1
|
Lai HL, Chen CI, Lin YC, Lu LC, Huang CY. A path analysis investigation into menopausal osteoporosis, sarcopenia risk, and their impact on sleep quality, depressive symptoms and quality of life. Int J Orthop Trauma Nurs 2024; 52:101080. [PMID: 38218016 DOI: 10.1016/j.ijotn.2023.101080] [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: 09/30/2023] [Revised: 12/17/2023] [Accepted: 12/20/2023] [Indexed: 01/15/2024]
Abstract
PURPOSE The objective was to investigate the relationships among disease characteristics, sarcopenia risk, bone function, sleep quality, depressive symptoms, and health-related quality of life in menopausal women. Additionally, we also examined the potential mediating role of coping in the relationship between these factors and health outcomes for individuals with osteoporosis. METHODS In a cross-sectional approach, 201 participants were referred by a physician from the Family Medicine Department during their outpatient visits at a general hospital in Southern Taiwan. Data collection involved structured one-on-one interviews, and the analysis included descriptive and inferential statistics, along with a structural equation modeling. RESULTS The participants' bone function was strongly positively related to coping, physical and mental quality of life (QOL), and negatively related to sleep quality and depressive symptoms. The duration of osteoporosis was positively related to pain, sarcopenia risk, sleep quality, but negatively related to bone function, physical and mental QOL. This structural framework explains 36% of the variance in depressive symptoms, 25% in sleep disturbances, 54% in mental QOL, and 72% in physical QOL. The best-fit structural equation modeling showed that physical function, exercise, sarcopenia, pain, and coping were significant predictors of depressive symptoms, with coping acting as a mediator in these relationships. CONCLUSION Individuals who employed more active coping strategies exhibited fewer depressive symptoms, better sleep quality, and superior physical and mental QOL. Further, individuals with osteoporosis had lower pain levels, less sarcopenia risk, and higher engaged in exercise presentation improved physical and mental QOL. Future longitudinal research holds the promise of providing deeper insights into these complex relationships.
Collapse
Affiliation(s)
- Hui-Ling Lai
- Nursing Department, Tzu Chi University, Hualien, Taiwan, No.701, Sec.3, Jhongyang Rd., Hualien City, 97004, Taiwan.
| | - Chun-I Chen
- National Chung Cheng University, No.168, Sec. 1, University Rd., Minhsiung, Chiayi, 621301, Taiwan ROC.
| | - Yu-Ching Lin
- Department of Medical, E-Da DaChang Hospital, Kaohsiung, Taiwan; Department of Family Medicine and Physical Examination/ I-Shou University, Taiwan.
| | - Liu-Chun Lu
- E-DA DaChang Hospital, No.305, Dachang 1 Rd., Sanmin District, Kaohsiung City, 80794, Taiwan ROC.
| | - Chiung-Yu Huang
- Nursing Department, I-Shou University, No. 8, Yida Rd., Kaohsiung, 82445, Taiwan.
| |
Collapse
|
2
|
Yamaura R, Kasahara H, Iimuro S, Yamazaki T. The Association between Sleep and Bone Mineral Density: Cross-Sectional Study Using Health Check-up Data in a Local Hospital in Japan. JBMR Plus 2023; 7:e10820. [PMID: 38130763 PMCID: PMC10731111 DOI: 10.1002/jbm4.10820] [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: 04/03/2023] [Revised: 08/16/2023] [Accepted: 08/30/2023] [Indexed: 12/23/2023] Open
Abstract
This study aimed to investigate the association between daily sleep duration of <7 hours and lower bone mineral density (BMD) using data from annual health check-ups conducted in Japan between 2020 and 2022. Multivariate regression models were used, where BMD was the objective variable and daily sleep duration (<5 hours, 5 to <7 hours, 7 to <9 hours [reference], ≥9 hours) was the exposure variable adjusted for age, body mass index, physical activity, smoking status, and alcohol intake for men and women and further adjusted for menopausal status for women. The association between insomnia and BMD was also investigated. BMD was determined using calcaneal quantitative ultrasound and expressed as a percentage of the young adult mean (%YAM). In total, 896 men and 821 women were included. Median age was 54 years (interquartile range [IQR]: 46 to 64) for men and 55 years (IQR: 46 to 64) for women). Median BMD for men and women was 79%YAM (IQR: 71 to 89) and 75%YAM (IQR: 68 to 84), respectively. Approximately 80% of men and women slept <7 hours daily. Multivariate regression showed no association between sleep duration and BMD in men. However, women who slept 5 to <7 hours daily had significantly higher BMD by 3.9% compared with those who slept 7 to<9 hours (p = 0.004). No association between insomnia and BMD was found. Overall, a daily sleep duration of <7 hours was not independently associated with lower BMD compared to those who slept 7 to <9 hours in men and women. However, as there is evidence of both shorter and longer sleep durations being associated with an increased risk of adverse events, including cardiovascular events, our result needs to be interpreted with caution. © 2023 The Authors. JBMR Plus published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Reiko Yamaura
- Graduate School of MedicineInternational University of Health and WelfareTokyoJapan
| | - Hideko Kasahara
- International University of Health and WelfareSchool of MedicineNaritaJapan
| | - Satoshi Iimuro
- Innovation and Research Support CenterInternational University of Health and WelfareTokyoJapan
| | - Tsutomu Yamazaki
- Graduate School of MedicineInternational University of Health and WelfareTokyoJapan
| |
Collapse
|
3
|
Mattei J, Tamez M, O’Neill J, Haneuse S, Mendoza S, Orozco J, Lopez-Cepero A, Ríos-Bedoya CF, Falcón LM, Tucker KL, Rodríguez-Orengo JF. Chronic Diseases and Associated Risk Factors Among Adults in Puerto Rico After Hurricane Maria. JAMA Netw Open 2022; 5:e2139986. [PMID: 35019984 PMCID: PMC8756309 DOI: 10.1001/jamanetworkopen.2021.39986] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
IMPORTANCE As public health emergencies become more prevalent, it is crucial to identify adverse physical and mental health conditions that may be triggered by natural disasters. There is a lack of data on whether Hurricane Maria in 2017 influenced the disease burden of adults in Puerto Rico. OBJECTIVE To estimate the prevalence of chronic diseases and their associated risk factors among adults living in Puerto Rico before and after Hurricane Maria in 2017. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study used data from 2 previous cross-sectional studies, including the pre-Hurricane Maria Puerto Rico Assessment on Diet, Lifestyles and Disease (PRADLAD) study, conducted in 2015, and the post-Hurricane Maria Puerto Rico Observational Study of Psychosocial, Environmental, and Chronic Disease Trends (PROSPECT), conducted in 2019. Participants included adults aged 30 to 75 years residing in Puerto Rico. Data were analyzed from April to October 2020. EXPOSURES Self-reported data were obtained on sociodemographic, lifestyle, and psychosocial factors and medically diagnosed conditions using validated questionnaires. Anthropometrics were measured in triplicate. MAIN OUTCOMES AND MEASURES Data were obtained using similar protocols in both studies. Characteristics were contrasted for all participants across studies and for 87 PRADLAD participants who returned to PROSPECT. RESULTS A total of 825 participants from both cohorts were included, with 380 PRADLAD participants and 532 PROSPECT participants. In the 2019 PROSPECT study, the mean (SD) age was 53.7 (10.8) years, and 363 participants (68.2%) were assigned female at birth and 169 participants (31.8%) were assigned male at birth. In the 2019 cohort, 360 participants (67.7%) had college education or higher, 205 participants (38.5%) reported annual income greater than $20 001, and 263 participants (49.5%) were employed. Most sociodemographic variables were similar between studies, except for higher income and employment after the hurricane. In the main analysis, participants in 2019, compared with participants in 2015, had higher abdominal obesity (389 participants [73.2%] vs 233 participants [61.3%]), sedentarism (236 participants [44.4%] vs 136 participants [35.8%]), binge drinking (95 participants [17.9%] vs 46 participants [12.1%]), and social support (mean [SD] score, 26.9 [7.2] vs 24.7 [7.1]) but lower depressive symptoms (169 participants [31.7%] vs 200 participants [52.6%]) and perceived stress (mean [SD] score, 19.3 [9.5] vs 21.7 [7.7]). In 2019, compared with 2015, there were higher rates of hypertension (252 participants [47.3%] vs 149 participants [39.2%]), arthritis (172 participants [32.3%] vs 97 participants [25.6%]), high cholesterol (194 participants [36.4%] vs 90 participants [23.8%]), high triglycerides (123 participants [23.1%] vs 56 participants [14.7%]), eye disease (94 participants [17.6%] vs 48 participants [12.7%]), fatty liver disease (68 participants [12.8%] vs 29 participants [7.5%]), and osteoporosis (74 participants [13.9%] vs 20 participants [5.2%]). Secondary analysis for the 87 returning participants showed similar results. CONCLUSIONS AND RELEVANCE In this cross-sectional study, a higher prevalence of unhealthy behaviors and chronic conditions was noted among adults in Puerto Rico after Hurricane Maria, warranting long-term studies. Psychosocial factors were better, but still need attention. As natural disasters intensify, efforts should focus on continuous surveillance of health outcomes and promoting healthy behaviors, positive emotional health, and disease control, particularly in populations with higher risk for poor health.
