Aluminum osteodystrophy and celiac disease.
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Aluminum↗
Biomedical subjects
D Chappard
Publications and source records attributed to D Chappard.
Image analysis measurements of roughness by texture and fractal analysis correlate with contact profilometry.
Surface properties of a biomaterial are important factors that govern in part its biocompatibility. Among them, surface roughness is now recognized as a very important factor for cell interactions. Surface roughness (Ra) is routinely measured by contact profilometry but other methods are presently usable. We compared two methods (contact profilometry and image analysis of scanning electron microscopic images SEM) on a series of 12 titanium test pieces. The texture analysis of SEM pictures was done by the heterogeneity and run-length methods. Fractal geometry was also used with the "skyscraper" and "blanket" methods providing respectively the D(SKY) and D(BLANK) fractal dimensions. The fractal dimension of the profilometric curve was also computed (D(MINK)). Computer-simulated textures were used to evaluate the pertinence of the algorithms. A significant correlation was found between Ra and all the texture descriptors except heterogeneity. The correlation coefficient was dependent on the microscopic magnification. The fractal dimension of the curve was correlated with D(SKY) and D(BLANK). Run-length, D(SKY) and D(BLANK) were highly correlated, independent of the magnification used, a finding related to the self-similarity of the images. Image texture analysis can be a useful alternative to profilometry with brittle or soft materials or with objects having a complex shape.
Algorithms↗
Synchrotron X-ray microtomography (on a micron scale) provides three-dimensional imaging representation of bone ingrowth in calcium phosphate biomaterials.
This study used synchrotron X-ray microtomography on a micron scale to compare three-dimensional (3D) bone ingrowth after implantation of various calcium phosphate bone substitutes in a rabbit model. The advantage of using this new method for the study of biomaterials was then compared with histomorphometry for analysis of interconnection and bone ingrowth. The study focused on the newly formed bone-biomaterial interface. Macroporous Biphasic Calcium Phosphate (MBCP) ceramic blocks and two different injectable calcium phosphate biomaterials [an injectable bone substitute (IBS) consisting of a biphasic calcium phosphate granule suspension in hydrosoluble polymer and a calcium phosphate cement material (CPC)] were studied after in vivo implantation. Absorption or phase-contrast microtomography was performed with the dedicated set-up at beamline ID22. Experimental spatial resolution was between 1 and 1.4 microm, depending on experimental radiation. All calcium phosphates tested showed osteoconduction. IBS observations after 3D reconstruction showed interconnected bioactive biomaterial with total open macroporosity and complete bone ingrowth as early as 3 weeks after implantation. This experimentation was consistent with two-dimensional histomorphometric analysis, which confirmed its suitability for biomaterials. This 3D study relates the different types of bone substitution to biomaterial architecture. As porosity and interconnection increase, bone ingrowth becomes greater at the expense of the bone substitute: IBS>MBCP>CPC.
Animals↗
Comparison of histomorphometric descriptors of bone architecture with dual-energy X-ray absorptiometry for assessing bone loss in the orchidectomized rat.
We have compared different methods for measuring bone loss in the orchidectomized (ORX) rat model of male osteoporosis: densitometry (DXA), ash weight, anatomic bone indices, histomorphometry and two-dimensional trabecular architecture analysis. Forty-eight male Wistar rats were studied at 2, 4, 8 and 16 weeks (four groups). In each group, 6 rats were ORX and 6 sham-operated were used as control. DXA was performed on the whole body, tibia and femur. Histomorphometry was performed on the secondary spongiosa of the tibia: trabecular bone volume (BV/TV) and trabecular characteristics (number, separation and thickness) were measured. Architecture analysis comprised strut identification, star volume of the marrow spaces and trabeculae, Euler-Poincaré number (E) and Kolmogorov fractal dimension (Dk). Bone mineral densities of the whole body, tibia and femur were reduced at 16 weeks in the ORX group. BV/TV was significantly decreased in the ORX group from the fourth week. Differences in the sensitivity of the architectural methods were found. There were no differences in trabecular thickness nor in trabecular star volume between ORX and controls even after 16 weeks. E became different at 8 weeks. Trabecular number, node count, star volume of the marrow spaces and trabecular separation became significantly different at 4 weeks Dk was modified after 2 weeks (p < 0.05 at 2 weeks, p < 0.001 from 4 weeks). In the ORX model, Dk appeared the most potent descriptor of trabecular bone disorganization by revealing the earliest changes at the network level.
