Bone Mass Density Research Articles

How do carbohydrate quality indices influence on bone mass density in postmenopausal women? A case–control study

BackgroundCarbohydrates are the primary energy source in Asian countries, including Iran. An emerging method can be used to measure the quality of carbohydrates, including the carbohydrate quality index (CQI), which includes a variety of components. Low-carbohydrate diet score (LCDS) has been proposed as a new method of scoring micronutrient intake that could provide a reasonable explanation for the link between diet and the risk of chronic diseases.ObjectiveThis study aimed to investigate the relationship between CQI, LCDS, glycemic index (GI), glycemic load (GL), insulin load (IL), and insulin index (II) with bone mass density (BMD) in postmenopausal women.MethodIn this case–control study, 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy postmenopausal women aged 45–65 participated. The dual-energy X-ray absorptiometry (DEXA) method measured the BMD of the lumbar vertebrae and femoral neck. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake. Logistic regression were used to evaluate the relation between GI, GL, II, IL, CQI, and LCDS with BMD.ResultsDiets with higher GI increased the risk of osteopenia and osteoporosis, but LCDS and CQI decreased the risk of osteopenia and osteoporosis.ConclusionThese findings suggest that a higher intake of fruits and vegetables and receiving various dietary vitamins, minerals, and antioxidant compounds may be a useful way to prevent osteopenia in Iranian women.

The Preventable Effect of Taekwondo Sport among Cadets and Junior' Bone Mineral Density: DEXA Assessment.

Athletes competing in Taekwondo (TKD), the weight-category sport, tend to rapidly lose weight to achieve the desired body weight for better competitive results. Little is known about the effect of rapid weight reduction on bone mass density (BMD), especially during childhood and adolescence. The current study aimed to investigate the impact of rapid weight loss on BMD among cadets and juniors TKD athletes. A descriptive case series study design was conducted and collected from 28 males and females aged 12-17 years old, with mean age 14.4 ± 1.7. Dual-energy X-ray absorptiometry (DEXA) was used for both BMD and body composition assessment, and laboratory tests were also performed for the total calcium (Ca), TSH, free T4 (FT4), and 25-OH-vitamin D. Results showed normal levels of Ca (82.1%), TSH (96.4%), and FT4 (96.4%), whilst 85.7% had vitamin D deficiency. DEXA results showed that within male athletes, juniors had a wider range of BMD than cadets, while within females, results did not vary, with no statistical difference between both males and females. Our results suggested that children and adolescents' BMD was positively related to TKD sport regardless of the abnormal weight loss strategies used, as evidenced by laboratory results. Children and adolescents should be conscious and practice TKD sport adopting healthy weight loss behaviors.

Reference values for bone mass in young athletes: a cross-sectional study in São Paulo, Brazil

Reference values for bone mass in young athletes need to be used for screening purposes, and country/regional reference values should be used to improve precision of comparisons. The aim of the present study was to develop reference values for bone health variables in Brazilian young athletes. The bone mass content (BMC), bone mass density (BMD), and total body less head (TBLH) BMD using dual-energy X-ray absorptiometry were measured in 702 young athletes (327 men and 375 women) aged 8.5–18.5 years, divided into 5 groups, according to their age: group 1 (8.5–10.5 years), group 2 (10.6–12.5 years), group 3 (12.6–14.5 years), group 4 (14.6–16.5 years), and group 5 (16.6–18.5 years). Comparisons between the sexes and ages were performed and age-sex-smoothed reference values were constructed. Male athletes presented high BMC and BMD than female athletes in age groups 3, 4, and 5 (p < 0.005) and high TBLH BMD than female athletes in age groups 4 and 5 (p < 0.005). Reference values, including the percentiles are presented for the bone health variables of each sex and age group. The age-, sex-, and ethnic-specific reference data for bone variables presented in this study enabled more precise reference data for young Brazilian athletes. These data may assist in monitoring changes during an athletes’ growth and different phases of athletic training.

