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Sheftel CM, Sartori LC, Hunt ER, Manuel RSJ, Bell AM, Domingues RR, Wake LA, Scharpf BR, Vezina CM, Charles JF, Hernandez LL. Peripartal treatment with low-dose sertraline accelerates mammary gland involution and has minimal effects on maternal and offspring bone. Physiol Rep 2022; 10:e15204. [PMID: 35234346 PMCID: PMC8889862 DOI: 10.14814/phy2.15204] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 11/24/2022] Open
Abstract
Women mobilize up to 10% of their bone mass during lactation to provide milk calcium. About 8%–13% of mothers use selective serotonin reuptake inhibitors (SSRI) to treat peripartum depression, but SSRIs independently decrease bone mass. Previously, peripartal use of the SSRI fluoxetine reduced maternal bone mass sustained post‐weaning and reduced offspring bone length. To determine whether these effects were fluoxetine‐specific or consistent across SSRI compounds, we examined maternal and offspring bone health using the most prescribed SSRI, sertraline. C57BL/6 mice were given 10 mg/kg/day sertraline, from the beginning of pregnancy through the end of lactation. Simultaneously, we treated nulliparous females on the same days as the primiparous groups, resulting in age‐matched nulliparous groups. Dams were euthanized at lactation day 10 (peak lactation, n = 7 vehicle; n = 9 sertraline), lactation day 21 (weaning, n = 9 vehicle; n = 9 sertraline), or 3m post‐weaning (n = 10 vehicle; n = 10 sertraline) for analysis. Offspring were euthanized at peak lactation or weaning for analysis. We determined that peripartum sertraline treatment decreased maternal circulating calcium concentrations across the treatment period, which was also seen in nulliparous treated females. Sertraline reduced the bone formation marker, procollagen 1 intact N‐terminal propeptide, and tended to reduce maternal BV/TV at 3m post‐weaning but did not impact maternal or offspring bone health otherwise. Similarly, sertraline did not reduce nulliparous female bone mass. However, sertraline reduced immunofluorescence staining of the tight junction protein, zona occludens in the mammary gland, and altered alveoli morphology, suggesting sertraline may accelerate mammary gland involution. These findings indicate that peripartum sertraline treatment may be a safer SSRI for maternal and offspring bone rather than fluoxetine.
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Affiliation(s)
- Celeste M Sheftel
- Molecular and Cellular Pharmacology Training Program, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Luma C Sartori
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Emily R Hunt
- Department of Orthopedic Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Robbie S J Manuel
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Autumn M Bell
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Rafael R Domingues
- Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Lella A Wake
- Department of Orthopedic Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Brandon R Scharpf
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Chad M Vezina
- Department of Comparative Biosciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Julia F Charles
- Department of Orthopedic Surgery, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA.,Department of Medicine, Brigham and Women's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
| | - Laura L Hernandez
- Molecular and Cellular Pharmacology Training Program, University of Wisconsin-Madison, Madison, Wisconsin, USA.,Department of Animal and Dairy Sciences, University of Wisconsin-Madison, Madison, Wisconsin, USA
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2
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Canto-Cetina T, Rojano-Mejía D, Coral-Vázquez RM, Cetina-Manzanilla JA, Polanco-Reyes L, Canto P. Bone Mineral Density and Fractures In Postmenopausal Women Of Mayan-Mestizo Ethnic Origin With Different Body Mass Indices. Ann Hum Biol 2022; 48:567-571. [PMID: 35139707 DOI: 10.1080/03014460.2022.2041093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Obesity protects against bone loss, but it increases the risk of fragility fractures. AIM To determine if bone mineral density (BMD) and the prevalence of fractures are different in postmenopausal Mayan-mestizo women grouped according to their body mass index. SUBJECTS AND METHODS We studied 600 postmenopausal Maya-Mestizo women. A structured questionnaire for risk factors was applied. Body mass index (BMI) was determined. BMD was assessed at the lumbar spine and total hip by dual-energy X-ray absorptiometry. History of low trauma fracture was determined from medical records. ANOVA was used to compare mean BMD between women with different BMI. To compare the frequency of fractures according to BMI group, we used χ2. RESULTS According to WHO classification of BMI, 16.3% of women had normal BMI, 35.3% were overweight, and 48.4% had obesity. We found that women with obesity had a higher BMD versus women with normal BMI or overweight in all the anatomical sites analysed. The prevalence of history of fractures was 18.2%. We did not find differences between the women of different BMI; the wrist was the most frequent skeletal site of the fracture. CONCLUSIONS Obesity in postmenopausal Maya-Mestizo women is not a risk factor for developing fragility fractures.
