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Ersan N, Özel B. Evaluation of mandibular cortical and trabecular radiomorphometry in familial Mediterranean fever patients. Oral Surg Oral Med Oral Pathol Oral Radiol 2023; 136:640-648. [PMID: 37422403 DOI: 10.1016/j.oooo.2023.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/12/2023] [Accepted: 05/29/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE The objective of this retrospective study was to evaluate the mandibular cortical and trabecular morphology and microarchitecture of patients with familial Mediterranean fever (FMF) and compare them to those of healthy individuals by examining radiomorphometric indices on panoramic radiographs. STUDY DESIGN We examined a group of 56 FMF patients aged 5 to 71 years and an age- and sex-matched control group of individuals with no systemic diseases. We classified the FMF and control groups according to age and sex and the FMF group according to colchicine use. We evaluated the quantitative radiomorphometic indices of gonial index, antegonial index, molar cortical thickness, mental index, panoramic mandibular index, and lacunarity, and the qualitative mandibular cortical index on all panoramic radiographs and performed between and within group analysis. RESULTS Mean gonial index, antegonial index, and molar cortical thickness values of the FMF group were significantly smaller than those of the control group. Significantly fewer patients in the FMF group were classified as mandibular cortical index type 1 compared to the control group. There were no significant differences in quantitative index values according to colchicine use in the FMF group or regarding the categorical parameters of age, sex, and mandibular cortical index classification. CONCLUSIONS Radiomorphometric values of the mandibular basal cortex posterior to the mental foramen differ significantly in FMF patients compared to healthy counterparts. Dentists should note mandibular morphologic changes indicative of low bone density when examining panoramic images of patients with this disease.
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Affiliation(s)
- Nilüfer Ersan
- Department of Dentomaxillofacial Radiology, Yeditepe University Faculty of Dentistry, Istanbul, Turkey.
| | - Beliz Özel
- Department of Endodontics, Academic Centre for Dentistry Amsterdam, Amsterdam, Netherlands
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Ersan N, Özel B. Fractal dimension analysis of different mandibular regions in familial Mediterranean fever patients: A cross-sectional retrospective study. PLoS One 2023; 18:e0288170. [PMID: 37390096 PMCID: PMC10313079 DOI: 10.1371/journal.pone.0288170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023] Open
Abstract
Familial Mediterranean fever (FMF) is a genetic condition that may cause loss of bone mineral density (BMD) due to chronic inflammation. Previously, fractal dimension (FD) analysis values of mandibular cortical bone were shown to be lower in osteoporosis. Therefore, FD might be considered as an auxiliary tool to refer patients for dual-energy x-ray absorptiometry (DXA), which is the gold standard for BMD measurement. The purpose of this cross-sectional retrospective study was to evaluate trabecular and cortical microarchitecture of the mandible with FD analysis on panoramic radiographs in a subpopulation of FMF. Also, the effect of colchicine use was investigated. Forty-three FMF patients, aged between 10.8 and 71.2 years, and age- and gender-matched control group consisting of patients, who had no systemic diseases, were included. Demographic information such as age and gender, and colchicine use were recorded. In terms of age, the patients were classified as <30 and 30< years. On each panoramic radiographs five regions of interest were selected on the mandible as: 1- premolar, 2- molar, 3- angular, 4- condylar, and 5- basal cortical bone regions on right (R) and left (L) sides. Statistical significance was accepted at p<0.05 level. Intra- and inter-observer agreements demonstrated good to excellent consistency. In FMF patients, L3 and L4 values were higher, whereas L5 values were lower (p<0.05) than the control group. In terms of age, the difference between groups was insignificant in FMF patients (p>0.05), whereas in control group R3 and L4 values were higher in the 30< age group (p<0.05). Regarding gender and colchicine use, the difference between groups was insignificant (p>0.05). FMF disease might be a candidate for referral to DXA examination based on decreased bone density in the mandibular cortex detected by FD measurements on routine panoramic radiographs. Further studies are warranted to ascertain this relationship.
