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Valero C, Olmos JM, Humbert L, Castillo J, Hernández JL, Martínez J, Macías JG. 3D analysis of bone mineral density in a cohort: age- and sex-related differences. Arch Osteoporos 2021; 16:80. [PMID: 34076788 DOI: 10.1007/s11657-021-00921-w] [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: 09/09/2020] [Accepted: 03/08/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED Women have lower areal BMD (g/cm2) than men; however, the women have smaller-size bones. Our study showed that women ≤ 59 years have a hip volumetric BMD by DXA 3D similar to that of men of the same age. This makes us think about the importance of taking into account bone size at the time of analyzing the sex-related differences in bone mass. PURPOSE Women have lower areal BMD (g/cm2) than men; however, these studies do not take into account that women have smaller-size bones. Recently, three-dimensional (3D) modeling methods were proposed to analyze volumetric BMD (vBMD). We want to determine the values of vBMD at the hip by DXA-based 3D modeling in a cohort of people in order to know the age- and sex-related differences. METHODS A total of 2647 people of both sexes (65% women) were recruited from a large cohort (Camargo cohort, Santander, Spain). 3D-SHAPER® software (version 2.8, Galgo Medical, Barcelona, Spain) was used to derive 3D analysis from the hip DXA scans at baseline RESULTS: The differences were less pronounced for vBMD (cortical sBMD 9.3%, trabecular vBMD 6.4%, integral vBMD 2.2%) compared to aBMD (FN aBMD 11.4% and TH aBMD 13.3%). After stratifying by age (≤ 59 years, 60-69 years, 70-79 years, and ≥ 80 years), we observed in ≤ 59 years that aBMD was lower in women compared to men, at FN (0.758 [0.114] g/cm2 vs. 0.833 [0.117] g/cm2; p = 1.4 × 10-20) and TH (0.878 [0.117] g/cm2 vs. 0.990 [0.119] g/cm2; p = 4.1 × 10-40). Nevertheless, no statistically significant difference was observed for integral vBMD (331 [58] mg/cm3 in women and 326 [51] mg/cm3 in men; p = 0.19) and trabecular vBMD (190 [41] mg/cm3 in women and 195 [39] mg/cm3 in men; p = 0.20). CONCLUSION Our results make us think about the importance of taking into account bone size at the time of analyzing the sex-related differences in bone mass.
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Affiliation(s)
- Carmen Valero
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, Santander, Spain. .,University of Cantabria, IDIVAL, Santander, Spain.
| | - José Manuel Olmos
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.,University of Cantabria, IDIVAL, Santander, Spain
| | | | - Jesús Castillo
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.,University of Cantabria, IDIVAL, Santander, Spain
| | - José Luis Hernández
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.,University of Cantabria, IDIVAL, Santander, Spain
| | - Josefina Martínez
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.,University of Cantabria, IDIVAL, Santander, Spain
| | - Jesús González Macías
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, Santander, Spain.,University of Cantabria, IDIVAL, Santander, Spain
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García Hoyos M, Humbert L, Salmón Z, Riancho JA, Valero C. Analysis of volumetric BMD in people with Down syndrome using DXA-based 3D modeling. Arch Osteoporos 2019; 14:98. [PMID: 31494745 DOI: 10.1007/s11657-019-0645-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Accepted: 08/16/2019] [Indexed: 02/03/2023]
Abstract
UNLABELLED We analyzed volumetric bone mineral density, by 3D analysis, in 76 people with Down syndrome and 76 controls. People with Down syndrome, particularly men, have a lower hip volumetric bone mineral density than the general population. Besides, volumetric bone mineral density declines more rapidly in Down syndrome. INTRODUCTION People with Down syndrome (DS) have a lower areal bone mineral density (aBMD) estimated by dual-energy X-ray absorptiometry (DXA). However, they have smaller-sized bones, which could influence the measurements. Therefore, our objective was to determine volumetric BMD in these patients. MATERIALS AND METHODS We included 76 outpatients with DS and 76 control healthy volunteers matched for age and sex distribution. Clinical data were obtained with a standardized interview and physical exam, including age, sex, height, weight, and body mass index (BMI). aBMD was measured by dual-energy X-ray at the femoral neck (FN) and total hip (TH). The 3D-SHAPER® software (version 2.8, Galgo Medical, Barcelona, Spain) was used to derive 3D analysis from participants' hip DXA scans. RESULTS DS femurs had a similar 3D geometry, compared with the femurs of controls. However, 3D analysis showed that participants with DS had smaller cortical thickness (1.84 mm ± 0.17 vs. 2.02 ± 0.20 mm; p < 0.0001), cortical vBMD (777 ± 49 mg/cm3 vs. 809 ± 43 mg/cm3; p < 0.0001), and cortical sBMD (143 ± 19 mg/cm2 vs. 164 ± 22 mg/cm2; p < 0.0001). After adjustment for age and BMI, all 3D measurements remained lower in DS than in controls. These differences were more marked in men than in women. vBMD decreased with age in controls and DS, but the decline was greater in DS for all 3D parameters. CONCLUSION People with DS, particularly men, have a lower hip vBMD than the general population. Besides, vBMD declines more rapidly in DS.
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Affiliation(s)
- Marta García Hoyos
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | | | - Zaida Salmón
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - José A Riancho
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain
| | - Carmen Valero
- Department of Internal Medicine, University Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, Santander, Spain.
