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The Relationship between Sclerostin and Kidney Transplantation Mineral Bone Disorders: A Molecule of Controversies. 硬骨蛋白与肾移植矿物质骨病的关系:充满争议的分子。
IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-07-30 DOI: 10.1007/s00223-024-01261-w
Baris Afsar, Rengin Elsurer Afsar, Yasar Caliskan, Krista L Lentine

Kidney transplantation is the most effective treatment option for most patients with end-stage kidney disease due to reduced mortality, decreased cardiovascular events and increased quality of life compared to patients treated with dialysis. However, kidney transplantation is not devoid of both acute and chronic complications including mineral bone disorders (MBD) which are already present in patients with chronic kidney disease (CKD) before kidney transplantation. The natural history of MBD after kidney transplantation is variable and new markers are needed to define MBD after kidney transplantation. One of these promising molecules is sclerostin. The main action of sclerostin is to inhibit bone formation and mineralization by blocking osteoblast differentiation and function. In kidney transplant recipients (KTRs), various studies have shown that sclerostin is associated with graft function, bone parameters, vascular calcification, and arterial stiffness although non-uniformly. Furthermore, data for inhibition of sclerostin with monoclonal antibody romosozumab for treatment of osteoporosis is available for general population but not in KTRs which osteoporosis is highly prevalent. In this narrative review, we have summarized the studies investigating the change of sclerostin before and after kidney transplantation, the relationship between sclerostin and laboratory parameters, bone metabolism and vascular calcification in the context of kidney transplantation. We also pointed out the uncertainties, explained the causes of divergent findings and suggest further potential study topics regarding sclerostin in kidney transplantation.

与接受透析治疗的患者相比,肾移植可降低死亡率、减少心血管事件并提高生活质量,因此是大多数终末期肾病患者最有效的治疗选择。然而,肾移植并非没有急性和慢性并发症,其中包括肾移植前慢性肾病(CKD)患者已经存在的矿物质骨病(MBD)。肾移植后矿物质骨病的自然史是多变的,因此需要新的标志物来确定肾移植后的矿物质骨病。硬骨蛋白是其中一种很有前景的分子。硬骨素的主要作用是通过阻断成骨细胞的分化和功能来抑制骨形成和矿化。在肾移植受者(KTR)中,各种研究表明,硬骨素与移植物功能、骨参数、血管钙化和动脉僵化有关,但并不一致。此外,使用单克隆抗体罗莫索单抗抑制硬骨蛋白以治疗骨质疏松症的数据适用于普通人群,但不适用于骨质疏松症高发的 KTR。在这篇综述中,我们总结了有关肾移植前后硬骨素变化、硬骨素与实验室指标的关系、肾移植背景下的骨代谢和血管钙化的研究。我们还指出了其中的不确定性,解释了研究结果存在分歧的原因,并就肾移植中硬骨素的潜在研究课题提出了建议。
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引用次数: 0
3D U-Net Neural Network Architecture-Assisted LDCT to Acquire Vertebral Morphology Parameters: A Vertebral Morphology Comprehensive Analysis in a Chinese Population. 三维 U-Net 神经网络架构辅助 LDCT 获取椎体形态参数:中国人群椎体形态综合分析》。
IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-07-17 DOI: 10.1007/s00223-024-01255-8
Duoshan Ma, Yan Wang, Xinxin Zhang, Danyang Su, Mengze Ma, Baoxin Qian, Xiaopeng Yang, Jianbo Gao, Yan Wu

