Bone Reports最新文献_第6页

Effects of endurance exercise and dietary protein intake on osteokine, bone turnover, and inflammatory markers in endurance runners: A narrative review 耐力运动和膳食蛋白质摄入对耐力跑步者的骨因子、骨转换和炎症标志物的影响：一项叙述性综述

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-05-09 DOI: 10.1016/j.bonr.2025.101850

Sofia Valente Ferreira , Silar Gardy , Tyler A. Churchward-Venne , Andrea R. Josse , Jenna C. Gibbs

Bone stress injuries are pervasive among endurance runners due to repetitive sport-specific mechanical loading and a higher prevalence of low energy availability (i.e., inadequate dietary energy intake relative to exercise energy expenditure). Chronic endurance exercise promotes bone formation, thus, runners typically have higher bone mineral density (BMD) than non-weightbearing athletes and sedentary individuals. However, runners may experience increased bone resorption for hours to days following an endurance exercise bout. If recovery is insufficient, uncoupled bone turnover can pose a significant risk to their bone health. While skeletal-immune system crosstalk has been studied, the interaction during and after exercise in athletes is an emerging area of research. Nutritional interventions have been investigated for their effects on bone metabolism surrounding exercise. However, limited research has examined dietary protein intake in endurance athletes, particularly concerning its effects on bone metabolism and osteoimmunology. This narrative review provides an overview of the evidence on the effects of endurance exercise and dietary protein intake on osteokines, bone turnover, and inflammatory markers in endurance athletes. Acute bouts of high-intensity running increase osteokines and bone turnover markers that promote bone resoprtion which parallels increases in pro-inflammatory markers in endurance athletes, suggesting crosstalk between these systems during and after exercise. Chronic endurance exercise promotes increased resting levels of bone formation, while reducing resting pro-inflammatory markers. Adequate dietary protein ingestion habitually and pre-, during, and post-exercise may attenuate bone resportion and pro-inflammatory markers in endurance athletes.

在耐力跑者中，由于重复性运动特定的机械负荷和更普遍的低能量可用性（即，相对于运动能量消耗，饮食能量摄入不足），骨应力损伤是普遍存在的。长期耐力运动促进骨形成，因此，跑步者通常比非负重运动员和久坐不动的人有更高的骨密度（BMD）。然而，跑步者在耐力运动后可能会经历数小时到数天的骨吸收增加。如果恢复不充分，不耦合的骨转换会对他们的骨骼健康构成重大风险。虽然骨骼-免疫系统的相互作用已经被研究过，但运动员运动期间和运动后的相互作用是一个新兴的研究领域。营养干预对运动前后骨代谢的影响已被研究。然而，关于耐力运动员膳食蛋白质摄入量的研究有限，特别是关于其对骨代谢和骨免疫学的影响。本文综述了耐力运动和膳食蛋白质摄入对耐力运动员的骨因子、骨转换和炎症标志物影响的证据。急性高强度跑步增加骨因子和骨转换标志物，促进骨再吸收，这与耐力运动员中促炎标志物的增加相似，表明运动期间和运动后这些系统之间存在相互作用。慢性耐力运动促进了静息期骨形成水平的提高，同时减少了静息期促炎标志物。习惯、运动前、运动中和运动后摄入充足的膳食蛋白质可能会减弱耐力运动员的骨反应和促炎标志物。

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引用次数: 0

Diagnosis of skeletal fragility due to Loeys-Dietz syndrome and treatment with romosozumab followed by denosumab Loeys-Dietz综合征所致骨骼脆性的诊断和romosozumab和denosumab的治疗

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-05-06 DOI: 10.1016/j.bonr.2025.101849

Yasutaka Tsujimoto , Naoki Yamamoto , Hayato Fukumitsu , Hironori Bando , Masaaki Yamamoto , Keiko Tanaka , Naoya Morisada , Miwako Nagasaka , Keisuke Oe , Takahiro Niikura , Mika Yamauchi , Wataru Ogawa , Hidenori Fukuoka

Loeys–Dietz syndrome (LDS) is an autosomal dominant, inherited connective tissue disorder caused by a pathogenic variant in TGF-β signaling-related genes. LDS is associated with a high risk of low bone mineral density (BMD) and fractures.

