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Cheng T, Hou JL, Han ZY, Geng XL, Zhang YC, Fan KY, Liu L, Zhang HY, Huo YH, Li XF, Zhang SX. Genetically determined type 1 diabetes mellitus and risk of osteoporosis. Exp Gerontol 2024; 191:112434. [PMID: 38636571 DOI: 10.1016/j.exger.2024.112434] [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: 02/08/2024] [Revised: 04/13/2024] [Accepted: 04/15/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Observational evidence suggests that type 1 diabetes mellitus (T1DM) is associated with the risk of osteoporosis (OP). Nevertheless, it is not apparent whether these correlations indicate a causal relationship. To elucidate the causal relationship, a two-sample Mendelian randomization (MR) analysis was performed. METHODS T1DM data was obtained from the large genome-wide association study (GWAS), in which 6683 cases and 12,173 controls from 12 European cohorts were involved. Bone mineral density (BMD) samples at four sites were extracted from the GEnetic Factors for OSteoporosis (GEFOS) consortium, including forearm (FA) (n = 8,143), femoral neck (FN) (n = 32,735), lumbar spine (LS) (n = 28,498), and heel (eBMD) (n = 426,824). The former three samples were from mixed populations and the last one was from European. Inverse variance weighting, MR-Egger, and weighted median tests were used to test the causal relationship between T1DM and OP. A series of sensitivity analyses were then conducted to verify the robustness of the results. RESULTS Twenty-three independent SNPs were associated with FN-BMD and LS-BMD, twenty-seven were associated with FA-BMD, and thirty-one were associated with eBMD. Inverse variance-weighted estimates indicated a causal effect of T1DM on FN-BMD (odds ratio (OR) =1.033, 95 % confidence interval (CI): 1.012-1.054, p = 0.002) and LS-BMD (OR = 1.032, 95 % CI: 1.005-1.060, p = 0.022) on OP risk. Other MR methods, including weighted median and MR-Egger, calculated consistent trends. While no significant causation was found between T1DM and the other sites (FA-BMD: OR = 1.008, 95 % CI: 0.975-1.043, p = 0.632; eBMD: OR = 0.993, 95 % CI: 0.985-1.001, p = 0.106). No significant heterogeneity (except for eBMD) or horizontal pleiotropy was found for instrumental variables, suggesting these results were reliable and robust. CONCLUSIONS This study shows a causal relationship between T1DM and the risk of some sites of OP (FN-BMD, LS-BMD), allowing for continued research to discover the clinical and experimental mechanisms of T1DM and OP. It also contributes to the recommendation if patients with T1DM need targeted care to promote bone health and timely prevention of osteoporosis.
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Affiliation(s)
- Ting Cheng
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China; Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Jia-Lin Hou
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Zi-Yi Han
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Xin-Lei Geng
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Yao-Chen Zhang
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Ke-Yi Fan
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Liu Liu
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - He-Yi Zhang
- Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Yue-Hong Huo
- Department of Rheumatology, The Fifth People's Hospital of Datong, Datong, Shanxi Province, China
| | - Xiao-Feng Li
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China; Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China
| | - Sheng-Xiao Zhang
- Department of Rheumatology, The Second Hospital of Shanxi Medical University, Taiyuan, Shanxi Province, China; Shanxi Provincial Key Laboratory of Rheumatism Immune Microecology, Taiyuan, Shanxi Province, China; Key Laboratory of Cellular Physiology at Shanxi Medical University, Ministry of Education, Taiyuan, Shanxi Province, China.
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Yamada C, Ho A, Garcia C, Oblak AL, Bissel S, Porosencova T, Porosencov E, Uncuta D, Ngala B, Shepilov D, Skibo G, Mascarenhas AK, Akkaoui J, Lakshmana MK, Sankar U, Nichols F, Lamb BT, Groppa S, Movila A. Dementia exacerbates periodontal bone loss in females. J Periodontal Res 2024; 59:512-520. [PMID: 38243688 DOI: 10.1111/jre.13227] [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: 03/09/2023] [Revised: 12/01/2023] [Accepted: 12/06/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND Periodontitis is a chronic inflammatory disease defined by the pathologic loss of the periodontal ligament and alveolar bone in relation to aging. Although clinical cohort studies reported that periodontitis is significantly elevated in males compared to females, emerging evidence indicates that females with dementia are at a greater risk for periodontitis and decreased alveolar bone. OBJECTIVE This study aimed to evaluate whether dementia is a potential sex-dependent risk factor for periodontal bone loss using an experimental model of periodontitis induced in the triple transgenic (3x-Tg) dementia-like mice and clinical samples collected from senior 65 plus age patients with diagnosed dementia. MATERIALS AND METHODS We induced periodontitis in dementia-like triple-transgenic (3x-Tg) male and female mice and age-matched wild-type (WT) control mice by ligature placement. Then, alveolar bone loss and osteoclast activity were evaluated using micro-CT and in situ imaging assays. In addition, we performed dental examinations on patients with diagnosed dementia. Finally, dementia-associated Aβ42 and p-Tau (T181) and osteoclastogenic receptor activator of nuclear factor kappa-Β ligand (RANKL) in gingival crevicular fluid (GCF) collected from mice and clinical samples were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS Alveolar bone loss and in situ osteoclast activity were significantly elevated in periodontal lesions of 3x-Tg females but not males, compared to wild-type control mice. In addition, we also observed that the probing pocket depth (PPD) was also significantly elevated in female patients with dementia. Using ELISA assay, we observed that females had elevated levels of osteoclastogenic RANKL and dementia-associated Aβ42 and p-Tau (T181) in the GCF collected from experimental periodontitis lesions and clinical samples. CONCLUSION Altogether, we demonstrate that females with dementia have an increased risk for periodontal bone loss compared to males.
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Affiliation(s)
- Chiaki Yamada
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Anny Ho
- Institute of Neuro-immune Medicine, Nova Southeastern University, Ft. Lauderdale, Florida, USA
| | - Christopher Garcia
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Adrian L Oblak
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Stephanie Bissel
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Tatiana Porosencova
- Faculty of Dentistry, "Nicolae Testemițanu" State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Egor Porosencov
- Faculty of Dentistry, "Nicolae Testemițanu" State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Diana Uncuta
- Faculty of Dentistry, "Nicolae Testemițanu" State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Bidii Ngala
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Dmytro Shepilov
- Department of Cytology, Bogomoletz Institute of Physiology, NAS of Ukraine, Kyiv, Ukraine
| | - Galyna Skibo
- Department of Cytology, Bogomoletz Institute of Physiology, NAS of Ukraine, Kyiv, Ukraine
| | | | - Juliet Akkaoui
- Institute of Neuro-immune Medicine, Nova Southeastern University, Ft. Lauderdale, Florida, USA
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Madepalli K Lakshmana
- Herbert Wertheim College of Medicine, Florida International University, Miami, Florida, USA
| | - Uma Sankar
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Frank Nichols
- Department of Oral Health and Diagnostic Sciences, University of Connecticut School of Dental Medicine, Farmington, Connecticut, USA
| | - Bruce T Lamb
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Stanislav Groppa
- Department of Neurology, Institute of Emergency Medicine, Chisinau, Moldova
- Department of Neurology, "Nicolae Testemițanu" State University of Medicine and Pharmacy, Chisinau, Moldova
| | - Alexandru Movila
- Department of Biomedical Sciences and Comprehensive Care, Indiana University School of Dentistry, Indianapolis, Indiana, USA
- Indiana Center for Musculoskeletal Health, Indiana University School of Medicine, Indianapolis, Indiana, USA
- Institute of Neuro-immune Medicine, Nova Southeastern University, Ft. Lauderdale, Florida, USA
- Department of Oral Sciences and Translational Research, College of Dental Medicine, Nova Southeastern University, Davie, Florida, USA
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Kidwai-Khan F, Wang R, Skanderson M, Brandt CA, Fodeh S, Womack JA. A roadmap to artificial intelligence (AI): Methods for designing and building AI ready data to promote fairness. J Biomed Inform 2024; 154:104654. [PMID: 38740316 PMCID: PMC11144439 DOI: 10.1016/j.jbi.2024.104654] [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: 09/29/2023] [Revised: 05/01/2024] [Accepted: 05/10/2024] [Indexed: 05/16/2024]
Abstract
OBJECTIVES We evaluated methods for preparing electronic health record data to reduce bias before applying artificial intelligence (AI). METHODS We created methods for transforming raw data into a data framework for applying machine learning and natural language processing techniques for predicting falls and fractures. Strategies such as inclusion and reporting for multiple races, mixed data sources such as outpatient, inpatient, structured codes, and unstructured notes, and addressing missingness were applied to raw data to promote a reduction in bias. The raw data was carefully curated using validated definitions to create data variables such as age, race, gender, and healthcare utilization. For the formation of these variables, clinical, statistical, and data expertise were used. The research team included a variety of experts with diverse professional and demographic backgrounds to include diverse perspectives. RESULTS For the prediction of falls, information extracted from radiology reports was converted to a matrix for applying machine learning. The processing of the data resulted in an input of 5,377,673 reports to the machine learning algorithm, out of which 45,304 were flagged as positive and 5,332,369 as negative for falls. Processed data resulted in lower missingness and a better representation of race and diagnosis codes. For fractures, specialized algorithms extracted snippets of text around keywork "femoral" from dual x-ray absorptiometry (DXA) scans to identify femoral neck T-scores that are important for predicting fracture risk. The natural language processing algorithms yielded 98% accuracy and 2% error rate The methods to prepare data for input to artificial intelligence processes are reproducible and can be applied to other studies. CONCLUSION The life cycle of data from raw to analytic form includes data governance, cleaning, management, and analysis. When applying artificial intelligence methods, input data must be prepared optimally to reduce algorithmic bias, as biased output is harmful. Building AI-ready data frameworks that improve efficiency can contribute to transparency and reproducibility. The roadmap for the application of AI involves applying specialized techniques to input data, some of which are suggested here. This study highlights data curation aspects to be considered when preparing data for the application of artificial intelligence to reduce bias.
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Affiliation(s)
- Farah Kidwai-Khan
- Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA.
| | - Rixin Wang
- Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Cynthia A Brandt
- Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Samah Fodeh
- Yale School of Medicine, New Haven, CT, USA; VA Connecticut Healthcare System, West Haven, CT, USA
| | - Julie A Womack
- VA Connecticut Healthcare System, West Haven, CT, USA; Yale School of Nursing, New Haven, CT, USA
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Greening VA, Hernandez E, Mongle CS, Billings BK, Mngomezulu V, Wallace IJ, Grine FE. Variation, sexual dimorphism, and enlargement of the frontal sinus with age in adult South Africans. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2024; 183:e24899. [PMID: 38269496 DOI: 10.1002/ajpa.24899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 01/26/2024]
Abstract
OBJECTIVES To document frontal sinus volume (FSV) in a sample of sub-Saharan Africans with a view to evaluating claims that such populations exhibit comparatively small sinuses. This study also addresses questions related to sexual dimorphism, incidence of sinus aplasia, and the possibility that FSV continues to increase through adulthood. MATERIALS AND METHODS FSV was measured from CT scans of adult crania from the Dart Collection. Sex and age were known for each individual. Linear cranial dimensions were used to compute a geometric mean from which a scaled FSV was computed for each cranium. RESULTS FSV does not differ significantly between sexes, but females exhibit a higher incidence of aplasia. There is considerable variation in FSV in this sample, with the average ranking among the higher means reported for other population samples. The incidence of FS aplasia falls within the range of values recorded for other population samples. Although our study is cross-sectional rather than longitudinal, there is strong evidence that FSV continues to increase with age throughout adulthood. DISCUSSION The FSV mean of our sample contradicts the notion that sub-Saharan Africans possess small sinuses. In a global context, geography (climate and altitude) does not appear to be related to FSV. The absence of sexual dimorphism in our sample is unexpected, as significant dimorphism has been reported for most other population samples. Our results support other indications that the frontal sinus continues to expand throughout adulthood, especially in females, and that it is likely due to bone resorption.
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Affiliation(s)
- Victoria A Greening
- Department of Anthropology, Stony Brook University, Stony Brook, New York, USA
| | - Emily Hernandez
- Department of Anthropology, Stony Brook University, Stony Brook, New York, USA
| | - Carrie S Mongle
- Department of Anthropology, Stony Brook University, Stony Brook, New York, USA
- Turkana Basin Institute, Stony Brook University, Stony Brook, New York, USA
| | - Brendon K Billings
- Human Variation and Identification Research Unit, School of Anatomical Sciences, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Victor Mngomezulu
- Department of Diagnostic Radiology, Charlotte Maxeke Johannesburg Academic Hospital, Johannesburg, South Africa
| | - Ian J Wallace
- Department of Anthropology, University of New Mexico, Albuquerque, New Mexico, USA
| | - Frederick E Grine
- Department of Anthropology, Stony Brook University, Stony Brook, New York, USA
- Department of Anatomical Sciences, School of Medicine, Stony Brook University, Stony Brook, New York, USA
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Smit A, Meijer O, Winter E. The multi-faceted nature of age-associated osteoporosis. Bone Rep 2024; 20:101750. [PMID: 38566930 PMCID: PMC10985042 DOI: 10.1016/j.bonr.2024.101750] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
Age-associated osteoporosis (AAOP) poses a significant health burden, characterized by increased fracture risk due to declining bone mass and strength. Effective prevention and early treatment strategies are crucial to mitigate the disease burden and the associated healthcare costs. Current therapeutic approaches effectively target the individual contributing factors to AAOP. Nonetheless, the management of AAOP is complicated by the multitude of variables that affect its development. Main intrinsic and extrinsic factors contributing to AAOP risk are reviewed here, including mechanical unloading, nutrient deficiency, hormonal disbalance, disrupted metabolism, cognitive decline, inflammation and circadian disruption. Furthermore, it is discussed how these can be targeted for prevention and treatment. Although valuable as individual targets for intervention, the interconnectedness of these risk factors result in a unique etiology for every patient. Acknowledgement of the multifaceted nature of AAOP will enable the development of more effective and sustainable management strategies, based on a holistic, patient-centered approach.
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Affiliation(s)
- A.E. Smit
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - O.C. Meijer
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
| | - E.M. Winter
- Department of Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, the Netherlands
- Einthoven Laboratory for Experimental Vascular Medicine, Leiden, the Netherlands
- Department of Medicine, Center for Bone Quality, Leiden University Medical Center, Leiden, the Netherlands
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Zhang ZX, Xie L, Li Z. Global, regional, and national burdens of facial fractures: a systematic analysis of the global burden of Disease 2019. BMC Oral Health 2024; 24:282. [PMID: 38418992 PMCID: PMC10900718 DOI: 10.1186/s12903-024-04048-5] [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: 12/03/2023] [Accepted: 02/19/2024] [Indexed: 03/02/2024] Open
Abstract
BACKGROUND The incidence of facial fractures has undergone tremendous changes in recent years as a result of socio-economic development and aging populations. Currently, there is a lack of updated and comprehensive analyses of global trends and causes of facial fractures. The Global Burden of Disease (GBD) database is a product of a global research organization used to quantify the global impact of hundreds of diseases, injuries, and risk factors. The aim of this study was to update global burden of facial fractures from 1990 to 2019 by using the GBD2019. MATERIALS AND METHODS The present study extracted the global incidence, prevalence, and years lived with disability (YLDs) for facial fractures, as well as the age-standardized rates (ASRs) of these variables using the Global Burden of Disease (GBD) 2019 database. The estimated annual percentage change (EAPC) was used to assess the trends of ASRs. RESULTS Between 1990 and 2019, the incidence of facial fractures increased from 8,943,707 to 10,676,340, but the age-standardized incidence rate (ASIR) decreased from 161.5 to 138.8 per 100,000. Prevalence and YLDs exhibited the same trend as incidence. Over the 30 years, the incidence of facial fractures was consistently greater in males than in females. However, females aged ˃ 75 years had higher fracture incidence rates than males aged ˃ 75 years in 2019. The leading cause of facial fractures was falls, and both the age-standardized prevalence rate (ASPR) and age-standardized years lived with disability rate (ASYR) of falls increased with age. CONCLUSION Facial fractures still represent a significant burden to the world. Incidence, prevalence and YLDs all showed increasing trends, while ASRs decreased gradually from 1990 to 2019. Enhancing the quality of facial fractures data is helpful for monitoring the burden of facial fractures.
