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Gyasi RM, Asiedu HB, Siaw LP, Nyaaba E, Affum-Osei E, Lamptey RB, Muhonja F, Arthur DD, Asamoah E, Nimoh M, Adu-Gyamfi S. Food insecurity and mobility difficulty in middle-aged and older adults: The importance of bio-psychosocial factors. J Psychosom Res 2024; 184:111849. [PMID: 38950509 DOI: 10.1016/j.jpsychores.2024.111849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/21/2024] [Accepted: 06/21/2024] [Indexed: 07/03/2024]
Abstract
OBJECTIVE Food insecurity has been associated with mobility difficulty (MD) in old age. However, there is a scarcity of research on this topic from low- and middle-income countries, while the bio-psychological factors underlying this association are largely unknown. We investigated the food insecurity-MD link in Ghana and explored how sleep, anxiety, loneliness, and physical activity (PA) mediate the association. METHODS Community-based, representative cross-sectional data from the Aging, Health, Well-being, and Health-seeking Behavior Study were analyzed (N = 1201; Mage = 66.5; women = 63%). MD was assessed with items from the SF-36 of the Medical Outcomes Study. We assessed food insecurity with items on hunger and breakfast-skipping frequency due to lack of food and resources. Adjusted OLS and mediation models via bootstrapping technique evaluated the associations. RESULTS Results revealed the expected association between food insecurity and MD, such that greater food insecurity was significantly and positively associated with MD across paths (from β = 0.33 to β = 0.42, p < .001). Analyses of indirect effects showed that sleep problems (27.8%), anxiety (15.5%), loneliness (17.5%), and PA (18.0%) mediated the association between food insecurity and MD. Cross-level interactions revealed that food insecurity significantly modified the link between each mediator and MD. CONCLUSIONS Our data provide novel evidence that bio-psychological mechanisms may underlie the food insecurity-MD link and should, therefore, be considered relevant targets for interventions to prevent/manage MD in later life.
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Affiliation(s)
- Razak M Gyasi
- African Population and Health Research Center, Nairobi, Kenya; National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, NSW, Australia.
| | - Hubert Bimpeh Asiedu
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Lawrencia Pokuah Siaw
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Nyaaba
- Department of Geography and Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Emmanuel Affum-Osei
- Department of Human Resources, School of Business, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Richard Bruce Lamptey
- College of Science Library, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Faith Muhonja
- School of Public Health, Mount Kenya University, Kenya
| | - Dominic Degraft Arthur
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Edward Asamoah
- Department of Sociology and Social Work, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Nimoh
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Samuel Adu-Gyamfi
- Department of History and Political Studies, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Zheng Y, Wang J, Li Y, Wang Y, Suo C, Jiang Y, Jin L, Xu K, Chen X. Unraveling the role of BMI and blood markers in the relationship between plant-based diets and osteoporosis: A prospective cohort study. Prev Med 2024; 187:108103. [PMID: 39151805 DOI: 10.1016/j.ypmed.2024.108103] [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: 05/27/2024] [Revised: 08/13/2024] [Accepted: 08/13/2024] [Indexed: 08/19/2024]
Abstract
BACKGROUND The potential adverse effects of plant-based diets on bone health have raised significant concern, while the prospective evidence is limited. This study aimed to evaluate the association between plant-based diet indexes and incident osteoporosis while exploring the underlying mechanisms involved in this relationship. METHODS The analysis included 202,063 UK Biobank participants conducted between 2006 and 2022. Plant-based diet indexes (hPDI and uPDI) were calculated using the 24-h dietary questionnaire. Cox proportional risk regression and mediation analysis were used to explore the associations of plant-based diet indexes with osteoporosis, estimating the contribution of BMI and blood markers. RESULTS We found the highest quintile for hPDI (HR = 1.16; 95% CI: 1.05 to 1.28) and uPDI (HR = 1.15; 95% CI: 1.05 to 1.26) were associated with an increased risk of osteoporosis. BMI was identified as an important mediator in the association between hPDI and osteoporosis, with mediation proportions of 46.17%. For blood markers, the mediating (suppressing) effects of C-reactive protein, alkaline phosphatase, and insulin-like growth factor-1 on the association between uPDI (hPDI) and osteoporosis were significant, ranging from 5.63%-16.87% (4.57%-6.22%). CONCLUSION Adherence to a plant-based diet is associated with a higher risk of osteoporosis, with BMI and blood markers potentially contributing to this relationship. Notably, even a healthy plant-based diet necessitates attention to weight management to mitigate its impact on bone loss. These findings emphasize the importance of personalized dietary recommendations and lifestyle interventions to decrease the risk of osteoporosis.
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Affiliation(s)
- Yi Zheng
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Jiacheng Wang
- Department of Epidemiology, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Yucan Li
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China
| | - Yawen Wang
- Department of Biostatistics, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China
| | - Chen Suo
- Department of Biostatistics, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Yanfeng Jiang
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Li Jin
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China
| | - Kelin Xu
- Department of Biostatistics, School of Public Health, and the Key Laboratory of Public Health Safety of Ministry of Education, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China.
| | - Xingdong Chen
- State Key Laboratory of Genetic Engineering, Zhangjiang Fudan International Innovation Center, School of Life Sciences, Human Phenome Institute, Fudan University, Shanghai, China; Fudan University Taizhou Institute of Health Sciences, Taizhou, Jiangsu, China; National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China; Yiwu Research Institute of Fudan University, Yiwu, Zhejiang, China.
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3
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Barbato A, Vergatti A, Giaquinto A, Pizzulo IL, Perna L, Perruolo G, Abate V, Sibilio M, Mainolfi C, Soscia E, De Filippo G, Formisano P, Galletti F, Strazzullo P, Rendina D. Imiglucerase, cholecalciferol, and bone-diet in skeletal health management of type I Gaucher disease patients: a pilot study and systematic review. JBMR Plus 2024; 8:ziae071. [PMID: 39006867 PMCID: PMC11245647 DOI: 10.1093/jbmrpl/ziae071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 05/03/2024] [Accepted: 05/23/2024] [Indexed: 07/16/2024] Open
Abstract
Skeletal anomalies represent a characteristic feature of type 1 Gaucher disease (GD1). Here we evaluated the impact of an integrated therapy comprising enzyme-replacement therapy (ERT), cholecalciferol, and a normocalcemic-normocaloric-hyposodic diet (bone diet) on bone health in GD1 patients. We also performed a systematic review to compare our results with available data. From January 1, 2015 to February 28, 2019, all GD1 patients referred to Federico II University were enrolled and treated with the integrated therapy. Bone turnover markers and bone mineral density (BMD) were evaluated at baseline (T0) and after 24 months (T24). We enrolled 25 GD1 patients, all showing 25-hydroxy vitamin D (25OHD) levels < 50 nmol/l (hypovitaminosis D) at T0. Response to cholecalciferol treatment was effective, showing a direct relationship between 25OHD levels before and after treatment. At T0, 2 GD1 patients showed fragility fractures, 5 the Erlenmeyer flask deformity, 3 osteonecrosis, and 7 a BMD Z-score ≤ -2. Overall, GD1 patients with bone anomalies showed higher C-terminal telopeptide levels compared with those without bone anomalies. No new bone anomalies occurred during 2 years of follow-up. At T24, BMD remained stable across the entire study cohort, including in patients with bone anomalies. The systematic review showed that our study is the first that evaluated all bone health parameters. Hypovitaminosis D is prevalent in GD1 patients. The response to cholecalciferol treatment was effective but different to healthy subjects and in patients with metabolic bone disorders. Integrated therapy including ERT, cholecalciferol, and bone diet guarantees bone health.
