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Song S, Cai X, Hu J, Zhu Q, Shen D, Ma H, Zhang Y, Ma R, Yang W, Hong J, Zhang D, Li N. Effectiveness of Spironolactone in Reducing Osteoporosis and Future Fracture Risk in Middle-Aged and Elderly Hypertensive Patients. Drug Des Devel Ther 2024; 18:2215-2225. [PMID: 38882049 PMCID: PMC11180452 DOI: 10.2147/dddt.s466904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 05/23/2024] [Indexed: 06/18/2024] Open
Abstract
Objective While the role of aldosterone in bone metabolism is well established, the specific effects of the widely used aldosterone antagonist, spironolactone, on bone health are not fully understood. This study aimed to investigate the effects of spironolactone on osteoporosis and future fracture risk in middle-aged and elderly hypertensive patients, revealing its potential benefits for bone health. Methods Propensity score matching was employed in this study to create matched groups of spironolactone users and non-users at a 1:4 ratio. We investigated the association between spironolactone use and the risk of osteoporosis using multivariate logistic regression analysis. Furthermore, we conducted multivariate linear regression analysis to explore the relationship between cumulative dosage and the FRAX score. Subgroup analysis was also performed to assess the effects under different stratification conditions. Results In both pre-match and post-match analyses, multivariable logistic regression revealed a significant reduction in the risk of osteoporosis in the spironolactone usage group (pre-match: odds ratios [OR] 0.406, 95% confidence interval [CI], 0.280-0.588; post-match: OR 0.385, 95% CI, 0.259-0.571). Furthermore, post-match multivariable linear regression demonstrated a clear negative correlation between cumulative spironolactone dosage and the FRAX score. Subgroup analyses consistently supported these findings. Conclusion This study offers evidence supporting the significant positive impact of the antihypertensive drug spironolactone on bone health, resulting in a substantial reduction in the risk of osteoporosis and future fractures in hypertensive patients. Future research should consider conducting large-scale, multicenter, randomized controlled trials to further investigate the long-term effects of spironolactone on bone health in hypertensive patients.
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Affiliation(s)
- Shuaiwei Song
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Xintian Cai
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Junli Hu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Qing Zhu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Di Shen
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Huimin Ma
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Yingying Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Rui Ma
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Delian Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Hypertension Institute, Urumqi, Xinjiang, 830001, People's Republic of China
- NHC Key Laboratory of Hypertension Clinical Research, Urumqi, Xinjiang, 830001, People's Republic of China
- Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Urumqi, Xinjiang, 830001, People's Republic of China
- Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, Xinjiang, 830001, People's Republic of China
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Ma H, Cai X, Hu J, Song S, Zhu Q, Zhang Y, Ma R, Shen D, Yang W, Zhou P, Zhang D, Luo Q, Hong J, Li N. Association of systemic inflammatory response index with bone mineral density, osteoporosis, and future fracture risk in elderly hypertensive patients. Postgrad Med 2024; 136:406-416. [PMID: 38753519 DOI: 10.1080/00325481.2024.2354158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 05/08/2024] [Indexed: 05/18/2024]
Abstract
OBJECTIVES This study sought to investigate the relationship between the systemic inflammatory response index (SIRI) and bone mineral density (BMD), osteoporosis, and future fracture risk in elderly hypertensive patients. METHODS Elderly hypertensive patients (age ≥60 years) who attended our hospital between January 2021 and December 2023 and completed BMD screening were included in the study. Analyses were performed with multivariate logistic and linear regression. RESULTS The multiple linear regression indicated that SIRI levels were significantly negatively correlated with lumbar 1 BMD (β = -0.15, 95% CI: -0.24, -0.05), lumbar 2 BMD (β = -0.15, 95% CI: -0.24, -0.05), lumbar 3 BMD (β = -1.35, 95% CI: -0.23, -0.02), lumbar 4 BMD (β = -0.11, 95% CI: -0.30, -0.10), femur neck BMD (β = -0.11, 95% CI: -0.18, -0.05) and Ward's triangle BMD (β = -0.12, 95% CI: -0.20, -0.05) among elderly hypertensive patients, after fully adjusting for confounders. Furthermore, we observed that SIRI was positively associated with future fracture risk in elderly hypertensive patients. Specifically, SIRI was associated with an increased risk of major osteoporotic fractures (β = 0.33) and hip fractures (β = 0.25). The logistic regression analysis indicated that there is an association between the SIRI level and an increased risk of osteoporosis (OR = 1.60, 95% CI = 1.37, 1.87), after fully adjusting for confounders. CONCLUSIONS Our findings indicate a potential association between SIRI and BMD, osteoporosis, and the risk of future fractures in elderly hypertensive patients. However, further studies are warranted to confirm these findings.
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Affiliation(s)
- Huimin Ma
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Xintian Cai
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Junli Hu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Shuaiwei Song
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Qing Zhu
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Yingying Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Rui Ma
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Di Shen
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Wenbo Yang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Pan Zhou
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Delian Zhang
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Qin Luo
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Jing Hong
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
| | - Nanfang Li
- Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region, Xinjiang Hypertension Institute, NHC Key Laboratory of Hypertension Clinical Research, Key Laboratory of Xinjiang Uygur Autonomous Region "Hypertension Research Laboratory", Xinjiang Clinical Medical Research Center for Hypertension (Cardio-Cerebrovascular) Diseases, Urumqi, China
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Shi GX, Sun WD, Chen ZH, Yang CJ, Luo WL, Wang DF, Zhou ZZ. Drynaria Naringin alleviated mechanical stress deficiency-caused bone loss deterioration via Rspo1/Lgr4-mediated Wnt/β-catenin signalling pathway. In Vitro Cell Dev Biol Anim 2023; 59:706-716. [PMID: 37831321 DOI: 10.1007/s11626-023-00815-w] [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: 07/04/2023] [Accepted: 09/11/2023] [Indexed: 10/14/2023]
Abstract
Osteoporosis is a metabolic condition distinguished by the degradation of bone microstructure and mechanical characteristics. Traditional Chinese medicine (TCM) has been employed in China for the treatment of various illnesses. Naringin, an ingredient found in Drynariae TCM, is known to have a significant impact on bone metabolism. For this research, we studied the precise potential effect of Drynaria Naringin on protecting against bone loss caused by stress deficiency. In this study, a tail-suspension (TS) test was performed to establish a mouse model with hind leg bone loss. Some mice received subcutaneous injections of Drynaria Naringin for 30 d. Trabecular bone microarchitecture was evaluated using micro-computed tomography analysis and bone histological analysis. Bone formation and resorption markers were quantified in blood samples from mice or in the supernatant of MC3T3-E1 cells by ELISA analysis, Western blotting, and PCR. Immunofluorescence was utilized to visualize the location of β-catenin. Additionally, siRNA was employed to knockdown-specific genes in the cells. Our findings highlight the efficacy of Drynaria Naringin in protecting against the deterioration of bone loss and promoting bone formation and Rspo1 expression in a mouse model following the TS test. Specifically, in vitro experiments also indicated that Drynaria Naringin may promote osteogenesis through the Wnt/β-catenin signalling pathway. Moreover, our results suggest that Drynaria Naringin upregulates the expression of Rspo1/Lgr4, leading to the promotion of osteogenesis via the Wnt/β-catenin signalling pathway. Therefore, Drynaria Naringin holds potential as a therapeutic medication for osteoporosis. Drynaria Naringin alleviates bone loss deterioration caused by mechanical stress deficiency through the Rspo1/Lgr4-mediated Wnt/β-catenin signalling pathway.
