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2. Two-year outcomes on bone density and fracture incidence in patients with T2DM randomized to bariatric surgery versus intensive medical therapy

Author

Adam H, Maghrabi, Kathy, Wolski, Beth, Abood, Angelo, Licata, Claire, Pothier, Deepak L, Bhatt, Steven, Nissen, Stacy A, Brethauer, John P, Kirwan, Philip R, Schauer, and Sangeeta R, Kashyap

Subjects
Adult, Male, Incidence, Bariatric Surgery, Middle Aged, Fractures, Bone, Treatment Outcome, Diabetes Mellitus, Type 2, Bone Density, Body Composition, Humans, Hypoglycemic Agents, Female, Follow-Up Studies
Abstract

To determine the 2-year outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) vs. intensive medical therapy (IMT) on lean body mass, total bone mass, and bone mineral density (BMD) measures from the STAMPEDE trial.54 subjects (BMI: 36 ± 1 kg/m(2) , age: 48 ± 4 years) with type 2 diabetes (T2DM) (HbA1c : 9.7 ± 2%) were randomized to IMT, RYGB, or SG and underwent DXA at baseline and at 1 and 2 years.At 2 years, the reduction in BMI was similar after RYGB and SG and was greater than IMT (P 0.001). Lean mass was reduced by ∼10%, total bone mineral content reduced by ∼8%, and hip BMD reduced by ∼9% in both surgical groups and was significantly greater than IMT despite increases in vitamin D intake in all groups. The change in hip BMD correlated with weight loss (r = 0.84, P 0.0001) and changes in lean mass (r = 0.74, P 0.0001) and leptin (r = 0.53, P 0.0001). Peripheral fractures were self-reported in RYGB (4/18 patients), SG (2/19 patients), and IMT (4/16 patients).Surgically induced weight loss is associated with modest reductions in lean mass, bone mineral content, and BMD, despite calcium and vitamin D supplementation in patients with T2DM. Awareness for bone loss is indicated for patients undergoing bariatric procedures.

Published
2015

3. Parathyroid nuclear scan. A focused review on the technical and biological factors affecting its outcome

Author

Subramanian, Kannan, Mira, Milas, Donald, Neumann, Rikesh T, Parikh, Alan, Siperstein, and Angelo, Licata

Subjects
Mini-Review
Abstract

Technetium Parathyroid Scintigraphy (TS) is the most popular noninvasive localization procedure in patients with primary hyperparathyroidism (PHPT). Awareness of various factors involved in technetium uptake helps understand the outcome of TS.We utilize a case of changing TS scans in a patient to review the literature on the various biological and technical factors involved in technetium uptake by the abnormal parathyroid tissue. A 56 year female was diagnosed with PHPT and osteopenia. An initial scan using (99m)Tc-Tetrofosmin showed no definite areas of abnormal parathyroid tissue. Patient refused surgical exploration, was started on Bisphosponates and subsequently monitored. Five years later she suffered fracture of her right wrist. A repeat TS using (99m)Tc-Sestamibi revealed hypervascular parathyroid lesion in the right lower neck. She underwent successful removal of a right lower parathyroid adenoma.Technical factors like the type of Tc isotope used, imaging techniques and biological factors like biochemical parameters (calcium, vitamin D levels), adenoma size, content of oxyphilic cells, vascularity can affect the outcome of the scan.Clinicians should be aware of technical and biological factors that could result in negative scan in parathyroid nuclear scintigraphy.

Published
2014

4. Parenteral Nutrition-Associated Metabolic Bone Disease: Pathophysiology, Evaluation, and Treatment

Author

Douglas L. Seidner and Angelo Licata

Subjects
0303 health sciences, medicine.medical_specialty, Nutrition and Dietetics, 030309 nutrition & dietetics, business.industry, Medicine (miscellaneous), medicine.disease, Pathophysiology, Metabolic bone disease, 03 medical and health sciences, 0302 clinical medicine, Parenteral nutrition, Normal bone, Medicine, 030211 gastroenterology & hepatology, In patient, Medical prescription, business, Intensive care medicine
Abstract

Parenteral nutrition (PN) is generally given to provide adequate amounts of macronutrients and micronutrients to allow recovery after injury and illness. Maintenance of the skeleton is often neglected when one prepares a PN prescription. Although this may not be critical for the brief length of time that most patients receive PN, it becomes an important consideration in patients who need long-term PN, during which time metabolic bone disease (MBD) can develop. It is therefore important to have an understanding of the factors involved in normal bone metabolism and the impact that PN has on this process. This review describes some of the important factors that may play a role in the development of parenteral nutrition-associated metabolic bone disease (PN-MBD) and discusses a strategy for the diagnosis and treatment of this problem.

