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DeClercq MG, Eberhardt L, Zakko P, Keeley J, Audet M, Park D. Equivalence in osteoporosis workup and management after femoral neck fracture fixation and vertebral compression fracture cement augmentation: A single-center retrospective study highlighting persistent Underdiagnosis and Undertreatment. J Orthop 2024; 56:133-140. [PMID: 38854776 PMCID: PMC11153879 DOI: 10.1016/j.jor.2024.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/02/2024] [Accepted: 05/07/2024] [Indexed: 06/11/2024] Open
Abstract
Background The purpose of this study was to evaluate pre- and post-fracture medical management of osteoporosis among patients who underwent surgical fixation of femoral neck fractures (FNF) and vertebral compression fractures (VCF), and to investigate if there is a difference in treatment, management, and subsequent fractures between FNF and VCF patients. Methods Patients who underwent surgical fixation of FNF or VCF were retrospectively reviewed at a minimum 1 year follow up. Patients were excluded if their fracture was caused by high energy trauma or malignancy, <50 years-old, deceased, or lost to follow up. Patient demographics such as age, sex, BMI, American Society of Anesthesiology Physical Status Classification System and Charleston Comorbidity index were recorded. Management of osteoporosis, including medication regimen and dual-energy X-ray absorptiometry (DEXA) scans were assessed preoperatively and at minimum one year follow up. Subsequent fractures were also recorded. Results In the analysis of 370 patients (74.7% FNF, 25.2% VCF), demographics showed a predominantly female population (mean age 78.1). Preoperatively, 21.6% were diagnosed with osteoporosis, consistent between FNF and VCF. Postoperatively, there were no significant differences in new osteoporosis diagnoses, bisphosphonate use, or subsequent fractures. VCF patients, however, were more likely to receive denosumab and post-operative DEXA scans (p < 0.05). Within a year, 6.2% experienced subsequent fractures, with no significant FNF-VCF difference. Only 12.7% received appropriate post-operative osteoporosis treatment, 27.1% had DEXA scans, and 25% had a recorded osteoporosis diagnosis. Multivariable analysis highlighted pre-fracture osteoporosis diagnosis as the sole predictor for post-operative DEXA scans and anti-osteoporotic medication (p < 0.001). Conclusions This study suggests that factors beyond the type of fragility fracture may influence subsequent fracture risk and anti-osteoporotic medication administration in elderly patients. These findings underscore the importance of a comprehensive approach to fracture risk assessment and treatment decisions in this population. Level of evidence III.
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Affiliation(s)
- Madeleine Grace DeClercq
- Corewell Health, William Beaumont University Hospital, Department of Orthopedic Surgery, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Lauren Eberhardt
- Corewell Health, William Beaumont University Hospital, Department of Orthopedic Surgery, Royal Oak, MI, USA
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Philip Zakko
- Corewell Health, William Beaumont University Hospital, Department of Orthopedic Surgery, Royal Oak, MI, USA
| | - Jacob Keeley
- Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Megan Audet
- Corewell Health, William Beaumont University Hospital, Department of Orthopedic Surgery, Royal Oak, MI, USA
| | - Daniel Park
- Corewell Health, William Beaumont University Hospital, Department of Orthopedic Surgery, Royal Oak, MI, USA
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Lim J, Kim YJ, Kim S, Choi J. Increased risk of fragility fractures in patients with primary biliary cholangitis. JBMR Plus 2024; 8:ziae056. [PMID: 38855796 PMCID: PMC11162592 DOI: 10.1093/jbmrpl/ziae056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 03/31/2024] [Accepted: 04/15/2024] [Indexed: 06/11/2024] Open
Abstract
Large-scale studies on the risk of fragility fractures in patients with primary biliary cholangitis (PBC) are limited due to low incidence. We aimed to investigate whether PBC is associated with fragility fractures using real-world nationwide data. The Korean National Health Insurance Service claims data from 2007 to 2020 were analyzed in this population-based cohort study. Patients with PBC (n = 4951) were matched with controls (n = 19 793) using a 1:4 ratio based on age, sex, and follow-up duration. The primary outcome was fragility fracture, which comprised fractures of the vertebra, hip, distal radius, and proximal humerus. The incidence rates (IRs) and hazard ratios (HRs) were determined to assess the impact of PBC on fragility fractures. During the median follow-up period of 5.37 years, 524 patients in the PBC group had fragility fractures (IR, 18.59/1000 person-years [PYs]). After adjusting for covariates, PBC increased the risk of fragility fractures by 1.63-fold (95% confidence interval, 1.20-2.22; P = .002). The vertebra and hip were particularly susceptible to fracture in patients with PBC, with adjusted HRs of 1.77 and 2.23, respectively. In the subgroup analysis, the risk of fragility fracture was 2.53-fold higher in men and 1.59-fold higher in women with PBC than that in the respective matched control groups. Considering the morbidity and mortality related to fragility fractures, increasing awareness of fragility fracture risk and implementing appropriate preventive measures in patients with PBC are imperative.
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Affiliation(s)
- Jihye Lim
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, 07345, Republic of Korea
| | - Ye-Jee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Sehee Kim
- Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
| | - Jonggi Choi
- Department of Gastroenterology, Liver Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, 05505, Republic of Korea
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Demirel C, Halavina K, Hamzaraj K, Klement J, El-Shaer M, Hemetsberger R, Winter MP, Koschatko S, Jantsch C, Andreas M, Loewe C, Kammerlander A, Hengstenberg C, Bartko PE. Low Bone Mineral Density on Computed Tomography: Association with Poor Survival after Transcatheter Aortic Valve Replacement. J Clin Med 2024; 13:2698. [PMID: 38731227 PMCID: PMC11084390 DOI: 10.3390/jcm13092698] [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: 04/04/2024] [Revised: 04/25/2024] [Accepted: 05/01/2024] [Indexed: 05/13/2024] Open
Abstract
Background: Transcatheter aortic valve replacement (TAVR) has evolved as first-line therapy for severe aortic valve stenosis (AS), with pre-procedural computed tomography (CT) providing critical anatomical information. While primarily used for anatomical planning, TAVR-CT also offers an opportunity to assess low bone mineral density (BMD), a known indicator of frailty. Despite this, the prognostic role of BMD in TAVR patients remains unknown. This study aimed to evaluate BMD on routine TAVR-CT and its impact on long-term survival. Methods: In this retrospective study, 770 consecutive TAVR patients (mean age 80.7 ± 6.7 years, 54.0% males) between November 2015 and March 2022 were included. BMD was measured from a single axial image at the thoracic vertebral level on unenhanced CT scans. Cox regression models assessed the impact of BMD on mortality, and Restricted Cubic Spline models identified potential mortality thresholds. Results: The mean BMD value, as measured on non-contrast CT, was 147.5 ± 5.4 Hounsfield units, demonstrating a noteworthy association with mortality (adjusted hazard ratio per 100 HU decrease: 1.27 [95%CI: 1.01-1.59], p = 0.041). Restricted cubic spline analysis indicated that BMD below 200 HU was linked to a substantial increase in mortality risk. Upon crude Cox regression analysis, every 100 HU decrease was associated with a 32% increase in risk for death (HR 1.32 [95%CI: 1.068-1.65)], p = 0.010). Conclusions: In conclusion, low BMD on TAVR-CT is independently associated with reduced survival, suggesting its potential as a tool for comprehensive frailty assessment and improved risk prediction in TAVR patients.
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Affiliation(s)
- Caglayan Demirel
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Kseniya Halavina
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Kevin Hamzaraj
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Johanna Klement
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Manar El-Shaer
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Rayyan Hemetsberger
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Max Paul Winter
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Sophia Koschatko
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Charlotte Jantsch
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Martin Andreas
- Department of Internal Medicine II, Clinical Division of Cardiac Surgery, Medical University of Vienna, 1090 Vienna, Austria;
| | - Christian Loewe
- Department of Radiology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Andreas Kammerlander
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Christian Hengstenberg
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
| | - Philipp E. Bartko
- Department of Internal Medicine II, Clinical Division of Cardiology, Medical University of Vienna, 1090 Vienna, Austria; (C.D.); (K.H.); (K.H.); (J.K.); (M.E.-S.); (R.H.); (M.P.W.); (S.K.); (A.K.); (C.H.)
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Martiniakova M, Biro R, Penzes N, Sarocka A, Kovacova V, Mondockova V, Omelka R. Links among Obesity, Type 2 Diabetes Mellitus, and Osteoporosis: Bone as a Target. Int J Mol Sci 2024; 25:4827. [PMID: 38732046 PMCID: PMC11084398 DOI: 10.3390/ijms25094827] [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: 04/05/2024] [Revised: 04/25/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
Obesity, type 2 diabetes mellitus (T2DM) and osteoporosis are serious diseases with an ever-increasing incidence that quite often coexist, especially in the elderly. Individuals with obesity and T2DM have impaired bone quality and an elevated risk of fragility fractures, despite higher and/or unchanged bone mineral density (BMD). The effect of obesity on fracture risk is site-specific, with reduced risk for several fractures (e.g., hip, pelvis, and wrist) and increased risk for others (e.g., humerus, ankle, upper leg, elbow, vertebrae, and rib). Patients with T2DM have a greater risk of hip, upper leg, foot, humerus, and total fractures. A chronic pro-inflammatory state, increased risk of falls, secondary complications, and pharmacotherapy can contribute to the pathophysiology of aforementioned fractures. Bisphosphonates and denosumab significantly reduced the risk of vertebral fractures in patients with both obesity and T2DM. Teriparatide significantly lowered non-vertebral fracture risk in T2DM subjects. It is important to recognize elevated fracture risk and osteoporosis in obese and T2DM patients, as they are currently considered low risk and tend to be underdiagnosed and undertreated. The implementation of better diagnostic tools, including trabecular bone score, lumbar spine BMD/body mass index (BMI) ratio, and microRNAs to predict bone fragility, could improve fracture prevention in this patient group.
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Affiliation(s)
- Monika Martiniakova
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (R.B.); (V.K.)
| | - Roman Biro
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (R.B.); (V.K.)
| | - Noemi Penzes
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
| | - Anna Sarocka
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
| | - Veronika Kovacova
- Department of Zoology and Anthropology, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (R.B.); (V.K.)
| | - Vladimira Mondockova
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
| | - Radoslav Omelka
- Department of Botany and Genetics, Faculty of Natural Sciences and Informatics, Constantine the Philosopher University in Nitra, 949 01 Nitra, Slovakia; (N.P.); (A.S.); (V.M.); (R.O.)
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Wu TC, Tsou YJ, Wu WT, Lee RP, Wang JH, Yeh KT. Five-Year Outcomes of Continuous Treatment with Zoledronic Acid Versus Denosumab in Older Men with High Fracture Risk: Risk Factor Analysis of Bone Density Improvement and Incidence of New Fracture. J Clin Pharmacol 2024; 64:469-477. [PMID: 37897231 DOI: 10.1002/jcph.2378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 10/26/2023] [Indexed: 10/29/2023]
Abstract
Denosumab and zoledronic acid are both effective and easily administrable injectable anti-osteoporotic medications for postmenopausal women. This study investigated the treatment efficacy of these agents in older male patients with low a bone mass and history of fragility fracture. A cohort of 175 male patients receiving continuous zoledronic acid treatment and a cohort of 366 male patients receiving continuous denosumab treatment at our medical center between 2015 and 2020 were included, and we analyzed the efficacy of treatment by the improvement in bone mineral density (BMD) and the new-onset low-energy fracture rate after 5 years of continuous medication. BMD significantly improved after 5 years of medication, and >90% of patients were satisfied with their treatment medication. BMD improved more with denosumab than with zoledronic acid, especially in patients with T-scores higher than -2.5. Smoking, alcohol abuse, diabetes, and inflammatory polyarthritis were associated with poor improvements in BMD. The incidence rate of new fragile fracture was 4.4% and old age was significantly associated with the incidence rate of new fracture. In summary, our study revealed that denosumab and zoledronic acid both significantly increased BMD among older male patients with high fragility fracture rates over a 5-year follow-up period. Early medical treatment and lifestyle adjustment were crucial for improving quality of life.
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Affiliation(s)
- Tong-Che Wu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Clinical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Yun-Jui Tsou
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Clinical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Wen-Tien Wu
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Clinical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Ru-Ping Lee
- Institute of Medical Sciences, Tzu Chi University, Hualien, Taiwan
| | - Jen-Hung Wang
- Department of Medical Research, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
| | - Kuang-Ting Yeh
- School of Medicine, Tzu Chi University, Hualien, Taiwan
- Department of Clinical Education, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Department of Orthopedics, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan
- Graduate Institute of Clinical Pharmacy, Tzu Chi University, Hualien, Taiwan
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Codrea CI, Lincu D, Atkinson I, Culita DC, Croitoru AM, Dolete G, Trusca R, Vasile BS, Stan MS, Ficai D, Ficai A. Comparison between Two Different Synthesis Methods of Strontium-Doped Hydroxyapatite Designed for Osteoporotic Bone Restoration. MATERIALS (BASEL, SWITZERLAND) 2024; 17:1472. [PMID: 38611986 PMCID: PMC11012538 DOI: 10.3390/ma17071472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 03/15/2024] [Accepted: 03/17/2024] [Indexed: 04/14/2024]
Abstract
Development of efficient controlled local release of drugs that prevent systemic side effects is a challenge for anti-osteoporotic treatments. Research for new bone-regeneration materials is of high importance. Strontium (Sr) is known as an anti-resorptive and anabolic agent useful in treating osteoporosis. In this study, we compared two different types of synthesis used for obtaining nano hydroxyapatite (HA) and Sr-containing nano hydroxyapatite (SrHA) for bone tissue engineering. Synthesis of HA and SrHA was performed using co-precipitation and hydrothermal methods. Regardless of the synthesis route for the SrHA, the intended content of Sr was 1, 5, 10, 20, and 30 molar %. The chemical, morphological, and biocompatibility properties of HA and SrHA were investigated. Based on our results, it was shown that HA and SrHA exhibited low cytotoxicity and demonstrated toxic behavior only at higher Sr concentrations.
