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Kaur S, Kumari P, Singh G, Joshi N, Kaur T, Dhiman V, Singh G, Sachdeva N, Kumar D, Barnwal RP, Bhadada SK. Unveiling novel metabolic alterations in postmenopausal osteoporosis and type 2 diabetes mellitus through NMR-based metabolomics: A pioneering approach for identifying early diagnostic markers. J Proteomics 2024; 302:105200. [PMID: 38772440 DOI: 10.1016/j.jprot.2024.105200] [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: 04/26/2024] [Revised: 05/13/2024] [Accepted: 05/17/2024] [Indexed: 05/23/2024]
Abstract
BACKGROUND AND AIMS Postmenopausal osteoporosis (PMO) and type 2 diabetes mellitus (T2DM) frequently coexist in postmenopausal women. The study aimed to explore metabolic variations linked to these circumstances and their simultaneous presence through proton nuclear magnetic resonance metabolomics (1H NMR). MATERIALS AND METHODS Serum samples from 80 postmenopausal women, including 20 PMO individuals, 20 T2DM, 20 T2DM + PMO, and 20 healthy postmenopausal women, were analyzed using 1H NMR spectroscopy. RESULTS Our study revealed significant metabolic profile differences among the four groups. Notably, the T2DM + PMO group showed elevated levels of alanine, pyruvate, glutamate, lactate, and aspartate, indicating their involvement in lipid metabolism, energy, and amino acids. Importantly, our multivariate statistical analysis identified a metabolite set that accurately distinguished the groups, suggesting its potential as an early diagnostic marker. CONCLUSION The 1H NMR metabolomics approach uncovered metabolic biomarkers intricately linked to postmenopausal osteoporosis (PMO), type 2 diabetes mellitus (T2DM), and their concurrent presence. Among these biomarkers, alanine emerged as a pivotal player, showing its significant role in the metabolic landscape associated with PMO and T2DM. These findings shed light on the pathophysiological mechanisms underlying these conditions and underscore alanine's potential as a diagnostic biomarker.
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Affiliation(s)
- Simran Kaur
- Department of Biophysics, Panjab University, Chandigarh, India; Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Poonam Kumari
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Gurvinder Singh
- Centre of Biomedical Research, SGPGIMS campus, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | - Nainesh Joshi
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Takdeer Kaur
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Vandana Dhiman
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Gurpal Singh
- University Institute of Pharmaceutical Sciences, Panjab University, Chandigarh, India
| | - Naresh Sachdeva
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Dinesh Kumar
- Centre of Biomedical Research, SGPGIMS campus, Lucknow, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, 201002, India
| | | | - Sanjay Kumar Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
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Xie WQ, He M, Yu DJ, Li HZ, Jin HF, Ji BZ, Yang G, Chen LL, Rahmati M, Li YS. Correlation study between bone metabolic markers, bone mineral density, and sarcopenia. J Endocrinol Invest 2024; 47:1559-1572. [PMID: 38097848 DOI: 10.1007/s40618-023-02252-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 11/19/2023] [Indexed: 02/21/2024]
Abstract
OBJECTIVE To investigate the correlation between bone metabolism markers, bone mineral density (BMD), and sarcopenia. METHODS A total of 331 consecutive patients aged ≥ 60 years who were hospitalized between November 2020 and December 2021 were enrolled. Participants were divided into sarcopenia and non-sarcopenia groups according to the Asian Working Group on Sarcopenia criteria (AWGS, 2019). The clinical data, bone metabolism markers (β-CTX, N-MID, and TP1NP), and BMD were compared between the two groups. RESULTS Age, β-CTX, and N-MID of the sarcopenia group were higher than those of the non-sarcopenia group (P < 0.05), but the BMD T values were lower than those of the non-sarcopenia group (P < 0.05). Binary logistic regression analysis showed that increased femoral neck BMD (FNBMD) was a protective factor for sarcopenia, while increased β-CTX was a risk factor. Pearson/Spearman correlation analysis showed that the diagnostic indices of sarcopenia were positively correlated with FNBMD and negatively correlated with β-CTX and N-MID. Multiple linear regression analysis revealed that BMI and FNBMD significantly positively affected muscle strength and appendicular skeletal muscle mass (ASM). The FNBMD significantly positively affected physical performance, while β-CTX significantly negatively affected muscle strength, ASM, and physical performance. CONCLUSION Increased FNBMD may be a protective factor against sarcopenia, and increased β-CTX may be a risk factor. The FNBMD significantly positively affected the diagnostic indices of sarcopenia, while β-CTX significantly negatively affected them. BMD and bone metabolism marker levels may be considered in early screening for sarcopenia.
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Affiliation(s)
- W Q Xie
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - M He
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - D J Yu
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H Z Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - H F Jin
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - B Z Ji
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - G Yang
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China
| | - L L Chen
- Hunan Key Laboratory for Bioanalysis of Complex Matrix Samples, Changsha, 410000, Hunan, China
| | - M Rahmati
- Department of Physical Education and Sport Sciences, Faculty of Literature and Human Sciences, Lorestan University, Khorramabad, Iran
- Department of Physical Education and Sport Sciences, Faculty of Literature and Humanities, Vali-E-Asr University of Rafsanjan, Rafsanjan, Iran
| | - Y S Li
- Deparment of Orthopedics, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
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Herda AA, Nabavizadeh O. Effect of six weeks of resistance training on bone preservation in older adults: a randomized control trial. Aging Clin Exp Res 2023; 35:2633-2641. [PMID: 37838645 DOI: 10.1007/s40520-023-02575-9] [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: 08/09/2023] [Accepted: 09/20/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND It has been established that chronic resistance exercise contributes to positive changes to bone in older adults. AIMS This study evaluated the effect of 6 weeks of resistance exercise with either elastic bands or dumbbells vs. a control period on bone morphology of older adults. METHODS Fifty-seven adults (mean ± SD; age = 66.5 ± 7.09 yrs; height = 165.2 ± 10.6 cm; body mass = 74.5 ± 14.6 kg) were randomized into three groups (dumbbell, elastic, or control). Participants underwent a total body dual-energy X-ray absorptiometry (DXA) scan for total body and segmental bone mineral content (BMC) and bone mineral density (BMD) before and following 6-week intervention. Age-matched Z-scores for BMD and BMC were recorded. Data were analyzed using two-way repeated measures ANOVAs and 0.05 significance level. RESULTS BMCarm improved for the dumbbell group (p = 0.016) after the training, with no change in BMD for any group (p > 0.05). Additionally, significant (time x treatment group) interaction (p = 0.024) of age-matched Z-scores indicated an improvement in only the dumbbell group after 6 weeks (p = 0.015), with no change in the elastic group despite them having greater Z-scores than the control group. DISCUSSION This study is the first to demonstrate acute normative adaptations as dumbbell-based programs may promote positive maintenance of bone metrics over 6 weeks, despite the lack of significant change in absolute BMC or BMD. CONCLUSION Adults did not lose relative bone mass with acute exercise using dumbbells as the external load applied and this may lead to positive changes following chronic training. There was no bone-related impact from elastic bands, suggesting a weighted load or force produced relative to gravity is beneficial.
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Affiliation(s)
- Ashley A Herda
- Department of Health, Sport, and Exercise Sciences, University of Kansas Edwards Campus, 12604 Quivira Road, BEST 350X, Overland Park, KS, 66213, USA.
| | - Omid Nabavizadeh
- Department of Geriatric Medicine, University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
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Kim M, Park M. The Brown Algae Ishige sinicola Extract Ameliorates Ovariectomy-Induced Bone Loss in Rats and Suppresses Osteoclastogenesis through Downregulation of NFATc1/c-Fos. Nutrients 2022; 14:1683. [PMID: 35565651 PMCID: PMC9104637 DOI: 10.3390/nu14091683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 04/12/2022] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
Osteoporosis is characterized by reduction in bone mass and microarchitectural deterioration of the bone, which causes bone fragility and fracture susceptibility. Ishige sinicola, a brown alga, reportedly affects osteoblast differentiation. However, its protective effect on estrogen deficiency-induced bone loss has not been elucidated. This study aimed to investigate the effect of I. sinicola extract (ISE) on ovariectomy (OVX)-induced bone loss in vivo and osteoclastogenesis in vitro. Female Sprague-Dawley rats were randomly assigned to the sham-operated (SHAM) group and four OVX subgroups: SHAM, OVX, ISE20 (20 mg/kg), ISE200 (200 mg/kg), and estradiol (10 μg/kg). After 6 weeks of treatment, the bone mineral density (BMD), femur indices, and serum biomarker levels were measured. Furthermore, the effects of ISE on osteoclastogenesis and the expression of osteoclast-specific markers were measured. ISE administration improved the trabecular bone structure, bone biomechanical properties, BMD, and bone mineralization degree. In addition, the levels of serum bone turnover markers were decreased in the ISE group compared with those in the OVX group. Moreover, ISE inhibited osteoclast formation by downregulating NFATc1, TRAP, c-Src, c-Fos, and cathepsin K without any cytotoxic effects on RANKL-induced osteoclast formation. Therefore, we suggest that ISE has therapeutic potential in postmenopausal osteoporosis.
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Affiliation(s)
| | - Mihwa Park
- Department of Food and Nutrition, College of Health and Welfare, Silla University, Busan 46958, Korea;
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Ozasa R, Saito M, Ishimoto T, Matsugaki A, Matsumoto Y, Nakano T. Combination treatment with ibandronate and eldecalcitol prevents osteoporotic bone loss and deterioration of bone quality characterized by nano-arrangement of the collagen/apatite in an ovariectomized aged rat model. Bone 2022; 157:116309. [PMID: 34998980 DOI: 10.1016/j.bone.2021.116309] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 12/20/2021] [Accepted: 12/20/2021] [Indexed: 12/13/2022]
Abstract
Combination therapy with bisphosphonates and vitamin D3 analogs has been frequently used for the treatment of osteoporosis. However, its effects on bone anisotropies, such as orientations of collagen and apatite at the nanometer-scale, which is a promising bone quality index, and its trabecular architecture at the micrometer scale, are not well understood despite its important mechanical properties and its role in fracture risk. In the present study, we analyzed the effects of ibandronate (IBN), eldecalcitol (ELD), and their combination on the collagen/apatite orientation and trabecular architectural anisotropy using an estrogen-deficiency-induced osteoporotic rat model. Estrogen deficiency caused by ovariectomy (OVX) excessively increased the degree of collagen/apatite orientation or trabecular architectural anisotropy along the craniocaudal axis in the lumbar vertebra compared to that of the sham-operated group. The craniocaudal axis corresponds to the direction of principal stress in the spine. The excessive material anisotropy in the craniocaudal axis contributed to the enhanced Young's modulus, which may compensate for the reduced mechanical resistance by bone loss to some extent. The solo administration of IBN and ELD prevented the reduction of bone fraction (BV/TV) determined by μ-CT, and combination therapy showed the highest efficacy in BV/TV gain. Furthermore, the solo administration and combination treatment significantly decreased the degree of collagen/apatite orientation to the sham level. Based on the results of bone mass and collagen/apatite orientation, combination treatment is an effective strategy. This is the first report to demonstrate the efficacy of IBN, ELD, and combination treatment with IBN and ELD relative to the bone micro-architectural anisotropy characterized by collagen/apatite orientation.
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Affiliation(s)
- Ryosuke Ozasa
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Mitsuru Saito
- Department of Orthopaedic Surgery, Jikei University School of Medicine, 3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan.
| | - Takuya Ishimoto
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Aira Matsugaki
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Yoshihiro Matsumoto
- Product Research Department, Kamakura Research Laboratories, Chugai Pharmaceutical Co., Ltd., 200 Kajiwara, Kamakura, Kanagawa 247-8530, Japan.
| | - Takayoshi Nakano
- Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.
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Sotozono Y, Ikoma K, Kido M, Onishi O, Minami M, Wada H, Yamada S, Matsuda KI, Tanaka M, Takahashi K. Sweep imaging with Fourier transform as a tool with MRI for evaluating the effect of teriparatide on cortical bone formation in an ovariectomized rat model. BMC Musculoskelet Disord 2022; 23:16. [PMID: 34980094 PMCID: PMC8725572 DOI: 10.1186/s12891-021-04970-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 12/16/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Teriparatide (TPTD) is a drug for osteoporosis that promotes bone formation and improves bone quality. However, the effects of TPTD on cortical bone are not well understood. Sweep imaging with Fourier transform (SWIFT) has been reported as a useful tool for evaluating bound water of cortical bone, but it has yet to be used to investigate the effects of TPTD on cortical bone. This study aimed to evaluate the consequences of the effect of TPTD on cortical bone formation using SWIFT. METHODS Twelve-week-old female Sprague-Dawley rats (n = 36) were reared after ovariectomy to create a postmenopausal osteoporosis model. They were divided into two groups: the TPTD and non-TPTD groups. Rats were euthanized at 4, 12, and 24 weeks after initiating TPTD treatment. Tibial bones were evaluated using magnetic resonance imaging (MRI) and bone histomorphometry. In MRI, proton density-weighted imaging (PDWI) and SWIFT imaging were performed. The signal-to-noise ratio (SNR) was calculated for each method. The same area evaluated by MRI was then used to calculate the bone formation rate by bone histomorphometry. Measurements were compared using the Mann-Whitney U-test, and a P-value of < 0.05 was considered significant. RESULTS PDWI-SNR was not significantly different between the two groups at any time point (P = 0.589, 0.394, and 0.394 at 4, 12, and 24 weeks, respectively). Contrarily, SWIFT-SNR was significantly higher in the TPTD group than in the non-TPTD group at 4 weeks after initiating treatment, but it was not significantly different at 12 and 24 weeks (P = 0.009, 0.937, and 0.818 at 4, 12, and 24 weeks, respectively). The bone formation rate assessed by histomorphometry was significantly higher in the TPTD group than in the non-TPTD group at all timepoints (P < 0.05, all weeks). In particular, at 4 weeks, the bone formation rate was markedly higher in the TPTD group than in the non-TPTD group (P = 0.028, 1.98 ± 0.33 vs. 0.09 ± 0.05 μm3/μm2/day). CONCLUSIONS SWIFT could detect increased signals of bound water, reflecting the effect of TPTD on the cortical bone. The signal detected by SWIFT reflects a marked increase in the cortical bone formation rate.
