Bone Mineral Research Articles

Increased risk of mortality in lung transplant patients with fragility fractures.

The prevalence of osteoporosis among lung transplant candidates has been estimated at 31% to 46%, and significant bone loss occurs after lung transplantation, predominantly in the first year, with increased risk of incident fractures. This study aimed to evaluate the prevalence of fragility fractures in a population of lung transplant recipients and the associated risk factors as well as mortality after a fragility fracture. This was a cross-sectional monocentric study that included patients with lung transplantation occurring < 10years and > 1year who were undergoing lung transplantation monitoring. All patients underwent bone mineral density evaluation by dual-energy X-ray absorptiometry and radiography to establish the presence of vertebral fractures. Mortality was assessed 2years after the last inclusion. We included 131 patients (82 men, 62.6%), with mean age 56.8 ± 10.8years. The mean time from lung transplantation to inclusion was 3.5 ± 3.5years. Overall, 35 (26.5%) patients had a diagnosis of fractures after transplantation; 67 fractures were confirmed (average of 2 per patient), including 48 (71.6%) vertebral fractures. Odds of low bone mineral density at the femoral neck, total hip and spine was associated with fracture: odds ratio 0.007 [0.0002-0.3], 0.001 [0.0002-0.05], and 0.03 [0.001-0.6], respectively. Fracture post transplantation was significantly associated with death (hazard ratio 2.32 [1.01-5.33]). This study confirmed a high prevalence of vertebral fracture in lung transplant patients. Fracture after lung transplant was associated with mortality. Bone fragility needs more attention to reduce the fracture risk.

Tea consumption and bone health in postmenopausal women: a systematic review and meta-analysis.

The impact of tea on bone health in postmenopausal women has generated conflicting opinions. The current study pooled previous research to evaluate the relationship between tea consumption and bone health in postmenopausal women. Relevant papers published before October 2024 were included by conducting a comprehensive literature search in the Embase, PubMed, Scopus, and The Cochrane Library databases. Observational studies reporting the association between tea consumption and bone mineral density (BMD) or the risk of osteoporosis and fractures in women after menopause were deemed eligible. The weighted mean difference (WMD) for BMD and the pooled odds ratio (OR) for osteoporosis and fractures were calculated, together with their corresponding 95% confidence intervals (CIs). The meta-analysis examined 18 studies with a total of 48,615 individuals. The combined results indicated that postmenopausal women who consumed tea had higher BMD at several skeletal sites, including the lumbar spine (WMD, 0.02; 95% CI, 0.01-0.04; P < 0.001), greater trochanter (WMD, 0.02; 95% CI, 0.02-0.03; P < 0.001), femoral neck (WMD, 0.01; 95% CI, 0.00-0.02; P = 0.049), and ward's triangle (WMD, 0.02; 95% CI, 0.01-0.03; P = 0.002). Additionally, these women had a lower risk of osteoporosis (OR, 0.41; 95% CI, 0.26-0.67; P < 0.001) and fracture (OR, 0.81; 95% CI, 0.67-0.98; P = 0.031). The findings of this meta-analysis suggest that postmenopausal women who regularly consumed tea saw an increase in BMD and a decreased likelihood of developing osteoporosis and experiencing fractures. Future research should give priority to conducting prospective cohort studies with a more stringent methodology to verify the dose-response connection between tea consumption and the risk of osteoporosis or fracture in postmenopausal women. PROSPERO registration number CRD42019112196.

Association between serum hemoglobin level and bone mineral density in adults: Iranian multi-center osteoporosis study (IMOS).

