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Zhang X, Lu H, Fan M, Tian W, Wang Y, Cui M, Jiang Y, Suo C, Zhang T, Jin L, Xu K, Chen X. Bidirectional mediation of bone mineral density and brain atrophy on their associations with gait variability. Sci Rep 2024; 14:8483. [PMID: 38605086 PMCID: PMC11009386 DOI: 10.1038/s41598-024-59220-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 04/08/2024] [Indexed: 04/13/2024] Open
Abstract
This mediation analysis aimed to investigate the associations among areal bone mineral density, mobility-related brain atrophy, and specific gait patterns. A total of 595 participants from the Taizhou Imaging Study, who underwent both gait and bone mineral density measurements, were included in this cross-sectional analysis. We used a wearable gait tracking device to collect quantitative gait parameters and then summarized them into independent gait domains with factor analysis. Bone mineral density was measured in the lumbar spine, femoral neck, and total hip using dual-energy X-ray absorptiometry. Magnetic resonance images were obtained on a 3.0-Tesla scanner, and the volumes of brain regions related to mobility were computed using FreeSurfer. Lower bone mineral density was found to be associated with higher gait variability, especially at the site of the lumbar spine (β = 0.174, FDR = 0.001). Besides, higher gait variability was correlated with mobility-related brain atrophy, like the primary motor cortex (β = 0.147, FDR = 0.006), sensorimotor cortex (β = 0.153, FDR = 0.006), and entorhinal cortex (β = 0.106, FDR = 0.043). Bidirectional mediation analysis revealed that regional brain atrophy contributed to higher gait variability through the low lumbar spine bone mineral density (for the primary motor cortex, P = 0.018; for the sensorimotor cortex, P = 0.010) and the low lumbar spine bone mineral density contributed to higher gait variability through the primary motor and sensorimotor cortices (P = 0.026 and 0.010, respectively).
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Affiliation(s)
- Xin Zhang
- School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Heyang Lu
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Min Fan
- Taixing Disease Control and Prevention Center, Taizhou, Jiangsu, China
| | - Weizhong Tian
- Taizhou People's Hospital Affiliated to Nantong University, Taizhou, Jiangsu, China
| | - Yingzhe Wang
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Mei Cui
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Yanfeng Jiang
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Chen Suo
- School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Tiejun Zhang
- School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Li Jin
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Kelin Xu
- School of Public Health, The Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China.
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
| | - Xingdong Chen
- Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China.
- National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China.
- Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China.
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Liang H, Xiong C, Luo Y, Zhang J, Huang Y, Zhao R, Zhou N, Zhao Z, Luo X. Association between serum polyunsaturated fatty acids and bone mineral density in US adults: NHANES 2011-2014. Front Endocrinol (Lausanne) 2023; 14:1266329. [PMID: 38047106 PMCID: PMC10690584 DOI: 10.3389/fendo.2023.1266329] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 10/25/2023] [Indexed: 12/05/2023] Open
Abstract
Objective The purpose of this study was to investigate the association between serum polyunsaturated fatty acids (PUFAs) and bone mineral density (BMD). Methods We performed a cross-sectional study based on data from the National Health and Nutrition Examination Survey (NHANES) 2011-2014. The weighted multiple linear regression model was utilized to determine the association between serum PUFAs and BMD. Further smoothed curve fitting and threshold effect analysis were conducted. Finally, we performed a subgroup analysis. Results In total, 1979 participants aged 20-59 years were enrolled. After adjusting for all covariates, we found that serum docosapentaenoic acid (DPA) was positively associated with head BMD (β = 0.0015, 95% Cl: 0.0004, 0.0026, P = 0.008296) and lumbar spine BMD (β = 0.0005, 95% Cl: 0.0000, 0.0010, P = 0.036093), and serum eicosadienoic acid (EDA) was negatively associated with thoracic spine BMD (β = -0.0008, 95% Cl: -0.0016, -0.0000, P = 0.045355). Smoothed curve fitting revealed a nonlinear positive association between serum DPA and lumbar spine BMD. Threshold effect analysis indicated that the threshold of serum DPA was 81.4 µmol/L. Subgroup analysis revealed a positive correlation between serum DPA and head BMD in the subgroup aged 50-59 years (β = 0.0025, 95% Cl: 0.0002, 0.0049, P = 0.035249) and females (β = 0.0026, 95% Cl: 0.0008, 0.0044, P = 0.005005). There was a positive relationship between serum DPA and lumbar spine BMD in females (β = 0.0008, 95% Cl: 0.0001, 0.0015, P = 0.017900) and a negative association between serum EDA and thoracic spine BMD in the subgroup aged 30-39 years (β = -0.0016, 95% Cl: -0.0031, -0.0001, P = 0.041331), males (β = -0.0012, 95% Cl: -0.0023, -0.0001, P = 0.039364) and other races (β = -0.0021, 95% Cl: -0.0037, -0.0006, P = 0.008059). Conclusion This study demonstrated a linear positive relationship between serum DPA and head BMD, a nonlinear positive association between serum DPA and lumbar spine BMD, and a linear negative correlation between serum EDA and thoracic spine BMD in US adults.
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Affiliation(s)
- Hao Liang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Chuang Xiong
- Department of Bone and Soft Tissue Oncology, Chongqing University Cancer Hospital, Chongqing, China
| | - Yuangang Luo
- Department of Orthopedics, Qianjiang Central Hospital of Chongqing, Qianjiang, Chongqing, China
| | - Jun Zhang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Yanran Huang
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Runhan Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Nian Zhou
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Zenghui Zhao
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
| | - Xiaoji Luo
- Department of Orthopedic Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- Orthopedic Laboratory of Chongqing Medical University, Chongqing, China
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Foster JI, Williams KL, Timmer BHB, Brauer SG. The Association between Hearing Impairment and Postural Stability in Older Adults: A Systematic Review and Meta-analysis. Trends Hear 2022; 26:23312165221144155. [PMID: 36524292 PMCID: PMC9761226 DOI: 10.1177/23312165221144155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
There is growing evidence linking hearing impairment to higher falls risk through alterations in postural stability, with studies showing mixed results. The primary aim of this systematic review and meta-analysis was to determine the association between hearing impairment and postural instability in older adults, including differences based on severity of hearing impairment. This review was pre-registered in PROSPERO and performed in accordance with PRISMA guidelines across six databases. Primary research on adults aged 60 years and older with hearing loss and an objective measure of postural stability or gait were eligible for inclusion. Methodological quality was assessed using the modified Newcastle-Ottawa Scale (NOS) adapted for cross-sectional studies. Data were analysed using meta-analyses and a narrative synthesis. Inclusion in the meta-analyses required clearly defined audiometrically-assessed hearing impairment, and two subgroups of participants: mild (25-40 dB HL) and moderate to-severe (>40 dB HL) hearing impairment. Twenty-five eligible studies (n = 27,847) were included in the narrative synthesis, with quality ratings ranging from unsatisfactory to very good on the modified NOS. Eight studies were included in the meta-analysis which showed individuals with moderate to-severe hearing impairment were significantly slower on the 5 x sit-to-stand test (mean difference[95%CI] = 0.50 s [0.04, 0.97], p = .03), had a slower gait speed (mean difference[95%CI] = -0.11 s [-0.16, -0.05], p < .001) and had lower total Short Physical Performance Battery scores (mean difference[95%CI] = -0.79[-1.17, -0.41], p < .001) than those with normal hearing. This review provides evidence there is an inverse association between increasing severity of hearing impairment and poorer postural stability across both the meta-analysis and narrative synthesis.