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Affiliation(s)
- Gui-Xun Shi
- Department of Orthopedic Surgery, Anting Hospital, Jiading District, Shanghai, 200805, China
| | - Wei-Dong Sun
- Department of Orthopedic Surgery, Anting Hospital, Jiading District, Shanghai, 200805, China
| | - Zeng-Huan Chen
- Department of Anesthesiology, Putuo Central Hospital, Putuo District, Shanghai, 200333, China
| | - Chuan-Jun Yang
- Department of Orthopedic Surgery, Anting Hospital, Jiading District, Shanghai, 200805, China
| | - Wang-Lin Luo
- Department of Orthopedic Surgery, Anting Hospital, Jiading District, Shanghai, 200805, China
| | - Dan-Feng Wang
- Department of Orthopedic Surgery, Anting Hospital, Jiading District, Shanghai, 200805, China
| | - Ze-Zhu Zhou
- Department of Orthopedics, Shanghai Tenth People's Hospital, Tongji University School of Medicine, 301 Yanchang Road, Shanghai, 200072, China.
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Gutzwiller JP, Müller-Bolla K, Ferrari C, Stanga Z, Nydegger UE, Risch L, Risch M. Mortality risk factors in community-dwelling, subjectively healthy, Swiss older adults: update after 8-years follow-up. BMC Geriatr 2023; 23:303. [PMID: 37198577 DOI: 10.1186/s12877-023-03959-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Accepted: 04/07/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND Worldwide population is ageing, but little is known regarding risk factors associated with increased mortality in subjectively healthy, community-dwelling older adults. We present the updated results of the longest follow-up carried out on Swiss pensioners and we provide results on potential risk factors associated with mortality before the onset of the COVID-19 pandemic. MATERIALS AND METHODS Within the SENIORLAB study, we collected demographic data, anthropometric measures, medical history, and laboratory parameters of 1467 subjectively healthy, community-dwelling, Swiss adults aged ≥ 60 years over a median follow-up of 8.79 years. The variables considered in the multivariable Cox-proportional hazard model for mortality during follow-up were selected based on prior knowledge. Two separate models for males and females were calculated; moreover, we fitted the old model obtained in 2018 to the complete follow-up data to highlight differences and similarities. RESULTS The population sample included 680 males and 787 females. Age of participants ranged between 60 and 99 years. We experienced 208 deaths throughout the entire follow-up period; no patients were lost at follow-up. The Cox-proportional hazard regression model included female gender, age, albumin levels, smoking status, hypertension, osteoporosis and history of cancer within predictors of mortality over the follow-up period. Consistent findings were obtained also after gender stratification. After fitting the old model, female gender, hypertension, and osteoporosis still showed statistically significant independent associations with all-cause mortality. CONCLUSIONS Understanding the predictors of a healthy survival can improve the overall quality of life of the ageing population and simultaneously reduce their global economic burden. TRIAL REGISTRATION The present study was registered in the International Standard Randomized Controlled Trial Number registry: https://www.isrctn.com/ISRCTN53778569 (registration date: 27/05/2015).
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Affiliation(s)
- Jean-Pierre Gutzwiller
- Magendarm Thalwil AG, Zürcherstrasse 61, Thalwil, 8800, Switzerland
- University of Basel, Klingelbergstrasse 61, Basel, 4056, Switzerland
| | - Krisztina Müller-Bolla
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, Bern, Switzerland
| | | | - Zeno Stanga
- Department of Diabetes, Endocrinology, Nutritional Medicine and Metabolism, Bern University Hospital and University of Bern, Bern, Switzerland
- Department of General Internal Medicine, Bern University Hospital and University of Bern, Bern, Switzerland
| | - Urs E Nydegger
- Divisions of Clinical Chemistry and Haematology, Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, Bern, 3097, Switzerland
| | - Lorenz Risch
- Divisions of Clinical Chemistry and Haematology, Labormedizinisches Zentrum Dr. Risch, Waldeggstrasse 37, Liebefeld, Bern, 3097, Switzerland
- Labormedizinisches Zentrum Dr. Risch, Landstrasse 157, Schaan, 9494, Liechtenstein
| | - Martin Risch
- Central Laboratory, Kantonsspital Graubünden, Loëstrasse 170, Chur, 7000, Switzerland
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Chen X, He B, Zhou Y, Zhang X, Zhao L. Investigating the effect of history of fractures and hypertension on the risk of all-cause death from osteoporosis: A retrospective cohort study. Medicine (Baltimore) 2023; 102:e33342. [PMID: 37000086 PMCID: PMC10063279 DOI: 10.1097/md.0000000000033342] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 02/07/2023] [Accepted: 03/02/2023] [Indexed: 04/01/2023] Open
Abstract
To assess the coexistence effect between history of fractures and hypertension on the all-cause death risk of osteoporosis. In this retrospective cohort study, some characteristics of osteoporosis patients aged ≥ 20 years were extracted from the National Health and Nutrition Examination Survey (NHANES) database (2005-2010, 2013-2014), such as age, gender, smoking, drinking, the history of diabetes, cardiovascular and cerebrovascular diseases, fractures and hypertension. The outcome of this study was defined as all-cause death of osteoporosis. These patients were followed up until 2015 with an average follow-up time of 62.00 ± 34.79 months. Univariate and multivariate logistic regression was utilized to evaluate the association of history of fractures and hypertension on all-cause death risk of osteoporosis, respectively. The death risk factors were presented by using relative risk (RR) and 95% confidence interval (CI). The attributable proportion (AP) to explore the interaction between history of fractures and hypertension on the all-cause death risk of osteoporosis. Of the total 801 osteoporosis patients, 227 died. After adjusting age, gender, marital status, education background, annual household income, diabetes, the prior use of prednisone or cortisone medication, cardiovascular and cerebrovascular diseases, the history of fractures (RR = 1.502, 95% CI: 1.035-2.180), spine fracture (RR = 2.944, 95% CI: 1.244-6.967), hip fracture (RR = 2.033, 95% CI: 1.066-3.875) was significantly associated with the increased death risk of osteoporosis. However, there was no significant difference between hypertension and the all-cause death risk of osteoporosis (P > .05). Additionally, there was a significant interaction between the history of fractures and hypertension on the all-cause death risk of osteoporosis, and the interaction was an enhancement effect (AP = 0.456, 95% CI: 0.005-0.906). The co-existence of the history of fractures and hypertension could increase the all-cause death risk of osteoporosis, which indicated that osteoporosis patients with the history of fractures should actively monitor blood pressure levels and prevent the occurrence of hypertension.
