Impact of beverage consumption, age, and site dependency on dual energy X-ray absorptiometry (DEXA) measurements in perimenopausal women: a prospective study

Radiological Factors Associated with Bisphosphonate Treatment Failure and Their Impact on Fracture Healing in Postmenopausal Women with Osteoporotic Vertebral Fractures

(1) Background: Bisphosphonate treatment failure is one of the most difficult clinical problems for patients with osteoporosis. This study aimed to analyze the incidence of bisphosphonate treatment failure, associated radiological factors, and effect of fracture healing in postmenopausal women with osteoporotic vertebral fractures (OVFs). (2) Methods: A total of 300 postmenopausal patients with OVFs who were prescribed bisphosphonate were retrospectively analyzed and divided into two groups according to the treatment response: response (n = 116) and non-response (n = 184) groups. The radiological factors and the morphological patterns of OVFs were included in this study. (3) Results: The initial BMD values of the spine and femur in the non-response group were significantly lower than those in the response group (all Ps < 0.001). The initial BMD value of the spine (odd ratio = 1.962) and the fracture risk assessment tool (FRAX) hip (odd ratio = 1.32) showed statistical significance in logistic regression analysis, respectively (all Ps < 0.001). (4) Conclusions: The bisphosphonate non-responder group showed a greater decrease in BMD over time than the responder group. The initial BMD value of the spine and the FRAX hip could be considered radiological factors influencing bisphosphonate non-response in the postmenopausal patients with OVFs. The failure of bisphosphonate treatment for osteoporosis has a possible negative on the fracture healing process in OVFs.

MALAT1/miR-320a in bone marrow mesenchymal stem cells function may shed light on mechanisms underlying osteoporosis

INTRODUCTION

Growing evidence supports the involvement of long noncoding RNAs (lncRNAs) in bone metabolism and diseases. This study aims to investigate the involvement of the lncRNA metastasis-associated lung adenocarcinoma transcript 1 (MALAT1) in the pathological process of osteoporosis and the effects of MALAT1 on regulation of BMSC differentiation through competitive endogenous RNA (ceRNA) mechanisms.

MATERIAL AND METHODS

The expression of MALAT1 and miR-320a was determined using RT-PCR in bone tissue derived from female SD (Sprague Dawley) rats with osteoporosis. Immunohistochemical (IHC) staining was used to evaluate the expression of neuropilin-1 (NRP-1) and β-catenin. Bone marrow mesenchymal stem cells (BMSCs) were divided into 4 groups: control, NC (negative control), MALAT1 siRNA, and miR-320a mimics. Forty-eight hours later, the effect of MALAT1 on the miR-320a expression, proliferation and osteogenic differentiation of BMSCs was investigated. Two weeks later, the cell activity, alkaline phosphatase (ALP) activity, and mRNA expression of Osterix and Runx2 were evaluated. Three weeks later, alizarin red staining of calcified nodules and Western blot analysis of the expression of β-catenin, NRP-1, osteocalcin (OCN), and osteopontin (OPN) were performed.

RESULTS

Downregulated MALAT1or upregulated miR-320a expression inhibited the activity and osteogenic differentiation of BMSCs, resulting in low ALP activity and NRP-1 expression, fewer calcified nodules, decreased mRNA levels of Osterix and Runx2, and inhibited expression of NRP-1, OCN, and OPN. MALAT1 silencing did not decrease the protein level of β-catenin in the cytoplasm but suppressed that in the nucleus.

CONCLUSIONS

Downregulated MALAT1 and upregulated miR-320a expression play an important role in the pathological process of osteoporosis, via inhibition of the osteogenic differentiation of BMSCs.

Factors associated with gastro-duodenal ulcer in compensated type 2 diabetic patients: a Romanian single-center study

INTRODUCTION

Helicobacter pylori infection is accepted as the leading cause of chronic gastritis, ulcer disease and gastric cancer, with an important impact on health care burden, especially in countries with a high prevalence of infection. The aim of the study was to investigate the influence of H. pylori infection, medication, associated medical conditions or social habits on endoscopic ulcer occurrence in the compensated type 2 diabetic population.

MATERIAL AND METHODS

Two hundred and sixty type 2 diabetic patients investigated on endoscopy (57 patients with peptic ulcer and 203 controls) with a complete set of biopsies, demographic and medical data were enrolled.

