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Clinical Journal of the American... Nov 2023Secondary hyperparathyroidism is associated with osteoporosis and fractures. Etelcalcetide is an intravenous calcimimetic for the control of hyperparathyroidism in...
INTRODUCTION
Secondary hyperparathyroidism is associated with osteoporosis and fractures. Etelcalcetide is an intravenous calcimimetic for the control of hyperparathyroidism in patients on hemodialysis. Effects of etelcalcetide on the skeleton are unknown.
METHODS
In a single-arm, open-label, 36-week prospective trial, we hypothesized that etelcalcetide improves bone quality and strength without damaging bone-tissue quality. Participants were 18 years or older, on hemodialysis ≥1 year, without calcimimetic exposure within 12 weeks of enrollment. We measured pretreatment and post-treatment areal bone mineral density by dual-energy X-ray absorptiometry, central skeleton trabecular microarchitecture by trabecular bone score, and peripheral skeleton volumetric bone density, geometry, microarchitecture, and estimated strength by high-resolution peripheral quantitative computed tomography. Bone-tissue quality was assessed using quadruple-label bone biopsy in a subset of patients. Paired t tests were used in our analysis.
RESULTS
Twenty-two participants were enrolled; 13 completed follow-up (mean±SD age 51±14 years, 53% male, and 15% White). Five underwent bone biopsy (mean±SD age 52±16 years and 80% female). Over 36 weeks, parathyroid hormone levels declined 67%±9% ( P < 0.001); areal bone mineral density at the spine, femoral neck, and total hip increased 3%±1%, 7%±2%, and 3%±1%, respectively ( P < 0.05); spine trabecular bone score increased 10%±2% ( P < 0.001); and radius stiffness and failure load trended to a 7%±4% ( P = 0.05) and 6%±4% increase ( P = 0.06), respectively. Bone biopsy demonstrated a decreased bone formation rate (mean difference -25±4 µ m 3 / µ m 2 per year; P < 0.01).
CONCLUSIONS
Treatment with etelcalcetide for 36 weeks was associated with improvements in central skeleton areal bone mineral density and trabecular quality and lowered bone turnover without affecting bone material properties.
CLINICAL TRIAL REGISTRY NAME AND REGISTRATION NUMBER
The Effect of Etelcalcetide on CKD-MBD (Parsabiv-MBD), NCT03960437.
Topics: Humans; Male; Female; Adult; Middle Aged; Aged; Prospective Studies; Peptides; Bone and Bones; Bone Density; Absorptiometry, Photon
PubMed: 37574661
DOI: 10.2215/CJN.0000000000000254 -
BMC Endocrine Disorders Aug 2023The weight-adjusted waist circumference index (WWI) is a novel obesity indicator that offers improved accuracy in assessing both muscle and fat mass compared to...
BACKGROUND
The weight-adjusted waist circumference index (WWI) is a novel obesity indicator that offers improved accuracy in assessing both muscle and fat mass compared to traditional measures. This study aimed to investigate the association between WWI and bone mineral density (BMD) in adults.
METHODS
Weighted multivariate logistic regression, subgroup analysis, interaction tests and restricted cubic spline (RCS) curves were used to explore the relationship between WWI and BMD based on data from the National Health and Nutrition Examination Survey (NHANES).
RESULTS
This study had 40,568 individuals in total. At all four measurement sites, we detected a negative linear correlation between WWI and BMD. Even when quartile factors for WWI were created, this unfavorable connection maintained. In comparison to those in the lowest quartile, those in the highest percentile of WWI showed declines in lumbar BMD of 0.08 g/cm and femoral neck BMD of 0.03 g/cm, respectively. This adverse correlation, nevertheless, differed among several categories.
CONCLUSIONS
Our findings suggest an adverse correlation between WWI and BMD among US adults. Employing WWI as a tool for osteoporosis prevention in the general population may enhance interventions.