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Affiliation(s)
- Ze-Xing Zhang
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Long Xie
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Zhi Li
- State Key Laboratory of Oral & Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School & Hospital of Stomatology, Wuhan University, Wuhan, 430072, China.
- Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.
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Abrams MZ, Bass CR. Female vs. male relative fatality risk in fatal motor vehicle crashes in the US, 1975-2020. PLoS One 2024; 19:e0297211. [PMID: 38346063 PMCID: PMC10861033 DOI: 10.1371/journal.pone.0297211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 12/29/2023] [Indexed: 02/15/2024] Open
Abstract
Motor vehicle accidents are the leading cause of death for young adults 18-29 years old worldwide, resulting in nearly 1 million years of life lost annually in the United States. Despite improvements in vehicle safety technologies, young women are at higher risk of dying in car crashes compared with men in matched scenarios. Vehicle crash testing primarily revolves around test dummies representative of the 50th percentile adult male, potentially resulting in these differences in fatality risk for female occupants compared to males. Vehicle occupants involved in fatal car crashes were matched using seating location, vehicle type, airbag deployment, seatbelt usage, and age. The relative risk for fatality (R) between males and females was calculated using a Double Pair Comparison. Young women (20s-40s) are at approximately 20% higher risk of dying in car crashes compared with men of the same age in matched scenarios. In passenger cars, 25-year-old female occupants in passenger car crashes from 1975-2020 exhibit R = 1.201 (95% CI 1.160-1.250) compared to 25-year-old males, and R-1.117 (95% CI 1.040-1.207) for passenger car crashes from 2010-2020. This trend persists across vehicle type, airbag deployment, seatbelt use, and number of vehicles involved in a crash. Known sex-based differences do not explain this large risk differential, suggesting a need for expanded test methodologies and research strategies to address as-yet unexplored sex differences in crash fatalities. These differences should be further investigated to ensure equitable crash protection.
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Affiliation(s)
- Mitchell Z. Abrams
- Department of Biomedical Engineering, Injury and Orthopedic Biomechanics Laboratory, Duke University, Durham, North Carolina, United States of America
| | - Cameron R. Bass
- Department of Biomedical Engineering, Wayne State University, Detroit, Michigan, United States of America
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Shi D, Liu W, Hang J, Chen W. Whole egg consumption in relation to bone health of the US population: a cross-sectional study. Food Funct 2024; 15:1369-1378. [PMID: 38206082 DOI: 10.1039/d3fo04248k] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2024]
Abstract
Osteoporosis, a condition that is characterized by low bone mineral density (BMD), is a serious health concern worldwide. This study aims to explore the relationship between whole egg consumption and BMD levels in the US population. This study involves 19 208 participants with valid BMD and egg consumption data from the National Health and Nutrition Examination Survey (NHANES) during 2005-2006, 2007-2008, 2009-2010, 2013-2014 and 2017-2018. Linear regression analysis was conducted to evaluate the association between whole egg consumption and BMD levels. Mediation analysis was used to investigate the role of serum alkaline phosphatase (ALP) in the above relationship. After multivariate adjustment, participants consuming whole eggs over 3.53 ounce per day in their diet were found to have elevated BMD levels in the femur (0.013 g cm-2 with 95% CI: 0.004, 0.022) and lumbar spine (0.013 g cm-2 with 95% CI: 0.002, 0.024) (Ptrend < 0.05). The additive interaction of egg consumption and body mass index (BMI) on the BMD of both the femur and lumbar spine (Pinteraction < 0.05) was also analyzed. The association between whole egg consumption and BMD of both the femur and lumbar spine were significantly mediated by ALP with 71.8% and 83.3% mediation proportion, respectively. In general, higher whole egg consumption is positively related to an increase in the BMD scores of both the femur and lumbar spine among the US population.
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Affiliation(s)
- Da Shi
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Wei Liu
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
| | - Jiayi Hang
- Department of Agricultural, Food and Nutritional Science, Faculty of Agricultural, Life and Environmental Sciences, University of Alberta, Edmonton, Alberta, Canada
| | - Weihong Chen
- Department of Occupational and Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, China.
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Tsai DJ, Lin C, Lin CS, Lee CC, Wang CH, Fang WH. Artificial Intelligence-enabled Chest X-ray Classifies Osteoporosis and Identifies Mortality Risk. J Med Syst 2024; 48:12. [PMID: 38217829 DOI: 10.1007/s10916-023-02030-2] [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: 08/27/2023] [Accepted: 12/26/2023] [Indexed: 01/15/2024]
Abstract
A deep learning model was developed to identify osteoporosis from chest X-ray (CXR) features with high accuracy in internal and external validation. It has significant prognostic implications, identifying individuals at higher risk of all-cause mortality. This Artificial Intelligence (AI)-enabled CXR strategy may function as an early detection screening tool for osteoporosis. The aim of this study was to develop a deep learning model (DLM) to identify osteoporosis via CXR features and investigate the performance and clinical implications. This study collected 48,353 CXRs with the corresponding T score according to Dual energy X-ray Absorptiometry (DXA) from the academic medical center. Among these, 35,633 CXRs were used to identify CXR- Osteoporosis (CXR-OP). Another 12,720 CXRs were used to validate the performance, which was evaluated by the area under the receiver operating characteristic curve (AUC). Furthermore, CXR-OP was tested to assess the long-term risks of mortality, which were evaluated by Kaplan‒Meier survival analysis and the Cox proportional hazards model. The DLM utilizing CXR achieved AUCs of 0.930 and 0.892 during internal and external validation, respectively. The group that underwent DXA with CXR-OP had a higher risk of all-cause mortality (hazard ratio [HR] 2.59, 95% CI: 1.83-3.67), and those classified as CXR-OP in the group without DXA also had higher all-cause mortality (HR: 1.67, 95% CI: 1.61-1.72) in the internal validation set. The external validation set produced similar results. Our DLM uses CXRs for early detection of osteoporosis, aiding physicians to identify those at risk. It has significant prognostic implications, improving life quality and reducing mortality. AI-enabled CXR strategy may serve as a screening tool.
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Affiliation(s)
- Dung-Jang Tsai
- Department of Statistics and Information Science, Fu Jen Catholic University, New Taipei City, Taiwan, R.O.C
- Medical Technology Education Center, School of Medicine, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Artificial Intelligence of Things Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chin Lin
- Medical Technology Education Center, School of Medicine, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Artificial Intelligence of Things Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chin-Sheng Lin
- Division of Cardiology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chia-Cheng Lee
- Medical Informatics Office, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Chih-Hung Wang
- Department of Otolaryngology-Head and Neck Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C
- Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, R.O.C
| | - Wen-Hui Fang
- Artificial Intelligence of Things Center, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C..
- Department of Family and Community Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C..
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10
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Lary CW, Ghatan S, Gerety M, Hinton A, Nagarajan A, Rosen C, Ross RD, Bennett DA, DeStefano AL, Ikram MA, Rivadeneira F, Kiel DP, Seshadri S, Beiser A. Bone mineral density and the risk of incident dementia: A meta-analysis. J Am Geriatr Soc 2024; 72:194-200. [PMID: 37933827 PMCID: PMC10829515 DOI: 10.1111/jgs.18638] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 08/22/2023] [Accepted: 09/17/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND It is not known whether bone mineral density (BMD) measured at baseline or as the rate of decline prior to baseline (prior bone loss) is a stronger predictor of incident dementia or Alzheimer's disease (AD). METHODS We performed a meta-analysis of three longitudinal studies, the Framingham Heart Study (FHS), the Rotterdam Study (RS), and the Rush Memory and Aging Project (MAP), modeling the time to diagnosis of dementia as a function of BMD measures accounting for covariates. We included individuals with one or two BMD assessments, aged ≥60 years, and free of dementia at baseline with follow-up available. BMD was measured at the hip femoral neck using dual-energy X-ray absorptiometry (DXA), or at the heel calcaneus using quantitative ultrasound to calculate estimated BMD (eBMD). BMD at study baseline ("baseline BMD") and annualized percentage change in BMD prior to baseline ("prior bone loss") were included as continuous measures. The primary outcome was incident dementia diagnosis within 10 years of baseline, and incident AD was a secondary outcome. Baseline covariates included age, sex, body mass index, ApoE4 genotype, and education. RESULTS The combined sample size across all three studies was 4431 with 606 incident dementia diagnoses, 498 of which were AD. A meta-analysis of baseline BMD across three studies showed higher BMD to have a significant protective association with incident dementia with a hazard ratio of 0.47 (95% CI: 0.23-0.96; p = 0.038) per increase in g/cm2 , or 0.91 (95% CI: 0.84-0.995) per standard deviation increase. We observed a significant association between prior bone loss and incident dementia with a hazard ratio of 1.30 (95% CI: 1.12-1.51; p < 0.001) per percent increase in prior bone loss only in the FHS cohort. CONCLUSIONS Baseline BMD but not prior bone loss was associated with incident dementia in a meta-analysis across three studies.
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Affiliation(s)
- Christine W. Lary
- Roux Institute at Northeastern University, Portland, ME
- MaineHealth Institute for Research, Scarborough, ME
| | | | | | | | - Archana Nagarajan
- Roux Institute at Northeastern University, Portland, ME
- MaineHealth Institute for Research, Scarborough, ME
- Tufts University Graduate School of Biomedical Sciences, Boston, MA
| | | | - Ryan D. Ross
- Department of Anatomy & Cell Biology, Rush University Medical Center
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | | | | | | | - Douglas P. Kiel
- Hinda and Arthur Marcus Institute for Aging Research and Department of Medicine, Hebrew SeniorLife, Boston, MA
- Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, UT Health, San Antonio, TX
- Boston University School of Medicine, Boston, MA
| | - Alexa Beiser
- Boston University School of Public Health, Boston, MA
- Boston University School of Medicine, Boston, MA
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11
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Jia P, Yuan J. Weight change patterns across adulthood in relation to osteoporosis and fracture among non-obese individuals. Arch Osteoporos 2023; 19:2. [PMID: 38097861 DOI: 10.1007/s11657-023-01362-3] [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: 07/01/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
Weight change was an influencing factor of osteoporosis and fracture in a controversial way. Based on a nationally representative data, we found that weight change from obesity in midlife to non-obesity in late adulthood was associated with a reduction in the risk of osteoporosis and wrist fracture in male, but not in female. INTRODUCTION Obesity is usually recognized as a protective factor to osteoporosis and osteoporotic fracture. However, it is still unclear whether historical weight status was associated with the risk of osteoporosis and fracture. The aim of this study was to investigate the relationship between weight change patterns across adulthood and the prevalence of osteoporosis and fracture. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) with 8725 US adults aged ≥ 40 years were analyzed in this study. Weight change patterns were categorized as "stable non-obese," "obese with earlier weight gain," "obese with recent weight gain," and "revert to non-obese" based on the body mass index (BMI) at 25 years old, 10 years prior to baseline and at baseline. Body mineral density (BMD) was measured using dual x-ray absorptiometry (DXA), and osteoporosis was diagnosed based on the World Health Organization criteria. Self-reported occurrence of osteoporotic fractures were determined by questionnaires. RESULTS Compared with subjects in "stable non-obese" group, obese with earlier weight gain were positively related to the increase of BMD in both genders, while elevated BMD was only observed in female of "obese with recent weight gain" group and in male of "revert to non-obese" group after multiple adjustment. Moreover, changing from the obesity to non-obesity in the 10 years period before baseline was associated with a 81.6% lower risk of osteoporosis (odds ratio (OR) 0.184, 95% confidence interval (CI) 0.037-0.914 (P = 0.039)) and a 69.8% lower risk of wrist fracture (OR 0.302, 95%CI 0.120-0.757 (P = 0.012)) in male, but not in female. CONCLUSION Weight change from obesity in midlife to non-obesity in late adulthood was associated with a reduction in the risk of osteoporosis and wrist fracture in male. Our findings support the importance of investigating the mechanism of weight change in different life period.
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Affiliation(s)
- Pu Jia
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jing Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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12
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Vincent JI, MacDermid JC, Bassim CW, Santaguida P. Cluster analysis to identify the profiles of individuals with compromised bone health versus unfortunate wrist fractures within the Canadian Longitudinal Study of Aging (CLSA) database. Arch Osteoporos 2023; 18:148. [PMID: 38036802 PMCID: PMC10689536 DOI: 10.1007/s11657-023-01350-7] [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: 01/24/2023] [Accepted: 11/12/2023] [Indexed: 12/02/2023]
Abstract
We used cluster analysis to determine the profiles of individuals who sustained wrist fractures. We found two groups: (1) young and active and (2) older and less active. This information may be used to identify individuals who require further bone health interventions to optimize healthy aging. INTRODUCTION Distal radial fractures (DRF) are the most common of all fractures, with 6% of males and 33% of females having one at some point in their lifetime. We hypothesize that DRF consists of two subpopulations: one with compromised bone health that is early in the osteoporosis (OP) trajectory and another which are active and healthy and suffer a misfortune fracture due to their high activity levels or risk-taking behaviors. The latter is likely to recover with a minimal disability, while the former may signal a negative health trajectory of disability and early mortality. OBJECTIVE To determine the profiles of individuals who sustained wrist fractures using cluster analysis within the Comprehensive Cohort of the Canadian Longitudinal Study on Aging (CLSA) database considering factors that reflect bone health and activity levels. METHODS We included all the individuals who had a wrist fracture within the CLSA comprehensive cohort of the database (n = 968). The baseline data was used for this analysis. A 2-step cluster analysis was used to identify profiles that were both statistically and clinically meaningful. Variables that were used in the cluster analysis include demographic variables, physical activity status indicators, general health indicators, mobility indicators, bone health indicators, comorbid conditions, and lifestyle factors. RESULTS We were able to identify two distinct profiles that were statistically and clinically meaningful confirming our hypothesis. One cluster included a predominantly younger cohort, who are physically active, with less comorbid conditions, better bone health, and better general health, while the opposite was true of the first cohort. CONCLUSION We were able to identify two clusters-a healthy profile and a bone health compromised profile. This information may be used to identify the subgroup of people who should be targeted in the future for more intensive preventive health services to optimize healthy aging.
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Affiliation(s)
- Joshua I Vincent
- School of Physical Therapy, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
- Roth│McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, 268 Grosvenor St, London, ON, N6A 4V2, Canada.
