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Renal osteodystrophy (ROD) is a heterogeneous group of metabolic bone diseases complicating progressive chronic kidney disease (CKD). Bone biomarkers and bone imaging techniques may help to assess bone health and predict fractures in CKD but do have important inherent limitations. By informing on bone turnover and mineralization, a bone biopsy may help to guide prevention and treatment of ROD and its consequences. According to a recent survey conducted among European nephrologists, bone biopsies are performed rather exceptionally, both for clinical and research purposes. Obviously, clinical research in the field of ROD is threatened by vanishing clinical and pathological expertise, small patient cohorts and scientific isolation. In March 2016, the European Renal Osteodystrophy (EU-ROD) initiative was created under the umbrella of the ERA-EDTA CKD-mineral and bone disorder (MBD) Working Group to revitalize bone biopsy as a clinically useful tool in the diagnostic workup of CKD-MBD and to foster research on the epidemiology, implications and reversibility of ROD. As such, the EU-ROD initiative aims to increase the understanding of ROD and ultimately to improve outcomes in CKD patients. info:eu-repo/semantics/publishedVersion

Objectives: Bisphosphonates (BPs) are powerful inhibitors of osteoclastogenesis and are used to prevent osteoporotic bone loss and reduce the risk of osteoporotic fracture in patients suffering from postmenopausal osteoporosis. Patients with breast cancer or gynecological malignancies being treated with BPs or those receiving bone-targeted therapy for metastatic prostate cancer are at increased risk of bisphosphonate-related osteonecrosis of the jaw (BRONJ). Although BPs markedly ameliorate osteoporosis, their adverse effects largely limit the clinical application of these drugs. This study focused on providing a deeper understanding of one of the most popular BPs, the alendronate (ALN)-induced perturbation of the bone proteome and microenvironmental pathophysiology. Methods: To understand the molecular mechanisms underlying ALN-induced side-effects, an unbiased and global proteomics approach combined with big data bioinformatics was applied. This was followed by biochemical and functional analyses to determine the clinicopathological mechanisms affected by ALN. Results: The findings from this proteomics study suggest that the RIPK3/Wnt/GSK3/β-catenin signaling pathway is significantly perturbed upon ALN treatment, resulting in abnormal angiogenesis, inflammation, anabolism, remodeling, and mineralization in bone cells in an in vitro cell culture system. Conclusion: Our investigation into potential key signaling mechanisms in response to ALN provides a rational basis for suppressing BP-induced adverse effect and presents various therapeutic strategies.

Vitamin D supplementation in infancy is recommended to prevent rickets. At the population level, its effects on bone mineralisation are largely unknown. We aimed to explore whether adherence to national vitamin D supplementation guidelines (10 µg/d up to the age of 2 years), supplementation at the ages of 5 and 7 years, and serum 25-hydroxyvitamin D (s-25(OH)D) at various time points associated with bone mineral density (BMD) at the age of 7 years in the Odense Child Cohort, Denmark (n 1194). High adherence was defined as supplementation with 10 µg of vitamin D 6–7 times per week during ≥80 % of the observation time. s-25(OH)D was analysed using LC-MS/MS. Total-body-less-head (TBLH) BMD was measured by dual-energy X-ray absorptiometry. At the median age of 18·1 months, 53·9 % (n 475/881) reported high adherence. The median s-25(OH)D was 64·7, 78·8, 46·0 and 71·8 nmol/l in early pregnancy, late pregnancy, cord blood and at 5 years, respectively. The mean TBLH BMD at the median age of 7·1 years was 0·613 (SD 0·049) g/cm2 (z-score +0·363 (SD 0·824)). In adjusted analyses, vitamin D supplementation up to 18 months, and at 5 and 7 years, was not associated with TBLH BMD. Similarly, no robust associations were found between TBLH BMD and s-25(OH)D at any time point. No associations were found for TBLH bone mineral concentration or bone area. In this population with relatively high s-25(OH)D concentrations, no consistent associations were found between adherence to vitamin D supplementation recommendations or vitamin D status in pregnancy or childhood, and bone mineralisation at the age of 7 years.

Background: Long-term opioid therapy is a risk factor for low bone mineral density (BMD). However, other factors may also contribute to low BMD. Several studies have examined the variables that might contribute to low BMD in patients receiving opioid replacement therapy (OST). However, to our knowledge, there was no systemic review conducted to address this particular issue. Thus, we reviewed the articles on the factors associated with low BMD in the population of opioid use disorder receiving substitution therapy. Methods: The articles that examined correlates or risk factors of low BMD in OST population were retrieved from OVID, SCOPUS, and PUBMED from inception until July 2020 by two independent investigators. Results: A total of 429 articles from three databases were retrieved initially. After screening based on eligibility criteria, five articles were included in the final analysis. The risk factors or correlates found to be significantly associated with low BMD in the OST population include male gender, low body mass index, low testosterone level, methadone or heroin use, and longer duration of heavy alcohol use. The review limitations include small sample sizes and inconsistent definition of variables. Conclusion: OST patients should be screened for BMD and its associated factors. Guidelines and training of practitioners involving in the OST service should be provided to increase the detection of low BMD in the OST population.

Purpose: Some epidemiological studies and animal studies have reported a relationship between leukocyte telomere length (LTL) and bone mineral density (BMD). However, the causality underlying the purported relationship has not been determined. Here we performed a two-sample MR analysis to test the causal link between telomere length and BMD. Results: Our research suggested no causal link of LTL and BMD using IVW method. The weighted median, MR-Egger regression and MR.RAPS method yielded a similar pattern of effects. MR-Egger intercept test demonstrated our results were not influenced by pleiotropy. Heterogeneities among the genetic variants on heel estimated BMD and TB-BMD vanished after excluding rs6028466. “Leave-one-out” sensitivity analysis confirmed the stability of our results. Conclusion: Our MR analysis did not support causal effect of telomere length on BMD. Methods: We utilized 5 independent SNPs robustly associated with LTL as instrument variables. The outcome results were obtained from GWAS summary data of BMD. The two-sample MR analysis was conducted using IVW, weighted median, MR-Egger regression and MR.RAPS method. MR-Egger intercept test, Cochran’s Q test and I2 statistics and “leave-one-out” sensitivity analysis were performed to evaluate the horizontal pleiotropy, heterogeneities and stability of these genetic variants on BMD.

