Bone Mineral Loss Research Articles

Immediate versus conventional loading in short and ultra-short implants: a protocol design.

After tooth extraction, inevitable resorption of the postextraction socket occurs. Placing an immediate implant does not fully preserve the bone integrity of the socket. Preservation techniques cannot avoid alveolar resorption. In residual atrophies, bone augmentation techniques are necessary for subsequent rehabilitation with implants. The aim of this study was to propose a protocol of immediate loading in short implants as an alternative to bone augmentation techniques, comparing the immediate versus conventional loading, evaluating peri-implant bone loss, the biological and prosthetic complications, the survival of the implant and prosthesis and the patient satisfaction after one year. This study consists of a randomized controlled clinical trial. For implant planning, periapical intraoral radiographs and Cone Beam Computed Tomography will be used. All patients will receive Straumann Group® (Basel, Switzerland) titanium-zirconia implants with a 4.1mm or 4.8mm diameter and a 4 mm or 6 mm length. The expected results show similar or even minor bone loss, biological and prosthetic complications, identical or even better survival of the short implants with immediate loading, and greater satisfaction. Short implants demonstrate similar survival to conventional length implants, with comparable or even minor biological and prosthetic complications and bone loss. Immediate loading gives satisfactory results similar to conventional loading, with similar biological and prosthetic complications, and generally depends on poor hygiene levels. Bone loss is even less, and the satisfaction increases.

Comparison of physical fitness level among different competition categories in women's basketball

Acquiring good levels of physical fitness in women's basketball is crucial for success in this complex sport. Thus, the objective of the research is to compare the level of physical fitness in women's basketball between different competitive categories through a systematic review. For this purpose, four databases were consulted (Google Scholar, PubMed, Scielo and LILACS) in Portuguese, Spanish and/or English, in which 32 primary scientific articles were found on physical fitness in women's basketball in the competitive categories and 51 manuscripts complementary secondary about the theme. Physical fitness indicators are divided into anthropometric, metabolic and neuromuscular. Each indicator has a series of variables whose sum will allow us to understand the athlete's actual physical fitness status. The physical training of female players follows the same guidelines as male athletes, but three aspects deserve attention when prescribing programs: menstrual cycle, eating disorders and bone mineral loss. In addition, cardiovascular and neuromuscular characteristics distinguish genders and interfere with physical fitness gains. In general results, professional basketball players presented better averages in the group of indicators (63.1%), followed by formative (21.0%), college (10.5%) and semi-professional (5.26%) players. Finally, it was evident that as female players progress in chronological age, they mature biologically and acquire training support, advancing between the competitive categories. In this way, your physical fitness comes to denote improvement. However, there is a large individual biological variability that impacts the average numbers between the indicators.

Palliative effect of rotating magnetic field on glucocorticoid-induced osteonecrosis of the femoral head in rats by regulating osteoblast differentiation

With the substantial increase in the overuse of glucocorticoids (GCs) in clinical medicine, the prevalence of glucocorticoid-induced osteonecrosis of the femoral head (GC-ONFH) continues to rise in recent years. However, the optimal treatment for GC-ONFH remains elusive. Rotating magnetic field (RMF), considered as a non-invasive, safe and effective approach, has been proved to have multiple beneficial biological effects including improving bone diseases. To verify the effects of RMF on GC-ONFH, a lipopolysaccharide (LPS) and methylprednisolone (MPS)-induced invivo rat model, and an MPS-induced invitro cell model have been employed. The results demonstrate that RMF alleviated bone mineral loss and femoral head collapse in GC-ONFH rats. Meanwhile, RMF reduced serum lipid levels, attenuated cystic lesions, raised the expression of anti-apoptotic proteins and osteoprotegerin (OPG), while suppressed the expression of pro-apoptotic proteins and nuclear factor receptor activator-κB (RANK) in GC-ONFH rats. Besides, RMF also facilitated the generation of ALP, attenuated apoptosis and inhibits the expression of pro-apoptotic proteins, facilitated the expression of OPG, and inhibited the expression of RANK in MPS-stimulated MC3T3-E1 cells. Thus, this study indicates that RMF can improve GC-ONFH in rat and cell models, suggesting that RMF have the potential in the treatment of clinical GC-ONFH.

