ESTADO NUTRICIONAL Y DENSIDAD MINERAL ÓSEA DE MUJERES MAYORES DE 20 AÑOS PROCEDENTES DE EL SALVADOR, GUATEMALA Y HONDURAS / NUTRITIONAL STATUS AND BONE MINERAL DENSITY OF WOMEN OVER 20 YEARS OF AGE FROM EL SALVADOR, GUATEMALA AND HONDURAS

Introducción: El estado nutricional influye en el riesgo de enfermedades no transmisibles (ENT), como la osteoporosis, una epidemia silenciosa global, cuya prevalencia aumenta con la edad. El presente estudio tuvo como objetivo describir el estado nutricional y la densidad mineral ósea (DMO) de mujeres mayores de 20 años. Materiales y métodos: Estudio transversal descriptivo con muestra de conveniencia de 77 mujeres provenientes de El Salvador, Guatemala y Honduras, con datos recolectados en 2022-2023. Para evaluar el estado nutricional se utilizó equipo de bioimpedancia eléctrica mBCA514 SECA™ y el Sunlight MiniOmni™ para medir la DMO. Se analizaron los datos con estadística descriptiva,con el programa SPSS versión 29.0.1.0. Resultados: El promedio de edad fue de 34,8±7,8 años. Según el Índice de Masa Corporal, la prevalencia de sobrepeso (SP) y obesidad (OB) fue de 33,8% y 23,4%, respectivamente. El 31,2% se estimó con un rango elevado de grasa corporal y el 20,8% un rango alto, según el Índice de Masa Grasa. El 39% se estimó con grasa visceral elevada o alta y el 44,2% no presentó riesgo cardiovascular según la circunferencia de cintura. El Índice de Masa Magra y el ángulo de fase se estimó normal en la mayoría de las mujeres. La proporción de DMO alterada fue 5,1%. Conclusiones: La evaluación de la composición corporal demuestra una alta proporción de SO y OB en las mujeres procedentes de los tres países, confirmando la necesidad de su control fomentando estilos de vida saludables y el mejoramiento de su calidad de vida previniendo las ENT relacionadas

Introduction: Nutritional status influences the risk of non-communicable diseases (NCDs), such as osteoporosis, a silent global epidemic whose prevalence increases with age. This study aimed to describe the nutritional status and bone mineral density (BMD) of women over 20 years old. Materials and methods: Descriptive cross-sectional study with a convenience sample of 77 women from El Salvador, Guatemala, and Honduras, with data collected in 2022-2023. To evaluate nutritional status, mBCA514 SECA™ electrical bioimpedance equipment was used and the Sunlight MiniOmni™ was used to measure BMD. The data were analyzed with descriptive statistics, with the SPSS program version 29.0.1.0.Results: The average age was 34.8±7.8 years. According to the Body Mass Index, the prevalence of overweight (SP) and obesity (OB) was 33.8% and 23.4%, respectively. 31.2% were estimated to have an elevated range of body fat and 20.8% a high range, according to the Fat Mass Index. 39% were estimated to have elevated or high visceral fat and only 44.2% did not present cardiovascular risk according to waist circumference. The Lean Mass Index and phase angle were estimated to be normal in most women. The proportion of altered BMD was 5.1%. Conclusions: Body composition assessment demonstrates a high proportion of OW/OB in women from all three countries, confirming the need for control by promoting healthy lifestyles and improving their quality of life by preventing related NCDs

Lineamientos para la prevención y el tratamiento de la osteoporosis inducida por glucocorticoides en pediatría / Guidelines for the prevention and treatment of glucocorticoid-induced osteoporosis in pediatrics

Objetivo. Proporcionar un marco para profesionales de la salud que tratan a pacientes pediátricos bajo terapia con glucocorticoides (GC) y desarrollar recomendaciones para la prevención y el tratamiento de la osteoporosis inducida por GC en la población pediátrica. Métodos. Un panel de expertos en enfermedades óseas y pediátricas generó una serie de preguntas PICO que abordan aspectos relacionados con la prevención y el tratamiento de osteoporosis en pacientes bajo tratamiento con GC. Siguiendo la metodología GRADE, se realizó una revisión sistemática de la literatura, se resumieron las estimaciones del efecto y se calificó la calidad de la evidencia. Luego se procedió a la votación y a la formulación de las recomendaciones. Resultados. Se desarrollaron 7 recomendaciones y 6 principios generales para osteoporosis inducida por GC en población pediátrica. Conclusión. Estas recomendaciones proporcionan orientación para los médicos que deben tomar decisiones en pacientes pediátricos bajo tratamiento con GC.

Objective. To provide a framework for healthcare professionals managing pediatric patients who are on active glucocorticoid (GC) therapy and to develop recommendations for the prevention and treatment of GC-induced osteoporosis in the pediatric population. Methods. A panel of experts on bone and pediatric diseases developed a series of PICO questions that address issues related to the prevention and treatment of osteoporosis in patients on GC therapy. In accordance with the GRADE approach, we conducted a systematic review of the literature, summarized effect estimations, and classified the quality of the evidence. Then, voting and the formulation of recommendations followed. Results. Seven recommendations and six general principles were developed for GC-induced osteoporosis in the pediatric population. Conclusion. These recommendations provide guidance for clinicians who must make decisions concerning pediatric patients undergoing treatment with GC.

Embolismo por metacrilato luego de vertebroplastia percutánea. ¿Podemos mejorar la seguridad del paciente? / Methacrylate embolism after percutaneous vertebroplasty. Can we improve patient safety?

