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Endocrine
Published in: Endocrine 1/2013

01-02-2013 | Mini Review

Osteoporosis in chronic inflammatory disease: the role of malnutrition

Authors: Tiziana Montalcini, Stefano Romeo, Yvelise Ferro, Valeria Migliaccio, Carmine Gazzaruso, Arturo Pujia

Published in: Endocrine | Issue 1/2013

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Abstract

Osteoporosis is a metabolic bone disorder affecting million of people worldwide. Increased understanding of bone disease has led to a greater recognition of factors affecting bones, and consequently many secondary causes of osteoporosis were demonstrated. In this study, we aim to explore possible causes of bone loss and fractures in subjects affected by chronic inflammatory disease and to suggest new targets for intervention. In fact several studies, evaluated to perform this study, suggest that the patients with chronic inflammatory disease could be at high risk for fractures due to bone loss as consequence of malnutrition, caused by inflammation and hormonal change. Consequently, some actions could derive from the considerations of these mechanisms: a change in actual approach of chronic patients, that may include the investigation on the possible presence of osteoporosis, as well as further research on this topic to find a better therapy to prevent osteoporosis considering all the mechanisms described.
Literature
1.
2.
3.
S. Khosla, B. Riggs, Pathophysiology of age-related bone loss and osteoporosis. Endocrinol. Metab. Clin. N. Am. 34, 1015–1030 (2005)CrossRef
4.
S. Khosla, B. Riggs, R. Robb, J. Camp, S. Achenbach, A. Oberg, P.A. Rouleau, L.J. Melton 3rd, Relationship of volumetric bone density and structural parameters at different skeletal sites to sex steroid levels in women. J. Clin. Endocrinol. Metab. 90, 5096–5103 (2005)PubMedCrossRef
5.
K. Walker, Bone recognizing and treating secondary osteoporosis. Nat. Rev. Rheumatol. 8, 480–492 (2012)CrossRef
6.
V.E. MacRae, S.C. Wong, C. Farquharson, S.F. Ahmed, Cytokine actions in growth disorders associated with pediatric chronic inflammatory diseases. Int. J. Mol. Med. 18, 1011–1018 (2006)PubMed
7.
T. Larussa, E. Suraci, I. Nazionale, I. Leone, T. Montalcini, L. Abenavoli, M. Imeneo, A. Pujia, F. Luzza, No evidence of circulating autoantibodies against osteoprotegerin in patients with celiac disease. World J. Gastroenterol. 14(18), 1622–1627 (2012)CrossRef
8.
G.J. Tack, W.H. Verbeek, M.W. Schreurs, C.J. Mulder, The spectrum of celiac disease: epidemiology, clinical aspects and treatment. Nat. Rev. Gastroenterol. Hepatol. 4, 204–213 (2010)CrossRef
9.
P. Georgiadou, S. Adamopoulos, Skeletal muscle abnormalities in chronic heart failure. Curr. Heart Fail. Rep. 9, 128–132 (2012)PubMedCrossRef
10.
T. Montalcini, V. Emanuele, R. Ceravolo, G. Gorgone, G. Sesti, F. Perticone, A. Pujia, Relation of low bone mineral density and carotid atherosclerosis in postmenopausal women. Am. J. Cardiol. 94, 266–269 (2004)PubMedCrossRef
11.
D.L. Broussard, J.H. Magnus, Coronary heart disease risk and bone mineral density among U.S. women and men. J. Womens Health 17, 479–490 (2008)CrossRef
12.
R. Varma, W.S. Aronow, Y. Basis, T. Singh, K. Kalapatapu, M.B. Weiss, A.L. Pucillo, C.E. Monsen, Relation of bone mineral density to frequency of coronary heart disease. Am. J. Cardiol. 101, 1103–1104 (2008)PubMedCrossRef
13.
