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McGowan NG, Zhong JH, Trasande L, Hellmann J, Heffron SP. A randomized, placebo-controlled crossover trial to assess the influence of body weight on aspirin-triggered specialized pro-resolving mediators: Protocol for the DISCOVER Study. INTERNATIONAL JOURNAL OF CLINICAL TRIALS 2024; 11:53-60. [PMID: 38585621 PMCID: PMC10997378 DOI: 10.18203/2349-3259.ijct20240043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/09/2024]
Abstract
Background Low-dose aspirin is ineffective for primary prevention of cardiovascular events in people with body weight greater than 70kg. While the prevalent explanation for this is reduced platelet cyclooxygenase-1 (COX-1) inhibition at higher body weights, supporting data are limited, thereby demanding further investigation of the reason(s) underlying this observation. We propose that aspirin-mediated cyclooxygenase-2 (COX-2) acetylation and the resulting synthesis of 15-epi-lipoxin A4, a specialized pro-resolving mediator, is suboptimal in higher weight individuals, which may contribute to the clinical trial findings. Methods To test this hypothesis, we are conducting a double-blind, placebo-controlled, randomized, mechanistic crossover trial. Healthy men and women exhibiting a wide range of body weights take 81mg aspirin and 325mg aspirin for 3 weeks each, following 3-week placebo run-in and wash-out phases. Our target sample size is 90 subjects, with a minimum of 72 completing all visits estimated to be necessary to achieve power adequate to test our primary hypothesis. Results Our primary endpoint is the difference in change in plasma 15-epi-lipoxin A4 occurring with each dose of aspirin. Secondary endpoints include lipid mediator profiles, serum bioactive lipid profiles, and other endpoints involved in the resolution of vascular inflammation. Conclusions Study enrollment began in November 2021 and is ongoing. The results of this study will improve our understanding of the mechanisms underlying aspirin's role(s) in the prevention of adverse cardiovascular outcomes. They may also lead to additional studies with the potential to inform dosing strategies for patients based on body weight.
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Affiliation(s)
- Natalie G McGowan
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
- NYU Center for the Prevention of Cardiovascular Disease, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
| | - Judy H Zhong
- Department of Population Health, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
| | - Leonardo Trasande
- Department of Population Health, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
- Department of Pediatrics, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
- Department of Environmental Medicine, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
| | - Jason Hellmann
- Christina Lee Brown Envirome Institute, Diabetes and Obesity Center, Division of Environmental Medicine, University of Louisville School of Medicine, 500 S Preston St, Louisville, KY 40202 USA
| | - Sean P Heffron
- Leon H. Charney Division of Cardiology, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
- NYU Center for the Prevention of Cardiovascular Disease, NYU Grossman School of Medicine, 550 1 Ave, New York, NY 10016 USA
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Arrepia BF, Rocha TG, Medeiros AS, Ferreira MD, Fonseca-Gonçalves A, Visconti MA. The mandibular bone structure in children by fractal dimension and its correlation with pixel intensity values: a pilot study. Oral Radiol 2023; 39:771-778. [PMID: 37368081 DOI: 10.1007/s11282-023-00693-8] [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: 04/24/2023] [Accepted: 06/09/2023] [Indexed: 06/28/2023]
Abstract
OBJECTIVES To identify a normal pattern of mandibular trabecular bone in children based on the fractal dimension (FD), and its possible correlation with pixel intensity (PI) values, to facilitate the early diagnosis of possible diseases and/or future bone alterations. MATERIALS AND METHODS The 50 panoramic images were selected and divided into two groups, according to the children's age: 8-9 (Group 1; n = 25) and 6-7 (Group 2; n = 25). For FD and PI analyses, three regions of interest (ROIs) were selected, and their mean values were evaluated for each ROI, according to each group, using the t test for independent samples and the model of generalized estimation equations (GEE). Subsequently, these mean values were correlated by the Pearson test. RESULTS Comparing the groups, FD and PI did not differ from each other for any of the measured regions (p > 0.00). It was observed that in the mandible branch (ROI1), FD and PI means were 1.26 ± 0.01 and 81.0 ± 2.50, respectively. In the mandible angle (ROI2), the means were 1.21 ± 0.02 (FD) and 72.8 ± 2.13 (PI); and in the mandible, cortical (ROI3) values of FD = 1.03 ± 0.01 and PI = 91.3 ± 1.75 were obtained. There was no correlation between FD and PI in any of the analyzed ROI (r < 0.285). The FD means of ROI1 and ROI2 did not differ from each other (p = 0.053), but both were different from ROI3 (p < 0.00). All PI values differed from each other (p < 0.00). CONCLUSION The bone trabeculate pattern in 6-9-year-old children presented FD between 1.01 and 1.29. Besides that, there was no significant correlation between FD and PI.
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Affiliation(s)
- Beatriz Fernandes Arrepia
- Department of Pediatric Dentistry and Orthodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Thaiza Gonçalves Rocha
- Department of Pathology and Oral Diagnosis, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Annie Seabra Medeiros
- Department of Pathology and Oral Diagnosis, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Matheus Diniz Ferreira
- Department of Oral Diagnosis, Division of Oral Radiology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Andrea Fonseca-Gonçalves
- Department of Pediatric Dentistry and Orthodontics, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Augusta Visconti
- Department of Pathology and Oral Diagnosis, Dental School, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
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Florêncio G, Souza A, Chaim E, Santos A, Duran L, Carvalho C, Monte Alegre S. Phase Angle, Inflammation, and Sarcopenia in Late Postoperative Roux-En-Y Gastric Bypass. J Clin Med 2023; 12:5124. [PMID: 37568526 PMCID: PMC10419434 DOI: 10.3390/jcm12155124] [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: 02/12/2023] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 08/13/2023] Open
Abstract
Sarcopenic obesity is characterized by a disproportion between the amount of muscle to fat. Contrary to most studies evaluating parameters related to sarcopenic obesity in the elderly, this study aims to evaluate the phase angle (PhA) and sarcopenia in young individuals pre- and post-Roux-en-Y gastric bypass. A total of 69 volunteers (46 women and 23 men; 38.5 ± 8.1 years) participated in this study. Body composition and PhA were assessed using BIA. Sarcopenia was assessed using a handgrip strength test (HGS) and gait speed (GS), and appendicular lean mass (ALM) was assessed using Dual Energy X-ray Absorptiometry (DXA). The PhA was significantly lower (p < 0.0007) and the resistance (R) significantly higher (p = 0.0026) in the postoperative group. HGS was negatively correlated with R (r = -0.63669; p < 0.0001), hs-CRP (r = -0.45436; p = 0.0197), and leptin (r = -0.46505; p = 0.0043). GS was negatively correlated with R (r = -0.36220; p = 0.0254), and ALM was negatively correlated with reactance (r = -0.49485; p = 0.0034) and R (r = -0.65797; p ≤ 0.0001). PhA and other components of BIA provide a good correlation with sarcopenia, especially regarding the reduction in muscle function, in an early form, in individuals in the pre- and postoperative period of gastric bypass.
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Affiliation(s)
- Gisele Florêncio
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Aglécio Souza
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Elinton Chaim
- Department of Surgery, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Allan Santos
- Department of Nuclear Medicine, Clinic Hospital, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Louise Duran
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Camila Carvalho
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
| | - Sarah Monte Alegre
- Department of Internal Medicine, Faculty of Medical Sciences, State University of Campinas (UNICAMP), Campinas 13083-887, Brazil
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Chokphukiao P, Poncumhak P, Thaweewannakij T, Intaruk R, Amatachaya S. Seated push-up tests: Reliable and valid measures for older individuals when used by primary healthcare providers. J Back Musculoskelet Rehabil 2023:BMR220040. [PMID: 36872768 DOI: 10.3233/bmr-220040] [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] [Indexed: 03/07/2023]
Abstract
BACKGROUND Body composition decline, lower limb impairments, and mobility deficits affect independence of older people. The exploration for a practical measure involving upper extremities may offer an alternative tool to be used by primary healthcare (PHC) providers for these individuals. OBJECTIVE To explore reliability and validity of seated push-up tests (SPUTs) among older participants when used by PHC providers. METHODS Older participants (n= 146) with an average age of > 70 years were cross-sectionally assessed using various demanding forms of SPUTs and standard measures to assess validity of the SPUTs. Reliability of the SPUTs were assessed in nine PHC raters, including an expert, health professionals, village health volunteers, and care givers. RESULTS The SPUTs demonstrated very good agreement, with excellent rater and test-retest reliability (kappa values > 0.87 and ICCs > 0.93, p< 0.001). Moreover, the SPUT outcomes significantly correlated with lean body mass, bone mineral contents, muscle strength and mobility of older participants (r, rpb=-0.270 to 0.758, p< 0.05). CONCLUSION SPUTs are reliable and valid for older adults when used by PHC members. The incorporation of such practical measures is particularly important during this COVID-19 pandemic with limited people's hospital access.