To evaluate the feasibility of acquiring vertebral height from chest low-dose computed tomography (LDCT) images using an artificial intelligence (AI) system based on 3D U-Net vertebral segmentation technology and the correlation and features of vertebral morphology with sex and age of the Chinese population. Patients who underwent chest LDCT between September 2020 and April 2023 were enrolled. The Altman and Pearson's correlation analyses were used to compare the correlation and consistency between the AI software and manual measurement of vertebral height. The anterior height (Ha), middle height (Hm), posterior height (Hp), and vertebral height ratios (VHRs) (Ha/Hp and Hm/Hp) were measured from T1 to L2 using an AI system. The VHR is the ratio of Ha to Hp or the ratio of Hm to Hp of the vertebrae, which can reflect the shape of the anterior wedge and biconcave vertebrae. Changes in these parameters, particularly the VHR, were analysed at different vertebral levels in different age and sex groups. The results of the AI methods were highly consistent and correlated with manual measurements. The Pearson's correlation coefficients were 0.855, 0.919, and 0.846, respectively. The trend of VHRs showed troughs at T7 and T11 and a peak at T9; however, Hm/Hp showed slight fluctuations. Regarding the VHR, significant sex differences were found at L1 and L2 in all age bands. This innovative study focuses on vertebral morphology for opportunistic analysis in the mainland Chinese population and the distribution tendency of vertebral morphology with ageing using a chest LDCT aided by an AI system based on 3D U-Net vertebral segmentation technology. The AI system demonstrates the potential to automatically perform opportunistic vertebral morphology analyses using LDCT scans obtained during lung cancer screening. We advocate the use of age-, sex-, and vertebral level-specific criteria for the morphometric evaluation of vertebral osteoporotic fractures for a more accurate diagnosis of vertebral fractures and spinal pathologies.

目的 评估利用基于三维 U-Net 椎体分割技术的人工智能(AI)系统从胸部低剂量计算机断层扫描(LDCT)图像中获取椎体高度的可行性,以及中国人群椎体形态与性别和年龄的相关性和特征。研究对象为 2020 年 9 月至 2023 年 4 月期间接受胸部 LDCT 检查的患者。采用 Altman 和 Pearson 相关性分析比较人工智能软件和人工测量椎体高度的相关性和一致性。使用人工智能系统测量了从 T1 到 L2 的椎体前高(Ha)、椎体中高(Hm)、椎体后高(Hp)和椎体高度比(VHRs)(Ha/Hp 和 Hm/Hp)。VHR 是椎体 Ha 与 Hp 的比值或 Hm 与 Hp 的比值,可以反映椎体前楔和双凹的形状。这些参数的变化,尤其是 VHR 的变化,在不同年龄和性别组的不同椎体水平上进行了分析。人工智能方法的结果与人工测量结果高度一致和相关。皮尔逊相关系数分别为 0.855、0.919 和 0.846。VHR 的变化趋势在 T7 和 T11 出现低谷,在 T9 出现高峰;但 Hm/Hp 则略有波动。关于 VHR,在所有年龄段的 L1 和 L2 发现了明显的性别差异。这项创新性研究利用胸部 LDCT,在基于三维 U-Net 椎体分割技术的人工智能系统的辅助下,重点研究了中国大陆人群中用于机会分析的椎体形态,以及椎体形态随年龄增长的分布趋势。该人工智能系统展示了利用肺癌筛查中获得的 LDCT 扫描自动执行机会性椎体形态分析的潜力。我们提倡使用年龄、性别和椎体水平特异性标准对椎体骨质疏松性骨折进行形态学评估,以便更准确地诊断椎体骨折和脊柱病变。
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引用次数: 0
Association Between Dietary Acid Load and Grip Strength in Adults 50 Years and Older: A Cross-Sectional Study. 50 岁及以上成年人膳食酸负荷与握力之间的关系:一项横断面研究
IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-10-01 Epub Date: 2024-07-24 DOI: 10.1007/s00223-024-01258-5
Elsa M Konieczynski, Lisa Ceglia, Elise Reitshamer, Bess Dawson-Hughes

Minimal data exist on whether the acid-base balance of the diet is linked to muscle strength. The aim of this study was to determine if dietary acid load is associated with grip strength in a nationally representative sample of middle- to older-age adults. We examined the cross-sectional association of grip strength with dietary acid load quantified through potential renal acid load (PRAL) and net endogenous acid production (NEAP) in 4,059 adults aged 50 years and older in the 2011-2014 NHANES survey cycles. PRAL and NEAP were estimated from two 24-h recalls and categorized into sex-specific quartiles. Grip strength was measured on a dynamometer. Multiple linear regression models were used to determine the associations of PRAL and NEAP (as quartiles) with grip strength for men and women separately, adjusting for total energy, age, race/ethnicity, weight, physical activity, smoking, serum 25-hydroxyvitamin D, and estimated glomerular filtration rate. Mean grip strength was 26.8 ± 0.2 kg in women and 43.0 ± 0.4 kg in men. Adjusted grip strength was inversely associated with quartiles of PRAL (ptrend = 0.049) and NEAP (ptrend = 0.034) in women with quartile 4 vs 1 differences of - 1.21 and - 1.08 kg (both p < 0.05), respectively. Adjusted grip strength was not associated with PRAL or NEAP in men. Overall, we found inverse associations between dietary acid load and grip strength in middle- and older-age women, suggesting that an alkaline diet may be important in maintaining muscle strength in this population. There was no association between dietary acid load and grip strength in men.

