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Zhang M, Hou Y, Ren X, Cai Y, Wang J, Chen O. Association of a body shape index with femur bone mineral density among older adults: NHANES 2007-2018. Arch Osteoporos 2024; 19:63. [PMID: 39037488 DOI: 10.1007/s11657-024-01424-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
This study investigated the relationship between A body shape index (ABSI) and bone mineral density (BMD) in older Americans and found a negative linear association, which was particularly pronounced in diabetic population. An early focus on ABSI in the elderly population will help in the prevention of osteoporosis. OBJECTIVE A body shape index (ABSI) is an abdominal obesity index developed based on epidemiological statistics and high ABSI indicates that waist circumference (WC) is higher than expected for a given height and weight and corresponds to a more central concentration of body volume. The objective of this study was to determine whether there is a linear or nonlinear relationship between ABSI and total femur bone mineral density (BMD) in older Americans and whether the relationship between the ABSI and total femur BMD varies across populations. METHODS This cross-sectional study was based on data from the 2007-2018 National Health and Nutrition Examination Survey (NHANES). Weighted multiple linear regression, restricted cubic spline (RCS) curves, subgroup analysis, and interaction tests were used to examine the association between ABSI and total femur BMD. RESULTS This study included 2505 older adults. This study found a negative linear correlation between ABSI and total femur BMD (β = -3.2, 95%CI: -5.0, -1.4, p < 0.001). When participants were grouped according to quartiles of ABSI, those in the upper quartile had lower total femur BMD compared to those in the bottom quartile of ABSI. This negative association remained consistent across gender, age, education level, smoking, physical activity and BMI subgroups. However, in the diabetes subgroup, ABSI showed a stronger negative association with total femur BMD. CONCLUSIONS The study shows a negative linear association between ABSI and total femur BMD in older Americans, with this negative association being stronger in the diabetic population.
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Affiliation(s)
- Mengyuan Zhang
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Yue Hou
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Xiaohe Ren
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Yingying Cai
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Jingyi Wang
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China
| | - Ou Chen
- School of Nursing and Rehabilitation, Lixia District, Cheeloo College of Medicine, Shandong University, No.44 West Culture Road, Box 142, Jinan City, Shandong Province, China.
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2
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Ma G, Xu B, Zhang D, Zhu L, Zhang Y, Yang B, Qin X, Yin H, Wei X. Association between weight-adjusted waist index and bone mineral density in adolescents. Sci Rep 2024; 14:16509. [PMID: 39019936 PMCID: PMC11255232 DOI: 10.1038/s41598-024-66565-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2023] [Accepted: 07/02/2024] [Indexed: 07/19/2024] Open
Abstract
The negative effects of obesity and excess body fat on bone mineral density (BMD) have been widely reported. As opposed to waist circumference (WC) or body mass index (BMI), weight-adjusted waist index (WWI) is a superior method for assessing obesity. WWI also indicates centripetal obesity independently of the weight of the individual. An investigation of WWI and adolescents' BMD was conducted in this study. The National Health and Nutrition Examination Survey (NHANES) 2011-2018 provided the data for this cross-sectional investigation. In this study, weighted multivariate logit models were employed to assess the correlation between teenage BMD and WWI. Additionally, we conducted interaction tests and subgroup analysis. Through multivariate linear regression, we discovered that WWI was negatively linked with lumbar, trunk, and total BMD but not pelvis BMD in this study, which included 6828 subjects. We found that each unit increase in WWI resulted in a lumbar BMD decline of 0.04 g/cm2 (95%CI -0.04, -0.04), a trunk BMD decrease of 0.03 g/cm2 (95%CI -0.03, -0.02), and a total BMD decrease of 0.02 g/cm2 (95%CI -0.02, -0.02). In conclusion, in US teenagers, there were negative connections discovered between WWI and lumbar, trunk, and total BMD, but not pelvis BMD.
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Affiliation(s)
- Guoliang Ma
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China
| | - Bo Xu
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China
| | - Dian Zhang
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China
| | - Liguo Zhu
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China
- Beijing Key Laboratory of Bone Setting Technology of Traditional Chinese Medicine, Beijing, 100700, China
| | - Yili Zhang
- School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, 210023, China
| | - Bowen Yang
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China
| | - Xiaokuan Qin
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China
| | - He Yin
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China.
| | - Xu Wei
- Wangjing Hospital, China Academy of Traditional Chinese Medicine, No. 6, Zhonghuan South Road, Chaoyang District, Beijing, 100102, China.
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Liu X, Wu Y, Bennett S, Zou J, Xu J, Zhang L. The Effects of Different Dietary Patterns on Bone Health. Nutrients 2024; 16:2289. [PMID: 39064732 PMCID: PMC11280484 DOI: 10.3390/nu16142289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Revised: 07/05/2024] [Accepted: 07/14/2024] [Indexed: 07/28/2024] Open
Abstract
Bone metabolism is a process in which osteoclasts continuously clear old bone and osteoblasts form osteoid and mineralization within basic multicellular units, which are in a dynamic balance. The process of bone metabolism is affected by many factors, including diet. Reasonable dietary patterns play a vital role in the prevention and treatment of bone-related diseases. In recent years, dietary patterns have changed dramatically. With the continuous improvement in the quality of life, high amounts of sugar, fat and protein have become a part of people's daily diets. However, people have gradually realized the importance of a healthy diet, intermittent fasting, calorie restriction, a vegetarian diet, and moderate exercise. Although these dietary patterns have traditionally been considered healthy, their true impact on bone health are still unclear. Studies have found that caloric restriction and a vegetarian diet can reduce bone mass, the negative impact of a high-sugar and high-fat dietary (HSFD) pattern on bone health is far greater than the positive impact of the mechanical load, and the relationship between a high-protein diet (HPD) and bone health remains controversial. Calcium, vitamin D, and dairy products play an important role in preventing bone loss. In this article, we further explore the relationship between different dietary patterns and bone health, and provide a reference for how to choose the appropriate dietary pattern in the future and for how to prevent bone loss caused by long-term poor dietary patterns in children, adolescents, and the elderly. In addition, this review provides dietary references for the clinical treatment of bone-related diseases and suggests that health policy makers should consider dietary measures to prevent and treat bone loss.
