Femoral Bone Mineral Density Research Articles

Inhibition of osteocyte apoptosis does not prevent iron overload-induced bone resorption and bone loss.

Iron overload leads to apoptosis and increased expression of receptor activator of nuclear factor kappa-Β ligand (RANKL) in osteocytes, which in turn accelerates osteoclastogenesis. Since osteocytes are the main RANKL producers, we hypothesized that apoptotic osteocytes increase RANKL expression in osteocytes, which in turn stimulates osteoclastogenesis and bone resorption. In this study, alendronate or IG9402, a bisphosphonate (BP) analog which does not inhibit bone resorption, inhibited iron overload-induced osteocyte apoptosis and increased RANKL expression. Both BPs also prevented osteoblast apoptosis but did not inhibit the increase in osteoblastic RANKL. Alendronate, but not IG9402, prevented the increase in osteoclastogenesis and serum levels of the bone resorption marker C-telopeptide of type I collagen (CTX) in iron-overloaded mice. Alendronate also prevented the iron overload-induced reduction in femoral bone mineral density, disruption of bone microstructure, and weakness of bone strength. Although IG9402 did not prevent bone loss due to iron overload, it partially prevented reduction of strength, suggesting that osteocyte viability contributes to the maintenance of bone strength. In conclusion, although osteocyte apoptosis in the presence of iron overload leads to an increase in osteocytic RANKL production. However, blocking these events was not sufficient to inhibit iron overload-induced osteoclastogenesis and bone loss.

Synthesis and Structure-Activity Relationships of Novel Benzofuran Derivatives with Osteoblast Differentiation-Promoting Activity.

Osteoporosis is caused by an imbalance between bone resorption and formation, which decreases bone mass and strength and increases the risk of fracture. Therefore, osteoporosis is treated with oral resorption inhibitors, such as bisphosphonates, and parenteral osteogenic drugs, including parathyroid hormone and antisclerostin antibodies. However, orally active osteogenic drugs have not yet been developed. In the present study, to find novel candidates for oral osteogenic drugs, various benzofuran derivatives were synthesized and their effects on osteoblast differentiation were examined in mouse mesenchymal stem cells (ST2 cells). Among the compounds tested, 3-{4-[2-(2-isopropoxyethoxy)ethoxy]phenyl}benzofuran-5-carboxamide (23d) exhibited potent osteoblast differentiation-promoting activity, estimated as EC200 for increasing alkaline phosphatase activity, and good oral absorption in female rats, resulting in high Cmax/EC200. Dual-energy X-ray absorptiometry scanning revealed that 23d at 10 mg/kg/d for 8 weeks increased femoral bone mineral density in ovariectomized rats with an elevation in plasma bone-type alkaline phosphatase activity, and micro-computed tomography showed that it increased bone volume, mineral contents, and strength in femoral diaphysis cortical, but not trabecular bone during the experiment period. 23d potently inhibited cyclin-dependent kinase 8 (CDK8) activity, suggesting that its osteoblastogenic activity is mediated by the suppression of CDK8, as previously reported for diphenylether derivatives. In conclusion, the structure-activity relationships of novel benzofuran derivatives were clarified and 3,5-disubstituted benzofuran was identified as a useful scaffold for orally active osteogenic compounds. Compound 23d exhibited potent osteoblastogenic activity through CDK8 inhibition and osteogenic effects in ovariectomized rats, indicating its potential as an orally active anti-osteoporotic drug.

Characteristics of femur morphology and proximal femur bone mineral density in Japanese females with bisphosphonate-related atypical femur fractures.

To determine which parameters, including femur morphology, proximal femur bone mineral density, or patient characteristics, are associated with bisphosphonate-related atypical femur fractures (AFFs) and to investigate the relationships between AFF location and these parameters. Sixteen females with a history of bisphosphonate use who presented with AFFs and 38 females without AFFs, even those with long-term bisphosphonate use of > 5years, were compared. Patient characteristics; physique, gait ability, and history of pain and medication, were recorded. In terms of femur morphology, the mechanical lateral distal femoral articular angle (mLDFA), femoral bowing angle, femoral neck - shaft angle, and ratio of the femoral lateral cortex:neck width were measured via anteroposterior femur radiographs. Bone mineral density values of the femur neck, trochanter, inter, and Ward's triangle were used. Logistic regression analysis was conducted to determine independent factors for the AFF. In the 16 AFF patients, AFF locations were divided into 1: subtrochanteric, 2: proximal, 3: middle, and 4: distal femur diaphysis. The Spearman correlation coefficients (rs) between the AFF locations and the parameters were calculated. Logistic regression analysis revealed that the mLDFA and Ward's triangle values were significantly independently associated with AFF patients (odds ratios = 1.4 and 0.0, respectively). A more distal AFF location was significantly correlated with a shorter body height and greater BMI (rs = -0.69 and 0.67, respectively). An evaluation combining the mLDFA and Ward's triangle value could be used to predict the risk of bisphosphonate-related AFFs. Body height or BMI may be helpful for predicting AFF location.

