1
|
Tronstad I, Hoff M, Horn J, Vikjord SAA, Videm V, Johansson J, Nilsen TIL, Langhammer A. Rheumatoid arthritis, disease-modifying antirheumatic drugs and risk of major osteoporotic fracture: prospective data from the HUNT Study, Norway. RMD Open 2024; 10:e003919. [PMID: 38382944 PMCID: PMC10882308 DOI: 10.1136/rmdopen-2023-003919] [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: 11/17/2023] [Accepted: 01/31/2024] [Indexed: 02/23/2024] Open
Abstract
OBJECTIVES Rheumatoid arthritis has been associated with increased fracture risk. New treatments have improved the course of the disease substantially, but it is not clear if this influences fracture risk. We examined if rheumatoid arthritis, overall and according to disease-modifying antirheumatic drugs (DMARDs), is associated with a risk of major osteoporotic fractures. METHODS Overall, 92 285 participants in the population-based Nord-Trndelag Health Study (HUNT), Norway were included and linked with hospital records for a validated rheumatoid arthritis diagnosis (n=605), type of DMARD treatment and fracture diagnosis. Participants were followed up until the first major osteoporotic fracture, death, emigration or end of follow-up. Cox regression was used to estimate HRs for fractures among individuals with rheumatoid arthritis, overall and by DMARD treatment, compared with participants without rheumatoid arthritis. RESULTS A total of 9670 fractures were observed during follow-up, of which 88 were among those with rheumatoid arthritis. Compared with the reference group of participants without rheumatoid arthritis, those with the disease had an HR of fracture of 1.41 (95% CI 1.13 to 1.74). The association was largely similar for users of csDMARDs (HR 1.44; 95% CI 1.15 to 1.81), whereas the association for bDMARD users was weaker and less precise (HR 1.19; 95% CI 0.64 to 2.21). CONCLUSION Participants with rheumatoid arthritis had a 40% higher risk of fracture than participants without the disease. A similar fracture risk was observed for conventional synthetic DMARD use, whereas there was weak evidence that the use of biological DMARDs may be associated with a somewhat lower fracture risk.
Collapse
Affiliation(s)
- Ingebjørg Tronstad
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Department of Medicine and Rehabilitation, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Trøndelag, Norway
| | - Mari Hoff
- Department of Rheumatology, St Olavs Hospital Trondheim University Hospital, Trondheim, Trøndelag, Norway
- Neuromedicine and Movement Science, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway
| | - Julie Horn
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Department of Obstetrics and Gynecology, Nord-Trøndelag Hospital Trust, Levanger Hospital, Levanger, Trøndelag, Norway
| | - Sigrid Anna Aalberg Vikjord
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Clinic of Thoracic and Occupational Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Trøndelag, Norway
| | - Vibeke Videm
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway
- Department of Immunology and Transfusion Medicine, St Olavs Hospital Trondheim University Hospital, Trondheim, Trøndelag, Norway
| | - Jonas Johansson
- Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Troms, Norway
| | - Tom Ivar Lund Nilsen
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Trondheim, Trøndelag, Norway
| | - Arnulf Langhammer
- HUNT Research Centre, Department of Public Health and Nursing, Norwegian University of Science and Technology, Faculty of Medicine and Health Sciences, Levanger, Trøndelag, Norway
- Nord-Trøndelag Hospital Trust, Levanger, Norway, Levanger Hospital, Levanger, Trøndelag, Norway
| |
Collapse
|
2
|
Zhou Y, Zhu Y, Jin X, Zhang Y, Song J, Wu Z, Li Y, Yi J, Wang D, Hu M. Chroogomphus rutilus Regulates Bone Metabolism to Prevent Periodontal Bone Loss during Orthodontic Tooth Movement in Osteoporotic Rats. Nutrients 2023; 15:4906. [PMID: 38068764 PMCID: PMC10708235 DOI: 10.3390/nu15234906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 11/06/2023] [Accepted: 11/22/2023] [Indexed: 12/18/2023] Open
Abstract
Osteoporosis (OP) leads to the acceleration of tooth movement and aggravation of periodontal bone loss during orthodontic treatment. Chroogomphus rutilus (CR) is abundant in nutrients and demonstrates remarkable antioxidant and anti-inflammatory properties. In the present study, the components of CR, including 35.00% total sugar, 0.69% reducing sugar, 14.40% crude protein, 7.30% total ash, 6.10% crude fat, 0.51% total flavonoids, 1.94% total triterpenoids, 0.32% total sterol, 1.30% total saponins, 1.69% total alkaloids, and 1.02% total phenol, were first systematically examined, followed by an investigation into its regulatory effects on bone metabolism in order to mitigate bone loss during orthodontic tooth movement in osteoporotic rats. The results of the imaging tests revealed that CR treatment reduced periodontal bone loss and normalized tooth movement in the OP. In conjunction with analyses of intestinal flora and metabolomics, CR enhances the prevalence of anti-inflammatory genera while reducing the production of inflammatory metabolites. Meanwhile, CR reduced the levels of periodontal inflammatory factors, including TNF-α, IL-1β, and IL-6, by activating Wnt/β-catenin signaling, and promoted periodontal bone formation. These findings imply that CR is a potent supplementary therapy for controlling periodontal bone remodeling in patients with OP undergoing orthodontic treatment.
