The Benefit of #Menopausal Hormone Therapy on #Bone Density and Microarchitecture Persists After its Withdrawal

http://press.endocrine.org/doi/abs/10.1210/jc.2016-2695

MHT is associated with bone microarchitecture preservation, as assessed by TBS. The effect of MHT on TBS and BMD persists at least 2 years after withdrawal.

#INSULIN RESISTANCE IS ASSOCIATED WITH SMALLER CORTICAL #BONE SIZE IN NON-DIABETIC MEN AT THE AGE OF PEAK BONE MASS

http://press.endocrine.org/doi/10.1210/jc.2016-3609

In this cohort of non-diabetic men at the age of peak bone mass, insulin resistance is inversely associated with trabecular and cortical bone size. These associations persist after adjustment for body composition, muscle size or function, or sex steroid levels, suggesting an independent effect of insulin resistance on bone geometry.

Low intensity pulsed #ultrasound for #bone healing: systematic review of randomized controlled trials

http://www.bmj.com/content/356/bmj.j656

Based on moderate to high quality evidence from studies in patients with fresh fracture, LIPUS does not improve outcomes important to patients and probably has no effect on radiographic bone healing. The applicability to other types of fracture or osteotomy is open to debate.

low intensity pulsed ultrasound (LIPUS) for healing of fracture or osteotomy

Management of #Aromatase Inhibitor-Associated #Bone Loss (AIBL) in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS, and SIOG
http://www.sciencedirect.com/science/article/pii/S2212137417300258

In all patients initiating AI treatment, fracture risk should be assessed and recommendation with regard to exercise and calcium/vitamin D supplementation given. Bone-directed therapy should be given to all patients with a T-score<−2.0 or with a T-score of <–1.5 SD with one additional RF, or with ≥2 risk factors (without BMD) for the duration of AI treatment. Patients with T-score>−1.5 SD and no risk factors should be managed based on BMD loss during the first year and the local guidelines for postmenopausal osteoporosis. Compliance should be regularly assessed as well as BMD on treatment after 12 - 24 months. Furthermore, because of the decreased incidence of bone recurrence and breast cancer specific mortality, adjuvant bisphosphonates are recommended for all postmenopausal women at significant risk of disease recurrence.

#Bone Turnover Markers After #Sleep Restriction and Circadian Disruption: A Mechanism for Sleep-Related Bone Loss in Humans
https://academic.oup.com/jcem/article-abstract/doi/10.1210/jc.2017-01147/4036362/Bone-Turnover-Markers-After-Sleep-Restriction-and

P1NP levels were lower post intervention compared to baseline (p< 0.001); the decrease in P1NP was greater for the younger compared to older men (28.0% vs 18.2%, p<0.001). The intervention resulted in no change in CTX (Δ = 0.03 ± 0.02 ng/mL, p = 0.10). Sclerostin levels were higher post-intervention in the younger men only (Δ = 22.9% or 5.64 ± 1.10 pmol/L, p < 0.001).

Conclusions
These data suggest that 3 weeks of circadian disruption with concurrent sleep restriction can lead to an uncoupling of bone turnover wherein bone formation is decreased but bone resorption is unchanged. Circadian disruption and sleep restriction may be most detrimental to bone in early adulthood. Sleep abnormalities are associated with low bone mineral density (BMD). Underlying mechanisms are unknown

Effect of Gastric #Bypass on #Bone Mineral Density, Parathyroid Hormone and Vitamin D: 5 Years Follow-up
https://link.springer.com/article/10.1007/s11695-016-2114-3

The aim of the present study was to see if there are longitudinal changes in bone mineral density (BMD), vitamin D or parathyroid hormone (PTH) in females 5 years after Laparoscopic Roux-en-Y Gastric Bypass (LRYGB) The mean decrease in BMI between baseline and 5 years after surgery was 29.4 %. BMD of the spine and femur measured as z- and t-scores, showed a linear, statistically significant declining trend over the years. The fall in BMD of the spine and femoral neck between baseline and 5 years after surgery was 19 and 25 %, respectively. The mean fP-PTH showed a significant increase over the study period (20.2 μg/L increase, 95 % CI:−31.99 to −8.41). S-calcium, both free and corrected for albumin, showed a decrease between baseline and 5 years after surgery.

Eight patients developed osteopenia and one osteoporosis after a 5-year follow-up.