Previous studies have investigated the relationship between hemoglobin (Hb) levels and bone mineral density (BMD) with controversial findings. This study aimed to evaluate this association using data from the 4th Iranian Multicenter Osteoporosis Study (IMOS), a population-based national survey, including a population sample aged 50 years and older. The present study was conducted as a cross-sectional data analysis derived from the fourth round of the IMOS. Demographic information, Hb levels, and BMD measurements were collected. BMD was measured with dual-energy X-ray absorptiometry (DXA). Low BMD (osteopenia/osteoporosis) and osteoporosis were defined as a T-score less than -1 and less than -2.5 at each site including hip, femoral neck, or lumbar spine, respectively. Multiple linear regression analysis was used to assess the relationship between Hb levels and BMD. This study included 1,426 participants (54.2% female) with the mean age of 62.6 ± 8.0 years. The mean Hb levels among patients with or without osteoporosis were 12.9 ± 2.0 mg/dl and 13.1 ± 1.9 mg/dl, respectively (p-value = 0.08). It was demonstrated a positive relationship between Hb levels and BMD at hip (β = 0.0079, 95% CI: 0.002- 0.0135, p-value = 0.006) and femoral neck (β = 0.0064, 95% CI: 0.0015- 0.0113, p-value = 0.01) in only men. However, there was no significant correlation between Hb levels with low BMD and osteoporosis in either gender. Our findings showed a favorable relationship between Hb levels and BMD at the hip and femoral neck, particularly in men. This highlights gender and site-specific distinctions between hematological and skeletal health..Future studies should unravel these possible associations and investigate the underlying mechanisms.

A systematic review and hot topic analysis of ballet injury research: CiteSpace visualization atlas

Objective: This study aims to analyze trends, hot topics, and influential research on ballet-related injuries between 2000 and 2023, providing insights for prevention and management strategies. Methods: Using the Web of Science Core Collection, 787 articles were identified with subject terms related to ballet injuries. CiteSpace software (version 6.2.R2) was employed to conduct visual analyses of trends, keyword co-occurrences, and co-citations. The dataset was analyzed across dimensions such as time, geography, authorship, institutions, and hot topics. Results and Conclusions: The publication volume of ballet injury research has steadily increased, with the United States, England, and Australia leading in output. Central topics include risk factors, musculoskeletal disorders, and injury prevention strategies. Key clusters revealed five prominent research directions: risk factors, proprioception, physical activity, jump-related injuries, and bone mineral density. Authors such as Wanke Eileen M., Steinberg Nili, and Ambegaonkar Jatin P. emerged as influential contributors. Institutions like the University of Wolverhampton and Goethe University Frankfurt displayed significant academic impact. The research objects of ballet injury research are mainly female ballet dancers. Research on the causes of ballet injuries mainly focuses on physical activities and incorrect training plans. The most studied part of ballet injuries is the ankle joint.

The skeletal abnormalities and their clinical challenges in SATB2-Associated Syndrome

Abstract SATB2-Associated Syndrome (SAS) is an autosomal dominant genetic disorder caused by pathogenic variations in the special AT-rich sequence-binding protein 2 (SATB2) gene. In addition to neurodevelopmental and craniofacial defects, over 90% of patients with SAS manifest biochemical and/or radiographic skeletal abnormalities, and around one third of patients report clinical and/or radiographic fractures. SATB2 protein is a potent transcription factor that promotes osteoblast differentiation and maturation; loss-of-function pathogenic variations of the SATB2 gene result in a wide spectrum of skeletal abnormalities ranging from gross skeletal anomalies to abnormal bone turnover markers, low bone mineral density, and recurrent fractures. There is at present no known effective treatment for bone health in patients with SAS. We present an adult patient with SAS who has recurrent fractures despite long-term treatment with antiresorptive agents. We propose an alternative pharmacotherapy approach utilizing a PTH analogue to stimulate osteoblasts, hence addressing the underlying pathophysiology of bone disease in patients with SAS.

Single-cell transcriptomics reveals novel chondrocyte and osteoblast subtypes and their role in knee osteoarthritis pathogenesis.

