Basis Of Bone Mineral Density Research Articles

The Advantages of Radiofrequency Echographic MultiSpectrometry in the Evaluation of Bone Mineral Density in a Population with Osteoarthritis at the Lumbar Spine.

Osteoarthritis (OA) in the lumbar spine can potentially lead to an overestimation of bone mineral density (BMD), and this can be a challenge in accurately diagnosing conditions like osteoporosis, where precise measurement of BMD is crucial. Radiofrequency Echographic Multi Spectrometry (REMS) is being recognized as an innovative diagnostic tool for assessing bone status. The purpose of this study was to evaluate whether the use of REMS may enhance the identification of osteoporosis in patients with osteoarthritis. A cohort of 500 patients (mean age: 63.9 ± 11.2 years) diagnosed with osteoarthritis and having a medical prescription for dual-energy X-ray absorptiometry (DXA) were recruited for the study. All patients underwent BMD measurements at lumbar spine and femoral sites by both DXA and REMS techniques. The T-score values for BMD at the lumbar spine (BMD-LS) by DXA were significantly higher with respect to BMD-LS by REMS across all OA severity scores, and the differences were more pronounced in patients with a higher degree of OA severity (p < 0.001). Furthermore, the percentage of subjects classified as "osteoporotic", on the basis of BMD by REMS was markedly higher than those classified by DXA, both when considering all skeletal sites (39.4% vs. 15.1%, respectively) and the lumbar spine alone (30.5% vs. 6.0%, respectively). A similar pattern was observed when OA patients were grouped according to the Kellgren-Lawrence grading score. The findings from our study indicate that, in a population with varying severity levels of osteoarthritis, REMS demonstrated a higher capability to diagnose osteoporosis compared to DXA, and this could lead to earlier intervention and improved outcomes for patients with bone fragility, reducing the likelihood of fractures and associated complications.

Could radiofrequency echographic multispectrometry (REMS) overcome the overestimation in BMD by dual-energy X-ray absorptiometry (DXA) at the lumbar spine?

BackgroundOsteoarthritis (OA) and vertebral fractures at the lumbar spine lead to an overestimation of bone mineral density (BMD). Recently, a new approach for osteoporosis diagnosis, defined as radiofrequency echographic multi-spectrometry (REMS), represents an innovative diagnostic tool that seems to be able to investigate bone quality and provide an estimation of fracture risk independent of BMD.The aim of this paper was to evaluate whether the use of REMS technology can favor the diagnosis of osteoporosis in subjects with an apparent increase in BMD.MethodsIn a cohort of 159 postmenopausal (66.2 ± 11.6 yrs) women with overestimated BMD by DXA at the lumbar spine, we performed an echographic scan with the REMS technique.ResultsThe mean values of BMD at different skeletal sites obtained by the DXA and REMS techniques showed that the BMD T-scores by REMS were significantly lower than those obtained by the DXA technique both at the lumbar spine (p < 0.01) and at all femoral subregions (p < 0.05). In OA subjects, the percentage of women classified as “osteoporotic” on the basis of BMD by REMS was markedly higher with respect to those classified by DXA (35.1% vs 9.3%, respectively). Similarly, the REMS allows a greater number of fractured patients to be classified as osteoporotic than DXA (58.7% vs 23.3%, respectively).ConclusionsREMS technology by the analysis of native raw unfiltered ultrasound signals appears to be able to overcome the most common artifacts, such as OA and vertebral fracture of the lumbar spine, which affect the value of BMD by DXA.