Collapse
Affiliation(s)
- Ying Zhou
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun 130021, China; (Y.Z.); (J.S.); (Z.W.); (Y.L.)
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Yanfeng Zhu
- School of Life Sciences, Jilin University, Changchun 130012, China; (Y.Z.); (X.J.)
| | - Xinghui Jin
- School of Life Sciences, Jilin University, Changchun 130012, China; (Y.Z.); (X.J.)
| | - Yongfeng Zhang
- Engineering Research Center of Chinese Ministry of Education for Edible and Medicinal Fungi, Jilin Agricultural University, Changchun 130118, China;
| | - Jiyu Song
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun 130021, China; (Y.Z.); (J.S.); (Z.W.); (Y.L.)
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Zhina Wu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun 130021, China; (Y.Z.); (J.S.); (Z.W.); (Y.L.)
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | - Yutong Li
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun 130021, China; (Y.Z.); (J.S.); (Z.W.); (Y.L.)
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| | | | - Di Wang
- School of Life Sciences, Jilin University, Changchun 130012, China; (Y.Z.); (X.J.)
- Engineering Research Center of Chinese Ministry of Education for Edible and Medicinal Fungi, Jilin Agricultural University, Changchun 130118, China;
| | - Min Hu
- Department of Orthodontics, Hospital of Stomatology, Jilin University, Changchun 130021, China; (Y.Z.); (J.S.); (Z.W.); (Y.L.)
- Jilin Provincial Key Laboratory of Tooth Development and Bone Remodeling, Changchun 130021, China
| |
Collapse
|
3
|
Yang JG, Sun B, Wang Z, Li X, Gao JH, Qian JJ, Li J, Wei WJ, Zhang P, Wang W. Exosome-targeted delivery of METTL14 regulates NFATc1 m6A methylation levels to correct osteoclast-induced bone resorption. Cell Death Dis 2023; 14:738. [PMID: 37957146 PMCID: PMC10643436 DOI: 10.1038/s41419-023-06263-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/24/2023] [Accepted: 10/31/2023] [Indexed: 11/15/2023]
Abstract
Osteoporosis has a profound influence on public health. First-line bisphosphonates often cause osteonecrosis of the jaw meanwhile inhibiting osteoclasts. Therefore, it is important to develop effective treatments. The results of this study showed that the increased level of NFATc1 m6A methylation caused by zoledronic acid (ZOL), with 4249A as the functional site, is highly correlated with the decreased bone resorption of osteoclasts. Upstream, METTL14 regulates osteoclast bone absorption through the methylation functional site of NFATc1. Downstream, YTHDF1 and YTHDF2 show antagonistic effects on the post-transcriptional regulation of NFATc1 after the m6A methylation level is elevated by METTL14. In this study, meRIP-Seq, luciferase reporter assays, meRIP and other methods were used to elucidate the NFATc1 regulatory mechanism of osteoclasts from the perspective of RNA methylation. In addition, EphA2 overexpression on exosomes is an effective biological method for targeted delivery of METTL14 into osteoclasts. Importantly, this study shows that METTL14 released by exosomes can increase the m6A methylation level of NFATc1 to inhibit osteoclasts, help postmenopausal osteoporosis patients preserve bone mass, and avoid triggering osteonecrosis of the jaw, thus becoming a new bioactive molecule for the treatment of osteoporosis.