Se presenta un caso de embolismo pulmonar luego de vertebroplastia, realizada por fractura vertebral por osteoporosis. El embolismo se confirmó por métodos complementarios. Se sugiere atención a los síntomas respiratorios y radiografía de tórax posterior a la vertobroplastia a los efectos de mejorar la seguridad del paciente luego del procedimiento

A case of pulmonary embolism is presented after vertebroplasty, performed for a vertebral fracture due to osteoporosis. Embolism was confirmed by complementary methods. Attention to respiratory symptoms and a chest x-ray after vertobroplasty are suggested in order to improve patient safety after the procedure.

Resveratrol Alleviates Osteoporosis by Promoting Osteogenic Differentiation of Bone Marrow Mesenchymal Stem Cells via SITR1/PI3K/AKT Pathway / El Resveratrol Alivia la Osteoporosis al Promover la Diferenciación Osteogénica de las Células Madre Mesenquimales de la Médula Ósea a Través de la Vía SITR1/PI3K/AKT

SUMMARY: Senile osteoporosis is mainly caused by reduced osteoblast differentiation and has become the leading cause of fractures in the elderly worldwide. Natural organics are emerging as a potential option for the prevention and treatment of osteoporosis. This study was designed to study the effect of resveratrol on osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in osteoporosis mice. A mouse model of osteoporosis was established by subcutaneous injection of dexamethasone and treated with resveratrol administered by gavage. In vivo and in vitro, we used western blot to detect protein expression, and evaluated osteogenic differentiation of BMSCs by detecting the expression of osteogenic differentiation related proteins, calcium deposition, ALP activity and osteocalcin content. Resveratrol treatment significantly increased the body weight of mice, the level of serum Ca2+, 25(OH)D and osteocalcin, ration of bone weight, bone volume/total volume, trabecular thickness, trabecular number, trabecular spacing and cortical thickness in osteoporosis mice. In BMSCs of osteoporosis mice, resveratrol treatment significantly increased the expression of Runx2, osterix (OSX) and osteocalcin (OCN) protein, the level of calcium deposition, ALP activity and osteocalcin content. In addition, resveratrol treatment also significantly increased the expression of SIRT1, p-PI3K / PI3K and p-AKT / AKT in BMSCs of osteoporosis mice. In vitro, resveratrol increased the expression of SIRT1, p-PI3K / PI3K and p-AKT / AKT, Runx2, OSX and OCN protein, the level of calcium deposition, ALP activity and osteocalcin content in BMSCs in a concentration-dependent manner, while SIRT1 knockdown significantly reversed the effect of resveratrol. Resveratrol can attenuate osteoporosis by promoting osteogenic differentiation of bone marrow mesenchymal stem cells, and the mechanism may be related to the regulation of SIRT1/PI3K/AKT pathway.

La osteoporosis senil es causada principalmente por una diferenciación reducida de osteoblastos y se ha convertido en la principal causa de fracturas en las personas mayores en todo el mundo. Los productos orgánicos naturales están surgiendo como una opción potencial para la prevención y el tratamiento de la osteoporosis. Este estudio fue diseñado para estudiar el efecto del resveratrol en la diferenciación osteogénica de las células madre mesenquimales de la médula ósea (BMSC) en ratones con osteoporosis. Se estableció un modelo de osteoporosis en ratones mediante inyección subcutánea de dexametasona y se trató con resveratrol administrado por sonda. In vivo e in vitro, utilizamos Western blot para detectar la expresión de proteínas y evaluamos la diferenciación osteogénica de BMSC detectando la expresión de proteínas relacionadas con la diferenciación osteogénica, la deposición de calcio, la actividad de ALP y el contenido de osteocalcina. El tratamiento con resveratrol aumentó significativamente el peso corporal de los ratones, el nivel sérico de Ca2+, 25(OH)D y osteocalcina, la proporción de peso óseo, el volumen óseo/ volumen total, el espesor trabecular, el número trabecular, el espaciado trabecular y el espesor cortical en ratones con osteoporosis. En BMSC de ratones con osteoporosis, el tratamiento con resveratrol aumentó significativamente la expresión de las proteínas Runx2, osterix (OSX) y osteocalcina (OCN), el nivel de deposición de calcio, la actividad de ALP y el contenido de osteocalcina. Además, el tratamiento con resveratrol también aumentó significativamente la expresión de SIRT1, p-PI3K/PI3K y p-AKT/AKT en BMSC de ratones con osteoporosis. In vitro, el resveratrol aumentó la expresión de las proteínas SIRT1, p-PI3K/PI3K y p- AKT/AKT, Runx2, OSX y OCN, el nivel de deposición de calcio, la actividad de ALP y el contenido de osteocalcina en BMSC de manera dependiente de la concentración, mientras que La caída de SIRT1 revirtió significativamente el efecto del resveratrol. El resveratrol puede atenuar la osteoporosis al promover la diferenciación osteogénica de las células madre mesenquimales de la médula ósea, y el mecanismo puede estar relacionado con la regulación de la vía SIRT1/PI3K/AKT.