Research on treating knee osteoarthritis (KOA) is becoming more challenging due to a growing number of younger patients being affected. The pathogenesis of KOA is complex for being a multifactorial disease affecting the entire joint, with remodeling of subchondral bone playing a key role in the degeneration of the overlying cartilage. Therefore, this study constructed a bipedal postmenopausal KOA mouse model to better understand how the interplay between subchondral bone remodeling and cartilage degeneration contributes to KOA development. A single-cell atlas of the osteochondral composite tissue was established. Furthermore, three novel subtypes of chondrocytes, including Smoc2+ angiogenic chondrocytes, Angptl7+ angiogenic chondrocytes, and Col1a1+ osteogenic chondrocytes, were identified in femoral condyles of KOA mice. In addition, the Angptl7+ chondrocytes promoted angiogenesis in the subchondral bone of KOA mice by interacting with endothelial cells via the FGF2-FGFR2 signaling pathway. The number of H-type vessels was increased in the subchondral bone, recruiting osteoprogenitor cells and facilitating osteogenesis in KOA mice. Sparc+ osteoblasts have negatively regulated bone mineralization and osteoblastic differentiation, aggravated the pathological remodeling of subchondral bone, and promoted the progression of KOA. The above findings have offered new targets and opened up an avenue for the therapeutic intervention of KOA.

Signaling Pathways Driving MSC Osteogenesis: Mechanisms, Regulation, and Translational Applications

Mesenchymal stem cells (MSCs) are crucial for skeletal development, homeostasis, and repair, primarily through their differentiation into osteoblasts and other skeletal lineage cells. Key signaling pathways, including Wnt, TGF-β/BMP, PTH, Hedgehog, and IGF, act as critical regulators of MSC osteogenesis, playing pivotal roles in maintaining bone homeostasis and facilitating regeneration. These pathways interact in distinct ways at various stages of bone development, mineralization, and remodeling. This review provides an overview of the molecular mechanisms by which these pathways regulate MSC osteogenesis, their influence on bone tissue formation, and their implications in bone diseases and therapeutic strategies. Additionally, we explore the potential applications of these pathways in bone tissue engineering, with a particular focus on promoting the use of MSCs as seed cells for bone defect repair. Ultimately, this review aims to highlight potential avenues for advancing bone biology research, treating bone disorders, and enhancing regenerative medicine.

In Vivo Bone Mineral Density Assessment With Spectral Localizer Radiographs From Photon-Counting Detector CT

Purpose The aim of this study was to determine in a prospective patient study the accuracy of areal bone mineral density (aBMD) measurements with spectral localizer radiographs obtained with a clinical photon-counting detector computed tomography (PCD-CT) scanner in comparison with dual-energy x-ray absorptiometry (DXA). Methods In this institutional review board–approved, prospective study, 41 patients (15 females, 26 males; mean age 61.3 years, age range 35–78 years) underwent PCD-CT of the abdomen with a spectral localizer radiograph (tube voltage 140 kVp, tube current 30 mA) and DXA within a median of 45 days. aBMD values were derived for lumbar vertebrae L1–L4 from both methods and were compared with linear regression, Pearson correlation, intraclass correlation coefficients (ICCs), and Bland-Altman plots. T-scores were calculated on a patient level and were compared between methods. Results DXA and spectral localizer radiographs showed strong correlation in aBMD measurements (R = 0.97, P &lt; 0.001) and patient level T-scores (R = 0.99, P &lt; 0.001). There was a strong agreement between aBMD from both methods (ICC, 0.96; 95% CI, 0.94–0.97). Bland-Altman analysis revealed a very small mean difference in aBMD between methods (mean absolute error 0.019 g/cm2) with narrow limits of agreement (−0.083 g/cm2 to 0.121 g/cm2). Similarly, there were small differences in regard to the T-score (mean absolute error 0.156) with narrow limits of agreement (−0.422 to 0.734) between methods. ICCs indicated an excellent agreement between T-scores from DXA and spectral localizer radiographs (ICC, 0.98; 95% confidence interval, 0.95–0.99). Conclusions Our prospective patient study indicates that spectral localizer radiographs obtained with a clinical PCD-CT system enable accurate quantification of the lumbar bone areal mineral density. This opens up the opportunity for opportunistic screening of osteoporosis in patients who undergo CT for other indications.

The risk of osteonecrosis after apical patency during antiresorptive therapy in an animal model.

