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LLabre JE, Gil C, Amatya N, Lagalwar S, Possidente B, Vashishth D. Degradation of Bone Quality in a Transgenic Mouse Model of Alzheimer's Disease. J Bone Miner Res 2022; 37:2548-2565. [PMID: 36250342 PMCID: PMC9772191 DOI: 10.1002/jbmr.4723] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 10/03/2022] [Accepted: 10/14/2022] [Indexed: 12/31/2022]
Abstract
Alzheimer's disease (AD) patients present with symptoms such as impairment of insulin signaling, chronic inflammation, and oxidative stress. Furthermore, there are comorbidities associated with AD progression. For example, osteoporosis is common with AD wherein patients exhibit reduced mineralization and a risk for fragility fractures. However, there is a lack of understanding on the effects of AD on bone beyond loss of bone density. To this end, we investigated the effects of AD on bone quality using the 5XFAD transgenic mouse model in which 12-month-old 5XFAD mice showed accumulation of amyloid-beta (Aβ42) compared with wild-type (WT) littermates (n = 10/group; 50% female, 50% male). Here, we observed changes in cortical bone but not in cancellous bone quality. Both bone mass and bone quality, measured in femoral samples using imaging (micro-CT, confocal Raman spectroscopy, X-ray diffraction [XRD]), mechanical (fracture tests), and chemical analyses (biochemical assays), were altered in the 5XFAD mice compared with WT. Micro-CT results showed 5XFAD mice had lower volumetric bone mineral density (BMD) and increased endocortical bone loss. XRD results showed decreased mineralization with smaller mineral crystals. Bone matrix compositional properties, from Raman, showed decreased crystallinity along with higher accumulation of glycoxidation products and glycation products, measured biochemically. 5XFAD mice also demonstrated loss of initiation and maximum toughness. We observed that carboxymethyl-lysine (CML) and mineralization correlated with initiation toughness, whereas crystal size and pentosidine (PEN) correlated with maximum toughness, suggesting bone matrix changes predominated by advanced glycation end products (AGEs) and altered/poor mineral quality explained loss of fracture toughness. Our findings highlight two pathways to skeletal fragility in AD through alteration of bone quality: (i) accumulation of AGEs; and (ii) loss of crystallinity, decreased crystal size, and loss of mineralization. We observed that the accumulation of amyloidosis in brain correlated with an increase in several AGEs, consistent with a mechanistic link between elevated Aβ42 levels in the brain and AGE accumulation in bone. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Joan E. LLabre
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
- Shirley Ann Jackson, Ph.D. Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
| | - Cristianel Gil
- Department of Biology, Skidmore College, Saratoga Springs, NY, USA
| | - Neha Amatya
- Department of Biology, Skidmore College, Saratoga Springs, NY, USA
| | - Sarita Lagalwar
- Neuroscience Program, Skidmore College, Saratoga Springs, NY, USA
| | | | - Deepak Vashishth
- Department of Biomedical Engineering, Rensselaer Polytechnic Institute, Troy, NY, USA
- Shirley Ann Jackson, Ph.D. Center for Biotechnology and Interdisciplinary Studies, Rensselaer Polytechnic Institute, Troy, NY, USA
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2
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Jiang M, Wang T, Yan X, Liu Z, Yan Y, Yang K, Qi J, Zhou H, Qian N, Zhou Q, Chen B, Xu X, Xi X, Yang C, Deng L. A Novel Rhein Derivative Modulates Bone Formation and Resorption and Ameliorates Estrogen-Dependent Bone Loss. J Bone Miner Res 2019; 34:361-374. [PMID: 30320929 DOI: 10.1002/jbmr.3604] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2018] [Revised: 09/27/2018] [Accepted: 10/06/2018] [Indexed: 11/10/2022]
Abstract
Osteoporosis, an osteolytic disease that affects millions of people worldwide, features a bone remodeling imbalance between bone resorption by osteoclasts and bone formation by osteoblasts. Identifying dual target-directed agents that inhibit excessive bone resorption and increase bone formation is considered an efficient strategy for developing new osteoporosis treatments. Rhein, a natural anthraquinone, can be isolated from various Asian herbal medicines. Rhein and its derivatives have been reported to have various beneficial pharmacological effects, especially their bone-targeting ability and anti-osteoclastogenesis activity. Moreover, hydrogen sulfide (H2 S) was reported to prevent ovariectomy- (OVX-) induced bone loss by enhancing bone formation, and sulfur replacement therapy has been considered a novel and plausible therapeutic option. Based on this information, we synthesized a rhein-derived thioamide (RT) and investigated its effects