Association of hip fractures with cardiometabolic-renal risk factors in Southern Chinese patients with type 2 diabetes - the Hong Kong Diabetes Register.

INTRODUCTION: Diabetes and bone health are closely related. We examined the incidence and risk factors of hip fractures in Chinese patients with type 2 diabetes (T2D). MATERIALS AND METHODS: In this prospective cohort, we consecutively enrolled 22,325 adults with T2D above the age of 40 years in the Hong Kong Diabetes Register between 1994 and 2015 with crude hip fracture incidence rate censored in 2017. RESULTS: At baseline, the mean age of this cohort was 60.9 ± 10.5 years (mean duration of diabetes 6 years, 52.4% male). During a mean ± standard deviation (SD) follow-up period of 8.7 ± 5.2 years with 193,553 person-years, 603 patients were hospitalized due to hip fractures with an incidence (95% confidence interval, CI) of 315.1 (290.4-341.3) per 100,000 person-years. On multivariable analysis with competing death risk adjusted, the independent hazard ratios (95% CI) for hip fractures in T2D were 2.01 (1.61-2.51) for female sex, 1.08 (1.07-1.09) for age, 0.93 (0.90-0.95) for body mass index, 1.52 (1.25-1.85) for albuminuria and 1.12 (1.02-1.23) for low density lipoprotein-cholesterol. In men, the 30-day, 1-year and 5-year post-hip fracture mortality rate (95% CI) were 5.8 (2.4-9.1) %, 29.2 (22.3-35.5) % and 65.9 (57.3-72.8) % respectively. The corresponding rates in women were 3.4 (1.6-5.1) %, 18.6 (14.7-22.4) %, and 46.8 (40.9-52.1) %. CONCLUSIONS: Southern Chinese patients with T2D have a high risk of hip fracture associated with suboptimal cardiometabolic-renal risk factors and a high post-fracture mortality rate. The effects of improving modifiable risk factors on bone health warrants further evaluation.

Genome-wide association study identifies novel susceptible loci and highlights Wnt/beta-catenin pathway in the development of adolescent idiopathic scoliosis.

The genetic architecture of adolescent idiopathic scoliosis (AIS) remains poorly understood. Here we present the result of a 4-stage genome-wide association study composed of 5,953 AIS patients and 8,137 controls. Overall, we identified three novel susceptible loci including rs7593846 at 2p14 near MEIS1 (Pcombined = 1.19 × 10-13, OR = 1.21, 95% CI = 1.10-1.32), rs7633294 at 3p14.1 near MAGI1 (Pcombined = 1.85 × 10-12, OR = 1.20, 95% CI = 1.09-1.32), and rs9810566 at 3q26.2 near TNIK (Pcombined = 1.14 × 10-11, OR = 1.19, 95% CI = 1.08-1.32). We also confirmed a recently reported region associated with AIS at 20p11.22 (Pcombined = 1.61 × 10-15, OR = 1.22, 95% CI = 1.12-1.34). Furthermore, we observed significantly asymmetric expression of Wnt/beta-catenin pathway in the bilateral paraspinal muscle of AIS patients, including beta-catenin, TNIK, and LBX1. This is the first study that unveils the potential role of Wnt/beta-catenin pathway in the development of AIS, and our findings may shed new light on the etiopathogenesis of AIS.

Novel approach for quantification of porosity for biomaterial implants using microcomputed tomography (microCT).

Porous bioceramics have been widely investigated in orthopaedic tissue engineering. Attention has been given to manufacturing of a porous bioceramic that mimics the trabecular bone structure for proper bone regeneration. With the advance of biomedical imaging through microcomputed tomography (microCT), this study attempted to quantify the pore structure of different bioceramics. Two bioceramic blocks (BSC and ChronOS) were synthesized by two methods. The specification claimed the porosity of the bioceramic ranged from 40% to 70%. Six blocks of each bioceramic were evaluated by conventional water immersion method and microCT. The pore size and connectivity were evaluated with standardized protocols. By the water immersion method, the porosity of BSC and ChronOS was 60.4% and 74.7%, respectively. The three-dimensional results of microCT showed that BSC porosity was 26.2% and ChronOS was 60.0%. The pore connectivity was evaluated to be 2.6 for BSC and 39.7 for ChronOS. ChronOS had functional pores with 200 microm to 400 microm in diameter (87.8%+/-0.5%), which is significantly more than 52.8%+/-11.5% of pores in BSC (p<0.05). Providing information on the functional pores objectively, the microCT evaluation serves as a good standard for specification of the bioceramic-related implants.

Abnormal peri-pubertal anthropometric measurements and growth pattern in adolescent idiopathic scoliosis: a study of 598 patients.

STUDY DESIGN: A cross-sectional study of anthropometric parameters in adolescent idiopathic scoliosis (AIS). OBJECTIVE: To compare anthropometric parameters and growth pattern of AIS girls versus normal controls during peri-puberty. SUMMARY OF BACKGROUND DATA: Abnormal pattern of growth has been reported in AIS patients. The sequential changes of growth and the correlation with curve severity have not been properly studied. MATERIALS AND METHODS: Five hundred ninety-eight AIS girls and 307 healthy girls entered the study. Weight, height, body mass index (BMI), arm span, sitting height, and leg length were determined using standard techniques. Height and sitting height were adjusted by using the greatest Cobb angle to correct for spinal deformity (Bjure's formula). Puberty was graded by Tanner's staging. RESULTS: AIS girls had significantly shorter height (P = 0.001), corrected height (P = 0.005), arm span (P = 0.022), sitting height (P = 0.005) and leg length (P = 0.004) than the controls at pubertal stage I. From pubertal stages II through V, corrected height (P