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Affiliation(s)
- Pakwipa Chokphukiao
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Physical Therapy, Faculty of Allied Health Sciences, Naresuan University, Phitsanulok, Thailand
| | - Puttipong Poncumhak
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand.,Department of Physical Therapy, School of Allied Health Sciences, University of Phayao, Phayao, Thailand
| | - Thiwabhorn Thaweewannakij
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Roongnapa Intaruk
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
| | - Sugalya Amatachaya
- School of Physical Therapy, Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand.,Improvement of Physical Performance and Quality of Life (IPQ) Research Group, Khon Kaen University, Khon Kaen, Thailand
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5
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Poncumhak P, Phadungkit S, Chokphukiao P, Intaruk R, Amatachaya P, Amatachaya S. Validity and feasibility of using a seated push-up test among community-dwelling older adults. Hong Kong Physiother J 2022; 42:125-136. [PMID: 37560167 PMCID: PMC10406638 DOI: 10.1142/s1013702522500123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2022] [Accepted: 05/23/2022] [Indexed: 08/11/2023] Open
Abstract
BACKGROUND Older individuals face a high risk of mobility and body composition decline, which can affect their independence. In light of a current uncertain healthcare situation created by the coronavirus (COVID-19) pandemic, healthcare paradigm has been shifted with increased demand for a practical measure to promote standard home healthcare services for all individuals, including older adults. OBJECTIVE This study explored the feasibility and validity of seated push-up tests (SPUTs) as clinical measures to reflect the body composition, muscle strength, and mobility among community-dwelling older individuals, aged ≥ 65 years (n = 82 ). METHODS Participants were cross-sectionally assessed using SPUTs with various demanding forms, including the 1-time SPUT (1SPUT) along with its upper limb loading SPUT (ULL-SPUT), 5-time SPUT (5SPUT), 10-time SPUT (10SPUT), and 1-min SPUT (1minSPUT) and standard measures. RESULTS Participants who passed and failed a 1SPUT showed significant differences in the outcomes of all standard measures (p < 0 . 05 ). The ULL-SPUT significantly correlated to all body composition, muscle strength, and mobility (r = 0 . 247 -0.785; p < 0 . 05 ). Outcomes of 1minSPUT significantly correlated with muscle strength and mobility outcomes (r = 0 . 306 -0.526; p < 0 . 05 ). Participants reported no adverse effects following the SPUTs. CONCLUSION The findings suggest the use of the 1SPUT, ULL-SPUT, and 1minSPUT as practical measures to reflect the body composition, muscle strength, and mobility of older individuals, according to their functional levels. The tests may especially clinically benefit those with lower limb limitations and those in settings with limited space and equipment.
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Affiliation(s)
- Puttipong Poncumhak
- School of Physical Therapy, Faculty of Associated Medical Sciences Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group Khon Kaen University, Khon Kaen, Thailand
- Department of Physical Therapy, School of Allied Health Sciences University of Phayao, Phayao, Thailand
- Unit of Excellent of Physical Fitness and Exercise University of Phayao, Phayao, Thailand
| | - Supaporn Phadungkit
- School of Physical Therapy, Faculty of Associated Medical Sciences Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group Khon Kaen University, Khon Kaen, Thailand
| | - Pakwipa Chokphukiao
- School of Physical Therapy, Faculty of Associated Medical Sciences Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group Khon Kaen University, Khon Kaen, Thailand
| | - Roongnapa Intaruk
- School of Physical Therapy, Faculty of Associated Medical Sciences Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group Khon Kaen University, Khon Kaen, Thailand
| | - Pipatana Amatachaya
- Department of Physical Therapy, School of Allied Health Sciences University of Phayao, Phayao, Thailand
- Department of Mechanical Engineering, Faculty of Engineering and Architecture Rajamangala University of Technology Isan, Nakhon Ratchasima, Thailand
| | - Sugalya Amatachaya
- School of Physical Therapy, Faculty of Associated Medical Sciences Khon Kaen University, Khon Kaen, Thailand
- Improvement of Physical Performance and Quality of Life (IPQ) Research Group Khon Kaen University, Khon Kaen, Thailand
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Burridge K, Christensen SM, Golden A, Ingersoll AB, Tondt J, Bays HE. Obesity history, physical exam, laboratory, body composition, and energy expenditure: An Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) 2022. OBESITY PILLARS (ONLINE) 2022; 1:100007. [PMID: 37990700 PMCID: PMC10661987 DOI: 10.1016/j.obpill.2021.100007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/23/2023]
Abstract
Background This Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is intended to provide clinicians an overview of the clinical and diagnostic evaluation of patients with pre-obesity/obesity. Methods The scientific information for this CPS is based upon published scientific citations, clinical perspectives of OMA authors, and peer review by the Obesity Medicine Association leadership. Results This CPS outlines important components of medical, dietary, and physical activity history as well as physical exams, with a focus on specific aspects unique to managing patients with pre-obesity or obesity. Patients with pre-obesity/obesity benefit from the same preventive care and general laboratory testing as those without an increase in body fat. In addition, patients with pre-obesity/obesity may benefit from adiposity-specific diagnostic testing - both generally and individually - according to patient presentation and clinical judgment. Body composition testing, such as dual energy x-ray absorptiometry, bioelectrical impedance, and other measures, each have their own advantages and disadvantages. Some patients in clinical research, and perhaps even clinical practice, may benefit from an assessment of energy expenditure. This can be achieved by several methods including direct calorimetry, indirect calorimetry, doubly labeled water, or estimated by equations. Finally, a unifying theme regarding the etiology of pre-obesity/obesity and effectiveness of treatments of obesity centers on the role of biologic and behavior efficiencies and inefficiencies, with efficiencies more often associated with increases in fat mass and inefficiencies more often associated with decreases in fat mass. Conclusion The Obesity Medicine Association (OMA) Clinical Practice Statement (CPS) on History, Physical Exam, Body Composition and Energy Expenditure is one of a series of OMA CPSs designed to assist clinicians in the care of patients with the disease of pre-obesity/obesity.