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Affiliation(s)
- Antonio Barbato
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Anita Vergatti
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Alfonso Giaquinto
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Ilaria Libera Pizzulo
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Ludovica Perna
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Giuseppe Perruolo
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Veronica Abate
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Michelina Sibilio
- Metabolic Diseases Unit, Santobono-Pausilipon Children's Hospital, 80129 Naples, Italy
| | - Ciro Mainolfi
- Department of Advanced Biomedical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Ernesto Soscia
- Institute of Biostructures and Bioimaging of the National Research Council – CNR, 80131 Naples, Italy
| | - Gianpaolo De Filippo
- Assistance Publique-Hôpitaux de Paris, Hôpital Robert-Debré, Service d’Endocrinologie-Diabétologie, 75019 Paris, France
| | - Pietro Formisano
- Department of Translational Medical Sciences, Federico II University of Naples, 80131 Naples, Italy
| | - Ferruccio Galletti
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
| | - Pasquale Strazzullo
- Former Professor of Internal Medicine, Federico II University, 80131 Naples, Italy
| | - Domenico Rendina
- Department of Clinical Medicine and Surgery, Federico II University of Naples, 80131 Naples, Italy
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4
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Costa NDSD, Lima LS, Galiciolli MEA, Ribeiro DHF, Ribeiro MM, Garica GDPJ, Marçal IS, Silva JFD, Pereira ME, Oliveira CS, Guiloski IC. Drug-induced osteoporosis and mechanisms of bone tissue regeneration through trace elements. J Trace Elem Med Biol 2024; 84:127446. [PMID: 38615498 DOI: 10.1016/j.jtemb.2024.127446] [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: 01/02/2024] [Revised: 03/30/2024] [Accepted: 04/03/2024] [Indexed: 04/16/2024]
Abstract
Osteoporosis is associated with an imbalance in bone formation, with certain drugs used in disease treatment being implicated in its development. Supplementation with trace elements may contribute to bone regeneration, offering an alternative approach by enhancing bone mineral density (BMD) and thereby thwarting the onset of osteoporosis. This review aims to assess the mechanisms through which trace elements such as copper (Cu), iron (Fe), selenium (Se), manganese (Mn), and zinc (Zn) are linked to increased bone mass, thus mitigating the effects of pharmaceuticals. Our findings underscore that the use of drugs such as aromatase inhibitors (AIs), proton pump inhibitors (PPIs), antiretrovirals, glucocorticoids, opioids, or anticonvulsants can result in decreased BMD, a primary contributor to osteoporosis. Research indicates that essential elements like Cu, Fe, Se, Mn, and Zn, through various mechanisms, can bolster BMD and forestall the onset of the disease, owing to their protective effects. Consequently, our study recommends a minimum daily intake of these essential minerals for patients undergoing treatment with the aforementioned drugs, as the diverse mechanisms governing the effects of trace elements Cu, Fe, Mn, Se, and Zn facilitate bone remodeling.
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Affiliation(s)
- Nayara de Souza da Costa
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Luíza Siqueira Lima
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Maria Eduarda Andrade Galiciolli
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Deborah Helen Fabiano Ribeiro
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Milena Mariano Ribeiro
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Gisele de Paula Júlia Garica
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Isabela Saragioto Marçal
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Juliana Ferreira da Silva
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Meire Ellen Pereira
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Cláudia Sirlene Oliveira
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil
| | - Izonete Cristina Guiloski
- Instituto de Pesquisas Pelé Pequeno Príncipe, Curitiba 80035-000, Brazil; Faculdades Pequeno Príncipe, Curitiba 80230-020, Brazil.
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Wimalawansa SJ. Physiology of Vitamin D-Focusing on Disease Prevention. Nutrients 2024; 16:1666. [PMID: 38892599 PMCID: PMC11174958 DOI: 10.3390/nu16111666] [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: 04/07/2024] [Revised: 05/23/2024] [Accepted: 05/25/2024] [Indexed: 06/21/2024] Open
Abstract
Vitamin D is a crucial micronutrient, critical to human health, and influences many physiological processes. Oral and skin-derived vitamin D is hydroxylated to form calcifediol (25(OH)D) in the liver, then to 1,25(OH)2D (calcitriol) in the kidney. Alongside the parathyroid hormone, calcitriol regulates neuro-musculoskeletal activities by tightly controlling blood-ionized calcium concentrations through intestinal calcium absorption, renal tubular reabsorption, and skeletal mineralization. Beyond its classical roles, evidence underscores the impact of vitamin D on the prevention and reduction of the severity of diverse conditions such as cardiovascular and metabolic diseases, autoimmune disorders, infection, and cancer. Peripheral target cells, like immune cells, obtain vitamin D and 25(OH)D through concentration-dependent diffusion from the circulation. Calcitriol is synthesized intracellularly in these cells from these precursors, which is crucial for their protective physiological actions. Its deficiency exacerbates inflammation, oxidative stress, and increased susceptibility to metabolic disorders and infections; deficiency also causes premature deaths. Thus, maintaining optimal serum levels above 40 ng/mL is vital for health and disease prevention. However, achieving it requires several times more than the government's recommended vitamin D doses. Despite extensive published research, recommended daily intake and therapeutic serum 25(OH)D concentrations have lagged and are outdated, preventing people from benefiting. Evidence suggests that maintaining the 25(OH)D concentrations above 40 ng/mL with a range of 40-80 ng/mL in the population is optimal for disease prevention and reducing morbidities and mortality without adverse effects. The recommendation for individuals is to maintain serum 25(OH)D concentrations above 50 ng/mL (125 nmol/L) for optimal clinical outcomes. Insights from metabolomics, transcriptomics, and epigenetics offer promise for better clinical outcomes from vitamin D sufficiency. Given its broader positive impact on human health with minimal cost and little adverse effects, proactively integrating vitamin D assessment and supplementation into clinical practice promises significant benefits, including reduced healthcare costs. This review synthesized recent novel findings related to the physiology of vitamin D that have significant implications for disease prevention.
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Li J, Du B, Wang Y, Qiu J, Shi M, Wei M, Li L. Environmental perchlorate, thiocyanate, and nitrate exposures and bone mineral density: a national cross-sectional study in the US adults. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024; 31:34459-34472. [PMID: 38703319 DOI: 10.1007/s11356-024-33563-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 04/30/2024] [Indexed: 05/06/2024]
Abstract
Associations of perchlorate, thiocyanate, and nitrate exposures with bone mineral density (BMD) in adults have not previously been studied. This study aimed to estimate the associations of individual and concurrent exposure of the three chemicals with adult BMD. Based on National Health and Nutrition Examination Survey (NHANES, 2011-2018), 1618 non-pregnant adults (age ≥ 20 years and 47.0% female) were included in this study. Survey-weighted linear regression models were used to estimate individual urinary perchlorate, thiocyanate, and nitrate concentrations with lumbar spine BMD and total BMD in adults. Then, weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) models were conducted to evaluate associations of co-occurrence of the three chemicals with adult BMD. In all participants, nitrate exposure was inversely associated with lumbar spine BMD (β = - 0.054, 95%CI: - 0.097, - 0.010). In stratification analyses, significant inverse associations were observed in female and participants older than 40 years old. In WQS regressions, significant negative associations of the weighted sum of the three chemicals with total and lumbar spine BMD (β = - 0.014, 95%CI: - 0.021, - 0.007; β = - 0.011, 95%CI: - 0.019, - 0.004, respectively) were found, and the dominant contributor was nitrate. In the BKMR models, non-linear dose-response associations of nitrate exposure with lumbar spine and total BMD were observed. These findings suggested that environmental perchlorate, thiocyanate, and nitrate exposure may reduce adult BMD and nitrate is the main contributor.
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Affiliation(s)
- Juxiao Li
- Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong Province, People's Republic of China
| | - Bohai Du
- Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong Province, People's Republic of China
| | - Yuhan Wang
- Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong Province, People's Republic of China
| | - Jiahuang Qiu
- Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong Province, People's Republic of China
| | - Ming Shi
- Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong Province, People's Republic of China
| | - Muhong Wei
- Department of Epidemiology and Statistics, School of Public Health, Bengbu Medical College, Bengbu, Anhui, People's Republic of China
| | - Li Li
- Dongguan Key Laboratory of Environmental Medicine, School of Public Health, Guangdong Medical University, Dongguan, 523808, Guangdong Province, People's Republic of China.