Topics: Adult; Humans; Bone Density; Nutrition Surveys; Obesity; Waist Circumference; Absorptiometry, Photon
PubMed: 37537589
DOI: 10.1186/s12902-023-01418-y -
Journal of Orthopaedic Surgery and... Jul 2023Physical activity (PA) is generally encouraged for the treatment of osteoporosis. However, epidemiological statistics on the level of physical activity required for bone...
BACKGROUND
Physical activity (PA) is generally encouraged for the treatment of osteoporosis. However, epidemiological statistics on the level of physical activity required for bone health are scarce. The purpose of this research was to analyze the association between PA and total spine bone mineral density (BMD) in postmenopausal women.
METHODS
The research study included postmenopausal women aged ≥ 50 from the National Health and Nutrition Examination Survey. The metabolic equivalent (MET), weekly frequency, and duration of each activity were used to calculate PA. Furthermore, the correlations between BMD and PA were investigated by multivariable weighted logistic regression.
RESULTS
Eventually, 1681 postmenopausal women were included, with a weighted mean age of 62.27 ± 8.18 years. This study found that performing ≥ 38MET-h/wk was linked to a lower risk of osteoporosis after controlling for several covariates. Furthermore, the subgroup analysis revealed that the connection between total spine BMD and moderate-to-vigorous PA was more obvious among postmenopausal women aged < 65 years or individuals with normal BMI (< 25 kg/m).
CONCLUSION
Physical activity ranging from moderate to vigorous was linked to higher total spine BMD in postmenopausal women.
Topics: Humans; Female; Middle Aged; Aged; Bone Density; Nutrition Surveys; Cross-Sectional Studies; Postmenopause; Absorptiometry, Photon; Osteoporosis; Exercise; Osteoporosis, Postmenopausal
PubMed: 37454096
DOI: 10.1186/s13018-023-03976-2 -
Revue Medicale de Liege Oct 2023We here describe the case of a post-menopausal woman presenting with a recent vertebral fracture and cortical osteopenia on bone dual energy X-ray absorptiometry. Based...
We here describe the case of a post-menopausal woman presenting with a recent vertebral fracture and cortical osteopenia on bone dual energy X-ray absorptiometry. Based on this case, we will discuss the definition and diagnosis of osteoporosis as well as the indications to treat, which go beyond the densitometric-based definition of osteoporosis. We will also address the osteoporosis screening recommendations, and the blood workup required before treatment initiation. The choice of the treatment, its duration and the non-pharmacological measures will be discussed in another article.
Topics: Female; Humans; Bone Density; Osteoporosis; Absorptiometry, Photon; Bone Diseases, Metabolic
PubMed: 37830325
DOI: No ID Found -
Nutrition in Clinical Practice :... Oct 2023Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due... (Review)
Review
Undernutrition is highly prevalent in children who are critically ill and is associated with increased morbidity and mortality, including a higher risk of infection due to transitory immunological disorders, inadequate wound healing, reduced gut function, longer dependency on mechanical ventilation, and longer hospital stays compared with eutrophic children who are critically ill. Nutrition care studies have proposed that early interventions targeting nutrition assessment can prevent or minimize the complications of undernutrition. Stress promotes an acute inflammatory response mediated by cytokines, resulting in increased basal metabolism and nitrogen excretion and leading to muscle loss and changes in body composition. Therefore, the inclusion of body composition assessment is important in the evaluation of these patients because, in addition to the nutrition aspect, body composition seems to predict clinical prognosis. Several techniques can be used to assess body composition, such as arm measurements, calf circumference, grip strength, bioelectrical impedance analysis, and imaging examinations, including computed tomography and dual-energy x-ray absorptiometry. This review of available evidence suggests that arm measurements seem to be well-established in assessing body composition in children who are critically ill, and that bioelectrical impedance analysis with phase angle, handgrip strength, calf circumference and ultrasound seem to be promising in this evaluation. However, further robust studies based on scientific evidence are necessary.