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Affiliation(s)
- Cosmin Iulian Codrea
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- Department of Oxide Compounds and Materials Science, Institute of Physical Chemistry “Ilie Murgulescu” of the Romanian Academy, 060021 Bucharest, Romania; (I.A.)
| | - Daniel Lincu
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- Department of Oxide Compounds and Materials Science, Institute of Physical Chemistry “Ilie Murgulescu” of the Romanian Academy, 060021 Bucharest, Romania; (I.A.)
| | - Irina Atkinson
- Department of Oxide Compounds and Materials Science, Institute of Physical Chemistry “Ilie Murgulescu” of the Romanian Academy, 060021 Bucharest, Romania; (I.A.)
| | - Daniela C. Culita
- Department of Oxide Compounds and Materials Science, Institute of Physical Chemistry “Ilie Murgulescu” of the Romanian Academy, 060021 Bucharest, Romania; (I.A.)
| | - Alexa-Maria Croitoru
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- National Research Center for Micro and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- National Centre for Food Safety, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Georgiana Dolete
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- National Research Center for Micro and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- National Centre for Food Safety, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Roxana Trusca
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- National Research Center for Micro and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- National Centre for Food Safety, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Bogdan Stefan Vasile
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- National Research Center for Micro and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- National Centre for Food Safety, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Miruna Silvia Stan
- Department of Biochemistry and Molecular Biology, Faculty of Biology, University of Bucharest, Splaiul Independentei 91-95, 050095 Bucharest, Romania;
| | - Denisa Ficai
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- National Research Center for Micro and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- National Centre for Food Safety, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
| | - Anton Ficai
- Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, 060042 Bucharest, Romania; (D.L.); (A.-M.C.); (G.D.); (R.T.); (B.S.V.); (D.F.)
- National Research Center for Micro and Nanomaterials, Faculty of Chemical Engineering and Biotechnologies, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- National Centre for Food Safety, National University of Science and Technology Politehnica of Bucharest, Splaiul Independentei 313, 060042 Bucharest, Romania
- Academy of Romanian Scientists, Ilfov St. 3, 050044 Bucharest, Romania
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Falk SSI, Richter M, Schröder J, Böhme S, Mittlmeier T. Pre-existing osteoporosis and serum vitamin D levels in patients with distal radius fractures: are we missing something? Arch Orthop Trauma Surg 2024; 144:1281-1287. [PMID: 38305894 PMCID: PMC10896871 DOI: 10.1007/s00402-024-05199-4] [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: 09/25/2023] [Accepted: 12/30/2023] [Indexed: 02/03/2024]
Abstract
INTRODUCTION Given the significant therapeutic gap for osteoporosis, this study aims to investigate the most common osteoporosis-related fracture. The analysis will also consider patients' serum vitamin D levels and the indications for basic osteoporosis diagnostic tests and osteoporosis therapy prior to fracture. MATERIALS AND METHODS This prospective clinical trial included patients with distal radius fractures who underwent surgery at our hospital between 1 April 2021 and 7 April 2022. Blood samples were taken from all participants and existing risk factors for osteoporosis were recorded. In addition, the indication for a guideline-based osteoporosis diagnosis was assessed and the risk of another future fracture with FRAX® was calculated. This information was used to decide whether there was an indication for specific osteoporosis therapy. RESULTS A diagnosis gap of 53% and a treatment gap of 84% were identified among the 102 patients investigated. The patients' ages ranged from 46 to 91 years, with an average vitamin D level of 57 nmol/l, which was below the recommended level of 75 nmol/l. It was noted on a monthly basis that the vitamin D level (without substitution) never exceeded the recommended value of 75 nmol/l in any month. Three-quarters of patients had indications for a baseline osteoporosis diagnosis, yet less than 50% received one. According to FRAX® data, 57% of patients had indications for specific osteoporosis treatment before experiencing the fracture. CONCLUSION Even without a previous distal radius fracture, many patients are in need of osteoporosis diagnosis or treatment. Our research suggests that patients with distal radius fractures should have their vitamin D levels checked via a blood test and be evaluated for osteoporosis. As endogenous vitamin D levels are often inadequate, year-round vitamin D supplementation should be considered for the prevention of osteomalacia and as a basis for the treatment of osteoporosis. GERMAN CLINICAL TRIAL REGISTER ID DRKS00028085.
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Affiliation(s)
- Steffi S I Falk
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany.
| | - Meike Richter
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany
| | - Josephine Schröder
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany
| | - Sina Böhme
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany
| | - Thomas Mittlmeier
- Clinic of Trauma, Hand and Reconstructive Surgery, University of Rostock, Schillingallee 35, 18055, Rostock, Germany
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Maschhoff CW, Oquendo Y, Michaud JB, Carey D, Jamero C, Bishop JA, Jin C, DeBaun M, Gardner MJ. 3D Topographical Scanning for the Detection of Osteoporosis. J Frailty Sarcopenia Falls 2024; 9:4-9. [PMID: 38444543 PMCID: PMC10910256 DOI: 10.22540/jfsf-09-004] [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] [Accepted: 11/22/2023] [Indexed: 03/07/2024] Open
Abstract
Objectives Osteoporosis is associated with greater risk of fracture, which can lead to increased morbidity and mortality. DEXA scans are often inaccessible for patients, leaving many cases of osteoporosis undetected. A portable 3D topographical scan offers an easily accessible and inexpensive potential adjunct screening tool. We hypothesized that 3D scanning of arm and calf circumference and volume would correlate with DEXA T-scores. Methods 96 female patients were enrolled. Patients were consented and completed a topographical scan of bilateral arms and lower legs with a mobile 3D scanner for arm and calf circumference and volume in clinic. Patient charts were then retrospectively reviewed for DEXA T-scores. Results Forearm DEXA T-score was positively correlated with arm circumference (r = 0.49, p<0.01), arm volume (r=0.62, p<0.01), and calf volume (r=0.47, p<0.01). Femoral neck DEXA T-score was positively correlated with calf circumference (r=0.36, p<0.01) and calf volume (r=0.36, p<0.01). Conclusions Our results showed significant correlations between DEXA T-scores and topographical measurements from mobile device acquired 3D scans, although these were in the "moderate" range. Mobile device-based 3D scanning may hold promise as an adjunct screening tool for osteoporosis when DEXA scanning is not available or feasible for patients, although further studies are needed to elucidate the full potential of its clinical utility. At a minimum, identifying a patient as high risk may promote earlier diagnostic DEXA scanning.
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Affiliation(s)
- Clayton W. Maschhoff
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Yousi Oquendo
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - John B. Michaud
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - David Carey
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Christopher Jamero
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Julius A. Bishop
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Christopher Jin
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
| | - Malcolm DeBaun
- Department of Orthopaedic Surgery, Duke University, Durham, NC, USA
| | - Michael J. Gardner
- Department of Orthopaedic Surgery, Stanford University Medical Center, Stanford, CA, USA
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Stovall R, Kersey E, Li J, Baker R, Anastasiou C, Palmowski A, Schmajuk G, Gensler L, Yazdany J. Incidence Rate and Factors Associated With Fractures Among Medicare Beneficiaries With Ankylosing Spondylitis in the United States. Arthritis Care Res (Hoboken) 2024; 76:265-273. [PMID: 37605840 PMCID: PMC10843294 DOI: 10.1002/acr.25219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Revised: 06/30/2023] [Accepted: 08/15/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE We evaluated the incidence rate and factors associated with fractures among adults with ankylosing spondylitis (AS). METHODS We performed a retrospective cohort study with data from the Rheumatology Informatics System for Effectiveness registry linked to Medicare claims from 2016 to 2018. Patients were required to have two AS International Classification of Diseases codes 30 or more days apart and a subsequent Medicare claim. Then, 1 year of baseline characteristics were included, after which patients were observed for fractures. First, we calculated the incidence rate of fractures. Second, we constructed logistic regression models to identify factors associated with the fracture, including age, sex, race and ethnicity, body mass index, Medicare/Medicaid dual eligibility, area deprivation index, Charlson comorbidity index, smoking status, osteoporosis, historical fracture, and use of osteoporosis treatment, glucocorticoids, and opioids. RESULTS We identified 1,426 adults with prevalent AS. Mean ± SD age was 69.4 ± 9.8 years, 44.3% were female, and 77.3% were non-Hispanic White. Fractures occurred in 197 adults with AS. The overall incidence rate of fractures was 76.7 (95% confidence interval [CI] 66.4-88.6) per 1,000 person-years. Older age (odds ratio [OR] 2.8, 95% CI 1.39-5.65), historical fracture (OR 5.24, 95% CI 3.44-7.99), and use of more than 30 mg morphine equivalent (OR 1.86, 95% CI 1.08-3.19) conferred increased odds of fracture. CONCLUSIONS In this large sample of Medicare beneficiaries with AS, increasing age, historical fracture, and use of opioids had higher odds of fracture. Men and women were equally likely to have a fracture. Because opioid use was associated with fracture in AS, this high-risk population should be considered for interventions to mitigate risk.
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Affiliation(s)
- Rachael Stovall
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
| | - Emma Kersey
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
| | - Jing Li
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
| | | | - Christine Anastasiou
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
| | - Andriko Palmowski
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
- Department of Rheumatology and Clinical Immunology, Charité – Universitätsmedizin Berlin
- Section for Biostatistics and Evidence-Based Research, the Parker Institute, University of Copenhagen, Copenhagen, Denmark
| | - Gabriela Schmajuk
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
- San Francisco VA Healthcare System
- UCSF Institute for Health Policy Research
| | - Lianne Gensler
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
| | - Jinoos Yazdany
- Division of Rheumatology, University of California San Francisco (UCSF), San Francisco, CA
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Sylvester AD, Zbijewski W, Shi G, Meckel LA, Chu EY, Cunningham DL, Wescott DJ. Macroscopic differences in adult human femora are linked to body mass index. Anat Rec (Hoboken) 2024. [PMID: 38284320 DOI: 10.1002/ar.25397] [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: 07/28/2023] [Revised: 01/10/2024] [Accepted: 01/13/2024] [Indexed: 01/30/2024]
Abstract
Bone functional adaptation is routinely invoked to interpret skeletal morphology despite ongoing debate regarding the limits of the bone response to mechanical stimuli. The wide variation in human body mass presents an opportunity to explore the relationship between mechanical load and skeletal response in weight-bearing elements. Here, we examine variation in femoral macroscopic morphology as a function of body mass index (BMI), which is used as a metric of load history. A sample of 80 femora (40 female; 40 male) from recent modern humans was selected from the Texas State University Donated Skeletal Collection. Femora were imaged using x-ray computed tomography (voxel size ~0.5 mm), and segmented to produce surface models. Landmark-based geometric morphometric analyses based on the Coherent Point Drift algorithm were conducted to quantify shape. Principal components analyses were used to summarize shape variation, and component scores were regressed on BMI. Within the male sample, increased BMI was associated with a mediolaterally expanded femoral shaft, as well as increased neck-shaft angle and decreased femoral neck anteversion angle. No statistically significant relationships between shape and BMI were found in the female sample. While mechanical stimulus has traditionally been applied to changes in long bong diaphyseal shape it appears that bone functional adaptation may also result in fundamental changes in the shape of skeletal elements.
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Affiliation(s)
- Adam D Sylvester
- Center for Functional Anatomy and Evolution, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Wojciech Zbijewski
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Gengxin Shi
- Department of Biomedical Engineering, The Johns Hopkins University, Baltimore, Maryland, USA
| | - Lauren A Meckel
- Department of Cell Biology and Anatomy, Louisiana State University Health Science Center, Baton Rouge, Louisiana, USA
| | - Elaine Y Chu
- Department of Anthropology, Texas State University, San Marcos, Texas, USA
| | | | - Daniel J Wescott
- Department of Anthropology, Texas State University, San Marcos, Texas, USA
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11
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Biernat MM, Jędrzejuk D, Urbaniak-Kujda D, Biernat P, Laszkowska-Lewko M, Landwójtowicz M, Majdak E, Podolak-Dawidziak M, Wróbel T. Association of bone mineral density and potential risk factors for osteoporosis in patients with severe haemophilia A. Haemophilia 2024; 30:130-139. [PMID: 38082544 DOI: 10.1111/hae.14903] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 10/07/2023] [Accepted: 11/24/2023] [Indexed: 01/16/2024]
Abstract
INTRODUCTION In people with haemophilia (PWH), recurrent episodes of bleeding lead to joint deterioration and bone resorption. To date, the effects of various other factors on bone mineral density (BMD) reduction have found conflicting results. AIM The aim of this study was to analyse the relationships between BMD, bone mineral content (BMC), and trabecular bone score (TBS) parameters based on the dual X-ray absorptiometry method (DXA) and potential risk factors for osteoporosis in patients with severe haemophilia A. METHODS Fifty-five men with severe haemophilia A, aged 18-68 years, and 59 healthy volunteer men were enrolled in this study. Densitometric-derived lumbar spine and femoral neck BMD, BMC, and TBS were measured. Blood analyses were performed for morphology parameters, liver and kidney function parameters, and viral status. Serum levels of oestradiol (E2 ), testosterone (T), dehydroepiandrosterone sulphate (DHEA-S), parathormone, and vitamin D were measured. RESULTS Patients showed significantly lower BMD compared to controls (p < .003). The result below the expected range for age was nearly double (6.82% vs. 3.92%) in PWH under 50 years old compared to controls. Haemophilic patients also exhibited significantly higher vitamin D3 deficiency (p < .0001), which was strongly associated with low TBS. Additionally, low body mass index and high neutrophil/lymphocyte ratio were correlated with low BMC and BMD. CONCLUSIONS This study confirms the prevalence of low BMD and BMC in patients with haemophilia in Poland. Factors that contribute to low BMD are primarily vitamin D deficiency, low BMI, high neutrophil/lymphocyte ratio, and low testosterone/oestradiol ratio.
