1
|
Li J, Zhao J, Tian C, Dong L, Kang Z, Wang J, Zhao S, Li M, Tong X. Mechanisms of regulation of glycolipid metabolism by natural compounds in plants: effects on short-chain fatty acids. Nutr Metab (Lond) 2024; 21:49. [PMID: 39026248 PMCID: PMC11256480 DOI: 10.1186/s12986-024-00829-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Accepted: 07/10/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Natural compounds can positively impact health, and various studies suggest that they regulate glucose‒lipid metabolism by influencing short-chain fatty acids (SCFAs). This metabolism is key to maintaining energy balance and normal physiological functions in the body. This review explores how SCFAs regulate glucose and lipid metabolism and the natural compounds that can modulate these processes through SCFAs. This provides a healthier approach to treating glucose and lipid metabolism disorders in the future. METHODS This article reviews relevant literature on SCFAs and glycolipid metabolism from PubMed and the Web of Science Core Collection (WoSCC). It also highlights a range of natural compounds, including polysaccharides, anthocyanins, quercetins, resveratrols, carotenoids, and betaines, that can regulate glycolipid metabolism through modulation of the SCFA pathway. RESULTS Natural compounds enrich SCFA-producing bacteria, inhibit harmful bacteria, and regulate operational taxonomic unit (OTU) abundance and the intestinal transport rate in the gut microbiota to affect SCFA content in the intestine. However, most studies have been conducted in animals, lack clinical trials, and involve fewer natural compounds that target SCFAs. More research is needed to support the conclusions and to develop healthier interventions. CONCLUSIONS SCFAs are crucial for human health and are produced mainly by the gut microbiota via dietary fiber fermentation. Eating foods rich in natural compounds, including fruits, vegetables, tea, and coarse fiber foods, can hinder harmful intestinal bacterial growth and promote beneficial bacterial proliferation, thus increasing SCFA levels and regulating glucose and lipid metabolism. By investigating how these compounds impact glycolipid metabolism via the SCFA pathway, novel insights and directions for treating glucolipid metabolism disorders can be provided.
Collapse
Affiliation(s)
- Jiarui Li
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Jinyue Zhao
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Chuanxi Tian
- Beijing University of Chinese Medicine, Beijing, China
| | - Lishuo Dong
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Zezheng Kang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Jingshuo Wang
- The Affiliated Hospital, Changchun University of Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Shuang Zhao
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, China
| | - Min Li
- Research Laboratory of Molecular Biology, Guang'anmen Hospital of China Academy of Chinese Medical Sciences, Beijing, China.
| | - Xiaolin Tong
- Guang'anmen Hospital, Academician of Chinese Academy of Sciences, China Academy of Traditional Chinese Medical Sciences, Beijing, China.
| |
Collapse
|
2
|
Capdevila-Reniu A, Navarro-López M, Sierra-Benito C, Sapena V, Suárez-Lombraña A, Camafort-Babkowski M, López-Soto A. Clinical and subclinical arteriosclerotic disease in octagenarians with hip fracture. A case-control study. Med Clin (Barc) 2024:S0025-7753(24)00371-3. [PMID: 38987112 DOI: 10.1016/j.medcli.2024.05.003] [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: 12/04/2023] [Revised: 05/13/2024] [Accepted: 05/13/2024] [Indexed: 07/12/2024]
Abstract
BACKGROUND AND OBJECTIVES Evaluate clinical and subclinical arteriosclerotic disease in older patients with hip fracture compared with patients without fracture in order to increase knowledge about the relation between both diseases in older individuals. PATIENTS AND METHODS Age- and sex-matched case-control study of octogenarians with and without recent hip fracture. Vascular risk factors, subclinical vascular diseases (assessed by carotid plaques, carotid intima media thickness and arterial stiffness) as well as cardiovascular diseases were analyzed. Univariate and multivariate logistic models were used to estimate odds ratios (OR) with their 95% confidence intervals (CI) to assess the association of the arteriosclerosis and hip fracture. RESULTS We analyzed 95 patients per group with a median age of 82 [79-87] years of whom 77.9% were female. Patients in both groups have elevated rates of vascular disease (25%) without differences between them. Patients with hip fracture had higher subclinical arteriosclerotic alterations with higher percentage of carotid plaques (OR 3.25 [1.06-9.97]) compared with the control group. CONCLUSIONS Older patients with hip fracture had significantly higher presence of subclinical alterations but not increase on rate of cardiovascular arteriosclerotic disease compared with those without hip fracture.
Collapse
Affiliation(s)
- Aina Capdevila-Reniu
- Orthogeriatric Unit, Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Spain.
| | - Margarita Navarro-López
- Orthogeriatric Unit, Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Spain
| | - Cristina Sierra-Benito
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Spain
| | - Victor Sapena
- Medical Statistics Core Facility, IDIBAPS, Hospital Clinic, Barcelona, Spain
| | - Ana Suárez-Lombraña
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Spain
| | - Miguel Camafort-Babkowski
- Hypertension and Vascular Risk Unit, Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Spain
| | - Alfonso López-Soto
- Orthogeriatric Unit, Department of Internal Medicine, Hospital Clinic de Barcelona, University of Barcelona, Spain
| |
Collapse
|
3
|
Chen CC, Teng LY, Chien SH, Tsai SW. Association of muscle health impairment and atherosclerosis with major osteoporotic fracture risk in Taiwanese Vegetarians. Tzu Chi Med J 2024; 36:304-310. [PMID: 38993831 PMCID: PMC11236077 DOI: 10.4103/tcmj.tcmj_254_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/19/2023] [Accepted: 02/15/2024] [Indexed: 07/13/2024] Open
Abstract
Objectives Despite the beneficial effects of "vegetarian style" diet on atherosclerosis, it is also proven potentially detrimental to bone health. The influence of muscle health or atherosclerosis on major osteoporotic fracture (MOF) risk in vegetarians has rarely been explored. This prospective study aimed to investigate an association of MOF risk with muscle health and atherosclerosis in vegetarians. Materials and Methods We conducted a questionnaire survey with the Mini-Nutritional Assessment (MNA) on 39 vegetarians. The 10-year probability of MOF was determined using the Taiwanese Fracture Risk Assessment (FRAX®) calculator. Appendicular skeletal muscle (ASM) mass and bone mineral density were measured with dual-energy X-ray absorptiometry. Physical performance was evaluated using the 6-min walk test (6MWT). Common carotid artery intima-media thickness (ccIMT) was determined using sonography. Serum levels of parathyroid hormone (PTH), Vitamin D, adiponectin, and leptin were measured. Results Eleven (28.2%) of 39 vegetarians had a moderate-high risk of MOF, defined by FRAX-calculated risk ≥10%. These subjects had lower ASM (P < 0.005) and 6MWT distances (P < 0.01) but greater ccIMT than those with low risk. The MOF risk was negatively correlated with ASM (r = -0.51, P < 0.001) and 6MWT distances (r = -0.62, P < 0.001) but positively correlated with ccIMT (r = 0.56, P < 0.001). Linear regression analysis revealed that MOF risk scores were negatively associated with ASM and 6MWT distance while positively associated with ccIMT. There was no significant association of MOF risk with MNA scores, serum levels of PTH, Vitamin D, adiponectin, or leptin. Conclusion Decreased ASM mass, reduced physical performance, and atherosclerosis are significantly associated with MOF risk in vegetarians.
Collapse
Affiliation(s)
- Chia-Ching Chen
- Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Li-Yun Teng
- Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Sou-Hsin Chien
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Plastic Surgery, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
| | - Sen-Wei Tsai
- Department of Physical Medicine and Rehabilitation, Taichung Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Taichung, Taiwan
- School of Medicine, Tzu Chi University, Hualien, Taiwan
| |
Collapse
|
4
|
Nie X, Zhang Q, Wang Y, Liu Z, Xie D, Song Q, Yang C, Yu T, Sun Y. Causal effects of osteoporosis on structural changes in specific brain regions: a Mendelian randomization study. Cereb Cortex 2024; 34:bhad528. [PMID: 38216525 DOI: 10.1093/cercor/bhad528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 12/15/2023] [Accepted: 12/16/2023] [Indexed: 01/14/2024] Open
Abstract
Observational studies have reported that osteoporosis is associated with cortical changes in the brain. However, the inherent limitations of observational studies pose challenges in eliminating confounding factors and establishing causal relationships. And previous observational studies have not reported changes in specific brain regions. By employing Mendelian randomization, we have been able to infer a causal relationship between osteoporosis and a reduction in the surficial area (SA) of the brain cortical. This effect is partially mediated by vascular calcification. We found that osteoporosis significantly decreased the SA of global brain cortical (β = -1587.62 mm2, 95%CI: -2645.94 mm2 to -529.32 mm2, P = 0.003) as well as the paracentral gyrus without global weighted (β = - 19.42 mm2, 95%CI: -28.90 mm2 to -9.95 mm2, P = 5.85 × 10-5). Furthermore, we estimated that 42.25% and 47.21% of the aforementioned effects are mediated through vascular calcification, respectively. Osteoporosis leads to a reduction in the SA of the brain cortical, suggesting the presence of the bone-brain axis. Vascular calcification plays a role in mediating this process to a certain extent. These findings establish a theoretical foundation for further investigations into the intricate interplay between bone, blood vessels, and the brain.
Collapse
Affiliation(s)
- Xinlin Nie
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Qiong Zhang
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Yixuan Wang
- Department of Otolaryngology Head and Neck Surgery, Shaanxi Provincial People's Hospital, Xi'an 710000, China
| | - Zhaoliang Liu
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Dongheng Xie
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Qingxu Song
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Chen Yang
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Tiecheng Yu
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| | - Yang Sun
- Department of Orthopedic Center, the First Hospital of Jilin University, Changchun 130000, China
| |
Collapse
|
5
|
Szulc P, Lewis JR, Chapurlat R. Accelerated Bone Loss in Older Men With Severe Abdominal Aortic Calcification-the Prospective MINOS Study. J Clin Endocrinol Metab 2023; 109:e32-e39. [PMID: 37610245 DOI: 10.1210/clinem/dgad459] [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: 06/05/2023] [Revised: 06/30/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
CONTEXT Data on the association between the severity of abdominal aortic calcification (AAC) and bone loss are discordant. OBJECTIVE Our aim was to assess the association between baseline AAC and prospectively assessed bone loss in older men. METHODS This prospective cohort study started in 1995 (MINOS). Men aged 50 to 85 years (n = 778) had AAC assessed on the lateral radiograph of the spine using Kauppila's semiquantitative score and was followed prospectively for 7.5 years. Bone mineral density (BMD) and bone mineral content (BMC) were measured by dual-energy x-ray absorptiometry every 18 months. Statistical analysis was performed using linear mixed models. RESULTS In comparison to men without AAC (AAC = 0), severe AAC (>6) was associated with more rapid bone loss at the total hip (-0.62 ± 0.06 vs -0.32 ± 0.04%/year; P < .001), trochanter, and distal forearm (-0.72 ± 0.06 vs -0.45 ± 0.03%/year; P < .001). The highest decile (AAC >10) was associated with more rapid bone loss at the femoral neck, whole body, and ultradistal radius (-0.86 ± 0.12 vs -0.34 ± 0.05%/year; P < .001). The results were similar for BMD and for BMC. The patterns were similar in sensitivity analyses (eg, after excluding men with abdominal obesity, after excluding current smokers, after excluding men with ischemic heart disease or with diabetes mellitus, after excluding men with abnormal concentrations of lipids, bioavailable 17β-estradiol or 25-hydroxycholecalciferol, after excluding men with glomerular filtration rate <60 mL/min). CONCLUSION Severe AAC is associated with faster bone loss in older men and may contribute to the higher fracture risk observed in this population.
Collapse
Affiliation(s)
- Pawel Szulc
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, 69437, Lyon, France
| | - Joshua R Lewis
- Institute for Nutrition Research, Edith Cowan University, Joondalup, Perth, WA 6027, Australia
- Medical School, the University of Western Australia, Perth, WA 6009, Australia
| | - Roland Chapurlat
- INSERM UMR 1033, University of Lyon, Hospices Civils de Lyon, 69437, Lyon, France
| |
Collapse
|
6
|
Yolaçan H, Güler S. Does Femoral Arterial Calcification Have an Effect on Mortality in Patients Who Underwent Hemiarthroplasty Due to Hip Fracture? Cureus 2023; 15:e46437. [PMID: 37800162 PMCID: PMC10547848 DOI: 10.7759/cureus.46437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/03/2023] [Indexed: 10/07/2023] Open
Abstract
AIM We aimed to investigate the effect of femoral arterial calcification on mortality in patients who underwent hemiarthroplasty due to hip fracture. MATERIAL AND METHODS In our study, 481 patients who were operated for hip fracture between 01.01.2015 and 01.01.2021 were evaluated retrospectively. Femoral arterial calcification on the fractured side was evaluated in the preoperative pelvic anteroposterior (AP) X-ray, and the patients were divided into two subgroups according to the presence or absence of femoral arterial calcification. The overall survival and first-month and first-year survival of the patients were evaluated. Patients' age, gender, side, fracture type, treatment method, time between fracture and operation date, presence of femoral arterial calcification and type of anesthesia (regional, general) were recorded. RESULTS Of the 481 patients included in the study, 299 were female and 182 were male, and the mean age was calculated as 80.5. Of the patients, 187 were diagnosed with femoral neck fractures and the remaining 294 with pertrochanteric fractures. It was observed that the mortality rate in the first month after surgery was 58 (12%) for both groups, and the mortality rate in the first year was 173 (35.9%) for both groups. The overall postoperative mortality was calculated as 302 (62.7%) for both groups. Femoral arterial calcification was detected in 191 of 481 patients, and femoral arterial calcification was not observed in the remaining 290 patients. Similarly, when both groups were compared in terms of mortality in the first month after surgery, mortality in the first year and overall mortality rates, no significant difference was found between the groups (p>0.05). CONCLUSION In our study we showed that femoral arterial calcification has no effect on mortality in acute hip fractures treated by hemiarthroplasty in people over 65 years of age.
