1
|
Liu Y, Xie X, Bi S, Zhang Q, Song Q, Sun Y, Yu T. Risk of osteoporosis in patients treated with direct oral anticoagulants vs. warfarin: an analysis of observational studies. Front Endocrinol (Lausanne) 2023; 14:1212570. [PMID: 37842293 PMCID: PMC10570517 DOI: 10.3389/fendo.2023.1212570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/07/2023] [Indexed: 10/17/2023] Open
Abstract
Aims Evidence on the association between the risk of new-onset osteoporosis and oral anticoagulants remains controversial. We aimed to compare the risk of osteoporosis associated with the use of direct oral anticoagulants (DOACs) with that associated with warfarin use. Methods Studies published up to 15 March 2023 that investigated the association between the use of DOACs and warfarin and the incidence of osteoporosis were identified by online searches in PubMed, Embase, the Cochrane Library, and Web of Science conducted by two independent investigators. Random-effects or fixed-effect models were employed to synthesize hazard ratios (HRs)/relative ratios (RRs) with 95% confidence intervals (CIs) for estimating the risk of osteoporosis correlated with DOAC and warfarin prescriptions (PROSPERO No. CRD42023401199). Results Our meta-analysis ultimately included four studies involving 74,338 patients. The results suggested that DOAC use was associated with a significantly lower incidence of new-onset osteoporosis than warfarin use (pooled HR: 0.71, 95% CI: 0.57 to 0.88, p < 0.001, I 2: 85.1%). Subanalyses revealed that rivaroxaban was associated with a lower risk of osteoporosis than both warfarin and dabigatran. In addition, DOACs were associated with a lower risk of developing osteoporosis than warfarin in both male and female patients, in patients with atrial fibrillation (AF), and in patients who underwent therapy for > 365 days. Conclusion DOAC users experienced a lower incidence of osteoporosis than warfarin users. This study may give us insight into safe anticoagulation strategies for patients who are at high risk of developing osteoporosis. Systematic review registration https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023401199.
Collapse
Affiliation(s)
- Yumeng Liu
- Institute of Virology and AIDS Research, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Xiaoping Xie
- Department of Orthopedics, Orthopedics Center, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Songqi Bi
- Department of Orthopedics, Orthopedics Center, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Qiong Zhang
- Department of Orthopedics, Orthopedics Center, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Qingxu Song
- Department of Orthopedics, Orthopedics Center, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Yang Sun
- Department of Orthopedics, Orthopedics Center, First Hospital of Jilin University, Jilin University, Changchun, China
| | - Tiecheng Yu
- Department of Orthopedics, Orthopedics Center, First Hospital of Jilin University, Jilin University, Changchun, China
| |
Collapse
|
2
|
Bolamperti S, Villa I, Rubinacci A. Bone remodeling: an operational process ensuring survival and bone mechanical competence. Bone Res 2022; 10:48. [PMID: 35851054 PMCID: PMC9293977 DOI: 10.1038/s41413-022-00219-8] [Citation(s) in RCA: 113] [Impact Index Per Article: 56.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 05/02/2022] [Accepted: 05/15/2022] [Indexed: 12/12/2022] Open
Abstract
Bone remodeling replaces old and damaged bone with new bone through a sequence of cellular events occurring on the same surface without any change in bone shape. It was initially thought that the basic multicellular unit (BMU) responsible for bone remodeling consists of osteoclasts and osteoblasts functioning through a hierarchical sequence of events organized into distinct stages. However, recent discoveries have indicated that all bone cells participate in BMU formation by interacting both simultaneously and at different differentiation stages with their progenitors, other cells, and bone matrix constituents. Therefore, bone remodeling is currently considered a physiological outcome of continuous cellular operational processes optimized to confer a survival advantage. Bone remodeling defines the primary activities that BMUs need to perform to renew successfully bone structural units. Hence, this review summarizes the current understanding of bone remodeling and future research directions with the aim of providing a clinically relevant biological background with which to identify targets for therapeutic strategies in osteoporosis.
