bone mass loss
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2022 ◽  
pp. 120-129
Author(s):  
E. V. Biryukova ◽  
M. V. Shinkin

Osteoporosis (OP) has traditionally been seen as a pathology that mainly occurs in postmenopausal women and elderly men, and until recently, the problem of this disease among males has not been given sufficient priority. At the moment, however, OP in men is widely acknowledged to be an important issue of modern health care. Given the etiological and pathogenetic characteristics, two categories of OP have been identified: primary and secondary. In the structure of male OP, the secondary category of OP accounts for up to 40-60 % of all cases. Hypogonadism is one of the common causes of bone loss in men. Initially, males develop a larger bone mass compared to women and, accordingly, greater bone strength. Men over the age of 50 do not undergo rapid bone mass loss, as women do after menopause, and the bone mass decreases more gradually, in a linear manner. With ageing, the trabecular number (Tb.N) in men are relatively maintained with underlying more pronounced thinning of Tb. N associated with decreased osteoblast-forming activity. Although the prevalence of OP among men is significantly lower than among women, the clinical consequences of OP in men are of a great importance. The primary strategy of the anti-osteoporotic therapy is to prevent OP and low-traumatic fractures. According to the current guidelines for the treatment of OP in men, bisphosphonates (BP) are the drugs of choice. Zoledronic acid is a highly effective nitrogen-containing BP, the first drug to be injected once a year. Intravenous injection of zoledronic acid is as effective in reducing the risk of fractures in men as in women.


2021 ◽  
Vol 15 (1) ◽  
pp. 703-708
Author(s):  
Dimas I. Hutomo ◽  
Sri Lelyati C. Masulili ◽  
Fatimah M. Tadjoedin ◽  
Lindawati S. Kusdhany

Background: Menopause is a physiological phenomenon that occurs in aging women. Periodontal disease is associated with menopausal status. Alkaline phosphatase (ALP) plays a role in general and periodontal bone turnover. Calcium is essential for the maintenance of bone and teeth, and serum ALP and calcium are specific bone markers related to the acceleration of bone mass loss in elderly women and periodontitis. Objectives: The aim of this study was to correlate the levels of serum ALP and calcium with periodontal status in perimenopausal and postmenopausal women with periodontitis. Methods: A total of 22 perimenopausal and 49 postmenopausal women underwent a full periodontal examination assessing the pocket depth, number of teeth lost, clinical attachment loss, plaque index, calculus index, and papillary bleeding index. Using these measurements, the subjects were divided according to periodontal severity. Serum ALP and calcium were measured using the Enzyme-Linked Immunosorbent Assay (ELISA) method. A correlation between serum ALP and calcium to periodontal status was investigated. Results: Serum ALP was significantly correlated with the severity of periodontitis, clinical attachment loss, and the number of teeth lost among perimenopausal and postmenopausal women (p < 0.05). Serum calcium levels were not correlated with periodontal status. Conclusion: Postmenopausal women tended to have more periodontal breakdown, and the level of serum ALP was increased in severe periodontitis.


Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_5) ◽  
Author(s):  
Hanene Ferjani ◽  
Hiba Bettaieb ◽  
Kaouther Maatallah ◽  
Dorra Ben Nessib ◽  
Wafa Triki ◽  
...  

Abstract Background Enthesitis related arthritis (ERA) represents a clinical entity of juvenile idiopathic arthritis. This chronic rheumatic disease may lead to early bone mass loss and increase risk fracture. The aims of this study were to evaluate the prevalence of clinical osteoporosis in patients with ERA and to identify what factors are associated with increased occurrence of osteoporosis. Methods We reviewed the medical records of patients with confirmed ERA. We analyzed their demographic data and the clinical characteristics. Dual-energy X-ray absorptiometry (DEXA) was used to determine bone status. Osteoporosis was defined as Z score &lt;-2.5DS. Disease activity was evaluated by: erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI). Data were analyzed using the SPSS statistical package. A P-value &lt; 0.05 was considered significant. Results Thirty-three patients (27 male and 7 female) with a mean age at of 23.8 ± 7.5 years were enrolled. The mean age at disease onset was 12 ± 2.6 years. Median disease duration was 108 months [12–408]. The median ESR and CRP levels were 35 mm/h [8–90] and 20 mg/l [1–70] respectively. Median BASDAI score was 4.7 [1–9.7]. At bone densitometry, osteoporosis and osteopenia were found in 44.1% and 23.5% cases respectively. None of the patients had a history of osteoporotic fractures. Long term corticosteroid therapy and sedentarily were noted in 18.2% and 47.1% of patients respectively. On statistical analysis, osteoporosis was associated with these parameters: age at ERA onset (P = 0.035), disease duration (P = 0.04), CRP (P = 0.009), BASDAI score (P = 0.05) and sedentarily (P = 0.031). Neither corticosteroid therapy (P = 0.68) nor high ESR level (P = 0.73) were associated with osteoporosis. Conclusion In this study, osteoporosis was a common extra articular feature during ERA. As adult spondyloarthritis, disease activity, duration and sedentarily seem to be associated with the bone loss.


