Department of Orthopedic Surgery, Hamamatsu University School of Medicine, 1-20-1, Handayama, Higashi-Ku, Hamamatsu, Shizuoka, 431-3192, Japan.
Division of Materials and Manufacturing Science, Graduate School of Engineering, Osaka University, 2-1, Yamada-Oka, Suita, Osaka, 565-0871, Japan.
J Bone Miner Metab. 2023 Nov;41(6):752-759. doi: 10.1007/s00774-023-01460-9. Epub 2023 Sep 7.
The discrepancy between bone mineral density (BMD), the gold standard for bone assessment, and bone strength is a constraint in diagnosing bone function and determining treatment strategies for several bone diseases. Gastric hypochlorhydria induced by clinically used proton pump inhibitor (PPI) therapy indicates a discordance between changes in BMD and bone strength. Here, we used Cckbr-deficient mice with gastric hypochlorhydria to examine the effect of gastric hypochlorhydria on bone mass, BMD, and preferential orientation of the apatite crystallites, which is a strong indicator of bone strength.
Cckbr-deficient mice were created, and their femurs were analyzed for BMD and preferential orientation of the apatite c-axis along the femoral long axis.
Cckbr-deficient mouse femurs displayed a slight osteoporotic bone loss at 18 weeks of age; however, BMD was comparable to that of wild-type mice. In contrast, apatite orientation in the femur mid-shaft significantly decreased from 9 to 18 weeks. To the best of our knowledge, this is the first report demonstrating the deterioration of apatite orientation in the bones of Cckbr-deficient mice.
Lesions in Cckbr-deficient mice occurred earlier in apatite orientation than in bone mass. Hence, bone apatite orientation may be a promising method for detecting hypochlorhydria-induced osteoporosis caused by PPI treatment and warrants urgent clinical applications.
骨密度(BMD)是评估骨骼的金标准,但它与骨骼强度之间存在差异,这限制了我们对骨骼功能的诊断和多种骨骼疾病治疗策略的确定。临床上使用的质子泵抑制剂(PPI)治疗会导致胃酸分泌不足,从而表明 BMD 的变化与骨骼强度之间存在不一致性。在这里,我们使用胃酸分泌不足的 Cckbr 缺陷型小鼠来研究胃酸分泌不足对骨量、BMD 和磷灰石晶体择优取向的影响,后者是骨骼强度的一个强有力指标。
构建了 Cckbr 缺陷型小鼠,并对其股骨进行了 BMD 和磷灰石 c 轴沿股骨长轴的择优取向分析。
Cckbr 缺陷型小鼠在 18 周龄时出现轻微的骨质疏松性骨丢失;然而,BMD 与野生型小鼠相当。相比之下,股骨中段的磷灰石取向在 9 至 18 周之间显著降低。据我们所知,这是首次报道 Cckbr 缺陷型小鼠的磷灰石取向恶化。
Cckbr 缺陷型小鼠的病变在磷灰石取向方面比在骨量方面更早出现。因此,骨骼磷灰石取向可能是一种有前途的方法,可用于检测由 PPI 治疗引起的胃酸分泌不足导致的骨质疏松症,值得紧急临床应用。