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Kuliczkowska-Płaksej J, Zdrojowy-Wełna A, Jawiarczyk-Przybyłowska A, Gojny Ł, Bolanowski M. Diagnosis and therapeutic approach to bone health in patients with hypopituitarism. Rev Endocr Metab Disord 2024; 25:513-539. [PMID: 38565758 DOI: 10.1007/s11154-024-09878-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
The results of many studies in recent years indicate a significant impact of pituitary function on bone health. The proper function of the pituitary gland has a significant impact on the growth of the skeleton and the appearance of sexual dimorphism. It is also responsible for achieving peak bone mass, which protects against the development of osteoporosis and fractures later in life. It is also liable for the proper remodeling of the skeleton, which is a physiological mechanism managing the proper mechanical resistance of bones and the possibility of its regeneration after injuries. Pituitary diseases causing hypofunction and deficiency of tropic hormones, and thus deficiency of key hormones of effector organs, have a negative impact on the skeleton, resulting in reduced bone mass and susceptibility to pathological fractures. The early appearance of pituitary dysfunction, i.e. in the pre-pubertal period, is responsible for failure to achieve peak bone mass, and thus the risk of developing osteoporosis in later years. This argues for the need for a thorough assessment of patients with hypopituitarism, not only in terms of metabolic disorders, but also in terms of bone disorders. Early and properly performed treatment may prevent patients from developing the bone complications that are so common in this pathology. The aim of this review is to discuss the physiological, pathophysiological, and clinical insights of bone involvement in pituitary disease.
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Affiliation(s)
- Justyna Kuliczkowska-Płaksej
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
| | - Aleksandra Zdrojowy-Wełna
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
| | - Aleksandra Jawiarczyk-Przybyłowska
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland.
| | - Łukasz Gojny
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
| | - Marek Bolanowski
- Department and Clinic of Endocrinology, Diabetes and Isotope Therapy, Wroclaw Medical University, Wybrzeże Pasteura 4, Wrocław, 50-367, Poland
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Jepsen DB, Bergen ES, Pan J, van Poelgeest E, Osman A, Burghle A, Ryg J, Thompson W, Lundby C. Recommendations on deprescribing of bisphosphonates in osteoporosis guidelines: a systematic review. Eur Geriatr Med 2023; 14:747-760. [PMID: 37393587 DOI: 10.1007/s41999-023-00820-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Accepted: 06/14/2023] [Indexed: 07/04/2023]
Abstract
PURPOSE Advancing age, declining health status, and a shift in benefit/risk balance warrant judicious use of preventive medications in older persons, including consideration of deprescribing. Lack of guidance on deprescribing is a major barrier for prescribers to consider deprescribing in daily practice. The aim of this review was to evaluate to what extent osteoporosis guidelines include bisphosphonate deprescribing recommendations. METHODOLOGY We conducted a systematic review, searching PubMed, Embase, and grey literature. We included guidelines on treatment of osteoporosis with bisphosphonates. Two independent reviewers screened titles, abstracts, and full texts. Recommendations for deprescribing were extracted, and quality of guidelines were assessed. RESULTS Among 9345 references, 42 guidelines were included. A total of 32 (76%) guidelines included deprescribing recommendations: 29 (69%) guidelines included non-specific deprescribing recommendations framed as a drug holiday, of which 2 (5%) also included specific deprescribing recommendations based on individual health context (e.g. life expectancy, frailty, function, preferences/goals). Twenty-four (57%) guidelines included practical deprescribing recommendations, and 27 (64%) guidelines included recommendations for when deprescribing should not be considered. CONCLUSION Bisphosphonate deprescribing recommendations in osteoporosis guidelines were primarily framed as drug holidays, with limited guidance on how to make individualized deprescribing decisions based on individual health context. This suggests a need for additional focus on deprescribing in osteoporosis guidelines.
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Affiliation(s)
- Ditte Beck Jepsen
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark.
| | - Emilie Sofie Bergen
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jeffrey Pan
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Eveline van Poelgeest
- Department of Internal Medicine, Section of Geriatrics, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging and Later Life, Amsterdam, The Netherlands
| | - Abdiaziz Osman
- Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark
| | - Alaa Burghle
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark
| | - Jesper Ryg
- Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Wade Thompson
- Department of Anesthesiology, Pharmacology and Therapeutics, Therapeutics Initiative, Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Carina Lundby
- Clinical Pharmacology, Pharmacy and Environmental Medicine, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Hospital Pharmacy Funen, Odense University Hospital, Odense, Denmark
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
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Bautista Litardo N, López Gavilanez E. First Ecuadorian consensus statement on the management of osteoporosis. Arch Osteoporos 2023; 18:106. [PMID: 37505312 DOI: 10.1007/s11657-023-01315-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 07/19/2023] [Indexed: 07/29/2023]
Affiliation(s)
- N Bautista Litardo
- AECE Research Group, The Association of Clinical Endocrinologists of Ecuador, Cdla Urdesa Norte, Av. 1ra # 107 y calle 1ra. 090112, Guayaquil, Ecuador
| | - E López Gavilanez
- AECE Research Group, The Association of Clinical Endocrinologists of Ecuador, Cdla Urdesa Norte, Av. 1ra # 107 y calle 1ra. 090112, Guayaquil, Ecuador.
