1
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Lyu FF, Ramoo V, Chui PL, Ng CG, Zhang Y. Prevalence rate of primary osteoporosis in China: a meta-analysis. BMC Public Health 2024; 24:1518. [PMID: 38844897 PMCID: PMC11155107 DOI: 10.1186/s12889-024-18932-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 05/23/2024] [Indexed: 06/10/2024] Open
Abstract
BACKGROUND Primary osteoporosis (POP) is recognized as a "silent disease" and often ignored. This meta-analysis aimed to determine the prevalence of POP in the Chinese population over the past 20 years to raise awareness of the disease's epidemiology, which is hoped to help prevent and treat the condition better. METHODS Eight English and three Chinese language databases were searched systematically from January 2002 to December 2023. Relevant data were analysed using Stata 16.0. Meta-regression and subgroup analyses were performed to explore causes of heterogeneity. A funnel plot was further drawn in combination with Egger and Begg tests to determine publication bias. RESULTS A total of 45 studies (241,813 participants) were included. The meta-analysis revealed that the overall prevalence of POP in the Chinese population was 18.2% (95% CI: 14.7-21.7%), showing a positive correlation with age. Specifically, prevalence rates were 23.4% (18.3-28.5%) in women and 11.5% (9.1-13.9%) in men. A notable increase was observed within the span of 20 years (16.9% before 2010 and 20.3% in 2011-2020). Notably, regional variations were observed, with southern China reporting a lower prevalence of 16.4% compared to 20.2% in northern China. Meta-regression suggested that sample size significantly influenced the estimation of point prevalence (P = 0.037). CONCLUSIONS Over the past two decades, there has been an increase in the prevalence of POP within the Chinese population. The growing prevalence of older individuals and women further highlights the urgency for tailored disease prevention and control measures.
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Affiliation(s)
- Fang Fei Lyu
- School of Nursing, Yunnan University of Chinese Medicine, Kunming, Yunnan, 650500, China
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Vimala Ramoo
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia.
| | - Ping Lei Chui
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Chong Guan Ng
- Department of Psychological Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
| | - Yuanyuan Zhang
- Department of Nursing Science, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, 50603, Malaysia
- School of Medical and Health Engineering, Changzhou University, Changzhou, Jiangsu, 213000, China
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2
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Wen B, Zhang Y, He J, Tan L, Xiao G, Wang Z, Cui W, Wu B, Wang X, He L, Li M, Zhu Z, Sang D, Zeng C, Jia P, Liu F, Liu T. Causal impact of DNA methylation on refracture in elderly individuals with osteoporosis - a prospective cohort study. BMC Musculoskelet Disord 2024; 25:432. [PMID: 38831438 PMCID: PMC11149363 DOI: 10.1186/s12891-024-07521-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 05/13/2024] [Indexed: 06/05/2024] Open
Abstract
BACKGROUND Osteoporotic vertebral compression fractures (OVCF) in the elderly increase refracture risk post-surgery, leading to higher mortality rates. Genome-wide association studies (GWAS) have identified susceptibility genes for osteoporosis, but the phenotypic variance explained by these genes has been limited, indicating the need to explore additional causal factors. Epigenetic modifications, such as DNA methylation, may influence osteoporosis and refracture risk. However, prospective cohorts for assessing epigenetic alterations in Chinese elderly patients are lacking. Here, we propose to conduct a prospective cohort study to investigate the causal network of DNA polymorphisms, DNA methylation, and environmental factors on the development of osteoporosis and the risk of refracture. METHODS We will collect vertebral and peripheral blood from 500 elderly OVCF patients undergoing surgery, extract DNA, and generate whole genome genotype data and DNA methylation data. Observation indicators will be collected and combined with one-year follow-up data. A healthy control group will be selected from a natural population cohort. Epigenome-wide association studies (EWAS) of osteoporosis and bone mineral density will be conducted. Differential methylation analysis will compare candidate gene methylation patterns in patients with and without refracture. Multi-omics prediction models using genetic variants and DNA methylation sites will be built to predict OVCF risk. DISCUSSION This study will be the first large-scale population-based study of osteoporosis and bone mineral density phenotypes based on genome-wide data, multi-time point methylation data, and phenotype data. By analyzing methylation changes related to osteoporosis and bone mineral density in OVCF patients, the study will explore the feasibility of DNA methylation in evaluating postoperative osteoporosis intervention effects. The findings may identify new molecular markers for effective anti-osteoporosis treatment and inform individualized prevention and treatment strategies. TRIAL REGISTRATION chictr.org.cn ChiCTR2200065316, 02/11/2022.
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Affiliation(s)
- Bingtao Wen
- Department of Orthopedics, Peking University International Hospital, Beijing, China
| | - Yaning Zhang
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China
- Institute of Biomedical Research, Henan Academy of Sciences, Zhengzhou, Henan, China
| | - Jianhua He
- Department of Orthopedics, Peking University International Hospital, Beijing, China
| | - Lei Tan
- Department of Orthopedics, Peking University International Hospital, Beijing, China
| | - Guanggui Xiao
- Department of Rehabilitation, the Second Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China
| | - Zunliang Wang
- Beijing University of Posts and Telecommunications, Beijing, China
| | - Wei Cui
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Bingxuan Wu
- Department of Orthopedics, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Xianhai Wang
- Department of Orthopedics, Changping District Hospital, Beijing, China
| | - Lei He
- Department of Orthopedics, Changping District Hospital, Beijing, China
| | - Ming Li
- Department of Orthopedics, Tengzhou Central People's Hospital, Tengzhou, Shandong, China
| | - Zhongjiao Zhu
- Department of Orthopedics, Tengzhou Central People's Hospital, Tengzhou, Shandong, China
| | - Dacheng Sang
- Department of Orthopaedic Surgery, Yijishan Hospital, The First Affiliated Hospital of Wannan Medical College, Wannan Medical College, Wuhu, Anhui, China
| | - Changqing Zeng
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China
- Institute of Biomedical Research, Henan Academy of Sciences, Zhengzhou, Henan, China
| | - Peilin Jia
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China
| | - Fan Liu
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China
- Department of Forensic Sciences, College of Criminal Justice, Naif Arab University for Security Sciences, Riyadh, Kingdom of Saudi Arabia
| | - Tianzi Liu
- CAS Key Laboratory of Genomic and Precision Medicine, Beijing Institute of Genomics, Chinese Academy of Sciences and China National Center for Bioinformation, Beijing, China.
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China.
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3
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Yuan C, Yu XT, Wang J, Shu B, Wang XY, Huang C, Lv X, Peng QQ, Qi WH, Zhang J, Zheng Y, Wang SJ, Liang QQ, Shi Q, Li T, Huang H, Mei ZD, Zhang HT, Xu HB, Cui J, Wang H, Zhang H, Shi BH, Sun P, Zhang H, Ma ZL, Feng Y, Chen L, Zeng T, Tang DZ, Wang YJ. Multi-modal molecular determinants of clinically relevant osteoporosis subtypes. Cell Discov 2024; 10:28. [PMID: 38472169 PMCID: PMC10933295 DOI: 10.1038/s41421-024-00652-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 01/24/2024] [Indexed: 03/14/2024] Open
Abstract
Due to a rapidly aging global population, osteoporosis and the associated risk of bone fractures have become a wide-spread public health problem. However, osteoporosis is very heterogeneous, and the existing standard diagnostic measure is not sufficient to accurately identify all patients at risk of osteoporotic fractures and to guide therapy. Here, we constructed the first prospective multi-omics atlas of the largest osteoporosis cohort to date (longitudinal data from 366 participants at three time points), and also implemented an explainable data-intensive analysis framework (DLSF: Deep Latent Space Fusion) for an omnigenic model based on a multi-modal approach that can capture the multi-modal molecular signatures (M3S) as explicit functional representations of hidden genotypes. Accordingly, through DLSF, we identified two subtypes of the osteoporosis population in Chinese individuals with corresponding molecular phenotypes, i.e., clinical intervention relevant subtypes (CISs), in which bone mineral density benefits response to calcium supplements in 2-year follow-up samples. Many snpGenes associated with these molecular phenotypes reveal diverse candidate biological mechanisms underlying osteoporosis, with xQTL preferences of osteoporosis and its subtypes indicating an omnigenic effect on different biological domains. Finally, these two subtypes were found to have different relevance to prior fracture and different fracture risk according to 4-year follow-up data. Thus, in clinical application, M3S could help us further develop improved diagnostic and treatment strategies for osteoporosis and identify a new composite index for fracture prediction, which were remarkably validated in an independent cohort (166 participants).
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Affiliation(s)
- Chunchun Yuan
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xiang-Tian Yu
- Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Shanghai Geriatric Institute of Chinese Medicine, Shanghai, China
| | - Bing Shu
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiao-Yun Wang
- Shanghai Research Institute of Acupuncture and Meridian, Shanghai, China
| | - Chen Huang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Xia Lv
- Hudong Hospital of Shanghai, Shanghai, China
| | - Qian-Qian Peng
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Wen-Hao Qi
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Science, Fudan University, Shanghai, China
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Jing Zhang
- Green Valley (Shanghai) Pharmaceuticals Co., Ltd., Shanghai, China
| | - Yan Zheng
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Science, Fudan University, Shanghai, China
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Si-Jia Wang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - Qian-Qian Liang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Qi Shi
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ting Li
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
| | - He Huang
- CAS Key Laboratory of Computational Biology, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, China
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Science, Fudan University, Shanghai, China
| | - Zhen-Dong Mei
- Ministry of Education Key Laboratory of Contemporary Anthropology, Department of Anthropology and Human Genetics, School of Life Science, Fudan University, Shanghai, China
- State Key Laboratory of Genetic Engineering, School of Life Sciences and Human Phenome Institute, Fudan University, Shanghai, China
| | - Hai-Tao Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hong-Bin Xu
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Jiarui Cui
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hongyu Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hong Zhang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Bin-Hao Shi
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Pan Sun
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China
| | - Hui Zhang
- Hudong Hospital of Shanghai, Shanghai, China
| | | | - Yuan Feng
- Green Valley (Shanghai) Pharmaceuticals Co., Ltd., Shanghai, China
| | - Luonan Chen
- State Key Laboratory of Cell Biology, Shanghai Institute of Biochemistry and Cell Biology, Center for Excellence in Molecular Cell Science, Chinese Academy of Sciences, University of Chinese Academy of Sciences, Shanghai, China.
| | - Tao Zeng
- Guangzhou National Laboratory, Guangzhou, China.
| | - De-Zhi Tang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China.
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
| | - Yong-Jun Wang
- Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China.
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China.
- Spine Institute, Shanghai Academy of Traditional Chinese Medicine, Shanghai, China.
- Shanghai University of Traditional Chinese Medicine, Shanghai, China.
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4
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Hu Y, Li X, Chen X, Wang S, Cao L, Zhang H, Zhang Y, Wang Z, Yu B, Tong P, Zhou Q, Niu F, Yang W, Zhang W, Chen S, Yang Q, Shen T, Zhang P, Zhang Y, Miao J, Lin H, Wang J, Wang L, Ma X, Liu H, Stambler I, Bai L, Liu H, Jing Y, Liu G, Wang X, Wang D, Shi Z, Zhao RC, Su J. Expert consensus on Prospective Precision Diagnosis and Treatment Strategies for Osteoporotic Fractures. Aging Dis 2024:AD.2023.1223. [PMID: 38502589 DOI: 10.14336/ad.2023.1223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 12/23/2023] [Indexed: 03/21/2024] Open
Abstract
Osteoporotic fractures are the most severe complications of osteoporosis, characterized by poor bone quality, difficult realignment and fixation, slow fracture healing, and a high risk of recurrence. Clinically managing these fractures is relatively challenging, and in the context of rapid aging, they pose significant social hazards. The rapid advancement of disciplines such as biophysics and biochemistry brings new opportunities for future medical diagnosis and treatment. However, there has been limited attention to precision diagnosis and treatment strategies for osteoporotic fractures both domestically and internationally. In response to this, the Chinese Medical Association Orthopaedic Branch Youth Osteoporosis Group, Chinese Geriatrics Society Geriatric Orthopaedics Committee, Chinese Medical Doctor Association Orthopaedic Physicians Branch Youth Committee Osteoporosis Group, and Shanghai Association of Integrated Traditional Chinese and Western Medicine Osteoporosis Professional Committee have collaborated to develop this consensus. It aims to elucidate emerging technologies that may play a pivotal role in both diagnosis and treatment, advocating for clinicians to embrace interdisciplinary approaches and incorporate these new technologies into their practice. Ultimately, the goal is to improve the prognosis and quality of life for elderly patients with osteoporotic fractures.
