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High Dietary Sodium Intake Assessed by 24-hour Urine Specimen Increase Urinary Calcium Excretion and Bone Resorption Marker.

Sun Mi PARK ; Jaehwan JEE ; Ji Young JOUNG ; Yoon Young CHO ; Seo Young SOHN ; Sang Man JIN ; Kyu Yeon HUR ; Jae Hyeon KIM ; Sun Wook KIM ; Jae Hoon CHUNG ; Moon Kyu LEE ; Yong Ki MIN

Journal of Bone Metabolism.2014;21(3):189-194. doi:10.11005/jbm.2014.21.3.189

BACKGROUND: The average dietary sodium intake of Koreans is 2.6 times higher than the World Health Organization's recommended amount. The effect of a diet high in sodium on the skeletal system, especially osteoporosis, has not previously been examined in Korean postmenopausal women with low bone mass. We assessed the daily sodium intake, and determined the impact of sodium intake on urinary calcium excretion and bone resorption marker. METHODS: A retrospective review of medical records was performed for 86 postmenopausal subjects who were initially diagnosed with osteopenia or osteoporosis at the health promotion center. They were subsequently referred to the Division of Endocrinology and Metabolism between 2010 and 2013. All subjects completed a modified food frequency questionnaire. Twenty-four hour urine collection for sodium, calcium and creatinine excretion, and serum C-terminal telopeptides of type I collagen (CTX-I) were also obtained. RESULTS: The average amount of daily sodium and calcium intake were 3,466 mg and 813 mg, respectively. Average dietary sodium intake and 24-hour urinary sodium excretion showed significant positive linear correlation (r=0.29, P=0.006). There was also a significant positive linear correlation between 24-hour urine sodium and calcium excretion (r=0.42, P<0.001); CTX-I and 24-hour urinary calcium excretion (r=0.29, P=0.007). CONCLUSIONS: Excessive sodium intake assessed by 24-hour urine specimen is associated with high calcium excretion in urine. High calcium excretion is also related to increasing bone resorption marker.
Bone Diseases, Metabolic ; Bone Resorption* ; Calcium* ; Collagen Type I ; Creatinine ; Diet ; Endocrinology ; Female ; Health Promotion ; Humans ; Medical Records ; Metabolism ; Osteoporosis ; Retrospective Studies ; Sodium ; Sodium, Dietary* ; Urine Specimen Collection ; World Health ; World Health Organization ; Surveys and Questionnaires

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Microarray Analysis of Gene Expression Reveals that Cyclo-oxygenase-2 Gene Therapy Up-regulates Hematopoiesis and Down-regulates Inflammation During Endochondral Bone Fracture Healing.

K H William LAU ; Nicoleta L POPA ; Charles H RUNDLE

Journal of Bone Metabolism.2014;21(3):169-188. doi:10.11005/jbm.2014.21.3.169

BACKGROUND: Cyclo-oxygenase-2 (Cox-2) is an inflammatory mediator that is necessary for the tissue repair, including bone fracture healing. Although the application of Cox-2 gene therapy to a murine closed femoral fracture has accelerated bony union, but the beneficial effect was not observed until the endochondral stage of bone repair that is well after the inflammatory stage normally subsides. METHODS: To identify the molecular pathways through which Cox-2 regulates fracture healing, we examined gene expression profile in fracture tissues in response to Cox-2 gene therapy during the endochondral bone repair phase. Cox-2 gene therapy was applied to the closed murine femur fracture model. Microarray analysis was performed at 10 days post-fracture to examine global gene expression profile in the fracture tissues during the endochondral bone repair phase. The entire repertoire of significantly expressed genes was examined by gene set enrichment analysis, and the most up-regulated individual genes were evaluated further. RESULTS: The genes that normally promote inflammation were under-represented in the microarray analysis, and the expression of several inflammatory chemokines was significantly down-regulated. There was an up-regulation of two key transcription factor genes that regulate hematopoiesis and erythropoiesis. More surprisingly, there was no significant up-regulation in the genes that are normally involved in angiogenesis or bone formation. However, the expression of two tissue remodeling genes was up-regulated. CONCLUSIONS: The down-regulation of the inflammatory genes in response to Cox-2 gene therapy was unexpected, given the pro-inflammatory role of prostaglandins. Cox-2 gene therapy could promote bony union through hematopoietic precursor proliferation during endochondral bone repair and thereby enhances subsequently fracture callus remodeling that leads to bony union of the fracture gap.
Bony Callus ; Chemokines ; Cyclooxygenase 2 ; Down-Regulation ; Erythropoiesis ; Femoral Fractures ; Femur ; Fracture Healing ; Fractures, Bone* ; Gene Expression* ; Genetic Therapy* ; Hematopoiesis* ; Inflammation* ; Microarray Analysis* ; Osteogenesis ; Prostaglandins ; Transcription Factors ; Transcriptome ; Up-Regulation

