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Li RX, Xu N, Guo YN, Wang Y, Liang YW, Zhou XL, Jiang WT, Wei JX, Zhang XY, Zhou LN, Zhu L, Zhou YM, Xu J. Hemoglobin is associated with BMDs and risk of the 10-year probability of fractures in patients with type 2 diabetes mellitus. Front Endocrinol (Lausanne) 2024; 15:1305713. [PMID: 38323109 PMCID: PMC10846305 DOI: 10.3389/fendo.2024.1305713] [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: 10/19/2023] [Accepted: 01/02/2024] [Indexed: 02/08/2024] Open
Abstract
Purpose This study aimed to investigate the associations between hemoglobin (HGB) levels and bone mineral density (BMD) and fracture risk in type 2 diabetes mellitus(T2DM) population of different ages. Method This cross-sectional study included 641 patients with T2DM (57.9% males). BMD of the femoral neck (FN), total hip (TH), and lumbar spine (LS) were measured using dual-energy X-ray absorptiometry. The 10-year probability of fracture was assessed using a fracture risk assessment tool (FRAX). HGB and other biochemical indices were measured in a certified laboratory at our hospital. Statistical analysis was performed using SPSS 26.0 and R language (R version 4.1.0). Generalized additive models (GAMs) were used to identify the associations between HGB and BMD and fracture risk. Results Patients with osteoporosis have lower HGB levels than the non-osteoporotic population and lower FN BMD in patients with anemia than in the non-anemic population. In patients with T2DM, there was sex- and age-related variability in the correlation between HGB levels and BMDs and fracture risk. In older men, HGB level was an independent determinant of BMD and was positively correlated with FN and TH BMD. In non-older women, HGB level was an independent determinant of BMD and fracture risk, positively associated with BMDs and negatively associated with 10-year probability of fracture risk. GAMs revealed a positive linear association between HGB level and BMDs in non-older female patients but not in older male patients. Conclusion Our study provides a new perspective on the association of HGB level and BMDs with fracture risk. Relatively high HGB levels are a protective factor for bone quality in patients with T2DM. However, the bone-protective effect of HGB is influenced by age and sex and persists only in older men and non-older women with T2DM.
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Affiliation(s)
- Ren-xuan Li
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Na Xu
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Yu-ning Guo
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Yan Wang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Yan-wei Liang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Xiao-lian Zhou
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Wen-tong Jiang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Jian-xia Wei
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Xin-yuan Zhang
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
| | - Li-na Zhou
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Lei Zhu
- Department of Endocrinology, Shandong Provincial Third Hospital, Jinan, Shandong, China
| | - Yan-man Zhou
- Department of Nephrology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Department of Nephrology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Jin Xu
- Department of Endocrinology, Shandong Provincial Hospital, Shandong University, Jinan, Shandong, China
- Key Laboratory of Endocrine Glucose & Lipids Metabolism and Brain Aging, Ministry of Education; Department of Endocrinology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Department of Endocrinology, Shandong Clinical Research Center of Diabetes and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Institute of Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, “Chuangxin China” Innovation Base of Stem Cell and Gene Therapy for Endocrine Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Laboratory of Prevention and Control for Endocrine and Metabolic Diseases, Jinan, Shandong, China
- Department of Endocrinology, Shandong Engineering Research Center of Stem Cell and Gene Therapy for Endocrine and Metabolic Diseases, Jinan, Shandong, China
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Pepe J, Colangelo L, De Martino V, Occhiuto M, Iervolino D, Pasqualetti P, Minisola S, Cipriani C. Study of the link between hemotopoietic and skeletal systems in patients attending a referral center for osteoporosis. J Endocrinol Invest 2023; 46:2391-2397. [PMID: 37061647 PMCID: PMC10558366 DOI: 10.1007/s40618-023-02095-3] [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: 03/04/2023] [Accepted: 04/06/2023] [Indexed: 04/17/2023]
Abstract
PURPOSE To investigate the link between hematopoietic and skeletal tissues in patients with fragility fractures. METHODS We retrospectively analyzed the medical records of women older than 40 years who attended the Bone Disease Unit of "Sapienza" University of Rome for their first visit for osteoporosis from January 2020 to June 2022. RESULTS Fragility fractures were found in 61.8% of the sample. In particular, vertebral fractures in 35.5%, femoral fractures in 6.3%, Colles fractures in 16.5% and non-vertebral non-hip in 42.5%. Fractured patients were significantly older compared to non-fractured, had lower mean values of lumbar spine (p = 0.01), and femoral neck BMD (p = 0.007). A red blood cell distribution width (RDW) value higher than 15% was observed four times more in those with fractures compared to non-fractured patients (8.9% vs 2%, p = 0.01) and was associated with vertebral fracture after adjusting for age, BMI, menopause, nutritional status, smoking, osteoporosis and anemia (OR = 4.1, 95% CI 1.6-11.4, p = 0.003). Hematocrit was negatively associated with hip fracture also adjusting for age, BMI, menopause, nutritional status, smoking, osteoporosis (p = 0.025). CONCLUSION Our study demonstrates that RDW values were significantly associated with vertebral fracture and hematocrit with hip fracture. Since both parameters are included in the initial evaluation of patients with suspected bone fragility, our results should push doctors to look at these values with no incremental cost for national health services.