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Inpan R, Na Takuathung M, Sakuludomkan W, Dukaew N, Teekachunhatean S, Koonrungsesomboon N. Isoflavone intervention and its impact on bone mineral density in postmenopausal women: a systematic review and meta-analysis of randomized controlled trials. Osteoporos Int 2024; 35:413-430. [PMID: 37875614 DOI: 10.1007/s00198-023-06944-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/04/2023] [Indexed: 10/26/2023]
Abstract
Due to estrogen deficiency, postmenopausal women may suffer from an imbalance in bone metabolism that leads to bone fractures. Isoflavones, a type of phytoestrogen, have been suggested to improve bone metabolism and increase bone mass. Therefore, isoflavones are increasingly recognized as a promising natural alternative to hormone replacement therapy for postmenopausal women who face a heightened risk of osteoporosis and are susceptible to bone fractures. PURPOSE This study aimed to evaluate the efficacy of isoflavone interventions on bone mineral density (BMD) in postmenopausal women by means of systematic review and meta-analysis. METHODS The electronic database searches were performed on PubMed, Embase, Scopus, and Cochrane Library databases, covering literature up to April 20, 2023. A random-effects model was used to obtain the main effect estimates, with a mean difference (MD) and its 95% confidence interval (CI) as the effect size summary. The risk of bias assessment was conducted using the Risk of Bias 2 (RoB2) tool. RESULTS A total of 63 randomized controlled trials comparing isoflavone interventions (n = 4,754) and placebo (n = 4,272) were included. The results indicated that isoflavone interventions significantly improved BMD at the lumbar spine (MD = 0.0175 g/cm2; 95% CI, 0.0088 to 0.0263, P < 0.0001), femoral neck (MD = 0.0172 g/cm2; 95% CI, 0.0046 to 0.0298, P = 0.0073), and distal radius (MD = 0.0138 g/cm2; 95% CI, 0.0077 to 0.0198, P < 0.0001) in postmenopausal women. Subgroup analysis showed that the isoflavone intervention was effective for improving BMD when the duration was ≥ 12 months and when the intervention contained genistein of at least 50 mg/day. CONCLUSION This systematic review and meta-analysis suggests that isoflavone interventions, especially those containing genistein of at least 50 mg/day, can effectively enhance BMD in postmenopausal women.
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Affiliation(s)
- Ratchanon Inpan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Office of Research Administration, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Mingkwan Na Takuathung
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wannachai Sakuludomkan
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nahathai Dukaew
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Supanimit Teekachunhatean
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nut Koonrungsesomboon
- Department of Pharmacology, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
- Clinical Research Center for Food and Herbal Product Trials and Development (CR-FAH), Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand.
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De Lorenzo A, Pellegrini M, Gualtieri P, Itani L, Frank G, El Ghoch M, Di Renzo L. The Association between Obesity and Reduced Weight-Adjusted Bone Mineral Content in Older Adults: A New Paradigm That Contrasts with the Obesity Paradox. Nutrients 2024; 16:352. [PMID: 38337637 PMCID: PMC10857150 DOI: 10.3390/nu16030352] [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: 12/23/2023] [Revised: 01/20/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024] Open
Abstract
The relationship between body weight and bone mass in the elderly remains unclear, and whether obesity is a protective factor is still a matter of debate. For this reason, the aim of this study is to assess the association between body mass index (BMI) and bone mineral content adjusted by body weight, expressed as a percentage (w-BMC%), and to test the validity of the obesity paradox in this context. A cohort of 1404 older adults was categorized according to the World Health Organization's BMI cut-off points and completed a total and segmental body composition measurement by means of a dual X-ray absorptiometry scan. Individuals with obesity displayed a lower mean w-BMC% (3.06 ± 0.44%; 2.60 ± 0.37%) compared to those who were normal-weight (3.95 ± 0.54%; 3.38 ± 0.48%) and overweight (3.06 ± 0.44%; 3.04 ± 0.37%) in both genders. Linear regression analysis also showed a negative association between BMI and w-BMC% in males (β = -0.09; p < 0.001) and females (β = -0.06; p < 0.001). Finally, among individuals with obesity, and after adjusting for age, the linear regression models revealed a significant decrease of 0.75% and 0.28% in w-BMC% for every one-unit increase in the trunk fat/appendicular lean mass ratio in both males (β = -0.749; p < 0.0001) and females (β = -0.281; p < 0.001). In conclusion, we suggest a new paradigm regarding the impact of obesity on bone mass, in which the former does not appear to be a protective factor of the latter, especially in individuals with central obesity and low muscle mass.
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Affiliation(s)
- Antonino De Lorenzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.D.L.); (L.D.R.)
| | - Massimo Pellegrini
- Centre for the Study of Metabolism, Body Composition, and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Paola Gualtieri
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.D.L.); (L.D.R.)
| | - Leila Itani
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Beirut Arab University, Riad El Solh, Beirut 11072809, Lebanon;
| | - Giulia Frank
- PhD School of Applied Medical-Surgical Sciences, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy;
| | - Marwan El Ghoch
- Centre for the Study of Metabolism, Body Composition, and Lifestyle, Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomic, Department of Biomedicine and Prevention, University of Tor Vergata, Via Montpellier 1, 00133 Rome, Italy; (A.D.L.); (L.D.R.)
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Wang P, Cui H, Wang Z, Yuan P, Liu Y, Xu Z. The Association of nutritional status and physical activity on osteoporotic refractures among older adults. Geriatr Nurs 2024; 55:130-135. [PMID: 37988958 DOI: 10.1016/j.gerinurse.2023.10.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/14/2023] [Accepted: 10/18/2023] [Indexed: 11/23/2023]
Abstract
BACKGROUND This paper focuses on revealing the relationship between the Geriatric Nutritional Risk Index (GNRI) and Activity of Daily Living (ADL) with osteoporotic refracture. METHODS Data from 1068 inpatients with osteoporotic fractures were analyzed. Binary logistic regression, Cox proportional hazard regression and Kaplan-Meier curves were performed for osteoporosis characteristics and its risk factors. Receiver operating characteristic (ROC) curve was developed to predict the cut-off value. RESULTS The study showed that older age, lower ADL and lower GNRI were independent risk factors for osteoporotic fracture with OR of 1.039, 0.946, 0.892 and HR of 1.033, 0.967, 0.947 respectively. According to the results of ROC, the predictive accuracy of GNRI was high with an area under ROC (AUC) of 0.715, sensitivity of 76.6%, specificity of 53.5% and a threshold value of 99.65. CONCLUSION Older age, lower ADL and lower GNRI were independent risk factors for osteoporotic refracture.
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Affiliation(s)
- Peng Wang
- Department of Orthopedics, The Affiliated Wuxi People's Hospital to Nanjing Medical University, Wuxi, Jiangsu, 214023, China
| | - Hao Cui
- Department of Orthopedics, The Affiliated Wuxi People's Hospital to Nanjing Medical University, Wuxi, Jiangsu, 214023, China
| | - Zhenting Wang
- Department of Orthopedics, The Affiliated Wuxi People's Hospital to Nanjing Medical University, Wuxi, Jiangsu, 214023, China
| | - Peng Yuan
- Department of Rehabilitation Medicine, The Affiliated Wuxi People's Hospital to Nanjing Medical University, Wuxi, Jiangsu, 214023, China
| | - Yi Liu
- Department of Orthopedics, The Affiliated Wuxi People's Hospital to Nanjing Medical University, Wuxi, Jiangsu, 214023, China.
| | - Zhujie Xu
- Department of Orthopedics, The Affiliated Wuxi People's Hospital to Nanjing Medical University, Wuxi, Jiangsu, 214023, China; Wuxi Medical Center, Nanjing Medical University, Wuxi, Jiangsu, 214000, China.
