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Quek YY, Cheng LJ, Ng YX, Hey HWD, Wu XV. Effectiveness of anthocyanin-rich foods on bone remodeling biomarkers of middle-aged and older adults at risk of osteoporosis: a systematic review, meta-analysis, and meta-regression. Nutr Rev 2024; 82:1187-1207. [PMID: 37796900 DOI: 10.1093/nutrit/nuad121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
CONTEXT Current osteoporosis pharmacological treatment has undesirable side effects. There is increasing focus on naturally derived food substances that contain phytonutrients with antioxidant effects in promoting health and regulating immune response. OBJECTIVE This review aims to systematically evaluate the effectiveness of anthocyanin-rich foods on bone remodeling biomarkers in middle-aged and older adults (≥40 y old) at risk of osteoporosis. DATA SOURCES Randomized controlled trials were searched on 8 bibliographic databases of PubMed, Embase, Scopus, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Food Science and Technology Abstracts, Cochrane Library, and ProQuest. DATA EXTRACTION AND ANALYSIS Thirteen studies were included in the meta-analysis. Receptor activator of nuclear factor kappa-B ligand (RANKL) is exhibited from osteoblastic cells that gathered osteoclasts to bone sites for bone resorption, accelerating bone loss. Anthocyanin-rich food consumption showed statistically nonsignificant effects, with no substantial heterogeneity on bone remodeling biomarkers. However, there was a significant increase in lumbar spine L1-L4 bone mineral density. Mild-to-small effects were seen to largely favor the consumption of anthocyanin-rich foods. Berries (d = -0.44) have a larger effect size of RANKL than plums (d = 0.18), with statistically significant subgroup differences. Random-effects meta-regression found body mass index, total attrition rate, total energy, and dietary carbohydrate and fat intake were significant covariates for the effect size of RANKL. All outcomes had low certainty of evidence. CONCLUSION Anthocyanin-rich foods may improve bone health in middle-aged and older adults at risk of osteoporosis. This review contributes to the growing interest in nutrient-rich foods as a low-cost and modifiable alternative to promote human health and reduce disease burden. Future high-quality studies with larger sample sizes and longer treatment durations are required to fully understand the effect of anthocyanin-rich foods on bone health. SYSTEMATIC REVIEW REGISTRATION PROSPERO registration no. CRD42022367136.
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Affiliation(s)
- Yu Yi Quek
- Alexandra Hospital, National University Health System, Singapore
| | - Ling Jie Cheng
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Yu Xuan Ng
- Alexandra Hospital, National University Health System, Singapore
| | - Hwee Weng Dennis Hey
- Department of Orthopedic Surgery, University Spine Centre, National University Hospital, Singapore
- Department of Orthopedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Xi Vivien Wu
- Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- NUSMED Healthy Longevity Translational Research Program, National University of Singapore, Singapore
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Onizuka N, Onizuka T. Disparities in Osteoporosis Prevention and Care: Understanding Gender, Racial, and Ethnic Dynamics. Curr Rev Musculoskelet Med 2024; 17:365-372. [PMID: 38916641 PMCID: PMC11335991 DOI: 10.1007/s12178-024-09909-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/09/2024] [Indexed: 06/26/2024]
Abstract
PURPOSE Osteoporosis, the most prevalent metabolic bone disease, significantly impacts global public health by increasing fracture risks, particularly among post-menopausal women and the elderly. Osteoporosis is characterized by decreased bone mineral density (BMD) and deterioration of bone tissue, which leads to enhanced fragility. The disease is predominantly diagnosed using dual X-ray absorptiometry (DXA) and is significantly influenced by demographic factors such as age and hormonal changes. This chapter delves into the condition's complex nature, emphasizing the pervasive gender and racial disparities in its screening, diagnosis, and treatment. RECENT FINDINGS Recent findings highlight a substantial gap in the management of osteoporosis, with many individuals remaining under-screened and under-treated. Factors contributing to this include the asymptomatic early stages of the disease, lack of awareness, economic barriers, and inconsistent screening practices, especially in under-resourced areas. These challenges are compounded by disparities that affect different genders and races unevenly, influencing both the prevalence of the disease and the likelihood of receiving adequate healthcare services. The summary of this chapter underscores the urgent need for targeted strategies to overcome these barriers and improve health equity in osteoporosis care. Proposed strategies include enhancing public and healthcare provider awareness of osteoporosis, broadening access to diagnostic screenings, and integrating personalized treatment approaches. These efforts aim to align with global health objectives to mitigate the impacts of osteoporosis and ensure equitable health outcomes across all demographic groups.
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Affiliation(s)
- Naoko Onizuka
- Department of Orthopaedic Surgery, University of Minnesota, Minneapolis, MN, USA.
- TRIA Orthopedics Park Nicollet Methodist Hospital, St. Louis Park, MN, USA.
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Moser M, Adl Amini D, Albertini Sanchez L, Oezel L, Zhu J, Nevzati E, Carrino JA, Shue J, Sama AA, Cammisa FP, Girardi FP, Hughes AP. The Reciprocal Relationship Between Lumbar Intervertebral Disk Degeneration and the MRI-based Vertebral Bone Quality Score. Spine (Phila Pa 1976) 2024; 49:1227-1234. [PMID: 38270377 DOI: 10.1097/brs.0000000000004937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/18/2024] [Indexed: 01/26/2024]
Abstract
STUDY DESIGN Retrospective longitudinal study. OBJECTIVE To investigate the association between lumbar intervertebral disk degeneration (DD) and the vertebral bone quality (VBQ) score. BACKGROUND The VBQ score that is based on magnetic resonance imaging has been proposed as a measure of lumbar spine bone quality and is a significant predictor of healthy versus osteoporotic bone. However, the role of segmental contributing factors on VBQ is unknown. METHODS Nonsurgical patients who underwent repeated lumbar magnetic resonance imaging scans, at least three years apart primarily for low back pain were retrospectively included. VBQ was assessed as previously described. DD was assessed using the Pfirrmann grading (PFG) scale. PFG grades were summarized as PFG L1-4 for the upper three lumbar disk levels, as PFG L4-S1 for the lower two lumbar disc levels, and as PFG L1-S1 for all lumbar disc levels. Multivariable linear mixed models were used with adjustments for age, sex, race, body mass index, and the clustering of repeated measurements. RESULTS A total of 350 patients (54.6% female, 85.4% White) were included in the final analysis, with a median age at baseline of 60.1 years and a body mass index of 25.8 kg/m 2 . VBQ significantly increased from 2.28 at baseline to 2.36 at follow-up ( P = 0.001). In the unadjusted analysis, a significant positive correlation was found between PFG L1-4 , PFG L1-S1 , and VBQ at baseline ( P < 0.05) that increased over time ( P < 0.005). In the adjusted multivariable analysis, PFG L1-4 ( β = -0.0195; P = 0.021), PFG L4-S1 ( β = -0.0310; P = 0.007), and PFG L1-S1 ( β = -0.0160; P = 0.012) were independently and negatively associated with VBQ. CONCLUSIONS More advanced and long-lasting DD is associated with lower VBQ indicating less bone marrow fat content and potentially stronger bone. VBQ score as a marker of bone quality seems affected by DD.
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Affiliation(s)
- Manuel Moser
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
- Department of Neurosurgery, Cantonal Hospital Graubünden, Loëstrasse, Chur, Switzerland
| | - Dominik Adl Amini
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
- Center for Musculoskeletal Surgery, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Leonardo Albertini Sanchez
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
- Weill Cornell Medical College, New York, NY
| | - Lisa Oezel
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
- Department of Orthopedic Surgery and Traumatology, University Hospital Düsseldorf, Düsseldorf, Germany
| | - Jiaqi Zhu
- Biostatistics Core, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
| | - Edin Nevzati
- Department of Neurosurgery, Lucerne Cantonal Hospital, Spitalstrasse, Lucerne, Switzerland
- Faculty of Medicine, University of Basel, Klingelbergstrasse, Basel, Switzerland
| | - John A Carrino
- Department of Radiology and Imaging, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
| | - Jennifer Shue
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
| | - Andrew A Sama
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
| | - Frank P Cammisa
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
| | - Federico P Girardi
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
| | - Alexander P Hughes
- Spine Care Institute, Hospital for Special Surgery, Weill Cornell Medicine, New York, NY
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Xu T, Li C, Liao Y, Xu Y, Fan Z, Zhang X. Is there a causal relationship between resistin levels and bone mineral density, fracture occurrence? A mendelian randomization study. PLoS One 2024; 19:e0305214. [PMID: 39190724 DOI: 10.1371/journal.pone.0305214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 05/25/2024] [Indexed: 08/29/2024] Open
Abstract
BACKGROUND In a great many of observational studies, whether there is a relevance of resistin levels on bone mineral density (BMD) and fracture occurrence has been inconsistently reported, and the causality is unclear. METHODS We aim to assess the resistin levels on BMD and fracture occurrence within a Mendelian randomization (MR) analysis. Exposure and outcome data were derived from the Integrative Epidemiology Unit (IEU) Open genome wide association studies (GWAS) database. Screening of instrumental variables (IVs) was performed subject to conditions of relevance, exclusivity, and independence. Inverse variance weighting (IVW) was our primary method for MR analysis based on harmonized data. Weighted median and MR-Egger were chosen to evaluate the robustness of the results of IVW. Simultaneously, heterogeneity and horizontal pleiotropy were also assessed and the direction of potential causality was detected by MR Steiger. Multivariable MR (MVMR) analysis was used to identify whether confounding factors affected the reliability of the results. RESULTS After Bonferroni correction, the results showed a suggestively positive causality between resistin levels and total body BMD (TB-BMD) in European populations over the age of 60 [β(95%CI): 0.093(0.021, 0.165), P = 0.011]. The weighted median [β(95%CI): 0.111(0.067, 0.213), P = 0.035] and MR-Egger [β(95%CI): 0.162(0.025, 0.2983), P = 0.040] results demonstrate the robustness of the IVW results. No presence of pleiotropy or heterogeneity was detected between them. MR Steiger supports the causal inference result and MVMR suggests its direct effect. CONCLUSIONS In European population older than 60 years, genetically predicted higher levels of resistin were associated with higher TB-BMD. A significant causality between resistin levels on BMD at different sites, fracture in certain parts of the body, and BMD in four different age groups between 0-60 years of age was not found in our study.
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Affiliation(s)
- Taichuan Xu
- Department of Spine, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Chao Li
- Department of Spine, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Yitao Liao
- Department of Spine, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Yenan Xu
- Department of Spine, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Zhihong Fan
- Department of Spine, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
| | - Xian Zhang
- Department of Spine, Wuxi Affiliated Hospital of Nanjing University of Chinese Medicine, Wuxi, Jiangsu, China
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Feng B, Lu J, Han Y, Han Y, Qiu X, Zeng Z. The role of short-chain fatty acids in the regulation of osteoporosis: new perspectives from gut microbiota to bone health: A review. Medicine (Baltimore) 2024; 103:e39471. [PMID: 39183408 PMCID: PMC11346881 DOI: 10.1097/md.0000000000039471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Revised: 08/05/2024] [Accepted: 08/06/2024] [Indexed: 08/27/2024] Open
Abstract
Osteoporosis is a systemic skeletal disease characterized by low bone density and microarchitectural deterioration, resulting in increased fracture risk. With an aging population, osteoporosis imposes a heavy burden worldwide. Current pharmacotherapies such as bisphosphonates can reduce fracture risk but have limitations. Emerging research suggests that gut microbiota regulates bone metabolism through multiple mechanisms. Short-chain fatty acids (SCFAs) produced from microbial fermentation of dietary fiber beneficially impact bone health. Preclinical studies indicate that SCFAs such as butyrate and propionate prevent bone loss in osteoporosis models by inhibiting osteoclastogenesis and immune modulation. Early clinical data also suggest that SCFA supplementation may improve bone turnover markers in postmenopausal women. SCFAs likely act via inhibition of osteoclast differentiation, stimulation of osteoblast activity, regulation of T cells, and other pathways. However, optimal dosing, delivery methods, and long-term safety require further investigation. Modulating the gut-bone axis via supplementation, prebiotics/probiotics, diet, and lifestyle interventions represents an innovative therapeutic approach for osteoporosis. Harnessing the interplay between microbiome, metabolism, immunity, and bone may provide new directions for managing osteoporosis in the future.
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Affiliation(s)
- Boyi Feng
- Shenzhen Guangming District People’s Hospital, Shenzhen, China
| | - Jingjing Lu
- Shenzhen Guangming District People’s Hospital, Shenzhen, China
| | - Yanhua Han
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Yaguang Han
- First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xiaokui Qiu
- Shenzhen Guangming District People’s Hospital, Shenzhen, China
| | - Zhuoying Zeng
- Chemical Analysis and Physical Testing Institute, Shenzhen Center for Disease Control and Prevention, Shenzhen, China
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Yamamoto N, Shiroshita A, Kimura R, Kamo T, Ogihara H, Tsuge T. Diagnostic accuracy of chest X-ray and CT using artificial intelligence for osteoporosis: systematic review and meta-analysis. J Bone Miner Metab 2024:10.1007/s00774-024-01532-4. [PMID: 39167230 DOI: 10.1007/s00774-024-01532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/15/2024] [Indexed: 08/23/2024]
Abstract
INTRODUCTION Artificial intelligence (AI)-based systems using chest images are potentially reliable for diagnosing osteoporosis. METHODS We performed a systematic review and meta-analysis to assess the diagnostic accuracy of chest X-ray and computed tomography (CT) scans using AI for osteoporosis in accordance with the diagnostic test accuracy guidelines. We included any type of study investigating the diagnostic accuracy of index test for osteoporosis. We searched MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and IEEE Xplore Digital Library on November 8, 2023. The main outcome measures were the sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) for osteoporosis and osteopenia. We described forest plots for sensitivity, specificity, and AUC. The summary points were estimated from the bivariate random-effects models. We summarized the overall quality of evidence using the Grades of Recommendation, Assessment, Development, and Evaluation approach. RESULTS Nine studies with 11,369 participants were included in this review. The pooled sensitivity, specificity, and AUC of chest X-rays for the diagnosis of osteoporosis were 0.83 (95% confidence interval [CI] 0.75, 0.89), 0.76 (95% CI 0.71, 0.80), and 0.86 (95% CI 0.83, 0.89), respectively (certainty of the evidence, low). The pooled sensitivity and specificity of chest CT for the diagnosis of osteoporosis and osteopenia were 0.83 (95% CI 0.69, 0.92) and 0.70 (95% CI 0.61, 0.77), respectively (certainty of the evidence, low and very low). CONCLUSIONS This review suggests that chest X-ray with AI has a high sensitivity for the diagnosis of osteoporosis, highlighting its potential for opportunistic screening. However, the risk of bias of patient selection in most studies were high. More research with adequate participants' selection criteria for screening tool will be needed in the future.
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Affiliation(s)
- Norio Yamamoto
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan.
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan.
