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Gonçalves C, Moreira H, Santos R. Systematic review of mediterranean diet interventions in menopausal women. AIMS Public Health 2024; 11:110-129. [PMID: 38617417 PMCID: PMC11007410 DOI: 10.3934/publichealth.2024005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 12/21/2023] [Accepted: 12/25/2023] [Indexed: 04/16/2024] Open
Abstract
The increasing lifespan of women and their extended time spent in menopause pose significant challenges for health care systems, primarily due to the impacts of postmenopausal estrogen deficiency and aging on health. Menopause's onset is linked to a heightened prevalence of obesity, metabolic syndrome, cardiovascular disease, and osteoporosis. Diet is particularly relevant during menopause given its impact on quality of life and longevity and its modifiability. Because the Mediterranean diet is currently regarded as one of the healthiest dietary models in the world, the aim of this systematic review was to assess current evidence regarding the effectiveness of studies on the Mediterranean diet as an intervention for menopausal women. A systematic review of intervention-based studies involving the Mediterranean diet among menopausal women was performed in Scopus, PubMed, and Web of Science. The results of seven that met the inclusion criteria suggests that adherence to the Mediterranean diet can have beneficial impacts on menopausal women's health, including reductions in weight, blood pressure, blood ω6: ω3 ratio, triglycerides, total cholesterol, and LDL levels. Those results seem to be relevant for public health interventions aimed at improving menopausal women's quality of life.
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Affiliation(s)
- Carla Gonçalves
- CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
- EPIUnit - Instituto de Saúde Pública - Laboratório para a Investigação Integrativa e Translacional em Saúde Populacional (ITR), Universidade do Porto, Porto, Portugal
- CISAS - Center for Research and Development in Agrifood Systems and Sustainability, Instituto Politécnico de Viana do Castelo, 4900-347 Viana do Castelo, Portugal
| | - Helena Moreira
- CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Institute for Innovation, Capacity Building and Sustainability of Agri-food Production (Inov4Agro), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
- CIDESD - Research Center in Sports Sciences, Health Sciences and Human Development, Laboratory of Biomechanics, Body Composition and Health (LaB2Health), Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Ricardo Santos
- CIFI2D - Centre of Research, Education, Innovation and Intervention in Sport, Faculdade de Desporto, Universidade do Porto, Porto, Portugal
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Han Y, Wu J, Tan F, Sha J, Zhang B, Zhai J, Wang X. 45, X/ 46, X, psu idic (Y) (q11.2) Mosaicism in a Primary Amenorrhea Girl with Swyer Syndrome. Case Rep Genet 2023; 2023:9127512. [PMID: 36938529 PMCID: PMC10019959 DOI: 10.1155/2023/9127512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 02/24/2023] [Accepted: 03/04/2023] [Indexed: 03/21/2023] Open
Abstract
The female characters with a 46, XY karyotype, historically termed Swyer syndrome, are commonly divided into complete and partial gonadal dysgenesis. The former is completely made up of the 46, XY chromosome, while the latter results from 45, X/46, XY mosaicism. Both of them are sex chromosome disorders and are typically characterized by delayed puberty and primary amenorrhea due to disruption of the embryonic gonads into testes. In this report, we described a young female with mos 45, X [2]/46, X, psu idic (Y) (q11.2) [48] by karyotyping. Further copy number variation sequencing (CNV-seq) and fluorescent in situ hybridization (FISH) verified her chromosome alteration. The following gonadectomy and hormone replacement therapy were carried out, and the menstrual cycle recovered along with the development of bilateral breasts and uteruses. Herein, we aim to provide clinical management strategies for the patient with Swyer syndrome in clinical practice.