Conclusion

LRYGB is an efficient method for sustained long-term body weight loss. There is, however, a concomitant decrease in BMD and S-calcium, and an increase in fP-PTH

Diagnosis, Evaluation, Prevention, and Treatment of Chronic #Kidney Disease–Mineral and #Bone Disorder: Synopsis of the Kidney Disease: Improving Global Outcomes 2017 Clinical Practice Guideline Update


http://annals.org/aim/fullarticle/2672941/diagnosis-evaluation-prevention-treatment-chronic-kidney-disease-mineral-bone-disorder


The update process resulted in the revision of 15 recommendations. This synopsis focuses primarily on recommendations for diagnosis of and testing for CKD–MBD and treatment of CKD–MBD that emphasizes decreasing phosphate levels, maintaining calcium levels, and addressing elevated parathyroid hormone levels in adults with CKD stage G3a to G5 and those receiving dialysis. Key elements include basing treatment on trends in laboratory values rather than a single abnormal result and being cautious to avoid hypercalcemia when treating secondary hyperparathyroidism

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Effects of 24 Months of Treatment With #Romosozumab Followed by 12 Months of #Denosumab or Placebo in Postmenopausal Women With Low #Bone Mineral Density: A Randomized, Double‐Blind, Phase 2, Parallel Group Study

https://onlinelibrary.wiley.com/doi/abs/10.1002/jbmr.3452?af=R


Romosozumab markedly increased LS and TH BMD through month 24, with largest gains observed with romosozumab 210 mg QM (LS = 15.1%; TH = 5.4%). Women receiving romosozumab who transitioned to denosumab continued to accrue BMD, whereas BMD returned toward pretreatment levels with placebo. With romosozumab 210 mg QM, bone formation marker P1NP initially increased after treatment initiation and gradually decreased to below baseline by month 12, remaining below baseline through month 24; bone resorption marker β‐CTX rapidly decreased after treatment, remaining below baseline through month 24. Transition to denosumab further decreased both BTMs, whereas after transition to placebo, P1NP returned to baseline and β‐CTX increased above baseline. Adverse events were balanced between treatment groups through month 36. These data suggest that treatment effects of romosozumab are reversible upon discontinuation and further augmented by denosumab

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ANP32A regulates ATM expression and prevents #oxidative stress in cartilage, brain, and #bone

http://stm.sciencemag.org/content/10/458/eaar8426

Osteoarthritis is the most common joint disorder with increasing global prevalence due to aging of the population.
Current therapy is limited to symptom relief, yet there is no cure. Its multifactorial etiology includes oxidative stress and overproduction of reactive oxygen species, but the regulation of these processes in the joint is insufficiently understood.

We report that ANP32A protects the cartilage against oxidative stress, preventing osteoarthritis development and disease progression. ANP32A is down-regulated in human and mouse osteoarthritic cartilage. Microarray profiling revealed that ANP32A protects the joint by promoting the expression of ATM, a key regulator of the cellular oxidative defense.

Antioxidant treatment reduced the severity of osteoarthritis, osteopenia, and cerebellar ataxia features in Anp32a-deficient mice, revealing that the ANP32A/ATM axis discovered in cartilage is also present in brain and bone. Our findings indicate that modulating ANP32A signaling could help manage oxidative stress in cartilage, brain, and bone with therapeutic implications for osteoarthritis, neurological disease, and osteoporosis.

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The Microbial Metabolite #Butyrate Stimulates #Bone Formation via T Regulatory Cell-Mediated Regulation of WNT10B Expression

https://www.cell.com/immunity/fulltext/S1074-7613(18)30478-3?_returnURL=https%3A%2F%2Flinkinghub.elsevier.com%2Fretrieve%2Fpii%2FS1074761318304783%3Fshowall%3Dtrue

Highlights
• Treatment with the probiotic Lactobacillus rhamnosus GG (LGG) increases bone mass in mice by stimulating the production of butyrate

•LGG or butyrate expands the pool of Treg cells in the gut and the bone marrow

•Treg cells upregulate the expression of osteogenic Wnt ligand Wnt10b by CD8+ T cell

•Wnt10b stimulates bone formation by activating Wnt signaling in osteoblasts

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Effect of High-Dose Vitamin #D Supplementation on Volumetric #Bone #Density and Bone Strength

https://jamanetwork.com/journals/jama/article-abstract/2748796

..At trial end, radial volumetric BMD was lower for the 4000 IU group (−3.9 mg HA/cm3 [95% CI, −6.5 to −1.3]) and 10 000 IU group (−7.5 mg HA/cm3 [95% CI, −10.1 to −5.0]) compared with the 400 IU group with mean percent change in volumetric BMD of −1.2% (400 IU group), −2.4% (4000 IU group), and −3.5% (10 000 IU group).

