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Maus I, Dreiner M, Zetzsche S, Metzen F, Ross BC, Mählich D, Koch M, Niehoff A, Wirth B. Osteoclast-specific Plastin 3 knockout in mice fail to develop osteoporosis despite dramatic increased osteoclast resorption activity. JBMR Plus 2024; 8:ziad009. [PMID: 38549711 PMCID: PMC10971598 DOI: 10.1093/jbmrpl/ziad009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/11/2023] [Accepted: 11/26/2023] [Indexed: 05/07/2024] Open
Abstract
PLS3 loss-of-function mutations in humans and mice cause X-linked primary osteoporosis. However, it remains largely unknown how PLS3 mutations cause osteoporosis and which function PLS3 plays in bone homeostasis. A recent study showed that ubiquitous Pls3 KO in mice results in osteoporosis. Mainly osteoclasts were impacted in their function However, it has not been proven if osteoclasts are the major cell type affected and responsible for osteoporosis development in ubiquitous Pls3 KO mice. Here, we generated osteoclast-specific Pls3 KO mice. Additionally, we developed a novel polyclonal PLS3 antibody that showed specific PLS3 loss in immunofluorescence staining of osteoclasts in contrast to previously available antibodies against PLS3, which failed to show PLS3 specificity in mouse cells. Moreover, we demonstrate that osteoclast-specific Pls3 KO causes dramatic increase in resorptive activity of osteoclasts in vitro. Despite these findings, osteoclast-specific Pls3 KO in vivo failed to cause any osteoporotic phenotype in mice as proven by micro-CT and three-point bending test. This demonstrates that the pathomechanism of PLS3-associated osteoporosis is highly complex and cannot be reproduced in a system singularly focused on one cell type. Thus, the loss of PLS3 in alternative bone cell types might contributes to the osteoporosis phenotype in ubiquitous Pls3 KO mice.
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Affiliation(s)
- Ilka Maus
- Institute of Human Genetics, University of Cologne, University Hospital of Cologne, 50931 Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
| | - Maren Dreiner
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, 50933 Cologne, Germany
| | - Sebastian Zetzsche
- Institute of Human Genetics, University of Cologne, University Hospital of Cologne, 50931 Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
| | - Fabian Metzen
- Medical Faculty, Institute for Dental Research and Oral Musculoskeletal Biology, University of Cologne, 50931 Cologne, Germany
- Medical Faculty, Center for Biochemistry, University of Cologne, 50931 Cologne, Germany
| | - Bryony C Ross
- Institute of Human Genetics, University of Cologne, University Hospital of Cologne, 50931 Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
| | - Daniela Mählich
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, 50933 Cologne, Germany
| | - Manuel Koch
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
- Medical Faculty, Institute for Dental Research and Oral Musculoskeletal Biology, University of Cologne, 50931 Cologne, Germany
- Medical Faculty, Center for Biochemistry, University of Cologne, 50931 Cologne, Germany
| | - Anja Niehoff
- Institute of Biomechanics and Orthopaedics, German Sport University Cologne, 50933 Cologne, Germany
- Faculty of Medicine, Cologne Center for Musculoskeletal Biomechanics (CCMB), University of Cologne, 50931 Cologne, Germany
| | - Brunhilde Wirth
- Institute of Human Genetics, University of Cologne, University Hospital of Cologne, 50931 Cologne, Germany
- Center for Molecular Medicine Cologne, University of Cologne, 50931 Cologne, Germany
- Center for Rare Diseases, University of Cologne, University Hospital of Cologne, 50931 Cologne, Germany
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Amarnath SS, Kumar V, Das SL. Classification of Osteoporosis. Indian J Orthop 2023; 57:49-54. [PMID: 38107823 PMCID: PMC10721754 DOI: 10.1007/s43465-023-01058-3] [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: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 12/19/2023]
Abstract
Osteoporosis is defined by low bone quality, strength and increased fracture risk. Primary and secondary osteoporosis are the two forms of osteoporosis classified on the basis of factors affecting the metabolism of bone. Primary osteoporosis develops as a result of aging or menopause-related bone demineralization. Type I/postmenopausal and type II/senile osteoporosis are two subtypes of primary osteoporosis. Secondary osteoporosis is due to pathological conditions and medications other than aging and menopause that lead to deprivation of bone mass and elevated fracture risk. Classification of osteoporosis based on BMD testing with DEXA devised by the World Health Organization utilizes T-score in BMD reporting of women in menopausal transition or postmenopause and men ≥ 50 years. Z-scores are preferred, while BMD reporting in premenopausal women, adults < 50 years of age, and children. BMD alone is not diagnostic of osteoporosis in men < 50 years. The Fracture Risk Assessment Tool Model (FRAX) is a software algorithm that incorporates significant predictors of fracture risk and BMD in individuals to predict the risk of fracture. FRAX predicts the "10-year probability of a major fracture (hip, clinical spine, humerus, or wrist fracture) and the 10-year probability of a hip fracture".
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Affiliation(s)
- S. S. Amarnath
- Trauma and Orthopedic Surgeon, Trinity Central Hospital, Bangalore, India
| | - Vishal Kumar
- Department of Orthopedics, PGIMER, Chandigarh, India
| | - S. Lakshmana Das
- Department of Orthopedics, All India Institute of Medical Sciences, Bathinda, India
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Barik S, Kumar V. Male Osteoporosis and Frailty. Indian J Orthop 2023; 57:237-244. [PMID: 38107814 PMCID: PMC10721747 DOI: 10.1007/s43465-023-01027-w] [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: 08/29/2023] [Accepted: 10/12/2023] [Indexed: 12/19/2023]
Abstract
It is estimated that 50% women and 20% of men over the age of 50 years will have an osteoporosis-related fracture in their remaining life. Although, Osteoporosis is generally thought to be a disease affecting females, more than a third of hip fractures occur in males due to reduced bone strength. Along with Osteoporosis, the other pathological process which occurs simultaneously is Sarcopenia. It is defined as age-related atrophy of skeletal muscle mass that reduces muscle strength, function, and quality of life. This chapter discusses the various aspects of the disease process in the males including its classification, clinical features, diagnosis and treatment.