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Affiliation(s)
- Thelma Canto-Cetina
- Laboratorio de Biología de la Reproducción, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Mérida Yucatán, México
| | - David Rojano-Mejía
- UMAE Hospital de Traumatología, Ortopedia y Rehabilitación "Dr. Victorio de la Fuente Narváez", Instituto Mexicano del Seguro Social, Ciudad de México, México
| | - Ramón Mauricio Coral-Vázquez
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Ciudad de México, México.,Subdirección de Enseñanza e Investigación, Centro Médico Nacional "20 de Noviembre", Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Ciudad de México, México
| | | | - Lucila Polanco-Reyes
- Laboratorio de Biología de la Reproducción, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi", Mérida Yucatán, México
| | - Patricia Canto
- Unidad de Investigación en Obesidad, Facultad de Medicina, Universidad Nacional Autónoma de Ciudad de México, México.,Subdirección de Investigación Clínica, Dirección de Investigación, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán", Ciudad de México, México
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3
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Vazquez-Villegas ML, Rodriguez-Jimenez NA, Contreras-Haro B, Vasquez-Jimenez JC, Perez-Guerrero EE, Moran-Moguel MC, Sánchez-Rodríguez EN, Villagómez-Vega A, Nuño-Arana I, Becerra-Alvarado IN, Rubio-Arellano ED, Nava-Valdivia CA, Ponce-Guarneros JM, Fajardo-Robledo NS, Nava-Zavala AH, Gonzalez-Lopez L, Saldaña-Cruz AM. Genotypic Analyses of the Sclerostin rs851056 and Dickkopf rs1569198 Polymorphisms in Mexican-Mestizo Postmenopausal Osteoporosis: A Case-Control Study. Genet Test Mol Biomarkers 2021; 25:211-217. [PMID: 33734895 DOI: 10.1089/gtmb.2020.0199] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Background: The Wnt/β catenin pathway promotes bone mineralization stimulating proliferation, differentiation, and survival of osteoblasts; it also inhibits osteoclast differentiation and osteocyte activity. Sclerostin (SOST) and Dickkopf 1 (DKK1) are Wnt/β catenin pathway inhibitors. Genetic variability in the expression of SOST and DKK1 might be involved in the development of postmenopausal osteoporosis (OP). Aim: To determine whether the SOST rs851056 and DKK1 rs1569198 polymorphisms are associated with OP in Mexican-Mestizo postmenopausal women. Materials and Methods: Two hundred and eighty Mexican-Mestizo postmenopausal women were assessed for their bone mineral density by dual-energy X-ray absorptiometry (DXA). Patients were classified as OP or non-OP. Genomic DNA was extracted from peripheral blood leukocytes. Genetic polymorphisms were analyzed by quantitative polymerase chain reaction using TaqMan probes. Results: The frequency of OP was 40% among the study population. Osteoporotic patients were older (p < 0.001), had a higher frequency of smoking (p = 0.01), and lower body mass index (p < 0.001) compared with the non-osteoporotic patients. The genotypic frequencies of the rs851056 locus of the SOST gene were GG 19%, GC 45%, and CC 35%, whereas the genotypic frequencies of the rs1569198 locus of the DKK1 gene were GG 15%, GA 40%, and AA 44%. In relation to rs851056 locus of the SOST gene, no differences were observed between the OP and non-OP cohorts in the frequencies of the GC polymorphism (48.7% vs. 43.1%). Similarly, analyses of the DKK1 rs1569198 does not demonstrate differences in the GA genotypic frequencies between the OP and non-OP cohorts (42.5% vs. 38.9%). Conclusion: Polymorphisms SOST rs851056 and DKK1 rs1569198 polymorphisms are not associated with OP in Mexican-Mestizo postmenopausal women.
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Affiliation(s)
- Maria L Vazquez-Villegas
- Departamento de Salud Pública, Instituto Regional de Investigación en Salud Pública, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México.,Departamento de Epidemiologia, Unidad de Medicina Familiar N°, 4, Instituto Mexicano del Seguro Social (IMSS), Guadalajara, México
| | - Norma A Rodriguez-Jimenez
- Departamento de Fisiología, Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Betsabe Contreras-Haro
- Departamento de Ciencias Biomedicas, Centro Universitario de Tonalá, Universidad de Guadalajara, Tonalá, México
| | - Jose C Vasquez-Jimenez
- Centro Universitario de Investigaciones Biomédicas, Universidad de Colima, Colima, México
| | - Edsaul E Perez-Guerrero
- Departamento de Biología Molecular, Instituto de Investigación en Ciencias Biomédicas, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Maria-Cristina Moran-Moguel
- Departamento de Disciplinas Fisiológico, Metodológico e Instrumental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Esther N Sánchez-Rodríguez
- Departamento de Fisiología, Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Alejandra Villagómez-Vega
- Departamento de Fisiología, Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Ismael Nuño-Arana
- Instituto de Investigación en Genética Molecular, Centro Universitario de la Ciénega, Universidad de Guadalajara, Ocotlán, México
| | - Itzel N Becerra-Alvarado
- Departamento de Fisiología, Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Edy D Rubio-Arellano
- Departamento de Fisiología, Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Cesar A Nava-Valdivia
- Departamento de Microbiología y Patología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Juan M Ponce-Guarneros
- Departamento de Fisiología, Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Nicte S Fajardo-Robledo
- Laboratorio de Investigación y Desarrollo Farmacéutico, Centro Universitario de Ciencias Exactas e Ingenierías, Universidad de Guadalajara, Guadalajara, Mexico
| | - Arnulfo H Nava-Zavala
- Unidad de Investigación Biomédica 02, UMAE, Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, México.,Programa Internacional Facultad de Medicina, Universidad Autónoma de Guadalajara, Zapopan, México.,División de Medicina Interna, Servicio de Inmunología y Reumatología, Hospital General de Occidente, Secretaria de Salud Jalisco, Zapopan, México
