Bone Metabolic Markers in Patients with Obstructive Sleep Apnea Syndrome

Background： Obstructive sleep apnea syndrome （OSAS） is prevalent in obesity and is associated with many metabolic abnormalities. The relationship between OSAS and bone metabolism is still unclear. The aim of this study was to investigate the relationship between the severity of OSAS and bone metabolic markers. Methods： A total of 119 obese males were enrolled in this study in spring months from 2015 to 2017. All candidates underwent polysomnography, and their bone mineral density （BMD） and the serum levels of total procollagen type 1 N-tenninal propeptide （t-P I NP）, N-terminal midfragment ofosteocalcin （N-MID）, [3-C-terminal telopeptide of type 1 collagen （β-CTX）, vitamin D （VD）, and parathyroid hormone （PTH） were measured. The analysis of variance and Pearson correlation analysis were performed for data analyses. Results： No significant differences in the mean values of BMD were observed among the obesity, mild-to-moderate OSAS, and severe OSAS groups; and the serum levels oft-P1NP and [3-CTX in the severe OSAS group were significantly higher than those in the obesity group （48.42 ±23.78 ng/ml vs. 31.98 ± 9.85 ng/ml, P 〈 0.001 ; 0.53 ± 0.24 ng/ml vs. 0.41 ±0.13 ng/ml, P 0.011, respectively）. The serum level of VD in the obesity group was significantly higher than those in the mild-to-moderate and severe OSAS groups （both P 〈 0.001 ）, and decreased as the severity of OSAS increased （P 〈 0.001）. The serum level of PTH in the severe OSAS group was significantly higher than those in the obesity and mild-to-moderate OSAS groups （both P 〈 0.001 ）. The results of correlation analysis indicated that the level of apnea-hypopnea index （AHI） was correlated with the levels oft-P1NP （r = 0.396, P 〈 0.001 ）, VD （r = 0.404, P 〈 0.001 ）, and PTH （r = 0.400, P 〈 0.001 ）, whereas the level of minimum 02 saturation （SaO2min） was correlated with the levels ofVD （r = 0.258, P=0.016） andPTH（r= 0.376, P〈0.001）. Conclusions： The levels of bone resorption and formation markers in patients with severe OSAS were significantly increased compared to obese men, and the severity of OSAS was correlated with the serum levels of t-P1NP, VD, and PTH.

Correlations of single photon emission computed tomography joints scan and bone metabolic markers in active rheumatoid arthritis

Objective To explore the correlation between quantitative value of joint bone scan by single photon emission computed tomography(SPECT)and serum bone metabolic markers in patients with active rheumatoid arthritis(RA).Methods Clinical data of 60 newly diagnosed RA patients were retrospectively collected in Department

Vitamin E modulates androgen receptor gene expression to attenuate ovarian dysfunctions in a rat model of dehydroepiandrosterone-induced polycystic ovary

Objective:To investigate the protective effect of vitamin E in dehydroepiandrosterone(DHEA)-induced polycystic ovary in rats.Methods:Premature female Wistar rats were randomly allocated into four groups,with 7 rats in each group.Group栺received corn oil(vehicle)and served as the control group;group栻received 0.2 mL of 0.06 mg/g DHEA in corn oil;group栿received 200 mg/kg vitamin E;group桇received DHEA plus vitamin E.All treatments lasted for 15 days,with DHEA administered subcutaneously,while vitamin E and corn oil were administered orally.After the experiment,serum samples and ovaries were harvested for biochemical,immunohistochemical,hormonal,and histological analysis.The ovarian mRNA expression of androgen receptor was analyzed by reverse transcriptase quantitative polymerase chain reaction(qPCR).Results:The antioxidant and metabolic enzyme activity significantly decreased in the DHEA-treated rats compared to the control rats(P<0.05).Administration of vitamin E to DHEAtreated rats significantly decreased cytokines and malondialdehyde compared to the DHEA-treated rats.The histological analysis showed reduced atretic and cystic ovaries,increased E-cadherin and Bcl-2 expression,and reduced expression of Bax in the DHEAtreated rats co-treated with vitamin E.The mRNA expression of androgen receptor was upregulated in the DHEA-treated rats compared to the control rats.Conclusions:Vitamin E ameliorates the hyperandrogenic effect of DHEA-induced polycystic ovaries via metabolic,antioxidant,and anti-apoptotic pathways.