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Affiliation(s)
- Xiaohua Liu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Yangming Wu
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Samuel Bennett
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
| | - Jun Zou
- School of Exercise and Health, Shanghai University of Sport, Shanghai 200438, China; (X.L.)
| | - Jiake Xu
- School of Biomedical Sciences, The University of Western Australia, Perth, WA 6009, Australia
- Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen 518055, China
| | - Lingli Zhang
- School of Athletic Performance, Shanghai University of Sport, Shanghai 200438, China
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Lin R, Tao Y, Li C, Li F, Li Z, Hong X, Liu Y. Central obesity may affect bone development in adolescents: association between abdominal obesity index ABSI and adolescent bone mineral density. BMC Endocr Disord 2024; 24:81. [PMID: 38890674 PMCID: PMC11186089 DOI: 10.1186/s12902-024-01600-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 05/07/2024] [Indexed: 06/20/2024] Open
Abstract
PURPOSE Previous studies have suggested that obesity defined by body mass index(BMI) is a protective factor for bone mineral density(BMD), but have overlooked the potential influence of different types of obesity. This study aims to evaluate the correlation between abdominal obesity index A Body Shape Index(ABSI) and adolescent bone density, and analyze the relationship between abdominal obesity and bone metabolism. METHODS A total of 1557 adolescent participants were included in NHANES from 2007 to 2018. Calculate the ABSI using a specific formula that takes into account waist circumference and BMI. A weighted multiple linear regression model is used to evaluate the linear correlation between ABSI and BMD. Forest plots are used to analyze the correlations between subgroups, and cubic splines are limited to evaluate the nonlinear correlations and saturation effects between ABSI and BMD. RESULTS After adjusting for confounding factors, there was a significant linear correlation (P < 0.01) between ABSI and femoral BMD, both as a continuous variable and an ordered categorical variable. The restrictive cubic spline curve indicates a significant nonlinear correlation and saturation effect between adolescent ABSI and BMD. CONCLUSION Research has shown a significant negative correlation between ABSI and BMD at the four detection sites of the femur, and this correlation may vary slightly due to age, race, family income, and different detection sites. The research results indicate that compared to overall body weight, fat distribution and content may be more closely related to bone metabolism.
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Affiliation(s)
- Rubing Lin
- Department of Orthopedics, Shenzhen Children's Hospital, Shenzhen, Guangdong, China
| | - Yuao Tao
- Department of Spine Center, Medical School, Zhongda Hospital, Southeast University, Nanjing, Jiangsu, China
| | - Chuang Li
- Department of Biological Sciences, Purdue University, West Lafayette, USA
| | - Feifei Li
- Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, USA
| | - Zijian Li
- Medical School of Chinese PLA, Beijing, China
| | - Xingyu Hong
- Health Service Center of Baiyun Street, Jiaojiang District, Zhejiang, 318000, China.
| | - Yantong Liu
- Department of Computer Information Engineering, Kunsan National University, Gunsan, 54150, South Korea.
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Bergamo EP, Witek L, Ramalho IS, Lopes ACD, Nayak VV, Torroni A, Slavin BV, Bonfante EA, Uhrich KE, Graves DT, Coelho PG. Sustained Release of Salicylic Acid for Halting Peri-Implantitis Progression in Healthy and Hyperglycemic Systemic Conditions: A Gottingen Minipig Model. ACS Biomater Sci Eng 2024; 10:3097-3107. [PMID: 38591966 PMCID: PMC11094686 DOI: 10.1021/acsbiomaterials.4c00161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/20/2024] [Accepted: 03/21/2024] [Indexed: 04/10/2024]
Abstract
To develop a peri-implantitis model in a Gottingen minipig and evaluate the effect of local application of salicylic acid poly(anhydride-ester) (SAPAE) on peri-implantitis progression in healthy, metabolic syndrome (MS), and type-2 diabetes mellitus (T2DM) subjects. Eighteen animals were allocated to three groups: (i) control, (ii) MS (diet for obesity induction), and (iii) T2DM (diet plus streptozotocin for T2DM induction). Maxillary and mandible premolars and first molar were extracted. After 3 months of healing, four implants per side were placed in both jaws of each animal. After 2 months, peri-implantitis was induced by plaque formation using silk ligatures. SAPAE polymer was mixed with mineral oil (3.75 mg/μL) and topically applied biweekly for up to 60 days to halt peri-implantitis progression. Periodontal probing was used to assess pocket depth over time, followed by histomorphologic analysis of harvested samples. The adopted protocol resulted in the onset of peri-implantitis, with healthy minipigs taking twice as long to reach the same level of probing depth relative to MS and T2DM subjects (∼3.0 mm), irrespective of jaw. In a qualitative analysis, SAPAE therapy revealed decreased levels of inflammation in the normoglycemic, MS, and T2DM groups. SAPAE application around implants significantly reduced the progression of peri-implantitis after ∼15 days of therapy, with ∼30% lower probing depth for all systemic conditions and similar rates of probing depth increase per week between the control and SAPAE groups. MS and T2DM conditions presented a faster progression of the peri-implant pocket depth. SAPAE treatment reduced peri-implantitis progression in healthy, MS, and T2DM groups.
