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Zhang X, Krishnamoorthy S, Tang CTL, Hsu WWQ, Li GHY, Sing CW, Tan KCB, Cheung BMY, Wong ICK, Kung AWC, Cheung CL. Association of Bone Mineral Density and Bone Turnover Markers with the Risk of Diabetes: Hong Kong Osteoporosis Study and Mendelian Randomization. J Bone Miner Res 2023; 38:1782-1790. [PMID: 37850799 DOI: 10.1002/jbmr.4924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/18/2023] [Revised: 10/08/2023] [Accepted: 10/13/2023] [Indexed: 10/19/2023]
Abstract
Preclinical studies demonstrated that bone plays a central role in energy metabolism. However, how bone metabolism is related to the risk of diabetes in humans is unknown. We investigated the association of bone health (bone mineral density [BMD] and bone turnover markers) with incident type-2 diabetes mellitus (T2DM) based on the Hong Kong Osteoporosis Study (HKOS). A total of 993 and 7160 participants from the HKOS were studied for the cross-sectional and prospective analyses, respectively. The cross-sectional study evaluated the association of BMD and bone biomarkers with fasting glucose and glycated hemoglobin (HbA1c ) levels, whereas the prospective study examined the associations between BMD at study sites and the risk of T2DM by following subjects a median of 16.8 years. Body mass index (BMI) was adjusted in all full models. Mendelian randomization (MR) was conducted for causal inference. In the cross-sectional analysis, lower levels of circulating bone turnover markers and higher BMD were significantly associated with increased fasting glucose and HbA1c levels. In the prospective analysis, higher BMD (0.1 g/cm2 ) at the femoral neck and total hip was associated with increased risk of T2DM with hazard ratios (HRs) of 1.10 (95% confidence interval [CI], 1.03 to 1.18) and 1.14 (95% CI, 1.08 to 1.21), respectively. The presence of osteoporosis was associated with a 30% reduction in risk of T2DM compared to those with normal BMD (HR = 0.70; 95% CI, 0.55 to 0.90). The MR results indicate a robust genetic causal association of estimated BMD (eBMD) with 2-h glucose level after an oral glucose challenge test (estimate = 0.043; 95% CI, 0.007 to 0.079) and T2DM (odds ratio = 1.064; 95% CI, 1.036 to 1.093). Higher BMD and lower levels of circulating bone biomarkers were cross-sectionally associated with poor glycemic control. Moreover, higher BMD was associated with a higher risk of incident T2DM and the association is probably causal. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Xiaowen Zhang
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Suhas Krishnamoorthy
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Casey Tze-Lam Tang
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Warrington Wen-Qiang Hsu
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Gloria Hoi-Yee Li
- Department of Health Technology and Informatics, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chor-Wing Sing
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Kathryn Choon-Beng Tan
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Bernard Man-Yung Cheung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ian Chi-Kei Wong
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Research Department of Practice and Policy, School of Pharmacy, University College London, London, UK
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong, China
| | - Annie Wai-Chee Kung
- Department of Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Ching-Lung Cheung
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science Park, Pak Shek Kok, Hong Kong, China
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Leerling AT, Andeweg EH, Faber J, Streefland TC, Dekkers OM, Appelman‐Dijkstra NM, Winter EM. Immunological Characterization of Chronic Nonbacterial Osteomyelitis (CNO) in Adults: A Cross-Sectional Exploratory Study. JBMR Plus 2023; 7:e10818. [PMID: 38130757 PMCID: PMC10731106 DOI: 10.1002/jbm4.10818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 08/17/2023] [Accepted: 08/24/2023] [Indexed: 12/23/2023] Open
Abstract
Chronic nonbacterial osteomyelitis (CNO) is a rare disease spectrum affecting children and adults. Adult CNO may occur as isolated bone inflammation, or with a broad range of extraskeletal features. CNO pathophysiology, including the key drivers of inflammation, remains largely unknown. For pediatric CNO, a role for pro-inflammatory cytokine dysregulation has been proposed, but studies in adults are scarce. We therefore provide immunological characterization of adult CNO. Cross-sectional study in our referral center including adult CNO patients (n = 172) and healthy controls (n = 65). Inflammation parameters and systemic inflammatory based scores(SIBS, including neutrophil/lymphocyte ratio [NLR] and systemic immune inflammation index [SII]) were compared between groups. Cytokine expression was explored with electrochemiluminescent immunoassays in 33 patients, eight healthy controls and 21 osteoporosis patients. Routine inflammation markers were higher in patients than in controls, but generally remained within reference range. Systemic inflammation was more pronounced in patients with additional vertebral involvement as compared to those osteitis in the anterior chest wall alone, in patients with comorbid pustulosis palmoplantaris or psoriasis, and in patients with strongly rather than moderately increased lesional uptake on nuclear imaging. SII was elevated in CNO patients too, but NLR was not. Cytokine expression was generally nondifferential between patients and both control groups, and patients displayed low absolute concentrations of pro-inflammatory cytokines. In this adult CNO cohort, systemic inflammation was generally subtle, but more pronounced in patients with vertebral lesions, associated skin disease, and strongly increased uptake on nuclear imaging. SII was increased in patients compared to healthy controls. Contrasting pediatric studies, we found no increased expression of the pro-inflammatory cytokines that have been proposed to drive the inflammatory cascade, like interleukin-6, -8, and -17 (IL-6, IL-8, and IL-17), and tumor necrosis α (TNF-α). Further studies are needed to evaluate the use of SII in diagnosis and monitoring of CNO, and elucidate the role of cytokine dysregulation in adult disease. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC. on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Anne T. Leerling
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Bone QualityLeiden University Medical CenterLeidenThe Netherlands
| | - Elisabeth H. Andeweg
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Bone QualityLeiden University Medical CenterLeidenThe Netherlands
| | - Juliette Faber
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Bone QualityLeiden University Medical CenterLeidenThe Netherlands
| | - Trea C.M. Streefland
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
| | - Olaf M. Dekkers
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Natasha M. Appelman‐Dijkstra
