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Braz. j. biol ; 84: e251970, 2024. tab, graf
Article in English | MEDLINE, LILACS, VETINDEX | ID: biblio-1345559


Abstract In order to better understand the ossification processes in anurans our study was carried out on tadpoles and adults of Lithobates catesbeianus. In this sense, we characterized the kinetic properties of alkaline phosphatase with p-nitrophenylphosphatase (pNPP) and pyrophosphate (PPi) and evaluated the activities of tartrate-resistant acid phosphatase and acid phosphatase. The enzyme extracts were obtained from tadpoles and adult femurs, which were divided into epiphysis and diaphysis. After homogenization, the samples were submitted to differential centrifugation to obtain cell membranes and, further, to phospholipase C (PIPLC) treatment, to remove membrane-bound proteins anchored by phosphatidylinositol. The average of specific activity for pNPP hydrolysis (at pH 10.5) by alkaline phosphatase released by phosphatidylinositol-specific phospholipase C (PIPLC) from Bacillus cereus among different bone regions at different animal ages was 1,142.57, while for PPi hydrolysis (at pH 8.0), it was 1,433.82 Among the compounds tested for enzymatic activity, the one that influenced the most was EDTA, with approximately 67% of inhibition for pNPPase activity and 77% for PPase activity. In the case of kinetic parameters, the enzyme showed a "Michaelian" behavior for pNPP and PPi hydrolysis. The Km value was around 0.6mM for pNPPase activity and ranged from 0.01 to 0.11mM for PPase activity, indicating that the enzyme has a higher affinity for this substrate. The study of pNPP and PPi hydrolysis by the enzyme revealed that the optimum pH of actuation for pNPP was 10.5, while for PPi, which is considered the true substrate of alkaline phosphatase, was 8.0, close to the physiological value. The results show that regardless of the ossification type that occurs, the same enzyme or isoenzymes act on the different bone regions and different life stages of anurans. The similarity of the results of studies with other vertebrates shows that anurans can be considered excellent animal models for the study of biological calcification.

Resumo Para melhor compreender o processo de ossificação em anuros, nosso estudo foi conduzido em girinos e adultos de Lithobates catesbeianus. Nesse sentido, as propriedades cinéticas da fosfatase alcalina com p-nitrofenilfosfato (pNPP) e pirofosfato (PPi) foram caracterizadas, e as atividades enzimáticas das fosfatases ácida e ácida tartarato resistente foram avaliadas. Os extratos enzimáticos foram obtidos de fêmur de girinos e adultos, divididos em epífise e diáfise. Após a homogeneização as amostras foram submetidas à centrifugação diferencial para obter membrana celular e, em seguida, ao tratamento com fosfolipase C (PIPLC), para remover as proteínas de membrana ancoradas por fosfatidilinositol. A média da atividade específica da fosfatase alcalina, liberada pela PIPLC de Bacillus cereus, para a hidrólise de pNPP (pH 10,5) nas diferentes regiões do fêmur e idades dos animais foi de 1.142,57, enquanto para a hidrólise do PPi (pH 8,0) foi de 1.433,82 Entre os compostos testados para a atividade enzimática, o de maior influência foi o EDTA, inibindo aproximadamente 67% e 77% das atividades de pNPPase e PPase, respectivamente. Quanto aos parâmetros cinéticos, a enzima apresentou comportamento Michaeliano para a hidrólise dos dois substratos. O valor de Km foi de 0,6 mM para a atividade de pNPPase e variou de 0,01 a 0,11 para a atividade de PPase, indicando uma maior afinidade por esse substrato. O estudo da hidrólise de pNPP e PPi revelou que o pH ótimo aparente de atuação foi de 10,5 para o pNPP e 8,0 para o PPi, próximo ao fisiológico, sendo que esse é considerado o substrato natural da fosfatase alcalina. Os resultados demonstram que, apesar do tipo de ossificação que ocorre, a mesma enzima ou isoenzimas, atuam nos diferentes locais do osso e estágios de vida dos anuros. A similaridade dos estudos com os realizados com outros vertebrados apontam que os anuros podem ser considerados excelentes modelos animais para o estudo da calcificação biológica.

Animals , Osteogenesis , Alkaline Phosphatase/metabolism , Rana catesbeiana , Bone and Bones/metabolism , Kinetics
Electron. j. biotechnol ; 52: 52-58, July. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1283505


BACKGROUND: Osteoporosis attacks approximately 10% of the population worldwide. Sika Deer (Cervus nippon), one of China's precious traditional medicinal animals, has been widely recorded in ancient Chinese medical books and claimed for centuries to have numerous medical benefits including bone strengthening. This study aimed to find the use of Sika Deer bone in treating osteoporosis according to traditional records and to investigate the protective effect of Sika Deer bone polypeptide extract on glucocorticoidinduced osteoporosis (GIOP) in rats. RESULTS: Sika Deer bone polypeptide extract could increase serum Ca2+ and BGP, decrease serum P3+, ALP, PTH, and CT, but had no effect on serum NO in rats with GIOP. The immunohistochemical iNOS results of the rats' distal femur were negative in each group. Besides the model group, the eNOS color reaction in osteoblasts was strongly positive in the other three groups. CONCLUSIONS: Sika Deer bone polypeptide extract can improve pathological changes in the microstructure and stimulate the expression of eNOS in osteoblasts. The protective effect on bone might be mediated by eNOS-dependent NO generation.

Animals , Male , Rats , Osteoporosis/prevention & control , Peptides/pharmacology , Bone and Bones/metabolism , Deer , Osteoblasts , Dexamethasone , Rats, Wistar , Nitric Oxide Synthase Type III/drug effects
Actual. osteol ; 17(1): [35-44], 2021.
Article in English | LILACS, BINACIS, UNISALUD | ID: biblio-1292117


The masticatory apparatus is a functional unit of the human body, which is mainly responsible for speech, chewing, and swallowing. It is built of bones, joints, ligaments, teeth, and muscles. In addition, the oral cavity and its hard tissues are the first ones to be exposed to exogenous factors during feeding and breathing. The aim of the work was to review the literature of recent years on the toxicology of metals and their possible negative and sometimes positive effects on the metabolism of bones of the masticatory apparatus. In summary, metals commonly found in the environment affect the bones of the masticatory apparatus to varying degrees. Attention should be paid to the sources of individual metals in the environment and to prevent their excessive, unwanted effects on the bones of the masticatory apparatus. (AU)