The study of bone mass measurement by clavicle radiogrammetry in a comparison to the dual energy x-ray absorptiometry examination

Background: Clavicle radiogrammetry test related to chest radiography has been found to be useful in evaluation of osteoporosis. The diagnosis of osteoporosis was based on the measurement of bone mineral density (BMD) with dual energy x-ray absorptiometry. Objectives: The aim of this study was to evaluate bone mass measurement using clavicle radiograms to differentiate the goal standards related to the dual energy x-ray absorptiometry methods. Materials and methods: The population sample consisted of a 100 healthy Thai adult volunteers, (50 women, 50 men) aged from 24 to 76 years. The study subjects were divided as normal bone mass group, T-score ≥ -1.0 and the low bone mass group, T-score ≤ -1.0. Subsequently, posteroanterior (PA) chest radiographs were taken. Measurements of the clavicle radiograms were evaluated, and the images at the midshaft of both clavicles were calculated. An independent t-test was used to examine the differences between the normal and the low bone mass of each gender and two separate BMD sites. The confidence interval was 95% at level of significance 0.05. Pearson’s correlation was used to measure the strength and direction of linear relationship between the bone mass measurement using the dual energy x-ray absorptiometry (DEXA) test and clavicle radiogrammetry test. Results: The results showed 18 women and 28 men maintained a normal BMD, while 32 women and 22 men had low bone mass density. The average clavicle thickness measurements of the normal bone mass of the women group were lower than the normal bone mass measurements of men. Conversely, the low bone groups of women measurements were higher than low bone mass in the men’s group. A greater diminishing of cortical thickness of clavicle was found in the low bone mass than normal group for both genders. The average cortical thickness of clavicle in the low bone mass of women decreased by 17.8% (5.31 mm/6.46 mm) compared to normal women, while in men, which were fewer, 16.13% (7.07 mm/8.43 mm) between groups, respectively. The average measurements of the clavicle periosteal width and combined cortical thickness of clavicle showed a positive correlation with BMD, whereas, the clavicle endosteal width showed a negative correlation with BMD. Conclusion: Using the radiogrammetric method to measure the clavicle cortex thickness on the chest x-ray images showed a gradual thinning of the cortex with aging. By comparison, the measurements of clavicle cortex thickness showed a moderate relationship with BMD performed by DEXA in the assessment of osteoporosis.

Effects of high impact exercises on physical activity, bone mineral density, body mass index and body fat percentage among osteopenic young females

IntroductionWhile osteopenia was once considered an older disease, it is now commonly seen in young individuals. The low bone density in the young population is alarming, leading to demands to improve physical activity. The study aims to determine the effectiveness of high impact exercise among young females with osteopenia.MethodsA quasi-experimental study was conducted in the out-patient department of Jinnah Sindh medical university among forty-five females aged 18 to 30 years, with osteopenia. The participants were enrolled through convenience and a purposive sampling technique. A training program involving high impact exercise was given for 4 weeks following an initial screening using a DEXA scan. The outcome was measured with the pre- and post-intervention of an exercise program on bone mass density (BMD), body mass index (BMI) and body fat percentage (BFP).ResultsAt the end of the four weeks, BMI, BMD and BFP showed significant improvements (&lt;i&gt;p&lt;/i&gt; &lt; 0.05). The BMD was improved from –1.95 to –1.89. It was found that BMD was significantly associated with age (0.04).ConclusionsOur study confirmed that the bone health of young females needs special attention to avoid osteoporosis in the future. The high impact exercises did show significant improvements through training, but additional studies are required on a larger scale.