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Turżańska K, Tomczyk-Warunek A, Dobrzyński M, Jarzębski M, Patryn R, Niezbecka-Zając J, Wojciechowska M, Mela A, Zarębska-Mróz A. Strontium Ranelate and Strontium Chloride Supplementation Influence on Bone Microarchitecture and Bone Turnover Markers-A Preliminary Study. Nutrients 2023; 16:91. [PMID: 38201922 PMCID: PMC10781151 DOI: 10.3390/nu16010091] [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: 10/12/2023] [Revised: 12/19/2023] [Accepted: 12/24/2023] [Indexed: 01/12/2024] Open
Abstract
Despite strontium ranelate use in osteoporosis management being one of the promising concepts in disease treatment, there is no clear evidence that strontium organic compounds are more effective than inorganic ones. The aim of this study was to compare strontium chlorate and strontium ranelate influence on the mice bone microarchitecture. We investigated whether strontium chlorate (7.532 mmol/L) and strontium ranelate (7.78 mmol/L) solutions fed to healthy SWISS growing mice (n = 42) had an influence on the percent of bone volume (BV/TV), trabecular thickness (Tb.Th), number of trabeculae (Tb.N), and separation between each trabecula (Tb.Sp) in the chosen ROI (region of interest) in the distal metaphysis of the left femurs. The cortical bone surface was examined close to the ROI proximal scan. There was an increase in each examined parameter compared with the control group. There were no statistical differences between strontium ranelate and strontium chlorate parameters. Our study indicates that organic and inorganic strontium compounds similarly affect the bone microarchitecture and strength.
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Affiliation(s)
- Karolina Turżańska
- Department of Rehabilitation and Orthopaedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (K.T.); (J.N.-Z.); (A.Z.-M.)
| | - Agnieszka Tomczyk-Warunek
- Department of Rehabilitation and Orthopaedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (K.T.); (J.N.-Z.); (A.Z.-M.)
| | - Maciej Dobrzyński
- Department of Pediatric Dentistry and Preclinical Dentistry, Wroclaw Medical University, Krakowska 26, 50-425 Wroclaw, Poland;
| | - Maciej Jarzębski
- Department of Physics and Biophysics, Faculty of Food Science and Nutrition, Poznan University of Life Sciences, Wojska Polskiego 38/42, 60-637 Poznan, Poland;
| | - Rafał Patryn
- Department of Humanities and Social Medicine, Medical University of Lublin, Chodźki 7, 20-093 Lublin, Poland;
| | - Joanna Niezbecka-Zając
- Department of Rehabilitation and Orthopaedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (K.T.); (J.N.-Z.); (A.Z.-M.)
| | - Monika Wojciechowska
- Department of Pediatrics and Nephrology, Medical University of Lublin, 20-093 Lublin, Poland;
| | - Aneta Mela
- Department of Experimental and Clinical Pharmacology, Medical University of Warsaw, 02-097 Warsaw, Poland;
| | - Aneta Zarębska-Mróz
- Department of Rehabilitation and Orthopaedics, Medical University of Lublin, Jaczewskiego 8, 20-954 Lublin, Poland; (K.T.); (J.N.-Z.); (A.Z.-M.)
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Peacock-Johnson AM, Keresztes P. Osteoporosis: Diagnosis and management updates. Nursing 2023; 53:28-35. [PMID: 37973009 DOI: 10.1097/01.nurse.0000991592.29755.37] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023]
Abstract
ABSTRACT Osteoporosis, a common chronic bone disease, results in reduced bone mineral density and heightened fracture risk, particularly vertebral fractures. This article provides an overview of the condition's diagnosis and management updates.
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Affiliation(s)
- Annette M Peacock-Johnson
- Annette Peacock-Johnson and Patricia Keresztes are associate professors at Saint Mary's College Department of Nursing Science
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Sultan I, Taha I, El Tarhouny S, Mohammed RA, Allah AMA, Al Nozha O, Desouky M, Ghonimy A, Elmehallawy Y, Aldeeb N, Iskandarani YA. Determinants of Z-Score of Bone Mineral Density among Premenopausal Saudi Females in Different Age Groups: A Cross Sectional Study. Nutrients 2023; 15:4280. [PMID: 37836564 PMCID: PMC10574730 DOI: 10.3390/nu15194280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2023] [Revised: 09/30/2023] [Accepted: 10/04/2023] [Indexed: 10/15/2023] Open
Abstract
This is a comparative multicenter cross-sectional study that evaluated the potential determinants of Z-scores among premenopausal Saudi women before and after the age of peak bone density. The Study concluded that for better BMD among premenopausal women, attention should be paid to early physical activity and healthy nutrition, especially vitamin D, during the childbearing period. OBJECTIVE To explore the potential determinants of Z-scores among premenopausal Saudi females in different age groups before and after the expected age of peak bone density (PBD). METHODS This multicenter comparative cross-sectional study was conducted in Madinah and Jeddah, Saudi Arabia, between August 2021 and March 2022. We recruited 886 premenopausal females (605 (68.3%) below and 281 (31.7%) at or above the age of 30). The structured pre-coded Arabic questionnaire included sociodemographic data, a BMD questionnaire, menstrual history, an Arab Teen Lifestyle Study questionnaire, and food frequency data. Metabolic Equivalents (METs) were calculated from physical activity. Analysis of serum PTH, 25(OH) vitamin D (VD) was performed with chemiluminescent immunoassay. BMD was measured with a calcaneal qualitative ultrasound. RESULTS Most women had age-matched Z-scores, with very few (24 (2.7%)) being non-age-matched with no identified secondary causes. Significant Z-score determinants before PBD were BMI (OR: 0.167, p = 0.003) and total METs (OR: 0.160, p < 0.005). After the age of PBD, significant predictors were parity (OR: 0.340, p = 0.042), history of vitamin D deficiency (OR: 0.352, p = 0.048), and BMI (OR: 0.497, p = 0.019). CONCLUSIONS Early determinants of Z-scores among premenopausal women were the nutritional status and physical activity. After the age of PBD, parity and vitamin D status offer additional determinants. For better BMD, attention should be paid to early physical activity and healthy nutrition, especially for vitamin D, with intensification of efforts during the childbearing period.
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Affiliation(s)
- Intessar Sultan
- Ibn Sina National College for Medical Studies, Jeddah 22421, Saudi Arabia;
| | - Inass Taha
- College of Medicine, Taibah University, Medina 41477, Saudi Arabia; (I.T.); (O.A.N.); (M.D.)
| | - Shereen El Tarhouny
- Ibn Sina National College for Medical Studies, Jeddah 22421, Saudi Arabia;
- College of Medicine, Zagazig University, Zagazig 31527, Egypt
| | - Rehab A. Mohammed
- Faculty of Medicine for Girls, Al-Azhar University, Cairo 11765, Egypt;
| | - Azza M. Abdu Allah
- College of Applied Medical Sciences, Taibah University, Madinah 42353, Saudi Arabia;
- Faculty of Medicine, Menoufia University, Menoufia 32511, Egypt
| | - Omar Al Nozha
- College of Medicine, Taibah University, Medina 41477, Saudi Arabia; (I.T.); (O.A.N.); (M.D.)
| | - Maha Desouky
- College of Medicine, Taibah University, Medina 41477, Saudi Arabia; (I.T.); (O.A.N.); (M.D.)