Biobank data for studying the genetic architecture of osteoporosis and developing genetic risk scores

Osteoporosis is a chronic systemic disease of the skeleton, characterized by a decrease in bone mass and an impairment of bone microarchitecture, which can lead to a decrease in bone strength and an increase in the risk of minor trauma fractures. Osteoporosis is diagnosed on the basis of bone mineral density (BMD). BMD is characterized by high heritability that ranges according to various sources from 50 to 85%. As in the case of other complex traits, the most common approach to searching for genetic variants that affect BMD is a genome-wide association study. The lower effect size or frequency of a variant is, the larger the sample size is required to achieve statistically significant data on associations. Therefore, the studies involving hundreds of thousands of participants based on biobank data can identify the largest number of variants associated with BMD. In addition, biobank data are used in the development of genetic risk scores for osteoporosis that can be used both in combination with existing prognosis algorithms and independently of them. The aim of this review was to present the most significant studies of osteoporosis genetics, including those based on biobank data and genome-wide association studies, as well as studies on the genetic risk scores and the contribution of rare variants.

Molecular characterization and frequency of transforming growth factor beta 1 gene polymorphism and its relation to bone complications in Egyptian patients with β-thalassemia

Objective The objective of this study was to determine the frequency of transforming growth factor beta 1 (TGFβ1) C-509T gene polymorphism and its relation to bone complications in patients with β-thalassemia major in Egypt. Background Osteoporosis is the most prevalent bone complication in patients with β-thalassemia major despite regular blood transfusions and iron chelation therapy. It is characterized by low bone mineral density (BMD) resulting in reduced bone strength and increased risk of fractures. Genetic factors play an important role in the determination of BMD. The TGFβ1 gene, which encodes TGFβ1, is a strong candidate for susceptibility to osteoporosis, and several studies have reported associations between BMD and different polymorphisms of TGFβ1, although these studies have yielded conflicting results. Study design and methods Single nucleotide polymorphism in the TGFβ1 gene promoter (C-509T) was investigated in 100 regularly treated Egyptian children with β-thalassemia major by PCR/RFLP genotyping. BMD was measured by dual-energy radiograph absorptiometry and expressed as Z score. Results The frequency of TGFβ1 gene polymorphism C-509T genotypes in all studied patients was 6% for homozygous CC, 85% for heterozygous CT, and 9% for homozygous TT. C allele frequency was 48.5%, whereas T allele frequency was 51.5%. BMD Z score was significantly higher in TT genotype compared with CC genotype, with P value less than 0.05. Patients were grouped on the basis of BMD Z score: 51 (51%) patients with BMD deficit (Z score <−1) and 49 (49%) with normal BMD (Z score ≥−1). TGFβ1 gene polymorphism C-509T genotypes were distributed differently between the two groups; the TT genotype frequency was lower in patients with BMD deficit (P<0.05). Conclusion TGFB1 gene polymorphism C-509T is associated with BMD and genetic susceptibility to osteoporosis and may play a role in the pathogenesis and modification of bone complication in β-thalassemia major. BMD deficit is common in Egyptian children with β-thalassemia major. Analysis of this polymorphism at an early age could help in identification of thalassemic children at risk of osteoporosis and early management. However, large-scale studies are required to confirm these findings.

Evaluation of basal bone mineral density (BMD) in premature ovarian insufficiency (POI) patients. Preliminary results. (Protocol code IIBSP-IOP-2012-109. ClinicalTrials.gov ID:NCT02068976)

Introduction: Hypoestrogenism due to POI has a deleterious effect on the BMD, acting as a hazard to bone fracture. As POI is not a prevalent condition, these patients are prone to suffer a delay in diagnostic and on the onset of treatment.