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Affiliation(s)
- Edmara
T. P. Bergamo
- Department
of Prosthodontics, NYU Dentistry, New York, New York 10010, United States
| | - Lukasz Witek
- Biomaterials
Division, NYU Dentistry, New York, New York 10010, United States
- Department
of Biomedical Engineering, NYU Tandon School
of Engineering, Brooklyn, New York 11201, United States
- Hansjörg
Wyss Department of Plastic Surgery, NYU
Grossman School of Medicine, New
York, New York 10016, United States
| | - Ilana Santos Ramalho
- Department
of Prosthodontics and Periodontology, University
of Sao Paulo, Bauru School of Dentistry, Bauru, SP 17012-230, Brazil
| | - Adolfo Coelho de
Oliveira Lopes
- Department
of Prosthodontics and Periodontology, University
of Sao Paulo, Bauru School of Dentistry, Bauru, SP 17012-230, Brazil
| | - Vasudev Vivekanand Nayak
- Department
of Biochemistry and Molecular Biology, University
of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Andrea Torroni
- Hansjörg
Wyss Department of Plastic Surgery, NYU
Grossman School of Medicine, New
York, New York 10016, United States
| | - Blaire V. Slavin
- University
of Miami Miller School of Medicine, Miami, Florida 33136, United States
| | - Estevam A. Bonfante
- Department
of Prosthodontics and Periodontology, University
of Sao Paulo, Bauru School of Dentistry, Bauru, SP 17012-230, Brazil
| | - Kathryn E. Uhrich
- Department
of Chemistry, University of California Riverside, Riverside, California 92521, United States
| | - Dana T. Graves
- Department
of Periodontics, School of Dental Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, United States
| | - Paulo G. Coelho
- Department
of Biochemistry and Molecular Biology, University
of Miami Miller School of Medicine, Miami, Florida 33136, United States
- Division
of Plastic Surgery, Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida 33136, United States
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6
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Zhang Y, Wei J, Feng X, Lin Q, Deng J, Yuan Y, Li M, Zhai B, Chen J. Folic acid supplementation prevents high body fat-induced bone loss through TGR5 signaling pathways. Food Funct 2024; 15:4193-4206. [PMID: 38506303 DOI: 10.1039/d4fo00404c] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
Osteoporosis caused by bone loss is one of the serious global public health problems. Folic acid is a B vitamin with multiple physiological functions such as lipid regulation and antioxidant capacity, and its potential to improve bone loss has attracted our attention. Through NHANES database analysis, we found that folic acid intake was significantly correlated with whole-body bone mineral density (BMD) in people aged 20-60 years, and the association may be mediated by the body fat rate. Male C57Bl/6 mice were fed either a normal diet or a high-fat diet, and folic acid was added to drinking water for supplementation. Our results indicated that mice with high body fat showed bone microstructure damage and bone loss, while folic acid supplementation improved bone quality. At the same time, we found that mice with high body fat exhibited abnormal blood lipids, dysregulation of intestinal flora, and metabolic disorders. Folic acid supplementation improved these phenomena. Through the network analysis of intestinal flora and metabolites, we found that LCA and TGR5 may play important roles. The results showed that folic acid promoted the expression of LCA and TGR5 in mice, increased the phosphorylation of AMPK, and decreased the phosphorylation of NF-κB and ERK, thereby reducing bone loss. In summary, folic acid intake is closely related to BMD, and folic acid supplementation can prevent high body fat-induced bone loss. Our study provides new ideas and an experimental basis for preventing bone loss and osteoporosis.
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Affiliation(s)
- Yaxi Zhang
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Jieqiong Wei
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Xiangling Feng
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Qian Lin
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Jing Deng
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Yuehan Yuan
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Min Li
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Bingfang Zhai
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
| | - Jihua Chen
- Department of Nutrition Science and Food Hygiene, Xiangya School of Public Health, Central South University, Changsha 410008, China.
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Guimarães GC, Coelho JBC, Silva JGO, de Sant'Ana ACC, de Sá CAC, Moreno JM, Reis LM, de Oliveira Guimarães CS. Obesity, diabetes and risk of bone fragility: How BMAT behavior is affected by metabolic disturbances and its influence on bone health. Osteoporos Int 2024; 35:575-588. [PMID: 38055051 DOI: 10.1007/s00198-023-06991-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 11/26/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Osteoporosis is a metabolic bone disease characterized by decreased bone strength and mass, which predisposes patients to fractures and is associated with high morbidity and mortality. Like osteoporosis, obesity and diabetes are systemic metabolic diseases associated with modifiable risk factors and lifestyle, and their prevalence is increasing. They are related to decreased quality of life, functional loss and increased mortality, generating high costs for health systems and representing a worldwide public health problem. Growing evidence reinforces the role of bone marrow adipose tissue (BMAT) as an influential factor in the bone microenvironment and systemic metabolism. Given the impact of obesity and diabetes on metabolism and their possible effect on the bone microenvironment, changes in BMAT behavior may explain the risk of developing osteoporosis in the presence of these comorbidities. METHODS This study reviewed the scientific literature on the behavior of BMAT in pathological metabolic conditions, such as obesity and diabetes, and its potential involvement in the pathogenesis of bone fragility. RESULTS Published data strongly suggest a relationship between increased BMAT adiposity and the risk of bone fragility in the context of obesity and diabetes. CONCLUSION By secreting a broad range of factors, BMAT modulates the bone microenvironment and metabolism, ultimately affecting skeletal health. A better understanding of the relationship between BMAT expansion and metabolic disturbances observed in diabetic and obese patients will help to identify regulatory pathways and new targets for the treatment of bone-related diseases, with BMAT as a potential therapeutic target.
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Affiliation(s)
| | - João Bosco Costa Coelho
- Department of Veterinary Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | | | | | | | - Júlia Marques Moreno
- Department of Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - Lívia Marçal Reis
- Department of Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil
| | - Camila Souza de Oliveira Guimarães
- Department of Medicine, Federal University of Lavras, Lavras, Minas Gerais, Brazil.
- Departamento de Medicina, Universidade Federal de Lavras, Câmpus Universitário, Caixa Postal 3037, CEP 37200-900, Lavras, Minas Gerais, Brasil.
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8
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Chen R, Armamento-Villareal R. Obesity and Skeletal Fragility. J Clin Endocrinol Metab 2024; 109:e466-e477. [PMID: 37440585 PMCID: PMC10795939 DOI: 10.1210/clinem/dgad415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 07/06/2023] [Accepted: 07/11/2023] [Indexed: 07/15/2023]
Abstract
Skeletal fracture has recently emerged as a complication of obesity. Given the normal or better than normal bone mineral density (BMD), the skeletal fragility of these patients appears to be a problem of bone quality rather than quantity. Type 2 diabetes mellitus (T2DM), the incidence of which increases with increasing body mass index, is also associated with an increased risk for fractures despite a normal or high BMD. With the additional bone pathology from diabetes itself, patients with both obesity and T2DM could have a worse skeletal profile. Clinically, however, there are no available methods for identifying those who are at higher risk for fractures or preventing fractures in this subgroup of patients. Weight loss, which is the cornerstone in the management of obesity (with or without T2DM), is also associated with an increased risk of bone loss. This review of the literature will focus on the skeletal manifestations associated with obesity, its interrelationship with the bone defects associated with T2DM, and the available approach to the bone health of patients suffering from obesity.