INFLUÊNCIA DE LESÕES ESPORTIVAS E TREINAMENTO DE RESISTÊNCIA NA MASSA ÓSSEA DE ESQUIADORES

ABSTRACT Introduction: With the preparation and development of the Winter Olympic Games, there has been an increase in the popularity of skiing. Driven by this demand, the professional development of coaches requires updates in the analysis of skiers’ sports injuries, elaboration of corresponding prevention and treatment strategies, and resistance training to promote the development of athletes’ physical quality, such as bone mass and mineral density. Objective: Study the sports injuries of skiers and explore needs and ways of applying resistance training in skiing. Methods: The questionnaire survey was used to explore the main types of injuries and their influencing factors. Then, 20 volunteers were selected for the resistance training experiment; each group of 10 people included five men and five women. The control group maintained a normal daily life, while resistance training was added to the experimental group three times a week, based on the control group. Results: The research results showed that the current proportion of skiing injuries was relatively high, mainly in mild injuries. After nine weeks in the experimental resistance training group, both men and women had positive bone mass development. Conclusion: Resistance training can improve physical quality and reduce the occurrence of sports injuries, demonstrating the benefits of its implementation in endurance training for skiers. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

Loss of N-acetylglucosaminyl transferase V is involved in the impaired osteogenic differentiation of bone marrow mesenchymal stem cells.

The imbalance of bone resorption and bone formation causes osteoporosis (OP), a common skeletal disorder. Decreased osteogenic activity was found in the bone marrow cultures from N-acetylglucosaminyl transferase V (MGAT5)-deficient mice. We hypothesized that MGAT5 was associated with osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) and involved in the pathological mechanisms of osteoporosis. To test this hypothesis, the mRNA and protein expression levels of MGAT5 were determined in bone tissues of ovariectomized (OVX) mice, a well-established OP model, and the role of MGAT5 in osteogenic activity was investigated in murine BMSCs. As expected, being accompanied by the loss of bone mass density and osteogenic markers (runt-related transcription factor 2, osteocalcin and osterix), a reduced expression of MGAT5 in vertebrae and femur tissues were found in OP mice. In vitro, knockdown of Mgat5 inhibited the osteogenic differentiation potential of BMSCs, as evidenced by the decreased expressions of osteogenic markers and less alkaline phosphatase and alizarin red S staining. Mechanically, knockdown of Mgat5 suppressed the nuclear translocation of β-catenin, thereby downregulating the expressions of downstream genes c-myc and axis inhibition protein 2, which were also associated with osteogenic differentiation. In addition, Mgat5 knockdown inhibited bone morphogenetic protein (BMP)/transforming growth factor (TGF)-β signaling pathway. In conclusion, MGAT5 may modulate the osteogenic differentiation of BMSCs via the β-catenin, BMP type 2 (BMP2) and TGF-β signals and involved in the process of OP.

Effect of different schemes of androgen deprivation therapy on bone mass density in prostate cancer patients

ObjectivesTo evaluate aspects of the basal bone health status in prostate cancer patients. Furthermore, to evaluate in a real-world setting the effect of different schemes (intermittent or continuous) of androgen deprivation therapy (ADT) and the effect of denosumab in bone mass density (BMD). MethodsObservational, retrospective study of a cohort of prostate cancer patients in treatment with luteinizing hormone-releasing hormone (LH-RH) agonists, evaluated in the rheumatology department of a tertiary center. Demographics, FRAX score, LH-RH treatment scheme, osteoporosis treatment, laboratory data and BMD were collected. Mixed effect regression models to analyze the interaction between LH-RH treatment scheme, denosumab and BMD evolution were used. Results83 patients (mean age 71 ± 8 years) were included. At the basal evaluation, 16% of patients presented densitometric osteoporosis and 27% of patients presented high fracture risk. 80% of patients had inadequate vitamin D levels. Vitamin D > 30 ng/mL was correlated with higher T-scores. There was no association between LH-RH treatment scheme and BMD evolution, however there was a positive association with denosumab. ConclusionA high proportion of patients presented elevated fracture risk or inadequate vitamin D levels, not previously recognized. Bone health assessment and fracture risk evaluation are convenient in these patients. In a real-world setting, the effect of denosumab in BMD is detected, however the effect of intermittent LH-RH schema treatment is less evident.