Development and application of hepatocellular carcinoma risk prediction model based on clinical characteristics and liver related indexes

BACKGROUND Hepatocellular carcinoma(HCC)is difficult to diagnose with poor therapeutic effect,high recurrence rate and has a low survival rate.The survival of patients with HCC is closely related to the stage of diagnosis.At present,no specific serolo-gical indicator or method to predict HCC,early diagnosis of HCC remains a challenge,especially in China,where the situation is more severe.AIM To identify risk factors associated with HCC and establish a risk prediction model based on clinical characteristics and liver-related indicators.METHODS The clinical data of patients in the Affiliated Hospital of North Sichuan Medical College from 2016 to 2020 were collected,using a retrospective study method.The results of needle biopsy or surgical pathology were used as the grouping criteria for the experimental group and the control group in this study.Based on the time of admission,the cases were divided into training cohort(n=1739)and validation cohort(n=467).Using HCC as a dependent variable,the research indicators were incorporated into logistic univariate and multivariate analysis.An HCC risk prediction model,which was called NSMC-HCC model,was then established in training cohort and verified in validation cohort.RESULTS Logistic univariate analysis showed that,gender,age,alpha-fetoprotein,and protein induced by vitamin K absence or antagonist-II,gamma-glutamyl transferase,aspartate aminotransferase and hepatitis B surface antigen were risk factors for HCC,alanine aminotransferase,total bilirubin and total bile acid were protective factors for HCC.When the cut-off value of the NSMC-HCC model joint prediction was 0.22,the area under receiver operating characteristic curve(AUC)of NSMC-HCC model in HCC diagnosis was 0.960,with sensitivity 94.40%and specificity 95.35%in training cohort,and AUC was 0.966,with sensitivity 90.00%and specificity 94.20%in validation cohort.In early-stage HCC diagnosis,the AUC of NSMC-HCC model was 0.946,with sensitivity 85.93%and specificity 93.62%in training cohort,and AUC was 0.947,with sensitivity 89.10%and specificity 98.49%in validation cohort.CONCLUSION The newly NSMC-HCC model was an effective risk prediction model in HCC and early-stage HCC diagnosis.

Animal Modelling of Lumbar Corpectomy and Fusion and in vivo Growth of Spine Supporting Bone by Titanium Cage Implants: An Experimental Study

In this study a lumbar spinal fusion animal model is established to assess the effect of spinal fusion cage,and explore theminimum area ratio of titanium cage section to vertebral section that ensures bone healing and biomechanical property.Lumbarcorpectomy was conducted by posterolateral approach with titanium cage implantation combined with plate fixation.Titaniumcages with the same length but different diameters were used.After implantation of titanium cages,the progress of bone healingwas observed and the bone biomechanical properties were measured,including deformation and displacement in axial compression,flexion,extension,and lateral bending motion.The factors affecting the in vivo growth of spine supporting body wereanalyzed.The results show that the area ratio of titanium cage section to vertebral section should reach 1/2 to ensure the bonehealing,sufficient bone intensity and biomechanical properties.Some bone healing indicators,such as BMP,suggest that there isa relationship between the peak time and the peak value of bone formation and metabolism markers and the bone healing strength.

Effect of"Natural Polypill",Xuezhikang on Serum Cholesterol Metabolism Markers in Early Menopausal Women with Hypercholesterolemia

Objective:To analyze the effect of Xuezhikang on the markers of the serum lipid levels of cholesterol synthesis and absorption in early menopausal women with hypercholesterolemia,and preliminarily explore its lipid-lowering mechanism.Methods:A total of 90 early menopausal women with hypercholesterolemia were enrolled from December,2014 to May,2016 from Beijing Anzhen Hospital,Capital Medical University,who were randomly allocated to receive Xuezhikang(1200 mg/d,orally)or atorvastatin(10 mg/d,orally)according to a random number table.Serum levels of some related biomarkers,including cholesterol synthesis markers(squalene,dihydrocholesterol,dehydrocholesterol,and lathosterol),and absorption markers(campesterol,stigmasterol,and sitosterol)as well as safety indices were obtained at baseline and after 8 weeks of the intervention.Results:Eight weeks after treatment,both Xuezhikang and atorvastatin significantly reduced the levels of total cholesterol,triglycerides,low density cholesterol compared to baseline(all P<0.01).Xuezhikang significantly reduced the levels of squalene,dehydrocholesterol and lathosterol compared to baseline(all P<0.01),but atorvastatin only significantly reduced the level of squalene(P<0.01),compared to baseline.All cholesterol absorption markers showed no significant differences before and after treatment(P>0.05),however,a more obvious downward trend was shown in the Xuezhikang group.In addition,all the safety indices showed no significant differences between the two groups.Although the creatinekinase level in the Xuezhikang group was significantly higher,it remained within the safe range.Conclusions:Xuezhikang may have more comprehensive effects on the markers of cholesterol synthesis and metabolism in early menopausal women with hypercholesterolemia through ergosterol and flavonoids in its"natural polypill."