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Affiliation(s)
- Rui Chen
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
| | - Reina Armamento-Villareal
- Division of Endocrinology, Diabetes and Metabolism at Baylor College of Medicine, Houston, TX 77030, USA
- Department of Medicine, Michael E. DeBakey VA Medical Center, Houston, TX 77030, USA
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9
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Fighera TM, Santos BR, Motta L, Casanova G, Spritzer PM. Associations between bone mass, hormone levels, and body composition in postmenopausal women. Menopause 2023; 30:317-322. [PMID: 36729603 DOI: 10.1097/gme.0000000000002126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVES The aim of this study was to explore body composition parameters and hormone levels as risk factors for low bone mass (osteopenia/osteoporosis) in postmenopausal women. METHODS We analyzed biorepository samples from 139 postmenopausal women with no clinical evidence of cardiovascular disease. Inclusion criteria were menopause occurring after 40 years of age and no use of hormone therapy in the past 3 months. Bone mineral density and body composition were assessed by dual-energy x-ray absorptiometry. Sex hormone-binding globulin (SHBG) and follicle-stimulating hormone (FSH) levels were measured in all participants. Serum estradiol was measured by gas chromatography/tandem mass spectrometry in a subset of 57 participants. Free estrogen index was calculated by dividing estradiol by SHBG × 100. RESULTS Body mass index (25.0 [22.5-26.5] vs 27.7 [26.6-31.9] kg/m 2 , P < 0.001), estradiol (3.0 [2.7-4.5] vs 6.0 [2.7-15.0] pg/mL, P = 0.006), waist circumference (84 ± 9 vs 93 ± 12 cm, P < 0.001), appendicular lean mass (ALM) (15.739 ± 2.129 vs 17.184 ± 2.104 kg, P = 0.001), and fat mass index (9.36 [7.29-11.43] vs 11.38 [9.95-15.33] kg/m 2 , P < 0.001) were lower in women with low bone mass by dual-energy x-ray absorptiometry. Univariate analysis showed that free estrogen index, time since menopause, SHBG, and fat mass were significant predictors of low bone mass, and ALM was a significant predictor against low bone mass. Appendicular lean mass persisted as an independent predictor against low bone mass in multivariate models with fat mass and SHBG. In turn, fat mass was no longer significant in this multivariate model after inclusion of SHBG. No association of FSH with low bone mass was observed. CONCLUSIONS Appendicular lean mass was a significant independent predictor against low bone mass in postmenopausal women. Further prospective studies are needed to investigate whether lean mass, fat mass, and FSH have a direct effect on bone mass in postmenopausal women, adding to the consequences of hypoestrogenism in this group.
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Affiliation(s)
| | | | - Letícia Motta
- From the Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
| | - Gislaine Casanova
- From the Gynecological Endocrinology Unit, Division of Endocrinology, Hospital de Clínicas de Porto Alegre, Porto Alegre, Rio Grande do Sul, Brazil
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10
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Kanto A, Kotani Y, Murakami K, Tamaki J, Sato Y, Kagamimori S, Matsumura N, Iki M. Risk factors for future osteoporosis in perimenopausal Japanese women. Menopause 2022; 29:1176-1183. [PMID: 35969496 PMCID: PMC9512233 DOI: 10.1097/gme.0000000000002034] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/10/2022] [Indexed: 12/04/2022]
Abstract
OBJECTIVE The aims of this study were to investigate trends in bone mineral density (BMD) loss and related factors in early postmenopausal women in Japan, identify risk factors for future osteoporosis, and predict osteoporosis before it occurs. METHODS The study population consisted of women who were 50 to 54 years old at the time of the survey in 2002 or 2006. The study included a questionnaire and physical measurement findings (BMD, height, body weight [WT], body mass index [BMI], and handgrip strength). One hundred sixty-seven women continued to participate in the study and had BMD measurements at the 9- or 10-year follow-up of the Japanese Population-based Osteoporosis study. Statistical analyses were performed using Pearson correlation to examine each factor of physical measurement and BMD for lumbar spine (LS) and femoral neck (FN). The receiver operating characteristic curve of this data was also predictive of osteoporosis in 2011 for 2002 data; BMD at the age of 50 to 54 years was then used to predict the likelihood of being diagnosed with osteoporosis 9 and 10 years later. RESULTS At the baseline in 2002 and 2006, WT, BMI, height, and handgrip strength were positively correlated with BMD. The optimal cutoff values for BMD in 2006 to predict osteoporosis in 2016 were LS less than 0.834 g/cm 2 and FN less than 0.702 g/cm 2 . These data were also predictive of osteoporosis in 2011 for 2002 data; applying this to the 2002 data, LS/FN had a sensitivity of 92%/100%, a specificity of 87%/81%, a positive predictive value of 55%/48%, and a negative predictive value of 98%/100%. The larger WT and BMI also resulted in a greater decrease in BMD of FN after 9 or 10 years. CONCLUSIONS We have identified a cutoff value for BMD to predict future osteoporosis in menopausal women and found a negative correlation between WT and BMI in menopausal women and changes in BMD of the FN over the next 10 years.
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Affiliation(s)
- Akiko Kanto
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Yasushi Kotani
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Kosuke Murakami
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Junko Tamaki
- Department of Hygiene and Public Health, Faculty of Medicine, Osaka Medical Pharmaceutical University, Osaka, Japan
| | - Yuho Sato
- Department of Human Life, Jin-ai University, Fukui, Japan
| | | | - Noriomi Matsumura
- From the Department of Obstetrics and Gynecology, Faculty of Medicine, Kindai University, Osaka, Japan
| | - Masayuki Iki
- Department of Public Health, Faculty of Medicine, Kindai University, Osaka, Japan
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Li H, Gou Y, Tian F, Lian Q, Hu Y, Zhang L. The combined anti-osteoporotic effects of simvastatin and exercise in ovariectomized mice fed a high-fat diet. Exp Gerontol 2022; 164:111794. [PMID: 35421557 DOI: 10.1016/j.exger.2022.111794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 03/13/2022] [Accepted: 03/29/2022] [Indexed: 11/04/2022]
Abstract
BACKGROUND To evaluate and compare the effects of the combined intervention of simvastatin and exercise on the bone degeneration in a mice model of osteoporosis (OP) induced by obesity and estrogen deficiency. METHODS 56 female 3-month-old C57BL/6 mice were given a standard diet or a high-fat diet after ovariectomy (OVX) or sham surgery. Drug administration and exercise training were initiated 72 h after surgical operation, which were treated with simvastatin (10 mg/kg/day) or exercise (15 m/min for 30 min/day) or combined with simvastatin and exercise at 72 h for 8 weeks. The pathology of OP was assessed by histomorphology analyses, immunohistochemistry (IHC), micro-computed tomography (Micro-CT), enzyme-linked immunosorbent assay (ELISA) and cell culture. RESULTS The coexistence of obesity and estrogen deficiency significantly further exacerbated OP pathology, and combined intervention showed a better significant anti-osteoporosis effect than monotherapy. In details, simvastatin combined with exercise ameliorated the abnormal bone mass, microstructure and bone marrow adipocyte differentiation, significantly increased osteoprotegerin (OPG), type 1 collagen (Col-I), RUNX2 and osteocalcin (OCN) expression, decreased the expression of receptor activator of nuclear factor-kappaB ligand (RANKL) and peroxisome proliferator-activated receptor γ (PPARγ). Furthermore, combined intervention markedly improved abnormal metabolic status, reduced the levels of serum glucose, insulin, triglycerides (TG), low-density lipoprotein (LDL), leptin, CTX-1 and IL-1β, and increased the level of OCN. CONCLUSIONS The coexistence of obesity and estrogen deficiency further aggravates bone tissue degeneration and abnormal metabolic pathology, which could be better inhibited by the combination with simvastatin and exercise instead of single intervention, suggesting that combined intervention may be a potential candidate for amelioration of the progression of OP.