El aparato masticatorio constituye una unidad funcional del cuerpo humano especializada en la regulación y coordinación de los procesos del habla, la masticación y la deglución. Está constituida por huesos, ligamentos, articulaciones, músculos y dientes. El tejido óseo de la cavidad bucal es el primero en estar expuesto a factores exógenos durante la alimentación y la respiración. El objetivo del presente trabajo es realizar una revisión de lo reportado en la literatura en los últimos años, con respecto a los efectos beneficiosos o nocivos de los metales pesados sobre el metabolismo de los huesos del aparato masticatorio. En resumen, se evidencia que los metales presentes en el medioambiente afectan a estos huesos en diferentes grados. Se debe prestar especial atención a identificar las fuentes de donde provienen estos metales, para prevenir los efectos no deseados sobre el tejido óseo masticatorio generados por una excesiva exposición a ellos. (AU)

Humans , Bone and Bones/metabolism , Stomatognathic System/metabolism , Metals, Heavy , Jaw/metabolism , Metals, Heavy/toxicity
Chinese Journal of Traumatology ; (6): 314-318, 2020.
Article in English | WPRIM | ID: wpr-879643


In this paper, we review the results of previous studies and summarize the effects of various factors on the regulation of bone metabolism in traumatic bone infections. Infection-related bone destruction incorporates pathogens and iatrogenic factors in the process of bone resorption dominated by the skeletal and immune systems. The development of bone immunology has established a bridge of communication between the skeletal system and the immune system. Exploring the effects of pathogens, skeletal systems, immune systems, and antibacterials on bone repair in infectious conditions can help improve the treatment of these diseases.

Anti-Bacterial Agents/administration & dosage , Bone and Bones/metabolism , Cellular Microenvironment , Humans , Immune System/immunology , Lymphocyte Subsets/immunology , Osteitis/microbiology , Osteoblasts/physiology , Osteoclasts/physiology , Staphylococcal Infections
Rio de janeiro; s.n; 2019. 85 p. ilus.
Thesis in Portuguese | LILACS, BBO | ID: biblio-1023146


O objetivo foi avaliar o efeito do tratamento periodontal não cirúrgico, após 1 ano, na expressão salivar dos marcadores do metabolismo ósseo: TNF-α, SOST, PTH, OPG, OPN, OC, Leptina, IL-6, IL-1ß e FGF-23; em pacientes com periodontite crônica generalizada. Participaram deste estudo 15 pacientes com periodontite crônica generalizada (idade média 56,0  DP 9,6 anos). Quinze pacientes com gengivite (idade média 39,7  DP 4,4 anos) foram utilizados como controles. Foram utilizados os seguintes parâmetros clínicos: profundidade de bolsa à sondagem (PBS); nível de inserção clínica (NIC); índice de placa visível (IPV); índice de sangramento gengival (ISG) e índice de sangramento à sondagem (ISS). Foi realizada a coleta de saliva não estimulada (1ml) e congelada à -70°C para posterior análise. Os pacientes de ambos os grupos receberam tratamento periodontal não cirúrgico. Todos os dados foram coletados em 3 visitas no grupo com periodontite (baseline, 6 meses e 1 ano); e em 2 visitas no grupo com gengivite (baseline e 1 ano). Os biomarcadores foram mensurados por meio de um imunoensaio multiplex. No grupo com periodontite, houve redução significativa dos parâmetros % PBS ≥ 6 (p<0,001) e % NIC ≥ 5 (p<0,001), nas visitas 6 meses e 1 ano. Para os dados clínicos do grupo com gengivite, houve diminuição significativa após 1 ano para: % placa (p=0,001), % sangramento marginal (p=0,001), % sangramento sondagem (p=0,001), PBS (média pac.) (p=0,020) e NIC (média pac.) (p=0,001). Após o tratamento no grupo com periodontite, observou-se redução significativa da IL-1ß, IL-6, Leptina e TNF-α, entre a visita baseline e 6 meses (p=0,006; p=0,050; p=0,047; p= 0,014; respectivamente). Entre o baseline e 1 ano, houve diferença significante para a IL-1ß (p=0,010) e OPG (p=0,050). Já a IL-6 e OPG, mostraram uma tendência a redução após 1 ano (p=0,074; p=0,063; respectivamente). No grupo com gengivite, não foram observadas diferenças significativas entre as visitas baseline e 1 ano para todos os biomarcadores. No grupo com periodontite, na visita 1 ano, observamos correlação negativa significativa da OPG com % sangramento sondagem ( τ-b = -0,524 / p=0,006); no grupo com gengivite, na visita baseline, observamos correlação positiva significativa da IL-6 com % placa (τ-b= 0,548 / p= 0,005). Já na visita 1 ano, a Leptina passou a se correlacionar de forma mais forte com % placa (τ-b=0,624 / p=0,010) e com % sangramento marginal (τ-b=0,751 / p= 0,001). Concluindo, a terapia periodontal não cirúrgica levou a uma melhora significativa dos parâmetros clínicos periodontais associada à uma redução significante nos níveis de TNF-α, Leptina e IL-1ß; e uma tendência à redução dos biomarcadores OPG e IL-6. Após 1 ano, verificamos que os níveis dos biomarcadores do grupo com periodontite se aproximaram aos valores do grupo com gengivite, sugerindo que o tratamento periodontal foi capaz de equalizar a resposta imunológica.

