Serum Bone Research Articles

Serum Irisin level is associated with fall risk, muscle strength, and cortical porosity in postmenopausal women.

Irisin plays a role in bone-muscle crosstalk, but the relationship between the serum irisin level and bone microarchitecture remains unknown. This study aimed to investigate the relationships between serum irisin level and fall risk, muscle strength, bone mineral density (BMD), and bone microarchitecture among Chinese postmenopausal women. In all 138 postmenopausal women, handgrip strength, short physical performance battery (SPPB), and the timed up-and-go test were performed to evaluate muscle strength, physical performance, and fall risk, respectively. The serum irisin was measured. High-resolution peripheral quantitative computed tomography (HR-pQCT) was performed to acquire volumetric BMD and bone microarchitecture. Bivariate analysis was used to explore relationships between serum irisin level and muscle strength and HR-pQCT parameters. Univariate and multivariate linear regression analyses were performed to determine associations between serum irisin level and vBMD and cortical porosity (Ct.Po). All participants had a median serum irisin level of 3.91 μg/ml. Participants with high fall risk had significantly lower serum irisin levels than those with low fall risk (2.22 μg/ml vs. 4.16 μg/ml, p=0.024). Irisin level was positively related to handgrip strength (rs=0.185, p=0.030) and SPPB performance. In univariate linear regression, serum irisin level was positively associated with cortical volumetric BMD (Ct.vBMD, radius: standardized β=0.184, p=0.031; tibia: standardized β=0.242, p=0.004), but it had no significant associations with Ct.vBMD after multivariate adjustment. After adjusting by age, height, serum sclerostin level, and body fat ratio, only Ct.Po at the distal radius had a significantly negative association with serum irisin level (standardized β=-0.276, p=0.003). Postmenopausal women with lower serum irisin levels have a higher fall risk, weaker muscle strength, and higher cortical porosity. Moreover, serum irisin level has a positive association with Ct.vBMD, but it is affected by factors such as age.

Changes of serum calcium and bone turnover markers in maintenance hemodialysis patients treated with denosumab

A total of 20 patients (8 males and 12 females) aged (64.8±13.9) years who underwent regular hemodialysis and had bone loss or osteoporosis in Peking University People's Hospital from July to December 2021 were recruited. Sixty milligrams of denosumab were given subcutaneously. The average serum calcium decreased by 0.31 mmol/L and 40% (8/20) of the patients had hypocalcemia one month after treatment. The markers of bone turnover began to decrease 3 days after treatment, and continued to decrease until 5 months after denosumab medication. Multivariate logistic regression analysis failed to detect any independent risk factor for hypocalcemia (R2=0.516, P=0.021). Therefore, denosumab can significantly inhibit bone turnover in hemodialysis patients, however, patients with denosumab medication are more prone to hypocalcemia.

Rat Serum Osteocalcin Concentration Is Decreased by Restriction of Energy Intake

We studied the effects of energy restriction on serum osteocalcin concentration and bone formation rate in rats. The experiment was designed to achieve energy restriction by reducing the carbohydrate intake while providing identical quantities of protein, fat, vitamins and minerals. Energy intakes of three groups of post-weaning male rats were restricted by 20, 40 and 60% for 4 wk. Serum calclum, phosphorus, transthyretin, triiodothyronine (T3), thyroxine (T4), 1,25-dihydroxycholecalciferol, 25-hydroxycholecalciferol and immunoreactive parathyroid hormone (iPTH) concentrations were determined. Energy restriction (20, 40 and 60%) produced a significant and gradual drop of serum osteocalcin concentrations, although the serum concentrations of its key regulators, i.e., 1,25-dihydroxycholecalciferol and iPTH, were not significantly affected. On the contrary, serum concentrations of calcium, phosphorus, transthyretin, T3 and T4 were significantly lower in the energy-restricted groups. However, our results do not support their implication in the regulation of serum osteocalcin synthesis by energy intake. Serum osteocalcin concentration was positively correlated with bone mineral apposition (r = 0.50, P < 0.05) and bone mineralization (r = 0.50, P < 0.05) rates suggesting that its decrease resulted from a reduction of bone formation, and not from abnormal mineralization, because osteoid seam thickness was not modified. Energy intake seems to be an important determinant of serum osteocalcin concentration and bone formation; however, the exact mechanism underlying this regulation remains to be determined.