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Affiliation(s)
- Jacinta I. Foster
- University of
Queensland, St Lucia, QLD, Australia,Logan Hospital, Metro South Health
Service, Queensland Health, Meadowbrook, QLD,
Australia,Jacinta I. Foster, School of Health and
Rehabilitation Sciences, University of Queensland, St Lucia, QLD 4067,
Australia.
| | | | - Barbra H. B. Timmer
- University of
Queensland, St Lucia, QLD, Australia,Sonova AG, Stäfa, Switzerland
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Association between Osteoporosis and Meniere's Disease: Two Longitudinal Follow-Up Cohort Studies. Nutrients 2022; 14:nu14224885. [PMID: 36432572 PMCID: PMC9697712 DOI: 10.3390/nu14224885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Revised: 11/11/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
A high rate of Meniere's disease (MD) in patients with osteoporosis has been suggested. This research intended to estimate the bidirectional association of MD with osteoporosis. The ≥40-year-old population in the Korean National Health Insurance Service-Health Screening Cohort 2002-2019 was examined. In study I, 9529 patients with MD and 38,116 control I participants were analyzed for a previous history of osteoporosis. In study II, 65,858 patients with osteoporosis and 65,858 control II participants were analyzed for a previous history of MD. Stratified Cox proportional hazard models were applied to calculate the hazard ratios (HRs) and 95% confidence intervals (CIs) of MD for osteoporosis in study I and of osteoporosis for MD in study II. The rate of a prior history of osteoporosis was 13.3% for the MD group and 11.3% for the control I group. The patients with MD had a 1.12 times higher HR for previous osteoporosis (95% CI = 1.04-1.20). In study II, the rate or a prior history of MD was 3.7% for patients with osteoporosis and 2.0% for the control II group. The patients with osteoporosis had a 1.50 times higher HR for previous MD (95% CI = 1.40-1.61). Most subgroups according to age, sex, and comorbid conditions demonstrated consistent bidirectional associations between MD and osteoporosis. Adult patients with MD had a greater risk of osteoporosis. In addition, adult patients with osteoporosis also showed a higher risk of MD.
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Assessment of Metabolic Markers and Osteoporosis in 250 Patients with Superior Semicircular Canal Dehiscence Treated With Middle Fossa Craniotomy. World Neurosurg 2022; 166:e52-e59. [PMID: 35760329 DOI: 10.1016/j.wneu.2022.06.090] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Revised: 06/16/2022] [Accepted: 06/17/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Superior semicircular canal dehiscence (SSCD) is caused by bony defects in the osseous shell of the arcuate eminence separating the labyrinth and the intracranial space. This pathologic third window causes hydroacoustic transmission resulting in debilitating symptoms. We examine the pathophysiologic association between metabolic markers, previous medical history, and SSCD symptoms before and after middle fossa craniotomy (MFC) treatment. METHODS This study was conducted between March 2011 and September 2020 with patients with SSCD who underwent MFC. We used a Fisher test to compare variables, including bilateral SSCD, second surgery, ear anomaly, osteoporosis, arthritis, vitamin D, and preoperative/postoperative symptoms, and others. Point-biserial correlation analysis was performed to test correlations between continuous variables and categorical variables. RESULTS A total of 250 patients with SSCD underwent MFC repair. There was significant postoperative resolution in all symptoms (P < 0.0001). Laboratory 25-hydroxyvitamin D values correlated with preoperative aural fullness (rpb= 0.29; P = 0.03), and preoperative disequilibrium (rpb= -0.32; P = 0.02). Serum calcium values correlated with preoperative hearing loss (rpb= 0.16; P = 0.02). Osteoporosis history (n = 16; 6%) was more prevalent in female patients (P = 0.0001), associated with higher levels of preoperative hearing loss (odds ratio, 4.56; P = 0.02) and higher postoperative hearing loss resolution (odds ratio, 2.89; P = 0.0509). CONCLUSIONS Certain metabolic markers may predict SSCD presentation before and after surgery. Previous history of osteoporosis, autoimmune conditions, or arthritis may play a role in SSCD pathophysiology and can help predict clinical outcomes. Future evaluation should take metabolic laboratory values and acquire an exact medical history.
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García A, Rivera S, Alvear-Veas B, Goss D, Castillo-Bustamante M, Garcia JM. Association Between Early-Onset Osteoporosis With Hearing Loss and Benign Paroxysmal Positional Vertigo (BPPV): A Systematic Review and Meta-Analysis. Ann Otol Rhinol Laryngol 2022:34894221118424. [PMID: 35950312 DOI: 10.1177/00034894221118424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Osteoporosis is a chronic systemic disease characterized by low bone mass, progressive microarchitectural deterioration and increased bone fragility. Hearing loss and benign paroxysmal positional vertigo (BPPV) have been found in patients diagnosed with osteoporosis over 65 years, however, there is lack of information about these conditions in young patients. Herein, we conducted a systematic review and meta-analysis to provide evidence of the association between osteoporosis and audio-vestibular findings in young subjects. METHODS Systematic review and meta-analysis were performed according to PRISMA guidelines. Searches were conducted in PubMed, Embase, and Web of Science Core Collection. Mean age, proportion of patients with low mineral density, hearing loss, and BPPV were calculated for the systematic review and meta-analysis. Odds Ratio (OR) with their corresponding 95% confidence intervals (CI) were calculated. RESULTS A total of 26 articles were reviewed. Only 10 studies met inclusion criteria for the meta-analysis. Six were assessed pursuing the association between osteoporosis and hearing loss. Pooled evidence suggested in patients with osteoporosis, an increased risk for developing hearing loss (OR = 1.52, 95% CI 1.06-2.19; P = .02) compared to controls. Another 6 studies reported the association between osteoporosis and BPPV. A significant increased risk for BPPV was found in individuals with osteoporosis (OR = 1.58, 95% CI 1.02-2.4; P = .04). There was no publication bias. CONCLUSION Subjects younger than 65 years with osteoporosis have an increase odds for hearing loss and BPPV compared to controls. These conditions could be associated with early inner or middle ear bone morphologic changes.
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Affiliation(s)
- Alejandro García
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard University, Boston, MA, USA
| | - Sebastián Rivera
- Escuela de Fonoaudiología, Facultad de Salud, Universidad Santo Tomas, Viña del Mar, Chile
| | - Bernardita Alvear-Veas
- Departamento de Fonoaudiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Deborah Goss
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard University, Boston, MA, USA
| | - Melissa Castillo-Bustamante
- Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Harvard University, Boston, MA, USA.,Escuela de Medicina, Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia
| | - Juan Manuel Garcia
- Departamento de Otorrinolaringologia, Fundación Santa Fé de Bogotá, Universidad de Los Andes, Bogota, Colombia
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Szeto B, Valentini C, Lalwani AK. Low vitamin D status is associated with hearing loss in the elderly: a cross-sectional study. Am J Clin Nutr 2021; 113:456-466. [PMID: 33247302 DOI: 10.1093/ajcn/nqaa310] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/06/2020] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND The elderly are at increased risk of both hearing loss (HL) and osteoporosis. Bone mineral density (BMD) has been putatively linked to HL. However, the roles of serum calcium concentrations and vitamin D status have yet to be elucidated. OBJECTIVES The purpose of this study was to examine the relation between vitamin D status, parathyroid hormone (PTH), total calcium, BMD, and HL in a nationally representative sample of elderly adults. METHODS Using the NHANES (2005-2010), audiometry and BMD data of 1123 participants aged ≥70 y were analyzed in a cross-sectional manner. HL was defined as pure tone averages >25 dB HL at 500, 1000, and 2000 Hz (low frequency); 500, 1000, 2000, and 4000 Hz (speech frequency); and 3000, 4000, 6000, and 8000 Hz (high frequency) in either ear. Multivariable logistic regression was used to examine the relation between HL and total 25-hydroxyvitamin D [25(OH)D], PTH, total calcium, and BMD, adjusting for covariates. RESULTS In multivariable analyses, total 25(OH)D < 20 ng/mL was found to be associated with greater odds of low-frequency HL (OR: 2.02; 95% CI: 1.28, 3.19) and speech-frequency HL (OR: 1.96; 95% CI: 1.12, 3.44). A 1-unit decrease in femoral neck BMD (OR: 4.55; 95% CI: 1.28, 16.67) and a 1-unit decrease in total spine BMD (OR: 6.25; 95% CI: 1.33, 33.33) were found to be associated with greater odds of low-frequency HL. Serum PTH and total calcium were not found to be associated with HL. CONCLUSIONS In the elderly, low vitamin D status was associated with low-frequency and speech-frequency HL. Low vitamin D status may be a potential risk factor for age-related HL.
