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Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents

Tumor-induced rickets/osteomalacia (TIR/O) severely impairs bone microarchitecture and bone strength. However, no study has described the microarchitectural quality of bone in adolescent patients with TIR/O. TIR/O affects bone quality more severely than the inherited causes of hypophosphatemia, the...

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Autores principales: Jiajue, Ruizhi, Ni, Xiaolin, Jin, Chenxi, Yu, Wei, Huo, Li, Wu, Huanwen, Liu, Yong, Jin, Jin, Lv, Wei, Zhou, Lian, Xia, Yu, Chi, Yue, Cui, Lijia, Pang, Qianqian, Li, Xiang, Jiang, Yan, Wang, Ou, Li, Mei, Xing, Xiaoping, Meng, Xunwu, Xia, Weibo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234144/
https://www.ncbi.nlm.nih.gov/pubmed/35769089
http://dx.doi.org/10.3389/fendo.2022.883981
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author Jiajue, Ruizhi
Ni, Xiaolin
Jin, Chenxi
Yu, Wei
Huo, Li
Wu, Huanwen
Liu, Yong
Jin, Jin
Lv, Wei
Zhou, Lian
Xia, Yu
Chi, Yue
Cui, Lijia
Pang, Qianqian
Li, Xiang
Jiang, Yan
Wang, Ou
Li, Mei
Xing, Xiaoping
Meng, Xunwu
Xia, Weibo
author_facet Jiajue, Ruizhi
Ni, Xiaolin
Jin, Chenxi
Yu, Wei
Huo, Li
Wu, Huanwen
Liu, Yong
Jin, Jin
Lv, Wei
Zhou, Lian
Xia, Yu
Chi, Yue
Cui, Lijia
Pang, Qianqian
Li, Xiang
Jiang, Yan
Wang, Ou
Li, Mei
Xing, Xiaoping
Meng, Xunwu
Xia, Weibo
author_sort Jiajue, Ruizhi
collection PubMed
description Tumor-induced rickets/osteomalacia (TIR/O) severely impairs bone microarchitecture and bone strength. However, no study has described the microarchitectural quality of bone in adolescent patients with TIR/O. TIR/O affects bone quality more severely than the inherited causes of hypophosphatemia, the most common form of which is X-linked hypophosphatemia (XLH). Nevertheless, differences of the microarchitectural quality of the bone between TIR/O and XLH have never been clarified. Therefore, in this study, we used high-resolution peripheral quantitative computed tomography to assess bone microarchitecture in five Chinese adolescent TIR/O patients, and these were compared with 15 age- and gender-matched XLH patients as well as 15 age- and gender-matched healthy controls. Compared with the healthy controls, the TIR/O patients presented with significantly lower volumetric bone mineral densities (vBMDs), severely affected bone microarchitecture, and profoundly weaker bone strength. The distal tibia was more severely affected than the distal radius. Compared with the XLH patients, the TIR/O patients showed deteriorated bone quality notably at the distal tibia and in the cancellous compartment, reflected by 45.9% lower trabecular vBMD (p = 0.029), 40.2% lower trabecular fraction (p = 0.020), 40.6% weaker stiffness (p = 0.058), and 42.7% weaker failure load (p = 0.039) at the distal tibia. The correlation analysis showed that a higher level of serum FGF23 and a lower level of serum phosphate were associated with a poorer bone microarchitecture and a weaker estimated bone strength in the hypophosphatemic patients of our study. In conclusion, our study demonstrated significantly lower vBMDs, severely impaired bone microarchitecture, and profoundly weaker bone strength in Chinese adolescent patients with TIR/O, notably at the distal tibia, compared with the same parameters in age- and sex-matched healthy controls and XLH patients, which was possibly caused by excessive FGF23 production and secretion, chronically severe hypophosphatemia, and weak mechanical stimulus at the lower extremities. These findings further our understanding of the impact of different kinds of hypophosphatemic rickets/osteomalacia on bone quality.