Collapse
Affiliation(s)
- Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Martha Tamez
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - June O’Neill
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Sebastien Haneuse
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | | | | | - Andrea Lopez-Cepero
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Carlos F. Ríos-Bedoya
- FDI Clinical Research of Puerto Rico, San Juan
- McLaren Health Care, Graduate Medical Education, Grand Blanc, Michigan
| | - Luis M. Falcón
- College of Fine Arts, Humanities and Social Sciences, University of Massachusetts, Lowell
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences and Center for Population Health, University of Massachusetts, Lowell
| | - José F. Rodríguez-Orengo
- FDI Clinical Research of Puerto Rico, San Juan
- Department of Biochemistry, University of Puerto Rico Medical Sciences Campus, San Juan
| |
Collapse
|
4
|
Causal Roles of Sleep Duration in Osteoporosis and Cardiometabolic Diseases: A Mendelian Randomization Study. BIOMED RESEARCH INTERNATIONAL 2022; 2022:6819644. [PMID: 36277903 PMCID: PMC9586149 DOI: 10.1155/2022/6819644] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/01/2022] [Accepted: 09/22/2022] [Indexed: 11/17/2022]
Abstract
Sleep duration suggests some association with osteoporosis and cardiometabolic diseases, but it is unknown if these associations are causal or confounded. In this two-sample Mendelian randomization (MR) study, we included the largest genome-wide association studies (GWASs) associated with sleep duration and the outcome measures of osteoporosis and cardiometabolic diseases. Finally, 25 single nucleotide polymorphisms (SNPs) associated with short sleep duration and 7 SNPs associated with long sleep duration obtained the genome-wide significance (P < 5 × 10-8) and were used as instrumental variables. Genetic predisposition to short sleep duration was strongly associated with increased risk of coronary artery disease (beta-estimate: 0.199, 95% confidence interval CI: 0.081 to 0.317, standard error SE:0.060, P value = 0.001) and heart failure (beta-estimate: 0.145, 95% CI: 0.025 to 0.264, SE:0.061, P value = 0.017), which were both confirmed by the sensitivity analyses. Both short and long sleep duration may reduce the estimated bone mineral density (eBMD, beta-estimate: -0.086, 95% CI: -0.141 to -0.031, SE:0.028, P value = 0.002 for short sleep duration; beta-estimate: -0.080, 95% CI: -0.120 to -0.041, SE:0.020, P value < 0.0001 for long sleep duration). There was limited evidence of associations between sleep duration and fracture, type 2 diabetes, atrial fibrillation, fasting glucose, fasting insulin, or HbA1c. This study provides robust evidence that short sleep duration is causally associated with high risk of coronary artery disease and heart failure and suggests that short sleep duration should be avoided to prevent these two cardiovascular diseases. Short and long sleep duration show some MR association with reduced eBMD, which indicates that both short and long sleep duration may be prevented to reduce the incidence of osteoporosis.
Collapse
|
5
|
Pourreza S, Khademi Z, Mirzababaei A, Yekaninejad MS, Sadeghniiat-Haghighi K, Naghshi S, Mirzaei K. Association of plant-based diet index with inflammatory markers and sleep quality in overweight and obese female adults: A cross-sectional study. Int J Clin Pract 2021; 75:e14429. [PMID: 34081826 DOI: 10.1111/ijcp.14429] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 05/18/2021] [Accepted: 05/31/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Inflammation and sleep disturbances increase the risk of multiple diseases, including cardiovascular disease, type 2 diabetes and dementia. Since diet plays a significant role in inflammatory responses and sleep quality, this study aimed to investigate the association of a plant-based diet index (PDI) with sleep quality and inflammatory markers in overweight and obese women. METHODS 390 overweight and obese women aged 18-48 years participated in this cross-sectional study. A validated food frequency questionnaire (FFQ) was used to create an overall PDI, healthful plant-based diet index (hPDI) and unhealthful plant-based diet index (uPDI). Sleep quality was assessed by Pittsburgh Sleep Quality Index (PSQI). Higher scores on the PSQI were indicative of poor sleep. Anthropometric measurements and serum concentrations of high-sensitivity C-reactive protein (hs-CRP), interleukin 1 beta (IL-1β) and transforming growth factor-beta (TGF-β) were evaluated. Linear regression models were used to determine the association between exposure and outcomes. RESULTS After taking potential confounders into account, we found a significant inverse association between adherence to hPDI and hs-CRP (β = -0.14, 95% confidence interval [CI]: -0.22,0.06, P = .001) and a significant positive association between uPDI and hs-CRP (β = 0.13, 95% CI: 0.05,0.21, P = .001). Overall, PDI was significantly associated with TGF-β (β = 2.04, 95% CI: 0.54,3.55, P = .008). No association was detected between PDI indices and IL-1β. Higher adherence to uPDI was significantly associated with higher PSQI score (lower sleep quality) (β= 0.20, 95% CI:0.007,0.40, P = .04). A significant positive association was found between TGF-β (β = 0.05, 95% CI:0.005,0.10, P = .03) and hs-CRP (β = 0.32, 95% CI:0.02,0.62, P = .03) with PSQI. CONCLUSION Our findings indicated a significant association between adherence to a plant-based diet with inflammation and sleep quality in obese and overweight females. WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Sleep is an essential part of life, and sleep quality has a significant impact on individual well-being and performance. There is a bidirectional relationship between disturbed sleep and elevated levels of inflammatory markers. Diet plays a major part in sleep quality and its related health consequences. Plant-based diets are associated with lower risk of chronic diseases such as coronary artery disease (CAD), type 2 diabetes, obesity and reduced level of inflammation. WHAT DOES THIS ARTICLE ADD?: Adherence to a healthful plant-based diet is associated with lower level of hs-CRP, while adherence to an unhealthful plant-based diet is associated with higher concentrations of hs-CRP. Adherence to an unhealthful plant-based diet is associated with lower sleep quality.
