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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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Compression Fracture in Postpartum Osteoporosis.

Judith L GUTOWSKI

Journal of Bone Metabolism.2014;21(2):161-161. doi:10.11005/jbm.2014.21.2.161

No abstract available.
Fractures, Compression* ; Osteoporosis* ; Postpartum Period*

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Serum Bisphenol A Concentration in Postmenopausal Women with Osteoporosis.

Dong Hyun KIM ; Chi Hyuk OH ; Yoo Chul HWANG ; In Kyung JEONG ; Kyu Jeong AHN ; Ho Yeon CHUNG ; Jae Suk CHANG

Journal of Bone Metabolism.2012;19(2):87-93. doi:10.11005/jbm.2012.19.2.87

OBJECTIVES: Bishphenol A (BPA) is a representative endocrine disruptor and is also known as a xenoestrogen. The objective of the present study is to investigate how many patients are exposed to BPA and to analyze the relationships between serum BPA concentration, bone mineral density (BMD) and biochemical bone markers in postmenopausal women with osteoporosis. METHODS: Total 51 patients were enrolled for measuring BPA and clinical variables including BMD and bone markers. The relationship between BPA and clinical variables were analyzed by the Pearson's correlation test and the Kruskal-Wallis test. Serum BPA concentration was measured by enzyme linked immunosorbent assay (ELISA). RESULTS: BPA was detected in all samples. The mean BPA concentration was 1.44 +/- 0.52 ng/mL. There was no statistically significant correlation between BPA and clinical variables. CONCLUSION: There was no statistical significance between serum BPA concentration and clinical variables related to bone metabolism. To clarify the effect of BPA on bone metabolism, further large scaled and high risk group investigation may be needed.
Benzhydryl Compounds ; Bone Density ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Osteoporosis ; Phenols

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Mortality after Hip Fractures in Nonagenarians.

Bun Jung KANG ; Young Kyun LEE ; Ki Woong LEE ; Sung Hun WON ; Yong Chan HA ; Kyung Hoi KOO

Journal of Bone Metabolism.2012;19(2):83-86. doi:10.11005/jbm.2012.19.2.83

OBJECTIVES: Nonagenarians with hip fractures represent a special group of people because of their advanced age and co-morbidities. We evaluated mortality after hip fractures in nonagenarians. METHODS: Fifty-one patients were studied over a 2-year period. There were 39 female and 12 male patients. Twenty seven patients sustained an intertrochanteric fracture of the femur, 24 suffered from femoral neck fracture. The American Society of Anaesthetists (ASA) score of II was the most frequent among 51. Forty-one of them had one or more co-morbidities. Patient review was done 2 years after the fracture. RESULTS: The mortality rate at one year was 53.4% in men, and 15.7% in women. After multivariate analysis, the type of fracture (intertrochanteric fracture) was identified as a risk factor for one-year mortality (P = 0.025). CONCLUSION: The outcome in nonagenarians with hip fractures is poor due to the high rates of mortality, especially in men, and this could be informed to patients and their families before hip fracture surgery.
Aged, 80 and over ; Female ; Femoral Neck Fractures ; Femur ; Hip ; Hip Fractures ; Humans ; Male ; Multivariate Analysis ; Risk Factors

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Atypical Femoral Fracture Combined with Osteonecrosis of Jaw During Osteoporosis Treatment with Bisphosphonate.

Yougun WON ; Joon Ryul LIM ; Young Hwan KIM ; Hyung Keun SONG ; Kyu Hyun YANG

Journal of Bone Metabolism.2014;21(2):155-159. doi:10.11005/jbm.2014.21.2.155

Bisphosphonate, a potent anti-resorptive agent, is generally accepted as a safe, effective, well tolerated treatment for postmenopausal osteoporosis. Atypical femoral fracture (AFF) and bisphosphonate related osteonecrosis of jaw (BRONJ) are the increasing morbidities in patients treated with long term bisphosphonate. Pathogenic mechanisms of AFF and BRONJ are not fully identified and not identical. We report a case of BRONJ followed by AFF and its nonunion in a 67-year-old woman patient receiving an oral bisphosphonate during 7 years for the treatment of osteoporosis.
Aged ; Female ; Femoral Fractures* ; Humans ; Jaw* ; Osteonecrosis* ; Osteoporosis* ; Osteoporosis, Postmenopausal

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Hypertrophic Osteoarthropathy in Patient with Crohn's Disease: A Case Report.