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Affiliation(s)
- Yu Han
- Graduate School of Xuzhou Medical University, Huaihai West Road No. 84, Xuzhou, Jiangsu, China
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
| | - Jiebin Wu
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
| | - Fangfang Tan
- Graduate School of Xuzhou Medical University, Huaihai West Road No. 84, Xuzhou, Jiangsu, China
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
- Department of Gynecology and Obstetrics, Pizhou People's Hospital, Nanjing Road No. 9, Pizhou, Jiangsu, China
| | - Jing Sha
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
| | - Bei Zhang
- Graduate School of Xuzhou Medical University, Huaihai West Road No. 84, Xuzhou, Jiangsu, China
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
| | - Jingfang Zhai
- Graduate School of Xuzhou Medical University, Huaihai West Road No. 84, Xuzhou, Jiangsu, China
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
| | - Xuezhen Wang
- Department of Prenatal Diagnosis Medical Center, Xuzhou Central Hospital, Xuzhou Clinical School of Xuzhou Medical University, Jiefang South Road No. 199, Xuzhou, Jiangsu, China
- Graduate School of Bengbu Medical College, Donghai Avenue No. 2600, Bengbu, Anhui, China
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Wei MC, Chou YH, Yang YS, Kornelius E, Wang YH, Huang CN. Osteoporosis and Stress Urinary Incontinence in Women: A National Health Insurance Database Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E4449. [PMID: 32575826 PMCID: PMC7344808 DOI: 10.3390/ijerph17124449] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 06/06/2020] [Accepted: 06/18/2020] [Indexed: 12/21/2022]
Abstract
We aimed to determine the influence of osteoporosis and stress urinary incontinence in women. We hypothesized that women with osteoporosis had an increased risk of stress urinary incontinence. This retrospective study used data from the Taiwan Longitudinal Health Insurance database from 2005-2009. The study population was screened to identify women (age ≥ 40 years) newly diagnosed with osteoporosis (ICD-9-CM code = 733.0, 733.1). The osteoporosis cohort included 6125, and the non-osteoporosis cohort included 12,250 participants. The newly diagnosed stress urinary incontinence incidence was calculated to determine the influence of osteoporosis and stress urinary incontinence. We used the Cox proportional hazards model to predict the effects of stress urinary incontinence and the Kaplan-Meier analysis to estimate the cumulative incidence of stress urinary incontinence in women. Participants with osteoporosis experienced a 1.79 times higher risk than that of the non-osteoporosis group (95% CI = 1.28-2.51) for stress urinary incontinence, regardless of age. We did not observe a higher risk of stress urinary incontinence in participants with pathological fractures compared to those with simple osteoporosis. Our data emphasized that physicians and nurses should conduct urinary incontinence screening in women with osteoporosis to recommend proper treatment, medical help or to bring the disorder to light.
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Affiliation(s)
- Ming-Cheng Wei
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Department of Neurosurgery, Lee General Hospital, Yuanli Town, Miaoli 35845, Taiwan
| | - Ying-Hsiang Chou
- Department of Radiation Oncology, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
- Department of Medical Imaging and Radiological Sciences, Chung Shan Medical University Hospital, Taichung 40201, Taiwan
| | - Yi-Sun Yang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (Y.-S.Y.); (E.K.)
| | - Edy Kornelius
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (Y.-S.Y.); (E.K.)
| | - Yu-Hsun Wang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung 40201, Taiwan;
| | - Chien-Ning Huang
- Institute of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan;
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chung Shan Medical University Hospital, Taichung 40201, Taiwan; (Y.-S.Y.); (E.K.)
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Bristow SM, Gamble GD, Horne AM, Reid IR. Longitudinal changes in bone mineral density, bone mineral content and bone area at the lumbar spine and hip in postmenopausal women, and the influence of abdominal aortic calcification. Bone Rep 2019; 10:100190. [PMID: 30766896 PMCID: PMC6360344 DOI: 10.1016/j.bonr.2018.100190] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Accepted: 12/24/2018] [Indexed: 11/17/2022] Open
Abstract
Longitudinal studies often report that spine bone mineral density (BMD), measured by DXA, is stable in older adults, which has been attributed to osteophyte development and the presence of aortic calcification. A decline in projected spine area as a result of loss of intervertebral disc height might also contribute to higher BMD. We utilised data from 297 postmenopausal women (mean 73 years) who had DXA measurements of the lumbar spine, total hip and femoral neck 5 years apart, and abdominal aortic calcification scoring from vertebral morphometry. BMD declined by -4.4% at the total hip and -3.9% at the femoral neck (p < 0.001), but did not change at the spine (-0.5%, p = 0.12). In contrast, bone mineral content (BMC) declined by -4.0% at the total hip, -2.5% at the femoral neck and -1.7% at the spine (all p < 0.001). Bone area increased by 0.5% at the hip and 1.6% at the femoral neck but declined by -1.2% at the spine (all p < 0.001). 43% of the cohort had abdominal aortic calcification (AAC) present at baseline. The presence of AAC at baseline was not related to changes in BMD or BMC at the total hip or femoral neck, nor to BMD at the spine. However, women with AAC present had a smaller loss of BMC at the spine than those without (-0.8% versus -2.4%, p = 0.03). AAC score increased more over 5 years among those with AAC at baseline than those without (0.28 versus 0.16, p = 0.036). Thus, the stability of spine BMD is the result of both a loss of projected bone area (as a result of intervertebral disc changes and/or a decrease in projected area of the vertebral bodies) and the effects of aortic calcification. Future clinical trials should consider assessing changes in spine BMC as a more informative index of spine mineral status.