关于饮食酸碱平衡是否与肌肉力量有关的数据极少。本研究旨在确定具有全国代表性的中老年人样本中的膳食酸负荷是否与握力有关。我们研究了 2011-2014 年 NHANES 调查周期中 4059 名 50 岁及以上成年人的握力与膳食酸负荷(通过潜在肾酸负荷(PRAL)和内源性净产酸量(NEAP)量化)之间的横断面关联。PRAL和NEAP是通过两次24小时回忆估算得出的,并按性别分为四等分。握力是通过测力计测量的。采用多元线性回归模型分别确定男性和女性的 PRAL 和 NEAP(作为四分位数)与握力的关系,并对总能量、年龄、种族/民族、体重、体力活动、吸烟、血清 25- 羟维生素 D 和估计肾小球滤过率进行调整。女性的平均握力为 26.8 ± 0.2 千克,男性为 43.0 ± 0.4 千克。调整后的握力与女性的 PRAL 四分位数(ptrend = 0.049)和 NEAP 四分位数(ptrend = 0.034)成反比,四分位数 4 与四分位数 1 的差异分别为 - 1.21 千克和 - 1.08 千克(均为 p
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引用次数: 0
Zebrafish Models for Skeletal and Extraskeletal Osteogenesis Imperfecta Features: Unveiling Pathophysiology and Paving the Way for Drug Discovery. 骨骼和骨骼外骨发育不全特征的斑马鱼模型:揭示病理生理学,为药物发现铺平道路。
IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-25 DOI: 10.1007/s00223-024-01282-5
Cecilia Masiero, Carla Aresi, Antonella Forlino, Francesca Tonelli

In the last decades, the easy genetic manipulation, the external fertilization, the high percentage of homology with human genes and the reduced husbandry costs compared to rodents, made zebrafish a valid model for studying human diseases and for developing new therapeutical strategies. Since zebrafish shares with mammals the same bone cells and ossification types, it became widely used to dissect mechanisms and possible new therapeutic approaches in the field of common and rare bone diseases, such as osteoporosis and osteogenesis imperfecta (OI), respectively. OI is a heritable skeletal disorder caused by defects in gene encoding collagen I or proteins/enzymes necessary for collagen I synthesis and secretion. Nevertheless, OI patients can be also characterized by extraskeletal manifestations such as dentinogenesis imperfecta, muscle weakness, cardiac valve and pulmonary abnormalities and skin laxity. In this review, we provide an overview of the available zebrafish models for both dominant and recessive forms of OI. An updated description of all the main similarities and differences between zebrafish and mammal skeleton, muscle, heart and skin, will be also discussed. Finally, a list of high- and low-throughput techniques available to exploit both larvae and adult OI zebrafish models as unique tools for the discovery of new therapeutic approaches will be presented.

在过去的几十年中,斑马鱼因其易于遗传操作、体外受精、与人类基因同源性高以及与啮齿类动物相比饲养成本低等特点,成为研究人类疾病和开发新治疗策略的有效模型。由于斑马鱼与哺乳动物具有相同的骨细胞和骨化类型,因此被广泛用于研究常见和罕见骨病(如骨质疏松症和成骨不全症(OI))的发病机制和可能的新治疗方法。成骨不全症是一种遗传性骨骼疾病,由编码胶原蛋白 I 或合成和分泌胶原蛋白 I 所必需的蛋白质/酶的基因缺陷引起。然而,OI 患者也可能有骨骼以外的表现,如牙本质发育不全、肌肉无力、心脏瓣膜和肺部异常以及皮肤松弛。在这篇综述中,我们概述了现有的显性和隐性OI斑马鱼模型。此外,还将讨论斑马鱼与哺乳动物骨骼、肌肉、心脏和皮肤之间所有主要异同点的最新描述。最后,还将介绍一系列高通量和低通量技术,这些技术可用于将 OI 斑马鱼幼体和成体模型作为发现新治疗方法的独特工具。
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引用次数: 0
Higher Plasma Copper Exposure was Adversely Associated with Skeletal Muscle Indicators in Chinese Children Aged 6–9 Years: A Cross-Sectional Study 中国 6-9 岁儿童较高的血浆铜暴露量与骨骼肌指标呈负相关:一项横断面研究
IF 4.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1007/s00223-024-01287-0
Jie Xu, Jing Lan, Qiaoting Huang, Abubakar Tarawally, Lan Huang, Zheqing Zhang, Gengdong Chen

