiliation(s)
- Ralph Decker
- Division of Pediatric Endocrinology, Department of Pediatrics, Christian-Albrechts University, Kiel 24105, Germany
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24
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Lee DY, Chai YG, Lee EB, Kim KW, Nah SY, Oh TH, Rhim H. 17Beta-estradiol inhibits high-voltage-activated calcium channel currents in rat sensory neurons via a non-genomic mechanism. Life Sci 2002; 70:2047-59. [PMID: 12148697 DOI: 10.1016/s0024-3205(01)01534-x] [Citation(s) in RCA: 62] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
There is increasing evidence that estrogen influences electrical activity of neurons via stimulation of membrane receptors. Although the presence of intracellular estrogen receptors and their responsiveness in dorsal root ganglion (DRG) primary sensory neurons were reported, rapid electrical responses of estrogen in DRG neurons have not been reported yet. Therefore the current study was initiated to examine the rapid effects of estrogen on Ca2+ channels and to determine its detailed mechanism in female rat DRG neurons using whole-cell patch-clamp recordings. Application of 17beta-estradiol (1 microM) caused a rapid inhibition on high-voltage-activated (HVA)-, but not on low-voltage-activated (LVA)-Ca2+ currents. This rapid estrogen-mediated inhibition was reproducible and dose-dependent. This effect was also sex- and stereo-specific; it was greater in cells isolated from intact female rats and was more effective than that of 17alpha-estradiol, the stereoisomer of the endogenous 17alpha-estradiol. In addition, ovariectomy reduced the inhibition significantly but this effect was restored by administration of estrogen in ovariectomized subjects. Occlusion experiments using selective blockers revealed 17beta-estradiol mainly targeted on both L- and N-type Ca2+ currents. Overnight treatment of cells with pertussis toxin profoundly reduced 17beta-estradiol-mediated inhibition of the currents. On the other hand, estradiol conjugated to bovine serum albumin (EST-BSA) produced a similar extent of inhibition as 17beta-estradiol did. These results suggest that 17beta-estradiol can modulate L- and N-type HVA Ca2+ channels in rat DRG neurons via activation of pertussis toxin-sensitive G-protein(s) and non-genomic pathways. It is likely that such effects are important in estrogen-mediated modulation of sensory functions at peripheral level.
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Affiliation(s)
- Dong Yun Lee
- Biomedical Research Center, Korea Institute of Science and Technology, Seoul
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25
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Kanazawa S. Bone Maturation and Bone Mineralization in Precocious Puberty: Relation to Estrogen Receptor Gene Polymorphisms. Clin Pediatr Endocrinol 2002. [DOI: 10.1297/cpe.11.11] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Sanae Kanazawa
- Department of Pediatrics, Dokkyo University School of Medicine
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Taha W, Chin D, Silverberg AI, Lashiker L, Khateeb N, Anhalt H. Reduced spinal bone mineral density in adolescents of an Ultra-Orthodox Jewish community in Brooklyn. Pediatrics 2001; 107:E79. [PMID: 11331729 DOI: 10.1542/peds.107.5.e79] [Citation(s) in RCA: 35] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES Bone mass increases throughout childhood, with maximal bone mass accrual rate occurring in early to mid-puberty and slowing in late puberty. Prevention of osteoporosis and its morbidities depends primarily on the establishment of adequate peak bone mass. Physical activity, calcium intake, and vitamin D stores (from sunlight conversion of precursors of vitamin D and to a lesser degree from dietary intake) are vital determinants of bone mineral density (BMD). BMD is further controlled by genetic and environmental factors that are poorly understood. Observance of ultra-Orthodox Jewish customs may have a negative effect on the factors that promote bone health, and there have been anecdotal reports of higher fracture rates in this population. The ultra-Orthodox Jewish lifestyle encourages scholarly activity in preference to physical activity. Additionally, modest dress codes and inner-city dwelling reduce sunlight exposure. Orthodox Jews do not consume milk products for 6 hours after meat ingestion, leading to potentially fewer opportunities to consume calcium. Foods from the milk group are some of the best sources of dietary calcium. Our aims are to examine BMD in a group of healthy ultra-Orthodox Jewish adolescents in an urban community and to attempt to correlate it to physical activity and dietary factors. DESIGN AND METHODS We recruited 50 healthy, ultra-Orthodox Jews, ages 15 to 19 years (30 males and 20 females). None were taking corticosteroids or had evidence of malabsorption. All girls were postmenarchal and nulliparous. Pubic hair Tanner stage for boys and breast Tanner stage for girls were determined. Weight and height standard deviation scores were calculated. Calcium, phosphorus, protein, vitamin D, and calorie intake were assessed using a comprehensive food questionnaire referring to what has been eaten over the last year. Hours per week of weight-bearing exercise and walking were determined. Serum levels of calcium, intact parathyroid hormone (PTH), 25 hydroxyvitamin D (25[OH]D) and 1,25 dihydroxyvitamin D (1,25[OH](2)D) were