- Department of Orthopedic Surgery, Hashimoto Hospital, 902-1 Saitanishi, Yamamoto, Mitoyo, Kagawa, 768-0103, Japan.
| | - Akihiro Shiroshita
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ryota Kimura
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Orthopaedic Surgery, Akita University Graduate School of Medicine, Akita, Japan
| | - Tomohiko Kamo
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Physical Therapy, Faculty of Health Science, Gunma Paz University, Gunma, Japan
| | - Hirofumi Ogihara
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Division of Physical Therapy, Department of Rehabilitation, Faculty of Health Sciences, Nagano University of Health and Medicine, Nagano, Japan
| | - Takahiro Tsuge
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
- Scientific Research WorkS Peer Support Group (SRWS-PSG), Osaka, Japan
- Department of Rehabilitation, Kurashiki Medical Center, Kurashiki, Okayama, Japan
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Ton A, Bell JA, Karakash WJ, Alter TD, Erdman MK, Kang HP, Mills ES, Ragheb JM, Athari M, Wang JC, Alluri RK, Hah RJ. Risk of Subsequent Hip Fractures across Varying Treatment Patterns for Index Vertebral Compression Fractures. J Clin Med 2024; 13:4781. [PMID: 39200923 DOI: 10.3390/jcm13164781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 08/05/2024] [Accepted: 08/12/2024] [Indexed: 09/02/2024] Open
Abstract
Introduction: Vertebral compression fractures (VCFs) pose a considerable healthcare burden and are linked to elevated morbidity and mortality. Despite available anti-osteoporotic treatments (AOTs), guideline adherence is lacking. This study aims to evaluate subsequent hip fracture incidence after index VCF and to elucidate AOT prescribing patterns in VCF patients, further assessing the impact of surgical interventions on these patterns. Materials and Methods: Patients with index VCFs between 2010 and 2021 were identified using the PearlDiver database. Diagnostic and procedural data were recorded using International Classification of Diseases (ICD-9, ICD-10) and Current Procedural Terminology (CPT) codes. Patients under age 50 and follow-up
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Affiliation(s)
- Andy Ton
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Jennifer A Bell
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - William J Karakash
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Thomas D Alter
- Department of Orthopaedic Surgery, Mayo Clinic, Rochester, MN 55905, USA
| | - Mary Kate Erdman
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
- Department of Orthopaedic Surgery, University of Chicago Medical Center, Chicago, IL 60612, USA
| | - Hyunwoo Paco Kang
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Emily S Mills
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Jonathan Mina Ragheb
- Department of Orthopaedic Surgery, Kaiser Permanente Bernard J. Tyson School of Medicine, Los Angeles, CA 91101, USA
| | - Mirbahador Athari
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Jeffrey C Wang
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Ram K Alluri
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
| | - Raymond J Hah
- Department of Orthopaedic Surgery, Keck School of Medicine, The University of Southern California, Los Angeles, CA 90033, USA
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Lee SS, Al Halawani A, Teo JD, Weiss AS, Yeo GC. The Matrix Protein Tropoelastin Prolongs Mesenchymal Stromal Cell Vitality and Delays Senescence During Replicative Aging. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2402168. [PMID: 39120048 DOI: 10.1002/advs.202402168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 06/26/2024] [Indexed: 08/10/2024]
Abstract
Cellular senescence leads to the functional decline of regenerative cells such as mesenchymal stromal/stem cells (MSCs), which gives rise to chronic conditions and contributes to poor cell therapy outcomes. Aging tissues are associated with extracellular matrix (ECM) dysregulation, including loss of elastin. However, the role of the ECM in modulating senescence is underexplored. In this work, it is shown that tropoelastin, the soluble elastin precursor, is not only a marker of young MSCs but also actively preserves cell fitness and delays senescence during replicative aging. MSCs briefly exposed to tropoelastin exhibit upregulation of proliferative genes and concurrent downregulation of senescence genes. The seno-protective benefits of tropoelastin persist during continuous, long-term MSC culture, and significantly extend the MSC replicative lifespan. Tropoelastin-expanded MSCs further maintain youth-associated phenotype and function compared to age-matched controls, including preserved clonogenic potential, minimal senescence-associated beta-galactosidase activity, maintained cell sizes, reduced expression of senescence markers, suppressed secretion of senescence-associated factors, and increased production of youth-associated proteins. This work points to the utility of exogenously-supplemented tropoelastin for manufacturing MSCs that robustly maintain regenerative potential with age. It further reveals the active role of classical structural ECM proteins in driving cellular age-associated fitness, potentially leading to future interventions for aging-related pathologies.
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Affiliation(s)
- Sunny Shinchen Lee
- School of Life & Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Aleen Al Halawani
- School of Life & Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Jonathan D Teo
- School of Medical Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Anthony S Weiss
- School of Life & Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia
- Sydney Nano Institute, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Giselle C Yeo
- School of Life & Environmental Sciences and Charles Perkins Centre, The University of Sydney, Camperdown, NSW, 2006, Australia
- Sydney Nano Institute, The University of Sydney, Camperdown, NSW, 2006, Australia
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Evans AR, Bakhsheshian J, Graffeo CS, Smith ZA. Surgical management of spinal pathologies in the octogenarian: a narrative review. GeroScience 2024; 46:3555-3566. [PMID: 38285294 PMCID: PMC11226583 DOI: 10.1007/s11357-024-01083-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 01/15/2024] [Indexed: 01/30/2024] Open
Abstract
Optimal management paradigms of spinal pathologies in the octogenarian population are controversial given the higher incidence of comorbidities with concern for poor prognosis and fear of increased complications associated with surgical management. In this narrative review, we aim to detail the complex clinical considerations when approaching odontoid screw fixation/instrumented fusion, spinal decompression, and spinal fusion in the octogenarian. Literature review was conducted via Google Scholar and PubMed databases, with literature selected based on statistical power and clinical relevance to the following pathologies/surgical techniques: odontoid fracture, surgical decompression, and surgical fusion in the octogenarian. The aforementioned pathologies were selected based on prevalence in the advanced-age population in which surgical screening techniques and management remain nonuniform. Preoperative evaluation of the octogenarian patient increasingly includes frailty, sarcopenia, and osteopenia/osteoporosis assessments. In cases of odontoid fracture, conservative management appears to provide beneficial clinical outcomes with lower rates of complication compared to surgery; however, rates of radiographic odontoid fusion are far lower in conservatively managed patients. Regarding surgical decompression and fusion, the presence of comorbidities may be more predictive of outcome rather than age status, with the advent of minimally invasive techniques providing safety and efficacy in the surgical management of this age cohort. Age status may be less pertinent than previously thought in the decision to pursue spinal surgery for odontoid fracture, spinal decompression, or spinal fusion; however, each of these procedures has respective risks and benefits that must be considered within the context of each patient's comorbidity profile.
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Affiliation(s)
- Alexander R Evans
- Department of Neurosurgery, University of Oklahoma, Oklahoma City, OK, USA
| | | | | | - Zachary A Smith
- Department of Neurosurgery, University of Oklahoma, Oklahoma City, OK, USA.
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Abumunaser LA, Abumunaser IL, Sharaf RM, Kabouha Q. Knowledge and Awareness of Osteoporosis and Its Risk Factors Among the Adult Population in Jeddah, Saudi Arabia: An Analytical Cross-Sectional Study. Cureus 2024; 16:e65995. [PMID: 39100811 PMCID: PMC11296564 DOI: 10.7759/cureus.65995] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2024] [Indexed: 08/06/2024] Open
Abstract
BACKGROUND Osteoporosis is a medical condition that affects the bones, causing them to become weak and fragile. People with osteoporosis are at a higher risk for fractures, resulting in an increase in morbidity and mortality rates. Despite its high prevalence worldwide, osteoporosis remains underdiagnosed and undertreated, leading to significant public health concerns, especially in Saudi Arabia. MATERIAL AND METHODS An analytical cross-sectional study was conducted using an online questionnaire to assess the level of awareness of osteoporosis and its risk factors among the adult population in Jeddah, Saudi Arabia. The questionnaire was distributed to a diverse, representative sample of 232 adults in Jeddah, covering demographic data, knowledge and awareness of osteoporosis and its risk factors, and lifestyle practices related to prevention and management. Data were analyzed using IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp., employing descriptive analysis, cross-tabulation, and chi-square tests to evaluate knowledge levels and associated factors. RESULTS A total of 232 eligible adults participated, with a mean age of 35.6 ± 8.7 years. Most participants, 228 (98.3%), had heard of osteoporosis, and 137 (59.1%) had good overall knowledge of the disease. Key risk factors identified included calcium deficiency (210, 90.5%), increasing age (171, 73.7%), and family history (136, 58.6%). Although most participants accurately identified common risk factors, only 10.8% of participants consistently practiced a healthy and active lifestyle, highlighting the gap between awareness and preventive behaviors. Our study showed that gender (p-value = 0.049), educational level (p-value = 0.044), and whether the participant was diagnosed with or knew someone diagnosed with osteoporosis (p-value = 0.045) were statistically significant factors associated with the overall level of knowledge of osteoporosis in the participants. CONCLUSIONS This study emphasized the need for targeted interventions to improve knowledge and promote healthier lifestyle habits among adults in Jeddah to reduce the burden of osteoporosis. Future efforts should focus on bridging the gap between awareness and preventive actions, emphasizing the importance of healthy lifestyle habits and knowledge of osteoporosis risk factors.
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Affiliation(s)
- Lutf A Abumunaser
- Department of Orthopedic Surgery, Faculty of Medicine, King Abdulaziz University Hospital, Jeddah, SAU
| | - Ibrahim L Abumunaser
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Raed M Sharaf
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Qusai Kabouha
- College of Medicine, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
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Lee DY, Chung Y, Kim B, Lee JH, Lee K, Lee Y, Lee YH, Ahn SY, Kim YG, Hwang HS, Moon JY, Ryoo JH, Teopiz KM, McIntyre RS. Effect of RANKL on Lower Depressive Symptoms In Hemodialysis Patients. Calcif Tissue Int 2024; 115:124-131. [PMID: 38878178 DOI: 10.1007/s00223-024-01215-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 04/05/2024] [Indexed: 07/14/2024]
Abstract
Depression and osteoporosis are common diseases in dialysis patients. In addition, patients with osteoporosis are more susceptible to depression. Contrary to previous anti-osteoporosis agents, denosumab and romosozumab could be used in dialysis patients and have similar action mechanisms for blocking RANKL. RANKL causes bone resorption after binding RANKL, but binding with OPG leads to suppress of bone resorption. In recent mice study, inhibition of RANKL with denosumab improved depressive-like phenotype. Besides, it was found that OPG was associated with depression. Therefore, this study aimed to investigate the association of depressive symptoms with RANKL and OPG in hemodialysis patients. We conducted a cross-sectional study with a total of 172 hemodialysis patients. The participants were measured for plasma RANKL, OPG, MMP-2, and MMP-9 levels. Logistic regression analysis was performed to evaluate the effect of RANKL and OPG on the presence of depressive symptoms. The depressive symptoms were observed in 90 (52.3%) subjects. RANKL tertile 3 had negative association with BDI score (β - 4.527, 95% CI - 8.310 to - 0.743) in univariate analysis, and this association persisted even after multivariate adjustments (β - 5.603, 95% CI - 9.715 to -1.491) in linear regression. In logistic regression between RANKL tertiles and depressive symptoms, RANKL tertile 3 had significantly lower unadjusted OR (0.40, 95% CI 0.19-0.86), and multivariate-adjusted OR (0.31, 95% CI 0.12-0.82) for depressive symptoms. OPG was not significantly associated with depressive symptoms. Higher plasma RANKL concentrations were significantly associated with lower depressive symptoms in HD patients.Trial registration WHO registry, No. KCT0003281, date: January 12, 2017.
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Affiliation(s)
- Dong-Young Lee
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Yerin Chung
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea
| | - Beom Kim
- Department of Internal Medicine, Veterans Healthcare Service Medical Center, Seoul, Republic of Korea
| | - Jae-Hon Lee
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada
| | - Kangbaek Lee
- Yonsei Miso Dental Clinic, Seongnam, Republic of Korea
| | - Young Lee
- Veterans Healthcare Service Medical Center, Veterans Medical Research Institute, Seoul, Republic of Korea
| | - Yu Ho Lee
- Division of Nephrology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Shin Young Ahn
- Department of Internal Medicine, College of Medicine, Korea University, Seoul, Republic of Korea
| | - Yang Gyun Kim
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Hyeon Seok Hwang
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Ju-Young Moon
- Division of Nephrology, Department of Internal Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Jae-Hong Ryoo
- Departments of Occupational and Environmental Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Kayla M Teopiz
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University of Health Network, Toronto, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit, Poul Hansen Family Centre for Depression, University of Health Network, Toronto, ON, Canada.
- Braxia Health, Mississauga, ON, Canada.
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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12
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Zhang M, Hou Y, Ren X, Cai Y, Wang J, Chen O. Association of a body shape index with femur bone mineral density among older adults: NHANES 2007-2018. Arch Osteoporos 2024; 19:63. [PMID: 39037488 DOI: 10.1007/s11657-024-01424-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
This study investigated the relationship between A body shape index (ABSI) and bone mineral density (BMD) in older Americans and found a negative linear association, which was particularly pronounced in diabetic population. An early focus on ABSI in the elderly population will help in the prevention of osteoporosis. OBJECTIVE A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and high ABSI indicates that waist circumference (WC) is higher than expected for a given height and weight and corresponds to a more central concentration of body volume. The objective of this study was to determine whether there is a linear or nonlinear relationship between ABSI and total femur bone mineral density (BMD) in older Americans and whether the relationship between the ABSI and total femur BMD varies across populations. METHODS This cross-sectional study was based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multiple linear regression, restricted cubic spline (RCS) curves, subgroup analysis, and interaction tests were used to examine the association between ABSI and total femur BMD. RESULTS This study included 2505 older adults. This study found a negative linear correlation between ABSI and total femur BMD (β = -3.2, 95%CI: -5.0, -1.4, p < 0.001). When participants were grouped according to quartiles of ABSI, those in the upper quartile had lower total femur BMD compared to those in the bottom quartile of ABSI. This negative association remained consistent across gender, age, education level, smoking, physical activity and BMI subgroups. However, in the diabetes subgroup, ABSI showed a stronger negative association with total femur BMD. CONCLUSIONS The study shows a negative linear association between ABSI and total femur BMD in older Americans, with this negative association being stronger in the diabetic population.
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Affiliation(s)
- Mengyuan Zhang
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Yue Hou
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Xiaohe Ren
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Yingying Cai
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Jingyi Wang
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China.
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13
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Ma J, Wang XR, Zhou YX, Zhou WJ, Zhang JN, Sun CY. Navigating the gut-bone axis: The pivotal role of Coprococcus3 in osteoporosis prevention through Mendelian randomization. Medicine (Baltimore) 2024; 103:e38861. [PMID: 39029026 DOI: 10.1097/md.0000000000038861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2024] Open
Abstract
Osteoporosis (OP) constitutes a notable public health concern that significantly impacts the skeletal health of the global aging population. Its prevalence is steadily escalating, yet the intricacies of its diagnosis and treatment remain challenging. Recent investigations have illuminated a profound interlink between gut microbiota (GM) and bone metabolism, thereby opening new avenues for probing the causal relationship between GM and OP. Employing Mendelian randomization (MR) as the investigative tool, this study delves into the causal rapport between 211 varieties of GM and OP. The data are culled from genome-wide association studies (GWAS) conducted by the MiBioGen consortium, in tandem with OP genetic data gleaned from the UK Biobank, BioBank Japan Project, and the FinnGen database. A comprehensive repertoire of statistical methodologies, encompassing inverse-variance weighting, weighted median, Simple mode, Weighted mode, and MR-Egger regression techniques, was adroitly harnessed for meticulous analysis. The discernment emerged that the genus Coprococcus3 is inversely associated with OP, potentially serving as a deterrent against its onset. Additionally, 21 other gut microbial species exhibited a positive correlation with OP, potentially accentuating its proclivity and progression. Subsequent to rigorous scrutiny via heterogeneity and sensitivity analyses, these findings corroborate the causal nexus between GM and OP. Facilitated by MR, this study successfully elucidates the causal underpinning binding GM and OP, thereby endowing invaluable insights for deeper exploration into the pivotal role of GM in the pathogenesis of OP.