To evaluate whether performing apical patency (AP) poses a risk for the development of osteonecrosis in rats treated with the antiresorptive drugs Zoledronic Acid (ZA) or Denosumab (DMAB). Forty-two male Wistar rats were divided into six groups according to the medication administered and whether apical patency was performed (n = 7): ZA, ZA-AP, DMAB, DMAB-AP, and the control groups CON and CON-AP. The ZA and ZA-AP groups received 0.125 mg/kg of ZA, while the DMAB and DMAB-AP groups received 0.25 mg/kg of DMAB, both administered via intraperitoneal injection twice a week for 4 weeks. One week after completing drug administration, endodontic access was performed on the distal occlusal fossa of the lower left first molars in all animals. AP was carried out in the distal canal of the ZA-AP, DMAB-AP, and CON-AP groups using a size 10 K-file with the aid of an electronic apex locator, extending beyond the apical foramen. In the other groups, the file was inserted up short of apex as determined by electronic apex locator measurement. Coronal sealing was performed and after 21 days, the animals were euthanized, and visual analysis, micro-CT, and histopathological assessments were conducted to evaluate the presence or absence of osteonecrosis. Statistical analysis was performed using frequency statistics and a GLM multivariate ANOVA model followed by Tukey's test with significance at p < .05. None of the animals exhibited bone exposure or other clinical signs associated with medication-related osteonecrosis of the jaw. No cortical bone destruction, periosteal reaction, or bone sequestration was observed in the micro-CT or histopathological assessments. Medication significantly influenced some micro-CT parameters (p < .05), while the apical patency alone did not (p > .05). When interacting with medication*apical patency, the ZA-AP group showed a significantly lower percentage of bone volume and bone mineral density compared to the ZA group, a tendency not observed in DMAB groups (p < .05). Apical patency in rats treated with zoledronic acid or denosumab did not cause osteonecrosis of the jaw, only micro-CT changes in bone microarchitecture that cannot be linked to osteonecrosis in zoledronic acid treated animals.

Impact of Lumbar Degenerative Changes on Vertebral Bone Strength: A Finite Element Analysis.

Assessing the bone condition in patients with spinal disease is clinically valuable. However, evaluating bone strength in the presence of spine degenerative changes is challenging. Quantitative computed tomography (QCT) and finite element analysis (FEA) have been proposed as methods for more accurate bone quality assessment. This study investigates the relationship between bone strength predicted by FEA and other relevant biological parameters. This retrospective cross-sectional study included 127 patients with spinal disease who underwent preoperative CT scans between 2014 and 2020. Baseline patient characteristics, volumetric bone mineral density (vBMD) measured by QCT, and vertebral bone strength predicted by FEA were collected. The degree of degeneration was evaluated by classifying osteophyte formation, disc height narrowing, vertebral sclerosis, and spondylolisthesis into a grading scale ranging from 0 to 2. Multiple linear regression analysis was conducted to assess the effect of each factor on bone strength predicted by FEA. Of 127 patients, 120 patients (median age was 62 years) were included. The median vBMD and vertebral strength were 114.3 mg/cm3 and 7892.9 N, respectively. After adjusting for age, sex, body mass index, smoking status, diabetes mellitus, vBMD, and degenerative changes, multiple linear regression analysis revealed that sex, vBMD, and degree of degeneration independently increased the vertebral strength measured by FEA. This study suggests that in patients with spinal disease, vertebral bone strength is affected not only by sex and bone mineral density but also by degenerative changes. Thus, bone strength could be predicted more accurately in patients with spinal disease using FEA.

Exploring the potential cost-effectiveness and societal burden implications of screening for fracture risk in a UK general radiography setting.