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Affiliation(s)
- Yasutaka Sotozono
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Kazuya Ikoma
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan.
| | - Masamitsu Kido
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Okihiro Onishi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Masataka Minami
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Hiroaki Wada
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
| | - Shunji Yamada
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Ken-Ichi Matsuda
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Masaki Tanaka
- Department of Anatomy and Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kenji Takahashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto, Japan
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Puri T, Frost ML, Cook GJ, Blake GM. [ 18F] Sodium Fluoride PET Kinetic Parameters in Bone Imaging. Tomography 2021; 7:843-854. [PMID: 34941643 PMCID: PMC8708178 DOI: 10.3390/tomography7040071] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/19/2021] [Accepted: 11/20/2021] [Indexed: 11/16/2022] Open
Abstract
This report describes the significance of the kinetic parameters (k-values) obtained from the analysis of dynamic positron emission tomography (PET) scans using the Hawkins model describing the pharmacokinetics of sodium fluoride ([18F]NaF) to understand bone physiology. Dynamic [18F]NaF PET scans may be useful as an imaging biomarker in early phase clinical trials of novel drugs in development by permitting early detection of treatment-response signals that may help avoid late-stage attrition.
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Affiliation(s)
- Tanuj Puri
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK;
| | - Michelle L. Frost
- Institute of Cancer Research Clinical Trials & Statistics Unit (ICR-CTSU), Institute of Cancer Research, Sutton SM2 5NG, UK;
| | - Gary J. Cook
- Department of Cancer Imaging, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK;
| | - Glen M. Blake
- Department of Biomedical Engineering, School of Biomedical Engineering and Imaging Sciences, King’s College London, London SE1 7EH, UK;
- Correspondence: ; Tel.: +44-7762717295
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Fang L, Zhong S, Ma D, Li C, Hao Y, Gao Y, Zhang L, Shen L. A cross-sectional study: an assessment of low muscle mass and osteoporosis in type 2 diabetes mellitus patients with a high glycated hemoglobin level. Ther Adv Chronic Dis 2021; 12:20406223211026762. [PMID: 34262679 PMCID: PMC8246566 DOI: 10.1177/20406223211026762] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 06/02/2021] [Indexed: 12/05/2022] Open
Abstract
Background: Low muscle mass and osteoporosis are commonly observed in individuals with type 2 diabetes mellitus (T2DM). We investigated the prevalence of low muscle mass and osteoporosis in patients with T2DM who had high glycated hemoglobin (HbA1c) levels. Methods: We included 187 Chinese patients with T2DM who were aged ⩾50 years and evaluated their body composition using dual-energy X-ray absorptiometry. We measured levels of fasting blood glucose, HbA1c, B collagen-specific sequences (B-CTX), osteocalcin (OC), propeptide of type 1 procollagen (P1NP), and 25-hydroxy vitamin D. Results: Of the total patients, 82 were men and 105 were women. The prevalence rates of low muscle mass, osteopenia, and osteoporosis were 35.8%, 38.0%, and 31.0%, respectively. The prevalence rate of low muscle mass was significantly higher in women with HbA1c levels >9.0% than in those with HbA1c levels <9.0%. The prevalence rates of osteopenia and osteoporosis in men with HbA1c levels >9.0% differed significantly from those with HbA1c levels <9.0%. The appendicular skeletal muscle mass index (ASMI), trunk muscle mass, lumbar spinal bone mineral content (BMC), lumbar spine BMD, femoral BMC, and femoral BMD were significantly decreased, and the serum levels of B-CTX, OC, and P1NP were significantly increased in patients with T2DM who had osteoporosis. The ASMI was associated with osteopenia/osteoporosis in men and women with T2DM. Conclusions: In patients with T2DM, high HbA1c levels were associated with higher prevalence rates of low muscle mass in women and osteoporosis in men, and ASMI was a risk factor of osteoporosis.
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Affiliation(s)
- Lingna Fang
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Qianjin Road 91#, Kunshan, 215300, China
| | - Shao Zhong
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Dan Ma
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Chong Li
- Department of Orthopaedics, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Yanmin Hao
- Department of Orthopaedics, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Yan Gao
- Department of Orthopaedics, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Li Zhang
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
| | - Liwen Shen
- Department of Endocrinology and Metabolism, Kunshan Hospital Affiliated with Jiangsu University, Kunshan, China
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Exploring the Relationship of Bone Turnover Markers and Bone Mineral Density in Community-Dwelling Postmenopausal Women. DISEASE MARKERS 2021; 2021:6690095. [PMID: 33968284 PMCID: PMC8084639 DOI: 10.1155/2021/6690095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 03/15/2021] [Accepted: 03/30/2021] [Indexed: 11/18/2022]
Abstract
Aims To explore the relationships of procollagen type 1 N-terminal propeptide (P1NP) and β cross-linked C-telopeptide of type 1 collagen (β-CTX) with bone mineral density (BMD) in postmenopausal women. Methods All postmenopausal women were selected from a community-based case-control study. The anteroposterior L1-L4 and left proximal femur BMD were measured. P1NP and β-CTX were also collected and tested. The main correlation analysis was applied to explore the relationships of BMD, P1NP, and β-CTX. Results The total 1055 postmenopausal women were enrolled. The BMD at all sites kept a decrease continually with age (P < 0.01). In addition, the level of β-CTX increased significantly from 45 to 50 years old and remained at a high level in the later stage, while the level of P1NP changed little or even decreased with age. Logistic regression model showed that β-CTX has better ability to predict BMD than P1NP, as demonstrated by an area under the curve (AUC) of 0.63. Conclusion P1NP and β-CTX are important markers to monitor bone metabolism. This trial is registered with ChiCTR-SOC-17013090. The date of registration is Oct. 23, 2017.
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Wu H, Kioumourtzoglou MA, Just AC, Kloog I, Sanders A, Svensson K, McRae N, Tamayo-Ortiz M, Solano-González M, Wright RO, Téllez-Rojo MM, Baccarelli AA. Association of ambient PM 2·5 exposure with maternal bone strength in pregnant women from Mexico City: a longitudinal cohort study. Lancet Planet Health 2020; 4:e530-e537. [PMID: 33159880 PMCID: PMC7664993 DOI: 10.1016/s2542-5196(20)30220-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 08/25/2020] [Accepted: 08/25/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Pregnancy is associated with deteriorations in maternal bone strength and heightened susceptibility to bone fractures. We aimed to investigate whether ambient particulate matter (PM)2·5 concentrations were associated with bone strength during pregnancy. METHODS In this longitudinal cohort study, we analysed longitudinal data from women participating in the Programming Research in Obesity, Growth, Environment and Social Stressors (PROGRESS) cohort in Mexico City, Mexico. Eligible women were aged 18 years or older, at less than 20 weeks' gestation at the time of recruitment, planning to stay in Mexico City for the next 3 years, without heart or kidney disease, did not use steroids or anti-epileptic drugs, were not daily consumers of alcohol, and had access to a telephone. Daily ambient PM2·5 concentrations were estimated from a spatio-temporal model that was based on the individual's address. Trabecular bone strength was measured using quantitative ultrasound from the radius of the middle finger and cortical bone strength from the proximal phalanx of the middle finger, during the second trimester, third trimester, and 1 and 6 months post partum. Bone strength T scores were modelled with PM2·5 concentrations using linear mixed models and distributed lag models. FINDINGS Adjusting for multiple exposure windows, each 10 ug/m3 increase in PM2·5 exposure concentrations in the first trimester was associated with a 0·18 SD decrease (95% CI -0·35 to -0·01; p=0·033) in ultrasound speed-of-sound (SOS) T score of trabecular bone strength from the second trimester until 6 months post partum. Similarly, each 10 μg/m3 increase in third trimester PM2·5 exposure was associated with a 0·18 SD decrease (-0·36 to -0·01; p=0·044) in the SOS T score of trabecular bone strength from the third trimester until 6 months post partum. PM2·5 exposure in the first month post partum was associated with a 0·20 SD decline (-0·39 to -0·01; p=0·043) in cortical bone strength until 6 months post partum. INTERPRETATION Ambient PM2·5 exposure during and after pregnancy was associated with diminished trabecular and cortical bone strength. Early pregnancy PM2·5 exposure was associated with a greater decline in bone strength later during pregnancy. Late pregnancy and early post-partum exposures adversely affected the post-partum bone strength recovery. Technological and policy solutions to reduce PM2·5 pollution could improve public health by reducing bone fracture risk. FUNDING US National Institute of Environmental Health Sciences.
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Affiliation(s)
- Haotian Wu
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
| | | | - Allan C Just
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Itai Kloog
- Department of Geography, Ben Gurion University of the Negev, Be'er Sheva, Israel
| | - Alison Sanders
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Nia McRae
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, National Institute of Public Health, Ministry of Health, Cuernavaca, Morelos, Mexico; Mexican Council for Science and Technology, Mexico City, Mexico
| | - Maritsa Solano-González
- Center for Nutrition and Health Research, National Institute of Public Health, Ministry of Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Ministry of Health, Cuernavaca, Morelos, Mexico
| | - Andrea A Baccarelli
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
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11
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Bone turnover markers as an aid to monitor osteoporosis following allogeneic hematopoietic stem cell transplantation. Ann Hematol 2020; 99:1873-1882. [PMID: 32451708 DOI: 10.1007/s00277-020-04090-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2019] [Accepted: 05/13/2020] [Indexed: 10/24/2022]
Abstract
Bone turnover markers (BTMs) are useful parameters for assessing fracture risk and unlike bone mineral density (BMD), can be measured at any institution. However, BTM values have not been established in patients post-allogeneic hematopoietic stem cell transplantation (allo-HSCT). We investigated the practicality of BTMs in patients who underwent allo-HSCT by measuring levels of the serum bone resorption marker, tartrate-resistant acid phosphatase-5b (TRACP-5b), and the bone formation marker, bone-specific alkaline phosphatase (BAP), together with BMD, 1 month before and 6 months after allo-HSCT. Patients were classified into either the alendronate group (n = 14) if alendronate treatment (35 mg orally per week) was administered before allo-HSCT or within 1 month after allo-HSCT, or the control group (n = 16), in which patients did not receive alendronate treatment. Despite the high frequency of corticosteroids users in the alendronate group (71.4 vs. 18.9%; p < 0.01), the mean percentage changes in BMD at the lumbar spine (- 2.9 vs. - 3.1%; p = 0.44) and femoral neck (- 3.2 vs. - 4.1%; p = 1.00), TRACP-5b levels (- 4.8 vs. 9.9%; p = 0.45), and BAP levels (6.9 vs. 1.0%; p = 0.85) during 6 months did not differ significantly between the alendronate and control groups. Additionally, the percentage changes in BMD at the lumbar spine were negatively associated with the TRACP-5b levels 6 months after allo-HSCT (p = 0.03, r = 0.40). Our results indicate the possible effectiveness of alendronate treatment in allo-HSCT patients. BTM levels could be useful to monitor the BMD changes.
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12
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Negri AL, Barone R, Quiroga MA, Bravo M, Marino A, Fradinger E, Bogado CE, Zanchetta JR. Bone Mineral Density: Serum Markers of Bone Turnover and Their Relationships in Peritoneal Dialysis. Perit Dial Int 2020. [DOI: 10.1177/089686080402400207] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background The usefulness of bone mass measurements and bone turnover markers to estimate the risk of fracture and the type of underlying renal osteodystrophy are not well established in patients on peritoneal dialysis (PD). Objective To assess bone mass using total and regional bone densitometry in a group of patients on PD and to determine if serum markers of bone turnover identify patients with low bone mass. Methods Bone densitometry was studied by dual-energy x-ray absorptiometry (DEXA), and bone turnover using several serum markers, in 65 patients on PD. Bone mass was classified as normal, osteopenic, or osteoporotic according to World Health Organization criteria based on bone mineral density (BMD) T scores. Results T scores in the osteopenia range were present at the lumbar spine (LS) in 44.6% (45% of men and 44.4% of women) of patients and at the femoral neck (FN) in 56.9% (55% of men and 58% of women). T scores in the osteoporosis range were present at the LS in 13.8% of patients (10% of men and 15.5% of women) and at the FN in 21.5% (30% of men and 17.7% of women). Patients with BMD T scores in the osteoporosis range at both regions had increased serum intact parathyroid hormone (iPTH) levels compared to patients in the osteopenic/normal range. Bone mineral content in the whole skeleton (TBMC) correlated negatively with iPTH ( r = –0.34) and with total time on dialysis ( r = –0.26); in multivariate analysis, only iPTH correlated negatively with TBMC ( B = –0.26, p = 0.03). No correlations were found between the other bone markers and BMD T scores at the FN or LS. There were no significant differences in absolute BMD or BMD T scores at the LS or FN between patients with and patients without fractures. Conclusions BMD T scores in the osteopenia/osteoporosis range were observed at the LS in 58.4% of these patients on PD and at the FN in 78.4%. TBMC correlated negatively with iPTH. There were no correlations between markers of bone turnover and bone mass measurements at the two skeletal regions, although patients with BMD T scores in the osteoporosis range had increased serum iPTH levels. Bone mass measurements were not different between patients with and patients without fractures.