Osteoporosis Assessment among Adults with Liver Cirrhosis.

Osteopenic bone disease occurs frequently in patients with chronic liver cirrhosis, which most frequently presents with hepatic osteodystrophy. Thus, the relationship between nutritional status and bone mineral density has been poorly measured in liver cirrhosis. This single-center study consisted of a group of 70 patients diagnosed with liver cirrhosis. The nutritional status was evaluated with the Controlling Nutritional Status index, and volumetric vertebral bone mineral density was measured with quantitative computed tomography. Among the 70 patients included, osteopenia and osteoporosis were found in 71% and 24.3%, respectively. Malnutrition assessed with the Controlling Nutritional Status index was observed in 56 (80%) patients and was more frequent in alcoholic cirrhosis patients than viral cirrhosis patients (87.24% vs. 65.22%). Significant positive correlation with Controlling Nutritional Status score was found with Model for End-Stage Liver Disease (rho = 0.576, p-value < 0.0001), Child−Pugh score (rho = 0.670, p-value < 0.0001), International Normalized Ratio (rho = 0.517, p-value = 0.001), aspartate aminotransferase (rho = 0.293, p-value = 0.045), and bilirubin (rho =0.395, p-value = 0.02). Among the liver cirrhosis patients, 15 had osteoporosis and 49 had osteopenia at the lumbar spine (L1-L4 vertebrae), as determined by bone mass density via quantitative computed tomography. A non-significant relationship between Controlling Nutritional Status index-assessed nutritional status and bone mass density was documented. Regarding osteoporosis, no differences were found between the viral and alcohol types of liver cirrhosis patients (p-value = 0.870). Age, obesity, grade of varices, Child−Pugh score, and Model for End-Stage Liver Disease score were associated with osteoporosis in patients with liver cirrhosis.

Bone mass density following developmental exposures to perfluoroalkyl substances (PFAS): a longitudinal cohort study

BackgroundEnvironmental exposures to industrial chemicals, including perfluoroalkyl substances (PFAS), may play a role in bone development and future risk of osteoporosis. However, as prospective evidence is limited, the role of developmental PFAS exposures in bone density changes in childhood is unclear. The objective of this study was to estimate associations between serum-PFAS concentrations measured in infancy and early childhood and areal bone mineral density (aBMD) measured at age 9 years in a birth cohort of children from the Faroe Islands.MethodsWe prospectively measured concentrations of five PFAS in cord serum and serum collected at 18 months, 5 years and 9 years, and conducted whole-body DXA scans at the 9-year clinical visit. Our study included 366 mother-child pairs with DXA scans and at least one PFAS measurement. We estimated covariate-adjusted associations of individual PFAS concentrations with age-, sex- and height-adjusted aBMD z-scores using multivariable regression models and applied formal mediation analysis to estimate the possible impact of by several measures of body composition. We also evaluated whether associations were modified by child sex.ResultsWe found PFAS exposures in childhood to be negatively associated with aBMD z-scores, with the strongest association seen for perfluorononanoic acid (PFNA) at age 5 years. A doubling in age-5 PFNA was associated with a 0.15 decrease in aBMD z-score (95% CI: − 0.26, − 0.039). The PFNA-aBMD association was significantly stronger in males than females, although effect modification by sex was not significant for other PFAS exposures. Results from the mediation analysis suggested that any potential associations between aBMD and 18-month PFAS concentrations may be mediated by total body fat and BMI, although most estimated total effects for PFAS exposures at age 18 months were non-significant. PFAS exposures at age 9 were not associated with age-9 aBMD z-scores.ConclusionsThe PFAS-aBMD associations identified in this and previous studies suggest that bone may be a target tissue for PFAS. Pediatric bone density has been demonstrated to strongly track through young adulthood and possibly beyond; therefore, these prospective results may have important public health implications.

