Linoleic Acid: Associations with Bone Health Among Women Living with HIV and Effects on Osteoblast Metabolism Restricted; Files Only

Nesbeth, Paula-Dene (Spring 2024)

Permanent URL: https://etd.library.emory.edu/concern/etds/3x816p01c?locale=it
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Abstract

Osteoporosis is a serious bone disease characterized by severe bone loss, deteriorated bone microarchitecture, and increased risk of debilitating fractures. Postmenopausal women and people living with human immunodeficiency virus (HIV) infection, are at risk for osteoporosis. Over the adult lifespan, bone is homeostatically remodeled through a balance between bone formation by osteoblasts and bone resorption by osteoclasts. Factors that disrupt this remodeling process lead to bone loss and osteoporosis.

Polyunsaturated fatty acids (PUFA) are major dietary constituents involved in numerous cell functions, including as precursors to oxylipins which are potent lipid mediators active in both bone homeostasis and inflammation. The n-6 PUFA linoleic acid (LNA) is an essential fatty acid and the most consumed PUFA in the US diet. The role of LNA on bone health is controversial.

This dissertation utilizes clinical and molecular studies to determine the relationships between PUFA, PUFA metabolism, and bone health indicators. For Aim 1, we conducted cross-sectional high-resolution plasma metabolomics analyses to identify metabolites and metabolic pathways associated with bone mineral density (BMD) Z-scores and serum bone turnover markers (BTM), in women living with HIV (WLH) and at-risk women who are HIV-negative. The association of plasma PUFA concentrations with Z-scores and serum BTM were determined in these study participants (Aim 2). For Aim 3, we investigated the effects of LNA on osteoblast differentiation, gene expression, and energy metabolism in mouse osteoblast precursor cells.

Results indicated that: 1) lumbar spine Z-score was positively associated with metabolites enriched within n-6 PUFA metabolism in WLH; 2) however, individual plasma PUFA concentrations were not associated with either Z-scores (femoral neck, lumbar spine, and total hip) or serum BTM; and 3) LNA treatment in osteoblast precursor cells inhibited early differentiation, mitochondrial energy production, and increased intracellular concentrations of oxylipins derived from LNA and another n-6 PUFA, arachidonic acid (ARA). Plasma LNA and other PUFA were not related to indicators of bone health; however, possible effects may be mediated by their oxylipin derivates. LNA appears to play a role in bone health and metabolism.

Table of Contents

 CHAPTER 1 Introduction and Background............................................................. 1

Osteoporosis............................................................................................................... 1

Health conditions and diseases affecting the skeleton............................................... 3

Nutrition and bone health........................................................................................... 6

Specific research aims.............................................................................................. 11

Chapter 1 References............................................................................................... 14

CHAPTER 2 Extended Methods.............................................................................. 22

Chapter Overview.................................................................................................... 22

Extended Methods for Chapter 3 and Chapter 4...................................................... 22

Extended Methods for Chapter 5............................................................................. 28

Chapter 2 References............................................................................................... 36

CHAPTER 3 Plasma metabolomic associations with bone mineral density and serum markers of bone turnover in women living with and at risk for HIV....... 45

Abstract.................................................................................................................... 46

Introduction.............................................................................................................. 47

Methods.................................................................................................................... 49

Results...................................................................................................................... 54

Discussion................................................................................................................ 61

Conclusion............................................................................................................... 67

Chapter 3 References............................................................................................... 69

CHAPTER 4 Associations of plasma polyunsaturated fatty acids with bone mineral density and serum markers of bone turnover in women living with or at risk for HIV................................................................................................................ 94

Abstract.................................................................................................................... 95

Introduction.............................................................................................................. 97

Methods.................................................................................................................... 99

Results.................................................................................................................... 103

Discussion.............................................................................................................. 105

Conclusion............................................................................................................. 109

Chapter 4 References............................................................................................. 110

CHAPTER 5 Linoleic acid blunts early osteoblast differentiation and impairs oxidative phosphorylation in vitro.......................................................................... 134

Abstract.................................................................................................................. 135

Introduction............................................................................................................ 136

Materials and Methods........................................................................................... 138

Results.................................................................................................................... 144

Discussion.............................................................................................................. 148

Conclusion............................................................................................................. 154

Funding.................................................................................................................. 154

Acknowledgements................................................................................................ 154

Chapter 5 References............................................................................................. 155

CHAPTER 6 Summary of major contributions from population and molecular analyses: n-6 polyunsaturated fatty acids and modulation of bone homeostasis.................................................................................................................................... 180

Introduction............................................................................................................ 180

Major findings........................................................................................................ 181

Future directions.................................................................................................... 186

Conclusion............................................................................................................. 189

Chapter 6 References............................................................................................. 190

 

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