- College of Medicine, Menia University, Menia 61519, Egypt
| | | | - Yara Elmehallawy
- College of Medicine, Al Faisal University, Riyadh 11533, Saudi Arabia;
| | - Nawaf Aldeeb
- Department of Medicine, King Salman Medical City, Medina 42316, Saudi Arabia;
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Li L, Cheng S, Xu G. Application of neural network and nomogram for the prediction of risk factors for bone mineral density abnormalities: A cross-sectional NHANES-based survey. Heliyon 2023; 9:e20677. [PMID: 37829807 PMCID: PMC10565773 DOI: 10.1016/j.heliyon.2023.e20677] [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: 04/01/2023] [Revised: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 10/14/2023] Open
Abstract
Background The risk of bone mineral density abnormalities is inconsistent between eastern and western regions owing to differences in ethnicity and dietary habits. A diet comprising carbohydrates and dietary fiber is not the common daily diet of the American population. Thus far, no studies have assessed the risk of bone mineral density abnormalities in the American population, and no predictive model has considered the intake of carbohydrates, dietary fiber, and coffee, as well as levels of various electrolytes for assessing bone mineral density abnormalities, especially in the elderly. This study conducted a neural network analysis and established a predictive nomogram considering an unusual diet to determine risk factors for bone mineral density abnormalities in the American population, mainly to provide a reference for the prevention and treatment of related bone mineral density abnormalities. Methods Overall, 9871 patients who had complete data were selected from the National Health and Nutrition Examination Survey database during 2017-2020 as the research object, and patients' general clinical characteristics were compared. Neural networks and nomograms were analyzed to screen for and quantify risk factors for bone mineral density abnormalities. Finally, the receiver operating characteristic (ROC) curve, calibration curve, decision curve analysis (DCA), and community indifference curve (CIC) were constructed to comprehensively verify the accuracy, differential ability, and clinical practicability of the neural network and nomogram. Results The important risk factors for bone mineral density abnormalities were caffeine intake, carbohydrate consumption, body mass index (BMI), height, blood sodium, blood calcium, blood phosphorus, blood potassium, dietary fiber, vitamin D, participant age, weight, race, family history, and sex. The nomogram revealed that caffeine intake, carbohydrate consumption, blood potassium, and age were positively correlated with bone mineral density abnormalities, whereas BMI, height, blood phosphate, dietary fiber, and blood sodium were negatively correlated with bone mineral density abnormalities. Women were more prone to these abnormalities than men. The area under the ROC curve values of the neural network and nomogram were 85.8 % and 77.7 %, respectively. The Youden index was 58.04 % and 41.87 %, respectively. The detection sensitivity was 75.73 % and 65.06 %, respectively, and the specificity was 82.31 % and 76.81 %, respectively. Calibration curves of the neural network and nomogram showed better discrimination ability from the standard curve (P > 0.05). DCA and CIC analyses showed that the application of the neural network and nomogram to explore risk factors for bone mineral density abnormalities had certain clinical practicability, and the overall predictive effect of the model was good. Conclusion The outcomes of the neural network and nomogram analyses suggested that diet structure and electrolyte changes are important significant risk factors for bone mineral density abnormalities, especially with increasing carbohydrate and caffeine intake and decreasing dietary fiber intake. The established model can also provide a reference for future risk prediction.
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Affiliation(s)
- LuWei Li
- Department of Rheumatology and Immunology, The First People's Hospital of Nanning, Nanning, Guangxi, China
- Guilin Medical University, Guilin, Guangxi, China
| | - SiShuai Cheng
- Guilin Medical University, Guilin, Guangxi, China
- Department of Cardiovascular, The 924th Hospital of the Joint Service Support Force of the Chinese People's Liberation Army, Guilin, Guangxi, China
| | - GuoQuan Xu
- Guilin Medical University, Guilin, Guangxi, China
- Department of Urology, The First People's Hospital of Qinzhou, Qinzhou, Guangxi, China
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Lee J, Yoon I, Cha H, Kim HJ, Ryu OH. Inverted U-Shaped Relationship between Obesity Parameters and Bone Mineral Density in Korean Adolescents. J Clin Med 2023; 12:5869. [PMID: 37762810 PMCID: PMC10532009 DOI: 10.3390/jcm12185869] [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: 08/01/2023] [Revised: 08/29/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
As the association between obesity and bone health remains controversial in children and adolescents, we investigate the effects of obesity parameters on bone mineral density (BMD) in 2060 Korean adolescents who participated in the 2008-2011 Korea National Health and Nutrition Examination Survey (KNHANES). Multiple regression analysis and analysis of covariance (ANCOVA) were conducted to examine both the linear and non-linear associations between total-body-less-head (TBLH) BMD and four obesity parameters: body mass index, waist circumference, waist-to-height ratio, and total-body fat mass (FM). In a multiple linear regression analysis adjusted for age, menarcheal status (in females only), and total-body lean mass, there was no significant linear association between obesity parameters and TBLH BMD, except for total-body FM in males. However, upon adding a second-order polynomial term for each obesity parameter, a significant quadratic relationship between all obesity parameters and TBLH BMD was observed, with the corresponding quadratic term being negative. The results of ANCOVA also revealed an inverted U-shaped relationship between each obesity parameter and TBLH BMD. Our findings suggest the existence of an optimal range of obesity parameters for developing or maintaining optimal bone health in Korean Adolescents. Deviation from this range, in either direction (being underweight or having obesity), may compromise bone health.
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Affiliation(s)
- Jongseok Lee
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Insang Yoon
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Hwajung Cha
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Ho-Jung Kim
- School of Artificial Intelligence Convergence, Hallym University, Chuncheon 24253, Republic of Korea; (I.Y.); (H.C.); (H.-J.K.)
| | - Ohk-Hyun Ryu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Chuncheon Sacred Heart Hospital, Chuncheon 24253, Republic of Korea
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Shan J, Lv S, Chen L, Li T, Li J, Wang S, Zhang C. A cross-sectional study on Chinese oncology nurses' knowledge of bone health among cancer patients. Support Care Cancer 2023; 31:501. [PMID: 37526757 PMCID: PMC10393862 DOI: 10.1007/s00520-023-07966-2] [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: 03/11/2023] [Accepted: 07/23/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To understand the knowledge status, obstacle factors, and management confidence of oncology nurses on the bone health of cancer patients, and in addition to provide reference for establishing bone health knowledge training system for oncology nurses and guiding them to manage bone health of cancer patients. METHODS A total of 602 nurses engaged in oncology nursing in 6 hospitals in Hebei Province were selected by cluster sampling, and an online anonymous survey was conducted by sending questionnaires to oncology nurses from the Hebei Cancer Prevention and Control Association. The questionnaire was developed by the study team. There are 4 parts, namely general information, nurses' role and job responsibilities, knowledge of skeletal-related events (SREs) and cancer treatment-induced bone loss (CTIBL), and understanding and confidence in bone health management, for a total of 33 questions. RESULTS Thirty-seven percent of oncology nurses received training on bone health and other related contents; 40.48% of oncology nurses used domestic and foreign guidelines when managing patients with bone metastases or CTIBL. Only approximately one-third of oncology nurses had confidence in managing the side effects of bone metastases and bone modification drugs and identifying patients at risk of CTIBL and fracture; only 33.04% of oncology nurses believed that weight-bearing exercise can prevent bone loss; less than 50% of oncology nurses believed that aromatase inhibitor therapy, ovarian suppression therapy, androgen deprivation therapy, and low body weight were risk factors for pathological fractures. The reasons that hindered oncology nurses from optimizing the management of patients with bone metastases and understanding the preventive measures and risk factors for bone loss mainly included lack of relevant knowledge training, lack of understanding of effective intervention measures, and lack of training and professionalism of specialized nurses, including insufficient development time and guidelines for clinical nursing practice. CONCLUSION Managers must continuously improve the training system of oncology nurses, enrich the content of training pertaining to bone health for cancer patients, formulate clinical nursing practice guidelines, and give oncology nurses more time for professional development.
