Assessment of smoking for low bone mineral density in postmenopausal Turkish women

Determinants of bone mineral density in various regions of the skeleton among smokers and non-smokers: the role of physical activity

Background

The adult human skeleton is composed of cortical and cancellous bone. The proportions of these two types of bone tissue differ in various parts of the skeleton. The aim of this cross-sectional study was to quantify the determinants of bone mineral density (BMD) and bone mineral content in various regions of interest (ROIs) in smokers and never-smokers.

Methods

In this study, 4,332 bone scans of three regions of interest (ROIs) were analyzed: the forearm (distal and proximal), femur, and lumbar spine. Body composition and bone parameters were measured using dual-energy X-ray absorptiometry. Smoking was measured using the Global Adult Tobacco Survey questionnaire. Body mass index (BMI) was calculated, and physical activity (PA) was characterized by the metabolic equivalent of task (MET).

Results

Among women, the interaction between PA (positive β coefficient) and smoking (negative β coefficient) was a significant predictor of BMD in the distal and proximal forearm (adj. R2 = 0.40 and R2 = 0.58; p < 0.001). The interaction of three variables-age, smoking (negative β), and MET (positive β)-was significant for total hip BMD (adj. R2 = 0.54; p < 0.001). The interaction between BMI and MET (positive β) and smoking (negative β) was significant for BMD in the lumbar spine (adj. R2 = 0.62; p < 0.001). In men, the interaction between MET (positive β) and smoking (negative β) was significant for BMD in the forearm and lumbar spine (adj. R2 = 0.44, R2 = 0.46, and R2 = 0.49; p < 0.01). Smoking alone was a significant negative predictor of total hip BMD (adj. R2 = 0.34; p < 0.001).

Conclusion

Among both women and men, never-smokers had significantly better bone parameters than smokers. Smoking was a significant negative predictor for BMD in the various ROIs in both women and men. Physical activity was a significant positive predictor of BMD, with a strong association with bone parameters.

The influence of educational level in peri-menopause syndrome and quality of life among Chinese women

Objective: To investigate the influence of education level in the peri-menopausal symptoms and quality of life (QoL) among Chinese women.Methods: We carried out a cross-sectional study of 1632 peri-menopausal women (age 40-60 y) who visited Hangzhou Women's Hospital from November 2018 to November 2019. The menopausal symptoms were evaluated by modified Kupperman index (KI). World Health Organization Quality of Life (WHOQOL-BREF) questionnaire was used to evaluate the QoL.Result: In total, 1501 women were included in the analysis. The mean age of natural menopause was 49.63 years in China. The five most frequent symptoms in menopausal women were Hot flash (75.53%), sexual problems (72.62%), insomnia (67.29%), fatigue (65.56%), and irritability (61.89%). Natural menopausal age, parity, BMI, bone mineral density, depression, skin formication, total score of KI, and the score of WHOQOL-BREF questionnaire were different in different educational background women (p < .05).Conclusions: The results of the study suggest that education level is associated with the age of natural menopause and menopausal symptoms. A high educational level is correlated with a better score of WHOQOL-BREF in peri-menopause women.

Bone Mineral Density in Severely Obese Women: Health Risk and Health Protective Risk Factors in Three Different Bone Sites

Factors associated with bone mineral density (BMD) are poorly known in severely obese individuals i.e., a body mass index (BMI) > 35 kg/m2. The objectives of this study were to describe the bone health profile of severely obese Brazilian women, to identify the health risk and health protective factors for BMD in this group and to assess whether these factors vary according to three different bone sites. BMD was assessed using dual-energy X-ray absorptiometry (DXA). This study analyzed baseline data from 104 women who had an average BMI of 43.7 ± 4.5 kg/m2 and presented the following BMD status: 1.283 ± 0.094 g/cm2 for total body, 1.062 ± 0.159 g/cm2 for vertebral column and 1.195 ± 0.134 g/cm2 for hip. They took part in the "Effect of nutritional intervention and olive oil in severe obesity" randomized clinical trial (DieTBra Trial). The risk factors negatively associated with lower BMD were age ≥50 years for the three bone sites i.e., total body, vertebral column and hip. Smoking for total body BMD (p = 0.045); BMI ≥ 50kg/m2 for vertebral column and hip; menopause for hip; high C-reactive protein (CRP) levels (p = 0.049), insufficient zinc (p = 0.010) and previous fracture for vertebral column (p = 0.007). The protective factors positively associated with BMD were physical activity (≥150 min/week (p = 0.001)) for hip; type 2 diabetes mellitus (DM2) (p < 0.0001) total body and adequate vitamin D levels from food consumption (p = 0.039) for vertebral column. A BMI ≥ 50 kg/m2 was a risk factor for lower BMD. The findings showed that protective and risk factors varied by bone site. The original study is registered with ClinicalTrials.gov. (protocol number: NCT02463435).

