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Wu Y, Xu Z, Dong J, Zhang W, Li J, Ji H. Knowledge, Attitudes, and Practices of Patients with Knee Osteoarthritis Regarding Osteoporosis and Its Prevention: A Cross-Sectional Study in China. Int J Gen Med 2024; 17:3699-3709. [PMID: 39219673 PMCID: PMC11363913 DOI: 10.2147/ijgm.s471924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Accepted: 08/11/2024] [Indexed: 09/04/2024] Open
Abstract
Background Older age and female sex are risk factors for osteoarthritis and osteoporosis (OP). This study evaluated the knowledge, attitudes, and practices of patients with knee osteoarthritis (KOA) in China regarding OP and its prevention. This cross-sectional, questionnaire-based study enrolled patients with KOA at four grade-A tertiary hospitals in Shandong Province between 1st September and 20th November 2022. Methods The administered questionnaire contained 55 items across four dimensions (demographic information, knowledge, attitude, and practice). Logistic regression analyses were performed to identify factors associated with an overall questionnaire score ≥70% of the maximum possible score. SPSS 26.0 was used for the analyses; P<0.05 was considered significant. Results The analysis included 434 participants (261 females). The median knowledge, attitude, and practice scores were 7 (interquartile range: 5-10) (possible range, 0-17 points), 44 (interquartile range: 42-49) (possible range, 11-55 points), and 43 (interquartile range: 38-47) (possible range, 13-65 points), respectively. Multivariable logistic regression indicated that female sex (odds ratio [OR], 2.421; 95% confidence interval [95% CI] 1.558-3.762; P<0.001), age 56-65 years-old (OR, 4.222; 95% CI, 1.763-10.109; P=0.001 vs ≤55 years-old), age >65 years-old (OR, 4.358; 95% CI, 1.863-10.195; P=0.001 vs ≤55 years-old), middle/high/technical secondary school education (OR, 1.853; 95% CI, 1.002-3.428; P=0.049 vs primary school or below), and having KOA for 4-5 years (OR, 2.682; 95% CI, 1.412-5.094; P=0.003 vs ≤3 years) were independently associated with a high KAP score. Conclusion There is room for improvement in the knowledge and practices of patients with osteoarthritis in China regarding OP. The findings of this study may facilitate the design and implementation of education programs to increase awareness about OP prevention among patients with KOA.
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Affiliation(s)
- Yan Wu
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan, Shandong, 250014, People’s Republic of China
| | - Zhenzhen Xu
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Jing Dong
- School of Nursing, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, Shandong Province, 271016, People’s Republic of China
| | - Wenzhong Zhang
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Jing Li
- School of Nursing, Shandong University of Traditional Chinese Medicine, Jinan, Shandong Province, 250014, People’s Republic of China
| | - Hong Ji
- Department of Nursing, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan, Shandong, 250014, People’s Republic of China
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Jamil NA, Dhanaseelan J, Buhari NA. Effectiveness of an e-Book on Bone Health as Educational Material for Adolescents: Single-Group Experimental Study. JMIR Pediatr Parent 2024; 7:e56611. [PMID: 39186008 PMCID: PMC11368018 DOI: 10.2196/56611] [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: 01/21/2024] [Revised: 06/26/2024] [Accepted: 07/03/2024] [Indexed: 08/27/2024] Open
Abstract
Background Improved bone health during adolescence can have lifelong implications, reducing the risk of bone fragility. Objective This study aims to evaluate the effectiveness of an e-book in increasing knowledge about and promoting healthy practices related to bone health among Malay adolescents in Kuala Lumpur, Malaysia. Methods A total of 72 adolescents (female: n=51, 71%; age: mean 15, SD 0.74 y) were recruited from selected secondary schools. The participants answered a pretest web-based questionnaire on sociodemographic data, knowledge about osteoporosis, and physical activity. A video call was conducted to assess dietary calcium intake. Participants were provided with a link to an e-book on bone health and instructed to read it within 2 weeks. Postintervention assessments included those for knowledge, physical activity, dietary calcium intake, and acceptance of the e-book. Results There was a significant increase in the median knowledge score, which was 40.6% (IQR 31.3%-46.9%) during the pretest and 71.9% (IQR 53.9%-81.3%) during the posttest (P<.001). However, no changes were observed in dietary calcium intake or physical activity levels. Most participants did not meet the recommended calcium requirements (61/62, 98%) and exhibited sedentary behavior (pretest: 51/62, 82%; posttest: 48/62, 77%). The e-book, however, was well accepted, with the majority reporting that they understood the contents (70/72, 97%), liked the graphics (71/72, 99%), and approved of the layout (60/72, 83%) and font size (66/72, 92%) used. Conclusions The developed e-book effectively increases knowledge levels related to bone health and is well accepted among participants. However, this educational material did not improve bone health practices. Additional strategies are necessary to bridge the gap between knowledge and behavior change.
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Affiliation(s)
- Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, Kuala Lumpur, 50300, Malaysia, 60 392897081
| | - Jashwiny Dhanaseelan
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, Kuala Lumpur, 50300, Malaysia, 60 392897081
| | - Nurin Athirah Buhari
- Centre for Community Health Studies, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abd Aziz, Kuala Lumpur, 50300, Malaysia, 60 392897081
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Elahmer NR, Wong SK, Mohamed N, Alias E, Chin KY, Muhammad N. Mechanistic Insights and Therapeutic Strategies in Osteoporosis: A Comprehensive Review. Biomedicines 2024; 12:1635. [PMID: 39200100 PMCID: PMC11351389 DOI: 10.3390/biomedicines12081635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Revised: 05/10/2024] [Accepted: 07/16/2024] [Indexed: 09/01/2024] Open
Abstract
Osteoporosis, a metabolic bone disorder characterized by decreased bone mass per unit volume, poses a significant global health burden due to its association with heightened fracture risk and adverse impacts on patients' quality of life. This review synthesizes the current understanding of the pathophysiological mechanisms underlying osteoporosis, with a focus on key regulatory pathways governing osteoblast and osteoclast activities. These pathways include RANK/RANKL/OPG, Wingless-int (Wnt)/β-catenin, and Jagged1/Notch1 signaling, alongside the involvement of parathyroid hormone (PTH) signaling, cytokine networks, and kynurenine in bone remodeling. Pharmacotherapeutic interventions targeting these pathways play a pivotal role in osteoporosis management. Anti-resorptive agents, such as bisphosphonates, estrogen replacement therapy/hormone replacement therapy (ERT/HRT), selective estrogen receptor modulators (SERMs), calcitonin, anti-RANKL antibodies, and cathepsin K inhibitors, aim to mitigate bone resorption. Conversely, anabolic agents, including PTH and anti-sclerostin drugs, stimulate bone formation. In addition to pharmacotherapy, nutritional supplementation with calcium, vitamin D, and vitamin K2 holds promise for osteoporosis prevention. However, despite the availability of therapeutic options, a substantial proportion of osteoporotic patients remain untreated, highlighting the need for improved clinical management strategies. This comprehensive review aims to provide clinicians and researchers with a mechanistic understanding of osteoporosis pathogenesis and the therapeutic mechanisms of existing medications. By elucidating these insights, this review seeks to inform evidence-based decision-making and optimize therapeutic outcomes for patients with osteoporosis.
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Affiliation(s)
- Nyruz Ramadan Elahmer
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.R.E.); (S.K.W.); (N.M.); (K.-Y.C.)
- Department of Pharmacology, Pharmacy Faculty, Elmergib University, Al Khums 40414, Libya
| | - Sok Kuan Wong
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.R.E.); (S.K.W.); (N.M.); (K.-Y.C.)
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.R.E.); (S.K.W.); (N.M.); (K.-Y.C.)
| | - Ekram Alias
- Department of Biochemistry, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia;
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.R.E.); (S.K.W.); (N.M.); (K.-Y.C.)
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia; (N.R.E.); (S.K.W.); (N.M.); (K.-Y.C.)
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Kumar V, Barik S, Kumari K, Richa R, Raj V, Shukla M, Kumar A, Kumar R. Comparison of bone health among pre-menopausal and post-menopausal females in rural Eastern India: A pilot study. Post Reprod Health 2024:20533691241265027. [PMID: 38914519 DOI: 10.1177/20533691241265027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
PURPOSE The aim of this study was to identify the at-risk female population (pre- and post-menopausal), identify the risk factors for low bone mineral density (BMD) and assess the knowledge of the subjects regarding osteoporosis by Osteoporosis Knowledge Assessment Tool (OKAT) in both the groups and to determine areas for early intervention in a predominantly rural and tribal area of Eastern India. STUDY DESIGN This was a cross-sectional hospital-based study conducted in a predominant tribal and rural area of Eastern India. Females who were pre- and post-menopausal without a prior diagnosis of osteoporosis were included in the study. MAIN OUTCOME MEASURES Factors affecting osteoporosis and quantified knowledge regarding the disease. RESULTS A total of 388 females were included in the study (pre-menopausal = 190 and post-menopausal = 198). Although no significant difference was noted in the age at menarche between both the groups, a gradual significant shift in the age at menarche was noted in the younger females (p = .031). The mean OKAT score in the pre-menopausal and post-menopausal group was 9.5 ± 3.4 and 9.2 ± 3.5, respectively. 80% of females in the pre-menopausal group had normal T-scores whereas only 25% of the females in the post-menopausal group had normal T-scores. CONCLUSION Targeted educational programs which influence the preventive health behaviour in general and osteoporosis knowledge in particular would bridge this gap. Peer-led community intervention programs which focus on behaviour change with respect to lifestyle and diet modification in the younger population should be the step ahead to reduce the prevalence of the disease.