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Bone QualityLeiden University Medical CenterLeidenThe Netherlands
| | - Elizabeth M. Winter
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
- Center for Bone QualityLeiden University Medical CenterLeidenThe Netherlands
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Lewiecki EM, Czerwinski E, Recknor C, Strzelecka A, Valenzuela G, Lawrence M, Silverman S, Cardona J, Nattrass SM, Binkley N, Annett M, Pearman L, Mitlak B. Efficacy and Safety of Transdermal Abaloparatide in Postmenopausal Women with Osteoporosis: A Randomized Study. J Bone Miner Res 2023; 38:1404-1414. [PMID: 37417725 DOI: 10.1002/jbmr.4877] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [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: 03/16/2023] [Revised: 06/21/2023] [Accepted: 06/30/2023] [Indexed: 07/08/2023]
Abstract
Anabolic therapies, recommended for patients at very high fracture risk, are administered subcutaneously (SC). The objective of this study was to evaluate the efficacy and safety of the abaloparatide microstructured transdermal system (abaloparatide-sMTS) as an alternative to the SC formulation. This phase 3, noninferiority study (NCT04064411) randomly assigned postmenopausal women with osteoporosis (N = 511) 1:1 to open-label abaloparatide administered daily via abaloparatide-sMTS or SC injection for 12 months. The primary comparison between treatment groups was the percentage change in lumbar spine bone mineral density (BMD) at 12 months, with a noninferiority margin of 2.0%. Secondary endpoints included percentage change in total hip and femoral neck BMD, bone turnover markers, dermatologic safety, and new clinical fracture incidence. At 12 months, percentage increase from baseline in lumbar spine BMD was 7.14% (SE: 0.46%) for abaloparatide-sMTS and 10.86% (SE: 0.48%) for abaloparatide-SC (treatment difference: -3.72% [95% confidence interval: -5.01%, -2.43%]). Percentage change in total hip BMD was 1.97% for abaloparatide-sMTS and 3.70% for abaloparatide-SC. Median changes from baseline at 12 months in serum procollagen type I N-terminal propeptide (s-PINP) were 52.6% for abaloparatide-sMTS and 74.5% for abaloparatide-SC. Administration site reactions were the most frequently reported adverse events (abaloparatide-sMTS, 94.4%; abaloparatide-SC, 70.5%). Incidence of serious adverse events was similar between groups. Mild or moderate skin reactions occurred with abaloparatide-sMTS with no identifiable risk factors for sensitization reactions. Few new clinical fractures occurred in either group. Noninferiority of abaloparatide-sMTS to abaloparatide-SC for percentage change in spine BMD at 12 months was not demonstrated; however, clinically meaningful increases from baseline in lumbar spine and total hip BMD were observed in both treatment groups. © 2023 Radius Health, Inc and The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- E Michael Lewiecki
- New Mexico Clinical Research & Osteoporosis Center, Albuquerque, NM, USA
| | | | | | | | | | | | | | - Jose Cardona
- Indago Research & Health Center, Inc., Hialeah, FL, USA
| | | | - Neil Binkley
- University of Wisconsin Osteoporosis Clinical Research Program, Madison, WI, USA
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Cherian KE, Kapoor N, Paul TV. Disrupted Sleep Architecture Is Associated With Incident Bone Loss in Indian Postmenopausal Women: A Prospective Study. J Bone Miner Res 2022; 37:1956-1962. [PMID: 35880668 DOI: 10.1002/jbmr.4662] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 03/01/2022] [Revised: 07/06/2022] [Accepted: 07/21/2022] [Indexed: 11/06/2022]
Abstract
Inadequate sleep has been shown to be detrimental to several body systems, including the bone. We proposed to study the impact of insomnia on bone health in Indian postmenopausal women. In a 2-year prospective study, ambulant community-dwelling postmenopausal women aged >50 years were recruited through simple random sampling. Sleep duration was recorded based on self-reported sleep duration and sleep quality using the Women's Health Initiative Insomnia Rating Scale (WHIIRS). Anthropometry, bone biochemistry including bone turnover markers (C-terminal telopeptide of type 1 collagen [CTX], N-terminal telopeptide of type 1 pro-collagen [P1NP]), bone mineral density (BMD), and trabecular bone score (TBS) were assessed at baseline and at the end of 2 years. Among 190 postmenopausal women with mean (SD) age of 58.2 (6.9) years, 65/190 (34.2%) had insomnia (WHIIRS ≥ 9) and 20/190 (10.5%) developed osteoporosis at any site on follow-up. The percentage decline over 2 years in BMD in women with insomnia was significantly (p < 0.001) higher at femoral neck (2.9 [1.6] versus 1.2 [1.2]%) and lumbar spine (4.5 [2.0] versus 1.6 [1.1]%). The decrement in TBS was also significantly higher (p < 0.001) in women with suboptimal sleep (1.5 [2.1] versus 0.5 [1.0] %) when compared with those with adequate sleep. The increment in CTX (46.4 [32.2] versus 18.9 [26.4]) and decrement in P1NP (35.4 [9.1] versus 16.7 [18.9]), respectively, were also greater (p < 0.001) in women with insomnia compared with those without. On multivariate analysis, insomnia was the sole factor that was predictive (adjusted odds ratio [OR] = 9.3; 95% confidence interval [CI] 2.9-29.6; p < 0.001) of incident osteoporosis. In conclusion, poor sleep quality was associated with incident osteoporosis in Indian postmenopausal women. Optimal sleep may help to retard ongoing bone loss that results from sleep deprivation and requires further research. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Kripa Elizabeth Cherian
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - Nitin Kapoor
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
| | - Thomas Vizhalil Paul
- Department of Endocrinology, Diabetes and Metabolism, Christian Medical College and Hospital, Vellore, India
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Grey A, Bolland MJ, Horne A, Mihov B, Gamble G, Reid IR. Bone Mineral Density and Bone Turnover 10 Years After a Single 5 mg Dose or Two 5-Yearly Lower Doses of Zoledronate in Osteopenic Older Women: An Open-Label Extension of a Randomized Controlled Trial. J Bone Miner Res 2022; 37:3-11. [PMID: 34585780 DOI: 10.1002/jbmr.4453] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 05/12/2021] [Revised: 09/13/2021] [Accepted: 09/26/2021] [Indexed: 11/07/2022]
Abstract