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Affiliation(s)
- Jun Ma
- Department of Orthopedics, 2nd Hospital of Mudanjiang People, Heilongjiang Province, China
| | - Xin-Ran Wang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Heilongjiang Province, China
| | - Yu-Xin Zhou
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Heilongjiang Province, China
| | - Wei-Jin Zhou
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang Province, China
| | - Jian-Nan Zhang
- Department of Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Heilongjiang Province, China
| | - Chong-Yi Sun
- Department of Orthopedics, The Second Affiliated Hospital of Harbin Medical University, Heilongjiang Province, China
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14
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Kherrab A, Toufik H, Ghazi M, Benhima MA, Chbihi-Kaddouri A, Chergaoui I, Niamane R, El Maghraoui A. Prevalence of postmenopausal osteoporosis in Morocco: a systematic review and meta-analysis. Arch Osteoporos 2024; 19:61. [PMID: 39026053 DOI: 10.1007/s11657-024-01421-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 07/05/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION This systematic review and meta-analysis was conducted as part of the update of Moroccan recommendations for the management of postmenopausal osteoporosis. Its aim was to estimate the prevalence of postmenopausal osteoporosis in Morocco, based on available bibliographic data. METHODS We conducted a systematic search of the Medline/PubMed, Scopus, and Embase databases to identify articles published between January 2000 and January 2024. We included all observational studies reporting the prevalence of osteoporosis in postmenopausal women in Morocco. Two reviewers independently contributed to the study selection and data extraction. We assessed the risk of bias in the included studies using the Joanna Briggs Institute tool. Statistical analyses were performed using Stata with the Freeman-Tukey double arcsine transformation. Heterogeneity was assessed using the I2 test statistic. Meta-regression analysis was used to investigate the effect of the date on the prevalence. Publication bias was assessed by DOI plots and the LFK index. RESULTS An electronic search found a total of 161 citations from the databases. After excluding the irrelevant articles, 17 eligible studies were included. This meta-analysis included 5097 postmenopausal women. The pooled prevalence of postmenopausal osteoporosis was 32% (95% CI 28-36). Heterogeneity was statistically significant (I2 = 89.67%). There was no significant difference between subgroup analyses performed by risk of bias and sample size. The prevalence rate was significantly higher in 2006-2012 (36%; 95% CI 31-42; I2 = 88.7%; p < 0.001) than in 2013-2019 (27%; 95% CI 22-32; I2 = 85.9%; p < 0.001). Meta-regression showed that the prevalence of osteoporosis decreases very slightly (0.016% per year). This decrease becomes nonsignificant if only studies with a low risk of bias are included in the meta-regression (coefficient - 7.77, p = 0.667, I2 0%). No publication bias was detected in this meta-analysis. CONCLUSION Our results indicate that postmenopausal osteoporosis is prevalent in Morocco, which is a developing country; however, the prevalence of this disease is aligned with that of industrialized countries.
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Affiliation(s)
- Anass Kherrab
- Department of Rheumatology, Avicenne Military Hospital, Cadi Ayyad University, Marrakesh, Morocco.
| | - Hamza Toufik
- Department of Rheumatology, Mohammed V Military Hospital, Mohammed V University, Rabat, Morocco
| | - Mirieme Ghazi
- Department of Rheumatology, Avicenne Military Hospital, Cadi Ayyad University, Marrakesh, Morocco
| | - Mohamed Amine Benhima
- Department of Orthopaedic Surgery and Traumatology, Arrazi Hospital, VI University Hospital, Cadi Ayyad University, Marrakesh, Mohammed, Morocco
| | - Anass Chbihi-Kaddouri
- Department of Rheumatology, Avicenne Military Hospital, Cadi Ayyad University, Marrakesh, Morocco
| | - Ilyass Chergaoui
- Department of Rheumatology, Avicenne Military Hospital, Cadi Ayyad University, Marrakesh, Morocco
| | - Radouane Niamane
- Department of Rheumatology, Avicenne Military Hospital, Cadi Ayyad University, Marrakesh, Morocco
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Liu X, Wu Y, Bennett S, Zou J, Xu J, Zhang L. The Effects of Different Dietary Patterns on Bone Health. Nutrients 2024; 16:2289. [PMID: 39064732 PMCID: PMC11280484 DOI: 10.3390/nu16142289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/05/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Bone metabolism is a process in which osteoclasts continuously clear old bone and osteoblasts form osteoid and mineralization within basic multicellular units, which are in a dynamic balance. The process of bone metabolism is affected by many factors, including diet. Reasonable dietary patterns play a vital role in the prevention and treatment of bone-related diseases. In recent years, dietary patterns have changed dramatically. With the continuous improvement in the quality of life, high amounts of sugar, fat and protein have become a part of people's daily diets. However, people have gradually realized the importance of a healthy diet, intermittent fasting, calorie restriction, a vegetarian diet, and moderate exercise. Although these dietary patterns have traditionally been considered healthy, their true impact on bone health are still unclear. Studies have found that caloric restriction and a vegetarian diet can reduce bone mass, the negative impact of a high-sugar and high-fat dietary (HSFD) pattern on bone health is far greater than the positive impact of the mechanical load, and the relationship between a high-protein diet (HPD) and bone health remains controversial. Calcium, vitamin D, and dairy products play an important role in preventing bone loss. In this article, we further explore the relationship between different dietary patterns and bone health, and provide a reference for how to choose the appropriate dietary pattern in the future and for how to prevent bone loss caused by long-term poor dietary patterns in children, adolescents, and the elderly. In addition, this review provides dietary references for the clinical treatment of bone-related diseases and suggests that health policy makers should consider dietary measures to prevent and treat bone loss.
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Affiliation(s)
- Xiaohua Liu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Yangming Wu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Samuel Bennett
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Jun Zou
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Lingli Zhang
- School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China
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16
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Lv H, Feng Z, Chen X, Zhang Z, Zhou T, Wei J, Feng L, Tao Y, Chen F, Lu S. Global scientific trends on exosomes therapy for osteoporosis from 2004 to 2023: A bibliometric and visualized analysis. Medicine (Baltimore) 2024; 103:e38835. [PMID: 38996093 PMCID: PMC11245275 DOI: 10.1097/md.0000000000038835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2024] [Accepted: 06/14/2024] [Indexed: 07/14/2024] Open
Abstract
BACKGROUND Exosomes have emerged as pivotal mediators in modulating physiological and pathological processes implicated in osteoporosis (OP) through their distinctive mode of intracellular communication. The use of exosomes has evoked considerable interest, catalyzing a surge in research endeavors on a global scale. This study endeavors to scrutinize contemporary landscapes and burgeoning trends in this realm. METHODS The Web of Science Core Collection was used to retrieve publications on exosomes therapy for OP within the time frame of January 1, 2004 to December 31, 2023. The bibliometric methodology was applied to study and index the collected data. VOSviewer and citespace software were used to conduct visualization, co-authorship, co-occurrence, and publication trend analyses of exosome therapy in OP. RESULTS A total of 610 publications (443 articles and 167 reviews) from 51 countries and 911 institutions were included in this study. Shanghai Jiao Tong University, Central South University, Sichuan University, and Zhejiang University are leading research institutions in this field. Stem Cell Research Therapy published the highest number of articles and has emerged as the most cited journal. Of the 4077 scholars who participated in the study, Xie, Hui, Zhang, Yan, Tan, and Yi-Juan had the largest number of articles. Furthermore, according to the cluster analysis of external keywords, future research hotspots can be categorized into 3 directions: research status of exosomes for the treatment of OP, treatment of OP through exosome-regulated signaling pathways, and exosomes as targeted drug delivery systems. CONCLUSION This study suggests that the number of future publications on exosome therapy for OP will increase, with a focus on fundamental investigations into drug-loading capacities and molecular mechanisms. In summary, this study presents the first systematic bibliometric analysis of exosome therapy publications in OP, providing an objective and comprehensive overview of the field and a valuable reference for researchers in this domain.
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Affiliation(s)
- He Lv
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, China
| | - Zhe Feng
- Joint & Sports Medicine Surgery Division, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
| | - Xingyu Chen
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, China
| | - Zhenyu Zhang
- Gynecology Department, Guangdong Medical University Shunde Women and Children’s Hospital, Foshan, China
| | - Tianhao Zhou
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, China
| | - Jihu Wei
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, China
| | - Lin Feng
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, China
| | - Yizi Tao
- Faculty of Postgraduate, Guangxi University of Chinese Medicine, Nanning, China
| | - Feng Chen
- Spine Surgery Division, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
| | - Shijin Lu
- Centre for Translational Medical Research in Integrative Chinese and Western Medicine, Ruikang Hospital Affiliated to Guangxi University of Chinese Medicine, Nanning, China
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17
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Zhou P, Lu K, Li C, Xu MZ, Ye YW, Shan HQ, Yin Y. Association between systemic inflammatory response index and bone turnover markers in Chinese patients with osteoporotic fractures: a retrospective cross-sectional study. Front Med (Lausanne) 2024; 11:1404152. [PMID: 39055700 PMCID: PMC11269153 DOI: 10.3389/fmed.2024.1404152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Accepted: 07/02/2024] [Indexed: 07/27/2024] Open
Abstract
Background The systemic inflammatory response index (SIRI) is a novel composite biomarker of inflammation. However, there is limited information on its use in the context of osteoporotic fractures. Hence, this study aimed to investigate the association between baseline SIRI values and bone turnover markers (BTMs) in Chinese patients diagnosed with osteoporotic fractures (OPFs), to offer a more precise method for assessing bone health and inflammation in clinical settings. Methods A retrospective cross-sectional study was conducted on 3,558 hospitalized patients with OPFs who required surgery or hospitalization at the First People's Hospital of Kunshan City from January 2017 to July 2022. Baseline measurements of SIRI, β-CTX (beta-C-terminal telopeptide of type I collagen), and P1NP (procollagen type I N-terminal propeptide) were obtained. The analyses were adjusted for variables, including age, sex, body mass index (BMI), and other initial laboratory and clinical findings. Furthermore, multivariable logistic regression, smooth curve fitting, and threshold analysis were also performed. Results The results revealed a negative correlation between baseline SIRI values and both β-CTX and P1NP levels. After adjusting for covariates in the regression analysis, each unit increase in SIRI was found to be inked to a reduction of 0.04 (β = -0.04; 95% confidence interval [CI], -0.05 to -0.03; with p-value <0.001) in β-CTX levels and a decrease of 3.77 (β = 3.77; 95% CI, 5.07 to 2.47; with p-value <0.001) in P1NP levels. Furthermore, a curvilinear relationship and threshold effect were also identified. Turning points were identified at SIRI values of 1.41 and 1.63 on the adjusted smooth curve. Conclusion The results showed a negative correlation between the baseline SIRI value and β-CTX level, as well as the level of P1NP. This suggests a possible link between the systemic inflammatory response and reduced bone metabolism. If these findings are verified, SIRI has the potential to function as a predictive indicator for BTMs. Nevertheless, additional research is necessary to verify these findings.
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Affiliation(s)
- Peng Zhou
- Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Ke Lu
- Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Chong Li
- Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Min-zhe Xu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Yao-wei Ye
- Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Hui-qiang Shan
- Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Yi Yin
- Department of Orthopedics, Gusu School, Nanjing Medical University, The First People's Hospital of Kunshan, Suzhou, Jiangsu, China
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
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Lu J, Shi X, Fu Q, Han Y, Zhu L, Zhou Z, Li Y, Lu N. New mechanistic understanding of osteoclast differentiation and bone resorption mediated by P2X7 receptors and PI3K-Akt-GSK3β signaling. Cell Mol Biol Lett 2024; 29:100. [PMID: 38977961 PMCID: PMC11232284 DOI: 10.1186/s11658-024-00614-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Accepted: 06/24/2024] [Indexed: 07/10/2024] Open
Abstract
OBJECTIVE Osteoporosis is a global health issue characterized by decreased bone mass and microstructural degradation, leading to an increased risk of fractures. This study aims to explore the molecular mechanism by which P2X7 receptors influence osteoclast formation and bone resorption through the PI3K-Akt-GSK3β signaling pathway. METHODS An osteoporosis mouse model was generated through ovariectomy (OVX) in normal C57BL/6 and P2X7f/f; LysM-cre mice. Osteoclasts were isolated for transcriptomic analysis, and differentially expressed genes were selected for functional enrichment analysis. Metabolite analysis was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS), and multivariate statistical analysis and pattern recognition were used to identify differential lipid metabolism markers and their distribution. Bioinformatics analyses were conducted using the Encyclopedia of Genes and Genomes database and the MetaboAnalyst database to assess potential biomarkers and create a metabolic pathway map. Osteoclast precursor cells were used for in vitro cell experiments, evaluating cell viability and proliferation using the Cell Counting Kit 8 (CCK-8) assay. Osteoclast precursor cells were induced to differentiate into osteoclasts using macrophage colony-stimulating factor (M-CSF) and receptor activator of nuclear factor kappa-beta ligand (RANKL), and tartrate-resistant acid phosphatase (TRAP) staining was performed to compare differentiation morphology, size, and quantity between different groups. Western blot analysis was used to assess the expression of differentiation markers, fusion gene markers, and bone resorption ability markers in osteoclasts. Immunofluorescence staining was employed to examine the spatial distribution and quantity of osteoclast cell skeletons, P2X7 protein, and cell nuclei, while pit assay was used to evaluate osteoclast bone resorption ability. Finally, in vivo animal experiments, including micro computed tomography (micro-CT), hematoxylin and eosin (HE) staining, TRAP staining, and immunohistochemistry, were conducted to observe bone tissue morphology, osteoclast differentiation, and the phosphorylation level of the PI3K-Akt-GSK3β signaling pathway. RESULTS Transcriptomic and metabolomic data collectively reveal that the P2X7 receptor can impact the pathogenesis of osteoporosis through the PI3K-Akt-GSK3β signaling pathway. Subsequent in vitro experiments showed that cells in the Sh-P2X7 + Recilisib group exhibited increased proliferative activity (1.15 versus 0.59), higher absorbance levels (0.68 versus 0.34), and a significant increase in resorption pit area (13.94 versus 3.50). Expression levels of osteoclast differentiation-related proteins MMP-9, CK, and NFATc1 were markedly elevated (MMP-9: 1.72 versus 0.96; CK: 2.54 versus 0.95; NFATc1: 3.05 versus 0.95), along with increased fluorescent intensity of F-actin rings. In contrast, the OE-P2X7 + LY294002 group showed decreased proliferative activity (0.64 versus 1.29), reduced absorbance (0.34 versus 0.82), and a significant decrease in resorption pit area (5.01 versus 14.96), accompanied by weakened expression of MMP-9, CK, and NFATc1 (MMP-9: 1.14 versus 1.79; CK: 1.26 versus 2.75; NFATc1: 1.17 versus 2.90) and decreased F-actin fluorescent intensity. Furthermore, in vivo animal experiments demonstrated that compared with the wild type (WT) + Sham group, mice in the WT + OVX group exhibited significantly increased levels of CTX and NTX in serum (CTX: 587.17 versus 129.33; NTX: 386.00 versus 98.83), a notable decrease in calcium deposition (19.67 versus 53.83), significant reduction in bone density, increased trabecular separation, and lowered bone mineral density (BMD). When compared with the KO + OVX group, mice in the KO + OVX + recilisib group showed a substantial increase in CTX and NTX levels in serum (CTX: 503.50 versus 209.83; NTX: 339.83 versus 127.00), further reduction in calcium deposition (29.67 versus 45.33), as well as decreased bone density, increased trabecular separation, and reduced BMD. CONCLUSION P2X7 receptors positively regulate osteoclast formation and bone resorption by activating the PI3K-Akt-GSK3β signaling pathway.