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Affiliation(s)
- Vishal Kumar
- Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sitanshu Barik
- All India Institute of Medical Sciences Nagpur, Nagpur, India
| | - Kusum Kumari
- All India Institute of Medical Sciences - Deoghar, Deoghar, India
| | - Richa Richa
- All India Institute of Medical Sciences - Deoghar, Deoghar, India
| | - Vikash Raj
- All India Institute of Medical Sciences - Deoghar, Deoghar, India
| | - Mamta Shukla
- All India Institute of Medical Sciences - Deoghar, Deoghar, India
| | - Aman Kumar
- All India Institute of Medical Sciences - Deoghar, Deoghar, India
| | - Rajesh Kumar
- All India Institute of Medical Sciences - Deoghar, Deoghar, India
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Muhamad Jamil NK, Naina Mohamed I, Mokhtar SA, Leong JF, Kamudin NAF, Muhammad N. Barriers to osteoporosis management and adherence to Clinical Practice Guideline: a comparative study between tertiary East Coast hospitals and a Fracture Liaison Services (FLS)-accredited hospital in Malaysia. Arch Osteoporos 2024; 19:49. [PMID: 38864939 DOI: 10.1007/s11657-024-01407-1] [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: 02/29/2024] [Accepted: 05/16/2024] [Indexed: 06/13/2024]
Abstract
This study compares osteoporosis management between tertiary East Coast hospitals and a FLS-accredited hospital in Malaysia. It identifies significant barriers and highlights the superior performance of FLS in areas like timely treatment initiation and treatment monitoring. The insights are crucial for improving osteoporosis management strategies. INTRODUCTION Osteoporosis management poses a substantial healthcare challenge, necessitating effective strategies and Clinical Practice Guidelines (CPG) adherence. METHODS The study employed a self-administered online questionnaire via Google Forms. Orthopedic clinicians from all study sites were invited to participate via messaging platforms. A total of 135 participants completed the questionnaire and the data was proceeded to statistical analyses. RESULTS The study identified significant barriers, including inadequate knowledge of current osteoporosis guidelines and medications (p = 0.014), limited choice of anti-osteoporosis medication (p < 0.001), insufficient post-fracture care staff (p < 0.001), patients' financial constraints due to socioeconomic status (p = 0.027), and lack of doctor-patient time (p = 0.042). FLS demonstrated superior performance in CPG adherence in areas such as clinical diagnosis of osteoporosis without BMD assessment (p = 0.046), timely treatment initiation (p < 0.001), treatment monitoring using BMD (p = 0.004), reassessment treatment after 3-5 years of bisphosphonate therapy (p = 0.034) and considering anabolic agents in very high-risk patients (p = 0.018). CONCLUSION The findings highlight an essential opportunity for improvement and emphasize the necessity for robust strategies and strict adherence to Clinical Practice Guidelines (CPG), especially within tertiary East Coast hospitals. The exemplary efficacy demonstrated by the FLS model strongly advocates for its broader integration across multiple hospitals, promising substantial advancements in osteoporotic patient care outcomes throughout Malaysia.
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Affiliation(s)
- Nur Khadijah Muhamad Jamil
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yacob Latif, Bandar Tun Razak, 56000, Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia
- Pharmacology Department, Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yacob Latif, Bandar Tun Razak, 56000, Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia
| | - Sabarul Afian Mokhtar
- Department of Trauma and Orthopedics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Juzaily Fekry Leong
- Department of Trauma and Orthopedics, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yacob Latif, Bandar Tun Razak, 56000, Cheras, Kuala Lumpur, Malaysia
| | - Nur Azree Ferdaus Kamudin
- Department of Orthopedics, Faculty of Medicine, Universiti Sultan Zainal Abidin, Jalan Sultan Mahmud, 20400, Kuala Terengganu, Terengganu, Malaysia
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yacob Latif, Bandar Tun Razak, 56000, Cheras, Wilayah Persekutuan Kuala Lumpur, Malaysia.
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Nawaz HA, Alqusibri A. Motivation and Barriers for Seeking Osteoporosis Screening Services Among the Elderly Population in Al-Madina Munawara. Cureus 2024; 16:e63225. [PMID: 39070513 PMCID: PMC11281041 DOI: 10.7759/cureus.63225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2024] [Indexed: 07/30/2024] Open
Abstract
Background Osteoporosis is a chronic bone disease associated with a reduction in bone mass and an increased risk of fractures. The prevalence of osteoporosis is rising globally, including in Saudi Arabia, where there is a lack of information regarding the uptake of osteoporosis screening services. This study aims to examine self-efficacy and barriers toward osteoporosis screening in older women and men in Al-Madina Munawara, Saudi Arabia. Methods A cross-sectional study was conducted among adults aged 60 and above who attended primary healthcare centers. Convenience sampling was used to recruit participants, and a self-administered questionnaire was used to assess sociodemographic characteristics, osteoporosis status, general health-related characteristics, and screening self-efficacy. Analyses included multivariable regression analyses to evaluate the association between osteoporosis screening self-efficacy and potential explanatory variables. Data were collected in the last quarter of 2023. Results In a study involving 342 completed questionnaires, the mean age of participants was 66.2 years (SD = 4.3), with a range from 60 to 79 years, and the majority were male (230, 67.3%), having chronic diseases (226, 66.3%). Regarding osteoporosis risk factors and screening behaviors, the majority did not use prednisolone (252, 74.1%), did not have a family history of osteoporosis (216, 63.2%), had not experienced falls in the past five years (223, 65.2%), and had not undergone osteoporosis screening (299, 87.4%). The mean self-efficacy score for osteoporosis screening was 37.7 (SD = 4.7), ranging from 10 to 50, which indicated a moderate level of screening self-efficacy. In multivariate analysis, smokers were more likely to have higher scores in self-efficacy for osteoporosis screening compared to non-smokers (RR = 1.10; 95% CI = 1.01, 1.21). Participants who did osteoporosis screening (RR = 1.12; 95% CI = 1.01, 1.24) and those who were planning to do osteoporosis screening (RR = 1.10; 95% CI = 1.03, 1.19) were more likely to have higher score in self-efficacy for osteoporosis screening compared to their counterparts. Conclusion The participants had a fair level of screening self-efficacy. The smokers and those who had undergone or planned to undertake osteoporosis screening demonstrated higher self-efficacy scores than others. A lot of progress could be made in decreasing the burden of osteoporosis and enhancing the overall health and well-being of the older population by addressing these issues using specific interventions and policy measures.
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Affiliation(s)
- Heba A Nawaz
- Madinah Health Cluster, Saudi Ministry of Health, Madinah, SAU
| | - Asmaa Alqusibri
- Madinah Health Cluster, Saudi Ministry of Health, Madinah, SAU
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Xu P, Zhao N, Wang J. Knowledge, attitude, and practice toward osteoporosis among patients with chronic kidney disease in Zhejiang. Medicine (Baltimore) 2024; 103:e38153. [PMID: 38758880 PMCID: PMC11098230 DOI: 10.1097/md.0000000000038153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Accepted: 04/16/2024] [Indexed: 05/19/2024] Open
Abstract
Patients with chronic kidney disease (CKD) are considered high-risk group for osteoporosis. However, the current understanding of their knowledge, attitude, and practice toward osteoporosis remains unclear. CKD patients were recruited from Li Huili Hospital, Ningbo Medical Center between March 2023 and June 2023. A self-designed questionnaire was used to collect the participant's demographic characteristics and knowledge, attitude, and practice toward osteoporosis. A total of 500 valid questionnaires were included in the analysis, with participants aged 51.08 ± 14.76 years. The mean scores for knowledge, attitude, and practice were 6.67 ± 3.04 (range: 0-11), 33.99 ± 3.37 (range: 10-50), and 35.29 ± 5.54 (range: 9-45), respectively. Pearson correlation analysis revealed significant positive associations between knowledge and attitude scores (r = 0.440, P < .001), knowledge and practice scores (r = 0.376, P < .001), as well as attitude and practice scores (r = 0.403, P < .001). Structural equation modeling revealed direct associations between knowledge and attitude (path coefficient = 0.488, P < .001), and between attitude and practice (path coefficient = 0.485, P < .001). The knowledge also exhibited a directly positive effect on practice (path coefficient = 0.449, P < .001). Undergoing glucocorticoid therapy (odd ratio [OR] = 2.353, 95% confidence interval [CI]: 1.022-5.418, P = .044) and osteoporosis osteoporosis (OR = 1.565, 95% CI: 1.011-2.421, P = .044) were positively associated with knowledge. Moreover, disease duration >1 year was positively associated with practice (OR = 3.643, 95% CI: 1.754-7.565, P < .001). CKD patients demonstrated moderate knowledge, neutral attitude, and moderate practice toward osteoporosis. To address the practice gaps of CKD patients toward osteoporosis, targeted educational interventions and attitude support programs can be developed.