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Factors and Mechanisms Involved in the Coupling from Bone Resorption to Formation: How Osteoclasts Talk to Osteoblasts.

Kyoji IKEDA ; Sunao TAKESHITA

Journal of Bone Metabolism.2014;21(3):163-167. doi:10.11005/jbm.2014.21.3.163

Bone remodeling is the fundamental means by which the quality as well as quantity of the skeleton is maintained throughout adult life. When bone remodeling goes awry, a metabolic bone disease such as osteoporosis ensues. Among multiple phases of the complex remodeling process, we focus in this review on factors and mechanisms that are involved in the coupling of bone formation to preceding resorption.
Adult ; Bone Diseases, Metabolic ; Bone Remodeling ; Bone Resorption* ; Humans ; Osteoblasts* ; Osteoclasts* ; Osteogenesis ; Osteoporosis ; Skeleton

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Proximal Femoral Geometry as Fracture Risk Factor in Female Patients with Osteoporotic Hip Fracture.

Jun HAN ; Myung Hoon HAHN

Journal of Bone Metabolism.2016;23(3):175-182. doi:10.11005/jbm.2016.23.3.175

BACKGROUND: Proximal femoral geometry may be a risk factor of osteoporotic hip fractures. However, there existed great differences among studies depending on race, sex and age of subjects. The purpose of the present study is to analyze proximal femoral geometry and bone mineral density (BMD) in the osteoporotic hip fracture patients. Furthermore, we investigated proximal femoral geometric parameters affecting fractures, and whether the geometric parameters could be an independent risk factor of fractures regardless of BMD. METHODS: This study was conducted on 197 women aged 65 years or more who were hospitalized with osteoporotic hip fracture (femur neck fractures ; 84, intertrochanteric fractures; 113). Control group included 551 women who visited to check osteoporosis. Femur BMD and proximal femoral geometry for all subjects were measured using dual energy X-ray absorptiometry (DXA), and compared between the control and fracture groups. Besides, proximal femoral geometric parameters associated with fractures were statistically analyzed. RESULTS: There were statistically significant differences in the age and weight, cross-sectional area (CSA)/length/width of the femoral neck and BMD of the proximal femur between fracture group and control group. BMD of the proximal femur in the control group was higher than in the fracture group. For the femoral neck fractures group, the odds ratio (OR) for fractures decrease in the CSA and neck length (NL) of the femur increased by 1.97 times and 1.73 times respectively, regardless of BMD. The OR for fractures increase in the femoral neck width increased by 1.53 times. In the intertrochanteric fracture group, the OR for fractures increase in the femoral neck width increased by 1.45 times regardless of BMD. CONCLUSIONS: We found that an increase of the femoral neck width could be a proximal femoral geometric parameter which plays important roles as a risk factor for fracture independently of BMD.
Absorptiometry, Photon ; Bone Density ; Continental Population Groups ; Female* ; Femoral Neck Fractures ; Femur ; Femur Neck ; Hip Fractures ; Hip* ; Humans ; Neck ; Odds Ratio ; Osteoporosis ; Risk Factors*

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Pamidronate Down-regulates Tumor Necrosis Factor-alpha Induced Matrix Metalloproteinases Expression in Human Intervertebral Disc Cells.