Prevalence of Osteoporosis and Fracture in China

The aging of the population is associated with an increasing burden of fractures worldwide. However, the epidemiological features of fractures in mainland China are not well known. To assess the prevalence of and factors associated with osteoporosis, clinical fractures, and vertebral fractures in an adult population 40 years or older in mainland China. This cross-sectional study, the China Osteoporosis Prevalence Study, was conducted from December 2017 to August 2018. A random sample of individuals aged 20 years or older who represented urban and rural areas of China were enrolled, with a 99% participation rate. Weighted prevalence of osteoporosis, clinical fracture, and vertebral fracture by age, sex, and urban vs rural residence as determined by x-ray absorptiometry, questionnaire, and radiography. A total of 20 416 participants were included in this study; 20 164 (98.8%; 11 443 women [56.7%]; mean [SD] age, 53 [13] years) had a qualified x-ray absorptiometry image and completed the questionnaire, and 8423 of 8800 (95.7%) had a qualified spine radiograph. The prevalence of osteoporosis among those aged 40 years or older was 5.0% (95% CI, 4.2%-5.8%) among men and 20.6% (95% CI, 19.3%-22.0%) among women. The prevalence of vertebral fracture was 10.5% (95% CI, 9.0%-12.0%) among men and 9.7% (95% CI, 8.2%-11.1%) among women. The prevalence of clinical fracture in the past 5 years was 4.1% (95% CI, 3.3%-4.9%) among men and 4.2% (95% CI, 3.6%-4.7%) among women. Among men and women, 0.3% (95% CI, 0.0%-0.7%) and 1.4% (95% CI, 0.8%-2.0%), respectively, with osteoporosis diagnosed on the basis of bone mineral density or with fracture were receiving antiosteoporosis treatment to prevent fracture. In this cross-sectional study of an adult population in mainland China, the prevalence of osteoporosis and vertebral fracture were high and the prevalence of vertebral fracture and clinical fracture was similarly high in men and women. These findings suggest that current guidelines for screening and treatment of fractures among patients in China should focus equally on men and women and should emphasize the prevention of vertebral fractures.

Recent advances in the epigenetics of bone metabolism.

Osteoporosis is a common form of metabolic bone disease that is costly to treat and is primarily diagnosed on the basis of bone mineral density. As the influences of genetic lesions and environmental factors are increasingly studied in the pathological development of osteoporosis, regulated epigenetics are emerging as the important pathogenesis mechanisms in osteoporosis. Recently, osteoporosis genome-wide association studies and multi-omics technologies have revealed that susceptibility loci and the misregulation of epigenetic modifiers are key factors in osteoporosis. Over the past decade, extensive studies have demonstrated epigenetic mechanisms, such as DNA methylation, histone/chromatin modifications, and non-coding RNAs, as potential contributing factors in osteoporosis that affect disease initiation and progression. Herein, we review recent advances in epigenetics in osteoporosis, with a focus on exploring the underlying mechanisms and potential diagnostic/prognostic biomarker applications for osteoporosis.

Detection of osteoporosis in lumbar spine [L1-L4] trabecular bone: a review article

&lt;p class="abstract"&gt;The human bones are categorized based on elemental micro architecture and porosity. The porosity of the inner trabecular bone is high that is 40-95% and the nature of the bone is soft and spongy where as the cortical bone is harder and is less porous that is 5 to 15%. Osteoporosis is a disease that normally affects women usually after their menopause. It largely causes mild bone fractures and further stages lead to the demise of an individual. This analysis is on the basis of bone mineral density (BMD) standards obtained through a variety of scientific methods experimented from different skeletal regions. The detection of osteoporosis in lumbar spine has been widely recognized as a promising way to frequent fractures. Therefore, premature analysis of osteoporosis will estimate the risk of the bone fracture which prevents life threats. This paper focuses on the advanced technology in imaging systems and fracture probability analysis of osteoporosis detection. The various segmentation techniques are explored to examine osteoporosis in particular region of the image and further significant attributes are extracted using different methods to classify normal and abnormal (osteoporotic) bones. The limitations of the reviewed papers are more in feature dimensions, lesser accuracy and expensive imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and DEXA. To overcome these limitations it is suggested to have less feature dimensions, more accuracy and cost-effective imaging modality like X-ray. This is required to avoid bone fractures and to improve BMD with precision which further helps in the diagnosis of osteoporosis.&lt;/p&gt;