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Affiliation(s)
- Betsy Szeto
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Chris Valentini
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Anil K Lalwani
- Department of Otolaryngology-Head and Neck Surgery, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Juneja MK, Munjal S, Sharma A, Gupta AK, Bhadada S. Audiovestibular functioning of post-menopausal females with osteoporosis and osteopenia. J Otol 2021; 16:27-33. [PMID: 33505447 PMCID: PMC7814074 DOI: 10.1016/j.joto.2020.07.007] [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: 04/20/2020] [Revised: 07/29/2020] [Accepted: 07/29/2020] [Indexed: 11/29/2022] Open
Abstract
INTRODUCTION Osteoporosis and osteopenia are progressive disorders characterized by decreased bone mass, especially in postmenopausal women. These can be associated with body pain, fractures, hearing loss and balance disorders. The present study aims to evaluate audio-vestibular function in postmenopausal patients with osteopenia or osteoporosis. METHODS The study included 48 postmenopausal women (new subjects) diagnosed with osteoporosis (n = 23) or osteopenia (n = 25) in the age range of 50-66 years, as well as 28 normal women as controls. Audiological testing included pure tone audiometry (conventional and extended high-frequency audiometry), speech audiometry, impedance audiometry and otoacoustic emissions, including both transient evoked otoacoustic emissions (TEOAEs) and distortion product otoacoustic emissions (DPOAEs). All subjects also underwent vestibular evoked myogenic potentials testing (both ocular and cervical VEMPs). RESULTS In the present study, hearing was worse at all frequencies in the osteoporosis group in comparison with the osteopenia and control groups, with worse speech recognition and discrimination scores and OAEs. Vestibular function was affected in 95.65% of women with osteoporosis and 76% of those with osteopenia. CONCLUSION Osteoporosis and osteopenia are risk factors for vestibular dysfunction and hearing deficits in postmenopausal women. Thus, hearing and vestibular function should be monitored by audiological and vestibular testing periodically in these individuals.
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Affiliation(s)
- Manisha K. Juneja
- Speech and Hearing Unit, ENT Department, GMCH, Sec-32, Chandigarh, India
| | - Sanjay Munjal
- Speech & Hearing Unit, Dept. of Otolaryngology, PGIMER, Chandigarh, India
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Kelly RR, Sidles SJ, LaRue AC. Effects of Neurological Disorders on Bone Health. Front Psychol 2020; 11:612366. [PMID: 33424724 PMCID: PMC7793932 DOI: 10.3389/fpsyg.2020.612366] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/11/2020] [Indexed: 01/10/2023] Open
Abstract
Neurological diseases, particularly in the context of aging, have serious impacts on quality of life and can negatively affect bone health. The brain-bone axis is critically important for skeletal metabolism, sensory innervation, and endocrine cross-talk between these organs. This review discusses current evidence for the cellular and molecular mechanisms by which various neurological disease categories, including autoimmune, developmental, dementia-related, movement, neuromuscular, stroke, trauma, and psychological, impart changes in bone homeostasis and mass, as well as fracture risk. Likewise, how bone may affect neurological function is discussed. Gaining a better understanding of brain-bone interactions, particularly in patients with underlying neurological disorders, may lead to development of novel therapies and discovery of shared risk factors, as well as highlight the need for broad, whole-health clinical approaches toward treatment.
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Affiliation(s)
- Ryan R. Kelly
- Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Sara J. Sidles
- Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
| | - Amanda C. LaRue
- Research Services, Ralph H. Johnson VA Medical Center, Charleston, SC, United States
- Department of Pathology and Laboratory Medicine, Medical University of South Carolina, Charleston, SC, United States
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Makarova EV, Marchenkova LA, Eryomushkin MA, Styazkina EM, Chesnikova EI. Balance and muscle strength tests in patients with osteoporotic vertebral fractures to develop tailored rehabilitation programs. Eur J Transl Myol 2020; 30:9236. [PMID: 33117510 PMCID: PMC7582409 DOI: 10.4081/ejtm.2020.9236] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 07/30/2020] [Indexed: 01/01/2023] Open
Abstract
Authors perform a cross-sectional study of functional abilities of the patients with osteoporotic vertebral fractures (VFs). Trunk muscle isometric strength and postural balance impairments were estimated. The development of osteoporotic VFs is associated with a significant decrease in strength of all the body muscles, especially the deep spinal stabilization system, i.e trunk extensor (TE), trunk flexsor (TF), where the VFs contribute to inappropriate distribution of back muscle strength with TE:TF ration of 1:1 instead of 3:2, observed both normally and in patients with uncomplicated osteoporosis. There is also a deterioration of stabilometry and functional coordination assessment tests in patients with pathological VFs, that indicate abnormalities of both static and dynamic postural balance. The obtained data should be taken into account when developing rehabilitation programmes for osteoporosis patients who have suffered compression VFs.
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Affiliation(s)
- Ekaterina V Makarova
- Somatic rehabilitation, anti-aging and reproductive health department of FSBI "National Medical Research Center of Rehabilitation and Balneology" of Ministry of Health of Russian Federation
| | - Larisa A Marchenkova
- Somatic rehabilitation, anti-aging and reproductive health department of FSBI "National Medical Research Center of Rehabilitation and Balneology" of Ministry of Health of Russian Federation
| | - Mikhail A Eryomushkin
- Orthopedics, biomechanics, kinesiotherapy and manual therapy department of FSBI 'National Medical Research Center of Rehabilitation and Balneology' of the Ministry of Health of Russian Federation
| | - Elena M Styazkina
- Orthopedics, biomechanics, kinesiotherapy and manual therapy department of FSBI 'National Medical Research Center of Rehabilitation and Balneology' of the Ministry of Health of Russian Federation
| | - Ekaterina I Chesnikova
- Orthopedics, biomechanics, kinesiotherapy and manual therapy department of FSBI 'National Medical Research Center of Rehabilitation and Balneology' of the Ministry of Health of Russian Federation
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Association between Bone Metabolism and Vestibular Problems in the Modified Romberg Test: Data from the 2009-2010 Korean National Health and Nutrition Examination Survey. J Clin Med 2020; 9:jcm9082415. [PMID: 32731479 PMCID: PMC7466128 DOI: 10.3390/jcm9082415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 07/24/2020] [Accepted: 07/27/2020] [Indexed: 11/16/2022] Open
Abstract
Osteoporosis contributes to the occurrence of falling and vestibular problems, particularly in elderly patients. This study aimed to investigate the association between bone metabolism with vestibular problems and falling. A total of 4054 participants of the Korean National Health and Nutrition Examination Survey (KNHANES) from 2009 to 2010 aged ≥50 years old were surveyed on their history of falling, vestibular problems evaluated by the modified Romberg test, variables involving bone metabolism, and serum levels of vitamin D and alkaline phosphatase. They also underwent dual energy X-ray absorptiometry. The crude (simple) and adjusted odd ratios (ORs) of variables involving bone metabolism for vestibular problems in the modified Romberg test and falling were analyzed using a logistic regression model. A subgroup analysis was performed according to sex and the presence of menopause in females. Vestibular problems in the modified Romberg test group but not the falling group were associated with decreased serum vitamin D levels (p < 0.001; odds ratio (OR) = 0.951; 95% confidence interval (CI), 0.926-0.976). In subgroup analysis according to sex, the post-menopause group showed a higher rate of vestibular problems in the modified Romberg test compared to the pre-menopause group (4.5% vs. 0.7%, p = 0.019). In the post-menopause group, osteoporosis was positively associated with vestibular problems in the modified Romberg test (p = 0.001, OR = 10.971, 95% CI = 2.650-45.414). On the other hand, a history of hormone replacement therapy was negatively related with vestibular problems in this subgroup (p = 0.035; OR = 0.473; 95% CI = 0.239-0.948). A decrease in serum vitamin D levels may impact the vestibular system through neural signaling or by osteoporotic changes of the otic capsule, as well as otolith particles. Decreased estrogen levels in postmenopausal women may make them more prone to osteoporotic changes, which were associated with vestibular problems in the modified Romberg test. Because this is a cross-sectional study, the causal relationship of bone metabolism with vestibular function needs to be investigated.