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Affiliation(s)
- Sitanshu Barik
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, India
| | - Vishal Kumar
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, India
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Barik S, Raj V, Munshi BD, Rajput O, Prajapati S, Prasad SG, Kumar A. Development and Validation of India-specific Hindi Version of Osteoporosis Knowledge Assessment Tool. J Midlife Health 2023; 14:252-256. [PMID: 38504733 PMCID: PMC10946677 DOI: 10.4103/jmh.jmh_219_22] [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: 11/18/2022] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/21/2024] Open
Abstract
Purpose Patient education is one of the important components of reducing the morbidity of osteoporosis. The aim of this study is to validate the Hindi version of the Osteoporosis Knowledge Assessment Tool (OKAT-H) among a hospital-based sample in the age group of 18-44 years of age. Methods The study was conducted in two phases - translation and adaption of the OKAT in Hindi followed by its validation. The translated tool was analyzed by Flesch reading ease, McNemar test, Cronbach alpha, difficulty index, discrimination index, and principal factor analysis. Results Two hundred and sixty women with a mean age of 28.3 ± 17.2 years were enrolled in the study. The mean score of the OKAT-H tool obtained in the study was 11.3 ± 2.1. A significant difference was noted in the scores based on educational qualification or with any family history of either osteoporosis or fracture (P < 0.05). The Flesch score for the OKAT-H tool was 86. Inter-item correlation for all the items ranged between 0.15 and 0.5. The Cronbach's alpha measured 0.892 suggesting high internal consistency. Items number 6, 7, 8, 9, 13, and 14 showed a significant difference on the McNemar test questioning its consistency on test-retest. Conclusion A new shorter version of the tool may be developed since six items showed low consistency. The use of such an instrument in local language would help spread awareness about the disease as well as help the population in adopting osteoprotective strategies and also to seek help and advice regarding treatment.
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Affiliation(s)
- Sitanshu Barik
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Vikash Raj
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Boudhayan Das Munshi
- Department of General Medicine, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Ojasvi Rajput
- Department of Mathematics and Statistics, Indian Institute of Technology, Kanpur, Uttar Pradesh, India
| | - Shivji Prajapati
- Department of Orthopedics, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Sant Guru Prasad
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
| | - Ashish Kumar
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, Jharkhand, India
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Aggarwal V, Muthukrishnan J, Manrai M, Chauhan P, Vasdev V. The prevalence of osteoporosis and its association with serum testosterone and serum vitamin D in the elderly male population: A cross-sectional study. Med J Armed Forces India 2023; 79:189-193. [PMID: 36969120 PMCID: PMC10037054 DOI: 10.1016/j.mjafi.2021.03.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 03/21/2021] [Indexed: 11/17/2022] Open
Abstract
Background Male osteoporosis is under-diagnosed and poorly studied. With the ageing population, osteoporotic fracture in men is an emerging health problem. The aim of this study was to study the prevalence of osteoporosis and its association with serum testosterone and serum vitamin D in elderly men (>60 years old) attending the outpatient department (OPD). Methods An observational cross-sectional study was performed in elderly men (>60 years old) attending OPD of a tertiary care hospital of Western Maharashtra between April 2017 and June 2019. Patients with rheumatological disorders, history of vertebral/femoral fractures, chronic kidney disease, chronic liver disease, thyroid disorders and alcohol dependence were excluded. Data were analysed using the chi-square test and descriptive statistics. Results In total, 408 male patients were included. The mean age was 68.33 years. Osteoporosis was seen in 39.5% of patients (161/408) with a T score of ≤2.5. Osteopenia was noted in 48.3% of patients (197/408). T and Z scores had significant correlation (p = <0.001). Only 12% of elderly men had normal bone mineral density score. Serum testosterone, chronic obstructive pulmonary disease (COPD) and benign prostatic hypertrophy (BPH) were significantly associated with male osteoporosis with a p-value of 0.019, 0.016 and 0.010, respectively. Vitamin D levels, type 2 diabetes mellitus, hypertension and coronary artery disease did not show any significant association with male osteoporosis. Conclusion Osteoporosis was noted in 39.5% of the elderly men. In addition, decreased testosterone, COPD and BPH were significantly associated with male osteoporosis. It is important to screen elderly men to diagnose osteoporosis early and prevent osteoporotic fractures.
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Affiliation(s)
- Vivek Aggarwal
- Associate Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, India
| | - J. Muthukrishnan
- Senior Adviser (Medicine & Endocrinology), Base Hospital, Delhi Cantt, India
| | - Manish Manrai
- Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, India
| | | | - Vivek Vasdev
- Professor & Head, Department of Geriatric Medicine, Armed Forces Medical College, Pune, India
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Babu LK, Ghosh D. Looking at Mountains: Role of Sustained Hypoxia in Regulating Bone Mineral Homeostasis in Relation to Wnt Pathway and Estrogen. Clin Rev Bone Miner Metab 2022. [DOI: 10.1007/s12018-022-09283-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Wang Y, Zhang Y, Zhao L, Wang G, Yang C, Zhao C, Zhao W. Prevalence and Distribution of Osteopenia in Chinese Population: A System Review and Meta-Analysis. IRANIAN JOURNAL OF PUBLIC HEALTH 2022; 51:2435-2448. [PMID: 36561255 PMCID: PMC9745407 DOI: 10.18502/ijph.v51i11.11161] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2022] [Accepted: 04/18/2022] [Indexed: 11/21/2022]
Abstract
Background The number of patients with osteoporosis ranks first in the world in China and as a precursor state of osteoporosis, the number and incidence of osteopenia are much higher than that of osteoporosis. This meta-analysis was conducted to evaluate the incidence and distribution of osteopenia in adults in mainland of China over 10 years to provides reference for the early prevention of osteoporosis and policymaking. Methods Relevant data were extracted from the databases including CNKI, Wanfang, VIP, Web of Science, PubMed, EMBASE, and Medline about the surveys on osteoporosis and bone loss from 2010 to 2021 by searching. The random effects model was adopted for Meta-analysis, and the funnel plot was used to test publication bias. Results Forty-seven literatures were included in this study, covering 27 provinces and 38 regions in the mainland of China, with the study of 135,688 cases, showing that the prevalence of osteopenia in adults in the past decade was 28.3%(95% CI 24-33%), aged 40∼60 yr old, reaching the highest level. The incidence of osteopenia in males was higher than that in females (P<0.05), without significant difference in south and north China. Conclusion There is a large population with osteopenia in China, especially middle-aged population, both men and women should pay attention to osteopenia to delay its further progression.