E. Erbilen, S. Yazici, H. Ozhan, S. Bulur, S. Ordu, M. Yazici, Relationship between angiographically documented coronary artery disease and low bone mass in men. Circ. J. 7, 1095–1098 (2007)CrossRef
14.
M. Gossl, U.I. Modder, E.J. Atkinson, A. Lerman, S. Khosla, Osteocalcin expression by circulating endothelial progenitor cells in patients with coronary atherosclerosis. J. Am. Coll. Cardiol. 52, 1314–1325 (2008)PubMedCrossRef
15.
R. Ohmori, Y. Momiyama, H. Taniguchi, M. Kusuhara, H. Nakamura, F. Ohsuzu, Plasma osteopontin levels are associated with the presence and extent of coronary artery disease. Atherosclerosis 170, 333–337 (2003)PubMedCrossRef
16.
L. Graat-Verboom, M.A. Spruit, B.E. van den Borne, F.W. Smeenk, E.J. Martens, R. Lunde, E.F. Wouters, Correlates of osteoporosis in chronic obstructive pulmonary disease: an underestimated systemic component. Respir. Med. 103, 1143–1151 (2009)PubMedCrossRef
17.
G. Cascini, C. Falcone, C. Greco, B. Bertucci, S. Cipullo, O. Tamburrini, Whole-body magnetic resonance imaging for detecting bone metastases: comparison with bone scintigraphy. Radiol. Med. 113, 1157–1170 (2008)PubMedCrossRef
18.
K. Martensson, D. Chrysis, L. Savendahl, Interleukin-1 beta and TNF-alpha act in synergy to inhibit longitudinal growth in fetal rat metatarsal bones. J. Bone Miner. Res. 19, 1805–1812 (2004)PubMedCrossRef
19.
V.E. MacRae, C. Farquharson, S.F. Ahmed, The restricted potential for recovery of growth plate chondrogenesis and longitudinal bone growth following exposure to pro-inflammatory cytokines. J. Endocrinol. 189, 319–328 (2006)PubMedCrossRef
20.
J.C. Tan, R. Rabkin, Suppressors of cytokine signaling in health and disease. Pediatr. Nephrol. 20, 567–575 (2005)PubMedCrossRef
21.
E. Choy, Understanding the dynamics: pathways involved in the pathogenesis of rheumatoid arthritis. Rheumatology (Oxf.) 5, 3–11 (2012)CrossRef
22.
A. Giustina, G. Mazziotti, E. Canalis, Growth hormone, insulin-like growth factors, and the skeleton. Endocr. Rev. 29, 535–559 (2008)PubMedCrossRef
23.
S. Ferrari-Lacraz, S. Ferrari, Do RANKL inhibitors (denosumab) affect inflammation and immunity? Osteoporos. Int. 22, 435–446 (2011)PubMedCrossRef
24.
M. Chabaud, J.M. Durand, N. Buchs, F. Fossiez, G. Page, L. Frappart et al., Human interleukin-17: a T cell-derived proinflammatory cytokine produced by the rheumatoid synovium. Arthr. Rheum. 42, 963–970 (1999)CrossRef
25.
C.K. Wong, C.Y. Ho, E.K. Li, C.W. Lam, Elevation of proinflammatory cytokine (IL-18, IL-17, IL-12) and Th2 cytokine (IL-4) concentrations in patients with systemic lupus erythematosus. Lupus 9, 589–593 (2000)PubMedCrossRef
26.
K. Kurasawa, K. Hirose, H. Sano, H. Endo, H. Shinkai, Y. Nawata et al., Increased interleukin-17 production in patients with systemic sclerosis. Arthr. Rheum. 43, 2455–2463 (2000)CrossRef
27.
M.A. Lowes, T. Kikuchi, J. Fuentes-Duculan, I. Cardinale, L.C. Zaba, A.S. Haider et al., Psoriasis vulgaris lesions contain discrete populations of Th1 and Th17 T cells. J. Invest. Dermatol. 128, 1207–1211 (2008)PubMedCrossRef
28.