It is unclear whether blood concentrations of copper (Cu), magnesium (Mg), and calcium (Ca) influence skeletal muscle mass and strength in children. We aimed to explore the associations between plasma Cu, Mg, and Ca and skeletal muscle indicators in Chinese children. A total of 452 children aged 6 to 9 years old were recruited for this cross-sectional study. Whole body lean soft tissue mass (WLSTM), trunk lean soft tissue mass (TLSTM), and appendicular skeletal muscle mass (ASMM) were measured using dual-energy X-ray absorptiometry. Parameters of these indicators divided by Height2 (Ht2) and Weight (Wt) at the corresponding sites were calculated. Handgrip strength was also measured. Parameters of skeletal muscle indicators and handgrip strength that were below the sex-specific 20th percentile were considered low levels. Plasma concentrations of Cu, Mg, and Ca were measured using ICP-MS. After adjusting for several potential covariates, among the total subjects, for every one standard deviation increase in Cu concentrations, there was a 0.939% decrease in WLSTM/Wt, a 0.415% decrease in TLSTM/Wt, and a 0.47% decrease in ASMM/Wt. For every one standard deviation increase in Cu concentrations, there was a higher odd (OR: 1.36, 95%CI 1.06, 1.75) of low WLSTM/Wt, TLSTM/Wt (OR: 1.33, 95%CI 1.03, 1.71), ASMM/Ht2 (OR: 1.32, 95%CI 1.02, 1.69), as well as ASMM/Wt (OR: 1.56, 95%CI 1.23, 1.99). No significant associations were found between Mg, Ca, and most skeletal muscle indicators. Higher plasma Cu concentrations were adversely associated with skeletal muscle indicators at multiple sites in Chinese children.

目前尚不清楚血液中铜(Cu)、镁(Mg)和钙(Ca)的浓度是否会影响儿童骨骼肌的质量和力量。我们旨在探讨中国儿童血浆中铜、镁和钙与骨骼肌指标之间的关系。这项横断面研究共招募了 452 名 6 至 9 岁的儿童。研究采用双能 X 射线吸收测量法测量了全身瘦软组织质量(WLSTM)、躯干瘦软组织质量(TLSTM)和附属骨骼肌质量(ASMM)。计算出这些指标的参数除以相应部位的身高2(Ht2)和体重(Wt)。此外,还测量了握力。骨骼肌指标和手握力的参数如果低于性别百分位数的 20%,则被视为低水平。使用 ICP-MS 测量了血浆中铜、镁和钙的浓度。在对几个潜在的协变量进行调整后,在所有受试者中,铜浓度每增加一个标准差,WLSTM/Wt 就下降 0.939%,TLSTM/Wt 下降 0.415%,ASMM/Wt 下降 0.47%。铜浓度每增加一个标准差,WLSTM/Wt、TLSTM/Wt(OR:1.33,95%CI 1.03,1.71)、ASMM/Ht2(OR:1.32,95%CI 1.02,1.69)以及 ASMM/Wt (OR:1.56,95%CI 1.23,1.99)偏低的几率就会增加(OR:1.36,95%CI 1.06,1.75)。在镁、钙和大多数骨骼肌指标之间没有发现明显的关联。在中国儿童的多个部位,较高的血浆铜浓度与骨骼肌指标存在不利关系。
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引用次数: 0
Dental Abnormalities in Osteogenesis Imperfecta: A Systematic Review 成骨不全症的牙齿异常:系统综述
IF 4.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-18 DOI: 10.1007/s00223-024-01293-2
Laura Ventura, Sara J. E. Verdonk, Lidiia Zhytnik, Angela Ridwan-Pramana, Marjolijn Gilijamse, Willem H. Schreuder, Kirsten A. van Gelderen-Ziesemer, Ton Schoenmaker, Dimitra Micha, Elisabeth M. W. Eekhoff