The aim of this study was to evaluate the effect of non-surgical periodontal therapy, after 1 year, on the salivar expression of bone metabolism markers: TNF-α, SOST, PTH, OPG, OPN, OC, Leptin, IL-6, IL-1ß and FGF-23; in patients with generalized chronic periodontitis. Fifteen patients with generalized chronic periodontitis (mean age 56.0 ± SD 9.6 years) were included in this study. Fifteen patients with gingivitis (mean age 39.7 ± SD 4.4 years) were used as controls. Clinical evaluation parameters including probing pocket depth (PD), clinical attachment level (CAL), visible plaque index (VPI), gingival index bleeding (GI) and bleeding on probing (BOP) were used. Non-stimulated whole saliva was collected (1ml) and frozen at -70°C for further analysis. Patients from both groups received non-surgical periodontal treatment. All data were collected in 3 visits in the group with periodontitis (baseline, 6 months and 1 year); and in 2 visits in the group with gingivitis (baseline and 1 year). The biomarkers expression were evaluated through multiplex technology. In the group with periodontitis, there was a significant reduction of the parameters % PD ≥ 6 (p <0,001) and % CAL ≥ 5 (p <0,001), at 6 months and 1 year visits. For the clinical data of the group with gingivitis, there was a significant decrease after 1 year for: plaque (p=0,001), sulcus bleeding (p=0,001), bleeding on probing (p=0,001), PD (p=0,020) and CAL (p=0,001). After treatment in the group with periodontitis, a significant reduction of IL-1ß, IL-6, Leptin and TNF-α was observed between baseline and 6 months visit (p=0,006; p=0,050; p=0,047; p=0,014; respectively). Between baseline and 1 year, there was significant difference for IL-1ß (p=0,010) and OPG (p=0,050). On the other hand, IL-6 and OPG showed a tendency to decrease after 1 year (p=0,074; p=0,063; respectively). In the group with gingivitis, no significant differences were observed between the baseline visits and 1 year for all biomarkers. In the group with periodontitis, at the 1-year visit, we observed a significant negative correlation of OPG with bleeding on probing (τ-b=-0,524 / p=0,006); in the group with gingivitis, at the baseline visit, we observed a significant positive correlation of IL-6 with plaque (τ-b=0,548 / p=0,005). At the 1-year visit, Leptin correlated more strongly with plaque (τ-b=0,624 / p=0,010) and with sulcus bleeding (τ-b=0,751 / p=0,001). In conclusion, non-surgical periodontal therapy led to a significant improvement in periodontal clinical parameters associated with a significant reduction in levels of TNF-α, Leptin and IL-1ß; the OPG and IL-6 showed a tendency to reduce. After 1 year, we observed that the biomarkers levels in the group with periodontitis approximate the values of the group with gingivitis, suggesting that the periodontal treatment was able to equalize the immune response.

Humans , Male , Female , Adult , Middle Aged , Aged , Saliva/chemistry , Bone and Bones/metabolism , Chronic Periodontitis/therapy , Gingivitis/therapy , Bone Resorption , Biomarkers , Periodontal Index , Cytokines
Actual. osteol ; 14(3): 205-218, sept. - dic. 2018. ilus., graf.
Article in Spanish | LILACS | ID: biblio-1052695


La diabetes es una enfermedad crónica asociada con importantes comorbilidades. El sistema esquelético parece ser un objetivo adicional de daño mediado por diabetes. Se acepta que la diabetes tipo 1 y tipo 2 se asocian con un mayor riesgo de fractura ósea. Varios estudios han demostrado que los cambios metabólicos causados por la diabetes pueden influir en el metabolismo óseo disminuyendo la calidad y la resistencia del hueso. Sin embargo, los mecanismos subyacentes no se conocen por completo pero son multifactoriales y, probablemente, incluyen los efectos de la obesidad, hiperglucemia, estrés oxidativo y acumulación de productos finales de glicosilación avanzada. Estos darían lugar a un desequilibrio de varios procesos y sistemas: formación de hueso, resorción ósea, formación y entrecruzamiento de colágeno. Otros factores adicionales como la hipoglucemia inducida por el tratamiento, ciertos medicamentos antidiabéticos con un efecto directo sobre el metabolismo óseo y mineral, así como una mayor propensión a las caídas, contribuirían al aumento del riesgo de fracturas en pacientes con diabetes mellitus. Esta revisión tiene como objetivo describir los mecanismos fisiopatológicas subyacentes a la fragilidad ósea en pacientes diabéticos. (AU)

Diabetes is a chronic disease associated with important comorbidities. The skeletal system seems to be an additional target of diabetes mediated damage. It is accepted that type 1 and type 2 diabetes are associated with an increased risk of bone fracture. Several studies have shown that metabolic changes caused by diabetes can influence bone metabolism by decreasing bone quality and resistance. However, the underlying mechanisms are not completely known but they are multifactorial and probably include the effects of obesity, hyperglycemia, oxidative stress and accumulation of advanced glycosylation end products. These would lead to an imbalance of several processes and systems: bone formation, bone resorption, formation and collagen crosslinking. Other additional factors such as treatment-induced hypoglycemia, certain antidiabetic medications with a direct effect on bone and mineral metabolism, as well as an increased propensity for falls, would contribute to the increased risk of fractures in patients with diabetes mellitus. This review aims to describe the pathophysiological mechanisms underlying bone fragility in diabetic patients. (AU)

Humans , Male , Female , Middle Aged , Osteogenesis Imperfecta/physiopathology , Diabetes Mellitus/physiopathology , Osteogenesis Imperfecta/metabolism , Osteogenesis Imperfecta/drug therapy , Osteoporosis/diagnosis , Bone and Bones/metabolism , Glycosylation , Risk Factors , Oxidative Stress , Diabetes Mellitus/metabolism , Diabetes Mellitus/epidemiology , Diabetes Mellitus, Type 1/complications , Diabetes Mellitus, Type 2/complications , Fractures, Bone/complications , Fractures, Bone/prevention & control , Hyperglycemia/complications , Hypoglycemia/chemically induced , Hypoglycemic Agents/adverse effects , Obesity/complications
Actual. osteol ; 14(2): 125-147, Mayo - Ago. 2018. ilus, graf, tab
Article in Spanish | LILACS | ID: biblio-1116310


En consonancia con la orientación tradicional de nuestras investigaciones, la Osteología está incorporando progresivamente el análisis estructural-biomecánico óseo y las interacciones músculo-esqueléticas. En este artículo se sintetizan los aportes originales del CEMFoC a la Osteología moderna en el terreno biomecánico en forma didáctica, para que el lector aprecie sus posibles aplicaciones clínicas. Los hallazgos aportaron evidencias sucesivas en apoyo de dos proposiciones fundamentales: a) los huesos deben interpretarse como estructuras resistivas, biológicamente servocontroladas ("Los huesos tienden siempre a mantener un factor de seguridad que permite al cuerpo trabajar normalmente sin fracturarse" ­ Paradigma de Utah) y b) los huesos interactúan con su entorno mecánico, determinado principalmente por las contracciones musculares, en forma subordinada al entorno metabólico ("Los huesos son lo que los músculos quieren que sean, siempre que las hormonas lo permitan"). Los avances producidos se refieren, tanto cronológica como didácticamente, al conocimiento osteológico en general y al desarrollo de recursos novedosos para el diagnóstico no invasivo de fragilidad ósea, para distinguir entre osteopenias y osteoporosis, y para discriminar entre sus etiologías 'mecánica' y 'sistémica'. Finalmente, el nuevo conocimiento se integra en la proposición de un algoritmo diagnóstico para osteopenias y osteoporosis. El espíritu general de la presentación destaca que la evaluación osteomuscular dinámicamente integrada genera un nuevo espacio de análisis personalizado de los pacientes para la atención de cualquier osteopatía fragilizante con criterio biomecánico. (AU)

