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Welsh H, Brickley MB. Investigating femoral growth disruption in subadults from the 10th-13th century St. Étienne cemetery of Toulouse, France. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 185:e24984. [PMID: 38899835 DOI: 10.1002/ajpa.24984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 05/27/2024] [Accepted: 06/02/2024] [Indexed: 06/21/2024]
Abstract
OBJECTIVES The skeleton embodies an individual's environment and lived experiences. Studying childhood growth disruption can, therefore, aid in understanding the experiences of children in the past. This study evaluates growth disruption in a medieval Toulousian subadult sample to explore factors that may have influenced childhood growth and mortality at this site and to assess the utility of Harris line (HL) interpretations in bioarchaeology. MATERIALS AND METHODS Femoral growth disruption was assessed in n = 71 subadults (0.125-12.42 years) from the 10th-13th century St. Étienne cemetery of Toulouse, France, using femoral length, total area, cortical area, and relative cortical area. Femoral radiographs were assessed for HLs. To determine the prevalence of growth disruption, z-scores were calculated using data from the Denver growth study. RESULTS The majority of subadults in this sample suffered from femoral growth disruption. Young children (1.0-3.99 years) were the most affected, with >65% experiencing reduced appositional growth and linear growth stunting at time-of-death. Additionally, while many individuals presented with observable HLs, linear and appositional growth did not significantly differ between individuals with and without HLs. DISCUSSION Maternal malnutrition and inadequate complementary feeding practices likely contributed to the high prevalence of growth disruption among the youngest individuals in the study. The older children and adolescents buried at St. Étienne experienced an amelioration in growth deficits, indicating an improvement in nutrition and/or disease load. The results of this study suggest that more consideration is required when interpreting the presence/absence of HLs, and that studies assessing HLs may benefit from using a more individualistic approach.
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Affiliation(s)
- H Welsh
- Department of Anthropology, University of Toronto, Toronto, Ontario, Canada
| | - M B Brickley
- Department of Anthropology, McMaster University, Hamilton, Ontario, Canada
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Vore AS, Marsland P, Barney TM, Varlinskaya EI, Landin JD, Healey KL, Kibble S, Swartzwelder HS, Chandler LJ, Deak T. Adolescent intermittent ethanol (AIE) produces lasting, sex-specific changes in rat body fat independent of changes in white blood cell composition. Front Physiol 2024; 15:1285376. [PMID: 38332987 PMCID: PMC10851431 DOI: 10.3389/fphys.2024.1285376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/10/2024] [Indexed: 02/10/2024] Open
Abstract
Early initiation of alcohol use during adolescence, and adolescent binge drinking are risk factors for the development of alcohol use disorder later in life. Adolescence is a time of rapid sex-dependent neural, physiological, and behavioral changes as well as a period of heightened vulnerability to many effects of alcohol. The goal of the present studies was to determine age-related changes in blood (leukocyte populations) and body composition across adolescence and early adulthood, and to investigate whether adolescent intermittent ethanol (AIE) exposure would alter the trajectory of adolescent development on these broad physiological parameters. We observed significant ontogenetic changes in leukocyte populations that were mirrored by an age-related increase in cytokine expression among mixed populations of circulating leukocytes. Despite these developmental changes, AIE did not significantly alter overall leukocyte numbers or cytokine gene expression. However, AIE led to sex-specific changes in body fat mass and fat percentage, with AIE-exposed male rats showing significantly decreased fat levels and female rats showing significantly increased fat levels relative to controls. These changes suggest that while AIE may not alter overall leukocyte levels, more complex phenotypic changes in leukocyte populations could underlie previously reported differences in cytokine expression. Coupled with long-term shifts in adipocyte levels, this could have long-lasting effects on innate immunity and the capacity of individuals to respond to later immunological and physiological threats.
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Affiliation(s)
- Andrew S. Vore
- Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States
| | - Paige Marsland
- Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States
| | - Thaddeus M. Barney
- Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States
| | - Elena I. Varlinskaya
- Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States
| | - Justine D. Landin
- Department of Neurosciences, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC, United States
| | - Kati L. Healey
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Sandra Kibble
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - H. S. Swartzwelder
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States
| | - Lawrence J. Chandler
- Department of Neurosciences, Charleston Alcohol Research Center, Medical University of South Carolina, Charleston, SC, United States
| | - Terrence Deak
- Developmental Exposure Alcohol Research Center, Binghamton University-SUNY, Binghamton, NY, United States
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Blum AGR, Russo TDH, Nogueira RJN. Dual x-ray absorptiometry monitoring in pediatric short bowel syndrome: an integrative review. REVISTA PAULISTA DE PEDIATRIA : ORGAO OFICIAL DA SOCIEDADE DE PEDIATRIA DE SAO PAULO 2023; 42:e2023064. [PMID: 38126603 PMCID: PMC10742346 DOI: 10.1590/1984-0462/2024/42/2023064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 09/03/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE To analyze the bone health of pediatric patients with short bowel syndrome intestinal failure (SBS-IF). DATA SOURCE An integrative literature review was performed using the data published in the MEDLINE-PubMed and Scientific Electronic Library Online (SciELO) databases between January 2010 and April 2021, and through a manual search of the reference lists of relevant studies. Studies were included if they assessed bone mineral density by the Dual X-Ray Absorptiometry (DXA) technique, incorporated pediatric patients (up to 20 years of age) with SBS under parenteral nutrition (PN) and were written in English. Eleven primary sources met the inclusion criteria for this study. DATA SYNTHESIS Pediatric patients with SBS-IF under long-term parenteral nutrition experienced frequent changes in bone metabolism, leading to osteoporotic fractures and growth failure. These patients have deficiencies in multiple nutrients, such as calcium, magnesium, phosphorus, and vitamin D. Consequently, there are variations in the secretion and regulation of the parathyroid hormone. In addition, the pharmacotechnical limitations related to calcium and phosphorus in the PN solution, use of glucocorticoids, and difficulty performing physical activity are risk factors for the development of metabolic bone disease in pediatric patients with SBS-IF. CONCLUSIONS Low bone mineral density was associated with a high risk of developing osteoporosis, fractures, and growth deficiency in pediatric patients with SBS-IF on PN therapy in the long term.
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Whittier DE, Bevers MSAM, Geusens PPMM, van den Bergh JP, Gabel L. Characterizing Bone Phenotypes Related to Skeletal Fragility Using Advanced Medical Imaging. Curr Osteoporos Rep 2023; 21:685-697. [PMID: 37884821 PMCID: PMC10724303 DOI: 10.1007/s11914-023-00830-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2023] [Indexed: 10/28/2023]
Abstract
PURPOSE OF REVIEW Summarize the recent literature that investigates how advanced medical imaging has contributed to our understanding of skeletal phenotypes and fracture risk across the lifespan. RECENT FINDINGS Characterization of bone phenotypes on the macro-scale using advanced imaging has shown that while wide bones are generally stronger than narrow bones, they may be more susceptible to age-related declines in bone strength. On the micro-scale, HR-pQCT has been used to identify bone microarchitecture phenotypes that improve stratification of fracture risk based on phenotype-specific risk factors. Adolescence is a key phase for bone development, with distinct sex-specific growth patterns and significant within-sex bone property variability. However, longitudinal studies are needed to evaluate how early skeletal growth impacts adult bone phenotypes and fracture risk. Metabolic and rare bone diseases amplify fracture risk, but the interplay between bone phenotypes and disease remains unclear. Although bone phenotyping is a promising approach to improve fracture risk assessment, the clinical availability of advanced imaging is still limited. Consequently, alternative strategies for assessing and managing fracture risk include vertebral fracture assessment from clinically available medical imaging modalities/techniques or from fracture risk assessment tools based on clinical risk factors. Bone fragility is not solely determined by its density but by a combination of bone geometry, distribution of bone mass, microarchitecture, and the intrinsic material properties of bone tissue. As such, different individuals can exhibit distinct bone phenotypes, which may predispose them to be more vulnerable or resilient to certain perturbations that influence bone strength.
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Affiliation(s)
- Danielle E Whittier
- McCaig Institute for Bone and Joint Health and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada.
- Department of Cell Biology and Anatomy, University of Calgary, Calgary, Canada.
| | - Melissa S A M Bevers
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Biomedical Engineering, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - Piet P M M Geusens
- Subdivision of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium
| | - Joop P van den Bergh
- Department of Internal Medicine, VieCuri Medical Center, Venlo, The Netherlands
- NUTRIM School for Nutrition and Translational Research In Metabolism, Maastricht University Medical Center, Maastricht, The Netherlands
- Subdivision of Rheumatology, Department of Internal Medicine, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health and Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Canada
- Human Performance Laboratory, Faculty of Kinesiology, University of Calgary, Calgary, Canada
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Wu TM, Chin LS. Spontaneous long bone fractures in metabolic bone disease of prematurity: A case series and literature review. J Orthop Sci 2023; 28:1518-1524. [PMID: 34711491 DOI: 10.1016/j.jos.2021.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 08/02/2021] [Accepted: 08/22/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Tsung-Mu Wu
- Chi-Mei Medical Center, Orthopedic Department, No.901, Zhonghua Rd., Yongkang Dist., Tainan City, Taiwan.
| | - Lin-Shaw Chin
- Chi-Mei Medical Center, Orthopedic Department, No.901, Zhonghua Rd., Yongkang Dist., Tainan City, Taiwan.
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Dodo M, Ota C, Ishikawa M, Koseki I, Sugawara J, Tatsuta N, Arima T, Yaegashi N, Koseki T. Timing of Primary Tooth Eruption in Infants Observed by Their Parents. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1730. [PMID: 38002821 PMCID: PMC10670756 DOI: 10.3390/children10111730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Revised: 09/29/2023] [Accepted: 10/18/2023] [Indexed: 11/26/2023]
Abstract
BACKGROUND The timing of primary teeth eruption is a visible indicator of infant physical growth other than body weight or height. It also reflects neurological integrity and development as well as nutrition, socioeconomic state, or underlying diseases. Therefore, the timing of primary teeth eruption is one of the major concerns for parents in health checkups for infants and children. However, the detailed developmental timing of teeth eruption differs depending on the survey methodology, country, or generation. We hypothesized that the timing of primary teeth eruption differs between the medical checkup by dentists and the daily records by parents. METHODS We conducted a questionnaire survey on the date of eruption of primary teeth as an adjunct study among Miyagi Regional Center participants in the Japan Environment and Children's Study (JECS), a large-scale birth cohort study. A total of 1695 responses (3793 participants) were analyzed. RESULTS The median ages of eruption were 7.1 months (male) and 7.6 months (female) for mandibular primary central incisors, 8.7 months (male) and 9.2 months (female) for maxillary primary central incisors, 10.0 months (male) and 10.3 months (female) for maxillary primary lateral incisors, and 10.4 months (male) and 10.8 months (female) for mandibular primary lateral incisors, which were earlier than the reported timings based on dental check-ups. Comparing the eruption time of preterm and term infants, the eruption time was earlier in preterm infants in the corrected ages. CONCLUSIONS The eruption timing observed and described by the parents is earlier than that examined by dentists at regular check-ups. In addition to examining the primary teeth eruption of full-term birth children, we also examined that of preterm birth children because of the increasing number of premature births. To the best of our knowledge, this is the first report from a large cohort study to clarify the eruption time of primary teeth monitored by parents.
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Affiliation(s)
- Mina Dodo
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.D.); (M.I.); (I.K.); (T.K.)
| | - Chiharu Ota
- Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
- Department of Pediatrics, Tohoku University Hospital, Sendai 980-8574, Japan
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (J.S.); (T.A.); (N.Y.)
| | - Motohiro Ishikawa
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.D.); (M.I.); (I.K.); (T.K.)
| | - Ichie Koseki
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.D.); (M.I.); (I.K.); (T.K.)
| | - Junichi Sugawara
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (J.S.); (T.A.); (N.Y.)
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Nozomi Tatsuta
- Development and Environmental Medicine, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan;
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (J.S.); (T.A.); (N.Y.)
| | - Takahiro Arima
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (J.S.); (T.A.); (N.Y.)
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Nobuo Yaegashi
- Environment and Genome Research Center, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan; (J.S.); (T.A.); (N.Y.)
- Department of Obstetrics and Gynecology, Tohoku University Graduate School of Medicine, Sendai 980-8575, Japan
| | - Takeyoshi Koseki
- Division of Preventive Dentistry, Tohoku University Graduate School of Dentistry, Sendai 980-8575, Japan; (M.D.); (M.I.); (I.K.); (T.K.)