Collapse
Affiliation(s)
- Simona Bolamperti
- Osteoporosis and Bone and Mineral Metabolism Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132, Milano, Italy
| | - Isabella Villa
- Osteoporosis and Bone and Mineral Metabolism Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132, Milano, Italy
| | - Alessandro Rubinacci
- Osteoporosis and Bone and Mineral Metabolism Unit, IRCCS San Raffaele Hospital, Via Olgettina 60, 20132, Milano, Italy.
| |
Collapse
|
3
|
Xie X, Liu Y, Li J, Gu F, Zhang K, Sui Z, Zhang J, Yu T. Fracture risks in patients with atrial fibrillation treated with different oral anticoagulants: a meta-analysis and systematic review. Age Ageing 2022; 51:6514231. [PMID: 35077554 PMCID: PMC8789302 DOI: 10.1093/ageing/afab264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 09/13/2021] [Indexed: 01/10/2023] Open
Abstract
Aims evidence on the difference in fracture risks for patients with atrial fibrillation (AF) receiving direct oral anticoagulants (DOACs) versus warfarin remains controversial. We aim to compare the fracture risks between the DOAC and warfarin prescriptions among the AF patients. Methods and Results we systematically searched PubMed, EMBASE, the Cochrane Library and Web of Science up to 19 April 2021 for relevant studies. And the observational studies regarding the relationship between the DAOC versus warfarin prescriptions and fracture risks among the patients with AF were included in this meta-analysis. Two investigators independently screened the articles and extracted the relevant data. A random- or fixed-effect model was applied to calculate the pooled hazard ratio/relative ratios with 95% confidence intervals of fracture risks associated with the DOAC and warfarin prescriptions. Six studies comprising 351,208 patients and 9,424 fractures were included in this meta-analysis. Overall, the AF patients treated with DOACs tend to present a lower risk of any fracture compared with those treated with warfarin (relative ratio: 0.82, 95% confidence interval (CI): 0.74–0.91). Sub-analyses for each individual DOAC indicate that apixaban and rivaroxan are associated with lower risk of any fracture compared with warfarin (HR: 0.75, 95% CI: 0.60–0.92, and HR: 0.79, 95% CI: 0.71–0.88, respectively). Conclusion this meta-analysis suggests that DOAC users have a lower risk of fractures than the warfarin users. The results of this study may provide optimal anticoagulation opportunities for AF patients with high fracture risk factors.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Tiecheng Yu
- Address correspondence to: Tiecheng Yu, Department of Orthopedics, The First Hospital of Jilin University, Changchun, China. Tel: +(0086) 135-9605-8780; E-mail:
| |
Collapse
|
4
|
Menaquinone 4 Reduces Bone Loss in Ovariectomized Mice through Dual Regulation of Bone Remodeling. Nutrients 2021; 13:nu13082570. [PMID: 34444729 PMCID: PMC8398915 DOI: 10.3390/nu13082570] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 07/22/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022] Open
Abstract
Epidemiologic studies showed that higher vitamin K (VK) consumption correlates with a reduced risk of osteoporosis, yet the dispute remains about whether VK is effective in improving bone mineral density (BMD). We sought to discover the anti-osteoporotic effect of menaquinone-4 (MK-4) and evaluate the expression of critical genes related to bone formation and bone resorption pathways in the body. Fifty female C57BL/6 mice (aged 13 weeks) were randomly arranged to a sham-operated group (SHAM, treated with corn oil) and four ovariectomized groups that were administered corn oil (OVX group), estradiol valerate (EV, 2 mg/kg body weight as the positive control), low or high doses of VK (LVK and HVK; 20 and 40 mg MK-4/kg body weight, respectively) by gavage every other day for 12 weeks. Body and uterine weight, serum biochemical indicators, bone microarchitecture, hematoxylin-eosin (HE) staining, and the mRNA expression of critical genes related to bone formation and bone resorption pathways were assessed. Either dose of MK-4 supplementation increased the alkaline phosphatase (ALP), decreased the undercarboxylated osteocalcin (ucOC) and tartrate-resistant acid phosphatase (TRACP, p < 0.05) levels, and presented higher BMD, percent bone volume (BV/TV), trabecular thickness (Tb.Th), and lower trabecular separation (Tb.Sp) and structure model index (SMI, p < 0.05) compared with the OVX group. Additionally, both doses of MK4 increased the mRNA expression of Runx2 and Bmp2 (p < 0.05), whereas the doses down-regulated Pu.1 and Nfatc1 (p < 0.05) mRNA expression, the high dose decreased Osx and Tgfb (p < 0.05) mRNA expression, and the low dose decreased Mitd and Akt1 (p < 0.05) mRNA expression. These data show the dual regulatory effects of MK-4 on bone remodeling in ovariectomized mice: the promotion of bone anabolic activity and inhibition of osteoclast differentiation, which provides a novel idea for treating osteoporosis.