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Dotevall A, Barrenäs ML, Landin-Wilhelmsen K. Hearing loss but not bone-regulating hormones predicts fractures in older women-a 17-year follow-up of the Gothenburg BEDA study. Osteoporos Int 2020; 31:557-565. [PMID: 31720709 DOI: 10.1007/s00198-019-05204-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 10/21/2019] [Indexed: 02/06/2023]
Abstract
UNLABELLED High-frequency hearing loss and S-Ca, but not hormones related to bone structure and strength, or lifestyle factors, predicted incident fractures during 17 years of follow-up in women up to 97 years of age. INTRODUCTION The fracture risk increases and inner ear function deteriorates with increasing age. The aim of this study was to investigate whether hearing loss was of greater importance than bone-regulating hormones for the risk of fracture in elderly women. METHODS In 1997, a random population sample of 63-82-year-old women, n = 552, underwent a physical examination, audiometry and blood sampling for analyses of serum albumin-adjusted calcium (S-Ca), parathyroid hormone (PTH), 25(OH) vitamin D and insulin-like growth factor-1 (IGF-1). Data on medication, lifestyle, previous fractures, hearing, vision and dizziness were obtained using questionnaires. Data on subsequent fractures were retrieved, and censored at death, through December 2013. RESULTS In 1997, 228 women (41%) reported a previous fracture, most commonly of the wrist (18%). During the following 17 years, 323 fractures occurred in 207 women (38%). Hip fractures were the most frequent, in 96 women (17%). In a Cox regression analysis adjusted for age and previous fractures, hearing loss, reflected by a high pure tone average ≥ 59 dB, almost doubled the risk of a subsequent fracture (hazard ratio (HR) 1.81, 95% CI 1.25; 2.61, p = 0.002). S-Ca (HR 1.21 (1.02; 1.44) p = 0.028) also predicted future fractures, whereas PTH, IGF-1, 25(OH) vitamin D, hormone replacement therapy, smoking, degree of physical activity, impaired vision and dizziness did not. CONCLUSION Hearing loss and higher S-Ca, but not bone-regulating hormones, medication or lifestyle factors predicted incident fractures, mainly caused by falling, during 17 years of follow-up in women up to 97 years of age.
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Affiliation(s)
- A Dotevall
- Department of Medicine, Sahlgrenska University Hospital/Östra, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - M-L Barrenäs
- Department of Physiology at the Institute of Neuroscience and Physiology at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - K Landin-Wilhelmsen
- Department of Medicine, Sahlgrenska University Hospital/Östra, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Shupak A, Faranesh N. Bone Mineral Density in Patients Suffering from Ménière's Disease. Audiol Neurootol 2020; 25:158-163. [PMID: 32088708 DOI: 10.1159/000506039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 01/17/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Previous studies have reported an association between reduced bone mineral density and the occurrence of benign paroxysmal positional vertigo, balance impairment, and saccular dysfunction. Furthermore, the results of recent animal studies have raised the possibility that vestibular dysfunction could affect bone remodeling and bone mass. The goal of the study was to compare bone mineral density of patients suffering from definite Ménière's disease to that of a matched control group. METHODS We conducted a case-control cross-sectional study in a tertiary referral center. The study group included 23 patients suffering from definite Ménière's disease, and the control group was comprised of 23 patients matched in their race, gender, and age parameters in whom no vestibular pathology could be found. Dual energy X-ray absorptiometry of the femoral head was used for the assessment of bone mineral density. The T and Z scores of the femoral heads' bone mineral density were compared. RESULTS The average T scores were -1.53 ± 1.08 in the study and -0.39 ± 0.72 (p = 0.016) in the control groups, and the Z scores were -0.4 ± 0.63 and 0.33 ± 0.31 (p = 0.018), respectively. Seventeen patients (74%) of the study group and 9 (39%) of the control group had T scores less than -1.0, indicating osteopenia/osteoporosis (p = 0.036). CONCLUSIONS The results showed a significant association between Ménière's disease and reduced bone mineral density of the femoral head. Bone mineral density studies of the weight-bearing bones are warranted in Ménière's disease for the early diagnosis and treatment of osteopenia/osteoporosis on the one hand and possible benefit of this treatment for the evolution of Ménière's disease on the other hand.
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Affiliation(s)
- Avi Shupak
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel, .,Department of Otolaryngology Head and Neck Surgery, Carmel Medical Center, Haifa, Israel, .,The Bruce Rappaport Faculty of Medicine, The Technion, Haifa, Israel,
| | - Nabil Faranesh
- Unit of Otoneurology, Lin Medical Center, Haifa, Israel.,Department of Otolaryngology, Head and Neck Surgery, French Hospital, Nazareth, Israel
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Baker BJ, May C. Meniere’s Disease and Concurrent BPPV in an Older Adult: A Case Report. PHYSICAL & OCCUPATIONAL THERAPY IN GERIATRICS 2020. [DOI: 10.1080/02703181.2019.1667471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Barbara J. Baker
- Physical Therapy Department, Grand Valley State University, Calvin College Rehabilitation Services, Grand Rapids, MI, USA
| | - Christopher May
- Physical Therapy Department, Grand Valley State University, Calvin College Rehabilitation Services, Grand Rapids, MI, USA
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Zhou L, Shen N, Feng M, Liu H, Duan M, Huang X. Study of age-related changes in Middle ear transfer function. Comput Methods Biomech Biomed Engin 2019; 22:1093-1102. [PMID: 31268350 DOI: 10.1080/10255842.2019.1632297] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Lei Zhou
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital affiliated to Fudan University, Xuhui District, P. R. China
| | - Na Shen
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital affiliated to Fudan University, Xuhui District, P. R. China
| | - Miaolin Feng
- State Key Laboratory of Ocean Engineering, Shanghai Jiao Tong University, Shanghai, P. R. China
| | - Houguang Liu
- School of Mechatronic Engineering, China University of Mining and Technology, Xuzhou, P.R. China
| | - Maoli Duan
- Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm
- Department of Neurotology and Audiology, Karolinska University Hospital, Stockholm, Sweden
- Department of Otolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - Xinsheng Huang
- Department of Otorhinolaryngology-Head and Neck Surgery, Shanghai Zhongshan Hospital affiliated to Fudan University, Xuhui District, P. R. China
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Mohebi S, Torkaman G, Bahrami F, Darbani M. Postural instability and position of the center of pressure into the base of support in postmenopausal osteoporotic and nonosteoporotic women with and without hyperkyphosis. Arch Osteoporos 2019; 14:58. [PMID: 31161413 DOI: 10.1007/s11657-019-0581-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 02/18/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED In postmenopausal women, thoracic hyperkyphosis affects postural instability in the sagittal plane, whereas osteoporosis affects it in the frontal plane. Decrease of hip muscle strength can be changed the center of pressure distance to the center of base of support. These results may be important to design the therapeutic exercise for decreasing the postural instability. PURPOSE In this study, we investigated the effect of bone mineral density (BMD) and thoracic kyphosis on the center of pressure (CoP) sway and its location related to the base of support (BoS). METHODS Ten young and 39 postmenopausal women voluntarily participated in this study. Postmenopausal women were divided into four groups according to the thoracic kyphosis angle (normal kyphotic < 50° ≤ hyperkyphotic) and T-score values. The isometric strength of the trunk and lower limb muscles were measured. The CoP postural sway was measured in a comfortable double stance position, and the location of the CoP was then determined related to the BoS. RESULTS In both hyperkyphotic groups (osteoporotic and normal BMD), the strength of back extension and hip adduction showed a significant decrease compared to the normal kyphotic groups. In the osteoporotic groups (hyper- and normal kyphotic), hip abduction and ankle plantar flexion were significantly weaker than those in the nonosteoporotic groups. In both hyperkyphotic groups, velocity of the CoP displacement in the anterior-posterior (AP) direction was significantly higher than that in the young group, while, in both of the osteoporotic groups, velocity of the CoP displacement in the medio-lateral (ML) direction was significantly higher than that in the young group. In postmenopausal women, hip extensor strength negatively and significantly correlated with the CoP distance to the center of the BoS. CONCLUSION It appears that thoracic hyperkyphosis affects postural instability in the AP direction and that a decrease of BMD affects postural instability in the ML direction.
