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Huang J, Wu T, Jiang YR, Zheng XQ, Wang H, Liu H, Wang H, Leng HJ, Fan DW, Yuan WQ, Song CL. β-Receptor blocker enhances the anabolic effect of PTH after osteoporotic fracture. Bone Res 2024; 12:18. [PMID: 38514644 PMCID: PMC10958005 DOI: 10.1038/s41413-024-00321-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 02/07/2024] [Accepted: 02/15/2024] [Indexed: 03/23/2024] Open
Abstract
The autonomic nervous system plays a crucial role in regulating bone metabolism, with sympathetic activation stimulating bone resorption and inhibiting bone formation. We found that fractures lead to increased sympathetic tone, enhanced osteoclast resorption, decreased osteoblast formation, and thus hastened systemic bone loss in ovariectomized (OVX) mice. However, the combined administration of parathyroid hormone (PTH) and the β-receptor blocker propranolol dramatically promoted systemic bone formation and osteoporotic fracture healing in OVX mice. The effect of this treatment is superior to that of treatment with PTH or propranolol alone. In vitro, the sympathetic neurotransmitter norepinephrine (NE) suppressed PTH-induced osteoblast differentiation and mineralization, which was rescued by propranolol. Moreover, NE decreased the PTH-induced expression of Runx2 but enhanced the expression of Rankl and the effect of PTH-stimulated osteoblasts on osteoclastic differentiation, whereas these effects were reversed by propranolol. Furthermore, PTH increased the expression of the circadian clock gene Bmal1, which was inhibited by NE-βAR signaling. Bmal1 knockdown blocked the rescue effect of propranolol on the NE-induced decrease in PTH-stimulated osteoblast differentiation. Taken together, these results suggest that propranolol enhances the anabolic effect of PTH in preventing systemic bone loss following osteoporotic fracture by blocking the negative effects of sympathetic signaling on PTH anabolism.
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Affiliation(s)
- Jie Huang
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
| | - Tong Wu
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
| | - Yi-Rong Jiang
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
| | - Xuan-Qi Zheng
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
| | - Huan Wang
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
| | - Hao Liu
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
| | - Hong Wang
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
- Beijing Key Laboratory of Spinal Disease, 100191, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, 100191, Beijing, China
| | - Hui-Jie Leng
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
- Beijing Key Laboratory of Spinal Disease, 100191, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, 100191, Beijing, China
| | - Dong-Wei Fan
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
- Beijing Key Laboratory of Spinal Disease, 100191, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, 100191, Beijing, China
| | - Wan-Qiong Yuan
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China
- Beijing Key Laboratory of Spinal Disease, 100191, Beijing, China
- Engineering Research Center of Bone and Joint Precision Medicine, 100191, Beijing, China
| | - Chun-Li Song
- Department of Orthopedics, Peking University Third Hospital, 100191, Beijing, China.
- Beijing Key Laboratory of Spinal Disease, 100191, Beijing, China.
- Engineering Research Center of Bone and Joint Precision Medicine, 100191, Beijing, China.
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Lee SW, Yoon Y, Kwon J, Heu JY, Hwang J. Clinical Significance of Discordance between Hip and Spine Bone Mineral Density in Korean Elderly Patients with Hip Fractures. J Clin Med 2023; 12:6448. [PMID: 37892586 PMCID: PMC10607011 DOI: 10.3390/jcm12206448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 10/09/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
The clinical significance of BMD discordance has not yet been elucidated. The objective of this study was to evaluate the clinical significance of BMD discordance between the hip and spine for hip fractures. The BMD was measured and related factors were investigated in 109 elderly patients hospitalized for a hip fracture (fracture group) and 109 patients hospitalized without a hip fracture (non-fracture group). BMD discordance of the hip and spine was classified as minor discordance (normal and osteopenia, and osteopenia and osteoporosis) and major discordance (normal and osteoporosis). The risk of hip fracture was calculated according to the type of discordance: no discordance, low hip, and lower spine. There was no significant difference between the general characteristics of the fracture group and the non-fracture group. The rate of BMD discordance and low hip discordance were significantly higher in the fracture group (53.2%, 43.1%) than in the non-fracture group (28.4%, 19.3%). The odds ratio of hip fracture was 2.86 times higher in patients with BMD discordance than in those without discordance and 3.42 times higher in the patients with low hip discordance than in those without no hip discordance. The presence of discordance, particularly when there is low hip discordance, might be related to the hip fractures.