A.M. Tyagi, K. Srivastava, M.N. Mansoori, R. Trivedi, N. Chattopadhyay, D. Singh, Estrogen deficiency induces the differentiation of IL-17 secreting Th17 cells: a new candidate in the pathogenesis of osteoporosis. PLoS ONE 7, e44552 (2012)PubMedCrossRef
29.
G. Schett, Effects of inflammatory and anti-inflammatory cytokines on the bone. Eur. J. Clin. Invest. 41, 1361–1366 (2011)PubMedCrossRef
30.
S. Koch, P. Nava, C. Addis, W. Kim, T.L. Denning, L. Li, C.A. Parkos, A. Nusrat, The Wnt antagonist Dkk1 regulates intestinal epithelial homeostasis and wound repair. Gastroenterology 141, 259–268 (2011)PubMedCrossRef
31.
R. Baron, G. Rawadi, Targeting the Wnt/β catenin pathway to regulate bone formation in the adult skeleton. Endocrinology 148, 2635–2643 (2007)PubMedCrossRef
32.
C.R. Plata-Salamán, Cytokines and feeding. Int. J. Obes. 25, S48–S52 (2001)CrossRef
33.
A. Inui, Cancer anorexia-cachexia syndrome: are neuropeptides the key? Cancer Res. 59, 4493–4501 (1999)PubMed
34.
J.M. Argiles, S. Busquets, F.J. Lopez-Soriano, The pivotal role of cytokines in muscle wasting during cancer. Int. J. Biochem. Cell Biol. 37, 1609–1619 (2005)PubMedCrossRef
35.
J.M. Argilés, S. Busquets, F.J. López-Soriano, Anti-inflammatory therapies in cancer cachexia. Eur. J. Pharmacol. 1, 81–86 (2011)CrossRef
36.
M.B. Reid, Y.P. Li, Tumor necrosis factor-alpha and muscle wasting: a cellular perspective. Respir. Res. 2, 269–272 (2001)PubMedCrossRef
37.
A. Laviano, M.M. Meguid, F. Rossi-Fanelli, Cancer anorexia: clinical implications, pathogenesis, and therapeutic strategies. Lancet Oncol. 4, 686–694 (2003)PubMedCrossRef
38.
A. Tournadre, P. Miossec, Interleukin-17 in inflammatory myopathies. Curr. Rheumatol. Rep. 14, 252–256 (2012)PubMedCrossRef
39.
J. von Maltzahn, N.C. Chang, C.F. Bentzinger, M.A. Rudnicki, Wnt signaling in myogenesis. Trends Cell Biol. (2012)
40.
R. Faggioni, K.R. Feingold, C. Grunfeld, Leptin regulation of the immune response and the immunodeficiency of malnutrition. FASEB J. 14, 2565–2571 (2001)CrossRef
41.
V. Sanna, A. Di Giacomo, A. La Cava, R.I. Lechler, S. Fontana, S. Zappacosta, G. Matarese, Leptin surge precedes onset of autoimmune encephalomyelitis and correlates with development of pathogenic T cell responses. J Clin Invest. 111, 241–250 (2003)PubMed
42.
M. Otero, R. Lago, F. Lago, F.F. Casanueva, C. Dieguez, J.J. Gómez-Reino, O. Gualillo, Leptin, from fat to inflammation: old questions and new insights. FEBS Lett. 579, 295–301 (2005)PubMedCrossRef
43.
H.S. Berner, S.P. Lyngstadaas, A. Spahr, M. Monjo, L. Thommesen, C.A. Drevon, U. Syversen, J.E. Reseland, Adiponectin and its receptors are expressed in bone-forming cells. Bone 35, 842–849 (2004)PubMedCrossRef
44.
C. Roux, A. Arabi, R. Porcher, P. Garnro, Serum leptin as a determinant of bone resorption in healthy postmenopausal women. Bone 33, 837–852 (2003)CrossRef
45.