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Affiliation(s)
- Jing Shan
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China.
| | - Sumei Lv
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
| | - Lu Chen
- Nursing Department, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, Shijiazhuang, Hebei, China
| | - Tianhua Li
- Department of Gynecological, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, Shijiazhuang, Hebei, China
| | - Jingwen Li
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
| | - Shuangyan Wang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
| | - Congcong Zhang
- Department of Orthopedics, The Fourth Hospital of Hebei Medical University, Hebei Provincial Cancer Institute, No. 12, Jiankang Road, Chang'an District, Shijiazhuang, Hebei, China
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Sala-Climent M, López de Coca T, Guerrero MD, Muñoz FJ, López-Ruíz MA, Moreno L, Alacreu M, Dea-Ayuela MA. The effect of an anti-inflammatory diet on chronic pain: a pilot study. Front Nutr 2023; 10:1205526. [PMID: 37521415 PMCID: PMC10381948 DOI: 10.3389/fnut.2023.1205526] [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: 04/14/2023] [Accepted: 06/28/2023] [Indexed: 08/01/2023] Open
Abstract
Objective Rheumatic diseases result in chronic pain (CP) and require treatment with drugs whose prolonged administration is associated with side effects. However, publications in the academic literature have suggested that diet modification and food supplementation can play a crucial role in alleviating the symptoms of inflammatory disease. Thus, it is hoped that the use of an anti-inflammatory diet for pain management might result in improved quality of life. Hence, here we aimed to investigate the effect of anti-inflammatory foods in patients with CP caused by rheumatic diseases. Methods After an exhaustive bibliography search, we designed a 13-item anti-inflammatory dietary guide based on a Mediterranean diet without red meat, gluten, or cow's milk (the AnMeD-S). We then conducted a pilot study to evaluate the efficacy of this anti-inflammatory diet in patients with CP. A food consumption score (with a maximum of 156 points) was then applied to evaluate patient adhesion to the proposed diet. Forty-five patients with CP were followed-up for 4 months. Variables related with quality of life (including pain perception, depression status, and sleep satisfaction) were measured using 9 validated questionnaires and anthropometric measurements were recorded before and after the participants followed the anti-inflammatory diet. Results We found a correlation between increased anti-inflammatory food intake and improved physical characteristics, stress, and pain in the patients we assessed. Moreover, decreased consumption of pro-inflammatory foods was positively correlated with sleep satisfaction. Following the AnMeD-S was associated with improved physical characteristics and quality-of-life in patients with CP. Conclusion The AnMeD-S, includes anti-inflammatory foods and restricts the consumption of certain pro-inflammatory foods (such as those containing gluten). This dietary pattern could provide relief from CP and improve the symptoms of stress and depression, as well as reducing sleep disturbances.
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Affiliation(s)
- Marta Sala-Climent
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Teresa López de Coca
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - María Dolores Guerrero
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Francisco Javier Muñoz
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
- Department of Mathematics, Physics and Technological Science, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | | | - Lucrecia Moreno
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
- Department of Pharmacy, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
| | - Mónica Alacreu
- Cátedra DeCo MICOF-CEU UCH, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
- Department of Mathematics, Physics and Technological Science, Universidad Cardenal Herrera-CEU, CEU Universities, Valencia, Spain
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Dominguez LJ, Veronese N, Ciriminna S, Pérez-Albela JL, Vásquez-López VF, Rodas-Regalado S, Di Bella G, Parisi A, Tagliaferri F, Barbagallo M. Association between Serum Magnesium and Fractures: A Systematic Review and Meta-Analysis of Observational Studies. Nutrients 2023; 15:nu15061304. [PMID: 36986033 PMCID: PMC10053795 DOI: 10.3390/nu15061304] [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: 12/22/2022] [Revised: 02/19/2023] [Accepted: 02/20/2023] [Indexed: 03/09/2023] Open
Abstract
Magnesium, an essential cation for numerous cellular processes, is a major component of bone. However, its relationship with the risk of fractures is still uncertain. The present systematic review and meta-analysis aim to investigate the impact of serum Mg on the risk of incident fractures. A systematic search was conducted using several databases including PubMed/Medline and Scopus from inception to 24 May 2022, including observational studies investigating serum Mg and the incidence of fractures considered as outcomes. Abstract and full-text screenings, data extractions, and risk of bias assessments were conducted by two investigators independently. Any inconsistencies were resolved by consensus with a third author. The Newcastle–Ottawa Scale was used to assess the study quality/risk of bias. Among 1332 records initially screened, 16 were retrieved as full-texts; of them, four papers were included in the systematic review with a total of 119,755 participants. We found that lower serum Mg concentrations were associated with a significantly higher risk of incident fractures (RR = 1.579; 95%CI: 1.216–2.051; p = 0.001; I2 = 46.9%). Our systematic review with meta-analysis suggests a strong association of serum Mg concentrations with incident fractures. Further research is needed to confirm our results among other populations and to assess whether serum Mg is potentially relevant in the prevention of fractures, which continue to increase and represent a significant health burden due to the associated disability.
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Affiliation(s)
- Ligia J. Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
- Faculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy
- Correspondence: or
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Stefano Ciriminna
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | | | | | | | - Giovanna Di Bella
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Angela Parisi
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Federica Tagliaferri
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, 90133 Palermo, Italy
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Moringa oleifera leaf attenuate osteoporosis in ovariectomized rats by modulating gut microbiota composition and MAPK signaling pathway. Biomed Pharmacother 2023; 161:114434. [PMID: 36841025 DOI: 10.1016/j.biopha.2023.114434] [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: 12/14/2022] [Revised: 02/09/2023] [Accepted: 02/20/2023] [Indexed: 02/25/2023] Open
Abstract
Moringa oleifera leaf (MLP) contains abundant complex nutrients with anti-osteoporosis potential. However, its efficacy and mechanisms against osteoporosis remain unknown. The purpose of this research is to investigate MLP's anti-osteoporotic effects and mechanisms. Animal experiments were used in this work to validate MLP's anti-osteoporotic efficacy. We investigated the mode of action of MLP, analyzed its impact on the gut microbiota, and predicted and validated its anti-osteoporosis-related molecular targets and pathways through network pharmacology, molecular docking, and western blotting. In an ovariectomized osteoporosis rat model, MLP significantly increased bone mineral density and improved bone metabolism-related indicators, bone microstructure, and lipid profile. Moreover, it improved gut microbiota composition and increased the expression of Occludin and Claudin-1 protein in the duodenum. Network pharmacology identified a total of 97 active ingredients and 478 core anti-osteoporosis targets. Of these, MAPK1 (also known as ERK2), MAPK3 (also known as ERK1), and MAPK8 (also known as JNK) were successfully docked with the active constituents of MLP. Interestingly, MLP increased ERK and VAV3 protein expression and decreased p-ERK and JNK protein expression in the femur. These findings confirm MLP's anti-osteoporotic efficacy, which could be mediated via regulation of gut microbiota and MAPK signaling.
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Nouri M, Mahmoodi M, Shateri Z, Ghadiri M, Rajabzadeh-Dehkordi M, Vali M, Gargari BP. How do carbohydrate quality indices influence on bone mass density in postmenopausal women? A case-control study. BMC Womens Health 2023; 23:42. [PMID: 36721166 PMCID: PMC9887922 DOI: 10.1186/s12905-023-02188-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 01/23/2023] [Indexed: 02/01/2023] Open
Abstract
BACKGROUND Carbohydrates are the primary energy source in Asian countries, including Iran. An emerging method can be used to measure the quality of carbohydrates, including the carbohydrate quality index (CQI), which includes a variety of components. Low-carbohydrate diet score (LCDS) has been proposed as a new method of scoring micronutrient intake that could provide a reasonable explanation for the link between diet and the risk of chronic diseases. OBJECTIVE This study aimed to investigate the relationship between CQI, LCDS, glycemic index (GI), glycemic load (GL), insulin load (IL), and insulin index (II) with bone mass density (BMD) in postmenopausal women. METHOD In this case-control study, 131 postmenopausal women with osteoporosis/osteopenia and 131 healthy postmenopausal women aged 45-65 participated. The dual-energy X-ray absorptiometry (DEXA) method measured the BMD of the lumbar vertebrae and femoral neck. A validated semi-quantitative food frequency questionnaire was used to assess dietary intake. Logistic regression were used to evaluate the relation between GI, GL, II, IL, CQI, and LCDS with BMD. RESULTS Diets with higher GI increased the risk of osteopenia and osteoporosis, but LCDS and CQI decreased the risk of osteopenia and osteoporosis. CONCLUSION These findings suggest that a higher intake of fruits and vegetables and receiving various dietary vitamins, minerals, and antioxidant compounds may be a useful way to prevent osteopenia in Iranian women.