measured. Lumbar spine (L) BMD was assessed by dual energy radiograph absorptiometry. The pediatric software supplied by Lunar Radiation Corporation, which contains gender- and age-specific norms, provided a z score for the lumbar BMD for each participant. L2 to L4 bone mineral apparent density (BMAD) was calculated from L2 to L4 BMD. RESULTS BMD of L2 to L4 was significantly decreased compared with age/sex-matched normative data: mean z score was -1.25 +/- 1.25 (n = 50). The mean L2 to L4 BMD z score +/- standard deviation was -1.71 +/- 1.18 for boys and -0.58 +/- 1.04 for girls. Eight boys (27%) had L2 to L4 BMD z scores <-2.5, which defines osteoporosis in adulthood. Twenty-seven adolescents (54%), 16 boys and 11 girls, had Tanner stage V. Two participants (4%) had delayed development of Tanner stage V. Mean consumption of calcium by participants under 19 years old was 908 +/- 506 mg/day (n = 46), which is lower than the adequate intake of 1300 mg/day for this age. The consumption of phosphorus was 1329 +/- 606 mg/day, and the consumption of vitamin D was 286 +/- 173 IU/day (n = 50). The mean serum 25(OH)D level was 18.4 +/- 7.6 ng/mL, and the mean serum 1,25(OH)(2)D level was 71.1 +/- 15.7 pg/mL (n = 50). Boys had significantly higher serum levels of 1,25(OH)(2)D than did girls (74.9 +/- 16.46 pg/mL vs 65.25 +/- 12.8 pg/mL, respectively). The serum levels of PTH, calcium, and protein were (mean +/- standard deviation): 33 +/- 16 pg/mL, 9.5 +/- 0.69 mg/dL, and 7.8 +/- 0.6 g/dL, respectively (n = 50). L2 to L4 BMD z score had positive correlation with walking hours (r = 0.4). L2 to L4 BMD z score had negative correlation with serum level of 1,25(OH)(2)D )r = -0.33; n = 50). We could not find significant correlation between L2 to L4 BMD z scores for the entire cohort and any of calcium, vitamin D, phosphorus, or protein intake. However, the L2 to L4 BMD z scores of boys had positive correlation with calcium, phosphorus, and protein intake (r = 42, r = 44, and r = 43, respectively). After adjustment for Tanner stage, boys who had Tanner stage V (n = 16) had stronger positive correlation between L2 to L4 BMD z scores and calcium and protein intake (r = 0.55 and r = 0.57, respectively), as was the correlation between L2 to L4 BMD z score and weight-bearing activity and walking hours (r = 0.77 and r = 0.72, respectively; n = 16). By multiple regression analysis with stepwise selection, sex, walking hours, weight-standard deviation scores, and serum PTH predicted 54% of the variability in L2 to L4 BMD z score. Sex, walking hours, and age predicted 65% of the variability in L2 to L4 BMAD. CONCLUSIONS Lumbar BMD is significantly decreased in ultra-Orthodox Jewish adolescents living in an urban community. Boys had profoundly lower spinal BMD than did girls. Previous studies have introduced estrogen as a critical factor in bone mineralization. (ABSTRACT TRUNCATED)
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Affiliation(s)
- W Taha
- Division of Pediatric Endocrinology, Maimonides Medical Center, Brooklyn, New York 11219, USA
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Arisaka O, Negishi M, Numata M, Hoshi M, Kanazawa S, Oyama M, Nitta A, Suzumuara H, Kuribayashi T, Nakayama Y. Precocious puberty resulting from congenital hypothalamic hamartoma: persistent darkened areolae after birth as the hallmark of estrogen excess. Clin Pediatr (Phila) 2001; 40:163-7. [PMID: 11307963 DOI: 10.1177/000992280104000307] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- O Arisaka
- Department of Pediatrics, Dokkyo University School of Medicine, Mibu, Tochigi, Japan
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Patel MS, Cole DE, Smith JD, Hawker GA, Wong B, Trang H, Vieth R, Meltzer P, Rubin LA. Alleles of the estrogen receptor alpha-gene and an estrogen receptor cotranscriptional activator gene, amplified in breast cancer-1 (AIB1), are associated with quantitative calcaneal ultrasound. J Bone Miner Res 2000; 15:2231-9. [PMID: 11092404 DOI: 10.1359/jbmr.2000.15.11.2231] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Quantitative bone ultrasound (QUS) has a significant heritable component. Because estrogen is required for attainment of peak bone mass, we studied alleles of two genes, estrogen receptor alpha (ER1) and amplified in breast cancer-1 (AIB1), for their association with QUS. In a volunteer sample of 663 white women aged 18-35 years, bone ultrasound attenuation (BUA), speed of sound (SOS), and heel stiffness index (SI), the latter consisting of the component measures of BUA and SOS, were measured at the right calcaneus by QUS. Subjects were genotyped for the ER1 polymorphisms Xba I and Pvu II and for the AIB1 polyglutamine tract polymorphism. In a multiple regression analysis, ER1 genotype was an independent predictor of QUS-SI (p = 0.03). Because AIB1 and ER1 enhance gene expression in a coordinate manner, we also searched for interactions. A gene-by-gene interaction effect was seen for QUS-SI (p = 0.009), QUS-BUA (p = 0.03), and QUS-SOS (p = 0.004). These remained significant after the inclusion of clinically relevant variables into the final regression model. Overall, these clinical and genetic factors accounted for up to 16% of the variance in peak QUS; the genetic markers alone accounted for 4-7%. This is the first demonstration of specific genetic effects on calcaneal QUS encoded by alleles of genes directly involved in mediating estrogen effects on bone.
