Significant Increase In Bone Mineral Density Research Articles

Development of Upper-Extremity Morphological Asymmetries in Male and Female Elite Youth Tennis Players: A Longitudinal Study.

This 2-year longitudinal study examined the development of upper-extremity bone mineral density (BMD), bone mineral content (BMC), and lean mass (LM) asymmetry magnitudes in male and female youth tennis players. Dominant and nondominant upper-extremity BMD, BMC, and LM values of 49 male and 31 female players were measured yearly using dual X-ray absorptiometry. From these values, asymmetry magnitudes were calculated and expressed as a percentage. Maturity offset was estimated using anthropometric measurements. Linear mixed effect models examined the development of BMD, BMC, and LM asymmetry magnitudes according to players' maturity offset, sex, and training volume. Adjusted for sex and training volume, a 1-year increment in maturity offset was associated with a significant increase in BMD (1.3% [2.2%]; P < .001) and BMC (0.6% [2.4%]; P = .011) asymmetry magnitudes. Male players displayed significantly higher LM asymmetry magnitudes (Δ3.2% [8.4%]; P = .002) compared with their female counterparts. Training volume was not significantly associated with asymmetry magnitude development. In contrast to LM, male and female youth tennis players' upper-extremity bones are still responsive to mechanical loading with a significant increase in BMD and BMC asymmetry magnitudes according to maturity offset.

Zinc improves Denosumab and eldecalcitol efficacy for bone mineral density in patients with hypozincemia.

We aimed to investigate the effects of zinc deficiency and zinc medication in osteoporosis patients undergoing denosumab (DMAb). This retrospective study was conducted at a single hospital. The participants were female osteoporosis patients visiting between April 2019 and April 2020. All patients were treated with DMAb and eldecalcitol and recommended zinc-rich food. Based on zinc medication and serum zinc levels at the 12th month of dietary guidance, patients were categorized into the following four groups: hypozincemia with zinc medication, latent zinc deficiency with zinc medication, without zinc medication, and control without zinc medication. Longitudinal serum zinc concentrations, bone mineral density (BMD), and occurrence of fractures were measured. We investigated the factors influencing no response to DMAb and eldecalcitol treatment. Among the 145 patients followed up for 24 months, dietary guidance did not change the serum zinc concentration; however, zinc medication significantly increased these levels. The hypozincemia group did not show a significant BMD increase in the lumbar spine and femoral neck after DMAb and eldecalcitol treatment during dietary guidance; however, zinc medication increased these to the same levels as the other groups. In multivariate analyses, hypozincemia and thyroid disease were identified as the factors affecting no response. While 28.2% of patients with latent zinc deficiency without zinc medication suffered fractures, no fractures occurred in hypozincemia patients with zinc medication. Hypozincemia may reduce the efficacy of DMAb and eldecalcitol in increasing BMD and fracture prevention.

Effect of Plyometrics on Bone Mineral Density in Young Adults: A Systematic Review and Meta-Analysis

ABSTRACT Context Osteoporosis is a chronic bone metabolic disease characterized by decreased bone mass, leading to increased frailty and a subsequent fracture risk. Peak bone mineral density (BMD) is achieved in early adulthood and may be the most important factor leading to the development of osteoporosis in older adults. Objective This study aimed to analyze the effects of plyometrics on BMD in young men and premenopausal women. Design This study used randomized controlled trials found in MEDLINE, Embase, and CINAHL published between January 1, 1990, and November 1, 2022. Keywords included plyometrics, jumping, jump training, bone health, and bone mineral density. Articles were assessed for methodological quality using the Consolidated Standards of Reporting Trials 2010 checklist. Eligibility Criteria Randomized controlled trials investigating BMD in healthy premenopausal women and men between the ages of 18 and 60 yr that compared plyometrics with control were included. Study Selection Two reviewers independently screened 553 abstracts. Main Outcome Measures Mean baseline and follow-up dual-energy x-ray absorptiometry scores and standard deviations were extracted to calculate the standard mean difference. After extraction, the magnitude of difference between control and treatment groups were analyzed using the Hedges and Olkin method for effect size. Results The 12 included studies had high methodological quality. Of the 12 studies, 10 reported statistically significant increase in BMD at ≥1 site when compared with control. Two studies showed equal improvement when compared with resistance-only training. After analysis, a large positive effect size with strongly positive correlation was seen between plyometrics and lumbar spine BMD. Conclusion Plyometric training is a safe and time-efficient method to improve BMD in premenopausal people 18–65 yr old. Large effect sizes were associated with increased training intensity and lasted months after the intervention was complete. Plyometrics seems to be a comparable alternative to resistance training with respect to bone health.