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Affiliation(s)
- Mehran Nouri
- Health Policy Research Center, Institute of Health, Shiraz University of Medical Sciences, Shiraz, Iran
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Marzieh Mahmoodi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Nutrition Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Zainab Shateri
- Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Marzieh Ghadiri
- Student Research Committee, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Milad Rajabzadeh-Dehkordi
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Community Nutrition, School of Nutrition and Food Science, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohebat Vali
- Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Bahram Pourghassem Gargari
- Nutrition Research Center, Department of Biochemistry and Diet Therapy, Faculty of Nutrition and Food Sciences, Tabriz University of Medical Sciences, Tabriz, Iran
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20
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Dong S, Shi J, Liu Y, Qu Y, Zhao X, Liu F, Du P, Sun Z. Boron Exposure Assessment of Desalinated Seawater on an Island in China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2451. [PMID: 36767817 PMCID: PMC9915379 DOI: 10.3390/ijerph20032451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/20/2022] [Accepted: 12/22/2022] [Indexed: 06/18/2023]
Abstract
This study aimed to investigate the boron level in drinking water and daily boron intake of island residents, and to have a health risk assessment of the boron exposure. One-year water boron surveillance was made through the 18 selected sampling sites (5 finished water and 13 tap water) covered by 5 water treatment plants with different water sources. We recruited 220 healthy volunteers (half men and half women) from 89 families covering all age groups living in Shengshan to provide basic information and living habits. One-third of the families attended the daily food boron intake evaluation through the double meal method for three days. In each family, only one family member provided the food samples. Urine samples were collected from all subjects to get the urine boron level. Furthermore, we used the EPA model and TDI for health risk assessments. The boron level in finished water and tap water with different sources were 0.68-1.46 mg/L and 0.62-1.26 mg/L for desalinated water, 0.30-0.39 mg/L and 0.20-0.50 mg/L for reservoir water, and 0.32-0.43 mg/L and 0.20-0.79 mg/L for mixture water. The average level of water boron intake, diet boron intake, and total boron intake was 0.113 ± 0.127 mg/d, 1.562 ± 0.927 mg/d, 1.674 ± 0.939mg/d, respectively, for the select sampling subjects. There were no significant differences in total boron intake for different age groups (1.685 ± 1.216 mg/d vs. 1.669 ± 0.793 mg/d for <45 yrs vs. ≥45 yrs, p = 0.968) and gender groups (1.754 ± 1.009 mg/d vs. 1.633 ± 0.923 mg/d for male vs. female, p = 0.735). Urine boron concentrations were similar in the two age groups (1.938 mg/g creatinine vs. 1.762 mg/g creatinine for <45 yrs vs. ≥45 yrs, p = 0.635). There were significant differences in urinary boron between males and females (1.569 mg/g creatinine vs. 2.148 mg/g creatinine, p = 0.018). The largest hazard quotient (HQ) of drinking water was 0.31, and the total boron exposures in this population were 0.03 mg/kg bw per day. The study showed that there was no possible non-carcinogenic risk of water boron exposure and lower health risk of total boron exposure to humans in this region, but its toxicity should not be ignored. The subsequent studies should strengthen the analysis of the subgroup populations.
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21
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Stępień KA, Krawczyk W, Giebułtowicz J. Dietary Supplements with Proline-A Comprehensive Assessment of Their Quality. Life (Basel) 2023; 13:life13020263. [PMID: 36836622 PMCID: PMC9958592 DOI: 10.3390/life13020263] [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: 12/19/2022] [Revised: 01/06/2023] [Accepted: 01/16/2023] [Indexed: 01/20/2023] Open
Abstract
Dietary supplements are food products commonly used worldwide to obtain nutritional and physiological effects. They can contain a wide variety of active substances and can be administered for health and disease. Their use can be beneficial if justified, and their quality is adequate. Unfortunately, data on the quality of supplements is scarce. As part of this work, we assess the quality of seven dietary supplements containing proline. The preparations were produced in the EU and the USA. The quality assessment consisted of the detection of potential impurities, the determination of the content of the main ingredient, and the release of proline. The technique used to analyse impurities and proline (Pro) content was liquid chromatography coupled with tandem mass spectrometry. We detected five contaminants. The main ingredient content was in the range of 73-121% in capsules and 103-156% in tablets. Five of the seven analysed dietary supplements released below 80% Pro (for each tablet/capsule at pH 1.2). One of the supplements may be inactive because a very low release of Pro was reported. The results, we hope, will increase consumer awareness of the quality of these preparations and result in a change in the regulations governing the marketing of these preparations, at least by making release testing mandatory.
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22
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Gu P, Pu B, Chen B, Zheng X, Zeng Z, Luo W. Effects of vitamin D deficiency on blood lipids and bone metabolism: a large cross-sectional study. J Orthop Surg Res 2023; 18:20. [PMID: 36611173 PMCID: PMC9826596 DOI: 10.1186/s13018-022-03491-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: 06/28/2022] [Accepted: 12/30/2022] [Indexed: 01/09/2023] Open
Abstract
To investigate the relationship between serum high-density lipoprotein (HDL-C) and spinal bone mineral density (BMD) under different serum 25-hydroxyvitamin D (25 (OH) D) levels in adults over 40 years old and to explore its mechanism. We include participants over the age of 40 with data on HDL-C, 25 (OH) D, spinal BMD, and other variables in the National Health and Nutrition Examination Survey 2007-2010 in the analysis. A weighted multiple linear regression model was used to evaluate the association between serum HDL-C and spinal BMD in different gender, ages, and serum 25 (OH) D levels. A total of 3599 subjects aged ≥ 40 years old were included in this study. Univariate analysis of the complete correction model showed a negative correlation between serum HDL-C and spinal BMD. In the two subgroups of serum 25 (OH) D, we found that the higher the serum HDL-C in the female with serum 25 (OH) D < 75 nmol/L aged 40-59 years old, the lower the total spinal BMD, and a similar relationship was found in the lumbar spine. However, no similar relationship was found in all populations with serum 25 (OH) D ≥ 75 nmol/L and males with serum 25 (OH) D < 75 nmol/L. These results suggest that among Americans over the age of 40, the increase in serum HDL-C is related to decreased BMD of spine only in women aged 40-59 years with vitamin D insufficiency or deficiency.
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Affiliation(s)
- Peng Gu
- grid.411866.c0000 0000 8848 7685Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - Bin Pu
- grid.411866.c0000 0000 8848 7685Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - BaiHang Chen
- grid.411866.c0000 0000 8848 7685Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China
| | - XiaoHui Zheng
- grid.411866.c0000 0000 8848 7685Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China ,grid.411866.c0000 0000 8848 7685The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405 Guangdong China
| | - ZhanPeng Zeng
- grid.411866.c0000 0000 8848 7685Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China ,grid.411866.c0000 0000 8848 7685The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405 Guangdong China
| | - WeiDong Luo
- grid.411866.c0000 0000 8848 7685Guangzhou University of Chinese Medicine, Guangzhou, Guangdong China ,grid.411866.c0000 0000 8848 7685The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, 510405 Guangdong China
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23
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Kamrul-Hasan ABM, Alam M, Kalam S, Saha R. Comparison of Vitamin D Status between Resident and Nonresident Bangladeshis with Type 2 Diabetes Mellitus: A Single-Center, Cross-Sectional Study. BANGLADESH JOURNAL OF ENDOCRINOLOGY AND METABOLISM 2023. [DOI: 10.4103/bjem.bjem_18_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
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24
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Maxwell CV, Shirley R, O'Higgins AC, Rosser ML, O'Brien P, Hod M, O'Reilly SL, Medina VP, Smith GN, Hanson MA, Adam S, Ma RC, Kapur A, McIntyre HD, Jacobsson B, Poon LC, Bergman L, Regan L, Algurjia E, McAuliffe FM. Management of obesity across women's life course: FIGO Best Practice Advice. Int J Gynaecol Obstet 2023; 160 Suppl 1:35-49. [PMID: 36635081 PMCID: PMC10107516 DOI: 10.1002/ijgo.14549] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Obesity is a chronic, progressive, relapsing, and treatable multifactorial, neurobehavioral disease. According to the World Health Organization, obesity affects 15% of women and has long-term effects on women's health. The focus of care in patients with obesity should be on optimizing health outcomes rather than on weight loss. Appropriate and common language, considering cultural sensitivity and trauma-informed care, is needed to discuss obesity. Pregnancy is a time of significant physiological change. Pre-, ante-, and postpartum clinical encounters provide opportunities for health optimization for parents with obesity in terms of, but not limited to, fertility and breastfeeding. Pre-existing conditions may also be identified and managed. Beyond pregnancy, women with obesity are at an increased risk for gastrointestinal and liver diseases, impaired kidney function, obstructive sleep apnea, and venous thromboembolism. Gynecological and reproductive health of women living with obesity cannot be dismissed, with accommodations needed for preventive health screenings and consideration of increased risk for gynecologic malignancies. Mental wellness, specifically depression, should be screened and managed appropriately. Obesity is a complex condition and is increasing in prevalence with failure of public health interventions to achieve significant decrease. Future research efforts should focus on interprofessional care and discovering effective interventions for health optimization.