- School of Rehabilitation Science, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada.
| | - Joy C MacDermid
- School of Physical Therapy, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada
- Roth│McFarlane Hand and Upper Limb Centre, St. Joseph's Hospital, 268 Grosvenor St, London, ON, N6A 4V2, Canada
- School of Rehabilitation Science, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Carol W Bassim
- Department of Research Methods, Evidence & Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
- Dept. of Medicine, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
| | - Pasqualina Santaguida
- Department of Research Methods, Evidence & Impact, McMaster University, 1280 Main St W, Hamilton, ON, L8S 4L8, Canada
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13
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Desai S, Lång P, Näreoja T, Windahl SH, Andersson G. RANKL-dependent osteoclast differentiation and gene expression in bone marrow-derived cells from adult mice is sexually dimorphic. Bone Rep 2023; 19:101697. [PMID: 37485233 PMCID: PMC10359713 DOI: 10.1016/j.bonr.2023.101697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/22/2023] [Accepted: 06/30/2023] [Indexed: 07/25/2023] Open
Abstract
Sex-specific differences in bone integrity and properties are associated with age as well as the number and activity of cells involved in bone remodeling. The aim of this study was to investigate sex-specific differences in adhesion, proliferation, and differentiation of mouse bone marrow derived cells into osteoclasts. The adherent fraction of bone marrow- derived cells from 12-week-old male and female C57BL/6J mice were assessed for their adhesion, proliferation, and receptor activator of nuclear factor κB (RANKL)-induced differentiation into osteoclasts. Female bone marrow derived macrophages (BMDMs) displayed higher adhesion and proliferation ratio upon macrophage colony stimulating factor (M-CSF) (day 0) and M-CSF + RANKL (day 4) treatment, respectively. On the contrary, male BMDMs differentiated more efficiently into osteoclasts upon RANKL-treatment compared to females (day 5). To further understand these sex-specific differences at the gene expression level, BMDMs treated with M-CSF (day 0) and M-CSF + RANKL (day 4), were assessed for their differential expression of genes through RNA sequencing. M-CSF treatment resulted in 1106 differentially expressed genes, while RANKL-treatment gave 473 differentially expressed genes. Integrin, adhesion, and proliferation-associated genes were elevated in the M-CSF-treated female BMDMs. RANKL-treatment further enhanced the expression of the proliferation- associated genes, and of genes associated with inhibition of osteoclast differentiation in the females, while RANK-signaling-associated genes were upregulated in males. In conclusion, BMDM adhesion, proliferation and differentiation into osteoclasts are sex-specific and may be directed by the PI3K-Akt signaling pathway for proliferation, and the colony stimulating factor 1-receptor and the RANKLsignaling pathway for the differentiation.
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Affiliation(s)
- Suchita Desai
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Pernilla Lång
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Tuomas Näreoja
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
- Department of Life Technologies, University of Turku, Finland
| | - Sara H. Windahl
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
| | - Göran Andersson
- Karolinska Institutet, Department of Laboratory Medicine - Division of Pathology, Huddinge, Sweden
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14
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Amarnath SS, Kumar V, Das SL. Classification of Osteoporosis. Indian J Orthop 2023; 57:49-54. [PMID: 38107823 PMCID: PMC10721754 DOI: 10.1007/s43465-023-01058-3] [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: 11/08/2023] [Accepted: 11/12/2023] [Indexed: 12/19/2023]
Abstract
Osteoporosis is defined by low bone quality, strength and increased fracture risk. Primary and secondary osteoporosis are the two forms of osteoporosis classified on the basis of factors affecting the metabolism of bone. Primary osteoporosis develops as a result of aging or menopause-related bone demineralization. Type I/postmenopausal and type II/senile osteoporosis are two subtypes of primary osteoporosis. Secondary osteoporosis is due to pathological conditions and medications other than aging and menopause that lead to deprivation of bone mass and elevated fracture risk. Classification of osteoporosis based on BMD testing with DEXA devised by the World Health Organization utilizes T-score in BMD reporting of women in menopausal transition or postmenopause and men ≥ 50 years. Z-scores are preferred, while BMD reporting in premenopausal women, adults < 50 years of age, and children. BMD alone is not diagnostic of osteoporosis in men < 50 years. The Fracture Risk Assessment Tool Model (FRAX) is a software algorithm that incorporates significant predictors of fracture risk and BMD in individuals to predict the risk of fracture. FRAX predicts the "10-year probability of a major fracture (hip, clinical spine, humerus, or wrist fracture) and the 10-year probability of a hip fracture".
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Affiliation(s)
- S. S. Amarnath
- Trauma and Orthopedic Surgeon, Trinity Central Hospital, Bangalore, India
| | - Vishal Kumar
- Department of Orthopedics, PGIMER, Chandigarh, India
| | - S. Lakshmana Das
- Department of Orthopedics, All India Institute of Medical Sciences, Bathinda, India
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15
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Kemp TD, Besler BA, Gabel L, Boyd SK. Predicting Bone Adaptation in Astronauts during and after Spaceflight. Life (Basel) 2023; 13:2183. [PMID: 38004323 PMCID: PMC10672697 DOI: 10.3390/life13112183] [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: 10/10/2023] [Revised: 10/27/2023] [Accepted: 11/03/2023] [Indexed: 11/26/2023] Open
Abstract
A method was previously developed to identify participant-specific parameters in a model of trabecular bone adaptation from longitudinal computed tomography (CT) imaging. In this study, we use these numerical methods to estimate changes in astronaut bone health during the distinct phases of spaceflight and recovery on Earth. Astronauts (N = 16) received high-resolution peripheral quantitative CT (HR-pQCT) scans of their distal tibia prior to launch (L), upon their return from an approximately six-month stay on the international space station (R+0), and after six (R+6) and 12 (R+12) months of recovery. To model trabecular bone adaptation, we determined participant-specific parameters at each time interval and estimated their bone structure at R+0, R+6, and R+12. To assess the fit of our model to this population, we compared static and dynamic bone morphometry as well as the Dice coefficient and symmetric distance at each measurement. In general, modeled and observed static morphometry were highly correlated (R2> 0.94) and statistically different (p < 0.0001) but with errors close to HR-pQCT precision limits. Dynamic morphometry, which captures rates of bone adaptation, was poorly estimated by our model (p < 0.0001). The Dice coefficient and symmetric distance indicated a reasonable local fit between observed and predicted bone volumes. This work applies a general and versatile computational framework to test bone adaptation models. Future work can explore and test increasingly sophisticated models (e.g., those including load or physiological factors) on a participant-specific basis.
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Affiliation(s)
- Tannis D. Kemp
- Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Bryce A. Besler
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Leigh Gabel
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
| | - Steven K. Boyd
- Department of Mechanical and Manufacturing Engineering, Schulich School of Engineering, University of Calgary, Calgary, AB T2N 1N4, Canada
- McCaig Institute for Bone and Joint Health, University of Calgary, Calgary, AB T2N 4Z6, Canada
- Department of Radiology, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 4Z6, Canada
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16
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Ha P, Kwak JH, Zhang Y, Shi J, Tran L, Liu TP, Pan HC, Lee S, Kim JK, Chen E, Shirazi-Fard Y, Stodieck LS, Lin A, Zheng Z, Dong SN, Zhang X, Wu BM, Ting K, Soo C. Bisphosphonate conjugation enhances the bone-specificity of NELL-1-based systemic therapy for spaceflight-induced bone loss in mice. NPJ Microgravity 2023; 9:75. [PMID: 37723136 PMCID: PMC10507033 DOI: 10.1038/s41526-023-00319-7] [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: 04/18/2022] [Accepted: 08/18/2023] [Indexed: 09/20/2023] Open
Abstract
Microgravity-induced bone loss results in a 1% bone mineral density loss monthly and can be a mission critical factor in long-duration spaceflight. Biomolecular therapies with dual osteogenic and anti-resorptive functions are promising for treating extreme osteoporosis. We previously confirmed that NELL-like molecule-1 (NELL-1) is crucial for bone density maintenance. We further PEGylated NELL-1 (NELL-polyethylene glycol, or NELL-PEG) to increase systemic delivery half-life from 5.5 to 15.5 h. In this study, we used a bio-inert bisphosphonate (BP) moiety to chemically engineer NELL-PEG into BP-NELL-PEG and specifically target bone tissues. We found conjugation with BP improved hydroxyapatite (HA) binding and protein stability of NELL-PEG while preserving NELL-1's osteogenicity in vitro. Furthermore, BP-NELL-PEG showed superior in vivo bone specificity without observable pathology in liver, spleen, lungs, brain, heart, muscles, or ovaries of mice. Finally, we tested BP-NELL-PEG through spaceflight exposure onboard the International Space Station (ISS) at maximal animal capacity (n = 40) in a long-term (9 week) osteoporosis therapeutic study and found that BP-NELL-PEG significantly increased bone formation in flight and ground control mice without obvious adverse health effects. Our results highlight BP-NELL-PEG as a promising therapeutic to mitigate extreme bone loss from long-duration microgravity exposure and musculoskeletal degeneration on Earth, especially when resistance training is not possible due to incapacity (e.g., bone fracture, stroke).
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Affiliation(s)
- Pin Ha
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jin Hee Kwak
- Herman Ostrow School of Dentistry, University of Southern California, Los Angeles, CA, 90089, USA
| | - Yulong Zhang
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Forsyth Institute, Cambridge, MA, 02142, USA
| | - Jiayu Shi
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Luan Tran
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Timothy Pan Liu
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Hsin-Chuan Pan
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Samantha Lee
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Jong Kil Kim
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Eric Chen
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Yasaman Shirazi-Fard
- Space Biosciences Division, NASA Ames Research Center, Moffett Field, CA, 94035, USA
| | - Louis S Stodieck
- BioServe Space Technologies and Aerospace Engineering Sciences, University of Colorado, Boulder, CO, 80303, USA
| | - Andy Lin
- Office of Advanced Research Computing, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Zhong Zheng
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Stella Nuo Dong
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Xinli Zhang
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA
| | - Benjamin M Wu
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
- Forsyth Institute, Cambridge, MA, 02142, USA.
- School of Dentistry, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
| | - Kang Ting
- Forsyth Institute, Cambridge, MA, 02142, USA.
| | - Chia Soo
- Division of Plastic and Reconstructive Surgery, Department of Surgery, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Orthopaedic Surgery and the Orthopaedic Hospital Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
- Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, Los Angeles, CA, 90095, USA.
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17
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Patel A, Allbritton-King JD, Paul S, Bhattacharyya T. Bone health is improving over time: data from Framingham cohorts. Arch Osteoporos 2023; 18:119. [PMID: 37715080 DOI: 10.1007/s11657-023-01327-6] [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: 02/14/2023] [Accepted: 09/01/2023] [Indexed: 09/17/2023]
Abstract
Hip fractures have steadily declined in the USA. We found that bone health, as measured by bone mineral density, has significantly improved over the past 30 years. Our findings contradict previous studies and offer one explanation for the decline in hip fractures. PURPOSE Despite the widespread undertreatment of osteoporosis, hip fractures have been declining in the USA. The reasons for this decline are unclear; however, one possible explanation could be that the bone health has improved over time. METHODS To determine the trends in bone density in the USA, we analyzed the bone mineral density scans of 7216 subjects across three generations in the Framingham Heart Study. We compared the mean femoral bone mineral density (BMD) between cohorts then constructed a linear regression model controlling for age, sex, BMI, and smoking rates. RESULTS We observed that the mean BMD of each successive Framingham cohort increased (p < 0.001). After controlling for age, subjects born later had higher BMD. The results from the linear-regression model developed on the original cohort indicated that the BMD of the women from the offspring and third generation were higher than what would be predicted. Younger generations demonstrated higher activity scores (p < 0.001), and lower smoking rates (p = 0.045). CONCLUSION These data suggest that bone health, measured by bone mineral density scans, is improving in later generations, in part due to decreased smoking rates and higher rates of activity.
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Affiliation(s)
- Amit Patel
- Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA
| | - Jules D Allbritton-King
- Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA
- Harvard-MIT Division of Health Sciences and Technology, Harvard Medical School, Boston, USA
| | - Subrata Paul
- NIAID Collaborative Bioinformatics Resource, National Institute of Allergy and Infectious Diseases, Maryland, USA
| | - Timothy Bhattacharyya
- Clinical and Investigative Orthopedics Surgery Unit, National Institute of Arthritis and Musculoskeletal and Skin Diseases, National Institutes of Health, 10 Center Drive, Bldg. 10-CRC, Room 4-2339, MSC1498, Bethesda, MD, 20892, USA.
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18
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Choi JY, Yang YM. Analysis of the association between osteoporosis and muscle strength in Korean adults: a national cross-sectional study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2023; 42:97. [PMID: 37700322 PMCID: PMC10498644 DOI: 10.1186/s41043-023-00443-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
BACKGROUND This study aimed to examine the associations between osteoporosis and hand grip strength (HGS), a surrogate marker of muscular strength, among Korean adults stratified by body mass index (BMI), age, and renal function. METHODS This study was conducted using the data obtained from the Korea National Health and Nutrition Examination Survey 2015-2019, a cross-sectional and nationally representative survey performed by the Korea Centers for Diseases Control and Prevention. RESULTS Of the 26,855 subjects included in this study, those with low muscle strength (LMS) and normal muscle strength were showed in 4,135 (15.4%) and 22,720 (84.6%) subjects, respectively. The osteoporotic subjects had a higher prevalence rate for LMS than those without osteoporosis after adjusting for age [odds ratio (OR), 1.684; 95% confidence interval (CI), 1.500-1.890). The subjects with osteoporosis and BMI < 18.5 kg/m2 also had a higher prevalence rate for LMS after adjusting for age compared to those with non-osteoporosis and BMI < 18.5 kg/m2 (OR, 1.872; 95% CI, 1.043-3.359). Compared to the non-osteoporotic subjects with estimated glomerular filtration rate (eGFR) ≥ 60 mL/min/1.73 m2, those with osteoporosis and eGFR ≥ 60 mL/min/1.73 m2 had a higher prevalence rate for LMS after controlling for age and sex (OR, 1.630; 95% CI, 1.427-1.862). CONCLUSIONS The results showed that osteoporosis was likely to contribute to an increased prevalence rate of LMS in terms of HGS. Aging, BMI, and renal function also had significant effects on the association between osteoporosis and LMS. This association is likely to assist in developing better strategies to estimate bone health in clinical or public health practice.
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Affiliation(s)
- Ji-Young Choi
- Department of Food and Nutrition, College of Natural Science and Public Health and Safety, Chosun University, Gwangju, Republic of Korea
| | - Young-Mo Yang
- Department of Pharmacy, College of Pharmacy, Chosun University, 309 Pilmun-daero, Dong-gu, Gwangju, 61452, Republic of Korea.
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Peel A, Jesudason D, Martin S, Wittert G. Association of alcohol and bone mineral density dependent on type of alcohol consumed. J Bone Miner Metab 2023; 41:702-713. [PMID: 37410200 DOI: 10.1007/s00774-023-01450-x] [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: 12/07/2022] [Accepted: 06/05/2023] [Indexed: 07/07/2023]
Abstract
INTRODUCTION Osteoporosis prevalence will increase in coming decades, with significant financial and economic implications. Whilst alcohol excess has significant detrimental impacts on bone mineral density (BMD), knowledge of low-volume consumption is inconsistent. Type of alcohol may mediate impact on BMD and warrants further investigation. MATERIALS AND METHODS Participants were drawn from the Florey Adelaide Male Aging Study, a cohort of community dwelling men from Adelaide, Australia (n = 1195). The final cohort (n = 693) provided information regarding alcohol consumption and undertook BMD scan at wave one (2002-2005) and wave two (2007-2010). Cross-sectional and longitudinal multivariable regression was performed for whole-body and spine BMD. To assess change in exposure over time, change in BMD was compared to change in covariates between waves. RESULTS Cross-sectionally, whole-body BMD was positively associated with obesity (p < 0.001), exercise (p = 0.009), prior smoking (p = 0.001), oestrogen concentration (p = 0.001), rheumatoid arthritis (p = 0.013) and grip strength (p < 0.001). No association was identified with volume of differing types of alcohol consumed. Spinal BMD was inversely associated with low-strength beer consumption (p = 0.003). The volume of alcohol consumed at Wave 1 did not predict change in whole-body or spinal BMD; however, increases in full-strength beer consumption between waves were associated with reduced spinal BMD (p = 0.031). CONCLUSION When consumed at quantities in the usual social range, alcohol was not associated with whole-body BMD. However, low-strength beer consumption was inversely related to spinal BMD.