Integrative analyses of genetic characteristics associated with skeletal endothelial cells

Abstract The osseous vascular endothelium encompasses a vast intricate framework that regulates bone remodeling. Osteoporosis, an age-associated systemic bone disease, is characterized by the degeneration of the vascular architecture. Nevertheless, the precise mechanisms underpinning the metamorphosis of endothelial cells (ECs) with advancing age remain predominantly enigmatic. In this study, we conducted a systematic analysis of differentially expressed genes (DEGs) and the associated pathways in juvenile and mature femoral ECs, utilizing data sourced from the Gene Expression Omnibus (GEO) repositories (GSE148804) and employing bioinformatics tools. Through this approach, we successfully discerned six pivotal genes, namely Adamts1, Adamts2, Adamts4, Adamts14, Col5a1, and Col5a2. Subsequently, we constructed a miRNA-mRNA network based on miRNAs displaying differential expression between CD31hiEMCNhi and CD31lowEMCNlow ECs, utilizing online repositories for prediction. The expression of miR-466i-3p and miR-466i-5p in bone marrow ECs exhibited an inverse correlation with age. Our in vivo experiments additionally unveiled miR-466i-5p as a pivotal regulator in osseous ECs and a promising therapeutic target for age-related osteoporosis.

Periodontitis and osteoporosis: a two-sample Mendelian randomization analysis

Abstract The incidences of periodontitis and osteoporosis are rising worldwide. Observational studies have shown that periodontitis is associated with increased risk of osteoporosis. We performed a Mendelian randomization (MR) study to genetically investigate the causality of periodontitis on osteoporosis. We explored the causal effect of periodontitis on osteoporosis by MR analysis. A total of 9 single nucleotide polymorphisms (SNP) were related to periodontitis. The primary approach in this MR analysis was the inverse variance-weighted (IVW) method. Simple median, weighted median, and penalized weighted median were used to analyze sensitivity. The fixed-effect IVW model and random-effect IVW model showed no significant causal effect of genetically predicted periodontitis on the risk of osteoporosis (OR=1.032; 95%CI: 0.923-1.153; P=0.574; OR=1.032; 95%CI: 0.920-1.158; P=0.588, respectively). Similar results were observed in simple mode (OR=1.031; 95%CI: 0.780-1.361, P=0.835), weighted mode (OR=1.120; 95%CI: 0.944-1.328, P=0.229), simple median (OR=1.003; 95%CI: 0.839-1.197, P=0.977), weighted median (OR=1.078; 95%CI: 0.921-1.262, P=0.346), penalized weight median (OR 1.078; 95%CI: 0.919-1.264, P=0.351), and MR-Egger method (OR=1.360; 95%CI: 0.998-1.853, P=0.092). There was no heterogeneity in the IVW and MR-Egger analyses (Q=7.454, P=0.489 and Q=3.901, P=0.791, respectively). MR-Egger regression revealed no evidence of a pleiotropic influence through genetic variants (intercept: -0.004; P=0.101). The leave-one-out sensitivity analysis indicated no driven influence of any individual SNP on the association between periodontitis and osteoporosis. The Mendelian randomization analysis did not show a significant detrimental effect of periodontitis on the risk of osteoporosis.

Embolismo por metacrilato luego de vertebroplastia percutánea / Methacrylate embolism after percutaneous vertebroplasty

Resumen Se presenta un caso de embolismo pulmonar luego de vertebroplastia, realizada por fractura vertebral por osteoporosis. El embolismo se confirmó por métodos complementarios. Se sugiere atención a los síntomas respiratorios y radiografía de tórax posterior a la vertobroplastia a los efectos de mejorar la seguridad del paciente luego del procedimiento.

Abstract A case of pulmonary embolism is presented after vertebroplasty, performed for a vertebral fracture due to osteoporosis. Embolism was confirmed by complementary methods. Attention to respiratory symptoms and a chest x-ray after vertobroplasty are suggested in order to improve patient safety after the procedure.

Meta-analysis of Distribution Frequency of Traditional Chinese Medicine Syndrome in Primary Osteoporosis / 中国实验方剂学杂志

ObjectiveTo systematically evaluate the distribution of traditional Chinese medicine（TCM） syndromes of primary osteoporosis（POP） in China by using evidence-based medicine methods， and to understand the distribution law of the syndromes. MethodChina National Knowledge Infrastructure（CNKI）， VIP Chinese Science and Technology Journal Database（VIP）， WanFang Data Knowledge Service Platform（WanFang） and China Biology Medicine（CBM） were searched to obtain representative literature， and each database was searched from the 1994 World Health Organization defined diagnostic criteria for osteoporosis until May 1， 2023. Two researchers independently screened literature according to the criteria， extracted data， and cross-checked them. Meta analysis was conducted using R4.1.3， and subgroup analysis was performed. ResultA total of 56 Chinese papers were included， involving 14 415 patients. After standardized classification of syndromes， 11 articles were excluded， and Meta analysis results of the ultimately included 45 Chinese articles showed that the distribution frequencies of liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome in 12 723 patients were 27%［95% confidence interval（CI） 0.24-0.31］， 32%（95% CI 0.29-0.36）， 36%（95% CI 0.30-0.42）. Subgroup analysis showed that there was a statistically significant difference in the distribution of the three TCM syndromes in the north and south（P<0.05）. In addition， the incidence of TCM syndrome fractures in different types of POP was 15%（95% CI 0.09-0.24） for liver-kidney Yin deficiency syndrome， 20%（95% CI 0.12-0.30） for spleen-kidney Yang deficiency syndrome， and 31%（95% CI 0.25-0.39） for kidney deficiency and blood stasis syndrome. ConclusionThe distribution of syndromes in POP patients is mainly kidney deficiency， accompanied by liver and spleen dysfunction. Liver-kidney Yin deficiency syndrome， spleen-kidney Yang deficiency syndrome and kidney deficiency and blood stasis syndrome are all the main syndromes of POP and osteoporotic fractures， and kidney deficiency and blood stasis syndrome is most closely related to the development of osteoporotic fractures. The reference standards for syndrome determination among the included studies are inconsistent， and in the future， it is necessary to focus on their determination standards to obtain consensus research results， at the same time， conduct large-scale syndrome research to obtain representative research results， providing a basis for clinical practice and research.