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Affiliation(s)
- Yan Hu
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xiaoqun Li
- First Affiliated Hospital of Naval Medical University, Shanghai, China
| | - Xiao Chen
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | | | - Liehu Cao
- Luodian Hospital, Baoshan District, Shanghai, China
| | - Hao Zhang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Yunfei Zhang
- Tangdu Hospital Air Force Medical University, Xi'an, China
| | - Zhiwei Wang
- Eastern Hepatobiliary Surgery Hospital, Shanghai, China
| | - Baoqing Yu
- Shanghai Pudong New Area People's Hospital, Shanghai, China
| | - Peijian Tong
- Zhejiang Provincial Hospital of Chinese Medicine, Hangzhou, China
| | - Qiang Zhou
- Third Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Feng Niu
- First Bethune Hospital of Jilin University, Changchun, China
| | - Weiguo Yang
- HKU Li Ka Shing Faculty of Medicine, Hongkong, China
| | - Wencai Zhang
- First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Shijie Chen
- Third Xiangya Hospital of Central South University, Changsha, China
| | | | - Tao Shen
- Shengjing Hospital of Chinese Medical University, Shenyang, China
| | - Peng Zhang
- Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Yong Zhang
- Tangdu Hospital Air Force Medical University, Xi'an, China
| | - Jun Miao
- Tianjin Hospital, Tianjin, China
| | | | - Jinwu Wang
- Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lei Wang
- Ruijin Hospital Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xin Ma
- Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Hongjian Liu
- First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ilia Stambler
- Department of Science, Technology and Society, Bar Ilan University, Ramat Gan, Israel
- International Society on Aging and Disease, Bryan, TX, USA
| | - Long Bai
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Han Liu
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Yingying Jing
- Institute of Translational Medicine, Shanghai University, Shanghai, China
| | - Guohui Liu
- Union Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xinglong Wang
- Department of Pharmacology & Toxicology, University of Arizona, Tucson, USA
| | - Dongliang Wang
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Zhongmin Shi
- Sixth People's Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, China
| | - Robert Chunhua Zhao
- International Society on Aging and Disease, Bryan, TX, USA
- Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences, School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Jiacan Su
- Xinhua Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
- Institute of Translational Medicine, Shanghai University, Shanghai, China
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5
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Luo N, Zhang L, Xiu C, Luo X, Hu S, Ji K, Liu Q, Chen J. Piperlongumine, a Piper longum-derived amide alkaloid, protects mice from ovariectomy-induced osteoporosis by inhibiting osteoclastogenesis via suppression of p38 and JNK signaling. Food Funct 2024; 15:2154-2169. [PMID: 38311970 DOI: 10.1039/d3fo03830k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
Postmenopausal osteoporosis (PMOP) is a metabolic bone disease that results from overproduction and hyperactivation of osteoclasts caused by insufficient estrogen in women after menopause. Current therapeutic strategies are mainly focused on treating PMOP patients who have already developed severe bone loss or even osteoporotic fractures. Obviously, a better strategy is to prevent PMOP from occurring in the first place. However, such reagents are largely lacking. Piperlongumine (PLM), an amide alkaloid extracted from long pepper Piper longum, exhibits the anti-osteoclastogenic effect in normal bone marrow macrophages (BMMs) and the protective effect against osteolysis induced by titanium particles in mice. This study examined the preventive effect of PLM on PMOP and explored the potential mechanism of this effect using both ovariectomized mice and their primary cells. The result showed that PLM (5 and 10 mg kg-1) administered daily for 6 weeks ameliorated ovariectomy-induced bone loss and osteoclast formation in mice. Further cell experiments showed that PLM directly suppressed osteoclast formation, F-actin ring formation, and osteoclastic resorption pit formation in BMMs derived from osteoporotic mice, but did not obviously affect osteogenic differentiation of bone marrow stromal cells (BMSCs) from these mice. Western blot analysis revealed that PLM attenuated maximal activation of p38 and JNK pathways by RANKL stimulation without affecting acute activation of NF-κB, AKT, and ERK signaling. Furthermore, PLM inhibited expression of key osteoclastogenic transcription factors NFATc1/c-Fos and their target genes (Dcstamp, Atp6v0d2, Acp5, and Oscar). Taken together, our findings suggest that PLM inhibits osteoclast formation and function by suppressing RANKL-induced activation of the p38/JNK-cFos/NFATc1 signaling cascade, thereby preventing ovariectomy-induced osteoporosis in mice. Thus, PLM can potentially be used as an anti-resorption drug or dietary supplement for the prevention of PMOP.
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Affiliation(s)
- Na Luo
- Department of Clinical Medicine, Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, 51 Huzhou Street, Gongshu District, Hangzhou, Zhejiang 310015, China.
- Orthopedic Institute, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Lei Zhang
- Orthopedic Institute, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Chunmei Xiu
- Department of Clinical Medicine, Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, 51 Huzhou Street, Gongshu District, Hangzhou, Zhejiang 310015, China.
| | - Xi Luo
- Orthopedic Institute, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Siyuan Hu
- Orthopedic Institute, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
| | - Kaizhong Ji
- Department of Clinical Medicine, Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, 51 Huzhou Street, Gongshu District, Hangzhou, Zhejiang 310015, China.
| | - Qingbai Liu
- Department of Orthopaedics, Lianshui County People's Hospital, The Affiliated Lianshui County People's Hospital of Kangda College of Nanjing Medical University, Huai'an, Jiangsu, China.
| | - Jianquan Chen
- Department of Clinical Medicine, Key Laboratory of Novel Targets and Drug Study for Neural Repair of Zhejiang Province, School of Medicine, Hangzhou City University, 51 Huzhou Street, Gongshu District, Hangzhou, Zhejiang 310015, China.
- Orthopedic Institute, Suzhou Medical College, Soochow University, Suzhou, Jiangsu, China
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6
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She P, Huang C, Peng L, Yang J, Wang L, Liu Q, Tang H. The effects of osteoporosis education program for patients with fragility fracture in China. Int J Orthop Trauma Nurs 2024; 52:101064. [PMID: 37956632 DOI: 10.1016/j.ijotn.2023.101064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Revised: 10/15/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023]
Affiliation(s)
- Pan She
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Chun Huang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Xiangya Nursing School, Central South University, No.172, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
| | - Lingli Peng
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Jiaqi Yang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Ling Wang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, China.
| | - Qingqing Liu
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China; Xiangya Nursing School, Central South University, No.172, Tongzipo Road, Yuelu District, Changsha, 410013, Hunan, China.
| | - Hongying Tang
- Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, No.87, Xiangya Road, Kaifu District, Changsha, 410008, Hunan, China.
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7
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Chen H, Shi G, Chen M, Wang R. Double Vertebrae Kümmell Disease: Five Cases Report and Literature Review. Orthop Surg 2023; 15:2454-2463. [PMID: 37435837 PMCID: PMC10475666 DOI: 10.1111/os.13799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 05/23/2023] [Accepted: 05/23/2023] [Indexed: 07/13/2023] Open
Abstract
Kümmell disease (KD) is a complication of osteoporotic vertebral compression fractures. There is a lot of literature on KD, but the reported cases are all single vertebrae. This study reports five double vertebrae KD cases (10 levels) and discusses the possible underlying mechanisms with a literature review. One hundred and thirty vertebrae KD were diagnosed from 2074 osteoporotic vertebral compression fractures patients treated in our hospital between 2015 and 2019. These vertebrae KD were divided into two groups, one-level vertebrae KD (n = 125) and double-level KD (n = 5). The diagnosis of KD is mainly based on the signs of intravertebral vacuum cleft on X-ray or CT scan. Double vertebrae KD cases were classified by using the KD staging system. The analysis was performed on KD to compare age, gender, femoral neck bone mineral density of femoral neck (BMD), vertebrae distribution, Cobb angle, and visual analog scale (VAS) between one-level KD and double-level by t-tests, Welch's t-test, or hypothesis testing. The mean age of the participants in the one-level KD group was 78.69 years, while the mean age in the double-level KD group was 82.4 years. The difference was statistically significant (t = 3.66, p = 0.0004). There were 89 females and 36 males in the one-level KD group, while the double-level KD group had five females and no males. The femoral neck BMD was significantly different between the two groups, with the one-level KD group having a mean BMD of -2.75 and the double-level KD group having a mean BMD of -4.2 (t = 2.99, p= 0.0061). The vertebrae distribution was different between the groups, with the one-level KD group having vertebrae from T7 to L4 and the double-level KD group having vertebrae from T11 to L1. The Cobb angle was also significantly different between the groups, with the one-level KD group having a mean angle of 20.58 and the double-level KD group having a mean angle of 31.54 (t = 6.22, p = 0.0001). Finally, the VAS scores were similar between the two groups, with the one-level KD group having a mean score of 8.63 and the double-level KD group having a mean score of 8.8 (t = 1.35, p = 0.1790). It is concluded that double vertebrae Kümmell disease has special clinical significance due to its potential to cause greater spinal instability and deformity, increased risk of neurological symptoms, more complex surgical management, and greater risk of complications.
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Affiliation(s)
- Hao Chen
- Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Guan Shi
- Beijing Friendship HospitalCapital Medical UniversityBeijingChina
| | - Mengmeng Chen
- Beijing Friendship HospitalCapital Medical UniversityBeijingChina
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Hua Y, Li Y, Zhou J, Fan L, Huang F, Wu Z, Xue H, Yang B, Chen P, Rui Y, Tian Y, Moayyeri A, Libanati C, Du W. Mortality following fragility hip fracture in China: a record linkage study. Arch Osteoporos 2023; 18:105. [PMID: 37498371 DOI: 10.1007/s11657-023-01304-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Accepted: 07/03/2023] [Indexed: 07/28/2023]
Abstract
Mortality risk declined over time. Patients with fragility hip fracture experienced an approximate ninefold excess mortality, peaking shortly after fracture, in comparison with that of the general population. Continuous efforts in lowering the occurrence of hip fracture have the potential to improve the survival of the elderly population in China. PURPOSE Hip fractures in older adults often lead to an elevated risk of death. However, few studies investigated mortality risk following hip fracture in mainland China. This retrospective cohort study aimed to evaluate the crude mortality and excess mortality after fragility hip fractures in Lishui residents aged 50 years and older. METHODS Patients having a fragility hip fracture between October 2013 and August 2019 were identified from the Lishui District Inpatient Data Collection and followed up until August 2020. Death information was ascertained from the linked death registry records. We calculated the follow-up mortality rate and corresponding 95% confidence intervals (CIs) as well as the standard mortality ratios (SMRs) in comparison with the mortality rates of Lishui residents. RESULTS During the study period, a total of 808 patients (63.4% females) with an average age of 75 years were admitted for fragility hip fractures. The 1st, 2nd, and 3rd year follow-up mortality rates were 16.51, 6.06, and 5.03 per 100 person-year, respectively. The SMRs were 8.46 (6.94, 9.97), 5.74 (4.86, 6.63), and 4.63 (3.98, 5.27) for the 1st, 2nd, and 3rd year following fragility hip fracture. CONCLUSION Although mortality risk declined over time, patients with fragility hip fracture experienced an approximate ninefold excess mortality, peaking shortly after fracture, in comparison with that of the general population. Continuous efforts in lowering the occurrence of hip fracture have the potential to improve the survival of the elderly population in China.
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Affiliation(s)
- Yiwen Hua
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China
| | - Ying Li
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China
| | | | - Lijun Fan
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China
| | - Feng Huang
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China
| | - Zhanpo Wu
- Department of Trauma Orthopedics, Lishui Renmin Hospital & Zhongda Hospital, Nanjing, China
| | - Hui Xue
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China
| | - Bingquan Yang
- Department of Trauma Orthopedics, Lishui Renmin Hospital & Zhongda Hospital, Nanjing, China
| | - Ping Chen
- Lishui Smart City Operating Command Center, Nanjing, China
| | - Yunfeng Rui
- Department of Trauma Orthopedics, Lishui Renmin Hospital & Zhongda Hospital, Nanjing, China
| | - Yong Tian
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China
| | | | | | - Wei Du
- School of Public Health, Southeast University, Gulou District, 87 Dingjiaqiao, Nanjing, 210000, Jiangsu, China.
