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Rezaei M, Forouzan K, Eini-Zinab H, Omidvar N, Jafaripour S, Rezazadeh A. Dietary diversity and its association with changes in anthropometric indices of community-dwelling older adults in Tehran, Iran: a longitudinal study (2017-2021). BMC Public Health 2024; 24:2253. [PMID: 39164719 PMCID: PMC11334311 DOI: 10.1186/s12889-024-19635-y] [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: 05/19/2024] [Accepted: 07/29/2024] [Indexed: 08/22/2024] Open
Abstract
BACKGROUND Dietary diversity refers to the consumption of a variety of foods or food groups over a given reference period, which is crucial for improving nutrition and overall health. This longitudinal study aimed to investigate the association between dietary diversity and anthropometric indices in community-dwelling older adults living in Tehran in 2017 and 2021. METHODS The current study was conducted on 368 older adults [204 (55.4%) women and 164 (44.6%) men] over 60 years of age living in Tehran, who were selected by a systematic cluster sampling method at two-time points, 2017 and 2021. Anthropometric measures (weight, height, hip circumference, and waist circumference) were assessed with standard methods. The participants' dietary intake was assessed by completing two non-consecutive 24-hour recalls, and dietary diversity score (DDS) was calculated based on Kant's method. Statistical analysis was performed using R software by the mixed effect model method. RESULTS The mean DDS of the participants in 2017 (5.07 ± 1.20) was higher than that in 2021 (4.94 ± 1.09) (p < 0.05). DDS and dairy diversity score decreased significantly over time. After adjusting for confounders, there was an inverse relationship between the DDS and Body Mass Index (BMI) (B = -0.22; SE = 0.09), but the interaction effect of year × DDS (B = 0.19; SE = 0.10) was not significant (p = 0.06). However, there was a positive relationship between the DDS and A Body Shape Index (ABSI) (B = 0.00; p = 0.022), after adjusting for confounders, this relationship was no longer significant. Additionally, the interaction effect of year and DDS on the ABSI was not significant. CONCLUSION The dietary intake and dietary diversity of older adult residents of Tehran declined dramatically with age, and a higher DDS was associated with improved anthropometric indices. DDS had an inverse relationship with general obesity in the studied participants, and the passage of time did not affect this relationship. The DDS can be used as a predictive index and is a powerful tool for investigating changes in nutritional status in longitudinal studies of old age. However, longer-duration studies are needed to obtain more conclusive results.
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Affiliation(s)
- Mahshid Rezaei
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Kimia Forouzan
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Samaneh Jafaripour
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Shamsalinia A, Hosseini SR, Bijani A, Ghadimi R, Kordbageri MR, Saadati K, Ghaffari F. Effects of Frailty Syndrome on Osteoporosis, Focusing on the Mediating Effect of Muscle Strength and Balance in Community-Dwelling Older Adults (≥60 years) in Iran: Results From the Amirkola Health and Aging Project Cohort Study. Geriatr Orthop Surg Rehabil 2024; 15:21514593241264647. [PMID: 39070931 PMCID: PMC11273585 DOI: 10.1177/21514593241264647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 05/21/2024] [Accepted: 06/09/2024] [Indexed: 07/30/2024] Open
Abstract
Introduction For older adults, maintaining muscle strength and balance is crucial to preserve an upright posture and independently manage their basic activities of daily living (ADL). This study aimed to examine whether muscle strength and balance mediate the relationship between frailty syndrome (FS) and osteoporosis in a large sample of community-dwelling older adults. Material and Methods This cross-sectional study is part of the second phase (2016-2017) of the Amirkola Health and Ageing Project (AHAP), a cohort study conducted on all elderly aged 60 and over in Amirkola, Northern Iran, since 2011. Data from 2018 older adults were collected by a trained person using bone mineral density (BMD), frailty index, activities of daily living (ADL), instrumental activities of daily living (IADL), handgrip strength (HGS), quadriceps muscle strength (QMS), Berg Balance Scale (BBS), and Timed Up and Go test (TUG test) and analyzed using analysis of variance, chi-square, and path analysis tests. Results The mean indices of femoral neck BMD and lumbar spine BMD, HGS, QMS, BBS, ADL, and IADL were lower in the frail older adults than in the pre-frail and non-frail older adults. In addition, the mean TUG test level was higher in the frail older adults than in the non-frail and pre-frail older adults. The results of the present study have indicated that frailty is significantly related to osteoporosis, and that balance and muscle strength can predict osteoporosis; these variables play a mediating role in the relationship between frailty and osteoporosis. Conclusion From the results of the present study, it can be concluded that frailty may increase the odds of osteoporosis. The results of the current study have indicated that balance (BBS and TUG test) and muscle strength (HGS and QMS) are associated with osteoporosis and these variables play a mediating role in the relationship between frailty and osteoporosis.
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Affiliation(s)
- Abbas Shamsalinia
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Seyed Reza Hosseini
- Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Ali Bijani
- Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | - Reza Ghadimi
- Social Determinants of Health (SDH) Research Centre, Health Research Institute, Babol University of Medical Science, Babol, Iran
| | | | - Kiyana Saadati
- Student Research Committee, Ramsar Campus, Mazandaran University of Medical Sciences, Ramsar, Iran
| | - Fatemeh Ghaffari
- Nursing Care Research Center, Health Research Institute, Babol University of Medical Science, Babol, Iran
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Yang Q, Wang X, Liu Y, Liu J, Zhu D. Metabolic factors are not the direct mediators of the association between type 2 diabetes and osteoporosis. Front Endocrinol (Lausanne) 2024; 15:1404747. [PMID: 39119008 PMCID: PMC11306037 DOI: 10.3389/fendo.2024.1404747] [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: 03/21/2024] [Accepted: 07/09/2024] [Indexed: 08/10/2024] Open
Abstract
Objective The causal relationship between type 2 diabetes mellitus (T2DM) and osteoporosis (OS) remains unclear. This study aims to investigate the causal relationship and explore the potential metabolic mechanism and its mediating role. Methods We conducted a comprehensive study, gathering data on 490,089 T2DM patients from the genome-wide association study (GWAS) database and selecting OS data from FinnGen and MRC-IEU sources, including 212,778 and 463,010 patients, respectively, for causal analysis. Simultaneously, we explored the potential roles of three obesity traits and 30 metabolic and inflammation-related mediating variables in the causal relationship. Results There is a strong causal relationship between T2DM and OS. The data from our two different database sources appeared in the same direction, but after correcting for body mass index (BMI), waist circumference (WC), and waist-to-hip ratio (WHR), the direction became the same. T2DM may increase the risk of OS [odds ratio (OR) > 1.5, p < 0.001]. Steiger's test results show that there is no reverse causality. No risk factors related to glycolipid metabolism, amino acid metabolism, and inflammation were found to mediate the causal relationship. Conclusion This study's findings indicate a robust causal relationship between T2DM and OS, influenced by relevant factors such as BMI. Our results shed light on the pathogenesis of OS and underscore the importance for clinicians to treat metabolic disorders to prevent osteoporosis.
