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Cai Y, Jun G, Zhuang X. Metformin treatment reduces the incidence of osteoporosis: a two-sample Mendelian randomized study. Osteoporos Int 2024; 35:1089-1098. [PMID: 38536446 PMCID: PMC11136748 DOI: 10.1007/s00198-023-07013-0] [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: 10/27/2023] [Accepted: 12/26/2023] [Indexed: 05/30/2024]
Abstract
It remains unclear whether the association between metformin and osteoporosis (OP) risk is causal. This two-sample Mendelian randomization (MR) study suggests a causal relationship between metformin treatment and a decrease in OP and fracture incidence, as well as an increase in bone mineral density (BMD) in the lumbar spine, femoral neck, and heel. Nonetheless, no significant causal effect is observed on forearm BMD. PURPOSE We utilize a MR approach to investigate the association between metformin treatment and the risk of OP. METHODS Metformin treatment was selected as exposures. Outcomes included OP; BMD at the forearm (FA), femoral neck (FN), and lumbar spine (LS); estimated heel bone mineral density (eBMD); and fracture. Summary statistics for exposures and outcomes were obtained from corresponding genome-wide association studies. Inverse variance-weighted (IVW) analysis was mainly applied; the weighted median (WM), penalized weighted median (PWM), maximum likelihood (ML), and MR-Egger regression (MR-Egger) method were also used to obtain robust estimates. A series of sensitivity analyses including Cochran's Q test, MR-Egger regression, leave-one-out analysis, and Mendelian randomization pleiotropy residual sum and outlier (MR-PRESSO) were used to detect pleiotropy or heterogeneity. RESULTS In the main analysis, IVW estimates demonstrated that metformin treatment had a definite causal effect on the risk of OP (odds ratio (OR): 0.859, 95% CI: 0.774-0.953, P = 0.004), LS-BMD (OR: 1.063, 95% CI: 1.023-1.105, P = 0.002), FN-BMD (OR: 1.034, 95% CI: 1.000-1.069, P = 0.049), eBMD (OR: 1.035, 95% CI: 1.023-1.047, P ≤ 0.001), and fracture(OR: 0.958, 95% CI: 0.928-0.989, P = 0.008). However, it did not have an effect on FA-BMD(OR: 1.050, 95% CI: 0.969-1.138, P = 0.237). CONCLUSIONS This study indicated that metformin treatment is significantly associated with a reduction in the risk of OP, fracture and higher LS-BMD, FN-BMD, and eBMD. However, there was no significant association with FA-BMD.
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Affiliation(s)
- Yaotian Cai
- Changzhou Traditional Chinese Medical Hospital, Affiliated to Nanjing University of Traditional Chinese Medicine, 25 North Heping Road, Changzhou, 213000, Jiangsu, China
| | - Gao Jun
- Changzhou Traditional Chinese Medical Hospital, Affiliated to Nanjing University of Traditional Chinese Medicine, 25 North Heping Road, Changzhou, 213000, Jiangsu, China.
| | - Xiaojie Zhuang
- Changzhou Traditional Chinese Medical Hospital, Affiliated to Nanjing University of Traditional Chinese Medicine, 25 North Heping Road, Changzhou, 213000, Jiangsu, China
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Chen KH, Su CM, Liu WJ, Tzeng HE, Lee CL, Tsai CH. The joint effects of physical activity and sleep duration on risk of osteoporosis in Taiwanese adult population: The Taiwan Biobank Study. Osteoporos Int 2024; 35:523-531. [PMID: 37947843 PMCID: PMC10867060 DOI: 10.1007/s00198-023-06947-9] [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: 10/27/2022] [Accepted: 10/09/2023] [Indexed: 11/12/2023]
Abstract
Most studies investigating the association between physical activity and osteoporosis prevention only focused on specific types of physical activity. This study's evidence regarding the combined effects or interaction of sleep duration and physical activity. The findings emphasize the role of sleep duration and physical activity in association with osteoporosis. PURPOSE The associations between physical activity, sleep duration, and prevalent osteoporosis in Taiwanese adults were studied in this cross-sectional study. METHODS The Taiwan Biobank enrolled a community-based cohort of ~ 120,000 volunteers (as of April 30, 2020) between 30 and 76 years of age with no history of cancer. Amongst, bone mineral density (BMD) measures by dual-energy X-ray absorptiometry (DXA) were available in 22,402 participants. After excluding individuals who had no complete data of BMI (n = 23), MET score (n = 207), T-score (n = 8,826), and sleep duration (n = 16), 13,330 subjects were included as the primary cohort. Univariate and multivariable regression analyses were performed to determine the associations between the presence of osteoporosis, physical activity level, sleep duration, and other variables. RESULTS The results showed that after adjustment, subjects with physical activity < 20 METs/week and ≥ 20 METs/week (aOR = 1.017 and 0.767, respectively) were associated with risk of osteoporosis than those with zero MET. The odds of osteoporosis were not significantly lower in subjects who slept for ≥ 8 h/day (aOR = 0.934,p=0.266). In addition, compared to short sleepers with no physical activity, adults with increased physical activity ≥ 20 METs/week and sleep ≥ 8 h/day had a significantly lowest likelihood of osteoporosis (aOR = 0.702). Those with medium physical activity (< 20 METs/week) plus average sleep duration (6.5-8 h/day) did not have significant higher odds of osteoporosis (aOR = 1.129,p=0.151). CONCLUSION The findings emphasize the joint role of sleep duration and physical activity in association with osteoporosis. Adults with high physical activity plus high sleep hours have the highest BMD and lowest risk of osteoporosis.