Impact of femoral stem alignment on periprosthetic bone density in THA: a study of the Avenir Complete stem.

Thigh pain, aseptic loosening, and failure after total hip arthroplasty has been reported. Therefore, this study examines the impact of femoral stem alignment on periprosthetic bone mineral density (BMD) in THA using the Avenir Complete cementless stem, focusing on the role of precise stem alignment in maintaining proximal femoral BMD. Consecutive patients who received the Avenir Complete stem via mini anterolateral approach in the supine position between March 2019 and March 2022 were included. Dual-energy X-ray absorptiometry was used to assess BMD changes, and computed tomography scans were used to evaluate stem alignment. BMD was maintained in the distal femur, but showed a slight decrease in the proximal femur. A negative correlation was observed among varus malalignment, anteversion errors, and changes in BMD in the proximal femur. The findings underscore the importance of accurate stem positioning in THA, particularly in avoiding varus malalignment and anteversion errors, as misalignment can adversely affect proximal femoral BMD and potentially lead to early stem loosening. This study enhances the understanding of the influence of the Avenir Complete stem on postoperative BMD, highlighting the need for precise alignment to optimize outcomes.

High prevalence of low bone mineral density in young adults with phenylketonuria

ABSTRACT Background It has been reported that phenylalanine (Phe)-restricted diets may have negative effects on bone health in patients with classical phenylketonuria (cPKU). We aimed to evaluate bone mineral density (BMD) in adults with cPKU and determine the risk factors associated with low BMD. Methods Eighty adult patients with cPKU were examined, including 41 women and 39 men. The age range was 18.3-39.4 years (median 22.8). The femoral and lumbar BMD were measured by dual energy X-ray absorptiometry. The patients were evaluated in two groups with low (Z-score ≤−2) and normal BMD (Z-score > −2). Results Low BMD was detected in 20 patients (25%). The low BMD group had significantly more males (75% vs 40%, p < 0.01) and lower mean body mass index (BMI, 22.4 vs 24.5 kg/m2, p = 0.02). Paradoxically, mean blood calcium and 25-hydroxy vitamin D levels were higher in the low BMD group, but only marginally (10.0 vs 9.8 mg/dl and 25.1 vs 21.0 µg/L respectively, p < 0.05). The groups did not differ significantly with regards to age, mean Phe levels at diagnosis, median Phe levels above the age of 12 years, other nutritional parameters or vitamin-mineral supplementation. There was no history of clinical fractures. Discussion Although osteopenia, osteoporosis and low BMD have been reported in PKU, conflicting data also exist. Our study of a large adult cPKU cohort strongly supports previously published limited data that suggest male sex and low BMI confer a higher risk for low BMD in cPKU; and age, Phe levels and dietary adherence do not. In our study, although the patients were young, low BMD was quite common (25%). Bone health should be evaluated even in young adults with cPKU, especially in males and those with low BMI, regardless of treatment compliance and vitamin-mineral status. Prospective studies reporting on clinical outcomes such as bone pain or fractures will be valuable in the coming years.

Associations of Habitual Skeletal Loading with Bone Changes During the Menopausal Transition: A Follow-up Study.

While weight-bearing physical activity (PA) benefits bone health, it remains unclear whether PA can counteract hormone-driven menopausal bone deterioration. This secondary analysis of a population-based prospective follow-up study examined changes in bone health indicators around menopause and evaluated whether accelerometer-measured habitual skeletal loading is associated with these changes. A total of 189 initially perimenopausal women without estrogen therapy (mean age 52 [SD 2] years) were followed until they became postmenopausal (mean follow-up time 15 [9] months). Femoral neck bone mineral density (FN BMD) and bone mineral content (BMC) were measured with dual x-ray absorptiometry (DXA). Femoral and tibial shaft volumetric BMD (vBMD), cross-sectional geometry, and stress-strain index (SSI) were assessed using quantitative computed tomography (QCT) in a subset of 61 women. Habitual skeletal loads (mean daily osteogenic index [OI] and low, medium, and high-intensity impact counts) were evaluated with multiple-day free-living accelerometry records. Longitudinal associations of habitual skeletal loads and bone outcomes were analyzed with GEE models. Consistent decreases were observed in FN BMD and BMC, and femoral and tibial shaft vBMD and SSI (p < 0.001) over the follow-up. Slight decreases over the follow-up were also observed in OI and medium impacts in the full sample, and medium and high impact counts in the subsample (p < 0.05). Medium impacts were associated with tibial shaft vBMD and SSI (β = 0.204, 95% CI [0.018, 0.391] and β = 0.077 95% CI [0.000, 0.154], respectively). High impacts were associated with femoral shaft vBMD (β = 0.186 95% CI [0.006, 0.366]. However, no association was observed between habitual skeletal loads and changes in bone characteristics over the follow-up. We observed a rather uniform skeletal response to the menopausal transition at all measured bone sites. Positive associations were found between medium and high-intensity impacts and bone characteristics at the femoral and tibial shafts. However, habitual skeletal loading did not seem to counteract bone deterioration during the menopausal transition.