Surface Functionalization of Hydroxyapatite Scaffolds with MgAlEu-LDH Nanosheets for High-Performance Bone Regeneration.

Although artificial bone repair scaffolds, such as titanium alloy, bioactive glass, and hydroxyapatite (HAp), have been widely used for treatment of large-size bone defects or serious bone destruction, they normally exhibit unsatisfied bone repair efficiency because of their weak osteogenic and angiogenesis performance as well as poor cell crawling and adhesion properties. Herein, the surface functionalization of MgAlEu-layered double hydroxide (MAE-LDH) nanosheets on porous HAp scaffolds is reported as a simple and effective strategy to prepare HAp/MAE-LDH scaffolds for enhanced bone regeneration. The surface functionalization of MAE-LDHs on the porous HAp scaffold can significantly improve its surface roughness, specific surface, and hydrophilicity, thus effectively boosting the cells adhesion and osteogenic differentiation. Importantly, the MAE-LDHs grown on HAp scaffolds enable the sustained release of Mg2+ and Eu3+ ions for efficient bone repair and vascular regeneration. In vitro experiments suggest that the HAp/MAE-LDH scaffold presents much enhanced osteogenesis and angiogenesis properties in comparison with the pristine HAp scaffold. In vivo assays further reveal that the new bone mass and mineral density of HAp/MAE-LDH scaffold increased by 3.18- and 2.21-fold, respectively, than that of pristine HAp scaffold. The transcriptome sequencing analysis reveals that the HAp/MAE-LDH scaffold can activate the Wnt/β-catenin signaling pathway to promote the osteogenic and angiogenic abilities.

Combination of vertebral bone quality scores from different magnetic resonance imaging sequences improves prognostic value for the estimation of osteoporosis

Background ContextRecent findings revealed a correlation between vertebral bone quality based on T1-weighted (VBQT1) magnetic resonance imaging (MRI) and volumetric bone mass density (vBMD) measured using quantitative computerized tomography. The coherence of VBQ for other MRI sequences, such as T2 or short tau inversion recovery (STIR), has not been examined. The combination of different VBQs has not been studied. PurposeThe aims of the study were to confirm the correlation between VBQT1 and vBMD and to examine VBQs from other MRI sequences and their combination with vBMD. Study Design/SettingThis was a retrospective cross-sectional study. Patient SampleThe sample consisted of patients older than 18 years, who received treatment at a level-one university spine center of the German Spine Society for degenerative or traumatic reasons in 2017–2021. Outcome MeasuresThe outcome measures were the correlation of VBQs from different MRI sequences with vBMD and the association of VBQs with osteopenia/osteoporosis. MethodsPatients’ VBQ was calculated based on the signal intensities of the vertebral bodies L1–4 in T1-, T2-, and STIR-weighted MRI. The VBQ was standardized according to the signal intensity of the cerebrospinal fluid. The vBMD was determined using data from a calibrated scanner (SOMATOM Definition AS+) and processed with CliniQCT (Mindways Software, Inc., USA). Groups were divided according to vBMD into the following groups: (I) osteoporosis/osteopenia (< 120 mg/m3) and (II) healthy (≥120 mg/m3). An analysis of the correlation between various VBQs and vBMD as well as receiver operating characteristic (ROC) and binary regression analyses were performed for the prediction of osteoporosis/osteopenia. ResultsWe included 136 patients (women: 56.6%) in the study (69.7 ± 15.0 years). According to vBMD, 108 patients (79.4%) had osteoporosis/osteopenia. Women were affected significantly more often than men (p = .045) and had significantly higher VBQT1 and VBQT2 values than men (VBQT1: p = .048; VBQT2: p = .013). VBQT1 and VBQT2 values were significantly higher in patients with osteoporosis/osteopenia than in healthy persons (VBQT1: p<.001; VBQT2: p = .025). VBQT1 and VBQT2 were significantly negatively correlated with vBMD with a moderate effect size (p<.001), while VBQSTIR was not significantly correlated with vBMD, although it showed a positive coherence. The combination of different VBQs in terms of VBQT1 × VBQT2 / VBQSTIR distinctly increased the effect size of the negative correlation with vBMD compared to VBQ alone. A cutoff value for VBQT1 × VBQT2 / VBQSTIR of 2.9179 achieved a sensitivity of 80.0%, a specificity of 75.0%, and an area under the curve (AUC) of 0.775 for the determination of osteoporosis. The mathematical model derived from the binary logistic regression showed an excellent AUC of 0.846. ConclusionsThis study confirms a significant correlation between VBQT1 and vBMD. The combination of VBQs from different MRI sequences enhances the prognostic value of VBQ for the determination of osteoporosis. While safe clinical application of VBQ for the determination of osteoporosis requires further validation, VBQ might offer opportunistic estimation for further diagnostics.

