Sen Guo

Introduction: Diffusion tensor imaging (DTI) studies have shown white matter (WM) microstructural alterations in individuals with dyslipidemia; however, DTI indices are not specific to WM pathology. However, neurite orientation dispersion and density imaging (NODDI) provides more specific measurements of WM microstructure. This study aimed to evaluate dyslipidemia‐related WM microstructure alterations and their association with cognitive and motor functions using NODDI.Methods: The DTI and NODDI metrics were analyzed through tract‐based spatial statistics between 24 older adults with dyslipidemia (low‐density lipoprotein ≥140 mg/dL, high‐density lipoprotein P value of <0.05 was considered statistically significant.Results: Individuals with dyslipidemia exhibited a notably reduced neurite density index (NDI) in several WM areas, including the posterior and superior corona radiata, the body, the genu, and the splenium of the corpus callosum, as well as the bilateral anterior and posterior internal capsule, compared with HCs. In the dyslipidemia group, lower NDI was significantly correlated with lower scores on the stand‐up test and the Japanese version of the Montreal Cognitive Assessment. No significant differences were found in DTI metrics or WM volumes between dyslipidemia individuals and HCs.Conclusion: Our findings suggest that NODDI can serve as a biomarker for assessing WM microstructural alterations in older adults with dyslipidemia. Particularly, NODDI indicates a lower intra‐axonal volume, which may suggest axonal loss associated with dyslipidemia, and correlates with cognitive and locomotor function decline.

This study included 52 Japanese older adults with Pittsburgh Sleep Quality Index (PSQI) scores > 5 and 52 healthy controls (HCs) with PSQI score ≤ 5. Diffusion‐weighted imaging (DWI) and 3D T1‐weighted imaging were acquired using 3T magnetic resonance imaging. The diffusion tensor image analysis along the perivascular space (DTI‐ALPS) index was calculated using preprocessed DWI. The choroid plexus volume (CPV) was calculated using FreeSurfer 6.0. The mean ALPS index and CPV were compared between the older adults with poor sleep quality (PSQ) and HCs using a general linear model, adjusted for covariates including age, sex, years of education, total intracranial volume, systolic blood pressure, hemoglobin A1c, and white matter lesion volume. We also conducted a partial correlation analysis between the mean ALPS index and CPV, Montreal Cognitive Assessment (MoCA), and PSQI scores, adjusting for all the mentioned covariates. The PSQ group had a significantly lower mean ALPS index than HCs. The mean ALPS index in the PSQ group was negatively correlated with CPV and positively correlated with the MoCA score. Therefore, older adults with PSQ may experience dysfunction in the excretory pathway of the perivascular space around the medullary veins. This impairment may be associated with an increase in CPV and cognitive dysfunction.

Purpose: Osteoporotic vertebral compression fracture (OVCF) is a common fragile fracture resulting from osteoporosis. We compared the efficacy and safety of romosozumab and commonly used osteoporosis drug treatments for the treatment of OVCF in postmenopausal women.Methods: Through searching and screening five databases, we included randomized controlled trials (RCTs) published through June 18, 2021 comparing different treatments. Following the Preferred Reporting Items for Systematic Reviews statement, the main objective was to evaluate the mean difference and risk ratio of the treatment effect. The primary measures of romosozumab efficacy used in this study were vertebral, non‐vertebral, and clinical fracture events, and secondary outcomes were bone mineral density (BMD) changes at the lumbar spine, total hip, and femoral neck and the incidence of adverse events (AEs),Results: Nine RCTs including 12 796 participants were included in the analysis, and romosozumab was compared with placebo, alendronate, and teriparatide in the treatment of osteoporosis in postmenopausal women. The incidence of fractures, low BMD, and AEs was analyzed. Compared with the controls, three doses of romosozumab were linked to evident advantages in the treatment of low BMD and fractures but associated with increased hypersensitivity and injection site reaction risks. Furthermore, fewer AEs were observed in the romosozumab arms (210 mg: risk ratio = 0.96, 95% confidence interval = 0.93–0.99; 140 mg: risk ratio = 0.28, 95% confidence interval = 0.08–0.98) than in the alendronate and placebo arms.Conclusions: Our meta‐analysis revealed the evident advantages of romosozumab in the treatment of osteoporosis and low BMD in postmenopausal women and increased risks of hypersensitivity and injection site reactions.