Among healthy adults, treatment with vitamin D for 3 years at a dose of 4000 IU per day or 10 000 IU per day, compared with 400 IU per day, resulted in statistically significant lower radial BMD; tibial BMD was significantly lower only with the 10 000 IU per day dose. There were no significant differences in bone strength at either the radius or tibia. These findings do not support a benefit of high-dose vitamin D supplementation for bone health; further research would be needed to determine whether it is harmful.

Association of Ambient and Household Air #Pollution With #Bone Mineral Content Among Adults in Peri-urban South India

..The annual mean (SD) PM2.5 exposure was 32.8 (2.5) μg/m3, and the annual mean (SD) BC exposure was 2.5 (0.2) μg/m3; 57.8% of participants used biomass cooking fuels. In fully adjusted models, PM2.5 was associated with lower BMC in the spine (mean difference, −0.57 g per 3 μg/m3 increase in PM2.5; 95% CI, −1.06 to −0.07 g per 3 μg/m3 increase in PM2.5) and hip (mean difference, −0.13 g per 3 μg/m3 increase in PM2.5; 95% CI, −0.3 to 0.03 g per 3 μg/m3 increase in PM2.5). After confounder adjustment, exposure to PM2.5 was also associated with lower bone mineral density in the spine (mean difference, −0.011 g/cm2 per 3 μg/m3 increase in PM2.5; 95% CI, −0.021 to 0 g/cm2 per 3 μg/m3 increase in PM2.5) and hip (mean difference, −0.004 g/cm2 per 3 μg/m3 increase in PM2.5; 95% CI, −0.008 to 0.001 g/cm2 per 3 μg/m3 increase in PM2.5). Exposure to BC was associated with lower BMC in the spine (mean difference, −1.13 g per 1 μg/m3 increase in BC; 95% CI, −2.81 to 0.54 g per 1 μg/m3 increase in BC) and hip (mean difference, −0.35 g per 1 μg/m3 increase in BC; 95% CI, −0.96 to 0.25 g per 1 μg/m3 increase in BC), although the confidence intervals were wider. There was no association between biomass fuel use and spine BMC (mean difference, 0.12 g; 95% CI, −0.45 to 0.68 g).

Conclusions and Relevance  In a cross-sectional analysis of a population-based cohort, ambient air pollution was associated with lower BMC in a young adult population in a peri-urban area of South India

https://bit.ly/2QSgw5H

Warmth Prevents #Bone Loss Through the Gut #Microbiota
https://2medical.news/2020/09/16/warmth-prevents-bone-loss-through-the-gut-microbiota/

Osteoporosis is the most prevalent metabolic bone disease, characterized by low bone mass and microarchitectural deterioration. Here, we show that warmth exposure (34°C) protects against ovariectomy-induced bone loss by increasing trabecular bone volume, connectivity density, and thickness, leading to improved biomechanical bone strength in adult female, as well as in young male mice. Transplantation of the warm-adapted microbiota phenocopies the warmth-induced bone effects. Both warmth …

#Bone mineral density and bone turnover ten years after a single 5mg dose or two 5-yearly lower doses of #zoledronate in osteopenic older women: an open-label extension of a randomized controlled trial

https://2medical.news/2021/10/06/bone-mineral-density-and-bone-turnover-ten-years-after-a-single-5mg-dose-or-two-5-yearly-lower-doses-of-zoledronate-in-osteopenic-older-women-an-open-label-extension-of-a-randomized-controlled-tria/

Age-related changes in #bone density, microarchitecture and strength in postmenopausal Black and White women: SWAN Longitudinal HR-pQCT Study

https://2medical.news/2021/10/21/age-related-changes-in-bone-density-microarchitecture-and-strength-in-postmenopausal-black-and-white-women-swan-longitudinal-hr-pqct-study/

A two-cohort study on the association between the gut #microbiota and #bone density, microarchitecture, and strength

https://2medical.news/2023/10/13/a-two-cohort-study-on-the-association-between-the-gut-microbiota-and-bone-density-microarchitecture-and-strength/