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Affiliation(s)
- J Pepe
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy.
| | - L Colangelo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - V De Martino
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - M Occhiuto
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
- Department of Public Health and Infectious Diseases, Section of Medical Statistics, Sapienza University of Rome, Rome, Italy
| | - D Iervolino
- Department of Public Health and Infectious Diseases, Section of Medical Statistics, Sapienza University of Rome, Rome, Italy
| | - P Pasqualetti
- Department of Public Health and Infectious Diseases, Section of Medical Statistics, Sapienza University of Rome, Rome, Italy
| | - S Minisola
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | - C Cipriani
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
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3
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Kikuchi S, Wada A, Kamihara Y, Yamamoto I, Kirigaya D, Kunimoto K, Horaguchi R, Fujihira T, Nabe Y, Minemura T, Dang NH, Sato T. A Novel Mechanism for Bone Loss: Platelet Count Negatively Correlates with Bone Mineral Density via Megakaryocyte-Derived RANKL. Int J Mol Sci 2023; 24:12150. [PMID: 37569526 PMCID: PMC10418703 DOI: 10.3390/ijms241512150] [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: 07/04/2023] [Revised: 07/23/2023] [Accepted: 07/27/2023] [Indexed: 08/13/2023] Open
Abstract
A potential association between hematopoietic stem cell status in bone marrow and surrounding bone tissue has been hypothesized, and some studies have investigated the link between blood count and bone mineral density (BMD), although their exact relationship remains controversial. Moreover, biological factors linking the two are largely unknown. In our present study, we found no clear association between platelet count and BMD in the female group, with aging having a very strong effect on BMD. On the other hand, a significant negative correlation was found between platelet count and BMD in the male group. As a potential mechanism, we examined whether megakaryocytes, the source of platelet production, secrete cytokines that regulate BMD, namely OPG, M-CSF, and RANKL. We detected the production of these cytokines by megakaryocytes derived from bone marrow mononuclear cells, and found that RANKL was negatively correlated with BMD. This finding suggests that RANKL production by megakaryocytes may mediate the negative correlation between platelet count and BMD. To our knowledge, this is the first report to analyze bone marrow cells as a mechanism for the association between blood count and BMD. Our study may provide new insights into the development and potential treatment of osteoporosis.
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Affiliation(s)
- Shohei Kikuchi
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Akinori Wada
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Yusuke Kamihara
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Imari Yamamoto
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Daiki Kirigaya
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Kohei Kunimoto
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Ryusuke Horaguchi
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Takuma Fujihira
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Yoshimi Nabe
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Tomoki Minemura
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
| | - Nam H. Dang
- Division of Hematology/Oncology, University of Florida, Gainesville, FL 32610, USA;
| | - Tsutomu Sato
- Department of Hematology, Faculty of Medicine, Academic Assembly, University of Toyama, 2630 Sugitani, Toyama 930-0194, Japan; (S.K.); (A.W.); (Y.K.); (I.Y.); (D.K.); (K.K.); (R.H.); (T.F.); (Y.N.); (T.M.)
