Search Results (1,302)

In Pteropus spp., metabolic bone disease has been consistently associated with fruit-based diets that are deficient in calcium, vitamin D precursors, and protein, as well as limited ultraviolet B (UVB) exposure, as reported in zoological surveys and clinical observations. Comparative mammalian physiology suggests that dysregulation of the endocrine axis involving parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), calcitonin, and calcitriol may contribute to disease development, although direct species-specific endocrine data in flying foxes remain scarce. This narrative review synthesizes current knowledge from published zoological reports, clinical observations, and comparative mammalian physiology regarding the etiology, pathophysiology, and clinical expression of metabolic bone disease in captive flying foxes. Much of the available evidence is derived from juvenile Pteropus vampyrus, and its applicability to other Pteropus species remains to be fully established. The limited availability and consistency of existing data, together with the scarcity of controlled experimental and longitudinal studies, necessarily constrain the conclusions that can be drawn. Nevertheless, this review highlights key nutritional and environmental risk factors and summarizes evidence-informed preventive management strategies to improve skeletal health and welfare in managed Pteropus populations. Full article

The skeletal muscle system is particularly susceptible to degenerative and inflammatory processes that threaten mobility, quality of life, and systemic health. Marine plants, including brown, red, and green algae, are valuable yet understudied sources of bioactive compounds with therapeutic potential against skeletal muscle inflammation and degeneration. This narrative review provides the first overview of polyphenols, polysaccharides, carotenoids, and multiminerals derived from marine plants, with a particular focus on their effects on skeletal muscle, bone, and joint tissues. It highlights both the therapeutic potential and the limitations of marine plant-derived bioactive compounds in the musculoskeletal system. The compounds discussed, such as phlorotannins, ulvan, fucoidan, carotenoids, spirulina derivatives, and Aquamin, modulate key signaling pathways, including NF-κB, JAK/STAT3, and the NLRP3 inflammasome. Among these, MAPK emerges as the most consistently affected axis across all compound classes, leading to a reduction in TNF-α, IL-1β, IL-6, and oxidative stress markers. These bioactive compounds have been shown in both in vitro and in vivo models to reduce muscle catabolism, enhance osteoblast differentiation and mineralization, and reduce cartilage inflammation. Despite favorable safety, biocompatibility, and biodegradability profiles, current evidence shows that systemic applications significantly dominate over local delivery, highlighting the untapped potential of localized delivery strategies. Overall, this narrative review underscores the growing importance of marine plant-derived bioactives as promising natural agents for maintaining musculoskeletal integrity and alleviating degenerative disorders. Full article

Background: Estrogen deficiency following human menopause or rodent ovariectomy (OVX) induces adverse alterations in body composition and metabolic function. This study investigated the combined effects of acetic acid supplementation and voluntary exercise on metabolic health and skeletal muscle mitochondrial function using an OVX mouse model. Methods: Forty female C57BL/6J mice (8 weeks old) were randomly assigned to 5 groups: sham (SHM), ovariectomized control (OVX), OVX with exercise (OVX-E), OVX with acetic acid (OVX-A), and OVX with both interventions (OVX-AE). Following a 1-week recovery from OVX, a 13-week intervention was initiated: 5% sodium acetate-supplemented chow and/or voluntary wheel running. Body composition, glucose tolerance, total energy expenditure, skeletal muscle mitochondrial function, and the contents of AMPKα, PGC-1α, and carbonyl protein were assessed. Results: OVX impaired whole-body metabolism and skeletal muscle mitochondrial function, specifically in the gastrocnemius muscle. While the exercise alone failed to mitigate the OVX-induced mitochondrial dysfunction, the combined treatment of exercise and acetic acid supplementation significantly rescued from the OVX-induced mitochondrial dysfunction. Conclusions: OVX resulted in detrimental changes in whole-body metabolism, but voluntary exercise and/or acetic acid supplementation had no rescuing effects on those parameters. In gastrocnemius muscle, acetic acid supplementation during exercise enhanced mitochondrial function in OVX mice. Full article

