Decreased Bone Mineral Density Research Articles

Guided bone regeneration therapy based on plaque control of peri-implantitis with follow-up at 7 years.

Peri-implantitis is a pathologic condition associated with dental plaque that occurs in the implant tissue and is characterized by inflammation of the mucous membrane surrounding the implant, followed by the progressive loss of supporting bone. In this study, a case of guided bone regeneration therapy based on plaque control of peri-implant inflammation was reported. Four years after surgery for the left second premolar implant, the patient presented with "left lower posterior tooth swelling and discomfort for more than 2 years". The X-ray periapical film showed a decrease in distal bone mineral density of implant, and the clinical diagnosis was peri-implantitis of the left second premolar. Implants underwent guided bone regeneration and regular periodontal maintenance treatment. Re-examination at 3.5 months, 11 months, 18 months, and 7 years showed that the alveolar bone height and bone mineral density were stable, and the periodontal depth became shallow. However, the gingival recession was mild. In the present case, follow-up at 7 years demonstrated that the clinical periodontal indexes could be remarkably improved after complete periodontal treatment for peri-implantitis, and the alveolar bone could be well restored and regenerated.

Glucocorticoids on bone remodeling in systemic lupus erythematosus mice.

Systemic lupus erythematosus requires glucocorticoids for management. This study investigates how glucocorticoids influence bone in a SLE mouse model, focusing on bone mineral density (BMD), microstructure, and remodeling markers. MRL/lpr and C57BL/6 mice were administered dexamethasone or saline as a control for 4-weeks. Bone assessments included analyses of BMD, bone structure, and serum levels of RANKL and OPG. Dexamethasone decreased BMD and altered cortical and trabecular bone thickness in both MRL/lpr and C57BL/6 mice. In C57BL/6 mice, cortical bone exhibited increased catabolism while trabecular bone showed signs of increased anabolism, whereas MRL/lpr mice did not show significant changes in bone turnover. Both strains experienced weight loss, with a significant decrease in femur length observed only in C57BL/6 mice. Dexamethasone exacerbated BMD reduction in MRL/lpr mice and halted its increase in C57BL/6 mice. C57BL/6 mice exhibited notable changes in cortical and trabecular bone structure, while MRL/lpr mice didn't. After receiving dexamethasone, both strains showed higher serum RANKL levels, especially in C57BL/6 mice. OPG decreased in both strains. Both glucocorticoids and SLE contribute to abnormal bone remodeling through RANKL/OPG pathway. Glucocorticoid (GC) treatment in a mouse model of systemic lupus erythematosus (SLE) leads to significant changes in bone parameters, including decreased bone mineral density (BMD) and alterations in bone structure. Those change are associated with the modulation of RANKL and OPG expression. Both GC and inflammation in SLE contribute to BMD reduction, and GC may have a certain protective effect on bone in the early stage of chronic inflammation. GC can upregulate RANKL expression and downregulate OPG expression in vivo. During a state of chronic inflammation, RANKL expression increases. However, OPG may not exert a significant influence on inflammatory stimulation.

P0415 Bone turnover biomarkers alteration in patients with Inflammatory Bowel Disease

Abstract Background Because of glucocorticoids, chronic inflammation, malabsorption, and other factors, patients with inflammatory bowel disease (IBD) are at varying risk for osteoporosis (OP) and decreased bone mineral density. This puts individuals at risk for osteoporotic fractures, which have a negative impact on their quality of life. The purpose of this study is to measure bone turnover markers (BTMs) representing bone resorption and formation in an Egyptian cohort of IBD patients, compare them to healthy controls, and investigate their relationship to disease activity, extension, and treatment modalities. Methods The cross-sectional study included 92 participants: 45 IBD patients, 25 ulcerative colitis (UC), 20 Crohn’s disease (CD), and 47 controls. Overnight fasting blood samples were withdrawn for BTMs including bone formation markers (Procollagen I N-terminal propeptide {PINP} and bone specific alkaline phosphatase {BSAP}), bone resorptive marker (C-terminal telopeptide of type I collagen {CTX}). Results Serum CTX, PINP, and BALP levels increased significantly in IBD patients, indicating increased turnover and metabolic bone disease, but there were no significant differences between the UC and CD groups. In terms of disease activity and intestinal involvement, BTM levels in UC and CD patients were comparable. Anti-tumour necrosis-α (anti-TNF-α) users had considerably reduced CTX and PINP increases compared to non-users. Conclusion Biochemical testing with BTMs may be useful in the initial evaluation of bone health in IBD patients. Anti-TNF-α users were less likely to experience bone alterations compared to non-users.

