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Dhakal S, Sharma K, Adhikari K, Joshi A, Poudyal S. Osteoporosis and its associated factors among patients attending Manakamana Hospital, Chitwan, Nepal. PLoS One 2024; 19:e0289517. [PMID: 38381757 PMCID: PMC10881011 DOI: 10.1371/journal.pone.0289517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 12/29/2023] [Indexed: 02/23/2024] Open
Abstract
BACKGROUND Osteoporosis is the most common skeletal disorder that weakens bones and increases their susceptibility to fractures. It is becoming an urgent and serious global epidemic. Early diagnosis and treatment are essential to reduce morbidity and mortality associated with it. This study aimed to find out the prevalence of osteoporosis among patients attending at Manakamana Hospital, Bharatpur, Chitwan, Nepal. METHODS A cross-sectional study was adopted and 623 patients attending at orthopaedic outpatients department (OPD) of Manakamana Hospital were selected using non-probability consecutive sampling technique. Data were collected from 15th October 2021 to 15th April, 2022, by using interview schedule, chart review and Bone Mineral Density (BMD) measurement through calcaneal ultrasonography. Ethical approval was obtained from Nepal Health Research Council Ethical Review Board prior to study procedures. Obtained data were analysed using descriptive statistics. Association between the variables were measured using chi-square test. RESULTS The mean age of the patients was 43.5 (±14.26) years. Nearly half (44%, n = 274) were middle aged adults, 59.7% were female and 56.0% were involved in agriculture and household chores. Nearly half of the patients (45.7%) were overweight/ obese, 7.9% were smokers and 13.5% had habit of alcohol use. Osteopenia or low bone density was detected in 58.9% patients and 19.4% had osteoporosis. The prevalence of osteoporosis was significantly associated with age group (p = <0.001) and educational status (p = 0.013) of the patients. CONCLUSIONS AND RECOMMENDATIONS Osteoporosis and osteopenia are prevalent in patients attending in the hospital. Hence, awareness, early screening, and treatment are necessary for the hospital attended patients to enhance their health and, minimize the risk of osteoporosis and the consequences associated with it.
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Affiliation(s)
| | - Kalpana Sharma
- Schools of Nursing, Chitwan Medical College, Bharatpur, Chitwan, Nepal
| | - Kishor Adhikari
- School of Public Health & Dept. of Community Medicine, Chitwan Medical College, Chitwan, Nepal
| | - Alisha Joshi
- Schools of Nursing, Chitwan Medical College, Bharatpur, Chitwan, Nepal
| | - Sunita Poudyal
- Schools of Nursing, Chitwan Medical College, Bharatpur, Chitwan, Nepal
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Shah MA, Faheem HI, Hamid A, Yousaf R, Haris M, Saleem U, Shah GM, Alhasani RH, Althobaiti NA, Alsharif I, Silva AS. The entrancing role of dietary polyphenols against the most frequent aging-associated diseases. Med Res Rev 2024; 44:235-274. [PMID: 37486109 DOI: 10.1002/med.21985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 01/27/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023]
Abstract
Aging, a fundamental physiological process influenced by innumerable biological and genetic pathways, is an important driving factor for several aging-associated disorders like diabetes mellitus, osteoporosis, cancer, and neurodegenerative diseases including Alzheimer's and Parkinson's diseases. In the modern era, the several mechanisms associated with aging have been deeply studied. Treatment and therapeutics for age-related diseases have also made considerable advances; however, for the effective and long-lasting treatment, nutritional therapy particularly including dietary polyphenols from the natural origin are endorsed. These dietary polyphenols (e.g., apigenin, baicalin, curcumin, epigallocatechin gallate, kaempferol, quercetin, resveratrol, and theaflavin), and many other phytochemicals target certain molecular, genetic mechanisms. The most common pathways of age-associated diseases are mitogen-activated protein kinase, reactive oxygen species production, nuclear factor kappa light chain enhancer of activated B cells signaling pathways, metal chelation, c-Jun N-terminal kinase, and inflammation. Polyphenols slow down the course of aging and help in combatting age-linked disorders. This exemplified in the form of clinical trials on specific dietary polyphenols in various aging-associated diseases. With this context in mind, this review reveals the new insights to slow down the aging process, and consequently reduce some classic diseases associated with age such as aforementioned, and targeting age-associated diseases by the activities of dietary polyphenols of natural origin.
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Affiliation(s)
| | - Hafiza Ishmal Faheem
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Ayesha Hamid
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Rimsha Yousaf
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Muhammad Haris
- Faculty of Pharmaceutical Sciences, Universiteit Gent, Ghent, Belgium
| | - Uzma Saleem
- Department of Pharmacology, Faculty of Pharmaceutical Sciences, Government College University, Faisalabad, Pakistan
| | - Ghulam Mujtaba Shah
- Department of Botany, Faculty of Health and Biological Sciences, Hazara University, Mansehra, Pakistan
| | - Reem H Alhasani
- Department of Biology, Faculty of Applied Science, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Norah A Althobaiti
- Department of Biology, College of Science and Humanities, Shaqra University, Al-Quwaiiyah, Saudi Arabia
| | - Ifat Alsharif
- Department of Biology, Jamoum University College, Umm Al-Qura University, Makkah, Saudi Arabia
| | - Ana Sanches Silva
- National Institute for Agrarian and Veterinary Research (INIAV), I.P., Rua dos Lágidos, Lugar da Madalena, Vairão, Vila do Conde, Portugal
- University of Coimbra, Faculty of Pharmacy, Polo III, Azinhaga de St Comba, Coimbra, Portugal
- Centre for Animal Science Studies (CECA), ICETA, University of Porto, Porto, Portugal
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Blouin S, Khani F, Messmer P, Roschger P, Hartmann MA, van Wijnen AJ, Thaler R, Misof BM. Vitamin C Deficiency Deteriorates Bone Microarchitecture and Mineralization in a Sex-Specific Manner in Adult Mice. J Bone Miner Res 2023; 38:1509-1520. [PMID: 37493605 PMCID: PMC10636228 DOI: 10.1002/jbmr.4889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 06/30/2023] [Accepted: 07/21/2023] [Indexed: 07/27/2023]
Abstract
Vitamin C (VitC) is essential for bone health, and low VitC serum levels increase the risk for skeletal fractures. If and how VitC affects bone mineralization is unclear. Using micro-computed tomography (μCT), histologic staining, as well as quantitative backscattered electron imaging (qBEI), we assessed the effects of VitC on femoral structure and microarchitecture, bone formation, and bone mineralization density distribution (BMDD) in the VitC incompetent Gulo-/- mouse model and wild-type mice. In particular, VitC-supplemented, 20-week-old mice were compared with age-matched counterparts where dietary VitC intake was excluded from week 15. VitC depletion in Gulo-/- mice severely reduced cortical thickness of the diaphyseal shaft and bone volume around the growth plate (eg, bone volume of the primary spongiosa -43%, p < 0.001). Loss of VitC also diminished the amount of newly formed bone tissue as visualized by histology and calcein labeling of the active mineralization front. BMDD analysis revealed a shift to higher calcium concentrations upon VitC supplementation, including higher average (~10% increase in female VitC deficient mice, p < 0.001) and peak calcium concentrations in the epiphyseal and metaphyseal spongiosa. These findings suggest higher bone tissue age. Importantly, loss of VitC had significantly more pronounced effects in female mice, indicating a higher sensitivity of their skeleton to VitC deficiency. Our results reveal that VitC plays a key role in bone formation rate, which directly affects mineralization. We propose that low VitC levels may contribute to the higher prevalence of bone-degenerative diseases in females and suggest leveraging this vitamin against these conditions. © 2023 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Stéphane Blouin
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Farzaneh Khani
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Phaedra Messmer
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Paul Roschger
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | - Markus A Hartmann
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
| | | | - Roman Thaler
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
- Department of Biochemistry & Molecular Biology, Mayo Clinic, Rochester, MN, USA
| | - Barbara M Misof
- Ludwig Boltzmann Institute of Osteology at Hanusch Hospital of OEGK and AUVA Trauma Centre Meidling, 1st Med. Dept. Hanusch Hospital, Vienna, Austria
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Vertebral trabecular bone texture analysis in opportunistic MRI and CT scan can distinguish patients with and without osteoporotic vertebral fracture: A preliminary study. Eur J Radiol 2023; 158:110642. [PMID: 36527774 DOI: 10.1016/j.ejrad.2022.110642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 11/29/2022] [Accepted: 11/30/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE To investigate the potential of texture parameters from opportunistic MRI and CT for the detection of patients with vertebral fragility fracture, to design a decision tree and to compute a Random Forest analysis for the prediction of fracture risk. METHODS One hundred and eighty vertebrae of sixty patients with at least one (30) or without (30) a fragility fracture were retrospectively assessed. Patients had a DXA, an MRI and a CT scan from the three first lumbar vertebrae. Vertebrae texture analysis was performed in routine abdominal or lumbar CT and lumbar MRI using 1st and 2nd order texture parameters. Hounsfield Unit Bone density (HU BD) was also measured on CT-scan images. RESULTS Twelve texture parameters, Z-score and HU BD were significantly different between the two groups whereas T score and BMD were not. The inter observer reproducibility was good to excellent. Decision tree showed that age and HU BD were the most relevant factors to predict the fracture risk with a 93 % sensitivity and 56 % specificity. AUC was 0.91 in MRI and 0.92 in CT-scan using the Random Forest analysis. The corresponding sensitivity and specificity were 72 % and 93 % in MRI and 83 and 89 % in CT. CONCLUSIONS This study is the first to compare texture indices computed from opportunistic CT and MR images. Age and HU-BD together with selected texture parameters could be used to assess risk fracture. Machine learning algorithm can detect fracture risk in opportunistic CT and MR imaging and might be of high interest for the diagnosis of osteoporosis.
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Effective Treatment of Femur Diaphyseal Fracture with Compression Plate - A Finite Element and In Vivo Study Comparing the Healing Outcomes of Nailing and Plating. Indian J Orthop 2022; 57:146-158. [PMID: 36660487 PMCID: PMC9789296 DOI: 10.1007/s43465-022-00795-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 11/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND The rigidity in osteosynthesis causes primary healing, and it takes longer to heal. The flexibility provided to the fixation allows micromotion between fragments which accelerates secondary healing. METHODS In this study, the healing outcomes of nailing and plating in different fixation stabilities were investigated and compared by using a finite element tool. The clinical observational study was also performed to verify the results of the finite element analysis. The nonlinear contact analysis was performed on 5 different fixation configurations capturing nail and plate in immediate post-surgery. RESULTS The finite element analysis results showed that flexibility instead of rigidity in interlock nail implantation increases the axial and shear micromotion near the fracture site by 47.4% (P < 0.05) and 12.4% (P < 0.05), respectively. For LCDCP implantation, the flexible fixation increases the axial and shear micromotion near fracture site by 75.7% (P < 0.05) and 25.3% (P < 0.05), respectively. CONCLUSION Our findings suggest that flexible fixations of interlock nail and LCDCP provide a preferred mechanical environment for healing, and hence, the LCDCP in flexible mode can be an effective alternative to interlock nail for the femur diaphyseal fracture. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s43465-022-00795-1.
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Do antihypertensive medications effect the mandibular cortical bone thickness? A study using cone beam computed tomography images. Oral Surg Oral Med Oral Pathol Oral Radiol 2022; 134:687-694. [PMID: 36241600 DOI: 10.1016/j.oooo.2022.03.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 03/26/2022] [Accepted: 03/29/2022] [Indexed: 12/13/2022]
Abstract
OBJECTIVE The aim of this study was to measure the association between antihypertensive medication use and mandibular cortical thickness. STUDY DESIGN This retrospective cross-sectional study was comprised of a study sample of 169 patients aged 40 to 69. Cone beam computed tomography scans were examined. The buccal cortical thickness of the mandibular ramus was measured. Participants were separated into the control or study group based on use of antihypertensive medications. The predictor variable was the use of antihypertensive medications. The primary outcome variable was cortical thickness of the mandible. Age was identified as a covariate affecting the outcome variable. The data was analyzed with a one-way analysis of covariance (ANCOVA) to remove the effect of age on the outcome variable. The groups were subdivided based on the sex of the patient. RESULTS The study sample was composed of 169 patients with a mean age of 52.1, and 54% were female. There were 67 patients in the antihypertensive group (39.6%). A mean difference of 0.21 mm was found (P = .0010, 95% CI 0.09, 0.34 mm). The difference persisted after adjusting for age with one-way ANCOVA testing (P < .001). CONCLUSIONS This study suggests that there may be an association between antihypertensive use and mandibular cortical thickness. Age may be an effect modifier with the effect increasing in older patients.
