Bone Microarchitectural Deterioration Research Articles

Effect of Collagen Peptide, Alone and in Combination with Calcium Citrate, on Bone Loss in Tail-Suspended Rats.

Oral administration of bovine collagen peptide (CP) combined with calcium citrate (CC) has been found to inhibit bone loss in ovariectomized rats. However, the protective effects of CP and CP–CC against bone loss have not been investigated in a tail-suspension simulated microgravity (SMG) rat model. Adult Sprague-Dawley rats (n = 40) were randomly divided into five groups (n = 8): a control group with normal gravity, a SMG control group, and three SMG groups that underwent once-daily gastric gavage with CP (750 mg/kg body weight), CC (75 mg/kg body weight) or CP–CC (750 and 75 mg/kg body weight, respectively) for 28 days. After sacrifice, the femurs were analyzed by dual-energy X-ray absorptiometry, three-point bending mechanical tests, microcomputed tomography, and serum bone metabolic markers. Neither CP nor CP–CC treatment significantly inhibited bone loss in SMG rats, as assessed by dual-energy X-ray absorptiometry and three-point bending mechanical tests. However, both CP and CP–CC treatment were associated with partial prevention of the hind limb unloading-induced deterioration of bone microarchitecture, as demonstrated by improvements in trabecular number and trabecular separation. CP–CC treatment increased serum osteocalcin levels. Dietary supplementation with CP or CP–CC may represent an adjunct strategy to reduce the risk of fracture in astronauts.

Impaired Bone Microarchitecture in Patients with Hereditary Hemochromatosis and Skeletal Complications

Hereditary hemochromatosis (HHC) is characterized by excessive intestinal iron absorption resulting in a pathological increase of iron levels. Parenchyma damage may be a consequence of iron deposition in affected organs (e.g., liver, pancreas, gonads) as well as bones and joints, leading to osteoporosis with increased fracture risk and arthropathy. Up to date, it is not known whether HHC can also be considered as a risk factor for osteonecrosis. Likewise, the underlying skeletal changes are unknown regarding, e.g., microstructural properties of bone. We aimed to study the spectrum of skeletal complications in HHC and the possible underlying microarchitectural changes. Therefore, we retrospectively analyzed all patients with HHC (n = 10) presenting in our outpatient clinic for bone diseases. In addition to dual-energy X-ray absorptiometry (DXA), high-resolution peripheral quantitative computed tomography (HR-pQCT) was performed and bone turnover markers, 25-OH-D3, ferritin and transferrin saturation were measured. Cortical volumetric bone mineral density (Ct.BMD) and cortical thickness (Ct.Th) were reduced, whereas trabecular microstructure (Tb.Th) and volumetric bone mineral density (Tb.BMD) were preserved compared to age- and gender-adjusted reference values from the literature. Interestingly, the occurrence of bone complications was age dependent; while younger patients presented with osteonecroses or transient bone marrow edema, patients older than 65 years presented with fractures. Our study provides first insights into altered bone microarchitecture in HHC and sheds new light on the occurrence of osteonecrosis. If available, HR-pQCT is a useful complement to fracture risk assessment and to determine microstructural deterioration and volumetric bone mineralization deficits.

Vindoline Inhibits RANKL-Induced Osteoclastogenesis and Prevents Ovariectomy-Induced Bone Loss in Mice.

Osteolytic bone diseases, for example postmenopausal osteoporosis, arise from the imbalances between osteoclasts and osteoblasts in the bone remodeling process, whereby osteoclastic bone resorption greatly exceeds osteoblastic bone formation resulting in severe bone loss and deterioration in bone structure and microarchitecture. Therefore, the identification of agents that can inhibit osteoclast formation and/or function for the treatment of osteolytic bone disease has been the focus of bone and orthopedic research. Vindoline (Vin), an indole alkaloid extracted from the medicinal plant Catharanthus roseus, has been shown to possess extensive biological and pharmacological benefits, but its effects on bone metabolism remains to be documented. Our study demonstrated for the first time, that Vin could inhibit osteoclast differentiation from bone marrow macrophages (BMMs) precursor cells as well as mature osteoclastic bone resorption. We further determined that the underlying molecular mechanism of action of Vin is in part due to its inhibitory effect against the activation of MAPK including p38, JNK, and ERK and intracellular reactive oxygen species (ROS) production. This effect ultimately suppressed the induction of c-Fos and NFATc1, which consequently downregulated the expression of the genes required for osteoclast formation and bone resorption. Consistent with our in vitro findings, in vivo administration of Vin protected mice against ovariectomy (OVX)-induced bone loss and trabecular bone deterioration. These results provided promising evidence for the potential therapeutic application of Vin as a novel treatment option against osteolytic diseases.