on bone resorption and bone formation in vitro and in vivo. It has been found that the RT-inhibited receptor activator of the nuclear factor-κB (NF-κB) ligand- (RANKL-) induced osteoclastogenesis and bone resorption in a dose-dependent manner. The expression of osteoclast marker genes was also suppressed by RT treatment. Furthermore, exploration of signal transduction pathways indicated that RT markedly blocked RANKL-induced osteoclastogenesis by attenuating MAPK pathways. However, RT treatment in an osteoblastic cell line, MC3TE-E1, indicated that RT led to an increase in the deposition of minerals and the expression of osteoblast marker genes, as demonstrated by Alizarin Red staining and alkaline phosphatase activity. Importantly, an OVX mouse model showed that RT could attenuate the bone loss in estrogen deficiency-induced osteoporosis in vivo with a smart H2 S-releasing property and that there was a considerable improvement in the biomechanical properties of bone. Accordingly, our current work highlights the dual regulation of bone remodeling by the rhein-derived molecule RT. This may be a highly promising approach for a new type of anti-osteoporosis agent. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Min Jiang
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Tianqi Wang
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xueming Yan
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Zhuochao Liu
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Yufei Yan
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Kai Yang
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jin Qi
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Hanbing Zhou
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Niandong Qian
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Qi Zhou
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bo Chen
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xing Xu
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Xiaobing Xi
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Department of Traumatology, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Chunhao Yang
- Department of Medicinal Chemistry, State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai, China
| | - Lianfu Deng
- Shanghai Key Laboratory for Bone and Joint Diseases, Shanghai Institute of Traumatology and Orthopaedics, Shanghai Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
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Chiang CY, Zebaze R, Wang XF, Ghasem-Zadeh A, Zajac JD, Seeman E. Cortical Matrix Mineral Density Measured Noninvasively in Pre- and Postmenopausal Women and a Woman With Vitamin D-Dependent Rickets. J Bone Miner Res 2018; 33:1312-1317. [PMID: 29489033 DOI: 10.1002/jbmr.3415] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Revised: 02/05/2018] [Accepted: 02/12/2018] [Indexed: 12/26/2022]
Abstract
Reduced bone mineral density (BMD) may be due to reduced mineralized bone matrix volume, incomplete secondary mineralization, or reduced primary mineralization. Because bone biopsy is invasive, we hypothesized that noninvasive image acquisition at high resolution can accurately quantify matrix mineral density (MMD). Quantification of MMD was confined to voxels attenuation photons above 80% of that produced by fully mineralized bone matrix because attenuation at this level is due to variation in mineralization, not porosity. To assess accuracy, 9 cadaveric distal radii were imaged at a voxel size of 82 microns using high-resolution peripheral quantitative computed tomography (HR-pQCT; XtremeCT, Scanco Medical AG, Bruttisellen, Switzerland) and compared with VivaCT 40 (µCT) at 19-micron voxel size. Associations between MMD and porosity were studied in 94 healthy vitamin D-replete premenopausal women, 77 postmenopausal women, and in a 27-year-old woman with vitamin D-dependent rickets (VDDR). Microstructure and MMD were quantified using StrAx (StraxCorp, Melbourne, Australia). MMD measured by HR-pQCT and µCT correlated (R = 0.87; p < 0.0001). The precision error for MMD was 2.43%. Cortical porosity and MMD were associated with age (r2 = 0.5 and -0.4, respectively) and correlated inversely in pre- and postmenopausal women (both r2 = 0.9, all p < 0.001). Porosity was higher, and MMD was lower, in post- than in premenopausal women (porosity 40.3% ± 7.0 versus 34.7% ± 3.5, respectively; MMD 65.4% ± 1.8 versus 66.6% ± 1.4, respectively, both p < 0.001). In the woman with VDDR, MMD was 5.6 SD lower and porosity was 5.6 SD higher than the respective trait means in premenopausal women. BMD was reduced (Z-scores femoral neck -4.3 SD, lumbar spine -3.8 SD). Low-radiation HR-pQCT may facilitate noninvasive quantification of bone's MMD and microstructure in health, disease, and during treatment. © 2018 American Society for Bone and Mineral Research.
