Journal of Bone Metabolism最新文献

Background: Hypothyroidism is the most common thyroid dysfunction, and current evidence suggests that it increases the risk of osteoporosis in these patients. Assessing the level of osteoporosis awareness and understanding among hypothyroid patients is an important requirement for implementing preventive interventions to maintain bone health.

Methods: Thyroid-stimulating hormone, thyroxine, and 25-hydroxy-vitamin D levels were recorded along with the patients' demographics. Osteoporosis awareness was assessed with the osteoporosis awareness scale (OAS), and knowledge level was assessed with the revised osteoporosis knowledge test (R-OKT). Health beliefs related to osteoporosis were evaluated using the osteoporosis health belief scale (OHBS).

Results: The median (interquartile range) values for OAS and R-OKT of 348 patients were calculated as 66.0 (32.0) and 9.0 (5.0), respectively. Female patients had higher OAS scores (P<0.001), OHBS benefits of exercise (P=0.002), and calcium intake (P<0.001) subscores compared to males. The distribution of OAS, R-OKT, and OHBS total and susceptibility scores differed significantly across education categories (P<0.001). The linear regression model revealed significant predictors of OAS score variation, including gender (β=-0.27, P<0.001), education (β=0.09, P=0.045), and osteoporosis knowledge (β=0.49, P<0.001).

Conclusions: Patients with hypothyroidism, particularly males and those with lower educational attainment, lack adequate knowledge and awareness regarding osteoporosis. To better comprehend and manage osteoporosis, targeted educational initiatives are required for this vulnerable group.

Background: Sarcopenia is an age-related disease, and is assumed to be associated with systemic inflammation. We examined the relationship between the neutrophil-to-lymphocyte ratio (NLR), an easily accessible inflammatory marker, and sarcopenia in older adults.

Methods: This retrospective cross-sectional study, medical records of patients visiting a tertiary hospital's health check-up center were analyzed. The study included older adults aged 60 and over, and who had their grip strength, skeletal muscle mass, and complete blood count with differential tests measured. In this study, sarcopenia was defined as the presence of both low muscle mass and weak grip strength according to the Asian Working Group for Sarcopenia 2019 criteria.

Results: Of the 2,385 participants, 74 participants (3.10%) had sarcopenia. The non-sarcopenia group was younger than the sarcopenia group (mean age, 65.8±5.4 vs. 73.2±7.5). The average NLR of participants without sarcopenia was 1.75±0.97 and the average NLR of participants with sarcopenia was 2.08±1.11 (P=0.004). The number of participants with sarcopenia increased across higher NLR quintile (P for trend=0.016), as well as those with low skeletal muscle mass (P for trend<0.001) and weak grip strength (P for trend=0.009).

Conclusions: Older adults with a high NLR may be considered for sarcopenia screening.

Background: This study evaluated the correlation between the degree and duration of thyroid-stimulating hormone (TSH) suppression and changes in bone mineral density (BMD) in patients who underwent surgery for differentiated thyroid carcinoma (DTC).

Methods: We included 65 women who underwent surgery for DTC and had at least two BMD measurements. Changes in BMD were statistically analyzed with a focus on postmenopausal women.

Results: The mean patient age was 52.2 years. During the follow-up period, 10 patients (15.4%) received osteoporosis treatment, and six (9.2%) experienced fractures. Analysis of 50 postmenopausal women revealed significant decreases in lumbar spine BMD (P=0.007), femoral neck BMD (P=0.008), and total hip BMD (P=0.010). Patients with TSH suppression <0.5 mU/L exhibited a 1.24%/y decrease in lumbar spine BMD, showing a marked reduction compared to a 0.33%/y decrease in BMD in the group with TSH ≥0.5 mU/L (P=0.025). Linear regression analysis comparing the duration of TSH suppression revealed a significant correlation with lumbar spine BMD (P<0.001). However, no correlation was observed between TSH suppression and decreased femoral neck BMD. Although not significant, the reduction in BMD in the lumbar spine was greater in the calcium and vitamin D non-supplementation group than in the supplementation group (1.31%/y vs. 0.71%/y; P=0.349).

Conclusions: Prolonged aggressive TSH suppression significantly affects lumbar spine BMD in patients with DTC. These findings highlight the need to balance TSH suppression with the risk of bone health deterioration, particularly in postmenopausal women.

