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Holloway-Kew KL, Betson AG, Anderson KB, Sepetavc F, Gaston J, Kotowicz MA, Liao WH, Henneberg M, Pasco JA. Fracture Risk and Use of Angiotensin-Converting Enzyme Inhibitors or Angiotensin II Receptor Blockers. Calcif Tissue Int 2022; 111:396-408. [PMID: 35833952 PMCID: PMC9474347 DOI: 10.1007/s00223-022-01004-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/24/2022] [Indexed: 11/28/2022]
Abstract
Medications used to treat hypertension may affect fracture risk. This study investigated fracture risk for users of angiotensin converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB). Participants (899 men, median age 70.3 yr (59.9-79.1), range 50.0-96.6 yr; 574 women, median age 65.5 yr (58.1-75.4), range 50.1-94.6 yr) were from the Geelong Osteoporosis Study. Medication use was self-reported and incident fractures were ascertained using radiological reports. Bone mineral density (BMD) was measured at the femoral neck. Participants were divided into four groups: (1) non-users without hypertension, (2) non-users with hypertension, (3) ACEI users and (4) ARB users. Dosage was calculated using the defined daily dose (DDD) criteria. Participants were followed from date of visit to first fracture, death or 31 December 2016, whichever occurred first. Cox proportional hazards models were used for analyses. At least one incident fracture was sustained by 156 men and 135 women over a median(IQR) of 11.5(6.2-13.2) and 10.9(6.3-11.6) years of follow-up, respectively. In unadjusted analyses, compared to non-users without hypertension, men in all three other groups had a higher risk of fracture (Hazard Ratio (HR, 95%CI) 1.54, 1.00-2.37; 1.90, 1.18-3.05; 2.15, 1.26-3.66), for non-users with hypertension, ACEI and ARB users, respectively). Following adjustment for age, prior fracture and BMD, these associations became non-significant. A dose effect for ARB use was observed; men using lower doses had a higher risk of fracture than non-users without hypertension, in both unadjusted (2.66, 1.34-5.29) and adjusted (2.03, 1.01-4.08) analyses, but this association was not observed at higher doses. For women, unadjusted analyses showed a higher risk for ACEI users compared to non-users without hypertension (1.74, 1.07-2.83). This was explained after adjustment for age, alcohol consumption, prior fracture and BMD (1.28, 0.74-2.22). No other differences were observed. In men, lower dose (0 < DDD ≤ 1) ARB use was associated with an increased risk of fracture. ACEI or ARB use was not associated with increased risk of incident fracture in women. These findings may be important for antihypertensive treatment decisions in individuals with a high risk of fracture.
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Affiliation(s)
- Kara L Holloway-Kew
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
| | - Amelia G Betson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Kara B Anderson
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Filip Sepetavc
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - James Gaston
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Mark A Kotowicz
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine, The University of Melbourne - Western Health, St Albans, Australia
| | - Wan-Hui Liao
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Internal Medicine, Taipei City Hospital Yangming Branch, Taipei, Taiwan
| | - Maciej Henneberg
- Biological and Comparative Anatomy Research Unit, Adelaide Medical School, University of Adelaide, Adelaide, Australia
- Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland
- Department of Archaeology, Flinders University, Adelaide, Australia
| | - Julie A Pasco
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Health Education and Research Building, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
- Barwon Health, Geelong, Australia
- Department of Medicine, The University of Melbourne - Western Health, St Albans, Australia
- Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
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Fretwurst T, Tritschler I, Rothweiler R, Nahles S, Altmann B, Schilling O, Nelson K. Proteomic profiling of human bone from different anatomical sites - A pilot study. Proteomics Clin Appl 2022; 16:e2100049. [PMID: 35462455 DOI: 10.1002/prca.202100049] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 04/11/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
PURPOSE The study aim is a comparative proteome-based analysis of different autologous bone entities (alveolar bone [AB], iliac cortical [IC] bone, and iliac spongiosa [IS]) used for alveolar onlay grafting. EXPERIMENTAL DESIGN Site-matched bone samples of AB, IC, and IS were harvested during alveolar onlay grafting. Proteins were extracted using a detergent-based (sodium dodecyl sulfate) strategy and trypsinized. Proteome analysis was performed using liquid chromatography-tandem mass spectrometry (LC-MS/MS). MaxQuant was used for peptide-to-spectrum matching, peak detection, and quantitation. Linear models for microarray analysis (LIMMA) were used to detect differentially abundant peptides and proteins. RESULTS A total of 1730 different proteins were identified across the 15 samples at a false discovery rate of 1%. Partial least-squares discriminant analysis approved segregation of AB, IC, and IS protein profiles. LIMMA statistics highlighted 66 proteins that were more abundant in AB then in IC (vs. 92 proteins were enriched in IC over AB). Gene Ontology enrichment analysis revealed a matrisomal versus an immune-related proteome fingerprint in AB versus IC. CONCLUSION AND CLINICAL RELEVANCE This pilot study demonstrates an ECM protein-related proteome fingerprint in AB and an immune-related proteome fingerprint in IS and IC.
