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Patra S, Boro H, Porchezhian P, Khan N, Pande M. Evaluation of bone mineral density (BMD) and trabecular bone score (TBS) in pheochromocytoma and paraganglioma; a multi-centric case-control study from India. Osteoporos Int 2024:10.1007/s00198-024-07198-y. [PMID: 39037490 DOI: 10.1007/s00198-024-07198-y] [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: 06/03/2024] [Accepted: 07/15/2024] [Indexed: 07/23/2024]
Abstract
Pheochromocytoma and paraganglioma (PPGL) have been associated with low bone mineral density (BMD) due to excess sympathetic system stimulation. Our study revealed low BMD and TBS (trabecular bone score) in cases compared to matched controls. Plasma-free nor-metanephrine and hypertension duration found to be most consistent predictive factors. PURPOSE Pheochromocytoma and paraganglioma (PPGL) have been associated with low bone mineral density (BMD) and increased fracture risks. Sympathetic nervous system stimulation has been shown to increase bone resorption and decrease bone formation via β2 receptors. Chronic inflammation and increased cytokine production add to more bone loss. TBS (trabecular bone score) is an established surrogate marker for bone histomorphometry. BMD and TBS data in pheochromocytoma and PPGL are scarce. The aim was to assess the BMD and TBS in pheochromocytoma and PPGL and look for clinical and biochemical predictors. METHODS This case-control study had sample size of 58 (29 cases and controls each). BMI-, age-, and sex-matched controls were taken for comparison. Both cases and controls had undergone DXA scan and BMD {Z-scores and bone mineral concentration (BMC) in g/cm2} and TBS were analyzed. Detailed clinical histories and relevant biochemistry values were noted. RESULTS The mean age of our case population was 29.5 ± 9.4 years with a mean age of HTN onset at 26.86 ± 6.6 years. Lumbar spine BMC (0.86 ± 0.14 vs 0.96 ± 0.15; p = 0.036), femoral neck Z-score (- 1.23 ± 1.07 vs - 0.75 ± 0.97; p = 0.003), and whole body BMC (0.91 ± 0.14 vs 1.07 ± 0.11; p = 0.000) were significantly low in cases compared to controls. Similarly, TBS was significantly lower in cases compared to controls (1.306 ± 0.113 vs 1.376 ± 0.083; p = 0.001). CONCLUSION This study establishes both low bone mass and poor bone quality in an Indian pheochromocytoma and PPGL patient's cohort. Plasma-free nor-metanephrine and duration of hypertension were found to be most consistent predictive factors in multivariate regression analysis.
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Affiliation(s)
- Shinjan Patra
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences Nagpur, Plot 2, Sector 20, Mihan, Nagpur, 441108, Maharashtra, India.
| | - Hiya Boro
- Department of Endocrinology, Aadhar Health Institute, Hisar, 125001, Haryana, India
| | - Pradakshna Porchezhian
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences Jodhpur, 2Nd Phase, M.I.A. Basni, Jodhpur, 342005, Rajasthan, India
| | - Naila Khan
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences Nagpur, Plot 2, Sector 20, Mihan, Nagpur, 441108, Maharashtra, India
| | - Minal Pande
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences Nagpur, Plot 2, Sector 20, Mihan, Nagpur, 441108, Maharashtra, India
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Jin H, Zhao H, Jin S, Yi X, Liu X, Wang C, Zhang G, Pan J. Menopause modified the association of blood pressure with osteoporosis among gender: a large-scale cross-sectional study. Front Public Health 2024; 12:1383349. [PMID: 38756892 PMCID: PMC11097953 DOI: 10.3389/fpubh.2024.1383349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/02/2024] [Indexed: 05/18/2024] Open
Abstract
Purpose This study aimed to assess the potential association between blood pressure and osteoporosis in a rural population with limited resources. Existing evidence on this association is limited, particularly in such settings. Methods Data from 7,689 participants in the Henan Rural Cohort study were analyzed. Four blood pressure indicators [systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP)] were measured. The logistic regression model and restricted cubic spline plots were used to assess the relationship between blood pressure indicators and osteoporosis prevalence. Results Positive trends were noted between blood pressure indicators and osteoporosis prevalence in the entire group and women (P trend < 0.05 for SBP, MAP, and PP). Women with higher SBP and PP exhibited elevated odds of osteoporosis compared with those with the lowest SBP and PP (ORs ranging from 1.15 to 1.5 for SBP and 1.06 to 1.83 for PP). No such associations were found in men. These relationships were only evident in postmenopausal women. Dose-response analysis confirmed these findings. Excluding participants taking hypertension medication did not alter the results. Conclusion In resource-limited settings, higher SBP and PP are associated with the increased prevalence of osteoporosis in women, potentially influenced by menopause-related factors. This indicates that potential gender-based differences and social inequalities may affect bone health. Clinical trial registration The Henan Rural Cohort Study has been registered at the Chinese Clinical Trial Register (Registration number: ChiCTR-OOC-15006699) http://www.chictr.org.cn/showproj.aspx?proj=11375.