Parathyroidectomy Improves Bone Density in Women With Primary Hyperparathyroidism and Preoperative Osteopenia.

Osteoporosis and/or bone fractures are indications of parathyroidectomy in primary hyperparathyroidism (PHPT), especially in women. However, the benefit of surgery in patients with osteopenia remains unclear. To evaluate bone mineral density (BMD) and bone remodeling biomarkers changes 1 year after parathyroidectomy in women with PHPT. In the prospective, monocentric, observational prospective cohort with primary hyperparathyroidism patients (CoHPT) cohort, women operated for sporadic PHPT since 2016 with ≥1 year follow-up were included. BMD (dual-X ray absorptiometry) and bone remodeling biomarkers [cross-linked C-telopeptide (CTX), procollagen type 1 N-terminal propeptide (P1NP), and bone-specific alkaline phosphatases] were assessed before and 1 year after parathyroidectomy. Referral center. A total of 177 women with PHPT (62.5 ± 13.3 years, 83.1% menopausal, 43.9% osteopenic, and 45.1% osteoporotic) were included. Parathyroidectomy. BMD change between before and 1 year after parathyroidectomy. Parathyroidectomy resulted in significant increase in BMD and decrease in serum bone remodeling biomarker concentrations. In the 72 patients with baseline osteopenia, mean BMD significantly increased at the lumbar spine [+0.05 g/cm2 (95% confidence interval [CI], 0.03-0.07)], the femoral neck [+0.02 g/cm2 (95% CI 0.00-0.04)], the total hip [+0.02 g/cm2 (95% CI 0.01-0.02)], and the forearm [+0.01 (95% CI 0.00-0.02)], comparable to osteoporotic patients. Among osteopenic patients, those with individual BMD gain (>0.03 g/cm2) at ≥1 site had higher preoperative serum CTX, P1NP, and urine calcium concentrations than those without improvement. Parathyroidectomy significantly improved BMD and remodeling biomarkers in women with osteopenia, thereby supporting the benefit of parathyroidectomy in these patients. Preoperative serum CTX and P1NP concentrations could be useful to predict expected BMD gain.

Bone Mineral Density Derived from Cardiac CT Scans: Using Contrast Enhanced Scans for Opportunistic Screening

Purpose: Osteoporosis is under-diagnosed and often co-exists with other diseases. Very low bone mineral density (BMD) indicates risk of osteoporosis and opportunistic screening for low BMD in CT-scans has been suggested. In a non-contrast enhanced thoracic CT scan, the scan-field-of-view includes vertebrae enabling BMD estimation. However, many CT scans are obtained by administration of contrast material. If the impact of contrast enhancement on BMD measurements could be quantified, considerably more patients are eligible for screening. Methods: This study investigated the impact of intravenous contrast on thoracic BMD measurements in cardiac CT scans pre- and post-contrast, including different contrast trigger levels of 130 and 180 Hounsfield units (HU). BMD was measured using quantitative CT with asynchronous calibration. Results: In 195 participants undergoing cardiac CT (mean age 57±9 years, 37 % females) contrast increased mean thoracic BMD from 116±33 mg/cm3 (non-enhanced CT) to 130±38 mg/cm3 (contrast-enhanced CT) (p<0.001). Using clinical cut-off values for very low (<80 mg/cm3) and low BMD (<120 mg/cm3) showed that 24 % (47/195 participants) were misclassified when BMD was measured on contrast-enhanced CT-scans. Of the misclassified patients, 6 % (12/195 participants) were categorized as having low BMD despite having very low BMD on the non-enhanced images. Contrast-CT using a higher contrast trigger level showed a significant increase in BMD compared to the lower trigger level (119±32 vs. 135±40 mg/cm3, p<0.01). Conclusion: For patients undergoing cardiac CT, using contrast-enhanced images to assess BMD entails substantial overestimation. Contrast protocol trigger levels also affect BMD measurements. Adjusting for these factors is needed before contrast-enhanced images can be used clinically. Mini abstract: Osteoporosis is under-diagnosed. Contrast-enhanced CT made to examine other diseases might be utilized simultaneously for bone mineral density (BMD) screening. These scans, however, likely entails overestimation of BMD due to the effect of contrast. Adjusting for this effect is needed before contrast-enhanced images can be implemented clinically for BMD screening.

Effect of Growth Hormone and Estrogen Replacement Therapy on Bone Mineral Density in Women with Turner Syndrome: A Meta-Analysis and Systematic Review.