Clinical Manifestations and Challenges in Adolescent and Adult Females With Classic Congenital Adrenal Hyperplasia Due to 21-Hydroxylase Deficiency.

Classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency (CAH) is a rare genetic condition that results in cortisol deficiency and excess production of adrenal androgens. While the introduction of newborn screening for CAH has reduced morbidity and mortality, management of CAH remains challenging. Lifelong treatment with glucocorticoids is required to replace the endogenous cortisol deficiency and reduce excess adrenal androgens. Undertreatment or overtreatment with glucocorticoids can lead to multiple disease- and treatment-related comorbidities, including impaired growth and compromised final height, menstrual irregularities and reduced fertility in females, and long-term cardiometabolic complications. In addition to avoiding adrenal crisis and sudden death, treatment goals in adolescent females with CAH are to obtain normal growth and bone maturation and normal timing of puberty. Management of adolescents is particularly challenging due to changes in growth and sex hormone levels that can lead to inadequate suppression of adrenal androgens and increasing independence that can affect treatment adherence. During the transition to adult care, treatment goals focus on preventing symptoms of hyperandrogenism, preserving menstrual regularity and fertility, and providing education and support for issues related to sexuality, atypical genitalia, and/or complications from previous surgical treatment. In addition, patients must be monitored continuously to prevent long-term complications such as decreased bone mineral density, obesity, diabetes, and hypertension. In this review, we discuss the challenges faced by adolescent and adult females with CAH and provide guidance to health-care professionals to help patients to navigate these challenges.

Investigating the preventive effects of pulsed electromagnetic fields on glucocorticoid-induced osteoporosis in rats

The use of pulsed electromagnetic field (PEMF) has demonstrated effectiveness in the management of femoral head osteonecrosis as well as nonunion fractures; however, the effects of PEMF on preventing glucocorticoid-induced osteoporosis (GIOP) have not been extensively studied. The aim of this investigation was to explore the effectiveness of PEMF stimulation in averting GIOP in rats and uncover the potential fundamental mechanisms involved. A total of seventy-two adult male Wistar rats composed the experimental group and were subsequently assigned to three groups for treatment. (1) On the first day (day 0), 24 rats in the PEMF group were intravenously injected with lipopolysaccharide (LPS) at a concentration of 10 μg/kg. This was followed by intramuscular injections of methylprednisolone acetate (MPSL) at a dose of 20 mg/kg for the subsequent three days (days 1–3). Subsequently, the rats were exposed to PEMF for 4 h daily, with the duration varying from 1 to 8 weeks. (2) Adhering to the injection schedule of the PEMF group, the MPSL group (consisting of 24 rats) was administered LPS and MPSL, omitting PEMF stimulation. (3) The PS group (n = 24) was administered injections of 0.9% saline solution in an identical manner and at the same time intervals as the other two groups. At 1, 2, 4, and 8 weeks after the last MPSL (or saline) injection, bone mineral density (BMD), bone mineral content (BMC), and the expression levels of bone morphogenetic protein-2 (BMP-2) mRNA and protein in the proximal femur were measured. Analysis of the PS and PEMF groups at 1, 2, 4, and 8 weeks after the final saline (or MPSL) injection revealed no statistically significant differences in BMD or BMC (P > 0.05). From weeks 2 through 8, the MPSL group rats displayed a marked decrease in BMD and BMC compared to those of the PS group, and at the 4-week and 8-week time points, these values were significantly lower than those of the PEMF group (P < 0.05). Compared with those in the MPSL and PS groups, the expression levels of BMP-2 mRNA markedly increased after PEMF treatment, peaking one week later and sustaining a heightened state for four weeks, but decreased only at the eighth week. Conversely, BMP-2 protein expression exhibited a similar upward trend, peaking two weeks after PEMF treatment and then remaining elevated for the subsequent eight weeks. PEMF stimulation has been shown to have prophylactic potential against GIOP in rats, possibly through the upregulation expression of BMP-2 expression.