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Affiliation(s)
- Armando L. Negri
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Roberto Barone
- Servicio de Terapia Renal Hurlingham SRL, Buenos Aires, Argentina
| | | | - Marina Bravo
- Fresenius Medical Care Argentina Caballito, Buenos Aires, Argentina
| | - Alicia Marino
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Erich Fradinger
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
| | - Cesar E. Bogado
- Instituto de Investigaciones Metabólicas, Buenos Aires, Argentina
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13
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Gossiel F, Paggiosi MA, Naylor KE, McCloskey EV, Walsh J, Peel N, Eastell R. The effect of bisphosphosphonates on bone turnover and bone balance in postmenopausal women with osteoporosis: The T-score bone marker approach in the TRIO study. Bone 2020; 131:115158. [PMID: 31740343 DOI: 10.1016/j.bone.2019.115158] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/25/2019] [Accepted: 11/13/2019] [Indexed: 10/25/2022]
Abstract
Postmenopausal osteoporosis is characterised by increased bone turnover and an imbalance between bone resorption and formation. Bisphosphonate treatment reduces bone turnover but their effect on bone balance is yet to be fully investigated. Using the T-score approach our aims were to: i) investigate the effects of oral nitrogen-containing bisphosphonates on bone balance and turnover in postmenopausal women with osteoporosis and ii) determine the relationship of the change in bone balance and turnover with the change in BMD at the lumbar spine and total hip. Women were recruited, mean age 67 years, and randomised to receive: ibandronate (n = 55, 150 mg/month), alendronate (n = 54, 70 mg/week) or risedronate (n = 56, 35 mg/week). They also received calcium and vitamin D daily. A fasting serum sample was collected at baseline and weeks 1, 2, 4, 12, 13, 48 and 96. The control group were 226 healthy premenopausal women receiving no treatments. PINP and CTX were measured using the iSYSIDS analyser and BMD (in g/cm2) of the lumbar spine and total hip were measured by DXA (Hologic Inc). PINP and CTX values were log10-transformed and normalised. T-scores were calculated using the mean and standard deviation from the premenopausal group. Bone turnover and bone balance were calculated from the T-scores. Mean levels (95% CI) of balance and turnover are shown in the table. The change in turnover at weeks 4, 12 and 48 was inversely correlated with the change in lumbar spine and total hip BMD at weeks 48 and 96, (p < .01 to p < .001). The change in balance at week 4 positively correlated with the change in total hip BMD at weeks 48, (p < .01). Bisphosphonates resulted in an initial positive balance and a reduction in turnover. Some of these changes were associated with increases in BMD. Bone turnover is a better predictor of BMD than bone balance.
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Affiliation(s)
- F Gossiel
- Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom.
| | - M A Paggiosi
- Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom
| | - K E Naylor
- Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom
| | - E V McCloskey
- Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom
| | - J Walsh
- Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom
| | - N Peel
- Metabolic Bone Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Northern General Hospital Sheffield, United Kingdom
| | - R Eastell
- Academic Unit of Bone Metabolism, The Mellanby Centre for Bone Research, University of Sheffield, Sheffield, United Kingdom
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Lorenzo‐Pouso AI, Pérez‐Sayáns M, Chamorro‐Petronacci C, Gándara‐Vila P, López‐Jornet P, Carballo J, García‐García A. Association between periodontitis and medication‐related osteonecrosis of the jaw: A systematic review and meta‐analysis. J Oral Pathol Med 2019; 49:190-200. [DOI: 10.1111/jop.12963] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2019] [Revised: 07/14/2019] [Accepted: 09/28/2019] [Indexed: 12/14/2022]
Affiliation(s)
- Alejandro I. Lorenzo‐Pouso
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Mario Pérez‐Sayáns
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Cintia Chamorro‐Petronacci
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Pilar Gándara‐Vila
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
| | - Pía López‐Jornet
- Faculty of Medicine Department of Oral Medicine Regional Campus of International Excellence "Campus Mare Nostrum" University of Murcia Espinardo Murcia Spain
| | - Javier Carballo
- Faculty of Sciences Department of Food Technology University of Vigo‐Ourense Campus Ourense Spain
| | - Abel García‐García
- Faculty of Medicine and Dentistry Oral Medicine Oral Surgery and Implantology Unit Health Research Institute of Santiago de Compostela (IDIS) University of Santiago de Compostela Santiago de Compostela A Coruña Spain
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Klein KO, Phillips SA. Review of Hormone Replacement Therapy in Girls and Adolescents with Hypogonadism. J Pediatr Adolesc Gynecol 2019; 32:460-468. [PMID: 31059821 DOI: 10.1016/j.jpag.2019.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 04/22/2019] [Accepted: 04/25/2019] [Indexed: 12/13/2022]
Abstract
Girls with either hypo- or hypergonadotropic hypogonadism need treatment with estrogens to initiate puberty and maintain a normal hormonal milieu. The focus of this review is hormone replacement treatment in girls with hypogonadism, to initiate and progress through puberty, and to maintain a healthy hormonal milieu in women. It also addresses what is known in the literature regarding estrogen levels in girls and women, instructive cases, practical tables for reference and application, and thoughts on future directions in this area. It represents a thorough literature review with author opinions and recommendations. Girls with normal ovarian function begin puberty on average at 10.5 years old, although there is variation according to ethnicity and degree of excess weight gain. The aim of estrogen therapy to initiate puberty is to mimic normal onset and rate of progression. On the basis of the currently available literature, when a diagnosis of hypogonadism is established, we recommend initiating treatment between age 11 and 12 years of age, with dose increases approximately every 6 months until adult levels are reached. In some situations, treatment may be delayed to allow time for diagnosis or permit more time for linear growth, or address unique risks found in girls treated for various cancers or blood disorders. When adult dosing is reached, progestins are also used to protect uterine health. This can be combined sequentially, allowing regular menstruation, or combined continuously when menstrual bleeding is not preferred. Treatment is continued until the average age of menopause, again with various considerations for longer or shorter duration on the basis of risk-benefit ratios. Transdermal estrogens are considered the most physiologic replacement and theoretically might have fewer associated risks. We review what is known about risks and outcomes and areas for future research.
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Affiliation(s)
- Karen O Klein
- Division of Endocriology, Department of Pediatrics, University of California, San Diego and Rady Children's Hospital, San Diego, California.
| | - Susan A Phillips
- Division of Endocriology, Department of Pediatrics, University of California, San Diego and Rady Children's Hospital, San Diego, California
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16
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Ohishi T, Fujita T, Nishida T, Asukai M, Suzuki D, Sugiura K, Matsuyama Y. Factors Influencing Serum Homocysteine Levels in Postmenopausal Osteoporotic Females - Comparison to Urinary Collagen Crosslinks. Endocr Res 2019; 44:117-125. [PMID: 30760054 DOI: 10.1080/07435800.2019.1577892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Purpose: The correlation between serum levels of homocysteine and bone mineral density remains controversial. The aim of this study was to identify the potential factors associated with the levels of serum total homocysteine (S-Hcy) and urinary N-terminal telopeptide of type I collagen (U-NTX) in female osteoporotic patients. Materials and Methods: This cross-sectional study included 163 female osteoporotic patients, aged between 48 and 91 years, who had never been treated with anti-osteoporosis therapy. Background data including spine and hip bone mineral density, ongoing therapy for the metabolic disease, aortic calcification score as evaluated by lateral lumbar X-ray film, and recent fragility fracture history were obtained. S-Hcy, U-NTX levels, and creatinine clearance were measured. Results: Multiple linear regression analysis revealed a significant correlation between S-Hcy levels and aortic calcification score (p = 0.022), creatinine clearance (p = 0.004), and recent fracture history (within 1 year after fracture) (p = 0.028); conversely, U-NTX levels correlated significantly with total hip bone mineral density (p < 0.0001) and recent fracture history (p = 0.0007). Conclusions: S-Hcy levels had no correlation with bone mineral density, but were associated with the degree of aortic calcification, renal function, and fracture events. These confounding factors should be taken into consideration when the relationship between S-Hcy and bone mineral density is discussed.
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Affiliation(s)
- Tsuyoshi Ohishi
- a Department of Orthopedic Surgery , Enshu Hospital , Hamamatsu, Shizuoka , Japan
| | - Tomotada Fujita
- a Department of Orthopedic Surgery , Enshu Hospital , Hamamatsu, Shizuoka , Japan
| | - Tatsuya Nishida
- a Department of Orthopedic Surgery , Enshu Hospital , Hamamatsu, Shizuoka , Japan
| | - Mitsuru Asukai
- b Department of Orthopedic Surgery , Shizuoka Municipal Hospital , Shizuoka , Japan
| | - Daisuke Suzuki
- c Suzuki Orthopedic Sports Clinic , Hamamatsu, Shizuoka , Japan
| | - Kaori Sugiura
- d Department of Orthopedic Surgery , Hamamatsu University School of Medicine , Hamamatsu, Shizuoka , Japan
| | - Yukihiro Matsuyama
- d Department of Orthopedic Surgery , Hamamatsu University School of Medicine , Hamamatsu, Shizuoka , Japan
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17
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Nishimura T, Arima K, Abe Y, Kanagae M, Mizukami S, Okabe T, Tomita Y, Goto H, Hasegawa M, Sou Y, Horiguchi I, Aoyagi K. Relationship between bone turnover markers and the heel stiffness index measured by quantitative ultrasound in post-menopausal Japanese women. Ann Hum Biol 2019; 46:330-334. [PMID: 30995879 DOI: 10.1080/03014460.2019.1607552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Osteoporosis in women is a serious health problem. The relationships between biochemical markers of bone turnover and bone mineral density (BMD) in women have been reported, but no study has examined relationships between tartrate-resistant acid phosphatase-5b (TRACP-5b) or bone-specific alkaline phosphatase (BAP) and bone mass measured by quantitative ultrasound (QUS) in Japanese post-menopausal women. Aim: To investigate the serum TRACP-5b and BAP levels and to determine their associations with the heel stiffness index measured by QUS in post-menopausal women. Subjects and methods: The subjects were 510 post-menopausal women who were invited to participate in periodic health examinations in 2011-2013 (the Unzen Study). The heel stiffness index (bone mass) was measured by QUS. Serum samples were collected and TRACP-5b and BAP levels were measured. Results: Multiple regression analysis showed that a higher log (TRACP-5b) was correlated with a lower stiffness index (p = 0.014) and log (BAP) was not correlated with stiffness index after adjusting for covariates (p = 0.136). Conclusion: Higher rates of bone resorption are associated with a lower stiffness index in Japanese post-menopausal women. These results may indicate that high bone resorption affects bone mass more than bone formation, resulting in a low bone mass.
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Affiliation(s)
- Takayuki Nishimura
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Yasuyo Abe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
| | - Mitsuo Kanagae
- Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | - Satoshi Mizukami
- Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | - Takuhiro Okabe
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | - Yoshihito Tomita
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan.,Department of Rehabilitation, Nishi-Isahaya Hospital , Nagasaki , Japan
| | | | - Maiko Hasegawa
- Medical Policy Division, Nagasaki Prefectural Government , Nagasaki , Japan
| | - Yoko Sou
- Ken-Nan Health Care Office , Nagasaki , Japan
| | - Itsuko Horiguchi
- Center for Public Relations Strategy, Nagasaki University , Nagasaki , Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences , Nagasaki , Japan
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18
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Lorenzo-Pouso AI, Pérez-Sayáns M, González-Palanca S, Chamorro-Petronacci C, Bagán J, García-García A. Biomarkers to predict the onset of biphosphonate-related osteonecrosis of the jaw: A systematic review. Med Oral Patol Oral Cir Bucal 2019; 24:e26-e36. [PMID: 30595601 PMCID: PMC6344011 DOI: 10.4317/medoral.22763] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/15/2018] [Indexed: 11/23/2022] Open
Abstract
Background The goal of this paper was to identify available biomarkers to predict the onset of biphosphonate-related osteonecrosis of the jaw (BRONJ). Material and Methods Case-control studies comparing the different concentrations of a series of molecules detected in serum and urine as matrices of BRONJ affected patients vs. non-affected were included. PRISMA guidelines for systematic reviews were used for the present paper. Two reviewers independently screened electronic databases (Medline, Web of science, and The Cochrane Library) and performed hand searches. Risk of bias assessment of selected studies was performed by the Newcastle-Ottawa Scale. This study is registered as PROSPERO CRD42017078149. Results From a total of 601 identified studies, 7 (4 articles with high methodological quality and 3 with medium) articles were included. They investigate 2623 patients, of whom 91 (3.47%) developed BRONJ. A total of 7 biomarkers were identified and classified into 3 groups: bone turnover, angiogenesis and endocrine markers. Conflicting results were found in relation to most biomarkers. Conclusions The present review suggests that no useful markers are currently available to evaluate BRONJ risk. Nevertheless, the present paper indicates that a paradigm shift from bone turnover biomarkers to angiogenesis and endocrine markers could shed light on this search. Key words:Biphosphonate, jaw, osteonecrosis, osteoporosis.
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Affiliation(s)
- A-I Lorenzo-Pouso
- Oral Medicine, Oral Surgery and Implantology Unit, Faculty of Medicine and Odontology, University of Santiago de Compostela, Rúa Entrerríos S/N, 15782 - Santiago de Compostela, (Spain),
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Mitsuboshi S, Yamada H, Nagai K, Okajima H. Clinical advantage and tolerability of ibandronate in hemodialysis patients: a retrospective study. RENAL REPLACEMENT THERAPY 2018. [DOI: 10.1186/s41100-018-0144-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Loh HH, Yee A, Loh HS. Bone health among patients with primary aldosteronism: a systematic review and meta-analysis. MINERVA ENDOCRINOL 2018; 44:387-396. [PMID: 30482008 DOI: 10.23736/s0391-1977.18.02867-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Recent studies showed a possible association between hyperaldosteronism and secondary hyperparathyroidism leading to reduced bone health, however results are conflicting. EVIDENCE ACQUISITION We conducted a meta-analysis to evaluate the relationship between primary aldosteronism (PA) with bone biochemical markers and to assess bone mineral density in patients with primary aldosteronism. EVIDENCE SYNTHESIS A total of 939 subjects were examined (37.5% with PA). Patients with PA had significantly higher serum parathyroid hormone, lower serum calcium, higher urine calcium excretion and higher serum alkaline phosphatase compared to patients without PA, with no significant difference in serum vitamin D between both groups. Bone mineral density of lumbar spine, femoral neck and total neck of femur were similar between two groups. With PA treatment, there was a significant increment in serum calcium and reduction in serum parathyroid hormone. CONCLUSIONS PA is associated with hypercalciuria with subsequent secondary hyperparathyroidism. This potentially affects bone health. We recommend this to be part of complication screening among patients with PA.