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Gavilanez EL, Luis IN, Mario NG, Johansson H, Harvey NC, Lorentzon M, Liu E, Vandenput L, McCloskey EV, Kanis JA. An assessment of intervention thresholds for high fracture risk in Chile. Arch Osteoporos 2022; 18:11. [PMID: 36527508 DOI: 10.1007/s11657-022-01198-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
Assessment and treatment pathways using FRAX-based intervention thresholds in Chile can be used to identify patients at high risk of fracture and avoid unnecessary treatment in those at low fracture risk. PURPOSE The aim of the present study was to explore treatment paths and characteristics of women eligible for treatment in Chile based on major osteoporotic fracture (MOF) probabilities derived from FRAX®. METHODS Intervention and assessment thresholds were derived using methods adopted by the National Osteoporosis Guideline Group for FRAX-based guidelines in the UK but based on the epidemiology of fracture and death in Chile. Age-dependent and hybrid assessment and intervention thresholds were applied to 1998 women and 1122 men age 50 years or more drawn from participants in the National Health Survey 2016-2017. RESULTS Approximately 12% of men and women had a prior fragility fracture and would be eligible for treatment for this reason. Using age-dependent thresholds, an additional 2.6% of women (0.3% of men) were eligible for treatment in that MOF probabilities lay above the upper assessment threshold. A BMD test would be recommended in 5% of men and 38% of women. With hybrid thresholds, an additional 13% of women (3.6% of men) were eligible for treatment and BMD recommended in 11% of men and 42% of women. CONCLUSION The application of hybrid intervention thresholds ameliorates the disparity in fracture probabilities seen with age-dependent thresholds. Probability-based assessment of fracture risk, including the use of the hybrid intervention thresholds for Chile, is expected to help guide decisions about treatment.
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Affiliation(s)
- Enrique Lopez Gavilanez
- AECE Research Group, The Association of Clinical Endocrinologists of Ecuador, Guayaquil, Ecuador
- Hospital Docente de La Policía Nacional Guayaquil #2, Guayaquil, Ecuador
| | - Imaicela N Luis
- AECE Research Group, The Association of Clinical Endocrinologists of Ecuador, Guayaquil, Ecuador
| | - Navarro G Mario
- AECE Research Group, The Association of Clinical Endocrinologists of Ecuador, Guayaquil, Ecuador
| | - Helena Johansson
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mattias Lorentzon
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Enwu Liu
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Liesbeth Vandenput
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Sahlgrenska Osteoporosis Centre, Institute of Medicine, University of Gothenburg, Gothenburg, Sweden
| | - Eugene V McCloskey
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK
- Department of Oncology and Metabolism, Mellanby Centre for Musculoskeletal Research, University of Sheffield, Sheffield, UK
| | - John A Kanis
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, S10 2RX, UK.
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Grili PPDF, Vidigal CV, da Cruz GF, Albergaria BH, Marques-Rocha JL, Pereira TSS, Guandalini VR. Dietary consumption of selenium inversely associated with osteoporosis in postmenopausal women. Front Nutr 2022; 9:997414. [PMID: 36172523 PMCID: PMC9511160 DOI: 10.3389/fnut.2022.997414] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 08/24/2022] [Indexed: 11/24/2022] Open
Abstract
Background Osteoporosis is a skeletal disease characterized by reduced bone mineral density (BMD), which increases the risk of falls and fractures and reduces mobility. Some nutrients have a well-established role in maintaining bone health and preventing osteoporosis, while selenium (Se) has aroused interest in bone health possibly because of its anti-inflammatory and antioxidant capacity. The aim of this study was to evaluate the association between dietary Se consumption and BMD in postmenopausal women. Materials and methods Cross-sectional, observational, analytical study carried out with women in menopause for at least 12 months, aged ≥ 50 years. Sociodemographic, lifestyle, and clinical data variables were studied. BMD was assessed using Dual Energy X-ray Absorptiometry (DXA) and the participants classified as having normal BMD, osteopenia, or osteoporosis. Dietary consumption of Se was assessed by the food frequency questionnaire (FFQ) and classified into quartiles of consumption. Multivariate logistic regression with three fit models was applied to investigate the association of BMD with Se consumption quartiles. The significance level adopted for all tests was 5.0%. Results The final sample consisted of 124 women aged in average 66.8 ± 6.1 years and with a time since menopause of 19.6 ± 8.8 years. According to the BMD, 41.9% of the women had osteopenia and 36.3% osteoporosis. The mean consumption of Se was 154.4 ± 88.7 μg/day. The highest consumption of Se was observed among women with normal BMD (51.9%), whereas lower consumption levels were found in 57.7% of women with osteopenia and in 60.0% of women with osteoporosis (p = 0.003). In the multivariate analysis, after adjusting for possible confounding variables, Se remained associated with the group of women with osteoporosis. Postmenopausal women in the highest quartile (≥94.0 μg/day) of Se consumption had an OR of 0.02 (95%CI: 0.001-0.41; p = 0.012) of having osteoporosis when compared with women in the lowest quartile. Conclusion Se consumption was associated with BMD and postmenopausal women with higher Se consumption were less likely to have osteoporosis.