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Affiliation(s)
- Yanpeng Wang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Yinzhen Zhang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Lanbo Zhao
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Guochen Wang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Chengan Yang
- Department of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, China
| | - Changwei Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, China
| | - Wenhai Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, China,Corresponding Author:
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Su CH, Chen YC, Yang YH, Wang CY, Ko PW, Huang PJ, Liaw CC, Liao WL, Cheng TL, Lee DY, Lo LC, Hsieh CL. Effect of the traditional Chinese herb Helminthostachys zeylanica on postsurgical recovery in patients with ankle fracture: A double-blinded randomized controlled clinical trial. JOURNAL OF ETHNOPHARMACOLOGY 2022; 295:115435. [PMID: 35671862 DOI: 10.1016/j.jep.2022.115435] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 05/24/2022] [Accepted: 06/01/2022] [Indexed: 06/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Helminthostachys zeylanica (HZ), which is also called "Dao-Di-U-Gon" in Taiwan, has anti-inflammatory and antiedema effects and is commonly used to treat edema in patients with fractures. The ugonin K component of HZ can induce osteogenesis and promote bone mineralization, its therapeutic effect, however, its therapeutic effect remains unclear. Therefore, the purpose of the present study was to investigate the effect of HZ on functional recovery in patients with ankle fractures requiring surgical treatment. METHODS A double-blinded, randomized, controlled study was conducted. A total of 45 patients with ankle fractures requiring surgical treatment were assigned to either the control group (n = 23 patients), which received the oral administration of HZ placebo 1.0 g t.i.d. for 42 days continuously, or to the treatment group (22 patients), which received HZ for 42 days. RESULTS The serum amino-terminal propeptide of type 1 procollagen (PINP) levels were similar in the first assessment (V1) between the control (45.90 ± 16.31 ng/mL) and treatment groups (52.61 ± 21.02 ng/mL; p = 0.240); the differences in PINP level between the third assessment (V3) and V1 were greater in the treatment group (35.84 ± 24.56 ng/mL) than in the control group (16.34 ± 11.97 ng/mL; p = 0.002). Radiographic healing time (RHT) was 9.09 ± 1.15 weeks in the treatment group, which was shorter than the 9.91 ± 0.79 weeks (p = 0.012) in the control group. CONCLUSION Oral administration of HZ for 42 days can increase serum PINP level and reduce the RHT. Therefore, HZ can be used to treat patients with ankle fractures requiring surgical treatment. However, a larger sample size is needed in future studies.
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Affiliation(s)
- Chin-Horng Su
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan; Orthopaedic Department, Yuan-Lin Christian Hospital, Changhua County, 510, Taiwan.
| | - Ya-Chih Chen
- Nursing Department, Yuan-Lin Christian Hospital, Changhua County, 510, Taiwan.
| | - Ya-Hui Yang
- Nursing Department, Yuan-Lin Christian Hospital, Changhua County, 510, Taiwan.
| | - Chun-Yi Wang
- Orthopaedic Department, Yuan-Lin Christian Hospital, Changhua County, 510, Taiwan.
| | - Po-Wei Ko
- Orthopaedic Department, Yuan-Lin Christian Hospital, Changhua County, 510, Taiwan.
| | - Peng-Ju Huang
- Orthopedic Department, Kaohsiung Medical University Hospital, Kaohsiung, 80708, Taiwan.
| | - Chih-Chuang Liaw
- Department of Marine Biotechnology and Resources, National Sun Yat-sen University, Kaohsiung, 804, Taiwan.
| | - Wen-Ling Liao
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
| | - Tsung-Lin Cheng
- Institute of Statistics and Information Science, National Changhua University of Education, Taiwan.
| | - Der-Yen Lee
- Graduate Institute of Integrated Medicine, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan.
| | - Lun-Chien Lo
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan; Department of Chinese Medicine, China Medical University Hospital, Taichung, 40447, Taiwan.
| | - Ching-Liang Hsieh
- Department of Chinese Medicine, China Medical University Hospital, Taichung, 40447, Taiwan; Graduate Institute of Acupuncture Science, College of Chinese Medicine, China Medical University, Taichung, 40402, Taiwan; Chinese Medicine Research Center, China Medical University, Taichung, 40402, Taiwan.
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Kalia M, Chaturvedi R, Rohilla R, Grover PK, Goel NK, Dalal M, Kaur R. Prevalence and predictors of low bone mineral density among adults aged 50 years and above in Chandigarh, India. J Family Med Prim Care 2022; 11:5231-5235. [PMID: 36505648 PMCID: PMC9731050 DOI: 10.4103/jfmpc.jfmpc_2179_21] [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: 11/03/2021] [Revised: 02/17/2022] [Accepted: 02/21/2022] [Indexed: 11/06/2022] Open
Abstract
Background Osteoporosis, defined as skeletal disorder characterized by reduced bone density and strength, is prevalent in both developing and developed countries. Dual energy X-ray absorptiometry (DEXA) is an effective tool to diagnose low bone mineral density (BMD). Objective This study objective was to know the prevalence and predictors of low BMD in a community-based screening program among the adult population using DEXA scan. Methods In this community-based study conducted between January and June 2016, a population-based screening program was offered to both males and females of age 50 years and above. BMD was measured to derive T-scores and classify as normal, osteopenic, and osteoporotic individuals. Results A total of 455 subjects were enrolled where 62.4% proportion was women; 42.6% subjects were in the age group of 50 to 59 years. The prevalence of osteoporosis and osteopenia was 20.9% and 48.1%, respectively. Hypertension (23.7%) and diabetes (8.4%) were common comorbidities. Age and gender (female) were independent predictors of low BMD. Conclusion Osteoporosis/osteopenia is present in both genders with increasing trend with age advancement. Institution of timely screening will prevent the morbidity associated with fractures due to low BMD.