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Affiliation(s)
- Karlijn Burridge
- Gaining Health, 528 Pennsylvania Ave #708 Glen Ellyn, IL 60137, USA
| | - Sandra M. Christensen
- Integrative Medical Weight Management, 2611 NE 125th St., Suite 100B, Seattle, WA, 98125, USA
| | - Angela Golden
- NP Obesity Treatment Clinic and NP from Home, LLC, PO Box 25959, Munds Park, AZ, 86017, USA
| | - Amy B. Ingersoll
- Enara Health, 3050 S. Delaware Street, Suite 130, San Mateo, CA, 94403, USA
| | - Justin Tondt
- Department of Family and Community Medicine, Eastern Virginia Medical School, P.O. Box 1980, Norfolk, VA, 23501, USA
| | - Harold E. Bays
- Louisville Metabolic and Atherosclerosis Research Center, 3288 Illinois Avenue, Louisville, KY, 40213, USA
- University of Louisville School of Medicine, USA
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7
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Body Composition as a Modulator of Bone Health Changes in Patients with Inflammatory Bowel Disease. Life (Basel) 2022; 12:life12020272. [PMID: 35207559 PMCID: PMC8875340 DOI: 10.3390/life12020272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/09/2022] [Accepted: 02/10/2022] [Indexed: 12/05/2022] Open
Abstract
Background: Bone impairment of multifactorial etiology is a common feature in inflammatory bowel disease (IBD). Body composition parameters, which might be selectively modified in these patients, are important determinants of bone strength. Our aim was to investigate the relationship between components of body composition and bone parameters in IBD patients. Methods: This is a cross-sectional, retrospective study including 80 IBD patients (43 women, 37 men). Lumbar spine (LS), femoral neck (FN) and whole body DXA scans were performed to analyze regional bone mineral density (BMD), as well as body composition, including appendicular skeletal muscle mass index (ASMI), total and visceral fat mass (VAT). Trabecular bone score (TBS) was assessed using iNsight Software. Results: Twenty (25%) IBD patients had inadequate LS-BMD z scores (<=−2DS). Lean mass (LM) was a significant determinant of LS-BMD, after adjusting for age, gender, BMI and fat mass (p < 0.01), while fat mass% remained associated with FN-BMD (p < 0.01). TBS correlated positively with BMI (r = 0.24, p < 0.05), LS-BMD (r = 0.56, p < 0.001), ASMI (r = 0.34, p < 0.001) and negatively with VAT/total fat% (r = −0.27, p < 0.05). Multivariate analysis showed that ASMI, LS-BMD (positively) and VAT/total fat% (negatively) were independently associated with TBS. Conclusions: In IBD patients, skeletal muscle mass and fat percentage and distribution are important factors associated with bone health.
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Mao L, Xia Z, Pan L, Chen J, Liu X, Li Z, Yan Z, Lin G, Wen H, Liu B. Deep learning for screening primary osteopenia and osteoporosis using spine radiographs and patient clinical covariates in a Chinese population. Front Endocrinol (Lausanne) 2022; 13:971877. [PMID: 36176468 PMCID: PMC9513384 DOI: 10.3389/fendo.2022.971877] [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: 06/17/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022] Open
Abstract
PURPOSE Many high-risk osteopenia and osteoporosis patients remain undiagnosed. We proposed to construct a convolutional neural network model for screening primary osteopenia and osteoporosis based on the lumbar radiographs, and to compare the diagnostic performance of the CNN model adding the clinical covariates with the image model alone. METHODS A total of 6,908 participants were collected for analysis, including postmenopausal women and men aged 50-95 years, who performed conventional lumbar x-ray examinations and dual-energy x-ray absorptiometry (DXA) examinations within 3 months. All participants were divided into a training set, a validation set, test set 1, and test set 2 at a ratio of 8:1:1:1. The bone mineral density (BMD) values derived from DXA were applied as the reference standard. A three-class CNN model was developed to classify the patients into normal BMD, osteopenia, and osteoporosis. Moreover, we developed the models integrating the images with clinical covariates (age, gender, and BMI), and explored whether adding clinical data improves diagnostic performance over the image mode alone. The receiver operating characteristic curve analysis was performed for assessing the model performance. RESULTS As for classifying osteoporosis, the model based on the anteroposterior+lateral channel performed best, with the area under the curve (AUC) range from 0.909 to 0.937 in three test cohorts. The models with images alone achieved moderate sensitivity in classifying osteopenia, in which the highest AUC achieved 0.785. The performance of models integrating images with clinical data shows a slight improvement over models with anteroposterior or lateral images input alone for diagnosing osteoporosis, in which the AUC increased about 2%-4%. Regarding categorizing osteopenia and the normal BMD, the proposed models integrating images with clinical data also outperformed the models with images solely. CONCLUSION The deep learning-based approach could screen osteoporosis and osteopenia based on lumbar radiographs.
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Affiliation(s)
- Liting Mao
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ziqiang Xia
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liang Pan
- Department of AI Research Lab, Guangzhou YLZ Ruitu Information Technology Co, Ltd, Guangzhou, China
| | - Jun Chen
- Department of Radiology, ZHUHAI Branch of Guangdong Hospital of Chinese Medicine, Zhuhai, China
| | - Xian Liu
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhiqiang Li
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Zhaoxian Yan
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Gengbin Lin
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Huisen Wen
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Bo Liu
- Department of Radiology, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
- *Correspondence: Bo Liu,
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9
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Lu L, Cai Y, Luo X, Wang Z, Fung SH, Jia H, Yu CL, Chan WY, Miu KK, Xiao W. A Core Omnigenic Non-coding Trait Governing Dex-Induced Osteoporotic Effects Identified Without DEXA. Front Pharmacol 2021; 12:750959. [PMID: 34899306 PMCID: PMC8651565 DOI: 10.3389/fphar.2021.750959] [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: 08/03/2021] [Accepted: 10/20/2021] [Indexed: 12/15/2022] Open
Abstract
Iatrogenic glucocorticoid (GC)-induced osteoporosis (GIO) is an idiosyncratic form of secondary osteoporosis. Genetic predisposition among individuals may give rise to variant degree of phenotypic changes but there has yet been a documented unified pathway to explain the idiosyncrasy. In this study, we argue that the susceptibility to epigenetic changes governing molecular cross talks along the BMP and PI3K/Akt pathway may underline how genetic background dictate GC-induced bone loss. Concordantly, osteoblasts from BALB/c or C57BL/6 neonatal mice were treated with dexamethasone for transcriptome profiling. Furthermore, we also confirmed that GC-pre-conditioned mesenchymal stem cells (MSCs) would give rise to defective osteogenesis by instigating epigenetic changes which affected the accessibility of enhancer marks. In line with these epigenetic changes, we propose that GC modulates a key regulatory network involving the scavenger receptor Cd36 in osteoblasts pre-conditioning pharmacological idiosyncrasy in GIO.
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Affiliation(s)
- Li Lu
- Guangdong Key Laboratory of Pharmaceutical Bioactive Substances, School of Life Science and Biopharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Yanzhen Cai
- Guangdong Key Laboratory of Pharmaceutical Bioactive Substances, School of Life Science and Biopharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Xiaoling Luo
- Guangdong Key Laboratory of Pharmaceutical Bioactive Substances, School of Life Science and Biopharmacy, Guangdong Pharmaceutical University, Guangzhou, China
| | - Zhangting Wang
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Sin Hang Fung
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Huanhuan Jia
- Guangdong Key Laboratory of Pharmaceutical Bioactive Substances, School of Life Science and Biopharmacy, Guangdong Pharmaceutical University, Guangzhou, China.,Guangdong Key Laboratory of Laboratory Animals, Guangdong Laboratory Animals Monitoring Institute, Guangzhou, China
| | - Chi Lam Yu
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Wai Yee Chan
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Kai Kei Miu
- School of Biomedical Sciences, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, SAR China
| | - Wende Xiao
- Department of Orthopedics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, China
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10
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Zhou Y, Wang X, Xin M, Zhuang H. Changes in bone mineral density, 25-hydroxyvitamin D 3 and inflammatory factors in patients with hyperthyroidism. Exp Ther Med 2021; 21:617. [PMID: 33936274 DOI: 10.3892/etm.2021.10049] [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: 04/29/2019] [Accepted: 12/17/2019] [Indexed: 11/05/2022] Open
Abstract
The present study aimed to evaluate changes in bone mineral density, 25-hydroxyvitamin D3 [25-(OH)D3] and inflammatory factors in patients with hyperthyroidism, in order to determine the correlations with the pathogenesis of hyperthyroidism. A total of 55 patients with hyperthyroidism (observation group) and 53 healthy patients (control group) enrolled at Weifang People's Hospital from March 2017 to February 2018 were randomly enrolled. The thyroid function, bone mineral density, 25-(OH)D3 and inflammatory factors were measured and compared between the two groups. The measurement data are presented as mean ± standard deviation (SD), and Student t-test was performed for the comparison between two groups. Chi-square test was used for enumeration data regarding sex. Pearson correlation analysis was performed for two-variable analysis on L1, 25-(OH)D3, interleukin (IL)-2, IL-6 with FT3, respectively. In regards to the results, no difference in sex, age and body mass index (BMI) between the two groups were found but the thyroid function was markedly enhanced in the observation group compared to the control group. Bone mineral density index and 25-(OH)D3 in the observation group were significantly lower than those in the control group (P<0.05). There were significant differences in the inflammatory factors between the two groups (P<0.05). The L1, 25-(OH)D3 and IL-2 levels were significantly negatively correlated with thyroid function index and free triiodothyronine (FT3) while a statistically positive correlation was found between IL-6 and FT3 (P<0.05). In conclusion, abnormal levels of bone mineral density, 25-(OH)D3 and inflammatory factors are observed in patients with hyperthyroidism, and there are correlations between L1, 25-(OH)D3, IL-2, IL-6 and FT3 in the pathogenesis of hyperthyroidism, which provides new insight for the diagnosis of hyperthyroidism.
