1
|
Condurache DG, D’Angelo S, Salih AM, Szabo L, McCracken C, Mahmood A, Curtis EM, Altmann A, Petersen SE, Harvey NC, Raisi-Estabragh Z. Bone health, cardiovascular disease, and imaging outcomes in UK Biobank: a causal analysis. JBMR Plus 2024; 8:ziae058. [PMID: 38784722 PMCID: PMC11114472 DOI: 10.1093/jbmrpl/ziae058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 05/25/2024] Open
Abstract
This study examined the association of estimated heel bone mineral density (eBMD, derived from quantitative ultrasound) with: (1) prevalent and incident cardiovascular diseases (CVDs: ischemic heart disease (IHD), myocardial infarction (MI), heart failure (HF), non-ischemic cardiomyopathy (NICM), arrhythmia), (2) mortality (all-cause, CVD, IHD), and (3) cardiovascular magnetic resonance (CMR) measures of left ventricular and atrial structure and function and aortic distensibility, in the UK Biobank. Clinical outcomes were ascertained using health record linkage over 12.3 yr of prospective follow-up. Two-sample Mendelian randomization (MR) was conducted to assess causal associations between BMD and CMR metrics using genetic instrumental variables identified from published genome-wide association studies. The analysis included 485 257 participants (55% women, mean age 56.5 ± 8.1 yr). Higher heel eBMD was associated with lower odds of all prevalent CVDs considered. The greatest magnitude of effect was seen in association with HF and NICM, where 1-SD increase in eBMD was associated with 15% lower odds of HF and 16% lower odds of NICM. Association between eBMD and incident IHD and MI was non-significant; the strongest relationship was with incident HF (SHR: 0.90 [95% CI, 0.89-0.92]). Higher eBMD was associated with a decreased risk in all-cause, CVD, and IHD mortality, in the fully adjusted model. Higher eBMD was associated with greater aortic distensibility; associations with other CMR metrics were null. Higher heel eBMD is linked to reduced risk of a range of prevalent and incident CVD and mortality outcomes. Although observational analyses suggest associations between higher eBMD and greater aortic compliance, MR analysis did not support a causal relationship between genetically predicted BMD and CMR phenotypes. These findings support the notion that bone-cardiovascular associations reflect shared risk factors/mechanisms rather than direct causal pathways.
Collapse
Affiliation(s)
- Dorina-Gabriela Condurache
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, England, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health National Health Service (NHS) Trust, West Smithfield, London EC1A 7BE, England, United Kingdom
| | - Stefania D’Angelo
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton SO16 6YD, England,United Kingdom
| | - Ahmed M Salih
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, England, United Kingdom
- Department of Population Health Sciences, University of Leicester, Leicester LE1 7RH, England, United Kingdom
- Department of Computer Science, Faculty of Science, University of Zakho, Zakho 42002, Kurdistan Region, Iraq
| | - Liliana Szabo
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, England, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health National Health Service (NHS) Trust, West Smithfield, London EC1A 7BE, England, United Kingdom
- Semmelweis University, Heart and Vascular Centre, Budapest, Hungary
| | - Celeste McCracken
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, National Institute for Health Research Oxford Biomedical Research Centre, University of Oxford, Oxford University Hospitals NHS Foundation Trust, Oxford OX3 9DU, England, United Kingdom
| | - Adil Mahmood
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, England, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health National Health Service (NHS) Trust, West Smithfield, London EC1A 7BE, England, United Kingdom
| | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton SO16 6YD, England,United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, England, United Kingdom
| | - Andre Altmann
- Department of Medical Physics and Biomedical Engineering, Centre for Medical Image Computing (CMIC), University College London, London WC1E 6BT, England, United Kingdom
| | - Steffen E Petersen
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, England, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health National Health Service (NHS) Trust, West Smithfield, London EC1A 7BE, England, United Kingdom
- Health Data Research UK, British Heart Foundation Data Science Centre, London NW1 2BE, England, United Kingdom
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton SO16 6YD, England,United Kingdom
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton SO16 6YD, England, United Kingdom
| | - Zahra Raisi-Estabragh
- NIHR Barts Biomedical Research Centre, William Harvey Research Institute, Centre for Advanced Cardiovascular Imaging, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, England, United Kingdom
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health National Health Service (NHS) Trust, West Smithfield, London EC1A 7BE, England, United Kingdom
| |
Collapse
|
2
|
Tan T, Tang L, Guo X, Li T, Tian Y, Ouyang Z. Associations of residential greenness with bone mineral density and osteoporosis: the modifying effect of genetic susceptibility. Ann Rheum Dis 2024; 83:669-676. [PMID: 38443139 DOI: 10.1136/ard-2023-224941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 01/03/2024] [Indexed: 03/07/2024]
Abstract
OBJECTIVES To investigate the associations of residential greenness with bone mineral density and incident osteoporosis, and further evaluate the potential modifying effect of genetic susceptibility. METHODS We used the Normalised Difference Vegetation Index (NDVI) at various buffer distances, including 300 m (NDVI300m), 500 m (NDVI500m), 1000 m (NDVI1000m) and 1500 m (NDVI1500m), to serve as indicators of greenness. We fitted linear regression, logistic regression and Cox proportional hazard models to assess the associations of residential greenness with estimated bone mineral density (eBMD), prevalent osteoporosis and incident osteoporosis, respectively. With the Polygenic Risk Score (PRS) for osteoporosis, we further assessed the joint effects of genetic risk and greenness on the risk of osteoporosis. We conducted causal mediation analyses to explore potential mediators. RESULTS Each IQR increase in NDVI300m was associated with 0.0007 (95% CI 0.0002 to 0.0013) increase in eBMD, 6% lower risk of prevalent osteoporosis (OR 0.94; 95% CI 0.92 to 0.97) and 5% lower risk of incident osteoporosis (HR 0.95; 95% CI 0.93 to 0.98). The joint effects of greenness and PRS on the risk of osteoporosis displayed a clear dose-response pattern. Compared with individuals exposed to low NDVI levels and high genetic risk, those exposed to high NDVI levels and low genetic risk had a 56% (95% CI 51% to 61%) lower risk of osteoporosis. The primary mediators in the association between greenness and incident osteoporosis were identified as PM2.5 and NO2. CONCLUSIONS Residential greenness was associated with higher bone mineral density and decreased risk of incident osteoporosis.
Collapse
Affiliation(s)
- Tingting Tan
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Immunology, School of Basic Medical Science, Central South University, Changsha, Hunan, China
| | - Linxi Tang
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaoning Guo
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Tao Li
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Osteopathy Laboratory of Surgical,The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yaohua Tian
- Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhengxiao Ouyang
- Department of Orthopedics, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Osteopathy Laboratory of Surgical,The Second Xiangya Hospital, Central South University, Changsha, China
| |
Collapse
|
3
|
Asamoto T, Takegami Y, Sato Y, Takahara S, Yamamoto N, Inagaki N, Maki S, Saito M, Imagama S. External validation of a deep learning model for predicting bone mineral density on chest radiographs. Arch Osteoporos 2024; 19:15. [PMID: 38472499 DOI: 10.1007/s11657-024-01372-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 02/27/2024] [Indexed: 03/14/2024]
Abstract
We developed a new model for predicting bone mineral density on chest radiographs and externally validated it using images captured at facilities other than the development environment. The model performed well and showed potential for clinical use. PURPOSE In this study, we performed external validation (EV) of a developed deep learning model for predicting bone mineral density (BMD) of femoral neck on chest radiographs to verify the usefulness of this model in clinical practice. METHODS This study included patients who visited any of the collaborating facilities from 2010 to 2020 and underwent chest radiography and dual-energy X-ray absorptiometry (DXA) at the femoral neck in the year before and after their visit. A total of 50,114 chest radiographs were obtained, and BMD was measured using DXA. We developed the model with 47,150 images from 17 facilities and performed EV with 2914 images from three other facilities (EV dataset). We trained the deep learning model via ensemble learning based on chest radiographs, age, and sex to predict BMD using regression. The outcomes were the correlation of the predicted BMD and measured BMD with diagnoses of osteoporosis and osteopenia using the T-score estimated from the predicted BMD. RESULTS The mean BMD was 0.64±0.14 g/cm2 in the EV dataset. The BMD predicted by the model averaged 0.61±0.08 g/cm2, with a correlation coefficient of 0.68 (p<0.01) when compared with the BMD measured using DXA. The accuracy, sensitivity, and specificity of the model were 79.0%, 96.6%, and 34.1% for T-score < -1 and 79.7%, 77.1%, and 80.4% for T-score ≤ -2.5, respectively. CONCLUSION Our model, which was externally validated using data obtained at facilities other than the development environment, predicted BMD of femoral neck on chest radiographs. The model performed well and showed potential for clinical use.
Collapse
Affiliation(s)
- Takamune Asamoto
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Yasuhiko Takegami
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan.
| | - Yoichi Sato
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| | - Shunsuke Takahara
- Department of Orthopaedic Surgery, Hyogo Prefectural Kakogawa Medical Center, Kakogawa, Hyogo, Japan
| | - Norio Yamamoto
- Department of Orthopaedic Surgery, Miyamoto Orthopaedic Hospital, Okayama, Japan
| | - Naoya Inagaki
- Department of Orthopaedic Surgery, The Jikei University Kashiwa Hospital, Chiba, Japan
| | - Satoshi Maki
- Department of Orthopaedic Surgery, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Mitsuru Saito
- Department of Orthopaedic Surgery, Jikei University School of Medicine, Tokyo, Japan
| | - Shiro Imagama
- Department of Orthopaedic Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, Aichi, 466-8560, Japan
| |
Collapse
|
4
|
Suiko M, Mizukami S, Arima K, Nakashima H, Nishimura T, Tomita Y, Abe Y, Tanaka N, Honda Y, Kojima M, Okawachi T, Hasegawa M, Sou Y, Tsujimoto R, Kanagae M, Osaki M, Aoyagi K. Association between physical performance and bone mass in community-dwelling postmenopausal Japanese women: The Unzen study. PLoS One 2024; 19:e0296457. [PMID: 38165878 PMCID: PMC10760765 DOI: 10.1371/journal.pone.0296457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 12/13/2023] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Low bone mass is an independent risk factor for osteoporotic fractures. We examined the association between physical performance and bone mass using quantitative ultrasound in community-dwelling postmenopausal Japanese women. METHODS We conducted a cross-sectional study on 524 community-dwelling postmenopausal Japanese women who were not being administered osteoporosis medications. Physical performance was assessed on the basis of grip strength, chair stand time, and functional reach. The stiffness index was measured as a quantitative ultrasound parameter for heel bone mass. RESULTS Physical performance, assessed by grip strength, chair stand time, and functional reach, and the stiffness index significantly decreased with age (both p<0.001). The multiple linear regression analysis showed that grip strength (p = 0.001), chair stand time (p = 0.004), and functional reach (p = 0.048) were significantly associated with the stiffness index after adjusting for age, body mass index, smoking, drinking, and exercise. CONCLUSIONS Physical performance was significantly associated with heel bone mass in community-dwelling postmenopausal Japanese women.
Collapse
Affiliation(s)
- Masahiro Suiko
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Satoshi Mizukami
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kazuhiko Arima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroki Nakashima
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takayuki Nishimura
- Department of Human Science, Faculty of Design, Kyushu University, Fukuoka, Japan
| | - Yoshihito Tomita
- Department of Physical Therapy, School of Rehabilitation, Tokyo Professional University of Health Science, Tokyo, Japan
| | - Yasuyo Abe
- Department of Health and Nutrition Science, Nishikyusyu University, Kanzaki, Japan
| | - Natsumi Tanaka
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Yuzo Honda
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Michiko Kojima
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Maiko Hasegawa
- Medical Policy Division, Nagasaki Prefectural Government, Nagasaki, Japan
| | - Youko Sou
- Ken-Nan Health Care Office, Nagasaki, Japan
| | - Ritsu Tsujimoto
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Mitsuo Kanagae
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Department of Rehabilitation, Nishi-Isahaya Hospital, Isahaya, Japan
| | - Makoto Osaki
- Department of Orthopedic Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kiyoshi Aoyagi
- Department of Public Health, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
- Leading Medical Research Core Unit, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| |
Collapse
|
5
|
Fischer CS, Ittermann T, Hannemann A, Schmidt CO, Mederake M, Schüll D, Histing T, Lange J, Haralambiev L. Are there associations between hip geometry and bone quality? An analysis on 3074 adults from a general population. Arch Orthop Trauma Surg 2024; 144:81-90. [PMID: 37646797 PMCID: PMC10774197 DOI: 10.1007/s00402-023-05031-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Accepted: 08/09/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Patients with reduced bone mineral density and altered hip geometry are susceptible for hip pathologies. Knowledge on associations between bone properties and hip geometric parameters might facilitate identification of patients at risk for hip pathologies. The aim of the present study was to identify associations of bone properties assessed by quantitative ultrasound (QUS) at the heel and hip geometric parameters like center-edge angle (CE), neck-shaft angle (NSA) and alpha angle. MATERIALS AND METHODS Hip geometric parameters (CE, NSA and alpha angle) of 3074 participants from the population-based Study of Health in Pomerania were assessed on magnetic resonance imaging. QUS was performed on both calcanei providing broadband ultrasound attenuation (BUA), speed of sound (SOS) and stiffness-index. Based on the stiffness-index the individual osteoporotic fracture risk (low, moderate or high) was determined. Associations between QUS-based and hip geometric parameters were calculated in linear regression models adjusted for age, sex, body height and weight. Interactions of QUS markers with age and sex on hip geometric parameters were tested. RESULTS Significant inverse associations between BUA (β = - 0.068), SOS (β = - 0.024) as well as stiffness-index (β = - 0.056) and CE were present, while fracture risk was positively associated with CE (β for high = 1.28 and moderate = 2.54 vs. low fracture risk). Interactions between BUA and sex as well as between SOS and age were detected in the models for CE. Furthermore, there was an inverse relation between fracture risk and NSA that was restricted to the moderate risk (β for moderate vs. low fracture risk = - 0.60). There were no significant associations between QUS parameters and alpha angle. CONCLUSIONS In the general population, several associations between QUS-based bone properties or fracture risk and hip geometry are present. Less dysplastic hips had a lower stiffness-index and a higher fracture risk, whereas more valgus hips had a lower fracture risk.