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Affiliation(s)
- Monika Maria Biernat
- Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Diana Jędrzejuk
- Department and Clinic of Endocrinology, Diabetology, and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Donata Urbaniak-Kujda
- Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Paweł Biernat
- Chair and Department of Drug Forms Technology, Wroclaw Medical University, Wrocław, Poland
| | - Magdalena Laszkowska-Lewko
- Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Marcin Landwójtowicz
- Department and Clinic of Endocrinology, Diabetology, and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Ewelina Majdak
- Department and Clinic of Endocrinology, Diabetology, and Isotope Therapy, Wroclaw Medical University, Wroclaw, Poland
| | - Maria Podolak-Dawidziak
- Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
| | - Tomasz Wróbel
- Department and Clinic of Hematology, Blood Neoplasms, and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland
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Gao Y, Ye W, Ge X, Wang H, Xiong J, Zhu Y, Wang Z, Wang J, Tang P, Liu W, Cai W. Assessing the utility of MRI-based vertebral bone quality (VBQ) for predicting lumbar pedicle screw loosening. EUROPEAN SPINE JOURNAL : OFFICIAL PUBLICATION OF THE EUROPEAN SPINE SOCIETY, THE EUROPEAN SPINAL DEFORMITY SOCIETY, AND THE EUROPEAN SECTION OF THE CERVICAL SPINE RESEARCH SOCIETY 2024; 33:289-297. [PMID: 37981599 DOI: 10.1007/s00586-023-08034-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 10/18/2023] [Accepted: 10/28/2023] [Indexed: 11/21/2023]
Abstract
STUDY DESIGN Retrospective cohort. OBJECTIVE The purpose of this study is to assess the potential of utilizing the MRI-based vertebral bone quality (VBQ) score as a predictive tool for pedicle screw loosening (PSL) in patients who have undergone pedicle screw fixation and to identify risk factors associated with VBQ scores. METHODS One hundred and sixteen patients who had undergone pedicle screw fixation between December 2019 and January 2021 and had more than a year of follow-up were divided into two groups of PSL and non-PSL. The radiological and clinical parameters investigated were age, gender, body mass index, the VBQ score, length of fusion and the DXA T-score. RESULTS Of the 116 patients included in the study, 22 patients developed pedicle screw loosening after surgery (18.97%). VBQ score of PSL group was higher than the non-PSL group (3.61 ± 0.63 vs. 2. 86 ± 0.43, p < 0.001). According to logistic regression, PSL was independently linked with a higher VBQ score (OR = 3.555, 95% confidence interval [1.620-7.802], p < 0.005). The AUC of predicting screw loosening was 0.774 (p < 0.001) for VBQ score, and the best threshold was 3.055 (sensitivity, 81.8%; specificity, 71.3%). High VBQ score was associated with age (r (114) = 0.29, p = 0.002), while it was not negatively correlated with T-scores of each part. CONCLUSION VBQ score is an independent predictor of pedicle screw loosening, with higher scores indicating a greater risk. Our results showed that older patients and women had higher VBQ scores.
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Affiliation(s)
- Yu Gao
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Wu Ye
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Xuhui Ge
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Haofan Wang
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Junjun Xiong
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Yufeng Zhu
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Zhuanghui Wang
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Jiaxing Wang
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Pengyu Tang
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China
| | - Wei Liu
- Department of Orthopedics, Second Affiliated Hospital of Naval Medical University, Shanghai, 200003, China.
| | - Weihua Cai
- Department of Orthopedics, First Affiliated Hospital of Nanjing Medical University, 300 Guangzhou Road, Nanjing, 210029, Jiangsu Province, China.
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13
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Feng JN, Zhang CG, Li BH, Zhan SY, Wang SF, Song CL. Global burden of hip fracture: The Global Burden of Disease Study. Osteoporos Int 2024; 35:41-52. [PMID: 37704919 DOI: 10.1007/s00198-023-06907-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Accepted: 08/31/2023] [Indexed: 09/15/2023]
Abstract
This study is the first to measure global burden of hip fracture in patients aged 55 years and older across 204 countries and territories from 1990 to 2019. Our study further proved that the global burden of hip fracture is still large. Hip fractures among males are perhaps underestimated, and older adults should be given more attention. PURPOSE Hip fracture is a tremendous universal public health challenge, but no updated comprehensive and comparable assessment of hip fracture incidence and burden exists for most of the world in older adults. METHODS Using data from the Global Burden of Diseases (GBD) 2019, we estimated the number and rates of the incidence, prevalence, and years lived with disability (YLD) of hip fracture across 204 countries and territories in patients aged 55 years and older from 1990 to 2019. RESULTS In 2019, the incidence, prevalence, and YLDs rates of hip fracture in patients aged 55 years and older were 681.35 (95% UI 508.36-892.27) per 100000 population, 1191.39 (95% UI 1083.80-1301.52) per 100000 population, and 130.78 (95% UI 92.26-175.30) per 100000 population. During the three decades, the incidence among people aged below 60 years showed a downward trend, whereas it showed a rapid upward trend among older adults. All the numbers and rates of hip fractures among females were higher than those among males and increased with age, with the highest number and rate in the highest age group. Notably, the male to female ratio of the incidence for people aged over 55 years increased from 0.577 in 1990 to 0.612 in 2019. Falls were the leading cause among both sexes and in all age groups. CONCLUSIONS The incidence and the number of hip fractures among patients aged 55 years and older increased over the past three decades, indicating that the global burden of hip fracture is still large. Hip fractures among males are perhaps underestimated, and older adults should be given more attention.
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Affiliation(s)
- Jing-Nan Feng
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Cheng-Gui Zhang
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
- Department of Orthopedics, Peking University Third Hospital, Beijing, China
| | - Bao-Hua Li
- Institute of Medical Innovation, Peking University Third Hospital, Beijing, China
| | - Si-Yan Zhan
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
- Institute for Artificial Intelligence, Peking University, Beijing, China
| | - Sheng-Feng Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China.
| | - Chun-Li Song
- Department of Orthopedics, Peking University Third Hospital, Beijing, China.
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14
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Jia P, Yuan J. Weight change patterns across adulthood in relation to osteoporosis and fracture among non-obese individuals. Arch Osteoporos 2023; 19:2. [PMID: 38097861 DOI: 10.1007/s11657-023-01362-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023]
Abstract
Weight change was an influencing factor of osteoporosis and fracture in a controversial way. Based on a nationally representative data, we found that weight change from obesity in midlife to non-obesity in late adulthood was associated with a reduction in the risk of osteoporosis and wrist fracture in male, but not in female. INTRODUCTION Obesity is usually recognized as a protective factor to osteoporosis and osteoporotic fracture. However, it is still unclear whether historical weight status was associated with the risk of osteoporosis and fracture. The aim of this study was to investigate the relationship between weight change patterns across adulthood and the prevalence of osteoporosis and fracture. METHODS Data from the National Health and Nutrition Examination Survey (NHANES) with 8725 US adults aged ≥ 40 years were analyzed in this study. Weight change patterns were categorized as "stable non-obese," "obese with earlier weight gain," "obese with recent weight gain," and "revert to non-obese" based on the body mass index (BMI) at 25 years old, 10 years prior to baseline and at baseline. Body mineral density (BMD) was measured using dual x-ray absorptiometry (DXA), and osteoporosis was diagnosed based on the World Health Organization criteria. Self-reported occurrence of osteoporotic fractures were determined by questionnaires. RESULTS Compared with subjects in "stable non-obese" group, obese with earlier weight gain were positively related to the increase of BMD in both genders, while elevated BMD was only observed in female of "obese with recent weight gain" group and in male of "revert to non-obese" group after multiple adjustment. Moreover, changing from the obesity to non-obesity in the 10 years period before baseline was associated with a 81.6% lower risk of osteoporosis (odds ratio (OR) 0.184, 95% confidence interval (CI) 0.037-0.914 (P = 0.039)) and a 69.8% lower risk of wrist fracture (OR 0.302, 95%CI 0.120-0.757 (P = 0.012)) in male, but not in female. CONCLUSION Weight change from obesity in midlife to non-obesity in late adulthood was associated with a reduction in the risk of osteoporosis and wrist fracture in male. Our findings support the importance of investigating the mechanism of weight change in different life period.
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Affiliation(s)
- Pu Jia
- Department of Orthopedics, Beijing Friendship Hospital, Capital Medical University, Beijing, 100050, China
| | - Jing Yuan
- Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
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15
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Barik S, Kumar V. Male Osteoporosis and Frailty. Indian J Orthop 2023; 57:237-244. [PMID: 38107814 PMCID: PMC10721747 DOI: 10.1007/s43465-023-01027-w] [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: 08/29/2023] [Accepted: 10/12/2023] [Indexed: 12/19/2023]
Abstract
It is estimated that 50% women and 20% of men over the age of 50 years will have an osteoporosis-related fracture in their remaining life. Although, Osteoporosis is generally thought to be a disease affecting females, more than a third of hip fractures occur in males due to reduced bone strength. Along with Osteoporosis, the other pathological process which occurs simultaneously is Sarcopenia. It is defined as age-related atrophy of skeletal muscle mass that reduces muscle strength, function, and quality of life. This chapter discusses the various aspects of the disease process in the males including its classification, clinical features, diagnosis and treatment.
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Affiliation(s)
- Sitanshu Barik
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, India
| | - Vishal Kumar
- Department of Orthopedics, All India Institute of Medical Sciences, Deoghar, India
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16
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Shen J, Yang L, Li X, Li X, Tian X, Xiao H, Dai J. Adherence to the dietary approaches to stop hypertension and bone health in the Chinese elderly. J Bone Miner Metab 2023; 41:844-853. [PMID: 37668764 DOI: 10.1007/s00774-023-01464-5] [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: 04/14/2023] [Accepted: 08/03/2023] [Indexed: 09/06/2023]
Abstract
INTRODUCTION Many studies have demonstrated the relationship between diet and bone health, but research on the Dietary Approaches to Stop Hypertension (DASH) dietary pattern and bone health across populations is rare. The purpose of this study was to examine associations between the DASH dietary pattern and bone health outcomes in Chinese elders, to verify whether higher adherence to the DASH was associated with better bone health in elderly populations. MATERIALS AND METHODS A total of 839 Chinese adults aged 50 years and above participated in this cross-sectional study. Bone mineral density (BMD) at calcaneus was measured via ultrasonic bone densitometer. A semiquantitative food frequency questionnaire (FFQ) was used to assess the usual dietary intake in the past 12 months. The DASH score was calculated based on energy-adjusted intakes of nine dietary components, including whole grains, beans, vegetables, fruits, dairy, red meat, total fat, sodium, and sugar-sweetened beverages. RESULTS In postmenopausal women, DASH score was significantly and positively correlated with BMD T-score after controlling potential covariates (β: 0.027 ± 0.012, P = 0.031) in multivariable linear regression models. In binary logistic regression analysis, male participants in the highest tertile of DASH score had lower risk of osteoporosis than those in the lowest tertile (odds ratio = 0.499; 95% confidence interval, 0.262-0.951; P = 0.035) after adjusting potential covariates. CONCLUSION Adherence to the DASH dietary pattern was associated with better bone health in Chinese elderly adults.
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Affiliation(s)
- Jing Shen
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Lei Yang
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China
| | - Xue Li
- Branch of The First Affiliated Hospital of Xinjiang Medical University, Changji City, Xinjiang, China
| | - Xiaoxia Li
- Branch of The First Affiliated Hospital of Xinjiang Medical University, Changji City, Xinjiang, China
| | - Xiaoli Tian
- Xinjiang Second Medical College, Karamay, Xinjiang, China
| | - Hui Xiao
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China.
| | - Jianghong Dai
- School of Public Health, Xinjiang Medical University, Urumqi, Xinjiang, China.
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Bibi M, Batool SA, Iqbal S, Zaidi SB, Hussain R, Akhtar M, Khan A, Alqahtani MS, Abbas M, Ur Rehman MA. Synthesis and characterization of mesoporous bioactive glass nanoparticles loaded with peganum harmala for bone tissue engineering. Heliyon 2023; 9:e21636. [PMID: 38027746 PMCID: PMC10665746 DOI: 10.1016/j.heliyon.2023.e21636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 10/08/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
Globally, there is an increase in a number of bone disorders including osteoarthritis (OA), osteomyelitis, bone cancer, and etc., which has led to a demand for bone tissue regeneration. In order to take use of the osteogenic potential of natural herbs, mesoporous bioactive glass nanoparticles (MBGNs) have the ability to deliver therapeutically active chemicals locally. MBGNs influence bioactivity and osteointegration of materials making them suitable for bone tissue engineering (BTE). In the present study, we developed Peganum Harmala (P. harmala) loaded MBGNs (PH-MBGNs) synthesized via modified Stöber process. The MBGNs were analyzed in terms of surface morphology, chemical make-up, amorphous nature, chemical interaction, pore size, and surface area before and after loading with P. harmala. A burst release of drug from PH-MBGNs was observed within 8 h immersion in phosphate buffer saline (PBS). PH-MBGNs effectively prevented Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) from spreading. Furthermore, PH-MBGNs developed a hydroxyapatite (HA) layer in the presence of simulated body fluid (SBF) after 21 days, which confirmed the in-vitro bioactivity of MBGNs. In conclusion, PH-MBGNs synthesized in this work are potential candidate for scaffolding or a constituent in the coatings for BTE applications.
