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Best Laboratory Screening in Diagnosing Secondary Osteoporosis and Fracture Risk Assessment Tool and the National Osteoporosis Guideline Group Performance in Determining Clinical Risk: A Cross-Sectional Evaluation of the Bone Health in Postmenopausal Brazilian Women. 诊断继发性骨质疏松和骨折风险评估工具的最佳实验室筛查和国家骨质疏松指南组在确定临床风险方面的表现:绝经后巴西妇女骨骼健康的横断面评估。
Q2 Medicine Pub Date : 2023-02-01 DOI: 10.11005/jbm.2023.30.1.47
Marcelo Luis Steiner, Gabriela Polvani Crotti, Juliana Daltrino Teodoro, Raissa Kaori Ikeda, Rodolfo Strufaldi, César Eduardo Fernandes, Luciano de Melo Pompei
Background Identifying postmenopausal women with a high risk of having osteoporosis and fractures is a current challenge. This study aimed to assess the diagnostic performance of biochemical tests in identifying secondary osteoporosis and the fracture risk assessment tool (FRAX) in identifying fracture risk. Methods Data from biochemical tests and bone densitometry of postmenopausal women were analyzed. Additionally, the FRAX result was obtained and the patients were classified according to the National Osteoporosis Guideline Group (NOGG). Results A total of 646 women were evaluated, of whom 201 (31.1%) had osteoporosis or a previous frailty fracture. These women had statistically different parathyroid hormone (PTH) and alkaline phosphatase serum levels (P<0.01 and P=0.02, respectively) than those without osteoporosis or fracture. However, those at high risk had a higher prevalence of hypovitaminosis D (46% vs. 36%) and hypocalciuria (17% vs. 9%). The FRAX showed an area under the curve of 0.757 (P<0.01) and 0.788 (P<0.01) for identifying women at risk for “major fractures” and “hip,” respectively. The NOGG categorization had a sensitivity of 19% to identify high-risk women, a specificity of 91.3% for low-risk women, with a positive predictive value of 57.4% and a negative predictive value of 64.6%. Conclusions The evaluation of PTH, 25-hydroxy-vitamin D, serum calcium, and 24-hr urinary calcium proved adequate for initial osteoporosis screening. The FRAX tool has a regular ability to screen women at risk for fracture, and the NOGG method has high specificity to identify those at low risk.
背景:确定绝经后妇女骨质疏松和骨折的高风险是当前的一个挑战。本研究旨在评估生化试验对继发性骨质疏松症的诊断效能,以及骨折风险评估工具(FRAX)对骨折风险的诊断效能。方法:对绝经后妇女的骨密度和生化指标进行分析。此外,获得FRAX结果,并根据国家骨质疏松指南组(NOGG)对患者进行分类。结果:共有646名女性接受了评估,其中201名(31.1%)患有骨质疏松症或先前的脆性骨折。这些妇女的甲状旁腺激素(PTH)和碱性磷酸酶血清水平有统计学差异(p)结论:PTH、25-羟基维生素D、血清钙和24小时尿钙的评估证明足以用于骨质疏松症的初步筛查。FRAX工具具有常规筛查骨折风险女性的能力,而NOGG方法在识别低风险女性方面具有高特异性。
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引用次数: 0
Health-Related Quality of Life in Osteoporosis Patients with and without Fractures in Tehran, Iran. 伊朗德黑兰伴有和不伴有骨折的骨质疏松症患者的健康相关生活质量
Q2 Medicine Pub Date : 2023-02-01 DOI: 10.11005/jbm.2023.30.1.37
Marziyeh Rajabi, Afshin Ostovar, Ali Akbari Sari, Sayed Mahmoud Sajjadi-Jazi, Abdoreza Mousavi, Bagher Larijani, Noushin Fahimfar, Rajabali Daroudi

Background: This study aimed to measure the health-related quality of life (HRQOL) of patients with osteoporosis with and without fractures in Tehran, the capital city of Iran.

Methods: We surveyed a sample of 478 patients with osteoporosis aged over 50 years. Participants with fractures included patients referred to hospitals due to osteoporotic fractures which were alive 6 months after the fracture. Participants without fractures were randomly selected from patients with a definite diagnosis of osteoporosis admitted to 3 outpatient clinics in Tehran. Data were collected using the EuroQol 5-dimensional 5-level questionnaire. Statistical differences between patients with and without fracture were tested with Pearson's χ2 test, Student's t-test, and the Mann-Whitney U-test. The association between HRQOL and other variables was evaluated using a multiple linear regression model.