MO645BONE MINERAL DENSITY IN POSTMENOPAUSAL WOMEN WITH TYPE 2 DIABETES MELLITUS WITH AND WITHOUT DIABETIC NEPHROPATHY

Abstract Background and Aims Diabetes mellitus and osteoporosis are both common human diseases. Diabetic nephropathy is characterized by the presence of pathological quantities of urine albumin excretion, diabetic glomerular lesions, and loss of glomerular filtration rate in diabetics. Little evidence has been reported on relationships between BMD and albuminuria. The aim of this study is to compare the bone mineral density (BMD) in postmenopausal women with type 2 diabetes mellitus (T2DM) with and without diabetic nephropathy. Method We retrospectively analyze the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry in 84 postmenopausal women with T2DM with (39) and without (45) diabetic nephropathy. The serum levels of calcium, phosphorus, total alkaline phosphatase, and urine albumin excretion were measured in all participants. Diagnosis of albuminuria was based on albumin-creatinine ratio (ACR). Results Age, body mass index (BMI) and time since menopause were not significantly different between the two groups. The T-scores of basal BMD at L4 were significantly lower in patients with diabetic nephropathy (-0,94 ± 0,40) compared to patients without nephropathy. No significant differences in serum creatinine were detected between two groups of patients. Our data suggest that ACR was negatively associated with lumbar spine and femoral neck BMD. Conclusion Our results suggest that postmenopausal women with diabetic nephropathy have a lower BMD and are at increased risk of osteoporosis in the lumbar spine compared with postmenopausal women without diabetic nephropathy. ACR was negatively associated with lumbar spine and femur neck BMD. One of the explanations that has been proposed for the association between albuminuria and osteoporosis is that albuminuria is associated with reduced bone blood flow, resulting in a decreased rate of bone remodeling and the development of osteoporosis.

Assessment of Bone Quality Using Radiogrammetric Parameters of Proximal Humerus in India: Defining the Osteoporotic Fracture Risk Limit Value and its Reliability.

World health organization (WHO) has defined osteoporosis clinically on the basis of bone mineral density (BMD) measurement by dual-energy X-ray absorptiometry (DXA) scan and the presence of fractures. This facility is expensive and not readily available in majority of the centers in India. The authors have attempted to study defined measurements on radiographs (radiogrammetric parameters) to diagnose osteoporosis in Indian population. We prospectively studied 200 proximal humerus radiographs for measuring radiogrammetric parameters and divided into Group A and B (N = 100 in each group). Group A involved patients with age < 50years and without any illness affecting bone quality. Group B involved patients with age > 50years and sustained acute osteoporotic fractures of distal radius/ anterior wedge vertebral fracture/intertrochanteric fracture following trivial trauma. Three parameters (cortical thickness, cortical index and deltoid tuberosity index) were measured by 3 observers at 2 different occasions. The mean age of patients was 37.87years and 58.38years for group A and B, respectively. The 'cortical thickness' of the proximal humerus diaphysis had the mean value for Group A and B to be 0.4 ± 0.07cm and 0.33 ± 0.06cm respectively. The mean values for the 'cortical index' of proximal humerus came out to be 0.4 ± 0.07 for group A and 0.32 ± 0.06 for group B. The 'deltoid tuberosity index' measurements showed the mean values for group A and B were 1.81 ± 0.23 and 1.55 ± 0.16, respectively. Inter-observer reliability for single measures was excellent for deltoid tuberosity index (ICC 0.8077) and good for cortical thickness (ICC 0.7032) and cortical index (ICC 0.7357). Observer 1 had excellent intra-observer reliabilities for all the three parameters. Observer 2 and 3 had excellent reliability for deltoid tuberosity index and good intra-observer reliability for cortical thickness and cortical index. The cortical thickness had a cut off of ≤ 0.372cm with a sensitivity of 86.02 and specificity of 82.12. The cortical index had a cut off of ≤ 0.378 with a sensitivity of 89.16 and specificity of 84.22. The deltoid tuberosity index had a cut off of ≤ 1.684 with a sensitivity of 96.61 and specificity of 84.08. The outcome of this study is likely to help in early diagnosis of osteoporosis at the community level in the absence of DXA scan as it identifies threshold values for radiogrammetric parameters which can be a predictor of the osteoporosis. The deltoid tuberosity index was found to be the most suitable of these parameters.