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Affiliation(s)
- Xiao Chen
- Department of TCM Orthopedics, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, P.R. China
| | - Binbin He
- Department of TCM Orthopedics, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, P.R. China
| | - Youliang Zhou
- Department of TCM Orthopedics, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, P.R. China
| | - Xinguo Zhang
- Department of TCM Orthopedics, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, P.R. China
| | - Liang Zhao
- Department of TCM Orthopedics, Shenzhen Hospital of Guangzhou University of Chinese Medicine (Futian), Shenzhen, P.R. China
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Yun JY, Yun YH. Health-promoting behavior to enhance perceived meaning and control of life in chronic disease patients with role limitations and depressive symptoms: a network approach. Sci Rep 2023; 13:4848. [PMID: 36964273 PMCID: PMC10039031 DOI: 10.1038/s41598-023-31867-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 03/20/2023] [Indexed: 03/26/2023] Open
Abstract
The association between health-related role limitations in the mental and physical subdomains and clinical status (i.e., chronic disease and comorbid depressive symptoms) is mediated by health-promoting behaviors. To enhance health-promoting behaviors in adults with chronic disease, it is necessary to identify item-level associations among targets of health-related monitoring and management. Therefore, the current study used a network approach to examine associations among health-related role limitations, depressive symptoms, existential well-being, socioeconomic position, and health-promoting behavior in adults with chronic disease. A total of 535 adults (mean ± SD age = 62.9 ± 11.9 years; males, n = 231, females, n = 304) who were regularly visiting an outpatient clinic for chronic disease treatment participated in this cross-sectional study. Data on participant demographics, chronic disease diagnoses, socioeconomic status, health-related role limitations (12-item short form survey scores), depressive symptoms (patient health questionnaire-9 scores), existential well-being (scores for four items of the McGill quality of life questionnaire-Revised), and health-promoting behavior (Healthy Habits Questionnaire scores) were acquired. "Undirected regularized partial correlations" and "directional joint probability distributions" among these variables were calculated using a mixed graphical model (MGM) and directed acyclic graph (DAG). In the MGM, the most influential nodes were emotional well-being, feelings of failure, and health-related limitations affecting usual role and physical activities. According to both the MGM and DAG, the relationship between emotional well-being and feelings of failure mediated the relationships of health-related role limitations with concentration difficulty and suicidal ideation. A positive mindset was dependent on the probability distributions of suicidal ideation, controllability of life, and positive self-image. Both the meaning of life and a positive mindset had direct associations with proactive living. Specifically, proactive living was associated with a balanced diet, regular exercise, volunteering in the community, and nurturing intimacy in social interactions. The meaning and controllability of life in individuals with chronic diseases could mediate the relationships of health-promoting behavior with health-related limitations related to usual role activities, physical activities, and depressive symptoms. Thus, interventions targeting health-promoting behaviors should aim to enhance the meaning and controllability of life (as it pertains to limitations in usual role and physical activities), as well as promote proactive screening and timely psychiatric treatment of depressive symptoms including feelings of failure, concentration difficulties, and suicidal ideation.
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Affiliation(s)
- Je-Yeon Yun
- Seoul National University Hospital, Seoul, Republic of Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Young Ho Yun
- Department of Biomedical Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
- Department of Family Medicine, Seoul National University Hospital, 101 Daehak-Ro, Jongno-Gu, Seoul, 03080, Republic of Korea.
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Prameswari HS, Putra ICS, Kamarullah W, Pranata R, Iqbal M, Karwiky G, Pramudyo M, Kusumawardhani NY, Achmad C, Martha JW, Akbar MR. Role of N-terminal pro-B type natriuretic peptide as a predictor of poor outcomes in patients with HFrEF receiving primary prevention implantable cardioverter-defibrillator therapy: a systematic review and dose-response meta-analysis. Open Heart 2023; 10:openhrt-2022-002225. [PMID: 36927867 PMCID: PMC10030785 DOI: 10.1136/openhrt-2022-002225] [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: 12/02/2022] [Accepted: 02/27/2023] [Indexed: 03/18/2023] Open
Abstract
INTRODUCTION Several studies have demonstrated that combining left ventricular ejection fraction and New York Heart Association functional class is insufficient for predicting risk of appropriate implantable cardioverter-defibrillator (ICD) shock in primary prevention candidates. Hence, our aim was to assess the relationship between N-terminal pro-B type natriuretic peptide (NT-pro BNP) along with appropriate ICD shock and all-cause mortality in order to improve the stratification process of patients with heart failure with reduced ejection fraction (HFrEF) being considered for primary preventive ICD therapy. METHODS A systematic literature search from several databases was conducted up until 9 June 2022. Studies were eligible if they investigated the relationship of NT-pro BNP with all-cause mortality and appropriate ICD shock. RESULTS This meta-analysis comprised nine studies with a total of 5117 participants. Our study revealed that high levels of NT-pro BNP were associated with all-cause mortality (HR=2.12 (95% CI=1.53 to 2.93); p<0.001, I2=78.1%, p<0.001 for heterogeneity) and appropriate ICD shock (HR=1.71 (95% CI=1.18 to 2.49); p<0.001, I2=43.4%, p=0.102 for heterogeneity). The adjusted HR for all-cause mortality and appropriate ICD shock increased by approximately 3% and 5%, respectively per 100 pg/mL increment pursuant to concentration-response model (Pnon-linearity <0.001). The curves became steeper after NT-pro BNP reached its inflection point (3000 pg/mL). CONCLUSION A positive concentration-dependent association between elevated NT-pro BNP levels along with the risk of all-cause mortality and appropriate ICD shock was found in patients with HFrEF with ICD. PROSPERO REGISTRATION NUMBER CRD42022339285.
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Affiliation(s)
- Hawani Sasmaya Prameswari
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Iwan Cahyo Santosa Putra
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - William Kamarullah
- Department of Emergency, R Syamsudin SH Regional Public Hospital, Sukabumi, West Java, Indonesia
| | - Raymond Pranata
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Mohammad Iqbal
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Giky Karwiky
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Miftah Pramudyo
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Nuraini Yasmin Kusumawardhani
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
- Department of Internal Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Chaerul Achmad
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Januar Wibawa Martha
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
| | - Mohammad Rizki Akbar
- Department of Cardiology and Vascular Medicine, University of Padjadjaran Faculty of Medicine, Bandung, Jawa Barat, Indonesia
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Abstract
OBJECTIVE To summarise available evidence and estimate the pooled prevalence of malnutrition among old people in Africa. DESIGN Systematic review and meta-analysis. SETTING Any healthcare or community research reporting the prevalence or incidence of malnutrition in Africa from January 2000 to October 2021. PARTICIPANTS Old people, aged above 60 years. OUTCOME MEASURES Malnutrition, either undernutrition or overnutrition. RESULTS A total of 1442 studies were retrieved based on the search strategy, where only 36 studies (n=15 266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2% to 77.3% across the continent. Overall, the pooled prevalence rates of undernutrition and overnutrition were 18% (95% CI: 15% to 22%; I2=98.1; p<0.001) and 33% (95% CI: 22% to 44%; p<0. 001), respectively. CONCLUSION The prevalence of malnutrition in old African people is high and differs by setting, assessment tool and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable and simple screening tool should be thought of.