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Affiliation(s)
- Pengjie Xu
- Department of Nephrology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Nadan Zhao
- Department of Radiology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
| | - Jiangdong Wang
- Department of Nephrology, Ningbo Medical Center Lihuili Hospital, Ningbo University, Ningbo, China
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Tan Y, Luo B, Sheng Z. Knowledge of osteoporosis prevention among people with endocrine disorders: A cross-sectional study. Nurs Health Sci 2023. [PMID: 38151333 DOI: 10.1111/nhs.13074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Revised: 11/30/2023] [Accepted: 12/13/2023] [Indexed: 12/29/2023]
Abstract
People with endocrine disorders are at an increased risk of osteoporosis, yet their knowledge of osteoporosis prevention is rarely studied. This study aimed to assess the knowledge related to osteoporosis prevention and its associated factors among people with endocrine disorders in China. A cross-sectional study was conducted in a Chinese hospital's Department of Metabolism and Endocrinology. A total of 562 people with endocrine disorders completed the Chinese version of the Osteoporosis Prevention and Awareness Tool to assess their knowledge of osteoporosis prevention. Results showed that participants had a mean knowledge of 59.36 ± 23.90 out of 100, with only 52.1% scoring above 60 points. Being female, having higher education, with comorbidities, with a recent osteoporosis diagnosis, and having received health education related to osteoporosis prevention were associated with higher knowledge of osteoporosis prevention. Our study indicates that more efforts are needed to improve the knowledge related to osteoporosis prevention among people with endocrine disorders. This may be realized by strengthening and expanding diverse education, focusing on males and those with lower education and without comorbidities.
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Affiliation(s)
- Yaqiong Tan
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Bihua Luo
- Clinical Nursing Teaching and Research Section, the Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology, the Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhifeng Sheng
- National Clinical Research Center for Metabolic Diseases, Department of Metabolism and Endocrinology, the Second Xiangya Hospital, Central South University, Changsha, China
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Ibrahim HA, Nahari MH, Al-khadher MA, Ismail NI, Elgzar WT. Gender Disparities in Osteoporosis Knowledge, Health Beliefs and Preventive Behaviors in Najran City, Saudi Arabia. Nutrients 2023; 15:3658. [PMID: 37630848 PMCID: PMC10457756 DOI: 10.3390/nu15163658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/24/2023] [Accepted: 08/14/2023] [Indexed: 08/27/2023] Open
Abstract
Osteoporosis is a chronic bone disease affecting both men and women, but it is more prevalent in women. Promoting a healthy lifestyle among adults, particularly women, is crucial in preventing and reducing the osteoporosis impact. This study aimed to compare the osteoporosis knowledge, health beliefs and preventive behaviors among adult male and female in Najran city Saudi Arabia. This cross-sectional study was performed on 516 males and 581 females in Najran City, Saudi Arabia, from January to April 2023. The data collection instrument is a self-reported online questionnaire consisting of basic data, the Osteoporosis Preventive Behavior (OPB) scale, the osteoporosis knowledge assessment tool, and the osteoporosis health belief scale. The results revealed that male participants had a higher OPB (26.70) than females (20.32). However, females have a higher knowledge (10.71), perceive themselves as more susceptible to osteoporosis (20.34) and had higher exercise barriers (20.11) compared to males (9.97, 18.79 and 19.20, respectively). Statistically significant correlations (p < 0.001) were observed between OPB, osteoporosis knowledge (r = 0.26), perceived susceptibility (r = 0.33), severity (r = 0.53), exercise (r = 0.54) and calcium (r = 0.33) benefits, exercise (r = 0.40) and calcium (r = 0.81) barriers and health motivation (r = 0.37). The study concluded significant disparities between males and females regarding osteoporosis-related knowledge, preventive behaviors, perceived susceptibility, severity, and exercise perceived barriers. The results suggest gender-based educational interventions to enhance OPB by addressing osteoporosis-related knowledge, perceived susceptibility, seriousness, benefits, and health motivation.
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Affiliation(s)
- Heba A. Ibrahim
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia;
| | - Mohammed H. Nahari
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Najran University, Najran 66441, Saudi Arabia;
| | - Mugahed A. Al-khadher
- Department of Medical Surgical Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia;
| | - Nemat I. Ismail
- Department of Obstetrics and Gynecology Nursing, Nursing College, Damanhour University, Damanhour 22511, Egypt;
| | - Wafaa T. Elgzar
- Department of Maternity and Childhood Nursing, Nursing College, Najran University, Najran 66441, Saudi Arabia;
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Low NY, Chan CY, Subramaniam S, Chin KY, Ima Nirwana S, Muhammad N, Fairus A, Ng PY, Jamil NA, Abd Aziz N, Mohamed N. Comparing the performance of body mass index, waist circumference and waist-to-height ratio in predicting Malaysians with excess adiposity. Ann Hum Biol 2022; 49:299-304. [PMID: 36373795 DOI: 10.1080/03014460.2022.2147585] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Body mass index (BMI) is a widely used surrogate tool to screen for obesity/adiposity, but it cannot differentiate between lean and fat mass. Thus, alternative tools to detect excess adiposity should be identified. AIM This study aimed to compare the performance of BMI, waist circumference (WC) and waist-to-height ratio (WtHR) in predicting Malaysians with excess body fat defined by dual-energy X-ray absorptiometry (DXA). SUBJECTS AND METHODS A total of 399 men and women aged ≥40 years were recruited from Klang Valley, Malaysia. The body composition of the subjects, including body fat percentage, was measured by DXA. The weight, height, WC and WHtR of the subjects were also determined. RESULTS BMI [sensitivity = 55.7%, specificity = 86.1%, area under curve (AUC) = 0.709] and WC (sensitivity = 62.7%, specificity = 90.3%, AUC = 0.765) performed moderately in predicting excess adiposity. Their performance and sensitivity improved with lower cut-off values. The performance of WHtR (sensitivity = 96.6%, specificity = 36.1, AUC = 0.664) was optimal at the standard cut-off value and no modification was required. CONCLUSION The performance of WC in identifying excess adiposity was greater than BMI and WHtR based on AUC values. Modification of cut-off values for BMI and WC could improve their performance and should be considered by healthcare providers in screening individuals with excess adiposity.
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Affiliation(s)
- Nie Yen Low
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Chin Yi Chan
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Soelaiman Ima Nirwana
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Ahmad Fairus
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Pei Yuen Ng
- Centre of Drug Delivery Research, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- School of Healthcare Sciences, Faculty of Health Science, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Noorazah Abd Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
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11
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Ranjan P, Vikram NK, Kumari A, Chopra S, Choranur A, Pradeep Y, Puri M, Malhotra A, Ahuja M, Meeta, Batra A, Balsarkar G, Goswami D, Guleria K, Sarkar S, Kachhawa G, Verma A, Kumari MK, Madan J, Dabral A, Kamath S, Rathore AM, Kumar R, Venkataraman S, Kaloiya G, Bhatla N, Kumari SS, Baitha U, Prakash A, Tiwaskar M, Tewary K, Misra A, Guleria R. Evidence and consensus-based clinical practice guidelines for management of overweight and obesity in midlife women: An AIIMS-DST initiative. J Family Med Prim Care 2022; 11:7549-7601. [PMID: 36994026 PMCID: PMC10041015 DOI: 10.4103/jfmpc.jfmpc_51_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 01/23/2022] [Accepted: 01/31/2022] [Indexed: 01/31/2023] Open
Affiliation(s)
- Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K. Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Ambuja Choranur
- President, Indian Menopause Society, Former Professor and Head, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, India
| | - Yashodhara Pradeep
- Era Medical College and University, Ex Professor and Head Department of Obstetrics and Gynaecology, RML Institute of Medical Sciences, KGMU, Lucknow, Vice President Elect, FOGSI, Ex Vice President, IMS, India
| | - Manju Puri
- Head, Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India
| | - Anita Malhotra
- Food and Nutrition, Department of Home Science, Vice-Principal, Lakshmibai College, University of Delhi, New Delhi, India
| | - Maninder Ahuja
- President, Society of Meaningful Life Management, Associate Editor, Journal of Midlife Health, India
| | - Meeta
- Indian Menopause Society, Editor-in-Chief, Journal of Mid-Life Health, India
| | - Achla Batra
- President, Association of Obstetricians and Gynaecologists of Delhi (AOGD), Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Geetha Balsarkar
- Department of Obstetrics and Gynaecology Seth G. S. Medical College, Mumbai, India
| | - Deepti Goswami
- Director Professor, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Verma
- Department of Home Science, University of Delhi, New Delhi, India
| | | | - Jagmeet Madan
- National President, Indian Dietetic Association, India
| | - Anjali Dabral
- Head, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Sandhya Kamath
- Ex-Professor of Medicine and Dean, Seth G S Medical College and KEM Hospital, Mumbai, and LT Municipal Medical College and General Hospital, Mumbai, India
| | - Asmita Muthal Rathore
- Director Professor and Head, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Raman Kumar
- President, Academy of Family Physicians of India, India
| | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Gaurishankar Kaloiya
- Clinical Psychology, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S. Shantha Kumari
- President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Prakash
- Department of Medicine, LHMC and SSK Hospital, New Delhi, India
| | | | - Kamlesh Tewary
- President, Association of the Physicians of India, India
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and President, Diabetes Foundation (India), New Delhi, India
| | - Randeep Guleria
- Director, All India Institute of Medical Sciences, New Delhi, India
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12
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Ong SC, Low JZ, Ooi GS. Application of health belief model in the assessment of factors affecting exercise behaviours in preventing osteoporosis. JOURNAL OF PHARMACEUTICAL HEALTH SERVICES RESEARCH 2022. [DOI: 10.1093/jphsr/rmac045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Abstract
Objectives
Osteoporosis is a skeletal disorder associated with weak and brittle bones, and more susceptible to fracture. Osteo-protective behaviours, such as exercise, may prevent osteoporosis. Therefore, this study aimed to assess the factors influencing the exercise behaviour in Malaysian adults and to assess their health beliefs and self-regulation in preventing osteoporosis.
