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Risk of fall in fragile elderly people with severe osteoporosis
S136
Abstracts
Importantly, a bimodal age-distribution of FSFs with a decreasing peak in young men and an increasing peak in elderly woman was found. Due to the latter, the number of FSFs was greater in women than in men. These findings challenge the prevailing view by demonstrating that in an aging population, FSFs are becoming more relevant in elderly women than in young men. This suggests a change in the mechanism from high to low energy trauma. It is therefore possible that osteoporotic alterations of the skeleton and/or the administration of bisphosphonates contribute to FSFs in the elderly, which are likely to become a relevant health care issue. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared. doi:10.1016/j.bone.2012.02.417
PP229 LCAT regulates osteoblasts and osteoclasts, but is not required for normal bone mass in mice with diet-induced obesity E.S. Kalyviotia,⁎, K.E. Kypreosb, F.A. Karagiannisc, E.A. Karaviab, H.C. Blaird, D.J. Papachristoua,d a Histology-Embryology, Unit of Bone Studies, University of Patras, School of Medicine, Rion, Patras, Greece b Pharmacology, University of Patras, School of Medicine, Rion, Patras, Greece c Hematology, University of Patras, School of Medicine, Rion, Patras, Greece d Pathology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA Abstract: Introduction: Osteoporosis (OP) is a common metabolic condition characterized by low bone mass and microarchitectural deterioration of bone tissue leading in bone fragility and susceptibility to fractures. Recent data propose that imbalances in lipid metabolism affect bone remodeling, contributing to OP. Thus, in the present study we aimed to investigate the involvement of LCAT (lecithin:cholesterol acyltransferase), a key enzyme responsible for the esterification of the free cholesterol of plasma lipoproteins in the regulation of bone remodeling band the development of OP in mice. Materials and methods: LCAT deficient (LCAT−/−) and control C57BL/6 12-week-old male mice (n = 6 mice/ group) were fed chow and western-type diet (WTD) for 24 weeks; their weight was monitored every 6 weeks. 7 and 5 days before sacrifice calcein was injected intraperitoneally. Following sacrifice, lumbar vertebrae and femora were removed for histological and histomorphometric analyses. Bone marrow (BM) mesenchymal stem cells were isolated, cultured and differentiated into osteoblasts. At days 10 and 21, osteoblasts were stained with von Kossa and Alkaline Phosphatase and examined for Runx2, Osterix and Osteopontin expressions with Flow Cytometry. Results: 1) 2) 3)
4) 5)
LCAT−/− mice fed WTD were significantly more sensitive to the development of diet-induced obesity (DIO) compared to the other groups. Lumbar trabecular bone volume/total volume and other static histomorphometrical parameters were similar between animal groups. Trabecular bone formation rate assessed with calcein labeling as well as osteoblast numbers and indices of bone resorption (TRAP positive cell number, osteoclast surface) was significantly reduced in LCAT−/− fed WTD compared to the control littermates. When stressed with WTD, more adipose tissue was accumulated within LCAT−/− mice BM, compared to the other experimental groups. At day 10, cultured osteoblasts derived from LCAT−/− mice fed WTD had significantly lower Runx2, Osterix and Osteopontin expression levels compared to osteoblasts from the other groups. No such differences were observed at day 21.
Conclusions: LCAT deficiency does not affect bone mass in mice. However, this enzyme prevents the accumulation of adipocytes in BM and regulates osteoblast and osteoclast number/function in mice fed WTD. Thus, LCAT might differentially regulate adiposity and bone remodeling in mice with DIO. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: E. Kalyvioti: none declared, K. Kypreos grant/research support from The European Community's Seventh Framework Programme (FP7-IR-Grant-PIRG02-GAGRANT-219129), F. Karagiannis: none declared, E. Karavia: none declared, H. Blair: none declared, D. Papachristou grant/research support from “The European Community's Seventh Framework Programme (FP7-IR-Grant-PIRG06-GA-256402)” and The University of Patras “Karathodori” Research Grant (#D155). This work is part of the activities of the research network “OsteoNet” of the University of Patras. doi:10.1016/j.bone.2012.02.418
PP230 Adipokine-related bone loss in patients before lung transplantation E.A. Kochetkova⁎, L. Ugay, K. Burya, S. Albavichus Vladivostok State Medical University, Vladivostok, Russian Federation Abstract: The aim of this study is to evaluate associations between the adipokines (tumor necrosis factor-alpha (TNF-α) and its receptors, leptin, adiponectin, resistin), body composition and bone mineral density (BMD) in patients with terminal stage of chronic respiratory failure. Material and methods: 63 patients with end-stage of chronic respiratory failure (COPD, emphysema and cystic fibrosis) and 55 healthy subjects were estimated. Bone mineral density and whole body composition was measured by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine (LS) and left femur neck (FN). We estimated respiratory function testing, serum levels TNF-α, TNFR-1, TNFR-2, leptin, adiponectin. Results: We indentified a decreased BMD characterized by T-scoreb −1.0 in 54/63 patients, as measured on the FN or the lumbar spine (LS). There was negative association between TNF-α and BMD (r=−0.43, p=0.04). Parameters of body compositions and serum concentrations of leptin and adiponectin were significantly associated with FN hip and LS. Serum leptin levels were significant lower (p=0.047) and adiponectin concentrations were higher (p=0.039) in the osteoporosis group. Serum leptin significantly positively correlated with parameters of body composition, and serum adiponectin concentrations were negatively associated with TNFR-1, TNFR-2 (p=0,007). There was a significant inverse relationship between leptin and adiponectin. Conclusion: These results show the possibly role of adipokines in the increase of bone loss at the terminal stage of chronic respiratory failure. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared.