Absorptiometry, Photon↗
Adherence of osteoblast-like cells on calcospherites developed on a biomaterial combining poly(2-hydroxyethyl) methacrylate and alkaline phosphatase.
The polymer poly(2-hydroxyethyl) methacrylate (pHEMA) can copolymerize with alkaline phosphatase (AlkP) to form a hybrid material. The enzyme retains its biological activity and forms hydroxyapatite nodules (calcospherites) when polymer pellets are incubated with a synthetic body fluid. Osteoblast-like cells (ROS 17/2.8) were seeded on pellets of pHEMA and pHEMA-AlkP on which calcospherites were grown. They were examined by scanning electron microscopy (SEM) with backscattered electron imaging. Cell surface and shape were measured by image analysis combining the SEM images. Cells grown on pHEMA-AlkP had an increased surface area (449 +/- 216 microm(2) vs. 204 +/- 80 microm(2)). The number of filopodia anchoring the cells on the free polymer surface was reduced on pHEMA-AlkP, but numerous thick pseudopodia permitted a direct anchorage on the calcospherites. Pseudopodia were wider and longer than the filopodia. The backscattered images revealed that each cell was seated on 7.1 +/- 1.5 calcospherites and partially covered 10.3 +/- 1.9 others. Antifibronectin and anti-bone sialoprotein antibodies were used to investigate cell attachment. With confocal microscopy, both molecules were located at the interface between the cells and the mineral, inside the cells, and as free molecules on the calcospherites. Immunogold labeling was done with the same antibodies and examined with transmission electron microscopy (TEM). Adsorption of fibronectin and bone sialoprotein was noticeable at the cell/calcospherite interface and on the surface of the hydroxyapatite crystals. Immunogold studies revealed adhesion proteins (bone sialoprotein, fibronectin) to be present at the surface of crystals and at focal points of cell contact.
Alkaline Phosphatase↗
Non-connected versus interconnected macroporosity in poly(2-hydroxyethyl methacrylate) polymers. An X-ray microtomographic and histomorphometric study.
Poly(2-hydroxyethyl methacrylate) (pHEMA) has potentially broad biomedical applications: it is biocompatible and has a hardness comparable to bone when bulk polymerized. Porous biomaterials allow bone integration to be increased, especially when the pores are interconnected. In this study, three types of porogens (sugar fibers, sucrose crystals, and urea beads) have been used to prepare macroporous pHEMA. The pore volume and interconnectivity parameters of the porosity were measured by X-ray microtomography and image analysis. Sucrose crystals, having a high volumetric mass, gave large pores that were located on the block sides. Urea beads and sugar fibers provided pores with the same star volume (2.65 +/- 0.46 mm3 and 2.48 +/- 0.52 mm3, respectively) but which differed in interconnectivity index, fractal dimension, and Euler-Poincarés number. Urea beads caused non-connected porosity, while sugar fibers created a dense labyrinth within the polymer. Interconnectivity was proved by carrying out surface treatment of the pHEMA (carboxymethylation in water), followed by von Kossà staining, which detected the carboxylic groups. Carboxymethylated surfaces were observed on the sides of the blocks and on the opened or interconnected pores. The disconnected pores were unstained. Macroporous polymers can be prepared with water-soluble porogens. X-ray microtomography appears a useful tool to measure porosity and interconnectedness.
Biocompatible Materials↗
Fractal dimension of trabecular bone: comparison of three histomorphometric computed techniques for measuring the architectural two-dimensional complexity.