Background. Rheumatoid arthritis (RA) is a chronic autoimmune disease frequently accompanied by cardiovascular, respiratory, skeletal, psychiatric, and neoplastic comorbidities that are associated with higher morbidity and poorer health-related quality of life (HRQoL). This study evaluated the associations between comorbidities and patient-reported physical health, emotional distress, daily functioning, and social relationships in adults with RA and explored patient-reported unmet needs relevant to integrated care. Methods. We conducted a cross-sectional survey among 286 adults with physician-confirmed RA, using a structured questionnaire (ICRA-Q) administered between June and July 2025 via online platforms and in-hospital supervised completion. The survey captured demographics, patient-reported physician-diagnosed comorbidities (current and/or past), perceived disease impact, functional limitations, emotional and social consequences, access to treatment, financial burden, and support needs. Analyses included descriptive statistics, χ² tests, t-tests/ANOVA, effect sizes (Cramer’s V and standardized mean differences), and multivariable logistic regression to explore predictors of high HRQoL impact and high difficulty in disease management. An exploratory classification into high-risk phenotypes was performed using predefined clinical, psychological, and socioeconomic criteria. Results. Most participants (98.6%) reported at least one comorbidity, most commonly hypertension, osteoporosis, and cardiovascular disease. Higher comorbidity burden and depression/anxiety were strongly associated with higher pain, reduced mobility, emotional distress, and financial strain. Exploratory high-risk phenotypes (severe somatic multimorbidity, high psychological vulnerability, high socioeconomic burden, and a composite very high-risk profile) were associated with poorer HRQoL indicators. Younger age, shorter disease duration, and higher perceived social support were associated with lower perceived burden. Conclusions. In this cross-sectional, patient-reported study, comorbidity burden—particularly psychological comorbidity—was strongly associated with poorer HRQoL and greater management difficulty in RA. These findings support the need for multidisciplinary, integrated care pathways; however, subgroup phenotypes should be considered exploratory and require external validation. Full article

Background/Objectives: Obesity is associated with cognitive decline, and metabolic bariatric surgery (MBS) can improve both physical and cognitive outcomes. However, cognitive improvements post-surgery are variable. This study explores the role of skeletal muscle health, specifically muscle strength and mass, in cognitive performance after MBS, aiming to identify factors that influence cognitive recovery. Methods: In this prospective study, 55 patients scheduled for MBS were assessed 1 month before and 12 months after surgery. Body composition, including appendicular lean mass (ALM) and fat mass, was measured using dual-energy X-ray absorptiometry (DXA). Handgrip strength (HGS) was assessed via dynamometry, and neurocognitive performance was evaluated using a standardized test battery. Results: Significant improvements in cognitive performance were observed at 12 months post-surgery in attention, memory, language, executive functions and overall cognitive performance. Regarding body composition, significant reductions were observed in fat mass and body mass index (BMI). A decrease in ALM and no changes in HGS were observed; however, when adjusted for body size, both showed an increase. Regression analysis identified baseline HGS, but not muscle mass, as a significant predictor of cognitive performance at 12 months post-surgery. Conclusions: MBS leads to significant improvements in cognitive function. Our results suggest that baseline HGS may play a role in predicting cognitive outcomes post-surgery, highlighting the need for comprehensive assessments of both physical and cognitive health in patients undergoing MBS. Further longitudinal studies are needed to explore causal relationships and the potential reversibility of cognitive deficits post-surgery. Full article

Background/objectives: Cannabidiol (CBD) is a non-psychoactive constituent of Cannabis sativa, which has potential skeletal benefits through modulation of bone cell function and inflammatory signalling. However, evidence of its effects and mechanisms in bone health remains fragmented. This scoping review summarised the current findings on the impact of CBD on bone outcomes and its mechanisms of action. Methods: A systematic search of PubMed, Scopus, and Web of Science was conducted in October 2025 for original studies published in English, with the primary objective of examining the effects of CBD on bone health, regardless of study design. After applying inclusion and exclusion criteria, 24 primary studies were included. Data on model design, CBD formulation, treatment parameters, bone-related outcomes, and proposed mechanisms were extracted and analysed descriptively. Results: Among the studies included, eleven demonstrated beneficial effects of CBD on bone formation, mineralisation, callus quality, or strength; eleven showed mixed outcomes; and two demonstrated no apparent benefit. Previous studies have shown that CBD suppresses bone resorption by reducing osteoclast differentiation and activity while promoting osteoblast proliferation and matrix deposition. Mechanistically, CBD’s effects involve activation of cannabinoid receptor 2, modulation of the receptor activator of nuclear factor-κB ligand/osteoprotegerin pathway, and regulation of osteoblastogenic and osteoclastogenic signalling through bone morphogenetic protein, Wnt, mitogen-activated protein kinase, nuclear factor-κB, and peroxisome proliferator-activated receptor signalling. The anti-inflammatory and antioxidant actions of CBD further contribute to a favourable bone microenvironment. Conclusions: Preclinical evidence suggests that CBD has a bone-protective role through multifaceted pathways that enhance osteoblast function and suppress osteoclast activity. Nevertheless, robust human trials are necessary to confirm its efficacy, determine its optimal dosing, and clarify its long-term safety. Full article