Efficacy of Recombinant Human Endostatin plus Neoadjuvant Chemotherapy for Osteosarcoma and Its Influence on Serum VEGF and MMP-9 Levels.

To investigate the efficacy of recombinant human endostatin (rh-Endo) plus neoadjuvant chemotherapy (NACT) for osteosarcoma (OSA) and its influence on serum vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9). The case data of 141 OSA patients presented to the North District, Xiangyang Central Hospital Affiliated to Hubei University of Arts and Sciences from January 2018 to June 2019, were analyzed retrospectively. Patients receiving NACT (methotrexate + ifosfamide + adriamycin) were assigned into the control group (CNG; n = 65), while those treated with rh-Endo plus NACT were included in the combination group (CMG; n = 76). The following aspects were compared: clinical efficacy, serum tumor markers, serum VEGF and MMP-9 contents, inflammatory factors, incidence of adverse reactions, limb function scores at 6 months of follow-up, and prognostic quality of life (QOL). A statistically higher overall response rate (ORR) was determined in CMG versus CNG (84.2% vs. 64.6%, P < 0.05). The pretreatment serum bone alkaline phosphatase (BALP), insulin-like growth factor (IGF)-1, serum amyloid A (SAA), VEGF, MMP-9, C-reactive protein (CRP), tumor necrosis factor (TNF)-α, and interleukin (IL)-10 levels differed insignificantly between the two cohorts (P > 0.05); while except IL-10 that showed increased expression in both cohorts and was comparatively higher in CMG, the other 8 parameters reduced in both cohorts after 2 weeks of drug withdrawal, and the reduction of each parameter was more significant in CMG (P < 0.05). The total adverse reaction rate was 30.2% in CMG, which was higher than that of 36.9% in CNG, albeit without a statistical difference (P > 0.05). An evidently higher 2-year survival rate was determined in CMG (P < 0.05). rh-Endo plus NACT is more effective than NACT alone in the treatment of osteosarcoma, which can validly restore the balance of vascular endothelial cells, reduce inflammation, and is worth promoting in clinic.

Bone and Cytokine Markers Associated With Bone Disease in Systemic Mastocytosis

Mastocytosis encompasses a heterogeneous group of diseases characterized by tissue accumulation of clonal mast cells, which frequently includes bone involvement. Several cytokines have been shown to play a role in the pathogenesis of bone mass loss in systemic mastocytosis (SM), but their role in SM-associated osteosclerosis remains unknown. To investigate the potential association between cytokine and bone remodeling markers with bone disease in SM, aiming at identifying biomarker profiles associated with bone loss and/or osteosclerosis. A total of 120 adult patients with SM, divided into 3 age and sex-matched groups according to their bone status were studied: (1) healthy bone (n= 46), (2) significant bone loss (n= 47), and (3) diffuse bone sclerosis (n= 27). Plasma levels of cytokines and serum baseline tryptase and bone turnover marker levels were measured at diagnosis. Bone loss was associated with significantly higher levels of serum baseline tryptase (P= .01), IFN-γ (P= .05), IL-1β (P= .05), and IL-6 (P= .05) versus those found in patients with healthy bone. In contrast, patients with diffuse bone sclerosis showed significantly higher levels of serum baseline tryptase (P < .001), C-terminal telopeptide (P < .001), amino-terminal propeptide of type I procollagen (P < .001), osteocalcin (P < .001), bone alkaline phosphatase (P < .001), osteopontin (P< .01), and the C-C Motif Chemokine Ligand 5/RANTES chemokine (P= .01), together with lower IFN-γ (P= .03) and RANK-ligand (P= .04) plasma levels versus healthy bone cases. SM with bone mass loss is associated with a proinflammatory cytokine profile in plasma, whereas diffuse bone sclerosis shows increased serum/plasma levels of biomarkers related to bone formation and turnover, in association with an immunosuppressive cytokine secretion profile.