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Affiliation(s)
- Yali Zhou
- Department of Traumatic Orthopaedics, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China
| | - Xixia Wang
- Department of Internal Medicine, Zhucheng BaiChiHe Hospital, Zhucheng, Shandong 262217, P.R. China
| | - Maoyuan Xin
- Department of Traumatic Orthopaedics, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China
| | - Haiting Zhuang
- Department of Anesthesiology, Weifang People's Hospital, Weifang, Shandong 261000, P.R. China
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Hammoud E, Toumi H, Jacob C, Pinti A, Lespessailles E, El Hage R. Does the Severity of Obesity Influence Bone Mineral Density Values in Premenopausal Women? J Clin Densitom 2021; 24:225-232. [PMID: 31109773 DOI: 10.1016/j.jocd.2019.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/20/2019] [Accepted: 04/23/2019] [Indexed: 10/26/2022]
Abstract
The aim of this study was to compare bone mineral content (BMC), bone mineral density (BMD), and geometric indices of hip bone strength among 3 groups of adult obese premenopausal women (severely obese, morbidly obese, and super morbidly obese). This study included 65 young adult premenopausal women whose body mass index (BMI) > 35 kg/m2. They were divided into 3 groups using international cut-offs for BMI. Body composition and bone variables were measured by DXA. DXA measurements were completed for the whole body (WB), lumbar spine, total hip (TH), and femoral neck (FN). Geometric indices of FN strength (cross-sectional area, cross-sectional moment of inertia [CSMI], section modulus [Z], strength index [SI], and buckling ratio) were calculated by DXA. Results showed that age and height were not significantly different among the 3 groups. WB BMC values were higher in super morbidly obese women compared to severely and morbidly obese women. WB BMD, L1-L4 BMD, total hip BMD, FN BMD, cross-sectional area, CSMI, Z, and buckling ratio values were not significantly different among the 3 groups. SI values were lower in super morbidly obese compared to morbidly and severely obese women. In the whole population (n = 65), body weight, BMI, lean mass, fat mass, and trunk fat mass were positively correlated to WB BMC and negatively correlated to SI. Weight and lean mass were positively correlated to WB BMD and CSMI. Our findings suggest that the severity of obesity does not influence BMD values in premenopausal women.
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Affiliation(s)
- Emneh Hammoud
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon; University of Orléans, I3MTO Laboratory, Orléans, France
| | - Hechmi Toumi
- University of Orléans, I3MTO Laboratory, Orléans, France
| | - Christophe Jacob
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon
| | - Antonio Pinti
- University of Orléans, I3MTO Laboratory, Orléans, France
| | | | - Rawad El Hage
- Department of Physical Education, Division of Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, Lebanon.
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Noce A, Marrone G, Ottaviani E, Guerriero C, Di Daniele F, Pietroboni Zaitseva A, Di Daniele N. Uremic Sarcopenia and Its Possible Nutritional Approach. Nutrients 2021; 13:nu13010147. [PMID: 33406683 PMCID: PMC7824031 DOI: 10.3390/nu13010147] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/21/2020] [Accepted: 12/30/2020] [Indexed: 12/11/2022] Open
Abstract
Uremic sarcopenia is a frequent condition present in chronic kidney disease (CKD) patients and is characterized by reduced muscle mass, muscle strength and physical performance. Uremic sarcopenia is related to an increased risk of hospitalization and all-causes mortality. This pathological condition is caused not only by advanced age but also by others factors typical of CKD patients such as metabolic acidosis, hemodialysis therapy, low-grade inflammatory status and inadequate protein-energy intake. Currently, treatments available to ameliorate uremic sarcopenia include nutritional therapy (oral nutritional supplement, inter/intradialytic parenteral nutrition, enteral nutrition, high protein and fiber diet and percutaneous endoscopic gastrectomy) and a personalized program of physical activity. The aim of this review is to analyze the possible benefits induced by nutritional therapy alone or in combination with a personalized program of physical activity, on onset and/or progression of uremic sarcopenia.
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Affiliation(s)
- Annalisa Noce
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
- Correspondence: (A.N.); (G.M.); Tel.: +39-06-2090-2194 (A.N.); +39-06-2090-2191 (G.M.)
| | - Giulia Marrone
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
- Correspondence: (A.N.); (G.M.); Tel.: +39-06-2090-2194 (A.N.); +39-06-2090-2191 (G.M.)
| | - Eleonora Ottaviani
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Cristina Guerriero
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Francesca Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
- PhD School of Applied Medical, Surgical Sciences, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy
| | - Anna Pietroboni Zaitseva
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
| | - Nicola Di Daniele
- UOC of Internal Medicine-Center of Hypertension and Nephrology Unit, Department of Systems Medicine, University of Rome Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (E.O.); (C.G.); (F.D.D.); (A.P.Z.); (N.D.D.)
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Kim BM, Kim SE, Lee DY, Choi D. Effect of Tissue-Selective Estrogen Complex on Hip Structural Geometry in Postmenopausal Women: A 12-Month Study. Front Endocrinol (Lausanne) 2021; 12:649952. [PMID: 33776942 PMCID: PMC7991728 DOI: 10.3389/fendo.2021.649952] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Accepted: 02/17/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hip structural analysis (HSA) is a method for evaluating bone geometry reflecting bone structural and biomechanical properties. However, tissue-selective estrogen complex (TSEC) treatment effects on HSA have not been investigated. OBJECTIVE This study was performed to evaluate the effect of TSEC treatment on hip geometry in postmenopausal Korean women. The treatment was given for 12 months, and hip geometry was measured by HSA. MATERIALS AND METHODS A total of 40 postmenopausal women who received TSEC containing conjugated estrogen 0.45 mg and bazedoxifene 20 mg for treating vasomotor symptoms were included in this retrospective cohort study. The changes in bone mineral density and parameters of HSA including the outer diameter, cross-sectional area, cross-sectional moment of inertia, cortical thickness, section modulus, and buckling ratio as determined by dual-energy X-ray absorptiometry were compared before and after 12 months of TSEC treatment. RESULTS Mean age and years since menopause were 55.1 and 4.5 years, respectively. Total hip bone mineral density significantly increased by 0.74% after treatment (P=0.011). The changes in HSA were mainly demonstrated in the narrow femoral neck: cross-sectional area (P=0.003) and cortical thickness (P<0.001) increased significantly. For the shaft region, only SM decreased significantly after treatment (P=0.009). However, most parameters did not change significantly with TSEC treatment in the intertrochanteric and shaft regions. CONCLUSIONS Our findings demonstrate that 12 months of TSEC treatment could improve bone geometry as measured by HSA. The findings suggest that TSEC might be an interesting option for the prevention of fracture as well as osteoporosis in postmenopausal women.
