Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic ret...Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic retrieval of CNKI,Wangfang Data,VIP,CBM,PubMed,Embase,Cochrane Library and other databases was conducted to include the clinical randomized controlled trial(RCT)of TCM compound as intervention measures for the treatment of senile osteoporosis as the study object.The retrieval time was set up until October 2019.The two researchers independently screened the literature according to inclusion criteria,extracted the data,and evaluated the quality of the included studies using Cochrane 5.1.0 bias risk assessment tool,and then used RevMan5.3 software for data analysis.Results:a total of 19 RCT literatures were included in the experimental group.In the control group,844 patients were treated with calcium or non-calcium.Meta analysis showed that total effective rate(RR=1.30,95%ci:1.19-1.43,P<0.05),lumbar vertebral bone density(MD=0.02,95%ci:0.01-0.04,P<0.05),femoral neck bone density(MD=0.01,95%ci:0.00~0.02,P<0.05),VAS score(MD=-1.04,95%ci:-1.67~0.40,P<0.05),BMC value(MD=0.06,95%ci:0.01~0.11,P=0.03),radial bone density(MD=0.04,95%ci:0.03~0.05,P<0.05),TCM syndrome score(MD=-6.76,95%ci:-7.94^-5.59,P<0.05),and TCM syndrome efficacy rate(RR=1.49,95%ci:1.28~1.73,P<0.05)were all statistically significant.ALP(MD=4.72,95%ci:-6~15.44,P=0.39),estradiol(MD=10.45,95%ci:-1.75~22.64,P=0.09),root bone index(MD=0.01,95%ci:-0.17~0.18,P=0.95),other bone mineral density(MD=0.11,95%ci:-0.01~0.22,P=0.06),urinary calcium/urinary creatinine(MD=-0.09,95%ci:There was no significant difference in serum calcium(MD=-0.01,95%ci:-0.11~0.09,P=0.83),serum phosphorus(MD=0.03,95%ci:-0.01~0.07,P=0.09).Among the Chinese herbal compounds used,astragalus is the most frequently used tonic.Conclusion:traditional Chinese medicine compound is effective in treating senile osteoporosis,and it is mainly used as tonic.展开更多
Osteoporosis is a serious public bone metabolic disease. However, the mechanisms underlying bone loss combined with ageing,which is known as senile osteoporosis, remains unknown. Here we show the detailed phenotype of...Osteoporosis is a serious public bone metabolic disease. However, the mechanisms underlying bone loss combined with ageing,which is known as senile osteoporosis, remains unknown. Here we show the detailed phenotype of this disease caused by SIRT6 knock out(KO) in mice. To the best of our knowledge, this is the first study to reveal that SIRT6 is expressed in both bone marrow stroma cells and bone-related cells in both mouse and human models, which suggests that SIRT6 is an important regulator in bone metabolism. SIRT6-KO mice exhibit a significant decrease in body weight and remarkable dwarfism. The skeleton of the SIRT6-KO mouse is deficient in cartilage and mineralized bone tissue. Moreover, the osteocalcin concentration in blood is lower, which suggests that bone mass is markedly lost. Besides, the tartrate-resistant acid phosphatase 5b(TRAP5b)concentration is much higher, which suggests that bone resorption is overactive. Both trabecular and cortical bones exhibit severe osteopenia, and the bone mineral density is decreased. Moreover, double-labelling analysis shows that bone formation is much slower. To determine whether SIRT6 directly regulates bone metabolism, we cultured primary bone marrow stromal cells for osteogenesis and osteoclastogenesis separately to avoid indirect interference in vivo responses such as inflammation. Taken together, these results show that SIRT6 can directly regulate osteoblast proliferation and differentiation, resulting in attenuation in mineralization. Furthermore, SIRT6 can directly regulate osteoclast differentiation and results in a higher number of small osteoclasts, which may be related to overactive bone resorption.展开更多
The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorat...The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.展开更多
Background:Hai Honghua medicinal liquor(HHML)formula has been used in clinical practice for a long time,mainly for the treatment of freshly closed fractures,to promote osteogenesis,to increase bone mass,and thus to pr...Background:Hai Honghua medicinal liquor(HHML)formula has been used in clinical practice for a long time,mainly for the treatment of freshly closed fractures,to promote osteogenesis,to increase bone mass,and thus to promote fracture healing.However,the underlying mechanisms of HHML in the treatment of osteoporosis(OP)are still unclear.Methods:Firstly,Traditional Chinese Medicines Systems Pharmacology Database and Analysis Platform and The Encyclopedia of Traditional Chinese Medicine were used to screen the targets of the active compounds of HHML.At the same time,OP targets were identified through GeneCards,Online Mendelian Inheritance in Man,DisGeNET,Therapeutic Target Database,Comparative Toxicogenomics Database and Human Phenotype Ontology databases.Next,protein-protein interaction and pathway networks were constructed for compound-disease common targets,and core targets and compounds were screened for molecular docking.Furthermore,rat bone marrow mesenchymal stem cells were extracted as model cells,and the osteogenic effects of HHML were verified via in vitro experiments.Results:Total of 343 common targets of HHML-OP and the top 10 target proteins in the protein-protein interaction network are TP53,AKT1,STAT3,HSP90AA1,ESR1,TNF,IL6,MAPK1,MAPK3 and MAPK8.Enrichment analysis yielded that the key molecular pathway was the PI3K/Akt signaling pathway.Molecular docking analysis showed that baicalein,erysodienone and naringenin docked with the target proteins AKT1,STAT3 and TP53,respectively,with low binding energy and high affinity.In addition,In vitro experiments demonstrated that HHML promoted the proliferation of bone marrow mesenchymal stem cells;compared with the control group,HHML-treated cells showed enhanced alkaline phosphatase staining,promoted the expression of OCN,RUNX2,BSP,and COL1 mRNAs as well as the expression of PI3K and AKT phosphorylated proteins.Secondly,the expression of target proteins revealed that HHML promoted the phosphorylation of STAT3 protein and inhibited the expression of P53.Conclusions:Our study investigated that HHML treatment with OP promotes bone formation possibly through activation of the PI3K/Akt signaling pathway and may involve STAT3 and TP53 target interactions.展开更多
OBJECTIVE:The aim of this study was to evaluate the effectiveness of Chinese herbal medicines for invigorating the kidney(CHMIK)on senile osteoporosis.METHODS:We searched for studies in English-language databases(Pub ...OBJECTIVE:The aim of this study was to evaluate the effectiveness of Chinese herbal medicines for invigorating the kidney(CHMIK)on senile osteoporosis.METHODS:We searched for studies in English-language databases(Pub Med,the Cochrane Library,and Web of Science)and Chinese-language databases(China National Knowledge Infrastructure,Wan Fang Data,VIP Chinese periodical service platform),and China Biology Medicine disc from their inception to September 2017.Randomized controlled trials comparing the effectiveness of Traditional Chinese Medicine therapies(alone or in combination)and conventional clinical medicine therapies among older adult patients with osteoporosis were identified.We conducted a network Meta-analysis with a Bayesian hierarchical random-effects model using RStudio software,Version 3.4.1.RESULTS:Forty-three randomized controlled trials assessing the differences between Traditional Chinese Medicine and conventional clinical medicine were identified,including 15 treatments and involving 3316 patients.The results of the network Meta-analysis indicated that alendronate(odds ratio[OR]=0.20,95%confidence interval[CI]:0.047-0.73)and calcium(OR=0.18,95%CI:0.11-0.30)are significantly more effective if combined with oral CHMIK.CHMIK alone is significantly more effective than both alendronate(OR=0.34,95%CI:0.10-1.0)and calcium(OR=0.13,95%CI:0.056-0.28).Moreover,CHMIK+tuina+calcium is more effective than CHMIK+calcium+vitamin D+alendronate(OR=18.0,95%CI:1.1-2.7 e+02).CONCLUSION:The present network Meta-analysis found that alendronate and calcium are more effective if combined with oral CHMIK and that oral CHMIK alone may be more effective than alendronate or calcium.Tuina may have an advantage over oral medicines.Oral CHMIK and calcitonin show the most potential for treating senile osteoporosis.展开更多