Determination of basal bone mineral density in the femur bones of male and female Wistar rats.

Changes in bone mineral content of calcium (Ca), phosphorous (P), magnesium and potassium for male and female Wistar rats during their development from 3 weeks old to adulthood (27 weeks old) were measured. Bone mineral content was related to areal bone mineral density (BMD) which was measured in vivo at the femoral neck using a calibrated X-ray transmission system to obtain basal curves as a function of the age of the specimen. Diagnostic curves were built to determine low BMD (osteopaenia) and osteoporosis in female rats fed a Ca-depleted diet (50%) based on the obtained data and the criteria established by the World Health Organization. Bone mineral content is directly related to sex and age, but P did not change throughout the experimental period. P content did not exhibit significant changes with growing, while Ca was greatest in male rats, producing significant differences in the Ca:P ratio. Male rats reach the Ca:P ratio peak before female rats. However, areal BMD does not follow the same trend. On the other hand, osteoporosis produced a 45% decrease in this parameter for young and mature adults. These results make Z-score values available to diagnose bone-mass losses and hence the possibility of improving the conditions of non-contact measurement of BMD in vivo. This technique can be used for future experiments with Wistar rats.

Long-term bone mineral density changes after surgical cure of patients with tumor-induced osteomalacia.

No systematic data are available regarding long-term bone mineral density (BMD) changes after surgical cure of patients with tumor-induced osteomalacia. From October 2001 through April 2018, we studied 10 consecutive patients (mean age ± SD, 45.5 ± 13.8years; 5 males and 5 females) with tumor-induced osteomalacia. We evaluated BMD when initially presented at our Center and after surgical removal of the tumor. Basal BMD and corresponding Z-score values (mean values ± SD) measured by DXA were as follows: L1-L4 = 0.692 ± 0.15g/cm2, Z-score = - 2.80 ± 1.60; femur neck 0.447 ± 0.10g/cm2, Z-score = - 2.66 ± 0.93; total femur = 0.450 ± 0.08g/cm2, Z-score = -3.04 ± 0.85). Furthermore, Trabecular Bone Score (TBS) was evaluated in three patients (basal values, 0.990 ± 0.32). Seven patients were intermittently followed after surgical excision of the tumor while supplemented with cholecalciferol and calcium salts; the remaining three were lost to follow-up. There was a striking increase of BMD values that peaked at 26.7 ± 6.50months: L1-L4 = 1.289 ± 0.247g/cm2, p < 0.001, Z-score + 1.75 ± 1.42; femur neck = 0.890 ± 0.235g/cm2, p = 0.028, Z-score = + 0.50 ± 1.40; total femur = 0.834 ± 0.150g/cm2, p = 0.005, Z-score = - 0.74 ± 1.14. In patients with the greatest bone involvement at lumbar site, there was a striking increase of an average 1.5% (p < 0.01) in respect to baseline Z-score value for each additional month of observation during the first 2-3years post-surgery. An improvement of trabecular microarchitecture was also documented (TBS, 1.255 ± 0.16). This is the first case series documenting an impressive increase of BMD at both lumbar and femoral sites, together with an improvement of trabecular microarchitecture as documented by TBS. This is the consequence of huge mineralization of the large amount of osteoid tissue after resolution of the disease.

Utility of Distal Forearm DXA as a Screening Tool for Primary Osteoporotic Fragility Fractures of the Distal Radius: A Case-Control Study.

