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Pan R, Wang R, Zhang Y, Ji H, Liang X, Zhao Y. The association of waist circumference with bone mineral density and risk of osteoporosis in US adult: National health and nutrition examination survey. Bone 2024; 185:117134. [PMID: 38821388 DOI: 10.1016/j.bone.2024.117134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 05/07/2024] [Accepted: 05/23/2024] [Indexed: 06/02/2024]
Abstract
PURPOSE Obesity and osteoporosis (OP) are receiving increasing attention. Waist circumference (WC) is an effective indicator for assessing central obesity. Currently, there is controversy regarding the relationship between WC and bone mineral density (BMD), as well as OP. Therefore, our study aims to utilize data from the National Health and Nutrition Examination Survey (NHANES) to evaluate the relationship between WC and BMD, as well as OP, in US adults. METHODS This cross-sectional study included subjects aged ≥18 years from the NHANES 1999-2018. Multivariate linear regression models were performed to investigate the association between WC and BMD. Multivariate logistic regression models were employed to assess the relationship between WC and OP. Restricted cubic spline curves were used to assess potential nonlinear association between WC and BMD, OP. Subgroup analysis and sensitivity analysis were performed to assess the robustness of the results. RESULTS Finally, 11,165 participants (non-OP, n = 10,465; OP, n = 700) were included in the final analysis. The results showed that WC was positively associated with total femur (TF), femoral neck (FN), and lumbar spine (LS) BMD, and might be a protective factor for OP, independent of traditional confounding factors. For each 1 cm increased in WC, TF BMD, FN BMD and LS BMD increased by 0.004 g/cm2, 0.003 g/cm2 and 0.003 g/cm2, respectively, and the risk of OP decreased by 3.1 %. Furthermore, there was a non-linear relationship between WC and BMD, OP. The association remained robust in sensitivity and subgroup analyses. CONCLUSION In US adults, there is a positive association between WC and BMD, and WC may be a protective factor for the risk of OP. The association between WC and BMD as well as OP exhibits a non-linear relationship.
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Affiliation(s)
- Runzhou Pan
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China.
| | - Rongrong Wang
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Yan Zhang
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Hong Ji
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Xue Liang
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
| | - Yongcai Zhao
- Department of Endocrinology, Cangzhou Central Hospital, Cangzhou, Hebei Province, China
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Weng Z, Ye J, Cai C, Liu Z, Liu Y, Xu Y, Yuan J, Zhang W, Liu L, Jiang J, Cheng X, Wang X. Inflammatory microenvironment regulation and osteogenesis promotion by bone-targeting calcium and magnesium repletion nanoplatform for osteoporosis therapy. J Nanobiotechnology 2024; 22:314. [PMID: 38840113 PMCID: PMC11151641 DOI: 10.1186/s12951-024-02581-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/24/2024] [Indexed: 06/07/2024] Open
Abstract
Osteoporosis is the most common bone metabolic disease that affects the health of middle-aged and elderly people, which is hallmarked by imbalanced bone remodeling and a deteriorating immune microenvironment. Magnesium and calcium are pivotal matrix components that participate in the bone formation process, especially in the immune microenvironment regulation and bone remodeling stages. Nevertheless, how to potently deliver magnesium and calcium to bone tissue remains a challenge. Here, we have constructed a multifunctional nanoplatform composed of calcium-based upconversion nanoparticles and magnesium organic frameworks (CM-NH2-PAA-Ald, denoted as CMPA), which features bone-targeting and pH-responsive properties, effectively regulating the inflammatory microenvironment and promoting the coordination of osteogenic functions for treating osteoporosis. The nanoplatform can efficaciously target bone tissue and gradually degrade in response to the acidic microenvironment of osteoporosis to release magnesium and calcium ions. This study validates that CMPA possessing favorable biocompatibility can suppress inflammation and facilitate osteogenesis to treat osteoporosis. Importantly, high-throughput sequencing results demonstrate that the nanoplatform exerts a good inflammatory regulation effect through inhibition of the nuclear factor kappa-B signaling pathway, thereby normalizing the osteoporotic microenvironment. This collaborative therapeutic strategy that focuses on improving bone microenvironment and promoting osteogenesis provides new insight for the treatment of metabolic diseases such as osteoporosis.
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Affiliation(s)
- Zhenzhen Weng
- Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Jing Ye
- Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Changxiong Cai
- Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Zikang Liu
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Yuanyuan Liu
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Yingying Xu
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Jinghong Yuan
- Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Wei Zhang
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Lubing Liu
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Junkai Jiang
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China
| | - Xigao Cheng
- Department of Orthopaedics, The Second Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China.
| | - Xiaolei Wang
- School of Chemistry and Chemical Engineering, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China.
- The National Engineering Research Center for Bioengineering Drugs and the Technologies, Institute of Translational Medicine, Nanchang University, Nanchang, 330088, Jiangxi, P. R. China.
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Castoldi NM, Pickering E, Sansalone V, Cooper D, Pivonka P. Bone turnover and mineralisation kinetics control trabecular BMDD and apparent bone density: insights from a discrete statistical bone remodelling model. Biomech Model Mechanobiol 2024; 23:893-909. [PMID: 38280951 PMCID: PMC11101591 DOI: 10.1007/s10237-023-01812-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/22/2023] [Indexed: 01/29/2024]
Abstract
The mechanical quality of trabecular bone is influenced by its mineral content and spatial distribution, which is controlled by bone remodelling and mineralisation. Mineralisation kinetics occur in two phases: a fast primary mineralisation and a secondary mineralisation that can last from several months to years. Variations in bone turnover and mineralisation kinetics can be observed in the bone mineral density distribution (BMDD). Here, we propose a statistical spatio-temporal bone remodelling model to study the effects of bone turnover (associated with the activation frequency Ac . f ) and mineralisation kinetics (associated with secondary mineralisation T sec ) on BMDD. In this model, individual basic multicellular units (BMUs) are activated discretely on trabecular surfaces that undergo typical bone remodelling periods. Our results highlight that trabecular BMDD is strongly regulated by Ac . f and T sec in a coupled way. Ca wt% increases with lower Ac . f and short T sec . For example, aAc . f = 4 BMU/year/mm3 and T sec = 8 years result in a mean Ca wt% of 25, which is in accordance with Ca wt% values reported in quantitative backscattered electron imaging (qBEI) experiments. However, for lower Ac . f and shorter T sec (from 0.5 to 4 years) one obtains a high Ca wt% and a very narrow skew BMDD to the right. This close link between Ac . f and T sec highlights the importance of considering both characteristics to draw meaningful conclusion about bone quality. Overall, this model represents a new approach to modelling healthy and diseased bone and can aid in developing deeper insights into disease states like osteoporosis.
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Affiliation(s)
- Natalia M Castoldi
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia.
- UMR 8208, MSME, Univ Paris Est Creteil, Univ Gustave Eiffel, CNRS, Créteil, France.
| | - Edmund Pickering
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia
- Centre for Biomedical Technologies, Queensland University of Technology, Brisbane, Australia
| | - Vittorio Sansalone
- UMR 8208, MSME, Univ Paris Est Creteil, Univ Gustave Eiffel, CNRS, Créteil, France
| | - David Cooper
- Department of Anatomy Physiology and Pharmacology, College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Peter Pivonka
- School of Mechanical, Medical and Process Engineering, Queensland University of Technology, Brisbane, Australia.
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Lorentzon M, Litsne H, Axelsson KF. The significance of recent fracture location for imminent risk of hip and vertebral fractures-a nationwide cohort study on older adults in Sweden. Osteoporos Int 2024; 35:1077-1087. [PMID: 38521820 PMCID: PMC11136805 DOI: 10.1007/s00198-024-07072-x] [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: 01/15/2024] [Accepted: 03/15/2024] [Indexed: 03/25/2024]
Abstract
The role of recent fracture site in predicting the most detrimental subsequent fractures, hip and vertebral, is unclear. This study found that most recent fracture sites were associated with an increased risk of both hip and vertebral fracture, a finding that may impact the design of secondary prevention programs. BACKGROUND Hip and vertebral fractures are the most serious in terms of associated morbidity, mortality, and societal costs. There is limited evidence as to which fracture types are associated with the highest risk for subsequent hip and vertebral fractures. This study aims to explore the dependency of imminent hip and vertebral fracture risk on the site of the recent index fracture. METHODS Conducted as a nationwide retrospective cohort study, we utilized Swedish national registers to assess the risk of hip and vertebral fractures based on the site of the recent (≤ 2 years) index fracture and an old (> 2 years) prevalent fracture. This risk was compared to that observed in individuals without any prevalent fractures. This study encompassed all Swedes aged 50 years and older between 2007 and 2010. Patients with a recent fracture were categorized into specific groups based on the type of their previous fracture and were followed until December 2017, with censoring for death and migration. The study assessed the risk of hip and vertebral fractures during the follow-up period. RESULTS The study included a total of 3,423,320 individuals, comprising 145,780 with a recent fracture, 293,051 with an old fracture, and 2,984,489 without a previous fracture. The median follow-up times for the three groups were 7.6 years (IQR 4.0-9.1), 7.9 years (5.8-9.2), and 8.5 years (7.4-9.7), respectively. Patients with a recent fracture at almost all sites exhibited a significantly increased risk of hip fracture and an elevated risk of vertebral fracture compared to controls. Patients with recent fractures had an increased risk of subsequent hip and vertebral fractures, regardless of the index fracture site. These results strengthen the notion that all patients with a recent fracture, regardless of fracture site, should be included in secondary prevention programs, to improve the prevention of the clinically most serious fractures.
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Affiliation(s)
- Mattias Lorentzon
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Litsne
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kristian F Axelsson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
- Region Västra Götaland, Närhälsan Norrmalm Health Centre, Skövde, Sweden.
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5
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Li CC, Liu IT, Cheng TT, Liang FW, Sun ZJ, Chang YF, Chang CS, Yang YC, Lu TH, Kuo LC, Wu CH. Decomposing and simplifying the Fracture Risk Assessment Tool-a module from the Taiwan-specific calculator. JBMR Plus 2024; 8:ziae039. [PMID: 38644977 PMCID: PMC11032218 DOI: 10.1093/jbmrpl/ziae039] [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: 11/21/2023] [Revised: 02/26/2024] [Accepted: 03/08/2024] [Indexed: 04/23/2024] Open
Abstract
The Fracture Risk Assessment Tool (FRAX®) is a widely utilized country-specific calculator for identifying individuals with high fracture risk; its score is calculated from 12 variables, but its formulation is not publicly disclosed. We aimed to decompose and simplify the FRAX® by utilizing a nationwide community survey database as a reference module for creating a local assessment tool for osteoporotic fracture community screening in any country. Participants (n = 16384; predominantly women (75%); mean age = 64.8 years) were enrolled from the Taiwan OsteoPorosis Survey, a nationwide cross-sectional community survey collected from 2008 to 2011. We identified 11 clinical risk factors from the health questionnaires. BMD was assessed via dual-energy X-ray absorptiometry in a mobile DXA vehicle, and 10-year fracture risk scores, including major osteoporotic fracture (MOF) and hip fracture (HF) risk scores, were calculated using the FRAX®. The mean femoral neck BMD was 0.7 ± 0.1 g/cm2, the T-score was -1.9 ± 1.2, the MOF was 8.9 ± 7.1%, and the HF was 3.2 ± 4.7%. Following FRAX® decomposition with multiple linear regression, the adjusted R2 values were 0.9206 for MOF and 0.9376 for HF when BMD was included and 0.9538 for MOF and 0.9554 for HF when BMD was excluded. The FRAX® demonstrated better prediction for women and younger individuals than for men and elderly individuals after sex and age stratification analysis. Excluding femoral neck BMD, age, sex, and previous fractures emerged as 3 primary clinical risk factors for simplified FRAX® according to the decision tree analysis in this study population. The adjusted R2 values for the simplified country-specific FRAX® incorporating 3 premier clinical risk factors were 0.8210 for MOF and 0.8528 for HF. After decomposition, the newly simplified module provides a straightforward formulation for estimating 10-year fracture risk, even without femoral neck BMD, making it suitable for community or clinical osteoporotic fracture risk screening.
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Affiliation(s)
- Chia-Chun Li
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
- Department of Family Medicine, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
| | - I-Ting Liu
- Department of Family Medicine, E-DA Hospital, 824 Kaohsiung, Taiwan
- Department of Geriatric Medicine, E-DA Hospital, 824 Kaohsiung, Taiwan
- School of Medicine, College of Medicine, I-Shou University, 840 Kaohsiung, Taiwan
| | - Tien-Tsai Cheng
- Division of Rheumatology, Allergy and Immunology, Kaohsiung Chang Gung Memorial Hospital, 833 Kaohsiung, Taiwan
| | - Fu-Wen Liang
- Department of Public Health, College of Health Sciences, Kaohsiung Medical University, 807 Kaohsiung, Taiwan
| | - Zih-Jie Sun
- Division of Family Medicine, National Cheng Kung University Hospital Dou Liu Branch, 640 Yunlin, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 704 Tainan, Taiwan
| | - Yin-Fan Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 704 Tainan, Taiwan
| | - Chin-Sung Chang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 704 Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 704 Tainan, Taiwan
| | - Tsung-Hsueh Lu
- Department of Public Health, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
| | - Li-Chieh Kuo
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
- Department of Occupational Therapy, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
| | - Chih-Hsing Wu
- Department of Family Medicine, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 704 Tainan, Taiwan
- Institute of Gerontology, College of Medicine, National Cheng Kung University, 701 Tainan, Taiwan
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6
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Kim S, Jang S, Lee O. Simultaneous visualization of micro-damage in cortical bone, trabecular bone, and intracortical vasculature for diagnosing osteoporosis: An animal model synchrotron imaging. Microsc Res Tech 2024; 87:695-704. [PMID: 37983745 DOI: 10.1002/jemt.24457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 10/24/2023] [Accepted: 11/04/2023] [Indexed: 11/22/2023]
Abstract
Osteoporosis (OP) is difficult to diagnose through the three-dimensional visualization of micro-damage. In this study, aimed to make an objective diagnosis by visualizing micro-damage caused by OP using synchrotron radiation-based μCT (SR-μCT). Female mice (n = 12) were randomly divided into an ovariectomized group (OVX, n = 6) in which both ovaries were excised and OP occurred, and a sham-operated group (SHAM, n = 6). After six weeks, all femurs (left and right) were excised from both groups (n = 12 per group). Thereafter, femurs were randomly divided into SR-μCT (OVX group, n = 6; SHAM group, n = 6) and μCT (OVX group, n = 6; SHAM group, n = 6) groups. In the SR-μCT group, micro-damage was visualized by manually segmenting the cortical bone, trabecular bone, and intracortical vasculature using a water-shedding algorithm. In addition, trabecular bone was obtained by automatic segmentation using μCT. Cortical bone volume/total volume was greater (p = .015), and cortical thickness was greater in the SHAM group than in the OVX group (p = .007). Among the trabecular bone parameters, the bone volume/total volume (TV) in OVX was significantly lower than that in the SHAM group (p = .012). The canal volume was greater (p = .021) and lacuna volume was greater (p < .001) in the SHAM group than in the OVX group. We expect that it will be possible to analyze damage and recovery mechanisms in the field of rehabilitation. SR-μCT has been proposed as an objective method for OP diagnosis as it allows the visualization of microstructures. RESEARCH HIGHLIGHTS: Damage mechanism for diagnosis and evaluation in an osteoporosis model. Synchrotron radiation can objectively diagnose osteoporosis. Visualization is possible by segmenting microdamage caused by osteoporosis.