Collapse
Affiliation(s)
- Sanaz Pourreza
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Zeinab Khademi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Mir Saeed Yekaninejad
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | | | - Sina Naghshi
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| |
Collapse
|
6
|
Abstract
PURPOSE OF REVIEW This review briefly summarizes the growing body of literature addressing the skeletal consequences of sleep and circadian disruption. RECENT FINDINGS The most recent data in the field suggest that the diurnal variation in bone turnover markers are because of endogenous circadian rhythmicity linked to clock genes in all bone cells; in a small human intervention study, cumulative sleep restriction with concurrent circadian disruption negatively alter bone turnover markers in a way that could explain the lower BMD and increased fracture risk identified in some prior night shift work studies; abnormal sleep duration and obstructive sleep apnea are associated with low BMD and increased fracture risk in some but not all studies. SUMMARY Normal physiology and some animal and human intervention studies suggest that sleep and circadian disruptions, such as night shift work, abnormal sleep durations and obstructive sleep apnea are detrimental to skeletal health. However, additional research in this area is needed to determine which sleep/circadian disturbances are most detrimental to skeletal health, the reversibility of such impairments, and underlying mechanisms.
Collapse
Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Metabolism and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| |
Collapse
|
7
|
A cross-sectional analysis of the association between sleep duration and osteoporosis risk in adults using 2005-2010 NHANES. Sci Rep 2021; 11:9090. [PMID: 33907283 PMCID: PMC8079413 DOI: 10.1038/s41598-021-88739-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 04/13/2021] [Indexed: 11/08/2022] Open
Abstract
Controversy remains regarding the relationship between bone health and sleep. In the literature, the effect of sleep on bone density in the clinical setting varies depending on the definition of normal sleep duration, sleep quality, selected population, and diagnostic tools for bone density. The aim of this study was to examine the association between bone mineral density (BMD)assessed by dual-energy X-ray absorptiometry and sleep duration/quality in the defined adult population from the National Health and Nutrition Examination Survey (NHANES) (a national household survey) within a 6-year period (2005–2010) and explore age differences. The basic variables, metabolic diseases, and bone density in the femoral neck as determined through dual-energy X-ray absorptiometry, were segregated, and analyzed according to different sleep durations (1–4, 5–6,7–8, and > 9 h/day) and sleep quality using multinomial regression models. A total of 12,793 subjects were analyzed. Our results reveal that women aged > 50 years with sleep duration < 5 h/day had a 7.35 (CI 3.438–15.715) odds of osteoporosis than those in other groups. This analysis is based on a nationally representative sample using survey and inspection data and clarifies the relationship between bone density and the effect of the combination of sleep quality and duration.
Collapse
|
8
|
Swanson CM, Blatchford PJ, Stone KL, Cauley JA, Lane NE, Rogers-Soeder TS, Redline S, Bauer DC, Wright KP, Wierman ME, Kohrt WM, Orwoll ES. Sleep duration and bone health measures in older men. Osteoporos Int 2021; 32:515-527. [PMID: 32930851 PMCID: PMC7933119 DOI: 10.1007/s00198-020-05619-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/01/2020] [Indexed: 01/11/2023]
Abstract
UNLABELLED The associations between objective measures of sleep duration and bone outcomes in older men are unknown. No consistent, significant association was identified between sleep duration and bone mineral density (BMD) in the current analysis. However, future research should determine if vitamin D status modifies this relationship. INTRODUCTION Prior studies, predominantly in women, reported that long and short self-reported sleep duration are associated with lower BMD. Associations between actigraphy-determined sleep duration and BMD or bone turnover markers (BTMs) in older men are unknown. METHODS Men in The Osteoporotic Fractures in Men (MrOS) Study with wrist actigraphy and concurrent BMD assessment but without comorbidities affecting bone health were included. Sleep duration was considered as a continuous (N = 1926) and dichotomized variable where men were classified as getting the recommended (7-8 h/night; N = 478) or short (< 6 h/night; N = 577) sleep. The cross-sectional association between BMD, BTMs, and sleep duration was examined using a t test or linear regression, where appropriate, in unadjusted and adjusted models. RESULTS There were no clinically or statistically significant differences in BMD at the L-spine, total hip, or femoral neck between men getting the recommended vs. short sleep duration, using actigraphy or self-reported sleep duration (all p ≥ 0.07). When sleep duration was considered as a continuous variable, femoral neck BMD was higher in men with longer self-reported sleep duration (β = 0.006 ±0.003, p = 0.02), but this was not significant after further adjustment. In men with low 25OHD (< 20 ng/mL), longer actigraphy-determined sleep duration was associated with higher total hip BMD (β = 0.016 ± 0.008; p = 0.04). Sleep duration and BTMs were not associated. CONCLUSION Sleep duration was not associated with hip or L-spine BMD or BTMs in older men. Future research should determine if vitamin D status or other factors modify this relationship.
Collapse
Affiliation(s)
- C M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA.
| | - P J Blatchford
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - K L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- San Francisco Coordinating Center, University of California San Francisco, San Francisco, CA, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - N E Lane
- Center for Musculoskeletal Health, University of California, Davis Health, Davis, CA, USA
| | | | - S Redline
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Division of Pulmonary Medicine, Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - D C Bauer
- San Francisco Coordinating Center, University of California San Francisco, San Francisco, CA, USA
- University of California San Francisco Medical Center, San Francisco, CO, USA
| | - K P Wright
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - M E Wierman
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, 12801 E. 17th Ave. Mail Stop 8106, Aurora, CO, 80045, USA
- Rocky Mountain Regional Veterans Affairs Medical Center, Aurora, CO, USA
| | - W M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
- Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), Aurora, CO, USA
| | - E S Orwoll
- Division of Endocrinology and Bone & Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | | |
Collapse
|
9
|
Potential Role of Lycopene in the Prevention of Postmenopausal Bone Loss: Evidence from Molecular to Clinical Studies. Int J Mol Sci 2020; 21:ijms21197119. [PMID: 32992481 PMCID: PMC7582596 DOI: 10.3390/ijms21197119] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Revised: 09/23/2020] [Accepted: 09/24/2020] [Indexed: 02/07/2023] Open
Abstract
Osteoporosis is a metabolic bone disease characterized by reduced bone mineral density, which affects the quality of life of the aging population. Furthermore, disruption of bone microarchitecture and the alteration of non-collagenous protein in bones lead to higher fracture risk. This is most common in postmenopausal women. Certain medications are being used for the treatment of osteoporosis; however, these may be accompanied by undesirable side effects. Phytochemicals from fruits and vegetables are a source of micronutrients for the maintenance of bone health. Among them, lycopene has recently been shown to have a potential protective effect against bone loss. Lycopene is a lipid-soluble carotenoid that exists in both all-trans and cis-configurations in nature. Tomato and tomato products are rich sources of lycopene. Several human epidemiological studies, supplemented by in vivo and in vitro studies, have shown decreased bone loss following the consumption of lycopene/tomato. However, there are still limited studies that have evaluated the effect of lycopene on the prevention of bone loss in postmenopausal women. Therefore, the aim of this review is to summarize the relevant literature on the potential impact of lycopene on postmenopausal bone loss with molecular and clinical evidence, including an overview of bone biology and the pathophysiology of osteoporosis.