| | - Laura Gonzalez-Lopez
- Departamento de Fisiología, Programa de Doctorado en Farmacología, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México.,Departamento de Salud Pública, Doctorado en Salud Pública, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
| | - Ana M Saldaña-Cruz
- Departamento de Fisiología, Instituto de Terapéutica Experimental y Clínica, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, México
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Lackey KA, Fehrenkamp BD, Pace RM, Williams JE, Meehan CL, McGuire MA, McGuire MK. Breastfeeding Beyond 12 Months: Is There Evidence for Health Impacts? Annu Rev Nutr 2021; 41:283-308. [PMID: 34115518 DOI: 10.1146/annurev-nutr-043020-011242] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Because breastfeeding provides optimal nutrition and other benefits for infants (e.g., lower risk of infectious disease) and benefits for mothers (e.g., less postpartum bleeding), health organizations recommend that healthy infants be exclusively breastfed for 4 to 6 months in the United States and 6 months internationally. Recommendations related to how long breastfeeding should continue, however, are inconsistent. The objective of this article is to review the literature related to evidence for benefits of breastfeeding beyond 1 year for mothers and infants. In summary, human milk represents a good source of nutrients and immune components beyond 1 year. Some studies point toward lower infant mortality in undernourished children breastfed for >1 year, and prolonged breastfeeding increases interbirth intervals. Data on other outcomes (e.g., growth, diarrhea, obesity, and maternal weight loss) are inconsistent, often lacking sufficient control for confounding variables. There is a substantial need for rigorous, prospective, mixed-methods, cross-cultural research on this topic. Expected final online publication date for the Annual Review of Nutrition, Volume 41 is September 2021. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Kimberly A Lackey
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
| | - Bethaney D Fehrenkamp
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
| | - Ryan M Pace
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
| | - Janet E Williams
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, Idaho 83844, USA
| | - Courtney L Meehan
- Department of Anthropology, Washington State University, Pullman, Washington 99164, USA
| | - Mark A McGuire
- Department of Animal, Veterinary and Food Sciences, University of Idaho, Moscow, Idaho 83844, USA
| | - Michelle K McGuire
- Margaret Ritchie School of Family and Consumer Sciences, University of Idaho, Moscow, Idaho 83844, USA;
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5
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Yan G, Huang Y, Cao H, Wu J, Jiang N, Cao X. Association of breastfeeding and postmenopausal osteoporosis in Chinese women: a community-based retrospective study. BMC WOMENS HEALTH 2019; 19:110. [PMID: 31409345 PMCID: PMC6692954 DOI: 10.1186/s12905-019-0808-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 08/01/2019] [Indexed: 12/30/2022]
Abstract
Background Postmenopausal osteoporosis (PMOP) has long been a pervasive public health concern. With the aging Chinese population, the prevention, assessment and management of postmenopausal osteoporosis were particularly important. During the breastfeeding, a large amount of Calcium loss from maternal bone for infants’ growth. However, whether this loss is completely reversible remains controversial. As the relationship between breastfeeding and postmenopausal osteoporosis is different from society to society and is not clear from the literature, the purpose of this study was to determine whether breastfeeding was an independent factor for the development of PMOP based on Chinese postmenopausal population. Methods A retrospective cross-sectional investigation was conducted at Tianjin Xiaobailou health Community Healthcare Center between December 2017 and June 2018. Postmenopausal women over the age of 50 who underwent the annual health examination or visited the center to perform bone densitometry as a part of routine screening for disease were recruited. A trained community nurse administered a questionnaire to all participants by face-to-face interview. Participants were questioned about age, BMI, Vitamin D and calcium intake, the history of smoking, drinking and fracture, age of menarche, age of menopause, the number of pregnancy, parity, feeding pattern (breastfeeding, artificial feeding and mixed feeding) and overall breastfeeding duration. BMD measurements were carried out using quantitative ultrasound (QUS) at the bilateral radius. Results A total of 202 women who met the inclusive and exclusive criteria were enrolled. Univariate analysis revealed that overall breastfeeding more than 24 months increased the risk of osteoporosis (OR 39.00, 95%CI 2.40–634.65, p = 0.010). However, multivariate estimate of the risk of osteoporosis by overall breastfeeding duration suggested that when controlling for age, BMI, the number of pregnancy and parity, the overall breastfeeding duration was not an independent risk factor for postmenopausal osteoporosis (OR 5.22, 95%CI 0.18–147.76, p = 0.333). Additionally, age (OR 1.16, 95%CI 1.05–1.29, p = 0.003), BMI (OR 1.26, 95%CI 1.04–1.54, p = 0.021) and the number of pregnancy (OR 1.80, 95%CI 1.08–2.98, p = 0.024) were significant associated with postmenopausal osteoporosis. Conclusion Breastfeeding was not associated with postmenopausal osteoporosis, while age, BMI and the number of pregnancy may contribute to increasing risk of postmenopausal osteoporosis in Chinese women. Electronic supplementary material The online version of this article (10.1186/s12905-019-0808-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Guiming Yan
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China.