Topics: Humans; Child; Critical Illness; Hand Strength; Absorptiometry, Photon; Body Composition; Malnutrition
PubMed: 37721465
DOI: 10.1002/ncp.11061 -
Seminars in Musculoskeletal Radiology Feb 2024The importance and impact of imaging biomarkers has been increasing over the past few decades. We review the relevant clinical and imaging terminology needed to... (Review)
Review
The importance and impact of imaging biomarkers has been increasing over the past few decades. We review the relevant clinical and imaging terminology needed to understand the clinical and research applications of body composition. Imaging biomarkers of bone, muscle, and fat tissues obtained with dual-energy X-ray absorptiometry, computed tomography, magnetic resonance imaging, and ultrasonography are described.
Topics: Humans; Body Composition; Absorptiometry, Photon; Magnetic Resonance Imaging; Ultrasonography; Tomography, X-Ray Computed
PubMed: 38330972
DOI: 10.1055/s-0043-1776430 -
Nutrients Oct 2023Little is known about the inflammatory potential of diet and its relation to bone health. This cross-sectional study examined the association between the inflammatory... (Randomized Controlled Trial)
Randomized Controlled Trial
Little is known about the inflammatory potential of diet and its relation to bone health. This cross-sectional study examined the association between the inflammatory potential of diet and bone-related outcomes in midwestern, post-menopausal women enrolled in the Heartland Osteoporosis Prevention Study (HOPS) randomized controlled trial. Dietary intake from the HOPS cohort was used to calculate Dietary Inflammatory Index (DII) scores, which were energy-adjusted (E-DII) and analyzed by quartile. The association between E-DII and lumbar and hip bone mineral density (BMD) and lumbar trabecular bone scores (TBS; bone structure) was assessed using ANCOVA, with pairwise comparison to adjust for relevant confounders (age, education, race/ethnicity, smoking history, family history of osteoporosis/osteopenia, BMI, physical activity, and calcium intake). The cohort included 272 women, who were predominately white (89%), educated (78% with college degree or higher), with a mean BMI of 27 kg/m, age of 55 years, and E-DII score of -2.0 ± 1.9 (more anti-inflammatory). After adjustment, E-DII score was not significantly associated with lumbar spine BMD ( = 0.53), hip BMD ( = 0.29), or TBS at any lumbar location ( > 0.05). Future studies should examine the longitudinal impact of E-DII scores and bone health in larger, more diverse cohorts.
Topics: Humans; Female; Middle Aged; Cross-Sectional Studies; Postmenopause; Diet; Bone Density; Osteoporosis; Absorptiometry, Photon; Lumbar Vertebrae
PubMed: 37836561
DOI: 10.3390/nu15194277 -
Journal of Clinical Densitometry : the... 2023The Santa Fe Bone Symposium (SFBS) held its 23rd annual event on August 5-6, 2023, in Santa Fe, New Mexico, USA. Attendees participated in-person and remotely,... (Review)
Review
The Santa Fe Bone Symposium (SFBS) held its 23rd annual event on August 5-6, 2023, in Santa Fe, New Mexico, USA. Attendees participated in-person and remotely, representing many states and countries. The program included plenary presentations, panel discussions, satellite symposia, a Project ECHO workshop, and a session on healthcare policy and reimbursement for fracture liaison programs. A broad range of topics were addressed, including transitions of osteoporosis treatments over a lifetime; controversies in vitamin D; update on Official Positions of the International Society for Clinical Densitometry; spine surgery and bone health; clinical applications of bone turnover markers; basic bone biology for clinicians; premenopausal-, pregnancy-, and lactation-associated osteoporosis; cancer treatment induced bone loss in patients with breast cancer and prostate cancer; genetic testing for skeletal diseases; and an update on nutrition and bone health. There were also sessions on rare bone diseases, including managing patients with hypophosphatasia; treatment of X-linked hypophosphatemia; and assessment and treatment of patients with hypoparathyroidism. There were oral presentations of abstracts by endocrinology fellows selected from those who participated in the Santa Fe Fellows Workshop on Metabolic Bone Diseases, held the 2 days prior to the SFBS. These proceedings of the 2023 SFBS present the clinical highlights and insights generated from many formal and informal discussions in Santa Fe.