Background: Studies outside Japan have linked sugar-sweetened beverage (SSB) intake with weight gain; however, evidence in Japanese adults is scarce, and no study has examined beverage-derived energy in relation to anthropometric indices and handgrip strength. Methods: The participants were employees of Fujita Health University aged 20–39 years (n = 76; male n = 35, average age: 29.97 ± 4.67 years; female n = 41, average age: 27.29 ± 4.53 years). Energy from beverage intake was assessed via the Brief Beverage Intake Questionnaire-15, and energy from alcoholic drinks, milk, SSBs, and total beverages was calculated. The associations of energy from different beverages with nutrient intake, BMI, skeletal muscle mass index (SMI), and handgrip strength were analyzed via ordinary least squares (OLS) regression; quantile regression (QR) and the generalized additive model (GAM) were used for sensitivity analyses. Results: Increased SSB intake was associated with increased BMI (standardized β = 0.35, 95% CI 0.12–0.58, p(OLS) < 0.001; p(QR) = 0.23; p(GAM) < 0.001) and was nonlinearly associated with increased SMI (standardized β = 0.21, 95% CI 0.043–0.37, p(OLS) = 0.02; p(QR) = 0.11; p(GAM) = 0.02), even after adjustment for total energy intake. Modest milk intake was linked to higher protein intake and a higher SMI without a higher BMI (standardized β = 0.18, 95% CI 0.020–0.35, p(OLS) = 0.03; p(QR) = 0.39; p(GAM) = 0.03). Conclusions: A positive association was found between SSB intake and both BMI and SMI and between MILK intake and SMI. Clarification in larger, diverse Japanese populations will be necessary. Full article

Background: Sclerostin, an osteocyte-derived glycoprotein, plays a key role in bone metabolism by inhibiting the Wnt/β-catenin signaling pathway. While it is a recognized therapeutic target in osteoporosis, its relationship with sarcopenia remains unclear. This study aimed to investigate the associations between serum sclerostin levels, sarcopenia, and osteoporosis in older women. Methods: We conducted a cross-sectional study of 79 postmenopausal women aged ≥65 years. Sarcopenia was defined based on grip strength and appendicular skeletal muscle mass (ASM), osteoporosis was diagnosed according to femoral T-scores, and serum sclerostin levels were measured using ELISA. Associations with clinical variables and bone mineral density (BMD) were evaluated using correlation and logistic regression analyses. Results: Sclerostin levels were significantly higher in women with sarcopenia (p = 0.036) and exhibited a negative correlation with grip strength (r = −0.298, p = 0.008) but not with ASM. Positive correlations were found between sclerostin and multiple femoral BMD parameters. In a logistic regression analysis, sclerostin was modestly associated with sarcopenia (p = 0.045); however, no significant association was observed with osteoporosis (p = 0.257). Conclusions: Elevated sclerostin levels are associated with reduced muscle strength and sarcopenia in older women, independent of muscle mass, indicating that sclerostin may reflect a functional decline in musculoskeletal health. Muscle strength should therefore be considered when interpreting sclerostin’s clinical implications in aging populations. Full article

