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Guo JY, Wang SN, Zhang ZL, Luan M. Associations between organophosphate esters and bone mineral density in adults in the United States: 2011-2018 NHANES. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 278:116414. [PMID: 38714086 DOI: 10.1016/j.ecoenv.2024.116414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 04/18/2024] [Accepted: 04/28/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Organophosphate esters (OPEs) are used extensively as flame retardants and plasticizers. Laboratory studies have shown that OPEs exhibit osteotoxicity by inhibiting osteoblast differentiation; however, little is known about how OPEs exposure is associated with bone health in humans. OBJECTIVES We conducted a cross-sectional study to investigate the association between OPEs exposure and bone mineral density (BMD) in adults in the United States using data from the 2011-2018 National Health and Nutrition Examination Survey (NHANES). METHODS Multivariate linear regression models were used to assess the association between concentrations of individual OPE metabolites and BMDs. We also used the Bayesian kernel machine regression (BKMR) and quantile g-computation (qgcomp) models to estimate joint associations between OPE mixture exposure and BMDs. All the analyses were stratified according to gender. RESULTS A total of 3546 participants (median age, 40 years [IQR, 30-50 years]; 50.11% male) were included in this study. Five urinary OPE metabolites with a detection rate of > 50% were analyzed. After adjusting for the potential confounders, OPE metabolite concentrations were associated with decreased total-body BMD and lumbar spine BMD in males, although some associations only reached significance for bis(1-chloro-2-propyl) phosphate (BCPP), dibutyl phosphate (DBUP), and bis(2-chloroethyl) phosphate (BCEP) (β = -0.013, 95% CI: -0.026, -0.001 for BCPP and total-body BMD; β = -0.022, 95% CI: -0.043, -0.0001 for DBUP and lumbar spine BMD; β=-0.018, 95% CI: -0.034, -0.002 for BCEP and lumbar spine BMD). OPE mixture exposure was also inversely associated with BMD in males, as demonstrated in the BMKR and qgcomp models. CONCLUSIONS This study provides preliminary evidence that urinary OPE metabolite concentrations are inversely associated with BMD. The results also suggested that males were more vulnerable than females. However, further studies are required to confirm these findings.
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Affiliation(s)
- Jing-Yi Guo
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China; Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Su-Na Wang
- Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen-Lin Zhang
- Department of Osteoporosis and Bone Disease, Shanghai Clinical Research Center of Bone Disease, Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
| | - Min Luan
- Clinical Research Center, Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Zhang X, Yang L, Zhang J, Lix LM, Leslie WD, Kan B, Yang S. Secular Trends in Peak Bone Mineral Density: The National Health and Nutrition Examination Survey 1999-2018. Calcif Tissue Int 2024; 114:480-489. [PMID: 38522039 DOI: 10.1007/s00223-024-01198-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Accepted: 02/19/2024] [Indexed: 03/25/2024]
Abstract
Peak bone mineral density (BMD) is one of the most important factors influencing the development of osteoporosis. It was predicted that a 10% increase in peak BMD will delay the onset of osteoporosis by 13 years. However, changes in peak BMD over time are unknown. This study aimed to investigate secular trends in peak BMD among young adults in the United States. Based on the National Health and Nutrition Examination Survey from 1999-2018, 3,975 males aged 19-28 years and 2370 females aged 31-40 years were our target population for estimating peak lumbar spine BMD. BMD was measured by dual-energy X-ray absorptiometry. Generalized linear models adjusted for multiple covariates were used to examine the secular trends in peak BMD in males and females, respectively. Secular trends for peak lumbar spine BMD from 1999-2000 to 2017-2018 were not statistically significant in males or females (all Plinear and Pquadratic > 0.05). Similar results were observed in race/ethnicity subgroups (all Plinear and Pquadratic > 0.05). However, in stratified analyses by obesity category, peak lumbar spine BMD in obese males and females increased from 1999-2000 to 2009-2010 and then decreased until 2017-2018, while peak lumbar spine BMD in non-obese females decreased from 1999-2000 to 2005-2006 and then increased until 2017-2018 (all Pquadratic < 0.05). Peak lumbar spine BMD was greater in obese males and females than in non-obese males and females up to 2009-2010, but not from 2011-2012 onwards. Overall, there were no significant secular trends in peak lumbar spine BMD. However, secular trends differed between obese and non-obese groups.
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Affiliation(s)
- Xiaohua Zhang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Linghua Yang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Juan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - William D Leslie
- Department of Internal Medicine, University of Manitoba, Winnipeg, MB, Canada
| | - Bo Kan
- Department of Clinical Laboratory, The Second Hospital of Jilin University, Changchun, Jilin, China
| | - Shuman Yang
- Department of Orthopedics, The First Affiliated Hospital of Jinzhou Medical University, Jinzhou, Liaoning, China.
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, 232-1163 Xinmin Street, Changchun, 130021, Jilin, China.
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Xu B, Radojčić MR, Anderson DB, Shi B, Yao L, Chen Y, Feng S, Lee JH, Chen L. Trends in prevalence of fractures among adults in the United States, 1999-2020: a population-based study. Int J Surg 2024; 110:721-732. [PMID: 37921645 PMCID: PMC10871608 DOI: 10.1097/js9.0000000000000883] [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: 07/03/2023] [Accepted: 10/22/2023] [Indexed: 11/04/2023]
Abstract
BACKGROUND Population data that examines recent national trends in the prevalence of fractures are lacking in the United States (US). MATERIALS AND METHODS Analyses were based on 1999-2020 data from the National Health and Nutrition Examination Survey (NHANES). Primary outcomes included the prevalence of hip, wrist, and vertebral fractures among adults aged greater than or equal to 50 years. Changes in the prevalence over time were determined by joinpoint regression analysis. The authors also described the variation by fracture subtypes, sociodemographic characteristics, and their combination. RESULTS For adults aged greater than or equal to 50 years in NHANES 2017-March 2020, the authors estimated that there was 2.6 million Americans with hip fractures, 14.6 million Americans with wrist fractures, and 5.2 million Americans with vertebral fractures. The prevalence of wrist fractures significantly increased from 8.7% (7.4-9.9%) in 1999-2000 to 12.8% (11.6-14.1%) in 2017-March 2020 among adults aged greater than or equal to 50 years ( P for trend=0.04); significant increases were also observed in fractures that occurred at age less than 50 years, non-Hispanic White, high family income groups, and several combination subgroups (e.g. fractures occurred at age <50 years among women). The prevalence of vertebral fractures increased from 2.2% (1.7-2.8%) in 1999-2000 to 4.6% (3.7-5.5%) in 2017-March 2020 among adults aged greater than or equal to 50 years ( P for trend=0.02); significant increases were also observed in 50-64 years, women, non-Hispanic White, high family income groups and several combination subgroups (e.g. fractures that occurred at age <50 years among women). The authors did not observe significant trend changes in the prevalence of hip fractures among adults aged greater than or equal to 50 years between 1999 and 2020. CONCLUSION The estimated prevalence of wrist and vertebral fractures significantly increased among US adults aged greater than or equal to 50 years from 1999 to 2020, although hip fractures did not significantly change.