Fragility fractures lead to considerable societal costs and individual suffering. Despite the availability of cost-effective treatments for high-risk patients, a significant treatment gap exists, with many high-risk individuals remaining unidentified and untreated. The aim of this study was to explore the potential cost-effectiveness and societal impact of opportunistic screening for fracture risk with IBEX Bone Health (BH), a software solution that provides bone mineral density from wrist radiographs, in a UK general radiography setting. The study used a health economic model that compared the health outcomes and costs of screening with IBEX BH versus usual care for men and women aged 50 and older who had a forearm radiograph for any reason. The model incorporated data on fracture incidence, fracture risk reduction, mortality, quality of life, and fracture and treatment costs from published sources and Royal Cornwall Hospitals NHS Trust. Costs and health outcomes in terms of quality-adjusted life years (QALYs) were simulated over the remaining lifetime of patients. The analysis took the perspective of the National Health Service (NHS) and Personal Social Services in the UK. The results showed that screening with IBEX BH was associated with a gain of 0.013 QALYs and a cost saving of £109 per patient compared with usual care, making it a dominant (cost-saving) strategy. Sensitivity analyses confirmed the robustness of the results under various assumptions. Widespread adoption of IBEX BH in the NHS was estimated to save 8,066 QALYs and £65,930,555 in healthcare costs over the lifetime of patients visiting hospitals for wrist radiographs each year. IBEX BH could be a cost-effective tool for early identification and prevention of fragility fractures in the UK, addressing the current challenges of low provision and access to fracture risk assessment and treatment.

Immune cell profiles and predictive modeling in osteoporotic vertebral fractures using XGBoost machine learning algorithms.

Osteoporosis significantly increases the risk of vertebral fractures, particularly among postmenopausal women, decreasing their quality of life. These fractures, often undiagnosed, can lead to severe health consequences and are influenced by bone mineral density and abnormal loads. Management strategies range from non-surgical interventions to surgical treatments. Moreover, the interaction between immune cells and bone cells plays a crucial role in bone repair processes, highlighting the importance of osteoimmunology in understanding and treating bone pathologies. This study aims to investigate the xCell signature-based immune cell profiles in osteoporotic patients with and without vertebral fractures, utilizing advanced predictive modeling through the XGBoost algorithm. Our findings reveal an increased presence of CD4 + naïve T cells and central memory T cells in VF patients, indicating distinct adaptive immune responses. The XGBoost model identified Th1 cells, CD4 memory T cells, and hematopoietic stem cells as key predictors of VF. Notably, VF patients exhibited a reduction in Th1 cells and an enrichment of Th17 cells, which promote osteoclastogenesis and bone resorption. Gene expression analysis further highlighted an upregulation of osteoclast-related genes and a downregulation of osteoblast-related genes in VF patients, emphasizing the disrupted balance between bone formation and resorption. These findings underscore the critical role of immune cells in the pathogenesis of osteoporotic fractures and highlight the potential of XGBoost in identifying key biomarkers and therapeutic targets for mitigating fracture risk in osteoporotic patients.

Use of 3D-DXA in the assessment of bone structure among patients with chronic kidney disease

IntroductionPatients in later stages of chronic kidney disease (CKD) have a 2- to 14-fold increase in fracture risk. Bone mineral density (BMD) assessment is limited due to the inability to measure trabecular and cortical bone characteristics and the interference of aortic calcifications.Study objectiveThis study aimed to assess the trabecular bone score (TBS) and three-dimensional dual-energy X-ray absorptiometry (3D-DXA) in participants across all CKD stages.Patients and methodsIn total, 64 CKD patients (consisting of 28 female participants and 36 male participants, with an average age of 69.5 years) were included. There were 9, 12, 8, 9, 11, and 15 participants in stages G1, G2, G3a, G3b, G4, and G5 of CKD, respectively. BMD at the lumbar spine (LS) and proximal femur, as well as the LS TBS, were analyzed. The proximal femur parameters such as cortical and trabecular volumetric (v)BMD, cortical thickness (CTh), and surface (s)BMD at the total hip (TH) and femoral neck (FN) were analyzed using 3D-Shaper software.ResultsComparison between the earlier stages (G1-G3a) and the later CKD stages (G3b-G5) showed significant differences in carboxy terminal collagen crosslinks (CTx) (386 vs.1053 ng/L), TH areal bone mineral density (aBMD; 0.991 vs. 0.859 g/cm2), cortical TH vBMD (831 vs. 795 mg/cm3), FN (837 vs. 788 mg/cm3), TH cortical sBMD (170 mg/cm2), and TH Cth (2.03 vs. 1.92 mm; all p &amp;lt; 0.05). Cross-sectional comparisons between each CKD stage showed a gradual decrease in the LS BMD, TH cortical vBMD, sBMD (FN and TH), and TH Cth. Strong positive associations between the glomerular filtration rate (GFR) and cortical parameters (FN/TH vBMD and TH Cth) were observed (p &amp;lt; 0.01).ConclusionIn conclusion, advanced stages of CKD (G3b–G5) were associated with lower cortical bone parameters. The majority of the cortical parameters were correlated with the GFR, demonstrating a direct relationship between the kidney function and bone structure.