Application value of bone cement containing rhbFGF and RHBMP-2 in PKP treatment of osteoporotic lumbar compression fracture / 中国骨伤

OBJECTIVE@#To investigate the effect of bone cement containing recombinant human basic fibroblast growth factor (rhbFGF) and recombinant human bone morphogenetic protein-2 (rhBMP-2) in percutaneous kyphoplasty(PKP)treatment of osteoporotic vertebral compression fracture(OVCF).@*METHODS@#A total of 103 OVCF patients who underwent PKP from January 2018 to January 2021 were retrospectively analyzed, including 40 males and 63 females, aged from 61 to 78 years old with an average of (65.72±3.29) years old. The injury mechanism included slipping 33 patients, falling 42 patients, and lifting injury 28 patients. The patients were divided into three groups according to the filling of bone cement. Calcium phosphate consisted of 34 patients, aged(65.1±3.3) years old, 14 males and 20 females, who were filled with calcium phosphate bone cement. rhBMP-2 consisted of 34 patients, aged (64.8±3.2) years old, 12 males and 22 females, who were filled with bone cement containing rhBMP-2. And rhbFGF+rhBMP-2 consisted of 35 patients, aged (65.1±3.6) years old, 14 males and 21 females, who were filled with bone cement containing rhbFGF and rhBMP-2. Oswestry disability index (ODI), bone mineral density, anterior edge loss height, anterior edge compression rate of injured vertebra, visual analog scale (VAS) of pain, and the incidence of refracture were compared between groups.@*RESULTS@#All patients were followed for 12 months. Postoperative ODI and VAS score of the three groups decreased (P<0.001), while bone mineral density increased (P<0.001), anterior edge loss height, anterior edge compression rate of injured vertebra decreased first and then slowly increased (P<0.001). ODI and VAS of group calcium phosphate after 1 months, 6 months, 12 months were lower than that of rhBMP-2 and group rhbFGF+rhBMP-2(P<0.05), bone mineral density after 6 months, 12 months was higher than that of rhBMP-2 and group calcium phosphate(P<0.05), and anterior edge loss height, anterior edge compression rate of injured vertebra of group rhbFGF+rhBMP-2 after 6 months and 12 months were lower than that of group rhBMP-2 and group calcium phosphate(P<0.05). There was no statistical difference in the incidence of re-fracture among the three groups (P>0.05).@*CONCLUSION@#Bone cement containing rhbFGF and rhBMP-2 could more effectively increase bone mineral density in patients with OVCF, obtain satisfactory clinical and radiological effects after operation, and significantly improve clinical symptoms.

Vertebral fractures combined with prolonged activated partial prothrombin time:A case report / 北京大学学报(医学版)

With the development of modern medical standards,autoimmune diseases and their associ-ated successive osteoporosis have received increasing attention in recent years.Patients with autoimmune diseases,due to the characteristics of the disease and the prolonged use of glucocorticoid hormone thera-py,may affect the bone formation and bone absorption of the patient,followed by severe successive osteo-porosis,thereby increasing the risk of osteoporotic vertebral fractures.Vertebral compression fractures of the spine are common fracture types in patients with osteoporotic fractures.Osteoporosis is a common complication after glucocorticoid therapy in patients with autoimmune diseases.Percutaneous vertebro-plasty(PVP)and percutaneous kyphoplasty(PKP)are minimally invasive operation and are commonly used surgical methods for the treatment of osteoporotic vertebral compression fractures.However,due to the operation of spinal puncture during the operation,there are serious surgical risks such as bone cement leakage,spinal epidural hemorrhage,subdural hemorrhage,and subarachnoid hemorrhage in both PVP and PKP.As a result,it is necessary to evaluate the patient's body before surgery carefully,especially in the case of blood coagulation.This article reports a case of autoimmune disease patient admitted to Peking University People's Hospital due to lumbar 4 vertebral compression fracture combined with Sj?gren's syn-drome.The patient's preoperative examination showed that the activated partial thromboplastin time(APTT)was significantly prolonged.After completing the APTT extended screening experiment and lu-pus anticoagulant factor testing,the multi-disciplinary team(MDT)of Peking University People's Hospi-tal jointly discussed the conclusion that the patient's test results were caused by an abnormal self-immuni-ty anti-copulant lupus(LAC).Based on the results of the laboratory examination,the patient was con-sidered to be diagnosed with combined antiphospholipid syndrome(APS).For such patients,compared with the patient's tendency to bleed,we should pay more attention to the risk of high blood clotting in the lower limbs of the patient,pulmonary clots and so on.With timely anti-coagulation treatment,the patient safely passed the peripheral period and was successfully discharged from the hospital.Therefore,for pa-tients with autoimmune diseases with prolonged APTT in the perioperative period,doctors need to careful-ly identify the actual cause and carry out targeted treatment in order to minimize the risk of surgical and perioperative complications and bring satisfactory treatment results to the patients.