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Affiliation(s)
- Bin Xu
- The Second Hospital of Shandong University
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Maja R. Radojčić
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
| | - David B. Anderson
- Faculty of Medicine and Health, The University of Sydney, Sydney School of Health Sciences
- Sydney Musculoskeletal Health, Patyegarang Precinct
| | - Baoyi Shi
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Liang Yao
- Department of Health Research Methods, Evidence, and Impact, McMaster University, Ontario, Canada
| | - Yujie Chen
- Program in Child Health Evaluative Sciences, The Hospital for Sick Children
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto
| | - Shiqing Feng
- The Second Hospital of Shandong University
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute
| | - Jae Hyup Lee
- Department of Orthopedic Surgery, SMG-SNU Boramae Medical Center
- Institute of Medical and Biological Engineering, Medical Research Center
- Department of Orthopedic Surgery, College of Medicine, Seoul National University, Seoul, Republic of Korea
| | - Lingxiao Chen
- Department of Orthopaedics, Qilu Hospital of Shandong University, Shandong University Centre for Orthopaedics, Advanced Medical Research Institute
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, People's Republic of China
- Sydney Musculoskeletal Health, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
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Maldonado LY, Bosques L, Cromer SJ, Azar SS, Yu EW, Burnett-Bowie SAM. Racial and Ethnic Disparities in Metabolic Bone Disease. Endocrinol Metab Clin North Am 2023; 52:629-641. [PMID: 37865478 DOI: 10.1016/j.ecl.2023.05.004] [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] [Indexed: 10/23/2023]
Abstract
Racial and ethnic disparities exist in the prevalence and management of osteoporosis, metastatic cancer, and sickle cell disease. Despite being the most common metabolic bone disease, osteoporosis remains underscreened and undertreated among Black women. Skeletal-related events in metastatic cancer include bone pain, pathologic fractures, and spinal cord compression. Disparities in screening for and treating skeletal-related events disproportionately affect Black patients. Metabolic bone disease contributes significantly to morbidity in sickle cell disease; however, clinical guidelines for screening and treatment do not currently exist. Clinical care recommendations are provided to raise awareness, close health care gaps, and guide future research efforts.
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Affiliation(s)
- Lauren Y Maldonado
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Bigelow 730, Boston, MA 02114, USA; Department of Pediatrics, MassGeneral Hospital for Children and Harvard Medical School, 175 Cambridge Street, Boston, MA 02114, USA
| | - Linette Bosques
- Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Bigelow 730, Boston, MA 02114, USA
| | - Sara J Cromer
- Department of Medicine, Endocrine Division, Massachusetts General Hospital and Harvard Medical School, 50 Blossom Street, Thier 1051, Boston, MA 02114, USA
| | - Sharl S Azar
- Hematology and Medical Oncology Division, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Yawkey 9-536, Boston, MA 02114, USA
| | - Elaine W Yu
- Department of Medicine, Endocrine Division, Massachusetts General Hospital and Harvard Medical School, 50 Blossom Street, Thier 1051, Boston, MA 02114, USA
| | - Sherri-Ann M Burnett-Bowie
- Department of Medicine, Endocrine Division, Massachusetts General Hospital and Harvard Medical School, 50 Blossom Street, Thier 1051, Boston, MA 02114, USA.
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Wu Q, Dai J. Racial/Ethnic Differences in Bone Mineral Density for Osteoporosis. Curr Osteoporos Rep 2023; 21:670-684. [PMID: 38019343 DOI: 10.1007/s11914-023-00838-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/13/2023] [Indexed: 11/30/2023]
Abstract
PURPOSE OF REVIEW We primarily aim to review differences in bone mineral density (BMD) for osteoporosis among different racial/ethnic groups and to highlight the magnitude of racial/ethnic differences in obesity and diabetes. We also explore the factors contributing to the BMD differences among various subgroups. In addition, we investigate the existing disparities in research, educational initiatives, screening practices, and treatment options for osteoporosis and discuss these findings' clinical and public health implications. RECENT FINDINGS Racial/ethnic differences in BMD for osteoporosis exist in the USA and other countries. There are disparities regarding osteoporosis screening and treatment. Understanding the factors contributing to these differences can help develop targeted interventions and policies to reduce their impact. Clinicians should consider the racial/ethnic differences in BMD when making treatment decisions and providing preventive care. Future research could contribute to developing effective strategies for preventing osteoporosis among different racial/ethnic groups. This review offered a comprehensive examination of differences in BMD across various racial and ethnic groups, elucidating the influence of genetic, lifestyle, and cultural factors on these differences. This review also highlighted the disparities in osteoporosis screening, treatment options, research on medical effectiveness, and educational outreach tailored to each subgroup. Recognizing the importance of addressing these inequalities, we present this review to advocate for targeted interventions to reduce disparities in osteoporosis and improve bone health for all populations.
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Affiliation(s)
- Qing Wu
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, 250 Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA.
| | - Jingyuan Dai
- Department of Biomedical Informatics, College of Medicine, The Ohio State University, 250 Lincoln Tower, 1800 Cannon Drive, Columbus, OH, 43210, USA
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Kim KY, Park J, Yang S, Shin J, Park JH, Park B, Kim BT. Discordance in Secular Trends of Bone Mineral Density Measurements in Different Ages of Postmenopausal Women. J Korean Med Sci 2023; 38:e364. [PMID: 37904660 PMCID: PMC10615637 DOI: 10.3346/jkms.2023.38.e364] [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: 01/13/2023] [Accepted: 07/04/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Age-adjusted bone mineral density (BMD) in postmenopausal women decreases in developed countries whereas incidence of osteoporotic fracture decreases or remains stable. We investigated secular trends of bone density from 2008 to 2017 among different age groups of postmenopausal women. METHODS We analyzed BMD data obtained from health check-ups of 4,905 postmenopausal women during three survey cycles from 2008 to 2017. We divided them into 3 groups by age (50-59 years, 60-69 years, and 70 years or more) and observed the transition of lumbar and femoral BMD in each group, before and after adjusting for variables that may affect BMD. RESULTS Age-adjusted BMD, bone mineral content (BMC), and T-score demonstrated a declining trend over the survey period at lumbar spine (-2.8%), femur neck (-3.5%) and total femur (-4.3%), respectively. In the analysis for the age groups, the BMD, BMC, and T-score presented linear declining trend (-6.1%) in younger postmenopausal women while women aged over 70 or more showed linear increasing trends (+6.3%) at lumbar spine during the survey period. Femoral neck and total femur BMD demonstrated a declining linear trend only in the 50-59 and 60-69 years groups (-5.5%, -5.2%, respectively), but not in the 70 years or more group. CONCLUSION BMD in younger postmenopausal women has decreased considerably but has increased or plateaued in elderly women. This discordance of BMD trends among different age groups may contribute to decreased incidence of osteoporotic fracture despite a recent declining BMD trend in postmenopausal women.
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Affiliation(s)
- Kwang Yoon Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Jaesun Park
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Sungwon Yang
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Junghwa Shin
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Ji Hyun Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Hospital, Suwon, Korea
| | - Bumhee Park
- Office of Biostatistics, Medical Research Collaborating Center, Ajou Research Institute for Innovative Medicine, Ajou University Hospital, Suwon, Korea
- Department of Biomedical Informatics, Ajou University School of Medicine, Suwon, Korea
| | - Bom Taeck Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea.
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Patel A, Allbritton-King JD, Paul S, Bhattacharyya T. Bone health is improving over time: data from Framingham cohorts. Arch Osteoporos 2023; 18:119. [PMID: 37715080 DOI: 10.1007/s11657-023-01327-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 09/01/2023] [Indexed: 09/17/2023]
Abstract
Hip fractures have steadily declined in the USA. We found that bone health, as measured by bone mineral density, has significantly improved over the past 30 years. Our findings contradict previous studies and offer one explanation for the decline in hip fractures. PURPOSE Despite the widespread undertreatment of osteoporosis, hip fractures have been declining in the USA. The reasons for this decline are unclear; however, one possible explanation could be that the bone health has improved over time. METHODS To determine the trends in bone density in the USA, we analyzed the bone mineral density scans of 7216 subjects across three generations in the Framingham Heart Study. We compared the mean femoral bone mineral density (BMD) between cohorts then constructed a linear regression model controlling for age, sex, BMI, and smoking rates. RESULTS We observed that the mean BMD of each successive Framingham cohort increased (p < 0.001). After controlling for age, subjects born later had higher BMD. The results from the linear-regression model developed on the original cohort indicated that the BMD of the women from the offspring and third generation were higher than what would be predicted. Younger generations demonstrated higher activity scores (p < 0.001), and lower smoking rates (p = 0.045). CONCLUSION These data suggest that bone health, measured by bone mineral density scans, is improving in later generations, in part due to decreased smoking rates and higher rates of activity.