Trabecular bone has been reported as having two-dimensional (2-D) fractal characteristics at the histological level, a finding correlated with biomechanical properties. However, several fractal dimensions (D) are known and computational ways to obtain them vary considerably. This study compared three algorithms on the same series of bone biopsies, to obtain the Kolmogorov, Minkowski-Bouligand, and mass-radius fractal dimensions. The relationships with histomorphometric descriptors of the 2-D trabecular architecture were investigated. Bone biopsies were obtained from 148 osteoporotic male patients. Bone volume (BV/TV), trabecular characteristics (Tb.N, Tb.Sp, Tb.Th), strut analysis, star volumes (marrow spaces and trabeculae), inter-connectivity index, and Euler-Poincaré number were computed. The box-counting method was used to obtain the Kolmogorov dimension (D(k)), the dilatation method for the Minkowski-Bouligand dimension (D(MB)), and the sandbox for the mass-radius dimension (D(MR)) and lacunarity (L). Logarithmic relationships were observed between BV/TV and the fractal dimensions. The best correlation was obtained with D(MR) and the lowest with D(MB). Lacunarity was correlated with descriptors of the marrow cavities (ICI, star volume, Tb.Sp). Linear relationships were observed among the three fractal techniques which appeared highly correlated. A cluster analysis of all histomorphometric parameters provided a tree with three groups of descriptors: for trabeculae (Tb.Th, strut); for marrow cavities (Euler, ICI, Tb.Sp, star volume, L); and for the complexity of the network (Tb.N and the three D's). A sole fractal dimension cannot be used instead of the classic 2-D descriptors of architecture; D rather reflects the complexity of branching trabeculae. Computation time is also an important determinant when choosing one of these methods.
Cluster Analysis↗
Bone microarchitecture and bone fragility in men: DXA and histomorphometry in humans and in the orchidectomized rat model.
In men, the risk of fragility fractures increases as bone mineral declines but there is an overlap in the bone mineral density (BMD) measurements between patients with and those without fractures. Biomechanical competence of trabecular (Tb) bone depends on the amount of bone and on microarchitecture. We have developed new histomorphometric methods for evaluating microarchitecture on histological sections. These methods were used in the orchidectomized male rat (ORX--a model of hypogonadism-induced osteoporosis) and on transiliac bone biopsies performed in male osteoporotic patients. ORX rats were studied at 2, 4, 8, and 16 weeks post-ORX. Bone mineral content (BMC) was reduced at 16 weeks. Trabecular bone volume (BV/TV) was significantly decreased from the 4th week. Differences in the sensitivity of the methods were found. Fractal dimension was modified as early as 2 weeks and appeared the most potent descriptor of Tb disorganization. The architectural changes in this model mimic those observed in hypogonadic men. We examined the relationships among BMD, micro-architecture, and vertebral fracture in 108 men with lumbar osteopenia (T-score <-2.5). At least one vertebral fracture was observed in 62 patients and none in 46 patients. After adjusting for age, body mass index (BMI), and BMD, there was no significant difference between the two groups in BV/TV, Tb.Th, and Star volume. In contrast, the mean values of ICI and Tb.Sp were significantly higher whereas Tb.N and nodes were lower in patients with vertebral fracture. Logistic regression analysis showed that ICI, strut analysis, and Tb.N were significant predictors of the presence of vertebral fracture: odds ratios for an alteration of I SD ranged from 1.7 for nodes to 3.2 for ICI. These results strongly suggest that bone Tb microarchitecture is a major and independent determinant of vertebral fracture in men with osteoporosis.
Absorptiometry, Photon↗
Texture analysis of X-ray radiographs is a more reliable descriptor of bone loss than mineral content in a rat model of localized disuse induced by the Clostridium botulinum toxin.