Background: Prodromal symptoms might lead to an early diagnosis of atypical femoral fracture (AFF). However, incomplete AFF can progress to complete fractures because they are often misdiagnosed as degenerative diseases such as lumbar canal stenosis or knee and hip osteoarthritis. The purpose of this study was to examine how many AFFs are misdiagnosed as degenerative diseases and the characteristics of the site of prodromal symptoms in a multicenter study.

Methods: We retrospectively analyzed the medical records of patients with AFFs at two institutions. In addition, a survey was sent to affiliated institutions to collect data on prodromal symptoms.

Results: Analysis in two institutions revealed 46 AFFs in 35 patients. Seventeen fractures were associated with localized prodromal symptoms in the groin or lateral thigh (conventional type), and 12 fractures had prodromal symptoms not localized to the fracture site, such as widespread lateral thigh, knee, or lateral lower leg (modified type). Eleven fractures were misdiagnosed as degenerative diseases. The survey of 11 affiliated institutions revealed that prodromal pain was reported in 29 of 49 AFFs. Nineteen fractures were associated with modified prodromal pain, and 9 fractures were misdiagnosed as degenerative diseases.

Conclusions: Twenty-one percent of AFFs were misdiagnosed with degenerative diseases. All of the misdiagnosed cases were associated with prodromal symptoms. We believe that the prodromal symptoms of AFF are diverse and very similar to those of degenerative diseases, which may have caused the misdiagnosis.

Background: This study aimed to infer a causal gene network associated with bone metastasis in lung cancer and to validate its reliability through experimental gene expression analysis.

Methods: Using DNA microarray data from the Gene Expression Omnibus, we analyzed samples from primary lung cancer and those with bone metastasis. Commonly expressed genes in both groups were identified, and a causal network was inferred using Bayesian network inference with Java Objects based on the Bayesian Dirichlet score. To evaluate the network, we predicted the expression changes of downstream genes following knockdown of a key upstream gene and compared these predictions with mRNA expression levels in fatty acid desaturase 1 (FADS1)-knockdown lung cancer cells.

Results: The genes FADS1, cardiotrophin-like cytokine factor 1 (CLCF1), chromosome 4 open reading frame 48, sushi, nidogen and EGF like domains 1, FK506-binding protein 15, and coenzyme Q10A (COQ10A) were identified as directly associated with lung cancer bone metastasis. Among them, FADS1 appeared to have a regulatory role, influencing downstream targets. Notably, CLCF1 and COQ10A showed significantly increased expression in FADS1-knockdown cells, consistent with the network's predictions.

Conclusions: These findings suggest that Bayesian network analysis is a reliable machine learning approach for uncovering causal gene relationships in cancer metastasis. Furthermore, FADS1 may serve as a potential therapeutic target in lung cancer bone metastasis. The validity of this network was supported by in vitro experiments using a lung cancer cell line.

Background: Limb dominance is influenced by daily activity and muscle strength. Previous studies have demonstrated lateral differences in bone mineral density (BMD), bone mineral content (BMC), and lean mass as a result of asymmetric mechanical loading. Understanding these variations is crucial, especially in conditions with regional bone demineralization, where the contralateral limb can serve as a reference. We aimed to analyze side-to-side differences in BMD, BMC, and lean mass, as measured by dual energy X-ray absorptiometry (DXA), in healthy subjects.

Methods: A cross-sectional study included 802 whole-body composition assessments in Spanish adults (20-80 years). Athletes and individuals with bone metabolism disorders were excluded. Hand and foot dominance were self-reported. BMD, BMC, and lean mass were measured using a DXA scanner (Lunar Prodigy).

Results: The sample (57.1% women, 42.9% men; mean age, 53.0±16.7 years) showed strong correlations between dominant and non-dominant limbs (r>0.90). The dominant upper limb had significantly higher BMD (~4%), BMC (~5-6%), and lean mass (~3-4%) in both sexes. In women, the dominant lower limb showed slight differences (~1%), while in men, only lean mass was significantly higher. Aging led to BMD and BMC reductions after a peak in the fourth decade in women and the third in men. Lean mass showed a higher decline in men in both upper and lower limbs.

Conclusions: Limb dominance affects body composition differently between sexes, primarily in the upper limb, potentially due to differences in physical activity or mechanical loading. This study provides insight into how laterality and aging influence body composition in healthy individuals.