Young Mi KANG ; Seong Hwan HONG ; Jae Ho YANG ; Jin Cheol OH ; Jin Oh PARK ; Byung Ho LEE ; Sang Yoon LEE ; Hak Sun KIM ; Hwan Mo LEE ; Seong Hwan MOON

Journal of Bone Metabolism.2016;23(3):165-173. doi:10.11005/jbm.2016.23.3.165

BACKGROUND: N-containing bisphosphonates (BPs), such as pamidronate and risedronate, can inhibit osteoclastic function and reduce osteoclast number by inducing apoptotic cell death in osteoclasts. The aim of this study is to demonstrate the effect of pamidronate, second generation nitrogen-containing BPs and to elucidate matrix metallo-proteinases (MMPs) mRNA expression under serum starvation and/or tumor necrosis factor alpha (TNF-α) stimulation on metabolism of intervertebral disc (IVD) cells in vitro. METHODS: Firstly, to test the effect of pamidronate on IVD cells in vitro, various concentrations (10⁻¹², 10⁻¹⁰, 10⁻⁸, and 10⁻⁶ M) of pamidronate were administered to IVD cells. Then DNA and proteoglycan synthesis were measured and messenger RNA (mRNA) expressions of type I collagen, type II collagen, and aggrecan were analyzed. Secondly, to elucidate the expression of MMPs mRNA in human IVD cells under the lower serum status, IVD cells were cultivated in full serum or 1% serum. Thirdly, to elucidate the expression of MMPs mRNA in IVD cells under the stimulation of 1% serum and TNF-α (10 ng/mL) In this study, IVD cells were cultivated in three dimensional alginate bead. RESULTS: Under the lower serum culture, IVD cells in alginate beads showed upregulation of MMP 2, 3, 9, 13 mRNA. The cells in lower serum and TNF-α also demonstrated upregulation of MMP-2, 3, 9, and 13 mRNA. The cells with various doses of pamidronate and lower serum and TNF-α were reveled partial down-regulation of MMPs. CONCLUSIONS: Pamidronate, N-containing second generation BPs, was safe in metabolism of IVD in vitro maintaining chondrogenic phenotype and matrix synthesis, and down-regulated TNF-α induced MMPs expression.
Aggrecans ; Cell Death ; Collagen ; Collagen Type I ; Collagen Type II ; Diphosphonates ; DNA ; Down-Regulation ; Humans* ; In Vitro Techniques ; Intervertebral Disc* ; Matrix Metalloproteinases* ; Metabolism ; Osteoclasts ; Phenotype ; Proteoglycans ; Risedronate Sodium ; RNA, Messenger ; Starvation ; Tumor Necrosis Factor-alpha* ; Up-Regulation

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The Influence of the Type of Continuous Exercise Stress Applied during Growth Periods on Bone Metabolism and Osteogenesis.

Sangun LEE ; Takao SUZUKI ; Hiromi IZAWA ; Atsuko SATOH

Journal of Bone Metabolism.2016;23(3):157-164. doi:10.11005/jbm.2016.23.3.157

BACKGROUND: In this study, we examined the influence of exercise loading characteristics on bone metabolic responses and bone morphology in the growth phase and adulthood. METHODS: Running exercise (RUN) and jumping exercise (JUM) were used for the exercise loading in 28-day-old male Wistar rats. Bone metabolism was measured by blood osteocalcin (OC) and tartrate-resistant acid phosphatase (TRACP) levels. For bone morphology, the maximum bone length, bone weight, and bone strength of the femur and tibia were measured. RESULTS: A pre- and post-exercise loading comparison in the growth phase showed significantly increased OC levels in the RUN and JUM groups and significantly decreased TRACP levels in the JUM group. On the other hand, a pre- and post-exercise loading comparison in adulthood showed significantly decreased TRACP levels in the RUN and JUM groups. Femur lengths were significantly shorter in the RUN and JUM groups than in the control (CON) group, while bone weight was significantly greater in the JUM group than in the CON group. CONCLUSIONS: Exercise loading activates OC levels in the growth phase and suppresses TRACP levels in adulthood. On the other hand, these results suggest that excessive exercise loading may suppress bone length.
Acid Phosphatase ; Femur ; Hand ; Humans ; Male ; Metabolism* ; Osteoblasts ; Osteocalcin ; Osteoclasts ; Osteogenesis* ; Rats, Wistar ; Running ; Tibia

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Prolonged Practice of Swimming Is Negatively Related to Bone Mineral Density Gains in Adolescents.

