The pattern and trends of disease burden due to low bone mineral density from 1990 to 2019 in China: findings from the Global Burden of Disease Study 2019

The incidence, prevalence, and health burden of hip fractures in China: Data from the global burden of disease study 2019

Background

Hip fracture is commonly in the elderly as a consequence of osteoporsis. Currently, China is entering an aging society and there is a lack of studies about the epidemiology and health burden of hip fracturs there.

Methods

We used data from the Global Burden of Disease study 2019 (GBD 2019) to estimate the incidence, prevalence and disease burden of hip fractures in China and the temporal trends from 1990 to 2019. These estimates were produced by DisMod-MR 2.1, a Bayesian meta-regression tool. Estimated annual percentage change (EAPC) was used to represent the temporal trends.

Results

In 2019, there was estimated to be 2.0 million incident and 2.6 million prevalent hip fracture cases in China. The age standardized incidence and prevalence rate were estimated to be 117.8 (95 % UI, 83.8 to 161.6) per 100,000 and 139.8 (95 % UI, 125.7 to 154.7) per 100,000, respectively. From 1990 to 2019, the incidence (EAPC, 1.06; 95 % CI, 0.6 to 1.52) and prevalence (EAPC, 1.41; 95 % CI, 1.02 to 1.8) rates have increased, while the age standardized DALY decreased (95 %CI, -1.8; 95 % CI, -2.3 to -1.2). The incidence and DALY rates of hip fractures increased with age, and female people have higher incidence rate and disease burden. Falls were the leading cause for hip fractures, followed by road injuries.

Conclusion

Due to population growth and ageing, the challenges from hip fractures are expected to increase in the future, and related measures are in need to reduce the related health and economic burden.

Adherence to the dietary approaches to stop hypertension and bone health in the Chinese elderly

INTRODUCTION

Many studies have demonstrated the relationship between diet and bone health, but research on the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and bone health across populations is rare. The purpose of this study was to examine associations between the DASH dietary pattern and bone health outcomes in Chinese elders, to verify whether higher adherence to the DASH was associated with better bone health in elderly populations.

MATERIALS AND METHODS

A total of 839 Chinese adults aged 50 years and above participated in this cross-sectional study. Bone mineral density (BMD) at calcaneus was measured via ultrasonic bone densitometer. A semiquantitative food frequency questionnaire (FFQ) was used to assess the usual dietary intake in the past 12 months. The DASH score was calculated based on energy-adjusted intakes of nine dietary components, including whole grains, beans, vegetables, fruits, dairy, red meat, total fat, sodium, and sugar-sweetened beverages.

RESULTS

In postmenopausal women, DASH score was significantly and positively correlated with BMD T-score after controlling potential covariates (β: 0.027 ± 0.012, P = 0.031) in multivariable linear regression models. In binary logistic regression analysis, male participants in the highest tertile of DASH score had lower risk of osteoporosis than those in the lowest tertile (odds ratio = 0.499; 95% confidence interval, 0.262-0.951; P = 0.035) after adjusting potential covariates.

CONCLUSION

Adherence to the DASH dietary pattern was associated with better bone health in Chinese elderly adults.

Identification of key immune genes of osteoporosis based on bioinformatics and machine learning

Introduction

Immunity is involved in a variety of bone metabolic processes, especially osteoporosis. The aim of this study is to explore new bone immune-related markers by bioinformatics method and evaluate their ability to predict osteoporosis.

Methods

The mRNA expression profiles were obtained from GSE7158 in Gene expression Omnibus (GEO), and immune-related genes were obtained from ImmPort database (https://www.immport.org/shared/). immune genes related to bone mineral density(BMD) were screened out for differential analysis. protein-protein interaction (PPIs) networks were used to analyze the interrelationships between different immune-related genes (DIRGs). Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) analyses of DIRGs function were performed. A least absolute shrinkage and selection operation (LASSO) regression model and multiple Support Vector Machine-Recursive Feature Elimination (mSVM-RFE) model were constructed to identify the candidate genes for osteoporosis prediction The receiver operator characteristic (ROC) curves were used to validate the performances of predictive models and candidate genes in GEO database (GSE7158,GSE13850).Through the RT - qPCR verify the key genes differentially expressed in peripheral blood mononuclear cells Finally, we constructed a nomogram model for predicting osteoporosis based on five immune-related genes. CIBERSORT algorithm was used to calculate the relative proportion of 22 immune cells.