Collapse
|
5
|
Chen L, Shi X, Weng SJ, Xie J, Tang JH, Yan DY, Wang BZ, Xie ZJ, Wu ZY, Yang L. Vitamin K2 Can Rescue the Dexamethasone-Induced Downregulation of Osteoblast Autophagy and Mitophagy Thereby Restoring Osteoblast Function In Vitro and In Vivo. Front Pharmacol 2020; 11:1209. [PMID: 32848799 PMCID: PMC7431688 DOI: 10.3389/fphar.2020.01209] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic long-term glucocorticoids (GC) use is associated with glucocorticoid-induced osteoporosis (GIOP) by inhibiting the survival and impairing the functions of osteoblasts. Autophagy and mitophagy play key roles in osteoblast differentiation, mineralization and survival, and mounting evidence have implicated osteoblast autophagy and mitophagy as a novel mechanism in the pathogenesis of GIOP. Vitamin K2 (VK2) is an essential nutrient supplement that have been shown to exert protective effects against osteoporotic bone loss including GIOP. In this study, we showed that the glucocorticoid dexamethasone (Dex) deregulated osteoblast autophagy and mitophagy by downregulating the expression of autophagic and mitophagic markers LC3-II, PINK1, Parkin. This consequently led to inhibition of osteoblast differentiation and mineralization function in vitro. Interestingly, co-treatment with VK2 significantly attenuated the Dex-induced downregulation of LC3-II, PINK1, Parkin, thereby restoring autophagic and mitophagic processes and normal osteoblastic activity. In addition, using an established rat model of GIOP, we showed that VK2 administration can protect rats against the deleterious effects of Dex on bone by reinstating autophagic and mitophagic activities in bone tissues. Collectively, our results provide new insights into the role of osteoblast autophagy and mitophagy in GIOP. Additionally, the use of VK2 supplementation to augment osteoblast autophagy/mitophagy may significantly improve clinical outcomes of GIOP patients.
Collapse
Affiliation(s)
- Liang Chen
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China
| | - Xiang Shi
- School of Mental Health, Wenzhou Medical University, Wenzhou, China
| | - She-Ji Weng
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Jun Xie
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China
| | - Jia-Hao Tang
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China
| | - De-Yi Yan
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China
| | - Bing-Zhang Wang
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China
| | - Zhong-Jie Xie
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Zong-Yi Wu
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China
| | - Lei Yang
- Department of Orthopedic Surgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.,Key Laboratory of Orthopedics of Zhejiang Province, Wenzhou, China
| |
Collapse
|
6
|
Usman N, Qaseem A, Jayaraj JS, Fathima N, Janapala RN. Drug-induced Reduction of Gamma Carboxylation in Osteocalcin: What is the Fallback? Cureus 2019; 11:e5504. [PMID: 31667038 PMCID: PMC6816527 DOI: 10.7759/cureus.5504] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Osteoporosis is a medical condition in which bone becomes fragile and weak. In this condition, the quality and density of the bone are reduced. Vitamin K is vital for bone mineralization as it plays a vital role in the gamma-carboxylation of osteocalcin. Therefore, if there is a deficiency of vitamin K, it can lead to osteoporosis due to undercarboxylated osteocalcin. Warfarin is the most widely used anticoagulant in the elderly. In this article, we reviewed how Warfarin, an inhibitor of vitamin K, affects bone remodeling and leads to osteoporosis.