Collapse
Affiliation(s)
- Hakan Yolaçan
- Orthopaedics and Traumatology, Aksaray University Training and Research Hospital, Aksaray, TUR
| | - Serkan Güler
- Orthopaedics and Traumatology, Aksaray University Training and Research Hospital, Aksaray, TUR
| |
Collapse
|
7
|
Solorzano A, Brady M, Bhatt N, Johnson A, Burgess B, Leyva H, Puangmalai N, Jerez C, Wood R, Kayed R, Deane R. Central and peripheral tau retention modulated by an anti-tau antibody. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.17.553682. [PMID: 37645819 PMCID: PMC10462070 DOI: 10.1101/2023.08.17.553682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/31/2023]
Abstract
Tau protein blood levels dependent on its distribution to peripheral organs and possible elimination from the body. Thus, the peripheral distribution of CSF-derived tau protein was explored, especially since there is a transition to blood-based biomarkers and the emerging idea that tau pathology may spread beyond brain. Near infrared fluorescence (NIRF) was mainly used to analyze tau (tau-NIRF) distribution after its intracisternal or intravenous injection. There was a striking uptake of blood- or CSF-derived tau-NIRF protein by the skeletal structures, liver, small intestine (duodenum), gall bladder, kidneys, urinary bladder, lymph nodes, heart, and spleen. In aging and in older APP/PS1 mice, tau uptake in regions, such as the brain, liver, and skeleton, was increased. In bone (femur) injected tau protein was associated with integrin-binding sialoprotein (IBSP), a major non-collagenous glycoprotein that is associated with mineralization. Tau-NIRF was cleared slowly from CSF via mainly across the cribriform plate, and cervical lymph nodes. In brain, some of the CSF injected tau protein was associated with NeuN-positive and PDGFRý-positive cells, which may explain its retention. The presence of tau in the bladders suggested excretion routes of tau. CSF anti-tau antibody increased CSF tau clearance, while blood anti-tau antibody decreased tau accumulation in the femur but not in liver, kidney, and spleen. Thus, the data show a body-wide distribution and retention of CSF-derived tau protein, which increased with aging and in older APP/PS1 mice. Further work is needed to elucidate the relevance of tau accumulation in each organ to tauopathy.
Collapse
|
8
|
Pickering ME, Oris C, Chapurlat R. Periostin in Osteoporosis and Cardiovascular Disease. J Endocr Soc 2023; 7:bvad081. [PMID: 37362382 PMCID: PMC10285762 DOI: 10.1210/jendso/bvad081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Indexed: 06/28/2023] Open
Abstract
Context Osteoporosis (OP) and cardiovascular disease (CVD), prevalent disorders worldwide, often coexist and share common risk factors. The identification of common biomarkers could significantly improve patients' preventive care. Objectives The objectives are 1, to review periostin (Postn) involvement in osteoporosis and in CVD, and 2, identify if Postn could be a common biomarker. Design This is a scoping review on Postn in OP and CVD. Methods Databases were searched, in vitro and in vivo, for publications in English on Postn, bone, and the cardiovascular system, with no limit regarding publication date. Results Postn appears as a key factor in OP and CVD. Its role as a potential biomarker in both pathologies is described in recent studies, but a number of limitations have been identified. Conclusions Current evidence provides fragmented views on Postn in OP and CVD and does not encapsulate Postn as a common pivotal thread linking these comorbidities. A number of gaps impede highlighting Postn as a common biomarker. There is room for future basic and clinical research with Postn as a marker and a target to provide new therapeutic options for aging patients with concomitant OP and CVD.
Collapse
Affiliation(s)
- Marie-Eva Pickering
- Correspondence: Marie-Eva Pickering, MD, Rheumatology Department, CHU Gabriel Montpied, 58 rue Montalembert, 63000 Clermont-Ferrand, France.
| | - Charlotte Oris
- Service de Biologie, CHU Gabriel Montpied, 63000 Clermont-Ferrand, France
| | - Roland Chapurlat
- Service de Rhumatologie, Hospices Civils de Lyon, 69437 Lyon, Cedex 03, France
- Inserm UMR 1033, 69437 Lyon, Cedex 03, France
| |
Collapse
|
9
|
Yano C, Yokomoto-Umakoshi M, Fujita M, Umakoshi H, Yano S, Iwahashi N, Katsuhara S, Kaneko H, Ogata M, Fukumoto T, Terada E, Matsuda Y, Sakamoto R, Ogawa Y. Coexistence of bone and vascular disturbances in patients with endogenous glucocorticoid excess. Bone Rep 2022; 17:101610. [PMID: 36035657 PMCID: PMC9398912 DOI: 10.1016/j.bonr.2022.101610] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 08/10/2022] [Indexed: 10/28/2022] Open
Abstract
Purpose Bone and vascular diseases are considered to share pathogenic mechanisms. Excess glucocorticoids, key regulators of cardiovascular and metabolic homeostasis, may promote both diseases simultaneously. We used endogenous Cushing's syndrome (CS) to investigate whether glucocorticoid excess underlies coexisting bone and vascular diseases. Methods We included 194 patients with adrenal tumors (ATs): autonomous cortisol secretion (ACS, n = 97) and non-functional AT (n = 97). ACS was further classified into overt CS (n = 17) and subclinical CS (SCS, n = 80). Arterial stiffness was defined as a brachial-ankle pulse wave velocity (baPWV) ≥ 1800 cm/s. Results Patients with ACS had higher coexistence rates of vertebral fracture and arterial stiffness (23 % vs. 2 %; p < 0.001) and vertebral fracture and abdominal aortic calcification (22 % vs. 1 %; p < 0.001) than those with non-functional AT. In patients with ACS, baPWV was negatively correlated with trabecular bone score (TBS, r = -0.33; p = 0.002), but not with bone mineral density, and vertebral fracture was associated with arterial stiffness in the logistic regression analysis. In the multivariate analysis of variance, the degree of cortisol excess (defined as CS, SCS, and non-functional AT) determined the correlation between TBS and baPWV (partial η2 = 0.07; p < 0.001). In the analysis of covariance, patients with coexisting vertebral fracture and arterial stiffness had higher levels of serum cortisol after the 1-mg dexamethasone suppression test than those without. Conclusion In endogenous glucocorticoid excess, bone and vascular diseases frequently coexisted, and deteriorated bone quality, not bone loss, was related to arterial stiffness. Thus, glucocorticoid excess may perturb the bone-vascular axis.
Collapse
Affiliation(s)
- Chieko Yano
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Maki Yokomoto-Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masamichi Fujita
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hironobu Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Seiichi Yano
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Norifusa Iwahashi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Shunsuke Katsuhara
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Hiroki Kaneko
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Masatoshi Ogata
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Tazuru Fukumoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Eriko Terada
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yayoi Matsuda
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Ryuichi Sakamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Yoshihiro Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| |
Collapse
|
10
|
Porter T, Sim M, Prince RL, Schousboe JT, Bondonno C, Lim WH, Zhu K, Kiel DP, Hodgson JM, Laws SM, Lewis JR. Abdominal aortic calcification on lateral spine images captured during bone density testing and late-life dementia risk in older women: A prospective cohort study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2022; 26:100502. [PMID: 36213133 PMCID: PMC9535408 DOI: 10.1016/j.lanwpc.2022.100502] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Dementia after the age of 80 years (late-life) is increasingly common due to vascular and non-vascular risk factors. Identifying individuals at higher risk of late-life dementia remains a global priority. METHODS In prospective study of 958 ambulant community-dwelling older women (≥70 years), lateral spine images (LSI) captured in 1998 (baseline) from a bone density machine were used to assess abdominal aortic calcification (AAC). AAC was classified into established categories (low, moderate and extensive). Cardiovascular risk factors and apolipoprotein E (APOE) genotyping were evaluated. Incident 14.5-year late-life dementia was identified from linked hospital and mortality records. FINDINGS At baseline women were 75.0 ± 2.6 years, 44.7% had low AAC, 36.4% had moderate AAC and 18.9% had extensive AAC. Over 14.5- years, 150 (15.7%) women had a late-life dementia hospitalisation (n = 132) and/or death (n = 58). Compared to those with low AAC, women with moderate and extensive AAC were more likely to suffer late-life dementia hospitalisations (9.3%, 15.5%, 18.3%, respectively) and deaths (2.8%, 8.3%, 9.4%, respectively). After adjustment for cardiovascular risk factors and APOE, women with moderate and extensive AAC had twice the relative hazards of late-life dementia (moderate, aHR 2.03 95%CI 1.38-2.97; extensive, aHR 2.10 95%CI 1.33-3.32), compared to women with low AAC. INTERPRETATION In community-dwelling older women, those with more advanced AAC had higher risk of late-life dementia, independent of cardiovascular risk factors and APOE genotype. Given the widespread use of bone density testing, simultaneously capturing AAC information may be a novel, non-invasive, scalable approach to identify older women at risk of late-life dementia. FUNDING Kidney Health Australia, Healthway Health Promotion Foundation of Western Australia, Sir Charles Gairdner Hospital Research Advisory Committee Grant, National Health and Medical Research Council of Australia.
Collapse
Key Words
- AAC, abdominal aortic calcification
- AAC24, abdominal aortic calcification 24 scale scores
- AD, Alzheimer's disease
- APOE, apolipoprotein E
- ASVD, atherosclerotic vascular disease
- AUC, area under the curve
- Aging
- CAC, coronary artery calcification
- CVD, cardiovascular disease
- DXA, dual-energy X-ray absorptiometry
- Dementia
- Epidemiology
- FRS, Framingham General Cardiovascular Risk Scores
- IDI, integrated discrimination improvement
- Imaging
- LSI, lateral spine imaging
- NRI, net reclassification improvement
- ROC, receiver operator characteristics
- Vascular disease
Collapse
Affiliation(s)
- Tenielle Porter
- Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Marc Sim
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Richard L. Prince
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - John T. Schousboe
- Park Nicollet Clinic and HealthPartners Institute, HealthPartners, Minneapolis, MN, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Catherine Bondonno
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Wai H. Lim
- Medical School, University of Western Australia, Crawley, WA, Australia
- Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Kun Zhu
- Medical School, University of Western Australia, Crawley, WA, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Douglas P. Kiel
- Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine Beth, Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA
| | - Jonathan M. Hodgson
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
| | - Simon M. Laws
- Centre for Precision Health, Edith Cowan University, Joondalup, WA, Australia
- Collaborative Genomics and Translation Group, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences, Curtin Health Innovation Research Institute, Curtin University, Bentley, WA, Australia
| | - Joshua R. Lewis
- Nutrition & Health Innovation Research Institute, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
- Medical School, University of Western Australia, Crawley, WA, Australia
- Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, the University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
11
|
Gebre AK, Prince RL, Schousboe JT, Kiel DP, Thompson PL, Zhu K, Lim WH, Sim M, Lewis JR. Calcaneal quantitative ultrasound is associated with all-cause and cardiovascular disease mortality independent of hip bone mineral density. Osteoporos Int 2022; 33:1557-1567. [PMID: 35147712 PMCID: PMC9187548 DOI: 10.1007/s00198-022-06317-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 01/20/2022] [Indexed: 11/26/2022]
Abstract
UNLABELLED Osteoporosis has been linked with increased risk of cardiovascular disease previously. However, few studies have detailed bone and vascular information. In a prospective study of older women, we demonstrated heel quantitative ultrasound measures were associated with increased cardiovascular and all-cause mortality, independent of established cardiovascular risk factors. INTRODUCTION Osteoporosis and low bone mineral density (BMD) have been previously linked to cardiovascular disease (CVD) and mortality. Calcaneal quantitative ultrasound (QUS) is used to evaluate bone material properties, especially in older women. However, it is uncertain whether it is related to risk of mortality. This study was aimed to investigate the association between calcaneal QUS measurements and 15-year all-cause and CVD mortality in 1404 older women (mean age 75.2 ± 2.7 years). METHODS One thousand four hundred four older women, participants of Calcium Intake Fracture Outcome study (CAIFOS), had calcaneal bone measured at baseline (1998) and followed for 15 years. The primary outcomes, any deaths, and deaths attributable to cardiovascular causes ascertained by using linked data were obtained from Western Australia data linkage system. RESULTS Over the 15 years of follow-up (17,955 person years), 584 of the women died, and 223 from CVD. For every standard deviation (SD), reduction in broadband ultrasound attenuation (BUA) in minimally and multivariable-adjusted model including cardiovascular risk factors increased relative hazards for all-cause (multivariable-adjusted HR 1.15; 95%CI: 1.06-1.26, p = 0.001) and CVD mortality (multivariable-adjusted HR 1.20; 95%CI: 1.04-1.38, p = 0.010). Such relationships also persisted when hip BMD was included in the model (all-cause mortality HR 1.19; 95%CI: 1.07-1.33, p = 0.002; CVD mortality HR 1.28; 95%CI: 1.07-1.53, p = 0.008). CONCLUSION BUA is associated with all-cause and CVD mortality in older women independent of BMD and established CVD risk factors. Understanding why and how these are related may provide further insights about the bone-vascular nexus as well as therapeutic targets benefiting both systems.
Collapse
Affiliation(s)
- A K Gebre
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
- School of Pharmacy, College of Health Sciences, Mekelle University, Mekelle, Ethiopia
| | - R L Prince
- Medical School, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - J T Schousboe
- Park Nicollet Osteoporosis Center and HealthPartners Institute, HealthPartners, Minneapolis, MN, 55416, USA
- Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, 55455, USA
| | - D P Kiel
- Marcus Institute for Aging Research, Hebrew SeniorLife, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, 02215, USA
| | - P L Thompson
- Medical School, The University of Western Australia, Perth, Australia
- Department of Cardiology, Sir Charles Gairdner Hospital, Perth, Australia
| | - K Zhu
- Medical School, The University of Western Australia, Perth, Australia
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, Australia
| | - W H Lim
- Medical School, The University of Western Australia, Perth, Australia
- Renal Department, Sir Charles Gairdner Hospital, Perth, Australia
| | - M Sim
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia
- Medical School, The University of Western Australia, Perth, Australia
| | - J R Lewis
- Institute for Nutrition Research, School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, 6027, Australia.
- Medical School, The University of Western Australia, Perth, Australia.