Osteogenesis imperfecta (OI) is a rare genetic disorder characterized by fragile bones and skeletal deformities. Individuals with OI may have dental abnormalities such as dentinogenesis imperfecta (DI) type I, malocclusions, and unerupted or missing teeth. This review comprehensively examines these dental abnormalities to assess their prevalence among the OI population and explore potential differences across different clinical types of OI and pathogenic variants. In accordance with the PRISMA guidelines, a systematic literature search in PubMed, Embase, and Web of Science was conducted that included articles up to June 2024. Out of 672 articles screened, 34 were included. The included studies confirmed that dental abnormalities are prevalent in OI, with DI prevalence ranging from approximately 20 to 48%. Those with a more severe skeletal phenotype (OI type III/IV) exhibited more dental abnormalities than those with a milder skeletal phenotype (OI type I). Notably, OI type V individuals generally do not have DI, although a few isolated cases have been reported. The prevalence of occlusion types varied: Class I occlusion ranged from 14.8 to 50% and Class II malocclusion ranged from 0 to 37.5%, while Class III malocclusion from 4.1 to 84%. This differs from the general population, where Class III malocclusion is typically the least common. Open bites, cross-bites, and unerupted and missing teeth are also commonly reported, particularly in OI types III and IV. This review emphasizes the need for comprehensive dental examinations in OI due to the high prevalence of dental abnormalities. Additionally, the review draws attention to the lack of clear guidelines for diagnosing DI.

成骨不全症(OI)是一种罕见的遗传性疾病,以骨骼脆弱和骨骼畸形为特征。OI 患者可能有牙科异常,如牙本质发育不全(DI)I 型、畸形、牙齿不齐或缺失。本综述全面研究了这些牙齿异常,以评估其在 OI 患者中的发病率,并探讨不同临床类型的 OI 和致病变体之间的潜在差异。根据 PRISMA 指南,我们在 PubMed、Embase 和 Web of Science 中进行了系统的文献检索,包括截至 2024 年 6 月的文章。在筛选出的 672 篇文章中,有 34 篇被纳入。所纳入的研究证实,牙齿异常在 OI 中很普遍,DI 患病率约为 20% 到 48%。骨骼表型较重(OI III/IV 型)的患者比骨骼表型较轻(OI I 型)的患者表现出更多的牙齿异常。值得注意的是,OI V 型患者一般没有 DI,但也有少数个别病例的报道。闭塞类型的发病率各不相同:I 类咬合从 14.8%到 50%不等,II 类错牙合从 0%到 37.5%不等,III 类错牙合从 4.1%到 84%不等。这与普通人群不同,在普通人群中,III类咬合不正通常是最不常见的。开合咬合、交叉咬合、牙齿未畸形和缺失也是常见报告,尤其是在 OI III 和 IV 型中。本综述强调,由于牙齿畸形的高发率,有必要对 OI 患者进行全面的牙科检查。此外,该综述还提请注意缺乏诊断 DI 的明确指南。
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引用次数: 0
Irisin Ameliorates Muscle Atrophy by Inhibiting the Upregulation of the Ubiquitin‒Proteasome System in Chronic Kidney Disease 鸢尾素通过抑制慢性肾病患者泛素-蛋白酶体系统的上调改善肌肉萎缩状况
IF 4.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-16 DOI: 10.1007/s00223-024-01283-4
Shiyuan Wang, Yajing Pan, Qi Pang, Aihua Zhang

