1
|
Kwak MK, Lee EJ, Park JW, Park SY, Kim BJ, Kim TH, Suh K, Koh JM, Lee SH, Byun DW. CD4 T cell count is inversely associated with lumbar spine bone mass in HIV-infected men under the age of 50 years. Osteoporos Int 2019; 30:1501-1510. [PMID: 30915506 DOI: 10.1007/s00198-019-04942-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Accepted: 03/14/2019] [Indexed: 01/21/2023]
Abstract
UNLABELLED HIV-infected men under the age of 50 years had a lower bone mass compared to that of HIV-uninfected men. Lower CD4 T cell counts, independent of whether antiretroviral therapy (ART) was used, were associated with lower BMD. HIV-infected patients with low CD4 T cell counts may need follow-up and intervention regarding bone health, including younger patients. INTRODUCTION HIV-infected patients have a low bone mineral density (BMD) owing to multifactorial interaction between common osteoporosis risk factors and HIV-related factors, including chronic inflammation and ART. Although HIV infection and ART might affect bone metabolism, little data is available for patients aged under 50 years. We aimed to investigate the association of HIV infection-induced low CD4 T cell counts and ART with BMD in men aged under 50 years. METHODS We performed an age- and body mass index-matched case-control study. BMD values of HIV-infected and HIV-uninfected men (< 50 years) were compared, and HIV-infected men were stratified by CD4 T cell counts and ART use. RESULTS After adjusting confounders, HIV-infected men with CD4 T cell counts ≥ 500 cells/μL (n = 28) and < 500 cells/μL (n = 139) had lower BMD at the femoral neck (FN, p < 0.001) and total hip (TH, p < 0.001) than HIV-uninfected men (n = 167). HIV-infected men with CD4 T cell counts < 500/μL had lower BMD at the lumbar spine (LS, p = 0.034) than those with counts of ≥ 500 cells/μL, but not at FN and TH. The CD4 T cell count (γ = 0.169, p = 0.031) was positively correlated with BMD at LS. There was no significant difference in the BMD (p = 0.499-> 0.999) between the ART-naïve (n = 75) and ART-user group (n = 92). CONCLUSIONS Despite their relatively younger age, HIV-infected men had a lower BMD than HIV-uninfected men. Lower CD4 T cell counts, irrespective of ART, might result in lower bone mass.
Collapse
Affiliation(s)
- M K Kwak
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 04401, South Korea
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Dontan Sacred Heart Hospital, 7, Keunjaebong-gil, Hwaseong-Si, Gyeonggi-Do, 18450, South Korea
| | - E J Lee
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - J W Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, 31 Suncheonhyang 6-gil, Dongnam-gu, Cheonan-si, Chungcheongnam-do, 31151, South Korea
| | - S Y Park
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - B -J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - T H Kim
- Division of Infectious Diseases, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, 59 Daesagwan-ro, Yongsan-gu, Seoul, 04401, South Korea
| | - K Suh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 04401, South Korea
| | - J -M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
| | - D -W Byun
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Soonchunhyang University Hospital, Soonchunhyang University College of Medicine, Seoul, 04401, South Korea.
| |
Collapse
|
2
|
Kim H, Lee SH, Kim BJ, Koh JM. Association between obesity and femoral neck strength according to age, sex, and fat distribution. Osteoporos Int 2017; 28:2137-2146. [PMID: 28352995 DOI: 10.1007/s00198-017-4015-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 03/17/2017] [Indexed: 01/22/2023]
Abstract
UNLABELLED Indicators of total and abdominal obesity were negatively associated with femoral neck strength indices. There are age-, sex-, and fat distribution-specific differences in the magnitude of these associations. These suggested that indicators of obesity with different magnitude according to age, sex, and fat distribution associated with poor bone health. INTRODUCTION Fat regulates bone metabolism, but the associations of total and abdominal obesity with bone health are inconsistent. We investigated the association between indicators of obesity and composite indices of femoral neck (FN) strength reflecting the risk of hip fracture. METHODS This population-based cross-sectional study examined data from the Korea National Health and Nutrition Examination Surveys. Participants were divided into groups according to age (25-49/≥50 years) and sex. We examined total fat mass (TFM) and percentage fat mass (pFM) as indicators of total obesity and truncal fat mass (TrFM) as an indicator of abdominal obesity. We calculated the composite indices of FN strength and anthropometric clinical indicators of abdominal obesity. RESULTS TFM, pFM, and TrFM were negatively associated with the composite indices, irrespective of age and sex (P < 0.001-0.005). Most anthropometric clinical indicators of abdominal obesity showed negative associations with the composite indices regardless of age and sex (P < 0.001-0.048), except for women aged 25-49 years. In men, magnitudes of the negative contributions of TFM to the composite indices were significantly stronger at age 25-49 years than at age ≥50 years. Magnitudes of negative associations of TFM with the composite indices were greater in men than in women. TrFM had a more detrimental effect than TFM on FN strength in men aged 25-49 years and in women of both ages. CONCLUSION Indicators of total and abdominal obesity negatively associated with FN strength, and magnitudes of their effects on bone health differed according to age, sex, and fat distribution.