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia.
| |
Collapse
|
12
|
Bayram S, Yıldırım AM, Birişik F, Salduz A. Radiological parameter associated with the survival of old patients with hip fracture. Injury 2021; 52:3388-3396. [PMID: 34332708 DOI: 10.1016/j.injury.2021.07.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 07/13/2021] [Accepted: 07/16/2021] [Indexed: 02/02/2023]
Abstract
AIM We aimed to investigate the relationship between radiological parameters and survival of patients with hip fracture aged >65 years. METHODS We performed a retrospective cohort study with reviewed recorded data of patients who were treated for hip fracture. Radiological parameters were included the psoas:lumbar vertebral index (PLVI) by evaluating computed tomography (to assess sarcopenia), the cortical thickness index (CTI), Dorr morphology, canal-to-calcar ratio (CCR) and presence of iliac and femoral arterial calcification on both lower extremities by evaluating hip and pelvis radiographs. A multivariate Cox algorithm was applied to recognize these radiological factors independently associated with survival. RESULTS A total of 304 patients [200 (65.8%) female and 104 (34.2%) male] were included, and the average age was 79.3 ± 8.3 years. During the study period, 154 (50.6%) patients died, whereas 150 (50.4%) were alive with a mean survival of 35.7 months. The survival rates at 1 month, 6 months and 1 year after surgery were 92.8%, 79.7% and 73.4%, respectively. A total of 120 patients were diagnosed with femoral neck fracture, at a mean age of 75.1 years, and 204 patients were diagnosed with intertrochanteric fracture, at a mean age of 82.2 years. The multivariate analysis demonstrated that presence of femoral calcification on the fracture side were independently associated with a poor overall survival. CONCLUSION Although sarcopaenia was significantly higher in the deceased group, sarcopaenia was not significantly correlated with survival. However, the presence of femoral calcification on the fracture side was the only independent radiological parameter associated with poor overall survival, as patients had 1.4 times higher mortality rate. We did not find a significant difference between the intertrochanteric and femoral neck fracture groups with regard to CCR, CTI and Dorr type. However, the rate of femoral calcification in both the fracture and unaffected sides was significantly higher in the intertrochanteric group. LEVEL OF EVIDENCE Level III prognostic study.
Collapse
Affiliation(s)
- Serkan Bayram
- Department of Orthopaedics and Traumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey.
| | - Ahmet Müçteba Yıldırım
- Department of Orthopaedics and Traumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| | - Fevzi Birişik
- Department of Orthopaedics and Traumatology, Istanbul Research and Training Hospital University of Health Sciences, Istanbul, Turkey
| | - Ahmet Salduz
- Department of Orthopaedics and Traumatology, Istanbul University, Istanbul Faculty of Medicine, Istanbul, Turkey
| |
Collapse
|
13
|
Natesan V, Kim SJ. Lipid Metabolism, Disorders and Therapeutic Drugs - Review. Biomol Ther (Seoul) 2021; 29:596-604. [PMID: 34697272 PMCID: PMC8551734 DOI: 10.4062/biomolther.2021.122] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/24/2021] [Accepted: 10/01/2021] [Indexed: 11/05/2022] Open
Abstract
Different lifestyles have an impact on useful metabolic functions, causing disorders. Different lipids are involved in the metabolic functions that play various vital roles in the body, such as structural components, storage of energy, in signaling, as biomarkers, in energy metabolism, and as hormones. Inter-related disorders are caused when these functions are affected, like diabetes, cancer, infections, and inflammatory and neurodegenerative conditions in humans. During the Covid-19 period, there has been a lot of focus on the effects of metabolic disorders all over the world. Hence, this review collectively reports on research concerning metabolic disorders, mainly cardiovascular and diabetes mellitus. In addition, drug research in lipid metabolism disorders have also been considered. This review explores lipids, metabolism, lipid metabolism disorders, and drugs used for these disorders.
Collapse
Affiliation(s)
- Vijayakumar Natesan
- Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalainagar 608002, Tamilnadu, India
| | - Sung-Jin Kim
- Department of Pharmacology and Toxicology, Metabolic Diseases Research Laboratory, School of Dentistry, Kyung Hee University, Seoul 02447, Republic of Korea
| |
Collapse
|
14
|
Wang Y, Wang R, Liu Y, Bai L, Liu L, He L, Deng H, Li T, Xu S, Chen L, Wen K, Qi B. Associations between bone mineral density in different measurement locations and coronary artery disease: a cross-sectional study. Arch Osteoporos 2021; 16:100. [PMID: 34169345 DOI: 10.1007/s11657-021-00940-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Accepted: 05/04/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED The bone mineral density (BMD) loss is closely related to coronary heart disease (CAD). The BMD measured at different locations differ in BMD values, the risk to CAD, and the capability to identify CAD. An average BMD of the right and left femoral neck being below - 1.70 has the ability to indicate risk of CAD. PURPOSE Previous studies have reported that low bone mineral density (BMD) is closely related to coronary artery disease (CAD); however, it is not clear that the BMD loss at which location to what extent has the greatest effect in identifying risk of CAD. This study aimed to evaluate the ability of different measurement sites of BMD in identifying CAD and analyze the best measurement sites and the optimal cut-off of BMD for CAD. METHODS This was a cross-sectional study in which 180 of 817 participants were diagnosed with CAD. All participants in the study were measured by dual-energy X-ray absorptiometry (DEXA) for BMD at 8 locations, and following measurements were derived: the average BMD of lumbar spine (L1-L4), femoral neck (left and right), and total proximal femur (left and right). The association between BMD at different locations and CAD was analyzed using logistic regression. The receiver operating characteristic (ROC) curve was used to select the optimal measurement location and cut-off value of the BMD for identifying CAD. RESULTS There were significant differences in BMD at 3 different measurement locations. Higher BMD is a protective factor against CAD, which is more pronounced in the femoral neck and total proximal femur (ORs = 0.47 ~ 0.66, P < 0.001) than in the lumbar spine (ORs = 0.74 ~ 0.79, P < 0.001). The optimal site for predicting the risk of CAD by BMD is the femoral neck, with the AUC (area under the ROC curve) is 0.72 (95% CI: 0.67 ~ 0.76) and the cut-off is - 1.70. CONCLUSION The BMD below particular cut-off of the femoral neck rather than of the lumbar spine may have certain further research value for revealing the risk of CAD.
Collapse
Affiliation(s)
- Yaoling Wang
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Ruiyun Wang
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Yun Liu
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Lijuan Bai
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Lihua Liu
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Linfeng He
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Heng Deng
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Tao Li
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Sha Xu
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China
| | - Li Chen
- Novartis Pharmaceuticals Corporation, East Hanover, USA
| | - Kai Wen
- School of Software & Microelectronics, Peking University, Beijing, China
| | - Benling Qi
- Department of Geriatrics, Union Hospital of Tongji Medical College Huazhong University of Science & Technology, Wuhan, 430022, China.
| |
Collapse
|
15
|
Birişik F, Bilgin Y, Bayram S, Öztürkmen Y. Does Presence of Femoral Arterial Calcification Have an Effect on Postoperative Complication and Mortality in Patients With Hip Fracture? Cureus 2021; 13:e14878. [PMID: 34113507 PMCID: PMC8177717 DOI: 10.7759/cureus.14878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2021] [Indexed: 12/03/2022] Open
Abstract
Introduction In this study, we investigated the relationship between femoral arterial calcification on preoperative hip radiography and post-operative complications and all-time mortality rates in patients with hip fracture >65 years old. Methods This retrospective study was conducted by evaluating the records of patients who were operated for hip fractures. All patients were divided into two groups according to the presence of lower extremity arterial calcification (LEAC) at the femoral artery which was diagnosed using the hip radiograph. The patients with and without the presence of LEAC were assigned as groups 1 and 2, respectively. A multivariate Cox algorithm was applied to recognize whether this radiological factor is independently associated with survival. Results The study included 530 patients (540 hips; 191 males and 339 females) with an average age of 80.8 ± 7.6 years. In the study after 24.8±19.9 months (range:0-65 months) follow-up period, 336 (63.3%) patients had expired. Conversely, 194 (36.7%) patients are surviving. Survival rates at one month and one year after surgery were 89.5% and 65.7%, respectively. 234 of 540 hips (230 patients) have LEAC on the femoral artery. The survival rate at one month, one year, and overall survival were significantly higher in patients with LEAC. The postoperative infection rate was also two times higher in patients with LEAC than without LEAC (p = 0.021). Multivariate analysis demonstrated that age, treatment modality (hemiarthroplasty), and the presence of femoral arterial calcification were independently associated with poor overall survival. Conclusions In our study, we found that the presence of femoral arterial calcification on the affected side of the hip identified on hip radiograph was independently associated with poor one month, one year, and overall survival as the patients had 1.5 times higher mortality rate. Additionally, a significant correlation was found between age and survival of patients with hip fracture, especially patients >80 years old.
Collapse
Affiliation(s)
- Fevzi Birişik
- Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Yücel Bilgin
- Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| | - Serkan Bayram
- Orthopaedics and Traumatology, Istanbul University School of Medicine, Istanbul, TUR
- Orthopaedics, Istanbul University, Istanbul, TUR
| | - Yusuf Öztürkmen
- Orthopaedics and Traumatology, Istanbul Training and Research Hospital, Istanbul, TUR
| |
Collapse
|
16
|
The Dual Role of Vitamin K2 in "Bone-Vascular Crosstalk": Opposite Effects on Bone Loss and Vascular Calcification. Nutrients 2021; 13:nu13041222. [PMID: 33917175 PMCID: PMC8067793 DOI: 10.3390/nu13041222] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 03/30/2021] [Accepted: 04/04/2021] [Indexed: 12/13/2022] Open
Abstract
Osteoporosis (OP) and vascular calcification (VC) represent relevant health problems that frequently coexist in the elderly population. Traditionally, they have been considered independent processes, and mainly age-related. However, an increasing number of studies have reported their possible direct correlation, commonly defined as “bone-vascular crosstalk”. Vitamin K2 (VitK2), a family of several natural isoforms also known as menaquinones (MK), has recently received particular attention for its role in maintaining calcium homeostasis. In particular, VitK2 deficiency seems to be responsible of the so-called “calcium paradox” phenomenon, characterized by low calcium deposition in the bone and its accumulation in the vessel wall. Since these events may have important clinical consequences, and the role of VitK2 in bone-vascular crosstalk has only partially been explained, this review focuses on its effects on the bone and vascular system by providing a more recent literature update. Overall, the findings reported here propose the VitK2 family as natural bioactive molecules that could be able to play an important role in the prevention of bone loss and vascular calcification, thus encouraging further in-depth studies to achieve its use as a dietary food supplement.
Collapse
|
17
|
Zhang YW, Lu PP, Li YJ, Dai GC, Chen MH, Zhao YK, Cao MM, Rui YF. Prevalence, Characteristics, and Associated Risk Factors of the Elderly with Hip Fractures: A Cross-Sectional Analysis of NHANES 2005-2010. Clin Interv Aging 2021; 16:177-185. [PMID: 33542622 PMCID: PMC7851483 DOI: 10.2147/cia.s291071] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022] Open
Abstract
Objective This cross-sectional study was aimed to update the assessment of prevalence, characteristics, and risk factors of the elderly with hip fractures in a non-institutionalized American population. Methods This current study included a total of 31,034 participants from the existing National Health and Nutritional Examination Survey (NHANES) database from 2005 to 2010, and 4,265 participants aged 65 years and older were ultimately identified. Their condition of hip fractures was determined by method of questionnaires according to the orthopedic surgeons' diagnosis, and related epidemiological and demographic data were further collected. The univariate analysis was used to screen the risk factors of hip fractures in the elderly, and the logistic regression model was established to conduct the multivariate analysis. Results Of the total 4,265 participants with clear information of hip fractures in elderly, 127 individuals with hip fractures were identified according to results of questionnaires, exhibiting a prevalence of 28.49 per 1,000 (95% confidence interval [CI]=21.38-35.60) for males and 31.03 per 1,000 (95% CI=23.72-38.35) for females. The mean age of the elderly with hip fractures was 77.12±5.88 years and tumble (48.0%) was the primary factor. In univariate analysis, age, race, smoking, drinking alcohol, and combined with osteoporosis were regarded as risk factors. Multivariate analysis showed that age (80 years and older), living alone, smoking, combined with diabetes and osteoporosis were the independent risk factors. Conclusion Our nationwide data indicate the prevalence of hip fractures in the elderly is generally on the rise, and the female occupies a higher proportion. Age (especially aged 80 years and older), race (mainly Non-Hispanic white), smoking, drinking alcohol, living alone, combined with diabetes and osteoporosis may be closely linked to the occurrence of hip fractures in the elderly, although these variables still need to be verified in further prospective investigations.
Collapse
Affiliation(s)
- Yuan-Wei Zhang
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Pan-Pan Lu
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Ying-Juan Li
- Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Department of Geriatrics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Guang-Chun Dai
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Min-Hao Chen
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Ya-Kuan Zhao
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Mu-Min Cao
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| | - Yun-Feng Rui
- Department of Orthopedics, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Multidisciplinary Team (MDT) for Geriatric Hip Fracture Management, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China.,Orthopaedic Trauma Institute (OTI), Southeast University, Nanjing, Jiangsu, People's Republic of China.,Trauma Center, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, Jiangsu, People's Republic of China
| |
Collapse
|
18
|
Majjad A, Ghassem MA, Toufik H, Sadni S, Debbarh Z, Djossou JH, El Ouardi N, Taoubane L, Abouqal R, Achemlal L, El Maghraoui A. Relationship between vertebral fracture prevalence and abdominal aortic calcification in women with rheumatoid arthritis. Bone 2020; 141:115599. [PMID: 32822872 DOI: 10.1016/j.bone.2020.115599] [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] [Received: 04/25/2020] [Revised: 07/21/2020] [Accepted: 08/13/2020] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Vertebral fracture assessment (VFA)-detected abdominal aortic calcification (AAC) has been validated as an indicator of increased risk of vertebral fractures (VFs) in other populations but this relationship in rheumatoid arthritis (RA) is unclear. We assess the prevalence of AAC on VFA scans and its potential relationship with prevalent VFs in a cohort of RA women. METHODS We enrolled 250 women with RA. VFA images, and scans of the lumbar spine and proximal femur were obtained using dual-energy x-ray absorptiometry. The presence/severity of VFs and AAC were carried out using validated approaches. RESULTS AAC was detected in 95 of 250 (38%) eligible subjects and 83 (33.2%) had at least one VF. Significantly subjects with VFs had a higher AAC score (3.4 ± 3.8 versus 0.7 ± 1.4; p˂0.001) and higher prevalence of AAC than those without VFs (65% versus 26%; P˂0.001). The group with VFs tended to be older, had more menopausal women, and lower lumbar spine and total hip BMD than those without VF. They also had a long-standing disease and high DAS 28-CRP, a great steroid cumulative dose, and a high prevalence of rheumatoid factor (RF). In multivariate analyses, a significant association was noted between prevalent VFs and age of patients, RA disease activity, presence of densitometric osteoporosis, RF, and VFA-detected AAC, whereas there was no significant association with steroid cumulative dose and disease duration. CONCLUSION VFA is a convenient tool for the diagnosis of VFs and AAC. In this cohort, VFA-detected AAC was independently associated with prevalent VFs.