Marcelo R RIBEIRO-DOS-SANTOS ; Kyle R LYNCH ; Ricardo R AGOSTINETE ; Santiago MAILLANE-VANEGAS ; Bruna TURI-LYNCH ; Igor H ITO ; Rafael LUIZ-DE-MARCO ; Mario A RODRIGUES-JUNIOR ; Rômulo A FERNANDES

Journal of Bone Metabolism.2016;23(3):149-155. doi:10.11005/jbm.2016.23.3.149

BACKGROUND: The practice of swimming in "hypogravity" conditions has potential to decrease bone formation because it decreases the time engaged in weight-bearing activities usually observed in the daily activities of adolescents. Therefore, adolescents competing in national levels would be more exposed to these deleterious effects, because they are engaged in long routines of training during most part of the year. To analyze the effect of swimming on bone mineral density (BMD) gain among adolescents engaged in national level competitions during a 9-month period. METHODS: Fifty-five adolescents; the control group contained 29 adolescents and the swimming group was composed of 26 athletes. During the cohort study, BMD, body fat (BF) and fat free mass (FFM) were assessed using a dual-energy x-ray absorptiometry scanner. Body weight was measured with an electronic scale, and height was assessed using a stadiometer. RESULTS: During the follow-up, swimmers presented higher gains in FFM (Control 2.35 kg vs. Swimming 5.14 kg; large effect size [eta-squared (ES-r)=0.168]) and BMD-Spine (Swimming 0.087 g/cm² vs. Control 0.049 g/cm²; large effect size [ES-r=0.167]) compared to control group. Male swimmers gained more FFM (Male 10.63% vs. Female 3.39%) and BMD-Spine (Male 8.47% vs. Female 4.32%) than females. Longer participation in swimming negatively affected gains in upper limbs among males (r=-0.438 [-0.693 to -0.085]), and in spine among females (r=-0.651 [-0.908 to -0.036]). CONCLUSIONS: Over a 9-month follow-up, BMD and FFM gains were more evident in male swimmers, while longer engagement in swimming negatively affected BMD gains, independently of sex.
Absorptiometry, Photon ; Adipose Tissue ; Adolescent* ; Athletes ; Body Weight ; Bone Density* ; Cohort Studies ; Female ; Follow-Up Studies ; Humans ; Male ; Osteogenesis ; Spine ; Sports ; Swimming* ; Upper Extremity ; Weight-Bearing

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Comparison in Adherence to Osteoporosis Guidelines according to Bone Health Status in Korean Adult.

Hee Sook LIM ; Soon Kyung KIM ; Hae Hyeog LEE ; Dong Won BYUN ; Yoon Hyung PARK ; Tae Hee KIM

Journal of Bone Metabolism.2016;23(3):143-148. doi:10.11005/jbm.2016.23.3.143

BACKGROUND: Osteoporosis one of the most serious disease to decrease the quality of life and cause economic loss. Thus, prevention of osteoporosis has become an important health concern. The study examined in adherence to osteoporosis guidelines and compared the levels of adherence to osteoporosis guidelines between bone health status in Korean adult. METHODS: This study used data from a nationally represented sample of Koreans (n=3,419) from 2008 to 2011 Korea National Health and Nutrition Examination Survey. We were divided into three groups by T-score: normal, osteopenia and osteoporosis. Assessment of adherence level was based on 5 components of osteoporosis guidelines, considering intake of sodium, calcium and protein, smoking and regular exercise. RESULTS: The sex, body mass index, income and educational level did not significantly differ between three groups. Deficient intake of calcium was significantly associated with a threefold greater odds in osteoporosis group (OR 3.6; 95% confidence interval [CI] 2.52-5.22). Excessive protein intake was significantly increased the risk only in osteoporosis group compared to the normal group (OR 1.71; 95% CI 1.15-2.62). Smoking increased the risk in osteoporosis group compared to the normal group (OR 2.88; 95% CI 1.75-4.76), osteoporosis group compared to the osteopenia group (OR 2.69; 95% CI 1.61-4.55). CONCLUSIONS: Nutritional factor (intake of calcium and protein) and lifestyle-related factor (smoking and exercise) must be accompanied the management for bone health. An adherence of guidelines is considered very important for the prevention of osteoporosis.
Adult* ; Body Mass Index ; Bone Diseases, Metabolic ; Calcium ; Diet ; Guideline Adherence ; Humans ; Korea ; Life Style ; Nutrition Surveys ; Osteoporosis* ; Quality of Life ; Smoke ; Smoking ; Sodium