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Affiliation(s)
- Jiajia Lu
- Department of Orthopedic Trauma, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 1279 Sanmen Road, Shanghai, 200434, China
- Department of Orthopedic Trauma, Shanghai Changzheng Hospital, Shanghai, 200434, China
| | - Xiaojian Shi
- Department of Orthopedic Trauma, Haimen People's Hospital of Jiangsu Province, Nantong, 226100, China
| | - Qiang Fu
- Department of Orthopedic Trauma, Shanghai Changzheng Hospital, Shanghai, 200434, China
| | - Yaguang Han
- Department of Orthopedic Trauma, Shanghai Changzheng Hospital, Shanghai, 200434, China
| | - Lei Zhu
- Department of Orthopedic Trauma, Shanghai Changzheng Hospital, Shanghai, 200434, China
| | - Zhibin Zhou
- Department of Orthopaedics, General Hospital of Northern Theater Command, No. 83, Culture Road, Shenhe District, Shenyang, 110016, Liaoning, China.
| | - Yongchuan Li
- Department of Orthopedic Trauma, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 1279 Sanmen Road, Shanghai, 200434, China.
| | - Nan Lu
- Department of Orthopedic Trauma, Shanghai Fourth People's Hospital, School of Medicine, Tongji University, 1279 Sanmen Road, Shanghai, 200434, China.
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Ji J, Li Z, Xue L, Xue H, Wen T, Yang T, Ma T, Tu Y. The impact of thyroid function on total spine bone mineral density in postmenopausal women. Endocrine 2024; 85:279-286. [PMID: 38308787 DOI: 10.1007/s12020-024-03712-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/21/2024] [Indexed: 02/05/2024]
Abstract
PURPOSE Osteoporosis has been a widespread concern for older women, especially postmenopausal women. Thyroid function is crucial for bone metabolism. However, the relationship between thyroid function variation within thyroxine reference range and bone mineral density (BMD) remains ambiguous. The objective of this study was to evaluate the effect of subclinical hypothyroidism or hyperthyroidism on total spinal BMD in postmenopausal women. METHODS Based on data from the National Health and Nutrition Examination Survey (NHANES) 2007-2010, multivariable weighted logistic regression was used to evaluate the relationships between total spine BMD and TSH among postmenopausal women aged ≥50. RESULTS After accounting for a number of variables, this study discovered that the middle TSH tertile was associated with a decreased probability of osteoporosis. Additionally, the subgroup analysis revealed that postmenopausal women over the age of 65 or people with an overweight BMI had a clearer relationship between total spine BMD and TSH. CONCLUSION The total spinal BMD had a positive relationship with thyroid stimulating hormone in postmenopausal women, and that appropriate TSH level (1.38-2.32 mIU/L) was accompanied by higher total spinal BMD.
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Affiliation(s)
- Jiazhong Ji
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Zhaoyang Li
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Long Xue
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Huaming Xue
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Tao Wen
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Tao Yang
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China
| | - Tong Ma
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China.
| | - Yihui Tu
- Department of Orthopaedics, Yangpu Hospital, School of Medicine, Tongji University, Shanghai, 200090, China.
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20
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Zubick P, Dahlke S. Family/caregiver influence on osteoporosis management for older people: an integrative review. Osteoporos Int 2024; 35:1153-1163. [PMID: 38622263 DOI: 10.1007/s00198-024-07081-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 03/22/2024] [Indexed: 04/17/2024]
Abstract
An integrative literature review was conducted to understand family/caregiver influence on osteoporosis management for older people. Findings include caregivers' overprotection, caregivers' risks for fragility fractures due to caregiving role, poor bone health in caregivers, and caregivers' burden and facilitators. Caregivers should be included in bone health and discharge planning. Literature on family/caregiver influence on osteoporosis management for older people is sparse. Older people are prone to osteoporosis and fragility fractures due to their age, often triggering the need for a caregiver after experiencing a fragility fracture. These fractures pose significant costs to the patient and health systems and are projected to increase with the aging population. This study applied an integrative literature review methodology to key literature findings on family/caregiver influence on osteoporosis management for older people. Key findings include caregivers' tendency to overprotect persons who experience hip fracture by limiting mobilization, thus impeding recovery, caregivers' risks for their own fragility fractures due to the demands of their caregiving role, risks of poor bone health in caregivers, and caregivers' experience of significant burden for which facilitators have been identified. Family caregivers of older people with osteoporosis have unique needs and require support and resources, especially after their loved one experiences a hip fracture. Informal caregivers must be considered in bone health education and discharge planning. They should be considered in the creation of osteoporosis guidelines and within the work of fracture liaison services. More research is needed to increase understanding about family caregiver influence on osteoporosis management.
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Affiliation(s)
- Paula Zubick
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada
| | - Sherry Dahlke
- Faculty of Nursing, University of Alberta, Edmonton Clinic Health Academy, 11405-87 Ave NW, Edmonton, Alberta, T6G 1C9, Canada.
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21
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Li Z, Li Y, Liu C, Gu Y, Han G. Research progress of the mechanisms and applications of ginsenosides in promoting bone formation. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 129:155604. [PMID: 38614042 DOI: 10.1016/j.phymed.2024.155604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2023] [Revised: 04/03/2024] [Accepted: 04/07/2024] [Indexed: 04/15/2024]
Abstract
BACKGROUND Bone deficiency-related diseases caused by various factors have disrupted the normal function of the skeleton and imposed a heavy burden globally, urgently requiring potential new treatments. The multi-faceted role of compounds like ginsenosides and their interaction with the bone microenvironment, particularly osteoblasts can promote bone formation and exhibit anti-inflammatory, vascular remodeling, and antibacterial properties, holding potential value in the treatment of bone deficiency-related diseases and bone tissue engineering. PURPOSE This review summarizes the interaction between ginsenosides and osteoblasts and the bone microenvironment in bone formation, including vascular remodeling and immune regulation, as well as their therapeutic potential and toxicity in the broad treatment applications of bone deficiency-related diseases and bone tissue engineering, to provide novel insights and treatment strategies. METHODS The literature focusing on the mechanisms and applications of ginsenosides in promoting bone formation before March 2024 was searched in PubMed, Web of Science, Google Scholar, Scopus, and Science Direct databases. Keywords such as "phytochemicals", "ginsenosides", "biomaterials", "bone", "diseases", "bone formation", "microenvironment", "bone tissue engineering", "rheumatoid arthritis", "periodontitis", "osteoarthritis", "osteoporosis", "fracture", "toxicology", "pharmacology", and combinations of these keywords were used. RESULTS Ginsenoside monomers regulate signaling pathways such as WNT/β-catenin, FGF, and BMP/TGF-β, stimulating osteoblast generation and differentiation. It exerts angiogenic and anti-inflammatory effects by regulating the bone surrounding microenvironment through signaling such as WNT/β-catenin, NF-κB, MAPK, PI3K/Akt, and Notch. It shows therapeutic effects and biological safety in the treatment of bone deficiency-related diseases, including rheumatoid arthritis, osteoarthritis, periodontitis, osteoporosis, and fractures, and bone tissue engineering by promoting osteogenesis and improving the microenvironment of bone formation. CONCLUSION The functions of ginsenosides are diverse and promising in treating bone deficiency-related diseases and bone tissue engineering. Moreover, potential exists in regulating the bone microenvironment, modifying biomaterials, and treating inflammatory-related bone diseases and dental material applications. However, the mechanisms and effects of some ginsenoside monomers are still unclear, and the lack of clinical research limits their clinical application. Further exploration and evaluation of the potential of ginsenosides in these areas are expected to provide more effective methods for treating bone defects.
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Affiliation(s)
- Ze Li
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, Changchun, 130021, PR China
| | - Yanan Li
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, Changchun, 130021, PR China
| | - Chaoran Liu
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, Changchun, 130021, PR China
| | - Yuqing Gu
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, Changchun, 130021, PR China
| | - Guanghong Han
- Department of Oral Geriatrics, Hospital of Stomatology, Jilin University, Changchun, 130021, PR China.
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22
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Zheng W, Meng Z, Zhu Z, Wang X, Xu X, Zhang Y, Luo Y, Liu Y, Pei X. Metal-Organic Framework-Based Nanomaterials for Regulation of the Osteogenic Microenvironment. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2024; 20:e2310622. [PMID: 38377299 DOI: 10.1002/smll.202310622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Revised: 02/01/2024] [Indexed: 02/22/2024]
Abstract
As the global population ages, bone diseases have become increasingly prevalent in clinical settings. These conditions often involve detrimental factors such as infection, inflammation, and oxidative stress that disrupt bone homeostasis. Addressing these disorders requires exogenous strategies to regulate the osteogenic microenvironment (OME). The exogenous regulation of OME can be divided into four processes: induction, modulation, protection, and support, each serving a specific purpose. To this end, metal-organic frameworks (MOFs) are an emerging focus in nanomedicine, which show tremendous potential due to their superior delivery capability. MOFs play numerous roles in OME regulation such as metal ion donors, drug carriers, nanozymes, and photosensitizers, which have been extensively explored in recent studies. This review presents a comprehensive introduction to the exogenous regulation of OME by MOF-based nanomaterials. By discussing various functional MOF composites, this work aims to inspire and guide the creation of sophisticated and efficient nanomaterials for bone disease management.
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Affiliation(s)
- Wenzhuo Zheng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Zihan Meng
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Zhou Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xu Wang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiangrui Xu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yaowen Zhang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yankun Luo
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yanhua Liu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xibo Pei
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, 610041, China
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23
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Xu H, Tian F, Liu Y, Liu R, Li H, Gao X, Ju C, Lu B, Wu W, Wang Z, Zhu L, Hao D, Jia S. Magnesium malate-modified calcium phosphate bone cement promotes the repair of vertebral bone defects in minipigs via regulating CGRP. J Nanobiotechnology 2024; 22:368. [PMID: 38918787 PMCID: PMC11197294 DOI: 10.1186/s12951-024-02595-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 05/28/2024] [Indexed: 06/27/2024] Open
Abstract
Active artificial bone substitutes are crucial in bone repair and reconstruction. Calcium phosphate bone cement (CPC) is known for its biocompatibility, degradability, and ability to fill various shaped bone defects. However, its low osteoinductive capacity limits bone regeneration applications. Effectively integrating osteoinductive magnesium ions with CPC remains a challenge. Herein, we developed magnesium malate-modified CPC (MCPC). Incorporating 5% magnesium malate significantly enhances the compressive strength of CPC to (6.18 ± 0.49) MPa, reduces setting time and improves disintegration resistance. In vitro, MCPC steadily releases magnesium ions, promoting the proliferation of MC3T3-E1 cells without causing significant apoptosis, proving its biocompatibility. Molecularly, magnesium malate prompts macrophages to release prostaglandin E2 (PGE2) and synergistically stimulates dorsal root ganglion (DRG) neurons to synthesize and release calcitonin gene-related peptide (CGRP). The CGRP released by DRG neurons enhances the expression of the key osteogenic transcription factor Runt-related transcription factor-2 (RUNX2) in MC3T3-E1 cells, promoting osteogenesis. In vivo experiments using minipig vertebral bone defect model showed MCPC significantly increases the bone volume fraction, bone density, new bone formation, and proportion of mature bone in the defect area compared to CPC. Additionally, MCPC group exhibited significantly higher levels of osteogenesis and angiogenesis markers compared to CPC group, with no inflammation or necrosis observed in the hearts, livers, or kidneys, indicating its good biocompatibility. In conclusion, MCPC participates in the repair of bone defects in the complex post-fracture microenvironment through interactions among macrophages, DRG neurons, and osteoblasts. This demonstrates its significant potential for clinical application in bone defect repair.
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Affiliation(s)
- Hailiang Xu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Fang Tian
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Youjun Liu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Renfeng Liu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Hui Li
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Xinlin Gao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Cheng Ju
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Botao Lu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Weidong Wu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Zhiyuan Wang
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China
| | - Lei Zhu
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China.
| | - Dingjun Hao
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China.
| | - Shuaijun Jia
- Department of Spine Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi, 710054, China.
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, Shaanxi, 710054, China.
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24
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Hu S, Wen Y, Li J, Chen W, Bai Y, Gong F. Bioequivalence of Recombinant Human Teriparatide Injection in Healthy Adult Female Subjects in the Fasting State. Clin Pharmacol Drug Dev 2024. [PMID: 38923284 DOI: 10.1002/cpdd.1440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 05/28/2024] [Indexed: 06/28/2024]
Abstract
A single-center, randomized, open, 2-period, self-crossover, single-dose trial was conducted to evaluate the bioequivalence of the test (T) and reference (R) preparations in healthy adult female subjects under fasting conditions. Seventy-six subjects were enrolled in the study, and subjects were randomly divided into 2 groups at a 1:1 ratio and were administered once per period, with a 4-day washout period. In each period, plasma drug concentrations, blood calcium changes, and antibodies were determined for pharmacokinetics, pharmacodynamics, and immunogenicity analysis, respectively, and adverse events were recorded for safety analysis. The 90% confidence intervals for the geometric mean ratios (T:R) of maximum plasma concentration, area under the plasma concentration-time curve from time 0 to the last measurable concentration, and area under the plasma concentration-time curve from time 0 to infinity were within the predefined bioequivalence criterion of 80%-125%, indicating bioequivalence between the T and R preparations under fasting conditions. Comparable serum calcium levels demonstrated pharmacodynamics similarity, and no differences were found in immunogenicity profiles. Additionally, the incidence of adverse reactions to the T preparation was 18.4% lower than that of the R preparation (31.6%). This study confirmed the bioequivalence of the T and R preparations under fasting conditions, along with comparable immunogenicity profiles and good safety.
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Affiliation(s)
- Shengling Hu
- Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Infectious Diseases, Wuhan, China
- Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
- Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, China
| | - Yalei Wen
- Beijing Bokangjian Gene Technology Co., Ltd, Beijing, China
| | - Jing Li
- Beijing Bokangjian Gene Technology Co., Ltd, Beijing, China
| | - Wenming Chen
- Beijing Bokangjian Gene Technology Co., Ltd, Beijing, China
| | - Yichuan Bai
- Beijing Bokangjian Gene Technology Co., Ltd, Beijing, China
| | - Fengyun Gong
- Department of Infectious Diseases, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
- Hubei Clinical Research Center for Infectious Diseases, Wuhan, China
- Wuhan Research Center for Communicable Disease Diagnosis and Treatment, Chinese Academy of Medical Sciences, Wuhan, China
- Joint Laboratory of Infectious Diseases and Health, Wuhan Institute of Virology and Wuhan Jinyintan Hospital, Chinese Academy of Sciences, Wuhan, China
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25
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Lyu FF, Ramoo V, Chui PL, Ng CG, Zhang Y. Prevalence rate of primary osteoporosis in China: a meta-analysis. BMC Public Health 2024; 24:1518. [PMID: 38844897 PMCID: PMC11155107 DOI: 10.1186/s12889-024-18932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Primary osteoporosis (POP) is recognized as a "silent disease" and often ignored. This meta-analysis aimed to determine the prevalence of POP in the Chinese population over the past 20 years to raise awareness of the disease's epidemiology, which is hoped to help prevent and treat the condition better. METHODS Eight English and three Chinese language databases were searched systematically from January 2002 to December 2023. Relevant data were analysed using Stata 16.0. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. A funnel plot was further drawn in combination with Egger and Begg tests to determine publication bias. RESULTS A total of 45 studies (241,813 participants) were included. The meta-analysis revealed that the overall prevalence of POP in the Chinese population was 18.2% (95% CI: 14.7-21.7%), showing a positive correlation with age. Specifically, prevalence rates were 23.4% (18.3-28.5%) in women and 11.5% (9.1-13.9%) in men. A notable increase was observed within the span of 20 years (16.9% before 2010 and 20.3% in 2011-2020). Notably, regional variations were observed, with southern China reporting a lower prevalence of 16.4% compared to 20.2% in northern China. Meta-regression suggested that sample size significantly influenced the estimation of point prevalence (P = 0.037). CONCLUSIONS Over the past two decades, there has been an increase in the prevalence of POP within the Chinese population. The growing prevalence of older individuals and women further highlights the urgency for tailored disease prevention and control measures.