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Affiliation(s)
- Sarah M Bristow
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Greg D Gamble
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Anne M Horne
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand
| | - Ian R Reid
- Department of Medicine, Faculty of Medical and Health Sciences, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand.,Department of Endocrinology, Auckland District Health Board, Auckland, New Zealand
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Ahn KS, Kang CH, Cho SB, Cho KH, Han KD, Park YG, Kim YH. Height Loss Was Associated With Osteoporosis in Korean Elderly Men, Not in Women: The Korea National Health and Nutrition Examination Survey 2008-2010. J Clin Densitom 2019; 22:59-66. [PMID: 28781229 DOI: 10.1016/j.jocd.2017.07.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Revised: 07/03/2017] [Accepted: 07/07/2017] [Indexed: 01/28/2023]
Abstract
The degree of height loss varies among individuals, and excessive height loss can be a vertebral fracture or bone loss manifestation. The objective of this study was to examine the relationships between height loss and bone mineral density (BMD) and to assess the prevalence of osteoporosis according to the height loss quartiles. Data from the Korea National Health and Nutrition Examination Survey were analyzed. A total of 2799 participants more than 60 years old were included and subdivided into quartiles according to height loss (Q1-Q4). Height loss was calculated with the difference between the self-reported maximum adult height and the actual measured height. BMD was measured by dual-energy X-ray absorptiometry at the total femur (TF), femoral neck, and lumbar spine. Multivariable linear and logistic regression analyses were conducted to study the height loss-BMD and the height loss-osteoporosis prevalence relationships, respectively. After adjustments for all covariates, height loss was negatively associated with BMD at all the 3 sites (TF and lumbar spine, p < 0.001; femoral neck, p = 0.002) in men, but only at TF (p = 0.008) in women. Men with Q4 height loss had an increased prevalence of osteoporosis compared with those with Q1 (odds ratio = 2.092 and 95% confidence interval = 1.076-4.068). In women, the prevalence of osteoporosis was not associated with height loss. In conclusion, Q4 height loss in elderly men was associated with the increased prevalence of osteoporosis in Korea.
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Affiliation(s)
- Kyung-Sik Ahn
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Chang Ho Kang
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Sung Bum Cho
- Department of Radiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Hwan Cho
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea
| | - Kyung-Do Han
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Yong-Gyu Park
- Department of Medical Statistics, Catholic University College of Medicine, Seoul, Republic of Korea
| | - Yang-Hyun Kim
- Department of Family Medicine, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Republic of Korea.
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Mai X, Marshall B, Hovey KM, Sperrazza J, Wactawski-Wende J. Risk factors for 5-year prospective height loss among postmenopausal women. Menopause 2018; 25:883-889. [PMID: 29738411 PMCID: PMC6059996 DOI: 10.1097/gme.0000000000001108] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Height loss is common in older women and has been associated with increased morbidity and mortality. In this study, we identified factors that could predict prospective height loss in postmenopausal women. METHODS Height was measured in 1,024 postmenopausal women, enrolled in the Buffalo Osteoporosis and Periodontal Disease Study, at baseline and 5 years later using a fixed stadiometer. Demographics, lifestyle, medical history, and medication use were assessed at baseline. Stepwise logistic regression was used to identify factors that are associated with marked height loss of ≥1 inch. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for each predictor. Receiver-operating characteristic (ROC) curve was performed to determine the discriminatory ability of the prediction model. RESULTS The mean loss of height was 0.4 (SD 0.7) inches. Age (OR 1.11, 95% CI 1.06-1.16), weight (OR 1.05, 95% CI 1.03-1.07), use of oral corticosteroids (OR 4.96, 95% CI 1.25-19.72), and strenuous exercise at age 18 ≥ three times per week (OR 0.55, 95% CI 0.31-0.98) were significantly associated with marked height loss in the multivariable-adjusted model. The area under the ROC curve is 72.1%. Addition of bone mineral density measures did not improve the discriminatory ability of the prediction model. CONCLUSIONS This set of available variables may be useful in predicting the 5-year risk of height loss of 1 inch or more in postmenopausal women. These findings may help to target older women at risk of height loss who may benefit most from prevention strategies for fracture and mortality.