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The Effect of Self-Reported Lactose Intolerance and Dairy Consumption on Bone Mineral Density Among American Hip Arthroplasty Patients: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17197182. [PMID: 33008062 PMCID: PMC7579615 DOI: 10.3390/ijerph17197182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/20/2020] [Accepted: 09/29/2020] [Indexed: 11/17/2022]
Abstract
The relationship between osteoporosis and lactose intolerance is unclear. This study aims to evaluate the association between self-reported lactose intolerance and symptom severity caused by lactose malabsorption and bone mineral density (BMD). A total of 496 American hip arthroplasty patients took part in this study. Information on BMD and socio-demographic factors were retrospectively extracted from medical records. BMD of the lumbar spine (LS), femoral neck of the operative hip (FNOH), and femoral neck of the non-operative hip (FNH) were measured via dual-energy x-ray absorptiometry scans (DXA). Patients also completed a survey regarding dietary and lifestyle habits from the time of surgery. We found that 9.3% of participants reported lactose intolerance and 33.3%% suffered from either osteopenia or osteoporosis in at least one (location). The population that did not self-identify as lactose intolerant consumed significantly more dairy (p < 0.0001) and animal protein (p = 0.004) than those with intolerance. There was no significant difference in BMD between self-identified lactose intolerant individuals and non-lactose intolerant individuals. In a stepwise multiple regression analysis, body mass index (BMI) and age were the only common predictors of BMD for all locations (p < 0.05). However, yogurt intake was a significant predictor of BMD of FNOH in the multivariate analysis. This study suggests that lactose intolerance is not associated with bone mineral density. We also found that being vegan or vegetarian may increase the risk of low BMD.
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Ibáñez Vodnizza S, van der Horst-Bruinsma I. Sex differences in disease activity and efficacy of treatment in spondyloarthritis: is body composition the cause? Curr Opin Rheumatol 2020; 32:337-342. [PMID: 32453036 DOI: 10.1097/bor.0000000000000717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
PURPOSE OF REVIEW The body composition and fat distribution is different between men and women, with different levels of circulating adipokines. These differences become more evident when suffering from an inflammatory disease, such as spondyloarthritris. In this review, we will explore the influence of obesity, body composition and adipokines on the differences in disease activity, progression and response to treatment, between men and women with spondyloarthritis. RECENT FINDINGS Obesity, mainly determined by the body fat content, which is higher in women, is related to worse disease activity scores. Men with higher disease activity lose more muscle mass than women. Leptin, which is usually found at higher levels in overweight women, seems to be associated with greater spinal radiographic progression when it rises during the course of the disease. Being a woman and obesity, mainly because of the body fat content, are related to a worse response to TNF-α blockers. SUMMARY Overlooking biological sex variation in body composition, circulating adipokines and hormonal levels, and the subsequent differences in clinical presentation, may ultimately hamper clinical treatment.
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Hammoud E, Toumi H, Jacob C, Pinti A, Lespessailles E, El Hage R. Influence of sarcopenia on bone health parameters in a group of eumenorrheic obese premenopausal women. J Bone Miner Metab 2020; 38:385-391. [PMID: 31797065 DOI: 10.1007/s00774-019-01071-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2019] [Accepted: 11/24/2019] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The aim of this study was to compare bone mineral density (BMD) and geometric indices of hip bone strength in a group of obese sarcopenic premenopausal women (n = 27) and a group of obese premenopausal women with normal appendicular lean mass (ALM)/body mass index ratio (BMI) (n = 26). MATERIALS AND METHODS The ALM/BMI criterion of The Foundation for the National Institute of Health was used; women with an ALM/BMI ratio < 0.512 m2 were considered obese sarcopenic. Body composition and bone variables were measured by DXA. DXA measurements were completed for the whole body (WB), lumbar spine (L1-L4), total hip (TH) and femoral neck (FN). Hip geometry parameters including cross-sectional area (CSA), cross-sectional moment of inertia (CSMI), section modulus (Z), strength index (SI) and buckling ratio (BR) were derived by DXA. RESULTS Age, weight and BMI were not significantly different between the two groups. Height, lean mass, skeletal muscle mass index, ALM and the ratio ALM/BMI were significantly higher in obese women with normal ALM/BMI ratio compared to obese sarcopenic women. Fat mass percentage was significantly higher in obese sarcopenic women compared to obese women with normal ALM/BMI ratio. WB BMC, TH BMD, FN BMD, CSA, CSMI and Z were significantly higher in obese women with normal ALM/BMI ratio compared to obese sarcopenic women. In the whole population (n = 53), ALM and the ratio ALM/BMI were positively correlated to WB BMC, CSA, CSMI and Z. CONCLUSION The present study suggests that sarcopenia negatively influences bone mineral density and hip geometry parameters before menopause in eumenorrheic obese women.
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Affiliation(s)
- Emneh Hammoud
- Division of Education, Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, P.O. Box 100, Tripoli, Lebanon
- I3MTO Laboratory, EA 4708, University of Orléans, 45067, Orléans, France
| | - Hechmi Toumi
- I3MTO Laboratory, EA 4708, University of Orléans, 45067, Orléans, France
- Plateforme Recherche Innovation Médicale Mutualisée d'Orléans, Centre Hospitalier Régional d'Orléans, 14 Avenue de l'Hôpital, 45100, Orléans, France
| | - Christophe Jacob
- Division of Education, Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, P.O. Box 100, Tripoli, Lebanon
| | - Antonio Pinti
- I3MTO Laboratory, EA 4708, University of Orléans, 45067, Orléans, France
| | - Eric Lespessailles
- I3MTO Laboratory, EA 4708, University of Orléans, 45067, Orléans, France
- Plateforme Recherche Innovation Médicale Mutualisée d'Orléans, Centre Hospitalier Régional d'Orléans, 14 Avenue de l'Hôpital, 45100, Orléans, France
| | - Rawad El Hage
- Division of Education, Department of Physical Education, Faculty of Arts and Sciences, University of Balamand, Kelhat El-Koura, P.O. Box 100, Tripoli, Lebanon.
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Subramaniam S, Chan CY, Soelaiman IN, Mohamed N, Muhammad N, Ahmad F, Ng PY, Jamil NA, Abd Aziz N, Chin KY. The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above. Diagnostics (Basel) 2020; 10:E178. [PMID: 32218298 PMCID: PMC7235708 DOI: 10.3390/diagnostics10040178] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. METHODS The bone health status of Malaysians aged ≥40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden's index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score <-1) showed a sensitivity of 82.1% (95% CI: 77.9-85.7%), specificity of 51.5% (95% CI: 46.5-56.6%) and AUC of 0.668 (95% CI: 0.630-0.706) in identifying subjects with suboptimal bone health (DXA T-score <-1) (p < 0.001). At QUS T-score ≤-2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score ≤-2.5) (sensitivity 14.4% (95% CI: 8.1-23.0%); specificity 96.1% (95% CI: 94.4-97.4%); AUC 0.553 (95% CI: 0.488-0.617); p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8-72.3%); specificity 72.8% (95% CI: 68.1-77.2%); J = 0.405; AUC 0.702 (95% CI: 0.666-0.739); p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0-86.9%); specificity 61.8% (95% CI: 58.1-65.5%); J = 0.412; AUC 0.706 (95% CI: 0.654-0.758); p < 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.
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Affiliation(s)
- Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Chin-Yi Chan
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Ima Nirwana Soelaiman
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia;
| | - Pei-Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noorazah Abd Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia;
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
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Lewandowicz A, Sławiński P, Kądalska E, Targowski T. Some clarifications of terminology may facilitate sarcopenia assessment. Arch Med Sci 2020; 16:225-232. [PMID: 32051727 PMCID: PMC6963130 DOI: 10.5114/aoms.2020.91293] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/13/2017] [Indexed: 01/11/2023] Open
Affiliation(s)
- Andrzej Lewandowicz
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Piotr Sławiński
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Ewa Kądalska
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
| | - Tomasz Targowski
- Department of Geriatrics, National Institute of Geriatrics, Rheumatology and Rehabilitation, Warsaw, Poland
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Zhu Y, Ruan Z, Lin Z, Long H, Zhao R, Sun B, Cheng L, Tang L, Xia Z, Li C, Zhao S. The association between CD31 hiEmcn hi endothelial cells and bone mineral density in Chinese women. J Bone Miner Metab 2019; 37:987-995. [PMID: 30919130 DOI: 10.1007/s00774-019-01000-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/11/2019] [Indexed: 01/28/2023]
Abstract
Osteoporosis is the most common bone disease in humans. During bone remodeling, specialized blood vessels influenced by the endothelial cells (CD31hiEmcnhi, also called type H cells) are formatted to supply nutrients. Reductions in vascular supply are associated with bone loss resulting in osteoporosis. Therefore, the objective of the present study was to explore the association between the CD31hiEmcnhi endothelial cells and bone mineral density (BMD). In this prospective study, 134 Chinese women were enrolled and examined. BMD was measured by DEXA method while the percentage of CD31hiEmcnhi endothelial cells in the intertrochanteric part was measured by flow cytometry. The percentage of CD31hiEmcnhi endothelial cells in postmenopausal subjects was significantly lower compared with premenopausal women (8.7 ± 4.0% vs 13.2 ± 5.6%, P < 0.01). Meanwhile, the CD31hiEmcnhi endothelial cell levels in osteopenia and osteoporosis were significantly lower compared with subjects with normal BMD (9.84 ± 4.2% in osteopenia and 7.11 ± 3.2% in osteoporosis vs 12.7 ± 5.6% in subjects with normal T score, P < 0.01). Multiple regression analyses showed that the CD31hiEmcnhi endothelial cells level was positively associated with femur neck and total hip BMD, but not with lumbar BMD. Our study suggests a significantly positive association between CD31hiEmcnhi endothelial cells and local BMD in Chinese women. The proportion of CD31hiEmcnhi endothelial cells is a marker of bone quality and represents a potential target for treatment of bone loss.