Published
2000
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5. Clinical practice guidelines for healthy eating for the prevention and treatment of metabolic and endocrine diseases in adults: cosponsored by the American Association of Clinical Endocrinologists/the American College of Endocrinology and the Obesity Society

Author

J. Michael Gonzalez-Campoy, Kristin Castorino, Ayesha Ebrahim, Dan Hurley, Lois Jovanovic, Jeffrey I. Mechanick, Steven M. Petak, Yi-Hao Yu, Sachiko T. St. Jeor, Kristina A. Harris, Penny Kris-Etherton, Robert Kushner, Maureen Molini-Blandford, Quang T. Nguyen, Raymond Plodkowski, David B. Sarwer, Karmella T. Thomas, Timothy S. Bailey, Zachary T. Bloomgarden, Lewis Braverman, Elise M. Brett, Felice A. Caldarella, Pauline Camacho, Lawrence J. Cheskin, Sam Dagogo-Jack, Gregory Dodell, Daniel Einhorn, Alan Garber, Timothy Garvey, Hossein Gharib, George Grunberger, Richard A. Haas, Yehuda Handelsman, R. Mack Harrell, Howard M. Lando, Matthew J. Levine, Angelo Licata, Janet B. McGill, Molly McMahon, Elizabeth Pearce, Rachel Pessah-Pollack, Herbert Rettinger, Donna Ryan, George E. Shambaugh, Vin Tangpricha, Asha Thomas, Joseph Torre, Sandra Weber, and Daniel Weiss

Subjects
Endocrinology, Metabolic Diseases, Endocrinology, Diabetes and Metabolism, Humans, General Medicine, Endocrine System Diseases, United States, Nutrition Policy
Published
2013

6. Effect of once-yearly zoledronic acid on the spine and hip as measured by quantitative computed tomography: results of the HORIZON Pivotal Fracture Trial