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Affiliation(s)
- Andrew Peel
- Freemasons Foundation Centre for Men's Health, South Australia Health Medical Research Institute and University of Adelaide, Level 6 University of Adelaide Medical School, North Terrace, Adelaide, 5000, Australia.
| | - David Jesudason
- Queen Elizabeth Hospital, Woodville, South Australia, Australia
| | - Sean Martin
- Australian Institute of Family Studies, Melbourne, Australia
| | - Gary Wittert
- Freemasons Foundation Centre for Men's Health, South Australia Health Medical Research Institute and University of Adelaide, Level 6 University of Adelaide Medical School, North Terrace, Adelaide, 5000, Australia
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20
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Zhou T, Wang J, Li Y, Lu Y, Liu J, Hong J, Quan M, Wang D, Chen P. Association between walking speed and calcaneus stiffness index in older adults. J Bone Miner Metab 2023; 41:693-701. [PMID: 37351651 DOI: 10.1007/s00774-023-01447-6] [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: 04/24/2023] [Accepted: 06/04/2023] [Indexed: 06/24/2023]
Abstract
INTRODUCTION The aim here is to examine the association between objectively measured usual walking speed (UWS) and bone status in community-dwelling older Chinese. MATERIALS AND METHODS This is a cross-sectional study of a population of 1528 adults (817 females, mean age 68.5 ± 5.3; 711 males, mean age 69.1 ± 5.2) aged 60-79, living in communities in Shanghai. Walking speed was assessed using a 4-m walk test at a usual-pace walking speed a walking speed at which the subject felt relaxed-and bone status measured by quantitative ultrasound (QUS). The health-related characteristics of participants include family background, physical activity level, chronic disease, smoking and alcohol consumption, frequency of falls, vitamin intake, and hormone therapy. RESULTS Multiple linear regression is used to analyses any association between UWS and bone status, adjusting for confounding factors showing a significant association between faster UWS and a higher calcaneal stiffness index (SI) (p < 0.01). Comparing the lowest quartile of the data set with the highest at UWS, a high SI is achieved with 5.34 (95% CI = 3.22, 7.46) (p < 0.01), after adjusting for confounders. An increase of 1 dm/s was associated with a 0.91 (95% CI = 0.53, 1.29) increase in SI. This relationship for most subgroups is consistent. CONCLUSION Our findings suggest that UWS can be a sensitive indicator of calcaneal bone loss among an older population.
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Affiliation(s)
- Tang Zhou
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Jingjing Wang
- Shanghai Research Institute of Sports Science, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
- Shanghai Anti-Doping Agency, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
| | - Yiyan Li
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Yanhua Lu
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Jiajia Liu
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China
| | - Jintao Hong
- Shanghai Research Institute of Sports Science, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
- Shanghai Anti-Doping Agency, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China
| | - Minghui Quan
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China.
- Shanghai Frontiers Science Research Base of Exercise and Metabolic Health, Shanghai University of Sport, Shanghai, 200438, China.
| | - Dao Wang
- Shanghai Research Institute of Sports Science, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China.
- Shanghai Anti-Doping Agency, 87 Wuxing Road, Xuhui District, Shanghai, 200030, China.
| | - Peijie Chen
- School of Exercise and Health, Shanghai University of Sport, 399 Changhai Road, Yangpu District, Shanghai, 200438, China.
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21
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Saleh A, Shibli F, El Masri J, Mouslem H, Odeh M, Fawaz H, Almealawy YF, Bdair A, Ghazi M, Alnajjar AH, Elzayat MA, Salameh P. Osteoporosis and vitamin D consumption: knowledge and practice in different Arab countries. Arch Osteoporos 2023; 18:85. [PMID: 37341798 DOI: 10.1007/s11657-023-01298-8] [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: 04/01/2023] [Accepted: 06/06/2023] [Indexed: 06/22/2023]
Abstract
Despite the high prevalence of osteoporosis and vitamin D deficiency, the knowledge about osteoporosis and vitamin D-related practices were moderate in some countries in the Middle East and North Africa (MENA) region. Improving knowledge through awareness campaign and screening programs is essential to enhance vitamin D-related practices. PURPOSE Osteoporosis is the most common skeletal disease, which usually remains silent until fractures occur. Vitamin D deficiency impairs bone mineralization and increases the risk of osteoporosis. Despite being relatively sunny, the Middle East and North Africa (MENA) region has a high prevalence of osteoporosis and hypovitaminosis D. This study aims to assess the knowledge about osteoporosis and vitamin D-related practices and to determine the correlation between them in some countries of the MENA region. METHODS A cross-sectional study was performed in Lebanon, Syria, Egypt, Palestine, Iraq, Jordan, and Saudi Arabia. From each country, 600 participants were enrolled. The survey included four sections: sociodemographic information, past medical history, Osteoporosis Knowledge Assessment Tool to assess the knowledge about osteoporosis, and Practice Towards Vitamin D scale to assess vitamin D-related practices. RESULTS Our study found that 67.14% of respondents had moderate knowledge about osteoporosis and 42.31% had moderate vitamin D-related practices. Higher knowledge level was reported in the young, females, Syrians, singles, postgraduates, and healthcare employees (p < 0.05). Better vitamin D-related practices were detected in the elderly, males, Egyptians, married, and high school or below educational level (p < 0.05). The Internet was the most listed source of information. Adequate osteoporosis knowledge was associated with better vitamin D-related practices (p < 0.001). CONCLUSION Most participants, representing some countries of the MENA region, displayed moderate knowledge regarding osteoporosis and moderate vitamin D-related practices. Adequate knowledge about osteoporosis is essential to improve practices, so awareness campaigns and screening programs should be more frequently implemented.
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Affiliation(s)
- Aalaa Saleh
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon.
| | - Farah Shibli
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
| | - Jad El Masri
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
- Faculty of Medicine, Neuroscience Research Center, Lebanese University, Beirut, Lebanon
- iNSPECT-LB (Intitut National de Santé Publique, Epidémiologie Clinique Et Toxicologie-Liban), Beirut, Lebanon
| | - Hadi Mouslem
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
| | - Mahmoud Odeh
- School of Medicine, University of Jordan, Amman, Jordan
| | - Hassan Fawaz
- Faculty of Medicine, Damascus University, Damascus, Syria
| | | | - Amjad Bdair
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Maya Ghazi
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
| | - Anas H Alnajjar
- College of Medicine, Sulaiman Alrajhi University, Al Bukayriyah, Saudi Arabia
| | | | - Pascale Salameh
- Faculty of Medical Sciences, Lebanese University, Hadath Campus, Beirut, Lebanon
- iNSPECT-LB (Intitut National de Santé Publique, Epidémiologie Clinique Et Toxicologie-Liban), Beirut, Lebanon
- Faculty of Pharmacy, Lebanese University, Beirut, Lebanon
- University of Nicosia Medical School, Nicosia, Cyprus
- School of Medicine, Byblos, Lebanon
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22
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Khandelwal S, Lane NE. Osteoporosis: Review of Etiology, Mechanisms, and Approach to Management in the Aging Population. Endocrinol Metab Clin North Am 2023; 52:259-275. [PMID: 36948779 DOI: 10.1016/j.ecl.2022.10.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Abstract
Osteoporosis is the most common metabolic bone disease. With special respect to the aging population, it is very common, not only due to changes in lifestyle and diet but as a result of the aging process there is low-grade inflammation and immune system activation that directly affects bone strength and quality. This article provides a review of the incidence, etiology, and approach to screening and management of osteoporosis in the aging population. A thorough screening of lifestyle, environmental, and clinical conditions will be reviewed which identifies appropriate candidates for screening and treatment.
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Affiliation(s)
- Sonali Khandelwal
- Rush University Medical Center, 1611 West Harrison Suite 510, Chicago, IL 60612, USA.
| | - Nancy E Lane
- University of California at Davis School of Medicine
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23
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Schömig F, Becker L, Schönnagel L, Völker A, Disch AC, Schnake KJ, Pumberger M. Avoiding Spinal Implant Failures in Osteoporotic Patients: A Narrative Review. Global Spine J 2023; 13:52S-58S. [PMID: 37084355 PMCID: PMC10177307 DOI: 10.1177/21925682231159066] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
Abstract
STUDY DESIGN Narrative review. OBJECTIVES With an aging population, the prevalence of osteoporosis is continuously rising. As osseous integrity is crucial for bony fusion and implant stability, previous studies have shown osteoporosis to be associated with an increased risk for implant failure and higher reoperation rates after spine surgery. Thus, our review's purpose was to provide an update of evidence-based solutions in the surgical treatment of osteoporosis patients. METHODS We summarize the existing literature regarding changes associated with decreased bone mineral density (BMD) and resulting biomechanical implications for the spine as well as multidisciplinary treatment strategies to avoid implant failures in osteoporotic patients. RESULTS Osteoporosis is caused by an uncoupling of the bone remodeling cycle based on an unbalancing of bone resorption and formation and resulting reduced BMD. The reduction in trabecular structure, increased porosity of cancellous bone and decreased cross-linking between trabeculae cause a higher risk of complications after spinal implant-based surgeries. Thus, patients with osteoporosis require special planning considerations, including adequate preoperative evaluation and optimization. Surgical strategies aim towards maximizing screw pull-out strength, toggle resistance, as well as primary and secondary construct stability. CONCLUSIONS As osteoporosis plays a crucial role in the fate of patients undergoing spine surgery, surgeons need to be aware of the specific implications of low BMD. While there still is no consensus on the best course of treatment, multidisciplinary preoperative assessment and adherence to specific surgical principles help reduce the rate of implant-related complications.
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Affiliation(s)
- Friederike Schömig
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Luis Becker
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lukas Schönnagel
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Völker
- Department of Orthopaedic, Trauma and Plastic Surgery, University Hospital Leipzig, Leipzig, Germany
| | - Alexander C Disch
- University Comprehensive Spine Center, University Center for Orthopedics, Traumatology and Plastic Surgery, Universitätsklinikum Carl Gustav Carus, Dresden, Germany
| | - Klaus John Schnake
- Center for Spinal and Scoliosis Surgery, Malteser Waldkrankenhaus St Marien gGmbH, Erlangen, Germany
- Department of Orthopedics and Traumatology, Paracelsus Private Medical University Nuremberg, Nuremberg, Germany
| | - Matthias Pumberger
- Center for Musculoskeletal Surgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
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24
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Torimitsu S, Nishida Y, Yajima D, Inokuchi G, Makino Y, Motomura A, Chiba F, Yamaguchi R, Hoshioka Y, Iwase H. Statistical analysis of biomechanical properties and size of the sternum and its fracture risk in a Japanese sample. Leg Med (Tokyo) 2023; 62:102242. [PMID: 36924618 DOI: 10.1016/j.legalmed.2023.102242] [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: 01/10/2023] [Revised: 02/07/2023] [Accepted: 03/08/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVE Sternal fractures can have life-threatening complications. To understand chest injury mechanisms, sufficient data regarding the mechanical properties and structure of the sternum are required. The aim of this study was to examine the mechanical properties and size of the sternum in a Japanese forensic sample. MATERIALS AND METHODS Sterna were obtained from 120 Japanese dead bodies of known age and sex. The sample thickness (ST) and the sample width (SW) were measured using a computed tomographic image. Three-point-bending tests were conducted using a three-point-bending apparatus to assess the fracture load (FL) of the sample. Then, the flexural strength (FS) was calculated and the natural logarithm of FL (ln FL) and FS (ln FS) were also calculated. RESULTS The values of ST, ln FL, and ln FS for male samples were significantly greater than those for female samples. Both ln FL and ln FS had significant negative correlations with age regardless of sex; the Pearson product-moment correlation coefficients were larger for female samples than for male samples. Although age was significantly negatively correlated with SW in female samples, there was no significant correlation between age and SW in male samples. No significant correlations were found between age and ST regardless of sex. CONCLUSION This is the first study to present quantitative data on the biomechanical properties of the sternum. Because of the smaller sternal strength of elderly women, it is especially important for them to avoid the risk of sternal fractures.
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Affiliation(s)
- Suguru Torimitsu
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Yoshifumi Nishida
- Department of Mechanical Engineering, Tokyo Institute of Technology, 2-12-1, O-okayama, Meguro-ku, Tokyo 152-8552, Japan.
| | - Daisuke Yajima
- Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
| | - Go Inokuchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Yohsuke Makino
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Ayumi Motomura
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan; Department of Forensic Medicine, School of Medicine, International University of Health and Welfare, 4-3, Kozunomori, Narita, Chiba 286-8686, Japan.
| | - Fumiko Chiba
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Rutsuko Yamaguchi
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Yumi Hoshioka
- Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
| | - Hirotaro Iwase
- Department of Forensic Medicine, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo 113-0033, Japan; Education and Research Center of Legal Medicine, Graduate School of Medicine, Chiba University, 1-8-1, Inohana, Chuo-ku, Chiba 260-8670, Japan.
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25
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Thompson AR, Joyce M, Stratton K, Orwoll ES, Carlson HL, Carlson NL, Marshall LM. Lifetime Smoking History and Prevalence of Osteoporosis and Low Bone Density in U.S. Adults, National Health and Nutrition Examination Survey 2005-2010. J Womens Health (Larchmt) 2023; 32:323-331. [PMID: 36399604 DOI: 10.1089/jwh.2022.0153] [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] [Indexed: 11/19/2022] Open
Abstract
Background: Osteoporosis is common among older adults. Women are more likely to have osteoporosis than men. The prevalence varies with race/ethnicity, with the highest prevalence observed among non-Hispanic, Asian women. Prior studies identified a negative association between smoking and bone mineral density (BMD). The association between smoking and osteoporosis has not been investigated according to race/ethnicity. Materials and Methods: We included 4,226 U.S. adults aged 50 years or older with complete information on smoking history, BMD, and other independent variables from the 2005-2010 National Health and Nutrition Examination Surveys. Design-based multinomial logistic regression was utilized to estimate prevalence odds ratios (POR) of osteoporosis (T-score ≤ -2.5) and of low bone density (T-score between -1.0 and -2.5) in relation to lifetime smoking pack-years, stratified by sex and race/ethnicity. Results: Participants were 61.5 (standard error 0.21) years old on average and 48% women (n = 2,027). Among women, a smoking history ≥30 pack-years was positively associated with osteoporosis (POR: 2.40; 95% confidence interval [CI]: 1.42-4.06). Similar POR were observed among non-Hispanic White, non-Hispanic Black, and Mexican American women. However, POR for ≥30 pack-years and low bone density were positive but not statistically significant. Among men, null associations of smoking history, osteoporosis, and low bone density were observed, except for a positive association of ≥30 pack-years and low bone density among non-Hispanic Black men. Conclusion: Osteoporosis was twice as prevalent among women who smoked ≥30 pack-years than among women who never smoked, regardless of race/ethnicity. Smoking history and osteoporosis were not associated among men.