Collapse
Affiliation(s)
- Norina Usman
- Internal Medicine, Veterans Affairs Palo Alto Health Care System - Stanford University School of Medicine, Palo Alto, USA
| | - Aisha Qaseem
- Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA
| | - Joseph S Jayaraj
- Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, New York, USA
| | - Nida Fathima
- Internal Medicine, Sri Siddhartha Medical College, Tumkur, IND
| | - Rajesh Naidu Janapala
- Internal Medicine, Icahn School of Medicine at Mount Sinai/Queens Hospital Center, New York, USA
| |
Collapse
|
7
|
Li W, Zhang S, Liu J, Liu Y, Liang Q. Vitamin K2 stimulates MC3T3‑E1 osteoblast differentiation and mineralization through autophagy induction. Mol Med Rep 2019; 19:3676-3684. [PMID: 30896842 PMCID: PMC6472126 DOI: 10.3892/mmr.2019.10040] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2018] [Accepted: 03/06/2019] [Indexed: 01/02/2023] Open
Abstract
Vitamin K2 likely exerts its protective effects during osteoporosis by promoting osteoblast differentiation and mineralization. However, the precise mechanism remains to be fully elucidated. Autophagy maintains cell homeostasis by breaking down and eliminating damaged proteins and organelles. Increasing evidence in recent years has implicated autophagy in the development of osteoporosis. The aim of the present study was to verify whether vitamin K2 (VK2) can induce autophagy during the differentiation and mineralization of osteoblasts. In the present study, MC3T3-E1 osteoblasts were treated with various doses of VK2 (10−8−10−3 M) for 1–5 days. The results revealed no cytotoxicity at concentrations below 10−5 M, but cell viability was reduced in a dose-dependent manner at concentrations above 10−5 M. Furthermore, MC3T3-E1 osteoblasts were seeded in 6-well plates in complete medium supplemented with dexamethasone, β-glycerophosphate and vitamin C (VC) for osteogenic differentiation. MC3T3-E1 osteoblasts treated with different concentrations (10−5, 10−6 and 10−7 M) of VK2 for 24 h on days 1, 3, 5 and 7 of the differentiation protocol. It was confirmed that VK2 promoted osteoblast differentiation and mineralization by using alkaline phosphatase (ALP) and alizarin red staining. Using western blotting, immunofluorescence, monodansylcadaverine staining and reverse transcription-quantitative polymerase chain reaction, it was observed that VK2 induced autophagy in osteoblasts. The results revealed that VK2 (1 µM) significantly increased ALP activity and the conversion of microtubule associated protein 1 light chain 3-α (LC3)II to LC3I in MC3T3-E1 osteoblasts (P<0.05) at every time point. The number of fluorescent bodies and the intensity increased with VK2, and decreased following treatment with 3-MA+VK2. There was an increase in the mRNA expression levels of ALP, osteocalcin (OCN) and Runt-related transcription factor 2 in VK2-treated cells (P<0.01). The present study further confirmed the association between autophagy and osteoblast differentiation and mineralization through treatment with an autophagy inhibitor [3-methyladenine (3-MA)]. Osteoblasts treated with 3-MA exhibited significant inhibition of ALP activity and osteogenic differentiation (both P<0.05). In addition, ALP activity and osteogenesis in the VK2+3-MA group was lower compared with VK2-treated cells (P<0.05 for both). The present study confirmed that VK2 stimulated autophagy in MC3T3 cells to promote differentiation and mineralization, which may be a potential therapeutic target for osteoporosis.