Results: The patients' mean age±standard deviation was 67.3±11.9 years, and 74.1% were women. One hundred and seventeen (23%) patients had hip fractures, 56 (11%) had vertebral fractures, 127 (25%) had forearm fractures, and 178 (40%) had no fractures. The median (interquartile range) values of HRQOL scores of those with hip, vertebral, and forearm fractures and those with no history of fracture were 0.53 (0.22), 0.60 (0.28), 0.64 (0.26), and 0.64 (0.27), respectively. The multiple regression model revealed a significant relationship between the HRQOL scores and sex, marital status, employment status, presence of any chronic illness in addition to osteoporosis, and type of fracture.

Conclusions: Osteoporosis and its related fractures can reduce the HRQOL.

背景:本研究旨在测量伊朗首都德黑兰伴有和不伴有骨折的骨质疏松患者的健康相关生活质量(HRQOL)。方法:我们调查了478例50岁以上骨质疏松症患者。骨折的参与者包括因骨质疏松性骨折而转诊到医院的患者,这些患者在骨折后6个月仍存活。没有骨折的参与者是从德黑兰3个门诊诊所明确诊断为骨质疏松症的患者中随机选择的。采用EuroQol 5维5级问卷收集数据。采用Pearson χ2检验、Student’st检验和Mann-Whitney u检验检验有无骨折患者的统计学差异。采用多元线性回归模型评估HRQOL与其他变量的相关性。结果:患者平均年龄±标准差为67.3±11.9岁,女性占74.1%。117例(23%)患者有髋部骨折,56例(11%)有椎体骨折,127例(25%)有前臂骨折,178例(40%)无骨折。髋部、椎体和前臂骨折及无骨折史患者HRQOL评分中位数(四分位数范围)分别为0.53(0.22)、0.60(0.28)、0.64(0.26)和0.64(0.27)。多元回归模型显示,HRQOL评分与性别、婚姻状况、就业状况、是否患有除骨质疏松症外的任何慢性疾病以及骨折类型有显著关系。结论:骨质疏松及其相关骨折可降低HRQOL。
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引用次数: 0
Sphenoid Bone Determines the Curvature of the Cranial Vault in Postnatal Skull Development in C57BL/6 Mice. 在C57BL/6小鼠出生后颅骨发育过程中,蝶骨决定了颅穹窿的曲率。
Q2 Medicine Pub Date : 2023-02-01 DOI: 10.11005/jbm.2023.30.1.93
Dinuka Adasooriya, Minjae Kyeong, Sung-Won Cho

Background: The skull is a complex structure formed by the craniofacial bones' elaborate organization. The growth pattern in each craniofacial bone of the postnatal skull has been presented in wild-type mice. However, the skull's growth pattern, determined by the craniofacial bones' coordinated growth, is unfamiliar. This study aimed to examine the overall morphological change in the mid-sagittal plane of the postnatal mice's skulls and interaction between the craniofacial bones.

Methods: Geometric morphometric principal component analysis was performed in the mid-sagittal plane of 31 wild-type mice's skulls from postnatal days 28 to 98. The relationship between the cranial base and cranial vault was investigated by comparing skulls with early fusion and non-fusion of intersphenoid synchondrosis (ISS).

Results: The cranial vault flattening and sphenoid bone length increased with age. The cranial vault curvature and sphenoid base length showed a positive correlation that was confirmed by comparing the skulls with early fusion and non-fusion of ISS. The sphenoid bone length and cranial vault angle significantly decreased in the skulls with early fusion of ISS compared to non-fusion skulls.

Conclusions: It is suggested that the cranial vault flattening is sphenoid bone length-induced but cranial vault length-independent during postnatal mice skull development.

