JBMR Plus最新文献

{"title":"Standardization of body composition parameters between GE Lunar iDXA and Hologic Horizon A and their clinical impact","authors":"Colin Vendrami, Guillaume Gatineau, Elena Gonzalez Rodriguez, Olivier Lamy, D. Hans, E. Shevroja","doi":"10.1093/jbmrpl/ziae088","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae088","url":null,"abstract":"\u0000 Body composition (BC) measured by dual X-ray absorptiometry (DXA) differs between devices. We aimed to compare regional and total BC measurements assessed by the Hologic Horizon A™ and the GE Lunar iDXA™ devices; to determine device-specific calibration equations for each BC parameter; and to assess the impact of this standardization procedure on the assessment of sarcopenia, lipedema, obesity and cardiovascular risk with DXA. A total of 926 postmenopausal women (aged 72.9 ± 6.9 years, height 160.3 ± 6.6 cm, weight 66.1 ± 12.7 kg) underwent BC assessment on each device within one hour, following the ISCD guidelines. The included sample was split into 80% train and 20% test datasets stratified by age, height and weight. Inter-device differences in BC parameters were assessed with Bland–Altman analysis, Pearson or Spearman correlation coefficients and t-tests or Wilcoxon tests. The equations were developed in the train dataset using backward stepwise multiple linear regressions and were evaluated in the test dataset with the R-squared and mean absolute error. We compared the abovementioned BC-derived health conditions before and after standardization in the test set with respect to relative risk, accuracy, Kappa score and McNemar tests. Total and regional body masses were similar (p > 0.05) between devices. Bone mineral content was greater for all regions in the Lunar device (p < 0.05), while fat and lean masses differed among regions. Regression equations showed high performance metrics in both datasets. The BC assessment from Hologic classified 2.13 times more sarcopenic cases (McNemar: p < 0.001), 1.39 times more lipedema (p < 0.001), 0.40 times less high cardiovascular risk (p < 0.001) and similarly classified obesity (p > 0.05), compared to Lunar. After standardization, the differences disappeared (p > 0.05), and the classification metrics improved. This study discusses how hardware and software differences impact BC assessments. The provided standardization equations address these issues and improve the agreement between devices. Future studies and disease definitions should consider these differences.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone turnover biomarkers reflect radiation-induced bone injuries in women with non-metastatic rectal cancer","authors":"Per Magnusson, Maria Sääf, A. Martling, A. S. Röjvall, Diana Atanasova, Franciszek Wilamowski, A. Rådestad, C. Buchli, J. Segelman","doi":"10.1093/jbmrpl/ziae087","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae087","url":null,"abstract":"\u0000 Preoperative radiotherapy (RT) for non-metastatic rectal cancer reduces local recurrence rates but can cause pelvic insufficiency fractures. Despite the high morbidity from RT-induced skeletal injuries, predictive and preventive measures are lacking. How these injuries are reflected by bone biomarkers are largely unknown. The aim was to assess longitudinal changes in bone biomarkers and their relation to RT-related bone injuries in women with rectal cancer. This longitudinal cohort study includes 47 women with non-metastatic rectal cancer treated with surgery ± preoperative RT with or without chemotherapy. Sclerostin, bioactive sclerostin, C-terminal telopeptide cross-links of collagen type I (CTX), bone-specific alkaline phosphatase (BALP), and type I procollagen intact N-terminal propeptide (PINP), were measured at baseline, after RT, and one year postoperatively. Pelvic magnetic resonance imaging were used for detection of skeletal injury. Sixteen of 36 (44%) irradiated women had radiation-induced bone injuries and were compared to 11 women (RT–) and 20 women (RT+) without bone injuries. Serum CTX, BALP and PINP increased during the first year after RT in women with radiation-induced bone injuries. The difference in mean change of CTX (p = 0.037) and BALP (p = 0.042) was conferred by longitudinal regression analyses adjusted for serum estradiol. Serum sclerostin and bioactive sclerostin remained stable over time. Taken together, bone markers may be of interest for future research on fracture prediction or preventive measures in women susceptible to radiation-induced bone injury. Due to few measure points, the full pattern cannot be captured regarding the relation over time between bone biomarkers and skeletal injury from irradiation.