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Pariente E, Olmos JM, Landeras R, Nan D, González-Macías J, Hernández JL. Relationship between spinal osteoarthritis and vertebral fractures in men older than 50 years: data from the Camargo Cohort Study. J Bone Miner Metab 2017; 35:114-121. [PMID: 26825659 DOI: 10.1007/s00774-016-0735-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2015] [Accepted: 12/24/2015] [Indexed: 10/22/2022]
Abstract
Spinal osteoarthritis has been suggested as a risk factor for vertebral fractures. However, results are conflicting: most of the data are focused on the lumbar region, and referred to postmenopausal women, whereas data for men are scarce. The aim of this study is to assess the relationship between spinal osteoarthritis and vertebral fractures in men over 50 years of age. We conducted a cross-sectional study, nested in a prospective population-based cohort, including 507 community-dwelling men, 93 of them with at least one vertebral fracture. Vertebral fractures, osteophytosis, and disc space narrowing (DSN) were assessed by lateral thoracic and lumbar radiographs. Anthropometric, clinical, and densitometric variables were also analyzed. A multiple logistic regression model was performed. Eighty-five percent of vertebral fractures were located at the thoracic spine. Osteophytosis and DSN showed a bimodal distribution, with major frequency peaks at mid- and distal lumbar spine. The three distributions overlapped around the T9 vertebra. We did not find any relationship between lumbar osteoarthritis and vertebral fractures. Nevertheless, thoracic osteophytosis (OR, 1.84; 95 % CI, 1.05-3.17; p = 0.03) and DSN (OR, 2.52; 95 % CI, 1.43-4.46; p = 0.001) were found to be independently associated with prevalent vertebral fractures, after adjusting for confounders. Our results suggest a positive relationship between radiologic osteoarthritic changes at the thoracic spine and prevalent vertebral fractures in men more than 50 years of age. Osteoarthritis may act as a local risk factor, in addition to other mechanical factors, resulting in a greater propensity to fracture, especially at the mid-thoracic region.
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Affiliation(s)
- Emilio Pariente
- "Camargo-Interior" Primary Care Center, Servicio Cántabro de Salud, OSPC, Muriedas, Cantabria, Spain
| | - José M Olmos
- Bone Metabolism Unit, Department of Internal Medicine, Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, RETICEF, 39008, Santander, Cantabria, Spain
| | - Rosa Landeras
- Department of Radiology, University Hospital Marqués de Valdecilla, Santander, Spain
| | - Daniel Nan
- Bone Metabolism Unit, Department of Internal Medicine, Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, RETICEF, 39008, Santander, Cantabria, Spain
| | - Jesús González-Macías
- Bone Metabolism Unit, Department of Internal Medicine, Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, RETICEF, 39008, Santander, Cantabria, Spain
| | - José Luis Hernández
- Bone Metabolism Unit, Department of Internal Medicine, Hospital Marqués de Valdecilla, University of Cantabria, IDIVAL, RETICEF, 39008, Santander, Cantabria, Spain.
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Olmos JM, Hernández JL, García-Velasco P, Martínez J, Llorca J, González-Macías J. Serum 25-hydroxyvitamin D, parathyroid hormone, calcium intake, and bone mineral density in Spanish adults. Osteoporos Int 2016; 27:105-13. [PMID: 26134682 DOI: 10.1007/s00198-015-3219-6] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/18/2015] [Indexed: 11/28/2022]
Abstract
UNLABELLED Vitamin D insufficiency is very common among Spanish community-dwelling adult subjects. A threshold of serum 25(OH)D around 30 ng/ml would be necessary for the prevention of secondary hyperparathyroidism and hip bone loss in our population, regardless of the dairy calcium ingestion. INTRODUCTION This study aims to assess 25-hydroxyvitamin D-25(OH)D-status in Spanish adult subjects and to analyze its relationships with serum PTH levels, calcium intake, and bone mineral density (BMD). METHODS A total of 1811 individuals (1154 postmenopausal women and 657 men) aged 44-93 years participated in the study. Serum 25(OH)D, intact parathyroid hormone (PTH), aminoterminal propeptide of type I collagen (P1NP), and C-terminal telopeptide of type I collagen (β-CTX) levels were measured by electrochemiluminescence. BMD was determined by dual x-ray absorptiometry (DXA) at lumbar spine, femoral neck, and total hip. RESULTS Serum 25(OH)D levels were below 10, 20, and 30 ng/ml in 5, 40, and 83 % of participants, respectively. There was a significant seasonal difference in mean serum 25(OH)D, with higher levels in summer-autumn. In multivariate analysis, 25(OH)D levels were negatively correlated with age, serum PTH and creatinine, body mass index, smoking, alcohol intake, and a number of chronic diseases, but positively with dairy calcium intake. The magnitude of the difference in serum PTH according to 25(OH)D quartiles was not influenced by calcium intake. A threshold of serum 25(OH)D around 30 ng/ml was observed for serum PTH and hip BMD. CONCLUSIONS Vitamin D insufficiency is very common among Spanish community-dwelling adult subjects. A threshold of serum 25(OH)D around 30 ng/ml would be necessary for the prevention of secondary hyperparathyroidism and hip bone loss in our population, regardless of the dairy calcium ingestion. Programs to improve vitamin D status may be required in our country.
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Affiliation(s)
- J M Olmos
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain.
- IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), University of Cantabria, Santander, Spain.
| | - J L Hernández
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain
- IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), University of Cantabria, Santander, Spain
| | | | - J Martínez
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain
- IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), University of Cantabria, Santander, Spain
| | - J Llorca
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain
- Epidemiology Unit, Medical School, University of Cantabria, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública (CIBERESP), Santander, Spain
| | - J González-Macías
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Avda. Valdecilla s/n, 39008, Santander, Spain
- IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), University of Cantabria, Santander, Spain
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Association of Trabecular Bone Score with Inflammation and Adiposity in Patients with Psoriasis: Effect of Adalimumab Therapy. J Osteoporos 2016; 2016:5747852. [PMID: 27293954 PMCID: PMC4880682 DOI: 10.1155/2016/5747852] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2016] [Accepted: 04/21/2016] [Indexed: 12/27/2022] Open
Abstract
Studies on trabecular bone score (TBS) in psoriasis are lacking. We aim to assess the association between TBS and inflammation, metabolic syndrome features, and serum adipokines in 29 nondiabetic patients with psoriasis without arthritis, before and after 6-month adalimumab therapy. For that purpose, adjusted partial correlations and stepwise multivariable linear regression analysis were performed. No correlation was found between TBS and disease severity. TBS was negatively associated with weight, BMI, waist perimeter, fat percentage, and systolic and diastolic blood pressure before and after adalimumab. After 6 months of therapy, a negative correlation between TBS and insulin resistance (p = 0.02) and leptin (p = 0.01) and a positive correlation with adiponectin were found (p = 0.01). The best set of predictors for TBS values at baseline were female sex (p = 0.015), age (p = 0.05), and BMI (p = 0.001). The best set of predictors for TBS following 6 months of biologic therapy were age (p = 0.001), BMI (p < 0.0001), and serum adiponectin levels (p = 0.027). In conclusion, in nondiabetic patients with moderate-to-severe psoriasis, TBS correlates with metabolic syndrome features and inflammation. This association is still present after 6 months of adalimumab therapy. Moreover, serum adiponectin levels seem to be an independent variable related to TBS values, after adalimumab therapy.
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Hernández JL, Nan D, Martínez J, Pariente E, Sierra I, González-Macías J, Olmos JM. Serum uric acid is associated with quantitative ultrasound parameters in men: data from the Camargo cohort. Osteoporos Int 2015; 26:1989-95. [PMID: 25731808 DOI: 10.1007/s00198-015-3083-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Accepted: 02/18/2015] [Indexed: 12/13/2022]
Abstract
UNLABELLED This study analyzes the association between serum uric acid levels and heel quantitative ultrasound (QUS) parameters in men aged 50 or more from the Camargo cohort. We found that higher serum uric acid levels are positively associated with all QUS measurements, suggesting a better bone quality in men with elevated serum uric acid values. INTRODUCTION Higher serum uric acid concentrations have been associated with higher bone mineral density and lower prevalence of fractures. However, there are no studies that have assessed the bone quality properties in Caucasians. Therefore, we have analyzed the association between quantitative ultrasound (QUS) and serum uric acid levels in adult men from a population-based cohort. METHODS A total of 868 men older than 50 were recruited from a larger cohort (Camargo Cohort) after excluding those with any known condition or drug treatment with a possible influence on bone metabolism, or those with a previous diagnosis of gout or taking hipouricemic agents. Bone turnover markers (PINP and CTX), 25OH-vitamin D and PTH levels were measured by electrochemiluminiscence. BMD was determined by DXA, and heel QUS with a gel-coupled device. RESULTS Lumbar, femoral neck and total hip BMD was significantly higher in men with higher serum uric acid levels. QUS parameters were also significantly higher in men with high uric acid levels than those with lower values, and increased continuously across quartiles after adjustment for confounding variables. In multiple regression analysis, serum uric acid was significantly associated with all QUS parameters. Finally, men with serum acid levels above median showed higher values in all the QUS parameters than men with lower values. CONCLUSIONS Higher serum uric acid levels in men older than 50 years are positively associated with QUS parameters. These data might suggest a better bone quality in men with elevated serum uric acid values.
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Affiliation(s)
- J L Hernández
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), University of Cantabria, Santander, Spain,
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Hernández JL, Olmos JM, Romaña G, Llorca J, Martínez J, Castillo J, de Juan J, Pérez-Pajares I, Ruiz S, González-Macías J. Influence of vitamin D status on the effect of statins on bone mineral density and bone turnover markers in postmenopausal women. J Clin Endocrinol Metab 2014; 99:3304-9. [PMID: 24878047 DOI: 10.1210/jc.2014-1102] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE This study sought to assess whether the association between statin use and bone mineral density (BMD) and bone turnover markers is modulated by serum 25-hydroxyvitamin D (25OHD) levels in postmenopausal women. Design, Participants, and Settings: Approximately 1422 postmenopausal women were recruited from the Camargo Cohort after excluding those with any known medical disorder or drug that might affect bone metabolism. Participants were categorized into four groups: 25OHD levels of 20 ng/mL or less and not taking statins (group 1; n = 492); 25OHD levels greater than 20 ng/mL and on statins (group 2; n = 143); 25OHD levels of 20 ng/mL or less and using statins (group 3; n = 112); and 2OHD levels greater than 20 ng/mL and non-statin use (group 4; n = 675). Multivariate analyses were performed to compare BMD and bone turnover markers between groups. RESULTS Women in group 2 had an adjusted femoral neck and total hip BMD higher than women in group 1 (P < .0001 and P = .003, respectively). A trend toward a significant difference was observed regarding lumbar BMD (P = .08). Serum aminoterminal propeptide of type 1 collagen and C-terminal telopeptide of type 1 collagen levels were lower in group 2 than in group 1, in crude and adjusted models, although only serum C-terminal telopeptide of type 1 collagen difference was significant (P = .009). CONCLUSIONS Women on statins and serum 25OHD levels above 20 ng/mL have greater BMD and less bone resorption than those without either of the factors. Differences, however, are not significant in women with only one of them. Vitamin D and statins seem to interact positively in their effects on bone metabolism.