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Diamond TH, Bryant C, Quinn R, Mohanty ST, Bonar F, Baldock PA, McDonald MM. Increased Bone Formation and Accelerated Bone Mass Accrual in a Man Presenting with Diffuse Osteosclerosis/High Bone Mass Phenotype and Adenocarcinoma of Unknown Primary. JBMR Plus 2023; 7:e10734. [PMID: 37614304 PMCID: PMC10443075 DOI: 10.1002/jbm4.10734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 12/20/2022] [Accepted: 01/19/2023] [Indexed: 02/22/2023] Open
Abstract
A 71-year-old man was referred for evaluation of incidental generalized osteosclerosis. He was found to have a high bone mass (HBM) with an elevated lumbar spine bone mineral density (BMD) Z-score of +5.3. Over an 18-month period, his lumbar spine BMD measured by dual energy X-ray absorptiometry (DXA) had increased by +64% from 1.09 to 1.79 g/cm2 and femoral neck by +21% from 0.83 to 1.01 g/cm2. Biochemical markers of bone turnover were markedly increased (serum propeptide of type 1 collagen and urine telopeptides greater than 10-times normal). The high bone formation and increased skeletal calcium acquisition resulted in profound hypocalcemia (low serum calcium 1.88 mmol/L) and hypocalciuria (low urinary calcium <0.2 mmol/day). Positron emission tomography (PET) with 2-deoxy-2-[fluorine-18] fluoro-D-glucose (FDG) confirmed diffuse osteosclerosis without focal areas of abnormal FDG uptake in the skeleton or elsewhere to suggest either an underlying primary malignancy or metastatic disease. Bone biopsy showed markedly sclerotic woven and lamellar bone. The marrow space was devoid of typical bone cells and adipocytes and instead was filled by fibromyxoid stroma, infiltrated by small clusters of tumor cells. Bone histomorphometry and micro-computed tomography demonstrated an elevated trabecular bone volume and trabecular plate thickness. The bone disorder in this case is unique and raises the possibility of a new yet undefined novel anabolic paracrine factor (or factors) secreted by an adenocarcinoma of unknown primary that resulted in dramatic increases in BMD, HBM, and radiological osteosclerosis. The differential diagnosis and potential mechanisms responsible for the HBM are discussed. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Terrence H. Diamond
- Department of EndocrinologySt George Hospital Campus, University of New South WalesSydneyAustralia
| | - Carl Bryant
- Department of RadiologySt George Private HospitalSydneyAustralia
| | - Richard Quinn
- Department of Nuclear MedicineSt George Private HospitalSydneyAustralia
| | - Sindhu T. Mohanty
- Skeletal Diseases ProgramThe Garvan Institute of Medical ResearchDarlinghurstAustralia
| | - Fiona Bonar
- Department of Anatomical PathologyDouglass Hanly Moir Pathology and Royal Prince Alfred HospitalSydneyAustralia
| | - Paul A. Baldock
- Skeletal Diseases ProgramThe Garvan Institute of Medical ResearchDarlinghurstAustralia
- St Vincent's Clinical CampusSchool of Clinical Medicine, University of New South WalesKensingtonAustralia
| | - Michelle M. McDonald
- Skeletal Diseases ProgramThe Garvan Institute of Medical ResearchDarlinghurstAustralia
- St Vincent's Clinical CampusSchool of Clinical Medicine, University of New South WalesKensingtonAustralia
- School of Medicine Science, Faculty of Medicine and HealthThe University of SydneySydneyAustralia
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van Gemert MJC, Zwinderman AH, Koppen PJV, Neumann HAM, Vlaming M. Child Abuse, Misdiagnosed by an Expertise Center-Part II-Misuse of Bayes' Theorem. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10050843. [PMID: 37238391 DOI: 10.3390/children10050843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 04/26/2023] [Accepted: 05/04/2023] [Indexed: 05/28/2023]
Abstract
A newborn girl had, from two weeks on, small bruises on varying body locations, but not on her chest. Her Armenian grandmother easily bruised, too. Her mother was diagnosed with hypermobility-type Ehlers-Danlos-Syndrome (hEDS), an autosomal dominant connective tissue disorder, with a 50% inheritance probability. Referral to a University Medical Center located "Dutch Expertise Center for Child Abuse" resulted (prior to consultation) in physical abuse suspicion. Protocol-based skeletal X-rays showed three healed, asymptomatic rib fractures. A protocol-based Bayesian likelihood ratio guesstimation gave 10-100, erroneously used to suggest a 10-100 times likelier non-accidental-than-accidental cause. Foster care placement followed, even in a secret home, where she also bruised, suggesting hEDS inheritance. Correct non-accidental/accidental Bayes' probability of symptoms is (likelihood ratio) × (physical abuse incidence). From the literature, we derived an infant abuse incidence between about ≈0.0009 and ≈0.0026 and a likelihood ratio of <5 for bruises. For rib fractures, we used a zero likelihood ratio, arguing their cause was birth trauma from the extra delivery pressure on the chest, combined with fragile bones as the daughter of an hEDS-mother. We thus derived a negligible abuse/accidental probability between <5 × 0.0009 <0.005 and <5 × 0.0026 <0.013. The small abuse incidence implies that correctly using Bayes' theorem will also miss true infant physical abuse cases. Curiously, because likelihood ratios assess how more often symptoms develop if abuse did occur versus non-abuse, Bayes' theorem then implies a 100% infant abuse incidence (unwittingly) used by LECK. In conclusion, probabilities should never replace differential diagnostic procedures, the accepted medical method of care. Well-known from literature, supported by the present case, is that (child abuse pediatrics) physicians, child protection workers, and judges were unlikely to understand Bayesian statistics. Its use without statistics consultation should therefore not have occurred. Thus, Bayesian statistics, and certainly (misused) likelihood ratios, should never be applied in cases of physical child abuse suspicion. Finally, parental innocence follows from clarifying what could have caused the girl's bruises (inherited hEDS), and rib fractures (birth trauma from fragile bones).
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Affiliation(s)
- Martin J C van Gemert
- Department of Biomedical Engineering & Physics, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands
| | - Aeilko H Zwinderman
- Department of Clinical Epidemiology & Bio-Statistics, Amsterdam University Medical Centers, Location AMC, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Peter J van Koppen
- Department of Criminal Law and Criminology, Faculty of Law, VU University, 1081 HV Amsterdam, The Netherlands
| | | | - Marianne Vlaming
- Private Practice, Criminal Psychology and Law, 6986 CL Angerlo, The Netherlands
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Dienes B, Bazsó T, Szabó L, Csernoch L. The Role of the Piezo1 Mechanosensitive Channel in the Musculoskeletal System. Int J Mol Sci 2023; 24:ijms24076513. [PMID: 37047487 PMCID: PMC10095409 DOI: 10.3390/ijms24076513] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 03/23/2023] [Accepted: 03/27/2023] [Indexed: 04/03/2023] Open
Abstract
Since the recent discovery of the mechanosensitive Piezo1 channels, many studies have addressed the role of the channel in various physiological or even pathological processes of different organs. Although the number of studies on their effects on the musculoskeletal system is constantly increasing, we are still far from a precise understanding. In this review, the knowledge available so far regarding the musculoskeletal system is summarized, reviewing the results achieved in the field of skeletal muscles, bones, joints and cartilage, tendons and ligaments, as well as intervertebral discs.
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Gamsjaeger S, Rauch F, Glorieux FH, Paschalis EP. Cortical bone material / compositional properties in growing children and young adults aged 1.5-23 years, as a function of gender, age, metabolic activity, and growth spurt. Bone 2022; 165:116548. [PMID: 36122648 DOI: 10.1016/j.bone.2022.116548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/22/2022] [Accepted: 09/13/2022] [Indexed: 11/02/2022]
Abstract
Bone material / compositional properties are significant determinants of bone quality, thus strength. Raman spectroscopic analysis provides information on the quantity and quality of all three bone tissue components (mineral, organic matrix, and tissue water). The overwhelming majority of the published reports on the subject concern adults. We have previously reported on these properties in growing children and young adults, in the cancellous compartment. The purpose of the present study was to create normative reference data of bone material / compositional properties for children and young adults, in the cortical compartment. We performed Raman (Senterra (Bruker Optik GmbH), 50× objective, with an excitation of 785 nm (100 mW) and a lateral resolution of ~0.6 μm) microspectroscopic analysis of transiliac bone samples from 54 individuals between 1.5 and 23 years of age, with no known metabolic bone disease, and which have been previously used to establish histomorphometric, bone mineralization density distribution, and cancellous bone quality reference values. The bone quality indices that were determined were: mineral/matrix ratio (MM) from the integrated areas of the v2PO4 (410-460 cm-1) and the amide III (1215-1300 cm-1) bands, tissue water in nanopores approximated by the ratio of the integrated spectral area ~ 494-509 cm-1 to Amide III band, the glycosaminoglycan (GAG) content (ratio of integrated area 1365-1390 cm-1 to the Amide III band, the sulfated proteoglycan (sPG) content as the ratio of the integrated peaks ~1062 cm-1 and 1365-1390 cm-1, the pyridinoline (Pyd) content estimated from the ratio of the absorbance height at 1660 cm-1 / area of the amide I (1620-1700 cm-1) band, and the mineral maturity / crystallinity (MMC) estimated from the inverse of the full width at half height of the v1PO4 (930-980 cm-1) band. Analyses were performed at the three distinct cortical surfaces (endosteal, osteonal, periosteal) at specific anatomical microlocations, namely the osteoid, and the three precisely known tissue ages based on the presence of fluorescence double labels. Measurements were also taken in interstitial bone, a much older tissue that has undergone extensive secondary mineralization. Overall, significant dependencies of the measured parameters on tissue age were observed, while at any given tissue age, sex and subject age were minimal confounders. The established Raman database in the cortical compartments complements the previously published one in cancellous bone, and provides healthy baseline bone quality indices that may serve as a valuable tool to identify alterations due to pediatric disease.
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Affiliation(s)
- S Gamsjaeger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140 Vienna, Austria
| | - F Rauch
- Shriners Hospitals for Children and McGill University, Montreal, QC H4A 0A9, Canada
| | - F H Glorieux
- Shriners Hospitals for Children and McGill University, Montreal, QC H4A 0A9, Canada
| | - E P Paschalis
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Heinrich Collin Str. 30, A-1140 Vienna, Austria.
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Sahtout GF, Burhan AS, Nawaya FR. Effect of cigarette smoking on alveolar bone thickness and density in patients undergoing leveling and alignment of crowded lower anterior teeth: a controlled clinical trial. J Int Med Res 2022; 50:3000605221138461. [PMID: 36418930 PMCID: PMC9703496 DOI: 10.1177/03000605221138461] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 10/22/2022] [Indexed: 09/29/2023] Open
Abstract
OBJECTIVE To evaluate the effect of cigarette smoking on the alveolar bone thickness and density in patients undergoing leveling and alignment of crowded lower anterior teeth. METHODS This controlled clinical trial involved 17 smokers and 17 nonsmokers with mild to moderate crowding of the anterior mandibular teeth. Two cone-beam computed tomography images of the mandible were taken before and after treatment. The length of each tooth root was calculated in each T0 image, and the root was divided into three equal regions. Three lines were drawn parallel to the line of the cementoenamel junction at these three regions of the root, and the previously drawn lines were used to measure bone thickness and bone density. RESULTS The mean changes in cortical bone thickness and bone density were significantly smaller in smokers than nonsmokers. Cortical bone thickness and bone density were significantly lower after than before treatment in both smokers and nonsmokers. CONCLUSION In addition to all of its known dangers, cigarette smoking may also harm the alveolar bone by decreasing the bone thickness and density during orthodontic treatment in heavy smokers.
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Affiliation(s)
- Ghaith F Sahtout
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Ahmad S Burhan
- Department of Orthodontics and Dentofacial Orthopaedics, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Fehmieh R Nawaya
- Department of Pediatric Dentistry, Faculty of Dentistry, Syrian Private University, Damascus Countryside, Syria
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Freire Ribeiro AB, Bruininks BD, Street GM, Smock AJ, Scibora LM. Comparison of Tibial Geometry, Density, and Strength in College-Aged Female Eumenorrheic Dancers, Gymnasts, and Runners: A Peripheral Quantitative Computed Tomography Study. J Dance Med Sci 2022; 26:165-172. [PMID: 35697494 DOI: 10.12678/1089-313x.091522c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
INTRODUCTION Weightbearing activities such as gymnastics, soccer, weightlifting, and running have often been used as benchmarks in skeletal research since they have been shown to promote densitometric and geometric benefits. In comparison with other sports, there is a paucity of information in relation to dance and its osteogenic potential. OBJECTIVE This study aimed to compare tibial geometry, density, and strength in college-aged dancers versus gymnasts and runners. METHODS A total of 60 trained eumenorrheic collegiate-aged female dancers (n = 11), gymnasts (n = 11), runners (n = 19), and sedentary controls (n = 19) were included in the study. Bone measurements, including total area (ToA), volumetric (total vBMD) and cortical density (CoD), compressive bone strength (BSI), and polar strength stress index (SSIp) of the dominant limb, were assessed using peripheral quantitative computed tomography (pQCT) at the distal and proximal tibia (4% and 66% of limb length). RESULTS No significant differences in ToA, CoD, CoA, and total vBMD were found between dancers and the comparison athletes at the measured sites. In addition, strength indices (BSI and SSIp) at the distal and proximal sites were similar between the dancing and both athlete groups. CONCLUSION Results suggest dance elicits similar structural adaptations at the tibia compared to benchmark high-impact and repetitive impact sports; thus, indicating dance, in its various forms, can have a positive effect on important bone variables that influence density and strength. These adaptations may potentially delay or prevent bone fragility later in life. Future studies should compare individual styles of dance separately, longitudinally, and include other important lower (e.g., hip) and upper body (e.g., radius) sites to further identify which forms provide the greatest osteogenic benefits.