Association between Serum Uric Acid Levels and Bone Mineral Density in Taiwanese Elderly Population.

Osteoporosis is a progressive metabolic bone disorder characterised by a decline in bone mineral density (BMD). Some previous studies have reported a controversial relationship between uric acid and osteoporosis. This cross-sectional study aimed to assess the association between serum uric acid levels and BMD in older adults from Taiwan. Data from participants aged ≥ 60 years were collected from 2008 to 2018. Furthermore, the participants were classified based on uric acid level quartiles. Regression models were used to assess the association between uric acid levels and bone health, including BMD values and risk of at least osteopenia. Crude and adjusted models of potential confounders, including age, sex and body mass index (BMI), were used. Compared with the first quartile of uric acid levels, the odds ratios for osteoporosis decreased in the higher uric acid level groups after adjustment for age, sex and BMI. The boxplot analysis showed that BMD values were higher in the groups with higher uric acid levels; moreover, the results of the multivariable linear regression model showed a consistent pattern. Notably, uric acid levels were positively correlated with BMD values. Higher uric acid levels in the elderly population might decrease the risk of at least osteopenia. As opposed to the anti-hyperuricemic policy for younger adults with a relatively lower risk of osteoporosis, BMD evaluation and urate-lowering therapy, goal adjustments should be considered for older adults with lower uric acid levels.

Association of osteoporosis and skeletal muscle loss with serum type I collagen carboxyl-terminal peptide β glypeptide: A cross-sectional study in elder Chinese population.

Type I collagen carboxyl-terminal peptide β (β-CTX) increases in osteoporosis. The study aimed to explore the relationship between serum β-CTX and the risk of osteoporosis as well as sarcopenia in Chinese elderly inpatients. Around 228 patients whose age >65 years were recruited in this cross-sectional study. Dual-energy X-ray scanning was used to access skeletal muscle and bone mass. Serum concentration of β-CTX as well as the prevalence of osteoporosis were significantly higher in low skeletal muscle index (SMI) group than that in the normal SMI group (P < 0.05). Serum β-CTX levels negatively correlated with SMI and bone mass (P < 0.05). Total muscle mass, appendicular skeletal muscle mass, SMI, total bone mass, and bone mass at various sites including the limbs, spine, and pelvis decreased significantly, and the prevalence of low SMI increased with the increase of the quartiles of β-CTX. Higher serum β-CTX had an increased risk of low SMI and osteoporosis (P < 0.05). Summarily, with increasing serum β-CTX levels, both muscle and bone mass decreased in Chinese elderly inpatients. Serum β-CTX was positively associated with the risk of not only osteoporosis but also skeletal muscle loss.

Associations between serum total cholesterol level and bone mineral density in older adults.

Osteoporosis is a major clinical problem in elderly men and women. The correlation between total cholesterol and bone mineral density remains controversial. NHANES is the cornerstone for national nutrition monitoring to inform nutrition and health policy. Sample sizes and the location of the study and the time when it was conducted: we obtained 4236 non-cancer elderly from NHANES (National Health and Nutrition Examination Survey) database from 1999 to 2006. Data were analyzed with the use of the statistical packages R and EmpowerStats. We analyzed the relationship between total cholesterol and lumbar bone mineral density. We performed research population description, stratified analysis, single factor analysis, multiple equation regression analysis, smooth curve fitting, and threshold effect and saturation effect analysis. A significant negative association between serum cholesterol levels and bone mineral density of the lumbar spine in US non cancer affected older adults aged 60 years or older. Older adults ≥ 70 years of age had an inflection point at 280 mg / dl, and those with moderate physical activity had an inflection point at 199 mg / dl, The smooth curves they fitted were all U-shaped. There is a negative association between total cholesterol and lumbar spine bone mineral density in non-cancer elderly greater than or equal to 60 years of age.

Predictive biomarkers of ossification progression and bone metabolism dynamics in patients with cervical ossification of the posterior longitudinal ligament.