Skeletal Muscle Measurements Based on Abdominal Computerized Tomography (CT) Predict Risk of Osteoporosis in Incident Hemodialysis Patients.

Objective: Osteoporosis is prevalent in patients with chronic kidney disease (CKD), with risk increasing as CKD progresses, subsequently elevating fracture risk. While previous studies have shown a link between low skeletal muscle mass and osteoporosis in the general population, there is limited research exploring this relationship in patients with advanced CKD (stages 3-5D). This study aimed to evaluate whether skeletal muscle area (SMA), as measured by abdominal CT, is correlated with bone mineral density (BMD) in advanced CKD patients beginning hemodialysis. Methods: This single-center, retrospective cohort study included patients who started maintenance hemodialysis at Daejeon St. Mary's Hospital from January 2018 to September 2021. Patients who underwent abdominal CT and BMD assessments within three months of dialysis initiation were enrolled, resulting in a sample of 87 individuals. Baseline characteristics were analyzed, with patients stratified by sex and SMA quartiles. Pearson's correlation and multivariate regression analyses were conducted to the relationship between SMA and BMD T-scores. Results: The study cohort had an average age of 65.4 years, with 52.9% of participants being male. Male patients exhibited significantly higher SMA and BMD T-scores in both the lumbar spine and femur compared to female patients. SMA showed the strongest positive correlation with BMD at both sites (lumbar spine, r = 0.424; femur, r = 0.514; p < 0.001). Multivariate analysis identified SMA as an independent positive predictor of BMD, while alkaline phosphatase (ALP) was independently associated with lower femur BMD. In the SMA-based subgroup analysis, patients with lower SMA had significantly lower BMD T-scores and a higher risk of osteoporosis. Logistic regression indicated that patients in the lowest SMA quartile had substantially increased odds of osteoporosis compared to those in the highest quartile, with an adjusted odds ratio of 30.59 (p = 0.008). Conclusions: Lower skeletal muscle mass is significantly associated with lower bone density and a higher risk of osteoporosis in advanced CKD patients initiating hemodialysis. SMA, as measured by abdominal CT, may serve as a useful marker for identifying patients at elevated osteoporosis risk in this population.

Relationship between multi-nutrient intake and bone loss and osteoporosis in U.S. adults: Findings from NHANES.

The relationship between dietary nutrient intake and bone mineral density (BMD) has not been clarified. In the U.S. population, we have demonstrated that dietary intake of multiple nutrients (potassium, magnesium, and sodium) is positively associated with BMD and negatively associated with the prevalence of osteopenia. This study examined whether there is an association between dietary potassium, magnesium, and sodium intake and BMD, osteopenia, and osteoporosis, using data from the National Health and Nutrition Examination Surveys from 2005 to 2010, 2013 to 2014, and 2017 to 2018. We assessed the association of dietary potassium, magnesium, and sodium intake with BMD in 10,355 National Health and Nutrition Examination Survey participants during 2005 to 2010, 2013 to 2014, and 2017 to 2018. BMD of the whole femur was estimated by dual-energy X-ray absorptiometry. We utilized multiple linear regression models to examine the associations of dietary potassium, magnesium, and sodium intake with femoral BMD, osteopenia, and osteoporosis, after adjusting for various confounders. Dietary potassium, magnesium, and sodium intake are positively correlated with femur BMD when corrected for the confounders of age, sex, race/ethnicity, smoking behavior, education level, body mass index, poverty income ratio, serum uric acid, serum cholesterol, potential renal acid load, dietary calcium intake, dietary protein intake, and dietary vitamin D intake. Dietary intake of potassium, magnesium, and sodium was adversely correlated with the development of osteopenia and osteoporosis. Our study showed that intake of dietary nutrients (potassium, magnesium, and sodium) was correlated positively to femur BMD and adversely to osteopenia and osteoporosis in the U.S. population. Further research is needed on the association of dietary elemental intake with BMD.

Epimedium applied in the clinical treatment of osteoporosis patients with periodontitis.