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Affiliation(s)
- Austin R Thompson
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon, USA.,Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA
| | - Molly Joyce
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon, USA
| | - Kalera Stratton
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon, USA
| | - Eric S Orwoll
- Division of Endocrinology, Diabetes, and Clinical Nutrition, Department of Medicine, Oregon Health & Science University, Portland, Oregon, USA
| | - Hans L Carlson
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA
| | - Nels L Carlson
- Department of Orthopaedics and Rehabilitation, Oregon Health & Science University, Portland, Oregon, USA
| | - Lynn M Marshall
- School of Public Health, Oregon Health & Science University-Portland State University, Portland, Oregon, USA
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Bandyopadhyay K, Ray S, Shikha D, Bhalla GS, Khetan A. Risk factors of osteoporosis in soldiers of the Armed Forces: A cross-sectional study from Western India. Med J Armed Forces India 2023; 79:194-200. [PMID: 36969126 PMCID: PMC10037050 DOI: 10.1016/j.mjafi.2021.04.008] [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: 10/28/2020] [Accepted: 04/15/2021] [Indexed: 11/20/2022] Open
Abstract
Background Osteoporosis may result from risk factors such as smoking, alcohol, low body mass index, less physical exercise, and dietary calcium deficiency. The risk of osteoporosis fractures can be reduced with lifestyle changes, which include diet, exercise, and preventing falls. The present study is an effort to measure the burden of risk factors of osteoporosis in adult male soldiers in the Armed Forces. Methods The present study was a cross-sectional study among serving soldiers in South-Western part of India, and 400 participants consented to be included in the study. After obtaining informed consent, the questionnaire was distributed. Venous blood samples were collected to measure serum calcium, phosphorus, vitamin D, and parathyroid hormone (PTH). Results The prevalence of vitamin D3 severe deficiency (<10 ng/mL) was 38.5%, and the prevalence of vitamin D3 deficiency (10-19 ng/mL) was 33%. Low serum calcium (<8.4 mg/dL) and serum phosphorus (<2.5 mg/dL) were found among 19.5% and 11.5%, respectively, whereas a raised serum PTH level (>66.5 pg/mL) was seen in 5.5% of the participants. A statistically significant association was found between consumption of milk and milk products and levels of calcium. With a cutoff value of 20 ng/mL for vitamin D3 deficiency, a statistically significant association was found for consumption of fish, physical activity, and sun exposure. Conclusion A remarkably large percentage of otherwise normal healthy soldiers have deficiency or insufficiency of vitamin D and might be prone to osteoporosis. Despite significant advances in our understanding and management options for male osteoporosis, there still remain important gaps in knowledge which needs to be looked into.
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Affiliation(s)
| | - Sougat Ray
- SSO (Health), HQ Western Naval Command, Mumbai, India
| | - Deep Shikha
- Graded Specialist (Surgery), Military Hospital Bhathinda, Punjab, India
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27
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Damani JJ, De Souza MJ, Strock NCA, Koltun KJ, Williams NI, Weaver C, Rogers CJ. Associations Between Inflammatory Mediators and Bone Outcomes in Postmenopausal Women: A Cross-Sectional Analysis of Baseline Data from the Prune Study. J Inflamm Res 2023; 16:639-663. [PMID: 36814438 PMCID: PMC9939790 DOI: 10.2147/jir.s397837] [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: 11/16/2022] [Accepted: 01/27/2023] [Indexed: 02/17/2023] Open
Abstract
Purpose Hypoestrogenism triggers increased production of inflammatory mediators, which contribute to bone loss during postmenopausal osteoporosis. This study aimed to investigate the association between circulating inflammatory markers and bone outcomes in postmenopausal women. Materials and methods We conducted a cross-sectional, secondary analysis of baseline data from participants who completed a 12-month randomized controlled trial, The Prune Study (NCT02822378), which included healthy postmenopausal women (n=183, 55-75 years old) with bone mineral density (BMD) T-score between 0.0 and -3.0 at any site. BMD was measured using dual-energy X-ray absorptiometry, and bone geometry and strength were measured using peripheral quantitative computed tomography. Blood was collected at baseline to measure (1) serum biomarkers of bone turnover, including procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide and (2) inflammatory markers, including serum high-sensitivity C-reactive protein (hs-CRP) and plasma pro-inflammatory cytokines, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, IL-8, and monocyte chemoattractant protein (MCP)-1, using enzyme-linked immunosorbent assay. The associations between bone and inflammatory outcomes at baseline were analyzed using correlation and regression analyses. Results Serum hs-CRP negatively correlated with P1NP (r=-0.197, p=0.042). Plasma IL-1β, IL-6, IL-8, and TNF-α negatively correlated with trabecular bone score at the lumbar spine (all p<0.05). In normal-weight women, plasma IL-1β, IL-6, and IL-8 negatively correlated (p<0.05) with trabecular and cortical bone area, content, and density at various sites in the tibia and radius. Serum hs-CRP positively predicted lumbar spine BMD (β=0.078, p=0.028). Plasma IL-6 negatively predicted BMD at the total body (β=-0.131, p=0.027) and lumbar spine (β=-0.151, p=0.036), whereas plasma TNF-α negatively predicted total hip BMD (β=-0.114, p=0.028). Conclusion At baseline, inflammatory markers were inversely associated with various estimates of bone density, geometry, and strength in postmenopausal women. These findings suggest that inflammatory markers may be an important mediator for postmenopausal bone loss.
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Affiliation(s)
- Janhavi J Damani
- The Intercollege Graduate Degree Program in Integrative and Biomedical Physiology, Huck Institutes of the Life Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Mary Jane De Souza
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Nicole C A Strock
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Kristen J Koltun
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA,Department of Sports Medicine and Nutrition, University of Pittsburgh, Pittsburgh, PA, USA
| | - Nancy I Williams
- Department of Kinesiology, The Pennsylvania State University, University Park, PA, USA
| | - Connie Weaver
- Department of Exercise and Nutritional Sciences, San Diego State University, San Diego, CA, USA
| | - Connie J Rogers
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA,Center for Molecular Immunology and Infectious Disease, The Pennsylvania State University, University Park, PA, USA,Department of Nutritional Sciences, University of Georgia, Athens, GA, USA,Correspondence: Connie J Rogers, 280 Dawson Hall, University of Georgia, Athens, GA, 30602, USA, Tel +1 706-542-4869, Email
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28
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Davenport A. Differences in prevalence of reduced and low bone mineral density between lumbar spine and femoral neck in peritoneal dialysis patients using dual-energy X-ray absorptiometry (DXA). ARCH ESP UROL 2023:8968608221146867. [PMID: 36627766 DOI: 10.1177/08968608221146867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The pattern of chronic kidney disease-mineral bone disease has changed following the increase in elderly patients receiving dialysis, with escalating likelihood of osteoporosis, with associated increased fracture risk and mortality. Thus, we wished to determine the prevalence of osteoporosis in our peritoneal dialysis (PD) cohort. Lumbar spine (LS) and femoral neck (FN) bone mineral density (BMD) measured by dual-energy X-ray absorptiometry (DXA), and low BMD (osteoporosis) and reduced BMD (osteopenia) defined according to the World Health Organisation T scores. DXA scans from 734 patients, 57.2% male, mean age 61.0 ±16.0 years, 34.6% diabetic, with a median 8.0 (2-24) months of treatment with PD were reviewed. Fewer patients had normal BMD at the FN vs. LS (24.1 vs. 55%), and more classified as reduced (FN 55.9 vs. 34% LS) and low BMD (FN 17 vs. 11% LS), χ 2 112.2, p < 0.001. Agreement between FN and LS T scores was r = 0.36 with Spearman rank correlation, and 0.34 by Kendall's tau b, Cohen's kappa score 0.17, and Bland-Altman bias -0.37 (95% limits of agreement -1.8 to 1.08). The prevalence of reduced and low BMD was much greater when using FN T scores compared to LS, with LS T scores a mean of 0.34 higher than FN. DXA scanning at the LS can be affected by overlying vascular calcification and electron densities in the bowel, and as such we suggest that FN T scores are used to report BMD in PD patients.
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Affiliation(s)
- Andrew Davenport
- UCL Department of Renal Medicine, Royal Free Hospital, University College London Medical School, UK
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Ó Breasail M, Pearse C, Zengin A, Jarjou L, Cooper C, Ebeling PR, Prentice A, Ward KA. Longitudinal Change in Bone Density, Geometry, and Estimated Bone Strength in Older Men and Women From The Gambia: Findings From the Gambian Bone and Muscle Aging Study (GamBAS). J Bone Miner Res 2023; 38:48-58. [PMID: 36270918 PMCID: PMC10098512 DOI: 10.1002/jbmr.4727] [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: 03/22/2022] [Revised: 10/03/2022] [Accepted: 10/19/2022] [Indexed: 01/10/2023]
Abstract
Musculoskeletal aging in the most resource-limited countries has not been quantified, and longitudinal data are urgently needed to inform policy. The aim of this prospective study was to describe musculoskeletal aging in Gambian adults. A total of 488 participants were recruited stratified by sex and 5-year age band (aged 40 years and older); 386 attended follow-up 1.7 years later. Outcomes were dual-energy X-ray absorptiometry (DXA) (n = 383) total hip areal bone mineral density (aBMD), bone mineral content (BMC), bone area (BA); peripheral quantitative computed tomography (pQCT) diaphyseal and epiphyseal radius and tibia (n = 313) total volumetric BMD (vBMD), trabecular vBMD, estimated bone strength indices (BSIc), cross-sectional area (CSA), BMC, and cortical vBMD. Mean annualized percentage change in bone outcomes was assessed in 10-year age bands and linear trends for age assessed. Bone turnover markers, parathyroid hormone (PTH), and 25-hydroxyvitamin D (25(OH)D) were explored as predictors of change in bone. Bone loss was observed at all sites, with an annual loss of total hip aBMD of 1.2% in women after age 50 years and in men at age 70 years plus. Greater loss in vBMD and BSIc was found at the radius in both men and women; strength was reduced by 4% per year in women and 3% per year in men (p trend 0.02, 0.03, respectively). At cortical sites, reductions in BMC, CSA, and vBMD were observed, being greatest in BMC in women, between 1.4% and 2.0% per annum. Higher CTX and PINP predicted greater loss of trabecular vBMD in women and BMC in men at the radius, and higher 25(OH)D with less loss of tibial trabecular vBMD and CSA in women. The magnitude of bone loss was like those reported in countries where fragility fracture rates are much higher. Given the predicted rise in fracture rates in resource-poor countries such as The Gambia, these data provide important insights into musculoskeletal health in this population. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Mícheál Ó Breasail
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- MRC Nutrition and Bone Health Research Group, University of Cambridge, Cambridge, UK
| | - Camille Pearse
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Ayse Zengin
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash Medical Centre, Monash University, Clayton, Australia
| | - Landing Jarjou
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash Medical Centre, Monash University, Clayton, Australia
| | - Ann Prentice
- MRC Nutrition and Bone Health Research Group, University of Cambridge, Cambridge, UK
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
| | - Kate A Ward
- MRC Nutrition and Bone Health Research Group, University of Cambridge, Cambridge, UK
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, UK
- MRC Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, Gambia
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30
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Wang D, Yang Y. The Relationship Between Serum 25-Hydroxyvitamin D Levels and Osteoporosis in Postmenopausal Women. Clin Interv Aging 2023; 18:619-627. [PMID: 37096217 PMCID: PMC10122466 DOI: 10.2147/cia.s405317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 04/07/2023] [Indexed: 04/26/2023] Open
Abstract
Background Vitamin D status is indicated by serum 25-hydroxyvitamin D [25(OH)D] levels, and the positive effects of high levels of vitamin D on bone mineral density (BMD) have not been ascertained. Therefore, we performed a study to analyze the association between serum 25(OH)D levels and osteoporosis in postmenopausal women. Methods We conducted a cross-sectional study using data from the National Health and Nutrition Examination Survey (NHANES). Multiple logistic regression was used to explore the relationship between serum 25(OH)D and osteoporosis of total femur, femoral neck and lumbar spine, with stratified analyses for age (<65 and ≥65 years), BMI (<25, 25 to <30, ≥30 kg/m2) and survey months (winter months and summer months). Results In total, 2058 participants were enrolled in our study. In the fully adjusted model, compared with serum 25(OH)D levels <50 nmol/L, the odds ratios (ORs) and 95% confidence intervals (CIs) of serum 25(OH)D 50-<75 nmol/L and ≥75 nmol/L were 0.274 (0.138, 0.544) and 0.374 (0.202, 0.693) in osteoporosis of total femur, 0.537 (0.328, 0.879) and 0.583 (0.331, 1.026) in osteoporosis of femoral neck, and 0.614 (0.357, 1.055) and 0.627 (0.368, 1.067) in osteoporosis of lumbar spine, respectively. The protective effect of high 25(OH)D was observed at all three skeletal sites in those ≥65 years of age, whereas it was observed only in the total femur in those <65 years of age. Conclusion In conclusion, adequate vitamin D may reduce the risk of osteoporosis in postmenopausal women in the United States, especially in those aged 65 years and older. More attention should be given to serum 25 (OH) D levels to prevent osteoporosis.
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Affiliation(s)
- Dongmei Wang
- Department of Radiology, Shanghai Municipal Hospital of Traditional Chinese Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, People’s Republic of China
| | - Yimei Yang
- Department of Obstetrics and Gynecology, Affiliated Hospital of Nantong University, Nantong, People’s Republic of China
- Correspondence: Yimei Yang, Affiliated Hospital of Nantong University, #20 Xisi Road, Nantong, 226001, People’s Republic of China, Email
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31
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The Impact of Osteoporosis on 2-Year Outcomes in Patients Undergoing Long Cervical Fusion. J Am Acad Orthop Surg 2023; 31:e44-e50. [PMID: 36548156 DOI: 10.5435/jaaos-d-22-00361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 09/04/2022] [Indexed: 12/24/2022] Open
Abstract
INTRODUCTION Osteoporosis affects nearly 200 million individuals worldwide. Given this notable disease burden, there have been increased efforts to investigate complications in patients with osteoporosis undergoing cervical fusion (CF). However, there are limited data regarding long-term outcomes in osteoporotic patients in the setting of ≥4-level cervical fusion. METHODS The New York State Statewide Planning and Research Cooperative System database was used to identify patients who underwent posterior or combined anterior-posterior ≥4-level CF for cervical radiculopathy or myelopathy from 2009 to 2011, with a minimum follow-up surveillance of 2 years. The following were compared between patients with and without osteoporosis: demographics, hospital-related parameters, medical/surgical complications, readmissions, and revisions. Binary multivariate stepwise logistic regression was used to identify independent predictors of outcomes. RESULTS A total of 2,604 patients were included (osteoporosis: n = 136 (5.2%); nonosteoporosis: n = 2,468). Patients with osteoporosis were older (66.9 ± 11.2 vs. 60.0 ± 11.4 years, P < 0.001), more often female (75.7% vs. 36.2%, P < 0.001), and White (80.0% vs. 65.3%, P = 0.007). Both cohorts had comparable comorbidity burdens (Charlson/Deyo: 1.1 ± 1.2 vs. 1.0 ± 1.3, P = 0.262), total hospital charges ($100,953 ± 94,933 vs. $91,618 ± 78,327, P = 0.181), and length of stay (9.7 ± 10.4 vs. 8.4 ± 9.6 days, P = 0.109). Patients with osteoporosis incurred higher rates of overall medical complication rates (41.9% vs. 29.4%, P = 0.002) and individual surgical complications, such as nonunion (2.9% vs. 0.7%, P = 0.006). Osteoporosis was associated with medical complications (OR = 1.57, P = 0.021), surgical complications (OR = 1.52, P = 0.030), and readmissions (OR = 1.86, P = 0.003) at 2 years. DISCUSSION Among patients who underwent multilevel cervical fusion, those with osteoporosis had higher risk of adverse postoperative outcomes at two years. These data indicate that preoperative screening and management of osteoporosis may be important for optimizing long-term outcomes in patients who require multilevel CF. DATA AVAILABILITY AND TRIAL REGISTRATION NUMBERS The data used in this study are available for public use at https://www.health.ny.gov/statistics/sparcs/.