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Affiliation(s)
- Patricia Paula da Fonseca Grili
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Camila Vilarinho Vidigal
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Geise Ferreira da Cruz
- Department of Integrated Education, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | - Ben Hur Albergaria
- Department of Social Medicine, Federal University of Espirito Santo, Vitória, Espirito Santo, Brazil
| | - José Luiz Marques-Rocha
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Department of Integrated Education, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
| | | | - Valdete Regina Guandalini
- Postgraduate Program in Nutrition and Health, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
- Department of Integrated Education, Health Sciences Center, Federal University of Espírito Santo, Vitória, Espírito Santo, Brazil
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da Cruz GF, Lunz TM, Rocha de Jesus T, Costa MB, Vidigal CV, Albergaria BH, Marques-Rocha JL, Guandalini VR. Low appendicular skeletal muscle mass index is associated with the anthropometric variables of post-menopausal women. BMC Geriatr 2022; 22:639. [PMID: 35922763 PMCID: PMC9346057 DOI: 10.1186/s12877-022-03313-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Accepted: 07/18/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Skeletal muscle mass is a central component of body composition and its decline is enhanced during aging. We verified the association between the appendicular skeletal muscle mass index (ASMI) with the anthropometric variables, biochemical variables, and lifestyle of postmenopausal women. METHODS Cross-sectional observational study conducted with postmenopausal women. Sociodemographic, clinical, lifestyle, physical activity level, biochemical, and anthropometric markers were collected. Body composition was assessed by dual-energy densitometry. Multivariate logistic regression analysis was applied. RESULTS One hundred fourteen women aged in average 66.0 ± 5.8 years were evaluated. There was a significant association between ASMI and age (p = 0.004), body mass (p < 0.001), body mass index (BMI) (p < 0.001), adductor pollicis muscle thickness (APMT) (p < 0.001), plasma calcium levels (p = 0.003), calf circumference (CC), and waist circumference (WC) (p < 0.001 for both). Adjusted regression analyses revealed the influence of BMI, CC, and APMT in the 1st tertile of ASMI (p < 0.05), BMI and CC in the 2rd tertile of ASMI. CONCLUSIONS ASMI was associated with BMI and muscle mass reserve indicators such as CC and DAPMT. In clinical practice, this indicates that simple, low-cost measures with good applicability can be used to predict and track the risk of depletion of skeletal muscle mass and consequent sarcopenia.
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Affiliation(s)
- Geise Ferreira da Cruz
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Tatiana Mion Lunz
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Tatielle Rocha de Jesus
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Mariana Braga Costa
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Camila Vilarinho Vidigal
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Ben-Hur Albergaria
- Department of Social Medicine, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - José Luiz Marques-Rocha
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil
| | - Valdete Regina Guandalini
- Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil.
- Department of Integrated Education, Federal University of Espirito Santo, Marechal Campos, avenue, 1468 - Maruípe, Vitória, Espírito Santo, 29040-090, Brazil.
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You K, Yang L, Shen J, Liu B, Guo Y, Chen T, Li G, Lu H. Relationship between Gut Microbiota and Bone Health. Mini Rev Med Chem 2022; 22:2406-2418. [PMID: 35249483 DOI: 10.2174/1389557522666220304230920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 11/16/2021] [Accepted: 12/14/2021] [Indexed: 11/22/2022]
Abstract
Gut microbiota (GM) are microorganisms that live in the host gastrointestinal tract, and their abundance varies throughout the host's life. With the development of sequencing technology, the role of GM in various diseases has been increasingly elucidated. Unlike earlier studies on orthopedic diseases, this review elucidates the correlation between GM health and bone health, and discusses the potential mechanism of GM effects on host metabolism, inflammation, and ability to induce or aggravate some common orthopedic diseases such as osteoarthritis, osteoporosis, rheumatoid arthritis, etc. Finally, the prospective methods of GM manipulation and evaluation of potential GM-targeting strategies in the diagnosis and treatment of orthopedic diseases are reviewed.
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Affiliation(s)
- Ke You
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Lianjun Yang
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Jun Shen
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Bin Liu
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Yuanqing Guo
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Tao Chen
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Guowei Li
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
| | - Hai Lu
- Department of Spine Surgery, The Fifth Affiliated Hospital, Sun Yat-sen University, Zhuhai 519000, Guangdong, China
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Souto Braz RR, Campos SL, Villela DW, Antonino GB, Araújo Batista PK, Guerino MR, Rodrigues FTM, Pereira Alves KF, Duarte JVT, de Andrade Silva D, Lima DF, da Silva AFF, de Oliveira KCV, dos Santos EKD, Leite WS, de Lucena LC, de Lima Ferreira AP, Monte-Silva K, das Graças Rodrigues de Araújo M, Taiar R. Effectiveness of Whole-Body Vibration Combined with Multicomponent Training on the Risk of Falls and Quality of Life in Elderly Women with Osteoporosis: Study Protocol for a Randomized Controlled Clinical Trial. BIOLOGY 2022; 11:biology11020266. [PMID: 35205132 PMCID: PMC8869511 DOI: 10.3390/biology11020266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 01/31/2022] [Accepted: 02/02/2022] [Indexed: 11/16/2022]
Abstract
Osteoporosis and the risk of falls increase the risk of fractures and events of falls. Prescriptions and programs for different forms of exercise have different impacts on the risk of falls, and exercises from multiple categories of whole-body vibration can be effective. This study aims to evaluate the effectiveness of whole-body vibration (WBV) protocol combined with multicomponent training (MCT) in elderly women with osteoporosis and their history of falls. Our proposal is a protocol for a randomized clinical trial, divided into two stages: First, development of a protocol for WVB combined with MCT for elderly women with osteoporosis and a history of falls, under the Guidelines of the American College of Sports Medicine, and following the recommendations of the Standard Protocol Items Recommendations for Interventional Trials (SPIRIT), and second, a randomized controlled clinical trial following the Consolidated Standards of Reporting Trials (CONSORT). This trial will have implications for the effectiveness of a vibration protocol combined with multicomponent exercise on the risk of falls and quality of life for older women with osteoporosis. We expect that adding full-body vibration to an exercise protocol will decrease the risk of falls and improve participants’ quality of life, as well as their strength, balance, and functional capacity.