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spelling pubmed-92341442022-06-28 Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents Jiajue, Ruizhi Ni, Xiaolin Jin, Chenxi Yu, Wei Huo, Li Wu, Huanwen Liu, Yong Jin, Jin Lv, Wei Zhou, Lian Xia, Yu Chi, Yue Cui, Lijia Pang, Qianqian Li, Xiang Jiang, Yan Wang, Ou Li, Mei Xing, Xiaoping Meng, Xunwu Xia, Weibo Front Endocrinol (Lausanne) Endocrinology Tumor-induced rickets/osteomalacia (TIR/O) severely impairs bone microarchitecture and bone strength. However, no study has described the microarchitectural quality of bone in adolescent patients with TIR/O. TIR/O affects bone quality more severely than the inherited causes of hypophosphatemia, the most common form of which is X-linked hypophosphatemia (XLH). Nevertheless, differences of the microarchitectural quality of the bone between TIR/O and XLH have never been clarified. Therefore, in this study, we used high-resolution peripheral quantitative computed tomography to assess bone microarchitecture in five Chinese adolescent TIR/O patients, and these were compared with 15 age- and gender-matched XLH patients as well as 15 age- and gender-matched healthy controls. Compared with the healthy controls, the TIR/O patients presented with significantly lower volumetric bone mineral densities (vBMDs), severely affected bone microarchitecture, and profoundly weaker bone strength. The distal tibia was more severely affected than the distal radius. Compared with the XLH patients, the TIR/O patients showed deteriorated bone quality notably at the distal tibia and in the cancellous compartment, reflected by 45.9% lower trabecular vBMD (p = 0.029), 40.2% lower trabecular fraction (p = 0.020), 40.6% weaker stiffness (p = 0.058), and 42.7% weaker failure load (p = 0.039) at the distal tibia. The correlation analysis showed that a higher level of serum FGF23 and a lower level of serum phosphate were associated with a poorer bone microarchitecture and a weaker estimated bone strength in the hypophosphatemic patients of our study. In conclusion, our study demonstrated significantly lower vBMDs, severely impaired bone microarchitecture, and profoundly weaker bone strength in Chinese adolescent patients with TIR/O, notably at the distal tibia, compared with the same parameters in age- and sex-matched healthy controls and XLH patients, which was possibly caused by excessive FGF23 production and secretion, chronically severe hypophosphatemia, and weak mechanical stimulus at the lower extremities. These findings further our understanding of the impact of different kinds of hypophosphatemic rickets/osteomalacia on bone quality. Frontiers Media S.A. 2022-06-13 /pmc/articles/PMC9234144/ /pubmed/35769089 http://dx.doi.org/10.3389/fendo.2022.883981 Text en Copyright © 2022 Jiajue, Ni, Jin, Yu, Huo, Wu, Liu, Jin, Lv, Zhou, Xia, Chi, Cui, Pang, Li, Jiang, Wang, Li, Xing, Meng and Xia https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Jiajue, Ruizhi
Ni, Xiaolin
Jin, Chenxi
Yu, Wei
Huo, Li
Wu, Huanwen
Liu, Yong
Jin, Jin
Lv, Wei
Zhou, Lian
Xia, Yu
Chi, Yue
Cui, Lijia
Pang, Qianqian
Li, Xiang
Jiang, Yan
Wang, Ou
Li, Mei
Xing, Xiaoping
Meng, Xunwu
Xia, Weibo
Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents
title Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents
title_full Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents
title_fullStr Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents
title_full_unstemmed Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents
title_short Bone Volumetric Density, Microarchitecture, and Estimated Bone Strength in Tumor-Induced Rickets/Osteomalacia Versus X-linked Hypophosphatemia in Chinese Adolescents
title_sort bone volumetric density, microarchitecture, and estimated bone strength in tumor-induced rickets/osteomalacia versus x-linked hypophosphatemia in chinese adolescents
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9234144/
https://www.ncbi.nlm.nih.gov/pubmed/35769089
http://dx.doi.org/10.3389/fendo.2022.883981
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