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Affiliation(s)
- Fang Fei Lyu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, 650500, China
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Vimala Ramoo
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Yuanyuan Zhang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
- School of Medical and Health Engineering, Changzhou University, Changzhou, Jiangsu, 213000, China
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26
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Ahire JJ, Kumar V, Rohilla A. Understanding Osteoporosis: Human Bone Density, Genetic Mechanisms, Gut Microbiota, and Future Prospects. Probiotics Antimicrob Proteins 2024; 16:875-883. [PMID: 37874496 DOI: 10.1007/s12602-023-10185-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/18/2023] [Indexed: 10/25/2023]
Abstract
Osteoporosis is a systemic condition of the skeleton that leads to diminished bone mass, a breakdown in the bone tissue's microscopic architecture, and an elevated risk of breaking a bone. The elderly and women particularly after menopause are disproportionately affected, and the condition generally stays undiagnosed until a broken bone causes severe pain and immobility. Causes of osteoporosis include low bone mass, more than normal bone loss, changes in hormone levels (decreased estrogen or testosterone), certain diseases and therapies, and lifestyle factors like smoking and inactivity. The spine, hip, and forearm are particularly vulnerable to osteoporosis-related fractures. The purpose of this article is to present a thorough understanding of osteoporosis, including the disease's connection to bone density in humans, and the major part played by genetic pathways and gut flora. The causes of osteoporosis, the effects of aging on bone density, and why some groups experience a higher incidence of the disease than others are investigated. The paper also includes animal and human experiments investigating the link between gut flora and osteoporosis. Finally, it looks to the future and speculates on possible developments in osteoporosis prevention and therapy.
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Affiliation(s)
- Jayesh J Ahire
- Dr. Reddy's Laboratories Limited, Hyderabad, 500016, India.
| | - Vikram Kumar
- Department of Basic and Applied Sciences, National Institute of Food Technology Entrepreneurship and Management, Sonipat, 131028, India
| | - Alka Rohilla
- Institute of Biology Sciences, Faculty of Science, University of Malaya, 5060, Kuala Lumpur, Malaysia
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Li W, Niu Y, Qiu Z, Zhou S, Zhong W, Xiong Z, Zhao D, Yang Y, Zhao H, Yu X. New evidence on the controversy over the correlation between vertebral osteoporosis and intervertebral disc degeneration: a systematic review of relevant animal studies. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:2354-2379. [PMID: 38642137 DOI: 10.1007/s00586-024-08256-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 03/28/2024] [Accepted: 04/02/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE The effect of vertebral osteoporosis on disc degeneration remains controversial. The aim of this study was to conduct a systematic review and meta-analysis of relevant animal studies to shed more light on the effects and mechanisms of vertebral osteoporosis on disc degeneration and to promote the resolution of the controversy. METHODS The PubMed, Cochrane Library, and Embase databases were searched for studies that met the inclusion criteria. Basic information and data were extracted from the included studies and data were analyzed using STATA 15.1 software. This study was registered on INPLASY with the registration number INPLASY202370099 and https://doi.org/10.37766/inplasy2023.7.0099 . RESULTS A total of 13 studies were included in our study. Both animals, rats and mice, were covered. Meta-analysis results showed in disc height index (DHI) (P < 0.001), histological score (P < 0.001), number of osteoblasts in the endplate (P = 0.043), number of osteoclasts in the endplate (P < 0.001), type I collagen (P < 0.001), type II collagen (P < 0.001), aggrecan (P < 0.001), recombinant a disintegrin and metalloproteinase with thrombospondin-4 (ADAMTS-4) (P < 0.001), matrix metalloproteinase-1 (MMP-1) (P < 0.001), MMP-3 (P < 0.001), MMP-13 (P < 0.001), the difference between the osteoporosis group and the control group was statistically significant. In terms of disc volume, the difference between the osteoporosis group and the control group was not statistically significant (P = 0.459). CONCLUSION Our study shows that vertebral osteoporosis may exacerbate disc degeneration. Abnormal bone remodeling caused by vertebral osteoporosis disrupts the structural integrity of the endplate, leading to impaired nutrient supply to the disc, increased expression of catabolic factors, and decreased levels of type II collagen and aggrecan may be one of the potential mechanisms.
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Affiliation(s)
- Wenhao Li
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yiqun Niu
- China Medical Technology Press Co., Ltd, Beijing, 100089, China
| | - Ziye Qiu
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Shibo Zhou
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Wenqing Zhong
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Zhencheng Xiong
- West China Hospital, West China Medical School, Sichuan University, Chengdu, 610041, China
| | - Dingyan Zhao
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - Yongdong Yang
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China
| | - He Zhao
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China.
| | - Xing Yu
- Dongzhimen Hospital Affiliated to Beijing University of Chinese Medicine, Beijing, 100700, China.
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28
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Shen X, Zhang M, Cai H, Leslie WD, Lix LM, Jiang D, Feng L, Cheng H, Shi X, Gao Y, Yang S. Associations of global biomarkers of oxidative stress with osteoporosis, bone microstructure and bone turnover: Evidence from human and animal studies. Bone 2024; 183:117077. [PMID: 38521234 DOI: 10.1016/j.bone.2024.117077] [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: 09/25/2023] [Revised: 01/31/2024] [Accepted: 03/20/2024] [Indexed: 03/25/2024]
Abstract
PURPOSE Human evidence on the association between oxidative stress and osteoporosis is inconsistent. Fluorescent Oxidation Products (FlOPs) are global biomarkers of oxidative stress. We examined the associations of FlOPs (excitation/emission wavelengths 320/420 nm for FlOP_320, 360/420 nm for FlOP_360, and 400/475 nm for FlOP_400) with osteoporosis, bone microstructure, and bone turnover markers in humans and rats. METHODS In humans, we conducted a 1:2 age, sex, hospital, and specimen-matched case-control study to test the association between FlOPs and osteoporosis diagnosed from dual-energy X-ray absorptiometry. In eight-week-old male Wistar rats, we administrated D-galactose and 0.9 % saline for 90 days in treatment and control groups (n = 8/group); micro-CT was used to determine bone microstructure. RESULTS In humans, higher levels of FlOP_320 (OR for per 1 SD increase = 1.49, 95 % CI: 1.01-2.20) and FlOP_360 (OR for per 1 SD increase = 1.59, 95 % CI: 1.07-2.37) were associated with increased odds of osteoporosis. FlOP_400 were not associated with osteoporosis. D-galactose treated rats, as compared with control rats, showed higher levels of FlOP_320 and MDA, and lower P1NP levels during 90 days of experiment (all P < 0.05). The D-galactose group had lower trabecular bone volume fraction (0.07 ± 0.03 vs. 0.13 ± 0.05; P = 0.008) and volumetric BMD (225.4 ± 13.8 vs. 279.1 ± 33.2 mg HA/cm3; P = 0.001) than the control group. CONCLUSION In conclusion, higher FlOP_320 levels were associated with increased odds of osteoporosis, impaired bone microstructure and decreased bone formation.
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Affiliation(s)
- Xue Shen
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Mengmeng Zhang
- FAW General Hospital of Jilin Province, Changchun, Jilin, China
| | - Hanqing Cai
- Department of Endocrinology, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - William D Leslie
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Depeng Jiang
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lijie Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - Haitao Cheng
- FAW General Hospital of Jilin Province, Changchun, Jilin, China
| | - Xianbao Shi
- Department of Pharmacy, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Yuzhong Gao
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
| | - Shuman Yang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China; Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
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Din RU, Nishtar T, Cheng X, Yang H. Assessing osteoporosis in postmenopausal women: preliminary results using a novel lumbar spine phantom-based MRI scoring method. LA RADIOLOGIA MEDICA 2024; 129:912-924. [PMID: 38625420 DOI: 10.1007/s11547-024-01814-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 04/02/2024] [Indexed: 04/17/2024]
Abstract
OBJECTIVE To develop a novel magnetic resonance imaging (MRI) phantom for producing F-score (for fat) and W-score (for water) and to evaluate the performance of these scores in assessing osteoporosis and related vertebral fractures. MATERIALS AND METHODS First, a real-time phantom consisting of oil and water tubes was manufactured. Then, 30 female volunteers (age: 62.3 ± 6.3 years) underwent lumbar spine examination with MRI (using a novel phantom) and dual-energy X-ray absorptiometry (DXA), following ethical approval. MRI phantom-based F-score and W-score were defined by normalizing the vertebral signal intensities (SIs) by the oil and water SIs of the phantom on T1- and T2-weighted images, respectively. The diagnostic performances of the new scores for assessing osteoporosis and vertebral fractures were examined using receiver operating characteristic analysis and compared with DXA-measured areal bone mineral density (DXA-aBMD). RESULTS The F-score and W-score were greater in the osteoporotic patients (3.93 and 2.29) than the non-osteoporotic subjects (3.05 and 1.79) and achieved AUC values of 0.85 and 0.74 (p < 0.05), respectively, when detecting osteoporosis. Similarly, F-score and W-score had greater values for the fracture patients (3.94 and 2.53) than the non-fracture subjects (3.14 and 1.69) and produced better AUC values (0.90 for W-score and 0.79 for F-score) compared to DXA-aBMD (AUC: 0.27, p < 0.05). In addition, the F-score and W-score had a strong correlation (r = 0.77; p < 0.001). CONCLUSION A novel real-time lumber spine MRI phantom was developed, based upon which newly defined F-score and W-score were able to detect osteoporosis and demonstrated an improved ability over DXA-aBMD in differentiating patients with vertebral fractures.
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Affiliation(s)
- Rahman Ud Din
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing, 100124, China
| | - Tahira Nishtar
- Department of Imaging and Interventional Radiology, Lady Reading Hospital (LRH-MTI), Peshawar, Pakistan
| | - Xiaoguang Cheng
- Department of Radiology, Beijing Jishuitan Hospital, National Centre for Orthopaedics, Capital Medical University, Beijing, China
| | - Haisheng Yang
- Department of Biomedical Engineering, College of Chemistry and Life Science, Beijing University of Technology, 100 Pingleyuan, Chaoyang District, Beijing, 100124, China.
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30
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Yu Y, Li X, Zheng M, Zhou L, Zhang J, Wang J, Sun B. The potential benefits and mechanisms of protein nutritional intervention on bone health improvement. Crit Rev Food Sci Nutr 2024; 64:6380-6394. [PMID: 36655469 DOI: 10.1080/10408398.2023.2168250] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Osteoporosis commonly occurs in the older people and severe patients, with the main reason of the imbalance of bone metabolism (the rate of bone resorption exceeding the rate of bone formation), resulting in a decrease in bone mineral density and destruction of bone microstructure and further leading to the increased risk of fragility fracture. Recent studies indicate that protein nutritional support is beneficial for attenuating osteoporosis and improving bone health. This review summarized the classical mechanisms of protein intervention for alleviating osteoporosis on both suppressing bone resorption and regulating bone formation related pathways (promoting osteoblasts generation and proliferation, enhancing calcium absorption, and increasing collagen and mineral deposition), as well as the potential novel mechanisms via activating autophagy of osteoblasts, altering bone related miRNA profiles, regulating muscle-bone axis, and modulating gut microbiota abundance. Protein nutritional intervention is expected to provide novel approaches for the prevention and adjuvant therapy of osteoporosis.
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Affiliation(s)
- Yonghui Yu
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
| | - Xinping Li
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
| | - Mengjun Zheng
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
| | - Linyue Zhou
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
| | - Jingjie Zhang
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
| | - Jing Wang
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
| | - Baoguo Sun
- China-Canada Joint Lab of Food Nutrition and Health (Beijing), Key Laboratory of Special Food Supervision Technology for State Market Regulation, Beijing Technology and Business University, Beijing, China
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Yıldız Potter İ, Yeritsyan D, Mahar S, Kheir N, Vaziri A, Putman M, Rodriguez EK, Wu J, Nazarian A, Vaziri A. Proximal femur fracture detection on plain radiography via feature pyramid networks. Sci Rep 2024; 14:12046. [PMID: 38802519 PMCID: PMC11130146 DOI: 10.1038/s41598-024-63001-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 05/23/2024] [Indexed: 05/29/2024] Open
Abstract
Hip fractures exceed 250,000 cases annually in the United States, with the worldwide incidence projected to increase by 240-310% by 2050. Hip fractures are predominantly diagnosed by radiologist review of radiographs. In this study, we developed a deep learning model by extending the VarifocalNet Feature Pyramid Network (FPN) for detection and localization of proximal femur fractures from plain radiography with clinically relevant metrics. We used a dataset of 823 hip radiographs of 150 subjects with proximal femur fractures and 362 controls to develop and evaluate the deep learning model. Our model attained 0.94 specificity and 0.95 sensitivity in fracture detection over the diverse imaging dataset. We compared the performance of our model against five benchmark FPN models, demonstrating 6-14% sensitivity and 1-9% accuracy improvement. In addition, we demonstrated that our model outperforms a state-of-the-art transformer model based on DINO network by 17% sensitivity and 5% accuracy, while taking half the time on average to process a radiograph. The developed model can aid radiologists and support on-premise integration with hospital cloud services to enable automatic, opportunistic screening for hip fractures.