Sung Min RHEE ; Ki Jeong PARK ; Yong Chan HA

Journal of Bone Metabolism.2014;21(2):151-154. doi:10.11005/jbm.2014.21.2.151

Numerous causes of hypertrophic osteoarthropathy (HOA) have been reported. Commonly, secondary osteoarthropathy accompanies pulmonary diseases such as carcinoma of the lung, pleural tumors, lung abscesses, and bronchiectasis. However, HOA in inflammatory bowel disease is a rare complication. There are only a few reports of secondary HOA with Crohn's disease. Our purpose was to report another case of HOA in Crohn's disease. We describe a case of a 27-year-old man with underlying Crohn's disease presenting with 2 years of pain in multiple joints. Radiographic findings suggested HOA in extremities. We performed a conservative treatment including medication and rehabilitations. The patient's symptoms were much improved at the latest follow-up. Although numerous studies on HOA have been published, the pathogenesis of HOA is still unclear. Various treatment modalities were recommended but further studies to uncover the pathogenesis of HOA with Crohn's disease and to establish a treatment modality are needed.
Adult ; Bronchiectasis ; Crohn Disease* ; Extremities ; Follow-Up Studies ; Humans ; Inflammatory Bowel Diseases ; Joints ; Lung ; Lung Abscess ; Lung Diseases ; Periostitis

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Physicians' Attitudes to Contemporary Issues on Osteoporosis Management in Korea.

Yong Chan HA ; Young Kyun LEE ; Yong Taik LIM ; Sun Mee JANG ; Chan Soo SHIN

Journal of Bone Metabolism.2014;21(2):143-149. doi:10.11005/jbm.2014.21.2.143

BACKGROUND: In management of osteoporosis, several concerns here have been raised. The current issue included the utilization of dual energy X-ray absorptiometry (DXA) and fracture-risk assessment (FRAX), screening of vitamin D deficiency and secondary osteoporosis, and long-term use of bisphosphonate and calcium supplements. There was no study on physicians' attitude on these current issues in Korea. Therefore, we investigated the physicians' attitude on these issues by survey. METHODS: We administered a 30-item questionnaire to all members of Korean Society for Bone and Mineral Research by email survey form. One hundred participants answered the questionnaire. The questionnaire included the questions about the physicians' attitude to current issues and the barriers to osteoporosis treatment in Korea. RESULTS: Most physicians used bone densitometry devices (99%) and, central DXA was the most accessible device (95%). Eighty-eight percent were aware of FRAX(R), but among them, only 19.3% used it. The main reason for not using FRAX(R) was the lack of time in their proactive (76%). Screening for vitamin D status and secondary osteoporosis was performed by 59% and 52% of the respondents, respectively. The lack of awareness among patients and high costs of medication were perceived as the most important barriers to osteoporosis management in Korea. CONCLUSIONS: This study provides physicians' perspective to the current issue for diagnostic and treatment of osteoporosis in Korea. To further improve osteoporosis management, educational programs for patients and doctors, and the improvement of reimbursement system should be considered in Korea.
Absorptiometry, Photon ; Calcium ; Surveys and Questionnaires ; Densitometry ; Electronic Mail ; Humans ; Korea ; Mass Screening ; Osteoporosis* ; Vitamin D ; Vitamin D Deficiency

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Association of Arterial Stiffness and Osteoporosis in Healthy Men Undergoing Screening Medical Examination.

Nam Lee KIM ; Ha Min JANG ; Sul Ki KIM ; Ki Dong KO ; In Cheol HWANG ; Heuy Sun SUH

Journal of Bone Metabolism.2014;21(2):133-141. doi:10.11005/jbm.2014.21.2.133

BACKGROUND: Association of arterial stiffness and osteoporosis has been previously reported in women. However, this association is still controversial for men. Therefore, we investigated correlation of arterial stiffness and osteoporosis by measuring brachial-ankle (ba) pulse wave velocity (PWV) and bone mineral density (BMD). METHODS: We reviewed medical charts of 239 people (women: 128, men: 111) who visited the Health Promotion Center, retrospectively. ba-PWV was measured by automatic wave analyzer. Lumbar spine (L1-L4) BMD and femur BMD were measured by dual energy X-ray absorptiometry. Metabolic syndrome was based on the National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATPIII) definition. Body mass index (BMI)>25 kg/m2 was used instead of waist circumference. RESULTS: In Pearson's correlation analysis, PWV and femur BMD (Neck, total) had a significant inverse relationship in men (r=-0.254, P=0.007; r=-0.202, P=0.034). In women, PWV and the L-spine, femur (Neck, total) had a significant inverse relationship. (r=-0.321, P<0.001; r=-0.189, P=0.032; r=-0.177, P=0.046) Age and PWV showed the greatest association in both men and women (r=0.46 P<0.001; r=0.525, P<0.001) In multiple regression analysis, the L-spine BMD and PWV had an independent relationship in women after adjusting for age, metabolic syndrome, BMI, smoking, drinking and exercise. (r=-0.229, P=0.015). No independent association was found between PWV and BMD in men. CONCLUSIONS: The association between arterial stiffness and BMD was confirmed in women. However, this association was not statistically significant for men.
Absorptiometry, Photon ; Body Mass Index ; Bone Density ; Cholesterol ; Drinking ; Education ; Female ; Femur ; Health Promotion ; Humans ; Male ; Mass Screening* ; Osteoporosis* ; Pulse Wave Analysis ; Retrospective Studies ; Smoke ; Smoking ; Spine ; Vascular Stiffness* ; Waist Circumference

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