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Affiliation(s)
- Se-Won Lee
- Department of Orthopedic Surgery, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea;
| | - Younghyun Yoon
- Department of Orthopedic Surgery, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea; (Y.Y.); (J.K.)
| | - Junhyuk Kwon
- Department of Orthopedic Surgery, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea; (Y.Y.); (J.K.)
| | - Jun-Young Heu
- Department of Orthopedic Surgery, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea;
| | - Jihyo Hwang
- Department of Orthopedic Surgery, Gangnam Sacred Heart Hospital, College of Medicine, Hallym University, Seoul 07441, Republic of Korea; (Y.Y.); (J.K.)
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3
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Zheng XQ, Huang J, Lin JL, Song CL. Pathophysiological mechanism of acute bone loss after fracture. J Adv Res 2023; 49:63-80. [PMID: 36115662 PMCID: PMC10334135 DOI: 10.1016/j.jare.2022.08.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 07/29/2022] [Accepted: 08/31/2022] [Indexed: 10/14/2022] Open
Abstract
BACKGROUND Acute bone loss after fracture is associated with various effects on the complete recovery process and a risk of secondary fractures among patients. Studies have reported similarities in pathophysiological mechanisms involved in acute bone loss after fractures and osteoporosis. However, given the silence nature of bone loss and bone metabolism complexities, the actual underlying pathophysiological mechanisms have yet to be fully elucidated. AIM OF REVIEW To elaborate the latest findings in basic research with a focus on acute bone loss after fracture. To briefly highlight potential therapeutic targets and current representative drugs. To arouse researchers' attention and discussion on acute bone loss after fracture. KEY SCIENTIFIC CONCEPTS OF REVIEW Bone loss after fracture is associated with immobilization, mechanical unloading, blood supply damage, sympathetic nerve regulation, and crosstalk between musculoskeletals among other factors. Current treatment strategies rely on regulation of osteoblasts and osteoclasts, therefore, there is a need to elucidate on the underlying mechanisms of acute bone loss after fractures to inform the development of efficacious and safe drugs. In addition, attention should be paid towards ensuring long-term skeletal health.
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Affiliation(s)
- Xuan-Qi Zheng
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Jie Huang
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Jia-Liang Lin
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China
| | - Chun-Li Song
- Department of Orthopaedics, Peking University Third Hospital, Beijing, China; Beijing Key Laboratory of Spinal Disease Research, Beijing, China.
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Osipov B, Paralkar MP, Emami AJ, Cunningham HC, Tjandra PM, Pathak S, Langer HT, Baar K, Christiansen BA. Sex differences in systemic bone and muscle loss following femur fracture in mice. J Orthop Res 2022; 40:878-890. [PMID: 34081357 PMCID: PMC8639826 DOI: 10.1002/jor.25116] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 04/29/2021] [Accepted: 05/31/2021] [Indexed: 02/04/2023]
Abstract
Fracture induces systemic bone loss in mice and humans, and a first (index) fracture increases the risk of future fracture at any skeletal site more in men than women. The etiology of this sex difference is unknown, but fracture may induces a greater systemic bone loss response in men. Also sex differences in systemic muscle loss after fracture have not been examined. We investigated sex differences in systemic bone and muscle loss after transverse femur fracture in 3-month-old male and female C57BL/6 J mice. Whole-body and regional bone mineral content and density (BMC and BMD), trabecular and cortical bone microstructure, muscle contractile force, muscle mass, and muscle fiber size were quantified at multiple time points postfracture. Serum concentrations of inflammatory cytokines (IL-1β, IL-6, and TNF-α) were measured 1-day postfracture. One day postfracture, IL-6 and Il-1B were elevated in fracture mice of both sexes, but TNF-α was only elevated in male fracture mice. Fracture reduced BMC, BMD, and trabecular bone microstructural properties in both sexes 2 weeks postfracture, but declines were greater in males. Muscle contractile force, mass, and fiber size decreased primarily in the fractured limb at 2 weeks postfracture and females showed a trend toward greater muscle loss. Bone and muscle properties recovered by 6 weeks postfracture. Overall, postfracture systemic bone loss is greater in men, which may contribute to sex differences in subsequent fracture risk. In both sexes, muscle loss is primarily confined to the injured limb and fracture may induce greater inflammation in males.