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Affiliation(s)
- Kun-Hui Chen
- Department of Orthopedic Surgery, Taichung Veterans General Hospital, Taichung, 407219, Taiwan
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 402204, Taiwan
- Department of Computer Science & Information Engineering, College of Computing and Informatics, Providence University, Taichung City, 43301, Taiwan
| | - Chen-Ming Su
- Department of Sports Medicine, China Medical University, Taichung, 406040, Taiwan
| | - Wei-Ju Liu
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407219, Taiwan
- Intelligent Data Mining Laboratory, Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407219, Taiwan
| | - Huey-En Tzeng
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 402204, Taiwan
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407219, Taiwan
- School of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
- Division of Transfusion Medicine /Hematology - Oncology, Taichung Veterans General Hospital, Taichung, 40705, Taiwan
| | - Chia-Lin Lee
- Department of Post-Baccalaureate Medicine, College of Medicine, National Chung Hsing University, Taichung, 402204, Taiwan.
- Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407219, Taiwan.
- Intelligent Data Mining Laboratory, Department of Medical Research, Taichung Veterans General Hospital, Taichung, 407219, Taiwan.
- Department of Public Health, College of Public Health, China Medical University, Taichung, 406040, Taiwan.
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, 112304, Taiwan.
| | - Chun-Hao Tsai
- Department of Sports Medicine, China Medical University, Taichung, 406040, Taiwan.
- Department of Orthopedics, China Medical University Hospital, Taichung, 406040, Taiwan.
- College of Biomedical Engineering, China Medical University, Taichung, 406040, Taiwan.
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Chen Y, Zhu S, Lin Z, Zhang Y, Jin C, He S, Chen X, Zhou X. Metformin alleviates ethanol-induced cardiomyocyte injury by activating AKT/Nrf2 signaling in an ErbB2-dependent manner. Mol Biol Rep 2023; 50:3469-3478. [PMID: 36765018 DOI: 10.1007/s11033-023-08310-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 01/26/2023] [Indexed: 02/12/2023]
Abstract
BACKGROUND Metformin, a first-line oral anti-diabetic drug, has recently been reported to exert protective effect on various cardiovascular diseases. However, the potential role of metformin in ethanol-induced cardiomyocyte injury is still unknown. Therefore, this study was aimed to investigate the effect of metformin on ethanol-induced cardiomyocyte injury and its underlying mechanism. METHODS AND RESULTS H9c2 cardiomyocytes were exposed to ethanol for 24 h to establish an ethanol-induced cardiomyocyte injury model, and followed by treatment with metformin in the presence or absence of Lapatinib (an ErbB2 inhibition). CCK8 and LDH assays demonstrated that metformin improved cell viability in cardiomyocytes exposed to ethanol. Furthermore, metformin suppressed cardiomyocyte apoptosis and reduced the expressions of apoptosis-related proteins (Bax and C-CAS-3). In addition, our results showed that metformin activated the AKT/Nrf2 pathway, and then promoted Nrf2 nuclear translocation and the transcription of its downstream antioxidant genes (HO-1, CAT and SOD2), thereby inhibiting oxidative stress. Interestingly, we found that ErbB2 protein expression was significantly inhibited in ethanol-treated cardiomyocytes, which was markedly reversed by metformin. In contrast, Lapatinib largely abrogated the activation of AKT/Nrf2 signaling by metformin, accompanied by the increases in oxidative stress and cardiomyocyte apoptosis, indicating that metformin prevented ethanol-induced cardiomyocyte injury in an ErbB2-dependent manner. CONCLUSION In summary, our study provides the first evidence that metformin protects cardiomyocyte against ethanol-induced oxidative stress and apoptosis by activating ErbB2-mediated AKT/Nrf2 signaling. Thus, metformin may be a potential novel treatment approach for alcoholic cardiomyopathy.