The gut microbiota(GM)plays a crucial role in maintaining the overall health and well-being of the host.Recent studies have demonstrated that the GM may significantly influence bone metabolism and degenerative skeleta...The gut microbiota(GM)plays a crucial role in maintaining the overall health and well-being of the host.Recent studies have demonstrated that the GM may significantly influence bone metabolism and degenerative skeletal diseases,such as osteoporosis(OP).Interventions targeting GM modification,including probiotics or antibiotics,have been found to affect bone remodeling.This review provides a comprehensive summary of recent research on the role of GM in regulating bone remodeling and seeks to elucidate the regulatory mechanism from various perspectives,such as the interaction with the immune system,interplay with estrogen or parathyroid hormone(PTH),the impact of GM metabolites,and the effect of extracellular vesicles(EVs).Moreover,this review explores the potential of probiotics as a therapeutic approach for OP.The insights presented may contribute to the development of innovative GM-targeted therapies for OP.展开更多
As the major cell precursors in osteogenesis, mesenchymal stem cells(MSCs) are indispensable for bone homeostasis and development. However, the primary mechanisms regulating osteogenic differentiation are controversia...As the major cell precursors in osteogenesis, mesenchymal stem cells(MSCs) are indispensable for bone homeostasis and development. However, the primary mechanisms regulating osteogenic differentiation are controversial. Composed of multiple constituent enhancers, super enhancers(SEs) are powerful cis-regulatory elements that identify genes that ensure sequential differentiation. The present study demonstrated that SEs were indispensable for MSC osteogenesis and involved in osteoporosis development. Through integrated analysis, we identified the most common SE-targeted and osteoporosis-related osteogenic gene,ZBTB16. ZBTB16, positively regulated by SEs, promoted MSC osteogenesis but was expressed at lower levels in osteoporosis.Mechanistically, SEs recruited bromodomain containing 4(BRD4) at the site of ZBTB16, which then bound to RNA polymerase IIassociated protein 2(RPAP2) that transported RNA polymerase Ⅱ(POL Ⅱ) into the nucleus. The subsequent synergistic regulation of POL Ⅱ carboxyterminal domain(CTD) phosphorylation by BRD4 and RPAP2 initiated ZBTB16 transcriptional elongation, which facilitated MSC osteogenesis via the key osteogenic transcription factor SP7. Bone-targeting ZBTB16 overexpression had a therapeutic effect on the decreased bone density and remodeling capacity of Brd4^(fl/fl)Prx1-cre mice and osteoporosis(OP) models.Therefore, our study shows that SEs orchestrate the osteogenesis of MSCs by targeting ZBTB16 expression, which provides an attractive focus and therapeutic target for osteoporosis.展开更多
Despite the diverse roles of tripartite motif(Trim)-containing proteins in the regulation of autophagy,the innate immune response,and cell differentiation,their roles in skeletal diseases are largely unknown.We recent...Despite the diverse roles of tripartite motif(Trim)-containing proteins in the regulation of autophagy,the innate immune response,and cell differentiation,their roles in skeletal diseases are largely unknown.We recently demonstrated that Trim21 plays a crucial role in regulating osteoblast(OB)differentiation in osteosarcoma.However,how Trim21 contributes to skeletal degenerative disorders,including osteoporosis,remains unknown.First,human and mouse bone specimens were evaluated,and the results showed that Trim21 expression was significantly elevated in bone tissues obtained from osteoporosis patients.Next,we found that global knockout of the Trim21 gene(KO,Trim2^(1-/-))resulted in higher bone mass compared to that of the control littermates.We further demonstrated that loss of Trim21 promoted bone formation by enhancing the osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)and elevating the activity of OBs;moreover,Trim21 depletion suppressed osteoclast(OC)formation of RAW264.7 cells.In addition,the differentiation of OCs from bone marrow-derived macrophages(BMMs)isolated from Trim21^(-/-)and Ctsk-cre;Trim21^(f/f)mice was largely compromised compared to that of the littermate control mice.Mechanistically,YAP1/β-catenin signaling was identified and demonstrated to be required for the Trim21-mediated osteogenic differentiation of BMSCs.More importantly,the loss of Trim21 prevented ovariectomy(OVX)-and lipopolysaccharide(LPS)-induced bone loss in vivo by orchestrating the coupling of OBs and OCs through YAP1 signaling.Our current study demonstrated that Trim21 is crucial for regulating OB-mediated bone formation and OC-mediated bone resorption,thereby providing a basis for exploring Trim21 as a novel dual-targeting approach for treating osteoporosis and pathological bone loss.展开更多
Postmenopausal osteoporosis and osteopenia are chronic and uncurable conditions that invariably lead to an increased risk of vertebral, hip, and femoral neck fracture if left untreated. Clinical guidelines establish, ...Postmenopausal osteoporosis and osteopenia are chronic and uncurable conditions that invariably lead to an increased risk of vertebral, hip, and femoral neck fracture if left untreated. Clinical guidelines establish, in general, pharmacological combinations allied to lifestyle changes as the mainstay of their management, and also increasing bone marrow density, lowering fracture risk, and improving quality of life are their main therapeutic goals. The objective of this systematic review was to analyze the available data in the scientific medical literature regarding the role of the ibandronate and cholecalciferol combination in postmenopausal osteoporosis and osteopenia management. Based on our results, we concluded that the above combination is safe and feasible for the clinical control of both conditions.展开更多
Background: Osteoporosis (OP) is a common clinical manifestation of multiple myeloma (MM). The aim of this study was to investigate the possible molecular pathways and shared genes in the co-occurrence of OP and MM. M...Background: Osteoporosis (OP) is a common clinical manifestation of multiple myeloma (MM). The aim of this study was to investigate the possible molecular pathways and shared genes in the co-occurrence of OP and MM. Methods: The Gene Expression Omnibus database was used to retrieve gene expression information. Use WGCNA and differential analysis to screen out Hub genes. The GENEMANIA was used to build protein-protein interaction (PPI) networks. Enrichment analyses were performed to explore the functions. Validation datasets were selected to verify the diagnostic marker reliability of PLAGL1. The immune microenvironment of diseases was analyzed by immune infiltration analyses. Results: We confirmed a hub gene called PLAGL1, which is significantly under-expressed in both OP and MM. We found hub genes were associated with glucose and energy metabolism. Subsequently, the reliability of PLAGL1 for diagnosing OP and MM was verified using ROC curves, with all areas under the curve > 0.75. Moreover, PLAGL1 regulates t lymphocytes and may participate in the occurrence of OP in MM through immune pathways. Conclusions: PLAGL1 is a hub gene for the co-occurrence of OP and MM. It can regulate T-lymphocyte involvement in disease development. PLAGL1 may be a novel diagnostic marker for the co-occurrence of OP and MM.展开更多