Osteoporosis and periodontitis, prevalent in middle-aged and elderly populations, share common features of bone loss and chronic inflammation. This study explores the hypothesis that Epimedium, known for its bone-strengthening properties, may enhance the effectiveness of conventional osteoporosis treatment in patients with coexisting periodontitis. This retrospective study analyzed clinical data from 120 patients with osteoporosis and periodontitis, divided into 2 groups. The control group received calcium carbonate, vitamin D, and zoledronic acid (CC + VD + ZA) therapy, while the observation group received additional Epimedium flavonoid treatment. Outcomes assessed included changes in bone mineral density (BMD), bone metabolism markers (β-CTx, N-MID, CT, ALP), periodontal indices (PD, AL, SBI, PLI), and inflammatory markers in gingival crevicular fluid (GCF) before and 6 months posttreatment. Compared to the control group, the observation group showed significantly greater increases in lumbar spine and proximal femur BMD and reductions in BM markers (P < .05). Periodontal health metrics (PD, AL, SBI, PLI) and GCF inflammatory markers (TNF-α, IL-1β, IL-6, IL-8, hs-CRP, ICAM-1, HMGB1, PGE2) were markedly improved in the observation group, correlating with enhanced total effective rates (TER) for osteoporosis (95.0%) and periodontitis (91.7%) and a reduced adverse event rate (AER). Epimedium shows promise as an adjunctive therapy in patients with osteoporosis and periodontitis, contributing to improved BMD, reduced inflammation, and enhanced periodontal health, suggesting its potential for broader clinical application in managing these coexisting conditions.

Musculoskeletal and body composition response to high-dose testosterone with finasteride after chronic incomplete spinal cord injury-a randomized, double-blind, and placebo-controlled pilot study.

High-dose testosterone replacement therapy (TRT), paired with finasteride (type II 5α-reductase inhibitor), improves body composition, muscle strength, and bone mineral density (BMD) in older men, without inducing prostate enlargement-a side effect associated with TRT. Men with spinal cord injury (SCI) exhibit neuromuscular impairment, muscle atrophy, bone loss, and increased central adiposity, along with low testosterone. However, sparse evidence supports TRT efficacy after SCI. This parallel-group, double-blind, placebo-controlled, and randomized clinical trial (RCT) is a pilot study that enrolled men (N = 12) with low to low-normal testosterone and gait impairments after chronic motor-incomplete SCI. Participants received high-dose intramuscular TRT (testosterone-enanthate, 125 mg/week) with finasteride (5 mg/day) vs. vehicle+placebo for 12 months. Change relative to baseline was determined for body composition, musculoskeletal outcomes, and prostate size, with effect sizes calculated between groups using Hedges' g. Adverse events and feasibility were assessed. TRT + finasteride consistently increased testosterone (g = 1.16-3.08) and estradiol (g = 0.43-3.48), while concomitantly reducing dihydrotestosterone (g = 0.31-2.27). Very large effect sizes at both 6 and 12 months suggest TRT + finasteride increased whole-body fat-free (lean) mass (+3-4% vs. baseline, g = 2.12-2.14) and knee extensor (KE) whole-muscle cross-sectional area (+8-11% vs. baseline, g = 2.06-2.53) more than vehicle+placebo. Moderate-to-large effect sizes suggest TRT + finasteride increased KE maximal voluntary isometric torque (+15-40% vs. baseline, g = 0.47-1.01) and femoral neck and distal femur BMD from 6 months onward (g = 0.51-1.13), compared with vehicle+placebo, and reduced fat mass 9-14% within the whole-body, trunk, and android (visceral) regions at 12 months (g = 0.77-1.27). TRT + finasteride also produced small effect sizes favoring lesser prostate growth than vehicle+placebo (g = 0.31-0.43). The participant retention, drug compliance, and incidence and severity of adverse events were similar among the groups. These data provide proof-of-concept and rationale for larger RCTs aimed at discerning the impact of TRT + finasteride on body composition, musculoskeletal health, and physical function in men with SCI, along with effect sizes and variance of responses to assist in planning subsequent trials. ClinicalTrials.gov, identifier NCT02248701.

Circulating Proneurotensin Levels Predict Impaired Bone Mineralisation in Postmenopausal Women With Type 2 Diabetes Mellitus.