We present a case report of a 43-year-old premenopausal woman with skeletal fragility who was diagnosed with LDS type 4 due to a large heterozygous deletion in the TGFB2 gene. Upon initial referral, she was evaluated for secondary osteoporosis. Although mild abnormalities in calcium metabolism, menstrual irregularities, and lack of exercise were observed, they were not associated with this condition. However, a thorough family history and physical examination raised the suspicion of Marfan syndrome and related disorders, which were subsequently confirmed using genetic testing. Treatment with romosozumab for 1 year increased the lumbar spine BMD from 0.750 g/cm² (Z-score −2.1) to 0.881 g/cm² (Z-score −1.0) and the femoral neck BMD from 0.407 g/cm² (Z-score − 3.0) to 0.428 g/cm² (Z-score − 2.6), with a slight increase in total hip BMD from 0.525 g/cm² (Z-score −2.6) to 0.527 g/cm² (Z-score −2.4). Subsequent therapy with denosumab for 1 year further improved the lumbar spine BMD to 0.939 g/cm² (Z-score, −0.5), femoral neck BMD to 0.496 g/cm² (Z-score, −2.0), and total hip BMD to 0.552 g/cm² (Z-score, −2.2). To our knowledge, this is the first case report of an improvement in BMD with romosozumab, followed by denosumab, for skeletal fragility due to LDS. Our findings suggest that this treatment regimen may be an effective therapeutic option for the management of skeletal fragility in patients with LDS.

Loeys-Dietz综合征（LDS）是一种常染色体显性遗传性结缔组织疾病，由TGF-β信号相关基因的致病性变异引起。LDS与低骨密度（BMD）和骨折的高风险相关。我们报告了一例43岁的绝经前妇女，骨骼脆弱，由于TGFB2基因的大量杂合缺失，被诊断为LDS 4型。在初次转诊时，她被评估为继发性骨质疏松症。虽然观察到轻微的钙代谢异常、月经不规则和缺乏运动，但它们与这种情况无关。然而，彻底的家族史和体格检查提出了马凡氏综合征和相关疾病的怀疑，随后通过基因检测证实了这一点。使用romosozumab治疗1年，腰椎骨密度从0.750 g/cm2 （z -评分- 2.1）增加到0.881 g/cm2 (z -评分- 1.0)，股骨颈骨密度从0.407 g/cm2 （z -评分- 3.0）增加到0.428 g/cm2 (z -评分- 2.6)，髋部总骨密度从0.525 g/cm2 （z -评分- 2.6）轻微增加到0.527 g/cm2 （z -评分- 2.4）。随后用denosumab治疗1年进一步改善腰椎骨密度至0.939 g/cm2 (z -评分，- 0.5)，股骨颈骨密度至0.496 g/cm2 (z -评分，- 2.0)，全髋关节骨密度至0.552 g/cm2 （z -评分，- 2.2）。据我们所知，这是首个使用romosozumab改善BMD的病例报告，随后使用denosumab治疗LDS引起的骨骼脆弱。我们的研究结果表明，这种治疗方案可能是治疗LDS患者骨骼脆性的有效选择。

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引用次数: 0

Osteosarcopenia as a risk factor for depression: Longitudinal findings from the SHARE study 骨骼肌减少症是抑郁症的危险因素：SHARE研究的纵向发现

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-05-05 DOI: 10.1016/j.bonr.2025.101848

Nicola Veronese , Francesco Saverio Ragusa , Shaun Sabico , Ligia Juliana Dominguez , Mario Barbagallo , Gustavo Duque , Lee Smith , Nasser Al-Daghri

Background

Osteosarcopenia (i.e., the co-existence of osteoporosis and sarcopenia) and depression are highly prevalent among older people. However, the association between osteosarcopenia and depression in older people is largely unknown. Therefore, the present study aims to investigate this possible association in a representative sample of the older adult population in Europe and Israel.

Methods

Osteosarcopenia was defined as the concomitant presence of osteoporosis and sarcopenia; depressive symptoms in the SHARE study were self-reported using the EURO-D scale. The association between the presence of osteosarcopenia at baseline in people free from depression and incident depression during 12 years of follow-up was analyzed using a Cox's regression analysis, adjusting for several baseline covariates.

Results

16,452 participants were included (mean age 63.7, SD 9.6; females 50.6 %). During the follow-up period, 5056 participants (31.1 % of the initial population) became depressed. People affected by osteosarcopenia became depressed in more than half of the cases compared to a quarter of controls. After adjusting for several potential baseline confounding variables, only sarcopenia (HR, hazard ratio = 1.17; 95 % CI, confidence intervals 1.04–1.32; p = 0.009) and osteosarcopenia (HR = 1.27; CI 95 % 1.12–1.58; p = 0.003) were significantly associated with a higher risk of depression.

Limitations

Definition of sarcopenia using an anthropometric equation; definition of depression using the EURO-D scale.