Collapse
Affiliation(s)
- Cornelius Sebastian Fischer
- Department of Traumatology and Reconstructive Surgery, BG Unfallklinik Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstraße 95, 72076, Tübigen, Germany.
| | - Till Ittermann
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | | | - Moritz Mederake
- Department of Traumatology and Reconstructive Surgery, BG Unfallklinik Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstraße 95, 72076, Tübigen, Germany
| | - Daniel Schüll
- Department of Traumatology and Reconstructive Surgery, BG Unfallklinik Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstraße 95, 72076, Tübigen, Germany
| | - Tina Histing
- Department of Traumatology and Reconstructive Surgery, BG Unfallklinik Tübingen, Eberhard Karls University Tübingen, Schnarrenbergstraße 95, 72076, Tübigen, Germany
| | - Jörn Lange
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Lyubomir Haralambiev
- Center for Orthopaedics, Trauma Surgery and Rehabilitation Medicine, University Medicine Greifswald, Greifswald, Germany
- Department of Trauma and Orthopaedic Surgery, BG Klinikum Unfallkrankenhaus Berlin, Berlin, Germany
| |
Collapse
|
6
|
Kim J, Kim BY, Lee JS, Jeong YM, Cho HJ, Park E, Kim D, Kim SS, Kim BT, Choi YJ, Won YY, Jin HS, Chung YS, Jeong SY. UBAP2 plays a role in bone homeostasis through the regulation of osteoblastogenesis and osteoclastogenesis. Nat Commun 2023; 14:3668. [PMID: 37339951 PMCID: PMC10281941 DOI: 10.1038/s41467-023-39448-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/14/2023] [Indexed: 06/22/2023] Open
Abstract
Osteoporosis is a condition characterized by decreased bone mineral density (BMD) and reduced bone strength, leading to an increased risk of fractures. Here, to identify novel risk variants for susceptibility to osteoporosis-related traits, an exome-wide association study is performed with 6,485 exonic single nucleotide polymorphisms (SNPs) in 2,666 women of two Korean study cohorts. The rs2781 SNP in UBAP2 gene is suggestively associated with osteoporosis and BMD with p-values of 6.1 × 10-7 (odds ratio = 1.72) and 1.1 × 10-7 in the case-control and quantitative analyzes, respectively. Knockdown of Ubap2 in mouse cells decreases osteoblastogenesis and increases osteoclastogenesis, and knockdown of ubap2 in zebrafish reveals abnormal bone formation. Ubap2 expression is associated with E-cadherin (Cdh1) and Fra1 (Fosl1) expression in the osteclastogenesis-induced monocytes. UBAP2 mRNA levels are significantly reduced in bone marrow, but increased in peripheral blood, from women with osteoporosis compared to controls. UBAP2 protein level is correlated with the blood plasma level of the representative osteoporosis biomarker osteocalcin. These results suggest that UBAP2 has a critical role in bone homeostasis through the regulation of bone remodeling.
Collapse
Affiliation(s)
- Jeonghyun Kim
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea
| | - Bo-Young Kim
- Division of Intractable Disease, Center for Biomedical Sciences, National Institute of Health, Korea Centers for Disease Control & Prevention, Cheongju, Republic of Korea
| | - Jeong-Soo Lee
- Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
- Microbiome Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
- KRIBB School, University of Science and Technology, Daejeon, Republic of Korea
| | - Yun-Mi Jeong
- Disease Target Structure Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Hyun-Ju Cho
- Microbiome Convergence Research Center, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
| | - Eunkuk Park
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Dowan Kim
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Sung-Soo Kim
- Department of Biomedical Laboratory Science, College of Life and Health Sciences, Hoseo University, Asan, Republic of Korea
| | - Bom-Taeck Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Yong Jun Choi
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Ye-Yeon Won
- Department of Orthopedic Surgery, Ajou University School of Medicine, Suwon, Republic of Korea
| | - Hyun-Seok Jin
- Department of Biomedical Laboratory Science, College of Life and Health Sciences, Hoseo University, Asan, Republic of Korea.
| | - Yoon-Sok Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Republic of Korea.
| | - Seon-Yong Jeong
- Department of Medical Genetics, Ajou University School of Medicine, Suwon, Republic of Korea.
- Department of Biomedical Sciences, Ajou University Graduate School of Medicine, Suwon, Republic of Korea.
| |
Collapse
|
7
|
Métrailler A, Hans D, Lamy O, Gonzalez Rodriguez E, Shevroja E. Heel quantitative ultrasound (QUS) predicts incident fractures independently of trabecular bone score (TBS), bone mineral density (BMD), and FRAX: the OsteoLaus Study. Osteoporos Int 2023:10.1007/s00198-023-06728-4. [PMID: 37154943 PMCID: PMC10382398 DOI: 10.1007/s00198-023-06728-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 03/16/2023] [Indexed: 05/10/2023]
Abstract
This study aimed to better define the role of heel-QUS in fracture prediction. Our results showed that heel-QUS predicts fracture independently of FRAX, BMD, and TBS. This corroborates its use as a case finding/pre-screening tool in osteoporosis management. INTRODUCTION Quantitative ultrasound (QUS) characterizes bone tissue based on the speed of sound (SOS) and broadband ultrasound attenuation (BUA). Heel-QUS predicts osteoporotic fractures independently of clinical risk factors (CRFs) and bone mineral density (BMD). We aimed to investigate whether (1) heel-QUS parameters predict major osteoporotic fractures (MOF) independently of the trabecular bone score (TBS) and (2) the change of heel-QUS parameters over 2.5 years is associated with fracture risk. METHODS One thousand three hundred forty-five postmenopausal women from the OsteoLaus cohort were followed up for 7 years. Heel-QUS (SOS, BUA, and stiffness index (SI)), DXA (BMD and TBS), and MOF were assessed every 2.5 years. Pearson's correlation and multivariable regression analyses were used to determine associations between QUS and DXA parameters and fracture incidence. RESULTS During a mean follow-up of 6.7 years, 200 MOF were recorded. Fractured women were older, more treated with anti-osteoporosis medication; had lower QUS, BMD, and TBS; higher FRAX-CRF risk; and more prevalent fractures. TBS was significantly correlated with SOS (0.409) and SI (0.472). A decrease of one SD in SI, BUA or SOS increased the MOF risk by (OR(95%CI)) 1.43 (1.18-1.75), 1.19 (0.99-1.43), and 1.52 (1.26-1.84), respectively, after adjustment for FRAX-CRF, treatment, BMD, and TBS. We found no association between the change of QUS parameters in 2.5 years and incident MOF. CONCLUSION Heel-QUS predicts fracture independently of FRAX, BMD, and TBS. Thus, QUS represents an important case finding/pre-screening tool in osteoporosis management. The change in QUS over time was not associated with future fractures, making it inappropriate for patient monitoring.
Collapse
Affiliation(s)
- Antoine Métrailler
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Didier Hans
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Olivier Lamy
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Elena Gonzalez Rodriguez
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland
| | - Enisa Shevroja
- Interdisciplinary Center for Bone Diseases, Lausanne University Hospital and Lausanne University, Avenue Pierre Decker 4, 1011, Lausanne, Switzerland.
| |
Collapse
|
8
|
Fernández-Pérez JJ, Mascaraque-Ruiz P, Martín-Gómez C, Martínez-Caballero I, Otón T, Carmona L, Lerma-Lara S. Musculoskeletal and Gait Characteristics in Patients with Stickler Syndrome: A Cross-Sectional Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9121895. [PMID: 36553338 PMCID: PMC9777477 DOI: 10.3390/children9121895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 11/24/2022] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
BACKGROUND Stickler syndrome (SS) is a connective tissue disorder of fibrillary collagen with very variable clinical manifestations, including premature osteoarthritis and osteopenia. This musculoskeletal alteration may affect gait maturity or produce strength difficulties. OBJECTIVE Our aim was to describe the musculoskeletal characteristics, bone stiffness, gait kinematics, and kinetics of SS patients. METHODS This is a cross-sectional study of children and youngsters with SS recruited by telephone calls through the Spanish SS Association. All participants underwent an analysis of musculoskeletal characteristics, including a 3D gait analysis. RESULTS The sample included 26 SS patients, mainly boys (65.4%) with a median age of 11 (IQR 5-14). The manual muscle testing was normal in 88.5% of patients. The median distance covered in the 6-min walking test was 560.1 ± 113.4 m. Bone stiffness index scores were 70.9 ± 19.7 for children under 10 years and 88.3 ± 17.5 for children older than 10 years. The gait indicators GPS and GDI were: 7.4 ± 1.9 and 95.3 ± 9.7, respectively, for the left side and 6.8 ± 2.0 and 97.7 ± 9.5 for the right side, respectively. CONCLUSIONS In our series of patients with SS, we found muscle-articular involvement does not have a high impact on strength or gait problems. More work is needed to understand the effect of SS on the musculoskeletal system.
Collapse
Affiliation(s)
- Juan José Fernández-Pérez
- Toledo Physiotherapy Research Group (GIFTO), Faculty of Physiotherapy and Nursing, Castilla la Mancha University, 45004 Toledo, Spain
| | | | - Carlos Martín-Gómez
- Facultad de Ciencias de la Salud, CSEU La Salle, UAM, 28023 Madrid, Spain
- Fundación Hospital Universitario Niño Jesús, 28009 Madrid, Spain
| | | | - Teresa Otón
- Instituto de Salud Musculoesquelética, 28045 Madrid, Spain
| | - Loreto Carmona
- Instituto de Salud Musculoesquelética, 28045 Madrid, Spain
| | - Sergio Lerma-Lara
- Facultad de Ciencias de la Salud, CSEU La Salle, UAM, 28023 Madrid, Spain
- Correspondence:
| |
Collapse
|
9
|
Najafi M, Najafi M, Keshtkar AA, Sedaghat M, Khalilifard AR, Larijani B, Hamidi Z. QUS characteristics in Normal Population: a Mini Review and our experience. J Diabetes Metab Disord 2022; 21:1635-1640. [PMID: 36404808 PMCID: PMC9672166 DOI: 10.1007/s40200-022-01113-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Revised: 06/08/2022] [Accepted: 08/13/2022] [Indexed: 11/29/2022]
Abstract
Objectives Quantitative ultrasound (QUS) is a bone densitometry method that is less expensive and more portable than DXA. It is also noninvasive. QUS parameters include speed of sound (SOS), broad band ultrasound attenuation (BUA), and stiffness index (SI). This study defined normal values of QUS parameters in Iranian men and women. Methods QUS of heels measured in 258 Iranian men and women, aged 20-76 y/o. They were participants of Iranian Multicenter Osteoporosis study (IMOS), selected by randomized sampling. QUS device was an Achilles+ (GE-Lunar) device. Results Percentiles of SI (2.5%, 50%, and 97.5%) determined. We found a good agreement between the Iranian reference values and western reference (used by device) value in defining normal and osteoporotic people (κ = 0.875). Conclusion Results from this study suggest that QUS of the heel may be a good method for diagnosis of low bone mass in different regions.
Collapse
Affiliation(s)
- Maryam Najafi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Minoo Najafi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Abbas Ali Keshtkar
- Department of Health Sciences Education Development, School of Public Health, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mojtaba Sedaghat
- Department of Community Medicine, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Ali Reza Khalilifard
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Bagher Larijani
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Zohreh Hamidi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| |
Collapse
|
10
|
Mizukami S, Arima K, Abe Y, Tomita Y, Nakashima H, Honda Y, Uchiyama M, Ookawachi T, Goto H, Hasegawa M, Sou Y, Kanagae M, Osaki M, Aoyagi K. Association between fat mass by bioelectrical impedance analysis and bone mass by quantitative ultrasound in relation to grip strength and serum 25-hydroxyvitamin D in postmenopausal Japanese women: the Unzen study. J Physiol Anthropol 2022; 41:7. [PMID: 35264253 PMCID: PMC8908611 DOI: 10.1186/s40101-022-00281-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 03/01/2022] [Indexed: 11/21/2022] Open
Abstract
Background Whether fat mass or lean mass affects bone mass in postmenopausal women is controversial. This study aimed to explore the association between body composition measured by bioelectrical impedance analysis (BIA) and bone mass measured by quantitative ultrasound (QUS) in postmenopausal women in Japan. Methods We conducted a cross-sectional study, The Unzen Study, on 382 community-dwelling postmenopausal Japanese women (mean (standard deviation) age: 68.2 (7.2) years) who participated in periodic health examinations. The stiffness index (SI) was measured using QUS, and body composition (e.g., fat mass and muscle mass) was measured using BIA. Grip strength was measured. Fasting blood samples were collected, and 25-hydroxyvitamin D (25(OH)D), tartrate-resistant acid phosphatase-5b (TRACP-5b), and parathyroid hormone (PTH) levels were measured. Data on current smoking, alcohol consumption, exercise, and any comorbidities (heart disease, lung disease, stroke, or diabetes mellitus) were collected. Results The SI increased with increasing quartiles of fat mass and muscle mass (both p for trend < 0.001), respectively. There were positive correlations between SI and log (25(OH)D) or grip strength. Fat mass significantly correlated with grip strength. Multiple linear regression analysis showed that higher fat mass was independently and significantly associated with higher SI after adjusting for age, height, comorbidity, current smoking, alcohol consumption, exercise, log (25(OH)D), log (TRACP-5b), log (PTH), and grip strength (p = 0.001). In contrast, no association was observed between muscle mass and SI. Conclusions Fat mass, but not muscle mass, was a significant determinant of SI in community-dwelling postmenopausal Japanese women.
Collapse
|
11
|
Chen H, Ye R, Guo X. Lack of causal association between heart failure and osteoporosis: a Mendelian randomization study. BMC Med Genomics 2022; 15:232. [PMID: 36333784 PMCID: PMC9636651 DOI: 10.1186/s12920-022-01385-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Accepted: 10/26/2022] [Indexed: 11/06/2022] Open
Abstract
Objectives Heart failure (HF) has been implicated in osteoporosis. However, causality remains unestablished. Here, we sought to assess causal associations of genetic liability to HF with osteoporosis using Mendelian randomization (MR) analyses. Methods Independent single nucleotide polymorphisms associated with HF at genome-wide significance were derived from a large genome-wide association study (GWAS) (including up to 977,323 individuals). We obtained summary statistics for forearm (FA) bone mineral density (BMD) (n = 8,143), femoral neck (FN) BMD (n = 32,735), lumbar spine (LS) BMD (n = 28,498), heel (HE) BMD (n = 426,824), and fracture (n = 1,214,434) from other GWAS meta-analyses. Inverse variance weighted (IVW) and several supplementary methods were performed to calculate the MR estimates. Results Genetically determined HF has no causal effect on FA-BMD (odds ratio (OR) 1.17; 95% confidence interval (CI) 0.82, 1.66; P = 0.389), FN-BMD (OR 1.01; 95% CI 0.85, 1.19; P = 0.936), LS-BMD (OR 0.96; 95% CI 0.80, 1.17; P = 0.705), HE-BMD (OR 1.01; 95% CI 0.90, 1.13; P = 0.884), and fracture risk (OR 1.00; 95% CI 0.92, 1.10; P = 0.927). Complementary analyses returned broadly consistent results. Conclusion This MR study provides genetic evidence that HF may not lead to an increased risk of reduced BMDs or fracture. Supplementary Information The online version contains supplementary material available at 10.1186/s12920-022-01385-8.