背景:颅骨是由颅面骨精细组织形成的复杂结构。野生型小鼠出生后颅骨各颅面骨的生长模式已经呈现。然而,颅骨的生长模式,由颅面骨的协调生长决定,是不熟悉的。本研究旨在研究出生后小鼠颅骨中矢状面整体形态学变化及颅面骨间的相互作用。方法:对31只出生28 ~ 98天的野生型小鼠颅骨中矢状面进行几何形态计量学主成分分析。通过比较早期融合和未融合的蝶骨间软骨联合症(ISS)颅骨,探讨颅底和颅穹窿的关系。结果:随着年龄的增长,颅拱顶变平,蝶骨长度增加。通过比较ISS早期融合和未融合的颅骨,证实了颅拱顶曲率和蝶骨基底长度呈正相关。与未融合的颅骨相比,ISS早期融合颅骨的蝶骨长度和颅顶角明显减小。结论:出生后小鼠颅骨发育过程中颅拱顶变平是由蝶骨长度引起的,但与颅拱顶长度无关。
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引用次数: 0
Fracture Liaison Service in Korea: 2022 Position Statement of the Korean Society for Bone and Mineral Research. 韩国骨折联络服务:2022年韩国骨与矿物研究学会立场声明。
Q2 Medicine Pub Date : 2023-02-01 DOI: 10.11005/jbm.2023.30.1.31
Jae-Young Lim, Young Yul Kim, Jin-Woo Kim, Seongbin Hong, Kyunghoon Min, Jaewon Beom, Byung-Ho Yoon, Sang Yoon Lee, Sung Hye Kong, Jun-Il Yoo, Myung Sook Park, Jae-Hwi Nho, Sangbong Ko, Min Wook Joo, Dong Hwan Kim, Chan Ho Park, Tae-Young Kim, Seil Sohn, So Young Park, A Ram Hong, Young Joo Kwon, Sung Bae Park, Young-Kyun Lee, Nam Hoon Moon, Bo Ryun Kim, Yongsoon Park, Yonghan Cha, Yong-Chan Ha

Osteoporosis and osteoporotic fractures cause socioeconomic concerns, and medical system and policies appear insufficient to prepare for these issues in Korea, where the older adult population is rapidly increasing. Many countries around the world are already responding to osteoporosis and osteoporotic fractures by adopting fracture liaison service (FLS), and such an attempt has only begun in Korea. In this article, we introduce the operation methods for institutions implementing FLS and characteristics of services, and activities of the FLS Committee for FLS implementation in the Korean Society for Bone and Mineral Research. In addition, we hope that the current position statement will contribute to the implementation of FLS in Korea and impel policy changes to enable a multidisciplinary and integrated FLS operated under the medical system.

骨质疏松症和骨质疏松性骨折引起了社会经济方面的担忧,而在老年人口迅速增加的韩国,医疗系统和政策似乎不足以应对这些问题。在骨质疏松症和骨质疏松性骨折治疗方面,世界上很多国家都采用了骨折联络服务(FLS),但韩国只是刚刚开始。本文介绍了韩国骨与矿物研究学会实施骨与矿物研究的机构的运作方法和服务特点,以及骨与矿物研究协会实施骨与矿物研究的骨与矿物研究委员会的活动。此外,我们希望目前的立场声明将有助于在韩国实施FLS,并推动政策变化,以实现在医疗系统下运行的多学科和综合FLS。
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引用次数: 2
Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry. 双能x线骨密度测量在儿童炎症性肠病患者中的应用。
Q2 Medicine Pub Date : 2023-02-01 DOI: 10.11005/jbm.2023.30.1.59
Hasan M Isa, Amira A Ezzaldin, Mohamed M Alabbasi, Noora H ALaazmi, Abdulrahman S Masood, Hissa M Alabbasi

Background: Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD.

Methods: This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis.

Results: Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn's disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9-14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans.

Conclusions: This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.