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Wu X, Park S. A Prediction Model for Osteoporosis Risk Using a Machine-Learning Approach and Its Validation in a Large Cohort. J Korean Med Sci 2023; 38:e162. [PMID: 37270917 DOI: 10.3346/jkms.2023.38.e162] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/15/2023] [Indexed: 06/06/2023] Open
Abstract
BACKGROUND Osteoporosis develops in the elderly due to decreased bone mineral density (BMD), potentially increasing bone fracture risk. However, the BMD is not regularly measured in a clinical setting. This study aimed to develop a good prediction model for the osteoporosis risk using a machine learning (ML) approach in adults over 40 years in the Ansan/Anseong cohort and the association of predicted osteoporosis risk with a fracture in the Health Examinees (HEXA) cohort. METHODS The 109 demographic, anthropometric, biochemical, genetic, nutrient, and lifestyle variables of 8,842 participants were manually selected in an Ansan/Anseong cohort and included in the ML algorithm. The polygenic risk score (PRS) of osteoporosis was generated with a genome-wide association study and added for the genetic impact of osteoporosis. Osteoporosis was defined with < -2.5 T scores of the tibia or radius compared to people in their 20s-30s. They were divided randomly into the training (n = 7,074) and test (n = 1,768) sets-Pearson's correlation between the predicted osteoporosis risk and fracture in the HEXA cohort. RESULTS XGBoost, deep neural network, and random forest generated the prediction model with a high area under the curve (AUC, 0.86) of the receiver operating characteristic (ROC) with 10, 15, and 20 features; the prediction model by XGBoost had the highest AUC of ROC, high accuracy and k-fold values (> 0.85) in 15 features among seven ML approaches. The model included the genetic factor, genders, number of children and breastfed children, age, residence area, education, seasons to measure, height, smoking status, hormone replacement therapy, serum albumin, hip circumferences, vitamin B6 intake, and body weight. The prediction models for women alone were similar to those for both genders, with lower accuracy. When the prediction model was applied to the HEXA study, the correlation between the fracture incidence and predicted osteoporosis risk was significant but weak (r = 0.173, P < 0.001). CONCLUSION The prediction model for osteoporosis risk generated by XGBoost can be applied to estimate osteoporosis risk. The biomarkers can be considered for enhancing the prevention, detection, and early therapy of osteoporosis risk in Asians.
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Affiliation(s)
- Xuangao Wu
- Department of Bioconvergence, Hoseo University, Asan, Korea
| | - Sunmin Park
- Department of Bioconvergence, Hoseo University, Asan, Korea
- Department of Food and Nutrition, Obesity/Diabetes Research Center, Hoseo University, Asan, Korea.
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Liu Y, Zeng Y, Lu J, Zhang X, Zhang Z, Li H, Liu P, Ma B, Gu Y, Song L. Correlation of hemoglobin with osteoporosis in elderly Chinese population: A cross-sectional study. Front Public Health 2023; 11:1073968. [PMID: 37124822 PMCID: PMC10133547 DOI: 10.3389/fpubh.2023.1073968] [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: 10/19/2022] [Accepted: 03/21/2023] [Indexed: 05/02/2023] Open
Abstract
Introduction In the elder population, both low hemoglobin (Hb)/anemia and osteoporosis (OP) are highly prevalent. However, the relationship between Hb and OP is still poorly understood. This study was to evaluate the correlation between Hb and OP in Chinese elderly population. Methods One thousand and sisty-eight individuals aged 55-85 years were enrolled into this cross-sectional study during June 2019-November 2019. Data on the demographics and clinical characteristics were recorded. Detections of complete blood count, liver/kidney function, glucose metabolism and lipid profile, and thoracolumbar X-ray were performed, and bone mineral density (BMD) at lumbar spine 1-4, femur neck, and total hip was measured by dual-energy X-ray absorptiometry (DXA). Univariate and multivariate linear regression analyses were employed to evaluate the correlation between Hb with BMD T-score. Logistic regression analysis was performed to access the correlation between different Hb levels and the odds ratio (OR) for OP. Results Compared with non-OP group, OP patients had lower level of Hb. Univariate linear regression analysis indicated Hb level was positively related to the BMD of lumbar spine 1-4, femur neck and total hip, and this relationship remained after adjusting confounding variables [gender, age, body mass index (BMI), diabetes mellitus (DM) and morphological vertebral fracture]. Logistic regression analysis showed the ORs for OP decreased with the increase of Hb. Compared with the subjects with the lowest quartile of Hb, the OR for OP in the highest quartile group was 0.60 (0.41-0.89) after adjusting for gender, age and BMI, and the OR for OP was 0.62 (0.41-0.92) after further adjustment for gender, age, BMI, DM, and lipid indexes. Discussion In conclusion, Lower Hb level is related to lower BMD in the elderly population. However, whether Hb level could be used to predict the risk of OP needs to be further determined in more longitudinal clinical studies.