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Affiliation(s)
- José L Hernández
- Bone Metabolic Unit (J.L.H., J.M.O., J.M., S.R., J.G.-M.), Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, Instituto de Investigación Marqués de Valdecilla, University of Cantabria, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad, and Epidemiology Unit (J.L.), Medical School, University of Cantabria, Centro de Investigación Biomédica en Red Epidemiología y Salud Pública, 39008 Santander, Spain; and Centro de Salud Camargo (G.R., J.C., J.d.J., I.P.-P.), 39600 Santander, Spain
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Hernández JL, Olmos JM, Romaña G, Martinez J, Castillo J, Yezerska I, Pinedo G, González-Macías J. Bone mineral density in statin users: a population-based analysis from a Spanish cohort. J Bone Miner Metab 2014; 32:184-91. [PMID: 23784551 DOI: 10.1007/s00774-013-0481-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Accepted: 05/12/2013] [Indexed: 12/01/2022]
Abstract
We studied 2,315 subjects (1,422 women and 893 men) from the Camargo Cohort and analyzed the differences in BMD between statin or non-statin users. We also studied effects of the type of statin, dose, pharmacokinetic properties, and length of treatment on bone mineral density (BMD). Of the subjects, 478 (21 %) were taking statins (256 women and 222 men). Overall, they had higher BMD than non-users (p < 0.0001). In adjusted multivariate models, women taking statins had higher BMD at femoral neck (p = 0.002) and total hip (p = 0.04) than non- users. No differences were found in men. Women taking simvastatin had higher increases in BMD than non-statin users at femoral neck (p = 0.02) and total hip (p = 0.009), those taking fluvastatin had lower BMD values at lumbar spine (p = 0.028), and those receiving lovastatin had higher increases at femoral neck (p = 0.006). In men, only atorvastatin was associated with higher femoral neck BMD than non-statin use (p = 0.029). Comparing with non-statin users, only women receiving lipophilic statins had greater BMD at femoral neck (p = 0.003). According to drug potency, women on high- or lower-potency agents showed higher BMD values at femoral neck than non-users (p = 0.028 and 0.022, respectively). In men, only high-potency statins were associated with higher femoral neck BMD than non-use (p = 0.021). No differences between dose or length of statin therapy were noted regarding BMD in either sex. In summary, in a large population-based cohort, women on statins had higher BMD at the hip than non-users. Overall, this increase in BMD was more evident in subjects on lipophilic or high-potency statins.
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Affiliation(s)
- José L Hernández
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria, IFIMAV, Red temática de investigación cooperativa en envejecimiento y fragilidad (RETICEF), Cantabria, Spain,
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Abstract
Osteoporosis is a prevalent disease that typically reduces bone strength and predisposes to fractures. It is a multifactorial disorder resulting from the interaction of genetic and acquired factors. Candidate gene studies and, more recently, genome-wide studies have identified a number of polymorphisms significantly associated with bone mass and fractures. Anti-resorptive drugs, which inhibit the differentiation and activity of osteoclasts, are frequently used to treat patients with osteoporosis.Several candidate gene studies have explored the association of genetic factors with drug response, including some common polymorphisms of the gene encoding FDPS (Farnesyl diphosphate synthase), an enzyme that is the main target of aminobisphosphonates. Although scarce data are available, interesting opportunities are open for a better understanding of the pharmacogenetics of osteoporosis and osteoporotic fractures. They include the reanalysis of data already available from epidemiological studies and clinical trials, as well as obtaining pharmacogenetic data in new studies. However, based upon the experience with previous genome-wide association studies, large collaborative efforts would be likely needed to obtain meaningful results.
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Affiliation(s)
- José A Riancho
- Bone Laboratory, Department of Internal Medicine, Hospital U.M. Valdecilla-IDIVAL, University of Cantabria, Av. Valdecilla s/n, Santander, 39008, Spain,
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García-Ibarbia C, Pérez-Núñez MI, Olmos JM, Valero C, Pérez-Aguilar MD, Hernández JL, Zarrabeitia MT, González-Macías J, Riancho JA. Missense polymorphisms of the WNT16 gene are associated with bone mass, hip geometry and fractures. Osteoporos Int 2013; 24:2449-54. [PMID: 23417354 DOI: 10.1007/s00198-013-2302-0] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Accepted: 01/28/2013] [Indexed: 01/09/2023]
Abstract
UNLABELLED Two missense polymorphisms of WNT16 were associated with hip bone mineral density (BMD), the buckling ratio of the femoral neck, calcaneal ultrasound and hip fractures in individuals under 80 years of age. These results confirm the association of the WNT16 gene with bone mass and osteoporotic fractures. INTRODUCTION Osteoporosis has a strong genetic component. Wnt ligands stimulate the differentiation of osteoblast precursors and play a major role in skeletal homeostasis. Therefore, the aim of this study was to explore the association of allelic variants of the WNT16 gene with BMD, other structural parameters of bone and osteoporotic hip fractures. METHODS Six single nucleotide polymorphisms were analysed in 1,083 Caucasian individuals over 49 years of age. RESULTS Two missense polymorphisms (rs2908004 and rs2707466) were associated with femoral neck BMD, with average differences across genotypes of 35 mg/cm(2) (p = 0.00037 and 0.0015, respectively). Likewise, the polymorphisms were associated with calcaneal quantitative ultrasound parameters (p = 0.00004 and 0.0014, respectively) and the buckling ratio, an index of cortical instability of the femoral neck (p = 0.0007 and 0.0029, respectively). Although there were no significant differences in the genotype frequency distributions between 294 patients with hip fractures and 670 controls, among the subgroup under 80 years of age, TT genotypes were underrepresented in patients with fractures (odds ratio 0.50; CI 0.27-0.94). CONCLUSION Common missense polymorphisms of the WNT16 gene are associated with BMD at the hip, calcaneal ultrasound and the buckling ratio of the femoral neck, as well as with hip fractures in individuals under 80 years of age. Overall, these results confirm the association of the WNT16 locus with BMD identified in genome-wide association studies and support its role in determining the risk of osteoporotic fractures.