This study aimed to establish biomarkers to predict the progression of ossification by examining ossification volume and bone metabolism dynamics in patients with ossification of the posterior longitudinal ligament (OPLL). We assessed OPLL progression using computed tomography-based three-dimensional (3D) image analysis and examined bone metabolism dynamics in 107 patients with OPLL (men, 72; women, 35; mean age, 63.6years). The volume of OPLL was calculated twice during the follow-up period, and OPLL progression was evaluated by the annual rate of ossification increase. Bone metabolism dynamics were assessed by routine blood tests and analysis of various serum biomarkers (including 25-hydroxyvitamin D, intact parathyroid hormone, fibroblast growth factor 23, intact N-terminal propeptide of type 1, tartrate-resistant acid phosphatase isoform 5b, sclerostin, and Dickkopf-1) and bone mineral density (BMD). Patients were classified into the progression (P) or non-progression (NP) group according to the annual rate of increase in previous 3D image analyses, and associated factors between these groups were compared. The P and NP groups consisted of 29 patients (23 men and 6 women) and 78 patients (49 men and 29 women), respectively. Univariate analysis revealed significant differences in terms of age, body mass index, serum phosphorus, serum sclerostin, and BMD. In multivariate analysis, age, serum phosphorus, and serum sclerostin were identified as independent factors associated with OPLL progression. Younger age, hypophosphatemia, and high serum sclerostin are risk factors for OPLL progression. Serum phosphorus and sclerostin could serve as important biomarkers for predicting ossification progression.

TOTAL SERUM CALCIUM AND EUMELANISM IN JUVENILE BANK MYNA, ACRIDOTHERES GINGINIANUS (LATHAM)

A series of scarce minerals (Ca, Zn, Cu, Fe) obtained from the diet are known to act ascritical regulatory factors in the biosynthesis of eumelanin and phaeomelanin pigments in animals.Juvenile Bank myna is dull brown in colour, whereas adult is bluish grey coloured. A link has beenfound between degree of eumelanism, total serum calcium and bone weight in juvenile Bank mynawith increasing age. Gradual increase in total femur weight was corresponded by increasing degreeof eumelanin pigment and reduction in total serum calcium level.

Bone Metabolism Parameters in Azerbaijani Pre and Postmenopausal Women with Diabetes.

This study aimed to determine the directionality of changes in serum bone remodeling markers and bone mineral density in the pre- and postmenopausal women with diabetes mellitus. This study was carried out during the years 2016-2017 on the basis of Azerbaijan Medical University and included 142 pre- and postmenopausal women with type 1 and 2 diabetes mellitus (DM 1and DM2) were compared with 43 age-matched non-diabetics. The groups evaluated Ca2+, PTH, CT, 25(OH)D levels, serum bone remodeling markers (ALP, P1NP, b-CTx), lumbar spine, proximal and femoral neck areas using DXA assessment. The results showed inconsistency observed between bone remodeling processes in women with diabetes. A negative correlation was observed between duration of diabetes and Lumbar T-scores (DM1: r = -0.568, P = 0.001; DM2: r = -0.267, P = 0.04). Lumbar T-scores was negatively correlated with b-CTx level (DM1: r = -0.452, P = 0.002; DM2: r = -0.357, P = 0.09). Postmenopausal groups with DM1 and DM2 were slightly higher b-CTx levels than premenopausal. The patients with DM2 compared to DM1 had higher average BMD at all measured areas. Bone fragility is the result not so much of a decrease in BMD, but alterations in bone microstructure, as indicated by the disregulation of bone remodeling markers. This suggests that patients with diabetes are at a higher risk of bone turnover disorders compared to individuals without diabetes, which does not necessarily correlate with differences in BMD.

Osteoporosis in men with hypogonadism because of ApoA-I Leu75Pro amyloidosis under long-term testosterone therapy.