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Affiliation(s)
- Huai H Loh
- Faculty of Medicine and Health Sciences, University of Malaysia, Sarawak, Malaysia -
| | - Anne Yee
- Department of Psychological Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Huai S Loh
- Clinical Academic Unit, Newcastle University Medicine Malaysia, Johor, Malaysia
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Park SG, Jeong SU, Lee JH, Ryu SH, Jeong HJ, Sim YJ, Kim DK, Kim GC. The Changes of CTX, DPD, Osteocalcin, and Bone Mineral Density During the Postmenopausal Period. Ann Rehabil Med 2018; 42:441-448. [PMID: 29961742 PMCID: PMC6058582 DOI: 10.5535/arm.2018.42.3.441] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2017] [Accepted: 08/25/2017] [Indexed: 01/08/2023] Open
Abstract
Objective To investigate appropriate treatment time and useful bone turnover markers (BTMs) for monitoring bone turnover during the postmenopausal period, we analyzed changes of two bone resorption markers; serum carboxyterminal telopeptide of collagen I (s-CTX), urine deoxypyridinoline (u-DPD), one bone formation marker; serum osteocalcin (s-OC), and bone mineral density (BMD) in Korean postmenopausal women. Methods Seventy-eight menopausal women were divided into three groups according to postmenopausal period: group I (0–5 years), group II (6–10 years), group III (≥10 years). All groups were subdivided into an osteoporosis group (T-score≤-2.5) and a non-osteoporosis group (T-score>-2.5). BTMs such as s-CTX, u-DPD, s-OC, and BMD (g/cm2) were measured by dual-energy X-ray absorptiometry (DXA) in all patients. Analysis of variables among groups based on the postmenopausal period was performed using ANOVA. Results There was significant negative correlation between BMD and postmenopausal period. The levels of all BTMs including s-CTX, u-DPD, and s-OC were highest in group II and the increased levels of all BTMs subsequently declined in group III. The levels of BTMs were higher in the osteoporosis groups than in the non-osteoporosis groups in all subjects. It was statistically significant that the level of s-CTX in group I was higher in the osteoporosis group than in the non-osteoporosis group. Conclusion This study showed that bone resorption and bone formation were the highest 5–10 years after menopause, and s-CTX is more useful than u-DPD among the bone resorption markers. It’s important to measure serially both BMD and BTM within 10 years after menopause for accurate diagnosis and management for postmenopausal osteoporosis.
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Affiliation(s)
- Seok Gyo Park
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Seong Uk Jeong
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Jae Hyun Lee
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Sang Hyeong Ryu
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Ho Joong Jeong
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Young Joo Sim
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Dong Kyu Kim
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
| | - Ghi Chan Kim
- Department of Physical Medicine and Rehabilitation, Kosin University College of Medicine, Busan, Korea
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Souza LS, Rochette NF, Pedrosa DF, Magnago RPL, Filho TBF, Vieira FLH, Fin IDCF, Eis SR, Graceli JB, Rangel LBA, Silva IV. Role of APOE Gene in Bone Mineral Density and Incidence of Bone Fractures in Brazilian Postmenopausal Women. J Clin Densitom 2018; 21:227-235. [PMID: 28784276 DOI: 10.1016/j.jocd.2017.03.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2016] [Accepted: 03/20/2017] [Indexed: 12/23/2022]
Abstract
Osteoporosis is one of the major diseases that affects mostly postmenopausal women. Despite being a multifactorial disease, some genes have been shown to play an important role in osteoporosis. Bone mineral density (BMD) is still largely used to diagnose it, although many other biomarkers are used to better follow the disease onset. It has been shown that the apolipoprotein E (APOE) gene could be a biomarker for risk of fractures as well as to predict lower BMD in patients with osteoporosis. The human APOE gene encodes 3 protein isoforms called ApoE2, ApoE3, and ApoE4, resulting in 4 possible genotypes, because they are a product of a single nucleotide polymorphism found in this gene. So far, the APOE4 allele has been associated with low BMD in postmenopausal women and to incidence of bone breaking in older women. This study aimed to investigate the role of ApoE isoforms in a cohort of 413 postmenopausal Brazilian women. These patients were randomly recruited, clinically examined, and subjected to dual-energy X-ray absorptiometry to measure their BMD. Patients were further grouped as normal BMD (T-score < 0.5) or low BMD (T-score > 1.0, osteopenic or osteoporotic). Patients with osteopenia or osteoporosis were further genotyped for APOE alleles as well as tested for many serum bone turnover biomarkers. Our data showed that presence of the APOE3 allele was associated with both higher BMDs and higher serum concentrations of osteocalcin and alkaline phosphatase, biomarkers for bone formation. On the other hand, the APOE2 and APOE4 alleles were associated with lower BMD as well as higher levels of serum C-terminus collagen peptide and urinary deoxipyridinolines, biomarkers for bone resorption. However, these effects on lower BMD and bone resorption biomarkers observed in either APOE2 or APOE4 alleles were eliminated when patients' genotype carried the APOE3 allele. Codominance of the APOE3 allele was also associated with lesser cases of bone fractures in these patients within a 5-year follow-up. In conclusion, our data show that APOE4 may be associated with lower bone formation as well as increased risk of osteoporosis and bone fractures, whereas APOE3 seems to decrease lowering BMD in postmenopausal women, and its presence seemed to lower the incidence of bone breaking in patients with osteoporosis.
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Affiliation(s)
- Leticia S Souza
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Neuza Felix Rochette
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Diego França Pedrosa
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Rafaella P Lopes Magnago
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Teodiano B Freire Filho
- Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Laboratory of Artificial Intelligence, Electrical Engineering Department, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Fernando Luiz H Vieira
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Department of Physiological Sciences, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Irani do Carmo F Fin
- Centro de Diagnóstico e Pesquisa em Osteoporose do Espírito Santo (CEDOES), Vitória, Espírito Santo, Brazil
| | - Sergio R Eis
- Centro de Diagnóstico e Pesquisa em Osteoporose do Espírito Santo (CEDOES), Vitória, Espírito Santo, Brazil
| | - Jones B Graceli
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Ciências Fisiológicas, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Leticia B A Rangel
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Laboratory of Cellular and Molecular Biology of Cancer, Department of Pharmaceutical Sciences, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Ian V Silva
- Aging Cell Biology Laboratory, Department of Morphology, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil; Programa de Pós-Graduação em Biotecnologia, Health Sciences Center, Universidade Federal do Espírito Santo, Vitória, Espírito Santo, Brazil.
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Verroken C, Zmierczak HG, Goemaere S, Kaufman JM, Lapauw B. Bone Turnover in Young Adult Men: Cross-Sectional Determinants and Associations With Prospectively Assessed Bone Loss. J Bone Miner Res 2018; 33:261-268. [PMID: 28987002 DOI: 10.1002/jbmr.3303] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/19/2017] [Accepted: 10/02/2017] [Indexed: 01/08/2023]
Abstract
Biochemical markers of bone turnover are higher in young adult men than in middle-aged men or young adult women. Nonetheless, little is known about the determinants and clinical significance hereof. The present study examined determinants of serum bone turnover markers in men around peak bone mass age, and explored whether bone turnover at this age predicts subsequent changes in bone mass. We used cross-sectional and longitudinal data from 973 and 428 healthy men, respectively, aged 25 to 45 years at baseline, including baseline procollagen type I amino-terminal propeptide (P1NP), osteocalcin, and C-terminal telopeptide of type I collagen (CTX) from fasting serum samples, baseline questionnaire-assessed physical activity levels, and baseline and follow-up dual-energy X-ray absorptiometry-derived areal bone mineral density (aBMD) and body composition. Mean follow-up time was 12.4 ± 0.4 years. At baseline, all bone turnover markers were inversely associated with total body fat mass (β ≤ -0.20, p < 0.001), and positively with physical activity during sports activities (β ≥ 0.09, p ≤ 0.003), and, albeit not independently from fat mass, total body lean mass (β ≥ 0.20, p ≤ 0.003). Mean annual aBMD changes in the longitudinal cohort were -0.19% ± 0.24% at the total body, -0.14% ± 0.42% at the spine, -0.49% ± 0.47% at the femoral neck, and -0.25% ± 0.37% at the total hip (all p < 0.001). Higher bone turnover markers at baseline were associated with larger decreases in aBMD at all measurement sites (β ≤ -0.08, p ≤ 0.081 for P1NP; β ≤ -0.16, p ≤ 0.002 for osteocalcin; and β ≤ -0.21, p < 0.001 for CTX). In conclusion, our findings show that sports activities and body composition, primarily fat mass, are the main identified determinants of bone turnover in men around peak bone mass age. Further, bone turnover at this age is an important determinant of subsequent changes in bone mass, with higher levels of bone turnover markers being associated with greater decreases in aBMD. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Charlotte Verroken
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Hans-Georg Zmierczak
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Stefan Goemaere
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium
| | - Jean-Marc Kaufman
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Bruno Lapauw
- Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium.,Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
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24
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Crawford MR, Pham N, Khan L, Bena JF, Schauer PR, Kashyap SR. INCREASED BONE TURNOVER IN TYPE 2 DIABETES PATIENTS RANDOMIZED TO BARIATRIC SURGERY VERSUS MEDICAL THERAPY AT 5 YEARS. Endocr Pract 2017; 24:256-264. [PMID: 29144812 DOI: 10.4158/ep-2017-0072] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The aim of our study was to determine the 5-year outcomes of bariatric surgery versus intensive medical therapy on bone turnover in patients with type 2 diabetes mellitus (T2DM) from the STAMPEDE trial. METHODS This was an ancillary investigation of a 5-year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (body mass index [BMI], 36.5 ± 3.6 kg/m2) and uncontrolled T2DM (glycated hemoglobin 9.3 ± 1.6% [78 mmol/mol]). Patients were randomized to intensive medical therapy (IMT; n = 25), Roux-en-Y gastric bypass (RYGB; n = 37), or sleeve gastrectomy (SG; n = 33) for diabetes treatment. Bone formation marker osteocalcin (OC), bone resorption marker serum C-telopeptide of type 1 collagen (CTX), and intact parathyroid hormone (PTH) were assessed at baseline and 5 years postintervention. Analysis with key clinical parameters and outcomes (i.e., age, menopausal status, gender, weight loss) was performed. RESULTS Percent change in CTX at 5 years increased in both surgical groups, by 137 ± 108% in RYGB ( P<.001) and 61.1 ± 90% in SG ( P<.001) compared to 29.8 ± 93% in IMT ( P = .12). OC also increased from baseline in the surgical cohorts, by 138 ± 19% in RYGB ( P<.001) and 71 ± 69% in SG ( P<.001) compared to 43.8 ± 121.1% in IMT ( P = .83). Increases in both CTX and OC correlated linearly with increases in PTH levels in RYGB patients ( P<.001). Increase in CTX correlated with decreased BMI in SG patients ( P = .039). CONCLUSION In patients with T2DM, bone turnover remains chronically elevated at 5 years following RYGB, and to a lesser extent in SG patients. ABBREVIATIONS BMI = body mass index; BTM = bone turnover marker; CTX = C-telopeptide of type 1 collagen; HbA1c = glycated hemoglobin; IMT = intensive medical therapy; OC = osteocalcin; PPI = proton-pump inhibitor; PTH = parathyroid hormone; RYGB = Roux-en-Y gastric bypass; SG = sleeve gastrectomy; T2DM = type 2 diabetes mellitus; TZD = thiazolidinedione.
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25
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Tarantino U, Iolascon G, Cianferotti L, Masi L, Marcucci G, Giusti F, Marini F, Parri S, Feola M, Rao C, Piccirilli E, Zanetti EB, Cittadini N, Alvaro R, Moretti A, Calafiore D, Toro G, Gimigliano F, Resmini G, Brandi ML. Clinical guidelines for the prevention and treatment of osteoporosis: summary statements and recommendations from the Italian Society for Orthopaedics and Traumatology. J Orthop Traumatol 2017; 18:3-36. [PMID: 29058226 PMCID: PMC5688964 DOI: 10.1007/s10195-017-0474-7] [Citation(s) in RCA: 115] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The Italian Society for Orthopaedics and Traumatology conceived this guidance-which is primarily addressed to Italian orthopedic surgeons, but should also prove useful to other bone specialists and to general practitioners-in order to improve the diagnosis, prevention, and treatment of osteoporosis and its consequences. MATERIALS AND METHODS Literature reviews by a multidisciplinary team. RESULTS The following topics are covered: the role of instrumental, metabolic, and genetic evaluations in the diagnosis of osteoporosis; appraisal of the risk of fracture and thresholds for intervention; general strategies for the prevention and treatment of osteoporosis (primary and secondary prevention); the pharmacologic treatment of osteoporosis; the setting and implementation of fracture liaison services for tertiary prevention. Grade A, B, and C recommendations are provided based on the main levels of evidence (1-3). Toolboxes for everyday clinical practice are provided. CONCLUSIONS The first up-to-date Italian guidelines for the primary, secondary, and tertiary prevention of osteoporosis and osteoporotic fractures are presented.
