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Liu Y, Liu Y, Huang Y, Le S, Jiang H, Ruan B, Ao X, Shi X, Fu X, Wang S. The effect of overweight or obesity on osteoporosis: A systematic review and meta-analysis. Clin Nutr 2023; 42:2457-2467. [PMID: 37925778 DOI: 10.1016/j.clnu.2023.10.013] [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: 02/03/2023] [Revised: 08/17/2023] [Accepted: 10/13/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Osteoporosis and obesity are closely related, and the relationships between different types of obesity and osteoporosis are inconsistent. OBJECTIVE Our objective was to summarize earlier data concerning the association between osteoporosis and obesity (general and central), and to compare the impacts of these two obesity indicators on osteoporosis. METHODS From inception to May 2021, a comprehensive search in electronic bibliographic databases was conducted, and the search was updated in December 2021, July 2022 and June 2023. The data were independently extracted and evaluated by two investigators from epidemiological studies that reported the impact of obesity on the odds of incident osteoporosis. RESULTS There were 24 studies included in the final analysis when it came to general obesity measured by body mass index (BMI). Individuals with overweight and obesity had decreased odds of osteoporosis (odds ratio (OR), 0.451, 95% confidence intervals (CIs): 0.366-0.557). Sensitivity analyses showed that both overweight and obesity were decreased odds of osteoporosis, with reductions of 48.6% and 70.1%, respectively (OR, 0.514, 95% CI: 0.407-0.649; OR, 0.299, 95% CI: 0.207-0.433). Conversely, individuals classified as underweight were found to have higher odds of osteoporosis (OR, 2.540, 95% CI: 1.483-4.350). In term of central obesity, the final analysis consisted of 7 studies. No significant association was observed between central obesity and osteoporosis (OR, 0.913, 95% CI: 0.761-1.096). CONCLUSIONS General overweight and obesity were associated with lower odds of developing osteoporosis, whereas underweight was associated with higher odds. However, central obesity did not show a significant association with osteoporosis. These findings underscore the importance of considering the impact of obesity on osteoporosis. Further research is necessary to reinforce the evidence and validate our findings.
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Affiliation(s)
- Yupeng Liu
- Department of Epidemiology and Biostatistics, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Yi Liu
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Yufeng Huang
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Siyu Le
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Huinan Jiang
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Binye Ruan
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Xuemei Ao
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Xudong Shi
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China
| | - Xiaoyi Fu
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.
| | - Shuran Wang
- Department of Nutrition and Food Hygiene, School of Public Health and Management of Wenzhou Medical University, Wenzhou, China.
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Gao SS, Capitán-Morales LC, Wang YJ, Yao YF, Zhang YH, Verdera AB, Zhang WT. The epidemiological status of osteoporotic hip fractures: A bicentric comparative and retrospective study. J Back Musculoskelet Rehabil 2022; 35:1299-1310. [PMID: 35570480 DOI: 10.3233/bmr-210245] [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] [Indexed: 02/04/2023]
Abstract
BACKGROUND Osteoporotic hip fractures have posed a significant burden to society, and more epidemiological data is required. OBJECTIVE To compare the epidemiological differences of hip fracture patients in Spain and China. METHOD This was a retrospective comparative study. Comparisons were made in terms of morbidity, demographic and anthropometric characteristics, length of stay, cost of hospitalization, and mortality by consulting the medical histories of osteoporotic hip fractures in two hospitals. The t test was used for measurement data, and the X2 test was used for count data. The difference is statistically significant when p< 0.05. RESULTS A total of 757 patients were enrolled in this study, with 426 from Virgen Macarena University Hospital (HUVM) and 331 from Xi'an Daxing Hospital (XDH). The average age was 81.4 ± 9.26 and 76.0 ± 8.08 years; the proportion of women was 74.9% and 68.0%, respectively. The incidence of osteoporotic hip fractures in Seville residents over 50 years old was approximately 239 per 100,000 residents, compared to 158 per 100,000 residents in Xi'an. The timing of surgery in Spanish patients was significantly longer than in Chinese patients, 78.7 ± 48.2 vs. 60.7 ± 43.1 hours, p= 0.000. There were 81 deaths in Spain and 43 deaths in China during the one-year follow-up period (p= 0.026). CONCLUSIONS In terms of incidence, demographics, surgical methods, and mortality, there are significant differences between hip fracture patients in Seville, Spain and Xi'an, China.