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Affiliation(s)
- Qifan Yang
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Xinyu Wang
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Yanwei Liu
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
| | - Jing Liu
- Department of Gynecology and Obstetrics, Jinan Maternity and Child Care Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Dong Zhu
- Department of Orthopedics, The First Hospital of Jilin University, Changchun, China
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Sanjari M, Fahimfar N, Mansourzadeh MJ, Khalagi K, Hesari E, Hajivalizadeh F, Namazi N, Sajjadi-Jazi SM, Mahmoudi M, Tanhaei M, Shirazi S, Larijani B, Ostovar A. Iran osteoporosis registry: protocol for nationwide study. J Diabetes Metab Disord 2024; 23:1387-1396. [PMID: 38932820 PMCID: PMC11196458 DOI: 10.1007/s40200-023-01334-x] [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: 04/09/2023] [Accepted: 10/17/2023] [Indexed: 06/28/2024]
Abstract
Background Osteoporotic fractures can result in significant health complications and an increased risk of death. Registry studies could provide better treatment options and improve patient outcomes by providing useful information about the disease. The present study describes the protocol for an osteoporosis registry in Iran. Materials and methods This registry is a prospective multicenter cohort study recruiting patients with osteoporosis from Iran. The inclusion criteria of the study are individuals diagnosed with primary or secondary osteoporosis according to the diagnostic criteria of the study; patients will be identified and recruited from outpatient clinics in this registry. All patients diagnosed with primary or secondary osteoporosis are the target population of the study. Our expected sample size is 1000 participants and the study will continue for at least 2 years. The measurements of the Iranian Osteoporosis Registry include four parts: (i) variables measured by the specific questionnaires package, (ii) bone mineral density (BMD, (iii) clinical examination, and (iv) lab data. The final questionnaire package includes "demographics information", "socioeconomic status", "lifestyle", "reproductive health", "medical history and medication", "Osteoporosis diagnosis gap", "Osteoporosis adherence and treatment gap", "fracture history and fall risk assessment", "FRAX ® tool ", "hospitalization and death outcomes", "low back pain", "hospitalization history", "attitude toward osteoporosis", "osteoporosis awareness", "osteoporosis related-performance", "quality of life (Iranian version of SF12 questionnaire )", and "food frequency questionnaire (FFQ)". Clinical examination of this registry includes anthropometric measurements (including height, weight, body mass index (BMI), waist circumference, hip circumference, and right wrist circumference), and blood pressure. The baseline questionnaires will be filled out right after patients are diagnosed with osteoporosis and then osteoporotic patients will be followed up regularly on a yearly basis. In the follow-up visit, variables that may have changed over time are updated. The main outcomes include registration of fall, fracture, hospitalization, medication adherence, and death. An online web-based user-friendly software is also developed for data collection. Data analysis will be conducted with the collaboration of data-mining experts and epidemiologists at the end of each follow-up. Conclusion The Iran Osteoporosis Registry will be a valuable source of information regarding osteoporosis outcomes (i.e. fractures, hospitalizations, adherence, and death at the national level), and its results will be very beneficial and practical for policy makers in the field of musculoskeletal diseases.
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Affiliation(s)
- Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
- School of Public Health, Epidemiology and Biostatistics Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Mansourzadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Hesari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
- School of Public Health, Epidemiology and Biostatistics Department, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hajivalizadeh
- Deputy of Public Health, Center for Non-Communicable Disease Control & Prevention, Ministry of Health and Medical Education, Tehran, Iran
| | - Nazli Namazi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sayed Mahmoud Sajjadi-Jazi
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Mahmoudi
- Rheumatology Research center, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Sara Shirazi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, No 10, Jalale Al Ahmad St., Next to Dr, Tehran, Iran
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Naemi R, Sanjari M, Aalaa M, Atlasi R, Fahimfar N, Ostovar A, Nomali M, Mehrdad N, Larijani B. Osteoporosis e-learning courses: A systematic review to develop a comprehensive virtual course for General Practitioners. J Diabetes Metab Disord 2024; 23:251-266. [PMID: 38932826 PMCID: PMC11196521 DOI: 10.1007/s40200-023-01361-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 11/23/2023] [Indexed: 06/28/2024]
Abstract
Purpose One of the key strategies for effective management of osteoporosis is training health care professionals on early diagnosis and treatment of osteoporosis according to a structured course. The aim was to investigate the e-learning courses on osteoporosis around the world in order to develop an online course on osteoporosis management for general practitioners (GPs). Methods In this review, the Web of Science, Scopus, PubMed, Embase, and ERIC databases and the Google search engine were searched until March, 2021.Then, the contents of the eligible courses were extracted by two researchers independently and verified. After that, the content for an online course for GPs was developed and approved by a panel of experts constituted of endocrinologists, orthopedists, and other specialties involved in the management of osteoporosis to develop the final online course for GPs. Results In this review, 22 e-learning courses provided through 3 studies, and 19 websites were included. The content of the osteoporosis e-learning course was categorized into ten thematic categories including bone health, osteoporosis definitions and pathophysiology, prevention of osteoporosis, diagnosis of osteoporosis, fractures, non-pharmacological treatments, pharmacological treatments, treatment follow-up, postmenopausal considerations and hands-on work. The final modules for the osteoporosis e-learning contained five main categories, including bone measurement and fracture risk assessment, diagnosis of osteoporosis, clinical management, monitoring and follow-up, and sarcopenia. Conclusion Through a systematic approach, we developed modules for e-learning of osteoporosis management, which can be used to improve knowledge and skills of GPs in their practice in our setting. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01361-8.
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Affiliation(s)
- Roya Naemi
- Department of Health Information Management, School of Paramedical Sciences, Ardabil University of Medical Sciences, Ardabil, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Jalal Al-E- Ahmad Highway, Tehran, 1411713139 Iran
| | - Maryam Aalaa
- Department of E-Learning in Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Rasha Atlasi
- Evidence-Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Jalal Al-E- Ahmad Highway, Tehran, 1411713139 Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Jalal Al-E- Ahmad Highway, Tehran, 1411713139 Iran
| | - Mahin Nomali
- Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Tehran, Iran
| | - Neda Mehrdad
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Azarakhshi M, Larijani B, Fahimfar N, Tehrani MRM, Khalagi K, Mansourzadeh MJ, Khadembashiri MA, Sanjari M, Nabipour I, Ostovar A. The association of osteoporosis and cardiovascular disease risk score based on the Framingham and ACC/AHA risk prediction models: a cross-sectional analysis of Bushehr Elderly Health Program. J Diabetes Metab Disord 2024; 23:555-562. [PMID: 38932842 PMCID: PMC11196446 DOI: 10.1007/s40200-023-01313-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 09/14/2023] [Indexed: 06/28/2024]
Abstract
Background The association between osteoporosis and cardiovascular disease, two major health problems, has been reported in some studies. In this study was aimed to investigate the relationship between osteoporosis and the CVD risk score based on Framingham and American College of Cardiology and the American Heart Association (ACC/AHA) prediction models in the population over 60 years old. Methods A cross-sectional analysis was conducted on data from 2389 men and women participating in the Bushehr Elderly Health (BEH) program. Osteoporosis was defended as T-score ≤ - 2.5 at any site (total hip, femoral neck and lumbar spine (L1-L4). Based on Framingham and ACC/AHA risk scores, participants were categorized as non-high risk (< 20%) or high-risk (≥ 20%). Logistic regression model, was applied to investigate the relationship between osteoporosis and cardiovascular disease risk scores. All comparisons were stratified by sex. Results Considering the cut point of ≥ 20% for CVD risk, 36.7% of women and 66.2% of men were categorized as having high risk of CVD in ACC/AHA model. These values in women and men based on the Framingham model were 30% and 35.7%, respectively. In general, there was a negative significant correlation between BMD in the femoral neck, total hip and TBS except for the spine with the CVD risk score in both models. After adjusting for confounding variables, a significant positive association was observed between osteoporosis only at femoral neck with CVD risk score ≥ 20% based on ACC/AHA in both genders. Conclusion The ACC/AHA model is effective in identifying the CVD risk difference between individuals with and without osteoporosis.