Collapse
Affiliation(s)
- H Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, South Korea
| | - S H Lee
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, South Korea.
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-Gu, Seoul, 05505, South Korea.
| | - B J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, South Korea
| | - J M Koh
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 138-736, South Korea
| |
Collapse
|
3
|
Kim BJ, Lee YS, Lee SY, Park SY, Dieplinger H, Yea K, Lee SH, Koh JM, Kim GS. Afamin stimulates osteoclastogenesis and bone resorption via Gi-coupled receptor and Ca2+/calmodulin-dependent protein kinase (CaMK) pathways. J Endocrinol Invest 2013; 36:876-82. [PMID: 23698732 DOI: 10.3275/8975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Afamin was recently identified as a novel osteoclast-derived coupling factor that can stimulate the in vitro and in vivo migration of preosteoblasts. AIM In order to understand in more detail the biological roles of afamin in bone metabolism, we investigated its effects on osteoclastic differentiation and bone resorption. METHODS Osteoclasts were differentiated from mouse bone marrow cells. Tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells were considered as osteoclasts, and the resorption area was determined by incubating the cells on dentine discs. The intracellular cAMP level was determined using a direct enzyme immunoassay. Signaling pathways were investigated using western blot and RT-PCR. Recombinant afamin was administered exogenously to bone cell cultures. RESULTS Afamin stimulated both osteoclastogenesis and in vitro bone resorption. Consistently, the expressions of osteoclast differentiation markers were significantly increased by afamin. Although afamin mainly affected the late-differentiation stages of osteoclastogenesis, the expression levels of receptor activator of nuclear factor-κB ligand (RANKL)-dependent signals were not changed. Afamin markedly decreased the levels of intracellular cAMP with reversal by pretreatment with pertussis toxin (PTX), a specific inhibitor of Gi-coupled receptor signaling. In addition, PTX almost completely blocked afamin-stimulated osteoclastogenesis. Furthermore, pretreatment with KN93 and STO609 - Ca2+/cal - mo dulin-dependent protein kinase (CaMK) and CaMK kinase inhibitors, respectively - significantly prevented decreases in the intracellular cAMP level by afamin while attenuating afamin-stimulated osteoclastogenesis. CONCLUSION Afamin enhances osteoclastogenesis by decreasing intracellular cAMP levels via Gi-coupled receptor and CaMK pathways.