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Affiliation(s)
- Sanaz Mohebi
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
| | - Giti Torkaman
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, P. O. Box: 1411713116, Ale-Ahmad Ave., Tehran, Iran.
| | - Fariba Bahrami
- Human Motor Control and Computational Neuroscience Lab, School of Electrical and Computer Engineering, College of Engineering, University of Tehran, Tehran, Iran
| | - Malihe Darbani
- Physical Therapy Department, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran
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Dewan N, MacDermid JC, Grewal R, Beattie K. Association of Modifiable Risk Factors with Bone Mineral Density among People with Distal Radius Fracture: A Cross-Sectional Study. Physiother Can 2019; 71:58-68. [PMID: 30787500 DOI: 10.3138/ptc.2017-72] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: This study determined the extent to which modifiable risk factors (balance, muscle strength, and physical activity [PA]) explained variability in bone mineral density (BMD) among people with a recent distal radius fracture (DRF). Method: This cross-sectional study included 190 patients, aged 50-80 years, with a DRF. Participants were assessed for balance, muscle strength, PA, fracture-specific pain, and disability. Areal BMD at the femoral neck (BMD-FN) and total hip (BMD-TH) was assessed. Correlation and multiple linear regression was used to determine the contribution of modifiable risk factors to BMD. Results: Balance, handgrip strength, knee extension strength, and plantar-flexion strength had significant bivariate associations with BMD-FN. There was a weak to moderate correlation (r = 0.25-0.40; p < 0.05) of balance and grip strength with BMD. Grip strength independently (p < 0.05) explained 17% and 12% of the variability in BMD-FN (n = 81) and BMD-TH (n = 82), respectively. Stratified by age, balance (R 2 = 0.10; p = 0.04) and grip strength (R 2 = 0.32; p = 0.003) were independent significant predictors of BMD-FN among women aged 50-64 years and 65-80 years, respectively. Conclusions: Grip strength of the unaffected hand is independently associated with BMD-FN and BMD-TH in people with recent DRF. It may act as a surrogate for general bone health, frailty, or overall muscle strength rather than as a direct target for intervention.
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Affiliation(s)
- Neha Dewan
- School of Rehabilitation Science, Faculty of Health Sciences.,Roth
- McFarlane Clinical Research Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Care
| | - Joy C MacDermid
- School of Rehabilitation Science, Faculty of Health Sciences.,Roth
- McFarlane Clinical Research Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Care.,Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Ruby Grewal
- Roth
- McFarlane Clinical Research Laboratory, Hand and Upper Limb Centre, St. Joseph's Health Care.,Department of Surgery, Schulich School of Medicine & Dentistry, Western University, London, Ont
| | - Karen Beattie
- School of Rehabilitation Science, Faculty of Health Sciences.,Department of Medicine, McMaster University, Hamilton
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Abstract
It is from the discovery of leptin and the central nervous system as a regulator of bone remodeling that the presence of autonomic nerves within the skeleton transitioned from a mere histological observation to the mechanism whereby neurons of the central nervous system communicate with cells of the bone microenvironment and regulate bone homeostasis. This shift in paradigm sparked new preclinical and clinical investigations aimed at defining the contribution of sympathetic, parasympathetic, and sensory nerves to the process of bone development, bone mass accrual, bone remodeling, and cancer metastasis. The aim of this article is to review the data that led to the current understanding of the interactions between the autonomic and skeletal systems and to present a critical appraisal of the literature, bringing forth a schema that can put into physiological and clinical context the main genetic and pharmacological observations pointing to the existence of an autonomic control of skeletal homeostasis. The different types of nerves found in the skeleton, their functional interactions with bone cells, their impact on bone development, bone mass accrual and remodeling, and the possible clinical or pathophysiological relevance of these findings are discussed.
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Affiliation(s)
- Florent Elefteriou
- Department of Molecular and Human Genetics and Orthopedic Surgery, Center for Skeletal Medicine and Biology, Baylor College of Medicine , Houston, Texas
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Gargeshwari A, Jha RH, Singh NK, Kumar P. Behavioural and objective vestibular assessment in persons with osteoporosis and osteopenia: a preliminary investigation. Braz J Otorhinolaryngol 2018; 84:744-753. [PMID: 29030130 PMCID: PMC9442882 DOI: 10.1016/j.bjorl.2017.08.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 07/20/2017] [Accepted: 08/26/2017] [Indexed: 01/12/2023] Open
Abstract
INTRODUCTION Calcium is vital for the functioning of the inner ear hair cells as well as for the neurotransmitter release that triggers the generation of a nerve impulse. A reduction in calcium level could therefore impair the peripheric vestibular functioning. However, the outcome of balance assessment has rarely been explored in cases with osteopenia and osteoporosis, the medical conditions associated with reduction in calcium levels. OBJECTIVE The present study aimed to investigate the impact of osteopenia and osteoporosis on the outcomes of behavioural and objective vestibular assessment tests. METHODS The study included 12 individuals each in the healthy control group and osteopenia group, and 11 individuals were included in the osteoporosis group. The groups were divided based on the findings of bone mineral density. All the participants underwent behavioural tests (Fukuda stepping, tandem gait and subjective visual vertical) and objective assessment using cervical and ocular vestibular evoked myogenic potentials. RESULTS A significantly higher proportion of the individuals in the two clinical groups' demonstrated abnormal results on the behavioural balance assessment tests (p<0.05) than the control group. However, there was no significant difference in latencies or amplitude of cervical vestibular evoked myogenic potential and oVEMP between the groups. The proportion of individuals with absence of ocular vestibular evoked myogenic potential was significantly higher in the osteoporosis group than the other two groups (p<0.05). CONCLUSION The findings of the present study confirm the presence of balance-related deficits in individuals with osteopenia and osteoporosis. Hence the clinical evaluations should include balance assessment as a mandatory aspect of the overall audiological assessment of individuals with osteopenia and osteoporosis.
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Affiliation(s)
- Aditi Gargeshwari
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India
| | - Raghav Hira Jha
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India.
| | - Niraj Kumar Singh
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India
| | - Prawin Kumar
- All India Institute of Speech and Hearing, Department of Audiology, Manasagangothri, Karnataka, India
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Kim SY, Kong IG, Lim H, Choi HG. Increased Risk of Sudden Sensory Neural Hearing Loss in Osteoporosis: A Longitudinal Follow-Up Study. J Clin Endocrinol Metab 2018; 103:3103-3109. [PMID: 29846624 DOI: 10.1210/jc.2018-00717] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Accepted: 05/23/2018] [Indexed: 02/05/2023]
Abstract
CONTEXT The results of a previous population cohort study suggested an association between osteoporosis and sudden sensory neural hearing loss (SSNHL). OBJECTIVES To use a nationwide cohort in the Korean population to investigate the risk of SSNHL in patients with osteoporosis. DESIGN, SETTING, AND PARTICIPANTS Data entered from 2002 to 2013 were collected from the Korean National Health Insurance Service-National Sample Cohort. A total of 68,241 patients with osteoporosis aged ≥50 years were matched with 68,241 control individuals. The crude (simple) and adjusted hazard ratios (HRs) of SSNHL in those with osteoporosis were analyzed using the Cox proportional hazard model. A subgroup analysis was performed according to age and sex. RESULTS The risk of SSNHL was greater in the osteoporosis group than in the control group (adjusted HR, 1.56; 95% CI, 1.37 to 1.78; P < 0.001). The risk of SSNHL in those with osteoporosis was greater in patients aged <60 years, regardless of sex. Women aged ≥60 years had a higher HR for SSNHL in the presence of osteoporosis (women aged 60 to 69 years: adjusted HR, 1.67; 95% CI, 1.34 to 2.08; P < 0.001; women aged ≥70 years: adjusted HR, 1.90; 95% CI, 1.29 to 2.79; P < 0.001). CONCLUSIONS The risk of SSNHL was greater for patients with osteoporosis aged ≥50 years. Middle-age adults, as well as the elderly, are at an increased risk of SSNHL in the presence of osteoporosis.
