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Nirmal D, Abdul S, Jaiswal P, Naunihal Singh S, Avaragollapuravarga Mathada A, Nagaraj P. Effect of duration of sodium valproate therapy on bone mineral density and vitamin D levels. Epilepsy Behav 2024; 153:109733. [PMID: 38447300 DOI: 10.1016/j.yebeh.2024.109733] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 02/29/2024] [Accepted: 02/29/2024] [Indexed: 03/08/2024]
Abstract
OBJECTIVE This study aimed to evaluate the impact of prolonged sodium valproate use on bone mineral density (BMD) and Vitamin D levels in pediatric epilepsy patients. METHODS In a cross-sectional study conducted at the Epilepsy Clinic of Niloufer Hospital, Hyderabad, India, 50 pediatric patients (aged 4-10 years) were recruited. The cohort comprised 30 epilepsy patients on sodium valproate treatment (cases) and 20 healthy siblings without epilepsy or valproate use (controls). BMD was assessed using dual-energy X-ray absorptiometry to measure height-adjusted total body less head Z-scores (TBLH Z-scores), and serum 25-hydroxyvitamin D levels were measured. Statistical analysis included independent samples t-tests, Mann-Whitney U tests, and Pearson correlation, with a preliminary power analysis ensuring adequate sample size. RESULTS Cases exhibited significantly lower BMD TBLH Z-scores (Mean = -1.543) compared to controls (Mean = 0.515, p <.001) and reduced Vitamin D levels (Mean = 9.17 for cases vs. 27.80 for controls, p <.001). A negative correlation was observed between the duration of sodium valproate use and both BMD Z-scores (r = -0.626, p <.001) and Vitamin D levels (r = -0.707, p <.001). CONCLUSIONS The findings suggest a significant negative impact of prolonged sodium valproate use on both bone density and Vitamin D levels in pediatric patients. These results underscore the importance of monitoring and managing bone health in children receiving long-term sodium valproate therapy.
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Affiliation(s)
- Dinesh Nirmal
- Niloufer Hospital for Women and Children, Hyderabad, India.
| | - Samee Abdul
- Niloufer Hospital for Women and Children, Hyderabad, India
| | | | | | | | - Preeti Nagaraj
- Niloufer Hospital for Women and Children, Hyderabad, India
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Marchasson G, Philippoteaux C, Legroux-Gérot I, Hélène B, Cortet B, Paccou J. Bone mineral density T-scores comparison between obese and non-obese individuals included in a Fracture Liaison Service following a recent fragility fracture. Arch Osteoporos 2024; 19:20. [PMID: 38520592 DOI: 10.1007/s11657-024-01379-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 03/14/2024] [Indexed: 03/25/2024]
Abstract
We used data from a Fracture Liaison Service to compare the mean T-scores of obese and non-obese patients after a recent fragility fracture. After adjusting for age, sex, and diabetes mellitus, T-score values were significantly higher at all measurement sites in obese patients, with a mean difference of 1 SD. PURPOSE This study aimed to compare the mean T-scores of obese and non-obese patients after recent fragility fractures. METHODS Over a period of 5 and a half years, from January 2016 to May 2021, patients from a fracture liaison service were identified and their demographic characteristics, osteoporosis risk factors, BMD T-scores, and fracture sites were compared between obese (BMI ≥ 30 kg/m2) and non-obese (19 kg/m2 < BMI < 30 kg/m2) patients. RESULTS A total of 712 patients were included (80.1% women; mean age 73.8 ± 11.3 years). Sixteen % had type 2 diabetes mellitus and 80% had a major osteoporotic fracture (MOF). 135 patients were obese and 577 non-obese, with obese patients younger (p < 0.001) and more frequently female (p = 0.03). Obese patients presented with fewer hip fractures (10% vs. 21%, p = 0.003) and more proximal humerus fractures (16% vs. 7%, p < 0.001) than non-obese patients. After adjusting for age, sex, and diabetes mellitus, BMD T-score values were significantly higher at all measurement sites (lumbar spine, total hip, and femoral neck) in obese patients than in non-obese patients for all types of fractures, with a mean difference of 1 standard deviation (p < 0.001 for all comparisons). The same results were observed in the population limited to MOF. CONCLUSIONS Given the crucial role of BMD T-score in determining the need for anti-osteoporotic medication following fragility fractures, it is reasonable to question the existing T-score thresholds in obese patients.
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Affiliation(s)
- Gauthier Marchasson
- Department of Rheumatology, Univ. Lille, CHU Lille, Lille University Hospital, 59000, Lille, France
| | - Cécile Philippoteaux
- Department of Rheumatology, Univ. Lille, CHU Lille, Lille University Hospital, 59000, Lille, France
| | - Isabelle Legroux-Gérot
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France
| | - Béhal Hélène
- Department of Biostatistics, CHU Lille, 59000, Lille, France
| | - Bernard Cortet
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France
| | - Julien Paccou
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France.
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Slutzky-Shraga I, Hirsch D, Gorshtein A, Masri-Iraqi H, Shochat T, Robenshtok E, Shimon I, Tsvetov G. Features of patients and fracture risk in hypoparathyroidism; a single center study. J Endocrinol Invest 2024; 47:593-601. [PMID: 37610611 DOI: 10.1007/s40618-023-02177-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Accepted: 08/16/2023] [Indexed: 08/24/2023]
Abstract
PURPOSE Patients with hypoparathyroidism (hypoPT) have low bone turnover and high bone mineral density (BMD). However, data on fracture risk are conflicting. The objectives of this study were: 1. To describe clinical/biochemical characteristics of hypoPT patients followed at a single medical center. 2. To identify postsurgical hypoPT patients and investigate their fracture rate compared with gender/age-matched post-surgical normocalcemic patients. METHODS Retrospective analysis of patient's medical records treated at the tertiary medical center in 2010-2021 identified by computerized medical database search. RESULTS The cohort included 133 patients (91% women, mean age 64 ± 13 years) of whom 105 (79%) had post-thyroidectomy hypoparathyroidism and the remainder had an autoimmune/idiopathic/other etiology. Mean follow-up time was 21 ± 12 and 27 ± 12 years, respectively. The control group included 142 post-thyroidectomy patients without hypoparathyroidism. Patients in the postsurgical hypoparathyroidism group were older and had higher calcium and PTH levels at diagnosis than the non-surgical hypoPT patients. Comparing the postsurgical hypoPT and postsurgical normocalcemic control patients revealed a significantly higher BMD in the hypoPT group. Yet, fracture rates were 31% in the postsurgical hypoparathyroidism group and 21% in the control group (P = 0.1) over a similar median follow-up period (17 and 18.4 years, respectively). In both groups the most common fracture site was the spine (50% and 70%, respectively; p = 0.33), mainly nonclinical morphometric fractures. Higher phosphorus blood level was associated with increased fracture risk. CONCLUSIONS The relatively high BMD in patients with postsurgical hypoparathyroidism is not associated with lower fracture risk. Silent morphometric fractures are quite common in this group of patients.
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Affiliation(s)
- I Slutzky-Shraga
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel.
- Clalit Healthcare Services, Yaffo District, Tel Aviv, Israel.
- Department of Endocrinology, Diabetes & Metabolism, Rabin Medical Center - Beilinson Hospital, 39 Jabotinski St., 4941492, Petach Tikva, Israel.
| | - D Hirsch
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - A Gorshtein
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - H Masri-Iraqi
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - T Shochat
- Statistical Consulting Unit, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
| | - E Robenshtok
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - I Shimon
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - G Tsvetov
- Institute of Endocrinology, Diabetes and Metabolism, Rabin Medical Center - Beilinson Hospital, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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Ewen AM, Jeldi AJ, Welsh F, Picard F. No changes in bone mineral density following total knee arthroplasty using an all-polyethylene tibial component. Eur J Orthop Surg Traumatol 2024; 34:1057-1064. [PMID: 37907769 DOI: 10.1007/s00590-023-03762-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 10/06/2023] [Indexed: 11/02/2023]
Abstract
PURPOSE Polyethylene particles produced from metal-backed tibial (MBT) implants are understood to contribute to bone loss and component loosening. This, along with advanced surgical techniques, improved materials and increasing costs, has renewed interest in all-polyethylene tibias (APTs). We investigated peri-APT bone mineral density (BMD) in patients, expecting to find no differences between two post-operative values. METHODS Patients over 65 years, with BMI ≤ 37.5 kg/m2 and no previous joint replacements were recruited to have computer-navigated total knee arthroplasty using an APT. The study cohort (n = 27) had mean age of 71.9 (SD 4.35) and BMI of 31.2 (SD 3.8). The BMD examinations were performed 6 weeks and 18 months post-operatively. Six regions of interest (ROI) were identified on anterior/posterior and lateral dual-energy X-ray absorptiometry scans. For each ROI, BMD relative differences (RDs) were determined between limbs and RDs at the two time points were compared. RESULTS No differences were found between the RDs for any ROI. No revisions or complications were reported. At 18 months post-operatively, 79.2% of the cohort were very satisfied or satisfied with the outcome of their surgery and Oxford Knee Scores improved significantly compared to pre-operatively (p < 0.001). Mean knee range of motion was 102° (SD 10.7°), and mean leg alignment was 2.0° valgus (1-6°valgus). CONCLUSION Results from BMD analysis suggest that implants were well fixated without compromising function. We believe that using APTs with computer navigation is a viable cheaper option to MBTs for patients who are less active, have lower BMI and good bone quality.
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Affiliation(s)
- Alistair M Ewen
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK.
| | - Artaban J Jeldi
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK
| | - Findlay Welsh
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK
| | - Frederic Picard
- Golden Jubilee National Hospital, Agamemnon Street, Clydebank, G81 4DY, UK
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Rupel K, Dal Broi C, Ottaviani G, Bellassai L, Bogdan Preda TM, Di Lenarda R, Biasotto M. Changes in mandibular radiomorphometric indices in osteoporosis patients treated with denosumab: a retrospective case-control study. BMC Oral Health 2024; 24:89. [PMID: 38229055 DOI: 10.1186/s12903-024-03870-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 01/06/2024] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND Radiomorphometric indices measured on Dental Panoramic Radiography (DPR) can reflect Bone Mineral Density (BMD). The aim of our study is to evaluate changes in DPR radiographic markers in patients undergoing antiresorptive therapy with denosumab and correlate them to BMD and serum bone turnover markers (BTM). METHODS We evaluated two radiomorphometric indices: Mandibular Cortical Width (MCW) and Panoramic Mandibular Index (PMI), in patients undergoing antiresorptive therapy with denosumab at T0 (before starting the therapy) and at T1 (after 12 months), comparing results with a control group of healthy patients who performed two DPRs at a one-year time distance. Correlation analysis was performed in the denosumab group, as well as ROC curves were obtained for both indices. RESULTS The study included 18 patients and 21 controls according to specific inclusion and exclusion criteria, matched by gender and age. Both MCW and PMI were significantly lower at T0 in the denosumab group, consistently with lower BMD. MCW showed significant correlation with femoral and lumbar DEXA and was significantly lower in patients with osteoporosis compared to osteopenia. Only PMI index increased significantly in the denosumab group from T0 to T1. After one year (T1), there weren't any differences between patients and controls for both indices. No significant correlations were found with BTMs. Sensitivity and specificity for MCW and PMI were also calculated. CONCLUSIONS Our results show how CMW shows sufficient sensitivity and specificity to be used as a radiographic marker to screen and intercept patients with osteoporosis. PMI seems to be able to reflect changes in response to antiresorptive therapy with denosumab. Further studies are needed to confirm our hypothesis.
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Affiliation(s)
- Katia Rupel
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy.
| | - Chiara Dal Broi
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | - Giulia Ottaviani
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | - Laura Bellassai
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | | | - Roberto Di Lenarda
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
| | - Matteo Biasotto
- Department of Medicine, Surgery and Health Sciences, University of Trieste, Strada di Fiume, n 447 - 34129, Trieste, Italy
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Kim S, Kim H, Lee I, Choi E, Baek J, Lee J, Kim HR, Yun BH, Choi YS, Seo SK. Effects of Hormone Replacement Therapy on Bone Mineral Density in Korean Adults With Turner Syndrome. J Korean Med Sci 2024; 39:e9. [PMID: 38193328 PMCID: PMC10782041 DOI: 10.3346/jkms.2024.39.e9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/16/2023] [Indexed: 01/10/2024] Open
Abstract
BACKGROUND Turner syndrome (TS) is a common chromosomal abnormality, which is caused by loss of all or part of one X chromosome. Hormone replacement therapy in TS is important in terms of puberty, growth and prevention of osteoporosis however, such a study has never been conducted in Korea. Therefore, the purpose of our study was to determine relationship between the starting age, duration of estrogen replacement therapy (ERT) in TS and develop a hormone replacement protocol suitable for the situation in Korea. METHODS This is retrospective study analyzed the medical records in TS patients treated at the Severance hospital, Yonsei University College of Medicine, Seoul, Korea from 1997 to 2019. Total of 188 subjects who had received a bone density test at least once were included in the study. Korean National Health and Nutrition Examination Survey (KNHANES) was used for achieving bone mineral density (BMD) of normal control group. Student's t-test, Mann-Whitney U test, ANOVA and correlation analysis were performed using SPSS 18.0. RESULTS Each BMD measurement was significantly lower in women with TS than in healthy Korean women. Early start and longer duration of ERT is associated with higher lumbar spine BMD but not femur neck BMD. Femur neck BMD, but not lumbar spine BMD was significantly higher in women with mosaicism than 45XO group. CONCLUSION Early onset and appropriate duration of hormone replacement therapy is important for increasing bone mineral density in patients with Turner syndrome. Also, ERT affects differently to TS patients according to mosaicism.
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Affiliation(s)
- SunYoung Kim
- Dream Foret Obstetrics and Gynecology, Jeju, Korea
| | - Heeyon Kim
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Inha Lee
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
- Department of Obstetrics and Gynecology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Euna Choi
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - JinKyung Baek
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jaekyung Lee
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Hae-Rim Kim
- Department of Statistics, University of Seoul, Seoul, Korea
| | - Bo Hyon Yun
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Young Sik Choi
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea
| | - Seok Kyo Seo
- Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
- Institute of Women's Life Medical Science, Yonsei University College of Medicine, Seoul, Korea.