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Shih HY, Lu JH, Xiong AH, Tse JMW, Wong BST. Topical application of the plant extract SDTL-E in ovariectomized rats: A potential new approach for treating osteoporosis. Front Med (Lausanne) 2022; 9:988235. [DOI: 10.3389/fmed.2022.988235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
Current osteoporosis medications have drawbacks of causing side effects and having slow onset, therefore developing osteoporosis drugs with faster onset and less side effects is essential. This study investigated the effects of the natural plant extract, SDTL-E, in ovariectomized (OVX)-induced osteoporosis rats. Rats were randomly assigned to sham operation control group (Control Group); OVX rat model group (Model Group) or OVX rat SDTL-E treatment group (SDTL-E Group). All groups underwent ovariectomy, but the Control Group did not have the ovaries removed. SDTL-E Group was treated with SDTL-E, Model and Control Groups were treated with vegetable oil, treatments were topically applied twice daily for 20 days. Results showed when compared with Model Group, SDTL-E Group significantly restored serum estradiol back to near Control Group level, serum ALP activity, serum and urinary calcium were significantly decreased, bone mechanics indicators increased and trabecular bone numbers slightly increased. These results demonstrated 20 days of SDTL-E topical treatment improved bone strength and trabecular bone structure in OVX-induced osteoporosis rats. The underlying mechanisms include restoring estradiol level, reducing bone turnover, net bone resorption, bone calcium loss, and calcium excretion through kidney. These findings suggest topical application of plant extract is a potential new approach with quick efficacy for treating osteoporosis.
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Prevalence of osteopenic syndrome and osteoporosis among residents of the older age group of Kyrgyzstan. ACTA BIOMEDICA SCIENTIFICA 2022. [DOI: 10.29413/abs.2022-7.4.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Osteoporosis is the most common metabolic bone disease. However, because it is asymptomatic, it cannot be diagnosed until a clinical event such as a fracture occurs. It is osteoporotic fractures, not osteoporosis itself, that lead to noticeable clinical and economic consequences.The aim. To study the frequency of osteopenia and osteoporosis in the older age group of the population of Kyrgyzstan using ultrasound bone densitometry.Materials and methods. A total of 1988 people were examined – 1105 women, 883 men. By age, the patients were divided into three age groups: 40–59, 60–74 and 75–90 years old. A portable ultrasonic bone densitometer SONOST-3000 (South Korea) was used to measure bone mineral density.Results. The prevalence of osteoporosis, osteopenia, and normal bone mineral density in the first age group was 20.9 %, 40.0 % and 39.1 %; in the second group – 30.2 %, 38.9 % and 30.9 %, and in the third group – 39.9 %, 34.9 % and 25.2 %, respectively. The incidence of osteoporosis increased with age and was gender-dependent – more common in women (p < 0.05 and p < 0.041, respectively). The probability of developing osteoporosis was lower in patients with a higher body weight (p < 0.002). Smoking had a bad effect on bone density (p < 0.001), physical exercise, on the contrary, inhibited the development of osteoporosis (p < 0.001). The use of alcohol and tea had no effect on the development of osteoporosis in our study (p = 0.421, p = 0.387, respectively).Conclusions. The study of osteoporosis from an epidemiological point of view in Kyrgyz residents revealed a higher-than-expected incidence of osteoporosis according to densitometry. Further large-scale studies are needed throughout the country, which will help to understand the outcome of low bone mineral density in the population of Kyrgyz residents.
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Closed-wedge high tibial osteotomy is more advantageous to maintain the correction than open-wedge high tibial osteotomy in osteopenic patients. Knee Surg Sports Traumatol Arthrosc 2022; 31:1563-1570. [PMID: 35635568 DOI: 10.1007/s00167-022-07006-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the incidence of correction loss and survival rate between closed-wedge and open-wedge high tibial osteotomies (CWHTO and OWHTO, respectively) in patients with osteopenic and normal bone. METHODS Retrospective review was conducted for 115 CWHTOs and 119 OWHTOs performed in osteopenic patients [- 2.5 < Bone mineral density (BMD) T scores ≤ - 1] and 136 CWHTOs and 138 OWHTOs performed in normal patients (BMD T score > - 1) from 2012 to 2019. Demographics were not different between CW- and OWHTOs in osteopenic and normal patients (n.s., respectively). Radiographically, the mechanical axis (MA), medial proximal tibial angle (MPTA), and posterior tibial slope (PTS) were evaluated pre- and postoperatively (2 weeks after HTO). The occurrence of hinge fractures was investigated using radiographs taken on the operation day. The correction change was calculated as the last follow-up value minus postoperative MPTA. Correction loss was defined when the correction change was ≥ 3°. The survival rate (failure: correction loss) was investigated. RESULTS There were no significant differences in the pre and postoperative MA, MPTA, PTS, and value changes between CW- and OWHTOs in osteopenic and normal patients (n.s., respectively); the incidence of unstable hinge fractures also did not differ significantly (CWHTO vs. OWHTO = 7 vs. 7.6% in osteopenic patients; 2.9 vs. 3.6% in normal patients; n.s., respectively). The average correction change (CWHTO = - 0.6°, OWHTO = - 1.3°, p = 0.007), incidence of correction loss (CWHTO = 1.7%, OWHTO = 9.2%, p = 0.019), and 5-year survival rates (CWHTO = 98.3%, OWHTO = 90.8%, p = 0.013) differed significantly in osteopenic patients; there were no significant differences in these results in normal patients (n.s., respectively). CONCLUSION CWHTO was more advantageous than OWHTO regarding the correction loss in osteopenic patients. Intra- and postoperative care that consider poor bone quality will be required when performing OWHTOs in osteopenic patients. LEVEL OF EVIDENCE III.
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Hsu CL, Huang WL, Chen HH, Cheng-Yen Lai J. Non-fermented tea consumption protects against osteoporosis among Chinese male elders using the Taiwan biobank database. Sci Rep 2022; 12:7382. [PMID: 35513482 PMCID: PMC9072314 DOI: 10.1038/s41598-022-11066-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Accepted: 04/19/2022] [Indexed: 11/09/2022] Open
Abstract
Few studies compared the effects of non-fermented and fermented tea among the general population. We aimed to compare the risk of incident osteoporosis (OP) between non-fermented tea and fermented tea drinkers by this retrospective nationwide population-based analysis from the Taiwan Biobank. Participants ≥ 40 years who drink fermented tea (n = 2205) were compared with those who drink non-fermented tea (n = 1034) from 2008 to 2015 with a mean follow-up period of 3.64 years. OP was defined by T-score ≤ − 2.5. Multivariate Cox proportional hazards regression models were performed to estimate the risk of developing OP between the two groups. Separate models were used to determine the relationship between tea consumption and OP stratified by sex and age. There was a significant interaction between sex, age, and type of tea consumed. In men aged ≥ 60 years, the risk of developing OP decreased by 79% for those who drank non-fermented tea (hazard ratio, 0.21; 95% confidence level, 0.05–0.94) than those who drank fermented tea. Additionally, those with a family history of OP had a higher risk of developing osteoporosis. This study suggests that male elderly who consume non-fermented tea have a lower risk of OP. Drinking non-fermented tea, such as green tea, could be suggested, especially for those with a family history of osteoporosis.
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Affiliation(s)
- Chiao-Lin Hsu
- Center for Health Management, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan.,Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, No. 386, Dazhong 1st Rd., Zuoying Dist., Kaohsiung City, 81362, Taiwan
| | - Wei-Lun Huang
- Taipei Veterans General Hospital, Taitung Branch, No. 1000, Gengsheng Rd., Taitung City, Taitung County, Taiwan
| | - Hung-Hui Chen
- School of Nursing, College of Medicine, National Taiwan University, No. 1, Sec. 1, Ren'ai Rd., Zhongzheng Dist., Taipei City, 10051, Taiwan. .,Department of Nursing, National Taiwan University Hospital, No. 7, Chung Shan S. Rd., Zhongzheng Dist., Taipei City, 10002, Taiwan.
| | - Jerry Cheng-Yen Lai
- Department of Medical Research, Taitung MacKay Memorial Hospital, 1, Lane 303, Changsha Street, Taitung City, 95054, Taiwan. .,Master Program in Biomedicine, College of Science and Engineering, National Taitung University, No. 684, Section 1, Zhonghua Road, Taitung City, 950, Taiwan.
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Sergio RO, Nayelli RGE. Evaluation of the bone mineral density in the Mexican female population using the Radiofrequency Echographic Multi Spectrometry (REMS) technology. Arch Osteoporos 2022; 17:43. [PMID: 35257242 DOI: 10.1007/s11657-022-01080-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 02/15/2022] [Indexed: 02/03/2023]
Abstract
The bone health status of a Mexican female population, including a cohort of 455 women aged over 40 years, was assessed by Radiofrequency Echographic Multi Spectrometry (REMS). PURPOSE Assessment of the bone health status in an average female Mexican population with REMS. The secondary objective investigated age- and body mass index (BMI)-related effects on the diagnostic classification and the influence of risk factors for osteoporosis. METHODS Women aged over 40 years underwent a REMS scan at the lumbar spine and both femoral necks. The degree of correlation of the bone mineral density (BMD) across axial sites was assessed by the Pearson correlation coefficient (r), along with the diagnostic discordance. The association between risk factors, age, and BMI and diagnostic classification was determined by the chi-squared test. RESULTS Four hundred seventy-one women were enrolled. Osteoporosis was diagnosed in 11.0%, 8.1%, and 8.3% of cases at the lumbar spine and right and left femoral neck, respectively. The diagnostic agreement between the lumbar spine and femoral necks was about 73% (85% considering a 0.3 T-score tolerance), whereas the agreement between the femoral necks was 97.4% (99.6% considering a 0.3 T-score tolerance). Most of discordant cases were minor discordances. The correlation between the lumbar spine and femoral neck was r = 0.82 and 0.85, respectively, whereas both femoral necks correlated with r = 0.97. As expected, the prevalence of osteoporosis increased with age and decreased as BMI increased. CONCLUSION The widespread applicability of the non-ionizing REMS technology has been demonstrated in a representative Mexican cohort, covering wide age and BMI ranges. Age and BMI variations correlate with the prevalence of osteoporosis, in line with the recent scientific literature.
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Affiliation(s)
- Rosales-Ortiz Sergio
- Hospital de Gineco Obstetricia, No. 4 "Luis Castelazo Ayala", IMSS, Mexico City, Mexico.
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Effect of osteoporosis-related reduction in the mechanical properties of bone on the acetabular fracture during a sideways fall: A parametric finite element approach. PLoS One 2022; 17:e0263458. [PMID: 35130332 PMCID: PMC8820641 DOI: 10.1371/journal.pone.0263458] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/19/2022] [Indexed: 11/19/2022] Open
Abstract
Purpose The incidence of acetabular fractures due to low-energy falls is increasing among the geriatric population. Studies have shown that several biomechanical factors such as body configuration, impact velocity, and trochanteric soft-tissue thickness contribute to the severity and type of acetabular fracture. The effect of reduction in apparent density and elastic modulus of bone as well as other bone mechanical properties due to osteoporosis on low-energy acetabular fractures has not been investigated. Methods The current comprehensive finite element study aimed to study the effect of reduction in bone mechanical properties (trabecular, cortical, and trabecular + cortical) on the risk and type of acetabular fracture. Also, the effect of reduction in the mechanical properties of bone on the load-transferring mechanism within the pelvic girdle was examined. Results We observed that while the reduction in the mechanical properties of trabecular bone considerably affects the severity and area of trabecular bone failure, reduction in mechanical properties of cortical bone moderately influences both cortical and trabecular bone failure. The results also indicated that by reducing bone mechanical properties, the type of acetabular fracture turns from elementary to associated, which requires a more extensive intervention and rehabilitation period. Finally, we observed that the cortical bone plays a substantial role in load transfer, and by increasing reduction in the mechanical properties of cortical bone, a greater share of load is transmitted toward the pubic symphysis. Conclusion This study increases our understanding of the effect of osteoporosis progression on the incidence of low-energy acetabular fractures. The osteoporosis-related reduction in the mechanical properties of cortical bone appears to affect both the cortical and trabecular bones. Also, during the extreme reduction in the mechanical properties of bone, the acetabular fracture type will be more complicated. Finally, during the final stages of osteoporosis (high reduction in mechanical properties of bone) a smaller share of impact load is transferred by impact-side hemipelvis to the sacrum, therefore, an osteoporotic pelvis might mitigate the risk of sacral fracture.
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Lee DY, Shin S. Association of Sarcopenia with Osteopenia and Osteoporosis in Community-Dwelling Older Korean Adults: A Cross-Sectional Study. J Clin Med 2021; 11:129. [PMID: 35011870 PMCID: PMC8745168 DOI: 10.3390/jcm11010129] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 12/26/2022] Open
Abstract
Sarcopenia and bone disorders, such as osteopenia and osteoporosis, are common musculoskeletal disorders in older adults. Therefore, this study aimed to establish the association between sarcopenia and bone disorders such as osteoporosis and osteopenia according to sex. We analyzed 3077 participants from the 2008-2011 Korean National Health and Nutrition Examination Survey aged 65 years or older. After adjusting for all covariates, such as physical examinations, exercise, and nutrient intake (model 4), the odds ratios for the association between sarcopenia and bone disorders were 2.051 (95% confidence interval [CI]: 1.498-2.808) in osteopenia and 2.258 (95% CI: 1.584-3.218) in osteoporosis. However, when sex was analyzed separately, the odds ratio was significantly different in men (osteopenia-2.068, 95% CI: 1.462-2.924; osteoporosis-3.247, 95% CI: 1.953-5.399), but not in women. Therefore, the results of this study show an association between sarcopenia and bone disorders in older Korean adults. Sarcopenia is significantly related to osteopenia and osteoporosis, especially in men, when stratified by sex.