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Affiliation(s)
- Subok Kim
- Department of Software Convergence, Graduate School, Soonchunhyang University, Asan, Republic of Korea
| | - Sanghun Jang
- Department of Physical Therapy, College of Health and Life Sciences, Korea National University of Transportation, Jeungpyeong-gun, Republic of Korea
| | - Onseok Lee
- Department of Software Convergence, Graduate School, Soonchunhyang University, Asan, Republic of Korea
- Department of Medical IT Engineering, College of Medical Sciences, Soonchunhyang University, Asan, Republic of Korea
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Chen Y, Yang C, Deng Z, Xiang T, Ni Q, Xu J, Sun D, Luo F. Gut microbially produced tryptophan metabolite melatonin ameliorates osteoporosis via modulating SCFA and TMAO metabolism. J Pineal Res 2024; 76:e12954. [PMID: 38618998 DOI: 10.1111/jpi.12954] [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: 03/03/2024] [Revised: 03/22/2024] [Accepted: 03/29/2024] [Indexed: 04/16/2024]
Abstract
Osteoporosis (OP) is a severe global health issue that has significant implications for productivity and human lifespan. Gut microbiota dysbiosis has been demonstrated to be closely associated with OP progression. Melatonin (MLT) is an important endogenous hormone that modulates bone metabolism, maintains bone homeostasis, and improves OP progression. Multiple studies indicated that MLT participates in the regulation of intestinal microbiota and gut barrier function. However, the promising effects of gut microbiota-derived MLT in OP remain unclear. Here, we found that OP resulted in intestinal tryptophan disorder and decreased the production of gut microbiota-derived MLT, while administration with MLT could mitigate OP-related clinical symptoms and reverse gut microbiota dysbiosis, including the diversity of intestinal microbiota, the relative abundance of many probiotics such as Allobaculum and Parasutterella, and metabolic function of intestinal flora such as amino acid metabolism, nucleotide metabolism, and energy metabolism. Notably, MLT significantly increased the production of short-chain fatty acids and decreased trimethylamine N-oxide-related metabolites. Importantly, MLT could modulate the dynamic balance of M1/M2 macrophages, reduce the serum levels of pro-inflammatory cytokines, and restore gut-barrier function. Taken together, our results highlighted the important roles of gut microbially derived MLT in OP progression via the "gut-bone" axis associated with SCFA metabolism, which may provide novel insight into the development of MLT as a promising drug for treating OP.
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Affiliation(s)
- Yueqi Chen
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
- Department of Orthopedics, Chinese PLA 76th Army Corps Hospital, Beijing, Xining, China
| | - Chuan Yang
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
- Department of Biomedical Materials Science, Third Military Medical University, Chongqing, China
| | - Zihan Deng
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Tingwen Xiang
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Qingrong Ni
- Department of Dermatology, Air Force Medical Center, Fourth Military Medical University, Beijing, China
| | - Jianzhong Xu
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Dong Sun
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Fei Luo
- Department of Orthopedics, Southwest Hospital, Third Military Medical University, Chongqing, China
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8
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Andreasen C, Dahl C, Solberg LB, Borgen TT, Wisløff T, Gjertsen JE, Figved W, Stutzer JM, Nissen FI, Nordsletten L, Frihagen F, Bjørnerem Å, Omsland TK. Epidemiology of forearm fractures in women and men in Norway 2008-2019. Osteoporos Int 2024; 35:625-633. [PMID: 38085341 PMCID: PMC10957687 DOI: 10.1007/s00198-023-06990-6] [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: 03/27/2023] [Accepted: 11/24/2023] [Indexed: 03/22/2024]
Abstract
The purpose of this paper is to describe rates of forearm fractures in adults in Norway 2008-2019. Incidence rate of distal forearm fractures declined over time in both sexes. Forearm fracture constitute a significant health burden and prevention strategies are needed. PURPOSE To assess age- and sex-specific incidence rates, and time trends for forearm fractures in Norway, and compare these with incidence rates in other Nordic countries. METHODS Data on all patients aged 20-107 years with forearm fractures treated in Norwegian hospitals from 2008 to 2019 was retrieved from the Norwegian Patient Registry. Fractures were identified based on International Classification of Disease 10th revision code S52. Age- and sex-specific incidence rates and changes in incidence rates were calculated. RESULTS We identified 181,784 forearm fractures in 45,628,418 person-years. Mean annual forearm fracture incidence rates per 100,000 person-years were 398 (95% CI 390-407) for all, 565 (95% CI 550-580) for women, and 231 (95% CI 228-234) for men above 20 years. Mean annual number of forearm fractures was 15,148 (95% CI 14,575-15,722). From 2008 to 2019, age-adjusted total incidence rates of forearm fractures S52 diagnoses declined by 3.5% (incidence rate ratio (IRR) of 0.997 (95% CI 0.994-0.999)) in men. The corresponding decline in women was not significant (IRR: 0.999 (95% CI 0.997-1.002)). In the same period, the age-adjusted incidence rates of distal forearm fractures declined by 7.0% in men (IRR = 0.930; 95% CI 0.886-0.965) and 4.7% in women (IRR = 0.953; 95% CI 0.919-0.976). The incidence rates of distal forearm fractures were similar to rates in Sweden and Finland. CONCLUSION Age-adjusted incidence rates of distal forearm fractures in both sexes declined over time.
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Affiliation(s)
- Camilla Andreasen
- Department of Orthopaedic Surgery, University Hospital of North Norway, 9038, Tromsø, Norway.
- Department of Clinical Medicine, UiT The Arctic University of Norway, Post Office Box 6050, 9037, Langnes, Tromsø, Norway.
| | - Cecilie Dahl
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318, Oslo, Norway
| | - Lene B Solberg
- Division of Orthopaedic Surgery, Oslo University Hospital, 0424, Oslo, Norway
| | - Tove T Borgen
- Department of Rheumatology, Vestre Viken Hospital Trust, Drammen Hospital, 3004, Drammen, Norway
| | - Torbjørn Wisløff
- Health Services Research Unit, Akershus University Hospital, 1478, Lørenskog, Norway
| | - Jan-Erik Gjertsen
- Department of Orthopaedic Surgery, Haukeland University Hospital, 5021, Bergen, Norway
- Department of Clinical Medicine, University of Bergen, 5007, Bergen, Norway
| | - Wender Figved
- Department of Orthopaedic Surgery, Vestre Viken Hospital Trust, Bærum Hospital, 1346, Gjettum, Norway
- Institute of Clinical Medicine, University of Oslo, 0372, Oslo, Norway
| | - Jens M Stutzer
- Department of Orthopaedic Surgery, Møre and Romsdal Hospital Trust, Hospital of Molde, 6412, Molde, Norway
| | - Frida I Nissen
- Department of Orthopaedic Surgery, University Hospital of North Norway, 9038, Tromsø, Norway
- Department of Clinical Medicine, UiT The Arctic University of Norway, Post Office Box 6050, 9037, Langnes, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, 9037, Tromsø, Norway
| | - Lars Nordsletten
- Division of Orthopaedic Surgery, Oslo University Hospital, 0424, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, 0372, Oslo, Norway
| | - Frede Frihagen
- Institute of Clinical Medicine, University of Oslo, 0372, Oslo, Norway
- Department of Orthopaedic Surgery, Østfold Hospital Trust, 1714, Grålum, Norway
| | - Åshild Bjørnerem
- Department of Clinical Medicine, UiT The Arctic University of Norway, Post Office Box 6050, 9037, Langnes, Tromsø, Norway
- Department of Obstetrics and Gynaecology, University Hospital of North Norway, 9037, Tromsø, Norway
- Norwegian Research Centre for Women's Health, Oslo University Hospital, 0424, Oslo, Norway
| | - Tone K Omsland
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, 0318, Oslo, Norway
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9
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Al Zadjali F, Brooks J, O'Neill TW, Stanmore E. Experiences of postmenopausal osteoporosis: a narrative review. Disabil Rehabil 2024; 46:828-840. [PMID: 36705072 DOI: 10.1080/09638288.2023.2169770] [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: 02/16/2022] [Revised: 01/11/2023] [Accepted: 01/13/2023] [Indexed: 01/28/2023]
Abstract
PURPOSE A narrative review was conducted to identify, critically appraise, and synthesise primary research on the lived experiences of postmenopausal women with osteoporosis. MATERIALS AND METHODS A systematic search of qualitative studies published between January 1960 and August 2021 was conducted across seven databases. The selected qualitative studies reported the lived experiences of postmenopausal women with osteoporosis, both with and without a history of fragility fractures. RESULTS A total of 17 publications (n = 334) were identified. These results suggest that osteoporosis and fragility fractures significantly affected postmenopausal women's lives. They reported difficulties in carrying out daily activities due to pain and change in their routines to cope with health problems. Some women were satisfied with the information provided by healthcare professionals. Their medicine adherence was also determined by their belief in the importance of their scheduled treatment for osteoporosis. CONCLUSION Qualitative studies that explored the lived experiences of postmenopausal women with osteoporosis can provide important insights into the impact of the disease on women's lives and potential pathways for improving care and management.Implications for rehabilitationOsteoporosis and fragility fractures affect the quality of life of postmenopausal women worldwide.The provision of targeted and tailored health information for postmenopausal women with osteoporosis is paramount in improving their health literacy and aiding in the long-term management of their bone health.What is already knownOsteoporosis and related fragility fractures are common, affecting more than 200 million people worldwide, including three million people in the UK.Osteoporotic fractures have significant clinical and public health impacts.What this study addsOsteoporosis, particularly fragility fractures, has a significant impact on the lives of postmenopausal women, including pain and functional impairment.Women's belief in the importance of their scheduled treatment plays a significant role in their concordance with the prescribed medications for osteoporosis.Provision of targeted health information for postmenopausal women with osteoporosis is key to their involvement in decision-making and disease management.
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Affiliation(s)
- Faiza Al Zadjali
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Jane Brooks
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, University of Manchester, Manchester, UK
- Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, UK
- NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester, UK
| | - Emma Stanmore
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester, UK
- School of Health Sciences, Division of Nursing, Midwifery and Social Work, University of Manchester, Manchester Academic Health Science Centre (MAHSC), Manchester, UK
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10
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Hoehmann CL, Mubin NF, Hinnenkamp G, Modica EJ, Eckardt PA, Cuellar JC. Predicting Instability Risk Following Hemiarthroplasty for Femoral Neck Hip Fractures in Geriatric Patients. J Arthroplasty 2024; 39:708-715. [PMID: 37776983 DOI: 10.1016/j.arth.2023.09.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 09/18/2023] [Accepted: 09/25/2023] [Indexed: 10/02/2023] Open
Abstract
BACKGROUND Although a rare complication, dislocation following hemiarthroplasty (HA) for a femoral neck hip fracture is associated with increased mortality, readmission, and possible revision surgery. To date many of the specific risk factors have been difficult to demonstrate. Patient factors, surgical factors, as well as morphological factors need to be assessed. Therefore, the purpose of this study was to elucidate the risk factors for dislocation of HA following femoral neck hip fractures in the geriatric population. METHODS This was a retrospective review of 270 patients who had hip fractures. Medical records between the years 2016 and 2022 informed binomial regression predictive models. The discriminative ability of variables in the final model and acetabular anteversion to predict dislocation was assessed with area under the curve (AUC) estimates. RESULTS Center edge angle (odds ratio 1.23), abduction angle (odds ratio 1.17), and depth width ratio (2.96e-11) were significant predictors of dislocation (P = .003, .028, and <.001, respectively). Center edge angle and depth width ratio (<44.1 ° and .298), respectively, were cut scores for risk. Dementia had a high discriminative of ability, as did men (AUC = 0.617, 0.558, respectively). Acetabular anteversion was not predictive of dislocation (P = .259) and theorized anteversion safe zones had poor discriminative ability with AUCs of 0.510 and 0.503, respectively. CONCLUSIONS Morphological factors related to hip dysplasia and a shallow acetabulum, which can be assessed with a radiograph alone, were found to be predictors of instability following HA in the elderly. Hemiarthroplasty implant design and manufacturer, and also acetabular version did not contribute to instability risk.
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Affiliation(s)
- Christopher L Hoehmann
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, New York
| | - Nailah F Mubin
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, New York
| | - Glyn Hinnenkamp
- Department of Orthopaedic Surgery, Nassau University Medical Center, East Meadow, New York
| | - Edward J Modica
- Department of Medicine, New York Institute of Technology College of Osteopathic Medicine, Old Westbury, New York
| | | | - John C Cuellar
- Department of Orthopaedic Surgery, Good Samaritan Hospital, West Islip, New York
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11
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Scotcher M, Uren N, Qureshi A, Hancock N, Round J. Fracture-related infection in revision proximal femoral intramedullary nails. Injury 2024; 55:111338. [PMID: 38281349 DOI: 10.1016/j.injury.2024.111338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 01/04/2024] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
BACKGROUND The proximal femoral nail is a commonly used fixation device for extra-capsular neck of femur fractures at our UK NHS Trust. Fracture-related infection (FRI) is a catastrophic complication that can be associated with internal fixation. FRI is often diagnosed late, and causes significant impact on the patient and healthcare system, leading to extended hospital stays, reduced quality of life, high healthcare costs and increased mortality and morbidity. AIM This study aims to evaluate whether failed proximal femoral nails treated at a major trauma centre in the United Kingdom are undergoing routine intraoperative microbiology sampling, as outlined by the FRI Consensus Group in 2020, and also to establish how often fracture-related infection is present in failed proximal femoral nails. METHOD Electronic patient record systems were reviewed over a 4-year period between 2018-2022 to identify patients who had a proximal femoral nailing, and those who required revision surgery. From this cohort, we then identified whether sampling had taken place during revision surgery, and the number of samples taken. RESULTS 1041 proximal femoral nails were performed at our trust during the 4-year period. 60 of these implants failed, with 52 of these undergoing revision surgery at our hospital. Only 56% cases had intra-operative samples taken for microbiology testing, with an average of 9 samples sent per case. Intra-operative sampling confirmed infection in 25% of cases with samples sent. Of the cases requiring ≥ 3 operations, 75% of cases had confirmed infection. DISCUSSION The data shows that more can be done to ensure earlier diagnosis of fracture-related infection in failed proximal femoral nails. We should have a high suspicion of FRI in this cohort of patients. This study highlights the importance of a standardised protocol to ensure routine intra-operative sampling during proximal femoral nail revision surgery.