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Hassan AB, Tayem YI, Sadat-Ali M, Almarabheh AJ, Alawadhi A, Butt AJ, Jahrami H, Saleh J, Matar ME, Shaikh M, Hasan SK, Karashi AR. The estimated prevalence of osteoporosis in Bahrain: a multi-centered-based study. BMC Musculoskelet Disord 2024; 25:9. [PMID: 38167308 PMCID: PMC10759480 DOI: 10.1186/s12891-023-07145-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 12/21/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES the primary aim of this study was to examine the prevalence and risk factors of low bone mineral density in Bahrain. METHODS this was a retrospective study, which targeted a cohort of 4822 Bahraini subjects (mean age 59.36 years: 93% females). Demographic data and results of lumbar and femur DEXA scan for the targeted sample, over the period 2016-2018, were retrieved from four hospitals. RESULTS The prevalence of low BMD was 62.3% (46.4% had osteopenia and 15.9% had osteoporosis). The highest rate of osteopenia was detected at the age group younger than 44 years. However, with increasing age, the rate of osteopenia declined, whereas osteoporosis increased (P < 0.001). Females were found to be at higher risk of developing both osteopenia (45.8%) and osteoporosis (18.1%) compared to males (39% and 12.4%, respectively) (P < 0.001). Postmenopausal women exhibited higher rates of low BMD (42.4% osteopenia, 22.3% osteoporosis) compared to elderly men (30.9% osteopenia, 9% osteoporosis). CONCLUSIONS We reported high prevalence of osteopenia and osteoporosis in Bahrain. Low BMD was more common in females, especially in postmenopausal women. Highest prevalence of osteopenia happened at young age. Therefore, we advocate screening at younger age than previously recommended.
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Affiliation(s)
- Adla Bakri Hassan
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain.
- King Abdullah Medical City, Manama, Kingdom of Bahrain.
| | - Yasin I Tayem
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | - Mir Sadat-Ali
- King Abdullah Medical City, Manama, Kingdom of Bahrain
| | - Amer J Almarabheh
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
| | | | - Ahsan J Butt
- King Hamad University Hospital, Manama, Kingdom of Bahrain
| | - Haitham Jahrami
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- Psychiatric Hospital, Government Hospitals, Manama, Kingdom of Bahrain
| | - Jamal Saleh
- Orthocare, Orthopaedic Centre, Manama, Kingdom of Bahrain
| | - Mai E Matar
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- King Abdullah Medical City, Manama, Kingdom of Bahrain
| | - Mansoor Shaikh
- Orthocare, Orthopaedic Centre, Manama, Kingdom of Bahrain
| | - Salman K Hasan
- King Hamad University Hospital, Manama, Kingdom of Bahrain
| | - Ali R Karashi
- College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Kingdom of Bahrain
- Salmaniya Medical Complex, Government Hospitals, Manama, Kingdom of Bahrain
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Tanner SB, Krueger D, Szalat A, Prout T, Lau A, Malabanan A, Rosen H, Shuhart C. Bilateral hip DXA Reporting: 2023 Official Positions of the International Society for Clinical Densitometry. J Clin Densitom 2024; 27:101438. [PMID: 38030473 DOI: 10.1016/j.jocd.2023.101438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2023]
Abstract
INTRODUCTION This position development conference (PDC) Task Force examined the use and reporting of bilateral hip bone mineral density (BMD) measurements. This was deemed appropriate as increased availability of Dual-energy X-ray Absorptiometry (DXA) technology offering bilateral hip measurement resulted in more routine clinical use. The International Society for Clinical Densitometry Official Positions accept bilateral hip BMD measurement for clinical use but currently do not include recommendations for reporting those studies. METHODS Four key questions regarding bilateral hip reporting were proposed by the PDC Steering Committee. Relevant literature was identified using PubMed. Questions included whether bilateral hip measurements are appropriate for diagnostic classification or monitoring, as well as which bilateral hip regions of interest should be reported for diagnosis and monitoring. Additionally, the appropriate nomenclature for bilateral hip acquisition was defined. RESULTS The literature review demonstrated that bilateral hip measurement is appropriate and diagnostic classification should be based on the lowest T-score at the right or left side femoral neck or total hip; the mean T-score should not be used for diagnostic purposes. Mean bilateral total hip is preferred for BMD monitoring. The terms hip, or total hip were deemed appropriate nomenclature instead of femur or total proximal femur. CONCLUSION Bilateral hip acquisition is clinically appropriate and reporting and nomenclature standards are offered herein when a bilateral hip study is acquired. In terms of future research, the impact of discordant hips on diagnosis and monitoring was identified as a significant knowledge gap.
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Affiliation(s)
- S Bobo Tanner
- Department of Medicine, Divisions of Rheumatology, Allergy & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Diane Krueger
- School of Medicine and Public Health, Osteoporosis Clinical Research Program, University of Wisconsin-Madison, Madison, WI, USA.
| | - Auryan Szalat
- Osteoporosis Center, Internal Medicine Ward, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Tyler Prout
- Radiology Department, University of Wisconsin, Madison, Wisconsin USA
| | - Adrian Lau
- Division of Endocrinology and Metabolism, Department of Medicine, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Alan Malabanan
- Bone Health Clinic, Boston Medical Center, Boston, MA, USA
| | - Harold Rosen
- Osteoporosis Prevention and Treatment Center, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Christopher Shuhart
- Bone Health and Osteoporosis Center, Swedish Medical Group, Seattle, WA, USA
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Weaver AA, Ronning IN, Armstrong W, Miller AN, Kiani B, Shayn Martin R, Beavers KM, Stitzel JD. Computed tomography assessment of pelvic bone density: Associations with age and pelvic fracture in motor vehicle crashes. Accid Anal Prev 2023; 193:107291. [PMID: 37716194 PMCID: PMC10591932 DOI: 10.1016/j.aap.2023.107291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Revised: 08/22/2023] [Accepted: 09/06/2023] [Indexed: 09/18/2023]
Abstract
Motor vehicle crash (MVC) occupants routinely get a computed tomography (CT) scan to screen for internal injury, and this CT can be leveraged to opportunistically derive bone mineral density (BMD). This study aimed to develop and validate a method to measure pelvic BMD in CT scans without a phantom, and examine associations of pelvic BMD with age and pelvic fracture incidence in seriously injured MVC occupants from the Crash Injury Research and Engineering Network (CIREN) study. A phantom-less muscle-fat calibration technique to measure pelvic BMD was validated using 45 quantitative CT scans with a bone calibration phantom. The technique was then used to measure pelvic BMD from CT scans of 252 CIREN occupants (ages 16+) in frontal MVCs who had sustained either abdominal or pelvic injury. Pelvic BMD was analyzed in relation to age and pelvic fracture incidence. In the validation set, phantom-based calibration vs. phantom-less muscle-fat calibration yielded similar BMD values at the anterior superior iliac spine (ASIS; R2 = 0.95, p < 0.001) and iliac crest (R2 = 0.90, p < 0.001). Pelvic BMD was measured in 150 female and 102 male CIREN occupants aged 16-89, and 25% of these occupants sustained pelvic fracture. BMD at the ASIS and iliac crest declined with age (p < 0.001). For instance, iliac crest BMD decreased an average of 25 mg/cm3 per decade of age. The rate of iliac crest BMD decline was 7.6 mg/cm3 more per decade of age in occupants with pelvic fracture compared to those not sustaining pelvic fracture. Findings suggest pelvic BMD may be a contributing risk factor for pelvic fracture in MVCs.
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Affiliation(s)
- Ashley A Weaver
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States.
| | - Isaac N Ronning
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States; University of British Columbia, 2329 West Mall, Vancouver, BC V6T 1Z4, Canada
| | - William Armstrong
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States.
| | - Anna N Miller
- Department of Orthopaedic Surgery, Washington University School of Medicine, 600 S. Euclid Ave., St. Louis, MO 63110, United States.
| | - Bahram Kiani
- Department of Radiology, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States.
| | - R Shayn Martin
- Department of Surgery, Wake Forest University School of Medicine, Medical Center Blvd., Winston-Salem, NC 27157, United States.
| | - Kristen M Beavers
- Department of Health and Exercise Science, Wake Forest University, Worrell Professional Center, Winston-Salem, NC 27109, United States.
| | - Joel D Stitzel
- Department of Biomedical Engineering, Wake Forest University School of Medicine, 575. N. Patterson Ave., Winston-Salem, NC 27101, United States.
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Burt LA, Wyatt PM, Morrison A, Boyd SK. Bone Quality in Competitive Athletes: A Systematic Review. J Musculoskelet Neuronal Interact 2023; 23:456-470. [PMID: 38037364 PMCID: PMC10696374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Accepted: 09/08/2023] [Indexed: 12/02/2023]
Abstract
The study objective was to assess bone quality measured by high resolution peripheral quantitative computed tomography (HR-pQCT) in competitive athletes. Medline, EMBASE and Sport Discus were searched through May 2022. Prior to submission, a follow-up database search was performed (January 2023). Studies of competitive athletes using HR-pQCT to assess bone quality were included. Athletes were aged between 14 and 45 years. Data extraction included study design and location (country), skeletal imaging modality and site, bone variables and any additional musculoskeletal-related outcome. Information identifying sports and athletes were also extracted. This review included 14 manuscripts and a total of 928 individuals (male: n=75; female: n=853). Athletes comprised 78% (n=722) of the included individuals and 93% of athletes were female. Assessment scores indicate the studies were good to fair quality. The athletes included in this review can be categorized into three groups: 1) healthy athletes, 2) athletes with compromised menstrual function (e.g., amenorrhoea), and 3) athletes with compromised bone health (e.g., bone stress injuries). When assessing bone quality using HR-pQCT, healthy competitive athletes had denser, stronger and larger bones with better microarchitecture, compared with controls. However, the same cannot be said for athletes with amenorrhoea or bone stress injuries.
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Affiliation(s)
- Lauren A. Burt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Paige M. Wyatt
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Canadian Sports Institute, Calgary, Canada
| | - Alida Morrison
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - Steven K. Boyd
- McCaig Institute for Bone and Joint Health, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Eslamipour F, Gheitasi M, Hovanloo F, Yaghoubitajani Z. High versus Low-Intensity Resistance Training on Bone Mineral Density and Content Acquisition by Postmenopausal Women with Osteopenia: A Randomized Controlled Trial. Med J Islam Repub Iran 2023; 37:126. [PMID: 38318407 PMCID: PMC10843212 DOI: 10.47176/mjiri.37.126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Indexed: 02/07/2024] Open
Abstract
Background The menopause stage in women reduces estrogen levels and bone indicators. This study compared the effects of high-intensity resistance training (HIRT) and low-intensity resistance training (LIRT) on bone mineral density (BMD) and bone mineral content (BMC), T-score, and Z-score in postmenopausal women with osteopenia. Methods A randomized controlled trial was conducted among 45 postmenopausal women, aged 50 to 60, who were randomly assigned into 3 parallel groups (n = 15 in each). The exercise program was performed by the interventional groups-the HIRT and LIRT groups-at 4 different intensities, 3 times a week for 24 weeks: 8 repetitions at 80% of 1 repetition maximum and 16 repetitions at 40% of 1 repetition maximum. The evaluated areas (BMD, BMC, T-score, and Z-score) included the lumbar spine (LS) and the femur neck (FN) using a DEXA machine. One-way analysis of covariance and Bonferroni's post hoc tests were used for data analysis. Results The results indicated significant differences in BMD, BMC, T-scores, and Z-scores between the means of the LS and the FN in all groups. In addition, significant differences were revealed in the BMC of the LS, the BMD, T-scores (P < 0.001), Z-scores (P = 0.001), and in the BMC of the FN (P < 0.001), the BMD (P = 0.001), T-scores, and Z-scores (P < 0.001), respectively. In addition, the HIRT group's bone indices were considerably greater than those of the LIRT group (P < 0.00). Nonetheless, LIRT was significantly greater than that of the control group (P > 0.00). Conclusion According to the current findings, HIRT seems to be the most effective training program compared with LIRT for bone indicators improvement in the femur neck and the lumbar spine among postmenopausal women with osteopenia.
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Affiliation(s)
- Fatemeh Eslamipour
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Mehdi Gheitasi
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Fariborz Hovanloo
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
| | - Zohreh Yaghoubitajani
- Department of Health and Sport Rehabilitation, Faculty of Sport Sciences and Health, Shahid Beheshti University, Tehran, Iran
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Li J, Guo J, Wang X, Zhang X, Zhang Y, Bu M, Yao X, She Y. Efficacy and safety of tai chi exercise on bone health: An umbrella review. Osteoporos Int 2023; 34:1853-1866. [PMID: 37430003 PMCID: PMC10579121 DOI: 10.1007/s00198-023-06830-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/08/2023] [Indexed: 07/12/2023]
Abstract
PURPOSE To critically evaluate systematic reviews (SRs) of the Tai Chi (TC) exercise on bone health and provide more recently available evidence. METHODS SRs with or without meta-analysis (MA) of TC on bone health were comprehensively searched in eight electronic databases (PubMed, EMBASE, Cochrane Library, Web of Science, China National Knowledge Infrastructure, Wanfang Database, Chinese Biomedical Literature Database, and Chinese Scientific Journals Database) and in the international prospective register of systematic reviews of (PROSPERO) from initiation to March 2023. Descriptive analyses of SRs were performed, and reporting and methodological quality of the included SRs were evaluated using the updated version of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist and A Measurement Tool to Assess Systematic Reviews 2 (AMSTAR-2). The certainty of the synthesized evidence was assessed with the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. RESULTS Eighteen SRs, 15 with MAs, were included. Forty-nine RCTs and 16 NRSIs with 3956 and 1157 participants, respectively, were included in these SRs. The reporting quality of the included SRs ranged from high to low, but most received critically low AMSTAR-2 scores. Efficacy of TC on nine bone health biomarkers has been explored, covering bone mineral density (BMD) and serum biomarkers. The results showed that compare to non-intervention, perimenopausal and postmenopausal participants who practiced TC may benefit in BMD of the lumbar spine [MD = 0.04, 95% CI (0.02, 0.07)], and femoral neck [MD = 0.04, 95% CI (0.02, 0.06)], but not BMD of the femoral proximal trochanter [MD = 0.02, 95% CI (0.00, 0.03)], ward's triangle [MD = 0.02, 95% CI (-0.01, 0.04)], and femoral shaft [SMD = 0.16, 95% CI (-0.11, 0.44)]. Elders practicing TC may benefit in BMD of the femoral neck [SMD = 0.28, 95% CI (0.10, 0.45)], femoral proximal trochanter [SMD = 0.39, 95% CI (0.05, 0.73)], and ward's triangle [SMD = 0.21, 95% CI (0.05,0.37)], but may not in BMD of lumbar spine [SMD = 0.03, 95% CI (-0.22, 0.27)]. CONCLUSION We have low certainty that for perimenopausal and postmenopausal women, compare to those with no exercise, TC could improve BMD of the lumbar spine, femoral neck. We also have low certainty that in elder population, TC practitioners may benefit in BMD of femoral neck, and Ward's triangle. REGISTRATION PROSPERO (CRD42020173543).
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Affiliation(s)
- Jie Li
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Jiaojiao Guo
- Hebei Academy of Traditional Chinese Medicine, Shijiazhuang, China
| | - Xi Wang
- School of Pharmacy, Hebei University of Chinese Medicine, Shijiazhuang, China
| | - Xuanping Zhang
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Yan Zhang
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Ming Bu
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China
| | - Xiaoguang Yao
- Department of Surgery, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China.
| | - Yanfen She
- School of Acupuncture-Moxibustion and Tuina, Hebei University of Chinese Medicine, No. 3 Xingyuan Road, Luquan District, Shijiazhuang, Hebei Province, China.