RESULTS

On univariate regression analysis, H. pylori infection (42.1% vs. 35.5%, p = 0.359) or a history of peptic ulcer (61.4% vs. 61.6%, p = 0.981) was not a predictor for ulcer on endoscopy in the diabetic population, and heartburn was more frequent in diabetics without ulcer (21.2% vs. 8.8%, p = 0.033). Anemia was the best predictor for ulcer on endoscopy in both diabetics with (p < 0.001, OR = 4.77, 95% CI: 2.02-11.28) and without (p = 0.027, OR = 2.76, 95% CI: 1.10-6.91) chronic proton pump inhibitor (PPI) therapy. In diabetic patients on PPI more than 1 month anticoagulants - acenocoumarol or low-weight molecular heparin (p = 0.038, OR = 2.37, 95% CI: 1.04-5.40), low-dose aspirin 75-125 mg/day (p = 0.029, OR = 2.61, 95% CI: 1.08-6.28) and alcohol consumption (p = 0.015, OR = 2.70, 95% CI: 1.19-6.13) were predictors for ulcer on endoscopy.

CONCLUSIONS

In diabetic patients, anemia is the most important predictor for ulcer on endoscopy, but not H. pylori or digestive symptoms, while low-dose aspirin or anticoagulant therapy and alcohol consumption are the most important predictors for ulcer in diabetics on chronic proton pump inhibitor therapy.

KIR2DL2/S2 and KIR2DS5 in alcoholic cirrhotic patients undergoing liver transplantation

INTRODUCTION

The molecular mechanisms underlying alcoholic liver fibrosis and cirrhosis are not completely understood. Hepatic fibrosis involves the interplay of diverse cells and factors, including hepatic stellate cells (HSCs), Kupffer, NK cells, and T-lymphocyte subsets. Killer-cell immunoglobulin-like receptors (KIR) are membrane receptors involved in mediation between NK and activated HSCs, regulating NK cell function through their interaction with HLA-I molecules. The aim of this study was to analyse the genetic association between KIR genes and the susceptibility to or protection from alcoholic cirrhosis (AC) in a cohort of male AC patients undergoing liver transplantation (LT) with and without concomitant viral infections.

MATERIAL AND METHODS

KIR genotyping was performed in nuclear DNA extracted from 281 AC patients and compared with 319 male controls.

RESULTS

Significant differences between total AC patients and healthy controls were only found in the case of KIR2DL2 and KIR2DS5. KIR2DL2 was significantly underrepresented in non-viral AC patients (52.6% vs. 63.3%; p = 0.015), while patients heterozygous for KIR2DL2 were also underrepresented in the non-viral AC group compared with controls (p = 0.034). KIR2DS5 was overrepresented in this group compared with healthy controls (p = 0.002). All these observations were only evident in AC patients older than 54 years old.

CONCLUSIONS

Our data suggest a contrary effect of KIR2DL2 and KIR2DS5 in AC patients older than 54 years, in whom the presence of KIR2DL2 appears to be protective against AC, whereas the presence of KIR2DS5 seems to promote the fibrotic process, particularly in patients with no associated viral infection.

DEXA sensitivity analysis in patients with adult spinal deformity

BACKGROUND

Adult spinal deformity (ASD) is a debilitating condition that commonly requires surgical intervention. However, ASD patients may also present with osteoporosis, predisposing them to surgical complications and failure of instrumentation. As a result, proper detection of low bone mineral density (BMD) is critical in order to ensure proper patient care. Typically dual-energy x-ray absorptiometry (DEXA) scans are performed on the hip and spine. Unfortunately, in ASD patients, the latter is often inaccurate PURPOSE: In this study, we consider the value of obtaining a forearm DEXA scan in addition to a hip scan in patients suffering from ASD and osteoporosis in order to accurately detect low BMD.

STUDY DESIGN

Retrospective study.

PATIENT SAMPLE

Patient data between 2016 and 2018 from a single academic medical center was utilized. Two hundred eighty-six patients met the initial search criteria.

OUTCOME MEASURES

No outcomes measures related to self-reporting, physiology, or functionality were evaluated in this study. Primary outcome measures analyzed included T-scores across various anatomic locations and diagnoses relating to low bone density (ie, osteopenia and osteoporosis).

METHODS

This retrospective study examines patients that underwent DEXA studies between 2016 and 2018 and were previously diagnosed with both osteoporosis and adult spinal deformity. For each patient, age, gender, body mass index, and smoking history were noted, as well as whether there was long-term prednisone use. T-scores from both the forearm and hip were recorded and analyzed. Diagnoses from hip DEXA scans were compared with those obtained from forearm scans to identify which region was more sensitive in detecting low BMD. From this data, the frequency of a missed diagnosis, due to reliance on hip or spine T-scores for detection of low BMD, was extrapolated. No external funding source was received in support of this study.

