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Freire EBL, Brasil d’Alva C, Madeira MP, Lima GEDCP, Fernandes VO, Aguiar LB, Portella LB, Galvão Ozório R, Ponte CMM, Montenegro APDR, Montenegro Junior RM. Heterogeneity and high prevalence of bone manifestations, and bone mineral density in congenital generalized lipodystrophy subtypes 1 and 2. Front Endocrinol (Lausanne) 2024; 15:1326700. [PMID: 38633760 PMCID: PMC11021684 DOI: 10.3389/fendo.2024.1326700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 03/11/2024] [Indexed: 04/19/2024] Open
Abstract
Introduction Congenital Generalized Lipodystrophy (CGL) is a rare autosomal recessive disease caused by mutations in genes responsible for the formation and development of adipocytes. Bone abnormalities are described. However, there is a scarcity of data. Objective To describe bone characteristics in a large CGL1 and 2 case series. Methods Cross-sectional study that assessed bone radiological features of CGL patients of a reference hospital in Fortaleza (CE), Brazil. Patients underwent clinical and bone mineral metabolism evaluation, radiographs of the axial and appendicular skeleton and bone mineral density (BMD) assessment by DEXA (dual energy X-ray absorptiometry). Results Nineteen patients were included, fourteen were CGL1 and 5, CGL2. Median age was 20 years (8-42) and 58% were women. Median BMI and percentage of body fat were, respectively, 21 Kg/m² (16-24), and 10.5% (7.6-15). The median leptin concentration was 1 ng/mL (0.1-3.3). Diabetes mellitus and dyslipidemia were present in 79% and 63% of patients, respectively. Median calcium and phosphate were normal in almost all patients (95%). Median parathyroid hormone and 25-OH-vitamin D were 23 pg/mL (7-75) and 28 ng/mL (18-43). Osteolytic lesions, osteosclerosis and pseudo-osteopoikylosis, were present in 74%, 42% and 32% of patients, respectively. Lytic lesions were found predominantly in the extremities of long bones, bilaterally and symmetrically, spine was spared. Osteosclerosis was present in axial and appendicular skeleton. Pseudo-osteopoikilosis was found symmetrically in epiphyses of femur and humerus, in addition to the pelvis. BMD Z-score greater than +2.5 SD was observed in 13 patients (68.4%). BMD was higher in CGL1 compared to CGL2 in lumbar spine and total body in adults. No associations were found between high BMD and HOMA-IR (p=0.686), DM (p=0.750), osteosclerosis (p=0.127) or pseudo-osteopoikilosis (p=0.342), and, between pain and bone lesions. Fractures were found in 3 patients. Conclusion Bone manifestations are prevalent, heterogeneous, and silent in CGL1 and CGL2. Osteolytic lesions are the most common, followed by osteosclerosis and pseudo-osteopoikilosis. Bone mass is high in most cases. There was no pain complaint related to bone lesions. Thus, systematic assessment of bone manifestations in CGL is essential. Studies are needed to better understand its pathogenesis and clinical consequences.