Collapse
Affiliation(s)
- Jin-Gang Yang
- Department of Stomatology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, 200336, China
| | - Bao Sun
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Zheng Wang
- Concordia Institute for Information Systems Engineering, Concordia University, 1455 De Maisonneuve Blvd. W., Montreal, QC H3G 1M8, Canada
| | - Xing Li
- Department of Oral Maxillofacial-Head Neck Oncology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jia-Hui Gao
- Department of Ecology, College of Life Sciences, Henan Normal University, No. 46 Jianshe East Road, Xinxiang, Henan Province, 453007, China
| | - Jia-Jun Qian
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai, 200011, China
| | - Jiang Li
- Department of Oral Pathology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai, 200011, China.
| | - Wen-Jia Wei
- Department of Stomatology, Tongren Hospital, Shanghai Jiao Tong University School of Medicine, No. 1111 Xianxia Road, Shanghai, 200336, China.
| | - Ping Zhang
- Department of Oral and Maxillofacial Surgery, Affiliated Hospital of Stomatology, Nanjing Medical University, No. 136 Hanzhong Road, Nanjing, Jiangsu Province, 210029, China.
| | - Wei Wang
- Department of General Dentistry, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, No. 639 Zhizaoju Road, Shanghai, 200011, China.
| |
Collapse
|
4
|
Yin S, Du L, He Q, Pan Y, Li T, Ren X, Chen S, Zhang X. Walking more, not faster, is associated with bone health in China of community-dwelling older women:A cross-sectional study. Prev Med 2023; 175:107722. [PMID: 37783314 DOI: 10.1016/j.ypmed.2023.107722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/28/2023] [Accepted: 09/29/2023] [Indexed: 10/04/2023]
Abstract
AIMS To examine the association between daily steps and step intensity with bone health in Chinese community-dwelling older women. METHODS Data from 1116 women in the Physical Activity and Health in Older Women Study in China, 2021. Three bone parameters: bone quality index (BQI), speed of sound (SOS), and broadband ultrasound attenuation (BUA) were measured in the left heel using an ultrasound bone densitometer and transformed into dichotomous variables from medians. Daily steps and step intensity (slow step time, brisk step time, peak 1-min cadence, peak 30-min cadence, and peak 60-min cadence) were measured using a triaxial accelerometer. Participants with high BQI, SOS, and BUA levels were used as references for logistic regression models to explore the association of daily steps and step intensity with bone health. RESULTS Daily steps were positively associated with the BQI (odds ratio [OR] = 0.94, confidence interval [CI] = 0.89,1.00), SOS (OR = 0.93, CI = 0.88,0.99), and BUA (OR = 0.93, CI = 0.88,0.99) among older women. There was no significant association between peak cadence and bone health. Slow step time was positively associated with the BQI (OR = 0.94, CI = 0.90,0.99) and SOS (OR = 0.93, CI = 0.88,0.97), while brisk step time was positively associated with the BQI (OR = 0.89, CI = 0.82,0.97), SOS (OR = 0.87, CI = 0.80,0.94), and BUA (OR = 0.89, CI = 0.82,0.97). Moreover, 10,000 steps/day or more was significantly associated with the BQI (OR = 0.52, CI = 0.33,0.81), SOS (OR = 0.55, CI = 0.35,0.86), and BUA (OR = 0.45, CI = 0.28, 0.70) compared to <6000 steps/day. CONCLUSION Increasing the number of daily steps or the duration of walking, whether fast or slow, may benefit the bone health of older women.
