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Bagherzadeh M, Sajjadi-Jazi SM, Sharifi F, Ebrahimpur M, Amininezhad F, Ostovar A, Shafiee G, Heshmat R, Mehrdad N, Razi F, Nabipour I, Larijani B. Effects of metabolic syndrome on bone health in older adults: the Bushehr Elderly Health (BEH) program. Osteoporos Int 2020; 31:1975-1984. [PMID: 32440891 DOI: 10.1007/s00198-020-05455-4] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2020] [Accepted: 05/05/2020] [Indexed: 12/24/2022]
Abstract
UNLABELLED Based on the clinical, BMD, and TBS data of 2380 participants aged ≥ 60 which was gathered during the BEH program, stage II, we showed that MetS was positively associated with BMD, while a negative or no association was observed between MetS and TBS depending on the sex and the adjustment model. INTRODUCTION The results of previous reports in regard to the effect of metabolic syndrome (MetS) on bone health are not conclusive. This study aimed to evaluate the association between MetS with bone mineral density (BMD) and trabecular bone score (TBS) as an indicator of bone quantity and quality, respectively. METHODS Using a cross-sectional design, this study was carried out based on the data collected during the BEH Program, stage II. MetS was defined according to NCEP-ATP III criteria. BMD (at the lumbar spine and the hip) and lumbar spine TBS were assessed by dual-energy X-ray absorptiometry device. RESULTS The data of 2380 participants (women = 1228, men = 1152) aged ≥ 60 were analyzed. In the fully adjusted regression models (including BMI), significant associations between MetS and mean BMD were observed across all locations in men (P values ≤ 0.001) and in the lumbar spine in women (P value = 0.003). In addition, the prevalence of osteoporosis (based on BMD) was significantly lower in those with MetS than those without MetS in both sexes, even after full adjustments (women, OR = 0.707, P value = 0.013; men, OR = 0.563, P value = 0.001). In contrast, in age-adjusted regression analyses, the prevalence of degraded bone microarchitecture (TBS ≤ 1.2) was significantly increased in those with MetS than those without, irrespective of the participants' sex (P values < 0.05). The mean TBS was also negatively associated with MetS in women (β = - 0.075, P value = 0.007) but not in men (β = - 0.052, P value = 0.077), in age-adjusted regression models. However, after including BMI in the adjusted models, all significant associations between TBS values and MetS disappeared. CONCLUSION It seems that a positive association exists between MetS and BMD, while MetS is either not associated or negatively correlated with bone quality as measured by TBS.
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Affiliation(s)
- M Bagherzadeh
- Clinical Research Development Center, Shahid Beheshti Hospital, Qom University of Medical Sciences, Qom, Iran
| | - S M Sajjadi-Jazi
- Cell therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - M Ebrahimpur
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Amininezhad
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - A Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - G Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - R Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - N Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - F Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - I Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - B Larijani
- Endocrinology and Metabolism Research center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Abstract
BACKGROUND/AIMS Evidence of increased risk of osteoporosis and osteopenia in chronic liver disease and cirrhosis is inconsistent. This study aims to investigate this relationship and to identify the predictors of increased loss of bone mineral density in Saudi patients. PATIENTS AND METHODS One hundred and sixty-four patients and controls who are age and gender matched, were included in this study with 1:1 ratio. Patients' included in this study were adults with confirmed liver cirrhosis. Bone mineral densitometry (BMD) at both lumbar spine (LS) and femoral neck (FN) were collected for both groups. Univariate and multivariate regression analyses were performed to identify predictors of BMD loss. RESULTS Results showed that cirrhotic patients are at higher risk of developing osteoporosis or osteopenia at LS (OR 2.23, 95% CI [1.19-4.19], P = 0.01) but not at FN, when compared to control sample. Patients with cirrhosis were found to have lower vitamin D and PTH levels (P = 0.0005) and (P = 0.006), respectively. Of the possible predictors tested (gender, age, body mass index [BMI], phosphorus, calcium, parathyroid hormone (PTH), vitamin D, and Model for End Stage Liver Disease [MELD] score), female gender was the main predictor of loss of BMD at LS only (OR 4.80, 95% CI [1.47-15.73], P = 0.01). CONCLUSIONS The study showed that cirrhotic patients are at increased susceptibility of having decreased BMD, particularly at the LS and it highlights the need for preventive measures, especially for female patients.
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Affiliation(s)
- Ibrahim N. Muhsen
- College of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Omar AlFreihi
- College of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Faisal Abaalkhail
- College of Medicine, Alfaisal University, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia,Liver Transplantation and Hepatobiliary Surgery, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdullah AlKhenizan
- Department of Family Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Mohammed Khan
- Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Abdelmoneim Eldali
- Department of Biostatistics, Epidemiology and Scientific Computing, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Fahad Alsohaibani
- Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia,Address for correspondence: Dr. Fahad Alsohaibani, Department of Medicine, Section of Gastroenterology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia. E-mail:
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Shariati-Sarabi Z, Rezaie HE, Milani N, Rezaie FE, Rezaie AE. Evaluation of Bone Mineral Density in Perimenopausal Period. Arch Bone Jt Surg 2018; 6:57-62. [PMID: 29430497 PMCID: PMC5799602] [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] [Received: 11/05/2016] [Accepted: 08/27/2017] [Indexed: 06/08/2023]
Abstract
BACKGROUND The menopausal transition called perimenopause, happens after the reproductive years, and is specified with irregular menstrual cycles, perimenopause symptoms and hormonal changes. Women going through peri menopausal period are vulnerable to bone loss . Osteoporosis is one of the most common debilitating metabolic bone diseases, especially in the women almost around 50 years. This study was intended to evaluate the prevalence of osteopenia/osteoporosis amongst asymptomatic individuals during the menopause transition period. METHODS A total of 714 asymptomatic peri-menopausal female volunteers were recruited through a billboard invitation for participation in the study. The subjects were selected based on already defined inclusion and exclusion criteria. The project, which was conducted between 2010 and 2014 was affiliated to the Educational and Therapeutic Center, Imam Reza Hospital, Mashhad, Iran. Bone Mineral Densitometry (BMD) measured by DEXA (dual-energy X-ray absorptiometry) was carried out on two distinct sites, the proximal femur and the lumbar vertebrae from L1 to L4. Pertained data were analyzed. RESULTS The mean age of the subjects was 49.7±2.years. The overall prevalence of osteopenia and osteoporosis in these peri-menopausal individuals were 37.6 % and 10% respectively. Thirty five point two percent of 714 women presented with osteopenia and eight percent of them have osteoporosis in the femoral neck, respectively. Nonetheless, BMD values at the lumbar spine indicated 41.6% and 12% of individual participants being affected by osteopenia and osteoporosis. CONCLUSION In general osteopenia or osteoporosis, occurred in 48% of this study population, implying that special attention is required for the bone health status of Iranian women who undergo menopause.Level of evidence: II.
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Affiliation(s)
- Zhaleh Shariati-Sarabi
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Hamid Etemad Rezaie
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Nasrin Milani
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Farnaz Etemad Rezaie
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
| | - Ali Etemad Rezaie
- Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran Neurosurgery Department, Ghaem Hospital, Mashhad University of Medical Sciences, Mashhad, Iran Internal Medicine Department, Imam Reza hospital, Mashhad University of Medical Sciences, Mashhad, Iran Rosalind Franklin University of Medicine and Science 3333 Green Bay Road, North Chicago, USA
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