Intravenous zoledronate reduces fracture risk (5 mg at 18-month intervals) and prevents bone loss (doses of 1 to 5 mg for 3 to >5 years), but the duration of action of a single 5 mg dose and the effects of lower doses beyond 5 years are unknown. We report the second open-label extension (years 5 to 10) of a 2-year randomized, multidose, placebo-controlled, double-blinded trial. A total of 116 older women who completed 5 years of participation either continued observation without further treatment (zoledronate 5 mg and placebo at baseline) or received repeat doses of 1 or 2.5 mg zoledronate (zoledronate 1 mg and zoledronate 2.5 mg at baseline, respectively). Outcomes were spine, hip, and total body bone mineral density (BMD) and serum markers of bone turnover. After a single 5 mg dose of zoledronate, mean BMD at the lumbar spine and total hip was maintained at or above baseline levels for 9 and 10 years, respectively. The mean level of the bone resorption marker β-C-terminal telopeptide of type I collagen (β-CTX) was at least 25% lower than that in the placebo group for 9 years. In women administered 5-yearly doses of 2.5 mg zoledronate, mean BMD at the total hip and lumbar spine was maintained at or above baseline levels for 9 and 10 years, respectively. Redosing with 1 or 2.5 mg zoledronate at 5 years reduced bone turnover markers for 3 to 4 years. BMD increased for 3 to 4 years after redosing with 1 mg zoledronate. In the group given 5-yearly 2.5 mg zoledronate, β-CTX was at least 20% lower than that in the placebo group for 10 years. Both a single baseline 5 mg dose of zoledronate and 5-yearly doses of 1 and 2.5 mg zoledronate prevented bone loss at hip and spine for 8 to 10 years in older postmenopausal women. Clinical trials to evaluate the effects on fracture risk of these very infrequent and lower doses of zoledronate are justified. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Andrew Grey
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Mark J Bolland
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Anne Horne
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Borislav Mihov
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Greg Gamble
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Ian R Reid
- Department of Medicine, University of Auckland, Auckland, New Zealand
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Vilaca T, Paggiosi M, Walsh JS, Selvarajah D, Eastell R. The Effects of Type 1 Diabetes and Diabetic Peripheral Neuropathy on the Musculoskeletal System: A Case-Control Study. J Bone Miner Res 2021; 36:1048-1059. [PMID: 33825260 DOI: 10.1002/jbmr.4271] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 09/15/2020] [Revised: 02/05/2021] [Accepted: 02/10/2021] [Indexed: 12/22/2022]
Abstract
Fracture risk is increased in type 1 diabetes (T1D). Diabetic neuropathy might contribute to this increased risk directly through effects on bone turnover and indirectly through effects on balance, muscle strength, and gait. We compared patients with T1D with (T1DN+, n = 20) and without (T1DN-, n = 20) distal symmetric sensorimotor polyneuropathy and controls (n = 20). We assessed areal bone mineral density (aBMD) and appendicular muscle mass by dual-energy X-ray absorptiometry, microarchitecture by high-resolution peripheral quantitative tomography at the standard ultra-distal site and at an exploratory 14% bone length site at the tibia and radius, bone turnover markers, and muscle strength, gait, and balance by Short Physical Performance Battery (SPPB). At the standard ultra-distal site, tibial cortical porosity was 56% higher in T1DN+ compared with T1DN- (p = .009) and correlated positively with the severity of neuropathy (Toronto Clinical Neuropathy Score; r = 0.347, p = .028) and negatively with nerve conduction amplitude and velocity (r = -0.386, p = .015 and r = -0.358, p = .025, respectively). Similar negative correlations were also observed at the radius (r = -0.484, p = .006 and r = -0.446, p = .012, respectively). At the exploratory 14% offset site (less distal), we found higher trabecular volumetric BMD (tibia 25%, p = .024; radius 46%, p = .017), trabecular bone volume (tibia 25%, p = .023; radius 46%, p = .017), and trabecular number (tibia 22%, p = .014; radius 30%, p = .010) in T1DN- compared with controls. Both CTX and PINP were lower in participants with TD1 compared with controls. No difference was found in aBMD and appendicular muscle mass. T1DN+ had worse performance in the SPPB compared with T1DN- and control. In summary, neuropathy was associated with cortical porosity and worse performance in physical tests. Our findings suggest that bone structure does not fully explain the rate of fractures in T1D. We conclude that the increase in the risk of fractures in T1D is multifactorial with both skeletal and non-skeletal contributions. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Tatiane Vilaca
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Margaret Paggiosi
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Jennifer S Walsh
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
| | - Dinesh Selvarajah
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, UK
| | - Richard Eastell
- Academic Unit of Bone Metabolism, University of Sheffield, Sheffield, UK
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Langdahl JH, Frederiksen AL, Hansen SJ, Andersen PH, Yderstraede KB, Dunø M, Vissing J, Frost M. Mitochondrial Point Mutation m.3243A>G Associates With Lower Bone Mineral Density, Thinner Cortices, and Reduced Bone Strength: A Case-Control Study. J Bone Miner Res 2017; 32:2041-2048. [PMID: 28603900 DOI: 10.1002/jbmr.3193] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [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: 04/08/2017] [Revised: 05/19/2017] [Accepted: 05/31/2017] [Indexed: 12/17/2022]
Abstract
Mitochondrial dysfunction is associated with several clinical manifestations including diabetes mellitus (DM), neurological disorders, renal and hepatic diseases, and myopathy. Although mitochondrial dysfunction is associated with increased bone resorption and decreased bone formation in mouse models, effects of alterations in mitochondrial function on bone remodeling and mass have not been investigated in humans. We recruited 45 carriers (29 females, 16 males) with the m.3243A>G mutation and healthy controls matched for gender, age, height, and menopausal status. DXA and HRpQCT scans were performed, and bone turnover markers (BTMs) P1NP and CTX were measured. Cases and controls were well matched except for body weight, which was lower in cases (63.6 ± 18.1 kg versus 74.6 ± 14.8 kg, p < 0.01), and manifest DM was present in 25 of 45 cases (none in controls). Bone scans showed lower BMD at the lumbar spine, total hip, and femoral neck in cases. Mean lumbar spine, total hip, and femoral neck T-scores were -1.5, -1.3, and -1.6 in cases, respectively, and -0.8, -0.3, and -0.7 in controls (all p < 0.05). The m.3243A>G mutation was associated with lower BMD, cortical but not trabecular density, cortical thickness, and estimated bone strength. Furthermore, BTMs were lower in the m.3243A>G group before but not after adjustment for DM. The mitochondrial point mutation m.3243A>G was associated with decreased bone mass and strength. Although the coexistence of DM may have influenced bone turnover, the bone phenotype observed in m.3243A>G cases appeared to mirror age-related deterioration in bone, suggesting that mitochondrial dysfunction may cause a premature aging of bone. © 2017 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals Inc.