Author

Eastell, R, Lang, T, Boonen, S, Cummings, S, Delmas, Pd, Cauley, Ja, Horowitz, Z, Kerzberg, E, Bianchi, G, Kendler, D, Leung, P, Man, Z, Mesenbrink, P, Eriksen, Ef, Black, Dm, Eduardo, Kerzberg, Zulema, Man, Carlos, Mautalen, Maria, Ridruejo, Guillermo, Tate, Jorge, Velasco, Michael, Hooper, Mark, Kotowicz, Peter, Nash, Richard, Prince, Anthony, Roberts, Philip, Sambrook, Harald, Dobnig, Gerd, Finkenstedt, Guenter, Hoefle, Klaus, Klaushofer, Martin, Pecherstorfer, Peter, Peichl, Jean, Body, Steven, Boonen, JEAN PIERRE DEVOGELAER, Piet, Geusens, Jean, Kaufman, João, Brenol, Jussara, Kochen, Rubem, Lederman, Sebastiao, Radominski, Vera, Szejnfeld, Cristiano, Zerbini, Jonathan, Adachi, Jacques, Brown, Denis, Choquette, David, Hanley, Robert, Josse, David, Kendler, Richard, Kremer, Frederic, Morin, Wojciech, Olszynski, Alexandra, Papaioannou, Chiu, Kinyuen, Baoying, Chen, Shouqing, Lin, Nohemi, Casas, Monique, Chalem, Juan, Jaller, Jose, Molina, Hannu, Aro, Jorma, Heikkinen, Heikki, Kröger, Lasse, Mäkinen, Juha, Saltevo, Jorma, Salmi, Matti, Välimäki, CLAUDE LAURENT BENHAMOU, Pierre, Delmas, Patrice, Fardellone, Georges, Werhya, Bruno, Allolio, Dieter, Felsenberg, Joachim, Happ, Manfred, Hartard, Johannes, Hensen, Peter, Kaps, Joern, Kekow, Ruediger, Moericke, Bernd, Ortloff, Peter, Schneider, Siegfried, Wassenberg, PING CHUNG LEUNG, Adam, Balogh, Bela, Gomor, Tibor, Hidvégi, Laszlo, Koranyi, Péter, Lakatos, Gyula, Poór, Zsolt, Tulassay, RIVKA DRESNER POLLAK, Varda, Eshed, JOSEPH FOLDES, A., SOPHIA ISH SHALOM, Iris, Vered, Mordechai, Weiss, Silvano, Adami, Antonella, Barone, Gerolamo, Bianchi, Giannini, Sandro, GIOVANNI CARLO ISAIA, Luisetto, Giovanni, Salvatore, Minisola, Nicola, Molea, Ranuccio, Nuti, Sergio, Ortolani, Mario, Passeri, Alessandro, Rubinacci, Bruno, Seriolo, Luigi, Sinigaglia, WOONG HWAN CHOI, MOO II KANG, GHI SU KIM, HYE SOON KIM, YONG KI KIM, SUNG KIL LIM, HO YOUNG SON, HYUN KOO YOON, Carlos, Abud, Pedro, Garcia, Salomon, Jasqui, Luis, Ochoa, Javier, Orozco, Javier, Santos, Ian, Reid, Sigbjørn, Elle, Johan, Halse, Arne, Høiseth, Hans, Olav, HØIVIK INGUN RØED, Arne, Skag, Jacob, Stakkestad, Unni, Syversen, Janusz, Badurski, Edward, Czerwinski, Roman, Lorenc, EWA MARCINOWSKA SUCHOWIERSKA, Andrzej, Sawicki, Jerzy, Supronik, Eduard, Ailamazyan, Lidiya, Benevolenskaya, Alexander, Dreval, Leonid, Dvoretsky, Raisa, Dyomina, Vadim, Mazurov, Galina, Melnichenko, Ashot, Mkrtoumyan, ALEXANDER ORLOV MOROZOV, Olga, Ostroumova, Eduard, Pikhlak, Tatiana, Shemerovskaya, Nadezhda, Shostak, Irina, Skripnikova, Vera, Smetnik, Evgenia, Tsyrlina, Galina, Usova, Alsu, Zalevskaya, Irina, Zazerskaya, Eugeny, Zotkin, Osten, Ljunggren, Johan, Lofgren, Mats, Palmér, Maria, Saaf, Martin, Stenström, Paul, Hasler, Olivier, Lamy, Kurt, Lippuner, Claude, Merlin, René, Rizzoli, Robert, Theiler, Alan, Tyndall, Daniel, Uebelhart, JUNG FU CHEN, PO QUANG CHEN, LIN SHOW CHIN, JAWL SHAN HWANG, TZAY SHING YANG, Mayuree, Jirapinyo, Rojanasthien, Sattaya, Sutin, Sriussadaporn, Soontrapa, Supasin, Nimit, Taechakraichana, Kittisak, Wilawan, Hugh, Donnachie, Richard, Eastell, William, Fraser, Alistair, Mclellan, David, Reid, John, Abruzzo, Ronald, Ackerman, Robert, Adler, John, Aloia, Charles, Birbara, Barbara, Bode, Henry, Bone, Donald, Brandon, Jane, Cauley, Felicia, Cosman, Daniel, Dionne, Robert, Downs, James, Dreyfus, RONALD EMKEY, VICTOR E. L. I. N. O. F. F., Joseph, Fanciullo, Darrell, Fiske, Palmieri, Genaro, Gollapudi, M., Richard, Gordon, James, Hennessey, Paul, Howard, Karen, Johnson, Conrad, Johnston, Risa, Kagan, Shelly, Kafka, Jeffrey, Kaine, Terry, Klein, William, Koltun, Meryl, Leboff, Bruce, Levine, MICHAEL LEWIECKI, E., CORA ELIZABETH LEWIS, Angelo, Licata, Michael, Lillestol, Barry, Lubin, Raymond, Malamet, Antoinette, Mangione, Velimir, Matkovic, Daksha, Mehta, Paul, Miller, Sam, Miller, Murphy, FREDERIK T., Susan, Nattrass, David, Podlecki, Christopher, Recknor, Clifford, Rosen, Daniel, Rowe, Robert, Rude, Thomas, Schnitzer, Yvonne, Sherrer, Stuart, Silverman, Kenna, Stephenson, Barbara, Troupin, Joseph, Tucci, Reina, Villareal, Nelson, Watts, Richard, Weinstein, Robert, Weinstein, Michael, Weitz, and Richard, White