Apo A-I Leu75Pro amyloidosis is a rare systemic hereditary disease, whose hallmark and earliest involvement is testicular impairment, characterized by hypogonadism and macrorchidism; renal and hepatic involvement are the other characteristics. To evaluate for the first time the prevalence of osteopenia, osteoporosis and vertebral fractures (VFs) in men with this form of amyloidosis affected by hypogonadism and under long-term testosterone replacement therapy (TRT). Retrospective study on 50 men>50 years (median age 64.5) with dual-energy X-ray absorptiometry (DXA), hormonal, and biochemical data available at least 3 years after the start of TRT. Serum gonadal hormones and bone markers, lumbar and femoral DXA-scan with morphometric assay for evaluation of VFs were assessed. At 7.5 years from start of TRT, lumbar and/or femoral osteopenia and osteoporosis were found in 54% and 10% of patients, respectively. Of the men who had the morphometric assay performed, five of 34 (14.7%) had VFs. Compared to patients with normal bone mineral density, men with osteopenia and osteoporosis were older, had lower body mass index, higher sex hormone binding globulin and showed more frequently renal involvement. Multiorgan involvement, without different TRT dosage, was associated with lower testosterone levels. Men with hypogonadism because of Apo A-I Leu75Pro amyloidosis under long-term TRT had a high burden of low bone mass (64%) and VFs (almost 15%). Osteopenia-osteoporosis was more frequently observed in older patients with multi-organ disease, which might contribute to impair bone health beyond hypogonadism.

Gout of feet and ankles in different stages: The potentiality of a new semiquantitative DECT scoring system in monitoring urate deposition.

The purpose of this study was to investigate the diagnostic performance of a novel semi-quantitative dual-energy computed tomography (DECT) scoring system in monitoring urate deposition. This study included 287 patients with gout. All patients underwent ankle/foot DECT scans. DECT scores at different stages were compared and their diagnostic efficacies evaluated. Associations between DECT scores and clinical variables were evaluated. Gouts with positive DECT results in early, middle, and late stages were 78.5 %, 81.4 %, and 95.8 %, respectively (all P > .05). The total and ankle/midfoot DECT scores at different stages significantly increased with disease duration (all P < .05). DECT scores of 4 regions excluding the first metatarsophalangeal joint in early and middle stages were lower than those in late stage (all P < .05). DECT scores achieved excellent diagnostic performance for differentiating gout in early stage from middle and late stages (area under the curve, 0.923 and 0.949), with high sensitivity, specificity, positive predictive value, and negative predictive value (all > 85 %). Total DECT score was highly positively correlated with the volume of urate crystals (R = 0.873, P < .001). Disease duration, serum uric acid level, bone erosion, and Achilles tendon involvement significantly affected total DECT scores (all P < .01). In conclusion, longer disease duration, higher serum uric acid levels, bone erosion, and Achilles tendon involvement were closely associated with total DECT scores. DECT scoring system may be an invaluable tool for gout diagnosis owing to its high detection efficacy and a surrogate method to evaluate the amount of urate crystals and erosion of surrounding tissues.

Measuring of Specific Bone Alkaline phosphatase ( BAP ) Bone Remodeling biomarker for Post-COVID Iraqi Patient

Background: There are several diseases in the body following recovery from COVID-19 infection because this virus operates on human genes in various types of peripheral tissue in the human body. It penetrates host cells via Angiotensin-converting enzyme-2 receptors and may have effects on bone remodeling, leading to osteopenia or osteoporosis, which are characterized by low bone mineral density, resulting in diminished bone strength. Bone Alkaline Phpsphatase is an enzyme released into the bloodstream as a soluble homodimer after being cleaved by a phospholipase and can be utilized as a biomarker of bone development. Objective: This research was designed to investigate the alteration of bone homeostasis balance in Iraqi post-COVID-19 infection patients. Cases and Methods: This is a case control study. The study has received approval from the ethical committee at the Faculty of Medicine, Baghdad University, established on November 20, 2021–March 2, 2022. A hundred and thirty individuals were enrolled in this study. The subjects were divided into two groups; the first group (80) post-COVID-19 infection patients and the second group (50) non-COVID-19 individuals. Also, measuring markers like serum Angiotensin-converting enzyme-2 and Bone Alkaline Phosphatase by using the ELISA technique. The bone mineral density was measured by a DEXA scan. Results:This study found that there is an effect of coronavirus infection on the bone strength measured by the mean ± SD Bone Alkaline Phosphatase level, which was found to be highly significant in the serum of post-COVID-19 patients when compared with non-COVID-19 individuals (P-value = 0.001), but the mean ± SD of Angiotensin-converting enzyme-2 level was statistically non-significant between the two groups (P-value = 0.13). who had recovered from a coronavirus infection for 3 months or more. Also, the bone mineral density of Post COVID-19 patients that was measured by DEXA scan had a highly significant T-score% when compared between the two groups. Conclusions:This research found that COVID-19 has an impact on the bone remodeling process, leading to osteopenia or osteoporosis, which may be identified by checking the blood levels of the bone biomarker BAP and the bone mineral density (by DEXA scan) at least three months following coronavirus recovery. This investigation also discovered that some of the individuals had osteopenia rather than osteoporosis.