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Affiliation(s)
- Amit Patel
- Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA
| | - Jules D Allbritton-King
- Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, USA
| | - Subrata Paul
- NIAID Collaborative Bioinformatics Resource, National Institute of Allergy and Infectious Diseases, Maryland, USA
| | - Timothy Bhattacharyya
- Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA.
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Gao J, Xie C, Yang J, Tian C, Zhang M, Lu Z, Meng X, Cai J, Guo X, Gao T. The Effects of n-3 PUFA Supplementation on Bone Metabolism Markers and Body Bone Mineral Density in Adults: A Systematic Review and Meta-Analysis of RCTs. Nutrients 2023; 15:2806. [PMID: 37375709 DOI: 10.3390/nu15122806] [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: 05/18/2023] [Revised: 06/07/2023] [Accepted: 06/15/2023] [Indexed: 06/29/2023] Open
Abstract
Supplemental n-3 polyunsaturated fatty acids (PUFA) on bone metabolism have yielded inconsistent results. This study aimed to examine the effects of n-3 PUFA supplementation on bone metabolism markers and bone mineral density through a meta-analysis of randomized controlled trials. A systematic literature search was conducted using the PubMed, Web of Science, and EBSCO databases, updated to 1 March 2023. The intervention effects were measured as standard mean differences (SMD) and mean differences (MD). Additionally, n-3 PUFA with the untreated control, placebo control, or lower-dose n-3 PUFA supplements were compared, respectively. Further, 19 randomized controlled trials (RCTs) (22 comparisons, n = 2546) showed that n-3 PUFA supplementation significantly increased blood n-3 PUFA (SMD: 2.612; 95% CI: 1.649 to 3.575). However, no significant effects were found on BMD, CTx-1, NTx-1, BAP, serum calcium, 25(OH)D, PTH, CRP, and IL-6. Subgroup analyses showed significant increases in femoral neck BMD in females (0.01, 95% CI: 0.01 to 0.02), people aged <60 years (0.01, 95% CI: 0.01 to 0.01), and those people in Eastern countries (0.02, 95% CI: 0.02 to 0.03), and for 25(OH)D in people aged ≥60 years (0.43, 95% CI: 0.11 to 0.74), treated with n-3 PUFA only (0.36, 95% CI: 0.06 to 0.66), and in studies lasting ≤6 months (0.29, 95% CI: 0.11 to 0.47). NTx-1 decreased in both genders (-9.66, 95% CI: -15.60 to -3.71), and serum calcium reduction was found in studies lasting >6 months (-0.19, 95% CI: -0.37 to -0.01). The present study demonstrated that n-3 PUFA supplementation might not have a significant effect on bone mineral density or bone metabolism markers, but have some potential benefits for younger postmenopausal subjects in the short term. Therefore, additional high-quality, long-term randomized controlled trials (RCTs) are warranted to fully elucidate the potential benefits of n-3 PUFA supplementation, as well as the combined supplementation of n-3 PUFA, on bone health.
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Affiliation(s)
- Jie Gao
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
| | - Chenqi Xie
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
| | - Jie Yang
- Health Service Center of Xuejiadao Community, Qingdao 266520, China
| | - Chunyan Tian
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
| | - Mai Zhang
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Zhenquan Lu
- School of Public Health, Qingdao University, Qingdao 266071, China
| | - Xiangyuan Meng
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
- Department of Toxicology, School of Public Health, Jilin University, Changchun 130021, China
| | - Jing Cai
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
| | - Xiaofei Guo
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
| | - Tianlin Gao
- School of Public Health, Qingdao University, Qingdao 266071, China
- Institute of Nutrition & Health, Qingdao University, Qingdao 266021, China
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Rosengren BE, Karlsson J, Bergman E, Ahlborg H, Jehpsson L, Karlsson MK. Time Trends in Trajectories of Forearm Mineral Content and Bone Size during Childhood-Results from Cross-Sectional Measurements with the Same Apparatus Four Decades Apart. JBMR Plus 2023; 7:e10720. [PMID: 36936361 PMCID: PMC10020921 DOI: 10.1002/jbm4.10720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 12/05/2022] [Accepted: 01/13/2023] [Indexed: 01/19/2023] Open
Abstract
Evidence suggests that single photon absorptiometry (SPA)-measured forearm bone mineral density (BMD) is lower in contemporary children in Malmö than it was four decades ago, but the fracture incidence in the at-risk population (all Malmö children) has been stable during the same period. The aim of this study was to evaluate if improvements in skeletal structure over time may explain this observation. In 2017-2018 we measured distal forearm bone mineral content (BMC; mg/cm) and periosteal diameter (mm) in 238 boys and 204 girls aged 7-15 using SPA. Based on the SPA measurements, we calculated forearm BMD (mg/cm2), bone mineral apparent density (BMAD, mg/cm3), section modulus, and strength index (BMAD × section modulus). The results were compared with those derived from measurements of 55 boys and 61 girls of the same ages using the same scanner in 1979-1981. We used log-linear regression with age, sex, and cohort as predictors to investigate differences in trait trajectories (trait versus age slopes [mean percent difference in beta values (95% confidence interval)]). SPA-measured forearm BMC was lower at each age in 2017-2018 compared to 1979-1981 (a mean age and sex adjusted relative difference of 9.1%), the forearm BMC trajectory was similar in 2017-2018 to that in 1979-1981 (reference) [0.0%/year (-1.0%, 1.0%)], while the 2017-2018 forearm periosteal diameter trajectory was steeper [1.1%/year (0.3%, 2.0%)]. Since bone size influences both BMD (BMC divided by scanned area) and mechanical characteristics, the forearm BMD trajectory was flatter in 2017-2018 [-1.1%/year (-2.0%, -0.2%)] and the forearm section modulus trajectory steeper [3.9%/year (1.4%, 6.4%)]. Forearm strength index trajectory was similar [1.8%/year (-0.5%, 4.1%)]. The lower SPA-measured forearm BMD trajectory in contemporary children compared to four decades ago may be offset by changes in forearm bone structure, resulting in similar overall bone strength. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Björn E. Rosengren
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and OrthopedicsLund University, Skåne University HospitalMalmöSweden
| | - Jessica Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and OrthopedicsLund University, Skåne University HospitalMalmöSweden
| | - Erika Bergman
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and OrthopedicsLund University, Skåne University HospitalMalmöSweden
| | - Henrik Ahlborg
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and OrthopedicsLund University, Skåne University HospitalMalmöSweden
| | - Lars Jehpsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and OrthopedicsLund University, Skåne University HospitalMalmöSweden
| | - Magnus K. Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and OrthopedicsLund University, Skåne University HospitalMalmöSweden
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Hassanabadi N, Berger C, Papaioannou A, Cheung AM, Rahme E, Leslie WD, Goltzman D, Morin SN. Variation in bone mineral density and fractures over 20 years among Canadians: a comparison of the Canadian Multicenter Osteoporosis Study and the Canadian Longitudinal Study on Aging. Osteoporos Int 2023; 34:357-367. [PMID: 36449036 PMCID: PMC9852141 DOI: 10.1007/s00198-022-06623-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 11/22/2022] [Indexed: 12/05/2022]
Abstract
UNLABELLED International variations in osteoporosis and fracture rates have been reported, with temporal trends differing between populations. We observed higher BMD and lower fracture prevalence in a recently recruited cohort compared to that of a cohort recruited 20 years ago, even after adjusting for multiple covariates. PURPOSE We explored sex-specific differences in femoral neck bone mineral density (FN-BMD) and in prevalent major osteoporotic fractures (MOF) using two Canadian cohorts recruited 20 years apart. METHODS We included men and women aged 50-85 years from the Canadian Multicentre Osteoporosis Study (CaMos, N = 6,479; 1995-1997) and the Canadian Longitudinal Study on Aging (CLSA, N = 19,534; 2012-2015). We created regression models to compare FN-BMD and fracture risk between cohorts, adjusting for important covariates. Among participants with prevalent MOF, we compared anti-osteoporosis medication use. RESULTS Mean (SD) age in CaMos (65.4 years [8.6]) was higher than in CLSA (63.8 years [9.1]). CaMos participants had lower mean body mass index and higher prevalence of smoking (p < 0.001). Adjusted linear regression models (estimates [95%CI]) demonstrated lower FN-BMD in CaMos women (- 0.017 g/cm2 [- 0.021; - 0.014]) and men (- 0.006 g/cm2 [- 0.011; 0.000]), while adjusted odds ratios (95%CI) for prevalent MOF were higher in CaMos women (1.99 [1.71; 2.30]) and men (2.33 [1.82; 3.00]) compared to CLSA. In women with prevalent MOF, menopausal hormone therapy use was similar in both cohorts (43.3% vs 37.9%, p = 0.076), but supplements (32.0% vs 48.3%, p < 0.001) and bisphosphonate use (5.8% vs 17.3%, p < 0.001) were lower in CaMos. The proportion of men with MOF who received bisphosphonates was below 10% in both cohorts. CONCLUSION Higher BMD and lower fracture prevalence were noted in the more recently recruited CLSA cohort compared to CaMos, even after adjusting for multiple covariates. We noted an increase in bisphosphonate use in the recent cohort, but it remained very low in men.