Improvement effect of velvet antler polypeptide in osteoporosis model rats and its effect on SIRT1/FOXO1 signaling pathway / 吉林大学学报(医学版)

Objective:To discuss the protective effect of velvet antler peptide(VAP)in the osteoporosis(OP)model rats,and to clarify the possible mechanism.Methods:Sixty 12-week-old SD rats were randomly divided into control group,model group,positive drug group(treated with 1 mg·kg-1·d-1 of alendronate sodium by gavage),low dose of VAP group(treated with 100 mg·kg-1·d-1 VAP),medium dose of VAP group(treated with 200 mg·kg-1·d-1 VAP),and high dose of VAP group(treated with 300 mg·kg-1·d-1 VAP),and there were ten rats in each group.Except for control group,the rats in the other groups were injected with dexamethasone(2 mg·kg-1)to replicate the OP rat model,while the rats in control group were injected with the equivalent volume of saline twice a week for 11 consecutive weeks.Dual-energy X-ray absorptiometry was used to detect the bone mineral density(BMD)of femur tissue of the rats in various groups;enzyme-linked immunosorbent assay(ELISA)method was used to detect the levels of serum calcium(Ca2+),phosphate(P),osteoprotegerin(OPG),alkaline phosphatase(ALP),and osteocalcin(OCN)in serum of the rats in various groups;biochemical method was used to detect the malondialdehyde(MDA)level and superoxide dismutase(SOD)activity in serum of the rats in various groups;HE staining was used to observe the pathomorphology of bone tissue of the rats in various groups;Western blotting method was used to detect the expression levels of silent information regulator 1(SIRT1),catalase(CAT),Runt-related transcription factor 2(RUNX2),and forkhead box protein O1(FOXO1)proteins in bone tissue of the rats in various groups.Results:Compared with control group,the BMD of femoral tissue of the rats in model group was decreased(P<0.05);compared with model group,the BMD of femur tissue of the rats in positive drug group,medium dose of VAP group,and high dose of VAP group were increased(P<0.05 or P<0.01).Compared with control group,the levels of Ca2+,P,OPG,and SOD activities in serum of the rats in model group were decreased(P<0.05),and the levels of ALP,OCN,and MDA were increased(P<0.05);compared with model group,the level of OPG in serum of the rats in low dose of VAP group was significantly increased(P<0.05),the levels of Ca2+,P,OPG,and activities of SOD in serum of the rats in positive drug group,medium dose of VAP group,and high dose of VAP group were significantly increased(P<0.05 or P<0.01),and the levels of ALP,OCN,and MDA in serum of the rats in positive drug group and different doses of VAP groups were decreased(P<0.05 or P<0.01).The HE staining results showed that compared with control group,the rats in model group had fewer bone cells and disordered arrangements in the bone tissue,thinner bone trabeculae with large fractures,and an expanded marrow cavity;compared with model group,the rats in positive drug group,medium dose of VAP group,and high dose of VAP group had thicker bone trabeculae arranged more tightly.The Western blotting results showed that compared with control group,the expression levels of SIRT1,CAT,RUNX2,and FOXO1 proteins in bone tissue of the rats in model group were decreased(P<0.05);compared with model group,the expression levels of SIRT1,CAT,RUNX2,and FOXO1 proteins in bone tissue of the rats in positive drug group,medium dose of VAP group,and high dose of VAP group were significantly increased(P<0.05 or P<0.01).Conclusion:VAP has the protective effect against OP in the rats,and its mechanism may be related to mediating the antioxidant stress action through the SIRT1/FOXO1 signaling pathway.

Changes and predictive value of serum Omentin-1 levels in patients with type 2 diabetes under different bone metabolic states / 国际检验医学杂志

Objective To investigate the changes and predictive value of Omentin-1 levels in patients with type 2 diabetes mellitus(T2DM)under different bone metabolic status.Methods A total of 120 T2DM pa-tients admitted to a hospital from June 2021 to December 2022 were selected and divided into group A(normal bone mass,T-value-1.0,36 cases),Group B(bone loss,-2.5＜T-value＜-1.0,49 cases)and group C(osteoporosis,T-value-2.5,35 cases)according to different bone mineral density.Another 50 healthy sub-jects who underwent physical examination in a hospital during the same period were selected as the healthy control group.Basic data,serum Omentin-1 and bone metabolism levels of the 4 groups were compared,and the correlation between serum Omentin-1 and bone metabolism and blood glucose levels was analyzed by Pear-son correlation analysis.Multiple stepwise regression analysis was conducted to analyze the factors affecting bone mineral density in T2DM patients.Receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of serum Omentin-1 level in T2DM with osteoporosis.Results The fasting blood glucose(FBG)level of groups A,B and C was higher than that of healthy control group,and the hemoglobin A1c(HbA1c)and homeostasis model assessment of insulin resistance(HOMA-IR)of healthy control group,group A and group B were lower than that of group C,with statistical significance(P＜0.05).Omentin-1,type Ⅰ procollagen N-terminal propeptide(P Ⅰ NP)and osteocalcin(BGP)in healthy control group,group A and group B were higher than those in group C,while the β-CTX sequence of type Ⅰ collagen in healthy con-trol group,group A and group B was lower than that in group C,and the difference was statistically signifi-cant(P＜0.05).Pearson correlation analysis showed that the serum Omentin-1 level in T2DM patients was negatively correlated with the levels of HbA1c,HOMA-IR and β-CTX(r=-0.770,-0.807,-0.759,P＜0.05),and positively correlated with the levels of P Ⅰ NP and BGP(r=0.868,0.879,P＜0.05),but no sig-nificant correlation with FBG level(r=-0.085,P=0.152).Omentin-1,P Ⅰ NP,β-CTX,BGP,HbA1c and HOMA-IR were independent influencing factors of BMD in T2DM patients(P＜0.05).ROC curve analysis showed that the area under the curve of serum Omentin-1 level predicting T2DM with osteoporosis was 0.835(95％CI:0.764-0.906),and when the cut-off value was 50.325 ng/mL,the sensitivity was 0.854,the speci-ficity was 0.801,and the Youden index was 0.655.Conclusion Serum Omentin-1 expression is low in T2DM patients,and its expression is closely related to bone mineral density,bone metabolism and insulin resistance in T2DM patients,and can effectively predict the occurrence of T2DM with osteoporosis.