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Affiliation(s)
- Hetong Li
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Yu Gou
- Department of Orthopaedic Surgery, Tianjin Hospital, Tianjin University, Tianjin, PR China
| | - Faming Tian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, PR China
| | - Qiangqiang Lian
- School of Public Health, North China University of Science and Technology, Tangshan, Hebei, PR China
| | - Yunpeng Hu
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, PR China
| | - Liu Zhang
- Department of Orthopedic Surgery, Hebei Medical University, Shijiazhuang, Hebei, PR China.
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Rinonapoli G, Pace V, Ruggiero C, Ceccarini P, Bisaccia M, Meccariello L, Caraffa A. Obesity and Bone: A Complex Relationship. Int J Mol Sci 2021; 22:ijms222413662. [PMID: 34948466 PMCID: PMC8706946 DOI: 10.3390/ijms222413662] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 12/13/2021] [Accepted: 12/13/2021] [Indexed: 12/29/2022] Open
Abstract
There is a large literature on the relationship between obesity and bone. What we can conclude from this review is that the increase in body weight causes an increase in BMD, both for a mechanical effect and for the greater amount of estrogens present in the adipose tissue. Nevertheless, despite an apparent strengthening of the bone witnessed by the increased BMD, the risk of fracture is higher. The greater risk of fracture in the obese subject is due to various factors, which are carefully analyzed by the Authors. These factors can be divided into metabolic factors and increased risk of falls. Fractures have an atypical distribution in the obese, with a lower incidence of typical osteoporotic fractures, such as those of hip, spine and wrist, and an increase in fractures of the ankle, upper leg, and humerus. In children, the distribution is different, but it is not the same in obese and normal-weight children. Specifically, the fractures of the lower limb are much more frequent in obese children. Sarcopenic obesity plays an important role. The authors also review the available literature regarding the effects of high-fat diet, weight loss and bariatric surgery.
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Affiliation(s)
- Giuseppe Rinonapoli
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
- Correspondence:
| | - Valerio Pace
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
| | - Carmelinda Ruggiero
- Orthogeriatric Service, Geriatric Unit, Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, 06156 Perugia, Italy;
| | - Paolo Ceccarini
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
| | - Michele Bisaccia
- Department of Orthopaedics and Traumatology, AORN San Pio “Gaetano Rummo Hospital”, Via R.Delcogliano, 82100 Benevento, Italy; (M.B.); (L.M.)
| | - Luigi Meccariello
- Department of Orthopaedics and Traumatology, AORN San Pio “Gaetano Rummo Hospital”, Via R.Delcogliano, 82100 Benevento, Italy; (M.B.); (L.M.)
| | - Auro Caraffa
- Orthopaedic and Traumatology Unit, Department of Medicine, University of Perugia, 06156 Perugia, Italy; (V.P.); (P.C.); (A.C.)
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13
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Granato R, Bergamo ETP, Witek L, Bonfante EA, Marin C, Greenberg M, Kurgansky G, Coelho PG. Clinical, histological, and nanomechanical parameters of implants placed in healthy and metabolically compromised patients. J Dent 2020; 100:103436. [PMID: 32738285 DOI: 10.1016/j.jdent.2020.103436] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/04/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES To evaluate the clinical outcomes, histological parameters, and bone nanomechanical properties around implants retrieved from healthy and metabolic syndrome (MS) patients. METHODS Twenty-four patients with edentulous mandibles (12/condition), received four implants between the mental foramina. An additional implant prototype was placed for retrieval histology. The following clinical outcomes were evaluated: insertion torque (IT), implant stability quotient (ISQ) values at baseline and after 60 days of healing, and implant survival. The prototype was retrieved after the healing and histologically processed for bone morphometric evaluation of bone-to-implant contact (%BIC) and bone area fraction occupancy (%BAFO), and bone nanoindentation to determine the elastic modulus (Em) and hardness (H). Descriptive statistical procedures and survival tests were used to analyze the data. RESULTS The final study population was comprised of 10 women and 11 men (∼64 years). A total of 105 implants were placed, 21 retrieved for histology. Implant survival rates were similar between groups (>99 %). Similarly, IT and ISQ analyses showed no significant association with systemic condition (p > 0.216). Histological micrographs depicted similar bone morphology, woven bone, for both conditions. While MS (33 ± 5.3 %) and healthy (39 ± 6.5 %) individuals showed no significant difference for %BIC (p = 0.116), significantly higher %BAFO was observed for healthy (45 ± 4.6 %) relative to MS (30 ± 3.8 %) (p < 0.001). No significant differences on bone nanomechanical properties was observed (p > 0.804). CONCLUSIONS Although no significant influence on clinical parameters and bone nanomechanical properties was observed, MS significantly reduced bone formation in the peri-implant area in the short-term. CLINICAL SIGNIFICANCE A lower amount of bone formation in the peri-implant area was observed in comparison to healthy patients, although the other short-term clinical outcomes were not significantly different. Considering the escalating prevalence of MS patients in need for implant treatment, it becomes crucial to understand bone-to-implant response to determine the ideal loading time in this population.
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Affiliation(s)
- Rodrigo Granato
- Postgraduate Program in Dentistry, University of Grande Rio, Rio de Janeiro, RJ, Brazil
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil.