Impaired Bone Microarchitecture and Lower Estimated Bone Strength in Children with Type 1 Diabetes

Objective: To evaluate peripheral bone geometry, volumetric bone mineral density (vBMD) and microarchitecture, and to estimate bone strength in children and adolescents with type 1 diabetes. Design and Methods: In a cross-sectional study, high resolution peripheral quantitative CT (HR-pQCT) was performed of the radius and tibia in 84 children with type 1 diabetes and 55 healthy control siblings. Estimated bone strength was assessed using a micro-finite element analysis solver. Multivariate regression analyses were performed adjusting for age, sex, height and body mass index. Results: The median age was 13.2 years in the diabetes group vs. 11.5 years in controls. The median (range) diabetes duration was 4.2 (0.4;15.9) years; median (range) latest year Hb1Ac was 7.8 (5.9;11.8) % (61.8 (41;106) mmol/mol). In adjusted analyses, type 1 diabetes patients had reduced estimated bone strength (failure load) in radius, -324.4 (-545.7;-103.1) kN, p=.004, and tibia, -753.3 (-1149;-357.7) kN, p< .001. In the radius and tibia, children with type 1 diabetes had reduced cortical area, trabecular vBMD, trabecular number and trabecular bone volume fraction and increased trabecular inhomogeneity, adjusted p<.05 for all. Latest year HbA1c was negatively associated with bone microarchitecture (radius and tibia), and with trabecular vBMD and estimated bone strength (tibia). Conclusion: Children with type 1 diabetes had reduced bone sizes, trabecular vBMD and estimated bone strength and adverse microarchitecture, inversely correlated to higher last year HbA1c levels. HR-pQCT holds potential to identify early adverse bone changes and to explain the increased fracture risk in young type 1 diabetes patients. Funding Statement: This study was supported financially by The Consultant’s Research Fund at Odense University Hospital (ID: A1869). Declaration of Interests: The authors have no conflict of interest to declare. Ethics Approval Statement: The study was approved by the Regional Ethical Committee of Southern Denmark (ProjectID: S-20160159) and the Data Protection Agency (Journal nr:18/44863).

Continuous decline in bone mineral density and deterioration of bone microarchitecture 7 years after Roux-en-Y gastric bypass surgery.

ObjectiveRoux-en-Y-gastric bypass (RYGB) surgery is an effective treatment for morbid obesity. A possible overlooked side effect is negative bone metabolic consequences. DesignA seven-year prospective study following ten women and seven men after RYGB (baseline mean age 43 ± 8 years, BMI 42 ± 6 kg/m2).MethodsLumbar spine and total hip bone mineral density (BMD) using dual energy x-ray absorptiometry, distal radius and tibia bone geometry, volumetric BMD, microarchitecture and finite element estimated bone strength using high-resolution peripheral quantitative CT and biochemical markers of bone remodelling were assessed at baseline, 2 and 7 years.ResultsCompared to baseline, body weight was 24 ± 10% lower after 2 years and 21 ± 11% after 7 years. During the 7 years of follow-up, radius and tibia vBMD had declined 13 ± 8% and 8 ± 7% from baseline to 2 years and further 10 ± 7% and 7 ± 8% from 2 to 7 years (all P < 0.001). At both radius and tibia, cortical thickness declined and cortical porosity increased. From baseline to 7 years, there were clear indications of deteriorations of the trabecular network with fewer, more widely spaced and more in-homogeneously distributed trabeculae in both radius and tibia. Overall, declines in estimated bone strength of 16 ± 9% in radius and 16 ± 7% in tibia were observed (both P < 0.001).ConclusionSeven years after RYGB, evidence of continuous declines in BMD and ongoing deterioration of bone microarchitecture and reduced estimated bone strength compared to baseline and 2 years post-surgery results were found. These findings emphasize the need for regular assessment of bone health in patients with prior RYGB.