Evaluation and optimization of physical, mechanical, and biological characteristics of 3D printed Whitlockite/calcium silicate composite scaffold for bone tissue regeneration using response surface methodology.

Calcium phosphate-based bioscaffolds are used for bone tissue regeneration because of their physical and chemical resemblance to human bone. Calcium, phosphate, sodium, potassium, magnesium, and silicon are important components of human bone. The successful biomimicking of human bone characteristics involves incorporating all the human bone elements into the scaffold material. In this work, Mg-Whitlockite (WH) and Calcium Silicate (CS) were selected as matrix and reinforcement respectively, because of their desirable elemental composition and regenerative properties. The magnesium in WH increases mineralization in bone, and the silicon ions in CS support vascularization. The Mg-WH was synthesized using the wet chemical method, and powder characterization tests were performed. Response surface methodology (RSM) is used to design the experiments with a combination of material compositions, infill ratios (IFs), and sintering temperatures (STs). The WH/CS bioceramic composite is 3D printed in three different compositions: 100/0, 75/25, and 50/50 wt%, with IFs of 50%, 75%, and 100%. The physical and mechanical characterization study of printed samples is conducted and the result is optimized using RSM. ANOVA (Analysis of Variance) is used to establish the relationship between input parameters and responses. The optimized input parameters were the WH/CS composition of 50/50 wt%, IF of 50%, and ST of 1150 °C, which bring out the best possible combination of physical and mechanical characteristics. The RSM optimized response was a density of 2.27 g cm-3, porosity of 36.74%, wettability of 45.79%, shrinkage of 25.13%, compressive strength of 12 MPa, and compressive modulus of 208.49 MPa with 92% desirability. The biological characterization studies were conducted for the scaffold samples prepared with optimized input parameters. The biological studies confirmed the capabilities of the WH/CS composite scaffolds in bone regenerative applications.

Multi-organ frailty is enhanced by periodontitis-induced inflammaging

BackgroundThe incidence of periodontitis is high in older individuals. However, its impact on multi-organ frailty remains unclear. We developed mouse models with varying severity and duration of periodontitis to examine its effects.MethodsWe generated mouse models with mild and severe periodontitis, categorizing the disease duration into 3-month and 5-month periods for analysis. The organs assessed for frailty included the gastrocnemius muscle, soleus muscle, brain, and femur.ResultsOur study found that periodontitis induced systemic inflammation resembling inflammaging and other symptoms characteristic of age-induced frailty. Notably, muscle impairment developed specifically in slow-twitch muscles, and the femur emerged as the most vulnerable bone, exhibiting reduced bone mineral density even with mild and short-duration periodontitis. This condition resulted in the co-occurrence of bone fragility and slow-twitch muscle dysfunction. Cognitive function assessment revealed increased activated microglia and decreased adult neurogenesis in the hippocampus, impairing spatial learning. Thus, periodontitis induced both physical and cognitive frailties. Therapeutic intervention for the periodontitis, which halted the exacerbation of bone resorption markers, did not restore femur bone mineral density.ConclusionThis study underscores the role of periodontitis in inducing multifaceted organ frailty with vulnerability, varying by organ, and the necessity of early intervention, particularly regarding bone density loss.