背景:炎症性肠病(IBD)是一种慢性炎症免疫介导的疾病,影响胃肠道系统并改变骨生长和骨矿物质密度(BMD)。在这里,我们的目的是研究儿科IBD患者低骨密度的患病率和预测因素。方法:本回顾性横断面分析研究纳入了IBD患儿,采用全身和腰椎双能x线骨密度仪评估骨密度。骨质疏松定义为BMD Z-score≤-2,骨质减少定义为-2 ~ -1,正常定义为>-1。比较了骨质疏松症患者和非骨质疏松症患者的临床和实验室结果。结果:48例患者中,男性30例(62.5%),克罗恩病35例(72.9%),溃疡性结肠炎13例(27.1%)。平均诊断年龄9.9±2.8岁。BMD扫描时的中位年龄为11.9岁(四分位数范围为9.9-14.3岁)。全身骨密度扫描分别确定了13例(27.1%)和16例(33.3%)骨质疏松和骨质减少患者。脊柱骨密度扫描分别显示17例(39.5%)和14例(32.6%)患者骨质疏松和骨质减少。低身体质量指数(BMI) z -评分(p=0.038)、回肠结肠疾病部位(p=0.008)和低钙水平(p=0.008)是总体骨密度扫描中骨质疏松症的显著预测因子。低BMI Z-score (p=0.039)、血红蛋白水平降低(p=0.018)、低钙水平(p=0.033)和使用英夫利昔单抗(p=0.019)是脊柱骨密度扫描中骨质疏松的重要预测因素。结论:本研究显示,在IBD患儿中,低骨密度的患病率很高。低BMI、回肠结疾病部位、低血红蛋白和低钙水平以及英夫利昔单抗的使用与骨质疏松症显著相关。
{"title":"Bone Mineral Density in Patients with Pediatric Inflammatory Bowel Disease Using Dual Energy X-Ray Absorptiometry.","authors":"Hasan M Isa,&nbsp;Amira A Ezzaldin,&nbsp;Mohamed M Alabbasi,&nbsp;Noora H ALaazmi,&nbsp;Abdulrahman S Masood,&nbsp;Hissa M Alabbasi","doi":"10.11005/jbm.2023.30.1.59","DOIUrl":"https://doi.org/10.11005/jbm.2023.30.1.59","url":null,"abstract":"<p><strong>Background: </strong>Inflammatory bowel disease (IBD) is a chronic inflammatory immune-mediated condition that affects the gastrointestinal system and alters bone growth and bone mineral density (BMD). Here we aimed to study the prevalence and predictors of a low BMD in pediatric patients with IBD.</p><p><strong>Methods: </strong>This retrospective cross-sectional analytical study included pediatric patients with IBD in whom BMD was evaluated using dual energy X-ray absorptiometry of the total body and lumbar spine. Osteoporosis was defined as a BMD Z-score ≤-2, osteopenia as -2 to -1, and normal as >-1. Clinical and laboratory findings were compared between patients with and without osteoporosis.</p><p><strong>Results: </strong>Of the 48 patients, 30 (62.5%) were males, 35 (72.9%) had Crohn's disease, and 13 (27.1%) had ulcerative colitis. The mean age at diagnosis was 9.9±2.8 years. The median age at the time of the BMD scans was 11.9 (interquartile range, 9.9-14.3) years. Total body BMD scans identified 13 (27.1%) and 16 (33.3%) patients with osteoporosis and osteopenia, respectively. Spinal BMD scans revealed that 17 (39.5%) and 14 (32.6%) patients had osteoporosis and osteopenia, respectively. A low body mass index (BMI) Z-score (p=0.038), ileocolonic disease location (p=0.008), and a low calcium level (p=0.008) were significant predictors of osteoporosis on the total body BMD scans. A low BMI Z-score (p=0.039), decreased hemoglobin level (p=0.018), low calcium level (p=0.033), and infliximab use (p=0.019) were significant predictors of osteoporosis on the spinal BMD scans.</p><p><strong>Conclusions: </strong>This study showed a high prevalence of low BMD among pediatric patients with IBD. A low BMI, ileocolonic disease location, low hemoglobin and calcium levels, and infliximab use were significantly associated with osteoporosis.</p>","PeriodicalId":15070,"journal":{"name":"Journal of Bone Metabolism","volume":"30 1","pages":"59-68"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ad/e3/jbm-2023-30-1-59.PMC10036179.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9252185","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 2
Molecular and Cellular Crosstalk between Bone and Brain: Accessing Bidirectional Neural and Musculoskeletal Signaling during Aging and Disease. 骨与脑之间的分子和细胞串联:在衰老和疾病过程中获取双向神经和肌肉骨骼信号。
Q2 Medicine Pub Date : 2023-02-01 Epub Date: 2023-02-28 DOI: 10.11005/jbm.2023.30.1.1
Charles A Schurman, Jordan B Burton, Jacob Rose, Lisa M Ellerby, Tamara Alliston, Birgit Schilling

Molecular omics technologies, including proteomics, have enabled the elucidation of key signaling pathways that mediate bidirectional communication between the brain and bone tissues. Here we provide a brief summary of the clinical and molecular evidence of the need to study the bone-brain axis of cross-tissue cellular communication. Clear clinical and molecular evidence suggests biological interactions and similarities between bone and brain cells. Here we review the current mass spectrometric techniques for studying brain and bone diseases with an emphasis on neurodegenerative diseases and osteoarthritis/osteoporosis, respectively. Further study of the bone-brain axis on a molecular level and evaluation of the role of proteins, neuropeptides, osteokines, and hormones in molecular pathways linked to bone and brain diseases is critically needed. The use of mass spectrometry and other omics technologies to analyze these cross-tissue signaling events and interactions will help us better understand disease progression and comorbidities and potentially identify new pathways and targets for therapeutic interventions. Proteomic measurements are particularly favorable for investigating the role of signaling and secreted and circulating analytes and identifying molecular and metabolic pathways implicated in age-related diseases.

