The Short-Term Effect of Prunes in Improving Bone in Men

Osteoporosis is a major health concern in aging populations, where 54% of the U.S. population aged 50 and older have low bone mineral density (BMD). Increases in inflammation and oxidative stress play a major role in the development of osteoporosis. Men are at a greater risk of mortality due to osteoporosis-related fractures. Our earlier findings in rodent male and female models of osteoporosis, as well as postmenopausal women strongly suggest the efficacy of prunes (dried plum) in reducing inflammation and preventing/reversing bone loss. The objective of this study was to examine the effects of two doses of prunes, daily, on biomarkers of inflammation and bone metabolism in men with some degree of bone loss (BMD; t-score between −0.1 and −2.5 SD), for three months. Thirty-five men between the ages of 55 and 80 years were randomized into one of three groups: 100 g prunes, 50 g prunes, or control. Consumption of 100 g prunes led to a significant decrease in serum osteocalcin (p < 0.001). Consumption of 50 g prunes led to significant decreases in serum osteoprotegerin (OPG) (p = 0.003) and serum osteocalcin (p = 0.040), and an increase in the OPG:RANKL ratio (p = 0.041). Regular consumption of either 100 g or 50 g prunes for three months may positively affect bone turnover.

Investigation of the Relationship between the Mid_Thigh Adipose Tissue Distribution Measured by MRI and Serum Osteocalcin—A Sex-Based Approach

Osteocalcin, in its non-carboxylated form, has a positive effect on glucose metabolism. Additionally, osteocalcin levels are related to body composition, especially muscle mass. The relation to the distribution of different adipose tissue types, such as subcutaneous, intermuscular, and visceral adipose tissue, is unclear. This study aimed to investigate associations between serum osteocalcin and the distribution of subcutaneous and intermuscular adipose tissue of the mid-thigh. Furthermore, the influence of different training methods on osteocalcin levels was investigated. We performed adipose tissue quantification of subcutaneous adipose tissue (SAT) and intramuscular adipose tissue (IMAT) using MRI measurements of the mid-thigh in 128 volunteers (63 male/65 female). Laboratory analysis included blood lipid panel, serum insulin, adiponectin, and osteocalcin measurements. The main observation was a significant correlation of total serum osteocalcin (TOC) and the distribution of adipose tissue of the mid-thigh (SAT/(SAT + IMAT)) (cc = −0.29/p-value = 0.002), as well as the cross-sectional muscle area (MA), increasing with the weekly resistance training duration in males. Additionally, TOC (p-value = 0.01) and MA (p-value = 0.03) were negatively related to serum insulin. The significant relationship between TOC and SAT/(SAT + IMAT) is a new finding and confirms the negative influence of IMAT on glucose metabolism in a sex-specific approach. We could substantiate this by the negative relation of TOC with serum insulin.

STUDY OF SERUM OSTEOPROTEGERIN AND RECEPTOR ACTIVATOR OF NUCLEAR FACTOR KAPPA-Β LIGAND IN PATIENTS WITH RHEUMATIC DISEASES

Although rheumatological diseases are widespread, they still have an unclear etiology, pathogenesis, and therapy. Researchers are looking for biomarkers associated with inflammatory and degenerative joint diseases. Serum Osteoprotegerin (s-OPG) and serum Receptor Activator of Nuclear Factor Kappa-Β Ligand (s-RANKL) have not been studied in patients with Diffuse idiopathic skeletal hyperostosis (DISH), spondylosis, ankylosing spondylitis, and gout. The aim of this study was to investigate s-OPG and s-RANKL in patients with various rheumatic diseases. Materials and methods: We studied 135 patients with rheumatic diseases, of which 55 were diagnosed with DISH, 50 with spondylosis, 23 with ankylosing spondylitis, 7 with gout, and 25 were a control group. s-OPG and s-RANKL, serum calcium, ionized calcium, serum phosphorus, alkaline phosphatase, uric acid, urea, creatine, and serum osteocalcin were tested using the ELISA method in the Clinical Laboratory of "St. George" University Hospital, Plovdiv. The results were processed using the statistical program SPSS ver 26, with significance p<0.05. Results: Patients with DISH and ankylosing spondylitis had higher levels of s-OPG, s-RANKL, and s-OPG/s-RANKL ratio than the control group (p<0.05). The s-OPG/s-RANKL ratio in patients with spondylosis and gout was lower than in patients with DISH and ankylosing spondylitis (p<0.05). There are strong correlations between s-OPG, s-RANKL, and the biochemical parameters related to bone metabolism (serum calcium, ionized calcium, serum phosphorus, alkaline phosphatase, uric acid, urea, creatine, and serum osteocalcin)(p <0.05). Conclusion: Our studies show that changes in bone metabolism are similar in patients with DISH and ankylosing spondylitis. Further research is needed to look for a common pathogenetic pathway linking degenerative and inflammatory rheumatic diseases of the axial skeleton.