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Affiliation(s)
- Jakob Høgild Langdahl
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | - Anja Lisbeth Frederiksen
- Department of Clinical Genetics, Odense University Hospital, Odense, Denmark.,Institute of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Stinus Jørn Hansen
- Institute of Clinical Research, University of Southern Denmark, Odense, Denmark.,Department of Endocrinology, Odense University Hospital, Odense, Denmark
| | - Per Heden Andersen
- Department of Endocrinology, Hospital of Southwest Jutland, Esbjerg, Denmark
| | | | - Morten Dunø
- Department of Clinical Genetics, Rigshospitalet, Copenhagen, Denmark
| | - John Vissing
- Copenhagen Neuromuscular Center, Department of Neurology, Rigshospitalet, Copenhagen, Denmark
| | - Morten Frost
- Department of Endocrinology, Odense University Hospital, Odense, Denmark
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Rolvien T, Koehne T, Kornak U, Lehmann W, Amling M, Schinke T, Oheim R. A Novel ANO5 Mutation Causing Gnathodiaphyseal Dysplasia With High Bone Turnover Osteosclerosis. J Bone Miner Res 2017; 32:277-284. [PMID: 27541832 DOI: 10.1002/jbmr.2980] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [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: 06/14/2016] [Revised: 08/04/2016] [Accepted: 08/17/2016] [Indexed: 01/01/2023]
Abstract
Gnathodiaphyseal dysplasia (GDD) is a rare skeletal syndrome that involves an osteopetrosis-like sclerosis of the long bones and fibrous dysplasia-like cemento-osseous lesions of the jawbone. Although the genetic analysis of the respective patients has revealed mutations in the ANO5 gene as an underlying cause, there is still no established consensus regarding the bone status of GDD patients. We report a new case of GDD in a 13-year-old boy with recurrent diaphyseal fractures of the femur, in whom we identified a novel de novo missense mutation in the ANO5 gene, causing a p.Ser500Phe substitution at the protein level. After confirming the presence of GDD-characteristic abnormalities within the jaw bones, we focused on a full osteologic assessment using dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT), and serum analyses. We thereby identified increased trabecular bone mass accompanied by elevated serum markers of bone formation and bone resorption. The high turnover bone pathology was further confirmed through the analysis of an iliac crest biopsy, where osteoblast and osteoclast indices were remarkably increased. Taken together, our findings provide evidence for a critical and generalized role of anoctamin-5 (the protein encoded by the ANO5 gene) in skeletal biology. As it is reasonable to speculate that modifying the function of anoctamin-5 might be useful for therapeutically activating bone remodeling, it is now required to analyze its function at a molecular level, for instance in mouse models. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Tim Rolvien
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till Koehne
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.,Department of Orthodontics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Uwe Kornak
- Institute of Medical Genetics and Human Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Wolfgang Lehmann
- Department of Trauma, Hand and Reconstructive Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael Amling
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Thorsten Schinke
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ralf Oheim
- Department of Osteology and Biomechanics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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Sathyapalan T, Aye M, Rigby AS, Fraser WD, Thatcher NJ, Kilpatrick ES, Atkin SL. Soy Reduces Bone Turnover Markers in Women During Early Menopause: A Randomized Controlled Trial. J Bone Miner Res 2017; 32:157-164. [PMID: 27465911 DOI: 10.1002/jbmr.2927] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 02/08/2016] [Revised: 07/19/2016] [Accepted: 07/21/2016] [Indexed: 01/14/2023]
Abstract
Menopausal estrogen loss leads to an increased bone loss. Soy isoflavones can act as selective estrogen receptor modulators, their role in bone turnover is unclear. The primary outcome was assessing changes in plasma bone turnover markers. The secondary outcomes were assessing changes in cardiovascular risk markers including insulin resistance, blood pressure, and lipid profile. We performed a double-blind randomized parallel study in which 200 women within 2 years after the onset of their menopause were randomized to 15 g soy protein with 66 mg isoflavone (SPI) or 15 g soy protein alone (SP), daily for 6 months. There was a significant reduction in type I collagen crosslinked beta C-telopeptide (βCTX) (bone-resorption marker) with SPI supplementation (0.40 ± 0.17 versus 0.15 ± 0.09 μg/L; p < 0.01) compared to SP supplementation (0.35 ± 0.12 versus 0.35 ± 0.13 μg/L; p = 0.92) after 6 months. There was also a significant reduction in type I procollagen-N-propeptide (P1NP) (bone formation marker) with SPI supplementation (50.5 ± 25.0 versus 34.3 ± 17.6 μg/L; p < 0.01), more marked between 3 and 6 months. Following SPI there was a significant reduction in fasting glucose, fasting insulin, insulin resistance, and systolic blood pressure whereas no significant changes in these parameters was observed with SP. There were no significant changes in fasting lipid profile and diastolic blood pressure with either preparation. There was a significant increase in TSH and reduction in free thyroxine (p < 0.01) with SPI supplementation though free tri-iodothyronine was unchanged. In conclusion, soy protein with isoflavones may confer a beneficial effect on bone health, analogous to the mode of action of antiresorptive agents, albeit to a less magnitude. There was a significant improvement of cardiovascular risk markers, but a significant increase in TSH and reduction in free thyroxine after SPI supplementation indicating a detrimental effect on thyroid function. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Thozhukat Sathyapalan