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Affiliation(s)
- Benjamin Osipov
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Manali P. Paralkar
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Armaun J. Emami
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Hailey C. Cunningham
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Priscilla M. Tjandra
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
| | - Suraj Pathak
- Department of Neurobiology, Physiology and Behavior, University of California Davis, Davis, CA, USA
| | - Henning T. Langer
- Department of Physiology and Membrane Biology, University of California Davis, Davis, CA, USA
| | - Keith Baar
- Department of Neurobiology, Physiology and Behavior, University of California Davis, Davis, CA, USA.,Department of Physiology and Membrane Biology, University of California Davis, Davis, CA, USA
| | - Blaine A. Christiansen
- Department of Orthopaedic Surgery, University of California Davis Health, Sacramento, CA, USA
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Cilia C, Friggieri D, Vassallo J, Xuereb-anastasi A, Formosa MM. Whole Genome Sequencing Unravels New Genetic Determinants of Early-Onset Familial Osteoporosis and Low BMD in Malta. Genes (Basel) 2022; 13:204. [PMID: 35205249 PMCID: PMC8871631 DOI: 10.3390/genes13020204] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Revised: 01/17/2022] [Accepted: 01/18/2022] [Indexed: 11/19/2022] Open
Abstract
Background: Osteoporosis is a skeletal disease with a strong genetic background. The study aimed to identify the genetic determinants of early-onset familial osteoporosis and low bone mineral density (BMD) in a two-generation Maltese family. Methods: Fifteen relatives aged between 28–74 years were recruited. Whole genome sequencing was conducted on 12 relatives and shortlisted variants were genotyped in the Malta Osteoporotic Fracture Study (MOFS) for replication. Results: Sequential variant filtering following a dominant inheritance pattern identified rare missense variants within SELP, TGF-β2 and ADAMTS20, all of which were predicted to be likely pathogenic and participate in osteoimmunology. TGF-β2 c.1136C>T was identified in five individuals from the MOFS in heterozygosity, four of whom had osteopenia/osteoporosis at the lumbar spine and hip, and/or had sustained a low-trauma fracture. Heterozygosity for the ADAMTS20 c.4090A>T was accompanied by lower total hip BMD (p = 0.018) and lower total serum calcium levels in MOFS (p < 0.01), recapitulating the findings from the family. Women carrying at least one copy of the alternative allele (TC/CC) for SELP c.2177T>C exhibited a tendency for lower lumbar spine BMD and/or wrist fracture history relative to women with TT genotype. Conclusions: Our findings suggest that the identified variants, alone or in combination, could be causal factors of familial osteoporosis and low BMD, requiring replication in larger collections.
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Zhang C, Zhu J, Jia J, Guan Z, Sun T, Zhang W, Yuan W, Wang H, Leng H, Song C. Effect of Single Versus Multiple Fractures on Systemic Bone Loss in Mice. J Bone Miner Res 2021; 36:567-578. [PMID: 33181861 DOI: 10.1002/jbmr.4211] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/02/2020] [Accepted: 11/04/2020] [Indexed: 01/15/2023]
Abstract
Systemic bone loss after initial fracture contributes to an increased risk of secondary fracture. Clinical research has revealed an association between the risk of future fracture and the number or magnitude of prior fractures. However, the change in systemic bone mass after single versus multiple fractures is unknown. We used ipsilateral femur and tibia fractures as multiple fractures and a femur or tibia fracture as a single fracture to investigate the influence of single versus multiple fractures on systemic bone mass. Seventy-two adult male C57BL/6J mice underwent transverse osteotomies of the ipsilateral femur and/or tibia with subsequent internal fixation. The dynamic change of in vivo whole-body BMD was assessed at 4 days, 2 weeks, and 4 weeks after fracture. The microstructure of the L5 vertebral body and contralateral femur was assessed using micro-CT (μCT) and biomechanical tests (vertebral compression test and three-point bending test) at 2 and 4 weeks. Tartrate-resistant acid phosphatase (TRAP) staining, sequential fluorescence labeling, and systemic inflammatory cytokines were also quantified. A greater decrease in whole-body BMD was observed after multiple than single fractures. The trabecular bone volume fraction, trabecular number, and trabecular thickness of the L5 vertebral body were significantly reduced. There were no significant differences in cortical thickness, trabecular bone microstructure, or bone strength in the contralateral femur. At 4 days and 2 weeks, we observed significant increases in the serum levels of IL-6 and TNF-α. We also observed an increase in the osteoclast number of the L5 vertebral body at 4 days. These data indicate that systemic bone loss might increase with the number or severity of prior fractures, and the mechanism may be partly associated with an increased osteoclast number and a more severe inflammatory response. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Chenggui Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Junxiong Zhu
