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An Innovative Herbal Product for the Prevention of Osteoporosis

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Chinese Journal of Integrative Medicine 2011年第10期17卷 744-749页

作者：梁秉中郑景辉陈一香 Institute of Chinese Medicine The Chinese University of Hong Kong Jockey Club Centre for Osteoporosis Care and Control The Chinese University of Hong Kong

Objective： To prevent the deterioration of osteopenia, a triple herb product Bo-gu Ling （补骨灵, ELP） was created for a clinical trial on post-menopausal women suffering from osteopenia. Methods： The design of the clinical trial was of randomized, double-blind, placebo-controlled nature. A total of 150 women aged 40-60 years, who were after menopause for at least 1 year and their lumbar spine bone mineral density （BMD） must be lower than 0.891 g/cm2, were recruited and randomly divided into the ELP group treated with ELP and the placebo group, with 75 in each group. The primary endpoint was the BMD of the lumbar spine that was assessed at baseline, 6 and 12 months after treatment. Secondary endpoints included peripheral quantitative computed tomography （pQCT） measurements of distal tibia and the changes in the quality of life （QOL）. Results： The spine BMD of the ELP group was increased by 0.69% in the subjects who were more than 10 years after menopause. In contrast, the placebo group of the same stratum decreased by 0.61% （P=0.067）. In the subjects with more than 10 years duration of menopause, the hip BMD increased by 0.21% in the ELP group, compared with a decrease of 0.52% in the placebo group （P=0.159）. The tibia strengthstrain index was increased by 1.94% in the ELP group compared with 0.33% in the placebo group （P=0.047）. Physical function of SF-36 QOL questionnaire was remarkably improved compared with the baseline, but did not show dominance over the placebo group. Conclusion： ELP showed potential benefit in improving BMD on the women who experienced over 10 years of menopause.

关键词： prevention of osteoporosis herbal product bone mineral density

Benefit of infusions with ibandronate treatment in children with osteogenesis imperfecta

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Chinese Medical Journal 2011年第19期124卷 3049-3053页

作者： LI Mei XIA Wei-bo XING Xiao-ping YU Wei HU Ying-ying JIANG Yan WANG Ou LIU Hai-juan HAN Lan-wen MENG Xun-wu XU Ling Department of Endocrinology Endocrine Key Laboratory of the Ministryof Health of China Peking Union Medical College Hospital Peking Union Medical CollegeChinese Academy of Medical Sciences Beijing 100730 China Department of Radiology Paeking Union Miedical College Hospital Peking Union Medical College Chinese Academy of Medical Sciences Beijing100730 China Department of Gynaecology and Obstetrics Peking Union Medical College Hospital Peking UnionMedical College Chinese Academy of Medical Sciences Beijing100730 China

Background Osteogenesis imperfecta （OI） is a rare bone disease and its effective treatment is relatively deficient. We tried to assess the effects of new bisphosphonate, ibandronate on children with OI.Methods In this open-label, prospective, controlled study, 30 children with OI were enrolled. They received either infusions of ibandronate （2 mg） in every three months or oral calcitriol 0.25 μg daily for 24 months. All patients took 500 mg calcium plus 200 U vitamin D daily together. The endpoints were the change of annual new fracture rate （observed by case history and X ray films of spine）, bone mineral density （BMD, measured by dual energy X-ray absortiometry）, serum concentration of carboxy-telopeptide cross-links of type Ⅰ collagen （CTX, bone resorption marker） and alkaline phosphatase （ALP, bone formation marker） during the follow-up.Results After the cyclic infusions of ibandronate, the annual new fracture rate was significantly decreased from 1.9 to 0.13 time, obviously lower than that of calcitriol group, which decreased from 1.8 to 1.0 time after the treatment （P 〈0.001）.The significant increase of BMD at the lumbar spine, femoral neck, trochanter, total hip was found in the group of ibandronate by 59.0%, 42.0%, 47.5% and 36.6% in time dependent manner （compared with the baseline, P 〈0.001）. The increase of BMD in ibandronate group was greater than that of calcitriol group （P 〈0.001）. The concentrations of ALP and CTX were obviously decreased in ibandronate group, and the reduction of CTX was more significant than that of ALP （P 〈0.001）. The tolerance of the children to ibandronate was quite well. Mild fever and muscle pain were found in 9 cases within 1-3 days after the first infusion of ibandronate, which could relieve after 1-2 days without special management.Conclusions The benefits of cyclic infusions of ibandronate to children with OI are significant because ibandronate could significantly reduce annual bone fracture rate, increase lumbar and hip BMD, preserve vertebral morphometry of patients thr