Methods
A cross-sectional, self-administered questionnaire was conducted throughout Malaysia through a web-based or physical-based survey. The questionnaire consisted of three sections: demographic data, ten questions regarding social and family history related to osteoporosis and 38 questions with seven subdomains (i.e. susceptibility, seriousness, barriers, benefits, health motivation, self-efficacy and self-regulation) which measured the health belief scores and self-regulation using 5-point Likert scale. Descriptive, inferential analysis and linear regression were used to analyse the data.
Key findings
A total of 679 participants completed the questionnaire. The mean health belief score was 63.7%, which was moderate. Most participants (64.4%) perceived low susceptibility to osteoporosis [mean score = 47.0%, standard deviation (SD) = 16.2]. Participants with age 18–27 years (44.8%), single (45.0%) and monthly income <RM 1000 (45.2%), perceived significant lower susceptibility to osteoporosis. Participants’ perception scores were high on the benefits of exercise (75.7%, SD = 16.4), health motivation (74.9%, SD = 17.1) and perceived low barriers to exercise (71.7%, SD = 14.9). Respondents who were at risk of osteoporosis and with family and friends diagnosed with osteoporosis obtained a higher score than those who did not.
Conclusions
The health belief score in the Malaysian population was moderate. However, the majority of participants were unaware of the susceptibility and seriousness of osteoporosis. Efforts need to be taken to break the barriers associated with exercise in preventing osteoporosis.
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Affiliation(s)
- Siew Chin Ong
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia , Pulau Pinang , Malaysia
| | - Joo Zheng Low
- Discipline of Social and Administrative Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia , Pulau Pinang , Malaysia
- Department of Pharmacy, Hospital Sultan Ismail Petra , Kelantan , Malaysia
| | - Guat See Ooi
- Discipline of Clinical Pharmacy, School of Pharmaceutical Sciences, Universiti Sains Malaysia , Pulau Pinang , Malaysia
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13
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Evaluation of Knowledge, Attitudes, and Practices Related to Osteoporosis and Correlates of Perceived High Risk among People Living in Two Main Districts of Lebanon. J Osteoporos 2022; 2022:1188482. [PMID: 35656005 PMCID: PMC9152399 DOI: 10.1155/2022/1188482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 03/11/2022] [Accepted: 04/26/2022] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND The prevalence of osteoporosis is increasing in Lebanon. AIM We evaluated the knowledge, attitudes, and practices related to osteoporosis and correlates of its perceived high risk among people living in Beirut and Mount Lebanon districts of Lebanon. METHODS This study is a cross-sectional study which consisted of 376 participants that were selected from the two districts within two or three households after two geographical areas were randomly selected from each stratum classified by education and altitude. They were then asked to fill a KAP survey on osteoporosis and provide information on factors likely related to its perceived high risk. RESULTS The majority of participants had a low (20.2%) and moderate (65.4%) knowledge of osteoporosis, with a higher knowledge in females than in males. A higher percentage of young people perceived it as a serious health risk than that of older people. In contrast, 85.9% participants reported drinking caffeinated beverages and 51.6% participants reported that they do not exercise. Glucose intolerance due to epigenetic and genetic factors, female sex, and older age were risk factors of a perceived high risk of osteoporosis, while any physical exercise, abstention from caffeine for 48 to 72 hours, and higher education were protective factors. CONCLUSION A nationwide KAP study should be conducted; likewise, awareness campaigns should be adopted.
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Chan CY, Subramaniam S, Chin KY, Ima-Nirwana S, Muhammad N, Fairus A, Ng PY, Aini JN, Aziz NA, Mohamed N. Effect of a Screening and Education Programme on Knowledge, Beliefs, and Practices Regarding Osteoporosis among Malaysians. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6072. [PMID: 35627609 PMCID: PMC9141639 DOI: 10.3390/ijerph19106072] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/14/2022] [Accepted: 05/16/2022] [Indexed: 12/31/2022]
Abstract
Background: Osteoporosis is an emerging geriatric condition with high morbidity and healthcare cost in developing nations experiencing rapid population ageing. Thus, identifying strategies to prevent osteoporosis is critical in safeguarding skeletal health. This study aimed to evaluate the effects of a bone health screening and education programme on knowledge, beliefs, and practice regarding osteoporosis among Malaysians aged 40 years and above. Methods: A longitudinal study was conducted from April 2018 to August 2019. During the first phase of the study, 400 Malaysians (190 men, 210 women) aged ≥ 40 years were recruited in Klang Valley, Malaysia. Information on subjects’ demography, medical history, knowledge, and beliefs regarding osteoporosis, physical activity status, and dietary and lifestyle practices were obtained. Subjects also underwent body anthropometry measurement and bone mineral density scan (hip and lumbar spine) using a dual-energy X-ray absorptiometry device. Six months after the first screening, similar investigations were carried out on the subjects. Results: During the follow-up session, 72 subjects were lost to follow up. Most of them were younger subjects with a lower awareness of healthy practices. A significant increase in knowledge, beliefs (p < 0.05), calcium supplement intake (p < 0.001), and dietary calcium intake (p = 0.036) and a reduction in coffee intake (p < 0.001) were found among subjects who attended the follow-up. In this study, the percentage of successful referrals was 41.86%. Subjects with osteoporosis were mostly prescribed alendronate plus vitamin D3 by medical doctors, and they followed the prescribed treatment accordingly. Conclusions: The bone health screening and education programmes in this study are effective in changing knowledge, beliefs, and practice regarding osteoporosis. The information is pertinent to policymakers in planning strategies to prevent osteoporosis and its associated problems among the middle-aged and elderly population in Malaysia. Nevertheless, a more comprehensive bone health education program that includes long-term monitoring and consultation is needed to halt the progression of bone loss.
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Affiliation(s)
- Chin Yi Chan
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Shaanthana Subramaniam
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Norliza Muhammad
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
| | - Ahmad Fairus
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia;
| | - Pei Yuen Ng
- Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Jamil Nor Aini
- Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noorazah Abd Aziz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia;
| | - Norazlina Mohamed
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (K.-Y.C.); (S.I.-N.); (N.M.)
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15
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Nikoobar A, Kolahi AA. Knowledge and Preventive Practices About Osteoporosis Among Elementary School Teachers of Bandar-Abbas in 2020. Front Nutr 2022; 9:849639. [PMID: 35445060 PMCID: PMC9014264 DOI: 10.3389/fnut.2022.849639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Accepted: 03/10/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose To assess knowledge and preventive practices about osteoporosis among elementary school teachers of Bandar-Abbas in 2020. Materials and Methods In this cross-sectional study, the schools were selected using simple random sampling, and the teachers were invited to fill out an online questionnaire. The knowledge section of the questionnaire assessed general knowledge and knowledge regarding risk/protective factors, nutrition, and physical activity. The preventive practices section assessed dietary habits using a food frequency questionnaire, asking about 16 items in six groups, intakes of which were compared to the recommendations of the Iranian food pyramid. This section also assessed physical activity using the International Physical Activity Questionnaire. Results Totally, 377 school teachers with a mean [standard deviation (SD)] age of 38 (6.7) participated in this study. The level of overall knowledge of 128 (33.9%) teachers was high, 222 (58.9%) moderate, and 27 (7.2%) low. The median [interquartile range (IQR)] intakes of fruits [2 (1-2)] and meats/eggs [1.7 (1.4-2.2)] were adequate, while those of dairy products [1.5 (0.9-2.3)], nuts/legumes [0.5 (0.2-1.1)], and vegetables [0.3 (0.1-1)] were inadequate. The median (IQR) intakes of tea/coffee [1 (0.6-2)] and cola [0.1 (0-0.3)] were considered limited. The physical activity level of 121 (32.1%) teachers was high, 124 (32.9%) moderate, and 135 (35%) low. Conclusion Knowledge of the teachers about osteoporosis was moderate, and their preventive practices were somewhat adequate concerning dietary habits and moderate concerning physical activity.
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Affiliation(s)
- Ali Nikoobar
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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16
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Dong W, Sun Z, Bai R. Prevalence of and Factors Associated With Nutritional Supplement Use Among Older Chinese Adults: A Nationwide Cross-Sectional Study in China. Front Public Health 2022; 10:822087. [PMID: 35400059 PMCID: PMC8987002 DOI: 10.3389/fpubh.2022.822087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 02/28/2022] [Indexed: 11/17/2022] Open
Abstract
Objective This study identified the prevalence of nutritional supplement (NS) use among older Chinese adults and explored the factors associated with NS use in this population. Methods We used data from 11,089 Chinese men and women aged ≥ 65 years from the 2018 Chinese Longitudinal Healthy Longevity Survey. The chi-square test was used to examine the differences in demographics, health status and lifestyles at different levels. Multivariate logistic regression was used to assess the association between NS use and demographic and lifestyle characteristics. Results Twelve percent of Chinese adults aged 65 years and above used NS. In terms of the type of supplement used, the most commonly used was calcium (8.49%), followed by protein (2.73%) and multivitamins (2.40%). In terms of demographic characteristics, women, older people, urban residents with other marital status, higher educational level, better living conditions and better lifestyle habits showed a greater use of some kinds of NS to varying degrees. Factors associated with the use of any NS included female gender [OR = 1.71, 95% confidence intervals (95% CI): 1.09-1.44], age 85-94 (OR = 1.30, 95% CI: 1.08-1.58), urban household registration (hukou) (OR = 1.25, 95% CI:1.46-2.00), higher education (primary school and middle school: OR = 1.32, 95% CI:1.14-1.52; high school and above: OR = 1.56, 95% CI:1.25-1.94), average and poor living standard (average: OR = 0.64, 95% CI:0.56-0.73; poor: OR = 0.42, 95% CI:0.32-0.55), poor health status (OR = 1.36, 95% CI:1.13-1.63), former smoking (OR = 1.33, 95% CI:1.11-1.60), and having exercise habits (former exercise: OR = 2.24, 95% CI:1.83-2.74; current exercise: OR = 2.28, 95% CI:2.00-2.61). Women reported taking 2-3 kinds of NSs, and more than 50% of NS users reported taking supplements often. Conclusion This study provides information on the current prevalence of NS use among older Chinese adults, and it clarifies the association of NS use with demographic, lifestyle and other factors. Providing scientifically based health guidance on NS use for older people is crucial to promoting their health.