Osteoporosis is a serious implication of Turner syndrome (TS). Common methods for the treatment of TS are growth hormone (GHT) and estrogen replacement therapy (ERT). We examined the relationship between the treatment of TS and bone mineral density (BMD) of the lumbar spine. The purpose of our study was to show the currency of BMD states among patients with TS for treatment with GHT and ERT. We searched databases for studies published from inception to April 2023. The articles were related to TS, osteoporosis, ERT, GHT, BMD and treatment patients with TS. We applied the selection criteria: lumbar spine values at L1-L4; dual-energy X-ray absorptiometry (DXA); treatment which was applied: one group of articles: ERT and two group of articles: GHT; results performed as means ± SD. In total, 79 articles were analyzed, of which 20 studies were included and 5 were considered for meta-analysis. The total number of women in the articles selected was 71. Based on the results of the meta-analysis, the effect of ERT on BMD demonstrated a significant increase in BMD (the standardized mean difference in the random model was 0.593 g/cm2, 95% CI: 0.0705 to 1.116; p = 0.026), which showed that treatment with estrogen particularly increases bone mass during treatment, which contributes to reducing the risk of fractures. The effect of GHT on BMD demonstrated a non-significant decrease in BMD in patients with TS. The results for growth hormone show that this therapy does not improve bone density. However, our review emphasizes the beneficial effect of supplementing growth hormone (GH) on the clinical presentation of TS.

The Effect of Denosumab in Elderly Patients Regarding Bone Density and Fracture Risk.

With an aging population, the importance of treating and diagnosing osteoporosis is increasing. Osteoporosis, previously known as a resorptive change primarily related to endocrinological mechanisms, is also being approached as a phenomenon of senile change. Denosumab is gaining popularity among osteoporosis medications due to its ability to increase bone mineral density (BMD) and the economic benefit arising from the 6-month cycle. In line with previous literature, this study aimed to examine the BMD-augmenting effect of denosumab through which it reduces fracture risk in individuals aged over 80 years. We reviewed patients who received denosumab between 2018 and 2022 with a minimum clinical observation period of 12 months. BMD was measured every 12 months, and patients were classified per their period of denosumab use. Fracture risk was evaluated using the fracture risk assessment tool (FRAX) and fracture incidence during the observation period were assessed. Among 155 patients, a significant increase in BMD was observed at 3 sites: the lumbar spine, femoral neck, and total hip (p<0.001, p<0.001, and p=0.001, respectively). The patients were divided according to the length of clinical follow-up they received, and similar results were found in all subgroups. Fracture risk assessment was performed using FRAX and the incidence of fracture events during follow-up. FRAX significantly decreased in all subgroups except those who received 24 months of follow-up (p=0.003, p=0.41, p=0.001 in the 12, 24, and ≥36 months groups, respectively). Denosumab use resulted in long-term BMD increase and reduced fracture risk in individuals aged 80 and above.

Factors associated with bone response to teriparatide in young postmenopausal women with osteoporosis.

To investigate the factors associated with changes in vertebral bone mineral density during teriparatide treatment. Single centre, longitudinal study involving 145 osteoporotic postmenopausal women treated with teriparatide. Clinical evaluation, bone mineral density (BMD) measurements assessment and laboratory analyses were performed at baseline then after 12 and 18months of treatment. Bone non-response to treatment was defined as no significant increase in BMD at 18months as compared to baseline. Of the 145 women initially included, 109 completed the 18-month course of the treatment. 75% of them had a history of prior osteoporotic treatment. Baseline mean age was 60 ± 8years. Mean baseline vertebral T-score was -3.7 ± 0.7 and 83 (76%) women had suffered at least one vertebral fracture. At the end of treatment, 18 women (17%) were classified as non-responders. In the responder group (n = 91), vertebral BMD increased by 0.091 ± 0.04g/cm2 (12.2 ± 5.3%). Clinical characteristics, baseline BMDs and the percentage of women previously treated with bisphosphonates as well as the duration of prior treatment did not significantly differ between the two groups of responders and non-responders. At baseline, non-responders had significant mean lower C-terminal fragment of type 1 collagen (CTX) values than responders (p < 0.01). Only baseline CTX values (r = 0.30 p < 0.01) were independently correlated to vertebral BMD changes during teriparatide treatment. A minority of treated women had no vertebral densitometric gain after 18months of teriparatide therapy. Low levels of baseline bone remodeling were the main factor associated with poor response to treatment.

A 2-Year Longitudinal Study of Bone Mineral Density in Collegiate Distance Runners.