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141662963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Macrophages modulate mesenchymal stem cell function via tumor necrosis factor alpha in tooth extraction model.","authors":"Aung Ye Mun, Kentaro Akiyama, Ziyi Wang, Jiewen Zhang, Wakana Kitagawa, Teisaku Kohno, Ryuji Tagashira, Kei Ishibashi, Naoya Matsunaga, Tingling Zou, Mitsuaki Ono, Takuo Kuboki","doi":"10.1093/jbmrpl/ziae085","DOIUrl":"10.1093/jbmrpl/ziae085","url":null,"abstract":"<p><p>Mesenchymal stem cells (MSCs) and macrophages collaboratively contribute to bone regeneration after injury. However, detailed mechanisms underlying the interaction between MSCs and inflammatory macrophages (M1) remain unclear. A macrophage-depleted tooth extraction model was generated in 5-wk-old female C57BL/6J mice using clodronate liposome (12.5 mg/kg/mouse, intraperitoneally) or saline injection (control) before maxillary first molar extraction. Mice were sacrificed on days 1, 3, 5, 7, and 10 after tooth extraction (<i>n</i> = 4). Regenerated bone volume evaluation of tooth extraction socket (TES) and histochemical analysis of CD80⁺M1, CD206⁺M2 (anti-inflammatory macrophages), PDGFRα⁺MSC, and TNF-α⁺ cells were performed. In vitro, isolated MSCs with or without TNF-α stimulation (10 ng/mL, 24 h, <i>n</i> = 3) were bulk RNA-sequenced (RNA-Seq) to identify TNF-α stimulation-specific MSC transcriptomes. Day 7 micro-CT and HE staining revealed significantly lower mean bone volume (clodronate vs control: 0.01 mm³ vs 0.02 mm³, <i>p</i><.0001) and mean percentage of regenerated bone area per total TES in clodronate group (41.97% vs 54.03%, <i>p</i><.0001). Clodronate group showed significant reduction in mean number of CD80⁺, TNF-α⁺, PDGFRα⁺, and CD80⁺TNF-α⁺ cells on day 5 (306.5 vs 558.8, <i>p</i><.0001; 280.5 vs 543.8, <i>p</i><.0001; 365.0 vs 633.0, <i>p</i><.0001, 29.0 vs 42.5, <i>p</i><.0001), while these cells recovered significantly on day 7 (493.3 vs 396.0, <i>p</i>=.0004; 479.3 vs 384.5, <i>p</i>=.0008; 593.0 vs 473.0, <i>p</i>=.0010, 41.0 vs 32.5, <i>p</i>=.0003). RNA-Seq analysis showed that 15 genes (|log2FC| > 5.0, log2TPM > 5) after TNF-α stimulation were candidates for regulating MSC's immunomodulatory capacity. In vivo, <i>Clec4e</i> and <i>Gbp6</i> are involved in inflammation and bone formation. <i>Clec4e</i>, <i>Gbp6</i>, and <i>Cxcl10</i> knockdown increased osteogenic differentiation of MSCs in vitro. Temporal reduction followed by apparent recovery of TNF-α-producing M1 macrophages and MSCs after temporal macrophage depletion suggests that TNF-α activated MSCs during TES healing. In vitro mimicking the effect of TNF-α on MSCs indicated that there are 15 candidate MSC genes for regulation of immunomodulatory capacity.</p>","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11289833/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141859792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone microarchitecture and strength assessed by HR-pQCT in individuals with type 2 diabetes and prediabetes: the Maastricht study","authors":"V. van Hulten, C. Sarodnik, J. Driessen, Rikke Viggers, N. Rasmussen, Piet P M M Geusens, Nicolaas S Schaper, M. Schram, B. D. de Galan, Annemarie Koster, Sandrine P G Bours, Peter Vestergaard, Coen D. A. Stehouwer, J. P. van den Bergh","doi":"10.1093/jbmrpl/ziae086","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae086","url":null,"abstract":"\u0000 Type 2 Diabetes (T2D) is a prevalent disease and has been associated with an increased fracture risk despite normal or even higher areal bone mineral density (BMD). The aim of this study was to estimate the association between glucose metabolism status (GMS) and measurements of glycemic control with high-resolution peripheral quantitative computed tomography (HR-pQCT) parameters of bone microarchitecture and strength.\u0000 Participants of The Maastricht Study who underwent a HR-pQCT scan at the distal radius and tibia were included. GMS was determined by use of an oral glucose tolerance test and grouped into a normal glucose metabolism (NGM), prediabetes or T2D. Linear regression models were used, stratified by sex with multiple adjustments.\u0000 This study incorporated cross-sectional data from 1569 (885 (56.4%) NGM, 251 (16.0%) prediabetes and 433 (27.6%) T2D) men, and 1606 (1159 (72.2%) NGM, 231 (14.4%) prediabetes and 216 (13.4%) T2D) women. The mean age was 60.1 ± 8.6 and 57.8 ± 9.0 years for men and women, respectively.\u0000 After adjustment, T2D was associated with a higher total BMD measured by HR-pQCT and cortical thickness, and a smaller total and trabecular area in men and women compared to NGM. In women, T2D was additionally associated with a higher stiffness and failure load at the radius. Results were more pronounced at the distal radius than at the distal tibia.\u0000 To conclude, these findings suggest that in this cohort of Maastricht Study participants, total and trabecular bone area are smaller, but bone microarchitecture, density and bone strength assessed by HR-pQCT are not impaired in individuals with T2D.