Collapse
Affiliation(s)
- Weiwei Li
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Shaokun Zhang
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Jie Liu
- Science Experiment Center of China Medical University, Shenyang, Liaoning 110122, P.R. China
| | - Yongyi Liu
- Department of Orthopedics, The First Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| | - Qingwei Liang
- Department of Sports Medicine, The First Hospital of China Medical University, Shenyang, Liaoning 110000, P.R. China
| |
Collapse
|
8
|
Kim L, Brudzynski K. Identification of menaquinones (vitamin K2 homologues) as novel constituents of honey. Food Chem 2018; 249:184-192. [DOI: 10.1016/j.foodchem.2018.01.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2017] [Revised: 12/29/2017] [Accepted: 01/01/2018] [Indexed: 11/26/2022]
|
9
|
Cosso R, Falchetti A. Vitamin K and bone metabolism: the myth and the truth. EXPERT REVIEW OF PRECISION MEDICINE AND DRUG DEVELOPMENT 2016. [DOI: 10.1080/23808993.2016.1174061] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
|
10
|
Tubic B, Magnusson P, Mårild S, Leu M, Schwetz V, Sioen I, Herrmann D, Obermayer-Pietsch B, Lissner L, Swolin-Eide D. Different osteocalcin forms, markers of metabolic syndrome and anthropometric measures in children within the IDEFICS cohort. Bone 2016; 84:230-236. [PMID: 26772621 DOI: 10.1016/j.bone.2016.01.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Revised: 12/11/2015] [Accepted: 01/05/2016] [Indexed: 01/20/2023]
Abstract
OBJECTIVE Osteocalcin (OC), an aboundant non-collagenous bone protein, is inversely associated with parameters of glucose metabolism. Interactions between bone tissue and energy metabolism have not been thoroughly investigated during childhood. This study investigated OC, metabolic parameters and anthropometric characteristics in normal weight and overweight/obese children. METHODS This study comprised 108 (46 normal weight/62 overweight/obese) Swedish 2-9year old children. Anthropometric data, insulin, glucose, glycosylated haemoglobin (HbA1c), HOMA index, vitamin D, adiponectin, total OC, carboxylated OC (cOC) and undercarboxylated OC (ucOC) were analysed. RESULTS No difference was found for total OC between the normal and overweight/obese groups, with a mean (±SD) value of 82.6 (±2.8) ng/mL and 77.0 (±2.4) ng/mL, (P=0.11), respectively. Overweight children had lower cOC levels, mean 69.1 (±2.2) ng/mL, vs. normal weight children, mean 75.6 (±2.5) ng/mL (P=0.03). The mean ucOC levels of 7.9 (±0.4) ng/mL in overweight children did not differ vs. normal weight children, mean level 7.0 (±0.4) ng/mL, (P=0.067). None of the three OC forms correlated with any of the measured parameters. CONCLUSIONS The cOC levels were lower in overweight children. There was no correlation between the three OC forms and any of the measured anthropometric or metabolic parameters. OC has been suggested to have a possible metabolic role, but in general the current study in prepubertal children does not support the hypothesis of an association between OC and a positive metabolic profile.
Collapse
Affiliation(s)
- Bojan Tubic
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, SE-416 85 Göteborg, Sweden.
| | - Per Magnusson
- Department of Clinical Chemistry and Department of Clinical and Experimental Medicine, Linköping University, SE-581 85, Linköping, Sweden.
| | - Staffan Mårild
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, SE-416 85 Göteborg, Sweden.
| | - Monica Leu
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Box 454, SE-405 30 Göteborg, Sweden.
| | - Verena Schwetz
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, A-8036, Graz, Austria.
| | - Isabelle Sioen
- Department of Public Health, Ghent University, De Pintelaan 185, B-9000 Gent, Belgium; Research Foundation, Flanders, Brussels, Belgium.
| | - Diana Herrmann
- Leibniz Institute for Prevention Research and Epidemiology, BIPS, Achterstr. 30, DE-28359, Bremen, Germany.
| | - Barbara Obermayer-Pietsch
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Medical University of Graz, A-8036, Graz, Austria.
| | - Lauren Lissner
- Section for Epidemiology and Social Medicine (EPSO), Department of Public Health and Community Medicine, The Sahlgrenska Academy at University of Gothenburg, Box 454, SE-405 30 Göteborg, Sweden.
| | - Diana Swolin-Eide
- Department of Pediatrics, Institute of Clinical Sciences, The Queen Silvia Children's Hospital, The Sahlgrenska Academy at the University of Gothenburg, SE-416 85 Göteborg, Sweden.