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Mo Aye
- Academic Diabetes, Endocrinology and Metabolism, Hull York Medical School, University of Hull, Hull, UK
| | - Alan S Rigby
- Department of Academic Cardiology, University of Hull, Hull, UK
| | - William D Fraser
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
| | | | - Eric S Kilpatrick
- Department of Clinical Chemistry, Sidra Medical and Research Center, Doha, Qatar
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Guañabens N, Ruiz-Gaspà S, Gifre L, Miquel R, Peris P, Monegal A, Dubrueil M, Arias A, Parés A. Sclerostin Expression in Bile Ducts of Patients With Chronic Cholestasis May Influence the Bone Disease in Primary Biliary Cirrhosis. J Bone Miner Res 2016; 31:1725-33. [PMID: 27019303 DOI: 10.1002/jbmr.2845] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [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: 12/10/2015] [Revised: 03/12/2016] [Accepted: 03/23/2016] [Indexed: 02/06/2023]
Abstract
Sclerostin is involved in the regulation of osteoblastogenesis and little is known about its role in the development of bone disease in primary biliary cirrhosis (PBC), characterized by low bone formation. Therefore, we have assessed the circulating levels and the liver expression of sclerostin in this cholestatic disease. Serum sclerostin levels were measured in 79 women with PBC (mean age 60.6 ± 1.2 years) and in 80 control women. Lumbar and femoral bone mineral density (BMD), as well as parameters of mineral metabolism and bone remodeling, were measured. Moreover, sclerostin gene (SOST) expression in the liver was assessed by real-time PCR in samples of liver tissue taken by biopsy in 11 PBC patients and in 5 normal liver specimens. Presence and distribution of sclerostin was evaluated in liver slices from 11 patients by immunohistochemistry. The severity of histologic lesions was assessed semiquantitatively in the same liver samples. PBC patients had higher sclerostin levels than controls (75.6 ± 3.9 versus 31.7 ± 1.6 pmol/L, p < 0.001). Serum sclerostin correlated inversely with markers of bone formation and resorption. Sclerostin mRNA in the liver was overexpressed compared with control samples (2.7-fold versus healthy liver). Sclerostin was detected by immunohistochemistry in 7 of the 11 liver samples, mainly located in the bile ducts. Liver sclerostin was associated with the severity of cholangitis (p = 0.02) and indirectly with the degree of lobular inflammation (p = 0.03). Sclerostin mRNA expression was higher in samples that tested positive by immunohistochemistry and particularly in those with lobular granuloma (p = 0.02). The increased expression of sclerostin in the liver and the association with histologic cholangitis may explain the high serum levels of this protein in patients with PBC, thus suggesting that sclerostin may influence the decreased bone formation in this cholestatic disease. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Núria Guañabens
- Department of Rheumatology, Metabolic Bone Diseases Unit, Hospital Clínic, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research Network in Hepatic and Digestive Diseases (CIBERehd), Hospital Clínic, Barcelona, Spain
| | - Silvia Ruiz-Gaspà
- Center for Biomedical Research Network in Hepatic and Digestive Diseases (CIBERehd), Hospital Clínic, Barcelona, Spain
| | - Laia Gifre
- Department of Rheumatology, Metabolic Bone Diseases Unit, Hospital Clínic, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Rosa Miquel
- Pathology Department, Hospital Clínic, Barcelona, Spain
| | - Pilar Peris
- Department of Rheumatology, Metabolic Bone Diseases Unit, Hospital Clínic, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
- Center for Biomedical Research Network in Hepatic and Digestive Diseases (CIBERehd), Hospital Clínic, Barcelona, Spain
| | - Ana Monegal
- Department of Rheumatology, Metabolic Bone Diseases Unit, Hospital Clínic, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Marta Dubrueil
- Center for Biomedical Research Network in Hepatic and Digestive Diseases (CIBERehd), Hospital Clínic, Barcelona, Spain
| | - Ana Arias
- Department of Rheumatology, Metabolic Bone Diseases Unit, Hospital Clínic, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Albert Parés
- Center for Biomedical Research Network in Hepatic and Digestive Diseases (CIBERehd), Hospital Clínic, Barcelona, Spain
- Liver Unit, Hospital Clínic, Barcelona, IDIBAPS, University of Barcelona, Barcelona, Spain
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Guañabens N, Mumm S, Gifre L, Ruiz-Gaspà S, Demertzis JL, Stolina M, Novack DV, Whyte MP. Idiopathic Acquired Osteosclerosis in a Middle-Aged Woman With Systemic Lupus Erythematosus. J Bone Miner Res 2016; 31:1774-82. [PMID: 27005479 PMCID: PMC5010446 DOI: 10.1002/jbmr.2842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 10/19/2015] [Revised: 03/17/2016] [Accepted: 03/20/2016] [Indexed: 02/06/2023]
Abstract