Conclusions

The present study identified a significant association between osteosarcopenia and depression over 12 years of follow-up, mainly driven by sarcopenia. If future research confirms the present findings, it may then be prudent to target those with osteosarcopenia to aid in the prevention of onset depression.

背景：骨骼肌减少症（即骨质疏松症和骨骼肌减少症并存）和抑郁症在老年人中非常普遍。然而，骨骼肌减少症与老年人抑郁症之间的关系在很大程度上是未知的。因此，本研究的目的是在欧洲和以色列老年人口的代表性样本中调查这种可能的关联。方法将骨骼肌减少症定义为骨质疏松症和骨骼肌减少症并存；SHARE研究中的抑郁症状采用EURO-D量表自我报告。在12年的随访中，无抑郁症患者基线时骨骼肌减少症的存在与事件性抑郁症之间的关系通过Cox回归分析进行了分析，调整了几个基线协变量。结果共纳入16452名参与者(平均年龄63.7岁，SD 9.6；女性50.6%)。在随访期间，5056名参与者（占初始人群的31.1%）变得抑郁。受骨骼肌减少症影响的患者中有超过一半的人患上了抑郁症，而对照组中只有四分之一的人患上了抑郁症。在调整了几个潜在的基线混杂变量后，只有肌肉减少症(HR，风险比= 1.17；95% CI，置信区间1.04 ~ 1.32；p = 0.009)和骨骼肌减少症(HR = 1.27；Ci 95% 1.12-1.58；P = 0.003)与较高的抑郁风险显著相关。局限性使用人体测量方程定义肌肉减少症；用EURO-D量表来定义抑郁症。结论：本研究在12年的随访中发现骨骼肌减少症与抑郁症之间存在显著关联，主要由骨骼肌减少症引起。如果未来的研究证实了目前的发现，那么针对骨质减少症患者来帮助预防抑郁症的发作可能是谨慎的。

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引用次数: 0

Combination or sequential teriparatide for osteoporosis treatment in denosumab-users: real-world bone mineral density outcomes 联合或序贯特立帕肽治疗denosumumab使用者骨质疏松症：真实世界骨密度结果

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-28 DOI: 10.1016/j.bonr.2025.101847

Shejil KUMAR , Courtney STREETER , Michelle M. MCDONALD , Roderick J. CLIFTON- BLIGH , Matti L. GILD , Christian M. GIRGIS

The optimal osteoanabolic strategy in denosumab (Dmab)-users remains uncertain. In treatment-naïve patients, Dmab/teriparatide (TPTD) combinations result in dramatic bone mineral density (BMD) gains at the spine and hip. However, BMD outcomes with combination Dmab/TPTD have not been investigated in patients on established Dmab.

We retrospectively reviewed patients with osteoporosis at two Sydney centers between 2013 and 2023. Eligible patients were managed with Dmab immediately before ≥12-months TPTD. Patients were grouped according to whether TPTD was added to ongoing Dmab (combination) or Dmab was withheld during TPTD (sequence). BMD outcomes were assessed during TPTD.

The total cohort (N = 23; 11 = combination, 12 = sequence) had mean age 77 ± 7 years and were predominantly female (87 %). Overall, prior vertebral (52 %) and non-vertebral fractures (2.4 ± 1.5) were prevalent and pre-TPTD BMD T-scores (SD) low at lumbar spine (−2.4 ± 1.2) and total hip (−2.2 ± 0.6). Median Dmab exposure was 5-doses (IQR 3–11), median overall antiresorptive exposure was 6-years (IQR 4–11) and majority (>90 %) received 18-months TPTD. Groups were similar in age, sex, Dmab and overall antiresorptive exposure, fracture prevalence, DXA interval and pre-TPTD BMD values. Combination Dmab/TPTD was associated with significant lumbar spine BMD gains (+0.080 g/cm² ± 0.059 g/cm², p = 0.004; +9.8 %). No significant BMD change occurred during sequential Dmab/TPTD (+0.026 g/cm² ± 0.049 g/cm², p = 0.107; +3.5 %). Combination Dmab/TPTD resulted in greater lumbar spine BMD gains (p = 0.039). Hip and femoral neck BMD remained stable in both groups.