| |
Collapse
|
11
|
Misra D, Zhang Y, Peloquin C, Choi HK, Kiel DP, Neogi T. Incident long-term warfarin use and risk of osteoporotic fractures: propensity-score matched cohort of elders with new onset atrial fibrillation. Osteoporos Int 2014; 25:1677-84. [PMID: 24833176 PMCID: PMC4180421 DOI: 10.1007/s00198-014-2662-0] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 08/21/2013] [Indexed: 10/25/2022]
Abstract
UNLABELLED Association between warfarin use and fracture risk is unclear. We examined the association between long-term warfarin use and fracture risk at the hip, spine, and wrist in elders. No significant association was found between long-term warfarin use and fracture risk, despite biological plausibility. INTRODUCTION Prior studies examining the association of warfarin use and osteoporotic fractures have been conflicting, potentially related to methodological limitations. Thus, we examined the association of long-term warfarin use with risk of hip, spine, and wrist fractures among older adults with atrial fibrillation, attempting to address prior methodologic challenges. METHODS We included men and women ≥ 65 years of age with incident atrial fibrillation and without prior history of fractures from The Health Improvement Network followed between 2000 and 2010. Long-term warfarin use was defined in two ways: (1) warfarin use ≥ 1 year; (2) warfarin use ≥ 3 years. Propensity-score matched cohorts of warfarin users and nonusers were created to evaluate the association between long-term warfarin use and risk of hip, spine, and wrist fractures separately as well as combined, using Cox-proportional hazards regression models. RESULTS Among >20,000 participants with incident atrial fibrillation, the hazard ratios (HR) for hip fracture with warfarin use ≥ 1 and ≥ 3 years, respectively, were 1.08 (95%CI 0.87, 1.35) and 1.13 (95% CI 0.84, 1.50). Similarly, no significant associations were observed between long-term warfarin use and risk of spine or wrist fracture. When risk of any fracture was assessed with warfarin use, no association was found [HR for warfarin use ≥ 1 year 0.92 (95%CI 0.77, 1.10); HR for warfarin use ≥ 3 years 1.12 (95%CI 0.88, 1.43)]. CONCLUSIONS Long-term warfarin use among elders with atrial fibrillation was not associated with increased risk of osteoporotic fractures and therefore does not appear to necessitate additional surveillance or prophylaxis.
Collapse
Affiliation(s)
- D Misra
- Boston University School of Medicine, 650 Albany St, Suite X-200, Clinical Epidemiology Unit, Boston, MA, 02118, USA,
| | | | | | | | | | | |
Collapse
|
12
|
Sukkar SG. Vitamin D deficiency, health and sun exposure: a caveat for the Mediterranean lifestyle. MEDITERRANEAN JOURNAL OF NUTRITION AND METABOLISM 2012. [DOI: 10.1007/s12349-012-0110-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
|
13
|
Tarroni P, Villa I, Mrak E, Zolezzi F, Mattioli M, Gattuso C, Rubinacci A. Microarray analysis of 1,25(OH)₂D₃ regulated gene expression in human primary osteoblasts. J Cell Biochem 2012; 113:640-9. [PMID: 21956231 DOI: 10.1002/jcb.23392] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Though extensive studies have been conducted, questions regarding the molecular effectors and pathways underlying the regulatory role of 1,25(OH)(2)D(3) in human osteoblasts other than cell differentiation and matrix protein production remain unanswered. This study aims to identify genes and pathways that are modulated by 1,25(OH)(2)D(3) treatment in human osteoblasts. Primary osteoblast cultures obtained from human bone tissue samples were treated with 1,25(OH)(2)D(3) (10(-7) M) for 24 h and their transcritptomes were profiled by microarray analysis using the Affymetrix GeneChip. Statistical analysis was conducted to identify genes whose expression is significantly modulated following 1,25(OH)(2)D(3) treatment. One hundred and fifty-eight genes were found to be differentially expressed. Of these, 136 were upregulated, indicating clear transcriptional activation by 1,25(OH)(2)D(3). Biostatistical evaluation of microarray data by Ingenuity Pathways Analysis (IPA) revealed a relevant modulation of genes involved in vitamin D metabolism (CYP24), immune functions (CD14), neurotransmitter transporters (SLC1A1, SLC22A3), and coagulation [thrombomodulin (THBD), tissue plasminogen activator (PLAT), endothelial protein C receptor (PROCR), thrombin receptor (F2R)]. We identified a restricted number of highly regulated genes and confirmed their differential expression by real-time quantitative PCR (RT qPCR). The present genome-wide microarray analysis on 1,25(OH)(2)D(3) -treated human osteoblasts reveals an interplay of critical regulatory and metabolic pathways and supports the hypothesis that 1,25(OH)(2)D(3) can modulate the coagulation process through osteoblasts, activates osteoclastogenesis through inflammation signaling, modulates the effects of monoamines by affecting their reuptake.