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Affiliation(s)
- Maria Bibi
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
| | - Syeda Ammara Batool
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
| | - Sajid Iqbal
- Department of Nuclear and Quantum Engineering Korea Advanced Institute of Science and Technology (KAIST) 34141, Daejeon, Republic of Korea
| | - Shaher Bano Zaidi
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
| | - Rabia Hussain
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
| | - Memoona Akhtar
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
| | - Ahmad Khan
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
| | - Mohammed S. Alqahtani
- Radiological Sciences Department, College of Applied Medical Sciences, King Khalid University, Abha 61421, Saudi Arabia
| | - Mohamed Abbas
- Electrical Engineering Department, College of Engineering, King Khalid University, Abha 61421, Saudi Arabia
| | - Muhammad Atiq Ur Rehman
- Department of Materials Science and Engineering, Institute of Space Technology Islamabad, Islamabad 44000, Pakistan
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18
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Liu D, Hu Z, Tang Z, Li P, Yuan W, Li F, Chen Q, Min W, Zhao C. Early risk assessment and prediction model for osteoporosis based on traditional Chinese medicine syndromes. Heliyon 2023; 9:e21501. [PMID: 38027808 PMCID: PMC10663826 DOI: 10.1016/j.heliyon.2023.e21501] [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: 06/16/2023] [Revised: 10/19/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Objective To evaluate the risk factors of osteoporosis and establish a risk prediction model based on routine clinical information and traditional Chinese medicine (TCM) syndromes. Methods Adults aged 30-82 who lived in 12 grass-roots communities or rural towns in Shanghai, Jilin Province, and Jiangsu Province from December 2019 to January 2022 through a multi-stage sampling method were included in this study. The risk factors and risk prediction of osteoporosis in women and men were explored and established by univariate analysis and multivariate logistic regression model. ROC curve and Hosmer-Lemeshow goodness-of-fit test were used to evaluate the prediction model. Results A total of 3000 subjects including 2243 females (75 %) and 757 males (25 %) were included in this study. The logistic prediction model of osteoporosis in women was Logit (P) = -2.946 + 0.960 (age ≥50 years old) + 0.633 (BMI ≥24 kg/m2) - 0.545 (daily exposure to sunlight >30 min) + 0.519 (no intake of dairy products) + 0.827 (coronary heart disease) + 0.383 (lumbar disc herniation) + 0.654 (no intake of calcium tablets and vitamin D) - 0.509 (insomnia) + 0.580 (flushed face and congested eyes) + 1.194 (thready and rapid pulse) + 1.309 (sunken and slow pulse). The logistic prediction model of osteoporosis in men was Logit (P) = -1.152-0.644 (daily exposure to sunlight >30 min) + 0.975 (no intake of calcium tablets and vitamin D) - 0.488 (insomnia). The area under the ROC curve (AUC) of female and male osteoporosis prediction models was 0.743 and 0.679, respectively. The Hosmer-Lemeshow goodness-of-fit test was >0.5. Conclusions There are some significant differences in risk factors between female and male patients with osteoporosis. The risk of osteoporosis are found to be associated with TCM syndromes, and osteoporosis risk prediction models based on routine clinical information and TCM syndrome is effective.
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Affiliation(s)
- Dan Liu
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Zhijun Hu
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Zhanying Tang
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Pan Li
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Weina Yuan
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Fangfang Li
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Qian Chen
- Department of Rehabilitation Medicine, Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Wen Min
- Department of Orthopedics, Affiliated Hospital of Nanjing University of Chinese Medicine, Nanjing, 210004, Jiangsu Province, China
| | - Changwei Zhao
- Department of Orthopedics, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun, 130021, Jilin Province, China
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Yang Q, Wang M, Zhang T, Wen J, Long L, Xia C. Association of cholecystectomy with osteoporosis risk: a prospective study using data from the UK Biobank. Front Endocrinol (Lausanne) 2023; 14:1259475. [PMID: 37929032 PMCID: PMC10623420 DOI: 10.3389/fendo.2023.1259475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 10/02/2023] [Indexed: 11/07/2023] Open
Abstract
Objective To investigate whether prior cholecystectomy is associated with incident osteoporosis. Background Cholecystectomy may have consequences involving abnormal metabolism. Studies investigating the association between prior cholecystectomy and osteoporosis have yielded inconsistent results. Methods In total, 17,603 UK Biobank participants underwent cholecystectomy, and 35,206 matched controls were included in this study. They were followed up for incident osteoporosis, which was determined using ICD-10 codes (M80-82). The association between cholecystectomy and osteoporosis was assessed using Cox proportional regression modeling. The association between osteoporosis risk and cholecystectomy was further analyzed across age, sex, serum vitamin D level, and body mass index (BMI) categories. Results Within a median follow-up period of 13.56 years, 3,217 participants were diagnosed with osteoporosis. After adjustment for relevant confounders, prior cholecystectomy was associated with a 1.21 times higher risk of osteoporosis in women (hazard ratio (HR): 1.21 [95% CI, 1.12-1.31], p < 0.001) and a 1.45 times higher risk in men (HR: 1.45 [95% CI, 1.10-1.90], p = 0.007). In women, the association was stronger for patients who were aged 40-55 years, with BMI < 18.5 kg/m2, and vitamin D between 30 and 50 nmol/ml. No significant interactions between cholecystectomy and income level, education level, presence of hypertension, or diabetes were identified in either sex. Conclusions Our findings indicated that people who underwent cholecystectomy had a higher risk of developing osteoporosis after adjustment for potential confounders. Our findings suggest that awareness of the risk of osteoporosis in patients with a history of cholecystectomy is merited.
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Affiliation(s)
- Qin Yang
- Section for HepatoPancreatoBiliary Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu and The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Ming Wang
- Section for HepatoPancreatoBiliary Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu and The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Tongtong Zhang
- Department of General Surgery, The Third People’s Hospital of Chengdu and The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Jun Wen
- Section for HepatoPancreatoBiliary Surgery, Department of General Surgery, The Third People’s Hospital of Chengdu and The Affiliated Hospital of Southwest Jiaotong University, Chengdu, China
| | - Lu Long
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Congying Xia
- Department of Cardiology, West China Hospital, Sichuan University, Chengdu, China
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20
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White M, Hisatomi L, Villegas A, Pina D, Garfinkel A, Agrawal G, Punatar N, Wise BL, Teng P, Le H. Impact of COVID-19 pandemic on pharmacologic treatment of patients newly diagnosed with osteoporosis. PLoS One 2023; 18:e0291472. [PMID: 37703271 PMCID: PMC10499214 DOI: 10.1371/journal.pone.0291472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/29/2023] [Indexed: 09/15/2023] Open
Abstract
PURPOSE This study determined whether initiation of pharmacologic treatment was delayed for newly diagnosed osteoporosis patients during the COVID-19 pandemic. METHODS 1,189 patients ≥50 years with newly diagnosed osteoporosis using dual-energy x-ray absorptiometry (DXA) screening at a single academic institution were included. Patients with previous osteoporosis were excluded. Patients diagnosed between March 1, 2018-January 31, 2020 (pre-pandemic cohort, n = 576) were compared to those diagnosed between March 1, 2020-January 31, 2022 (pandemic cohort, n = 613). Age, sex, race, ethnicity, ordering providers (primary vs specialty), and pharmacological agents were evaluated. Primary outcomes included proportion of patients prescribed therapy within 3 and 6-months of diagnosis, and mean time from diagnosis to treatment initiation. RESULTS The pre-pandemic cohort had more White patients (74.3 vs 68.4%, p = .02) and no differences between remaining demographic variables. Only 40.5% of newly diagnosed patients initiated pharmacologic therapy within 6 months. Patients treated at 3-months (31.8 vs 35.4%, p = 0.19) and 6-months (37.8 vs 42.9, p = 0.08) were comparable between cohorts (47.2 vs 50.2% p = 0.30). Mean time from diagnosis to treatment initiation was similar (46 vs 45 days, p = 0.72). There were no treatment differences based on gender, race, or ethnicity or between ordering providers (65.1 vs 57.4% primary care, p = 0.08). Bisphosphonates were most often prescribed in both cohorts (89% vs 82.1%). CONCLUSIONS This is the first study assessing COVID-19's impact on pharmacologic treatment of newly diagnosed osteoporosis. 40.5% of newly diagnosed patients were treated pharmacologically within six months of diagnosis, and the pandemic did not significantly affect treatment rates.
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Affiliation(s)
- Micaela White
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, United States of America
| | - Lauren Hisatomi
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, United States of America
- California Northstate University, College of Medicine, Elk Grove, CA, United States of America
| | - Alex Villegas
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, United States of America
| | - Dagoberto Pina
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, United States of America
| | - Alec Garfinkel
- California Northstate University, College of Medicine, Elk Grove, CA, United States of America
| | - Garima Agrawal
- Department of Internal Medicine, University of California Davis, Sacramento, CA, United States of America
| | - Nisha Punatar
- Department of Internal Medicine, University of California Davis, Sacramento, CA, United States of America
| | - Barton L. Wise
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, United States of America
- Department of Internal Medicine, University of California Davis, Sacramento, CA, United States of America
| | - Polly Teng
- Department of Internal Medicine, University of California Davis, Sacramento, CA, United States of America
| | - Hai Le
- Department of Orthopaedic Surgery, University of California Davis, Sacramento, CA, United States of America
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21
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Ercan S, İnce Parpucu T, Başkurt Z, Başkurt F. Health belief model - male osteoporosis: a cross-sectional study. Cent Eur J Public Health 2023; 31:184-190. [PMID: 37934477 DOI: 10.21101/cejph.a7789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/19/2023] [Indexed: 11/08/2023]
Abstract
OBJECTIVES The aim of this study is to examine the knowledge levels, beliefs, and self-efficacies of men regarding osteoporosis according to the health belief model. METHODS Men aged 55 years and older were included in the study. After the descriptive characteristics of the participants were recorded, the Male Osteoporosis Knowledge Quiz, Osteoporosis Health Belief Scale, Osteoporosis Self-Efficacy Scale, and Osteoporosis Knowledge Test were administered to the participants face-to-face. RESULTS A total of 435 men with an average age of 67.3 ± 0.4 years participated in the study. When the participants were categorized according to age subgroups, it was found that marital status (p = 0.002), economic status (p = 0.016), and education level (p < 0.001) differed with age. The results of the osteoporosis-specific measurement tools used in data collection also differed with age (p < 0.05). It was observed that men's levels of osteoporosis knowledge decreased with increasing age (p < 0.05). The lowest scores for the exercise benefits and health motivation subdimensions of the Osteoporosis Health Belief Scale and the Osteoporosis Self-Efficacy Scale were obtained from the subgroup that included the oldest participants (p < 0.05). The highest scores for the calcium barriers subdimension of the Osteoporosis Health Belief Scale were obtained from younger participants (p = 0.036). The level of osteoporosis knowledge showed a low-to-moderate correlation with each question of the Osteoporosis Health Belief Scale (p < 0.05). Age, education, associating the role of physiotherapy with primary-secondary treatment approaches, and health beliefs were the factors that affected the osteoporosis knowledge levels of the participating men (p < 0.05). CONCLUSIONS The knowledge of osteoporosis and preventive beliefs and behaviours of men need to be increased. Knowledge and perceptions of susceptibility to osteoporosis should be developed in men with appropriate education from an early age. We recommend that exercise and physiotherapy approaches should be utilized to a greater extent, especially for individuals in the at-risk age range.
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Affiliation(s)
- Sabriye Ercan
- Department of Sports Medicine, Faculty of Medicine, Suleyman Demirel University, Isparta, Turkey
| | - Tuba İnce Parpucu
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Suleyman Demirel University, Isparta, Turkey
| | - Zeliha Başkurt
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Suleyman Demirel University, Isparta, Turkey
| | - Ferdi Başkurt
- Department of Physiotherapy and Rehabilitation, Health Sciences Faculty, Suleyman Demirel University, Isparta, Turkey
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Beaudart C, Demonceau C, Sabico S, Veronese N, Cooper C, Harvey N, Fuggle N, Bruyère O, Rizzoli R, Reginster JY. Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:1789-1806. [PMID: 37400668 PMCID: PMC10460304 DOI: 10.1007/s40520-023-02478-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION The objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis. METHODS Medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI). RESULTS From the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k = 10, n = 2992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD + 4.75% (95% CI 3.45, 6.05); total hip: MD + 2.72% (95% CI 2.06; 3.37); femoral neck: MD + 2.26% (95% CI 1.67; 2.85). Denososumab (k = 2, n = 242), Teriparatide (k = 2, n = 309) and Abaloparatide (k = 2, n = 248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures. CONCLUSIONS Medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.
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Affiliation(s)
- Charlotte Beaudart
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - Céline Demonceau
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - Shaun Sabico
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451 Saudi Arabia
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine, Geriatrics Section, University of Palermo, via del Vespro, 141, 90127 Palermo, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Nicholas Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Hopitaux Universitaires Geneve, Geneva, Switzerland
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
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23
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Lis-Studniarska D, Lipnicka M, Studniarski M, Irzmański R. Applications of Artificial Intelligence Methods for the Prediction of Osteoporotic Fractures. Life (Basel) 2023; 13:1738. [PMID: 37629595 PMCID: PMC10455761 DOI: 10.3390/life13081738] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 08/03/2023] [Accepted: 08/10/2023] [Indexed: 08/27/2023] Open
Abstract
Background: Osteoporosis is a socio-economic problem of modern aging societies. Bone fractures and the related treatments generate the highest costs. The occurrence of osteoporotic fractures is a cause of chronic disability, many complications, reduced quality of life, and often premature death. Aim of the study: The aim of the study was to determine which of the patient's potential risk factors pertaining to various diseases and lifestyle have an essential impact on the occurrence of low-energy fractures and the hierarchy of these factors. Methods: The study was retrospective. The documentation of 222 patients (206 women and 16 men) from an osteoporosis treatment clinic in Łódź, Poland was analyzed. Each patient was described by a vector consisting of 27 features, where each feature was a different risk factor. Using artificial neural networks, an attempt was made to create a model that, based on the available data, would be able to predict whether the patient would be exposed to low-energy fractures. We developed a neural network model that achieved the best result for the testing data. In addition, we used other methods to solve the classification problem, i.e., correctly dividing patients into two groups: those with fractures and those without fractures. These methods were logistic regression, k-nearest neighbors and SVM. Results: The obtained results gave us the opportunity to assess the effectiveness of various methods and the importance of the features describing patients. Using logistic regression and the recursive elimination of features, a ranking of risk factors was obtained in which the most important were age, chronic kidney disease, neck T-score, and serum phosphate level. Then, we repeated the learning procedure of the neural network considering only these four most important features. The average mean squared error on the test set was about 27% for the best variant of the model. Conclusions: The comparison of the rankings with different numbers of patients shows that the applied method is very sensitive to changes in the considered data (adding new patients significantly changes the result). Further cohort studies with more patients and more advanced methods of machine learning may be needed to identify other significant risk factors and to develop a reliable fracture risk system. The obtained results may contribute to the improved identification patients at risk of low-energy fractures and early implementation of comprehensive treatment.