Ancestors of the Antarctic icefishes (family Channichthyidae) were benthic and had no swim bladder, making it energetically expensive to rise from the ocean floor. To exploit the water column, benthopelagic icefishes were hypothesized to have evolved a skeleton with “reduced bone,” which gross anatomical data supported. Here, we tested the hypothesis that changes to icefish bones also occurred below the level of gross anatomy. Histology and micro‐CT imaging of representative craniofacial bones (i.e., ceratohyal, frontal, dentary, and articular) of extant Antarctic fish species specifically evaluated two features that might cause the appearance of “reduced bone”: bone microstructure (e.g., bone volume fraction and structure linear density) and bone mineral density (BMD, or mass of mineral per volume of bone). Measures of bone microstructure were not consistently different in bones from the icefishes Chaenocephalus aceratus and Champsocephalus gunnari, compared to the related benthic notothenioids Notothenia coriiceps and Gobionotothen gibberifrons. Some quantitative measures, such as bone volume fraction and structure linear density, were significantly increased in some icefish bones compared to homologous bones of non‐icefish. However, such differences were rare, and no microstructural measures were consistently different in icefishes across all bones and species analyzed. Furthermore, BMD was similar among homologous bones of icefish and non‐icefish Antarctic notothenioids. In summary, “reduced bone” in icefishes was not due to systemic changes in bone microstructure or BMD, raising the prospect that “reduced bone” in icefish occurs only at the gross anatomic level (i.e., smaller or fewer bones). Given that icefishes exhibit delayed skeletal development compared to non‐icefish Antarctic fishes, combining these phenotypic data with genomic data might clarify genetic changes driving skeletal heterochrony., Antarctic icefishes are amazing examples of evolutionary adaptation. Here, we show quantitatively that icefish skeletons did not change bone microstructure or bone mineral density, relative to closely related fish species.

Purpose To evaluate the relationship between bone mineral density (BMD) and magnetic susceptibility, and between proton density fat fraction and susceptibility, in inflamed trabecular bone. Methods Two different phantoms modeling the fat fraction (FF) and BMD values of healthy bone marrow and disease states were scanned using a multiecho gradient echo acquisition at 3T. After correction for fat‐water chemical shift, susceptibility mapping was performed, and susceptibility measurements were compared with BMD and FF values using linear regression. Patients with spondyloarthritis were scanned using the same protocol, and susceptibility values were calculated in areas of inflamed bone (edema) and fat metaplasia, both before and after accounting for the contribution of fat to the total susceptibility. Results Susceptibility values in the phantoms were accurately described by a 2D linear function, with a negative correlation between BMD and susceptibility and a positive correlation between FF and susceptibility (adjusted R2 = 0.77; P = 3·10−5). In patients, significant differences in susceptibility were observed between fat metaplasia and normal marrow, but these differences were eliminated by removing the fat contribution to the total susceptibility. Conclusions BMD and proton density fat fraction both influence the total susceptibility of bone marrow and failure to account for the fat contribution could lead to errors in BMD quantification. We propose a method for removing the fat contribution from the total susceptibility, based on the observed linear relationship between susceptibility and FF. In inflamed bone, the overall increase in susceptibility in areas of fat metaplasia is at least partly due to increased fat content.

Bone, vascular smooth muscle, and arachnoid trabeculae are composed of the same type of collagen. However, no studies have investigated the relationship between bone mineral density deterioration and cerebral atrophy, both of which occur in normal, healthy aging. Accordingly, we evaluated whether bone mineral density was associated with brain parenchymal atrophy and ventricular enlargement in healthy individuals. Intracranial cavity, brain parenchyma, and lateral ventricles volumes were measured using brain magnetic resonance imaging (MRI) with a semiautomated tool. We included 267 individuals with no history of dementia or other neurological diseases, who underwent one or more dual-energy X-ray absorptiometry scans and brain MRIs simultaneously (within 3 years of each other) at our hospital over an 11-year period. We found that progression of brain parenchymal atrophy was positively associated with bone mineral density after full adjustment (B, 0.94; P < 0.001). In addition, individuals with osteoporosis showed more parenchymal atrophy among those younger than 80 years. In addition, we observed greater ventricular enlargement in individuals with osteoporosis among those older than 80 years. We believe that osteoporosis may play a role in the acceleration of parenchymal atrophy during the early-stages, and ventricular enlargement in the late-stages, of normal aging-related cerebral atrophy.