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Affiliation(s)
- Yichen Liu
- Department of Endocrinology, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, School of Medicine, Tongji University, Shanghai, China
| | - Yue Zeng
- Department of Endocrinology, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, School of Medicine, Tongji University, Shanghai, China
| | - Jun Lu
- Department of Endocrinology and Metabolism, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaoya Zhang
- Department of Endocrinology, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, School of Medicine, Tongji University, Shanghai, China
| | - Zikai Zhang
- Division of Science and Research, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Huijuan Li
- Department of Endocrinology, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, School of Medicine, Tongji University, Shanghai, China
| | - Peipei Liu
- Department of Endocrinology, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Bin Ma
- Division of Spine, Department of Orthopedics, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
| | - Yiqun Gu
- Ganquan Community Health Service Center, Shanghai, China
| | - Lige Song
- Department of Endocrinology, Shanghai Tongji Hospital, School of Medicine, Tongji University, Shanghai, China
- Institute of Osteoporosis and Metabolic Bone Diseases, School of Medicine, Tongji University, Shanghai, China
- *Correspondence: Lige Song,
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6
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Circulating platelet concentration is associated with bone mineral density in women. Arch Osteoporos 2022; 17:44. [PMID: 35257290 DOI: 10.1007/s11657-022-01089-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 02/26/2022] [Indexed: 02/03/2023]
Abstract
In this cross-sectional study, enrollment included 818 female adults undergoing bone mineral density (BMD) assessment during the health examination. Subjects with osteoporosis had the lowest circulating platelet concentrations. The circulating platelet concentration was positively correlated with BMD. A high platelet concentration had independently low odds of osteoporosis. PURPOSE Platelets play an important role in bone metabolism. However, the association between circulating platelet counts and bone mineral density (BMD) has been inconsistently reported. We aimed to investigate the relationship between platelet counts and osteoporosis in Chinese women. METHODS In this cross-sectional study, a total of 818 female adults who underwent BMD assessment during the health examination were enrolled. Blood cell counts and biochemistry data were recorded. RESULTS Subjects with osteoporosis had the lowest platelet counts (238 ± 59 × 109/L) compared with subjects with osteopenia (256 ± 64 × 109/L) and a normal BMD (269 ± 76 × 109/L, P < 0.001). The circulating platelet concentration was positively correlated with the BMD of the lumbar spine (r = 0.195, P < 0.001), left hip (r = 0.145, P < 0.001), and right hip (r = 0.149, P < 0.001). According to the receiver operating characteristic curve, the cutoff platelet concentration for differentiating osteoporosis was 260 × 109/L. A high platelet concentration had significantly low odds of osteoporosis after adjusting for other covariates (odds ratio = 0.574, 95% confidence interval: 0.346‒0.953, P = 0.032). CONCLUSION The circulating platelet concentration was significantly correlated with BMD in Chinese women.