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Affiliation(s)
- Wanyue Dong
- School of Elderly Care Services and Management, Nanjing University of Chinese Medicine, Nanjing, China
| | - Zhonghe Sun
- Department of Social Work, Nanjing First Hospital, Nanjing Medical University, Nanjing, China
| | - Ruhai Bai
- School of Public Affairs, Nanjing University of Science and Technology, Nanjing, China
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17
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Ranjan P, Vikram NK, Choranur A, Pradeep Y, Ahuja M, Puri M, Malhotra A, Kumari A, Chopra S, Batra A, Balsalkar G, Goswami D, Guleria K, Sarkar S, Kachhawa G, Verma A, Kumari MK, Madan J, Dabral A, Kamath S, Rathore AM, Kumar R, Venkataraman S, Kaloiya G, Bhatla N, Kumari SS, Baitha U, Prakash A, Tiwaskar M, Tewary K, Misra A, Guleria R. Executive summary of evidence and consensus-based Clinical Practice Guidelines for management of obesity and overweight in midlife women: An AIIMS-DST initiative. Diabetes Metab Syndr 2022; 16:102426. [PMID: 35248973 DOI: 10.1016/j.dsx.2022.102426] [Citation(s) in RCA: 4] [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: 01/10/2022] [Revised: 02/08/2022] [Accepted: 02/09/2022] [Indexed: 12/17/2022]
Abstract
BACKGROUND AND AIMS Weight gain is an independent risk factor for decline in cardiometabolic and overall health-related quality of life in midlife women. The AIIMS-DST initiative aims to develop and validate stepwise recommendations specific for weight management in midlife women. METHODS The key clinical questions specific to weight management in midlife women were finalised with the help of a multidisciplinary team of experts in the guideline development group (GDG). Phase I included a systematic and/or narrative review to gather evidence, grading of evidence and expert opinion was sought to develop clinical practice recommendations for each clinical question. Phase II focused on validation of clinical practice recommendations using the peer-review, Delphi method and GRADE approach. RESULTS -The guidelines provide clinical practice points to address challenges encountered by midlife women in their attempts to manage obesity via lifestyle modification techniques. The initiation of discussion would help the healthcare provider to identify the weight management needs of the women, educate women on different modalities of weight management, and empower them to incorporate corrective lifestyle behaviours. Before initiating the management, a comprehensive assessment of clinical and lifestylerelated parameters should be completed. A personalised behavioural lifestyle modification program addressing the midlife specific barriers for optimal metabolic, musculoskeletal, and mental health should be planned. A consistent follow-up is required for maintenance of corrective eating and activity habits by addressing midlife specific barriers for sustenance of healthy weight. CONCLUSION These recommendations will be useful in opportunistic screening and management of obesity in midlife women across healthcare settings.
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Affiliation(s)
- Piyush Ranjan
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Ambuja Choranur
- President, Indian Menopause Society, Former Professor and Head, Department of Obstetrics and Gynaecology, Osmania Medical College, Hyderabad, India
| | - Yashodhara Pradeep
- Era Medical College and University, Ex Prof. and Head Department of Obstetrics and Gynaecology, RML Institute of Medical Sciences, KGMU, Lucknow, Vice President Elect, FOGSI, Ex Vice President, IMS, India
| | - Maninder Ahuja
- President, Society of Meaningful Life Management, Associate Editor, Journal of Midlife Health, India
| | - Manju Puri
- Head, Department of Obstetrics and Gynaecology, LHMC and SSK Hospital, New Delhi, India
| | - Anita Malhotra
- Food and Nutrition, Department of Home Science, Vice-principal, Lakshmibai College, University of Delhi, New Delhi, India
| | - Archana Kumari
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Sakshi Chopra
- Department of Home Science, University of Delhi, New Delhi, India
| | - Achla Batra
- President, Association of Obstetricians & Gynaecologists of Delhi (AOGD), Professor, Department of Obstetrics and Gynaecology, VMMC and Safdarjung Hospital, New Delhi, India
| | - Geetha Balsalkar
- Department of Obstetrics and Gynaecology Seth G. S. Medical College, Mumbai, India
| | - Deepti Goswami
- Director Professor, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Kiran Guleria
- Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
| | - Siddharth Sarkar
- Department of Psychiatry and NDDTC, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Kachhawa
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - Aditi Verma
- Department of Home Science, University of Delhi, New Delhi, India
| | | | - Jagmeet Madan
- National President, Indian Dietetic Association, India
| | - Anjali Dabral
- Head, Department of Obstetrics and Gynaecology, VMMC and safdarjung Hospital, New Delhi, India
| | - Sandhya Kamath
- Ex-Professor of Medicine and Dean, Seth G S Medical College and KEM Hospital, Mumbai, and LT Municipal Medical College and General Hospital, Mumbai, India
| | - Asmita Muthal Rathore
- Director Professor and Head, Department of Obstetrics and Gynaecology, Maulana Azad Medical College, New Delhi, India
| | - Raman Kumar
- President, Academy of Family Physicians of India, India
| | - Srikumar Venkataraman
- Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi, India
| | - Gaurishankar Kaloiya
- Clinical Psychology, Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Neerja Bhatla
- Head, Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - S Shantha Kumari
- President, The Federation of Obstetric and Gynaecological Societies of India, India
| | - Upendra Baitha
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Anupam Prakash
- Department of Medicine, LHMC and SSK Hospital, New Delhi, India
| | | | - Kamlesh Tewary
- President, Association of the Physicians of India, India
| | - Anoop Misra
- Chairman, Fortis-C-DOC Centre of Excellence for Diabetes, Metabolic Diseases and Endocrinology, Chairman, National Diabetes, Obesity and Cholesterol Foundation (N-DOC) and President, Diabetes Foundation (India), New Delhi, India
| | - Randeep Guleria
- Director, All India Institute of Medical Sciences, New Delhi, India
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18
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Qu Q, Zhu J, Wang H, Zhang Q, Zhang Y, Yan Z, Fan Q, Wang Y, He Y, Yao L, Xu L, Zhang C, Jia J. Exploring Alternative Measurements of Cardiorespiratory Fitness in Patients With Mild Ischemic Stroke at Acute Phase. Front Neurol 2022; 13:801696. [PMID: 35222244 PMCID: PMC8864240 DOI: 10.3389/fneur.2022.801696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/10/2022] [Indexed: 11/17/2022] Open
Abstract
Background While emerging studies have suggested an association of cardiorespiratory fitness (CRF) with stroke risk and overall health outcomes, little is known regarding the optimum methods of CRF measurement in patients with mild acute ischemic stroke. Objective The aim of this study was to explore the association between the 6-min walk distance (6MWD) and other measurements related to CRF in patients with mild ischemic stroke at the acute stage. Methods A total of 30 patients with stroke and 71 healthy subjects matched for age and grip strength (GS) were prospectively recruited. All patients were within 14 days after stroke onset and presented mild motor impairment (with a full score of Fugl-Meyer Motor Assessment). Demographic data of both groups and clinical information of the stroke group were documented, and the CRF comparison between the two groups was conducted. Each participant underwent a one-time assessment of 6MWD and a series of measurements related to CRF, including GS, 10-m walk test (10mWT), five-times sit-to-stand time (FTSST), functional reaching test (FRT), Berg Balance Scale (BBS), and waistline. Pearson's product-moment correlation coefficient test and multiple linear regression were performed to explore the indicators of CRF. Results Significant moderate correlations (0.3 < r <0.6) were found between 6MWD and GS of left hand (GS-left) (r = 0.573, p = 0.001), GS of right hand (GS-right) (r = 0.524, p = 0.003), FTSST (r = −0.551, p = 0.002), 10mWT (r = 0.554, p = 0.001), and FRT (r = 0.449, p = 0.021) in the patient group. While 6MWD displayed significant moderate correlations with waistline (r = 0.364, p = 0.002), 10mWT (r = 0.512, p < 0.001), FTSST (r = −0.573, p < 0.001), and FRT (r = 0.550, p < 0.001) in the healthy group. All these dependent variables were entered into a stepwise multiple linear regression analysis to evaluate their values in estimating CRF as measured by 6MWD in each group. Analyses suggested that GS-left (p = 0.002) and FTSST (p = 0.003) were the indicators of CRF in the patient group with stroke and explained 51.4% of the variance of 6MWD (R2 = 0.514); FTSST (p < 0.001), 10mWT (p < 0.001), and FRT (p = 0.021) were the indicators of CRF in the healthy group and explained 58.9% of variance of 6MWD (R2 = 0.589). Conclusions Our data confirmed that CRF is impaired in patients with mild ischemic stroke at the acute phase. Moreover, GS-left may be an optional indicator of CRF in patients with mild acute ischemic stroke, but not in healthy people. Clinical Trial Registration www.chictr.org.cn, identifier: ChiCTR2000031379.