Dietary Intake, Serum Hormone Concentrations, Amenorrhea and Bone Mineral Density of Physique Athletes and Active Gym Enthusiasts.

As the diet, hormones, amenorrhea, and bone mineral density (BMD) of physique athletes (PA) and gym enthusiasts (GE) are little-explored, we studied those in 69 females (50 PA, 19 GE) and 20 males (11 PA, 9 GE). Energy availability (EA, kcal·kgFFM−1·d−1 in DXA) in female and male PA was ~41.3 and ~37.2, and in GE ~39.4 and ~35.3, respectively. Low EA (LEA) was found in 10% and 26% of female PA and GE, respectively, and in 11% of male GE. In PA, daily protein intake (g/kg body mass) was ~2.9−3.0, whereas carbohydrate and fat intakes were ~3.6−4.3 and ~0.8−1.0, respectively. PA had higher protein and carbohydrate and lower fat intakes than GE (p < 0.05). Estradiol, testosterone, IGF-1, insulin, leptin, TSH, T4, T3, cortisol, or BMD did not differ between PA and GE. Serum IGF-1 and leptin were explained 6% and 7%, respectively, by EA. In non-users of hormonal contraceptives, amenorrhea was found only in PA (27%) and was associated with lower fat percentage, but not EA, BMD, or hormones. In conclusion, off-season dietary intakes, hormone levels, and BMD meet the recommendations in most of the PA and GE. Maintaining too-low body fat during the off-season may predispose to menstrual disturbances.

Dietary 25-hydroxycholecalciferol modulates gut microbiota and improves the growth, meat quality, and antioxidant status of growing-finishing pigs.

25-Hydroxycholecalciferol (25OHD3) is the active metabolite of regular vitamin D3 in vivo, which has a stronger biological activity and is more easily absorbed by the intestine than regular vitamin D3. Our study aimed to detect the potential influences of 25OHD3 on pork quality, antioxidant status, and intestinal microbiota of growing-finishing pigs receiving low-phosphorus (P) diet. Forty pigs [initial body weight (BW): 49.42 ± 4.01 kg] were allocated into two groups including low-P diet (CON group) and low-P diet supplemented with 50 μg/kg 25OHD3 (25OHD3 group). The whole experiment lasted for 88 days, including phase 1 (day 1-28), phase 2 (day 29-60), and phase 3 (day 61-88). The results showed that 25OHD3 supplementation tended to decrease feed conversion ratio in phase 3 and overall phase in comparison with the CON group. 25OHD3 increased (p < 0.05) serum contents of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px), and decreased (p < 0.05) serum bone-specific alkaline phosphatase level. 25OHD3 increased (p < 0.05) mucosal GSH-Px activity in the duodenum and ileum, and tended to increase redness value and the activities of total antioxidant capacity and SOD in longissimus dorsi. 25OHD3 significantly upregulated the mRNA level of copper/zinc superoxide dismutase, and tended to change the mRNA levels of nuclear factor E2-related factor 2 and kelch-like ECH-associated protein 1 in longissimus dorsi. Moreover, 25OHD3 supplementation decreased (p < 0.05) n-6/n-3 and iodine value in longissimus dorsi. For bone quality, 25OHD3 supplementation increased (p < 0.05) calcium content, bone mineral content, and breaking strength in the metacarpal bones. Moreover, the colonic abundance of Lactobacillus was significantly higher in pigs fed with 25OHD3, and exhibited a positive association with serum antioxidant status, pork quality, and bone characteristics. Overall, the inclusion of 25OHD3 in low P diet partly improved production performance, meat quality, antioxidant capacity, bone properties, and gut microbiota composition of growing-finishing pigs.