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Li Y, Hao W, Guan J, Li B, Meng L, Sun S, Sheng T, Dong S, Zhou Q, Liu M, Zhang Z, Shen T, Shen Y, Zhao B. Relationship between indices of circulating blood cells and bone homeostasis in osteoporosis. Front Endocrinol (Lausanne) 2022; 13:965290. [PMID: 36133307 PMCID: PMC9483170 DOI: 10.3389/fendo.2022.965290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 08/16/2022] [Indexed: 11/13/2022] Open
Abstract
Bone development have been shown to play an important role in regulating hematopoiesis as one major component of bone marrow microenvironment. Recent studies support the notion that there is an intricate relationship between hematopoiesis and bone homeostasis, however, little is known about the alterations in the hematopoietic lineages in pathologic conditions. Using various osteoporotic mouse models, we show here that bone microarchitecture abnormalities alter parameters of peripheral blood cells. The level of white blood cells is dynamics and negatively correlated with bone mineral density during the progression of osteoporosis. Furthermore, our clinical data confirm that osteoporosis is associated with abnormal circulating blood cell counts. These results demonstrated a causal link that osteoporosis is accompanied by the altered circulating blood cells, supporting the idea of a close interplay between hematopoiesis and bone homeostasis. Our study would propose that routine complete blood count might be applied as a potential diagnostic and putative marker for osteoporosis.
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Affiliation(s)
- Yuan Li
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
- Suzhou Research Institute, Shandong University, Suzhou, China
- National Medical Products Administration (NMPA) Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Baobing Zhao, ; Yuan Li,
| | - Weimin Hao
- Department of Spine Surgery, Heze Municipal Hospital, Heze, Shandong, China
| | - Jianming Guan
- Department of Hematology, Heze Municipal Hospital, Heze, Shandong, China
| | - Bo Li
- Department of Orthopedics, Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University, Guangzhou, China
| | - Li Meng
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shuangjiao Sun
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Tianyuan Sheng
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Shuangxi Dong
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Qian Zhou
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Mingjie Liu
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhongkai Zhang
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Tao Shen
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Medical Products Administration (NMPA) Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Yuemao Shen
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Medical Products Administration (NMPA) Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Baobing Zhao
- Key Lab of Chemical Biology, Ministry of Education (MOE), School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
- National Medical Products Administration (NMPA) Key Laboratory for Technology Research and Evaluation of Drug Products, School of Pharmaceutical Sciences, Cheeloo College of Medicine, Shandong University, Jinan, China
- *Correspondence: Baobing Zhao, ; Yuan Li,
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Chuang TL, Koo M, Chuang MH, Wang YF. Bone Mineral Density and Hemoglobin Levels: Opposite Associations in Younger and Older Women. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18105495. [PMID: 34065536 PMCID: PMC8161311 DOI: 10.3390/ijerph18105495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 05/18/2021] [Accepted: 05/19/2021] [Indexed: 01/17/2023]
Abstract
This cross-sectional, retrospective medical record review study aimed to investigate the association between hemoglobin levels and bone mineral density (BMD) in adult women. Medical records obtained from general health examinations conducted from June 2014 to July 2020 at a regional hospital in southern Taiwan were reviewed. Anthropometric and laboratory data were recorded. BMD of the lumbar spine and bilateral femoral neck regions was assessed by dual energy X-ray absorptiometry. Linear regression analysis was used to assess the association between BMD and hemoglobin level with and without adjusting for other anthropometric and laboratory data. The study included 9606 female patients with a mean age of 55.9 years. Of these, 2756 (28.7%) were aged ≤ 50 years and 6850 (71.3%) were aged > 50 years. Results from multiple linear regression analysis showed that hemoglobin and femoral and lumbar spine BMD were significantly correlated. A higher hemoglobin level was significantly associated with a lower BMD level in females aged ≤ 50 years, but with a higher BMD level in those aged > 50 years. Given the relationship between bone metabolism and hematopoiesis, additional research is needed to elucidate the association between hemoglobin and BMD levels in different age groups, particularly in premenopausal and perimenopausal women.
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Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622401, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-term Care, Tzu Chi University of Science and Technology, Hualien City, Hualien 973302, Taiwan;
| | - Mei-Hua Chuang
- Faculty of Pharmacy, National Yang-Ming University, Taipei 112304, Taiwan;
- Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622401, Taiwan;
- School of Medicine, Tzu Chi University, Hualien 970374, Taiwan
- Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 622401, Taiwan
- Correspondence: ; Tel.: +886-5-2648000 (ext. 5700)
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