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Affiliation(s)
- Yong Zhu
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Zhe Ruan
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Zhangyuan Lin
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Haitao Long
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Ruibo Zhao
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Buhua Sun
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Liang Cheng
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Lanhua Tang
- Department of Oncology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Zhuying Xia
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Changjun Li
- Department of Endocrinology, Endocrinology Research Center, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China
| | - Shushan Zhao
- Department of Orthopedics, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, 410008, Hunan, People's Republic of China.
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, People's Republic of China.
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20
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Ruan Z, Zhu Y, Lin Z, Long H, Zhao R, Sun B, Cheng L, Zhao S. Association between rs12742784 polymorphism and hip fracture, bone mineral density, and EPHB2 mRNA expression levels in elderly Chinese women. Climacteric 2019; 23:93-98. [PMID: 31352841 DOI: 10.1080/13697137.2019.1640195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Objective: This study aimed to determine the association between rs12742784 polymorphism in the non-coding area and hip fracture, bone mineral density (BMD), and EPHB2 mRNA expression levels in elderly Chinese women.Methods: We investigated 250 Chinese women (mean age: 63.5 ± 8.3 years) including 123 hip fracture patients and 127 non-fracture controls. All participants underwent clinical examination to meet the inclusion criteria. Lumbar and hip BMD were detected by dual-energy X-ray absorptiometry. rs12742784 polymorphism was determined by restriction fragment length polymorphism and EPHB2 mRNA expression levels were measured by real-time polymerase chain reaction.Results: Distribution of rs12742784 genotypes agreed with Hardy-Weinberg equilibrium. The frequency of the CT + TT genotype was significantly associated with decreased risk of hip fracture (adjusted odds ratio = 0.57, p < 0.01) after adjusting for age and body mass index, and with increased BMD and EPHB2 mRNA expression levels. The T allele of the rs12742784 single nucleotide polymorphism (SNP) was a protective factor for hip fracture (adjusted odds ratio = 0.56, p < 0.01).Conclusion: rs12742784 polymorphism was associated with EPHB2 mRNA expression levels, BMD, and hip fracture in Chinese women. The T allele of the rs12742784 SNP was a protective factor for osteoporosis and hip fracture.
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Affiliation(s)
- Z Ruan
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Y Zhu
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - Z Lin
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - H Long
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - R Zhao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - B Sun
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - L Cheng
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China
| | - S Zhao
- Department of Orthopedics, Xiangya Hospital, Central South University, Changsha, P.R. China.,National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, P.R. China
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21
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Temmerman A, Rasmusson L, Kübler A, Thor A, Merheb J, Quirynen M. A Prospective, Controlled, Multicenter Study to Evaluate the Clinical Outcome of Implant Treatment in Women with Osteoporosis/Osteopenia: 5-Year Results. J Dent Res 2018; 98:84-90. [PMID: 30205020 DOI: 10.1177/0022034518798804] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
The impact of osteoporosis on implant treatment is still a matter of debate in the scientific community, as it may possibly lead to higher failure rates. As long-term controlled trials are missing, the aim of this study was to verify the long-term outcome of implants placed in patients with systemic osteoporosis. Postmenopausal women in need of implants underwent bone mineral density measurements in hip and spine, using dual X-ray absorptiometry scans. Based on T-scores, they were divided into 2 groups: group O (osteoporosis group) with a T-score ≤-2 or group C (control group) with a T-score of ≥-1. Implants were placed in a 2-stage manner and loaded 4 to 8 wk after abutment surgery. Six months after loading and thereafter yearly, clinical and radiographical parameters were assessed. In total, 148 implants were placed in 48 patients (mean age: 67 y [range, 59-83]). Sixty-three implants were placed in 20 patients (group O) and 85 implants in 28 patients (group C). After 5 y, 117 implants (38 in group O and 79 in the group C) in 37 patients were assessed. Cumulative survival rate on an implant level was 96.5% (group O: 91.5%; group C: 100.0% [ P < 0.05]) and 95.7% (group O: 89.2%; group C: 100.0% [ P > 0.05]) on a patient level. The overall marginal bone-level alterations, after 5 y of loading, were -0.09 ± 0.78 mm (group O: -0.15 ± 0.50 mm; group C: -0.06 ± 0.89 mm) on an implant level and -0.09 ± 0.54 mm (group O: -0.18 ± 0.43 mm; group C: 0.06 ± 0.58 mm) on a patient level ( P > 0.05). Oral implant therapy in osteoporotic patients is a reliable treatment option with comparable osseointegration rates, implant survival, and marginal bone-level alterations after 5 y of functional loading (ClinicalTrials.gov NCT00745121).
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Affiliation(s)
- A Temmerman
- 1 Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - L Rasmusson
- 2 Department of Oral and Maxillofacial Surgery, The Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - A Kübler
- 3 Department of Oral and Maxillofacial Plastic Surgery, University of Würzburg, Würzburg, Germany
| | - A Thor
- 4 Department of Oral and Maxillofacial Surgery, Institute of Surgical Sciences, Uppsala University, Uppsala, Sweden
| | - J Merheb
- 1 Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
| | - M Quirynen
- 1 Section of Periodontology, Department of Oral Health Sciences, KU Leuven & Dentistry, University Hospitals, KU Leuven, Leuven, Belgium
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22
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Lee JE, Kim KM, Kim LK, Kim KY, Oh TJ, Moon JH, Choi SH, Lim S, Kim SW, Shin CS, Jang HC. Comparisons of TBS and lumbar spine BMD in the associations with vertebral fractures according to the T-scores: A cross-sectional observation. Bone 2017; 105:269-275. [PMID: 28963079 DOI: 10.1016/j.bone.2017.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 08/29/2017] [Accepted: 09/26/2017] [Indexed: 01/09/2023]
Abstract
Trabecular bone score (TBS) is a parameter of bone quality that has been shown to be related to vertebral fractures. This study aimed to analyze the difference in discriminatory power of TBS for vertebral fractures according to the bone mineral density (BMD) T-score. Areal BMD at the lumbar spine (LS, L1-L4), femur neck (FN) and total hip were assessed using dual x-ray absorptiometry (Discovery W, Hologic, Bedford, MA) in 929 women aged 50years or older. TBS was analyzed using iNsight software (Med-Imaps, Pessac, France). Vertebral fractures were identified on lateral X-ray films of the thoracic and lumbar spine using a semi-quantitative method. The study subjects consisted of 158 subjects (17.0%) with normal BMD, 461 (49.6%) with osteopenia and 310 (33.4%) with osteoporosis. The incident vertebral fractures were observed in 92 (9.9%) subjects, including 59 fractures in osteoporosis, 29 fractures in osteopenia, and only 4 fractures in normal BMD. We stratified study subjects into two groups according to their BMD T-scores, osteoporosis or osteopenia/normal BMD. The logistic regression model showed that LS BMD values per each 1 standard deviation (SD) decrease were significantly associated with increased risk of vertebral fracture in both osteoporosis and osteopenia/normal BMD group with stronger association in osteoporosis group. However, a TBS value that was lower by 1SD was significantly associated with vertebral fracture risk only in the osteopenia/normal BMD group. The TBS use in addition to FN BMD and age also showed significantly better discriminatory power for vertebral fracture only in the osteopenia/normal BMD group, but not osteoporosis group. In conclusion, TBS is significantly associated with vertebral fractures in subjects with osteopenia/normal BMD levels. Additional assessment of bone microarchitecture using TBS is better able to identify women at risk of fracture, in particular, those with relatively higher BMD.