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Affiliation(s)
- Qingming Qu
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Jie Zhu
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Hewei Wang
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Qi Zhang
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Yongli Zhang
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Zhijie Yan
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Qiwei Fan
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
| | - Yuanyuan Wang
- Department of Rehabilitation Medicine, The People's Hospital of Jiaozuo City, Jiaozuo, China
| | - Ying He
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Liqing Yao
- Department of Rehabilitation Medicine, The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lijuan Xu
- Linping Hospital of Integrated Traditional Chinese and Western Medicine, Linping, China
| | - Chao Zhang
- Hangzhou Xiaoshan Neighborhood United Hospital, Hangzhou, China
| | - Jie Jia
- Department of Rehabilitation Medicine, Fudan University Huashan Hospital, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- National Clinical Research Center for Aging and Medicine, Fudan University Huashan Hospital, Shanghai, China
- *Correspondence: Jie Jia
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Vikram N, Ranjan P, Choranur A, Pradeep Y, Ahuja M, Meeta M, Puri M, Malhotra A, Kumari A, Chopra S, Batra A, Balsalkar G, Goswami D, Guleria K, Sarkar S, Kachhawa G, Verma A, Kumari MK, Madan J, Dabral A, Kamath S, Rathore A, Kumar R, Venkataraman S, Kaloiya G, Bhatla N, Kumari SS, Baitha U, Prakash A, Tiwaskar M, Tewary K, Misra A, Guleria R. Executive summary of evidence and consensus-based clinical practice guidelines for management of obesity and overweight in midlife women: An AIIMS-DST initiative. J Midlife Health 2022; 13:34-49. [PMID: 35707299 PMCID: PMC9190956 DOI: 10.4103/jmh.jmh_7_22] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/08/2022] [Accepted: 02/10/2022] [Indexed: 12/03/2022] Open
Abstract
Weight gain is an independent risk factor for decline in cardiometabolic and overall health-related quality of life in midlife women. The AIIMS-DST initiative aims to develop and validate stepwise recommendations specific for weight management in midlife women. The key clinical questions specific to weight management in midlife women were finalized with the help of a multidisciplinary team of experts in the guideline development group. Phase I including a systematic and/or narrative review, grading of evidence, and expert opinion was sought to develop clinical practice recommendations for each clinical question. Phase II focused on validation of clinical practice recommendations using the peer-review, Delphi method, and GRADE approach. The guidelines provide clinical practice points to address challenges encountered by midlife women in their attempts to manage obesity via lifestyle modification techniques. The initiation of discussion would help the health-care provider to identify the weight management needs of the women, educate women on different modalities of weight management, and empower them to incorporate corrective lifestyle behaviors. Before initiating the management, a comprehensive assessment of clinical and lifestyle-related parameters should be completed. A personalized behavioral lifestyle modification program addressing the midlife-specific barriers for optimal metabolic, musculoskeletal, and mental health should be planned. A consistent follow-up is required for maintenance of corrective eating and activity habits by addressing midlife-specific barriers for sustenance of healthy weight. These recommendations will be useful in opportunistic screening and management of obesity in midlife women across health-care settings.
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Amin MFM, Zakaria WMW, Yahya N. Correlation between Hounsfield unit derived from head, thorax, abdomen, spine and pelvis CT and t-scores from DXA. Skeletal Radiol 2021; 50:2525-2535. [PMID: 34021364 DOI: 10.1007/s00256-021-03801-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/24/2021] [Accepted: 04/25/2021] [Indexed: 02/02/2023]
Abstract
OBJECTIVES CT examination can potentially be utilised for early detection of bone density changes with no additional procedure and radiation dose. We hypothesise that the Hounsfield unit (HU) measured from CT images is correlated to the t-scores derived from dual energy X-ray absorptiometry (DXA) in multiple anatomic regions. MATERIALS & METHODS Data were obtained retrospectively from all patients who underwent both CT examinations - brain (frontal bone), thorax (T7), abdomen (L3), spine (T7 & L3) or pelvis (left hip) - and DXA between 2014 and 2018 in our centre. To ensure comparability, the period between CT and DXA studies must not exceed one year. Correlations between HU values and t-scores were calculated using Pearson's correlation. Receiver operating characteristic (ROC) curves were generated, and the area under the curve (AUC) was used to determine threshold HU values for predicting osteoporosis. RESULTS The inclusion criteria were met by 1043 CT examinations (136 head, 537 thorax, 159 lumbar and 151 left hip). The left hip consistently provided the most robust correlations (r = 0.664-0.708, p < 0.001) and the best AUC (0.875-0.893). Meanwhile, thorax T7 and lumbar L3 showed average correlations (range of r values is 0.497-0.679, p < 0.001, AUC range = 0.680-0.783, 95% CI 0.561-0.922, all p < 0.02) and moderate AUC (0.680-0.783). Frontal bone shows low correlation and weak AUC with r < 0.5, AUC = 0.538-0.655, all p > 0.05. CONCLUSION HU values derived from the hip, T7 and L3 provided a good to moderate correlation to t-scores with a good prediction for osteoporosis. The suggested optimal thresholds may be used in clinical settings after external validations are performed.
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Affiliation(s)
- Mohamad Farhan Mohamad Amin
- Radiology Department, Hospital Putrajaya, Precint 7, 62000, Putrajaya, Malaysia.,Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia.,Radiology Department, Hospital Tengku Ampuan Rahimah, Jalan Langat, 41200, Klang, Selangor, Malaysia
| | | | - Noorazrul Yahya
- Diagnostic Imaging and Radiotherapy, Faculty of Health Sciences, National University of Malaysia, Jalan Raja Muda Aziz, 50300, Kuala Lumpur, Malaysia.
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21
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Wang W, Liu Y, Zhang L, Ran L, Xiong S, Tan X. Associations between Indoor Environmental Quality and Infectious Diseases Knowledge, Beliefs and Practices of Hotel Workers in Wuhan, China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:6367. [PMID: 34208312 PMCID: PMC8296191 DOI: 10.3390/ijerph18126367] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Revised: 06/06/2021] [Accepted: 06/09/2021] [Indexed: 12/23/2022]
Abstract
Knowledge, beliefs, and practices regarding infectious diseases are key elements that ensure practitioners' health and safety. It is important to carry out such a survey in hotels. This study aims to determine the levels of knowledge, beliefs, and practices regarding infectious diseases among practitioners and their associations with the environmental quality of hotels in Wuhan, China. We surveyed infectious disease knowledge, beliefs, and practices of practitioners in 18 hotels and detected these hotels' environment, including physical factors of temperature, humidity, noise, and the indoor air quality of benzene, toluene, xylene, formaldehyde, CO, CO2, the total count of fungi, aerobic plate count, PM10, and PM2.5. 128 practitioners were included, and 28.9% were male. The questionnaire included knowledge, beliefs, and practices regarding infectious diseases. Our study found moderate levels of knowledge and beliefs, and good health practices. People's beliefs toward COVID-19 were correlated significantly with their knowledge (p < 0.05). Beliefs and health practices were correlated significantly with environmental quality (p < 0.05). However, the environmental quality was correlated negatively with the classification of hotels. Conclusively, despite the good health practices of practitioners, the knowledge and beliefs toward infectious diseases need to strengthen. Hotels should emphasize health education in practitioners and the improvement of environmental hygiene. Integrating all three components into a comprehensive environmental promotion program is warranted.
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Affiliation(s)
- Wenjing Wang
- School of Health, Wuhan University, Wuhan 430071, China; (W.W.); (L.Z.); (L.R.)
| | - Yixin Liu
- Hongshan Center for Disease Control and Prevention, Wuhan 430071, China; (Y.L.); (S.X.)
| | - Ling Zhang
- School of Health, Wuhan University, Wuhan 430071, China; (W.W.); (L.Z.); (L.R.)
| | - Li Ran
- School of Health, Wuhan University, Wuhan 430071, China; (W.W.); (L.Z.); (L.R.)
| | - Siyuan Xiong
- Hongshan Center for Disease Control and Prevention, Wuhan 430071, China; (Y.L.); (S.X.)
| | - Xiaodong Tan
- School of Health, Wuhan University, Wuhan 430071, China; (W.W.); (L.Z.); (L.R.)