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Affiliation(s)
- Nazila Hassanabadi
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - Claudie Berger
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | | | - Angela M Cheung
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Elham Rahme
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - William D Leslie
- Department of Medicine, University of Manitoba, Winnipeg, Canada
| | - David Goltzman
- Department of Medicine, McGill University, Montreal, Canada
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada
| | - Suzanne N Morin
- Department of Medicine, McGill University, Montreal, Canada.
- Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, 5252 de Maisonneuve O; Room 3E.11, Montreal, Quebec, H4A 3S5, Canada.
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11
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Liu X, Chen F, Liu L, Zhang Q. Prevalence of osteoporosis in patients with diabetes mellitus: a systematic review and meta-analysis of observational studies. BMC Endocr Disord 2023; 23:1. [PMID: 36597121 PMCID: PMC9809067 DOI: 10.1186/s12902-022-01260-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Accepted: 12/22/2022] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Osteoporosis (OP) and diabetes mellitus (DM) are two major healthcare issues in the world. Numerous population based-studies have reported an increased prevalence of OP among individuals with DM, though, estimates vary significantly. PURPOSE The objective of this study is to estimate the prevalence of OP in patients with DM. METHODS To identify relevant literature, PubMed, Embase, Medline, CBM and Cochrane Library were searched for studies published from inception till July 2022, The search was conducted, and studies were included without countries and language restrictions. For full-text articles included in the study, the references were also independently searched. Random inverse variance-weighted models were used by Stata version 17.0 to estimate the prevalence of OP in patients with diabetes across studies. The heterogeneity was examined with I2 via the χ2 test on Cochrane's Q statistic. Subgroup analysis and meta-regression were used to explore potential sources of heterogeneity. Egger's test was used to assess publication bias. RESULTS A high OP prevalence of 27.67% (95% confidence interval (CI) 21.37-33.98%) was found in a pooled analysis of 21 studies involving 11,603 T2DM patients. Methodological value of the included articles was high, with only three medium-quality studies and no low-quality studies. A significantly high heterogeneity (I2 = 98.5%) was observed. CONCLUSIONS Worldwide, a high prevalence of OP was found in patients with T2DM. Therefore, strong measures to prevent and treat osteoporosis in diabetic patients are required. TRIAL REGISTRATION This study has been registered on PROSPERO, number CRD42021286580 .
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Affiliation(s)
- Xueying Liu
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
| | - Fuhua Chen
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
| | - Lei Liu
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
| | - Qiu Zhang
- Department of Endocrinology, First Affiliated Hospital of Anhui Medical University, Hefei, 230032 China
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12
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Aaltonen HL, O'Reilly MK, Linnau KF, Dong Q, Johnston SK, Jarvik JG, Cross NM. m2ABQ-a proposed refinement of the modified algorithm-based qualitative classification of osteoporotic vertebral fractures. Osteoporos Int 2023; 34:137-145. [PMID: 36336755 PMCID: PMC10246552 DOI: 10.1007/s00198-022-06546-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Accepted: 08/29/2022] [Indexed: 11/09/2022]
Abstract
Currently, there is no reproducible, widely accepted gold standard to classify osteoporotic vertebral body fractures (OVFs). The purpose of this study is to refine a method with clear rules to classify OVFs for machine learning purposes. The method was found to have moderate interobserver agreement that improved with training. INTRODUCTION The current methods to classify osteoporotic vertebral body fractures are considered ambiguous; there is no reproducible, accepted gold standard. The purpose of this study is to refine classification methodology by introducing clear, unambiguous rules and a refined flowchart to allow consistent classification of osteoporotic vertebral body fractures. METHODS We developed a set of rules and refinements that we called m2ABQ to classify vertebrae into five categories. A fracture-enriched database of thoracic and lumbar spine radiographs of patients 65 years of age and older was retrospectively obtained from clinical institutional radiology records using natural language processing. Five raters independently classified each vertebral body using the m2ABQ system. After each annotation round, consensus sessions that included all raters were held to discuss and finalize a consensus annotation for each vertebral body where individual raters' evaluations differed. This process led to further refinement and development of the rules. RESULTS Each annotation round showed increase in Fleiss kappa both for presence vs absence of fracture 0.62 (0.56-0.68) to 0.70 (0.65-0.75), as well as for the whole m2ABQ scale 0.29 (0.25-0.33) to 0.54 (0.51-0.58). CONCLUSION The m2ABQ system demonstrates moderate interobserver agreement and practical feasibility for classifying osteoporotic vertebral body fractures. Future studies to compare the method to existing studies are warranted, as well as further development of its use in machine learning purposes.
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Affiliation(s)
- H L Aaltonen
- Department of Radiology, University of Washington, Seattle, WA, USA.
- Department of Medical Imaging and Physiology, Lund University, Malmo, Sweden.