Collapse
|
12
|
Roberts JA, Shen Y, Strehlau R, Patel F, Kuhn L, Coovadia A, Kaufman JJ, Shiau S, Arpadi SM, Yin MT. Comparison of quantitative ultrasonography and dual X-ray absorptiometry for bone status assessment in South African children living with HIV. PLoS One 2022; 17:e0276290. [PMID: 36251674 PMCID: PMC9576091 DOI: 10.1371/journal.pone.0276290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 09/29/2022] [Indexed: 11/07/2022] Open
Abstract
Children living with HIV (CLHIV) have decreased bone mineral content (BMC) and density (BMD), increasing risk for fracture and future osteoporosis. While DXA is the gold-standard for bone assessments, it lacks availability in resource-constrained settings (RCS). Quantitative ultrasound (QUS) offers an alternative owing to its portability, low cost, ease of handling, and lack of ionizing radiation. While QUS has detected reduced bone quality in CLHIV, the relationship between QUS and DXA in this population remains unexplored. At baseline and 12 months, BMC and BMD of the whole body, lumbar spine, and radius were measured by DXA in a longitudinal cohort of CLHIV in Johannesburg, South Africa. Calcaneal speed of sound (SOS) and broadband ultrasound attenuation (BUA) and radius SOS were obtained by QUS, and calcaneal stiffness index (SI) was calculated. Spearman correlations, with and without HIV stratification, were performed between QUS and DXA measurements at each visit and for absolute difference in measurements between visits. At baseline and 12-months, calcaneal BUA and SI displayed strong positive correlations with DXA, with only modest correlations between radial QUS and DXA at baseline. Longitudinal measures of QUS did not correlate with DXA. At both baseline and 12-months, individuals with DXA whole-body BMD z-score < -1 displayed significantly lower calcaneal BUA and SI. Cross-sectionally, calcaneal QUS correlates strongly with whole body DXA and may represent a viable diagnostic alternative in RCS. Longitudinally, the two methods do not correlate well, possibly reflecting that each method assesses distinct aspects of bone architecture.
Collapse
Affiliation(s)
- Jackson A. Roberts
- Columbia University Vagelos College of Physicians and Surgeons, New York, New York, United States of America
| | - Yanhan Shen
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Renate Strehlau
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Faeezah Patel
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Louise Kuhn
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
| | - Ashraf Coovadia
- Empilweni Services and Research Unit, Rahima Moosa Mother and Child Hospital, Department of Paediatrics and Child Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Jonathan J. Kaufman
- Cyberlogic, Inc., New York, New York, United States of America
- Department of Orthopedics, The Mount Sinai Medical Center, New York, New York, United States of America
| | - Stephanie Shiau
- Department of Biostatistics and Epidemiology, Rutgers School of Public Health, Rutgers University, Piscataway, New Jersey, United States of America
| | - Stephen M. Arpadi
- Gertrude H. Sergievsky Center, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, United States of America
- Department of Pediatrics, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| | - Michael T. Yin
- Division of Infectious Disease, Department of Medicine, Vagelos College of Physicians & Surgeons, Columbia University Irving Medical Center, New York, New York, United States of America
| |
Collapse
|
13
|
Torró-Ferrero G, Fernández-Rego FJ, Agüera-Arenas JJ, Gomez-Conesa A. Effect of physiotherapy on the promotion of bone mineralization in preterm infants: a randomized controlled trial. Sci Rep 2022; 12:11680. [PMID: 35804078 PMCID: PMC9270394 DOI: 10.1038/s41598-022-15810-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 06/29/2022] [Indexed: 11/21/2022] Open
Abstract
Preterm infants have a low level of bone mineralization compared to those born at term. The purpose of the present study was to investigate the effect of reflex locomotion therapy (RLT) on bone mineralization and growth in preterm infants and compare its effect to other physiotherapy procedures. Forty-six preterm infants born at 29–34 weeks were randomized into three groups: one group received RLT (n = 17); the other group received passive movements with gentle joint compression (n = 14); and the control group received massages (n = 15). All the treatments were performed at the neonatal unit for one month. The main outcome measure was bone mineralization, which was measured using the tibial speed of sound (Tibial-SOS). All the groups were similar in terms of gestational age (31.8 ± 1.18), birth weight (1,583.41 ± 311.9), and Tibia-SOS (1,604.7 ± 27.9) at the beginning of the intervention. At the end of the study, significant differences were found among the groups in the Tibial-SOS [F(4,86) = 2.77, p = 0.049, ηp2 = 0.114] in terms of the benefit to the RLT group. In conclusion, RLT has been effective at improving Tibial-SOS levels and has been more effective than other physical therapy modalities; therefore, it could be considered an effective physiotherapeutic modality for the prevention and treatment of osteopenia from prematurity.
Collapse
Affiliation(s)
- Galaad Torró-Ferrero
- International School of Doctorate of the University of Murcia (EIDUM), University of Murcia, Murcia, Spain.
| | | | - Juan José Agüera-Arenas
- Neonatal Intensive Care Unit, Clinic Hospital University Virgen de La Arrixaca, Murcia, Spain
| | - Antonia Gomez-Conesa
- Research Group Research Methods and Evaluation in Social Sciences, Mare Nostrum Campus of International Excellence, University of Murcia, Murcia, Spain
| |
Collapse
|
14
|
Kurban S, Selver Eklioglu B, Selver MB. Investigation of the relationship between serum sclerostin and dickkopf-1 protein levels with bone turnover in children and adolescents with type-1 diabetes mellitus. J Pediatr Endocrinol Metab 2022; 35:673-679. [PMID: 35411762 DOI: 10.1515/jpem-2022-0001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Accepted: 03/15/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Diabetes mellitus (DM) is widely known to have a detrimental effect on bone health and is associated with increased fracture risk. Recently, the Wnt/beta-catenin signaling pathway and its inhibitors sclerostin and dickkopf-1 (Dkk-1) were found to be involved in the control of bone mass. The present study aimed to measure serum sclerostin and Dkk-1 protein levels in children and adolescents with type-1 DM and compare with other bone turnover markers and bone mineral density (BMD). METHODS This study was performed on 40 children and adolescents with type-I DM and 40 healthy children and adolescents. Anthropometric measurements and pubertal examination were done. In addition to laboratory analysis, dickkopf-1, sclerostin, cross-linked N-telopeptides of type I collagen (NTx), bone alkaline phosphatase (bALP), and osteocalcin levels were studied. BMD of the participants was measured by calcaneus ultrasonography. RESULTS Dickkopf-1 levels of the children and adolescents with type-1 DM were significantly higher, vitamin D, NTx, osteocalcin, and phosphorus levels were significantly lower than those of the controls (p<0.001). Fasting blood glucose, HbA1c, and insulin were significantly higher in the type 1 DM group (p<0.01). CONCLUSIONS Both bone remodeling and its compensatory mechanism bone loss are lower in children and adolescents with type-1 DM than in the controls. Also, higher levels of Dkk-1 play a role in decreased bone turnover in these patients. Since Dkk-1 and sclerostin seem to take a role in treating metabolic bone diseases in the future, we believe that our findings are significant in this respective.
Collapse
Affiliation(s)
- Sevil Kurban
- Department of Biochemistry, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Beray Selver Eklioglu
- Division of Pediatric Endocrinology, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
| | - Muhammed Burak Selver
- Department of Pediatrics, Necmettin Erbakan University Faculty of Medicine, Konya, Turkey
- Istanbul University, Institute of Health Sciences and Institute of Child Health Social Pediatrics PhD Program, Istanbul, Turkey
| |
Collapse
|
15
|
Desbiens LC, Sidibé A, Ung RV, Mac-Way F. FGF23-Klotho Axis and Fractures in Patients Without and With Early CKD: A Case-Cohort Analysis of CARTaGENE. J Clin Endocrinol Metab 2022; 107:e2502-e2512. [PMID: 35139204 PMCID: PMC9113817 DOI: 10.1210/clinem/dgac071] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Whether fibroblast growth factor-23 (FGF23) and α-Klotho are associated with fractures, especially in chronic kidney disease (CKD), remains controversial. OBJECTIVE We evaluated how FGF23, α-Klotho, and traditional mineral parameters predict fractures in individuals with and without early CKD. METHODS We conducted a stratified case-cohort analysis using CARTaGENE, a population-based survey from Quebec, Canada. Individuals aged 40 to 69 years were selected according to outcome and CKD status (non-CKD: eGFR > 60 mL/min/1.73 m2; CKD stage 3: eGFR 30-60 mL/min/1.73 m2]). Baseline levels of c-terminal FGF23 (cFGF23), α-Klotho, parathyroid hormone (PTH), phosphate, and calcium were analyzed for associations with osteoporotic fracture incidence from recruitment (2009-2010) through March 2016. Adjusted Cox models were used, and predictors were treated linearly or flexibly using splines. RESULTS A total of 312 patients (159 non-CKD; 153 CKD) were included; 98 had ≥ 1 fracture at any site during a median follow up of 70 months. Compared with non-CKD, CKD patients had increased levels of cFGF23 but similar levels of α-Klotho. cFGF23 was linearly associated with increased fracture incidence (adjusted HR = 1.81 [1.71, 1.93] per doubling for all participants). The association of α-Klotho with fracture followed a U-curve (overall P = 0.019) but was attenuated by adjustment for potential mediators (bone mineral density, phosphate, PTH). PTH and phosphate also had U-shaped associations with fracture. Associations were mostly similar between non-CKD and CKD. Adjustment for cFGF23 strongly attenuated the association between CKD status and fractures. CONCLUSION cFGF23 is associated linearly with fracture incidence while α-Klotho, PTH, and phosphate levels have a U-shaped association.
Collapse
Affiliation(s)
- Louis-Charles Desbiens
- CHU de Québec Research Center, L’Hôtel-Dieu-de-Québec Hospital, Endocrinology and Nephrology Axis, Quebec City, QC G1R 2J6, Canada
- Department and Faculty of Medicine, Université Laval, Quebec City, QC G1V 5C3, Canada
| | - Aboubacar Sidibé
- CHU de Québec Research Center, L’Hôtel-Dieu-de-Québec Hospital, Endocrinology and Nephrology Axis, Quebec City, QC G1R 2J6, Canada
- Department of Social and Preventive Medicine, Faculty of Medicine, Université Laval, Quebec City, QC G1V 5C3, Canada
| | - Roth-Visal Ung
- CHU de Québec Research Center, L’Hôtel-Dieu-de-Québec Hospital, Endocrinology and Nephrology Axis, Quebec City, QC G1R 2J6, Canada
| | - Fabrice Mac-Way
- CHU de Québec Research Center, L’Hôtel-Dieu-de-Québec Hospital, Endocrinology and Nephrology Axis, Quebec City, QC G1R 2J6, Canada
- Department and Faculty of Medicine, Université Laval, Quebec City, QC G1V 5C3, Canada
| |
Collapse
|
16
|
Kasher M, Freidin MB, Williams FM, Cherny SS, Malkin I, Livshits G. Shared Genetic Architecture Between Rheumatoid Arthritis and Varying Osteoporotic Phenotypes. J Bone Miner Res 2022; 37:440-453. [PMID: 34910834 DOI: 10.1002/jbmr.4491] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/19/2021] [Accepted: 12/08/2021] [Indexed: 11/08/2022]
Abstract
Rheumatoid arthritis (RA) and low bone mineral density (BMD), an indicator of osteoporosis (OP), appear epidemiologically associated. Shared genetic factors may explain this association. This study aimed to investigate the presence of pleiotropy to clarify the potential genetic association between RA and OP. We examined BMDs at varying skeletal sites reported in UK Biobank as well as OP fracture acquired from the Genetic Factors for Osteoporosis (GEFOS) Consortium and the TwinsUK study. PRSice-2 was used to assess the potential shared genetic overlap between RA and OP. The presence of pleiotropy was examined using colocalization analysis. PRSice-2 revealed that RA was significantly associated with OP fracture (β = 351.6 ± 83.9, p value = 2.76E-05), total BMD (β = -1763.5 ± 612.8, p = 4.00E-03), spine BMD (β = -919.8 ± 264.6, p value = 5.09E-04), and forearm BMD (β = -66.09 ± 31.40, p value = 3.53E-02). Through colocalization analysis, the same causal genetic variants, associated with both RA and OP, were apparent in 12 genes: PLCL1, BOLL, AC011997.1, TNFAIP3, RP11-158I9.1, CDK6, CHCHD4P2, RP11-505C13.1, PHF19, TRAF1, C5, and C11orf49 with moderate posterior probabilities (>50%). Pleiotropy is involved in the association between RA and OP phenotypes. These findings contribute to the understanding of disease mechanisms and provide insight into possible therapeutic advancements and enhanced screening measures. © 2021 American Society for Bone and Mineral Research (ASBMR).
Collapse
Affiliation(s)
- Melody Kasher
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Maxim B Freidin
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Frances Mk Williams
- Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK
| | - Stacey S Cherny
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Epidemiology and Preventive Medicine, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ida Malkin
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gregory Livshits
- Human Population Biology Research Unit, Department of Anatomy and Anthropology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Twin Research and Genetic Epidemiology, School of Life Course Sciences, King's College London, London, UK.,Adelson Medical School, Ariel University, Ariel, Israel
| |
Collapse
|
17
|
Bone Quality in Patients with Parkinson's Disease Determined by Quantitative Ultrasound (QUS) of the Calcaneus: Influence of Sex Differences. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052804. [PMID: 35270499 PMCID: PMC8910506 DOI: 10.3390/ijerph19052804] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 02/23/2022] [Accepted: 02/24/2022] [Indexed: 02/04/2023]
Abstract
(1) Background: Parkinson’s disease (PD) is a relatively common neurodegenerative disease in elderly individuals, with a high risk of falls. There is abundant literature on the relationship between PD and osteoporosis. The aim of this study is to describe the bone quality of a population with PD by calcaneal ultrasound and to compare it with a healthy control, assessing the influence of possible sex differences. (2) Methods: 21 patients diagnosed with PD were recruited. The control group was composed of 30 healthy individuals with similar sociodemographic characteristics. The bone quality of all participants was assessed using calcaneal quantitative ultrasound (QUS). The parameters recorded were broadband ultrasound attenuation (BUA, in decibels per megahertz), imaging speed of sound (SOS, in meters per second), stiffness index (SI) and T-score of each participant. Bone mineral density (BMD) was estimated using the equation BMD = 0.002592 × (BUA + SOS) − 3.687 (g/cm2). (3) Results: significant differences were observed between the healthy control and the PD group: the T-score was lower in the PD group (p < 0.05) and SOS was higher in Parkinson’s disease patients (p < 0.05), while 28.6% of the PD patients were osteoporotic with T-score values lower than −1.5 compared to 16.7% of osteoporotic individuals in the control group (p < 0.01). Regarding the sex, there were significant differences (p < 0.05) between the females of the PD group vs. control group, showing a significant difference in the SI (71.4 ± 14.7 vs. 87.8 ± 12), T-score (−2.19 ± 1.1 vs. −0.15 ± 0.8), BUA (104.5 ± 13 vs. 116 ± 10.6) and BMD (0.49 ± 0.09 vs. 0.60 ± 0.08), with no difference in the comparison between the male groups; and the comparison between both sexes in T-score only showed significant differences for the PD group (p < 0.05), with worse bone quality in women. (4) Conclusions: this study shows poorer bone quality in female patients with PD, who have a higher percentage of osteoporosis than healthy patients. The QUS technique of the calcaneus seems adequate for these determinations in patients with Parkinson’s disease.