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Affiliation(s)
- Megan Scotcher
- Department of Trauma & Orthopaedics, University Hospitals Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK.
| | - Nicholas Uren
- Department of Trauma & Orthopaedics, University Hospitals Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
| | - Amir Qureshi
- Department of Trauma & Orthopaedics, University Hospitals Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
| | - Nick Hancock
- Department of Trauma & Orthopaedics, University Hospitals Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
| | - Joanne Round
- Department of Trauma & Orthopaedics, University Hospitals Southampton, Tremona Road, Southampton, Hampshire, SO16 6YD, UK
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12
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Li HL, Shen Y, Tan LH, Fu SB, Guan CH, Zhen DH, Lv HH, Wu XY, Tang XL. Association between BMI and osteoporotic fractures at different sites in Chinese women: a case-control retrospective study in Changsha. BMC Musculoskelet Disord 2024; 25:187. [PMID: 38424521 PMCID: PMC10903060 DOI: 10.1186/s12891-024-07271-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 02/08/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND Osteoporotic fractures are a growing problem in an aging society. The association between body mass index (BMI) and osteoporotic fractures varies by fracture site and ethnicity. Limited knowledge exists regarding this association in native Chinese, particularly utilizing local databases as reference sources. OBJECTIVE To investigate the association between BMI and osteoporotic fractures at different sites in Chinese women. METHODS Three thousand ninety-eight female patients with radiographic fractures and 3098 age- and sex-matched healthy controls without fractures were included in the study. Both of them underwent assessment using dual-energy X-ray absorptiometry (DXA), with BMD measurements calculated using our own BMD reference database. Participants were classified into underweight (BMI < 18.5 kg/m2), normal weight (18.5 ≤ BMI < 24.0 kg/m2), overweight (24 ≤ BMI < 28 kg/m2) and obese (BMI ≥ 28 kg/m2) according to the Chinese BMI classification standard. RESULTS There were 2296 (74.1%) vertebral fractures, 374 (12.1%) femoral neck fractures, and 428 (13.8%) other types of fractures in the case group. Bone mineral density (BMD) was almost lower in the fracture groups compared to the control groups (p = 0.048 to < 0.001). Compared with normal weight, underweight had a protective effect on total [odds ratio (OR) = 0.61; 95% confidence interval (CI), 0.49 -0.75; P< 0.001], and lumbar fractures (OR = 0.52; 95% CI, 0.41 - 0.67; P < 0.001), while obesity was associated with an increased risk for total (OR = 2.26; 95% CI, 1.85 - 2.76; P < 0.001), lumbar (OR = 2.17; 95% CI, 1.72 - 2.73; P < 0.001), and femoral neck fractures (OR = 4.08; 95% CI, 2.18 - 7.63; P < 0.001). Non-linear associations were observed between BMI and fractures: A J-curve for total, lumbar, and femoral neck fractures, and no statistical change for other types of fractures. Underweight was found to be a risk factor for other types of fracturess after adjusting for BMD (OR = 2.29; 95% CI, 1.09 - 4.80; P < 0.001). Osteoporosis and osteopenia were identified as risk factors for almost all sites of fracture when compared to normal bone mass. CONCLUSIONS Underweight has a protective effect on total and lumbar spine fractures in Chinese women, while obesity poses a risk factor for total, lumbar, and femoral neck fractures. The effect of BMI on fractures may be mainly mediated by BMD.
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Affiliation(s)
- Hong-Li Li
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 DongGang West Road, Lanzhou, Gansu, 730000, PR China
- Department of Metabolism and Endocrinology, and Hunan Provincial Key Laboratory for Metabolic Bone Diseases, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha, Hunan, 410011, PR China
| | - Yi Shen
- Department of Orthopaedics, The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha, Hunan, 410011, PR China
| | - Li-Hua Tan
- Department of Radiology, The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha, Hunan, 410011, PR China
| | - Song-Bo Fu
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 DongGang West Road, Lanzhou, Gansu, 730000, PR China
| | - Cong-Hui Guan
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 DongGang West Road, Lanzhou, Gansu, 730000, PR China
| | - Dong-Hu Zhen
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 DongGang West Road, Lanzhou, Gansu, 730000, PR China
| | - Hai-Hong Lv
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 DongGang West Road, Lanzhou, Gansu, 730000, PR China
| | - Xi-Yu Wu
- Department of Metabolism and Endocrinology, and Hunan Provincial Key Laboratory for Metabolic Bone Diseases, National Clinical Research Center for Metabolic Diseases, The Second Xiangya Hospital, Central South University, No.139 Middle Renmin Road, Changsha, Hunan, 410011, PR China.
| | - Xu-Lei Tang
- Department of Endocrinology, The First Hospital of Lanzhou University, No.1 DongGang West Road, Lanzhou, Gansu, 730000, PR China.
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Guyan F, Gianduzzo E, Waltenspül M, Dietrich M, Kabelitz M. Cortical Thickness Index and Canal Calcar Ratio: A Comparison of Proximal Femoral Fractures and Non-Fractured Femora in Octogenarians to Centenarians. J Clin Med 2024; 13:981. [PMID: 38398294 PMCID: PMC10889276 DOI: 10.3390/jcm13040981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 01/26/2024] [Accepted: 02/06/2024] [Indexed: 02/25/2024] Open
Abstract
Background: The cortical thickness index (CTI) is a measure of bone quality and it correlates with the risk of proximal femoral fractures. The purpose of this study was to investigate the CTI in femoral neck, trochanteric fractures and non-fractured femora in geriatric patients and to determine whether there is a correlation between the CTI and the presence of a fracture. Methods: One hundred and fifty patients (fifty femoral neck- (FNFx), fifty trochanteric fractures (TFx) and fifty non-fractured (NFx)) with a mean age of 91 (range 80-104) years were included. Hip radiographs (antero-posterior (ap), lateral) were evaluated retrospectively. Measurements on the proximal femoral inner and outer cortices, including CTI and Dorr's canal calcar ratio (CCR), were assessed for inter-observer reliability (ICC), differences of each fracture and correlation of parameters. Results: The mean ap CTI on the affected side was 0.43, 0.45 and 0.55 for FNFx, TFx and NFx, respectively. There was a significant difference of the ap CTI and CCR comparing the injured and healthy side for both fracture cohorts (p < 0.001). Patients with FNFx or TFx had significantly lower CTI on both sides compared to the NFx group (p < 0.05). There was no difference for CTI (p = 0.527) or CCR (p = 0.291) when comparing both sides in the NFx group. The mean inter-observer reliability was good to excellent (ICC 0.88). Conclusions: In proximal femoral fractures, the CTI and CCR are reduced compared with those in non-fractured femora. Both parameters are reliable and show a good correlation in geriatric patients. Therefore, especially for geriatric patients, the CTI and CCR may help to predict fracture risk and consult patients in daily practice.
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Affiliation(s)
| | | | | | | | - Method Kabelitz
- Clinic for Orthopaedics, Hand Surgery and Trauma Surgery, Stadtspital Zürich, Tièchestrasse 99, 8037 Zürich, Switzerland; (F.G.); (E.G.)
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14
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Liu J, Gao Z, Liu X. Mitochondrial dysfunction and therapeutic perspectives in osteoporosis. Front Endocrinol (Lausanne) 2024; 15:1325317. [PMID: 38370357 PMCID: PMC10870151 DOI: 10.3389/fendo.2024.1325317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/03/2024] [Indexed: 02/20/2024] Open
Abstract
Osteoporosis (OP) is a systemic skeletal disorder characterized by reduced bone mass and structural deterioration of bone tissue, resulting in heightened vulnerability to fractures due to increased bone fragility. This condition primarily arises from an imbalance between the processes of bone resorption and formation. Mitochondrial dysfunction has been reported to potentially constitute one of the most crucial mechanisms influencing the pathogenesis of osteoporosis. In essence, mitochondria play a crucial role in maintaining the delicate equilibrium between bone formation and resorption, thereby ensuring optimal skeletal health. Nevertheless, disruption of this delicate balance can arise as a consequence of mitochondrial dysfunction. In dysfunctional mitochondria, the mitochondrial electron transport chain (ETC) becomes uncoupled, resulting in reduced ATP synthesis and increased generation of reactive oxygen species (ROS). Reinforcement of mitochondrial dysfunction is further exacerbated by the accumulation of aberrant mitochondria. In this review, we investigated and analyzed the correlation between mitochondrial dysfunction, encompassing mitochondrial DNA (mtDNA) alterations, oxidative phosphorylation (OXPHOS) impairment, mitophagy dysregulation, defects in mitochondrial biogenesis and dynamics, as well as excessive ROS accumulation, with regards to OP (Figure 1). Furthermore, we explore prospective strategies currently available for modulating mitochondria to ameliorate osteoporosis. Undoubtedly, certain therapeutic strategies still require further investigation to ensure their safety and efficacy as clinical treatments. However, from a mitochondrial perspective, the potential for establishing effective and safe therapeutic approaches for osteoporosis appears promising.
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Affiliation(s)
- Jialing Liu
- Department of Geriatrics, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Zhonghua Gao
- School of Medicine, Ezhou Vocational University, Ezhou, China
| | - Xiangjie Liu
- Department of Geriatrics, Liyuan Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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15
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Orford NR, Bone A, Kotowicz MA, Bailey M, Pasco JA, Maiden M, Kakho N, Cattigan C, Nichonghaile M, Jones C, Hodgson C, Nair P, Center J, Bellomo R. A pilot feasibility randomised controlled trial of bone antiresorptive agents on bone turnover markers in critically ill women. Sci Rep 2024; 14:2071. [PMID: 38267490 PMCID: PMC10810087 DOI: 10.1038/s41598-024-52607-1] [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: 08/22/2023] [Accepted: 01/21/2024] [Indexed: 01/26/2024] Open
Abstract
Critical illness is associated with increased bone turnover, loss of bone density, and increased risk of fragility fractures. The impact of bone antiresorptive agents in this population is not established. This trial examined the efficacy, feasibility, and safety of antiresorptive agents administered to critically ill women aged fifty years or greater. Women aged 50 years or greater admitted to an intensive care unit for at least 24 h were randomised to receive an antiresorptive agent (zoledronic acid or denosumab) or placebo, during critical illness and six months later (denosumab only). Bone turnover markers and bone mineral density (BMD) were monitored for 1 year. We studied 18 patients over 35 months before stopping the study due to the COVID-19 pandemic. Antiresorptive medications decreased the bone turnover marker type 1 cross-linked c-telopeptide (CTX) from day 0 to 28 by 43% (± 40%), compared to an increase of 26% (± 55%) observed with placebo (absolute difference - 69%, 95% CI - 127% to - 11%), p = 0.03). Mixed linear modelling revealed differences in the month after trial drug administration between the groups in serum CTX, alkaline phosphatase, parathyroid hormone, and phosphate. Change in BMD between antiresorptive and placebo groups was not statistically analysed due to small numbers. No serious adverse events were recorded. In critically ill women aged 50-years and over, antiresorptive agents suppressed bone resorption markers without serious adverse events. However, recruitment was slow. Further phase 2 trials examining the efficacy of these agents are warranted and should address barriers to enrolment.Trial registration: ACTRN12617000545369, registered 18th April 2017.
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Affiliation(s)
- Neil R Orford
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia.
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine (SPPHPM), Monash University, Melbourne, Australia.
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia.
- Department of Critical Care, University of Melbourne, Melbourne, Australia.
| | - Allison Bone
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine (SPPHPM), Monash University, Melbourne, Australia
| | - Mark A Kotowicz
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Department of Medicine-Western Health, The University of Melbourne, Melbourne, Australia
| | - Michael Bailey
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine (SPPHPM), Monash University, Melbourne, Australia
| | - Julie A Pasco
- IMPACT-Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Deakin University, Geelong, Australia
- Department of Medicine-Western Health, The University of Melbourne, Melbourne, Australia
| | - Matthew Maiden
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Nima Kakho
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Claire Cattigan
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Martina Nichonghaile
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Claire Jones
- Intensive Care Unit, University Hospital Geelong, Barwon Health, Geelong, Australia
| | - Carol Hodgson
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine (SPPHPM), Monash University, Melbourne, Australia
| | - Priya Nair
- Intensive Care Unit, St Vincent's Hospital Sydney, Sydney, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Jacqueline Center
- Intensive Care Unit, St Vincent's Hospital Sydney, Sydney, Australia
- Garvan Institute of Medical Research, Sydney, Australia
| | - Rinaldo Bellomo
- Australian and New Zealand Intensive Care Research Centre (ANZIC-RC), School of Public Health and Preventive Medicine (SPPHPM), Monash University, Melbourne, Australia
- Department of Critical Care, University of Melbourne, Melbourne, Australia
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16
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Zhang BF, Liu L, Xu K, Xu P. Serum cystatin C as a biomarker to predict all-cause mortality in geriatrics hip fracture. Heliyon 2024; 10:e24037. [PMID: 38283240 PMCID: PMC10818208 DOI: 10.1016/j.heliyon.2024.e24037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 12/09/2023] [Accepted: 01/02/2024] [Indexed: 01/30/2024] Open
Abstract
Background Cystatin C, a low-molecular-weight protein, belongs to cysteine protease inhibitors produced primarily by nucleated cells. Its serum concentration, independent of sex, age, or muscle mass, is a good predictor of renal dysfunction in older adults. This study evaluated the association between all-cause mortality and preoperative cystatin C levels in hip fractures. Materials and methods Data describing the demographic and clinical characteristics of the patients were gathered specifically from older individuals who had suffered hip fractures. The study used linear and non-linear multivariate Cox regression models to investigate the association between preoperative cystatin C levels and mortality. The analyses were conducted using the R and EmpowerStats software. Results In total, two thousand three hundred and ninety-four patients were included in this study. A total of 790 patients (33 %) died of all causes. The mean follow-up was 37.62 months. The preoperative cystatin C was 0.91 ± 0.41 mg/L. Linear multivariate Cox regression analysis revealed a significant association between preoperative cystatin C level and death, with a hazard ratio (HR) of 2.19 (95 % confidence interval [CI]: 1.72-2.79, P < 0.0001). Nevertheless, the correlation between the variables was inconsistent. A cystatin C concentration of 1.62 mg/L marked a significant change in the non-linear relationship. A preoperative cystatin C level below 1.62 mg/L was found to be significantly linked with an increased risk of mortality (HR = 2.60, 95 % CI: 1.92-3.52, P < 0.0001). The mortality reached its highest point when the preoperative cystatin C level was greater than 1.62 mg/L. After that, the mortality risk did not increase further (HR = 1.54, 95 % CI: 0.98-2.42, P = 0.0588). The non-linear relationship remained consistent in the propensity score-matching sensitive analysis. Conclusions The study found a non-linear relationship between preoperative cystatin C levels and mortality in geriatric hip fractures. This suggests that preoperative cystatin C can be used as a predictor of the risk of death. The registration number is ChiCTR2200057323.
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Affiliation(s)
- Bin-Fei Zhang
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Lin Liu
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Ke Xu
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
| | - Peng Xu
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, Shaanxi Province, China
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17
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Lu K, Wu YM, Shi Q, Gong YQ, Zhang T, Li C. A novel fracture liaison service using digital health: impact on mortality in hospitalized elderly osteoporotic fracture patients. Osteoporos Int 2024; 35:53-67. [PMID: 37698600 DOI: 10.1007/s00198-023-06905-5] [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: 03/23/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023]
Abstract
We examined the performance of an intelligent fracture liaison service (FLS) assisted by digital health (DH) to reduce all-cause mortality (ACM) risk. According to our findings, the new FLS reduced ACM by 36%. INTRODUCTION A well-designed secondary prevention program known as FLS enhances the bone densitometry-based assessment rate as well as osteoporosis (OP) medication usage following a fracture. However, there are only a few reports on FLS incorporating DH, and it remains unclear whether this integration has influenced patient ACM, which refers to the overall death rate from any cause during the study period. METHODS This retrospective observational study was conducted on data from the Fragility Fracture Registration System database linked to the Regional Health Registration Platform of Kunshan City and the Population Death Registration System of Jiangsu Province for one tertiary-level A hospital in China. Patients aged ≥ 50 years, who experienced an OP fracture between January 1, 2017, and July 27, 2022, requiring hospitalization, were selected for analysis. We compared the outcomes of patients who received routine fragility fracture management (the no-FLS group) or FLS (the FLS group). We employed multivariable Cox regression with inverse probability weighting based on the propensity score (PS). RESULTS Of 2317 patients, 756 (32.6%) received FLS and 1561 (67.4%) did not. Using PS matching, we minimized the baseline characteristic differences between the two groups in the propensity score-matched samples, relative to the unmatched samples. Based on our analysis, the new FLS reduced ACM by 36% (hazard ratio [HR], 0.64; 95% confidence interval [CI], 0.47 to 0.87; P-value = 0.004). Moreover, FLS patients experienced further reductions in fall-related mortality, refracture rate, and total refracture-related hospital costs, and had increased dual-energy X-ray absorptiometry (DXA) testing and treatment initiation rates, relative to the no-FLS patients. CONCLUSIONS A new FLS model implementation assisted by DH can effectively reduce ACM among elderly patients with OP fractures requiring surgery. In future investigations, we recommend examining the scalability of this model.