Study on anti-osteoporosis effect of different extracts of Polygoni Multiflori Radix Praeparata on zebrafish / 国际中医中药杂志

Objective:To study on anti-osteoporosis effect of different extracts of Polygoni Multiflori Radix Praeparata on zebrafish.Methods:Three kinds extracts of Polygoni Multiflori Radix Praeparata, anthraquinone and stilbene glycosides and the removal of anthraquinone and stilbene glycosides were prepared. Prednisolone was used to construct the osteoporosis model of young zebrafish. Normal control group, model group, disodium etidronate group and low-, medium- and high-dosage groups of different extracts of Polygoni Multiflori Radix Praeparata were set up. Alizarin red staining was used to investigate the mineralized skull area and bone density of juvenile zebrafish in each group. Alkaline phosphatase (AKP) and tartrate-resistant acid phosphatase (TRACP) kits were used to detect the activity of osteoblast and osteoclast enzymes in zebra larvae. The qRT PCR method was used to detect the mRNA expressions of osteoporosis related genes Runx2b, col1a2, sparc, and vdrb in each group of zebrafish.Results:Compared with model group, the skull mineralized area and bone mineral density in different extracts of Polygoni Multiflori Radix Praeparata significantly increased ( P<0.01). Polygoni Multiflori Radix Praeparata, anthraquinone and stilbene glycosides and the removal of anthraquinone and stilbene glycosides (medium- and high-dosage) could significantly increase the AKP activity of zebrafish ( P<0.01), and lower the TRAP activity of zebrafish ( P<0.01); the mRNA expression levels of Runx2b, col1a2, sparc and vdrb in juvenile zebrafish osteoporosis model were significantly up-regulated by different extracts of Polygoni Multiflori Radix Praeparata. ( P<0.01). Conclusion:Polygoni Multiflori Radix Praeparata, Anthraquinone and stilbene glycosides and the removal of anthraquinone and stilbene glycosides show better anti-osteoporosis effects. The comparison of the efficacy of three extracts from Polygonum multiflorum shows that in addition to anthraquinone and stilbene glycosides, other chemical components of Polygonum multiflorum have anti-osteoporosis effects.

Research progress of strontium and pregnancy and pregnancy diseases / 基础医学与临床

Strontium(Sr)is a trace element naturally found in the human skeletal system.In recent years,the po-tential impact of strontium on bone and cardiovascular health has called significant attention,particularly during pregnancy,when alterations in mineral metabolism may affect the health of both the mother and the fetus.This com-prehensive review assesses the current understanding of the role of strontium as a nutritional substance during preg-nancy,its effects on maternal health and fetal development,and its potential associations with pregnancy complica-tions such as preeclampsia,gestational hypertension,and lactation-induced osteoporosis.The review also summarizes the possible effects of strontium deficiency,excess,and supplementation,and provides information for developing prenatal nutrition supplementation guideline.

Effects of microRNA-103a-3p on osteoporosis through tumor protein 53-regulated inhibitor of apoptosis 1/P53 / 解剖学报

Objective To investigate the efeects of microRNA(miR)-103a-3p regulates tumor protein 53-regulated inhibitor of apoptosis 1(TRIAP1)on osteoblast differentiation and bone mass in ovariectomized mice.Methods MC3T3-E1 cells were divided into normal group,miR-103a-3p-NC group,miR-103a-3p mimic group,miR-103a-3p mimic+TRIAP1-NC group,miR-103a-3p mimic+TRIAP1 mimic group.mRNA expression of miR-103a-3p,TRIAP1,P53 were detected by Real-time PCR;Cell proliferation and apoptosis were detected by MTT test and flow cytometry;cytoskeleton and mineralization of cells were detected by F-actin immunofluorescence staining and alizarin staining;alkaline phosphatase(ALP)activity was detected by ELISA.24 female mice were divided into sham group,osteoporosis(OP)group,miR-103a-3p antagonist-NC group,miR-103a-3p antagonist group(six in each group),extract bilateral ovaries to establish an OP model,sham group mice only isolated fat around ovarian tissue.mRNA expression of miR-103a-3p,TRIAP1,P53,ALP,osteocalcin(OCN),osteopontin(OPN)of bone tissue were detected;microCT detect bone mineral density(BMD),bone mineral content(BMC);haematoxylin eosin staining was used to observe pathological changes of bone tissue.Results After miR-103a-3p mimic was transfected into cells,the miR-103a-3p and P53 expression increased,TRIAP1 expression decreased,cell proliferation decreased,apoptosis increased,F-actin expression decreased,the number of calcium nodules decreased,and ALP enzyme activity decreased(P<0.01);however,after TRIAP1 mimic was additionally transfected into cells,the above result caused by miR-103a-3p mimics were significantly reversed(P<0.01).In OP group,the miR-103a-3p and P53 expression in bone tissue increased,the TRIAP1,ALP,OCN and OPN expression decreased,BMD and BMC were decreased,and bone tissue construct was damaged(P<0.05);in miR-103a-3p antagonist group,the miR-103a-3p and P53 expression in bone tissue decreased,TRIAP1,ALP,OCN,OPN expression increased,BMD and BMC increased,and bone tissue construct was improved(P<0.05).Conclusion MiRNA-103a-3p mediate TRIAP1/P53 to inhibit proliferation and mineralization of osteoblast,while miR-103a-3p antagonistic treatment reduce bone loss in OP mice.

