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Cao Y, Hu Y, Lei F, Zhang X, Liu W, Huang X, Sun T, Lin L, Yi M, Li Y, Zhang J, Li Y, Wang G, Cheng Z. Associations between leisure-time physical activity and the prevalence and incidence of osteoporosis disease: Cross-sectional and prospective findings from the UK biobank. Bone 2024; 187:117208. [PMID: 39047901 DOI: 10.1016/j.bone.2024.117208] [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: 04/07/2024] [Revised: 07/06/2024] [Accepted: 07/20/2024] [Indexed: 07/27/2024]
Abstract
BACKGROUND Previous studies underscore the protective role of physical activity (PA) in bone health, yet the relationship between different PA categories and osteoporosis risk remains less explored. Understanding the relationships helps tailor health recommendations and policies to maximize the effects of preventing osteoporosis. METHODS The cross-sectional study involves 488,403 UK Biobank participants with heel quantitative ultrasound-estimated bone mineral density (eBMD) data. The longitudinal cohort involves 471,394 UK Biobank participants without initial osteoporosis and with follow-up records. PA exposure categories in our study included sedentary behavior (SB), total PA (TPA), and different category-specific PA including household, leisure, and work PA. The cases of osteoporosis were assessed using the International Classification of Diseases, 10th revision (ICD-10). The linear, logistic, and Cox proportional hazard regression models were used in our study. RESULTS In the cross-sectional study, 15,818 (3.28 %) participants had osteoporosis. TPA levels have a positive correlation with eBMD and a negative correlation with osteoporosis prevalence. Among different categories of PA, higher levels of leisure PA were correlated with increased eBMD and a lower osteoporosis risk (leisure PA: OR: 0.83, 95 % CI: 0.79 to 0.86;). In the longitudinal study, 16,058 (17.6 % male, 82.4 % female) (3.41 %) individuals developed osteoporosis during an average follow-up of 13 years. We observed consistent protective effects of high levels of PA on osteoporosis incidence risk, particularly within the category of leisure PA (TPA: HR: 0.78, 95 % CI: 0.74 to 0.82; leisure PA:HR: 0.83, 95 % CI: 0.80 to 0.87). Such associations are independent of genetic predisposition, with no evidence of gene-PA interactions, and keep steady among individuals using drugs affecting bone-density. Moreover, among different leisure PA items, strenuous sports, other exercises, and walking for pleasure conferred a substantial protective effect against osteoporosis. Additionally, non-elderly individuals and males exhibited lower osteoporosis risk from PA. CONCLUSION This study highlights activity categories differently associated with the risk of osteoporosis. Adherence to frequent leisure PA may have a protective effect against osteoporosis. Such associations are independent of genetic susceptibility to osteoporosis and keep steady among individuals using drugs affecting bone-density. This highlights that leisure PA could be suggested as a more effective intervention in the primary prevention of osteoporosis.
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Affiliation(s)
- Yuanyuan Cao
- Department of Orthopedics, Huanggang Central Hospital of Yangtze University, Huanggang Institute of Translational Medicine, Huanggang, China; State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China
| | - Yulian Hu
- Department of Neonatology, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Fang Lei
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China; Medical Science Research Center, Zhongnan Hospital of Wuhan University, Wuhan, China
| | - Xingyuan Zhang
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China; School of Basic Medical Sciences, Wuhan University, Wuhan, China
| | - Weifang Liu
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Xuewei Huang
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China; Department of Cardiology, The Third Xiangya Hospital of Central South University, Changsha, China
| | - Tao Sun
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Lijin Lin
- State Key Laboratory of New Targets Discovery and Drug Development for Major Diseases, Gannan Innovation and Translational Medicine Research Institute, Gannan Medical University, Ganzhou, China; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China
| | - Maolin Yi
- Department of Thyroid and Breast, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Yuping Li
- Department of Ophthalmology, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Jinpeng Zhang
- Department of Critical Care Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Yaping Li
- Department of Infectious Diseases, Huanggang Central Hospital of Yangtze University, Huanggang, China
| | - Guoping Wang
- Department of Integrated Chinese and Western Medicine, Huanggang Central Hospital of Yangtze University, Huanggang, China.
| | - Zhonghua Cheng
- Department of Orthopedics, Huanggang Central Hospital of Yangtze University, Huanggang Institute of Translational Medicine, Huanggang, China.