In this retrospective study, significant lumbar spine BMD gains occurred during combined Dmab/TPTD in patients on established Dmab. These results warrant prospective controlled studies to further inform optimal osteoanabolic strategies in Dmab-users.

denosumab （Dmab）使用者的最佳骨合成代谢策略仍不确定。在treatment-naïve患者中，Dmab/teriparatide （TPTD）联合治疗可显著提高脊柱和髋部骨矿物质密度（BMD）。然而，在已建立Dmab的患者中，尚未研究Dmab/TPTD联合治疗的BMD结果。我们回顾性分析了2013年至2023年间悉尼两个中心的骨质疏松症患者。符合条件的患者在TPTD≥12个月前立即接受Dmab治疗。根据是否将TPTD添加到正在进行的Dmab（联合）或在TPTD（序列）期间保留Dmab对患者进行分组。在TPTD期间评估BMD结果。总队列(N = 23；11例为合并，12例为顺序)，平均年龄77±7岁，以女性为主（87%）。总体而言，既往椎体骨折（52%）和非椎体骨折（2.4±1.5）普遍存在，tptd前BMD t评分（SD）在腰椎（- 2.4±1.2）和全髋关节（- 2.2±0.6）较低。中位Dmab暴露为5剂（IQR 3-11），中位总体抗吸收暴露为6年（IQR 4-11），大多数（> 90%）接受了18个月的TPTD。各组在年龄，性别，Dmab和总体抗吸收暴露，骨折发生率，DXA间隔和ttptd前BMD值方面相似。Dmab/TPTD联合用药可显著增加腰椎骨密度(+0.080 g/cm2±0.059 g/cm2, p = 0.004；+ 9.8%)。连续Dmab/TPTD组骨密度无显著变化(+0.026 g/cm2±0.049 g/cm2, p = 0.107；+ 3.5%)。Dmab/TPTD联合治疗导致腰椎骨密度增加（p = 0.039）。两组患者的髋关节和股骨颈骨密度均保持稳定。在这项回顾性研究中，在已建立Dmab的患者中，在Dmab/TPTD联合治疗期间，腰椎骨密度显著增加。这些结果支持前瞻性对照研究，以进一步为dmab使用者提供最佳的骨合成代谢策略。

{"title":"Combination or sequential teriparatide for osteoporosis treatment in denosumab-users: real-world bone mineral density outcomes","authors":"Shejil KUMAR , Courtney STREETER , Michelle M. MCDONALD , Roderick J. CLIFTON- BLIGH , Matti L. GILD , Christian M. GIRGIS","doi":"10.1016/j.bonr.2025.101847","DOIUrl":"10.1016/j.bonr.2025.101847","url":null,"abstract":"<div><div>The optimal osteoanabolic strategy in denosumab (Dmab)-users remains uncertain. In treatment-naïve patients, Dmab/teriparatide (TPTD) combinations result in dramatic bone mineral density (BMD) gains at the spine and hip. However, BMD outcomes with combination Dmab/TPTD have not been investigated in patients on <em>established</em> Dmab.</div><div>We retrospectively reviewed patients with osteoporosis at two Sydney centers between 2013 and 2023. Eligible patients were managed with Dmab immediately before ≥12-months TPTD. Patients were grouped according to whether TPTD was added to ongoing Dmab (<em>combination</em>) or Dmab was withheld during TPTD (<em>sequence</em>). BMD outcomes were assessed during TPTD.</div><div>The total cohort (<em>N</em> = 23; 11 = combination, 12 = sequence) had mean age 77 ± 7 years and were predominantly female (87 %). Overall, prior vertebral (52 %) and non-vertebral fractures (2.4 ± 1.5) were prevalent and pre-TPTD BMD T-scores (SD) low at lumbar spine (−2.4 ± 1.2) and total hip (−2.2 ± 0.6). Median Dmab exposure was 5-doses (IQR 3–11), median overall antiresorptive exposure was 6-years (IQR 4–11) and majority (>90 %) received 18-months TPTD. Groups were similar in age, sex, Dmab and overall antiresorptive exposure, fracture prevalence, DXA interval and pre-TPTD BMD values. Combination Dmab/TPTD was associated with significant lumbar spine BMD gains (+0.080 g/cm<sup>2</sup> ± 0.059 g/cm<sup>2</sup>, <em>p</em> = 0.004; +9.8 %). No significant BMD change occurred during sequential Dmab/TPTD (+0.026 g/cm<sup>2</sup> ± 0.049 g/cm<sup>2</sup>, <em>p</em> = 0.107; +3.5 %). Combination Dmab/TPTD resulted in greater lumbar spine BMD gains (<em>p</em> = 0.039). Hip and femoral neck BMD remained stable in both groups.</div><div>In this retrospective study, significant lumbar spine BMD gains occurred during combined Dmab/TPTD in patients on established Dmab. These results warrant prospective controlled studies to further inform optimal osteoanabolic strategies in Dmab-users.</div></div>","PeriodicalId":9043,"journal":{"name":"Bone Reports","volume":"25 ","pages":"Article 101847"},"PeriodicalIF":2.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143879309","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