Widely distributed osteosclerosis is an unusual radiographic finding with multiple causes. A 42-year-old premenopausal Spanish woman gradually acquired dense bone diffusely affecting her axial skeleton and focally affecting her proximal long bones. Systemic lupus erythematosus (SLE) diagnosed in adolescence had been well controlled. She had not fractured or received antiresorptive therapy, and she was hepatitis C virus antibody negative. Family members had low bone mass. Lumbar spine bone mineral density (BMD) measured by dual-photon absorptiometry (DPA) at age 17 years, while receiving glucocorticoids, was 79% the average value of age-matched controls. From ages 30 to 37 years, dual-energy X-ray absorptiometry (DXA) BMD Z-scores steadily increased in her lumbar spine from +3.8 to +7.9, and in her femoral neck from -1.4 to -0.7. Serum calcium and phosphorus levels were consistently normal, 25-hydroxyvitamin D (25OHD) <20 ng/mL, and parathyroid hormone (PTH) sometimes slightly increased. Her reduced estimated glomerular filtration rate (eGFR) was 38 to 55 mL/min. Hypocalciuria likely reflected positive mineral balance. During increasing BMD, turnover markers (serum bone-specific alkaline phosphatase [ALP], procollagen type 1 N propeptide [P1NP], osteocalcin [OCN], and carboxy-terminal cross-linking telopeptide of type 1 collagen [CTx], and urinary amino-terminal cross-linking telopeptide of type 1 collagen [NTx and CTx]) were 1.6- to 2.8-fold above the reference limits. Those of bone formation seemed increased more than those of resorption. FGF-23 was slightly elevated, perhaps from kidney disease. Serum osteoprotegerin (OPG) and TGFβ1 levels were normal, but sclerostin (SOST) and receptor activator of nuclear factor kappa-B ligand (RANKL) were elevated. Serum multiplex biomarker profiling confirmed a high level of SOST and RANKL, whereas Dickkopf-1 (DKK-1) seemed low. Matrix metalloproteinases-3 (MMP-3) and -7 (MMP-7) were elevated. Iliac crest biopsy revealed tetracycline labels, no distinction between thick trabeculae and cortical bone, absence of peritrabecular fibrosis, few osteoclasts, and no mastocytosis. Then, for the past 3 years, BMD Z-scores steadily decreased. Skeletal fluorosis, mastocytosis, myelofibrosis, hepatitis C-associated osteosclerosis, multiple myeloma, and aberrant phosphate homeostasis did not explain her osteosclerosis. Mutation analysis of the LRP5, LRP4, SOST, and osteopetrosis genes was negative. Microarray showed no notable copy number variation. Perhaps her osteosclerosis reflected an interval of autoimmune-mediated resistance to SOST and/or RANKL. © 2016 American Society for Bone and Mineral Research.
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Affiliation(s)
- Núria Guañabens
- Metabolic Bone Diseases Unit, Department of Rheumatology, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Steven Mumm
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA.,Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA
| | - Laia Gifre
- Metabolic Bone Diseases Unit, Department of Rheumatology, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Silvia Ruiz-Gaspà
- Metabolic Bone Diseases Unit, Department of Rheumatology, Hospital Clinic, CIBERehd, IDIBAPS, University of Barcelona, Barcelona, Spain
| | - Jennifer L Demertzis
- Musculoskeletal Disease Section, Mallinckrodt Institute of Radiology at Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Marina Stolina
- Department of Metabolic Disorders, Amgen Inc., Thousand Oaks, CA, USA
| | - Deborah V Novack
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA.,Department of Pathology, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA
| | - Michael P Whyte
- Division of Bone and Mineral Diseases, Department of Internal Medicine, Washington University School of Medicine at Barnes-Jewish Hospital, St. Louis, MO, USA.,Center for Metabolic Bone Disease and Molecular Research, Shriners Hospital for Children, St. Louis, MO, USA
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12
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van der Weijden MAC, van Denderen JC, Lems WF, Nurmohamed MT, Dijkmans BAC, van der Horst-Bruinsma IE. Etanercept Increases Bone Mineral Density in Ankylosing Spondylitis, but Does Not Prevent Vertebral Fractures: Results of a Prospective Observational Cohort Study. J Rheumatol 2016; 43:758-64. [PMID: 26879348 DOI: 10.3899/jrheum.150857] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2015] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Ankylosing spondylitis (AS) is characterized by chronic inflammation leading to ankylosis, but also to low bone mineral density (BMD) and vertebral fractures (VFx). Treatment with tumor necrosis factor-α blockers decreases inflammation and has shown to be effective in increasing BMD. We studied the effects of etanercept (ETN) on BMD and VFx in patients with AS after 2 years of treatment. Further, we studied changes in bone turnover markers and radiological damage. METHODS Patients with active AS, treated with ETN for 2 years, were included. BMD lumbar spine and hip were measured at baseline and after 2 years, as well as radiological damage (modified Stoke Ankylosing Spondylitis Spinal Score with the addition of the thoracic spine), VFx (Genant method), and change in bone turnover markers. RESULTS Forty-nine patients with AS were included. After 2 years of ETN, hip BMD increased by 2.2% (p = 0.014) and lumbar spine BMD by 7.0% (p < 0.001). The Bath Ankylosing Spondylitis Disease Activity Index decreased significantly (p < 0.001), as well as C-reactive protein and erythrocyte sedimentation rate (p < 0.001). Despite ETN therapy, the number of patients with VFx more than doubled (from 6 to 15 patients, p = 0.003). Also, the radiological damage increased significantly over time (from 12.1 to 18.5, p < 0.001); however, no significant change in bone turnover markers was found. CONCLUSION This prospective longitudinal observational cohort study showed that after 2 years of ETN, BMD of the hip and spine increased significantly, but the number of patients with VFx and the severity of VFx increased as well. Besides that, radiological progression, including the thoracic spine, increased significantly. Thus, the favorable bone-preserving effect is accompanied by unfavorable outcomes on VFx and radiological damage.