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Cumulative Burden of Being Underweight Increases the Risk of Hip Fracture: A Nationwide Population-Based Cohort Study. Healthcare (Basel) 2022; 10:healthcare10122568. [PMID: 36554091 PMCID: PMC9778138 DOI: 10.3390/healthcare10122568] [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] [Received: 11/23/2022] [Revised: 12/09/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
(1) Background: Being underweight is a known risk factor for hip fractures. However, it is unclear whether the cumulative underweight burden affects the incidence of hip fractures. Therefore, we explored the effect of the cumulative underweight burden on the development of hip fractures; (2) Methods: In a cohort of adults aged 40 years and older, 561,779 participants who were not underweight and had no hip fractures from 2007 to 2009 were identified. The risk of hip fracture from the time of the last examination to December 2018 according to the cumulative burden of being underweight (based on 0 to 3 examinations) was prospectively analyzed; (3) Results: During follow-up (mean 8.3 ± 0.8 years), the prevalence of newly diagnosed hip fractures was 0.2%, 0.4%, 0.5%, and 0.9% among those with 0, 1, 2, and 3 cumulative underweight, respectively. The adjusted hazard ratios (HRs) with 95% confidence intervals (CIs) of groups meeting the diagnostic criteria for underweight 1, 2, and 3 compared to 0 were 2.3 (1.6−3.3), 2.9 (1.8−4.5), and 4.5 (3.4−6.1), respectively (p for trend < 0.01); (4) Conclusions: The risk of hip fracture increased as the burden of underweight accumulated.
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Clements M, Heffernan M, Ward M, Hoey L, Doherty LC, Hack Mendes R, Clarke MM, Hughes CF, Love I, Murphy S, McDermott E, Grehan J, McCann A, McAnena LB, Strain JJ, Brennan L, McNulty H. A 2-Year Randomized Controlled Trial With Low-Dose B-Vitamin Supplementation Shows Benefits on Bone Mineral Density in Adults With Lower B12 Status. J Bone Miner Res 2022; 37:2443-2455. [PMID: 36128889 PMCID: PMC10092614 DOI: 10.1002/jbmr.4709] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 01/19/2023]
Abstract
Folate, vitamins B12, B6, and riboflavin are required for one-carbon metabolism and may affect bone health, but no previous randomized trial has investigated all four nutrients in this context. We investigated the effect of low-dose B-vitamins for 2 years on bone mineral density (BMD) in a dual-centered, 2-year randomized controlled trial (RCT) in adults aged ≥50 years. Eligible participants not consuming B-vitamin supplements or fortified foods >4 times weekly were randomized to receive daily either combined folic acid (200 μg), vitamin B12 (10 μg), vitamin B6 (10 mg), and riboflavin (5 mg), or "active" placebo, whereby both the intervention and placebo groups received vitamin D (10 μg). BMD was assessed before and after intervention using dual-energy X-ray absorptiometry (DXA) scanning of the total hip, femoral neck, and lumbar spine (L1 to L4). Of 205 eligible participants randomized, 167 completed the trial in full. B-vitamin intervention resulted in increases in serum folate (p < 0.001), serum B12 (p < 0.001), and plasma pyridoxal-5-phosphate (p < 0.001) and decreases in functional biomarkers of B-vitamin status, erythrocyte glutathione reductase activation coefficient (p < 0.001), serum methylmalonic acid (MMA; p < 0.001), and serum total homocysteine (p < 0.001). B-vitamin intervention had no overall effect on BMD, which declined in both treatment groups by approximately 1% (ranging from -0.7% to -1.4%). However, in participants with lower baseline B12 status (serum B12 <246 pmol/L or MMA ≥0.22 μmol/L), B-vitamin intervention reduced the 2-year BMD decline versus placebo: adjusted mean (95% confidence interval [CI]) change of -0.003 (-0.008, 0.002) versus -0.015 (-0.021, -0.010) g/cm2 at the total hip and -0.004 (-0.010, 0.001) versus -0.013 (-0.018, -0.007) g/cm2 at the femoral neck. In conclusion, the findings indicate that although low-dose B-vitamin intervention for 2 years had no overall effect on BMD, improving B-vitamin status appears to have specific benefits for bone health in adults with lower B12 status. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Michelle Clements
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Maria Heffernan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Mary Ward
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leane Hoey
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Leanne C Doherty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Roberta Hack Mendes
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Michelle M Clarke
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Catherine F Hughes
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Ingrid Love
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Shauna Murphy
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Eilish McDermott
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | - Jennifer Grehan
- Section of Radiography and Diagnostic Imaging, School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Liadhan B McAnena
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - J J Strain
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
| | - Lorraine Brennan
- UCD School of Agriculture and Food Science, Institute of Food and Health, Conway Institute, University College Dublin, Dublin, Ireland
| | - Helene McNulty
- Nutrition Innovation Centre for Food and Health (NICHE), School of Biomedical Sciences, Ulster University, Coleraine, Northern Ireland, UK
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Lee SW, Han K, Kwon HS. Weight change and the risk of hip fractures in patients with type 2 diabetes: a nationwide cohort study. Osteoporos Int 2022; 33:1755-1767. [PMID: 35438308 DOI: 10.1007/s00198-022-06398-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 04/04/2022] [Indexed: 01/18/2023]
Abstract
UNLABELLED Both weight gain and weight loss in type 2 diabetic population were associated with increased risk of hip fracture, while maintaining weight lowered the risk of hip fracture. Regarding the risk of hip fracture, we can propose active monitoring to maintain the weight of type 2 diabetes patients. INTRODUCTION In type 2 diabetes, patients are often asked to control their weight in order to reduce their diabetic morbidity. The American Diabetes Association recommends that diabetic patients conduct high-intensity interventions for regulating diet, physical activity, and behavior to reduce weight, followed by long-term comprehensive weight maintenance programs. Although such weight control attempts are required in diabetic patients, there are few studies on the effect of weight change on hip fracture in this population. We aim to investigate the association between body weight change and the incidence of hip fracture in subjects with type 2 diabetes using large-scale, nationwide cohort data on the Korean population. MATERIALS AND METHODS A total of 1,447,579 subjects (894,204 men and 553,375 women) > 40 years of age, who were diagnosed with type 2 diabetes, were enrolled in this study. Weight change within 2 years was divided into five categories: from weight loss ≥ 10% to weight gain ≥ 10%. The hazard ratios (HRs) and 95% confidence intervals for the incidence of hip fracture were analyzed, compared with the reference of the stable weight group (weight change < 5%). RESULTS Among 5 weight change groups, more than 10% weight loss showed the highest HR (HR, 1.605; 95% CI, 1.493 to 1.725), followed by more than 10% weight gain (HR, 1.457; 95% CI, 1.318 to 1.612). The effect of weight change on hip fracture risk was greater in males than in females, and those under 65 years of age were greater than those over 65 years of age. Baseline BMI did not play a role of weight change affecting the risk of hip fracture. The HR for hip fracture of subjects with regular exercise was lower than those without regular exercise. CONCLUSIONS In the type 2 diabetes population, both weight gain and weight loss were significantly associated with a higher risk of hip fracture, whereas maintaining body weight reduced the risk of hip fracture the most.
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Affiliation(s)
- S-W Lee
- Department of Orthopaedic Surgery, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Department of Orthopaedic Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - K Han
- Department of Statistics and Actuarial Science, Soongsil University, 369, Sangdo-ro, Dongjak-gu, 06978, Seoul, Republic of Korea.
| | - H-S Kwon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 10, Yuksam-ro, Youngdeungpo-gu, 07345, Seoul, Republic of Korea.
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Buettmann EG, Goldscheitter GM, Hoppock GA, Friedman MA, Suva LJ, Donahue HJ. Similarities Between Disuse and Age-Induced Bone Loss. J Bone Miner Res 2022; 37:1417-1434. [PMID: 35773785 PMCID: PMC9378610 DOI: 10.1002/jbmr.4643] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/17/2022] [Accepted: 06/24/2022] [Indexed: 11/07/2022]
Abstract
Disuse and aging are known risk factors associated with low bone mass and quality deterioration, resulting in increased fracture risk. Indeed, current and emerging evidence implicate a large number of shared skeletal manifestations between disuse and aging scenarios. This review provides a detailed overview of current preclinical models of musculoskeletal disuse and the clinical scenarios they seek to recapitulate. We also explore and summarize the major similarities between bone loss after extreme disuse and advanced aging at multiple length scales, including at the organ/tissue, cellular, and molecular level. Specifically, shared structural and material alterations of bone loss are presented between disuse and aging, including preferential loss of bone at cancellous sites, cortical thinning, and loss of bone strength due to enhanced fragility. At the cellular level bone loss is accompanied, during disuse and aging, by increased bone resorption, decreased formation, and enhanced adipogenesis due to altered gap junction intercellular communication, WNT/β-catenin and RANKL/OPG signaling. Major differences between extreme short-term disuse and aging are discussed, including anatomical specificity, differences in bone turnover rates, periosteal modeling, and the influence of subject sex and genetic variability. The examination also identifies potential shared mechanisms underlying bone loss in aging and disuse that warrant further study such as collagen cross-linking, advanced glycation end products/receptor for advanced glycation end products (AGE-RAGE) signaling, reactive oxygen species (ROS) and nuclear factor κB (NF-κB) signaling, cellular senescence, and altered lacunar-canalicular connectivity (mechanosensation). Understanding the shared structural alterations, changes in bone cell function, and molecular mechanisms common to both extreme disuse and aging are paramount to discovering therapies to combat both age-related and disuse-induced osteoporosis. © 2022 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Evan G Buettmann
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Galen M Goldscheitter
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Gabriel A Hoppock
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael A Friedman
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
| | - Larry J Suva
- Department of Veterinary Physiology and Pharmacology, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX, USA
| | - Henry J Donahue
- Department of Biomedical Engineering, Virginia Commonwealth University, Richmond, VA, USA
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Clark BE, Pope L, Belarmino EH. Perspectives from healthcare professionals on the nutritional adequacy of plant-based dairy alternatives: results of a mixed methods inquiry. BMC Nutr 2022; 8:46. [PMID: 35550654 PMCID: PMC9097167 DOI: 10.1186/s40795-022-00542-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 05/04/2022] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND Healthcare professionals are important sources of nutrition and health information for Americans. As plant-based (PB) dairy alternative products increase in popularity, concerns have been raised about their nutritional adequacy, and whether consumers understand nutritional differences to dairy. Healthcare professionals directly advise consumers on dietary choices, therefore we sought to examine their understanding and opinions of PB dairy alternatives. METHODS We analyzed comments submitted to the U.S. Food and Drug Administration (FDA) by health professionals (n = 191) in 2018-2019 in response to a request for public comment on the nutrition of PB dairy alternatives and the use of dairy terms like "milk", "cheese", and "yogurt" on their labels. Survey data from healthcare professionals (n = 417) was collected in 2020-2021. Comments and survey responses to open-ended questions were coded using template analysis and thematically analyzed. Logistic regression models examined perceptions across health professional characteristics for close-ended survey responses. RESULTS Three-fourths of health professionals believe consumers are confused about the nutritional differences between dairy and PB dairy alternatives. Over half (53%) do not believe either product is nutritionally superior to the other. Many believe dairy products have higher nutrient value, but also believe PB dairy alternatives can be part of a healthful diet. Compared to other types of health professionals, dietetics professionals demonstrated a more accurate understanding of the nutritional value of both products and were more likely to believe nutrients like protein (OR 2.02; 95% CI 1.22-3.34, p = 0.006) and vitamin D (OR 2.46; 95% CI 1.48-4.09, p = 0.001) may be nutrients of concern for PB dairy alternative consumers. They were also more likely to believe consumers are confused about these products (OR 3.44; 95% CI 1.65-7.21; p = 0.001). Health professionals who submitted comments to the FDA showed stronger opinions in favor of PB dairy alternatives. CONCLUSIONS Although PB dairy alternatives have nutritional value in certain diets, responses from health professionals suggest that changing their labeling to be different than dairy may reduce confusion. Improved nutrition education among health professionals may also be necessary.
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Affiliation(s)
- Bridget E Clark
- Department of Nutrition and Food Sciences, University of Vermont, 256 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405-0086, USA
| | - Lizzy Pope
- Department of Nutrition and Food Sciences, University of Vermont, 256 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405-0086, USA
| | - Emily H Belarmino
- Department of Nutrition and Food Sciences, University of Vermont, 256 Carrigan Wing, 109 Carrigan Drive, Burlington, VT, 05405-0086, USA.
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Osteoporosis knowledge and health beliefs among middle-aged men and women in the Southern United States. J Osteopath Med 2022; 122:453-459. [DOI: 10.1515/jom-2022-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 04/08/2022] [Indexed: 11/15/2022]
Abstract
Abstract
Context
The most common skeletal disease, osteoporosis, causes bone fragility due to decreased bone mass and bone microarchitecture destruction. The health belief model is often applied to asymptomatic, prevention-related diseases such as osteoporosis. Steps to mitigate the insidious nature of osteoporosis, including education, motivation, and monitoring of bone mineral density, must begin at an earlier age.
Objectives
This study evaluates the knowledge and health beliefs surrounding osteoporosis in a population of males and females 35–50 years old to determine sex-based differences in osteoporosis knowledge and beliefs and to assess the correlation between perceptions and health motivation.
Methods
Participants (81 males, 92 females) completed two questionnaires: the Osteoporosis Knowledge Test and the Osteoporosis Health Belief Scale. Descriptive statistics were performed along with Pearson product-moment correlation analysis to determine the relationships between the variables. Sex-based differences were calculated utilizing independent t-tests.
Results
We discovered a statistically significant negative correlation between the barriers to exercise and health motivation (−0.434, p < 0.001) and a statistically significant positive correlation between the benefits of exercise and health motivation (0.385, p < 0.001). However, there was not a statistically significant correlation between health motivation with the following: the benefits of calcium, susceptibility, and the seriousness of osteoporosis. Between males and females, there was a statistically significant difference in exercise and calcium knowledge, susceptibility, and the benefits of both exercise and calcium (p < 0.05).
Conclusions
Males and females 35–50 years old perceive themselves to have a low susceptibility to osteoporosis. They do not consider osteoporosis a serious disease and have little motivation to mitigate its inception or progression. Their perceptions show that barriers to exercise impact health motivation more than the perceived benefits of exercise.
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Lee J, Han K, Park SH, Kim MK, Lim DJ, Yoon KH, Kang MI, Lee SH. Associations of variability in body weight and glucose levels with the risk of hip fracture in people with diabetes. Metabolism 2022; 129:155135. [PMID: 35032546 DOI: 10.1016/j.metabol.2022.155135] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2021] [Accepted: 01/06/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Diabetes is associated with a high risk of fragility fracture. However, there are controversies regarding the effect of fluctuations in metabolic parameters on the risk of fracture. We aimed to investigate the associations of body weight or glucose variability or their combination with the risk of hip fracture in people with diabetes. METHODS A population-based cohort study with 480,539 subjects over 40 years who had undergone three or more health examinations was performed. The degree of variability was evaluated using variability independent of the mean (VIM, 100 × standard deviation / meanbeta), coefficient of variation (CV), and average real variability (ARV, average of the absolute differences between consecutive values). High variability was defined as having values in the highest quartile. Cox proportional hazards models were used to estimate the risk of hip fracture. RESULTS There were 2834 hip fracture events (0.59%) during the mean follow-up of 8.1 years. After multivariable adjustment for age, sex, alcohol consumption, smoking, regular exercise, income, glucose, body mass index, hemoglobin, estimated glomerular filtration rate, diabetes duration, diabetes treatment with multiple agents, and osteoporosis, the HRs (95% CI) of hip fracture were 1.36 (1.24-1.50) and 1.29 (1.16-1.43) for high body weight VIM and high glucose VIM, respectively. The HR (95% CI) of both high VIM group was 1.63 (1.44-1.83), suggesting an additive effect of variabilities in body weight and glucose. The results were consistent when using CV and ARV and in various sensitivity analyses. CONCLUSIONS High variability in body weight and glucose levels is associated with an increased incidence rate and risk of hip fracture in people with diabetes.