Relationship between insulin resistance surrogates and bone mineral density in postmenopausal women

Objective This study aimed to investigate the association between four insulin resistance (IR) surrogates and bone mineral density (BMD) and whether IR surrogates could be risk factors for osteoporosis (OP) in Chinese non-diabetic postmenopausal individuals. Methods Four non-insulin-based surrogates including triglyceride glucose (TyG), triglyceride glucose with body mass index (TyG-BMI), triglycerides (TG)/high-density lipoprotein cholesterol (HDL-C) and the metabolic score for insulin resistance (METS-IR) index were calculated. All individuals underwent dual-energy X-ray absorptiometry for measurement of BMD. Pearson correlation analysis was employed to evaluate the correlations between IR indices and BMD. Subsequently, logistic regression analysis was performed to investigate the relationship between these indices and OP while the receiver-operating characteristic curve was used to assess the predictive values for OP. Results Both TyG-BMI and the METS-IR index were significantly positively associated with BMD. As TyG-BMI and the METS-IR index increased, the prevalence of OP decreased. After adjusting confounding factors, the fourth quartile of TyG-BMI and the METS-IR index showed significantly decreased odds ratio of 0.304 and 0.352, respectively, for OP with respect to its first quartile value. The area under the curve of TyG-BMI and the METS-IR index was 0.616 and 0.605, respectively. Conclusions IR surrogates TyG-BMI and the METS-IR index were positively associated with BMD and may be protective factors for OP in Chinese non-diabetic postmenopausal women.

Effects of Teriparatide and Alendronate on Functional Recovery from Spinal Cord Injury and Postinjury Bone Loss

Objectives: This study evaluated the efficacy of teriparatide (TPTD) and alendronate (ALN) in mitigating bone loss, enhancing bone structure, and facilitating motor function recovery following spinal cord injury (SCI). Methods: All the rats were allocated into four groups: a sham surgery group (SHAM group), a normal saline group (SCI + NS group), a TPTD treatment group after SCI (SCI + TPTD group), and an ALN treatment group after SCI (SCI + ALN group). The Basso, Beattie, and Bresnahan (BBB) scores and gait analyses were used to assess the motor abilities of rats following SCI and the effects of treatment. HE staining, Masson’s trichrome staining, and LFB staining were performed to evaluate the extent of spinal cord tissue damage. Micro-CT was used to measure 12 bone-related parameters of the proximal tibia and create 3D images, and structural changes in the proximal tibial bone tissue were observed under a light microscope after HE staining. Results: After 12 weeks of treatment, the micro-CT data indicated that TPTD significantly increased key bone indicators, such as bone mineral density, after SCI (p &lt; 0.01), whereas ALN did not significantly improve these indicators (p &gt; 0.05). Compared with the SCI + NS group, the SCI + TPTD group presented significantly greater BBB scores and near-normal gait parameters (p &lt; 0.05). Analyses of pathological sections revealed that TPTD significantly reduced the cavity area in the spinal cord after SCI, decreased the proportion of scar tissue, and increased the retention of neural myelin (p &lt; 0.05). However, ALN had no significant effect on these indicators (p &gt; 0.05). Conclusions: TPTD was more effective than ALN at mitigating bone loss and promoting motor function recovery after SCI, and it demonstrated significant advantages in reducing spinal cord damage and improving tissue structure.

Factors associated with impaired physical functionality in x-linked hypophosphatemia

Abstract X-linked hypophosphatemia (XLH) is a rare inherited disorder characterized by elevated levels of fibroblast growth factor-23 (FGF23), chronic hypophosphatemia, impaired bone mineralization and chronic long-term manifestations. Treatment for XLH has been mainly focused on normalizing its biochemical abnormalities. Despite treatment, patients with XLH often present impaired physical function and decreased quality of life (QoL). We hypothesize that physical functionality and QoL is more strongly associated with chronic pain and decreased muscle mass than persistent biochemical abnormalities or exposure to conventional treatment. We conducted an observational, cross-sectional study with patients with XLH. Clinical records and biochemical parameters were assessed. QoL surveys SF36v.2 and WOMAC were applied. Functional status was measured by a physiatrist and an occupational therapist. Appendicular lean mass (ALM) was measured and compared to age and sex-matched healthy controls. Enthesopathies and osteoarthritis were evaluated. Pain was assessed using the Brief Pain Inventory, the Visual Analog Scale and the Doleur Neuropathique-4 scales. Muscle strength was evaluated by the Quadriceps Muscle isometric Strength (QMS) and physical performance with the 6-minute walk test (6MWT) and the Functional Independence Measure (FIM) scale. A total of 30 patients were included: 21 females; median age of 32 years. All participants had significant functional deficits, chronic pain and reduced QoL. Limitations in daily activities were significantly associated with higher severity of pain, decreased ALM, lower QMS, and less distance in 6MWT (P&amp;lt;.05). Neither FIM scale, phosphate levels, FGF23, nor the lifetime exposure to conventional treatment were associated with these functional variables. In conclusion, impaired physical functionality in patients with XLH was associated with lower muscle mass, lower muscle strength and severe chronic pain. These findings highlight the importance of, in addition to optimizing the biochemical control of the disease, expanding patient care including pain prevention and management as well as comprehensive physical therapy and rehabilitation.