Biomimetic Extracellular Vesicles Containing Biominerals for Targeted Osteoporosis Therapy.

Osteoporosis (OP) is a systemic skeletal disorder characterized by decreased bone mineral density and a heightened risk of fractures. Therapies for OP have primarily focused on balancing bone formation and bone resorption, but enhancing the remineralization of osteoporotic bone is also a key strategy for effective repair. Recent insights into biomineralization mechanisms have highlighted the essential role of mineral-containing extracellular vesicles (EVs) secreted by osteoblasts in promoting bone marrow mesenchymal stromal/stem cell (BMSC) differentiation and initiating matrix mineralization. Drawing from these principles, we developed a biomimetic approach to replicate the structure and function of the osteoblast-derived EVs by engineering biomimetic mitochondrial minerals with bone marrow homing cell membranes (CMs). This bone-targeted biomimetic system exhibits excellent biocompatibility, enhancing osteogenic differentiation and stimulating angiogenesis by regulating cellular energy metabolism. Additionally, the CM-coated structure shows affinity for collagen fibrils, effectively enhancing intrafibrillar collagen mineralization, thereby facilitating osteoporotic bone repair. Overall, the biomimetic system offers a safe and efficient therapeutic alternative, positioning it as a platform for bone tissue engineering and regenerative medicine.

Effects of Anti-Obesity Strategies on Bone Mineral Density: A Comprehensive Meta-Analysis of Randomized Controlled Trials.

Although an appropriate weight management strategy is essential for obese individuals, weight loss can have adverse effects on bone mineral density (BMD). We conducted a systematic review of randomized controlled trials to evaluate changes in BMD after the implementation of various weight loss strategies. The PubMed, Embase, Web of Science, and Cochrane Library databases were searched to find articles published from database inception until June 2023. Randomized controlled trials of various treatments for obese patients that reported changes in BMD were selected. The primary outcome was BMD of the whole body, lumbar spine, and total hip, measured using dual X-ray absorptiometry. Eighteen randomized controlled trials involving 2,510 participants with obesity were included in the analysis. At follow-up examination, the BMD of the lumbar spine decreased significantly after metabolic surgery (mean difference [MD]=-0.40 g/cm2; 95% confidence interval [CI], -0.73 to -0.07; I2=0%); lifestyle and pharmacological interventions did not result in a significant decrease in BMD at any location. Metabolic surgery also produced the most substantial difference in weight, with an MD of -3.14 (95% CI, -3.82 to -2.47). This meta-analysis is the first to examine the effects of all categories of anti-obesity strategies, including the use of anti-obesity medications, on BMD. Bariatric metabolic surgery can have adverse effects on BMD. Moreover, medications can be used as a treatment for weight loss without compromising bone quality.

Association of caffeine intake and sleep duration with bone mineral density: a cross-sectional study from National Health and Nutrition Examination Survey between 2011 and 2018