In consonance with the traditional spirit of our studies, skeletal research is being progressively focused on the structural-biomechanical analysis of bone and the muscle-bone interactions. In this article, the CEMFoC's members summarize their original findings in bone biomechanics and their potential clinical applications. These findings provided evidence supporting two fundamental hypotheses, namely, A. bones constitute resistive structures, which are biologically servo-controlled ('Bones tend to maintain a safety factor which allows the body to function normally avoiding fractures' ­ the 'Utah paradigm'), and B. the interactions of bones with their mechanical environment mainly are determined by the contraction of local muscles - 'bone-muscle units'), and are subordinated to the control of the metabolic environment ('Bones are what muscles wish them to be, provided that hormones allow for it'). The achievements in the field are presented in a chronological and didactical sequence concerning the general knowledge in Osteology and the development of novel resources for non-invasive diagnosis of bone fragility, aiming to distinguish between osteopenias and osteoporosis and the 'mechanical' and 'metabolic' etiology of these conditions. Finally, the integrated new knowledge is presented as supporting for a proposed diagnostic algorithm for osteopenias and osteoporosis. In general terms, the article highlights the dynamic evaluation of the musculoskeletal system as a whole, opening a new diagnostic field for a personalized evaluation of the patients affected by a boneweakening disease, based on functional and biomechanical criteria. (AU)

Humans , Animals , Rats , Bone and Bones/diagnostic imaging , Osteology/trends , Musculoskeletal System/diagnostic imaging , Osteogenesis Imperfecta/diagnostic imaging , Osteoporosis/etiology , Osteoporosis/diagnostic imaging , Parathyroid Hormone/administration & dosage , Parathyroid Hormone/therapeutic use , Biomechanical Phenomena , Bone and Bones/anatomy & histology , Bone and Bones/metabolism , Bone Diseases, Metabolic/etiology , Bone Diseases, Metabolic/diagnostic imaging , Algorithms , Calcitonin/therapeutic use , Cholecalciferol/pharmacology , Human Growth Hormone/therapeutic use , Diphosphonates/pharmacology , Glucocorticoids/adverse effects , Glucocorticoids/pharmacology , Musculoskeletal System/anatomy & histology , Musculoskeletal System/metabolism
J. bras. nefrol ; 40(2): 201-205, Apr.-June 2018. tab, graf
Article in English | LILACS | ID: biblio-954535


ABSTRACT About four decades ago, the relationship between dialysis-dementia and aluminum (Al) began to be established. The restriction of drugs containing Al and improvements on water quality used for dialysis resulted in the clinical disappearance of Al intoxication. However, high prevalence of Al deposition in bone tissue from Brazilian dialysis patients is still being detected. Through the case report of a patient on hemodialysis (HD) for one year, presenting significant Al deposition in bone tissue, we speculated if this problem is not being underestimated. We used extensive investigation to identify potential sources of Al exposure with a careful review of medication history and water quality controls. Al concentration was measured by different methods, including mass spectrometry, in poly-electrolyte concentrate solutions and solution for peritoneal dialysis, in an attempt to elucidate the possible sources of contamination. The objective of this case report is to alert the medical community about a potential high prevalence of Al deposition in bone tissue and to discuss the possible sources of contamination in patients with chronic kidney disease (CKD).

RESUMO Cerca de quatro décadas atrás, a relação entre demência relacionada à diálise e alumínio (Al) começou a ser estabelecida. A restrição de medicamentos contendo Al e melhorias na qualidade da água utilizada na diálise resultaram no desaparecimento clínico da intoxicação por Al. Contudo, no Brasil continua a ser identificada uma elevada prevalência de deposição de Al no tecido ósseo de pacientes em diálise. O presente relato de caso de um paciente em hemodiálise (HD) há um ano com deposição significativa de Al no tecido ósseo nos leva a especular se esse problema não tem sido subestimado. Realizamos uma ampla investigação para identificar possíveis fontes de exposição ao Al, com uma revisão cuidadosa do histórico de medicação e dos controles de qualidade da água. A concentração de Al foi medida por diferentes métodos, incluindo espectrometria de massa, nos concentrados polieletrolíticos para hemodiálise e soluções de diálise peritoneal, na tentativa de elucidar as possíveis fontes de contaminação. O objetivo do presente relato de caso é alertar a comunidade médica sobre uma possível elevada prevalência de deposição de Al no tecido ósseo e discutir as possíveis fontes de contaminação nos pacientes com doença renal crônica (DRC).

Humans , Male , Adult , Bone and Bones/metabolism , Renal Insufficiency, Chronic/metabolism , Aluminum/pharmacokinetics , Peritoneal Dialysis , Renal Insufficiency, Chronic/therapy
Int. j. morphol ; 36(2): 655-660, jun. 2018. tab
Article in English | LILACS | ID: biblio-954168


The present study evaluated the effect of a 20-week concurrent training program on bone metabolism in elderly women. The sample consisted of 51 elderly women living in the municipality of Muriaé (MG), distributed into two groups: a concurrent training group (CTG = 25), with an average age of 69.44 ± 6.82 years, and a control group (CG = 26), with mean age of 68.30 ± 6.34 years. Biophysical parameters were determined based on weight, height and body mass index. Bone metabolism was assessed by collecting second-morning urine samples before and after intervention to analyze levels of the biochemical marker deoxypyridinoline (DPD), which quantifies bone resorption. Results: The results showed a post-intervention decline in DPD content in the GTC when compared to controls (p = 0.007) and an improvement in the variables weight, BMI and DPD between the GTC and GC (p = 0.000). Conclusion: Concurrent training was efficient in improving bone metabolism in the elderly population studied.

El presente estudio evaluó los efectos de 20 semanas de entrenamiento concurrente sobre el metabolismo óseo de adultas mayores. La muestra fue compuesta por 51 mujeres adultas mayores, residentes en el municipio de Muriaé (MG), voluntarias, distribuidas en dos grupos, un grupo participó en entrenamiento concurrente (GTC=25), con una edad media de 69,44±6,82 años y un grupo control (GC=26) con una media de 68,30±6,34 años. Los parámetros biofísicos se determinaron por medio del peso corporal, la estatura e índice de masa corporal. Para la evaluación del metabolismo óseo, se realizó la recolección de la orina matinal en el pre y post-test, utilizando como reactivo el marcador bioquímico de deoxipiridinolina (DPD) que cuantifica la reabsorción ósea. Los resultados mostraron una reducción en la concentración de DPD en el GTC cuando se compararon los grupos (p = 0,007) y la mejora de las variables, peso corporal, IMC y DPD entre el GTC y el GC en el post-test (p = 0,000). Se percibe que el entrenamiento concurrente, para las mujeres adultas mayores fue eficiente en la mejoría de las condiciones de salud del metabolismo óseo.