Collapse
Affiliation(s)
- Abderrahim Majjad
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco.
| | - Mohamed A Ghassem
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Hamza Toufik
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Siham Sadni
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Zineb Debbarh
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Julien H Djossou
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Najlae El Ouardi
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Laila Taoubane
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | - Redouane Abouqal
- Laboratory of Biostatistics, Clinical Research and Epidemiology, Faculty of Medicine and Pharmacy, Rabat, Morocco
| | - Lahcen Achemlal
- Department of Rheumatology, Military Hospital Mohammed V, Rabat, Morocco
| | | |
Collapse
|
19
|
Silva EH, Wickramatilake CM, Lekamwasam S, Mudduwa LKB, Ubayasiri RA. Bone Mineral Density and Content Among Patients With Coronary Artery Disease: A Comparative Study. Am J Med Sci 2020; 361:751-758. [PMID: 33892918 DOI: 10.1016/j.amjms.2020.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2020] [Revised: 09/14/2020] [Accepted: 11/20/2020] [Indexed: 11/15/2022]
Abstract
INTRODUCTION Some studies indicate an association between coronary artery disease (CAD) and osteoporosis. This case-control study examined the association between body composition and bone mineral content (BMC) and density (BMD) among patients with CAD. MATERIALS AND METHODS A group of men (n = 73) with established CAD and age and sex matched controls (n=65) were included in the study. Data collected included socio-demographic information, disease related data (from cases), anthropometric measurements, serum vitamin D, calcium and phosphorous and body composition analysis using DEXA. Two groups were compared using independent sample t-test, Mann Whitney U-test or Chi square test. Pearson correlation and regression models were used to test the associations between body compartments. RESULTS Among cases, the mean disease duration was 29 (range 5-192) months and 15% had triple vessel disease. Patients had higher mean total body fat mass (TBFM) (18869.7 vs 16733.0) g, p = 0.018), truncal fat mass (TRFM) (9259.1 vs 7992.5 g, p = 0.009) and fat percentage (28.6 vs 25.9%, p = 0.001) compared to controls. Median serum vitamin D level was significantly lower among patients (20.0 ng/mL) compared to controls (27.1 ng/mL) (p = 0.003). In both groups, TBFM and total body lean mass (TBLM) both showed significant positive correlations with total body BMD/BMC and regional BMDs. Of the two, TBLM emerged the best predictor of TBBMC/TBBMD. These associations were greater among patients than controls. CONCLUSIONS TBLM appears to be the strongest predictor of TBBMD and TBBMC in patients and controls. The strength of associations was greater among patients compared to controls even after adjusting for possible confounders .
Collapse
Affiliation(s)
- Eranga H Silva
- Department of Medical Laboratory Science, Faculty of Allied Health Sciences, University of Ruhuna, Galle, Sri Lanka.
| | | | - Sarath Lekamwasam
- Department of Medicine, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | - Lakmini K B Mudduwa
- Department of Pathology, Faculty of Medicine, University of Ruhuna, Galle, Sri Lanka
| | | |
Collapse
|
20
|
Yokomoto-Umakoshi M, Umakoshi H, Ogata M, Fukumoto T, Matsuda Y, Miyazawa T, Sakamoto R, Ogawa Y. Coexistence of osteoporosis and atherosclerosis in pheochromocytoma: new insights into its long-term management. Osteoporos Int 2020; 31:2151-2160. [PMID: 32617610 DOI: 10.1007/s00198-020-05527-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 06/26/2020] [Indexed: 02/06/2023]
Abstract
UNLABELLED Osteoporosis and atherosclerosis frequently coexist in patients with pheochromocytoma. The presence of osteoporosis may predict that of atherosclerosis and vice versa in patients with PHEO. These findings have implications for the long-term management of the pheochromocytoma and its potential chronic complications. INTRODUCTION Pheochromocytoma (PHEO), a catecholamine-producing tumor, is often found incidentally, and it may be present for years before it is diagnosed. However, long-term exposure to catecholamines excess may induce chronic complications, such as osteoporosis and atherosclerosis. We aimed to evaluate concomitant osteoporosis and atherosclerosis in patients with PHEO. METHODS Fifty-one patients with PHEO and 51 patients with a non-functional adrenal tumor were compared radiographically for the prevalence of vertebral fracture (VF), a typical osteoporotic fracture, and abdominal aortic calcification (AAC). RESULTS In patients with PHEO, the prevalence of AAC was higher in those with VF (58%) than in those without (6%, p < 0.001). AAC was associated with VF after adjusting for age and sex (odds ratio, 1.53; 95% confidence interval, 1.07-2.46; p = 0.003) in patients with PHEO. The degree of catecholamine excess correlated with the presence of VF and AAC (p = 0.007). The prevalence of VF was higher in patients with PHEO (37%) than those with non-functional AT (12%, p = 0.005), but the prevalence of AAC was comparable between the two groups (25% and 19%, p = 0.636). VF and AAC more frequently coexisted in patients with PHEO (22%) than in those with non-functional AT (2%, p = 0.003). CONCLUSION This study represents the first demonstration that osteoporosis and atherosclerosis frequently coexist in patients with PHEO. The presence of osteoporosis may predict that of atherosclerosis and vice versa in patients with PHEO. These findings have implications for the long-term management of the PHEO and its potential chronic complications.
Collapse
Affiliation(s)
- M Yokomoto-Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - H Umakoshi
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | - M Ogata
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Fukumoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Matsuda
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - T Miyazawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - R Sakamoto
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - Y Ogawa
- Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
| | | |
Collapse
|
21
|
Chuang TL, Koo M, Wang YF. Association of Bone Mineral Density and Coronary Artery Calcification in Patients with Osteopenia and Osteoporosis. Diagnostics (Basel) 2020; 10:diagnostics10090699. [PMID: 32947910 PMCID: PMC7555969 DOI: 10.3390/diagnostics10090699] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/10/2020] [Accepted: 09/15/2020] [Indexed: 12/11/2022] Open
Abstract
The aim of this study was to investigate the association between bone mineral density (BMD) and coronary artery calcification (CAC) in adults with osteopenia or osteoporosis. A retrospective medical review study was conducted in a regional hospital in southern Taiwan. Medical records of patients who underwent both a coronary computed tomography scan and a BMD measurement were identified. Multinomial logistic regression analyses were used to assess the association between BMD and CAC levels in patients with osteopenia or osteoporosis. Of the 246 patients, 119 were female and 42.3% had CAC. For patients with osteopenia, after adjusting for the significant factors of CAC, no significant association was observed between BMD with either moderate CAC (0 < CAC score ≤ 100) or high CAC (CAC score > 100). However, in patients with osteoporosis, after adjusting for the significant factors of CAC, BMD in the lumbar spine was inversely associated with moderate CAC (odds ratio = 0.38, p = 0.035). In conclusion, a lower BMD in the lumbar spine was associated with an increased risk of moderate CAC in patients with osteoporosis. It is crucial to take action to maintain bone health, particularly in those who already have osteoporosis, to reduce the risk of developing CAC and its associated morbidity and mortality.
Collapse
Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan;
- School of Medicine, Tzu Chi University, Hualien City, Hualien 97004, Taiwan
| | - Malcolm Koo
- Department of Nursing, Tzu Chi University of Science and Technology, Hualien City, Hualien 97005, Taiwan;
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan;
- School of Medicine, Tzu Chi University, Hualien City, Hualien 97004, Taiwan
- Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi 62247, Taiwan
- Correspondence:
| |
Collapse
|
22
|
Zhang Q, Zhou J, Wang Q, Lu C, Xu Y, Cao H, Xie X, Wu X, Li J, Chen D. Association Between Bone Mineral Density and Lipid Profile in Chinese Women. Clin Interv Aging 2020; 15:1649-1664. [PMID: 32982199 PMCID: PMC7501971 DOI: 10.2147/cia.s266722] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 08/11/2020] [Indexed: 02/05/2023] Open
Abstract
Purpose Atherosclerotic cardiovascular disease may share the risk factors for low bone mineral density (BMD), one of which is dyslipidemia. The association between serum cholesterol and BMD remains controversial. Thus, the correlation between serum lipids and BMD in women was explored in the current study. Materials and Methods This cross-sectional study included 1116 Chinese female participants. Serum samples were collected to evaluate total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and other laboratory markers. Dual-energy X-ray absorptiometry was used to assess lumbar spine, femoral neck, and total hip BMD. Results In the postmenopausal women, a non-linear relationship was detected between TC, LDL-C, HDL-C, and lumbar spine BMD. Using segmented linear regression, the inflection points were 5.86 mmol/L, 3.52 mmol/L, and 2.37 mmol/L, respectively. To the left of the inflection point, the higher the serum lipid level, the lower the value for lumbar spine BMD. To the right of the inflection point, the higher the serum level of TC and LDL-C, the higher the value for lumbar spine BMD. In the premenopausal women, the association between HDL-C and femoral neck BMD was non-linear. In addition, LDL-C had a positive association with BMD of the femoral neck and HDL-C had an inverse association with BMD of the femoral neck in postmenopausal women. Conclusion In postmenopausal women, the relationship between TC, LDL-C, HDL-C, and lumbar spine BMD was non-linear. TC, LDL-C, and HDL-C were negatively associated with lumbar spine BMD when the values were less than 5.86 mmol/L, 3.52 mmol/L, and 2.37 mmol/L, respectively. The mechanisms of the association were unclear, and further research is warranted to clarify the relationship.
Collapse
Affiliation(s)
- Qi Zhang
- Sichuan University West China Hospital, Department of Endocrinology and Metabolism, Chengdu, Sichuan 610041, People's Republic of China
| | - Junteng Zhou
- Sichuan University West China Hospital, Department of Cardiology, Chengdu, Sichuan 610041, People's Republic of China
| | - Qin Wang
- Sichuan University West China Hospital, Department of Endocrinology and Metabolism, Chengdu, Sichuan 610041, People's Republic of China
| | - Chunyan Lu
- Sichuan University West China Hospital, Department of Endocrinology and Metabolism, Chengdu, Sichuan 610041, People's Republic of China
| | - Yong Xu
- Affiliated Hospital of Southwest Medical University, Department of Endocrinology and Metabolism, Luzhou, Sichuan 646000, People's Republic of China
| | - Hongyi Cao
- Chengdu Fifth People's Hospital, Department of Endocrinology and Metabolism, Chengdu, Sichuan 610041, People's Republic of China
| | - Xiaohua Xie
- The First People's Hospital of Liangshan Prefecture, Department of Endocrinology and Metabolism, Liangshan, Sichuan 615000, People's Republic of China
| | - Xueyan Wu
- Guangyuan Central Hospital, Department of Endocrinology and Metabolism, Guangyuan, Sichuan 628099, People's Republic of China
| | - Jing Li
- Sichuan University West China Hospital, Department of Endocrinology and Metabolism, Chengdu, Sichuan 610041, People's Republic of China
| | - Decai Chen
- Sichuan University West China Hospital, Department of Endocrinology and Metabolism, Chengdu, Sichuan 610041, People's Republic of China
| |
Collapse
|
23
|
Bochkareva EV, Butina EK, Savin AS, Drapkina OM. Breast artery calcification and osteoporosis in postmenopausal woman: a case report and opinion on the problem. КАРДИОВАСКУЛЯРНАЯ ТЕРАПИЯ И ПРОФИЛАКТИКА 2020. [DOI: 10.15829/1728-8800-2020-2574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Mammography is one of the most common screening test in the female population. In addition to identifying breast cancer, vascular calcification is clearly visualized on the mammogram, which is associated with an increased risk of cardiovascular disease, atherosclerosis, and a number of other chronic non-communicable diseases. The article presents a case report of a postmenopausal woman with breast artery calcification and osteoporosis. Identification of women at risk of non-cancer diseases significantly expands the prospects of using mammography for screening.
Collapse
Affiliation(s)
- E. V. Bochkareva
- National Medical Research Center for Therapy and Preventive Medicine
| | - E. K. Butina
- National Medical Research Center for Therapy and Preventive Medicine
| | - A. S. Savin
- National Medical Research Center for Therapy and Preventive Medicine
| | - O. M. Drapkina
- National Medical Research Center for Therapy and Preventive Medicine
| |
Collapse
|
24
|
Brief Report: Aging Attenuates the Association Between Coronary Artery Calcification and Bone Loss Among HIV-Infected Persons. J Acquir Immune Defic Syndr 2020; 82:46-50. [PMID: 31107297 DOI: 10.1097/qai.0000000000002092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Studies among HIV-uninfected persons (mostly in their sixth decade of life) show that detectable coronary artery calcium (CAC) is independently associated with low bone mineral density (BMD), suggesting a possible common pathogenic mechanism. AIM We assessed the relationship between CAC and BMD, which has not been well described among younger to middle-aged HIV-infected persons. METHODS We studied participants with baseline CAC and BMD measures from a prospective cohort of HIV-infected persons enrolled in the Study to Understand the Natural History of HIV/AIDS in the Era of Effective Therapy (SUN) during 2004-2006. We used logistic regression to assess the association between detectable CAC (>0 Agatston score) and BMD (g/cm, T-score), and adjusted for known traditional and HIV-related risk factors. RESULTS Among 472 participants (76% male, 30% non-Hispanic black, median age 41 years, and 71% with HIV RNA < 400 copies/mL), the majority had no detectable CAC (82%), but had baseline osteopenia (53%) or osteoporosis (10%). In univariate analysis, participants with detectable CAC had lower femoral neck/total hip T-scores, lower femoral neck/total hip/lumbar spine BMD, and higher rates of osteopenia/osteoporosis. After adjustment for age, all associations were no longer significant; adjustment for traditional risk factors excluding age and HIV-related variables failed to attenuate these associations. CONCLUSIONS We found aging attenuates the association between detectable CAC and BMD in this cohort. Aging remains an important contributor to non-AIDS-defining illnesses. These data reinforce the importance of developing screening and prevention strategies for aging HIV-infected persons given their excess risk across a wide spectrum of end-organ complications.