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Jialin Jia
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Zhiyuan Guan
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Tiantong Sun
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Wang Zhang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Wanqiong Yuan
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Hong Wang
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Huijie Leng
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
| | - Chunli Song
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.,Beijing Key Laboratory of Spinal Diseases, Beijing, China
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Chen B, Luo Z, Feng X, Pan K, Liu Q, Yang Y. Effect of high-quality care on limb function recovery and quality of life after osteoporotic hip fracture surgery in the elderly. J Musculoskelet Neuronal Interact 2021; 21:272-278. [PMID: 34059572 PMCID: PMC8185254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To evaluate the effect of high-quality care on limb function recovery and quality of life (QOL) after osteoporotic hip fracture (OHF) surgery in the elderly. METHODS 116 elderly patients with OHF enrolled in our hospital from January 2017 to December 2019 were assigned into observation group (high-quality care, n=58) and control group (routine care, n=58). After one month of intervention, Harris Hip Score (HHS) and Barthel Index (BI) were used to evaluating limb function and self-care ability, pain intensity numerical rating scale (PINRS) for pain assessment, self-rating anxiety scale (SAS), and self-rating depression scale (SDS) for emotion assessment. Besides, postsurgical complications, QOL and patient satisfaction were examined. RESULTS HHS and BI were higher in observation group (P<0.05); PINRS, SAS and SDS were lower in observation group (P<0.05); incidence of postsurgical complications in the observation group was significantly lower than that in the control group (P<0.05); QOL and patient satisfaction in the observation group were higher than those in the control group (P<0.05). CONCLUSION High-quality care promotes the recovery of limb function, the QOL and the satisfaction of elderly patients.
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Affiliation(s)
- Biying Chen
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Zhen Luo
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Xiaolei Feng
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Kaixia Pan
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Qiuqin Liu
- Department of Orthopaedics, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China
| | - Yexiang Yang
- Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, P.R. China,Corresponding author: Yexiang Yang, Department of Joint and Trauma Surgery, The Third Affiliated Hospital of Sun Yat-sen University, No.600 Tianhe Road, Tianhe District, Guangzhou 510630, Guangdong Province, P.R. China E-mail:
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8
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Roberts JL, Liu G, Darby TM, Fernandes LM, Diaz-Hernandez ME, Jones RM, Drissi H. Bifidobacterium adolescentis supplementation attenuates fracture-induced systemic sequelae. Biomed Pharmacother 2020; 132:110831. [PMID: 33022534 PMCID: PMC9979243 DOI: 10.1016/j.biopha.2020.110831] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2020] [Revised: 09/24/2020] [Accepted: 09/28/2020] [Indexed: 12/13/2022] Open
Abstract
The gut microbiota is an important contributor to both health and disease. While previous studies have reported on the beneficial influences of the gut microbiota and probiotic supplementation on bone health, their role in recovery from skeletal injury and resultant systemic sequelae remains unexplored. This study aimed to determine the extent to which probiotics could modulate bone repair by dampening fracture-induced systemic inflammation. Our findings demonstrate that femur fracture induced an increase in gut permeability lasting up to 7 days after trauma before returning to basal levels. Strikingly, dietary supplementation with Bifidobacterium adolescentis augmented the tightening of the intestinal barrier, dampened the systemic inflammatory response to fracture, accelerated fracture callus cartilage remodeling, and elicited enhanced protection of the intact skeleton following fracture. Together, these data outline a mechanism whereby dietary supplementation with beneficial bacteria can be therapeutically targeted to prevent the systemic pathologies induced by femur fracture.
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Affiliation(s)
- Joseph L. Roberts
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA,Nutrition and Health Sciences Program, Emory University, Atlanta, GA, USA
| | - Guanglu Liu
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
| | - Trevor M. Darby
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Lorenzo M. Fernandes
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Rheinallt M. Jones
- Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Hicham Drissi
- Department of Orthopaedics, Emory University School of Medicine, Atlanta, GA, USA; Nutrition and Health Sciences Program, Emory University, Atlanta, GA, USA.