Utilization of Nanotechnology to Improve Bone Health in Osteoporosis Exploiting Nigella sativa and Its Active Constituent Thymoquinone.

Osteoporosis, a chronic bone disorder, is one of the leading causes of fracture and morbidity risk. Numerous medicinally important herbs have been evaluated for their efficacy in improving bone mass density in exhaustive preclinical and limited clinical studies. Nigella sativa L. has been used as local folk medicine, and traditional healers have used it to manage various ailments. Its reported beneficial effects include controlling bone and joint diseases. The present manuscript aimed to provide a sound discussion on the pharmacological evidence of N. sativa and its active constituent, thymoquinone, for its utility in the effective management of osteoporosis. N. sativa is reported to possess anti-IL-1 and anti-TNF-α-mediated anti-inflammatory effects, leading to positive effects on bone turnover markers, such as alkaline phosphatase and tartrate-resistant acid phosphatase. It is reported to stimulate bone regeneration by prompting osteoblast proliferation, ossification, and decreasing osteoclast cells. Thymoquinone from N. sativa has exhibited an antioxidant effect on bone tissue by reducing the FeNTA-induced oxidative stress. The present manuscript highlights phytochemistry, pharmacological effect, and the important mechanistic perspective of N. sativa and its active constituents for the management of osteoporosis. Further, it also provides sound discussion on the utilization of a nanotechnology-mediated drug delivery approach as a promising strategy to improve the therapeutic performance of N. sativa and its active constituent, thymoquinone, in the effective management of osteoporosis.

Nanoparticle-mediated selective Sfrp-1 silencing enhances bone density in osteoporotic mice

Osteoporosis (OP) is characterized by a loss in bone mass and mineral density. The stimulation of the canonical Wnt/β-catenin pathway has been reported to promote bone formation, this pathway is controlled by several regulators as secreted frizzled-related protein-1 (Sfrp-1), antagonist of the pathway. Thus, Sfrp-1 silencing therapies could be suitable for enhancing bone growth. However, the systemic stimulation of Wnt/β-catenin has been correlated with side effects. This work hypothesizes the administration of lipid-polymer NPs (LPNPs) functionalized with a MSC specific aptamer (Apt) and carrying a SFRP1 silencing GapmeR, could favor bone formation in OP with minimal undesired effects. Suitable SFRP1 GapmeR-loaded Apt-LPNPs (Apt-LPNPs-SFRP1) were administered in osteoporotic mice and their biodistribution, toxicity and bone induction capacity were evaluated. The aptamer functionalization of the NPs modified their biodistribution profile showing a four-fold increase in the bone accumulation and a ten-fold decrease in the hepatic accumulation compared to naked LPNPs. Moreover, the histological evaluation revealed evident changes in bone structure observing a more compact trabecular bone and a cortical bone thickness increase in the Apt-LPNPs-SFRP1 treated mice with no toxic effects. Therefore, these LPNPs showed suitable properties and biodistribution profiles leading to an enhancement on the bone density of osteoporotic mice.

