Dataset Information

Plasma Biomarkers for Clinical Assessment of Bone Mineral Density in Heart Transplanted Patients-A Single-Center Study at Skane University Hospital in Lund.

ABSTRACT: We aimed to identify plasma biomarkers that predict changes in bone mineral density (BMD) and increase the understanding of impaired BMD after heart transplantation (HT). Twenty-eight adult patients were included. Data, including densitometry and 29 plasma proteins, before and 1 year after HT were analyzed. Pre-HT plasma levels of fibroblast growth factor 23 (FGF23) correlated with post-HT T score in lumbar spine, adjusted for age, gender, and BMI (1.72 [95% CI 1.33; 2.22], p = 0.011). Change (∆; post-HT-pre-HT) in plasma levels of melusin correlated to ∆T score from the lumbar spine (p = 0.028). ∆plasma levels of TR-AP, ITGB2, and Stromelysin-1 correlated to ∆T score from the femoral neck (p < 0.05). However, no correlations remained after adjustments for age, gender, and BMI. In conclusion, elevated plasma FGF23 pre-HT predicted an increase in lumbar BMD after HT. However, the results are surprising since FGF23 is known to be inversely correlated with BMD. This may partly be explained by the complex pathophysiology in this particular cohort. Due to the explorative nature of the study and the small sample size, further investigations of biochemical markers on bone metabolism in this patient population are encouraged.

SUBMITTER: Lofdahl E

PROVIDER: S-EPMC9487521 | biostudies-literature | 2022

REPOSITORIES: biostudies-literature

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Plasma Biomarkers for Clinical Assessment of Bone Mineral Density in Heart Transplanted Patients-A Single-Center Study at Skåne University Hospital in Lund.

Löfdahl Eveline E Ahmed Salaheldin S Ahmed Abdulla A Rådegran Göran G

Transplant international : official journal of the European Society for Organ Transplantation 20220328

We aimed to identify plasma biomarkers that predict changes in bone mineral density (BMD) and increase the understanding of impaired BMD after heart transplantation (HT). Twenty-eight adult patients were included. Data, including densitometry and 29 plasma proteins, before and 1 year after HT were analyzed. Pre-HT plasma levels of fibroblast growth factor 23 (FGF23) correlated with post-HT T score in lumbar spine, adjusted for age, gender, and BMI (1.72 [95% CI 1.33; 2.22], <i>p</i> = 0.011). Ch ...[more]

PMID: 36148003

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Project description:RATIONALE:Osteoporosis is common in individuals with chronic obstructive pulmonary disease. Lung-specific factors, including radiographic emphysema, independently associate with low bone mineral density in cross-sectional smoking cohorts. However, factors associated with progressive bone loss in smokers are understudied and largely unknown. OBJECTIVES:To determine the relationship between radiographic emphysema, circulating bone metabolism markers, and pulmonary function and accelerated bone mineral density loss in smokers. METHODS:Two hundred and forty male and female current and former smokers, 40 years of age or older, underwent baseline and 2-year assessments of pulmonary function, computed tomography-assessed emphysema, dual X-ray absorptiometry-measured bone mineral density, and circulating bone metabolism biomarker levels (type I collagen C-telopeptide [CTX], amino-terminal propeptide of type I procollagen [P1NP]). The association of radiographic emphysema, bone metabolism biomarker levels, and pulmonary function with accelerated hip bone mineral density loss, defined by the 75th percentile of annual hip bone mineral density decline, was determined by logistic regression modeling with adjustment for age, sex, inhaled and intermittent steroid use, active smoking, body mass index, and the presence of baseline low hip bone mineral density. RESULTS:Of those participants with accelerated hip bone mineral density loss, 22% had moderate or severe visually assessed emphysema compared with 7.2% of smokers without accelerated bone mineral density decline. Moderate to severe visually assessed emphysema (odds ratio, 2.84; 95% confidence interval, 1.01-7.98 compared with trace/mild or no visually assessed emphysema) and the 75th percentile of CTX levels (odds ratio, 2.38; 95% confidence interval, 1.20-4.72 compared with CTX levels below the 75th percentile), a marker of bone resorption, were associated with accelerated hip bone mineral density decline after adjustment for covariates and the presence of baseline low hip bone mineral density. FEV1% predicted was not associated with accelerated bone mineral density decline after adjustment for covariates. Multivariate modeling showed moderate to severe visually assessed emphysema, and the 75th percentiles of CTX were independently associated with accelerated hip bone mineral density decline after adjustment for covariates. CONCLUSIONS:Emphysema and elevated markers of bone resorption are independently associated with progressive bone mineral density loss in smokers. These clinical markers may guide targeted bone mineral density screening and monitoring in smokers at highest risk.

Project description:Many patients with SARS-CoV-2 infection develop neurological signs and symptoms; although, to date, little evidence exists that primary infection of the brain is a significant contributing factor. We present the clinical, neuropathological and molecular findings of 41 consecutive patients with SARS-CoV-2 infections who died and underwent autopsy in our medical centre. The mean age was 74 years (38-97 years), 27 patients (66%) were male and 34 (83%) were of Hispanic/Latinx ethnicity. Twenty-four patients (59%) were admitted to the intensive care unit. Hospital-associated complications were common, including eight patients (20%) with deep vein thrombosis/pulmonary embolism, seven (17%) with acute kidney injury requiring dialysis and 10 (24%) with positive blood cultures during admission. Eight (20%) patients died within 24 h of hospital admission, while 11 (27%) died more than 4 weeks after hospital admission. Neuropathological examination of 20-30 areas from each brain revealed hypoxic/ischaemic changes in all brains, both global and focal; large and small infarcts, many of which appeared haemorrhagic; and microglial activation with microglial nodules accompanied by neuronophagia, most prominently in the brainstem. We observed sparse T lymphocyte accumulation in either perivascular regions or in the brain parenchyma. Many brains contained atherosclerosis of large arteries and arteriolosclerosis, although none showed evidence of vasculitis. Eighteen patients (44%) exhibited pathologies of neurodegenerative diseases, which was not unexpected given the age range of our patients. We examined multiple fresh frozen and fixed tissues from 28 brains for the presence of viral RNA and protein, using quantitative reverse-transcriptase PCR, RNAscope® and immunocytochemistry with primers, probes and antibodies directed against the spike and nucleocapsid regions. The PCR analysis revealed low to very low, but detectable, viral RNA levels in the majority of brains, although they were far lower than those in the nasal epithelia. RNAscope® and immunocytochemistry failed to detect viral RNA or protein in brains. Our findings indicate that the levels of detectable virus in coronavirus disease 2019 brains are very low and do not correlate with the histopathological alterations. These findings suggest that microglial activation, microglial nodules and neuronophagia, observed in the majority of brains, do not result from direct viral infection of brain parenchyma, but more likely from systemic inflammation, perhaps with synergistic contribution from hypoxia/ischaemia. Further studies are needed to define whether these pathologies, if present in patients who survive coronavirus disease 2019, might contribute to chronic neurological problems.

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Dataset Information

Plasma Biomarkers for Clinical Assessment of Bone Mineral Density in Heart Transplanted Patients-A Single-Center Study at Skane University Hospital in Lund.

Publications

Plasma Biomarkers for Clinical Assessment of Bone Mineral Density in Heart Transplanted Patients-A Single-Center Study at Skåne University Hospital in Lund.

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