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Affiliation(s)
- Erika Bastos Lima Freire
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Catarina Brasil d’Alva
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Mayara Ponte Madeira
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Grayce Ellen da Cruz Paiva Lima
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
- University of Fortaleza, (UNIFOR), Fortaleza, CE, Brazil
| | - Virginia Oliveira Fernandes
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Department of Community Health, Federal University of Ceará, Fortaleza, CE, Brazil
| | - Lindenberg Barbosa Aguiar
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Radiology Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
| | - Leonardo Barreira Portella
- Radiology Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
| | - Renan Galvão Ozório
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
| | - Clarisse Mourão Melo Ponte
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Diagnostics of America (DASA), São Paulo, SP, Brazil
- Christus University Center, Fortaleza, CE, Brazil
| | - Ana Paula Dias Rangel Montenegro
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Pediatric Endocrinology Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
| | - Renan Magalhães Montenegro Junior
- Brazilian Group for the Study of Inherited and Acquired Lipodystrophies (BRAZLIPO), Fortaleza, Brazil
- Clinical Research Unit, Walter Cantídio University Hospital, Federal University of Ceará/EBSERH, Fortaleza, CE, Brazil
- Department of Clinical Medicine, Federal University of Ceará, Fortaleza, CE, Brazil
- Department of Community Health, Federal University of Ceará, Fortaleza, CE, Brazil
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Tan MY, Zhu SX, Wang GP, Liu ZX. Impact of metabolic syndrome on bone mineral density in men over 50 and postmenopausal women according to U.S. survey results. Sci Rep 2024; 14:7005. [PMID: 38523143 PMCID: PMC10961310 DOI: 10.1038/s41598-024-57352-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 03/18/2024] [Indexed: 03/26/2024] Open
Abstract
Metabolic Syndrome (MetS) and bone mineral density (BMD) have shown a controversial link in some studies. This research aims to study their association in males over 50 and postmenopausal females using National Health and Nutrition Examination Survey (NHANES) data. Postmenopausal females and males over 50 were included in the study. MetS was defined by the National Cholesterol Education Program Adult Treatment Panel III guidelines. BMD values were measured at the thoracic spine, lumbar spine, and pelvis as the primary outcome. Weighted multivariate general linear models have been employed to explore the status of BMD in patients with MetS. Additionally, interaction tests and subgroup analyses were conducted. Utilizing the NHANES database from 2003 to 2006 and 2011-2018, we included 1924 participants, with 1029 males and 895 females. In postmenopausal women, after adjusting for covariates, we found a positive correlation between MetS and pelvic (β: 0.030 [95%CI 0.003, 0.06]) and thoracic (β: 0.030 [95%CI 0.01, 0.06]) BMD, though not for lumbar spine BMD (β: 0.020 [95%CI - 0.01, 0.05]). In males over 50 years old, MetS was positively correlated with BMD in both Model 1 (without adjusting for covariates) and Model 2 (considering age and ethnicity). Specifically, Model 2 revealed a positive correlation between MetS and BMD at the pelvis (β: 0.046 [95%CI 0.02, 0.07]), thoracic spine (β: 0.047 [95%CI 0.02, 0.07]), and lumbar spine (β: 0.040 [95%CI 0.02, 0.06]). Subgroup analysis demonstrated that the relationship between MetS and BMD remained consistent in all strata, underscoring the stability of the findings. In postmenopausal women, after adjusting for all covariates, a significant positive correlation was observed between MetS and BMD in the pelvis and thoracic spine, whereas this correlation was not significant for lumbar spine BMD. Conversely, in males, positive correlations between MetS and BMD at the lumbar spine, thoracic spine, and pelvis were identified in Model 2, which adjusted for age and ethnicity; however, these correlations disappeared after fully adjusting for all covariates. These findings highlight the potential moderating role of gender in the impact of MetS on BMD.
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Affiliation(s)
- Mo-Yao Tan
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Si-Xuan Zhu
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Gao-Peng Wang
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Zhong-Xing Liu
- Dujiangyan Traditional Chinese Medicine Hospital, Chengdu, Sichuan, China.
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Greere D, Grigorescu F, Manda D, Lautier C, Poianã C. INSULIN RESISTANCE AND PATHOGENESIS OF POSTMENOPAUSAL OSTEOPOROSIS. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2023; 19:349-363. [PMID: 38356971 PMCID: PMC10863952 DOI: 10.4183/aeb.2023.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/16/2024]
Abstract
Osteoporosis (OP) is a disease predisposing postmenopausal women to fractures, and often accompanied by insulin resistance (IR) and metabolic syndrome (MetS). Previous studies provided contradictory results concerning prevalence of MetS in postmenopausal OP. To better understand the pathogenesis of IR, we reviewed cellular and molecular aspects and systematically reviewed studies providing homeostasis model assessment (HOMA) index. Bone is an active endocrine organ maintaining its integrity by orchestrated balance between bone formation and resorption. Both osteoblasts and osteoclasts contain receptors for insulin and insulin-like growth factor-1 (IGF-1) operating in skeletal development and in the adult life. Defects in this system generate systemic IR and bone-specific IR, which in turn regulates glucose homeostasis and energy metabolism through osteocalcin. Examination of genetic syndromes of extreme IR revealed intriguing features namely high bone mineral density (BMD) or accelerated growth. Studies of moderate forms of IR in postmenopausal women reveal positive correlations between HOMA index and BMD while correlations with osteocalcin were rather negative. The relation with obesity remains complex involving regulatory factors such as leptin and adiponectin to which the contribution of potential genetic factors and in particular, the correlation with the degree of obesity or body composition should be added.