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Affiliation(s)
- Ahmed Muhye Seid
- Department of Public Health, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
- Department of Public Health, Dire Dawa University, College of Medicine and Health Sciences, Dire Dawa, Ethiopia
| | - Netsanet Fentahun
- Department of Nutrition and Dietetics, Bahir Dar University College of Medical and Health Sciences, Bahir Dar, Ethiopia
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Seid AM, Babbel NF. Prevalence of malnutrition among old age people in Africa. FRONTIERS IN AGING 2022; 3:1002367. [PMID: 36439677 PMCID: PMC9686835 DOI: 10.3389/fragi.2022.1002367] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 10/10/2022] [Indexed: 04/14/2024]
Abstract
Background: Improved health care and rising life expectancy are creating a growing pool of old age people all over the world, including Africa. Malnutrition in the old age people is associated with both short- and long-term negative health outcomes. However, the reported burdens of malnutrition are fragmented and inconsistent, where more compiled evidence is warranted to aid decision-makers. Hence, this paper is aimed to estimate the pooled prevalence of malnutrition among old age people in Africa. Methods: A systematic search for research reporting the prevalence of malnutrition among old age people (aged above 60 years) was conducted from HINARI/PubMed and Google Scholar databases using combination keywords. Published articles in English language starting from January 2000 to October 2021 were screened. We presented the results based on the standard for reporting systematic review and meta-analysis of observational studies. A random-effect meta-analysis was done to estimate the prevalence of malnutrition along with the 95% confidence intervals. The publication bias was assessed using the funnel plot. Results: A total of 1,442 studies were retrieved based on the search strategy, where only 36 studies (n = 15,266 participants) reported from 11 African countries were included for meta-analysis. The reported prevalence of malnutrition ranges from 2.2 to 77.3% across Africa. Overall, the pooled prevalence of malnutrition was 18% (95% CI: 15-22; I2 = 98.1; p < 0.001). The prevalence is higher in the Central Africa (3.8%; 95% CI: 3.2-4.4), in the community (3.1%; 95% CI: 2.7-3.7), and among advanced age (3.5%; 95% CI: 2.3-5.4). Conclusion: The prevalence of malnutrition in African old age people is high and differs by setting, assessment tool, and country of residence. Hence, due attention to geriatric nutrition is mandatory, and the need for a valid, reliable, and simple screening tool should be thought of.
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Affiliation(s)
- Ahmed Muhye Seid
- School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
- Department of Public Health, College of Medicine and Health Sciences, Dire Dawa University, Dire Dawa, Ethiopia
| | - Netsanet Fentahun Babbel
- Department of Nutrition and Dietetics, School of Public Health, College of Medicine and Health Sciences, Bahir Dar University, Bahir Dar, Ethiopia
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10
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Wu HL, Yang J, Wei YC, Wang JY, Jia YY, Li L, Zhang L, Lu Y, Luo ZJ, Leng XY. Analysis of the prevalence, risk factors, and clinical characteristics of osteoporosis in patients with essential hypertension. BMC Endocr Disord 2022; 22:165. [PMID: 35761253 PMCID: PMC9235169 DOI: 10.1186/s12902-022-01080-w] [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: 03/02/2022] [Accepted: 06/22/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The present study investigated the prevalence of osteoporosis (OP) among patients with essential hypertension (EH) in the Changchun community and analysed the correlation between EH and OP. METHODS The study included 425 subjects with EH and 425 age- and sex-matched healthy controls. Bone mineral density (BMD) and serum creatinine (CR) levels were measured, and the subjects' current EH and OP statuses were surveyed to analyse the correlation between EH and OP. RESULTS The EH group exhibited lower BMD and a higher rate of having OP than the control group, and this difference was statistically significant (p < 0.05). A significant sex difference in the BMD T-score was observed among the subjects (male: - 1.19 ± 1.55, female: - 1.70 ± 1.34). In both the EH group and the control group, the rate of having OP in females was greater than that in males. However, the OP prevalence among subjects with EH varied significantly by age, body weight, fracture history, nocturnal urination frequency, depression and anxiety status, duration of hypertension, and antihypertensive medication use (p < 0.05). Two-way analysis of variance suggested an effect of the interaction between different EH statuses and bone mass conditions on the serum CR values (F = 3.584, p = 0.028, bias η2 = 0.008). CONCLUSIONS The prevalence of OP and low BMD were significantly higher among subjects with EH than among healthy controls. Additionally, the findings indicate that age, weight, fracture history, nocturnal urination frequency, depression and anxiety, duration of hypertension and antihypertensive drug use may be correlated to having OP in EH subjects, requiring further studies. Moreover, serum CR levels in subjects with different bone mass profiles were strongly influenced by the presence or absence of EH, and the serum CR levels differed significantly with the interaction of these two factors.
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Affiliation(s)
- Hai-Long Wu
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jie Yang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yu-Chi Wei
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Jian-Yu Wang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yu-Yan Jia
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Luan Li
- Changchun Medical College, Changchun, Jilin, China
| | - Lu Zhang
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Yan Lu
- Changchun University of Chinese Medicine, Changchun, Jilin, China
| | - Zong-Jian Luo
- The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin, China.
| | - Xiang-Yang Leng
- Changchun University of Chinese Medicine, Changchun, Jilin, China.