The aim of the study was to investigate the association of Cystatin C (CysC) to biochemical markers of bone turnover and bone mass, and to evaluate its prognostic significance in elderly males with chronic heart failure (CHF).A prospective cohort study was executed on sixtyeight males (mean age 68±7 years) with mild to moderate CHF, together with 19 of corresponding age- and body mass index-matched healthy individuals who underwent cardio vascular, bone mineral density (BMD), and body com position assessment. Biochemical assessment of all subjects included NT-pro-BNP, parathyroid hormone (PTH), 25-hydroxy vitamin D (25(OH)D), CysC, and biochemical markers of bone turnover including osteocalcin (OC), alkaline phosphatase (ALP), β-CrossLaps (β-CTx), osteoprotegerin (OPG), and receptor activator of nuclear factor κB ligand (RANKL).Serum CysC was significantly increased in males with CHF in comparison to healthy control ones. A significant positive association was found between CysC levels and OC in males with CHF, while OC and β-CTx increased in increasing CysC tertiles. In multivariate regression analysis, OC and smoking were a significant determinant of CysC in males with CHF. Level of CysC was found to be positively associated with an increased fatal risk in males with CHF.Serum osteocalcin is an independent predictor of CysC level in elderly males with CHF. Higher CysC level showed a negative relation to survival and bone loss in males with CHF. Further research is needed to confirm the potential role of CysC in the crosstalk between heart, kidney, bone, and energy metabolism in CHF.Cilj studije je bio da se ispita povezanost cistatina C (CisC) i biohemijskih markera metabolizma kosti i mineralne koštane gustine, kao i da se proceni prognostički značaj CisC kod starijih muškaraca sa hroničnom srčanom insuficijencijom (HSI).Ovo istraživanje je prospektivna studija kohorte koju je činilo šezdeset osam muškaraca (prosečne starosti 68±7 godina života) sa blagom do umerenom HSI i 19 zdravih osoba odgovarajuće starosti i indeksa telesne mase. Svi ispitanici su podvrgnuti proceni kardiovaskularnog sistema, mineralne koštane gustine i telesnog sastava. Biohemijska merenja kod svih ispitanika su uključivala određivanje NT-pro-BNP, paratiroidnog hormona (PTH), 25-hidroksi vitamina D (25 (OH) D), CisC i biohemijskih markera metabolizma kosti, uključujući osteokalcin (OC), alkalnu fosfatazu (ALP), beta-CrossLaps (b-CTx), osteoprotegerin (OPG) i ligand za receptor aktivator nuklearnog faktora B (RANKL).Serumski CisC je značajno povećan u muškaraca sa HSI u poređenju sa nivoom kod zdravih osoba. Značajna pozitivna povezanost detektovana je između nivoa CisC i OC kod muškaraca sa HSI, i vrednosti OC i b-CTx su povećane kod pacijenata u rastućim CisC tercijarima. U multivarijantnoj regresionoj analizi je pokazano da su OC i pušenje znač ajne determinante nivoa CisC kod muškaraca sa HSI. Nivo CisC je u pozitivnoj korelaciji sa povećanim rizikom za mortalitet kod muškaraca sa HSI.Serumski osteokalcin je nezavisan prediktor nivoa CisC kod starijih muškaraca sa HSI. Povećan nivo CisC je pokazao negativnu povezanost sa preživljanjem i gubitkom kosti kod muškaraca sa HSI. Potrebno je da buduća istraživanja potvrde potencijalnu ulogu CisC u komunikaciji između srca, bubrega, kosti i energetskog metabolizma u hroničnoj srčanoj insuficijenciji.

Aims: To understand the paradox of an increased fracture risk despite increased bone mineral density (BMD) in persons with type 2 diabetes (DM2). Patients and Methods: We studied 80 old persons with DM2. Mineral metabolism, parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), bone turnover – osteocalcin, procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX) – were measured and BMD was assessed at the lumbar spine (LS) and femoral neck (FN). Data was analyzed with the Statistical Package for the Social Sciences Program. Results: Low levels of 25OHD (84%) and high values of PTH (20%) were found. Osteocalcin was directly related to CTX, p

IntroductionSarcopenia is the pathological reduction of skeletal muscle mass and strength. This condition is often underestimated in clinical practice, particularly in connective tissue diseases. The purpose of this study is to evaluate the prevalence of low muscle mass in primary Sjögren’s syndrome (pSS) and to explore the relationships linking muscles and bone tissue.Material and methodsTwenty-eight postmenopausal pSS patients were matched with 30 healthy controls and their body composition analysis was performed by dual-energy X-ray absorptiometry to investigate for sarcopenia considering appendicular lean mass (ALM) and the skeletal muscle mass index (SMI) as references. Bone mineral density analysis of lumbar spine (L1–L4), whole femur, femoral neck and whole body was also performed. Linear regression was used to assess the relationship between body composition and bone mineralization.ResultsLow muscle mass was significantly higher in the pSS group compared to controls whether expressed as ALM, SMI [odds ratio (OR) = 18.40, confidence interval (CI): 4.84–72.08, p < 0.0001] or considering total body lean masses. Lean masses appeared to be the best estimators of bone mineralization: total lean body mass (TLBM) lumbar spine R2 = 0.72, p < 0.0001; TLBM femoral neck R2 = 0.36, p < 0.004; lean mass of upper limbs lumbar spine R2 = 0.70, p < 0.0001; femoral neck R2 = 0.66; lean mass of lower limbs lumbar spine R2 = 0.66, p < 0.0001; femoral neck R2 = 0.44, p = 0.008). Primary Sjögren’s syndrome patients had a significantly higher android/gynoid fat ratio compared to controls.ConclusionsFemale pSS patients have lower muscle mass compared to healthy controls and are exposed to a higher risk of developing sarcopenia than healthy subjects. Our research demonstrates that the amount of lean tissue is the main predictor of bone mineralization in pSS.

IntroductionFractures are a common complication of osteoporosis. The main aim of our study was to assess the relation between fractures identified as low energy fractures (fragility), bone mineral density (BMD), trabecular bone score (TBS), and handgrip in a group of postmenopausal women. An additional aim was to determine the relation between fragility fractures and age, height loss, and falls (reported in the last 12 months and 5 years).Material and methodsThe study was conducted in a group of 120 (mean age 69 years; 59–81, SD 5.3) postmenopausal patients who were referred to the Medical Centre for an osteoporosis screening appointment by their general practitioner. All patients were interviewed (with a questionnaire containing questions on fracture risk factors and highest height), had their anthropometric measures taken (current height and weight) as well as TBS analysis following their DXA (dual-energy X-ray absorptiometry) scan and handgrip measure.ResultsSixty patients from the study group had a history of fractures (with a total of 92 fractures), of whom 39 women (76 fractures) were identified as those with a low-energy fracture. Fragility fractures were more likely to be reported in older patients (Me 71 vs. 68 years, p < 0.05). Differences observed between TBS, handgrip and BMD in reference to fragility fractures were not statistically significant. Analysis showed significant correlations between BMD (neck and L1–L4) and TBS fracture risk categories. Falls reported in the last 5 years and height loss were factors which correlated with fragility fractures (p < 0.05).ConclusionsRisk of fragility fractures increases with age. Bone mineral density is insufficient as a fracture risk assessment tool. Information on falls and height loss may provide additional data on fracture risk assessment.

The link between low bone mineral density (BMD) scores leading to greater fracture risk is well established in the literature; what is not fully understood is the impact of total knee replacements/revisions or arthroplasties on BMD levels. This literature review attempts to answer this question. Several different databases using specific key terms were searched, with additional papers retrieved via bibliographic review. Based on the available evidence, total knee replacements/revisions and arthroplasties lower BMD and thus increase fracture risk. This review also addresses the possible implications of this research and possible options to reduce this risk.