Collapse
|
10
|
Ochs-Balcom HM, Hovey KM, Andrews C, Cauley JA, Hale L, Li W, Bea JW, Sarto GE, Stefanick ML, Stone KL, Watts NB, Zaslavsky O, Wactawski-Wende J. Short Sleep Is Associated With Low Bone Mineral Density and Osteoporosis in the Women's Health Initiative. J Bone Miner Res 2020; 35:261-268. [PMID: 31692127 PMCID: PMC8223077 DOI: 10.1002/jbmr.3879] [Citation(s) in RCA: 49] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 08/30/2019] [Accepted: 09/11/2019] [Indexed: 12/28/2022]
Abstract
Short sleep duration, recognized as a public health epidemic, is associated with adverse health conditions, yet little is known about the association between sleep and bone health. We tested the associations of usual sleep behavior and bone mineral density (BMD) and osteoporosis. In a sample of 11,084 postmenopausal women from the Women's Health Initiative (WHI; mean age 63.3 years, SD = 7.4), we performed a cross-sectional study of the association of self-reported usual hours of sleep and sleep quality (WHI Insomnia Rating Score) with whole body, total hip, femoral neck, and spine BMD using linear regression models. We also studied the association of sleep duration and quality with dual-energy X-ray absorptiometry (DXA)-defined low bone mass (T-score < -2.5 to <-1) and osteoporosis (T-score ≤ -2.5) using multinomial regression models. We adjusted for age, DXA machine, race, menopausal symptoms, education, smoking, physical activity, body mass index, alcohol use, physical function, and sleep medication use. In adjusted linear regression models, women who reported sleeping 5 hours or less per night had on average 0.012 to 0.018 g/cm2 significantly lower BMD at all four sites compared with women who reported sleeping 7 hours per night (reference). In adjusted multinomial models, women reporting 5 hours or less per night had higher odds of low bone mass and osteoporosis of the hip (odds ratio [OR] = 1.22; 95% confidence interval [CI] 1.03-1.45, and 1.63; 1.15-2.31, respectively). We observed a similar pattern for spine BMD, where women with 5 hours or less per night had higher odds of osteoporosis (adjusted OR = 1.28; 95% CI 1.02-1.60). Associations of sleep quality and DXA BMD failed to reach statistical significance. Short sleep duration was associated with lower BMD and higher risk of osteoporosis. Longitudinal studies are needed to confirm the cross-sectional effects of sleep duration on bone health and explore associated mechanisms. © 2019 American Society for Bone and Mineral Research.
Collapse
Affiliation(s)
- Heather M Ochs-Balcom
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Kathleen M Hovey
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| | - Christopher Andrews
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, MI, USA
| | - Jane A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Lauren Hale
- Program in Public Health, Department of Family, Population and Preventive Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Wenjun Li
- Department of Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Jennifer W Bea
- Department of Medicine, University of Arizona Cancer Center, Tucson, AZ, USA
| | - Gloria E Sarto
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA
| | - Marcia L Stefanick
- Stanford Prevention Research Center, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Katie L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA.,Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Nelson B Watts
- Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA
| | - Oleg Zaslavsky
- Department of Biobehavioral Nursing and Health Informatics, University of Washington School of Nursing, Seattle, WA, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, The State University of New York, Buffalo, NY, USA
| |
Collapse
|
11
|
Dou ZJ, Gao XL, Jia YL, Chen J, Yang JJ, Chen Y, Wu SJ, Liu T, Wang MT, Yang C, Zhang N, Wang B. CB1 receptor antagonist rimonabant protects against chronic intermittent hypoxia-induced bone metabolism disorder and destruction in rats. Sleep Breath 2020; 24:1441-1449. [PMID: 31898189 PMCID: PMC7679350 DOI: 10.1007/s11325-019-02009-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 12/19/2019] [Accepted: 12/23/2019] [Indexed: 12/11/2022]
Abstract
Objective The endocannabinoid system (ECS) regulates bone turn-over and remodeling. Chronic intermittent hypoxia (CIH) occurring during obstructive sleep apnea (OSA) may lead to disorders of the ECS and bone metabolism abnormalities. This study aimed to investigate whether or not the cannabinoid receptor 1 (CB1R) antagonist rimonabant (Ri) alleviates bone metabolism abnormalities and bone destruction induced by chronic intermittent hypoxia (CIH). Methods Healthy male Sprague Dawley (SD) rats (n=48) were randomly divided into 6 groups of 8 rats: 2 normal control (NC) groups, 2 intermittent hypoxia (IH) groups, and 2 IH + Ri groups. Rats in NC groups breathed room air for 4 weeks (4w NC group) and 6 weeks (6w NC group). Rats in IH groups experienced IH environment for 4 weeks (4w IH group) and 6 weeks (6w IH group). In addition to the same IH exposure, rats in IH + Ri group were given daily intraperitoneal injection of Ri at the dosage of 1.5 mg/kg/d for 4 weeks (4w IH + Ri group) and 6 weeks (6w IH + Ri group). Levels of serum tartrate-resistant acid phosphatase (TRAP, a marker of bone resorption) were determined by ELISA. Hematoxylin and eosin (HE) staining was performed on bone sections to observe the changes in bone microstructure. Expression of CB1R in bone tissue was determined by immunohistochemistry. Results TRAP levels were higher in the 4w IH and 6w IH groups than in the 4w NC and 6w NC groups; TRAP levels were lower in the 4w IH + Ri and 6w IH + Ri groups than in the 4w IH and 6w IH groups. HE staining showed that the morphology of bone cells in the NC group was normal, but the 4w IH group had mild edema of bone cells, reduction in trabecular bone, and destruction of bone microstructure. Changes were more severe in the 6w IH group than 4w IH. The 4w IH + Ri group was slightly improved compared with the 4w IH group. The 6w IH + Ri group was improved compared with the 4w IH + Ri group. The results of immunohistochemistry showed that the expression of CB1R in IH group was significantly higher than that in NC group. The expression of CB1R in the IH + Ri group was lower than that in the IH group. With the prolongation of hypoxia, the expression of CB1R in bone cells of IH group increased. The expression level of CB1R in IH + Ri group decreased with the prolongation of intervention time. Correlation analysis showed that the expression rate of CB1R in bone cells was positively correlated with the level of TRAP in serum. Conclusion CIH increases serum TRAP levels and triggers metabolic bone disorder by activating bone CB1R. Intervention with CB1R antagonist (rimonabant) reduces the bone dysmetabolism in the CIH rat model.