Humans , Female , Aged , Bone and Bones/metabolism , Bone Resorption/urine , Exercise/physiology , Bone Density , Time Factors , Body Weight , Biomarkers/urine , Body Mass Index
Actual. osteol ; 14(1): 31-35, Ene - Abr. 2018. tab
Article in English | LILACS | ID: biblio-1116836


Statins are a widely prescribed class of medications that inhibit similar pathways as the anti-resorptive bisphosphonate drugs. Statins target the mevalonate pathway by blocking HMG-CoA reductase. Several recent meta-analyses concluded statins are osteoprotective in the general population. Here we present current literature exploring the mechanisms underlying the putative osteoprotective effects of statins. We also review recent clinical studies, ranging from observational cohort studies to randomized clinical trials, testing the effect of statins on bone health in various populations. (AU)

Las estatinas son un grupo de drogas prescriptas en forma habitual, con la capacidad de bloquear vías de señalización similares a las inhibidas por los amino-bisfosfonatos. Las estatinas inhiben la vía del mevalonato, a través del bloqueo de diferentes enzimas. Varios metaanálisis recientes llevaron a la conclusión de que las estatinas tienen capacidad osteoprotectora en la población general. En esta revisión presentamos la literatura actual describiendo los mecanismos que subyacen en el potencial efecto osteoprotector de las estatinas, como así también estudios observacionales y clínicos aleatorizados sobre el efecto de estatinas en la salud ósea en diversas poblaciones. (AU)

Humans , Animals , Male , Female , Middle Aged , Aged , Aged, 80 and over , Mice , Osteoporosis/prevention & control , Bone Density/drug effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use , Osteoblasts/drug effects , Osteoclasts/drug effects , Osteoporosis/drug therapy , Bone and Bones/metabolism , Postmenopause/drug effects , Hydroxymethylglutaryl-CoA Reductase Inhibitors/pharmacology , GTP-Binding Proteins/drug effects , Simvastatin/administration & dosage , Diphosphonates/therapeutic use , Diphosphonates/pharmacology , Dyslipidemias/drug therapy , Fractures, Bone/prevention & control , Atorvastatin/administration & dosage , Mevalonic Acid/pharmacology
Rev. Col. Bras. Cir ; 45(1): e1577, fev. 2018. graf
Article in English | LILACS | ID: biblio-956549


ABSTRACT Objectives: to evaluate estradiol levels and autotransplantation heated ovarian tissue effects, after vitrification, on rats bone metabolism previously oophorectomized bilaterally. Methods: experimental study with 27 rats aged 11 to 12 weeks and weighing 200g to 300g, submitted to bilateral oophorectomy and ovarian tissue cryopreservation for subsequent reimplantation. Animals were divided into two groups, A and B, with 8 and 19 rats, respectively. Autotransplantation occurred in two periods according to castration time: after one week, in group A, and after one month in group B. Serum estradiol measurements and ovary and tibia histological analysis were performed before and after oophorectomy period (early or late) and one month after reimplantation. Results: in groups A and B, tibia median cortical thickness was 0.463±0.14mm (mean±SD) at the baseline, 0.360±0.14mm after oophorectomy and 0.445±0.17mm one month after reimplantation p<0.005). Trabecular means were 0.050±0.08mm (mean±SD) at baseline, 0.022±0.08mm after oophorectomy and 0.049±0.032mm one month after replantation (p<0.005). There was no statistical difference in estradiol variation between the two study groups (p=0.819). Conclusion: cryopreserved ovarian tissue transplantation restored bone parameters, and these results suggest that ovarian reimplantation in women may have the same beneficial effects on bone metabolism.

RESUMO Objetivos: avaliar os níveis de estradiol e os efeitos do autotransplante de tecido ovariano aquecido, após vitrificação, no metabolismo ósseo de ratas previamente ooforectomizadas bilateralmente. Métodos: trabalho experimental com 27 ratas com idades entre 11 e 12 semanas e pesando 200g a 300g, submetidas à ooforectomia bilateral e criopreservação de tecido ovariano para posterior reimplante. Os animais foram divididos em dois grupos, A e B, com oito e 19 ratas, respectivamente. O autotransplante ocorreu em dois períodos de acordo com o tempo de castração: após uma semana, no grupo A, e após um mês no grupo B. Mensurações de estradiol sérico e análise histológica de ovário e tíbia foram feitos antes e após o período de ooforectomia (precoce ou tardio) e um mês após o reimplante. Resultados: nos grupos A e B, as espessuras corticais médias da tíbia foram 0,463±0,14mm (média±DP) na linha de base, 0,360±0,14mm após ooforectomia e 0,445±0,17mm em um mês após o reimplante (p<0,005). As médias trabeculares foram 0,050±0,08mm (média±DP) na linha de base, 0,022±0,08mm após ooforectomia e 0,049±0,032mm em um mês após o reimplante (p<0,005). Não houve diferença estatística entre a variação do estradiol entre os dois grupos de estudo (p=0,819). Conclusão: o transplante de tecido ovariano criopreservado restabeleceu os parâmetros ósseos, e estes resultados sugerem que a reimplantação ovariana em mulheres pode apresentar os mesmos efeitos benéficos sobre o metabolismo ósseo.

Animals , Female , Rats , Ovary/transplantation , Bone and Bones/metabolism , Cryopreservation , Ovariectomy , Rats, Wistar , Estradiol/blood
Arch. endocrinol. metab. (Online) ; 61(4): 332-336, July-Aug. 2017. tab
Article in English | LILACS | ID: biblio-887575


ABSTRACT Objective The aim of the present study was to evaluate parameters of bone and mineral metabolism after bariatric surgery. Subjects and methods This sectional study included data from medical records from 61 bariatric surgery (BS) patients (minimum period of 6 months after the procedure) and from 30 class II and III obese patients as a control group (Cont), consisting of daily dietary intake of macronutrients, calcium and sodium, serum 25(OH)D and parathyroid hormone (PTH) and other biochemical serum and urinary parameters. Bone alkaline phosphatase (BAP), leptin, fibroblast growth factor-23 (FGF-23) and deoxypyridinoline (DPYD) were determined from available banked serum and urinary samples. Results Mean body mass index (BMI), median energy, carbohydrate, protein and sodium chloride consumption were significantly lower in the BS versus Cont, but calcium and lipids were not. No significant differences were found in ionized calcium, 25(OH)D, PTH and fibroblast growth factor 23 (FGF-23) between groups. Mean serum BAP was significantly higher for BS versus Cont and had a positive correlation with time after the surgical procedure. Mean serum leptin was significantly lower and median urinary DPYD higher in BS versus Cont. Conclusion The present study showed an increase in bone markers of both bone formation and resorption among bariatric patients up to more than 7 years after the surgical procedure, suggesting that an increased bone turnover persists even at a very long-term follow-up in such patients.