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Affiliation(s)
- C García-Ibarbia
- Department of Internal Medicine, Hospital U.M.Valdecilla-IFIMAV, RETICEF, University of Cantabria, Av Valdecilla sn, 39008, Santander, Spain
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Hernández JL, Olmos JM, Pariente E, Nan D, Martínez J, Llorca J, Valero C, Obregón E, González-Macías J. Influence of vitamin D status on vertebral fractures, bone mineral density, and bone turnover markers in normocalcemic postmenopausal women with high parathyroid hormone levels. J Clin Endocrinol Metab 2013; 98:1711-7. [PMID: 23457409 DOI: 10.1210/jc.2012-3931] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
OBJECTIVE The aims of the study were to analyze whether there is an association between serum PTH and the prevalence of vertebral fractures and its possible dependence on vitamin D status, and to assess the influence of serum 25-hydroxyvitamin D (25OHD) in the relationship between PTH and bone mineral density (BMD) or bone turnover markers (BTMs). DESIGN, PARTICIPANTS, AND SETTING A total of 820 postmenopausal women were recruited after excluding those with any known condition that could influence serum PTH levels, except for a possible low serum 25OHD. Serum PTH and 25OHD concentrations, as well as vertebral fracture prevalence, BMD, and BTM (CTX and PINP) values were recorded. Serum PTH levels were divided into tertiles, and women were grouped into those in the highest tertile (>58 pg/ml) and those below. Serum 25OHD levels were stratified in 3 categories (<20, 20-30, and >30 ng/ml). RESULTS Vertebral fracture prevalence was greater in women with PTH above 58 pg/ml (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.04-2.84). After stratifying by 25OHD, this difference was only significant in women below 20 ng/ml (OR, 2.00; 95% CI, 1.02-3.87), those with 25OHD between 20 and 30 ng/ml showing a trend toward this (OR, 1.99; 95% CI, 0.92-4.36). Differences in BMD or BTM between women above and below 58 pg/ml of PTH were also observed only in those below 20 ng/ml. CONCLUSION Elevated PTH levels are associated with increased prevalence of vertebral fractures, low bone mass, or higher BTM only in the presence of hypovitaminosis D. An adequate nutritional status in the vitamin appears to protect the bone from the deleterious effect of a high PTH.
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Affiliation(s)
- José L Hernández
- Bone Metabolism Unit, Department of Internal Medicine, Hospital Marqués de Valdecilla, 39008 Santander, Spain.
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Hernández JL, Olmos JM, Romaña G, Martinez J, Castillo J, Yezerska I, Ramos C, González-Macías J. Bone turnover markers in statin users: a population-based analysis from the Camargo Cohort Study. Maturitas 2013; 75:67-73. [PMID: 23489550 DOI: 10.1016/j.maturitas.2013.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2012] [Revised: 02/10/2013] [Accepted: 02/12/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE To analyze the effects of statin use on bone turnover markers (BTM), in participants from a large population-based cohort. SUBJECTS AND METHODS Cross-sectional study that included 2431 subjects (1401 women and 930 men) from the Camargo Cohort. We analyzed the differences in serum BTM between statin or non-statin users, by means of a generalized linear model, adjusted for a wide set of covariates and stratified by diabetes status. We also studied the effect of the type of statin, dose, pharmacokinetic properties, and length of treatment, on BTM. RESULTS Five hundred subjects (21%) were taking statins (273 women and 227 men). Overall, they had lower levels of aminoterminal propeptide of type I collagen (PINP) and C-terminal telopeptide of type I collagen (CTX) than non-users (p<0.0001). BTM levels were significantly lower in diabetic women using statins, than in female non-statin users with diabetes. In men, we found similar results, but only for CTX. All the statins users had lower levels of BTM than non-users, except subjects taking fluvastatin that showed slightly higher values. In the whole sample, no differences between dose or drug-potency were noted regarding BTM. When comparing with non-statin users, only subjects taking lipophilic statins had lower BTM levels (p<0.0001). Serum CTX levels were lower in women using statins for more than 3 vs. 1-3 years (p=0.006). CONCLUSIONS In a large population-based cohort, serum BTM were lower in participants taking statins than in non-users, and this effect was modulated by diabetes status. Overall, this decrease in BTM was more evident in subjects receiving the more lipophilic statins, especially when using for more than 3 years.
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Affiliation(s)
- José L Hernández
- Bone Metabolic Unit, Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria-IFIMAV, RETICEF, Santander, Spain.