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Fu Y, Ba L, Lü N, Yang H, Hong X, Zhou J, Sun Z. Burden of falls attributable to low bone mineral density among people aged 60 years and over in China from 1990 to 2019. Front Public Health 2023; 11:1204497. [PMID: 37448662 PMCID: PMC10338097 DOI: 10.3389/fpubh.2023.1204497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 05/31/2023] [Indexed: 07/15/2023] Open
Abstract
Objective Falls in older people have become a major public health, economic and societal problem. Osteoporosis predisposes older adults to high risk of falls, which were the most common outcome attributable to low bone mineral density (LBMD). In this study, we analyze the long-term trends in falls burden attributable to LBMD among people aged 60 years and over from 1990 to 2019, using data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019). Methods Data from GBD 2019 were used to assess the long-term trends in mortality and disability-adjusted life-year (DALY) rates by Joinpoint regression. The age-period-cohort (APC) model was used to evaluate the effects of age, period and cohort on mortality rate of falls attributable to LBMD. Results The mortality and DALYs rates of falls attributable to LBMD among people aged 60 years and over increased from 1990 to 2019, with average annual percentage changes (AAPCs) of 1.74% (95% CI: -1.47 to 2.01%) and 0.99% (95% CI: 0.80-1.19%), respectively. APC analysis revealed that the mortality rate due to LBMD significantly increased among the older people over the age of 75 years. The risk of falls mortality due to LBMD during the period of 1990-2019 initially declined but later elevated. An overall increasing risk for falls death attributable to LBMD was presented across birth cohorts, but in cohorts born after 1930, the upward trend has slowed down. The overall net drift per year attributable to LBMD was above 0. The corresponding results showed that the negative impact of period and cohort effects among males was more pronounced than those among females. Conclusions Falls attributable to LBMD remain an ongoing health burden in the older people in China, and the mortality has been on the rise from 1990 to 2019, especially among the older people aged 80+ years group. The prevention and treatment of LBMD should be emphasized, especially among males and oldest-old people. Furthermore, there is an urgent need to strengthen the implementation of system-wide, integrated and effective public health policies and other health interventions in China.
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Affiliation(s)
- Yali Fu
- Jiangsu Health Development Research Center, Nanjing, Jiangsu, China
- National Health Commission Key Laboratory of Contraceptives Adverse Reaction Surveillance, Nanjing, Jiangsu, China
- Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment, Nanjing, Jiangsu, China
| | - Lei Ba
- Jiangsu Health Development Research Center, Nanjing, Jiangsu, China
- National Health Commission Key Laboratory of Contraceptives Adverse Reaction Surveillance, Nanjing, Jiangsu, China
- Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment, Nanjing, Jiangsu, China
| | - Nianqing Lü
- Jiangsu Health Development Research Center, Nanjing, Jiangsu, China
- National Health Commission Key Laboratory of Contraceptives Adverse Reaction Surveillance, Nanjing, Jiangsu, China
- Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment, Nanjing, Jiangsu, China
| | - Huafeng Yang
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Xin Hong
- Nanjing Municipal Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Jinyi Zhou
- Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, Jiangsu, China
| | - Zhiming Sun
- Jiangsu Health Development Research Center, Nanjing, Jiangsu, China
- National Health Commission Key Laboratory of Contraceptives Adverse Reaction Surveillance, Nanjing, Jiangsu, China
- Jiangsu Provincial Medical Key Laboratory of Fertility Protection and Health Technology Assessment, Nanjing, Jiangsu, China
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Ju P, Jiang D. Effects of the obstruction of erector spinae plane in affected people undergoing percutaneous vertebroplasty. BMC Surg 2023; 23:149. [PMID: 37270470 DOI: 10.1186/s12893-023-02055-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 05/24/2023] [Indexed: 06/05/2023] Open
Abstract
BACKGROUND We aimed to compare the difference between the therapeutic effects of percutaneous vertebroplasty (PVP) as well as PVP combined with erector spinae plane blocked (ESPB) in osteoporotic vertebral compression fractures (OVCFs) therapy. METHODS After the reception, 100 affected people to OVCFs were randomly divided into the PVP group as a control as well as the PVP + ESPB group as the observation, which included fifty affected people per group. The visual analog scale (VAS) for pain as well as the Oswestry Disability Index (ODI) per group was assessed before the operation, two hours after the operation, and when patients were discharged from the hospital. Operating time was also evaluated on the charged bulk of bone cement during the surgery, blood loss during the surgery, as well as operating costs for each group. Additionally, to assess differences, comparisons have been done among available groups in terms of ambulation as well as defecation or stool after the operation at the earlier time. RESULTS The PVP + ESPB category acquired lower VAS and ODI scores when assessments were processed 2 h after the operation and when they were discharged from a hospital. They also had earlier postoperative ambulation and defecation time than the category of PVP (p < 0.05). Regarding the other indicators, there did not show significant differences. Besides, no complications occurred within both group, either after the operation or when they discharge from the hospital. CONCLUSION PVP + ESPB for OVCF is related to less VAS, further effective alleviation of pain, and fewer ODI values in affected people after the operation than only PVP. Besides, affected people can involve in ambulation more swiftly. The PVP + ESPB therapy improves the quicker recuperation of intestinal function as well as helps to improve the overall life quality of patients.
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Affiliation(s)
- Peng Ju
- Department of Orthopedics, The Third Affiliated Hospital of Chongqing Medical University, Shuanghu Branch Road, Huixing Street, Yubei District, Chongqing, 401120, China
| | - Dianming Jiang
- Department of Orthopedics, The Third Affiliated Hospital of Chongqing Medical University, Shuanghu Branch Road, Huixing Street, Yubei District, Chongqing, 401120, China.
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Cheah MH, Lai PSM, Khor HM, Ratnasingam J, Chandrasekaran CSK, Singh S, Zakaria MIB, Ong T. Fragility fracture care gap at a tertiary teaching hospital in Malaysia. Arch Osteoporos 2023; 18:63. [PMID: 37148374 DOI: 10.1007/s11657-023-01256-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 05/08/2023]
Abstract
Fracture begets fracture, pharmacological treatment is needed to prevent secondary fractures. This study found that there was a fragility fracture care gap where both bone health investigations and treatment initiation rates were low. Strategies such as Fracture Liaison Service is needed to address the care gap. PURPOSE This study aimed to investigate the clinical burden and secondary fracture prevention of fragility fractures at a tertiary teaching hospital in Malaysia. METHODS Electronic medical records of all patients admitted with fragility fractures between 1 January 2017-31 December 2018 were reviewed. Patients < 50 years old, with non-fragility fractures, restricted access to medical records, transferred to another hospital or who passed away during admission were excluded. Descriptive statistics were used to summarise patients' characteristics, frequency of fragility fractures, and secondary fracture prevention details. Binomial logistic regression was performed to analyse predictive factors for post-fracture bone health assessments and treatment initiation. RESULTS 1030 patients [female (767/1030, 74.5%)] presented with 1071 fractures [hip fractures (378/1071, 35.3%)]. 170/993 (17.1%) patients were initiated on anti-osteoporosis medications (AOMs) and 148/984 (15.0%) had bone mineral density (BMD) performed within 1-year post-fracture. Less than half (42.4%) of the patients remained on treatment at 1-year post-fracture. Older patients [65-74 years old: odds ratio (OR) = 2.18, 95%CI 1.05-4.52, p = 0.04; ≥ 75 years: OR = 3.06, 95%CI 1.54-6.07, p < 0.01], hip fractures (OR = 1.95, 95%CI 1.23-3.11, p < 0.01), Chinese ethnicity (OR = 1.90, 95%CI 1.07-3.35, p = 0.03),previously diagnosed with osteoporosis (OR = 2.65, 95%CI:1.32-5.31, p < 0.01) and a BMD test performed (OR = 12.48, 95%CI 8.04-19.37, p < 0.01) were found to have higher AOM initiation. Patients with past diagnosis of osteoporosis (OR = 4.45, 95%CI 2.25-8.81, p < 0.01) and initiated on AOM (OR = 11.34, 95%CI 7.57-16.97, p < 0.01) had a higher likelihood to undergo BMD testing. CONCLUSION The AOM initiation and BMD testing rates were low. There is a need to address the fragility fracture care gap with strategies such as Fracture Liaison Service.
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Affiliation(s)
- Min Hui Cheah
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Pauline Siew Mei Lai
- Department of Primary Care Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Hui Min Khor
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | | | | | - Simmrat Singh
- Department of Orthopaedic Surgery, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Mohd Idzwan Bin Zakaria
- Academic Unit Trauma and Emergency, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia
| | - Terence Ong
- Department of Medicine, Faculty of Medicine, Universiti Malaya, Kuala Lumpur, Malaysia.
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A model-based cost-effectiveness analysis of fracture liaison services in China. Arch Osteoporos 2022; 17:132. [PMID: 36195760 PMCID: PMC9532296 DOI: 10.1007/s11657-022-01170-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/23/2022] [Indexed: 02/03/2023]
Abstract
This study is a model-based cost-effectiveness analysis of fracture liaison services (FLS) in China, suggesting that FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. However, Chinese-specific real-world data is needed to confirm the results of our study. PURPOSE The study aimed to assess the potential cost-effectiveness of fracture liaison services (FLS) from the Chinese healthcare perspective with a lifetime horizon. METHODS A previously validated Markov microsimulation model was adapted to estimate the cost-effectiveness of FLS compared to no-FLS. The evaluation was conducted in patients aged 65 years with a recent fracture. Treatment pathways were differentiated by gender, FLS attendance, osteoporosis diagnosis, treatment initiation, and adherence. Given the uncertainty in FLS cost, the cost in the base-case analysis was assumed at US$200. Analyses were also performed to determine the maximum cost for making the FLS cost-saving and cost-effective at the Chinese willingness-to-pay (WTP) threshold. One-way sensitivity analyses were conducted. RESULTS When compared with no-FLS, the FLS was dominant (lower costs, higher quality-adjusted life years) in our target population at the FLS cost of US$200 per patient. For every 100 patients who were admitted to the FLS, approximately four hip fractures, nine clinical vertebral fractures, and three wrist fractures would be avoided over their lifetimes. Our findings were robust to numerous one-way sensitivity analyses; however, the FLS was not cost-effective in patients aged 80 years and older. CONCLUSION FLS could potentially lead to lifetime cost-saving in patients who have experienced a fracture. Our study informs the potential cost-effectiveness of FLS and the knowledge gap in China; more future research incorporating Chinese-specific real-world data are needed to confirm the results of our study and to better evaluate the cost-effectiveness of FLS in China.
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陈 昊, 潘 文, 张 有, 邢 朝, 张 柏, 孙 宝, 甄 志, 龚 良, 徐 寒. [Epidemiological and clinical characteristics analysis of 681 cases of thoracolumbar osteoporotic vertebral compression fractures]. ZHONGGUO XIU FU CHONG JIAN WAI KE ZA ZHI = ZHONGGUO XIUFU CHONGJIAN WAIKE ZAZHI = CHINESE JOURNAL OF REPARATIVE AND RECONSTRUCTIVE SURGERY 2022; 36:873-880. [PMID: 35848185 PMCID: PMC9288900 DOI: 10.7507/1002-1892.202204026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Revised: 05/24/2022] [Indexed: 01/24/2023]
Abstract
Objective To investigate the epidemiological and clinical characteristics of patients with thoracolumbar osteoporotic vertebral compression fracture (OVCF) treated by percutaneous vertebroplasty (PVP). Methods The clinical and imaging data of 681 patients with thoracolumbar OVCF treated with PVP between January 2017 and December 2021 were collected. The epidemiological and clinical characteristics of the patients with thoracolumbar OVCF in single center were summarized from the aspects of demographic distribution (mainly including gender, age), fracture characteristic analysis [including pathological segments, bone mineral density, and body mass index (BMI)], and operation related results (including the distribution of unilateral and bilateral puncture and bone cement injection, postoperative effectiveness analysis and refracture). Results Of the 681 patients, 134 (19.68%) were male and 547 (80.32%) were female, with a male-to-female ratio of 1∶4.08. The age ranged from 53 to 105 years, with an average of 75.3 years. The age group of 60-90 years old had the largest number of patients (91.04%); the high incidence age group of men was 70-90 years old (13.95%), and that of women was 60-80 years old (72.98%). A total of 836 vertebrae were involved, and the morbidity of thoracolumbar vertebrae (T 11-L 1) was the highest (56.34%, 471/836). The main type of fracture was compression fracture (92.58%, 774/836) and Kümmell disease (7.42%, 62/836). There were 489 cases (71.81%) of osteoporosis, including 66 males and 423 females, with a male-to-female ratio of 1∶6.42. There was significant difference in distribution of bone mineral density between male and female groups ( Z=-5.810, P<0.001). BMI showed 206 cases (30.25%) of underweight, 347 (50.95%) cases of normal, 58 cases (8.52%) of overweight, 42 cases (6.17%) of obese, and 28 cases (4.11%) of extremely obese. The difference in BMI distribution between male and female groups was significant ( Z=-2.220, P=0.026). Of 836 vertebral bodies, 472 (56.46%) were punctured unilaterally and 364 (43.54%) bilaterally. Most of the vertebral bodies (49.88%, 417/836) were injected with 5.0-6.9 mL bone cement, and most of them were distributed in thoracolumbar and lumbar vertebral bodies (T 11-L 3). The visual analogue scale (VAS) score and Oswestry disability index (ODI) of patients with unilateral puncture and bilateral puncture significantly improved at 6 months after operation ( P<0.001), and also the difference was significant between the two groups in the difference of pre- and post-operation ( P<0.001). There were 628 cases (92.22%) with the first occurrence of OVCF, and 53 cases (7.78%) with two or more times of OVCF, all of which were female patients, and 26 cases (49.06%) occurred in the adjacent segment of the previous PVP operation. Conclusion Female were more than male in OVCF patients. Thoracolumbar vertebral body has the highest morbidity. Patients with low BMI are more likely to have osteoporosis, and patients with high BMI have a higher risk of compression fracture. The amount of bone cement injected through bilateral puncture was greater than that through unilateral puncture.