关键词： osteogenesis imperfecta ibandronate annual new fracture rate bone mineral density

Effect of Qing'e Formula on Circulating Sclerostin Levels in Patients with Postmenopausal Osteoporosis

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2015年第4期35卷 525-530页

作者：杨艳萍帅波沈霖徐晓娟马陈吕林 Department of Integrated Traditional Chinese and Western Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and Technology

Summary： Serum sclerostin is positively associated with serum 25 hydroxyvitamin D concentration. Our preliminary studies confirmed that Qing＇e formula （QEF） could effectively increase serum 25 hy- droxyvitamin D concentration in patients with postmenopausal osteoporosis （PMOP）, but the effect of supplementation with QEF on serum sclerostin is unknown. This study investigated the effects of sup- plementation of QEF on serum sclerostin levels in patients with PMOP. Totally 120 outpatients and in- patients with PMOP treated in our hospital between January and October 2012 were randomly divided into QEF＋calcium group, alfacalcidol＋calcium group, and placebo＋calcium group （n=40 each）, with a follow-up period of 2 years. The serum levels of sclerostin, 25 hydroxyvitamin D, and bone turnover markers （β-CTX, N-MID and T-PINP） at baseline and at the 6th month, 1st year, 1.5th year, and 2nd year after treatment were measured. The results showed that the levels of circulating sclerostin were in- creased significantly at the 6th month after treatment in QEF＋calcium group and alfacalcidol＋calcium group as compared with placebo＋calcium group （P〈0.05）, but there was no significant difference be- tween the former two groups （P〉0.05）. The levels of β-CTX, N-MID and T-PINP in serum were de- creased in both QEF＋calcium group and alfacalcidol＋calcium group at the 6th month after treatment, without significant difference between the two groups （P〉0.05）. BUt the levels were significantly lower than that in placebo＋calcium group （P〈0.05）. These results suggest that the mechanism by which QEF modulates bone metabolism in patients with PMOP might be related with the effect of QEF in increas- ing sclerostin expression. Our findings provide a scientific rationale for using QEF as an effective drug to prevent bone loss in PMOP.

关键词： serum sclerostin Qing＇e formula 25 hydroxyvitamin D bone mineral density

Effects of denosumab treatment in chronic liver disease patients with osteoporosis

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World Journal of Gastroenterology 2020年第33期26卷 4960-4971页

作者： Chisato Saeki Mitsuru Saito Tsunekazu Oikawa Masanori Nakano Yuichi Torisu Masayuki Saruta Akihito Tsubota Division of Gastroenterology and Hepatology Department of Internal MedicineThe Jikei University School of MedicineTokyo 1058461Japan Department of Orthopaedic Surgery The Jikei University School of MedicineTokyo 1058461Japan Core Research Facilities Research Center for Medical ScienceThe Jikei University School of MedicineTokyo 1058461Japan