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Affiliation(s)
- Meenu Kalia
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Ruchi Chaturvedi
- Department of Community Medicine, Gian Sagar Medical College and Hospital, Patiala, Punjab, India
| | - Ravi Rohilla
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Parneet K. Grover
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India,Address for correspondence: Dr. Parneet K. Grover, Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India. E-mail:
| | - Naveen K. Goel
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Manjesh Dalal
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
| | - Ravneet Kaur
- Department of Community Medicine, Govt. Medical College and Hospital, Chandigarh, India
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Imran M, Singh A, Bhardwaj A, Agrawal D. Prevalence of Osteoporosis and Associated Risk Factors among Postmenopausal Women: A Cross-Sectional Study from Northern India. J Midlife Health 2022; 13:206-212. [PMID: 36950199 PMCID: PMC10025819 DOI: 10.4103/jmh.jmh_114_22] [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: 06/23/2022] [Revised: 07/11/2022] [Accepted: 08/18/2022] [Indexed: 01/28/2023] Open
Abstract
Context Prevalence statistics of postmenopausal osteoporosis and knowledge regarding its independent predictors are lacking, especially in India, where every third woman and every eighth man is suffering from it. Aim This study aims to investigate the prevalence of osteoporosis and associated risk factors among postmenopausal women. Study Settings and Design This was a hospital-based prospective cross-sectional study. Methods This study was carried out among postmenopausal women, who attended orthopaedics outpatient department from August 2020 to July 2021 and 587 women ranging in age between 50 and 80 years who had confirmed menopause were enrolled for the study. Finally, 539 women were recommended for bone mineral density testing, using dual energy X-ray absorptiometry. Statistical Analysis To analyze the differences between the groups, a Chi-square and Student's t-test were used for the categorical and continuous variables, respectively. P < 0.05 was considered to show significant associations. Results In our study, 54.7% of subjects belonged to <60 years of age group. Half of the subjects (51.9%) were illiterate. 37.7% of subjects were having 6 or more children. 14.5% of subjects were currently smoking or chewing tobacco. Age of menopause among 38.0% of subjects was after 50 years of age and duration of menopause at the time of enrolment in the study was more than 10 years in 48.8% of subjects. The prevalence of osteoporosis increased with the increase in the parity and increased number of abortions. Subjects with family history of symptoms related to osteoporosis, and fragility fracture; and self-history of fragility fracture had higher prevalence of osteoporosis (P < 0.05). Conclusion In our study, the overall prevalence of osteoporotic fractures among postmenopausal females was 82.2% (osteoporosis: 37.5% and osteopenia: 44.7%). The findings of current study and previous studies clearly indicate the urgent need of collective efforts towards the growing problem of osteoporosis in postmenopausal women.
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Affiliation(s)
- Mohammad Imran
- Department of Pharmacology, Maharaja Jitendra Narayan Medical College and Hospital, Cooch Behar, West Bengal, India
| | - Abhishek Singh
- Department of Community Medicine, SHKM Government Medical College, Mewat, Haryana, India
| | - Anu Bhardwaj
- Department of Community Medicine, Dr. BR Ambedkar Institute of Medical Sciences, Mohali, Punjab, India
| | - Deepika Agrawal
- Department of Community Medicine, Santosh Medical College, Ghaziabad, Uttar Pradesh, India
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Closed-wedge high tibial osteotomy is more advantageous to maintain the correction than open-wedge high tibial osteotomy in osteopenic patients. Knee Surg Sports Traumatol Arthrosc 2022; 31:1563-1570. [PMID: 35635568 DOI: 10.1007/s00167-022-07006-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 05/08/2022] [Indexed: 10/18/2022]
Abstract
PURPOSE To compare the incidence of correction loss and survival rate between closed-wedge and open-wedge high tibial osteotomies (CWHTO and OWHTO, respectively) in patients with osteopenic and normal bone. METHODS Retrospective review was conducted for 115 CWHTOs and 119 OWHTOs performed in osteopenic patients [- 2.5 < Bone mineral density (BMD) T scores ≤ - 1] and 136 CWHTOs and 138 OWHTOs performed in normal patients (BMD T score > - 1) from 2012 to 2019. Demographics were not different between CW- and OWHTOs in osteopenic and normal patients (n.s., respectively). Radiographically, the mechanical axis (MA), medial proximal tibial angle (MPTA), and posterior tibial slope (PTS) were evaluated pre- and postoperatively (2 weeks after HTO). The occurrence of hinge fractures was investigated using radiographs taken on the operation day. The correction change was calculated as the last follow-up value minus postoperative MPTA. Correction loss was defined when the correction change was ≥ 3°. The survival rate (failure: correction loss) was investigated. RESULTS There were no significant differences in the pre and postoperative MA, MPTA, PTS, and value changes between CW- and OWHTOs in osteopenic and normal patients (n.s., respectively); the incidence of unstable hinge fractures also did not differ significantly (CWHTO vs. OWHTO = 7 vs. 7.6% in osteopenic patients; 2.9 vs. 3.6% in normal patients; n.s., respectively). The average correction change (CWHTO = - 0.6°, OWHTO = - 1.3°, p = 0.007), incidence of correction loss (CWHTO = 1.7%, OWHTO = 9.2%, p = 0.019), and 5-year survival rates (CWHTO = 98.3%, OWHTO = 90.8%, p = 0.013) differed significantly in osteopenic patients; there were no significant differences in these results in normal patients (n.s., respectively). CONCLUSION CWHTO was more advantageous than OWHTO regarding the correction loss in osteopenic patients. Intra- and postoperative care that consider poor bone quality will be required when performing OWHTOs in osteopenic patients. LEVEL OF EVIDENCE III.
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Bibliometric Analysis of Global Research Productivity on Vitamin D and Bone Metabolism (2001-2020): Learn from the Past to Plan Future. Nutrients 2022; 14:nu14030542. [PMID: 35276901 PMCID: PMC8838326 DOI: 10.3390/nu14030542] [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: 12/14/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 02/04/2023] Open
Abstract
Vitamin D has long been known for preserving bone and non-skeletal health. Despite its magnitude of impact, scarce literature has explored the evolution of the relevant published literature. This study aimed at evaluating the trends and performance of Vitamin D and bone metabolism-related publications (2001−2020). All pertinent English language 16,887 articles were searched and extracted from the Web of Science (WoS) database and “R-Bibliometrix” was used for comprehensive analysis. Around 60,149 authors contributed from 114 countries, showing the USA on top with >1/4th of all articles, followed by Japan, China, and the United Kingdom. For authors, Cooper C, Dawson-Hughes B, and Holick MF were found to have written the most articles, citations and highest h-index, respectively. Corresponding authors from the top 20 countries collectively were responsible for around 84% of the articles. Among 2735 sources, Osteoporosis International (632), Journal of Bone and Mineral Research (569), and Bone (448) were foremost. Most prominent sources showed recent declining contributions. The increasing trend of publications with a higher spike from 2008 to 2014, followed by a gradual increase till 2017, was observed. Leading countries, affiliations, and authors showed collaborative publications and were mostly from developed countries with limited contributions, particularly from low- and middle-income countries.