The mechanisms underlying bone fragility and increased fracture risk observed in individuals with type 2 diabetes (T2D) are not yet fully elucidated. Previous research has suggested a role for neuropeptides in regulating bone metabolism; however, the contribution of the neuropeptide Neurotensin (NT), which is thoroughly implicated in T2D and cardiovascular disease, has not been investigated in this context. To study the relationship between circulating levels of the NT precursor proneurotensin (proNT) and bone mineralisation in T2D women. This is a cross-sectional investigation with a longitudinal prospective phase, involving 126 women with T2D who underwent bone density scans and had proNT levels measured. Biomarkers of bone metabolism and inflammation were also assessed. Data on bone mineral density (BMD) after 12months were available for 49 patients. Plasma proNT levels in relation to BMD. 32% of the participants had osteopenia/osteoporosis and exhibited higher proNT than those with normal BMD (200.8±113.7 vs. 161.6±108.8pg/mL; p=0.013). ProNT inversely correlated with femur BMD and T-score (p<0.01) and was associated with degraded bone architecture (TBS, p=0.02), and higher OPN, P1NP, TNF-α and IL-1β levels. Baseline proNT correlated with further BMD reduction at the 12-month follow-up, independently of potential confounders (p=0.02). In women with T2D, greater proNT levels are associated with impaired bone mineralisation and predict mineral density decline overtime. ProNT could potentially serve as a diagnostic tool for identifying patients at higher risk of osteopenia/osteoporosis, suggesting a significant connection between this neuropeptide and bone metabolism in diabetes.

The effect of plyometric exercise on bone mineralisation and physical fitness in adolescents

IntroductionPlyometric exercise is the preferred type of exercise to promote bone health due to its role on providing high-impact loading of bone tissue. This study aimed to evaluate the effect of plyometric training on bone mineralisation and physical fitness between male and female adolescents.MethodsThis study was a parallel 2-arm trial with 1:1 randomisation to the plyometric or control group. This study was conducted at SMA Negeri 21 Makassar, Indonesia, which included 18 second year of high school students actively engaging in physical activity at least once a week. The plyometric training consisted of a warming-up period, plyometric session, and cooling-down period performed by participants in the plyometric group, three days/week for six months. The control group was informed to stay active during the study period. Bone mineralisation and physical fitness were assessed at baseline and after the 6-month intervention.ResultsA significantly higher improvement of VO2 max was presented in the female plyometric group, compared to the control group (% improvement: 81.6 and 13.4 respectively; &lt;i&gt;p&lt;/i&gt; &lt; 0.001) over time. The plyometric group also experienced a significant increase (+4.9 cm) in body height over time, while the control group only demonstrated a slight increase (+1.4 cm). Significant increases in total dual femur BMD and trochanter BMC were observed in the male plyometric group.ConclusionsThe increases in BMD and BMC were only observed in male adolescents following plyometric training. Meanwhile, improvement in VO2 max was more pronounced in female adolescents engaging with plyometric training.

Association between modified dietary inflammation index score and lumbar vertebrae bone mineral density in patients with hypertension: data from NHANES—a population-based study

BackgroundThe modified Dietary Inflammation Index Score (M-DIS) is a scoring system used to quantify the inflammatory effects of nutrients and foods. Inflammation may affect Bone Mineral Density (BMD) and increase the risk of osteoporosis and fractures. The purpose of this study was to utilize data from the National Health and Nutrition Examination Survey (NHANES) to evaluate the relationship between M-DIS and lumbar vertebrae BMD in patients with hypertension.MethodsData from 2007 to 2008, 2009–2010, 2013–2014 and 2017–2018 NHANES cycles were collected for secondary analysis. Information provided by NHANES participants included complete dietary intake interviews and BMD measurements. M-DIS was calculated based on dietary intake interviews. Dual energy X-ray absorptiometry (DXA) was used to evaluate the average BMD of lumbar vertebrae (L1–L4). As an indicator of bone health, weighted multiple logistic regression and restricted spline analysis were utilized to study the relationship between M-DIS and lumbar vertebrae BMD in American patients with hypertension.ResultsA total of 3864 participants aged ≥ 20 years with complete data were included in this study. The proportion of osteopenia in the lumbar spine was 7.2%. After adjusting for confounding factors, negative correlations were observed between the BMD of each vertebral and its average BMD with M-DIS. In Model 3, the relationship between mean lumbar BMD and M-DIS was β = − 0.0103 (95% CI − 0.0160 to − 0.0046, P < 0.001). Notably, L1 showed a particularly significant negative correlation with β = − 0.0120 (95% CI − 0.0172 to − 0.0067, P < 0.001), while the proportion of osteopenia was highest in the L3 vertebra, accounting for 8.3%. Higher M-DIS was positively correlated with the incidence of osteopenia (OR 0.595, 95% CI 0.371–0.965, P = 0.041). Further analyses revealed that in hypertensive patients, elevated M-DIS in women was associated with lower lumbar BMD (P for nonlinearity = 0.093), while this trend was not significant in hypertensive men.ConclusionsThe results of this study suggest that a higher M-DIS (pro-inflammatory diet) is significantly associated with BMD in females with hypertension. These results indicate that female with hypertension who prefer a pro-inflammatory diet may be at an increased risk of osteopenia, highlighting the necessity for tailored dietary recommendations.