Muscle atrophy is a common complication of chronic kidney disease (CKD). Irisin, a novel muscle cytokine, protects against muscle atrophy, but its specific role in CKD-associated muscle atrophy requires further elucidation. Because the ubiquitin–proteasome system (UPS) plays an important role in CKD muscle atrophy, our study will explore whether irisin affects UPS and alleviate CKD-associated muscle atrophy. In this study, an adenine-fed mouse model of CKD and urotension II (UII)-induced C2C12 myotubes were used as in vivo and in vitro models of muscle atrophy. The results showed that renal function, mouse weight, and the cross-sectional area (CSA) of skeletal muscles were significantly improved in CKD mice treated with irisin. Moreover, irisin effectively mitigated the decreases in phosphorylated Forkhead box O 3a (p-FOXO3A) levels and increases in the levels of E3 ubiquitin ligases, such as muscle RING finger 1 (MuRF1) and muscle atrophy F-box (MAFbx/atrogin1), in both the muscles of CKD mice and UII-induced C2C12 myotubes. In addition, irisin significantly increased the expression levels of myogenic differentiation factor D (MyoD) in the muscles of CKD mice. Our study is the first to demonstrate that irisin ameliorates skeletal muscle atrophy by inhibiting UPS upregulation and improving satellite cell differentiation in CKD.

肌肉萎缩是慢性肾脏病(CKD)的常见并发症。鸢尾素是一种新型肌肉细胞因子,能防止肌肉萎缩,但它在 CKD 相关肌肉萎缩中的具体作用还需要进一步阐明。由于泛素-蛋白酶体系统(UPS)在 CKD 肌肉萎缩中发挥着重要作用,我们的研究将探讨鸢尾素是否会影响 UPS 并减轻 CKD 相关肌肉萎缩。本研究采用腺嘌呤喂养的 CKD 小鼠模型和尿张力Ⅱ(UII)诱导的 C2C12 肌管作为肌肉萎缩的体内和体外模型。结果表明,使用鸢尾素治疗的 CKD 小鼠的肾功能、小鼠体重和骨骼肌横截面积(CSA)均有明显改善。此外,鸢尾素还能有效缓解CKD小鼠肌肉和UII诱导的C2C12肌管中磷酸化叉头盒O 3a(p-FOXO3A)水平的下降和E3泛素连接酶(如肌肉RING指1(MuRF1)和肌肉萎缩F-box(MAFbx/atrogin1))水平的升高。此外,鸢尾素还能显著提高 CKD 小鼠肌肉中肌生成分化因子 D(MyoD)的表达水平。我们的研究首次证明了鸢尾素能通过抑制 UPS 上调和改善 CKD 中卫星细胞的分化来改善骨骼肌的萎缩。
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引用次数: 0
Sex-Specific Association of Clinical Parameters and Components of Femoral Bone Quality in Patients Undergoing Total Hip Arthroplasty 全髋关节置换术患者临床参数与股骨骨质成分的性别特异性关联
IF 4.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-14 DOI: 10.1007/s00223-024-01286-1
Assil-Ramin Alimy, Maximilian Lenard Thiessen, André Strahl, Christoph Kolja Boese, Simon von Kroge, Frank Timo Beil, Tim Rolvien, Christian Ries

Poor bone quality is a critical factor associated with an increased risk of complications after total hip arthroplasty (THA). However, no consistent recommendations have yet been established for assessing indicators of bone quality preoperatively. Thus, it remains unclear which preoperatively available and readily accessible parameters are most closely associated with femoral bone quality. Here, we obtained femoral neck specimens from 50 patients undergoing THA. Preoperative Dual-energy X-ray absorptiometry (DXA) scans, pelvic radiographs, and laboratory parameters were analyzed. In the obtained specimens, bone microstructure was assessed using micro-CT and histomorphometry. Additionally, matrix mineralization and osteocyte lacunar morphology were evaluated using quantitative backscattered electron imaging. Our analysis revealed that DXA-derived T-scores correlated with trabecular microstructure. Furthermore, radiographic indices and body mass index correlated differentially with aspects of bone quality in women and men. Contrary to previous observations, no correlation was found between serum vitamin D levels and osteoid indices, nor between clinical parameters and matrix mineralization. Age was strongly associated with the number of mineralized osteocyte lacunae, a factor that appeared to be independent of sex. Taken together, our study demonstrates that no single preoperatively available parameter exhibits a strong and consistent association with femoral bone quality. However, DXA remains a reliable preoperative measure for determining the trabecular microstructure of the femoral neck. In clinical practice, surgeons should adopt an individualized approach to preoperative assessments by considering age, sex, BMI, and radiographic indices to enhance their insight into femoral bone quality, particularly when DXA is unavailable.