Association between neck circumference and bone mineral loss: A cross-sectional study in Sichuan province in China

BackgroundThe associations of fat distribution with bone health are debatable. We aimed to investigate the associations between neck circumference (NC) and bone mineral loss among the adult Chinese population in Sichuan province. MethodsWe examined overall NC size and NC stratums (≤35 cm, 35<NC≤38 cm, >38 cm) with bone mineral density (BMD) at the femoral neck, lumbar spine, total hip skeletal sites in 135 men and 479 women respectively, and assessed whether adiposity, lipids, and calcium and phosphorus levels, might have a biased role in the relationship of NC and bone mineral loss with linear regression, logistic regression, and restricted cubic spline models. ResultsThe overall NC size is not independently associated with BMD at all sites. However, stratification for NC revealed that the positive correlation between NC and BMD at all sites were significant in the NC stratum 1 (≤35 cm) in women (all p<0.05) and NC stratum 2 (35<NC≤38 cm) in men (all p<0.05). Further linear regression analyses showed NC stratum 2 was positively correlated with BMD at all sites in men after adjustment for all confounders, and the risk of low bone mass was generally increased in men with NC stratum 3 (>38 cm) compared with NC stratum 1 using logistic regression. However, in women, no statistically significant association was observed between NC stratum 1 and BMD values after adjustment for the same confounders. ConclusionsOur findings suggest a NC stratum-specific association between NC size and bone mineral loss in men in Sichuan province in China, but not in women.

SHOULDER INSTABILITY IN SOUTHEAST ASIA: ARE WE THAT DIFFERENT? ALGORITHM AND TREATMENT STRATEGIES IN DEALING WITH MINOR AND MAJOR BONE LOSS

Concepts in glenoid tracking and treatment strategies of glenoid bone loss are well established. Initial observations in our practice in Singapore showed few patients with major bone loss requiring glenoid reconstructions. This led us to investigate the incidence of and the extent of bone loss in our patients with shoulder instability. Our study revealed bony Bankart lesions were seen in 46% of our patients but glenoid bone loss measured only 6–10% of the glenoid surface. In the same study we found that arthroscopic labral repair with capsular plication and Mason-Ellen suturing (Hybrid technique) was sufficient to stabilise patients with bipolar bone defects and minor glenoid bone loss. This led us to develop the concept of minor bone loss and a new algorithm.Our algorithm and strategies to deal with major bone loss will also be discussed, and techniques &amp; outcomes of Arthroscopic Bony Bankart repair, Arthroscopic Glenoid Reconstruction and Arthroscopic Remplissage procedures will be shown.

Impact of Pheochromocytoma or Paraganglioma on Bone Metabolism: A Systemic Review and Meta-analysis