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Tan HC, Seng JJB, Low LL. Osteoporosis awareness among patients in Singapore (OASIS)-a community hospital perspective. Arch Osteoporos 2021; 16:151. [PMID: 34623530 PMCID: PMC8497186 DOI: 10.1007/s11657-021-01012-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/26/2021] [Indexed: 02/03/2023]
Abstract
UNLABELLED This study examines factors associated with osteoporosis awareness and knowledge using Osteoporosis Prevention and Awareness Tool (OPAAT). Of 410 patients, majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 111.5; p < 0.001) and diabetic patients (OR: 1.67; p = 0.003) were associated with lower OPAAT scores. INTRODUCTION Lack of osteoporosis awareness forms a critical barrier to osteoporosis care and has been linked with increased institutionalization, healthcare expenditures, and decreased quality of life. This study aims to identify factors associated with osteoporosis awareness and knowledge among female Singaporeans. METHODOLOGY A cross-sectional study was conducted among adult female patients (aged 40 to 90 years old) who were admitted into Outram Community Hospital from April to October 2020. Osteoporosis awareness and knowledge were assessed using interviewer-administered Osteoporosis Prevention and Awareness Tool (OPAAT). High knowledge was defined as a OPAAT score ≥ 24. Multivariate logistical regression analyses were used to identify predictors of low OPAAT scores. RESULTS Of 410 patients recruited, their mean age was 71.9 ± 9.5 years old and majority of patients had a OPAAT score < 24 (n = 362, 88.3%). Patients with lower OPAAT scores tended to be older (72.5 ± 9.2 vs 67.5 ± 10.1, p < 0.001), attained lower education level (p < 0.001), and were more likely to live in public housing (92.5% vs 81.5%, p = 0.009). The prevalence of diabetes mellitus was higher in patients with low OPAAT scores (39.2% vs 18.8%, p = 0.006). After adjustment for covariates, lower education level (odds ratio (OR) (primary education): 3.63; OR (no formal education): 11.5; p < 0.05) and patients with diabetes mellitus (OR: 1.67; p = 0.03) were associated with lower OPAAT knowledge scores. CONCLUSION Elderly female patients in community hospital have inadequate osteoporosis awareness despite being at risk of fractures. There is a need to address the knowledge gap in osteoporosis, especially among diabetic patients or patients with lower education.
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Affiliation(s)
- Huey Chieng Tan
- grid.453420.40000 0004 0469 9402Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, Singapore, 168582 Singapore
| | - Jun Jie Benjamin Seng
- grid.466910.c0000 0004 0451 6215MOH Holdings (Singapore) Private Limited, 1 Maritime Square, Singapore, 099253 Singapore
| | - Lian Leng Low
- grid.453420.40000 0004 0469 9402Outram Community Hospital, SingHealth Community Hospitals, 10 Hospital Boulevard, Singapore, 168582 Singapore ,grid.163555.10000 0000 9486 5048Department of Family Medicine and Continuing Care, Singapore General Hospital, Outram Rd, Singapore, 169608 Singapore ,grid.4280.e0000 0001 2180 6431SingHealth Duke-NUS Family Medicine Academic Clinical Program, Outram Rd, Singapore, 169608 Singapore ,grid.453420.40000 0004 0469 9402SingHealth Regional Health System PULSES Centre, Singapore Health Services, Outram Rd, Singapore, 169608 Singapore
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23
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Yeap SS, Thambiah SC, Samsudin IN, Appannah G, Zainuddin N, Mohamad-Ismuddin S, Shahifar N, Md-Said S, Zahari-Sham SY, Suppiah S, Hew FL. Different reference ranges affect the prevalence of osteoporosis and osteopenia in an urban adult Malaysian population. Osteoporos Sarcopenia 2020; 6:168-172. [PMID: 33426304 PMCID: PMC7783114 DOI: 10.1016/j.afos.2020.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2020] [Revised: 09/16/2020] [Accepted: 11/17/2020] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES To determine the prevalence of osteopenia (OPe) and osteoporosis (OP) in an urban adult population in Malaysia, and to compare the change in the prevalence when using a Caucasian compared to an Asian reference range. METHODS A cross-sectional random sample of the population aged between 45 and 90 years from the state of Selangor, Malaysia, was invited to attend a bone health check-up. Participants with diseases known to affect bone metabolism or who were on treatment for OP were excluded. Bone mineral density was measured using dual energy X-ray absorptiometry. Based on the World Health Organization definitions, the prevalence of OPe and OP was calculated using the Asian and Caucasian T-scores. RESULTS A total of 342 subjects (222 females, 120 males), with a mean age of 59.68 (standard deviation: 8.89) years, who fulfilled the study criteria were assessed. Based on the Asian reference range, there were 140 (40.9%) subjects with OPe and 48 (14.0%) with OP. On applying the Caucasian reference range, there were 152 (44.4%) subjects with OPe and 79 (23.1%) with OP, with significant increases in males, females, and Chinese ethnic groups. Overall, 75 (21.9%) of subjects had a change in their diagnostic status. T-scores were consistently lower when the Caucasian reference range was used. CONCLUSIONS In a healthy urban Malaysian population, the prevalence of OP is 14.0% and OPe is 40.9%. Application of a Caucasian reference range significantly increased the number of subjects with OP and may potentially lead to over-treatment.
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Affiliation(s)
- Swan Sim Yeap
- Puchong Specialist Centre, Puchong, Selangor, Malaysia
- Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
| | - Subashini C. Thambiah
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Intan Nureslyna Samsudin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Geeta Appannah
- Department of Nutrition and Dietetics, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nurunnaim Zainuddin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Safarina Mohamad-Ismuddin
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Nasrin Shahifar
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Salmiah Md-Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Siti Yazmin Zahari-Sham
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Subapriya Suppiah
- Department of Imaging, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Fen Lee Hew
- Puchong Specialist Centre, Puchong, Selangor, Malaysia
- Department of Medicine, Subang Jaya Medical Centre, Subang Jaya, Selangor, Malaysia
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Chan CY, Subramaniam S, Mohamed N, Ima-Nirwana S, Muhammad N, Fairus A, Ng PY, Jamil NA, Aziz NA, Chin KY. Prevalence and factors of T-score discordance between hip and spine among middle-aged and elderly Malaysians. Arch Osteoporos 2020; 15:142. [PMID: 32918631 DOI: 10.1007/s11657-020-00821-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 09/08/2020] [Indexed: 02/03/2023]
Abstract
UNLABELLED T-score discordance between hip and spine is a common problem in the diagnosis of osteoporosis based on dual-energy X-ray absorptiometry. Not much information on the prevalence and risk factors of this problem is available in Malaysia. Our study found that factors like age, height, physical activity and menopausal status should be taken into account in the diagnosis of osteoporosis. INTRODUCTION AND OBJECTIVE T-score discordance between hip and spine is a common problem in bone mineral density assessment. A difference ≥ 1 standard deviation (SD) (regardless of diagnostic class) is considered minor, and a difference more than one diagnostic class is considered major discordance. This study aimed to determine the prevalence and factors of hip and spine T-score discordance in a population aged ≥ 40 years in Klang Valley, Malaysia. SUBJECTS AND METHODS In this cross-sectional study, subjects answered a demographic questionnaire and underwent body composition and bone health assessment using dual-energy X-ray absorptiometry. Chi-square and binary logistic regression analysis were used to assess the prevalence of T-score discordance among the subjects. RESULTS A total of 786 Malaysians (382 men, 404 women) subjects were recruited. The prevalence of minor and major discordance was 30.3% and 2.3%, respectively. Overall, factors related to T-score discordance were advanced age, decreased height, and being physically active. Sub-analysis showed that decreased height and being physically active predicted T-score discordance in men, being menopausal and Indian (vs Chinese) were predictors in women. CONCLUSIONS T-score discordance between hip and spine is common among Malaysian middle-aged and elderly population. Diagnosis of osteopenia/osteoporosis should be based on the T-score of more than one skeletal site as per the current recommendations.
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Affiliation(s)
- Chin Yi Chan
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Shaanthana Subramaniam
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Norazlina Mohamed
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Norliza Muhammad
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Ahmad Fairus
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Pei Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, 50300, Kuala Lumpur, Malaysia
| | - Noorazah Abd Aziz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia
| | - Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, 56000, Cheras, Malaysia. .,State Key Laboratory of Oncogenes and Related Genes, Renji-Med X Clinical Stem Cell Research Center, Department of Urology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
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Edelstein OE, Achdut N, Vered I, Sarid O. Determinants of Bone Mineral Screening Behavior among Three Ethno-Cultural Groups of Women in Israel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17176138. [PMID: 32846956 PMCID: PMC7503566 DOI: 10.3390/ijerph17176138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 08/16/2020] [Accepted: 08/21/2020] [Indexed: 11/16/2022]
Abstract
Bone mineral density (BMD) screening is one of the main means to detect and treat osteoporosis. Yet, the manner in which ethno-cultural background is associated with BMD health cognitions and screening behavior remains limited. Several ethno-cultural groups (n = 100 in each group)—Israeli-born Jews, Israeli-born Bedouin-Muslims, and Jewish immigrants from the Former Soviet Union (FSU), mean age 70 (SD = 7.1)—participated in face-to-face interviews in a cross-sectional survey, using valid and reliable questionnaires on BMD screening behavior, knowledge about osteoporosis, and theory of planned behavior (TPB) components. FSU immigrants reported the lowest BMD screening behavior. The multivariate analysis showed that higher knowledge level, positive attitudes, supportive subjective norms, and greater intentions increase the probability of BMD screening behavior. The TPB attitude component had a more pronounced effect on the probability of undergoing BMD screening among Israeli-born Bedouin-Muslims compared to Israeli-born Jews. Our findings contribute to the TPB by deepening our understanding of the associations between TPB components and BMD screening behaviors, from an ethno-cultural perspective. To assure sufficient BMD screening behavior among all ethno-cultural groups, intervention programs—suited to address the unique characteristics of each ethno-cultural group—are required.
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Affiliation(s)
- Offer E. Edelstein
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (N.A.); (O.S.)