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Affiliation(s)
- Rúbia Rayanne Souto Braz
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - Shirley Lima Campos
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Programa de Pós Graduação de Biologia Aplicada à Saúde, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil;
| | - Débora Wanderley Villela
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Gabriel Barreto Antonino
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
| | | | - Marcelo Renato Guerino
- Programa de Pós-Graduação em Saúde Translacional, Centro de Ciências Médicas, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil;
- Programa de Pós-Graduação em Ciências da Saúde, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
| | - François Talles Medeiros Rodrigues
- Programa de Pós-Graduação em Ciências da Saúde, Instituto de Ciências Biológicas, Universidade de Pernambuco (UPE), Recife 50100-010, PE, Brazil;
| | - Kennedy Freitas Pereira Alves
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - João Victor Torres Duarte
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Diana de Andrade Silva
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Daniel Florentino Lima
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Arthur Felipe Freire da Silva
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Karla Cybele Vieira de Oliveira
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - Edy Kattarine Dias dos Santos
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
| | - Wagner Souza Leite
- Programa de Pós Graduação de Biologia Aplicada à Saúde, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil;
| | | | - Ana Paula de Lima Ferreira
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
| | - Kátia Monte-Silva
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Programa de Pós-Graduação em Neuropsiquiatria e Ciências do Comportamento, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil
| | - Maria das Graças Rodrigues de Araújo
- Programa de Pós-Graduação em Fisioterapia, Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (R.R.S.B.); (S.L.C.); (D.W.V.); (G.B.A.); (K.F.P.A.); (K.C.V.d.O.); (E.K.D.d.S.); (A.P.d.L.F.); (K.M.-S.)
- Departamento de Fisioterapia, Universidade Federal de Pernambuco (UFPE), Recife 50670-901, PE, Brazil; (J.V.T.D.); (D.d.A.S.); (D.F.L.); (A.F.F.d.S.)
- Correspondence:
| | - Redha Taiar
- MATIM, Université de Reims Champagne-Ardenne, 51100 Reims, France;
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9
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Characteristics Associated with Acute-Phase Response following First Zoledronic Acid Infusion in Brazilian Population with Osteoporosis. J Osteoporos 2021; 2021:9492883. [PMID: 35003621 PMCID: PMC8731262 DOI: 10.1155/2021/9492883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 11/18/2021] [Accepted: 12/17/2021] [Indexed: 11/17/2022] Open
Abstract
We aimed to evaluate characteristics associated with acute-phase response (APR) following first zoledronic acid infusion in a Brazilian cohort. This retrospective cohort study enrolled all adults with osteoporosis who underwent a first zoledronic acid infusion at our centre between June 2015 and June 2019. Clinical demographics (age, sex, diabetes, smoking, body mass index, and previous oral bisphosphonate use) and laboratory data (calcium, parathyroid hormone, renal function, and serum 25-hydroxyvitamin D and carboxy-terminal crosslinked telopeptide of type 1 collagen [CTX], both before and after infusion) were compared between patients with and without APR. We evaluated association magnitude between the presence of APR and clinical variables through logistic regression. This study enrolled 400 patients (women, 80%). APR was observed in 24.5% (n = 98) of patients. The mean symptom duration in days was 3.5 ± 2.8. Patients with APR were younger (67 ± 12 vs. 71 ± 11 years; p=0.001), used oral bisphosphonates less frequently (34% × 50%; p=0.005), and had greater baseline CTX (0.535 ng/mL [0.375, 0.697] × 0.430 [0.249, 0.681]; p=0.03) and ΔCTX (-69 [-76; -50] × -54 [-72; -23]; p=0.002) than those without APR. The other variables were similar between the groups. Only ΔCTX was associated (OR, 0.62; 95% CI 0.41-0.98) with APR after accounting for age and bisphosphonate use. APR occurred in 24.5% of the cohort. Younger age and absence of prior oral bisphosphonate use were associated with APR following first zoledronic acid infusion. APR was associated with ΔCTX (but no other variables) after adjusting for these factors.
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10
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Ng JY, Hilal A, Maini I. What traditional, complementary, and integrative medicine recommendations exist across osteoporosis clinical practice guidelines? A systematic review and quality assessment. Integr Med Res 2021; 11:100803. [PMID: 34840950 PMCID: PMC8605333 DOI: 10.1016/j.imr.2021.100803] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 09/07/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022] Open
Abstract
Background Traditional, complementary and integrative medicine (TCIM) is sought by more than 50% of patients with osteoporosis. Despite this, many healthcare providers lack the knowledge to adequately counsel patients on safe and effective TCIM use. The purpose of this study was to determine the quantity and quality of TCIM recommendations in clinical practice guidelines (CPGs) for the treatment and/or management of osteoporosis. Methods MEDLINE, EMBASE and CINAHL databases, in addition to the Guidelines International Network, and the National Center for Complementary and Integrative Health website were searched from 2009–2020. CPGs making TCIM recommendations for the treatment/management of osteoporosis were assessed with the AGREE II instrument. Results Of 536 unique search results, 27 osteoporosis CPGs made mention of TCIM therapies. From highest to lowest, scaled domain percentages of all eligible CPGs averaged to 92.59% for scope and purpose, 88.79% for clarity in presentation, 55.04% for stakeholder involvement, 47.84% for editorial independence, 46.53% for rigor of development, and 36.96% for applicability. Of the 27 CPGs assessed, 4 CPGs were recommended as is by both appraisers, while 23 CPGs were recommended with modifications. Conclusions Recommendations pertaining to calcium and vitamin D supplementation and exercise were favorably recommended across nearly all CPGs. In the case of other TCIM interventions, recommendations varied greatly, which may present challenges for CPGs target users due to a lack of consistency. Given the varying quality of osteoporosis CPGs found, those requiring improvement may benefit from their guideline development panel utilizing the AGREE II instrument to inform future updates.