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Affiliation(s)
| | - Diana Yeritsyan
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA, 02215, USA
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue RN123, Boston, MA, 02215, USA
| | - Sarah Mahar
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA, 02215, USA
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue RN123, Boston, MA, 02215, USA
| | - Nadim Kheir
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA, 02215, USA
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue RN123, Boston, MA, 02215, USA
| | - Aidin Vaziri
- BioSensics, LLC, 57 Chapel Street, Newton, MA, 02458, USA
| | - Melissa Putman
- Division of Endocrinology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, 02114, USA
| | - Edward K Rodriguez
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA, 02215, USA
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue RN123, Boston, MA, 02215, USA
| | - Jim Wu
- Department of Radiology, Massachusetts General Brigham (MGB) and Harvard Medical School, 75 Francis Street, Boston, MA, 02215, USA
| | - Ara Nazarian
- Carl J. Shapiro Department of Orthopaedic Surgery, Beth Israel Deaconess Medical Center (BIDMC) and Harvard Medical School, 330 Brookline Avenue, Stoneman 10, Boston, MA, 02215, USA
- Musculoskeletal Translational Innovation Initiative, Beth Israel Deaconess Medical Center and Harvard Medical School, 330 Brookline Avenue RN123, Boston, MA, 02215, USA
- Department of Orthopaedic Surgery, Yerevan State University, Yerevan, Armenia
| | - Ashkan Vaziri
- BioSensics, LLC, 57 Chapel Street, Newton, MA, 02458, USA
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Zhao Y, Qiu J, Li Y, Khan MA, Wan L, Chen L. Machine-learning models for diagnosis of rotator cuff tears in osteoporosis patients based on anteroposterior X-rays of the shoulder joint. SLAS Technol 2024:100149. [PMID: 38796035 DOI: 10.1016/j.slast.2024.100149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Revised: 05/01/2024] [Accepted: 05/22/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVE This study aims to diagnose Rotator Cuff Tears (RCT) and classify the severity of RCT in patients with Osteoporosis (OP) through the analysis of shoulder joint anteroposterior (AP) X-ray-based localized proximal humeral bone mineral density (BMD) measurements and clinical information based on machine learning (ML) models. METHODS A retrospective cohort of 89 patients was analyzed, including 63 with both OP and RCT (OPRCT) and 26 with OP only. The study analyzed a series of shoulder radiographs from April 2021 to April 2023. Grayscale values were measured after plotting ROIs based on AP X-rays of shoulder joint. Five kinds of ML models were developed and compared based on their performance in predicting the occurrence and severity of RCT from ROIs' greyscale values and clinical information (age, gender, advantage side, lumbar BMD, and acromion morphology (AM)). Further analysis using SHAP values illustrated the significant impact of selected features on model predictions. RESULTS R1-6 had a positive correlation with BMD respectively. The nine variables, including greyscale R1-6, age, BMD, and AM, were used in the prediction models. The RF model was determined to be superior in effectively diagnosing RCT in OP patients, with high AUC scores of 0.998, 0.889, and 0.95 in the training, validation, and testing sets, respectively. SHAP values revealed that the most influential factors on the diagnostic outcomes were the grayscale values of all cancellous bones in ROIs. A column-line graph prediction model based on nine variables was constructed, and DCA curves indicated that RCT prediction in OP patients was favored based on this model. Furthermore, the RF model was also the most superior in predicting the types of RCT within the OPRCT group, with an accuracy of 86.364% and 73.684% in the training and test sets, respectively. SHAP values indicated that the most significant factor affecting the predictive outcomes was the AM, followed by the grayscale values of the greater tubercle, among others. CONCLUSIONS ML models, particularly the RF algorithm, show significant promise in diagnosing RCT occurrence and severity in OP patients using conventional shoulder X-rays based on the nine variables. This method presents a cost-effective, accessible, and non-invasive diagnostic strategy that has the potential to substantially enhance the early detection and management of RCT in OP patient population.
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Affiliation(s)
- Yu Zhao
- Postgraduate College, Guangzhou University of Chinese Medicine, Guangzhou 510080, China
| | - Jingjing Qiu
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen 518100, China; Postgraduate College, Guangzhou University of Chinese Medicine, Guangzhou 510080, China
| | - Yang Li
- College of Mechanical and Electrical Engineering, Shihezi University, Shihezi 832003, China
| | - Muhammad Attique Khan
- Department of Computer Science and Mathematics, Lebanese American University, Beirut, Lebanon
| | - Lei Wan
- The Third Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou University of Chinese Medicine, Guangzhou 510006, China.
| | - Lihua Chen
- Shenzhen Bao'an Traditional Chinese Medicine Hospital, Guangzhou University of Chinese Medicine, Shenzhen 518100, China; Postgraduate College, Guangzhou University of Chinese Medicine, Guangzhou 510080, China.
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Rui Z, Yan C, Wang Z, Yuan Y, Luan C, Wang L. The effects of alfacalcidol combined with calcitonin in the treatment of osteoporosis and its influence on levels of inflammation. Am J Transl Res 2024; 16:1690-1700. [PMID: 38883381 PMCID: PMC11170591 DOI: 10.62347/zmal4724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 02/10/2024] [Indexed: 06/18/2024]
Abstract
OBJECTIVE To investigate the effectiveness of Alfacalcidol combined with Calcitonin in the treatment of osteoporosis and its influence on the degree of pain, bone metabolism indexes, bone mineral density and inflammatory factor levels. METHODS In this retrospective study, 110 patients with osteoporosis treated in The Second Affiliated Hospital of Shandong First Medical University from January 2019 to June 2021 were selected as the study subjects. According to different treatment methods, these patients were divided into an observation group and a control group with 55 cases in each group. Patients from the control group were treated with the alfacalcidol capsules alone, while those from the observation group were treated with the alfacalcidol capsules combined with intramuscular calcitonin injection. Patients in both groups were treated for 6 months continuously. The treatment effect, visual analogue scale (VAS) score and Oswestry disability index (ODI), bone mineral density (BMD), serum markers levels such as calcium (Ca), phosphorus (P), alkaline phosphatase (ALP), tartrate-resistant acid phosphatase-5b (TRACP-5b), insulin-like growth factor (IGF-1), type I procollagen amino terminal propeptide (PINP) and β-collagen special sequence (β-Crosslaps), the levels of inflammatory factor including interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α), quality Life Questionnaire Core 30 (QLQ-C30) scores and incidences of adverse reactions were evaluated and compared between the two groups. RESULTS The effective rate of patients in the observation group was 90.91%, which was significantly higher than 74.54% in the control group (P<0.05). There was no significant difference in the term of VAS score, ODI score, serum markers levels, bone mineral density, inflammatory levels, QLQ-C30 before treatment between the two groups. Compared with the control group, the post-treatment VAS score, ODI score, the levels of IL-6, TNF-α, TRACP-5b, PINP and β-Crosslaps in the observation group were obviously lower, while the post-treatment QLQ-C30, bone mineral density, Ca, P, ALP, IGF-1 levels were significantly higher (all P<0.05). No statistical differences were found in the incidences of adverse reactions between the two groups (P>0.05). CONCLUSION The combination of Alfacalcidol combined with Calcitonin is effective in the treatment of osteoporosis patients, which can effectively improve the levels of bone metabolism indexes and bone mineral density, alleviate the symptoms, enhance the life quality and reduce the levels of inflammation. Therefore, it is worth promoting.
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Affiliation(s)
- Ze Rui
- Department of Foot and Ankle Surgery, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China
| | - Chao Yan
- Department of Hand Surgery, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China
| | - Zhiwei Wang
- Department of Foot and Ankle Surgery, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China
| | - Yufeng Yuan
- Department of Intensive Care Unit, Tai'an Traditional Medicine Hospital Tai'an, Shandong, China
| | - Chunyu Luan
- Department of Respiratory, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China
| | - Lin Wang
- Department of Orthopedics, The Second Affiliated Hospital of Shandong First Medical University Tai'an, Shandong, China
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Laird C, Williams KA, Benson H. Osteoporosis management in Australian aged care facilities: a mixed method study. Arch Osteoporos 2024; 19:37. [PMID: 38744716 PMCID: PMC11093840 DOI: 10.1007/s11657-024-01401-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 05/01/2024] [Indexed: 05/16/2024]
Abstract
Osteoporosis is a common but sub-optimally managed disease amongst aged care residents. Pharmacists undertaking comprehensive medication reviews is one strategy to improve osteoporosis management. Analysis of pharmacist medication review recommendations has identified common clinical practice issues that can be addressed to optimise osteoporosis management for aged care residents. PURPOSE This study investigates the prevalence of osteoporosis medicine use amongst Australian aged care residents and explores drug-related problems (DRPs) identified during medication reviews and pharmacist recommendations to resolve them. METHODS Resident demographics, medications, diagnoses, osteoporosis related DRPs, and recommendations to resolve them were extracted from medication review reports. A mixed methods approach was taken to analysis, involving descriptive statistical analysis and content analysis. RESULTS Medication review reports relating to 980 residents were collected. Antiresorptive therapies were used by 21.7% of residents, of which 87.2% were prescribed denosumab. Osteoporosis related DRPs represented 14.0% of all DRPs identified by pharmacists. Vitamin D was involved in 55.4% of these DRPs, the remainder concerned antiresorptive therapies (23.4%), medications contributing to osteoporosis (16.3%), and calcium (4.9%). Frequent deviations in practice from aged care clinical guidelines and consensus recommendations concerning vitamin D and calcium were found. DRPs and accompanying recommendations relating to denosumab revealed inadequate monitoring and inadvertent therapy disruptions. CONCLUSION Pharmacist identified DRPs and recommendations revealed common aspects of clinical practice that can be addressed to improve osteoporosis management for aged care residents. A need to raise awareness of aged care-specific consensus recommendations concerning vitamin D and calcium is evident. Facility protocols and procedures must be developed and implemented to ensure safe and effective use of denosumab.
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Affiliation(s)
- Catherine Laird
- Graduate School of Health, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia.
| | - Kylie A Williams
- Graduate School of Health, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia
| | - Helen Benson
- Graduate School of Health, University of Technology Sydney, PO Box 123, Sydney, NSW, 2007, Australia
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Xia B, Dai X, Shi H, Yin J, Xu T, Liu T, Yue G, Guo H, Liang R, Liu Y, Gao J, Wang X, Chen X, Tang J, Wang L, Zhu R, Zhang D. Lycopene Promotes Osteogenesis and Reduces Adipogenesis through Regulating FoxO1/PPARγ Signaling in Ovariectomized Rats and Bone Marrow Mesenchymal Stem Cells. Nutrients 2024; 16:1443. [PMID: 38794681 PMCID: PMC11123960 DOI: 10.3390/nu16101443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Revised: 04/25/2024] [Accepted: 05/08/2024] [Indexed: 05/26/2024] Open
Abstract
Recent interest in preventing the development of osteoporosis has focused on the regulation of redox homeostasis. However, the action of lycopene (LYC), a strong natural antioxidant compound, on osteoporotic bone loss remains largely unknown. Here, we show that oral administration of LYC to OVX rats for 12 weeks reduced body weight gain, improved lipid metabolism, and preserved bone quality. In addition, LYC treatment inhibited ROS overgeneration in serum and bone marrow in OVX rats, and in BMSCs upon H2O2 stimulation, leading to inhibiting adipogenesis and promoting osteogenesis during bone remodeling. At the molecular level, LYC improved bone quality via an increase in the expressions of FoxO1 and Runx2 and a decrease in the expressions of PPARγ and C/EBPα in OVX rats and BMSCs. Collectively, these findings suggest that LYC attenuates osteoporotic bone loss through promoting osteogenesis and inhibiting adipogenesis via regulation of the FoxO1/PPARγ pathway driven by oxidative stress, presenting a novel strategy for osteoporosis management.
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Affiliation(s)
- Bingke Xia
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Xuan Dai
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Hanfen Shi
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Jiyuan Yin
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Tianshu Xu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Tianyuan Liu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Gaiyue Yue
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Haochen Guo
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Ruiqiong Liang
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
| | - Yage Liu
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
- Food and Pharmacy College, Xuchang University, 88 Bayi Road, Xuchang 461000, China
| | - Junfeng Gao
- The Scientific Research Center, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China; (J.G.); (X.W.)
| | - Xinxiang Wang
- The Scientific Research Center, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing 100078, China; (J.G.); (X.W.)
| | - Xiaofei Chen
- Department of Pharmacology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450003, China; (X.C.); (J.T.)
| | - Jinfa Tang
- Department of Pharmacology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450003, China; (X.C.); (J.T.)
| | - Lili Wang
- Department of TCM Pharmacology, Chinese Material Medica School, Beijing University of Chinese Medicine, Beijing 102488, China
| | - Ruyuan Zhu
- Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Dongwei Zhang
- Diabetes Research Center, Traditional Chinese Medicine School, Beijing University of Chinese Medicine, Beijing 100029, China; (B.X.); (X.D.); (H.S.); (J.Y.); (T.X.); (T.L.); (G.Y.); (H.G.); (R.L.); (Y.L.)
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Wang J, Xue M, Hu Y, Li J, Li Z, Wang Y. Proteomic Insights into Osteoporosis: Unraveling Diagnostic Markers of and Therapeutic Targets for the Metabolic Bone Disease. Biomolecules 2024; 14:554. [PMID: 38785961 PMCID: PMC11118602 DOI: 10.3390/biom14050554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2024] [Revised: 04/25/2024] [Accepted: 05/01/2024] [Indexed: 05/25/2024] Open
Abstract
Osteoporosis (OP), a prevalent skeletal disorder characterized by compromised bone strength and increased susceptibility to fractures, poses a significant public health concern. This review aims to provide a comprehensive analysis of the current state of research in the field, focusing on the application of proteomic techniques to elucidate diagnostic markers and therapeutic targets for OP. The integration of cutting-edge proteomic technologies has enabled the identification and quantification of proteins associated with bone metabolism, leading to a deeper understanding of the molecular mechanisms underlying OP. In this review, we systematically examine recent advancements in proteomic studies related to OP, emphasizing the identification of potential biomarkers for OP diagnosis and the discovery of novel therapeutic targets. Additionally, we discuss the challenges and future directions in the field, highlighting the potential impact of proteomic research in transforming the landscape of OP diagnosis and treatment.
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Affiliation(s)
- Jihan Wang
- Xi’an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical University, Xi’an 710072, China; (J.W.)
| | - Mengju Xue
- School of Medicine, Xi’an International University, Xi’an 710077, China
| | - Ya Hu
- Department of Medical College, Hunan Polytechnic of Environment and Biology, Hengyang 421000, China
| | - Jingwen Li
- Xi’an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical University, Xi’an 710072, China; (J.W.)
- Research and Development Institute of Northwestern Polytechnical University in Shenzhen, Shenzhen 518057, China
| | - Zhenzhen Li
- Xi’an Key Laboratory of Stem Cell and Regenerative Medicine, Institute of Medical Research, Northwestern Polytechnical University, Xi’an 710072, China; (J.W.)
- Research and Development Institute of Northwestern Polytechnical University in Shenzhen, Shenzhen 518057, China
| | - Yangyang Wang
- School of Electronics and Information, Northwestern Polytechnical University, Xi’an 710129, China
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Lyu FF, Ying H, Zhang M, Xia LR, Liu Q, Cai L. Prevalence and influencing factors of kinesiophobia in older patients with primary osteoporosis: A cross-sectional survey. Geriatr Nurs 2024; 57:58-65. [PMID: 38537554 DOI: 10.1016/j.gerinurse.2024.03.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 06/04/2024]
Abstract
AIM To explore the prevalence of kinesiophobia in older patients with primary osteoporosis and analyze its influencing factors. METHODS A cross-sectional survey was conducted among 221 older patients with primary osteoporosis in a general hospital in Kunming, China. Data were collected through a sociodemographic-clinical questionnaire, Tampa Scale for Kinesiophobia-11 (TSK-11), Global Pain Scale (GPS), Five Facets Mindfulness Questionnaire-Short Form (FFMQ-SF), and Hospital Anxiety and Depression Scale (HADS). SPSS 27.0 software was utilized for univariate and binary logistic regression analyses. RESULTS The findings revealed that the prevalence of kinesiophobia in this study was 57.01 %. Age, history of fractures, chronic obstructive pulmonary disease (COPD), lumbar disc herniation, chronic pain, mindfulness, anxiety, and depression were identified as significant influencing factors of kinesiophobia in the binary logistic regression analyses. CONCLUSION Healthcare professionals should be attentive to occurrence of kinesiophobia. Timely measures should be implemented to improve pain, anxiety and depression, and employ mindfulness interventions to mitigate kinesiophobia.