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Olmos JM, Hernández JL, Llorca J, Nan D, Valero C, González-Macías J. Effects of 25-hydroxyvitamin D3 therapy on bone turnover markers and PTH levels in postmenopausal osteoporotic women treated with alendronate. J Clin Endocrinol Metab 2012; 97:4491-7. [PMID: 23043189 DOI: 10.1210/jc.2012-2999] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
OBJECTIVE Our objective was to know the extent to which a fall in bone turnover markers is influenced by serum 25-hydroxyvitamin D (25OHD) levels in patients on alendronate (ALN) treatment. DESIGN, PARTICIPANTS, AND SETTING A total of 140 postmenopausal osteoporotic women were randomized to receive either ALN or ALN plus 25OHD(3) (ALN+VitD) over a 3-month period. Serum 25OHD, PTH, C-terminal telopeptide of type I collagen (CTX), and amino-terminal propeptide of type I collagen (P1NP) were measured at baseline and at the end of the 3 months. RESULTS 25OHD rose four times above baseline levels in the ALN+VitD group, whereas no changes were seen in the ALN group. Administering ALN resulted in a significant decline in both serum CTX (53 ± 24%) and P1NP (46 ± 19%). After ALN+VitD, the fall in CTX amounted to 61 ± 20% (P = 0.06 compared with ALN) and P1NP to 50 ± 23% (P = 0.35). When patients were divided into those below and above 20 ng/ml of baseline serum 25OHD, in those below, CTX decreased by 48 ± 26% in the ALN group and by 61 ± 17% in the ALN+VitD group (P = 0.015). For P1NP, the corresponding figures were 43 ± 20 and 50 ± 23% (P = 0.2). In patients above 20 ng/ml, no differences were seen regarding CTX (58 ± 21% decrease in the ALN group and 60 ± 23% in the ALN+VitD group; P = 0.7) or P1NP (49 ± 18 and 50 ± 20%; P = 0.9). CONCLUSIONS Administration of 25OHD(3) is not an indispensable requirement for bisphosphonates to develop their bone antiresorptive effect. In fact, in patients with vitamin D sufficiency, no benefit is observed when the vitamin is added. However, in patients with vitamin D deficiency, an approximately 25% greater fall in the bone resorption marker CTX is seen with its administration.
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Affiliation(s)
- José M Olmos
- Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla-Instituto de Formación e Investigación Marqués de Valdecilla (IFIMAV), Universidad de Cantabria, Red Temática de Investigación Cooperativa en Envejecimiento y Fragilidad (RETICEF), E-39008 Santander, Spain
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Jackowski SA, Kontulainen SA, Cooper DML, Lanovaz JL, Baxter-Jones ADG. The timing of BMD and geometric adaptation at the proximal femur from childhood to early adulthood in males and females: a longitudinal study. J Bone Miner Res 2011; 26:2753-61. [PMID: 21773991 DOI: 10.1002/jbmr.468] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
During adolescence, the peak velocity in bone mass accretion preceded the peak velocity of estimated geometry at the hip. Whether this pattern continues into adulthood when maximum values are achieved remains unknown. The purpose of this study was (1) to identify the ages at which peak values of areal BMD (aBMD), cross-sectional area (CSA), and section modulus (Z) occur, (2) to determine the percent of adult peak attained during adolescence, and (3) to determine the relationship between body composition and the timing of the adult peak values. One-hundred and sixty-five (92 females) individuals' aBMD, CSA, and Z values were assessed serially at the narrow neck (NN), intertrochanter (IT), and shaft (S) using hip structural analysis (HSA). Peak bone values and the ages of attainment were assessed using factorial MANOVA. In males, aBMDp (NN 19.4 ± 2.7 years, IT 20 ± 3.4 years, and S 21.8 ± 2.8 years) occurred significantly earlier than CSAp at all sites (NN 21.6 ± 3.2 years, IT 21.1 ± 3.4 years, and S 22.3 ± 3.1 years) and earlier than Zp at the NN (22 ± 3.2 years) and IT (21.3 ± 2.9 years). In females, aBMDp (NN 17.9 ± 2.7 years, IT 18.7 ± 3.5 years, and S 19.7 ± 3.3 years) occurred significantly earlier than CSAp at all sites (NN 20.6 ± 3.6 years, IT 19.4 ± 3.9 years, and S 21.0 ± 3.3 years) and earlier than Zp at the NN (20.7 ± 3.4 years) and S (20.6 ± 3.5 years). The changes in bone mass precede changes in geometric CSA, and this timing may be integral for the development and maintenance of bone strength.
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Affiliation(s)
- Stefan A Jackowski
- College of Kinesiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
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15
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Abstract
OBJECTIVES The aims of this study were to compare in participants with and without metabolic syndrome (1) bone mineral density (BMD), (2) prevalent vertebral and nonvertebral fractures, and (3) calciotropic hormones and bone turnover markers and to examine the association of each component of metabolic syndrome with bone parameters. METHODS A cross-sectional study (495 men and 1,013 women) from the Camargo Cohort Study was conducted. A multivariable regression approach was used to analyze the relationship between the components of metabolic syndrome and bone parameters. RESULTS Women with metabolic syndrome had higher age-adjusted BMD at all localizations (P < 0.0001) than did women without metabolic syndrome. Adjusting for body mass index canceled out this difference at the spine and femoral neck, although borderline significance persisted at the total hip. Moreover, in regression analyses, waist circumference (P < 0.0001) and hypertension (P between 0.002 and <0.0001) highly correlated with BMD at the three sites. However, no significant differences in BMD were found in men between those with and without metabolic syndrome. No differences in the prevalence of vertebral or nonvertebral fractures between participants with metabolic syndrome and controls were found for either sex. 25-Hydroxyvitamin D was significantly lower (P < 0.0001) and parathyroid hormone was significantly higher (P < 0.0001) in women with metabolic syndrome than in women without metabolic syndrome, whereas no differences were seen in men. Propeptide of type I collagen and C-terminal telopeptide of type I collagen were significantly lower in participants with metabolic syndrome than in controls in either sex. CONCLUSIONS Women with metabolic syndrome show higher BMD than controls do, mainly driven by their higher body weight. Bone remodeling in these women is lower. Despite the greater bone mass and lower bone turnover, fracture prevalence is not reduced, suggesting worse bone quality and/or higher tendency to fall. No differences in BMD or fractures were seen in men, suggesting that the impact of metabolic syndrome on bone is sex dependent.