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An Experimental Study for Minimum Level of Decalcification to Detect the Osteolytic Bone Metastasis of Long Bone on Plain Radiography.

Jun Ho BAEK ; Il Hyung PARK ; Sung Hwa SEO

Journal of Bone Metabolism.2016;23(3):135-142. doi:10.11005/jbm.2016.23.3.135

BACKGROUND: In 1951, Ardran reported that metastatic bone lesions could be detectable on plain radiography with 30% to 50% of decalcification. Authors performed experimental study for minimum level of decalcification to detect the osteolytic bone metastasis of long bone with recent technique of radiographs. METHODS: One pair of fibula and humerus from two cadavers was cut into specimen 1 inch in length. Distal half of specimen was dipped into hydrochloride (HCl) with 15 min interval. All 16 specimens were checked by film-type radiography (FR), computed radiography (CR), digital radiography (DR). To exclude inter-observer's variance, 3 radiologists evaluated images. Calcium amount before and after decalcification was measured and expressed in percentage of decalcification. RESULTS: Osteolytic changes were detectable with 11% to 16% of decalcification for fibula and 3% to 8% for humerus on plain radiography with FR, CR, and DR. CONCLUSIONS: Our study showed that minimum of 3% and maximum of 16% of decalcification is necessary when osteolytic metastatic bone lesions of long bone could be detected on plain radiography.
Cadaver ; Calcium ; Decalcification Technique ; Fibula ; Humerus ; Neoplasm Metastasis* ; Osteolysis ; Radiographic Image Enhancement ; Radiography*

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Association between Homocysteine and Bone Mineral Density according to Age and Sex in Healthy Adults.

Joo Il KIM ; Ji Hyun MOON ; Hye Won CHUNG ; Mi Hee KONG ; Hyeon Ju KIM

Journal of Bone Metabolism.2016;23(3):129-134. doi:10.11005/jbm.2016.23.3.129

BACKGROUND: There are several studies about the relationship between serum homocysteine levels and bone mineral density (BMD), but the results are varied, and the studies are limited in Korea. In our study, the relationship between serum homocysteine levels and BMD by part according to age and sex is investigated. METHODS: From March 2012 to July 2015, the 3,337 healthy adults who took a medical examination were recruited. Subjects filled in the self-recording type questionnaire and physical examination, blood test, BMD of lumbar spine and femur were measured. After sorting by aging (≤49 year old, 50-59 year old, ≥60 year old) and sex, the results were adjusted with age and body mass index (BMI) and the relationship between serum homocysteine levels and BMD by lumbar spine and femur was analyzed by multiple regression analysis. RESULTS: As results of analysis, with the adjustment with age and BMI, all age groups of men had no significant relationship between log-converted serum homocysteine levels and BMD. In women aged under 50, there were significantly negative relationships at lumbar spine (β=-0.028, P=0.038), femur neck (β=-0.062, P=0.001), and total hip (β=-0.076, P<0.001), but there was no significant relationship in other age groups (50-59 year old and ≥60 year old). CONCLUSIONS: As the serum homocysteine levels increased in women aged under 50, BMD of the lumbar spine and femur decreased, and correlations between homocysteine and BMD were different by sex and age.
Adult* ; Aging ; Body Mass Index ; Bone Density* ; Female ; Femur ; Femur Neck ; Hematologic Tests ; Hip ; Homocysteine* ; Humans ; Korea ; Male ; Osteoporosis ; Physical Examination ; Spine

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