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Affiliation(s)
- Yunjie Chen
- Department of Pharmacy, Ningbo first Hospital, 315010, Ningbo, People's Republic of China.,Central Laboratory of the Medical Research Center, Ningbo First Hospital, 315010, Ningbo, People's Republic of China
| | - Suyan Zhu
- Department of Pharmacy, Ningbo first Hospital, 315010, Ningbo, People's Republic of China
| | - Zhu Lin
- Department of Pharmacy, Ningbo first Hospital, 315010, Ningbo, People's Republic of China
| | - Yuanbin Zhang
- Department of Pharmacy, Ningbo first Hospital, 315010, Ningbo, People's Republic of China.,Central Laboratory of the Medical Research Center, Ningbo First Hospital, 315010, Ningbo, People's Republic of China
| | - Cheng Jin
- School of Pharmaceutical Science, Wenzhou Medical University, 325000, Wenzhou, People's Republic of China
| | - Shengqu He
- School of Pharmaceutical Science, Wenzhou Medical University, 325000, Wenzhou, People's Republic of China
| | - Xueqin Chen
- Department of Traditional Chinese Medicine, Ningbo First Hospital, 315010, Ningbo, People's Republic of China.
| | - Xuan Zhou
- Department of Pharmacy, Ningbo first Hospital, 315010, Ningbo, People's Republic of China.
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Wei Z, pinfang K, jing Z, zhuoya Y, Shaohuan Q, Chao S. Curcumin Improves Diabetic Cardiomyopathy by Inhibiting Pyroptosis through AKT/Nrf2/ARE Pathway. Mediators Inflamm 2023; 2023:3906043. [PMID: 37101595 PMCID: PMC10125772 DOI: 10.1155/2023/3906043] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Revised: 02/15/2023] [Accepted: 03/04/2023] [Indexed: 04/28/2023] Open
Abstract
This study is aimed at exploring whether curcumin can regulate the AKT pathway, promote the transfer of Nrf2 into the nucleus, and inhibit cell pyroptosis in diabetic cardiomyopathy. Diabetic rats and cardiomyocytes were treated with curcumin to study its effect on myocardial pyroptosis. Whether curcumin can promote the transfer of Nrf2 into the nucleus through AKT pathway regulation was assessed by western blotting and immunofluorescence. The Nrf2 knockout vector and ml385 were used to block the Nrf2 pathway, and the differences between the different groups in the expression of pyroptosis protein, cell activity, and incidence of apoptosis were evaluated to verify the relationship between the effect of curcumin on pyroptosis inhibition and the Nrf2 pathway. Curcumin promoted the transfer of Nrf2 into the nucleus through the AKT pathway and increased the expression of the antioxidant factors HO-1 and GCLC. These effects reduced reactive oxygen species accumulation and mitochondrial damage in diabetic myocardium and inhibited diabetes-induced pyroptosis. However, in cardiomyocytes with a blocked Nrf2 pathway, the ability of curcumin to inhibit pyroptosis was significantly reduced, and the protective effect on the cells was lost. Curcumin can reduce the accumulation of superoxide in the myocardium through AKT/Nrf2/ARE pathway activation and inhibit pyroptosis. It also has a role in diabetic cardiomyopathy treatment. This study provides new directions for evaluating the mechanism of diabetic cardiomyopathy and treating diabetic myocardium.