Osteoporosis is one of the common orthopaedic diseases,characterised by increased bone fragility due to reduced bone mass and microstructural degeneration,posing a great threat to patients’quality of life and safety....Osteoporosis is one of the common orthopaedic diseases,characterised by increased bone fragility due to reduced bone mass and microstructural degeneration,posing a great threat to patients’quality of life and safety.In recent years,Chinese medicine(natural)has had a unique advantage in the treatment of osteoporosis and has shown good efficacy.Autophagy is an inherent cellular survival mechanism for the removal and recycling of damaged proteins and organelles and plays an important role in maintaining the stability of the intracellular environment and organ function.Therefore,this article aims to provide a comprehensive review of these Chinese medicines(natural)for the treatment of osteoporosis through autophagy.They have been intensively studied and reported to have effects such as promoting osteogenesis and anti-bone resorption.The Chinese medicines include plants such as Cistanche deserticola,Epimedium,Curculigo orchioides Gaertn,Achyranthes bidentata Blume,Leonurus japonicus Houtt,Ginseng,Chuanxiong Rhizome,Eucommia ulmoides,Morindae Officinalis Radix,Curcuma longa,Polygoni Cuspidati Rhizoma et Radix,Anemarrhena asphodeloides Bunge,Salvia miltiorrhiza Bge and Pueraria Lobata,thus providing evidence for the use of alternative herbal therapies for the effective treatment of osteoporosis.展开更多
Objective: To investigate the correlation between lower extremity vascular sclerosis and osteoporosis in elderly men with type 2 diabetes mellitus. Methods: A total of 359 elderly male patients with type II diabetes h...Objective: To investigate the correlation between lower extremity vascular sclerosis and osteoporosis in elderly men with type 2 diabetes mellitus. Methods: A total of 359 elderly male patients with type II diabetes hospitalized in the First Affiliated Hospital of Chongqing Medical University from January 2018 to June 2023 were retrospectively collected. According to the BMD (Bone Density Value), the patients were categorized into osteoporotic (T ≤ -2.5, n = 248) and non-osteoporotic groups (T > -2.5, n = 111). T test and Chi-square test were used to evaluate the differences in clinical data, biochemical markers and ABI between two groups. Multivariate logistic regression was used to analyze the risk factors of osteoporosis in elderly men with type 2 diabetes mellitus. Results: Compared with the non-osteoporotic group, the differences in diabetes course, systolic blood pressure, ABI, BMI, uric acid, triglyceride, and HDL in the osteoporotic group were statistically significant (P < 0.05). Logistic multivariate regression analysis showed that lower extremity vascular sclerosis was an independent risk factor for osteoporosis in elderly men with type 2 diabetes mellitus (P Conclusion: Atherosclerosis of the lower extremities in elderly men with T2DM is closely related to osteoporosis, and can lead to a decrease in bone mass, and an increase in osteoporosis.展开更多
BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in Chi...BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in China and the Asia-Pacific region is lack.AIM To assess the prevalence and clinical characteristics of osteoporosis in Chinese patients with PBC.METHODS This retrospective analysis included consecutive patients with PBC from a tertiary care center in China who underwent bone mineral density(BMD)assessment using dual-energy X-ray absorptiometry between January 2013 and December 2021.We defined subjects with T-scores≤-2.5 in any sites(L1 to L4,femoral neck,or total hip)as having osteoporosis.Demographic,serological,clinical,and histological data were collected.Independent risk factors for osteoporosis were identified by multivariate logistic regression analysis.RESULTS A total of 268 patients with PBC[236 women(88.1%);mean age,56.7±10.6 years;163 liver biopsies(60.8%)]were included.The overall prevalence of osteoporosis in patients with PBC was 45.5%(122/268),with the prevalence of osteoporosis in women and men being 47.0%and 34.4%,respectively.The prevalence of osteoporosis in postmenopausal women was significantly higher than that in premenopausal women(56.3%vs 21.0%,P<0.001).Osteoporosis in patients with PBC is associated with age,fatigue,menopausal status,previous steroid therapy,body mass index(BMI),splenomegaly,gastroesophageal varices,ascites,Mayo risk score,histological stage,alanine aminotransferase,albumin,bilirubin,platelet and prothrombin activity.Multivariate regression analysis identified that older age,lower BMI,previous steroid therapy,higher Mayo risk score,and advanced histological stage as the main independent risk factors for osteoporosis in PBC.CONCLUSION Osteoporosis is very common in Chinese patients with PBC,allowing for prior screening of BMD in those PBC patients with older age,lower BMI,previous steroid therapy and advanced liver disease.展开更多
Osteoporosis is a systemic bone disease,which leads to decreased bone mass and an increased risk of fragility fractures.Currently,there are many anti-resorption drugs and osteosynthesis drugs,which are effective in th...Osteoporosis is a systemic bone disease,which leads to decreased bone mass and an increased risk of fragility fractures.Currently,there are many anti-resorption drugs and osteosynthesis drugs,which are effective in the treatment of osteoporosis,but their usage is limited due to their contraindications and side effects.In regenerative medicine,the unique repair ability of mesenchymal stem cells(MSCs)has been favored by researchers.The exosomes secreted by MSCs have signal transduction and molecular delivery mechanisms,which may have therapeutic effects.In this review,we describe the regulatory effects of MSCs-derived exosomes on osteoclasts,osteoblasts,and bone immunity.We aim to summarize the preclinical studies of exosome therapy in osteoporosis.Furth-ermore,we speculate that exosome therapy can be a future direction to improve bone health.展开更多
BACKGROUND This case report presents a patient with pyogenic spondylitis(PS)associated with lactation-related osteoporosis during pregnancy.The 34-year-old female patient experienced low back pain for one month,beginn...BACKGROUND This case report presents a patient with pyogenic spondylitis(PS)associated with lactation-related osteoporosis during pregnancy.The 34-year-old female patient experienced low back pain for one month,beginning one month postpartum,with no history of trauma or fever.Dual-energy X-ray absorptiometry of the lumbar spine revealed a Z-score of-2.45,leading to a diagnosis of pregnancy and lactation-associated osteoporosis(PLO).The patient was advised to cease breastfeeding and take oral calcium and active vitamin D.Despite these interventions,her symptoms worsened,and she had difficulty walking one week later,prompting her to revisit our hospital.CASE SUMMARY Lumbar magnetic resonance imaging(MRI)scans showed abnormal signals in the L4 and L5 vertebral bodies and intervertebral space,while an enhancement scan displayed abnormal enhanced high signals around the L4/5 intervertebral disc,suggesting a lumbar infection.A needle biopsy was performed for bacterial culture and pathological examination,culminating in a final diagnosis of pregnancy and lactation-related osteoporosis with PS.Following treatment with antiosteoporotic medications and antibiotics,the patient’s pain gradually subsided,and she returned to normal life within five months.PLO is a rare condition that has garnered increasing attention in recent years.Spinal infections during lactation in pregnancy are also relatively uncommon.CONCLUSION Both conditions primarily manifest as low back pain but require distinct treatments.In clinical practice,when diagnosing patients with pregnancy and lactation-associated osteoporosis,the possibility of spinal infection should be considered.A lumbar MRI should be conducted as needed to prevent delays in diagnosis and treatment.展开更多