Preclinical and animal studies have suggested that excess catecholamines can lead to bone mineral loss. However, to date, no systematic review is available that has analyzed the impact of catecholamine excess in the context of pheochromocytoma/paraganglioma (PPGL) on bone metabolism. We conducted this meta-analysis to address this knowledge gap. Electronic databases were searched for studies evaluating bone metabolism, including assessments of bone mineral density (BMD), quantitative computed tomography (qCT), trabecular bone score (TBS), or bone turnover markers in patients with PPGL. These markers included those of bone resorption, such as tartrate-resistant acid phosphatase 5b (TRACP-5b) and cross-linked C-telopeptide of type I collagen (CTx), as well as markers of bone formation, such as bone-specific alkaline phosphatase (BS ALP). Out of the initially screened 1614 articles, data from six studies published in four different patient cohorts with PPGL that met all criteria were analysed. Individuals with PPGL had significantly lower TBS [Mean Difference (MD) -0.04 (95% CI: -0.05--0.03); p < 0.00001; I2 = 0%], higher serum CTx [MD 0.13 ng/ml (95% CI: 0.08-0.17); p < 0.00001; I2 = 0%], and higher BS-ALP [MD 1.47 U/L (95% CI: 0.30-2.64); p = 0.01; I2 = 1%]. TBS at 4-7 months post-surgery was significantly higher compared to baseline [MD 0.05 (95% CI: 0.02-0.07); p < 0.0001]. A decrease in CTx has been documented post-surgery. Bone health deterioration is a major concern in patients with PPGL. In addition to providing a definitive cure for catecholamine excess, monitoring and treating osteoporosis is essential for individuals with secondary osteoporosis due to PPGL. Long-term studies on bone health outcomes in PPGL are warranted.

Discordant responses of bone formation and absorption markers in Japanese infants with vitamin D deficiency: a comprehensive matched case-control study.

Vitamin D deficiency during infancy has been associated with increased bone turnover rate and bone mineral loss. However, few studies have examined bone turnover markers (BTMs) for both bone formation and resorption in infants with vitamin D deficiency. Here, we analyzed serum concentrations of 25OHD, intact parathormone (iPTH), and BTMs including total alkaline phosphatase (ALP), tartrate-resistant acid phosphatase isoform 5b (TRACP-5b), and serum type I collagen N-telopeptide (NTx) as well as basic clinical characteristics of 456 infants (626 samples) aged less than 12mo born at Saitama City Hospital, Japan (latitude 35.9° North) between January 2021 and December 2022. One hundred sixteen infants (147 samples) were classified as having vitamin D deficiency (25OHD < 12.0ng/mL), and 340 infants (479 samples) had sufficient vitamin D levels (25OHD ≥ 12.0ng/mL). In addition to 25OHD and ALP, both TRACP-5b and sNTx were measured in 331 infants (418 samples), while 90 infants (105 samples) had only TRACP-5b measured and 101 infants (103 samples) had only sNTx measured. Statistical comparison of 104 subjects each in the vitamin D deficiency and sufficiency groups after matching for the background characteristics revealed that the vitamin D deficiency group had significantly higher levels of ALP and iPTH compared with the sufficiency group (P = <.0001, .0012, respectively). However, no significant differences were found in TRACP-5b and NTx levels between the 2 groups (P = .19, .08, respectively). Our findings suggest discordant responses between bone formation and resorption markers in subclinical vitamin D deficiency during infancy.

Common questions and misconceptions about caffeine supplementation: what does the scientific evidence really show?

Caffeine is a popular ergogenic aid that has a plethora of evidence highlighting its positive effects. A Google Scholar search using the keywords "caffeine" and "exercise" yields over 200,000 results, emphasizing the extensive research on this topic. However, despite the vast amount of available data, it is intriguing that uncertainties persist regarding the effectiveness and safety of caffeine. These include but are not limited to: 1. Does caffeine dehydrate you at rest? 2. Does caffeine dehydrate you during exercise? 3. Does caffeine promote the loss of body fat? 4. Does habitual caffeine consumption influence the performance response to acute caffeine supplementation? 5. Does caffeine affect upper vs. lower body performance/strength differently? 6. Is there a relationship between caffeine and depression? 7. Can too much caffeine kill you? 8. Are there sex differences regarding caffeine's effects? 9. Does caffeine work for everyone? 10. Does caffeine cause heart problems? 11. Does caffeine promote the loss of bone mineral? 12. Should pregnant women avoid caffeine? 13. Is caffeine addictive? 14. Does waiting 1.5-2.0 hours after waking to consume caffeine help you avoid the afternoon "crash?" To answer these questions, we performed an evidence-based scientific evaluation of the literature regarding caffeine supplementation.