In Vitro Antiosteoporosis Activity and Hepatotoxicity Evaluation in Zebrafish Larvae of Bark Extracts of Prunus jamasakura Medicinal Plant.

Osteoporosis is one of the main health problems in the world today characterized by low bone mass and deterioration in bone microarchitecture. In recent years, the use of natural products approach to treat it has been in the increase. In this study, in vitro antiosteoporosis activity and hepatotoxicity of P. jamasakura bark extracts were evaluated. Methods. Mouse bone marrow macrophage (BMM) cells were incubated with tartrate-resistant acid phosphate (TRAP) buffers and p-nitrophenyl phosphate and cultured with different P. jamasakura bark extracts at concentrations of 0, 6.25, 12.5, 25, and 50 μg/ml in the presence of the receptor activator of nuclear factor kappa-Β ligand (RANKL) for 6 days. The osteoclast TRAP activity and cell viability were measured. Nitric oxide (NO) assay was conducted using murine macrophage-like RAW 264.7 cells treated with P. jamasakura ethanolic and methanolic bark extracts at concentrations of 0, 6.25, 12.5, 25, 50, 100, and 200 μg/ml. For hepatotoxicity assessment, zebrafish larvae were exposed to P. jamasakura bark extracts, 0.05% dimethyl sulfoxide as a negative control, and 5 μM tamoxifen as a positive control. The surviving larvae were anesthetized and assessed for hepatocyte apoptosis. Results. TRAP activity was significantly inhibited (p < 0.001) at all concentrations of P. jamasakura extracts compared to the control treatment. At 50 μg/ml, both ethanolic and methanolic extracts of P. jamasakura exhibited significant (p < 0.01) BMM cell viability compared to the control treatment. P. jamasakura ethanolic and methanolic extracts had significant inhibitory (p < 0.01) effects on lipopolysaccharide (LPS)-induced NO production at 200 μg/ml and exhibited significant (p < 0.01) and (p < 0.05) stimulative effects, respectively, on RAW 264.7 cell viability. No overt hepatotoxicity was observed in the liver of zebrafish larvae in any of the treatments. Conclusion. The TRAP activity of P. jamasakura bark gives a foundation for further studies to enhance future development of antiosteoporosis drug.

The Effect of Kinesitherapy on Bone Mineral Density in Primary Osteoporosis: A Systematic Review and Meta-Analysis of Randomized Controlled Trial.

Objective Osteoporosis (OP) is a well-established age-related disease, pathologically characterized by bone microarchitectural deterioration, increased fragility, and low BMD. Primary osteoporosis (POP) is the most common type of OP. Methods Publications pertaining to the effectiveness of kinesitherapy on BMD in POP from PubMed, SCI, Cochrane Library, Embase, VIP, CNKI, and Wanfang Database were retrieved from their inception to October 2019. Results A total of 21 studies with 1840 participants were included. The results of the meta-analysis revealed that kinesitherapy plus antiosteoporosis medications had a positive effect on lumbar spine BMD when the duration of intervention was 6 months (MD = 0.11 g/cm2; 95% CI: 0.06–0.15; P < 0.0001) or >6 months (MD = 0.04 g/cm2; 95% CI: 0.02–0.06; P < 0.0001) compared with antiosteoporosis medications alone. Additional kinesitherapy plus antiosteoporosis medications were associated with improved femoral neck BMD compared with antiosteoporosis medications alone (MD = 0.09 g/cm2; 95% CI: 0.03–0.16; P=0.004). Conclusions Kinesitherapy plus antiosteoporosis medications significantly improved lumbar spine and femoral neck BMD in the current low-quality evidence. Additional high-quality evidence is required to confirm the effect of kinesitherapy on BMD in patients with POP.

