Influence of soft tissue body composition on bone mass and metabolism

Total body bone mineral (TBBM), lean body mass (LBM), and fat mass (FM) were measured by dual photon ¹⁵³Gd absorptiometry in four female groups: (a) 27 patients with hip fracture, (b) 40 patients with spinal crush fracture, (c) 17 patients with osteoarthrosis, and (d) 26 healthy postmenopausal women. TBBM was significantly decreased in the two osteoporotic groups. The FM tended to be smaller in the two osteoporotic groups and larger in the osteoarthrotic group compared to the control group, whereas, LBM was virtually equal in all four groups. A significant negative correlation (p < 0.01) was found between fasting urinary calcium corrected for creatinine and FM, whereas no relation between plasma bone Gla protein and FM could be demonstrated. We conclude that an increased fat mass after the menopause decreases bone resorption without a corresponding decrease in bone formation.     

The control of bone induction in soft tissues.

The induction of bone at the boundary of parenchymal organs has been studied using acid demineralized rib implants in rabbits. The induction of bone is usually confined to that portion of an implant protruding from such an organ though both scant cartilage induction and the induction of bone within the territory of parenchymal organs were seen on a few occasions. Neonatal splenectomy does not influence the inductive properties of bone matrix in muscle or other soft tissues. The inclusion of composite autografts of liver and acid demineralized bone in muscle results in a reduction in the induction rate. It is postulated that the parenchymal organs exclude osteoprogenitor cells and possibly blood-bone bone-marrow-derived osteoinductor releasing cells by some mechanism that is diffusable, thus preventing the initial inductive event. Composite grafts of matrix and muscle produce bone in these tissue, demonstrating that once bone cell differentiation by induction is initiated bone tissue develops even in spleen, liver and kidney parenchyma.     

Osteopontin deficiency reduces experimental tumor cell metastasis to bone and soft tissues.

Osteopontin has been implicated in the metastasis of tumors, and human tumors with high metastatic activity often express osteopontin at high levels. Osteopontin contains an arginine-glycine-aspartate (RGD) motif that is recognized by integrin family members to promote various cell activities including attachment to substrate and it is abundant in bone, to which certain tumors preferentially metastasize. Therefore, we investigated the role of osteopontin in the experimental metastasis of tumor cells using recently established osteopontin-deficient mice. B16 melanoma cells, which produce little osteopontin, were injected into the left ventricle of osteopontin-deficient mice or wild-type mice. Animals were killed 2 weeks after injection. The number of tumors was reduced in the bones of osteopontin-deficient mice compared with the bones in wild-type mice. The number of tumors in the adrenal gland also was reduced. To investigate the osteopontin effect on metastases via a different route, we injected B16 melanoma cells into the femoral vein. Through this route, the number of lung tumors formed was higher than in the intracardiac route and was again less in osteopontin-deficient mice compared with wild-type mice. In conclusion, in an experimental metastasis assay, the number of tumors found in bone (after intracardiac injection) and lung (after left femoral vein injection) was significantly reduced in osteopontin-deficient mice compared with wild-type mice. Tumor numbers in other organs examined were small and not significantly different in the two situations.     

体重体成分与骨密度的关系

为了研究体成分与骨密度（ＢＭＤ）之间的关系，因体重与ＢＭＤ显著相关，体成分各个组成相加等于体重，而体成分与ＢＭＤ的关系仍不清楚。方法随机选取２０６名１６～５２岁健康的男女性汉族人，用双能Ｘ射线吸收法（ＤＸＡ）测量ＢＭＤ与体成分，进行ＢＭＤ与体重，体成分的多元线性回归分析。结果体重，瘦组织（ＬＴＭ）与男女性的ＢＭＤ显著正相关，脂肪组织（ＦＴＭ）仅对女性全身，腰椎ＢＭＤ起显著性作用。结论影响男女性ＢＭＤ的体成分中，ＬＴＭ是主要因素，ＦＴＭ仅对女性ＢＭＤ有影响。本文较全面地研究了体成分与ＢＭＤ的关系。     

Lesions produced by splinters of wood in soft tissues and bone

Summary Lesions produced by splinters of wood in the soft tissues and bones of the limbs are not uncommon and may be difficult to diagnose. A detailed history and a high index of suspicion are the key to making the correct diagnosis. Investigations are usually inconclusive. Complete excision results in prompt resolution.

---

Résumé Les lésions produites par des échardes au niveau des parties molles et des os de la jambe ne sont pas exceptionnelles et peuvent être de diagnostic difficile. Un interrogatoire détaillé et un degré élevé de probabilité sont les clés du diagnostic. Les examens complémentaires n'apportent habituellement aucun argument. L'ablation complète entraîne une guérison rapide.