- Correspondence:
| | - Netta Achdut
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (N.A.); (O.S.)
| | - Iris Vered
- Division of Endocrinology, Diabetes and Metabolism, The Chaim Sheba Medical Centre, Tel Hashomer, Ramat Gan 5262000, Israel;
| | - Orly Sarid
- Spitzer Department of Social Work, Ben-Gurion University of the Negev, Be’er Sheva 8410501, Israel; (N.A.); (O.S.)
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Subramaniam S, Chan CY, Soelaiman IN, Mohamed N, Muhammad N, Ahmad F, Ng PY, Jamil NA, Abd Aziz N, Chin KY. Development of Osteoporosis Screening Algorithm for Population Aged 50 Years and above in Klang Valley, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2526. [PMID: 32272697 PMCID: PMC7177333 DOI: 10.3390/ijerph17072526] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 03/29/2020] [Accepted: 04/05/2020] [Indexed: 02/06/2023]
Abstract
Background: The current osteoporosis screening instruments are not optimized to be used among the Malaysian population. This study aimed to develop an osteoporosis screening algorithm based on risk factors for Malaysians. Methods: Malaysians aged ≥50 years (n = 607) from Klang Valley, Malaysia were interviewed and their bone health status was assessed using a dual-energy X-ray absorptiometry device. The algorithm was constructed based on osteoporosis risk factors using multivariate logistic regression and its performance was assessed using receiver operating characteristics analysis. Results: Increased age, reduced body weight and being less physically active significantly predicted osteoporosis in men, while in women, increased age, lower body weight and low-income status significantly predicted osteoporosis. These factors were included in the final algorithm and the optimal cut-offs to identify subjects with osteoporosis was 0.00120 for men [sensitivity 73.3% (95% confidence interval (CI) = 54.1%-87.7%), specificity 67.8% (95% CI = 62.7%-85.5%), area under curve (AUC) 0.705 (95% CI = 0.608-0.803), p < 0.001] and 0.161 for women [sensitivity 75.4% (95% CI = 61.9%-73.3%), specificity 74.5% (95% CI = 68.5%-79.8%), AUC 0.749 (95% CI = 0.679-0.820), p < 0.001]. Conclusion: The new algorithm performed satisfactorily in identifying the risk of osteoporosis among the Malaysian population ≥50 years. Further validation studies are required before applying this algorithm for screening of osteoporosis in public.
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Affiliation(s)
- Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.-N.S.); (N.M.); (N.M.)
| | - Chin-Yi Chan
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.-N.S.); (N.M.); (N.M.)
| | - Ima-Nirwana Soelaiman
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.-N.S.); (N.M.); (N.M.)
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.-N.S.); (N.M.); (N.M.)
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.-N.S.); (N.M.); (N.M.)
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia;
| | - Pei-Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noorazah Abd Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia;
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.-N.S.); (N.M.); (N.M.)
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Subramaniam S, Chan CY, Soelaiman IN, Mohamed N, Muhammad N, Ahmad F, Ng PY, Jamil NA, Abd Aziz N, Chin KY. The Performance of a Calcaneal Quantitative Ultrasound Device, CM-200, in Stratifying Osteoporosis Risk among Malaysian Population Aged 40 Years and Above. Diagnostics (Basel) 2020; 10:E178. [PMID: 32218298 PMCID: PMC7235708 DOI: 10.3390/diagnostics10040178] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/20/2020] [Accepted: 03/24/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Calcaneal quantitative ultrasound (QUS) is widely used in osteoporosis screening, but the cut-off values for risk stratification remain unclear. This study validates the performance of a calcaneal QUS device (CM-200) using dual-energy X-ray absorptiometry (DXA) as the reference and establishes a new set of cut-off values for CM-200 in identifying subjects with osteoporosis. METHODS The bone health status of Malaysians aged ≥40 years was assessed using CM-200 and DXA. Sensitivity, specificity, area under the curve (AUC) and the optimal cut-off values for risk stratification of CM-200 were determined using receiver operating characteristic (ROC) curves and Youden's index (J). Results: From the data of 786 subjects, CM-200 (QUS T-score <-1) showed a sensitivity of 82.1% (95% CI: 77.9-85.7%), specificity of 51.5% (95% CI: 46.5-56.6%) and AUC of 0.668 (95% CI: 0.630-0.706) in identifying subjects with suboptimal bone health (DXA T-score <-1) (p < 0.001). At QUS T-score ≤-2.5, CM-200 was ineffective in identifying subjects with osteoporosis (DXA T-score ≤-2.5) (sensitivity 14.4% (95% CI: 8.1-23.0%); specificity 96.1% (95% CI: 94.4-97.4%); AUC 0.553 (95% CI: 0.488-0.617); p > 0.05). Modified cut-off values for the QUS T-score improved the performance of CM-200 in identifying subjects with osteopenia (sensitivity 67.7% (95% CI: 62.8-72.3%); specificity 72.8% (95% CI: 68.1-77.2%); J = 0.405; AUC 0.702 (95% CI: 0.666-0.739); p < 0.001) and osteoporosis (sensitivity 79.4% (95% CI: 70.0-86.9%); specificity 61.8% (95% CI: 58.1-65.5%); J = 0.412; AUC 0.706 (95% CI: 0.654-0.758); p < 0.001). Conclusion: The modified cut-off values significantly improved the performance of CM-200 in identifying individuals with osteoporosis. Since these values are device-specific, optimization is necessary for accurate detection of individuals at risk for osteoporosis using QUS.
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Affiliation(s)
- Shaanthana Subramaniam
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Chin-Yi Chan
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Ima Nirwana Soelaiman
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Norazlina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Norliza Muhammad
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
| | - Fairus Ahmad
- Department of Anatomy, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia;
| | - Pei-Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Aini Jamil
- Centre for Community Health Studies, Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noorazah Abd Aziz
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia;
| | - Kok-Yong Chin
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Malaysia; (S.S.); (C.-Y.C.); (I.N.S.); (N.M.); (N.M.)
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Chan CY, Subramaniam S, Mohamed N, Ima-Nirwana S, Muhammad N, Fairus A, Ng PY, Jamil NA, Abd Aziz N, Chin KY. Determinants of Bone Health Status in a Multi-Ethnic Population in Klang Valley, Malaysia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E384. [PMID: 31936034 PMCID: PMC7014230 DOI: 10.3390/ijerph17020384] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 12/30/2019] [Accepted: 01/04/2020] [Indexed: 12/11/2022]
Abstract
Background and objectives: Studies on osteoporosis risk factors are limited in Malaysia, so this study assesses the factors associated with bone health assessed using dual-energy X-ray absorptiometry (DXA) among Malaysians aged ≥40 years. Subjects and Methods: Data on demography, medical history, dietary and lifestyle practices of 786 Malaysians (51.4% women) aged ≥40 years recruited in Klang Valley were obtained. Their body composition and bone health were determined using DXA. The association between risk factors and bone health status was assessed using binary logistic regression. Results: The prevalence of suboptimal bone health and osteoporosis was higher in women (59.4% and 16.1%) than men (40.8% and 8.4%). Overall, the predictors of suboptimal bone health and osteoporosis among the subjects were increased age and higher fat mass. Lower monthly income was positively associated with osteoporosis. Being menopausal was a risk factor for both suboptimal bone health and osteoporosis in women. Women with no formal education were more likely to get osteoporosis. Being a smoker and Chinese were positively related to suboptimal bone health among men. Meanwhile, predictors of osteoporosis among men were regular alcohol and dairy product consumption, higher fat mass and having a tertiary education. Conclusions: This study calls for immediate and effective interventions for middle-aged and elderly populations with risk factors to halt the progression of bone loss.
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Affiliation(s)
- Chin Yi Chan
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (N.M.); (S.I.-N.); (N.M.)
| | - Shaanthana Subramaniam
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (N.M.); (S.I.-N.); (N.M.)
| | - Norazlina Mohamed
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (N.M.); (S.I.-N.); (N.M.)
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (N.M.); (S.I.-N.); (N.M.)
| | - Norliza Muhammad
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (N.M.); (S.I.-N.); (N.M.)
| | - Ahmad Fairus
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia;
| | - Pei Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Nor Aini Jamil
- Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia;
| | - Noorazah Abd Aziz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia;
| | - Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia; (C.Y.C.); (S.S.); (N.M.); (S.I.-N.); (N.M.)
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Chin KY, Chan CY, Subramaniam S, Muhammad N, Fairus A, Ng PY, Jamil NA, Aziz NA, Ima-Nirwana S, Mohamed N. Positive association between metabolic syndrome and bone mineral density among Malaysians. Int J Med Sci 2020; 17:2585-2593. [PMID: 33029101 PMCID: PMC7532478 DOI: 10.7150/ijms.49030] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/27/2020] [Indexed: 12/14/2022] Open
Abstract
Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.
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Affiliation(s)
- Kok-Yong Chin
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Chin Yi Chan
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Shaanthana Subramaniam
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Norliza Muhammad
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Ahmad Fairus
- Department of Anatomy, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Pei Yuen Ng
- Drug and Herbal Research Centre, Faculty of Pharmacy, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Nor Aini Jamil
- Centre for Community Health Studies (ReaCH), Faculty of Health Science, Universiti Kebangsaan Malaysia Kuala Lumpur Campus, Jalan Raja Muda Abdul Aziz, Kuala Lumpur 50300, Malaysia
| | - Noorazah Abd Aziz
- Department of Family Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Soelaiman Ima-Nirwana
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
| | - Norazlina Mohamed
- Department of Pharmacology, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Malaysia
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