Brimacomb, OE, Martinez, MP, McCormack, WP, and Almstedt, HC. A 2-year longitudinal study of bone mineral density in collegiate distance runners. J Strength Cond Res 37(8): 1654-1659, 2023-The purpose of this investigation was to examine changes in bone mineral density (BMD) of male and female collegiate distance runners over 2 years. Bone mineral density of 29 collegiate distance runners (16 men and 13 women) were measured 5 times over 24 months using dual-energy x-ray absorptiometry (DXA) at the anterior-posterior (AP) and lateral (LAT) spine, femoral neck (FN), total hip (TH), whole body (WB), and ultradistal (UD) forearm. Repeated-measures multivariate analysis of covariance, with bone-free lean mass (BFLM) as covariate, was used to compare mean BMD values. Adjusted for BFLM, there were no significant differences ( p > 0.05) in BMD at any site between sexes. There were no significant differences at the AP or LAT spine, FN, or WB between visit 1 and 5 for either sex. There was a significant increase in BMD ( p = 0.044) at the UD forearm over 2 years in males. However, 56% of the men ( n = 9) had a Z-score < -1.0 at the UD forearm. Seven of 11 women had Z-scores < -1.0 at the LAT spine and 4 of 13 had Z-scores < -1.0 at the AP spine. There were no significant changes in BMD at any site over the 2-year time frame, except a significant increase in BMD at the nondominant forearm in men. The spine appears to be an area of concern for women in this study when examining Z-score results. Coaches and medical staff need to continually educate collegiate endurance athletes about the importance of achieving and maintaining BMD through their college years.

Bone resorption during therapy with denosumab in patients with rheumatoid arthritis, positive for the main immunological markers

Objective. Inflammation in rheumatoid arthritis (RA) leads to the development of local and generalized bone loss. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibodies (ACCP) are believed to play a negative role in the radiological progression of RA. The use of such antiresorptive therapy as denosumab – monoclonal antibodies to RANKL (receptor activator of nuclear factor kappa-B ligand), reduces the activity of osteoclasts, increases bone mineral density (BMD), and also potentially affects the erosive process at RA. The aim of the study is to evaluate the effect of denosumab therapy on BMD and erosion count in patients with RA and osteoporosis (OP) in consideration of the positivity in the RF and ACCP in serum and the baseline RA activity. Materials and methods. The 12-month prospective study of the efficacy of denosumab therapy (60 mg subcutaneously every 6 months) in patients with RA and OP included 66 postmenopausal women; age – 59.4±7.5 years, duration of RA – 17.8±10.6 years, RF-positive – 47 (72%) patients, ACCP-positive – 48 (74%) patients. At baseline and after 12 months, dual-energy X-ray absorptiometry was performed with an assessment of BMD in the lumbar spine (L1– L4), proximal femur (hip neck and total hip), distal forearm; X-ray of the hands and distal parts of the feet in direct projection, followed by assessment of erosive-destructive changes according to the Sharp/van der Heijde method. Results. A significant increase in BMD was established in all studied sites of the skeleton despite the positivity of the RF and ACCP (for the hip neck p=0.05), while a significant increase in BMD in the RF- and ACCP-negative group was detected only in L1–L4 site. The progression of the increase in erosion count was noted in the RF- and ACCP-positive group while in the RF- and ACCP-negative group this indicator did not change. Regardless of the baseline activity of RA (by DAS28 (Disease Activity Score 28)) the BMD of most parts of the skeleton were stabilized. In patients with moderate RA activity, BMD increased significantly in L1–L4 in both groups: RF- and ACCP-positive and -negative , as well as in the total hip – in RF- and ACCP-positive group. The dynamics of the erosion count in RA patients did not depend on the baseline degree of DAS28 activity, no significant changes were detected in the analyzed groups. Conclusions. RF and ACCP positivity in serum in patients with RA and OP treated with denosumab did not have a negative effect on the dynamics of BMD, while the number of erosions increased. The baseline RA activity level did not affect the dynamics of the erosion count and the dynamics of BMD in most subgroups – BMD levels have been increased or stabilized.

Changes in bone mineral density after allogenic stem cell transplantation.