ObjectiveThe association between sleep duration, caffeine intake, and bone mineral density (BMD) is not well understood, with previous studies providing controversial results. This study explores the associations among caffeine intake, sleep duration, and BMD.MethodsData were sourced from the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2018, including 13,457 participants who self-reported sleep duration and caffeine intake, with BMD measured via dual X-ray absorptiometry. Multivariable linear regression models, adjusted for confounders, were used alongside restricted cubic splines to examine dose-response association.ResultsOf all participants, 6821 (50.7%) were males and 6636 were females (49.3%). The mean caffeine intake and sleep duration were 93.4 mg/day and 7.19 h, respectively. RCS results showed that BMD increased with the increase in caffeine intake, especially in the low dose range of 0-200 mg/day. The dose-response association between sleep duration and BMD showed that sleep durations of 0–6 h may promote the increase of BMD, but after sleep durations greater than 6 h, BMD decreases. After adjustment for potential confounders, compared to the lowest referent quartile, individuals with caffeine intake in quartiles 2, 3, and 4 had a positive correlation with BMD (0.62 95% CI: 0.24–1.37; 0.51 95% CI: 0.22–1.13; 0.75 95% CI: 0.41–1.46; P for trend < 0.05). In covariate-adjusted linear regression models, compared with those sleeping 6 h or less per night, the difference in BMD among those sleeping 6–7 h, 7–8 h, and 8–14.5 h per night were 1.81 (95% CI: 0.4122.71), 1.25 (95% CI: 0.55–2.93), and 0.87 (95% CI: 0.38–1.69). Associations of caffeine intake, sleep duration, and BMD stratified by sex and age failed to reach statistical significance.ConclusionsAssociation might exist between the consumption of caffeine, sleep duration, and BMD; however, when stratified by sex and age, the association did not reach statistical significance.

Clinical experience with denosumab discontinuation.

Discontinuing denosumab (DMAb) rapidly decreases bone mineral density (BMD) and increases the risk of multiple vertebral fractures. We wanted to examine if the recommendation stated in the ECTS position paper on DMAb discontinuation can prevent the bone loss in a clinical setting. We conducted a retrospective cohort study based on medical records of patients referred for DMAb discontinuation. We administered zoledronate (ZOL) 6 months after the last DMAb injection and 3, 6, 12, and 24 months thereafter if p-C-terminal collagen crosslinks (CTX) increased above 0.5 μg/l or BMD decreased (≥ 5% at the hip, ≥ 3% at the spine) at months 12 and 24. We included 66 women and men discontinuing DMAb after a mean treatment duration of 6.7 ± 2.7 (mean ± SD) years. BMD decreased 12 months after the initial ZOL treatment by 2.5 ± 4.2% and 1.9 ± 2.5% at the LS and TH, respectively (n = 44) (p ≤ 0.001 for all). There was no significant change in FNBMD (0.0 ± 5.1) (p > 0.05). No significant change in BMD was seen from month 12 to month 24 at any site (p > 0.05 for all). Thirty percent and twenty-two percent of patients experienced flu-like symptoms after the first and second ZOL infusion. No fractures occurred during the study period. Adhering to the recommendation in the ECTS position statement, a mean of 3 infusions of ZOL limited the bone loss 12 and 24 months after DMAb discontinuation, thereby preserving most of the BMD gained during DMAb treatment. The frequent occurrence of flu-like symptoms after ZOL proves to be a challenge, showing that routine prophylaxis against acute phase responses should be considered in patients treated with ZOL after discontinuing DMAb.

History of Health at Cayo Santiago-An Investigation of Environmental and Genetic Influences on the Skeletal Remains of the Introduced Rhesus Macaque (Macaca mulatta) Colony.

The Cayo Santiago rhesus macaque colony is a renowned primate population that has experienced significant natural and anthropogenic ecological variation in their 85-year history. Demographic and familial information is also tracked and collated for the majority of monkeys. Thus, the health history of rhesus macaques at Cayo Santiago should reflect the impacts of both environmental and genetic factors. In this study, we utilized a sample of skeletal remains comprised of 2787 individuals (1571 females, 1091 males), born between 1938 and 2017 from the derived skeletal collection of the primate colony to assess variation in survivorship, pathology, bone mineral density (BMD), and dental eruption status, in the context of hurricane impacts, nutritional fluctuations, and matriline genealogy. Results demonstrated that rhesus macaques at Cayo Santiago exhibit a range of skeletal pathologies that encompass biomedical and archaeological significance, multiple etiologies, severities, locations, and types, in addition to a secular trend of declining BMD that is hypothesized to reflect decreasing physical activity levels under increasing population densities. Specifically, hurricane impacts were found to increase the rate of systemic disease, decrease BMD in young adults, and delay eruption of the primary dentition. Certain matrilines exhibited heightened levels of systemic disease at early ages while others exhibited greater rates of congenital disease. Early-life adversity, through the experience of major hurricanes, may enhance inflammatory pathways, heightening the risk of disease and accelerating the aging process leading to reduced BMD. Such impacts may underly greater levels of observed infection post-hurricane through intensification of pathogen transmission and disease rates brought on by hurricane-adaptive social strategies that favor closer proximity. Familial susceptibility to disease indicates heritable host genetic factors are likely influencing disease patterning in the population. A cluster of congenital diseases may most convincingly illustrate this, or alternatively reflects low levels of genetic diversity in the population.