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Affiliation(s)
- Jie-Eun Lee
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Kyoung Min Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea.
| | - Lee-Kyung Kim
- Department of Internal Medicine, Halla General Hospital, Jeju, Republic of Korea
| | - Kyong Young Kim
- Department of Internal medicine, Gyeongsang National University Changwon Hospital, Republic of Korea
| | - Tae Jung Oh
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jae Hoon Moon
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Sung Hee Choi
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Soo Lim
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Sang Wan Kim
- Department of Internal Medicine, Borame Hospital and Seoul National University College of Medicine, Republic of Korea
| | - Chan Soo Shin
- Department of Internal Medicine, Seoul National University Hospital and Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital and Seoul National University College of Medicine, Seongnam, Republic of Korea
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23
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Ibáñez Vodnizza S, Visman IM, van Denderen C, Lems WF, Jaime F, Nurmohamed MT, van der Horst-Bruinsma IE. Muscle wasting in male TNF-α blocker naïve ankylosing spondylitis patients: a comparison of gender differences in body composition. Rheumatology (Oxford) 2017; 56:1566-1572. [PMID: 28605535 DOI: 10.1093/rheumatology/kex187] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2016] [Indexed: 12/14/2022] Open
Abstract
Objective To assess gender differences in body composition (BC) in a cohort of AS patients naïve to TNF-α blockers. Methods Patients included fulfilled the Modified New York criteria for AS. Demographic information and disease activity measures (ASDAS and BASDAI) were reported. BC was measured by whole body DXA. Body fat percentage (BF%), fat mass index (FMI), fat free mass index (FFMI) and android/gynoid fat ratio were reported and compared between men and women and with the reference population (percentiles). Results Seventy consecutive patients were included; 60% were men. Demographic variables were similar, except for dyslipidaemia (57.1% of men; 14.3% of women). Women had significantly more fat (BF%, FMI), and less muscle (FFMI) than men, but below the median of the reference population. Male AS patients had a markedly low FFMI (31.7th percentile) compared with the reference population. In the whole group, after multivariate analysis, an ASDAS CRP >3.5 was related to lower fat free mass content. In men, a significant relationship between having a high disease activity (ASDAS, BASDAI) and lower BF% or FMI percentile was found, but in women it was the opposite. Conclusion Muscle wasting, measured as low FFMI compared with the reference population, was found in male TNF-α blocker naïve AS patients, especially in those with active disease. Women had higher volumes of body fat than men, but near the median of the reference population. The relationships between fat content and disease activity support the complex association between adipose tissue and inflammation.
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Affiliation(s)
- Sebastián Ibáñez Vodnizza
- Rheumatology Department, Clínica Alemana de Santiago.,Rheumatology Department, Hospital Padre Hurtado, Santiago, Chile
| | - Ingrid M Visman
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam
| | | | - Willem F Lems
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam.,Amsterdam Rheumatology and Immunology Center, VU University Medical Center, The Netherlands
| | - Francisca Jaime
- Medicine Faculty, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Michael T Nurmohamed
- Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam.,Amsterdam Rheumatology and Immunology Center, VU University Medical Center, The Netherlands
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24
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Ioannidis G, Jantzi M, Bucek J, Adachi JD, Giangregorio L, Hirdes J, Pickard L, Papaioannou A. Development and validation of the Fracture Risk Scale (FRS) that predicts fracture over a 1-year time period in institutionalised frail older people living in Canada: an electronic record-linked longitudinal cohort study. BMJ Open 2017; 7:e016477. [PMID: 28864698 PMCID: PMC5588955 DOI: 10.1136/bmjopen-2017-016477] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
OBJECTIVES To develop and validate our Fracture Risk Scale (FRS) over a 1-year time period, using the long-term care (LTC) Resident Assessment Instrument Minimum Data Set Version 2.0 (RAI-MDS 2.0). DESIGN A retrospective cohort study. SETTING LTC homes in Ontario, Canada. PARTICIPANTS Older adults who were admitted to LTC and received a RAI-MDS 2.0 admission assessment between 2006 and 2010. RESULTS A total of 29 848 LTC residents were enrolled in the study. Of these 22 386 were included in the derivation dataset and 7462 individual were included in the validation dataset. Approximately 2/3 of the entire sample were women and 45% were 85 years of age or older. A total of 1553 (5.2%) fractures were reported over the 1-year time period. Of these, 959 (61.8%) were hip fractures. Following a hip fracture, 6.3% of individuals died in the emergency department or as an inpatient admission and did not return to their LTC home. Using decision tree analysis, our final outcome scale had eight risk levels of differentiation. The percentage of individuals with a hip fracture ranged from 0.6% (lowest risk level) to 12.6% (highest risk level). The area under the curve of the outcome scale was similar for the derivation (0.67) and validation (0.69) samples, and the scale exhibited a good level of consistency. CONCLUSIONS Our FRS predicts hip fracture over a 1-year time period and should be used as an aid to support clinical decisions in the care planning of LTC residents. Future research should focus on the transformation of our scale to a Clinical Assessment Protocol and to assess the FRS in other healthcare settings.
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Affiliation(s)
- George Ioannidis
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Geriatric Education and Research in Ageing Sciences Centre, Hamilton, Ontario, Canada
| | - Micaela Jantzi
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada
| | - Jenn Bucek
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada
| | - Jonathan D Adachi
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Geriatric Education and Research in Ageing Sciences Centre, Hamilton, Ontario, Canada
| | - Lora Giangregorio
- Department of Kinesiology, University of Waterloo, Waterloo, Ontario, Canada
| | - John Hirdes
- Department of Health Studies and Gerontology, University of Waterloo, Waterloo, Ontario, Canada
| | - Laura Pickard
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Geriatric Education and Research in Ageing Sciences Centre, Hamilton, Ontario, Canada
| | - Alexandra Papaioannou
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
- Geriatric Education and Research in Ageing Sciences Centre, Hamilton, Ontario, Canada
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25
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Measurement of lean body mass using bioelectrical impedance analysis: a consideration of the pros and cons. Aging Clin Exp Res 2017; 29:591-597. [PMID: 27568020 DOI: 10.1007/s40520-016-0622-6] [Citation(s) in RCA: 150] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2016] [Accepted: 08/09/2016] [Indexed: 10/21/2022]
Abstract
The assessment of body composition has important applications in the evaluation of nutritional status and estimating potential health risks. Bioelectrical impedance analysis (BIA) is a valid method for the assessment of body composition. BIA is an alternative to more invasive and expensive methods like dual-energy X-ray absorptiometry, computerized tomography, and magnetic resonance imaging. Bioelectrical impedance analysis is an easy-to-use and low-cost method for the estimation of fat-free mass (FFM) in physiological and pathological conditions. The reliability of BIA measurements is influenced by various factors related to the instrument itself, including electrodes, operator, subject, and environment. BIA assumptions beyond its use for body composition are the human body is empirically composed of cylinders, FFM contains virtually all the water and conducting electrolytes in the body, and its hydration is constant. FFM can be predicted by BIA through equations developed using reference methods. Several BIA prediction equations exist for the estimation of FFM, skeletal muscle mass (SMM), or appendicular SMM. The BIA prediction models differ according to the characteristics of the sample in which they have been derived and validated in addition to the parameters included in the multiple regression analysis. In choosing BIA equations, it is important to consider the characteristics of the sample in which it has been developed and validated, since, for example, age- and ethnicity-related differences could sensitively affect BIA estimates.