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Affiliation(s)
- Dorota Lis-Studniarska
- Central Clinical Hospital, Medical University of Łódź, Pomorska 251, 92-213 Łódź, Poland
| | - Marta Lipnicka
- Faculty of Mathematics and Computer Science, University of Łódź, Banacha 22, 90-238 Łódź, Poland; (M.L.); (M.S.)
| | - Marcin Studniarski
- Faculty of Mathematics and Computer Science, University of Łódź, Banacha 22, 90-238 Łódź, Poland; (M.L.); (M.S.)
| | - Robert Irzmański
- Department of Internal Medicine, Rehabilitation and Physical Medicine, Medical University of Łódź, plac Gen. Józefa Hallera 1, 90-645 Łódź, Poland;
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Cha Y, Seo SH, Kim JT, Kim JW, Lee SY, Yoo JI. Osteoporosis Feature Selection and Risk Prediction Model by Machine Learning Using a Cross-Sectional Database. J Bone Metab 2023; 30:263-273. [PMID: 37718904 PMCID: PMC10509024 DOI: 10.11005/jbm.2023.30.3.263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Revised: 07/03/2023] [Accepted: 07/19/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND The purpose of this study was to verify the accuracy and validity of using machine learning (ML) to select risk factors, to discriminate differences in feature selection by ML between men and women, and to develop predictive models for patients with osteoporosis in a big database. METHODS The data on 968 observed features from a total of 3,484 the Korea National Health and Nutrition Examination Survey participants were collected. To find preliminary features that were well-related to osteoporosis, logistic regression, random forest, gradient boosting, adaptive boosting, and support vector machine were used. RESULTS In osteoporosis feature selection by 5 ML models in this study, the most selected variables as risk factors in men and women were body mass index, monthly alcohol consumption, and dietary surveys. However, differences between men and women in osteoporosis feature selection by ML models were age, smoking, and blood glucose level. The receiver operating characteristic (ROC) analysis revealed that the area under the ROC curve for each ML model was not significantly different for either gender. CONCLUSIONS ML performed a feature selection of osteoporosis, considering hidden differences between men and women. The present study considers the preprocessing of input data and the feature selection process as well as the ML technique to be important factors for the accuracy of the osteoporosis prediction model.
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Affiliation(s)
- Yonghan Cha
- Department of Orthopaedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon,
Korea
| | - Sung Hyo Seo
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju,
Korea
| | - Jung-Taek Kim
- Department of Orthopedic Surgery, Ajou Medical Center, Ajou University School of Medicine, Suwon,
Korea
| | - Jin-Woo Kim
- Department of Orthopaedic Surgery, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul,
Korea
| | - Sang-Yeob Lee
- Department of Biomedical Research Institute, Gyeongsang National University Hospital, Jinju,
Korea
| | - Jun-Il Yoo
- Department of Orthopaedic Surgery, Inha University Hospital, Inha University School of Medicine, Incheon,
Korea
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25
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Lim CL, Keong NLS, Yap MMC, Tan AWK, Tan CH, Lim WS. The effects of community-based exercise modalities and volume on musculoskeletal health and functions in elderly people. Front Physiol 2023; 14:1227502. [PMID: 37492640 PMCID: PMC10363600 DOI: 10.3389/fphys.2023.1227502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 06/26/2023] [Indexed: 07/27/2023] Open
Abstract
The effects of different muscle loading exercise (MLEX) modes and volume on musculoskeletal health is not well-studied in older populations. Aim: Therefore, this study aimed to compare the effects of community-based MLEX modalities and volume on musculoskeletal health in elderly people. Methods: Elderly men (n = 86) and women (n = 170), age 50-82 years old, were assigned to the sedentary (SE, n = 60), muscle strengthening exercise (MSE, n = 71), aerobic exercise (AE, n = 62) and Tai Chi exercise (TCE, n = 63) groups, based on > 2 years of exercise history. Exercise volume was compared between "Minimum" ("Min" < 60 min/week), "Low" (60-120 min/week). "Moderate" (121-239 min/week) and "High" (240-720 min/week) volumes. Results: All three modes of MLEX were associated with lower percentage of body fat (BF%) and higher percentage of lean body mass (LBM%, p = 0.003 main effect of group, and p = 0.002 main effect of volume for both BF% and LBM%), but not with higher bone mineral density (BMD, total body, lumbar spine, total hip and neck of femur), than SE. TCE had a distinct advantage in trunk flexibility (p = 0.007 with MSE, p = 0.02 with AE, and p = 0.01 with SE), and both TCE (p = 0.03) and AE (p = 0.03) performed better than SE in the one-leg stand balance test. Isometric strength and throwing speed and peak power with a 2 kg power ball were higher in the MLEX than SE groups (p = 0.01), in the ranking order of MSE, AE and TCE. However, there was no difference in handgrip strength performance between the MLEX groups, which performed better than the SE participants. Accumulating >120 min/week of MLEX can promote body composition health and muscle functions, but 60 min/week of MSE alone may have equal or better outcomes in these parameters. Conclusion: Community-based MLEX classes may be used to mitigate age-related chronic disease that are associated with body composition and muscular functions.
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Affiliation(s)
- Chin Leong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | | | - Margaret Mei Chan Yap
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Alvin Wai Kit Tan
- Department of Endocrinology, Tan Tock Seng Hospital, National Healthcare Group, Singapore, Singapore
| | - Cher Heng Tan
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, National Healthcare Group, Singapore, Singapore
| | - Wee Shiong Lim
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, Singapore, Singapore
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Katthagen JC, Koeppe J, Stolberg-Stolberg J, Rischen R, Freistuehler M, Faldum A, Raschke MJ. Effects of anti-osteoporosis therapy on the risk of secondary fractures and surgical complications following surgical fixation of proximal humerus fracture in older people. Age Ageing 2023; 52:afad097. [PMID: 37368870 DOI: 10.1093/ageing/afad097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 03/10/2023] [Indexed: 06/29/2023] Open
Abstract
BACKGROUND age-related fragility fractures cause significant burden of disease. Within an ageing society, fracture and complication prevention will be essential to balance health expenditure growth. OBJECTIVE to assess the effect of anti-osteoporotic therapy on surgical complications and secondary fractures after treatment of fragility fractures. PATIENTS AND METHODS retrospective health insurance data from January 2008 to December 2019 of patients ≥65 years with proximal humeral fracture (PHF) treated using locked plate fixation (LPF) or reverse total shoulder arthroplasty were analysed. Cumulative incidences were calculated by Aalen-Johansen estimates. The influence of osteoporosis and pharmaceutical therapy on secondary fractures and surgical complications were analysed using multivariable Fine and Gray Cox regression models. RESULTS a total of 43,310 patients (median age 79 years, 84.4% female) with a median follow-up of 40.9 months were included. Five years after PHF, 33.4% of the patients were newly diagnosed with osteoporosis and only 19.8% received anti-osteoporotic therapy. A total of 20.6% (20.1-21.1%) of the patients had at least one secondary fracture with a significant reduction of secondary fracture risk by anti-osteoporotic therapy (P < 0.001). An increased risk for surgical complications (hazard ratio: 1.35, 95% confidence interval: 1.25-1.47, P < 0.001) after LPF could be reversed by anti-osteoporotic therapy. While anti-osteoporotic therapy was more often used in female patients (35.3 vs 19.1%), male patients showed significantly stronger effects reducing the secondary fracture and surgical complication risk. CONCLUSIONS a significant number of secondary fractures and surgical complications could be prevented by consequent osteoporosis diagnosis and treatment particularly in male patients. Health-politics and legislation must enforce guideline-based anti-osteoporotic therapy to mitigate burden of disease.
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Affiliation(s)
- Jan Christoph Katthagen
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, Muenster 48149, Germany
- Research Group "Mathematical Surgery", University Hospital Muenster, University of Muenster, Muenster 48149, Germany
| | - Jeanette Koeppe
- Research Group "Mathematical Surgery", University Hospital Muenster, University of Muenster, Muenster 48149, Germany
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstrasse 56, Muenster 48149, Germany
| | - Josef Stolberg-Stolberg
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, Muenster 48149, Germany
- Research Group "Mathematical Surgery", University Hospital Muenster, University of Muenster, Muenster 48149, Germany
| | - Robert Rischen
- Clinic for Radiology, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building A1, Muenster 48149, Germany
| | - Moritz Freistuehler
- Medical Management Division - Medical Controlling, University Hospital Muenster, Niels-Stensen-Straße 8, Muenster 48149, Germany
| | - Andreas Faldum
- Institute of Biostatistics and Clinical Research, University of Muenster, Schmeddingstrasse 56, Muenster 48149, Germany
| | - Michael J Raschke
- Department of Trauma-, Hand- and Reconstructive Surgery, University Hospital Muenster, Albert-Schweitzer-Campus 1, Building W1, Muenster 48149, Germany
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Xourafa A, Gaudio A. Special Issue: Metabolic Bone Diseases: Molecular Biology, Pathophysiology and Therapy. Int J Mol Sci 2023; 24:ijms24109065. [PMID: 37240410 DOI: 10.3390/ijms24109065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Bone is a vital tissue as it carries out various metabolic functions: support of the body, protection of the internal organs, mineral deposit and hematopoietic functions [...].
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Affiliation(s)
- Anastasia Xourafa
- UO di Medicina Interna, Policlinico "G. Rodolico", Via S. Sofia 78, 95123 Catania, Italy
| | - Agostino Gaudio
- UO di Medicina Interna, Policlinico "G. Rodolico", Via S. Sofia 78, 95123 Catania, Italy
- Department of Clinical and Experimental Medicine, University of Catania, 95123 Catania, Italy
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Doghish AS, Elballal MS, Elazazy O, Elesawy AE, Shahin RK, Midan HM, Sallam AAM, Elbadry AM, Mohamed AK, Ishak NW, Hassan KA, Ayoub AM, Shalaby RE, Elrebehy MA. miRNAs as potential game-changers in bone diseases: Future medicinal and clinical uses. Pathol Res Pract 2023; 245:154440. [PMID: 37031531 DOI: 10.1016/j.prp.2023.154440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/30/2023] [Accepted: 04/02/2023] [Indexed: 04/08/2023]
Abstract
MicroRNAs (miRNAs), short, highly conserved non-coding RNA, influence gene expression by sequential mechanisms such as mRNA breakdown or translational repression. Many biological processes depend on these regulating substances, thus changes in their expression have an impact on the maintenance of cellular homeostasis and result in the emergence of a variety of diseases. Relevant studies have shown in recent years that miRNAs are involved in many stages of bone development and growth. Additionally, abnormal production of miRNA in bone tissues has been closely associated with the development of numerous bone disorders, such as osteonecrosis, bone cancer, and bone metastases. Many pathological processes, including bone loss, metastasis, the proliferation of osteosarcoma cells, and differentiation of osteoblasts and osteoclasts, are under the control of miRNAs. By bringing together the most up-to-date information on the clinical relevance of miRNAs in such diseases, this study hopes to further the study of the biological features of miRNAs in bone disorders and explore their potential as a therapeutic target.
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Dovjak P, Iglseder B, Rainer A, Dovjak G, Weber M, Pietschmann P. Pulse-echo ultrasound measurement in osteoporosis screening: a pilot study in older patients. Aging Clin Exp Res 2023; 35:1221-1230. [PMID: 37093523 DOI: 10.1007/s40520-023-02404-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 03/30/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND A mere 25% of patients who need treatment for osteoporosis receive appropriate therapy, partly due to the time-consuming and stressful diagnostic workup for older patients with functional decline. AIMS The purpose of the present study was to investigate the accuracy of pulse-echo ultrasound measurement of the lower leg for the detection of osteoporosis in older patients, and evaluate the effect of a proposed diagnostic algorithm. METHODS Cortical thickness and the so-called density index (DI) were measured prospectively on the lower leg with a pulse-echo ultrasound (PEUS) device. The accuracy of the device was compared with dual-energy X-ray absorptiometry (DXA) of the hip. We calculated algorithms combining FRAX® scores and PEUS measures as a guide for specific treatment of osteoporosis. RESULTS Three hundred and thirty-three patients aged on average 81 years (82.1% women, 275/333) were included in the study. The sensitivity of the ultrasound device versus DXA for the detection of osteoporosis was 94.4% (84/89), and the specificity was 59% (144/247). The gender-specific sensitivity was 96.2% (75/78) for women and 81.8% (9/11) for men. DISCUSSION Clinical decisions for the specific treatment of osteoporosis could be based on the proposed algorithm, without additional DXA measurements, in 90.9% (303/333) of the patients. CONCLUSION Older patients with a similar risk profile as in our study population may benefit from PEUS, as it is a non-invasive, cost-effective, and efficient diagnostic tool with high accuracy in screening patients for osteoporosis and the risk of fractures.