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Affiliation(s)
- Cherie Y Chiang
- Department of Endocrinology, Austin Health, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Roger Zebaze
- Department of Endocrinology, Austin Health, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Xiao-Fang Wang
- Department of Endocrinology, Austin Health, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Ali Ghasem-Zadeh
- Department of Endocrinology, Austin Health, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Jeffrey D Zajac
- Department of Endocrinology, Austin Health, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia
| | - Ego Seeman
- Department of Endocrinology, Austin Health, Heidelberg, Australia.,Department of Medicine, University of Melbourne, Parkville, Australia.,Institute of Health and Ageing, Australian Catholic University, Melbourne, Australia
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Macdonald HM, Määttä M, Gabel L, Mulpuri K, McKay HA. Bone Strength in Girls and Boys After a Distal Radius Fracture: A 2-Year HR-pQCT Double Cohort Study. J Bone Miner Res 2018; 33:229-240. [PMID: 29024249 DOI: 10.1002/jbmr.3307] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Revised: 10/05/2017] [Accepted: 10/10/2017] [Indexed: 11/07/2022]
Abstract
We recently reported impaired bone strength in girls with low- to moderate-energy distal radius fractures (Fx) compared with girls with no history of forearm fractures (Non-Fx). We aimed to determine whether bone strength deficits observed at baseline were still present after 2 years. We assessed bone strength, microarchitecture, and bone mineral density (BMD) of the non-fractured (Fx) and non-dominant (Non-Fx) distal radius (7% site) at baseline, 12, and 24 months using high-resolution pQCT (Scanco Medical, Brüttisellen, Switzerland) in 104 girls (aged 11.0 ± 1.7 years; 47 Fx, 57 Non-Fx) and 157 boys (aged 12.7 ± 1.7 years; 86 Fx, 71 Non-Fx). Bone outcomes included total area (Tt.Ar) and bone mineral density (Tt.BMD), trabecular bone volume ratio (BV/TV), thickness (Tb.Th), separation (Tb.Sp), and number (Tb.N), and cortical BMD (Ct.BMD), thickness (Ct.Th), and porosity (Ct.Po). We used finite element analysis to estimate bone strength (failure load [F.Load]; ultimate stress [U.Stress]; load-to-strength ratio). We used sex-specific mixed-effects models to compare bone outcomes between Fx and Non-Fx over 2 years. In girls, those with fractures had 18% to 24% lower U.Stress and 5% to 9% lower Tt.BMD than Non-Fx at all time points (p < 0.017). In secondary analysis by fracture degree, girls with low-energy (LE) fractures had 19% to 21% lower F.Load, 25% to 47% lower U.Stress, 11% to 14% lower Tt.BMD, and 11% to 15% lower BV/TV than Non-Fx at all time points (p < 0.017). In contrast, boys' bone outcomes were similar between Fx and Non-Fx at all time points. In secondary analysis by fracture degree, boys with LE fractures had 10% lower Tt.BMD and 10% lower Ct.Th compared with Non-Fx at 12 months only. Deficits in distal radius bone strength and trabecular bone microarchitecture appear to track across 2 years after a forearm fracture in girls but not in boys. Longer follow-up is needed to determine whether deficits persist into adulthood in women and how they may influence future risk of fragility fracture. © 2017 American Society for Bone and Mineral Research.
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Affiliation(s)
- Heather M Macdonald
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada
| | - Mikko Määttä
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Orthopedics, University of British Columbia, Vancouver, Canada
| | - Leigh Gabel
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada
| | - Kishore Mulpuri
- Department of Orthopedics, University of British Columbia, Vancouver, Canada.,Department of Orthopedic Surgery, British Columbia Children's Hospital, Vancouver, Canada
| | - Heather A McKay
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, Canada.,Department of Family Practice, University of British Columbia, Vancouver, Canada.,Department of Orthopedics, University of British Columbia, Vancouver, Canada
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Karasik D, Demissie S, Zhou Y, Lu D, Broe KE, Bouxsein ML, Cupples LA, Kiel DP. Heritability and Genetic Correlations for Bone Microarchitecture: The Framingham Study Families. J Bone Miner Res 2017; 32:106-114. [PMID: 27419666 PMCID: PMC5310688 DOI: 10.1002/jbmr.2915] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2016] [Revised: 06/13/2016] [Accepted: 07/11/2016] [Indexed: 02/02/2023]
Abstract