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Affiliation(s)
- M S Patel
- Department of Pediatrics (Genetics), Hospital for Sick Children, Toronto, Ontario, Canada
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Filosa A, Di Maio S, Lamba M, Baron I, Saviano A, Esposito G. Bone age progression during five years of substitutive therapy for the induction of puberty in thalassemic girls--effects on height and sitting height. J Pediatr Endocrinol Metab 1999; 12:525-30. [PMID: 10417968 DOI: 10.1515/jpem.1999.12.4.525] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
UNLABELLED It is known that in thalassemic patients there is a disproportion between lower and upper segments whose causes have not yet been identified. We evaluated whether the administration of estrogens to induce puberty in hypogonadic thalassemic girls caused an inappropriate acceleration of bone maturation and whether this had a negative influence on final and sitting height. MATERIALS AND METHODS Twelve thalassemic patients with spontaneous puberty (Group A) and seven patients with hypogonadism (Group B) were studied. The mutations of the beta gene were identified by DNA analysis. We took into account four observations, ranging from the onset of spontaneous puberty in group A or the start of substitutive therapy in group B, to 5 years later. At each observation we considered: chronological age (CA), bone age (BA), height (Ht) expressed in cm and as standard deviation score (HtSDS) calculated with respect to CA (HtSDSCA) and BA (HtSDSBA), growth spurt, sitting height, expressed as SDS (SH-SDS), and height gain (HG). The delta BA and delta CA were calculated between the first and the final observation values to evaluate the bone age acceleration (delta BA/delta CA). RESULTS No acceleration of BA was noted. delta BA/delta CA was 0.98 +/- 0.1 in group A and 0.89 +/- 0.1 in group B (p > 0.05). All patients in group B had the most severe form (beta degree/beta degree) of thalassemia. During the final observation, SH-SDS was -1.43 +/- 1.2 and -2.9 +/- 0.6 in group A and B respectively (p < 0.002), while no difference between the two groups for HtSDSCA and HtSDSBA was observed. HG was greater in group A than in group B (17.7 +/- 5.4 cm vs 10.8 +/- 5.2 cm) (p < 0.002), such as the spurt 8.6 +/- 1.4 cm (group A) and 6.1 +/- 2.6 cm (group B) (p < 0.05). CONCLUSIONS Girls with hypogonadism did not show an inappropriate acceleration of BA, as they reached near final height similar to girls with spontaneous puberty. The auxological parameters showed a more severe body disproportion with the prevalence of the lower segment in the hypogonadic girls. This could be explained by a higher degree of bone marrow hyperplasia related to the most severe form of thalassemia and a higher blood consumption. As a consequence, damage at the vertebral level might determine an inability of the bone tissue to respond to estrogens. We suggest beginning estrogen therapy earlier in order to obtain better truncal growth.
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Affiliation(s)
- A Filosa
- XXIX Paediatric Division, Cardarelli Hospital, Naples, Italy
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Mayer EI, Homoki J, Ranke MB. Spontaneous growth and bone age development in a patient with 17alpha-hydroxylase deficiency: evidence of the role of sexual steroids in prepubertal bone maturation. J Pediatr 1999; 134:371-5. [PMID: 10064681 DOI: 10.1016/s0022-3476(99)70468-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
A male pseudohermaphrodite with 17alpha-hydroxylase deficiency and complete nonvirilization was monitored for excessive weight from the age of 3.5 to 11.5 years before the absence of sex steroids was detected. The retrospective analysis of growth data showed retarded bone age development despite adequate growth, which led to a remarkable increase in final height prognosis.
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Affiliation(s)
- E I Mayer
- Department of Endocrinology, University Children's Hospital Tübingen, Germany
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31
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Affiliation(s)
- S L Drop
- Department of Pediatrics, Sophia Children's Hospital, Erasmus University, Rotterdam, The Netherlands.