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Affiliation(s)
- Mona Azarakhshi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Mohajeri Tehrani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Mansourzadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Amin Khadembashiri
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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Fahimfar N, Hesari E, Mansourzadeh MJ, Khalagi K, Sanjari M, Hajivalizadeh S, Tanha K, Moheimani H, Hajivalizadeh F, Irani AD, Nematollahi S, Larijani B, Ostovar A. Prevalence of osteoporosis in the Iranian population: a systematic review and meta-analysis. J Diabetes Metab Disord 2024; 23:229-237. [PMID: 38932872 PMCID: PMC11196456 DOI: 10.1007/s40200-023-01352-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/11/2023] [Indexed: 06/28/2024]
Abstract
Purpose The prevalence of osteoporosis increases as the population ages. The aim of this study was to conduct a systematic review and meta-analysis to estimate the prevalence of osteoporosis among the general population ≥ 50 years old in Iran. Methods Multiple databases including Scopus, WOS, Medline, Embase, and Persian databases (SID and Magiran) were systematically searched to identify relevant research papers. All population-based studies estimating the prevalence of osteoporosis in the Iranian population were included and imported into Endnote software. Two authors independently reviewed the articles. The Newcastle-Ottawa Scale was used to assess the risk of bias. Statistical analysis was performed using Stata software, and a significance level of 0.05 was applied to the analyses. Results Totally 2117 documents were retrieved from the databases up until October 11, 2022. After reading the full texts, 10 documents were included in the study. Our results indicated that the pooled prevalence of osteoporosis in the femoral neck region was 0.19 (95%CI: 0.12-0.26) and 0.19 (95%CI: 0.13-0.25) for women and men, respectively. Pooled prevalence of spinal osteoporosis was 0.29 (95%CI: 0.21-0.38) among women and 0.16 (95%CI: 0.12-0.19) among men. The total pooled prevalence of osteoporosis was 0.38 (95%CI: 0.29-0.48) for women and 0.25 (95%CI: 0.22-0.29) for men. Conclusion Our study highlights the elevated prevalence of osteoporosis among individuals aged 50 years and older, with females exhibiting higher rates. Notably, osteoporosis in the femoral neck region demonstrated the lowest prevalence in both sexes. The implementation of comprehensive strategies is imperative to address osteoporosis problems effectively. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01352-9.
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Affiliation(s)
- Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Hesari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Mansourzadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Hajivalizadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kiarash Tanha
- Oxford Vaccine Group, Department of Pediatrics, University of Oxford, Oxford, UK
| | - Hamed Moheimani
- Department of Surgery, University of Pittsburgh, Pittsburgh, PA USA
| | - Fatemeh Hajivalizadeh
- Center for Non-Communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Amin Doosti Irani
- Departments of Epidemiology and Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Shahrzad Nematollahi
- School of Physical and Occupational Therapy, McGill University, Montreal, QC Canada
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Institute, No. 10, Jalal-Al-Ahmad Ave., Tehran, Iran
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Zhou J, Jia F, Qu M, Ning P, Huang X, Tan L, Liu D, Zhong P, Wu Q. The prevention effect of pulsed electromagnetic fields treatment on senile osteoporosis in vivo via improving the inflammatory bone microenvironment. Electromagn Biol Med 2024:1-15. [PMID: 38329038 DOI: 10.1080/15368378.2024.2314093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 10/26/2023] [Indexed: 02/09/2024]
Abstract
This study aimed to assess PEMF in a rat model of senile osteoporosis and its relationship with NLRP3-mediated low-grade inflammation in the bone marrow microenvironment. A total of 24 Sprague Dawley (SD) rats were included in this study. Sixteen of them were 24-month natural-aged male SD rats, which were randomly distributed into the Aged group and the PEMF group (n = 8 per group). The remaining 8 3-month -old rats were used as the Young positive control group (n = 8). Rats in the PEMF group received 12 weeks of PEMF with 40 min/day, five days per week, while the other rats received placebo PEMF intervention. Bone mineral density/microarchitecture, serum levels of CTX-1 and P1CP, and NLRP3-related signaling genes and proteins in rat bone marrow were then analyzed. The 12-week of PEMF showed significant mitigation of aging-induced bone loss and bone microarchitecture deterioration, i.e. PEMF increased the bone mineral density of the proximal femur and L5 vertebral body and improved parameters of the proximal tibia and L4 vertebral body. Further analysis showed that PEMF reversed aging-induced bone turnover, specifically, decreased serum CTX-1 and elevated serum P1CP. Furthermore, PEMF also dramatically inhibited NLRP3-mediated low-grade inflammation in the bone marrow, i.e. PEMF inhibited the levels of NLRP3, proCaspase1, cleaved Caspase1, IL-1β, and GSDMD-N. The study demonstrated that PEMF could mitigate the aging-induced bone loss and reverses the deterioration of bone microarchitecture probably through inhibiting NLRP3-mediated low-grade chronic inflammation to improve the inflammatory bone microenvironment in aged rats.
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Affiliation(s)
- Jun Zhou
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Feiyang Jia
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Mengjian Qu
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Pengyun Ning
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Xiarong Huang
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Lu Tan
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Danni Liu
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Peirui Zhong
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
| | - Qi Wu
- The First Affiliated Hospital, Rehabilitation Medicine Center, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- The First Affiliated Hospital, Acupuncture/Rehabilitation Laboratory, Hengyang Medical School, University of South China, Hengyang, Hunan, China
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
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9
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Khiyali Z, Rashedi V, Tavacol Z, Dehghan A, Bijani M. Smoking, alcohol consumption, drug abuse, and osteoporosis among older adults: a cross-sectional study on PERSIAN cohort study in Fasa. BMC Geriatr 2024; 24:80. [PMID: 38254032 PMCID: PMC10802063 DOI: 10.1186/s12877-024-04678-y] [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: 10/06/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024] Open
Abstract
BACKGROUND With increasing life expectancy and a growing population of older adults, the prevalence of osteoporosis has risen, resulting in a higher incidence of bone fractures, which necessitate extended treatment and specialized medical care. This study investigates the relationship between smoking, alcohol consumption, drug abuse, and osteoporosis among older adults in southern Iran, utilizing cohort data. METHODS This cross-sectional study is derived from the Fasa Adult Cohort Study (FACS), which included 10,133 individuals. From this cohort, we selected 1,631 older adults using census sampling methods. Our study aimed to explore the correlation between smoking, alcohol consumption, and drug abuse among older adults and the incidence of osteoporosis. We collected demographic information, nutritional indexes, medical history, glucocorticoid usage, and self-reported data on smoking, alcohol consumption, drug abuse, and osteoporosis through questionnaires. To investigate the relationship between smoking, alcohol, and drug use with osteoporosis while accounting for confounding factors, we employed logistic regression analysis. RESULTS The average age of the study participants was 64.09 ± 3.8 years, with a majority (898 (55.1%)) being female. Osteoporosis prevalence among the subjects was 25.20%. The results did not reveal a significant correlation between smoking, alcohol consumption, drug abuse, and osteoporosis (p > 0.05). Regression analysis identified gender, recent history of fractures within the past five years, history of using glucocorticoids, and physical activity as significant predictive risk factors for osteoporosis within the study population (p < 0.05). CONCLUSION The study underscores the significance of addressing osteoporosis risk factors in older adults. Healthcare policymakers and administrators can use these findings to identify and mitigate influential factors contributing to osteoporosis in this demographic.
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Affiliation(s)
- Zahra Khiyali
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Vahid Rashedi
- Iranian Research Center on Aging, Department of Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ziba Tavacol
- Department of Medical-Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran
| | - Azizallah Dehghan
- Noncommunicable Diseases Research Center (NCDRC), Fasa University of Medical Sciences, Fasa, Iran
| | - Mostafa Bijani
- Department of Medical-Surgical Nursing, School of Nursing, Fasa University of Medical Sciences, Fasa, Iran.
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10
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Sanjari M, Yarmohammadi H, Fahimfar N, Hajivalizadeh F, Hesari E, Mansourzadeh MJ, Gorgani K, Khalagi K, Hajipour F, Larijani B, Ostovar A. Mind the osteoporosis care gap with timely diagnosis: an executive summary of nationwide osteoporosis Campaigns 2019-2021. J Diabetes Metab Disord 2023; 22:1365-1372. [PMID: 37975090 PMCID: PMC10638315 DOI: 10.1007/s40200-023-01257-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 06/24/2023] [Indexed: 11/19/2023]
Abstract
Background The World Osteoporosis Day inaugurate on October 20 every year by the International Osteoporosis Foundation to initiate bone health and osteoporosis as a global health agenda for policymakers, health care providers, and the public. The reported the campaigns activities in three years 2019, 2020, and 2021. The aim of this campaigns was to promote the osteoporosis awareness to close osteoporosis care and data gaps. Methods World Osteoporosis Day campaigns were held during three consecutive years 2019-2021 through "structuring" and "implantation" phases. The slogan of "early detection and timely diagnosis of osteoporosis" was followed in different public awareness and healthcare professional educational events. Also, a short survey regarding the knowledge of women aged ≥ 50 years of osteoporosis was used in campaigns to gather data for future planning. These nationwide campaigns was supported by the Osteoporosis Research Center in collaboration with the non-communicable diseases management office of Iran's Ministry of Health. Results All activities stablished to close the "data" and "awareness" gap in osteoporosis care. 1972, 1881, and 2538 women aged ≥ 50 were participated in the world osteoporosis campaigns and educated in 2019, 2020, and 2021, respectively. More than thousands of online and published educational materials were provided and disseminated in group and face-to-face and virtual education via celebration meetings in primary healthcare facilities, parks and shopping malls. The wide-ranging health slogans and massages was distributed by way of SMS, press conferences on television, radio, and other social media platforms. In addition, the in-person and virtual events such as up-date osteoporosis symposiums, national osteoporosis research network meetings, osteoporosis essential courses, and subspecialty one-day seminars provided knowledge for health care teams and policy makers. Conclusion Closing the osteoporosis treatment gap was approached by nationwide campaigns to make an appropriate intervention to emphasize early diagnosis and awareness of osteoporosis to close the care gap. Supplementary Information The online version contains supplementary material available at 10.1007/s40200-023-01257-7.