Osteoporosis is a complication after allogenic stem cell transplantation (alloSCT). The purpose of this study was to assess changes in bone mineral density (BMD) 6 months and 3 years after alloSCT, as well as predictors of bone loss. A longitudinal, prospective, single-center study was conducted at Lille University Hospital between 2005 and 2016. Clinical, biological, radiologic (thoracic and lumbar spine) and densitometric (DXA) assessments were carried out at baseline (pre-transplant), 6 months and 3 years. Patients with myeloma were not included. Two hundred and fifty-eight patients were included (144 men). Among them, 60.1% had leukemia and 65.8% of them, acute myeloid leukemia. At baseline, 6 months and 3 years, DXA-confirmed that osteoporosis was observed in 17%, 22.8% and 17.5% of the patients, respectively, mainly at the femoral neck. At baseline, 6 months and 3 years, 9 (8.5%), 53 (21.5%) and 38 (16.7%) patients, respectively, were receiving anti-osteoporotic treatment. From baseline to 6-month follow-up, BMD decreased significantly (p&lt;0.001) at the lumbar spine (-36 [95%CI; -51 to -20] mg/cm² of hydroxyapatite), femoral neck (-43 [95%CI; -57 to -29] mg/cm² of hydroxyapatite) and total hip (-53 [95%CI; -68 to -39] mg/cm² of hydroxyapatite). From 6-month to 3-year follow-up, a significant increase in BMD was observed at the lumbar spine only (+31 [95%CI; 20 to 42] mg/cm² of hydroxyapatite, p&lt;0.001). At all 3 sites, changes in BMD did not differ between patients treated or untreated by anti-osteoporotic treatment from 6-month to 3 year follow-up. Incident fractures were found in 4.1% and 5.7% of the patients at 6 months and 3 years, respectively. Between baseline and 6 months, bone loss at all 3 sites was associated with corticosteroid intake. At the total hip, 23.3% of the decrease in BMD from baseline to 6 months was due to an active hematological disease (p&lt;0.05), a bone marrow stem cells (p&lt;0.01) and a corticosteroid intake (p&lt;0.01). Our study found evidence of bone fragility in alloSCT patients. Low BMD persisted at the hip 3 years after transplantation due to slower improvement at this site.

Effects of Rapid Weight Loss following Iron Supplementation on Bone Mineral Density and Serum Osteocalcin Levels in University Wrestlers

This experiment is designed for bone health in wrestlers and martial arts athletes who lose weight with Rapid Weight Loss (RWL). To clarify the effect of iron intake on the relationship between weight loss and bone densityFor athletes using the RWL strategy, iron intake was observed for bone mineral density (BMD), serum osteocalcin (OC) level, and serum iron marker. This study was conducted on 23 wrestlers (13 males and 10 females). It was divided into the trial 1 (iron intake and weight loss) and the trial 2 (only weight loss). In addition, between the first and second experiments, a washout period was given for 3 weeks} in order to eliminate the medicinal effect. All measurements were performed in the same group. However, the OC levels were reduced following RWL. In case of the males, the intake group after weight loss demonstrated a significant increase in BMD (p&lt;0.05). Correlation analysis of the data for the male group showed significant correlations between serum OC and iron contents (p&lt;0.05), total BMD and TIBC(total iron binding capacity) (p&lt;0.05), and transferrin and iron concentrations (p&lt;0.05). In the female group, serum OC and iron (p&lt;0.01), transferrin and TIBC(total iron binding capacity) (p&lt;0.01) showed correlations. In addition, between serum OC and ferritin (p&lt;0.05), total BMD and ferritin (p&lt;0.05), TIBC and iron (p&lt;0.05) were shown to have some degree of correlation in the global evaluations.

Assessing the bone-healing potential of bone marrow mesenchymal stem cells in jawbone osteoporosis in albino rats.

Osteoporosis is one of the most common yet difficult to treat diseases. It affects millions of people and costs the health care systems billions worldwide. All of the available kinds of pharmacological treatment have multiple side effects, which is why a need for safer treatment options has emerged. This study aimed to assess the bone-healing potential of bone marrow mesenchymal stem cells (BM‑MSCs) in jawbone osteoporosis in Wistar albino rats. Osteoporosis was induced with a daily intraperitoneal injection of 200 μg/100 g dexamethasone for 1 month. The rats were then randomly distributed into 2 groups: the osteoporotic group (left untreated); and the BM‑MSCs group (received an intravenous injection of 50 million cultured BM‑MSCs). Half of the rats from each group were sacrificed 2 weeks and the other half 6 weeks after the introduction of treatment. Bone regeneration was assessed by means of dual-energy X-ray absorptiometry (DEXA), real-time polymerase chain reaction (RT‑PCR), as well as the histopathological and histomorphometric analyses. As for the 1st sacrifice time, there were no significant differences between the osteoporotic and BM‑MSCs groups with regard to all parameters except for bone mineral density (BMD), which was significantly higher in the BM‑MSCs group. Regarding the 2nd sacrifice time, the DEXA analysis showed a significant increase in BMD in the BM‑MSCs group (p < 0.001). The RT‑PCR analysis showed a significant decrease in RANKL gene expression (p < 0.001) and a significant increase in OPG gene expression (p < 0.001) in the BM‑MSCs group. In addition, the histopathological examination of the BM‑MSCs group showed pronounced healing progress in the jawbone microarchitecture. The histomorphometric analysis also revealed that the bone area percentage significantly increased in the BM‑MSCs group (p < 0.001). This study proved that BM‑MSCs could be effective in the treatment of osteoporosis.