Clinical update of pulsed electromagnetic fields on osteoporosis

Objective To understand the effects of low-frequency pulsed electromagnetic fields （PEMFs） on chronic bony pain, bone mineral density （BMD）, bone strength and biochemical markers of bone metabolism in the patients of osteoporosis. Data sources Using the key words “pulsed electromagnetic fields” and “osteoporosis”, we searched the PubMed for related studies published in English from January 1996 to December 2007. We also searched the China National Knowledge Infrastructure （CNKI） for studies published in Chinese from January 1996 to December 2007.Study selection Inclusion criteria： （1） all articles which referred to the effects of low-frequency pulsed magnetic fields on osteoporosis either in primary osteoporosis or secondary osteoporosis; （2） either observational studies or randomized controlled studies. Exclusion criteria： （1） articles on experimental studies about osteoporosis; （2） repetitive studies; （3） case reports; （4） meta analysis.Results Totally 111 related articles were collected, 101 of them were published in Chinese, 10 were in English. Thirty-four were included and the remaining 84 were excluded.Conclusions Low-frequency PEMFs relieves the pain of primary osteoporosis quickly and efficiently, enhances bone formation and increases BMD of secondary osteoporosis. But the effects of PEMFs on bone mineral density of primary osteoporosis and bone resorption were controversial.

Effects of raloxifene hydrochloride on bone mineral density, bone metabolism and serum lipids in Chinese postmenopausal women with osteoporosis: a multi-center, randomized, placebo-controlled clinical trial

Background Raloxifene has been approved for prevention and treatment of postmenopausal osteoporosis in Caucasian women. It also has some positive effects on serum lipids in Caucasians. The objective of this study was to determine the effect of raloxifene hydrochloride on lumbar spine and total hip bone mineral density (BMD), bone metabolism, and serum lipids in Chinese postmenopausal women with osteoporosis.Methods This was a multi-center, randomized, double-blind, placebo-controlled clinical trial in which 204 postmenopausal Chinese women with osteoporosis were assigned to receive raloxifene (60 mg) or placebo treatment daily for 12 months. BMD, serum bone metabolism markers, and serum lipids were measured before and after drug administration. BMD was measured by Dual-Energy X-Ray Absorptiometry (DEXA) and bone metabolism markers were analyzed by one-step enzyme-linked immunosorbent assay. Serum lipids were measured by enzymatic analysis.Results At the end of the 12-month study, lumbar spine BMD increased in both groups with a mean increase of (3.3±4.8) % in the raloxifene group and (1.0±4.9) % in the placebo group (P<0.001). There was a mean increase in total hip BMD of (1.4±4.8) % in the raloxifene group and a mean decrease of (0.9±5.0) % in the placebo group (P<0.001). No subject in the raloxifene group had a new vertebral fracture and 5 placebo subjects had new fractures (P>0.05). In the raloxifene group, the median decreases in the biochemical markers of bone metabolism serum osteocalcin and C-telopeptide were 41.7% and 61.5%, respectively. These changes were statistically significant compared with those in the placebo group (10.6% and 35.6%, P<0.001, respectively). Both total cholesterol and low-density lipoprotein cholesterol decreased significantly in the raloxifene group compared with those in the placebo group (P<0.001, respectively) and there was no significant effect of raloxifene on high-density lipoprotein cholesterol and triglycerides compared with placebo. Conclusions Raloxifene 60 mg/d for 12 months significantly increases lumbar spine and total hip BMD, significantly decreases bone turnover, and has favourable effects on serum lipids in Chinese postmenopausal women with osteoporosis.

Simultaneous Determination of Catecholamines and Related Metabolites by Capillary Electrophoresis with Amperometric Detection

An electrophoretic method was developed for the determination of several important catecholamine markers, namely norepinephrine, epinephrine, dopamine, metanephrine, vanillylmandelic acid and homovanillic acid in urine samples. Under the optimum conditions, the six marker compounds could be well separated with the major coexisting interference compound uric acid within 24 rain at a separation voltage of 16 kV in a borate running buffer （80 mmol/L, pH=9.48）. Highly linear response can be obtained over three orders of magnitude for the above markers with the low limits of detection ranging from 1.0 ng/mL to 5.0 ng/mL（S/N=3）. The proposed capillary electrophoresis with amperometric detection（CE-AD） method has been used to simultaneously determine the six catecholamine markers in urine samples of healthy volunteers and patients suffering from different diseases avoiding redundant measurements and high assay cost; and the electrochemical profiles can suggest more diagnostic information of multiple diseases, which provides a promising and convenient entry into primary diagnoses of several clinical diseases.