Objective:To identify the level of knowledge,attitude,and practice(KAP)toward osteoporosis among Jordanian nurses.Methods:A cross-sectional design was adopted in this study.A convenience sample of 443 Jordanian nurses...Objective:To identify the level of knowledge,attitude,and practice(KAP)toward osteoporosis among Jordanian nurses.Methods:A cross-sectional design was adopted in this study.A convenience sample of 443 Jordanian nurses were recruited from the public and private healthcare settings in Jordan.The assessment tool used in the current study contained 35 items,measuring KAP among Jordanian nurses toward osteoporosis.The correlation Pearson test and regression test were used to analyze data using Statistical Package for Social Sciences,version 21.Results:The total KAP scores were 33.53,37.65,and 22.7,respectively.These results revealed that Jordanian nurses have a moderate level of KAP toward osteoporosis.Conclusions:Jordanian nurses showed a moderate KAP toward osteoporosis,which should be improved as an effective step to reducing the growing incidences of osteoporosis.The lack of KAP holds a serious and growing impact on the Jordanian health sector and patients’health in terms of cost,healthcare resources,and social life.Nurses can play a valuable role in educating patients on bone fracture causes,perceived percentage,risks,and prevention,as well as in helping them with nutrition and lifestyle recommendations.展开更多
The gut microbiota is closely associated with osteoporosis,but its specific mechanisms of action have not been fully elucidated.Short-chain fatty acids(SCFAs),produced by the fermentation of complex carbohydrates,are ...The gut microbiota is closely associated with osteoporosis,but its specific mechanisms of action have not been fully elucidated.Short-chain fatty acids(SCFAs),produced by the fermentation of complex carbohydrates,are key regulatory metabolites produced by the gut microbiota and play an important role in the regulation of various systems by the gut microbiota.In recent years,SCFAs have been found to be a key link between the gut microbiota and bone.SCFAs can affect bone metabolism by affecting the integrity of the intestinal mucosal barrier,regulating G protein-coupled receptors and inhibiting histone deacetylase activity etc.SCFAs are currently the focus of research,but the mechanisms of interaction between SCFAs and osteoporosis in China are less reported.This paper reviews the role of gut microbiota and its metabolites,SCFAs,as well as the research progress of SCFAs affecting osteoporosis,with the aim of providing innovative therapeutic opportunities for bone metabolic diseases.展开更多
Background:miRNAs are closely related to bone metabolism.Studies have shown that Erxian decoction can improve bone metabolism,possibly achieving this regulatory effect through miRNA targets.Netinfer was used to predic...Background:miRNAs are closely related to bone metabolism.Studies have shown that Erxian decoction can improve bone metabolism,possibly achieving this regulatory effect through miRNA targets.Netinfer was used to predict the miRNA targets of Erxian decoction for the treatment of postmenopausal osteoporosis,and the results were validated by clinical trials.Methods:In this study,we identified possible targets of Erxian decoction in osteoporosis by means of network pharmacological analysis and bioinformatic prediction.Fifteen cases of postmenopausal osteoporosis with kidney Yin and Yang deficiency(In traditional Chinese medicine,kidney Yin nourishes and moistens the tissues of the internal organs of the body,while kidney Yang promotes and warms the tissues of the internal organs of the body.)were treated with Erxian decoction for four weeks,and serum bone metabolism indices(P1NP,osteocalcin,andβ-CTX)and miRNA-335-5p expression were measured before and after treatment.Results:The constructed miRNA postmenopausal osteoporosis related gene network of the effective compound of the Erxian decoction has 296 points and 981 edges.The 39 postmenopausal osteoporosis related genes regulated by miRNA-335-5p were enriched in ossification,while the signaling pathways were enriched in rheumatoid arthritis,the Toll signaling pathway,the HIF-1 signaling pathway,and the MAPK signaling pathway.After taking Erxian decoction,the expression of the serum bone formation index(P1NP,osteocalcin)and miRNA-335-5p gene expression levels increased significantly.The alterations in P1NP and osteocalcin were correlated with the changes in miRNA-335-5p.Conclusion:Circulating miRNA-335-5p may serve as an important target of Erxian decoction in the treatment of postmenopausal women.The effect of Erxian decoction on bone formation is significant,but the underlying mechanism requires further investigation.展开更多
Osteoporosis is a common bone disease in women worldwide, leading to decreased bone density and an accelerated risk of fractures. The causes of osteoporosis in women include age (senile osteoporosis), menopause-associ...Osteoporosis is a common bone disease in women worldwide, leading to decreased bone density and an accelerated risk of fractures. The causes of osteoporosis in women include age (senile osteoporosis), menopause-associated hormonal changes, deficiencies in calcium and vitamin D, genetics, lifestyle factors, medical conditions, and some type of medications. The consequences of osteoporosis are colossal, consisting of fractures, decreased quality of life, psychological impacts, and economic burden. To effectively control the menace of osteoporosis in women, numerous strategies are advocated. Adequate calcium and vitamin D consumption through diet or supplements is vital. Regular weight-bearing activities and strength training that promote bone density. Maintaining a healthy life-style through avoiding smoking, limiting alcohol in-take and maintaining a wholesome body weight is essential. Hormone replacement therapy and some medications may be recommended in certain cases. Early detection through regular bone density and blood tests is crucial to lowering its impact. Creating a supportive network through educational programs and resources fosters awareness and empowerment. By engaging these strategies, women can be empowered to combat osteoporosis, reduce fracture risk, and build stronger bones for their overall well-being.展开更多
基金National key research and development plan (2018YFC1704703)
文摘Objective:Tsystematic evaluation and Meta analysis were used to evaluate the effectiveness of TCM compound in the treatment of senile osteoporosis and to analyze the regularity of its medication.Methods:Electronic retrieval of CNKI,Wangfang Data,VIP,CBM,PubMed,Embase,Cochrane Library and other databases was conducted to include the clinical randomized controlled trial(RCT)of TCM compound as intervention measures for the treatment of senile osteoporosis as the study object.The retrieval time was set up until October 2019.The two researchers independently screened the literature according to inclusion criteria,extracted the data,and evaluated the quality of the included studies using Cochrane 5.1.0 bias risk assessment tool,and then used RevMan5.3 software for data analysis.Results:a total of 19 RCT literatures were included in the experimental group.In the control group,844 patients were treated with calcium or non-calcium.Meta analysis showed that total effective rate(RR=1.30,95%ci:1.19-1.43,P<0.05),lumbar vertebral bone density(MD=0.02,95%ci:0.01-0.04,P<0.05),femoral neck bone density(MD=0.01,95%ci:0.00~0.02,P<0.05),VAS score(MD=-1.04,95%ci:-1.67~0.40,P<0.05),BMC value(MD=0.06,95%ci:0.01~0.11,P=0.03),radial bone density(MD=0.04,95%ci:0.03~0.05,P<0.05),TCM syndrome score(MD=-6.76,95%ci:-7.94^-5.59,P<0.05),and TCM syndrome efficacy rate(RR=1.49,95%ci:1.28~1.73,P<0.05)were all statistically significant.ALP(MD=4.72,95%ci:-6~15.44,P=0.39),estradiol(MD=10.45,95%ci:-1.75~22.64,P=0.09),root bone index(MD=0.01,95%ci:-0.17~0.18,P=0.95),other bone mineral density(MD=0.11,95%ci:-0.01~0.22,P=0.06),urinary calcium/urinary creatinine(MD=-0.09,95%ci:There was no significant difference in serum calcium(MD=-0.01,95%ci:-0.11~0.09,P=0.83),serum phosphorus(MD=0.03,95%ci:-0.01~0.07,P=0.09).Among the Chinese herbal compounds used,astragalus is the most frequently used tonic.Conclusion:traditional Chinese medicine compound is effective in treating senile osteoporosis,and it is mainly used as tonic.