The role of oxidative stress in bone tissue in the pathogenesis of osteopenia in patients with chronic lymphocytic leukemia

Introduction. A decrease in bone mineral density (BMD), the development of osteopenia and osteoporosis is observed in patients with chronic lymphocytic leukemia (CLL). Patients with CLL are at a higher risk of developing fractures due to osteoporosis compared to healthy age-matched individuals. The pathogenesis of the osteodestructive process in CLL has been poorly studied and may be associated with excessive generation of reactive oxygen species and/or inhibition of antioxidant defense.Aim: to investigate the relationship between indicators of oxidative stress in bone tissue and indicators of osteopenia in patients with CLL.Materials and methods. The study included 48 male patients with CLL aged 50–70 years, divided into group 1 (n = 34) without signs of osteopenia and group 2 (n = 14) with signs of osteopenia based on osteodensitometry (T-score from –1.0 SD to –2.5 SD). BMD, T- and Z-scores were assessed in the lumbar spine, proximal femoral neck (PFC), and proximal femur. In the bone tissue homogenate, the content of products of oxidative modification of proteins (OMP) was determined spectrophotometrically in spontaneous and metal-catalyzed modes, reserve-adaptation potential, and general antioxidant status.Results. Osteopenia was detected in 30 % of patients with CLL according to osteodensitometry in the neck of the proximal femur. In patients with CLL and osteopenia, signs of oxidative stress were observed in the bone tissue: early OMP products of a neutral and basic nature, late products of a neutral nature accumulated in the spontaneous detection mode; early and late OMP products of a neutral and basic nature accumulated in the induced mode; reserve-adaptive potential, the general antioxidant status decreased. Signs of osteopenia in the PFC in patients with CLL in the femoral neck increased as the content of early and late OMP products in the bone tissue increased in spontaneous and metal-induced detection modes, and the general antioxidant status in the bone tissue decreased.Conclusion. Based on the data obtained, it is possible to modernize diagnostic criteria and therapeutic approaches.

Modification of bone architecture following sleeve gastrectomy: a 5-year follow-up.

Bariatric surgery induces a decrease in areal bone mineral density (aBMD), but the long-term effect on trabecular and cortical volumetric bone mineral density (vBMD) has not been well assessed. The main aim of this 5-year longitudinal study was to investigate the changes following sleeve gastrectomy (SG) in aBMD, bone turnover markers and trabecular and cortical vBMD. Forty-five patients with obesity were assessed before and 1, 2 and 5years after SG. Trabecular and cortical vBMD, cortical thickness and structural parameters were assessed by 3D-Shaper® software at hip. Values of bone turnover markers peaked after 1year and decreased after 2 and 5years, but without returning to baseline values. aBMD decreased mostly at femoral neck(-9.7%) and total hip(-10.7%) over the 5years, with the greatest loss occurring at 1year(-5.9% and -6.3%, respectively). A similar profile of decrease was observed for integral hip vBMD with significant decreases of 6.6%, 7.7% and 10.7% after 1, 2 and 5years, mainly due to a reduction in the trabecular (10.5%, 12.0% and 17.2%, respectively) rather than cortical (1.4%, 1.9% and 2.9%, respectively) component. A modest decrease in mean cortical thickness (2.5%, 2.8% and 3.9%, respectively) and an alteration in the structural parameters were concomitantly observed. Older age and greater body weight loss were the factors most associated with an increased loss of aBMD and vBMD. In conclusion, the study demonstrates that SG induces not only an alteration in bone turnover and aBMD, but also a reduction in vBMD at hip, predominantly due to trabecular component deterioration as determined by 3D-Shaper® software. The maintenance of bone deterioration for at least 5years - that is, after 4years of relative body weight stabilization or minimal weight regain - suggests the need for a therapeutic approach to preserve bone health in patients who undergo SG.