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Affiliation(s)
- Mahnaz Sanjari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Yarmohammadi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Hajivalizadeh
- Center for Non-Communicable Disease Control & Prevention, Deputy of Public Health, Ministry of Health and Medical Education, Tehran, Iran
| | - Elahe Hesari
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Javad Mansourzadeh
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kobra Gorgani
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Khalagi
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Firouzeh Hajipour
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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11
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Zhou F, Sheng B, Lv F. Quantitative analysis of vertebral fat fraction and R2 * in osteoporosis using IDEAL-IQ sequence. BMC Musculoskelet Disord 2023; 24:721. [PMID: 37697287 PMCID: PMC10494397 DOI: 10.1186/s12891-023-06846-4] [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: 04/26/2023] [Accepted: 08/30/2023] [Indexed: 09/13/2023] Open
Abstract
OBJECTIVE To investigate the correlation between FF, R2* value of IDEAL-IQ sequence and bone mineral density, and to explore their application value in the osteoporosis. METHODS We recruited 105 women and 69 men aged over 30 years who voluntarily underwent DXA and MRI examination of lumbar spine at the same day. Participants were divided into normal, osteopenia and osteoporosis group based on T-score and BMD value of DXA examination. One-way ANOVA was adopted to compare the quantitative parameters among the three groups. Independent samples t-test was utilized to compare FF and R2* value between men and women.Pearson correlation analysis was used to research the correlation between FF, R2* value and BMD. RESULTS Age, height, weight, BMD and FF value were significantly different among three groups (p < 0.05). No significant difference was found in FF value between male and female group, while R2* value were significantly different. Vertebral FF was moderately negatively correlated with aBMD, especially in women (r = -0.638, p < 0.001). R2* was mildly to moderately positively correlated with aBMD in men (r = 0.350, p = 0.003), but not in women. Moreover, FF was positively correlated with age, R2* was negatively correlated with age in men, and BMD was negatively correlated with age. CONCLUSIONS The vertebral FF value of IDEAL-IQ sequence has the potential to be a new biological marker for the assessment of osteoporosis. Vertebral FF is moderately negatively correlated with aBMD, especially in women, allowing accuratly quantify the bone marrow fat. R2* value is mildly to moderately correlated with BMD in men and can be served as a complementary tool in the assessment of osteoporosis.
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Affiliation(s)
- Feng Zhou
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, 1 Youyi Road, Chongqing, 400016 China
| | - Bo Sheng
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, 1 Youyi Road, Chongqing, 400016 China
| | - Furong Lv
- Department of Radiology, the First Affiliated Hospital of Chongqing Medical University, Yuzhong District, 1 Youyi Road, Chongqing, 400016 China
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12
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Malekmirzaei E, Farshbaf-Khalili A, Pakpour V. The self-care behaviors and health literacy can play important preventive roles in older female osteoporosis. BMC Womens Health 2023; 23:429. [PMID: 37568152 PMCID: PMC10422789 DOI: 10.1186/s12905-023-02546-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 07/13/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Osteoporosis is a common complication of aging and menopause. Self-care and health literacy are among the factors affecting health status. The purpose of this research was to determine the preventive roles of self-care behaviors and health literacy in older women with osteoporosis. METHODS This cross‑sectional analytical research was conducted on 250 postmenopausal women consisting of 125 osteoporotic and 125 healthy people aged 60-70. They were selected by purposive sampling in Tabriz Sina Hospital from September 2021 to December 2021. Data collection instruments were a demographic questionnaire, a Menopausal Self‑Care Questionnaire, and a European Health Literacy Survey Questionnaire. Data were analyzed using SPSS 23 software. RESULTS The mean (SD) total score of self-care in healthy women was 118.97 (19.92) and in women with osteoporosis was 84.7 (14.98) (p < 0.001). Also, healthy women all had sufficient health literacy (100%), but 52.8% of women with osteoporosis had insufficient health literacy. The odds of osteoporosis decreased significantly with the rise in the total score of self-care behaviors [Odds ratio 95% confidence interval (95% CI); p: 0.909 (0.880 to 0.939); p < 0.001] and its subdomains as well as with increasing health literacy level [OR (95% CI); p: 0.322 (0.266 to 0.383); p < 0.001]. There was a significant positive correlation between self-care behaviors and health literacy (r = 0.616, p < 0.001). CONCLUSIONS Self-care in aged women is particularly important in reducing the risk of osteoporosis, and empowering women in the field of health literacy is an important factor in improving self-care behaviors and ultimately the health of these people.
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Affiliation(s)
- Elahe Malekmirzaei
- School of Nursing and Midwifery, Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Azizeh Farshbaf-Khalili
- Physical Medicine and Rehabilitation Research Center, Aging Research Institute, Tabriz University of Medical Science, Tabriz, Iran
| | - Vahid Pakpour
- Department of Community Health Nursing, School of Nursing and Midwifery, Department of Geriatric Health, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
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13
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Wáng YXJ. Estimation of osteoporosis prevalence among a population is reasonable only after the concerned reference bone mineral density database and cutpoint T-score have been validated. Osteoporos Int 2023; 34:417-418. [PMID: 36445411 DOI: 10.1007/s00198-022-06538-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 08/18/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Yì Xiáng J Wáng
- Department of Imaging and Interventional Radiology, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong SAR, China.
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14
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Xiao PL, Lu HD. Response to: Estimation of osteoporosis prevalence among a population is reasonable only after the concerned reference bone mineral density database and cutpoint T-score have been validated. Osteoporos Int 2023; 34:419-420. [PMID: 36445412 DOI: 10.1007/s00198-022-06603-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 11/07/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Pei-Lun Xiao
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Hua-Ding Lu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China.
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15
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Ghadiri M, Cheshmazar E, Shateri Z, Gerami S, Nouri M, Gargari BP. Healthy plant-based diet index as a determinant of bone mineral density in osteoporotic postmenopausal women: A case-control study. Front Nutr 2023; 9:1083685. [PMID: 36712516 PMCID: PMC9879057 DOI: 10.3389/fnut.2022.1083685] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023] Open
Abstract
Introduction The association between plant-based diet indices and bone mineral density (BMD) of women with osteoporosis have not been studied in Iranian women. This study aimed to evaluate the association between plant-based diet indices and BMD in postmenopausal women with osteopenia/osteoporosis. Materials and methods The present research was a case-control study conducted on 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy women. The BMD of the femoral neck and lumbar vertebrae was measured by the Dual-energy X-ray absorptiometry (DXEA) method. Participants were asked to complete a validated semi-quantitative food frequency questionnaire (FFQ). We used three versions of plant-based diet indices, including plant-based diet index (PDI), healthy plant-based diet index (hPDI), and unhealthy plant-based diet index (uPDI). Two different multivariable logistic regression was used for the crude and adjusted model to assess the relationship between PDI, hPDI, and uPDI with odds of femoral and lumbar BMD. Results There was a reverse association between last tertile of hPDI with femoral BMD abnormality in the both adjusted model [Model 1: odds ratio (OR): 0.33; 95% confidence interval (CI): 0.19-0.63 and Model 2: OR: 0.30; 95% CI: 0.15-0.58, respectively]. Furthermore, we found a reverse relationship between hPDI with lumbar BMD abnormality in the first adjusted model (OR: 0.36; 95% CI: 0.19-0.67). On the other hand, a negative association was observed in the second and last tertile of hPDI with lumbar BMD abnormality (OR: 0.47; 95% CI: 0.24-0.90 and OR: 0.34; 95% CI: 0.17-0.64, respectively). According to the results, the association of femoral BMD abnormality in the last tertile of uPDI compared to the first tertile in the both adjusted models (Model 1: OR: 2.85; 95% CI: 1.52-5.36 and Model 2: OR: 2.63; 95% CI: 1.37-5.06) were significant. Also, we observed a positive relationship between the last tertile of uPDI with lumbar BMD abnormality compared to the lowest tertile in the both adjusted models (Model 1; OR: 4.16; 95% CI: 2.20-7.85, Model 2; OR: 4.23; 95% CI: 2.19-8.19). Conclusion Overall, the findings indicated that in postmenopausal women with osteoporosis, a healthy plant-based diet could prevent bone loss, and an unhealthy plant-based diet might have detrimental effects on BMD.