| | - Yaqi Huang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Hong Cao
- Department of bone medicine of Tianjin Hospital, Tianjin, China
| | - Jie Wu
- Xiao Bai Lou Community Healthcare Service Center, Heping district, Tianjin, China
| | - Nan Jiang
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
| | - Xiaona Cao
- School of Nursing, Tianjin Medical University, Tianjin, 300070, China
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6
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Weaver SR, Hernandez LL. Could use of Selective Serotonin Reuptake Inhibitors During Lactation Cause Persistent Effects on Maternal Bone? J Mammary Gland Biol Neoplasia 2018; 23:5-25. [PMID: 29603039 DOI: 10.1007/s10911-018-9390-6] [Citation(s) in RCA: 4] [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: 12/14/2017] [Accepted: 03/13/2018] [Indexed: 02/07/2023] Open
Abstract
The lactating mammary gland elegantly coordinates maternal homeostasis to provide calcium for milk. During lactation, the monoamine serotonin regulates the synthesis and release of various mammary gland-derived factors, such as parathyroid hormone-related protein (PTHrP), to stimulate bone resorption. Recent evidence suggests that bone mineral lost during prolonged lactation is not fully recovered following weaning, possibly putting women at increased risk of fracture or osteoporosis. Selective Serotonin Reuptake Inhibitor (SSRI) antidepressants have also been associated with reduced bone mineral density and increased fracture risk. Therefore, SSRI exposure while breastfeeding may exacerbate lactational bone loss, compromising long-term bone health. Through an examination of serotonin and calcium homeostasis during lactation, lactational bone turnover and post-weaning recovery of bone mineral, and the effect of peripartum depression and SSRI on the mammary gland and bone, this review will discuss the hypothesis that peripartum SSRI exposure causes persistent reductions in bone mineral density through mammary-derived PTHrP signaling with bone.
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Affiliation(s)
- Samantha R Weaver
- Endocrine and Reproductive Physiology Program, University of Wisconsin-Madison, Madison, WI, USA
| | - Laura L Hernandez
- Department of Dairy Science, University of Wisconsin-Madison, Madison, WI, USA.
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7
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Chávez B, Vilchis F, Rojano-Mejía D, Coral Vázquez RM, Aguirre-García MDC, Canto P. Association of CYP1A1 and CYP1B1 polymorphisms with bone mineral density variations in postmenopausal Mexican-Mestizo women. Gynecol Endocrinol 2017; 33:607-610. [PMID: 28300467 DOI: 10.1080/09513590.2017.1301921] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Herein, we investigated potential associations between polymorphisms of genes related to estrogen metabolism and bone mineral density (BMD) in postmenopausal women. This was a cross-sectional study, in which two hundred and ninety postmenopausal Mexican-Mestizo women were studied. The BMD of the lumbar spine (LS), total hip (TH), and femoral neck (FN) was measured. The distribution of the genetic polymorphisms, including rs1799814 and rs1048943 at CYP1A1 as well as rs1056836 at CYP1B1, were analyzed by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP), single-stranded conformational polymorphism (SSCP), and DNA sequencing. Deviations from Hardy-Weinberg equilibrium (HWE) were tested, and linkage disequilibrium (LD) was calculated by direct correlation (r2). Moreover, haplotype analysis was performed. All polymorphisms were in HWE. The genotype and allele distributions of the three single nucleotide polymorphisms (SNPs) studied showed no significant differences. However, statistical significance was reached when constructing haplotypes. The CG haplotype in CYP1A1 was associated with variations in LS and FN BMD after adjustment for covariates (p = 0.021 and 0.045, respectively), but the association with TH BMD was not significant. These results suggested that the CG haplotype in CYP1A1 may play an important role in the mechanism of osteoporosis and may be useful as a genetic marker.
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Affiliation(s)
- Bertha Chávez
- a Departamento de Biología de la Reproducción , Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , México D.F , México
| | - Felipe Vilchis
- a Departamento de Biología de la Reproducción , Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , México D.F , México
| | - David Rojano-Mejía
- b Unidad de Medicina Física y Rehabilitación, Región Centro, UMAE Lomas Verdes, Instituto Mexicano del Seguro Social , México D.F , México
| | - Ramón Mauricio Coral Vázquez
- c Sección de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional , México D.F , México
- d Subdirección de Enseñanza e Investigación, Centro Médico Nacional 20 de Noviembre, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado , México D.F , México
| | | | - Patricia Canto
- f Unidad de Investigación en Obesidad, Facultad de Medicina, Universidad Nacional Autónoma de México & Clínica de Obesidad, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán" , México D.F , México
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8
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Abstract
Most premenopausal women with low trauma fracture(s) or low bone mineral density have a secondary cause of osteoporosis or bone loss. Where possible, treatment of the underlying cause should be the focus of management. Premenopausal women with an ongoing cause of bone loss and those who have had, or continue to have, low trauma fractures may require pharmacologic intervention. Clinical trials provide evidence of benefits of bisphosphonates and teriparatide for bone mineral density in several types of premenopausal osteoporosis, but studies are small and do not provide evidence regarding fracture risk reduction.