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Affiliation(s)
- D.I.I. Greere
- “C.I. Parhon” National Institute of Endocrinology - Clinical Endocrinology, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy - Endocrinology, Bucharest, Romania
| | - F. Grigorescu
- Institut Convergences Migrations - Molecular - Endocrinology, Montpellier, France
| | - D. Manda
- “C.I. Parhon” National Institute of Endocrinology - Molecular Cellular and Structural Endocrinology Laboratory, Bucharest, Romania
| | - C. Lautier
- Université de Montpellier, Montpellier, France
| | - C. Poianã
- “C.I. Parhon” National Institute of Endocrinology - Clinical Endocrinology, Bucharest, Romania
- “Carol Davila” University of Medicine and Pharmacy - Endocrinology, Bucharest, Romania
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Li Y, Yang X, Peng L, Xia Q, Zhang Y, Huang W, Liu T, Jia D. Role of Seipin in Human Diseases and Experimental Animal Models. Biomolecules 2022; 12:biom12060840. [PMID: 35740965 PMCID: PMC9221541 DOI: 10.3390/biom12060840] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 02/05/2023] Open
Abstract
Seipin, a protein encoded by the Berardinelli-Seip congenital lipodystrophy type 2 (BSCL2) gene, is famous for its key role in the biogenesis of lipid droplets and type 2 congenital generalised lipodystrophy (CGL2). BSCL2 gene mutations result in genetic diseases including CGL2, progressive encephalopathy with or without lipodystrophy (also called Celia’s encephalopathy), and BSCL2-associated motor neuron diseases. Abnormal expression of seipin has also been found in hepatic steatosis, neurodegenerative diseases, glioblastoma stroke, cardiac hypertrophy, and other diseases. In the current study, we comprehensively summarise phenotypes, underlying mechanisms, and treatment of human diseases caused by BSCL2 gene mutations, paralleled by animal studies including systemic or specific Bscl2 gene knockout, or Bscl2 gene overexpression. In various animal models representing diseases that are not related to Bscl2 mutations, differential expression patterns and functional roles of seipin are also described. Furthermore, we highlight the potential therapeutic approaches by targeting seipin or its upstream and downstream signalling pathways. Taken together, restoring adipose tissue function and targeting seipin-related pathways are effective strategies for CGL2 treatment. Meanwhile, seipin-related pathways are also considered to have potential therapeutic value in diseases that are not caused by BSCL2 gene mutations.
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Affiliation(s)
- Yuying Li
- West China Pancreatitis Centre, Centre for Integrated Traditional Chinese Medicine and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.L.); (X.Y.); (Q.X.)
| | - Xinmin Yang
- West China Pancreatitis Centre, Centre for Integrated Traditional Chinese Medicine and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.L.); (X.Y.); (Q.X.)
| | - Linrui Peng
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China; (L.P.); (Y.Z.)
| | - Qing Xia
- West China Pancreatitis Centre, Centre for Integrated Traditional Chinese Medicine and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.L.); (X.Y.); (Q.X.)
| | - Yuwei Zhang
- Department of Endocrinology and Metabolism, West China Hospital of Sichuan University, Chengdu 610041, China; (L.P.); (Y.Z.)
| | - Wei Huang
- West China Pancreatitis Centre, Centre for Integrated Traditional Chinese Medicine and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.L.); (X.Y.); (Q.X.)
- Institutes for Systems Genetics & Immunology and Inflammation, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu 610041, China
- Correspondence: (W.H.); (T.L.)
| | - Tingting Liu
- West China Pancreatitis Centre, Centre for Integrated Traditional Chinese Medicine and Western Medicine, West China-Liverpool Biomedical Research Centre, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.L.); (X.Y.); (Q.X.)
- Correspondence: (W.H.); (T.L.)
| | - Da Jia
- Key Laboratory of Birth Defects and Related Diseases of Women and Children, Department of Paediatrics, West China Second University Hospital, State Key Laboratory of Biotherapy and Collaborative Innovation Center of Biotherapy, Sichuan University, Chengdu 610041, China;
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