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13
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Schaper M, Harcus J. Preliminary image findings of lower limb stress fractures to aid ultrasonographic diagnoses: A systematic review and narrative synthesis. ULTRASOUND (LEEDS, ENGLAND) 2021; 29:208-217. [PMID: 34777541 PMCID: PMC8579372 DOI: 10.1177/1742271x21995523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Accepted: 01/21/2021] [Indexed: 11/15/2022]
Abstract
INTRODUCTION This systematic review investigates which image appearances are most common when diagnosing lower limb stress fractures using ultrasound imaging, with the aim of outlining an image critique guideline for operators to support confident diagnoses. METHOD A comprehensive literature search of medical databases and handsearching was undertaken to identify relevant studies. All studies were critically examined for quality using the CASP critical appraisal tool. Results from eight studies were combined and interpreted using a narrative synthesis. FINDINGS A clear outline of common stress fracture appearances using ultrasound were identified in a combined total of 119 participants. Each finding was ranked according to its popularity. Periosteal thickening (78/119) and cortical disruption/irregularity (83/119) were noted in all eight studies. Hypervascularity of the periosteum visualised by colour Doppler imaging (66/119) was reported in six of the eight studies. Soft tissue hypervascularity (13/119), bony callus formation (5/119) and cortical break (22/119) were seen in three studies. CONCLUSIONS Based on the findings, we offer a guideline of the most significant preliminary image findings to be utilised by operators when examining athletes suspected of having lower limb stress fractures. The results show a gap in research for evaluating changes in appearance depending on the injury severity. Further research into distinguishing stress fractures from pathological involvement may in future reduce reliance on plain film radiography.
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Affiliation(s)
| | - James Harcus
- Leeds Institute of Cardiovascular and Metabolic Medicine,
University of Leeds, Leeds, UK
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14
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Qin L, He T, Chen S, Yang D, Yi W, Cao H, Xiao G. Roles of mechanosensitive channel Piezo1/2 proteins in skeleton and other tissues. Bone Res 2021; 9:44. [PMID: 34667178 PMCID: PMC8526690 DOI: 10.1038/s41413-021-00168-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 06/16/2021] [Accepted: 07/08/2021] [Indexed: 12/12/2022] Open
Abstract
Mechanotransduction is a fundamental ability that allows living organisms to receive and respond to physical signals from both the external and internal environments. The mechanotransduction process requires a range of special proteins termed mechanotransducers to convert mechanical forces into biochemical signals in cells. The Piezo proteins are mechanically activated nonselective cation channels and the largest plasma membrane ion channels reported thus far. The regulation of two family members, Piezo1 and Piezo2, has been reported to have essential functions in mechanosensation and transduction in different organs and tissues. Recently, the predominant contributions of the Piezo family were reported to occur in the skeletal system, especially in bone development and mechano-stimulated bone homeostasis. Here we review current studies focused on the tissue-specific functions of Piezo1 and Piezo2 in various backgrounds with special highlights on their importance in regulating skeletal cell mechanotransduction. In this review, we emphasize the diverse functions of Piezo1 and Piezo2 and related signaling pathways in osteoblast lineage cells and chondrocytes. We also summarize our current understanding of Piezo channel structures and the key findings about PIEZO gene mutations in human diseases.
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Affiliation(s)
- Lei Qin
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Tailin He
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, Guangdong, China
| | - Sheng Chen
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, Guangdong, China
- Department of Orthopedics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Dazhi Yang
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Weihong Yi
- Department of Orthopedics, Huazhong University of Science and Technology Union Shenzhen Hospital, Shenzhen, Guangdong, China.
| | - Huiling Cao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, Guangdong, China.
| | - Guozhi Xiao
- Department of Biochemistry, School of Medicine, Guangdong Provincial Key Laboratory of Cell Microenvironment and Disease Research, Shenzhen Key Laboratory of Cell Microenvironment, Southern University of Science and Technology, Shenzhen, Guangdong, China.
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15
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Gut microbiome depletion and repetitive mild traumatic brain injury differentially modify bone development in male and female adolescent rats. Bone Rep 2021; 15:101123. [PMID: 34553007 PMCID: PMC8441164 DOI: 10.1016/j.bonr.2021.101123] [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: 07/12/2021] [Revised: 08/14/2021] [Accepted: 08/27/2021] [Indexed: 11/21/2022] Open
Abstract
Dysregulation of the gut microbiome has been shown to disrupt both bone formation and bone resorption in several preclinical and clinical models. However, the role of microbiome in adolescent bone development remains poorly understood. This effect of disrupted bone development may be more pronounced during adolescence, when bone development is vulnerable to environmental stimuli and external insults (e.g., antibiotic treatment and traumatic brain injury), as this is a critical window of development. Therefore, in this study, we sought to investigate the effect of repetitive mild traumatic brain injury (RmTBI) and gut microbiome depletion by antibiotic treatment on femur length and bone density in male and female adolescent Sprague Dawley rats. Rats were randomly assigned to receive standard or antibiotic autoclaved drinking water and to receive sham or RmTBIs injuries. Using micro-computed tomography (μCT), we found sexually dimorphic changes in adolescent bone development in response to microbiome depletion and RmTBI. Specifically, gut microbiome depletion stunted femur growth in males and altered cross sectional bone area (CSA), bone area fraction, and the bone volume of low and mid density bone in the distal metaphyseal region of the femur. Conversely, RmTBI and antibiotic treatment individually disrupted bone growth, bone area fraction, and bone volume of high-density bone within the distal metaphyseal region of the femur in females, but not when combined. Therefore, findings from this study indicate that gut microbiome and RmTBI may alter bone development in a sex-dependent manner during adolescence.
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16
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Wu P, Cai Z, Jiang WH, Lu G, Wu PQ, Xie ZW, Peng JZ, Chen C, Qi JY, Xu LZ, Shen KL, Zeng HS, Yin GQ. Two novel mutations in TCIRG1 induced infantile malignant osteopetrosis: a case report. BMC Pediatr 2021; 21:297. [PMID: 34210262 PMCID: PMC8246672 DOI: 10.1186/s12887-021-02774-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 06/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Infantile malignant osteopetrosis (IMO) is a rare autosomal recessive disease characterized by a higher bone density in bone marrow caused by the dysfunction of bone resorption. Clinically, IMO can be diagnosed with medical examination, bone mineral density test and whole genome sequencing. CASE PRESENTATION We present the case of a 4-month-old male infant with abnormal skull development, hypocalcemia and premature closure of the cranial sutures. Due to the hyper bone density showed by his radiographic examination, which are characteristic patterns of IMO, we speculated that he might be an IMO patient. In order to confirm this diagnosis, a high-precision whole exome sequencing of the infant and his parents was performed. The analysis of high-precision whole exome sequencing results lead to the identification of two novel heterozygous mutations c.504-1G > C (a splicing site mutation) and c.1371delC (p.G458Afs*70, a frameshift mutation) in gene TCIRG1 derived from his parents. Therefore, we propose that there is a close association between these two mutations and the onset of IMO. CONCLUSIONS To date, these two novel mutations in gene TCIRG1 have not been reported in the reference gene database of Chinese population. These variants have likewise not been reported outside of China in the Genome Aggregation Database (gnomAD). Our case suggests that the use of whole exome sequencing to detect these two mutations will improve the identification and early diagnosis of IMO, and more specifically, the identification of homozygous individuals with TCIRG1 gene mutation. We propose that these mutations in gene TCIRG1 could be a novel therapeutic target for the IMO in the future.
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Affiliation(s)
- Ping Wu
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Department of Respirology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
- Department of Allergy, Immunology and Rheumatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Zhe Cai
- Department of Allergy, Immunology and Rheumatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
- Guangzhou Institute of Pediatrics, Guangzhou Women and Children's Medical Center, Guangzhou, 510623, China
- Institute Pasteur of Shanghai, Chinese Academy of Science, Shanghai, 200031, China
- Department of Chemical Pathology, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China
| | - Wen-Hui Jiang
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Gen Lu
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Pei-Qiong Wu
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Zhi-Wei Xie
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jun-Zheng Peng
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Chen Chen
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Jun-Ye Qi
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Li-Zhen Xu
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Kun-Ling Shen
- Department of Respirology, Beijing Children's Hospital, Capital Medical University, Beijing, 100045, China
| | - Hua-Song Zeng
- Department of Allergy, Immunology and Rheumatology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China
| | - Gen-Quan Yin
- Department of Respirology, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, 510120, Guangdong, China.
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17
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Cousminer DL, Wagley Y, Pippin JA, Elhakeem A, Way GP, Pahl MC, McCormack SE, Chesi A, Mitchell JA, Kindler JM, Baird D, Hartley A, Howe L, Kalkwarf HJ, Lappe JM, Lu S, Leonard ME, Johnson ME, Hakonarson H, Gilsanz V, Shepherd JA, Oberfield SE, Greene CS, Kelly A, Lawlor DA, Voight BF, Wells AD, Zemel BS, Hankenson KD, Grant SFA. Genome-wide association study implicates novel loci and reveals candidate effector genes for longitudinal pediatric bone accrual. Genome Biol 2021; 22:1. [PMID: 33397451 PMCID: PMC7780623 DOI: 10.1186/s13059-020-02207-9] [Citation(s) in RCA: 86] [Impact Index Per Article: 28.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 11/18/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Bone accrual impacts lifelong skeletal health, but genetic discovery has been primarily limited to cross-sectional study designs and hampered by uncertainty about target effector genes. Here, we capture this dynamic phenotype by modeling longitudinal bone accrual across 11,000 bone scans in a cohort of healthy children and adolescents, followed by genome-wide association studies (GWAS) and variant-to-gene mapping with functional follow-up. RESULTS We identify 40 loci, 35 not previously reported, with various degrees of supportive evidence, half residing in topological associated domains harboring known bone genes. Of several loci potentially associated with later-life fracture risk, a candidate SNP lookup provides the most compelling evidence for rs11195210 (SMC3). Variant-to-gene mapping combining ATAC-seq to assay open chromatin with high-resolution promoter-focused Capture C identifies contacts between GWAS loci and nearby gene promoters. siRNA knockdown of gene expression supports the putative effector gene at three specific loci in two osteoblast cell models. Finally, using CRISPR-Cas9 genome editing, we confirm that the immediate genomic region harboring the putative causal SNP influences PRPF38A expression, a location which is predicted to coincide with a set of binding sites for relevant transcription factors. CONCLUSIONS Using a new longitudinal approach, we expand the number of genetic loci putatively associated with pediatric bone gain. Functional follow-up in appropriate cell models finds novel candidate genes impacting bone accrual. Our data also raise the possibility that the cell fate decision between osteogenic and adipogenic lineages is important in normal bone accrual.
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Affiliation(s)
- Diana L Cousminer
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA.
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Yadav Wagley
- Department of Orthopedic Surgery, University of Michigan Medical School, Ann Arbor, MI, USA
| | - James A Pippin
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Ahmed Elhakeem
- MRC Integrative Epidemiology Unit, Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Gregory P Way
- Genomics and Computational Biology Graduate Group, University of Pennsylvania, Philadelphia, PA, USA
- Imaging Platform, Broad Institute of MIT and Harvard, Cambridge, MA, 02140, USA
| | - Matthew C Pahl
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Shana E McCormack
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Alessandra Chesi
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jonathan A Mitchell
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Joseph M Kindler
- Division of Gastroenterology, Hepatology and Nutrition, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Denis Baird
- MRC Integrative Epidemiology Unit, Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - April Hartley
- MRC Integrative Epidemiology Unit, Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Laura Howe
- MRC Integrative Epidemiology Unit, Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Heidi J Kalkwarf
- Department of Pediatrics, Cincinnati Children's Hospital, University of Cincinnati, Cincinnati, OH, USA
| | - Joan M Lappe
- Department of Medicine and College of Nursing, Creighton University School of Medicine, Omaha, NB, USA
| | - Sumei Lu
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Michelle E Leonard
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Matthew E Johnson
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Hakon Hakonarson
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Vicente Gilsanz
- Center for Endocrinology, Diabetes & Metabolism, Children's Hospital Los Angeles, Los Angeles, CA, USA
| | - John A Shepherd
- Department of Epidemiology and Population Science, University of Hawaii Cancer Center, Honolulu, HI, USA
| | - Sharon E Oberfield
- Division of Pediatric Endocrinology, Columbia University Medical Center, New York, NY, USA
| | - Casey S Greene
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
- Childhood Cancer Data Lab, Alex's Lemonade Stand Foundation, Philadelphia, PA, USA
| | - Andrea Kelly
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Deborah A Lawlor
- MRC Integrative Epidemiology Unit, Population Health Science, Bristol Medical School, University of Bristol, Bristol, UK
| | - Benjamin F Voight
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
- Department of Systems Pharmacology and Translational Therapeutics, University of Pennsylvania, Philadelphia, PA, USA
- Institute of Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Andrew D Wells
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Babette S Zemel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kurt D Hankenson
- Department of Orthopedic Surgery, University of Michigan Medical School, Ann Arbor, MI, USA.
| | - Struan F A Grant
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA.