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Affiliation(s)
- Tobias Fretwurst
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | | | - René Rothweiler
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Susanne Nahles
- Department of Oral and Maxillofacial Surgery, Berlin Institute of Health, Corporate Member of Freie Universität Berlin, Charité - Universitätsmedizin Berlin, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Brigitte Altmann
- Department of Prosthetic Dentistry, Center for Dental Medicine, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany.,G.E.R.N Center for Tissue Replacement, Regeneration & Neogenesis, Department of Prosthetic Dentistry, Medical Center - University of Freiburg, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Oliver Schilling
- Institute of Surgical Pathology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
| | - Katja Nelson
- Department of Oral- and Craniomaxillofacial Surgery/Translational Implantology, Faculty of Medicine, Medical Center, University of Freiburg, Freiburg, Germany
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Holloway-Kew KL, Betson AG, Anderson KB, Gaston J, Kotowicz MA, Liao WH, Henneberg M, Pasco JA. Association between bone measures and use of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers. Arch Osteoporos 2021; 16:137. [PMID: 34536130 DOI: 10.1007/s11657-021-01004-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 09/13/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Angiotensin-converting enzyme inhibitor use in women was associated with lower femoral neck and lumbar spine bone mineral density as well as trabecular bone score compared to non-users. No differences were identified for men or for those who used ARB medications. PURPOSE Many individuals at high fracture risk use medications such as angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARB) that could affect bone; thus, this study aimed to investigate whether there are any differences in bone mineral density (BMD) and trabecular bone score (TBS) between ACEI users, ARB users, and non-users. METHODS Participants (685 men, 573 women) were from the Geelong Osteoporosis Study. Current medication use was self-reported. BMD at the femoral neck (FNBMD) and lumbar spine (LSBMD) were measured using DXA. TBS was calculated using TBS iNsight software. Linear regression models were used to investigate associations between ACEI or ARB use and bone measures, adjusting for other potential confounders. Due to interaction terms, data were stratified by age. RESULTS There were 88 (12.8%) men and 41 (7.2%) women taking an ACEI medication, and 71 (10.4%) men and 76 (13.3%) women taking an ARB medication. Compared to non-users, ACEI use was associated with lower FNBMD (- 7.2%), LSBMD (- 12.2%), and TBS (- 9.0%) for women aged < 65 years. Lower TBS was also observed for women aged ≥ 65 years (- 17.3%). No differences were identified for ARB use. CONCLUSIONS Women who used an ACEI medication had lower values for FNBMD, LSBMD and TBS compared to non-users. No differences were identified for men or for those who used ARB medications.
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Affiliation(s)
- Kara L Holloway-Kew
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.
| | - Amelia G Betson
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Kara B Anderson
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - James Gaston
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia
| | - Mark A Kotowicz
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.,Barwon Health, Geelong, Australia.,Department of Medicine, The University of Melbourne-Western Health, St Albans, Australia
| | - Wan-Hui Liao
- Department of Medical Education, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Maciej Henneberg
- Biological and Comparative Anatomy Research Unit, Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Institute of Evolutionary Medicine, University of Zurich, Zurich, Switzerland.,Department of Archaeology, Flinders University, Adelaide, Australia
| | - Julie A Pasco
- Epi-Centre for Healthy Ageing (ECHA), School of Medicine, Health Education and Research Building, IMPACT Institute, Deakin University, Level 3 (Barwon Health), PO Box 281, Geelong, VIC, 3220, Australia.,Barwon Health, Geelong, Australia.,Department of Medicine, The University of Melbourne-Western Health, St Albans, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Prahran, Australia
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