Humans , Male , Female , Adult , Middle Aged , Bone and Bones/metabolism , Gastric Bypass/adverse effects , Biliopancreatic Diversion/adverse effects , Bone Remodeling/physiology , Obesity/surgery , Postoperative Period , Sodium/urine , Time Factors , Calcium/urine , Retrospective Studies , Alkaline Phosphatase/blood , Amino Acids/urine , Obesity/metabolism , Obesity/drug therapy
Actual. osteol ; 13(2): 125-133, Mayo - Ago. 2017. graf, tab
Article in Spanish | LILACS | ID: biblio-1118076


La osteoporosis es un trastorno común en las mujeres posmenopáusicas; sin embargo, también puede afectar a hombres y mujeres jóvenes premenopáusicas. El objetivo del presente trabajo fue evaluar la prevalencia de causas secundarias de baja masa ósea en un grupo de mujeres premenopáusicas que consultaron en una Institución especializada en Osteología. Material y métodos: se realizó un estudio retrospectivo, de corte transversal, descriptivo y observacional. Se analizaron las historias clínicas de 88 pacientes que consultaron por baja masa ósea durante un período de 19 meses, con la finalidad de encontrar posibles causas secundarias. A su vez, se definió como pacientes con diagnóstico de baja masa ósea idiopática aquellas en las cuales no se encontró ninguna causa secundaria de pérdida ósea. Resultados: de las 88 mujeres evaluadas, el 48,9% presentaba al menos una causa secundaria para baja masa ósea (amenorrea secundaria, hipercalciuria, tratamiento con glucorticoides, hipovitaminosis D y enfermedad celíaca) y el 51,1% fueron consideradas idiopáticas. Conclusiones: es esencial evaluar exhaustivamente a las mujeres premenopáusicas con baja masa ósea a fin de descartar posibles causas secundarias y tomar las medidas preventivas necesarias para mejorar esa condición. (AU)

Objective: osteoporosis is a common disorder in postmenopausal women, however it can also affect men and premenopausal young women. The purpose of this study was to evaluate the prevalence of secondary causes of low bone mass in premenopausal women that consulted physicians in an institution specialized in osteology for a period of 19 months. Material and methods: this is a retrospective, transversal, descriptive and observational study. The clinical history of 88 patients who consulted a physician due to low bone mass for a period of 19 months in an institution specialized in osteology. Were analyzed the patient's clinical history in order to find secondary causes. We define as suffering Low Bone Mass those patients who did not have secondary causes. Results: of the 88 women tested, 48,9% had one or more secondary causes or risks factors for low bone mass (secondary amenorrea, hypercalciuria, treatment with glucocorticoids, hypovitamiosis D and celiac disease) and 51,1% patients were considered idiopathic. Conclusions: we conclude that it is essential to exhaustively search for secondary causes of low bone mass in premenopausal women, due to the high prevalence of secondary osteoporosis in this population. (AU)

Humans , Female , Adult , Young Adult , Osteoporosis/chemically induced , Bone Diseases, Metabolic/complications , Premenopause/metabolism , Osteoporosis/physiopathology , Osteoporosis/prevention & control , Avitaminosis/complications , Bone and Bones/metabolism , Bone Diseases, Metabolic/etiology , Bone Diseases, Metabolic/blood , Fractures, Stress/prevention & control , Celiac Disease/complications , Prevalence , Retrospective Studies , Risk Factors , Cohort Studies , Densitometry , Hypercalciuria/complications , Osteoporotic Fractures/prevention & control , Amenorrhea/complications , Glucocorticoids/adverse effects
Actual. osteol ; 13(2): 157-176, Mayo - Ago. 2017. ilus
Article in Spanish | LILACS | ID: biblio-1118319


Existen numerosas patologías que generan situaciones invalidantes debido a problemas asociados a nivel de defectos óseos. Esto genera, en muchas oportunidades, cuestiones sanitarias de alto impacto. La ingeniería de tejidos óseos pretende generar propuestas novedosas para reparar pérdidas o fracturas óseas, promoviendo regenerar el tejido mediante el implante de matrices biodegradables que puedan actuar como estructuras para la adhesión celular, favoreciendo el crecimiento y la diferenciación hasta formar hueso de novo. El incremento notable de los conocimientos en las áreas biotecnológicas, de síntesis química, así como de biomedicina, permiten el desarrollo de numerosos tipos de matrices de tercera generación, biodegradables y no tóxicas, con características que proponen sean consideradas en la regeneración tisular ósea. Este trabajo intenta resumir los tipos de matrices que mayor impacto han tenido hasta el momento en la medicina regenerativa ósea, mostrando los casos más relevantes de resultados experimentales y clínicos, y propone algunas perspectivas que se deberían considerar para poder aplicarlas a la práctica clínica. Esta es un área que invita a los investigadores a posicionarse en un pensamiento complejo desde el punto de vista científico-filosófico. (AU)

There are several pathologies that generate disability due to complications associated with bone defects. This often generates high impact health troubles. Bone tissue engineering aims to generate novel means to repair bone loss or bone fractures, promoting tissue regeneration through the implantation biodegradables scaffolds, which can act as structures for cell adhesion, that promts cell growth and differentiation for the novo bone formation. The remarkable for the novo bone formation in biotechnology, chemical synthesis, and biomedical knowledge allows the development of numerous types of third generation scaffolds, applied to promote bone tissue regeneration. This brief report aims to review the scaffolds that have had more impact in bone regenerative medicine so far, describing the most relevant experimental and clinical results. This is an area that invites researchers to situate themselves in a complex thought of scientific-philosophical point of view. (AU)