- Center for Spatial and Functional Genomics, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Division of Endocrinology and Diabetes, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
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18
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Bland VL, Bea JW, Blew RM, Roe DJ, Lee VR, Funk JL, Going SB. Influence of Changes in Soft Tissue Composition on Changes in Bone Strength in Peripubertal Girls: The STAR Longitudinal Study. J Bone Miner Res 2021; 36:123-132. [PMID: 32810295 DOI: 10.1002/jbmr.4168] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 08/11/2020] [Accepted: 08/14/2020] [Indexed: 01/09/2023]
Abstract
Obesity and osteoporosis remain two major public health concerns. Soft tissue composition and bone are interrelated; however, it is still not well understood how changes in adiposity during adolescence affect bone development. The aim of this study was to assess how changes in DXA-derived total body lean mass (TBLM) and total body fat mass (TBFM) associate with 2-year changes in bone outcomes at the 20% femur, 66% tibia, 66% radius, and 4% tibia, as measured by pQCT, during the years surrounding the onset of menarche in a cohort of 9- to 12-year-old (baseline) adolescent girls (70% Hispanic). From baseline to 2-year follow-up, girls showed statistically significant increases in all bone outcomes, except radial endosteal circumference. In separate linear regression models, change in TBLM and change in TBFM were both positively associated with 2-year changes in bone outcomes at all measured bone sites, after controlling for relevant covariates. However, when change in TBLM and change in TBFM were included in the same model, change in TBLM was the predominant predictor of bone outcomes, explaining 4% to 14% of the variance in bone strength outcomes. Change in TBFM remained a positive predictor of tibia polar strength strain index (SSIp) (2% variance explained). A significant interaction between change in TBFM and menarcheal status was identified at the radius for SSIp and indicated that greater gains in TBFM were beneficial for SSIp in girls that were premenarcheal at baseline but detrimental for girls who were postmenarcheal at baseline. The overall findings suggest that changes in TBLM during the peripubertal years have a greater influence on bone outcomes than changes in TBFM. While gains in TBFM might benefit the weight bearing 66% tibia, greater gains in TBFM may be detrimental to bone development at the non-weight bearing 66% radius after the onset of menarche. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Victoria L Bland
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Jennifer W Bea
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA.,Department of Medicine, University of Arizona, Tucson, AZ, USA.,The University of Arizona Cancer Center, Tucson, AZ, USA
| | - Robert M Blew
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Denise J Roe
- The University of Arizona Cancer Center, Tucson, AZ, USA.,Department of Epidemiology and Biostatistics, University of Arizona, Tucson, AZ, USA
| | - Vinson R Lee
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
| | - Janet L Funk
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA.,Department of Medicine, University of Arizona, Tucson, AZ, USA
| | - Scott B Going
- Department of Nutritional Sciences, University of Arizona, Tucson, AZ, USA
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19
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Associations between cola consumption and bone mineral density in Korean adolescents and young adults: a cross-sectional study using data from the Korea National Health and Nutrition Examination Survey, 2008-2011. J Nutr Sci 2020; 9:e56. [PMID: 33354327 PMCID: PMC7737184 DOI: 10.1017/jns.2020.49] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 10/14/2020] [Accepted: 10/20/2020] [Indexed: 11/24/2022] Open
Abstract
The present study aimed to elucidate the relationship between cola consumption and bone mineral density (BMD) in Korean adolescents and young adults. We used data from the Korea National Health and Nutrition Examination Survey 2008–2011. A total of 2499 adolescents and young adults aged 12–25 years were included. The study participants were classified as cola drinkers and non-cola drinkers according to 24-h dietary recall data. BMD was measured using dual X-ray absorptiometry. In the male population, whole body, whole femur and femoral neck BMD in cola drinkers were lower than that of non-cola drinkers by 4% (95% CI −0⋅071, −0⋅007), 5% (−0⋅092, −0⋅012) and 5% (−0⋅090, −0⋅001), respectively. In both sex groups, cola drinkers had less frequent milk consumption than non-cola drinkers. However, there were no significant differences in cola consumption according to calcium intake in both sexes. In conclusion, cola intake and BMD were inversely associated with Korean male adolescents and young adults. Considering the importance of peak bone mass attainment at adolescents and the increasing trend in carbonated beverage consumption in South Korea, further studies are needed to elucidate the causality between cola intake and lower BMD.
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20
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Halffman CM, Potter BA, McKinney HJ, Tsutaya T, Finney BP, Kemp BM, Bartelink EJ, Wooller MJ, Buckley M, Clark CT, Johnson JJ, Bingham BL, Lanoë FB, Sattler RA, Reuther JD. Ancient Beringian paleodiets revealed through multiproxy stable isotope analyses. SCIENCE ADVANCES 2020; 6:6/36/eabc1968. [PMID: 32917621 PMCID: PMC7473743 DOI: 10.1126/sciadv.abc1968] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 07/16/2020] [Indexed: 06/04/2023]
Abstract
The earliest Native Americans have often been portrayed as either megafaunal specialists or generalist foragers, but this debate cannot be resolved by studying the faunal record alone. Stable isotope analysis directly reveals the foods consumed by individuals. We present multi-tissue isotope analyses of two Ancient Beringian infants from the Upward Sun River site (USR), Alaska (~11,500 years ago). Models of fetal bone turnover combined with seasonally-sensitive taxa show that the carbon and nitrogen isotope composition of USR infant bone collagen reflects maternal diets over the summer. Using comparative faunal isotope data, we demonstrate that although terrestrial sources dominated maternal diets, salmon was also important, supported by carbon isotope analysis of essential amino acids and bone bioapatite. Tooth enamel samples indicate increased salmon use between spring and summer. Our results do not support either strictly megafaunal specialists or generalized foragers but indicate that Ancient Beringian diets were complex and seasonally structured.
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Affiliation(s)
- Carrin M Halffman
- Department of Anthropology, University of Alaska Fairbanks, Fairbanks, AK, USA.
| | - Ben A Potter
- Arctic Studies Center, Liaocheng University, Liaocheng City, Shandong Province, China.
| | - Holly J McKinney
- Department of Anthropology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Takumi Tsutaya
- Japan Agency for Marine-Earth Science and Technology, Research Institute for Marine Resources Utilization, Yokosuka, Kanagawa, Japan
| | - Bruce P Finney
- Departments of Biological Sciences and Geosciences, Idaho State University, Pocatello, ID, USA
| | - Brian M Kemp
- Laboratories of Molecular Anthropology and Microbiome Research, Norman, OK, USA
- Department of Anthropology, University of Oklahoma, Norman, OK, USA
| | - Eric J Bartelink
- Department of Anthropology, California State University, Chico, CA, USA
| | - Matthew J Wooller
- Alaska Stable Isotope Facility, Water and Environmental Research Center, Institute of Northern Engineering, University of Alaska Fairbanks, Fairbanks, AK, USA
- Marine Biology Department, College of Fisheries and Ocean Sciences, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Michael Buckley
- Department of Earth and Environmental Sciences Manchester Institute of Biotechnology, University of Manchester, Manchester, UK
| | - Casey T Clark
- Joint Institute for the Study of Atmosphere and Ocean, University of Washington, Seattle, WA, USA
- Water and Environmental Research Center, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Jessica J Johnson
- Department of Biology and Wildlife/Institute of Arctic Biology, University of Alaska Fairbanks, Fairbanks, AK, USA
| | - Brittany L Bingham
- Laboratories of Molecular Anthropology and Microbiome Research, Norman, OK, USA
| | - François B Lanoë
- Bureau of Applied Research in Anthropology, University of Arizona, Tucson AZ, USA
- Archaeology Department, University of Alaska Museum of the North, Fairbanks, AK, USA
| | | | - Joshua D Reuther
- Department of Anthropology, University of Alaska Fairbanks, Fairbanks, AK, USA
- Archaeology Department, University of Alaska Museum of the North, Fairbanks, AK, USA
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21
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Dahan-Oliel N, Collins J, Rauch D, Bukovy G, Hamdy R, Rauch F. Bone densities and bone geometry in children and adolescents with arthrogryposis. Bone 2020; 137:115454. [PMID: 32464275 DOI: 10.1016/j.bone.2020.115454] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 05/07/2020] [Accepted: 05/23/2020] [Indexed: 01/28/2023]
Abstract
OBJECTIVE To describe bone densitometry results using lumbar spine dual-energy X-ray absorptiometry and forearm peripheral quantitative computed tomography (pQCT) in children with arthrogryposis multiplex congenita (AMC). STUDY DESIGN Prospective study. RESULTS Lumbar spine areal bone mineral density (BMD) was measured in 58 participants (mean age 6.8 years, range 1 month to 19.7 years; 26 males). The diagnostic subgroup was Amyoplasia in 27 participants, distal arthrogryposis (unclassified, n = 13; type 2A, n = 1; type 2B, n = 2; type 8, n = 2) in 18 patients, an unclassified form of arthrogryposis in 6 patients, and a syndromic form of arthrogryposis in 7 patients. The mean lumbar spine areal BMD was -0.4 (SD: 1.5) which was significantly below 0 (p < 0.05, one-sample t-test). The mean lumbar spine bone mineral apparent density z-score (+0.4 [SD: 1.4]), a measure that is largely independent of bone size, was not significantly different from 0 (P > 0.05). A subset of 22 patients aged 6 years or older (mean age 10.9 years, 11 males) had forearm pQCT analysis. Mean z-scores for trabecular and cortical volumetric BMD at the radius were similar to healthy controls. Radius periosteal bone circumference and bone mineral content were appropriate for height. These densitometric results did not differ between patients with Amyoplasia or individuals with other diagnoses. CONCLUSIONS Low areal BMD in children and adolescents with AMC reflects their smaller bone size rather than a specific bone mass deficit. These data do not suggest that children and adolescents with AMC in general require regular monitoring by bone densitometry unless there are specific clinical concerns.
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Affiliation(s)
- Noemi Dahan-Oliel
- Shriners Hospital for Children, Montreal, Quebec, Canada; School of Physical and Occupational Therapy, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | | | - Damian Rauch
- Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Gloria Bukovy
- Shriners Hospital for Children, Montreal, Quebec, Canada
| | - Reggie Hamdy
- Shriners Hospital for Children, Montreal, Quebec, Canada; Faculty of Medicine, Division of Orthopaedic Surgery, McGill University, Montreal, Quebec, Canada
| | - Frank Rauch
- Shriners Hospital for Children, Montreal, Quebec, Canada; Department of Pediatrics, McGill University, Montreal, Quebec, Canada.
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22
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Swan KR, Ives R, Wilson LAB, Humphrey LT. Ontogenetic changes in femoral cross-sectional geometry during childhood locomotor development. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2020; 173:80-95. [PMID: 32656773 DOI: 10.1002/ajpa.24080] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 02/10/2020] [Accepted: 05/06/2020] [Indexed: 01/24/2023]
Abstract
OBJECTIVES The femur is a major weight-bearing bone that is variably loaded throughout growth as children transition through locomotory states prior to the attainment of a mature bipedal gait. Here, we document ontogenetic trends in femoral cross-sectional geometry (CSG) and explore how changes in loading regime may impact the structural arrangement of cortical bone along the length of the developing diaphysis. MATERIALS AND METHODS Micro-CT scans of 110 immature femora were generated from a documented archaeological sample ranging in age from birth to 8.5 years old. CSG properties indicative of relative bone strength and bending rigidity were analyzed from cross-sections extracted at 35%, 50% and 65% of total intermetaphyseal length. RESULTS Infants experience a marked redistribution of cortical bone between birth and 7 months facilitating a more advantageous mechanical structure for early load bearing behaviors as bone is displaced further from the section centroid. Early walkers are characterized by a mediolaterally reinforced cross-section that becomes more circular as gait continues to develop. DISCUSSION During ontogeny the femur undergoes distinct morphological phases, which correspond with changes in loading regime. This study illustrates the importance of loading conditions in shaping immature bone morphology. Nonmechanical factors such as changes in hormonal environmental can also impact on this dynamic.