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26
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Ibáñez Vodnizza SE, Nurmohamed MT, Visman IM, van Denderen JC, Lems WF, Jaime F, van der Horst-Bruinsma IE. Fat Mass Lowers the Response to Tumor Necrosis Factor-α Blockers in Patients with Ankylosing Spondylitis. J Rheumatol 2017; 44:1355-1361. [PMID: 28711878 DOI: 10.3899/jrheum.170094] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/25/2017] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Our main objective was to assess the relationship between body composition (BC) and response to tumor necrosis factor-α (TNF-α) blocker treatment in patients with ankylosing spondylitis (AS). Our secondary objective was to evaluate the change of BC after treatment, accounting for sex and age. METHODS All included patients fulfilled the modified New York criteria for AS and were naive to TNF-α blocker. They were followed for at least 6 months after the start of etanercept or adalimumab. The Ankylosing Spondylitis Disease Activity Score containing C-reactive protein (ASDAS-CRP) and the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) were reported. BC was assessed by whole body dual-energy X-ray absorptiometry. Body fat percentage (BF%), fat mass index (FMI), and fat free mass index (FFMI) were reported as absolute values and as percentiles. RESULTS Forty-one patients were included (61% men). The median followup was 14.3 months (interquartile range 8.4-19.4). After multivariate regression analysis, more fat at baseline (BF%, FMI, or FMI percentile) was significantly related with a lower chance of achieving a clinically important improvement of the ASDAS-CRP or BASDAI after treatment. The body composition did not change significantly after treatment, but there was a trend toward muscle recovery in men (FFMI change from 34.0th to 37.4th percentile). CONCLUSION Higher body fat content at baseline was independently associated with a worse response to treatment with TNF-α blockers, measured by ASDAS-CRP and BASDAI change, and might contribute to the lower response rates in female patients. Also, there is a trend toward muscle mass recovery in male patients after treatment.
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Affiliation(s)
- Sebastián E Ibáñez Vodnizza
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile.,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
| | - Michael T Nurmohamed
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile.,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
| | - Ingrid M Visman
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile.,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
| | - J Christiaan van Denderen
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile.,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
| | - Willem F Lems
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile.,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
| | - Francisca Jaime
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile.,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center
| | - Irene E van der Horst-Bruinsma
- From the Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center, Amsterdam, the Netherlands; Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado, Santiago, Chile. .,S.E. Ibáñez Vodnizza, MD, Rheumatology Department, Clínica Alemana de Santiago and Hospital Padre Hurtado; M.T. Nurmohamed, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; I.M. Visman, Amsterdam Rheumatology and Immunology Center, Reade; J.C. van Denderen, MD, PhD, Amsterdam Rheumatology and Immunology Center; W.F. Lems, MD, Professor, Amsterdam Rheumatology and Immunology Center, Reade and VU University Medical Center; F. Jaime, MD, Faculty of Medicine, Pontificia Universidad Católica de Chile; I.E. van der Horst-Bruinsma, MD, PhD, Amsterdam Rheumatology and Immunology Center, VU University Medical Center.
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The Influence of Tribological Pairings and Other Factors on Migration Patterns of Short Stems in Total Hip Arthroplasty. BIOMED RESEARCH INTERNATIONAL 2017; 2017:8756432. [PMID: 28497067 PMCID: PMC5406728 DOI: 10.1155/2017/8756432] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 03/11/2017] [Accepted: 03/28/2017] [Indexed: 01/13/2023]
Abstract
Over the last decade, the number of short stem total hip arthroplasty procedures has increased. Along with the possible benefits associated with short stems is a smaller implant-bone contact surface, which may have a negative influence on primary stability and impair osseointegration. Previous studies observed migration of short stems, especially within the first three months. The variables that influence migration in short stem hip implants remain unknown. Therefore, the purpose of this study was to associate the migration of short stems with its possible influencing variables. Migration data from two different short stem studies were retrospectively analyzed. Migration within the first two postoperative years was determined by model-based Roentgen stereophotogrammetric analysis. Migration was correlated to bearing couple, type and size of stem, size of acetabular cup, and age, gender, weight, and height of patients using a multiple factor analysis. Eigenvalue analysis explained 80.7% of the overall variance for the first three dimensions. The four most dominant variables in the first dimension were weight, stem size, acetabular cup size, and patient height (correlations of 0.81, 0.80, 0.71, and 0.70, resp.). None of the analyzed parameters (bearing couple, type and size of stem, size of acetabular cup, and age, gender, weight, and height of patients) affected the migration pattern of short stem THA with primary metaphyseal fixation.
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28
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Affiliation(s)
- Won Young Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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29
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Associations Between Fat Mass and Multisite Pain: A Five‐Year Longitudinal Study. Arthritis Care Res (Hoboken) 2017; 69:509-516. [DOI: 10.1002/acr.22963] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 06/15/2016] [Accepted: 06/21/2016] [Indexed: 12/27/2022]
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Chen YD, Huang CY, Liu HY, Yao WF, Wu WG, Lu YL, Wang W. Serum CX3CL1/fractalkine concentrations are positively associated with disease severity in postmenopausal osteoporotic patients. Br J Biomed Sci 2016; 73:121-128. [PMID: 27476376 DOI: 10.1080/09674845.2016.1209897] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
BACKGROUND The chemokine (C-X3-C motif) ligand 1 (CX3CL1), also called fractalkine (FKN), has recently been reported to be involved in osteoclastogenic process and pathological bone destruction. OBJECTIVE This study aimed to investigate the link between serum CX3CL1/FKN levels with disease progression of postmenopausal osteoporotic patients. METHODS A total of 53 women with postmenopausal osteoporosis (PMOP group), 51 postmenopausal non-osteoporotic female patients (PMNOP group) and 50 premenopausal non-osteoporotic healthy women of childbearing age (control group) were enrolled in the study. The bone mineral density (BMD) for all subjects was determined via dual-energy X-ray absorptiometry of the lumbar spine, femoral neck, internal trochanter, total hip, greater trochanter and Ward's triangle. The levels of FKN in the serum were examined using the enzyme-linked immunosorbent assay method. The serum bone resorption markers TRACP-5b, NTX levels, inflammation markers IL-1β and IL-6 as well as oestrogen-2(E2) were also detected in all participants. The visual analogue scores (VAS) and Oswestry Disability Index (ODI) for low back pain were recorded in PMOP females for evaluation of osteoporotic pain and function. RESULTS FKN levels were significantly higher in postmenopausal osteoporotic patients compared with postmenopausal non-osteoporotic females (139.8 ± 44.3 pg/mL VS 116.5 ± 23.1 pg/mL, p < 0.05) and healthy controls (139.8 ± 44.3 pg/mL VS 109.7 ± 19.4 pg/mL, p < 0.05). Serum FKN concentrations were negatively associated with BMD at femoral neck (r = -0.394, p = 0.004), total hip(r = -0.374, p = 0.006), internal trochanter(r = -0.340, p = 0.013), greater trochanter(r = -0.376, p = 0.006), Ward's triangle(r = -0.343, p = 0.012), L1-L4 lumbar spine(r = -0.339, p = 0.013) and positively associated with VAS (r = 0.321, p = 0.019) and ODI (r = 0.377, p = 0.005) scores, bone turnover makers (TRACP-5b:r = 0.341, p = 0.012; NTX:r = 0.364, p = 0.007)as well as inflammation markers (IL-1β: r = 0.396, p = 0.003; IL-6:r = 0.355, p = 0.009) in postmenopausal osteoporotic patients. CONCLUSIONS Serum FKN may serve as a novel biomarker for assessing disease progression and a new potential therapeutic target for anti-resorptive treatment in osteoporosis patients.
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Affiliation(s)
- Yi-Ding Chen
- a Department of Endocrinology , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
| | - Ci-You Huang
- a Department of Endocrinology , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
| | - Hai-Ying Liu
- b Department of Nursing , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
| | - Wei-Feng Yao
- a Department of Endocrinology , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
| | - Wei-Guo Wu
- a Department of Endocrinology , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
| | - Yu-Lian Lu
- a Department of Endocrinology , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
| | - Wen Wang
- a Department of Endocrinology , Nanjing Medical University Affiliated Wuxi Second Hospital , Wuxi , China
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