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THE EFFECT OF COMBINED ANTIHYPERTENSIVE THERAPY ON THE CONDITION OF THE ARTERIAL WALL IN WOMEN WITH ARTERIAL HYPERTENSION AND POSTMENOPAUSAL OSTEOPOROSIS. WORLD OF MEDICINE AND BIOLOGY 2022. [DOI: 10.26724/2079-8334-2022-4-82-26-31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Vallibhakara SAO, Nakpalat K, Sophonsritsuk A, Tantitham C, Vallibhakara O. Effect of Vitamin E Supplement on Bone Turnover Markers in Postmenopausal Osteopenic Women: A Double-Blind, Randomized, Placebo-Controlled Trial. Nutrients 2021; 13:nu13124226. [PMID: 34959779 PMCID: PMC8709036 DOI: 10.3390/nu13124226] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Revised: 11/19/2021] [Accepted: 11/22/2021] [Indexed: 12/24/2022] Open
Abstract
Vitamin E is a strong anti-oxidative stress agent that affects the bone remodeling process. This study evaluates the effect of mixed-tocopherol supplements on bone remodeling in postmenopausal osteopenic women. A double-blinded, randomized, placebo-controlled trial study was designed to measure the effect of mixed-tocopherol on the bone turnover marker after 12 weeks of supplementation. All 52 osteopenic postmenopausal women were enrolled and allocated into two groups. The intervention group received mixed-tocopherol 400 IU/day, while the control group received placebo tablets. Fifty-two participants completed 12 weeks of follow-up. Under an intention-to-treat analysis, vitamin E produced a significant difference in the mean bone resorption marker (serum C-terminal telopeptide of type I collagen (CTX)) compared with the placebo group (-0.003 ± 0.09 and 0.121 ± 0.15, respectively (p < 0.001)). In the placebo group, the CTX had increased by 35.3% at 12 weeks of supplementation versus baseline (p < 0.001), while, in the vitamin E group, there was no significant change of bone resorption marker (p < 0.898). In conclusion, vitamin E (mixed-tocopherol) supplementation in postmenopausal osteopenic women may have a preventive effect on bone loss through anti-resorptive activity.
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Affiliation(s)
- Sakda Arj-Ong Vallibhakara
- Faculty of Medicine, Bangkokthonburi University, Bangkok 10170, Thailand;
- Child Safety Promotion and Injury Prevention Research Center, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand
| | - Katanyuta Nakpalat
- Woman Health Centre, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok 10210, Thailand;
| | - Areepan Sophonsritsuk
- Reproductive, Endocrinology & Infertility Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.S.); (C.T.)
| | - Chananya Tantitham
- Reproductive, Endocrinology & Infertility Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.S.); (C.T.)
| | - Orawin Vallibhakara
- Reproductive, Endocrinology & Infertility Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand; (A.S.); (C.T.)
- Correspondence:
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Salari N, Ghasemi H, Mohammadi L, Behzadi MH, Rabieenia E, Shohaimi S, Mohammadi M. The global prevalence of osteoporosis in the world: a comprehensive systematic review and meta-analysis. J Orthop Surg Res 2021; 16:609. [PMID: 34657598 PMCID: PMC8522202 DOI: 10.1186/s13018-021-02772-0] [Citation(s) in RCA: 221] [Impact Index Per Article: 73.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 10/04/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Osteoporosis affects all sections of society, including families with people affected by osteoporosis, government agencies and medical institutes in various fields. For example, it involves the patient and his/her family members, and government agencies in terms of the cost of treatment and medical care. Providing a comprehensive picture of the prevalence of osteoporosis globally is important for health policymakers to make appropriate decisions. Therefore, this study was conducted to investigate the prevalence of osteoporosis worldwide. METHODS A systematic review and meta-analysis were conducted in accordance with the PRISMA criteria. The PubMed, Science Direct, Web of Science, Scopus, Magiran, and Google Scholar databases were searched with no lower time limit up till 26 August 2020. The heterogeneity of the studies was measured using the I2 test, and the publication bias was assessed by the Begg and Mazumdar's test at the significance level of 0.1. RESULTS After following the systematic review processes, 86 studies were selected for meta-analysis. The sample size of the study was 103,334,579 people in the age range of 15-105 years. Using meta-analysis, the prevalence of osteoporosis in the world was reported to be 18.3 (95% CI 16.2-20.7). Based on 70 studies and sample size of 800,457 women, and heterogenicity I2: 99.8, the prevalence of osteoporosis in women of the world was reported to be 23.1 (95% CI 19.8-26.9), while the prevalence of osteoporosis among men of the world was found to be 11.7 (95% CI 9.6-14.1 which was based on 40 studies and sample size of 453,964 men.). The highest prevalence of osteoporosis was reported in Africa with 39.5% (95% CI 22.3-59.7) and a sample size of 2989 people with the age range 18-95 years. CONCLUSION According to the medical, economic, and social burden of osteoporosis, providing a robust and comprehensive estimate of the prevalence of osteoporosis in the world can facilitate decisions in health system planning and policymaking, including an overview of the current and outlook for the future; provide the necessary facilities for the treatment of people with osteoporosis; reduce the severe risks that lead to death by preventing fractures; and, finally, monitor the overall state of osteoporosis in the world. This study is the first to report a structured review and meta-analysis of the prevalence of osteoporosis worldwide.