BACKGROUND Effective treatment of osteoporosis is essential for improving morbidity and health-related quality of life in chronic liver disease(CLD)patients.Denosumab has been shown to increase bone mineral density(BMD)and decrease the risk of osteoporotic fracture in the general population.However,there are few reports evaluating the efficacy of denosumab in CLD patients.AIM To investigated the effects and safety of denosumab in CLD patients with osteoporosis.METHODS Sixty CLD patients with osteoporosis were subcutaneously administered denosumab once every 6 mo.The study period for evaluating efficacy and safety was 12 mo.Changes from baseline in BMD at the lumbar spine,femoral neck,and total hip were evaluated at 12 mo of denosumab treatment.bone turnover and quality were assessed by measuring serum tartrate-resistant acid phosphatase-5b(bone resorption marker),serum total procollagen type I N-terminal propeptide(bone formation maker),and plasma pentosidine(bone quality marker).RESULTS Among the 405 CLD patients,138(34.1%)patients were diagnosed with osteoporosis;among these,78 patients met the exclusion criteria and thus 60 patients were finally included in the present study.The median percentage changes from baseline to 12 mo of denosumab treatment in BMD at the lumbar spine,femoral neck,and total hip were+4.44%,+3.71%,and+4.03%,respectively.Denosumab significantly improved BMD,regardless of sex,patient age,and presence of liver cirrhosis.Serum tartrate-resistant acid phosphatase-5b and procollagen type I N-terminal propeptide levels constantly and significantly declined after denosumab treatment(Pbone turnover,and improved bone quality marker levels in CLD patients with osteoporosis,irrespective of differences in baseline characteristics.

关键词： Chronic liver disease Denosumab Osteoporosis bone mineral density bone turnover bone quality

Relationship between Glucocorticoid-induced Osteoporosis and Vitamine D Receptor Genotypes

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Journal of Huazhong University of Science and Technology(Medical Sciences) 2002年第4期22卷 317-319页

作者：李裕明徐琳沈凌迅余立凯陈璐璐 DepartmentofInternalMedicine

By means of polym erase chain reaction- restriction fragment length polymorphism (PCR- RFL P) assay,the association between vitamine D receptor (VDR) genotypes and bone min- eral density (BMD) in the patients receiving long- term glucocorticoid therapy was studied.The clinical data and blood of71patients with rheumatosis who received long- term glucocorticoid ther- apy were collected.BMD was m easured by dual- energy X- ray absorptimometry.VDR gene frag- ment(about185 bp) was amplified by PCR from the extracted genomic DNA,then digested with restriction endonuclease Bsm I.The genotypes were evaluated based on the fragment length fol- lowing endonuclease digestion and the association between genotypes and BMD or Z- score values was analyzed.Among the 71cases,the detected genotypes were Bb and bb with the distribution frequency being 11.3% and 88.7% respectively.The distribution frequency of the alleles was in agreement with the Hardy- Weinberg equilibrium.There was no significant difference between the two genotypes in age,gender,body m ass index(BMI) ,disease duration,disease types,time of glucocorticoid administration and cumulative dosage(P>0 .0 5 ) .Osteoporosis rate of the patients with Bb or bb genotype was37.5 % and33.3% respectively,with the difference being notsignif- icant (χ2 =0 .0 5 ,P=0 .8) .The BMD and Z- score values at lumbar spine and femur in two geno- types were not similar,but the difference had no significant (P>0 .0 5 ) .The distribution frequen- cy of bb type of VDR genotypes in Han populations of China was m ore prevalent,followed by Bb and bb types in turn.In the patients receiving long- term glucocorticoid therapy,there was no sig- nificant difference in BMD between Bb and bb genotypes.The data suggest that the VDR geno- types may not be m eans of identifying patients at greater risk of glucocorticoid- induced osteoporo- sis,which await to be further confirmed by a large sample size.

关键词： glucocorticoid vitamine D receptor bone mineral density genotypes polymerase chain reaction- restriction fragm ent length polym orphism

Is there higher percentage of undetected osteopenia and osteoporosis among patients with ulcerative colitis in Saudi Arabia?