基金supported by NSFC grants 81371136 and JCPT2011-9 (Xue-Dong Zhou),NSFC grants 81470711 and 81200760 (Li-Wei Zheng)Ling Ye (Professor, Sate Key Laboratory of Oral Diseases, West China Hospital of Stomatology, Sichuan University) for financial aid
文摘Osteoporosis is a serious public bone metabolic disease. However, the mechanisms underlying bone loss combined with ageing,which is known as senile osteoporosis, remains unknown. Here we show the detailed phenotype of this disease caused by SIRT6 knock out(KO) in mice. To the best of our knowledge, this is the first study to reveal that SIRT6 is expressed in both bone marrow stroma cells and bone-related cells in both mouse and human models, which suggests that SIRT6 is an important regulator in bone metabolism. SIRT6-KO mice exhibit a significant decrease in body weight and remarkable dwarfism. The skeleton of the SIRT6-KO mouse is deficient in cartilage and mineralized bone tissue. Moreover, the osteocalcin concentration in blood is lower, which suggests that bone mass is markedly lost. Besides, the tartrate-resistant acid phosphatase 5b(TRAP5b)concentration is much higher, which suggests that bone resorption is overactive. Both trabecular and cortical bones exhibit severe osteopenia, and the bone mineral density is decreased. Moreover, double-labelling analysis shows that bone formation is much slower. To determine whether SIRT6 directly regulates bone metabolism, we cultured primary bone marrow stromal cells for osteogenesis and osteoclastogenesis separately to avoid indirect interference in vivo responses such as inflammation. Taken together, these results show that SIRT6 can directly regulate osteoblast proliferation and differentiation, resulting in attenuation in mineralization. Furthermore, SIRT6 can directly regulate osteoclast differentiation and results in a higher number of small osteoclasts, which may be related to overactive bone resorption.
基金supported by the National Natural Science Foundation of China (32072191)Daxing District Major Scientific and Technological Achievements Transformation Project (2020006)+1 种基金Beijing Innovation Team Project of Livestock Industry Technology SystemBeijing Science and Technology Special Project (Z201100002620005)。
文摘The aging of the global population has made postmenopausal osteoporosis prevention essential;however,pharmacological treatments are limited.Herein,we evaluate the effect of calcium-fortified fresh milk(FM)in ameliorating postmenopausal osteoporosis in a rat model established using bilateral ovariectomy.After 3 months of FM(containing vitamin D,and casein phosphopeptides,1000 mg Ca/100 g)or control milk(110 mg Ca/100 g milk)supplementation,bone changes were assessed using dual-energy X-ray absorptiometry,microcomputed tomography,and bone biomechanical testing.The results revealed that FM can regulate bone metabolism and gut microbiota composition,which act on bone metabolism through pathways associated with steroid hormone biosynthesis,relaxin signaling,serotonergic synapse,and unsaturated fatty acid biosynthesis.Furthermore,FM administration significantly increased bone mineral content and density in the lumbar spine and femur,as well as femoral compressive strength,while improving femoral trabecular bone parameters and microarchitecture.Mechanistically,we found that the effects may be due to increased levels of estrogen,bone formation marker osteocalcin,and procollagen typeⅠN-propeptide,and decreased expression of the bone resorption marker C-telopiptide and tartrate-resistant acid phosphatase 5b.Overall,the findings suggest that FM is a potential alternative therapeutic option for ameliorating postmenopausal osteoporosis.
基金supported by the Project of State Administration of Traditional Chinese Medicine of Sichuan Province of China (No.2021MS407).
文摘Background:Hai Honghua medicinal liquor(HHML)formula has been used in clinical practice for a long time,mainly for the treatment of freshly closed fractures,to promote osteogenesis,to increase bone mass,and thus to promote fracture healing.However,the underlying mechanisms of HHML in the treatment of osteoporosis(OP)are still unclear.Methods:Firstly,Traditional Chinese Medicines Systems Pharmacology Database and Analysis Platform and The Encyclopedia of Traditional Chinese Medicine were used to screen the targets of the active compounds of HHML.At the same time,OP targets were identified through GeneCards,Online Mendelian Inheritance in Man,DisGeNET,Therapeutic Target Database,Comparative Toxicogenomics Database and Human Phenotype Ontology databases.Next,protein-protein interaction and pathway networks were constructed for compound-disease common targets,and core targets and compounds were screened for molecular docking.Furthermore,rat bone marrow mesenchymal stem cells were extracted as model cells,and the osteogenic effects of HHML were verified via in vitro experiments.Results:Total of 343 common targets of HHML-OP and the top 10 target proteins in the protein-protein interaction network are TP53,AKT1,STAT3,HSP90AA1,ESR1,TNF,IL6,MAPK1,MAPK3 and MAPK8.Enrichment analysis yielded that the key molecular pathway was the PI3K/Akt signaling pathway.Molecular docking analysis showed that baicalein,erysodienone and naringenin docked with the target proteins AKT1,STAT3 and TP53,respectively,with low binding energy and high affinity.In addition,In vitro experiments demonstrated that HHML promoted the proliferation of bone marrow mesenchymal stem cells;compared with the control group,HHML-treated cells showed enhanced alkaline phosphatase staining,promoted the expression of OCN,RUNX2,BSP,and COL1 mRNAs as well as the expression of PI3K and AKT phosphorylated proteins.Secondly,the expression of target proteins revealed that HHML promoted the phosphorylation of STAT3 protein and inhibited the expression of P53.Conclusions:Our study investigated that HHML treatment with OP promotes bone formation possibly through activation of the PI3K/Akt signaling pathway and may involve STAT3 and TP53 target interactions.
基金Supported by the National Natural Science Foundation of China"Kidney Health Bone,Marrow Link Brain",a Study of Chinese Nourishing Kidney Herbs’Mechanism of Treatment of Osteoporosis Based on Neuropeptide Network"Too Salty to Hurt the Bone",A Study on the Molecular Mechanism of High Salt Affecting Bone Metabolism Based on Related Ion Channels and Intervention of A Compound Chinese Medicine for Reinforcing Kidney(No.81473509,81673837).