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering - NYU Tandon School of Engineering, New York University, Brooklyn, NY, USA
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, University of São Paulo, Bauru School of Dentistry, Bauru, SP, Brazil
| | - Charles Marin
- Department of Oral Surgery, Federal University of Santa Catarina, Florianopolis, SC, Brazil
| | - Michael Greenberg
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Gregory Kurgansky
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA
| | - Paulo G Coelho
- Department of Mechanical and Aerospace Engineering - NYU Tandon School of Engineering, Brooklyn, NY, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health School of Medicine, New York, NY, USA
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14
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de Oliveira PGFP, Bonfante EA, Bergamo ETP, de Souza SLS, Riella L, Torroni A, Benalcazar Jalkh EB, Witek L, Lopez CD, Zambuzzi WF, Coelho PG. Obesity/Metabolic Syndrome and Diabetes Mellitus on Peri-implantitis. Trends Endocrinol Metab 2020; 31:596-610. [PMID: 32591106 DOI: 10.1016/j.tem.2020.05.005] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 05/08/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
Abstract
Literature has reported that up to 50% of dental implants may be affected by peri-implantitis, a bacteria-induced chronic inflammatory process, which promotes osteoclast-mediated bone resorption and inhibits bone formation, leading to progressive bone loss around implants. Current evidence points toward an increased risk for the development of peri-implantitis in both obesity/metabolic syndrome (MetS) and diabetes mellitus (DM) conditions relative to the healthy population. Currently, there is no effective treatment for peri-implantitis and the 50% prevalence in MetS and DM, along with its predicted increase in the worldwide population, presents a major concern in implant dentistry as hyperglycemic conditions are associated with bone-healing impairment; this may be through dysfunction of osteocalcin-induced glucose metabolism. The MetS/DM proinflammatory systemic condition and altered immune/microbiome response affect both catabolic and anabolic events of bone-healing that include increased osteoclastogenesis and compromised osteoblast activity, which could be explained by the dysfunction of insulin receptor that led to activation of signals related with osteoblast differentiation. Furthermore, chronic hyperglycemia along with associated micro- and macro-vascular ailments leads to delayed/impaired wound healing due to activation of pathways that are particularly important in initiating events linked to inflammation, oxidative stress, and cell apoptosis; this may be through deactivation of AKT/PKB protein, which possesses a pivotal role in drive survival and eNOS signaling. This review presents an overview of the local and systemic mechanisms synergistically affecting bone-healing impairment in MetS/DM individuals, as well as a rationale for hierarchical animal model selection, in an effort to characterize peri-implantitis disease and treatment.
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Affiliation(s)
- Paula Gabriela Faciola Pessôa de Oliveira
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil; Department of Periodontology, School of Dentistry, University Center of State of Para, Belem, PA, Brazil
| | - Estevam A Bonfante
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Edmara T P Bergamo
- Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Sérgio Luis Scombatti de Souza
- Department of Oral and Maxillofacial Surgery and Periodontology, School of Dentistry of Ribeirao Preto, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Leonardo Riella
- Division of Nephrology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andrea Torroni
- Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health School of Medicine, New York, NY, USA
| | - Ernesto B Benalcazar Jalkh
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Prosthodontics and Periodontology, Bauru School of Dentistry, University of Sao Paulo, Bauru, SP, Brazil
| | - Lukasz Witek
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Department of Biomedical Engineering, NYU Tandon School of Engineering, New York University, Brooklyn, NY, USA
| | - Christopher D Lopez
- Department of Plastic and Reconstructive Surgery, Johns Hopkins School of Medicine Baltimore, MD, USA
| | - Willian Fernando Zambuzzi
- Department of Chemical and Biological Sciences, Bioscience Institute (IBB), UNESP - São Paulo State University, Botucatu, São Paulo, Brazil
| | - Paulo G Coelho
- Department of Biomaterials and Biomimetics, New York University College of Dentistry, New York, NY, USA; Hansjörg Wyss Department of Plastic Surgery, NYU Langone Health School of Medicine, New York, NY, USA; Department of Mechanical and Aerospace Engineering, NYU Tandon School of Engineering, Brooklyn, NY, USA.
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15
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Campillo-Sánchez F, Usategui-Martín R, Ruiz -de Temiño Á, Gil J, Ruiz-Mambrilla M, Fernández-Gómez JM, Dueñas-Laita A, Pérez-Castrillón JL. Relationship between Insulin Resistance (HOMA-IR), Trabecular Bone Score (TBS), and Three-Dimensional Dual-Energy X-ray Absorptiometry (3D-DXA) in Non-Diabetic Postmenopausal Women. J Clin Med 2020; 9:jcm9061732. [PMID: 32503328 PMCID: PMC7355807 DOI: 10.3390/jcm9061732] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Revised: 05/16/2020] [Accepted: 05/29/2020] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Insulin may play a key role in bone metabolism, where the anabolic effect predominates. This study aims to analyze the relationship between insulin resistance and bone quality using the trabecular bone score (TBS) and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in non-diabetic postmenopausal women by determining cortical and trabecular compartments. METHODS A cross-sectional study was conducted in non-diabetic postmenopausal women with suspected or diagnosed osteoporosis. The inclusion criteria were no menstruation for more than 12 months and low bone mass or osteoporosis as defined by DXA. Glucose was calculated using a Hitachi 917 auto-analyzer. Insulin was determined using an enzyme-linked immunosorbent assay (EIA). Insulin resistance was estimated using a homeostasis model assessment of insulin resistance (HOMA-IR). DXA, 3D-DXA, and TBS were thus collected. Moreover, we examined bone parameters according to quartile of insulin, hemoglobin A1C (HbA1c), and HOMA-IR. RESULTS In this study, we included 381 postmenopausal women. Women located in quartile 4 (Q4) of HOMA-IR had higher values of volumetric bone mineral density (vBMD) but not TBS. The increase was higher in the trabecular compartment (16.4%) than in the cortical compartment (6.4%). Similar results were obtained for insulin. Analysis of the quartiles by HbA1c showed no differences in densitometry values, however women in Q4 had lower levels of TBS. After adjusting for BMI, statistical significance was maintained for TBS, insulin, HOMA-IR, and HbA1c. CONCLUSIONS In non-diabetic postmenopausal women there was a direct relationship between insulin resistance and vBMD, whose effect is directly related to greater weight. TBS had an inverse relationship with HbA1c, insulin, and insulin resistance unrelated to weight. This might be explained by the formation of advanced glycosylation products (AGEs) in the bone matrix, which reduces bone deformation capacity and resistance, as well as increases fragility.