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Affiliation(s)
- Peter Dovjak
- Department of Acute Geriatrics, Salzkammergut Clinic Gmunden, Miller Von Aichholzstraße 49, 4810, Gmunden, Austria.
| | - Bernhard Iglseder
- Department of Geriatric Medicine, Christian Doppler Hospital, Paracelsus Medical University, Salzburg, Austria
| | - Anna Rainer
- Department of Acute Geriatrics, Salzkammergut Clinic Gmunden, Miller Von Aichholzstraße 49, 4810, Gmunden, Austria
| | - Gregor Dovjak
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Michael Weber
- Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, Vienna, Austria
| | - Peter Pietschmann
- Institute of Pathophysiology and Allergy Research, Center for Pathophysiology, Infectiology and Immunology, Medical University of Vienna, Vienna, Austria
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Zhao DC, Lin XY, Hu J, Zhou BN, Zhang Q, Wang O, Jiang Y, Xia WB, Xing XP, Li M. Health-related quality of life of men with primary osteoporosis and its changes after bisphosphonates treatment. BMC Musculoskelet Disord 2023; 24:309. [PMID: 37076878 PMCID: PMC10114430 DOI: 10.1186/s12891-023-06397-8] [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: 12/16/2022] [Accepted: 04/04/2023] [Indexed: 04/21/2023] Open
Abstract
INTRODUCTION Osteoporosis leads to more serious consequences in men than in women, but less is known about its impacts on health-related quality of life (HRQoL) of men, and whether the anti-osteoporosis treatment can improve HRQoL of men with osteopenia/osteoprosis. METHODS We enrolled men with primary osteoporosis and age-matched healthy controls. We collected medical history, serum levels of carboxyl-terminal type I collagen telopeptide, procollagen type I propeptides, and bone mineral density of patients. All patients and controls completed the short-form 36 (SF-36) questionnaires. Changes in HRQoL of osteopenia/osteoporosis men were prospectively evaluated after alendronate or zoledronic acid treatment. RESULTS A total of 100 men with primary osteoporosis or osteopenia and 100 healthy men were included. The patients were divided into three subgroups: osteopenia (n = 35), osteoporosis (n = 39) and severe osteoporosis (n = 26). Men with osteoporosis or severe osteoporosis had impaired HRQoL in domains of physical health compared to healthy controls. HRQoL scores in physical health related domains of patients with severe osteoporosis were significantly lower compared to healthy controls, and were the poorest among the three subgroups of patients. Fragility fracture history was correlated with lower SF-36 scores about physical health. In 34 men with newly diagnosed osteoporosis receiving bisphosphonates treatment, HRQoL scores were significantly improved in domains of physical health after treatments. CONCLUSIONS The HRQoL is significantly impaired in men with osteoporosis, and the more severe the osteoporosis, the poorer the HRQoL. Fragility fracture is an important influencing factor of deteriorated HRQoL. Bisphosphonates treatment is beneficial to improve HRQoL of osteopenia/osteoporosis men.
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Affiliation(s)
- Di-Chen Zhao
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Xiao-Yun Lin
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Jing Hu
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Bing-Na Zhou
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Qian Zhang
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Ou Wang
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Yan Jiang
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Wei-Bo Xia
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Xiao-Ping Xing
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China
| | - Mei Li
- Department of Endocrinology, National Health Commission Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Shuaifuyuan No. 1, Beijing, Dongcheng District, 100730, China.
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Rouco H, García-García P, Briffault E, Diaz-Rodriguez P. Modulating osteoclasts with nanoparticles: A path for osteoporosis management? WILEY INTERDISCIPLINARY REVIEWS. NANOMEDICINE AND NANOBIOTECHNOLOGY 2023:e1885. [PMID: 37037204 DOI: 10.1002/wnan.1885] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2022] [Revised: 01/27/2023] [Accepted: 02/21/2023] [Indexed: 04/12/2023]
Abstract
Osteoclasts are the cells responsible for the bone resorption process during bone remodeling. In a healthy situation, this process results from an equilibrium between new matrix formation by osteoblast and matrix resorption by osteoclast. Osteoporosis (OP) is a systemic bone disease characterized by a decreased bone mass density and alterations in bone microarchitecture, increasing fracture predisposition. Despite the variety of available therapies for OP management there is a growing gap in its treatment associated to the low patients´ adherence owing to concerns related with long-term efficacy or safety. This makes the development of new and safe treatments necessary. Among the newly developed strategies, the use of synthetic and natural nanoparticles to modulate osteoclasts differentiation, activity, apoptosis or crosstalk with osteoblasts have arisen. Synthetic nanoparticles exert their therapeutic effect either by loading antiresorptive drugs or including molecules for osteoclasts gene regulation. Moreover, this control over osteoclasts can be improved by their targeting to bone extracellular matrix or osteoclast membranes. Furthermore, natural nanoparticles, also known as extracellular vesicles, have been identified to play a key role in bone homeostasis. Consequently, these systems have been widely studied to control osteoblasts and osteoclasts under variable environments. Additionally, the ability to bioengineer extracellular vesicles has allowed to obtain biomimetic systems with desirable characteristics as drug carriers for osteoclasts. The analyzed information reveals the possibility of modulating osteoclasts by different mechanisms through nanoparticles decreasing bone resorption. These findings suggest that controlling osteoclast activity using nanoparticles has the potential to improve osteoporosis management. This article is categorized under: Implantable Materials and Surgical Technologies > Nanomaterials and Implants Implantable Materials and Surgical Technologies > Nanotechnology in Tissue Repair and Replacement Nanotechnology Approaches to Biology > Nanoscale Systems in Biology.
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Affiliation(s)
- Helena Rouco
- School of Pharmacy, University of Nottingham, Nottingham, UK
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma Group (GI-1645), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Patricia García-García
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma Group (GI-1645), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Biomedical Technologies (ITB), La Laguna, Spain
| | - Erik Briffault
- Department of Chemical Engineering and Pharmaceutical Technology, Universidad de La Laguna, La Laguna, Spain
| | - Patricia Diaz-Rodriguez
- Department of Pharmacology, Pharmacy and Pharmaceutical Technology, I+D Farma Group (GI-1645), Facultad de Farmacia, Instituto de Materiales (iMATUS) and Health Research Institute of Santiago de Compostela (IDIS), Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- Institute of Biomedical Technologies (ITB), Universidad de La Laguna, La Laguna, Spain
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Schulz AE, Green BW, Gupta K, Patel RD, Loloi J, Raskolnikov D, Watts KL, Small AC. Management of large kidney stones in the geriatric population. World J Urol 2023; 41:981-992. [PMID: 36856833 DOI: 10.1007/s00345-023-04333-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Accepted: 02/08/2023] [Indexed: 03/02/2023] Open
Abstract
PURPOSE The aim of this review is to highlight the unique factors that predispose geriatric patients to nephrolithiasis and to compare the utility and efficacy of surgical techniques in this specific patient population. METHODS PubMed and EMBASE databases were reviewed, and studies were organized according to surgical treatments. RESULTS Few prospective studies exist comparing kidney stone removal in the elderly to younger cohorts. In addition, various age cut-offs were used to determine who was considered elderly. Most studies which analyzed Percutaneous Nephrolithotomy (PCNL) found a slightly higher rate of minor complications but comparable stone free rate and operative time. For ureteroscopy (URS) and extracorporeal shockwave lithotripsy (ESWL), there were minimal complications observed and no difference in clinical success in the elderly. All surgical techniques were presumed to be safe in the elderly and most found no difference in stone-free rates. CONCLUSIONS Unique attributes of the geriatric population contribute to stone formation and must be considered when determining appropriate management modalities. This review provides an overview of the utility and efficacy of PCNL, URS and ESWL in the elderly, as well as a porposed algorithm for management in this population.
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Affiliation(s)
| | | | - Kavita Gupta
- Montefiore Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Bronx, NY, 10461, USA
| | - Rutul D Patel
- Montefiore Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Bronx, NY, 10461, USA
| | - Justin Loloi
- Montefiore Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Bronx, NY, 10461, USA
| | - Dima Raskolnikov
- Montefiore Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Bronx, NY, 10461, USA
| | - Kara L Watts
- Montefiore Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Bronx, NY, 10461, USA
| | - Alexander C Small
- Montefiore Department of Urology, Montefiore Medical Center, Albert Einstein College of Medicine, 1250 Waters Place, Bronx, NY, 10461, USA.
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Li TL, Liu HD, Ren MX, Zhou Z, Jiang WK, Yang M. Daytime administration of melatonin has better protective effects on bone loss in ovariectomized rats. J Orthop Surg Res 2023; 18:234. [PMID: 36949499 PMCID: PMC10035168 DOI: 10.1186/s13018-023-03695-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Accepted: 03/08/2023] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVE To explore the difference in the protective effects of intraperitoneal injection of exogenous melatonin of daytime or nighttime on bone loss in ovariectomized (OVX) rats. METHODS After bilateral ovariectomy and sham surgery, 40 rats were randomly divided into four groups: sham operation group (Sham), ovariectomy (OVX), and daytime melatonin injection group (OVX + DMLT, 9:00, 30 mg/kg/d) and nighttime injection of melatonin (OVX + NMLT, 22:00, 30 mg/kg/d). After 12 weeks of treatment, the rats were sacrificed. The distal femur, blood and femoral marrow cavity contents were saved. The rest of the samples were tested by Micro-CT, histology, biomechanics and molecular biology. Blood was used for bone metabolism marker measurements. CCK-8, ROS, and Cell apoptosis are performed using MC3E3-T1 cells. RESULTS Compared with treatment at night, the bone mass of the OVX rats was significantly increased after the daytime administration. All microscopic parameters of trabecular bone increased, only Tb.Sp decreased. Histologically, the bone microarchitecture of the OVX + DMLT was also more dense than the bone microarchitecture of the OVX + LMLT. In the biomechanical experiment, the femur samples of the day treatment group were able to withstand greater loads and deformation. In molecular biology experiments, bone formation-related molecules increased, while bone resorption-related molecules decreased. After treatment with melatonin administration at night, the expression of MT-1β was significantly decreased. In cell experiments, the MC3E3-T1 cells treated with low-dose MLT had higher cell viability and greater efficiency in inhibiting ROS production than the MC3E3-T1 cells treated with high-dose MLT, which in turn more effectively inhibited apoptosis. CONCLUSION Daytime administration of melatonin acquires better protective effects on bone loss than night in OVX rats.
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Affiliation(s)
- Tian-Lin Li
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu, 241001, Anhui, People's Republic of China
| | - He-Dong Liu
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu, 241001, Anhui, People's Republic of China
| | - Mao-Xian Ren
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu, 241001, Anhui, People's Republic of China
| | - Zhi Zhou
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu, 241001, Anhui, People's Republic of China
| | - Wen-Kai Jiang
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu, 241001, Anhui, People's Republic of China
| | - Min Yang
- Department of Trauma Orthopedics, The First Affiliated Hospital of Wannan Medical College, Yijishan Hospital, No. 2, Zhe Shan Xi Road, Wuhu, 241001, Anhui, People's Republic of China.
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The association between abdominal obesity and femoral neck bone mineral density in older adults. J Orthop Surg Res 2023; 18:171. [PMID: 36879308 PMCID: PMC9987092 DOI: 10.1186/s13018-023-03654-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 02/28/2023] [Indexed: 03/08/2023] Open
Abstract
BACKGROUND The relationship between obesity and osteoporosis is complex, with contradictory findings reported. Our aim was to evaluate the association between waist circumference (WC), as an easy-to-determine clinical index of abdominal obesity, and femoral neck bone mineral density (BMD) among older adults, using the National Health and Nutrition Examination Survey (NHANES) database. METHODS Data of five NHANES cycles (2005-2010, 2013-2014, and 2017-2018), including 5801 adults aged ≥ 60 years, were used in the analysis. Weighted multiple regression analyses were performed to evaluate the association between WC and femoral neck BMD. Weighted generalized additive models and smooth curve fitting were further performed to characterize nonlinearities in the association. RESULTS There was a positive association between WC and femoral neck BMD in non-adjusted models. After adjusting for body mass index (BMI), the association became negative. On subgroup analysis stratified by sex, this negative association only existed for men. An inverted U-shaped curve relationship between WC and femoral neck BMD was further identified, with an inflection point at a WC of 95 cm for both men and women. CONCLUSIONS Abdominal obesity is a negative predictor of bone health among older adults, independent of BMI. The association between WC and femoral neck BMD followed an inverted U-shaped curve.
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Dong A, Fei X, Huang Y, Huang Y. Efficacy of anti-osteoporosis treatment for men with osteoporosis: a meta-analysis. J Bone Miner Metab 2023; 41:258-267. [PMID: 36847867 DOI: 10.1007/s00774-023-01407-0] [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: 10/25/2022] [Accepted: 01/29/2023] [Indexed: 03/01/2023]
Abstract
INTRODUCTION Osteoporosis and fracture are important healthcare problems for men worldwide, which are relevant to severe disability and mortality. This meta-analysis aimed to assess the effectiveness of pharmacological therapy in men with osteoporosis, and to provide evidence-based hints for clinical practice. MATERIALS AND METHODS PubMed, Embase, Web of Science were searched from inception to July 31, 2022. Pooled standardized mean difference (SMD) and relative risk (RR) were calculated. Heterogeneity between included studies and publication bias were detected. RESULTS Twenty clinical studies were enrolled in this meta-analysis. The pooled SMD for mean percentage differences of change from baseline in lumbar spine BMD between the treatment group and the control group was 4.95 (95% CI 2.48, 7.42, I2 = 99%, p < 0.0001). For mean percentage differences of change in femoral neck BMD, the overall SMD was 3.08 (95% CI 0.95, 5.20, I2 = 99%, p = 0.0045). For a change in total hip BMD, the overall SMD was 1.06 (95% CI 0.50, 1.63, I2 = 82%, p = 0.0002). The overall RR for incident vertebral fractures was 0.50 (95% CI 0.37, 0.68, I2 = 5%, p = 0.3971). The pooled RR for nonvertebral fractures and clinical fracture were 0.74 (95% CI 0.41, 1.33, I2 = 28%, p = 0.3139) and 0.81 (95% CI 0.54, 1.21, I2 = 0%, p = 0.2992). CONCLUSION Findings in this meta-analysis indicate that pharmacological treatment increases lumbar spine, femoral neck, total hip BMD, and decreases incident vertebral fractures in men with osteoporosis.