The Role of Inflammatory and Nutritional Indices in Postmenopausal Osteoporosis: A Retrospective Study.

Background: Postmenopausal osteoporosis is characterized by impaired bone metabolism, inflammation, and nutritional deficiencies. This study aimed to evaluate the potential of inflammatory and nutritional markers in identifying decreased bone mineral density (BMD) in postmenopausal women. Methods: This cross-sectional study retrospectively analyzed postmenopausal women from January 2018 and December 2023. A total of 368 women were divided into three groups based on T-scores: 61 women with osteoporosis (T-score ≤ -2.5), 153 women with osteopenia (-1 > T-score > -2.5), and 154 women with normal BMD (T-score > -1). Inflammatory and nutritional biomarkers included the neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), monocyte/lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), pan-immune inflammation value (PIV), geriatric nutritional risk index (GNRI), triglycerides, total cholesterol, and body weight index (TCBI), prognosis nutritional index (PNI), hemoglobin, albumin, lymphocyte, and platelet (HALP) score, 25-OH Vitamin D level, Na, K, Ca, Mg, and their ratios. Results: The GNRI was significantly lower in the osteoporosis group compared to the control group. The NLR, PLR, SII, SIRI, PIV, TCBI, PNI, and HALP were similar between the groups. The GNRI and TCBI showed a positive correlation with T-scores. The Mg level was lower in the osteoporosis group than in the control group and osteopenia group, and the Na/Mg ratio was higher. Additionally, the Ca/Mg ratio was lower in the osteoporosis group than in the control group. The T-score was positively correlated with Mg and Ca/Mg, while the Na/Mg ratio showed a significant negative correlation. Vitamin D, other minerals, and their ratios did not show significant differences between the groups. Conclusions: Our findings suggest that the GNRI could serve as a useful indicator for assessing bone health and the risk of osteoporosis. Furthermore, maintaining appropriate levels of Mg and balanced Na/Mg and Ca/Mg ratios appears crucial for BMD.

The Application of L-Serine-Incorporated Gelatin Sponge into the Calvarial Defect of the Ovariectomized Rats.

Osteoporosis, characterized by decreased bone mineral density due to an imbalance between osteoblast and osteoclast activity, poses significant challenges in bone healing, particularly in postmenopausal women. Current treatments, such as bisphosphonates, are effective but associated with adverse effects like medication-related osteonecrosis of the jaw, necessitating safer alternatives. This study investigated the use of L-serine-incorporated gelatin sponges for bone regeneration in calvarial defects in an ovariectomized rat model of osteoporosis. Thirty rats were divided into three groups: a control group, a group treated with a gelatin sponge containing an amino acid mixture, and a group treated with a gelatin sponge containing L-serine. Bone regeneration was assessed using micro-computed tomography (micro-CT) and histological analyses. The L-serine group showed a significant increase in bone volume (BV) and bone area compared to the control and amino acid groups. The bone volume to total volume (BV/TV) ratio was also significantly higher in the L-serine group. Immunohistochemical analysis demonstrated that L-serine treatment suppressed the expression of cathepsin K, a marker of osteoclast activity, while increasing serine racemase activity. These findings suggest that L-serine-incorporated gelatin sponges not only enhance bone formation but also inhibit osteoclast-mediated bone resorption, providing a promising and safer alternative to current therapies for osteoporosis-related bone defects. Further research is needed to explore its clinical applications in human patients.

Fluoxetine inhibited RANKL-induced osteoclastic differentiation in vitro.