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Affiliation(s)
- Nader Salari
- Department of Biostatistics, School of Health, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hooman Ghasemi
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Loghman Mohammadi
- Department of Statistics, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Mohammad hasan Behzadi
- Department of Statistics, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Elham Rabieenia
- Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shamarina Shohaimi
- Department of Biology, Faculty of Science, University Putra Malaysia, Serdang, Selangor Malaysia
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
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Lee SJ, Lee JH, Lee HJ, Oh JW, Park IH. Pullout strength of pedicle screws using cadaveric vertebrae with or without artificial demineralization. Spine J 2021; 21:1580-1586. [PMID: 33872804 DOI: 10.1016/j.spinee.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To evaluate the differences in the pullout strength and displacement of pedicle screws in cadaveric thoracolumbar vertebrae with or without artificial demineralization. METHODS Five human lumbar and five thoracic vertebrae from one cadaver were divided into two hemivertebrae. The left-side specimens were included in the simulated osteopenic model group and the right-side bones in a control group. In the model group, we immersed each specimen in HCl (1 N) solution for 40 minutes. We measured bone mineral density (BMD) using dual-energy X-ray absorptiometry and quantitative computerized tomography. We inserted polyaxial pedicle screws into the 20 pedicles of the cadaveric lumbar and thoracic spine after measuring the BMD of the 2 hemivertebrae of each specimen. We measured the pullout strength and displacement of the screws before failure in each specimen using an Instron system. RESULTS The average pullout strength of the simulated osteopenic model group was 76% that of the control group. In the control and model groups, the pullout strength was 1678.87±358.96 N and 1283.83±341.97 N, respectively, and the displacement was 2.07±0.34 mm and 2.65±0.50 mm, respectively (p<.05). We detected positive correlations between pullout strength and BMD in the control group and observed a negative correlation between displacement and BMD in the model group. CONCLUSIONS By providing an anatomically symmetric counterpart, the human cadaveric model with or without demineralization can be used as a test bed for pullout tests of the spine. In the simulated osteopenic model group, pullout strength was significantly decreased compared with the untreated control group. CLINICAL SIGNIFICANCE Decreased bone mineral density may significantly reduce the pullout strength of a pedicle screw, even though the range is osteopenic rather than osoteoporotic.
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Affiliation(s)
- Suk-Joong Lee
- Department of Orthopaedic Surgery, Gyeongsang National University School of Medicine and Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Jin-Han Lee
- Department of Orthopaedic Surgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea
| | - Hyun-Joo Lee
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea; Department of Orthopaedic Surgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea
| | - Ji Won Oh
- Department of Anatomy, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea; Biomedical Research Institute, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea
| | - Il-Hyung Park
- Department of Orthopaedic Surgery, School of Medicine, Kyungpook National University, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea; Department of Orthopaedic Surgery, Kyungpook National University Hospital, 130 Dongduk-ro, Jung-gu, Daegu, Republic of Korea.
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Seshadri MS, Gopi M, Murali P, Kumar K. Osteoporosis in a Rural Community - Long-Term Effects of a Community Level Program of Calcium and Vitamin D Supplementation - A Prospective Observational Study. Indian J Endocrinol Metab 2021; 25:305-312. [PMID: 35136737 PMCID: PMC8793951 DOI: 10.4103/ijem.ijem_141_21] [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: 03/30/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 11/06/2022] Open
Abstract
In a defined geographic area in rural India (1,60,000 population), osteoporosis detection and calcium and vitamin D supplementation program was instituted. Of the eligible 15,386 subjects, 5,992 (38%) participated in the program; 2,882 (48%) had osteopenia and osteoporosis; supervised calcium and vitamin D supplementation was instituted; 2,113 (73.3% of those identified) completed 2 years of supplementation. The mean duration of the follow-up was 5 years (range 2-8 years). On follow-up, three groups emerged; those who were regular, those who were irregular, and those who did not take supplements. In those who were regular with calcium and vitamin D supplementation, we found a significant reduction in fractures (RR 0.27, 95% CI 0.09-0.81) compared with those who did not take supplements. There was no significant difference in falls between the three groups. Mortality was significantly lower (RR 0.53, 95% CI 0.31-0.91) in those who were regular with calcium and vitamin D supplements compared to those who did not take supplements. While the reduction in fractures was probably due to calcium and vitamin D supplementation, the reduction in mortality was probably because those who took regular supplements accessed healthcare services more readily for other comorbidities as part of their follow-up program.
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Affiliation(s)
- Mandalam S. Seshadri
- Department of Medicine and Endocrinology, Thirumalai Mission Hospital, Vanapadi Road, Ranipet, Vellore, Tamil Nadu, India
| | - Manigandan Gopi
- Department of Medicine and Endocrinology, Thirumalai Mission Hospital, Vanapadi Road, Ranipet, Vellore, Tamil Nadu, India
| | - Priyanka Murali
- Department of Medicine and Endocrinology, Thirumalai Mission Hospital, Vanapadi Road, Ranipet, Vellore, Tamil Nadu, India
| | - Kaliyaperumal Kumar
- Department of Medicine and Endocrinology, Thirumalai Mission Hospital, Vanapadi Road, Ranipet, Vellore, Tamil Nadu, India
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Hong J, Ye F, Yu B, Gao J, Qi F, Wang W. Identification of the specific microRNAs and competitive endogenous RNA mechanisms in osteoporosis. J Int Med Res 2021; 48:300060520954722. [PMID: 33021861 PMCID: PMC7543140 DOI: 10.1177/0300060520954722] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Objective Osteoporosis and osteoarthritis are metabolic skeletal disorders. This study
aimed to identify specific networks of competitive endogenous RNA (ceRNA) in
osteoporosis that differ from those in osteoarthritis. Methods The dataset GSE74209 was downloaded from the Gene Expression Omnibus, and
differentially expressed microRNAs (DEmiRNAs) in osteoporotic samples and
osteoarthritic samples were identified. After predicting target genes and
linked long noncoding (lnc)RNAs, ceRNA networks of DEmiRNAs were
constructed. The nodes that overlapped between ceRNA networks and the
Comparative Toxicogenomics Database were selected as key candidates. Results Fifteen DEmiRNAs (including 2 downregulated and 13 upregulated miRNAs) were
identified in osteoporotic samples versus osteoarthritic samples; these
targeted 161 genes and linked to 60 lncRNAs. The ceRNA network consisted of
6 DEmiRNAs, 63 target genes, and 53 lncRNAs. After searching the Comparative
Toxicogenomics Database and mining the literature, 2 lncRNAs
(MALAT1 and NEAT1), 2 DEmiRNAs
(hsa-miR-32-3p,
downregulated; and hsa-miR-22-3p, upregulated) and 6 genes
(SP1, PTEN, ESR1,
ERBB3, CSF1R, and
CDK6) that relate to cell death, growth, and
differentiation were identified as key candidates separating osteoporosis
from osteoarthritis. Conclusions Two miRNA–ceRNA networks (including
NEAT1/MALAT1-hsa-miR-32-3p-SP1/FZD6
and
NEAT1/MALAT1-hsa-miR-22-3p-PTEN/ESR1/ERBB3/CSF1R/CDK6)
might have crucial and specific roles in osteoporosis.