包括蛋白质组学在内的分子全息技术已经能够阐明介导大脑和骨组织之间双向交流的关键信号通路。在此,我们简要总结了临床和分子证据,说明有必要对跨组织细胞通讯的骨-脑轴进行研究。明确的临床和分子证据表明,骨细胞和脑细胞之间存在生物相互作用和相似性。在此,我们回顾了目前用于研究大脑和骨骼疾病的质谱技术,重点分别放在神经退行性疾病和骨关节炎/骨质疏松症上。我们亟需在分子水平上进一步研究骨-脑轴,并评估蛋白质、神经肽、骨激素和激素在与骨和脑疾病相关的分子通路中的作用。利用质谱和其他全息技术来分析这些跨组织信号传导事件和相互作用,将有助于我们更好地了解疾病的进展和合并症,并有可能确定新的治疗干预途径和靶点。蛋白质组测量尤其有利于研究信号传导、分泌和循环分析物的作用,并确定与老年相关疾病有关的分子和代谢途径。
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引用次数: 0
Erratum to: Effect of Lactobacillus Fermentum as a Probiotic Agent on Bone Health in Postmenopausal Women. 作为益生菌剂的发酵乳杆菌对绝经后妇女骨骼健康的影响。
Q2 Medicine Pub Date : 2023-02-01 DOI: 10.11005/jbm.2023.30.1.115
Hee Soo Han, Jung Geul Kim, Yoon Hyo Choi, Kyoung Min Lee, Tae Hun Kwon, Sae Hun Kim
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引用次数: 0
Daily Walking Accompanied with Intermittent Resistance Exercise Prevents Osteosarcopenia: A Large Cohort Study. 一项大型队列研究:每日步行伴间歇性阻力运动可预防骨骼肌减少症。
Q2 Medicine Pub Date : 2022-11-01 DOI: 10.11005/jbm.2022.29.4.255
Sangyeob Lee, Ji-Seok Kim, Ki-Soo Park, Kyung-Wan Baek, Jun-Il Yoo

Background: This study aimed to analyze the effects of walking and resistance exercises on bone structure, bone mineral density (BMD), and skeletal muscle mass. We used data from the fourth Korean National Health and Nutrition Examination Survey (KNHANES).

Methods: A total of 3,477 participants aged ≥19 years underwent hip structural analysis (HSA), BMD, and skeletal muscle index (SMI). All radiologic evaluations were performed using dual energy X-ray absorptiometry (DXA). The Korean short version of the International Physical Activity Questionnaire was used to measure physical activity status. The physical activity recommendations of the American College of Rheumatology Work Group Panel were used to evaluate the extent of activity.

Results: The BMD and SMI in the group in which walking activity was performed 5 days or more per week for at least 30 min per day were significantly higher than those in the group in which walking activity was not performed. HSA and SMI in the group in which resistance exercise was performed 2 days or more per week for at least 30 min per day were found to be significantly higher than those in the group in which strengthening exercises were not performed.

Conclusions: If resistance exercise and walking are combined, bone loss and muscle loss are prevented maintaining cortical thickness in the elderly. Walking for more than 5 days a week and resistance exercise for more than 2 days a week will help to maintain the skeletal muscle as well as the cortex around the femur neck, thus helping to prevent fragility fractures in older individuals.

背景:本研究旨在分析步行和阻力运动对骨结构、骨密度(BMD)和骨骼肌质量的影响。我们使用的数据来自第四次韩国国家健康和营养检查调查(KNHANES)。方法:共有3477名年龄≥19岁的参与者进行了髋关节结构分析(HSA)、BMD和骨骼肌指数(SMI)。所有放射学评估均采用双能x线吸收仪(DXA)进行。使用韩国版的国际身体活动问卷来测量身体活动状况。美国风湿病学会工作组小组的体力活动建议被用来评估活动的程度。结果:每周进行5天或以上每天至少30分钟步行活动的组的BMD和SMI显著高于不进行步行活动的组。每周进行阻力运动2天或以上,每天至少30分钟的组的HSA和SMI明显高于未进行强化运动的组。结论:如果阻力运动和步行相结合,可以防止骨质流失和肌肉流失,保持老年人皮质厚度。每周进行5天以上的步行和2天以上的抗阻运动有助于保持骨骼肌和股骨颈周围的皮质,从而有助于预防老年人的脆性骨折。
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引用次数: 0
The Role of Bisphosphonates Prior to Denosumab Treatment on Rebound Fractures: A Mini Review. 双膦酸盐在Denosumab治疗前对反跳性骨折的作用:一个小型回顾。
Q2 Medicine Pub Date : 2022-11-01 DOI: 10.11005/jbm.2022.29.4.217
Arthur Costa Inojosa, Laís Mendes, Leonardo Bandeira, Francisco Bandeira