A narrative review of recent developments in osseointegration and anti-corrosion of titanium dental implants with nano surface 综述了近年来纳米表面钛牙种植体的骨整合与抗腐蚀研究进展

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-24 DOI: 10.1016/j.bonr.2025.101846

Hoda Ghodrati , Ali Goodarzi , Mohammad Golrokhian , Farnaz Fattahi , Reza Mahmoudi Anzabi , Meysam Mohammadikhah , Saiedeh Sadeghi , Sabah Mirhadi

Titanium (Ti) is widely acknowledged as the top choice for constructing dental implants because of its remarkable biocompatibility and biomechanical characteristics. Its rapid oxidation in the presence of oxygen forms a protective titanium dioxide (TiO₂) layer on the implants’ surface, ensuring resistance to corrosion. This thin oxide layer plays a crucial role in establishing the favorable biocompatibility of Ti implants. However, under mechanical loading conditions, the integrity of the TiO₂ layer can be compromised through the dynamic interactions between the implant and bone tissue, leading to localized damage and subsequent corrosion. This corrosion weakens the implant and may result in the release of metallic particles or ions into the surrounding living tissues. Consequently, corrosion serves as a potential catalyst for the emergence of malfunctions in dental implants, whether biological or mechanical in nature. To address this issue, extensive research has focused on nanoscale surface modifications aimed at enhancing the durability and resistance to chemical and electrochemical changes exhibited by dental implants made from Ti. Hence, this narrative review specifically examines nano surface modifications of titanium dental implants, focusing on their effects on corrosion resistance, biomechanical performance, and osseointegration, distinguishing it from other reviews that address broader aspects of titanium implants or general corrosion mechanisms.

钛（Ti）因其卓越的生物相容性和生物力学特性而被广泛认为是构建牙种植体的首选材料。它在氧气的存在下迅速氧化，在植入物表面形成一层保护性的二氧化钛（TiO2）层，确保抗腐蚀。这种薄的氧化层对钛植入物的生物相容性起着至关重要的作用。然而，在机械载荷条件下，TiO2层的完整性会因种植体与骨组织之间的动态相互作用而受到破坏，导致局部损伤和随后的腐蚀。这种腐蚀削弱了植入物，并可能导致金属颗粒或离子释放到周围的活组织中。因此，无论是生物的还是机械的，腐蚀都是牙种植体出现故障的潜在催化剂。为了解决这一问题，广泛的研究集中在纳米级表面改性上，旨在提高钛牙种植体的耐久性和抗化学和电化学变化的能力。因此，这篇叙述性综述专门研究了钛牙种植体的纳米表面修饰，重点关注它们对耐腐蚀性、生物力学性能和骨整合的影响，将其与其他涉及钛种植体更广泛方面或一般腐蚀机制的综述区分开来。

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引用次数: 0

Artificial intelligence in pediatric osteopenia diagnosis: evaluating deep network classification and model interpretability using wrist X-rays 人工智能在儿童骨量减少诊断中的应用：利用腕部x光评估深度网络分类和模型可解释性

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-23 DOI: 10.1016/j.bonr.2025.101845

Chelsea E. Harris , Lingling Liu , Luiz Almeida , Carolina Kassick , Sokratis Makrogiannis

Osteopenia is a bone disorder that causes low bone density and affects millions of people worldwide. Diagnosis of this condition is commonly achieved through clinical assessment of bone mineral density (BMD). State of the art machine learning (ML) techniques, such as convolutional neural networks (CNNs) and transformer models, have gained increasing popularity in medicine. In this work, we employ six deep networks for osteopenia vs. healthy bone classification using X-ray imaging from the pediatric wrist dataset GRAZPEDWRI-DX. We apply two explainable AI techniques to analyze and interpret visual explanations for network decisions. Experimental results show that deep networks are able to effectively learn osteopenic and healthy bone features, achieving high classification accuracy rates. Among the six evaluated networks, DenseNet201 with transfer learning yielded the top classification accuracy at 95.2 %. Furthermore, visual explanations of CNN decisions provide valuable insight into the blackbox inner workings and present interpretable results. Our evaluation of deep network classification results highlights their capability to accurately differentiate between osteopenic and healthy bones in pediatric wrist X-rays. The combination of high classification accuracy and interpretable visual explanations underscores the promise of incorporating machine learning techniques into clinical workflows for the early and accurate diagnosis of osteopenia.