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Affiliation(s)
- 昊 陈
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 文琦 潘
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 有磊 张
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 朝辉 邢
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 柏青 张
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 宝亭 孙
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 志雷 甄
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 良伟 龚
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
| | - 寒 徐
- 北京德尔康尼骨科医院骨二科(北京 100143)The Second Department of Orthopedics, Beijing DCN Orthopedic Hospital, Beijing, 100143, P. R. China
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Zhang Y, Huang X, Sun K, Li M, Wang X, Han T, Shen H, Qi B, Xie Y, Wei X. The Potential Role of Serum IGF-1 and Leptin as Biomarkers: Towards Screening for and Diagnosing Postmenopausal Osteoporosis. J Inflamm Res 2022; 15:533-543. [PMID: 35095282 PMCID: PMC8791302 DOI: 10.2147/jir.s344009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 01/07/2022] [Indexed: 01/05/2023] Open
Abstract
Purpose To investigate the differences of several serum markers among population with different bone mass and to explore the utility of new potential biomarker for the diagnosing and screening for postmenopausal osteoporosis (PMOP). Materials and Methods A total of 1055 postmenopausal women were screened and gathered data on BMD screening, biological samples, and questionnaire information. A liquid chip assay was used to measure serum IL-6, IGF-1, BMP-2, VEGF, leptin and FGF23. The predictive value of the indicator panels was assessed using the area under the receiver-operator characteristic curve (AUC). Statistical analyses were conducted by using SAS 9.4 and R software 4.1.1. Figures were created in GraphPad Prism 8.0. Results When compared against the normal group, in addition to the vitamin D, the PMOP group showed a significant increase in median values for other indicators (P < 0.05), especially in P1NP and β-CTX. Among the six cytokines representing different osteoporosis mechanisms, currently, we found that only IGF-1 and leptin showed significant differences between the groups. Also, the liquid chip assay results showed that IGF-1 and leptin, as newer cytokines in osteoporosis, not only have significant differences between groups, but also have a strong correlation with each other (P < 0.05). Then, we reported the accuracy of different indicator combinations by using AUC and, moreover, we demonstrated that IGF-1 with leptin did significantly provide incremental value to the AUC of conventional indexes, it markedly improved diagnostic efficacy, displaying an IDI of 9.45% (P = 0.000). Conclusion IFG-1 and leptin seem to be key biomarker associated with PMOP. The high prevalence of PMOP makes these cytokines might bear the potential of becoming a very useful screening test also for clinical follow-up of patients.
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Affiliation(s)
- Yili Zhang
- School of Traditional Chinese Medicine & School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Xinyi Huang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, People’s Republic of China
| | - Kai Sun
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Mengyuan Li
- School of Traditional Chinese Medicine & School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, People’s Republic of China
| | - Xu Wang
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Tao Han
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Hao Shen
- Changxindian Community Health Service Center, Beijing, People’s Republic of China
| | - Baoyu Qi
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
| | - Yanming Xie
- Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
- Correspondence: Yanming Xie; Xu Wei, Tel +86 13911112416; +86 13488716557, Email ;
| | - Xu Wei
- Wangjing Hospital, China Academy of Chinese Medical Sciences, Beijing, People’s Republic of China
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Wang M, Liang H, Cui L. Clinical practice of Best Practice Nursing Care Standards for Older Adults with Fragility Hip Fracture: A propensity score matched analysis. Appl Nurs Res 2021; 62:151491. [PMID: 34814995 DOI: 10.1016/j.apnr.2021.151491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 08/16/2021] [Accepted: 08/21/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND Fragility hip fracture (FHF) is a significant cause of morbidity and mortality in older adults. In 2018, Best Practice Nursing Care Standards for Older Adults with Fragility Hip Fracture (NSOF) were released by The International Collaboration of Orthopaedic Nursing (ICON). However, there are only limited clinical data about the application of this standard in clinical practice in China. AIMS To determine the clinical practice effect of the NSOF. METHODS A retrospective single-centre cohort study was performed from January 2016 to June 2020. Patients were divided into the standardized nursing care group (SN group) and the conventional nursing care group (CN group) depending on whether they were cared for according to the NSOF criteria. The propensity score matched (PSM) analysis was conducted in this study. The perioperative and follow-up outcomes between the two groups were analyzed. RESULTS A total of 204 patients diagnosed with FHF were included in the study. After a 1:1 matching, 56 cases were identified in the SN group as well as the CN group. Patients in the SN group had significantly shorter preoperative wait times for surgery (17.4 ± 4.6 vs. 24.4 ± 7.6 h, p < 0.05) and a higher proportion of individuals performing exercise within 24 h after surgery (94.6% vs. 66.1%, p < 0.05). Notably, patients in the SN group also had a significantly shorter length of stay than those in the CN group (9.4 ± 3.1 vs. 14.2 ± 5.1 days, p < 0.05). At the 6-month follow-up, the incidence of refracture was significantly lower (3.6% vs. 14.3%, p < 0.05), and the timed up and go mobility index was improved in the SN group compared to the CN group (20.3 ± 1.7 vs. 24.6 ± 2.2 s, p < 0.05). CONCLUSION This study showed that application of the NSOF resulted in a significant improvement in the treatment of older adults patients with FHF.
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Affiliation(s)
- Meng Wang
- Department of Traditional Chinese Medicine, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China
| | - Hongyin Liang
- Department of General Surgery, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China
| | - Lin Cui
- Department of Orthopedic, General Hospital of Western Theater Command (Chengdu Military General Hospital), Chengdu, China.
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Li J, Wu X, Shi Y, Zhao H. FGD5-AS1 facilitates the osteogenic differentiation of human bone marrow-derived mesenchymal stem cells via targeting the miR-506-3p/BMP7 axis. J Orthop Surg Res 2021; 16:665. [PMID: 34772438 PMCID: PMC8588622 DOI: 10.1186/s13018-021-02694-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/25/2021] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Osteoporosis is a systemic disease characterized by impaired bone formation, increased bone resorption, and brittle bone fractures. The osteogenic differentiation of human bone marrow-derived mesenchymal stem cells (hBMSCs) is considered to be a vital process for bone formation. Numerous studies have reported that long non-coding RNAs (lncRNAs) are involved in the osteogenic differentiation of hBMSCs. The present study aimed to investigate the effect of FGD5 antisense RNA 1 (FGD5-AS1) on osteogenic differentiation. METHODS RT-qPCR was performed to detect the expression of FGD5-AS1, miR-506-3p, and osteogenesis-related genes OCN, OPN, OSX, and RUNX2. Western blotting was carried out to detect the protein levels of osteogenesis-related markers. In addition, the regulatory effect of FGD5-AS1 on osteogenic differentiation was detected through alkaline phosphatase (ALP) activity, Alizarin Red S (ARS) staining, and Cell Counting Kit-8 (CCK-8). Bioinformatics analysis and luciferase reporter assay were used to predict and validate the interaction between FGD5-AS1 and miR-506-3p as well as miR-506-3p and bone morphogenetic protein 7 (BMP7). RESULTS The RT-qPCR analysis revealed that FGD5-AS1 was upregulated in hBMSCs following induction of osteogenic differentiation. In addition, FGD5-AS1 knockdown attenuated hBMSC viability and osteogenic differentiation. Bioinformatics analysis and luciferase reporter assays verified that FGD5-AS1 could directly interact with microRNA (miR)-506-3p. Furthermore, miR-506-3p could directly target the 3'-untranslated region (3'-UTR) of BMP7. Additionally, functional assays demonstrated that miR-506-3p silencing could restore the suppressive effect of FGD5-AS1 knockdown on osteogenic differentiation and viability of hBMSCs, and miR-506-3p could attenuate osteogenic differentiation via targeting BMP7. CONCLUSIONS Taken together, the results of the present study suggested that FGD5-AS1 could positively regulate the osteogenic differentiation of hBMSCs via targeting the miR-506-3p/BMP7 axis.
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Affiliation(s)
- Jun Li
- Department of Spinal Surgery, Changzhou Hospital of Traditional Chinese Medicine, No. 25 Heping North Road, Changzhou, Jiangsu, 213000, P.R. China
| | - Xingbiao Wu
- Department of Spinal Surgery, Changzhou Hospital of Traditional Chinese Medicine, No. 25 Heping North Road, Changzhou, Jiangsu, 213000, P.R. China
| | - Yaohua Shi
- Department of Spinal Surgery, Changzhou Hospital of Traditional Chinese Medicine, No. 25 Heping North Road, Changzhou, Jiangsu, 213000, P.R. China
| | - Hong Zhao
- Department of Spinal Surgery, Changzhou Hospital of Traditional Chinese Medicine, No. 25 Heping North Road, Changzhou, Jiangsu, 213000, P.R. China.
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Correlation Analysis of Adverse Reactions of Antiosteoporosis Drugs by Different Mechanisms with Bone Turnover and Vitamin D. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2021; 2021:5402949. [PMID: 34675985 PMCID: PMC8526207 DOI: 10.1155/2021/5402949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2021] [Accepted: 09/22/2021] [Indexed: 11/17/2022]
Abstract
Objective The risk factors for the most common adverse reactions of two types of antiosteoporosis drugs in the first treatment of postmenopausal osteoporosis were analyzed to investigate the relationship between the occurrence of adverse reactions and different bone transition states and vitamin D levels. Methods A total of 381 postmenopausal women who were diagnosed with osteoporosis in the Osteoporosis Clinic of Ningxia Medical University General Hospital from January 2017 to June 2020 were enrolled. A telephone follow-up survey was conducted on the mentioned subjects. According to the survey results, the mentioned subjects were selected according to their first use of antiosteoporosis drugs. They were divided into zoledronic acid and teriparatide acetate groups. The subjects in the two groups were divided into two groups according to the presence or absence of adverse reactions after medication and according to vitamin D level and P1NP level, and the correlation between the two factors and the occurrence of adverse reactions was analyzed. Results Among the 307 patients treated with zoledronic acid for antiosteoporosis, 99 patients developed acute phase adverse reactions (APR+), accounting for 32.2% of the total subjects. 56.7 percent of the subjects had vitamin D deficiency. The 25(OH)D level of the APR + subjects was 16.75 ± 9.20 ng/mL, significantly lower than that of the APR− patients (23.68 ± 10.67 ng/mL). Serological P1NP level in APR+ patients was 73.95 ± 34.50 ng/ml, significantly higher than that of APR− patients with 55.80 ± 36.91 ng/ml. Musculoskeletal symptoms were observed in 14 of the 74 subjects treated with teriparatide acetate, accounting for 18.9% of the total subjects. The 25(OH)D level was deficient in 59.5% of the subjects. The 25(OH)D level of the subjects with musculoskeletal symptoms was 15.96 ± 8.17 ng/ml, while that of the subjects without musculoskeletal symptoms was 20.86 ± 8.52 ng/ml, which showed no statistical significance. The reason was considered to be related to the small sample size included in the study. The P1NP level of subjects with musculoskeletal symptoms was 96.85 ± 58.52 ng/ml, significantly higher than the P1NP level of subjects without musculoskeletal symptoms (55.28 ± 27.87 ng/ml). Conclusions The 25(OH)D level in vivo was negatively correlated with the acute phase adverse reactions after the first infusion of zoledronic acid. When the rate of bone formation is increased and osteoblasts are active, the risk of acute phase adverse reactions is increased with the use of zoledronic acid as antiosteoporosis therapy. There was no significant correlation between 25(OH)D levels and musculoskeletal symptoms after teriparatide acetate treatment of osteoporosis. When the rate of bone formation is increased and osteoblasts are active, the risk of adverse reactions to musculoskeletal symptoms is increased with antiosteoporosis treatment with teriparatide acetate.