Effect of platelet-rich plasma on bone regenerate consolidation in distraction osteogenesis: An experimental study in rabbits.

The aim of this study was to determine the effect of platelet-rich plasma (PRP) on bone regenerate consolidation in a rabbit model of distraction osteogenesis. In this study, 12 male New Zealand rabbits weighing 1600 to 2000 g were used. All the rabbits were randomly divided into two groups (n = 6 per group): PRP group and control group. A two-ring, circular external fixator was applied to the right tibia of each rabbit in both groups. After corticotomy, all the tibiae were distracted at a rate of 0.5 mm/day for 20 days. PRP was injected to the osteotomy sites on the 7th, 14th, and 21st days postoperatively. Mineral density of the new bone tissue formed in the distraction zone was measured using quantitative computed tomography in the 3rd, 4th, and 5th weeks. At the end of the 6th week, the animals were sacrificed, and the specimens were evaluated biomechanically and histologically. Microcomputed tomography assessment showed significant bone mineral density increase from the 3rd to the 6th week (62.3% and 43.7% for the PRP and control groups, respectively). In the PRP group, the measurements on the 3rd, 4th, and 5th weeks were 416 ± 29, 487 ± 9.9, and 675 ± 37.8 HU (Hounsfield units), respectively, whereas in the control group were 313, 374, and 450 HU, respectively. In the comparison of weekly measurements of the two groups, the increase in bone density in the PRP group was higher than that in the control group (P < 0.001). During the mechanical tests, in the PRP group, the mean torsion was 46.50°and the mean torque 0.53 Nm, while in the control group, the mean torsion was 19.33°and the mean torque 0.65 Nm. The mechanical analysis of the groups revealed significant differences in the mean maximum torsion angles (P = 0.024). The histological examination showed that both groups had external and internal periosteal calli. Callus tissue in four rabbits in the PRP group and two rabbits in the control group was remodeled; normal bone formation occurred and distracted bone ends were completely healed. The results of the present study have indicated that PRP injection can enhance bone regenerate consolidation and increase bone mineral density during the healing process of distraction osteogenesis.

Efficacy of Yigu® versus Aclasta® in Chinese postmenopausal women with osteoporosis: a multicenter prospective study

SummaryZoledronic acid (ZOL) is a therapy inhibiting bone resorption. In this study, generic ZOL (Yigu®) showed its clinical efficacy consistency with original ZOL (Aclasta®) in Chinese postmenopausal women with osteoporosis. This study provides a practical basis for the application of Yigu® in Chinese population.IntroductionYigu® has been approved its bioequivalence to Aclasta®. However, the clinical efficacy and safety of Yigu® have not been evaluated yet. Here, we compared the effectiveness and safety between Yigu® and Aclasta® in Chinese postmenopausal women with osteoporosis and assessed the efficacy of intravenous infusion of ZOL.MethodsThis was a randomized open-label, active-controlled study in postmenopausal women with osteoporosis of 14 clinical centers in China. Postmenopausal women with osteoporosis were recruited and randomized to receive a single infusion of 5 mg Yigu® or Aclasta®. The primary endpoint was the percentage change in bone mineral density (BMD) at lumbar spine after 12 months of treatment and was assessed for equivalence. The secondary endpoint was the percentage change in BMD at proximal femur after 12 months. Additional secondary endpoints were percentage changes in BMD at the above sites after 6 months of treatment and changes in bone turnover biomarkers during ZOL treatment. Safety was also evaluated and compared between two groups.ResultsA total of 458 postmenopausal women with osteoporosis were enrolled (n = 227, Yigu®; n = 231, Aclasta®). The mean percentage change in the BMD had no statistical difference at the lumbar spine (5.32% vs 5.18%), total hip (2.72% vs 2.83%), and femoral neck (2.37% vs 2.81%) between Yigu® and Aclasta® groups after 12 months of treatment. The mean difference of BMD change at the lumbar spine after 12 months between two groups was 0.15% (95% CI: − 0.71 to 1.00, equivalence margin: − 1.5%, 1.5%), demonstrating the treatments were equivalent. Meanwhile, the decreases in the P1NP and β-CTX showed no difference between two groups after 14 days and 6 and 12 months of treatment. As regards the whole sample, BMD significantly increased after 12 months of treatment. Also, serum C-terminal telopeptide of type 1 collagen (β-CTX) and procollagen 1 N-terminal peptide (P1NP) significantly decreased at each visit period. The overall adverse events were comparable and quite well between two groups.ConclusionIntravenous infusion of zoledronic acid achieved the potent anti-resorptive effects which led to significant increase in BMD of Chinese postmenopausal women with osteoporosis. Yigu® was equivalent to Aclasta® with respect to efficacy and safety.