Highlights • Significant association of atherosclerosis and bone mineral density has been reported. • The association has been reported in postmenopausal women and elderly men. • This study reported the association in an international cohort of middle-aged men. • Coronary artery calcification was used as a biomarker of coronary atherosclerosis. • Vertebral bone density was used as a surrogate marker of bone mineral density., Introduction Inverse associations of cardiovascular disease (CVD) and atherosclerosis with osteoporosis and bone mineral density (BMD) have been reported in post-menopausal women and elderly men. We aimed to investigate an association between vetebral bone density (VBD) and coronary artery cacification (CAC) in an international multi-ethnic cohort of middle-aged men in the EBCT and Risk Factor Assessment among Japanese and US Men in the Post-World-War-II birth cohort (ERA JUMP). Methods ERA JUMP examined 1134 men aged 40–49 (267 white, 84 black, and 242 Japanese Americans, 308 Japanese in Japan, and 233 Koreans in South Korea) free from CVD for CAC, and VBD, biomarkers of coronary atherosclerosis and BMD, respectively, with electron-beam computed tomography, and other risk factors. CAC was quantified with the Agatston method and VBD by computing the mean Hounsfield Unit (HU) value of the T12 to L3 vertebrae. To examine multivariable-adjusted associations of CAC with VBD, we used robust linear and logistic regressions. Results The mean VBD and median CAC were 175.4 HU (standard deviation: 36.3) and 0 (interquartile range: (0, 4.5)), respectively. The frequency of CAC was 19.0%. There was no significant interaction by race. VBD had a significant inverse association with CAC score (β = −0.207, p-value = 0.005), while a 10-unit increase in VBD was significantly associated with the frequency of CAC (odds ratio (95% confidence interval) = 0.929 (0.890–0.969)). Both associations remained significant after adjusting for covariates. Conclusions VBD had a significant inverse association with CAC in this international multi-ethnic cohort of men aged 40–49.

After decades of pioneering and improvement, kidney transplantation is now the renal replacement therapy of choice for most patients with end-stage kidney disease (ESKD). Where focus has traditionally been on surgical techniques and immunosuppressive treatment with prevention of rejection and infection in relation to short-term outcomes, nowadays, so many people are long-living with a transplanted kidney that lifestyle, including diet and exposure to toxic contaminants, also becomes of importance for the kidney transplantation field. Beyond hazards of immunological nature, a systematic assessment of potentially modifiable—yet rather overlooked—risk factors for late graft failure and excess cardiovascular risk may reveal novel targets for clinical intervention to optimize long-term health and downturn current rates of premature death of kidney transplant recipients (KTR). It should also be realized that while kidney transplantation aims to restore kidney function, it incompletely mitigates mechanisms of disease such as chronic low-grade inflammation with persistent redox imbalance and deregulated mineral and bone metabolism. While the vicious circle between inflammation and oxidative stress as common final pathway of a multitude of insults plays an established pathological role in native chronic kidney disease, its characterization post-kidney transplant remains less than satisfactory. Next to chronic inflammatory status, markedly accelerated vascular calcification persists after kidney transplantation and is likewise suggested a major independent mechanism, whose mitigation may counterbalance the excess risk of cardiovascular disease post-kidney transplant. Hereby, we first discuss modifiable dietary elements and toxic environmental contaminants that may explain increased risk of cardiovascular mortality and late graft failure in KTR. Next, we specify laboratory and clinical readouts, with a postulated role within persisting mechanisms of disease post-kidney transplantation (i.e., inflammation and redox imbalance and vascular calcification), as potential non-traditional risk factors for adverse long-term outcomes in KTR. Reflection on these current research opportunities is warranted among the research and clinical kidney transplantation community.

It has been suggested that visceral fat (VF) might be a negative determinant of bone health. The purpose of this cross-sectional study was to assess an interplay among fat, visceral fat (VF), muscle mass, bone mineral density (BMD), and markers of bone turnover in men aged 60-75 years. BMD, lean mass, total fat, VF and appendicular skeletal muscle mass (ASM) were assessed using dual-energy X-ray absorptiometry. Using ELISA assays, we measured serum levels of markers of bone turnover (osteocalcin, parathyroid hormone, human procollagen I N-terminal peptide, and degradation products of C-terminal telopeptide of type I collagen). Mean values of bone markers were within normal range. VF was found not to be associated with BMD and bone turnover markers. ASM was inversely correlated with age, and positively with BMD and lean mass. In linear regression, ASM, VF, total fat, lean mass and body mass index were significant single predictors of BMD. However, after adjustment for age, all these associations were no longer significant. In conclusion, in contrast to some studies on postmenopausal women, in older non-diabetic men with normal lean mass and body fat VF was not associated with BMD and markers of bone formation and resorption.