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Ding J, Zhang C, Guo Y. The association of OPG polymorphisms with risk of osteoporotic fractures: A systematic review and meta-analysis. Medicine (Baltimore) 2021; 100:e26716. [PMID: 34397809 PMCID: PMC8341286 DOI: 10.1097/md.0000000000026716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 07/02/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Subjects with low bone mineral density and osteoporosis are more likely to suffer osteoporotic fractures during their lifetime. Polymorphisms in osteoprotegerin (OPG) gene are found to be associated with low bone mineral density and osteoporosis risk but their association with fracture risk is inconclusive. Here, we performed a meta-analysis to investigate the relationship between OPG polymorphisms with susceptibility to osteoporotic fractures. METHODS Eligible studies investigating the association between common OPG polymorphisms (A164G, T245G, T950C, and G1181C) and risk of osteoporotic fracture were retrieved from PubMed, EMBASE, Web of Science, and the Cochrane Library. Odds ratio (OR) and the 95% confidence interval (CI) were calculated in the allelic, dominant, recessive, and homozygous model. Subgroup analyses of vertebral fractures, Caucasians, and postmenopausal women were also performed. RESULTS A total of 14 studies comprising 5459 fracture cases and 9860 non-fracture controls were included. A163G was associated with fracture risk in dominant (OR = 1.29, 95%CI 1.11-1.50), recessive (OR = 1.64, 95%CI 1.10-2.44), and homozygous model (OR = 1.73, 95%CI 1.16-2.59). T245G was significantly correlated with susceptibility to fractures in all genetic models. Subjects with CC genotype of T950C had a reduced risk of fracture compared to those with CT or TT genotypes (OR = 0.81, 95%CI 0.70-0.94, P = .004). Subgroup analysis showed that A163G and T245G but not T950C and G1181C were associated with vertebral fracture risk. CONCLUSION OPG A163G and T245G polymorphisms were risk factors of osteoporotic fractures while T950C had a protective role. These polymorphisms can be used as predictive markers of fractures.
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Estimating the future clinical and economic benefits of improving osteoporosis diagnosis and treatment among women in China: a simulation projection model from 2020 to 2040. Arch Osteoporos 2021; 16:118. [PMID: 34338927 DOI: 10.1007/s11657-021-00958-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 05/06/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Annual osteoporotic fractures is projected to increase by 135% from 6.9 M (2020) to 16.2 M (2040), increasing the economic burden by 121% from $29.9B (2020) to $65.9B (2040). INTRODUCTION Globally, aging populations drive significant increases in osteoporosis prevalence. In China, the number of women aged ≥ 65 years is expected to more than double from 2020 (91.5 M) to 2040 (183.6 M). Using a microsimulation model, impact of increased diagnosis and treatment of postmenopausal women (PMW) with osteoporosis on anticipated reduction in fractures and associated costs in China from 2020 to 2040 was projected. METHODS A microsimulation model was developed to project annual incidence and costs of osteoporotic fractures among PMW in China from 2020 to 2040. Fracture risk was estimated using the simplified Fracture Risk Assessment Tool (FRAX). Fractures estimates were based on annualized FRAX risk and impact of treatment. Published literature informed inputs for direct and indirect fracture costs, DXA screening costs, and treatment costs and efficacy. China's current screening and treatment rates were compared against 50% increases to (i) case finding (screening rate and subsequent treatment rate) and (ii) treatment rate among those at highest fracture risk. RESULTS From 2020 to 2040, 241.7 M osteoporotic fractures are projected to cost $997B. Increased treatment scenario prevented 24.6 M fractures and saved $56B. Increased case finding scenario prevented 26 M fractures and saved $61.7B. CONCLUSION Osteoporosis underdiagnosis and undertreatment among the aging Chinese population will considerably burden patients, caregivers, and society. Policy changes to increase screening and treatment rates may result in significant cost savings and clinical benefits.
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Chandran M, Mitchell PJ, Amphansap T, Bhadada SK, Chadha M, Chan DC, Chung YS, Ebeling P, Gilchrist N, Habib Khan A, Halbout P, Hew FL, Lan HPT, Lau TC, Lee JK, Lekamwasam S, Lyubomirsky G, Mercado-Asis LB, Mithal A, Nguyen TV, Pandey D, Reid IR, Suzuki A, Chit TT, Tiu KL, Valleenukul T, Yung CK, Zhao YL. Development of the Asia Pacific Consortium on Osteoporosis (APCO) Framework: clinical standards of care for the screening, diagnosis, and management of osteoporosis in the Asia-Pacific region. Osteoporos Int 2021; 32:1249-1275. [PMID: 33502559 PMCID: PMC8192320 DOI: 10.1007/s00198-020-05742-0] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 11/11/2020] [Indexed: 01/07/2023]
Abstract
UNLABELLED Guidelines for doctors managing osteoporosis in the Asia-Pacific region vary widely. We compared 18 guidelines for similarities and differences in five key areas. We then used a structured consensus process to develop clinical standards of care for the diagnosis and management of osteoporosis and for improving the quality of care. PURPOSE Minimum clinical standards for assessment and management of osteoporosis are needed in the Asia-Pacific (AP) region to inform clinical practice guidelines (CPGs) and to improve osteoporosis care. We present the framework of these clinical standards and describe its development. METHODS We conducted a structured comparative analysis of existing CPGs in the AP region using a "5IQ" model (identification, investigation, information, intervention, integration, and quality). One-hundred data elements were extracted from each guideline. We then employed a four-round Delphi consensus process to structure the framework, identify key components of guidance, and develop clinical care standards. RESULTS Eighteen guidelines were included. The 5IQ analysis demonstrated marked heterogeneity, notably in guidance on risk factors, the use of biochemical markers, self-care information for patients, indications for osteoporosis treatment, use of fracture risk assessment tools, and protocols for monitoring treatment. There was minimal guidance on long-term management plans or on strategies and systems for clinical quality improvement. Twenty-nine APCO members participated in the Delphi process, resulting in consensus on 16 clinical standards, with levels of attainment defined for those on identification and investigation of fragility fractures, vertebral fracture assessment, and inclusion of quality metrics in guidelines. CONCLUSION The 5IQ analysis confirmed previous anecdotal observations of marked heterogeneity of osteoporosis clinical guidelines in the AP region. The Framework provides practical, clear, and feasible recommendations for osteoporosis care and can be adapted for use in other such vastly diverse regions. Implementation of the standards is expected to significantly lessen the global burden of osteoporosis.
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Affiliation(s)
- M Chandran
- Department of Endocrinology, Osteoporosis and Bone Metabolism Unit, Singapore General Hospital, 20, College Road, Academia, Singapore, 169856, Singapore.
| | - P J Mitchell
- Synthesis Medical NZ Limited, Pukekohe, Auckland, New Zealand
| | - T Amphansap
- Department of Orthopedics, Police General Hospital, Bangkok, Thailand
| | - S K Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - M Chadha
- Department of Endocrinology, Hinduja Hospital and Research Centre, Mumbai, India
| | - D-C Chan
- Internal Medicine, National University Hospital Chu-Tung Branch, Chinese Taipei, Taiwan
| | - Y-S Chung
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, South Korea
| | - P Ebeling
- Department of Medicine in the School of Clinical Sciences, Monash Health, Melbourne, Australia
| | - N Gilchrist
- Canterbury District Health Board, Christchurch, New Zealand
| | - A Habib Khan
- Section of Chemical Pathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - P Halbout
- International Osteoporosis Foundation, Nyon, Switzerland
| | - F L Hew
- Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Malaysia
| | - H-P T Lan
- Musculoskeletal and Metabolic Unit, Biomedical Research Center, Pham Ngoc Thach University of Medicine, Bone and Muscle Research Group, Ton Duc Thang University, Ho Chi Minh City, Vietnam
| | - T C Lau
- Division of Rheumatology, Department of Medicine, National University Hospital, Singapore, Singapore
| | - J K Lee
- Department of Orthopedics, Beacon International Specialist Centre, Petaling Jaya, Malaysia
| | - S Lekamwasam
- Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | | - L B Mercado-Asis
- Faculty of Medicine and Surgery, University of Santo Tomas, Manila, Philippines
| | - A Mithal
- Endocrinology, Diabetes Division, Mithal, M. Max Healthcare - Pan-Max, Gurgaon, India
| | - T V Nguyen
- Genetics and Epidemiology of Osteoporosis Laboratory, Bone Biology Division, Garvan Institute of Medical Reseach, Sydney, Australia
| | - D Pandey
- Department of Orthopaedics, National Trauma Centre, Kathmandu, Nepal
| | - I R Reid
- Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
| | - A Suzuki
- Department of Endocrinology, School of Medicine, Fujita Health University, Toyoake, Japan
| | - T T Chit
- East Yangon General Hospital, Yangon, Myanmar
| | - K L Tiu
- Polytrauma and Fragility Fracture team, Department of Orthopaedics and Traumatology, Queen Elizabeth Hospital, Hong Kong, SAR, China
| | - T Valleenukul
- Department of Orthopedics, Bhumibol Adulyadej Hospital, Bangkok, Thailand
| | - C K Yung
- Department of Endocrinology and Patient Safety Unit, Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, Brunei Darussalam
| | - Y L Zhao
- Department of Obstetrics and Gynecology, Beijing United Family Hospital, Beijing, China
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Liu S, Chen R, Ding N, Wang Q, Huang M, Liu H, Xie Z, Ou Y, Sheng Z. Setting the new FRAX reference threshold without bone mineral density in Chinese postmenopausal women. J Endocrinol Invest 2021; 44:347-352. [PMID: 32495298 DOI: 10.1007/s40618-020-01315-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 05/27/2020] [Indexed: 10/24/2022]
Abstract
PURPOSE Despite the large number of osteoporosis patients in China, the diagnosis and treatment rates remain low. The Fracture Risk Assessment Tool (FRAX) can be used to effectively evaluate fracture risk. In this study, we explored the Chinese-specific thresholds of FRAX without the T-score. METHODS In all, 264 postmenopausal women aged > 50 years were randomly recruited from community-medical centers. All subjects completed self-reported questionnaires, BMD measurements, and spinal radiographs. The 10-year hip and major osteoporotic fracture risks were calculated by FRAX. A new threshold for both 10-year hip and major osteoporotic fracture risk was explored with receiver operating characteristic (ROC) curve analysis. RESULTS Overall, 92 subjects were diagnosed with osteoporosis. Among them, 14 participants with T-score > - 2.5 were diagnosed with osteoporosis based on clinical fractures. ROC analysis showed the cut-off value of the 10-year hip osteoporotic fracture for detecting osteoporosis was 0.95%, while that of 10-year major osteoporotic fracture was 4.95%. The sensitivity and specificity of the 10-year hip osteoporotic fracture probability for detecting osteoporosis were 0.86 and 0.59, respectively, while the guideline-recommended threshold had a sensitivity of 0.49 and specificity of 0.83. The sensitivity and specificity of the 10-year major osteoporotic fractures with the new threshold were 0.76 and 0.69, respectively, while the recommended threshold had a sensitivity of 0 and specificity of 1. CONCLUSION Current guideline-recommended FRAX thresholds without BMD showed low sensitivity. Therefore, 10-year osteoporotic hip fracture probability ≥ 0.95% and 10-year osteoporotic major fracture probability ≥ 4.95% are recommended as the new thresholds.