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Affiliation(s)
- Do-Youn Lee
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan-si 38541, Gyungbuk, Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan-si 38541, Gyeongbuk, Korea
| | - Sunghoon Shin
- Research Institute of Human Ecology, Yeungnam University, Gyeongsan-si 38541, Gyungbuk, Korea;
- Neuromuscular Control Laboratory, Yeungnam University, Gyeongsan-si 38541, Gyeongbuk, Korea
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Torres ML, Wanionok NE, McCarthy AD, Morel GR, Fernández JM. Systemic oxidative stress in old rats is associated with both osteoporosis and cognitive impairment. Exp Gerontol 2021; 156:111596. [PMID: 34678425 DOI: 10.1016/j.exger.2021.111596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/25/2021] [Accepted: 10/14/2021] [Indexed: 10/20/2022]
Abstract
Aging is associated both with an increase in memory loss and with comorbidities such as Osteoporosis, which could be causatively linked. In the present study, a deleterious effect on bone is demonstrated for the first time in a model of aged rats with impaired memory. We show that bone marrow progenitor cells obtained from rats with memory deficit have a decrease in their osteogenic capacity, and an increase both in their osteoclastogenic profile and adipogenic capacity, when compared to aged rats with preserved memory. Rats with impaired (versus preserved) memory also show alterations in long-bone micro-architecture (decreased trabecular bone and osteocyte density, increased TRAP-positive osteoclasts), lower bone quality (decreased trabecular bone mineral content and density) and an increase in bone marrow adiposity. Interestingly, the development of bone alterations and memory deficit in old rats is associated with significantly higher levels of serum oxidative stress (versus unaffected aged rats). In conclusion, we have found for the first time in an aged rat model, a relationship between alterations in bone quality and memory impairment, with increased systemic oxidative stress as a possible unifying mechanism.
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Affiliation(s)
- María Luz Torres
- LIOMM (Laboratorio de Investigaciones en Osteopatías y Metabolismo Mineral), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata-CIC, Calle 47 y 115, 1900 La Plata, Argentina
| | - Nahuel Ezequiel Wanionok
- LIOMM (Laboratorio de Investigaciones en Osteopatías y Metabolismo Mineral), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata-CIC, Calle 47 y 115, 1900 La Plata, Argentina
| | - Antonio Desmond McCarthy
- LIOMM (Laboratorio de Investigaciones en Osteopatías y Metabolismo Mineral), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata-CIC, Calle 47 y 115, 1900 La Plata, Argentina
| | - Gustavo Ramón Morel
- Biochemistry Research Institute of La Plata "Professor Doctor Rodolfo R. Brenner" (INIBIOLP), Argentina
| | - Juan Manuel Fernández
- LIOMM (Laboratorio de Investigaciones en Osteopatías y Metabolismo Mineral), Departamento de Ciencias Biológicas, Facultad de Ciencias Exactas, Universidad Nacional de La Plata-CIC, Calle 47 y 115, 1900 La Plata, Argentina.
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Salari N, Ghasemi H, Mohammadi L, Behzadi MH, Rabieenia E, Shohaimi S, Mohammadi M. The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. J Orthop Surg Res 2021; 16:609. [PMID: 34657598 PMCID: PMC8522202 DOI: 10.1186/s13018-021-02772-0] [Citation(s) in RCA: 217] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/04/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Osteoporosis affects all sections of society, including families with people affected by osteoporosis, government agencies and medical institutes in various fields. For example, it involves the patient and his/her family members, and government agencies in terms of the cost of treatment and medical care. Providing a comprehensive picture of the prevalence of osteoporosis globally is important for health policymakers to make appropriate decisions. Therefore, this study was conducted to investigate the prevalence of osteoporosis worldwide. METHODS A systematic review and meta-analysis were conducted in accordance with the PRISMA criteria. The PubMed, Science Direct, Web of Science, Scopus, Magiran, and Google Scholar databases were searched with no lower time limit up till 26 August 2020. The heterogeneity of the studies was measured using the I2 test, and the publication bias was assessed by the Begg and Mazumdar's test at the significance level of 0.1. RESULTS After following the systematic review processes, 86 studies were selected for meta-analysis. The sample size of the study was 103,334,579 people in the age range of 15-105 years. Using meta-analysis, the prevalence of osteoporosis in the world was reported to be 18.3 (95% CI 16.2-20.7). Based on 70 studies and sample size of 800,457 women, and heterogenicity I2: 99.8, the prevalence of osteoporosis in women of the world was reported to be 23.1 (95% CI 19.8-26.9), while the prevalence of osteoporosis among men of the world was found to be 11.7 (95% CI 9.6-14.1 which was based on 40 studies and sample size of 453,964 men.). The highest prevalence of osteoporosis was reported in Africa with 39.5% (95% CI 22.3-59.7) and a sample size of 2989 people with the age range 18-95 years. CONCLUSION According to the medical, economic, and social burden of osteoporosis, providing a robust and comprehensive estimate of the prevalence of osteoporosis in the world can facilitate decisions in health system planning and policymaking, including an overview of the current and outlook for the future; provide the necessary facilities for the treatment of people with osteoporosis; reduce the severe risks that lead to death by preventing fractures; and, finally, monitor the overall state of osteoporosis in the world. This study is the first to report a structured review and meta-analysis of the prevalence of osteoporosis worldwide.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hooman Ghasemi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Loghman Mohammadi
- Department of Statistics, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad hasan Behzadi
- Department of Statistics, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Elham Rabieenia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor Malaysia
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Comparison of HU histogram analysis and BMD for proximal femoral fragility fracture assessment: a retrospective single-center case-control study. Eur Radiol 2021; 32:1448-1455. [PMID: 34647175 DOI: 10.1007/s00330-021-08281-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/03/2021] [Accepted: 08/17/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES To evaluate the feasibility of HU histogram analysis (HUHA) to assess proximal femoral fragility fractures with respect to BMD. METHODS This retrospective study included 137 patients with femoral fragility fractures who underwent hip CT and 137 control patients without fractures who underwent abdominal CT between January 2018 and February 2019. HUHA was calculated with the 3D volume of interest from the femoral head to the lesser trochanter. HUHAfat (percentage of negative HU values) and HUHAbone (percentage of HU values ≥ 125 HU) were assumed to be fat and bone components, respectively. Statistical significance was assessed using the area under the receiver operating characteristic curve (AUC), Spearman correlation (ρ), and odds ratio. RESULTS HUHAfat was strongly positively correlated (ρ = 0.56) and BMD was moderately negatively correlated with fragility fractures (ρ = - 0.37). AUC of HUHAfat (0.82, 95% CI [0.77, 0.87]) significantly differed from that of BMD (0.69, 95% CI [0.63, 0.75]) (p < .001). The cutoff value was 15.8% for HUHAfat (sensitivity: 90.4%; specificity: 67.7%) and 0.709 g/cm2 for BMD (sensitivity: 87.5%; specificity: 51.5%), with higher HUHAfat and lower BMD values indicating fragility fractures. The odds ratio of HUHAfat was 19.5 (95% CI [9.9, 38.2], p < .001), which was higher than that of BMD, 7.4 (95% CI [4.0, 13.6], p < .001). CONCLUSION HUHAfat revealed better performance than BMD and demonstrated feasibility in assessing proximal femoral fragility fractures. KEY POINTS • HUHAfat showed a strong positive correlation (Spearman ρ = 0.56, p < .001), and BMD showed a moderate negative correlation (Spearman ρ = - 0.37, p < .001) with proximal femoral fragility fractures. • HUHAfat (AUC = 0.82) performed significantly better than BMD in assessing proximal femoral fragility fractures (AUC = 0.69) (p < .001). • The odds ratio of HUHAfat for proximal femoral fragility fractures was higher than that of BMD (19.5 and 7.4, respectively; p < .001).
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Naganathar N, Yau WP, Mok ZH, Tan ZYF, Chew STH. Alendronate use in older patients with reduced renal function: challenges and opportunities in clinical practice. Osteoporos Int 2021; 32:1981-1988. [PMID: 33721033 DOI: 10.1007/s00198-021-05907-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Accepted: 03/01/2021] [Indexed: 12/31/2022]
Abstract
UNLABELLED In this retrospective cohort study, alendronate use among older osteoporosis patients (age>65 years) with reduced renal function (creatinine clearance<35ml/min) was not associated with significant deterioration in renal function from baseline nor increased incidence of osteoporotic fractures or acute kidney injury, compared with patients conservatively managed with only calcium/vitamin D supplementation. INTRODUCTION Oral bisphosphonates are not recommended in patients with creatinine clearance (CrCl) <35ml/min, although this is not supported by post hoc analyses of pivotal oral bisphosphonate studies. As both osteoporosis and renal insufficiency are more prevalent with advancing age, it is important to determine the safety and efficacy of oral bisphosphonates among these patients. METHODS Patients with CrCl <35ml/min on alendronate (group A, n=98), with CrCl <35ml/min conservatively managed (group B, n=96), and with CrCl ≥35ml/min on alendronate (group C, n=96) were followed up to 22 months. Primary outcomes were mean change in CrCl from baseline in group A compared with groups B and C, respectively. Secondary outcomes were the incidence of osteoporotic fractures and adverse events between groups. RESULTS There was no significant change in CrCl from baseline when comparing group A (-1.53±6.83ml/min) with group B (0.59±5.17ml/min) (p=0.075), and group A with group C (-3.71±7.54ml/min) (p=0.163). There was no significant increase in incidences of osteoporotic fractures in group A compared with group B (adjusted relative risk (aRR) 2.02, 95% confidence interval (CI) 0.64-6.37) and group A compared with group C (aRR 1.15, 95% CI 0.46-2.89). There was no significant difference in incidences of acute kidney injury (AKI) in group A compared with group B (aRR 0.48, 95% CI 0.20-1.12). Although statistically non-significant, there was an increase in AKI incidence in group A compared with group C (RR 7.84, 95% CI 0.98-62.66). CONCLUSION Among patients with CrCl <35ml/min, alendronate therapy was not associated with significant deterioration in renal function from baseline. Although not powered for secondary outcomes, there were no statistically significant differences in osteoporotic fracture or AKI incidence between the groups.
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Affiliation(s)
- N Naganathar
- Department of Pharmacy, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore.
| | - W -P Yau
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore, Singapore
| | - Z H Mok
- Department of Pharmacy, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - Z Y F Tan
- Department of Pharmacy, Changi General Hospital, 2 Simei Street 3, Singapore, 529889, Singapore
| | - S T H Chew
- Department of Geriatric Medicine, Changi General Hospital, Singapore, Singapore
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Choi KH, Lee JH, Lee DG. Sex-related differences in bone metabolism in osteoporosis observational study. Medicine (Baltimore) 2021; 100:e26153. [PMID: 34032772 PMCID: PMC8154389 DOI: 10.1097/md.0000000000026153] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 05/07/2021] [Indexed: 01/04/2023] Open
Abstract
Although the incidence is lower in men than women, osteoporosis remains a significant health issue in men as it may give rise to severe complications if not managed appropriately. As men and women show different biological and social backgrounds, we retrospectively evaluated the differences in the bone metabolism between men and women using bone biomarkers.Bone mineral density (BMD) was determined in all patients using dual-energy X-ray absorptiometry (DXA) and analyzing various bone biomarkers such as carboxyl-terminal collagen crosslinks (CTX), osteocalcin (OCT), and alkaline phosphatase (ALP). The CTX/OCT ratio was used to estimate the association between bone absorption and formation.OCT, CTX, and ALP levels were elevated in patients with osteoporosis. Women displayed a higher incidence of osteoporosis and greater reduction in BMD than men. The mean OCT level in men was lower than that in women. Moreover, men showed significantly lower OCT levels than women of aged 65 and under 80 years old. Among patients with osteoporosis, men had a higher ratio of bone markers than women.Levels of biomarkers of bone formation and absorption were increased in the osteoporosis group. However, men showed lower increases in bone formation biomarkers than did women, indicating that the rate of bone formation relative to bone absorption did not increase in men compared with that in women. Therefore, we suggest that men and women have different bone metabolism in old age.
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Affiliation(s)
| | - Jong Ho Lee
- Department of Laboratory Medicine, College of Medicine, Yeungnam University, Daegu, Republic of Korea
| | - Dong Gyu Lee
- Department of Physical Medicine and Rehabilitation
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Nerlich AG, Kirchhoff SM, Panzer S, Lehn C, Bachmeier BE, Bayer B, Anslinger K, Röcker P, Peschel OK. Chronic active non-lethal human-type tuberculosis in a high royal Bavarian officer of Napoleonic times-a mummy study. PLoS One 2021; 16:e0249955. [PMID: 33945536 PMCID: PMC8096010 DOI: 10.1371/journal.pone.0249955] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Accepted: 03/26/2021] [Indexed: 11/24/2022] Open
Abstract
In paleopathology, morphological and molecular evidence for infection by mycobacteria of the M. tuberculosis complex (MTC) is frequently associated with early death. In the present report, we describe a multidisciplinary study of a well-preserved mummy from Napoleonic times with a long-standing tuberculous infection by M. tuberculosis senso stricto who died at the age of 88 years of focal and non-MTB related bronchopneumonia. The well-preserved natural mummy of the Royal Bavarian General, Count Heinrich LII Reuss-Köstritz (1763–1851 CE), was extensively investigated by macro- and histomorphology, whole body CT scans and organ radiography, various molecular tissue analyses, including stable isotope analysis and molecular genetic tests. We identified signs for a long-standing, but terminally inactive pulmonary tuberculosis, tuberculous destruction of the second lumbar vertebral body, and a large tuberculous abscess in the right (retroperitoneal) psoas region (a cold abscess). This cold abscess harboured an active tuberculous infection as evidenced by histological and molecular tests. Radiological and histological analysis further revealed extensive arteriosclerosis with (non-obliterating) coronary and significant carotid arteriosclerosis, healthy bone tissue without evidence of age-related osteopenia, evidence for diffuse idiopathic skeletal hyperostosis and mild osteoarthrosis of few joints. This suggests excellent living conditions correlating well with his diet indicated by stable isotope results and literary evidence. Despite the clear evidence of a tuberculous cold abscess with bacterioscopic and molecular proof for a persisting MTC infection of a human-type M. tuberculosis strain, we can exclude the chronic MTC infection as cause of death. The detection of MTC in historic individuals should therefore be interpreted with great caution and include further data, such as their nutritional status.