Collapse
|
18
|
Shiba T, Sawaya Y, Hirose T, Sato R, Ishizaka M, Kubo A, Urano T. Features of older community-dwelling adults with osteosarcopenia requiring support or care. J Phys Ther Sci 2022; 34:341-346. [PMID: 35527844 PMCID: PMC9057679 DOI: 10.1589/jpts.34.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 02/01/2022] [Indexed: 11/30/2022] Open
Abstract
[Purpose] This study aimed to investigate the problems associated with osteosarcopenia
and its effect on physical performance, nutritional status, and support or care required
by older community-dwelling adults. [Participants and Methods] This study investigated 141
older community-dwelling adults requiring support or care using an ambulatory
rehabilitation service. The patients were divided into a control, osteopenia only,
sarcopenia only, and osteosarcopenia group. We investigated the associations of each
condition with the baseline information, grip strength, gait speed, Mini Nutritional
Assessment-Short Form score, and support or care level required. [Results] The
osteosarcopenia group consisted of 43.3% of the total study participants. Osteosarcopenia
was more closely associated with body mass index, support or care level, grip strength,
gait speed, skeletal muscle mass index, and Mini Nutritional Assessment-Short Form score
than osteopenia or sarcopenia alone. [Conclusion] Osteosarcopenia is highly prevalent in
older community-dwelling adults requiring support or care, which may suggest a greater
effect on physical performance, nutritional status, and support or care required than that
exerted by osteopenia or sarcopenia alone.
Collapse
Affiliation(s)
- Takahiro Shiba
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Yohei Sawaya
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tamaki Hirose
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Ryo Sato
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| | - Masahiro Ishizaka
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Akira Kubo
- Department of Physical Therapy, School of Health Sciences, International University of Health and Welfare, Japan
| | - Tomohiko Urano
- Nishinasuno General Home Care Center, Department of Day Rehabilitation, Care Facility for the Elderly “Maronie-en”: 533-4 Iguchi, Nasushiobara-shi, Tochigi 329-2763, Japan
| |
Collapse
|
19
|
Pulse-Echo Measurements of Bone Tissues. Techniques and Clinical Results at the Spine and Femur. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2022; 1364:145-162. [DOI: 10.1007/978-3-030-91979-5_7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
|
20
|
Tian X, Fu J, Tian J, Yang Y, Liang W, Fan W, Zhao R. The Efficacy of Brief School-Based Exercise Programs in Improving Pubertal Bone Mass and Physical Fitness: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9648. [PMID: 34574572 PMCID: PMC8472274 DOI: 10.3390/ijerph18189648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 09/09/2021] [Accepted: 09/10/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE To examine the effects of three types of school-based exercises on bone health and physical fitness function in Chinese boys and girls. METHODS One hundred and seventy-four Chinese boys and girls were randomly assigned into four groups: (1) sham exercise (ShEx); (2) high-impact exercise (HiEx); (3) high-impact exercise with various directions (HiExVi); and (4) high-intensity interval exercise (HiInEx). Speed of sound (SOS) and physical fitness parameters were determined before and after six-month intervention. RESULTS At the end of six-month intervention, participants in all groups show an increment of SOS compared with the baseline (p < 0.05), and the changes were higher in HiEx (mean: 38.878 m/s, 95% CI: 32.885~44.872, p = 0.001) and HiExVi groups (49.317 m/s, 42.737~55.897, p < 0.001) compared with ShEx group (20.049 m/s, 13.751~26.346). Six-month exercise training generated a reduction of percent of body fat (PBF) and waist-hip ratio (WHR) (p < 0.05). The decrease of PBF was greater in HiExVi (-1.222%, -1.820~-0.624, p = 0.012) and HiInEx groups (-1.395%, -1.809~-0.982, p = 0.003), whereas the reduction of WHR was larger in HiEx (-0.026, -0.039~-0.014, p = 0.009), HiExVi (-0.024, -0.036~-0.012, p = 0.021), and HiInEx groups (-0.035, -0.046~-0.024, p < 0.001) compared with ShEx group. Balance function (BLF), vital capacity (VC), standing long jump (SLJ), and sit up (SU) increased in all intervention groups (p < 0.05). The BLF increased in HiEx (6.332 s, 4.136~8.528, p = 0.001), HiExVi (10.489 s, 8.934~12.045, p < 0.001), and HiInEx groups (9.103 s, 7.430~10.776, p < 0.001) showed a greater change than that of ShEx group (1.727 s, 0.684~2.770). The increment of VC (273.049 mL, 199.510~346.587, p < 0.001) and SU (2.537 times/min, 0.639~4.435, p = 0.017) was higher in HiInEx group, whereas the accrual in SLJ was larger in HiExVi (7.488 cm, 4.936~10.040, p = 0.007) compared with ShEx group (58.902 mL, 7.990~109.814; -0.463 times/min, -2.003~1.077; 1.488 cm, -0.654~3.630). CONCLUSION The brief school-based exercises were effective in improving schoolchildren's health, but they showed different effects, with HiEx mostly improving bone health, HiInEx largely benefiting physical fitness function, and HiExVi enhancing both bone and physical fitness.
Collapse
Affiliation(s)
| | - Jian Fu
- College of Physical Education, Yangzhou University, Yangzhou 225002, China; (X.T.); (J.T.); (Y.Y.); (W.L.); (W.F.)
| | | | | | | | | | - Renqing Zhao
- College of Physical Education, Yangzhou University, Yangzhou 225002, China; (X.T.); (J.T.); (Y.Y.); (W.L.); (W.F.)
| |
Collapse
|
21
|
Development of Metabolic Syndrome Decreases Bone Mineral Density T-Score of Calcaneus in Foot in a Large Taiwanese Population Follow-Up Study. J Pers Med 2021; 11:jpm11050439. [PMID: 34065445 PMCID: PMC8160603 DOI: 10.3390/jpm11050439] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 12/16/2022] Open
Abstract
Studies have suggested that there may be common pathogenic pathways linking osteoporosis and metabolic syndrome (MetS) due to the multiple risk factors for atherosclerotic cardiovascular disease caused by MetS. However, results on the association between MetS and bone health are inconsistent and sometimes contradictory. In this study, we aimed to investigate the associations between the effects of MetS risk factors and bone mineral density (BMD) T-score in a longitudinal study of 27,033 participants from the Taiwan Biobank with a follow-up period of 4 years. BMD of the calcaneus was measured in the non-dominant foot using ultrasound in the Taiwanese population. The overall prevalence rates of MetS were 16.7% (baseline) and 21.2% (follow-up). The participants were stratified into four groups according to the status of MetS (no/yes at baseline and follow-up). We investigated associations between MetS and its five components (baseline, follow-up) with BMD ΔT-score and found that the (no, yes) MetS group, (no, yes) abdominal obesity group, (no, yes) hypertriglyceridemia group, and (no, yes) low high-density lipoprotein (HDL) cholesterol group had the lowest ΔT-score. Furthermore, in the (no, yes) MetS group, high Δwaist circumference (p = 0.009), high Δtriglycerides (p = 0.004), low ΔHDL cholesterol (p = 0.034), and low Δsystolic blood pressure (p = 0.020) were significantly associated with low ΔT-score, but Δfasting glucose was not. In conclusion, in this large population-based cohort study, our data provide evidence that the development of MetS is strongly associated with increased rates of BMD loss in the Taiwanese population. This suggests that the prevention of MetS should be taken into consideration in the prevention of osteoporosis in the Taiwanese population.
Collapse
|
22
|
Caplliure-Llopis J, Escrivá D, Benlloch M, de la Rubia Ortí JE, Estrela JM, Barrios C. Poor Bone Quality in Patients With Amyotrophic Lateral Sclerosis. Front Neurol 2021; 11:599216. [PMID: 33391162 PMCID: PMC7775537 DOI: 10.3389/fneur.2020.599216] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Accepted: 11/23/2020] [Indexed: 12/30/2022] Open
Abstract
Objective: Musculoskeletal functional deterioration in Amyotrophic lateral sclerosis (ALS) is associated with an increase in bone fractures. The purpose of this study was to evaluate the influence of sex, ALS type, on bone quality in patients with ALS compared to healthy controls. The impact on bone health of the clinical status and some metabolic parameters was also analyzed in ALS patients. Methods: A series of 33 voluntary patients with ALS, and 66 healthy individuals matched in sex and age underwent assessment of bone mass quality using quantitative ultrasound (QUS) of the calcaneus. Ultrasonic broadband attenuation (BUA), the speed of sound (SOS), stiffness index and T-score were measured. Bone mineral density (BMD) was estimated using standard equations. Apart from fat and muscle mass percentage determinations, clinical baseline measures in ALS patients included ALSFRS-R score, Barthel index for activities of daily living, pulmonary function measured using FVC, and muscular strength assessed by a modified MRC grading scale. Laboratory tests included serum calcium, 25-HO-cholecalciferol (Vitamin D), alkaline phosphatase (ALP), T4 and TSH. Results: All bone parameters evaluated were statistically significant lower in ALS patients than in healthy controls. ALS females showed significantly lower bone parameters than healthy females. According to the estimated BMD, there were 25 ALS patients (75.8%) and 36 (54.5%) healthy individuals showing an osteoporotic profile (BMD <0.700 g/cm2). Only 16.7% of the ALS females had T-scores indicative of healthy bones. There was no correlation between any of the clinical parameters analyzed and the bone QUS measurements. Vitamin D and TSH levels positively correlated with all the bone parameters. Conclusions: This study confirms that ALS patients, particularly females, exhibited deteriorated bone health as compared to healthy individuals. These structural bone changes were independent of ALS subtype and clinical status. Bone health in ALS patients seems to be related to certain metabolic parameters such as Vitamin D and TSH levels.
Collapse
Affiliation(s)
- Jordi Caplliure-Llopis
- School of Doctorate, Valencia Catholic University, Valencia, Spain.,Primary Care Services, La Ribera University Hospital, Alzira, Spain
| | - Dolores Escrivá
- Intensive Care Unit, La Fe Polytechnic and University Hospital, Valencia, Spain
| | - María Benlloch
- Department of Anatomy and Physiology, School of Medicine and Health Sciences, Valencia Catholic University, Valencia, Spain
| | - José Enrique de la Rubia Ortí
- Department of Anatomy and Physiology, School of Medicine and Health Sciences, Valencia Catholic University, Valencia, Spain
| | | | - Carlos Barrios
- Institute of Research on Musculoskeletal Disorders, Valencia Catholic University, Valencia, Spain
| |
Collapse
|
23
|
Hannemann A, Nauck M, Völzke H, Weidner H, Platzbecker U, Hofbauer LC, Rauner M, Baschant U. Interactions of Anemia, FGF-23, and Bone in Healthy Adults-Results From the Study of Health in Pomerania (SHIP). J Clin Endocrinol Metab 2021; 106:e288-e299. [PMID: 33034626 DOI: 10.1210/clinem/dgaa716] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/16/2020] [Indexed: 02/07/2023]
Abstract
CONTEXT Osteoporosis and anemia are among the most common diseases in the aging population with an increasing prevalence worldwide. OBJECTIVE As the bone-derived hormone fibroblast growth factor 23 (FGF-23) was recently reported to regulate erythropoiesis, we examined age-related associations between hemoglobin levels and bone quality, bone turnover, and FGF-23 concentrations. DESIGN We used data from more than 5000 adult subjects who participated in the population-based cohorts of the Study of Health in Pomerania (SHIP and SHIP-Trend). Bone quality was assessed by quantitative ultrasound at the heel, bone turnover by measurement of carboxy-terminal telopeptide of type I collagen (CTX), and intact amino-terminal propeptide of type I procollagen (P1NP) serum concentrations, respectively. Anemia was defined as hemoglobin <13 g/dL in men and <12 g/dL in women. Carboxy-terminal FGF-23 levels were measured in plasma in a subset of 852 subjects. RESULTS Anemic subjects had poorer bone quality, higher fracture risk, and lower serum levels of P1NP than nonanemic individuals. Linear regression models revealed positive associations between hemoglobin and bone quality in subjects aged 40 or above and inverse associations with CTX in subjects aged 60 or above. Hemoglobin and FGF-23 concentrations were inversely associated, while FGF-23 was not related to bone quality or turnover. CONCLUSION Our data corroborate a close link between FGF-23 and anemia, which is related to poor bone quality in elderly people. We observed no direct association of FGF-23 with bone parameters. Further studies are needed clarifying the role of FGF-23 on bone and red blood cell production.
Collapse
Affiliation(s)
- Anke Hannemann
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
| | - Henry Völzke
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, University Medicine, Greifswald, Germany
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Heike Weidner
- Department of Medicine III and Center for Healthy Aging, Dresden Technical University Medical Center, Dresden, Germany
| | - Uwe Platzbecker
- Medical Clinic and Policlinic 1, Hematology and Cellular Therapy, Leipzig University Hospital, Germany
| | - Lorenz C Hofbauer
- Department of Medicine III and Center for Healthy Aging, Dresden Technical University Medical Center, Dresden, Germany
| | - Martina Rauner
- Department of Medicine III and Center for Healthy Aging, Dresden Technical University Medical Center, Dresden, Germany
| | - Ulrike Baschant
- Department of Medicine III and Center for Healthy Aging, Dresden Technical University Medical Center, Dresden, Germany
| |
Collapse
|
24
|
Gao C, Song H, Chen B, Zhang Z, Yue H. The Assessment of the Osteoporosis Self-Assessment Tool for Asians and Calcaneal Quantitative Ultrasound in Identifying Osteoporotic Fractures and Falls Among Chinese People. Front Endocrinol (Lausanne) 2021; 12:684334. [PMID: 34040589 PMCID: PMC8143027 DOI: 10.3389/fendo.2021.684334] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 04/20/2021] [Indexed: 01/22/2023] Open
Abstract
The lack of DXA has made the diagnosis and treatment of osteoporosis extremely difficult in the vast rural areas of China, which has the largest population with high risks of osteoporosis. The aims of this cross-sectional study were to evaluate the association between the osteoporosis self-assessment tool for Asians (OSTA) and calcaneus quantitative ultrasound (QUS) in populations residing in Shanghai, China, and their assessment in predicting osteoporotic fractures and falls. A population of 12,033 participants, including 1272 males (average age 68.3 ± 9.8 years, range 28-100 years) and 10,761 females (average 56.8 ± 11.4 years, range 23-99 years), was gathered. OSTA and calcaneus QUS (Sonost 2000, OsteoSys) values were measured. Spearman's correlation and Cohen's kappa were used to determine the association and agreement between the OSTA and QUS. Receiver operating characteristic (ROC) curves were adapted to assess the performance and optimal cutoff values for the OSTA and QUS in osteoporotic fracture and fall screening. In total, the prevalence of osteoporotic fractures (low-trauma fractures including fractures of the spine, hip, forearm, humerus and ribs) was 15.2% in women, and 17.7% reported a history of falls (falling from standing height more than once in the past year). The percentages of men with the same history were 8.4% and 11.7%, respectively. The association between the OSTA and QUS was found to be rs = 0.393, κ = 0.137, p < 0.001. The OSTA (cutoff < -1) revealed an area under ROC curve (AUC) of 0.590 in identifying female individuals with moderate or high risk of osteoporosis defined by QUS (T-score < -1). The QUS T-score lower than -1.55 or -1.40 in postmenopausal women may lead to an increased risk of falls or osteoporotic fractures, respectively. The agreement between QUS and the OSTA seemed to be limited in determining individuals at risk of osteoporosis. Measuring bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA) may still be necessary in the clinical diagnosis of osteoporosis. OSTA and QUS T-scores less than the respective cutoff values may indicate an increased risk of osteoporotic fractures and falls that individual should be further treated and screened by DXA.