Determination of bone mass and hip axis length of contralateral side in patients with hip fracture

Introduction: The currently accepted definition of osteoporosis as follows: A progressive systemic skeletal disease characterized by a low bone mass and microarchitectural deterioration of bone tissue leading to an increase in bone fragility and a susceptibility to fractures. BMD compared with age and sex matched controls (Z-scores) or with young adult sex matched controls (T-scores). Hip axis length (HAL) is the dimension along the femoral neck axis from the base of greater trochanter through the femoral head and the acetabulum to the inner pelvic brim, and it is one of the strongest predictors of fracture risk. Material and method: Twenty five patients with hip fracture of which 14 patients had intertrochantric fracture and 11 had neck femur fracture were included in our study. Bone mineral density of contralateral hip at neck, trochanteric region, Ward’s triangle, upper shaft and total BMD were assessed. Hip axis length was calculated automatically by the machine. All the parameters were analyzed and compared for statistical reporting of results. Summary and Conclusion: We conclude that the patients with hip fractures have significantly lower bone mass in proximal femur, femoral neck region and intertrochanteric region. The mean hip axis length of patients with femoral neck fractures (10.25 ± 0.73 cm) is more than patients with intertrochanteric fractures (9.76 ± 0.80 cm).

Bone fracture risk: Density and microarchitecture qualification

Osteoporosis is a systemic skeletal disease where an increase in bone fragility is due to low bone mass and micro-architectural deterioration of bone tissue, which occur over a long period of time without clinical significance.Currently, Double Energy X-ray Absorption (DEXA) is the gold standard for bone mineral density assessment and the diagnosis of osteoporosis, but the majority of fractures occur in patients who would not be considered at fracture risk based on their Bone Mineral Density (BMD) values. It has long been known that fracture risk depends not only on mass loss, but also on bone architecture, whose alterations are an independent factor of increased fragility.The Bone Elastic Structure Test, BES TEST®, is a recently introduced analysis that assesses bone quality as expressed by the elastic properties of the trabecular micro-architecture from a virtual biopsy of the patient and could be a helpful add-on to densitometry for predicting fragility fractures and patient monitoring.The aim of this study is the comparison of DEXA and BES TEST® ability as 3-year risk estimators in a clinical application.In the CONTROL group, the BSI T-score is significantly different from the femoral DEXA T-score (p = 0.0005). In the FRACTURED group, the BSI T-score is significantly different from both the femoral DEXA T-score (p = 0.0266) and the lumbar DEXA T-score (p = 0.0051). Inter-group t-test statistical analysis (95% significance) shows that the femoral DEXA T-score (neck) of the CONTROL and the FRACTURED groups are not significantly different (p = 0.1478), while the BSI T-score of the CONTROL and the FRACTURED groups highlights a significant difference (p = 0.0001). Despite the small number of subjects, our data seem to confirm that the BSI could be a helpful add-on to densitometry for predicting fragility fractures and patient monitoring.

Phytoconstituents as novel osteo-protective agents: Implications in bone health.

Osteoporosis is a progressive and chronic bone disorder characterized by low bone mass and microarchitectural deterioration of skeletal tissues. Osteoporosis leads to alteration in bone mineral content resulting in decreased bone strength with elevated fracture risks frequently associated with greater morbidity. The latest research in the area of photomedicine had sparked interest in harnessing the active components from plants in both disease control and management across the globe. We in the present review have taken a comprehensive approach to identify forty known plants and their phytoconstituents, which encompasses (i) the genetic diversity of various plants, (ii) their active components and (iii) their osteoprotective role in osteoporosis. Thus, the present review is an attempt for the first time to collectively document the therapeutic properties of valuable medicinal plants in preventing and treating bone loss in osteoporosis.

Osteoporosis and fragility fractures: risk assessment, management and prevention.

Osteoporosis is a chronic skeletal condition characterised by low bone mass and microarchitectural deterioration of the bones that disproportionately affects older people. Older people with osteoporosis are at increased risk of sustaining fragility fractures, and this risk is compounded by factors such as falls and frailty. Fragility fractures can have several physical and psychological effects, potentially affecting an older person's quality of life and reducing their life expectancy. Therefore, it is important that nurses can identify individuals at risk of osteoporosis and recognise the factors that may predict fragility fractures. This article outlines the main risk factors for osteoporosis and details the assessment and management of patients with this condition. It also explains the pharmacological interventions and lifestyle changes that can reduce the risk of fragility fractures in older people with osteoporosis.