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141683702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and risk factors for AFF among Lebanese patients with hip and shaft fractures","authors":"Abir Bou Khalil, Ryan Yammine, Vanessa Rameh, Catherina Zadeh, Randa Saad, Hasan Mallah, Nabil J Khoury, G. E. Fuleihan","doi":"10.1093/jbmrpl/ziae069","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae069","url":null,"abstract":"\u0000 This retrospective study investigates the prevalence of atypical femoral fractures (AFFs) among patients admitted with hip and shaft fractures at a tertiary referral center in Beirut, Lebanon.\u0000 We analyzed electronic medical records and radiology studies of patients aged above 40 admitted with hip and shaft fractures between January 2006 and December 2019. Fractures were confirmed by ICD9 or ICD10 codes. All cases were reviewed by radiologists, and AFFs were identified according to the 2013 revised American Society of Bone and Mineral Research (ASBMR) criteria.\u0000 We identified 1366 hip and shaft fracture patients, of which 14 female patients had 19 AFFs. This represents a prevalence of 1.0% among all hip and shaft fractures patients and 1.7% among all female hip and shaft fracture patients. Bilateral AFFs were found in five of the 14 patients. Patients with AFF tended to be younger, with a mean age of 74.3 (±8.6) years compared to 78.0 (±10.6) for patients with non-AFF fractures. 36% of AFF patients had a prior history of non-traumatic fracture at first admission. A high percentage of patients with AFFs reported intake of proton pump inhibitors (42.9%) and glucocorticoids (21.4%). Bisphosphonate exposure was noted in 64.3% of AFF patients. None of the AFF patients were active smokers or consumed alcohol regularly. Bone Mineral Density assessments were available for seven AFF patients, indicating osteoporosis in four and osteopenia in three cases. Hip Axis Length measurements showed no significant difference between AFF patients (N = 7) and sex and age-matched controls (N = 21). The study underlines the prevalence and characteristics of AFFs in Lebanon, which is consistent with the numbers reported in the literature (0.32 - 5%). A larger prospective study that includes hospitals across the nation is needed to gain a more comprehensive view of the prevalence of AFFs in the Lebanese population.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bone mineral density is not associated with incident high-intensity back pain: a 10-year cohort study in men","authors":"M. Estee, Yuanyuan Wang, S. Heritier, D. Urquhart, F. Cicuttini, M. Kotowicz, K. Anderson, S. Brennan-Olsen, J. Pasco, A. Wluka","doi":"10.1093/jbmrpl/ziae076","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae076","url":null,"abstract":"\u0000 Although patients believe osteoporosis is a painful condition, health professionals assume it is painless unless a fracture occurs. The association between bone mineral density (BMD) and back-pain has not been examined longitudinally in community-based adults in an unbiased population, using gold standard measures. This study aimed to examine the association between BMD and incident high-intensity back pain and/or high-disability over 10 years in Australian men without high-intensity symptoms at baseline. Men with no high-intensity back pain and/or high-disability attending the Geelong Osteoporosis Study at the 5-year visit (2006-2010) (considered the baseline for the current study), were followed for 10 years (2016-2021). Back pain and disability were assessed using the Graded Chronic Pain Scale at both time points. At baseline, dual energy X-ray absorptiometry was used to measure lumbar spine and total hip BMD and spinal artefacts. The relationships between BMD and incident high-intensity pain and/or high-disability at follow-up were examined using binary logistic regression, adjusted for age, body mass index, depression, education, smoking, mobility and spinal artefacts. Six hundred and seventy-nine participants had no to low-intensity pain and/or no to low-disability at baseline. Four hundred and forty-one attended follow-up, providing back pain and disability data. Thirty-seven men developed high-intensity pain and/or high-disability. No association of BMD at any site was seen with incident high-intensity pain and/or high-disability. BMD was not associated with incident high-intensity pain or disability in community-based men. These data provide evidence to dispel the erroneous community-held belief that low BMD is related to back-pain and disability.