Background:Osteoporotic fragility fractures frequently occur at the distal part of the radius. This suggests that initial osteoporosis evaluation at this site may inform screening and treatment to prevent additional fractures. The purpose of this study was to investigate the utility of distal forearm dual x-ray absorptiometry (DXA) as a screening tool to assess the risk of fragility fractures at the distal part of the radius.Methods:This retrospective, case-control study included postmenopausal women who had sustained a distal radial fracture (fracture group, n = 110) and postmenopausal women with no history of fracture (control group, n = 95). DXA measurements at the spine, hip, and distal part of the forearm (ultra-distal, mid-distal, and one-third distal sections) were compared between the groups on the basis of bone mineral density (BMD), T-score, and the proportion of patients with a T-score of ≤–2.5 standard deviations (SD). We also investigated the regional differences on the basis of T-score among the skeletal sites. Furthermore, the reliability of distal forearm DXA measurements was validated by assessing the statistical correlation (r) with volumetric BMD by computed tomography (CT).Results:Compared with the control group, the fracture group showed significantly lower BMD and T-scores and higher proportions of patients with a T-score of ≤–2.5 SD at the ultra-distal, mid-distal, and one-third distal forearm; however, the spine and hip measurements did not differ significantly between the 2 groups. With respect to regional differences, in the fracture group, T-scores were significantly lower and the proportions of patients with a T-score of ≤–2.5 SD were significantly higher for the 3 distal forearm sites compared with the spine and hip. DXA measurements at all 3 of the distal forearm regions exhibited high correlation with volumetric BMD by CT (r = 0.83 to 0.92).Conclusions:Some postmenopausal women were found to exhibit bone loss preferentially at the distal part of the radius, which may render them vulnerable to fragility fractures. Forearm DXA for the assessment of local bone loss may demonstrate benefit in screening for those at risk for distal radial fractures and facilitate the early identification of patients who require intervention for osteoporosis.Level of Evidence:Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.

Efficacy and safety of ossein-hydroxyapatite complex versus calcium carbonate to prevent bone loss

Objective: This study aimed to compare the efficacy and safety of ossein-hydroxyapatite complex (OHC) versus calcium carbonate (CC) for preventing bone loss during perimenopause in current clinical practice.Methods: The prospective, comparative, non-randomized, open-label study included 851 perimenopausal women with basal bone mineral density (BMD) T-score ≥−2 standard deviations (SDs). Participants received either OHC (712 mg calcium/day) or CC (1000 mg calcium/day) over 3 years. BMD was evaluated by dual-energy X-ray absorptiometry at the lumbar spine (L2–L4) at baseline and after 18 and 36 months of follow-up. Adverse drug reactions (ADRs) were also recorded.Results: In women receiving OHC, BMD at the L2–L4 site remained stable over the 3-year follow-up period (mean [SD] change 0.00 [0.11] g/cm2). BMD in the CC arm decreased −3.1% (mean [SD] − 0.03 [0.11] g/cm2). Between-group differences were statistically significant (p < 0.001) and favored OHC. ADRs were more frequent in the CC group (7.7% vs. 2.7% in the OHC group; p = 0.001), affecting primarily the gastrointestinal system.Conclusion: OHC showed greater efficacy and tolerability than CC for bone loss prevention in perimenopausal women in real-world practice. As the daily dose of calcium was higher in the CC group, the differences might be linked to the ossein compound in OHC.

Comparison of serum levels of vitamin D and vitamin D-binding protein in normal, osteopenic and osteoporotic postmenopausal women.