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Affiliation(s)
- Aimei Dong
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China.
| | - Xiuwen Fei
- Department of Emergency Department, Peking University First Hospital, Beijing, 100034, China
| | - Yucheng Huang
- Department of General Practice, Peking University First Hospital, Beijing, 100034, China
| | - Youyuan Huang
- Department of Endocrinology, Peking University First Hospital, Beijing, 100034, China
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Huang X, Zhang Z, Zou L, Li W, He J. Association between androgen receptor gene alteration and osteoporosis in Chinese Han elderly men. PeerJ 2023; 11:e14782. [PMID: 36815982 PMCID: PMC9933766 DOI: 10.7717/peerj.14782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 01/03/2023] [Indexed: 02/15/2023] Open
Abstract
Objective To explore the role of blood glucose, blood lipids, and androgen receptor gene (CAG)n genotype in the pathogenesis of osteoporosis in Chinese Han men and to provide theoretical value for screening people susceptible to osteoporosis. Methods Patients who visited the First Affiliated Hospital of Chengdu Medical College from February 2021 to October 2021 were selected as research subjects to measure bone density by double-energy X-ray, osteoporosis patients as osteoporosis group (40 patients), and non-osteoporosis patients as the control group (40 patients). The STR method detected the repeat times of the androgen receptor gene (CAG)n in the two groups. The repeat times ≤22 were the SS genotype, and >22 were the LL genotype. Meanwhile, the patient's age, body mass index (BMI), blood glucose, blood lipids, calcium, phosphorus, and alkaline phosphatase examined on day one after admission were collected, and the statistical analysis was performed using SPSS 26.0. Results The results of the univariate analysis showed that there was no significant difference in age, calcium, phosphorus, alkaline phosphatase, and glycosylated hemoglobin between the two groups (P > 0.05). There were significant differences in average blood glucose, total cholesterol, triglyceride, high-density lipoprotein, low-density lipoprotein, and genotype frequency (P < 0.05). The multivariate logistic regression analysis results showed significant differences in total cholesterol and genotype frequency between the two groups (P < 0.05). Conclusion Androgen receptor LL genotype and elevated total cholesterol may be the risk factors for osteoporosis in older men of Han nationality.
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Affiliation(s)
- Xin Huang
- Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Sichuan, China,Department of Orthopedics, Chengdu Seventh People’s Hospital (Orthopedics, Affiliated Cancer Hospital, Chengdu Medical College), Sichuan, China,Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Sichuan, China
| | - Zhengdong Zhang
- Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Sichuan, China,Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Sichuan, China
| | - Liangxuan Zou
- Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Sichuan, China,Department of Orthopedics, Chengdu Seventh People’s Hospital (Orthopedics, Affiliated Cancer Hospital, Chengdu Medical College), Sichuan, China,Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Sichuan, China
| | - Wenbo Li
- Collaborative Innovation Center of Sichuan for Elderly Care and Health, Chengdu Medical College, Sichuan, China,Department of Orthopedics, Chengdu Seventh People’s Hospital (Orthopedics, Affiliated Cancer Hospital, Chengdu Medical College), Sichuan, China,Department of Orthopedics, First Affiliated Hospital of Chengdu Medical College, Sichuan, China
| | - Jun He
- Department of Orthopedics, Chengdu Seventh People’s Hospital (Orthopedics, Affiliated Cancer Hospital, Chengdu Medical College), Sichuan, China
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Ivan S, Daniela O, Jaroslava BD. Sex differences matter: Males and females are equal but not the same. Physiol Behav 2023; 259:114038. [PMID: 36423797 DOI: 10.1016/j.physbeh.2022.114038] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/18/2022] [Accepted: 11/19/2022] [Indexed: 11/23/2022]
Abstract
Sex differences between males and females can be detected early in life. They are present also later even to a much greater extent affecting our life in adulthood and a wide spectrum of physical, psychological, cognitive, and behavioral characteristics. Moreover, sex differences matter also in individual's health and disease. In this article, we reviewed at first the sex differences in brain organization and function with respect to the underlying biological mechanisms. Since the individual functional differences in the brain, in turn, shape the behavior, sex-specific psychological/behavioral differences that can be observed in infants but also adults are consequently addressed. Finally, we briefly mention sex-dependent variations in susceptibility to selected disorders as well as their pathophysiology, diagnosis, and response to therapy. The understanding of biologically determined variability between males and females can have important implications, especially in gender-specific health care. We have the impression that it is very important to emphasize that sex matters. Males and females are differently programmed by nature, and it must be respected. Even though we as males and females are not the same, we would like to emphasize that we are still equal and together form a worthy colorful continuum.
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Affiliation(s)
- Szadvári Ivan
- Institute of Physiology, Medical School, Comenius University, Bratislava, Slovakia
| | - Ostatníková Daniela
- Institute of Physiology, Medical School, Comenius University, Bratislava, Slovakia
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Mendelian randomization analyses of associations between breast cancer and bone mineral density. Sci Rep 2023; 13:1721. [PMID: 36720901 PMCID: PMC9889794 DOI: 10.1038/s41598-023-28899-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/27/2023] [Indexed: 02/01/2023] Open
Abstract
The purpose of this study was to verify whether there is a causal relationship between breast cancer and bone mineral density (BMD). Summary statistics for exposures and outcomes were obtained from corresponding genome-wide association studies. The bidirectional and multivariate mediated Mendelian randomization (MR) analyses were performed. In the bidirectional MR analysis, breast cancer might reduce the BMD of the heel (HE-BMD) (FDR = 1.51 × 10-4) as might its ER+ subtype (FDR = 1.51 × 10-4). From BMD to breast cancer, no significant association was found (FDR > 0.05). The mediating MR analysis showed that Higher free testosterone (FT) only mediated the causal relationship between breast cancer and HE-BMD by 2.9%; both ER+ type and FT were independent factors of HE-BMD (ER+: P = 0.021; FT: P = 6.88 × 10-6). Higher FT could increase the risk of breast cancer (FDR = 1.21 × 10-3) as could total testosterone (TT) (FDR = 5.81 × 10-3). Similarly, higher FT could increase the risk of ER+ subtype (FDR = 2.51 × 10-6) as could TT (FDR = 5.55 × 10-4). These results indicate that BMD is not a risk factor for breast cancer but breast cancer and its ER+ subtype are risk factors for BMD loss. Furthermore, higher FT and TT levels are associated with both an increased incidence of breast cancer and increased bone density.
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Zheng M, Wan Y, Liu G, Gao Y, Pan X, You W, Yuan D, Shen J, Lu J, Wang X, Zheng G, Han Z, Li X, Chen K, Xing X, Zhang D, Weng C, Wei Q, Zhang Y, Lin H. Differences in the prevalence and risk factors of osteoporosis in chinese urban and rural regions: a cross-sectional study. BMC Musculoskelet Disord 2023; 24:46. [PMID: 36658540 PMCID: PMC9850530 DOI: 10.1186/s12891-023-06147-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 01/09/2023] [Indexed: 01/20/2023] Open
Abstract
BACKGROUND Bone mineral density (BMD) and prevalence of osteoporosis may differ between urban and rural populations. This study aimed to investigate the differences in BMD characteristics between urban and rural populations in Jiangsu, China. METHODS A total of 2,711 participants aged 20 years and older were included in the cross-sectional study. Multistage and stratified cluster random sampling was used as the sampling strategy. BMD was measured by the method of dual-energy x-ray absorptiometry (DXA). Data were collected through questionnaires/interview. BMD values at the lumbar spine (L1-L4), femoral neck, total hip, and greater trochanter were collected. Descriptive statistics were used to demonstrate the characteristics of urban and rural participants. Multivariate logistic regression analysis was utilized to analyze the factors that may be associated with osteoporosis in urban and rural populations. RESULTS Of these participants, 1,540 (50.49%) were females and 1,363 (42.14%) were from urban. The prevalence of osteoporosis in urban and rural populations was 5.52% and 10.33%, respectively. In terms of gender, the prevalence of osteoporosis was 2.68% in males and 13.82% in females. For menopausal status, the prevalence of osteoporosis was 30.34% in postmenopausal females and 4.78% in premenopausal females. In urban populations, older age [adjusted odds ratio (AOR) = 2.36, 95%CI, 2.35-2.36), hypertension (AOR = 1.37, 95%CI, 1.36-1.37), unmarried (AOR = 4.04, 95%CI, 3.99-4.09), smoking everyday (AOR = 2.26, 95%CI, 2.23-2.28), family history of osteoporosis (AOR = 1.66, 95%CI, 1.65-1.67), dyslipidemia (AOR = 1.05, 95%CI, 1.04-1.05), and higher β-crosslaps (β-CTX) level (AOR = 1.02, 95%CI, 1.02-1.02) were associated with an increased risk of osteoporosis, while males (AOR = 0.04, 95%CI, 0.04-0.04), higher education level (AOR = 0.95, 95%CI, 0.95-0.95), and aquatic product intake (AOR = 0.99, 95%CI, 0.99-0.99) were related to decreased risk of osteoporosis. Similar results were also observed in rural populations, and (all P < 0.05). CONCLUSION The prevalence of osteoporosis in rural populations was higher than that in urban populations, and the factors associated with the risk of osteoporosis were similar in urban and rural populations.
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Affiliation(s)
- Miao Zheng
- grid.452666.50000 0004 1762 8363The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 China
| | - Yanan Wan
- grid.410734.50000 0004 1761 5845Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Gongwen Liu
- grid.410745.30000 0004 1765 1045Department of Orthopedics, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, 215004 China
| | - Yan Gao
- grid.452273.50000 0004 4914 577XDepartment of Orthopedics, The First People’s Hospital of Kunshan, Kunshan, 215300 China
| | - Xiaoqun Pan
- grid.410734.50000 0004 1761 5845Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009 China
| | - Wanxi You
- Department of Chronic Disease Prevention and Control, Luhe District Center for Disease Control and Prevention, Nanjing, 215200 China
| | - Donglan Yuan
- grid.412676.00000 0004 1799 0784Department of Nuclear Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029 China
| | - Jianxin Shen
- Department of Chronic Disease Prevention and Control, Suzhou Wujiang District Center for Disease Control and Prevention, Suzhou, 215200 China
| | - Junhua Lu
- Department of Chronic Disease Prevention and Control, Chongchuan District Center for Disease Control and Prevention, Nantong, 226001 China
| | - Xia Wang
- grid.452883.0Department of Osteoporosis, Third Affiliated Hospital of Nantong University, Nantong, 226000 China
| | - Gangfeng Zheng
- Department of Chronic Diseases, Jingjiang Center for Disease Control and Prevention, Jingjiang 214500, Beijing, China
| | - Zhiqiang Han
- grid.452858.60000 0005 0368 2155Taizhou Hospital of Traditional Chinese Medicine, Taizhou, 225300 China
| | - Xinlin Li
- Department of Chronic Diseases, Nantong Center for Disease Control and Prevention, Nantong, 214500 China
| | - Kai Chen
- grid.411634.50000 0004 0632 4559XuYi People’s Hospital, Huaian, 211700 China
| | - Xiaoxi Xing
- Quanshan District Center for Disease Control and Prevention, Xuzhou, 221002 China
| | - Dong Zhang
- grid.452666.50000 0004 1762 8363The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 China
| | - Chengwei Weng
- grid.452666.50000 0004 1762 8363The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, 215004 China
| | - Qi Wei
- The Osteoporosis Clinical Center, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China.
| | - Yongqing Zhang
- Department of Non-Communicable Chronic Disease Control, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, 210009, China.
| | - Hua Lin
- Department of Orthopedics, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, 210008, China.
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Tao J, Yan Z, Huang W, Feng T. Seropositive for hepatitis B and C viruses is associated with the risk of decreased bone mineral density in adults: An analysis of studies from the NHANES database. Front Med (Lausanne) 2023; 10:1120083. [PMID: 37035336 PMCID: PMC10073499 DOI: 10.3389/fmed.2023.1120083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 02/24/2023] [Indexed: 04/11/2023] Open
Abstract
Background Some studies had reported that patients with viral hepatitis are at increased risk of reduced bone mineral density and even osteoporosis. However, the interaction between reduced bone mineral density (BMD) and viral hepatitis remains inconclusive. Therefore, our study collected hepatitis test results and bone mineral density from respondents in the NHANES database. The aim of this study was to investigate whether there is an association between hepatitis and a decrease in bone mineral density. Methods The respondents with both hepatitis- and BMD-related indicators from the NHANES database in the United States from 2005-2010, 2013-2014, to 2017-2020 were collected for this study. BMD were compared between respondents who were positive and negative for respondents related to hepatitis B and C. BMD was measured using dual-energy X-ray absorptiometry of the femur and lumbar spine. Finally, multiple regression analysis was performed between hepatitis B surface antigen (HBsAg) and hepatitis C RNA (HCV-RNA) and BMD in the respondents. Results A total of 15,642 respondents were included in the hepatitis B surface antigen-related survey. Of these, 1,217 respondents were positive for hepatitis B surface antigen. A total of 5111 hepatitis C RNA-related responders were included. Hepatitis C RNA-positive had 268 respondents. According to the results of the multiple regression analysis, the femoral BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.018 (-0.026, -0.009) (P < 0.01). Moreover, spinal BMD was significantly lower in HBsAg (+) respondents compared to HBsAg (-) respondents: -0.020 (-0.030, -0.010) (P < 0.01). According to the results of multiple regression analysis for hepatitis C RNA, HCV-RNA (+) respondents had significantly lower BMD compared to HCV-RNA (-) respondents: -0.043 (-0.059, -0.026) (P < 0.01). Conclusion During the analysis of respondents in the NHANES database in the United States, positive tests for hepatitis B surface antigen and hepatitis C RNA were found to be associated with a reduction in BMD. Positive serology for these hepatitis indicators may increase the risk of reduced BMD. Of course, this conclusion still needs to be further confirmed by more large clinical trials.
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Affiliation(s)
- Jiasheng Tao
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Zijian Yan
- The First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong Province, China
| | - Wenmian Huang
- Affiliated Stomatological Hospital, Guangzhou Medical University, Guangzhou, Guangdong Province, China
| | - Tao Feng
- Department of Orthopedics, Nantong Hospital of Traditional Chinese Medicine, Nantong, Jiangsu, China
- *Correspondence: Tao Feng
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Nguyen VH. Making a Move on the Mark of Osteoporosis in Men. Gerontol Geriatr Med 2023; 9:23337214231204729. [PMID: 37811134 PMCID: PMC10559691 DOI: 10.1177/23337214231204729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 09/12/2023] [Accepted: 09/13/2023] [Indexed: 10/10/2023] Open
Affiliation(s)
- Vu H. Nguyen
- University of Missouri, Columbia, MO, USA
- Columbia College of Missouri, Columbia, MO, USA
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Camp K, Hartos J, Atanda A. Use of Clinical Practice Guidelines and Quality Metrics to Assess Primary Care Management of Osteoporosis. Gerontol Geriatr Med 2023; 9:23337214231202152. [PMID: 37786542 PMCID: PMC10541736 DOI: 10.1177/23337214231202152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 08/23/2023] [Accepted: 09/01/2023] [Indexed: 10/04/2023] Open
Abstract
Background: Clinical practice guidelines and quality measures provide recommendations for physicians addressing osteoporosis management. This study explored the alignment of osteoporosis clinical practice in a primary care geriatric clinic with recommended guidelines. Methods: This retrospective chart review included 388 patients 65 or older from a primary care geriatric clinic diagnosed with osteopenia or osteoporosis, with or without a fragility fracture. Data included history of falls and use of DXA scans, FRAX® fracture risk assessment tool, osteoporosis medication, and fall risk mitigation plans. Results: For age-related primary fracture prevention, 68% of women and 87% of men had documented DXA scans, and 45% of patients diagnosed with osteoporosis and 42% determined at high risk were prescribed osteoporosis medication. For secondary fracture prevention, 72% of women aged 67 to 85 had DXA scans and 21% were prescribed osteoporosis medication. Only 10% of patients with a history of falls had documented fall risk management plans. Conclusion: Although showing higher rates of primary and secondary prevention outcomes than did research results from general primary care, gaps were identified for high fracture risk patients and fall risk management documentation. Medical record review may not provide sufficient data to capture factors influencing decision-making for fracture prevention.