Collapse
Affiliation(s)
- Zhan-Jun Dou
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Xiao-Ling Gao
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, No. 382, Wuyi Road, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Yan-Li Jia
- Department of Respiratory, Linfen Centrol Hospital, Linfen, Shanxi, People's Republic of China
| | - Jie Chen
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, No. 382, Wuyi Road, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Jiao-Jiao Yang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Yan Chen
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, No. 382, Wuyi Road, Taiyuan, 030001, Shanxi, People's Republic of China
| | - Shu-Jie Wu
- Medical Records Statistics Office, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Tao Liu
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Mei-Ting Wang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Chong Yang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Na Zhang
- Department of the Second Clinical Medicine, Shanxi Medical University, Taiyuan, Shanxi, People's Republic of China
| | - Bei Wang
- Department of Respiratory and Critical Care Medicine, The Second Hospital of Shanxi Medical University, No. 382, Wuyi Road, Taiyuan, 030001, Shanxi, People's Republic of China.
| |
Collapse
|
12
|
Swanson CM, Blatchford PJ, Orwoll ES, Cauley JA, LeBlanc ES, Fink HA, Wright KP, Wierman ME, Kohrt WM, Stone KL. Association between objective sleep duration and bone mineral density in older postmenopausal women from the Study of Osteoporotic Fractures (SOF). Osteoporos Int 2019; 30:2087-2098. [PMID: 31139855 PMCID: PMC6800619 DOI: 10.1007/s00198-019-05007-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 05/02/2019] [Indexed: 10/26/2022]
Abstract
Methodological limitations preclude determination of the association between sleep duration and bone mineral density (BMD) from existing literature. This was the first study to use objective sleep duration to determine its association with BMD. Nocturnal sleep duration, assessed objectively (actigraphy) or subjectively (questionnaire), was not independently associated with BMD in postmenopausal women. INTRODUCTION Both long and short self-reported sleep durations are associated with low bone mineral density (BMD) in men and women. The association between sleep duration measured by actigraphy and BMD in postmenopausal women is unknown. METHODS The Study of Osteoporotic Fractures (SOF) ancillary sleep study was used to determine the association between sleep duration and BMD at the total hip and femoral neck in postmenopausal women ≥ 75 years old. Sleep duration was assessed by wrist actigraphy (average 4 nights) and questionnaire. BMD was compared between postmenopausal women with short (< 6 h/night) vs. NIH-recommended (7-8 h/night) sleep durations. Data were analyzed using a 2-sample t test (unadjusted) and multivariate regression model (adjusted). Simple linear regression was used to estimate the difference in BMD per additional hour of sleep when sleep duration was considered as a continuous, rather than dichotomized, variable. RESULTS Total hip BMD was higher in women with actigraphically assessed shorter sleep duration in unadjusted models only. No clinically or statistically significant differences in total hip or femoral neck BMD were observed according to nocturnal sleep duration after adjusting for body mass index (BMI) in dichotomized (N = 874) or continuous (N = 1624) sleep duration models or when subjective sleep duration was used. When sleep duration included daytime naps, longer sleep duration was associated with lower total hip BMD (β = - 0.005, p = 0.04). CONCLUSIONS Nocturnal sleep duration, whether assessed objectively (actigraphy) or subjectively (questionnaire), was not independently associated with BMD in older postmenopausal women.
Collapse
Affiliation(s)
- C M Swanson
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA.
| | - P J Blatchford
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado, Aurora, CO, USA
| | - E S Orwoll
- Division of Endocrinology and Bone & Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - J A Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - E S LeBlanc
- Kaiser Permanente Center for Health Research NW, Portland, OR, USA
| | - H A Fink
- Geriatric Research Education and Clinical Center, Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA
| | - K P Wright
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - M E Wierman
- Division of Endocrinology, Metabolism and Diabetes, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, 80045, USA
- Research Service, Rocky Mountain Regional Veterans Affairs Medical Center Aurora, Aurora, CO, USA
| | - W M Kohrt
- Division of Geriatric Medicine, and Eastern Colorado VA Geriatric, Research, Education, and Clinical Center (GRECC), University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - K L Stone
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
- San Francisco Coordinating Center, University of California San Francisco, San Francisco, CA, USA
| |
Collapse
|
13
|
Onambele-Pearson G, Wullems J, Doody C, Ryan D, Morse C, Degens H. Influence of Habitual Physical Behavior - Sleeping, Sedentarism, Physical Activity - On Bone Health in Community-Dwelling Older People. Front Physiol 2019; 10:408. [PMID: 31037056 PMCID: PMC6476278 DOI: 10.3389/fphys.2019.00408] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2018] [Accepted: 03/25/2019] [Indexed: 11/15/2022] Open
Abstract
Sedentary behavior (SB) has emerged as an independent public-health risk and may contribute to the lower bone mineral density (BMD) in old (>60 years of age) than young adults. The purpose of this study was to quantify SB and habitual physical behavior (PB) in community-dwelling older adults and how this correlates with BMD. In 112 relatively healthy and independent-living individuals aged 72.5 ± 6.4 years, BMD, PB and SB were determined using dual energy X-ray absorptiometry and 7-day three-dimensional accelerometry, respectively. In men, only healthy and osteopenic BMDs were found, whereas in women, osteoporotic BMD classifications also occurred. Our sample spent ∼61%, 7%, 12% and 19% of daily waking hours in SB, standing, LIPA [light intensity physical activity (PA)] and MVPA (medium-to-vigorous intensity PA), respectively. In men, after accounting for covariates (BMI, total fat, android:gynoid ratio), sleeping (hours/day), number of breaks in SB, number of SB ≥ 5 min, number of PA bouts, total duration of PA bouts (min), mean PA bouts duration (min), LIPA (%PA bout time) and MVPA (%PA bout time) were all predictors of BMD. In women, after accounting for covariates (age, BMI, total fat, android:gynoid ratio), SB (hours/day), SB (% waking hours), LIPA (hours/day), LIPA (% waking hours), MVPA (% waking hours) and number of short SB (i.e., <5 min), total time spent in PA (min) significantly correlated with BMD. In conclusion, the PB predictors of bone health in older persons include: night time sleeping duration, number of short bouts of SB, number and duration of bouts of PA relative to total waking hours. While radar graphs of PB patterns for healthy, osteopenic, osteoporotic individuals highlighted significant differences in PB between them, they were not consistent with the expectations from the Mechanostat Theory: i.e., more loading leads to better bone. Rather, our results suggest that a balance of activities must be maintained across the PB spectrum, where certain PB parameters are especially impactful in each sex, supporting the recently coined multifactorial-based variations in the Mechanostat threshold.