Collapse
Affiliation(s)
- Chao Gao
- Shanghai Clinical Research Center of Bone Diseases, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Huijiang Song
- Department of Internal Medicine, Caolu Community Health Service Center, Shanghai, China
| | - Bihua Chen
- Department of Internal Medicine, Longhua Community Health Service Center, Shanghai, China
| | - Zhenlin Zhang
- Shanghai Clinical Research Center of Bone Diseases, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Hua Yue
- Shanghai Clinical Research Center of Bone Diseases, Department of Osteoporosis and Bone Diseases, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
- *Correspondence: Hua Yue,
| |
Collapse
|
25
|
Fu Y, Li C, Luo W, Chen Z, Liu Z, Ding Y. Fragility fracture discriminative ability of radius quantitative ultrasound: a systematic review and meta-analysis. Osteoporos Int 2021; 32:23-38. [PMID: 32728897 PMCID: PMC7755656 DOI: 10.1007/s00198-020-05559-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Accepted: 07/21/2020] [Indexed: 01/11/2023]
Abstract
The fragility fracture discriminative ability of radius quantitative ultrasound (QUS) was evaluated in a systematic review of 13 studies, including 16,681 individuals and 1296 fractures. The radial speed of sound (SOS) per standard deviation (SD) decrease contributed to an increased risk of total and hip fracture by 32% and 66% in women. Osteoporotic fracture, as a devastating consequence of osteoporosis, brings severe socio-economic burden. The availability of dual-energy X-ray absorptiometry (DXA), as the gold standard of diagnosis, was quite limited in remote areas. Radius QUS measured by SOS shows potential in fracture discriminative ability where DXA equipment is not available. This study aimed to provide a comprehensive evaluation of the association between radius QUS and fracture risk. A detailed article search was carried out on PubMed, EMBASE, Cochrane Libraries, CNKI, Wan-Fang database, VIP, and SinoMed for studies published between January 1980 and February 2020. We determined the estimated relative risk (RR) for fracture per each radial SOS SD decrease. A meta-analysis of studies was performed under the random-effects model. A total of 16,681 individuals were included in this review. Among the participants, 5892 were male and 10,789 were female. A total of 1296 cases of fragility fracture were included. With each SD decrease in radial SOS, the risk of overall fragility fracture and hip fracture was increased by 21% and 55%, respectively. Particularly, the risk was increased by 32% and 66% for women. The association was even stronger for postmenopausal women. Radius QUS showed great potential as an effective tool for fracture risk evaluation, especially for women.
Collapse
Affiliation(s)
- Y Fu
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - C Li
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - W Luo
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Z Chen
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Z Liu
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Y Ding
- Department of Orthopaedic Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
- Bioland Laboratory (Guangzhou Regenerative Medicine and Health Guangdong Laboratory), Guangzhou, China.
| |
Collapse
|
26
|
Lin YH, Wang CF, Chiu H, Lai BC, Tu HP, Wu PY, Huang JC, Chen SC. Air Pollutants Interaction and Gender Difference on Bone Mineral Density T-Score in Taiwanese Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9165. [PMID: 33302461 PMCID: PMC7764089 DOI: 10.3390/ijerph17249165] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/03/2020] [Accepted: 12/05/2020] [Indexed: 12/18/2022]
Abstract
Osteoporosis is defined as a systemic skeletal disease characterized by a reduction in bone mass and microarchitectural deterioration of bone tissue. Previous studies have reported associations between air pollution and lower bone mineral density; however, few studies have investigated the association between air pollution and osteoporosis. In this study, we combined two databases, the first including 5000 individuals registered in the Taiwan Biobank, and the second containing detailed daily data on air pollution. After multivariable adjustments, ozone (O3) (unstandardized coefficient β, 0.015; p = 0.008) was significantly positively associated with T-score, whereas carbon monoxide (CO) (unstandardized coefficient β, -0.809; p < 0.001), sulfur dioxide (SO2) (unstandardized coefficient β, -0.050; p = 0.005), nitric oxide (NO) (unstandardized coefficient β, -0.040; p < 0.001), nitrogen dioxide (NO2) (unstandardized coefficient β, -0.023; p < 0.001), and nitrogen oxide (NOx) (unstandardized coefficient β, -0.017; p < 0.001) were significantly negatively associated with T-score. The interactions between CO and NOx (p = 0.001) and SO2 and NO2 (p = 0.004) on T-score were statistically significant. An increase in exposure to CO, NO and NOx was associated with a faster decline in T-score in the female participants compared to the male participants. In addition, an increase in O3 was associated with a faster increase in T-score in the female participants compared to the male participants. In conclusion, the air pollutants CO, SO2, NO, NO2, and NOx were associated with osteoporosis. In addition, there were interaction and synergetic effects between CO and NOx and SO2 and NO2 on T-score. We also observed differences in the associations between air pollutants and T-score between the female and male participants.
Collapse
Affiliation(s)
- Yu-Hsuan Lin
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Chen-Feng Wang
- Institute of Electronics, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Hsuan Chiu
- Department of General Medicine, Kaohsiung Medical University Hospital, Kaohsiung 807, Taiwan
| | - Bo-Cheng Lai
- Institute of Electronics, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Hung-Pin Tu
- Department of Public Health and Environmental Medicine, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Pei-Yu Wu
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
| | - Jiun-Chi Huang
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Szu-Chia Chen
- Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Department of Internal Medicine, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung 812, Taiwan
- Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- Research Center for Environmental Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| |
Collapse
|
27
|
Ross RD, Shah RC, Leurgans SE, Buchman AS, Bennett DA. Association of Heel Bone Mineral Density With Incident Disability and Mortality in Community-Dwelling Older Adults. JBMR Plus 2020; 4:e10390. [PMID: 32995693 PMCID: PMC7507511 DOI: 10.1002/jbm4.10390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2020] [Revised: 06/25/2020] [Accepted: 06/30/2020] [Indexed: 11/25/2022] Open
Abstract
Age‐related bone loss is common in older adults. However, the association of low bone mass with incident disability and mortality is not well established. A sample of 738 participants in the Rush Memory and Aging Project (MAP) was evaluated at baseline for bone mineral density (BMD) using quantitative ultrasound at the calcaneus. An annual interview assessed basic activities of daily living (BADL), instrumental activities of daily living (IADL), mobility disability, and history of hip fracture. The associations between baseline BMD and risk of death; incident BADL, IADL, and mobility disability; and hip fracture were investigated using Cox hazard models, adjusting for age, sex, education, race, and body mass index (BMI). The robustness of our findings was evaluated by adjusting for confounding factors and health conditions including joint pain, musculoskeletal medications, smoking status, motor function, global cognition, falls, cardiovascular events, and diabetes. Participants were on average (mean ± SD) 80.9 ± 7.0 years old, 72% female, and 3.8% black, with a baseline BMI of 27.3 ± 5.4 kg/m2, and a baseline of BMD of 0.44 ± 0.14 g/cm2. In models adjusted for age, sex, education, race, and BMI, lower BMD was associated with a higher rate of death (hazard ratio [HR] 1.20; 95% confidence interval [CI], 1.08–1.33), incident BADL disability (HR 1.20; 95% CI, 1.05–1.37), and hip fracture (HR 2.57; 95% CI, 1.72–3.82), but not of IADL disability (HR 1.00; 95% CI, 0.85–1.17) or mobility disability (HR 1.13; 95% CI, 0.97–1.32). The association between BMD and mortality was not significant in fully adjusted models, but the BMD and BADL associations remained significant in models adjusting for both demographic variables and BMD‐modifying health conditions. BMD is associated with incident disability in older adults. © 2020 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Ryan D Ross
- Department of Cell & Molecular Medicine Rush University Medical Center Chicago IL USA.,Department of Orthopedic Surgery Rush University Medical Center Chicago IL USA
| | - Raj C Shah
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA.,Department of Family Medicine Rush University Medical Center Chicago IL USA
| | - Sue E Leurgans
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA.,Department of Neurological Sciences Rush University Medical Center Chicago IL USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA.,Department of Neurological Sciences Rush University Medical Center Chicago IL USA
| | - David A Bennett
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA.,Department of Neurological Sciences Rush University Medical Center Chicago IL USA
| |
Collapse
|
28
|
Cheng L, Pohlabeln H, Ahrens W, Lauria F, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, Michels N, Moreno LA, Page AS, Pitsiladis Y, Hebestreit A. Cross-sectional and longitudinal associations between physical activity, sedentary behaviour and bone stiffness index across weight status in European children and adolescents. Int J Behav Nutr Phys Act 2020; 17:54. [PMID: 32345301 PMCID: PMC7189536 DOI: 10.1186/s12966-020-00956-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 04/13/2020] [Indexed: 12/15/2022] Open
Abstract
Background The associations between physical activity (PA), sedentary behaviour (SB) and bone health may be differentially affected by weight status during growth. This study aims to assess the cross-sectional and longitudinal associations between PA, SB and bone stiffness index (SI) in European children and adolescents, taking the weight status into consideration. Methods Calcaneus SI was first measured by quantitative ultrasound among children aged 2–9 years old in 2007/08. It was measured again after 2 years in the IDEFICS study and after 6 years in the I. Family study. A sample of 2008 participants with time spent at sports clubs, watching TV and playing computer/games self-reported by questionnaire, and a subsample of 1037 participants with SB, light PA (LPA) and moderate-to-vigorous PA (MVPA) objectively measured using Actigraph accelerometers were included in the analyses. Weight status was defined as thin/normal and overweight/obese according to the extended International Obesity Task Force criteria. Linear mixed-effects models were used to estimate the cross-sectional and longitudinal associations between PA, SB and SI percentiles, stratified by weight status. Results The cross-sectional association between weekly duration of watching TV and SI percentiles was negative in thin/normal weight group (β = − 0.35, p = 0.008). However, baseline weekly duration of watching TV (β = − 0.63, p = 0.021) and change after 2 years (β = − 0.63, p = 0.022) as well as the change in weekly duration of playing computer/games after 6 years (β = − 0.75, p = 0.019) were inversely associated with corresponding changes in SI percentiles in overweight/obese group. Change in time spent at sports clubs was positively associated with change in SI percentiles after 2 years (β = 1.28, p = 0.001), with comparable effect sizes across weight status. In the subsample with accelerometer data, we found a positive cross-sectional association between MVPA and SI percentiles in thin/normal weight group. Baseline MVPA predicted changes in SI percentiles after 2 and 6 years in all groups. Conclusions Our results suggested the beneficial effect of PA on SI. However, the increasing durations of screen-based SB might be risk factors for SI development, especially in overweight/obese children and adolescents.
Collapse
Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.,Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Fabio Lauria
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Public Health, School of Health Sciences, University of Skövde, Skövde, Sweden
| | - Nathalie Michels
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, 9000, Ghent, Belgium
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009, Zaragoza, Spain
| | - Angie S Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Yannis Pitsiladis
- Collaborating Centre of Sports Medicine, University of Brighton, Brighton, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Achterstraße 30, 28359, Bremen, Germany.
| | | |
Collapse
|
29
|
Cheng L, Pohlabeln H, Ahrens W, Russo P, Veidebaum T, Chadjigeorgiou C, Molnár D, Eiben G, De Henauw S, Moreno L, Page A, Hebestreit A. Sex differences in the longitudinal associations between body composition and bone stiffness index in European children and adolescents. Bone 2020; 131:115162. [PMID: 31760215 DOI: 10.1016/j.bone.2019.115162] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 10/20/2019] [Accepted: 11/20/2019] [Indexed: 10/25/2022]
Abstract
Fat mass (FM) and fat free mass (FFM) may influence bone health differentially. However, existing evidences on associations between FM, FFM and bone health are inconsistent and vary according to sex and maturity. The present study aims to evaluate longitudinal associations between FM, FFM and bone stiffness index (SI) among European children and adolescents with 6 years follow-up. A sample of 2468 children from the IDEFICS/I.Family was included, with repeated measurements of SI using calcaneal quantitative ultrasound, body composition using skinfold thickness, sedentary behaviors and physical activity using self-administrated questionnaires. Regression coefficients (β) and 99%-confidence intervals (99% CI) were calculated by sex-specified generalized linear mixed effects models to analyze the longitudinal associations between FM and FFM z-scores (zFM and zFFM) and SI percentiles, and to explore the possible interactions between zFM, zFFM and maturity. Baseline zFFM was observed to predict the change in SI percentiles in both boys (β = 4.57, 99% CI: 1.36, 7.78) and girls (β = 3.42, 99% CI: 0.05, 6.79) after 2 years. Moreover, baseline zFFM (β = 8.72, 99% CI: 3.18, 14.27 in boys and β = 5.89, 99% CI: 0.34, 11.44 in girls) and the change in zFFM (β = 6.58, 99% CI: 0.83, 12.34 in boys and β = 4.81, 99% CI: -0.41, 10.02 in girls) were positively associated with the change in SI percentiles after 6 years. In contrast, a negative association was observed between the change in zFM and SI percentiles in boys after 6 years (β = -3.70, 99% CI: -6.99, -0.42). Besides, an interaction was observed between the change in zFM and menarche on the change in SI percentiles in girls at 6 years follow-up (p = .009), suggesting a negative association before menarche while a positive association after menarche. Our findings support the existing evidences for a positive relationship between FFM and SI during growth. Furthermore, long-term FM gain was inversely associated with SI in boys, whereas opposing associations were observed across menarche in girls.