Effects of Exercise Speed and Circle Diameter on Markers of Bone and Joint Health in Juvenile Sheep as an Equine Model

Though circular exercise is commonly used in equestrian disciplines, it may be at the detriment of horses’ musculoskeletal system. To investigate the effects of circular exercise on bone and joint health, 42 lambs were randomly assigned to a non-exercised control, straight-line, small circle, or large circle exercise regime at a slow (1.3 m/s) or fast (2.0 m/s) speed for 12 wk. Blood samples were taken biweekly. Animals were humanely euthanized upon study completion, and the fused third and fourth metacarpals were collected for biomechanical testing and bone density analysis. Fast groups were found to have more bone formation and less resorption activity than slow groups as evidenced by serum biomarker concentrations (p &lt; 0.05). Sheep in the large fast group tended to have greater flexural rigidity and fracture force for the outside leg compared to the inside leg (p &lt; 0.1). Sheep in the small slow group tended to have increased bone mineral density of the outside leg compared to the inside leg, whereas the opposite occurred in the large slow group (p &lt; 0.1). These results provide further evidence for potential asymmetric musculoskeletal adaptations to circular exercise while emphasizing the importance of speed as a positive influence on bone metabolism and strength.

Association between urinary catecholamines and glucocorticoids and bone mineral density and osteoporosis in Puerto Rican adults.

Chronic stress leads to elevated stress hormones, which may be linked to bone breakdown. Puerto Rican adults living on the US mainland have higher prevalence of stress than the general population, and higher and/or similar prevalence of osteoporosis compared with non-Hispanic Whites. The role of stress on bone remains unclear and may be modified by diet. A Dietary Approaches to Stop Hypertension (DASH) pattern, as a measure of dietary quality, was most protective for bone outcomes among Puerto Ricans. In this cross-sectional study, 958 Boston Puerto Rican Health Study participants were included (aged: 59.9 ± 7.6 y). Stress markers (epinephrine, norepinephrine, cortisol) were collected via 12-hr urine samples and elevated concentrations were categorized using sex-specific cut-offs. Bone mineral density (BMD) was assessed via dual energy x-ray absorptiometry. Analysis of covariance models with least squares means were used to test differences in mean BMD between participants with elevated and non-elevated stress markers. Multivariable logistic regression examined associations between stress markers and osteoporosis in post-menopausal females and males. Models were adjusted for age, height, smoking, alcohol use, education, glucocorticoid use, and diabetes. Higher urinary epinephrine was associated with lower BMD at the lumbar spine (P=.012), femoral neck (P=.005), trochanter (P<.001), and total hip (P<.001) in Puerto Rican adults, and with higher odds of osteoporosis among males (OR = 4.01 [95%CI: 1.11, 14.5], P=.03). An interaction between DASH and norepinephrine was noted for post-menopausal females at the lumbar spine. No associations were noted for norepinephrine or cortisol (P>.11), although higher urinary norepinephrine was associated with lower lumbar spine BMD in post-menopausal females not taking estrogen, with lower adherence to DASH (P=.03). Higher urinary epinephrine and norepinephrine were associated with poorer bone outcomes in Puerto Rican adults, in a sex-specific manner, warranting future longitudinal studies to clarify associations. Dietary quality may moderate these associations.