Collapse
Affiliation(s)
- Gladys Onambele-Pearson
- Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - Jorgen Wullems
- Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, United Kingdom.,Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium
| | - Conor Doody
- Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - Declan Ryan
- Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, United Kingdom.,Faculty of Health and Society, University of Northampton, Northampton, United Kingdom
| | - Christopher Morse
- Department of Exercise and Sport Science, Manchester Metropolitan University, Manchester, United Kingdom
| | - Hans Degens
- School of Healthcare Science, Manchester Metropolitan University, Manchester, United Kingdom.,Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.,University of Medicine and Pharmacy of Târgu Mureş, Târgu Mureş, Romania
| |
Collapse
|
14
|
Tong Q, Wu W, Wu Q, Yu Y, Lv X, Wang B, Wang G. Sleep onset latency is related with reduced bone mineral density in elderly people with insomnia: a retrospective study. Clin Interv Aging 2018; 13:1525-1530. [PMID: 30214172 PMCID: PMC6121751 DOI: 10.2147/cia.s161922] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Purpose Inconsistent outcome about association between insufficient sleep and bone mineral density (BMD) has been reported. The present study aimed to determine whether BMD was associated with score of Pittsburgh Sleep Quality Index (PSQI). Methods A total of 410 patients (mean age 81.6±5.9 years) attending our hospital for evaluation of sleep were retrospectively studied. Dual-Energy X-ray Absorptiometry was used to measure BMD and T-score at femoral neck and lumbar spines over L2–L4 regions. Subjective sleep status was evaluated by the PSQI questionnaires. The Mann–Whitney U test and chi-square analysis were used to compare continuous variables and categorical variables, respectively. Spearman correlation test was conducted to find the relationship between BMD and other clinical factors. Multinomial logistic regressions analysis was performed to analyze independent factors predicting BMD. Results Majority of the participants with osteoporosis (OP) were female and had lower body mass index (BMI) and higher sleep onset latency score. Spearman correlation test showed that gender, BMI, score of total PSQI, and sleep onset latency were significantly related to BMD and T-score in femoral neck and lumbar region L2–L4. Finally, multinomial logistic regression analysis demonstrated that gender and age were independent factors for OP and osteopenia and that after adjustment for gender, age, and BMI, sleep onset latency of <15 minutes (OR: 0.38; 95% CI: 0.15–0.96; P=0.04) and 16–30 minutes (OR: 0.37; 95% CI: 0.17–0.79; P=0.01) were less likely to have reduced BMD. Conclusion There was a significant association between BMD and sleep onset latency, suggesting that, in elderly patients with sleep problem, BMD measurement and intervention for OP might be valuable.
Collapse
Affiliation(s)
- Qian Tong
- Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China, .,Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China,
| | - Wanzhen Wu
- Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China,
| | - Qing Wu
- Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China,
| | - Yanbo Yu
- Wenzhou Medical University, Wenzhou, 325035 Zhejiang, China
| | - Xiaoling Lv
- Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China,
| | - Bozhong Wang
- Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China,
| | - Guofu Wang
- Zhejiang Chinese Medical University, Hangzhou 310053, Zhejiang, China, .,Department of Geriatrics, Zhejiang Hospital, Zhejiang Provincial Key Lab of Geriatrics, Hangzhou 310013, Zhejiang, China,
| |
Collapse
|
15
|
Wang D, Ruan W, Peng Y, Li W. Sleep duration and the risk of osteoporosis among middle-aged and elderly adults: a dose-response meta-analysis. Osteoporos Int 2018; 29:1689-1695. [PMID: 29574520 DOI: 10.1007/s00198-018-4487-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2018] [Accepted: 03/12/2018] [Indexed: 12/31/2022]
Abstract
It remains unclear how many hours of sleep are associated with the lowest risk of osteoporosis. This meta-analysis was performed to assess the dose-response relationship between sleep duration and risk of osteoporosis. PubMed and Web of Science were searched from inception to December 3, 2017, supplemented by manual searches of the bibliographies of retrieved articles. Data were pooled using fixed- and random-effects models. Restricted cubic spline analysis with four knots was used to model the sleep duration and osteoporosis association. Four cross-sectional studies with eight records were eligible for inclusion in the meta-analysis. A U-shaped dose-response relationship was observed between sleep duration and risk of osteoporosis, with the lowest risk observed at a sleep duration category of 8-9 h per day. Compared with 8-h sleep duration per day, the pooled odds ratio for osteoporosis were 1.03 (95% CI 1.01-1.06) for each 1-h reduction among individuals with shorter sleep duration and 1.01 (95% CI 1.00-1.02) for each 1-h increment among individuals with longer sleep duration. Our dose-response meta-analysis shows a U-shaped relationship between sleep duration and risk of osteoporosis, with the lowest osteoporosis risk at about 8 h per day of sleep duration. Both short and long sleep duration is associated with a significantly increased risk of osteoporosis in the middle-aged and elderly adults, appropriate sleep duration could help for delay or prevention of osteoporosis.
Collapse
Affiliation(s)
- D Wang
- Department of Occupational & Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, 430030, China
- Wuhan Prevention and Treatment Center for Occupational Diseases, Wuhan, Hubei, 430030, People's Republic of China
| | - W Ruan
- Department of Clinical Medicine, Xi'an Medical University, Xi'an, Shanxi, 710000, People's Republic of China
| | - Y Peng
- Department of Emergency, Wuhan Center for Diseases Prevention and Control, Wuhan, Hubei, 430015, People's Republic of China
| | - W Li
- Department of Social Medicine and Health Management, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, No.13 Hangkong Road, Wuhan, Hubei, 430030, People's Republic of China.
| |
Collapse
|
16
|
The Association between Daytime Napping Characteristics and Bone Mineral Density in Elderly Thai Women without Osteoporosis. Sci Rep 2018; 8:10016. [PMID: 29968782 PMCID: PMC6030206 DOI: 10.1038/s41598-018-28260-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2018] [Accepted: 06/20/2018] [Indexed: 11/29/2022] Open
Abstract
Low bone mass is more prevalent with increasing age. Studies have found associations between sleep duration, sleep quality and obstructive sleep apnea and bone mineral density (BMD). However, less is known about the relationship between daytime napping and BMD. We aimed to investigate the association between daytime napping and BMD in elderly Thai women. Demographic data, lifestyle information and sleep characteristics were obtained by interviewing 387 elderly women. Weight and height were measured. Serum 25-hydroxyvitamin D [25(OH)D] was measured by radioimmunoassay. BMD was measured by dual-energy X-ray absorptiometry (DXA). Higher BMI and having type 2 diabetes (T2DM) were correlated with higher lumbar spine 2–4 (L2-4) BMD, while younger age, higher BMI and higher serum 25(OH)D level were correlated with higher femoral neck (FN) and total hip (TH) BMD. After adjusting for age, age at menopause, BMI, 25(OH)D level and T2DM, a higher frequency of weekly daytime napping was associated with lower FN and TH BMD but not at L2-4 BMD. Additionally, longer daytime napping duration was negatively associated with BMD at TH. In summary higher frequency and longer duration of daytime napping are associated with lower femoral BMD in elderly women. Mechanisms underlying these associations should be further explored.