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Affiliation(s)
- Ke Lu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Ya-Ming Wu
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China
| | - Qin Shi
- Department of Orthopedics, The First Affiliated Hospital of Soochow University, Orthopedic Institute of Soochow University, Suzhou, Jiangsu, China
| | - Ya-Qin Gong
- Information Department, Affiliated Kunshan Hospital of Jiangsu University, Suzhou, Jiangsu, China
| | - Ting Zhang
- Chronic Disease Department, Kunshan Center For Disease Control and Prevention, Suzhou, Jiangsu, China
| | - Chong Li
- Department of Orthopedics, Affiliated Kunshan Hospital of Jiangsu University, No. 566 East of Qianjin Road, Suzhou, 215300, Jiangsu, China.
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Xiao Y, Xie X, Chen Z, Yin G, Kong W, Zhou J. Advances in the roles of ATF4 in osteoporosis. Biomed Pharmacother 2023; 169:115864. [PMID: 37948991 DOI: 10.1016/j.biopha.2023.115864] [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: 09/07/2023] [Revised: 11/01/2023] [Accepted: 11/07/2023] [Indexed: 11/12/2023] Open
Abstract
Osteoporosis (OP) is characterized by reduced bone mass, decreased strength, and enhanced bone fragility fracture risk. Activating transcription factor 4 (ATF4) plays a role in cell differentiation, proliferation, apoptosis, redox balance, amino acid uptake, and glycolipid metabolism. ATF4 induces the differentiation of bone marrow mesenchymal stem cells (BM-MSCs) into osteoblasts, increases osteoblast activity, and inhibits osteoclast formation, promoting bone formation and remodeling. In addition, ATF4 mediates the energy metabolism in osteoblasts and promotes angiogenesis. ATF4 is also involved in the mediation of adipogenesis. ATF4 can selectively accumulate in osteoblasts. ATF4 can directly interact with RUNT-related transcription factor 2 (RUNX2) and up-regulate the expression of osteocalcin (OCN) and osterix (Osx). Several upstream factors, such as Wnt/β-catenin and BMP2/Smad signaling pathways, have been involved in ATF4-mediated osteoblast differentiation. ATF4 promotes osteoclastogenesis by mediating the receptor activator of nuclear factor κ-B (NF-κB) ligand (RANKL) signaling. Several agents, such as parathyroid (PTH), melatonin, and natural compounds, have been reported to regulate ATF4 expression and mediate bone metabolism. In this review, we comprehensively discuss the biological activities of ATF4 in maintaining bone homeostasis and inhibiting OP development. ATF4 has become a therapeutic target for OP treatment.
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Affiliation(s)
- Yaosheng Xiao
- Department of Orthopaetics, First Affiliated Hospital of Gannan Medical University, Ganzhou 341000, China
| | - Xunlu Xie
- Department of Pathology, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Zhixi Chen
- Department of Pharmacy, Gannan Medical University, Ganzhou 341000, China
| | - Guoqiang Yin
- Ganzhou Hospital Affiliated to Nanchang University, Ganzhou 341000, China
| | - Weihao Kong
- Department of Joint Surgery, Ganzhou People's Hospital, Ganzhou 341000, China
| | - Jianguo Zhou
- Department of Joint Surgery, Ganzhou People's Hospital, Ganzhou 341000, China.
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Zhang A, Fu H, Wang J, Chen Z, Fan J. Establishing a nomogram to predict refracture after percutaneous kyphoplasty by logistic regression. Front Neuroinform 2023; 17:1304248. [PMID: 38187823 PMCID: PMC10767997 DOI: 10.3389/fninf.2023.1304248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Introduction Several studies have examined the risk factors for post-percutaneous kyphoplasty (PKP) refractures and developed many clinical prognostic models. However, no prior research exists using the Random Forest (RF) model, a favored tool for model development, to predict the occurrence of new vertebral compression fractures (NVCFs). Therefore, this study aimed to investigate the risk factors for the occurrence of post-PKP fractures, compare the predictive performance of logistic regression and RF models in forecasting post-PKP fractures, and visualize the logistic regression model. Methods We collected clinical data from 349 patients who underwent PKP treatment at our institution from January 2018 to December 2021. Lasso regression was employed to select risk factors associated with the occurrence of NVCFs. Subsequently, logistic regression and RF models were established, and their predictive capabilities were compared. Finally, a nomogram was created. Results The variables selected using Lasso regression, including bone density, cement distribution, vertebral fracture location, preoperative vertebral height, and vertebral height restoration rate, were included in both the logistic regression and RF models. The area under the curves of the logistic regression and RF models were 0.868 and 0.786, respectively, in the training set and 0.786 and 0.599, respectively, in the validation set. Furthermore, the calibration curve of the logistic regression model also outperformed that of the RF model. Conclusion The logistic regression model provided better predictive capabilities for identifying patients at risk for post-PKP vertebral fractures than the RF model.
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Affiliation(s)
- Aiqi Zhang
- The Second Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Hongye Fu
- The Fourth Clinical Medical College of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Junjie Wang
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhe Chen
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jiajun Fan
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
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Billington EO, Miyagishima RC, Hasselaar C, Arain M. Women's perspectives regarding osteoporosis, fracture risk, and pharmacologic treatment: a cross-sectional study. Osteoporos Int 2023; 34:2069-2076. [PMID: 37608123 DOI: 10.1007/s00198-023-06890-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Accepted: 08/15/2023] [Indexed: 08/24/2023]
Abstract
We assessed women's perspectives regarding early preventative therapy for osteoporosis. More than a third of early menopausal women were concerned about bone loss and future fractures, and approximately half were willing to take an intravenous or oral bisphosphonate around the time of menopause to preserve bone health. PURPOSE Bisphosphonate medications can prevent the substantial bone loss that occurs during early menopause, but little is known about whether women would accept bisphosphonate treatment at this time in their life, when imminent fracture risk is low. We assessed women's perspectives regarding bone loss, fracture risk, and preventative pharmacotherapy in early menopause. METHODS In this cross-sectional study, Canadian women aged ≥ 45 years were recruited via Facebook advertisement to complete an electronic survey. Primary outcome was the proportion of early menopausal respondents (≤ 5 years since final menstrual period) who were worried about bone loss and fractures. Secondary outcomes were the proportion of early menopausal women willing to accept pharmacologic intervention aimed at preventing either bone loss or future fractures. We compared responses between early menopausal women and older women (> 5 years since final menstrual period). RESULTS 2033 women responded to the Facebook advertisement, 1195 eligible women (aged: 45 to 89 years) started the survey, and 966 completed it. Among early menopausal respondents (N = 98), 38 (42%) were worried about future fractures and 9 of 25 (36%) who had a prior bone mineral density scan were worried about their results. A total of 42 (47%) were willing to start medication to prevent fractures, and 48 (54%) would start medication to prevent bone loss. Responses were comparable between early menopausal women and older women. CONCLUSION Menopausal women are concerned about bone loss and fractures. Many women would consider early menopausal pharmacotherapy, with the goals of preserving bone health and lowering their risk of fractures.
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Affiliation(s)
- Emma O Billington
- Cumming School of Medicine, Division of Endocrinology & Metabolism, University of Calgary, Richmond Road Diagnostic & Treatment Centre, Room 18118, 1820 Richmond Road SW, Calgary, AB, Canada.
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada.
| | | | - Charley Hasselaar
- McCaig Institute for Bone & Joint Health, University of Calgary, Calgary, AB, Canada
| | - Mubashir Arain
- Health Systems Knowledge & Evaluation, Alberta Health Services, Alberta, Canada
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Barros-Sevillano S, Espinoza-Martinez D, Rubio-Zavaleta L. What is known about osteoporosis research in Latin America?: A bibliometric analysis of three decades. Medicine (Baltimore) 2023; 102:e36103. [PMID: 38050309 PMCID: PMC10695571 DOI: 10.1097/md.0000000000036103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Accepted: 10/23/2023] [Indexed: 12/06/2023] Open
Abstract
Identifying the gaps in scientific production in a topic allows directing research in order to make better public investment decisions. Bibliometric data on osteoporosis in Latin America are very limited and unclear and, given the impact of this disease in this region, it is relevant to analyze the latest trends in the subject. The study approach was quantitative, observational-descriptive, cross-sectional. Data were collected from journals indexed in Scopus between 1990 and 2019, using a search strategy that included Medical Subject Headings terms for "Osteoporosis" and other related terms, as well as VOSviewer software to create cooperative and co-occurrence word maps. 3261 documents were analyzed, with an annual scientific production rate of 5% (163 documents), where 73.9% were original articles. The countries with the highest scientific production in osteoporosis were Brazil (55.2%) and Argentina (18%). Extra-regional cooperation was mainly with the United States (16.35%) and Spain (5.18%). Six of the 10 most productive countries had their own government agencies as the main funders. The National Council for Scientific and Technological Development was the institution that funded the most (n = 194). The term "osteoporosis" together with the terms "bone mineral density," "fractures," and "menopause" were the most frequently addressed subjects. Latin American scientific production in osteoporosis has shown a significant increase. However, in the last 3 years it has shown a slight reduction. Greater intraregional collaboration involving universities, institutions and health societies is needed.
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Affiliation(s)
- Shamir Barros-Sevillano
- Facultad de Ciencias de la Salud, Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
| | - David Espinoza-Martinez
- Facultad de Ciencias de la Salud, Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad César Vallejo, Trujillo, Peru
| | - Luis Rubio-Zavaleta
- Facultad de Ciencias de la Salud, Escuela de Medicina, Universidad César Vallejo, Trujillo, Peru
- Sociedad Científica de Estudiantes de Medicina de la Universidad César Vallejo, Trujillo, Peru
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Wang L, Wang C, Zhang D, Wang W, Wang F. Effectiveness and safeties of hemocoagulase and tranexamic acid to reduce perioperative blood loss in intertrochanteric fracture PFNA fixation. Acta Orthop Belg 2023; 89:645-650. [PMID: 38205755 DOI: 10.52628/89.4.11959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
This study evaluated the efficacy of hemocoagulase and tranexamic acid (TXA) in minimizing perioperative blood loss in perioperative period of proximal femoral nail antirotation (PFNA) repair. 99 patients having intertrochanteric fracture PFNA fixation were randomly assigned to the hemocoagulase, TXA, and control groups (n=33 per group). In the hemocoagulase group, 1 KU of hemocoagulase was injected preoperatively and postoperatively local sprayed, respectively; in the TXA group, 0.5g TXA was injected preoperatively and postoperatively local sprayed, respectively; and in the control group, 100 mL of physiological saline was injected before surgery and was used by postoperative local spraying, respectively. The hemocoagulase and TXA groups exhibited significant differences in preoperative hemoglobin (HB) and hematocrit (HCT) levels on postoperative days 1 and 3, intraoperative bleeding, 24-hour postoperative drainage, total perioperative bleeding, transfusion rate, and postoperative hospitalization duration compared to the control group. Furthermore, the hemocoagulase and TXA groups showed significant differences in postoperative day 3 HB and HCT levels and postoperative hospitalization duration compared to each other. In conclusions, the combined use of systemic preoperative and local postoperative hemocoagulase and TXA spraying is found to significantly decrease perioperative blood loss in intertrochanteric fracture patients undergoing PFNA. Hemocoagulase is observed to have a superior effect compared to TXA.
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Allam AK, Anand A, Flores AR, Ropper AE. Computer Vision in Osteoporotic Vertebral Fracture Risk Prediction: A Systematic Review. Neurospine 2023; 20:1112-1123. [PMID: 38171281 PMCID: PMC10762393 DOI: 10.14245/ns.2347022.511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Osteoporotic vertebral fractures (OVFs) are a significant health concern linked to increased morbidity, mortality, and diminished quality of life. Traditional OVF risk assessment tools like bone mineral density (BMD) only capture a fraction of the risk profile. Artificial intelligence, specifically computer vision, has revolutionized other fields of medicine through analysis of videos, histopathology slides and radiological scans. In this review, we provide an overview of computer vision algorithms and current computer vision models used in predicting OVF risk. We highlight the clinical applications, future directions and limitations of computer vision in OVF risk prediction.
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Affiliation(s)
- Anthony K. Allam
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Adrish Anand
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Alex R. Flores
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
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Sangondimath G, Sen RK, T. FR. DEXA and Imaging in Osteoporosis. Indian J Orthop 2023; 57:82-93. [PMID: 38107793 PMCID: PMC10721776 DOI: 10.1007/s43465-023-01059-2] [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: 10/02/2023] [Accepted: 11/11/2023] [Indexed: 12/19/2023]
Abstract
Background Reduced bone density and increased fragility are hallmarks of osteoporosis, making the disease a major public health concern. The disease necessitates early diagnosis and appropriate therapy depend on an accurate evaluation of bone health. Essential tools for assessing osteoporosis include dual-energy X-ray absorptiometry (DEXA) and other imaging modalities. Methods This chapter focuses on dual-energy X-ray absorptiometry (DEXA) and other imaging methods as essential tools for assessment of osteoporosis. The chapter also explores complementary imaging modalities that help overcome limitation of DEXA by providing insights into the microarchitecture and bone quality. Results T-scores, used to categorise bone health, are determined by DEXA by comparing bone mineral density to age-matched standards. Bone mineral density (BMD) is the most common indicator of bone health; nevertheless, DEXA may misclassify bone health owing to reasons other than BMD. These constraints may be overcome with the use of complementary imaging methods, which provide information on the microarchitecture and quality of bone. The evaluation of bone structure is aided by high-resolution peripheral quantitative computed tomography (HR-pQCT), which produces precise 3D images of the trabecular and cortical bone compartments. Independent of traditional methods of gauging fracture risk, quantitative ultrasonography (QUS) uses an analysis of the characteristics of sound waves to determine bone health. Diagnostic precision is improved by magnetic resonance imaging (MRI) due to its ability to view bone marrow and trabecular structure without the use of ionising radiation. Discussion New methods, such as the trabecular bone score (TBS), examine bone texture and provide more data on the likelihood of fracture than conventional DEXA. By modelling bone strength using imaging data, finite element analysis (FEA) provides a biomechanical viewpoint on breakage probability. These combined methods boost diagnostic accuracy and pave the way for individualised treatment plans. Imaging helps with therapy monitoring as well as diagnosis. By monitoring bone density and structure over time, therapy effectiveness or course corrections may be quickly identified. The availability of sophisticated imaging techniques and the standardisation of procedures provide obstacles not withstanding their advantages. Ongoing work is being done to solve these issues and standardise and disseminate these methods in a variety of contexts. Conclusion The evaluation of osteoporosis is significantly aided by DEXA and other imaging methods. While DEXA is still the gold standard for diagnosing osteoporosis, other imaging techniques may shed light on bone health in greater detail. These methods improve fracture risk prediction and treatment assessment by providing information on bone architecture, quality, and strength. Integration of several imaging modalities shows potential for bettering osteoporosis therapy and patient outcomes as the field develops.