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Affiliation(s)
- Fang Fei Lyu
- School of Nursing, Yunnan University of Traditional Chinese Medicine, Kunming, Yunnan 650500, China.
| | - Hua Ying
- Outpatient Department, First People's Hospital of Changshu City, Changshu, Jiangsu 215500, China
| | - Min Zhang
- Pain Department, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan 650500, China
| | - Li Rong Xia
- Traditional Chinese Medicine Nursing Clinic, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan 650500, China
| | - Qian Liu
- Dermatology Department, Yunnan Provincial Hospital of Traditional Chinese Medicine, Kunming, Yunnan 650500, China
| | - Li Cai
- Operating Room, First People's Hospital of Changshu City, Changshu, Jiangsu 215500, China
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Mi B, Zhang J, Jiang K, Meng H, Shan L, Hao D. Weight-adjusted waist index is a potential early predictor of degraded bone microarchitecture: A cross-sectional study of the national health and nutrition examination survey 2007-2008. J Orthop Surg (Hong Kong) 2024; 32:10225536241268827. [PMID: 39075015 DOI: 10.1177/10225536241268827] [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] [Indexed: 07/31/2024] Open
Abstract
PURPOSE This study aimed to investigate the association between weight-adjusted waist index (WWI) and trabecular bone score (TBS) and to assess the ability of WWI to identify individuals with degraded bone microarchitecture (DBMA). METHODS This cross-sectional study included participants aged 20 and older from the National Health and Nutrition Examination Survey. Furthermore, WWI was calculated by waist circumference and body weight. In addition, linear regression models were employed to investigate the association between WWI and TBS, while logistic regression models were employed to determine the association between WWI and the risk of DBMA. Finally, the performance of WWI in identifying individuals with DBMA was using the receiver operating characteristic (ROC) curves with area under the ROC curve. RESULTS A total of 4,179 participants with a mean age of 49.90 years were included in the final analysis. WWI was negatively associated with TBS and positively associated with an increased risk of DBMA. Furthermore, the associations between WWI and TBS, as well as DBMA risk, were stable regardless of stratification by age, sex, race, or body mass index (BMI). Moreover, WWI achieved good performances in identifying individuals with DBMA or low TBS. In addition, the combination of WWI and BMI showed better performances in identifying individuals with DBMA or low TBS than WWI or BMI alone. CONCLUSION WWI established a negative association with TBS and a positive association with the risk of DBMA. Clinicians should be alert to the potential risk of DBMA among individuals with high WWI. Moreover, WWI, alone or in combination with BMI, has the potential to serve as an early screening strategy in identifying individuals with DBMA.
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Affiliation(s)
- Baoguo Mi
- Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Jitao Zhang
- Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Kuo Jiang
- Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Hailan Meng
- Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Lequn Shan
- Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China
| | - Dingjun Hao
- Department of Spine Surgery, Hong Hui Hospital, Xi'an Jiaotong University, Xi'an, China
- Shaanxi Key Laboratory of Spine Bionic Treatment, Xi'an, China
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Kuyl EV, Agarwal AR, Patel PK, Harris AB, Gu A, Rao S, Thakkar SC, Golladay GJ. Osteoporotic Patients Undergoing Total Hip Arthroplasty Have a Similar 5-Year Cumulative Incidence Rate of Periprosthetic Fracture Regardless of Cemented Versus Cementless Femoral Stem Fixation. J Arthroplasty 2024; 39:1285-1290.e1. [PMID: 37952741 DOI: 10.1016/j.arth.2023.11.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Revised: 10/30/2023] [Accepted: 11/04/2023] [Indexed: 11/14/2023] Open
Abstract
BACKGROUND In osteoporotic patients, surgeons may utilize cemented femoral fixation to minimize risk of fracture. The purpose of this study was to compare 5-year implant survivability in patients who have osteoporosis who underwent elective total hip arthroplasty (THA) with cementless versus cemented fixation. METHODS A retrospective analysis of patients who have osteoporosis undergoing THA with either cemented or cementless femoral fixation was conducted using a national administrative claims database. Of the 18,431 identified THA patients who have osteoporosis, 15,867 (86.1%) underwent cementless fixation. The primary outcome was a comparison of the 5-year cumulative incidences of aseptic revision, mechanical loosening, and periprosthetic fracture (PPF). Kaplan-Meier and Multivariable Cox Proportional Hazard Ratio analyses were used, controlling for femoral fixation method, age, sex, a comorbidity scale, use of osteoporosis medication, and important comorbidity. RESULTS There was no difference in aseptic revision (Hazard's Ratio (HR): 1.13; 95% Confidence Interval (CI): 0.79 to 1.62; P value: .500) and PPF (HR: 0.96; 95% CI: 0.64 to 1.44; P value: .858) within 5 years of THA between fixation cohorts. However, patients who had cemented fixation were more likely to suffer mechanical loosening with 5 years post-THA (HR: 1.79; 95% CI: 1.17 to 2.71; P-value: .007). CONCLUSIONS We found a similar 5-year rate of PPF when comparing patients who underwent cementless versus cemented femoral fixation for elective THA regardless of preoperative diagnosis of osteoporosis. While existing registry data support the use of cemented fixation in elderly patients, a more thorough understanding of the interplay between age, osteoporosis, and implant design is needed to delineate in whom cemented fixation is most warranted for PPF prevention.
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Affiliation(s)
- Emile-Victor Kuyl
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Amil R Agarwal
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Parth K Patel
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Andrew B Harris
- Department of Orthopaedic Surgery, Johns Hopkins Medicine, Baltimore, Maryland
| | - Alex Gu
- Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Sandesh Rao
- Washington Orthopaedics and Sports Medicine, Washington, District of Columbia
| | | | - Gregory J Golladay
- Department of Orthopaedic Surgery, Virginia Commonwealth University, Richmond, Virginia
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Chen Z, Encarnacion AM, Rajan RPS, Yao H, Lee S, Kim E, Lee TH. Discovery of a novel homoisoflavonoid derivative 5g for anti-osteoclastic bone loss via targeting FGFR1. Eur J Med Chem 2024; 270:116335. [PMID: 38555854 DOI: 10.1016/j.ejmech.2024.116335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/29/2024] [Accepted: 03/05/2024] [Indexed: 04/02/2024]
Abstract
Several flavonoids have been shown to exert anti-osteoporosis activity. However, the structure-activity relationship and the mechanism of anti-osteoporosis activity of flavonoids remain unknown. In this study, we prepared a series of novel homoisoflavonoid (HIF) derivatives to evaluate their inhibitory effects on osteoclastogenesis using TRAP-activity in vitro assay. Then, the preliminary structure-activity relationship was studied. Among the evaluated novel flavonoids, derivative 5g exerted the most inhibitory bioactivity on primary osteoclast differentiation without interfering with osteogenesis. It was hence selected for further in vitro, in vivo and mechanism of action investigation. Results show that 5g likely directly binds to the fibroblast growth factor receptor 1 (FGFR1), decreasing the activation of ERK1/2 and IκBα/NF-κB signaling pathways, which in turn blocks osteoclastogenesis in vitro and osteoclastic bone loss in vivo. Our study shows that homoisoflavonoid (HIF) derivatives 5g can serve as a potential novel candidate for treating osteoporosis via inhibition of FGFR1.
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Affiliation(s)
- Zhihao Chen
- Department of Oral Biochemistry, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Alessandra Marie Encarnacion
- Department of Interdisciplinary Program of Biomedical Engineering, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | | | - Hongyuan Yao
- Department of Interdisciplinary Program of Biomedical Engineering, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Sunwoo Lee
- Department of Chemistry, Chonnam National University, Gwangju, 61186, Republic of Korea
| | - Eunae Kim
- Department of Pharmacy, College of Pharmacy, Chosun University, Gwangju, 61452, Republic of Korea; Host-directed Antiviral Research Center, College of Veterinary Medicine, Chonnam National University, Gwangju, 61186, Republic of Korea.
| | - Tae-Hoon Lee
- Department of Oral Biochemistry, Dental Science Research Institute, School of Dentistry, Chonnam National University, Gwangju, 61186, Republic of Korea.
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Chiu CT, Lee JI, Lu CC, Huang SP, Chen SC, Geng JH. The association between body mass index and osteoporosis in a Taiwanese population: a cross-sectional and longitudinal study. Sci Rep 2024; 14:8509. [PMID: 38605101 PMCID: PMC11009266 DOI: 10.1038/s41598-024-59159-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
This study investigates the correlation between body mass index (BMI) and osteoporosis utilizing data from the Taiwan Biobank. Initially, a comprehensive analysis of 119,009 participants enrolled from 2008 to 2019 was conducted to assess the association between BMI and osteoporosis prevalence. Subsequently, a longitudinal cohort of 24,507 participants, initially free from osteoporosis, underwent regular follow-ups every 2-4 years to analyze the risk of osteoporosis development, which was a subset of the main cohort. Participants were categorized into four BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese groups (BMI ≥ 27 kg/m2). A T-score ≤ - 2.5 standard deviations below that of a young adult was defined as osteoporosis. Overall, 556 (14.1%), 5332 (9.1%), 2600 (8.1%) and 1620 (6.7%) of the participants in the underweight, normal weight, overweight and obese groups, respectively, had osteoporosis. A higher prevalence of osteoporosis was noted in the underweight group compared with the normal weight group (odds ratio [OR], 2.20; 95% confidence interval [95% CI], 1.99 to 2.43; p value < 0.001) in multivariable binary logistic regression analysis. Furthermore, in the longitudinal cohort during a mean follow-up of 47 months, incident osteoporosis was found in 61 (9%), 881 (7.2%), 401 (5.8%) and 213 (4.6%) participants in the underweight, normal weight, overweight and obese groups, respectively. Multivariable Cox proportional hazards analysis revealed that the risk of incident osteoporosis was higher in the underweight group than in the normal weight group (hazard ratio [HR], 1.63; 95% CI 1.26 to 2.12; p value < 0.001). Our results suggest that BMI is associated with both the prevalence and the incidence of osteoporosis. In addition, underweight is an independent risk factor for developing osteoporosis. These findings highlight the importance of maintaining normal weight for optimal bone health.
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Affiliation(s)
- Chao-Tse Chiu
- Department of Orthopaedics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Jia-In Lee
- Department of Psychiatry, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Cheng-Chang Lu
- Department of Orthopaedics, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
- Department of Orthopaedics, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Shu-Pin Huang
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, 807, Kaohsiung, Taiwan
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Ph.D. Program in Environmental and Occupational Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Institute of Medical Science and Technology, College of Medicine, National Sun Yat-Sen University, Kaohsiung, 804, Taiwan
| | - Szu-Chia Chen
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospita, l, Kaohsiung Medical University, 812, Kaohsiung, Taiwan
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan
| | - Jiun-Hung Geng
- Department of Urology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
- Department of Urology, School of Medicine, College of Medicine, Kaohsiung Medical University, 807, Kaohsiung, Taiwan.
- Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung, 807, Taiwan.
- Department of Urology, Kaohsiung Municipal Siaogang Hospital, No. 482, Shanming Rd, Xiaogang District, Kaohsiung, 812, Taiwan.
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Jeong S, Kim IK, Moon H, Kim H, Song BW, Choi JW, Kim SW, Lee S, Chae DS, Lim S. A 70% Ethanol Neorhodomela munita Extract Attenuates RANKL-Induced Osteoclast Activation and H 2O 2-Induced Osteoblast Apoptosis In Vitro. Molecules 2024; 29:1741. [PMID: 38675559 PMCID: PMC11052068 DOI: 10.3390/molecules29081741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/28/2024] Open
Abstract
The rapid aging of the population worldwide presents a significant social and economic challenge, particularly due to osteoporotic fractures, primarily resulting from an imbalance between osteoclast-mediated bone resorption and osteoblast-mediated bone formation. While conventional therapies offer benefits, they also present limitations and a range of adverse effects. This study explores the protective impact of Neorhodomela munita ethanol extract (EN) on osteoporosis by modulating critical pathways in osteoclastogenesis and apoptosis. Raw264.7 cells and Saos-2 cells were used for in vitro osteoclast and osteoblast models, respectively. By utilizing various in vitro methods to detect osteoclast differentiation/activation and osteoblast death, it was demonstrated that the EN's potential to inhibit RANKL induced osteoclast formation and activation by targeting the MAPKs-NFATc1/c-Fos pathway and reducing H2O2-induced cell death through the downregulation of apoptotic signals. This study highlights the potential benefits of EN for osteoporosis and suggests that EN is a promising natural alternative to traditional treatments.
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Affiliation(s)
- Seongtae Jeong
- The Interdisciplinary Graduate Program in Integrative Biotechnology, Yonsei University, Seoul 03722, Republic of Korea;
| | - Il-Kwon Kim
- Department of Convergence Science, College of Medicine, Catholic Kwandong University, International St. Mary’s Hospital, Incheon 22711, Republic of Korea;
| | - Hanbyeol Moon
- Department of Integrated Omics for Biomedical Sciences, Graduate School, Yonsei University, Seoul 03722, Republic of Korea;
| | - Hojin Kim
- Department for Medical Science, College of Medicine, Catholic Kwandong University, Gangneung-si 25601, Republic of Korea;
| | - Byeong-Wook Song
- Department of Convergence Science, College of Medicine, Catholic Kwandong University, Gangneung-si 25601, Republic of Korea; (B.-W.S.); (S.W.K.); (S.L.)
| | - Jung-Won Choi
- Medical Science Research Institute, College of Medicine, Catholic Kwandong University, Incheon Metropolitan City 22711, Republic of Korea;
| | - Sang Woo Kim
- Department of Convergence Science, College of Medicine, Catholic Kwandong University, Gangneung-si 25601, Republic of Korea; (B.-W.S.); (S.W.K.); (S.L.)
| | - Seahyoung Lee
- Department of Convergence Science, College of Medicine, Catholic Kwandong University, Gangneung-si 25601, Republic of Korea; (B.-W.S.); (S.W.K.); (S.L.)
| | - Dong-Sik Chae
- Department of Orthopedic Surgery, International St. Mary’s Hospital, Catholic Kwandong University, Gangneung-si 25601, Republic of Korea
| | - Soyeon Lim
- Department of Convergence Science, College of Medicine, Catholic Kwandong University, Gangneung-si 25601, Republic of Korea; (B.-W.S.); (S.W.K.); (S.L.)
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Tariq S, Tariq S, Baig M, Valjevac A. Editorial: Osteoporosis and adipokines: the potential for future treatment. Front Endocrinol (Lausanne) 2024; 15:1405412. [PMID: 38660520 PMCID: PMC11039904 DOI: 10.3389/fendo.2024.1405412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2024] [Accepted: 04/02/2024] [Indexed: 04/26/2024] Open
Affiliation(s)
- Saba Tariq
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, United Kingdom
- Department of Pharmacology, University Medical and Dental College, The University of Faisalabad, Faisalabad, Pakistan
| | - Sundus Tariq
- Department of Physiology, International School of Medicine, Istanbul Medipol University, Research Institute for Health Sciences and Technologies (SABITA), Istanbul, Türkiye
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Amina Valjevac
- Department of Human Physiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Miyairi Y, Nakashima H, Ito S, Segi N, Ouchida J, Oishi R, Yamauchi I, Machino M, Seki T, Ishizuka S, Takegami Y, Hasegawa Y, Imagama S. Obesity Is Associated with Asymptomatic Vertebral Fractures: A Yakumo Study. J Clin Med 2024; 13:2063. [PMID: 38610830 PMCID: PMC11012555 DOI: 10.3390/jcm13072063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 03/22/2024] [Accepted: 03/25/2024] [Indexed: 04/14/2024] Open
Abstract
(1) Background: Patients with primary vertebral fracture (VF) are at high risk of re-fracture and mortality. However, approximately two-thirds of patients with VFs receive minimal clinical attention. (2) Methods: The current study aimed to investigate the factors associated with asymptomatic VFs in middle-aged and elderly individuals who underwent resident health examinations. (3) Results: The current study included 217 participants aged > 50 years. VFs were diagnosed based on lateral radiographic images using Genant's semiquantitative (SQ) method. The participants were divided into non-VF (N; SQ grade 0) and asymptomatic VF (F; SQ grades 1-3) groups. Data on body composition, blood tests, quality of life measures, and radiographic parameters were assessed. A total of 195 participants were included in the N group (mean age, 64.8 ± 7.8 years), and 22 were in the F group (mean age, 66.1 ± 7.9 years). The F group had a significantly higher body mass index (BMI), body fat percentage (BF%), and proportion of patients with knee osteoarthritis (KOA) than the N group. The F group had a significantly higher knee joint pain visual analog scale (VAS) score and painDETECT score than the N group. Logistic regression analysis showed that BF% was associated with asymptomatic VFs. (4) Conclusions: Middle-aged and elderly individuals with asymptomatic VF presented with high BMIs, BF%, and incidence of KOA.