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Affiliation(s)
- Umberto Tarantino
- Policlinico Tor Vergata Foundation, Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
| | - Giovanni Iolascon
- Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy
| | - Luisella Cianferotti
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Laura Masi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Gemma Marcucci
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Francesca Giusti
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Francesca Marini
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Simone Parri
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy
| | - Maurizio Feola
- Policlinico Tor Vergata Foundation, Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
| | - Cecilia Rao
- Policlinico Tor Vergata Foundation, Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
| | - Eleonora Piccirilli
- Policlinico Tor Vergata Foundation, Orthopaedics and Traumatology, University of Rome Tor Vergata, Rome, Italy
| | - Emanuela Basilici Zanetti
- Nursing Science, Center of Excellence for Culture and Nursing Research-IPASVI, University of Rome Tor Vergata, Rome, Italy
| | - Noemi Cittadini
- Nursing Science, Center of Excellence for Culture and Nursing Research-IPASVI, University of Rome Tor Vergata, Rome, Italy
| | - Rosaria Alvaro
- Nursing Science, Center of Excellence for Culture and Nursing Research-IPASVI, University of Rome Tor Vergata, Rome, Italy
| | - Antimo Moretti
- Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy
| | - Dario Calafiore
- Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy
| | - Giuseppe Toro
- Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy
| | - Francesca Gimigliano
- Department of Medical and Surgical Specialties and Dentistry, Second University of Naples, Naples, Italy
| | - Giuseppina Resmini
- Section of Orthopaedics and Traumatology, Centre for the Study of Osteoporosis and Metabolic Bone Disease, Treviglio-Caravaggio Hospital, Bergamo, Italy
| | - Maria Luisa Brandi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University Hospital of Florence, University of Florence, Viale Pieraccini, 6, 50139, Florence, Italy.
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26
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Lucinda LMF, Aarestrup BJV, Reboredo MM, Pains TDA, Chaves RZ, Reis JEP, Louzada MJQ, Guerra MO. Evaluation of the anti-osteoporotic effect of Ginkgo biloba L. in Wistar rats with glucocorticoid-induced-osteoporosis by bone densitometry using dual-energy x-ray absorptiometry (DEXA) and mechanical testing. AN ACAD BRAS CIENC 2017; 89:2833-2841. [PMID: 29044313 DOI: 10.1590/0001-3765201720160479] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/01/2017] [Indexed: 11/22/2022] Open
Abstract
Evaluate the effect of the extract of Ginkgo biloba in the bone alkaline phosphatase, bone mineral density, in the mechanical properties of the tibia in rats with glucocorticoid-induced-osteoporosis. After osteoporosis induction, the rats were divided into five groups: Osteoporosis; EGb1 (28 mg/Kg); EGb2 (56 mg/Kg); alendronate (0.2 mg/animal) and control. The animals were treated during 20 and 30 days. The control group was compared with the osteoporosis's (Student's t-test), while the other were analyzed by ANOVA test followed by Tukey/Dunnett'T3 (p<0.05). In the osteoporosis group the bone alkaline phosphatase, bone mineral density, the bone stiffness, the maximum load and the resilience were reduced. The bone alkaline phosphatase values increased in the EGb1 and EGb2 groups (30 days). In addition, in the EGb2 and alendronate groups (20 and 30 days) the bone mineral density increased. The extract of Ginkgo biloba restored bone alkaline phosphatase and bone mineral density using dual-energy x-ray absorptiometry.
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Affiliation(s)
- Leda M F Lucinda
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora/UFJF, São Pedro, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
| | - Beatriz J V Aarestrup
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora/UFJF, São Pedro, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
| | - Maycon M Reboredo
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora/UFJF, São Pedro, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
| | - Thais D A Pains
- Faculdade de Medicina, Universidade Federal de Juiz de Fora/UFJF, Avenida Eugênio do Nascimento, s/n, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
| | - Raphael Z Chaves
- Faculdade de Medicina, Universidade Federal de Juiz de Fora/UFJF, Avenida Eugênio do Nascimento, s/n, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
| | - João E P Reis
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora/UFJF, São Pedro, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
| | - Mário J Q Louzada
- Faculdade de Medicina Veterinária de Araçatuba, Universidade do Estado de São Paulo/UNESP, Rua Clovis Pestana, 793, 16050-680 Araçatuba, SP, Brazil
| | - Martha O Guerra
- Centro de Biologia da Reprodução, Universidade Federal de Juiz de Fora/UFJF, São Pedro, Caixa Postal 328, 36001-970 Juiz de Fora, MG, Brazil
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Liang J, Lian S, Qian X, Wang N, Huang H, Yao J, Tang K, Chen L, Li L, Lin W, Chen H, Li M, Lin L, Lu J, Bi Y, Wang W, Ning G, Wen J, Chen G. Association Between Bone Mineral Density and Pancreatic β-Cell Function in Elderly Men and Postmenopausal Women. J Endocr Soc 2017; 1:1085-1094. [PMID: 29264561 PMCID: PMC5686605 DOI: 10.1210/js.2017-00025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2017] [Accepted: 05/12/2017] [Indexed: 11/26/2022] Open
Abstract
Purpose: To explore the association between bone mineral density (BMD) and β-cell function. Methods: A cross-sectional study was performed in Fujian, China, from 2011 to 2012. The study included 572 elderly men older than age 60 years and 1558 postmenopausal women aged 45 to 86 years, excluding those with diabetes and insulin resistance. Fasting glucose and insulin concentrations were measured. Pancreatic β-cell function was estimated by using the homeostasis model assessment (HOMA-β). Calcaneus BMD was measured by using quantitative ultrasonography. Multiple regression analyses were applied to explore the association. Results: Participants with decreased BMD had lower fasting glucose (P < 0.001 in postmenopausal women; P = 0.007 in elderly men) and greater HOMA-β (P = 0.001 in postmenopausal women; P = 0.008 in elderly men) than those with normal BMD, whereas no statistical differences in insulin were seen among categories of BMD. After adjustment for all confounders, HOMA-β was still significantly negatively related to BMD in both groups (all P < 0.001), and remarkable positive relationships were found between BMD and fasting glucose. Furthermore, binary logistic regression presented fully adjusted odds ratios for diabetes in those with osteoporosis vs those with normal BMD: 0.60 [95% confidence interval (CI), 0.38 to 0.94] and 0.66 (95% CI, 0.49 to 0.91) in the original selected population of elderly men (n = 1070) and postmenopausal women (n = 2825), respectively. Conclusions: BMD was independently inversely associated with HOMA-β and positively associated with fasting glucose in both elderly men and postmenopausal women, suggesting that bone mass may be a predictor of glucose metabolism. Further research is needed to verify the associations and determine the exact mechanism underlying them.
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Affiliation(s)
- Jixing Liang
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Shuimei Lian
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Xiaofang Qian
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Nengying Wang
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Huibin Huang
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Jin Yao
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Kaka Tang
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Ling Chen
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Liantao Li
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Wei Lin
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Hongjie Chen
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Meizhi Li
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Lixiang Lin
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Jieli Lu
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Yufang Bi
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Weiqing Wang
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Guang Ning
- Department of Endocrinology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200025, China
| | - Junping Wen
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
| | - Gang Chen
- Department of Endocrinology, Fujian Provincial Hospital, Fujian Academy of Medical Sciences, Fujian Medical University, Fuzhou 350001, China
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28
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Gao C, Qiao J, Li SS, Yu WJ, He JW, Fu WZ, Zhang ZL. The levels of bone turnover markers 25(OH)D and PTH and their relationship with bone mineral density in postmenopausal women in a suburban district in China. Osteoporos Int 2017; 28:211-218. [PMID: 27468899 DOI: 10.1007/s00198-016-3692-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 06/28/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED This study evaluated the levels of bone turnover markers (BTMs) and investigated relationships between them and bone mineral density (BMD) in postmenopausal women in China suburban district. The prevalence of osteoporosis was 25.03 % at lumbar spine and 6.23 % at femoral neck, and BTMs were negatively correlated with BMDs. INTRODUCTION The aims of this study were to evaluate the levels of bone turnover markers (BTMs), including serum N-terminal procollagen of type I collagen (P1NP), beta C-terminal cross-linked of type I collagen (β-CTX), 25-hydroxyvitamin D [25(OH)D], and parathyroid hormone (PTH), and to investigate relationships between these markers and bone mineral density (BMD) as well the prevalence of osteoporosis in postmenopausal women of suburban district. METHODS A population of 4822 postmenopausal women aged 55-69 years old (62.22 ± 6.75) from the suburban district was recruited voluntarily. BMD was measured at the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry; 2251 women in this group had the serum BTMs 25(OH)D and PTH tested. RESULTS The prevalence of osteoporosis was 25.03 % at lumbar spine and 6.23 % at femoral neck. The median (interquartile range) values of serum P1NP, β-CTX, 25(OH)D, and PTH were 59.3 ng/mL (44.7-75.52), 0.370 ng/mL (0.280-0.490), 23.0 ng/mL (17.1-30.5), and 31.4 pg/mL (24.9-39.7), respectively. Serum P1NP and β-CTX levels presented significantly negative correlations with BMDs at the all the sites (Betastd = -0.098 to -0.208, respectively, P < 0.001), whereas PTH levels were negatively correlated with BMDs of the femoral neck and total hip (Betastd = -0.062 and -0.054, P < 0.01, respectively). Serum 25(OH)D had positive associations with BMDs at total hip (Betastd = 0.051, P < 0.01). CONCLUSIONS The BMD of postmenopausal women in China suburban area is higher than that in downtown area, and over 60 % of the participants had their serum 25(OH)D level over 20 ng/mL. BTMs were negatively correlated with BMDs, suggesting that BTMs are reliable factors for early declines in BMD.
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Affiliation(s)
- C Gao
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - J Qiao
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - S S Li
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - W J Yu
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - J W He
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - W Z Fu
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China
| | - Z L Zhang
- Metabolic Bone Disease and Genetic Research Unit, Division of Osteoporosis and Bone Diseases, Department of Endocrinology and Metabolism, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 200233, China.
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Reider L, Beck T, Alley D, Miller R, Shardell M, Schumacher J, Magaziner J, Cawthon PM, Barbour KE, Cauley JA, Harris T. Evaluating the relationship between muscle and bone modeling response in older adults. Bone 2016; 90:152-8. [PMID: 27352990 PMCID: PMC5494965 DOI: 10.1016/j.bone.2016.06.012] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 06/14/2016] [Accepted: 06/20/2016] [Indexed: 12/25/2022]
Abstract
Bone modeling, the process that continually adjusts bone strength in response to prevalent muscle-loading forces throughout an individual's lifespan, may play an important role in bone fragility with age. Femoral stress, an index of bone modeling response, can be estimated using measurements of DXA derived bone geometry and loading information incorporated into an engineering model. Assuming that individuals have adapted to habitual muscle loading forces, greater stresses indicate a diminished response and a weaker bone. The purpose of this paper was to evaluate the associations of lean mass and muscle strength with the femoral stress measure generated from the engineering model and to examine the extent to which lean mass and muscle strength account for variation in femoral stress among 2539 healthy older adults participating in the Health ABC study using linear regression. Mean femoral stress was higher in women (9.51, SD=1.85Mpa) than in men (8.02, SD=1.43Mpa). Percent lean mass explained more of the variation in femoral stress than did knee strength adjusted for body size (R(2)=0.187 vs. 0.055 in men; R(2)=0.237 vs. 0.095 in women). In models adjusted for potential confounders, for every percent increase in lean mass, mean femoral stress was 0.121Mpa lower (95% CI: -0.138, -0.104; p<0.001) in men and 0.139Mpa lower (95% CI: -0.158, -0.121; p<0.001) in women. The inverse association of femoral stress with lean mass and with knee strength did not differ by category of BMI. Results from this study provide insight into bone modeling differences as measured by femoral stress among older men and women and indicate that lean mass may capture elements of bone's response to load.
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Affiliation(s)
- Lisa Reider
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, United States.
| | - Thomas Beck
- Beck Radiological Innovations, Inc., United States
| | - Dawn Alley
- Center for Medicare and Medicaid Innovation, Centers for Medicare and Medicaid Services, Baltimore, MD, United States
| | - Ram Miller
- Novartis Institute for Biomedical Research, United States; Department of Epidemiology and Public Health, University of Maryland, School of Medicine, United States
| | - Michelle Shardell
- National Institute on Aging, Longitudinal Study Section, United States
| | - John Schumacher
- Department of Sociology and Anthropology, University of Maryland Baltimore County, United States
| | - Jay Magaziner
- University of Maryland, School of Medicine, United States
| | - Peggy M Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA, United States; Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, United States
| | - Kamil E Barbour
- National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control, United States
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, United States
| | - Tamara Harris
- Laboratory of Epidemiology and Population Sciences Intramural Research Program, National Institute on Aging, United States
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Prior JC, Hitchcock CL, Vigna YM, Seifert-Klauss V. Premenopausal Trabecular Bone Loss is Associated with a Family History of Fragility Fracture. Geburtshilfe Frauenheilkd 2016; 76:895-901. [PMID: 27582584 DOI: 10.1055/s-0042-103751] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
INTRODUCTION Although a fragility fracture family history (FFFH+) has repeatedly been shown to be associated with lower bone mineral density (BMD), its relationship to human BMD change is unclear. Animal research, however, documented that different purebred strains within rodent species have wide ranges in rates of bone acquisition during growth as well as in change post-ovariectomy. Our objective was to compare the rate of premenopausal spinal trabecular BMD change between women with and without a general family history of fragility fracture. PARTICIPANTS AND METHODS Healthy premenopausal community women participated in prospective observational studies at two academic medical research centres: Vancouver, Canada (n = 66) and Munich, Germany (n = 20). The primary outcome was annual spinal BMD change, measured by quantitative computed tomography (QCT). The two studies employed similar methodologies for assessing QCT and FFFH. RESULTS Volunteer community participants had a mean age of 36.0 (SD, 6.9) years, body mass index 22.5 (2.4) and baseline QCT of 150.2 (22.5) mg/cm3 trabecular bone. The rates of BMD change were similar in both cities: - 3.5 (5.1)/year Vancouver, - 2.0 (3.4)/year Munich (95 % CI of difference: - 3.9, 0.9). Over a third of the women (31 of the 86, 36 %) reported FFFH+. Those with and without a FFFH were similar in demographics, nutrition, exercise, menstrual cycle and luteal phase lengths and physiological measures (serum calcium, osteocalcin and estradiol). However, women with FFFH+ lost trabecular BMD more rapidly: FFFH+, - 4.9 (5.0), FFFH-, - 2.2 (4.4) mg/cm3/year (95 % CI diff - 0.7 to - 4.8, F1.83 = 7.88, p = 0.006). FFFH+ explained 7.7 % of the variance in QCT volumetric trabecular spinal bone change/year in these healthy premenopausal women. CONCLUSION This study shows for the first time that having a history of a fragility fracture in a family member is associated with a greater rate of premenopausal spinal trabecular bone loss.