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Affiliation(s)
- Xiaodan Mai
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY
| | - Britt Marshall
- Department of Medicine. Penn State Milton S. Hershey Medical Center. Hershey, PA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY
| | - Jill Sperrazza
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo, NY
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY
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García-Peña C, Pérez-Zepeda MU. Validity of Knee-Estimated Height to Assess Standing Height in Older Adults: A Secondary Longitudinal Analysis of the Mexican Health and Aging Study. J Nutr Health Aging 2017; 21:262-265. [PMID: 28244564 PMCID: PMC5749405 DOI: 10.1007/s12603-016-0761-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE The main objective was to test the validity of height estimated by knee height in Mexican older adults, as a surrogate for standing height. DESIGN Cohort study. SETTING Data were drawn from the first and third waves of the Mexican Health and Aging Study. PARTICIPANTS Included participants were community-dwelling 50-year or older adults with measured height at baseline and in follow-up. Subjects with a lower limb fracture in the follow-up were excluded. MEASUREMENTS Main measurements were baseline standing height and 11-year follow-up and knee-estimated height in follow-up. Population specific equations were used to estimate standing height from knee height. Comparisons between baseline standing height and knee-derived height were done with simple correlations, limits of agreement (Bland-Altman plot) and Deming regressions. RESULTS A total of 136 50-year or older adults were followed-up for eleven years, with a mean age of 60. There was a positive correlation between knee-estimated height and baseline standing height of 0.895 (p<0.001) for men and of 0.845 (p<0.001) for women. Limits of agreement for men were from -6.95cm to 7.09cm and for women from -6.58cm to 8.44cm. CONCLUSION According to our results, knee-estimated height could be used interchangeably with standing height in Mexican older adults, and these results might apply also to other populations.
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Affiliation(s)
- C García-Peña
- Mario Ulises Pérez Zepeda Geriatric Epidemiology Research Department at the Instituto Nacional de Geriatría, Periférico Sur 2767, colonia San Jerónimo Lídice, delegación La Magdalena Contreras, ciudad de México, Distrito Federal, México. Phone number: +52 55 55739087, ,
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Jørgensen L, Hansen JB, Brox J, Mathiesen E, Vik A, Jacobsen BK. Serum osteoprotegerin levels are related to height loss: the Tromsø Study. Eur J Epidemiol 2011; 26:305-12. [PMID: 21331661 PMCID: PMC3088831 DOI: 10.1007/s10654-011-9555-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Accepted: 02/04/2011] [Indexed: 11/26/2022]
Abstract
Severe loss of body height is often a consequence of osteoporotic vertebral fractures. Osteoprotegerin (OPG) and receptor activator of nuclear factor-kB ligand (RANKL) are cytokines essential for the regulation of bone resorption. The aim of this study was to assess the relationship between the OPG/RANKL system and height loss. A total of 4,435 inhabitants from the municipality of Tromsø, Norway (2,169 men and 2,266 women) were followed for 6 years. Baseline measurements included height, weight, bone mineral density, OPG, RANKL, serum parathyroid hormone and information about lifestyle, prevalent diseases and use of medication. Height was measured again at follow-up, and the loss of height was categorized into 4 groups: ≤1, 1.1-2, 2.1-3, >3 cm. We found increasing height loss with increasing baseline OPG levels in both men and women (P trend = 0.02 and 0.001, respectively), after adjustments for age and other confounders. However, when the women were stratified according to menopausal status and use of hormone replacement therapy (HRT), a significant relationship was present only among postmenopausal women not using HRT (P trend = 0.02). No relations between OPG and height loss were found in post-menopausal HRT-users and premenopausal women (P trend ≥0.39). We conclude that height loss is positively associated with OPG in men and in postmenopausal women not using HRT. No relationship was found between RANKL and height loss.
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Affiliation(s)
- Lone Jørgensen
- Department of Community Medicine, University of Tromsø, 9037 Tromsø, Norway.