     

The uptake of sodium-22 by bone and certain soft tissues

Groups of young rats were intravenously injected with²²Na. At various short time intervals thereafter samples of liver, skeletal muscle, kidney, serum and thoroughly-cleaned compact bone were removed and assayed for both stable and radioisotopic concentrations of sodium. Penetration of²²Na into the analysed soft tissues was very rapid and after 10 minutes only a small amount of tissue sodium remained relatively unavailable to the circulation. The rate of²²Na-uptake by the tibial compact bone could be divided into two components:

1. a fast process which appears to be limited only by the blood circulation in bone and is compatible with the cycling concept and
2. a much slower process which may involve solid state diffusion, recrystallisation and physiological remodelling and which is adequately defined by a power function expression.

     

Reaction of the bone- and soft tissues to implanted bone wax in the sheep]

2,5 gr. of bone wax (Knochenwachs) were implanted in the iliac crest of 10 sheep. The induction of a foreign body reaction and chronic inflammation was proven demonstrable until the 12th week after implantation of the bone wax. In this period only partial resorption of the wax occurred simultaneously with significantly retarded osseous regeneration. From a clinical point of view it therefore seems necessary when using bone wax to pay particular attention to inflammatory reactions, reduced new bone formation and eventual occurrence of pseudo-arthrosis.     

藏族成人骨强度与体成分关系研究

目的分析藏族成人骨强度分布特点及其与体成分之间的关系,为完善我国不同民族骨质相关数据并找出合理的防治骨质疏松症方法提供依据。方法采用整群抽样法抽取西藏藏族自治区日喀则市,甘肃省甘南藏族自治州、天祝藏族自治县藏族成年居民共817名,采用超声骨密度仪及生物电阻抗分析仪分别测量受试者右足跟骨骨强度及体成分相关指标,采用多元逐步回归法分析骨强度与体成分各指标之间的关系。结果藏族成年男性、女性骨强度分别在18~29岁、30~39岁达到峰值,之后随年龄增长骨强度下降;60岁之后男性骨强度高于女性,差异有统计学意义(P0.001);甘肃藏族成人骨量异常的发生高于西藏藏族(χ2=4.097,P=0.044);多元线性回归分析显示,肌肉量、皮下脂肪量及内脏脂肪量为藏族成人骨强度的影响因素(P=0.000)。结论藏族成人骨强度在30岁左右达到峰值,50岁后女性是OP的危险人群;甘肃藏族成人患OP的危险性高于西藏藏族成人;肌肉量及皮下脂肪量是OP发病的保护性因素,而内脏脂肪量是OP发病的危险因素。     

Unusual metastases of hepatocellular carcinoma (hcc) to bone and soft tissues of lower limb

Hepatocellular carcinoma metastasizing to bones and soft tissues of extremities is an unusual occurrence. The present report describes two such cases, where this unusual happening was the presenting feature. Role of immunohistochemistry for diagnosis is emphasized.     

An investigation into the relationship between soft tissue body composition and bone mineral density in a young adult twin sample

The purpose of this study was to investigate the relationship of fat mass (FM) and lean mass (LM) with bone mineral density (BMD) independent of genetic effects. We also assessed the extent to which genetic and environmental influences explain the associations between these phenotypes. Body composition and BMD were measured using dual‐energy X‐ray absorptiometry in 57 monozygotic and 92 same‐sex dizygotic twin pairs, aged 23 to 31 years, chosen to represent a wide range of intrapair differences in body mass index (BMI; 0 to 15.2 kg/m²). Heritability estimates were adjusted for height and gender. In multiple linear regression analysis, intrapair differences in both FM and LM were independently associated with intrapair differences in BMD at most skeletal sites after adjustment for gender and differences in height. Within monozygotic and dizygotic pairs, LM was a significantly stronger predictor of whole‐body BMD than FM (p < .01). Additive genetic factors explained 87% [95% confidence interval (CI) 80%–91%), 81% (95% CI 70%–88%), and 61% (95% CI 41%–75%) of the variation in whole‐body BMD, LM, and FM, respectively. Additive genetic factors also accounted for 69% to 88% of the covariance between LM and BMD and for 42% to 72% of the covariance between FM and BMD depending on the skeletal site. The genetic correlation between LM and whole‐body BMD (r_g = 0.46, 95% CI 0.32–0.58) was greater than that of FM and whole‐body BMD (r_g = 0.25, 95% CI 0.05–0.42). In conclusion, our data indicate that peak BMD is influenced by acquired body weight as well as genetic factors. In young adulthood, LM and BMD may have more genes in common than do FM and BMD. © 2011 American Society for Bone and Mineral Research.     