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141364263","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monthly treatment with romosozumab for one year increases bone mineral at the hip, but not the knee, in women with chronic spinal cord injury","authors":"Laura E. Crack, Narina Simonian, Thomas J. Schnitzer, W. B. Edwards","doi":"10.1093/jbmrpl/ziae077","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae077","url":null,"abstract":"\u0000 Bone loss below the level of neurological lesion is a well-known complication of spinal cord injury (SCI). To date, most research has focused on pharmaceutical intervention using antiresorptives to prevent bone loss during the acute phase of SCI; however, limited research has investigated treatments for established osteoporosis during chronic SCI. Romosozumab, a monoclonal antibody with both antiresorptive and anabolic effects, has demonstrated significant increases in bone mineral density for women with established post-menopausal osteoporosis. Therefore, the purpose of this study was to examine the efficacy of monthly treatment with romosozumab to improve dual-energy X-ray absorptiometry (DXA) derived areal bone mineral density at the hip, and computed tomography (CT) derived bone mineral content and strength at the hip and knee in women with chronic SCI and an inability to ambulate. Twelve female participants with chronic SCI were recruited to receive one year of monthly subcutaneous injections of romosozumab (210 mg). DXA and CT scans were taken at baseline, and months 3, 6 and 12 to quantify bone mineral, and finite element analysis was used to predict bone strength. Longitudinal mixed effects models were employed to determine the impact of treatment on bone properties. After 12 months of treatment, areal bone mineral density at the lumbar spine and total hip were significantly increased with median changes of 10.2% (IQR: 8.3 – 15.2%, p < 0.001) and 4.2% (IQR: 3.4 – 7.7%, p = 0.009), respectively. Improvements at the hip were primarily due to increases in trabecular, not cortical, bone and effects were sufficient to significantly increase finite element predicted strength by 20.3% (IQR: 9.5 – 37.0%, p = 0.004). Treatment with romosozumab did not lead to any significant improvement in bone mineral at the distal femur or proximal tibia. These findings provide promising results for romosozumab treatment to improve bone mineral and reduce fracture risk at the hip, but not the knee, in women with chronic SCI.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141373002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inorganic phosphate additives in meals and adaptations to 5 days of dietary inorganic phosphate loading alter acute calcium homeostasis in two randomized cross-over studies in healthy adults","authors":"M. Turner, Tom Mazzetti, Kathryn Neville, Emilie C. Ward, Jenny Munroe, Michael A. Adams, R. Holden","doi":"10.1093/jbmrpl/ziae075","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae075","url":null,"abstract":"\u0000 Diets containing inorganic phosphate additives are unbalanced with respect to calcium and these diets have been linked to the development of altered bone metabolism. Using two randomized cross-over studies in healthy humans, we (1) characterized the hormonal and urinary response to two meals with the same reported phosphorus amount (562-572 mg), where one was manufactured with inorganic phosphate additives and a comparatively lower Ca:P molar ratio (0.26 vs. 0.48), and (2) assessed how acute homeostatic mechanisms adapt following 5-day exposure to recommended dietary phosphorus amount (~700 mg P/day) compared to a diet enriched with inorganic phosphate additives (~1100 mg P/day). Participants were then challenged with 500 mg of oral phosphorus in the form of inorganic phosphate after an overnight fast following each diet condition. Measurements included serum calcium, phosphate, PTH, and FGF-23, vitamin D metabolites, and urine calcium and phosphate excretion. Following the meal containing inorganic phosphate additives with a low Ca:P ratio, serum phosphate was higher and more phosphate was excreted in the urine compared to the low additive meal. Although the Ca:P and calcium content was lower in the high additive meal, the same amount of calcium was excreted into the urine. Subsequently increasing only dietary phosphate through additives resulted in lower 24-hour excretion of calcium. The oral phosphate challenge promoted urinary calcium excretion, despite no consumption of calcium, which was attenuated when pre-acclimated to a high phosphate diet. These data suggest that ingestion of inorganic phosphate promotes calcium excretion, but homeostatic mechanisms may exist to reduce calcium excretion that are responsive to dietary intake of phosphate. Future studies are required to evaluate potential implication of diets enriched with inorganic phosphate additives on bone health.","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.8,"publicationDate":"2024-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141379086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intermittent dosing of zoledronic acid based on bone turnover marker assessment reduces vertebral