A Meta-analysis of the Effect of Adjuvant Probiotics in Patients with Osteoporosis / 昆明医科大学学报

Objective Systematically evaluate the efficacy of probiotics in treating osteoporosis.Methods Computer search of Cochrane Library,Web of Science,PubMed,Embase,VIP,CNT and Wanfang data knowledge service platform,the search time limit of August 15,2023,included as a randomized controlled experiment of probiotics for the treatment of osteoporosis.Two researchers independently screened the literature,extracted the data,and evaluated the risk of bias in the included literature.The effects of probiotic treatment on BMD,blood calcium,vitamin D,parathyroid hormone,osteocalcin,bone alkaline phosphatase and adverse reactions were analyzed by using Stata A.14 and Revman.5.4 software.Results Eight articles were finally included,Including 744 study subjects,The results of the Meta-analysis showed that,Add probiotics to traditional drug therapy,Can increase hip bone mineral density in patients[WMD 0.05(0.01,0.10)]g/cm3,Increase the calcium ion concentration in the patient's blood[WMD 0.26(0.02,0.50)]mmol/L mmol/L,Increase the concentration of blood osteocalcin[WMD 1.84(0.60,3.07)]ng/mL,Lower the bone-specific alkaline phosphatase concentration[SMD-1.06(-2.06,-0.07)],And reduce the incidence of nausea and diarrhea,However,there was no significant change in vitamin D and parathyroid hormone.Conclusion The addition of probiotics on the basis of routine treatment may improve the level of bone mineral density and reduce the adverse reactions of gastrointestinal tract,which is beneficial to the prognosis of patients.

Correlation between DKK1 promoter methylation level and diabetic microangiopathopathy complicated with osteoporosis / 中华内分泌外科杂志

Objective:To investigate the correlation between the promoter methylation level of Dickkopf-related protein 1 (DKK1) gene and diabetic microangiopaopathy complicated with osteoporosis.Methods:Patients with type 2 diabetes mellitus (T2DM) microangiopathopathy who were admitted to our hospital from Jan. 2019 to Dec. 2022 were collected as research objects, and divided into observation group (44 cases) and control group (58 cases) according to whether they were complicated with osteoporosis. Bone mineral density (BMD) of lumbar spine (L1-4) was measured, and bone metabolism indexes, including serum calcium, serum phosphorus, 25-hydroxy vitamin D3[25-hydroxy vitamin D3, 25- (OH) D3], PTH, C-terminal telopeptide of typeI collagen (CTX), procollagen of aminoterminal propeptide (PINP) and tartrate resistant acid phosphatase (TRACP) levels were detected; The promoter methylation level of DKK1 gene was determined.Results:The methylation level of DKK1 gene promoter in the observation group was 5.17%±0.73%, which was significantly higher than that in the control group (3.81%±0.61%), with statistical significance ( t=5.22, P<0.001). The 25- (OH) D3 level, PTH and lumbar bone density in the observation group were significantly lower than those in the control group, while the CTX and TRACP levels were significantly higher than those in the control group ( t was 5.58, 4.35, 4.12, 4.05 and 4.17, respectively, P<0.001). In all patients, the promoter methylation level of DKK1 gene was significantly positively correlated with CTX and TRACP ( r was 0.41 and 0.39, P was 0.006 and 0.027, respectively), and significantly negatively correlated with PTH and lumbar bone density ( r was -0.38 and -0.43, respectively). P=0.015 and 0.003, respectively). ROC curve analysis showed that the area under the curve of DKK1 methylation level to distinguish type 2 diabetes microangionopathy with and without osteoporosis was 0.841 (0.762-0.921), and the sensitivity and specificity were 86.4% and 72.4%, respectively. Conclusion:The methylation level of DKK1 gene promoter is associated with osteoporosis and bone metabolism in T2DM patients with microangiopathia.

Zoledronic acid affects osteogenic differentiation and bone formation by regulating the expression of SIRT3/P53 / 中华内分泌外科杂志

