Bone microarchitecture, diabetes and change in bone mineral density in Puerto Rican adults

波多黎各成年人的骨微结构、糖尿病和骨矿物质密度变化

• 批准号: 9754780
• 负责人: Katherine L Tucker
• 金额: $ 67.6万
• 依托单位: UNIVERSITY OF MASSACHUSETTS LOWELL
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-03 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9754780
• 关键词: Address; Adult; Advanced Glycosylation End Products; Affect; Age; Animals; Antioxidants; Blood specimen; Bone Density; Boston; Caribbean Hispanic; Caribbean region; Complex; Data; Defect; Development; Diabetes Mellitus; Diet; Dual-Energy X-Ray Absorptiometry; Early Diagnosis; Elderly; Fasting; Fracture; Future; High Prevalence; Hip region structure; Hispanics; Human; Image; Incidence; Individual; Insulin Resistance; Intake; Intervention; Link; Longitudinal Studies; Longitudinal cohort study; Measurement; Measures; Mediating; Mediator of activation protein; Methods; Non-Insulin-Dependent Diabetes Mellitus; Not Hispanic or Latino; Osteoporosis; Participant; Plasma; Population; Population Group; Porosity; Prevalence; Public Health; Publishing; Puerto Rican; Quality of life; Questionnaires; Research; Risk; Risk Factors; Scanning; Serum; Skin; Testing; Time; Trabecular Bone Score; Underserved Population; Vertebral column; Vitamin B6; Work; aged; bone; bone health; bone loss; bone mass; bone quality; bone strength; disability; fracture risk; fragility fracture; health disparity; high risk; high risk population; hip bone; improved; innovation; inorganic phosphate; mechanical properties; men; negative affect; novel; osteoporosis with pathological fracture; pentosidine; prevent; therapy development; tool

PROJECT SUMMARY Recent national data indicate a higher prevalence of osteoporosis (OP) among Hispanics, compared with non- Hispanic whites or blacks. As one of the fastest growing segments of the U.S. population, this group is projected to have the largest increase in OP-related fracture from 2005 to 2025. Hispanic adults of Caribbean origin have been shown to have poorer bone quality than non-Hispanic whites. Puerto Ricans, in particular, have higher prevalence of OP than previously appreciated. Although higher bone mineral density (BMD) has been noted in those with type 2 diabetes (T2D), T2D contributes to compromised bone strength, cortical defects and increased cortical porosity increasing risk of fracture. This is of particular concern for Puerto Ricans who have a high prevalence of T2D. One mechanism for poor bone quality among those with T2D is the accumulation of advanced glycation end-products (AGE), which affect bone mechanical properties. Animal studies suggest that antioxidant activity from vitamin B6 may inhibit AGE formation. Greater plasma pyridoxyl- 5'-phosphate (PLP, vitamin B6) concentration and intake of vitamin B6 has been associated with less bone loss over time and reduced risk of fracture; but mechanisms are unclear. Trabecular bone score (TBS), a novel measure of trabecular microarchitecture of the lumbar spine, is indicative of fragility fracture risk, even among those with normal BMD; however, research on TBS for assessing bone quality is limited and urgently needed. Further, assessment of bone strength by novel micro-indentation may elucidate differences in bone quality among T2D at risk for OP. Therefore, our central hypothesis is that Puerto Rican adults with T2D will have poor bone strength (micro-indentation), and greater loss of TBS at the spine and of BMD at the spine and hip compared to individuals without T2D; and that this will be moderated by high plasma AGE concentration. Our secondary hypothesis is that greater plasma PLP will be associated with lower plasma AGE and therefore higher bone strength (micro-indentation), and less loss of TBS and BMD over time. All available 860 Puerto Rican adults who participated in the Boston Puerto Rican Osteoporosis Study with valid BMD data will be invited to participate in the proposed study. Participants will complete a questionnaire, a repeat DXA scan, undergo bone micro-indentation, skin autofluorescence measurement of AGES and provide a fasting blood sample. The proposed research is innovative in the inclusion of TBS as a measure of bone quality, micro- indentation to evaluate bone strength, the examination of AGE as an effect modifier linking diabetes and bone health, and the consideration of PLP as a factor in AGE in a longitudinal study. This work is urgently needed to improve our understanding of complex risk factors for bone health, and to provide important information for the development of future interventions to prevent bone loss and fracture risk, particularly in high-risk populations with health disparities.

项目摘要 最近的国家数据表明，与非 - 西班牙裔白人或黑人。作为美国人口中增长最快的部分之一，该群体是 预计从2005年到2025年，与运营相关的骨折的增加最大。西班牙裔成年人 与非西班牙裔白人相比，起源的骨质质量较差。特别是波多黎各人 OP的患病率高于以前所欣赏的。尽管较高的骨矿物质密度（BMD）具有 在患有2型糖尿病（T2D）的患者中注意到，T2D有助于骨骼强度损害 缺陷和皮质孔隙率增加，增加了骨折的风险。这是波多黎各尤其关注的 t2d的高流行率。 T2D患者中骨骼质量差的一种机制是 晚期糖基化终产物（年龄）的积累，影响骨骼机械性能。动物 研究表明，来自维生素B6的抗氧化活性可能抑制年龄的形成。较大的血浆吡氧基 - 5'-磷酸（PLP，维生素B6）浓度和维生素B6的摄入量与骨骼较少有关 随着时间的流逝损失和骨折风险降低；但是机制尚不清楚。小梁骨评分（TBS），一种小说 腰椎小梁微体系结构的度量，即使在 BMD正常的人；但是，对评估骨质质量的TBS的研究是有限的，急需的。 此外，通过新型微观识别评估骨骼强度可能会阐明骨质质量的差异 在有op风险的T2D中。因此，我们的核心假设是，具有T2D的波多黎各成年人 骨骼强度差（微观调节），脊柱和脊柱上的BMD的TBS损失更大 与没有T2D的个体相比；并且这将通过高血浆年龄浓度来调节。我们的 次要假设是，更大的血浆PLP将与较低的血浆年龄有关，因此 随着时间的推移，较高的骨骼强度（微观指示），TBS和BMD的损失较小。所有可用的860波多黎各 参加波士顿波士顿骨质疏松症研究的Rican成年人将使用有效的BMD数据 邀请参加拟议的研究。参与者将完成问卷，重复DXA扫描， 接受骨微观识别，皮肤自动荧光测量年龄，并提供禁食的血液 样本。拟议的研究在包含TBS作为骨质质量的量度方面具有创新性 评估骨强度的凹痕，年龄的检查作为效果修饰剂连接糖尿病和骨骼 在纵向研究中，健康以及将PLP视为年龄的因素。迫切需要这项工作 提高我们对骨骼健康的复杂风险因素的理解，并为 开发未来的干预措施，以防止骨质流失和骨折风险，尤其是在高风险人群中 存在健康差异。