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Affiliation(s)
- Maria A C van der Weijden
- From the Department of Rheumatology, VU University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, the Netherlands.M.A. van der Weijden, MD, MSc, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; J.C. van Denderen, MD, PhD, Department of Rheumatology, Jan van Breemen Research Institute/Reade; W.F. Lems, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; B.A. Dijkmans, MD, Professor, Department of Rheumatology, VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade.
| | - J Christiaan van Denderen
- From the Department of Rheumatology, VU University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, the Netherlands.M.A. van der Weijden, MD, MSc, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; J.C. van Denderen, MD, PhD, Department of Rheumatology, Jan van Breemen Research Institute/Reade; W.F. Lems, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; B.A. Dijkmans, MD, Professor, Department of Rheumatology, VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade
| | - Willem F Lems
- From the Department of Rheumatology, VU University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, the Netherlands.M.A. van der Weijden, MD, MSc, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; J.C. van Denderen, MD, PhD, Department of Rheumatology, Jan van Breemen Research Institute/Reade; W.F. Lems, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; B.A. Dijkmans, MD, Professor, Department of Rheumatology, VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade
| | - Michael T Nurmohamed
- From the Department of Rheumatology, VU University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, the Netherlands.M.A. van der Weijden, MD, MSc, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; J.C. van Denderen, MD, PhD, Department of Rheumatology, Jan van Breemen Research Institute/Reade; W.F. Lems, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; B.A. Dijkmans, MD, Professor, Department of Rheumatology, VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade
| | - Ben A C Dijkmans
- From the Department of Rheumatology, VU University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, the Netherlands.M.A. van der Weijden, MD, MSc, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; J.C. van Denderen, MD, PhD, Department of Rheumatology, Jan van Breemen Research Institute/Reade; W.F. Lems, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; B.A. Dijkmans, MD, Professor, Department of Rheumatology, VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade
| | - Irene E van der Horst-Bruinsma
- From the Department of Rheumatology, VU University Medical Center; Department of Rheumatology, Jan van Breemen Research Institute/Reade, Amsterdam, the Netherlands.M.A. van der Weijden, MD, MSc, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; J.C. van Denderen, MD, PhD, Department of Rheumatology, Jan van Breemen Research Institute/Reade; W.F. Lems, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; M.T. Nurmohamed, MD, Professor, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade; B.A. Dijkmans, MD, Professor, Department of Rheumatology, VU University Medical Center; I.E. van der Horst-Bruinsma, MD, PhD, Department of Rheumatology, VU University Medical Center, and Department of Rheumatology, Jan van Breemen Research Institute/Reade
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Li M, Wang A, Hu L, Song Z, Zhao Y, Sun Y, Yan L, Li X. Effects of estradiol-drospirenone on menopausal symptoms, lipids and bone turnover in Chinese women. Climacteric 2014; 18:214-8. [PMID: 25362969 DOI: 10.3109/13697137.2014.978753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To investigate the effects of a hormone replacement preparation containing 1 mg estradiol plus 2 mg drospirenone on menopausal symptoms, blood lipids, and bone turnover markers in postmenopausal women. METHODS A prospective, self-controlled trial was conducted in 64 Chinese postmenopausal women aged 45-60 (mean 52.5 ± 3.37) years who were treated with estradiol-drospirenone for at least 6 months. The Kupperman index, blood lipid concentrations, bone mineral density, and bone turnover markers were measured before (baseline) and at 1, 3, and 6 months after treatment. RESULTS In comparison with baseline, the Kupperman index score was significantly improved at 1, 3, and 6 months after estradiol-drospirenone treatment (20.57 ± 6.52 vs. 16.37 ± 5.19, 13.34 ± 4.52, and 12.70 ± 4.42, respectively; all p < 0.01). After 6 months of treatment, concentrations of low density lipoprotein cholesterol, triglycerides, and total cholesterol were significantly decreased, high density lipoprotein cholesterol concentrations were significantly increased (all p < 0.05), and bone mineral densities of the lumbar spine and hip were significantly improved (both p < 0.001 compared with baseline). At both 3 and 6 months after treatment, bone alkaline phosphatase concentrations were significantly decreased compared with baseline (61.14 ± 12.38 IU/l and 58.77 ± 11.35 IU/l, respectively, vs. 65.81 ± 14.75 IU/l; p < 0.05), as were tartrate-resistant acid phosphatase concentrations (5.99 ± 2.98 IU/l and 4.90 ± 2.90 IU/l, respectively, vs. 6.15 ± 3.02 IU/l; p < 0.05). CONCLUSION Estradiol-drospirenone effectively alleviates menopausal symptoms and also has beneficial effects on blood lipids and bone metabolism.
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Affiliation(s)
- M Li
- * Obstetrics and Gynecology Department of Navy General Hospital of Chinese PLA , Beijing
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14
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Markula-Patjas KP, Ivaska KK, Pekkinen M, Andersson S, Moilanen E, Viljakainen HT, Mäkitie O. High adiposity and serum leptin accompanied by altered bone turnover markers in severe juvenile idiopathic arthritis. J Rheumatol 2014; 41:2474-81. [PMID: 25320222 DOI: 10.3899/jrheum.131107] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE To evaluate interactions between skeleton and adipose tissue, and association of adipokines and bone turnover markers with disease-related factors in patients with severe juvenile idiopathic arthritis (JIA). METHODS Forty-nine patients (median age 14.8 yrs, median disease duration 10.2 yrs) with refractory polyarticular JIA and 89 sex-matched and age-matched healthy controls participated in the study. Study subjects underwent clinical examination, body composition assessment with dual-energy X-ray absorptiometry, and analyses for leptin, adiponectin, and bone turnover markers. RESULTS Patients with JIA were shorter and more often overweight (p = 0.001) or obese (p < 0.001) than controls. They had significantly higher serum leptin, even when adjusted for fat mass (p < 0.001), than did controls. Adiponectin did not differ between the groups. Concentration of carboxyterminal telopeptide of type I collagen was higher (p = 0.006) in patients. The inverse association between leptin and bone turnover markers disappeared in controls but was strengthened in patients when adjusted for fat mass. Leptin, adiponectin, or bone markers did not associate with variables of disease activity. CONCLUSION Patients with severe JIA had high adiposity accompanied by increased bone resorption. Their serum leptin was higher, even independently of fat mass. Leptin tended to associate inversely with bone turnover markers but did not associate with variables of disease activity.