| | - M K O'Reilly
- Department of Radiology, University of Washington, Seattle, WA, USA
- Department of Radiology, University of Limerick Hospital Group, Limerick, Ireland
- Clinical Learning, Evidence, And Research [CLEAR] Center for Musculoskeletal Disorders, Seattle, USA
| | - K F Linnau
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Q Dong
- Clinical Learning, Evidence, And Research [CLEAR] Center for Musculoskeletal Disorders, Seattle, USA
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, WA, USA
| | - S K Johnston
- Department of Radiology, University of Washington, Seattle, WA, USA
- Clinical Learning, Evidence, And Research [CLEAR] Center for Musculoskeletal Disorders, Seattle, USA
| | - J G Jarvik
- Department of Radiology, University of Washington, Seattle, WA, USA
- Clinical Learning, Evidence, And Research [CLEAR] Center for Musculoskeletal Disorders, Seattle, USA
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - N M Cross
- Department of Radiology, University of Washington, Seattle, WA, USA
- Clinical Learning, Evidence, And Research [CLEAR] Center for Musculoskeletal Disorders, Seattle, USA
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13
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Rosengren BE, Bergman E, Karlsson J, Ahlborg H, Jehpsson L, Karlsson MK. Downturn in Childhood Bone Mass: A
Cross‐Sectional
Study Over Four Decades. JBMR Plus 2021; 6:e10564. [PMID: 35079676 PMCID: PMC8770995 DOI: 10.1002/jbm4.10564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Accepted: 09/26/2011] [Indexed: 11/17/2022] Open
Abstract
Screen time and physical inactivity have increased among children. As physical activity is a determinant of bone mass, there is a concern that children today have lower bone mass than earlier. If this is true, fractures may become more common in the future. In 2017–2018, we used single‐photon absorptiometry (SPA) to measure distal forearm bone mineral density (BMD; mg/cm2) in a normative cohort of 238 boys and 204 girls aged 7 to 15 years. We compared these results to BMD in a normative cohort collected in 1979–1981 (55 boys and 61 girls aged 7 to 15 years) measured by the same scanner. To investigate difference between the two cohorts, we used multiple linear regression with age, sex, and cohort as predictors. Predicted bone density at age 16 years was estimated through the slope values. The bone density‐age slope was flatter in the cohort measured in 2017–2018 than in the cohort measured 1979–1981 (−5.6 mg/cm2/yr [95% confidence interval −9.6 to −1.5]). Predicted bone density was at age 16 years in 2017–2018 in boys was 10% lower (−0.9 SD) and in girls 11% lower (−1.1 SD) than in their counterparts measured in 1979–1981. We found indications that children nowadays develop lower bone mass than four decades ago, giving concern that they may have a higher risk of osteoporosis and fragility fractures as they grow old. © 2021 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
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Affiliation(s)
- Björn E Rosengren
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics Lund University, Skåne University Hospital Malmö Sweden
| | - Erika Bergman
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics Lund University, Skåne University Hospital Malmö Sweden
| | - Jessica Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics Lund University, Skåne University Hospital Malmö Sweden
| | - Henrik Ahlborg
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics Lund University, Skåne University Hospital Malmö Sweden
| | - Lars Jehpsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics Lund University, Skåne University Hospital Malmö Sweden
| | - Magnus K Karlsson
- Clinical and Molecular Osteoporosis Research Unit, Department of Clinical Sciences and Orthopedics Lund University, Skåne University Hospital Malmö Sweden
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14
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Watanabe H, Minagawa Y, Suzuki I, Kitamura K, Watanabe Y, Kabasawa K, Platonova K, Hinata A, Nakamura K. Secular changes in bone mineral density of adult Japanese women from 1995 to 2013. Fukushima J Med Sci 2021; 67:128-134. [PMID: 34744088 PMCID: PMC8784192 DOI: 10.5387/fms.2021-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Introduction: Secular changes in hip fracture incidence have been reported in the last few decades in Japan, but whether long-term bone mineral density (BMD) is also changing is unclear. This study aimed to determine whether BMD of Japanese women has changed over time. Methods: Subjects were 10,649 adult women who underwent BMD measurement in a health check-up population in Niigata, Japan, between 1995 and 2013. BMD of the distal, non-dominant forearm was measured by dual-energy X-ray absorptiometry. Demographic information and BMI were also obtained. Secular trends were determined by linear regression analysis. Results: BMD of subjects in their 40’s decreased significantly in the age-adjusted model (P for trend=0.0162), but not in the age- and BMI-adjusted model (P for trend=0.2171). BMD of subjects in their 50’s decreased marginally in the age-adjusted model (P for trend=0.0535), but not in the age- and BMI-adjusted model (P for trend=0.6601). BMDs of subjects in their 30’s and 60’s did not significantly change, while BMIs of subjects in their 40’s-60’s decreased significantly. Conclusions: A secular decrease in BMD, partly attributed to decreases in BMI, was observed in middle-aged Japanese women from 1995 to 2013. Measures to help maintain suitable BMI will be necessary to prevent a decrease in BMD among women.
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Affiliation(s)
- Hiroaki Watanabe
- Department of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences.,Department of Clinical Engineering and Medical Technology, Niigata University of Health and Welfare
| | | | | | - Kaori Kitamura
- Department of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Yumi Watanabe
- Department of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Keiko Kabasawa
- Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kseniia Platonova
- Department of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Aya Hinata
- Department of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
| | - Kazutoshi Nakamura
- Department of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences
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15
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Chin EL, Van Loan M, Spearman SS, Bonnel EL, Laugero KD, Stephensen CB, Lemay DG. Machine Learning Identifies Stool pH as a Predictor of Bone Mineral Density in Healthy Multiethnic US Adults. J Nutr 2021; 151:3379-3390. [PMID: 34313764 DOI: 10.1093/jn/nxab266] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 06/14/2021] [Accepted: 07/21/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND A variety of modifiable and nonmodifiable factors such as ethnicity, age, and diet have been shown to influence bone health. Previous studies are usually limited to analyses focused on the association of a few a priori variables or on a specific subset of the population. OBJECTIVE Dietary, physiological, and lifestyle data were used to identify directly modifiable and nonmodifiable variables predictive of bone mineral content (BMC) and bone mineral density (BMD) in healthy US men and women using machine-learning models. METHODS Ridge, lasso, elastic net, and random forest models were used to predict whole-body, femoral neck, and spine BMC and BMD in healthy US men and women ages 18-66 y, with a BMI (kg/m2) of 18-44 (n = 313), using nonmodifiable anthropometric, physiological, and demographic variables; directly modifiable lifestyle (physical activity, tobacco use) and dietary (via FFQ) variables; and variables approximating directly modifiable behavior (circulating 25-hydroxycholecalciferol and stool pH). RESULTS Machine-learning models using nonmodifiable variables explained more variation in BMC and BMD (highest R2 = 0.75) compared with when using only directly modifiable variables (highest R2 = 0.11). Machine-learning models had better performance compared with multivariate linear regression, which had lower predictive value (highest R2 = 0.06) when using directly modifiable variables only. BMI, body fat percentage, height, and menstruation history were predictors of BMC and BMD. For directly modifiable features, betaine, cholesterol, hydroxyproline, menaquinone-4, dihydrophylloquinone, eggs, cheese, cured meat, refined grains, fruit juice, and alcohol consumption were predictors of BMC and BMD. Low stool pH, a proxy for fermentable fiber intake, was also predictive of higher BMC and BMD. CONCLUSIONS Modifiable factors, such as diet, explained less variation in the data compared with nonmodifiable factors, such as age, sex, and ethnicity, in healthy US men and women. Low stool pH predicted higher BMC and BMD. This trial was registered at www.clinicaltrials.gov as NCT02367287.
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Affiliation(s)
- Elizabeth L Chin
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA
| | | | - Sarah S Spearman
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA
| | - Ellen L Bonnel
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA.,University of California, Davis, Davis, CA, USA
| | - Kevin D Laugero
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA.,University of California, Davis, Davis, CA, USA
| | - Charles B Stephensen
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA.,University of California, Davis, Davis, CA, USA
| | - Danielle G Lemay
- USDA ARS Western Human Nutrition Research Center, Davis, CA, USA.,University of California, Davis, Davis, CA, USA
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16
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Osco KM, Campa F, Coratella G, Correa BD, de Alencar Silva BS, Dos Santos VR, Milanez VF, Gobbo LA. Resistance but not elastic tubes training improves bioimpedance vector patterns and body composition in older women: A randomized trial. Exp Gerontol 2021; 154:111526. [PMID: 34425204 DOI: 10.1016/j.exger.2021.111526] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 07/29/2021] [Accepted: 08/16/2021] [Indexed: 12/26/2022]
Abstract
The present study aimed to investigate the effects of traditional resistance training compared to elastic tubes training on bioimpedance vector patterns, body composition, and strength in older women. Thirty-eight older women (age 68.7 ± 6.9 years, body mass index 28.8 ± 7.2 kg/m2) were randomly assigned to perform traditional resistance or elastic tubes training three times per week for 12 weeks. Body composition was assessed by dual energy X-ray absorptiometry and bioelectrical impedance vector analysis. In addition, handgrip strength was measured using a dynamometer. Only the participants who followed the 12-week traditional resistance training program significantly (p < 0.05) decreased fat mass (ES: -0.69) and extracellular water (ES: -1.06), and increased total body water (ES: 0.49), intracellular water (ES: 1.11), body cell mass (ES: 0.82), muscle mass (ES: 0.94), and phase angle (ES: 0.99), while no change occurred in the elastic tubes training group. Furthermore, a vector leftward displacement (ES: 1.11) into the resistance-reactance graph was found only after the traditional resistance training program. The handgrip strength increased for both traditional and elastic tubes training groups (ES: 0.64, ES: 0.71, respectively). Traditional resistance training improved body composition and strength in the older women group, while training using elastic tubes was effective only for the latter. The present outcomes encourage the use of systematic resistance training to counteract the effects of aging in older women.