Humans , Tissue Engineering/methods , Regenerative Medicine/methods , Bone and Bones/metabolism , Bone and Bones/chemistry , Bone Diseases/therapy , Bone Regeneration , Osseointegration , Tissue Engineering/trends , Regenerative Medicine/trends , Fractures, Bone/therapy
Actual. osteol ; 13(1): 46-57, Ene - Abr. 2017. ilus, graf, tab
Article in English | LILACS | ID: biblio-1118908


Based on the hypothesis that fluoride acts as a bone anabolic agent, the aim of this study was to measure in rats the osseointegration of implants (grade II titanium wire, 1 mm diameter, 4 mm long) submitted to anodic oxidation in 2 M phosphoric acid solution (control implants) or b) in 2 M phosphoric acid solution plus 0.2 M NaF (F-modified implants). Chemical composition of the implants surface was assessed by energy-dispersive X-ray spectroscopy. The surface of F-modified implants contained a 2.57% fluorine in weight. Adult male Sprague Dawley rats (300-350 g body weight) received two implants (in the femur and in the tibia, close to the knee) in each hind limb. Control and F-modified implants were inserted in the left and right hind limbs, respectively. Three weeks after surgery, the animals were sacrificed. The undecalcified bones were embedded in methylmetacrylate. Sections were obtained to measure two histomorphometric magnitudes: bone-toimplant contact (BIC) and bone volume in a defined volume of tissue around the implant (BV/TV). BIC was significantly increased on F-modified implants with respect to their controls (57.2%±3.3%, vs. 47.9±3.4, p<0.05). BV/TV did not differ significantly between F-modified and control implants (24.5±2.2% vs. 22.9±1.4, p=0.30). Profiles of the average gray pixel levels of pseudo3D images showed a greater roughness of F-modified implants respect to their controls (p<0.05). The relative contributions of surface roughness and its fluorine content to the osseointegration process requires further research. (AU)

Con la hipótesis de que el ión fluoruro actúa como anabólico sobre las células óseas, el objetivo de este trabajo fue determinar el grado de osteo-integración (en la rata) de implantes (alambre de titanio II, 1 mm de diámetro, 4 mm de largo) anodizados en solución de ácido fosfórico 2 M + NaF 0,2 M (implantes-F) comparados con implantes controles, anodizados en solución de ácido fosfórico 2 M. La composición química de la superficie de los implantes fue evaluada mediante el espectro de dispersión de rayos X producidos durante la observación en el microscopio electrónico de barrido. La superficie de los implantes-F contiene 2.57% de flúor. Ratas macho Sprague-Dawley recibieron dos implantes (en el fémur y en tibia, próximos a la rodilla). Los implantes-F y controles se insertaron en las patas izquierda y derecha respectivamente. En los cortes de hueso sin decalcificación previa se midió el contacto hueso-implante (BIC) y volumen óseo en un volumen definido de tejido (BV/TV). BIC fue significativamente mayor con los Implantes-F respecto de los controles (57,2±3,3% vs. 47,9±3,4, p<0,05). BV/TV no exhibió diferencias significativas entre implantes-F y controles (24,5±2,2% vs. 22,9±1,4, p=0,30). Los perfiles de los niveles de grises de los imágenes pseudo3D de las superficies de los implantes pusieron en evidencia la mayor rugosidad de los implantes-F respecto de los controles (p<0,05). Las contribuciones relativas de la rugosidad y del flúor en el proceso de osteo-integración requieren investigación adicional. (AU)

Animals , Rats , Prostheses and Implants/ultrastructure , Osseointegration/physiology , Bone-Anchored Prosthesis/ultrastructure , Osteoblasts/chemistry , Tibia/cytology , Titanium/chemistry , Bone and Bones/cytology , Bone and Bones/metabolism , Ceftriaxone/administration & dosage , Dental Implants , Diclofenac/administration & dosage , Rats, Sprague-Dawley , Femur/cytology , Fluorides/chemistry , Fluorine/analysis , Isoflurane/administration & dosage , Ketamine/administration & dosage , Acepromazine/administration & dosage
Actual. osteol ; 13(1): 28-36, Ene - Abr. 2017. tab
Article in Spanish | LILACS | ID: biblio-1118788


El pico de masa ósea (PMO) se alcanza entre los 20 y 35 años, pero la aposición ósea continúa hasta alcanzar el pico de fortaleza ósea (PFO). Se crea así una ventana entre ambos picos que podría ser evaluada mediante marcadores bioquímicos de recambio óseo, ya que durante dicho período la densidad mineral permanece constante. El objetivo fue determinar el final de la aposición ósea mediante marcadores bioquímicos óseos. Se evaluaron por décadas entre 20 y 49 años de edad 139 sujetos sanos de ambos sexos (69 hombres y 70 mujeres), determinando fosfatasa alcalina ósea (FAO), osteocalcina (OC), propéptido amino terminal del colágeno tipo 1 (P1NP) y telopéptido C-terminal del colágeno tipo 1 (CTX). Los marcadores correlacionan negativamente con la edad (OC: r= -0,3; p<0,01; P1NP: r= -0,4; p< 0,01 y CTX: r= -0,4; p<0,01), exceptuando FAO. En hombres de 20-29 años, P1NP y el CTX fueron significativamente mayores vs. 30-39 años (p<0,05 y p<0,001, respectivamente), y entre 30-39 años vs. de 40-49 años en P1NP y CTX (p<0,05; p<0,001, respectivamente). En mujeres de 20-29 años, P1NP y CTX fueron significativamente mayores vs. 30-39 años (p<0,0001 y p<0,01, respectivamente). Conclusión: los marcadores de remodelado óseo más sensibles y específicos permitirían determinar bioquímicamente el fin de la aposición ósea que se produce entre el PMO y el PFO. Si bien es necesario ampliar el número de sujetos evaluados, los datos que surgen de la presente investigación sentarían las bases para futuros estudios epidemiológicos referidos al fin de la aposición ósea. (AU)