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Olmos JM, Valero C, del Barrio AG, Amado JA, Hernández JL, Menéndez-Arango J, González-Macías J. Time course of bone loss in patients with anorexia nervosa. Int J Eat Disord 2010; 43:537-42. [PMID: 19658172 DOI: 10.1002/eat.20731] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To evaluate the time course of bone mineral density (BMD) in women with anorexia nervosa (AN) during 2-year follow-up. METHOD We prospectively studied 51 female with AN aged 18-38 years, and 40 age-matched healthy women (19-34 years). BMD was measured in lumbar spine (LS), femoral neck (FN), and total hip (TH) by DXA. RESULTS At baseline, weight, body mass index, and lumbar and hip BMD were significantly (p < .001) lower in AN patients than in controls. Patients who gain weight showed a significant increase in BMD at FN (+1.6%; p < .05), and TH (+4.4%; p < .05) and lower nonsignificant changes in LS (+1.3%). Weight at entry, and percent change of weight were significant determinants (p < .05) of the variability in percent change of BMD at FN and TH, whereas weight at entry was the main determinant of bone modifications at lumbar spine. DISCUSSION Our data emphasize the influence of weight gain in recovery of bone mass in AN patients, especially at the hip.
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Affiliation(s)
- José M Olmos
- Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla, University of Cantabria, RETICEF, Santander, Spain.
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Olmos JM, Hernández JL, Martínez J, Pariente E, Llorca J, González-Macías J. Bone turnover markers in Spanish adult men The Camargo Cohort Study. Clin Chim Acta 2010; 411:1511-5. [PMID: 20594548 DOI: 10.1016/j.cca.2010.06.010] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2010] [Revised: 05/26/2010] [Accepted: 06/08/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND This cross-sectional study was performed to determine the reference ranges for two bone turnover markers-aminoterminal propeptide of type I collagen (P1NP) and C-terminal telopeptide of type I collagen (beta-CTX)-in normal adult Spanish men as measured in serum by automated methods. METHODS A community-based population of 660 healthy men > or = 50 years was evaluated. Fasting serum levels of P1NP, beta-CTX, 25-hydroxyvitamin D, and intact parathyroid hormone were measured on the Elecsys 2010 automated analyzer (Roche). BMD at lumbar spine, femoral neck and total hip was determined by DXA. RESULTS Mean age of participants was 65 + or - 9 years. Logarithmic transformation of both markers was performed to allow for normal distribution. Mid-95% ranges for P1NP and beta-CTX were 15-78 ng/ml and 0.069-0.760 ng/ml, respectively. Median and interquartile range of serum P1NP and beta-CTX were 33.5 [25.5;44.4] ng/ml and 0.27 [0.19;0.38] ng/ml, respectively. Mean values of P1NP (37.1 + or - 16.7 ng/ml) were similar to those previously described. beta-CTX mean values (0.300 + or - 0.171 ng/ml) were also similar to those quoted by the manufacturers in men younger than 70 years, but slightly lower than those reported in subjects older than 70 years. Both markers were higher among osteoporotic men. After excluding from the analysis those men who were found to have BMD below -2.5 T-score, 25OHD serum level below 30 ng/ml or serum PTH above 65 pg/ml, P1NP and beta-CTX ranges were 17-71 ng/ml and 0.070-0.681 ng/ml, again respectively. CONCLUSIONS Values obtained from this well-characterized population study provide reference ranges for serum automated P1NP and beta-CTX in normal Spanish adult men.
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Affiliation(s)
- José M Olmos
- Department of Internal Medicine, Hospital Universitario Marqués de Valdecilla-IFIMAV, Universidad de Cantabria, RETICEF, Santander, Spain.
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Bhattacharya A, Watts NB, Davis K, Kotowski S, Shukla R, Dwivedi AK, Coleman R. Dynamic bone quality: a noninvasive measure of bone's biomechanical property in osteoporosis. J Clin Densitom 2010; 13:228-36. [PMID: 20347363 PMCID: PMC2862806 DOI: 10.1016/j.jocd.2010.01.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2009] [Revised: 12/31/2009] [Accepted: 01/01/2010] [Indexed: 10/19/2022]
Abstract
We describe a novel approach to characterize bone quality noninvasively, a measurement that quantifies aggregate shock-absorption capacity of load-bearing bones as a measure of mechanical structural integrity during exposure to real-time self-induced in vivo loading associated with heel strike. The outcome measure, damping factor, was estimated at 5 load-bearing anatomical sites: ankle, tibial tuberosity, femoral condyle, lower back (at 3rd lumbar vertebra), and upper back (7th thoracic vertebra) plus the forehead in 67 patients with postmenopausal osteoporosis with and without documented vertebral fractures. The damping value was significantly lower in patients with vertebral fractures compared with those without a fracture (range: -36% to -72%; median: -44%). In these women with osteoporosis, damping factor was able to discriminate between patients with and without vertebral fractures, whereas traditional measures of bone density and biomechanical measures obtained from bone geometry were not significantly different between the groups.