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13
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Huang X, Xiu P, Shu Y, Song Y, Zhou Z, Zhou C, Feng G, Wang L, Liu L, Tang J, Yang X. The Effect of Halo-Pelvic Traction on Bone Mineral Density of Vertebrae and Corresponding Risk Factors. Orthop Surg 2023; 15:2918-2926. [PMID: 37706221 PMCID: PMC10622268 DOI: 10.1111/os.13858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 09/15/2023] Open
Abstract
OBJECTIVES Decreased bone mineral density (BMD) is associated with complications in implantation surgery for severe spinal deformity. In this quantitative study, we aimed to investigate the impact of halo-pelvic traction on vertebral bone mineral density (BMD) and identify the risk factors for a decrease in BMD. METHODS Patients who underwent halo-pelvic traction at our hospital between 2019 and 2022 were included in the study. Patients' data, including height, weight, and BMD pre- and post-traction, were collected and analyzed. Quantitative computed tomography (QCT) was used to determine the BMD. The paired rank sum test was used to evaluate the changes in each measurement parameter. Linear regression was used to identify risk factors for a decrease in BMD. RESULTS Fifteen patients were included in the study, nine women and six men, with an average age of 21.2 ± 7.3 years. Eleven patients had severe rigid scoliosis, while four had tuberculotic kyphosis. One expert measured the BMD values of 345 vertebrae using QCT. The average traction time was 143.3 ± 44.4 days. The average pre-traction BMD was 183.1 ± 73.8 mg/cm3 , and the average post-traction BMD was 140.5 ± 61.3 mg/cm3 (p < 0.01) Patients' height increased from an average of 151.3 ± 12.8 cm pre-traction to 165.5 ± 13.7 cm post-traction (p < 0.01), with traction length averaging 14.3 ± 6.2 cm (p < 0.01). The Cobb angle of the main curve declined from an average of 112.5° ± 24.4° pre-traction to 67.7° ± 19.8° post-traction (p < 0.01). Linear regression revealed a positive correlation between BMD loss and traction length and a negative correlation between BMD loss and correction rate. CONCLUSIONS Halo-pelvic traction can lead to a decrease in the BMD of the spinal vertebrae, with traction length positively correlated with BMD loss and correction rate negatively correlated with BMD loss. To prevent osteoporosis, physicians should ensure a limited traction length while utilizing better management techniques.
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Affiliation(s)
- Xianming Huang
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
- Department of OrthopaedicsXinqiao Hospital of Army Medical UniversityChongqingChina
- Department of Pediatric SurgeryDazhou Central HospitalDazhouChina
| | - Peng Xiu
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Yi Shu
- Department of Radiology, West China HospitalSichuan UniversityChengduChina
| | - Yueming Song
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Zhongjie Zhou
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Chunguang Zhou
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Ganjun Feng
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Lei Wang
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Limin Liu
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
| | - Jing Tang
- Department of Radiology, West China HospitalSichuan UniversityChengduChina
| | - Xi Yang
- Department of Orthopaedic Surgery, West China HospitalSichuan UniversityChengduChina
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Giangregorio LM, Bleakney RR, Brien S, Butcher SJ, Chan BCF, Chilibeck PD, Devries MC, Funnell L, Jain R, Keller HH, Milligan J, Mourtzakis M, O’Hare BS, Thabane L, Cheung AM. Finding the Optimal Resistance Training Intensity for Your Bones: Protocol for a Randomized Controlled Trial. Phys Ther 2023; 103:pzad120. [PMID: 37669136 PMCID: PMC10549785 DOI: 10.1093/ptj/pzad120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/17/2023] [Accepted: 05/04/2023] [Indexed: 09/07/2023]
Abstract
OBJECTIVE The purpose of this trial is to evaluate the effect of twice-weekly, moderate-to-high intensity progressive resistance training (PRT) for 1 year on lumbar spine bone mineral density (BMD) in individuals with low BMD, compared to attention control. Secondary analyses will examine if resistance training improves other health outcomes; if high intensity is more effective than moderate intensity resistance training for all outcomes; the cost of intervention versus benefit; the willingness to pay; and harms. METHODS For this study, 324 men or postmenopausal women aged ≥50 years with a femoral neck, total hip, or lumbar spine BMD T-score of ≤-1, or a Fracture Risk Assessment Tool probability of ≥20% for major osteoporotic fracture or ≥ 3% for hip fracture are being recruited to participate in a randomized controlled trial with 1:1:1 randomization. Participants will be stratified by site (3 centers) to twice-weekly, supervised PRT at moderate intensity (about 10 repetitions maximum), to high intensity PRT (≤6 repetitions maximum), or to a home posture and balance exercise program (attention control) for 1 year (resistance training to comparator allocation ratio of 2:1). The primary outcome is lumbar spine BMD via dual-energy X-ray absorptiometry. Secondary outcomes include trabecular bone score, proximal femur and total hip BMD and structure, bone-free and appendicular lean mass, physical functioning, falls, fractures, glucose metabolism, cost per life-year gained, adverse events, and quality of life. Between-group differences will be tested in intention-to-treat and per-protocol analyses using analysis of covariance, chi-square tests, or negative binomial or logistic regression, adjusting for site and baseline values. IMPACT The Finding the Optimal Resistance Training Intensity For Your Bones trial will support decision making on resistance training for people at risk of fracture.
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Affiliation(s)
- Lora M Giangregorio
- Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Robert R Bleakney
- Department of Medical Imaging, University of Toronto, Toronto, Ontario, Canada
| | - Sheila Brien
- Canadian Osteoporosis Patient Network, Toronto, Ontario, Canada
| | - Scotty J Butcher
- School of Rehabilitation Science, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Brian C F Chan
- KITE Research Institute, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
| | - Philip D Chilibeck
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Michaela C Devries
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Larry Funnell
- Canadian Osteoporosis Patient Network, Toronto, Ontario, Canada
| | - Ravi Jain
- Osteoporosis Strategy, Osteoporosis Canada, Toronto, Ontario, Canada
| | - Heather H Keller
- Schlegel-UW Research Institute for Aging, University of Waterloo, Waterloo, Ontario, Canada
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - James Milligan
- Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Marina Mourtzakis
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | | | - Lehana Thabane
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
- Biostatistics Unit, St Joseph’s Healthcare, Hamilton, Ontario, Canada
- Faculty of Health Sciences, University of Johannesburg, Auckland Park, Johannesburg, South Africa
| | - Angela M Cheung
- Department of Medicine, University Health Network, University of Toronto, Toronto, Ontario, Canada
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15
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Karimi F, Mardani P. Determinants of Bone Mineral Density in Iranian Women with Polycystic Ovary Syndrome. Int J Endocrinol Metab 2023; 21:e137594. [PMID: 38666045 PMCID: PMC11041818 DOI: 10.5812/ijem-137594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 09/08/2023] [Accepted: 09/25/2023] [Indexed: 04/28/2024] Open
Abstract
Background Whether the endocrine aberrations caused by polycystic ovary syndrome (PCOS) might influence bone density in women of reproductive age is controversial. Objectives The present study aimed to compare PCOS women to a control group matched in terms of age and body mass index (BMI) regarding bone indices and to clarify the potential relationship between their hormonal changes and bone density. Methods This case-control study consisted of 61 PCOS patients, and 35 women with normal ovulatory function served as controls. Bone parameters, including bone mineral content (BMC) and bone mineral density (BMD) in addition to T- and Z-scores, were measured at the lumbar vertebrae, neck of the left femur, hip, and distal part of the radial bone, using dual-energy X-ray absorptiometry. Blood samples were taken to be tested for biochemical parameters and serum concentrations of insulin, osteocalcin, parathyroid hormone (PTH), vitamin D, follicle-stimulating hormone (FSH), luteinizing hormone (LH), total testosterone, dehydroepiandrosterone sulfate (DHEAS), and estradiol were measured. Insulin resistance was evaluated through the homeostatic model assessment of insulin resistance (HOMA-IR). Results The results revealed greater levels of HOMA-IR and total testosterone in PCOS women than in controls. Nevertheless, the two groups were comparable in terms of bone parameters. In the control group, BMI was the only determinant of bone density at most of the skeletal sites. Nonetheless, BMI and HOMA-IR were independently and positively associated with bone indices at the femoral neck (FN) and total hip in the PCOS group. Parathyroid hormone and vitamin D concentrations were not different in the two groups. However, phosphate levels were higher in PCOS patients (P = 0.025). Osteocalcin was inversely correlated to BMI, and both groups had a negative correlation between DHEAS and PTH. Serum phosphate was inversely and independently associated with estrogen in the PCOS group (r = -0.377, P = 0.004). Conclusions Body mass index and HOMA-IR were independent and positive determinants of FN and total hip bone density in the PCOS subjects. Nonetheless, in the non-PCOS women, BMI was the only independent determinant of bone density at most of the skeletal sites. Additionally, osteocalcin was inversely correlated with BMI in both groups.
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Affiliation(s)
- Fariba Karimi
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Parisa Mardani
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Anupama D, Noronha JA, Acharya KK, Prabhu M, Ravishankar N, Nayak BS. Effect of Lifestyle Modification Intervention Programme on Bone Mineral Density among Postmenopausal Women with Osteoporosis. Sultan Qaboos Univ Med J 2023; 23:387-393. [PMID: 37655089 PMCID: PMC10467558 DOI: 10.18295/squmj.1.2023.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 01/15/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023] Open
Abstract
Objectives Osteoporosis is one of the major public health problems worldwide among postmenopausal osteoporotic women. Lifestyle modification interventions along with pharmacotherapy help to revert bone loss and prevent complications. Methods A randomised controlled trial was conducted at Kasturba Hospital, Manipal from January 2019 to December 2021 among postmenopausal women with osteoporosis. The postmenopausal women who attended the osteoporosis clinic and were within the age group of 45-65 years, could speak and understand English or Kannada and whose bone mineral density (BMD) score was between -1 and -3 were included in the study. The total sample size of the study was 120 with 60 in each of the experimental and control groups. After obtaining informed consent, a stratified block randomisation method was used to allocate the participants to intervention and control groups. The BMD was monitored by the portable ultrasound densitometer by a technician at the outpatient departments. The baseline information was collected by a structured demographic questionnaire. Intervention group participants received a lifestyle modification intervention program (LMIP) whereas the control group received standard regular care from the physician. Follow-up was done at three and six months. Results The results revealed that the increase in the BMD median score among the experimental group was from -2.2 (-2.5- -1.8) to -1.5 (-1.8- -0.65) whereas in the control group, it was from -2.3 (-2.6- -1.9) to -2.0 (-2.4- -1.5). The results of the Mann Whitey U test showed a statistical significance between the intervention and control groups in the post-test after six months (U = 505.5; P <0.05). Wilcoxon signed rank test showed a significant change in both the intervention and control groups from pre-test to post-test I (3 months) and post-test II (6 months; P <0.001). Conclusion The lifestyle modification intervention was found to be effective in improving the bone health status of postmenopausal women. Hence it is very important to integrate it into regular therapy.
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Affiliation(s)
- D.S Anupama
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | - Judith A. Noronha
- Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, India
| | | | - Mukhyaprana Prabhu
- Departments of Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
| | - N. Ravishankar
- Department of Biostatistics, Vallabhbhai Patel Chest Institute, University of Delhi, Delhi, India
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Shevchuk S, Marynych L, Malovana T, Denyshchych L. Vitamin D level in patients with systemic lupus erythematosus: its relationship to disease course and bone mineral density. Lupus Sci Med 2023; 10:e000968. [PMID: 37558268 PMCID: PMC10414063 DOI: 10.1136/lupus-2023-000968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Accepted: 07/28/2023] [Indexed: 08/11/2023]
Abstract
OBJECTIVE To determine vitamin D levels in patients with SLE and evaluate their relationship to bone mineral density (BMD) and the disease course. METHODS The study included 101 patients with SLE and 29 individuals in the control group. The study participants were tested for vitamin D level, erythrocyte sedimentation rate (ESR), C reactive protein (CRP), interleukin (IL)-6, osteocalcin (OC) and collagen type I C-terminal telopeptide (CTX), and the dual-energy X-ray absorptiometry was provided to assess BMD in the lumbar spine and the hip. RESULTS The mean serum vitamin D level was 18.98±0.88 ng/mL, and women had 25.42% lower vitamin D levels than men (p<0.05). There was no correlation between vitamin D levels and patient's age or disease course. There was a significant inverse correlation between vitamin D levels and cumulative dose of glucocorticoids (r=-0.26) and serum inflammatory markers, particularly CRP (r=-0.39), IL-6 (r=-0.37) and ESR (r=-0.15). Vitamin D level was associated with the bone turnover markers (BTMs). In women of reproductive age with vitamin D deficiency, BMD of the lumbar spine and the hip was 9.5-23.1% higher than in those with no vitamin deficiency, respectively, and the mean lumbar spine Z-score in women of reproductive age with vitamin D insufficiency and deficiency was significantly 2.0 and 2.9 times lower than in patients with normal vitamin D level. CONCLUSIONS Hypovitaminosis D is quite common in patients with SLE and is associated with high inflammatory activity (SLE Disease Activity Index, ESR, CRP, IL-6), severity of organ damage (Damage Index), cumulative dose of glucocorticoids, BTM changes (decrease in OC, increase in CTX) and BMD decline. Vitamin D status was not associated with the patient's age or disease course.
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Affiliation(s)
- Sergii Shevchuk
- Vinnytsia National Medical University, Vinnytsia, Ukraine
- Research Institute for Rehabilitation of Individuals with Disabilities (Educational and Scientific Treatment Facility) of Vinnytsia National Medical University, Vinnytsia, Ukraine
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Duranson A, Thevenet V, Guyon F, Babin G, Lebreton C, Renaud T, Gaillard AL, Dupuy Q, Bouleftour W, Magne N, Petit A. Pelvic insufficiency fractures after intensity modulated radiation therapy combined with chemotherapy for cervix carcinoma: Incidence and impact of bone mineral density. Clin Transl Radiat Oncol 2023; 41:100650. [PMID: 37441540 PMCID: PMC10334122 DOI: 10.1016/j.ctro.2023.100650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/15/2023] [Accepted: 06/04/2023] [Indexed: 07/15/2023] Open
Abstract
Background and Purpose The aim of this study was to evaluate the incidence and predictive factors of Pelvic Insufficiency Fractures (PIFs) occurring after Intensity Modulated Radiation Therapy (IMRT) combined with chemotherapy for locally advanced cervical cancer (CC). Material and methods Medical records of patients receiving radio-chemotherapy with IMRT between 2010 and 2020 for advanced CC were reviewed. PIFs were detected during follow-up on pelvic Magnetic Resonance Imaging (MRI) or Computed Tomography (CT). The cumulative incidence rate of PIFs and its confidence interval were calculated at 2 and 5 years of follow-up. Pre-therapeutic Bone Mineral Density (BMD) (g/cm3) was evaluated on CT simulation for sacrum and the fourth lumbar (L4) vertebrae. Sacrum dosimetric parameters (V30Gy, V40Gy, D50%, Dmean) were analyzed. Results 136 patients were included. The median follow-up was 4.4 years. Median dose of D50% and V40Gy sacrum were 35.2 Gy (20.6-46.4) and 32.2% (7.2-73.4) respectively. The 2-year and 5-year cumulative incidence rates were 15.7% (95% CI: 9.88-22.71) and 22% (95% CI: 14.58-30.45) respectively. Median time interval between RT completion and PIFs' detection was 11.5 months (IQR: 7.4-22.3). Univariate analysis showed that older age (p < 0.01), postmenopausal status at baseline (p < 0.01), and lower sacral and spinal BMD at baseline (respectively p < 0.001 and p < 0.01) were significantly associated to all sites of PIFs, and lower sacral BMD with sacral fractures (p < 0.001). Conclusion Post-IMRT PIFs were detected in 18.4% of patients with locally advanced CC. Individual predisposing factors as older age, postmenopausal status, decreased bone density on the CT simulation were mainly predictive.