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Affiliation(s)
- Adi Cohen
- Division of Endocrinology, Department of Medicine, Columbia University Medical Center, Columbia University, College of Physicians & Surgeons, PH8-864, 630 West 168th Street, New York, NY 10032, USA.
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9
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Kovacs CS. Maternal Mineral and Bone Metabolism During Pregnancy, Lactation, and Post-Weaning Recovery. Physiol Rev 2016; 96:449-547. [PMID: 26887676 DOI: 10.1152/physrev.00027.2015] [Citation(s) in RCA: 251] [Impact Index Per Article: 31.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
During pregnancy and lactation, female physiology adapts to meet the added nutritional demands of fetuses and neonates. An average full-term fetus contains ∼30 g calcium, 20 g phosphorus, and 0.8 g magnesium. About 80% of mineral is accreted during the third trimester; calcium transfers at 300-350 mg/day during the final 6 wk. The neonate requires 200 mg calcium daily from milk during the first 6 mo, and 120 mg calcium from milk during the second 6 mo (additional calcium comes from solid foods). Calcium transfers can be more than double and triple these values, respectively, in women who nurse twins and triplets. About 25% of dietary calcium is normally absorbed in healthy adults. Average maternal calcium intakes in American and Canadian women are insufficient to meet the fetal and neonatal calcium requirements if normal efficiency of intestinal calcium absorption is relied upon. However, several adaptations are invoked to meet the fetal and neonatal demands for mineral without requiring increased intakes by the mother. During pregnancy the efficiency of intestinal calcium absorption doubles, whereas during lactation the maternal skeleton is resorbed to provide calcium for milk. This review addresses our current knowledge regarding maternal adaptations in mineral and skeletal homeostasis that occur during pregnancy, lactation, and post-weaning recovery. Also considered are the impacts that these adaptations have on biochemical and hormonal parameters of mineral homeostasis, the consequences for long-term skeletal health, and the presentation and management of disorders of mineral and bone metabolism.
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Affiliation(s)
- Christopher S Kovacs
- Faculty of Medicine-Endocrinology, Memorial University of Newfoundland, St. John's, Newfoundland, Canada
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10
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Ahn E, Lee J, Park YS, Noh HM, Kim BH. Association between delivery at an advanced maternal age and osteoporosis in elderly Korean women. J Bone Miner Metab 2015; 33:666-73. [PMID: 25304003 DOI: 10.1007/s00774-014-0630-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Accepted: 08/18/2014] [Indexed: 12/24/2022]
Abstract
Although several reproductive factors have been associated with low bone mineral density (BMD) in elderly women, few studies have evaluated the long-term effects of delivery at a high-risk maternal age on BMD. Using nationally representative survey data collected from 736 women aged 65 years or older, we evaluated the relationship between delivery during adolescence or at an age of 35 years or older and osteoporosis in elderly women. Data regarding demographic and socioeconomic characteristics, medical history, lifestyle risk factors, reproductive history, and history of osteoporosis and fracture were collected by administration of self-report questionnaires. Anthropometric data and BMD were measured in accordance with standardized guidelines. Independent determinants of BMD were identified by stepwise multiple linear regression analysis, and the resulting model was used to evaluate the risk of osteoporosis according to delivery during adolescence or at an advanced age. Of the 736 subjects, 426 (60.1 %) were found to have osteoporosis (T score ≤ -2.5), and 19.2 and 38.9 % reported delivery during adolescence and at an advanced age, respectively. The incidence of delivery during adolescence or at an advanced age was significantly higher in subjects with osteoporosis than in those without osteoporosis. After adjustment for covariates, multiple logistic regression analysis revealed that elderly women with a history of delivery at an advanced maternal age are at an increased (2.164-fold greater) risk of osteoporosis (95 % confidence interval 1.109-4.223) compared with elderly women without a history of delivery at an advanced age. However, a history of delivery during adolescence did not affect the risk.