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Affiliation(s)
- Kati P Markula-Patjas
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki.
| | - Kaisa K Ivaska
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki
| | - Minna Pekkinen
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki
| | - Sture Andersson
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki
| | - Eeva Moilanen
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki
| | - Heli T Viljakainen
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki
| | - Outi Mäkitie
- From the Pediatric Research Center, University of Tampere and Tampere University Hospital, Tampere; Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku, Turku;Folkhälsan Research Center; Children's Hospital, Helsinki University Central Hospital and University of Helsinki, Helsinki; The Immunopharmacology Research Group, University of Tampere School of Medicine, Tampere, Finland.K.P. Markula-Patjas, MD, Pediatric Research Center, University of Tampere and Tampere University Hospital; K.K. Ivaska, PhD, Department of Cell Biology and Anatomy, Institute of Biomedicine, University of Turku; M. Pekkinen, PhD, Folkhälsan Research Center; S. Andersson, MD, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; E. Moilanen, MD, PhD, The Immunopharmacology Research Group, University of Tampere School of Medicine and Tampere University Hospital; H.T. Viljakainen, PhD, Children's Hospital, Helsinki University Central Hospital and University of Helsinki; O. Mäkitie, MD, PhD, Folkhälsan Research Center, and Children's Hospital, Helsinki University Central Hospital and University of Helsinki
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15
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Macdonald HM, Wood AD, Aucott LS, Black AJ, Fraser WD, Mavroeidi A, Reid DM, Secombes KR, Simpson WG, Thies F. Hip bone loss is attenuated with 1000 IU but not 400 IU daily vitamin D3: a 1-year double-blind RCT in postmenopausal women. J Bone Miner Res 2013; 28:2202-13. [PMID: 23585346 DOI: 10.1002/jbmr.1959] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [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: 11/15/2012] [Revised: 03/25/2013] [Accepted: 04/08/2013] [Indexed: 11/08/2022]
Abstract
Few year-long vitamin D supplementation trials exist that match seasonal changes. The aim of this study was to determine whether daily oral vitamin D3 at 400 IU or 1000 IU compared with placebo affects annual bone mineral density (BMD) change in postmenopausal women in a 1-year double-blind placebo controlled trial in Scotland. White women aged 60 to 70 years (n = 305) were randomized to one of two doses of vitamin D or placebo. All participants started simultaneously in January/February 2009, attending visits at bimonthly intervals with 265 (87%) women attending the final visit and an additional visit 1 month after treatment cessation. BMD (Lunar iDXA) and 1,25-dihydroxyvitamin D[1,25(OH)2 D], N-terminal propeptide of type 1 collagen [P1NP], C-terminal telopeptide of type I collagen [CTX], and fibroblast growth factor-23 [FGF23] were measured by immunoassay at the start and end of treatment. Circulating PTH, serum Ca, and total 25-hydroxyvitamin D [25(OH)D] (latter by tandem mass spectrometry) were measured at each visit. Mean BMD loss at the hip was significantly less for the 1000 IU vitamin D group (0.05% ± 1.46%) compared with the 400 IU vitamin D or placebo groups (0.57% ± 1.33% and 0.60% ± 1.67%, respectively) (p < 0.05). Mean (± SD) baseline 25(OH)D was 33.8 ± 14.6 nmol/L; comparative 25(OH)D change for the placebo, 400 IU, and 1000 IU vitamin D groups was -4.1 ± 11.5 nmol/L, +31.6 ± 19.8 nmol/L, and +42.6 ± 18.9 nmol/L, respectively. Treatment did not change markers of bone metabolism, except for a small reduction in PTH and an increase in serum calcium (latter with 1000 IU dose only). The discordance between the incremental increase in 25(OH)D between the 400 IU and 1000 IU vitamin D and effect on BMD suggests that 25(OH)D may not accurately reflect clinical outcome, nor how much vitamin D is being stored.
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Affiliation(s)
- Helen M Macdonald
- School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK
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16
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Szentpetery A, McKenna MJ, Murray BF, Ng CT, Brady JJ, Morrin M, Radovits B, Veale DJ, Fitzgerald O. Periarticular bone gain at proximal interphalangeal joints and changes in bone turnover markers in response to tumor necrosis factor inhibitors in rheumatoid and psoriatic arthritis. J Rheumatol 2013; 40:653-62. [PMID: 23457381 DOI: 10.3899/jrheum.120397] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVE Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) are characterized by periarticular bone erosion; periarticular bone formation is a feature in PsA. The effect of anti-tumor necrosis factor-α (TNF-α) on periarticular bone remodeling is unclear in both diseases. Our aim was to assess the response of bone turnover markers (BTM) and hand bone mineral density (BMD) to anti-TNF over 3 years in RA and PsA. METHODS We measured serum bone-specific alkaline phosphatase (bone ALP), procollagen type-I N-propeptide (PINP), intact osteocalcin, C-terminal cross-linking telopeptides (CTX-I), urinary N-terminal cross-linking telopeptide of type-I collagen (NTX-I), and free deoxypyridinoline crosslinks (fDPD) at baseline, 1, 12, and 36 months. BMD measurements (hands/spine/hip) were obtained at 3 timepoints. RESULTS We recruited 62 patients (RA 35; PsA 27). BTM correlated significantly with hand BMD but not with central BMD. Low hand BMD was associated with RA and increased BTM. Following anti-TNF therapy, hip BMD declined while spine and hand BMD were unchanged. Periarticular BMD at proximal interphalangeal (PIP) joints increased while it decreased at metacarpophalangeal joints. Bone ALP increased steadily and was always higher in PsA. PINP and intact osteocalcin increased to a lesser extent, but resorption markers did not change. CONCLUSION At baseline, hand BMD was inversely associated with BTM. Bone formation rather than resorption markers better showed the bone response to anti-TNF. Despite a lack of effect on central BMD, the modest effect of anti-TNF on PIP BMD may provide evidence that BTM reflect specifically bone remodeling activity at periarticular sites of inflammation in RA and PsA.
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Affiliation(s)
- Agnes Szentpetery
- Department of Rheumatology, the Metabolism Laboratory, St. Vincent's University Hospital, Dublin, Ireland
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