Patients with urolithiasis, particularly hypercalciuria, may have reduced bone mineral density (BMD). There are numerous risk factors contributing to reduction of BMD such as advanced age, sedentary life-style, smoking, low calcium intake, etc. The aim of our study was to investigate the association of lifestyle risk factors and daily intake of milk and dairy products with determinants of BMD in a group of recurrent calcium stone formers (RSF) compared with healthy subjects (HS). The study was carried out at the De-partment of Mineral Research, Faculty of Medicine in Osijek, Croatia. The study included 144 subjects, i.e. 56 RSF and 78 HS. BMD was assessed by dual-energy x-ray absorptiometry. A standard self-reported questionnaire was used to collect data on lifestyle risk factors. Current dietary intake was assessed by personal interview that included questions about milk and dairy product intake. Low BMD was observed in 44.64% of RSF and 35.90% of HS. RSF consumed significantly less milk and dairy products than HS. Calcium restriction in dietary recommendations might be unnecessary due to the impact on bone mineral loss in RSF and dual-energy x-ray absorptiometry should be included in the routine evaluation of RSF., Bolesnici s urolitijazom, osobito oni s hiperkalciurijom, imaju smanjenu koštanu mineralnu gustoću (bone mineral density, BMD). Rizični čimbenici gubitka koštane mase su uznapredovala dob, sjedilački način života, pušenje i smanjen unos kalcija. Cilj našeg istraživanja bio je ustanoviti povezanost rizičnih čimbenika i dnevnog unosa mlije-ka i mliječnih prerađevina s odrednicama BMD u bolesnika s recidivirajućom kalcijskom urolitijazom te ih usporedi-ti sa zdravim ispitanicima. Istraživanje je provedeno na Zavodu za mineralni metabolizam Medicinskog fakulteta u Osijeku. U istraživanju su sudjelovala 144 ispitanika, od čega 56 bolesnika s recidivirajućom kalcijskom urolitija-zom i 78 zdravih ispitanika. BMD je određen metodom dvoenergetske apsorpciometrije X zraka (DXA). Podatci o čimbenicima rizika dobiveni su anketnim upitnikom, a unos hrane je ocijenjen osobnim intervjuom koji je uključi-vao pitanja o unosu mlijeka i mliječnih proizvoda. Snižen BMD zabilježen je u 44,64% bolesnika s recidivirajućom urolitijazom i u 35,90% zdravih ispitanika. Bolesnici s recidivirajućom urolitijazom konzumirali su znatno manje mlijeka i mliječnih proizvoda u odnosu na zdrave ispitanike. Nepotrebna je preporuka smanjenog unosa kalcija bolesnicima s recidivirajućom urolitijazom zbog utjecaja na gubitak koštane mase, a DXA treba biti dio rutinske procjene bolesnika s recidivirajućom urolitijazom.

application/pdf, The aim of the present study was to examine the effect of 28 days of dietary difructose anhydride (DFA) III supplementation on calcium (Ca) metabolism in late-lactation dairy cows. Twenty-four multiparous pregnant Holstein cows were divided into two groups. The DFA group was fed total mixed ration (TMR) supplemented with 40 g of DFA III, and the control group was fed TMR only. The replenishment of bone Ca reserves was evaluated by measuring bone mineral density (BMD) and blood biochemical bone markers. Serum Ca concentrations, urinary Ca-to-creatinine (Cre) (Ca/Cre) ratios, and milk Ca concentrations were also analyzed. The BMD of the 4th caudal vertebra in the DFA group was higher than in the control group on day 28. With respect to bone markers, the ratios of undercarboxylated osteocalcin (ucOC) to osteocalcin (OC) in the DFA group were significantly lower than those in the control group on days 21 and 28. Milk Ca concentrations in the DFA group were also higher than those in the control group on days 14, 21, and 28, whereas serum Ca concentrations and urinary Ca/Cre ratios were unchanged in both groups. These results suggest that dietary supplementation with DFA III increased BMD and decreased serum ucOC/OC ratios in late-lactation dairy cows; this indicates that the replenishment of bone Ca reserves may be enhanced by dietary DFA III supplementation. ? 2018 The Japanese Society of Veterinary Science.

Osteoporosis is a chronic, systemic skeletal disorder characterised by decreased bone density. It leads to an increased risk of bone fractures – one of the major causes of disability in modern societies. Bisphosphonates are the most commonly used medications in the treatment of postmenopausal osteoporosis. Denosumab, a new approach to fracture prevention, is a fully human monoclonal antibody that targets nuclear factor-B ligand (RANKL), an important cytokine regulating formation and function of osteoclasts. Generally, denosumab is not used as initial therapy; however, in some cases it should be considered. It concerns patients at high risk of fracture, such as older patients who have difficulty with the dosing requirements of oral bisphosphonates or who have markedly impaired renal function. Denosumab can be also considered in patients who present intolerance or unresponsiveness to other therapies. Clinical studies have shown that denosumab is highly effective in increasing bone mineral density (BMD) in postmenopausal women regardless of the site analysed, as well as reducing the risk of bone fractures. The risk of developing antiresorptive, agent-induced osteonecrosis of the jaw related to denosumab therapy is low.

Introduction: In phenylketonuria (PKU), a natural protein-restricted dietary treatment prevents severe cognitive impairment. Nutrient deficiencies may occur due to strict diet. This study is aimed at evaluating the dietary intake and blood concentrations of micronutrients and essential fatty acids (FA), bone mineral density (BMD) and fracture history in patients on long-term dietary treatment. Methods: Sixty early diagnosed Dutch patients (aged 1-39 years) were included in a multi-center cross-sectional study. Their dietary intake, blood concentrations of micronutrients, FA, fracture history and BMD were assessed. Results: Selenium dietary intake and serum concentrations were low in 14 and 46% of patients, respectively. The serum 25-OH vitamin D2 + D3 concentration was low in 14% of patients while 20% of patients had a low vitamin D intake. Zinc serum concentrations were below normal in 14% of patients, despite adequate intake. Folic acid serum concentrations and intake were elevated. Despite safe total protein and fat intake, arginine plasma concentrations and erythrocyte eicosapentaenoic acid were below reference values in 19 and 6% of patients, respectively. Low BMD (Z-score Conclusions: Dutch patients with PKU on long-term dietary treatment have a near normal nutrient status. Supplementation of micronutrients of which deficiency may be deleterious (e.g., vitamin D and selenium) should be considered. BMD warrants further investigation.