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Affiliation(s)
- Andreas G. Nerlich
- Institute of Pathology, Academic Clinic München-Bogenhausen, Munich, Germany
- * E-mail:
| | - Sonja M. Kirchhoff
- Department of Radiology, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Stephanie Panzer
- Department of Radiology, Trauma Center Murnau, Murnau, Germany
- Paracelsus Medical University Salzburg, Salzburg, Austria
| | - Christine Lehn
- Institute of Legal Medicine, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Beatrice E. Bachmeier
- Institute of Laboratory Medicine, University Hospital, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Birgit Bayer
- Institute of Legal Medicine, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Katja Anslinger
- Institute of Legal Medicine, Ludwig-Maximilians University (LMU), Munich, Germany
| | - Pascale Röcker
- Institute of Pathology, Academic Clinic München-Bogenhausen, Munich, Germany
| | - Oliver K. Peschel
- Institute of Legal Medicine, Ludwig-Maximilians University (LMU), Munich, Germany
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Chen Y, Zhu J, Zhou Y, Peng J, Wang B. Efficacy and Safety of Denosumab in Osteoporosis or Low Bone Mineral Density Postmenopausal Women. Front Pharmacol 2021; 12:588095. [PMID: 33935694 PMCID: PMC8080120 DOI: 10.3389/fphar.2021.588095] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 02/05/2021] [Indexed: 11/13/2022] Open
Abstract
Denosumab, a human monoclonal antibody, acts against the receptor activator of nuclear factor-κB ligand and is a promising antiresorptive agent in patients with osteoporosis. This study aimed to update the efficacy and safety of denosumab vs. placebo in osteoporosis or low bone mineral density (BMD) postmenopausal women. PubMed, Embase, Cochrane library, and ClinicalTrials.gov were searched for randomized controlled trials (RCTs) reporting the efficacy and safety data of denosumab vs. placebo in osteoporosis or low BMD postmenopausal women. A random-effects model was used to calculate pooled weight mean differences (WMDs) or relative risks (RRs) with corresponding 95% confidence intervals (CIs) for treatment effectiveness of denosumab vs. placebo. Eleven RCTs including 12,013 postmenopausal women with osteoporosis or low BMD were preferred for the final meta-analysis. The summary results indicated that the percentage change of BMD in the denosumab group was greater than that of BMD in placebo at 1/3 radius (WMD: 3.43; 95%CI: 3.24–3.62; p < 0.001), femoral neck (WMD: 3.05; 95%CI: 1.78–4.33; p < 0.001), lumbar spine (WMD: 6.25; 95%CI: 4.59–7.92; p < 0.001), total hip (WMD: 4.36; 95%CI: 4.07–4.66; p < 0.001), trochanter (WMD: 6.00; 95%CI: 5.95–6.05; p < 0.001), and total body (WMD: 3.20; 95%CI: 2.03–4.38; p < 0.001). Moreover, denosumab therapy significantly reduced the risk of clinical fractures (RR: 0.57; 95%CI: 0.51–0.63; p < 0.001), nonvertebral fracture (RR: 0.83; 95%CI: 0.70–0.97; p = 0.018), vertebral fracture (RR: 0.32; 95%CI: 0.25–0.40; p < 0.001), and hip fracture (RR: 0.61; 95%CI: 0.37–0.98; p = 0.042). Finally, denosumab did not cause excess risks of adverse events. These findings suggested that postmenopausal women receiving denosumab had increased BMDs and reduced fractures at various sites without inducing any adverse events.
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Affiliation(s)
- Yi Chen
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jun Zhu
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Yiqin Zhou
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Jinhui Peng
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
| | - Bo Wang
- Department of Orthopedics, Shanghai Changzheng Hospital, Naval Medical University, Shanghai, China
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21
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Lim Y, Ha J, Yoon KH, Baek KH, Kang MI. Measures of physical performance as a predictor of fracture risk independent of BMD: The Chungju metabolic disease cohort study. Bone 2021; 145:115878. [PMID: 33571697 DOI: 10.1016/j.bone.2021.115878] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/31/2021] [Accepted: 02/03/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND Bone mineral density (BMD) assessments alone might not be sufficient for assessing fracture risk in the whole population, and decreased balance is an important risk factor for fracture. The aim of this study was to evaluate the association between baseline physical performance and fracture risk. METHODS This community-based cohort study was conducted in rural areas. The follow-up examination was performed in 4015 subjects for approximately 4 years. We used the one-leg standing time (OLST) to assess static balance and the timed up-and-go test (TUGT) to assess dynamic balance. Fractures were assessed during the medical interview. RESULTS The participants were divided into quartile groups according to their performance level, and the lowest baseline OLST performance was associated with a 2.1-fold increased risk of major osteoporotic fracture (MOF) independent of age, gender, hip BMD, fall incidence, and lifestyle factors. The participants in the low performance quartile of baseline OLST or TUGT performance had an increased incidence of osteoporosis and falling compared to that in the participants in the highest baseline performance quartile after adjusting for covariates. Among the participants with a femoral neck T-score above -2.5, the participants with an OLST below 14 s had a 1.7-fold higher risk of MOF than the participants with an OLST of 14 s or more. CONCLUSIONS The measurement of static balance by the OLST predicted the risk of fracture in Korean adults independent of BMD and fall history. Our results suggest that the OLST may have clinical utility in identifying individuals at risk of fracture, especially those who might not be adequately identified by BMD measurements alone.
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Affiliation(s)
- Yejee Lim
- Division of General Internal Medicine, Department of Internal Medicine, Seoul National University Bundang Hospital, 82, Gumi-ro 173-beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, Republic of Korea
| | - Jeonghoon Ha
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, Republic of Korea
| | - Kun Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, Republic of Korea
| | - Ki Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, Republic of Korea.
| | - Moo-Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, Republic of Korea.
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Bae IS, Kim JM, Cheong JH, Ryu JI, Choi KS, Han MH. Does the skull Hounsfield unit predict shunt dependent hydrocephalus after decompressive craniectomy for traumatic acute subdural hematoma? PLoS One 2020; 15:e0232631. [PMID: 32353054 PMCID: PMC7192490 DOI: 10.1371/journal.pone.0232631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Accepted: 04/17/2020] [Indexed: 11/30/2022] Open
Abstract
Background and purpose Posttraumatic hydrocephalus affects 11.9%–36% of patients undergoing decompressive craniectomy (DC) after traumatic brain injury and necessitates a ventriculo-peritoneal shunt placement. As bone and arachnoid trabeculae share the same collagen type, we investigated possible connections between the skull Hounsfield unit (HU) values and shunt-dependent hydrocephalus (SDHC) in patients that received cranioplasty after DC for traumatic acute subdural hematoma (SDH). Methods We measured HU values in the frontal bone and internal occipital protuberance from admission brain CT. Receiver operating characteristic curve analysis was performed to identify the optimal cut-off skull HU values for predicting SDHC in patients receiving cranioplasty after DC due to traumatic acute SDH. We investigated independent predictive factors for SDHC occurrence using multivariable logistic regression analysis. Results A total of 162 patients (>15 years of age) were enrolled in the study over an 11-year period from two university hospitals. Multivariable logistic analysis revealed that the group with simultaneous frontal skull HU ≤797.4 and internal occipital protuberance HU ≤586.5 (odds ratio, 8.57; 95% CI, 3.05 to 24.10; P<0.001) was the only independent predictive factor for SDHC in patients who received cranioplasty after DC for traumatic acute SDH. Conclusions Our study reveals a potential relationship between possible low bone mineral density and development of SDHC in traumatic acute SDH patients who had undergone DC. Our findings provide deeper insight into the association between low bone mineral density and hydrocephalus after DC for traumatic acute SDH.
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Affiliation(s)
- In-Suk Bae
- Department of Neurosurgery, Eulji University Eulji Hospital, Seoul, Korea
| | - Jae Min Kim
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyonggi-do, Korea
| | - Jin Hwan Cheong
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyonggi-do, Korea
| | - Je Il Ryu
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyonggi-do, Korea
| | - Kyu-Sun Choi
- Department of Neurosurgery, Hanyang University Medical Center, Seoul, Korea
| | - Myung-Hoon Han
- Department of Neurosurgery, Hanyang University Guri Hospital, Gyonggi-do, Korea
- * E-mail:
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Wang Y, Yu S, Hsu C, Tsai C, Cheng T. Underestimated fracture risk in postmenopausal women-application of the hybrid intervention threshold. Osteoporos Int 2020; 31:475-483. [PMID: 31696272 DOI: 10.1007/s00198-019-05201-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 10/16/2019] [Indexed: 01/07/2023]
Abstract
UNLABELLED This study evaluated the fragility fracture risk of Taiwanese postmenopausal women with osteopenia. With the incorporation of FRAX and hybrid intervention threshold (HIT), 25% of the participants had high fracture risk. We suggest intervention for fragility fracture for postmenopausal women should be guided by FRAX and HIT instead of bone mineral density alone. INTRODUCTION To explore the risk of fragility fracture in Taiwanese postmenopausal women with osteopenia using the hybrid intervention threshold (HIT) and Fracture Risk Assessment tool (FRAX). METHODS The Taiwan Osteoporosis Association (TOA) conducted a nationwide bone mineral density (BMD) survey between 2008 and 2011 using a bus equipped with a dual-energy X-ray absorptiometry (DXA) machine. All participants completed a structured questionnaire, which included the elements in the FRAX. Based on the results, the group made up of postmenopausal women with osteopenia was identified. In order to explore the risk of fragility fracture by HIT and FRAX among Taiwan postmenopausal women with osteopenia, the 10-year probability of fracture (FRAX score) and individual intervention threshold (IIT) in this group were calculated. If the FRAX score of a participant was higher than or equal to the IIT or fixed intervention threshold (FIT), the participant was considered as above the HIT (HIT could be reached by being over a threshold at either major osteoporotic fracture or hip fracture) and categorized as having a high FRAX fracture risk. RESULTS A total of 13,068 postmenopausal women were enrolled in the program. A total of 5743 (43.9%) participants had osteopenia, of which 1434 (25.0%) had high FRAX fracture risk. CONCLUSIONS One quarter of Taiwanese postmenopausal women with osteopenia had high fragility fracture risk evaluated by FRAX and HIT. Due to the poor sensitivity of BMD for fragility fracture, we suggest that intervention for fragility fracture for postmenopausal women should also be guided by FRAX and HIT instead of BMD alone.
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Affiliation(s)
- Y Wang
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan
| | - S Yu
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan
| | - C Hsu
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan
| | - C Tsai
- Department of Obstetrics and Gynecology, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan.
| | - T Cheng
- Division of Rheumatology, Allergy, and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan.
- College of Medicine, Chang Gung University, No. 123, Dapi Road, Niaosung District, 83301, Kaohsiung City, Taiwan.
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Kim H, Yoo S, Park SG. Young cancer survivors have lower bone mineral density compared with healthy controls: a nationwide population-based study in Korea. Sci Rep 2020; 10:654. [PMID: 31959794 PMCID: PMC6971234 DOI: 10.1038/s41598-020-57503-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 01/02/2020] [Indexed: 11/17/2022] Open
Abstract
Direct effects of cancer cells and various cancer treatments can cause bone loss in cancer survivors. The aim of this study was to assess the risk of bone loss in Korean cancer survivors, and the relationship between body composition and bone mineral density (BMD). We hypothesized that cancer survivors would have lower BMD than healthy people, and increased muscle mass has a protective effect on BMD. We measured BMD and body composition in 259 cancer survivors (99 men and 160 women). Subjects were selected from the Korean National Health and Nutrition Survey conducted from 2008 to 2011. Body composition and BMD were measured by dual-energy X-ray absorptiometry. We examined the linear trend of lumbar BMD according to tertiles of lean mass (LM) and fat mass (FM) by linear regression, adjusting for age, alcohol consumption, smoking, exercise, 25-hydroxyvitamin D, height, protein intake, and menopausal status. Cancer survivors under 50 years of age had lower lumbar BMD compared with healthy controls (0.93 ± 0.04 g/cm2 vs. 1.02 ± 0.01 g/cm2, p = 0.032 in males; 0.95 ± 0.02 g/cm2 vs. 0.98 ± 0.01 g/cm2, p = 0.015 in females). Lumbar BMD significantly increased from the lowest to highest tertiles of LM in male (p for trend < 0.001) and marginally significantly increased in female survivors (p for trend = 0.060). In this study of Korean cancer survivors, young survivors were at higher risk of having low lumbar BMD. Higher LM had beneficial effects on BMD in cancer survivors. To prevent osteoporosis and fractures, efforts to increase lean body mass, including bone, are needed for young cancer survivors.