The service tree (Sorbus domestica L.) fruits are rich in polyphenols, which exhibit promising therapeutic effects on bone health. This review summarizes the potential benefits of polyphenols identified in Sorbus domestica L. fruits, such as chlorogenic acid (CGA), protocatechuic acid (PCA), rutin, epicatechin, and naringin on bone biology and on bone-related diseases, including osteoporosis and diabetes mellitus. Current evidence suggests that the aforementioned polyphenols may modulate osteoblast and osteoclast activity, enhance mineralization, mitigate oxidative stress and inflammation, thereby supporting overall bone health. Specific studies highlight the anabolic and anti-resorptive effects of CGA, the osteoprotective potential of PCA, and the ability of rutin, epicatechin, and naringin to promote osteogenic differentiation and inhibit osteoclastogenesis. Although the exact mechanisms are still unclear, it is believed that these bioactive metabolites can act through a variety of signalling pathways and epigenetic mechanisms. Despite existing preclinical evidence, there is a significant gap in clinical trials evaluating the direct impact of polyphenols mentioned above on bone health in humans. Therefore, further research is needed to confirm their effectiveness in clinical settings. The therapeutic potential of the most common polyphenols from Sorbus domestica L. fruits has been evaluated by available in vitro and in vivo studies, which highlight their promising potential as dietary interventions to prevent bone loss and improve skeletal integrity in metabolic bone diseases. Based on available information, maximum health benefits may be achieved if mature Sorbus domestica L. fruits are consumed approximately two weeks after harvest or as unripe fruit-based fermented products. Full article

Background/Objectives: Malocclusion is one of the most prevalent oral health concerns in paediatric dentistry, with anterior open bite (AOB) and posterior crossbite (PCB) being among the most common forms. Non-nutritive sucking habits (NNSHs), including digit-sucking habits (DSHs) and pacifier-sucking habits (PSHs), have been linked to malocclusion development. While both habits are known to impact dental and skeletal development, their comparative effects remain unclear. This systematic review and meta-analysis aims to determine the difference in the development and prevalence of anterior open bite and posterior crossbite between patients with digit-sucking and pacifier-sucking habits. Materials and Methods: An exhaustive review of the literature was conducted on the 25 November 2024 across three databases, namely EBSCOhost (including PubMed-Medline), Web of Science and Scopus. The following PICO question was constructed for the systematic review: “In children and teenagers, is there a difference in the development and prevalence of malocclusions (Anterior Open bite & Posterior Crossbite) between patients with a history of digit sucking habits and patients with a history of pacifier sucking habits?”A meta-analysis was also performed with the selected studies, and the software used to carry out the meta-analysis was R 4.3.1 (R Core Team (2023)). Results: From the initial search, 102 articles were found and a further 11 articles were obtained from manual findings. 12 articles were included in the final systematic review and meta-analysis. The meta-analysis indicated that the risk of AOB and PCB was increased by both DSH and PSH. Conclusions: Both DSH and PSH significantly increased the risk of AOB and PCB. PSH posed a significantly higher risk than DSH for PCB development (OR = 2.66, p < 0.001), while no significant difference in AOB prevalence was observed between DSH and PSH (OR = 1.77, p = 0.150). Full article

Background: This study investigated the relationships between hematological and bone metabolism variables in 35 elite female trail runners, focusing on identifying key hematological correlates of bone health. Methods: Forty-four hematological variables, including biochemical, hormonal, metabolic, liver enzyme, and iron profiles, as well as complete blood count and platelet indices, were analyzed. Bone mineral density (BMD) and bone mineral content (BMC) were assessed at multiple skeletal regions via dual-energy X-ray absorptiometry (DXA). A cross-sectional design was employed, utilizing descriptive statistics, correlation analyses, and multiple linear regression to analyze the associations between hematological markers and BMC and BMD. Results: Significant but moderate associations were identified: magnesium consistently emerged as a negatively associated factor, particularly associated with BMC and BMD in the lumbar spine (L1–L4) and whole-body, potentially reflecting hypothesized mineral mobilization during chronic physical stress. Follicle-stimulating hormone showed positive associations with BMD, suggesting a potential protective association in bone turnover regulation. Additionally, calcium and thyroid hormones were linked to regional bone properties, highlighting site-specific skeletal vulnerabilities. Conclusions: These findings suggest a complex interplay between mineral homeostasis and hormonal balance that may be related to skeletal integrity in elite female trail runners. This work provides a foundation for developing evidence-based guidelines to support the health and performance of female endurance athletes. Further research is warranted to confirm these results through longitudinal evaluations. Full article