骨外固定架与髂骨皮瓣移植联合应用治疗小腿骨及软组织缺损

目的探讨骨外固定架与髂骨皮瓣移植I期联合修复胫骨缺损伴小腿软组织缺损的方法和临床效果。方法对28例胫骨及其周围软组织缺损早期应用骨外固定架与髂骨皮瓣移植治疗。皮肤缺损面积：5cm×5cm～9cm×20cm;手术切除皮瓣面积：5cm×7cm～12cm×23cm;切取髂骨块5cm×3.5cm～10cm×3.5cm。对于较大面积的骨皮组织缺损,应用同时携带旋髂深及旋髂浅双血管蒂的髂骨皮瓣移植治疗。结果髂骨植骨骨性愈合时间31周,无不愈合病例。骨皮瓣全部存活,无感染、坏死,外形及功能恢复满意。结论早期应用单侧外固定支架与髂骨皮瓣移植联合是修复合并骨及软组织缺损的小腿严重创伤的一种良好方法,双血管蒂为骨皮瓣的存活提供了可靠保障。     

绝经后女性体成分与骨强度的相关性研究

目的 探讨绝经后女性瘦组织(LM)、体脂量(FM)对骨强度的影响。方法101例健康女性受试者(年龄61. 3±7. 1岁)行腰椎、髓部及全身双能X线吸收测量法扫描获取腰椎(LS_BMD )、股骨颈(FN_BMD)、全髓(TH_BMD)、全身骨密度(TB_BMD)及全身骨矿物质含量(TB_BMC)。结果 年龄、绝经年龄、身高、体重与TB_BMD,TB_BMC,LS????_BMD,FN_BMD,TH_BMD存在线性相关性,P均<0.05。LM及FM与TB_BMD,TB_BMC,LS_BMD,FN_BMD,TH_BMD存在轻~中度正相关性(r=0.219~0.580, P均<0.05 )。逐步多元线性回归分析,校正FM则LM对上述骨强度指标的影响消失,只有FM进人回归模型,FM解释TB_BMD,TB_BMC,LS_BMD,FN_BMD及TH_ BMD变量变化分别为26. 1% ,60.9% ,13. 1% ,19.9% ,16. 1%。结论 是FM而非LM决定绝经后女性骨强度。     

男性青少年身体成分与骨矿含量的关系

为了解青少年身体成分中瘦体重和体脂含量究竟那种成分对骨矿含量影响起主要作用，我们对５８名男性青少年（年龄１７．２±０．７岁，范围：１５．５—１８．７岁）进行人体测量，计算出瘦体重和体脂含量，用ＢＨ－６０１２型二维扫描单光子骨密度仪测量非优势侧桡骨中远１／３处及桡骨超远端骨矿含量（ＢＭＣ，ｇ）、骨宽（ＢＷ，ｃｍ）、骨密度（ＢＭＤ，ｇ／ｃｍ２），为消除身高的影响分别计算桡骨中远１／３处和桡骨超远端ＢＭＤ／身高值（ＢＭＤ／Ｈ，ｇ／ｃｍ３）。以桡骨中远１／３处及桡骨超远端的ＢＭＣ、ＢＭＤ、ＢＭＤ／Ｈ作因变量，年龄、身高、瘦体重、体脂含量作自变量进行多元线性回归分析，结果表明瘦体重和体脂含量均与骨矿含量有关（Ｐ＜０．０５），但经骨形态即骨宽较正的骨密度及身高校正的ＢＭＤ／Ｈ仅与瘦体重有关（Ｐ＜０．０５），因此说明男性青少年身体成分中瘦体重对桡骨超远端骨密度的影响作用较大。     

Umbilical venous IGF-1 concentration, neonatal bone mass, and body composition.