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Affiliation(s)
- Karen R Swan
- Department of Earth Sciences, Natural History Museum, London, UK
| | - Rachel Ives
- Department of Earth Sciences, Natural History Museum, London, UK
| | - Laura A B Wilson
- School of Biological, Earth and Environmental Sciences, University of New South Wales, Sydney, New South Wales, Australia
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23
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Korčeková Z, Korček P, Čunát V, Staníčková Z, Zemanová P, Straňák Z. Tibial speed of sound changes in preterm infants during the first year of life. Bone 2020; 132:115191. [PMID: 31846825 DOI: 10.1016/j.bone.2019.115191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/26/2019] [Accepted: 12/13/2019] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Metabolic bone disease of prematurity (MBD) frequently affects preterm infants. The accurate diagnosis of the MBD remains a challenging issue despite characteristic clinical, laboratory and imaging features. Recently, non-invasive quantitative ultrasound (QUS) measuring speed of sound (SOS) has been applied to assess bone status. Limited data are available on comparison of QUS among preterm infants. OBJECTIVE To evaluate development of tibial bone SOS values in preterm infants during the first year of life and compare the SOS values among different birth weight categories. METHODS QUS was used in 153 infants below 34 weeks of gestation. The study group was divided into 3 subgroups based on birth weight (BW): ≤1000 g, 1001-1500 g and >1500 g. SOS measurement was performed at 6 and 12 months of corrected age (CA). RESULTS Overall, we found significant increase in mean tibial SOS between 6 and 12 months of CA (3004 ± 123 vs 3253 ± 109 m/s, p = 0.001). There were significant differences in SOS among birth weight categories at 6 months of CA (p = 0.045). However, these differences were not statistically significant at 12 months of CA (p = 0.289). The infants ≤ 1000 g scored the highest SOS values at both time points. CONCLUSIONS Tibial SOS significantly increases during infancy in preterm newborns. Significant variation exists in SOS at 6 months, but not at 12 months of corrected age according to BW. Moreover, inverse correlation between BW and SOS indicating better bone status was revealed in extremely low birth weight infants at both 6 or at 12 months of CA.
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Affiliation(s)
- Zuzana Korčeková
- Institute for the care of mother and child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic
| | - Peter Korček
- Institute for the care of mother and child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic; 3rd Faculty of Medicine, Charles University, Ruská 2411/87, Prague 10000, Czech Republic.
| | - Václav Čunát
- Institute for the care of mother and child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic
| | - Zuzana Staníčková
- Institute for the care of mother and child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic
| | - Patrícia Zemanová
- Institute for the care of mother and child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic
| | - Zbyněk Straňák
- Institute for the care of mother and child - Neonatology, Podolské nábřeží 157/36, Prague 14700, Czech Republic; 3rd Faculty of Medicine, Charles University, Ruská 2411/87, Prague 10000, Czech Republic
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24
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Tenforde AS, Roberts WO, Krabak BJ, Davis IS, Fredericson M, Luke AC, Ackerman KE. Recommendations to Optimize Health in Youth Runners. Strength Cond J 2020. [DOI: 10.1519/ssc.0000000000000504] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Lalayiannis A, Crabtree N, Fewtrell M, Biassoni L, Milford D, Ferro C, Shroff R. Assessing bone mineralisation in children with chronic kidney disease: what clinical and research tools are available? Pediatr Nephrol 2020; 35:937-957. [PMID: 31240395 PMCID: PMC7184042 DOI: 10.1007/s00467-019-04271-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Revised: 04/19/2019] [Accepted: 04/26/2019] [Indexed: 12/11/2022]
Abstract
Mineral and bone disorder in chronic kidney disease (CKD-MBD) is a triad of biochemical imbalances of calcium, phosphate, parathyroid hormone and vitamin D, bone abnormalities and soft tissue calcification. Maintaining optimal bone health in children with CKD is important to prevent long-term complications, such as fractures, to optimise growth and possibly also to prevent extra-osseous calcification, especially vascular calcification. In this review, we discuss normal bone mineralisation, the pathophysiology of dysregulated homeostasis leading to mineralisation defects in CKD and its clinical consequences. Bone mineralisation is best assessed on bone histology and histomorphometry, but given the rarity with which this is performed, we present an overview of the tools available to clinicians to assess bone mineral density, including serum biomarkers and imaging such as dual-energy X-ray absorptiometry and peripheral quantitative computed tomography. We discuss key studies that have used these techniques, their advantages and disadvantages in childhood CKD and their relationship to biomarkers and bone histomorphometry. Finally, we present recommendations from relevant guidelines-Kidney Disease Improving Global Outcomes and the International Society of Clinical Densitometry-on the use of imaging, biomarkers and bone biopsy in assessing bone mineral density. Given low-level evidence from most paediatric studies, bone imaging and histology remain largely research tools, and current clinical management is guided by serum calcium, phosphate, PTH, vitamin D and alkaline phosphatase levels only.
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Affiliation(s)
- A.D. Lalayiannis
- Nephrology Department Great Ormond St. Hospital for Children NHS Foundation Trust and University College London Institute of Child Health, London, UK
| | - N.J. Crabtree
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - M. Fewtrell
- Nephrology Department Great Ormond St. Hospital for Children NHS Foundation Trust and University College London Institute of Child Health, London, UK
| | - L. Biassoni
- Nephrology Department Great Ormond St. Hospital for Children NHS Foundation Trust and University College London Institute of Child Health, London, UK
| | - D.V. Milford
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - C.J. Ferro
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
| | - R. Shroff
- Nephrology Department Great Ormond St. Hospital for Children NHS Foundation Trust and University College London Institute of Child Health, London, UK
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26
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Kopiczko A. Bone mineral density in old age: the influence of age at menarche, menopause status and habitual past and present physical activity. Arch Med Sci 2020; 16:657-665. [PMID: 32399115 PMCID: PMC7212225 DOI: 10.5114/aoms.2019.81314] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 12/09/2018] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION In this study, the hypothesis that bone mineral density (BMD) of peri-, pre- and postmenopausal women is associated with the current level of habitual physical activity, as well as past physical activity, at the age of building peak bone mass, was tested. MATERIAL AND METHODS The study involved 500 Polish women aged 40 to 70. For the assessment of BMD and bone mineral content (BMC) the densitometry method (dual-energy X-ray absorptiometry, DXA) of the forearm bone was used. The International Physical Activity Questionnaire (IPAQ) was used to assess the present level of physical activity. The assessment of past physical activity was related to adolescence. RESULTS There was a significant, strong influence on the norm BMD in the distal forearm sections values in the distal forearm sections of such variables as: older age of the first menstruation (OR = 1.37; p = 0.002), sufficient present physical activity (OR = 1.57; p = 0.001), and particularly high past physical activity (OR = 6.77; p = 0.003). Significantly lower chances for the norm BMD dis were found in women with the oldest hormonal status (OR = 0.09; p < 0.001). In the proximal segment, the analogous conditions of the norm BMD, and in addition the chances for good mineralization, were increased by higher body mass index (OR = 1.11; p < 0.001). Sufficient present activity increased the chances of good forearm mineralization in the proximal part more than four times (OR = 4.2; p < 0.001), and a high level of past physical activity increased these chances several dozen times (OR = 69.9; p < 0.001). CONCLUSIONS Physical activity proved to be one of the most important factors determining the statistically significant correct mineralization of bone tissue of women.
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Affiliation(s)
- Anna Kopiczko
- Department of Anthropology and Health Promotion, Faculty of Biomedical Sciences, Józef Piłsudski University of Physical Education, Warsaw, Poland
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27
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Wolfe JA, Wolfe H, Banaag A, Tintle S, Perez Koehlmoos T. Early Pediatric Fractures in a Universally Insured Population within the United States. BMC Pediatr 2019; 19:343. [PMID: 31594543 PMCID: PMC6781295 DOI: 10.1186/s12887-019-1725-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Accepted: 09/16/2019] [Indexed: 11/26/2022] Open
Abstract
Background Musculoskeletal injury, including fracture, is one of the most common causes of morbidity in pediatric patients. The purpose of this epidemiologic study is to determine the prevalence and risk factors for fracture in a large cohort of pediatric patients under the age of 5. Results Of the 233,869 patients included in the study, 13,698 fractures were identified in 10,889 patients. The highest annual incidence was in the 4 year old age group with a rate of 24.2 fractures per 1000 children. The annual incidence within all age groups was 11.7 fractures per 1000 children. The two most common fractures were forearm and humerus fractures. Fracture incidence was increased in male children, patients who live outside the US, and in Caucasian patients. An increase in rate of fracture was also identified in children of officers when compared with children of enlisted service members. There were 35 abuse related fractures in our cohort, with 19 of them occurring in children less than 1 year old. Only three children in our cohort had Osteogenesis Imperfecta. Conclusion Fractures are common injuries in young children with an incidence over the first 5 years of life of 5.86%. Multiple risk factors were also identified including age, race, geographic location and socioeconomic status. The results of this study are an important contribution to epidemiologic and public health literature and serve to characterize the incidence of and risk factors for sustaining an early childhood fracture.
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Affiliation(s)
- Jared A Wolfe
- Department of Orthopaedics, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA.
| | - Heather Wolfe
- Department of Obstetrics and Gynecology, Malcolm Grow Medical Clinic, 1060 Perimeter Rd, Joint Base Andrews, Prince George's County, MD, 20762, USA
| | - Amanda Banaag
- Department of Health Services Administration, The Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Bethesda, USA
| | - Scott Tintle
- Department of Orthopaedics, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD, 20889, USA
| | - Tracey Perez Koehlmoos
- Department of Health Services Administration, Department of Preventive Medicine & Biostatistics, Uniformed Services University of the Health Sciences, Bethesda, USA
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28
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Fuggle NR, Curtis EM, Ward KA, Harvey NC, Dennison EM, Cooper C. Fracture prediction, imaging and screening in osteoporosis. Nat Rev Endocrinol 2019; 15:535-547. [PMID: 31189982 DOI: 10.1038/s41574-019-0220-8] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Osteoporosis is associated with increased fragility of bone and a subsequent increased risk of fracture. The diagnosis of osteoporosis is intimately linked with the imaging and quantification of bone and BMD. Scanning modalities, such as dual-energy X-ray absorptiometry or quantitative CT, have been developed and honed over the past half century to provide measures of BMD and bone microarchitecture for the purposes of clinical practice and research. Combined with fracture prediction tools such as Fracture Risk Assessment Tool (FRAX) (which use a combination of clinical risk factors for fracture to provide a measure of risk), these elements have led to a paradigm shift in the ability to diagnose osteoporosis and predict individuals who are at risk of fragility fracture. Despite these developments, a treatment gap exists between individuals who are at risk of osteoporotic fracture and those who are receiving therapy. In this Review, we summarize the epidemiology of osteoporosis, the history of scanning modalities, fracture prediction tools and future directions, including the most recent developments in prediction of fractures.
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Affiliation(s)
- Nicholas R Fuggle
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Kate A Ward
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- MRC Nutrition and Bone Health Research Group, Cambridge, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- Victoria University of Wellington, Wellington, New Zealand
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
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29
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Pham-Short A, Donaghue KC, Ambler G, Briody J, Garnett S, Munns CF, Craig ME. Abnormal Cortical and Trabecular Bone in Youth With Type 1 Diabetes and Celiac Disease. Diabetes Care 2019; 42:1489-1495. [PMID: 31167891 DOI: 10.2337/dc18-2376] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Accepted: 05/14/2019] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study compared bone health in youth with type 1 diabetes and celiac disease (CD) versus type 1 diabetes alone. RESEARCH DESIGN AND METHODS This was a case-control study of 42 youth with coexisting type 1 diabetes and CD and 40 with type 1 diabetes matched for age, sex, diabetes duration, and HbA1c. Bone mineral density (BMD), bone mineral content (BMC), and BMC-to-lean tissue mass (LTM) ratio were measured using DXA and reported as z-scores for height. Total, trabecular, and cortical bone and muscle parameters were measured using peripheral quantitative computed tomography (pQCT) and reported as z-scores for age. RESULTS Mean age at assessment was 14.3 ± 3.1 years; diabetes duration, 8.0 ± 3.5 years; HbA1c, 8.2 ± 1.5% (66 ± 5 mmol/mol); and 25-hydroxy vitamin D, 71 ± 21 nmol/L. Comparing youth with coexisting CD versus type 1 diabetes alone, DXA showed lower BMC-to-LTM ratio (0.37 ± 1.12 vs. 0.73 ± 2.23, P = 0.007) but no difference in total BMD. Youth with coexisting CD also had lower BMC-to-LTM ratio versus the general population (P = 0.04). Radial pQCT showed lower total BMC (-0.92 ± 1.40 vs. -0.26 ± 1.23, P = 0.03) despite similar bone and muscle cross-sectional area. In multivariable linear regression, lower BMC was associated with higher insulin dose (P = 0.03) but not HbA1c. CONCLUSIONS Youth with both type 1 diabetes and CD have lower BMC relative to LTM and lower BMC, indicating abnormal trabecular and cortical bone development despite similar bone and muscle size. These findings suggest that the two conditions confer a lower bone turnover state. We recommend further examination of bone health in this population; future research should examine early interventions to improve bone health.