Botulism is a generalized paralyzing disease caused by the toxin of Clostridium botulinum (BTX). The toxin acts 3-4 days after injection by blocking the release of acetylcholine to the muscle. Six Wistar rats received a 2-U injection of BTX in the right quadriceps. Six rats were similarly injected with saline and were used as control. Paralysis of the quadriceps was obtained 4-5 days after the injection. Animals were killed 4 weeks after the BTX injection. The bone mineral content (BMC) was measured by dual-energy X-ray absorptiometry (DXA) on the femur and tibia. No side-to-side difference was observed for BMC on the whole tibia and femur in the BTX group. When subregions were selected in the bones, a significant decrease in BMC was obtained on the proximal tibia (-17.4 +/- 2.5%, p < 0.02). No significant difference could be observed on the proximal or distal femur, nor on the diaphyseal shafts. Numeric X-rays were done and a region of interest was transferred to an image analyzer. The texture of the trabecular bone was analyzed by the run length and fractal methods (skyscrapers and blanket). Significant differences were obtained on the proximal tibia for all methods except with fractal skyscrapers. On the distal femur, significant differences were obtained with the run length method, and the skyscrapers and the blanket method in the vertical direction. No differences were obtained with any method on the tibia and femur from control animals. Bone is a highly anisotropic material and its architecture at the microscopic level is conditioned by strains. The trabecular pattern differs in the proximal tibia than in the distal femural. Depending on the trabecular anisotropy, the algorithms can be more or less pertinent. BTX induced a significant bone loss on the bony subparts that are directly influenced by disuse. Texture analysis of X-ray images can reveal differences that were not evidenced by naked eyes. However, a combination of several methods appears necessary to appreciate the bone loss.
Absorptiometry, Photon↗
Osteoporosis in men: a potential role for the sex hormone binding globulin.
The exact mechanism of bone loss remains unknown in primary male osteoporosis. It has been suggested that estrogen and sex hormone binding globulin (SHBG) play a role in regulating bone turnover and bone mass in healthy men > 65 years of age. In the present study, 80 men (mean age 49.7 years) with bone mineral density >2.5 SD below the young adult value and 40 age-matched controls were recruited to evaluate the relationships between sex hormone levels, bone biochemical markers levels, and bone mineral density. Fasting serum samples were assayed for total and free testosterone total estradiol, and SHBG. The free androgen index, was calculated as: [total testosterone/SHBG * 100]. Bone remodeling was evaluated by measurement of urinary levels of the C-telopeptide of type I collagen (CTx) and free deoxypyridinoline (D-Pyr), serum osteocalcin, and bone-specific alkaline phosphatase (bSAP). There was no significant difference between controls and osteoporotic men according to age, body mass index (BMI), total testosterone, and estradiol. In contrast, serum SHBG level was significantly higher (+42.2%), whereas free androgen index was lower (-24.8%) in patients with primary or secondary osteoporosis. Testosterone and estradiol levels did not correlate with any bone resorption or bone formation markers. In contrast, stepwise linear regression analysis showed that SHBG was significantly correlated with D-Pyr (r = 0.45, p < 0.05) and CTx (r = 0.34, p < 0.05) in primary osteoporosis. In secondary osteoporosis, SHBG was correlated with D-Pyr (r = 0.48, p < 0.05) and bSAP (r = 0.55, p < 0.01). After adjustment for age and BMI, hip bone mineral density (BMD) was not associated with testosterone or estradiol but only with serum SHBG (r = -0.33, p < 0.01) in primary osteoporosis. The same relationship was observed in men with secondary osteoporosis (r = -0.34, p < 0.01). Among osteoporotic patients, spinal radiography showed at least one vertebral crush fracture in 36 men and none in 44. Serum SHBG concentration was significantly associated with the presence of vertebral fracture: the odds ratio was 2.0 (95% confidence interval [CI] 1.2-3.5) for an increase of one standard deviation of SHBG. In conclusion, the present study showed that serum SHBG concentration is increased in middle-aged men with primary or secondary osteoporosis and is correlated with bone remodeling markers, hip bone mineral density, and vertebral fracture risk.
Adult↗
Lean, fat and bone masses are influenced by orchidectomy in the rat. A densitometric X-ray absorptiometric study.
In man, hypogonadism is a risk factor for osteoporosis. Orchidectomy (ORX) in the rat leads to an imbalance between resorption and formation resulting in bone loss. We have measured whole body weight, lean and fat mass, whole bone mass (BMC) in the ORX rat model by dual X-ray densitometry (DXA). Forty-eight male Wistar rats (18-19 weeks old) were studied at 2, 4, 8 and 16 weeks. In each group, 6 rats were ORX and 6 sham-operated were used as control. DXA was performed on the whole body and isolated tibia. The whole body weight of the ORX animals became significantly decreased only at 16 weeks. Whole body BMC was reduced from 8 weeks in the ORX group. The most striking result was a net decrease in lean mass that reached -15.7% at 16 weeks. On the other hand, fat mass remained unchanged during the time series in the ORX animals.