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Affiliation(s)
- Jeremy Y Ng
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Centre for Learning and Discovery, McMaster University, Hamilton, Ontario, Canada
| | - Arwa Hilal
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Centre for Learning and Discovery, McMaster University, Hamilton, Ontario, Canada
| | - Ishana Maini
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, Centre for Learning and Discovery, McMaster University, Hamilton, Ontario, Canada
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11
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Sousa BÉCA, Silva BC, de Oliveira Guidotti T, Pires MC, Soares MMS, Kakehasi AM. Trabecular bone score in women with differentiated thyroid cancer on long-term TSH-suppressive therapy. J Endocrinol Invest 2021; 44:2295-2305. [PMID: 33730348 DOI: 10.1007/s40618-021-01537-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 02/15/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Thyrotropin stimulating hormone (TSH) suppression in patients with differentiated thyroid cancer (DTC) aims to decrease the growth and proliferation of thyroid cancer cells. However, the effect of TSH-suppressive therapy on bone microarchitecture remains undefined. METHODS Cross-sectional study including 43 women with DTC undergoing TSH-suppressive therapy (sTSH) compared to 20 women also on levothyroxine (LT4) therapy but with TSH in the low-normal range (nTSH) since the thyroid surgery. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA), and trabecular bone score (TBS) was evaluated using the TBS iNsigth software. Fracture risk assessed by FRAX, with and without TBS, was calculated. The relationship between suppressive therapy-related parameters and bone parameters was investigated. RESULTS The TBS mean values were not significantly different in the sTSH and nTSH groups (1.273 ± 0.12 vs 1.307 ± 0.14, p = 0.7197). In both groups, postmenopausal women had degraded microarchitecture (TBS 1.216 ± 0.11 vs 1.213 ± 0.09, p = 0.9333), while premenopausal women had normal microarchitecture (1.328 ± 0.11 vs 1.401 ± 0.12, p = 0.195). The percentage of all postmenopausal women with degraded TBS was 54.7%, while the percentage of osteoporosis diagnoses was 16.1%. The TBS-adjusted FRAX-probability of fracture was similar in sTSH and nTSH groups. Body mass index (BMI) and menopausal status were the only variables associated with TBS and BMD. CONCLUSION Trabecular microarchitecture assessed by TBS was similar between women on long-term suppressive therapy in DTC and those on LT4 replacement therapy aiming at a TSH level within the low-normal reference range. Low TBS values were observed in postmenopausal women of both groups, suggesting that not only suppressed TSH levels but also a low-normal TSH is associated with deteriorated bone microarchitecture in postmenopausal women following total thyroidectomy.
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Affiliation(s)
- B É C A Sousa
- Graduate Program in Sciences Applied To Adult Health Care, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minas Gerais State, Brazil.
| | - B C Silva
- School of Medicine, University Center of Belo Horizonte - UNI-BH, Belo Horizonte, Brazil
- Division of Endocrinology, Felício Rocho Hospital, Belo Horizonte, Brazil
- Division of Endocrinology, Santa Casa de Belo Horizonte, Belo Horizonte, Brazil
| | - T de Oliveira Guidotti
- Physiotherapy Academic, Federal University of Minas Gerais - UFMG, Belo Horizonte, Brazil
| | - M C Pires
- Statistics Department, Federal University of Minas Gerais - UFMG, Belo Horizonte, Brazil
| | - M M S Soares
- Graduate Program in Sciences Applied To Adult Health Care, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minas Gerais State, Brazil
- Division of Endocrinology, Felício Rocho Hospital, Belo Horizonte, Brazil
- Department of Internal Medicine and Endocrinology, Federal University of Minas Gerais - UFMG, Belo Horizonte, Brazil
| | - A M Kakehasi
- Graduate Program in Sciences Applied To Adult Health Care, Federal University of Minas Gerais - UFMG, Belo Horizonte, Minas Gerais State, Brazil
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12
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Huang X, Chen B, Thabane L, Adachi JD, Li G. Fragility of results from randomized controlled trials supporting the guidelines for the treatment of osteoporosis: a retrospective analysis. Osteoporos Int 2021; 32:1713-1723. [PMID: 33595680 DOI: 10.1007/s00198-021-05865-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 01/29/2021] [Indexed: 12/11/2022]
Abstract
UNLABELLED This is the first report on the fragility of results from randomized controlled trials (RCTs) for the treatment of osteoporosis. The results of aforementioned RCTs appear to depend on a small number of events and are generally statistically fragile. INTRODUCTION Osteoporosis remains a health concern worldwide. Evidence-based guideline recommendations that are mainly based on results of clinical trials are important to clinical decision-making. The fragility index (FI) is a novel statistical metric to measure the fragility of results from an RCT. Our study aimed to analyze the fragility of the clinical trials referenced in the guidelines for the treatment of osteoporosis. METHODS Trials were included if they investigated primary osteoporosis, randomized patients to treatment or control in a 1:1 design, and reported fracture outcome as the primary endpoint. The FI and fragility quotient (FQ) were calculated for assessing the robustness of results from the eligible RCTs. An FI was defined as the minimum number of events in the intervention group that needs to change from a non-event to an event in order to render a significant result non-significant (or vice versa). The FQ was calculated by dividing the FI by the sample size of the trial. RESULTS Of the 372 RCTs identified from the guidelines, 42 were eligible for analyses. Their median FI was 10 (25th-75th percentile [Q1-Q3]: 4-18), with a median FQ of 0.007 (Q1-Q3: 0.0017-0.019). Approximately one third of the RCTs had a FI of less than or equal to 5. There were 17 (40.5%) trials where the number of patients lost to follow-up was greater than the FI. The FI was significantly associated with sample size, journal impact factor, and the percent of patients lost to follow-up. CONCLUSION Results from some RCTs supporting guideline recommendations for the treatment of osteoporosis depend on a small number of events. The FI and FQ may provide additional, intuitive metrics to help interpret the robustness of trial results.