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Affiliation(s)
| | - Ricardo Usategui-Martín
- IOBA, University of Valladolid, 47011 Valladolid, Spain
- Correspondence: (R.U.-M.); (J.L.P.-C.); Tel./Fax: +34-98-342-3184 (R.U.-M. & J.L.P.-C.)
| | - Ángela Ruiz -de Temiño
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
| | - Judith Gil
- Hospital Nuestra Señora de Sonsoles, 05004 Avila, Spain;
| | - Marta Ruiz-Mambrilla
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
| | | | - Antonio Dueñas-Laita
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
- Department of Medicine, University of Valladolid Service of Clinical Toxicology, Río Hortega University Hospital, 47012 Valladolid, Spain
| | - José Luis Pérez-Castrillón
- Department Medicine, University of Valladolid, 47005 Valladolid, Spain; (Á.R.-d.T.); (M.R.-M.); (A.D.-L.)
- Department of Internal Medicine, Department of Medicine, University of Valladolid, Río Hortega University Hospital, 47012 Valladolid, Spain
- Correspondence: (R.U.-M.); (J.L.P.-C.); Tel./Fax: +34-98-342-3184 (R.U.-M. & J.L.P.-C.)
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Fintini D, Cianfarani S, Cofini M, Andreoletti A, Ubertini GM, Cappa M, Manco M. The Bones of Children With Obesity. Front Endocrinol (Lausanne) 2020; 11:200. [PMID: 32390939 PMCID: PMC7193990 DOI: 10.3389/fendo.2020.00200] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Accepted: 03/20/2020] [Indexed: 12/11/2022] Open
Abstract
Excess adiposity in childhood may affect bone development, ultimately leading to bone frailty. Previous reports showing an increased rate of extremity fractures in children with obesity support this fear. On the other hand, there is also evidence suggesting that bone mineral content is higher in obese children than in normal weight peers. Both adipocytes and osteoblasts derive from multipotent mesenchymal stem cells (MSCs) and obesity drives the differentiation of MSCs toward adipocytes at the expense of osteoblast differentiation. Furthermore, adipocytes in bone marrow microenvironment release a number of pro-inflammatory and immunomodulatory molecules that up-regulate formation and activation of osteoclasts, thus favoring bone frailty. On the other hand, body adiposity represents a mechanical load, which is beneficial for bone accrual. In this frame, bone quality, and structure result from the balance of inflammatory and mechanical stimuli. Diet, physical activity and the hormonal milieu at puberty play a pivotal role on this balance. In this review, we will address the question whether the bone of obese children and adolescents is unhealthy in comparison with normal-weight peers and discuss mechanisms underlying the differences in bone quality and structure. We anticipate that many biases and confounders affect the clinical studies conducted so far and preclude us from achieving robust conclusions. Sample-size, lack of adequate controls, heterogeneity of study designs are the major drawbacks of the existing reports. Due to the increased body size of children with obesity, dual energy absorptiometry might overestimate bone mineral density in these individuals. Magnetic resonance imaging, peripheral quantitative CT (pQCT) scanning and high-resolution pQCT are promising techniques for the accurate estimate of bone mineral content in obese children. Moreover, no longitudinal study on the risk of incident osteoporosis in early adulthood of children and adolescents with obesity is available. Finally, we will address emerging dietary issues (i.e., the likely benefits for the bone health of polyunsaturated fatty acids and polyphenols) since an healthy diet (i.e., the Mediterranean diet) with balanced intake of certain nutrients associated with physical activity remain the cornerstones for achieving an adequate bone accrual in young individuals regardless of their adiposity degree.
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Affiliation(s)
- Danilo Fintini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
- *Correspondence: Danilo Fintini
| | - Stefano Cianfarani
- Diabetes and Growth Disorders Unit, Dipartimento Pediatrico Universitario Ospedaliero Bambino Gesù Children's Hospital, Tor Vergata University, Rome, Italy
- Department of Women's and Children's Health, Karolinska Institute and University Hospital, Stockholm, Sweden
| | - Marta Cofini
- Pediatric Clinic, Department of Surgical and Biomedical Sciences, University of Perugia, Perugia, Italy
| | - Angela Andreoletti
- Pediatric Resident, Pediatric Clinic, University of Brescia, Brescia, Italy
| | - Grazia Maria Ubertini
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Marco Cappa
- Endocrinology Unit, Pediatric University Department, Bambino Gesù Children's Hospital, Rome, Italy
| | - Melania Manco
- Research Area for Multifactorial Diseases, Bambino Gesù Children's Hospital, Rome, Italy
- Melania Manco
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Corbo F, Brunetti G, Crupi P, Bortolotti S, Storlino G, Piacente L, Carocci A, Catalano A, Milani G, Colaianni G, Colucci S, Grano M, Franchini C, Clodoveo ML, D'Amato G, Faienza MF. Effects of Sweet Cherry Polyphenols on Enhanced Osteoclastogenesis Associated With Childhood Obesity. Front Immunol 2019; 10:1001. [PMID: 31130968 PMCID: PMC6509551 DOI: 10.3389/fimmu.2019.01001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2019] [Accepted: 04/18/2019] [Indexed: 12/14/2022] Open
Abstract
Childhood obesity is associated with the development of severe comorbidities, such as diabetes, cardiovascular diseases, and increased risk of osteopenia/osteoporosis and fractures. The status of low-grade inflammation associated to obesity can be reversed through an enhanced physical activity and by consumption of food enrich of anti-inflammatory compounds, such as omega-3 fatty acids and polyphenols. The aim of this study was to deepen the mechanisms of bone impairment in obese children and adolescents through the evaluation of the osteoclastogenic potential of peripheral blood mononuclear cells (PBMCs), and the assessment of the serum levels of RANKL and osteoprotegerin (OPG). Furthermore, we aimed to evaluate the in vitro effects of polyphenol cherry extracts on osteoclastogenesis, as possible dietary treatment to improve bone health in obese subjects. High RANKL levels were measured in obese with respect to controls (115.48 ± 35.20 pg/ml vs. 87.18 ± 17.82 pg/ml; p < 0.01), while OPG levels were significantly reduced in obese than controls (378.02 ± 61.15 pg/ml vs. 436.75 ± 95.53 pg/ml, respectively, p < 0.01). Lower Ad-SoS- and BTT Z-scores were measured in obese compared to controls (p < 0.05). A significant elevated number of multinucleated TRAP+ osteoclasts (OCs) were observed in the un-stimulated cultures of obese subjects compared to the controls. Interestingly, obese subjects displayed a higher percentage of CD14+/CD16+ than controls. Furthermore, in the mRNA extracts of obese subjects we detected a 2.5- and 2-fold increase of TNFα and RANKL transcripts compared to controls, respectively. Each extract of sweet cherries determined a dose-dependent reduction in the formation of multinucleated TRAP+ OCs. Consistently, 24 h treatment of obese PBMCs with sweet cherry extracts from the three cultivars resulted in a significant reduction of the expression of TNFα. In conclusion, the bone impairment in obese children and adolescents is sustained by a spontaneous osteoclastogenesis that can be inhibited in vitro by the polyphenol content of sweet cherries. Thus, our study opens future perspectives for the use of sweet cherry extracts, appropriately formulated as nutraceutical food, as preventive in healthy children and therapeutic in obese ones.