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Affiliation(s)
- Agathe Duranson
- Department of Radiation Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Vincent Thevenet
- Department of Statistics, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Frédéric Guyon
- Department of Surgery, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Guillaume Babin
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Coriolan Lebreton
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Tiphaine Renaud
- Department of Medical Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Anne-Lise Gaillard
- Department of Diagnostic Radiology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Quentin Dupuy
- Department of Medical Physics, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
| | - Wafa Bouleftour
- Department of Medical Oncology, North Hospital, University Hospital of Saint-Etienne, Saint-Etienne, France
| | - Nicolas Magne
- Department of Radiation Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
- Cellular and Molecular Radiobiology Laboratory, Lyon-Sud Medical School, Unité Mixte de Recherche CNRS5822/IP2I, University of Lyon, Lyon, France
| | - Adeline Petit
- Department of Radiation Oncology, Institut Bergonié, Comprehensive Cancer Center, Bordeaux, France
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19
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Hornick MA, Van Name M. Decreased Bone Density and Strength in Young People After Bariatric Surgery: How Much Matters? J Bone Miner Res 2023. [PMID: 37314023 DOI: 10.1002/jbmr.4831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 04/24/2023] [Accepted: 05/15/2023] [Indexed: 06/15/2023]
Affiliation(s)
- Matthew A Hornick
- Department of Surgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Michelle Van Name
- Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut, USA
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20
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Mohammadi FG, Sebro R. Opportunistic Screening for Osteoporosis Using Hand Radiographs: A Preliminary Study. Stud Health Technol Inform 2023; 302:911-912. [PMID: 37203534 DOI: 10.3233/shti230306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Patients with low bone mineral density (BMD) are at risk for fractures however are often undiagnosed. Therefore, there is a need to opportunistically screen for low BMD in patients who present for other studies. This is a retrospective study of 812 patients aged 50 years or older who had dual-energy X-ray absorptiometry (DXA) and radiographs of the hands within 12 months of each other. This dataset was randomly split into training/validation (n=533) and test (n=136) datasets. A deep learning (DL) framework was used to predict osteoporosis/osteopenia. Correlations between the textural analysis of the bones and DXA measurements were obtained. We found that the DL model had an accuracy of 82.00%, sensitivity of 87.03%, specificity of 61.00% and an area under the curve (AUC) of 74.00% to detect osteoporosis/osteopenia. Our findings show that radiographs of the hand can be used to screen for osteoporosis/osteopenia and identify patients who should get formal DXA evaluation.
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Affiliation(s)
- Farid Ghareh Mohammadi
- Department of Radiology, Mayo Clinic, Jacksonville, Fl, 32224, USA
- Center for Augmented Intelligence, Mayo Clinic, Jacksonville, Fl, 32224, USA
| | - Ronnie Sebro
- Department of Radiology, Mayo Clinic, Jacksonville, Fl, 32224, USA
- Center for Augmented Intelligence, Mayo Clinic, Jacksonville, Fl, 32224, USA
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21
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Yang L, Dempsey M, Brennan A, Whelan B, Erjiang E, Wang T, Egan R, Gorham K, Heaney F, Armstrong C, Ibarrola GM, Gsel A, Yu M, Carey JJ. Ireland DXA-FRAX may differ significantly and substantially to Web-FRAX. Arch Osteoporos 2023; 18:43. [PMID: 36939937 PMCID: PMC10027809 DOI: 10.1007/s11657-023-01232-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Accepted: 03/07/2023] [Indexed: 03/21/2023]
Abstract
Appropriate use of FRAX reduces the number of people requiring DXA scans, while contemporaneously determining those most at risk. We compared the results of FRAX with and without inclusion of BMD. It suggests clinicians to carefully consider the importance of BMD inclusion in fracture risk estimation or interpretation in individual patients. PURPOSE FRAX is a widely accepted tool to estimate the 10-year risk of hip and major osteoporotic fracture in adults. Prior calibration studies suggest this works similarly with or without the inclusion of bone mineral density (BMD). The purpose of the study is to compare within-subject differences between FRAX estimations derived using DXA and Web software with and without the inclusion of BMD. METHOD A convenience cohort was used for this cross-sectional study, consisting of 1254 men and women aged between 40 and 90 years who had a DXA scan and complete validated data available for analysis. FRAX 10-year estimations for hip and major osteoporotic fracture were calculated using DXA software (DXA-FRAX) and the Web tool (Web-FRAX), with and without BMD. Agreements between estimates within each individual subject were examined using Bland-Altman plots. We performed exploratory analyses of the characteristics of those with very discordant results. RESULTS Overall median DXA-FRAX and Web-FRAX 10-year hip and major osteoporotic fracture risk estimations which include BMD are very similar: 2.9% vs. 2.8% and 11.0% vs. 11% respectively. However, both are significantly lower than those obtained without BMD: 4.9% and 14% respectively, P < 0.001. Within-subject differences between hip fracture estimates with and without BMD were < 3% in 57% of cases, between 3 and 6% in 19% of cases, and > 6% in 24% of cases, while for major osteoporotic fractures such differences are < 10% in 82% of cases, between 10 and 20% in 15% of cases, and > 20% in 3% of cases. CONCLUSIONS Although there is excellent agreement between the Web-FRAX and DXA-FRAX tools when BMD is incorporated, sometimes there are very large differences for individuals between results obtained with and without BMD. Clinicians should carefully consider the importance of BMD inclusion in FRAX estimations when assessing individual patients.
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Affiliation(s)
- Lan Yang
- Insight SFI Research Centre for Data Analytics, Data Science Institute, University of Galway, IDA Business Park, Lower Dangan, Galway, H91 AEX4, Ireland.
| | - Mary Dempsey
- School of Engineering, College of Science and Engineering, University of Galway, Galway, Ireland
| | - Attracta Brennan
- School of Computer Science, College of Science and Engineering, University of Galway, Galway, Ireland
| | - Bryan Whelan
- School of Medicine, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
| | - E Erjiang
- School of Management, Guangxi Minzu University, Nanning, China
| | - Tingyan Wang
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - Rebecca Egan
- Department of Rheumatology, Galway University Hospitals, Galway, Ireland
| | - Kelly Gorham
- Department of Rheumatology, Galway University Hospitals, Galway, Ireland
| | - Fiona Heaney
- Department of Rheumatology, Galway University Hospitals, Galway, Ireland
| | | | | | - Amina Gsel
- Department of Rheumatology, Galway University Hospitals, Galway, Ireland
| | - Ming Yu
- Department of Industrial Engineering, Tsinghua University, Beijing, China
| | - John J Carey
- School of Medicine, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
- Department of Rheumatology, Galway University Hospitals, Galway, Ireland
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22
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Malekian S, Mirghafourvand M, Najafipour F, Ostadrahimi A, Ghassab-Abdollahi N, Farshbaf-Khalili A. The Associations between Bone Mineral Density and Oxidative Stress Biomarkers in Postmenopausal Women. Korean J Fam Med 2023; 44:95-101. [PMID: 36966739 PMCID: PMC10040269 DOI: 10.4082/kjfm.22.0022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 04/08/2022] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND Oxidative stress plays an essential role in bone health among postmenopausal women. This study aimed to compare the oxidative stress biomarkers among postmenopausal women aged 50-65 years with normal bone mineral density, osteopenia, and osteoporosis. METHODS In this observational study, 120 women with normal bone mineral density, 82 with osteopenia, and 86 with osteoporosis were selected based on the densitometry data obtained from the dual-energy X-ray absorptiometry method. The serum total antioxidant capacity (TAC), superoxide dismutase (SOD) activity, and malondialdehyde (MDA) levels were measured using biochemical methods. A binary logistic regression model adjusted for confounders was used to estimate the risk of osteopenia and osteoporosis. The P-value of <0.05 was considered statistically significant. RESULTS There were significant differences between the three groups in age, menopausal age, body mass index, and education (P<0.05). According to the binary logistic regression model, higher SOD activity and serum TAC levels were associated with a lower risk of osteoporosis (adjusted odds ratio [aOR], 0.991; 95% confidence intervals [CI], 0.986 to 0.996; and aOR, 0.373; 95% CI, 0.141 to 0.986, respectively). MDA was a significant risk factor for osteopenia in postmenopausal women (aOR, 1.702; 95% CI, 1.125 to 2.576). CONCLUSION Higher SOD activity and serum TAC levels in the studied postmenopausal women were associated with a significantly lower risk of osteoporosis. Moreover, the risk of osteopenia increased significantly with higher serum MDA levels.
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Affiliation(s)
- Sanaz Malekian
- Department of Midwifery, Faculty of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mojgan Mirghafourvand
- Social Determinants of Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Farzad Najafipour
- Endocrinology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Alireza Ostadrahimi
- Nutrition Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Nafiseh Ghassab-Abdollahi
- Department of Geriatric Health, Faculty of Health Science, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding Author: Azizeh Farshbaf-Khalili https://orcid.org/0000-0001-5754-4613 Tel: +98-4133361928, Fax: +98-41134796969, E-mail:
| | - Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Centre, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran
- Corresponding Author: Azizeh Farshbaf-Khalili https://orcid.org/0000-0001-5754-4613 Tel: +98-4133361928, Fax: +98-41134796969, E-mail:
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23
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Yang Y, Chen Z, Huang Z, Tao J, Li X, Zhou X, Du Q. Risk factors associated with low bone mineral density in children with idiopathic scoliosis: a scoping review. BMC Musculoskelet Disord 2023; 24:48. [PMID: 36670417 PMCID: PMC9854192 DOI: 10.1186/s12891-023-06157-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Accepted: 01/11/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Children with idiopathic scoliosis (IS) have a high risk of osteoporosis and IS with low bone mineral density (BMD) are susceptible to curve progression. This review aims to explore the risk factors of low BMD in children with IS. METHODS Studies were retrieved from 5 databases that were published up to January 2022. Search terms are keywords in titles or abstracts, including subject headings related to "Scoliosis", "Bone Mineral Density", and "Risk Factors". Observational studies on risk factors of low BMD in children with IS were enrolled in this review. The number of studies, sample size, outcome measures, research type, endocrine, and lifestyle-related factors, gene/signal pathway, and other contents were extracted for qualitative analysis. RESULTS A total of 56 studies were included in this scoping review. Thirty studies involved genetic factors that may affect BMD, including the Vitamin-D receptor gene, RANK/RANKL signal pathway, the function of mesenchymal stem cells, Runx2, Interleukin-6 (IL-6), and miR-145/β-catenin pathway. Eight studies mentioned the influence of endocrine factors on BMD, and the results showed that serum levels of IL-6, leptin and its metabolites, and ghrelin in children with IS were different from the age-matched controls. In addition, there were 18 articles on lifestyle-related factors related to low BMD in children with IS, consisting of physical activity, calcium intake, Vitamin D level, and body composition. CONCLUSIONS Genetic, endocrine, and lifestyle-related factors might relate to low BMD and even osteoporosis in IS. To prevent osteoporosis, the effectiveness of regular screening for low BMD risk factors in children with IS needs to be investigated. Additionally, clear risk factors suggest strategies for bone intervention. Future studies should consider the effectiveness of calcium and vitamin D supplements and physical activity in BMD improvement.
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Affiliation(s)
- Yuqi Yang
- College of Global Public Health, New York University, New York, NY, 10003, USA
| | - Zhengquan Chen
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Zefan Huang
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Jing Tao
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Xin Li
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China
| | - Xuan Zhou
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
| | - Qing Du
- Department of Rehabilitation, Xinhua Hospital, School of Medicine, Shanghai Jiaotong University, 1665 Kongjiang Road, Shanghai, 200092, China.
- Chongming Hospital, Shanghai University of Medicine & Health Sciences, Shanghai, 202150, China.
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24
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Gharibzadeh S, Goodarzi G, Tehrani SS, Fahimfar N, Razi F, Sanjari M, Khalagi K, Shafiee G, Heshmat R, Amini A, Nabipour I, Larijani B, Ostovar A. Bone mass and microarchitecture in T2DM patients and corticosteroids therapy: the Bushehr Elderly Health program. J Diabetes Metab Disord 2022; 21:717-25. [PMID: 35673425 DOI: 10.1007/s40200-022-01040-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Abstract
Purpose Our study examined whether T2DM and glucocorticoids treatment affect bone quality and quantity that are measured by Bone Mineral Density (BMD) and Trabecular Bone Score (TBS). Materials & methods Participants in this study were 2294 women and men aged over 60 years who participated in stage II of the Bushehr Elderly Health (BEH) program. Patients with T2DM and those who received glucocorticoids were included. BMD was detected using the DXA method and the TBS of L1-L4 was evaluated by TBS iNsight® software. To evaluate the correlation between TBS and BMD levels with diabetes and taking corticosteroids sex-specific multivariable linear regression models were appplied. Results TBS and BMD were not significantly different in those who had received glucocorticoids versus those who did not.T2DM revealed a significant association with both BMD and TBS in men (beta = 0.12, p < 0.001 and beta = 0.063, p = 0.03, respectively). BMD values were significantly higher in diabetic women (beta = 0.073, p < 0.01). BMI had a significant association with both TBS and BMD but in an opposite direction, in women and men (BMD: beta = -0.22, -0.24, and regarding TBS: beta = 0.37, 0.25, all p-values < 0.001). Conclusion Our findings showed that T2DM had major effects on BMD in both men and women. However, T2DM only affects TBS in men. Furthermore, neither BMD nor TBS were affected by GC intake in men or women.Based on the variable importance of covariates, BMI was the most influential factor on both BMD and TBS, although in opposite directions, in both sexes.