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11
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Yuan J, Peng L, Luan F, Li J, Zhang J, Jiang W, Wang W. Causal Effects of Genetically Predicted Cystatin C on Osteoporosis: A Two-Sample Mendelian Randomization Study. Front Genet 2022; 13:849206. [PMID: 35646051 PMCID: PMC9136661 DOI: 10.3389/fgene.2022.849206] [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] [Received: 01/19/2022] [Accepted: 04/19/2022] [Indexed: 11/21/2022] Open
Abstract
Objectives: Although it has long been reported that high levels of cystatin C could contribute to the development of osteoporosis in some studies, no evidence has established a causal association between them thus far. Methods: A Mendelian randomization (MR) study was conducted to determine the causal effect of cystatin C on osteoporosis based on public databases obtained from separately published genome-wide association studies (GWASs). The single-nucleotide polymorphisms (SNPs) for cystatin C were extracted from the MR-Base (CKDGen, 33,152 participants), and the SNPs for osteoporosis were extracted from the United Kingdom Biobank project (United Kingdom Biobank, including 5,266 osteoporosis cases and 331,893 controls). We defined the odds ratio (OR) of IVW methods as the primary outcome. In addition, weighted median and MR-Egger regressions were used in the sensitivity analysis. Results: In IVW, we found that genetically predicted cystatin C was causally associated with the risk of osteoporosis with an OR of 1.02 [95% confidence interval (CI) = 1.003-1.025, p = 0.01]. In the further sensitivity analysis, weighted median regression also showed directionally similar estimates (OR = 1.02, 95% CI = 1.005-1.03, p = 0.005), and MR-Egger regression (OR = 1.02, 95% CI = 1.000-1.036, p = 0.15) revealed similar estimates but with lower precision. The funnel plot, MR-Egger intercept, and MR-PRESSO all indicate that no directional pleiotropic effect was observed. Conclusion: In conclusion, our MR study showed evidence of a causal association between serum cystatin C levels and osteoporosis, which also needs to be verified by studies with larger sample sizes in the future. Early monitoring of cystatin C may enable us to prevent osteoporosis-related diseases.
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Affiliation(s)
- Jiaqin Yuan
- Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, China.,Department of Orthopedics, Yibin Hospital, West China Hospital of Sichuan University, Yibin, China
| | - Lipeng Peng
- Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, China.,Department of Orthopedics, Yibin Hospital, West China Hospital of Sichuan University, Yibin, China
| | - Fujun Luan
- Trauma Orthopaedics, Yongchuan Hospital of Chongqing Medical University, Chongqing, China
| | - Jie Li
- Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, China.,Department of Orthopedics, Yibin Hospital, West China Hospital of Sichuan University, Yibin, China
| | - Jinglin Zhang
- Public Health, Chongqing Medical University, Chongqing, China
| | - Wei Jiang
- Department of Orthopedics, The Second People's Hospital of Yibin, Yibin, China.,Department of Orthopedics, Yibin Hospital, West China Hospital of Sichuan University, Yibin, China
| | - Wenting Wang
- Department of Anesthesiology, The Second Affiliated Hospital of Hainan Medical University, Haikou, China
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12
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Shaban M, Mohammed H, Hassan S. Role of community health nurse in the prevention of elderly dehydration: A mini-review. JOURNAL OF INTEGRATIVE NURSING 2022. [DOI: 10.4103/jin.jin_36_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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13
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Rodríguez-Gómez I, Gray SR, Ho FK, Petermann-Rocha F, Welsh P, Cleland J, Iliodromiti S, Ara I, Pell J, Sattar N, Ferguson LD, Celis-Morales C. Osteoporosis and Its Association With Cardiovascular Disease, Respiratory Disease, and Cancer: Findings From the UK Biobank Prospective Cohort Study. Mayo Clin Proc 2022; 97:110-121. [PMID: 34996542 DOI: 10.1016/j.mayocp.2021.07.019] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 06/21/2021] [Accepted: 07/08/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To investigate sex-specific associations of osteoporosis with incidence of and mortality from cardiovascular disease (CVD), respiratory disease, and cancer as well as with all-cause mortality. METHODS In total, 305,072 participants (53% [161,383] women) of UK Biobank were included in this study (2007-2010). Self-reported diagnosis of osteoporosis at baseline was the exposure of interest. The outcomes were CVD, respiratory disease, chronic obstructive pulmonary disease (COPD), all cancer, and prostate and breast cancer incidence and mortality and all-cause mortality. Associations between osteoporosis and outcomes were investigated using Cox proportional hazards models. RESULTS In men, osteoporosis was associated with a higher incident risk of all respiratory diseases (hazard ratio [HR], 1.26; 95% CI, 1.06 to 1.50) including COPD (HR, 1.82; 95% CI, 1.38 to 2.40). Men with osteoporosis also had a higher mortality risk from all causes (HR, 1.71; 95% CI, 1.38 to 2.11), CVD (HR, 1.68; 95% CI, 1.19 to 2.37), respiratory disease (HR, 2.35; 95% CI, 1.70 to 3.24), and COPD (HR, 3.64; 95% CI, 2.24 to 5.91). These associations persisted after adjustment for age, body mass index, and comorbidities. Women with osteoporosis had a higher risk of incident CVD (HR, 1.24; 95% CI, 1.97 to 1.44), respiratory disease (HR, 1.23; 95% CI, 1.13 to 1.33), and COPD (HR, 1.29; 95% CI, 1.10 to 1.52). Women with osteoporosis also had a higher mortality risk from respiratory disease (HR, 1.31; 95% CI, 1.00 to 1.72) and breast cancer (HR, 1.60; 95% CI, 1.14 to 2.26). CONCLUSION Compared with women, men with osteoporosis had a higher risk of all-cause mortality, mortality from respiratory diseases including COPD, and cancer incidence. Osteoporosis was strongly associated with respiratory disease and COPD in both sexes, even after full adjustment for covariates, although men with osteoporosis experienced a higher risk of adverse outcomes.
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Affiliation(s)
- Irene Rodríguez-Gómez
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain; Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Stuart R Gray
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | | | - Paul Welsh
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - John Cleland
- Robertson Centre for Biostatistics, Institute of Health and Wellbeing, University of Glasgow, Glasgow Royal Infirmary, Glasgow, United Kingdom
| | - Stamatina Iliodromiti
- Centre for Women's Health, Institute of Population Health Sciences, Queen Mary University London, London, United Kingdom
| | - Ignacio Ara
- GENUD Toledo Research Group, Universidad de Castilla-La Mancha, Toledo, Spain; CIBER of Frailty and Healthy Aging (CIBERFES), Madrid, Spain
| | - Jill Pell
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom
| | - Naveed Sattar
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Lyn D Ferguson
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, United Kingdom
| | - Carlos Celis-Morales
- Institute of Cardiovascular and Medical Sciences, BHF Glasgow Cardiovascular Research Centre, Glasgow, United Kingdom; Centro de Investigación en Fisiología del Ejercicio (CIFE), Universidad Mayor, Santiago, Chile; Grupo de Estudio en Educación, Actividad Física y Salud (GEEAFyS), Universidad Católica del Maule, Talca, Chile.