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Affiliation(s)
- Marzieh Ghadiri
- Nutrition Research Center, Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Elhameh Cheshmazar
- Department of Nutrition, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shirin Gerami
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Nouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran,Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran,Mehran Nouri,
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran,*Correspondence: Bahram Pourghassem Gargari, ,
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16
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Azangou-Khyavy M, Saeedi Moghaddam S, Mohammadi E, Shobeiri P, Rashidi MM, Ahmadi N, Shahsavan S, Shirzad Moghaddam Z, Sohrabi H, Pourghasem F, Kalantar R, Ghaffari A, Hashemi SM, Rezaei N, Larijani B. Attributable disease burden related to low bone mineral density in Iran from 1990 to 2019: results from the Global Burden of Disease 2019. Arch Osteoporos 2022; 17:140. [PMID: 36355233 DOI: 10.1007/s11657-022-01180-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Accepted: 10/12/2022] [Indexed: 11/11/2022]
Abstract
PURPOSE Low bone mineral density (BMD) including low bone mass and osteoporosis is a bone state that carries the risk of fractures and the consequent burden. Since Iran has an aging population and is considered a high-risk country regarding fracture, the objective of this study was to report the low BMD attributable burden in Iran from 1990 to 2019 at national and subnational levels. MATERIALS AND METHODS In this study, the Global Burden of Disease (GBD) study 2019 estimates of exposure value and attributable burden were used. For each risk-outcome pair, following the estimation of relative risk, exposure level, and the Theoretical Minimum Risk Exposure Level (TMREL), the Population Attributable Fractions (PAFs) and attributable burden were computed. The Summary Exposure Value (SEV) index was also computed. RESULTS Although the age-standardized DALYs and deaths decreased (- 41.0 [95% uncertainty interval: - 45.7 to - 33.2] and - 43.3 [- 48.9 to - 32.5]), attributable all age numbers in Iran increased from 1990 to 2019 (64.3 [50.6 to 89.1] and 66.8 [49.7 to 102.0]). The male gender had a higher low BMD attributed burden in Iran at national and subnational levels except for Tehran. Among low BMD-associated outcomes, motor vehicle road injuries and falls accounted for most of the low BMD-attributed burden in Iran. The SEV for low BMD remained constant from 1990 to 2019 in the country and females had higher SEVs. CONCLUSION Low BMD and the associated outcomes has to gain attention in Iran's health system due to an aging population. Hence, timely interventions by health systems and the population at stake might assist in reducing the burden attributed to low BMD.
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Affiliation(s)
- Mohammadreza Azangou-Khyavy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Parnian Shobeiri
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad-Mahdi Rashidi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Ahmadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Shahsavan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zeinab Shirzad Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Hanye Sohrabi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Fateme Pourghasem
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhaneh Kalantar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aydin Ghaffari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Melika Hashemi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Negar Rezaei
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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17
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Khalagi K, Fahimfar N, Hajivalizadeh F, Sanjari M, Mansourzadeh MJ, Gharibzadeh S, Shafiee G, Kamali K, Alaeddini F, Farzadfar F, Mohseni S, Namazi N, Razi F, Gorgani K, Kateb Saber K, Panahi N, Heshmat R, Raeisi A, Larijani B, Ostovar A. Iranian Multi-center Osteoporosis Study (IMOS), 2021–2022: the study protocol. BMC Geriatr 2022; 22:818. [PMID: 36274119 PMCID: PMC9589816 DOI: 10.1186/s12877-022-03532-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 10/16/2022] [Indexed: 11/18/2022] Open
Abstract
Background This paper presents the protocol of the 4th round of Iranian Multi-center Osteoporosis Study (IMOS), a national survey with the primary objective of estimating the prevalence of osteoporosis and sarcopenia and their risk factors in a representative sample of urban and rural populations. Methods The target population of the survey is all individuals ≥ 50 years in Iran. A multi-stage random sampling method has been used in the study. We stratified the 31 provinces of the country into 5 strata based on the distribution of their potential risk factors for osteoporosis and randomly selected one or two provinces from each stratum. Then, we invited 2530 people aged ≥ 50 years recruited in the 8th National Survey of None Communicable Diseases (NCD) Risk Factors (STEPs-2021) in the selected provinces to participate in IMOS. Body composition measurements including bone mineral density, muscle mass, and fat mass are measured through Dual-energy X-ray Absorptiometry (DXA) method using HOLOGIC (Discovery and Horizon) devices; and Trabecular Bone Score (TBS) is measured on the DXA scans using iNsight software. Anthropometric measurement and physical examinations are made by a trained nurses and other required information are collected through face-to-face interviews made by trained nurses. Laboratory measurements are made in a central lab. The prevalence of osteoporosis and sarcopenia will be estimated after applying sampling design, non-response, and post-stratification weights to the data. Discussion IMOS will provide valuable information on the prevalence and determinants of osteoporosis and sarcopenia at the national level, and the results can be used in evaluating health system interventions and policymaking in the field of musculoskeletal diseases.
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18
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Xiao PL, Cui AY, Hsu CJ, Peng R, Jiang N, Xu XH, Ma YG, Liu D, Lu HD. Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporos Int 2022; 33:2137-2153. [PMID: 35687123 DOI: 10.1007/s00198-022-06454-3] [Citation(s) in RCA: 95] [Impact Index Per Article: 47.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2022] [Accepted: 05/28/2022] [Indexed: 10/18/2022]
Abstract
This systematic review and meta-analysis estimated the global, regional prevalence, and risk factors of osteoporosis. Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from 8.0% in Oceania to 26.9% in Africa). Osteoporosis is a common metabolic bone disorder in the elderly, usually resulting in bone pain and an increased risk of fragility fracture, but few summarized studies have guided global strategies for the disease. Therefore, we pooled the epidemiologic data to estimate the global, regional prevalence, and potential risk factors of osteoporosis. We conducted a comprehensive literature search through PubMed, EMBASE, Web of Science, and Scopus, to identify population-based studies that reported the prevalence of osteoporosis based on the World Health Organization (WHO) criteria. Meta-regression and subgroup analyses were used to explore the sources of heterogeneity. The study was registered in the PROSPERO database (CRD42021285555). Of the 57,933 citations evaluated, 108 individual studies containing 343,704 subjects were included. The global prevalence of osteoporosis and osteopenia was 19.7% (95%CI, 18.0%-21.4%) and 40.4% (95%CI, 36.9%-43.8%). Prevalence varied greatly according to countries (from 4.1% in Netherlands to 52.0% in Turkey) and continents (from Oceania 8.0% to 26.9% in Africa). The prevalence was higher in developing countries (22.1%, 95%CI, 20.1%-24.1%) than in developed countries (14.5%, 95%CI, 11.5%-17.7%). Our study indicates a considerable prevalence of osteoporosis among the general population based on WHO criteria, and the prevalence varies substantially between countries and regions. Future studies with robust evidence are required to explore risk factors to provide effective preventive strategies for the disease.