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Affiliation(s)
- Junyi Hong
- Department of Orthopaedics, Zhejiang Xiaoshan Hospital, Hangzhou City, Zhejiang Province, China
| | - Fusheng Ye
- Department of Orthopaedics, Zhejiang Xiaoshan Hospital, Hangzhou City, Zhejiang Province, China
| | - Binjia Yu
- Department of Orthopaedics, Zhejiang Xiaoshan Hospital, Hangzhou City, Zhejiang Province, China
| | - Junwei Gao
- Department of Orthopaedics, Zhejiang Xiaoshan Hospital, Hangzhou City, Zhejiang Province, China
| | - Feicheng Qi
- Department of Orthopaedics, Zhejiang Xiaoshan Hospital, Hangzhou City, Zhejiang Province, China
| | - Wei Wang
- Department of Orthopaedics, Zhejiang Xiaoshan Hospital, Hangzhou City, Zhejiang Province, China
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Gupta PK, Singh S, Mahto SK, Sheoran A, Garga UC, Lal AK, Jain P, Mathews SE. Prevalence and predictors of low bone mineral density in treatment-naive HIV-infected patients and its correlation with CD4 cell counts. Tzu Chi Med J 2021; 33:49-54. [PMID: 33505878 PMCID: PMC7821822 DOI: 10.4103/tcmj.tcmj_177_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 08/23/2019] [Accepted: 09/02/2019] [Indexed: 12/03/2022] Open
Abstract
Objective: HIV virtually affects every organ system of the body. The skeletal system is no exception, and antiretroviral therapy (ART) has been implicated in bone diseases. However, not many studies have been done to evaluate bone disease in treatment (ART) naive HIV-infected patients, and hence, the present study was executed. Materials and Methods: One hundred and twenty HIV-infected ART-naive patients and 80 age- and sex-matched healthy controls were recruited for this study. A thorough history and physical examination was done followed by laboratory investigations after an overnight fasting. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry scan at the level of lumbar spine, femur, and forearm. Results: Of 120 ART-naive HIV-infected cases, the prevalence of osteoporosis and osteopenia was 13% and 41%, respectively, as compared to 0% and 17.5% in controls (P < 0.001). The mean BMD in cases was 0.842 g/cm2 which was approximately 25% lesser than that in controls. Hypovitaminosis-D was seen in 100% of cases as compared to 65% of controls (P < 0.01). A significant association of low BMD was seen with HIV-infection per se (P < 0.001), low CD4 cell counts (P < 0.001), low Vitamin D levels (P < 0.001), long duration of disease (P < 0.04), history of opportunistic infections (P < 0.03), and history of tuberculosis in the past (P < 0.05). Conclusion: Bone diseases such as osteoporosis and osteopenia characterized by low BMD are very common in HIV-infected patients. Virus per se, along with low CD4 cell counts and low Vitamin D levels are major predictors of pathological fractures in these individuals.
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Affiliation(s)
- Pulin Kumar Gupta
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sanchit Singh
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Subodh Kumar Mahto
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ankita Sheoran
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Umesh Chand Garga
- Department of Radiology, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ashok Kumar Lal
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Piyush Jain
- Department of Medicine, PGIMER, Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Namikawa T, Yokota K, Iwabu J, Munekage M, Uemura S, Tsujii S, Maeda H, Kitagawa H, Karashima T, Kumon M, Inoue K, Kobayashi M, Hanazaki K. Incidence and risk factors of osteoporotic status in outpatients who underwent gastrectomy for gastric cancer. JGH OPEN 2020; 4:903-908. [PMID: 33102762 PMCID: PMC7578282 DOI: 10.1002/jgh3.12347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/14/2020] [Accepted: 04/08/2020] [Indexed: 02/06/2023]
Abstract
Background and Aim Disorders in bone metabolism have long been recognized as typical sequelae of gastrectomy; however, the pathogenesis has not been fully elucidated, resulting in a variation of reported incidence. This study aimed to evaluate current bone health by measuring bone mineral density (BMD) in patients treated by gastrectomy for gastric cancer, with a focus on incidence and risk factors of osteoporosis. Methods The study enrolled 81 patients who underwent gastrectomy for gastric cancer at Kochi Medical School. BMD of the lumbar spine was measured by dual‐energy X‐ray mineral absorptiometry, with the results expressed as a percentage of the young adult mean (YAM). Clinical data were also obtained to investigate associations with BMD. Results Of the 81 study patients, 12 (14.8%) were deemed to have osteoporosis, defined by a percentage of YAM <70, with a dominance of females over males (66.7% vs 17.4%; P < 0.001). The median body weight, hemoglobin concentration, and serum alkaline phosphatase (ALP) level of the patients with osteoporosis was significantly lower than in those with a percentage of YAM ≥70 group (39.6 kg vs 53.1 kg, P < 0.001; 10.9 mg/dL vs 12.5 mg/dL, P = 0.010; 210 U/L vs 251 U/L, P = 0.002). Further analyses revealed a significant positive correlation between body weight and percentage of YAM (r = 0.441, P < 0.001). Despite the administration of bisphosphonates in these patients during this study, one acquired a bone fracture. Conclusion Osteoporosis was found in 14.8% of postoperative gastric cancer patients, with female gender, low body weight, and low ALP proposed as risk factors for osteoporosis and thus future bone fracture.