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14
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Association of vitamin D receptor gene polymorphism with the occurrence of low bone density, osteopenia, and osteoporosis in patients with type 2 diabetes. J Diabetes Metab Disord 2021; 20:1375-1383. [PMID: 34900789 DOI: 10.1007/s40200-021-00871-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 07/31/2021] [Indexed: 10/20/2022]
Abstract
Purpose This study aims to analyze the association between VDR gene polymorphism and the occurrence of "low bone density (LBD)/osteopenia/osteoporosis" or LBDOO in type 2 diabetes (T2D) patients among a clustered population in northwest of Iran. The studied VDR gene polymorphism included ApaI (rs7975232), BsmI (rs1544410), FokI (rs2228570), EcoRV (rs4516035) and, TaqI (rs731236). Methods In this population-based cross-sectional study, patients with T2D were identified within a group of 1266 participants based on self-report of diabetes, history of diabetes medication, and recorded laboratory data. Separately for each polymorphism and gender, crude and adjusted (age, BMI) odds ratios (ORs) were calculated for participants with T2D through logistic regression analysis. Results The prevalence of T2D was 16.41% in people residing in the city of Sanandaj in 2011. Of the participants with T2D, 13.92% and 81.29% had osteoporosis and vitamin D deficiency, respectively. In women, the tt genotype of the TaqI gene significantly decreased the risk of LBDOO versus the Tt genotype, after adjusting for BMI and age (adjusted OR:0.18, CI95%: 0.03-0.97). Conversely, the EE genotype of the EcoRV gene enhanced the risk of LBDOO versus the Ee genotype (adjusted OR:7.64, CI95%: 2.03-28.72). Conclusion The polymorphism of both TaqI and EcoRV genes was associated with the risk of LBDOO in women with T2D. This is the first time a study has highlighted this effect for the polymorphism of the EcoRV gene; we believe that this study would serve as a basis for future studies.
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15
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Lung T, Di Cesare P, Risch L, Nydegger U, Risch M. Elementary Laboratory Assays as Biomarkers of Ageing: Support for Treatment of COVID-19? Gerontology 2021; 67:503-516. [PMID: 34340235 PMCID: PMC8450824 DOI: 10.1159/000517659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Accepted: 05/19/2021] [Indexed: 11/24/2022] Open
Abstract
Youth, working age and the elderly: On a timeline, chronological age (CA) and biological age (BA) may dissociate; nosological entities manifest themselves at different BAs. In determining which disease corresponds to a given age decade, statistical registries of causes of death are unreliable and this does not change with SARS CoV-2 infection. Beyond adolescence, ageing metrics involve estimations of changes in fitness, including prediction models to estimate the number of remaining years left to live. A substantial disparity in biomarker levels and health status of ageing can be observed: the difference in CA and BA in the large cohorts under consideration is glaring. Here, we focus more closely on ageing and senescence metrics in order to make information available for risk analysis non the least with COVID-19, including the most recent risk factors of ABO blood type and 3p21.31 chromosome cluster impacting on C5a and SC5b-9 plasma levels. From the multitude of routine medical laboratory assays, a potentially meaningful set of assays aimed to best reflect the stage of individual senescence; hence risk factors the observational prospective SENIORLABOR study of 1,467 healthy elderly performed since 2009 and similar approaches since 1958 can be instantiated as a network to combine a set of elementary laboratory assays quantifying senescence.
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Affiliation(s)
- Thomas Lung
- Labormedizinisches Zentrum Dr. Risch, Vaduz, Liechtenstein
| | | | - Lorenz Risch
- Labormedizinisches Zentrum Dr. Risch, Vaduz, Liechtenstein
| | - Urs Nydegger
- Labormedizinisches Zentrum Dr. Risch, Vaduz, Liechtenstein
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Pepe J, Agosti P, Cipriani C, Tettamanti M, Nobili A, Colangelo L, Santori R, Cilli M, Minisola S. Underdiagnosis and undertreatment of osteoporotic patients admitted in internal medicine wards in Italy between 2010 and 2016 (the REPOSI Register). Endocrine 2021; 71:484-493. [PMID: 33433894 DOI: 10.1007/s12020-020-02553-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 11/11/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate clinical features, treatments, and outcomes of osteoporotic patients admitted to internal medicine and geriatric wards compared with non-osteoporotic patients (REPOSI registry). METHODS We studied 4714 patients hospitalized between 2010 and 2016. We reported age, sex, educational level, living status, comorbidities and drugs taken, Cumulative Illness Rating Scale (CIRS), Barthel Index, Short-Blessed Test, 4-item Geriatric Depression Scale, serum hemoglobin, creatinine, and clinical outcomes. Osteoporosis was defined based on the diagnoses recorded at admission, according to the following ICD9: 733, 805-813, 820-823. RESULTS Twelve percent of the patients had a preadmission diagnosis of osteoporosis. Only 20% of these had been prescribed oral bisphosphonates; 34% were taking vitamin D supplements. Osteoporotic patients were significantly older, with lower BMI, higher CIRS, and taking more drugs. They were significantly more depressed, less independent, with a higher severity of cognitive impairment compared with non-osteoporotic patients. At discharge, the number of patients receiving treatment for osteoporosis did not change. Length of stay and inhospital mortality did not differ between groups. Osteoporotic patients were more frequently nonhome discharged compared with those without osteoporosis (14.8 vs. 7.9%, p = 0.0007), mostly discharged to physical therapy or rehabilitation (8.8 vs. 2.5% of patients, p < 0.0001). Among osteoporotic patients deceased 3 months after discharge, the number of those treated with vitamin D, with or without calcium supplements, was significantly lower compared with survivors (12 vs. 32%, p = 0.0168). CONCLUSIONS The diagnosis of osteoporosis is poorly considered both during hospital stay and at discharge; osteoporotic patients are frailer compared to non-osteoporotic patients.
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Affiliation(s)
- Jessica Pepe
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy.
| | - Pasquale Agosti
- Department of Pathophysiology and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, and Fondazione Luigi Villa, Università degli Studi di Milano, Milan, Italy
| | - Cristiana Cipriani
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Mauro Tettamanti
- Neuroscience Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Alessandro Nobili
- Neuroscience Department, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Luciano Colangelo
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Rachele Santori
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Mirella Cilli
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
| | - Salvatore Minisola
- Department of Clinical, Internal, Anesthesiological and Cardiovascular Sciences, "Sapienza" University of Rome, Rome, Italy
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Sha NN, Zhang JL, Poon CCW, Li WX, Li Y, Wang YF, Shi W, Lin FH, Lin WP, Wang YJ, Zhang Y. Differential responses of bone to angiotensin II and angiotensin(1-7): beneficial effects of ANG(1-7) on bone with exposure to high glucose. Am J Physiol Endocrinol Metab 2021; 320:E55-E70. [PMID: 33103451 DOI: 10.1152/ajpendo.00158.2020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Osteoporosis, diabetes, and hypertension are common concurrent chronic disorders. This study aimed to explore the respective effects of angiotensin II (ANG II) and angiotensin(1-7) [ANG(1-7)], active peptides in the renin-angiotensin system, on osteoblasts and osteoclasts under high-glucose level, as well as to investigate the osteo-preservative effects of ANG II type 1 receptor (AT1R) blocker and ANG(1-7) in diabetic spontaneously hypertensive rats (SHR). ANG II and ANG(1-7), respectively, decreased and increased the formation of calcified nodules and alkaline phosphatase activity in MC3T3-E1 cells under high-glucose level, and respectively stimulated and inhibited the number of matured osteoclasts and pit resorptive area in RANKL-induced bone marrow macrophages. Olmesartan and Mas receptor antagonist A779 could abolish those effects. ANG II and ANG(1-7), respectively, downregulated and upregulated the expressions of osteogenesis factors in MC3T3-E1 cells. ANG II promoted the expressions of cathepsin K and MMP9 in RAW 264.7 cells, whereas ANG(1-7) repressed these osteoclastogenesis factors. ANG II rapidly increased the phosphorylation of Akt and p38 in RAW 264.7 cells, whereas ANG(1-7) markedly reduced the phosphorylation of p38 and ERK under high-glucose condition. After treatments of diabetic SHR with valsartan and ANG(1-7), a significant increase in trabecular bone area, bone mineral density, and mechanical strength was only found in the ANG(1-7)-treated group. Treatment with ANG(1-7) significantly suppressed the increase in renin expression and ANG II content in the bone of SHR. Taken together, ANG II/AT1R and ANG(1-7)/Mas distinctly regulated the differentiation and functions of osteoblasts and osteoclasts upon exposure to high-glucose condition. ANG(1-7) could protect SHR from diabetes-induced osteoporosis.