Selective serotonin reuptake inhibitor correlates with decreased bone mineral density and impedes orthodontic tooth movement. The present study aimed to examine the effects of fluoxetine on osteoclast differentiation and function. Human peripheral blood mononuclear cells (hPBMCs) and murine RAW264.7 cells were cultured with RANKL to stimulate osteoclast differentiation. The resulting multinucleated cells displayed characteristics of mature osteoclasts. Fluoxetine at 0.01-1 μM did not impact cellular viability or oxidative stress. However, 10 μM fluoxetine significantly reduced clonal growth, cell viability, and increased cytotoxicity and lipid peroxidation in RAW 264.7 cells. Further, application of 0.1 μM fluoxetine potently suppressed osteoclast differentiation of both RAW264.7 and hPBMCs, with reduced osteoclast numbers and downregulation of osteoclastic genes matrix metalloproteinase-9, cathepsin K, and integrin β3 at mRNA and protein levels. Fluoxetine also disrupted F-actin ring formation essential for osteoclast resorptive function. Mechanistically, fluoxetine inhibited NF-kB signaling by reducing phosphorylation of pathway members IκBα and p65, preventing IκBα degradation and blocking p65 nuclear translocation. In conclusion, this study demonstrates fluoxetine suppressing osteoclast differentiation in association with disrupting NF-kB activation, providing insight into orthodontic treatment planning for patients taking fluoxetine.

The study of risk factors for osteoporosis with prolonged use of anticonvulsants: intermediate results

The mechanisms of anticonvulsant effects on bone metabolism are not studied sufficiently. This determines the relevance of research on factors that influence the development of osteoporosis in patients taking long-term anticonvulsants. The aim of the study to evaluate the effect of modifiable and non-modifiable osteoporosis risk factors on changes in bone mineral density during long-term therapy with anticonvulsants. Materials and methods. The study included 100 adult patients receiving anticonvulsants for moren12 months and 58 healthy volunteers. All participants underwent a clinical screening with assessment of factors affecting bone metabolism and a densitometric study using quantitative computed tomography at three points (L1, L2 and femoral neck). Results. CT-densitometry results showed decrease bone mineral density in the most part of the participants in both study groups. According to the data of the analysis of the influence of osteoporosis risk factors on bone mineral density values, it was found that the presence of fractures in the anamnesis and low level of motor activity increased the risk of osteoporosis development in patients taking long-term anticonvulsants (p (χ2) &lt; 0.001). Conclusion. The results of the study confirm the importance of continuing research on factors affecting bone metabolism and developing a set of preventive measures to prevent the development of osteoporosis.

Association Between Dietary Tryptophan Intake and Bone Health: A Cross-Sectional Study

The relationship between dietary tryptophan intake and the risk of low bone mineral density (LBMD) has not been thoroughly evaluated. This study aimed to examine the relationship between dietary tryptophan intake and LBMD. A total of 12,003 participants aged 50 years and older with complete data on bone mineral density (BMD) and tryptophan intake from the National Health and Nutrition Examination Survey (NHANES) 2005 to 2020 were included in this cross-sectional study. The median dietary tryptophan intake among the 12,003 participants was 1822.14 mg/day, with significantly lower levels observed in individuals with LBMD compared to those with normal bone mass (1740.45 mg/day vs. 2041.39 mg/day, p < 0.001). For every 2.7-fold increase in dietary tryptophan intake, the risk of low BMD decreases by 22%. When dietary tryptophan intake was categorized into quartiles, significantly lower risks of LBMD were observed in the third [Odds Ratio (OR) = 0.68, 95% confidence interval (CI): 0.51–0.91] and fourth (OR = 0.65, 95% CI: 0.49–0.87) quartiles compared to the reference group after multivariable adjustment. Moreover, the restricted cubic spline (RCS) results revealed a negative nonlinear relationship between dietary tryptophan intake and LBMD (p for overall < 0.001, p for nonlinear < 0.05), with this correlation remaining consistent across various population subgroups and exhibiting no significant interaction according to stratification variables. Sensitivity analyses further substantiated these findings. Overall, we found that increased dietary tryptophan intake may be associated with a lower risk of LBMD among individuals aged ≥ 50 years, highlighting the importance of optimizing tryptophan nutrition for reducing osteoporosis risk.