Osteopontin, a bridge links osteoarthritis and osteoporosis.

Osteoarthritis (OA) is the most prevalent joint disease characterized by degradation of articular cartilage, inflammation, and changes in periarticular and subchondral bone of joints. Osteoporosis (OP) is another systemic skeletal disease characterized by low bone mass and bone mineral density (BMD) accompanied by microarchitectural deterioration in bone tissue and increased bone fragility and fracture risk. Both OA and OP are mainly affected on the elderly people. Recent studies have shown that osteopontin (OPN) plays a vital role in bone metabolism and homeostasis. OPN involves these biological activities through participating in the proliferation, migration, differentiation, and adhesion of several bone-related cells, including chondrocytes, synoviocytes, osteoclasts, osteoblasts, and marrow mesenchymal stem cells (MSCs). OPN has been demonstrated to be closely related to the occurrence and development of many bone-related diseases, such as OA and OP. This review summarizes the role of OPN in regulating inflammation activity and bone metabolism in OA and OP. Furthermore, some drugs that targeted OPN to treat OA and OP are also summarized in the review. However, the complex mechanism of OPN in regulating OA and OP is not fully elucidated, which drives us to explore the depth effect of OPN on these two bone diseases.

Bone metabolism and bone mass density following successful treatment of catecholamine secreting tumors

Searchable abstracts of presentations at key conferences in endocrinology ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Observational Study on Efficacy of Ibandronate Sodium 3 mg IV Injection in Treatment of Postmenopausal Osteoporosis

Objective: To evaluate the efficacy of Ibandronate sodium 3 mg IV injection in routine clinical practice for treatment of postmenopausal osteoporosis. Materials and Methods: With approval of the Ethical Committee, 21 bisphosphonate naïve patients were recruited to receive Ibandronate sodium 3 mg IV injection every three months for 12 months. After the last injection, the patients were followed up at months 12 and 18. The serum level of bone resorption marker, the carboxy-terminal collagen crosslinks (sCTX) were measured at baseline, one week, and every three months before the next injection. Bone mass density (BMD) were evaluated at baseline and month 12. Adverse events were evaluated. Serum creatinine were evaluated at baseline, end of treatment, and end of follow up. Results: Median sCTX reduction was 86.9% within one week after injection from 614.5 pg/mL to 84.0 pg/mL. Median sCTX declined to 329.0, 289.0, 305.0, 285.0 pg/mL at month 3, 6, 9, and 12, respectively. Six months after the last treatment, median sCTX was elevated to 433.0 pg/mL or 75.1% of the baseline. Two non-responders, or 9.5%, with low sCTX at the baseline were found. At month 12, lumbar spine and hip BMD were significantly increased by 4.29% (p=0.003), and 2.20% (p=0.05), respectively. For safety perspective, there was no change in median estimated glomerular filtration rate (eGFR) level from baseline to month 12. Mild to moderate adverse effects had occurred in 33.3% of the patients, myalgia and flu-like symptoms were the most common findings. Conclusion: Ibandronate injection is effective for postmenopausal osteoporosis treatment. It rapidly reduced sCTX to lower than the average level of premenopausal reference range, which could relate to fracture risk reduction. It has significantly increased lumbar spine and hip BMD. Safety profile was promising with a quick off-response and an unchanged renal function. Ibandronate injection has better compliance and advantage for patients having difficulty in complying with oral treatment. Keywords: IV bisphosphonate; Postmenopausal osteoporosis; Bone turnover marker; Quick off-response

