Graeff-Armas, Laura A.

Abstract Disclosure: S.V. Rupani: None. J. Sfeir: None. L. Graeff-Armas: None. Bone microarchitecture is an important factor that impacts bone strength. Unlike other factors that affect bone strength, such as bone mineral density and bone turnover, assessment of bone microarchitecture is not yet widely accessible in clinical practice. Computed tomography is the primary method of non-invasively assessing bone microarchitecture. High-resolution peripheral quantitative CT (HR-pQCT) is an emerging imaging modality that provides a three-dimensional assessment of bone densitometry, morphometry, and microarchitecture with a low effective radiation dose. It provides a quantitative and qualitative assessment of cortical and trabecular structural and mechanical properties. We present two similar cases of osteoporosis in males, where knowledge of bone microarchitecture through HR-pQCT helped formulate two distinct and targeted therapeutic approaches. The first case is of a 46-year-old male with a history of idiopathic osteoporosis with multiple nontraumatic vertebral fractures. Given his presentation and age, anabolic therapy such as teriparatide was being considered. He underwent HR-pQCT scanning, which showed average radial trabecular parameters, but his cortical porosity was significantly above average, with similar findings in his tibial parameters. Since teriparatide has been shown to increase cortical porosity, this would not be the best option for our patient, given the risk of further weakening of the microarchitecture of his cortical bone. Therefore, denosumab, which has been shown to decrease cortical porosity, was chosen. Our second patient is a 52-year-old male with idiopathic osteoporosis with multiple nontraumatic vertebral fractures, whose HR-pQCT showed average cortical parameters at both the radius and tibia but low trabecular number and increased trabecular separation at both sites. Since teriparatide increases trabecular thickness and mass, we could confidently choose teriparatide for this patient, with less concern for significant deleterious effects on his cortical bone parameters. These case reports highlight the impact that the assessment of qualitative properties of bone, such as microarchitecture, can have in the management of osteoporosis. Currently, the lack of sufficient validated normative data for HR-pQCT limits its widespread use in the diagnosis of osteoporosis and fracture prediction. However, given that HR-pQCT can characterize the properties of trabecular and cortical bone, it may have a role in helping guide osteoporosis treatment, especially in challenging and atypical cases. Presentation: 6/3/2024

(1) Background. Cognitive dysfunction is prevalent among cancer survivors. Inflammation may contribute to impaired cognition, and diet represents a novel strategy to mitigate cognitive decline. The purpose was to (1) assess the impact of an educational cooking class on cancer survivor eating habits and their inflammatory potential and (2) determine the relationship between diet and cognitive function. (2) Methods. This was a non-randomized interventional study of a virtual educational cooking class in post-treatment, adult cancer survivors. Energy-adjusted Dietary Inflammatory Index (E-DII™) scores and subjective cognitive function were assessed at baseline and 1 month post-intervention. (3) Results. Of 22 subjects, all were female, White, and primarily had breast cancer (64%). There was a significant decrease in E-DII scores, which became more anti-inflammatory, one month after intervention (−2.3 vs. −2.7, p = 0.005). There were significant increases in cognition, including perceived cognitive impairment (COG-PCI, p < 0.001), comments from others (COG-OTH, p < 0.001), and quality of life (COG-QOL, p < 0.001). A change in calories was a significant predictor of a change in perceived cognitive ability (COG-PCA) after adjustment (β = 0.007, p = 0.04; 95% CI (0.000, 0.014)). (4) Conclusions. Educational cooking classes may be an effective way to impact diet-derived inflammation; additional research is needed to assess the long-term effects of dietary changes on cognition.