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Affiliation(s)
- Gururaj Sangondimath
- Department of Spine Services, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, 110070 India
| | - Ramesh Kumar Sen
- Department of Orthopedics, Max Super Speciality Hospital, Mohali, 160055 India
| | - Fazal Rehman T.
- Department of Spine Services, Indian Spinal Injuries Center, Vasant Kunj, New Delhi, 110070 India
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Pu M, Zhang B, Zhu Y, Zhong W, Shen Y, Zhang P. Hounsfield Unit for Evaluating Bone Mineral Density and Strength: Variations in Measurement Methods. World Neurosurg 2023; 180:e56-e68. [PMID: 37544597 DOI: 10.1016/j.wneu.2023.07.146] [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: 07/12/2023] [Accepted: 07/31/2023] [Indexed: 08/08/2023]
Abstract
OBJECTIVE To assess the consistency and accuracy of various measurements of the Hounsfield unit (HU) in lumbar vertebrae. METHODS The study reviewed lumbar spine computed tomography images of 60 postmenopausal women aged >50 years. A total of 240 vertebrae were measured and analyzed for the variations of HU values in different sections and regions. Investigated the relationship between HU values of the lumbar spine under different measurements and dual-energy X-ray absorptiometry results and the ability to identify patients with osteoporosis. RESULTS HU values measured in midsagittal (r = 0.763), midcoronal (r = 0.768), and midaxial (r = 0.786) sections exhibited a strong positive correlation with dual-energy X-ray absorptiometry T-scores. HU values measured in midsagittal and midaxial sections of the vertebral body were in good agreement (P > 0.1), but decreased in the midcoronal (P < 0.001). HU values in the middle of the vertebral body were significantly higher than in the near end plate (P < 0.001). HU values varied between L1 and L4 vertebrae, but all had a good ability to identify osteoporosis and did not differ significantly in screening ability (P > 0.05). CONCLUSIONS An averaged HU value in axial multilevel is a comprehensive assessment of vertebral bone density. Using the HU value of the lumbar spine can help identify patients with osteoporosis, and the screening ability does not differ significantly across vertebral segments.
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Affiliation(s)
- Mengyang Pu
- Department of Orthopedics, Shaoxing People's Hospital (Shaoxing Hospital, Zhejiang University School of Medicine), Shaoxing Province, Zhejiang, China; Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Bo Zhang
- Department of Radiology, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Ying Zhu
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Wentao Zhong
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Yixin Shen
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China
| | - Peng Zhang
- Department of Orthopedics, Second Affiliated Hospital of Soochow University, Suzhou, Jiangsu Province, China.
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Solarino G, Bizzoca D, Dramisino P, Vicenti G, Moretti L, Moretti B, Piazzolla A. Total hip arthroplasty following the failure of intertrochanteric nailing: First implant or salvage surgery? World J Orthop 2023; 14:763-770. [PMID: 37970621 PMCID: PMC10642404 DOI: 10.5312/wjo.v14.i10.763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/16/2023] [Accepted: 09/06/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Proximal femur fractures, including both intracapsular (femoral neck fractures) and extracapsular fractures (intertrochanteric femoral fractures, IFFs), affect around 1.5 million people per year worldwide. Mechanical failures of intertrochanteric nailing in IFFs could be managed with revision total hip arthroplasty (THA). AIM To describe the surgical complexity and the procedure-related complication rates in patients with trochanteric nailing failure and treated with THA. METHODS Patients referred to our level I trauma center between April 2012 and July 2018 with failed cephalomedullary nailing following trochanteric fractures were retrospectively recruited. All patients underwent a salvage surgical procedure, i.e., cephalomedullary nail removal and conversion to THA. The same surgical and anesthesiology team performed the surgical procedures under spinal anesthesia. All patients underwent clinical and radiographic follow-ups for at least 24 mo. Complications and re-operations were recorded. RESULTS Seventy-four patients met the inclusion criteria (male: 29; female: 45; mean age: 73.8-years-old; range: 65-89) and were included in the current study. The average operative time was 117 min (76-192 min). The average blood loss was 585 mL (430-1720 mL). Among the 74 patients, 43 (58.1%) required transfusion of three or more blood units. Two patients died within the 4th d after surgery because of pulmonary embolism, and 1 patient died 9 mo after surgery due to ischemic myocardial infarction. The complication rate in the 71 patients who completed the minimum 24-mo follow-up was 22.5%. In 3 cases out of 71 (4.2%) periprosthetic acetabular fracture was observed during the follow-up. One of these periacetabular fractures occurred intraoperatively. An intraoperative periprosthetic femur fracture was observed in 5 patients out of 71 (7.0%). Four of these patients needed a re-operation to fix the fracture with plates and cerclages; in one of these patients, femoral stem revision was also necessary. In 4 patients out of 71 (5.6%), an early THA dislocation was observed, whereas in 1 case (1.4%) a late THA dislocation was observed. Three patients out of 71 (4.2%) developed a periprosthetic joint infection during the study follow-up. CONCLUSION The present study demonstrated that salvage options for IFF fixation failure are complex procedures with a relevant intraoperative and postoperative complication rate.
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Affiliation(s)
| | - Davide Bizzoca
- DiMePre-J, University of Bari Aldo Moro, Bari 70154, Italy
| | | | | | - Lorenzo Moretti
- Orthopaedic and Trauma Unit Policlinico di Bari, Bari 70124, Italy
| | - Biagio Moretti
- DiBraiN, University of Bari Aldo Moro, Bari 70154, Italy
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Je M, Kang K, Yoo JI, Kim Y. The Influences of Macronutrients on Bone Mineral Density, Bone Turnover Markers, and Fracture Risk in Elderly People: A Review of Human Studies. Nutrients 2023; 15:4386. [PMID: 37892460 PMCID: PMC10610213 DOI: 10.3390/nu15204386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/24/2023] [Accepted: 09/26/2023] [Indexed: 10/29/2023] Open
Abstract
Osteoporosis is a health condition that involves weak bone mass and a deteriorated microstructure, which consequently lead to an increased risk of bone fractures with age. In elderly people, a fracture attributable to osteoporosis elevates mortality. The objective of this review was to examine the effects of macronutrients on bone mineral density (BMD), bone turnover markers (BTMs), and bone fracture in elderly people based on human studies. A systematic search was conducted in the PubMed®/MEDLINE® database. We included human studies published up to April 2023 that investigated the association between macronutrient intake and bone health outcomes. A total of 11 meta-analyses and 127 individual human studies were included after screening the records. Carbohydrate consumption seemed to have neutral effects on bone fracture in limited studies, but human studies on carbohydrates' effects on BMD or/and BTMs are needed. The human studies analyzed herein did not clearly show whether the intake of animal, vegetable, soy, or milk basic proteins has beneficial effects on bone health due to inconsistent results. Moreover, several individual human studies indicated an association between eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and osteocalcin. Further studies are required to draw a clear association between macronutrients and bone health in elderly people.
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Affiliation(s)
- Minkyung Je
- Department of Food and Nutrition, Gyeongsang National University, 501 Jinju-daero, Jinju 52828, Republic of Korea; (M.J.); (K.K.)
| | - Kyeonghoon Kang
- Department of Food and Nutrition, Gyeongsang National University, 501 Jinju-daero, Jinju 52828, Republic of Korea; (M.J.); (K.K.)
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, 27 Inhang-Ro, Incheon 22332, Republic of Korea;
| | - Yoona Kim
- Department of Food and Nutrition, Institute of Agriculture and Life Science, Gyeongsang National University, 501 Jinju-daero, Jinju 52828, Republic of Korea
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Shi H, Gao Y, Zhao W, Wang H, Wu X, Wang F, Yang X, Li J. Development of a prediction model for postoperative complications and economic burden analysis in older patients with hip fractures. Heliyon 2023; 9:e20342. [PMID: 37780772 PMCID: PMC10539933 DOI: 10.1016/j.heliyon.2023.e20342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 09/16/2023] [Accepted: 09/19/2023] [Indexed: 10/03/2023] Open
Abstract
Purpose The high rates of disability and mortality due to postoperative complications of hip fractures in the elderly, especially the oldest-old individuals, have become an increasingly serious global public health concern. This study aimed to establish a nomogram prediction model and analyze the economic burden to guide clinical decision-making and improve patient prognosis. Methods Data of 514 patients aged over 80 years with hip fractures who received surgical treatment were retrospectively collected, and the patients were divided into training and validation cohorts. Independent risk factors for postoperative complications were identified based on logistic regression analysis, and a nomogram was constructed. The model was evaluated for its discrimination and consistency using receiver operating characteristic (ROC) curves and calibration curves, and for its clinical benefit using decision curve analysis (DCA). The economic burden was analyzed using propensity score matching (PSM). Results The American Society of Anesthesiologists (ASA) classification ≥Ⅲ, anemia, male sex, diabetes mellitus, and the number of comorbidities were found to be independent risk factors for postoperative complications in oldest-old patients with hip fracture (all P < 0.05). The areas under the curve (AUC) of the nomogram prediction model for the training and validation cohorts were 0.743 and 0.767, respectively, indicating reliable discrimination. The calibration curves and DCA showed that the model has good consistency and high benefits. The direct economic burden of postoperative complications for the patients was US$1045.10. Conclusions The nomogram model can accurately quantify the risk of postoperative complications among oldest-old patients with hip fractures and guide clinical professionals to implement early and targeted preventive treatment for high-risk patients.
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Affiliation(s)
- Haoning Shi
- School of Nursing, Weifang Medical University, Weifang 261053, Shandong Province, PR China
| | - Ying Gao
- School of Nursing, Weifang Medical University, Weifang 261053, Shandong Province, PR China
- Linyi People's Hospital, Linyi 276034, Shandong Province, PR China
| | - Wanying Zhao
- School of Public Health, Weifang Medical University, Weifang 261053, Shandong Province, PR China
| | - Hongyu Wang
- School of Public Health, Weifang Medical University, Weifang 261053, Shandong Province, PR China
| | - Xueqian Wu
- School of Public Health, Weifang Medical University, Weifang 261053, Shandong Province, PR China
| | - Fei Wang
- School of Public Health, Weifang Medical University, Weifang 261053, Shandong Province, PR China
| | - Xiao Yang
- School of Nursing, Weifang Medical University, Weifang 261053, Shandong Province, PR China
| | - Jing Li
- School of Public Health, Weifang Medical University, Weifang 261053, Shandong Province, PR China
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Billington EO, Hasselaar CM, Kembel L, Myagishima RC, Arain MA. Effectiveness and Cost of Using Facebook Recruitment to Elicit Canadian Women's Perspectives on Bone Health and Osteoporosis: Cross-Sectional Survey Study. J Med Internet Res 2023; 25:e47970. [PMID: 37773625 PMCID: PMC10576225 DOI: 10.2196/47970] [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: 04/06/2023] [Revised: 08/16/2023] [Accepted: 08/31/2023] [Indexed: 10/01/2023] Open
Abstract
BACKGROUND Surveys can help health researchers better understand the public's perspectives and needs regarding prevalent conditions such as osteoporosis, which affects more than two-thirds of postmenopausal women. However, recruitment of large cohorts for survey research can be time-consuming and expensive. With 2.9 billion active users across the globe and reasonable advertising costs, Facebook (Meta Platforms, Inc) has emerged as an effective recruitment tool for surveys, although previous studies have targeted young populations (<50 years of age) and none have focused on bone health. OBJECTIVE We assessed the effectiveness and cost of using Facebook to recruit Canadian women aged ≥45 years to share their perspectives on bone health and osteoporosis via a web-based survey. METHODS We developed a 15-minute web-based survey with the goal of eliciting perspectives on bone health and osteoporosis. A Facebook advertisement was placed for 2 weeks in February 2022, during which time it was shown to women of age ≥45 years who resided in Canada, inviting them to participate and offering a chance to win 1 of 5 CAD $100 gift cards (at the time of this study [February 14, 2022], a currency exchange rate of CAD $1=US $0.79 was applicable). Those who clicked on the advertisement were taken to an eligibility screening question on the survey home screen. Individuals who confirmed eligibility were automatically directed to the first survey question. All individuals who answered the first survey question were considered participants and included in the analyses. We determined the survey reach, click rate, cooperation rate, completion rate, cost per click, and cost per participant. Sociodemographic characteristics of respondents were compared with data from the 2021 Canadian Census. RESULTS The Facebook advertisement was shown to 34,086 unique Facebook users, resulting in 2033 link clicks (click rate: 6.0%). A total of 1320 individuals completed the eligibility screening question, 1195 started the survey itself (cooperation rate: 58.8%), and 966 completed the survey (completion rate: 47.5%). The cost of the advertising campaign was CAD $280.12, resulting in a cost per click of CAD $0.14 and a cost per participant of CAD $0.23. The 1195 participants ranged in age from 45-89 years (mean 65, SD 7 years), 921 (93.7%) were of White ethnicity, 854 (88.3%) had completed some postsecondary education, and 637 (65.8%) resided in urban areas. Responses were received from residents of all 10 Canadian provinces and 2 of 3 territories. When compared to 2021 Canadian Census data, postsecondary education and rural residence were overrepresented in our study population. CONCLUSIONS Facebook advertising is an efficient, effective, and inexpensive way of recruiting large samples of older women for participation in web-based surveys for health research. However, it is important to recognize that this modality is a form of convenience sampling and the benefits of Facebook recruitment must be balanced with its limitations, which include selection bias and coverage error.
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Affiliation(s)
- Emma Olive Billington
- Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- McCaig Institute for Bone & Joint Health, Calgary, AB, Canada
- Dr David Hanley Osteoporosis Centre, Alberta Health Services, Calgary, AB, Canada
| | | | - Lorena Kembel
- Health Systems Evaluation & Evidence, Alberta Health Services, Calgary, AB, Canada
| | - Rebecca C Myagishima
- Health Systems Evaluation & Evidence, Alberta Health Services, Calgary, AB, Canada
| | - Mubashir A Arain
- Health Systems Evaluation & Evidence, Alberta Health Services, Calgary, AB, Canada
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Fu Q, Bustamante-Gomez NC, Reyes-Pardo H, Gubrij I, Escalona-Vargas D, Thostenson JD, Palmieri M, Goellner JJ, Nookaew I, Barnes CL, Stambough JB, Ambrogini E, O’Brien CA. Reduced osteoprotegerin expression by osteocytes may contribute to rebound resorption after denosumab discontinuation. JCI Insight 2023; 8:e167790. [PMID: 37581932 PMCID: PMC10561722 DOI: 10.1172/jci.insight.167790] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 08/03/2023] [Indexed: 08/17/2023] Open
Abstract
Denosumab is an anti-RANKL Ab that potently suppresses bone resorption, increases bone mass, and reduces fracture risk. Discontinuation of denosumab causes rapid rebound bone resorption and bone loss, but the molecular mechanisms are unclear. We generated humanized RANKL mice and treated them with denosumab to examine the cellular and molecular conditions associated with rebound resorption. Denosumab potently suppressed both osteoclast and osteoblast numbers in cancellous bone in humanized RANKL mice. The decrease in osteoclast number was not associated with changes in osteoclast progenitors in bone marrow. Long-term, but not short-term, denosumab administration reduced osteoprotegerin (OPG) mRNA in bone. Localization of OPG expression revealed that OPG mRNA is produced by a subpopulation of osteocytes. Long-term denosumab administration reduced osteocyte OPG mRNA, suggesting that OPG expression declines as osteocytes age. Consistent with this, osteocyte expression of OPG was more prevalent near the surface of cortical bone in humans and mice. These results suggest that new osteocytes are an important source of OPG in remodeling bone and that suppression of remodeling reduces OPG abundance by reducing new osteocyte formation. The lack of new osteocytes and the OPG they produce may contribute to rebound resorption after denosumab discontinuation.