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Auyeung TW, Lee JSW, Leung J, Kwok T, Leung PC, Woo J. Effects of height loss on morbidity and mortality in 3145 community-dwelling Chinese older women and men: a 5-year prospective study. Age Ageing 2010; 39:699-704. [PMID: 20817934 DOI: 10.1093/ageing/afq101] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND height loss beginning in mid-life and post-menopausal period was associated with adverse health outcomes. However, height loss occurring after old age has been little studied. We examined how height loss was related to bone mineral density (BMD) change, fracture incidence and cause-specific mortality in older adults. METHODS the stature and BMD of 3145 community-dwelling men and women aged ≥65 were measured at baseline and after 4 years. All fracture and cause-specific mortality events were searched in a territory-wide clinical information database and death registry. RESULTS twenty-five (1.6%) men and 64 (4.0%) women lost >2 cm after 4 years. In women, the BMD decline was faster in the rapid height losers (adjusted difference = 4.18%, P < 0.001). There was no corresponding difference observed in men. Rapid height loss was associated with excess all fractures and hip fractures (adjusted HR for all fractures = 2.86, P < 0.001; adjusted HR for hip fractures = 4.74, P < 0.01) in women but only hip fractures (adjusted HR = 4.93, P < 0.05) in men. The all-cause (adjusted HR = 3.43, P < 0.01) and respiratory disease mortality (adjusted HR = 5.64, P < 0.05) were higher in men with rapid height loss, whereas those in women were insignificant. CONCLUSIONS modest height loss occurring after old age, >2 cm in 4 years, was associated with excess hip fracture, total and respiratory disease mortality in older men. In women, it was associated with excess BMD decline, all fractures and hip fractures but not mortality. Further research is needed to determine the usefulness of regular stature measurement as an indicator of bone health in the primary-care setting in older adults.
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Affiliation(s)
- Tung Wai Auyeung
- Department of Medicine and Geriatrics, Tuen Mun Hospital, Tuen Mun, New Territories, Hong Kong.
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Grønskag AB, Forsmo S, Romundstad P, Langhammer A, Schei B. Incidence and seasonal variation in hip fracture incidence among elderly women in Norway. The HUNT Study. Bone 2010; 46:1294-8. [PMID: 19944199 DOI: 10.1016/j.bone.2009.11.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2009] [Revised: 11/18/2009] [Accepted: 11/18/2009] [Indexed: 12/14/2022]
Abstract
There is a substantial variation in hip fracture incidence between populations. The Scandinavian countries have the highest incidence of hip fractures worldwide, and latitude and seasonal variation have been discussed as possible reasons for the high fracture incidences. The purpose of this study was to investigate time dependent and seasonal variation of hip fractures in a population based cohort of women aged 65+ residing in a rural county in Norway and followed for 9.3 years. Information at baseline was collected as part of The Nord-Trøndelag Health Study (HUNT) during 1995-97, and 8362 women with no previous hip fracture and with a mean age of 74.3 years were included in the study. All hip fractures occurring after inclusion in the health study were registered (mean follow-up: 9.3 years) by medical journals and x-ray reports. A total of 5661 of the women had their forearm bone mineral density (BMD) measured by single energy x-ray bone densitometers (SXA) as part of HUNT. In total, 782 women sustained a first hip fracture during follow-up, and the overall hip fracture incidence rate per 1000 person-years was 13.1 (95 % CI: 12.2-14.1). The hip fracture incidence increased exponentially by age from 2.1 (95% CI: 1.2-3.8) in the age group 65-69 years to 49.7 (95% CI: 41.2-59.8) among the women aged 90+, respectively. In age-stratified analyses no changes in the incidence of hip fractures were observed during the nine years of follow up. The occurrence of fractures varied by season of the year, characterized by higher fracture rates during the winter months. In conclusion, the hip fracture rates in this population of elderly women are highest in the winter months. There was, however, no indication of an increasing hip fracture incidence in this rural area. Compared to similar studies from more urban areas in Norway, the hip fracture rates in this population seem somewhat lower.