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Affiliation(s)
- Karla Minacca Osco
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil; Post-Graduation Program in Physical Therapy, School of Technology and Sciences, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Francesco Campa
- Department for Life Quality Studies, Università degli Studi di Bologna, Rimini, Italy.
| | - Giuseppe Coratella
- Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy
| | - Bianca Dias Correa
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil; Post-Graduation Program in Physical Therapy, School of Technology and Sciences, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Bruna Spolador de Alencar Silva
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil; Department of Physical Education, Post-Graduation Program in Movement Sciences, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Vanessa Ribeiro Dos Santos
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil
| | - Vinicius Flavio Milanez
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil; Department of Physical Education, Universidade Oeste Paulista (UNOESTE), Presidente Prudente, Brazil
| | - Luís Alberto Gobbo
- Skeletal Muscle Assessment Laboratory (LABSIM), Department of Physical Education, School of Technology and Sciences, São Paulo State University (UNESP), Presidente Prudente, Brazil; Post-Graduation Program in Physical Therapy, School of Technology and Sciences, Sao Paulo State University (UNESP), Presidente Prudente, Brazil; Department of Physical Education, Post-Graduation Program in Movement Sciences, Sao Paulo State University (UNESP), Presidente Prudente, Brazil
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17
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Noel SE, Santos MP, Wright NC. Racial and Ethnic Disparities in Bone Health and Outcomes in the United States. J Bone Miner Res 2021; 36:1881-1905. [PMID: 34338355 PMCID: PMC8607440 DOI: 10.1002/jbmr.4417] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
Osteoporosis is a bone disease classified by deterioration of bone microarchitecture and decreased bone strength, thereby increasing subsequent risk of fracture. In the United States, approximately 54 million adults aged 50 years and older have osteoporosis or are at risk due to low bone mass. Osteoporosis has long been viewed as a chronic health condition affecting primarily non-Hispanic white (NHW) women; however, emerging evidence indicates racial and ethnic disparities in bone outcomes and osteoporosis management. The primary objective of this review is to describe disparities in bone mineral density (BMD), prevalence of osteoporosis and fracture, as well as in screening and treatment of osteoporosis among non-Hispanic black (NHB), Hispanic, and Asian adults compared with NHW adults living on the US mainland. The following areas were reviewed: BMD, osteoporosis prevalence, fracture prevalence and incidence, postfracture outcomes, DXA screening, and osteoporosis treatments. Although there are limited studies on bone and fracture outcomes within Asian and Hispanic populations, findings suggest that there are differences in bone outcomes across NHW, NHB, Asian, and Hispanic populations. Further, NHB, Asian, and Hispanic populations may experience suboptimal osteoporosis management and postfracture care, although additional population-based studies are needed. There is also evidence that variation in BMD and osteoporosis exists within major racial and ethnic groups, highlighting the need for research in individual groups by origin or background. Although there is a clear need to prioritize future quantitative and qualitative research in these populations, initial strategies for addressing bone health disparities are discussed. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Michelly P Santos
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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18
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Viezens L, Sellenschloh K, Püschel K, Morlock MM, Lehmann W, Huber G, Weiser L. Impact of Screw Diameter on Pedicle Screw Fatigue Strength-A Biomechanical Evaluation. World Neurosurg 2021; 152:e369-e376. [PMID: 34087457 DOI: 10.1016/j.wneu.2021.05.108] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 05/22/2021] [Accepted: 05/24/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Loosening of pedicle screws is a frequently observed complication in spinal surgery. Because additional stabilization procedures such as cement augmentation or lengthening of the instrumentation involve relevant risks, optimal stability of the primarily implanted pedicle screw is of essential importance. The aim of the present study was to investigate the effect of increasing the screw diameter on pedicle screw stability. METHODS A total of 10 human cadaveric vertebral bodies (L4) were included in the present study. The bone mineral density was evaluated using quantitative computed tomography and the pedicle diameter using computed tomography. The vertebrae underwent instrumentation using 6.0-mm × 45-mm pedicle screws on 1 side and screws with the largest possible diameter (8-10-mm × 45-mm) on the other side. Fatigue testing was performed by applying a cyclic loading (craniocaudal sinusoidal 0.5 Hz) with increasing peak force (100 N + 0.1 N/cycle) until screw head displacement of 5.4 mm was reached. RESULTS The mean fatigue load was 334 N for the 6-mm diameter screws and was increased significantly to 454 N (+36%) for the largest possible diameter screws (P < 0.001). With an increase in the fatigue load by 52%, this effect was even more pronounced in vertebrae with reduced bone density (bone mineral density <120 mg/cm3; n = 7; P < 0.001). The stiffness of the construct was significantly greater in the largest diameter screw group compared with the standard screw group during the entire testing period (start, P < 0.001; middle, P < 0.001; end, P = 0.009). CONCLUSIONS Increasing the pedicle screw diameter from a standard 6-mm screw to the largest possible diameter (8-10 mm) led to a significantly greater fatigue load.
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Affiliation(s)
- Lennart Viezens
- Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany; Division of Spine Surgery, Department of Trauma and Orthopaedic Surgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Kay Sellenschloh
- Institute of Biomechanics, Hamburg University of Technology, Hamburg, Germany
| | - Klaus Püschel
- Institute of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael M Morlock
- Institute of Biomechanics, Hamburg University of Technology, Hamburg, Germany
| | - Wolfgang Lehmann
- Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Gerd Huber
- Institute of Biomechanics, Hamburg University of Technology, Hamburg, Germany
| | - Lukas Weiser
- Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany.
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19
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Weiser L, Huber G, Sellenschloh K, Püschel K, Morlock MM, Viezens L, Lehmann W. Rescue Augmentation: Increased Stability in Augmentation After Initial Loosening of Pedicle Screws. Global Spine J 2021; 11:679-685. [PMID: 32875910 PMCID: PMC8165920 DOI: 10.1177/2192568220919123] [Citation(s) in RCA: 3] [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] [Indexed: 11/17/2022] Open
Abstract
STUDY DESIGN Biomechanical study. OBJECTIVES Failure of pedicle screws is a major problem in spinal surgery not only postoperatively, but also intraoperatively. The aim of this study was to evaluate whether cement augmentation may restore mounting of initially loosened pedicle screws. METHODS A total of 14 osteoporotic or osteopenic human cadaveric vertebral bodies (L2)-according to quantitative computed tomography (QCT)-were instrumented on both sides by conventional pedicle screws and cement augmented on 1 side. In vitro fatigue loading (cranial-caudal sinusoidal, 0.5 Hz) with increasing peak force (100 N + 0.1 N/cycles) was applied until a screw head displacement of 5.4 mm (∼20°) was reached. After loosening, the nonaugmented screw was rescue augmented, and fatigue testing was repeated. RESULTS The fatigue load reached 207.3 N for the nonaugmented screws and was significantly (P = .009) exceeded because of initial cement augmentation (300.6 N). The rescue augmentation after screw loosening showed a fatigue load of 370.1 N which was significantly higher (P < .001) compared with the nonaugmented screws. The impact of bone density on fatigue strength decreased from the nonaugmented to the augmented to the rescue-augmented screws and shows the greatest effect of cement augmentation on fatigue strength at low bone density. CONCLUSIONS Rescue augmentation leads to similar or higher fatigue strengths compared with those of the initially augmented screws. Therefore, the cement augmentation of initially loosened pedicle screws is a promising option to restore adequate screw stability.