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Roebuck G, Mazzolini M, Mohebbi M, Pasco JA, Stuart AL, Forbes M, Berk M, Williams L. Anxiety disorders are associated with reduced bone mineral density in men: Findings from the Geelong Osteoporosis Study. Acta Psychiatr Scand 2023; 148:47-59. [PMID: 37157170 PMCID: PMC10952552 DOI: 10.1111/acps.13563] [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: 02/05/2023] [Revised: 03/29/2023] [Accepted: 04/11/2023] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Certain psychiatric disorders, including depression, appear to impact adversely on bone health. Anxiety disorders are highly prevalent but few studies have examined their effects on bone tissue. This study investigated the effect of anxiety disorders on bone mineral density (BMD). METHODS This prospective cohort study used data from the Geelong Osteoporosis Study. Participants were women and men aged ≥20 years randomly selected from the electoral roll and followed up for a mean of 14.7 and 11.0 years, respectively. Participants were assessed for a lifetime history of an anxiety disorder using the Structured Clinical Interview for DSM-IV-TR. BMD in the lumbar spine and femoral neck was measured using dual-energy x-ray absorptiometry. RESULTS Eight hundred and ninety women and 785 men participated in the study. Adjusting for sociodemographic, biometric and lifestyle factors, medical comorbidities and medication use, anxiety disorders were associated with reduced BMD at the lumbar spine (partial η2 = 0.006; p = 0.018) and femoral neck (partial η2 = 0.006; p = 0.003) in men. These associations became non-significant when men with a history of comorbid mood disorders were excluded from the analysis. There was no significant association between anxiety disorders and BMD in women (p ≥ 0.168). CONCLUSIONS Anxiety disorders are associated with reduced BMD in men. This effect may be mediated by comorbid depression.
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Affiliation(s)
- Gregory Roebuck
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
- Phoenix Australia – Centre for Posttraumatic Mental Health, Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
| | - Michael Mazzolini
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
- Melbourne Medical School, Faculty of Medicine, Dentistry and Health SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | | | - Julie A. Pasco
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
- Department of Medicine – Western HealthUniversity of MelbourneSt AlbansVictoriaAustralia
- Department of Epidemiology and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Amanda L. Stuart
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
| | - Malcolm Forbes
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
- Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
| | - Michael Berk
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
- Orygen, The National Centre of Excellence in Youth Health, and the Florey Institute for Neuroscience and Mental Health, Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
| | - Lana Williams
- The Institute for Mental and Physical Health and Clinical Translation (IMPACT), School of Medicine, Barwon HealthDeakin UniversityGeelongVictoriaAustralia
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Hajmir MM, Mirzababaei A, Clark CCT, Ghaffarian-Ensaf R, Mirzaei K. The interaction between MC4R gene variant (rs17782313) and dominant dietary patterns on depression in obese and overweight women: a cross sectional study. BMC Endocr Disord 2023; 23:83. [PMID: 37072742 PMCID: PMC10111691 DOI: 10.1186/s12902-023-01335-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2022] [Accepted: 04/05/2023] [Indexed: 04/20/2023] Open
Abstract
BACKGROUND Previous studies have shown that the minor allele (C allele) for melanocortin 4 receptor (MC4R) rs17782313 may be associated with depressed mood. Moreover, dietary patterns have potentially adverse effects on depression. This study investigates the interactions between the MC4R gene variant (rs17782313) and dietary patterns on depression among Iranian obese and overweight women. METHODS A total of 289 Iranian overweight and obese women, aged 18-50 years, were enrolled in this cross-sectional study. Biochemical, anthropometric, and body composition indices were assessed in all participants. Moreover, MC4R rs17782313, by the restriction fragment length polymorphism (PCR-RFLP) method, and depression, using the 21-item Depression Anxiety Stress Scales (DASS) questionnaire, were assessed. Food intakes were assessed by completing a 147-item semi-quantitative food frequency questionnaire (FFQ). RESULTS By the use of factor analysis, 2 major dietary patterns were extracted: healthy dietary pattern (HDP) and unhealthy dietary pattern (UDP). Binary logistic analysis showed that individuals with minor allele risk (CC) with high adherence to the unhealthy pattern increased odds for depression (OR: 8.77, 95%CI: -0.86-18.40, P: 0.07), after controlling for confounders. Also, a logical inverse relationship was observed between CT genotype and HDP on depression in the crude and adjusted models (OR: -0.56, 95% CI: -3.69-2.57, P: 0.72) (OR: -4.17, 95% CI: -9.28-0.94, P: 0.11), although this interaction was not statistically significant. CONCLUSION According to the above findings, adherence to unhealthy food intake pattern increases odds of depression in MC4R risk allele (C allele) carriers. To confirm these findings, more studies are needed in the form of clinical trials and prospective studies with higher sample sizes.