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9
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Li B, Liu M, Wang Y, Gong S, Yao W, Li W, Gao H, Wei M. Puerarin improves the bone micro-environment to inhibit OVX-induced osteoporosis via modulating SCFAs released by the gut microbiota and repairing intestinal mucosal integrity. Biomed Pharmacother 2020; 132:110923. [PMID: 33125971 DOI: 10.1016/j.biopha.2020.110923] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/15/2020] [Accepted: 10/20/2020] [Indexed: 01/01/2023] Open
Abstract
SCOPE Half of women over the age of 50 will experience a fracture related osteoporosis in their lifetime. The common treatment is estrogen replacement therapy, which can cause many side effects. Puerarin as a phytoestrogen has been proven to improve postmenopausal osteoporosis. However, the mechanisms of anti-osteoporosis remain unclear due to its low bioavailability. The aim of this study is to investigate whether the anti-osteoporosis effects of puerarin are related to modulations in the gut microbiota and focus on the mechanism of gut / bone axis. METHODS We established ovariectomized (OVX) rats as osteoporosis model. The femur was analyzed by microcomputed tomography (μ-CT) and we measured serum biochemical indices and inflammatory factors. 16S rRNA sequencing was employed to evaluate the gut microbiota composition in the fecal samples. Short-chain fatty acids (SCFAs) was analyzed by GC. The expression of intestinal inflammatory factors and adhesion proteins was confirmed by western blotting and qPCR. RESULTS Puerarin increased the BMD and improved the intestinal mucosal integrity to reduce the systemic inflammation. The disorder of gut microbiota was improved and its metabolites SCFAs were elevated. Metabolic pathways such as amino acid metabolism, LPS biosynthesis and butyrate metabolism were enriched. CONCLUSION Puerarin treatment modulated the gut microbiota disorder to elicit the anti-osteoporosis effects in OVX rats, by improving the bone micro-environment via regulating the SCFAs levels and repairing the intestinal mucosal integrity.
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Affiliation(s)
- Bo Li
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China
| | - Mingyan Liu
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China
| | - Yu Wang
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China
| | - Shiqiang Gong
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China
| | - Weifan Yao
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China
| | - Wenshuai Li
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China
| | - Hua Gao
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Division of Pharmacology Laboratory, National Institutes for Food and Drug Control, Beijing, 102629, China.
| | - Minjie Wei
- School of Pharmacy, China Medical University, Shenyang, 110122, China; Liaoning Key Laboratory of Molecular Targeted Anti-Tumor Drug Development and Evaluation, Shenyang, 110122, China.
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10
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Mitkovic MM, Bumbasirevic M, Milenkovic S, Gajdobranski D, Bumbasirevic V, Mitkovic MB. Influence of coronavirus disease 2019 pandemic state of emergency in orthopaedic fracture surgical treatment. Int Orthop 2020; 45:815-820. [PMID: 32728928 PMCID: PMC7389160 DOI: 10.1007/s00264-020-04750-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Accepted: 07/23/2020] [Indexed: 12/23/2022]
Abstract
Purpose After the appearance of first COVID-19 cases in Serbia, state of emergency was declared on 15 March 2020 and lasted for 54 days. The aim of this report is to compare orthopaedic fracture frequencies in this period, when the walk was limited at the home mostly, with those during the same part in the previous year with regular state, thus to examine staying at home as a factor influencing the frequency of different fracture types. Methods There were 86 patients during the state of emergency in year 2020 and 106 patients during the same part of year 2019 with a regular state, having orthopaedic trauma surgery. Number of fractures, gender distribution, and age of patients have been compared between these periods. Results Total number of fractures decreased for about 19% during the state of emergency. There was nonsignificant difference in fracture frequency for all skeletal areas (p > 0.05), except for distal femoral fractures which occurred more often during the state of emergency (p < 0.05). Female ratio was higher during state of emergency than in regular state for femoral neck fractures. Conclusion Restricted going outside the home for 54 days has the influence in total number of fractures and gender distribution in femoral neck fractures. The method of external fixation used could be assumed as a reducing factor of intraoperative virus pandemic propagation among medical staff.
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Affiliation(s)
- Milan M Mitkovic
- Clinic for Orthopaedics and Traumatology, Clinical Center Nis, Nis, Serbia.