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Affiliation(s)
- Amit Bhattacharya
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH
| | - Nelson B. Watts
- University Bone Health and Osteoporosis Center, Department of Internal Medicine, Cincinnati, OH
| | - Kermit Davis
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH
| | - Susan Kotowski
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH
| | - Rakesh Shukla
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH
| | - Alok Kumar Dwivedi
- University of Cincinnati College of Medicine, Department of Environmental Health, Cincinnati, OH
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Olmos JM, Hernández JL, Martínez J, Castillo J, Valero C, Pérez Pajares I, Nan D, González-Macías J. Bone turnover markers and bone mineral density in hypertensive postmenopausal women on treatment. Maturitas 2010; 65:396-402. [DOI: 10.1016/j.maturitas.2010.01.007] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Revised: 01/07/2010] [Accepted: 01/08/2010] [Indexed: 01/22/2023]
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20
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Bone turnover markers in Spanish postmenopausal women. Clin Chim Acta 2009; 409:70-4. [DOI: 10.1016/j.cca.2009.08.020] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2009] [Revised: 08/27/2009] [Accepted: 08/27/2009] [Indexed: 11/18/2022]
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Nissen N, Madsen JS, Bladbjerg EM, Beck Jensen JE, Jørgensen NR, Langdahl B, Abrahamsen B, Brixen K. No association between hip geometry and four common polymorphisms associated with fracture: the Danish osteoporosis prevention study. Calcif Tissue Int 2009; 84:276-85. [PMID: 19225709 DOI: 10.1007/s00223-009-9219-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2008] [Accepted: 01/16/2009] [Indexed: 10/21/2022]
Abstract
Both osteoporosis and hip geometry are independently associated with fracture risk. There is a significant genetic contribution to the risk of osteoporosis, and evidence provided by twin studies has suggested that hip geometry may also in part be genetically programmed. Polymorphisms in a number of genes, including those coding for methylene-tetrahydrofolate reductase (MTHFR c.677C > T), the purinergic P2X(7) receptor (Glu496Ala and Ile568Asn), and the low-density lipoprotein receptor-related protein 5 (LRP5 exon 9 [c.266A > G]), have been associated with an increased fracture incidence and/or reduced bone mineral density (BMD). The aim of the present study was to test whether these polymorphisms influence hip structural geometry in perimenopausal women. The four polymorphisms were genotyped in 800 healthy recently perimenopausal women never using hormone replacement therapy. BMD of the femoral neck was measured using a Hologic QDR-2000 densitometer and femoral neck axis length, neck width, neck shaft angle, and femoral head diameter were measured from the screen images. Genotype frequencies were compatible with Hardy-Weinberg equilibrium. No significant differences between homozygotes for the minor allele and carriers of the common allele regarding parameters of hip geometry were demonstrated. According to the anthropometric characteristics of the subjects, only body height in the MTHFR TT genotype group was significantly different from the combined CT/CC genotype group (P < 0.05). The geometric dimensions of the proximal femur in perimenopausal women are not associated with the MTHFR c.677C > T, P2X(7) (Glu496Ala), P2X(7) (Ile568Asn), and LRP5 exon 9 (c.266A > G) polymorphisms.
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Affiliation(s)
- N Nissen
- Department of Endocrinology, Odense University Hospital, University of Southern Denmark, Odense, 5000, Odense C, Denmark.
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Gregory JS, Aspden RM. Femoral geometry as a risk factor for osteoporotic hip fracture in men and women. Med Eng Phys 2008; 30:1275-86. [PMID: 18976949 DOI: 10.1016/j.medengphy.2008.09.002] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2008] [Revised: 09/25/2008] [Accepted: 09/25/2008] [Indexed: 10/21/2022]
Abstract
Osteoporotic hip fracture is associated with high mortality and morbidity and often results in a loss of mobility and independence. Osteoporosis is diagnosed by measuring Bone Mineral Density (BMD), a measure of the amount of mineral in a bone. Although BMD continues to serve well it does not fully account for bone strength and only partially accounts for the risk of hip fracture. The shape and structure of the proximal femur also help to determine how forces act in the hip in a fall and their measurement can aid the prediction of hip fracture. This review examines the link between simple geometrical measures of the proximal femur and hip fracture, or bone strength. It will explore how they relate to each other and to anthropometric factors such as sex, height, weight and age. Limitations in these measures will be identified and new methods of analysis reviewed that encompass many different aspects of the shape of the femur. These new methods show great promise for improving the prediction of fracture risk in the future.
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Affiliation(s)
- Jennifer S Gregory
- Bone and Musculoskeletal Programme, Division of Applied Medicine, University of Aberdeen, UK.
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Bhattacharya A, Watts NB, Gordon J, Shukla R, Waters T, Bartels S, Coleman R. Bone Quantity and Quality of Youths Working on a Farm—A Pilot Study. J Agromedicine 2008; 12:27-38. [DOI: 10.1080/10599240801985589] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Guijarro M, Valero C, Paule B, Gonzalez-Macias J, Riancho JA. Bone mass in young adults with Down syndrome. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2008; 52:182-189. [PMID: 18261017 DOI: 10.1111/j.1365-2788.2007.00992.x] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
BACKGROUND Down syndrome (DS) is a frequent cause of intellectual disability. With the increasing life expectancy of these patients, concerns have been raised about the risk of osteoporosis. In fact, several investigators have reported a reduced bone mass in DS. However, the results may be confounded by comorbid diseases, and differences in lifestyle habits and body size. Therefore, we planned to determine anthropometric and lifestyle factors influencing bone mineral density (BMD) in young adults with DS. METHODS Thirty-nine patients with DS (mean age 26 years) and 78 controls were studied. Areal BMD was measured by dual x-ray densitometry (DXA); volumetric BMD at the lumbar spine and femoral neck was estimated with published formulae. RESULTS DS patients had lower areal BMD than controls at all regions (spine, hip and total body). Height and projected bone area were also lower. There were no differences between both groups regarding estimated volumetric BMD at the femoral neck. However, spine volumetric BMD was also lower in DS than controls. In multivariate analysis, DS, male sex, little physical activity and low sunlight exposure were associated with lower spine volumetric BMD; on the other hand, fat mass and sunlight exposure were associated with femoral neck volumetric BMD. CONCLUSION This study shows that patients with DS had a reduced areal BMD, but it is in part a consequence of the reduced body size, particularly at the femoral neck. Physical activity and sunlight exposure are associated to volumetric BMD and should be stimulated in order to maintain an adequate bone mass in these patients.
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Affiliation(s)
- M Guijarro
- Department of Internal Medicine, Hospital U.M. Valdecilla, University of Cantabria, Santander, Spain
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