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Affiliation(s)
- Nan-Nan Sha
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Jia-Li Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Christina Chui-Wa Poon
- Department of Applied Biology and Chemical Technology, The Hong Kong Polytechnic University, Kowloon, China
| | - Wen-Xiong Li
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yue Li
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Yi-Fei Wang
- National TCM Clinical Research Base of Hypertension, the affiliated Hospital of Shandong University of TCM, Jinan, China
| | - Wei Shi
- National TCM Clinical Research Base of Hypertension, the affiliated Hospital of Shandong University of TCM, Jinan, China
| | - Fu-Hui Lin
- Department of Orthopaedic, Shenzhen Pingle Orthopaedic Hospital, Shenzhen, China
| | - Wen-Ping Lin
- Department of Orthopaedic, Shenzhen Pingle Orthopaedic Hospital, Shenzhen, China
| | - Yong-Jun Wang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
| | - Yan Zhang
- Spine Disease Research Institute, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- Key Laboratory of Theory and Therapy of Muscles and Bones, Ministry of Education, Shanghai, China
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Kessler M, Thumé E, Scholes S, Marmot M, Facchini LA, Nunes BP, Machado KP, Soares MU, de Oliveira C. Modifiable risk factors for 9-year mortality in older English and Brazilian adults: The ELSA and SIGa-Bagé ageing cohorts. Sci Rep 2020; 10:4375. [PMID: 32152345 PMCID: PMC7062886 DOI: 10.1038/s41598-020-61127-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Accepted: 02/14/2020] [Indexed: 12/19/2022] Open
Abstract
To quantify and compare 9-year all-cause mortality risk attributable to modifiable risk factors among older English and Brazilian adults. We used data for participants aged 60 years and older from the English Longitudinal Study of Ageing (ELSA) and the Bagé Cohort Study of Ageing (SIGa-Bagé). The five modifiable risk factors assessed at baseline were smoking, hypertension, diabetes, obesity and physical inactivity. Deaths were identified through linkage to mortality registers. For each risk factor, estimated all-cause mortality hazard ratios (HR) and population attributable fractions (PAF) were adjusted by age, sex, all other risk factors and socioeconomic position (wealth) using Cox proportional hazards modelling. We also quantified the risk factor adjusted wealth gradients in mortality, by age and sex. Among the participants, 659 (ELSA) and 638 (SIGa-Bagé) died during the 9-year follow-up. Mortality rates were higher in SIGa-Bagé. HRs and PAFs showed more similarities than differences, with physical inactivity (PAF 16.5% ELSA; 16.7% SIGa-Bagé) and current smoking (PAF 4.9% for both cohorts) having the strongest association. A clear graded relationship existed between the number of risk factors and subsequent mortality. Wealth gradients in mortality were apparent in both cohorts after full adjustment, especially among men aged 60-74 in ELSA. A different pattern was found among older women, especially in SIGa-Bagé. These findings call attention for the challenge to health systems to prevent and modify the major risk factors related to non-communicable diseases, especially physical inactivity and smoking. Furthermore, wealth inequalities in mortality persist among older adults.
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Affiliation(s)
- Marciane Kessler
- Department of Postgraduate Program in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil.
- Department of Epidemiology & Public Health, University College London (UCL), London, United Kingdom.
| | - Elaine Thumé
- Department of Postgraduate Program in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Shaun Scholes
- Department of Epidemiology & Public Health, University College London (UCL), London, United Kingdom
| | - Michael Marmot
- Department of Epidemiology & Public Health, University College London (UCL), London, United Kingdom
| | - Luiz Augusto Facchini
- Department of Postgraduate Program in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
- Department of Postgraduate Program in Epidemiology, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Bruno Pereira Nunes
- Department of Postgraduate Program in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Karla Pereira Machado
- Department of Postgraduate Program in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Mariangela Uhlmann Soares
- Department of Postgraduate Program in Nursing, Federal University of Pelotas (UFPel), Pelotas, Rio Grande do Sul, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology & Public Health, University College London (UCL), London, United Kingdom
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Bojincă VC, Popescu CC, Decianu RD, Dobrescu A, Bălănescu ȘM, Bălănescu AR, Bojincă M. A novel quantitative method for estimating bone mineral density using B-mode ultrasound and radiofrequency signals-a pilot study on patients with rheumatoid arthritis. Exp Ther Med 2019; 18:1661-1668. [PMID: 31410123 PMCID: PMC6676208 DOI: 10.3892/etm.2019.7746] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/31/2019] [Indexed: 11/23/2022] Open
Abstract
The objective of the present study was to evaluate whether an innovative quantitative ultrasound (QUS) technique, Radiofrequency Echographic Multi Spectromety, which combines B-mode ultrasound and radiofrequency signals, is reliable in typical Romanian patients compared to previous results obtained using dual-energy X-ray absorptiometry (DXA). The study prospectively included previously unscreened post-menopausal females with rheumatoid arthritis (RA) and age-matched healthy controls. Bone mineral density (BMD) measurements were performed with an EchoS machine (Echolight®), which combines B-mode ultrasound and radiofrequency signals. The study included 106 RA patients, with a median disease duration of 3.2 (0.5-22) years and 119 controls. RA patients had a significantly lower body weight, body mass index (BMI) and basal metabolic rate (BMR) than the controls, while the prevalence of obesity and body fat differed insignificantly. RA patients had a significantly lower spine and hip BMD, higher fracture risk and higher prevalence of osteoporosis. Compared to RA patients without osteoporosis, those with osteoporosis were significantly older and had a longer menopause duration, but they had a significantly lower BMI, body fat, BMR and prevalence of obesity. Among the controls and RA patients, the median spine and hip BMD became significantly higher as the BMI increased from underweight to obesity. In conclusion, osteoporosis is prevalent among RA patients, as a part of a complex transformation of body mass composition, involving BMI and fat mass. The novel QUS scanning technique was able to replicate the results of the established DXA measurement of BMD and is potentially suitable for screening wide populations for osteoporosis.