Collapse
Affiliation(s)
- B J Kim
- Division of Endocrinology and Metabolism, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap2- Dong, Songpa-Gu, Seoul 138-736, Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
4
|
Bae SJ, Choe JW, Chung YE, Kim BJ, Lee SH, Kim HY, Koh JM, Kim HK, Kim GS. The association between serum osteocalcin levels and metabolic syndrome in Koreans. Osteoporos Int 2011; 22:2837-46. [PMID: 21153019 DOI: 10.1007/s00198-010-1504-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2010] [Accepted: 11/12/2010] [Indexed: 01/06/2023]
Abstract
UNLABELLED The association between serum osteocalcin levels and metabolic syndrome (MS) in Korean individuals was investigated. Serum osteocalcin levels are significantly lower in subjects with MS than in those without the disease, regardless of glucose metabolism. INTRODUCTION Osteocalcin was recently shown to affect energy metabolism. In the present study, we investigated the possible association between serum osteocalcin concentrations and MS. METHODS A cross-sectional community-based survey was conducted. Serum osteocalcin, type 1 collagen C-telopeptide (CTX) and total alkaline phosphatase (ALP) concentrations were determined in 567 subjects. MS was defined according to NCEP-ATP III criteria. RESULTS Serum osteocalcin concentrations were significantly lower in subjects with MS than those without MS in postmenopausal women (18.923 ± 7.685 vs 22.513 ± 7.344 ng/ml, P<0.001) and marginally lower in subjects with MS than those without MS in men (14.550 ± 5.090 vs 16.125 ± 4.749 ng/ml, P=0.086) after adjustment for age and BMI. Further controlling with CTX or ALP did not affect this association in postmenopausal women; however, controlling with osteocalcin abolished the association between CTX and MS. Significant differences in serum osteocalcin levels by MS status were noted in subjects with normal glucose tolerance as well as those with abnormal glucose tolerance (P=0.032 and P<0.001, respectively). Compared with subjects with the highest quartile of osteocalcin, those in the lower quartile groups (Q1-Q3) had significantly increased risks of MS (ORs=5.18, CIs=1.15-23.42) in men. In postmenopausal women, the ORs for MS were significantly higher in the lowest quartile than in the highest quartile (ORs=5.25, CIs=2.42-11.36). CONCLUSIONS These findings suggest that osteocalcin is associated with MS, independently of glucose metabolism.
Collapse
Affiliation(s)
- S J Bae
- Health Promotion Center, Asan Medical Center, University of Ulsan College of Medicine, 388-1 Poongnap 2-Dong, Songpa-Gu, Seoul, Republic of Korea
| | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Koh JM, Kim JY, Chung YE, Park JY, Shong YK, Hong SK, Kim GS, Lee KU. Increased urinary albumin excretion in Cushing's syndrome: remission after correction of hypercortisolaemia. Clin Endocrinol (Oxf) 2000; 52:349-53. [PMID: 10718833 DOI: 10.1046/j.1365-2265.2000.00917.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVES Increased urinary albumin excretion (UAE) in diabetic and nondiabetic subjects is frequently associated with insulin resistance syndrome and central obesity. Cushing's syndrome is also characterized by central obesity and insulin resistance. This study was undertaken to see whether increased UAE is found in Cushing's syndrome. DESIGN Cross-sectional study. PATIENTS Thirteen consecutive patients with Cushing's syndrome. MEASUREMENTS Patients collected three overnight urine samples for the measurement of UAE by radioimmunoassay. UAE was also measured in 479 nondiabetic subjects who comprised the control population for this study. In the patients who had initial microalbuminuria, UAE was remeasured 2 months after successful removal of pituitary or adrenal tumours. Kidney biopsy was performed in three patients during adrenalectomy. RESULTS Eleven out of 13 patients (84.6%) had increased UAE (> 9.6 micrograms/min), and eight patients (61.5%) had microalbuminuria or overt proteinuria (> 20 micrograms/min). Kidney biopsy revealed apparently normal glomerular structures without evidence of diabetic nephropathy. After correction of hypercortisolaemia, UAE declined profoundly in all of the patients. CONCLUSIONS More than 80% of patients with Cushing's syndrome had increased UAE. This was almost completely reversed after successful treatment of hypercortisolaemia. These results indicate that endogenous hypercortisolaemia increases UAE by a mechanism that is presently unknown.