Objective:To explore the mechanism of zoledronic acid (ZOL) affects osteogenic differentiation and bone formation through the regulation of sirtuin 3 (SIRT3) / P53 expression.Methods:Bone marrow mesenchymal stem cells (BMSCs) were induced to differentiate into osteogenic cells, the expression of SIRT3 in the cells was detected, and the targeting regulation relationship between SIRT3 and P53 was analyzed. The intracellular expressions of SIRT3 and P53 were intervened and ZOL was used to treat the cells. MTT method, Western blot method and kit were used to detect cell viability, osteogenesis-related genes Osteoprotegerin (OPG), runt-related transcription factor 2 (Runx2) expression, alkaline phosphatase (ALP) activity and alizarin red S (ARS) staining, respectively. Ovariectomy (OVX) was used to construct a rat model and explore the effect of ZOL on the progression of osteoporosis (OP) in vivo.Results:ZOL promoted osteogenic differentiation of BMSCs. The expression of SIRT3 was down-regulated in the serum of OP patients (0.78±0.23) compared with that of healthy subjects (1.00±0.26 vs. 0.78±0.23. t=3.85, P<0.001). During the osteogenic differentiation of BMSCs, the expression level of SIRT3 gradually increased with the prolonged induction of osteogenesis. Compared with the p53 protein expression and BMSCs activity in the control group, SIRT3 knockout could increase the expression level of p53 protein (0.59±0.05 vs. 1.01±0.11. t=6.02, P=0.004) but inhibited the activity of BMSCs (100.00±8.41 vs. 51.26±5.59. t=8.36, P=0.001). After ZOL treatment, the inhibitory effect of SIRT3 on cell viability (49.61±5.11 vs. 87.61±7.31. t=7.38, P=0.002) and osteogenesis was relieved, and the level of P53 was inhibited (1.10±0.10 vs. 0.69±0.04. t=6.59, P=0.003). P53 overexpression partially offseted the effects of ZOL on cell viability (84.61±6.52 vs. 66.54±5.47. t=3.68, P=0.021) and osteogenesis. Compared with the sham surgery group, the OVX group showed inhibition of osteogenesis in rats, and ZOL treatment significantly improved osteogenic inhibition. ZOL treatment increased the expression level of SIRT3 protein in bone tissue of OVX rats, but inhibited the expression level of P53. Conclusion:ZOL promoted osteogenic differentiation and bone formation of BMSCs by promoting the ubiquitination and degradation of P53 by SIRT3.

One case report of repeated chest tightness and palpitation cured after strengthening calcium supplementation / 中华内分泌外科杂志

The incidence of parathyroid hyperfunction is high and its clinical manifestations are diverse. Some patients develop chest tightness and palpitations as the main discomfort, which may be caused by the hypocalcemia and hypercalcemia related to negative calcium balance and parathyroid hyperfunction. We report a case of 53 years old male with parathyroid hyperfunction who was diagnosed with osteoporosis before and received conventional regular supplementation of vitamin D and calcium supplements. However, his condition worsened and he developed chest tightness and palpitation. After 1 month of sufficient supplementation of calcium, the symptoms of chest tightness and palpitation disappeared completely. Then we continued to provide the patients enough vitamin D and calcium supplementation actively. After 1 year of follow-up, the patient's condition was stable. His discomfort of chest tightness and palpitation never recurred, and all the bone metabolism indicators returned to normal.

Effects of Hesperidin on Osteoporosis through Anti-Inflammatory and Antioxidant Activity in Rat Models / 世界科学技术-中医药现代化

Objective To study the anti-osteoporotic effect of different concentrations of hesperidin on ovariectomized rat model of osteoporosis(Ovariectomy,OVX)by reducing inflammatory molecules and oxidative stress response mechanism and the relationship between hesperidin and dose.Methods SD female rats were randomly divided into OVX group and Sham group,and OVX operation and sham operation were performed respectively.OVX group was randomly divided into 5 groups with 6 rats in each group,and 6 rats in Sham group were randomly selected as normal control group.They were Sham group(Sham rats+1%CMC suspension),control group(OVX rats+1%CMC suspension),HP1 group(OVX rats+5 mg·kg-1 HP),HP2 group(OVX rats+10 mg·kg-1 HP),HP3 group(OVX rats+20 mg·kg-1 HP)and AN group(OVX rats+2.5 mg·kg-1 AN).After 4 weeks of ovariectomized or sham operation,the drug was given by oral administration every morning for 10 weeks.After 10 weeks of administration,the change of body weight of rats was measured.Before the rats were killed,the serum of abdominal aorta was obtained and placed in the specimen cabinet at-20℃,the levels of Ca2+ and P5+,the levels of inflammatory factors TNF-α,IL-6 and IL-1β,and the levels of periosseous transition markers ALP,ACP,β-CTx and OC were also measured.After the rats were killed,the left femur was also placed in the specimen cabinet at-20℃.After treatment,the levels of oxidative stress factor TRARS and antioxidant enzymes GSH,GST,GR,GPx and CAT in the left femur were measured,and the bone mineral density,Young's modulus,maximum load,energy absorption and maximum stress in the middle part of the left femur were measured,and the expression level of SIRT1 gene was obtained.Results Compared with the control group,after 10 weeks of treatment with different concentrations of HP,the weight gain was significantly reduced(P<0.001),the levels of Ca2+ and P5+ in OVX rats were significantly decreased(P<0.001),and the levels of periosseous transition markers ALP,ACP,β-CTx and OC were significantly decreased(P<0.001).It significantly increased bone mineral density,Young's modulus,maximum load,energy absorption,maximum stress and stiffness(P<0.001),significantly decreased the level of OVX-induced thiobarbituric acid reactive substances and increased the levels of antioxidant enzymes GSH,GST,GR,GPx and CAT(P<0.001),and significantly decreased the levels of inflammatory molecules TNF-α,IL-6 and IL-1β(P<0.001).The expression level of SIRT1 gene was significantly decreased(P<0.001).Compared with the control group,the above parameters in the high concentration HP group were significantly different from those in the control group(P<0.001).Conclusion It is suggested that hesperidin can inhibit osteoporosis by reducing pro-inflammatory cytokines and oxidative stress in ovariectomized rats in a concentration-dependent manner.