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Affiliation(s)
- S Liu
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Health Management Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - R Chen
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Health Management Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Department of Metabolism and Endocrinology, The Affiliated Zhuzhou Hospital Of XiangYa School Of Medicine, Central South University, Changjiang South Road116, Zhuzhou, 412007, Hunan, People's Republic of China
| | - N Ding
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Health Management Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Q Wang
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Health Management Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - M Huang
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Health Management Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - H Liu
- Department of Metabolism and Endocrinology, The Affiliated Zhuzhou Hospital Of XiangYa School Of Medicine, Central South University, Changjiang South Road116, Zhuzhou, 412007, Hunan, People's Republic of China
| | - Z Xie
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Y Ou
- Hospital Infection Control Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China
| | - Z Sheng
- Department of Metabolism and Endocrinology, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
- National Clinical Research Center for Metabolic Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
- Health Management Center, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
- Hunan Provincial Key Laboratory of Metabolic Bone Diseases, The 2nd Xiangya Hospital, Central South University, 139 Renmin Road, Changsha, 410011, Hunan, People's Republic of China.
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Dai W, Peng L, Xiong Y, Reynolds N, He A, Liu M, Yang J, She P, Zhang Y. Osteoporosis health beliefs and self-efficacy among orthopedic nurses in Hunan Province, China. Int J Orthop Trauma Nurs 2020; 40:100839. [PMID: 33358604 DOI: 10.1016/j.ijotn.2020.100839] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 11/11/2020] [Accepted: 12/02/2020] [Indexed: 01/22/2023]
Abstract
Osteoporosis is a growing health problem worldwide. Health beliefs and self-efficacy in regard to osteoporosis may be important targets in preventive behaviours. This study aimed to describe beliefs around osteoporosis held by orthopaedic nurses as well as the nurses' self-efficacy and the associations between knowledge, health beliefs and self-efficacy. A cross-sectional study was conducted with nurses working in orthopaedic departments in 13 tertiary hospitals in Hunan Province, China. Participants completed a questionnaire consisting of the Osteoporosis Health Belief Scale (OHBS), the Osteoporosis Self-Efficacy Scale (OSES) and a survey of their socio-demographic characteristics. A total of 558 nurses completed the survey (response rate 95%). The nurses' scores regarding their perception of the susceptibility to and seriousness of osteoporosis were moderately low (mean OHBS score = 124.72, range 45-171; SD = 14.71), while their corresponding self-efficacy scores were moderately high (mean OSES score = 72.01, range 0-120; SD = 23.15). Knowledge regarding osteoporosis was positively associated with self-efficacy (r = 0.232, p = 0.000) but not with health beliefs (r = 0.030, p = 0.484). The findings of this study revealed moderately high self-efficacy and moderate health beliefs related to osteoporosis among orthopaedic nurses. Osteoporosis knowledge was not associated with health beliefs or self-efficacy. The findings indicate that educational programs should not only focus on knowledge improvement but also changes in health beliefs to improve actual behaviour in practice.
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Affiliation(s)
- Weiwei Dai
- Wound Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, PR China.
| | - Lingli Peng
- Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, PR China.
| | - Yang Xiong
- International Medical Center, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, PR China.
| | - Nancy Reynolds
- School of Nursing, Johns Hopkins University, 525 N. Wolfe Street, Baltimore, MD, USA.
| | - Ailan He
- Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, PR China.
| | - Mingming Liu
- Xiangya School of Nursing, Central South University, Changsha, 410000, Hunan province, PR China.
| | - Jiaqi Yang
- Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, PR China.
| | - Pan She
- Orthopedics Department, Xiangya Hospital, Central South University, Changsha, 410008, Hunan province, PR China.
| | - Yan Zhang
- Xiangya School of Nursing, Central South University, Changsha, 410000, Hunan province, PR China.
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Ebeling PR, Chan DC, Lau TC, Lee JK, Songpatanasilp T, Wong SH, Hew FL, Sethi R, Williams M. Secondary prevention of fragility fractures in Asia Pacific: an educational initiative. Osteoporos Int 2020; 31:805-826. [PMID: 31788717 DOI: 10.1007/s00198-019-05197-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/15/2019] [Indexed: 12/16/2022]
Abstract
The Asia -Pacific Bone Academy (APBA) Fracture Liaison Service (FLS) Focus Group educational initiative has stimulated activity across the Asia -Pacific region with the intention of supporting widespread implementation of new FLS. In 2017, the APBA FLS Focus Group developed a suite of tools to support implementation of FLS across the Asia-Pacific region as a component of a multi-faceted educational initiative. This article puts this initiative into context with a narrative review describing the burden of fragility fractures in the region, the current secondary fracture prevention care gap and a summary of emerging best practice. The results of a survey to evaluate the impact of the APBA educational initiative is presented, in addition to commentary on recent activities intended to improve the care of individuals who sustain fragility fractures across the Asia -Pacific. A FLS Toolbox for Asia-Pacific was developed which included the following sections:1. The burden of fragility fractures in the Asia-Pacific region.2. A summary of evidence for FLS in the Asia-Pacific.3. A generic, fully referenced FLS business plan template.4. Potential cost savings accrued by each country, based on a country-specific FLS Benefits Calculator.5. How to start and expand FLS programmes in the Asia-Pacific context.6. A step-by-step guide to setting up FLS in countries in the Asia-Pacific region.7. Other practical tools to support FLS establishment.8. FLS online resources and publications.The FLS Toolbox was provided as a resource to support FLS workshops immediately following the 5th Scientific Meeting of the Asian Federation of Osteoporosis Societies (AFOS) held in Kuala Lumpur in October 2017. The FLS workshops addressed three key themes:• The FLS business case.• Planning the FLS patient pathway.• The role of the FLS coordinator in fragility fracture care management.A follow-up survey of 142 FLS workshop participants was conducted in August-September 2018. The survey included questions regarding how FLS were developed, funded, the scope of service provision and the support provided by the educational initiative. Almost one-third (30.3%) of FLS workshop participants completed the survey. Survey responses were reported for those who had established a FLS at the time the survey was conducted and, separately, for those who had not established a FLS. Findings for those who had established a FLS included:• 78.3% of respondents established a multidisciplinary team to develop the business case for their FLS.• 87.0% of respondents stated that a multidisciplinary team was established to design the patient pathway for their FLS.• 26.1% of respondents stated that their FLS has sustainable funding.• The primary source of funding for FLS was from public hospitals (83.3%) as compared with private hospitals (16.7%).Most hospitals that had not established a FLS at the time the survey was conducted were either in the process of setting-up a FLS (47%) or had plans in place to establish a FLS for which approval is being sought (29%). The primary barrier to establishing a new FLS was lack of sustainable funding. The APBA FLS Focus Group educational initiative has stimulated activity across the Asia-Pacific region with the intention of supporting widespread implementation of new FLS. A second edition of the FLS Toolbox is in development which is intended to complement ongoing efforts throughout the region to expedite widespread implementation of FLS.
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Affiliation(s)
- P R Ebeling
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash Health, Translational Research Facility, Level 7, 246 Clayton Rd, Clayton, VIC, 3168, Australia.
| | - D-C Chan
- Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan
- Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan
- Superintendent Office, Chutung Branch, National Taiwan University Hospital, Hsinchu, Taiwan
| | - T C Lau
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - J K Lee
- Department of Orthopedic Surgery, Beacon International Specialist Centre, Petaling Jaya, Selangor, Malaysia
| | - T Songpatanasilp
- Department of Orthopaedics, Phramongkutklao Hospital and College of Medicine, Bangkok, Thailand
| | - S H Wong
- Department of Orthopaedics, International Medical Centre, Central, Hong Kong
| | - F L Hew
- Puchong Medical Specialist Centre, Puchong, Selangor, Malaysia
- Sime Darby Medical Centre, Subang Jaya, Selangor, Malaysia
| | - R Sethi
- Amgen Asia Holding Limited, Hong Kong, Hong Kong
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Yang D, Zhang Y, Ma X, Huo L, Li L, Gao Y. Resources utilisation and economic burden of percutaneous vertebroplasty or percutaneous kyphoplasty for treatment of osteoporotic vertebral compression fractures in China: a retrospective claim database study. BMC Musculoskelet Disord 2020; 21:255. [PMID: 32303207 PMCID: PMC7165412 DOI: 10.1186/s12891-020-03279-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Accepted: 04/07/2020] [Indexed: 12/12/2022] Open
Abstract
Background Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF. Objective To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective. Methods A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate the re-surgery rate. Results Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in 1 year, and 7.95% in 2 years. There was no significant difference in re-surgery rate between PVP and PKP (p = 0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5122 USD (34,195 CNY/4878USD for PVP, 44,414 CNY/6336 USD for PKP, p < 0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city. Conclusion From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.
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Affiliation(s)
- Dehong Yang
- Department of Spinal Surgery, Nanfang Hospital, Southern Medical University, AD: No.1838 North Guangzhou Avenue, Guangzhou, 510515, PR China.
| | - Yanlei Zhang
- Shanghai Branch, Lilly Suzhou Pharmaceutical Co.Ltd, AD: No. 288 Shimen No.1 Road, Jing'an District, Shanghai, 200041, PR China
| | - Xiao Ma
- Shanghai Branch, Lilly Suzhou Pharmaceutical Co.Ltd, AD: No. 288 Shimen No.1 Road, Jing'an District, Shanghai, 200041, PR China
| | - Li Huo
- Shanghai Branch, Lilly Suzhou Pharmaceutical Co.Ltd, AD: No. 288 Shimen No.1 Road, Jing'an District, Shanghai, 200041, PR China
| | - Liran Li
- Department of Health Economics, Shanghai Centennial Co. Ltd, AD: 702A, B Block, Fenglin International Center, No. 388 Fenglin Road, Shanghai, 200030, PR China
| | - Yue Gao
- Department of Health Economics, Shanghai Centennial Co. Ltd, AD: 702A, B Block, Fenglin International Center, No. 388 Fenglin Road, Shanghai, 200030, PR China
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25
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Yin R, Jiang J, Deng H, Wang Z, Gu R, Wang F. miR-140-3p aggregates osteoporosis by targeting PTEN and activating PTEN/PI3K/AKT signaling pathway. Hum Cell 2020; 33:569-581. [PMID: 32253621 DOI: 10.1007/s13577-020-00352-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2019] [Accepted: 03/14/2020] [Indexed: 01/08/2023]
Abstract
Osteoporosis (OP) is a systemic bone metabolic disorder, which negatively affects the quality of life in the elders and postmenopausal females. Healthy volunteers and postmenopausal females with OP were enrolled in the present study. Bone densitometry (BMD) was detected by dual-energy X-ray absorptiometry (DXA). CD14+PBMCs and C2C12 cells were cultured to induce osteoclast differentiation and osteoblast differentiation, respectively. The interaction between miR‑140-3p and PTEN was predicted and verified by TargetScan 7.2 and dual luciferase reporter assay, respectively. miRNA/RNA level and protein level were detected by quantitative real-time polymerase chain reaction (qRT-PCR) and western blot, respectively. Cell proliferation and apoptosis were detected by 5-ethynyl-2'-deoxyuridine (EdU) staining and flow cytometry, respectively. Cell differentiation of CD14+PBMCs and C2C12 cells were detected by tartrate-resistant acid phosphatase (TRAP) staining and alizarin red staining, respectively. The activity of alkaline phosphatase (ALP) was detected by ALP assay. Differences were observed in age, body mass index (BMI), and BMD between the OP group and the control group. Higher miR‑140-3p level and lower PTEN level were found in PBMCs of OP group compared to control group; there was a negative correlation between them in the serum of OP group. miR-140-3p targeted and downregulated the expression of PTEN. miR-140-3p inhibitor inhibited cell proliferation, differentiation, and promoted cell apoptosis of CD14+PBMCs; while promoted cell proliferation, differentiation and inhibited cell apoptosis of C2C12 cells, by targeting PTEN and inactivating PTEN/PI3K/AKT signaling pathway. These findings suggested a potential therapeutic role of miR-140-3p in the treatment of patients with OP.
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Affiliation(s)
- Ruofeng Yin
- Department of Orthopedics, China-Japan Union Hospital, No. 126, Xiantai Street, Changchun, 130031, Jilin, China
| | - Jiajia Jiang
- Department of Orthopedics, China-Japan Union Hospital, No. 126, Xiantai Street, Changchun, 130031, Jilin, China
| | - Huimin Deng
- Jilin Medical Products Administration, Changchun, 130033, Jilin, China
| | - Zhaobin Wang
- Department of Orthopaedics, Liaohe Hospital, Liaoyuan, 136299, Jilin, China
| | - Rui Gu
- Department of Orthopedics, China-Japan Union Hospital, No. 126, Xiantai Street, Changchun, 130031, Jilin, China
| | - Fei Wang
- Department of Orthopedics, China-Japan Union Hospital, No. 126, Xiantai Street, Changchun, 130031, Jilin, China.