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Affiliation(s)
- Lukas Weiser
- Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany,Lukas Weiser, Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Robert Koch Str 40, 37099 Göttingen, Germany.
| | - Gerd Huber
- Institute of Biomechanics, TUHH Hamburg University of Technology, Hamburg, Germany
| | - Kay Sellenschloh
- Institute of Biomechanics, TUHH Hamburg University of Technology, Hamburg, Germany
| | - Klaus Püschel
- Institute of Forensic Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michael M. Morlock
- Institute of Biomechanics, TUHH Hamburg University of Technology, Hamburg, Germany
| | - Lennart Viezens
- Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany
| | - Wolfgang Lehmann
- Department of Trauma Surgery, Orthopaedic Surgery and Plastic Surgery, University Medical Center Göttingen, Göttingen, Germany
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20
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Xu Y, Wu Q. Trends in osteoporosis and mean bone density among type 2 diabetes patients in the US from 2005 to 2014. Sci Rep 2021; 11:3693. [PMID: 33580184 PMCID: PMC7881186 DOI: 10.1038/s41598-021-83263-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 01/14/2021] [Indexed: 12/19/2022] Open
Abstract
This study aimed to examine how bone health changed among T2DM patients in the past decade. Continuous National Health and Nutrition Examination Survey (NHANES) data from 2005-2006 to 2013-2014 were analyzed to examine the trends of bone mineral density (BMD) and the prevalence trends of osteoporosis osteopenia among T2DM patients and non-diabetic people aged 40 years and older. The age- and BMI-adjusted mean BMD of the femur neck for the four NHANES cycles decreased linearly in both T2DM patients and non-diabetic people (both Plinear trend ≤ 0.009). Among women with T2DM, the mean BMD in 2013-2014 was significantly lower than that in 2005-2006, even after adjusting for multiple covariates. During 2005-2014, the prevalence of osteoporosis among T2DM patients and non-diabetic people increased but with no significant linear trend (both Plinear trend > 0.05), while the prevalence of osteopenia in the two populations increased linearly (both Plinear trend < 0.04). Age- and BMI-adjusted mean BMD decreased in 2013-2014 in patients with T2DM and non-diabetic people, while the prevalence of osteoporosis and osteopenia increased in both groups.
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Affiliation(s)
- Yingke Xu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA
- Nevada Institute of Personalized Medicine, College of Science, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA
| | - Qing Wu
- Department of Epidemiology and Biostatistics, School of Public Health, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA.
- Nevada Institute of Personalized Medicine, College of Science, University of Nevada, Las Vegas, Las Vegas, NV, 89154, USA.
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21
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Zheng XY, Zhou Z, Gao Y, Chen Y, Li R, Zhou M, Zhu D. Racial differences and factors associated with low femoral neck bone mineral density: an analysis of NHANES 2005-2014 data. Arch Osteoporos 2021; 16:9. [PMID: 33409707 DOI: 10.1007/s11657-020-00850-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Accepted: 11/02/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED Using national representative data, we found the prevalence of and risk factors associated with low BMD differed by race and ethnicity. PURPOSE Race/ethnicity is an important determinant of osteoporosis risk. The study aims were to (1) estimate the racial and ethnic differences in the prevalence of low BMD, (2) identify factors associated with low BMD by race and ethnic group, and (3) evaluate if the association between sleep duration and low BMD is modified by age, sex, gender, and/or race/ethnicity. METHODS Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2014, totally, 7992 participants aged ≥ 50 years were included as the primary cohort. Three race/ethnic groups were included: non-Hispanic Whites, Hispanics, and non-Hispanic Blacks. Low BMD was defined by femoral neck BMD T-scores less than - 1, as measured by DXA scan. Univariate and multivariate analyses were performed to determine associations between participants' demographics, comorbidities, lifestyle characteristics, and prevalent low BMD. RESULTS Prevalence of low BMD was 50.8% among non-Hispanic Whites, 23.7% among non-Hispanic Blacks, and 44.0% among Hispanics. After adjusting for confounders, advanced age, female gender, and fracture history were significantly associated with increased odds of low BMD in all three race/ethnic groups. Family history of osteoporosis, ever used glucocorticoids daily, and vitamin D deficiency or insufficiency were associated with increased odds of low BMD only among non-Hispanic Whites. Cardiovascular disease (CVD) history and diabetes were associated with low BMD only among non-Hispanic Blacks. Short sleep duration was not associated with low BMD in all ethnic groups, but was significantly associated with low BMD in older adults (> 65 years) and females. CONCLUSIONS Prevalence of low BMD among three race/ethnic groups in the USA is determined, with race/ethnic disparities in several risk factors associated with low BMD identified. By contrast, advanced age, female gender, and fracture history are associated with increased odds of low BMD across all race/ethnic groups. The association between sleep duration and low BMD is modified by age and sex. Together, these findings may help clinicians and healthcare providers formulate better care for individual's bone health.
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Affiliation(s)
- Xiao-Yun Zheng
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China.
| | - Zhi Zhou
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Yan Gao
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Yi Chen
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Rui Li
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Mo Zhou
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
| | - Dan Zhu
- Department of Senior Official Ward, China-Japan Friendship Hospital, 2 Yinghua Dongjie, Beijing, 100029, China
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22
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Galvez-Fernandez M, Grau-Perez M, Garcia-Barrera T, Ramirez-Acosta S, Gomez-Ariza JL, Perez-Gomez B, Galan-Labaca I, Navas-Acien A, Redon J, Briongos-Figuero LS, Dueñas-Laita A, Perez-Castrillon JL, Tellez-Plaza M, Martin-Escudero JC. Arsenic, cadmium, and selenium exposures and bone mineral density-related endpoints: The HORTEGA study. Free Radic Biol Med 2021; 162:392-400. [PMID: 33137469 PMCID: PMC9019194 DOI: 10.1016/j.freeradbiomed.2020.10.318] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND OBJECTIVES Experimental data suggest that trace elements, such as arsenic (As), cadmium (Cd), and selenium (Se) can influence the bone remodeling process. We evaluated the cross-sectional association between As, Cd, and Se biomarkers with bone mineral density (BMD) measured at the calcaneus, in a representative sample of a general population from Spain. As secondary analyses we evaluated the associations of interest in subgroups defined by well-established BMD determinants, and also conducted prospective analysis of osteoporosis-related incident bone fractures restricted to participants older than 50 years-old. METHODS In N = 1365 Hortega Study participants >20 years-old, urine As and Cd were measured by inductively coupled-plasma mass spectrometry (ICPMS); plasma Se was measured by atomic absorption spectrometry (AAS) with graphite furnace; and BMD at the calcaneus was measured using the Peripheral Instaneuous X-ray Imaging system (PIXI). As levels were corrected for arsenobetaine (Asb) to account for inorganic As exposure. RESULTS The median of total urine As, Asb-corrected urine As, urine Cd, and plasma Se was 61.3, 6.53 and 0.39 μg/g creatinine, and 84.9 μg/L, respectively. In cross-sectional analysis, urine As and Cd were not associated with reduced BMD (T-score < -1 SD). We observed a non-linear dose-response of Se and reduced BMD, showing an inverse association below ~105 μg/L, which became increasingly positive above ~105 μg/L. The evaluated subgroups did not show differential associations. In prospective analysis, while we also observed a U-shape dose-response of Se with the incidence of osteoporosis-related bone fractures, the positive association above ~105 μg/L was markedly stronger, compared to the cross-sectional analysis. CONCLUSIONS Our results support that Se, but not As and Cd, was associated to BMD-related disease. The association of Se and BMD-related disease was non-linear, including a strong positive association with osteoporosis-related bone fractures risk at the higher Se exposure range. Considering the substantial burden of bone loss in elderly populations, additional large prospective studies are needed to confirm the relevance of our findings to bone loss prevention in the population depending on Se exposure levels.