Tyrosine kinases (TK) are critical enzymes involved in cellular processes in the joints, such as proliferation, differentiation, and apoptosis. These inhibitors target key pathways involved in cartilage degeneration and inflammation, offering hope for improved management of these conditions. This review examines the role of TK inhibitors in modulating chondrocyte activity and explores their therapeutic potential in cartilage-related diseases, including rheumatoid arthritis (RA) and osteoarthritis (OA). A search has been conducted across several relevant publications using the terms cartilage regeneration, chondrocyte activity, OA, RA, and TK inhibitors in PubMed and Google Scholar to construct this review. TK inhibitors have the potential to manage inflammatory and degenerative joint disorders. Tofacitinib, gefitinib, imatinib and other TK inhibitors have anti-inflammatory effects through various pathways, aiding in treating cartilage diseases. Tofacitinib and baricitinib are already approved for RA, while other TK inhibitors are under continuous investigation for approval in RA and OA. Nonetheless, certain obstacles like serious side effects, limited joint-specificity, and inadequate clinical research impede their utilization. Despite these challenges, TK inhibitors signify a promising treatment strategy for joint diseases, presenting the potential to improve disease management strategies and promote cartilage regeneration.

Background: To investigate the contribution of radiological characteristics of baseline fragility vertebral fractures (FVF) and clinical characteristics to the development of radiological worsening (RW).

Methods: Patients were recruited between 2015 and 2018. The primary outcome was the identification of RW in a radiological second image, defined as the progression of prevalent FVF, new FVF, or both. Data on fracture risk fractures, bone mineral density, analgesia requirements, and antiosteoporosis treatment were recorded. The radiological features of baseline FVF included fracture number, location(s), severity grade (Genant method), kyphosis angle, and spine index deformity.

Results: A total of 223 patients with at least one follow-up radiological evaluation were included. Another 199 patients had no radiological follow-up. Of those with follow-up, 69% presented RW, accounting for 36.5% of the total cohort (422 patients). The incidence rate of RW was 73.8/1,000 patient-years. Among those with RW, 61% showed progression of FVF, 27% developed new FVF, and 12% had both. The multivariate analysis demonstrated that multiple FVF and worse grades of FVF at baseline were variables significantly associated with RW. Baseline characteristics of FVF that increased the risk of RW by progression of FVF was grade 1 (odds ratio [OR], 3.22; 95% confidence interval [CI], 1.47-7.02) and grade 2 (OR, 1.97; 95% CI, 1.05-3.68) and by new FVF was grade 3 (OR, 3.19; 95% CI, 1.39-7.33) FVF.

Conclusions: Approximately one-third of patients with FVF experienced RW, with progression of FVF being the most common event. A higher number of FVF and a greater severity at baseline are associated with RW.

Background: Yerba mate (YM) drinking is associated with higher lumbar spine and femoral neck bone mineral density (BMD) in postmenopausal women. We analyzed its effect on total hip BMD and reported the contribution of the trabecular and cortical components to this effect.

Methods: A control group of 147 non-drinkers was compared to 153 YM drinkers. Left hip BMD was measured using dual energy X-ray absorptiometry (DXA), and three-dimensional (3D)-Shaper software was used to estimate integral volumetric BMD (vBMD), cortical surface BMD (sBMD), and trabecular vBMD through 3D modeling.

Results: No significant difference was found between groups in either age (p=0.746) or body mass index (BMI; p=0.329). The YM group had significantly higher total hip BMD, integral vBMD, cortical sBMD, and trabecular BMD (all p<0.0001). The frequency of DXA-based osteoporosis diagnosis was lower in YM drinkers (3.3% vs. 10.9%; odds ratio [OR], 0.276). The rate of low-impact fractures was significantly reduced in YM drinkers (5.9% vs. 12.9%; OR, 2.197). Linear regression analyses revealed that cortical and trabecular parameters correlated positively with BMI and negatively with age in both groups. The slope of the lines did not differ between groups, but the elevation was uniformly higher in the YM group (p=0.0004 to p<0.0001).

Conclusions: Our study provides novel insights into YM consumption and bone health in postmenopausal women. We confirm its positive association with BMD and demonstrate, for the first time, that both cortical and trabecular compartments contribute to this effect. Our findings also suggest a potential protective role of YM against osteoporosis and fragility fractures.