and non-vertebral fractures.","authors":"Tove Tveitan Borgen, Sindre Lee-Ødegård, Barbara Fink Eriksen, Erik Fink Eriksen","doi":"10.1093/jbmrpl/ziae072","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae072","url":null,"abstract":"<p><p>Previous studies have demonstrated that the administration of zoledronic acid (ZOL) once yearly for 3 years or once over 3 years, yields similar antifracture efficacy. Bone turnover markers can predict the antifracture efficacy of antiresorptive agents, with procollagen type 1 N-terminal propeptide (P1NP) being the most useful marker. In this retrospective cohort study, we explored the effects of intravenous dosing of ZOL guided by serum (S)-P1NP assessment on bone mineral density (BMD) and fractures. Consenting patients (<i>N</i> = 202, mean age 68.2 years) with osteoporosis were treated with ZOL for an average of 4.4 (range 2-8) years. S-P1NP and BMD were measured at baseline and every 1-2 years. We assessed the number of subsequent vertebral and nonvertebral fractures in the 2-year time periods. The number of patients assessed was 202, 147, 69, and 29 at years 1-2, 3-4, 5-6, and 7-8, respectively. A new ZOL infusion was given if S-P1NP exhibited values above 35 μg/L. BMD increased by 6.2% (SD 4.0) over the first 2 years and stabilized in years 2-8 (<i>P</i> <.05). Median S-P1NP exhibited an initial reduction from 58.0 to 31.3 μg/L at year 2 and then increased to 39.0 μg/L at years 7-8. Compared with fractures observed in the last 2 years before baseline, fracture rates exhibited consistent reductions, for vertebral fractures odds ratio (OR) [95% confidence interval] = 0.61 [0.47, 0.80], <i>P</i> <.001 and for nonvertebral fractures OR = 0.23 [0.18, 0.31], <i>P</i> <.001. In conclusion, intermittent dosing of intravenous ZOL based on the assessment of S-P1NP with cut-off at 35 μg/L resulted in an initial increase followed by a stable BMD, suppression of S-P1NP, and stable reduction of fractures for 8 years. Only 39% of patients needed more than one infusion. This approach reduces healthcare costs and might also reduce the risk of rare side effects such as osteonecrosis of the jaw and atypical femoral fracture.</p>","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11208720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141467924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Natural history and complications of normocalcemic hyperparathyroidism: a retrospective cohort study.","authors":"Caroline Wei Shan Hoong, Stephen M Broski, Jad G Sfeir, Bart Lyman Clarke","doi":"10.1093/jbmrpl/ziae074","DOIUrl":"https://doi.org/10.1093/jbmrpl/ziae074","url":null,"abstract":"<p><p>Normocalcemic hyperparathyroidism (NHPT) is variably defined, and information regarding complications and natural history are scarce. We aimed to describe the phenotype of NHPT in relation to hypercalcemic hyperparathyroidism (PHPT) and controls, to determine risk of progression, and to develop a predictive model for progression to PHPT. This is a retrospective chart review of 232 patients at a tertiary medical center, comparing 75 controls, 73 patients with NHPT, and 84 with PHPT. NHPT was intermediate in biochemical profile between controls and PHPT with respect to cCa, iPTH, intraindividual coefficient of variant of cCa, phosphorus, and 25(OH)D. NHPT patients had an increased adjusted risk of urolithiasis (OR 5.34, 95%CI, 2.41-12.71, <i>P</i> < .001) and fragility fractures (OR 4.53, 95%CI, 1.63-14.84, <i>P</i> = .006) versus controls, after adjustment for age, sex, and BMI. Fewer NHPT compared with PHPTH patients achieved cure with parathyroidectomy (<i>P</i> = .001). NHPT more often had nonlocalizing imaging or polyglandular disease (<i>P</i> = .005). Parathyroidectomy improved biochemical but not BMD parameters in NHPT. Over a median follow-up of 4.23 (IQR 1.76-5.31) years, NHPT patients managed expectantly experienced no change in iPTH, and progression to PHPT occurred in 9%. An XGBoost model combining 6 factors for progression (mean index 2 iPTH, mean index 2 cCa, 24-h urinary calcium, age, 25(OH)D, and presence of urolithiasis) had an area under the curve 1.00 (95%CI, 1.00-1.00, <i>P</i> < .001) for predicting combined progression. NHPT is a mild variant of PHPT at intermediate risk of urolithiasis and fragility fractures. Cure was less often achieved with parathyroidectomy, which did not improve BMD parameters. Progression was infrequent with conservative management. Because only a minority progressed to PHPT, in addition to lower surgical success rates, we suggest conservative management for the majority of NHPT unless risk factors for progression are identified.</p>","PeriodicalId":14611,"journal":{"name":"JBMR Plus","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11406159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142287303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}