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25
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Rontogianni A, Dontas IA, Halazonetis D, Tosios K, Lelovas P, Venetsanou K, Galanos A, Tsolakis AI. Intrauterine growth restriction affects bone mineral density of the mandible and the condyle in growing rats. J Musculoskelet Neuronal Interact 2022; 22:93-101. [PMID: 35234164 PMCID: PMC8919654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES To investigate in growing rats the effect of intrauterine growth restriction (IUGR) on the bone mineral density of the mandible and tibia, as well as the quality of the mandibular and condylar bone. METHODS Twelve male rats were born IUGR by mothers sustaining 50% food restriction during pregnancy. Twelve control male rats were born by mothers fed ad libitum. Dual-energy X-ray absorptiometry (DEXA) of the tibia, proximal tibial metaphysis and the mandible, biochemical markers, histology and histomorphometrical analysis on the mandibular and subchondral bone of the condyle were performed. RESULTS IUGR significantly affected bone mineral density (BMD) of both tibial and mandibular bones. IUGR rats had significantly lower osteocalcin values (p=0.021) and phosphorus (p=0.028), but not 25-OH vitamin D (p=0.352). Bone area percentage in the mandible was significantly lower (51.21±5.54) in IUGR compared to controls (66.00±15.49), and for subchondral bone of the condyle for IUGR (47.01±6.82) compared to controls (68.27±13.37). IUGR had a significant reduction in the fibrous layer, but not the proliferating layer, with the hypertrophic layer significantly increased. CONCLUSION Maternal restricted nutrition during gestation can affect BMD of the mandible and the tibia of the offspring animals.
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Affiliation(s)
- Aliki Rontogianni
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece,Corresponding author: Aliki Rontogianni, 34 Zalokosta str, Halandri, Athens, Greece E-mail:
| | - Ismene A. Dontas
- Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Demetrios Halazonetis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Konstantinos Tosios
- Department of Oral Medicine and Oral Pathology, School of Dentistry, National and Kapodistrian University of Athens, Greece
| | - Pavlos Lelovas
- Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Kyriaki Venetsanou
- Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Antonios Galanos
- Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Apostolos I. Tsolakis
- Department of Orthodontics, School of Dentistry, National and Kapodistrian University of Athens, Greece
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26
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Ben-Porat T, Peretz S, Rottenstreich A, Weiss R, Szalat A, Elazary R, Abu Gazala M. Changes in bone mineral density following laparoscopic sleeve gastrectomy: 2-year outcomes. Surg Obes Relat Dis 2021; 18:335-342. [PMID: 35058132 DOI: 10.1016/j.soard.2021.12.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/15/2021] [Accepted: 12/19/2021] [Indexed: 10/19/2022]
Abstract
BACKGROUND Emerging evidence suggests that sleeve gastrectomy (SG) leads to significant bone mineral density (BMD) losses, but there is a paucity of studies evaluating skeletal consequences beyond 12-months post-operatively. OBJECTIVES To evaluate BMD changes 2 years postoperatively. SETTING A university hospital. METHODS Thirty-three women (mean age: 34.4 ± 12.3 years) who underwent SG and completed 24 months of follow-up were evaluated prospectively at baseline and at 3 (M3), 6 (M6), 12 (M12), and 24 (M24) months postoperatively. Data collected included BMD at the total hip, femoral neck, and lumbar spine measured by dual-energy x-ray absorptiometry and anthropometrics, biochemical, nutritional, and physical activity parameters. RESULTS At M24, patients achieved a mean body mass index and excess weight loss of 32.4 ± 5.1 kg/m2 and 64.5 ± 21.4%, respectively; however, weight stabilized at M12. Femoral neck BMD decreased significantly from baseline to M24 (.924 ± .124 versus .870 ± .129 g/cm2, P < .001), with no change between M12 and M24 (P = .273). Total hip BMD decreased significantly from baseline to M24 (1.004 ± .105 versus .965 ± .132 g/cm2, P < .001) but increased between M12 and M24 (P = .001). No significant changes were noted in lumbar spine BMD. The percentage of changes in the femoral neck and the total hip BMD from baseline to M24 positively correlated with postoperative excess weight loss (r = .352, P = .045, and r = .416, P = .018, respectively). CONCLUSION Despite notable weight loss, women who underwent SG experienced significant bone loss at the total hip and femoral neck more than 2 years postoperatively. Future studies should investigate intervention strategies to attenuate skeletal deterioration after SG.
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Affiliation(s)
- Tair Ben-Porat
- Department of Human Metabolism and Nutrition, Braun School of Public Health, Hebrew University, Jerusalem, Israel; Department of Nutrition, Hadassah-Hebrew University Medical Center, Jerusalem, Israel.
| | - Shiraz Peretz
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Amihai Rottenstreich
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ram Weiss
- Technion School of Medicine and the Department of Pediatrics, Rambam Medical Center, Haifa, Israel
| | - Auryan Szalat
- Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel; Osteoporosis Center, Endocrinology and Metabolism Service, Internal Medicine Ward, Hadassah Medical Organization, Jerusalem, Israel
| | - Ram Elazary
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mahmud Abu Gazala
- Department of Surgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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27
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Ma M, Feng Z, Liu X, Jia G, Geng B, Xia Y. The Saturation Effect of Body Mass Index on Bone Mineral Density for People Over 50 Years Old: A Cross-Sectional Study of the US Population. Front Nutr 2021; 8:763677. [PMID: 34722617 PMCID: PMC8554069 DOI: 10.3389/fnut.2021.763677] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 09/20/2021] [Indexed: 12/26/2022] Open
Abstract
Background: Previous studies had revealed that Body Mass Index (BMI) positively affected Bone Mineral Density (BMD). However, an excessively high BMI was detrimental to health, especially for the elderly. Moreover, it was elusive how much BMI was most beneficial for BMD in older adults to maintain. Objective: To investigate whether there was a BMI saturation effect value that existed to maintain optimal BMD. Methods: A cross-sectional study was conducted using the datasets of the National Health and Nutrition Examination Survey (NHANES) 2005–2006, 2007–2008, 2009–2010, 2013–2014, and 2017–2018. After adjusting for covariates, an analysis of the association between BMI and BMD in different femoral regions (Total femur, Femoral neck, Trochanter, Intertrochanter, and Ward's triangle) and lumbar spine regions (Total spine, L1, L2, L3, and L4) in the whole population was performed using the multivariate linear regression models, smoothing curve fitting, and saturation effects analysis models. Then, subgroup analyses were performed according to gender, age, and race. Results: A total of 10,910 participants (5,654 males and 5,256 females) over 50 years were enrolled in this population-based study. Multivariate linear regression analyses in the population older than 50 years showed that BMI was positively associated with femoral BMD and lumbar spine BMD (P < 0.001, respectively). Smoothing curve fitting showed that the relationship between BMI and BMD was not simply linear and that a saturation value existed. The saturation effect analysis showed that the BMI saturation value was 26.13 (kg/m2) in the total femur, 26.82 (kg/m2) in the total spine, and showed site-specificity in L1 (31.90 kg/m2) and L2 (30.89 kg/m2). The saturation values were consistent with the whole participants in males, while there was high variability in the females. BMI saturation values remained present in subgroup analyses by age and race, showing specificity in some age (60–70 years old) groups and in some races. Conclusions: Our study showed a saturation value association between BMI and BMD for people over 50 years old. Keeping the BMI in the slightly overweight value (around 26 kg/m2) might reduce other adverse effects while obtaining optimal BMD.
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Affiliation(s)
- Ming Ma
- The Second School of Clinical Medical, Lanzhou University, Lanzhou, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, China.,Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
| | - Zhiwei Feng
- The Second School of Clinical Medical, Lanzhou University, Lanzhou, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, China
| | - Xiaolong Liu
- The Second School of Clinical Medical, Lanzhou University, Lanzhou, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, China
| | - Gengxin Jia
- The Second School of Clinical Medical, Lanzhou University, Lanzhou, China.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, China
| | - Bin Geng
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, China.,Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
| | - Yayi Xia
- Orthopaedics Key Laboratory of Gansu Province, Lanzhou, China.,Department of Orthopaedics, Lanzhou University Second Hospital, Lanzhou, China
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28
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Nam B, Sung YK, Choi CB, Kim TH, Jun JB, Bae SC, Yoo DH, Cho SK. Fracture Risk and Its Prevention Patterns in Korean Patients with Polymyalgia Rheumatica: a Retrospective Cohort Study. J Korean Med Sci 2021; 36:e263. [PMID: 34697929 PMCID: PMC8546306 DOI: 10.3346/jkms.2021.36.e263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Accepted: 08/30/2021] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND To evaluate the incidence of fractures and fracture risk factors in Korean patients with polymyalgia rheumatica (PMR). METHODS All PMR patients who visited a rheumatology clinic at a tertiary referral hospital between March 2005 and March 2018 were retrospectively assessed. We estimated bone mineral density (BMD) screening rate within 6 months of the first visit and classified the patients according to the performance and results of BMD screening. Incidence rates (IRs) of fractures were calculated in each group and risk factors for fractures were identified using Poisson regression analysis. RESULTS A total of 95 PMR patients with median (interquartile range) age of 64.0 (56.0-72.0) years were included. Baseline BMD was assessed in only 55.8% of these patients (n = 53); 24 patients with osteoporosis, 20 with osteopenia, and 9 with normal BMD. During 433.1 person-years (PYs) of observation, 17 fractures occurred in 12 patients (IR, 3.93 [95% confidence interval (CI), 2.46-6.26]/100 PYs); 8.32 (95% CI, 4.09-16.90)/100 PYs in the osteopenia group, 3.40 (95% CI, 1.30-8.90)/100 PYs in the osteoporosis group, and 3.37 (95% CI, 1.53-7.39)/100 PYs in the no BMD test group. Risk factors for fractures were female sex, advanced age (≥ 65 years), longer follow-up duration, initial glucocorticoid dose ≥ 10 mg/day, and higher cumulative glucocorticoid dose over the first 6 months. CONCLUSION The incidence rate of fractures in Korean patients with PMR was 3.93/100 PYs. Female sex, advanced age, longer follow-up duration, and increased glucocorticoid dose are risk factors for osteoporotic fracture.
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Affiliation(s)
- Bora Nam
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Yoon-Kyoung Sung
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Chan-Bum Choi
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Tae-Hwan Kim
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Jae-Bum Jun
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Sang-Cheol Bae
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Dae-Hyun Yoo
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea
| | - Soo-Kyung Cho
- Department of Rheumatology, Hanyang University Hospital for Rheumatic Diseases, Seoul, Korea
- Hanyang University Institute for Rheumatology Research, Seoul, Korea.
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Ehsanbakhsh A, Azarkar G, Ziaee M, Taghavieh A. Prevalence of Bone Density Reduction and Its Related Factors in Hemophilia Patients in South Khorasan Province in 2018. Galen Med J 2021; 9:e1711. [PMID: 34466574 PMCID: PMC8344027 DOI: 10.31661/gmj.v9i0.1711] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 09/19/2019] [Accepted: 04/27/2020] [Indexed: 11/16/2022] Open
Abstract
Background: The present study aimed to determine the prevalence of bone density reduction and its associated factors in hemophilia patients in South Khorasan Province in 2018. Materials and Methods: This case-control study was conducted on all patients with hemophilia type A with medical records in Hemophilia center in South Khorasan province. A number of 57 eligible subjects who met the criteria were selected based on census method. Thereafter, 60 non-hemophilic individuals who were similar to hemophilic patients in terms of age and body mass index were selected by convenience sampling method. DXA device was used to measure bone mineral density (BMD) in two locations of femoral neck and lumbar vertebrae. Data were analyzed in SPSS software (version 19), using Chi-square, Fisher’s exact test, and independent t-test. A P-value less than 0.05 was considered statistically significant. Results: The prevalence rate of bone density reduction in spine bone in hemophilia patients was measured at 31.6% and 13.3% in non-hemophilia subjects (P=0.02); moreover, this rate in hip bone was reported as 7% and 5%, respectively (P=0.65). Relative frequency of bone density reduction in the spine and hip bone was not significantly different among hemophilia patients based on age, severity of hemophilia, vitamin D, hepatitis and smoking (P>0.05). However, a significant difference was detected in terms of body mass index (P<0.05). Conclusion: Based on the obtained results, the prevalence of bone density reduction in hemophilic patients was significantly higher, as compared to that of non-hemophilia patients. This necessitates the implementation of drastic preventive measures, prompt diagnosis, timely treatment, and appropriate therapeutic measures.
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Affiliation(s)
- Alireza Ehsanbakhsh
- Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran
| | - Ghodsiyeh Azarkar
- Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran
- Correspondence to: Ghodsiyeh Azarkar, Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran Telephone Number: 00989155639854 Email Address:
| | - Masood Ziaee
- Infectious Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Taghavieh
- Department of Radiology, Birjand University of Medical Sciences, Birjand, Iran
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Abstract
As SARS-CoV-2 stunned and overtook everyone's lives, multiple daily briefings, protocols, policies and incident command committees were mobilized to provide frontline staff with the tools, supplies and infrastructure needed to address the COVID-19 pandemic. Medical resources were immediately shifted. In light of the necessity for self-isolation, telemedicine was expanded, although there has been concern than non-pandemic disorders were being ignored. Ambulatory care services such as bone densitometry and osteoporosis centered clinics came to a near halt. Progress with fracture prevention has been challenged. Despite the prolonged pandemic and the consequent sense of exhaustion, we must re-engage with chronic bone health concerns and fracture prevention. Creating triaging systems for bone mineral testing and in person visits, treating individuals designated as high risk of fracture using fracture risk assessment tools such as FRAX, maintaining telemedicine, leveraging other bone health care team members to monitor and care for osteoporotic patients, and re-engaging our primary care colleagues will remain paramount but challenging. The pandemic persists. Thus, we will summarize what we have learned about COVID-19 and bone health and provide a framework for osteoporosis diagnosis, treatment, and follow-up with the extended COVID-19 pandemic. The goal is to preserve bone health, with focused interventions to sustain osteoporosis screening and treatment initiation/maintenance rates.
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Affiliation(s)
- R R Narla
- Division of Metabolism, Endocrinology and Nutrition, Department of Medicine, School of Medicine, University of Washington, Seattle, WA, USA
- Division of Endocrinology, Metabolism and Nutrition, Veterans Affairs Puget Sound Health Care System, Seattle, WA, USA
| | - R A Adler
- Endocrinology and Metabolism Section (111P), McGuire Veterans Affairs Medical Center, Central Virginia Veterans Affairs Health Care System, 1201 Broad Rock Boulevard, Richmond, VA, 23249, USA.
- Division of Endocrinology, Metabolism, and Diabetes Mellitus, Virginia Commonwealth University, Richmond, VA, USA.
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El-Bagalaty AE, Ismaeel MM. Suit therapy versus whole-body vibration on bone mineral density in children with spastic diplegia. J Musculoskelet Neuronal Interact 2021; 21:79-84. [PMID: 33657757 PMCID: PMC8020017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Osteoporosis because of physical inactivity is one of the major complications associated with neuromuscular disorders. The study aimed to compare using Suit therapy and whole-body vibration in addition to selected physical therapy program to improve Bone Mineral Density in children with cerebral palsy of spastic diplegia. METHODS Forty-six patients were classified randomly into two equal groups. Patients in the group (A) engaged in a selected physical therapy program, also besides, suit therapy training program while those in the group (B) received the same selected physical therapy program received by group (A) in addition to the whole-body vibration training program. The treatment programs were conducted three times per week for twelve successive weeks. Measurements obtained included bone mineral density at the lumbar spine as well as at the femoral neck. These measures were recorded pre- and post-treatment. RESULTS There was a significant improvement in favor of the whole-body Vibration group. Bone mineral density improved significantly at both the lumbar spine (P=.038) and the femoral neck (P=.005) in the WBV group as compared to the Suit therapy group. CONCLUSIONS Whole-body vibration is effective in improving Bone Mineral Density rather than Suit therapy in children with cerebral palsy of spastic diplegia.