Collapse
|
17
|
Swanson CM, Kohrt WM, Buxton OM, Everson CA, Wright KP, Orwoll ES, Shea SA. The importance of the circadian system & sleep for bone health. Metabolism 2018; 84:28-43. [PMID: 29229227 PMCID: PMC5994176 DOI: 10.1016/j.metabol.2017.12.002] [Citation(s) in RCA: 85] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Revised: 11/28/2017] [Accepted: 12/01/2017] [Indexed: 01/01/2023]
Abstract
Adequate sleep timed appropriately during the circadian night is important for numerous biological processes and systems. New evidence suggests that both sleep timing and duration may be important for optimal bone health as well. This review examines the diurnal variation of bone turnover markers (BTMs) and the importance of circadian clock genes in regulating bone mass. In addition, this review explores the evidence for a link between shift work (and its associated disturbances in sleep duration/quality and circadian alignment) and alterations in bone metabolism and bone health. Finally, we review how commonly used medications and over-the-counter substances (e.g. caffeine, melatonin) complicate the relationship between sleep and circadian disorders and bone health.
Collapse
Affiliation(s)
- Christine M Swanson
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Wendy M Kohrt
- Division of Geriatric Medicine, University of Colorado Anschutz Medical Campus, Eastern Colorado VA Geriatric, Research, Education, and Clinical Center, Aurora, CO, USA
| | - Orfeu M Buxton
- Department of Biobehavioral Health, Pennsylvania State University, University Park, PA, USA; Division of Sleep Medicine, Harvard Medical School, Boston, MA, USA; Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women's Hospital, Boston, MA, USA; Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, MA, USA
| | - Carol A Everson
- Department of Medicine, Division of Endocrinology, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Kenneth P Wright
- Division of Endocrinology, Metabolism, and Diabetes, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Integrative Physiology, University of Colorado Boulder, Boulder, CO, USA
| | - Eric S Orwoll
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, OR, USA
| | - Steven A Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, OR, USA; OHSU-PSU School of Public Health, Portland, OR, USA
| |
Collapse
|
18
|
Swanson CM, Shea SA, Wolfe P, Cain SW, Munch M, Vujović N, Czeisler CA, Buxton OM, Orwoll ES. Bone Turnover Markers After Sleep Restriction and Circadian Disruption: A Mechanism for Sleep-Related Bone Loss in Humans. J Clin Endocrinol Metab 2017; 102:3722-3730. [PMID: 28973223 PMCID: PMC5630251 DOI: 10.1210/jc.2017-01147] [Citation(s) in RCA: 49] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 07/21/2017] [Indexed: 12/26/2022]
Abstract
CONTEXT Sleep abnormalities are associated with low bone mineral density. Underlying mechanisms are unknown. OBJECTIVE Investigate the impact of sleep restriction with circadian disruption on bone biomarkers. DESIGN Intervention study. PARTICIPANTS AND METHODS Four bone biomarkers [C-terminal cross-linked telopeptide of type I collagen (CTX) = bone resorption, N-terminal propeptide of type I procollagen (P1NP) = bone formation, sclerostin and fibroblast growth factor 23 = osteocyte function] were measured in bihourly serum samples over 24 hours at baseline and after ∼3 weeks of sleep restriction (5.6 hours sleep/24 hours) with concurrent circadian disruption (recurring 28-hour "day" in dim light) in 10 men (age groups: 20 to 27 years, n = 6; 55 to 65 years, n = 4). The effects of sleep/circadian disruption and age on bone biomarker levels were evaluated using maximum likelihood estimation in a mixed model for repeated measures. RESULTS P1NP levels were lower after intervention compared with baseline (P < 0.001); the decrease in P1NP was greater for younger compared with older men (28.0% vs 18.2%, P < 0.001). There was no change in CTX (Δ = 0.03 ± 0.02 ng/mL, P = 0.10). Sclerostin levels were higher postintervention in the younger men only (Δ = 22.9% or 5.64 ± 1.10 pmol/L, P < 0.001). CONCLUSIONS These data suggest that 3 weeks of circadian disruption with concurrent sleep restriction can lead to an uncoupling of bone turnover wherein bone formation is decreased but bone resorption is unchanged. Circadian disruption and sleep restriction may be most detrimental to bone in early adulthood.
Collapse
Affiliation(s)
- Christine M. Swanson
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239
- Division of Endocrinology, University of Colorado, Aurora, Colorado 80045
| | - Steven A. Shea
- Oregon Institute of Occupational Health Sciences, Oregon Health & Science University, Portland, Oregon 97239
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Oregon Health & Science University and Portland State University School of Public Health, Portland, Oregon 97239
| | - Pamela Wolfe
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado 80045
| | - Sean W. Cain
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Clayton, Victoria 3800, Australia
| | - Mirjam Munch
- Charité University Medicine Berlin, Institute of Physiology, 10117 Berlin, Germany
| | - Nina Vujović
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
| | - Charles A. Czeisler
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
| | - Orfeu M. Buxton
- Sleep Health Institute, Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, Massachusetts 02115
- Division of Sleep Medicine, Harvard Medical School, Boston, Massachusetts 02115
- Department of Biobehavioral Health, Pennsylvania State University, University Park, Pennsylvania 16802
- Department of Social and Behavioral Sciences, Harvard Chan School of Public Health, Boston, Massachusetts 02115
| | - Eric S. Orwoll
- Division of Endocrinology and Bone and Mineral Unit, Oregon Health & Science University, Portland, Oregon 97239
| |
Collapse
|
19
|
Marques EA, Figueiredo P, Gudnason V, Lang T, Sigurdsson G, Sigurdsson S, Aspelund T, Siggeirsdottir K, Launer L, Eiriksdottir G, Harris TB. Associations of 24-hour sleep duration and CT-derived measurements of muscle and bone: The AGES-Reykjavik Study. Exp Gerontol 2017; 93:1-6. [PMID: 28404506 DOI: 10.1016/j.exger.2017.04.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Revised: 03/02/2017] [Accepted: 04/06/2017] [Indexed: 12/18/2022]
Abstract
BACKGROUND Although the importance of sleep on preservation of several physiological functions is well known, the relationship with the two interconnected tissues - muscle and bone is less understood. OBJECTIVES This study aimed to examine the association of 24-hour sleep duration with mid-thigh muscle composition and proximal femur volumetric bone mineral density (vBMD). METHODS 2438 men and 3326 women aged 66 to 96years, residents in the Reykjavik area, were included in this cross-sectional study. Proximal femur integral vBMD, mid-thigh muscle area and muscle attenuation were assessed with computed tomography. Sleep and nap habits were assessed using a questionnaire. RESULTS We found that after adjustment for age and BMI long sleep duration (>8h/d) was negatively associated with thigh lean area in both men (B=-2.21, 95% confidence interval (CI): -4.01, -0.40) and women (B=-2.39, 95% CI: -3.75, -1.03) and with muscle attenuation (B=-0.95, 95% CI: -1.47, -0.43) only in women. After adjustments for age, health and lifestyle factors the association between long sleep duration and muscle lean area was attenuated and became nonsignificant while associations with muscle attenuation remained marginally significant (B=-0.51, 95% CI: -1.03, -0.002). Sleep duration was not associated with proximal femur integral vBMD in the multivariate models. CONCLUSION Long sleep duration, particularly in old women, can affect thigh muscle attenuation (increase in intramuscular fat). Whether optimization of sleep can ameliorate age-associated intramuscular or intermuscular adipose tissue warrants further studies.