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Affiliation(s)
- Hyoeun Kim
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, (48108), Republic of Korea
| | - Sunmi Yoo
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, (48108), Republic of Korea.
| | - Seung Guk Park
- Department of Family Medicine, Inje University Haeundae Paik Hospital, Busan, (48108), Republic of Korea
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The health and economic burden of osteoporotic fractures in Singapore and the potential impact of increasing treatment rates through more pharmacological options. Arch Osteoporos 2019; 14:114. [PMID: 31773442 DOI: 10.1007/s11657-019-0664-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Accepted: 10/24/2019] [Indexed: 02/03/2023]
Abstract
PURPOSE This study aims to estimate the health and economic burden of osteoporosis in Singapore from 2017 to 2035, and to quantify the impact of increasing the treatment rate of osteoporosis. METHODS Population forecast data of women and men aged 50 and above in Singapore from 2017 to 2035 was used along with prevalence rates of osteoporosis to project the osteoporosis population over time. The population projections by sex and age group were used along with osteoporotic fracture incidence rates by fracture type (hip, vertebral, other), and average direct and indirect costs per case to forecast the number of fractures, the total direct health care costs, and the total indirect costs due to fractures in Singapore. Data on treatment rates and effects were used to model the health and economic impact of increasing treatment rate of osteoporosis, using different hypothetical levels. RESULTS Between 2017 and 2035, the incidence of osteoporotic fractures is projected to increase from 15,267 to 24,104 (a 57.9% increase) F 10,717 to 17,225 (a 60.7% increase) and M 4550 to 6878 (a 51.2% increase). The total economic burden (including direct costs and indirect costs to society) associated with these fractures is estimated at S$183.5 million in 2017 and is forecasted to grow to S$289.6 million by 2035. However, increasing the treatment rate for osteoporosis could avert up to 29,096 fractures over the forecast period (2017-2035), generating cumulative total cost savings of up to S$330.6 million. CONCLUSION Efforts to improve the detection, diagnosis, and treatment of osteoporosis are necessary to reduce the growing clinical, economic, and societal burden of fractures in Singapore.
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Arnautovic-Halimic A, Begic A, Agic-Bilalagic S, Basic A, Hadzimuratovic A, Ahmed-Jesenkovic D. Evaluation of Thyroid Hormone Status and Bone Density Ratio in Euthyroid Postmenopausal Women in Early and Late Stage of Bone Loss. Mater Sociomed 2019; 31:115-118. [PMID: 31452636 PMCID: PMC6690304 DOI: 10.5455/msm.2019.31.115-118] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Osteoporosis is a consequence of reduction in bone mass and disorders of bone structure, which makes the bones prone to fractures. Physiological variations of thyroid-stimulating hormone (TSH) may be an early indicator of the predisposing basis of the emergence of osteoporosis. Aim: To evaluate the thyroid hormone status and bone density ratio in euthyroid postmenopausal women in early and late stage of bone loss. Methods: The research is an observational, intersected, controlled study involving postmenopausal women admitted to the Clinic for Nuclear medicine and endocrinology of the Clinical Center University of Sarajevo (CCUS). The study included a total of 120 postmenopausal subjects divided into two groups. First group included 60 postmenopausal patients with osteoporosis, 30 of them were at the early stage of postmenopause, and 30 were in the late postmenopausal phase. The second group consisted of 60 postmenopausal patients with preserved bone mass, 30 of which were in the early stage of postmenopause and 30 in the late postmenopausal phase. For all patients included in the study follicle-stimulating hormone (FSH), TSH, free thyroxine (FT4), free triiodothyronine (FT3) were analyzed. Results: The mean duration of the postmenopausal period was statistically significantly higher in the group of women with osteoporosis (11.4 ± 1.1 years). The mean values of FSH were statistically significantly higher in the group of women with osteoporosis (54.0 ± 2.6 IU / L). The mean level of TSH and FT3 did not statistically significantly differ in the group of women with osteoporosis compared to the control group of women. The mean FT4 level in women with osteoporosis was statistically significantly lower (14.7 ± 0.29 pmol / L) compared to the control group of women (15.95 ± 0.3 pmol / L) (p = 0.004). Conclusion: In our examined group, the FT4 patient (mean) was significantly lower in the serum of women with osteoporosis compared to subjects with preserved bone mass. It would be most effective to recognize risk factors in order to influence them on time, and to alleviate and slow down the consequences of osteoporosis. One of these possible factors is the hormonal status of the thyroid gland, that is, TSH whose physiological variations may be an early indicator of the predisposing basis for the emergence of osteoporosis. The frequency and prevalence of these medical problems require additional research, and it is also a great challenge to understand the effects of thyroid hormone on bone tissue.
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Affiliation(s)
- Ajla Arnautovic-Halimic
- Clinic for Nuclear medicine and endocrinology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amela Begic
- Clinic for Nuclear medicine and endocrinology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Selma Agic-Bilalagic
- Clinic for Nuclear medicine and endocrinology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Amila Basic
- Clinic for Nuclear medicine and endocrinology, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Dzan Ahmed-Jesenkovic
- Department for Biostatistics and epidemiology, Faculty of Medicine, University of Sarajevo, Sarajevo, Bosnia and Herzegovina
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Wang Y, Ding H, Wang X, Wei Z, Feng S. Associated Factors for Osteoporosis and Fracture in Chinese Elderly. Med Sci Monit 2019; 25:5580-5588. [PMID: 31350990 PMCID: PMC6681684 DOI: 10.12659/msm.914182] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Background The factors associated with osteoporosis are poorly understood in the Chinese population. This study aimed to examine the factors associated with osteoporosis and with fractures in a Chinese elderly population. Material/Methods This was a cross-sectional study of elderly people living in Tianjin between 2012 and 2014. Bone mineral density was measured by dual X-ray absorptiometry. The subjects completed a questionnaire about lifestyle habits, personal and family medical history, calcium intake, and exercising. Data were gathered on occurrence of fracture at 5 years or August 2018, whichever occurred first. Results There were 298 individuals with osteoporosis (18.5% male, median age 67 years) and 397 without (46.3% male, median age 62 years). Male sex (OR=0.051, 95% CI: 0.021–0.126), age (OR=1.049, 95% CI: 1.099–1.202), being divorced/widowed (OR=2.445, 95% CI: 1.219-4.904), digestive ulcer history (OR=3.805, 95% CI: 1.539–9.405), family history of hunchback (OR=2.659, 95% CI: 1.145–6.175), family history of osteoarthropathy (OR=4.222, 95% CI: 2.128–8.375), fracture history (OR=2.138, 95% CI: 1.307–3.496), drinking green tea (OR=0.352, 95% CI: 0.217–0.574), and exercising (OR=0.303, 95% CI: 0.193–0.475) were independently associated with osteoporosis. Digestive ulcer history (OR=3.183, 95% CI: 1.178–8.5992), exercising (OR=0.354, 95% CI: 0.139–0.903), and taking calcium supplements during follow-up (OR=0.262, 95% CI: 0.112–0.611) were independently associated with fractures in patients with osteoporosis. Conclusions Female sex, age, marital status, history of digestive ulcer and fracture, and family history of hunchback and osteoarthropathy are associated with osteoporosis among elderly subjects, while drinking green tea and exercising are inversely associated. Among the patients with osteoporosis, a history of digestive ulcer is associated with fractures, while exercising and taking calcium supplements are inversely associated.
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Affiliation(s)
- Yuqiang Wang
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland).,Department of Orthopedic Surgery, Affiliated Hospital of Logistics, University of Chinese Armed Police Force, Tianjin, China (mainland)
| | - Han Ding
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Xiaohua Wang
- Department of Neurological, Intensive Care Unit, Tianjin Huanhu Hospital, Tianjin, China (mainland)
| | - Zhijian Wei
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland)
| | - Shiqing Feng
- Department of Orthopedics, Tianjin Medical University General Hospital, Tianjin, China (mainland)
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Prevalence and Predictors of Osteoporosis Among the Chinese Population in Klang Valley, Malaysia. APPLIED SCIENCES-BASEL 2019. [DOI: 10.3390/app9091820] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
The prevalence of osteoporosis is forecasted to escalate in Malaysia with an increasing elderly population. This study aimed to analyze the prevalence and the risk factors of osteoporosis among middle-aged and elderly Chinese Malaysians. Three hundred sixty seven Malaysian Chinese aged ≥40 years in Klang Valley, Malaysia, were recruited. All subjects completed a structured questionnaire comprised of demographic details, medical history, diet, and lifestyle practices. Body anthropometry and bone mineral density measurements were also performed. The relationship between bone health status and risk factors was determined using multivariate logistic regression. Fifteen-point-three percent of the overall study population and 32.6% of those aged ≥71 years had osteoporosis. The prevalence of osteoporosis among women (18.9%) was higher than men (11.5%). The significant predictors of osteoporosis were age, body weight, and low monthly income. Lean mass, low education level, and being underweight predicted osteoporosis in women. Lean mass was the only significant predictor of osteoporosis in men. Overall, 15.3% of the Malaysian Chinese aged ≥40 years from Klang Valley, Malaysia, had osteoporosis. Osteoporosis was associated positively with increased age and low monthly income and negatively with body weight. Therefore, osteoporosis preventive strategies targeting Chinese elderly from a low socioeconomic background is necessary.
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Hong N, Kim CO, Youm Y, Choi JY, Kim HC, Rhee Y. Elevated Red Blood Cell Distribution Width Is Associated with Morphometric Vertebral Fracture in Community-Dwelling Older Adults, Independent of Anemia, Inflammation, and Nutritional Status: The Korean Urban Rural Elderly (KURE) Study. Calcif Tissue Int 2019; 104:26-33. [PMID: 30159752 DOI: 10.1007/s00223-018-0470-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Accepted: 08/25/2018] [Indexed: 10/28/2022]
Abstract
Elevated red blood cell distribution width (RDW), a simple measure of red blood cell size heterogeneity, has been associated with increased mortality and morbidity in the elderly population, which might reflect systemic inflammation and malnutrition. However, whether elevated RDW is associated with prevalent morphometric vertebral fracture (VF) in older adults has not been investigated. We examined 2127 individuals (mean age 71.7 years; women 66%) from a community-based cohort. VF was defined as ≥ 25% reduction in vertebral column height using the Genant semiquantitative method. Multiple VF was defined as the presence of VF at two or more sites. The prevalence of any VF and multiple VF was 14% and 4%, respectively, increasing from the lowest to the highest RDW tertiles (12-18% and 3-6%, p for trend < 0.05 for all). RDW was positively associated with age, body mass index (BMI), malnutrition, and high-sensitivity C-reactive protein (hsCRP), whereas it was negatively associated with albumin, hemoglobin, and ferritin levels. Elevated RDW was associated with any VF [adjusted odds ratio (aOR) 1.26; p = 0.008] and multiple VF (aOR 1.36; p = 0.010) after adjustment for covariates, including age, sex, BMI, hsCRP, malnutrition, self-reported previous fracture, falls, osteoporosis, and hemoglobin and ferritin levels. The association between elevated RDW and VF remained robust in subgroups with (aOR 1.39; p = 0.048) or without anemia (aOR 1.26; p = 0.030). Elevated RDW was associated with prevalent morphometric VF in community-dwelling elderly individuals, independent of anemia, inflammation, and nutritional status.
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Affiliation(s)
- Namki Hong
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
- Graduate School, Yonsei University College of Medicine, Seoul, South Korea
| | - Chang Oh Kim
- Division of Geriatrics, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Yoosik Youm
- Department of Sociology, Yonsei University College of Social Sciences, Seoul, South Korea
| | - Jin-Young Choi
- Department of Radiology, Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Yumie Rhee
- Department of Internal Medicine, Severance Hospital, Endocrine Research Institute, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
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Do HJ, Shin JS, Lee J, Lee YJ, Kim MR, Nam D, Kim EJ, Park Y, Suhr K, Ha IH. Association between liver enzymes and bone mineral density in Koreans: a cross-sectional study. BMC Musculoskelet Disord 2018; 19:410. [PMID: 30474546 PMCID: PMC6260874 DOI: 10.1186/s12891-018-2322-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Accepted: 10/25/2018] [Indexed: 01/03/2023] Open
Abstract
Background Osteoporosis is a major health concern for both men and women, and associated fractures incur substantial economic burden. While there are a multitude of studies on bone mineral density (BMD) and liver diseases, not many studies have assessed the association between liver enzyme levels and BMD in homogeneous populations. Methods The current study investigated the association between serum liver enzyme levels and BMD at various sites in Koreans. Out of 21,517 surveyees of the 5th Korean National Health and Nutrition Examination Survey (2010–2012), 7160 participants’ data on BMD, serum liver enzymes, and full covariate data were included for cross-sectional analysis. BMD at the femoral neck, lumbar spine, entire femur, and whole body was assessed using dual energy X-ray absorptiometry (DEXA), and liver enzymes included aspartate aminotransferase (AST), alanine aminotransferase (ALT), and gamma(γ)-glutamyl transferase (GGT) levels. Differences in participant characteristics by BMD and liver enzyme levels were analyzed, and complex sample design regression analysis adjusted for multiple covariates was performed to assess the relationship between liver enzymes and BMD. Results Negative associations were seen with GGT and BMD at all sites (P ≤ 0.02), ALT with lumbar spine (P = 0.0013), and AST with lumbar BMD (P = 0.0009). In particular, GGT presented strong negative associations with BMD in postmenopausal women and elder men. Conclusions This study demonstrates a negative relationship between liver enzyme levels and BMD, and suggests that a significant association exists between osteoporosis/decreased BMD and liver disorders. Electronic supplementary material The online version of this article (10.1186/s12891-018-2322-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ho Jeong Do
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Joon-Shik Shin
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Jinho Lee
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Yoon Jae Lee
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 538 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Me-Riong Kim
- Jaseng Hospital of Korean Medicine, 536 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea
| | - Dongwoo Nam
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul, Republic of Korea
| | - Eun-Jung Kim
- Department of Acupuncture & Moxibustion, College of Korean Medicine, Dongguk University, 123 Dongdae-ro, Gyeongju, Gyeongsangbuk-do, Republic of Korea
| | - Yeoncheol Park
- Department of Acupuncture & Moxibustion, Kyung Hee University Hospital at Gangdong, 892 Dongnam-ro, Gangdong-gu, Seoul, Republic of Korea
| | - Kristin Suhr
- Prevention Sciences, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - In-Hyuk Ha
- Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 538 Gangnam-daero, Gangnam-gu, Seoul, Republic of Korea.