Alagille Syndrome and Its Clinical and Laboratory Features: A Case Report

Alagille syndrome (ALGS) is a genetic-driven condition of chronic cholestasis, involving the intrahepatic bile ducts, heart, vessels, kidneys, skeletal tissues, eyes, and nervous system. Pathological mechanisms are still not defined. JAG1 and NOTCH2 gene mutations are responsible for most cases (96–97%). Diagnosis is based on clinical and laboratory findings—especially the presence of chronic cholestasis—and on genetic assessment. Bone abnormalities, deficiency of liposoluble vitamins, heart issues, and pruritus are the most prominent features of ALGS. Diagnostic imaging, such as ultrasonography, magnetic resonance imaging, and bone mass density assessment, is useful to study hepatic disease progression, estimate the risk of bone fracture, and rule out malignities. Therapy is based on ursodeoxycholic acid, rifampicin, cholestyramine, and supplementation of liposoluble vitamins. New therapeutic approaches are under investigation. Here, we describe a case of an individual with ALGS presenting with congenital chronic cholestasis and a long clinical history, in which pruritus is the main symptom.

Molecular mechanisms, physiological roles, and therapeutic implications of ion fluxes in bone cells: Emphasis on the cation-Cl- cotransporters.

Bone turnover diseases are exceptionally prevalent in human and come with a high burden on physical health. While these diseases are associated with a variety of risk factors and causes, they are all characterized by common denominators, that is, abnormalities in the function or number of osteoblasts, osteoclasts, and/or osteocytes. As such, much effort has been deployed in the recent years to understand the signaling mechanisms of bone cell proliferation and differentiation with the objectives of exploiting the intermediates involved as therapeutic preys. Ion transport systems at the external and in the intracellular membranes of osteoblasts and osteoclasts also play an important role in bone turnover by coordinating the movement of Ca2+ , PO4 2- , and H+ ions in and out of the osseous matrix. Even if they sustain the terminal steps of osteoformation and osteoresorption, they have been the object of very little attention in the last several years. Members of the cation-Cl- cotransporter (CCC) family are among the systems at work as they are expressed in bone cells, are known to affect the activity of Ca2+ -,PO4 2- -,and H+ -dependent transport systems and have been linked to bone mass density variation in human. In this review, the roles played by the CCCs in bone remodeling will be discussed in light of recent developments and their potential relevance in the treatment of skeletal disorders.

Nystose attenuates bone loss and promotes BMSCs differentiation to osteoblasts through BMP and Wnt/β-catenin pathway in ovariectomized mice

Increasing the osteogenic differentiation ability and decreasing the adipogenic differentiation ability of bone marrow mesenchymal stem cells (BMSCs) is a potential strategy for the treatment of osteoporosis (OP). Naturally derived oligosaccharides have shown significant anti-osteoporotic effects. Nystose (NST), an oligosaccharide, was isolated from the roots of Morinda officinalis How. (MO). The aim of the present study was to investigate the effects of NST on bone loss in ovariectomized mice, and explore the underlying mechanism of NST in promoting differentiation of BMSCs to osteoblasts. Administration of NST (40, 80 and 160 mg/kg) and the positive control of estradiol valerate (0.2 mg/kg) for 8 weeks significantly prevented bone loss induced by ovariectomy (OVX), increased the bone mass density (BMD), improved the bone microarchitecture and reduced urine calcium and deoxypyridinoline (DPD) in ovariectomized mice, while inhibited the increase of body weight without significantly affecting the uterus weight. Furthermore, we found that NST increased osteogenic differentiation, inhibited adipogenic differentiation of BMSCs in vitro, and upregulated the expression of the key proteins of BMP and Wnt/β-catenin pathways. In addition, Noggin and Dickkopf-related protein-1 (DKK-1) reversed the effect of NST on osteogenic differentiation and expression of the key proteins in BMP and Wnt/β-catenin pathway. The luciferase activities and the molecular docking analysis further supported the mechanism of NST. In conclusion, these results indicating that NST can be clinically used as a potential alternative medicine for the prevention and treatment of postmenopausal osteoporosis.