Objective:To compare the serum levels of vitamin D, vitamin D binding protein (VDBP) calcium and phosphate in normal, osteopenic and osteoporotic postmenopausal women categorized on the basis of bone mineral density (BMD) scores.Methods:A cross sectional study carried out from May 2017 to August 2018. BMD measured by Dual energy X-ray Absorptiometry categorized women (aged 20- 70 years) into normal (n=37) (T score ≥ -1.0) osteopenic (n=25) (-2.5< T score, < -1) and osteoporotic (n= 26) (T score < -2.5) according to WHO classification. Serum concentrations of vitamin D, VDBP, calcium, phosphate analyzed by enzyme linked immunosorbent assay were compared by Analysis of VarianceResults:In normal females higher levels of vitamin D and VDBP were observed [15.82 (8 - 69.18), 469.9 (269.57 - 875.55)] vs. osteopenic [(7.45 (4.66 - 15.1), 296.05 (232.58 - 420.23)] and osteoporotic women [(7.25 (3.97 - 17.49), 272.94 (202.23 - 351.24)]; [median interquartile range]; p value < 0.0001.Conclusion:Vitamin D and VDBP are linked with bone health and estimation of VDBP appears to be a valuable tool for the assessment of increased bone loss and possible risks of bone fractures especially in postmenopausal women.

Osteoporosis risk factors and bone microstructure evaluation: a population breakdown

Osteoporosis is a silent disease, characterized by a decreasing bone strength, which leads to a progressive increase in fracture risk. As mean average human lifespan is growing, a parallel rise in the rate of osteoporosis is observed. Currently, diagnosis is made on the basis of bone mineral density, which seems to be a poor fracture predictor in about 40-50% of cases, and of clinical risk factors, but the trabecular structure arrangement should be evaluated as well. The BSI (Bone Structure Index) is a new index computed from simulated application of loads on a virtual biopsy of the patient. In this work, we aim to identify the distributions of BSI and of fragility fracture risk factors recognized by the scientific community in a population of over 300 female volunteers.

Antiosteoporotic effect of icariin in ovariectomized rats is mediated via the Wnt/β-catenin pathway.

Icariin (ICA), the main active flavonoid glucoside isolated from Herba Epimedii, has been shown to prevent postmenopausal bone loss in vitro. However, the mechanisms by which ICA prevents bone loss in vivo remain poorly understood. In the present study, the effect of ICA in an ovariectomized (OVX) rat model of osteoporosis was evaluated. Sprague-Dawley rats were divided into sham-operated and OVX groups. The OVX rats were randomly divided into five groups: OVX group (water only), Fosamax (positive) group (5.04 mg/kg, weekly, administered orally), and OVX-ICA groups (125, 250 or 500 mg/kg, daily, administered orally) and treated for 12 weeks. The 125, 250 and 500 mg/kg doses of ICA were designated as low (L-ICA), medium (M-ICA) and high (H-ICA), respectively. Compared with the sham-operated group, the OVX rats had significantly decreased bone mineral density (BMD), reduced serum osteoprotegerin (OPG) and increased serum bone gla protein (BGP) concentrations. ICA significantly increased BMD, biomechanical strength, trabecular bone number and trabecular bone thickness, and reduced lumbar trabecular bone separation. Treatment with ICA also completely normalized the expression of osteoblast markers by increasing serum concentrations of OPG and BGP. Enhanced mineralization was demonstrated by increased expression of differentiation markers. Although further in vivo studies are required to investigate the efficacy of ICA in improving bone mass, this study demonstrates that ICA has strong osteogenic activity, inducing osteogenic differentiation and inhibiting resorption by osteoclasts. It also demonstrates an antiosteoporotic effect for ICA on the basis of BMD, biochemical markers, biomechanical tests and histopathological parameters. Compared with L-ICA and H-ICA, M-ICA was more effective and caused no liver or kidney damage.

Osteocalcin gene polymorphism and bone density in Hungarian athletes.