IGF-1 is a key growth factor during fetal life. Using DXA, we found that the concentration of IGF-1 in umbilical cord serum is strongly related to neonatal whole body bone mineral content, lean mass, and fat mass. However IGF-1 did not explain the relationships of maternal smoking, fat mass, and physical activity with neonatal bone mass. The study supports a direct role for circulating IGF-1 in growth of the fetal skeleton. INTRODUCTION: Evidence is accumulating that the risk of osteoporosis in later life may be determined in part by environmental influences during intrauterine and early postnatal life. We previously reported that maternal birthweight, smoking, fat stores, and physical activity during pregnancy predict neonatal bone mass. While the growth hormone/insulin-like growth factor 1 (GH/IGF-1) axis is an important determinant of postnatal skeletal growth, there are few data relating the concentration of growth factors in umbilical cord blood to bone mineral content (BMC) and other indices of body composition in the newborn infant. MATERIALS AND METHODS: We conducted a population-based study in a cohort of full-term, newborn infants whose mothers were characterized for lifestyle, body composition, and nutrition through their normal pregnancies. In a sample of 119 infants from the cohort, we related cord serum IGF-1 and insulin-like growth factor binding protein (IGFBP)-3 concentrations to neonatal body composition measured by DXA and evaluated the extent to which this cytokine mediates the previously reported effects of maternal diet and lifestyle on neonatal bone mass. RESULTS: There were strong positive associations between cord serum IGF-1 concentration and whole body BMC (r = 0.38, p < 0.001), whole body lean mass (r = 0.40, p < 0.001), and whole body fat mass (r = 0.50, p < 0.001) after adjusting for gestational age and sex. There was no association between cord serum IGF-1 and BMC adjusted for bone size. Neither cord serum IGF-1 nor IGFBP-3 explained the relationships that we previously reported between maternal influences and neonatal bone mass. CONCLUSIONS: Cord serum IGF-1 is more closely related to the size of the neonatal skeleton than to its degree of mineralization. Documented maternal determinants of neonatal bone mass seem to mediate their effects independently of variations in cord serum IGF-1 in healthy pregnancies.     

Comparisons of body size, composition, and whole body bone mass between North American and South African children.

We compared whole body BMC of 811 black, white, and mixed ancestral origin children from Detroit, MI; Johannesburg, South Africa; and Cape Town, South Africa. Our findings support the role of genetic and environmental influences in the determination of bone mass in prepubertal children. INTRODUCTION: Higher bone mass and lower fracture rates have been shown in black compared with white children and adults in North America. MATERIALS AND METHODS: We compared whole body BMC (WBBMC), whole body fat mass (WBFM), and whole body fat free soft tissue (WBFFST) data between three ethnic groups of children from Detroit, MI (n = 181 white, USW; n = 230 black, USB), Johannesburg, South Africa (n = 73 white, SAW; n = 263 black, SAB), and Cape Town, South Africa (n = 64 mixed ancestral origin, SAM). RESULTS: SAB and SAW groups were slightly older than USW and USB groups (9.5 +/- 0.3 versus 9.3 +/- 0.1 yr); however, USB and USW boys were significantly taller, were heavier, and had a higher BMI than SAM and SAB boys. USB girls were significantly taller than SAB girls and heavier than SAB and SAM girls. In South Africa and the United States, black children had a significantly higher WBBMC than white children, after adjusting for selected best predictors. After adjusting for age, weight, and height, WBBMC was significantly higher in the SAB and SAW boys than in USW and USB and in the SAM group compared with the USW and USB groups. WBFFST and WBFM made significant contributions to a best linear model for log(WBBMC), together with age, height, and ethnicity. The best model accounted for 79% of the WBBMC variance. When included separately in the model, the model containing WBFFST accounted for 76%, and the model containing WBFM accounted for 70%, of the variance in WBBMC. CONCLUSIONS: WBBMC is lower in children of European ancestry compared with African ancestry, irrespective of geographical location; however, South African children have significantly higher WBBMC compared with USB and USW groups, thereby acknowledging the possible contribution of environmental factors. Reasons for the significantly higher WBBMC in the children of mixed ancestral origin compared with the other groups need to be studied further.     

Whole body bone mass and body composition in a girl with achondroplasia, at ages 9 through 12.

A 9-yr-old white female with achondroplasia was one of a group of 773 children who were recruited for a study of the accumulation of whole body skeletal mass during four annual measurements. Measurements of bone, fat, and lean mass were obtained with a Hologic 1000W instrument. The following variables are used to compare the subject with the 130 healthy white girls who participated in the study: bone mineral content (BMC), bone mineral density (BMD), and bone mineral apparent density (BMAD). Ratios of BMC to weight or BMC to height, and BMD to weight or height, were also calculated. We found that the BMC of the subject was lower when compared to the reference group, but the ratios of BMC to weight or BMC to height were similar in both. BMD was also lower in the patient, but, when expressed in relation to height and weight, the ratios were similar or slightly higher in the case. BMAD was higher in the subject with achondroplasia at all ages. The subject had a lower percentage fat and higher percentage lean mass than the reference children. We conclude that the accumulation of bone mass in this subject with achondroplasia is appropriate for her reduced body size.