Author(s):  
Cokorda Gde Oka Dharmayuda ◽  
Cokorda Krishna Dalem Pemayun ◽  
I. Ketut Wahyu Trisaputra ◽  
Richard Afandi ◽  
Sri Mahadhana ◽  
...  

Hypertrophic non-union differs from other forms of non-union due to its the biological capacity for union, in which it results from mechanical instability, namely the implant being unable to provide long lasting stability. Non-weight bearing state will cause bone resorption and further bone-mass loss with worsened prognosis. A 64-year-old female patient presented with inability to walk normally resulting from prolonged non-weight bearing-induced severe disuse atrophy in hypertrophic non-union of the left femur. Implant revision and osteoclasis were performed, followed by an urgent implant revision a few days later using double plating technique by placing the second plate on the anterior part of the femur. Post-operative X-ray showed satisfactory two implants placement and physiological alignment was achieved. Inappropriate initial treatment on the acute phase has led to prolonged non weight bearing state, resulting in disuse atrophy of the bone. This should have been predicted during the first implant revision on drilling both cortices, since even the slightest distraction resulted in severe consequences. Double plating system leads to absolute stability so acceptable union can be achieved. Initial treatment on acute setting of fracture should maximize every effort to restore proper functional state and should promote early mobilization. Any maltreatment will result in prolonged morbidity and will require more reconstruction effort with less than normal end result. Robust fixation and alignment can be achieved with double plating system; however, prolonged immobilization should be anticipated.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ying Xue ◽  
Ran Li ◽  
Yong Zhao ◽  
Ling Li ◽  
Yun Zhou

Abstract Background Sleeve gastrectomy (SG) is a profoundly effective operation for severe obese patients, but is closely associated with bone mass loss. Previous studies have reported changes of various serum factors which may be associated with bone mass loss after SG. However, those results are contradictory. In this study, we assessed the effects of SG on bone mass, microstructure of femurs, and changes in bone turnover markers (BTMs), serum adipokines, inflammatory factors and gastrointestinal hormones after SG in high-fat diet (HFD) induced obese rats. Methods Eight-week-old male Sprague–Dawley (SD) rats were fed with HFD to induce obesity. Then, SG and sham surgery were performed in anesthetized obese rats. SD rats in control group were fed with standard chow. Microstructure of femurs was scanned and analyzed by micro-computed tomography in control group, HFD sham group and HFD SG group. Serum inflammatory factors, adipokines markers, gastrointestinal hormones and BTMs were also measured. Results Bone mineral density (BMD) of trabecular bone in both HFD sham group and HFD SG group were remarkably decreased compared with control group. All serum BTMs were significantly higher in HFD SG group than HFD sham group. In the meantime, serum levels of several important inflammatory factors, gastrointestinal hormones and adipokines such as tumor necrosis factor-α (TNF-α), interleukin (IL)-6, monocyte chemoattractant protein-1(MCP-1), ghrelin, insulin and leptin in HFD SG group were remarkably reduced compared with HFD sham group, whereas glucagon-like peptide-1 (GLP-1), adiponectin, fibroblast growth factor (FGF)-19 and FGF-21 were dramatically increased after SG. Protein tyrosine phosphatase 1B (PTP1B) was significantly increased in the HFD sham group than control group. Spearman’s correlation analysis indicated that serum osteocalcin (OC) and 25-hydroxy vitamin D3 (25(OH)D3) were positively correlated with BMD of trabecular bone, whereas serum PTP1B and TNF-α were negatively related to BMD of trabecular bone. Conclusions SG aggravates bone mass loss and activates bone remodeling in obese rats. Levels of BTMs, adipokines, inflammatory factors, and gastrointestinal hormones could be affected by SG in obese rats. Serum PTP1B level might be associated with abnormal bone mass in obese rats.