Journal Article↗
Comparison insight dual X-ray absorptiometry (DXA), histomorphometry, ash weight, and morphometric indices for bone evaluation in an animal model (the orchidectomized rat) of male osteoporosis.
We have compared the measurements obtained by different methods: dual energy X-ray absorptiometry (DXA), histomorphometry, ash weight, and two morphometric indices (robusticity and bone weight/bone length index) in the orchidectomized (ORX) rat model of male osteoporosis. We examined 144 male wistar rats: 48 sham-operated, 48 ORX, and 48 ORX-treated with a bisphosphonate (risedronate) 2 or 10 mg/kg/day, 5 days per week. Rats were sacrificed at 2, 4, 8, or 16 weeks after the beginning of the study. DXA was performed on a Hologic QDR 2000 on the whole body, whole tibia, and tibial metaphysis. Bone volumes (C.BV/C.TV, and BV/TV) were measured by histomorphometry on the proximal tibial. A significant correlation was obtained between weight measured by DXA and scale (r = 0.993, P <0.000001). However, DXA underestimated weight by 0.3%. This discrepancy was dependent on the rat's weight. The weight bone length (WL) index was linearly correlated with BMD (r = 0.86), BMC (r = 0.96), and ash weight (r = 0.97). Correlation with robusticity was lower than with the WL index. A significant correlation was found between BMC of the metaphyseal region and the bone volumes but this explained only 27% of the variance; correlation with BMD was poorer (r = 0.40). BMC and ash weight were highly correlated (r = 0.992, P <0.000001). However, DXA overestimated BMC by 11% and the overestimation was found to be clearly dependent on the net mineral content of the bone.
Absorptiometry, Photon↗
Gamma irradiation of human bone allografts alters medullary lipids and releases toxic compounds for osteoblast-like cells.
The uncertainties about the transmission of prion proteins from xenogenic grafts prepared from bovine bone has led to the reconsideration of allogenic bone as a grafting material. Allografting is a complementary technique to autografting nowadays when large bone volumes are necessary. Several preparation techniques have been proposed. Fresh-frozen, freeze-dried and gamma irradiation are the most common. However, a large amount of lipids is present in the medullary spaces (near 70% in weight for a human femoral head). They are known to strongly influence the biocompatibility of the bone graft. The exact changes of lipids upon the sterilization and storage processes are poorly known. The aims of the present study were to appreciate the effects of gamma irradiation on medullary lipids and to identify the cytotoxicity of gamma-irradiated bank bone with/without lipid on cultures of osteoblast-like cells. Bone cores from 8 femoral heads retrieved during prosthesis surgery for arthritis were prepared with a drilling trephine. Cores were either sterilized by gamma radiations (25000 gray) or kept frozen until lipid extraction and lipofuschine-like dosage by Folch's method and fluorometric study. Peroxidated lipids appeared 2 to 3-fold higher in the gamma-irradiated cores than in frozen ones. Slices were prepared from bone cores and were transferred on confluent osteoblast-like cell layers (Saos-2). The raw slices (containing lipids) did not induce cell death. On the other hand, cell death was dramatically increased around the gamma-irradiated slices. Defatted slices which had been sterilized by gamma radiations or UV did not induce cell death. Defatting procedures should be added when preparing bone allografts in human bone banks.
Bone Transplantation↗
Poly(2-hydroxy ethyl methacrylate)-alkaline phosphatase: a composite biomaterial allowing in vitro studies of bisphosphonates on the mineralization process.