Collapse
Affiliation(s)
- Lan Cheng
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany
| | - Wolfgang Ahrens
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany; Faculty of Mathematics and Computer Science, University of Bremen, Bremen, Germany
| | - Paola Russo
- Institute of Food Sciences, National Research Council, Avellino, Italy
| | - Toomas Veidebaum
- Department of Chronic Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Dénes Molnár
- Department of Pediatrics, Medical School, University of Pécs, Pécs, Hungary
| | - Gabriele Eiben
- Department of Biomedicine and Public Health, School of Health and Education, University of Skövde, Skövde, Sweden
| | | | - Luis Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, 50009 Zaragoza, Spain
| | - Angie Page
- Centre for Exercise, Nutrition & Health Sciences, University of Bristol, Bristol, UK
| | - Antje Hebestreit
- Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.
| |
Collapse
|
30
|
Desbiens LC, Goupil R, Mac-Way F. Predictive value of quantitative ultrasound parameters in individuals with chronic kidney disease: A population-based analysis of CARTaGENE. Bone 2020; 130:115120. [PMID: 31676408 DOI: 10.1016/j.bone.2019.115120] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 09/11/2019] [Accepted: 10/22/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND The use of calcaneal quantitative ultrasound (QUS) to predict fractures has not been well studied in early CKD populations. We compared the association of QUS with incidental fractures and its predictive properties in non-CKD and CKD individuals. METHODS Analysis of a prospective population-based survey of 40- to 69-year-old individuals recruited between 2009 and 2010. QUS parameters (stiffness index [SI], speed of sound [SOS], broadband attenuation [BUA]) were measured at baseline. Renal function was measured using baseline creatinine and was classified into CKD stages (non-CKD, stage 2, stage 3). Fracture incidence at any site or at major osteoporotic fracture sites for up to 7 years of follow-up was identified in administrative databases using a validated algorithm. The association (age-adjusted hazard ratio per standard deviation decrease in Cox models), discrimination (c-statistic) and calibration (standardized incidence ratio [SIR]) of QUS parameters with fracture outcomes was computed in each CKD stratum. RESULTS We included 18,306 individuals (9,011 non-CKD; 8,595 CKD stage 2; 700 CKD stage 3). During a median follow-up of 70 months, we identified 782 fractures at any site and 326 major osteoporotic fractures. Although all QUS parameters (SI, SOS and BUA) were associated with any or major fracture incidence in non-CKD and CKD patients, the magnitude of these associations was lower for any fracture and for BUA. QUS parameters moderately discriminated incidental fractures across CKD strata but underestimated fracture incidence in CKD stage 3 even after adjustment for demographics and clinical risk factors. At a given QUS value, CKD stage 3 patients had higher fracture risk than non-CKD and CKD stage 2 patients. CONCLUSIONS QUS parameters are associated with fracture incidence in both non-CKD and CKD but underestimate fracture incidence in individuals with early CKD.
Collapse
Affiliation(s)
- Louis-Charles Desbiens
- CHU de Québec Research Center, L'Hôtel-Dieu-de-Québec 10 McMahon, Quebec City, QC, G1R 2J6, Canada; Department and Faculty of Medicine, Université Laval. 1050, avenue de la Médecine, local 4211, Quebec City, QC, G1V 0A6, Canada.
| | - Rémi Goupil
- Hôpital du Sacré-Coeur de Montréal, Nephrology Division, 5400 Boul Gouin O, Montreal, QC, H4J 1C5, Canada; Department and Faculty of Medicine, Université de Montréal, 2900, boul. Édouard-Montpetit, local S-759, Montreal, QC, H3T 1J4, Canada.
| | - Fabrice Mac-Way
- CHU de Québec Research Center, L'Hôtel-Dieu-de-Québec 10 McMahon, Quebec City, QC, G1R 2J6, Canada; Department and Faculty of Medicine, Université Laval. 1050, avenue de la Médecine, local 4211, Quebec City, QC, G1V 0A6, Canada.
| |
Collapse
|
31
|
Jafri L, Majid H, Ahmed S, Naureen G, Khan AH. Calcaneal Ultrasound and Its Relation to Dietary and Lifestyle Factors, Anthropometry, and Vitamin D Deficiency in Young Medical Students. Front Endocrinol (Lausanne) 2020; 11:601562. [PMID: 33551995 PMCID: PMC7859491 DOI: 10.3389/fendo.2020.601562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Accepted: 11/26/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Bone quality and peak bone mass are greatly affected by lifestyle factors. The objective of the study was to investigate the relationships between anthropometry, dietary and caloric intake, body composition measurements, physical activity, and vitamin D status with quantitative ultrasound-based bone parameters among medical students. METHODS Both male and female medical college students were included in this study. A detailed questionnaire was administered, collecting clinical, dietary, physical activity information, physical examination details, including body mass index (BMI). Body composition (total body fat, total body water, muscle mass, mean visceral fat mass, basal metabolic rate, bone mass using a bioelectrical impedance analyzer) and calcaneal heel ultrasound parameters were measured using an Osteosys Sonost-3000, Ultrasound Bone Densitometer were measured, respectively. RESULTS In this cross-sectional study, 211 healthy students with a mean age of 20.1 ± 1.1 years, 51.7% (n = 109) were males. Majority (79.4%) of the young adults had vitamin D deficiency. The mean BMI, calcium intake, and vitamin D levels were 22.35 ± 3.43 kg/m2, 788.7 ± 364.8 mg/day, and 15.02 ± 8.63 ng/ml, respectively. Female subjects compared to males had statistically significantly lower daily energy intake, muscle mass, visceral fat mass, calcium intake, and vitamin D levels. In addition the median Z-scores in females [-1.40 (-0.57 to -1.82)] was significantly poorer than the male [-0.50 (0.20 to -1.3)] counterparts, p-value <0.001. Multiple regression analysis showed that overall body fat percent (p-value 0.016) and visceral fat percent (p-value 0.029) were the only significant negative predictors to the calcaneal bone quality index (BQI) values. CONCLUSION Adolescent lifestyle patterns can influence young adult bone strength. The young Pakistani females exhibited significantly lower dietary intakes and more inadequate bone parameters compared to males. Our data suggest that total body and visceral fat percent are the predominant negatively associated determinant of bone strength for this cohort. Calcaneal ultrasound can be utilized for mass screening of young adults for identification of low BMD.
Collapse
Affiliation(s)
- Lena Jafri
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
- *Correspondence: Lena Jafri,
| | - Hafsa Majid
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Sibtain Ahmed
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Ghazala Naureen
- Department of Medicine - Western Health, The University of Melbourne and Australian Institute for Musculoskeletal Science, The University of Melbourne and Western Health, St Albans, VIC, Australia
| | - Aysha Habib Khan
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| |
Collapse
|
32
|
Nies AT, Weiss S, Schaeffeler E, Hannemann A, Völker U, Wallaschofski H, Schwab M. The Membrane Transporter OAT7 (SLC22A9) Is Not a Susceptibility Factor for Osteoporosis in Europeans. Front Endocrinol (Lausanne) 2020; 11:532. [PMID: 33013684 PMCID: PMC7461822 DOI: 10.3389/fendo.2020.00532] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/30/2020] [Indexed: 01/14/2023] Open
Abstract
Bone production, maintenance, and modeling are a well-balanced process involving mineralization by osteoblasts and resorption by osteoclasts. Sex steroid hormones, including their conjugated forms, contribute majorly to maintaining this balance. Recently, variants in the SLC22A9 gene have been associated with osteoporosis in Korean females. We had recently shown that SLC22A9, encoding organic anion transporter 7 (OAT7), is an uptake transporter of estrone sulfate and identified several genetic variants in Europeans leading to functional consequences in vitro. We therefore hypothesized that SLC22A9 genetic variants may contribute to the pathophysiology of osteoporosis in Europeans. To test this hypothesis, we examined the associations of SLC22A9 variants with bone quality, fractures, and bone turnover markers. We genotyped SLC22A9 variants in 5,701 (2,930 female) subjects (age range, 20-93 years) extracted from the population-based Study of Health in Pomerania (SHIP and SHIP-TREND) covered by the Illumina Infinium HumanExome BeadChip version v1.0 (Exome Chip). Descriptive data (e.g., history of fractures), ultrasonography of the calcaneus, as well as serum concentrations of carboxy-terminal telopeptide of type I collagen, amino-terminal propeptide of type I procollagen, and vitamin D were determined. Comprehensive statistical analyses revealed no association between low-frequency and rare SLC22A9 variants and bone quality, fractures, and bone turnover markers. Our results indicate that single genetic SLC22A9 variants do not have a major impact on osteoporosis risk prediction in Europeans, yet findings need to be replicated in larger-scale studies.
Collapse
Affiliation(s)
- Anne T. Nies
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
- *Correspondence: Anne T. Nies
| | - Stefan Weiss
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald and University of Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Elke Schaeffeler
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
| | - Anke Hannemann
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald and University of Greifswald, Greifswald, Germany
- DZHK (German Centre for Cardiovascular Research), Partner Site Greifswald, Greifswald, Germany
| | - Henri Wallaschofski
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Matthias Schwab
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Tübingen, Germany
- Departments of Clinical Pharmacology, Pharmacy and Biochemistry, University of Tübingen, Tübingen, Germany
- Matthias Schwab
| |
Collapse
|
33
|
Madimenos FC, Liebert MA, Cepon‐Robins TJ, Urlacher SS, Josh Snodgrass J, Sugiyama LS, Stieglitz J. Disparities in bone density across contemporary Amazonian forager‐horticulturalists: Cross‐population comparison of the Tsimane and Shuar. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2019; 171:50-64. [DOI: 10.1002/ajpa.23949] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 09/26/2019] [Accepted: 10/07/2019] [Indexed: 01/12/2023]
Affiliation(s)
- Felicia C. Madimenos
- Department of Anthropology Queens College (CUNY) Flushing New York
- New York Consortium on Evolutionary Primatology (NYCEP) New York New York
| | - Melissa A. Liebert
- Department of Anthropology Northern Arizona University Flagstaff Arizona
| | | | | | | | - Lawrence S. Sugiyama
- Department of Anthropology University of Oregon Eugene
- Institute of Cognitive and Decision Sciences University of Oregon Eugene Oregon
| | - Jonathan Stieglitz
- Université Toulouse 1 Capitole Toulouse France
- Institute for Advanced Study in Toulouse Toulouse France
| |
Collapse
|
34
|
Schraders K, Zatta G, Kruger M, Coad J, Weber J, Brough L, Thomson J. Quantitative Ultrasound and Dual X-Ray Absorptiometry as Indicators of Bone Mineral Density in Young Women and Nutritional Factors Affecting It. Nutrients 2019; 11:nu11102336. [PMID: 31581575 PMCID: PMC6836084 DOI: 10.3390/nu11102336] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 09/24/2019] [Accepted: 09/29/2019] [Indexed: 12/31/2022] Open
Abstract
Young adulthood is an important stage in the accrual of bone mass. Young women are often unaware of the need, and how to optimize modifiable risk factors, particularly intake of nutrients associated with good bone health. In this study, an accessible way to estimate osteoporosis risk, quantitative ultrasound (QUS), is compared to the gold-standard technique dual X-ray absorptiometry (DXA) in a group of 54 healthy young women (18–26 years) from Manawatu, New Zealand, and the relationship with nutrient intake is investigated. Broadband ultrasound attenuation and speed of sound (BUA, SOS) were assessed by QUS calcaneal scans and bone mineral concentration/density (BMC/BMD) were determined by DXA scans of the lumbar spine and hip (total and femoral neck). Dietary intake of energy, protein, and calcium was estimated using three-day food diaries and questionnaires. DXA mean Z-scores (>−2.0) for the hip (0.19) and spine (0.2) and QUS mean Z-scores (>−1.0) (0.41) were within the expected ranges. DXA (BMD) and QUS (BUA, SOS) measurements were strongly correlated. Median intakes of protein and calcium were 83.7 g/day and 784 mg/day, respectively. Protein intake was adequate and, whilst median calcium intake was higher than national average, it was below the Estimated Average Requirement (EAR). No significant relationship was found between dietary intake of calcium or protein and BMD or BMC. To conclude, QUS may provide a reasonable indicator of osteoporosis risk in young women but may not be an appropriate diagnostic tool. Increased calcium intake is recommended for this group, regardless of BMD.
Collapse
Affiliation(s)
- Katie Schraders
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Giancarla Zatta
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Marlena Kruger
- School of Health Sciences, College of Health, Massey University, Palmerston North 4442, New Zealand.
| | - Jane Coad
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Janet Weber
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Louise Brough
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
| | - Jasmine Thomson
- School of Food and Advanced Technology, College of Sciences, Massey University, Palmerston North 4442, New Zealand.
- Fonterra Research and Development Centre, Fonterra Co-operative Group Limited, Palmerston North 4442, New Zealand.
| |
Collapse
|
35
|
Quantitative ultrasound for monitoring bone status in institutionalized adults with refractory epilepsy and intellectual disability: A 7-year follow-up study. Seizure 2019; 71:35-41. [DOI: 10.1016/j.seizure.2019.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 06/03/2019] [Accepted: 06/06/2019] [Indexed: 11/18/2022] Open
|
36
|
Lu HF, Hung KS, Chu HW, Wong HSC, Kim J, Kim MK, Choi BY, Tai YT, Ikegawa S, Cho EC, Chang WC. Meta-Analysis of Genome-Wide Association Studies Identifies Three Loci Associated With Stiffness Index of the Calcaneus. J Bone Miner Res 2019; 34:1275-1283. [PMID: 30779856 DOI: 10.1002/jbmr.3703] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Revised: 01/27/2019] [Accepted: 02/12/2019] [Indexed: 01/11/2023]
Abstract
The stiffness index (SI) from quantitative ultrasound measurements is a good indicator of BMD and may be used to predict the risk of osteoporotic fracture. We conducted a genomewide association study (GWAS) for SI using 7742 individuals from the Taiwan Biobank, followed by a replication study in a Korean population (n = 2955). Approximately 6.1 million SNPs were subjected to association analysis, and SI-associated variants were identified. We further conducted a meta-analysis of Taiwan Biobank significant SNPs with a Korean population-based cohort. Candidate genes were prioritized according to epigenetic annotations, gene ontology, protein-protein interaction, GWAS catalog, and expression quantitative trait loci analyses. Our results revealed seven significant single-nucleotide polymorphisms (SNPs) within three loci: 7q31.31, 17p13.3, and 11q14.2. Conditional analysis showed that three SNPs, rs2536195 (CPED1/WNT16), rs1231207 (SMG6), and rs4944661 (LOC10050636/TMEM135), were the most important signals within these regions. The associations for the three SNPs were confirmed in a UK Biobank estimated BMD GWAS; these three cytobands were replicated successfully after a meta-analysis with a Korean population cohort as well. However, two SNPs were not replicated. After prioritization, we identified two novel genes, RAB15 and FNTB, as strong candidates for association with SI. Our study identified three SI-associated SNPs and two novel SI-related genes. Overall, these results provide further insight into the genetic architecture of osteoporosis. Further studies in larger East Asian populations are needed. © 2019 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Hsing-Fang Lu
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Laboratory of Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Kuo-Sheng Hung
- Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Neurosurgery, Taipei Medical University-Wan Fang Hospital, Taipei, Taiwan.,Graduate Institute of Injury, Prevention and Control, College of Public Health, Taipei Medical University, Taipei, Taiwan
| | - Hou-Wei Chu
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Henry Sung-Ching Wong
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Jihye Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.,Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Mi Kyung Kim
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.,Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Bo Youl Choi
- Department of Preventive Medicine, College of Medicine, Hanyang University, Seoul, South Korea.,Institute for Health and Society, Hanyang University, Seoul, South Korea
| | - Yu-Ting Tai
- Department of Anesthesiology, Taipei Medical University, Taipei, Taiwan
| | - Shiro Ikegawa
- Laboratory of Bone and Joint Diseases, RIKEN Center for Integrative Medical Sciences, Tokyo, Japan
| | - Er-Chieh Cho
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Clinical Pharmacy, School of Pharmacy, College of Pharmacy, Taipei Medical University, Taipei, Taiwan
| | - Wei-Chiao Chang
- School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Master Program for Clinical Pharmacogenomics and Pharmacoproteomics, School of Pharmacy, Taipei Medical University, Taipei, Taiwan.,Department of Pharmacy, Taipei Medical University-Wanfang Hospital, Taipei, Taiwan.,Center for Biomarkers and Biotech Drugs, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medicine Research, Taipei Medical University-Shuang Ho Hospital, New Taipei City, Taiwan
| |
Collapse
|
37
|
Steell L, Sillars A, Welsh P, Iliodromiti S, Wong SC, Pell JP, Sattar N, Gill JMR, Celis-Morales CA, Gray SR. Associations of dietary protein intake with bone mineral density: An observational study in 70,215 UK Biobank participants. Bone 2019; 120:38-43. [PMID: 30292817 DOI: 10.1016/j.bone.2018.10.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Revised: 10/01/2018] [Accepted: 10/03/2018] [Indexed: 01/31/2023]
Abstract
PURPOSE Adequate dietary protein intake is important for the maintenance of bone health; however, data in this area is ambiguous with some suggestion that high protein intake can have deleterious effects on bone health. The aim of the current study was to explore the associations of protein intake with bone mineral density (BMD). METHODS We used baseline data from the UK Biobank (participants aged 40-69 years) to examine the association of protein intake with BMD (measured by ultrasound). These associations were examined, in women (n = 39,066) and men (n = 31,149), after adjustment for socio-demographic and lifestyle confounders and co-morbidities. RESULTS Protein intake was positively and linearly associated with BMD in women (β-coefficient 0.010 [95% CI 0.005; 0.015, p < 0.0001]) and men (β-coefficient 0.008 [95% CI 0.000; 0.015, p = 0.044]); per 1.0 g/kg/day increment in protein intake, independently of socio-demographics, dietary factors and physical activity. CONCLUSIONS The current data have demonstrated that higher protein intakes are positively associated with BMD in both men and women. This indicates that higher protein intakes may be beneficial for both men and women.