doi:10.1016/j.bone.2012.02.419
PP231 Risk of fall in fragile elderly people with severe osteoporosis F. D'amico⁎, F. Caronzolo, G. Gaglio, A. Granata, A. Grippa, G. Lombardo, T. Pipicella, P. Spatola, E. Russo Department of Geriatrics, Hospital of Patti Messina, Patti, Italy Abstract: Objective: This study evaluated the connection between frailty and risk of fall in elderly people affected by severe osteoporosis. Methods: The subjects were all N 85: 46 women (mean age 88+3) and 6 men (mean age 88+2) affected by severe osteoporosis. In 8 women and 1 man we discovered a new spinal fracture after note-79-drug treatment. 38 women and 5 men had multiple spinal fractures (N3). 45 subjects were prescribed teriparatide treatment (PTH 1–34) and 7 were prescribed parathormone (PTH 1–84). The design of the study included at T0–T9–T18: 1) spine and hip DEXA densitometry; 2) spine Xray with morphometry; 3) Blood tests (Blood count, Protydogram , Creatinine, Phosphotemia, Calcium, Phosphaturia, Calciuria, Transaminase, Parathormone, FT3, FT4, TSH); 4) Multidimensional evaluation (MMSE-GDS-ADL-IADL-CIRS); 5) Numerical Rating Scale; and 6) Tinetti balance and gait Scale. Results: At T0 we considered : 1) Geriatric Depression State(GDS): mild depression 41.9% subjects (pb 0.05), severe depression 58.1% (pb 0.05); 2) Numerical rating scale (NRS): mild pain 25.6% subjects (pb 0.01), strong pain 74.4% subjects (pb 0.01); and 3) Tinetti balance and gait scale: mean score 8 (risk of fall) 83.8% subjects (pb 0.5); mean score 1 (non walking) 16.2% subjects (pb 0.5). At T18 we evaluated: 1) GDS: mild depression 65.1% subjects (pb 0.05), strong depression 34.9% subjects (pb 0.05); 2) NRS: mild pain 23.9% subjects (pb 0.01), moderate pain 58.1% subjects (pb 0.01), strong pain 18.6% subjects (pb 0.01); and 3) Tinetti balance and gait scale: mean score 14 (risk of fall) 93.1% subjects (pb 0.5), mean score 1 (non walking) 6.9% (pb 0.5). At T0 we also detected: MMSE mean score=19.5; mean comorbidity index=3 and mean severe comorbidity index=2.23. At T18 in all subjects we detected no new spine fractures through spine X-rays and morphometry. Conclusion: The study evaluated in the elderly people affected by severe osteoporosis the incidence of spine fractures in the spine region. We also indicated the fragility markers (depression, pain, fall) and the consequences of teriparatide (PTH 1–34) and parathormone (PTH 1–84) treatments on the change of those markers and the eventual improvement of life quality. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared. doi:10.1016/j.bone.2012.02.420
PP232/NIOP02 Long-term dietary vitamin D intake and risk of fracture and osteoporosis: A longitudinal cohort study of Swedish middle-aged and elderly women G. Snellmana,⁎, L. Byberga, E. Warensjö Lemminga, H. Melhusb, R. Gedeborgc, H. Mallmina, A. Wolkd, K. Michaëlssona
Abstracts
Importantly, a bimodal age-distribution of FSFs with a decreasing peak in young men and an increasing peak in elderly woman was found. Due to the latter, the number of FSFs was greater in women than in men. These findings challenge the prevailing view by demonstrating that in an aging population, FSFs are becoming more relevant in elderly women than in young men. This suggests a change in the mechanism from high to low energy trauma. It is therefore possible that osteoporotic alterations of the skeleton and/or the administration of bisphosphonates contribute to FSFs in the elderly, which are likely to become a relevant health care issue. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared. doi:10.1016/j.bone.2012.02.417
PP229 LCAT regulates osteoblasts and osteoclasts, but is not required for normal bone mass in mice with diet-induced obesity E.S. Kalyviotia,⁎, K.E. Kypreosb, F.A. Karagiannisc, E.A. Karaviab, H.C. Blaird, D.J. Papachristoua,d a Histology-Embryology, Unit of Bone Studies, University of Patras, School of Medicine, Rion, Patras, Greece b Pharmacology, University of Patras, School of Medicine, Rion, Patras, Greece c Hematology, University of Patras, School of Medicine, Rion, Patras, Greece d Pathology, University of Pittsburgh, School of Medicine, Pittsburgh, PA, USA Abstract: Introduction: Osteoporosis (OP) is a common metabolic condition characterized by low bone mass and microarchitectural deterioration of bone tissue leading in bone fragility and susceptibility to fractures. Recent data propose that imbalances in lipid metabolism affect bone remodeling, contributing to OP. Thus, in the present study we aimed to investigate the involvement of LCAT (lecithin:cholesterol acyltransferase), a key enzyme responsible for the esterification of the free cholesterol of plasma lipoproteins in the regulation of bone remodeling band the development of OP in mice. Materials and methods: LCAT deficient (LCAT−/−) and control C57BL/6 12-week-old male mice (n = 6 mice/ group) were fed chow and western-type diet (WTD) for 24 weeks; their weight was monitored every 6 weeks. 