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Affiliation(s)
- Anna Pham-Short
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Kim C Donaghue
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Geoffrey Ambler
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Julie Briody
- Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia.,Department of Nuclear Medicine, The Children's Hospital at Westmead, Westmead, New South Wales, Australia
| | - Sarah Garnett
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Craig F Munns
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia.,Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia
| | - Maria E Craig
- Institute of Endocrinology and Diabetes, The Children's Hospital at Westmead, Westmead, New South Wales, Australia .,Children's Hospital Westmead Clinical School, University of Sydney, Sydney, New South Wales, Australia.,School of Women's and Child's Health, University of New South Wales, Sydney, New South Wales, Australia
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30
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Ramot R, Kachhawa G, Kulshreshtha V, Varshney S, Sankar MJ, Devasenathipathy K, Sreenivas V, Khadgawat R. Bone Mass in Newborns Assessed by DXA - A Systematic Review and Meta-analysis. Indian J Endocrinol Metab 2019; 23:198-205. [PMID: 31161103 PMCID: PMC6540894 DOI: 10.4103/ijem.ijem_681_18] [Citation(s) in RCA: 3] [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] [Indexed: 11/04/2022] Open
Abstract
PURPOSE Peak bone mass - a key determinant of osteoporotic fractures result from bone accretion starting form intrauterine life to early adulthood. Optimal skeletal growth in-utero and infancy may offer protection against osteoporosis in adult life. We attempted to pool the data from available literature to get a consensus on average bone mass among healthy newborns (age ≤30 days after birth). METHODS Systematic review was conducted (PRISMA guidelines) to generate pooled estimates of bone mass parameters at whole body (WB) and lumbar spine (LS), based on both fixed and random effect models of meta-analyses. Two investigators independently carried out a comprehensive literature search using PubMed, Google Scholar and Embase. Meta-regression was applied to further explore causes of heterogeneity. RESULTS Out of a total 2703 studies, 2682 was excluded leaving 21 studies for final analysis. Thirteen studies reported bone mass by Hologic® and eight by Lunar®. The pooled WBBMC was 66.2g (95% CI 65.4 to 67.05 by fixed effect model, while the corresponding parameter for LS was 2.3g (95% CI 2.2 to 2.4). The subgroup and meta-regression analyses done for controlling potential confounders did not significantly affect heterogeneity. CONCLUSION We generated the pooled estimate of bone mass (WBBMC) among healthy newborn subjects. There was high degree of heterogeneity among studies.
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Affiliation(s)
- Rekha Ramot
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Vidushi Kulshreshtha
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Shweta Varshney
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - M. Jeeva Sankar
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - K. Devasenathipathy
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| | - V. Sreenivas
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Khadgawat
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
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31
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Bone Measurements by Peripheral Quantitative Computed Tomography in Rodents. Methods Mol Biol 2019; 1914:533-558. [PMID: 30729485 DOI: 10.1007/978-1-4939-8997-3_29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/13/2023]
Abstract
This chapter provides information for the in vivo use of peripheral quantitative computed tomography in rats and mice to determine bone density and cortical geometric data, including suggestions for study design, instrument setting, and data interpretation. This update also provides guidance for the use of pQCT to extract muscle and fat cross-sectional area information from the bone scans.
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32
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Mostoufi-Moab S, Ward LM. Skeletal Morbidity in Children and Adolescents during and following Cancer Therapy. Horm Res Paediatr 2019; 91:137-151. [PMID: 30481777 PMCID: PMC6536370 DOI: 10.1159/000494809] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 10/23/2018] [Indexed: 01/07/2023] Open
Abstract
Skeletal abnormalities are common in children and adolescents diagnosed and treated for a malignancy. The spectrum ranges from mild pain to debilitating osteonecrosis and fractures. In this review, we summarize the impact of cancer therapy on the developing skeleton, provide an update on therapeutic strategies for prevention and treatment, and discuss the most recent advances in musculoskeletal research. Early recognition of skeletal abnormalities and strategies to optimize bone health are essential to prevent long-term skeletal sequelae and diminished quality of life in childhood cancer survivors.
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Affiliation(s)
- Sogol Mostoufi-Moab
- Department of Pediatrics, The Children's Hospital of Philadelphia, The University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA,
| | - Leanne M. Ward
- Department of Pediatrics, The Children’s Hospital of Eastern Ontario, University of Ottawa, Ontario, Canada, K1H 8L1
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33
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Chadwick KP, Mueske NM, Horenstein RE, Shefelbine SJ, Wren TAL. Children with myelomeningocele do not exhibit normal remodeling of tibia roundness with physical development. Bone 2018; 114:292-297. [PMID: 29991457 PMCID: PMC7173944 DOI: 10.1016/j.bone.2018.07.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/14/2018] [Accepted: 07/03/2018] [Indexed: 11/25/2022]
Abstract
Skeletal loading through daily movement is an important factor in the normal development of bones. This loading is affected by the neurological and muscle deficits that result from myelominingocele (MM). While children with MM have been shown to have atypical gait, decreased bone accrual, and increased fracture risk, it is still unclear what morphological bone differences exist and to what extent they relate to physical developmental and ambulation level. This study analyzed computed tomography images of the tibia from 77 children with MM and 124 typically developing (TD) children between the ages of 6 and 16 years. Differences in cross-sectional roundness along the length of the tibia diaphysis were observed across developmental stages (pre-pubertal, pubertal, post-pubertal) and ambulation level (MM non-ambulatory, MM assistive devices, MM independent, and TD). The results showed that tibia cross-sectional morphology becomes less round with development in TD children (p < 0.017). In children with MM, however, roundness is maintained throughout adolescence (p > 0.017), with greater roundness in less ambulatory children (p < 0.0083). These in vivo results align with mechanobiological modeling studies suggesting that intracortical loads (caused by joint loading) as well as periosteal loads (imposed by surrounding muscles) are critical in promoting non-circular cross-sectional bone shape remodeling.
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Affiliation(s)
- Kyle P Chadwick
- Children's Hospital Los Angeles, Los Angeles, CA, United States of America.
| | - Nicole M Mueske
- Children's Hospital Los Angeles, Los Angeles, CA, United States of America
| | | | | | - Tishya A L Wren
- Children's Hospital Los Angeles, Los Angeles, CA, United States of America; University of Southern California, Los Angeles, CA, United States of America
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Di Iorgi N, Maruca K, Patti G, Mora S. Update on bone density measurements and their interpretation in children and adolescents. Best Pract Res Clin Endocrinol Metab 2018; 32:477-498. [PMID: 30086870 DOI: 10.1016/j.beem.2018.06.002] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Following the increased awareness about the central role of the pediatric age in building bone for life, clinicians face more than ever the necessity of assessing bone health in pediatric subjects at risk for early bone mass derangements or in healthy children, in order to optimize their bone mass accrual and prevent osteoporosis. Although the diagnosis of osteoporosis is not made solely upon bone mineral density measurements during growth, such determination can be very useful in the follow-up of pediatric patients with primary and secondary osteoporosis. The ideal instrument would give information on the mineral content and density of the bone, and on its architecture. It should be able to perform the measurements on the skeletal sites where fractures are more frequent, and it should be minimally invasive, accurate, precise and rapid. Unfortunately, none of the techniques currently utilized fulfills all requirements. In the present review, we focus on the pediatric use of dual-energy X-ray absorptiometry (DXA), quantitative computed tomography (QCT), peripheral QCT (pQCT), and magnetic resonance imaging (MRI), highlighting advantages and limits for their use and providing indications for bone densitometry interpretation and of vertebral fractures diagnosis in pediatric subjects.
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Affiliation(s)
- Natascia Di Iorgi
- Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy.
| | - Katia Maruca
- Pediatric Bone Densitormetry Service and Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Institute, Milano, Italy
| | - Giuseppa Patti
- Department of Pediatrics, Istituto Giannina Gaslini, University of Genova, Genova, Italy
| | - Stefano Mora
- Pediatric Bone Densitormetry Service and Laboratory of Pediatric Endocrinology, IRCCS San Raffaele Institute, Milano, Italy.
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Calarge CA, Mills JA, Ziegler EE, Schlechte JA. Calcium and Vitamin D Supplementation in Boys with Risperidone-Induced Hyperprolactinemia: A Randomized, Placebo-Controlled Pilot Study. J Child Adolesc Psychopharmacol 2018; 28:145-150. [PMID: 29112461 PMCID: PMC5831755 DOI: 10.1089/cap.2017.0104] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND The chronic use of antipsychotics has been associated with impaired bone mineralization, partially mediated by hyperprolactinemia. We examined if calcium and vitamin D supplementation promote bone mineral accrual in boys with risperidone-induced hyperprolactinemia. METHODS Between February 2009 and November 2013, medically healthy, 5- to 17-year-old boys were enrolled in a 36-week double-blind, placebo-controlled study, examining the skeletal effects of supplementation with 1250 mg calcium carbonate and 400 IU of vitamin D3 in risperidone-induced hyperprolactinemia. Anthropometric, dietary, physical activity, and psychiatric assessments were conducted at baseline and week 18 and 36. Plasma prolactin and vitamin D concentrations were measured at baseline and week 36. Total body less head bone mineral content (BMC) and radius trabecular bone mineral density (BMD) were measured at baseline, week 18, and week 36, using dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, respectively. Linear mixed-effects regression analysis examined the longitudinal effect of treatment on skeletal outcomes. RESULTS Forty-seven boys (mean age: 11.0 ± 2.6 years) were randomized and 38 completed the study. At study entry, the average dietary calcium intake was below the recommended limit, but the average vitamin D concentration was normal. Calcium and vitamin D supplementation failed to significantly increase BMC or trabecular BMD. It also failed to affect several other skeletal and anthropometric outcomes, including plasma vitamin D concentration. CONCLUSIONS In this 9-month long pilot study, supplementation with a modest dose of calcium and vitamin D did not increase bone mass accrual in risperidone-treated boys with hyperprolactinemia. Alternative approaches should be investigated to optimize bone health in this population to prevent future morbidity and premature mortality. ClinicalTrials.gov Identifier: NCT00799383.
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Affiliation(s)
- Chadi A. Calarge
- Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
- Department of Pediatrics, Baylor College of Medicine, Houston, Texas
| | - James A. Mills
- Department of Psychiatry, The University of Iowa, Iowa City, Iowa
| | | | - Janet A. Schlechte
- Department of Internal Medicine, The University of Iowa, Iowa City, Iowa
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Abstract
Identifying children most susceptible to clinically significant fragility fractures (low trauma fractures or vertebral compression fractures) or recurrent fractures is an important issue facing general pediatricians and subspecialists alike. Over the last decade, several imaging technologies, including dual-energy X-ray absorptiometry and peripheral quantitative computed tomography, have become useful to identify abnormal bone mineralization in children and in adolescents. This review aimed to summarize the latest literature on the utility of these modalities as they pertain to use in pediatrics. In addition, we review several disease states associated with poor bone health and increased fracture risk in children, and discuss the implications of low bone mineral density in these patients. Finally, we will highlight the gaps in knowledge with regard to pediatric bone health and make recommendations for future areas of research.
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Affiliation(s)
- Halley Wasserman
- Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Catherine M Gordon
- Divisions of Adolescent Medicine and Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
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Yair R, Cahaner A, Uni Z, Shahar R. Maternal and genetic effects on broiler bone properties during incubation period. Poult Sci 2017; 96:2301-2311. [DOI: 10.3382/ps/pex021] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 01/05/2017] [Indexed: 01/07/2023] Open
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Sá-Caputo DC, Dionello CDF, Frederico ÉHFF, Paineiras-Domingos LL, Sousa-Gonçalves CR, Morel DS, Moreira-Marconi E, Unger M, Bernardo-Filho M. WHOLE-BODY VIBRATION EXERCISE IMPROVES FUNCTIONAL PARAMETERS IN PATIENTS WITH OSTEOGENESIS IMPERFECTA: A SYSTEMATIC REVIEW WITH A SUITABLE APPROACH. AFRICAN JOURNAL OF TRADITIONAL, COMPLEMENTARY, AND ALTERNATIVE MEDICINES : AJTCAM 2017; 14:199-208. [PMID: 28480432 PMCID: PMC5412226 DOI: 10.21010/ajtcam.v14i3.22] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Patients with osteogenesis imperfecta (OI) have abnormal bone modelling and resorption. The bone tissue adaptation and responsivity to dynamic and mechanical loading may be of therapeutic use under controlled circumstances. Improvements due to the wholebody vibration (WBV) exercises have been reported in strength, motion, gait, balance, posture and bone density in several osteopenic individuals, as in post-menopausal women or children with disabling conditions, as patients with OI. The aim of this investigation was to systematically analyse the current available literature to determine the effect of WBV exercises on functional parameters of OI patients. MATERIALS AND METHODS Three reviewers independently accessed bibliographical databases. Searches were performed in the PubMed, Scopus, Science Direct and PEDro databases using keywords related to possible interventions (including WBV) used in the management of patients with osteogenesis imperfecta. RESULTS Three eligible studies were identified by searches in the analysed databases. CONCLUSION It was concluded that WBV exercises could be an important option in the management of OI patients improving the mobility and functional parameters. However, further studies are necessary for establishing suitable protocols for these patients.