Expert opinion on the clinical use of calcium and vitamin D supplements in osteoporosis in Indian settings

Background: Several clinical studies demonstrated that calcium intake decreases the risk of osteoporosis and osteoporotic fractures. However, understanding the prescription practice of calcium supplements employed in Indian contexts may help in improving patient management and developing evidence-based recommendations for optimizing the treatment. So, this study aimed to gather clinicians’ perspective regarding the use of calcium and vitamin D supplements for the management of osteoporosis in Indian settings. Methods: The current survey involved 17 questions pertaining to current feedback, clinical observations, and clinical experience of specialists on osteoporosis management and the use of calcium and vitamin D supplements. Results: According to 30%, 26%, 25%, and 19% of the experts, higher dietary sodium (salt) intake was generally associated with negative calcium balance and bone mineral loss, increased risk of fracture, decreased calcium excretion in the urine and decreased dietary calcium absorption. Calcium and vitamin D were recommended by 78% of the respondents for the management of osteoporosis. Approximately 72% of the respondents stated calcium aspartate anhydrous as the preferred calcium supplement to manage osteoporosis. Around 49% of the respondents reported a reduced risk of bone fractures among those who consume more calcium than the average amount. Further 48%, 30%, and 25% of the respondents indicated that calcium aspartate anhydrous have better absorption, better bioavailability, and better gastrointestinal tolerability. Conclusions: According to the expert’s opinion, both calcium and vitamin D administration in conjunction with maintaining a balanced sodium intake were recommended for managing osteoporosis.

Nutritional considerations for people living with a Fontan circulation: a narrative review.

The population of people living with a Fontan circulation are highly heterogenous, including both children and adults, who have complex health issues and comorbidities associated with their unique physiology throughout life. Research focused on nutritional considerations and interventions in the Fontan population is extremely limited beyond childhood. This review article discusses the current literature examining nutritional considerations in the setting of Fontan physiology and provides an overview of the available evidence to support nutritional management strategies and future research directions. Protein-losing enteropathy, growth deficits, bone mineral loss, and malabsorption are well-recognised nutritional concerns within this population, but increased adiposity, altered glucose metabolism, and skeletal muscle deficiency are also more recently identified issues. Emergencing evidence suggets that abnormal body composition is associated with poor circulatory function and health outcomes. Many nutrition-related issues, including the impact of congenital heart disease on nutritional status, factors contributing to altered body composition and comorbidities, as well as the role of the microbiome and metabolomics, remain poodly understood.

Prediction of osteoporosis using MRI and CT scans with unimodal and multimodal deep-learning models.

Osteoporosis is the systematic degeneration of the human skeleton, with consequences ranging from a reduced quality of life to mortality. Therefore, the prediction of osteoporosis reduces risks and supports patients in taking precautions. Deep-learning and specific models achieve highly accurate results using different imaging modalities. The primary purpose of this research was to develop unimodal and multimodal deep-learning-based diagnostic models to predict bone mineral loss of the lumbar vertebrae using magnetic resonance (MR) and computed tomography (CT) imaging. Patients who received both lumbar dual-energy X-ray absorptiometry (DEXA) and MRI (n = 120) or CT (n = 100) examinations were included in this study. Unimodal and multimodal convolutional neural networks (CNNs) with dual blocks were proposed to predict osteoporosis using lumbar vertebrae MR and CT examinations in separate and combined datasets. Bone mineral density values obtained by DEXA were used as reference data. The proposed models were compared with a CNN model and six benchmark pre-trained deep-learning models. The proposed unimodal model obtained 96.54%, 98.84%, and 96.76% balanced accuracy for MRI, CT, and combined datasets, respectively, while the multimodal model achieved 98.90% balanced accuracy in 5-fold cross-validation experiments. Furthermore, the models obtained 95.68%-97.91% accuracy with a hold-out validation dataset. In addition, comparative experiments demonstrated that the proposed models yielded superior results by providing more effective feature extraction in dual blocks to predict osteoporosis. This study demonstrated that osteoporosis was accurately predicted by the proposed models using both MR and CT images, and a multimodal approach improved the prediction of osteoporosis. With further research involving prospective studies with a larger number of patients, there may be an opportunity to implement these technologies into clinical practice.