骨质差是导致全髋关节置换术(THA)后并发症风险增加的关键因素。然而,对于术前评估骨质量指标,目前还没有一致的建议。因此,目前仍不清楚哪些术前可用且容易获得的参数与股骨头质量最密切相关。在此,我们从 50 名接受 THA 的患者身上获取了股骨颈标本。对术前双能 X 射线吸收测量(DXA)扫描、骨盆X光片和实验室参数进行了分析。在获得的标本中,使用显微 CT 和组织形态学评估了骨的微观结构。此外,还使用定量反向散射电子成像技术对基质矿化和骨细胞裂隙形态进行了评估。我们的分析表明,DXA得出的T值与骨小梁微结构相关。此外,放射指数和体重指数与女性和男性骨质的相关性也不同。与之前的观察结果相反,血清维生素 D 水平与骨质指数之间以及临床参数与基质矿化之间均未发现相关性。年龄与矿化骨细胞裂隙的数量密切相关,这一因素似乎与性别无关。综上所述,我们的研究表明,没有一个术前可用的参数与股骨头质量有强烈而一致的关联。然而,DXA仍然是确定股骨颈骨小梁微结构的可靠术前指标。在临床实践中,外科医生应采用个体化的术前评估方法,考虑年龄、性别、体重指数和影像学指标,以提高他们对股骨头质量的洞察力,尤其是在无法使用DXA的情况下。
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引用次数: 0
Osteocyte Sptbn1 Deficiency Alters Cell Survival and Mechanotransduction Following Formation of Plasma Membrane Disruptions (PMD) from Mechanical Loading 骨细胞 Sptbn1 基因缺陷会改变细胞存活率和机械负荷形成质膜破坏 (PMD) 后的机械传导性
IF 4.2 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-14 DOI: 10.1007/s00223-024-01285-2
Mackenzie L. Hagan, Anik Tuladhar, Kanglun Yu, Dima W. Alhamad, Husam Bensreti, Jennifer Dorn, Victor M. Piedra, Nicholas Cantu, Eric G. Stokes, Daniel Blumenthal, Rachel L. Roberts, Vanshika Balayan, Sarah M. Bass, Thomas Dickerson, Anabel Liyen Cartelle, Marlian Montesinos-Cartagena, Mohamed E. Awad, Alberto A. Castro, Theodore Garland, Marion A. Cooley, Maribeth Johnson, Mark W. Hamrick, Paul L. McNeil, Meghan E. McGee-Lawrence

We and others have shown that application of high-level mechanical loading promotes the formation of transient plasma membrane disruptions (PMD) which initiate mechanotransduction. We hypothesized that increasing osteocyte cell membrane fragility, by disrupting the cytoskeleton-associated protein β2-spectrin (Sptbn1), could alter osteocytic responses and bone adaptation to loading in a PMD-related fashion. In MLO-Y4 cells, treatment with the spectrin-disrupting agent diamide or knockdown of Sptbn1 via siRNA increased the number of PMD formed by fluid shear stress. Primary osteocytes from an osteocyte-targeted DMP1-Cre Sptbn1 conditional knockout (CKO) model mimicked trends seen with diamide and siRNA treatment and suggested the creation of larger PMD, which repaired more slowly, for a given level of stimulus. Post-wounding cell survival was impaired in all three models, and calcium signaling responses from the wounded osteocyte were mildly altered in Sptbn1 CKO cultures. Although Sptbn1 CKO mice did not demonstrate an altered skeletal phenotype as compared to WT littermates under baseline conditions, they showed a blunted increase in cortical thickness when subjected to an osteogenic tibial loading protocol as well as evidence of increased osteocyte death (increased lacunar vacancy) in the loaded limb after 2 weeks of loading. The impaired post-wounding cell viability and impaired bone adaptation seen with Sptbn1 disruption support the existence of an important role for Sptbn1, and PMD formation, in osteocyte mechanotransduction and bone adaptation to mechanical loading.