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Affiliation(s)
- P-L Xiao
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - A-Y Cui
- Department of Orthopaedics, Honghui Hospital, Xi'an Jiao Tong University, Xi'an, 710000, China.
| | - C-J Hsu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - R Peng
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - N Jiang
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - X-H Xu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - Y-G Ma
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - D Liu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China
| | - H-D Lu
- Department of Orthopaedics, The Fifth Affiliated Hospital of Sun Yat-Sen University, Zhuhai, 519000, Guangdong, China.
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Barnett JB, Zeng W. Healthy Eating for Successful Living in Older Adults™ community education program—evaluation of lifestyle behaviors: A randomized controlled trial. FRONTIERS IN AGING 2022; 3:960986. [PMID: 36187849 PMCID: PMC9521496 DOI: 10.3389/fragi.2022.960986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 07/11/2022] [Indexed: 11/13/2022]
Abstract
Objective: Older adults face many chronic health issues including heart disease and osteoporosis, which are preventable through changes in lifestyle behaviors. The Healthy Eating for Successful Living in Older Adults™ (HESL) is a 6-week community education program designed specifically for persons aged ≥60 years, to promote behavioral changes toward a healthy lifestyle. Our objective is to evaluate the HESL. This is the first official evaluation of the HESL since its initiation in 2005.Study Design: A cluster randomized controlled trial.Method: Program implementation and evaluation took place between July 2018 and January 2020. Twenty-nine sites, with 292 participants aged ≥60 years from across five states (mostly from Massachusetts), were randomized into the intervention group (IG) (16 sites; n = 150 participants) and control group (CG) (13 sites; n = 142 participants). The HESL workshops followed a scripted curriculum including information from the USDA’s MyPlate™ and the USDA 2015–2020 dietary guidelines. Intervention elements included goal setting, self-assessment, group support, and problem solving through brainstorming. The CG received no intervention. Outcome measures were collected in both groups at baseline, 2 weeks postintervention (week 8), and 6 months postintervention. These included self-reported lifestyle behaviors, a composite healthy behavior index (HBI), body mass index [weight (kg)/height (m2)], and waist-to-hip circumference ratio (WHR). Mixed-effects regression models were used to examine the impact of the intervention.Results: The IG showed significantly improved responses to most healthy lifestyle behavior questions at week 8 compared to the CG. However, not all improved responses were sustained at month 6. Significant improvements detected at month 6 included responses to the question on making food choices that are healthy for the heart, using MyPlate™ tools for food choices, reading nutrition labels when shopping/planning meals, and confidence in managing own health (p < 0.001 in most cases). HBI was significantly improved at week 8 and month 6 (p < 0.001). WHR decreased significantly (p < 0.05) at month 6.Conclusion: Positive changes in lifestyle behaviors and WHR were observed in older adults due to the HESL intervention.Clinical Trial Registration:clinicaltrial.gov, Identifier: NCT04991844; https://clinicaltrials.gov/ct2/show/NCT04991844
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Affiliation(s)
- Junaidah B. Barnett
- Health and Healing Research Education and Service, Boston, MA, United States
- Department of Nutrition, Harvard School of Public Health, Harvard University, Boston, MA, United States
- Tufts University Sensory and Science Center, Medford, MA, United States
- *Correspondence: Junaidah B. Barnett,
| | - Wu Zeng
- Department of Global Health, School of Health, Georgetown University, Washington, DC, United States
- Schneider Institutes for Health Policy, The Heller School for Social Policy and Management, Brandeis University, Waltham, MA, United States
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20
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Chegini M, Shirani P, Omidvar N, Eini-Zinab H, Pour-Ebrahim F, Rezazadeh A. Relationship between diet quality and depression among Iranian older adults in Tehran. BMC Geriatr 2022; 22:708. [PMID: 36028815 PMCID: PMC9419352 DOI: 10.1186/s12877-022-03380-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 08/12/2022] [Indexed: 11/26/2022] Open
Abstract
Background Depression is one of the prevalent mental disorders that is common in older ages. Evidence suggests that dietary intake status may potentially be associated with depression. However, this association has not been well studied in older adults, and the nature of the association remains unclear. This study aimed to investigate the association between diet quality and depression in free-living older adults living in Tehran city. Methods This cross-sectional study was conducted on 583 older adults (279 men and 304 women) aged 60 to 80 years living in Tehran city, selected by the systematic cluster sampling method. Individuals' dietary intake was determined by two non-consecutive 24-h dietary recalls, and diet quality was assessed calculating score of Healthy Eating Index-2015 (HEI-2015). The validated short form of the Geriatric Depression Scale (GDS-11) was used to assess depression status. A logistic regression model was used to assess the chance of depression across tertiles of HEI-2015 score. Results The point prevalence of depression was 22.5%, which was significantly higher in women (91 (69.5%) women vs. 40 (30.5%) men). A higher percentage of seniors at the higher tertile of HEI score were women, belonged to Fars ethnicity and had a higher score of activity of daily living (ADL). After adjustment for all potential confounders, the trend of depression chance was significantly decreased in those with higher HEI-2015 scores (p-for trend < 0.05). Conclusion Higher quality of diet was associated with a lower possibility of depression in the studied participants. Further studies are required to investigate the possible causal relationship. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-03380-1.
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Affiliation(s)
- Maedeh Chegini
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Pedram Shirani
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nasrin Omidvar
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Eini-Zinab
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Fatemeh Pour-Ebrahim
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Arezoo Rezazadeh
- Department of Community Nutrition, National Nutrition and Food Technology Research Institute, School of Nutrition and Food Technology, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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21
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Panahi N, Fahimfar N, Roshani S, Arjmand B, Gharibzadeh S, Shafiee G, Migliavacca E, Breuille D, Feige JN, Grzywinski Y, Corthesy J, Razi F, Heshmat R, Nabipour I, Farzadfar F, Soltani A, Larijani B, Ostovar A. Association of amino acid metabolites with osteoporosis, a metabolomic approach: Bushehr elderly health program. Metabolomics 2022; 18:63. [PMID: 35915271 DOI: 10.1007/s11306-022-01919-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Accepted: 07/07/2022] [Indexed: 11/25/2022]
Abstract
INTRODUCTION AND OBJECTIVES Amino acids are the most frequently reported metabolites associated with low bone mineral density (BMD) in metabolomics studies. We aimed to evaluate the association between amino acid metabolic profile and bone indices in the elderly population. METHODS 400 individuals were randomly selected from 2384 elderly men and women over 60 years participating in the second stage of the Bushehr elderly health (BEH) program, a population-based prospective cohort study that is being conducted in Bushehr, a southern province of Iran. Frozen plasma samples were used to measure 29 amino acid and derivatives metabolites using the UPLC-MS/MS-based targeted metabolomics platform. We conducted Elastic net regression analysis to detect the metabolites associated with BMD of different sites and lumbar spine trabecular bone score, and also to examine the ability of the measured metabolites to differentiate osteoporosis. RESULTS We adjusted the analysis for possible confounders (age, BMI, diabetes, smoking, physical activity, vitamin D level, and sex). Valine, leucine, isoleucine, and alanine in women and tryptophan in men were the most important amino acids inversely associated with osteoporosis (OR range from 0.77 to 0.89). Sarcosine, followed by tyrosine, asparagine, alpha aminobutyric acid, and ADMA in women and glutamine in men and when both women and men were considered together were the most discriminating amino acids detected in individuals with osteoporosis (OR range from 1.15 to 1.31). CONCLUSION We found several amino acid metabolites associated with possible bone status in elderly individuals. Further studies are required to evaluate the utility of these metabolites as clinical biomarkers for osteoporosis prediction and their effect on bone health as dietary supplements.