J.M. Gimble, M.E. Nuttall, Bone and fat: old questions, new insights. Endocrine 23, 183–188 (2004)PubMedCrossRef
46.
47.
G.S. Kim, J.S. Hong, S.W. Kim, J.M. Koh, C.S. An, J.Y. Choi, S.L. Cheng, Leptin induces apoptosis via ERK/cPLA2/cytochrome c pathway in human bone marrow stromal cells. J. Biol. Chem. 13, 21920–21929 (2003)CrossRef
48.
H. Blain, A. Vuillemin, F. Guillemin, B. Hanesse, N. de Talance, B. Doucet, C. Jeandel, Serum leptin levels is a predictor of bone mineral density in postmenopausal women. J. Clin. Endocrinol. Metab. 87, 1030–1035 (2002)PubMedCrossRef
49.
A. Goulding, R.W. Taylor, Plasma leptin values in relation to bone mass and density to dynamic biochemical markers of bone resorption and formation in postmenopausal women. Calcif. Tissue Int. 63, 56–458 (1998)CrossRef
50.
M. Yamauchi, T. Sugimoto, T. Yamaguchi, D. Nakaoka, M. Kanzawa, S. Yano, R. Ozuru, T. Sugishita, K. Chihara, Plasma leptin concentrations are associated with bone mineral density and presence of vertebral fractures in postmenopausal women. Clin. Endocrinol. (Oxf.) 55, 341–347 (2001)CrossRef
51.
M.D. Kontogianni, U.G. Dafni, J.G. Routsias, F.N. Skopouli, Blood leptin and resistin as possible mediators of the relation between fat mass and BMD in perimenopausal women. J. Bone Miner. Res. 19, 546–551 (2004)PubMedCrossRef
52.
F. Rauch, W.F. Blum, K. Klein, B. Allolio, E. Schonau, Does leptin have an effect on bone in adult women? Calcif. Tissue Int. 63, 453–455 (1998)PubMedCrossRef
53.
M. Yılmaz, I. Keles, G. Aydın, S. Orkun, M. Bayram, F.C. Sevinc, U. Kisa, I. Yetkin, Plasma leptin concentration in postmenopausal women with osteoporosis. Endocr. Res. 31, 133–138 (2005)CrossRef
54.
G. Sahin, G. Polat, S. Bagis, A. Milcan, O. Bagdatoglu, C. Erdogan, H. Camdeviren, Body composition, bone mineral density and circulating leptin levels in postmenopausal Turkish women. Rhematol. Int. 23, 87–91 (2003)
55.
M. Shaarawy, A.F. Abassi, H. Hassan, M.E. Salem, Relationship between serum leptin concentrations and bone mineral density as well as biochemical markers of bone turnover in women with postmenopausal osteoporosis. Fertil. Steril. 79, 919–924 (2003)PubMedCrossRef
56.
P. Marie, F. Debias, M. Cohen-Solal, M.C. Vernejoul, New factors controlling bone remodeling. Joint Bone Spine 67, 150–156 (2000)PubMed
57.
58.
S. Pinto, A.G. Roseberry, H. Liu, S. Diano, M. Shanabrough, X. Cai, J.M. Friedman, T.L. Horvath, Rapid rewiring of arcuate nucleus feeding circuits by leptin. Science 304, 110–115 (2004)PubMedCrossRef
59.
R.E. Hubbard, M.S. O’Mahony, B.L. Calver, K.W. Woodhouse, Nutrition, inflammation, and leptin levels in aging and frailty. J. Am. Geriatr. Soc. 56, 279–284 (2008)PubMedCrossRef
60.
E. Toussirot, D. Binda, C. Gueugnon, G. Dumoulin, Adiponectin in autoimmune diseases. Curr. Med. Chem. (2012). [Epub ahead of print]
61.