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Affiliation(s)
- Amira E. El-Bagalaty
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Egypt
| | - Marwa M.I. Ismaeel
- Department of Physical Therapy for Pediatrics, Faculty of Physical Therapy, Cairo University, Egypt,Corresponding author: Marwa M.I. Ismaeel, Ph.D. P.T., 7 Ahmed Elzayyat Street, Bain Elsarayat, Giza, Egypt E-mail:
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Tang H, He JH, Gu HB, Zhu K, Lu CJ, Sun LL, Gui GP, Deng FY, Lei SF. The different correlations between obesity and osteoporosis after adjustment of static mechanical loading from weight and fat free mass. J Musculoskelet Neuronal Interact 2021; 21:351-7. [PMID: 34465673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
OBJECTIVES To explore complex correlations between obesity (OB) and osteoporosis (OP) after adjustment of static mechanical loading from weight and fat free mass (FFM). METHODS A total of 3749 Chinese aged ≥65 years were selected from our ongoing cohort study. OB indices and bone mineral density (BMD) were measured for each subject. Linear regression analyses were performed to explore the correlations between OB indices and OP under three adjustment models (unadjusted, adjusted with weight and adjusted with FFM). RESULTS Under no adjustment, three general obesity indices (body mass index: BMI, fat mass: FM, and percentage FM: PFM) were positively associated with BMD at three skeletal sites (P<0.001) in the regression analyses. However, after the adjustment with weight, these associations were mostly significant but reverse i.e., negatively in direction. After adjustment with FFM, the three indices were still positively and significantly (P<0.001) associated with BMD but regression coefficients were smaller compared to the unadjusted associations. Similar associations were observed for central adiposity and lower limb adiposity indices. CONCLUSIONS The combined relation of OB to OP due to the physiological factors secreted from adipose tissues and the static mechanical loading from FM is positive in direction.
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Tamimi A, Tamimi F, Juweid M, Al-Qudah AA, Masri AA, Dahbour S, Bahou YA, Shareef A, Tamimi I. Could vagus nerve stimulation influence bone remodeling? J Musculoskelet Neuronal Interact 2021; 21:255-262. [PMID: 34059570 PMCID: PMC8185259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
Abstract
OBJECTIVES To investigate the effect of vagus nerve stimulation (VNS) on the bone mineral density (BMD) in epileptic patients. METHODS A prospective cohort study was conducted on individuals with refractory seizures who underwent VNS surgery between January 2012 and December 2018. BMD was measured preoperatively and between 6 months and one year after surgery. RESULTS Twenty-one patients (mean age (±SD)=23.6±12.3 years) were recruited for the implantation of a VNS device. The mean absolute increase in lumbar BMD in the 21 patients was 0.04±0.04 g/cm2 resulting in an overall percent increase from baseline of 4.7±6.1%. BMD increased by an amount ≥ the least significant change (LSC) for the lumbar spine in 13 patients (61.9%). The lumbar Z score also increased in these patients from -1.22±1.15 to -0.88±1.22, P=0.006). Pre and Post VNA femoral BMD was measured in only 11 patients and, of those 3 showed a significant increase in BMD, 1 a significant decrease and 7 no change. CONCLUSION The implantation of a VNS was associated with an increase in lumbar BMD. This study could lead to a new application for VNS in the treatment of osteoporosis.
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Affiliation(s)
- Ahmad Tamimi
- Neurosurgery Department, Jordan University Hospital, Jordan
| | - Faleh Tamimi
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar,Faculty of Dentistry, McGill University, Canada
| | - Malik Juweid
- Nuclear Medicine Department, Jordan University Hospital, Jordan
| | | | - Amira Al Masri
- Pediatric Neurology Department, Jordan University Hospital, Jordan
| | - Said Dahbour
- Neurology Department, Jordan University Hospital, Jordan
| | - Yakub Al Bahou
- Neurology Department, Jordan University Hospital, Jordan
| | | | - Iskandar Tamimi
- Orthopedic surgery Department, Hospital Regional Universitario de Malaga, Spain,Corresponding author: Iskandar Tamimi, Servicio de Cirugía Ortopédica y Traumatologia. Hospital Regional Universitario de Málaga, Avd Carlos Haya SN, 29010 Málaga. Spain E-mail:
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Zafeiris EP, Babis GC, Zafeiris CP, Chronopoulos E. Association of vitamin D, BMD and knee osteoarthritis in postmenopausal women. J Musculoskelet Neuronal Interact 2021; 21:509-516. [PMID: 34854390 PMCID: PMC8672405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The aim of this study was to analyze the association of knee OA with bone mineral density (BMD) and vitamin D serum levels in postmenopausal women. METHODS A cross-sectional study including 240 postmenopausal women with knee OA was conducted. Demographic data were recorded along with balance and functionality scores. Knee OA severity was assessed by the radiological Kellgren & Lawrence scale. BMD and T-scores were calculated in hips and lumbar spine. Serum levels of vitamin D were also measured. RESULTS High BMI (p<0.005), high number of children (p=0.022) and family history of hip fracture (p=0.011) are significantly associated with knee OA severity. Lumbar spine OP is negatively associated with knee OA (p<0.005). A significant difference was detected between vitamin D deficiency and severe knee OA, adjusted for BMD [OR (95%CI); 3.1 (1.6-6.1), p=0.001]. BMD does not affect the relationship of vitamin D levels in relation to OA and vitamin D levels do not affect the relationship of BMD with OA. CONCLUSIONS Low BMD has a protective role against knee OA while vitamin D deficiency contributes significantly to knee OA severity. However, the association between OA and OP is not affected by vitamin D deficiency and the association of OA and vitamin D serum levels is not affected by BMD.
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Affiliation(s)
- Evangelos P. Zafeiris
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece;,Corresponding author: Evangelos P. Zafeiris, 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Agias Olgas 3-5, 14233, Athens, Greece E-mail:
| | - George C. Babis
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece
| | - Christos P. Zafeiris
- Orthopaedics and Spine Surgery, Metropolitan General Hospital, Athens, Greece,Laboratory for Research of the Musculoskeletal System, School of Medicine University of Athens, Greece
| | - Efstathios Chronopoulos
- 2nd Department of Orthopaedics, National and Kapodistrian University of Athens, School of Medicine, Athens, Greece;,Laboratory for Research of the Musculoskeletal System, School of Medicine University of Athens, Greece
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Chen K, Wu R, Mo B, Yan X, Shen D, Chen M. Comparison between liraglutide alone and liraglutide in combination with insulin on osteoporotic rats and their effect on bone mineral density. J Musculoskelet Neuronal Interact 2021; 21:142-148. [PMID: 33657765 PMCID: PMC8020012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
OBJECTIVES To compare the therapeutic efficacy of liraglutide (LRG) single drug combined with insulin (Ins) on osteoporosis in rats and its effect on bone mineral density (BMD). A rat model of diabetes combined with osteoporosis was established. METHODS 40 Sprague-Dawley rats were divided into four groups (blank, control, LRG and LRG+Ins). Serum levels of CrossLaps, procollagen type I N propeptide (PINP), alkaline phosphatase (AKP) and osteocalcin (BGP) were detected by ELISA. Blood glucose was measured by its reaction with glucose oxidase. Serum insulin was analyzed by radioimmunology. Bone calcium and phosphorus contents were also recorded. ELISA was used to detect inflammatory factors. Bone mineral density (BMD) measurement was also performed. RESULTS BMD of the control group was significantly lower than that of the other three groups (p<0.05) and BMD of the LRG + Ins group was significantly higher than that of the LRG group (p<0.05). The inflammatory factors of the control group were significantly higher than those in the other three groups (p<0.05). The inflammatory factors were negatively correlated with BMD (p<0.05). CONCLUSIONS liraglutide in combination with insulin for the treatment of diabetes complicated with osteoporosis can reduce blood glucose in vivo, promote production of islet, effectively improve osteoporosis symptoms, increase BMD and reduce the levels of inflammatory factors in vivo.
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Affiliation(s)
- Kai Chen
- Department of Orthopedics, Fenghua People’s Hospital, P.R. China
| | - Ruofei Wu
- Department of Orthopedics, Fenghua People’s Hospital, P.R. China
| | - Bin Mo
- Department of Orthopedics, Fenghua People’s Hospital, P.R. China
| | - Xuegang Yan
- Department of Orthopedics, Fenghua People’s Hospital, P.R. China
| | - Dongjun Shen
- Department of Orthopedics, Fenghua People’s Hospital, P.R. China
| | - Maoxi Chen
- Department of Orthopedics, Fenghua People’s Hospital, P.R. China,Corresponding author: Dr. Maoxi Chen, Department of Orthopedics, Fenghua People’s Hospital, No.36 Gongyuan Road, Ningbo 315500, P.R. China E-mail:
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Gkastaris K, Goulis DG, Potoupnis M, Anastasilakis AD, Kapetanos G. Obesity, osteoporosis and bone metabolism. J Musculoskelet Neuronal Interact 2020; 20:372-381. [PMID: 32877973 DOI: pmid/32877973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Obesity and osteoporosis have become major global health problems over the last decades as their prevalence is increasing. The interaction between obesity and bone metabolism is complex and not fully understood. Historically, obesity was thought to be protective against osteoporosis;however, several studies have challenged this belief. Even though the majority of the studies suggest that obesity has a favourable effect on bone density, it is unclear what the effect of obesity is on skeletal microarchitecture. Additionally, the effects of obesity on skeletal strength might be site-dependent as obese individuals are at higher risk of certain fractures. Several mechanical, biochemical and hormonal mechanisms have been proposed to explain the association between the adipose tissue and bone. Mechanical loading has positive effects on bone health, but this may not suffice in obesity. Low-grade systemic inflammation is probably harmful to the bone and increased bone marrow adipogenesis may lead to decreased bone mass in obese individuals. Finally, visceral abdominal fat may exert different actions to the bone compared with the subcutaneous fat. Achieving a better understanding of the association between adipose and bone tissue may help to identify new molecular therapeutic targets that will promote osteoblastic activity and/or inhibit adipogenesis and osteoclastic activity.
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Affiliation(s)
- Konstantinos Gkastaris
- Department of Endocrinology and Diabetes, Royal United Hospitals Bath NHS Foundation Trust, Bath, United Kingdom
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics & Gynecology, Medical School, Aristotle University of Thessaloniki, Greece
| | - Michael Potoupnis
- Academic Orthopaedic Unit of Papageorgiou General Hospital, Aristotle University of Thessaloniki, Greece
| | | | - Georgios Kapetanos
- Academic Orthopaedic Unit of Papageorgiou General Hospital, Aristotle University of Thessaloniki, Greece
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Lee J, Chang G, Kang H, Ham DW, Lee JS, Jung HS, Song KS. Impact of Bone Mineral Density on the Incidence of Age-Related Vertebral Fragility Fracture. J Korean Med Sci 2020; 35:e116. [PMID: 32356418 PMCID: PMC7200181 DOI: 10.3346/jkms.2020.35.e116] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/25/2020] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND Vertebral fragility fracture (VFF) is a common fracture related to osteoporosis. However, VFF might be asymptomatic and often occurs in patients without osteoporosis. Therefore, we investigated the characteristics of age-related VFF and their correlation with bone mineral density (BMD). Furthermore, we analyzed other factors affecting VFF. METHODS Medical records from a single center were retrospectively reviewed for 2,216 patients over 50 years old with vertebral fractures conservatively treated from 2005 to 2016. Patients' age, gender, body mass index (BMI), BMD, fracture level, previous vertebral fractures, and anti-osteoporosis medications were obtained. Patients were divided into fragility/non-fragility groups and age sub-groups. The odds ratio for VFF in relation to BMD was evaluated. We also identified other predictive factors for VFF by age groups. RESULTS The fragility group had a higher women ratio, older age, lower BMI, lower BMD, and greater incidence of previous vertebral fractures than the non-fragility group. VFFs were seen in 41.18% of normal BMD patients aged 50-59 and 67.82% of those aged 60-69. The proportion of VFFs increased with age in all WHO osteoporosis classifications. Patients with osteopenia and osteoporosis were 1.57 and 2.62 fold more likely to develop VFFs than normal BMD. In the younger group (under 70), age, women, BMD, and previous vertebral fracture were significant factors affecting VFF, and in the older group (70 and over), age, women, and BMD were factors. In the fragility group, anti-osteoporosis medication rates were 25.08% before and 45.96% after fracture. CONCLUSION Considerable VFFs occurred in the younger age groups without osteoporosis and age itself was another important predictor of VFF especially in older age groups. The discrepancy between the incidence of VFF and BMD suggests the necessity of supplemental screening factors and anti-osteoporosis treatment guidelines using only BMD should be reconsidered.
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Affiliation(s)
- Jeongik Lee
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Geunwu Chang
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyun Kang
- Department of Anesthesiology and Pain Medicine, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Dae Woong Ham
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Jae Sung Lee
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Hyoung Seok Jung
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Kwang Sup Song
- Department of Orthopaedic Surgery, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea.
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Simon D, Haschka J, Muschitz C, Kocijan A, Baierl A, Kleyer A, Schett G, Kapiotis S, Resch H, Sticherling M, Rech J, Kocijan R. Bone microstructure and volumetric bone mineral density in patients with hyperuricemia with and without psoriasis. Osteoporos Int 2020; 31:931-939. [PMID: 31925472 DOI: 10.1007/s00198-019-05160-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Accepted: 09/09/2019] [Indexed: 12/15/2022]
Abstract
UNLABELLED We analyzed volumetric bone mineral density (vBMD) and bone microstructure using HR-pQCT in subjects with normouricemia (NU) and subjects with hyperuricemia (HU) with and without psoriasis (PSO). HU was associated with higher cortical vBMD and thickness. Differences in average and trabecular vBMD were found between patients with PSO + HU and NU. INTRODUCTION Hyperuricemia (HU) and gout are co-conditions of psoriasis and psoriatic arthritis. Current data suggest a positive association between HU and areal bone mineral density (BMD) and a negative influence of psoriasis on local bone, even in the absence of arthritis. However, the influence of the combination of HU and psoriasis on bone is still unclear. The aim of this study was to assess the impact of HU with and without psoriasis on bone microstructure and volumetric BMD (vBMD). METHODS Healthy individuals with uric acid levels within the normal range (NU), with hyperuricemia (HU), patients with hyperuricemia and psoriasis (PSO + HU), and patients with uric acid within the normal range and psoriasis (PSO + NU) were included in our study. Psoriasis patients had no current or past symptoms of arthritis. Average, trabecular, and cortical vBMD (mgHA/cm3); trabecular number (Tb.N, 1/mm) and thickness (Tb.Th, mm); inhomogeneity of the network (1/N.SD, mm); and cortical thickness (Ct.Th., mm) were carried out at the ultradistal radius using high-resolution peripheral quantitative computed tomography. In addition, bone turnover markers such as DKK-1, sclerostin, and P1NP were analyzed. RESULTS In total, 130 individuals were included (44 NU participants (34% female), 50 HU (24%), 16 PSO + HU (6%), 20 PSO + NU (60%)). Subjects were aged: NU 54.5 (42.8, 62.1), HU 57.5 (18.6, 65.1), PSO + HU 52.0 (42.3, 57.8), and PSO + NU 42.5 (34.8, 56.8), respectively. After adjusting for age, sex, BMI, and diabetes, patients in the HU group revealed significantly higher values of cortical vBMD (p < 0.001) as well as cortical thickness (p = 0.04) compared to the NU group. PSO + NU showed no differences to NU, but PSO + HU demonstrated both lower average (p = 0.03) and trabecular vBMD (p = 0.02). P1NP was associated with average, cortical, and trabecular vBMD as well as cortical thickness while sclerostin levels were related to trabecular vBMD. CONCLUSION Hyperuricemia in otherwise healthy subjects was associated with a better cortical vBMD and higher cortical thickness. However, patients with both psoriasis and hyperuricemia revealed a lower vBMD.