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Affiliation(s)
- Nekoo Panahi
- Metabolic Disorders Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahin Roshani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- The Netherlands Cancer Institute, Amsterdam, the Netherlands
| | - Babak Arjmand
- Metabolomics and Genomics Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Research Centre for Emerging and Reemerging Infectious Diseases, Pasteur Institute of Iran, Tehran, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Eugenia Migliavacca
- Nestlé Institute of Health Sciences, Nestlé Research, CH-1015, Lausanne, Switzerland
| | - Denis Breuille
- Nestlé Institute of Health Sciences, Nestlé Research, CH-1015, Lausanne, Switzerland
| | - Jerome N Feige
- Nestlé Institute of Health Sciences, Nestlé Research, CH-1015, Lausanne, Switzerland
| | - Yohan Grzywinski
- Institute of Food Safety and Analytical Science, Nestlé Research, CH-1015, Lausanne, Switzerland
| | - John Corthesy
- Institute of Food Safety and Analytical Science, Nestlé Research, CH-1015, Lausanne, Switzerland
| | - Farideh Razi
- Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Farshad Farzadfar
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Akbar Soltani
- Evidence-Based Medicine Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Jamshidi A, Vojdanian M, Soroush M, Akbarian M, Aghaei M, Hajiabbasi A, Mirfeizi Z, Khabbazi A, Alishiri G, Haghighi A, Salimzadeh A, Karimzadeh H, Shirani F, Fard MRH, Nazarinia M, Soroosh S, Anjidani N, Gharibdoost F. Efficacy and safety of the biosimilar denosumab candidate (Arylia) compared to the reference product (Prolia®) in postmenopausal osteoporosis: a phase III, randomized, two-armed, double-blind, parallel, active-controlled, and noninferiority clinical trial. Arthritis Res Ther 2022; 24:161. [PMID: 35773713 PMCID: PMC9245232 DOI: 10.1186/s13075-022-02840-8] [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] [Received: 04/11/2022] [Accepted: 06/15/2022] [Indexed: 12/05/2022] Open
Abstract
Background/objective Osteoporosis is a global health concern with an increasing prevalence worldwide. Denosumab is an antiresoptive agent that has been demonstrated to be effective and safe in osteoporotic patients. This study aimed to compare the efficacy and safety of the biosimilar denosumab candidate (Arylia) to the originator product (Prolia®) in postmenopausal osteoporotic patients. Methods In this randomized, double-blind, active-controlled, noninferiority trial, postmenopausal osteoporotic patients received 60 mg of subcutaneous Arylia or Prolia® at months 0, 6, and 12 and were followed up for 18 months. The primary endpoint was the noninferiority of the biosimilar product to the reference product in the percentage change of bone mineral density (BMD) in 18 months at the lumbar spine (L1-L4), total hip, and femoral neck. The secondary endpoints were safety assessment, the incidence of new vertebral fractures, and the trend of bone turnover markers (BTMs). Results A total of 190 patients were randomized to receive either biosimilar (n = 95) or reference (n = 95) denosumab. In the per-protocol (PP) analysis, the lower limits of the 95% two-sided confidence intervals of the difference between Arylia and Prolia® in increasing BMD were greater than the predetermined noninferiority margin of − 1.78 at the lumbar spine, total hip, and femoral neck sites (mean differences [95% CIs] of 0.39 [− 1.34 to 2.11], 0.04 [− 1.61 to 1.69], and 0.41 [− 1.58 to 2.40], respectively). The two products were also comparable in terms of safety, new vertebral fractures, and trend of BTMs. Conclusion The efficacy of the biosimilar denosumab was shown to be noninferior to that of the reference denosumab, with a comparable safety profile at 18 months. Trial registration ClinicalTrials.gov, NCT03293108; Registration date: 2017–09-19. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02840-8.
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Affiliation(s)
- Ahmadreza Jamshidi
- Rheumatology Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Vojdanian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Soroush
- Rheumatology Department, AJA University of Medical Sciences, Tehran, Iran
| | - Mahmoud Akbarian
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehrdad Aghaei
- Golestan Rheumatology Research Center (GRRC), Golestan University of Medical Sciences, Gorgan, Iran
| | - Asghar Hajiabbasi
- Department of Rheumatology, Guilan Rheumatology Research Center, School of Medicine, Razi Hospital, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Mirfeizi
- Rheumatic Diseases Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Alireza Khabbazi
- Connective Tissue Diseases Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Gholamhosein Alishiri
- Chemical Injuries Research Center, Systems Biology and Poisonings Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
| | - Anousheh Haghighi
- Rheumatology Department, Iran University of Medical Sciences, Tehran, Iran
| | - Ahmad Salimzadeh
- Rheumatology Research Center, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Hadi Karimzadeh
- Department of Internal Medicine, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fatemeh Shirani
- Department of Rheumatology, Iran University of Medical Sciences, Tehran, Iran
| | - Mohammad Reza Hatef Fard
- Rheumatology Ward, Internal Medicine Department, Mashhad University of Medical Sciences, Mashhad, Iran
| | - MohammadAli Nazarinia
- Shiraz Geriatric Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soosan Soroosh
- Rheumatology Department, AJA University of Medical Sciences, Tehran, Iran
| | | | - Farhad Gharibdoost
- Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
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Lan H, Liu WH, Zheng H, Feng H, Zhao W, Hung WL, Li H. Bifidobacterium lactis BL-99 protects mice with osteoporosis caused by colitis via gut inflammation and gut microbiota regulation. Food Funct 2022; 13:1482-1494. [PMID: 35060590 DOI: 10.1039/d1fo02218k] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Patients diagnosed with inflammatory bowel disease or related conditions also frequently suffer from osteoporosis as a consequence of changes in the intestinal microenvironment and consequent dysbiosis. We hypothesized that anti-inflammatory probiotic treatment would be sufficient to alleviate intestinal inflammation and thereby prevent the development of osteoporosis. To that end, the ability of Bifidobacterium lactis BL-99 administration to protect against bone loss in an experimental model of dextran sodium sulfate-induced ulcerative colitis (UC) was analyzed, and the underlying molecular mechanisms were interrogated in detail. The results of these analyses revealed that BL-99 administration suppressed colitis-associated weight loss (P < 0.05), disease activity index scores, and the production of proinflammatory cytokines (TNF-α, IL-1β, IL-6, and IL-17) (P < 0.05). Colon tissue pathological sections similarly revealed BL-99-mediated reductions in tissue injury severity. Micro-computed tomography (Micro-CT) analyses further exhibited significant improvements in percent bone volume (BV/TV) as well as trabecular number and thickness in BL-99-treated animals (P < 0.05). Such probiotic supplementation also resulted in pronounced changes in the composition of the gut microbiota. Moreover, BL-99 intervention markedly increased the expression of intestinal barrier-related proteins (Claudin-1, MUC2, ZO-1, and Occludin). Together, these results suggest that BL-99 can be utilized as a beneficial probiotic preparation to prevent the incidence of osteoporosis in UC patients owing to its ability to shape the intestinal microflora and to suppress inflammatory cytokine production.
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Affiliation(s)
- Hui Lan
- School of Public Health, Xiamen University, Xiamen 361102, Fujian, China.
| | - Wei-Hsien Liu
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, Inner Mongolia, China.
| | - Hanying Zheng
- School of Public Health, Xiamen University, Xiamen 361102, Fujian, China.
| | - Haotian Feng
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, Inner Mongolia, China.
| | - Wen Zhao
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, Inner Mongolia, China.
| | - Wei-Lian Hung
- Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot 010110, Inner Mongolia, China.
| | - Hongwei Li
- School of Public Health, Xiamen University, Xiamen 361102, Fujian, China.