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Lai YC, Tang PL, Kuo TJ, Hsu CJ. Different impacts of dementia on two-year mortality after osteosynthesis and hemiarthroplasty in treating geriatric hip fractures. Arch Gerontol Geriatr 2018; 79:116-122. [PMID: 30196144 DOI: 10.1016/j.archger.2018.08.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2018] [Revised: 08/22/2018] [Accepted: 08/27/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Geriatric hip fractures are mostly managed by internal fixation (IF) or hemiarthroplasty (HA). Survivorship of dementia patients following these surgeries has not been extensively compared in literature. By analysis of nationwide database, this study aimed to investigate the impact of dementia on two-year mortality after IF and HA in treating geriatric hip fractures. METHOD From retrospective review of Taiwan's National Health Insurance Research Database, we enrolled 153,623 subjects aged 65 years and older with hospitalization for first hip fracture operated by IF (93,029 cases) or HA (60,594 cases) between 2000 and 2011. Postoperative mortality was compared between subjects with and without dementia after adjustments of age, gender, Charlson comorbidity index and hospital level. RESULTS The prevalence of dementia was 5.24% in the IF and 5.29% in the HA group. In the IF group, dementia increased adjusted hazard ratio of one-year (1.06, 95%CI:1.00-1.13) and two-year mortality (1.10, 95%CI:1.05-1.16). However, short and long-term mortality following HA was not significantly impacted by dementia (in-hospital OR:0.79, 95%CI:0.60-1.03; three-month HR:0.99, 95%CI:0.87-1.12; one-year HR:1.01, 95%CI:0.93-1.10; two-year HR:1.03, 95%CI:0.96-1.09). In a subgroup of dementia patients, mortality following IF was 15% higher than HA in one (p = 0.004) and two years (p < 0.001). The negative prognostic factors included female (HR:1.10; 95%CI:1.03-1.18) and aging 65-84 years (HR:1.15; 95%CI:1.00-1.32). CONCLUSION Dementia increased one and two-year mortality following geriatric hip fracture treated by IF, rather than HA. Dementia patients undergoing HA, especially female or 65-84 years old, sustained better one and two-year survival than those receiving IF.
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Affiliation(s)
- Yu-Cheng Lai
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Occupational Therapy, Shu Zen junior College of Medicine and Management, Kaohsiung, Taiwan; Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan.
| | - Pei-Ling Tang
- Research Center of Medical Informatics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Nursing, Meiho Unervisity, Pingtung, Taiwan; College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.
| | - Tsu-Jen Kuo
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, Taiwan; Department of Stomatology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; Department of Dental Technology, Shu-Zen junior College of Medicine and Management, Kaohsiung, Taiwan.
| | - Chien-Jen Hsu
- Department of Orthopedics, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan; School of Nursing, Fooyin University, Kaohsiung, Taiwan.
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Yu TY, Cho H, Kim TY, Ha YC, Jang S, Kim HY. Utilization of Osteoporosis-Related Health Services: Use of Data from the Korean National Health Insurance Database 2008-2012. J Korean Med Sci 2018; 33:e20. [PMID: 29215807 PMCID: PMC5729648 DOI: 10.3346/jkms.2018.33.e20] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2017] [Accepted: 09/30/2017] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Osteoporosis and its related fractures are increasingly being recognized as major health problems because of the rapidly increasing elderly population. In this study, we investigated the annual trend of osteoporosis-related health services utilization. METHODS Participants aged over 50 years were identified from the Korean National Health Insurance Service database between 2008 and 2012. Health service utilization rate and treatment rate were calculated through the operational definition. RESULTS In this period, the number of osteoporosis patients, aged over 50 years, using the medical service, increased by 33.2%. This increase was higher in males than in females. Moreover, the number of newly diagnosed osteoporosis patients increased by 4.3% in women and 20.4% in men. To estimate the proportion of osteoporosis patients who utilize medical services, we analyzed prevalence data from the Korea National Health and Nutrition Examination Survey from 2008 to 2010. Less than 60% of patients with osteoporosis were estimated to have utilized medical services because of osteoporosis. Drug treatment rates were 34.1%, 31.1%, and 33.5% in 2008, 2009, and 2010, respectively. CONCLUSION This study demonstrated an increasing trend in the utilization of the osteoporosis-related health services from 2008 to 2012 in Korea. The proportion of newly diagnosed osteoporosis patients and the prevalence of access to medical services increased more in men than in women. Therefore, an increasing need for prevention and treatment of male osteoporosis was observed. The osteoporosis treatment rate was lower than that for other chronic diseases; more efforts are needed to improve awareness regarding osteoporosis treatment.
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Affiliation(s)
- Tae Yang Yu
- Department of Internal Medicine, Wonkwang University School of Medicine, Iksan, Korea
| | - Hyemin Cho
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Tae Young Kim
- Department of Orthopaedic Surgery, Hallym University School of Medicine, Anyang, Korea
| | - Yong Chan Ha
- Department of Orthopaedic Surgery, Chung-Ang University College of Medicine, Seoul, Korea
| | - Sunmee Jang
- College of Pharmacy and Gachon Institute of Pharmaceutical Sciences, Gachon University, Incheon, Korea
| | - Ha Young Kim
- Department of Internal Medicine, Wonkwang University Sanbon Hospital, Gunpo, Korea.
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Kim MK, Kwon HS, Song KH, Kang MI, Baek KH. The Relationship of Serum Serotonin Levels to the Rate of Bone Loss and Fractures in Men. J Clin Densitom 2018; 21:35-40. [PMID: 27614420 DOI: 10.1016/j.jocd.2016.08.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Accepted: 08/16/2016] [Indexed: 11/22/2022]
Abstract
Recent genetic studies in rodents have revealed that circulating serotonin plays a key role in regulating bone formation and skeletal mass. However, the reported effects of circulating serotonin on bone mass in humans have been conflicting. We determined whether circulating serotonin levels influenced the rate of bone loss and fractures in men. We assessed the effect of serum serotonin on bone loss rate in a population-based cohort of 202 ambulatory men aged 56-70 years who were followed up for a median duration of 3.7 years. Serum serotonin levels were assayed, and the Timed Up and Go Test (TUGT) was performed, at baseline. Dual-energy X-ray absorptiometry was performed both at baseline and during follow-up. Fracture prevalence was assessed using questionnaires. The serotonin levels were inversely associated with the lumbar spine bone mineral density (r = -0.174, p = 0.028) at baseline. No association was evident between the bone mineral densities of the femoral neck or total hip and serotonin level. The annual rates of bone loss from the lumbar spine, the femoral neck, and the total hip were 0.01%, 0.46%, and 0.46%, respectively. The baseline serum serotonin level did not predict the bone loss rate in any skeletal site. Lower limb disability evident upon TUGT at baseline predicted bone loss from the total hip. No significant difference of serotonin level was observed between subjects with and without fractures. The serum serotonin level was not associated with the rate of bone loss in elderly men. Thus, the circulating serotonin level does not reliably predict bone loss.
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Affiliation(s)
- Mee Kyoung Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk-Sang Kwon
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Ho Song
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Moo-Il Kang
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Hyun Baek
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Lim Y, Jo K, Ha HS, Yim HW, Yoon KH, Lee WC, Son HY, Baek KH, Kang MI. The prevalence of osteoporosis and the rate of bone loss in Korean adults: the Chungju metabolic disease cohort (CMC) study. Osteoporos Int 2017; 28:1453-1459. [PMID: 28083665 DOI: 10.1007/s00198-016-3893-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2016] [Accepted: 12/18/2016] [Indexed: 12/23/2022]
Abstract
UNLABELLED Because the rate of bone loss is an important risk factor for fracture, we studied longitudinal changes in bone mineral density (BMD). Although the BMD of the hip decreased over time, spine BMD remained largely stable or increased. Therefore, spine BMD may not be appropriate for assessing BMD change. INTRODUCTION The rate of age-dependent bone loss has been shown to be an important risk factor for fracture. However, longitudinal rates of BMD loss in Korea have not yet been reported. The objective of this study was to evaluate longitudinal changes in BMD in Korea. METHODS This cohort study was performed in a population of individuals 40 years of age or older living in the rural area of Chungju City, Korea. A second BMD examination was conducted approximately 4 years after a baseline examination. A total of 3755 of the 6007 subjects completed the follow-up visit, corresponding to a follow-up rate of 62.51%. RESULTS The age-standardized osteoporosis prevalence was 12.81% in males and 44.35% in females. In males, the average annual BMD loss at the total hip increased from -0.25% per year in their 40s to -1.12% per year in their 80s. In females, the average annual BMD loss at the total hip increased from -0.69% per year in their 40s to -1.51% per year in their 80s. However, the average annual percentage change in spine BMD in females increased from -0.91% per year in their 40s to +1.39% per year in their 80s. CONCLUSIONS A substantial number of subjects had osteoporosis, even though we standardized the prevalence of osteoporosis. In total hip, the mean BMD was decreased during the follow-up period; in addition, the annual percentage loss increased with age. However, spine BMD remained approximately stable or increased over time and therefore may not be appropriate for assessing BMD change.
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Affiliation(s)
- Y Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - K Jo
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - H-S Ha
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - H-W Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
- Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - K-H Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - W-C Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - H-Y Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - K H Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea.
| | - M-I Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea.
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Choi HS, Park JH, Kim SH, Shin S, Park MJ. Strong familial association of bone mineral density between parents and offspring: KNHANES 2008-2011. Osteoporos Int 2017; 28:955-964. [PMID: 27747365 DOI: 10.1007/s00198-016-3806-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Accepted: 10/06/2016] [Indexed: 01/12/2023]
Abstract
UNLABELLED Bone mineral density (BMD) of offspring was significantly associated with their parents' BMD. Parental BMD Z-score ≤-1 was a significant predictor for BMD Z-score ≤-1 in their offspring. Peak bone mass acquisition during early adulthood is more substantially influenced by genetic factors rather than lifestyle or environmental factors. INTRODUCTION A person's BMD is affected by both genetic and environmental factors. Family history of osteoporosis or fragility fracture is a well-known risk factor for low bone mass or fracture. The purpose of the present study was to investigate the familial association of BMD between parents and offspring in Korean population. METHODS This is a cross-sectional study based on the data from the Korea National Health and Nutrition Examination Surveys (KNHANES) conducted from 2008 to 2011. A total of 5947 subjects (3135 parents and 2812 offspring) were included. RESULTS In age-adjusted partial correlation analyses, all BMD values acquired from the lumbar spine, femur neck, total hip, and whole body showed significant associations between parents and offspring. Among these associations, whole-body BMD showed the strongest relationship between offspring and parents. The narrow-sense heritability of BMD ranged from 0.203 to 0.542 in male offspring and from 0.396 to 0.689 in female offspring. Multiple linear regression analyses showed that offspring's BMD was independently associated with BMD of both parents after adjusting for covariates. Lifestyle or environmental factors including dietary calcium intake, serum 25-hydroxyvitamin D level, regular exercise, current smoking, and alcohol intake showed only moderate or no associations with BMD. In multiple logistic regression analyses in offspring aged 19-25 years, the son's risk of having BMD Z-score ≤-1 was associated with both parents' BMD Z-score ≤-1, while the daughter's risk was only associated with maternal BMD Z-score ≤-1. CONCLUSIONS Our findings confirm the strong familial association of BMD between parents and offspring in Korean population and suggest that peak bone mass acquisition during early adulthood is more substantially influenced by genetic factors rather than lifestyle or environmental factors.