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Affiliation(s)
- Jeongmin Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Eunpyeong St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 03312, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul 06978, Republic of Korea
| | - Sang Hyun Park
- Department of Medical Statistics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Mee Kyoung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 07345, Republic of Korea
| | - Dong-Jun Lim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Kun-Ho Yoon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Moo-Il Kang
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea
| | - Seung-Hwan Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea; Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul 06591, Republic of Korea.
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Tozzi R, Masi D, Cipriani F, Contini S, Gangitano E, Spoltore ME, Barchetta I, Basciani S, Watanabe M, Baldini E, Ulisse S, Lubrano C, Gnessi L, Mariani S. Circulating SIRT1 and Sclerostin Correlates with Bone Status in Young Women with Different Degrees of Adiposity. Nutrients 2022; 14:nu14050983. [PMID: 35267956 PMCID: PMC8912833 DOI: 10.3390/nu14050983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/22/2022] [Accepted: 02/23/2022] [Indexed: 11/28/2022] Open
Abstract
Sirtuin1 (SIRT1) and sclerostin play important roles in adipose tissue and bone metabolism. We evaluated the circulating SIRT1 and sclerostin relationship with mass and quality of bone while considering the degree of adiposity. Sixty-six premenopausal women (16 underweight, 25 normal weight and 25 with obesity), aged <50 years, were enrolled. Plasma SIRT1, sclerostin and DXA body composition (total fat mass (FM), abdominal visceral adipose tissue, lean mass, trabecular bone score (TBS) and lumbar spine and femoral neck (FN) bone mineral density (BMD)) were assessed. The patients with obesity showed the lowest SIRT1 and TBS values and the highest sclerostin concentrations; BMD increased with FM and BMI and had an inverse association with SIRT1. Sclerostin was negatively correlated with SIRT1 (ρ = −0.37, p = 0.002). When spine BMD, FN BMD and TBS were standardized for BMI, a positive correlation with SIRT1 and a negative correlation with sclerostin were seen (p < 0.005). In the regression analysis, sclerostin was the best independent, negative predictor for BMD and TBS, while SIRT1 directly predicted TBS (p < 0.05). In conclusion, blood measurement of SIRT1 and sclerostin could represent a snapshot of the bone status that, taking into account the degree of adiposity, may reduce the interference of confounding factors in the interpretation of bone health parameters.
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Affiliation(s)
- Rossella Tozzi
- Department of Molecular Medicine, “Sapienza” University of Rome, 00161 Rome, Italy;
| | - Davide Masi
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Fiammetta Cipriani
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Savina Contini
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Elena Gangitano
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Maria Elena Spoltore
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Ilaria Barchetta
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Sabrina Basciani
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Mikiko Watanabe
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Enke Baldini
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.U.)
| | - Salvatore Ulisse
- Department of Surgical Sciences, “Sapienza” University of Rome, 00161 Rome, Italy; (E.B.); (S.U.)
| | - Carla Lubrano
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Lucio Gnessi
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
| | - Stefania Mariani
- Department of Experimental Medicine, Section of Medical Physiopathology, Food Science and Endocrinology, “Sapienza” University of Rome, 00161 Rome, Italy; (D.M.); (F.C.); (S.C.); (E.G.); (M.E.S.); (I.B.); (S.B.); (M.W.); (C.L.); (L.G.)
- Correspondence: ; Tel.: +39-06499-70721; Fax: +39-06446-1450
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Bristow SM, Bolland MJ, Gamble GD, Leung W, Reid IR. Dietary calcium intake and change in bone mineral density in older adults: a systematic review of longitudinal cohort studies. Eur J Clin Nutr 2022; 76:196-205. [PMID: 34131304 DOI: 10.1038/s41430-021-00957-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Accepted: 05/28/2021] [Indexed: 02/05/2023]
Abstract
Many older adults do not achieve recommended intakes of calcium and there is some concern over the potential impact of this on bone health. The objective of this review was to examine evidence from cohort studies on the relationship between calcium intake and change in bone mineral density (BMD) in older adults, something not undertaken in the last two decades. Data sources included Ovid Medline, Embase, and PubMed and references from retrieved reviews and articles. The final search was performed in February 2021. We included cohort studies of calcium intake in participants aged >50 years with change in BMD over ≥1 year as an outcome. We identified 23 studies of women and 7 of men. Most studies found no association between calcium intake and change in BMD in women (71%) or men (71%). Among women, five studies reported high rates (>30% of participants) of hormone treatment or osteoporosis therapy (HT/OT) use; 80% of these studies reported a positive association between calcium intake and change in BMD, compared with 10% of studies in which HT/OT use was low. No study in women in which the mean age was >60 years reported a positive association between calcium intake and change in BMD. We conclude that calcium intake across the ranges consumed in these studies (mean intake in all but one study >500 mg/day) is not an important determinant of bone loss, particularly among women >60 years. The positive findings in studies with high rates of HT/OT use are likely to arise from confounding as a result of co-administration of calcium supplements with these medications.
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Affiliation(s)
- Sarah M Bristow
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Mark J Bolland
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - Greg D Gamble
- Department of Medicine, University of Auckland, Auckland, New Zealand
| | - William Leung
- Department of Medicine, University of Auckland, Auckland, New Zealand.,Department of Public Health, University of Otago, Wellington, New Zealand
| | - Ian R Reid
- Department of Medicine, University of Auckland, Auckland, New Zealand.
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Talevski J, Sanders KM, Watts JJ, Nicholson GC, Seeman E, Iuliano S, Prince R, March L, Winzenberg T, Duque G, Ebeling PR, Borgström F, Kanis JA, Stuart AL, Beauchamp A, Brennan-Olsen SL. Sex differences in recovery of quality of life 12 months post-fracture in community-dwelling older adults: analyses of the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS). Osteoporos Int 2022; 33:67-75. [PMID: 34235548 DOI: 10.1007/s00198-021-06058-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 06/29/2021] [Indexed: 12/21/2022]
Abstract
In this study of 695 Australian older adults (aged ≥50 years), we found that men and women had a similar trajectory of health-related quality of life (HRQoL) recovery following fragility fracture at any skeletal site. These results provide us with critical knowledge that improves our understanding of health outcomes post-fracture. INTRODUCTION Mortality is higher in men than that in women following a fragility fracture, but it is unclear whether recovery of patient-reported outcomes such as health-related quality of life (HRQoL) differs between sexes. This study aimed to identify sex differences in HRQoL recovery 12 months post-fracture. METHODS Data were from the Australian arm of the International Costs and Utilities Related to Osteoporotic Fractures Study (AusICUROS). Participants recruited to AusICUROS were adults aged ≥50 years who sustained a fragility fracture. HRQoL was measured using the EQ-5D-3L at three time-points post-fracture: within 2 weeks (including pre-fracture recall) and at 4 and 12 months. Multivariate logistic regression analyses were undertaken, adjusting for confounders including age, education, income, and healthcare utilization post-fracture. RESULTS Overall, 695 AusICUROS participants (536 women, 77.1%) were eligible for analysis with fractures at the hip (n = 150), distal forearm (n = 261), vertebrae (n = 61), humerus (n = 52), and other skeletal sites (n = 171). At the time of fracture, men were younger, reported a higher income, and were more likely to be employed, compared with women. For all fracture sites combined, there were no differences between men and women in recovery to pre-fracture HRQoL at 12-month follow-up (adjusted OR = 1.09; 95% CI: 0.75-1.61). When stratified by fracture site, no significant sex differences were seen for hip (OR = 1.02; 95% CI: 0.42-2.52), distal forearm (OR = 1.60; 95% CI: 0.68-3.78), vertebral (OR = 2.28; 95% CI: 0.61-8.48), humeral (OR = 1.62; 95% CI: 0.16-9.99), and other fractures (OR = 1.00; 95% CI: 0.44-2.26). CONCLUSION Community-dwelling men and women who survived the 12 months following fragility fracture had a similar trajectory of HRQoL recovery at any skeletal site.
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Affiliation(s)
- J Talevski
- Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia.
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia.
| | - K M Sanders
- Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
| | - J J Watts
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
| | - G C Nicholson
- Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia
- Rural Clinical School, The University of Queensland, Toowoomba, Australia
| | - E Seeman
- Departments of Endocrinology and Medicine, The University of Melbourne/Austin Health, Heidelberg, Victoria, Australia
- Mary McKillip Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - S Iuliano
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
- Departments of Endocrinology and Medicine, The University of Melbourne/Austin Health, Heidelberg, Victoria, Australia
| | - R Prince
- Department of Endocrinology and Diabetes, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
- Medical School, Sir Charles Gardner Unit, The University Western Australia, Perth, Western Australia, Australia
| | - L March
- Institute of Bone and Joint Research, Royal North Shore Hospital, University of Sydney, Sydney, New South Wales, Australia
| | - T Winzenberg
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - G Duque
- Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia
| | - F Borgström
- Quantify Research, Stockholm, Sweden
- Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institute, Stockholm, Sweden
| | - J A Kanis
- Mary McKillip Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - A L Stuart
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine Deakin University, Geelong, Victoria, Australia
| | - A Beauchamp
- Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
- School of Rural Health, Monash University, Victoria, Australia
| | - S L Brennan-Olsen
- Department of Medicine-Western Health, WCHRE Building, The University of Melbourne, 176 Furlong Road, St Albans, Victoria, VIC, 3021, Australia
- Australian Institute for Musculoskeletal Science (AIMSS), The University of Melbourne and Western Health, Victoria, Australia
- School of Health and Social Development, Deakin University, Geelong, Victoria, Australia
- Institute for Health Transformation, Deakin University, Geelong, Victoria, Australia
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Yoo J, Lee BJ. Anthropometric, biochemical, and nutritional risk factors for osteoporosis in Korean adults based on a large cross-sectional study. PLoS One 2021; 16:e0261361. [PMID: 34898647 PMCID: PMC8668121 DOI: 10.1371/journal.pone.0261361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 11/25/2021] [Indexed: 11/18/2022] Open
Abstract
Background Osteoporosis a common bone disorder characterized by decreases in bone mass, tension, and strength. Although many previous studies worldwide have sought to identify the risk factors for osteoporosis, studies that simultaneously examine a variety of factors, such as biochemical, anthropometric and nutritional components, are very rare. Therefore, the objective of this study was to simultaneously examine the association of osteoporosis with biochemical profiles, anthropometric factors, and nutritional components in a large-scale cross-sectional study. Method This cross-sectional study was based on data from the Korea National Health and Nutrition Examination Survey (KNHANES VI-VII) from 2015 to 2018. Based on data from 16,454 participants, logistic regression was used to examine the association between various parameters in a crude analysis and in models adjusted for confounders. Results In men, osteoporosis was significantly associated with the anthropometric variables height and weight; the biochemical components hemoglobin, hematocrit, urea nitrogen and urine pH and creatinine; and the nutritional components total food intake, energy, water, protein, phosphorus, and kalium. However, these associations disappeared in adjusted model 2. In women, osteoporosis was significantly related to the anthropometric measures height, weight, and systolic blood pressure; the biochemical components hemoglobin, hematocrit and urine pH; and the nutritional components total food intake, water, calcium, phosphorus, and kalium. Most of these associations were maintained in the adjusted models. Conclusion Osteoporosis was linked to various anthropometric, biochemical and urine and nutritional components in Korean women, but the association between osteoporosis and risk factors differed according to sex.
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Affiliation(s)
- Junghun Yoo
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Bum Ju Lee
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
- * E-mail:
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Han SY, Kim YK. Yukmijihwang-Tang Suppresses Receptor Activator of Nuclear Factor Kappa-B Ligand (RANKL)-Induced Osteoclast Differentiation and Prevents Ovariectomy (OVX)-Mediated Bone Loss. Molecules 2021; 26:molecules26247579. [PMID: 34946658 PMCID: PMC8706552 DOI: 10.3390/molecules26247579] [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: 11/30/2021] [Revised: 12/06/2021] [Accepted: 12/10/2021] [Indexed: 11/16/2022] Open
Abstract
Yukmijihwang-tang (YJ) has been used to treat diabetes mellitus, renal disorders, and cognitive impairment in traditional medicine. This study aimed to evaluate the anti-osteoporotic effect of YJ on ovariectomy (OVX)-induced bone loss in a rat and receptor activator of nuclear factor kappa-B ligand (RANKL)-mediated osteoclast differentiation in bone marrow macrophages (BMMs). YJ reduced the formation of tartrate-resistant acid phosphatase (TRAP)-positive multinucleated cells (MNCs) in an osteoclast/osteoblast co-culture system by regulating the ratio of RANKL/osteoprotegerin (OPG) by osteoblasts. Overall, YJ reduced TRAP-positive cell formation and TRAP activity and F-actin ring formation. Analysis of the underlying mechanisms indicated that YJ inhibited the activation of the nuclear factor of activated T cell cytoplasmic 1 (NFATc1) and c-Fos, resulting in the suppression of osteoclast differentiation-related genes such as TRAP, ATPase, H+ transporting, lysosomal 38 kDa, V0 subunit d2, osteoclast-associated receptor, osteoclast-stimulatory transmembrane protein, dendritic cell-specific transmembrane protein, matrix metalloproteinase-9, cathepsin K, and calcitonin receptor. YJ also inhibited the nuclear translocation of NFATc1. Additionally, YJ markedly inhibited RANKL-induced phosphorylation of signaling pathways activated in the early stages of osteoclast differentiation including the p38, JNK, ERK, and NF-κB. Consistent with these in vitro results, the YJ-administered group showed considerably attenuated bone loss in the OVX-mediated rat model. These results provide promising evidence for the potential novel therapeutic application of YJ for bone diseases such as osteoporosis.
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Affiliation(s)
- Sang-Yong Han
- Department of Herbal Medicine, College of Pharmacy, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Korea;
- Wonkwang Oriental Medicines Research Institute, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Korea
| | - Yun-Kyung Kim
- Department of Herbal Medicine, College of Pharmacy, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Korea;
- Wonkwang Oriental Medicines Research Institute, Wonkwang University, 460 Iksandae-ro, Iksan 54538, Korea
- Correspondence: ; Tel.: +82-63-850-6803
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Liu DH, Hsu CY, Wu PC, Chen YC, Chen YY, Chen JF, Yu SF, Cheng TT. Simple Self-Assessment Tool to Predict Osteoporosis in Taiwanese Men. Front Med (Lausanne) 2021; 8:713535. [PMID: 34869412 PMCID: PMC8635042 DOI: 10.3389/fmed.2021.713535] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Although the self-assessment tools for predicting osteoporosis are convenient for clinicians, they are not commonly used among men. We developed the Male Osteoporosis Self-Assessment Tool for Taiwan (MOSTAi) to identify the patients at risk of osteoporosis. Methods: All the participants completed a questionnaire on the clinical risk factors for the fracture risk assessment tool. The risk index was calculated by the multivariate regression model through the item reduction method. The receiver operating characteristic (ROC) curve was used to analyze its sensitivity and specificity, and MOSTAi was developed and validated. Results: A total of 2,290 men participated in the bone mineral density (BMD) survey. We chose a model that considered two variables (age and weight). The area under the curve (AUC) of the model was 0.700. The formula for the MOSTAi index is as follows: 0.3 × (weight in kilograms) - 0.1 × (years). We chose 11 as the appropriate cut-off value for the MOSTAi index to identify the subjects at the risk of osteoporosis. Conclusions: The MOSTAi is a simple, intuitive, and country-specific tool that can predict the risk of osteoporosis in Taiwanese men. Due to different demographic characteristics, each region of the world can develop its own model to identify patients with osteoporosis more effectively.