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Affiliation(s)
- So Young Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, CHA Bundang Medical Center, CHA University, Seongnam, Korea
| | - Il Gyu Kong
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Korea
| | - Hyun Lim
- Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea
| | - Hyo Geun Choi
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University College of Medicine, Anyang, Korea
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Kshithi K, Vijendra Shenoy S, Panduranga Kamath M, Sreedharan S, Manisha N, Khadilkar MN, Kamboj V, Bhat JS. Audiological profiling in postmenopausal women with osteoporosis. Am J Otolaryngol 2018. [PMID: 29530429 DOI: 10.1016/j.amjoto.2018.03.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
OBJECTIVES To compare the audiological profiles in postmenopausal women with and without osteoporosis and to study the pattern of hearing loss in osteoporotic patients. MATERIALS AND METHODS 80 postmenopausal women were evaluated at a tertiary referral center and were divided into normal, osteopenic and osteoporotic based on BMD results. The hearing evaluation was done using PTA, Impedance audiometry and DPOAE and the results were compared between the groups and analyzed. RESULTS Osteoporotic patients had higher incidence of sensorineural hearing loss than normal and osteopenic patients and the results were statistically significant (P ≤0.001) on PTA and DPOAE testing. The mean pure tone thresholds were significantly higher in osteoporotic patients in comparison with normal and osteopenic patients. The average hearing loss in osteoporotic patients with sensorineural loss was of mild degree. CONCLUSION The data reveal that osteoporosis is associated with sensorineural hearing loss in postmenopausal women. The underlying mechanism needs further research but cochlear dysfunction could be an important factor.
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Hearing impairment increases the risk of distal radius, hip, and spine fractures: A longitudinal follow-up study using a national sample cohort. PLoS One 2018; 13:e0192820. [PMID: 29438391 PMCID: PMC5811044 DOI: 10.1371/journal.pone.0192820] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 01/23/2018] [Indexed: 02/02/2023] Open
Abstract
Objective Hearing impairment has been suggested to increase the risk of falls. However, most previous studies were conducted in an older population without classification of the fracture regions. This study aimed to delineate the risk of each fracture type in all age populations. Methods The Korean National Health Insurance Service-National Sample Cohort was collected from 2002 to 2013. A total of 4,854 severe hearing-impaired and 1,354 profound hearing-impaired participants were matched for age, group, sex, income group, and region of residence with 19,416 and 5,416 control participants, respectively. The fracture diagnosis was based on the International Classification of Disease (ICD-10) codes as follows: distal radius fracture (S525), hip fracture (S720, S721, S722), and spine fracture (S220, S32). Crude (simple) and adjusted hazard ratios (HRs) for each fracture associated with severe or profound hearing impairment were analyzed using the Cox proportional hazard model. Results The severe hearing-impaired group had an increased risk of distal radius fracture, hip fracture, and spine fracture compared with the control group (adjusted HR = 1.67, 95% CI = 1.38–2.03, P < 0.001 for hip fracture). The profound hearing-impaired group had an increased risk of hip and spine fracture (adjusted HR = 2.21, 95% CI = 1.44–3.39, P < 0.001 for hip fracture). Conclusion The risk of distal radius fracture, hip fracture, and spine fracture was increased in the severe hearing-impaired group compared with the control group.
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Lee SS, Han KD, Joo YH. Association between low bone mineral density and hearing impairment in postmenopausal women: the Korean National Health and Nutrition Examination Survey. BMJ Open 2018; 8:e018763. [PMID: 29371277 PMCID: PMC5786079 DOI: 10.1136/bmjopen-2017-018763] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE To investigate the relationship between bone mineral density (BMD) and hearing impairment using a nationally demonstrative sample of Korean female adults. STUDY DESIGN Cross-sectional study of a national health survey. METHODS Data from the 2009-2010 Korean National Health and Nutrition Examination Surveys (KNHANES) with 19 491 participants were analysed, and 8773 of these participants were enrolled in this study. BMD was measured using dual-energy X-ray absorptiometry. Auditory functioning was evaluated by pure-tone audiometric testing according to established KNHANES protocols. We deliberated auditory impairment as pure-tone averages at frequencies of 0.5, 1.0, 2.0 and 3.0 kHz at a threshold of ≥40 decibels hearing level in the auricle with better hearing status. RESULTS Among women aged 19 years and older, prevalences of bilateral hearing impairment in premenopausal and postmenopausal women were 0.1%±0.1% and 11.5%±1.1% (mean±SE), respectively. Hearing impairment was meaningfully associated with low BMD in postmenopausal women. Logistic regression models indicated that lower BMDs of the total femur (OR=0.779; 95% CI 0.641 to 0.946, P=0.0118) and femur neck (OR=0.746; 95% CI 0.576 to 0.966, P=0.0265) were significantly associated with hearing impairment among postmenopausal women. CONCLUSIONS Postmenopausal Korean women with low BMD of the total femur and femoral neck showed an increased risk for developing hearing impairment. Further epidemiological and investigational studies are needed to elucidate this association.
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Affiliation(s)
- Seong-Su Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Kyung-do Han
- Department of Biostatistics, Catholic University of Korea, Seoul, Republic of Korea
| | - Young-Hoon Joo
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Catholic University of Korea, Bucheon, Republic of Korea
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Chan KC, Tsai YT, Yang YH, Chen PC, Chang PH. Osteoporosis is associated with increased risk for benign paroxysmal positional vertigo: a nationwide population-based study. Arch Osteoporos 2017; 12:106. [PMID: 29177633 DOI: 10.1007/s11657-017-0403-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 11/06/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Recent evidence has indicated that osteoporosis is a risk factor for benign paroxysmal positional vertigo (BPPV). This large population-based study demonstrated that patients with osteoporosis had a 1.82-fold higher risk of developing BPPV than those without osteoporosis through the use of the Taiwan National Health Insurance Research Database. PURPOSE Benign paroxysmal positional vertigo (BPPV) is one of the most frequent causes of vertigo. Osteoporosis reflects a homeostatic imbalance in the rate of bone turnover, with the rate of bone resorption exceeding that of bone formation. Recent evidence has indicated that osteoporosis is a risk factor for BPPV. We aimed to validate the risk of BPPV in osteoporotic patients through a nationwide, population-based, cohort study. METHODS Patients treated for osteoporosis were identified from entries made in the Taiwan National Health Insurance Research Database (NHIRD) between 2000 and 2013. Each osteoporosis patient was age- and sex-matched with four randomly selected subjects without osteoporosis. We compared the incidence rates of BPPV in the two cohorts (with and without osteoporosis) and identified risk factors. RESULTS We identified 6649 osteoporosis patients and 26,596 match controls. According to the incidence of BPPV among the two groups, patients with osteoporosis were found to have a 1.82-fold higher risk of developing BPPV than those without osteoporosis. The incidence rate ratio (IRR) between osteoporotic patients and the control cohort was 2.0 (p < 0.001). CONCLUSIONS This large population-based study demonstrated that patients with osteoporosis were associated with an increased risk for BPPV. The results of this study provide some insight into the management of BPPV.
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Affiliation(s)
- Kai-Chieh Chan
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan.,School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan
| | - Yao-Te Tsai
- School of Medicine, Chang Gung University, Taoyuan, Taiwan.,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan.,Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, Chiayi, Taiwan
| | - Yao-Hsu Yang
- Department of Traditional Chinese Medicine, Chiayi Chang Gung Memorial Hospital, Chiayi, Taiwan.,Health Information and Epidemiology Laboratory of Chang Gung Memorial Hospital, Chiayi, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Po-Hung Chang
- Department of Otolaryngology-Head and Neck Surgery, Chang Gung Memorial Hospital, No 5, Fu Hsing Street, Kwei-Shan, Taoyuan, 333, Taiwan. .,School of Medicine, Chang Gung University, Taoyuan, Taiwan. .,Graduate Institute of Clinical Medical Sciences, Chang Gung University, Kwei-Shan, Taoyuan, Taiwan.
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Altered auditory and vestibular functioning in individuals with low bone mineral density: a systematic review. Eur Arch Otorhinolaryngol 2017; 275:1-10. [DOI: 10.1007/s00405-017-4768-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 10/04/2017] [Indexed: 12/21/2022]
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Upala S, Rattanawong P, Vutthikraivit W, Sanguankeo A. Significant association between osteoporosis and hearing loss: a systematic review and meta-analysis. Braz J Otorhinolaryngol 2016; 83:646-652. [PMID: 27670202 PMCID: PMC9449069 DOI: 10.1016/j.bjorl.2016.08.012] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2016] [Revised: 07/12/2016] [Accepted: 08/22/2016] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. OBJECTIVE We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. METHODS This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than -2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. RESULTS A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p=0.04, I2=82%, Pheterogeneity=0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p=0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p=0.02). CONCLUSION Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.