High-resolution peripheral quantitative computed tomography (HR-pQCT) measures bone microarchitecture and volumetric bone mineral density (vBMD), important risk factors for osteoporotic fractures. We estimated the heritability (h2 ) of bone microstructure indices and vBMD, measured by HR-pQCT, and genetic correlations (ρG ) among them and between them and regional aBMD measured by dual-energy X-ray absorptiometry (DXA), in adult relatives from the Framingham Heart Study. Cortical (Ct) and trabecular (Tb) traits were measured at the distal radius and tibia in up to 1047 participants, and ultradistal radius (UD) aBMD was obtained by DXA. Heritability estimates, adjusted for age, sex, and estrogenic status (in women), ranged from 19.3% (trabecular number) to 82.8% (p < 0.01, Ct.vBMD) in the radius and from 51.9% (trabecular thickness) to 98.3% (cortical cross-sectional area fraction) in the tibia. Additional adjustments for height, weight, and radial aBMD had no major effect on h2 estimates. In bivariate analyses, moderate to high genetic correlations were found between radial total vBMD and microarchitecture traits (ρG from 0.227 to 0.913), except for cortical porosity. At the tibia, a similar pattern of genetic correlations was observed (ρG from 0.274 to 0.948), except for cortical porosity. Environmental correlations between the microarchitecture traits were also substantial. There were high genetic correlations between UD aBMD and multivariable-adjusted total and trabecular vBMD at the radius (ρG = 0.811 and 0.917, respectively). In summary, in related men and women from a population-based cohort, cortical and trabecular microarchitecture and vBMD at the radius and tibia were heritable and shared some h2 with regional aBMD measured by DXA. These findings of high heritability of HR-pQCT traits, with a slight attenuation when adjusting for aBMD, supports further work to identify the specific variants underlying volumetric bone density and fine structure of long bones. Knowledge that some of these traits are genetically correlated can serve to reduce the number of traits for genetic association studies. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- David Karasik
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Faculty of Medicine, Bar Ilan University, Safed, Israel
| | - Serkalem Demissie
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Yanhua Zhou
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Darlene Lu
- Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Kerry E Broe
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA
| | - Mary L Bouxsein
- Center for Advanced Orthopedic Studies, Beth Israel Deaconess Medical Center, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - L Adrienne Cupples
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Framingham Heart Study, Framingham, MA, USA
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Meyer U, de Jong JJ, Bours SGP, Keszei AP, Arts JJ, Brink PRG, Menheere P, van Geel TACM, van Rietbergen B, van den Bergh JPW, Geusens PP, Willems PC. Early changes in bone density, microarchitecture, bone resorption, and inflammation predict the clinical outcome 12 weeks after conservatively treated distal radius fractures: an exploratory study. J Bone Miner Res 2014; 29:2065-73. [PMID: 24644096 DOI: 10.1002/jbmr.2225] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 02/26/2014] [Accepted: 03/12/2014] [Indexed: 01/08/2023]
Abstract
Fracture healing is an active process with early changes in bone and inflammation. We performed an exploratory study evaluating the association between early changes in densitometric, structural, biomechanical, and biochemical bone parameters during the first weeks of fracture healing and wrist-specific pain and disability at 12 weeks in postmenopausal women with a conservatively treated distal radius fracture. Eighteen patients (aged 64 ± 8 years) were evaluated at 1 to 2 and 3 to 4 weeks postfracture, using high-resolution peripheral quantitative computed tomography (HR-pQCT), micro-finite element analysis, serum procollagen type-I N-terminal propeptide (P1NP), carboxy-terminal telopeptide of type I collagen (ICTP), and high-sensitive C-reactive protein (hsCRP). After 12 weeks, patients rated their pain and disability using Patient Rated Wrist Evaluation (PRWE) questionnaire. Additionally, Quick Disability of the Arm Shoulder and Hand (QuickDASH) questionnaire and active wrist range of motion was evaluated. Linear regression models were used to study the relationship between changes in bone parameters and in hsCRP from visit 1 to 2 and PRWE score after 12 weeks. A lower PRWE outcome, indicating better outcome, was significantly related to an early increase in trabecular bone mineral density (BMD) (β -0.96 [95% CI -1.75 to -0.16], R(2) = 0.37), in torsional stiffness (-0.14 [-0.28 to -0.004], R(2) = 0.31), and to an early decrease in trabecular separation (209 [15 to 402], R(2) = 0.33) and in ICTP (12.1 [0.0 to 24.1], R(2) = 0.34). Similar results were found for QuickDASH. Higher total dorsal and palmar flexion range of motion was significantly related to early increase in hsCRP (9.62 [3.90 to 15.34], R(2) = 0.52). This exploratory study indicates that the assessment of early changes in trabecular BMD, trabecular separation, calculated torsional stiffness, bone resorption marker ICTP, and hsCRP after a distal radius fracture provides valuable information regarding the 12-week clinical outcome in terms of pain, disability, and range of motion and validates its use in studies on the process of early fracture healing. © 2014 American Society for Bone and Mineral Research.
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Affiliation(s)
- Ursina Meyer
- Department of Human Movement Sciences, Maastricht University, Maastricht, The Netherlands; Research School NUTRIM, Maastricht University, Maastricht, The Netherlands; Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland
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