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Affiliation(s)
- H S Choi
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Dongguk University Ilsan Hospital, Koyang, Gyeonggi-do, Korea
| | - J H Park
- Department of Statistics, Dongguk University, Seoul, Korea
| | - S H Kim
- Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, 761-1 Sanggye-7-dong, Nowon-gu, Seoul, 139-707, Korea
| | - S Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, 102 Daehak-ro, Jongro-gu, Seoul, 03080, Korea
- Institute of Environmental Medicine, Seoul National University Medical Research Center, 102 Daehak-ro, Jongro-gu, Seoul, 03080, Korea
| | - M J Park
- Department of Pediatrics, Sanggye Paik Hospital, Inje University College of Medicine, 761-1 Sanggye-7-dong, Nowon-gu, Seoul, 139-707, Korea.
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Lim Y, Kim K, Ko SH, Cho K, Jang EH, Lee SH, Lim DJ, Baek KH, Ha HS, Park MS, Yim HW, Lee WC, Yoon KH, Son HY, Oh KW, Kang MI. Gender- and age-group-specific associations between physical performance and bone mineral density, falls, and osteoporotic fractures in Koreans: the Chungju Metabolic Disease Cohort study. J Bone Miner Metab 2016; 34:336-46. [PMID: 26056017 DOI: 10.1007/s00774-015-0674-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2015] [Accepted: 04/08/2015] [Indexed: 10/23/2022]
Abstract
Several factors increase the risk of fragility fracture, including low bone mineral density, falls, and poor physical performance. The associations among these factors have been investigated; however, most of the subjects of previous studies were either elderly men or elderly women, and the associations were controversial. The aim of this study was to evaluate the associations between physical performance and bone mineral density, and the history of falls and fractures, stratified by gender and age group. We analyzed 5368 subjects who were aged 50 years or older, including 1288 younger men (younger than 70 years), 1615 younger women (younger than 70 years), 1087 older men (70 years or older), and 1378 older women (70 years or older). We used the one-leg standing time (OLST) for assessing static balance and the timed up-and-go test (TUGT) for assessing dynamic balance. The subjects in the worst performance quartile for the OLST were more likely to have osteoporosis than those in the best performance quartile. Additionally, women who had experienced a fracture during the past 2 years were 1.68 times more likely to be in the worst performance quartile for the OLST than women without a previous fracture. Although the TUGT time was not associated with either the incidence of osteoporosis or the fracture history, the odds ratios for falling were 1.51 and 1.28 as the TUGT time increased by one standard deviation in younger men and younger women, respectively. The findings of the present study show that the OLST was associated with the incidence of osteoporosis and previous fracture and that the TUGT time was associated with the incidence of falling.
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Affiliation(s)
- Yejee Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Kyunghee Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Sun-Hee Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Kwanhoon Cho
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Eun-Hee Jang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Dong Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Ki Hyun Baek
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Hee-Sung Ha
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Mi Sun Park
- Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Hyeon-Woo Yim
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
- Clinical Research Coordinating Center, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Won-Chul Lee
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 137-701, South Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Ho Young Son
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea
| | - Ki Won Oh
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 29 Saemunan-ro, Jongno-gu, Seoul, 110-746, South Korea
| | - Moo-Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, 222 Banpo-daero Seocho-gu, Seoul, 137-701, South Korea.
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Baeg MK, Yoon SK, Ko SH, Han KD, Choi HJ, Bae SH, Choi JY, Choi MG. Males seropositive for hepatitis B surface antigen are at risk of lower bone mineral density: the 2008–2010 Korea National Health and Nutrition Examination Surveys. Hepatol Int 2016; 10:470-7. [DOI: 10.1007/s12072-015-9672-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Accepted: 09/14/2015] [Indexed: 01/05/2023]
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Uras Y, Uysal Y, Arikan TA, Kop A, Caliskan M. Hydrogeochemistry of the drinking water sources of Derebogazi Village (Kahramanmaras) and their effects on human health. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2015; 37:475-490. [PMID: 25446040 DOI: 10.1007/s10653-014-9659-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 11/09/2014] [Indexed: 06/04/2023]
Abstract
The aim of this study was to investigate the sources of drinking water for Derebogazi Village, Kahramanmaras Province, Turkey, in terms of hydrogeochemistry, isotope geochemistry, and medical geology. Water samples were obtained from seven different water sources in the area, all of which are located within quartzite units of Paleozoic age, and isotopic analyses of (18)O and (2)H (deuterium) were conducted on the samples. Samples were collected from the region for 1 year. Water quality of the samples was assessed in terms of various water quality parameters, such as temperature, pH, conductivity, alkalinity, trace element concentrations, anion-cation measurements, and metal concentrations, using ion chromatography, inductively coupled plasma (ICP) mass spectrometry, ICP-optical emission spectrometry techniques. Regional health surveys had revealed that the heights of local people are significantly below the average for the country. In terms of medical geology, the sampled drinking water from the seven sources was deficient in calcium and magnesium ions, which promote bone development. Bone mineral density screening tests were conducted on ten females using dual energy X-ray absorptiometry to investigate possible developmental disorder(s) and potential for mineral loss in the region. Of these ten women, three had T-scores close to the osteoporosis range (T-score < -2.5).
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Affiliation(s)
- Yusuf Uras
- Geology Engineering Department, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey,
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Lee SH, Han K, Yang HK, Kim HS, Cho JH, Kwon HS, Park YM, Cha BY, Yoon KH. A novel criterion for identifying metabolically obese but normal weight individuals using the product of triglycerides and glucose. Nutr Diabetes 2015; 5:e149. [PMID: 25915739 PMCID: PMC4423196 DOI: 10.1038/nutd.2014.46] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2014] [Accepted: 12/07/2014] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES Metabolically obese but normal weight (MONW) individuals constitute a subgroup of normal weight individuals that display impaired insulin sensitivity with a higher risk of developing diabetes, cardiovascular disease and mortality. We aimed to propose a novel criterion for defining MONW by examining the usefulness and the cutoff value of the TyG index, a product of the levels of triglycerides and glucose, in identifying MONW individuals. In addition, the performance of this criterion in predicting the future incidence of diabetes was assessed. SUBJECTS/METHODS A total of 7541 non-diabetic, normal weight (body mass index ⩾18.5 and <25 kg m(-)(2)) subjects were selected from the Korea National Health and Nutrition Examination Survey conducted in 2009-2010. Another 3185 participants with follow-up studies were selected from a prospective community-based cohort study. The TyG index was calculated as ln(fasting triglycerides (mg dl(-1)) × fasting glucose (mg dl(-1))/2). RESULTS The levels of the TyG index paralleled the prevalence of metabolic syndrome and its components. The cutoff value of the TyG index that reflected MONW based on the receiver operating characteristics analysis was 8.82 for men and 8.73 for women, with the area under the curve values being 0.855 and 0.868, respectively. The sensitivity and the specificity were 84.2 and 77.6% in men and 69.1 and 89.4% in women, respectively. Individuals designated as MONW, who have a normal weight and TyG levels higher than cutoff, displayed a metabolically unhealthy phenotype and an approximately twofold higher risk of developing diabetes compared with metabolically healthy normal weight subjects. CONCLUSIONS We propose a simple diagnostic criterion of MONW, which might be used to discriminate subjects with a higher risk of metabolic diseases.
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Affiliation(s)
- S-H Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea
| | - K Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - H K Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea
| | - H-S Kim
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea
| | - J-H Cho
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea
| | - H-S Kwon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Yeouido St Mary's Hospital, Seoul, Korea
| | - Y-M Park
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - B-Y Cha
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea
| | - K-H Yoon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Seoul St Mary's Hospital, Seoul, Korea
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea. E-mail:
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Yang HK, Lee SH, Han K, Kang B, Lee SY, Yoon KH, Kwon HS, Park YM. Lower serum zinc levels are associated with unhealthy metabolic status in normal-weight adults: The 2010 Korea National Health and Nutrition Examination Survey. DIABETES & METABOLISM 2015; 41:282-290. [PMID: 25908414 DOI: 10.1016/j.diabet.2015.03.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2014] [Revised: 03/17/2015] [Accepted: 03/18/2015] [Indexed: 01/24/2023]
Abstract
AIM This study investigated whether serum zinc concentration is associated with glucose tolerance, insulin resistance and metabolic health status in Korean adults. METHODS Subjects with available serum zinc levels were recruited from the fifth Korea National Health and Nutrition Examination Survey (KNHANESV) cohort. Those in the highest quartile on homoeostasis model assessment for insulin resistance (HOMA-IR) and with a body mass index (BMI) of 18.5-25kg/m(2) were classified as metabolically obese and normal weight (MONW). RESULTS A total of 1813 subjects with a mean age of 45.2±0.5 years and a mean BMI of 24.01±0.11kg/m(2) were enrolled. Those in the lower serum zinc quartiles exhibited higher levels of fasting blood glucose and insulin resistance indices compared with those in the higher quartiles. However, these associations were positive only in normal-weight subjects. Those categorized as MONW exhibited significantly lower serum zinc levels than the metabolically healthy and normal weight (MHNW) subjects (131.6±3.0μg/dL vs 141.7±2.8μg/dL, respectively; P=0.0026), whereas serum zinc levels did not differ according to metabolic health in obese subjects. The odds ratio for being categorized as MONW was 4.12 (95% CI: 1.75, 9.72) among those in the lowest serum zinc quartile compared with those in the highest quartile even after adjusting for possible confounding factors. CONCLUSION Lower serum zinc levels were associated with unhealthy metabolic status in normal-weight adults. Further prospective studies are required to define the role of zinc in metabolic health.
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Affiliation(s)
- H K Yang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, Republic of Korea
| | - S H Lee
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, Republic of Korea
| | - K Han
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - B Kang
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, Republic of Korea
| | - S Y Lee
- Division of AIDS, Center for Immunology and Pathology, National Institute of Health, Korea Centers for Disease Control and Prevention, Seoul, Republic of Korea
| | - K H Yoon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, Republic of Korea
| | - H S Kwon
- Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea; Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, #62 Yeouido-dong, Youngdeungpo-gu, 150-713, Seoul, Korea.
| | - Y M Park
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, 915, Greene Street, 29208 Columbia, SC, USA.
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Lee S, Choi MG, Yu J, Ryu OH, Yoo HJ, Ihm SH, Kim DM, Hong EG, Park K, Choi M, Choi H. The effects of the Korean reference value on the prevalence of osteoporosis and the prediction of fracture risk. BMC Musculoskelet Disord 2015; 16:69. [PMID: 25886842 PMCID: PMC4382837 DOI: 10.1186/s12891-015-0523-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Accepted: 03/06/2015] [Indexed: 12/02/2022] Open
Abstract
Background Since the reference value is the core factor of the T-score calculation, it has a significant impact on the prevalence of osteoporosis. The purpose of this study was to determine the effects of using the Korean reference value on the prevalence of osteoporosis and on the prediction of fracture risk. Methods We used femoral neck bone mineral density (BMD) data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008–2011. The Korean reference was identified by the mean and standard deviation of men and women aged 20–29 years. We compared the prevalence and the fracture risk assessment tool (FRAX™) probability obtained from the Korean reference and the NHANES III reference. Results In men, the prevalence of osteoporosis increased when using the Korean men’s reference, and the difference increased up to 9% for those in their 80s. In women, the prevalence increased when using the NHANES III reference, and the difference increased up to 17% for those in their 80s. The reference value also affected the fracture risk probability, and the difference from changing the reference value increased in women and in subjects with more clinical fracture risk factors. In major osteoporotic fractures, the difference of the risk probability was up to 6% in women aged 70–79 years with two clinical risk factors. For femoral neck fractures, the difference was up to 7% in women aged 50–59 years with two clinical risk factors. Conclusions We confirmed that the reference value had significant effects on the prevalence of osteoporosis and on the fracture risk probability. The KNHANES 2008–2011 BMD data reflected the characteristics of the Korean BMD status well with regard to data size and study design; therefore, these data can be used as reference values.
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Affiliation(s)
- Sungwha Lee
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym Medical University, Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, South Korea.
| | - Moon-Gi Choi
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym Medical University, Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, South Korea.
| | - Jaemyung Yu
- Department of Internal Medicine, Gangnam Sacred Heart Hospital, Hallym Medical University, 1, Singil-ro, Seoul, 150-950, Yeongdeungpo-gu, South Korea.
| | - Ohk-Hyun Ryu
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym Medical University, Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, South Korea.
| | - Hyung Joon Yoo
- Department of Internal Medicine, Gangnam Sacred Heart Hospital, Hallym Medical University, 1, Singil-ro, Seoul, 150-950, Yeongdeungpo-gu, South Korea.
| | - Sung-Hee Ihm
- Department of Internal Medicine, Hallym University Sacred Heart Hospital, 22, Gwanpyeong-ro 170 beon-gil, Dongan-gu, Anyang-si, 431-796, Gyeonggi-do, South Korea.
| | - Doo-Man Kim
- Department of Internal Medicine, Kangdong Sacred Heart Hospital, Hallym Medical University, 150, Seongan-ro, Seoul, 134-701, Gangdong-gu, South Korea.
| | - Eun-Gyung Hong
- Department of Internal Medicine, Dongtan Sacred Heart Hospital, Hallym Medical University, 7, Keunjaebong-gil, Hwaseong-si, 445-907, Gyeonggi-do, South Korea.
| | - Kyutae Park
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym Medical University, Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, South Korea.
| | - Myungjin Choi
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym Medical University, Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, South Korea.
| | - Hyunhee Choi
- Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Hallym Medical University, Chuncheon Sacred Heart Hospital, 77, Sakju-ro, Chuncheon-si, Gangwon-do, South Korea.