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Affiliation(s)
- X Huang
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China
| | - B Chen
- Department of Endocrinology, Guangdong Second Provincial General Hospital, Guangzhou, China
| | - L Thabane
- Department of Health research methods, Evidence, and Impact (HEI), McMaster University, 1280 Main St West, Hamilton, ON, L8S 4 L8, Canada
| | - J D Adachi
- Department of Medicine, McMaster University, Hamilton, ON, Canada
| | - G Li
- Center for Clinical Epidemiology and Methodology (CCEM), Guangdong Second Provincial General Hospital, Guangzhou, China.
- Department of Health research methods, Evidence, and Impact (HEI), McMaster University, 1280 Main St West, Hamilton, ON, L8S 4 L8, Canada.
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13
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He Y, Chen D, Guo Q, Shi P, You C, Feng Y. MicroRNA-151a-3p Functions in the Regulation of Osteoclast Differentiation: Significance to Postmenopausal Osteoporosis. Clin Interv Aging 2021; 16:1357-1366. [PMID: 34290498 PMCID: PMC8286966 DOI: 10.2147/cia.s289613] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Accepted: 06/05/2021] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Studies have found the pivotal role of miRNAs in the progression of postmenopausal osteoporosis (OP). However, the function of miRNAs in OP is unclear. This study aimed to explore the biological functions of microRNA-151a-3p in OP. METHODS RT-qPCR was employed to assess the expression of microRNA-151a-3p in serum isolated from OP patients and healthy controls. Dual-energy X-ray absorptiometry (DXA) was used to measure the bone mineral density (BMD) of the lumbar spine. The expression levels of c-Fos, NFATc1, and TRAP were tested by Western blot. Ovariectomized (OVX) rats were treated with antago microRNA-151a-3p or antago NC, and then serum and lumbar vertebrae were collected for ELISA and bone histomorphology analysis. RESULTS The expression of microRNA-151a-3p in postmenopausal women with osteoporosis was significantly up-regulated, and microRNA-151a-3p level was negatively correlated with BMD. During osteoclastogenesis, microRNA-151a-3p level was obviously increased. Overexpression of microRNA-151a-3p promoted the differentiation of RANKL-induced THP-1 and RAW264.7 cells into osteoclasts, whereas silencing of microRNA-151a-3p resulted in the opposite results. Silencing of microRNA-151a-3p in OVX rats altered osteoclastogenesis-related factors and raised BMD. CONCLUSION MicroRNA-151a-3p could partly regulate osteoporosis by promoting osteoclast differentiation, and miRNA-151a-3p could be a potential therapeutic target for postmenopausal osteoporosis.
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Affiliation(s)
- Yuehui He
- Community Medicine Department, Beijing Jishuitan Hospital, Beijing City, 100096, People’s Republic of China
| | - Di Chen
- Community Medicine Department, Beijing Jishuitan Hospital, Beijing City, 100096, People’s Republic of China
| | - Qian Guo
- Community Medicine Department, Beijing Jishuitan Hospital, Beijing City, 100096, People’s Republic of China
| | - Pinghua Shi
- Community Medicine Department, Beijing Jishuitan Hospital, Beijing City, 100096, People’s Republic of China
| | - Conglei You
- Community Medicine Department, Beijing Jishuitan Hospital, Beijing City, 100096, People’s Republic of China
| | - Yanping Feng
- Community Medicine Department, Beijing Jishuitan Hospital, Beijing City, 100096, People’s Republic of China
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14
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Study of the Influence of Sociodemographic and Lifestyle Factors on Consumption of Dairy Products: Preliminary Study in Portugal and Brazil. Foods 2020; 9:foods9121775. [PMID: 33266244 PMCID: PMC7760362 DOI: 10.3390/foods9121775] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 02/07/2023] Open
Abstract
Sociodemographic characteristics, including regional variations, have been associated with different food consumption patterns. Behavioral factors and lifestyle variables may also contribute to different food dietary trends. In this way, the present study intended to investigate the consumption habits of the most relevant types of dairy products around the world and relate them to sociodemographic factors, for example, age, sex, education and country as well as with some anthropometric and behavioral aspects, for example, body mass index, satisfaction with body weight and exercise or sedentary lifestyles. One other objective of the study was to categorize the lifestyles of the participants, according to measured variables linked with hours of inactivity or exercise, in order to use these as possible differentiating variables for the consumption of dairy products. The study involved a questionnaire survey undertaken on a non-probabilistic convenience sample of participants from Portugal (PT) and Brazil (BR), and participation was voluntary and anonymous. The data analysis involved different statistical techniques: basic statistics, chi-square tests, factor analysis, cluster analysis and tree classification analysis. The results showed that semi skimmed milk is never consumed by about half of the participants (47.4% for PT and 46.7 for BR), and those numbers increase for skimmed (64.8% for PT and 50.9% for BR), chocolate flavored milk (82.6% for PT and 65.6% for BR) and enriched milks (94.8% for PT and 85.3% for BR). Cheeses are also consumed in the two countries by small numbers of people. The number of participants consuming imported cheeses in both countries was particularly low (only 4.0% consume these more than once a week in both countries), suggesting national products may be preferred. It was further observed that those who consume cheese do it seldom (once a week) or sometimes (2–3 times per week). Butter is also consumed