RESULTS

Two hundred eighty-six patients matched the initial search criteria. Only 68% had one T-score value. However, 24.8% of patients had data for both the hip and forearm, whereas 7.1% had data for the forearm, hip, and spine. Among the 85 patients with more than one anatomical site of study, the forearm was more sensitive than the hip in its ability to detect osteopenia or osteoporosis 41.2% of the time. A two-tailed t test showed no statistically significant difference between hip T-scores and forearm T-scores. However, for more than 17% of patients, the forearm allowed clinicians to detect osteoporosis or osteopenia in a setting where using only the hip data would have missed such a diagnosis.

CONCLUSIONS

Clinicians need to ensure they survey at least two locations when conducting DEXA studies before precluding a diagnosis of osteopenia or osteoporosis. All ASD patients being evaluated for low bone density should receive DEXA scans that survey at least the hip and the forearm. Misdiagnoses can be costly in the setting of ASD. They occur frequently when only a single hip scan is relied upon to assess BMD.

Bone mineral density in old age: the influence of age at menarche, menopause status and habitual past and present physical activity

INTRODUCTION

In this study, the hypothesis that bone mineral density (BMD) of peri-, pre- and postmenopausal women is associated with the current level of habitual physical activity, as well as past physical activity, at the age of building peak bone mass, was tested.

MATERIAL AND METHODS

The study involved 500 Polish women aged 40 to 70. For the assessment of BMD and bone mineral content (BMC) the densitometry method (dual-energy X-ray absorptiometry, DXA) of the forearm bone was used. The International Physical Activity Questionnaire (IPAQ) was used to assess the present level of physical activity. The assessment of past physical activity was related to adolescence.

RESULTS

There was a significant, strong influence on the norm BMD in the distal forearm sections values in the distal forearm sections of such variables as: older age of the first menstruation (OR = 1.37; p = 0.002), sufficient present physical activity (OR = 1.57; p = 0.001), and particularly high past physical activity (OR = 6.77; p = 0.003). Significantly lower chances for the norm BMD dis were found in women with the oldest hormonal status (OR = 0.09; p < 0.001). In the proximal segment, the analogous conditions of the norm BMD, and in addition the chances for good mineralization, were increased by higher body mass index (OR = 1.11; p < 0.001). Sufficient present activity increased the chances of good forearm mineralization in the proximal part more than four times (OR = 4.2; p < 0.001), and a high level of past physical activity increased these chances several dozen times (OR = 69.9; p < 0.001).

CONCLUSIONS

Physical activity proved to be one of the most important factors determining the statistically significant correct mineralization of bone tissue of women.

Exposure to biomass smoke, cigarettes, and alcohol modifies the association between tumour necrosis factor (-308G/A, -238G/A) polymorphisms and tuberculosis in Mexican carriers

INTRODUCTION

Exposure to biomass smoke, cigarettes, alcohol, and the impairment of immunoregulation are considered to be risk factors for tuberculosis. Tumour necrosis factor (TNF) -308G/A and -238G/A gene polymorphisms have been associated with tuberculosis. However, the results remain inconsistent. The aim of this study was to determine the association between TNF polymorphisms and tuberculosis in the presence of biomass smoke, cigarettes, and alcohol in a Mexican population.

MATERIAL AND METHODS

TNF polymorphisms were determined in 118 tuberculosis patients and 223 controls. We performed a univariate, bivariate, stratified analysis. Odds ratios, confidence intervals, and p-values were calculated.

RESULTS

Occupational biomass smoke exposure was associated with tuberculosis between the patients and controls (OR = 1.70, 95% CI: 1.08-2.70, p = 0.02). We also found an association of the -308A allele carriers between the patients and controls without exposure to occupational (p = 0.04, OR = 0.16, 95% CI: 0.01-0.92) and in-home (p = 0.02, OR = 0.14, 95% CI: 0.01-0.81) biomass smoke, as well as an association with alcohol (p = 0.01, OR = 0.24, 95% CI: 0.05-0.75). The haplotype analysis revealed an association of the -308A/-238G haplotype between patients and nonconsanguineous controls without exposure to occupational (p = 0.02, OR = 0.12, 95% CI: 0.01-0.99) and in-home (p = 0.01, OR = 0.1, 95% CI: 0.01-0.9) biomass smoke, cigarette use (p = 0.04, OR = 0.28, 95% CI: 0.08-0.98), and alcohol (p = 0.02, OR = 0.22, 95% CI: 0.05-0.88) intake.

CONCLUSIONS

The TNF -308A allele and the -308A/-238G haplotype are associated with tuberculosis, as are exposure to biomass smoke, cigarettes, and alcohol. No association for the -238G/A polymorphism was found. Our results provide insight into a possible protective role of TNF polymorphisms in tuberculosis in our population.