Collapse
Affiliation(s)
- Shuting Yin
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China
| | - Litao Du
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China
| | - Qiang He
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China
| | - Yang Pan
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China
| | - Ting Li
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China
| | - Xiaoyu Ren
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China
| | - Si Chen
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, 44 West Wenhua Road, Lixia District, Jinan City, Shandong Province 250102, China
| | - Xianliang Zhang
- School of Physical Education, Shandong University, 17922 Jingshi Road, Lixia District, Jinan City, Shandong Province 250061, China.
| |
Collapse
|
5
|
Rashidi MM, Saeedi Moghaddam S, Azadnajafabad S, Heidari-Foroozan M, Hashemi SM, Mohammadi E, Esfahani Z, Ebrahimi N, Shobeiri P, Malekpour MR, Abbasi-Kangevari M, Rashedi S, Mohammadi Fateh S, Larijani B, Farzadfar F. Low bone mineral density, a neglected condition in North Africa and Middle East: estimates from the Global Burden of Disease Study, 1990-2019. Osteoporos Int 2023; 34:1577-1589. [PMID: 37217657 DOI: 10.1007/s00198-023-06778-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 04/25/2023] [Indexed: 05/24/2023]
Abstract
Due to the high prevalence of low bone mineral density in North Africa and Middle East region, estimating its attributable burden would help to a better understanding of this neglected condition for policymakers and health researchers. This study presented the number of attributable deaths has doubled from 1990 to 2019. PURPOSE This study provides the latest estimates of the burden of low bone mineral density (BMD) from 1990 to 2019 in North Africa and Middle East (NAME) region. METHODS The data were extracted from the global burden of disease (GBD) 2019 study to estimate epidemiological indices such as deaths, disability-adjusted life years (DALYs), and summary exposure value (SEV). SEV is a measure of the exposure of the population to a risk factor that considers the amount of exposure by the level of risk. RESULTS Our findings showed that in 1990-2019, the number of deaths and DALYs attributable to low BMD had almost doubled in the region and caused 20,371 (95% uncertainty intervals: 14,848-24,374) deaths and 805,959 (630,238-959,581) DALYs in 2019. However, DALYs and death rates showed a decreasing trend after age standardization. Saudi Arabia had the highest, and Lebanon had the lowest age-standardized DALYs rates in 2019, with rates of 434.2 (329.6-534.3) and 90.3 (70.6-112.1) per 100,000, respectively. The highest burden attributable to low BMD was in the 90-94 and over 95 age groups. Also, there was a decreasing trend in age-standardized SEV to low BMD for both sexes. CONCLUSION Despite the decreasing trend of age-standardized burden indices, considerable amounts of deaths and DALYs were attributable to low BMD, especially in the elderly population, in the region in 2019. As the positive effects of proper interventions will be detectable in the long term, robust strategies and comprehensive stable policies are the ultimate solutions to achieving desired goals.
Collapse
Affiliation(s)
- Mohammad-Mahdi Rashidi
- 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
- Kiel Institute for the World Economy, Kiel, Germany
| | - Sina Azadnajafabad
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Heidari-Foroozan
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Student Research Committee, School of Medicine, Shahid Beheshti 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
| | - Esmaeil Mohammadi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Neurological Surgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Zahra Esfahani
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Department of Biostatistics, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Narges Ebrahimi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, 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-Reza Malekpour
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohsen Abbasi-Kangevari
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Rashedi
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- Rajai Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Sahar Mohammadi Fateh
- Non-Communicable Diseases 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.