Osteoporosis is a prevalent skeletal disorder characterized by reduced bone mass and microarchitectural deterioration, leading to increased fracture risk, particularly in aging populations. Postmenopausal osteoporosis (PMOP) remains the most common primary form and results from abrupt estrogen deficiency after menopause, which disrupts bone remodeling by accelerating the receptor activator of nuclear factor-κB ligand (RANKL)-mediated osteoclastogenesis, suppressing Wnt/β-catenin signaling, and promoting inflammatory cytokine production. In contrast, drug-induced osteoporosis (DIOP) encompasses a heterogeneous group of secondary bone disorders arising from pharmacologic exposures. Glucocorticoids suppress osteoblastogenesis, enhance osteoclast activity, and increase reactive oxygen species; long-term bisphosphonate therapy may oversuppress bone turnover, resulting in microdamage accumulation; denosumab withdrawal triggers a unique rebound surge in RANKL activity, often leading to rapid bone loss and multiple vertebral fractures. Medications including aromatase inhibitors, SSRIs, proton pump inhibitors, heparin, and antiepileptic drugs impair bone quality through diverse mechanisms. Standard antiresorptive agents remain first-line therapies, while anabolic agents such as teriparatide, abaloparatide, and romosozumab provide enhanced benefits in high-risk or drug-suppressed bone states. Transitional bisphosphonate therapy is essential when discontinuing denosumab, and individualized treatment plans—including drug holidays, lifestyle interventions, and monitoring vulnerable patients—are critical for optimizing outcomes. Emerging approaches such as small interfering RNA (siRNA)-based therapeutics, anti-sclerostin agents, digital monitoring technologies, and regenerative strategies show promise for future precision medicine management. Understanding the distinct and overlapping molecular mechanisms of osteoporosis is essential for improving fracture prevention and long-term skeletal health. Full article

Background. Glucocorticoid-induced osteoporosis represents a well-known type of secondary osteoporosis (SOp). While the most prevalent sub-category includes corticotherapy, another important contributor is represented by Cushing’s syndrome. In this traditional landscape, adrenal incidentalomas do not involve a standard cause of SOp, since most of them are non-functioning adrenal tumours (NFATs). Yet, 30–40% of them are not entirely “non-functioning”, due to mild autonomous cortisol secretion (MACS). Despite not being a guideline-based diagnosis, a lower ACTH might point to various NFATs/MACS complications. Objective. This study aimed to determine the relationship between the bone health status of post-menopausal women with NFATs/MACS and their baseline morning ACTH level. The bone health indicators were DXA, FRAX, and bone remodelling markers. Methods. This was a retrospective, real-life, transversal study in adult females who were hospitalized in a single tertiary centre of endocrinology. They were all anti-osteoporotic drug-naïve. The subjects underwent CT and DXA scanning and a 1 mg dexamethasone suppression test (DST). Results. The cohort (sample size of N = 84 patients, 61.49 ± 7.86 years) had a type 2 diabetes rate of 18%, arterial hypertension rate of 75%, and a dyslipidemia rate of 78%. Median ACTH was 11.89 pg/mL. The prevalence of MACS was 30.95%. The mean largest tumour diameter (LTD) was 2.25 ± 0.99 cm. ACTH correlated with second-day cortisol after the 1 mg DST (r = −0.301, p = 0.024), and LTD (r = −0.434, p < 0.001). ROC analysis for the bone resorption marker CrossLaps showed an AUC of 0.647 (p = 0.05), with the highest Youden index for the cut-off at 0.32 ng/mL (sensitivity 87.50%, specificity 39.50%). Bone impairment (osteoporosis + osteopenia) was found in 65% of patients, with an osteoporotic fracture prevalence of 4.76%. The lowest mean T-score (−1.12 ± 1.00) showed osteopenia, and the median trabecular bone score pointed a partially degraded microarchitecture [median (interquartile interval): 1.320 (1.230, 1.392)]. FRAX and FRAXplus estimations correlated with bone mineral density (BMD) at all three central DXA sites, regardless of the ACTH cut-off. Patients with a low ACTH (<10 pg/mL) displayed similar bone/adrenal features when compared to those with normal ACTH, except forbut they had a higher MACS rate (45.45% versus 21.57%, p = 0.021) and a larger LTD (2.67 ± 0.98 versus 1.98 ± 0.92 cm, p = 0.003). Fracture estimation showed that only in patients with a low ACTH, the 10-year fracture risk for major osteoporotic fractures (MOF) adjusted for lumbar BMD was lower than the risk for MOF adjusted for diabetes (p = 0.036), and the 10-year hip fracture risk was lower when adjusted for lumbar BMD (p = 0.007). ACTH correlated with lumbar BMD (r = 0.591, p = 0.002) only in the group with an ACTH < 10 pg/mL, suggesting its potential usefulness as a bone biomarker in these cases. On the other hand, MACS-negative subjects with a low ACTH versus those with a normal ACTH showed higher CrossLaps (0.60 ± 0.27 versus 0.42 ± 0.21 ng/mL, p = 0.022), indicating an elevated bone resorption even in patients with tumours that are regarded as true non-secretors. Conclusions. A subgroup of patients diagnosed with NFATs/MACS might be prone to skeletal damage, and biomarkers such as ACTH (specifically, suppressed ACTH) might serve as a surrogate pointer to help refine this higher risk in daily practice. Further research to address other ACTH cut-offs will place ACTH assays in the overall bone status evaluation in these patients, most probably not as a single biomarker, but in addition to other assays. Full article