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Affiliation(s)
- J C Prior
- Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada; Dept. of Medicine, University of British Columbia, Vancouver, BC, Canada; Vancouver Coastal Health Research Institute, Vancouver, BC, Canada
| | - C L Hitchcock
- Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Y M Vigna
- Centre for Menstrual Cycle and Ovulation Research, Division of Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - V Seifert-Klauss
- Frauenklinik und Poliklinik, Gynecologic Endocrinology and Interdisciplinary Osteoporosis Center (IOZ), Klinikum rechts der Isar, TUM Munich, Germany
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Abstract
Low bone mineral density is a strong risk factor for fractures in the older woman. Biochemical markers of bone turnover may predict fracture risk independently of bone mineral density. High levels of bone resorption markers are associated with increased risk of fracture in both retrospective and prospective studies, although the evidence for bone formation markers and fracture risk is equivocal. For example, the risk of fracture is increased up to two-fold in women with elevated levels of several markers of bone resorption. Prediction models have been developed to predict the 10–year risk of fracture using bone mineral density and biochemical markers of bone turnover and these could prove very useful in clinical practice.
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Noble P, Singer ER, Jeffery NS. Does subchondral bone of the equine proximal phalanx adapt to race training? J Anat 2016; 229:104-13. [PMID: 27075139 PMCID: PMC5341590 DOI: 10.1111/joa.12478] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/04/2016] [Indexed: 11/29/2022] Open
Abstract
Sagittal fractures of the first phalanx are a common, potentially catastrophic injury in racehorses. These fractures are often linked to an acute, one time, biomechanical event; however, recent evidence implies that chronic exposure to stress can lead to the accumulation of bony changes that affect the structural integrity of the bone and increase the likelihood of fracture. The aim of the study was to compare variations of two common metrics of bone adaptation - subchondral bone density and thickness across the proximal articular surface of the first phalanx in Thoroughbred horses that (1) raced but never experienced a first phalanx fracture (Raced Control); (2) raced and had experienced fracture of the contralateral first phalanx (Contralateral to Fracture); (3) had never raced or experienced a first phalanx fracture (Unraced Control). A total of 22 first phalangeal bones were sampled post-mortem and imaged using micro-computed tomography calibrated for mineral density measures. Measurements of volumetric subchondral bone mineral density and thickness were taken from images at five sites from medial to lateral, in three coronal planes (25, 50 and 75% dorsal-palmar). At each of the 15 sites, measurements were repeated and averaged across 10 adjacent micro-computed tomography slices of bone, spanning 0.75 mm. The magnitude and variance of these measurements were compared between sites and between cohorts with non-parametric statistical tests. Across the proximal osteochondral surface of the first phalanx, the pattern of subchondral bone volumetric bone mineral density and thickness varied with each coronal section studied. The subchondral bone thickness was greater for the central and dorsal coronal sections, compared with the palmar section. For the race-fit groups (Raced Control and Contralateral to Fracture), the highest volumetric bone mineral density was in the central sagittal groove. The volumetric bone mineral density was significantly greater in the sagittal groove in the central coronal section in the raced than the unraced group. The Contralateral to Fracture group demonstrated significantly greater variance of volumetric bone mineral density compared with the Raced Control and Unraced Control (P < 0.0001), with no difference in variance noted between the Raced Control and Unraced Control groups. There was a small (R rank = 0.3) but significant correlation between subchondral bone volumetric bone mineral density and thickness in the Contralateral to Fracture group (P = 0.005). The findings demonstrate that differences exist in subchondral bone volumetric bone mineral density and thickness across the proximal osteochondral surface of the equine first phalanx in horses with different training histories. The findings also demonstrate that the subchondral bone of the sagittal groove of the equine first phalanx adapts to race-training in the race-fit groups (Raced Control and Contralateral to Fracture) with an increase in volumetric bone mineral density relative to unraced controls. Within the race-trained groups, the Contralateral to Fracture bones had a greater variance of volumetric bone mineral density, suggesting that stress-induced bone adaptation had become more erratic, potentially contributing to the aetiology of sagittal fractures of the first phalanx in the Thoroughbred racehorse.
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Affiliation(s)
- Phillipa Noble
- School of Veterinary ScienceUniversity of LiverpoolLiverpoolUK
| | - Ellen R. Singer
- Department of Musculoskeletal BiologyInstitute of Ageing and Chronic DiseaseNestonUK
| | - Nathan S. Jeffery
- Department of Musculoskeletal BiologyInstitute of Ageing and Chronic DiseaseNestonUK
- Human Anatomy Resource CentreUniversity of LiverpoolLiverpoolUK
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Huo K, Hashim SI, Yong KLY, Su H, Qu QM. Impact and risk factors of post-stroke bone fracture. World J Exp Med 2016; 6:1-8. [PMID: 26929915 PMCID: PMC4759351 DOI: 10.5493/wjem.v6.i1.1] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 11/27/2015] [Accepted: 01/22/2016] [Indexed: 02/06/2023] Open
Abstract
Bone fracture occurs in stroke patients at different times during the recovery phase, prolonging recovery time and increasing medical costs. In this review, we discuss the potential risk factors for post-stroke bone fracture and preventive methods. Most post-stroke bone fractures occur in the lower extremities, indicating fragile bones are a risk factor. Motor changes, including posture, mobility, and balance post-stroke contribute to bone loss and thus increase risk of bone fracture. Bone mineral density is a useful indicator for bone resorption, useful to identify patients at risk of post-stroke bone fracture. Calcium supplementation was previously regarded as a useful treatment during physical rehabilitation. However, recent data suggests calcium supplementation has a negative impact on atherosclerotic conditions. Vitamin D intake may prevent osteoporosis and fractures in patients with stroke. Although drugs such as teriparatide show some benefits in preventing osteoporosis, additional clinical trials are needed to determine the most effective conditions for post-stroke applications.
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Nishimura T, Arima K, Abe Y, Kanagae M, Mizukami S, Okabe T, Tomita Y, Goto H, Horiguchi I, Aoyagi K. Relationship Between Urinary Cross-Linked N-Telopeptide of Type-I Collagen and Heel Stiffness Index Measured by Quantitative Ultrasound in Middle-Aged and Elderly Men. Medicine (Baltimore) 2015; 94:e1797. [PMID: 26554777 PMCID: PMC4915878 DOI: 10.1097/md.0000000000001797] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of the present study was to investigate the age-related patterns and the relationship between levels of urinary cross-linked N-telopeptide of type-I collagen (NTx) and heel stiffness index measured by quantitative ultrasound (QUS) in men with a special reference to age groups of aged 40 to 59 years and ≥60 years.A total of 379 men participated in this study. Heel stiffness index (bone mass) was measured by QUS. Spot urine samples were collected, and urinary NTx was measured. The values were corrected for creatinine (Cre) concentration.Stiffness index was significantly lower in men aged ≥60 years compared with men aged 40 to 59 years (P < 0.0001). There was no significant difference of Log (NTx/Cre) by 10-year age groups. Multiple regression analysis showed that higher level of urinary NTx/Cre was significantly correlated with lower stiffness index after adjusting for age and body mass index in men aged ≥60 years, but not in men aged 40 to 59 years.Higher rates of bone resorption were associated with lower stiffness index only in elderly men. Our results may indicate a different mechanism of low bone mass among different age groups.
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Affiliation(s)
- Takayuki Nishimura
- From the Department of Public Health (TN, KA, YA, TO, YT, KA), Nagasaki University Graduate School of Biomedical Sciences, Nagasaki; Department of Rehabilitation (MK, SM, TO, YT), Nishi-Isahaya Hospital, Isahaya; Goto Health Care Office (HG), Nagasaki; and Center for Public Relations Strategy (IH), Nagasaki University, Nagasaki, Japan
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Henriksen K, Christiansen C, Karsdal MA. Role of biochemical markers in the management of osteoporosis. Climacteric 2015; 18 Suppl 2:10-8. [DOI: 10.3109/13697137.2015.1101256] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Swanson CM, Srikanth P, Lee CG, Cummings SR, Jans I, Cauley JA, Bouillon R, Vanderschueren D, Orwoll ES, Nielson CM. Associations of 25-Hydroxyvitamin D and 1,25-Dihydroxyvitamin D With Bone Mineral Density, Bone Mineral Density Change, and Incident Nonvertebral Fracture. J Bone Miner Res 2015; 30:1403-13. [PMID: 25707402 PMCID: PMC4506713 DOI: 10.1002/jbmr.2487] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 02/06/2015] [Accepted: 02/18/2015] [Indexed: 12/22/2022]
Abstract
Relationships between 1,25-dihydroxyvitamin D (1,25(OH)2 D) and skeletal outcomes are uncertain. We examined the associations of 1,25(OH)2 D with bone mineral density (BMD), BMD change, and incident non-vertebral fractures in a cohort of older men and compared them with those of 25-hydroxyvitamin D (25OHD). The study population included 1000 men (aged 74.6 ± 6.2 years) in the Osteoporotic Fractures in Men (MrOS) study, of which 537 men had longitudinal dual-energy X-ray absorptiometry (DXA) data (4.5 years of follow-up). A case-cohort design and Cox proportional hazards models were used to test the association between vitamin D metabolite levels and incident nonvertebral and hip fractures. Linear regression models were used to estimate the association between vitamin D measures and baseline BMD and BMD change. Interactions between 25OHD and 1,25(OH)2 D were tested for each outcome. Over an average follow-up of 5.1 years, 432 men experienced incident nonvertebral fractures, including 81 hip fractures. Higher 25OHD was associated with higher baseline BMD, slower BMD loss, and lower hip fracture risk. Conversely, men with higher 1,25(OH)2 D had lower baseline BMD. 1,25(OH)2 D was not associated with BMD loss or nonvertebral fracture. Compared with higher levels of calcitriol, the risk of hip fracture was higher in men with the lowest 1,25(OH)2 D levels (8.70 to 51.60 pg/mL) after adjustment for baseline hip BMD (hazard ratio [HR] = 1.99, 95% confidence interval [CI] 1.19-3.33). Adjustment of 1,25(OH)2 D data for 25OHD (and vice versa) had little effect on the associations observed but did attenuate the hip fracture association of both vitamin D metabolites. In older men, higher 1,25(OH)2 D was associated with lower baseline BMD but was not related to the rate of bone loss or nonvertebral fracture risk. However, with BMD adjustment, a protective association for hip fracture was found with higher 1,25(OH)2 D. The associations of 25OHD with skeletal outcomes were generally stronger than those for 1,25(OH)2 D. These results do not support the hypothesis that measures of 1,25(OH)2 D improve the ability to predict adverse skeletal outcomes when 25OHD measures are available. © 2015 American Society for Bone and Mineral Research.
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Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Priya Srikanth
- Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Christine G Lee
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,Research Service, Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Steven R Cummings
- California Pacific Medical Research Institute, San Francisco, CA, USA
| | - Ivo Jans
- Laboratory of Diagnostic Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Vanderschueren
- Laboratory of Diagnostic Medicine, KU Leuven, University Hospitals Leuven, Leuven, Belgium.,Laboratory of Clinical and Experimental Endocrinology, KU Leuven, University Hospitals Leuven, Leuven, Belgium
| | - Eric S Orwoll
- Division of Endocrinology, Oregon Health & Science University, Portland, OR, USA.,Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Carrie M Nielson
- Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA.,Department of Public Health and Preventive Medicine, Oregon Health & Science University, Portland, OR, USA
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Chen HL, Tung YT, Chuang CH, Tu MY, Tsai TC, Chang SY, Chen CM. Kefir improves bone mass and microarchitecture in an ovariectomized rat model of postmenopausal osteoporosis. Osteoporos Int 2015; 26:589-99. [PMID: 25278298 DOI: 10.1007/s00198-014-2908-x] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2014] [Accepted: 09/17/2014] [Indexed: 02/02/2023]
Abstract
SUMMARY Kefir treatment in ovariectomized (OVX) rats could significantly decrease the levels of bone turnover markers and prevent OVX-induced bone loss, deterioration of trabecular microarchitecture, and biomechanical dysfunction that may be due to increase intracellular calcium uptake through the TRPV6 calcium channel. INTRODUCTION Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to an increased fracture risk. The incidence of osteoporosis increases with age and occurs most frequently in postmenopausal women due to estrogen deficiency, as the balance between bone resorption and bone formation shifts towards increased levels of bone resorption. Among various methods of prevention and treatment for osteoporosis, an increase in calcium intake is the most commonly recommended preventive measure. Kefir is a fermented milk product made with kefir grains that degrade milk proteins into various peptides with health-promoting effects, including immunomodulating-, antithrombotic-, antimicrobial-, and calcium-absorption-enhancing bioactivities. METHODS The aim of this study is to investigate the effect of kefir on osteoporosis prophylaxis in an ovariectomized rat model. A total of 56 16-week-old female Sprague-Dawley (SD) rats were divided into 7 experimental groups: sham (normal), OVX/Mock, OVX/1X kefir (164 mg/kg BW/day), OVX/2X kefir (328 mg/kg BW/day), OVX/4X kefir (656 mg/kg BW/day), OVX/ALN (2.5 mg/kg BW/day), and OVX/REBONE (800 mg/kg BW/day). After 12-week treatment with kefir, the bone physiology in the OVX rat model was investigated. Accordingly, the aim of this study was to investigate the possible transport mechanism involved in calcium absorption using the Caco-2 human cell line. RESULTS A 12-week treatment with kefir on the OVX-induced osteoporosis model reduced the levels of C-terminal telopeptides of type I collagen (CTx), bone turnover markers, and trabecular separation (Tb. Sp.). Additionally, treatment with kefir increased trabecular bone mineral density (BMD), bone volume (BV/TV), trabecular thickness (Tb. Th), trabecular number (Tb. N), and the biomechanical properties (hardness and modulus) of the distal femur with a dose-dependent efficacy. In addition, in in vitro assay, we found that kefir increased intracellular calcium uptake in Caco-2 cell through TRPV6 calcium channels and not through L-type voltage-operated calcium channels. CONCLUSION The protective effect of kefir in the OVX rat model may occur through increasing intracellular calcium uptake through the TRPV6 calcium channel.