| | - Farshad Farzadfar
- 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
| |
Collapse
|
6
|
Zeelenberg ML, Den Hartog D, Panneman MJM, Polinder S, Verhofstad MHJ, Van Lieshout EMM. Trends in incidence, health care consumption, and costs for proximal femoral fractures in the Netherlands between 2000 and 2019: a nationwide study. Osteoporos Int 2023:10.1007/s00198-023-06774-y. [PMID: 37119329 PMCID: PMC10382328 DOI: 10.1007/s00198-023-06774-y] [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: 03/17/2023] [Accepted: 04/21/2023] [Indexed: 05/01/2023]
Abstract
This study evaluated the incidence rates and societal burden of hip fractures in The Netherlands. Although incidence in the elderly population is decreasing and hospital stay is at an all-time low, the burden of medical costs and crude numbers of proximal femoral fractures are still rising in our aging population. PURPOSE The aim of this nationwide study was to provide an overview of the incidence rate and economic burden of acute femoral neck and trochanteric fractures in The Netherlands. METHODS Data of patients who sustained acute proximal femoral fractures in the period January 1, 2000, to December 31, 2019, were extracted from the National Medical Registration of the Dutch Hospital Database. The incidence rate, hospital length of stay (HLOS), health care and lost productivity costs, and years lived with disability (YLD) were calculated for age- and sex-specific groups. RESULTS A total of 357,073 patients were included. The overall incidence rate increased by 22% over the 20-year study period from 16.4 to 27.1/100,000 person-years (py). The age-specific incidence rate in elderly > 65 years decreased by 16% (from 649.1 to 547.6/100,000 py). The incidence rate in men aged > 90 has surpassed the incidence rate in women. HLOS decreased in all age groups, hip fracture subtypes, and sexes from a mean of 18.5 to 7.2 days. The mean health care costs, over the 2015-2019 period, were lower for men (€17,723) than for women (€23,351) and increased with age to €26,639 in women aged > 80. Annual cumulative costs reached €425M, of which 73% was spent on women. CONCLUSION The total incidence of hip fractures in The Netherlands has increased by 22%. Although incidence in the elderly population is decreasing and HLOS is at an all-time low, the burden of medical costs and crude numbers of proximal femoral fractures are still rising in our aging population.
Collapse
Affiliation(s)
- M L Zeelenberg
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - D Den Hartog
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | | | - S Polinder
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M H J Verhofstad
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - E M M Van Lieshout
- Trauma Research Unit Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| |
Collapse
|
7
|
Wu L. INFLUENCE OF TAI CHI SOFTBALL ON BODY COMPOSITION AND BONE DENSITY. REV BRAS MED ESPORTE 2023. [DOI: 10.1590/1517-8692202329012022_0314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
ABSTRACT Introduction Tai Chi Softball fully reflects the most complete and coherent concept of Tai Chi exercise, round and smooth, natural and continuous, and is very suitable for the daily exercise of middle-aged and elderly people. Objective Explore the effect of Tai Chi Softball exercise on body shape and bone mineral density of middle-aged and elderly women. Methods 45 volunteers were recruited and divided into a Tai Chi Softball group and a control group; the Tai Chi Softball group was guided by professional trainers to perform Tai Chi Softball exercises for six months. The control group did not perform Tai Chi Softball exercises and tested various physical indicators for comparison. Results The weight and BMI of middle-aged and elderly women showed a decreasing trend. The abdominal and arm skinfold measurements were significantly different from those before the experiment (P < 0.01). Body fat percentage decreased significantly, and muscle weight increased, showing statistical significance (P < 0.05). Conclusion Tai Chi Softball exercise can alleviate the rapid decline in bone mineral density and bone mineral content in middle-aged and elderly women. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.
Collapse
|
8
|
Efficacy of Moxibustion for Primary Osteoporosis: A Trial Sequential Meta-Analysis of Randomized Controlled Trials. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2022; 2022:1268876. [PMID: 36204122 PMCID: PMC9532117 DOI: 10.1155/2022/1268876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 07/21/2022] [Accepted: 08/12/2022] [Indexed: 11/21/2022]
Abstract
Background Primary osteoporosis (PO) is a systemic metabolic skeletal disease. Previous studies have shown that moxibustion can reduce pain intensity and enhance response rate, bone mineral density (BMD), and living function of the patients with PO. However, consensus on its efficacy does not exist, and evidence of moxibustion for PO is also insufficient. Methods We searched five English and four Chinese databases with various additional sources and published reviews through December 1, 2021, to evaluate potentially concerned randomized controlled trials (RCTs). Two independent researchers addressed selection screening, data extraction, and risk of bias assessment. The data of this meta-analysis were analyzed using the RevMan v.5.4 software. Additionally, the trial sequential analysis v.0.9.5.10 β was used to estimate the sample size. In contrast, the quality of evidence from the RCTs was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation tool. Results The current meta-analysis included 14 RCTs containing 898 participants. The methodological quality of the RCTs was moderate. The review demonstrated that a combination of moxibustion and conventional medicine (CM) significantly reduced pain intensity and improved the BMD compared with CM. Furthermore, it was found that moxibustion plus CM/moxibustion could improve response rates compared with CM. However, it was found that the reduction of pain intensity and improvement of BMD by moxibustion showed no significant difference compared with CM. It was also evident that the sample size of most outcomes was inadequate. Moreover, all evidence obtained in this study was ranked as low to critically low. Conclusions In conclusion, it was demonstrated that moxibustion is a potentially effective agent for treating PO. However, high-quality studies should be implemented in the future because this study only obtained low-quality evidence. This study was registered in the PROSPERO platform (CRD42021291310).