Primary components of MCT ketogenic diet are detrimental to bone loss associated with accelerated aging and age-related neurotoxicity in mice.

Medium chained triglycerides (MCT) ketogenic diet is being extensively investigated for its neuroprotective effects against adverse effects associated with aging and neurodegenerative disorders. Aging is a common risk factor for the development of both osteoporosis and neurological disorders. Hence, suppression of aging and age-related neurodegeneration might contribute to delaying skeletal aging. The present study was designed to investigate the effects of the primary components of the MCT diet, against bone resorption associated with D-gal-induced accelerated aging and D-gal /AlCl3-induced age-related toxicity. We report bone loss in accelerated aged mice and age-related neurotoxic mice through declined Sirtuin1 (SIRT1) expression, depleted bone turnover markers, (P1NP and β-CTX-1), low bone mineral density (BMD), and deterioration of trabecular bone microarchitecture in both the distal femur and proximal tibia bones. Administration of MCT dietary components decanoic acid and octanoic acid, led to a decrease in body weight and only octanoic acid increased serum levels of ketone body, β-hydroxybutyrate (β-HB), but both of them failed to reverse the diminishing effects on bone health associated with aging and age-related neurotoxicity. Surprisingly, decanoic acid, octanoic acid, and their combination also exhibited negative effects on trabecular bone microarchitecture and BMD in the distal femur and proximal tibia bones of healthy mice. The findings from this study provide supporting evidence on the deterioration of bone health associated with aging and age-related neurotoxicity, and the bone resorption potential of MCT dietary supplements that are being prescribed in healthy older populations and elderly persons diagnosed with neurological disorders.

Quantitative computed tomography analysis of proximal femur bone mineral density and its relation to hip fracture risk.

Hip fractures significantly reduce the quality of life and mobility of older adults. This study aimed to analyze the correlation between volumetric bone mineral density (vBMD) in different regions of the proximal femur as measured by quantitative computed tomography (QCT) and various subtypes of hip fractures. This case-control study included patients over the age of 65 years admitted to Huadong Hospital Affiliated to Fudan University for hip fractures from November 2022 to December 2023; additionally, patients from the health examination center or outpatient center treated during the same period were included as a control group. Age and gender were matched to eliminate potential confounding factors. The vBMD at the femoral neck (FN), intertrochanteric (IT), and subtrochanteric (ST) regions in the hip fracture groups [FN fracture (FNF) and IT fracture (ITF)] and control group were measured using QCT. A total of 107 patients with FNF, 77 with ITF, and 72 controls were included. After matching for age and gender was completed, 48 individuals were included in each of the three groups. The vBMD at the IT, FN, and ST regions were significantly lower in patients with hip fractures compared to those in the control group for both genders (P<0.001). The vBMD of the FN and IT regions of females in the ITF group was lower than that of those in the FNF group (P<0.05). Additionally, the vBMD of the ST region in both genders was lower in the ITF group than in the FNF group (male: P<0.05; female: P<0.001). In all three groups, females had a significantly lower vBMD in all three regions compared to males (P<0.001). The decline in vBMD was more pronounced in the ITF group than in the FNF group for both genders, with the largest reduction compared to controls observed in the ST region of females in the ITF group. Older adult individuals with a lower hip vBMD are more susceptible to experiencing osteoporotic hip fracture than are those with a normal vBMD. Reduced ST vBMD may serve as an indicator for ITF, especially among females.

Association between advanced lung cancer inflammation index and osteoporosis in patients with type 2 diabetes mellitus: evidence from NHANES.

Previous studies have shown a significantly increased prevalence of osteoporosis (OP) in patients with type 2 diabetes mellitus (T2DM), which is closely associated with inflammation and nutrition. This study aimed to investigate the relationship between the advanced lung cancer inflammation index (ALI) and OP in patients with T2DM. This cross-sectional analysis was conducted based on data from middle-aged and older adults aged 50 years and older with T2DM from the National Health and Nutrition Examination Survey (NHANES).Weighted multivariable logistic regression and linear regression were utilized to investigate the correlation between the ALI and OP with femur bone mineral density (BMD) in individuals with T2DM. Restricted cubic splines (RCS) were employed to assess potential nonlinear relationships, and receiver operating characteristic (ROC) curves were used to evaluate diagnostic accuracy. A total of 1596 patients with T2DM were included in this study, among whom 736 had OP. After adjusting for covariates, the multivariable logistic regression model showed that compared to participants in the fourth quartile of log2-transformed ALI, those in the first quartile had an increased prevalence of OP in T2DM (OR = 1.95, 95% CI=1.28-2.96, p < 0.01). The multivariable linear regression model indicated that a low log2-transformed ALI is associated with a low femur BMD.RCS demonstrated a linear dose-response relationship between the ALI index and OP in T2DM (p = 0.686), with the area under the ROC curve being 0.57 (95% CI: 0.54-0.60, p < 0.001), and the optimal cutoff value was 6.04. Our findings indicate that low levels of ALI are independently associated with an increased prevalence of OP in middle-aged and older adults with T2DM in the United States. ALI may serve as a potential biomarker for assessing the prevalence of OP in middle-aged and older adults with T2DM.