Topics: Male; Female; Humans; Absorptiometry, Photon; Osteoporosis; Fractures, Bone; Bone Diseases, Metabolic; Bone Density
PubMed: 37944445
DOI: 10.1016/j.jocd.2023.101432 -
Journal of Orthopaedic Surgery and... Aug 2023In the aging process of the body, in addition to changes in fat and muscle content, there is also bone loss, implying the possibility of a strong muscle-bone-lipid link....
INTRODUCTION
In the aging process of the body, in addition to changes in fat and muscle content, there is also bone loss, implying the possibility of a strong muscle-bone-lipid link. In this study, we initially investigated the relationship between lumbar BMD and low muscle mass and the relationship between "muscle-bone-lipid."
METHODS
The datasets from the National Health and Nutrition Examination Survey (NHANES) 2011-2018 were used in a cross-sectional investigation. BMD and appendicular skeletal muscle (ASM) were measured by dual-energy X-ray absorptiometry (DXA), and appendicular skeletal muscle was adjusted by body mass index (BMI) as a marker of sarcopenia. Weighted multivariate regression and logistic regression analysis were used to explore the independent relationship between lumbar BMD and sarcopenia. Fitted smoothing curves and threshold effect analysis were used to describe the nonlinear relationship.
RESULT
In 8386 participants with ages 20-59 years, there was a negative association between lumbar BMD and sarcopenia. In the fully adjusted model, the risk of developing sarcopenia decreased by 93% for each 1-unit increase in lumbar BMD (OR = 0.07, 95%CI 0.03-0.20). The risk of sarcopenia was 58% lower in participants in the highest quartile of lumbar BMD than in those in the lowest quartile (OR = 0.42, 95%CI 0.27-0.64). This negative association was more pronounced in the population of women with BMI ≥ 25.
CONCLUSION
Our findings suggest that lumbar BMD is negatively associated with sarcopenia in US adults. The dynamic balance between "muscle-bone-lipid" is likely to be related to the pathogenesis of bone loss.
Topics: Humans; Adult; Female; Bone Density; Sarcopenia; Nutrition Surveys; Cross-Sectional Studies; Absorptiometry, Photon; Bone Diseases, Metabolic; Lipids
PubMed: 37559054
DOI: 10.1186/s13018-023-04034-7 -
Biological Trace Element Research Sep 2023Several previous studies have found the deleterious effects of cadmium exposure on bone. However, studies on the effects of cadmium exposure on bone mineral density...
Several previous studies have found the deleterious effects of cadmium exposure on bone. However, studies on the effects of cadmium exposure on bone mineral density (BMD) in gender- and race-specific groups are still lacking. The aim of this study was to investigate the relationship between cadmium exposure and BMD in adults and the gender and racial differences therein. Weighted multivariate regression, generalized weighted model, and smoothed curve fitting were used to explore the relationship between lumbar BMD with blood cadmium (B-Cd) and urine cadmium (U-Cd) based on data from the National Health and Nutrition Examination Survey (NHANES). In addition, subgroup analyses were further used to investigate the differential associations across gender and race. Of the 4335 adult participants. After adjusting for primary demographic variables, B-Cd [- 0.018 (- 0.028, - 0.008)] and U-Cd [- 0.010 (- 0.020, - 0.001)] were shown to be negatively related to lumbar BMD. In the fully adjusted model, the negative association between B-Cd and lumbar BMD was maintained [- 0.010 (- 0.018, - 0.002)]. In the subgroup analysis stratified by gender and race, this relationship was retained in females and non-Hispanic blacks. Furthermore, these negative associations were most pronounced among non-Hispanic black women [B-Cd and lumbar BMD, - 0.046 (- 0.076, - 0.017); U-Cd and lumbar BMD, -0.034 (- 0.063, - 0.006)]. Our findings suggest that there are significant sex and race differences in the negative association between cadmium exposure and BMD. This negative association was most prominent in non-Hispanic black females.
Topics: Adult; Humans; Female; Bone Density; Cadmium; Nutrition Surveys; Absorptiometry, Photon; Sex Factors
PubMed: 36508128
DOI: 10.1007/s12011-022-03521-y