We have immobilized the mineralizing agent alkaline phosphatase (AlkP) in a hydrophilic polymer: poly(2-hydroxy ethyl methacrylate) - (pHEMA) - in a copolymerization technique. Histochemical study on polymer sections revealed that AlkP has retained its enzymic activity. The image analysis of sections using a tessellation method showed a lognormal distribution of the area of the tiles surrounding AlkP particles, thus confirming a homogeneous distribution of the enzyme in the polymer. Pellets of pHEMA-AlkP were incubated with a synthetic body fluid containing organic phosphates (beta-glycerophosphate). Mineral deposits with a rounded shape (calcospherites) were obtained in about 17 days. We have investigated the effects of three bisphosphonic pharmacological compounds (etidronate, alendronate and tiludronate) on this system which mimics the mineralization process of cartilage and woven bone. Bisphosphonates at a concentration of 10(-2) M totally inhibited AlkP in solution at a concentration of 10(-4) mg/ml. Inhibition has been reported being due to the chelation of a metal cofactor (Zn2+). Etidronate and alendronate appeared to similarly inhibit the calcospherite deposition onto the pHEMA-AlkP material. Both bisphosphonates possess three sites for the mineral complexion by Ca chemisorbtion. On the other hand, tiludronate having only two sites, was associated with a reduced inhibitory effect on mineralization but larger crystals were obtained. The pHEMA-AlkP material contains an immobilized enzyme in a hydrogel and mimics the physiological conditions of matrix vesicles entrapped within the cartilage (or bone) matrix. It provides an interesting method to study the effects of pharmacological compounds on the mineralization process in bone and cartilage in a non cellular and protein-free model.
Alendronate↗
Trabecular bone microarchitecture, bone mineral density, and vertebral fractures in male osteoporosis.
Some studies have indicated that the risk of fragility fractures in men increases as bone mineral levels decrease, but there is an overlap in the bone mineral density (BMD) measurements between patients with or without fractures. Furthermore, it has been suggested that the biomechanical competence of trabecular bone is dependent not only on the absolute amount of bone present but also on the trabecular microarchitecture. In the present study, 108 men (mean age 52.1 years) with lumbar osteopenia (T score < -2.5) were recruited to examine the relationships between BMD, architectural changes in trabecular bone, and the presence of vertebral fractures. Lumbar BMD was assessed from L2 to L4 in the anteroposterior view with dual-energy X-ray absorptiometry. At the upper left femur, hip BMD was measured at the transcervical site. Spinal X-ray films were analyzed independently by two trained investigators, and vertebral fracture was defined as a reduction of at least 20% in the anterior, middle, or posterior vertebral height. Transiliac bone biopsy specimens were obtained for all patients. Histomorphometric studies were performed on an image analyzer, and the following parameters were determined: trabecular bone volume (BV/TV), trabecular thickness (Tb.Th), number (Tb.N), and separation (Tb.Sp), interconnectivity index (ICI), characterization of the trabecular network (node count and strut analysis), and star volume of the marrow spaces. Spinal radiographs evidenced at least one vertebral crush fracture in 62 patients (group II) and none in 46 patients (group I). After adjusting for age, body mass index, and BMD, there were no significant differences between the two groups in BV/TV, Tb.Th, or star volume. In contrast, the mean values of ICI, free end-to-free end struts (FF/TSL), and Tb.Sp were significantly higher, whereas Tb.N and node-to-node struts (NN/TSL) were lower in patients with at least one vertebral fracture. Logistic regression analysis showed that only ICI, FF/TSL, NN/TSL, and Tb.N were significant predictors of the presence of vertebral fracture: odds ratios for an alteration of 1 SD ranged from 1.7 (1.0-3.2) for NN/TSL to 3.2 (1.1-10.1) for ICI. Patients with at least three vertebral fractures (n = 23) were categorized as "multiple fractures." The results of logistic regression showed that spine BMD, BV/TV, and all architectural parameters were significant predictors of multiple vertebral fractures: odds ratios for an alteration of 1 SD ranged from 2.2 (1.1-4.6) for star volume to 3.7 (1.4-9.7) for ICI. These results strongly suggest that bone trabecular microarchitecture is a major and independent determinant of vertebral fractures in middle-aged men with osteopenia.
Absorptiometry, Photon↗
[In vitro study of the effect of bisphosphonates on mineralization induced by a composite material: poly 2(hydroxyethyl) methacrylate coupled with alkaline phosphatase].