Effect of the Sr-Fe layered double hydroxide coating based on the microenvironment response on implant osseointegration in osteoporotic rats.

Osteoporosis is a disease that manifests itself as an abnormality of bone metabolism and is characterized by low bone mass and destruction of the bone microstructure. Since bone resorption occurs more rapidly than new bone formation, osteoporosis leads to reduced orthopedic implant stability. From a microenvironmental point of view, the rationale for this outcome is that osteoclasts are overactive in the bone tissue of patients with osteoporosis, and the large amount of H+ they produce leads to local chronic acidosis, which promotes bone mineral loss. Therefore, we designed a weakly alkaline layered double hydroxide (LDH) coating to modulate the pathologically acidic microenvironment and the osteogenic-osteoclastic coupling by releasing Sr2+. We prepared Sr-Fe LDH coatings on pure titanium implants using a hydrothermal method in this study and characterized the material using SEM, AFM, XRD, XPS, EDS, ICP, pH acidimeter, etc. We found that the coatings had good nanomorphology and were able to efficiently neutralize H+ as well as steadily release Sr2+ for up to 21 days. In vitro, the coating not only significantly promoted the adhesion, proliferation, and differentiation of osteoblasts, but also inhibited the differentiation of osteoclasts at the same time. In addition, in animal experiments, the coating significantly improved the mechanical stability of the implant in osteoporotic rats, increasing Sr-Fe LDH@Ti maximal push-out force by 72.2% compared to Ti. At the same time, the coating was effective in reversing the osteoporotic state, resulting in a 58.5% increase in BV/TV (%), and a 12.4% increase in Tb. N (1 mm-1), a 31.6% increase in Tb. Th (μm), and a 30.9% increase in BA (%). Our results suggest that this Sr-Fe LDH nanocoating material with acid-neutralizing, as well as long-term Sr2+-releasing capabilities, is a novel and effective orthopedic implant coating material under osteoporotic conditions.

INVESTIGATION OF THE RADIOLOGICAL TECHNIQUES TO DETECT OSTEOLYTIC LESIONS, FRACTURES, AND OSTEOPOROSIS IN MULTIPLE MYELOMA PATIENTS

Aim: Multiple myeloma is a malignancy of clonal plasmacytes. Osteolytic lesions represent a criterion for symptomatic myeloma and are associated with bone loss, pathological fractures, and osteoporosis. Skeletal surveys with other sophisticated techniques and dual-energy x-ray absorptiometry (DEXA) are used to screen lytic lesions, and bone mineral loss, respectively. Here, we aimed to investigate the rates of detection regarding osteolytic lesions and bone mineral loss by several imaging techniques.&#x0D; Materials and Methods: The study was carried out in Adnan Menderes University Hospital/Turkey, between the years 2004- 2020. Three-hundred and ten symptomatic myeloma patients were screened retrospectively. The results of radiological techniques were recorded. The detection rate of osteolytic lesions, fractures, and plasmacytomas by imaging techniques, as well as bone mineral loss with DEXA was recorded. Also, associations with gender, myeloma type, lytic lesions, and osteoporosis were investigated.&#x0D; Results: Skeletal survey and PET-CT detected lytic lesions in 71.3% and 81.2% of patients, respectively. PET-CT had a sensitivity of 96.1% and specificity of 90.6% to detect lytic lesions. MRI was only used for patients with suspicious fractures and detected them for all patients who underwent MRI. The osteoporosis rate was 83.1% for 113 patients who underwent DEXA. Any association between lytic lesions and gender/myeloma type was not detected. &#x0D; Conclusion: Our study demonstrated that osteolytic lesions are not correlated with gender or myeloma type. PET-CT is a sensitive and specific method for detecting osteolytic lesions. Although DEXA is sensitive, its specificity is limited to detect osteoporosis in patients with lytic lesions.