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Affiliation(s)
- H-L Chen
- Department of Bioresources, Da-Yeh University, Changhwa, 515, Taiwan
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Osteoarthritis and bone mineral density: are strong bones bad for joints? BONEKEY REPORTS 2015; 4:624. [PMID: 25628884 PMCID: PMC4303262 DOI: 10.1038/bonekey.2014.119] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 11/19/2014] [Indexed: 02/02/2023]
Abstract
Osteoarthritis (OA) is a common and disabling joint disorder affecting millions of people worldwide. In OA, pathological changes are seen in all of the joint tissues including bone. Although both cross-sectional and longitudinal epidemiological studies have consistently demonstrated an association between higher bone mineral density (BMD) and OA, suggesting that increased BMD is a risk factor for OA, the mechanisms underlying this observation remain unclear. Recently, novel approaches to examining the BMD-OA relationship have included studying the disease in individuals with extreme high bone mass, and analyses searching for genetic variants associated with both BMD variation and OA, suggesting possible pleiotropic effects on bone mass and OA risk. These studies have yielded valuable insights into potentially relevant pathways that might one day be exploited therapeutically. Although animal models have suggested that drugs reducing bone turnover (antiresorptives) may retard OA progression, it remains to be seen whether this approach will prove to be useful in human OA. Identifying individuals with a phenotype of OA predominantly driven by increased bone formation could help improve the overall response to these treatments. This review aims to summarise current knowledge regarding the complex relationship between BMD and OA.
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Liu C, Fuertes E, Flexeder C, Hofbauer LC, Berdel D, Hoffmann B, Kratzsch J, von Berg A, Heinrich J. Associations between ambient air pollution and bone turnover markers in 10-year old children: results from the GINIplus and LISAplus studies. Int J Hyg Environ Health 2014; 218:58-65. [PMID: 25153026 DOI: 10.1016/j.ijheh.2014.07.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 07/21/2014] [Accepted: 07/25/2014] [Indexed: 11/16/2022]
Abstract
Negative associations between bone turnover markers and bone mineral density have been reported. In order to study the association between ambient air pollution and bone turnover markers, as indicators of bone loss, we investigated associations between land-use regression modeled air pollution (NO2, PM2.5 mass, PM2.5 - 10 [coarse particles], PM10 mass and PM2.5 absorbance) and bone turnover markers in 2264 children aged 10 years. Serum osteocalcin and C-terminal telopeptide of type I collagen (CTx), measured by Modular-System (Roche), were the two bone turnover markers considered in this analysis. In total population, NO2, PM2.5 - 10 and PM10 mass exposure were positively and significantly associated with both osteocalcin and CTx. A 2.5 (95% CI: 0.6, 4.4) ng/ml increase in osteocalcin and a 24.0 (95% CI: 6.7, 41.3) ng/L increase in CTx were observed per IQR (6.7μg/m(3)) increase in NO2, independent of socioeconomic status, sex, age, pubertal status, fasting status and total physical activity. The estimated coefficients were 3.0 (95% CI: 0.1, 5.8) for osteocalcin and 32.3 (95% CI: 6.1, 58.5) for CTx with PM2.5 - 10; 3.2 (95% CI: 0.0, 6.4) for osteocalcin and 30.7 (95% CI: 1.7, 59.7) for CTx with PM10. Children living close to a major road (≤ 350m) had higher levels of both osteocalcin (1.4 [-1.2, 4.0] ng/ml) and CTx (16.2 [-7.4, 39.8] ng/L). The adverse impact of ambient air pollution on bone turnover rates observed in one of the study areas showed stimulation of more such studies.
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Affiliation(s)
- Chuang Liu
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; Faculty of Medicine, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Elaine Fuertes
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany; School of Population and Public Health, The University of British Columbia, Vancouver, Canada
| | - Claudia Flexeder
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany
| | - Lorenz C Hofbauer
- Medizinische Klinik III, Universitätsklinikum Dresden, Dresden, Germany
| | - Dietrich Berdel
- Department of Pediatrics, Marien Hospital Wesel, Wesel, Germany
| | - Barbara Hoffmann
- IUF Leibniz Research Institute for Environmental Medicine and Medical Faculty, Heinrich-Heine-University of Düsseldorf, Düsseldorf, Germany
| | - Jürgen Kratzsch
- Institute of Laboratory Medicine, Clinical Chemistry and Molecular Diagnostics, University Hospital Leipzig, Leipzig, Germany
| | - Andrea von Berg
- Department of Pediatrics, Marien Hospital Wesel, Wesel, Germany
| | - Joachim Heinrich
- Helmholtz Zentrum München, German Research Centre for Environmental Health, Institute of Epidemiology I, Ingolstädter Landstraße 1, 85764 Neuherberg, Germany.
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Fındık Y, Baykul T. Effects of low-intensity pulsed ultrasound on autogenous bone graft healing. Oral Surg Oral Med Oral Pathol Oral Radiol 2014; 117:e255-60. [DOI: 10.1016/j.oooo.2012.05.023] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2012] [Revised: 04/26/2012] [Accepted: 05/29/2012] [Indexed: 12/22/2022]
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Luo L, Xia W, Nie M, Sun Y, Jiang Y, Zhao J, He S, Xu L. Association of ESR1 and C6orf97 gene polymorphism with osteoporosis in postmenopausal women. Mol Biol Rep 2014; 41:3235-43. [PMID: 24481879 DOI: 10.1007/s11033-014-3186-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 01/18/2014] [Indexed: 01/23/2023]
Abstract
The estrogen receptor 1 (ESR1) and Chromosome 6 Open Reading Frame 97 (C6orf97) gene polymorphisms were earlier reported to be associated with osteoporosis in the European cohort. The aim of this study was to investigate the association of four single nucleotide polymorphisms (SNP) with bone mineral density (BMD), fracture, vertebral fracture, bone turnover or 25-hydroxyvitamin D [25(OH)D] in 1,753 randomly selected postmenopausal women in China. Vertebral fracture, BMD of lumbar spine (2-4), femoral neck and total hip were measured respectively. Serum N-terminal procollagen of type 1 collagen (P1NP), β-isomerized type I collagen C-telopeptide breakdown products (β-CTX) and 25(OH)D3 were also determined. Binary logistic regression revealed significant associations between fracture risk with rs1999805 (P=0.041, OR 1.633, 95%CI 1.020-2.616) and rs6929137 (P=0.005, OR 1.932, 95%CI 1.226-3.045) in recessive model. Significant association was also observed between vertebral fracture risk and rs1038304 (P=0.039, OR 0.549, 95%CI 0.311-0.969) in recessive model. Liner regression analyses showed that only the CC group of rs4870044 was significantly associated with total hip in dominant model (P=0.034). Our findings suggest that ESR1 and C6orf97 gene polymorphism is associated with fracture and vertebral fracture risk in Chinese postmenopausal women.
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Affiliation(s)
- Lianmei Luo
- Department of Obstetrics and Gynecology & Beijing Tsinghua Chang Gung Hospital of Tsinghua University, Beijing, 102218, China
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Adami S, Palacios S, Rizzoli R, Levine AB, Sutradhar S, Chines AA. The efficacy and safety of bazedoxifene in postmenopausal women by baseline kidney function status. Climacteric 2013; 17:273-84. [PMID: 23937421 DOI: 10.3109/13697137.2013.830605] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
INTRODUCTION Two global, double-blind, placebo- and active-controlled, phase-3 studies (2-year prevention (n = 1583) and 3-year treatment (n = 7492)) have shown that bazedoxifene (BZA) is safe and effective for prevention and treatment of postmenopausal osteoporosis. OBJECTIVE To evaluate the efficacy/safety of BZA according to baseline kidney function. METHODS Data for the BZA 20- and 40-mg and placebo groups from both studies were integrated for assessment of bone turnover markers (BTMs), bone mineral density (BMD), and fracture incidence (treatment study only). Safety was assessed using integrated data for the BZA, placebo, and raloxifene 60-mg groups from both studies. Baseline glomerular filtration rate (GFR) was estimated by the Modification of Diet in Renal Disease Study equation; among subjects with baseline GFR, renal function categories were defined by GFR (ml/min per 1.73 m(2)): normal (GFR ≥ 90; n = 1982), mild impairment (60 ≤ GFR < 90; n = 6032), or moderate/severe impairment (GFR < 60; n = 723). RESULTS Demographics were similar across treatment groups and within GFR subgroups. Across GFR subgroups, BZA 20 and 40 mg reduced BTM levels and improved lumbar spine and total hip BMD versus placebo. At month 24, there were significant treatment-by-GFR (p = 0.003) and treatment-by-serum creatinine (p = 0.034) interactions for the increase in lumbar spine BMD versus placebo. Fracture incidence was lower with BZA than placebo across all GFR categories, with no treatment-by-GFR interaction. There were no significant differences among treatment groups in incidences of overall, serious, or renal-related adverse events across GFR subgroups. CONCLUSIONS Mild to moderate kidney impairment did not affect the efficacy and safety of BZA in postmenopausal women.
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Affiliation(s)
- S Adami
- University of Verona , Verona , Italy
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Kaufman JM, Palacios S, Silverman S, Sutradhar S, Chines A. An evaluation of the Fracture Risk Assessment Tool (FRAX®) as an indicator of treatment efficacy: the effects of bazedoxifene and raloxifene on vertebral, nonvertebral, and all clinical fractures as a function of baseline fracture risk assessed by FRAX®. Osteoporos Int 2013; 24:2561-9. [PMID: 23595562 DOI: 10.1007/s00198-013-2341-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2012] [Accepted: 03/06/2013] [Indexed: 12/25/2022]
Abstract
SUMMARY The relationship between baseline Fracture Risk Assessment Tool (FRAX®) and treatment efficacy was evaluated using data from a pivotal phase 3 study. Relative risk of vertebral, nonvertebral, and all clinical fractures decreased with increasing probability of fracture for bazedoxifene (BZA) versus placebo but remained generally constant for raloxifene (RLX). INTRODUCTION To determine whether the FRAX® predicts osteoporosis treatment efficacy, we evaluated reductions in fracture incidence associated with BZA and RLX according to baseline fracture risk determined by FRAX® using data from a phase 3 osteoporosis treatment study. METHODS Hazard ratios (HRs) for effects of BZA and RLX versus placebo on incidence of vertebral, nonvertebral, and all clinical fractures were calculated using a Cox regression model. Cox regression analyses were performed in subgroups at or above 10-year fracture probability thresholds determined by FRAX®. RESULTS HRs for the risk of vertebral, nonvertebral, and all clinical fractures versus placebo decreased with increasing 10-year fracture probability for BZA, while those for RLX remained stable. In all 10-year fracture probability subgroups, all BZA doses significantly reduced vertebral fracture risk versus placebo (HR = 0.22-0.66). BZA at 20, 40, and 20/40 mg significantly reduced risk of nonvertebral fractures (HR = 0.45, 0.44, and 0.45, respectively) and all clinical fractures (HR = 0.38, 0.41, and 0.40, respectively) for ≥20.0 % fracture probability. Vertebral fracture risk reductions for RLX 60 mg versus placebo were significant in subgroups at lower fracture probabilities (≥2.5- ≥ 10.0 %), but not higher (≥12.5 %), and in no subgroups for nonvertebral or all clinical fractures. CONCLUSION The antifracture efficacy of BZA increased with increasing baseline FRAX® score, but there was no clear relationship between RLX and baseline FRAX®. These findings provide independent confirmation of current literature, suggesting that the relationship between FRAX® and treatment efficacy varies for different agents.
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Affiliation(s)
- J-M Kaufman
- Department of Endocrinology and Unit for Osteoporosis and Metabolic Bone Diseases, Ghent University Hospital, Ghent, Belgium,
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Kanterewicz E, Peris P, Puigoriol E, Yáñez A, Rosique P, Del Rio L. Distribution of serum βCTX in a population-based study of postmenopausal women taking into account different anti-osteoporotic therapies (the FRODOS Cohort). J Bone Miner Metab 2013; 31:231-9. [PMID: 23223942 DOI: 10.1007/s00774-012-0410-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2011] [Accepted: 11/09/2012] [Indexed: 11/25/2022]
Abstract
This cross-sectional study evaluated the distribution of serum cross-linked C-telopeptides of collagen type I (βCTXs) in postmenopausal women, the characteristics of bone remodeling, and the factors influencing this bone marker, especially the use of anti-osteoporotic drugs. Women (n = 4,175) aged 59-70 years randomly selected from the community were invited to participate, measuring βCTXs and lumbar and femoral bone mineral density at recruitment. Risk factors for osteoporosis and the use of anti-osteoporotic treatment were collected with a structured questionnaire. We evaluated the percentage of women with increased (βCTXs >0.620 ng/mL) and decreased bone turnover (βCTXs <0.100 ng/mL) and those reaching the so-called treatment target (values of βCTXs within the lower half of the reference range for healthy young premenopausal women). Two thousand nine hundred sixty-eight women (70 %) participated (2,405 non-treated and 563 treated). Increased and decreased bone turnover was observed in 16.4 and 1.8 %, respectively, of non-treated women with significant differences compared with treated women (9.7 and 14.2 %, respectively, p < 0.001); 28 % of non-treated osteoporotic individuals had increased bone turnover versus 14 % of osteopenic participants and 8.8 % of women with normal bone density (p < 0.001). Women receiving bisphosphonates presented the highest percentages of decreased bone turnover (27 %) and βCTXs (43 %) within the treatment target. Increased bone turnover is observed in 16.4 % of non-treated postmenopausal women and is more frequent in individuals with osteoporosis, whereas decreased bone turnover is unusual. Most participants taking bisphosphonates had values within the treatment target, but nearly one quarter had decreased bone turnover.