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Affiliation(s)
- Qiang Fu
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | | | - Humberto Reyes-Pardo
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | - Igor Gubrij
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | | | | | - Michela Palmieri
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | - Joseph J. Goellner
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
| | - Intawat Nookaew
- Center for Musculoskeletal Disease Research
- Department of Biomedical Informatics, and
| | - C. Lowry Barnes
- Center for Musculoskeletal Disease Research
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Jeffrey B. Stambough
- Center for Musculoskeletal Disease Research
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
| | - Elena Ambrogini
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
| | - Charles A. O’Brien
- Center for Musculoskeletal Disease Research
- Division of Endocrinology and Metabolism
- Department of Orthopaedic Surgery, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA
- Central Arkansas Veterans Healthcare System, Little Rock, Arkansas, USA
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Beaudart C, Demonceau C, Sabico S, Veronese N, Cooper C, Harvey N, Fuggle N, Bruyère O, Rizzoli R, Reginster JY. Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:1789-1806. [PMID: 37400668 PMCID: PMC10460304 DOI: 10.1007/s40520-023-02478-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION The objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis. METHODS Medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI). RESULTS From the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k = 10, n = 2992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD + 4.75% (95% CI 3.45, 6.05); total hip: MD + 2.72% (95% CI 2.06; 3.37); femoral neck: MD + 2.26% (95% CI 1.67; 2.85). Denososumab (k = 2, n = 242), Teriparatide (k = 2, n = 309) and Abaloparatide (k = 2, n = 248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures. CONCLUSIONS Medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.
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Affiliation(s)
- Charlotte Beaudart
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - Céline Demonceau
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - Shaun Sabico
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451 Saudi Arabia
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine, Geriatrics Section, University of Palermo, via del Vespro, 141, 90127 Palermo, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Nicholas Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Hopitaux Universitaires Geneve, Geneva, Switzerland
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
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Ye Z, Wang Y, Xiang B, Wang H, Tao H, Zhang C, Zhang S, Sun D, Luo F, Song L. Roles of the Siglec family in bone and bone homeostasis. Biomed Pharmacother 2023; 165:115064. [PMID: 37413904 DOI: 10.1016/j.biopha.2023.115064] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 06/23/2023] [Accepted: 06/23/2023] [Indexed: 07/08/2023] Open
Abstract
Tremendous progress has been seen in the study of the role of sialic acid binding im-munoglobulin type lectins (Siglecs) in osteoimmunology in the past two decades. Interest in Siglecs as immune checkpoints has grown from the recognition that Siglecs have relevance to human disease. Siglecs play important roles in inflammation and cancer, and play key roles in immune cell signaling. By recognizing common sialic acid containing glycans on glycoproteins and glycolipids as regulatory receptors for immune cell signals, Siglecs are expressed on most immune cells and play important roles in normal homeostasis and self-tolerance. In this review, we describe the role that the siglec family plays in bone and bone homeostasis, including the regulation of osteoclast differentiation as well as recent advances in inflammation, cancer and osteoporosis. Particular emphasis is placed on the relevant functions of Siglecs in self-tolerance and as pattern recognition receptors in immune responses, thereby potentially providing emerging strategies for the treatment of bone related diseases.
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Affiliation(s)
- Zi Ye
- The Fourth Corps of Students of the Basic Medical College, Army Medical University, Chongqing 400037, China
| | - Yetong Wang
- The Fourth Corps of Students of the Basic Medical College, Army Medical University, Chongqing 400037, China
| | - Binqing Xiang
- Department of Surgical Anesthesia, First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Heng Wang
- Army Border Defense 331st Brigade, Dandong 118000, China
| | - Haiyan Tao
- Health Management Center, First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Chengmin Zhang
- Department of Orthopaedics, First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Shuai Zhang
- Department of Orthopaedics, First Affiliated Hospital, Army Medical University, Chongqing 400038, China
| | - Dong Sun
- Department of Orthopaedics, First Affiliated Hospital, Army Medical University, Chongqing 400038, China.
| | - Fei Luo
- Department of Orthopaedics, First Affiliated Hospital, Army Medical University, Chongqing 400038, China.
| | - Lei Song
- Department of Orthopaedics, First Affiliated Hospital, Army Medical University, Chongqing 400038, China.
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Dahl C, Ohm E, Solbakken SM, Anwar N, Holvik K, Madsen C, Frihagen F, Bjørnerem Å, Igland Nissen F, Solberg LB, Omsland TK. Forearm fractures - are we counting them all? An attempt to identify and include the missing fractures treated in primary care. Scand J Prim Health Care 2023; 41:247-256. [PMID: 37417884 PMCID: PMC10478616 DOI: 10.1080/02813432.2023.2231028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 06/25/2023] [Indexed: 07/08/2023] Open
Abstract
OBJECTIVE Norway has a high incidence of forearm fractures, however, the incidence rates based on secondary care registers can be underestimated, as some fractures are treated exclusively in primary care. We estimated the proportion of forearm fracture diagnoses registered exclusively in primary care and assessed the agreement between diagnosis for forearm fractures in primary and secondary care. DESIGN Quality assurance study combining nationwide data from 2008 to 2019 on forearm fractures registered in primary care (Norwegian Control and Payment of Health Reimbursement) and secondary care (the Norwegian Patient Registry). SETTING AND PATIENTS Forearm fracture diagnoses in patients aged ≥20 treated in primary care (n = 83,357) were combined with injury diagnoses for in- and outpatients in secondary care (n = 3,294,336). MAIN OUTCOME MEASURES Proportion of forearm fractures registered exclusively in primary care, and corresponding injury diagnoses for those registered in both primary and secondary care. RESULTS Of 189,105 forearm fracture registrations in primary and secondary care, 13,948 (7.4%) were registered exclusively in primary care. The proportion ranged from 4.9% to 13.5% on average between counties, but was higher in some municipalities (>30%). Of 66,747 primary care forearm fractures registered with a diagnosis in secondary care, 62% were incident forearm fractures, 28% follow-up controls, and 10% other fractures or non-fracture injuries. CONCLUSION An overall small proportion of forearm fractures were registered only in primary care, but it was larger in some areas of Norway. Failing to include fractures exclusively treated in primary care could underestimate the incidence rates in these areas.
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Affiliation(s)
- Cecilie Dahl
- Department of Community Medicine and Global Health, University of Oslo, Institute of Health and Society, Oslo, Norway
| | - Eyvind Ohm
- Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway
| | - Siri Marie Solbakken
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Nudrat Anwar
- Department of Community Medicine and Global Health, University of Oslo, Institute of Health and Society, Oslo, Norway
| | - Kristin Holvik
- Department of Physical Health and Ageing, Norwegian Institute of Public Health, Oslo, Norway
| | - Christian Madsen
- Department of Health and Inequality, Norwegian Institute of Public Health, Oslo, Norway
| | - Frede Frihagen
- Department of Orthopedic Surgery, Østfold Hospital Trust, Grålum, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Åshild Bjørnerem
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
- Norwegian Research Center for Women’s Health, Oslo University Hospital, Oslo, Norway
| | - Frida Igland Nissen
- Department of Clinical Medicine, UiT - The Arctic University of Norway, Tromsø, Norway
- Department of Obstetrics and Gynecology, University Hospital of North Norway, Tromsø, Norway
- Department of Orthopedic Surgery, University Hospital of North Norway, Tromsø, Norway
| | - Lene B. Solberg
- Division of Orthopedic Surgery, Oslo University Hospital, Oslo, Norway
| | - Tone Kristin Omsland
- Department of Community Medicine and Global Health, University of Oslo, Institute of Health and Society, Oslo, Norway
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Zhang A, Lin Y, Kong M, Chen J, Gao W, Fan J, Wang J, Chen Z. A nomogram for predicting the risk of new vertebral compression fracture after percutaneous kyphoplasty. Eur J Med Res 2023; 28:280. [PMID: 37563667 PMCID: PMC10416413 DOI: 10.1186/s40001-023-01235-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/16/2023] [Indexed: 08/12/2023] Open
Abstract
BACKGROUND New vertebral compression fractures (NVCFs) are common adverse events in percutaneous kyphoplasty (PKP). The present study aimed to investigate the risk factors for NVCFs in patients after PKP and to construct a nomogram for the prediction of the risk of re-fracture. METHODS We retrospectively analyzed the medical records of patients after PKP surgery between January 2017 and December 2020. Patients were divided into an NVCF group (n = 225) and a control group (n = 94) based on the presence or absence of NVCFs, respectively, at follow-up within 2 years after surgery. Lasso regression was used to screen for risk factors for re-fracture. Based on the results, a Lasso-logistic regression model was developed, and its prediction performance was evaluated using receiver operating characteristic curves, calibration, and decision curve analysis. The model was visualized, and a nomogram was constructed. RESULTS A total of eight potential predictors were obtained from Lasso screening. Advanced age, low body mass index, low bone mineral density, lack of anti-osteoporosis treatment, low preoperative vertebral body height, vertebral body height recovery ≥ 2, cement leakage, and shape D (lack of simultaneous contact of bone cement with the upper and lower plates) were included in the logistic regression model. CONCLUSIONS A nomogram for predicting postoperative NVCF in PKP was developed and validated. This model can be used for rational assessment of the magnitude of the risk of developing NVCFs after PKP, and can help orthopedic surgeons make clinical decisions aimed at reducing the occurrence of NVCFs.
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Affiliation(s)
- Aiqi Zhang
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, Zhejiang, China
| | - Yichen Lin
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, Zhejiang, China
| | - Mingxiang Kong
- Department of Orthopedics, Zhejiang Provincial People's Hospital, Hangzhou, Zhejiang, China
| | - Jiahao Chen
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, Zhejiang, China
| | - Wei Gao
- The Second Clinical Medical College of Zhejiang, Chinese Medical University, Hangzhou, Zhejiang, China
| | - Jiajun Fan
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Junjie Wang
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China
| | - Zhe Chen
- Department of Orthopedics, The Second Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, Zhejiang, China.
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Zhang Y, Wu H, Li C, Liu C, Liu M, Liu X, Yin Q, Li X, Xie R. Associations between weight-adjusted waist index and bone mineral density: results of a nationwide survey. BMC Endocr Disord 2023; 23:162. [PMID: 37537589 PMCID: PMC10399051 DOI: 10.1186/s12902-023-01418-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 07/17/2023] [Indexed: 08/05/2023] Open
Abstract
BACKGROUND The weight-adjusted waist circumference index (WWI) is a novel obesity indicator that offers improved accuracy in assessing both muscle and fat mass compared to traditional measures. This study aimed to investigate the association between WWI and bone mineral density (BMD) in adults. METHODS Weighted multivariate logistic regression, subgroup analysis, interaction tests and restricted cubic spline (RCS) curves were used to explore the relationship between WWI and BMD based on data from the National Health and Nutrition Examination Survey (NHANES). RESULTS This study had 40,568 individuals in total. At all four measurement sites, we detected a negative linear correlation between WWI and BMD. Even when quartile factors for WWI were created, this unfavorable connection maintained. In comparison to those in the lowest quartile, those in the highest percentile of WWI showed declines in lumbar BMD of 0.08 g/cm2 and femoral neck BMD of 0.03 g/cm2, respectively. This adverse correlation, nevertheless, differed among several categories. CONCLUSIONS Our findings suggest an adverse correlation between WWI and BMD among US adults. Employing WWI as a tool for osteoporosis prevention in the general population may enhance interventions.
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Affiliation(s)
- Ya Zhang
- Department of Gland Surgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China
| | - Haiyang Wu
- Duke Molecular Physiology Institute, Duke University School of Medicine, Duke University, Durham, NC, USA
| | - Cheng Li
- Department of Orthopaedic Surgery, Beijing Jishuitan Hospital, Fourth Clinical College of Peking University, Beijing, China
| | - Changxiong Liu
- Department of Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China
| | - Mingjiang Liu
- Department of Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China
| | - Xiaozhu Liu
- Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiming Yin
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Xianzhe Li
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Ruijie Xie
- Department of Microsurgery, The Affiliated Nanhua Hospital, Hengyang Medical school, University of South China, Hengyang, China.
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany.
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Sheik Ali A. Osteoporosis: A Narrative Review. Cureus 2023; 15:e43031. [PMID: 37674960 PMCID: PMC10479953 DOI: 10.7759/cureus.43031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/08/2023] Open
Abstract
Osteoporosis is a disease of global concern, with significant implications for mortality, morbidity, strain on national health resources, and the negative impact on the quality of life associated with the condition. As we witness a primarily aging population, future predictions indicate that risk factors for osteoporosis will be more prevalent, leading to an increase in the number of individuals suffering from the condition and associated fractures. However, the future of osteoporosis in terms of diagnosis and treatment is optimistic. Understanding of bone quality and examination of it has improved with the onset of magnetic resonance imaging (MRI) and other imaging techniques such as micro-computer tomography. Innovative therapies specifically targeting osteoporotic bone metabolism on a microscopic level hold promise. This narrative review provides details on the background, prognosis, and future treatment strategies of osteoporosis.
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Affiliation(s)
- Azizi Sheik Ali
- Department of Respiratory Medicine, University of Exeter, Exeter, GBR
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Lv X, Lin Y, Zhang Z, Li B, Zeng Z, Jiang X, Zhao Q, Li W, Wang Z, Yang C, Yan H, Wang Q, Huang R, Hu X, Gao L. Investigating the association between serum ADAM/ADAMTS levels and bone mineral density by mendelian randomization study. BMC Genomics 2023; 24:406. [PMID: 37468870 DOI: 10.1186/s12864-023-09449-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 06/14/2023] [Indexed: 07/21/2023] Open
Abstract
PURPOSE A Disintegrin and Metalloproteinase (ADAM) and A Disintegrin and Metalloproteinase with Thrombospondin Motif (ADAMTS) have been reported potentially involved in bone metabolism and related to bone mineral density. This Mendelian Randomization (MR) analysis was performed to determine whether there are causal associations of serum ADAM/ADAMTS with BMD in rid of confounders. METHODS The genome-wide summary statistics of four site-specific BMD measurements were obtained from studies in individuals of European ancestry, including forearm (n = 8,143), femoral neck (n = 32,735), lumbar spine (n = 28,498) and heel (n = 426,824). The genetic instrumental variables for circulating levels of ADAM12, ADAM19, ADAM23, ADAMTS5 and ADAMTS6 were retrieved from the latest genome-wide association study of European ancestry (n = 5336 ~ 5367). The estimated causal effect was given by the Wald ratio for each variant, the inverse-variance weighted model was used as the primary approach to combine estimates from multiple instruments, and sensitivity analyses were conducted to assess the robustness of MR results. The Bonferroni-corrected significance was set at P < 0.0025 to account for multiple testing, and a lenient threshold P < 0.05 was considered to suggest a causal relationship. RESULTS The causal effects of genetically predicted serum ADAM/ADAMTS levels on BMD measurements at forearm, femoral neck and lumbar spine were not statistically supported by MR analyses. Although causal effect of ADAMTS5 on heel BMD given by the primary MR analysis (β = -0.006, -0.010 to 0.002, P = 0.004) failed to reach Bonferroni-corrected significance, additional MR approaches and sensitivity analyses indicated a robust causal relationship. CONCLUSION Our study provided suggestive evidence for the causal effect of higher serum levels of ADAMTS5 on decreased heel BMD, while there was no supportive evidence for the associations of ADAM12, ADAM19, ADAM23, and ADAMTS6 with BMD at forearm, femoral neck and lumbar spine in Europeans.