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Biomechanical rationale for implant choices in femoral neck fracture fixation in the non-elderly. Injury 2015; 46:445-52. [PMID: 25597514 DOI: 10.1016/j.injury.2014.12.031] [Citation(s) in RCA: 99] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Revised: 12/01/2014] [Accepted: 12/13/2014] [Indexed: 02/02/2023]
Abstract
Femoral neck fractures represent a relatively uncommon injury in the non-elderly population often resulting from high-energy trauma. The cornerstone of their management is anatomic reduction and stable internal fixation of the femoral neck in an attempt to salvage the femoral head. Complications including avascular necrosis of the femoral head, non-union and post-traumatic osteoarthritis are not uncommon. The clinical outcomes of these patients can be improved with good pre-operative planning, optimization of surgical procedures and introduction of new improved implants and techniques. In the herein study, we attempt to describe the biomechanical properties of the hip and compare the performance of the most commonly used devices. Experimental evidence suggests that in Pauwels type III fracture patterns a cephalomedullary nail was significantly stronger in axial loading. Moreover, in unstable basicervical patterns cannulated screws (triangular configuration) demonstrated a lower ultimate load to failure, whereas in subcapital or transervical patterns both the cannulated screws (triangular configuration) and the sliding hip screw demonstrated no compromise in fixation strength. The fracture pattern appears to be the major determinant of the ideal type of implant to be selected. For a successful outcome each patient needs to be considered on an individual basis taking into account all patient and implant related factors.
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Moon SS, Lee YS. Prevalence and clinical characteristics of blepharoptosis in patients with diabetes in the Korea National Health and Nutrition Examination Survey (KNHANES) 2009-2010. Endocrine 2015; 48:504-10. [PMID: 24839195 DOI: 10.1007/s12020-014-0279-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Accepted: 04/25/2014] [Indexed: 12/01/2022]
Abstract
We investigated the prevalence and clinical characteristics of ptosis in patients with diabetes in the general Korean population. This cross-sectional study is based on data from the fourth and fifth Korea National Health and Nutrition Examination Surveys , conducted in 2009 and 2010 among members of the Korean population. Participants included 5,811 males and 7,650 females 20 years of age or older. Ptosis was defined as the marginal reflex distance 1 of <2 mm. Homeostatic model assessment of insulin resistance was calculated in participants without diabetes. HbA1c was measured and diabetic retinopathy was defined in participants with diabetes by ophthalmologic examination. The prevalence of ptosis was 20.8 and 9.4 % among participants with diabetes (n = 1,379) and those without diabetes (n = 12,082), respectively. Results of multiple regression analyses of the correlation between ptosis and the study variables showed that diabetes was a significant determinant in the general population. Patients with diabetes and ptosis had longer duration of diabetes (7.49 ± 0.51 vs. 6.19 ± 0.23 years, P = 0.012), higher serum creatinine level (80.4 ± 1.76 vs. 76.9 ± 0.88 mmol/l, P = 0.009), and higher prevalence of hypertension (60.3 vs. 47.9 %, P < 0.001), and were older (67.0 ± 0.6 vs. 60.5 ± 0.4 years, P < 0.001) compared to those without ptosis. Prevalence of ptosis was found to be remarkably higher in subjects with diabetes compared to those without diabetes. Diabetes is an independent risk factor for ptosis in the general Korean population. Screening for ptosis is warranted for patients with diabetes and longer duration, higher serum creatinine, hypertension, and old age.
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Affiliation(s)
- Seong-Su Moon
- Department of Internal Medicine, Dongguk University College of Medicine, Dongdae-ro 87, Gyeongju, Gyeongbuk , South Korea, 780-350,
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Kim MK, Yun KJ, Kim MH, Lim DJ, Kwon HS, Song KH, Kang MI, Baek KH. The effects of thyrotropin-suppressing therapy on bone metabolism in patients with well-differentiated thyroid carcinoma. Bone 2015; 71:101-5. [PMID: 25445448 DOI: 10.1016/j.bone.2014.10.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Revised: 10/01/2014] [Accepted: 10/12/2014] [Indexed: 10/24/2022]
Abstract
Studies on the effects of levothyroxine (LT4) therapy on bone and bone metabolism have yielded conflicting results. This 1-year prospective study examined whether LT4 in patients with well-differentiated thyroid carcinoma (DTC) is a risk factor for bone mass loss and the subsequent development of osteoporosis. We examined 93 patients with DTC over 12months after initiating LT4 therapy (early postoperative period). We examined another 33 patients on long-term LT4 therapy for DTC (late postoperative period). Dual energy X-ray absorptiometry was performed at baseline and after 1year. The mean bone losses during the early postoperative period in the lumbar spine, femoral neck, and total hip, calculated as the percentage change between levels at baseline and 12months, were -0.88, -1.3 and -0.81%, respectively. Bone loss was more evident in postmenopausal women (lumbar spine -2.1%, femoral neck -2.2%, and hip -2.1%; all P<0.05). We compared the changes in annual bone mineral density (BMD) in postmenopausal women according to calcium/vitamin D supplementation. Bone loss tended to be higher in the postmenopausal women receiving no supplementation. There was no decrease in BMD among patients during the late postoperative period. The mean bone loss was generally greater in the early than in the late postoperative group, and this was significant at the lumbar spine (P=0.041) and femoral neck (P=0.010). TSH-suppressive levothyroxine therapy accelerates bone loss, predominantly in postmenopausal women and exclusively during the early post-thyroidectomy period.
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Affiliation(s)
- Mee Kyoung Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-Jin Yun
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Min-Hee Kim
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong-Jun Lim
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyuk-Sang Kwon
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki-Ho Song
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Moo-Il Kang
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ki Hyun Baek
- Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
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Kim SR, Han K, Choi JY, Ersek J, Liu J, Jo SJ, Lee KS, Yim HW, Lee WC, Park YG, Lee SH, Park YM. Age- and sex-specific relationships between household income, education, and diabetes mellitus in Korean adults: the Korea National Health and Nutrition Examination Survey, 2008-2010. PLoS One 2015; 10:e0117034. [PMID: 25622031 PMCID: PMC4306546 DOI: 10.1371/journal.pone.0117034] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 12/17/2014] [Indexed: 02/03/2023] Open
Abstract
Background To investigate the effects of age and sex on the relationship between socioeconomic status (SES) and the prevalence and control status of diabetes mellitus (DM) in Korean adults. Methods Data came from 16,175 adults (6,951 men and 9,227 women) over the age of 30 who participated in the 2008-2010 Korea National Health and Nutrition Examination Survey. SES was measured by household income or education level. The adjusted odds ratios (ORs) and corresponding 95% confidence intervals (95% CI) for the prevalence or control status of diabetes were calculated using multiple logistic regression analyses across household income quartiles and education levels. Results The household income-DM and education level-DM relationships were significant in younger age groups for both men and women. The adjusted ORs and 95% CI for diabetes were 1.51 (0.97, 2.34) and 2.28 (1.29, 4.02) for the lowest vs. highest quartiles of household income and education level, respectively, in women younger than 65 years of age (both P for linear trend < 0.05 with Bonferroni adjustment). The adjusted OR and 95% CI for diabetes was 2.28 (1.53, 3.39) for the lowest vs. highest quartile of household income in men younger than 65 (P for linear trend < 0.05 with Bonferroni adjustment). However, in men and women older than 65, no associations were found between SES and the prevalence of DM. No significant association between SES and the status of glycemic control was detected. Conclusions We found age- and sex-specific differences in the relationship of household income and education with the prevalence of DM in Korea. DM preventive care is needed for groups with a low SES, particularly in young or middle-aged populations.
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Affiliation(s)
- So-Ra Kim
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Jin-Young Choi
- Catholic Medical Center, The Catholic University of Korea, Seoul, Korea
| | - Jennifer Ersek
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina, Columbia, South Carolina, United States of America
| | - Junxiu Liu
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina, Columbia, South Carolina, United States of America
| | - Sun-Jin Jo
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kang-Sook Lee
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyeon Woo Yim
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Won-Chul Lee
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong Gyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St.Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail: (YMP); (SHL)
| | - Yong-Moon Park
- Graduate School of Public Health, The Catholic University of Korea, Seoul, Korea
- Department of Preventive Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, The University of South Carolina, Columbia, South Carolina, United States of America
- * E-mail: (YMP); (SHL)
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Kim Y, Kim JH, Cho DS. Gender Difference in Osteoporosis Prevalence, Awareness and Treatment: Based on the Korea National Health and Nutrition Examination Survey 2008~2011. J Korean Acad Nurs 2015; 45:293-305. [DOI: 10.4040/jkan.2015.45.2.293] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yunmi Kim
- College of Nursing, Eulji University, Seongnam, Korea
| | - Jung Hwan Kim
- Department of Family Medicine, Eulji Hospital, Seoul, Korea
| | - Dong Sook Cho
- College of Nursing, Eulji University, Seongnam, Korea
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Kim HJ, Oh YK, Lee JS, Lee DY, Choi D, Yoon BK. Effect of transdermal estrogen therapy on bone mineral density in postmenopausal korean women. J Menopausal Med 2014; 20:111-7. [PMID: 25580422 PMCID: PMC4286655 DOI: 10.6118/jmm.2014.20.3.111] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 10/30/2014] [Accepted: 11/25/2014] [Indexed: 12/26/2022] Open
Abstract
Objectives To evaluate the effects of transdermal estrogen therapy on bone mineral density (BMD) in postmenopausal Korean women. Methods A total of 149 healthy postmenopausal women were retrospectively evaluated: 100 were on hormone therapy (HT) and 49 were the control group. For the HT group, 54 applied estrogen transdermally using either a patch (n = 21) or gel (n = 33), and 46 took estrogen orally (conjugated estrogen 0.625 mg or equivalent). Demographic profiles and changes in BMD over two years were compared according to the route of the estrogen. Results No differences were found in age, age at menopause, parity, body mass index, and type of menopause among the oral, transdermal and control groups. Compared with controls, HT significantly increased BMD after 2 years in both the lumbar spine and the total hip. The increases in BMD at both lumbar spine and hip were comparable between the oral and transdermal groups. There were also no differences in BMD changes according to progestogen addition in either the oral or transdermal groups. Conclusion Transdermal estrogen therapy increases BMD, comparable to oral estrogen, in postmenopausal Korean women.
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Affiliation(s)
- Hyo Jeong Kim
- Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoon Kyung Oh
- Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Soo Lee
- Center for Health Promotion, Samsung Medical Center, Seoul, Korea
| | - Dong-Yun Lee
- Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - DooSeok Choi
- Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Byung-Koo Yoon
- Department of Obstetrics, Gynecology and Women's Health, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Lee KS, Bae SH, Lee SH, Lee J, Lee DR. New reference data on bone mineral density and the prevalence of osteoporosis in Korean adults aged 50 years or older: the Korea National Health and Nutrition Examination Survey 2008-2010. J Korean Med Sci 2014; 29:1514-22. [PMID: 25408583 PMCID: PMC4234919 DOI: 10.3346/jkms.2014.29.11.1514] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2014] [Accepted: 07/28/2014] [Indexed: 11/20/2022] Open
Abstract
This cross-sectional study was performed to investigate the reference values for bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA) and the prevalence of osteoporosis in the Korean population by applying domestic reference data. In total, 25,043 Korean adults ≥20 yr of age (11,792 men and 13,251 women) participated in the study. The BMDs of the total hip, femoral neck, and lumbar spine were measured by DXA (Discovery-W, Hologic Inc.), and subjects with a BMD - 2.5 standard deviations or lower than the mean BMD for young adults (20-29 yr old) were considered to have osteoporosis. When applying the new reference values determined in this study from Korean subjects, the overall prevalence of osteoporosis increased in men aged ≥50 yr compared with that provided by the DXA manufacturer from Japanese subjects (12.2% vs. 7.8%, P<0.001) and decreased in postmenopausal women aged ≥50 yr (32.9% vs. 38.7%, P<0.001). According to the findings of this study, use of the reference values provided by the DXA manufacturer has resulted in the underdiagnosis of osteoporosis in Korean men and the overdiagnosis of osteoporosis in Korean women. Our data will serve as valuable reference standards for the diagnosis and management for osteoporosis in the Korean population.
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Affiliation(s)
- Kyung-Shik Lee
- Department of Family Medicine, Bundang Jesaeng Hospital, Seongnam, Korea
| | - Su-Hyun Bae
- Department of Family Medicine, Ajou University Hospital, Suwon, Korea
| | - Seung Hwa Lee
- Department of Family Medicine, Ajou University Hospital, Suwon, Korea
| | - Jungun Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
| | - Dong Ryul Lee
- Department of Family Medicine, Wonkwang University Sanbon Hospital, Wonkwang University School of Medicine, Gunpo, Korea
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Lee WY. Brief review of articles in 'endocrinology and metabolism' in 2013. Endocrinol Metab (Seoul) 2014; 29:251-6. [PMID: 25309783 PMCID: PMC4192822 DOI: 10.3803/enm.2014.29.3.251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Won-Young Lee
- Department of Endocrinology and Metabolism, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
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50
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Affiliation(s)
- Se Hwa Kim
- Department of Internal Medicine, Kwandong University College of Medicine, Incheon, Korea
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