Peak bone mass is achieved between 20-35 years; however bone apposition continues to reach an optimal skeleton strength. The window between peak bone mass and peak bone apposition may be evaluated by biochemical bone turnover markers. The objective of this study was to determine the end of bone apposition through biochemical bone markers in both sexes. A total of 139 subjects (69 men and 70 women) were divided by decades between 20 and 49 years of age. Bone alkaline phosphatase (BAL), osteocalcin (OC), type I collagen propeptide (P1NP) and type I collagen C-terminal telopeptide (CTX) were evaluated. Except BAL, the other bone markers negatively correlated with the age [OC (r= -0.3; p<0.01); P1NP (r= -0.4; p<0.01) and CTX (r= -0.4; p<0.01)]. Regarding men aged 20 to 29 years, P1NP and CTX were significantly higher vs. 30-39 years (p<0.05 y p<0.001, respectively) and. vs. 40-49 years (p<0.05; p<0.001, respectively). In women, the results were similar. Regarding 20-29 years, P1NP and CTX were higher vs. 30-39 years (p<0.001 y p<0.01, respectively). Bone remodeling rate decreases after the third decade, suggesting the end of the apposition period of peak bone mass. Conclusion: The most specific and sensitive bone markers would biochemically determine the end of bone apposition that extends between the peak of bone mass and the peak of bone strength. Although it is necessary to increase the number of subjects evaluated, the data that emerge from the present study would establish the bases for future epidemiological studies referring to the end of bone apposition. (AU)

Humans , Male , Female , Adult , Middle Aged , Young Adult , Bone Resorption/physiopathology , Biomarkers , Osteoblasts/physiology , Osteoclasts/physiology , Osteogenesis/physiology , Bone and Bones/metabolism , Bone Density/physiology , Osteocalcin/blood , Calcium/blood , Age Factors , Bone Remodeling/physiology , Creatinine/blood , Collagen Type I/biosynthesis , Collagen Type I/blood , Densitometry , Alkaline Phosphatase/blood , Osteoporotic Fractures/prevention & control
Actual. osteol ; 13(1): 58-66, Ene - Abr. 2017. ilus
Article in English | LILACS | ID: biblio-1118913


Connexins (Cxs) are a family of transmembrane proteins that form gap junctions and hemi-channels, which mediate cell-cell communication between neighboring cells and the respective extracellular milieu in different tissues. Most tissues and cell types throughout the body express one or more Cx proteins, highlighting its importance in regulating cell growth, differentiation, adhesion, migration, cell death and others. Moreover, Cx can propagate intracellular signals through its C-terminus domain, and thus function beyond a mere channel. Cx43 is the most highly expressed and most well studied Cx in bone and musculoskeletal tissues, although Cx40, Cx45, Cx46 and more recently, the Cx37 have been described in bone tissue, along with Cx26, Cx32 and Cx39 in other musculoskeletal tissues. Here, we discuss the basic structure of gap junctions and the role of the Cxs in musculoskeletal tissue, with special focus on Cx37. (AU)

Las conexinas (Cxs) son una familia de proteínas transmembrana que forman uniones en hendidura y hemicanales encargados de mediar la comunicación entre células vecinas y el respectivo medio extracelular en diferentes tejidos. La mayoría de los tejidos y células expresan una o más proteínas conexina, jugando un papel importante en la regulación de la proliferación celular, diferenciación, adhesión, migración y muerte celular, entre otras funciones. Además de actuar como un canal, las conexinas pueden propagar señales intracelulares a través del dominio C-terminal. La Cx43 es la conexina mas expresada y mejor estudiada en el tejido óseo y el músculo, aunque las Cx40, Cx45, Cx46, y mas recientemente Cx37, son también detectadas en el hueso. A su vez la expresión de la Cx26, Cx32 y Cx39 ha sido observada en otros tejidos músculoesqueléticos. En este manuscrito describimos la estructura básica de las uniones tipo gap y el papel que las Cxs, y en especial la Cx37, tienen en tejidos músculo-esqueléticos. (AU)

Humans , Bone and Bones/metabolism , Bone Resorption/prevention & control , Connexins/physiology , Osteoblasts/metabolism , Osteocytes/metabolism , Tendons/metabolism , Signal Transduction/physiology , Cartilage/metabolism , Cell Communication/physiology , Cell Physiological Phenomena , Gap Junctions/drug effects , Gap Junctions/physiology , Connexin 43/physiology , Muscle, Skeletal/metabolism , Bone Density Conservation Agents/therapeutic use , Ligaments/metabolism , Anti-Arrhythmia Agents/adverse effects
Ann. hepatol ; 16(2): 207-214, Mar.-Apr. 2017. tab, graf
Article in English | LILACS | ID: biblio-887224


ABSTRACT Background. Patients with chronic hepatitis B virus (HBV) are often treated with nucleoside/nucleotide antiviral agents and metabolic bone toxicity is a possible concern. Objective. To determine the relationships between fibroblast growth factor 23 (FGF23), a phosphaturic hormone, bone mineral density (BMD), and bone biochemical abnormalities in these patients. Material and methods. This is a cross-sectional observational study comparing HBV-infected subjects treated for at least one year with tenofovir (TDF), lamuvidine (LVD), entacavir (ETV), or not treated (CON). Patients with abnormalities in either calcium (Ca), phosphate (PO4), intact parathyroid hormone (iPTH) or FGF23 were further evaluated with BMD by DXA. Results. No difference in liver enzymes or renal function seen among groups, but hypophosphatemia was seen in all groups with the highest incidence with TDF treatment (14%). FGF 23 levels were found to be elevated in 11.1% of TDF patients, 2.77% amongst controls. No elevations were found in the LVD or ETV groups. Among a subset of subjects (FGF23, PO4, and/or Ca abnormalities) who underwent further evaluation, 67% had insufficient 25-OH vitamin D, and 30% had elevated 24 h urinary Ca or PO4 excretion. No patients with FGF23 abnormalities had urine abnormalities. 40% had low DXA Z-score (<-2) at spine or hip but there was no difference between control and antiviral treatment groups and the mean FRAX score was 2.33% for major osteoporotic fractures and 0.29% for hip fracture. Conclusion. Abnormalities in bone metabolism, particularly involving vitamin D insufficiency, in HBV-treated subjects were observed with a small increased likelihood in TDF treated patients.

Humans , Antiviral Agents/therapeutic use , Phosphates/blood , Bone and Bones/drug effects , Calcium/blood , Lamivudine/therapeutic use , Hepatitis B, Chronic/drug therapy , Fibroblast Growth Factors/blood , Tenofovir/therapeutic use , Guanine/analogs & derivatives , Antiviral Agents/adverse effects , Time Factors , Vitamin D Deficiency/chemically induced , Bone and Bones/metabolism , Bone and Bones/diagnostic imaging , Biomarkers/blood , Absorptiometry, Photon , Bone Density/drug effects , Cross-Sectional Studies , Risk Factors , Treatment Outcome , Bone Remodeling/drug effects , Hepatitis B, Chronic/diagnosis , Hepatitis B, Chronic/blood , Fractures, Bone/chemically induced , Tenofovir/adverse effects , Guanine/adverse effects , Guanine/therapeutic use