Background A scientific, personalized, and quantitative exercise prescription that has the potential to be an important therapeutic agent for all ages in the prevention of chronic disease is highly recommended. However, it is often poorly implemented, as clinicians lack the necessary knowledge and skills while participants have low adherence due to design defects (eg, prescriptions fail to take individual willingness, the appeal of exercise, and complex physical conditions into account). Intelligent personalized prescription is thus worth exploring. Objective The aim of this study was to investigate whether a year-long cloud platform–based and intelligent personalized exercise prescription intervention could improve Chinese middle-aged and older adult community dwellers’ health outcomes. Methods A total of 177 participants (aged 52-85 years; mean 67.93, SD 7.05) were recruited from 2 Chinese community health service centers in Anhui Province, China. The exercise intervention was delivered over 12 months with a single-group pretest–posttest design. After being assessed in terms of physical activity, health-related lifestyle, history of chronic diseases and drug use, family history of disease and cardiovascular function, body composition, bone mineral density, and physical fitness through an eHealth promotion system, participants with relative contraindications for exercise were personally prescribed the health care exercise mode by an intelligent system, while those without relative contraindication and who had a regular exercise habit were prescribed the scientific fitness mode. Paired t tests were used for the analysis. Results A total of 97 participants were classified into the health care mode, and the remaining 80 participants were assigned to the scientific fitness mode. Significant changes in heart rate (mean difference [MD] 2.97; 95% CI 1.1-4.84; P=.002), subendocardial viability ratio (MD –0.13; CI: –1.19 to –0.63; P Conclusions The observations suggest that our exercise prescription intervention program might promote certain health outcomes in Chinese middle-aged and older adult community dwellers, yet we are unable to recommend such a program given the existing limitations. Future randomized controlled trials with diverse samples are warranted to confirm our findings.

Background: Osteoporosis is a common metabolic bone disease, which always leads to osteoporotic fractures. Biomarkers of bone mineral density (BMD) are helpful for prevention and early diagnosis of osteoporosis. This study aims to identify metabolomic biomarkers of low BMD. Methods: We included 701 participants who had BMD measures by dual-energy X-ray absorptiometry scans and donated fasting plasma samples from three clinical centres as a discovery set and another 278 participants from the fourth centre as an independent replication set. We used a liquid chromatography-mass spectrometry-based metabolomics approach to profile the global metabolites of fasting plasma. Findings: Among the 265 named metabolites identified in our study, six were associated with low BMD (FDR-adjusted P

// Yanrong Fu 1, 2, 3, * , Youfang Hu 2, * , Zhenying Qin 2 , Yan Zhao 2 , Zi Yang 2 , Yinfang Li 4 , Guanyu Liang 2 , Heyun Lv 5 , Hong Hong 6 , Yuan Song 7 , Yarong Wei 8 , Hongni Yue 9 , Wen Zheng 10 , Guoqin Liu 11 , Yufei Ni 12 , Mei Zhu 13 , Aiping Wu 14 , Juhua Yan 15 , Chenbo Ji 3 , Xirong Guo 3 , Juan Wen 3 , Rui Qin 2 1 Department of Child Health Care, the Second Affiliated Hospital of Nanjing Medical University, Nanjing Medical University, Nanjing, 210011, China 2 Department of Child Health Care, Jiangsu Women and Children Health Hospital, Women and Child Branch Hospital of Jiangsu Province Hospital, the First Affiliated Hospital with Nanjing Medical University, Nanjing, 210036, China 3 Nanjing Maternity and Child Health Care Institute, Nanjing Maternity and Child Health Care Hospital, Obstetrics and Gynecology Hospital Affiliated to Nanjing Medical University, Nanjing, 210029, China 4 Department of Pediatrics, Nanjing First Hospital, Nanjing Medical University, Nanjing, 210006, China 5 Department of Child Health Care, Jiangning Maternity and Child Health Care Institute, Nanjing, 211100, China 6 Department of Child Health Care, Drum Tower Maternity and Child Health Care Institute, Nanjing, 210009, China 7 Department of Child Health Care, Suzhou Municipal Hospital, Suzhou, 215000, China 8 Department of Child Health Care, Wuxi Maternity and Child Health Care Hospital, Wuxi, 214000, China 9 Department of Child Health Care, Huai’an Maternity and Child Health Care Hospital, Huai’an, 223001, China 10 Department of Child Health Care, Yancheng Maternity and Child Health Care Institute, Yancheng, 224000, China 11 Department of Child Health Care, Dafeng Maternity and Child Health Care Hospital, Dafeng, 224100, China 12 Department of Child Health Care, Nantong Maternity and Child Health Care Hospital, Nantong, 226000, China 13 Department of Child Health Care, Xuzhou Children's Hospital, Xuzhou, 221000, China 14 Department of Child Health Care, Xinghua Maternity and Child Health Care Hospital, Xinghua, 225700, China 15 Department of Child Health Care, Kunshan Maternity and Child Health Care Institute, Kunshan, 215300, China * These authors contributed equally to this work Correspondence to: Rui Qin, email: qinrui329@163.com Juan Wen, email: wenj2010@gmail.com Keywords: serum 25-hydoxyvitamin D, bone mineral density, 0-7 year old children Received: September 14, 2016 Accepted: October 28, 2016 Published: November 04, 2016 ABSTRACT Objective: To describe the status of serum 25-hydoxyvitamin D [25(OH)D] concentrations and identify the relationship between 25(OH)D and bone mineral density (BMD). In an effort to explore the appropriate definition of vitamin D (VD) deficiency in 0–7 year old children. Results: The median serum 25(OH)D concentrations was 62.9 nmol/L and 28.9% of the children had a low 25(OH)D (< 50 nmol/L). And a linear relation between 25(OH)D concentrations and BMD was surveyed (r = 0.144 , P < 0.001). After adjusting for the confounders, serum 25(OH)D was positively associated with BMD (β = 172.0, 95%CI = 142.8–201.2, P < 0.001), and low 25(OH)D (< 75 nmol/L) had a high stake for low BMD (OR = 1.424, 95%CI = 1.145–1.769, P = 0.001). Additionally, there was a nonlinear relation between 25(OH)D and low BMD, and a critical value for 25(OH)D of 75 nmol/L appeared for low BMD. The prevalence of low BMD was 14.1% in children with 25(OH)D ≥ 75 nmol/L, much lower than that of the concentrations between 50–75 nmol/L and < 50 nmol/L. Materials and Methods: A total of 4,846 children 0–7 years old were recruited in Jiangsu Province, China. BMD and serum 25(OH)D concentrations were determined by quantitative ultrasound and enzyme-linked immunosorbent assay, respectively. Linear regression and logistic regression analyses were used to assess the association of 25(OH)D concentrations with BMD. Conclusions: Serum 25(OH)D concentrations was related with BMD and 25(OH)D concentrations < 75 nmol/L might be a more appropriate definition of VD deficiency in 0–7 year old children.