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Affiliation(s)
- Eunju Ahn
- Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Yongin, Republic of Korea
| | - Jungkwon Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, 81 Irwon-Ro, Gangnam-gu, Seoul, 135-710, Republic of Korea.
| | - Yong Soon Park
- Department of Family Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, 77 Sakju-ro, Chuncheon, Gangwon-do, 200-704, Republic of Korea.
| | - Hye-Mi Noh
- Department of Family Medicine, Hallym University Sacred Heart Hospital, Hallym University College of Medicine, Anyang, Republic of Korea
| | - Bo Ha Kim
- Health Screening Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
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Gonçalves ACS, Ferreira MDF, Hasselmann MH, Faerstein E. O efeito da amamentação na massa óssea de mulheres na pós-menopausa: revisão sistemática de estudos observacionais. REVISTA BRASILEIRA DE SAÚDE MATERNO INFANTIL 2015. [DOI: 10.1590/s1519-38292015000300002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Objetivos:avaliar o efeito da amamentação na massa óssea de mulheres na pós-menopausa.Métodos:trata-se de revisão sistemática de estudos observacionais. A pesquisa da literatura foi realizada nas bases de dados bibliográficos Lilacs, Medline e Scopus, em junho de 2015, sem restrição quanto ao ano de publicação. Para ser incluído nesta revisão, o artigo deveria avaliar o histórico de amamentação e a massa óssea na pós-menopausa, sendo suas referências checadas para busca de novos estudos. Dois revisores, de forma independente, realizaram a extração de dados e a avaliação da suscetibilidade a vieses dos estudos.Resultados:foram selecionados 34 estudos, dos quais seis (26,5%) mostraram que a prática de amamentação aumentou significativamente a massa óssea e 15 (44%) encontraram o inverso. Constatou-se grande diversidade entre os estudos quanto à população de estudo, mensuração da exposição e sítios de avaliação da massa óssea, dificultando a comparabilidade entre os resultados.Conclusões:a marcante heterogeneidade dos estudos torna inconclusiva a direção da associação entre a amamentação e a massa óssea em mulheres na pós-menopausa, sendo necessários estudos com maior rigor metodológico para avaliar esse problema de grande relevância para as áreas clínica e de saúde pública.
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Zhang W, Ma X, Xue P, Gao Y, Wu X, Zhao J, Wang Y, Li S. Associations between fat distribution and volumetric bone mineral density in Chinese adults. Endocrine 2014; 47:862-8. [PMID: 24705911 DOI: 10.1007/s12020-014-0252-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2013] [Accepted: 03/24/2014] [Indexed: 12/13/2022]
Abstract
The aim of this study was to explore the association between fat distribution and volumetric bone mineral density (vBMD) in Chinese Adults. Using a cross-sectional investigation of 867 participants including 521 women and 346 men from China, vBMD and subcutaneous adipose tissue (SCAT) or visceral adipose tissue (VAT) were measured accordingly by quantitative computed tomography. The peak vBMD values of the spine were observed at ages 30-39 years in women and at ages 20-29 years in men. In women, the peak values of VAT and SCAT were observed, respectively, at ages ≥ 70 years and at the age range of 60-69 years. In men, the peak values of VAT and SCAT were observed, respectively, at ages ≥ 70 years and at ages 30-39 years. Using the correlation tests, there was no correlation between SCAT and vBMD in both genders. Most relationships between VAT and BMD were negative (r = -0.204, P < 0.01, in premenopausal women; r = -0.150, P < 0.05, in postmenopausal women; and r = -0.181, P < 0.05, in middle-aged men). After multiple linear regression analysis, no correlations were observed. There appears to be no correlation between fat distribution and vBMD in Chinese adults, and further studies are needed to explore associations between fat distribution and vBMD.
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Affiliation(s)
- Wei Zhang
- Department of Radiology, The Third Hospital of Hebei Medical University, 139 Ziqiang Road, Shijiazhuang, 050000, Hebei, China,
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13
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Bone mineral density in postmenopausal Mexican-Mestizo women with normal body mass index, overweight, or obesity. Menopause 2014; 20:568-72. [PMID: 23615649 DOI: 10.1097/gme.0b013e318277694f] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Obesity and osteoporosis are two important public health problems that greatly impact mortality and morbidity. Several similarities between these complex diseases have been identified. The aim of this study was to analyze if different body mass indexes (BMIs) are associated with variations in bone mineral density (BMD) among postmenopausal Mexican-Mestizo women with normal weight, overweight, or different degrees of obesity. METHODS We studied 813 postmenopausal Mexican-Mestizo women. A structured questionnaire for risk factors was applied. Height and weight were used to calculate BMI, whereas BMD in the lumbar spine (LS) and total hip (TH) was measured by dual-energy x-ray absorptiometry. We used ANCOVA to examine the relationship between BMI and BMDs of the LS, TH, and femoral neck (FN), adjusting for confounding factors. RESULTS Based on World Health Organization criteria, 15.13% of women had normal BMI, 39.11% were overweight, 25.96% had grade 1 obesity, 11.81% had grade 2 obesity, and 7.99% had grade 3 obesity. The higher the BMI, the higher was the BMD at the LS, TH, and FN. The greatest differences in size variations in BMD at these three sites were observed when comparing women with normal BMI versus women with grade 3 obesity. CONCLUSIONS A higher BMI is associated significantly and positively with a higher BMD at the LS, TH, and FN.