Bone Mineral Is More Heterogeneously Distributed in the Femoral Heads of Osteoporotic and Diabetic Patients: A Pilot Study.

ABSTRACTOsteoporosis is associated with systemic bone loss, leading to a significant deterioration of bone microarchitecture and an increased fracture risk. Although recent studies have shown that the distribution of bone mineral becomes more heterogeneous because of estrogen deficiency in animal models of osteoporosis, it is not known whether osteoporosis alters mineral distribution in human bone. Type 2 diabetes mellitus (T2DM) can also increase bone fracture risk and is associated with impaired bone cell function, compromised collagen structure, and reduced mechanical properties. However, it is not known whether alterations in mineral distribution arise in diabetic (DB) patients’ bone. In this study, we quantify mineral content distribution and tissue microarchitecture (by μCT) and mechanical properties (by compression testing) of cancellous bone from femoral heads of osteoporotic (OP; n = 10), DB (n = 7), and osteoarthritic (OA; n = 7) patients. We report that though OP cancellous bone has significantly deteriorated compressive mechanical properties and significantly compromised microarchitecture compared with OA controls, there is also a significant increase in the mean mineral content. Moreover, the heterogeneity of the mineral content in OP bone is significantly higher than controls (+25%) and is explained by a significant increase in bone volume at high mineral levels. We propose that these mineral alterations act to exacerbate the already reduced bone quality caused by reduced cancellous bone volume during osteoporosis. We show for the first time that cancellous bone mineralization is significantly more heterogeneous (+26%) in patients presenting with T2DM compared with OA (non‐DB) controls, and that this heterogeneity is characterized by a significant increase in bone volume at low mineral levels. Despite these mineralization changes, bone microarchitecture and mechanical properties are not significantly different between OA groups with and without T2DM. Nonetheless, the observed alterations in mineral heterogeneity may play an important tissue‐level role in bone fragility associated with OP and DB bone. © 2019 The Authors. JBMR Plus published by Wiley Periodicals, Inc. on behalf of American Society for Bone and Mineral Research.

Prospective Study Evaluating Changes in Bone Quality in Premenopausal Women With Breast Cancer Undergoing Adjuvant Chemotherapy

BackgroundOvarian suppression from chemotherapy results in bone loss in premenopausal women with breast cancer (BC). Less is known about bone microarchitecture changes. We used high-resolution peripheral quantitative computed tomography (HR-pQCT) to measure volumetric bone density and trabecular and cortical microarchitecture in this population. Materials and MethodsThe primary endpoint was to assess changes in cortical thickness and trabecular bone density by HR-pQCT. Premenopausal women with stage I to III BC undergoing adjuvant chemotherapy underwent a bone mineral density (BMD) dual energy x-ray absorptiometry scan and HR-pQCT (voxel size, 82 microns) at baseline and 12 months. Paired t tests were used to observe the change over time in bone microarchitecture and areal and volumetric density. ResultsEighteen patients were evaluated, of which 12 patients had baseline and matched 12-month imaging. The mean age was 45.2 years (range, 35-51 years), 17 (94%) patients had hormone receptor-positive BC, and 16 (89%) initiated tamoxifen. At 12 months, there was a significant decrease in femoral neck (P < .05) and lumbar spine and total hip (P < .01) BMD. Changes detected by HR-pQCT at 12 months included significant decreases in cortical thickness and area at the tibia (P < .05), and total and cortical volumetric BMD at the radius and tibia (P < .01), as well as an increase in tibial trabecular area (P < .05). ConclusionPremenopausal women undergoing chemotherapy experience BMD decline and trabecular and cortical bone microarchitecture deterioration. In this population, future efforts should focus on therapy-induced bone loss and optimizing bone density-related management.

Bone Metabolism in Inflammatory Bowel Disease and Celiac Disease

Osteoporosis is a systemic skeletal disease characterized by low bone mass and microarchitecture deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Several gastrointestinal disorders have been associated with osteoporosis including inflammatory bowel disease and celiac disease. Different factors can explain low bone density and fractures in these patients.

Serum Proteomic Analysis Reveals Vitamin D-Binding Protein (VDBP) as a Potential Biomarker for Low Bone Mineral Density in Mexican Postmenopausal Women.