我们和其他人已经证明,施加高水平的机械负荷会促进瞬时质膜破坏(PMD)的形成,从而启动机械传导。我们假设,通过破坏细胞骨架相关蛋白β2-谱蛋白(Sptbn1)来增加成骨细胞细胞膜的脆性,可能会以与PMD相关的方式改变成骨细胞的反应和骨对负荷的适应性。在 MLO-Y4 细胞中,用谱蛋白破坏剂二酰胺处理或通过 siRNA 敲除 Sptbn1 会增加流体剪切应力形成的 PMD 数量。来自骨细胞靶向 DMP1-Cre Sptbn1 条件性基因敲除(CKO)模型的原代骨细胞模拟了二硫化物和 siRNA 处理的趋势,并表明在一定程度的刺激下会形成更大的 PMD,修复速度更慢。在所有三种模型中,创伤后细胞存活都受到了影响,在 Sptbn1 CKO 培养物中,来自创伤骨细胞的钙信号反应发生了轻微改变。虽然在基线条件下,Sptbn1 CKO小鼠与WT同窝鼠相比没有表现出骨骼表型的改变,但在接受成骨性胫骨加载方案时,它们的皮质厚度增加缓慢,而且在加载2周后,有证据表明加载肢体的骨细胞死亡增加(空洞增加)。Sptbn1破坏后出现的伤口后细胞存活率降低和骨适应性减弱的现象证明,Sptbn1和PMD的形成在骨细胞机械传导和骨对机械加载的适应中发挥着重要作用。
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引用次数: 0
Bone Quality and Mineralization and Effects of Treatment in Osteogenesis Imperfecta. 成骨不全症的骨质和矿化以及治疗效果
IF 3.3 3区 医学 Q2 ENDOCRINOLOGY & METABOLISM Pub Date : 2024-09-04 DOI: 10.1007/s00223-024-01263-8
Barbara M Misof, Nadja Fratzl-Zelman

Osteogenesis imperfecta (OI) is a rare congenital bone dysplasia characterized by high fracture rates and broad variations in clinical manifestations ranging from mild to increasingly severe and perinatal lethal forms. The underlying mutations affect either the synthesis or processing of the type I procollagen molecule itself or proteins that are involved in the formation and mineralization of the collagen matrix. Consequently, the collagen forming cells, the osteoblasts, become broadly dysfunctional in OI. Strikingly, hypermineralized bone matrix seems to be a frequent feature in OI, despite the variability in clinical severity and mutations in the so far studied different forms of human OI. While the causes of the increased mineral content of the bone matrix are not fully understood yet, there is evidence that the descendants of the osteoblasts, the osteocytes, which play a critical role not only in bone remodeling, but also in mineralization and sensing of mechanical loads, are also highly dysregulated and might be of major importance in the pathogenesis of OI. In this review article, we firstly summarize findings of cellular abnormalities in osteoblasts and osteocytes, alterations of the organic matrix, as well as of the microstructural organization of bone. Secondly, we focus on the hypermineralization of the bone matrix in OI as observed in several different forms of human OI as well as in animal models, its measurement and potential mechanical implications and its effect on the bone mineral density measured by dual X-ray absorptiometry. Thirdly, we give an overview of established medication treatments of OI and new approaches with a focus of their known or possible effects on the bone material, particularly on bone matrix mineralization.

成骨不全症(OI)是一种罕见的先天性骨发育不良症,其特点是骨折率高,临床表现差异大,从轻微到越来越严重,甚至围产期致死。潜在的基因突变会影响 I 型胶原蛋白分子本身或参与胶原基质形成和矿化的蛋白质的合成或加工。因此,在 OI 中,胶原形成细胞--成骨细胞--会出现广泛的功能障碍。令人震惊的是,尽管迄今研究的不同形式的人类 OI 在临床严重程度和突变方面存在差异,但高矿化骨基质似乎是 OI 的一个常见特征。虽然骨基质矿物质含量增加的原因尚未完全明了,但有证据表明,成骨细胞的后代--骨细胞在骨重塑、矿化和感知机械负荷方面发挥着关键作用,它们也受到了严重的调控,可能在 OI 的发病机制中起着重要作用。在这篇综述文章中,我们首先总结了成骨细胞和骨细胞的细胞异常、有机基质的改变以及骨的微观结构组织的研究结果。其次,我们重点讨论了在几种不同形式的人类 OI 和动物模型中观察到的 OI 骨基质的高矿化、其测量和潜在的机械影响,以及其对通过双 X 射线吸收测量法测量的骨矿物质密度的影响。第三,我们概述了治疗骨质疏松症的现有药物疗法和新方法,重点介绍了这些疗法对骨材料,特别是骨基质矿化的已知或可能影响。
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引用次数: 0
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Calcified Tissue International
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