K.E. Barbour, J.M. Zmuda, R. Boudreau, E.S. Strotmeyer, M.J. Horwitz, R.W. Evans, Health ABC Study et al., The effects of adiponectin and leptin on changes in bone mineral density. Osteoporos. Int. 23, 1699–1710 (2012)PubMedCrossRef
62.
K.E. Barbour, J.M. Zmuda, R. Boudreau, E.S. Strotmeyer, M.J. Horwitz, R.W. Evans et al., Adipokines and the risk of fracture in older adults. J. Bone Miner. Res. 26, 1568–1576 (2011)PubMedCrossRef
63.
E. Guillod-Maximin, A.F. Roy, C.M. Vacher, A. Aubourg, V. Bailleux, A. Lorsignol et al., Adiponectin receptors are expressed in hypothalamus and colocalized with proopiomelanocortin and neuropeptide Y in rodent arcuate neurons. J. Endocrinol. 200, 93–105 (2009)PubMedCrossRef
64.
T. Constans, Y. Bacq, J.F. Brechot, J.L. Guilmot, P. Choutet, F. Lamisse, Protein-energy malnutrition in elderly medical patients. J. Am. Geriatr. Soc. 40, 263–268 (1992)PubMed
65.
J. Woo, Y.T. Mak, R. Swaminathan, Nutritional status of general medical patients: influence of age and disease. J. Nutr. Biochem. 2, 274–280 (1991)CrossRef
66.
R.C. Nelson, L.R. Franzi, Nutrition and aging. Med. Clin. N. Am. 73, 1531–1550 (1989)PubMed
67.
J.P. McWhirter, C.R. Pennington, Incidence and recognition of malnutrition in hospital. Br. Med. J. 308, 945–948 (1994)CrossRef
68.
J.E. Morley, A.J. Silver, M. Fiatarone, A.D. Mooradian, Geriatric grand rounds: nutrition and the elderly. J. Am. Geriatr. Soc. 34, 823–832 (1986)PubMed
69.
D.H. Sullivan, G.A. Patch, R.C. Walls, D.A. Lipschitz, Impact of nutrition status on morbidity and mortality in a select population of geriatric rehabilitation patients. Am. J. Clin. Nutr. 51, 749–758 (1990)PubMed
70.
R.K. Chandra, The relation between immunology, nutrition and disease in elderly people. Age Ageing 19, 25–31 (1990)CrossRef
71.
M.A. Fiatarone, W.J. Evans, The etiology and reversibility of muscle dysfunction in the aged. J. Gerontol. 48, 77–83 (1993)PubMedCrossRef
72.
A.N. Galanos, C.F. Pieper, J.C. Cornoni-Huntley, C.W. Bales, G.G. Fillenbaum, Nutrition and function: is there a relationship between body mass index and the functional capabilities of community-dwelling elderly? J. Am. Geriatr. Soc. 42, 368–373 (1994)PubMed
73.
J. Lopes, D.M. Russell, J. Whitwell, K.N. Jeejeebhoy, Skeletal muscle function in malnutrition. Am. J. Clin. Nutr. 36, 602–610 (1982)PubMed
74.
M.J. Ronis, K. Mercer, J.R. Chen, Effects of nutrition and alcohol consumption on bone loss. Curr. Osteoporos. Rep. 9, 53–59 (2011)PubMedCrossRef
75.
J.P. Bonjour, Calcium and phosphate: a duet of ions playing for bone health. J. Am. Coll. Nutr. 30, 438S–448S (2011)PubMed
76.
P. Bordelon, M.V. Ghetu, R. Langan, Recognition and management of vitamin D deficiency. Am. Fam. Physician 80, 841–846 (2009)PubMed
77.
S. Boonen, H.A. Bischoff-Ferrari, C. Cooper, P. Lips, O. Ljunggren, P.J. Meunier, J.Y. Reginster, Addressing the musculoskeletal components of fracture risk with calcium and vitamin D: a review of the evidence. Calcif. Tissue Int. 78, 257–270 (2006)PubMedCrossRef
78.