Collapse
|
9
|
Li L, Li A, Zhu L, Gan L, Zuo L. Roxadustat promotes osteoblast differentiation and prevents estrogen deficiency-induced bone loss by stabilizing HIF-1α and activating the Wnt/β-catenin signaling pathway. J Orthop Surg Res 2022; 17:286. [PMID: 35597989 PMCID: PMC9124388 DOI: 10.1186/s13018-022-03162-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 05/03/2022] [Indexed: 02/08/2023] Open
Abstract
Background Osteoporosis is a very common skeletal disorder that increases the risk of fractures. However, the treatment of osteoporosis is challenging. Hypoxia-inducible factor-1α (HIF-1α) plays an important role in bone metabolism. Roxadustat is a novel HIF stabilizer, and its effects on bone metabolism remain unknown. This study aimed to investigate the effects of roxadustat on osteoblast differentiation and bone remodeling in an ovariectomized (OVX) rat model. Methods In vitro, primary mouse calvarial osteoblasts were treated with roxadustat. Alkaline phosphatase (ALP) activity and extracellular matrix mineralization were assessed. The mRNA and protein expression levels of osteogenic markers were detected. The effects of roxadustat on the HIF-1α and Wnt/β-catenin pathways were evaluated. Furthermore, osteoblast differentiation was assessed again after HIF-1α expression knockdown or inhibition of the Wnt/β-catenin pathway. In vivo, roxadustat was administered orally to OVX rats for 12 weeks. Then, bone histomorphometric analysis was performed. The protein expression levels of the osteogenic markers HIF-1α and β-catenin in bone tissue were detected. Results In vitro, roxadustat significantly increased ALP staining intensity, enhanced matrix mineralization and upregulated the expression of osteogenic markers at the mRNA and protein levels in osteoblasts compared with the control group. Roxadustat activated the HIF-1α and Wnt/β-catenin pathways. HIF-1α knockdown or Wnt/β-catenin pathway inhibition significantly attenuated roxadustat-promoted osteoblast differentiation. In vivo, roxadustat administration improved bone microarchitecture deterioration and alleviated bone loss in OVX rats by promoting bone formation and inhibiting bone resorption. Roxadustat upregulated the protein expression levels of the osteogenic markers, HIF-1α and β-catenin in the bone tissue of OVX rats. Conclusion Roxadustat promoted osteoblast differentiation and prevented bone loss in OVX rats. The use of roxadustat may be a new promising strategy to treat osteoporosis. Supplementary Information The online version contains supplementary material available at 10.1186/s13018-022-03162-w.
Collapse
Affiliation(s)
- Luyao Li
- Department of Nephrology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
| | - Afang Li
- Department of Nephrology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
| | - Li Zhu
- Department of Nephrology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
| | - Liangying Gan
- Department of Nephrology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China
| | - Li Zuo
- Department of Nephrology, Peking University People's Hospital, No. 11 Xizhimen South Street, Beijing, 100044, China.