Collapse
|
25
|
Chuang TL, Chuang MH, Koo M, Lin CH, Wang YF. Association of bone mineral density and trabecular bone score with cardiovascular disease. Tzu Chi Med J 2020; 32:234-239. [PMID: 32955509 PMCID: PMC7485677 DOI: 10.4103/tcmj.tcmj_234_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/15/2019] [Accepted: 12/03/2019] [Indexed: 12/14/2022] Open
Abstract
Traditionally, osteoporosis and cardiovascular disease (CVD) are considered as separate chronic diseases. Increasing evidence now links osteoporosis with hypertension, abnormal lipid metabolism, atherosclerosis, vascular calcification (VC), and congestive heart failure. VC coexists with bone loss, and aortic calcification is a strong predictor of low bone mineral density (BMD) and fragility fractures. The same holds true for coronary artery calcification (CAC): the lower the BMD, the higher the CAC. Trabecular bone score (TBS) iNsight software can analyze the existing BMD database to obtain the bony microstructure score (TBS). Many TBS-related studies include fracture risk, normal aging, diabetes, potential genes, obesity, and asthma severity prediction. The inverse relationship of TBS to VC may provide insight into bone–vascular interactions in chronic kidney disease. A higher TBS has been associated with moderate, but not high, CAC. One explanation is that bone microstructural remodeling becomes more active during early coronary calcification. Increased risk of 10-year likelihood of hip fracture and major osteoporotic fracture as estimated by the fracture risk assessment tool FRAX® is significantly and independently associated with more severe CAC scores. Dual-energy X-ray absorptiometry and FRAX® can be used to predict fracture risk and CAC scores, identifying patients who may benefit from early intervention. This review will discuss the relationship and possible mechanism of BMD, TBS, and FRAX® with CVD and VC or CAC.
Collapse
Affiliation(s)
- Tzyy-Ling Chuang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Mei-Hua Chuang
- Faculty of Pharmacy, National Yang-Ming University, Taipei, Taiwan.,Department of Pharmacology, School of Medicine, Tzu Chi University, Hualien, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-Term Care, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Chun-Hung Lin
- Department of General Surgery, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| | - Yuh-Feng Wang
- Department of Nuclear Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Center of Preventive Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Chiayi, Taiwan
| |
Collapse
|
26
|
Lv F, Cai X, Yang W, Gao L, Chen L, Wu J, Ji L. Denosumab or romosozumab therapy and risk of cardiovascular events in patients with primary osteoporosis: Systematic review and meta- analysis. Bone 2020; 130:115121. [PMID: 31678488 DOI: 10.1016/j.bone.2019.115121] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2019] [Revised: 09/27/2019] [Accepted: 10/22/2019] [Indexed: 01/10/2023]
Abstract
BACKGROUND Osteoporosis and cardiovascular (CV) diseases are closely correlated. RANKL/RANK/OPG pathway and Wnt signalling pathway both implicated in the pathogenesis of osteoporosis and cardiovascular diseases. We aimed to investigate the effect of denosumab or romosozumab therapy on cardiovascular outcomes in patients with primary osteoporosis. METHODS PubMed, Cochrane library, and EMBASE databases were systematically searched from the inception dates to June 4, 2019. Randomized clinical trials evaluating the effect of denosumab or romosozumab versus active comparators or placebo for at least 6 months in patients with primary osteoporosis or osteopenia were included. Two investigators independently extracted data for study characteristics, outcomes of interest, and risk of bias in accordance with PRISMA guidelines. RESULTS 17 relevant studies (denosumab: n=11, 13615 participants; romosozumab: n=6, 12219 participants) were included. No associations between denosumab therapy and risk of a composite cardiovascular outcome (1.06 [95 % CI, 0.88-1.28], p=0.54), three-point major adverse cardiovascular event (3P MACE, 1.01 [95 % CI, 0.83-1.23], p=0.93), and four-point major adverse cardiovascular event (4P MACE, 0.99 [95 % CI, 0.83-1.18], p=0.89) were identified. Romosozumab therapy did not increase the risk of composite cardiovascular outcome (1.26 [95 % CI, 0.95-1.68], p=0.11), and 3P MACE (1.41 [95 % CI, 0.99-2.02], p=0.06), while increased the risk of 4P MACE (1.39 [95 % CI, 1.01-1.90], p=0.04) among elderly men and postmenopausal woman with osteoporosis over a period of 12-36 months. Denosumab or romosozumab did not increase or reduce specific cardiovascular outcomes, including CV death or death, myocardial infarction, stroke, atrial fibrillation, heart failure, aortic and intracranial aneurysm, aortic dissection, aortic valve disease and hypertension (all p>0.05). Sensitivity analysis conducted by random effects model altered the result of 4P MACE in romosozumab (1.36 [0.99-1.87], p=0.06). No other significant difference was detected in the sensitivity analyses and subgroup analyses. CONCLUSIONS Denosumab therapy was not associated with any risk of composite and specific cardiovascular outcomes among patients with primary osteoporosis than active comparators or placebo, while romosozumab therapy might increase the risk of 4P MACE.
Collapse
Affiliation(s)
- Fang Lv
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Xiaoling Cai
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| | - Wenjia Yang
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Leili Gao
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Ling Chen
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Jing Wu
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China
| | - Linong Ji
- Department of Endocrinology and Metabolism, Peking University People's Hospital, No.11 Xizhimen South Street, Xicheng District, Beijing, 100044, China.
| |
Collapse
|
27
|
Lewis JR, Eggermont CJ, Schousboe JT, Lim WH, Wong G, Khoo B, Sim M, Yu M, Ueland T, Bollerslev J, Hodgson JM, Zhu K, Wilson KE, Kiel DP, Prince RL. Association Between Abdominal Aortic Calcification, Bone Mineral Density, and Fracture in Older Women. J Bone Miner Res 2019; 34:2052-2060. [PMID: 31310354 DOI: 10.1002/jbmr.3830] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Revised: 06/11/2019] [Accepted: 07/17/2019] [Indexed: 12/12/2022]
Abstract
Although a relationship between vascular disease and osteoporosis has been recognized, its clinical importance for fracture risk evaluation remains uncertain. Abdominal aortic calcification (AAC), a recognized measure of vascular disease detected on single-energy images performed for vertebral fracture assessment, may also identify increased osteoporosis risk. In a prospective 10-year study of 1024 older predominantly white women (mean age 75.0 ± 2.6 years) from the Perth Longitudinal Study of Aging cohort, we evaluated the association between AAC, skeletal structure, and fractures. AAC and spine fracture were assessed at the time of hip densitometry and heel quantitative ultrasound. AAC was scored 0 to 24 (AAC24) and categorized into low AAC (score 0 and 1, n = 459), moderate AAC (score 2 to 5, n = 373), and severe AAC (score >6, n = 192). Prevalent vertebral fractures were calculated using the Genant semiquantitative method. AAC24 scores were inversely related to hip BMD ( r s = -0.077, p = 0.013), heel broadband ultrasound attenuation ( r s = -0.074, p = 0.020), and the Stiffness Index ( r s = -0.073, p = 0.022). In cross-sectional analyses, women with moderate to severe AAC were more likely to have prevalent fracture and lumbar spine imaging-detected lumbar spine fractures, but not thoracic spine fractures (Mantel-Haenszel test of trend p < 0.05). For 10-year incident clinical fractures and fracture-related hospitalizations, women with moderate to severe AAC (AAC24 score >1) had increased fracture risk (HR 1.48; 95% CI, 1.15 to 1.91; p = 0.002; HR 1.46; 95% CI, 1.07 to 1.99; p = 0.019, respectively) compared with women with low AAC. This relationship remained significant after adjusting for age and hip BMD for clinical fractures (HR 1.40; 95% CI, 1.08 to 1.81; p = 0.010), but was attenuated for fracture-related hospitalizations (HR 1.33; 95% CI, 0.98 to 1.83; p = 0.073). In conclusion, older women with more marked AAC are at higher risk of fracture, not completely captured by bone structural predictors. These findings further support the concept that vascular calcification and bone pathology may share similar mechanisms of causation that remain to be fully elucidated © 2019 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Joshua R Lewis
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, The University of Western Australia, Perth, WA, Australia.,Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | | | - John T Schousboe
- Park Nicollet Osteoporosis Center and HealthPartners Institute, Minneapolis, MN, USA, and Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA
| | - Wai H Lim
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Renal Medicine, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | - Germaine Wong
- Centre for Kidney Research, Children's Hospital at Westmead School of Public Health, Sydney Medical School, The University of Sydney, Sydney, NSW, Australia
| | - Ben Khoo
- Medical School, The University of Western Australia, Perth, WA, Australia.,Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, WA, Australia.,School of Physics, University of Western Australia, Nedlands, WA, Australia
| | - Marc Sim
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, The University of Western Australia, Perth, WA, Australia
| | - MingXiang Yu
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Department of Endocrinology & Metabolism, Shanghai Zhongshan Hospital, Fudan University, Shanghai, China
| | - Thor Ueland
- Research Institute of Internal Medicine, Oslo University Hospital, Oslo, Norway
| | - Jens Bollerslev
- Section of Specialized Endocrinology, Department of Endocrinology, Oslo University Hospital, Oslo, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Jonathan M Hodgson
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia.,Medical School, The University of Western Australia, Perth, WA, Australia
| | - Kun Zhu
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
| | | | - Douglas P Kiel
- Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Richard L Prince
- Medical School, The University of Western Australia, Perth, WA, Australia.,Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Perth, WA, Australia
| |
Collapse
|
28
|
Hong WJ, Chen W, Yeo KJ, Huang PH, Chen DY, Lan JL. Increased risk of osteoporotic vertebral fracture in rheumatoid arthritis patients with new-onset cardiovascular diseases: a retrospective nationwide cohort study in Taiwan. Osteoporos Int 2019; 30:1617-1625. [PMID: 31127317 DOI: 10.1007/s00198-019-04966-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 04/07/2019] [Indexed: 12/27/2022]
Abstract
INTRODUCTION Both cardiovascular diseases (CVD) and osteoporosis are common comorbidities in rheumatoid arthritis (RA) patients. Although accumulating evidence indicates a link between CVD and osteoporotic fracture, whether CVD contributes to osteoporotic fracture risk in RA has yet to be explored. We examined the incidence rate and risk factors of osteoporotic vertebral fracture in RA patients with new-onset CVD (RA-CVD) and evaluated the effects of medications on such fracture risk. METHODS A retrospective study was conducted using a nationwide database from 2000 to 2010: 1267 RA-CVD and 1267 non-CVD patients were enrolled from 30,507 patients with newly diagnosed RA. The main outcome was the development of osteoporotic vertebral fracture. After being adjusted for age, gender, and comorbidities, the Cox proportional hazard model was used to identify independent factors contributing to osteoporotic vertebral fracture. RESULTS The adjusted hazard ratio (aHR) of developing osteoporotic vertebral fracture was 1.47-fold greater in RA-CVD group than in non-CVD group (95% confidence interval 1.19-1.81, p < 0.001). Both the age above 40 years and female gender were significant risk factors for developing osteoporotic vertebral fracture in RA-CVD patients. Using patients not taking medication as a reference group, the aHR of osteoporotic vertebral fracture was significantly lower in those receiving statins (0.50), low-dose corticosteroids (0.57), or hydroxychloroquine (0.12). CONCLUSIONS The risk of osteoporotic vertebral fracture was significantly increased in RA-CVD patients, particularly women above 40 years of age, and could be reduced by statin therapy. However, the protective effect of low-dose corticosteroids or hydroxychloroquine on osteoporotic vertebral fracture risk needs further validation.
Collapse
Affiliation(s)
- W-J Hong
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
| | - W Chen
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - K-J Yeo
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
| | - P-H Huang
- Division of Rheumatology and Immunology, China Medical University Hospital, Taichung, Taiwan
- College of Medicine, China Medical University, Taichung, Taiwan
| | - D-Y Chen
- College of Medicine, China Medical University, Taichung, Taiwan.
- Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, No. 2, Yude Road, Taichung, 40447, Taiwan.
| | - J-L Lan
- College of Medicine, China Medical University, Taichung, Taiwan.
- Translational Medicine Laboratory, Rheumatology and Immunology Center, China Medical University Hospital, Taichung, Taiwan.