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Affiliation(s)
- Danubia C Sá-Caputo
- Programa de Pâs-graduaçâo em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Carla da F Dionello
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Programa de Pâs-graduaçâo em Ciencias Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Éric Heleno F. F Frederico
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Laisa L Paineiras-Domingos
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Programa de Pâs-graduaçâo em Ciencias Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Cintia Renata Sousa-Gonçalves
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Danielle S Morel
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Programa de Pâs-graduaçâo em Ciencias Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, Brazil
| | - Eloá Moreira-Marconi
- Programa de Pâs-graduaçâo em Fisiopatologia Clínica e Experimental, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
| | - Marianne Unger
- Division of Physiotherapy, Faculty of Medicine and Health Sciences, Stellenbosch University, South Africa
| | - Mario Bernardo-Filho
- Departamento de Biofísica e Biometria, Instituto de Biologia Roberto Alcantara Gomes, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil
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Tuna Kırsaçlıoğlu C, Kuloğlu Z, Tanca A, Küçük NÖ, Aycan Z, Öcal G, Ensari A, Kalaycı AG, Girgin N. Bone mineral density and growth in children with coeliac disease on a gluten free-diet. Turk J Med Sci 2016; 46:1816-1821. [PMID: 28081333 DOI: 10.3906/sag-1508-52] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Accepted: 04/06/2016] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND/AIM To evaluate changes in growth and bone metabolism during consumption of a gluten-free diet (GFD) in children with coeliac disease (CD). MATERIALS AND METHODS Thirty-seven children with CD (mean age of 8.8 ± 4.6 years, 21 girls) were enrolled. Anthropometric measurements, bone mineral density (BMD) in lumbar 2-4 vertebrae, and serum alkaline phosphatase, calcium, and phosphorus levels at diagnosis and at follow-up were recorded. RESULTS The mean follow-up period was 3.5 ± 2.3 years. The BMD of patients was significantly lower than that of control subjects at the time of diagnosis but not after 1 year of the GFD. Incidence of low BMD with respect to z-scores for chronological age (CA) was significantly higher than z-scores for height age (HA) (P = 0.006). At the first year of GFD, BMD, BMD z-score, height-for-age z-scores, and weight-for-age z-scores were significantly increased compared with the baseline, but not after 1 year of the GFD. CONCLUSION In CD, the first year of GFD is important in weight gain, linear growth, and improvement of BMD. A considerable relation of low BMD in children with CD, with respect to z-scores for CA, may be a result of misinterpretation of low BMD due to short stature.
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Affiliation(s)
- Ceyda Tuna Kırsaçlıoğlu
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Zarife Kuloğlu
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Aydan Tanca
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Nuriye Özlem Küçük
- Department of Nuclear Medicine, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Zehra Aycan
- Department of Pediatric Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Gönül Öcal
- Department of Pediatric Endocrinology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Arzu Ensari
- Department of Pathology, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Ayhan Gazi Kalaycı
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
| | - Nurten Girgin
- Department of Pediatric Gastroenterology, Hepatology and Nutrition, Faculty of Medicine, Ankara University, Ankara, Turkey
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Chen HL, Lee WT, Lee PL, Liu PL, Yang RC. Postnatal Changes in Tibial Bone Speed of Sound of Preterm and Term Infants during Infancy. PLoS One 2016; 11:e0166434. [PMID: 27832193 PMCID: PMC5104474 DOI: 10.1371/journal.pone.0166434] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2016] [Accepted: 10/28/2016] [Indexed: 11/19/2022] Open
Abstract
This study aimed to evaluate changes in tibial bone speed of sound (SOS) over time, in preterm and term infants during infancy, in addition to identifying factors influencing the development of tibial SOS during infancy. Preterm (n = 155) and term (n = 65) infants were enrolled in this study. Tibial bone SOS was measured using quantitative ultrasonography (QUS) on the left tibia of newborn infants after birth (within 7 days), at 1 month old, and then every 2 months until subjects were approximately 12-15 months old. Follow-up checks included anthropometric measurements and tibial bone SOS. Mean tibial bone SOS at birth was significantly higher in term infants (mean ± SD, 2968.5 ± 99.7 m/s) than in preterm infants (2912.2 ± 122.6 m/s). Values of follow-up tibial bone SOS declined for the first 4 months, and then increased gradually until 12-15 months old. This increasing trend was greater in preterm infants after 2 months of corrected age than in term infants. There were no significant differences by 12-15 months of age between preterm and term infants. A longitudinal mixed-effect model controlling for internal correlations and other covariates in the two groups showed that age and the SOS value at birth were important factors affecting the tibial bone SOS in both preterm and term newborn infants during infancy. There are significant differences in the pattern of change in tibial bone SOS values between preterm and term infants during the first 12-15 months of life. Age and SOS value at birth were important factors affecting the pattern of tibial bone SOS change in both preterm and term newborn infants during infancy.
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Affiliation(s)
- Hsiu-Lin Chen
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
- * E-mail:
| | - Wei-Te Lee
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Pei-Lun Lee
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Po-Len Liu
- Department of Respiratory Therapy, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - Rei-Cheng Yang
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
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Misof BM, Roschger P, Blouin S, Recker R, Klaushofer K. Bone matrix mineralization is preserved during early perimenopausal stage in healthy women: a paired biopsy study. Osteoporos Int 2016; 27:1795-803. [PMID: 26650378 DOI: 10.1007/s00198-015-3446-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2015] [Accepted: 11/30/2015] [Indexed: 12/14/2022]
Abstract
UNLABELLED Bone matrix mineralization based on quantitative backscatter electron imaging remained unchanged during the first year of menopause in paired transiliac biopsy samples from healthy women. This suggests that the reported early perimenopausal reductions in bone mineral density are caused by factors other than decreases in the degree of mineralization. INTRODUCTION It is unknown whether perimenopausal loss of bone mass is associated with a drop in bone matrix mineralization. METHODS For this purpose, we measured the bone mineralization density distribution (BMDD) by quantitative backscatter electron imaging (qBEI) in n = 17 paired transiliac bone biopsy samples at premenopausal baseline and 12 months after last menses (obtained at average ages of 49 ± 2 and 55 ± 2 years, respectively) in healthy women. For interpretation of BMDD outcomes, previously measured bone mineral density (BMD) and biochemical and histomorphometric markers of bone turnover were revisited for the present biopsy cohort. RESULTS Menopause significantly decreased BMD at the lumbar spine (-4.5 %) and femoral neck (-3.8 %), increased the fasting urinary hydroxyproline/creatinine ratio (+60 %, all p < 0.01) and histomorphometric bone formation rate (+25 %, p < 0.05), but affected neither cancellous nor cortical BMDD variables (paired comparison p > 0.05). Mean calcium concentrations of cancellous (Cn.CaMean) and cortical bone (Ct.CaMean) were within normal range (p > 0.05 compared to established reference data). Ct.CaMean was significantly correlated with Cn.CaMean before (R = 0.81, p < 0.001) and after menopause (R = 0.80, p < 0.001) and to cortical porosity of mineralized tissue (Ct.Po.) after menopause (R = -0.57, p = 0.02). CONCLUSIONS Surprisingly, the BMDD was found not affected by the changes in bone turnover rates in this cohort. This suggests that the substantial increase in bone formation rates took place shortly before the second biopsy, and the bone mineralization changes lag behind. We conclude that during the first year after the last menses, the degree of bone matrix mineralization is preserved and does not contribute to the observed reductions in BMD.
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Affiliation(s)
- B M Misof
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Kundratstr. 37, A-1120, Vienna, Austria.
| | - P Roschger
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Kundratstr. 37, A-1120, Vienna, Austria
| | - S Blouin
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Kundratstr. 37, A-1120, Vienna, Austria
| | - R Recker
- Osteoporosis Research Center, Creighton University, Omaha, Nebraska, USA
| | - K Klaushofer
- Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, 1st Medical Department, Hanusch Hospital, Kundratstr. 37, A-1120, Vienna, Austria
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Zhang Z, Lindstrom MJ, Farrell PM, Lai HJ. Pubertal Height Growth and Adult Height in Cystic Fibrosis After Newborn Screening. Pediatrics 2016; 137:peds.2015-2907. [PMID: 27244789 PMCID: PMC4845866 DOI: 10.1542/peds.2015-2907] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/29/2016] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND To examine long-term growth benefit of newborn screening (NBS), adolescent peak height velocity (PHV), and adult height were compared between the screened (diagnosed early via NBS) and the control (identified generally by symptoms) in the Wisconsin Randomized Clinical Trial. METHODS Data from 107 children born in 1985-1994 and followed through 2012 were analyzed. PHV was estimated by a semiparametric growth curve model and compared with Tanner reference. RESULTS Meconium ileus (MI; n = 25) was associated with the worst pubertal growth and adult height, including 1 child who did not experience apparent PHV; children with pancreatic sufficiency (n = 18) achieved the best growth (normal PHV and adult height). In children with pancreatic insufficiency without meconium ileus (n = 64), the subgroup most likely to benefit from NBS, screened children had similar PHV but better adult height compared with controls. Specifically, in boys, the screened group (n = 22) achieved normal PHV (9.5 cm at 13.5 years); the control group (n = 19) had similar onset age (13.6 years) but 0.6-cm lower magnitude (P = .08). In girls, the screened group (n = 10) had somewhat later (12.5 years vs 11.7 years, P = .12) and lower PHV (7.3 cm vs 7.9 cm, P = .33) than the controls (n = 13), coinciding with later menarche (13.6 years vs 12.2 years, P = .10). Adult height was taller in the screened than the control (50th vs 29th percentile, P = .02), even after adjusted for genetic potential (32nd vs15th percentile, P = .006). Differences in adult height were primarily attributable to NBS and better prepubertal growth. CONCLUSIONS Early linear growth benefits of NBS were sustained through puberty, leading to better adult height in cystic fibrosis.
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Affiliation(s)
| | | | | | - HuiChuan J. Lai
- Departments of Nutritional Sciences,,Biostatistics and Medical Informatics, and,Pediatrics, University of Wisconsin–Madison, Madison, Wisconsin
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Dufrane D, Docquier PL, Delloye C, Poirel HA, André W, Aouassar N. Scaffold-free Three-dimensional Graft From Autologous Adipose-derived Stem Cells for Large Bone Defect Reconstruction: Clinical Proof of Concept. Medicine (Baltimore) 2015; 94:e2220. [PMID: 26683933 PMCID: PMC5058905 DOI: 10.1097/md.0000000000002220] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Long bone nonunion in the context of congenital pseudarthrosis or carcinologic resection (with intercalary bone allograft implantation) is one of the most challenging pathologies in pediatric orthopedics. Autologous cancellous bone remains the gold standard in this context of long bone nonunion reconstruction, but with several clinical limitations. We then assessed the feasibility and safety of human autologous scaffold-free osteogenic 3-dimensional (3D) graft (derived from autologous adipose-derived stem cells [ASCs]) to cure a bone nonunion in extreme clinical and pathophysiological conditions. Human ASCs (obtained from subcutaneous adipose tissue of 6 patients and expanded up to passage 4) were incubated in osteogenic media and supplemented with demineralized bone matrix to obtain the scaffold-free 3D osteogenic structure as confirmed in vitro by histomorphometry for osteogenesis and mineralization. The 3D "bone-like" structure was finally transplanted for 3 patients with bone tumor and 3 patients with bone pseudarthrosis (2 congenital, 1 acquired) to assess the clinical feasibility, safety, and efficacy. Although minor clones with structural aberrations (aneuploidies, such as tri or tetraploidies or clonal trisomy 7 in 6%-20% of cells) were detected in the undifferentiated ASCs at passage 4, the osteogenic differentiation significantly reduced these clonal anomalies. The final osteogenic product was stable, did not rupture with forceps manipulation, did not induce donor site morbidity, and was easily implanted directly into the bone defect. No acute (<3 mo) side effects, such as impaired wound healing, pain, inflammatory reaction, and infection, or long-term side effects, such as tumor development, were associated with the graft up to 4 years after transplantation. We report for the first time that autologous ASC can be fully differentiated into a 3D osteogenic-like implant without any scaffold. We demonstrated that this engineered tissue can safely promote osteogenesis in extreme conditions of bone nonunions with minor donor site morbidity and no oncological side effects.