Osteoporosis is a skeletal disease mainly affecting women over 50 years old and it represents a serious public health problem because of the high socioeconomic burden. This disease is characterized by deterioration of bone microarchitecture, low bone mineral density (BMD), and increased risk of fragility fractures. This study aimed to identify serum useful proteins as biomarkers for the diagnosis and/or prognosis of osteoporosis and fracture risk. We collected 446 serum samples from postmenopausal women aged ≥45 years old. Based on the BMD measurement, we classified the participants into three groups: osteoporotic, osteopenic, and normal. In an initial discovery stage, we conducted a proteomic approach using two-dimensional differential gel electrophoresis (2D-DIGE). The peptides into the spots of interest were identified through matrix-assisted laser desorption/ionization-time of flight (MALDI-TOF/TOF). Enzyme-linked immunosorbent assay (ELISA) was performed to validate the proteins of interest. We identified 27 spots of interest when comparing low BMD versus normal BMD postmenopausal women. Based on their relevance in bone metabolism, we analyzed three proteins: ceruloplasmin (CP), gelsolin (GSN), and vitamin D-binding protein (VDBP). Our results demonstrated that low serum VDBP levels correlate with low BMD (osteopenic and osteoporotic). Therefore, VDBP could be considered as a novel, potential, and non-invasive biomarker for the early detection of osteoporosis.

FAKTOR-FAKTOR YANG MEMPENGARUHI MOTIVASI PENCEGAHAN OSTEOPOROSIS

Background: Osteoporosis is characterized by a decrease in bone mass density and deterioration of bone microarchitecture, so that the bones become brittle and break easily. Efforts should be made to minimize the complications of osteoporosis by preventing osteoporosis. To do osteoporosis prevention requires good motivation. The purpose of this study was to analyze lifestyle as osteoporosis factor. Subjects of this research were Kadilangu villagers. The samples were 102 responden selected by using total sampling method. Method of the research is a corelational study. This research has two variables, the independent variable is factors that influence motivation (age, gender, education level, level of knowledge) and the dependent variable is the motivation to prevent osteoporosis. Collecting data use questionnaire paper. Data analysis use logistic regresion test with p=0,05. The result of this research is knowledge is the factor that affect on prevention motivation of osteoporosis, that is with value p = 0,000, OR 56,571 ; CI 95 % 4,094 until 297,099. Variable age, gender, dan education have no effect on prevention motivation of osteoporosis. Statistical test results of these variables are: age (p = 0,463), gender (p = 0,696, education (p = 0,671). The value of Nagelkerke R Square is 49,4 %. The conclusion of this study is that the factors that influence the motivation to prevent osteoporosis are the level of knowledge, while the age, gender, and level of education have no effect on preventing osteoporosis on villagers of Kadilangu, Baki, Sukoharjo. Keywords: age, education, gender, knowledge, motivation, osteoporosis

Ionizing Radiation Exacerbates the Bone Loss Induced by Iron Overload in Mice.

Patients with radiotherapy are at significant risks of bone loss and fracture. On the other hand, osteoporosis often occurs in disorders characterized by iron overload. Either ionizing radiation (IR) or iron overload alone has detrimental effects on bone metabolism, but their combined effects are not well defined. In this study, we evaluated the effects of IR on bone loss in an iron-overload mouse model induced by intraperitoneal injection of ferric ammonium citrate (FAC). In the present study, we found that IR additively aggravated iron overload induced by FAC injections. Iron overload stimulated hepcidin synthesis, while IR had an inhibitory effect and even inhibited the stimulatory effects of iron overload. Micro-CT analysis demonstrated that the loss of bone mineral density and bone volume, and the deterioration of bone microarchitecture were greatest in combined treatment group. Iron altered the responses of bone cells to IR. Iron enhanced the responses of osteoclasts to IR with elevated osteoclast differentiation, but did not affect osteoblast differentiation. Our study indicates that IR and iron in combination lead to a more severe impact on the bone homeostasis when compared with their respective effects. IR aggravated iron overload induced bone loss by heightened bone resorption relative to formation. The addictive effects may be associated with the exacerbated iron accumulation and osteoclast differentiation.

Impaired bone microarchitecture in distal interphalangeal joints in patients with primary hypertrophic osteoarthropathy assessed by high-resolution peripheral quantitative computed tomography.