Collapse
Affiliation(s)
- J M Koh
- Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | | | | | | | | | | | | | | |
Collapse
|
6
|
Park KY, Koh JM, Kim YI, Park HJ, Gong G, Hong SJ, Ahn IM. Prevalences of Gs alpha, ras, p53 mutations and ret/PTC rearrangement in differentiated thyroid tumours in a Korean population. Clin Endocrinol (Oxf) 1998; 49:317-23. [PMID: 9861322 DOI: 10.1046/j.1365-2265.1998.00515.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE In thyroid tumours, ras, Gs alpha, p53 mutations and ret/PTC rearrangement have been reported with variable prevalences in different geographical regions. We studied the prevalence of these mutations and rearrangement in thyroid tumours in a Korean population. As MDM2 and Bcl-1 protein expressions have been suggested to be associated with p53 protein, we also studied possible relationships among them. PATIENTS AND DESIGN Eleven cases of adenomatous goitre, eight cases of follicular adenoma, five cases of follicular carcinoma and 37 cases of papillary carcinoma were included in this study. To find mutations and rearrangement, RT-PCR, SSCP and/or direct sequencing, after subcloning if necessary, were used, and immunohistochemical stainings were performed for p53, MDM2 and Bcl-2 proteins in cases of papillary carcinoma. RESULTS We could not find any rearrangement for ret/PTC-1, -2, -3 and mutation of Gs alpha. For the ras oncogene, K and H-ras mutations were not found, but N-ras mutations, point mutation of CAA to CGA in codon 61, were detected in one follicular adenoma (12.5%, 1/8) and one follicular carcinoma (33%, 1/3). p53 mutations were detected in only one case of papillary carcinoma (3%, 1/31: exon 8, codon 266 GGA-->GAA). In 30 cases of papillary carcinoma without p53 mutation, the prevalences of positive immunohistochemical staining were 13.3% for p53 protein, 53.3% for MDM2 protein and 56.7% for Bcl-2 protein. While over-expression of p53 protein was not significantly related to that of MDM2 and Bcl-2 proteins, over-expression of MDM2 and Bcl-2 in papillary carcinoma were associated. CONCLUSION ret/PTC rearrangement, Gs alpha, ras and p53 mutations are relatively rare in differentiated thyroid neoplasms from a Korean population, which may reflect genetic and environmental differences from patients in countries with high prevalences. P53 protein over-expression was noted in 13.3% of papillary carcinoma cases without p53 mutation and was not significantly related to MDM2 and Bcl-2 expression.
Collapse
MESH Headings
- Adenoma/chemistry
- Adenoma/genetics
- Carcinoma/chemistry
- Carcinoma/genetics
- Carcinoma, Papillary/chemistry
- Carcinoma, Papillary/genetics
- Carcinoma, Papillary, Follicular/chemistry
- Carcinoma, Papillary, Follicular/genetics
- Drosophila Proteins
- GTP-Binding Protein alpha Subunits, Gs/genetics
- Gene Rearrangement
- Genes, p53
- Genes, ras
- Humans
- Immunohistochemistry
- Korea
- Neoplasm Proteins/genetics
- Nuclear Proteins
- Oncogene Proteins/genetics
- Point Mutation
- Polymorphism, Single-Stranded Conformational
- Prevalence
- Proto-Oncogene Proteins/analysis
- Proto-Oncogene Proteins/genetics
- Proto-Oncogene Proteins c-bcl-2/analysis
- Proto-Oncogene Proteins c-bcl-2/genetics
- Proto-Oncogene Proteins c-mdm2
- Proto-Oncogene Proteins c-ret
- Receptor Protein-Tyrosine Kinases/genetics
- Reverse Transcriptase Polymerase Chain Reaction
- Thyroid Neoplasms/chemistry
- Thyroid Neoplasms/genetics
- Tumor Suppressor Protein p53/analysis
Collapse
Affiliation(s)
- K Y Park
- Department of Internal Medicine, Asan Institute for Life Sciences and Technology, Seoul, Korea
| | | | | | | | | | | | | |
Collapse
|
7
|
Abstract
Sixteen Korean female laborers who had been exposed to a cleaning solvent composed mainly of 2-bromopropane developed primary ovarian failure. Histologic findings from these patients' ovaries were similar to those observed in ovarian failure caused by radiation or chemotherapy, i.e., reduced number and developmental arrest of primary follicles, interstitial fibrosis and hyalinization of blood vessels. We followed their clinical course for 2 years and found that two patients recovered normal ovarian function spontaneously: one became pregnant and delivered a normal full-term baby, and the other resumed regular menstrual periods with normal hormonal values. Our observations support the idea that the increasing prevalence of ovarian failure in recent years might be due to an increase in presently unidentified environmental toxic agents.
Collapse
Affiliation(s)
- J M Koh
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | | | | | | | | | | | | |
Collapse
|