by only about half of the adult population (43.8% for PT and 49.5% for BR), but the percentage of those who never consume butter increases for skimmed butter (66.0% for PT and 82.6% for BR) and unsalted butter (70.2% for PT and 69.1% for BR). The consumption of yogurts also follows similar low consumption patterns. The most frequently consumed yogurt types in Portugal are liquid (30.5% consume regularly) and natural yogurts (34.8% consume regularly), while in Brazil the most frequent are creamy fruit pulp yogurt (14.4% consume regularly), liquid (13.7% consume regularly) and Greek type yogurt (10.2% consume regularly). A factor analysis and a cluster analysis established groups according to lifestyles, as follows: 1—Screeners, 2—Exercisers, 3—Travelers and 4—Others. These lifestyles were found to be influential in the consumption of dairy products for all classes of dairy tested: milk, cheese, yogurt and butter. For example, the screeners were found to consume more milk, more butter, more cheese and more yogurt. Additionally, other influential factors were age, sex, education, BMI and satisfaction with body weight. Nevertheless, country was not a meaningfully discriminant variable in relation to the other variables included in the classification analysis. The results concluded that, despite some small differences in the patterns of consumption of dairy products in both countries, the levels of consumption of dairy products are extremely low, for all classes studied (milk, cheese, yogurt or butter). Additionally, it was concluded that some factors are influential on the level of consumption of dairy products, and therefore decision makers can plan their interventions according to the characteristics of the targeted segments of the population, according to lifestyle, age, sex, education, BMI and satisfaction with body weight.
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15
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Eastell R, Rosen CJ, Black DM, Cheung AM, Murad MH, Shoback D. Pharmacological Management of Osteoporosis in Postmenopausal Women: An Endocrine Society* Clinical Practice Guideline. J Clin Endocrinol Metab 2019; 104:1595-1622. [PMID: 30907953 DOI: 10.1210/jc.2019-00221] [Citation(s) in RCA: 414] [Impact Index Per Article: 82.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 01/28/2019] [Indexed: 12/20/2022]
Abstract
OBJECTIVE The objective is to formulate clinical practice guidelines for the pharmacological management of osteoporosis in postmenopausal women. CONCLUSIONS Evidence from clinical trials and insights from clinical experience with pharmacologic therapies for osteoporosis were critically evaluated in formulating this guideline for the management of postmenopausal osteoporosis. Patient preferences, data on adherence and persistence, and risks and benefits from the patient and provider perspectives were also considered in writing committee deliberations. A consensus by the Writing Committee members was achieved for four management principles: (i) The risk of future fractures in postmenopausal women should be determined using country-specific assessment tools to guide decision-making. (ii) Patient preferences should be incorporated into treatment planning. (iii) Nutritional and lifestyle interventions and fall prevention should accompany all pharmacologic regimens to reduce fracture risk. (iv) Multiple pharmacologic therapies are capable of reducing fracture rates in postmenopausal women at risk with acceptable risk-benefit and safety profiles.
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Affiliation(s)
| | | | - Dennis M Black
- University of California San Francisco, San Francisco, California
| | | | - M Hassan Murad
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minnesota
| | - Dolores Shoback
- Endocrine Research Unit, San Francisco Veterans Affairs Medical Center, San Francisco, California
- Department of Medicine, University of California San Francisco, San Francisco, California
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16
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Skrypnik D, Bogdański P, Skrypnik K, Mądry E, Karolkiewicz J, Szulińska M, Suliburska J, Walkowiak J. Influence of endurance and endurance-strength training on mineral status in women with abdominal obesity: a randomized trial. Medicine (Baltimore) 2019; 98:e14909. [PMID: 30896645 PMCID: PMC6709101 DOI: 10.1097/md.0000000000014909] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/15/2019] [Accepted: 02/22/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Obesity and exercise are associated with disturbances of mineral metabolism, which can lead to physical inefficiency. Our study aimed to compare the influence of endurance and endurance-strength training on mineral status in women with abdominal obesity. METHODS Thirty-eight abdominally obese women were randomized into groups A and B and underwent 3 months long training: group A-endurance training and group B-endurance-strength training. Anthropometric and body composition measurements were carried out and the Graded Exercise Test was performed. Blood, urine, and hair samples were collected for mineral content analysis. RESULTS Endurance training decreased serum Fe and Zn concentrations as well as hair Zn and Cu content, and increased urine Zn concentration. Endurance-strength training increased serum Mg and Cu concentrations, decreased serum Fe and Zn concentrations, decreased hair Ca and Mg content, and increased urine Ca and Zn concentrations. After training, serum and urine Fe concentration was higher in group A, while urine Ca concentration was higher in group B. A number of correlations was found. CONCLUSIONS Both endurance and endurance-strength training have a significant effect on mineral metabolism in obese women; the favorable effects of endurance-strength exercise predominate in iron, magnesium, zinc, and copper balance.