Denosumab After Teriparatide in Premenopausal Women With Idiopathic Osteoporosis

We have previously reported that teriparatide is associated with substantial increases in bone mineral density (BMD) at the lumbar spine (LS), total hip (TH), and femoral neck (FN) and small declines at the distal radius in 41 premenopausal women with idiopathic osteoporosis (IOP), all severely affected with low trauma fractures and/or very low BMD. Effects of teriparatide dissipate if not followed by antiresorptives. To assess the effects of 12 and 24 months of denosumab in premenopausal women with IOP completing 24 months of teriparatide. This was a preplanned phase 2B extension study. Premenopausal women with IOP who had completed a course of teriparatide received denosumab 60 mg every 6 months over 24 months. The main outcome measure was within-group change in BMD at the LS at 12 months. Secondary outcomes include change in 12-month BMD at other sites, 24-month BMD at all sites, trabecular bone score (TBS), and bone turnover markers (BTMs). After completing teriparatide, 32 participants took denosumab for 12 months and 29 for 24 months, with statistically significant increases in BMD at the LS (5.2 ± 2.6% and 6.9 ± 2.6%), TH (2.9 ± 2.4% and 4.6 ± 2.8%), and FN (3.0 ± 3.8% and 4.7 ± 4.9%). Over the entire 24-month teriparatide and 24-month denosumab treatment period, BMD increased by 21.9 ± 7.8% at the LS, 9.8 ± 4.6% at the TH, and 9.5 ± 4.7% at the FN (all P < .0001). TBS increased by 5.8 ± 5.6% (P < .001). Serum BTM decreased by 75% to 85% by 3 months and remained suppressed through 12 months of denosumab. Denosumab was generally well tolerated. These data support the use of sequential teriparatide and denosumab to increase BMD in premenopausal women with severe osteoporosis.

Specific Bioactive Collagen Peptides in Osteopenia and Osteoporosis: Long-Term Observation in Postmenopausal Women.

BackgroundThe effects of specific collagen peptides on bone mineral density (BMD) in subjects with osteoporosis or osteopenia have already been investigated in 131 postmenopausal women in a randomized controlled trial. The purpose of this follow-up observation was to determine the longer-term effects of the same specific bioactive collagen peptides after a total intervention time of 4 years.MethodsIn this open-label follow-up observation, 31 postmenopausal women with reduced BMD (initial T-score lower than −1 of either the femoral neck or the lumbar spine) completed the follow-up. BMD was measured via dual energy X-ray absorptiometry. Absolute changes in BMD and T-scores in the spine and femoral neck were assessed. The number of fractures was also recorded. All participants received specific bioactive collagen peptides.ResultsSupplementation with bioactive collagen peptides during follow-up led to a clinically relevant increase in BMD in the spine. These findings were consistent with the results for the femoral neck.ConclusionsLong-term supplementation with specific bioactive collagen peptides appears to be effective in counteracting losses in BMD. Moreover, significant increases in BMD could contribute to improved bone stability.

The Impact of Natural Calcium Carbonate and Ubiquinone on Bone Mineral Density in Rabbits