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Affiliation(s)
| | | | - Jun Iwabu
- Department of Surgery Kochi Medical School Nankoku Japan
| | | | - Sunao Uemura
- Department of Surgery Kochi Medical School Nankoku Japan
| | | | | | | | | | | | - Keiji Inoue
- Department of Urology Kochi Medical School Nankoku Japan
| | - Michiya Kobayashi
- Department of Human Health and Medical Sciences Kochi Medical School Nankoku Japan
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Upadhyaya GK, Iyengar K, Jain VK, Vaishya R. Challenges and strategies in management of osteoporosis and fragility fracture care during COVID-19 pandemic. J Orthop 2020; 21:287-290. [PMID: 32523258 PMCID: PMC7265833 DOI: 10.1016/j.jor.2020.06.001] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2020] [Accepted: 06/01/2020] [Indexed: 12/17/2022] Open
Abstract
Background COVID-19 has resulted in restriction of face to face consultations and mechanisms to access health care. Osteoporosis and fragility fractures forms a significant proportion of adult trauma and orthopaedic workload even during the pandemic. Aims We assess the challenges and strategies used in the management of osteoporosis and fragility fracture care during the COVID-19 pandemic. Methods We have done a comprehensive review of the literature using suitable keywords on the search engines of PubMed, SCOPUS, Google Scholar and Research Gate in the first week of May 2020 on developments and guidance during the current COVID-19 pandemic. Results Osteoporosis and fragility fractures management has been hampered by lock down and infection transmission strategies used to contain the COVID-19 pandemic. Access to diagnostic tests, treatment facilities with the need to use clinical and prediction tools to guide management Telemedicine has an evolving role. Conclusion Osteoporosis and fragility fractures in elderly individuals pose a real challenge for an appropriate diagnosis and management, during the COVID-19 pandemic. A clinical decision along with use of clinical prediction tools for osteoporosis should be used to direct treatment. Obligatory fractures such as hip fractures require operative intervention. Non-obligatory fractures such as distal radius fractures can be managed conservatively with use of telemedicine applications in monitoring both types of patients.
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Affiliation(s)
- Gaurav K. Upadhyaya
- Department of Orthopaedics, All India Institute of Medical Sciences, Rae Bareli, UP, India
| | | | - Vijay K. Jain
- Department of Orthopaedics, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
- Corresponding author.
| | - Raju Vaishya
- Department of Orthopaedics, Indraprastha Apollo Hospital, Sarita Vihar, Mathura Road, 110076, New Delhi, India
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Chinda D, Shimoyama T, Sawada K, Iino C, Sakuraba H, Nakaji S, Fukuda S. Lifestyle Factors Rather Than Helicobacter pylori Infection or Estradiol Level are Associated With Osteopenia in Japanese Men. Am J Mens Health 2020; 13:1557988319848219. [PMID: 31043139 PMCID: PMC6498780 DOI: 10.1177/1557988319848219] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Although decreased calcium absorption, decreased bone formation, alcohol
drinking, and smoking have been considered as causes of osteopenia in men, the
cause is unknown in half of the cases. Many reports highlighted the association
between Helicobacter pylori infection and
osteoporosis, mainly in East Asia and Japan. To identify relevant factors of
osteoporosis in men, we examined estrogen and calcium intakes and other
lifestyle factors together with gastric mucosal atrophy caused by Helicobacter pylori infection. This study is a
cross-sectional study design of 268 healthy men who underwent general medical
examinations. Multivariate analysis was performed, with age, body mass index,
smoking habit, drinking habit, exercise habit, estradiol level, calcium intake,
and Helicobacter pylori infection and its
associated gastric mucosal atrophy as the independent variables and the presence
of osteopenia as the dependent variable. The adjusted odds ratio was 0.74 (95%
Confidence Interval [0.29, 1.90], p = .531) and
1.31 (95% Confidence Interval [0.54, 3.21], p =
.552), when Helicobacter pylori infection was
positive without and with gastric mucosal atrophy, respectively. Helicobacter pylori infection and gastric mucosal
atrophy were not significant factors. Low body mass index, smoking habit, and
low calcium intake were significantly associated with decreased bone density. In
conclusion, Helicobacter pylori infection was not
a significant risk, whereas low body mass index, current smoking, and lower
calcium intake had a significant influence on the development of osteopenia in
men.
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Affiliation(s)
- Daisuke Chinda
- 1 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Japan.,2 Department of Community Medicine, Hirosaki University Graduate School of Medicine, Japan
| | - Tadashi Shimoyama
- 1 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Japan.,3 Aomori General Health Examination Center, Japan
| | - Kaori Sawada
- 4 Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan
| | - Chikara Iino
- 1 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Japan
| | - Hirotake Sakuraba
- 1 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Japan
| | - Shigeyuki Nakaji
- 4 Department of Social Medicine, Hirosaki University Graduate School of Medicine, Japan
| | - Shinsaku Fukuda
- 1 Department of Gastroenterology and Hematology, Hirosaki University Graduate School of Medicine, Japan
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Kewalramani R, Murthy CS, Gupta R. The second mesiobuccal canal in three-rooted maxillary first molar of Karnataka Indian sub-populations: A cone-beam computed tomography study. J Oral Biol Craniofac Res 2019; 9:347-351. [PMID: 31528537 DOI: 10.1016/j.jobcr.2019.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Revised: 03/02/2019] [Accepted: 08/29/2019] [Indexed: 01/19/2023] Open
Abstract
Introduction Elusive second mesiobuccal canal (MB2) in maxillary first molar are often missed during endodontic therapy and are a major cause of treatment failures. Its prevalence is known to vary among different populations and there is limited information on its prevalence in Indian population. Aim This study investigated the prevalence and location of second mesiobuccal (MB2) canal in mesiobuccal root of maxillary first molar using cone beam computed tomography (CBCT) images in an Indian population. Materials and methods CBCT images of 598 three rooted maxillary first molars were studied. In each CBCT image, the floor of pulp chamber was located and advanced by 2 mm to standardize the observation for MB2 canal. Its location was determined in relation to mesiobuccal (MB1) and palatal (P) canal. Statistical analysis The data was analysed using descriptive statistics. The presence of MB2 canal was correlated with age, gender and tooth position using Chi square test. Results The prevalence of MB2 canal in three rooted maxillary first molar was 61.9%. It was seen that the prevalence of MB2 was highest in 20-40years age group (67.4%) followed by > 40 years (57.5%) and lowest in <20 years (50.6%) and the difference was statistically significant (p = 0.005). It is located mesiopalatally; 2.5 mm ± 0.6 mm palatally and 1.0 ± 0.4mmmesially to the MB1 canal or present directly on the line joining the MB1 and palatal canal. Conclusion There is a high probability of finding MB2 canal in Indian patients. The access cavity must be modified from a triangular shape to rhomboid shape. Troughingmesiopaltally (about 2.5 mm palatally and 1 mm mesially) from MB1 to a depth of about 2 mm from the floor of pulp chamber may be necessary for locating MB2 canal.
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Affiliation(s)
| | - Chethana S Murthy
- Department of Conservative Dentistry and Endodontics, Vokkaligara Sangha Dental College, Bangalore, India
| | - Ravi Gupta
- Faculty of Dentistry, Melaka Manipal Medical College (Manipal Campus), Manipal Academy of Higher Education, Manipal, 576104, Karnataka, India
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