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Affiliation(s)
- D Simon
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - J Haschka
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria
- Karl Landsteiner Institute for Rheumatology and Gastroenterology, 1060, Vienna, Austria
| | - C Muschitz
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria
| | | | - A Baierl
- Department of Statistics and Operations Research, University of Vienna, Oskar Morgenstern-Platz 1, 1090, Vienna, Austria
| | - A Kleyer
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - G Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - S Kapiotis
- Central Laboratory, St. Vincent Group, 1060, Vienna, Austria
| | - H Resch
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria
- Karl Landsteiner Institute for Rheumatology and Gastroenterology, 1060, Vienna, Austria
- Medical Faculty of Bone Diseases, Sigmund Freud University Vienna, Sigmund Freud Platz 1, Vienna, Austria
| | - M Sticherling
- Department of Dermatology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - J Rech
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU) Erlangen-Nürnberg and Universitätsklinikum Erlangen, 91054, Erlangen, Germany
| | - R Kocijan
- St. Vincent Hospital Vienna, Medical Department II, Academic Teaching Hospital of the Medical University Vienna, Stumpergasse 13, 1060, Vienna, Austria.
- Karl Landsteiner Institute for Rheumatology and Gastroenterology, 1060, Vienna, Austria.
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Buehring B, Thomas J, Wittkämper T, Baraliakos X, Braun J. [Evaluation of the trabecular bone score (TBS) in routine clinical care of patients with inflammatory rheumatic and non-inflammatory diseases : Correlation with conventional bone mineral density measurement and prevalence of vertebral fractures]. Z Rheumatol 2020; 79:1067-1074. [PMID: 32162022 PMCID: PMC7708337 DOI: 10.1007/s00393-020-00764-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Hintergrund Osteoporosebedingte Frakturen sind bei Patienten mit rheumatoider Arthritis (RA) häufig. Die Messung der Knochenmineraldichte (KDM) mit der Dual-Energie-Röntgenabsorptionsmessung (DXA) allein sagt das Frakturrisiko nur begrenzt voraus. Der Trabecular Bone Score (TBS) ist ein Surrogatmarker für die trabekuläre Mikroarchitektur des Knochens, der das Frakturrisiko unabhängig von der KDM vorhersagen kann. Ziel Ermittlung der Prävalenz von KDM, TBS und osteoporotisch bedingten Wirbelkörperbrüchen („vertebral fractures“ [VF]) bei Patienten mit RA im Vergleich zu Kontrollen mit nichtentzündlichen Muskel-Skelett-Erkrankungen (MSK). Methoden Die Daten von Patienten mit von Rheumatologen diagnostizierter RA und verfügbaren TBS- und DXA-Messungen, die in unserem Krankenhaus von 2006 bis 2014 erhoben wurden, wurden retrospektiv analysiert. Den RA-Patienten wurden Kontrollen mit nichtentzündlichen MSK zugeordnet. Eine „reduzierte Knochengesundheit“ wurde definiert als ein T‑Score <−1,0 und/oder ein TBS-Wert <−1,31. Statistische Vergleiche wurden mit dem Mann-Whitney- und dem Wilcoxon-Test durchgeführt. Ergebnisse Es wurden 143 Patienten mit RA (Alter 72,1 ± 11,1 Jahre, 72 % weiblich) und 106 Kontrollen (Alter 69,6 ± 12,6 Jahre, 75 % weiblich) eingeschlossen. RA-Patienten hatten häufiger eine erniedrigte KDM (n = 102; 71,3 %) und einen erniedrigen TBS-Wert (n = 125; 87,4 %) als die Kontrollen (n = 63; 59,4 % und n = 79; 74,5 %, p = 0,049 und p = 0,009). RA-Patienten hatten mehr VF (n = 52, 36,4 %) als Kontrollen (n = 24, 22,6 %, p = 0,02). Insgesamt hatten 20 Patienten mit VF (26,3 %) eine normale Wirbelsäulen-KDM und 9 (11,8 %) auch eine normale Hüft-KDM. Bei Patienten mit VF war die Kombination eines niedrigen TBS bei normaler WS-KDM häufiger als ein normaler TBS bei niedriger WS-KDM (p = 0,008 für RA, p = 0,025 für Kontrollen). Diskussion VF treten bei Patienten mit normaler KDM auf. Bei Patienten mit VF wurde eine niedrige TBS bei normaler Wirbelsäulen-KDM häufiger gefunden als eine normale TBS bei niedriger Wirbelsäulen-KDM. Die Messung des TBS scheint für die Erkennung eines erhöhten Frakturrisikos bei RA-Patienten mit normaler WS-KDM nützlich zu sein.
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Affiliation(s)
- B Buehring
- Rheumazentrum Ruhrgebiet, Ruhr Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland.
| | - J Thomas
- Rheumazentrum Ruhrgebiet, Ruhr Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | | | - X Baraliakos
- Rheumazentrum Ruhrgebiet, Ruhr Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
| | - J Braun
- Rheumazentrum Ruhrgebiet, Ruhr Universität Bochum, Claudiusstr. 45, 44649, Herne, Deutschland
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Kim HJ, Kim JE, Choo J, Min J, Chang S, Lee SC, Pyun WB, Seo KS, Karm MH, Koo KT, Rhyu IC, Myoung H, Heo MS. A clinical pilot study of jaw bone mineral density measured by the newly developed dual-energy cone-beam computed tomography method compared to calibrated multislice computed tomography. Imaging Sci Dent 2019; 49:295-299. [PMID: 31915615 PMCID: PMC6941836 DOI: 10.5624/isd.2019.49.4.295] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Revised: 10/04/2019] [Accepted: 10/07/2019] [Indexed: 01/09/2023] Open
Abstract
Purpose This clinical pilot study was performed to determine the effectiveness of dual-energy cone-beam computed tomography (DE-CBCT) in measuring bone mineral density (BMD). Materials and Methods The BMD values obtained using DE-CBCT were compared to those obtained using calibrated multislice computed tomography (MSCT). After BMD calibration with specially designed phantoms, both DE-CBCT and MSCT scanning were performed in 15 adult dental patients. Three-dimensional (3D) Digital Imaging and Communications in Medicine data were imported into a dental software program, and the defined regions of interest (ROIs) on the 3-dimensional surface-rendered images were identified. The automatically-measured BMD values of the ROIs (g/cm3), the differences in the measured BMD values of the matched ROIs obtained by DE-CBCT and MSCT 3D images, and the correlation between the BMD values obtained by the 2 devices were statistically analyzed. Results The mean BMD values of the ROIs for the 15 patients as assessed using DE-CBCT and MSCT were 1.09±0.07 g/cm3 and 1.13±0.08 g/cm3, respectively. The mean of the differences between the BMD values of the matched ROIs as assessed using DE-CBCT and calibrated MSCT images was 0.04±0.02 g/cm3. The Pearson correlation coefficient between the BMD values of DE-CBCT and MSCT images was 0.982 (r=0.982, P<0.001). Conclusion The newly developed DE-CBCT technique could be used to measure jaw BMD in dentistry and may soon replace MSCT, which is expensive and requires special facilities.
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Affiliation(s)
- Hyun Jeong Kim
- Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | | | | | | | | | | | - Woong Beom Pyun
- Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Kwang-Suk Seo
- Department of Dental Anesthesiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Myong-Hwan Karm
- Department of Dental Anesthesiology, Seoul National University Dental Hospital, Seoul, Korea
| | - Ki-Tae Koo
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - In-Chul Rhyu
- Department of Periodontology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Hoon Myoung
- Department of Oral and Maxillofacial Surgery and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
| | - Min-Suk Heo
- Department of Oral and Maxillofacial Radiology and Dental Research Institute, School of Dentistry, Seoul National University, Seoul, Korea
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine, China Medical University, Taichung, Taiwan.,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Hung Kuo
- Department of Research, Taichung Tzu Chi Hospital, Taichung, Taiwan
| | - Kuan-Fu Liao
- College of Medicine, Tzu Chi University, Hualien, Taiwan .,Division of Hepatogastroenterology, Department of Internal Medicine, Taichung Tzu Chi Hospital, Taichung, Taiwan
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Acharya N, Chattopadhyay A, Dhir V. 'DESIRABLE' or not? Ann Rheum Dis 2019; 80:e138. [PMID: 31492704 DOI: 10.1136/annrheumdis-2019-216236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 09/01/2019] [Indexed: 11/03/2022]
Affiliation(s)
- Nupoor Acharya
- Internal Medicine (Rheumatology Unit), Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Arghya Chattopadhyay
- Internal Medicine (Rheumatology Unit), Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Varun Dhir
- Internal Medicine (Rheumatology Unit), Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Stoffers IE, de Vries MC, Hannema SE. Physical changes, laboratory parameters, and bone mineral density during testosterone treatment in adolescents with gender dysphoria. J Sex Med 2019; 16:1459-1468. [PMID: 31405768 DOI: 10.1016/j.jsxm.2019.06.014] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 05/25/2019] [Accepted: 06/23/2019] [Indexed: 01/17/2023]
Abstract
INTRODUCTION Current treatment guidelines for adolescents with gender dysphoria recommend therapy with gonadotropin-releasing hormone agonists (GnRHa) and testosterone in transgender males. However, most evidence on the safety and efficacy of testosterone is based on studies in adults. AIM This study aimed to investigate the efficacy and safety of testosterone treatment in transgender adolescents. METHODS The study included 62 adolescents diagnosed with gender dysphoria who had started GnRHa treatment and had subsequently received testosterone treatment for more than 6 months. MAIN OUTCOME MEASURE Virilization, anthropometry, laboratory parameters, and bone mineral density (BMD) were analyzed. RESULTS Adolescents were treated with testosterone for a median duration of 12 months. Voice deepening began within 3 months in 85% of adolescents. Increased hair growth was first reported on the extremities, followed by an increase of facial hair. Acne was most prevalent between 6 and 12 months of testosterone therapy. Most adolescents had already completed linear growth; body mass index and systolic blood pressure increased but diastolic blood pressure did not change. High-density lipoprotein (HDL) cholesterol and sex hormone binding globulin significantly decreased, but hematocrit, hemoglobin, prolactin, androstenedione, and dehydroepiandrosterone sulfate significantly increased, although not all changes were clinically significant. Other lipids and HbA1c did not change. Vitamin D deficiency was seen in 32-54% throughout treatment. BMD z-scores after 12 to 24 months of testosterone treatment remained below z-scores before the start of GnRHa treatment. CLINICAL IMPLICATIONS Adolescents need to be counseled about side effects with potential longer term implications such as increased hematocrit and decreased HDL cholesterol and decreased BMD z-scores. They should be advised on diet, including adequate calcium and vitamin D intake; physical exercise; and the use of tobacco and alcohol to avoid additional risk factors for cardiovascular disease and osteoporosis. STRENGTHS & LIMITATIONS Strengths are the standardized treatment regimen and extensive set of safety parameters investigated. Limitations are the limited duration of follow-up and lack of a control group so some of the observed changes may be due to normal maturation rather than to treatment. CONCLUSION Testosterone effectively induced virilization beginning within 3 months in the majority of adolescents. Acne was a common side effect, but no short-term safety issues were observed. The increased hematocrit, decreased HDL cholesterol, and decreased BMD z-scores are in line with previous studies. Further follow-up studies will need to establish if the observed changes result in adverse outcomes in the long term. Stoffers IE, de Vries MC, Hannema SE. Physical Changes, Laboratory Parameters, and Bone Mineral Density During Testosterone Treatment in Adolescents with Gender Dysphoria. J Sex Med 2019;16:1459-1468.
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Affiliation(s)
- Iris E Stoffers
- Department of Pediatrics, Leiden University Medical Centre, Leiden, the Netherlands
| | - Martine C de Vries
- Department of Pediatrics, Leiden University Medical Centre, Leiden, the Netherlands; Department of Medical Ethics and Health Law, Leiden University Medical Centre, Leiden, the Netherlands
| | - Sabine E Hannema
- Department of Pediatrics, Leiden University Medical Centre, Leiden, the Netherlands.
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Babaei M, Shamsi R, Heidari B, Bijani A, Hosseini SR. Serum Uric Acid Status and Its Association with Bone Mineral Density in the Elderly People Aged 60 Years and More. Int J Endocrinol Metab 2019; 17:e80780. [PMID: 31497038 PMCID: PMC6708522 DOI: 10.5812/ijem.80780] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 04/17/2019] [Accepted: 06/02/2019] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Osteoporosis is associated with decreased antioxidant defenses and serum uric acid (UA) as an antioxidant may exert a protective effect on bone mass. OBJECTIVES This study aimed to determine the association between serum UA and bone mineral density (BMD) in the elderly population. METHODS All participants of the Amirkola Health and Ageing Project aged ≥ 60 years entered the study. BMD in the femoral neck (FN-BMD) and lumbar spine (LS-BMD) was determined by dual energy X-ray absorptiometry and osteoporosis was defined as BMD T-score < - 2.5 at either FN or LS. The patients were classified according to serum UA levels as < 4; 4 - 4.99; 5 - 5.99; 6 - 6.99 and > 7 mg/dL. In statistical analysis, the value of BMD as well as frequency of osteoporosis in each subgroup were compared with the control group (UA < 4 mg/dL). RESULTS A total of 1080 patients were studied. By increasing serum UA from < 4 mg/dL to > 7 mg/dL the BMD at both measurement sites increased as well. The serum UA was associated with decreased risk of osteoporosis. In multivariate analysis, the odds of osteoporosis in the subgroup with serum UA levels between 4 - 4.99 mg/dL was significantly lower than the control group (OR = 0.66, 95% CI, 0.44 - 0.99). Age and female sex were associated with increased odds of osteoporosis (OR = 1.08, 95% CI, 1.05 - 1.10 and OR = 10.62, 95% CI, 7.53 - 14.97 respectively). CONCLUSIONS These findings indicate a negative association between serum UA and osteoporosis in the elderly population aged ≥ 60 years.