The association between dietary flavonoid intake and bone mineral density and osteoporosis in US adults: data from NHANES 2007–2008, 2009–2010 and 2017–2018

BackgroundEpidemiological studies investigating the association between flavonoid intake and bone mineral density (BMD) draw inconsistent conclusions. Our study aims to investigate the association between flavonoid intake and BMD and osteoporosis and the mediating role of composite dietary antioxidant index (CDAI) in their relationship using data from the National Health and Nutrition Examination Survey (NHANES).MethodsThe study assessed the relationship between flavonoid intake and femur BMD and osteoporosis in 10,225 individuals from NHANES 2007–2010 and 2017–2018. Multivariable linear regression analyses were used to detect the association between flavonoid intake and femur BMD in adult Americans. Restricted cubic splines (RCS) were used to examine the nonlinear relationship between flavonoid intake and their subclasses and osteoporosis risk in individuals 20 years or older. We explored the mediating role of CDAI in the association between flavonoid intake and BMD.ResultsIn fully adjusted multivariable regression analyses, compared with people in the first quartile, people in the fourth quartile of total flavonoid intake have a higher BMD at total femur (0.013, 95% CI: 0.004, 0.022, P = 0.001), femur neck (0.010, 95% CI: 0.004, 0.017, P = 0.001), trochanter (0.010, 95% CI: 0.004, 0.017, P = 0.001), and intertrochanter (0.012, 95% CI: 0.003, 0.020, P = 0.006). The positive relationship between flavonoid intake and femur BMD was present in both sexes. Furthermore, we found that people in the fourth quartile of total flavonoid intake have a lower risk of osteoporosis compared with the first quartile (OR = 0.686, 95% CI: 0.528–0.890, P = 0.005). RCS found a linear inverse relationship between total flavonoid intake and osteoporosis in individuals ≥ 20 years (Overall P = 0.015, nonlinear P = 0.086). Moreover, CDAI partially mediates the association of total flavonoid intake with femur BMD.ConclusionsOur findings suggest that higher flavonoid intake is associated with higher BMD and lower risk of osteoporosis in Americans. Furthermore, we found distinct associations between different flavonoid subclasses and osteoporosis risk. More studies with stronger evidence are needed to explore the causal association between flavonoid intake and bone health and their underlying mechanisms.

Low Bone Mineral Density Is Associated with High-Frequency Hearing Impairment in Women Over 50: An Observational Study in Korea.

Osteoporosis and hearing impairment are known to be associated, but specific data regarding gender, bone mineral density (BMD) measurement sites, and hearing frequency ranges remain unclear. This study aimed to clarify the relationship between hearing loss and BMD in adults over the age of 50. Additionally, the study sought to determine the frequency ranges of pure tone audiometry (PTA) related to osteoporosis, identify BMD measurement sites, and investigate gender differences. A total of 1,523 adults (651 men and 872 women) over the age of 50, who participated in a medical health check-up at a university hospital, were included. PTA was conducted to assess hearing, and BMD was measured using dual-energy X-ray absorptiometry at the lumbar vertebrae (LV) and femur. In women over the age of 50, a significant association was observed between hearing impairment and osteoporosis (P<0.01), but no such association was found in men. Lumbar BMD (L1-4) in women was significantly associated with hearing loss at 4,000 and 8,000 Hz (both P<0.05), whereas femoral neck and total femur BMD showed no significant relationship. In multiple logistic regression analysis, the odds ratio (OR) between osteoporosis and hearing threshold at 4,000 Hz (OR, 2.078; 95% confidence interval [CI], 1.092-3.954) and 8,000 Hz (OR, 2.648; 95% CI, 1.543-4.544) remained statistically significant in women after adjusting for age and other risk factors. In women over the age of 50, low BMD at the LV is significantly associated with hearing impairment, particularly at the high frequencies of 4,000 and 8,000 Hz.

Sex hormone deficiency in male and female mice expressing the Alzheimer's disease-associated risk-factor TREM2 R47H variant impacts the musculoskeletal system in a sex- and genotype-dependent manner.