2021 ◽  
Vol 22 (17) ◽  
pp. 9135
Author(s):  
Wei-Shiung Lian ◽  
Re-Wen Wu ◽  
Yu-Shan Chen ◽  
Jih-Yang Ko ◽  
Shao-Yu Wang ◽  
...  

Skeletal tissue involves systemic adipose tissue metabolism and energy expenditure. MicroRNA signaling controls high-fat diet (HFD)-induced bone and fat homeostasis dysregulation remains uncertain. This study revealed that transgenic overexpression of miR-29a under control of osteocalcin promoter in osteoblasts (miR-29aTg) attenuated HFD-mediated body overweight, hyperglycemia, and hypercholesterolemia. HFD-fed miR-29aTg mice showed less bone mass loss, fatty marrow, and visceral fat mass together with increased subscapular brown fat mass than HFD-fed wild-type mice. HFD-induced O2 underconsumption, respiratory quotient repression, and heat underproduction were attenuated in miR-29aTg mice. In vitro, miR-29a overexpression repressed transcriptomic landscapes of the adipocytokine signaling pathway, fatty acid metabolism, and lipid transport, etc., of bone marrow mesenchymal progenitor cells. Forced miR-29a expression promoted osteogenic differentiation but inhibited adipocyte formation. miR-29a signaling promoted brown/beige adipocyte markers Ucp-1, Pgc-1α, P2rx5, and Pat2 expression and inhibited white adipocyte markers Tcf21 and Hoxc9 expression. The microRNA also reduced peroxisome formation and leptin expression during adipocyte formation and downregulated HFD-induced leptin expression in bone tissue. Taken together, miR-29a controlled leptin signaling and brown/beige adipocyte formation of osteogenic progenitor cells to preserve bone anabolism, which reversed HFD-induced energy underutilization and visceral fat overproduction. This study sheds light on a new molecular mechanism by which bone integrity counteracts HFD-induced whole-body fat overproduction.


Antioxidants ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1248
Author(s):  
Wei-Shiung Lian ◽  
Re-Wen Wu ◽  
Yu-Shan Chen ◽  
Jih-Yang Ko ◽  
Shao-Yu Wang ◽  
...  

Senescent osteoblast overburden accelerates bone mass loss. Little is understood about microRNA control of oxidative stress and osteoblast senescence in osteoporosis. We revealed an association between microRNA-29a (miR-29a) loss, oxidative stress marker 8-hydroxydeoxyguanosine (8-OHdG), DNA hypermethylation marker 5-methylcystosine (5mC), and osteoblast senescence in human osteoporosis. miR-29a knockout mice showed low bone mass, sparse trabecular microstructure, and osteoblast senescence. miR-29a deletion exacerbated bone loss in old mice. Old miR-29a transgenic mice showed fewer osteoporosis signs, less 5mC, and less 8-OHdG formation than age-matched wild-type mice. miR-29a overexpression reversed age-induced senescence and osteogenesis loss in bone-marrow stromal cells. miR-29a promoted transcriptomic landscapes of redox reaction and forkhead box O (FoxO) pathways, preserving oxidation resistance protein-1 (Oxr1) and FoxO3 in old mice. In vitro, miR-29a interrupted DNA methyltransferase 3b (Dnmt3b)-mediated FoxO3 promoter methylation and senescence-associated β-galactosidase activity in aged osteoblasts. Dnmt3b inhibitor 5′-azacytosine, antioxidant N-acetylcysteine, or Oxr1 recombinant protein attenuated loss in miR-29a and FoxO3 to mitigate oxidative stress, senescence, and mineralization matrix underproduction. Taken together, miR-29a promotes Oxr1, compromising oxidative stress and FoxO3 loss to delay osteoblast aging and bone loss. This study sheds light on a new antioxidation mechanism by which miR-29a protects against osteoblast aging and highlights the remedial effects of miR-29a on osteoporosis.