Serum Osteocalcin and Bone Mineral Density as Markers of Post-menopausal Osteoporosis: A Meta-analysis

Osteocalcin (OC) and bone mineral density (BMD) measurements determine the bone mass and microarchitecture of bone. Both are used for diagnosing osteoporosis and their role as a biomarker in postmenopausal osteoporosis (PMO) remains controversial. To determine the relationship between serum OC and PMO and compare BMD vs OC, a metaanalysis was carried forward with case-control studies. Studies reporting mean/median and standard deviation of osteocalcin in post-menopausal women with and without osteoporosis were included. From the same studies, BMD measurements in both groups were included. Fifteen studies were included with 1864 postmenopausal women. We found significant increase in serum OC (Standardized Mean Difference of 0.918 and SE of 0.476 (p=0.054), confidence interval (CI) (-0.015 to 1.852) and significant decrease in BMD values (SMD of -2.321 and SE of 0.345 (p= <0.001) (CI - 2.998 to -1.643)) in PMO. T score also significantly decreased in PMO (SMD <0 (-3.785). Heterogeneity was observed in all parameters analyzed for more than 90%. We concluded that in our metanalysis, there was a significant increase in serum osteocalcin levels with SMD> 0 and significantly low BMD/t score levels with SMD <0 in postmenopausal osteoporotic women as compared to healthy postmenopausal women. Osteocalcin gives the current status of bone remodeling and is not influenced by multiple factors whereas BMD measures the bone mass, yet techniques vary and are influenced by many factors. SMD < 0 alone cannot be used to detect osteoporosis or predict osteoporotic fractures. Increased osteocalcin and low BMD/T score after menopause together are good indicators to detect osteoporosis. This conjunction can economically burden the patient and thus our study concludes that SMD > 0 serum osteocalcin solely can be implemented as a promising marker for diagnosing osteoporosis.

Low Serum Osteocalcin Level as a Risk Factor for Metabolic Syndrome in Korean Men: A Retrospective Longitudinal Study

Background: Recent studies have suggested that low serum osteocalcin levels are associated with metabolic syndrome (MetS). However, the association between serum osteocalcin levels and the incidence of MetS remains unclear. This aim of this study was to investigate the relationship between serum osteocalcin levels and MetS development in Korean men.Methods: This retrospective study included 2,837 Korean men who were not diagnosed with MetS and recruited from the Health Promotion Center from January 2003 through December 2018. They were followed up at the center until the participant was newly diagnosed with MetS or until the last follow-up visit if the participant was not diagnosed with MetS. Serum osteocalcin levels were measured using an electrochemiluminescence immunoassay. The participants were divided into quartiles (Q1–Q4) based on their serum osteocalcin levels. Cox proportional hazard models were used to test the independent association of serum osteocalcin levels with the development of MetS, and hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated.Results: In the baseline analysis, blood pressure, body mass index, waist circumference, waist-hip ratio, body fat mass, fasting glucose, hemoglobin A1c (P for trend < 0.001 for all), total cholesterol (P for trend = 0.026), triglyceride (P for trend = 0.003), and low-density lipoprotein cholesterol (P for trend = 0.031) varied inversely with the osteocalcin quartile. In addition, the prevalence of abdominal obesity (P for trend = 0.001), high blood pressure (P for trend = 0.008), and hyperglycemia (P for trend < 0.001) decreased as the osteocalcin quartile increased. After a mean follow-up time of 2.76 years, MetS occurred in 518 participants (18.26%), and baseline serum osteocalcin levels were found to be inversely associated with the incident risk of MetS (P for trend < 0.001 across quartiles of osteocalcin levels). In a fully adjusted model, HR for MetS in the first quartile (the lowest osteocalcin concentration) was significantly higher than that for MetS in the fourth quartile (HR, 1.40; 95% CI, 1.06–1.84).Conclusion: Low serum osteocalcin levels at baseline were associated with unfavorable metabolic profiles and a higher risk of incident MetS in Korean men.