The relationship between hormone replacement therapy and periodontal disease in postmenopausal women: a cross-sectional study the Korea National Health and Nutrition Examination Survey from 2007 to 2012

Background

The purpose of this study was to investigate the relationship between hormone replacement therapy (HRT) and periodontal disease in postmenopausal women using data from the 4th and 5th Korea National Health and Nutrition Examination Survey (KNHANES).

Methods

The study included data from 5,482 postmenopausal women aged 45–74 years in the 2007–2012 KNHANES. The use of female HRT for at least one month was reclassified as HRT+/HRT-. The Community Periodontal Index of Treatment Needs (CPITN) was used to assess periodontal status. Propensity score matching (PSM) was used to control selection bias, and factors affecting education, family income, and age of menopause were used as covariates in PSM. A chi-square test was used to confirm the bivariate relationship between the variables. Binary logistic regression analysis was used to adjust for confounders (age, education, family income, body mass index, age of menopause, alcohol, smoking, dental clinic visits in the past one year, use of oral care products and frequency of tooth brushing per day).

Results

After adjusting for all covariates, HRT was associated with periodontal disease (OR: 0.79; 95% CI: 0.66–0.94). In particular, the relationship between HRT and periodontal disease was more evident in those with menopause under 45 years of age disease (OR: 0.55; 95% CI: 0.35–0.87).

Conclusions

The results of this study supported that it is important that hormone therapy be actively considered in the policy towards postmenopausal women. Especially, health programs such as hormone replacement therapy, non-smoking, and use of oral care products are needed for women who undergo premature menopause.

Factors Associated with Bone Health in Malaysian Middle-Aged and Elderly Women Assessed via Quantitative Ultrasound

Risk factors for osteoporosis may vary according to different populations. We aimed to investigate the relationship between risk factors of osteoporosis and bone health indices determined via calcaneal quantitative ultrasound (QUS) in a group of Malaysian women aged 50 years or above. A cross-sectional study was performed on 344 Malaysian women recruited from a tertiary medical centre in Kuala Lumpur, Malaysia. They answered a self-administered questionnaire on their social-demographic details, medical history, lifestyle, and physical activity status. Their height was measured using a stadiometer, and their body composition estimated using a bioelectrical impedance device. Their bone health status was determined using a water-based calcaneal QUS device that generated three indices, namely speed of sound (SOS), broadband ultrasound attenuation (BUA), and stiffness index (SI). A T-score was computed from SI values using a reference database from a mainland Chinese population. Women with three or more lifetime pregnancies, who were underweight and not drinking coffee had a significantly lower BUA. Stepwise multiple linear regression showed that SOS was predicted by age alone, BUA and SI by years since menopause, body mass index (BMI), and number of lifetime pregnancies, and T-score by years since menopause and percentage of body fat. As a conclusion, suboptimal bone health in middle-aged and elderly Malaysian women as indicated by QUS is associated with old age, being underweight, having a high body fat percentage, and a high number of lifetime pregnancies. Women having several risk factors should be monitored more closely to protect their bones against accelerated bone loss.

P4 medicine and osteoporosis: a systematic review

BACKGROUND

Osteoporosis is the most frequent bone metabolic disease. In order to improve early detection, prediction, prevention, diagnosis, and treatment of the disease, a new model of P4 medicine (personalized, predictive, preventive, and participatory medicine) could be applied. The aim of this work was to systematically review the publications of four different types of "omics" studies related to osteoporosis, in order to discover novel predictive, preventive, diagnostic, and therapeutic targets for better management of the geriatric population.

METHODS

To systematically search the PubMed database, we created specific groups of criteria for four different types of "omics" information on osteoporosis: genomic, transcriptomic, proteomic, and metabolomic. We then analyzed the intersections between them in order to find correlations and common pathways or molecules with important roles in osteoporosis, and with a potential application in disease prediction, prevention, diagnosis, or treatment.

RESULTS

Altogether, 180 publications of "omics" studies in the field of osteoporosis were found and reviewed at first selection. After introducing the inclusion and exclusion criteria (the secondary selection), 46 papers were included in the systematic review.

CONCLUSIONS

The intersection of reviewed papers identified five genes (ESR1, IBSP, CTNNB1, SOX4, and IDUA) and processes like the Wnt pathway, JAK/STAT signaling, and ERK/MAPK, which should be further validated for their predictive, diagnostic, or other clinical value in osteoporosis. Such molecular insights will enable us to fit osteoporosis into the P4 strategy and could increase the effectiveness of disease prediction and prevention, with a decrease in morbidity in the geriatric population.