Healthcare ◽  
2021 ◽  
Vol 9 (8) ◽  
pp. 948
Author(s):  
Chao-Hsin Cheng ◽  
Ching-Yuan Lin ◽  
Tsung-Hsun Cho ◽  
Chih-Ming Lin

A relationship exists between metabolic syndrome (MetS) and human bone health; however, whether the combination of demographic, lifestyle, and socioeconomic factors that are associated with MetS development also simultaneously affects bone density remains unclear. Using a machine learning approach, the current study aimed to estimate the usefulness of predicting bone mass loss using these potentially related factors. The present study included a sample of 23,497 adults who routinely visited a health screening center at a large health center at least once during each of three 3-year stages (i.e., 2006–2008, 2009–2011, and 2012–2014). The demographic, socioeconomic, lifestyle characteristics, body mass index (BMI), and MetS scoring index recorded during the first 3-year stage were used to predict the subsequent occurrence of osteopenia using a non-concurrence design. A concurrent prediction was also performed using the features recorded from the same 3-year stage as the predicted outcome. Machine learning algorithms, including logistic regression (LR), support vector machine (SVM), random forest (RF), and extreme gradient boosting (XGBoost), were applied to build predictive models using a unique feature set. The area under the receiver operating characteristic curve (AUC), accuracy, sensitivity, specificity, precision, and F1 score were used to evaluate the predictive performances of the models. The XGBoost model presented the best predictive performance among the non-concurrence models. This study suggests that the ensemble learning model with a MetS severity score can be used to predict the progression of osteopenia. The inclusion of an individual’s features into a predictive model over time is suggested for future studies.


Antioxidants ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1209
Author(s):  
Sajeev Wagle ◽  
Hyun-Jaung Sim ◽  
Govinda Bhattarai ◽  
Ki-Choon Choi ◽  
Sung-Ho Kook ◽  
...  

While total body irradiation (TBI) is an everlasting curative therapy, the irradiation can cause long-term bone marrow (BM) injuries, along with senescence of hematopoietic stem cells (HSCs) and mesenchymal stem cells (MSCs) via reactive oxygen species (ROS)-induced oxidative damages. Thus, ameliorating or preventing ROS accumulation and oxidative stress is necessary for TBI-requiring clinical treatments. Here, we explored whether administration of ferulic acid, a dietary antioxidant, protects against TBI-mediated systemic damages, and examined the possible mechanisms therein. Sublethal TBI (5 Gy) decreased body growth, lifespan, and production of circulating blood cells in mice, together with ROS accumulation, and senescence induction of BM-conserved HSCs and MSCs. TBI also impaired BM microenvironment and bone mass accrual, which was accompanied by downregulated osteogenesis and by osteoclastogenic and adipogenic activation in BM. Long-term intraperitoneal injection of ferulic acid (50 mg/kg body weight, once per day for 37 consecutive days) protected mice from TBI-mediated mortality, stem cell senescence, and bone mass loss by restoring TBI-stimulated disorders in osteogenic, osteoclastic, and adipogenic activation in BM. In vitro experiments using BM stromal cells supported radioprotective effects of ferulic acid on TBI-mediated defects in proliferation and osteogenic differentiation. Overall, treatment with ferulic acid prevented TBI-mediated liver damage and enhanced endogenous antioxidant defense systems in the liver and BM. Collectively, these results support an efficient protection of TBI-mediated systemic defects by supplemental ferulic acid, indicating its clinical usefulness for TBI-required patients.


Cells ◽  
2021 ◽  
Vol 10 (8) ◽  
pp. 1895
Author(s):  
Francesca Marini ◽  
Francesca Giusti ◽  
Federica Cioppi ◽  
Davide Maraghelli ◽  
Tiziana Cavalli ◽  
...  

Primary hyperparathyroidism (PHPT) is the most common endocrinopathy in multiple endocrine neoplasia type 1 (MEN1). Persistent levels of increased parathyroid hormone (PTH) result in a higher incidence of osteopenia and osteoporosis compared to the general population. Surgical removal of hyper-functioning parathyroid tissue is the therapy of choice. This retrospective study evaluated the effect of parathyroidectomy (PTX) on bone metabolism and bone mass in two series of patients with MEN1 PHPT and sporadic PHPT (sPHPT) by comparing bone metabolism-related biochemical markers and bone mineral density (BMD) before and after surgery. Our data confirmed, in a higher number of cases than in previously published studies, the efficacy of PTX, not only to rapidly restore normal levels of PTH and calcium, but also to normalize biochemical parameters of bone resorption and bone formation, and to improve spine and femur bone mass, in both MEN1 PHPT and sPHPT. Evaluation of single-patient BMD changes after surgery indicates an individual variable bone mass improvement in a great majority of MEN1 PHPT patients. In MEN1 patients, PTX is strongly suggested in the presence of increased PTH and hypercalcemia to prevent/reduce the early-onset bone mass loss and grant, in young patients, the achievement of the bone mass peak; routine monitoring of bone metabolism and bone mass should start from adolescence. Therapy with anti-fracture drugs is indicated in MEN1 patients with BMD lower than the age-matched normal values.


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