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World Journal of Gastroenterology 2021年第27期27卷 4481-4483页

作者： Ivna Olic Akrapovic Mislav Radic Ante Tonkic Intensive Care Unit of the Department of Internal Medicine University Hospital Centre SplitSplit 21000Croatia Division of Rheumatology and Clinical Immunology Centre of Excellence for Systemic Sclerosis Ministry of Health Republic of CroatiaUniversity Hospital Centre SplitSplit 21000Croatia School of Medicine University of SplitSplit 21000Croatia Department of Gastroenterology and Hepatology University Hospital Centre SplitSplit 21000Croatia

Detection of prevalence and development of osteopenia or osteoporosis in patients with inflammatory bowel disease using only bone mineral density could be inappropriate to detect all individuals at risk for osteoporosis.Numerous patients could remain undetected by using only bone mineral density as a screening method,especially in patients with ulcerative colitis.Therefore,trabecular bone score should be used as a complementary method.

关键词： Inflammatory bowel disease Osteoporosis bone mineral density Trabecular bone score

A randomized, multicenter controlled trial to compare the efficacy of recombinant human parathyroid hormone （1-34） with elcatonin in postmenopausal women with osteoporosis in China

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Chinese Medical Journal 2009年第24期122卷 2933-2938页

作者： ZHANG Xiu-zhen WANG Bo YANG Jun XUAN Miao SONG Li-ge LI Hong GUO Xiao-hui LU Xiao-feng XUE Qing-yun YANG Gang-yi JI Qiu-he SHEN Jie LIU Zhi-min LI Cheng-jiang WU Tian-feng TONG Xiao-cui JIA Yuan Department of Endocrinology Tongji Hospital of Tongji University Shanghai 200065 China Department of Endocrinology Peking University First Hospital Beijing 100034 China Department of Endocrinology General Hospital of the Chinese People's Liberation Army Beijing Military Region Beijing 100700 China Department of Endocrinology Beijing Hospital Beijing 100730 China Department of Endocrinology Second Affiliated Hospital of Chongqing Medical University Chongqing 400010 China Department of Endocrinology Xijing Hospital of Fourth Military Medical University Xi'an Shaanxi 710032 China Department of Endocrinology Nanfang Hospital of Nanfang Medical University Guangzhou Guangdong 510515 China Department of Endocrinology Changzheng Hospital Second Military Medical University Shanghai 200003 China Department of Endocrinology First Affiliated Hospital of Zhejiang University Hangzhou Zhejiang 310003 China Department of Endocrinology Zhejiang Hospital Hangzhou Zhejiang 310013 China

Background Recombinant human parathyroid hormone （1-34）（rhPTH （1-34）） given by injection is a new seventh class drug of biological products, which is prepared by adopting gene recombination technique, rhPTH （1-34） is mainly used to treat osteoporosis, especially for postmenopausal women. This study compared the clinical efficacy and safety of rhPTH （1-34） with elcatonin for treating postmenopausal women with osteoporosis in 11 urban areas of China. Methods Two hundred and five women with osteoporosis were enrolled in a 6-month, multicenter, randomized, controlled study. They were randomized to receive either rhPTH （1-34） 20 ug （200 U） daily or elcatonin 20 U weekly. Lumbar spine （L1-4） and femoral neck bone mineral density （BMD）, as well as biochemical markers of bone turnover were measured. Adverse events were recorded. Results rhPTH （1-34） increased lumbar BMD significantly more than did elcatonin at 3 months and 6 months （2.38% vs 0.59%, P 〈0.05; 5.51% vs 1.55%, P 〈0.01）, but there were no significant increases of BMD in these two groups at femoral neck. There were larger mean increases in bone markers in the rhPTH （1-34） group than in the elcatonin group at 3 months and 6 months （serum bone-specific alkaline phosphatase （BSAP） 36.79% vs 0.31%; 92.42% vs -0.17%; urinary N-telopeptide/creatinine （NTX/Cr） 48.91% vs -5.32%; 68.82% vs -10.86%）. Both treatments were well tolerated and there were no significant differences detected between the two groups in the proportion of any adverse events and any serious adverse events （67.0% vs 59.0%; 0 vs 0）. Conclusions rhPTH （1-34） has more positive effects on bone formation, as shown by the larger increments of lumbar BMD and bone formation markers, than elcatonin, with only mild adverse events and no significant change in the liver, kidney or hematological indices.