- Faculty of Medicine, University of Nis, Nis, Serbia.
| | - Marko Bumbasirevic
- Clinic for Orthopaedics and Traumatology, Clinical Center of Serbia, Belgrade, Serbia
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Sasa Milenkovic
- Clinic for Orthopaedics and Traumatology, Clinical Center Nis, Nis, Serbia
- Faculty of Medicine, University of Nis, Nis, Serbia
| | | | | | - Milorad B Mitkovic
- Clinic for Orthopaedics and Traumatology, Clinical Center Nis, Nis, Serbia
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Morato-Martínez M, López-Plaza B, Santurino C, Palma-Milla S, Gómez-Candela C. A Dairy Product to Reconstitute Enriched with Bioactive Nutrients Stops Bone Loss in High-Risk Menopausal Women without Pharmacological Treatment. Nutrients 2020; 12:nu12082203. [PMID: 32722015 PMCID: PMC7468696 DOI: 10.3390/nu12082203] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 07/17/2020] [Accepted: 07/22/2020] [Indexed: 01/06/2023] Open
Abstract
Osteoporosis is a multifactorial disease characterized by the loss of bone mass and deterioration of the internal structure of the bone, increasing the risk of fractures, and is becoming an economic and social problem. The main treatment is pharmacological, however, the population demands other therapies, such as foods with nutrients beneficial to bone health. Seventy-eight healthy menopausal women at risk of osteoporosis or untreated osteopenia were recruited for a randomized, parallel, double-blind clinical trial with two intervention groups: one group consumed a serving a day of the experimental enriched product (experimental group (EG)) and the other group (control group (CG)) consumed the same product without enrichment. The main objective was to compare the effect of consuming a dairy preparation to reconstitute, similar to yogurt when prepared, enriched in calcium, vitamin D, vitamin K, vitamin C, zinc, magnesium, L-leucine and probiotic (Lactobacillus plantarum 3547) on bone metabolism markers for 24 weeks. The EG showed a significantly increased bone mass compared to the CG (0.01 ± 0.03 vs. −0.01 ± 0.03 kg; p < 0.05). In addition, the EG maintained their bone mineral density (BMD) compared to the CG, whose BMD significantly decreased at the end of the study. For biochemical markers, the EG significantly increased the serum levels of the N-terminal propeptide of type I collagen (P1NP) bone formation marker (13.19 ± 25.17 vs. −4.21 ± 15.62 ng/mL; p < 0.05), and decreased the carbo-terminal telopeptide of type I collagen (CTx) bone resorption marker compared to the CG (−0.05 ± 0.19 vs. 0.04 ± 0.14 ng/mL; p < 0.05). On the other hand, the EG exhibited a significantly decreased systolic and diastolic blood pressure compared to the start of the study. Finally, the EG significantly increased their dietary calcium and vitamin D intake compared to the CG. In conclusion, the regular consumption of a dairy product to reconstitute enriched with bioactive nutrients improves bone health markers in menopausal women at risk of osteoporosis without pharmacological treatment.
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Affiliation(s)
- Marina Morato-Martínez
- Nutrition Department, La Paz University Hospital Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (M.M.-M.); (S.P.-M.); (C.G.-C.)
| | - Bricia López-Plaza
- Nutrition Research Group, La Paz University Hospital Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
- Correspondence: ; Tel.: +34-917-277-000 (ext. 42507)
| | - Cristina Santurino
- Nutrition Research Group, La Paz University Hospital Institute for Health Research (IdiPAZ), 28046 Madrid, Spain;
| | - Samara Palma-Milla
- Nutrition Department, La Paz University Hospital Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (M.M.-M.); (S.P.-M.); (C.G.-C.)
| | - Carmen Gómez-Candela
- Nutrition Department, La Paz University Hospital Institute for Health Research (IdiPAZ), Autonomous University of Madrid, 28046 Madrid, Spain; (M.M.-M.); (S.P.-M.); (C.G.-C.)
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Abstract
PURPOSE OF REVIEW Identifying individuals at high fracture risk can be used to target those likely to derive the greatest benefit from treatment. This narrative review examines recent developments in using specific risk factors used to assess fracture risk, with a focus on publications in the last 3 years. RECENT FINDINGS There is expanding evidence for the recognition of individual clinical risk factors and clinical use of composite scores in the general population. Unfortunately, enthusiasm is dampened by three pragmatic randomized trials that raise questions about the effectiveness of widespread population screening using clinical fracture prediction tools given suboptimal participation and adherence. There have been refinements in risk assessment in special populations: men, patients with diabetes, and secondary causes of osteoporosis. New evidence supports the value of vertebral fracture assessment (VFA), high resolution peripheral quantitative CT (HR-pQCT), opportunistic screening using CT, skeletal strength assessment with finite element analysis (FEA), and trabecular bone score (TBS). The last 3 years have seen important developments in the area of fracture risk assessment, both in the research setting and translation to clinical practice. The next challenge will be incorporating these advances into routine work flows that can improve the identification of high risk individuals at the population level and meaningfully impact the ongoing crisis in osteoporosis management.