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Affiliation(s)
- Sikarin Upala
- Bassett Medical Center and Columbia University College of Physicians and Surgeons, Department of Internal Medicine, Cooperstown, United States; Mahidol University, Faculty of Medicine Siriraj Hospital, Department of Preventive and Social Medicine, Bangkok, Thailand
| | - Pattara Rattanawong
- University of Hawaii, Department of Internal Medicine, Honolulu, United States
| | | | - Anawin Sanguankeo
- Bassett Medical Center and Columbia University College of Physicians and Surgeons, Department of Internal Medicine, Cooperstown, United States; Mahidol University, Faculty of Medicine Siriraj Hospital, Department of Preventive and Social Medicine, Bangkok, Thailand.
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Association Between Osteoporosis/Osteopenia and Vestibular Dysfunction in South Korean Adults. Ear Hear 2016; 37:615-9. [PMID: 27232074 DOI: 10.1097/aud.0000000000000320] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Bigelow RT, Semenov YR, Anson E, du Lac S, Ferrucci L, Agrawal Y. Impaired Vestibular Function and Low Bone Mineral Density: Data from the Baltimore Longitudinal Study of Aging. J Assoc Res Otolaryngol 2016; 17:433-40. [PMID: 27447468 DOI: 10.1007/s10162-016-0577-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Accepted: 07/05/2016] [Indexed: 12/21/2022] Open
Abstract
Animal studies have demonstrated that experimentally induced vestibular ablation leads to a decrease in bone mineral density, through mechanisms mediated by the sympathetic nervous system. Loss of bone mineral density is a common and potentially morbid condition that occurs with aging, and we sought to investigate whether vestibular loss is associated with low bone mineral density in older adults. We evaluated this question in a cross-sectional analysis of data from the Baltimore Longitudinal Study of Aging (BLSA), a large, prospective cohort study managed by the National Institute on Aging (N = 389). Vestibular function was assessed with cervical vestibular evoked myogenic potentials (cVEMPs), a measure of saccular function. Bone mineral density was assessed using dual-energy X-ray absorptiometry (DEXA). In two-way t test analysis, we observed that individuals with reduced vestibular physiologic function had significantly lower bone mineral density. In adjusted multivariate linear regression analyses, we observed that older individuals with reduced vestibular physiologic function had significantly lower bone mineral density, specifically in weight-bearing hip and lower extremity bones. These results suggest that the vestibular system may contribute to bone homeostasis in older adults, notably of the weight-bearing hip bones at greatest risk of osteoporotic fracture. Further longitudinal analysis of vestibular function and bone mineral density in humans is needed to characterize this relationship and investigate the potential confounding effect of physical activity.
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Affiliation(s)
- Robin T Bigelow
- Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA.
| | - Yevgeniy R Semenov
- Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA
| | - Eric Anson
- Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA
| | - Sascha du Lac
- Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Clinical Research Branch, National Institute on Aging, Baltimore, MD, USA
| | - Yuri Agrawal
- Department of Otolaryngology - Head & Neck Surgery, Johns Hopkins University School of Medicine, 601 N Caroline Street, Baltimore, MD, 21287, USA.
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Jung DJ, Cho HH, Lee KY. Association of Bone Mineral Density With Hearing Impairment in Postmenopausal Women in Korea. Clin Exp Otorhinolaryngol 2016; 9:319-325. [PMID: 27136368 PMCID: PMC5115157 DOI: 10.21053/ceo.2015.01858] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 12/29/2015] [Accepted: 01/16/2016] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVES Previous studies examining the association between osteoporosis (OP) and hearing loss (HL) have shown conflicting results. The objective of the present study was to examine the association between hearing impairment and OP in postmenopausal women, using appropriate statistical analyses. METHODS Total 1,009 participants were included in the current study. The propensity score matched (PSM) cohort was defined as the cohort including participants diagnosed with OP and participants without OP. Three statistical models were developed where model 1 was unadjusted, model 2 included age, and model 3 included age, body mass index, alcohol intake, smoking habit, diabetes mellitus, hypertension, high density lipoprotein cholesterol, triglyceride level, vitamin D, and alkaline phosphatase. RESULTS There were 776 and 233 participants in the groups diagnosed without and with OP, respectively. For propensity score matching, 233 pairs were selected from the 776 participants without OP. In the total cohort, using statistical models 2 and 3, no significant difference in the four hearing thresholds was identified between the 2 groups. Logistic regression indicated that, in model 3, participants with OP had a 1.128 (P=0.323) increased risk HL. A significant HL risk was not observed in participants with OP. Using statistical model 3, there were no significant associations among lumbar spine or femoral neck T-scores and changes in the hearing thresholds. In the PSM cohort, statistical models also showed similar results. CONCLUSION The current study did not demonstrate and association between bone mineral density and hearing impairment in the study population of postmenopausal Korean women.
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Affiliation(s)
- Da Jung Jung
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Hyun Ho Cho
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
| | - Kyu-Yup Lee
- Department of Otorhinolaryngology-Head and Neck Surgery, Kyungpook National University Hospital, Kyungpook National University School of Medicine, Daegu, Korea
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Kim JY, Lee SB, Lee CH, Kim HM. Hearing loss in postmenopausal women with low bone mineral density. Auris Nasus Larynx 2016; 43:155-60. [DOI: 10.1016/j.anl.2015.07.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 07/16/2015] [Accepted: 07/22/2015] [Indexed: 12/16/2022]
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Moon IJ, Byun H, Woo SY, Gwak GY, Hong SH, Chung WH, Cho YS. Factors Associated With Age-related Hearing Impairment: A Retrospective Cohort Study. Medicine (Baltimore) 2015; 94:e1846. [PMID: 26512592 PMCID: PMC4985406 DOI: 10.1097/md.0000000000001846] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Age-related hearing impairment (ARHI) is a complex degenerative disease in the elderly. As multiple factors interact during the development of ARHI, it is important to elucidate the major influencing factors to understand and prevent ARHI. We aimed to identify risk factors associated with the development of ARHI with a retrospective cohort from 2001 to 2010. The records of the adult subjects over 40 years of age who consecutively underwent a comprehensive health checkup including pure-tone audiometry at the Health Promotion Center were reviewed. During this period, 1560 subjects who underwent pure-tone audiometry more than twice, had no other otologic diseases, and were followed-up more than 2 years were included. A pure-tone average (PTA: 0.5, 1, 2, 4 kHz) was calculated. Development of ARHI was defined as a PTA at follow-up more than 10 dB greater than the baseline PTA. Times to the first development of ARHI were investigated. Overall, 12.7% of subjects developed ARHI within the first 4 years. High blood ionized calcium (hazard ratio [HR] 0.084), albumin (HR 0.239), systolic blood pressure (HR 0.577), thyroid hormone (T3) (HR 0.593), and alpha fetoprotein levels (HR 0.883) were associated with decreased hazard for the development of ARHI. In contrast, high blood high-density lipoprotein (HR 2.105), uric acid (HR 1.684), total protein (HR 1.423), and total bilirubin levels (HR 1.220) were potential risk factors for the development of ARHI. Development of ARHI is common among the aged population, and a variety of factors may interact during this process. The results of this study can be used for counseling of adults at high-risk of developing ARHI with regard to regular audiological check-up.
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Affiliation(s)
- Il Joon Moon
- From the Department of Otorhinolaryngology-Head and Neck Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine (IJM, HB, SHH, W-HC, Y-SC); Biostatistics Team, Samsung Biomedical Research Institute (S-yW); and Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea (G-YG)
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Is there a relationship between premature hair greying and hearing impairment? The Journal of Laryngology & Otology 2015; 129:1097-100. [PMID: 26412241 DOI: 10.1017/s0022215115002571] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
OBJECTIVE There is evidence for a strong correlation between low bone mineral density and hearing loss. Furthermore, premature hair greying has been associated with low bone mineral density. Hence, this study aimed to investigate, for the first time, the relationship between premature hair greying and hearing impairment. METHODS Fifty patients with premature hair greying (20 women and 30 men), aged under 40 years (mean, 30.1 ± 4.9 years), who had onset of hair greying in their twenties, were recruited, along with 45 age- and sex-matched healthy control subjects (17 women and 28 men; mean age, 28.7 ± 5.1 years). Each participant was tested with low frequency audiometry at 0.125 to 2 kHz, high frequency audiometry at 4 to 8 kHz, and extended high frequency audiometry at 9 to 20 kHz. RESULTS Hearing thresholds were similar at all frequencies from 0.25 to 4 kHz (p > 0.05); however, significant hearing loss was observed at all frequencies from 8 to 20 kHz in the premature hair greying group compared with the control group (p < 0.05). CONCLUSION Patients with premature hair greying had hearing impairment at extended high frequencies. Premature hair greying may be an important risk factor for hearing loss.