G. Isaia, R. Giorgino, G.B. Rini, M. Bevilacqua, D. Maugeri, S. Adami, Prevalence of hypovitaminosis D in elderly women in Italy: clinical consequences and risk factors. Osteoporos. Int. 14, 577–582 (2003)PubMedCrossRef
79.
O. Sahota, M.K. Mundey, P. San, I.M. Godber, D.J. Hosking, Vitamin D insufficiency and the blunted PTH response in established osteoporosis: the role of magnesium deficiency. Osteoporos. Int. 17, 1013–1021 (2006)PubMedCrossRef
80.
J. Aaseth, G. Boivin, O. Andersen, Osteoporosis and trace elements—an overview. J. Trace Elem. Med. Biol. 26, 149–152 (2012)PubMedCrossRef
81.
M.A. Daamen, J.M. Schols, T. Jaarsma, J.P. Hamers, Prevalence of heart failure in nursing homes: a systematic literature review. Scand. J. Caring Sci. 24, 202–208 (2010)PubMedCrossRef
82.
J.M. Chandler, S.I. Zimmerman, C.J. Girman, A.R. Martin, W. Hawkes, J.R. Hebel, P.D. Sloane, L. Holder, J. Magaziner, Low bone mineral density and risk of fracture in white female nursing home residents. J. Am. Med. Assoc. 30(284), 972–977 (2000)CrossRef
83.
R. Thibault, C. Pichard, The evaluation of body composition: a useful tool for clinical practice. Ann. Nutr. Metab. 60, 6–16 (2012)PubMedCrossRef
84.
A.D. Anastasilakis, K.A. Toulis, S.A. Polyzos, C.D. Anastasilakis, P. Makras, Long-term treatment of osteoporosis: safety and efficacy appraisal of denosumab. Ther. Clin. Risk Manag. 8, 295–306 (2012)PubMedCrossRef
85.
G. Mazziotti, J. Bilezikian, E. Canalis, D. Cocchi, A. Giustina, New understanding and treatments for osteoporosis. Endocrine 41, 58–69 (2012)PubMedCrossRef
86.
C. Roggia, Y. Gao, S. Cenci, M.N. Weitzmann, G. Toraldo, G. Isaia, R. Pacifici, Upregulation of TNF-producing T cells in the bone marrow: a key mechanism by which estrogen deficiency induces bone loss in vivo. Proc. Natl Acad. Sci. U. S. A. 98, 13960–13965 (2001)PubMedCrossRef
87.
R. Kimble, S. Bain, R. Pacifici, The functional block of TNF but not of IL-6 prevents bone loss in ovariectomized mice. J. Bone Miner. Res. 12, 935–941 (1997)PubMedCrossRef
88.
K. Sinningen, E. Tsourdi, M. Rauner, T.D. Rachner, C. Hamann, L.C. Hofbauer, Skeletal and extraskeletal actions of denosumab. Endocrine 42, 52–62 (2012)PubMedCrossRef
89.
B.F. Ricciardi, J. Paul, A. Kim, L.A. Russell, J.M. Lane, Osteoporosis drug therapy strategies in the setting of disease-modifying agents for autoimmune disease. Osteoporos. Int. (2012). doi:10.​1007/​s00198-012-2113-8
90.
S. Wei, H. Kitaura, P. Zhou, F.P. Ross, S.L. Teitelbaum, IL-1 mediates TNF-induced osteoclastogenesis. J. Clin. Invest. 115, 282–290 (2005)PubMed
Metadata
Title
Osteoporosis in chronic inflammatory disease: the role of malnutrition
Authors
Tiziana Montalcini
Stefano Romeo
Yvelise Ferro
Valeria Migliaccio
Carmine Gazzaruso
Arturo Pujia
Publication date
01-02-2013
Publisher
Springer US
Published in
Endocrine / Issue 1/2013
Print ISSN: 1355-008X
Electronic ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-012-9813-x

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