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Affiliation(s)
- Nilüfer Ersan
- Yeditepe University Faculty of Dentistry, Department of Dentomaxillofacial Radiology, Istanbul, Turkiye
| | - Beliz Özel
- Yeditepe University Faculty of Dentistry, Department of Endodontics, Istanbul, Turkiye
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Orhan C, Seyhan B, Baykara O, Yildiz M, Kasapcopur O, Buyru N. Vitamin D binding protein genotype frequency in familial Mediterranean fever patients. Scand J Rheumatol 2020; 49:484-488. [PMID: 32940108 DOI: 10.1080/03009742.2020.1762922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Objective: Familial Mediterranean fever (FMF) is an autosomal recessive disorder characterized by recurrent short episodes (1-3 days) of inflammation and fever. FMF is associated with MEFV gene mutations but some patients with FMF symptoms do not have a mutation in the coding region of the MEFV gene. Vitamin D binding protein (VDBP) has important functions, including transporting vitamin D and its metabolites to target cells. Circulating levels of vitamin D are decreased in several inflammatory conditions, including FMF. Thus, we hypothesize that VDBP may play a crucial role in FMF pathogenesis, in addition to the MEFV gene. Method: VDBP genotyping was performed by polymerase chain reaction (PCR)-restriction fragment length polymorphism in 107 FMF patients and 25 healthy individuals without FMF or family history. For this, after amplification of genomic DNA, PCR products were digested with restriction enzymes HaeIII and StyI and evaluated electrophoretically. Results: We observed a statistically significant difference in the frequency of the 1F-2 genotype. The frequency of allele 2 was significantly higher and allele 1S was significantly lower compared to the [MEFV(-)] group and healthy controls (p = 0.034, 0.001, and 0.012, respectively). We observed a significant association between the presence of allele 2 and amyloidosis (p = 0.026) and arthritis (p = 0.044) in the [MEFV(-)] group. Conclusion: Our results suggest that FMF symptoms in the absence of MEFV gene mutations may be due to the presence of VDBP allele 2. Therefore, VDBP genotype may explain the symptoms in FMF [MEFV(-)] patients.
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Affiliation(s)
- C Orhan
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - B Seyhan
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - O Baykara
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - M Yildiz
- Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - O Kasapcopur
- Department of Pediatric Rheumatology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
| | - N Buyru
- Department of Medical Biology, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa , Istanbul, Turkey
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Bindoli S, Franceschet G, Galozzi P, Zaninotto M, Camozzi V, Sfriso P. Osteoporosis in Systemic Autoinflammatory Diseases: A Case-Control Study. Front Endocrinol (Lausanne) 2019; 10:636. [PMID: 31620089 PMCID: PMC6759948 DOI: 10.3389/fendo.2019.00636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 09/03/2019] [Indexed: 01/22/2023] Open
Abstract
Objective: To assess if patients affected by systemic autoinflammatory diseases (SAIDs) present an increased risk of osteoporosis (OP). Methods: Forty adults patients referred to the Rheumatology Unit of Padova University Hospital affected by Familial Mediterranean Fever (FMF), TNF-Receptor Associated Periodic Syndrome (TRAPS), and Mevalonate Kinase Deficiency (MKD) and 40 healthy subjects were enrolled. Blood and urine samples were collected in order to define phosphocalcic metabolism, including Receptor activator of nuclear factor kappa-B ligand (RANKL) and osteoprotegerin (OPG), and among inflammatory markers serum amyloid A (SAA). Femur and lumbar dual-energy X-ray absorptiometry (DXA) scans were performed and Trabecular Bone Score (TBS) was calculated on DXA lumbar images. Results: We did not observe a statistically significant difference between Bone Mineral Density (BMD) and TBS of patients compared to controls. Also, the values of phosphocalcic metabolites in patients did not statistically differ from those in controls. However, SAA and OPG levels were significantly higher in patients compared to healthy subjects (p = 0.0244 and p = 0.0064, respectively). Conclusion: Patients of our cohort affected by FMF, TRAPS, and MKD do not present an increased risk of OP compared to the healthy controls. TBS and BMD are similar between the two groups underlining a preserved bone quality in patients. High OPG levels could suggest a protective role and a bone re-balancing action in response to an inflammatory background. Finally, it should be taken into account a modulatory role played by a pro-inflammatory cytokine such as SAA on bone homeostasis.