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Affiliation(s)
- Kathlene Camp
- University of North Texas Health Science Center, Fort Worth, USA
| | | | - Adenike Atanda
- University of North Texas Health Science Center, Fort Worth, USA
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Hart DA. Sex differences in musculoskeletal injury and disease risks across the lifespan: Are there unique subsets of females at higher risk than males for these conditions at distinct stages of the life cycle? Front Physiol 2023; 14:1127689. [PMID: 37113695 PMCID: PMC10126777 DOI: 10.3389/fphys.2023.1127689] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 03/28/2023] [Indexed: 04/29/2023] Open
Abstract
Sex differences have been reported for diseases of the musculoskeletal system (MSK) as well as the risk for injuries to tissues of the MSK system. For females, some of these occur prior to the onset of puberty, following the onset of puberty, and following the onset of menopause. Therefore, they can occur across the lifespan. While some conditions are related to immune dysfunction, others are associated with specific tissues of the MSK more directly. Based on this life spectrum of sex differences in both risk for injury and onset of diseases, a role for sex hormones in the initiation and progression of this risk is somewhat variable. Sex hormone receptor expression and functioning can also vary with life events such as the menstrual cycle in females, with different tissues being affected. Furthermore, some sex hormone receptors can affect gene expression independent of sex hormones and some transitional events such as puberty are accompanied by epigenetic alterations that can further lead to sex differences in MSK gene regulation. Some of the sex differences in injury risk and the post-menopausal disease risk may be "imprinted" in the genomes of females and males during development and sex hormones and their consequences only modulators of such risks later in life as the sex hormone milieu changes. The purpose of this review is to discuss some of the relevant conditions associated with sex differences in risks for loss of MSK tissue integrity across the lifespan, and further discuss several of the implications of their variable relationship with sex hormones, their receptors and life events.
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Murray S, Langdahl B, Casado E, Brooks K, Libanati C, Di Lecce L, Lazure P. Preparing the Leaders of Tomorrow: Learnings from a Two-Year Community of Practice in Fragility Fractures. J Eur CME 2022; 11:2142405. [DOI: 10.1080/21614083.2022.2142405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Affiliation(s)
- Suzanne Murray
- Department of Research, AXDEV Group Inc, Brossard, QC, Canada
| | - Bente Langdahl
- Department of Endocrinology and Internal Medicine, Aarhus University Hospital, Aarhus, Denmark
| | - Enrique Casado
- Department of Rheumatology, University Hospital Parc Taulí, I3PT Research Institute, Sabadell, Barcelona, Spain
| | | | | | | | - Patrice Lazure
- Department of Research, AXDEV Group Inc, Brossard, QC, Canada
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Nguyen-Khac V, Bonnet-Lebrun A, Skalli W, Adamsbaum C, Linglart A, Wicart P. Changes in adipose bone marrow and bone morphology in X-linked hypophosphatemic rickets. Orthop Traumatol Surg Res 2022; 109:103529. [PMID: 36565743 DOI: 10.1016/j.otsr.2022.103529] [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: 03/03/2022] [Revised: 08/01/2022] [Accepted: 08/26/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION X-linked hypophosphatemic (XLH) rickets causes significant bone deformities in the lower limbs resulting from a bone mineralization defect. According to Frost's Mechanostat theory, compensatory modeling of the bones takes place during increased mechanical loads. In addition, mechanical stimuli modulate the differentiation of mesenchymal stem cells; common precursors to bone marrow adipocytes and osteoblasts. HYPOTHESIS Bone deformities of the lower limbs lead to increased femoral bone mass and decreased fatty infiltration of the bone marrow (FIBM) in children with XLH rickets compared to a control group. PATIENTS AND METHODS Eleven children (10.3years [6-17]) with XLH rickets and 22 healthy children (10.2years [5-15.5]) underwent lower limb Magnetic Resonance Imaging. A calculation of FIBM was performed at the mid-femur, as well as a calculation of the total bone cross-sectional area (CSA), the cortical CSA, the anteroposterior and mediolateral axes of the femur, bone marrow and the thickness of the femoral cortices. RESULTS Total bone CSA, total cortical CSA and bone marrow CSA were higher in the XLH group than in the control group (p<0.05). The mid-lateral diameters of the femur and bone marrow were more elongated than those of the control group (p<0.001). Only the anterior cortex was thinned in the XLH group (p=0.001), while there was no difference with the control group for the posterior, medial and lateral cortices. The total percentage of FIBM was 72.81% [±3.95] and 77.4% [±5.52] for the XLH and control groups respectively (p<0.001). DISCUSSION The increase in bone mass in the XLH population reflects an adaptation of bone tissue to the bone deformities present in this pathology. The decrease in FIBM indicates a lower risk of osteoporosis in the XLH population and may constitute a new monitoring parameter in this pathology. LEVEL OF STUDY III; Case-control study.
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Affiliation(s)
| | - Aurore Bonnet-Lebrun
- ENSAM, Institut de Biomécanique Humaine G.-Charpark, 151, Boulevard de l'Hôpital, 75013 Paris, France
| | - Wafa Skalli
- ENSAM, Institut de Biomécanique Humaine G.-Charpark, 151, Boulevard de l'Hôpital, 75013 Paris, France
| | - Catherine Adamsbaum
- Hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Agnès Linglart
- Hôpital Bicêtre, AP-HP, 78, rue du Général-Leclerc, 94270 Le Kremlin-Bicêtre, France
| | - Philippe Wicart
- Hospital Necker-Enfants-Malades, AP-HP, 149, rue de Sèvre, 75015 Paris, France
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Klara J, Lewandowska-Łańcucka J. How Efficient are Alendronate-Nano/Biomaterial Combinations for Anti-Osteoporosis Therapy? An Evidence-Based Review of the Literature. Int J Nanomedicine 2022; 17:6065-6094. [PMID: 36510618 PMCID: PMC9738991 DOI: 10.2147/ijn.s388430] [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: 09/03/2022] [Accepted: 11/16/2022] [Indexed: 12/12/2022] Open
Abstract
Osteoporosis is defined as a systemic skeletal disease characterized by low bone mass and microarchitectural deterioration of bone tissue, with a consequent increase in bone fragility and susceptibility to fracture. Because of the systemic nature of osteoporosis, the associated escalation in fracture risk affects virtually all skeletal sites. The problem is serious since it is estimated that more than 23 million men and women are at high risk of osteoporotic-like breakages in the European Union. Alendronate (ALN) is the most commonly prescribed oral nitrogen-containing bisphosphonate (BP) for the prevention and the therapy of osteoporosis. This is also one of the most intensely studied drugs in this field. However, ALN is characterized by restricted oral absorption and bioavailability and simultaneously its administration has serious side-effects (jaw osteonecrosis, irritation of the gastrointestinal system, nausea, musculoskeletal pain, and cardiovascular risks). Therefore, delivery systems enabling controlled release and local action of this drug are of great interest, being widely researched and presented in the literature. In this review, we discuss the current trends in the design of various types of alendronate carriers. Our paper is focused on the most recent developments in the field of nano/biomaterials-based systems for ALN delivery, including nano/microformulations, synthetic/natural polymeric and inorganic materials, hydrogel-based materials, scaffolds, coated-like structures, as well as organic-inorganic hybrids. Topics related to the treatment of complex bone diseases including osteoporosis have been covered in several more general reviews; however, the systems for this particular drug have not yet been discussed in detail.
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Affiliation(s)
- Joanna Klara
- Faculty of Chemistry, Jagiellonian University, Kraków, 30-387, Poland
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Chronic Disease Screening and Health Promotion Strategies for Older Men. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Ahmadi A, Mazloomnejad R, Kasravi M, Gholamine B, Bahrami S, Sarzaeem MM, Niknejad H. Recent advances on small molecules in osteogenic differentiation of stem cells and the underlying signaling pathways. Stem Cell Res Ther 2022; 13:518. [PMID: 36371202 PMCID: PMC9652959 DOI: 10.1186/s13287-022-03204-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/09/2022] [Indexed: 11/15/2022] Open
Abstract
Bone-related diseases are major contributors to morbidity and mortality in elderly people and the current treatments result in insufficient healing and several complications. One of the promising areas of research for healing bone fractures and skeletal defects is regenerative medicine using stem cells. Differentiating stem cells using agents that shift cell development towards the preferred lineage requires activation of certain intracellular signaling pathways, many of which are known to induce osteogenesis during embryological stages. Imitating embryological bone formation through activation of these signaling pathways has been the focus of many osteogenic studies. Activation of osteogenic signaling can be done by using small molecules. Several of these agents, e.g., statins, metformin, adenosine, and dexamethasone have other clinical uses but have also shown osteogenic capacities. On the other hand, some other molecules such as T63 and tetrahydroquinolines are not as well recognized in the clinic. Osteogenic small molecules exert their effects through the activation of signaling pathways known to be related to osteogenesis. These pathways include more well-known pathways including BMP/Smad, Wnt, and Hedgehog as well as ancillary pathways including estrogen signaling and neuropeptide signaling. In this paper, we review the recent data on small molecule-mediated osteogenic differentiation, possible adjunctive agents with these molecules, and the signaling pathways through which each small molecule exerts its effects.
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Affiliation(s)
- Armin Ahmadi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985711151, Tehran, Iran
| | - Radman Mazloomnejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985711151, Tehran, Iran
| | - Mohammadreza Kasravi
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985711151, Tehran, Iran
| | - Babak Gholamine
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985711151, Tehran, Iran
| | - Soheyl Bahrami
- Ludwig Boltzmann Institute for Experimental and Clinical Traumatology in AUVA Research Center, Vienna, Austria
| | - Mohammad Mahdi Sarzaeem
- Department of Orthopedic Surgery, Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hassan Niknejad
- Department of Pharmacology, School of Medicine, Shahid Beheshti University of Medical Sciences, P.O. Box: 1985711151, Tehran, Iran.
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Artificial intelligence used to diagnose osteoporosis from risk factors in clinical data and proposing sports protocols. Sci Rep 2022; 12:18330. [PMID: 36316387 PMCID: PMC9622877 DOI: 10.1038/s41598-022-23184-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
Osteoporosis (OP) is characterized by diminished bone mass and deteriorating bone structure that increases the chance of fractures in the spine, hips, and wrists. In this paper, a novel data processing method of artificial intelligence (AI) is used for evaluating, predicting, and classifying OP risk factors in clinical data of men and women separately. Additionally, artificial intelligence was used to suggest the most appropriate sports programs for treatment. Data was obtained from dual-energy x-ray absorption scanning center of Ayatollah Kashani, Milad, and Khatam al-Anbia hospitals in Tehran, Iran. The subjects included 1224 men and women. Models were developed using decision tree, random forest (RF), k-nearest neighbor, support vector machine, gradient boosting (GB), Extra trees, Ada Boost (AB), and artificial neural network multilayer perceptron analysis to predict osteoporosis and to recommend sports programs. Data was divided into training (80%) and test dataset (20%). The results were obtained on a 20% test dataset. Area under receiver operating characteristic curve (AUROC) was used to compare the performance of the models. To predict healthy individuals, osteopenia and osteoporosis, the FR algorithm with AUROC 0.91 performed best in men and the GB algorithm with AUROC 0.95 performed best in women compared to other classification algorithms. Prediction of RF algorithm in women and men with AUROC 0.96 and 0.99, respectively, showed the highest performance in diagnosing the type of exercise for healthy individuals and those with osteopenia and OP. Eight AI algorithms were developed and compared to accurately predict osteoporosis risk factors and classify individuals into three categories: healthy, osteopenia, and OP. In addition, the AI algorithms were developed to recommend the most appropriate sports programs as part of treatment. Applying the AI algorithms in a clinical setting could help primary care providers classify patients with osteoporosis and improve treatment by recommending appropriate exercise programs.
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The Therapeutic Potential of the Endocannabinoid System in Age-Related Diseases. Biomedicines 2022; 10:biomedicines10102492. [PMID: 36289755 PMCID: PMC9599275 DOI: 10.3390/biomedicines10102492] [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: 08/21/2022] [Revised: 09/24/2022] [Accepted: 10/03/2022] [Indexed: 11/25/2022] Open
Abstract
The endocannabinoid system (ECS) dynamically regulates many aspects of mammalian physiology. ECS has gained substantial interest since growing evidence suggests that it also plays a major role in several pathophysiological conditions due to its ability to modulate various underlying mechanisms. Furthermore, cannabinoids, as components of the cannabinoid system (CS), have proven beneficial effects such as anti-inflammatory, immunomodulatory, neuromodulatory, antioxidative, and cardioprotective effects. In this comprehensive review, we aimed to describe the complex interaction between CS and most common age-related diseases such as neuro-degenerative, oncological, skeletal, and cardiovascular disorders, together with the potential of various cannabinoids to ameliorate the progression of these disorders. Since chronic inflammation is postulated as the pillar of all the above-mentioned medical conditions, we also discuss in this paper the potential of CS to ameliorate aging-associated immune system dysregulation.
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