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Abstract
The Asia-Pacific region includes countries with diverse cultural, demographic, and socio-political backgrounds. Countries such as Japan have very high life expectancy and an aged population. China and India, with a combined population over 2.7 billion, will experience a huge wave of ageing population with subsequent osteoporotic injuries. Australia will experience a similar increase in the osteoporotic fracture burden, and is leading the region by establishing a national hip fracture registry with governmental guidelines and outcome monitoring. While it is impossible to compare fragility hip fracture care in every Asia-Pacific country, this review of 4 major nations gives insight into the challenges facing diverse systems. They are united by the pursuit of internationally accepted standards of timely surgery, combined orthogeriatric care, and secondary fracture prevention strategies.
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Yılmaz E, Peker SV, Baydur H. The Effect of Preoperative Video-assisted Patient Education on Postoperative Activities of Daily Living and Quality of Life in Patients with Femoral Fracture. JOURNAL OF CLINICAL AND EXPERIMENTAL INVESTIGATIONS 2020. [DOI: 10.5799/jcei/7844] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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28
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Osteoporosis knowledge and related factors among orthopedic nurses in Hunan province of China. Int J Orthop Trauma Nurs 2020; 36:100714. [DOI: 10.1016/j.ijotn.2019.100714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 08/24/2019] [Accepted: 09/01/2019] [Indexed: 11/19/2022]
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Xia W, Cooper C, Li M, Xu L, Rizzoli R, Zhu M, Lin H, Beard J, Ding Y, Yu W, Cavalier E, Zhang Z, Kanis JA, Cheng Q, Wang Q, Reginster JY. East meets West: current practices and policies in the management of musculoskeletal aging. Aging Clin Exp Res 2019; 31:1351-1373. [PMID: 31376119 PMCID: PMC6763533 DOI: 10.1007/s40520-019-01282-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022]
Abstract
Healthy aging is defined as the process of developing and maintaining the functional ability that enables wellbeing in older age. Healthy aging is dependent upon intrinsic capacity, a composite of physical and mental capacities, and the environment an individual inhabits and their interactions with it. Maintenance of musculoskeletal health during aging is a key determinant of functional ability. Sarcopenia, osteoporosis and osteoarthritis, are a triad of musculoskeletal diseases of aging that are major contributors to the global burden of disease and disability worldwide. The prevention and management of these disorders is of increasing importance with pressure mounting from the aging population. In a new initiative, the Chinese Medical Association, Chinese Society of Osteoporosis and Bone Mineral Research, and the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases jointly organized a symposium to discuss current practices and policies in the management of musculoskeletal aging. The meeting allowed experts from Europe and China to share their experience and recommendations for the management of these three major diseases. Discussing and analyzing similarities and differences in their practice should lead, through a mutual enrichment of knowledge, to better management of these diseases, in order to preserve intrinsic capacity and retard the age-related degradation of physical ability. In future, it is hoped that sharing of knowledge and best practice will advance global strategies to reduce the burden of musculoskeletal disease and promote healthy aging tailored to meet the individual patient’s needs.
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Affiliation(s)
- Weibo Xia
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | - Mei Li
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Ling Xu
- Department of Gynaecology and Obstetrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Rene Rizzoli
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- Division of Bone Diseases, Geneva University Hospitals, Faculty of Medicine, Geneva, Switzerland
| | - Mei Zhu
- Department of Endocrinology, Tianjin Medical University General Hospital, Tianjin, China
| | - Hua Lin
- Department of Orthopaedics, Nanjing Drum Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, China
| | - John Beard
- Department of Aging and Lifecourse, World Health Organization (WHO), 20 Avenue Appia, 1211 Geneva 27, Switzerland
| | - Yue Ding
- Department of Orthopaedics, Memorial Hospital of Sun Yat-sen University, Guangzhou, China
| | - Wei Yu
- Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart Tilman Route 52, Porte 53, Domaine du Sart-Tilman, Liege, Belgium
| | - Zhenlin Zhang
- Department of Osteoporosis and Bone Disease, Shanghai JiaoTong University Affiliated Six People’s Hospital, Shanghai, China
| | - John A. Kanis
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Qun Cheng
- Department of Osteoporosis and Bone Disease, Huadong Hospital Affiliated to Fudan University, Shanghai, China
| | - Quimei Wang
- Department of Geriatrics, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000 Liege, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Lu J, Ren Z, Liu X, Xu YJ, Liu Q. Osteoporotic Fracture Guidelines and Medical Education Related to the Clinical Practices: A Nationwide Survey in China. Orthop Surg 2019; 11:569-577. [PMID: 31322836 PMCID: PMC6712375 DOI: 10.1111/os.12476] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2018] [Revised: 04/10/2019] [Accepted: 05/05/2019] [Indexed: 01/06/2023] Open
Abstract
Objectives To investigate the knowledge and practices of Chinese doctors in the management of osteoporotic fractures after the Chinese osteoporotic fracture guidelines update and aseries of medical education in 2017. Methods This was a cross‐sectional survey of doctors in 71 cities across Mainland China. Based on the 2017 Chinese guidelines for the diagnosis and treatment of osteoporotic fractures, a questionnaire was designed and pre‐tested for reliability and validity. Doctors were surveyed with the questionnaire after scientific meetings during February 2017 to January 2018 through WeChat or conference digital platforms or in paper form. Descriptive statistics was used to analyze the responses to the questionnaire. Results Overall, 314 valid questionnaires were confirmed. Regarding diagnosis, 77% agreed that osteoporosis could be diagnosed once an osteoporotic fracture occurred; 83% believed that the bone mineral density criteria for osteoporosis diagnosis would be T ≤ −2.5 SD. For treatment, almost all (99.7%) agreed with anti‐osteoporosis treatment being one of the basic principles of osteoporotic fracture treatment; 71.6% considered bisphosphonates as the most commonly used anti‐osteoporosis drug; 97% believed that patients who have used anti‐osteoporosis drugs should reassess osteoporosis after osteoporotic fractures instead of discontinue; 95% thought that the patients who did not use anti‐osteoporosis medications before osteoporotic fracture should be treated with anti‐osteoporosis drugs after fracture treatment as early as possible; 89% agreed that the standard use of bisphosphonates after osteoporotic fracture would not affect bone healing adversely; 59% believed the course of bisphosphonates treatment for osteoporosis would be 3–5 years, and 27% considered it to be 1–3 years. The patient follow‐up rate was poor: 46% selected follow‐up rate <30%; only 20% selected follow‐up rate >50%. Only 31% of the hospitals had long‐term management programs for osteoporotic fractures. Conclusions Doctors generally adhered to the updated Chinese guidelines for osteoporotic fractures; frequent participation in medical education can help doctors to increase their awareness of osteoporosis as well as their acceptance and practice of the guidelines.
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Affiliation(s)
- Jin Lu
- Medical Affairs, Osteoporosis Franchise, Sandoz China, Tianjin, China
| | - Zhong Ren
- Medical Affairs, Osteoporosis Franchise, Sandoz China, Chengdu, China
| | - Xun Liu
- Medical Affairs, Osteoporosis Franchise, Sandoz China, Shanghai, China
| | - You-Jia Xu
- Orthopaedic Department, The 2nd Affiliate Hospital of Suzhou University, Suzhou, China
| | - Qiang Liu
- Orthopaedic Department, Shanxi Da Yi Hospital, Taiyuan, China
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miR-363-3p is activated by MYB and regulates osteoporosis pathogenesis via PTEN/PI3K/AKT signaling pathway. In Vitro Cell Dev Biol Anim 2019; 55:376-386. [PMID: 31025251 DOI: 10.1007/s11626-019-00344-5] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2019] [Accepted: 03/26/2019] [Indexed: 12/17/2022]
Abstract
Osteoporosis results from the imbalance between osteogenesis and bone resorption mediated by osteoblasts and osteoclasts. During the disease process of osteoporosis, the alteration of gene expression occurs, which lead to the disease progression. MicroRNAs (miRNAs) have been previously demonstrated to be modulators for bone metabolism via regulation of osteoblast and osteoclast differentiation. In the present study, we detected the expression levels of five osteoporosis-related miRNAs in bone and serum samples of patient with or without osteoporosis. The downstream molecular mechanism of miR-363-3p was analyzed and detected by using bioinformatics analysis and mechanism experiment. The upstream transcription factor of miR-363-3p was analyzed by applying bioinformatics analysis and ChIP assay and luciferase reporter assay. The role of this pathway in osteoclastogenesis was demonstrated by functional assays. MiR-363-3p was significantly highly expressed in osteoporotic samples. Mechanistically, miR-363-3p promotes osteoclastogenesis and inhibits osteogenic differentiation by targeting PTEN and therefore activating PI3K/AKT signaling pathway. MiR-363-3p was activated by its upstream transcription activator MYB. This study revealed that MYB-induced upregulation of miR-363-3p regulates osteoporosis pathogenesis via PTEN/PI3K/AKT signaling pathway.
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32
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The epidemiology of osteoporosis, associated fragility fractures, and management gap in China. Arch Osteoporos 2019; 14:32. [PMID: 30848398 DOI: 10.1007/s11657-018-0549-y] [Citation(s) in RCA: 134] [Impact Index Per Article: 26.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 11/12/2018] [Indexed: 02/03/2023]
Abstract
BACKGROUND Osteoporosis has been one of the most common but largely under-diagnosed clinical problems among elderly population. The disease burden is even greater in China because of limited medical resources and large population size. This article is aimed to provide an overview of disease burden, secular trend, and management gap of osteoporosis and related fractures in China. METHODS Based on the related studies published in English and Chinese from 1990 to 2017, we investigated the prevalence/incidence of osteoporosis and osteoporotic fracture in Chinese mainland, Hong Kong, and Taiwan, characterizing the secular trend and disease burden in different regions. Strict inclusion criteria were applied to control the study quality. We further examined the diagnosis and treatment gap of osteoporosis management observed in clinical practice in China and summarized the efforts made by Chinese government and scholars to combat this situation. RESULTS Twenty-seven studies concerning osteoporosis prevalence in China (including Chinese mainland, Hong Kong, and Taiwan) met the inclusion criteria and were included in the final analysis. Another 15 studies about hip fracture incidence and 13 studies about vertebral fracture prevalence/incidence were also included. The epidemiological data varied greatly across studies due to different design and population included. A higher prevalence was indicated in female population, older age groups, and residents in northern China compared to their counterparts. Though attenuated increased rates or slight decline patterns have been observed in Hong Kong and Taiwan, osteoporotic fracture incidence still showed steady increase in Chinese mainland. The diagnosis and treatment of osteoporosis as well as post-fracture management were still insufficient in China. CONCLUSION Due to its silent nature, osteoporosis and its related fractures remain largely under-diagnosed and under-managed in China. It also highlights the scarcity of high-quality studies specifically focus on longtime documentation of disease burden change and male population, especially in mainland area.
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Mo J, Huang K, Wang X, Sheng X, Wang Q, Fang X, Fan S. The Sensitivity of Orthopaedic Surgeons to the Secondary Prevention of Fragility Fractures. J Bone Joint Surg Am 2018; 100:e153. [PMID: 30562300 DOI: 10.2106/jbjs.17.01297] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Orthopaedic surgeons must play an important role in the secondary prevention of fragility fractures; however, some surgeons are more aware than others of their responsibility regarding fracture prevention. The purpose of the present study was to identify which factors can lead to a higher sensitivity for fracture prevention. METHODS A cross-sectional survey was distributed to orthopaedic surgeons via online invitation or at academic conferences in China from July through October 2015. A total of 452 surgeons responded. As the primary outcome measure, we created a sensitivity scoring system for fracture prevention based on the respondents' answers to 5 questions regarding behavior in the following areas: risk-factor evaluation, pharmacologic therapy, nonpharmacologic therapy, patient education, and follow-up. Multivariable linear regression and multivariable logistic regression analyses were used to identify factors related to surgeon sensitivity to fracture prevention. RESULTS Very few surgeons reported having received adequate training regarding fracture prevention or reading guidelines or other fracture prevention literature (22% and 30%, respectively). Most respondents initiated pharmacologic or nonpharmacologic therapy (82% and 75%, respectively) for the treatment of confirmed osteoporosis among patients with fragility fractures, but only half performed a risk-factor evaluation, patient education, or timely patient follow-up (51%, 52%, and 48%, respectively). In the multivariable linear regression model, the orthopaedic surgeon's age (β = 0.09, p = 0.003), self-rated knowledge level regarding osteoporosis or related issues (β = 0.16, p < 0.001), self-perceived effectiveness in using preventive measures for patients with a fragility fracture (β = 0.62, p < 0.001), and use of clinical pathways for fragility fractures in his or her workplace (β = 1.24, p < 0.001) were independently associated with sensitivity scores for fracture prevention. Similar results were obtained from a multivariable logistic regression model. CONCLUSIONS In China, the sensitivity of orthopaedic surgeons to the secondary prevention of fragility fractures is relatively low. Implementation of a comprehensive prevention approach and targeted continuing medical education are required to encourage surgeons to take greater responsibility for screening, treating, educating, and following their patients with fragility fractures.