7 and 5 days before sacrifice calcein was injected intraperitoneally. Following sacrifice, lumbar vertebrae and femora were removed for histological and histomorphometric analyses. Bone marrow (BM) mesenchymal stem cells were isolated, cultured and differentiated into osteoblasts. At days 10 and 21, osteoblasts were stained with von Kossa and Alkaline Phosphatase and examined for Runx2, Osterix and Osteopontin expressions with Flow Cytometry. Results: 1) 2) 3)
4) 5)
LCAT−/− mice fed WTD were significantly more sensitive to the development of diet-induced obesity (DIO) compared to the other groups. Lumbar trabecular bone volume/total volume and other static histomorphometrical parameters were similar between animal groups. Trabecular bone formation rate assessed with calcein labeling as well as osteoblast numbers and indices of bone resorption (TRAP positive cell number, osteoclast surface) was significantly reduced in LCAT−/− fed WTD compared to the control littermates. When stressed with WTD, more adipose tissue was accumulated within LCAT−/− mice BM, compared to the other experimental groups. At day 10, cultured osteoblasts derived from LCAT−/− mice fed WTD had significantly lower Runx2, Osterix and Osteopontin expression levels compared to osteoblasts from the other groups. No such differences were observed at day 21.
Conclusions: LCAT deficiency does not affect bone mass in mice. However, this enzyme prevents the accumulation of adipocytes in BM and regulates osteoblast and osteoclast number/function in mice fed WTD. Thus, LCAT might differentially regulate adiposity and bone remodeling in mice with DIO. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: E. Kalyvioti: none declared, K. Kypreos grant/research support from The European Community's Seventh Framework Programme (FP7-IR-Grant-PIRG02-GAGRANT-219129), F. Karagiannis: none declared, E. Karavia: none declared, H. Blair: none declared, D. Papachristou grant/research support from “The European Community's Seventh Framework Programme (FP7-IR-Grant-PIRG06-GA-256402)” and The University of Patras “Karathodori” Research Grant (#D155). This work is part of the activities of the research network “OsteoNet” of the University of Patras. doi:10.1016/j.bone.2012.02.418
PP230 Adipokine-related bone loss in patients before lung transplantation E.A. Kochetkova⁎, L. Ugay, K. Burya, S. Albavichus Vladivostok State Medical University, Vladivostok, Russian Federation Abstract: The aim of this study is to evaluate associations between the adipokines (tumor necrosis factor-alpha (TNF-α) and its receptors, leptin, adiponectin, resistin), body composition and bone mineral density (BMD) in patients with terminal stage of chronic respiratory failure. Material and methods: 63 patients with end-stage of chronic respiratory failure (COPD, emphysema and cystic fibrosis) and 55 healthy subjects were estimated. Bone mineral density and whole body composition was measured by dual-energy X-ray absorptiometry (DEXA) at the lumbar spine (LS) and left femur neck (FN). We estimated respiratory function testing, serum levels TNF-α, TNFR-1, TNFR-2, leptin, adiponectin. Results: We indentified a decreased BMD characterized by T-scoreb −1.0 in 54/63 patients, as measured on the FN or the lumbar spine (LS). There was negative association between TNF-α and BMD (r=−0.43, p=0.04). Parameters of body compositions and serum concentrations of leptin and adiponectin were significantly associated with FN hip and LS. Serum leptin levels were significant lower (p=0.047) and adiponectin concentrations were higher (p=0.039) in the osteoporosis group. Serum leptin significantly positively correlated with parameters of body composition, and serum adiponectin concentrations were negatively associated with TNFR-1, TNFR-2 (p=0,007). There was a significant inverse relationship between leptin and adiponectin. Conclusion: These results show the possibly role of adipokines in the increase of bone loss at the terminal stage of chronic respiratory failure. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared.