Collapse
Affiliation(s)
- L Steell
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK; Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK
| | - A Sillars
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - P Welsh
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - S Iliodromiti
- Department of Obstetrics and Gynaecology, School of Medicine, University of Glasgow, UK
| | - S C Wong
- Developmental Endocrinology Research Group, School of Medicine, University of Glasgow, Glasgow, UK
| | - J P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - N Sattar
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - J M R Gill
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - C A Celis-Morales
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - S R Gray
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
| |
Collapse
|
38
|
Lizondo V, Caplliure-Llopis J, Escrivá D, De La Rubia JE, Barrios C. Bone quality in young adults with intellectual disability involved in adapted competitive football. Eur J Sport Sci 2019; 19:850-859. [PMID: 30624162 DOI: 10.1080/17461391.2018.1563633] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
The objective of this study was to analyse bone quality parameters of football players with intellectual disability (ID) participating in adapted competitive football. Sixty-seven male football players with ID were studied: 22 with Down syndrome (DS) and 45 without DS. The average age was 26 years (range: 16 ̶ 50 years). A group of 25 age-matched sedentary individuals with ID (11 DS and 14 non-DS) and another group of 20 healthy participants of the same age group not involved in competitive football were comparatively analysed. There were no differences in the bone quality parameters when the healthy sedentary individuals were compared with both the sedentary and the football players with ID. However, the speed of sound (SOS), T-score, and estimated bone mineral density (BMD) were of higher values in the football players with ID than in the sedentary ID group (p < 0.05). On comparing the football players with non-DS ID with the sedentary non-DS individuals, significant differences were noted in SOS (p < 0.01), T-scores (p < 0.01), and estimated BMD (p < 0.01). Four of the 45 non-DS (8.9%) and none of the football players with DS had T-scores less than -1.5. Two of the 14 sedentary non-DS participants (14.3%) had T-scores indicating osteoporosis. In summary, the ID population actively involved in football showed higher values of bone mass parameters than their sedentary ID and healthy peers. The participants with non-DS ID showed a higher prevalence of osteoporosis than the football players with DS. Participation in sports seems to prevent bone loss in individuals with ID.
Collapse
Affiliation(s)
- Vicente Lizondo
- a School of Doctorate , Valencia Catholic University , Valencia , Spain
| | | | - Dolores Escrivá
- b Nursing School , Valencia Catholic University , Valencia , Spain
| | | | - Carlos Barrios
- c Institute for Research on Musculoskeletal Disorders , Valencia Catholic University , Valencia , Spain
| |
Collapse
|
39
|
Agreement Between Dual-Energy X-Ray Absorptiometry and Quantitative Ultrasound to Evaluate Bone Health in Adolescents: The PRO-BONE Study. Pediatr Exerc Sci 2018; 30:466-473. [PMID: 29804497 DOI: 10.1123/pes.2017-0217] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PURPOSE The present study aims to investigate the association between dual-energy X-ray absorptiometry (DXA) and quantitative ultrasound (QUS) parameters and the intermethods agreement in active males. METHODS In this cross-sectional study, bone health (by DXA and calcaneal QUS), physical activity (by accelerometers), and anthropometrics measurements were assessed in 117 active adolescents (12-14 y old). Bivariate correlation coefficients were calculated to assess the relationships between DXA standard regions of interest and QUS parameters. Intraclass correlation coefficients and Bland-Altman plots were used to assess the level of agreement between bone mineral content regions derived from DXA and stiffness index. The measurements were z score transformed for comparison. RESULTS Most QUS parameters were positive and significantly correlated with DXA outcomes (stiffness index: r = .43-.52; broadband ultrasound attenuation: r = .50-.58; speed of sound: r = .25-.27) with the hip showing the highest correlations. Moreover, the present study found fair to good intraclass correlation coefficients of agreement (.60-.68) between DXA and QUS to assess bone health. The Bland-Altman analysis showed a limited percentage of outliers (3.2%-8.6%). CONCLUSION QUS device could represent an acceptable alternative method to assess bone health in active adolescent males.
Collapse
|
40
|
Relationship between the Second to Fourth Finger Length Ratio and Calcaneus Quantitative Ultrasound. Sci Rep 2018; 8:14603. [PMID: 30279568 PMCID: PMC6168508 DOI: 10.1038/s41598-018-33056-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 09/20/2018] [Indexed: 12/20/2022] Open
Abstract
This study aimed to characterize the relationship between the ratio of the length of the second and fourth fingers (2D:4D value) and the speed of sound of the calcaneus by quantitative ultrasound (QUS-SOS) in undergraduate female students. We recruited 138 young women with a mean age of 19.6 ± 1.4 years. The participants' calcaneus QUS-SOS was measured using an ultrasound bone densitometer. We also measured the participants' weight, height, and grip strength. A self-reported questionnaire was used to obtain information on participants' secondary sexual characteristics, and exercise habits. The present study showed that the 2D:4D value of both hands was significantly correlated with the calcaneus QUS-SOS. The 2D:4D value of the left hand was also positively associated with the calcaneus QUS-SOS results in several respects. These findings suggest that the 2D:4D value may be useful for the screening of risk for a low bone quality in undergraduate female students.
Collapse
|
41
|
Subramaniam S, Ima-Nirwana S, Chin KY. Performance of Osteoporosis Self-Assessment Tool (OST) in Predicting Osteoporosis-A Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E1445. [PMID: 29987247 PMCID: PMC6068473 DOI: 10.3390/ijerph15071445] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 06/28/2018] [Accepted: 07/04/2018] [Indexed: 12/15/2022]
Abstract
Bone health screening plays a vital role in the early diagnosis and treatment of osteoporosis to prevent fragility fractures among the elderly and high-risk individuals. Dual-energy X-ray absorptiometry (DXA), which detects bone mineral density, is the gold standard in diagnosing osteoporosis but is not suitable for screening. Therefore, many screening tools have been developed to identify individuals at risk for osteoporosis and prioritize them for DXA scanning. The Osteoporosis Self-assessment Tool (OST) is among the first tools established to predict osteoporosis in postmenopausal women. It can identify the population at risk for osteoporosis, but its performance varies according to ethnicity, gender, and age. Thus, these factors should be considered to ensure the optimal use of OST worldwide. Overall, OST is a simple and economical screening tool to predict osteoporosis and it can help to optimize the use of DXA.
Collapse
Affiliation(s)
- Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur 56000, Malaysia.
| |
Collapse
|
42
|
Takahata Y. Usefulness of circuit training at home for improving bone mass and muscle mass while losing fat mass in undergraduate female students. Lipids Health Dis 2018; 17:104. [PMID: 29743072 PMCID: PMC5944040 DOI: 10.1186/s12944-018-0743-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2018] [Accepted: 04/13/2018] [Indexed: 02/07/2023] Open
Abstract
Background The purpose of this study was to determine whether or not circuit training at home affects the calcaneus quantitative ultrasound status as well as other indices of body composition among undergraduate female students. Methods Forty-one adolescents were recruited (18.5 ± 0.6 years old). The stiffness index of the calcaneus, broadband ultrasound attenuation of the calcaneus, speed of sound of the calcaneus, and body frame index. This was a three-month intervention study, so the measurements were conducted at baseline, 2 months later, and 3 months later while the subjects underwent circuit training at home. The subjects were divided into two groups: namely, the exercising group and non-exercising group. Results In the exercising group, broadband ultrasound attenuation of the calcaneus was higher 2 months later (p = 0.033) as well as 3 months later (p = 0.036), and the speed of sound of the calcaneus was higher 3 months later (p = 0.018). In addition, the muscle mass was strongly positively correlated with the calcaneus QUS-SOS (p = 0.004), while the body fat percentage was a strongly negatively correlated with the calcaneus QUS-BUA (p = 0.043). In the non-exercising group, the stiffness index of the calcaneus was higher 2 months later (p = 0.002) as well as 3 months later (p = 0.002). Furthermore, the body percentage was strongly positively correlated with the calcaneus QUS-SI (p = 0.009). Conclusions These findings suggest that the calcaneus quantitative ultrasound status and muscle mass while losing fat mass may be improved by means of a simple exercise regimen within a short period among undergraduate female students.
Collapse
Affiliation(s)
- Yoko Takahata
- Faculty of Nursing, Baika Women's University, Shukunosho 2-19-5, Ibaraki, Osaka, 567-8578, Japan.
| |
Collapse
|
43
|
A Cross-Sectional Study of the Association between Autoantibodies and Qualitative Ultrasound Index of Bone in an Elderly Sample without Clinical Autoimmune Disease. J Immunol Res 2018; 2018:9407971. [PMID: 29854851 PMCID: PMC5952466 DOI: 10.1155/2018/9407971] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Revised: 03/05/2018] [Accepted: 03/17/2018] [Indexed: 12/15/2022] Open
Abstract
Bone loss is characteristic of the ageing process and a common complication of many autoimmune diseases. Research has highlighted a potential role of autoantibodies in pathologic bone loss. The confounding effects of immunomodulatory drugs make it difficult to establish the contribution of autoantibodies amongst autoimmune disease sufferers. We attempted to examine the relationship between autoantibodies and bone mass in a population of 2812 elderly participants without clinical autoimmune disease. Serum samples were assayed for a panel of autoantibodies (anti-nuclear, extractable nuclear antigen, anti-neutrophil cytoplasmic, thyroid peroxidase, tissue transglutaminase, anti-cardiolipin, rheumatoid factor, and cyclic citrullinated peptide). Bone mass was measured using quantitative ultrasound (QUS) of the calcaneus. The relationship between each autoantibody and bone mass was determined using linear regression models. Anti-nuclear autoantibodies were the most prevalent, positive in approximately 11%, and borderline in roughly 23% of our sample. They were also the only autoantibody observed to be significantly associated with QUS index in the univariate analysis (n = 1628; r = -0.20; 95% CI: -0.40-0.00; p = 0.046). However, statistical significance was lost after adjustment for various other potential confounders. None of the other autoantibodies was associated with QUS index in either univariate or multivariate analysis. We are limited by the cross-sectional nature of the study and the low prevalence of autoantibodies in our nonclinical sample.
Collapse
|
44
|
Oo WM, Naganathan V, Bo MT, Hunter DJ. Clinical utilities of quantitative ultrasound in osteoporosis associated with inflammatory rheumatic diseases. Quant Imaging Med Surg 2018; 8:100-113. [PMID: 29541626 PMCID: PMC5835660 DOI: 10.21037/qims.2018.02.02] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Accepted: 01/29/2018] [Indexed: 01/27/2023]
Abstract
Secondary osteoporosis is an important co-morbidity related to inflammatory rheumatic diseases that is attributed to several factors including inflammatory cytokines, inactivity and glucocorticoid treatment. Quantitative ultrasound (QUS) has been utilized in osteoporosis research due to its detectability of bone density as well as bone quality. The current narrative review is to address the potential utilities of QUS in secondary osteoporosis of inflammatory rheumatic diseases, focusing on the clinical aspects of QUS in these diseases, based on the conformity of QUS with dual emission X-ray absorptiometry (DXA), the relationship with disease characteristics, and its capability of fracture prediction. Although limited data demonstrate that QUS had moderate to strong correlation with DXA, and might be useful as a potential imaging tool to screen for osteoporosis, further research is still required for QUS to be utilized effectively for the best outcome in these patients with rheumatic diseases.
Collapse
Affiliation(s)
- Win Min Oo
- Rheumatology Department, Royal North Shore Hospital, and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| | - Vasikaran Naganathan
- Centre for Education and Research on Ageing and the Ageing and Alzheimers Institute, Sydney Medical School, The University of Sydney and Concord Hospital, Sydney, Australia
| | - Myat Thae Bo
- University of Medicine-Mandalay, Mandalay, Myanmar
| | - David J. Hunter
- Rheumatology Department, Royal North Shore Hospital, and Institute of Bone and Joint Research, Kolling Institute, University of Sydney, Sydney, Australia
| |
Collapse
|
45
|
Tabor E, Pluskiewicz W, Tabor K. Clinical Conformity Between Heel Ultrasound and Densitometry in Postmenopausal Women: A Systematic Review. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2018; 37:363-369. [PMID: 28777482 DOI: 10.1002/jum.14340] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/02/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To assess the conformity between heel ultrasound and densitometry, and the clinical application of densitometry T-score "gold standard" in quantitative ultrasound as a method of osteoporosis diagnosis in postmenopausal women. METHODS The study is a systematic review of studies published in the last 17 years in PubMed, NLM Gateway, Medline, Embase, and Cochrane Library. Calcaneal quantitative ultrasound sensitivity and specificity were analyzed with regard to densitometry measurements in postmenopausal women. In addition, we summarized the values of ultrasound T-scores, for which their accuracy in osteoporosis diagnosis is the highest. RESULTS The inclusion criteria met 15 research studies conducted on postmenopausal women. In 11 of them, the authors concluded that clinical conformity between heel ultrasound and densitometry is good. The recommended quantitative ultrasound T-score for osteoporosis diagnosis ranged between -1 and -3.65. CONCLUSIONS Heel ultrasound should be considered to be as accurate as densitometry in diagnosing osteoporosis. Nevertheless, it needs to have separate T-score ranges determined, because those used in densitometry are not adequate.