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Affiliation(s)
- William D Leslie
- Departments of Medicine and Radiology, University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, Canada.
| | - Suzanne N Morin
- Department of Medicine, McGill University- McGill University Health Center, Montreal, Quebec, Canada
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Feng Y, Zhu L, Gu Y, Wang LJ, Niu BJ, Cai F, Chen L. Association of Gremlin-2 gene polymorphisms with osteoporosis risk in Chinese postmenopausal women. Biosci Rep 2020; 40:BSR20200554. [PMID: 32297643 DOI: 10.1042/BSR20200554] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Revised: 04/08/2020] [Accepted: 04/14/2020] [Indexed: 12/18/2022] Open
Abstract
The Gremlin-2 (GREM2) plays crucial roles in modulating bone homeostasis through the bone morphogenetic protein-2 pathway. However, GREM2 gene variants in osteoporosis were less frequent in a Chinese population. Therefore, the present study recruited 310 patients with osteoporosis and 339 healthy postmenopausal women to assess the correlation of GREM2 gene polymorphisms with the risk of osteoporosis. Polymerase chain reaction (PCR) and Sanger sequencing were utilized to genotype samples. The results showed that GREM2 gene rs4454537, not rs11588607, polymorphism was significantly associated with an increased risk of osteoporosis in postmenopausal women. Moreover, stratified analyses indicated a significant association between rs4454537 polymorphisms and body mass index of <25 kg/m2. Additionally, the association between GREM2 rs4454537 polymorphism and clinical characteristics was assessed, which showed that this locus decreased the bone mineral density (BMD) in postmenopausal osteoporotic individuals. Furthermore, individuals with CC genotype appeared to have a higher GREM2 expression compared with those bearing the TT genotype of rs4454537 polymorphism. However, the genotype distribution of rs4454537 polymorphism showed no statistical difference between osteoporotic patients as a function of fracture status. In summary, GREM2 rs4454537 polymorphism decreases BMD and increases osteoporotic risk in postmenopausal women.
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Xu B, He Y, Lu Y, Ren W, Shen J, Wu K, Xu K, Wu J, Hu Y. Glucagon like peptide 2 has a positive impact on osteoporosis in ovariectomized rats. Life Sci 2019; 226:47-56. [PMID: 30959027 DOI: 10.1016/j.lfs.2019.04.013] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2018] [Revised: 04/03/2019] [Accepted: 04/03/2019] [Indexed: 01/01/2023]
Abstract
AIMS In this study, we evaluate the effects of glucagon-like peptide 2 (GLP-2) on bone microarchitecture, bone turnover markers (BTMs) and inflammation markers in ovariectomized (OVX) rats. MATERIAL AND METHODS In total, 31 Sprague-Dawley rats were divided into the following three groups: sham (control sham-operated with vehicle, n = 7), OV (OVX with vehicle, n = 12), and GLP-2 (OVX with GLP-2, n = 12). Intervention began at the 12th week after surgery and lasted for 4 weeks. The dosage of the GLP-2 was 160 μg/kg/d through subcutaneous injections, and normal saline was used as the vehicle agent. After 4 weeks of treatment, serum BTM and inflammation marker levels were measured by ELISA, and femora samples were analyzed by qRT-PCR, micro-CT, histology and histomorphometry. KEY FINDINGS After 4 weeks of treatment, serum TRAcP-5b and RANKL levels as well as the CTX-1/P1NP ratio in the GLP-2 group decreased, and ALP activity, P1NP level, and OPG/RANKL ratio increased significantly; qRT-PCR analysis showed that mRNA levels of RANKL decreased, and Runx2, ALP, and Col-1 levels as well as the OPG/RANKL ratio increased significantly in the GLP-2 group compared with the OV group. In bone histology analysis, GLP-2 significantly decreased the AV/MV, Oc.N and Oc.S but increased the Ob.N, BFR and MAR. Analysis with μ-CT showed that the BMD, BV/TV, Tb.N and Conn.D increased significantly in the GLP-2 group compared with the OV group. The levels of serum inflammation markers TNF-α, IL-1β and IL-6 decreased, and TGF-β levels increased in the GLP-2 group compared with the OV group. SIGNIFICANCE GLP-2 may have a positive impact on osteoporosis by promoting bone formation, inhibiting bone resorption and decreasing circulatory inflammation in ovariectomized rats.