- Rheumatology and Immunology Center, China Medical University Hospital, No. 2, Yude Road, Taichung, 40447, Taiwan.
| |
Collapse
|
29
|
Gonciulea A, Wang R, Althoff KN, Estrella MM, Sellmeyer DE, Palella FJ, Lake JE, Kingsley LA, Brown TT. Proteinuria Is Associated With Increased Risk of Fragility Fracture in Men With or at Risk of HIV Infection. J Acquir Immune Defic Syndr 2019; 81:e85-e91. [PMID: 30939529 PMCID: PMC6565496 DOI: 10.1097/qai.0000000000002039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Proteinuria has been associated with bone loss and fractures in general population, but data in HIV-infected population are lacking. SETTING Prospective, multicenter cohort study of men with or at risk of HIV infection. METHODS Between 2006 and 2015, urine protein measurements and bone fracture histories were ascertained semiannually in 947 HIV-infected (HIV+) and 969 HIV-uninfected (HIV-) men aged 40 years or older. Proteinuria was defined as protein-to-creatinine ratio ≥200 mg/g at ≥2 consecutive visits. Outcome measures (1) all fractures (excluding fractures of skull, face, and digits) and (2) fragility fractures (fractures of vertebral column, femur, wrist, and humerus). Multivariable Cox proportional hazards models assessed the association between proteinuria and fracture after adjusting for additional risk factors. RESULTS The overall period prevalence of proteinuria was higher among HIV+ than HIV- (29% vs 6%, P < 0.001). Men with proteinuria had a significantly higher risk of fragility fracture compared with men without proteinuria [adjusted hazard ratio (aHR) = 2.29 (1.12-4.66)] and did not differ by HIV serostatus (p-interaction = 0.83). The risk of all fractures was not statistically different between men with or without proteinuria [aHR = 1.31 (0.84-2.05)]. Among HIV+ men, the association between confirmed proteinuria and fragility fracture was attenuated [aHR = 2.12 (0.95-4.73)] after additional adjustment for CD4 T-cell count/mm, history of AIDS, the presence of detectable plasma HIV-1 RNA, and cumulative exposure to tenofovir disoproxil fumarate. CONCLUSIONS Proteinuria was more common in HIV+ than in HIV- men and was a strong independent risk factor for fragility fracture regardless of HIV serostatus. Proteinuria should prompt consideration of a thorough evaluation for bone disease among HIV+ persons.
Collapse
Affiliation(s)
- Anda Gonciulea
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins, University, Baltimore, MD
| | - Ruibin Wang
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Keri N Althoff
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD
| | - Michelle M Estrella
- Kidney Health Research Collaborative, San Francisco VA Health Science Center, University of California, San Francisco, San Francisco, CA
| | - Deborah E Sellmeyer
- Division of Endocrinology, Gerontology, and Metabolism, Stanford University, Palo Alto, CA
| | - Frank J Palella
- Division of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, IL
| | - Jordan E Lake
- Division of Infectious Diseases, McGovern Medical School, University of Texas Health Science Center, Houston, TX
| | - Lawrence A Kingsley
- Department of Infectious Diseases and Microbiology, University of Pittsburgh School of Public Health, Pittsburgh, PA
| | - Todd T Brown
- Division of Endocrinology, Diabetes, and Metabolism, Johns Hopkins, University, Baltimore, MD
| |
Collapse
|
30
|
Pickering ME, Millet M, Rousseau JC, Croset M, Szulc P, Borel O, Sornay Rendu E, Chapurlat R. Selected serum microRNA, abdominal aortic calcification and risk of osteoporotic fracture. PLoS One 2019; 14:e0216947. [PMID: 31086410 PMCID: PMC6516733 DOI: 10.1371/journal.pone.0216947] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2018] [Accepted: 05/01/2019] [Indexed: 01/17/2023] Open
Abstract
CONTEXT MicroRNA (miRNA) regulate post-transcriptionally the expression of osteogenesis and angiogenesis associated genes and emerge as potential non-invasive biomarkers in vascular and bone diseases. Severe abdominal aortic calcification (AAC) is associated with higher risk of cardiovascular event and of fragility fracture. OBJECTIVE To identify miRNA linked to the aggravation of AAC and to incident osteoporotic fracture. DESIGN Postmenopausal women (>50 years) with available serum at inclusion and data for each outcome (Kauppila score and incident fracture) were selected from the OFELY prospective cohort. We conducted a case-control study in 434 age-matched women, 50% with incident osteoporotic fracture over 20 years of follow-up and a second study in 183 women to explore AAC over 17 years. METHODS Serum expression of three miRNA involved in vascular calcification and bone turnover regulation (miRs-26a-5p,-34a-5p, and -223-5p) was quantified at baseline by TaqMan Advanced miRNA technology and expressed by relative quantification. Outcomes were the association of miRNA levels with (1) incident osteoporotic fractures during 20 years, (2) AAC aggravation during 17 years. RESULTS MiRNA level was not associated with incident fractures (miR-26a-5p: 1.06 vs 0.99, p = 0.07; miR-34a-5p: 1.15 vs 1.26, p = 0.35; miR-223a-5p: 1.01 vs 1.05, p = 0.32). 93 women had an increase in Kauppila score over 17 years while 90 did not. None of the miRNAs was associated with an aggravation in AAC (miR-26a-5p: 1.09 vs 1.10, p = 0.95; miR-34a-5p: 0.78 vs 0.73, p = 0.90; miR-223-5p: 0.97 vs 0.78, p = 0.11). CONCLUSIONS Circulating miR-26a-5p, -34a-5p and -223-5p are not significantly associated with incident fracture and AAC aggravation.
Collapse
Affiliation(s)
- Marie-Eva Pickering
- Service de Rhumatologie et Pathologie Osseuse, Hôpital E Herriot, HCL, Lyon, France
- Inserm UMR 1033, Lyon, France
| | | | | | | | | | | | | | - Roland Chapurlat
- Service de Rhumatologie et Pathologie Osseuse, Hôpital E Herriot, HCL, Lyon, France
- Inserm UMR 1033, Lyon, France
| |
Collapse
|
31
|
Exploring the Links Between Common Diseases of Ageing—Osteoporosis, Sarcopenia and Vascular Calcification. Clin Rev Bone Miner Metab 2018. [DOI: 10.1007/s12018-018-9251-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
|
32
|
Neergaard JS, Dragsbæk K, Kehlet SN, Hansen HB, Hansen G, Byrjalsen I, Alexandersen P, Lindgren LM, Bihlet AR, Riis BJ, Andersen JR, Qvist P, Karsdal MA, Christiansen C. Cohort Profile: The Prospective Epidemiological Risk Factor (PERF) study. Int J Epidemiol 2018; 46:1104-1104i. [PMID: 27789666 DOI: 10.1093/ije/dyw251] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 01/09/2023] Open
Affiliation(s)
| | | | | | | | - G Hansen
- Nordic Bioscience A/S, Herlev, Denmark
| | | | | | - L M Lindgren
- Center for Clinical and Basic Research, Ballerup, Denmark
| | | | - B J Riis
- Nordic Bioscience A/S, Herlev, Denmark
| | | | - P Qvist
- Nordic Bioscience A/S, Herlev, Denmark
| | | | | |
Collapse
|
33
|
Kendrick J, Shah P, Andrews E, You Z, Nowak K, Pasch A, Chonchol M. Effect of Treatment of Metabolic Acidosis on Vascular Endothelial Function in Patients with CKD: A Pilot Randomized Cross-Over Study. Clin J Am Soc Nephrol 2018; 13:1463-1470. [PMID: 30237219 PMCID: PMC6218835 DOI: 10.2215/cjn.00380118] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Accepted: 08/08/2018] [Indexed: 01/01/2023]
Abstract
BACKGROUND AND OBJECTIVES We examined the effect of alkali replacement for metabolic acidosis on vascular endothelial function in patients with CKD. METHODS We performed a pilot, prospective, open-label 14-week crossover study examining the effect of oral sodium bicarbonate treatment on vascular function in 20 patients with an eGFR of 15-44 ml/min per 1.73 m2 with low serum bicarbonate levels (16-21 mEq/L). Each period was 6 weeks in duration with a 2-week washout period in between. Patients were treated to goal serum bicarbonate of ≥23 mEq/L. The primary end point was change in brachial artery flow-mediated dilation (FMD) between treatment and control conditions. Secondary end points included changes in markers of inflammation, bone turnover, mineral metabolism, and calcification. RESULTS Eighteen patients completed the study and were included in the primary efficacy analysis. The mean (SD) age and eGFR were 59 (12) years and 26 (8) ml/min per 1.73 m2, respectively. Serum bicarbonate increased significantly with sodium bicarbonate treatment (+2.7±2.9 mEq/L, P≤0.001), whereas there was no change in bicarbonate levels in the control group. FMD significantly improved after sodium bicarbonate therapy (mean±SD, FMD baseline: 4.1%±4.1%; 6 weeks: 5.2%±2.9%; P=0.04) There was no significant change in FMD in the control group (mean±SD, FMD baseline: 4.6%±3.1%; 6 weeks: 4.1%±3.4%; P=0.20). Compared with control, sodium bicarbonate treatment resulted in a significant increase in FMD (mean, 1.8%; 95% confidence interval, 0.3 to 3.3; P=0.02). There was no significant change in bone markers or serum calcification propensity with treatment. Serum phosphorus and intact fibroblast growth factor 23 increased significantly during treatment. CONCLUSIONS Treatment of metabolic acidosis with sodium bicarbonate significantly improved vascular endothelial function in patients with stages 3b and 4 CKD.
Collapse
Affiliation(s)
- Jessica Kendrick
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado; and
| | - Pratik Shah
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado; and
| | - Emily Andrews
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado; and
| | - Zhiying You
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado; and
| | - Kristen Nowak
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado; and
| | - Andreas Pasch
- Department of Biomedical Research, University of Bern and Calciscon, Bern, Switzerland
| | - Michel Chonchol
- Division of Renal Diseases and Hypertension, University of Colorado Denver, Aurora, Colorado; and
| |
Collapse
|
34
|
Appelman-Dijkstra NM, Papapoulos SE. Clinical advantages and disadvantages of anabolic bone therapies targeting the WNT pathway. Nat Rev Endocrinol 2018; 14:605-623. [PMID: 30181608 DOI: 10.1038/s41574-018-0087-0] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The WNT signalling pathway is a key regulator of bone metabolism, particularly bone formation, which has helped to define the role of osteocytes - the most abundant bone cells - as orchestrators of bone remodelling. Several molecules involved in the control of the WNT signalling pathway have been identified as potential targets for the development of bone-building therapeutics for patients with osteoporosis. Several of these molecules have been investigated in animal models, but only inhibitors of sclerostin (which is produced by osteocytes) have been investigated in phase III clinical studies. Here, we review the rationale for these developments and the specificity and potential off-target actions of WNT-based therapeutics. We also describe the available preclinical and clinical studies and discuss the benefits and risks of using sclerostin inhibitors for the management of patients with osteoporosis.
Collapse
|
35
|
Guan XQ, Xue YJ, Wang J, Ma J, Li YC, Zheng C, Wu SZ. Low bone mineral density is associated with global coronary atherosclerotic plaque burden in stable angina patients. Clin Interv Aging 2018; 13:1475-1483. [PMID: 30197509 PMCID: PMC6112784 DOI: 10.2147/cia.s168445] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Background Accelerated atherosclerosis is considered to be the linking factor between low bone mineral density (BMD) and increased cardiovascular events and mortality, while some coronary angiographic studies do not support this point. In this study, we attempt to provide a distinct comprehensive view of the relationship between BMD and the angiographically determined coronary atherosclerotic burden. Methods A total of 459 consecutive patients with stable chest pain suspected of coronary artery disease (CAD) underwent both dual-energy X-ray absorptiometry scan and selective coronary angiography. The association between BMD and global coronary atherosclerotic plaque burden as represented by the multivessel involvement and the modified Gensini score was analyzed. Results Multivariable analysis revealed that the low BMD at femoral neck and total hip was an independent correlate of multivessel CAD. The T-scores measured at femoral neck and total hip were both negatively and independently associated to the modified Gensini score. These inversely correlated relationships between BMD and CAD were not observed at lumbar spine 1–4. Conclusion This cross-sectional study elucidated an inverse relationship between hip BMD and the modified Gensini score, and low hip BMD values (T-scores) were significantly and independently associated with increased risk of multivessel coronary disease in patients hospitalized for stable chest pain.
Collapse
Affiliation(s)
- Xue-Qiang Guan
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China,
| | - Yang-Jing Xue
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jie Wang
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Jun Ma
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Yue-Chun Li
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Cheng Zheng
- Department of Cardiology, Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, People's Republic of China
| | - Sai-Zhu Wu
- Department of Cardiology, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China,
| |
Collapse
|
36
|
Pieralice S, Vigevano F, Del Toro R, Napoli N, Maddaloni E. Lifestyle Management of Diabetes: Implications for the Bone-Vascular Axis. Curr Diab Rep 2018; 18:84. [PMID: 30121859 DOI: 10.1007/s11892-018-1060-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
PURPOSE OF REVIEW To describe the main pathways involved in the interplay between bone and cardiovascular disease and to highlight the possible impact of physical activity and medical nutrition therapy on the bone-vascular axis. RECENT FINDINGS Diabetes increases the risk of both cardiovascular disease and bone fragility fractures, sharing common pathogenic pathways, including OPG/RANK/RANKL, the FGF23/Klotho axis, calciotropic hormones, and circulating osteogenic cells. This may offer new therapeutic targets for future treatment strategies. As lifestyle intervention is the cornerstone of diabetes treatment, there is potential for an impact on the bone-vascular axis. Evidence published suggests the bone-vascular axis encompasses key pathways for cardiovascular disease. This, along with studies showing physical activity plays a crucial role in the prevention of both bone fragility and cardiovascular disease, suggests that lifestyle intervention incorporating exercise and diet may be helpful in managing skeletal health decline in diabetes. Studies investigating the controversial role of high-fiber diet and dietary vitamin D/calcium on bone and cardiovascular health suggest an overall benefit, but further investigations are needed in this regard.