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Abstract
We studied the acquisition of bone mineral and related changes in body mass, pubertal status, and sex hormones in 75 healthy prepubertal and pubertal girls aged 7.5-16 years. Bone mineral density of the lumbar spine (L-1, L-2, L-3, L-4) was measured in children by quantitative computerized tomography. Skeletal mineralization accelerated markedly at puberty. Age, weight, height, and body mass index (BMI) were highly correlated with bone mineral density.
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Affiliation(s)
- Z Orbak
- Department of Pediatrics, Atatürk University, Medical Faculty, Erzurum, Turkey
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Indrayana NS, Glinka J, Mieke S. Mandibular ramus flexure in an Indonesian population. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 1998; 105:89-90. [PMID: 9537930 DOI: 10.1002/(sici)1096-8644(199801)105:1<89::aid-ajpa8>3.0.co;2-8] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
- N S Indrayana
- Department of Forensic Medicine, Airlangga University, School of Medicine, Surabaya, Indonesia
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Rissman EF, Wersinger SR, Taylor JA, Lubahn DB. Estrogen receptor function as revealed by knockout studies: neuroendocrine and behavioral aspects. Horm Behav 1997; 31:232-43. [PMID: 9213137 DOI: 10.1006/hbeh.1997.1390] [Citation(s) in RCA: 148] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Estrogens are an important class of steroid hormones, involved in the development of brain, skeletal, and soft tissues. These hormones influence adult behaviors, endocrine state, and a host of other physiological functions. Given the recent cloning of a second estrogen receptor (ER) cDNA (the ER beta), work on alternate spliced forms of ER alpha, and the potential for membrane estrogen receptors, an animal with a null background for ER alpha function is invaluable for distinguishing biological responses of estrogens working via the ER alpha protein and those working via another ER protein. Data generated to date, and reviewed here, indicate that there are profound ramifications of the ER alpha disruption on behavior and neuroendocrine function. First, data on plasma levels of estradiol (E2), testosterone (T), and luteinizing hormone (LH) in wild-type (WT) versus ER alpha- mice confirm that ER alpha is essential in females for normal regulation of the hypothalamic-pituitary gonadal axis. Second, ovariectomized female ER alpha- mice do not display sexual receptivity when treated with a hormonal regime of estrogen and progesterone that induces receptivity in WT littermates. Finally, male sexual behaviors are disrupted in ER alpha- animals. Given decades of data on these topics our findings may seem self-evident. However, these data represent the most direct test currently possible of the specific role of the ER alpha protein on behavior and neuroendocrinology. The ER alpha- mouse can be used to ascertain the specific functions of ER alpha, to suggest functions for the other estrogen receptors, and to study indirect effects of ER alpha on behavior via actions on other receptors, neurotransmitters, and neuropeptides.
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Affiliation(s)
- E F Rissman
- Department of Biology, University of Virginia, Charlottesville 22903, USA.
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35
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Sharawy M. The effect of ovariectomy on the temporomandibular joint of growing rats. J Oral Maxillofac Surg 1996. [DOI: 10.1016/s0278-2391(96)90353-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Smith EP, Korach KS. Oestrogen receptor deficiency: consequences for growth. ACTA PAEDIATRICA (OSLO, NORWAY : 1992). SUPPLEMENT 1996; 417:39-43; discussion 44. [PMID: 9055907 DOI: 10.1111/j.1651-2227.1996.tb14292.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
These oestrogen-resistant and aromatase-deficient cases now establish a more complete picture of how androgen and oestrogen combine to regulate pubertal growth (47, 48) and demonstrate that oestrogen deficiency states need not be lethal (1). Whereas original concepts suggested that skeletal maturation and pubertal growth were attributable to androgen and, therefore, were not sexually dimorphic, current evidence preserves the notion of common mechanisms in both sexes, but points to oestrogen as the principal steroid involved in the final phases of skeletal maturation. Oestrogen can be viewed as a primary determinant of the final height of a child, in the sense that oestrogen initiates and completes epiphyseal closure. The full scope of the effects of androgen on epiphyseal maturation and linear height regulation is less clear but evidence suggests that androgen has direct and indirect effects through its aromatization to oestrogen (Fig. 2). Remarkably, under unusual circumstances, a rather prolonged period of continued growth can be achieved with minimal bone-age advancement, as long as oestrogen concentrations and/or sensitivity are low. Given this more complete understanding of the role of oestrogen, and with the availability of more sensitive assays for oestradiol (49), a new era in sex-steroid physiology and pubertal growth has been inaugurated (50). However, any therapies directed towards manipulating growth with sex steroids will need to take account of the possibility of untoward effects on other processes, such as the accretion of bone mineral mass (51,52).
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Affiliation(s)
- E P Smith
- Children's Hospital Medical Centre, Cincinnati, Ohio, USA
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