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Affiliation(s)
- Shuai-Shuai Gao
- Xi'an Daxing Hospital, Shaanxi, China.,University of Seville, Seville, Spain
| | - Luis C Capitán-Morales
- Hospital Universitario Virgen Macarena, Seville, Spain.,University of Seville, Seville, Spain
| | | | | | | | - Aurelio Borrás Verdera
- Hospital Universitario Virgen Macarena, Seville, Spain.,University of Seville, Seville, Spain
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Becker N, Hafner T, Pishnamaz M, Hildebrand F, Kobbe P. Patient-specific risk factors for adverse outcomes following geriatric proximal femur fractures. Eur J Trauma Emerg Surg 2022; 48:753-761. [PMID: 35325262 PMCID: PMC9001566 DOI: 10.1007/s00068-022-01953-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2022] [Accepted: 03/11/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Proximal femur fractures (PFFs) occur frequently among geriatric patients due to diverse risk factors, such as a lower bone mineral density and the increased risk of falls. METHODS In this review, we focus on recent literature of patient-specific risk factors and their impact on common complications and outcome parameters in patients with PFF. RESULTS Patient- and treatment related factors have a significant impact on outcome and are associated with an increased risk of mortality, impairments in functional rehabilitation and complicative courses. CONCLUSION Geriatric patients at high risk for complications are nursing home inhabitants suffering from severe osteoporosis, dementia and sarcopenia. The early and ongoing assessment for these individual risk factors is crucial. Strategies including interdisciplinary approaches, addressing comorbidities and facilitating an optimal risk factor evaluation result in a beneficial outcome. The ongoing ambulant assessment and therapy of complicating factors (e.g., malnutrition, sarcopenia, frailty or osteoporosis) have to be improved.
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Affiliation(s)
- Nils Becker
- Department of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany.
| | - Tobias Hafner
- Department of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Miguel Pishnamaz
- Department of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Frank Hildebrand
- Department of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany
| | - Philipp Kobbe
- Department of Orthopedics, Trauma and Reconstructive Surgery, RWTH Aachen University Hospital, Aachen, Germany
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GhaseminasabParizi M, Sedaghat Z, Mazloomi SM, Tangestani H, Shams M, Fararouei M. Cosmetic use and serum level of lead (not cadmium) affect bone mineral density among young Iranian women. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:13459-13465. [PMID: 34590230 DOI: 10.1007/s11356-021-16606-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 09/14/2021] [Indexed: 06/13/2023]
Abstract
Bone mineral density is a crucially important index for skeletal health. A low amount of bone density (osteoporosis) is a common health problem among men and especially women. Among different parts of the body, women's face is the area on which many types of (facial) cosmetics are routinely applied. The aims of this study were to measure the association of cosmetic use with BMD of the lumbar spine and femoral neck among young female students. This is a cross-sectional study on 65 female students in the 2017 academic year. The study participants were students at Shiraz University of Medical Sciences who were selected randomly using phone directory sampling method. Based on the results of multiple linear regression, adjusted for several important covariates, cosmetic use is inversely associated with the BMD z-scores. Lead was significantly associated with trochanteric z-score (B = -0.002 to 95% CI = -0.004 to -0.0003, p = 0.02) and total lumbar z-score (B = -0.002 to 95% CI = -0.004 -0.0005, p = 0.01). In the present study, duration of using cosmetics was significantly associated with BMD of key skeletal regions. The big market of cosmetics in many countries especially those in the Middle East is highly a vastly neglected health issue. Many more observational prospective or interventional studies are required to understand the benefits and hazards caused by cosmetics in women.
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Affiliation(s)
- Maryam GhaseminasabParizi
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, PO Box: 71536-75541, Shiraz, Iran
| | - Zahra Sedaghat
- Student Research Center for Health Sciences, Department Epidemiology, School of Public Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Seyed Mohammad Mazloomi
- Nutrition Research Center, Department of Food Hygiene and Quality Control, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, PO Box: 71536-75541, Shiraz, Iran
| | - Hadith Tangestani
- Nutrition Research Center, Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, PO Box: 71536-75541, Shiraz, Iran
| | - Mesbah Shams
- Endocrine and Metabolism Research Center, Shiraz University of Medical Sciences, Central Building of Shiraz University of Medical Sciences, Zand St, PO Box: 71348-14336, Shiraz, Iran
| | - Mohammad Fararouei
- HIV/AIDS Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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El Miedany Y, Abu-Zaid MH, El Gaafary M, El Naby MMH, Fathi N, Saber HG, Hassan W, Eissa M, Mohannad N, Khaled H, Mortada M, Nasef SI, Galal S, Ghaleb R, Tabra SAA, Mohamed SS, Medhat BM, Aly HM, Elolemy G, Fouad NA, Ganeb SS, Adel Y, Ibrahim MME, Farouk O, Gadallah N. Egyptian consensus on treat-to-target approach for osteoporosis: a clinical practice guideline from the Egyptian Academy of bone health and metabolic bone diseases. EGYPTIAN RHEUMATOLOGY AND REHABILITATION 2021. [DOI: 10.1186/s43166-020-00056-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Abstract
Background
This study was carried out to achieve an Egyptian expert consensus on a treat-to-target management strategy for osteoporosis using Delphi technique. A scientific committee identified researchers and clinicians with expertise in osteoporosis in Egypt. Delphi process was implemented (2 rounds) to establish a consensus on 15 clinical standards: (1) concept, (2) diagnosis, (3) case identification, (4) whom to treat, (5) who should treat?, (6) case stratification and intervention thresholds, (7) falls risk, (8) investigations, (9) treatment target, (10) management, (11) optimum treatment duration, (12) monitoring, (13) drug holiday, (14) osteoporosis in men, and (15) post-fracture care and fracture liaison service.