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Affiliation(s)
- Dung-Huan Liu
- Department of Physical Medicine and Rehabilitation, China Medical University Hospital, Taichung, Taiwan.,Doctoral Degree Program of Biomedical Science and Engineering, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Department of Physical Therapy, Graduate Institute of Rehabilitation Science, China Medical University, Taichung, Taiwan
| | - Chung-Yuan Hsu
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Pei-Ching Wu
- Doctoral Degree Program of Biomedical Science and Engineering, College of Biological Science and Technology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan.,Department of Chinese Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Ying-Chou Chen
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - You-Yin Chen
- Department of Biomedical Engineering, National Yang Ming Chiao Tung University, Taipei, Taiwan.,The Ph.D. Program for Neural Regenerative Medicine, College of Medical Science and Technology, Taipei Medical University, Taipei, Taiwan
| | - Jia-Feng Chen
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Shan-Fu Yu
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Tien-Tsai Cheng
- Division of Rheumatology, Allergy and Immunology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Schwartz AV, Pan Q, Aroda VR, Crandall JP, Kriska A, Piromalli C, Wallia A, Temprosa M, Florez H. Long-term effects of lifestyle and metformin interventions in DPP on bone density. Osteoporos Int 2021; 32:2279-2287. [PMID: 34086101 PMCID: PMC10088864 DOI: 10.1007/s00198-021-05989-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 05/03/2021] [Indexed: 12/19/2022]
Abstract
UNLABELLED In the Diabetes Prevention Program Outcome Study (DPPOS), a cohort at high risk of diabetes, randomization to intensive lifestyle intervention or metformin, both associated with weight loss, did not have long-term negative effects on BMD compared with the placebo group. Potential positive effects of metformin on bone warrant further investigation. INTRODUCTION Randomization to lifestyle intervention (ILS) or metformin in the Diabetes Prevention Program (DPP) resulted in weight loss and reduced progression to diabetes. Weight loss is associated with reduced bone mineral density (BMD), but the long-term effects of these interventions on BMD are unknown. In the DPP Outcome Study (DPPOS), we determined if randomization to ILS or metformin, compared with placebo, was associated with differences in BMD approximately 16 years later. METHODS Of 3234 DPP participants, 2779 continued in DPPOS and were offered ILS in group format. Those randomized to metformin were offered unmasked metformin. At DPPOS year 12, 1367 participants had dual-energy X-ray absorptiometry scans. BMD in metformin and ILS groups was compared to placebo using sex-specific linear regression models, adjusted for age, race/ethnicity, and weight and weight-bearing activity at DPP baseline. RESULTS At DPPOS year 12, mean age was 66.5 (±9.5) years. Femoral neck BMD was similar in the ILS and placebo groups in men (difference = -0.021 g/cm2, 95%CI (-0.063, 0.021)) and in women (+0.014 g/cm2, 95%CI (-0.014, 0.042)). Femoral neck BMD was higher in the metformin compared to placebo group although not statistically different in men (+0.017 g/cm2, 95% CI (-0.023, 0.058)) and in women (+0.019 g/cm2, 95% CI (-0.009, 0.047)). Prevalence of osteoporosis was low and similar across treatment groups in men (0.9%; p=0.745) and women (2.4%; p=0.466). CONCLUSION In a cohort at high risk of diabetes, lifestyle intervention or metformin did not appear to have long-term negative effects on BMD. Potential positive effects of metformin on bone warrant further research.
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Affiliation(s)
- A V Schwartz
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
| | - Q Pan
- Department of Statistics and The Biostatistics Center, George Washington University, Washington, D.C., USA
| | - V R Aroda
- MedStar Health Research Institute, Hyattsville, MD, USA
- Brigham Women's Hospital, Boston, MA, USA
| | - J P Crandall
- Albert Einstein College of Medicine, New York City, NY, USA
| | - A Kriska
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - A Wallia
- Division of Endocrinology, Metabolism, and Molecular Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - M Temprosa
- Department of Biostatistics and Bioinformatics and The Biostatistics Center, George Washington University, Washington, D.C., USA
| | - H Florez
- Department of Public Health Sciences and Medicine, University of Miami Miller School of Medicine, Miami, FL, USA
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Bliuc D, Tran T, Adachi JD, Atkins GJ, Berger C, van den Bergh J, Cappai R, Eisman JA, van Geel T, Geusens P, Goltzman D, Hanley DA, Josse R, Kaiser S, Kovacs CS, Langsetmo L, Prior JC, Nguyen TV, Solomon LB, Stapledon C, Center JR. Cognitive decline is associated with an accelerated rate of bone loss and increased fracture risk in women: a prospective study from the Canadian Multicentre Osteoporosis Study. J Bone Miner Res 2021; 36:2106-2115. [PMID: 34289172 DOI: 10.1002/jbmr.4402] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 06/10/2021] [Accepted: 06/22/2021] [Indexed: 01/11/2023]
Abstract
Cognitive decline and osteoporosis often coexist and some evidence suggests a causal link. However, there are no data on the longitudinal relationship between cognitive decline, bone loss and fracture risk, independent of aging. This study aimed to determine the association between: (i) cognitive decline and bone loss; and (ii) clinically significant cognitive decline (≥3 points) on Mini Mental State Examination (MMSE) over the first 5 years and subsequent fracture risk over the following 10 years. A total of 1741 women and 620 men aged ≥65 years from the population-based Canadian Multicentre Osteoporosis Study were followed from 1997 to 2013. Association between cognitive decline and (i) bone loss was estimated using mixed-effects models; and (ii) fracture risk was estimated using adjusted Cox models. Over 95% of participants had normal cognition at baseline (MMSE ≥ 24). The annual % change in MMSE was similar for both genders (women -0.33, interquartile range [IQR] -0.70 to +0.00; and men -0.34, IQR: -0.99 to 0.01). After multivariable adjustment, cognitive decline was associated with bone loss in women (6.5%; 95% confidence interval [CI], 3.2% to 9.9% for each percent decline in MMSE from baseline) but not men. Approximately 13% of participants experienced significant cognitive decline by year 5. In women, fracture risk was increased significantly (multivariable hazard ratio [HR], 1.61; 95% CI, 1.11 to 2.34). There were too few men to analyze. There was a significant association between cognitive decline and both bone loss and fracture risk, independent of aging, in women. Further studies are needed to determine mechanisms that link these common conditions. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Dana Bliuc
- Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.,Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | - Thach Tran
- Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.,Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | | | - Gerald J Atkins
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, Australia
| | - Claudie Berger
- Canadian Multicentre Osteoporosis Study (CaMos) National Coordinating Centre, McGill University, Montreal, QC, Canada
| | - Joop van den Bergh
- Research School Nutrim, Department of Internal Medicine, Subdivision of Rheumatology, Maastricht University Medical Center, Maastricht, The Netherlands.,Department of Internal Medicine, VieCuri Medical Centre of Noord-Limburg, Venlo, The Netherlands
| | - Roberto Cappai
- School of Biomedical Sciences, University of Melbourne, Melbourne, Australia
| | - John A Eisman
- Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.,Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales (UNSW) Sydney, Sydney, Australia.,School of Medicine Sydney, University of Notre Dame Australia, Sydney, Australia
| | - Tineke van Geel
- Department of Data and Analytics, Máxima Medical Center, Veldhoven, The Netherlands
| | - Piet Geusens
- Biomedical Research Institute, University Hasselt, Hasselt, Belgium
| | - David Goltzman
- Department of Medicine, McGill University, Montreal, QC, Canada
| | - David A Hanley
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Robert Josse
- Department of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephanie Kaiser
- Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | | | - Lisa Langsetmo
- School of Public Health, University of Minnesota, Minneapolis, Minnesota, USA
| | - Jerilynn C Prior
- Department of Medicine and Endocrinology, University of British Columbia, Vancouver, BC, Canada
| | - Tuan V Nguyen
- Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.,Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales (UNSW) Sydney, Sydney, Australia
| | - Lucian B Solomon
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, Australia.,Orthopaedic and Trauma Service, Royal Adelaide Hospital, Adelaide, Australia
| | - Catherine Stapledon
- Centre for Orthopaedic and Trauma Research, University of Adelaide, Adelaide, Australia
| | - Jacqueline R Center
- Osteoporosis and Bone Biology, Garvan Institute of Medical Research, Sydney, Australia.,Clinical School, St Vincent's Hospital, Faculty of Medicine, University of New South Wales (UNSW) Sydney, Sydney, Australia
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Yang X, Ye J, Cheng B, Cheng S, Liu L, Meng P, Liang C, Yao Y, Wen Y, Zhang Z, Li C, Zhang H, Chen Y, Zhang J, Pan C, Jia Y, Zhang F. Evaluating the associations of adult heel BMD with birth weight and growth parameters at age 10 in UK Biobank cohort. Bone 2021; 152:116038. [PMID: 34118445 DOI: 10.1016/j.bone.2021.116038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/25/2021] [Accepted: 06/07/2021] [Indexed: 02/06/2023]
Abstract
OBJECTIVE This study was aimed to evaluate the associations of adult heel bone mineral density (BMD) with birth weight and growth parameters at the age of ten years. METHODS The analysis data (97178-178,494 subjects) was derived from the UK Biobank cohort. Birth weight, comparative body size and height size at the age of ten years were determined by self-report. The heel BMD was estimated by the Quantitative Ultrasound Index through the calcaneus. Linear regression analysis was applied to test the associations of adult heel BMD with birth weight and growth parameters at the age of ten years, respectively. Age, sex, body mass index and 10 principle components (PC) of population structure were used as covariates in the regression analysis of total samples. In sex-specific analysis, age, body mass index and 10 PC were used as covariates. RESULTS We observed significant associations of heel BMD with birth weight (b = -0.020, P = 1.974 × 10-13), comparative body size (b = 0.020, P = 2.539 × 10-6) and comparative height size (b = -0.020, P = 5.892 × 10-11) at the age of ten years in total samples. In females, birth weight (b = -0.040, P = 2.870 × 10-24) and comparative height size (b = -0.040, P = 2.034 × 10-20) were statistically associated with adult heel BMD. In males, comparative body size appeared to be associated with adult heel BMD (b = 0.030, P = 1.590 × 10-7). CONCLUSION Our study results support the predictive effects of birth weight and growth parameters at the age of ten years on adult heel BMD. We also observed sex-specific association between adult heel BMD and growth parameters at the age of ten years.
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Affiliation(s)
- Xuena Yang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jing Ye
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Bolun Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Shiqiang Cheng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Li Liu
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Peilin Meng
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chujun Liang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yao Yao
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yan Wen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Zhen Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chun'e Li
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Huijie Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yujing Chen
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Jingxi Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Chuyu Pan
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China
| | - Yumeng Jia
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
| | - Feng Zhang
- Key Laboratory of Trace Elements and Endemic Diseases of National Health and Family Planning Commission, School of Public Health, Health Science Center, Xi'an Jiaotong University, Xi'an, China.
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Lary CW, Rosen CJ, Kiel DP. Osteoporosis and Dementia: Establishing a Link. J Bone Miner Res 2021; 36:2103-2105. [PMID: 34515377 PMCID: PMC8595864 DOI: 10.1002/jbmr.4431] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Accepted: 08/29/2021] [Indexed: 12/17/2022]
Affiliation(s)
| | | | - Douglas P Kiel
- Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Boston, MA, USA.,Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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49
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Noel SE, Santos MP, Wright NC. Racial and Ethnic Disparities in Bone Health and Outcomes in the United States. J Bone Miner Res 2021; 36:1881-1905. [PMID: 34338355 PMCID: PMC8607440 DOI: 10.1002/jbmr.4417] [Citation(s) in RCA: 56] [Impact Index Per Article: 18.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Revised: 07/12/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022]
Abstract
Osteoporosis is a bone disease classified by deterioration of bone microarchitecture and decreased bone strength, thereby increasing subsequent risk of fracture. In the United States, approximately 54 million adults aged 50 years and older have osteoporosis or are at risk due to low bone mass. Osteoporosis has long been viewed as a chronic health condition affecting primarily non-Hispanic white (NHW) women; however, emerging evidence indicates racial and ethnic disparities in bone outcomes and osteoporosis management. The primary objective of this review is to describe disparities in bone mineral density (BMD), prevalence of osteoporosis and fracture, as well as in screening and treatment of osteoporosis among non-Hispanic black (NHB), Hispanic, and Asian adults compared with NHW adults living on the US mainland. The following areas were reviewed: BMD, osteoporosis prevalence, fracture prevalence and incidence, postfracture outcomes, DXA screening, and osteoporosis treatments. Although there are limited studies on bone and fracture outcomes within Asian and Hispanic populations, findings suggest that there are differences in bone outcomes across NHW, NHB, Asian, and Hispanic populations. Further, NHB, Asian, and Hispanic populations may experience suboptimal osteoporosis management and postfracture care, although additional population-based studies are needed. There is also evidence that variation in BMD and osteoporosis exists within major racial and ethnic groups, highlighting the need for research in individual groups by origin or background. Although there is a clear need to prioritize future quantitative and qualitative research in these populations, initial strategies for addressing bone health disparities are discussed. © 2021 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Michelly P Santos
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, MA, USA.,Center for Population Health, University of Massachusetts Lowell, Lowell, MA, USA
| | - Nicole C Wright
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
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50
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Lee EW, Nam JY. Sex Difference in the Socioeconomic Burden of Osteoporosis among South Koreans. Healthcare (Basel) 2021; 9:healthcare9101304. [PMID: 34682984 PMCID: PMC8544502 DOI: 10.3390/healthcare9101304] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Revised: 09/23/2021] [Accepted: 09/27/2021] [Indexed: 01/23/2023] Open
Abstract
Background: The prevalence of osteoporosis is increasing with the aging of the population and the socioeconomic burden. The purpose of this study was to determine the socioeconomic burden of osteoporosis in Korea. Methods: The prevalence of osteoporosis was analyzed using 2017 National Patients Sample and Korea National Health and Nutrition Examination Survey data. Direct costs were divided into healthcare and non-healthcare costs, and indirect costs were calculated by assessing the cost of loss of productivity for labor loss due to disease. Results: The prevalence of osteoporosis diagnosis was 1.91% in total, which was 13 times higher in women than in men (3.57% vs. 0.26%). The socioeconomic cost of osteoporosis was 299.1 million USD based on main diagnosis, and the cost was 13 times higher in women than in men (277.6 vs. 21.5 million USD). The total cost based on main and secondary diagnosis was 981.8 million USD. Similarly, the cost was seven times higher in women than in men (862.4 vs. 119.4 million USD). Conclusions: Osteoporosis increases the socioeconomic burden of disease, and it is significantly higher in women than in men. The policy support for the implementation of prevention and management programs would be necessary to reduce the burden of osteoporosis.
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Affiliation(s)
- Eun-Whan Lee
- Gyeonggi Research Institute, Suwon 16207, Korea;
| | - Jin Young Nam
- Department of Healthcare Management, Eulji University, Seongnam 13135, Korea
- Correspondence: ; Tel.: +82-31-740-7451; Fax: +82-31-741-7172
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