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Affiliation(s)
- Mahya Mehri Hajmir
- Students' Scientific Center, Tehran University of Medical Sciences (TUMS), PO Box 1417755331, Tehran, Iran
| | - Atieh Mirzababaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran
| | - Cain C T Clark
- Centre for Intelligent Healthcare, Coventry University, Coventry, CV1 5FB, UK
| | | | - Khadijeh Mirzaei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences (TUMS), P.O. Box:14155-6117, Tehran, Iran.
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Understanding health problems in people with extremely low health-related quality of life in Korea. Sci Rep 2022; 12:4037. [PMID: 35260609 PMCID: PMC8904781 DOI: 10.1038/s41598-022-07528-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 02/07/2022] [Indexed: 11/08/2022] Open
Abstract
Little is known about patients reporting extremely poor health-related quality of life (HRQoL). This study targeted population with inferior HRQoL and examined their problems experienced with HRQoL dimensions, and impacts of different morbidities on these problems. Data were obtained from a population-based survey in Korea. HRQoL was measured by EQ-5D questionnaire and low-HRQoL population was defined as individuals whose EQ-5D utility score was among the lowest 5% of total survey population. Logistic regression models were used to evaluate the impact of fifteen morbidities on HRQoL dimensions. Of 2976 low-HRQoL participants, females and low socioeconomic individuals were predominant. They experienced significantly more problems in all dimensions, with pain/discomfort, and mobility as the most frequently reported problems. Problems in HRQoL dimensions diverged according to diseases. Individuals with arthritis experienced more difficulties with mobility (aOR 2.62, 95% CI 1.77–3.87) and pain/discomfort (aOR 2.86, 95% CI 1.78–4.60). Stroke patients experienced more problems in self-care (aOR 2.24, 95% CI 1.59–3.15) and usual activities (aOR 1.87, 95% CI 1.11–3.14). Having two or more diseases was associated with worse outcomes in usual activities and increased risk of depression. Thus, efforts to improve status of low-HRQoL should be customized to fulfil unmet needs corresponding to various diseases, and depression prevention is needed for those with multimorbidity status.
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Ng JS, Chin KY. Potential mechanisms linking psychological stress to bone health. Int J Med Sci 2021; 18:604-614. [PMID: 33437195 PMCID: PMC7797546 DOI: 10.7150/ijms.50680] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Accepted: 11/30/2020] [Indexed: 02/06/2023] Open
Abstract
Chronic psychological stress affects many body systems, including the skeleton, through various mechanisms. This review aims to provide an overview of the factors mediating the relationship between psychological stress and bone health. These factors can be divided into physiological and behavioural changes induced by psychological stress. The physiological factors involve endocrinological changes, such as increased glucocorticoids, prolactin, leptin and parathyroid hormone levels and reduced gonadal hormones. Low-grade inflammation and hyperactivation of the sympathetic nervous system during psychological stress are also physiological changes detrimental to bone health. The behavioural changes during mental stress, such as altered dietary pattern, cigarette smoking, alcoholism and physical inactivity, also threaten the skeletal system. Psychological stress may be partly responsible for epigenetic regulation of skeletal development. It may also mediate the relationship between socioeconomic status and bone health. However, more direct evidence is required to prove these hypotheses. In conclusion, chronic psychological stress should be recognised as a risk factor of osteoporosis and stress-coping methods should be incorporated as part of the comprehensive osteoporosis-preventing strategy.