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Affiliation(s)
- Zhang Wei
- Department of Cardiovascular Medicine of The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui, China 233000
| | - Kang pinfang
- Department of Cardiovascular Medicine of The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui, China 233000
| | - Zhou jing
- Department of Cardiovascular Medicine of The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui, China 233000
| | - Yao zhuoya
- Department of Cardiovascular Medicine of The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui, China 233000
| | - Qian Shaohuan
- Department of Cardiovascular Medicine of The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui, China 233000
| | - Shi Chao
- Department of Cardiac Surgery of The First Affiliated Hospital of Bengbu Medical College, Bengbu City, Anhui, China 233000
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Role of PI3K/Akt-Mediated Nrf2/HO-1 Signaling Pathway in Resveratrol Alleviation of Zearalenone-Induced Oxidative Stress and Apoptosis in TM4 Cells. Toxins (Basel) 2022; 14:toxins14110733. [PMID: 36355983 PMCID: PMC9694162 DOI: 10.3390/toxins14110733] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 10/18/2022] [Accepted: 10/19/2022] [Indexed: 01/26/2023] Open
Abstract
Zearalenone (ZEA) is a common mycotoxin that induces oxidative stress (OS) and affects the male reproductive system in animals. Resveratrol (RSV) has good antioxidant activity and can activate nuclear factor erythroid 2-related factor (Nrf2) to protect cells through the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway. The objective of this study was to investigate the protective effect and the mechanism of RSV on OS and apoptosis in TM4 cells induced by ZEA. Prior to being exposed to ZEA, TM4 cells were pretreated with RSV or the PI3K/Akt inhibitor LY294002. Cell viability was measured by Cell Counting Kit-8 (CCK-8) assays. Flow cytometry was used to determine the level of apoptosis and intracellular reactive oxygen species (ROS). The expression of poly ADP-ribose polymerase (PARP), caspase-3, BCL2-associated X (Bax)/B-cell lymphoma-2 (Bcl-2), and PI3K/Akt-mediated Nrf2/heme oxygenase 1 (HO-1) signaling pathway-related proteins was evaluated by Western blotting. Nrf2 siRNA transfection and LY294002 treatment were used to investigate the role of the Nrf2/HO-1 and PI3K/Akt signaling pathways in RSV alleviation of ZEA-induced OS. The results showed that pretreatment with RSV significantly reduced the expression of apoptosis-related proteins and increased cell viability. Catalase (CAT) activity and glutathione (GSH) levels were also increased, whereas malondialdehyde (MDA) and ROS levels decreased (p < 0.05). RSV also upregulated Akt phosphorylation, Nrf2 nuclear translocation, and HO-1 expression under conditions of OS (p < 0.05). Transfection with Nrf2 siRNA abolished the protective effects of RSV against ZEA-induced cytotoxicity (p < 0.05), ROS accumulation (p < 0.05), and apoptosis (p < 0.05). LY294002 completely blocked the RSV-mediated increase in Nrf2 nuclear translocation (p < 0.05), HO-1 expression (p < 0.05), and cytoprotective activity (p < 0.05). Collectively, the above findings indicate that RSV can protect against ZEA-induced OS and apoptosis in TM4 cells by PI3K/Akt-mediated activation of the Nrf2/HO-1 signaling pathway.
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Ma Y, Qiu S, Zhou R. Osteoporosis in Patients With Respiratory Diseases. Front Physiol 2022; 13:939253. [PMID: 35903070 PMCID: PMC9315364 DOI: 10.3389/fphys.2022.939253] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 06/07/2022] [Indexed: 11/13/2022] Open
Abstract
Climate change, environmental pollution, and virus epidemics have sharply increased the number of patients suffering from respiratory diseases in recent years. Prolonged periods of illness and drug use increase the occurrence of complications in these patients. Osteoporosis is the common bone metabolism disease with respiratory disturbance, which affects prognosis and increases mortality of patients. The problem of osteoporosis in patients with respiratory diseases needs more attention. In this review, we concluded the characteristics of osteoporosis in some respiratory diseases including COPD, asthma, COVID-19, tuberculosis, and lung cancer. We revealed that hypoxia was the common pathogenesis of osteoporosis secondary to respiratory diseases, with malnutrition and corticosteroid abuse driving the progression of osteoporosis. Hypoxia-induced ROS accumulation and activated HIF-1α lead to attenuated osteogenesis and enhanced osteoclastogenesis in patients with respiratory diseases. Tuberculosis and cancer also invaded bone tissue and reduced bone strength by direct infiltration. For the treatment of osteoporosis in respiratory patients, oral-optimized bisphosphonates were the best treatment modality. Vitamin D was a necessary supplement, both for calcium absorption in osteogenesis and for improvement of respiratory lesions. Reasonable adjustment of the dose and course of corticosteroids according to the etiology and condition of patients is beneficial to prevent the occurrence and development of osteoporosis. Additionally, HIF-1α was a potential target for the treatment of osteoporosis in respiratory patients, which could be activated under hypoxia condition and involved in the process of bone remodeling.
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Affiliation(s)
- Yue Ma
- Department of Pulmonary and Critical Care Medicine, Shengjing Hospital of China Medical University, Shenyang, China
| | - Shui Qiu
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
| | - Renyi Zhou
- Department of Orthopedics, First Hospital of China Medical University, Shenyang, China
- *Correspondence: Renyi Zhou,
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