文摘OBJECTIVE:The aim of this study was to evaluate the effectiveness of Chinese herbal medicines for invigorating the kidney(CHMIK)on senile osteoporosis.METHODS:We searched for studies in English-language databases(Pub Med,the Cochrane Library,and Web of Science)and Chinese-language databases(China National Knowledge Infrastructure,Wan Fang Data,VIP Chinese periodical service platform),and China Biology Medicine disc from their inception to September 2017.Randomized controlled trials comparing the effectiveness of Traditional Chinese Medicine therapies(alone or in combination)and conventional clinical medicine therapies among older adult patients with osteoporosis were identified.We conducted a network Meta-analysis with a Bayesian hierarchical random-effects model using RStudio software,Version 3.4.1.RESULTS:Forty-three randomized controlled trials assessing the differences between Traditional Chinese Medicine and conventional clinical medicine were identified,including 15 treatments and involving 3316 patients.The results of the network Meta-analysis indicated that alendronate(odds ratio[OR]=0.20,95%confidence interval[CI]:0.047-0.73)and calcium(OR=0.18,95%CI:0.11-0.30)are significantly more effective if combined with oral CHMIK.CHMIK alone is significantly more effective than both alendronate(OR=0.34,95%CI:0.10-1.0)and calcium(OR=0.13,95%CI:0.056-0.28).Moreover,CHMIK+tuina+calcium is more effective than CHMIK+calcium+vitamin D+alendronate(OR=18.0,95%CI:1.1-2.7 e+02).CONCLUSION:The present network Meta-analysis found that alendronate and calcium are more effective if combined with oral CHMIK and that oral CHMIK alone may be more effective than alendronate or calcium.Tuina may have an advantage over oral medicines.Oral CHMIK and calcitonin show the most potential for treating senile osteoporosis.
基金supported by the National Key Research and Development Program of China (2022YFD1300400)the 2115 Talent Development Program of China Agricultural University。
文摘The gut microbiota(GM)plays a crucial role in maintaining the overall health and well-being of the host.Recent studies have demonstrated that the GM may significantly influence bone metabolism and degenerative skeletal diseases,such as osteoporosis(OP).Interventions targeting GM modification,including probiotics or antibiotics,have been found to affect bone remodeling.This review provides a comprehensive summary of recent research on the role of GM in regulating bone remodeling and seeks to elucidate the regulatory mechanism from various perspectives,such as the interaction with the immune system,interplay with estrogen or parathyroid hormone(PTH),the impact of GM metabolites,and the effect of extracellular vesicles(EVs).Moreover,this review explores the potential of probiotics as a therapeutic approach for OP.The insights presented may contribute to the development of innovative GM-targeted therapies for OP.
基金supported by the National Natural Science Foundation of China [82172385 to H.S., 82172349 to Y.W.]the Key-Area Research and Development Program of Guangdong Province [2019B020236001 to H.S.]+3 种基金the Shenzhen Key Medical Discipline Construction Fund [ZDSYS20190902092851024 to H.S.]the Natural Science Foundation of Guangdong Province [2020A1515010097 to Z.X.]the Shenzhen Outstanding Science and Technology Innovation Talents-Outstanding Youth Fund project [RCYX20210706092106042 to Z.X.]Funding for open access charge:Shenzhen Key Medical Discipline Construction Fund。
文摘As the major cell precursors in osteogenesis, mesenchymal stem cells(MSCs) are indispensable for bone homeostasis and development. However, the primary mechanisms regulating osteogenic differentiation are controversial. Composed of multiple constituent enhancers, super enhancers(SEs) are powerful cis-regulatory elements that identify genes that ensure sequential differentiation. The present study demonstrated that SEs were indispensable for MSC osteogenesis and involved in osteoporosis development. Through integrated analysis, we identified the most common SE-targeted and osteoporosis-related osteogenic gene,ZBTB16. ZBTB16, positively regulated by SEs, promoted MSC osteogenesis but was expressed at lower levels in osteoporosis.Mechanistically, SEs recruited bromodomain containing 4(BRD4) at the site of ZBTB16, which then bound to RNA polymerase IIassociated protein 2(RPAP2) that transported RNA polymerase Ⅱ(POL Ⅱ) into the nucleus. The subsequent synergistic regulation of POL Ⅱ carboxyterminal domain(CTD) phosphorylation by BRD4 and RPAP2 initiated ZBTB16 transcriptional elongation, which facilitated MSC osteogenesis via the key osteogenic transcription factor SP7. Bone-targeting ZBTB16 overexpression had a therapeutic effect on the decreased bone density and remodeling capacity of Brd4^(fl/fl)Prx1-cre mice and osteoporosis(OP) models.Therefore, our study shows that SEs orchestrate the osteogenesis of MSCs by targeting ZBTB16 expression, which provides an attractive focus and therapeutic target for osteoporosis.
基金supported by the Natural Science Foundation with grants from the National Key R&D Program of China(2018YFC2002500)National Natural Science Foundation of China(81602360,82072470,82350003,92049201)+6 种基金Key Laboratory Construction Project of Guangzhou Science and Technology Bureau(202102100007)supported by the Clinical Frontier Technology Program of the First Affiliated Hospital of Jinan University,China(No.JNU1AF-CFTP-2022-a01221)Natural Science Foundation of Guangdong Province(2021A1515012154,2019A1515011082,2017A030313665,2018A030313544,2020B1515120038)Science and Technology Projects in Guangzhou(201707010493,202102010069)Macao Foundation for Development of Science and Technology(0029/2019/A)Youth Talent Support Project of Guangzhou Association for Science&Technology(X20200301018)pilot project of clinical collaboration from National Administration of Traditional Chinese Medicine and National Health Commission of the People’s Republic of China and Logistics Support Department of the Central Military Commission。
文摘Despite the diverse roles of tripartite motif(Trim)-containing proteins in the regulation of autophagy,the innate immune response,and cell differentiation,their roles in skeletal diseases are largely unknown.We recently demonstrated that Trim21 plays a crucial role in regulating osteoblast(OB)differentiation in osteosarcoma.However,how Trim21 contributes to skeletal degenerative disorders,including osteoporosis,remains unknown.First,human and mouse bone specimens were evaluated,and the results showed that Trim21 expression was significantly elevated in bone tissues obtained from osteoporosis patients.Next,we found that global knockout of the Trim21 gene(KO,Trim2^(1-/-))resulted in higher bone mass compared to that of the control littermates.We further demonstrated that loss of Trim21 promoted bone formation by enhancing the osteogenic differentiation of bone marrow mesenchymal stem cells(BMSCs)and elevating the activity of OBs;moreover,Trim21 depletion suppressed osteoclast(OC)formation of RAW264.7 cells.In addition,the differentiation of OCs from bone marrow-derived macrophages(BMMs)isolated from Trim21^(-/-)and Ctsk-cre;Trim21^(f/f)mice was largely compromised compared to that of the littermate control mice.Mechanistically,YAP1/β-catenin signaling was identified and demonstrated to be required for the Trim21-mediated osteogenic differentiation of BMSCs.More importantly,the loss of Trim21 prevented ovariectomy(OVX)-and lipopolysaccharide(LPS)-induced bone loss in vivo by orchestrating the coupling of OBs and OCs through YAP1 signaling.Our current study demonstrated that Trim21 is crucial for regulating OB-mediated bone formation and OC-mediated bone resorption,thereby providing a basis for exploring Trim21 as a novel dual-targeting approach for treating osteoporosis and pathological bone loss.