Biologic Antiresorptive: Denosumab.

Osteoporosis is an age-related common bone disorder characterized by low bone mineral density and increased fragility fracture risk. Various Antiresorptive medications are being used to target osteoclast mediated bone resorption to prevent bone loss and reduce fracture risk. Denosumab is a novel biological antiresorptive drug that belongs to the class of monoclonal antibodies. It binds to and inhibits the cytokine receptor activator of nuclear factor kappa-B ligand (RANKL), which is requisite for osteoclast differentiation, function and survival. Denosumab has been shown to be a potent and effective therapy for osteoporosis, with clinical trial data demonstrating significant improvement in bone mineral density (BMD) and reductions in fracture risk at various skeletal sites for more than 10 years of treatment. Denosumab has a favourable benefit/risk profile, with low rates of complications such as infection, atypical femoral fracture and osteonecrosis of the jawbone. However, denosumab treatment requires continuous administration, as discontinuation leads to rapid bone mineral loss and increased risk of multiple vertebral fractures due to rebound of bone turnover. Therefore, modification to another anti-osteoporosis drug therapy after denosumab discontinuation is required to maintain bone health. Denosumab is a promising biological antiresorptive therapy for osteoporosis that offers high efficacy and safety, but also poses challenges for long-term management.

Pathogenetic and associative relationships between the parameters of periodontal health and bone mineral density in women living in a megalopolis

Relevance. Osteoporosis and chronic periodontitis are serious issues of modern life. The hypothesis that these two diseases are associated is still open-ended and doesn’t allow setting the record straight for the lack of sufficient evidence.Purpose. The study aimed to detect the relationship between periodontal health parameters and mineral bone density characteristics in postmenopausal women.Material and methods. The study examined 109 female patients with diagnosed moderate chronic generalized periodontitis (К05.31). The participants formed two groups: the main group (76 women) and the control group (33 women). Dual-energy X-ray absorptiometry, FRAХ® and CCI assessed the mineral bone density and patients’ systemic health. Dental status was evaluated using the OHI-S, CAL, PPD, PMA, PI, and PBI. X-ray assessment was based on the Fuchs index for upper and lower jaws, and the mandibular cortical index (MCI) was evaluated by CBCT scans in Galaxis Galileos software (Sirona), Orthophos SL CBCT scanner. The data were statistically analysed using licensed STATISTICA 13.3 software. In descriptive statistics for variables, the median was quartiles corresponding to the 25th percentile and the 75th percentile. The Shapiro-Wilk test and χ2 (chi-square) evaluated the normality of variables.Results. Periodontal pocket depth (PPD) was 4.44 (4.30:4.20:4.50) in the main group. The cumulative change in the clinical attachment level (CAL) was 5.53 (5.50:5.40:5.80), which was significantly higher than the control group parameters (р &lt; 0.001). Bone mineral density of L1-L4 vertebrae corresponded to osteopenia (g/cm2) -0.83 (-080: -0.78: -0.91), spine (Neck) Т-score was -1.70 (-1.7: -2.2: -2.0). In the patients of the control group, the CBCT did not show any signs of inf lammatory destruction, and the DXA test did not reveal any loss of bone mineral densit y.Conclusion. There are mean significant (less than 0.05) correlations between right femoral neck Т-scores and periodontal pocket depth parameters (R = -0.39) and between the same parameter and the clinical attachment level (CAL) (R = -0.37). A significantly high degree of negative correlation is between the spine Т-score of L1-L4 and PPD, correlation coefficient (R = -0.72).