doi:10.1016/j.bone.2012.02.419
PP231 Risk of fall in fragile elderly people with severe osteoporosis F. D'amico⁎, F. Caronzolo, G. Gaglio, A. Granata, A. Grippa, G. Lombardo, T. Pipicella, P. Spatola, E. Russo Department of Geriatrics, Hospital of Patti Messina, Patti, Italy Abstract: Objective: This study evaluated the connection between frailty and risk of fall in elderly people affected by severe osteoporosis. Methods: The subjects were all N 85: 46 women (mean age 88+3) and 6 men (mean age 88+2) affected by severe osteoporosis. In 8 women and 1 man we discovered a new spinal fracture after note-79-drug treatment. 38 women and 5 men had multiple spinal fractures (N3). 45 subjects were prescribed teriparatide treatment (PTH 1–34) and 7 were prescribed parathormone (PTH 1–84). The design of the study included at T0–T9–T18: 1) spine and hip DEXA densitometry; 2) spine Xray with morphometry; 3) Blood tests (Blood count, Protydogram , Creatinine, Phosphotemia, Calcium, Phosphaturia, Calciuria, Transaminase, Parathormone, FT3, FT4, TSH); 4) Multidimensional evaluation (MMSE-GDS-ADL-IADL-CIRS); 5) Numerical Rating Scale; and 6) Tinetti balance and gait Scale. Results: At T0 we considered : 1) Geriatric Depression State(GDS): mild depression 41.9% subjects (pb 0.05), severe depression 58.1% (pb 0.05); 2) Numerical rating scale (NRS): mild pain 25.6% subjects (pb 0.01), strong pain 74.4% subjects (pb 0.01); and 3) Tinetti balance and gait scale: mean score 8 (risk of fall) 83.8% subjects (pb 0.5); mean score 1 (non walking) 16.2% subjects (pb 0.5). At T18 we evaluated: 1) GDS: mild depression 65.1% subjects (pb 0.05), strong depression 34.9% subjects (pb 0.05); 2) NRS: mild pain 23.9% subjects (pb 0.01), moderate pain 58.1% subjects (pb 0.01), strong pain 18.6% subjects (pb 0.01); and 3) Tinetti balance and gait scale: mean score 14 (risk of fall) 93.1% subjects (pb 0.5), mean score 1 (non walking) 6.9% (pb 0.5). At T0 we also detected: MMSE mean score=19.5; mean comorbidity index=3 and mean severe comorbidity index=2.23. At T18 in all subjects we detected no new spine fractures through spine X-rays and morphometry. Conclusion: The study evaluated in the elderly people affected by severe osteoporosis the incidence of spine fractures in the spine region. We also indicated the fragility markers (depression, pain, fall) and the consequences of teriparatide (PTH 1–34) and parathormone (PTH 1–84) treatments on the change of those markers and the eventual improvement of life quality. This article is part of a Special Issue entitled ECTS 2012. Disclosure of interest: None declared. doi:10.1016/j.bone.2012.02.420
PP232/NIOP02 Long-term dietary vitamin D intake and risk of fracture and osteoporosis: A longitudinal cohort study of Swedish middle-aged and elderly women G. Snellmana,⁎, L. Byberga, E. Warensjö Lemminga, H. Melhusb, R. Gedeborgc, H. Mallmina, A. Wolkd, K. Michaëlssona