Results

A total of 1158 DEGs and 66 DIRGs were identified between high-BMD and low-BMD women. These DIRGs were mainly enriched in cytokine-mediated signaling pathway, positive regulation of response to external stimulus and the cellular components of genes are mostly localized to external side of plasma membrane. And the KEGG enrichment analysis were mainly involved in Cytokine-cytokine receptor interaction, PI3K-Akt signaling pathway, Neuroactive ligand-receptor interaction,Natural killer cell mediated cytotoxicity. Then five key genes (CCR5, IAPP, IFNA4, IGHV3-73 and PTGER1) were identified and used as features to construct a predictive prognostic model for osteoporosis using the GSE7158 dataset.

Conclusion

Immunity plays an important role in the development of osteoporosis.CCR5, IAPP, IFNA4, IGHV3-73 and PTGER1were play an important role in the occurrences and diagnosis of OP.

Bibliometric and visualized analysis of exercise and osteoporosis from 2002 to 2021

Background

Bibliometric analysis was designed to investigate a systematic understanding of developments in exercise and osteoporosis research over the past 20 years.

Methods

Relevant publications from the Web of Science Core Collection were downloaded on April 26, 2022. CiteSpace, VOSviewer, and the online bibliometric analysis platform were used to conduct this scientometric study.

Results

A total of 5518 publications were in 1202 academic journals with 137405 co-cited references in by 5637 institutions from 98 countries/regions. The country leading the research was the USA. The University of Melbourne was the most active institution. Osteoporosis International was the most productive journal concerning exercise and osteoporosis research. According to the burst references, "low-level vibration," "high-frequency" and "resistance exercise" have been recognized as the hotspots research in the domain. The keywords co-occurrence analysis identified "skeletal muscle," "sarcopenia" and "mesenchymal stem cell" as the important future research directions.

Conclusion

This study was the first comprehensive metrological and statistical analysis of exercise and osteoporosis research over the past 20 years. Our findings would provide guidance to understand the research frontiers and hot directions in the near future.

Risk of fracture following gastric surgery for benign and malignant conditions: A study level pooled analysis of population-based cohort studies

BACKGROUND

Metabolic changes may occur following gastric surgery, which has been reported to contribute to bone loss, osteoporosis and even bone fracture. However, the evidence regarding the relationship between gastric surgery for benign and malignant conditions and risk of fracture is controversial. This study was conducted with the aim to evaluate whether gastric surgery is associated with a high risk of fracture.

METHODS

Major electronic databases were searched from inception through October 2021 for population-based cohort studies investigating the associations between gastric surgery (including bariatric gastric surgeries and surgeries for gastric benign and malignant gastric tumors) and risk of fracture compared with controls. Pooled relative risks (RRs) with 95% confidence intervals (CIs) were derived using the random-effects Mantel-Haenszel model. Multiple subgroup analyses and sensitivity analyses were carried out to test sources of heterogeneity stratified by various study characteristics and the robustness of the results.

RESULTS

A total of 14 studies comprising 693134 individuals were identified for analysis. The RR for the risk of fracture in people undergoing gastric surgery was 1.45 [95% confidence interval (CI) 1.23 - 1.72; I2 = 95.8%; P < 0.001] compared with that in control populations, among which the fracture sites of upper limb, spine, lower limb, pelvis and hip showed consistent significant results (all P < 0.05), whereas nonsignificant associations was noted for other fracture sites. Significant associations were also observed for patients having total or subtotal gastrectomy (RR 2.22, 95% CI 1.66 to 3.00), gastric bypass (RR 1.48, 95% CI 1.26 to 1.74), and a similar trend was observed for preserved passage procedures (including sleeve gastrectomy, gastric banding, vertical banded gastroplasty and other procedures that preserved the passage through the duodenum and proximal small bowel, in contrast to gastric bypass), though the difference did not reach statistically significant (RR 1.10, 95% CI 0.95 to 1.26). An evident increased risk in the age range from 40-59 years was observed (40-49 years: RR 1.36, 95% CI 1.19-1.55; 50-59 years: RR 2.48, 95% CI 1.58-3.90).

CONCLUSION

From this large pooled analysis of population-based cohort studies, evidence supports that fracture risk is increased in gastric surgery survivors compared with the control population. Early prevention and effective intervention strategies of bone fracture should be taken from clinicians and health policy makers.

CLINICAL TRIAL REGISTRATION

PROSPERO (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=291394), identifier CRD42021291394.