骨质疏松症是一种导致骨密度低的骨骼疾病，影响着全世界数百万人。这种情况的诊断通常通过临床评估骨矿物质密度（BMD）来实现。最先进的机器学习（ML）技术，如卷积神经网络（cnn）和变压器模型，在医学上越来越受欢迎。在这项工作中，我们使用来自儿童手腕数据集GRAZPEDWRI-DX的x射线成像，采用六个深度网络进行骨质减少与健康骨骼分类。我们应用两种可解释的人工智能技术来分析和解释网络决策的视觉解释。实验结果表明，深度网络能够有效地学习到骨质减少和健康骨骼的特征，实现了较高的分类准确率。在六个被评估的网络中，带有迁移学习的DenseNet201的分类准确率最高，达到95.2%。此外，CNN决策的可视化解释提供了对黑箱内部工作原理的有价值的见解，并提供了可解释的结果。我们对深度网络分类结果的评估强调了他们在儿童手腕x光片中准确区分骨质减少和健康骨骼的能力。高分类准确性和可解释的视觉解释的结合强调了将机器学习技术纳入临床工作流程以早期准确诊断骨质减少的前景。

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引用次数: 0

Bone mechanical loading reduces heart rate and increases heart rate variability in mice 在小鼠中，骨机械负荷降低心率并增加心率变异性

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-16 DOI: 10.1016/j.bonr.2025.101844

Julian A. Vallejo , Mark Gray , Jackson Klump , Andrew Wacker , Mark Dallas , Mark L. Johnson , Michael J. Wacker

Cardiovascular disease and osteoporosis are clinically associated. Bone adapts to mechanical forces by altering its overall structure and mass. In response to mechanical strain bone cells release signaling molecules and activate the nervous system. Bone also exhibits endocrine functions that modulate a number of tissues including the heart. We hypothesized that bone mechanical loading acutely alters cardiac function via neural and/or endocrine mechanisms. To test this hypothesis, we performed in vivo tibia mechanical loading in anesthetized mice while monitoring heart parameters using electrocardiogram (ECG). An immediate, transient reduction in resting heart rate was observed during tibial loading in both adult male and female mice (p < 0.01) with concurrent increases in heart rate variability (HRV) (p < 0.01). ECG intervals, PR, QRS and QTc were unaffected with loading. In further studies, we found that at least 3 N of load was necessary to elicit this heart response in adult mice. With aging to 11–12 months the responsiveness of the heart to loading was blunted, suggesting this bone-heart connection may weaken with age. Administration of lidocaine around the tibia significantly diminished the heart rate response to bone loading (p < 0.05). Moreover, pre-treatment with sympathetic antagonist propranolol inhibited this heart rate response to loading (p < 0.05), while parasympathetic antagonist atropine did not (p > 0.05). This suggests that a neuronal afferent pathway in the hindlimb and reduction in efferent sympathetic tone mediate this bone-neuro-heart reflex. In conclusion, the findings that tibia bone loading age-dependently modulates heart function support the concept of physiological coupling of the skeletal and cardiovascular systems.

心血管疾病和骨质疏松症在临床上是相关的。骨骼通过改变其整体结构和质量来适应机械力。作为对机械应变的反应，骨细胞释放信号分子并激活神经系统。骨骼还具有调节包括心脏在内的许多组织的内分泌功能。我们假设骨机械负荷通过神经和/或内分泌机制剧烈改变心功能。为了验证这一假设，我们对麻醉小鼠进行了体内胫骨机械负荷，同时使用心电图（ECG）监测心脏参数。在成年雄性和雌性小鼠的胫骨负荷期间，观察到静息心率立即短暂降低(p <；0.01)，同时心率变异性（HRV）增加(p <；0.01)。心电图间期、PR、QRS和QTc均不受负荷影响。在进一步的研究中，我们发现至少需要3n的负荷才能在成年小鼠中引起这种心脏反应。随着年龄增长到11-12个月，心脏对负荷的反应变得迟钝，这表明这种骨-心联系可能会随着年龄的增长而减弱。在胫骨周围施用利多卡因显著降低了对骨负荷的心率反应(p <；0.05)。此外，交感拮抗剂心得安预处理可抑制这种心率对负荷的反应(p <；0.05)，而副交感神经拮抗剂阿托品没有(p >；0.05)。这表明后肢的神经元传入通路和传出交感神经张力的减少介导了这种骨-神经-心反射。总之，胫骨骨负荷年龄依赖性调节心脏功能的研究结果支持了骨骼和心血管系统生理耦合的概念。