文摘Postmenopausal osteoporosis and osteopenia are chronic and uncurable conditions that invariably lead to an increased risk of vertebral, hip, and femoral neck fracture if left untreated. Clinical guidelines establish, in general, pharmacological combinations allied to lifestyle changes as the mainstay of their management, and also increasing bone marrow density, lowering fracture risk, and improving quality of life are their main therapeutic goals. The objective of this systematic review was to analyze the available data in the scientific medical literature regarding the role of the ibandronate and cholecalciferol combination in postmenopausal osteoporosis and osteopenia management. Based on our results, we concluded that the above combination is safe and feasible for the clinical control of both conditions.
文摘Background: Osteoporosis (OP) is a common clinical manifestation of multiple myeloma (MM). The aim of this study was to investigate the possible molecular pathways and shared genes in the co-occurrence of OP and MM. Methods: The Gene Expression Omnibus database was used to retrieve gene expression information. Use WGCNA and differential analysis to screen out Hub genes. The GENEMANIA was used to build protein-protein interaction (PPI) networks. Enrichment analyses were performed to explore the functions. Validation datasets were selected to verify the diagnostic marker reliability of PLAGL1. The immune microenvironment of diseases was analyzed by immune infiltration analyses. Results: We confirmed a hub gene called PLAGL1, which is significantly under-expressed in both OP and MM. We found hub genes were associated with glucose and energy metabolism. Subsequently, the reliability of PLAGL1 for diagnosing OP and MM was verified using ROC curves, with all areas under the curve > 0.75. Moreover, PLAGL1 regulates t lymphocytes and may participate in the occurrence of OP in MM through immune pathways. Conclusions: PLAGL1 is a hub gene for the co-occurrence of OP and MM. It can regulate T-lymphocyte involvement in disease development. PLAGL1 may be a novel diagnostic marker for the co-occurrence of OP and MM.
基金the financial support from the Science and Technology Development Program of Jilin Provincial Science and Technology Department,(No.20210101200JC).
文摘Osteoporosis is one of the common orthopaedic diseases,characterised by increased bone fragility due to reduced bone mass and microstructural degeneration,posing a great threat to patients’quality of life and safety.In recent years,Chinese medicine(natural)has had a unique advantage in the treatment of osteoporosis and has shown good efficacy.Autophagy is an inherent cellular survival mechanism for the removal and recycling of damaged proteins and organelles and plays an important role in maintaining the stability of the intracellular environment and organ function.Therefore,this article aims to provide a comprehensive review of these Chinese medicines(natural)for the treatment of osteoporosis through autophagy.They have been intensively studied and reported to have effects such as promoting osteogenesis and anti-bone resorption.The Chinese medicines include plants such as Cistanche deserticola,Epimedium,Curculigo orchioides Gaertn,Achyranthes bidentata Blume,Leonurus japonicus Houtt,Ginseng,Chuanxiong Rhizome,Eucommia ulmoides,Morindae Officinalis Radix,Curcuma longa,Polygoni Cuspidati Rhizoma et Radix,Anemarrhena asphodeloides Bunge,Salvia miltiorrhiza Bge and Pueraria Lobata,thus providing evidence for the use of alternative herbal therapies for the effective treatment of osteoporosis.
文摘Objective: To investigate the correlation between lower extremity vascular sclerosis and osteoporosis in elderly men with type 2 diabetes mellitus. Methods: A total of 359 elderly male patients with type II diabetes hospitalized in the First Affiliated Hospital of Chongqing Medical University from January 2018 to June 2023 were retrospectively collected. According to the BMD (Bone Density Value), the patients were categorized into osteoporotic (T ≤ -2.5, n = 248) and non-osteoporotic groups (T > -2.5, n = 111). T test and Chi-square test were used to evaluate the differences in clinical data, biochemical markers and ABI between two groups. Multivariate logistic regression was used to analyze the risk factors of osteoporosis in elderly men with type 2 diabetes mellitus. Results: Compared with the non-osteoporotic group, the differences in diabetes course, systolic blood pressure, ABI, BMI, uric acid, triglyceride, and HDL in the osteoporotic group were statistically significant (P < 0.05). Logistic multivariate regression analysis showed that lower extremity vascular sclerosis was an independent risk factor for osteoporosis in elderly men with type 2 diabetes mellitus (P Conclusion: Atherosclerosis of the lower extremities in elderly men with T2DM is closely related to osteoporosis, and can lead to a decrease in bone mass, and an increase in osteoporosis.
基金Capital’s Funds for Health Improvement and Research,No.CFH2018-1-2172Beijing Ditan Hospital Scientific Research Fund Project,No.DTYM202102.
文摘BACKGROUND Osteoporosis is an extrahepatic complication of primary biliary cholangitis(PBC)that increases the risk of fractures and mortality.However,Epidemiological studies of osteoporosis in patients with PBC in China and the Asia-Pacific region is lack.AIM To assess the prevalence and clinical characteristics of osteoporosis in Chinese patients with PBC.METHODS This retrospective analysis included consecutive patients with PBC from a tertiary care center in China who underwent bone mineral density(BMD)assessment using dual-energy X-ray absorptiometry between January 2013 and December 2021.We defined subjects with T-scores≤-2.5 in any sites(L1 to L4,femoral neck,or total hip)as having osteoporosis.Demographic,serological,clinical,and histological data were collected.Independent risk factors for osteoporosis were identified by multivariate logistic regression analysis.RESULTS A total of 268 patients with PBC[236 women(88.1%);mean age,56.7±10.6 years;163 liver biopsies(60.8%)]were included.The overall prevalence of osteoporosis in patients with PBC was 45.5%(122/268),with the prevalence of osteoporosis in women and men being 47.0%and 34.4%,respectively.The prevalence of osteoporosis in postmenopausal women was significantly higher than that in premenopausal women(56.3%vs 21.0%,P<0.001).Osteoporosis in patients with PBC is associated with age,fatigue,menopausal status,previous steroid therapy,body mass index(BMI),splenomegaly,gastroesophageal varices,ascites,Mayo risk score,histological stage,alanine aminotransferase,albumin,bilirubin,platelet and prothrombin activity.Multivariate regression analysis identified that older age,lower BMI,previous steroid therapy,higher Mayo risk score,and advanced histological stage as the main independent risk factors for osteoporosis in PBC.CONCLUSION Osteoporosis is very common in Chinese patients with PBC,allowing for prior screening of BMD in those PBC patients with older age,lower BMI,previous steroid therapy and advanced liver disease.
基金Supported by National Natural Science Foundation of China,No.81703533Natural Science Foundation of Shanghai,No.20ZR1449500+2 种基金Shanghai Jiao Tong University Medical Engineering Cross Fund,No.YG2019GD02Science Technology Development Fund of Shanghai Pudong New Area,No.PKJ2020-Y28Medical Discipline Construction Project of Pudong Health Committee of Shanghai,No.PWYts2021-05.