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Affiliation(s)
- Cynthia V Maxwell
- Maternal Fetal Medicine; Sinai Health and Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Rachelle Shirley
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Amy C O'Higgins
- Maternal Fetal Medicine, Sinai Health, University of Toronto, Toronto, Ontario, Canada
| | - Mary L Rosser
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York-Presbyterian, New York, New York, USA
| | - Patrick O'Brien
- Institute for Women's Health, University College London, London, UK
| | - Moshe Hod
- Helen Schneider Hospital for Women, Rabin Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sharleen L O'Reilly
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland.,School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Virna P Medina
- Department of Obstetrics and Gynecology, Faculty of HealthUniversidad del Valle, Clínica Imbanaco Quirón Salud, Universidad Libre, Cali, Colombia
| | - Graeme N Smith
- Department of Obstetrics and Gynecology, Kingston Health Sciences Centre, Queen's University, Kingston, Ontario, Canada
| | - Mark A Hanson
- Institute of Developmental Sciences, University Hospital Southampton, Southampton, UK.,NIHR Southampton Biomedical Research Centre, University of Southampton, Southampton, UK
| | - Sumaiya Adam
- Department of Obstetrics and Gynecology, School of Medicine, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.,Diabetes Research Centre, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
| | - Ronald C Ma
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, SAR, China.,Hong Kong Institute of Diabetes and Obesity, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Anil Kapur
- World Diabetes Foundation, Bagsvaerd, Denmark
| | - Harold David McIntyre
- Mater Health, University of Queensland, Mater Health Campus, South Brisbane, Queensland, Australia
| | - Bo Jacobsson
- Department of Obstetrics and Gynecology, Sahlgrenska University Hospital/Ostra, Gothenburg, Sweden.,Department of Genetics and Bioinformatics, Domain of Health Data and Digitalisation, Institute of Public Health, Oslo, Norway
| | - Liona C Poon
- Department of Obstetrics and Gynecology, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong, SAR, China
| | - Lina Bergman
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.,Department of Obstetrics and Gynecology, Stellenbosch University, Cape Town, South Africa.,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Esraa Algurjia
- The World Association of Trainees in Obstetrics & Gynecology, Paris, France.,Elwya Maternity Hospital, Baghdad, Iraq
| | - Fionnuala M McAuliffe
- UCD Perinatal Research Centre, School of Medicine, University College Dublin, National Maternity Hospital, Dublin, Ireland
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25
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Filip N, Cojocaru E, Badulescu OV, Clim A, Pinzariu AC, Bordeianu G, Jehac AE, Iancu CE, Filip C, Maranduca MA, Sova IA, Serban IL. SARS-CoV-2 Infection: What Is Currently Known about Homocysteine Involvement? Diagnostics (Basel) 2022; 13:10. [PMID: 36611302 PMCID: PMC9818222 DOI: 10.3390/diagnostics13010010] [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: 10/28/2022] [Revised: 12/12/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022] Open
Abstract
Since December 2019, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly throughout the world causing health, social and economic instability. The severity and prognosis of patients with SARS-CoV-2 infection are associated with the presence of comorbidities such as cardiovascular disease, hypertension, chronic lung disease, cerebrovascular disease, diabetes, chronic kidney disease, and malignancy. Thrombosis is one of the most serious complications that can occur in patients with COVID-19. Homocysteine is a non-proteinogenic α-amino acid considered a potential marker of thrombotic diseases. Our review aims to provide an updated analysis of the data on the involvement of homocysteine in COVID-19 to highlight the correlation of this amino acid with disease severity and the possible mechanisms by which it intervenes.
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Affiliation(s)
- Nina Filip
- Department of Morpho-Functional Sciences (II), Discipline of Biochemistry, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Elena Cojocaru
- Department of Morpho-Functional Sciences (I), Discipline of Morphopathology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Oana Viola Badulescu
- Department of Morpho-Functional Sciences (II), Discipline of Pathophysiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Andreea Clim
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alin Constantin Pinzariu
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Gabriela Bordeianu
- Department of Morpho-Functional Sciences (II), Discipline of Biochemistry, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Alina Elena Jehac
- Department of Dentoalveolar and Maxillofacial Surgery, Faculty of Dental Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristina Elena Iancu
- Department of Biochemistry, Faculty of Pharmacy, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Cristiana Filip
- Department of Morpho-Functional Sciences (II), Discipline of Biochemistry, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Minela Aida Maranduca
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ivona Andreea Sova
- IOSUD Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
| | - Ionela Lacramioara Serban
- Department of Morpho-Functional Sciences (II), Discipline of Physiology, Faculty of Medicine, “Grigore T. Popa” University of Medicine and Pharmacy, 700115 Iasi, Romania
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26
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Fengmin Z, Baijun W, Jiangtao B, Li L, Patwary AK. Investigating revisit intention of medical tourists in China through nutritional knowledge, perceived medical quality, and trust in the physiologist: A recommendation on health tourism policy measures. Front Public Health 2022; 10:893497. [PMID: 36091519 PMCID: PMC9458905 DOI: 10.3389/fpubh.2022.893497] [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: 03/13/2022] [Accepted: 08/02/2022] [Indexed: 01/22/2023] Open
Abstract
Good medical care has long been a top priority in health tourism to keep the flow of visitors coming for medical treatment. Medical tourism encompasses a range of treatments, from basic check-ups to surgical operations. For its friendly character and high quality of service, China has earned a reputation as one of Asia's top destinations for health tourism. Along with India and Taiwan, Japan, Thailand, and South Korea are China's top tourism destinations. Considering the above fact, this study aims to examine the influence of nutritional knowledge, perceived medical quality, and trust in physiologists on revisiting the intention of medical tourists in China. This study is cross-sectional and follows a quantitative approach. The researchers used questionnaires as a survey tool to obtain information from the respondents. The respondents of this chosen international tourists in China who come for medical treatment purposes. A systematic random sampling technique was used to select the respondents, and 315 usable responses were collected from the respondents and proceeded with further analysis. The study conducted structural equation modeling using Smart PLS version 3. The results found that nutritional knowledge, perceived medical quality, and trust in physiologists significantly influence the revisit intention of medical tourists in China.
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Affiliation(s)
| | - Wu Baijun
- Chengde Medical University, Chengde, China,*Correspondence: Wu Baijun
| | | | - Liu Li
- School of Marxism Studies, North Minzu University, Yinchuan, China
| | - Ataul Karim Patwary
- Faculty of Hospitality, Tourism and Wellness, Universiti Malaysia Kelantan, Pengkalan Chepa, Malaysia
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