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Affiliation(s)
- Eduardo Kanterewicz
- Rheumatology Unit, Hospital General de Vic, C/Francesc Pla, 1, 08500, Vic (Barcelona), Spain.
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Hu WW, Zhang Z, He JW, Fu WZ, Wang C, Zhang H, Yue H, Gu JM, Zhang ZL. Establishing reference intervals for bone turnover markers in the healthy shanghai population and the relationship with bone mineral density in postmenopausal women. Int J Endocrinol 2013; 2013:513925. [PMID: 23533403 PMCID: PMC3600195 DOI: 10.1155/2013/513925] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 01/10/2013] [Accepted: 01/11/2013] [Indexed: 11/17/2022] Open
Abstract
The reference ranges of bone turnover markers (BTMs) were important during the treatment of osteoporosis, and the associations with bone mineral density (BMD) were controversial. The aim of this study was to establish the reference ranges of N-terminal procollagen of type l collagen (P1NP), osteocalcin (OC), and beta C-terminal cross-linked telopeptides of type I collagen ( β -CTX) in Shanghai area and to investigate the relationships between BTMs and BMD in postmenopausal women. 2,799 subjects recruited in Shanghai City were measured BTMs to establish the reference ranges. Additional 520 healthy postmenopausal women were also measured BTMs, these women measured BMD in addition. BTMs were measured using the Roche electrochemiluminescence system. We used the age range of 35 to 45-year-olds to calculate reference intervals. The reference range of OC was 4.91 to 13.90 ng/mL for women and 5.58 to 16.57 ng/mL for men, P1NP was 13.72 to 32.90 ng/mL for women and 16.89 to 42.43 ng/mL for men, and β -CTX was 0.112 to 0.210 ng/mL for women and 0.100 to 0.378 ng/mL for men. BTMs significantly negatively correlated with lumbar spine and femoral and total hip in postmenopausal women (Betastd = -0.157 ~ -0.217, P < 0.001). We established the normal reference ranges of P1NP, OC, and β -CTX in the Shanghai area. This study also found that BTMs correlated with BMD and suggested that BTMs were the key determining factors of early BMD decreases.
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Affiliation(s)
- Wei-Wei Hu
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Zeng Zhang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Jin-Wei He
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Wen-Zhen Fu
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Chun Wang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Hao Zhang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Hua Yue
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Jie-Mei Gu
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
| | - Zhen-Lin Zhang
- Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Sixth People's Hospital Shanghai Jiao Tong University, 600 Yi-Shan Road, Shanghai 200233, China
- *Zhen-Lin Zhang:
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Guillaume N, Desoutter J, Chandesris O, Merlusca L, Henry I, Georgin-Lavialle S, Barete S, Hirsch I, Bouredji D, Royer B, Gruson B, Lok C, Sevestre H, Mentaverri R, Brazier M, Meynier J, Hermine O, Marolleau JP, Kamel S, Damaj G. Bone complications of mastocytosis: a link between clinical and biological characteristics. Am J Med 2013. [PMID: 23200108 DOI: 10.1016/j.amjmed.2012.07.018] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Mastocytosis is a heterogeneous group of clonal mast cell disorders in which bone manifestations are frequently seen, but poorly understood. In this study, we analyzed correlation of clinical findings in mastocytosis patients with bone mineral density and bone turnover markers. METHODS Serum levels of bone turnover markers were measured in mastocytosis patients and healthy volunteers. Bone disease was evaluated using radiographic imaging, and measurement of bone mineral density. RESULTS Of 45 adult mastocytosis patients, bone abnormalities were detected in 34 (75%). Bone lesions were documented on radiographic imaging in 16 patients (36%), and bone mineral density in 24 patients (53%), of which 9 patients (20%) had osteoporosis and 15 (33%) had osteopenia. Serum levels of bone turnover markers that evaluate bone resorption (C-telopeptide, deoxypyridinoline), bone formation (bone-specific alkaline phosphatase), and bone remodeling (osteoprotegerin) were significantly higher in the patient population than in the control population (n=28). Levels of C-telopeptide and osteoprotegerin were higher in patients with advanced systemic mastocytosis than in patients with cutaneous or indolent systemic mastocytosis. Moreover, C-telopeptide and osteoprotegerin levels were significantly correlated with those of serum tryptase, a diagnostic marker of mastocytosis. CONCLUSION The observed bone turnover markers variations indicate a complex process of bone turnover in mastocytosis-related bone manifestations. The highly significant correlation between serum tryptase and serum bone turnover markers levels, and the positive correlation of levels of bone turnover markers with advanced disease, support the existence of a link between bone remodeling and mast cell burden.
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Lin JC, Hsieh TY, Wu CC, Chen PJ, Chueh TH, Chang WK, Chu HC. Association between chronic hepatitis C virus infection and bone mineral density. Calcif Tissue Int 2012; 91:423-9. [PMID: 23052227 DOI: 10.1007/s00223-012-9653-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Accepted: 09/06/2012] [Indexed: 02/06/2023]
Abstract
Whether chronic hepatitis C virus (HCV) infection is a risk factor for the development of bone disease has long been controversial. For this reason, chronic HCV-infected participants (n = 69) were recruited into a prospective cohort study and underwent dual-energy X-ray absorptiometry for determination of bone mineral density (BMD). Fibrosis staging was evaluated according to the noninvasive index FIB-4. T scores at the femoral neck and lumbar spine were used as the primary outcome variables to assess the association between degree of liver disease and BMD. The study cohort was 41 % male with a mean age of 53.6 years. The mean BMD, Z score, and T score values of lumbar spine in chronic hepatitis C (CHC) patients were significantly lower than those in healthy controls (p < 0.001). The rate of osteoporosis for CHC patients aged 45-54 years was significantly higher than that of the control group (p = 0.011). Bone alkaline phosphatase and C-terminal cross-linking telopeptide of type I collagen levels were also significantly higher in CHC patients with reduced BMD. Patients with more advanced liver fibrosis had significantly lower BMD. In conclusion, reduced BMD is common in this population of chronic HCV-infected patients and associated with liver disease severity. This extrahepatic manifestation is probably secondary to increased bone turnover in osteodystrophy pathogenesis.
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Affiliation(s)
- Jung-Chun Lin
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
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Zanatta M, Valenti MT, Donatelli L, Zucal C, Dalle Carbonare L. Runx-2 gene expression is associated with age-related changes of bone mineral density in the healthy young-adult population. J Bone Miner Metab 2012; 30:706-14. [PMID: 22903460 DOI: 10.1007/s00774-012-0373-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Accepted: 06/21/2012] [Indexed: 01/06/2023]
Abstract
Bone mineral density (BMD) and peak bone mass (PBM) are important determinants of skeletal resistance. The development of bone densitometry improved the possibility of studying BMD and the influence of genetic and environmental factors on bone. Heredity factors are important for BMD, and Runx-2 is accepted as a regulator of osteoblasts and bone formation. The aim of our study was to evaluate the behavior of Runx-2 during skeletal maturity in the healthy young-adult population. We analyzed spine and hip BMD in 153 volunteers, 98 women and 55 men, using dual-energy X-ray absorptiometry. In a subgroup of these volunteers, a sample of peripheral blood was taken to perform gene expression analysis of Runx-2 both in peripheral mesenchymal stem cells (MSCs; 28 subjects) and in peripheral mononuclear cells (PBMCs; 140 subjects). In our work BMD was comparable in both genders after puberty, then became higher in men than women during the third and fourth decades. PBM was achieved in the third decade in women and in the fourth in men. More interestingly, Runx-2 gene expression highly correlated with BMD in both genders. MSCs and PBMCs showed the same gene expression profile of Runx-2. In conclusion, PBM is reached earlier in females, BMD becomes higher in males later in life, and BMD and PBM are strictly associated with Runx-2. In addition, PBMC should be considered an important source for gene expression analysis in bone diseases.
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Affiliation(s)
- Mirko Zanatta
- Department of Medicine, Clinic of Internal Medicine, Section D, University of Verona, Piazzale Scuro, Verona, Italy
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Hou JM, Xue Y, Lin QM. Bovine lactoferrin improves bone mass and microstructure in ovariectomized rats via OPG/RANKL/RANK pathway. Acta Pharmacol Sin 2012; 33:1277-84. [PMID: 22902986 DOI: 10.1038/aps.2012.83] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
AIM Lactoferrin (LF), an 80-kDa iron-binding glycoprotein, is a pleiotropic factor found in colostrum, milk, saliva and epithelial cells of the exocrine glands. The aim of this study was to evaluate the effects of LF on the bones in ovariectomized (Ovx) rats and to identify the pathways that mediate the anabolic action of LF on the bones. METHODS Female Sprague-Dawley rats (6-month-old) underwent ovariectomy, and were treated with different doses of LF (10, 100, 1000, and 2000 mg·kg(-1)·d(-1), po) or with 7β-estradiol (0.1 mg·kg(-1), im, each week) as the positive control. By the end of 6 month-treatments, the bone mass and microstructure in the rats were scanned by micro-computed tomography (micro-CT), and the bone metabolism was evaluated with specific markers, and the mRNA levels of osteoprotegerin (OPG) and the receptor-activator of nuclear factor κB ligand (RANKL) in femur were measured using qRT-PCR. RESULTS LF treatment dose-dependently elevated the bone volume (BV/TV), trabecular thickness (TbTh) and trabecular number (TbN), and reduced the trabecular separation (TbSp) in Ovx rats. Furthermore, higher doses of LF (1000 and 2000 mg·kg(-1)·d(-1)) significantly increased the bone mineral density (BMD) compared with the untreated Ovx rats. The higher doses of LF also significantly increased the serum levels of OC and BALP, and decreased the serum levels of β-CTx and NTX. LF treatment significantly increased the OPG mRNA levels, and suppressed the RANKL mRNA levels, and the RANKL/OPG mRNA ratio in Ovx rats. CONCLUSION Oral administration of LF preserves the bone mass and improves the bone microarchitecture. LF enhances bone formation, reduces bone resorption, and decreases bone mass loss, possibly through the regulation of OPG/RANKL/RANK pathway.
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Bauer D, Krege J, Lane N, Leary E, Libanati C, Miller P, Myers G, Silverman S, Vesper HW, Lee D, Payette M, Randall S. National Bone Health Alliance Bone Turnover Marker Project: current practices and the need for US harmonization, standardization, and common reference ranges. Osteoporos Int 2012; 23:2425-33. [PMID: 22797491 PMCID: PMC4011662 DOI: 10.1007/s00198-012-2049-z] [Citation(s) in RCA: 109] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2012] [Accepted: 06/05/2012] [Indexed: 11/18/2022]
Abstract
UNLABELLED This position paper reviews how the National Bone Health Alliance (NBHA) will execute a project to help assure health professionals of the clinical utility of bone turnover markers; the current clinical approaches concerning osteoporosis and the status and use of bone turnover markers in the USA; the rationale for focusing this effort around two specific bone turnover markers; the need to standardize bone marker sample collection procedures, reference ranges, and bone turnover marker assays in clinical laboratories; and the importance of harmonization for future research of bone turnover markers. INTRODUCTION Osteoporosis is a major global health problem, with the prevalence and incidence of osteoporosis for at-risk populations estimated to be 44 million Americans. The potential of bone markers as an additional tool for health care professionals to improve patient outcomes and impact morbidity and mortality is crucial in providing better health care and addressing rising health care costs. This need to advance the field of bone turnover markers has been recognized by a number of organizations, including the International Osteoporosis Foundation (IOF), National Osteoporosis Foundation, International Federation of Clinical Chemistry, and Laboratory Medicine (IFCC), and the NBHA. METHODS This position paper elucidates how this project will standardize bone turnover marker sample collection procedures in the USA, establish a USA reference range for one bone formation (serum procollagen type I N propeptide, s-PINP) and one bone resorption (serum C-terminal telopeptide of type I collagen, s-CTX) marker, and standardize bone turnover marker assays used in clinical laboratories. This effort will allow clinicians from the USA to have confidence in their use of bone turnover markers to help monitor osteoporosis treatment and assess future fracture risk. This project builds on the recommendations of the IOF/IFCC Bone Marker Standards Working Group by developing USA reference standards for s-PINP and s-CTX, the markers identified as most promising for use as reference markers. RESULTS The goals of this project will be realized through the NBHA and will include its governmental, academic, for-profit, and non-profit sector stakeholders as well as major academic and commercial laboratories. Upon completion, a parallel effort will be pursued to make bone turnover marker measurements reliable and accepted by all health care professionals for facilitating treatment decisions and ultimately be reimbursed by all health insurance payers. CONCLUSIONS Successful completion of this project will help assure health professionals from the USA of the clinical utility of bone turnover markers and ties in with the parallel effort of the IOF/IFCC to develop worldwide bone turnover reference ranges.
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Affiliation(s)
- D Bauer
- University of California, San Francisco, USA.
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