To date, the only published reports of bone mineral density (BMD) in MPS IV involve patients with MPS IVA; no reports exist describing BMD for MPS IVB. In this prospective study of BMD in three patients with MPS IVB, BMD was acquired by dual-energy X-ray absorptiometry (DXA) at whole body (WB), lumbar spine (LS), and lateral distal femur (LDF). Functional abilities, ambulatory status, medical history, and height z-score were evaluated. Three patients with MPS IVB (two females), aged 17.7, 31.4 and 31.7 years, were evaluated. Every patient was ambulatory and one sustained two fractures caused by trauma. Whole body and hip DXA scans were technically invalid in every patient due to the presence of prosthetic hip hardware. Lumbar spine was valid in only 1 patient due skeletal abnormalities, and was normal (Z-score of − 0.8). The LDF was valid in every patient and was low at all three regions of interest: average LDF z-scores were − 3.1 (range, − 2.9 to − 3.6), − 2.3 (range, − 2.0 to − 2.5), and − 2.1 (range, − 2.0 to − 2.3) for region 1–region 3, respectively. Patients with MPS IVB have low BMD of the lower extremities even with full-time ambulation. Routine body sites to measure by DXA were problematic; hip and WB were invalid due to artifact, and LS had limited utility. The LDF was the only body site consistently available on all patients. Patients did not experience low-energy fractures despite low BMD., Highlights • This is the first report of BMD in MPS IVB. • Assessment of BMD in 3 patients with Morquio B is challenging using typical body sites measured by DXA. • Hip replacements preclude proximal femur and whole body DXA; abnormal vertebral shape limits the use of lumbar spine DXA. • The lateral distal femur DXA was obtainable and technically valid. • Despite ambulation, lower extremity BMD was below normal.

// Jinsong Wei 1 , Ming Li 2 , Feng Gao 3 , Rong Zeng 1 , Guiyou Liu 4 , Keshen Li 5, 6 1 Department of Orthopedic Surgery, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China 2 Departmentof Endocrinology and Metabolism, The Fourth Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang, China 3 Department of Trauma and Emergency Surgeon, The Second Affiliated Hospital, Harbin Medical University, Harbin, China 4 Genome Analysis Laboratory, Tianjin Institute of Industrial Biotechnology, Chinese Academy of Sciences, China 5 Institute of Neurology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China 6 Stroke Center, Neurology & Neurosurgery Division, The Clinical Medicine Research Institute & The First Affiliated Hospital, Jinan University, Guangzhou, China Correspondence to: Guiyou Liu, e-mail: liuguiyou1981@163.com Keshen Li, e-mail: keshenli2012@163.com Keywords: osteoporosis, bone mineral density, pathway analysis, genome-wide association studies Received: November 12, 2015 Accepted: March 29, 2016 Published: April 23, 2016 ABSTRACT Osteoporosis is a common human complex disease. It is mainly characterized by low bone mineral density (BMD) and low-trauma osteoporotic fractures (OF). Until now, a large proportion of heritability has yet to be explained. The existing large-scale genome-wide association studies (GWAS) provide strong support for the investigation of osteoporosis mechanisms using pathway analysis. Recent findings showed that different risk pathways may be involved in BMD in different tissues. Here, we conducted multiple pathway analyses of a large-scale lumbar spine BMD GWAS dataset (2,468,080 SNPs and 31,800 samples) using two published gene-based analysis software including ProxyGeneLD and the PLINK. Using BMD genes from ProxyGeneLD, we identified 51 significant KEGG pathways with adjusted P

Chronic kidney disease (CKD) is associated with numerous complications such as bone mineral disorder. The aim of our study was to analyze the correlation of bone turnover markers with Bone Mineral Density (BMD) measurements in Tunisian end stage renal diseases (ESRD) patients.This study included 100 ESRD Tunisian patients. Their estimated glomerular filtration rate (eGFR) was15 mL × minWe observed a statistically significant negative correlation between BALP levels and total body BMD (r = -0.268; P = 0.015) particularly in femoral neck (FN) (r = -0.219; P = 0.037). BALP concentrations were negatively associated with total BMD especially in FN for patients with BMI30, FGF23 concentrations were also negatively correlated with BMD in lumbar spine site (LS) (r = -0.209; P = 0.046). For osteopenic patients we found an inverse correlation between 25(OH)D concentrations and BMD in LS position (r = -0.336; P = 0.038). In men group, we have also found a negative correlation between iPTH and total BMD (r = -0.326; P = 0.015). However we found a positive correlation between calcium expression and BMD in LS site (r = 0.270; P = 0.031).FGF23 and BALP can predict bone loss in ESRD through their strong correlation with BMD in LS and FN sites respectively.Hronično bubrežno oboljenje (CKD) je praćeno brojnim komplikacijama kao što je poremećaj minerala kostiju. Svha ovog izučavanja je bila da analizira korelaciju markera promena u kostima sa mineralnom gustinom kostiju (BMD) i stupnja renalnih oboljenja kod pacijenata u Tunisu.Proučavanje je uključilo 100 ESRD tuniskih pacijenata. Njihova prosečna brzina glomerularne filtracije (eGFR) bila je15 mL × minNađena je značajno negativna statistička korelacija BALP nivoa i ukupnog telesnog BMD (r= -0,268: P = 0,015) u femoralnom delu vrata (FN) (r = -0,219; P = 0,037). BALP je bila u negativnoj korelaciji sa ukupnom BMD naročito kod FN pacijenata sa BMI30, FGF23 koncentracije su bile takođe u negativnoj korelaciji sa BMD u lumbalnom delu (LS) (r = -0,209, P = 0,046). Kod osteopeničnih pacijenata nađene je inverzna korelacija između 25(OH)D koncentracije i DMD u LS polažaju (r = -0,336; P = 0,038). U grupi muških osoba nađena je negativna korelacija između iPTH i ukupnog BMD (r = -0,326; P = 0,015). Međutim, nađena je pozitivna korelacija između ekspresije kalcijuma i BMD u LS (r = 0,270: P = 0,031).FGF23 i BALP mogu da predvide gubitak kosti kod ESRD preko izrazite korelacije sa BMD u LS i FN položajima.