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Affiliation(s)
- Anna Brenne Grønskag
- Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
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Berecki-Gisolf J, Spallek M, Hockey R, Dobson A. Height loss in elderly women is preceded by osteoporosis and is associated with digestive problems and urinary incontinence. Osteoporos Int 2010; 21:479-85. [PMID: 19597905 DOI: 10.1007/s00198-009-0987-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2008] [Accepted: 04/21/2009] [Indexed: 10/20/2022]
Abstract
SUMMARY This study explores risk factors for height loss and consequences in terms of health and wellbeing, in older women. Osteoporosis, low body-mass index, being born in Europe and using medications for both sleep and anxiety were risk factors for height loss. Height loss was associated with digestive problems; excessive height loss was also associated with urinary stress-incontinence and a decline in self-rated health. INTRODUCTION Height loss is associated with osteoporosis, but little is known about its consequences. We aimed to examine the risk factors for height loss and the symptoms associated with height loss. METHODS Elderly participants of the Australian Longitudinal Study on Women's Health (aged 70-75 in 1996) who provided data on height at any two consecutive surveys (held in 1996, 1999, 2002, and 2005) were included (N = 9,852). A regression model was fitted with height loss as the outcome and sociodemographics, osteoporosis, and other risk factors as explanatory variables. Symptoms related to postural changes or raised intra-abdominal pressure were analyzed using height loss as an explanatory variable. RESULTS Over 9 years, average height loss per year was -0.12% (95% confidence intervals [95% CI] = -0.13 to -0.12) of height at baseline. Height loss was greater among those with osteoporosis and low body mass index and those taking medications for sleep and anxiety. After adjusting for confounders, symptoms associated with height loss of > or =2% were heartburn/indigestion (odds ratio [OR] = 1.19, 95% CI = 1.01 to 1.40), constipation (OR = 1.18, 95% CI = 1.01 to 1.37), and urinary stress incontinence (OR = 1.20, 95% CI = 1.02 to 1.41). CONCLUSION These findings highlight the importance of monitoring height among the elderly in general practice and targeting associated symptoms.
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Affiliation(s)
- J Berecki-Gisolf
- School of Population Health, Faculty of Health Sciences, University of Queensland, Herston, QLD, 4006, Australia.
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Past and current weight change and forearm bone loss in middle-aged women: the Nord-Trøndelag Health Study, Norway. Menopause 2010; 16:1197-204. [PMID: 19455067 DOI: 10.1097/gme.0b013e3181a6cbb1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The aim of this study was to investigate the association between bone loss and weight change before and concurrently to the assessment of forearm bone loss over 4.6 years in a population-based cohort of middle-aged women followed for more than 15 years. METHODS Among 8,856 women aged 45 to 60 years attending the first Nord-Trøndelag Health Study study, Norway (1984-1986), a 35% random sample was invited for forearm densitometry at Nord-Trøndelag Health Study 2 (1995-1997), and 2,188 women (78%) attended. After an average period of 4.6 years, they were subsequently invited for follow-up densitometry in 2001, and 1,421 women (67.8%) met. Weight and height were measured on all three occasions. RESULTS During the total period of observation since baseline (15.5 y), the mean weight had increased by 3.4 kg, mostly in the youngest women. Weight loss had an accelerating and weight gain a decelerating effect on bone loss, and this was observed both for weight change occurring before the bone mineral density follow-up and for concurrent weight change. The relationship between prior weight gain or loss and bone loss seemed to persist, independent of the weight change observed during the period of bone loss assessment. CONCLUSIONS Despite no mechanical impact of body weight on the forearm, weight loss in midlife women seems to be associated with a long-lasting negative effect on bone and vice versa for weight gain. This is presumably explained by humoral factors.
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Abstract
BACKGROUND It is not yet established what specific measures of obesity might be most strongly associated with risk of coronary artery disease. We compared the waist-height ratio to waist-hip ratio, waist circumference, and body mass index as predictors of subsequent coronary heart disease (CHD) in a group of predominantly postmenopausal women. METHODS The data come from the prospective Nurses' Health Study cohort. We included 45,563 women in 1986 who were aged 40-65 years and were free of heart disease, stroke, and cancer. Waist circumference, hip circumference, height, weight, age, and other covariates were collected by questionnaire. Our primary end point was incident coronary heart disease reported up to June 2002. Areas under the receiver operating characteristic curves (AUCs) were estimated nonparametrically for each of the anthropometric measures. We estimated differences between the AUCs for weight-height ratio and the other measures, with corresponding 95% confidence intervals. We used Cox proportional hazard models to estimate the relationships with risk of CHD. RESULTS Waist-height ratio, waist-hip ratio, and waist circumference were similar in predicting subsequent risk of CHD. All 3 waist-derived measures were superior to body-mass index (BMI) in predicting CHD. The unadjusted AUCs were 0.62 (95% confidence interval = 0.60-0.64) for waist-height ratio, 0.63 (0.61-0.65) for waist-hip ratio, 0.62 (0.60-0.64) for waist-circumference, and 0.57 (0.55-0.59) for BMI. CONCLUSION Waist-height ratio is comparable with waist circumference and waist-hip ratio for prediction of coronary heart disease incidence among middle-aged and older women, but superior to BMI.
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