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Affiliation(s)
- Sara Bindoli
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Giulio Franceschet
- Endocrinology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Paola Galozzi
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Martina Zaninotto
- Department of Laboratory Medicine, University-Hospital of Padova, Padova, Italy
| | - Valentina Camozzi
- Endocrinology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
| | - Paolo Sfriso
- Rheumatology Unit, Department of Medicine DIMED, University of Padova, Padova, Italy
- *Correspondence: Paolo Sfriso
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Alghadir AH, Gabr SA, Al-Eisa E. Physical activity and lifestyle effects on bone mineral density among young adults: sociodemographic and biochemical analysis. J Phys Ther Sci 2015; 27:2261-70. [PMID: 26311965 PMCID: PMC4540860 DOI: 10.1589/jpts.27.2261] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2015] [Accepted: 04/13/2015] [Indexed: 11/24/2022] Open
Abstract
[Purpose] The purpose of this study was to assess the possible role of physical activities, calcium consumption and lifestyle factors in both bone mineral density and bone metabolism indices in 350 young adult volunteers. [Subjects and Methods] All volunteers were recruited for the assessment of lifestyle behaviors and physical activity traits using validated questioners, and bone mineral density (BMD), serum osteocalcin (s-OC), bone-specific alkaline phosphatase (BAP), and calcium were estimated using dual-energy X-ray absorptiometry analysis, and immunoassay techniques. [Results] Male participants showed a significant increase in BMD along with an increase in bone metabolism markers compared with females in all groups. However, younger subjects showed a significant increase in BMD, OC, BAP, and calcium compared with older subjects. Osteoporosis was more common in older subjects linked with abnormal body mass index and waist circumference. Bone metabolism markers correlated positively with BMD, physically activity and negatively with osteoporosis in all stages. Also, moderate to higher calcium and milk intake correlated positively with higher BMD. However, low calcium and milk intake along with higher caffeine, and carbonated beverage consumption, and heavy cigarette smoking showed a negative effect on the status of bone mineral density. Stepwise regression analysis showed that life style factors including physical activity and demographic parameters explained around 58-69.8% of the bone mineral density variation in young adults especially females. [Conclusion] body mass index, physical activity, low calcium consumption, and abnormal lifestyle have role in bone mineral density and prognosis of osteoporosis in young adults.
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Affiliation(s)
- Ahmad H. Alghadir
- Rehabilitation Research Chair, Department of Rehabilitation
Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
| | - Sami A. Gabr
- Rehabilitation Research Chair, Department of Rehabilitation
Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
- Department of Anatomy, Faculty of Medicine, Mansoura
University, Egypt
| | - Einas Al-Eisa
- Rehabilitation Research Chair, Department of Rehabilitation
Sciences, College of Applied Medical Sciences, King Saud University, Saudi Arabia
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Resorlu H, Resorlu M, Gokmen F, Akbal A, Adam G, Komurcu E, Goksel F, Guven M, Aras AB, Sariyildirim A, Cevizci S. Association between mean platelet volume and bone mineral density in patients with ankylosing spondylitis and diagnostic value of diffusion-weighted magnetic resonance imaging. J Phys Ther Sci 2015; 27:1137-40. [PMID: 25995574 PMCID: PMC4433995 DOI: 10.1589/jpts.27.1137] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2014] [Accepted: 12/11/2014] [Indexed: 11/25/2022] Open
Abstract
[Purpose] The aim this study was to assess the relation between bone mineral density
(BMD) and mean platelet volume (MPV) in ankylosing spondylitis (AS) patients, and evaluate
the diagnostic role of the diffusion-weighted magnetic resonance imaging (MRI). [Subjects
and Methods] Fifty patients diagnosed with AS were divided into two groups on the basis of
BMD, a normal group (n=30) and an osteopenic (n=20) group. [Results] Duration of disease
in the group with a normal BMD was 10.3±7.0 years, while it was 16.7±12.2 years in the
osteopenia group. MPV was high in the osteopenia group, while no significant differences
were observed between the groups in terms of apparent diffusion coefficient (ADC) and
platelet distribution width (PDW). There was a positive correlation between MPV and
duration of disease. Correlations between ADC value and the lumbar T score, femoral neck T
score, and duration of disease were insignificant. A negative correlation was observed
between BMD and disease duration. [Conclusion] Diffusion-weighted imaging provides
valuable results in osteoporosis but is not a suitable technique for evaluating BMD in
patients with AS because of the local and systemic inflammatory effects in the
musculoskeletal system. The common pathophysiology of atherosclerosis and osteoporosis
plays an important role in the negative correlation observed between MPV and BMD in
patients with AS.
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Affiliation(s)
- Hatice Resorlu
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Mustafa Resorlu
- Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Ferhat Gokmen
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Ayla Akbal
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Gurhan Adam
- Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Erkam Komurcu
- Department of Orthopedics, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Ferdi Goksel
- Department of Orthopedics, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Mustafa Guven
- Department of Neurosurgery, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Adem Bozkurt Aras
- Department of Neurosurgery, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Abdullah Sariyildirim
- Department of Radiology, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
| | - Sibel Cevizci
- Department of Public Health, Faculty of Medicine, Canakkale Onsekiz Mart University, Turkey
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