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Affiliation(s)
- Xin Lv
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Yuhong Lin
- Faculty of Forensic Medicine, Zhongshan School of Medicine, Sun Yat-Sen University, Guangzhou, China
| | - Zhilei Zhang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Bo Li
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Ziliang Zeng
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Xu Jiang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Qiancheng Zhao
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Wenpeng Li
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Zheyu Wang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Canchun Yang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Haolin Yan
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Qiwei Wang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Renyuan Huang
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China
| | - Xumin Hu
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China.
| | - Liangbin Gao
- Department of Orthopedics, Sun Yat-sen Memorial Hospital of Sun Yat-sen University, 107 Yanjiang West Road, Guangzhou, 510120, China.
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Bodden J, Dieckmeyer M, Sollmann N, Burian E, Rühling S, Löffler MT, Sekuboyina A, El Husseini M, Zimmer C, Kirschke JS, Baum T. Incidental vertebral fracture prediction using neuronal network-based automatic spine segmentation and volumetric bone mineral density extraction from routine clinical CT scans. Front Endocrinol (Lausanne) 2023; 14:1207949. [PMID: 37529605 PMCID: PMC10390306 DOI: 10.3389/fendo.2023.1207949] [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: 04/18/2023] [Accepted: 06/14/2023] [Indexed: 08/03/2023] Open
Abstract
Objectives To investigate vertebral osteoporotic fracture (VF) prediction by automatically extracted trabecular volumetric bone mineral density (vBMD) from routine CT, and to compare the model with fracture prevalence-based prediction models. Methods This single-center retrospective study included patients who underwent two thoraco-abdominal CT scans during clinical routine with an average inter-scan interval of 21.7 ± 13.1 months (range 5-52 months). Automatic spine segmentation and vBMD extraction was performed by a convolutional neural network framework (anduin.bonescreen.de). Mean vBMD was calculated for levels T5-8, T9-12, and L1-5. VFs were identified by an expert in spine imaging. Odds ratios (ORs) for prevalent and incident VFs were calculated for vBMD (per standard deviation decrease) at each level, for baseline VF prevalence (yes/no), and for baseline VF count (n) using logistic regression models, adjusted for age and sex. Models were compared using Akaike's and Bayesian information criteria (AIC & BIC). Results 420 patients (mean age, 63 years ± 9, 276 males) were included in this study. 40 (25 female) had prevalent and 24 (13 female) had incident VFs. Individuals with lower vBMD at any spine level had higher odds for VFs (L1-5, prevalent VF: OR,95%-CI,p: 2.2, 1.4-3.5,p=0.001; incident VF: 3.5, 1.8-6.9,p<0.001). In contrast, VF status (2.15, 0.72-6.43,p=0.170) and count (1.38, 0.89-2.12,p=0.147) performed worse in incident VF prediction. Information criteria revealed best fit for vBMD-based models (AIC vBMD=165.2; VF status=181.0; count=180.7). Conclusions VF prediction based on automatically extracted vBMD from routine clinical MDCT outperforms prediction models based on VF status and count. These findings underline the importance of opportunistic quantitative osteoporosis screening in clinical routine MDCT data.
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Affiliation(s)
- Jannis Bodden
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Michael Dieckmeyer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, University of Bern, Bern, Switzerland
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Egon Burian
- Department of Diagnostic and Interventional Radiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sebastian Rühling
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Maximilian T. Löffler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Medical Center Freiburg, Freiburg im Breisgau, Germany
| | - Anjany Sekuboyina
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Informatics, Technical University of Munich, Munich, Germany
- Munich School of BioEngineering, Technical University of Munich, Munich, Germany
| | - Malek El Husseini
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Department of Informatics, Technical University of Munich, Munich, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Jan S. Kirschke
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Thomas Baum
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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Nishimura Y, Inagaki Y, Noda T, Nishioka Y, Myojin T, Ogawa M, Kido A, Imamura T, Tanaka Y. Risk factors for mortality after hip fracture surgery in Japan using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. Arch Osteoporos 2023; 18:91. [PMID: 37418095 PMCID: PMC10329059 DOI: 10.1007/s11657-023-01293-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 05/29/2023] [Indexed: 07/08/2023]
Abstract
We investigated the risk factors for mortality of hip fracture in the elderly using the National Database of Health Insurance Claims in Japan, and survival was significantly related to sex, age, fracture type, surgical procedure, delayed operative date, comorbidities, blood transfusions, and pulmonary embolism. PURPOSE Hip fracture is the most common fracture in the elderly and is known to have a high mortality rate. In Japan, to the best of our knowledge, no studies have reported on mortality risk factors for hip fracture using nationwide registry databases. This study aimed to determine the number of occurrences of hip fracture and factors that increase mortality using the National Database of Health Insurance Claims and Specific Health Checkups of Japan. METHODS This study included extracted data from patients who were hospitalized and underwent surgical treatment for hip fracture between 2013 and 2021, using a nationwide health insurance claims database in Japan. Patient characteristics, such as sex, age, fracture type, surgical procedure, delayed operative date, comorbidities, blood transfusions, and pulmonary embolism, were tabulated to obtain 1-year and in-hospital mortality rates. RESULTS Both 1-year and in-patient survival were significantly lower in men, older patients, patients who underwent surgery after 3 days of admission, and patients with trochanteric and subtrochanteric fractures, internal fixation, more preoperative comorbidities, blood transfusions, and pulmonary embolism. CONCLUSIONS Survival was significantly related to sex, age, fracture type, surgical procedure, delayed operative date, comorbidities, blood transfusions, and pulmonary embolism. As the number of male patients with hip fracture will increase with the aging of society, medical staff must provide sufficient information before surgery to avoid postoperative mortality.
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Affiliation(s)
- Yuki Nishimura
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
| | - Yusuke Inagaki
- Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan.
| | - Tatsuya Noda
- Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan.
| | - Yuichi Nishioka
- Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan
| | - Tomoya Myojin
- Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan
| | - Munehiro Ogawa
- Department of Sports Medicine, Nara Medical University, Kashihara, Japan
| | - Akira Kido
- Department of Rehabilitation Medicine, Nara Medical University, Kashihara, Japan
| | - Tomoaki Imamura
- Department of Public Health, Health Management and Policy, Nara Medical University, Kashihara, Japan
| | - Yasuhito Tanaka
- Department of Orthopaedic Surgery, Nara Medical University, Kashihara, Japan
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Kakar MU, Karim H, Shabir G, Iqbal I, Akram M, Ahmad S, Shafi M, Gul P, Riaz S, Rehman R, Salari H. A review on extraction, composition, structure, and biological activities of polysaccharides from different parts of Nelumbo nucifera. Food Sci Nutr 2023; 11:3655-3674. [PMID: 37457175 PMCID: PMC10345683 DOI: 10.1002/fsn3.3376] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Revised: 03/30/2023] [Accepted: 04/04/2023] [Indexed: 07/18/2023] Open
Abstract
Nelumbo nucifera (lotus plant) is an important member of the Nelumbonaceae family. This review summarizes the studies conducted on it since the past 15 years to provide an understanding on future areas of focus. Different parts of this plant, that is, leaves, roots, and seeds, have been used as food and for the treatment of various diseases. Polysaccharides have been extracted from different parts using different methods. The manuscript reviews the methods of extraction of polysaccharides used for leaves, roots, and seeds, along with their yield. Some methods can provide better yield while some provide better biological activity with low yield. The composition and structure of extracted polysaccharides have been determined in some studies. Although monosaccharide composition has been determined in various studies, too little information about the structure of polysaccharides from N. nucifera is available in the current literature. Different useful biological activities have been explored using in vivo and in vitro methods, which include antioxidant, antidiabetic, antitumor, anti-osteoporotic, immunomodulatory, and prebiotic activities. Antitumor activity from polysaccharides of lotus leaves is yet to be explored, besides lotus root has been underexplored as compared to other parts (leaves and seeds) according to our literature survey. Studies dedicated to the successful use of combination of extraction methods can be conducted in future. The plant provides a therapeutic as well as nutraceutical potential; however, antimicrobial activity and synergistic relationships of polysaccharides from different parts of the plant need further exploration.
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Affiliation(s)
- Mohib Ullah Kakar
- Faculty of Marine SciencesLasbela University of Agriculture, Water and Marine Sciences (LUAWMS)UthalBalochistanPakistan
| | - Hammad Karim
- Sheikh Zayed Medical CollegeRahim Yar KhanPunjabPakistan
| | | | - Imran Iqbal
- Department of Information and Computational SciencesSchool of Mathematical Sciences and LMAMPeking UniversityBeijingChina
| | - Muhammad Akram
- Department of Life Sciences, School of ScienceUniversity of Management and Technology (UMT)LahorePakistan
| | - Sajjad Ahmad
- Faculty of Veterinary and Animal SciencesLasbela University of Agriculture, Water and Marine Sciences (LUAWMS)UthalBalochistanPakistan
| | - Muhammad Shafi
- Faculty of Marine SciencesLasbela University of Agriculture, Water and Marine Sciences (LUAWMS)UthalBalochistanPakistan
| | - Pari Gul
- Institute of BiochemistryUniversity of BalochistanQuettaPakistan
| | - Sania Riaz
- Department of Bioinformatics and BiosciencesCapital University of Science and TechnologyIslamabadPakistan
| | - Rizwan‐ur‐ Rehman
- Department of Bioinformatics and BiosciencesCapital University of Science and TechnologyIslamabadPakistan
| | - Hamid Salari
- Department of Horticulture, Faculty of AgricultureKabul UniversityKabulAfghanistan
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Zhou L, Qin B, Yassine DM, Luo M, Liu X, Wang F, Wang Y. Structure and function of the highly homologous deubiquitinases ubiquitin specific peptidase 25 and 28: Insights into their pathophysiological and therapeutic roles. Biochem Pharmacol 2023; 213:115624. [PMID: 37245535 DOI: 10.1016/j.bcp.2023.115624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 05/19/2023] [Accepted: 05/22/2023] [Indexed: 05/30/2023]
Abstract
Deubiquitination is the reverse process of ubiquitination, an important protein post-translational modification. Deubiquitination is assisted by deubiquitinating enzymes (DUBs), which catalyze the hydrolysis and removal of ubiquitin chains from targeted proteins and play an important role in regulating protein stability, cell signaling transduction, and programmed cell death. Ubiquitin-specific peptidases 25 and 28 (USP25 and USP28), important members of the USP subfamily of DUBs, are highly homologous, strictly regulated, and closely associated with various diseases, such as cancer and neurodegenerative diseases. Recently, the development of inhibitors targeting USP25 and USP28 for disease treatment has garnered extreme attention. Several non-selective and selective inhibitors have shown potential inhibitory effects. However, the specificity, potency, and action mechanism of these inhibitors remain to be further improved and clarified. Herein, we summarize the structure, regulation, emerging physiological roles, and target inhibition of USP25 and USP28 to provide a basis for the development of highly potent and specific inhibitors for the treatment of diseases, such as colorectal cancer, breast cancer and so on.
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Affiliation(s)
- Lihui Zhou
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Biying Qin
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Demna Mohamed Yassine
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Maoguo Luo
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Xiaoling Liu
- School of Life Sciences, Beijing University of Chinese Medicine, Beijing, China
| | - Feng Wang
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China
| | - Yanfeng Wang
- Key Laboratory of Molecular Medicine and Biotherapy, School of Life Science, Beijing Institute of Technology, Beijing 100081, China.
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Lyu Z, Hu Y, Guo Y, Liu D. Modulation of bone remodeling by the gut microbiota: a new therapy for osteoporosis. Bone Res 2023; 11:31. [PMID: 37296111 DOI: 10.1038/s41413-023-00264-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 04/01/2023] [Accepted: 04/18/2023] [Indexed: 06/12/2023] Open
Abstract
The gut microbiota (GM) plays a crucial role in maintaining the overall health and well-being of the host. Recent studies have demonstrated that the GM may significantly influence bone metabolism and degenerative skeletal diseases, such as osteoporosis (OP). Interventions targeting GM modification, including probiotics or antibiotics, have been found to affect bone remodeling. This review provides a comprehensive summary of recent research on the role of GM in regulating bone remodeling and seeks to elucidate the regulatory mechanism from various perspectives, such as the interaction with the immune system, interplay with estrogen or parathyroid hormone (PTH), the impact of GM metabolites, and the effect of extracellular vesicles (EVs). Moreover, this review explores the potential of probiotics as a therapeutic approach for OP. The insights presented may contribute to the development of innovative GM-targeted therapies for OP.
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Affiliation(s)
- Zhengtian Lyu
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Yongfei Hu
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Yuming Guo
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China
| | - Dan Liu
- State Key Laboratory of Animal Nutrition, College of Animal Science and Technology, China Agricultural University, Beijing, 100193, China.