Postmenopausal osteoporosis: Effect of moderate-intensity treadmill exercise on bone proteomics in ovariectomized rats.

This study aimed to identify the key proteins in the bone mass of ovariectomized (OVX) rats after a period of regular moderate-intensity treadmill exercise and to investigate their effects using tag mass spectrometry and quantitative proteomics with a view to improving the understanding and treatment of postmenopausal osteoporosis. Sixty three-month-old female Sprague-Dawley tats of specific-pathogen-free grade were randomly and equally divided into a sham operation group, ovariectomized group (OVX) and ovariectomized combined exercise (OVX + EX) group, and the latter took moderate-intensity treadmill exercise for 17 weeks. After this period of time, body composition and bone density were measured using dual-energy x-ray absorptiometry, and serum bone metabolism indicators were measured using an enzyme immunoassay. In addition, the bone microstructure was examined using micro-computed tomography and scanning of the femur, and femur proteins were subject to proteomic analysis. Compared with the rats in the OVX group, the bone metabolism indicators in the OVX + EX group decreased significantly, femur bone density increased significantly, the number of the trabeculae increased, and continuity was higher. In the OVX + EX group, 17 proteins were significantly upregulated and 33 significantly downregulated. The main gene ontology and signaling pathways enriched by the proteins were identified as the tumor necrosis factor-mediated signaling pathways. The protein-protein interaction network identified the key proteins, and the correlation analysis of these proteins and the bone parameters found histone deacetylase 8(HDAC8) and leucine-rich transmembrane and O-methyltransferase domain containing (LRTOMT) and trimethylguanosine synthase 1(TGS1) and ankyrin repeat domain 46(ANKRD46) to be the key targets of exercise in relation to postmenopausal osteoporosis. Moderate-intensity treadmill exercise significantly improved the bone mass of OVX rats, and differentially expressed proteins, such as HDAC8 and LRTOMT and TGS1 and ANKRD46, could be the target of moderate-intensity treadmill exercise.

Effect of Dietary Geranylgeraniol and Green Tea Polyphenols on Glucose Homeostasis, Bone Turnover Biomarkers, and Bone Microstructure in Obese Mice

Previously, we demonstrated that the administration of either geranylgeraniol (GGOH) or green tea polyphenols (GTP) improved bone health. This study examined the combined effects of GGOH and GTP on glucose homeostasis in addition to bone remodeling in obese mice. We hypothesized that GGOH and GTP would have an additive or synergistic effect on improving glucose homeostasis and bone remodeling possibly in part via suppression of proinflammatory cytokines. Forty-eight male C57BL/6J mice were assigned to a high-fat diet (control), HFD + 400 mg GGOH/kg diet (GG), HFD + 0.5% GTP water (TP), or HFD + GGOH + GTP (GGTP) diet for 14 weeks. Results demonstrated that GTP supplementation improved glucose tolerance in obese mice. Neither GGOH nor GTP affected pancreas insulin or bone formation procollagen type I intact N-terminal, bone volume at the lumbar vertebrae, or bone parameters at the trabecular bone and cortical bone of the femur. There was an interactive effect for serum bone resorption collagen type 1 cross-linked C-telopeptide concentrations, resulting in no-GGOH and no-GTP groups having the highest values. GGOH increased trabecular number and decreased trabecular separation at the lumbar vertebrae. GTP increased trabecular thickness at lumbar vertebrae. The GG group produced the greatest connectivity density and the lowest structure model index. Only GTP, not GGOH, decreased adipokines concentrations (resistin, leptin, monocyte chemoattractant protein-1, and interleukin-6). In an obese male mouse model, individual GGOH and GTP supplementation improved glucose homeostasis, serum CTX, and trabecular microstructure of LV-4. However, the combined GGOH and GTP supplementation compromises such osteoprotective effects on serum CTX and trabecular bone of obese mice.

