Adiposity and Bone Loss in Spinal Cord Injury

脊髓损伤中的肥胖和骨质流失

• 批准号: 8653535
• 负责人: Leslie R. Morse
• 金额: $ 55.61万
• 依托单位: SPAULDING REHABILITATION HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-04-05 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8653535
• 关键词: Adipose tissue; Affect; Aging; Alcohol consumption; Amputation; Blood; Body Weight; Body mass index; Bone Density; Bone Resorption; Bone remodeling; Boston; Chronic; Chronic Phase; Clinical; Cross-Sectional Studies; Data; Decubitus ulcer; Distal; Enrollment; Equilibrium; Fatty acid glycerol esters; Femur; Fracture; General Population; Glosso-Sterandryl; Health; Health behavior; Hip Fractures; Hip region structure; Hormones; Impairment; Individual; Injury; Intervention; Knee; Left; Leg; Leptin; Link; Longitudinal Studies; Lower Extremity; Measures; Mechanical Stimulation; Mechanics; Mediating; Mediator of activation protein; Metaphysis; Modeling; Motor; Muscle; Natural History; Neurologic; Obesity; Osteocalcin; Osteogenesis; Osteomyelitis; Osteoporosis; Osteoporosis prevention; Paralysed; Participant; Pathogenesis; Pattern; Population; Postmenopausal Osteoporosis; Postmenopause; Protocols documentation; Risk; Scanning; Senile Osteoporosis; Severities; Site; Smoking; Source; Spinal cord injury; Testing; Trauma; Vertebral column; Visceral; adiponectin; arm; base; bone; bone disuse atrophy; bone loss; bone mass; bone metabolism; clinically relevant; design; disability; improved; innovation; long bone; medical complication; novel; osteoporosis with pathological fracture; prevent; programs; protective effect; public health relevance; response; tibia

DESCRIPTION (provided by applicant): Excessive bone loss occurs following spinal cord injury (SCI) leading to osteoporosis and an increased risk of low-impact fracture in up to 50% of all individuals with neurologically complete SCI. These fractures can be catastrophic as they limit mobility, worsen disability, and predispose to medical complications While the underlying cause of this bone loss remains to be clarified, it is distinct in severity and pattern from other known causes of osteoporosis including disuse and postmenopausal osteoporosis. In contrast, the metaphyses of the distal femur and proximal tibia (i.e., above and below the knee) are the most commonly fractured sites following SCI. Currently, little is known about the cause of, the natural history, or the specific factors that contribute to the severity of bone loss following SCI. Based on preliminary studies, we hypothesize that visceral fat is involved in the pathogenesis of SCI-induced bone loss and may be a mediator of osteoporosis severity and fracture risk in this population. We propose to investigate the relationship between visceral fat, circulating levels of fat derived hormones, and longitudinal change in bone mineral density in chronic SCI. Participants with SCI whose health behaviors (smoking, alcohol use) and comorbid illnesses are known due to enrollment in a longitudinal health study at VA Boston will be studied. This study will be the first large longitudinal study of bone loss in chronic SCI, and is both significant and innovative because it will be the first to use SCI as a clinical model to characterize adipose mediated bone loss occurring in isolation from mechanical loading. Defining the rate of bone loss at the distal femur and proximal tibia and assessing relationships with visceral fat will have important implications for the management and prevention of osteoporosis in SCI. If confirmed, these findings will lay the groundwork for novel clinical programs that target excess body weight and to promote mechanical stimulation of bone to improve bone mass and prevent osteoporotic fractures.

描述（由申请人提供）：脊髓损伤（SCI）后发生过度骨质流失，导致骨质疏松症和低冲击骨折的风险增加，在所有神经完全性SCI患者中高达50%。这些骨折可能是灾难性的，因为它们限制了活动能力，加重了残疾，并易导致医学并发症。虽然这种骨质流失的潜在原因尚不清楚，但其严重程度和模式与其他已知的骨质疏松症原因（包括废用和绝经后骨质疏松症）不同。相反，股骨远端和胫骨近端（即膝盖上方和下方）是脊髓损伤后最常见的骨折部位。目前，对脊髓损伤后骨质流失的原因、自然历史或具体因素知之甚少。根据初步研究，我们假设内脏脂肪参与了sci诱导的骨质流失的发病机制，并可能是该人群骨质疏松严重程度和骨折风险的中介。我们建议研究慢性脊髓损伤患者内脏脂肪、循环脂肪源性激素水平和骨密度纵向变化之间的关系。脊髓损伤患者的健康行为（吸烟、饮酒）和合并症由于在VA Boston的纵向健康研究登记而已知，将被研究。这项研究将是慢性脊髓损伤中骨质流失的第一个大型纵向研究，具有重要意义和创新性，因为它将首次使用脊髓损伤作为临床模型来表征脂肪介导的骨质流失，而不受机械负荷的影响。确定股骨远端和胫骨近端骨质流失率，并评估与内脏脂肪的关系，将对脊髓损伤骨质疏松症的管理和预防具有重要意义。如果得到证实，这些发现将为新的临床项目奠定基础，以超重为目标，促进骨的机械刺激，以改善骨量，预防骨质疏松性骨折。

项目成果

Spinal Cord Injury and Osteoporosis: Causes, Mechanisms, and Rehabilitation Strategies

• DOI: 10.4172/2329-9096.1000127
• 发表时间: 2013-04
• 期刊: International journal of physical medicine & rehabilitation
• 作者: C. Tan;R. Battaglino;L. Morse

Adiponectin is associated with bone strength and fracture history in paralyzed men with spinal cord injury.

• DOI: 10.1007/s00198-014-2786-2
• 发表时间: 2014-11
• 期刊: Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA
• 作者: Tan CO;Battaglino RA;Doherty AL;Gupta R;Lazzari AA;Garshick E;Zafonte R;Morse LR
• 通讯作者: Morse LR

Vitamin D, diet, and lifestyle in a chronic SCI population.

慢性 SCI 人群的维生素 D、饮食和生活方式。

• DOI: 10.1038/s41393-018-0148-1
• 发表时间: 2019
• 期刊: Spinal cord
• 影响因子: 2.2
• 作者: Koutrakis,NicholasE;Goldstein,RebekahL;Walia,Palak;Polak,MadelineM;Lazzari,AntonioA;Tun,CarlosG;Hart,JaimeE;Garshick,Eric
• 通讯作者: Garshick,Eric

Association between weekly exercise minutes and resting IL-6 in adults with chronic spinal cord injury: findings from the fracture risk after spinal cord injury exercise study.

慢性脊髓损伤成人每周运动分钟数与静息 IL-6 之间的关联：脊髓损伤运动研究后骨折风险的发现。

• DOI: 10.1038/s41393-022-00833-7
• 发表时间: 2022
• 期刊: Spinal cord
• 影响因子: 2.2
• 作者: Park,Andrew;Ryder,Stephanie;Sevigny,Mitch;Monden,KimberleyR;Battaglino,RicardoA;Nguyen,Nguyen;Goldstein,Richard;Morse,LeslieR
• 通讯作者: Morse,LeslieR

Measurement of Bone: Diagnosis of SCI-Induced Osteoporosis and Fracture Risk Prediction.

骨测量：SCI 引起的骨质疏松症的诊断和骨折风险预测。

• DOI: 10.1310/sci2104-267
• 发表时间: 2015
• 期刊: Topics in spinal cord injury rehabilitation
• 影响因子: 2.9
• 作者: Troy,KarenL;Morse,LeslieR
• 通讯作者: Morse,LeslieR