Denosumab is a potent anti-resorptive medication used to treat patients at high risk for osteoporosis; however, its beneficial effects on the skeletal system are quickly reversed after discontinuation. In contrast, bisphosphonates (BPs) are anti-resorptive agents with residual effects on the bone matrix; thus, these are capable of preserving bone mass for a long time. Therefore, subsequent anti-resorptive treatment with BPs is mandatory to prevent rebound fractures. Furthermore, BP administration before denosumab treatment appears to be a reasonable strategy for reducing hyperactivation of bone remodeling. In this review, we summarize the effects of BP administration before denosumab treatment in preventing rebound fractures after denosumab discontinuation.

Denosumab是一种有效的抗吸收药物,用于治疗骨质疏松症高危患者;然而,它对骨骼系统的有益作用在停药后很快被逆转。相比之下,双膦酸盐(BPs)是抗骨吸收剂,对骨基质有残留作用;因此,它们能够长时间保存骨量。因此,后续的bp抗吸收治疗是必要的,以防止反弹骨折。此外,在denosumab治疗前给药降压似乎是减少骨重塑过度激活的合理策略。在这篇综述中,我们总结了在denosumab治疗前给药BP对预防denosumab停药后反弹骨折的作用。
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引用次数: 0
Five-Year Assessment of Multiple Gene Variants Associated with Bone Marrow Hypocellularity, Reduced Bone Density, and Ovarian Insufficiency in Adolescence. 与青春期骨髓细胞过少、骨密度降低和卵巢功能不全相关的多基因变异的五年评估。
Q2 Medicine Pub Date : 2022-11-01 DOI: 10.11005/jbm.2022.29.4.271
E Scott Sills, Conor Harrity, Samuel H Wood

This study covers the 5-year interval prior to COVID-19 admission for an otherwise healthy 46,XX adolescent expanding the developmental characterization of an unusual convergence of amenorrhea and genetic mutations. The patient experienced rapid collapse of endogenous estradiol output followed by secondary amenorrhea at 13 years of age. Euploid, diffusely hypocellular bone marrow was present on biopsy, although anemia or reduced total immunoglobulin production was not identified. Bone density was 1.5 years below mean; multiple dental anomalies were also documented. While alterations in "master regulator" genes RUNX2, SALL1, and SAMD9 are usually diagnosed in early childhood when missed milestones, dysmorphic features, or chronic infection/immune impairment warrant cross-disciplinary evaluation, this study is the first known report to associate ovarian failure with adolescence with such variants. Immunoglobulin patterns, osseous histomorphology, dentition, hematology/renal screening, pelvic anatomy, ovarian reserve data, and thyroid findings are also correlated. Although severe pathology is typically encountered when any of these genes are disrupted alone, this longitudinal survey reveals that a mild phenotype can prevail if these 3 variants occur simultaneously. Periodic monitoring is planned given the unclassified status of this unique mutation set.

本研究涵盖了一名健康的46,xx青少年在COVID-19入院前的5年时间间隔,扩大了闭经和基因突变异常趋同的发育特征。患者13岁时出现内源性雌二醇分泌迅速下降,继发性闭经。活检显示整倍体弥漫性低细胞骨髓,但未发现贫血或总免疫球蛋白产生减少。骨密度比平均值低1.5年;多处牙齿异常也被记录。虽然“主调控”基因RUNX2、SALL1和SAMD9的改变通常在儿童早期被诊断出来,当错过里程碑、畸形特征或慢性感染/免疫损伤需要跨学科评估时,这项研究是第一个将卵巢功能衰竭与青春期的此类变异联系起来的已知报告。免疫球蛋白模式、骨组织形态学、牙列、血液学/肾脏筛查、盆腔解剖、卵巢储备数据和甲状腺结果也相关。虽然当这些基因中的任何一个单独被破坏时通常会遇到严重的病理,但这项纵向调查显示,如果这3种变异同时发生,则可能会出现轻微的表型。鉴于该独特突变集的未分类状态,计划进行定期监测。
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引用次数: 0
期刊
Journal of Bone Metabolism
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