Collapse
Affiliation(s)
- Elżbieta Tabor
- School of Medicine, Division of Dentistry, Doctoral Studies, Medical University of Silesia in Katowice, Poland
| | - Wojciech Pluskiewicz
- Medical University of Silesia in Katowice, School of Medicine with the Division of Dentistry, Metabolic Bone Diseases Unit, Department and Clinic of Internal Diseases, Diabetology and Nephrology, Zabrze, Poland
| | - Kamil Tabor
- School of Medicine, Division of Dentistry, Doctoral Studies, Medical University of Silesia in Katowice, Poland
| |
Collapse
|
46
|
Alomari AH, Wille ML, Langton CM. Bone volume fraction and structural parameters for estimation of mechanical stiffness and failure load of human cancellous bone samples; in-vitro comparison of ultrasound transit time spectroscopy and X-ray μCT. Bone 2018; 107:145-153. [PMID: 29198979 DOI: 10.1016/j.bone.2017.11.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Revised: 11/07/2017] [Accepted: 11/29/2017] [Indexed: 11/30/2022]
Abstract
Conventional mechanical testing is the 'gold standard' for assessing the stiffness (N mm-1) and strength (MPa) of bone, although it is not applicable in-vivo since it is inherently invasive and destructive. The mechanical integrity of a bone is determined by its quantity and quality; being related primarily to bone density and structure respectively. Several non-destructive, non-invasive, in-vivo techniques have been developed and clinically implemented to estimate bone density, both areal (dual-energy X-ray absorptiometry (DXA)) and volumetric (quantitative computed tomography (QCT)). Quantitative ultrasound (QUS) parameters of velocity and attenuation are dependent upon both bone quantity and bone quality, although it has not been possible to date to transpose one particular QUS parameter into separate estimates of quantity and quality. It has recently been shown that ultrasound transit time spectroscopy (UTTS) may provide an accurate estimate of bone density and hence quantity. We hypothesised that UTTS also has the potential to provide an estimate of bone structure and hence quality. In this in-vitro study, 16 human femoral bone samples were tested utilising three techniques; UTTS, micro computed tomography (μCT), and mechanical testing. UTTS was utilised to estimate bone volume fraction (BV/TV) and two novel structural parameters, inter-quartile range of the derived transit time (UTTS-IQR) and the transit time of maximum proportion of sonic-rays (TTMP). μCT was utilised to derive BV/TV along with several bone structure parameters. A destructive mechanical test was utilised to measure the stiffness and strength (failure load) of the bone samples. BV/TV was calculated from the derived transit time spectrum (TTS); the correlation coefficient (R2) with μCT-BV/TV was 0.885. For predicting mechanical stiffness and strength, BV/TV derived by both μCT and UTTS provided the strongest correlation with mechanical stiffness (R2=0.567 and 0.618 respectively) and mechanical strength (R2=0.747 and 0.736 respectively). When respective structural parameters were incorporated to BV/TV, multiple regression analysis indicated that none of the μCT histomorphometric parameters could improve the prediction of mechanical stiffness and strength, while for UTTS, adding TTMP to BV/TV increased the prediction of mechanical stiffness to R2=0.711 and strength to R2=0.827. It is therefore envisaged that UTTS may have the ability to estimate BV/TV along with providing an improved prediction of osteoporotic fracture risk, within routine clinical practice in the future.
Collapse
Affiliation(s)
- Ali Hamed Alomari
- Science & Engineering Faculty and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia; The University College in Al-Qunfudah, Umm Al-Qura University, Saudi Arabia
| | - Marie-Luise Wille
- Science & Engineering Faculty and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia
| | - Christian M Langton
- Science & Engineering Faculty and Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, QLD, Australia; Laboratory of Ultrasonic Electronics, Doshisha University, Kyotanabe, Japan.
| |
Collapse
|
47
|
Kabore FN, Eymard-Duvernay S, Zoungrana J, Badiou S, Bado G, Héma A, Diouf A, Delaporte E, Koulla-Shiro S, Ciaffi L, Cournil A. TDF and quantitative ultrasound bone quality in African patients on second line ART, ANRS 12169 2LADY sub-study. PLoS One 2017; 12:e0186686. [PMID: 29117238 PMCID: PMC5678709 DOI: 10.1371/journal.pone.0186686] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 10/03/2017] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Bone demineralization, which leads to osteoporosis and increased fracture risk, is a common metabolic disorder in HIV-infected individuals. In this study, we aimed to assess the change in bone quality using quantitative ultrasound (QUS) over 96 weeks of follow-up after initiation of second-line treatment, and to identify factors associated with change in bone quality. METHODS AND FINDINGS In a randomized trial (ANRS 12169), TDF and PI-naïve participants failing standard first-line treatment, from Burkina Faso, Cameroon, and Senegal were randomized to receive either TDF/FTC/LPVr, ABC/ddI/LPVr or TDF/FTC/DRVr. Their bone quality was assessed using calcaneal QUS at baseline and every 24 weeks until week 96. Stiffness index (SI) was used to measure bone quality. Out of 228 participants, 168 (74%) were women. At baseline, median age was 37 years (IQR: 33-46 years) and median T-CD4 count was 199 cells/μl (IQR: 113-319 cells/μl). The median duration of first-line antiretroviral treatment (ART) was 52 months (IQR: 36-72 months) and the median baseline SI was 101 (IQR: 87-116). In multivariable analysis, factors associated with baseline SI were sex (β = -10.8 [-18.1,-3.5] for women), age (β = -8.7 [-12.4,-5.1] per 10 years), body mass index (BMI) (β = +0.8 [0.1,1.5] per unit of BMI), and study site (β = +12.8 [6.5,19.1] for Cameroon). After 96 weeks of second-line therapy, a reduction of 7.1% in mean SI was observed, as compared with baseline. Factors associated with SI during the follow-up were similar to those found at baseline. Exposure to TDF was not associated with a greater loss of bone quality over time. CONCLUSION Bone quality decreased after second-line ART initiation in African patients independently of TDF exposure. Factors associated with bone quality include age, sex, baseline BMI, study site, and duration of follow-up.
Collapse
Affiliation(s)
| | - Sabrina Eymard-Duvernay
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, U1175-INSERM, University of Montpellier, Montpellier, France
| | - Jacques Zoungrana
- Department of Infectious Diseases, University Hospital Souro Sanou, Bobo-Dioulasso, Burkina Faso
| | - Stéphanie Badiou
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, U1175-INSERM, University of Montpellier, Montpellier, France
- Biochemistry Department, University Hospital, Montpellier, France
| | - Guillaume Bado
- Department of Infectious Diseases, University Hospital Souro Sanou, Bobo-Dioulasso, Burkina Faso
| | - Arsène Héma
- Department of Hospital Hygiene, University Hospital Souro Sanou, Bobo-Dioulasso, Burkina Faso
| | - Assane Diouf
- Centre Régional de Recherche et de Formation (CRCF), Dakar, Senegal
| | - Eric Delaporte
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, U1175-INSERM, University of Montpellier, Montpellier, France
- Department of Infectious Diseases, University Hospital, Montpellier, France
| | - Sinata Koulla-Shiro
- Servives des maladies infectieuses, Yaoundé central hospital, Yaoundé, Cameroon
- Faculté de Médecine et des Sciences Biomédicales, University of Yaoundé 1, Yaoundé, Cameroon
| | - Laura Ciaffi
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, U1175-INSERM, University of Montpellier, Montpellier, France
| | - Amandine Cournil
- Unité Mixte Internationale 233, Institut de Recherche pour le Développement, U1175-INSERM, University of Montpellier, Montpellier, France
| |
Collapse
|
48
|
Szmodis M, Zsákai A, Bosnyák E, Protzner A, Trájer E, Farkas A, Szőts G, Tóth M. Reference data for ultrasound bone characteristics in Hungarian children aged 7-19 years. Ann Hum Biol 2017; 44:704-714. [PMID: 29037074 DOI: 10.1080/03014460.2017.1390152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Backround: Osteoporosis is a common disease and physical activity (PA) has a favourable influence on bone status. AIM To establish normative data for calcaneal quantitative ultrasound (QUS) bone characteristics in children and to analyse the relationships between PA, anthropometric and bone parameters. SUBJECTS AND METHODS Hungarian children aged 7-19 (n = 2674; 1325 girls, 1349 boys) provided PA, anthropometric and bone data. QUS parameters were registered with Sonost3000 densitometer (speed of sound: SOS, m/s; broadband ultrasound attenuation: BUA, dB/MHz; bone quantity index (BQI = αSOS + βBUA). Reference centiles of QUS parameters were constructed by LMS method. Multivariate linear regression models were used to analyse the relationships. RESULTS QUS bone parameters increased with age. There were no gender differences, except in 11- and 19-year-old children, where boys showed higher values. SOS (1497.15 ± 15.72 vs 1494.05 ± 14.81 m/s) and BQI (65.31 ± 16.71 vs 62.26 ± 15.78) were higher in athletic children. The regression model revealed significant relations between SOS and age, relative muscle mass and PA; BUA correlated with gender, morphological age, BMI, relative muscle mass and PA. CONCLUSIONS Changes in the bone parameters among 7-19-year-old Hungarian children depended on age, anthropometric dimensions and the level of PA. The normative data could be used for monitoring QUS bone parameters in children, leading to more effective interventions for healthy bones.
Collapse
Affiliation(s)
- Márta Szmodis
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Annamária Zsákai
- b Department of Biological Anthropology , Eötvös Loránd University , Budapest , Hungary
| | - Edit Bosnyák
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Anna Protzner
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Emese Trájer
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Anna Farkas
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Gábor Szőts
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary
| | - Miklós Tóth
- a Department of Health Sciences and Sport Medicine , University of Physical Education , Budapest , Hungary.,c Department of Medical Chemistry , Semmmelweis University , Budapest , Hungary.,d Faculty of Health Sciences , University of Pécs , Pécs , Hungary
| |
Collapse
|
49
|
Jang DH, Da Silva E, Tavakkoli J, Slatkovska L, Cheung AM, Pejović-Milić A. Assessment of the effect of strontium, lead, and aluminum in bone on dual-energy x-ray absorptiometry and quantitative ultrasound measurements: A phantom study. Med Phys 2017; 45:81-91. [PMID: 29080282 DOI: 10.1002/mp.12641] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Revised: 09/13/2017] [Accepted: 09/14/2017] [Indexed: 11/11/2022] Open
Abstract
PURPOSE Dual-energy X-ray absorptiometry (DXA) is the gold standard technique to measure areal bone mineral density (aBMD) for the diagnosis of osteoporosis. Because DXA relies on the attenuation of photon to estimate aBMD, deposition of bone-seeking metallic elements such as strontium, lead, and aluminum that differ in atomic numbers from calcium can cause inaccurate estimation of aBMD. Quantitative ultrasound (QUS) is another technique available to assess bone health by measuring broadband ultrasound attenuation (BUA), speed of sound (SOS), and an empirically derived quantity called stiffness index (SI). Because the acoustic properties are not prone to significant change due to changes in microscopic atomic composition of bone, it is hypothesized that QUS is unaffected by the presence of bone-seeking elements in the bone. The objective of this study was to investigate the effect of strontium, lead, and aluminum on DXA-derived aBMD and QUS parameters using bone-mimicking phantoms compatible with both techniques. METHODS Bone-mimicking phantoms were produced by homogeneously mixing finely powdered hydroxyapatite compounds that contain varying concentrations of strontium, lead, or aluminum with porcine gelatin solution. Seven strontium-substituted phantoms were produced with varying molar ratio of Sr/(Sr + Ca) ranging from 0% to 2%. Four lead-doped phantoms and four aluminum-doped phantoms were constructed with the respective analyte concentrations ranging from 50 to 200 ppm. An additional 0 ppm phantom was produced to be used as a baseline for the lead and aluminum phantom measurements. All phantoms had uniform volumetric bone mineral density (vBMD) of 200 mg/cm3 , and were assessed using a Hologic Horizon® DXA device and a Hologic Sahara® QUS device. Furthermore, theoretical aBMD bias for mol/mol% substitution of calcium with the three bone-seeking elements was calculated. RESULTS Strong positive linear relationship was found between aBMD measured by DXA and strontium concentration (P < 0.001, r = 0.995). From the measurement of lead and aluminum phantoms using DXA, no statistically significant relationship was observed between aBMD and the analyte concentrations. For the QUS system, with an exception of BUA and lead concentration that exhibited statistically significant relationship (P < 0.038, r = 0.899), no statistically significant change was observed in all QUS parameters with respect to the clinically relevant concentration of all three elements. The calculated theoretical aBMD bias induced by 1 mol/mol% substitution of calcium with strontium, lead, and aluminum were 10.8%, 4.6%, and -0.7%, respectively. CONCLUSION aBMD measured by DXA was prone to overestimation in the presence of strontium, but acoustic parameters measured by QUS are independent of strontium concentration. The deviation in aBMD induced by the clinically relevant concentrations of lead and aluminum under 200 ppm could not be detected using the Hologic Horizon® DXA device. Furthermore, the SI measured by the QUS system was not affected by lead or aluminum concentrations used in this study.
Collapse
Affiliation(s)
- Deok Hyun Jang
- Department of Physics, Ryerson University, Toronto, ON, Canada
| | - Eric Da Silva
- Department of Physics, Ryerson University, Toronto, ON, Canada
| | - Jahan Tavakkoli
- Department of Physics, Ryerson University, Toronto, ON, Canada.,Institute for Biomedical Engineering, Science and Technology (iBEST), Keenan Research Centre for Biomedical Science, St. Michael's Hospital, Toronto, ON, Canada
| | - Lubomira Slatkovska
- Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Osteoporosis Program, University Health Network, Toronto, ON, Canada
| | - Angela M Cheung
- Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada.,Osteoporosis Program, University Health Network, Toronto, ON, Canada
| | | |
Collapse
|
50
|
Chin KY. A review on the performance of osteoporosis self-assessment tool for Asians in determining osteoporosis and fracture risk. Postgrad Med 2017; 129:734-746. [PMID: 28695762 DOI: 10.1080/00325481.2017.1353394] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
The prevalence of osteoporosis in Asian countries is growing. An effective screening method will enable patients at risk for osteoporosis to receive early diagnosis and treatment, and avoid overcrowding the limited dual-energy x-ray absorptiometry (DXA) machines available in Asian countries. Many simple osteoporosis screening algorithms have been developed but they are not validated for use in Asian populations. osteoporosis self-assessment tools for Asians (OSTA), established using a multinational Asian cohort, is the first screening algorithm that caters for the Asian populations. It considers only body weight and age in the algorithm. It shows consistently high performance and sensitivity in identifying postmenopausal women at risk for osteoporosis in many Asian countries. Its usage has been expanded for identifying osteoporosis in men, as well as determining fracture risk for both sexes. However, the performance of OSTA is influenced by age, sex, ethnicity and site of BMD measurement to define osteoporosis. Its usage is also limited in individuals without apparent risk factors. These limitations should be noted by physicians considering the use of OSTA in clinical setting. As a conclusion, OSTA is a cost-effective measure for osteoporosis screening in primary healthcare setting.
Collapse
Affiliation(s)
- Kok-Yong Chin
- a Department of Pharmacology , Universiti Kebangsaan Malaysia Medical Centre , Cheras , Malaysia
| |
Collapse
|