关键词： recombinant human parathyroid hormone elcatonin osteoporosis bone mineral density

Relationship between Muscle Strength, Muscle Mass and BMD in Postmenopausal Female of Zhuang in Guangxi Province of China

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Journal of Biosciences and Medicines 2022年第2期10卷 87-97页

作者： Peizhao Shi Songyi Mo Jiahui Li Qingxiu Feng Yuanxin Huang Xinling Ma Biao Li Ziyang Fang Huiling Liu Guangwu Huang Ling Tang Jinhua Wang Xiaoyan Fang School of Basic Medical Sciences Youjiang Medical University for Nationalities Baise China Department of Orthopedics Affiliated Hospital of Hebei University of Engineering Handan China Department of Clinical Medicine Medical School of Nanjing University Nanjing China Affiliated Hospital of Youjiang Medical University for Nationalities Baise China School of Nursing Youjiang Medical University for Nationalities Baise China West China School of Basic Medical Sciences & Forensic Medicine Sichuan University Chengdu China

Objective: To explore the correlation between muscle strength, muscle mass and bone mineral density (BMD) in Zhuang female population, body composition analysis and grip strength, and to analyze the possible influencing factors of BMD. Methods: 182 postmenopausal women were selected from Guangxi Province of China. Broadband ultrasound attenuation (BUA) was used to evaluate BMD. Grip dynamometer to assess muscle strength. Height, weight and muscle mass of each part were measured by body composition measuring instrument. Body mass index (BMI), skeletal muscle mass index (SMI) and limb skeletal muscle mass (SM) were calculated according to the measurement results. Results: BUA, grip strength and SMI in postmenopausal women of Zhuang nationality showed a decreasing trend with age (p p p r = 0.305, p Conclusion: With the increase of age, the decline rate of muscle strength of postmenopausal Zhuang women in Guangxi is slower than that of BMD and muscle mass. SM can better reflect the BMD level of the body than SMI, and the LSM is the main influencing factor of BMD.

关键词： Muscle Strength Muscle Mass Musculoskeletal System bone mineral density Postmenopausal Females

Quantitative Evaluation of Fat Composition in Lumbar Vertebral Body and Paraspinal Muscle by Proton density Fat Fraction with MRI

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Open Journal of Orthopedics 2022年第3期12卷 85-96页

作者： Yuji Kasukawa Michio Hongo Toshihito Ebina Taishi Chiba Daisuke Kudo Ryota Kimura Yoichi Shimada Naohisa Miyakoshi Department of Orthopedic Surgery Akita University Graduate School of Medicine Akita Japan Department of Orthopedic Surgery Kakunodate General Hospital Senboku Japan Radiology Division Kakunodate General Hospital Senboku Japan Independent Administrative Institution Akita Prefectural Development and Disability Organization Akita Japan

Purpose: bone marrow and muscle adiposity have been considered to correlate with osteoporosis and Sarcopenia. Proton density Fat Fraction (PDFF) can be measured by Magnetic Resonance Imaging (MRI). The purpose of the present study was to measure PDFF in the lumbar spine, paraspinal muscle and subcutaneous fat tissue. Methods: Participants were comprised of 30 patients (18 males, 12 females;age range, 14 - 87 years) who underwent MRI due to low back symptoms. PDFFs for the body of the fourth lumbar vertebra (L4), paraspinal muscle, and subcutaneous fat were measured. Results: PDFFs of the vertebral body and subcutaneous fat were significantly higher than that of paraspinal muscle (p 63 years) than in younger subjects (Conclusions: PDFF of the vertebral body was significantly higher than that of paraspinal muscle. PDFFs of the vertebral body and paraspinal muscle were significantly lower in younger subjects than in older subjects.

关键词： Proton density Fat Fraction Vertebral Body bone Marrow Para-Spinal Muscle Age bone mineral density