文摘Osteoporosis is a systemic bone disease,which leads to decreased bone mass and an increased risk of fragility fractures.Currently,there are many anti-resorption drugs and osteosynthesis drugs,which are effective in the treatment of osteoporosis,but their usage is limited due to their contraindications and side effects.In regenerative medicine,the unique repair ability of mesenchymal stem cells(MSCs)has been favored by researchers.The exosomes secreted by MSCs have signal transduction and molecular delivery mechanisms,which may have therapeutic effects.In this review,we describe the regulatory effects of MSCs-derived exosomes on osteoclasts,osteoblasts,and bone immunity.We aim to summarize the preclinical studies of exosome therapy in osteoporosis.Furth-ermore,we speculate that exosome therapy can be a future direction to improve bone health.
文摘BACKGROUND This case report presents a patient with pyogenic spondylitis(PS)associated with lactation-related osteoporosis during pregnancy.The 34-year-old female patient experienced low back pain for one month,beginning one month postpartum,with no history of trauma or fever.Dual-energy X-ray absorptiometry of the lumbar spine revealed a Z-score of-2.45,leading to a diagnosis of pregnancy and lactation-associated osteoporosis(PLO).The patient was advised to cease breastfeeding and take oral calcium and active vitamin D.Despite these interventions,her symptoms worsened,and she had difficulty walking one week later,prompting her to revisit our hospital.CASE SUMMARY Lumbar magnetic resonance imaging(MRI)scans showed abnormal signals in the L4 and L5 vertebral bodies and intervertebral space,while an enhancement scan displayed abnormal enhanced high signals around the L4/5 intervertebral disc,suggesting a lumbar infection.A needle biopsy was performed for bacterial culture and pathological examination,culminating in a final diagnosis of pregnancy and lactation-related osteoporosis with PS.Following treatment with antiosteoporotic medications and antibiotics,the patient’s pain gradually subsided,and she returned to normal life within five months.PLO is a rare condition that has garnered increasing attention in recent years.Spinal infections during lactation in pregnancy are also relatively uncommon.CONCLUSION Both conditions primarily manifest as low back pain but require distinct treatments.In clinical practice,when diagnosing patients with pregnancy and lactation-associated osteoporosis,the possibility of spinal infection should be considered.A lumbar MRI should be conducted as needed to prevent delays in diagnosis and treatment.
文摘Objective:To identify the level of knowledge,attitude,and practice(KAP)toward osteoporosis among Jordanian nurses.Methods:A cross-sectional design was adopted in this study.A convenience sample of 443 Jordanian nurses were recruited from the public and private healthcare settings in Jordan.The assessment tool used in the current study contained 35 items,measuring KAP among Jordanian nurses toward osteoporosis.The correlation Pearson test and regression test were used to analyze data using Statistical Package for Social Sciences,version 21.Results:The total KAP scores were 33.53,37.65,and 22.7,respectively.These results revealed that Jordanian nurses have a moderate level of KAP toward osteoporosis.Conclusions:Jordanian nurses showed a moderate KAP toward osteoporosis,which should be improved as an effective step to reducing the growing incidences of osteoporosis.The lack of KAP holds a serious and growing impact on the Jordanian health sector and patients’health in terms of cost,healthcare resources,and social life.Nurses can play a valuable role in educating patients on bone fracture causes,perceived percentage,risks,and prevention,as well as in helping them with nutrition and lifestyle recommendations.
基金National Natural Science Foundation of China(No.82172431)。
文摘The gut microbiota is closely associated with osteoporosis,but its specific mechanisms of action have not been fully elucidated.Short-chain fatty acids(SCFAs),produced by the fermentation of complex carbohydrates,are key regulatory metabolites produced by the gut microbiota and play an important role in the regulation of various systems by the gut microbiota.In recent years,SCFAs have been found to be a key link between the gut microbiota and bone.SCFAs can affect bone metabolism by affecting the integrity of the intestinal mucosal barrier,regulating G protein-coupled receptors and inhibiting histone deacetylase activity etc.SCFAs are currently the focus of research,but the mechanisms of interaction between SCFAs and osteoporosis in China are less reported.This paper reviews the role of gut microbiota and its metabolites,SCFAs,as well as the research progress of SCFAs affecting osteoporosis,with the aim of providing innovative therapeutic opportunities for bone metabolic diseases.
基金supported by Suzhou Special Project for Diagnosis and Treatment Technology of Clinical Key Diseases(No.LCZX202127)。
文摘Background:miRNAs are closely related to bone metabolism.Studies have shown that Erxian decoction can improve bone metabolism,possibly achieving this regulatory effect through miRNA targets.Netinfer was used to predict the miRNA targets of Erxian decoction for the treatment of postmenopausal osteoporosis,and the results were validated by clinical trials.Methods:In this study,we identified possible targets of Erxian decoction in osteoporosis by means of network pharmacological analysis and bioinformatic prediction.Fifteen cases of postmenopausal osteoporosis with kidney Yin and Yang deficiency(In traditional Chinese medicine,kidney Yin nourishes and moistens the tissues of the internal organs of the body,while kidney Yang promotes and warms the tissues of the internal organs of the body.)were treated with Erxian decoction for four weeks,and serum bone metabolism indices(P1NP,osteocalcin,andβ-CTX)and miRNA-335-5p expression were measured before and after treatment.Results:The constructed miRNA postmenopausal osteoporosis related gene network of the effective compound of the Erxian decoction has 296 points and 981 edges.The 39 postmenopausal osteoporosis related genes regulated by miRNA-335-5p were enriched in ossification,while the signaling pathways were enriched in rheumatoid arthritis,the Toll signaling pathway,the HIF-1 signaling pathway,and the MAPK signaling pathway.After taking Erxian decoction,the expression of the serum bone formation index(P1NP,osteocalcin)and miRNA-335-5p gene expression levels increased significantly.The alterations in P1NP and osteocalcin were correlated with the changes in miRNA-335-5p.Conclusion:Circulating miRNA-335-5p may serve as an important target of Erxian decoction in the treatment of postmenopausal women.The effect of Erxian decoction on bone formation is significant,but the underlying mechanism requires further investigation.
文摘Osteoporosis is a common bone disease in women worldwide, leading to decreased bone density and an accelerated risk of fractures. The causes of osteoporosis in women include age (senile osteoporosis), menopause-associated hormonal changes, deficiencies in calcium and vitamin D, genetics, lifestyle factors, medical conditions, and some type of medications. The consequences of osteoporosis are colossal, consisting of fractures, decreased quality of life, psychological impacts, and economic burden. To effectively control the menace of osteoporosis in women, numerous strategies are advocated. Adequate calcium and vitamin D consumption through diet or supplements is vital. Regular weight-bearing activities and strength training that promote bone density. Maintaining a healthy life-style through avoiding smoking, limiting alcohol in-take and maintaining a wholesome body weight is essential. Hormone replacement therapy and some medications may be recommended in certain cases. Early detection through regular bone density and blood tests is crucial to lowering its impact. Creating a supportive network through educational programs and resources fosters awareness and empowerment. By engaging these strategies, women can be empowered to combat osteoporosis, reduce fracture risk, and build stronger bones for their overall well-being.