Effect of Fermented Soymilk-Honey from Different Probiotics on Osteocalcin Level in Menopausal Women

Osteoporosis has been discovered to be a risk factor for menopausal women. Although synbiotics (probiotics and prebiotics) are found in fermented soymilk-honey made using local probiotics, their effect on osteocalcin levels is still unknown. Therefore, this study’s objective was to determine the influence of fermented soymilk-honey from different probiotics on osteocalcin levels. A 90-day pre–post quasi-experimental study with a control design was conducted on 54 postmenopausal women divided into three intervention groups namely, the soymilk (SM) group, the soymilk-honey fermented with Lactobacillus casei subsp. casei R-68 (SMH Lc) group, and the soymilk-honey fermented with Lactobacillus plantarum 1 R 1.3.2 (SMH Lp) group. Participants consumed 100 mL of soymilk (SM) or fermented soymilk with honey (SMH Lc or SMH Lp) for 90 days. At the beginning and end of the study, the blood serum osteocalcin level was measured and subjects’ health status was assessed, such as cholesterol total, random blood glucose, and uric acid levels. Our results presented that in the SMH Lp group, 90 days supplementation of soy-honey milk fermented with Lactobacillus plantarum 1 R 1.3.2 significantly reduced the level of blood serum osteocalcin. Based on these results it is justified to perform more detailed studies on the effect of fermented soy-honey milk on bone health.

Association of Serum Osteocalcin and Neutrophil-Lymphocyte Ratio with Bone Mineral Density for the Diagnosis of Osteoporosis

Introduction: Osteoporosis is often under diagnosed, under treated and imposed a considerable economic burden on the health system. About two fifth of the post-menopausal women of Bangladesh are affected. Early diagnosis is necessary to halt the disease process. Serum osteocalcin, neutrophil-lymphocyte ratio (NLR) increases and bone mineral density (BMD) decreases in osteoporosis. There is no specific diagnostic test for osteoporosis except BMD. It is costly, has radiation hazard and not available in all laboratories in our country. On the other hand, serum osteocalcin and NLR are easily available and a promising marker which can be done as routine blood test for the diagnosis of osteoporosis. Objective: The objective of the study was to evaluate the association of serum osteocalcin and NLR with BMD for the diagnosis of osteoporosis. Materials and methods: This cross-sectional study was conducted in the Department of Laboratory Medicine and the Department of Orthopedic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU) and Dhaka Medical College Hospital (DMCH) from March, 2020 to February, 2021. A total 50 diagnosed patient of osteoporosis, who fulfil the inclusion and exclusion criteria were selected as study population. They were grouped as normal, osteopenia and osteoporosis according to T-score of BMD report. Serum osteocalcin and NLR evaluated from routine blood test. Statistical analysis was done by statistical package for social science (SPSS) software windows version 22. Results: Negative Pearson’s correlation was found between serum osteocalcin with T-score of BMD (r=-0.812, p=0.002) and between NLR with T-score of BMD (r=-0.826, p=0.001). In receiver operating characteristic (ROC) curve analysis, cut off value of serum osteocalcin was 18.65 ng/mL having sensitivity 67.0% and specificity 70.0% with a cut off value of NLR was 4.54 with sensitivity 72.0% and specificity 75.0%. Conclusion: Serum osteocalcin and NLR has significant negative correlation with T-score of BMD. Because of high sensitivity and specificity, serum osteocalcin and NLR may be used to diagnosis of osteoporosis

Stress Hyperglycemia and Osteocalcin in COVID-19 Critically Ill Patients on Artificial Nutrition

We aimed to study the possible association of stress hyperglycemia in COVID-19 critically ill patients with prognosis, artificial nutrition, circulating osteocalcin, and other serum markers of inflammation and compare them with non-COVID-19 patients. Fifty-two critical patients at the intensive care unit (ICU), 26 with COVID-19 and 26 non-COVID-19, were included. Glycemic control, delivery of artificial nutrition, serum osteocalcin, total and ICU stays, and mortality were recorded. Patients with COVID-19 had higher ICU stays, were on artificial nutrition for longer (p = 0.004), and needed more frequently insulin infusion therapy (p = 0.022) to control stress hyperglycemia. The need for insulin infusion therapy was associated with higher energy (p = 0.001) and glucose delivered through artificial nutrition (p = 0.040). Those patients with stress hyperglycemia showed higher ICU stays (23 ± 17 vs. 11 ± 13 days, p = 0.007). Serum osteocalcin was a good marker for hyperglycemia, as it inversely correlated with glycemia at admission in the ICU (r = −0.476, p = 0.001) and at days 2 (r = −0.409, p = 0.007) and 3 (r = −0.351, p = 0.049). In conclusion, hyperglycemia in critically ill COVID-19 patients was associated with longer ICU stays. Low circulating osteocalcin was a good marker for stress hyperglycemia.