Correlation of Vitamin D Level and Bone Mineral Density in Epilepsy Children Who Received Oral Antiepileptic Drug

BACKGROUND: Vitamin D plays an essential role in achieving adequate bone mineralization. Antiepileptic drug (AED) will cause a change in calcium serum levels and bone mineral density (BMD) through increase catabolism of Vitamin D in the liver, as well as having a direct effect on the bone. AIM: The aimed of this study was to know the correlation of Vitamin D [25(OH)D] level and BMD in epilepsy children who received oral AED. METHODS: This cross-sectional study was conducted from May to September 2016. Subjects were collected using consecutive sampling in 1−11-year-old epilepsy children who went to the pediatric Neurology and Endocrinology outpatient clinic at Sanglah Hospital. Age, sex, body weight, body height, type and number of AED used, and duration of treatment were recorded. Measurement of 25(OH)D level and BMD was performed. Pearson test was used to analyze the strength of correlation based on normality test result. RESULTS: Thirty subjects were collected, male (19/63.33%), mean age was 7.22 years, mean treatment duration was 1.71 years. Type of AED was inducer AED (18/60%) and non-inducer AED (12/40%). Mean Vitamin D level was 27.19 ng/mL and mean BMD was 0.78 g/cm2. Partial correlation test of Vitamin D level with BMD after controlling age found r = 0.118 with p = 0.54. CONCLUSION: There was weak correlation between Vitamin D level and BMD in epilepsy children who received oral AED, but the correlation analysis was not sufficient to prove the relationship.

Efficacy of zoledronate, denosumab or teriparatide in postmenopausal women with type 2 diabetes mellitus at high risk of fragility fractures: protocol of an open, blinded endpoint randomized controlled pilot trial.

People with type 2 diabetes (T2D) are at high risk of fragility fractures; however, there are no randomized controlled trials evaluating the efficacy of anti-osteoporosis drugs as a primary pre-specified endpoint in T2D. To compare the efficacy of anti-osteoporotic drugs in postmenopausal women with T2D. Prospective, randomized, open, blinded endpoint clinical pilot trial. Postmenopausal women (⩾50 years) with T2D (duration ⩾5 years), HbA1c 7-10%, eGFR ⩾45 mL/min/1.73 m2 and prior vertebral (clinical/morphometric), hip, radius, humeral fragility fracture or bone mineral density (BMD) T-score (adjusted for diabetes) at lumbar spine/femoral neck ⩽-2.5 and high FRAX score will be eligible for inclusion. Subjects with secondary causes of osteoporosis, prior exposure to bone-active therapies or history of use of glucocorticoids/pioglitazone/thiazides/canagliflozin will be excluded. Finally, eligible subjects will undergo estimation of serum calcium, phosphate, alkaline phosphatase, parathyroid hormone, 25-hydroxyvitamin D and bone turnover markers (BTMs) (total procollagen type I N-propeptide, β-CTX) along with trabecular bone score (TBS) and high-resolution peripheral quantitative computed tomography (HR-pQCT) of non-dominant hand and leg. After a 2-week run in phase, they will be randomized in a 1:1:1:1 ratio to receive yearly zoledronate, or biannually denosumab or daily teriparatide (in addition to standard of care, i.e., calcium 1000 mg/day and cholecalciferol 1000 IU/day) or only standard of care (control). The primary endpoints will be change in areal BMD and frequency of incident fractures at 18 months. The secondary endpoints will be change in HR-pQCT parameters, TBS and BTMs at 18 months. Adverse events will be recorded for all randomized participants. The study has been approved by the Institute Ethics Committee. Written informed consent will be obtained from each participant. The trial is expected to provide information regarding optimal anti-osteoporotic therapy in people with T2D and bone fragility. Prospectively registered in Clinical Trial Registry of India (CTRI/2022/02/039978).