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Affiliation(s)
- Mansour Babaei
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
- Department of Internal Medicine, Division of Rheumatology, Babol University of Medical Sciences, Babol, Iran
| | - Reza Shamsi
- Student Committee Research, Babol University of Medical Sciences, Babol, Iran
| | - Behzad Heidari
- Mobility Impairment Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
- Clinical Research Development Unit of Rouhani Hospital, Babol University of Medical Sciences, Babol, Iran
- Corresponding Author: Department of Internal Medicine, Division of Rheumatology, Babol University of Medical Sciences, Babol, Iran.
| | - Ali Bijani
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
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Montazeri-Najafabady N, Dabbaghmanesh MH, Mohammadian Amiri R, Akbarzadeh M. Association of Vitamin D Receptor BsmI Gene Polymorphism with BMD Z-Score in Iranian Children and Adolescents (9 - 18 Years Old). Int J Endocrinol Metab 2019; 17:e82677. [PMID: 31372170 PMCID: PMC6635677 DOI: 10.5812/ijem.82677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2018] [Revised: 02/06/2019] [Accepted: 04/09/2019] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND The vitamin D receptor (VDR) gene variants are known as the main risk factor for low bone mass. OBJECTIVES In this study, the association of vitamin D receptor genetic variants, BsmI (rs1544410) and FokI (rs2228570), with bone mass in Iranian children and adolescents, was evaluated. METHODS The study population comprised of children and adolescents aged between 9 to 18 years (FokI: 123 boys and 120 girls, BsmI: 108 boys and 110 girls). Vitamin D, calcium, phosphorus, total cholesterol (TC), High-density lipoprotein-cholesterol (HDL-C) and triglyceride (TG) concentrations were assayed. Bone mineral density and body composition parameters were measured by the Hologic system DXA. BMD Z-score ≤ -2 was considered as low bone density for chronologic age. PCR-restriction fragment length polymorphism was done for genotyping of BsmI and FokI polymorphisms. The association between VDR variants and bone mineral density was investigated using logistic regression analysis. RESULTS No significant differences in body composition and biochemical parameters were detected among the evaluated VDR genotypes. For VDR BsmI, the mean values for Z-score of the lumbar spine, neck, inter and total femur was greater in the bb genotype compared to BB and Bb genotypes. Logistic regression analysis revealed a significant association between femoral neck Z-score and VDR BsmI genotypes in an additive genetic model (unadjusted model (P = 0.035; Bb vs. bb), model 1 (adjusted for age and sex, P = 0.021; Bb vs. bb), model 2 (adjusted for age, sex and BMI, P = 0.013; Bb vs. bb) and model 3 (adjusted for age, sex, BMI and puberty, P = 0.011; Bb vs. bb, P = 0.049; BB vs. bb)) and dominant genetic model ((unadjusted model, P = 0.033; BB+Bb vs. bb), model 1 (adjusted for age and sex, P = 0.023; BB+Bb vs. bb), model 2 (adjusted for age, sex and BMI, P = 0.012; BB+Bb vs. bb and model 3 (adjusted for age, sex, BMI and puberty, P = 0.012; BB+Bb vs. bb)). CONCLUSIONS This investigation indicated that VDR BsmI polymorphism may be associated with BMD Z-score of the femoral neck but not the lumbar spine, in Iranian children and adolescents.
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Affiliation(s)
- Nima Montazeri-Najafabady
- Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hossein Dabbaghmanesh
- Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
- Corresponding Author: Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Rajee Mohammadian Amiri
- Endocrinology and Metabolism Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Akbarzadeh
- Cellular and Molecular Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Robinson L, Aldridge VK, Clark EM, Misra M, Micali N. Bone health in adult women with ED: A longitudinal community-based study. J Psychosom Res 2019; 116:115-122. [PMID: 30577982 PMCID: PMC7105899 DOI: 10.1016/j.jpsychores.2018.12.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Revised: 12/11/2018] [Accepted: 12/12/2018] [Indexed: 11/26/2022]
Abstract
Although Eating Disorders (ED) are known to affect bone health and development, little is known about the longitudinal effect of ED and ED behaviours on bone health in community dwelling adult women. Women (n = 3507) enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) participated in a two-phase prevalence study to assess lifetime ED and ED behaviours (fasting, restrictive eating, vomiting and misuse of medication). Crude and adjusted linear regression methods investigated the association between ED diagnoses and behaviours, and total body, hip, leg and arm bone mineral density (BMD) DXA scans at mean ages of 48 and 52 years. Lifetime occurrence of Anorexia Nervosa (AN) was associated with lower BMD Z-scores for the whole body (mean difference (MD) = -0.28; 95% CI: -0.49, -0.05), hip (MD = -0.45; 95% CI -0.74, -0.16), leg (MD = -0.28; 95% CI -0.52, -0.03) and arm (MD = -0.44; 95% CI -0.68, -0.19) compared to no ED. This effect was mostly accounted for by lowest ever BMI. In post-hoc analyses, Restrictive AN, but not Binge-Purge AN was associated with a lower total body BMD Z-scores (MD = -0.37; 95% CI -0.62, -0.12). Lifetime Fasting and Restrictive Eating were associated with low BMD of the total body, hip, arm and leg in adjusted analyses, all p < 0.05. Both lifetime ED diagnoses and ED behaviours in a large community sample were predictive of low BMD in mid-life. This study confirms that the effects of AN, fasting and restrictive eating, and low BMI on bone health seen in clinical samples also occur in community samples.
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Affiliation(s)
- Lauren Robinson
- Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, 103 Denmark Hill, SE5 8AZ, UK; Institute of Child Health, University College London, Gower Street, London WC1E 6BT, UK.
| | - Victoria K Aldridge
- Institute of Child Health, University College London, Gower Street, London WC1E 6BT, UK; Health and Life Sciences, De Montfort University, Leicester LE1 9BH3, UK
| | - Emma M Clark
- Division of Pediatric Endocrinolgy, Massachusetts General Hospital for Children, Boston, MA 02114, USA
| | - Madhusmita Misra
- Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Nadia Micali
- Institute of Child Health, University College London, Gower Street, London WC1E 6BT, UK; Child and Adolescent Psychiatry Division, Department of Child and Adolescent health, Geneva University Hospital, Geneva, Switzerland; Dept. of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, US; Musculoskeletal Research Unit, University of Bristol, Bristol, UK
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Jaworski M, Wierzbicka E, Pludowski P, Szalecki M. Forearm bone density, cross-sectional size and muscle cross-sectional area in adolescents with diabetes mellitus type 1 assessed by peripheral quantitative computed tomography. J Musculoskelet Neuronal Interact 2019; 19:435-447. [PMID: 31789294 PMCID: PMC6944798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVES The mechanical components of bone strength (size, shape and density) in adolescents with T1DM are not extensively studied. METHODS The studied group comprises 39 adolescents, aged 11,9-18,0 yrs. The bone and muscle properties were investigated at the forearm (66% and 4% site). All measurements were performed using pQCT method. RESULTS The mean Z-score calculated for the ratio of the total cortical bone cross-sectional area to muscle cross-sectional area at 66% was lower than zero in girls (-0,93+/-1,06; p=0,0042). Significant differences between Tanner stages were noted in boys for mean Z-scores for bone masses, cross-sectional dimensions and strength. CONCLUSIONS T1DM girls revealed a decreased ratio of cortical bone area/muscle area, reflecting disturbed adaptation of the cortical shaft to the muscle force. When the Z-scores of cortical shell dimensions were investigated, cases in Tanner stage 5 diverged from "less mature" individuals, which may suggests that bone shaft development in these individuals was impaired, affecting both size and strength.
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Affiliation(s)
- Maciej Jaworski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland,Corresponding author: Maciej Jaworski, Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Al. Dzieci Polskich 20, 04-730 Warsaw, Poland E-mail:
| | - Elzbieta Wierzbicka
- Department of Human Nutrition, Warsaw University of Life Sciences-SGGW, Warsaw, Poland
| | - Pawel Pludowski
- Department of Biochemistry, Radioimmunology and Experimental Medicine, The Children’s Memorial Health Institute, Warsaw, Poland
| | - Mieczyslaw Szalecki
- Department of Endocrinology and Diabetology, The Children’s Memorial Health Institute, Warsaw, Poland,Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland
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Qiao Y, Wang B, Yang JJ, Fan YF, Guo Q, Dou ZJ, Huang YQ, Feng TT, Wang SJ, An DD, Gao XL. Bone Metabolic Markers in Patients with Obstructive Sleep Apnea Syndrome. Chin Med J (Engl) 2018; 131:1898-1903. [PMID: 30082519 PMCID: PMC6085856 DOI: 10.4103/0366-6999.238149] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Background: Obstructive sleep apnea syndrome (OSAS) is prevalent in obesity and is associated with many metabolic abnormalities. The relationship between OSAS and bone metabolism is still unclear. The aim of this study was to investigate the relationship between the severity of OSAS and bone metabolic markers. Methods: A total of 119 obese males were enrolled in this study in spring months from 2015 to 2017. All candidates underwent polysomnography, and their bone mineral density (BMD) and the serum levels of total procollagen type 1 N-terminal propeptide (t-P1NP), N-terminal midfragment of osteocalcin (N-MID), β-C-terminal telopeptide of type 1 collagen (β-CTX), vitamin D (VD), and parathyroid hormone (PTH) were measured. The analysis of variance and Pearson correlation analysis were performed for data analyses. Results: No significant differences in the mean values of BMD were observed among the obesity, mild-to-moderate OSAS, and severe OSAS groups; and the serum levels of t-P1NP and β-CTX in the severe OSAS group were significantly higher than those in the obesity group (48.42 ± 23.78 ng/ml vs. 31.98 ± 9.85 ng/ml, P < 0.001; 0.53 ± 0.24 ng/ml vs. 0.41 ± 0.13 ng/ml, P = 0.011, respectively). The serum level of VD in the obesity group was significantly higher than those in the mild-to-moderate and severe OSAS groups (both P < 0.001), and decreased as the severity of OSAS increased (P < 0.001). The serum level of PTH in the severey and mild-to-moderate OSAS groups (both P < 0.001). The results of correlation analysis indicated that the level of apnea-hypopnea index (AHI) was correlated with the levels of t-P1NP (r = 0.396, P < 0.001), VD (r = –0.404, P < 0.001), and PTH (r = 0.400, P < 0.001), whereas the level of minimum O2 saturation (SaO2 min) was correlated with the levels of VD (r = 0.258, P = 0.016) and PTH (r = –0.376, P < 0.001). Conclusions: The levels of bone resorption and formation markers in patients with severe OSAS were significantly increased compared to obese men, and the severity of OSAS was correlated with the serum levels of t-P1NP, VD, and PTH.
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Affiliation(s)
- Yan Qiao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Bei Wang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Jiao-Jiao Yang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Yan-Feng Fan
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Qian Guo
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Zhan-Jun Dou
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Ya-Qiong Huang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Ting-Ting Feng
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Shu-Juan Wang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Dong-Dong An
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi 030001, China
| | - Xiao-Ling Gao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi 030001, China
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Abstract
BACKGROUND In postmenopausal women, there is rapid bone loss due to estrogen depletion. In women, reproductive factors such as age at menarche, breastfeeding, and parity are considered risk factors of osteoporosis. Many reports suggest that obesity is associated with a reduced risk of osteoporosis. This nationwide, population-based study aims to identify the association between maternal age and osteoporosis risk in postmenopausal women of different obesity classifications. METHODS We assessed data from the Korean National Health and Nutrition Examination Survey 2010-2012. The study included 1,328 postmenopausal women, after excluding women with missing data for reproductive history among 4,546 postmenopausal women in the survey. Multivariate regression was used to identify the association between childbirth age and postmenopausal bone mineral density after adjustments for confounding factors. RESULTS The prevalence of postmenopausal osteoporosis was 35.24% (n = 468). After dividing the subjects into obese and non-obese groups based on body mass index (BMI) and waist circumference, there were significant differences between non-osteoporosis and osteoporosis groups with regard to age at first childbirth, age at last childbirth, and parity in the BMI-based general obesity group. The prevalence of osteoporosis was highest in women older than 35 years old at last childbirth. The prevalence of osteoporosis was also greater in women with parity ≥ 4 compared to those with lower parity levels. CONCLUSION Postmenopausal women of older age at last childbirth and higher parity were at increased risk of osteoporosis in the BMI-based non-general obesity group.
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Affiliation(s)
- Ji Sun We
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea
| | - Kyungdo Han
- Department of Medical Statistics, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyuk-Sang Kwon
- Department of Internal Medicine, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea
| | - Kicheol Kil
- Department of Obstetrics and Gynecology, The Catholic University of Korea, Yeouido St. Mary's Hospital, Seoul, Korea
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Seo JY, Ha KY, Kim YH, Kim SC, Yoon EJ, Park HY. Bone Mineral Density and Osteoporotic Vertebral Fractures in Traditional, Unassisted, Free-Diving Women (Haenyeos). J Korean Med Sci 2018; 33:e316. [PMID: 30473654 PMCID: PMC6249170 DOI: 10.3346/jkms.2018.33.e316] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Accepted: 10/23/2018] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Water pressure and muscle contraction may influence bone mineral density (BMD) in a positive way. However, divers experience weightlessness, which has a negative effect on BMD. The present study investigated BMD difference in normal controls and woman free-divers with vertebral fracture and with no fracture. METHODS Between January 2010 and December 2014, traditional woman divers (known as Haenyeo in Korean), and non-diving women were investigated. The study population was divided into osteoporotic vertebral fracture and non-fracture groups. The BMD of the lumbar spine and femoral neck was measured. The radiological parameters for global spinal sagittal balance were measured. RESULTS Thirty free-diving women and thirty-three non-diving women were enrolled in this study. The mean age of the divers was 72.1 ± 4.7 years and that of the controls was 72.7 ± 4.0 years (P = 0.61). There was no statistical difference in BMD between the divers and controls. In divers, cervical lordosis and pelvic tilt were significantly increased in the fracture subgroup compared to the non-fracture subgroup (P = 0.028 and P = 0.008, respectively). Sagittal vertical axis was statistically significantly correlated with cervical lordosis (Spearman's rho R = 0.41, P = 0.03), and pelvic tilt (Spearman's rho R = 0.46, P = 0.01) in divers. CONCLUSION BMD did not differ significantly between divers and controls during their postmenopausal period. When osteoporotic spinal fractures develop, compensation mechanisms, such as increased cervical lordosis and pelvic tilt, was more evident in traditional woman divers. This may be due to the superior back muscle strength and spinal mobility of this group of women.
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Affiliation(s)
- Jun-Yeong Seo
- Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Kee-Yong Ha
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young-Hoon Kim
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Seong-Chan Kim
- Department of Orthopaedic Surgery, Jeju National University Hospital, Jeju National University School of Medicine, Jeju, Korea
| | - Eun-Ji Yoon
- Jeju National University School of Medicine, Jeju, Korea
| | - Hyung-Youl Park
- Department of Orthopaedic Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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