Abstract
BackgroundPsychological stress is associated with postmenopausal osteoporosis. However, the underlying mechanism of stress-related brain neural activity with osteoporosis is not fully elucidated. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to evaluate the metabolic activity of brain amygdala, a region involved in stress. We aimed to evaluate the relationship between metabolic activity of amygdala (AmygA) and osteoporosis in postmenopausal women.Materials and MethodsA total of 115 postmenopausal women who underwent 18F-FDG PET/CT and dual-energy X-ray absorptiometry for routine health screening were enrolled in this study. AmygA was defined as the maximum standardized uptake value (SUVmax) of amygdala divided by the mean SUV of temporal lobe. The levels of psychological stress were measured using the Psychosocial Well-being Index-Short Form (PWI-SF).ResultsThe participants with osteoporosis exhibited significantly higher AmygA than without osteoporosis (0.81 ± 0.16 vs. 0.61 ± 0.13, p < 0.001). The AmygA value of 0.69 was suggested as an optimal cut-off value to identify participant with osteoporosis (sensitivity; 79.1%, specificity; 83.3%, area under the curve; 0.841, p < 0.001). Furthermore, AmygA showed significant association with osteoporosis in postmenopausal woman by multivariate analysis. Psychological stress scale (PWI-SF) was well correlated with AmygA and AmygA was highest in high stress risk-, intermediate in moderate stress risk-, and lowest in healthy group.ConclusionsAmygA measured by 18F-FDG PET/CT is associated with osteoporosis in postmenopausal women. Our results provide the possibility that stress-related neurobiological activity involving amygdala is linked with postmenopausal osteoporosis.
Highlights
Osteoporosis is a common metabolic bone disease, postmenopausal women, characterized by low bone mineral density (BMD) and deterioration of micro-architectural bone tissue thereby reducing bone mass and strength, which collectively lead to increased susceptibility to fracture [1, 2]
We aimed to investigate whether the AmygA assessed by 18F-FDG PET/CT is associated with osteoporosis and the levels of psychological stress in postmenopausal women
Unlike to Amyg SUVmax, only AmygA was significantly positively correlated with the level of high-sensitivity C-reactive protein (hsCRP), which is a surrogate marker of systemic inflammation
Summary
Osteoporosis is a common metabolic bone disease, postmenopausal women, characterized by low bone mineral density (BMD) and deterioration of micro-architectural bone tissue thereby reducing bone mass and strength, which collectively lead to increased susceptibility to fracture [1, 2]. Accumulating evidences have suggested that psychological stress is associated with low BMD and can be a risk factor for osteoporosis in postmenopausal women [4, 5]. Psychological stress response proceeds to activate hypothalamic-pituitary-adrenal (HPA) axis thereby increasing the levels of glucocorticoid in systemic circulation [6]. The physiological stress is known to deteriorate bone structure through the modulation of stress hormone signaling [6], the underlying mechanism between stress-related brain neural activity and osteoporosis is still remained unclear. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an established method to evaluate the metabolic activity of brain amygdala, a region involved in stress. We aimed to evaluate the relationship between metabolic activity of amygdala (AmygA) and osteoporosis in postmenopausal women. The levels of psychological stress were measured using the Psychosocial Well-being Index-Short Form (PWI-SF)
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