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Affiliation(s)
- Jia-Sheng Ng
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras 56000, Malaysia
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Lopresti AL. The Effects of Psychological and Environmental Stress on Micronutrient Concentrations in the Body: A Review of the Evidence. Adv Nutr 2020; 11:103-112. [PMID: 31504084 PMCID: PMC7442351 DOI: 10.1093/advances/nmz082] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 06/14/2019] [Accepted: 07/08/2019] [Indexed: 12/21/2022] Open
Abstract
Stress is the nonspecific response of the body to any demand for change. Excess or chronic psychological or environmental stress is associated with an increased risk of mental and physical diseases, with several mechanisms theorized to be associated with its detrimental effects. One underappreciated potential mechanism relates to the effects of psychological and environmental stress on micronutrient concentrations. Micronutrients (vitamins and minerals) are essential for optimal physical and mental function, with deficiencies associated with an array of diseases. In this article, animal and human studies investigating the effects of various psychological and environmental stressors on micronutrient concentrations are reviewed. In particular, the effects of psychological stress, sleep deprivation, and physical exercise on micronutrient concentrations and micronutrient excretion are summarized. Micronutrients identified in this review include magnesium, zinc, calcium, iron, and niacin. Overall, the bulk of evidence suggests stress can affect micronutrient concentrations, often leading to micronutrient depletion. However, before definitive conclusions about the effects of stress can be made, the impact of different stressors, stress severity, and acute versus chronic stress on micronutrient concentrations requires investigation. Moreover, the impact of stress on micronutrients in different populations varying in age, gender, and premorbid health status and the durability of changes after a stressor is resolved require examination. The medical, physical, and psychological implications of nutrient changes caused by a stressor also remain to be determined.
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Affiliation(s)
- Adrian L Lopresti
- School of Psychology and Exercise Science, Murdoch University, Perth, Australia; and Clinical Research Australia, Duncraig, Australia,Address correspondence to ALL (e-mail: )
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[The risk of medical comorbidity in mental disorders with a particular focus on depressive syndromes]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2019; 65:129-143. [PMID: 31154922 DOI: 10.13109/zptm.2019.65.2.129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The risk of medical comorbidity in mental disorders with a particular focus on depressive syndromes Objectives: It has long been recognized that certain mental disorders, and in particular depressive syndromes, are associated with increased medical comorbidity. However, reliable data on the prevalence of comorbid medical diagnoses as well as the impact of these comorbidities on mortality are often rare and sometimes conflicting. Methods: A systematic literature review was conducted using PubMed and Google Scholar to provide a critical account of the current state of research on the comorbidities of medical and mental disorders, with a particular focus on depressive syndromes. Results: Among patients with mental disorders, all-cause mortality is about doubled as compared to the general population causing a significantly shortened life expectancy in the range of one to two decades. This excess mortality is primarily due to increased physical morbidity and mortality, and it cannot be excluded that, for patients with severe mental disorders, excess mortality has been increased over time. Depressive syndromes are often linked to a broad range of somatic symptoms and can be found in diseases, such as heart disease, stroke, diabetes mellitus, overweight/obesity, and asthma. Conclusion: Current studies provide ample evidence of close interactions between physical and mental health. Further developments in the field of psychosomatic medicine should take into consideration the health-related consequences of these interactions.
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Follis SL, Bea J, Klimentidis Y, Hu C, Crandall CJ, Garcia DO, Shadyab AH, Nassir R, Chen Z. Psychosocial stress and bone loss among postmenopausal women: results from the Women’s Health Initiative. J Epidemiol Community Health 2019; 73:888-892. [DOI: 10.1136/jech-2019-212516] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 05/28/2019] [Accepted: 06/01/2019] [Indexed: 12/29/2022]
Abstract
BackgroundBone loss is a major public health concern with large proportions of older women experiencing osteoporotic fractures. Previous research has established a relationship between psychosocial stressors and fractures. However, few studies have investigated bone loss as an intermediary in this relationship. This study investigates whether social stress is associated with bone loss during a 6-year period in postmenopausal women.MethodsData from 11 020 postmenopausal women from the USA was used to examine self-reported psychosocial stress in relation to change in bone mineral density (BMD) measured at the femoral neck, lumbar spine and total hip. Linear regression models were used to examine associations between social measures of psychosocial stress (social strain, social functioning and social support) and per cent change in BMD over 6 years.ResultsHigh social stress was associated with decreased BMD over 6 years. After adjustment for confounders, each point higher in social strain was associated with 0.082% greater loss of femoral neck BMD, 0.108% greater loss of total hip BMD and 0.069% greater loss of lumbar spine BMD (p<0.05). Low social functioning and low social support were associated with greater decreases in femoral neck BMD, and low social functioning was associated with greater decreases in total hip BMD.ConclusionThe findings provide evidence for an association between high social stress and greater bone loss over 6 years of follow-up. In agreement with the prior literature, the findings for social strain and social functioning suggest that poor quality of social relationships may be associated with bone loss in postmenopausal women.
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