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Affiliation(s)
- Denis Dufrane
- From the Endocrine Cell Therapy, Center of Tissue and Cell Therapy, Cliniques Universitaires Saint-Luc, Brussels, Belgium (DD, WA, NA); Orthopedic Surgery Service, Department of Surgery, Cliniques Universitaires Saint-Luc, Brussels, Belgium (P-LD, CD); and Center for Human Genetics, Cliniques Universitaires Saint-Luc - Université Catholique de Louvain, Brussels, Belgium (HAP)
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The Effects of Elk Velvet Antler Dietary Supplementation on Physical Growth and Bone Development in Growing Rats. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2015; 2015:819520. [PMID: 26366186 PMCID: PMC4561106 DOI: 10.1155/2015/819520] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/16/2015] [Revised: 06/16/2015] [Accepted: 06/18/2015] [Indexed: 11/23/2022]
Abstract
Elk velvet antler (EVA) has been used in traditional Oriental medicine for centuries to promote general health; however, little evidence for its effect on bone development is available. We investigated the effects of lifelong exposure of Wistar rats to a diet containing 10% EVA on physical growth and bone development. Measurements included weekly body weights, blood chemistry and kidney and testis/ovary indices (sacrificed at 5, 9, or 16 weeks of age), and bone traits of the femur bones by peripheral quantitative computed tomography (pQCT). Mean body weights were higher in the EVA group at 4–8 weeks in males and at 5 weeks of age in females. The kidney indices were greater in EVA dietary supplemented male rats at 5 and 16 weeks of age, in females at 16 weeks of age, and testis/ovary indices at 5 weeks of age. The femoral length was increased in both males and females at 5 weeks, and several pQCT-measured parameters had increased in EVA males and females. The activity of alkaline phosphatase (ALP) increased in EVA group while the content of calcium and phosphorus did not differ among groups. Our results seem to support a role for dietary supplementation of EVA on growth and bone development in this model.
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Brookes DSK, Briody JN, Munns CF, Davies PSW, Hill RJ. Cystic fibrosis-related bone disease in children: Examination of peripheral quantitative computed tomography (pQCT) data. J Cyst Fibros 2015; 14:668-77. [PMID: 25957706 DOI: 10.1016/j.jcf.2015.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2014] [Revised: 04/02/2015] [Accepted: 04/20/2015] [Indexed: 11/16/2022]
Abstract
BACKGROUND The investigation of skeletal health data beyond dual X-ray absorptiometry (DXA) is limited in young individuals with CF. We assessed volumetric bone mineral densities (BMD), and bone and muscle parameters using peripheral quantitative computed tomography (pQCT) in individuals with CF and controls, 7.00-17.99 years. METHODS Peripheral QCT (XCT 3000, Stratec) measurements were made in 53 individuals with CF and 53 controls. Bone mineral content (BMC), total volumetric BMD (vBMD) and cross sectional area (CSA) of the bone were measured at the 4% and 66% sites of the non-dominant tibia and radius. Additionally, trabecular vBMD and bone strength index (BSIc) were measured at the 4% sites, and cortical vBMD, muscle CSA (mCSA) and strength strain index (SSI) were measured at the 66% sites. RESULTS Pre-pubertal males with CF had greater trabecular vBMD (p=0.01) and total vBMD (p=0.00) at 4% tibia, and greater total vBMD (p=0.02) at 4% radius. Pre-pubertal females with CF had greater total vBMD at 66% tibia (p=0.02) and radius (p=0.04), and cortical vBMD (p=0.04) at the radius. At puberty, the CF cohort had less BMC at 4% tibia (males, p=0.02; females, p=0.01), and smaller mCSA at 66% tibia (males, p=0.02; females, p=0.01). Pubertal CF females had a smaller bone CSA (p=0.01) at 4% tibia, and lower bone strength (SSI) at the tibia (p=0.00) and radius (p=0.05) sites. CONCLUSIONS Bone strength parameters were not compromised prior to puberty in this CF cohort. At puberty, the bone phenotype changed for this CF cohort, showing several deficits compared to the controls. However, bone strength was adapting to the mechanical demands of the muscle. Altered bone parameters and their implications for lowered bone strength with increased age may be greatly influenced by: the CF cohort remaining smaller for age and/or a reduced bone strain, secondary to reduced muscle force.
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Affiliation(s)
- Denise S K Brookes
- The University of Queensland, Queensland Children's Medical Research Institute, Children's Nutrition Research Centre, Brisbane, Australia; The University of Queensland, School of Medicine, Brisbane, Australia.
| | | | - Craig F Munns
- The Children's Hospital at Westmead, Sydney, Australia; University of Sydney, School of Medicine, Sydney, Australia
| | - Peter S W Davies
- The University of Queensland, Queensland Children's Medical Research Institute, Children's Nutrition Research Centre, Brisbane, Australia; The University of Queensland, School of Medicine, Brisbane, Australia
| | - Rebecca J Hill
- The University of Queensland, Queensland Children's Medical Research Institute, Children's Nutrition Research Centre, Brisbane, Australia; The University of Queensland, School of Medicine, Brisbane, Australia
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Rantalainen T, Weeks BK, Nogueira RC, Beck BR. Effects of bone-specific physical activity, gender and maturity on tibial cross-sectional bone material distribution: a cross-sectional pQCT comparison of children and young adults aged 5-29 years. Bone 2015; 72:101-8. [PMID: 25465388 DOI: 10.1016/j.bone.2014.11.015] [Citation(s) in RCA: 26] [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: 06/23/2014] [Revised: 11/04/2014] [Accepted: 11/18/2014] [Indexed: 01/26/2023]
Abstract
Growth is the opportune time to modify bone accrual. While bone adaptation is known to be dependent on local loading and consequent deformations (strain) of bone, little is known about the effects of sex, and bone-specific physical activity on location-specific cross-sectional bone geometry during growth. To provide more insight we examined bone traits at different locations around tibial cross sections, and along the tibia between individuals who vary in terms of physical activity exposure, sex, and pubertal status. Data from 304 individuals aged 5-29 years (172 males, 132 females) were examined. Peripheral quantitative computed tomography (pQCT) was applied at 4%, 14%, 38%, and 66% of tibial length. Maturity was established by estimating age at peak height velocity (APHV). Loading history was quantified with the bone-specific physical activity questionnaire (BPAQ). Comparisons, adjusted for height, weight and age were made between sex, maturity, and BPAQ tertile groups. Few to no differences were observed between sexes or BPAQ tertiles prior to APHV, whereas marked sexual dimorphism and differences between BPAQ tertiles were observed after APHV. Cross-sectional location-specific differences between BPAQ tertiles were not evident prior to APHV, whereas clear location-specificity was observed after APHV. In conclusion, the skeletal benefits of physical activity are location-specific in the tibia. The present results indicate that the peri- or post-pubertal period is likely a more favourable window of opportunity for enhancing cross-sectional bone geometry than pre-puberty. Increased loading during the peri-pubertal period may enhance the bone of both sexes.
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Affiliation(s)
- Timo Rantalainen
- Centre for Physical Activity and Nutrition Research, School of Exercise and Nutrition Sciences, Deakin University, Melbourne, Australia.
| | - Benjamin K Weeks
- Griffith Health Institute, Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Rossana C Nogueira
- Griffith Health Institute, Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Belinda R Beck
- Griffith Health Institute, Centre for Musculoskeletal Research, School of Allied Health Sciences, Griffith University, Gold Coast, Australia
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Crawford B, Kim DG, Moon ES, Johnson E, Fields HW, Palomo JM, Johnston WM. Cervical vertebral bone mineral density changes in adolescents during orthodontic treatment. Am J Orthod Dentofacial Orthop 2014; 146:183-9. [PMID: 25085301 DOI: 10.1016/j.ajodo.2014.04.019] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 04/01/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022]
Abstract
INTRODUCTION The cervical vertebral maturation (CVM) stages have been used to estimate facial growth status. In this study, we examined whether cone-beam computed tomography images can be used to detect changes of CVM-related parameters and bone mineral density distribution in adolescents during orthodontic treatment. METHODS Eighty-two cone-beam computed tomography images were obtained from 41 patients before (14.47 ± 1.42 years) and after (16.15 ± 1.38 years) orthodontic treatment. Two cervical vertebral bodies (C2 and C3) were digitally isolated from each image, and their volumes, means, and standard deviations of gray-level histograms were measured. The CVM stages and mandibular lengths were also estimated after converting the cone-beam computed tomography images. RESULTS Significant changes for the examined variables were detected during the observation period (P ≤0.018) except for C3 vertebral body volume (P = 0.210). The changes of CVM stage had significant positive correlations with those of vertebral body volume (P ≤0.021). The change of the standard deviation of bone mineral density (variability) showed significant correlations with those of vertebral body volume and mandibular length for C2 (P ≤0.029). CONCLUSIONS The means and variability of the gray levels account for bone mineral density and active remodeling, respectively. Our results indicate that bone mineral density distribution and the volume of the cervical vertebral body changed because of active bone remodeling during maturation.
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Affiliation(s)
- Bethany Crawford
- Resident, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus
| | - Do-Gyoon Kim
- Associate professor, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus.
| | - Eun-Sang Moon
- Predoctoral student, College of Dentistry, Ohio State University, Columbus
| | - Elizabeth Johnson
- Resident, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus
| | - Henry W Fields
- Professor, Division of Orthodontics, College of Dentistry, Ohio State University, Columbus
| | - J Martin Palomo
- Associate professor, Department of Orthodontics, School of Dental Medicine, Case Western Reserve University, Cleveland, Ohio
| | - William M Johnston
- Professor, Division of Restorative, Prosthetic and Primary Care Dentistry, College of Dentistry, Ohio State University, Columbus
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Roschger P, Misof B, Paschalis E, Fratzl P, Klaushofer K. Changes in the degree of mineralization with osteoporosis and its treatment. Curr Osteoporos Rep 2014; 12:338-50. [PMID: 24947951 DOI: 10.1007/s11914-014-0218-z] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
The diagnosis of osteoporosis is based on low bone mineral density (BMD) and/or the occurrence of fragility fractures. The majority of patients, however, have also abnormally low bone matrix mineralization. The latter is indicative of alterations in bone turnover rates and/or in kinetics of mineral accumulation within the newly formed bone matrix. Osteoporosis therapies can alter the bone matrix mineralization according to their action on bone turnover and/or mineralization kinetics. Antiresorptives, including the most widely used bisphosphonates, reduce the bone turnover rate resulting in a decrease in heterogeneity and an increase in the degree of mineralization toward to or even beyond normal values. Anabolic agents increase the bone volume and the amount of newly formed bone resulting in a likely transient decrease in mean degree and homogeneity of mineralization. Hence, the measurement of bone matrix mineralization is a sensitive tool to evaluate the response to therapy.
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Affiliation(s)
- Paul Roschger
- 1st Medical Department, Hanusch Hospital, Ludwig Boltzmann Institute of Osteology at the Hanusch Hospital of WGKK and AUVA Trauma Centre Meidling, Heinrich Collin Str. 30, A-1140, Vienna, Austria,
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Bone Mineral Density in Children From Anthropological and Clinical Sciences: A Review. ANTHROPOLOGICAL REVIEW 2014. [DOI: 10.2478/anre-2014-0011] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract
Bone mineral density (BMD) is a frequent topic of discussion in the clinical literature in relation to the bone health of both adults and children. However, in archaeological and/ or anthropological studies the role of BMD is often cited as a possible factor in the poor skeletal preservation which can lead to an under-representation of juvenile skeletal remains. During skeletal development and growth throughout childhood and adolescence changes take place in both the size and shape of bones and these changes also result in the increasing of mineral content. BMD can be affected by many factors, which include, age, genetics, sexual maturation, amount of physical activity and dietary calcium. This paper aims to review the clinical and anthropological literature on BMD and discuss the numerous methods of measurement and how the availability of certain methods such as Dual-energy x-ray absorptiometry (DEXA) and quantitative computed tomography (QCT) can influence the study of bone density in archaeological skeletal collections and also the future potential for forensic anthropological studies.
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Hu J, Zhang T, Xu D, Qu J, Qin L, Zhou J, Lu H. Combined magnetic fields accelerate bone‐tendon junction injury healing through osteogenesis. Scand J Med Sci Sports 2014; 25:398-405. [PMID: 24845774 DOI: 10.1111/sms.12251] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2014] [Indexed: 12/29/2022]
Affiliation(s)
- J. Hu
- Department of Sports Medicine, Research Center of Sports Medicine Xiangya Hospital Central South University Changsha Hunan China
- Department of Spine Surgery Xiangya Hospital Central South University Changsha Hunan China
| | - T. Zhang
- Department of Sports Medicine, Research Center of Sports Medicine Xiangya Hospital Central South University Changsha Hunan China
- Department of Spine Surgery Xiangya Hospital Central South University Changsha Hunan China
| | - D. Xu
- Department of Sports Medicine, Research Center of Sports Medicine Xiangya Hospital Central South University Changsha Hunan China
| | - J. Qu
- Department of Sports Medicine, Research Center of Sports Medicine Xiangya Hospital Central South University Changsha Hunan China
- Department of Spine Surgery Xiangya Hospital Central South University Changsha Hunan China
| | - L. Qin
- Department of Orthopaedics and Traumatology The Chinese University of Hong Kong Hong Kong SAR China
| | - J. Zhou
- Department of Sports Medicine, Research Center of Sports Medicine Xiangya Hospital Central South University Changsha Hunan China
| | - H. Lu
- Department of Sports Medicine, Research Center of Sports Medicine Xiangya Hospital Central South University Changsha Hunan China
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