Collapse
Affiliation(s)
- Elisa A Marques
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, 7201 Wisconsin Avenue, Gateway Building, Suite 2N300, Bethesda, MD 20892-9205, USA.
| | - Pedro Figueiredo
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, 7201 Wisconsin Avenue, Gateway Building, Suite 2N300, Bethesda, MD 20892-9205, USA; Research Center in Sports Sciences, Health Sciences and Human Development, CIDESD, University Institute of Maia, ISMAI, Av. Carlos Oliveira Campos, Castelo da Maia 4475-690, Maia, Portugal
| | - Vilmundur Gudnason
- Icelandic Heart Association Research Institute, Kópavogur, Holtasmari 1, IS-201 Kópavogur, Iceland; University of Iceland, Reykjavik, Sæmundargata 2, 101 Reykjavík Ssn: 600169-2039, Iceland
| | - Thomas Lang
- Department of Radiology and Biomedical Imaging, University of California, 505 Parnassus Ave, San Francisco, CA 94143, USA
| | - Gunnar Sigurdsson
- Icelandic Heart Association Research Institute, Kópavogur, Holtasmari 1, IS-201 Kópavogur, Iceland; University of Iceland, Reykjavik, Sæmundargata 2, 101 Reykjavík Ssn: 600169-2039, Iceland; Landspitali-University Hospital, 101 Reykjavik, Iceland
| | - Sigurdur Sigurdsson
- Icelandic Heart Association Research Institute, Kópavogur, Holtasmari 1, IS-201 Kópavogur, Iceland
| | - Thor Aspelund
- Icelandic Heart Association Research Institute, Kópavogur, Holtasmari 1, IS-201 Kópavogur, Iceland; Centre of Public Health Sciences, University of Iceland, Stapi v. Hringbraut, 107 Reykjavík, Iceland
| | - Kristin Siggeirsdottir
- Icelandic Heart Association Research Institute, Kópavogur, Holtasmari 1, IS-201 Kópavogur, Iceland
| | - Lenore Launer
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, 7201 Wisconsin Avenue, Gateway Building, Suite 2N300, Bethesda, MD 20892-9205, USA
| | - Gudny Eiriksdottir
- Icelandic Heart Association Research Institute, Kópavogur, Holtasmari 1, IS-201 Kópavogur, Iceland
| | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, Intramural Research Program, National Institute on Aging, National Institutes of Health, Bethesda, 7201 Wisconsin Avenue, Gateway Building, Suite 2N300, Bethesda, MD 20892-9205, USA
| |
Collapse
|
20
|
Moradi S, Shab-Bidar S, Alizadeh S, Djafarian K. Association between sleep duration and osteoporosis risk in middle-aged and elderly women: A systematic review and meta-analysis of observational studies. Metabolism 2017; 69:199-206. [PMID: 28162775 DOI: 10.1016/j.metabol.2017.01.027] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Revised: 12/22/2016] [Accepted: 01/16/2017] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Increasing evidence has suggested an association between sleep duration and osteoporosis risk, although the results of previous studies have been inconsistent. To our knowledge, this is the first meta-analysis of the literature and quantitative estimates of the association between sleep duration and risk of osteoporosis in population-based studies of middle aged and elderly women. METHODS Pertinent studies were identified by searching PubMed and EMBASE databases up to February 2016. Five out of six included studies were cross-sectional and one was a prospective cohort study. They included 72,326 participants from three different countries. We extracted 31,625 individuals in these studies for our meta-analysis. RESULTS A pooled odds ratio analysis in women between 40 to 86years indicated that there is an inverse relationship between sleep duration and osteoporosis (overall OR =1.07 95% CI: 1.00-1.15). The negative association of long sleep duration (8h or more per day) with osteoporosis risk was observed in middle aged and elderly women (OR =1.22, 95% CI: 1.06-1.38) but not in women with short sleep duration (7h or less per day) (OR =0.98, 95% CI: 0.90-1.05). CONCLUSION This meta-analysis suggests that long sleep duration (8h or more per day) may be associated with a higher risk of osteoporosis in middle-aged and elderly. Further prospective cohort studies with longer follow-up periods, valid instruments for measurement of sleep duration and dynamic sleep quality are warranted to support the possible relationship between sleep duration and osteoporosis risk in women.
Collapse
Affiliation(s)
- Sajjad Moradi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, International Campus, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics,Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Shahab Alizadeh
- Department of Molecular Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
| |
Collapse
|
21
|
Xu X, Wang L, Chen L, Su T, Zhang Y, Wang T, Ma W, Yang F, Zhai W, Xie Y, Li D, Chen Q, Fu X, Ma Y, Zhang Y. Effects of chronic sleep deprivation on bone mass and bone metabolism in rats. J Orthop Surg Res 2016; 11:87. [PMID: 27485745 PMCID: PMC4970273 DOI: 10.1186/s13018-016-0418-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Accepted: 07/13/2016] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND This study aimed to assess the effects of chronic sleep deprivation (CSD) on bone mass and bone metabolism in rats. METHODS Twenty-four rats were randomly divided into CSD and control (CON) groups. Rats were subjected to CSD by using the modified multiple platform method (MMPM) to establish an animal model of CSD. Biochemical parameters such as levels of serum N-terminal propeptide of type I procollagen (PINP), N-terminal cross-linking telopeptide of type I collagen (NTX), growth hormone (GH), estradiol (E2), serum 25(OH)D, and calcium (Ca) were evaluated at 0, 1, 2, and 3 months. After 3 months, each fourth lumbar vertebra and the distal femoral metaphysis of the left extremity of rats were harvested for micro-computed tomography scans and histological analysis, respectively, after the rats were sacrificed under an overdose of pentobarbital sodium. RESULTS Compared with rats from the CON group, rats from the CSD group showed significant decreases in bone mineral density (BMD), bone volume over total volume, trabecular bone thickness, and trabecular bone number and significant increases in bone surface area over bone volume and trabecular bone separations (P < 0.05). Bone histomorphology studies showed that rats in the CSD group had decreased osteogenesis, impaired mineralization of newly formed bones, and deteriorative trabecular bone in the secondary spongiosa zone. In addition, they showed significantly decreased levels of serum PINP (1 month later) and NTX (3 months later) (P < 0.05). The serum 25(OH)D level of rats from the CSD group was lower than that of rats from the CON group after 1 month (P < 0.05). CONCLUSIONS CSD markedly affects bone health by decreasing BMD and 25(OH)D, deteriorating the bone microarchitecture, and decreasing bone formation and bone resorption markers.
Collapse
Affiliation(s)
- Xiaowen Xu
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Liang Wang
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Liying Chen
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Tianjiao Su
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Yan Zhang
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Tiantian Wang
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Weifeng Ma
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Fan Yang
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Wujie Zhai
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Yuanyuan Xie
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Dan Li
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Qiong Chen
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Xuemei Fu
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China
| | - Yuanzheng Ma
- Center of Orthopedics, The 309th Hospital of PLA, Beijing, 100091, China.
| | - Yan Zhang
- Center for Systems Biomedical Sciences, University of Shanghai for Science and Technology, Shanghai, 200093, China.
| |
Collapse
|