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引用次数: 0

A rat traumatized shoulder model for the study of post-surgical adhesions 大鼠创伤性肩关节模型的术后粘连研究

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-14 DOI: 10.1016/j.bonr.2025.101843

Yael Milgrom , Aharon S. Finestone , Charles Milgrom

A third of patients after open reduction and plating of proximal humerus fractures require subsequent plate removal principally because of adhesions which occur between the deep surface of the deltoid and fracture fixation zone and limit shoulder motion. A rat model of post-surgical shoulder adhesions was developed using a deltoid split approach commonly used in proximal humerus fracture surgery, with trauma induced by a straight diamond nasal rasp to the undersurface of the deltoid and supraspinatus tendon and adjoining proximal humerus. Using the model, the traumatized limb of 12 animals treated with an alginate mimetic injected into the wound before closure and 9 untreated animals were immobilized for 9 ± 1 days and then their passive range of shoulder flexion-extension measured, followed by histopathology examination. The total passive range of shoulder flexion-extension of 120 degrees in the alginate treated group was greater than the 84 degrees in the untreated group (p = 0.0043). The mean periosteal fibrotic capsule width in the injured area of untreated animals (515 ± 449 μm) was greater than that of animals treated with alginate (186 ± 180 μm, p = 0.003). Untreated animals had severe, grade 4 fibrosis and collagen deposition, and granulation tissue, while treated animals had mild grade 1 responses. The animal model developed produced limited shoulder motion and associated fibrotic changes. It can be used to evaluate potential treatments designed to prevent adhesions that develop after plating of proximal humeral fractures.

三分之一的肱骨近端骨折切开复位钢板后患者需要随后取下钢板，主要原因是三角肌深表面与骨折固定区之间发生粘连，限制了肩部活动。采用肱骨近端骨折手术中常用的三角肌劈开入路，建立大鼠术后肩关节粘连模型，用直菱形鼻锉对三角肌下表面、冈上肌腱和毗邻的肱骨近端造成创伤。采用该模型，在创口闭合前注射仿海藻酸盐治疗12只动物的创伤肢和未治疗的9只动物分别固定9±1 d，测量其被动屈伸幅度，并进行组织病理学检查。海藻酸盐治疗组肩关节屈伸总被动范围为120度，大于未治疗组的84度（p = 0.0043）。未治疗组损伤区骨膜纤维化囊平均宽度（515±449 μm）大于海藻酸盐组（186±180 μm, p = 0.003）。未治疗的动物有严重的4级纤维化、胶原沉积和肉芽组织，而治疗的动物有轻度的1级反应。建立的动物模型产生有限的肩部运动和相关的纤维化改变。它可用于评估预防肱骨近端骨折钢板后粘连的潜在治疗方法。

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引用次数: 0

The effect of acupuncture on reducing postoperative complications in fracture patients: A retrospective analysis using the TriNetX database 针刺对减少骨折患者术后并发症的影响：使用TriNetX数据库的回顾性分析

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-04 DOI: 10.1016/j.bonr.2025.101842

Yi-Pin Chang , Hsin-Hua Chen , Jui-Ju Tseng , Chia-I Tsai

Background

Bone fracture is a common orthopedic condition that affects millions of people worldwide. The management frequently involves surgery, which requires hospitalization. Patients with fractures often have a risk of developing complications, including pain, inflammation, infection, delayed healing, thrombosis, and organ failure. Acupuncture is widely used for conditions such as pain, respiratory issues, urinary system disorders, and gastrointestinal discomfort.

Methods

In this retrospective study, we evaluated the effectiveness of acupuncture in reducing postoperative complications in fracture patients. Using the TriNetX platform, we identified individuals hospitalized for their first fracture surgery and performed 1: 1 propensity score matching. Patients who received three or more acupuncture treatments within one week (n = 433) were compared to those who received none (n = 433), with matching based on age, sex, race, BMI, comorbidities, and medications (standardized mean differences). Postoperative complications within 180 days were analyzed using risk percentages, risk ratios, odds ratios, Kaplan-Meier analysis with log-rank tests, and hazard ratios, all reported with 95 % confidence intervals and P-values.

Results

Fourteen patients in the acupuncture group experienced respiratory failure with a risk of 3.2 %, while 29 patients in the non-acupuncture group developed respiratory failure with a risk of 6.7 %. The risk ratio was 0.48 (95 % CI 0.26–0.90) and the OR was 0.47 (95 % CI 0.24–0.89). The Kaplan-Meier analysis found a significantly higher survival probability in the acupuncture group (log-rank test P = 0.01; HR 0.44, 95%CI 0.23–0.83).