Phosphorus (P) is a key macromineral essential for numerous physiological processes, including energy metabolism, skeletal mineralization, and cellular signaling. In dairy cattle, its homeostasis is tightly regulated by parathyroid hormone, calcitriol, and fibroblast growth factor 23 (FGF23). Phosphorus deficiency is common during the transition period and is associated with reduced milk yield, anemia, muscle weakness, and immunosuppression in severe or prolonged cases. This review summarizes the current understanding of phosphorus metabolism in ruminants, emphasizing differences from monogastric species, hormonal regulation, and the clinical manifestations of deficiency. Particular attention is given to postpartum hypophosphatemia, its relationship with acute-phase proteins, and the pathogenesis of postpartum hemoglobinuria and recumbency. The review also discusses diagnostic methods for assessing phosphorus status, recent findings on FGF23 physiology in cattle, and including demonstrated effects of phosphorus imbalance on periparturient immune suppression and increased environmental phosphorus losses through manure. Maintaining optimal phosphorus nutrition is crucial for bovine health, productivity, and reduction in environmental phosphorus losses. Full article

Background: Higher intake of sugar-sweetened beverages (SSBs) increases the risk of childhood obesity, while the effects of non-caloric beverages (NCBs) and dairy beverages remain inconsistent. This study investigated changes in beverage intake following a 10-week lifestyle camp and explored associations between changes in beverage intake and anthropometric measures. Methods: Children from two camp sites and aged 7–14 years (n:190) with overweight/obesity were included and pooled for the present study. Beverage intake was assessed by a Food Frequency Questionnaire at baseline, at 10 weeks, and at a one- and three-year follow-up. Anthropometry was assessed at the same timepoints. Results: Compared to baseline, participants had lower odds of reporting a high intake of SSBs (OR: 0.14, 95%-CI: 0.07; 0.28), NCBs (OR: 0.19, 95%-CI: 0.11; 0.34) and chocolate milk (OR: 0.18, 95%-CI: 0.09; 0.36) at 10 weeks, relative to a low intake, and were more likely to report a high intake of water. One and three years after the camp, the changes attenuated, reaching baseline levels for water, SSBs, and NCBs at the three-year follow-up. Across time, only weak to moderate correlations were observed between changes in beverage intake and BMI-SDS, body fat (%), and skeletal muscle mass (Spearman’s rho = +/− 0.19–0.31). Conclusions: The lifestyle camp intervention effectively improved beverage intake among children with overweight/obesity; however, the changes were not sustained, emphasizing the need for long-term support to maintain the health benefits. Without a control group, it is not possible to determine whether these changes reflect natural variations in beverage intake. Full article