Results
The surveys were sent to an expert panel (n = 25), of whom 24 participated in the two rounds. Respondents were drawn from different governorates and health centres across Egypt including the Ministry of Health. Most of the participants were rheumatologists (76%), followed by internists (8%), orthopaedic doctors (4%), rehabilitation doctors (4%), primary care (4%), and ortho-geriatrics (4%) physicians. Seventy-two recommendations, categorised into 15 sections, were obtained. Agreement with the recommendations (rank 7–9) ranged from 83.4 to 100%. Consensus was reached (i.e. ≥ 75% of respondents strongly agreed or agreed) on the wording of all 15 clinical standards identified by the scientific committee. An algorithm for the management of postmenopausal osteoporosis has been suggested.
Conclusion
A wide and representative panel of experts established a consensus regarding the management of osteoporosis in Egypt. The developed guidelines provide a comprehensive approach to the assessment and management of osteoporosis for all Egyptian healthcare professionals who are involved in its management.
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Ali K, El Said SMS, Adly NN, Abdul-Rahman SA. The Relation Between Calcaneus Stiffness Index as a Measure of Bone Density and Body Mass Index in an Egyptian Cohort. J Multidiscip Healthc 2019; 12:1085-1090. [PMID: 32099376 PMCID: PMC6997196 DOI: 10.2147/jmdh.s230730] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Accepted: 11/25/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Obesity and osteoporosis are two conditions that are associated with morbidity and mortality; there is contradictory evidence regarding this association. PURPOSE The aim of the current study was to explore further the association between obesity and calcaneus stiffness index (CSI), as a measure of bone density, in a community-based cross-sectional study in an Egyptian population. METHODS A cross-sectional study was conducted among active subjects, aged ≥20 years old, over one year. CSI was measured by Quantitative ultrasound (QUS), in addition; QUS T-score and Z-score of the non-dominant heel scan were recorded. RESULTS Two hundred and eighty participants were recruited; 7 subjects were excluded because of Z score more than -2, mean age was 61 (± 11.9) years, and mean BMI was 29.7 (±5.6). Female participants were 77.7%, with mean of age 60.3 (± 11.6); and age range 20-82 years. Male participants were 22.3%, with mean of age 63.6 (± 12.7); and age range 30-80 years. Older subjects (>55 years) had significantly lower CSI and worse T-score than the younger subjects (P < 0.001 for both). In the younger age group, BMI was not significantly associated with CSI, even after adjustment for gender (P= 0.52). However, in the older age group, BMI was significantly associated with stiffness index (P= 0.049, O.R.= 1.73), even after adjustment for gender (P= 0.041, O.R.= 1.7). CONCLUSION Compared to young subjects, older subjects (≥55 years) had significantly lower bone strength as measured by CSI, and their BMI was significantly positively associated with bone density. In younger people (<55 years), BMI was not associated with bone strength.