Collapse
Affiliation(s)
- Silvia Pieralice
- Department of Medicine, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Francesca Vigevano
- Department of Medicine, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Rossella Del Toro
- Department of Medicine, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Nicola Napoli
- Department of Medicine, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy
| | - Ernesto Maddaloni
- Department of Medicine, Unit of Endocrinology and Diabetes, Campus Bio-Medico University of Rome, Via Alvaro del Portillo 21, 00128, Rome, Italy.
| |
Collapse
|
37
|
Aleksova J, Kurniawan S, Vucak-Dzumhur M, Kerr P, Ebeling PR, Milat F, Elder GJ. Aortic vascular calcification is inversely associated with the trabecular bone score in patients receiving dialysis. Bone 2018; 113:118-123. [PMID: 29775762 DOI: 10.1016/j.bone.2018.05.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Revised: 04/24/2018] [Accepted: 05/13/2018] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Progressive chronic kidney disease (CKD) confers a marked increase in risk for vascular calcification, cardiovascular disease, fracture and mortality, with likely contributing factors including dysregulated bone metabolism and mineral homeostasis. In general population studies, increased vascular calcification is directly related to mortality and inversely related to bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA). In patients with CKD, abnormalities in turnover, mineralization and bone volume reduce the ability of DXA to predict fracture. The trabecular bone score (TBS) obtained from lumbar spine DXA images, provides a surrogate measure of microarchitectural integrity not captured by BMD. This study aimed to examine the association of the TBS to prevalent abdominal aortic calcification (AAC) in patients with CKD receiving dialysis. METHODS We performed a cross-sectional study of dialysis patients awaiting transplantation. All patients underwent laboratory testing, lateral spinal radiographs including the abdominal aorta, DXA imaging and TBS assessment. AAC scores were determined using the Kauppila method. Correlations and linear regression models were used to determine predictors of AAC scores. RESULTS 146 patients (60% male, mean age 48 ± 13 years) were included, of whom 49% had prevalent calcification with an AAC score ≥ 1. Of those with calcification, the mean AAC score was 7 ± 5.5 and 42 patients had scores ≥ 6, considered to indicate severe AAC. TBS values corresponding to intermediate or high risk for fracture (<1.31) were present in 35% of patients. TBS values correlated inversely to AAC scores (β = -0.206, p = 0.013) and remained significant in multivariable linear regression, adjusting for age, BMI and time on dialysis (-0.160, p = 0.031). There was no significant correlation of AAC scores to any BMD parameter. CONCLUSION There is a high prevalence of AAC in relatively young dialysis patients awaiting transplantation and their AAC scores are inversely related to the TBS but not to DXA-derived BMD parameters. In patients with CKD on dialysis, TBS assessment reflects microarchitectural abnormalities of bone not captured by DXA. The inverse relationship of TBS to vascular calcification may provide insights into bone-vascular interactions in CKD.
Collapse
Affiliation(s)
- Jasna Aleksova
- Hudson Institute of Medical Research, Clayton, VIC 3168, Australia; Department of Medicine, Monash University, Clayton, VIC 3168, Australia; Department of Endocrinology, Monash Health, Clayton, VIC 3168, Australia
| | - Samantha Kurniawan
- School of Medicine, The University of Notre Dame Australia, Darlinghurst, NSW 2010, Australia
| | - Mirna Vucak-Dzumhur
- Department of Renal Medicine, Westmead Hospital, Westmead, NSW 2145, Australia
| | - Peter Kerr
- Hudson Institute of Medical Research, Clayton, VIC 3168, Australia; Department of Medicine, Monash University, Clayton, VIC 3168, Australia
| | - Peter R Ebeling
- Department of Medicine, Monash University, Clayton, VIC 3168, Australia; Department of Endocrinology, Monash Health, Clayton, VIC 3168, Australia
| | - Frances Milat
- Hudson Institute of Medical Research, Clayton, VIC 3168, Australia; Department of Medicine, Monash University, Clayton, VIC 3168, Australia; Department of Endocrinology, Monash Health, Clayton, VIC 3168, Australia
| | - Grahame J Elder
- Department of Renal Medicine, Westmead Hospital, Westmead, NSW 2145, Australia.; Osteoporosis and Bone Biology Division, Garvan Institute of Medical Research, Darlinghurst, NSW 2010, Australia..
| |
Collapse
|
38
|
Wei D, Zheng G, Gao Y, Guo J, Zhang T. Abdominal aortic calcification and the risk of bone fractures: a meta-analysis of prospective cohort studies. J Bone Miner Metab 2018. [PMID: 28642974 DOI: 10.1007/s00774-017-0849-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The relationship between abdominal aortic calcification (AAC) and bone fracture has been examined by some observational studies, but the results remain discordant. Therefore, we aimed to assess the link between them by conducting a meta-analysis of prospective studies. Relevant studies were identified by searching PubMed and EMBASE databases until the end of December 2016. Summary relative risks (RRs) and 95% confidence intervals (CIs) for associations between AAC and fracture risk were estimated with fixed- or random- effects models. Seven prospective studies were included in the final analysis. The summarized RRs of any type of fractures for the highest compared with the lowest category of AAC were 1.64 (95% CI 1.30-2.07, P = 0.000) with mild heterogeneity (I 2 = 30.1%, P = 0.188). Subgroup analysis showed that the association between AAC and fracture was not significantly modified by gender and follow-up length. Risks were similar when analyses were restricted to the studies with adjustment for bone mineral density (BMD) (RR = 1.76, 95% CI 1.31-2.38, P = 0.000, I 2 = 49.1%). For the specific type of fracture, severe AAC was significantly related with hip fracture (RR = 1.64, 95% CI 1.22-2.20, P = 0.001, n = 5), but not with vertebral (RR = 1.45, 95% CI 0.81-2.58, P = 0.213, n = 3) or non-vertebral fracture (RR = 1.35, 95% CI 0.96-1.88, P = 0.081, n = 3). There was no evidence of publication bias. Our findings demonstrated that AAC was significantly and independently associated with a higher fracture risk, especially for hip fracture.
Collapse
Affiliation(s)
- Dailin Wei
- Department of Endocrinology, Taian City Central Hospital, 29 longtan road, Tai'an, 271000, Shandong, People's Republic of China
| | - Guanlin Zheng
- Taishan Vocational College of Nursing, Tai'an, Shandong, People's Republic of China
| | - Yun Gao
- Department of Endocrinology, Taian City Central Hospital, 29 longtan road, Tai'an, 271000, Shandong, People's Republic of China
| | - Jinying Guo
- Department of Endocrinology, Taian City Central Hospital, 29 longtan road, Tai'an, 271000, Shandong, People's Republic of China
| | - Tie Zhang
- Department of Endocrinology, Taian City Central Hospital, 29 longtan road, Tai'an, 271000, Shandong, People's Republic of China.
| |
Collapse
|
39
|
Bendix EF, Johansen E, Ringgaard T, Wolder M, Starup-Linde J. Diabetes and Abdominal Aortic Calcification-a Systematic Review. Curr Osteoporos Rep 2018; 16:42-57. [PMID: 29380116 DOI: 10.1007/s11914-018-0418-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
PURPOSE OF REVIEW A systematic literature review was performed to evaluate diabetes mellitus (DM) as a risk factor of abdominal aortic calcification (AAC), and address factors that might contribute to the development of AAC in DM patients. RECENT FINDINGS DM is an independent risk factor of AAC development. Bone metabolism along with lifestyle factors among DM patients makes them more prone to AAC. Hip and vertebral fractures, high phosphate, smoking, hypertension, and low osteocalcin could make DM patients prone to AAC. Low levels of high-density lipoprotein (HDL), high low-density lipoprotein (LDL), high total cholesterol/HDL ratio, low bone mineral density (BMD) may be risk factors, but the literature is more ambiguous. Body mass index (BMI) does not appear to increase risk of AAC. High phosphate levels and low osteocalcin levels seem to be biomarkers of AAC in patients with diabetes. However, the association between DM and AAC is complicated.
Collapse
Affiliation(s)
- Emilie Frey Bendix
- Department of Endocrinology, Aalborg University Hospital, Mølleparkvej 4, 9220, Aalborg Øst, Denmark
- Faculty of Health, Aalborg University, Niels Jernes Vej 10, 9220, Aalborg Øst, Denmark
| | - Eskild Johansen
- Department of Endocrinology, Aalborg University Hospital, Mølleparkvej 4, 9220, Aalborg Øst, Denmark
- Faculty of Health, Aalborg University, Niels Jernes Vej 10, 9220, Aalborg Øst, Denmark
| | - Thomas Ringgaard
- Department of Endocrinology, Aalborg University Hospital, Mølleparkvej 4, 9220, Aalborg Øst, Denmark
- Faculty of Health, Aalborg University, Niels Jernes Vej 10, 9220, Aalborg Øst, Denmark
| | - Martin Wolder
- Department of Endocrinology, Aalborg University Hospital, Mølleparkvej 4, 9220, Aalborg Øst, Denmark
- Faculty of Health, Aalborg University, Niels Jernes Vej 10, 9220, Aalborg Øst, Denmark
| | - Jakob Starup-Linde
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Tage Hansens Gade 2, 8000, Aarhus C, Denmark.
| |
Collapse
|
40
|
FRAX® Fracture Risks Are Associated with Coronary Artery Calcification Score. DISEASE MARKERS 2017; 2017:1592598. [PMID: 29422704 PMCID: PMC5750485 DOI: 10.1155/2017/1592598] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Revised: 11/20/2017] [Accepted: 12/05/2017] [Indexed: 11/29/2022]
Abstract
Purpose To examine the association between fracture risk assessment tool (FRAX) scores and coronary artery calcification (CAC) score in adults. Methods The medical records of 81 adults who underwent both coronary computed tomography and bone mineral density (BMD) studies in a package during their health exams were reviewed at a regional hospital in Southern Taiwan. Data collected included health history, anthropomorphic characteristics, clinical laboratory results, and BMD. Fracture risk was determined using FRAX. Univariate and multivariate linear regression analysis were used to assess the association between CAC score and 10-year probability of hip fracture (HF) and major osteoporotic fracture (MOF) determined by FRAX. Results The mean age of the patients was 55.8 years, and 63.0% were male. Univariate linear regression analysis showed that increases in MOF and HF risks, as measured by FRAX, were significantly and positively associated with CAC score. Multiple linear regression analysis adjusting for potential confounders showed that CAC score remained significantly associated with four FRAX indicators, including right MOF (r = 0.45, P < 0.001), left MOF (r = 0.31, P = 0.021), right HF (r = 0.38, P = 0.001), and left HF (r = 0.23, P = 0.049). Conclusions Increased risks of MOF and HF as determined by FRAX were significantly and independently associated with CAC score.
Collapse
|
41
|
Liu FL, Lin CS, Yeh CC, Shih CC, Cherng YG, Wu CH, Chen TL, Liao CC. Risk and outcomes of fracture in peripheral arterial disease patients: two nationwide cohort studies. Osteoporos Int 2017; 28:3123-3133. [PMID: 28821915 DOI: 10.1007/s00198-017-4192-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 08/07/2017] [Indexed: 12/19/2022]
Abstract
UNLABELLED Using national insurance claims data of Taiwan, we found that patients with peripheral arterial disease (PAD) had increased risk of fracture during the follow-up period of 2000-2013. History of PAD was also associated with adverse outcomes in hospitalized fracture patients. Prevention strategies were needed in this susceptible population. INTRODUCTION Limited information was available on the association between PAD and fracture. The purpose of this study is to evaluate fracture risk and post-fracture outcomes in patients with PAD. METHODS We identified 6647 adults aged ≥ 20 years with newly diagnosed PAD using the Taiwan National Health Insurance Research Database in 2000-2004. Comparison cohort consisted of 26,588 adults without PAD randomly selected with frequency matching in age and sex. Events of fracture were identified during the follow-up period from January 1, 2000 until December 31, 2013, to evaluate adjusted hazard ratios (HR) and 95% confidence interval (CI) of fracture associated with PAD. Another nested cohort study of 799,463 hospitalized fracture patients analyzed adjusted odds ratios (ORs) and 95% CIs of adverse events after fracture among patients with and without PAD in 2004-2013. RESULTS Incidences of fracture in people with and without PAD were 22.1 and 15.5 per 1000 person-years, respectively (P < .0001). Compared with control, the adjusted HR of fracture was 1.59 (95% CI, 1.48-1.69) for PAD patients. In the nested cohort study, patients with PAD had higher post-fracture mortality (OR = 1.16; 95% CI, 1.09-1.25) and various complications. PAD patients also had comparatively higher medical expenditure (2691 vs. 2232 USD, P < .0001) and longer hospital stay (10.6 vs. 9.0 days, P < 0.0001) during fracture admission. CONCLUSIONS Increased risk of fracture and post-fracture adverse outcomes were associated with PAD. This susceptible population needs care to prevent fracture and to minimize adverse outcomes after it occurs.
Collapse
Affiliation(s)
- F-L Liu
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - C-S Lin
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing St., Taipei, 110, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - C-C Yeh
- Department of Surgery, China Medical University Hospital, China Medical University, Taichung, Taiwan
- Department of Surgery, University of Illinois, Chicago, IL, USA
| | - C-C Shih
- School of Chinese Medicine for Post-Baccalaureate, I-Shou University, Kaohsiung, Taiwan
| | - Y-G Cherng
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - C-H Wu
- Department of Family Medicine, National Cheng Kung University Hospital, Tainan, Taiwan
| | - T-L Chen
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing St., Taipei, 110, Taiwan
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan
| | - C-C Liao
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan.
- Department of Anesthesiology, Taipei Medical University Hospital, 252 Wuxing St., Taipei, 110, Taiwan.
- Health Policy Research Center, Taipei Medical University Hospital, Taipei, Taiwan.
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan.
| |
Collapse
|
42
|
Schousboe JT, Lewis JR, Kiel DP. Abdominal aortic calcification on dual-energy X-ray absorptiometry: Methods of assessment and clinical significance. Bone 2017; 104:91-100. [PMID: 28119178 DOI: 10.1016/j.bone.2017.01.025] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 01/20/2017] [Accepted: 01/20/2017] [Indexed: 10/20/2022]
Abstract
Abdominal aortic calcification (AAC) can be accurately recognized on lateral spine images intended for vertebral fracture assessment, that are obtained with dual-energy X-ray absorptiometry (DXA). Greater amounts of AAC are common in the older population for whom DXA is routinely done, and have been consistently associated with incident atherosclerotic cardiovascular disease (ASCVD) events. AAC has also been associated with incident fractures in some prospective studies, but not in others. However, further research is needed to quantify the extent to which measurement of AAC improves prediction of ASCVD events and its impact on physician and patient ASCVD risk management. Additionally, research to develop better, more precise, automated, quantitative methods of AAC assessment on lateral spine densitometric images will hopefully lead to better prediction of clinical outcomes. In conclusion, although the prime indication for densitometric lateral spine imaging remains vertebral fracture assessment, AAC that is found incidentally on lateral spine images should be reported, so that patients and their health care providers are aware of its presence.