Emphatic information on bone mineral loss using quantitative ultrasound sonometer for expeditious prediction of osteoporosis

Osteoporosis (OP) and osteoarthritis (OA) are skeletal disorders characterized by a reduction in bone density and quality, resulting in increased fragility and susceptibility to fractures. These illnesses are exhibiting a higher prevalence among both males and females. Fracture risk is determined by using the BMD score (Bone Mineral Density). Looking at the bone loss that comes with osteoarthritis (OA) and osteoporosis (OP), this study also looks at the technological methods used to test for these conditions in order to improve therapies and treatment plans for older people. As a matter of consideration, the prevalence of osteoporosis is higher among postmenopausal women (20%) compared to premenopausal women (14.28%) and males (6.77%). The utilization of a preliminary calcaneal Quantitative Ultrasound (QUS) examination is warranted in order to effectively handle the matter of osteoporosis. The prompt assessment of a patient can provide valuable insights into potential fractures and aid in the prevention of bone injury. In a nutshell, it is imperative to comprehend the impact of OA (osteoarthritis) and OP (osteoporosis) on bone health in order to effectively manage the escalating apprehensions surrounding these conditions. Sophisticated diagnostic techniques, such as the calcaneal quantitative ultrasound (QUS) test, have the potential to enhance the well-being of older individuals by enabling early detection and treatment of many ailments.

Do men improve their bone mineral density 1 year after parathyroidectomy for primary hyperparathyroidism? Results of a prospective study

BackgroundThe impact of parathyroidectomy on bone mineral density in men with primary hyperparathyroidism is poorly known. This study aimed to evaluate the bone mineral density and bone remodeling biomarker changes in men with primary hyperparathyroidism 1 year after parathyroidectomy. MethodsMen operated for sporadic primary hyperparathyroidism between 2016 and 2022, enrolled in a monocentric prospective cohort, were analyzed. Patients with follow-up <1 year or missing data were excluded. Bone mineral density (dual X-ray absorptiometry) was measured before and 12 months after parathyroidectomy. Bone mineral density change ≥0.03g/cm2 was deemed significant. Bone remodeling biomarkers were serum cross-linked C-telopeptide, procollagen type 1 N-terminal propeptide, and bone-specific alkaline phosphatases. ResultsForty-five men were included (mean age 58.8 ± 13.1 years). Before surgery, 49% had osteopenia, and 11% had osteoporosis. Mean serum calcium and median serum parathyroid hormone levels decreased significantly after surgery (P < .0001). One year after parathyroidectomy, the mean bone mineral density increased significantly at the lumbar spine (+0.04g/cm2 [0.01;0.70], P = .0054), femoral neck (+0.04g/cm2 [0.03;0.05], P < .0001) and total hip (+0.02g/cm2 [0.01;0.03], P = .0002). Considering significant bone mineral density gain (+1 point) and loss (–1 point) at each site, 29/45 patients (64% [95% CI 49;78]) improved. Bone remodeling biomarker concentrations significantly decreased (P < .001). ConclusionParathyroidectomy positively affects bone mineral density in men with primary hyperparathyroidism, supporting osteopenia as a surgical indication in these patients.

Osteoporosis and major fragility fractures (MOF) in sarcoidosis patients: association with disease severity

BackgroundThe reports on bone mineral loss or major osteoporosis fracture (MOF) in sarcoidosis are scarce and have conflicting outcomes. This study aimed to evaluate the prevalence and risk factors of MOF in sarcoidosis patients.MethodsIn a single-center cohort of 382 patients with sarcoidosis (55.8 ± 11.6 years) we evaluated bone mineral density at lumbar spine, at femoral neck and at total hip and the presence of MOF. Lung function measurements including diffusion capacity for carbon monoxide (DLCO) were assessed. Chest X-rays were performed and radiological staging was done by Scadding score.ResultsNinety patients (23.6%) with sarcoidosis have history of a MOF. BMD T-scores were lower in sarcoidosis with MOF with respect to those without MOF, but the difference was statistically significant only for BMD at femoral neck (p < 0.05). Moreover, BMD values at total hip was positively correlated with DLCO (%) (p < 0.001). Prevalence of MOF was higher in patients with sarcoidosis with lung parenchymal involvement (radiological stages 2–4) than in patients with sarcoidosis in chest X-ray stages 0 and 1 (28.3 vs 19.2% respectively, p < 0.05). Moreover, multiple regression analyses showed that X-ray Scadding score was positively associated with MOF.ConclusionsThis study shows that MOF represent a common and important complication in patients with moderate/severe sarcoidosis. The chest X-ray evaluation and the pulmonary function test could allow to define the risk of MOF in sarcoidosis patients.