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Affiliation(s)
- Yuichi Miyairi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Hiroaki Nakashima
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Sadayuki Ito
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Naoki Segi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Jun Ouchida
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Ryotaro Oishi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Ippei Yamauchi
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Masaaki Machino
- Department of Orthopedic Surgery, Meijo Hospital, Nagoya 460-0001, Japan;
| | - Taisuke Seki
- Department of Orthopedic Surgery, Aichi Medical University Medical Center, Nagakute 444-2148, Japan;
| | - Shinya Ishizuka
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
| | - Yukiharu Hasegawa
- Department of Rehabilitation, Kansai University of Welfare Science, Kashiwara 582-0026, Japan;
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, Nagoya 466-8560, Japan; (Y.M.); (S.I.); (N.S.); (J.O.); (R.O.); (I.Y.); (S.I.); (Y.T.); (S.I.)
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Ratnasingam J, Niyaz M, Mariyappan S, Ong T, Chan SP, Hew FL, Yeap SS, Velaiutham S, Thambiah SC, Lekamwasam S. Age-dependent FRAX-based assessment and intervention thresholds for therapeutic decision making in osteoporosis in the Malaysian population. Arch Osteoporos 2024; 19:18. [PMID: 38503995 DOI: 10.1007/s11657-024-01371-w] [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: 08/13/2023] [Accepted: 02/27/2024] [Indexed: 03/21/2024]
Abstract
Fracture risk stratification is crucial in countries with limited access to bone density measurement. 24.8% women were in the high-risk category while 30.4% were in the low-risk category. In the intermediate risk group, after recalculation of fracture risk with bone density, 38.3% required treatment. In more than half, treatment decisions can be made without bone density. PURPOSE We aimed to examine the role of age-dependent intervention thresholds (ITs) applied to the Fracture Risk Assessment (FRAX) tool in therapeutic decision making for osteoporosis in the Malaysian population. METHODS Data were collated from 1380 treatment-naïve postmenopausal women aged 40-85 years who underwent bone mineral density (BMD) measurements for clinical reasons. Age-dependent ITs, for both major osteoporotic fracture (MOF) and hip fracture (HF), were calculated considering a woman with a BMI of 25 kg/m2, aged between 40 and 85years, with a prior fragility fracture, sans other clinical risk factors. Those with fracture probabilities equal to or above upper assessment thresholds (UATs) were considered to have high fracture risk. Those below the lower assessment thresholds (LATs) were considered to have low fracture risk. RESULTS The ITs of MOF and HF ranged from 0.7 to 18% and 0.2 to 8%, between 40 and 85years. The LATs of MOF ranged from 0.3 to 11%, while those of HF ranged from 0.1 to 5.2%. The UATs of MOF and HF were 0.8 to 21.6% and 0.2 to 9.6%, respectively. In this study, 24.8% women were in the high-risk category while 30.4% were in the low-risk category. Of the 44.8% (n=618) in the intermediate risk group, after recalculation of fracture risk with BMD input, 38.3% (237/618) were above the ITs while the rest (n=381, 61.7%) were below the ITs. Judged by the Youden Index, 11.5% MOF probability which was associated with a sensitivity of 0.62 and specificity of 0.83 and 4.0% HF probability associated with a sensitivity of 0.63 and a specificity 0.82 were found to be the most appropriate fixed ITs in this analysis. CONCLUSION Less than half of the study population (44.8%) required BMD for osteoporosis management when age-specific assessment thresholds were applied. Therefore, in more than half, therapeutic decisions can be made without BMD based on these assessment thresholds.
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Affiliation(s)
| | - Mariyam Niyaz
- Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Shanmugam Mariyappan
- Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Terence Ong
- Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Siew Pheng Chan
- Department of Medicine, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia
| | - Fen Lee Hew
- Puchong Specialist Clinic, Puchong, Malaysia
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46
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Li J, Zhou X, Wen J, Liu S, Fan X. Establishment and validation of a nomogram clinical prediction model for osteoporosis in senile patients with type 2 diabetes mellitus. Sci Rep 2024; 14:5343. [PMID: 38438532 PMCID: PMC10912110 DOI: 10.1038/s41598-024-56127-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 03/01/2024] [Indexed: 03/06/2024] Open
Abstract
This study aimed to develop a predictive nomogram model to estimate the odds of osteoporosis (OP) in elderly patients with type 2 diabetes mellitus (T2DM) and validate its prediction efficiency. The hospitalized elderly patients with T2DM from the Affiliated Hospital of North Sichuan Medical University between July 2022 and March 2023 were included in this study. We sorted them into the model group and the validation group with a ratio of 7:3 randomly. The selection operator regression (LASSO) algorithm was utilized to select the optimal matching factors, which were then included in a multifactorial forward stepwise logistic regression to determine independent influencing factors and develop a nomogram. The discrimination, accuracy, and clinical efficacy of the nomogram model were analyzed utilizing the receiver operating characteristic (ROC) curve, calibration curve, and clinical decision curve analysis (DCA). A total of 379 study participants were included in this study. Gender (OR = 8.801, 95% CI 4.695-16.499), Geriatric Nutritional Risk Index (GNRI) < 98 (OR = 4.698, 95% CI 2.416-9.135), serum calcium (Ca) (OR = 0.023, 95% CI 0.003-0.154), glycated hemoglobin (HbA1c) (OR = 1.181, 95% CI 1.055-1.322), duration of diabetes (OR = 1.076, 95% CI 1.034-1.119), and serum creatinine (SCr) (OR = 0.984, 95% CI 0.975-0.993) were identified as independent influencing factors for DOP occurrence in the elderly. The area under the curve (AUC) of the nomogram model was 0.844 (95% CI 0.797-0.89) in the modeling group and 0.878 (95% CI 0.814-0.942) in the validation group. The nomogram clinical prediction model was well generalized and had moderate predictive value (AUC > 0.7), better calibration, and better clinical benefit. The nomogram model established in this study has good discrimination and accuracy, allowing for intuitive and individualized analysis of the risk of DOP occurrence in elderly individuals. It can identify high-risk populations and facilitate the development of effective preventive measures.
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Affiliation(s)
- Jing Li
- Department of General Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Xiaolong Zhou
- Department of General Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Jing Wen
- Department of Emergency, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
| | - Shiping Liu
- Department of General Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China.
| | - Xingfu Fan
- Department of General Medicine, Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, China
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47
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Ramoo K, Hairi NN, Yahya A, Choo WY, Hairi FM, Ismail N, Peramalah D, Kandiben S, Ali ZM, Ahmad N, Abdul Razak I, Bulgiba A. Sarcopenia and All-Cause Mortality Risk in Community-Dwelling Rural Malaysian Older Adults. Asia Pac J Public Health 2024; 36:225-231. [PMID: 38482589 DOI: 10.1177/10105395241237811] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Sarcopenia is associated with numerous adverse health outcomes, including frailty, disability, and mortality. Since the Asian Working Group for Sarcopenia 2019 guidelines, which were published in 2020, are relatively new, studies on the association between sarcopenia as defined by these guidelines and mortality are limited in the Asian region. Accordingly, this study aimed to examine the all-cause mortality risk associated with sarcopenia among community-dwelling older adults in rural Malaysia. This cohort study included 2404 older adults residing in Kuala Pilah District, Negeri Sembilan, Malaysia who were followed up for 83 months. The prevalence rates of sarcopenia and severe sarcopenia were 5.0% and 3.60%, respectively. Older adults with sarcopenia and severe sarcopenia had a 114% (hazard ratio [HR]: 2.14) and 146% (HR: 2.46) increased mortality risk compared with those without sarcopenia (HR: 2.14). Our findings indicate that early intervention is recommended to prevent sarcopenia in older adults.
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Affiliation(s)
- Karthikeyanathan Ramoo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran Naqiah Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
- Faculty of Public Health, Universitas Airlangga, Surabaya City, Indonesia
| | - Abqariyah Yahya
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Wan Yuen Choo
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Farizah Mohd Hairi
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Norliana Ismail
- Disease Control Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Devi Peramalah
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Shathanapriya Kandiben
- Centre for Epidemiology and Evidence-Based Practice, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | | | - NurSakinah Ahmad
- Mental Health, Injury Prevention, Violence and Substance Abuse Sector, Disease Control Division, Ministry of Health, Putrajaya, Malaysia
| | | | - Awang Bulgiba
- Academy of Sciences Malaysia, Kuala Lumpur, Malaysia
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48
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Smit A, Meijer O, Winter E. The multi-faceted nature of age-associated osteoporosis. Bone Rep 2024; 20:101750. [PMID: 38566930 PMCID: PMC10985042 DOI: 10.1016/j.bonr.2024.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Age-associated osteoporosis (AAOP) poses a significant health burden, characterized by increased fracture risk due to declining bone mass and strength. Effective prevention and early treatment strategies are crucial to mitigate the disease burden and the associated healthcare costs. Current therapeutic approaches effectively target the individual contributing factors to AAOP. Nonetheless, the management of AAOP is complicated by the multitude of variables that affect its development. Main intrinsic and extrinsic factors contributing to AAOP risk are reviewed here, including mechanical unloading, nutrient deficiency, hormonal disbalance, disrupted metabolism, cognitive decline, inflammation and circadian disruption. Furthermore, it is discussed how these can be targeted for prevention and treatment. Although valuable as individual targets for intervention, the interconnectedness of these risk factors result in a unique etiology for every patient. Acknowledgement of the multifaceted nature of AAOP will enable the development of more effective and sustainable management strategies, based on a holistic, patient-centered approach.
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Affiliation(s)
- A.E. Smit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - O.C. Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - E.M. Winter
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
- Department of Medicine, Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
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49
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Kavinda MD, Lee MH, Kang CH, Choi YH, Kim GY. 2,4'-Dihydroxybenzophenone Exerts Bone Formation and Antiosteoporotic Activity by Stimulating the β-Catenin Signaling Pathway. ACS Pharmacol Transl Sci 2024; 7:395-405. [PMID: 38357289 PMCID: PMC10863440 DOI: 10.1021/acsptsci.3c00251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/13/2023] [Accepted: 01/03/2024] [Indexed: 02/16/2024]
Abstract
2,4'-Dihydroxybenzophenone (DHP) is an organic compound derived from Garcinia xanthochymus, but there have been no reports on its biochemical functions and bioavailability. In this study, we evaluated whether DHP affects osteoblast differentiation and activation in MC3T3-E1 preosteoblast cells, as well as antiosteoporotic activity in zebrafish larvae. Nontoxic concentrations of DHP-treated MC3T3-E1 preosteoblast cells increased alkaline phosphatase (ALP) activation and mineralization in a concentration-dependent manner, accompanied by higher expression of osteoblast-specific markers, including Runt-related transcription factor 2 (RUNX2), osterix, and ALP. Consistent with the data in MC3T3-E1 preosteoblast cells, DHP upregulated osteoblast-specific marker genes in zebrafish larvae and simultaneously enhanced vertebral formation. We also revealed that DHP increased the phosphorylation of glycogen synthase kinase-3β (GSK-3β) at Ser9 and the total expression of β-catenin in the cytosol and markedly increased the localization of β-catenin into the nucleus. Furthermore, DHP restored the prednisolone (PDS)-induced marked decrease in ALP activity and mineralization, as well as osteoblast-specific marker expression. In PDS-treated zebrafish, DHP also alleviated PDS-induced osteoporosis by restoring vertebral formation and osteoblast-related gene expression. Taken together, these results suggest that DHP is a potential osteoanabolic candidate for treating osteoporosis by stimulating osteoblast differentiation.
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Affiliation(s)
| | - Mi-Hwa Lee
- Nakdonggang
National Institute of Biological Resources, Sanju 37242, Republic of Korea
| | - Chang-Hee Kang
- Nakdonggang
National Institute of Biological Resources, Sanju 37242, Republic of Korea
| | - Yung Hyun Choi
- Department
of Biochemistry, College of Korean Medicine, Dong-Eui University, Busan 47227, Republic
of Korea
| | - Gi-Young Kim
- Department
of Marine Life Science, Jeju National University, Jeju 63243, Republic of Korea
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50
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Koo S, Lee EJ, Xiong H, Yun DH, McDonald MM, Park SI, Kim JS. Real-Time Live Imaging of Osteoclast Activation via Cathepsin K Activity in Bone Diseases. Angew Chem Int Ed Engl 2024; 63:e202318459. [PMID: 38105412 DOI: 10.1002/anie.202318459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 12/19/2023]
Abstract
Intravital fluorescence imaging of functional osteoclasts within their intact disease context provides valuable insights into the intricate biology at the microscopic level, facilitating the development of therapeutic approaches for osteoclast-associated bone diseases. However, there is a lack of studies investigating osteoclast activity within deep-seated bone lesions using appropriate fluorescent probes, despite the advantages offered by the multi-photon excitation system in enhancing deep tissue imaging resolution. In this study, we report on the intravital tracking of osteoclast activity in three distinct murine bone disease models. We utilized a cathepsin K (CatK)-responsive two-photon fluorogenic probe (CatKP1), which exhibited a notable fluorescence turn-on response in the presence of active CatK. By utilizing CatKP1, we successfully monitored a significant increase in osteoclast activity in hindlimb long bones and its attenuation through pharmacological intervention without sacrificing mice. Thus, our findings highlight the efficacy of CatKP1 as a valuable tool for unraveling pathological osteoclast behavior and exploring novel therapeutic strategies.
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Affiliation(s)
- Seyoung Koo
- Department of Chemistry, Korea University, Seoul, 02841, Korea
- Department of Biomedical and Chemical Sciences, Hyupsung University, Hwaseong, 18330, Korea
| | - Eun Jung Lee
- Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, 02841, Korea
| | - Hao Xiong
- Department of Chemistry, Korea University, Seoul, 02841, Korea
| | - Da Hyeon Yun
- Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, 02841, Korea
| | - Michelle M McDonald
- Skeletal Diseases Program, The Garvan Institute of Medical Research, Darlinghurst, NSW, 2010, Australia
- St Vincent's Clinical Campus, School of Clinical Medicine, University of New South Wales, Kensington, NSW, 2052, Australia
- School of Medicine Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia
| | - Serk In Park
- Department of Biochemistry and Molecular Biology, Korea University College of Medicine, Seoul, 02841, Korea
- Vanderbilt Center for Bone Biology, Vanderbilt University School of Medicine, Nashville, TN, 37232, USA
| | - Jong Seung Kim
- Department of Chemistry, Korea University, Seoul, 02841, Korea
- TheranoChem Incorporation, Seoul, 02856, Korea
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