04Jun 2014
wiley-logo

J Bone Miner Res. 2014 Jul;29(7):1507-18. doi: 10.1002/jbmr.2226.

Bariatric surgery is a popular and effective treatment for severe obesity but may have negative effects on the skeleton. This review summarizes changes in bone density and bone metabolism from animal and clinical studies of bariatric surgery, with specific attention to Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), and sleeve gastrectomy (SG). Skeletal imaging artifacts from obesity and weight loss are also considered. Despite challenges in bone density imaging, the preponderance of evidence suggests that bariatric surgery procedures have negative skeletal effects that persist beyond the first year of surgery, and that these effects vary by surgical type. The long-term clinical implications and current clinical recommendations are presented. Further study is required to determine mechanisms of bone loss after bariatric surgery. Although early studies focused on calcium/vitamin D metabolism and mechanical unloading of the skeleton, it seems likely that surgically induced changes in the hormonal and metabolic profile may be responsible for the skeletal phenotypes observed after bariatric surgery.

Autor: Yu EW.
04Jun 2014

J Bone Miner Res 2014; 29:1651-1660.

The clinical and radiographic findings of adult patients with persistent hypophosphatasemia resemble those of the adult form of hypophosphatasia. Clinicians should take notice of persistent hypophosphatasemia, consider the diagnosis of hypophosphatasia, and be cautious when considering potent anti-remodeling therapy in these adults. This population warrants further evaluation.

Autor: McKiernan FO, Berg R, Fuehrer J.
04Jun 2014
Springer

Osteoporos Int. 2014 Jun 25(6):1697-708. doi: 10.1007/s00198-014-2676-7.

In conclusion, we found that diabetes patients have a different bone turnover than non-diabetes patients and the differences in bone turnover are enhanced at menopause. The results from this meta-analysis underscore the need to conduct more re- search within the assessment of fracture risk using bone markers in patients with diabetes. The methodological study conducted in this study showed that it is not likely that bone markers change configuration due to changes in blood glu- cose. Thus, other mechanisms, apart from possible assay variability, may influence the heterogeneity observed for bio- markers in this study

Autor: Starup-Linde J1, Eriksen SA, Lykkeboe S, Handberg A, Vestergaard PIn
05May 2014
Springer

Osteoporos Int (2014) 25:2347–2357

To revisit the question posed in the title of this review, is vitamin D a tonic for bone and soft tissue? Probably not, but levels of <25–40 nmol/L do have significant adverse consequences, so should be prevented. However, as with any potent bioactive compound, more is not necessarily better, and use of vitamin D should be based on trial data, not on inferences drawn from studies of associations.

Autor: I. R. Reid & M. J. Bolland
04May 2014
Springer

MrOs Sweden. Osteoporos Int 2014;25:1831-1836

Serum adiponectin is a risk factor for fracture. Nevertheless, the predictive value attenuates with time so that its use for the risk assessment in the long term is questionable. This study underlines the importance of testing the long-term stability of potential risk factors that might be used in fracture risk assessment..

Autor: H. Johansson, A. Odén, M. K. Karlsson, E. McCloskey, J. A. Kanis, C. Ohlsson, D. Mellström
04May 2014
jama

JAMA Intern Med. 2014 May 5. doi: 10.1001/jamainternmed.2014.162. [Epub ahead of print]

The clinical utility of medication monitoring has been a controversial issue in osteoporosis management. In the 1998 and 20012 coverage rules commonly called the “Bone Mass Measurement Act,” the Centers for Medicare & Medicaid Services (CMS) outlined provisions for bone mineral density (BMD) and bone turnover marker measurements for Medicare beneficiaries. The CMS covers BMD testing for 5 indications and bone turnover marker testing for 3 indications, including monitoring of US Food and Drug Administration–approved osteoporosis drug therapy. The CMS authorizes BMD measurements if at least 23 months have passed since the last measurement, or more frequently “when medically necessary.”1(p34324) The CMS also summarized appropriate use of bone turnover markers, assuming documentation of medical necessity: “because of significant specimen to specimen collagen crosslink physiologic variability (15-20%), current recommendations for appropriate utilization include: one or two base-line assays from specified urine collections on separate days; followed by a repeat assay about three months after starting anti-resorptive therapy; followed by a repeat assay in 12 months after the three-month assay; and thereafter not more than annually, unless there is a change in therapy in which circumstance an additional test may be indicated three months after the initiation of new therapy.

Autor: Gourlay ML, Ensrud KE.
04May 2014
jama

JAMA Intern Med. 2014 May 5. doi: 10.1001/jamainternmed.2014.1232. [Epub ahead of print]

Among postmenopausal women who discontinue alendronate therapy after 4 to 5 years, age and hip BMD at discontinuation predict clinical fractures during the subsequent 5 years. Follow-up measurements of DXA 1 year after discontinuation and of BAP or NTX 1 to 2 years after discontinuation are not associated with fracture risk and cannot be recommended.

Autor: Bauer DC, Schwartz A, Palermo L, Cauley J, Hochberg M, Santora A, Cummings SR, Black DM.
04May 2014
Springer

JAMA. 2014 May 28;311(20):2083-91. doi: 10.1001/jama.2014.5052.

Vitamin D3 did not reduce the rate of first treatment failure or exacerbation in adults with persistent asthma and vitamin D insufficiency. These findings do not support a strategy of therapeutic vitamin D3 supplementation in patients with symptomatic asthma.

Autor: Castro M, King TS, Kunselman SJ, Cact.ana MD, Denlinger L, Holguin F, Kazani SD, Moore WC, Moy J.etc
04May 2014

Bone 2014; 62:22-28

Notch1 and Notch2 inactivation increased porosity and reduced thickness of cortical bone. These effects were modest and more evident in 3 and 6 month old female than in male mice of the same age. In conclusion, Notch1 and Notch2 expression in osteoblast precursors regulates cancellous bone volume and microarchitecture.

Autor: Zanotti S, Canali E.
04May 2014
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Bone. 2015 May 24;79:37-42. doi: 10.1016/j.bone.2015.05.022. [Epub ahead of print]

The maintenance of bone homeostasis is largely dependent upon cellular communication between osteoclasts and osteoblasts. Microvesicles (MVs) have received a good deal of attention and are increasingly considered as mediators of intercellular communication due to their capacity to merge with and transfer a repertoire of bioactive molecular content (cargo) to recipient cells, triggering a variety of biologic responses. Here, we demonstrated that MVs shed from osteoblasts contain RANKL protein and can transfer it to osteoclast precursors through receptor ligand (RANKL-RANK), leading to stimulation of RANKL-RANK signaling to facilitate osteoclast formation. Such MV-mediated intercellular communication between osteoblasts and osteoclasts may represent a novel mechanism of bone modeling and remodeling. It may be worthwhile to further explore MVs as tools to modify the biological responses of bone cells or develop an alternative drug to treat bone diseases.

Autor: Deng L, Wang Y, Peng Y, Wu Y, Ding Y, Jiang Y, Shen Z, Fu Q.