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Nikfarjam M, Heshmat R, Gharibzadeh S, Ostovar A, Maleki V, Moludi J, Nabipour I, Shafiee G, Larijani B. The association between muscle indicators and bone mass density and related risk factors in the diabetic elderly population: Bushehr Elderly Health (BEH) Program. J Diabetes Metab Disord 2021; 20:1429-1438. [PMID: 34900794 PMCID: PMC8630123 DOI: 10.1007/s40200-021-00881-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 08/15/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Loss of muscle mass and strength and bone mass density are complications of the aging process. Studies show that the prevalence of sarcopenia and osteoporosis may be higher in patients with diabetes. Therefore, this study was aimed to investigate the relationship between muscle mass and strength indices and bone mass density in diabetic elderly. MATERIALS AND METHODS This cross-sectional study was conducted based on the data collected during the Bushehr Elderly Health (BEH) Program, stage II. Diabetes was defined as FPG ≥ 126 mg/dl or HbA1C ≥ 6.5 or taking anti-diabetic medication. Dual x-ray absorptiometry (DXA, Discovery WI, Hologic Inc, USA) was used to measure bone mineral density, fat mass, trabecular bone score (TBS) and muscle mass. Muscle strength was measured by grip strength.Osteoporosis was defined as the bone mineral density of ≥ 2.5 standard deviations (SD) below the average value of young normal adults (T-score of ≤ -2.5 SD) in the femoral neck, or lumbar spine (L1-L4) or total hip. To determine the relationship between skeletal muscle index (SMI) and muscle strength on bone status in a continuous scale was used from linear regression. To estimate the effect of SMI and muscle strength on osteoporosis was used from modified Poisson regression for analysis. RESULTS This study included 759 diabetic elderly with a mean age of 68.6 years and 56.9% of them were women. Skeletal muscle index (SMI) was related to all sites of BMDs and TBS L1-L4 after adjusted in full models (P-value < 0.001). The largest coefficients were observed for BMD L1-L4 in all models (β: 0.043 g/cm2; 95% CI: 0.030-0.057 in full model). Muscle strength was also associated with BMDs and TBS. Only, in model 2 (adjustments for age and sex effect), there was no significant relationship between muscle strength and BMD L1-L4 and TBS L1-L4. The strongest associations were observed for the total hip BMD and muscle strength (β: 0.034 g/cm2; 95% CI: 0.022- 0.046 in full model). Also, increased SMI and muscle strength was associated with decreased osteoporosis in crude and adjusted models (P < 0.001). CONCLUSIONS In this study, it was revealed that the reduction of SMI in elderly patients with diabetes was significantly associated with decreased BMD and TBS. The muscle strength was also associated with BMD and TBS. So, muscle strength and muscle mass should be measured separately ever since both are independently associated with BMD and TBS. Muscle strength and muscle mass were negatively associated with osteoporosis in older people with diabetes. Thus, we should pay more attention to muscle strength training in older people with diabetes, particularly in osteoporotic patients.
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Affiliation(s)
- Marzieh Nikfarjam
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
| | - Ramin Heshmat
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
| | - Safoora Gharibzadeh
- Department of Epidemiology and Biostatistics, Pasteur Institute of Iran, Tehran, Iran
| | - Afshin Ostovar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Maleki
- Clinical Cancer Research Center, Milad General Hospital, Tehran, Iran
- Knee and Sport Medicine Research Center, Milad Hospital, Tehran, Iran
| | - Jalal Moludi
- School of Nutrition Sciences and Food Technology, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Gita Shafiee
- Chronic Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, NO 10, Jalale-Al-Ahmad Ave, Chamran Highway, Tehran, Iran
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Association between biomarkers of bone health and osteosarcopenia among Iranian older people: The Bushehr Elderly Health (BEH) program. BMC Geriatr 2021; 21:654. [PMID: 34798818 PMCID: PMC8603566 DOI: 10.1186/s12877-021-02608-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 11/09/2021] [Indexed: 01/11/2023] Open
Abstract
Background Osteosarcopenia is referred to as co-incidence of osteoporosis/osteopenia and sarcopenia which is defined as a geriatric syndrome with a significant prevalence that increases morbidity and mortality. There are some relevant factors that can show an increased risk of incidence of osteosarcopenia. Aim We aimed to consider the association of bone turnover markers such as Osteocalcin (OC), C-terminal cross-linked telopeptide (CTX), Tartrate Resistant acid Phosphatase (TRAP), Bone Alkaline Phosphatase (BALP) and also other factors like vitamin D, calcium, phosphorous, and ALP with osteosarcopenia in elderly. Methods
We carried out a cross-sectional study on a random sample including 400 elder participants of Bushehr Elderly Health (BEH) study, in Iran. Osteopenia/ osteoporosis was defined as a T-score ≤ -1.0 standard deviation below the mean values of a young healthy adult. We defined sarcopenia as low muscle strength (handgrip strength<26 kg for men and <18 kg for women) with reduced skeletal muscle mass [Skeletal muscle index (SMI) < 7.0 kg/m2 for male and <5.4 kg/m2 for female]. Osteosarcopenia was considered as the presence of both osteopenia/osteoporosis and sarcopenia. We estimated the age-standardized prevalence of osteosarcopenia for men and women, separately. We used multivariable logistic regression to address the factors associated with osteosarcopenia. Results The results showed that there was a statistically significant difference in OC), CTX, TRAP were between the osteosarcopenia (-) and osteosarcopenia (+) groups. No statistically significant difference was observed in BALP, vitamin D, calcium, phosphorous, and ALP between the compared groups. In the multivariable logistic regression model, OC and CTX were associated with increased likelihood of osteosarcopenia [adjusted OR= 1.023(1.002-1.045 for OC, 4.363(1.389-15.474 for CTX)]. Furthermore, TRAP increases the odds of osteosarcopenia in crude model [OR= 1.333 (1.070- 1.660)]. Conclusions We observed the association between bone turnover markers particularly OC, CTX and osteosarcopenia. Given the rapid growth of the aging population, we should focus on geriatric diseases such as musculoskeletal disorders. Bone turnover markers maybe improve the early diagnosis, screening and assess the response to therapies in people with osteosarcopenia. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02608-w.
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Ховасова НО, Наумов АВ, Ткачева ОН, Дудинская ЕН. [Characteristics of geriatric and somatic status in patients with osteoporosis]. PROBLEMY ENDOKRINOLOGII 2021; 67:45-54. [PMID: 34297501 PMCID: PMC9112845 DOI: 10.14341/probl12751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/17/2021] [Accepted: 06/15/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Older adults with osteoporosis (OP) and high risk of falls are the most vulnerable group of patients with respect to the development of fractures. Falls and fractures in elderly patients with OP are associated with geriatric syndromes and worse functional status. AIM To аssess comorbidity and geriatric status in elderly and senile patients with and without OP. MATERIALS AND METHODS The study included 607 patients over 60 years of age hospitalized in the geriatric department. According to the presence of OP, the patients were divided into 2 groups: group 1 - patients with OP (n=178, 29.3%), group 2 - patients without OP (n=429, 70.7%). All patients underwent a general clinical study, an assessment of comorbidity -according to the Charlson index, and a comprehensive geriatric score. RESULTS OPs had 178 (29.3%) patients, more often these were women. 55.6% of patients with OP were disabled. Age--related diseases such as Alzheimer's disease, Parkinson's disease, osteoarthritis, anemia, thyroid disease, varicose veins were significantly more common in patients with OP. With almost all of these diseases, a univariate analysis revealed an association with OP. Geriatric syndromes such as frailty, hypodynamia, malnutrition, polypharmacy, urinary incontinence were significantly more common in group 1 patients. Patients with OP were more likely to live alone and use mobility aids compared to patients without OP.The univariate analysis demonstrated that OP is associated (OR 1.54 to 2.00) with frailty, hypodynamia, the use of aids in movement, sleep disorders, sensory vision deficiency, urinary incontinence. The Functional status of patients with OP was worse compared to patients without OP. Patients with OP suffered more fractures, and vertebral fractures were significantly more frequent. CONCLUSION Patients with OP have a high comorbidity, a burdened geriatric status. In elderly patients, it is necessary not only to screen and diagnose OP, to assess the risk of 10-years probability of major pathological fractures using the FRAX algorithm, but also to conduct a comprehensive geriatric assessment to diagnose geriatric syndromes that weaken the course of OP and lead to more serious consequences.
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Affiliation(s)
- Н. О. Ховасова
- Кафедра болезней старения Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Российский геронтологический научно-клинический центр
| | - А. В. Наумов
- Кафедра болезней старения Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Российский геронтологический научно-клинический центр
| | - О. Н. Ткачева
- Кафедра болезней старения Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Российский геронтологический научно-клинический центр
| | - Е. Н. Дудинская
- Кафедра болезней старения Российского национального исследовательского медицинского университета им. Н.И. Пирогова; Российский геронтологический научно-клинический центр
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