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Relation of the estrogen receptor and vitamin D receptor polymorphisms with bone mineral density in postmenopausal Mexican-mestizo women. Gene 2013; 537:10-4. [PMID: 24389498 DOI: 10.1016/j.gene.2013.12.054] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2013] [Revised: 12/17/2013] [Accepted: 12/21/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Since osteoporosis is a complex disease characterized by low bone mineral density (BMD), which is determined by an interaction of genetics with metabolic and environmental factors, the aim of this study was to analyze the possible association among one polymorphism of VDR and two polymorphisms of ESR1; as well as their haplotypes with BMD in postmenopausal Mexican-mestizo women. METHODS We studied 742 postmenopausal Mexican-mestizo women. A structured questionnaire for risk factors was applied and BMD was measured in the lumbar spine and total hip by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. One polymorphism of VDR (rs11568820) and two of ESR1 (rs2234693 and rs9340799) were studied. Real-time PCR allelic discrimination was used for genotyping. The differences between the means of the BMDs according to genotype were analyzed with covariance. Hardy-Weinberg equilibrium was tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2); haplotype analysis was conducted. RESULTS Rs9340799 of ESR1 and one haplotype formed by the two polymorphisms of the ESR1 were significantly associated with FN-BMD variations. Moreover, analysis of the genotype of rs11568820 of VDR and the rs2234693 of ESR1 showed no significant differences with BMD variations. CONCLUSIONS Our results showed that rs9340799 and one haplotype of ESR1 were significantly associated with BMD only at the femoral neck and this association remained after adjusting for covariates.
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Canto-Cetina T, Polanco Reyes L, González Herrera L, Rojano-Mejía D, Coral-Vázquez RM, Coronel A, Canto P. Polymorphism of LRP5, but not of TNFRSF11B, is associated with a decrease in bone mineral density in postmenopausal Maya-Mestizo women. Am J Hum Biol 2013; 25:713-8. [PMID: 24130145 DOI: 10.1002/ajhb.22464] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2013] [Revised: 09/06/2013] [Accepted: 09/07/2013] [Indexed: 01/15/2023] Open
Abstract
OBJECTIVE Osteoporosis is a complex disease characterized principally by low bone mineral density (BMD), which is determined by an interaction of genetic, metabolic, and environmental factors. The aim of this study was to analyze the possible association among one polymorphism of LRP5 and three polymorphisms of TNFRSF11B as well as their haplotypes with BMD variations in Maya-Mestizo postmenopausal women. METHODS We studied 583 postmenopausal women of Maya-Mestizo ethnic origin. A structured questionnaire for risk factors was applied and BMD was measured in lumbar spine (LS), total hip (TH), and femoral neck (FN) by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. One single-nucleotide polymorphism of LRP5 (rs3736228, p.A1330V) and three of TNFRSF11B (rs4355801, rs2073618, and rs6993813) were studied using real-time PCR allelic discrimination for genotyping. Differences between the means of the BMDs according to the genotype were analyzed with covariance. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2), and haplotype analysis of TNFRSF11B was conducted. RESULTS The Val genotype of the rs3736228 (p.A1330V) of LRP5 was significantly associated with BMD variations at the LS, TH, and FN. None of the three polymorphisms of TNFRSF11B was associated with BMD variations. CONCLUSIONS Our results show that p.A1330V was significantly associated with BMD variations at all three skeletal sites analyzed; the Val allele and the Val/Val genotype were those most frequently found in our population.
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Affiliation(s)
- Thelma Canto-Cetina
- Laboratorio de Biología de la Reproducción, Centro de Investigaciones Regionales "Dr. Hideyo Noguchi,", Mérida Yucatán, México
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Méndez JP, Rojano-Mejía D, Coral-Vázquez RM, Coronel A, Pedraza J, Casas MJ, Soriano R, García-García E, Vilchis F, Canto P. Impact of genetic variants of IL-6, IL6R, LRP5, ESR1 and SP7 genes on bone mineral density in postmenopausal Mexican-Mestizo women with obesity. Gene 2013; 528:216-20. [PMID: 23891823 DOI: 10.1016/j.gene.2013.07.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2013] [Revised: 05/31/2013] [Accepted: 07/02/2013] [Indexed: 12/25/2022]
Abstract
BACKGROUND Since obesity and osteoporosis present a high genetic predisposition and polymorphisms of IL-6, IL6R, LRP5, ESR1 and SP7 may influence the risk of both diseases, the aim of this study was to analyze the possible association of polymorphisms in these genes, as well as their haplotypes, with BMD variations in postmenopausal Mexican-Mestizo women with grade 2 or grade 3 obesity. METHODS One hundred eighty unrelated postmenopausal women with grade 2 or grade 3 obesity were included. BMD was measured in total hip and lumbar spine by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Rs1800795 of IL-6, rs2228145 of IL6R, rs3736228 of LRP5, rs9340799 (XbaI) and rs2234693 (PvuII), of ESR1, rs10876432 and rs2016266, of SP7 (and their haplotypes), were studied by real-time PCR allelic discrimination. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2), and haplotype analysis was conducted. RESULTS Using WHO criteria, 54.5% had grade 2 obesity, and 45.5% had grade 3 obesity. Regarding DXA results, 11.1% women had osteoporosis, 41.7% had osteopenia, and 47.2% had normal BMD. Genotype and haplotype analysis showed no significant differences with BMD variations at the lumbar spine, total hip or femoral neck. CONCLUSIONS We did not find a significant association between the polymorphisms analyzed or their haplotypes and BMD variations in postmenopausal women with obesity. The higher BMD observed in women with obesity could be the result of an adaptive response to the higher loading of the skeleton.