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Jaiswal R, Zoulakis M, Axelsson KF, Darelid A, Rudäng R, Sundh D, Litsne H, Johansson L, Lorentzon M. Increased Bone Material Strength Index Is Positively Associated With the Risk of Incident Osteoporotic Fractures in Older Swedish Women. J Bone Miner Res 2023; 38:860-868. [PMID: 37088885 DOI: 10.1002/jbmr.4816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/04/2023] [Accepted: 04/16/2023] [Indexed: 04/25/2023]
Abstract
No previous studies have investigated the association between the bone material strength index (BMSi; an indicator of bone material properties obtained by microindentation) and the risk of incident fracture. The primary purpose of this prospective cohort study was to evaluate if BMSi is associated with incident osteoporotic fracture in older women and, secondarily, with prevalent fractures, anthropometric traits, or measurements of bone mineral density (BMD) by dual-energy X-ray absorptiometry (DXA). In a population-based cohort, 647 women aged 75 to 80 years underwent bone microindentation using the OsteoProbe device. Data on clinical risk factors (CRFs), prevalent fractures, and incident fractures were collected using questionnaires, medical records, and a regional X-ray archive. BMD and vertebral fracture assessment (VFA) were assessed by DXA (Hologic, Discovery A). Associations between BMSi, anthropometrics, BMD, and prevalent fractures were investigated using correlation and linear and logistic regression. Cox proportional hazards and competing risks analysis by Fine and Gray were used to study the association between BMSi and the risk of fracture and mortality. BMSi was weakly associated with age (r = -0.13, p < 0.001) and BMI (r = -0.21, p < 0.001) and with BMD of lumbar spine (β = 0.09, p = 0.02) and total hip (β = 0.08, p = 0.05), but only after adjustments. No significant associations were found between BMSi and prevalent fractures (self-reported and/or VFA identified, n = 332). During a median follow-up time of 6.0 years, 121 major osteoporotic fractures (MOF), 151 any fractures, and 50 deaths occurred. Increasing BMSi (per SD) was associated with increased risk of MOF (hazard ratio [HR] = 1.29, 95% confidence interval [CI] 1.07-1.56), any fracture (HR = 1.29, 95% CI 1.09-1.53), and mortality (HR = 1.44, 95% CI 1.07-1.93). The risk of fracture did not materially change with adjustment for confounders, CRFs, femoral neck BMD, or when considering the competing risk of death. In conclusion, unexpectedly increasing BMSi was associated with greater fracture risk. The clinical relevance and potential mechanisms of this finding require further study. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Raju Jaiswal
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Michail Zoulakis
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Kristian F Axelsson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Närhälsan Norrmalm, Health Centre, Skövde, Sweden
| | - Anna Darelid
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Robert Rudäng
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Daniel Sundh
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Henrik Litsne
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Lisa Johansson
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Orthopedic Surgery, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Mattias Lorentzon
- Sahlgrenska Osteoporosis Centre, Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Department of Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
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Hao S, Tian C, Bai Y, Wu L, Hao L, Kuang Y, Yang S, Mao H, Gu Z. Photo-crosslinkable hyaluronic acid microgels with reactive oxygen species scavenging capacity for mesenchymal stem cell encapsulation. Int J Biol Macromol 2023:124971. [PMID: 37236562 DOI: 10.1016/j.ijbiomac.2023.124971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/15/2023] [Accepted: 05/17/2023] [Indexed: 05/28/2023]
Abstract
Mesenchymal stem cells (MSCs) have gained increasing attention in various biomedical applications. However, conventional therapeutic approaches, such as direct intravenous injection, are associated with low cell survival due to the shear force during injection and the oxidative stress microenvironments in the lesion area. Herein, a photo-crosslinkable antioxidant hydrogel based on tyramine- and dopamine-modified hyaluronic acid (HA-Tyr/HA-DA) was developed. Meanwhile, human umbilical cord-derived mesenchymal stem cells (hUC-MSCs) were encapsulated in HA-Tyr/HA-DA hydrogel using a microfluidic system to create size-controllable microgels (hUC-MSCs@microgels). The HA-Tyr/HA-DA hydrogel was demonstrated to have good rheology, biocompatibility, and antioxidant properties for cell microencapsulation. The hUC-MSCs encapsulated in microgels showed a high viability and a significantly improved the survival rate under oxidative stress conditions. Therefore, the presented work provides a promising platform for MSCs microencapsulation, which may further improve the stem cell-based biomedical applications.
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Affiliation(s)
- Shiqi Hao
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China
| | - Chen Tian
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China
| | - Yimeng Bai
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China
| | - Lihuang Wu
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China
| | - Lili Hao
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China
| | - Yi Kuang
- College of Chemical and Materials Engineering, Zhejiang A&F University, Lin'an 311300, China
| | - Shengxiang Yang
- College of Chemical and Materials Engineering, Zhejiang A&F University, Lin'an 311300, China.
| | - Hongli Mao
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China; NJTech-BARTY Joint Research Center for Innovative Medical Technology, Nanjing 210000, China.
| | - Zhongwei Gu
- Research Institute for Biomaterials, Tech Institute for Advanced Materials, College of Materials Science and Engineering, Jiangsu Collaborative Innovation Center for Advanced Inorganic Function Composites, Suqian Advanced Materials Industry Technology Innovation Center, Nanjing Tech University, Nanjing 211816, China; NJTech-BARTY Joint Research Center for Innovative Medical Technology, Nanjing 210000, China
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Ismail OM, El-Omar OM, Said UN. Exploring the Role of Urocortin in Osteoporosis. Cureus 2023; 15:e38978. [PMID: 37313093 PMCID: PMC10259878 DOI: 10.7759/cureus.38978] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/13/2023] [Indexed: 06/15/2023] Open
Abstract
Osteoporosis is a debilitating disease that affects over 200 million people worldwide. Overactive osteoclast activity leads to micro-architectural defects and low bone mass. This culminates in fragility fractures, such as femoral neck fractures. Treatments currently available either are not completely effective or have considerable side effects; thus, there is a need for more effective treatments. The urocortin (Ucn) family, composed of urocortin 1 (Ucn1), urocortin 2 (Ucn2), urocortin 3 (Ucn3), corticotropin-releasing factor (CRF) and corticotropin-releasing factor-binding protein (CRF-BP), exerts a wide range of effects throughout the body. Ucn1 has been shown to inhibit murine osteoclast activity. This review article will aim to bridge the gap between existing knowledge of Ucn and whether it can affect human osteoclasts.
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Affiliation(s)
- Omar M Ismail
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, GBR
| | - Omar M El-Omar
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, GBR
| | - Umar N Said
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, GBR
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Ahn TR, Yoon YC, Kim HS, Kim K, Lee JH. Association Between Pelvic Bone Computed Tomography-Derived Body Composition and Patient Outcomes in Older Adults With Proximal Femur Fracture. Korean J Radiol 2023; 24:434-443. [PMID: 37133212 PMCID: PMC10157326 DOI: 10.3348/kjr.2022.0835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2022] [Revised: 02/22/2023] [Accepted: 03/13/2023] [Indexed: 05/04/2023] Open
Abstract
OBJECTIVE To investigate the association between pelvic bone computed tomography (CT)-derived body composition and patient outcomes in older adult patients who underwent surgery for proximal femur fractures. MATERIALS AND METHODS We retrospectively identified consecutive patients aged ≥ 65 years who underwent pelvic bone CT and subsequent surgery for proximal femur fractures between July 2018 and September 2021. Eight CT metrics were calculated from the cross-sectional area and attenuation of the subcutaneous fat and muscle, including the thigh subcutaneous fat (TSF) index, TSF attenuation, thigh muscle (TM) index, TM attenuation, gluteus maximus (GM) index, GM attenuation, gluteus medius and minimus (Gmm) index, and Gmm attenuation. The patients were dichotomized using the median value of each metric. Multivariable Cox regression and logistic regression models were used to determine the association between CT metrics with overall survival (OS) and postsurgical intensive care unit (ICU) admission, respectively. RESULTS A total of 372 patients (median age, 80.5 years; interquartile range, 76.0-85.0 years; 285 females) were included. TSF attenuation above the median (adjusted hazard ratio [HR], 2.39; 95% confidence interval [CI], 1.41-4.05), GM index below the median (adjusted HR, 2.63; 95% CI, 1.33-5.26), and Gmm index below the median (adjusted HR, 2.33; 95% CI, 1.12-4.55) were independently associated with shorter OS. TSF index (adjusted odds ratio [OR], 6.67; 95% CI, 3.13-14.29), GM index (adjusted OR, 3.45; 95% CI, 1.49-7.69), GM attenuation (adjusted OR, 2.33; 95% CI, 1.02-5.56), Gmm index (adjusted OR, 2.70; 95% CI, 1.22-5.88), and Gmm attenuation (adjusted OR, 2.22; 95% CI, 1.01-5.00) below the median were independently associated with ICU admission. CONCLUSION In older adult patients who underwent surgery for proximal femur fracture, low muscle indices of the GM and gluteus medius/minimus obtained from their cross-sectional areas on preoperative pelvic bone CT were significant prognostic markers for predicting high mortality and postsurgical ICU admission.
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Affiliation(s)
- Tae Ran Ahn
- Department of Radiology, Gil Medical Center, Gachon University School of Medicine, Incheon, Korea
| | - Young Cheol Yoon
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyun Su Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyunga Kim
- Biomedical Statistics Center, Research Institute for Future Medicine, Samsung Medical Center, Seoul, Korea
| | - Ji Hyun Lee
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
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Yeni YN, Oravec D, Drost J, Zauel R, Flynn MJ. Stiffness and Strain Properties Derived From Digital Tomosynthesis-Based Digital Volume Correlation Predict Vertebral Strength Independently From Bone Mineral Density. J Biomech Eng 2023; 145:041009. [PMID: 36350266 PMCID: PMC9791669 DOI: 10.1115/1.4056196] [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: 05/25/2022] [Revised: 10/31/2022] [Indexed: 11/11/2022]
Abstract
Vertebral fractures are the most common osteoporotic fractures, but their prediction using standard bone mineral density (BMD) measurements from dual energy X-ray absorptiometry (DXA) is limited in accuracy. Stiffness, displacement, and strain distribution properties derived from digital tomosynthesis-based digital volume correlation (DTS-DVC) have been suggested as clinically measurable metrics of vertebral bone quality. However, the extent to which these properties correlate to vertebral strength is unknown. To establish this relationship, two independent experiments, one examining isolated T11 and the other examining L3 vertebrae within the L2-L4 segments from cadaveric donors were utilized. Following DXA and DTS imaging, the specimens were uniaxially compressed to fracture. BMD, bone mineral content (BMC), and bone area were recorded for the anteroposterior and lateromedial views from DXA, stiffness, endplate to endplate displacement and distribution statistics of intravertebral strains were calculated from DTS-DVC and vertebral strength was measured from mechanical tests. Regression models were used to examine the relationships of strength with the other variables. Correlations of BMD with vertebral strength varied between experimental groups (R2adj = 0.19-0.78). DTS-DVC derived properties contributed to vertebral strength independently from BMD measures (increasing R2adj to 0.64-0.95). DTS-DVC derived stiffness was the best single predictor (R2adj = 0.66, p < 0.0001) and added the most to BMD in models of vertebral strength for pooled T11 and L3 specimens (R2adj = 0.95, p < 0.0001). These findings provide biomechanical relevance to DTS-DVC calculated properties of vertebral bone and encourage further efforts in the development of the DTS-DVC approach as a clinical tool.
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Affiliation(s)
- Yener N. Yeni
- Bone & Joint Center, Henry Ford Hospital Integrative Biosciences Center (iBio), 6135 Woodward, Detroit, MI 48202
| | - Daniel Oravec
- Bone & Joint Center, Henry Ford Hospital Integrative Biosciences Center (iBio), 6135 Woodward, Detroit, MI 48202
| | - Joshua Drost
- Bone & Joint Center, Henry Ford Hospital Integrative Biosciences Center (iBio), 6135 Woodward, Detroit, MI 48202
| | - Roger Zauel
- Bone & Joint Center, Henry Ford Hospital Integrative Biosciences Center (iBio), 6135 Woodward, Detroit, MI 48202
| | - Michael J. Flynn
- Department of Radiology, Henry Ford Hospital, One Ford Place, Suite 2F, Detroit, MI 48202
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Axelsson KF, Litsne H, Lorentzon M. The Importance of Recent Prevalent Fracture Site for Imminent Risk of Fracture - A Retrospective, Nationwide Cohort Study of Older Swedish Men and Women. J Bone Miner Res 2023. [PMID: 36970835 DOI: 10.1002/jbmr.4806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 03/08/2023] [Accepted: 03/21/2023] [Indexed: 04/26/2023]
Abstract
There is limited evidence regarding which fracture types carry the highest risk for subsequent fracture. The aim of this study was to investigate how the risk of imminent fracture depends on index fracture site. This nationwide retrospective cohort study utilized national registers in Sweden to determine the risk of fracture according to recent (≤2 years) index fracture site and according to an old (>2 years) prevalent fracture compared with the risk observed in controls without a fracture. All Swedes 50 years or older between 2007 and 2010 were included in the study. Patients with a recent fracture were designated a specific fracture group depending on the type of previous fracture. Recent fractures were classified as major osteoporotic fracture (MOF), including fractured hip, vertebra, proximal humerus, and wrist, or non-MOF. Patients were followed until December 31, 2017, censored for death and emigration, and the risk of any fracture and hip fracture was assessed. A total of 3,423,320 persons were included in the study, 70,254 with a recent MOF, 75,526 with a recent non-MOF, 293,051 with an old fracture, and 2,984,489 persons with no previous fracture. The median time of follow-up for the four groups was 6.1 (interquartile range [IQR] 3.0-8.8), 7.2 (5.6-9.4), 7.1 (5.8-9.2), and 8.1 years (7.4-9.7), respectively. Patients with a recent MOF, recent non-MOF, and old fracture had a substantially increased risk of any fracture (hazard ratio [HR] adjusted for age and sex 2.11, 95% confidence interval [CI] 2.08-2.14; HR 2.24, 95% CI 2.21-2.27; and HR 1.77, 95% CI 1.76-1.78, respectively) compared with controls. All recent fractures, MOFs, and non-MOFs, as well as older fractures, increase the risk of subsequent fracture, suggesting that all recent fractures should be included in fracture liaison services and that case-finding strategies for those with older fractures may be warranted to prevent subsequent fractures. © 2023 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Kristian F Axelsson
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Region Västra Götaland, Närhälsan Norrmalm Health Centre, Skövde, Sweden
| | - Henrik Litsne
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Mattias Lorentzon
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Region Västra Götaland, Geriatric Medicine, Sahlgrenska University Hospital, Mölndal, Sweden
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Stief F, Sohn A, Vogt L, Meurer A, Kirchner M. Characterization of Postural Sway in Women with Osteoporosis and a Control Group by Means of Linear and Nonlinear Methods. Bioengineering (Basel) 2023; 10:bioengineering10040403. [PMID: 37106590 PMCID: PMC10135765 DOI: 10.3390/bioengineering10040403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 03/13/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
The mechanisms underlying the altered postural control and risk of falling in patients with osteoporosis are not yet fully understood. The aim of the present study was to investigate postural sway in women with osteoporosis and a control group. The postural sway of 41 women with osteoporosis (17 fallers and 24 non-fallers) and 19 healthy controls was measured in a static standing task with a force plate. The amount of sway was characterized by traditional (linear) center-of-pressure (COP) parameters. Structural (nonlinear) COP methods include spectral analysis by means of a 12-level wavelet transform and a regularity analysis via multiscale entropy (MSE) with determination of the complexity index. Patients showed increased body sway in the medial–lateral (ML) direction (standard deviation in mm: 2.63 ± 1.00 vs. 2.00 ± 0.58, p = 0.021; range of motion in mm: 15.33 ± 5.58 vs. 10.86 ± 3.14, p = 0.002) and more irregular sway in the anterior–posterior (AP) direction (complexity index: 13.75 ± 2.19 vs. 11.18 ± 4.44, p = 0.027) relative to controls. Fallers showed higher-frequency responses than non-fallers in the AP direction. Thus, postural sway is differently affected by osteoporosis in the ML and AP directions. Clinically, effective assessment and rehabilitation of balance disorders can benefit from an extended analysis of postural control with nonlinear methods, which may also contribute to the improvement of risk profiles or a screening tool for the identification of high-risk fallers, thereby prevent fractures in women with osteoporosis.
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Affiliation(s)
- Felix Stief
- Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
- Dr. Rolf M. Schwiete Research Unit for Osteoarthritis, Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
- Correspondence: ; Tel.: +49-(69)-6301-94862
| | - Anna Sohn
- Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Institute of Sports Sciences, Goethe University Frankfurt, 60487 Frankfurt am Main, Germany
| | - Andrea Meurer
- Department of Orthopedics (Friedrichsheim), University Hospital, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany
| | - Marietta Kirchner
- Institute of Medical Biometry, University Hospital Heidelberg, 69120 Heidelberg, Germany
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50
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Huang H, Chen J, Lin Z, Lin X. Rubiadin Regulates Bone Metabolism in Ovariectomized Rat Model by Inhibition of osteoclast formation and differentiation. ChemistrySelect 2023. [DOI: 10.1002/slct.202300115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/16/2023]
Affiliation(s)
- Hui Huang
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
| | - Jian Chen
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
| | - Zhengkun Lin
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
| | - Xiaomei Lin
- Department of Rehabilitation Zhongshan Hospital Xiamen University Xiamen 361004 China
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