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Affiliation(s)
- Damian Skrypnik
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences
| | - Paweł Bogdański
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences
| | - Katarzyna Skrypnik
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences
| | - Edyta Mądry
- Department of Physiology, Poznan University of Medical Sciences
| | - Joanna Karolkiewicz
- Department of Physiology, Biochemistry and Hygiene, Poznan University School of Physical Education
| | - Monika Szulińska
- Department of Treatment of Obesity, Metabolic Disorders and Clinical Dietetics, Poznan University of Medical Sciences
| | - Joanna Suliburska
- Institute of Human Nutrition and Dietetics, Poznan University of Life Sciences
| | - Jarosław Walkowiak
- Department of Pediatric Gastroenterology and Metabolic Diseases, Poznan University of Medical Sciences, Poznan, Poland
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17
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Oliveira FC, Carvalho JO, Gusmão SBS, Gonçalves LDS, Soares Mendes LM, Freitas SAP, Gusmão GODM, Viana BC, Marciano FR, Lobo AO. High loads of nano-hydroxyapatite/graphene nanoribbon composites guided bone regeneration using an osteoporotic animal model. Int J Nanomedicine 2019; 14:865-874. [PMID: 30774339 PMCID: PMC6361224 DOI: 10.2147/ijn.s192456] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND It has been difficult to find bioactive compounds that can optimize bone repair therapy and adequate osseointegration for people with osteoporosis. The nano-hydroxyapatite (nHAp)/carbon nanotubes with graphene oxides, termed graphene nanoribbons (GNR) composites have emerged as promising materials/scaffolds for bone regeneration due to their bioactivity and osseointegration properties. Herein, we evaluated the action of nHAp/GNR composites (nHAp/GNR) to promote bone regeneration using an osteoporotic model. MATERIALS AND METHODS First, three different nHAp/GNR (1, 2, and 3 wt% of GNR) were produced and characterized. For in vivo analyses, 36 Wistar rats (var. albinus, weighing 250-300 g, Comissão de Ética no Uso de Animais [CEUA] n.002/17) were used. Prior to implantation, osteoporosis was induced by oophorectomy in female rats. After 45 days, a tibial fracture was inflicted using a 3.0-mm Quest trephine drill. Then, the animals were separated into six sample groups at two different time periods of 21 and 45 days. The lesions were filled with 3 mg of one of the above samples using a curette. After 21 or 45 days of implantation, the animals were euthanized for analysis. Histological, biochemical, and radiographic analyses (DIGORA method) were performed. The data were evaluated through ANOVA, Tukey test, and Kolmogorov-Smirnov test with statistical significance at P<0.05. RESULTS Both nHAp and GNR exhibited osteoconductive activity. However, the nHAp/GNR exhibited regenerative activity proportional to their concentration, following the order of 3% >2% >1% wt. CONCLUSION Therefore, it can be inferred that all analyzed nanoparticles promoted bone regeneration in osteoporotic rats independent of analyzed time.
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Affiliation(s)
- Francilio Carvalho Oliveira
- Institute of Science and Technology, Brasil University, Itaquera 08230-030, São Paulo, Brazil,
- University Center for Health, Humanities and Technology of Piauí, (UNINOVAFAPI), Teresina, Piauí, Brazil
| | - Jancineide Oliveira Carvalho
- Institute of Science and Technology, Brasil University, Itaquera 08230-030, São Paulo, Brazil,
- University Center for Health, Humanities and Technology of Piauí, (UNINOVAFAPI), Teresina, Piauí, Brazil
| | - Suziete Batista Soares Gusmão
- LIMAV-Interdisciplinary Laboratory for Advanced Materials, Materials Science and Engineering Graduate Program, Technological Center, UFPI-Federal University of Piauí, Teresina 64049-550, Piaui, Brazil,
| | - Licia de Sousa Gonçalves
- University Center for Health, Humanities and Technology of Piauí, (UNINOVAFAPI), Teresina, Piauí, Brazil
| | | | | | | | - Bartolomeu Cruz Viana
- LIMAV-Interdisciplinary Laboratory for Advanced Materials, Materials Science and Engineering Graduate Program, Technological Center, UFPI-Federal University of Piauí, Teresina 64049-550, Piaui, Brazil,
- Department of Physics, Federal University of Piauí, Teresina 64049-550, Brazil
| | - Fernanda Roberta Marciano
- Institute of Science and Technology, Brasil University, Itaquera 08230-030, São Paulo, Brazil,
- Nanomedicine Lab, Department of Chemical Engineering, Northeastern University, Boston, MA 02115, USA
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA,
| | - Anderson Oliveira Lobo
- Institute of Science and Technology, Brasil University, Itaquera 08230-030, São Paulo, Brazil,
- LIMAV-Interdisciplinary Laboratory for Advanced Materials, Materials Science and Engineering Graduate Program, Technological Center, UFPI-Federal University of Piauí, Teresina 64049-550, Piaui, Brazil,
- Department of Chemistry, Massachusetts Institute of Technology, Cambridge, MA 02139, USA,
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