Subjects
musculoskeletal diseases, medicine.medical_specialty, Compressive Strength, Bone density, Endocrinology, Diabetes and Metabolism, Osteoporosis, Lumbar vertebrae, Zoledronic Acid, Article, Drug Administration Schedule, Bone densitometry, Absorptiometry, Photon, Clinical trials, Bone Density, Humans, Medicine, Quantitative computed tomography, Osteoporosis, Postmenopausal, Aged, Aged, 80 and over, Bone mineral, Lumbar Vertebrae, Bone Density Conservation Agents, Diphosphonates, medicine.diagnostic_test, Femur Neck, business.industry, musculoskeletal, neural, and ocular physiology, Imidazoles, Bone QCT, Bisphosphonates, musculoskeletal system, medicine.disease, body regions, Zoledronic acid, medicine.anatomical_structure, Female, Hip Joint, sense organs, Radiology, Tomography, X-Ray Computed, business, Densitometry, Follow-Up Studies, medicine.drug
Abstract

Changes in bone mineral density and bone strength following treatment with zoledronic acid (ZOL) were measured by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA). ZOL treatment increased spine and hip BMD vs placebo, assessed by QCT and DXA. Changes in trabecular bone resulted in increased bone strength.To investigate bone mineral density (BMD) changes in trabecular and cortical bone, estimated by quantitative computed analysis (QCT) or dual-energy X-ray absorptiometry (DXA), and whether zoledronic acid 5 mg (ZOL) affects bone strength.In 233 women from a randomized, controlled trial of once-yearly ZOL, lumbar spine, total hip, femoral neck, and trochanter were assessed by DXA and QCT (baseline, Month 36). Mean percentage changes from baseline and between-treatment differences (ZOL vs placebo, t-test) were evaluated.Mean between-treatment differences for lumbar spine BMD were significant by DXA (7.0%, p0.01) and QCT (5.7%, p0.0001). Between-treatment differences were significant for trabecular spine (p = 0.0017) [non-parametric test], trabecular trochanter (10.7%, p0.0001), total hip (10.8%, p0.0001), and compressive strength indices at femoral neck (8.6%, p = 0.0001), and trochanter (14.1%, p0.0001).Once-yearly ZOL increased hip and spine BMD vs placebo, assessed by QCT vs DXA. Changes in trabecular bone resulted in increased indices of compressive strength.

Published
2010
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7. Development and Validation of a Predictive Bone Fracture Risk Model for Astronauts.

Author

Emily Nelson, Beth Lewandowski, Angelo Licata, and Jerry Myers

Abstract

Abstract  There are still many unknowns in the physiological response of human beings to space, but compelling evidence indicates that accelerated bone loss will be a consequence of long-duration spaceflight. Lacking phenomenological data on fracture risk in space, we have developed a predictive tool based on biomechanical and bone loading models at any gravitational level of interest. The tool is a statistical model that forecasts fracture risk, bounds the associated uncertainties, and performs sensitivity analysis. In this paper, we focused on events that represent severe consequences for an exploration mission, specifically that of spinal fracture resulting from a routine task (lifting a heavy object up to 60 kg), or a spinal, femoral or wrist fracture due to an accidental fall or an intentional jump from 1 to 2 m. We validated the biomechanical and bone fracture models against terrestrial studies of ground reaction forces, skeletal loading, fracture risk, and fracture incidence. Finally, we predicted fracture risk associated with reference missions to the moon and Mars that represented crew activities on the surface. Fracture was much more likely on Mars due to compromised bone integrity. No statistically significant gender-dependent differences emerged. Wrist fracture was the most likely type of fracture, followed by spinal and hip fracture. [ABSTRACT FROM AUTHOR]

Published
2009
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8. Introduction.

Author

Angelo Licata

Abstract

Anabolic therapy for osteoporosis became a realitywith the introduction of teriparatide, the 1-34 aminoacid analog of native parathyroid hormone. Thisagent presaged a new avenue of treatment wherebydiseased bone might be reconstituted to its pristinestate. The interest in this approach prompted a recentmeeting in Washington DC, at which world leadersin the field gathered and shared information about avariety of control pathways for bone growth and thesites of potential anabolic agents. This issue ofClinical Reviews in Bone and Mineral Metabolismcontains several articles from some of these wellknownresearchers. [ABSTRACT FROM AUTHOR]

Published
2006

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