Supplementing Low-Sodium Bicarbonate-Calcic (Lete)® Water: Effects in Women on Bone and Systemic Metabolism.

Calcium (Ca) represents about 40% of the total mineral mass, mainly in the bone, providing mechanical strength to the skeleton and teeth. An adequate Ca intake is necessary for bone growth and development in children and adolescents and for maintaining bone mineral loss in elderly age. Ca deficiency predisposes to osteopenia and osteoporosis. Healthy nutrition, including an adequate intake of Ca-rich food, is paramount to prevent and cure osteoporosis. Recently, several clinical studies have demonstrated that, in conditions of Ca dysmetabolism, Ca-rich mineral water is beneficial as a valuable source of Ca to be used as an alternative to caloric Ca-rich dairy products. Although promising, these data have been collected from small groups of participants. Moreover, they mainly regard the effect of Ca-rich mineral water on bone metabolism. In contrast, an investigation of the effect of Ca supplementation on systemic metabolism is needed to address the spreading of systemic metabolic dysfunction often associated with Ca dysmetabolism. In the present study, we analyzed urine and blood sera of 120 women in perimenopausal condition who were subjected for six months to 2l daily consumption of bicarbonate-calcium mineral water marketed under ®Lete. Remarkably, this water, in addition to being rich in calcium and bicarbonate, is also low in sodium. A complete set of laboratory tests was carried out to investigate whether the specific water composition was such to confirm the known therapeutic effects on bone metabolism. Second, but not least, urine and blood sera were analyzed using NMR-based metabolomic procedures to investigate, other than the action on Ca metabolism, potential system-wide metabolic effects. Our data show that Lete water is a valid supplement for compensating for Ca dysmetabolism and preserving bone health and integrity.

Breast Cancer and Bone Mineral Density in a U.S. Cohort of Middle-Aged Women: Associations with Phosphate Toxicity.

Breast cancer is associated with phosphate toxicity, the toxic effect from dysregulated phosphate metabolism that can stimulate tumorigenesis. Phosphate toxicity and dysregulated phosphate metabolism are also associated with bone mineral abnormalities, including excessive bone mineral loss and deposition. Based on shared associations with dysregulated phosphate metabolism and phosphate toxicity, a hypothesis proposed in the present mixed methods-grounded theory study posits that middle-aged women with incidence of breast cancer had a greater magnitude of changes in bone mineral density over time compared with women who remained cancer-free. To test this hypothesis, a mixed-effects model was used to analyze the associations of breast cancer incidence with spinal bone mineral density changes in the U.S. Study of Women's Health Across the Nation. Compared with women in the cohort who remained cancer-free, women who self-reported breast cancer had higher bone mineral density at baseline, but had more rapid losses in bone mineral density during follow-up visits. These findings agree with the hypothesis that a greater magnitude of changes in bone mineral density over time is associated with breast cancer in a cohort of middle-aged women. The findings also have implications for studies investigating dysregulated phosphate metabolism and phosphate toxicity as causative factors of bone metastasis in metastatic breast cancer. Additionally, the authors previously found increased breast cancer risk associated with high dietary phosphate intake in the same cohort of middle-aged women, and more studies should investigate a low-phosphorus diet to reduce bone mineral abnormalities and tumorigenesis in breast cancer patients.