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Affiliation(s)
- Marta Galvez-Fernandez
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Preventive Medicine, Hospital Severo Ochoa, Avenida de Orellana, 28914, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Maria Grau-Perez
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Area of Renal Risk and Cardiometabolic Disease, Instituto de Investigación Sanitaria Hospital Clinic de Valencia (INCLIVA), Avinguda de Menéndez y Pelayo, 4, 46010, Valencia, Spain; Department of Statistics and Operational Research, University of Valencia, Calle Dr. Moliner, 50, 46100, Valencia, Spain
| | - Tamara Garcia-Barrera
- Department of Chemistry, University of Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Sara Ramirez-Acosta
- Department of Chemistry, University of Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Jose L Gomez-Ariza
- Department of Chemistry, University of Huelva, Avenida de las Fuerzas Armadas, 21007, Huelva, Spain
| | - Beatriz Perez-Gomez
- Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Iñaki Galan-Labaca
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain
| | - Ana Navas-Acien
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, 722W, 168th Street, NY, 10032, USA
| | - Josep Redon
- Area of Renal Risk and Cardiometabolic Disease, Instituto de Investigación Sanitaria Hospital Clinic de Valencia (INCLIVA), Avinguda de Menéndez y Pelayo, 4, 46010, Valencia, Spain
| | - Laisa S Briongos-Figuero
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
| | - Antonio Dueñas-Laita
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
| | - Jose Luis Perez-Castrillon
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
| | - Maria Tellez-Plaza
- Department of Preventive Medicine and Microbiology, Universidad Autonoma de Madrid, Calle Arzobispo Morcillo, 4, 28029, Madrid, Spain; Department of Chronic Diseases Epidemiology, National Center for Epidemiology, Carlos III Health Institute, Calle de Melchor Fernández Almagro, 5, 28029, Madrid, Spain; Area of Renal Risk and Cardiometabolic Disease, Instituto de Investigación Sanitaria Hospital Clinic de Valencia (INCLIVA), Avinguda de Menéndez y Pelayo, 4, 46010, Valencia, Spain.
| | - Juan Carlos Martin-Escudero
- Departments of Internal Medicine and Toxicology, University Hospital Rio Hortega, Calle Dulzaina, 2, 47012, Valladolid. University of Valladolid, Spain
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23
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Zhai T, Chen Q, Xu J, Jia X, Xia P. Prevalence and Trends in Low Bone Density, Osteopenia and Osteoporosis in U.S. Adults With Non-Alcoholic Fatty Liver Disease, 2005-2014. Front Endocrinol (Lausanne) 2021; 12:825448. [PMID: 35126317 PMCID: PMC8807487 DOI: 10.3389/fendo.2021.825448] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 12/28/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND & AIMS Non-alcoholic fatty liver disease (NAFLD) is suggested to be associated with bone mineral density (BMD) alterations; however, this has not been ascertained. The current study aimed to investigate the changes in BMD and the prevalence of osteopenia/osteoporosis in US adults with or without NAFLD and to evaluate their association. METHODS The study was conducted based on data collected from the U.S. National Health and Nutrition Examination Survey (NHANES) during the period 2005-2014. A total of 13 837 and 6 177 participants aged > 20 years were eligible for conducting the Hepatic Steatosis Index (HSI) and the US Fatty Liver Index (USFLI) analysis, respectively. RESULTS From 2005-2014, a downward trend in femoral neck BMD was observed in subjects with NAFLD aged ≥ 40. After adjustment for potential confounders, an upward shift occurred in the prevalence of osteopenia/osteoporosis at the femoral neck in adults aged ≥ 40, particularly in women ≥ 60 years old and men below the age of 60. Moreover, a negative association was found between BMD and NAFLD markers (USFLI, HSI), whereas NAFLD with advanced fibrosis was positively associated with the prevalence of spine fractures. CONCLUSIONS There was a trend toward lower BMD and higher prevalence of osteopenia/osteoporosis at the femoral neck in US adults with NAFLD aged ≥ 40 years during the period of 2005-2014. NAFLD with advanced fibrosis was positively associated with a higher risk of spine fracture. More research is required to fully investigate the mechanism and consequence of poor bone health in NAFLD patients and consider optimum management of osteopenia/osteoporosis for this population.
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Affiliation(s)
- Tianyu Zhai
- Department of Endocrinology and Metabolism, Zhongshan Hospital, and Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Qi Chen
- Department of Endocrinology and Metabolism, Zhongshan Hospital, and Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Jing Xu
- Department of Endocrinology and Metabolism, Zhongshan Hospital, and Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
| | - Xi Jia
- State Key Laboratory of Pharmaceutical Biotechnology, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Department of Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pu Xia
- Department of Endocrinology and Metabolism, Zhongshan Hospital, and Fudan Institute for Metabolic Diseases, Fudan University, Shanghai, China
- *Correspondence: Pu Xia,
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24
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Weiser L, Sellenschloh K, Püschel K, Morlock MM, Viezens L, Lehmann W, Huber G. Cortical threaded pedicle screw improves fatigue strength in decreased bone quality. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2020; 30:128-135. [DOI: 10.1007/s00586-020-06593-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Revised: 08/03/2020] [Accepted: 09/04/2020] [Indexed: 12/30/2022]
Abstract
Abstract
Purpose
Inadequate anchoring of pedicle screws in vertebrae with poor bone quality is a major problem in spine surgery. The aim was to evaluate whether a modified thread in the area of the pedicle could significantly improve the pedicle screw fatigue strength.
Methods
Fourteen human cadaveric vertebral bodies (L2 and L3) were used for in vitro testing. Bone density (BMD) was determined by quantitative computed tomography. Vertebral bodies were instrumented by standard pedicle screws with a constant double thread on the right pedicle and a partial doubling of the threads–quad thread–(cortical thread) in the area of the pedicle on the left pedicle. Pulsating sinusoidal, cyclic load (0.5 Hz) with increasing peak force (100 N + 0.1 N/cycles) was applied orthogonal to the screw axis. The baseline force remained constant (50 N). Fatigue test was terminated after exceeding 5.4-mm head displacement (~ 20° screw tilting).
Results
The mean fatigue load at failure was 264.9 N (1682 cycles) for the standard screws and was increased significantly to 324.7 N (2285 cycles) by the use of cortical threaded screws (p = 0.014). This effect is particularly evident in reduced BMD (standard thread 241.2 N vs. cortical thread 328.4 N; p = 0.016), whereas in the group of vertebrae with normal BMD no significant difference could be detected (standard thread 296.5 N vs. cortical thread 319.8 N; p = 0.463).
Conclusions
Compared to a conventional pedicle screw, the use of a cortical threaded pedicle screw promises superior fatigue load in vertebrae with reduced bone quality.
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25
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Wu Q, Xu Y, Lin G. Trends and Disparities in Self-Reported and Measured Osteoporosis among US Adults, 2007-2014. J Clin Med 2019; 8:jcm8122052. [PMID: 31766617 PMCID: PMC6947633 DOI: 10.3390/jcm8122052] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2019] [Revised: 11/19/2019] [Accepted: 11/20/2019] [Indexed: 11/25/2022] Open
Abstract
(1) Background: Studies examining osteoporosis trends among US adults by different socioeconomic status (SES) are limited. The prevalence of self-reported osteoporosis in the US is rarely reported. (2) Methods: Data from the National Health and Nutritional Examination Survey (NHANES) between 2007–2008 and 2013–2014 cycles were analyzed. Age-adjusted prevalence of self-reported and that of measured osteoporosis were calculated overall and by sex, race/ethnicity, education attainment, and SES. (3) Results: The prevalence of self-reported osteoporosis was higher than that of measured osteoporosis in all three survey cycles for women, and in 2007–2008 and 2009–2010 for men. Participants with high school/GED or higher educational attainment had an increased prevalence of measured osteoporosis during the study period. Among all SES groups, participants with low family income (PIR < 1.3) had the highest prevalence of measured osteoporosis, and the prevalence increased from 49.3 per 1000 population to 71.8 per 1000 population during the study period. (4) Conclusions: The prevalence of self-reported osteoporosis was higher than that of measured osteoporosis in US adults between 2007 and 2014. The age-adjusted prevalence of measured osteoporosis increased in participants with the educational attainment of high school/GED or above, and individuals with low family income.
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Affiliation(s)
- Qing Wu
- Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, NV 89154, USA;
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA;
- Correspondence: ; Tel.: +1-702-895-1439
| | - Yingke Xu
- Nevada Institute of Personalized Medicine, University of Nevada, Las Vegas, NV 89154, USA;
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA;
| | - Ge Lin
- Department of Environmental and Occupational Health, School of Public Health, University of Nevada, Las Vegas, NV 89154, USA;
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