NHANES data analysis of the cardiometabolic index in relation to lumbar spine bone mineral density.

to investigate the correlation between cardiometabolic index (CMI) and lumbar spine bone mineral density (LSBMD) in U.S. adults. the study selected eligible participants from the National Health and Nutrition Examination Survey (NHANES) database from 2011 to 2018. After adjusting for age, gender, race/ethnicity, body mass index (BMI), liver function markers, kidney function markers, blood routine indicators, metabolic markers, and chronic disease status, a logistic regression model combined with a restricted cubic spline model, smooth curve fitting, and threshold effect analysis was used to examine the association between CMI and LSBMD. Subgroup analysis was performed to verify the robustness of the results. among the 3,885 participants, for each unit increase in CMI, LSBMD decreased by 0.011 g/cm². Additionally, a turning point was identified at CMI = 0.797. When CMI was below 0.797, LSBMD decreased as CMI increased, showing a strong negative correlation (β = -0.077, 95 % CI: -0.097 to -0.058, p < 0.001). However, beyond this threshold, the relationship between CMI and LSBMD was no longer significant. Subgroup analysis revealed that the negative correlation between CMI and BMD was consistent across most subgroups (such as gender, BMI, hypertension, and high cholesterol), but instability was observed in subgroups such as individuals aged 51-59, Mexican Americans, non-Hispanic Blacks, and those with diabetes. there exists a non-linear inverse correlation with CMI and LSBMD, showing that CMI could be a potential contributing factor for decreased bone mineral density, with a more pronounced effect within a specific range.

Expert consensus on the diagnosis and treatment of pyruvate kinase deficiency

Pyruvate kinase deficiency (PKD) is a rare autosomal recessive disorder caused by mutations in the PKLR gene, encoding erythrocyte pyruvate kinase, which affects erythrocyte energy production, and then in turn affects erythrocyte function and longevity. PKD is characterized by chronic hemolytic anemia, and other features include chronic hemolytic complications, such as iron overload, decreased bone mineral density, and cardiopulmonary complications. The treatment of PKD requires individualized approach based on the patient's condition, including red blood cell transfusions, pyruvate kinase activators, and treatment for complications. This consensus focuses on the pathogenesis, clinical characteristics, diagnosis and treatment of PKD, and aims to provide better medical service for clinicians, such as diagnosis, treatment, monitoring, and prevention of complications for PKD patients.

Handgrip and its relation to age, fragility fractures, and BMD between sexes in a population aged 50+ years.

A decrease in bone mineral density (BMD) accompanied by muscle weakness during aging significantly increases the probability of low-energy fracture occurrence, but it can also happen in those with a non-osteoporotic score (treatment gap). To improve the identification process of those at risk, the authors proposed using the interconnectivity between bone mineral density and muscle tissue. A total of 20,776 patient records were collected from the database in the period 2008-2021. After applying inclusion criteria, a total of 7159 records were used in the study. Questionnaires regarding patients' history were collected at admission. Patients underwent lumbar spine and/or femoral neck DXA examination and handgrip testing with a handheld dynamometer. Statistical analysis was conducted using tests suitable for the distribution of the data. Osteoporosis was diagnosed in a total of 1914 patients. Depending on the diagnosis there was a significant (p < 0.001) difference in handgrip strength (HGS) between the BMD statuses (norm-osteopenia-osteoporosis). HGS was significantly (p < 0.001) correlated with both BMD neck (r = 0.2) and spine (r = 0.1) in females, and with BMD neck (r = 0.11) in the male population. In our study group HGS was significantly (p < 0.001) higher for all the analysed fractures in the no-fracture group of women. There was no such relationship in reference to the male population. Due to its relationship with BMD, its low cost, and availability, HGS might prove useful in identifying women at risk of a fragility fracture.