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Affiliation(s)
- Jian Mo
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China.,Department of Spine Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong Province, People's Republic of China
| | - Kangmao Huang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Xumeng Wang
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Xinyu Sheng
- School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Qiang Wang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Xiangqian Fang
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
| | - Shunwu Fan
- Department of Orthopaedic Surgery, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, People's Republic of China
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34
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Wang C, He H, Wang L, Jiang Y, Xu Y. Reduced miR-144-3p expression in serum and bone mediates osteoporosis pathogenesis by targeting RANK. Biochem Cell Biol 2018; 96:627-635. [PMID: 29334613 DOI: 10.1139/bcb-2017-0243] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
Osteoblasts and osteoclasts are responsible for the formation and resorption of bone, respectively. An imbalance between these two processes results in a disease called osteoporosis, in which a decreased level of bone strength increases the risk of a bone fracture. MicroRNAs (miRNAs) are small non-coding RNA molecules of 18-25 nucleotides that have been previously shown to control bone metabolism by regulating osteoblast and osteoclast differentiation. In this study, we detected the expression pattern of 10 miRNAs in serum samples from patients with osteoporosis, and identified the altered expression of 6 miRNAs by comparison with patients without osteoporosis. We selected miR-144-3p for further investigation, and showed that it regulates osteoclastogenesis by targeting RANK, and that it is conserved amongst vertebrates. Disrupted expression of miR-144-3p in CD14+ peripheral blood mononuclear cells changed TRAP activity and the osteoclast-specific genes TRAP, cathepsin K (CTSK), and NFATC. TRAP staining, CCK-8, and flow cytometry analyses revealed that miR-144-3p also affects osteoclast formation, proliferation, and apoptosis. Together, these results indicate that miR-144-3p critically mediates bone homeostasis, and thus, represents a promising novel therapeutic candidate for the treatment of this disease.
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Affiliation(s)
- Chunqing Wang
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China.,Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
| | - Hanliang He
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China.,Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
| | - Liang Wang
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China.,Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
| | - Yu Jiang
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China.,Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
| | - Youjia Xu
- Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China.,Department of Orthopaedics, The Second Affiliated Hospital of Soochow University, 1055 Sanxiang Road, Suzhou 215004, China
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Zhou J, Qin MZ, Liu Q, Liu JP. Investigation and analysis of osteoporosis, falls, and fragility fractures in elderly people in the Beijing area: a study on the bone health status of elderly people ≥ 80 years old with life self-care. Arch Osteoporos 2017; 12:108. [PMID: 29214357 DOI: 10.1007/s11657-017-0408-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 11/28/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Among ≥ 80 years old and under life self-care in the Beijing area, the prevalences of osteoporosis, falls, and fragility fracture were high; and these prevalences were even higher in women. The treatment rate of osteoporosis is very low. Therefore, comprehensive and standardized prevention and treatment should be promoted. PURPOSE The purpose of this study is to investigate prevalence of osteoporosis, falls, and fragility fractures in this population, and analyze related factors, in order to provide a basis for standardized prevention and treatment. METHODS From August 2015 to August 2016 in Beijing City, a total of 175 elderly individuals, who were ≥ 80 years old and had good self-care ability, were included into this study. The questionnaire, risk of falls, grip force, and walking speed were measured, and the Timed Up and Go test (TUG) and chair-rising test (CRT) were performed. RESULTS Compared to women, men have higher rates of smoking, drinking, drinking strong tea, longer outdoor activity time, as well as larger muscle strength and pace, and lower consumption of dairy products, fall risk assessment scale (FRA) score, 25OHD, administration rates of calcium and anti-osteoporosis drugs (P < 0.05, P < 0.01). Compared with men, women had higher bone turnover markers (P1NP, β-CTx, and OC) (P < 0.05, P < 0.01) and lower levels of sex hormones (E2, T) (P < 0.01). The overall prevalence of osteoporosis was 24.6%, and this was significantly higher in women than in men (52.5 vs. 9.6%, P < 0.01). Among these subjects, 62.9% had a history of fall after 80 years old, and this rate was higher in women than in men (77 vs. 55.3%, P < 0.01). The overall prevalence of fragility fractures was 25.1%, which was higher in women than in men (45.9 vs. 14.0%, P < 0.01). Risk factors included falls after age 80, high FRA score, and reduction in bone density of lumbar vertebrae 1-4, and odds ratio (OR) was 12.195, 1.339, and 0.076, respectively (P < 0.01). Anti-osteoporosis therapy was only performed on a small number of patients with fractures. CONCLUSION The prevalences of falls, prior fracture, and low BMD were high among ≥ 80 years old and under life self-care in the Beijing area. Therefore, a comprehensive approach to assessment and treatment should be promoted.
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Affiliation(s)
- Jian Zhou
- Department of Gerontology, Tongren Hospital of China Capital Medical University, No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China.
| | - Ming-Zhao Qin
- Department of Gerontology, Tongren Hospital of China Capital Medical University, No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China
| | - Qian Liu
- Department of Gerontology, Tongren Hospital of China Capital Medical University, No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China
| | - Jin-Ping Liu
- Department of Gerontology, Tongren Hospital of China Capital Medical University, No.1 of Dong Jiao Min Xiang, Dongcheng District, Beijing, 100730, China
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Yeap SS. The Asian Federation of Osteoporosis Societies' call to action to improve the undertreatment of osteoporosis in Asia. Osteoporos Sarcopenia 2017; 3:161-163. [PMID: 30775524 PMCID: PMC6372811 DOI: 10.1016/j.afos.2017.11.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Accepted: 11/13/2017] [Indexed: 11/26/2022] Open
Affiliation(s)
- Swan Sim Yeap
- Corresponding author. Department of Medicine, Subang Jaya Medical Centre, No 1, Jalan SS12/1A, Subang Jaya, Selangor, Malaysia.
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Dyer SM, Crotty M, Fairhall N, Magaziner J, Beaupre LA, Cameron ID, Sherrington C. A critical review of the long-term disability outcomes following hip fracture. BMC Geriatr 2016; 16:158. [PMID: 27590604 PMCID: PMC5010762 DOI: 10.1186/s12877-016-0332-0] [Citation(s) in RCA: 501] [Impact Index Per Article: 62.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/20/2016] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Hip fractures are an increasingly common consequence of falls in older people that are associated with a high risk of death and reduced function. This review aims to quantify the impact of hip fracture on older people's abilities and quality of life over the long term. METHODS Studies were identified through PubMed and Scopus searches and contact with experts. Cohort studies of hip fracture patients reporting outcomes 3 months post-fracture or longer were included for review. Outcomes of mobility, participation in domestic and community activities, health, accommodation or quality of life were categorised according to the World Health Organization's International Classification of Functioning and synthesised narratively. Risk of bias was assessed according to four items from the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. RESULTS Thirty-eight studies from 42 publications were included for review. Most followed a clearly defined sample from the time of fracture. Hip fracture survivors experienced significantly worse mobility, independence in function, health, quality of life and higher rates of institutionalisation than age matched controls. The bulk of recovery of walking ability and activities for daily living occurred within 6 months after fracture. Between 40 and 60 % of study participants recovered their pre-fracture level of mobility and ability to perform instrumental activities of daily living, while 40-70 % regained their level of independence for basic activities of daily living. For people independent in self-care pre-fracture, 20-60 % required assistance for various tasks 1 and 2 years after fracture. Fewer people living in residential care recovered their level of function than those living in the community. In Western nations, 10-20 % of hip fracture patients are institutionalised following fracture. Few studies reported impact on participation in domestic, community, social and civic life. CONCLUSIONS Hip fracture has a substantial impact on older peoples' medium- to longer-term abilities, function, quality of life and accommodation. These studies indicate the range of current outcomes rather than potential improvements with different interventional approaches. Future studies should measure impact on life participation and determine the proportion of people that regain their pre-fracture level of functioning to investigate strategies for improving these important outcomes.
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Affiliation(s)
- Suzanne M. Dyer
- Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Flinders University, Adelaide, Australia
- Cognitive Decline Partnership Centre, The University of Sydney, Sydney, Australia
| | - Maria Crotty
- Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Flinders University, Adelaide, Australia
- Cognitive Decline Partnership Centre, The University of Sydney, Sydney, Australia
| | - Nicola Fairhall
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Jay Magaziner
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, USA
| | - Lauren A. Beaupre
- Departments of Physical Therapy and Surgery (Division of Orthopaedic Surgery), University of Alberta, Edmonton, Canada
| | - Ian D. Cameron
- Cognitive Decline Partnership Centre, The University of Sydney, Sydney, Australia
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, The University of Sydney, St Leonards, Australia
| | - Catherine Sherrington
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - for the Fragility Fracture Network (FFN) Rehabilitation Research Special Interest Group
- Department of Rehabilitation, Aged and Extended Care, School of Health Sciences, Flinders University, Adelaide, Australia
- Cognitive Decline Partnership Centre, The University of Sydney, Sydney, Australia
- The George Institute for Global Health, Sydney Medical School, The University of Sydney, Sydney, Australia
- Department of Epidemiology and Public Health, School of Medicine, University of Maryland, Baltimore, USA
- Departments of Physical Therapy and Surgery (Division of Orthopaedic Surgery), University of Alberta, Edmonton, Canada
- John Walsh Centre for Rehabilitation Research, Sydney Medical School Northern, The University of Sydney, St Leonards, Australia
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Gore E, Mardon J, Lebecque A. Draining and salting as responsible key steps in the generation of the acid-forming potential of cheese: Application to a soft blue-veined cheese. J Dairy Sci 2016; 99:6927-6936. [PMID: 27344382 DOI: 10.3168/jds.2016-11094] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Accepted: 05/15/2016] [Indexed: 11/19/2022]
Abstract
A disregarded nutritional feature of cheeses is their high acid-forming potential when ingested, which is associated with deleterious effects on consumers' health. This work aimed to characterize the acid-forming potential of a blue-veined cheese during manufacturing to identify the main steps of the process involved in this phenomenon. Sampling was performed on 3 batches at 10 steps of the cheese-making process: reception of raw milk, pasteurization, maturation of milk, coagulation, stirring, draining of the curds, and 4 ripening stages: 21, 28, 42, and 56d. The acid-forming potential of each sample was evaluated by (1) the calculation of the potential renal acid load (PRAL) index (considering protein, Cl, P, Na, K, Mg, and Ca contents), and (2) its organic anion content (lactate and citrate), considered as alkalinizing elements. Draining and salting were identified as the main steps responsible for generation of the acid-forming potential of cheese. The draining process induced an increase in the PRAL index from 1.2mEq/100g in milk to 10.4mEq/100g in drained curds due to the increase in dry matter and the loss of alkaline minerals into the whey. The increase in PRAL value (20.3mEq/100g at d 56) following salting resulted from an imbalance between the strong acidogenic elements (Cl, P, and proteins) and the main alkalinizing ones (Na and Ca). Particularly, Cl had a major effect on the PRAL value. Regarding organic anions, draining induced a loss of 93% of the citrate content in initial milk. The lactate content increased as fermentation occurred (1,297.9mg/100g in drained curds), and then decreased during ripening (519.3mg/100g at d 56). This lactate level probably helps moderate the acidifying potential of end products. Technological strategies aimed at limiting the acid-forming potential of cheeses are proposed and deserve further research to evaluate their nutritional relevance.
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Affiliation(s)
- Ecaterina Gore
- Clermont University, VetAgro Sup, UPSP n°2011-03-100, CALITYSS, 89 avenue Europe, F-63370 Lempdes, France
| | - Julie Mardon
- Clermont University, VetAgro Sup, UPSP n°2011-03-100, CALITYSS, 89 avenue Europe, F-63370 Lempdes, France.
| | - Annick Lebecque
- Clermont University, VetAgro Sup, UPSP n°2011-03-100, CALITYSS, 89 avenue Europe, F-63370 Lempdes, France
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