| |
Collapse
|
10
|
Zhang W, Huang P, Lin J, Zeng H. The Role of Extracellular Vesicles in Osteoporosis: A Scoping Review. MEMBRANES 2022; 12:membranes12030324. [PMID: 35323799 PMCID: PMC8948898 DOI: 10.3390/membranes12030324] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/03/2022] [Accepted: 03/11/2022] [Indexed: 02/06/2023]
Abstract
As an insidious metabolic bone disease, osteoporosis plagues the world, with high incidence rates. Patients with osteoporosis are prone to falls and becoming disabled, and their cone fractures and hip fractures are very serious, so the diagnosis and treatment of osteoporosis is very urgent. Extracellular vesicles (EVs) are particles secreted from cells to the outside of the cell and they are wrapped in a bilayer of phospholipids. According to the size of the particles, they can be divided into three categories, namely exosomes, microvesicles, and apoptotic bodies. The diameter of exosomes is 30–150 nm, the diameter of microvesicles is 100–1000 nm, and the diameter of apoptotic bodies is about 50–5000 nm. EVs play an important role in various biological process and diseases including osteoporosis. In this review, the role of EVs in osteoporosis is systematically reviewed and some insights for the prevention and treatment of osteoporosis are provided.
Collapse
Affiliation(s)
- Weifei Zhang
- Department of Bone & Joint Surgery/National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen 518036, China;
| | - Pengzhou Huang
- National Cancer Center & Shenzhen Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shenzhen 518116, China;
| | - Jianjing Lin
- Arthritis Clinical and Research Center, Peking University People’s Hospital, Beijing 100044, China
- Department of Sports Medicine and Rehabilitation, Peking University Shenzhen Hospital, Shenzhen 518036, China
- Correspondence: (J.L.); (H.Z.)
| | - Hui Zeng
- Department of Bone & Joint Surgery/National & Local Joint Engineering Research Center of Orthopaedic Biomaterials, Peking University Shenzhen Hospital, Shenzhen 518036, China;
- Correspondence: (J.L.); (H.Z.)
| |
Collapse
|
11
|
ANTONESCU Oana-Raluca, SILIȘTEANU AE, RACHERIU M, MIHALACHE C. Assessment of the importance of physical activity and quality of life for patients diagnosed with osteoporosis during the COVID-19 pandemic. BALNEO AND PRM RESEARCH JOURNAL 2021. [DOI: 10.12680/balneo.2021.467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Introduction. Osteoporosis is one of the most important ten diseases worldwide, still causing extreme suffering to patients and huge costs to the health system. The rapid increase of the population 's aging was involved in many aspects of human health, and, among these ones, osteoporosis was one of the main public health issues.
The aim of the study was to assess the importance of physical activity and the quality of life in patients diagnosed with osteoporosis during the COVID-19 pandemic.
Material and methods. The study is longitudinal, it was conducted in an outpatient setting for a period of 1 year and it included 20 patients diagnosed with osteoporosis. The demographic variables (age, living environment, body mass index) were assessed, and as parameters: pain (VAS scale), fracture risk (FRAX score), quality of life (Qualeffo-41 questionnaire), bone mineral density at the spine and at the femur (DEXA). The patients received pharmacological treatment such as bisphosphonates and underwent physiotherapy for pains: low frequency currents (TENS), ultrasound and physical therapy.
Results and discussions. In all the studied cases, it was considered that the pain decreased following the use of the medicinal and physiotherapeutic treatment. This is an expected result given that other studies have shown this. Postmenopausal women in Romania with osteoporosis have a lower HRQoL than healthy controls, measured with the SF-36 instrument and the total QUALEFFO-41 score.
Conclusions. The obtained data point out the correlation between bone mineral density, fracture risks and exercises in patients diagnosed with osteoporosis. The FRAX score is useful to identify patients who need the combination of drug therapy and exercises to prevent vertebral and non-vertebral fractures in the next 10 years.
Keywords: osteoporosis, physical activity, quality of life, COVID-19,
Collapse
Affiliation(s)
- ANTONESCU Oana-Raluca
- County Clinical Emergency Hospital, 2-4 Corneliu Coposu Str., 550245, Sibiu, Romania
| | | | - Mihaela RACHERIU
- Lucian Blaga University of Sibiu, Faculty of Medicine, 2A Lucian Blaga Str., 550169, Sibiu, Romania
| | - Cosmin MIHALACHE
- Lucian Blaga University of Sibiu, Faculty of Medicine, 2A Lucian Blaga Str., 550169, Sibiu, Romania
| |
Collapse
|