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Affiliation(s)
- Violeta-Claudia Bojincă
- Internal Medicine and Rheumatology Department, Sfânta Maria Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 011172, Romania
| | - Claudiu C. Popescu
- Ion Stoia Clinical Centre for Rheumatic Diseases, Carol Davila University of Medicine and Pharmacy, Bucharest 031167, Romania
| | - Raluca-Daniela Decianu
- Internal Medicine and Rheumatology Department, Sfânta Maria Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 011172, Romania
| | - Andrei Dobrescu
- Internal Medicine and Rheumatology Department, Sfânta Maria Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 011172, Romania
| | - Șerban Mihai Bălănescu
- Cardiology Department, Elias University Emergency Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 011461, Romania
| | - Andra-Rodica Bălănescu
- Internal Medicine and Rheumatology Department, Sfânta Maria Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 011172, Romania
| | - Mihai Bojincă
- Rheumatology Department, Dr I. Cantacuzino Clinical Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest 030167, Romania
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Zhou H, Jiao G, Dong M, Chi H, Wang H, Wu W, Liu H, Ren S, Kong M, Li C, Zhang L, Chen Y. Orthosilicic Acid Accelerates Bone Formation in Human Osteoblast-Like Cells Through the PI3K-Akt-mTOR Pathway. Biol Trace Elem Res 2019; 190:327-335. [PMID: 30421162 DOI: 10.1007/s12011-018-1574-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 11/07/2018] [Indexed: 12/28/2022]
Abstract
Silicon is one of the essential trace elements in the human body; the deficiency of which may lead to bone diseases. Numerous animal experiments have shown that an appropriate increase in the intake of silicon is beneficial to enhancing bone density and toughness to prevent osteoporosis. However, the molecular mechanisms of the silicon-mediated osteogenesis process have not been sufficiently clarified. In this study, we determined the possible osteogenesis-related mechanisms of orthosilicic acid at a molecular level. We detected the relevant pathway and osteogenic indicators by immunofluorescence (IF), Western blot, alkaline phosphatase (ALP) staining (using 5-bromo-4-chloro-3-indolyl phosphate/nitro blue tetrazolium [BCIP/NBT]), ALP enzyme labeling method, osteocalcin (OCN), and N-terminal propeptide of type 1 procollagen (P1NP) enzyme-linked immunosorbent assay (ELISA). We found that orthosilicic acid is capable of enhancing the expression of phosphatidylinositol-4,5-bisphosphate 3-kinase (PI3K), phospho-protein kinase B (P-Akt), phospho-mammalian target of rapamycin (P-mTOR), and related osteogenic markers (runt-related transcription factor 2 [RUNX2], type I collagen [COL1], ALP, OCN, and P1NP). However, with the addition of PI3K-Akt-mTOR pathway-specific inhibitor LY294002, the expression of PI3K, P-Akt, P-mTOR, RUNX2, COL1, ALP, OCN, and P1NP decreased. The results indicated that the PI3K-Akt-mTOR pathway played a positive regulatory role in the process of orthosilicic acid-mediated osteogenesis in vitro.
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Affiliation(s)
- Hongming Zhou
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
- Department of Emergency Trauma Surgery, Linyi Central Hospital, Linyi, Shandong Province, China
| | - Guangjun Jiao
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Meng Dong
- Department of Orthopedics, Zibo Central Hospital, Zibo, Shandong Province, China
| | - Hai Chi
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Hongliang Wang
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Wenliang Wu
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Haichun Liu
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Shanwu Ren
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Meng Kong
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Ci Li
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Lu Zhang
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China
| | - Yunzhen Chen
- Department of Orthopedics, Qilu Hospital of Shandong University and Spine and Spinal Cord Disease Research Center, Shandong University, Jinan, Shandong, China.
- Department of Orthopedics, Qilu Hospital of Shandong University, No. 107, Wen Hua Xi Road, Ji'nan, 250012, Shandong Province, China.
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21
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Risk Factors for Poor Functional Recovery, Mortality, Recurrent Fractures, and Falls Among Patients Participating in a Fracture Liaison Service Program. J Am Med Dir Assoc 2019; 20:1129-1136.e1. [PMID: 30723057 DOI: 10.1016/j.jamda.2018.12.011] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/09/2018] [Accepted: 12/16/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE A fracture liaison service (FLS) for patients with fractures is a promising approach for improving outcomes, but barriers to the successful implementation of an FLS remain. The factors influencing the outcomes of patients already receiving FLS care are unclear. DESIGN A prospective multicenter cohort study. SETTINGS AND PARTICIPANTS Patients with incident hip and clinical vertebral fractures treated at 2 institutions between January 2014 and June 2016 were prospectively enrolled. Demographic profiles, comorbidities, prior fracture experiences, T scores, Fracture Risk Assessment Tool (FRAX) scores, and serum markers were examined. MEASURES Self-reported functional status (at the 4th month), mortality, recurrent fractures, and falls (at the 2-year follow-up). RESULTS Of 712 patients screened for eligibility, 600 (84%) participants (age 78 ± 10 years) were enrolled in the FLS program. At 4 months, 58%, 53%, and 60% of the participants reported improved mobility, self-care, and daily activities after FLS care, respectively. After 2 years, 85 (14%) died, 36 (6%) developed recurrent fractures, and 199 (33%) had 1 or more fall episodes. Multivariate logistic regression showed that neurologic disorders, heart disease, and diabetes were associated with a decreased probability of functional recovery. Cox regression showed that older age and chronic kidney disease (CKD) were predictive of increased mortality, whereas heart disease was correlated with an increased refracture risk. Older age and cancer or osteoarthritis were associated with a higher risk of falls. Importantly, a higher body mass index predicted a lower risk of mortality and a higher probability of improved self-care but a higher risk of fall at follow-up. CONCLUSIONS/IMPLICATIONS We discovered that comorbidities including CKD, heart disease, cancer, and osteoarthritis could influence short-term functional changes, survival, and the risk of refractures or falls among patients participating in FLSs. These factors are expected to aid in prognosis estimation and management planning for those with fractures.
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22
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Kim KJ. The importance of updating osteoporotic femur fracture data: Asian Federation of Osteoporosis Societies study. Osteoporos Sarcopenia 2018; 4:37-38. [PMID: 30775540 PMCID: PMC6362947 DOI: 10.1016/j.afos.2018.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 06/06/2018] [Accepted: 06/07/2018] [Indexed: 11/17/2022] Open
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