This study aimed to investigate the bone impairment in finger joints in primary hypertrophic osteoarthropathy (PHO) patients firstly by high-resolution peripheral quantitative computed tomography (HR-pQCT). Fifteen PHO patients and 15 healthy controls were enrolled in this study. Bone erosions in hands at distal interphalangeal joints (DIPs) in both PHO patients and controls were evaluated by X-ray. Bone geometry, vBMD, microstructure parameters, and size of individual bone erosion were also measured at the 3rd DIP by HR-pQCT as well. Blood biochemistry levels between the two groups were also compared. Compared to X-ray, HR-pQCT assessment were more sensitive for detection of bone erosions, with 14 PHO patients by HR-pQCT versus ten PHO patients by X-ray judged at the 3rd DIP. The average depth, width, and volume of erosions size in PHO patients were 1.38 ± 0.80 mm, 0.79 ± 0.27 mm, and 1.71 ± 0.52 mm3, respectively. The bone cross-areas including total area (+ 25.3%, p ≤ 0.05), trabecular area (+ 56.2%, p ≤ 0.05), and cortical perimeter (+ 10.7%, p ≤ 0.05) at the defined region of interest of 3rd DIP was significantly larger than controls. Total vBMD was 11.9% lower in PHO patients compared with the controls (p ≤ 0.05). Biochemical test results showed the increased levels of inflammatory cytokines, bone resorption markers, and joint degeneration markers in PHO patients. Serum prostaglandin PGE2, high-sensitive C-reactive protein (hsCRP) and erythrocyte sedimentation rate (ESR) levels were found negatively correlated with total vBMD. This study demonstrated higher sensitivity of the HR-pQCT measurement at DIPs by showing the differences in architecture and biomechanics parameters at DIPs between the PHO patients and healthy controls, which would be of interest clinically to investigate bone deterioration in PHO patients.

A Spatio-Temporal Ageing Atlas of the Proximal Femur.

Osteoporosis is an age-associated disease characterised by low bone mineral density (BMD) and micro-architectural deterioration leading to enhanced fracture risk. Conventional dual-energy X-ray absorptiometry (DXA) analysis has facilitated our understanding of BMD reduction in specific regions of interest (ROIs) within the femur, but cannot resolve spatial BMD patterns nor reflect age-related changes in bone microarchitecture due to its inherent averaging of pixel BMD values into large ROIs. To address these limitations and develop a comprehensive model of involutional bone loss, this paper presents a fully automatic pipeline to build a spatio-temporal atlas of ageing bone in the proximal femur. A new technique, termed DXA region free analysis (DXA RFA), is proposed to eliminate morphological variation between DXA scans by warping each image into a reference template. To construct the atlas, we use unprocessed DXA data from Caucasian women aged 20-97 years participating in three cohort studies in Western Europe ( ,000). A novel calibration procedure, termed quantile matching regression, is proposed to integrate data from different DXA manufacturers. Pixel-wise BMD evolution with ageing was modelled using smooth quantile curves. This technique enables characterisation of spatially-complex BMD change patterns with ageing, visualised using heat-maps. Furthermore, quantile curves plotted at different pixel coordinates showed consistently different rates of bone loss at different regions within the femoral neck. Given the close relationship between spatio-temporal bone loss and osteoporotic fracture, improved understanding of the bone ageing process could lead to enhanced prognostic, preventive and therapeutic strategies for the disease.

Impact of Diabetes Mellitus on Bone Health.

Long-term exposure to a diabetic environment leads to changes in bone metabolism and impaired bone micro-architecture through a variety of mechanisms on molecular and structural levels. These changes predispose the bone to an increased fracture risk and impaired osseus healing. In a clinical practice, adequate control of diabetes mellitus is essential for preventing detrimental effects on bone health. Alternative fracture risk assessment tools may be needed to accurately determine fracture risk in patients living with diabetes mellitus. Currently, there is no conclusive model explaining the mechanism of action of diabetes mellitus on bone health, particularly in view of progenitor cells. In this review, the best available literature on the impact of diabetes mellitus on bone health in vitro and in vivo is summarised with an emphasis on future translational research opportunities in this field.