Collapse
Affiliation(s)
- Paola Tarroni
- Axxam Spa, San Raffaele Biomedical Science Park, 20132 Milan, Italy.
| | | | | | | | | | | | | |
Collapse
|
14
|
Sullivan TR, Duque G, Keech AC, Herrmann M. An old friend in a new light: the role of osteocalcin in energy metabolism. Cardiovasc Ther 2011; 31:65-75. [PMID: 21975009 DOI: 10.1111/j.1755-5922.2011.00300.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Accumulating evidence suggests interactions between bone and energy metabolism, which may affect the risk of cardiovascular disease. Recent animal studies indicate that osteocalcin (OC) plays a key role in the coordinated regulation of glucose and insulin metabolism while insulin receptors on osteoblasts may regulate bone turnover and circulating OC levels. Association studies, weight loss interventions, and observational data lend some support to the existence and relevance of these mechanisms in humans. However, corroborating evidence from pharmacologic interventions in either bone or glucose metabolism is limited by the number, design, and complex pharmacological effects of the drugs used. Furthermore, such clinical trials are complicated by the alteration of metabolic feedback mechanisms in the insulin resistant state. Purpose-designed studies are needed to further establish the existence and significance of the role of OC and its subfractions in human insulin metabolism. In this review we summarize existing animal evidence regarding the role of OC and its subfractions in bone and energy metabolism and assess current clinical trial evidence relating to the significance and consequences of this relationship in humans.
Collapse
Affiliation(s)
- Tim R Sullivan
- Hornsby Kuring-gai Hospital, Northern Sydney Health Service, Hornsby, Australia
| | | | | | | |
Collapse
|
15
|
Motyl KJ, McCabe LR, Schwartz AV. Bone and glucose metabolism: a two-way street. Arch Biochem Biophys 2010; 503:2-10. [PMID: 20682281 DOI: 10.1016/j.abb.2010.07.030] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2010] [Revised: 07/27/2010] [Accepted: 07/29/2010] [Indexed: 12/20/2022]
Abstract
Evidence from rodent models indicates that undercarboxylated osteocalcin (ucOC), a product of osteoblasts, is a hormone affecting insulin production by the pancreas and insulin sensitivity in peripheral tissues, at least in part through enhanced secretion of adiponectin from adipocytes. Clinical research to test whether this relationship is found in humans is just beginning to emerge. Cross-sectional studies confirm associations between total osteocalcin (OC), ucOC and glucose metabolism but cannot distinguish causality. To date, longitudinal studies have not provided a consistent picture of the effects of ucOC or OC on fasting glucose and insulin sensitivity. Further exploration into the physiological and mechanistic effects of ucOC and OC, in rodent models and clinical studies, is necessary to determine to what extent the skeleton regulates energy metabolism in humans.
Collapse
Affiliation(s)
- Katherine J Motyl
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
| | | | | |
Collapse
|
16
|
Bao D, Ramu S, Contreras A, Upadhyayula S, Vasquez JM, Beran G, Vullev VI. Electrochemical Reduction of Quinones: Interfacing Experiment and Theory for Defining Effective Radii of Redox Moieties. J Phys Chem B 2010; 114:14467-79. [DOI: 10.1021/jp101730e] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Duoduo Bao
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| | - Sangeetha Ramu
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| | - Antonio Contreras
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| | - Srigokul Upadhyayula
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| | - Jacob M. Vasquez
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| | - Gregory Beran
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| | - Valentine I. Vullev
- Department of Bioengineering, University of California, Riverside, California 92521, Center for Bioengineering Research, University of California, Riverside, California 92521, and Department of Chemistry, University of California, Riverside, California 92521
| |
Collapse
|