The R47H variant of the triggering receptor expressed on myeloid cells 2 (TREM2) is a risk factor for Alzheimer's disease in humans and leads to lower bone mass accrual in female but not male 12-mo-old mice. To determine whether, as with aging, gonadectomy results in sex-specific musculoskeletal effects, gonad removal or SHAM surgery was performed in 4-mo-old TREM2R47H/+ mice and WT male and female littermates (n = 10-12/group), with sexes analyzed separately. Body weight was lower in males, but higher in females after gonadectomy, independently of their genotype. Gonadectomy also leads to decreased BMD in males at all sites and in the whole body (total) and spine in female mice for both genotypes. Total and femur BMD was lower in gonadectomized male mice 6-wk post-surgery, independently of the genotype. On the other hand, BMD was only lower in ovariectomized WT but not TREM2R47H/+ mice in all sites measured at this time point. Bone formation and resorption marker levels were not affected by orchiectomy, whereas CTX was higher 3wk after surgery and P1NP showed a tendency toward lower values at the 6-wk time point only in ovariectomized WT mice. Micro-CT analyses showed no differences resulting from gonadectomy in structural parameters in femoral cortical bone for either sex, but lower tissue mineral density in males of either genotype 6-wk post-surgery. Nevertheless, biomechanical properties were overall lower in gonadectomized males of either genotype, and only for WT ovariectomized mice. Distal femur cancellous bone structure was also affected by gonadectomy in a genotype- and sex-dependent manner, with genotype-independent changes in males, and only in WT female mice. Thus, expression of the TREM2 R47H variant minimally alters the impact of gonadectomy in the musculoskeletal system in males, whereas it partially ameliorates the consequences of ovariectomy in female mice.

Gu Sui Bu (Drynaria fortunei J. Smith) prevents osteoporosis in ovariectomized rats by inhibiting pyroptosis through NLRP3/GSDMD/CASPASE-1

Traditional Chinese medicine Gu Sui Bu (Drynaria fortunei J. Smith), has the effect of tonifying the kidneys and strengthening bone. There are many modern studies on the anti-osteoporosis pharmacological mechanism of Gu Sui Bu (Drynaria fortunei J. Smith) but no reports on the pharmacological mechanism of Gu Sui Bu (Drynaria fortunei J. Smith) improving cell pyroptosis and anti-osteoporosis have been found. AimThis study aims to verify the changes in cellular standard indicators in postmenopausal osteoporosis, thereby revealing the participating mechanism of pyroptosis and the intervention effect of Gu Sui Bu (Drynaria fortunei J. Smith) . MethodsGu Sui Bu (Drynaria fortunei J. Smith) subjected to UHPLC-Q-Orbitrap-MS/MS analysis, and the OVX rat model was constructed in vivo as the research object. It was divided into sham operation group (SHAM), ovariectomized osteoporosis model group (OVX) and Gu Sui Bu (Drynaria fortunei J. Smith) group (TFRD-L, TFRD-H). After 3 months of modeling, the medication group was treated with Gu Sui Bu (Drynaria fortunei J. Smith) and the samples were collected after 12 weeks of intervention. ELISA was used to detect the levels of Caspase-1, NLRP3, GSDMD, IL-1β, and IL-18 in rat serum; the right femur was taken for Micro-CT large bone microstructure scanning and femoral BMD detection; the femur was subjected to rat histopathology HE, TRAP staining; immunohistochemistry and immunofluorescence staining of rat histopathology were performed. WB and PCR were used to observe the expression of Osteoblasts and pyroptosis-related indicators Caspase-1, NLRP3, GSDMD and RUNX2, IL-1β, and IL-18. ResultsUHPLC-Q-Orbitrap-MS/MS analysis the main compounds in Gu Sui Bu (Drynaria fortunei J. Smith) samples were identified. These 9 chemical components are Palmitic acid, Fisetin, Caffeic acid, Naringin, Rutin, Uridine, Cafestol, Astilbin . Rat Micro-CT, The results of HE staining and TRAP showed that compared with the rats in the OVX group, the number of bone trabeculae in the rats in the Gu Sui Bu (Drynaria fortunei J. Smith) medication group (TFRD-L, TFRD-H) increased, became wider and thicker, and the bone density increased. Continuity increases and bone lacunae decrease. Rat serum ELISA, femoral tissue immunohistochemistry, immunofluorescence staining and WB, PCR showed that compared with the OVX group, Caspase-1, NLRP3, The expression levels of GSDMD and inflammation were reduced (p<0.05), and the expression of osteogenic marker RUNX2 was reduced and increased (p<0.05). ConclusionThe traditional Chinese medicine Gu Sui Bu (Drynaria fortunei J. Smith) can improve the bone density of ovariectomized osteoporosis model rats and significantly enhance the bone microstructure. At the same time, it reduced the expression of pyroptosis markers Caspase-1, NLRP3, and GSDMD in vivo, confirming that Gu Sui Bu (Drynaria fortunei J. Smith) may play an anti-osteoporosis effect through the NLRP3/GSDMD/Caspase-1 pathway.