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Affiliation(s)
- Khalid Ali
- Academic Department of Geriatrics, Brighton and Sussex Medical School, Brighton, UK
| | - Salma MS El Said
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Nermien N Adly
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Samia A Abdul-Rahman
- Geriatrics and Gerontology Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt
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Mahran DG, Farouk O, Ismail MA, Alaa MM, Eisa A, Ragab II. Effectiveness of home based intervention program in reducing mortality of hip fracture patients: A non-randomized controlled trial. Arch Gerontol Geriatr 2018; 81:8-17. [PMID: 30471472 DOI: 10.1016/j.archger.2018.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 11/08/2018] [Accepted: 11/12/2018] [Indexed: 12/23/2022]
Abstract
PURPOSE The study was done to investigate whether a postoperative intervention program is effective in reducing mortality and improving mobility in two comparative hip fracture patients over one year postoperatively. METHODS A non-randomized controlled trial study with an intervention group of hip fracture patients and historical control group with 12 months follow up. One hundred twenty four admitted hip fracture patients to the Trauma Unit of Assiut University Hospitals, aged 50 years and older were included from 1st July to 31st December 2014. They were divided into 64 and 60 patients as intervention and control groups respectively. Weight, height and bone mineral density were measured and baseline characteristics were taken. The intervention was a postoperative care program in the form of education sessions with an explanatory leaflet on discharge for nutrition and physical exercise program at home. Follow up phone calls were done at 3 months, 6 months and one year postoperatively by one assessor. Physical mobility was assessed by 24 items Western Ontario And McMaster Universities Osteoarthritis Index (WOMAC). RESULTS Mortality was significantly higher in the control group, WOMAC score was significantly better among intervention group through follow up. By multivariate Cox survival analysis, advancing age, no intervention, osteoporosis, postoperative complications, chest infections and heart attacks were significant predictors for mortality. CONCLUSION A significant improvement in mobility and reduction of mortality was achieved by application of a postoperative care program that could be incorporated into the hip fracture patients' care pathway.
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Affiliation(s)
- Dalia G Mahran
- Department of Public Health and Community Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt.
| | - Osama Farouk
- Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt
| | - Mervat A Ismail
- Adult Nursing Department, Faculty of Nursing, Assiut University, Assiut, Egypt
| | - Mohamed M Alaa
- Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt
| | - Amr Eisa
- Department of Orthopaedic and Trauma Surgery, Faculty of Medicine, Assiut University Hospitals, Assiut, Egypt
| | - Islam I Ragab
- Adult Medical Surgical Nursing Department, Faculty of Nursing, South Valley University, Qena, Egypt
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Said HG, El-Radi MA, Hassanein MY, Said GZ. Orthopaedic publications from Egypt in the last five years: a bibliometric report. INTERNATIONAL ORTHOPAEDICS 2018; 42:2507-2511. [DOI: 10.1007/s00264-018-4152-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 09/06/2018] [Indexed: 12/11/2022]
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Wanshi Arnoni V, Batista de Vasconcelos P, Sousa LGD, Ferreira B, Palinkas M, Acioli Righetti M, Pádua da Silva G, Aparecida Caldeira Monteiro S, Regalo SCH, Siéssere S. Evaluation of the electromyographic fatigue of the masseter and temporalis muscles in individuals with osteoporosis. Cranio 2018; 37:254-263. [PMID: 29327673 DOI: 10.1080/08869634.2017.1418618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES The objective of this study was to evaluate the electromyographic fatigue of the masseter and temporalis muscles in individuals with and without osteoporosis. METHODS Median frequency of the initial, mid, and final periods of the electromyographic signal in the 33 subjects with osteoporosis (OG) and 33 subjects without osteoporosis [control (CG)] was analyzed. RESULTS OG showed a decrease in median frequency along the electromyographic signal, with a significant difference for the right masseter: initial vs. mid periods, initial vs. final periods; left masseter: initial vs. final periods; temporal (right and left): initial vs. mid periods, initial vs. final periods, and mid vs. final periods. Percentage comparison of median frequency between the initial and mid periods and between initial and final periods in the OG showed a significant difference in the masticatory muscles. DISCUSSION The findings suggest that osteoporosis is associated with changes in the function of masticatory muscles, especially when measured by electromyographic fatigue.
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Affiliation(s)
- Veridiana Wanshi Arnoni
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Paulo Batista de Vasconcelos
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Luiz Gustavo de Sousa
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Bruno Ferreira
- b Department of Biomechanics, Medicine and Locomotive Apparatus Rehabilitation , Ribeirão Preto Medical University of São Paulo , São Paulo , Brazil
| | - Marcelo Palinkas
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Mariah Acioli Righetti
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Gabriel Pádua da Silva
- b Department of Biomechanics, Medicine and Locomotive Apparatus Rehabilitation , Ribeirão Preto Medical University of São Paulo , São Paulo , Brazil
| | - Solange Aparecida Caldeira Monteiro
- c Department of Stomatology, Public Health and Forensic Dentistry, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Simone Cecilio Hallak Regalo
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
| | - Selma Siéssere
- a Department Morphology, Physiology and Basic Pathology, Ribeirão Preto School of Dentistry , University of São Paulo , São Paulo , Brazil
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