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Affiliation(s)
- Filomena Corbo
- Department of Pharmacy-Drug science, University of Bari Aldo Moro, Bari, Italy
| | - Giacomina Brunetti
- Section of Human Anatomy and Histology, Department of Basic and Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Pasquale Crupi
- CREA-VE, Council for Agricultural Research and Economics-Research Centre for Viticulture and Enology, Turi, Italy
| | - Sara Bortolotti
- Section of Human Anatomy and Histology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Giuseppina Storlino
- Section of Human Anatomy and Histology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Laura Piacente
- Paediatric Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
| | - Alessia Carocci
- Department of Pharmacy-Drug science, University of Bari Aldo Moro, Bari, Italy
| | - Alessia Catalano
- Department of Pharmacy-Drug science, University of Bari Aldo Moro, Bari, Italy
| | - Gualtiero Milani
- Department of Pharmacy-Drug science, University of Bari Aldo Moro, Bari, Italy
| | - Graziana Colaianni
- Section of Human Anatomy and Histology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Silvia Colucci
- Section of Human Anatomy and Histology, Department of Basic and Medical Sciences, Neurosciences and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Maria Grano
- Section of Human Anatomy and Histology, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy
| | - Carlo Franchini
- Department of Pharmacy-Drug science, University of Bari Aldo Moro, Bari, Italy
| | - Maria Lisa Clodoveo
- Interdisciplinary Department of Medicine, University of Bari Aldo Moro, Bari, Italy
| | | | - Maria Felicia Faienza
- Paediatric Unit, Department of Biomedical Sciences and Human Oncology, University of Bari Aldo Moro, Bari, Italy
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18
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Harasymowicz NS, Dicks A, Wu CL, Guilak F. Physiologic and pathologic effects of dietary free fatty acids on cells of the joint. Ann N Y Acad Sci 2019; 1440:36-53. [PMID: 30648276 DOI: 10.1111/nyas.13999] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/08/2018] [Accepted: 12/14/2018] [Indexed: 12/14/2022]
Abstract
Fatty acids (FAs) are potent organic compounds that not only can be used as an energy source during nutrient deprivation but are also involved in several essential signaling cascades in cells. Therefore, a balanced intake of different dietary FAs is critical for the maintenance of cellular functions and tissue homeostasis. A diet with an imbalanced fat composition creates a risk for developing metabolic syndrome and various musculoskeletal diseases, including osteoarthritis (OA). In this review, we summarize the current state of knowledge and mechanistic insights regarding the role of dietary FAs, such as saturated FAs, omega-6 polyunsaturated FAs (PUFAs), and omega-3 PUFAs on joint inflammation and OA pathogeneses. In particular, we review how different types of dietary FAs and their derivatives distinctly affect a variety of cells within the joint, including chondrocytes, osteoblasts, osteoclasts, and synoviocytes. Understanding the molecular mechanisms underlying the effects of FAs on metabolic behavior, anabolic, and catabolic processes, as well as the inflammatory response of joint cells, may help identify therapeutic targets for the prevention of metabolic joint diseases.
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Affiliation(s)
- Natalia S Harasymowicz
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri.,Shriners Hospitals for Children-St. Louis, St. Louis, Missouri
| | - Amanda Dicks
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri.,Shriners Hospitals for Children-St. Louis, St. Louis, Missouri.,Department of Biomedical Engineering, Washington University, St. Louis, Missouri
| | - Chia-Lung Wu
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri.,Shriners Hospitals for Children-St. Louis, St. Louis, Missouri
| | - Farshid Guilak
- Department of Orthopaedic Surgery, Washington University, St. Louis, Missouri.,Shriners Hospitals for Children-St. Louis, St. Louis, Missouri.,Department of Biomedical Engineering, Washington University, St. Louis, Missouri
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Abstract
The interaction between obesity and bone metabolism is complex. The effects of fat on the skeleton are mediated by both mechanical and biochemical factors. Though obesity is characterized by higher bone mineral density, studies conducted on bone microarchitecture have produced conflicting results. The majority of studies indicate that obesity has a positive effect on skeletal strength, even though most likely the effects are site-dependent and, in fact, obese individuals might be at risk of certain types of fractures. Mechanical loading and higher lean mass are associated with improved outcomes, whereas systemic inflammation, observed especially with abdominal obesity, may exert negative effects. Weight loss interventions likely lead to bone loss over time. Pharmacological treatment options seem to be safe in terms of skeletal health; however, the skeletal effects of bariatric surgery are dependent on the type of surgical procedure. Malabsorptive procedures are associated with higher short-term adverse effects on bone health. In this narrative review, we discuss the effects of obesity and weight loss interventions on skeletal health.
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Affiliation(s)
- Christos Savvidis
- Department of Endocrinology, Hippokrateion General Hospital, Athens, Greece
| | - Symeon Tournis
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", KAT hospital, Medical school, Athens, Greece
| | - Anastasia D Dede
- Laboratory for Research of the Musculoskeletal System "Th. Garofalidis", KAT hospital, Medical school, Athens, Greece.
- Department of Endocrinology and Diabetes, Chelsea and Westminster Hospital, 369 Fulham Road, London, SW10 9NH, UK.
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