Conclusions

Acupuncture appeared to have the potential to reduce postoperative complications in bone fracture patients. Further large-scale studies are needed to provide stronger evidence.

骨骨折是一种常见的骨科疾病，影响着全世界数百万人。治疗通常包括手术，这需要住院治疗。骨折患者通常有发生并发症的风险，包括疼痛、炎症、感染、延迟愈合、血栓形成和器官衰竭。针灸被广泛用于治疗疼痛、呼吸系统疾病、泌尿系统疾病和胃肠道不适等疾病。方法回顾性研究针刺治疗骨折患者术后并发症的效果。使用TriNetX平台，我们确定了首次住院接受骨折手术的患者，并进行了1:1的倾向评分匹配。将一周内接受三次或三次以上针灸治疗的患者（n = 433）与未接受针灸治疗的患者（n = 433）进行比较，并根据年龄、性别、种族、BMI、合并症和药物进行匹配（标准化平均差异）。采用风险百分比、风险比、优势比、Kaplan-Meier log-rank检验分析和风险比分析180天内的术后并发症，所有报告的置信区间和p值均为95%。结果针刺组有14例患者发生呼吸衰竭，风险为3.2%；非针刺组有29例患者发生呼吸衰竭，风险为6.7%。风险比为0.48 (95% CI 0.26-0.90)， OR为0.47 （95% CI 0.24-0.89）。Kaplan-Meier分析发现，针刺组患者的生存率显著高于针刺组(log-rank检验P = 0.01；Hr 0.44, 95%ci 0.23-0.83)。结论针刺治疗有减少骨折患者术后并发症的潜力。需要进一步的大规模研究来提供更有力的证据。

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引用次数: 0

Ribosylation-induced increase in advanced glycation end products has limited impacts on mechanical properties in human cortical bone 核糖基化诱导的晚期糖基化终产物的增加对人类皮质骨的力学性能影响有限

IF 2.1 Q3 ENDOCRINOLOGY & METABOLISM

Bone Reports

Pub Date : 2025-04-02 DOI: 10.1016/j.bonr.2025.101841

Katelynn R. Gallagher, Olivia N. White, Andrew A. Tomaschke, Dyann M. Segvich, Joseph M. Wallace

Diabetes affects over 38 million individuals in the U.S. and is associated with a heightened risk of fractures despite normal or elevated bone mineral density (BMD). This increased fracture susceptibility may be linked to the accumulation of advanced glycation end products (AGEs), which are theorized to compromise bone quality by stiffening the collagen network, leading to tissue embrittlement. In this study, the mechanical effects of AGE accumulation in human cortical bone were evaluated in vitro. Bone beams, derived from a human femur, were incubated in a ribose solution to induce AGE accumulation, while control beams were incubated in a control solution. Dynamic Mechanical Analysis (DMA) and three-point bending tests were conducted to assess the mechanical properties of the bone beams. Fluorescent AGE analysis was performed to quantify and compare AGE levels between the groups. The study found no significant differences in mechanical properties between the control and ribose-treated groups, despite a significant elevation in normalized AGE content in the ribose group. These results suggest that AGE accumulation may have a weaker impact on the mechanical properties of human bone than previously hypothesized. However, this study emphasizes the need for further research to explore the relationship between AGE accumulation and bone quality. Understanding this relationship is crucial for developing strategies to reduce fracture risk in populations with high AGE levels, such as diabetic and elderly individuals.

在美国，糖尿病影响着超过3800万人，尽管骨密度（BMD）正常或升高，但糖尿病与骨折风险增加有关。这种增加的骨折易感性可能与晚期糖基化终产物（AGEs）的积累有关，理论上，AGEs会通过硬化胶原网络而损害骨质量，导致组织脆化。在本研究中，我们在体外评估了AGE在人皮质骨中蓄积的力学效应。来源于人股骨的骨梁在核糖溶液中孵育以诱导AGE积累，而对照梁在对照溶液中孵育。通过动态力学分析（DMA）和三点弯曲试验来评估骨梁的力学性能。采用荧光AGE分析来量化和比较各组之间的AGE水平。研究发现，尽管核糖组的标准化AGE含量显著升高，但对照组和核糖处理组之间的机械性能没有显著差异。这些结果表明，AGE的积累对人体骨骼力学性能的影响可能比先前假设的要弱。然而，本研究强调需要进一步研究AGE积累与骨质量的关系。了解这种关系对于制定策略来降低高AGE水平人群（如糖尿病和老年人）的骨折风险至关重要。

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引用次数: 0