We have immobilized the mineralizing agent alkaline phosphatase (AlkP) in a hydrophilic polymer (poly 2(hydroxyéthyl) methacrylate) (pHEMA) in a copolymerization technique. Histochemical study on polymer sections revealed that AlkP has retained its biological activity. The image analysis of sections using a tessellation method showed a lognormal distribution of the area of the tiles surrounding AlkP particles thus confirming a homogeneous distribution of the enzyme in the polymer. Pellets of pHEMA-AlkP were incubated with a synthetic body fluid containing organic phosphates (beta-glycerophosphate). Mineral deposits with a rounded shape (calcospherites) were obtained in about 17 days. We have investigated the effects of three bisphosphonates (etidronate, alendronate and tiludronate) on this system. Bisphosphonates at a concentration of 10(-2) M totally inhibited AlkP in solution at a concentration of 10(-4) mg/ml. Inhibition has been reported being due to the chelation of a metal cofactor (Zn2+). Etidronate and alendronate appeared to inhibit the calcospherite deposition onto the pHEMA-AlkP material in a similar way. Both bisphosphonates possess three sites for mineral complexion. On the other hand, tiludronate having only two sites was associated with a reduced inhibitory effect on mineralization. When used in microgravity conditions, mineralization was impaired with etidronate and larger crystals were obtained with tiludronate. However, these effects were obtained in non-physiological conditions (a 20 degrees C temperature was used during the STS80 flight of the space shuttle). The pHEMA-AlkP material provides an interesting method to study the effects of pharmacological compounds and environmental factors on the bone and cartilage mineralization process.
Alkaline Phosphatase↗
[Osteoporosis in males].
A shorter life expectancy, a higher peak bone mass and the absence of distinct menopause equivalent explain the lower incidence of osteoporotic fractures in men. In contrast to women, osteoporosis in younger men is in most cases secondary. Causes such as prolonged glucocorticoid therapy, ethanol abuse, hypogonadism and gastrointestinal disorders are now well recognized. The impact of cigarette smoking, low calcium intake, vitamin D deficiency, hypercalciuria and thyrotoxicosis is more controversial but seems to constitute real risk factors for bone loss. Furthermore increased propensity to fall also plays a major role in fracture risk, particularly in alcoholic patients and in elderly men with neurologic disorders.
Age Distribution↗
Bone mineral density and vertebral fractures in men.
In women, many studies indicate that the risk of vertebral fragility fractures increases as bone mineral density (BMD) declines. In contrast, few studies are available for BMD and vertebral fractures in men. It is uncertain that the strength of the relationship between BMD and fractures is similar in magnitude in middle-aged men and in postmenopausal women. In the present study, 200 men (mean age 54.7 years) with lumbar osteopenia (T-score < -1.5) were recruited to examine the relationships between spine BMD and hip BMD and the associations of BMD with vertebral fractures. Lumbar BMD was assessed from L2 to L4, in the anteroposterior view, using dual-energy X-ray densitometry. At the upper left femur, hip BMD was measured at five regions of interest: femoral neck, trochanter, intertrochanter, Ward's triangle and total hip. Spinal radiographs were analyzed independently by two trained investigators and vertebral fracture was defined as a reduction of at least 20% in the anterior, middle or posterior vertebral height. Spinal radiographs evidenced at least one vertebral crush fracture in 119 patients (59.5%). The results of logistic regression showed that age, femoral and spine BMDs were significant predictors of the presence of a vertebral fracture. Odds ratios for a decrease of 1 standard deviation ranged from 1.8 (1.3-2.8) for spine BMD to 2.3 (1.5-3.6) for total hip BMD. For multiple fractures odds ratios ranged from 1.7 (1.1-2.5) for spine BMD to 2.6 (1.7-4.3) for total hip BMD. In all models, odds ratios were higher for hip BMD than for spine BMD, particularly in younger men, under 50 years. A T-score < -2.5 in the femur (total femoral site) was associated with a 2.7-fold increase in the risk of vertebral fracture while a T-score < -2.5 in the spine was associated with only a 2-fold increase in risk. This study confirms the strong association of age and BMD with vertebral fractures in middle-aged men, shows that the femoral area is the best site of BMD measurement and suggests that a low femoral BMD could be considered as an index of severity in young men with lumbar osteopenia.
Absorptiometry, Photon↗