Oestrogens exert an influence on skeletal homeostasis during growth and adulthood. Regulation of osteoclasts and osteoblasts generation and apoptosis and prolongation of the lifespan of osteocytes are some of their actions on bone metabolism. Premature ovarian insufficiency (POI) and associated loss of oestrogen action on osteoclasts leads to trabecular perforation and loss of connectivity. Lack of oestrogens acting on osteoblast progenitors also causes a decrease in critical bone mass. Postmenopausal hypoestrogenism is associated with an increase in the number of lymphocyte B-cells expressing nuclear factor B ligand (RANKL) in the bone marrow and elevated expression of RANKL by B-cells. Increased concentration of RANKL stimulates activation of osteoclasts and leads to oestrogen deficiency-associated bone loss. It has been proven that women with POI have decreased bone mineral density (BMD) measured in lumbar spine and femoral neck. The loss of bone mass associated with oestrogen deficiency is greater in trabecular than in cortical bone, thus women with POI have a significant decrease in BMD, particularly in the lumbar spine vertebrae. Smoking cessation, weight-bearing, and muscle-strengthening exercises on most days of the week, avoidance of excessive alcohol intake, and adequate supplementation of calcium and vitamin D are the main lifestyle rules necessary to avoid decline in BMD. The most important component of decreased BMD treatment in POI patients is systemic hormonal replacement therapy (HRT). HRT should provide hormonal balance and should mimic normal ovarian function as much as possible.

// Xianfeng Lin 1,* , Chenchen Zhao 1,* , An Qin 2,* , Dun Hong 3 , Wenyue Liu 4 , Kangmao Huang 1 , Jian Mo 1 , Hejun Yu 1 , Shengjie Wu 5 and Shunwu Fan 1 1 Department of Orthopedics Surgery, Sir Run Run Shaw Hospital, Medical College of Zhejiang University, Hangzhou, China 2 Department of Orthopedics, Shanghai Key Laboratory of Orthopedic Implant, Shanghai Ninth People’s Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China 3 Department of Orthopedics Surgery, Taizhou Hospital of Wenzhou Medical University, Linhai, China 4 Department of Endocrinology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China 5 Department of Cardiology, The Key Laboratory of Cardiovascular Disease of Wenzhou The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China * These authors have contributed equally to this work Correspondence to: Shunwu Fan, email: // Shengjie Wu, email: // Keywords : serum uric acid, bone health, bone mineral density, bone mass loss, DXA, Gerotarget Received : June 30, 2015 Accepted : October 06, 2015 Published : October 19, 2015 Abstract Previous studies proposed that serum uric acid (UA), an endogenous antioxidant, could be a protective factor against bone loss. However, recently, a study with a population of US adults did not note the protective effects of serum UA. Therefore, the exact association between serum UA and bone health remains unclear. We performed a retrospective consecutive cohort study in a Chinese population to examine the association between serum UA and bone health. This cross-sectional study included 17,735 individuals who underwent lumbar spine bone mineral density (BMD) measurements as part of a health examination. In covariance analyses (multivariable-adjusted), a high serum UA level was associated with a high BMD, T-score, and Z-score. In binary logistic regression analyses (multivariable-adjusted), a high serum UA level was associated with low odds ratios (ORs) for at least osteopenia and osteoporosis in male (age ≥50 years) (OR = 0.72–0.60 and OR = 0.49–0.39, respectively) and postmenopausal female participants (OR = 0.61–0.51 and OR = 0.66–0.49, respectively). In conclusion, serum UA is associated with BMD, the T-score, and the Z-score, and has a strong protective effect against at least osteopenia and osteoporosis.

Aim of this study Aim of this study was to examine the effects of aromatase inhibitors (AIs), which are used in every phase of breast cancer treatment, on the bone mineral density (BMD) of patients with early-stage breast cancer. Material and methods Menopausal female patients who were diagnosed with stages 1–3 breast cancer and who were planned for anastrazole or letrozole as adjuvant therapy were examined. After the patients’ BMD was measured, 45 patients without osteoporosis were included in the study. Six months after AI therapy started, the patients’ BMD was measured again. Results In this study, we tried to show that there was a statistical difference in the BMD of 45 patients before and 6 months after treatment. Among all measurements (femur and lumbar T-scores), the femur Z-score (p = 0.52) was the only score that was not statistically significant. Statistical significance (p < 0.01) was detected in comparative analysis of the other measurements. According to this analysis, a significant loss of BMD was seen even in the first six months after AI treatment was introduced. Conclusions Female patients with breast cancer are at higher risk for bone loss and fractures than healthy women. In this study, we showed the negative effects on BMD of aromatase inhibitor therapy, one of the main contributions to osteoporosis in women with breast cancer. This study is the first to quantify the short-term effect of AI treatment on BMD in postmenopausal women with breast cancer.

OBJECTIVE: This study aimed to evaluate the impact of cancer treatment on bone mineral density (BMD) in the lumbar spine (LS) and femur in the postmenopausal women with cervical or endometrial cancer without bone metastasis compared to normal control postmenopausal women. METHODS: We retrospectively evaluated the BMD data in the LS, femur neck (FN) and trochanter (FT) by dual-energy X-ray absorptiometry and laboratory data of bone turnover markers at baseline and after one year in 130 patients with cervical cancer, 68 patients with endometrial cancer, and 225 healthy controls. RESULTS: There were no significant differences in the T-scores of basal BMD in LS and femur between patients with endometrial cancer and controls, and only T-score of basal BMD at the fourth lumbar vertebra (L4) was significantly lower in patients with cervical cancer compared to controls. One year later, T-scores of BMD at all LS sites and FN in patients with cervical cancer and T-scores of BMD at L3, L4, FN, and FT in those with endometrial cancer after cancer treatment were significantly lower compared to controls. Lower proportions of normal BMD at all skeletal sites except L2 in patients with endometrial cancer and those at L1, L4, and FN in patients with cervical cancer were observed compared to controls after cancer treatment. CONCLUSIONS: Our results suggest that cancer treatment increase bone loss in postmenopausal women with cervical and endometrial cancer.