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Affiliation(s)
- Bing'er Xu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yuting He
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yi Lu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Weiying Ren
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jiping Shen
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Kefen Wu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Kan Xu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Jiayu Wu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China
| | - Yu Hu
- Department of Geriatrics, Zhongshan Hospital, Fudan University, Shanghai 200032, China; Center for Evidence Based Medicine and Clinical Epidemiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
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Abstract
A history of prior fracture is the most reliable indicator of prospective fracture risk. Increased fracture risk is not confined to the region of the prior fracture, but is operant at all skeletal sites, providing strong evidence of systemic bone loss after fracture. Animal and human studies suggest that systemic bone loss begins shortly after fracture and persists for several years in humans. In fact, bone quantity and bone quality may never fully return to their pre-fracture levels, especially in older subjects, demonstrating a need for improved understanding of the mechanisms leading to systemic bone loss after fracture in order to reduce subsequent fracture risk. Although the process remains incompletely understood, mechanical unloading (disuse), systemic inflammation, and hormones that control calcium homeostasis may all contribute to systemic bone loss. Additionally, individual factors can potentially affect the magnitude and time course of systemic bone loss and recovery. The magnitude of systemic bone loss correlates positively with injury severity and age. Men may also experience greater bone loss or less recovery than women after fracture. This review details the current understanding of systemic bone loss following fracture, including possible underlying mechanisms and individual factors that may affect this injury response.
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Zhou X, Qiu YH, He P, Jiang F, Wu LF, Lu X, Lei SF, Deng FY. Why SNP rs227584 is associated with human BMD and fracture risk? A molecular and cellular study in bone cells. J Cell Mol Med 2018; 23:898-907. [PMID: 30370607 PMCID: PMC6349212 DOI: 10.1111/jcmm.13991] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2018] [Revised: 09/03/2018] [Accepted: 09/29/2018] [Indexed: 11/28/2022] Open
Abstract
A large number of SNPs significant for osteoporosis (OP) had been identified by genome-wide association studies. However, the underlying association mechanisms were largely unknown. From the perspective of protein phosphorylation, gene expression regulation, and bone cell activity, this study aims to illustrate association mechanisms for representative SNPs of interest. We utilized public databases and bioinformatics tool to identify OP-associated SNPs which potentially influence protein phosphorylation (phosSNPs). Associations with hip/spine BMD, as well as fracture risk, in human populations for one significant phosSNP, that is, rs227584 (major/minor allele: C/A, EAS population) located in C17orf53 gene, were suggested in prior meta-analyses. Specifically, carriers of allele C had significant higher BMD and lower risk of low-trauma fractures than carriers of A. We pursued to test the molecular and cellular functions of rs227584 in bone through osteoblastic cell culture and multiple assays. We identified five phosSNPs significant for OP (P < 0.01). The osteoblastic cells, which was transfected with wild-type C17orf53 (allele C at rs227584, P126), demonstrated specific interaction with NEK2 kinase, increased expression levels of osteoblastic genes significantly (OPN, OCN, COL1A1, P < 0.05), and promoted osteoblast growth and ALP activity, in contrast to those transfected with mutant C17orf53 (allele A at rs227584, T126). In the light of the consistent evidences between the present functional study in human bone cells and the prior association studies in human populations, we conclude that the SNP rs227584, via altering protein-kinase interaction, regulates osteoblastic gene expression, influences osteoblast growth and activity, hence to affect BMD and fracture risk in humans.
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Affiliation(s)
- Xu Zhou
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Ying-Hua Qiu
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Pei He
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Fei Jiang
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Long-Fei Wu
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Xin Lu
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Shu-Feng Lei
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
| | - Fei-Yan Deng
- Center for Genetic Epidemiology and Genomics, School of Public Health, Soochow University, Suzhou, Jiangsu, China.,Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, School of Public Health, Soochow University, Suzhou, Jiangsu, China
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