Collapse
Affiliation(s)
- John T Schousboe
- Park Nicollet Clinic and HealthPartners Institute, HealthPartners Inc., Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
| | - Joshua R Lewis
- University of Western Australia School of Medicine and Pharmacology, Sir Charles Gairdner Hospital Unit, Perth, Australia; Centre for Kidney Research, Children's Hospital at Westmead, School of Public Health, Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Douglas P Kiel
- Institute for Aging Research, Hebrew Senior Life, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
43
|
The anti-osteoporotic and anti-atherogenic effects of alendronate and simvastatin in ovariectomized rats fed high fat diet: A comparative study of combination therapy versus monotherapy. Biomed Pharmacother 2017; 89:1115-1124. [DOI: 10.1016/j.biopha.2017.02.105] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2016] [Revised: 02/27/2017] [Accepted: 02/27/2017] [Indexed: 12/31/2022] Open
|
44
|
Idoate F, Cadore EL, Casas-Herrero A, Zambom-Ferraresi F, Martínez-Velilla N, Rodriguez-Mañas L, Azcárate PM, Bottaro M, Ramírez-Vélez R, Izquierdo M. Noncoronary Vascular Calcification, Bone Mineral Density, and Muscle Mass in Institutionalized Frail Nonagenarians. Rejuvenation Res 2017; 20:298-308. [PMID: 28193134 DOI: 10.1089/rej.2016.1868] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
The purpose of this study was to compare the vascular calcification in thoracic aorta (TAC), abdominal aorta (AAC), iliac arteries (IAC), and femoral arteries (FAC) and bone mineral density (BMD) of the lumbar vertebrae between frail and robust nonagenarians, as well as to verify the associations between vascular calcification with BMD, muscle tissue quality, and quantity in both groups. Forty-two elderly subjects participated in this study: 29 institutionalized frail (92.0 ± 3.2 years) and 13 robust (89.0 ± 4.0 years) elderly participants. All patients underwent nonenhanced helical thoracic, abdominal, and thigh computed tomography. The frail group presented significantly greater FAC as well as less lumbar BMD than the robust group (p < 0.05). In the frail group, significant negative relationships were observed between the individual values of FAC with the individual values of BMD (r = -0.35 to -0.43, p < 0.05) and with the individual values of the quadriceps muscle quantity and quality (r = -0.52, p < 0.01), whereas no significant relationships were observed in the robust group. The robust group presented less vascular calcification and more BMD in the vertebral bodies than the frail group. In the frail group, femoral artery calcification was significantly negatively correlated with BMD, leg muscle quality, and muscle mass volume.
Collapse
Affiliation(s)
- Fernando Idoate
- 1 Department of Radiology, Clínica San Miguel , Pamplona, Spain
| | - Eduardo L Cadore
- 2 Exercise Research Laboratory, Federal University of Rio Grande do Sul , Porto Alegre, Brazil
| | - Alvaro Casas-Herrero
- 3 Division of Geriatric Medicine, Complejo Hospitalario de Navarra , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315) Pamplona, Navarra, Spain
| | - Fabricio Zambom-Ferraresi
- 4 Department of Health Sciences, Public University of Navarre , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315), Tudela, Navarre, Spain
| | - Nicolas Martínez-Velilla
- 3 Division of Geriatric Medicine, Complejo Hospitalario de Navarra , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315) Pamplona, Navarra, Spain
| | - Leocadio Rodriguez-Mañas
- 5 Division of Geriatric Medicine, University Hospital of Getafe , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00464), Madrid, Spain
| | | | - Martim Bottaro
- 7 College of Physical Education, University of Brasília , Brasília, Brazil
| | - Robinson Ramírez-Vélez
- 8 Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario , Bogotá, Colombia
| | - Mikel Izquierdo
- 4 Department of Health Sciences, Public University of Navarre , CIBER de Fragilidad y Envejecimiento Saludable (CB16/10/00315), Tudela, Navarre, Spain
| |
Collapse
|
45
|
Abstract
Patients with type 1 diabetes (T1DM) experience a disproportionate number of fractures for their bone mineral density (BMD). Differences in bone microarchitecture from those without the disease are thought to be responsible. However, the literature is inconclusive. New studies of the microarchitecture using three-dimensional imaging have the advantage of providing in vivo estimates of "bone quality," rather than examining areal BMD alone. There are drawbacks in that most studies have been done on those with less than a 30-year duration of T1DM, and the techniques used to measure vary as do the sites assessed. In addition to the rise in these imaging techniques, very recent literature presents evidence of an intimate relationship between skeletal health and vascular complications in T1DM. The following review provides an overview of the available studies of the bone microarchitecture in T1DM with a discussion of the burgeoning field of complications and skeletal health.
Collapse
Affiliation(s)
- Hillary A Keenan
- Research Division, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA, 02215, USA.
| | - Ernesto Maddaloni
- Research Division, Joslin Diabetes Center, Harvard Medical School, One Joslin Place, Boston, MA, 02215, USA
- Department of Medicine, Unit of Endocrinology and Diabetes, University Campus Bio-Medico of Rome, Rome, Italy
| |
Collapse
|
46
|
Chen Z, Yu Y. Aortic calcification was associated with risk of fractures: A meta-analysis. J Back Musculoskelet Rehabil 2016; 29:635-642. [PMID: 27232081 DOI: 10.3233/bmr-160700] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The objective of this meta-analysis was to systematically assess the association between aortic calcification (AC) and fractures. METHOD Relevant studies were identified through searching PubMed, EMBASE and Cochrane databases before August 2014. Two investigators extracted data independently from the included studies. A random-effects model was derived to composite the pooled HRs or ORs for association of aortic calcification with fractures. RESULTS A total of 15 articles (21927 subjects) were included in the final meta-analyses. Comparing with non-calcification subjects, patients with aortic calcification were associated with increased risk of fractures (OR = 2.97, 95% CI: 1.98-4.42). Stratified analysis indicated that patients with aortic calcification showed a higher risk of fractures in hemodialysis patients (OR = 1.89, 95% CI: 1.33-2.67; I2 = 0.0%, p= 0.781) and general population (OR = 2.90, 95% CI: 1.80-4.80; I2 = 33.0%, p= 0.225), respectively. Similar significant association between severe aortic calcification and fractures were also observed. CONCLUSIONS Patients with aortic calcification or severe aortic calcification were associated with higher risk of fractures.
Collapse
Affiliation(s)
- Zexin Chen
- Department of Clinical Epidemiology & Biostatistics, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Yunxian Yu
- Department of Epidemiology & Health Statistics, School of Public Health, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| |
Collapse
|
47
|
Vassalle C, Mazzone A. Bone loss and vascular calcification: A bi-directional interplay? Vascul Pharmacol 2016; 86:77-86. [DOI: 10.1016/j.vph.2016.07.003] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Revised: 06/22/2016] [Accepted: 07/01/2016] [Indexed: 02/07/2023]
|
48
|
Barzilay JI, Bůžková P, Fink HA, Cauley JA, Robbins JA, Garimella PS, Jalal DI, Mukamal KJ. Systemic markers of microvascular disease and bone mineral density in older adults : The cardiovascular health study. Osteoporos Int 2016; 27:3217-3225. [PMID: 27250972 DOI: 10.1007/s00198-016-3649-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2016] [Accepted: 05/23/2016] [Indexed: 10/21/2022]
Abstract
UNLABELLED Here we report that abnormal brain white matter and, to a lesser extent, albuminuria are associated with reduced bone mineral density in the hip, spine, and total body in men and women. These findings may explain the increased hip fracture risk reported in some studies in association with microvascular disorders. INTRODUCTION Markers of microvascular disease have been individually associated with increased risk of osteoporotic fractures in some studies. Here, we examine whether these markers are associated with reduced bone mineral density (BMD) individually and together. METHODS BMD testing using dual x-ray absorptiometry of the hip, lumbar spine, and total body was performed in 1473 participants from the Cardiovascular Health Study (mean age ~ 78 years): 1215 were assessed for urinary albumin-creatinine ratio, 944 for abnormal white matter disease (AWMD) by brain MRI, and 541 for retinal vascular disease with fundus photographs. Linear regression models were used to evaluate the cross-sectional association of each marker with BMD accounting for potentially confounding factors. RESULTS AWMD was associated with lower hip, spine, and total body BMD in women (β -3.08 to -4.53; p < 0.01 for all) and lower hip and total body BMD in men (β -2.90 to -4.24; p = 0.01-0.03). Albuminuria was associated with lower hip (β -3.37; p = .05) and total body (β -3.21; p = .02) BMD in men, but not in women. The associations of AWMD and albuminuria with BMD persisted with mutual adjustment and appeared to be additive to each other. Retinal vascular disease was not associated with BMD in men or women. CONCLUSION AWMD and, to a lesser extent, albuminuria were independently associated with lower BMD, suggesting that microvascular disease may play a role in the pathogenesis of reduced BMD. These findings need to be confirmed by longitudinal studies.
Collapse
Affiliation(s)
- J I Barzilay
- Kaiser Permanente of Georgia, Division of Endocrinology and the Division of Endocrinology, Emory University School of Medicine, Atlanta, GA, USA.
- Kaiser Permanente of Georgia, 3650 Steve Reynolds Blvd, Duluth, GA, 30096, USA.
| | - P Bůžková
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - H A Fink
- Geriatric Research Education and Clinical Center, VA Health Care System, Minneapolis, MN, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School, School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - J A Robbins
- Department of Medicine, University of California at Davis, Modesto, CA, USA
| | - P S Garimella
- Division of Nephrology, Tufts Medical Center, Boston, MA, USA
| | - D I Jalal
- Division of Renal Diseases and Hypertension, University of Colorado Anschutz Medical Center, Aurora, CO, USA
| | - K J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Center, Brookline, MA, USA
| |
Collapse
|
49
|
Aypak C, Türedi Ö, Bircan MA, Civelek GM, Araz M. Association between mean platelet volume and bone mineral density in postmenopausal women. J Phys Ther Sci 2016; 28:1753-8. [PMID: 27390409 PMCID: PMC4932050 DOI: 10.1589/jpts.28.1753] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2016] [Accepted: 02/22/2016] [Indexed: 12/11/2022] Open
Abstract
[Purpose] Osteoporosis is an inflammatory disease, and platelets play a critical role in bone remodeling. Mean platelet volume has been shown to be influenced by inflammation. Our aim was to evaluate the relationship between mean platelet volume and bone mineral density in postmenopausal women. [Subjects and Methods] The records of female patients who had been referred to a tertiary hospital for bone mineral density analysis were retrospectively reviewed. [Results] A total of 175 patients (mean age: 61.3 ± 9.0 years) were enrolled. Overall, 72% (126/175) of patients met the criteria for osteoporosis. Mean platelet volume was found to be inversely correlated with body mass index. There was a significant positive correlation between mean platelet volume and femoral neck bone mineral density in our normal weight osteoporotic group, whereas there was a significant negative correlation in our overweight-obese osteoporotic group. The negative correlation between mean platelet volume and femoral neck bone mineral density in the overweight-obese osteoporotic group persisted after adjustment for confounding factors. Multivariate analyses revealed that mean platelet volume was significantly associated with femoral neck bone mineral density in osteoporotic patients in both our normal weight and overweight-obese groups. [Conclusion] Regardless of mechanisms, mean platelet volume might be used as a biomarker for osteoporosis in clinical settings.
Collapse
Affiliation(s)
- Cenk Aypak
- Family Medicine Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Özlem Türedi
- Family Medicine Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Mustafa A Bircan
- Family Medicine Clinic, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| | - Gul M Civelek
- Physical Medicine and Rehabilitation Clinic, Ankara Children's Hematology Oncology Training and Research Hospital, Turkey
| | - Mine Araz
- Division of Nuclear Medicine, Diskapi Yildirim Beyazit Training and Research Hospital, Turkey
| |
Collapse
|
50
|
Ye C, Xu M, Wang S, Jiang S, Chen X, Zhou X, He R. Decreased Bone Mineral Density Is an Independent Predictor for the Development of Atherosclerosis: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0154740. [PMID: 27149062 PMCID: PMC4858264 DOI: 10.1371/journal.pone.0154740] [Citation(s) in RCA: 53] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/18/2016] [Indexed: 01/11/2023] Open
Abstract
Background There is conflicting evidence regarding the association between decreased bone mineral density (BMD) and atherosclerosis. To this end, we performed a systematic review and meta-analysis to clarify the association. Methods To identify relevant studies, PubMed, Embase, and the Cochrane Library were systematically searched up to November 2015. All observational and comparative studies directly investigating the relationship between decreased BMD and clinical consequences of atherosclerotic vascular abnormalities, including carotid artery calcification (CAC), cardiovascular disease (CAD), and coronary artery disease (CAD) were obtained, without limitation of language or publication year. Results A total of 25 studies involving 10,299 patients were included. The incidence of atherosclerotic vascular abnormalities was significantly increased in low BMD patients, compared to patients with normal BMD (OR, 1.81, 95% CI [1.01, 2.19], p<0.00001)). Similar results were also observed for postmenopausal women (OR, 2.23, 95% CI [1.72, 2.89], p<0.00001). Subgroup analyses of osteopenia, osteoporosis, and normal BMD also revealed that the combined ORs for the incidence of atherosclerotic vascular abnormalities increased as BMD decreased. Of note, after adjusting for age, sex, body mass index (BMI) and other vascular risk factors, decreased BMD remained significantly associated with the incidence of atherosclerotic vascular abnormalities (OR, 2.96, 95% CI [2.25, 3.88], p < 0.00001). Conclusions Based on the results of this study, decreased BMD is an independent predictor for the development of atherosclerosis in elderly individuals. Moreover, the risk of atherosclerotic vascular abnormalities increased as BMD decreased. Future studies focusing on individuals with different severities of atherosclerosis and comorbidities are of interest.
Collapse
Affiliation(s)
- Chenyi Ye
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Mingyuan Xu
- Department of Plastic Surgery, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Shengdong Wang
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Shuai Jiang
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Xi Chen
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Xiaoyu Zhou
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
| | - Rongxin He
- Department of Orthopedics, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of China
- * E-mail:
| |
Collapse
|