Osteoporosis, a public health problem, is mainly determined on the basis of bone mineral density (BMD). The rs1800247 polymorphism of the osteocalcin gene is associated with BMD. The results of one recent Polish study led us to the examination of a possible connection between polymorphism and bone ultrasound parameters in the Hungarian population, including elite athletes. A total of 302 subjects participated in the study. Genotype analysis was carried out via a DNA chip, and anthropometric measurements were taken according to the International Biological Program. Sixty-three (63) of the participants were also measured by ultrasound bone densitometer. The genotype frequencies of osteocalcin polymorphism in the total sample were: 59.9% for hh; 36.1% for Hh; and 3.97% for HH. We separated the 63 subjects by the presence or absence of H allele, and there were no significant differences between the two groups, either in the anthropometric, or in the ultrasound parameters. In grouping the sample by genotypes, no differences were detectable in any of the bone characteristics. Compared to the controls, athletes had significantly higher results in all of the bone ultrasound values. The polymorphism of the osteocalcin gene showed no effect on bone quantity in the examined Hungarian population.

Bone Density in Patients with Cervical Cancer or Endometrial Cancer in comparison with Healthy Control; According to the stages

Objective: To evaluate the bone mineral density (BMD) in the lumbar spine and femur in postmenopausal women with cervical cancer and endometrial cancer without bone metastasis in comparison with that in healthy control postmenopausal women, and to assess the loss of BMD according to the cancer stage.Materials and methods: We analyzed the BMD of the lumbar spine and femur using dual-energy X-ray absorptiometry (DXA) in 218 patients with cervical cancer, 85 patients with endometrial cancer, and 259 healthy controls. The serum levels of calcium (Ca), phosphorus (P), osteocalcin (OSC), and total alkaline phosphatase (ALP), and urine deoxypyridinoline(DPL) were measured in all participants.Results: Age, body mass index, parity, and time since menopause were not significantly different between the three groups. Serum Ca level was higher in the cervical cancer group (p = 0.000), however, urine DPL was lower in endometrial cancer group (p = 0.000). The T-scores of basal BMD at the second and fourth lumbar vertebra (L2, L4) were significantly lower in patients with cervical cancer (p = 0.038, 0.000, respectively) compared to those in the healthy control groups. Additionally, the incidence of osteoporosis and osteopenia basal status of bone mass was significantly higher in patients with cervical cancer compared to that in controls (p = 0.016). No differences in basal BMD of the lumbar spine and femur were observed between patients with cervical cancer according to their stages.Conclusion: Our results suggest that postmenopausal women with cervical cancer have a lower BMD and are at increased risk of osteoporosis in the lumbar spine before receiving anticancer treatment compared with postmenopausal women with endometrial cancer.

Polymorphisms of the farnesyl diphosphate synthase gene modulate bone changes in response to atorvastatin

Although their primary therapeutic indications are different, aminobisphosphonates and statins target enzymes in the mevalonate pathway, which is critical for bone homeostasis. Previous studies have shown that some polymorphisms of the gene encoding farnesyl diphosphate synthase (FDPS), the main target of aminobisphosphonates, modulate the response to these drugs. In this study, we explored whether those single nucleotide polymorphisms (SNPs) also influence the changes in bone mineral density (BMD) following therapy with statins. Sixty-six patients with coronary heart disease were studied at baseline and after 1-year therapy with atorvastatin. BMD was measured by DXA. Three SNPs of the FDPS gene (rs2297480, rs11264359 and rs17367421) were analyzed by using Taqman assays. The results showed that there was no association between the SNPs and basal BMD. However, rs2297480 and rs11264359 alleles, which are in linkage disequilibrium, were associated with changes in hip BMD following atorvastatin therapy. Thus, patients with AA genotype at the rs2297480 locus had a 0.8 ± 0.8 % increase in BMD at the femoral neck, whereas in patients with AC/CC genotypes, BMD showed a 2.3 ± 0.8 % decrease (p = 0.02). Similar results were obtained regarding changes of BMD at the femoral trochanter and when alleles at the rs11264359 locus were analyzed. However, there was no association between BMD and rs17367421 alleles. In conclusion, these results suggest that polymorphisms of the FDPS gene may influence the bone response to various drugs targeting the mevalonate pathway, including not only aminobisphosphonates but also statins.