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Vignaux G, Besnard S, Denise P, Elefteriou F. The Vestibular System: A Newly Identified Regulator of Bone Homeostasis Acting Through the Sympathetic Nervous System. Curr Osteoporos Rep 2015; 13:198-205. [PMID: 26017583 DOI: 10.1007/s11914-015-0271-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The vestibular system is a small bilateral structure located in the inner ear, known as the organ of balance and spatial orientation. It senses head orientation and motion, as well as body motion in the three dimensions of our environment. It is also involved in non-motor functions such as postural control of blood pressure. These regulations are mediated via anatomical projections from vestibular nuclei to brainstem autonomic centers and are involved in the maintenance of cardiovascular function via sympathetic nerves. Age-associated dysfunction of the vestibular organ contributes to an increased incidence of falls, whereas muscle atrophy, reduced physical activity, cellular aging, and gonadal deficiency contribute to bone loss. Recent studies in rodents suggest that vestibular dysfunction might also alter bone remodeling and mass more directly, by affecting the outflow of sympathetic nervous signals to the skeleton and other tissues. This review will summarize the findings supporting the influence of vestibular signals on bone homeostasis, and the potential clinical relevance of these findings.
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Affiliation(s)
- G Vignaux
- Department of Medicine, Vanderbilt Center for Bone Biology, Vanderbilt University Medical Center, 1235 Medical Research Building IV, 2215B Garland Avenue, Nashville, TN, 37232-0575, USA
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Vignaux G, Ndong JD, Perrien DS, Elefteriou F. Inner Ear Vestibular Signals Regulate Bone Remodeling via the Sympathetic Nervous System. J Bone Miner Res 2015; 30:1103-11. [PMID: 25491117 PMCID: PMC4772960 DOI: 10.1002/jbmr.2426] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Revised: 12/01/2014] [Accepted: 12/04/2014] [Indexed: 12/23/2022]
Abstract
The inner ear vestibular system has numerous projections on central brain centers that regulate sympathetic outflow, and skeletal sympathetic projections affect bone remodeling by inhibiting bone formation by osteoblasts and promoting bone resorption by osteoclasts. In this study, we show that bilateral vestibular lesions in mice cause a low bone mass phenotype associated with decreased bone formation and increased bone resorption. This reduction in bone mass is most pronounced in lower limbs, is not associated with reduced locomotor activity or chronic inflammation, and could be prevented by the administration of the β-blocker propranolol and by genetic deletion of the β2-adrenergic receptor, globally or specifically in osteoblasts. These results provide novel experimental evidence supporting a functional autonomic link between central proprioceptive vestibular structures and the skeleton. Because vestibular dysfunction often affects the elderly, these results also suggest that age-related bone loss might have a vestibular component and that patients with inner ear pathologies might be at risk for fracture. Lastly, these data might have relevance to the bone loss observed in microgravity, as vestibular function is altered in this condition as well. © 2015 American Society for Bone and Mineral Research.
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Affiliation(s)
- Guillaume Vignaux
- Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, Nashville, TN, USA
| | - Jean Dlc Ndong
- Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, Nashville, TN, USA
| | - Daniel S Perrien
- Department of Orthopaedic Surgery & Rehabilitation/Department of VA, Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, Nashville, TN, USA
| | - Florent Elefteriou
- Department of Medicine, Vanderbilt University Medical Center, Vanderbilt Center for Bone Biology, Nashville, TN, USA
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Duboeuf F, Burt-Pichat B, Farlay D, Suy P, Truy E, Boivin G. Bone quality and biomechanical function: a lesson from human ossicles. Bone 2015; 73:105-10. [PMID: 25532479 DOI: 10.1016/j.bone.2014.12.009] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2014] [Revised: 12/08/2014] [Accepted: 12/12/2014] [Indexed: 11/30/2022]
Abstract
In humans, the middle ear contains a chain of three ossicles with a major highly specific mechanical property (transmission of vibrations) and modeling that stops rapidly after birth. Their bone quality has been rarely studied either in noninflammatory ossicles or in those from ears with chronic inflammation. Our primary goal was to assess bone microarchitecture, morphology and variables reflecting bone quality from incuses, in comparison with those from human femoral cortical bone as controls. Secondly, the impact of chronic inflammation on quality of ossicles was documented. The study was performed on 15 noninflammatory incuses from 15 patients (35±32 years, range: 2-91). Comparisons were performed with 13 inflammatory incuses from 13 patients (55±20 years, range: 1-79) with chronic inflammation of the middle ear, essentially cholesteatoma. Microarchitecture and bone mineral density (BMD) were assessed by microcomputed tomography. Microhardness was measured by microindentation. Mineral and organic characteristics were investigated by Fourier transform infrared microspectroscopy. Noninflammatory incuses were composed of a compact, well mineralized bone without bone marrow and with sparse vessels. Remodeling activity was rarely observed. Woven or lamellar textures and numerous osteocytes were observed. In inflammatory incuses, architecture was degraded, organic tissue was abundant and bone cavities contained fibrocellular tissue and adipocytes. BMD of noninflammatory incuses was significantly higher than BMD from both control bones (4 embedded cortical femoral bone samples; age: 72±15 years, range: 50-85) and inflammatory incuses. Noninflammatory incuses were less hard than both control bone (8 cortical femoral bone samples; age: 49±18 years, range: 24-74) and inflammatory incuses. All incuses were more mineralized and less mature than controls. In conclusion, bone quality of incuses (dense, well mineralized, hard) is well adapted to their function of sound transmission. In inflammatory condition, incuses were degraded, thus explaining the decline of hearing. Moreover, microhardness was found higher than in noninflammatory incuses. Compared to bone with remodeling, the mineralization index in incuses does not explain variation of microhardness. Interestingly, a linear multiple regression model indicated that a combination of two variables, i.e., crystallinity index (crystal size/perfection) and carbonation (incorporation of carbonate ions in apatite) explains 26% of the increase in microhardness variability. Because the low remodeling level of ossicles could not prevent the reversibility of their degradation which impacts audition quality, an early management of ear inflammation in chronic otitis is recommended.
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Affiliation(s)
- François Duboeuf
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
| | - Brigitte Burt-Pichat
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
| | - Delphine Farlay
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
| | - Paul Suy
- ENT Department, Hôpital Edouard Herriot, Lyon, France.
| | - Eric Truy
- Université de Lyon, Lyon, France; ENT Department, Hôpital Edouard Herriot, Lyon, France; Lyon Neurosciences Research Center, Brain Dynamics and Cognition Team, CRNL, INSERM UMR 1028, CNRS UMR 5292, Lyon, France.
| | - Georges Boivin
- INSERM UMR 1033, Equipe Qualité Osseuse et Marqueurs Biologiques, Lyon, France; Université de Lyon, Lyon, France.
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Letter to the Editor: regarding “Copper deficiency and neuropathology related to the petrous bone”. Ann Epidemiol 2014; 24:488-9. [DOI: 10.1016/j.annepidem.2014.02.017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Accepted: 02/26/2014] [Indexed: 11/17/2022]
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38
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Mendy A, Vieira ER, Albatineh AN, Nnadi AK, Gasana J. Response to letter to the editor: regarding "copper deficiency and neuropathology related to the petrous bone". Ann Epidemiol 2014; 24:490-1. [PMID: 24731698 DOI: 10.1016/j.annepidem.2014.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Accepted: 03/04/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Angelico Mendy
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Edgar R Vieira
- Department of Physical Therapy, Florida International University, Miami, FL
| | - Ahmed N Albatineh
- Department of Biostatistics, Florida International University, Miami, FL
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