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Affiliation(s)
- Juan Pablo Méndez
- Unidad de Investigación en Obesidad, Facultad de Medicina, Universidad Nacional Autónoma de México, México, D.F., Mexico
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Rojano-Mejía D, Coral-Vázquez RM, Espinosa LC, López-Medina G, Aguirre-García MC, Coronel A, Canto P. JAG1 and COL1A1 polymorphisms and haplotypes in relation to bone mineral density variations in postmenopausal Mexican-Mestizo Women. AGE (DORDRECHT, NETHERLANDS) 2013; 35:471-478. [PMID: 22174012 PMCID: PMC3592947 DOI: 10.1007/s11357-011-9363-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Accepted: 12/05/2011] [Indexed: 05/31/2023]
Abstract
Osteoporosis is characterized by low bone mineral density (BMD). One of the most important factors that influence BMD is the genetic contribution. The collagen type 1 alpha 1 (COL1A1) and the JAGGED (JAG1) have been investigated in relation to BMD. The aim of this study was to investigate the possible association between two single-nucleotide polymorphisms (SNPs) of COL1A1, their haplotypes, and one SNP of JAG1 with BMD in postmenopausal Mexican-Mestizo women. Seven hundred and fifty unrelated postmenopausal women were included. Risk factors were recorded and BMD was measured in lumbar spine, total hip, and femoral neck by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Two SNPs in COL1A1 (rs1800012 and rs1107946) and one in JAG1 (rs2273061) were studied. Real-time PCR allelic discrimination was used for genotyping. The differences between the means of the BMDs according to genotype were analyzed with covariance. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r (2), and haplotype analysis of COL1A1 was conducted. Under a dominant model, the rs1800012 polymorphism of the COL1A1 showed an association with BMD of the lumbar spine (P = 0.021). In addition, analysis of the haplotype of COL1A1 showed that the G-G haplotype presented a higher BMD in lumbar spine. We did not find an association between the s1107946 and rs2273061 polymorphisms of the COL1A1 and JAG1, respectively. Our results suggest that the rs1800012 polymorphism of the COL1A1, in addition to one haplotype, were significantly associated with BMD variation in Mexican-Mestizo postmenopausal women.
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Affiliation(s)
- David Rojano-Mejía
- />División de Investigación Biomédica, Subdirección de Enseñanza e Investigación, Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, San Lorenzo No. 502, 2nd piso. Col. del Valle, Delegación Benito Juárez, C.P. 03100 Mexico, D.F. Mexico
- />Unidad de Medicina Física y Rehabilitación Centro, UMAE Hospital de Traumatología y Ortopedia “Lomas Verdes”, Instituto Mexicano del Seguro Social, México, D.F. México
| | - Ramón M. Coral-Vázquez
- />Sección de Posgrado, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico, D.F. Mexico
- />Subdirección de Enseñanza e Investigación, Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico, D.F. Mexico
| | - Leticia Cortes Espinosa
- />Servicio de Ginecología y Obstetricia, Hospital Regional Tacuba, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Mexico, D.F. Mexico
| | - Guillermo López-Medina
- />División de Investigación Biomédica, Subdirección de Enseñanza e Investigación, Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, San Lorenzo No. 502, 2nd piso. Col. del Valle, Delegación Benito Juárez, C.P. 03100 Mexico, D.F. Mexico
| | - María C. Aguirre-García
- />Unidad de Medicina Familiar No. 20, Instituto Mexicano del Seguro Social, Mexico, D.F. Mexico
| | - Agustín Coronel
- />División de Investigación Biomédica, Subdirección de Enseñanza e Investigación, Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, San Lorenzo No. 502, 2nd piso. Col. del Valle, Delegación Benito Juárez, C.P. 03100 Mexico, D.F. Mexico
| | - Patricia Canto
- />División de Investigación Biomédica, Subdirección de Enseñanza e Investigación, Centro Médico Nacional “20 de Noviembre”, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, San Lorenzo No. 502, 2nd piso. Col. del Valle, Delegación Benito Juárez, C.P. 03100 Mexico, D.F. Mexico
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Okyay DO, Okyay E, Dogan E, Kurtulmus S, Acet F, Eftal Taner C. Prolonged breast-feeding is an independent risk factor for postmenopausal osteoporosis. Maturitas 2013; 74:270-5. [DOI: 10.1016/j.maturitas.2012.12.014] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2012] [Revised: 11/28/2012] [Accepted: 12/21/2012] [Indexed: 12/20/2022]
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