Objective: The aim of this study was to investigate the effect of ubiquinone and/or calcium carbonate (CaCO3) on bone mineral density in rabbits at healing site in mandibular bone postoperatively. Materials and Methods: Sixty healthy white male New Zealand rabbits almost the same age, weight and circumstance were used in this study. All animals were submitted to operation in the mandibular bone region. The groove of 2mm diameter and 6mm length was drilled by the heavy-duty dental engine. After operation rabbits were randomly divided into six groups (each group 10 rabbits) five rabbits for each period; control group (groove was not filled by anything) and treated groups which subdivided into five groups as follows: group I (groove was filled with Ubiquinone), group II (groove was filled with CaCO3), group III (groove was filled with CaCO3: Ubiquinone as a ratio (1:1)), group IV (groove was filled with CaCO3: Ubiquinone as a ratio (1:2)) and group V (groove was filled with CaCO3: Ubiquinone as a ratio (2:1)). Estimated BMD using Densitometry analysis was measured after 15 and 30 days respectively. Results: Statistical analysis showed significant differences between all groups (control and treated). The estimated BMD showed significant increase group I(101±1.05), group II(111±2.23), group III(125±3.54), group IV(126±5.13) and group V(133±6.29) comparing to control group (92±0.15) at follow-up times at 15 day. Also in the present study we found that significant decrease in BMD after 30 days of operation in group I(144±3.45), group II(153±6.24), group III(160±8.94), group IV(165±9.11) and group V(182±12.56) compare to control group(109±1.25) respectively. Adding the ubiquinone and/or CaCO3 showed a significant increase in BMD manifested by bone healing like space-filling and newly formed bone trabeculae and a high number of lacunas compared with the control group. Conclusion: This study concluded that the addition of ubiquinone and/or CaCO3 was successfully increasing in bone healing by increasing BMD compared with the control group. Keywords: Ubiquinone, CaCO3, Bone healing, BMD (Bone Mineral Density).

The benefits of tenofovir discontinuation with or without bisphosphonate therapy in osteoporotic people living with HIV.

Treatment with bisphosphonates and discontinuation of tenofovir disoproxil fumarate (TDF) are recommended strategies for managing osteoporosis in people living with HIV (PLHIV). This study aimed to compare the effects on bone mineral density (BMD) of TDF discontinuation with and without bisphosphonate therapy in osteoporotic PLHIV. The present study is a retrospective cohort analysis of dual-energy X-ray absorptiometry scan results of PLHIV attending Chelsea and Westminster Hospital HIV clinic between 2009 and 2020. Osteoporotic (T-score<-2.5) patients with ≥6months' TDF exposure were included. Changes in BMD and T-scores at the lumbar spine (LS) and femoral neck (FN) were assessed. A total of 84 participants were included, of whom 43 discontinued TDF only (TS) and 41 switched from TDF and received bisphosphonates (TS+): 86.9% were male; 77.4% were white; median (interquartile range, IQR) age was 54.8 (51.0-58.5) years; and median (IQR) TDF exposure was 6.5(3.5-10.4) years. At a median follow-up of 2years after TDF-discontinuation, mean spine BMD increased significantly in both groups, but bisphosphonate recipients had greater improvements (4.83% vs. 7.79%; P<0.019); LS T-scores improved significantly but changes were comparable between groups (TS, 0.5 vs. TS+, 0.6; P=0.270). At the FN, no significant increases in BMD were observed (TS, 3.05% vs. TS+, 2.71%; P=0.205); T-scores significantly improved in bisphosphonate recipients only (+0.2; P=0.003). A greater proportion recovered from osteoporosis in the TS+ group (34.9% vs. 43.9%), although differences between groups were not significant (P=0.503). Our real-world data indicate that although TDF discontinuation significantly improved bone health in osteoporotic PLHIV, combining bisphosphonates with TDF discontinuation resulted in greater improvements in BMD.

Influence of denosumab on bone mineral density in a severe case of pregnancy-associated osteoporosis

Pregnancy and lactation-associated osteoporosis (PLO) with predominantly subsequent vertebral fracture is a rare but severe disease with an estimated incidence of 0.4 in 100,000. In the past, patients with PLO have been predominantly treated with oral and i.v. bisphosphonates to reduce subsequent fracture risk. Hereby, the use of bisphosphonates in premenopausal women is controversial, as bisphosphonates know to persist in bone for many years and can be exposed and circulate in maternal serum and subsequently pass the placenta barrier and may have a detrimental effect on fetal bone health. Here we report the effects of denosumab on the bone mineral density (BMD) and subsequent fracture risk in PLO. In this case presentation, denosumab was administered postpartum with 3000 IE vitamin D and 1000 mg of calcium daily in a patient with PLO and vertebral fracture of L1 and L4. After 18 months of treatment with denosumab, we could demonstrate a clinical significant increase of BMD at the lumbar spine, femoral neck, and total hip of 32.2%, 13.0%, and 11.5% respectively with no further subsequent fractures. As the patient had regular menstrual cycles and considered a further pregnancy, denosumab treatment was terminated and soon a second pregnancy occurred. After the second pregnancy, BMD decreased at the lumbar spine, femur neck, and total hip by −8.8%, −6.9%, and −7.0% respectively compared to the maximum values during treatment with denosumab, but was still significantly higher compared to baseline levels with no further fractures.