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Affiliation(s)
- Haidong Jin
- Department of Orthopaedic Surgery, The Second Clinical Medical School, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Hongfei Zhao
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Sufan Jin
- Faculty Development Center (Education Supervision and Teaching Evaluation Center), Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xianhong Yi
- Department of Orthopaedic Surgery, The Second Clinical Medical School, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Xiaotian Liu
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Chongjian Wang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Gongyuan Zhang
- Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, China
| | - Jun Pan
- Department of Orthopaedic Surgery, The Second Clinical Medical School, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
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Jadhav PP, Patwardhan VG. Effect of Hypertension on Bone Mineral Density of Patients with Rheumatoid Arthritis. Mediterr J Rheumatol 2023; 34:479-485. [PMID: 38282945 PMCID: PMC10815520 DOI: 10.31138/mjr.120923.eoh] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 02/01/2023] [Accepted: 03/20/2023] [Indexed: 01/30/2024] Open
Abstract
Objective Patients with rheumatoid arthritis (RA) are associated with low bone mineral density (BMD). Chronic comorbidities such as type II diabetes mellitus have shown to affect BMD parameters in patients with RA. Hypertension (HT) is a chronic disease and its coexistence with RA can alter bone health. The aim of this study was to investigate if HT affected BMD parameters in RA patients diagnosed for the first time. Methods Patients with the diagnosis of RA who underwent BMD studies formed the study population. Patients with HT were sorted from this population and formed a separate group. Healthy controls were drawn from subjects who came for a check-up. BMD was done with the GE Lunar DPX machine. Mean T Scores at spine, femur neck and total femur were recorded. Data from the three groups were analysed and compared. Linear regression analyses were performed. Results Analysis suggested that the age had inverse and BMI had direct correlation with BMD T scores in all groups. The additional diagnosis of HT in RA patients was associated with higher BMD as compared to patients with RA, but lower than controls. R2 values were 0.341, 0.402 and 0.436 for mean T scores at spine, femur neck and femur total respectively. Figures from multiple regression analysis suggest that BMI alone did not explain the higher T score values in HT patients. Conclusion Additional morbidity of HT in RA patients negates the porotic effect of RA as judged by bone densitometry. Hence, BMD reports should be read with caution in these patients.
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Li S, Li L, Feng A, Huang T, Chen C, He N, Huang L, Lyu J. The role of hypertension in bone mineral density among males older than 50 years and postmenopausal females: evidence from the US National Health and Nutrition Examination Survey, 2005-2010. Front Public Health 2023; 11:1142155. [PMID: 37397722 PMCID: PMC10311208 DOI: 10.3389/fpubh.2023.1142155] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 05/26/2023] [Indexed: 07/04/2023] Open
Abstract
Background Hypertension is a significant chronic disease that has been linked with bone mineral density (BMD) in various studies. However, the conclusions are contradictory. The purpose of our study was to identify the bone mineral density (BMD) of postmenopausal females and males older than 50 years with hypertension. Methods This cross-sectional study of 4,306 participants from the 2005-2010 US National Health and Nutrition Examination Survey explored the relationship between BMD and hypertension. Participants who had a mean systolic blood pressure (SBP) ≥140 mmHg, or a mean diastolic blood pressure (DBP) ≥90 mmHg, or were taking any prescribed medicine for high blood pressure were defined as having hypertension. BMD values were measured at the femoral neck and lumbar vertebrae as the primary outcome. Weight general linear model was used to describe the status of BMD in patients with hypertension. Weighted multivariate regression analysis was conducted to demonstrate the association between hypertension and BMD. Weighted restricted cubic spline (RCS) was used to assess the relationship between BMD and SBP and DBP. Results Our study found that there was a positive association between hypertension and lumbar BMD and the lumbar BMD was significantly higher in the presence of hypertension than in the control group in both males (1.072 vs. 1.047 g/cm2) and females (0.967 vs. 0.938 g/cm2; both p < 0.05), but a similar pattern was not found in the femoral neck. Meanwhile, lumbar BMD was positively associated with SBP and negatively associated with DBP both in males and females. The prevalence of low bone mass and osteoporosis at the lumbar vertebrae was lower in male patients with hypertension than in the control group. However, no difference was observed among postmenopausal females between the hypertension and control groups. Conclusions Hypertension was associated with higher BMD at the lumbar vertebrae in both males older than 50 years and postmenopausal females.
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Affiliation(s)
- Shuna Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Li Li
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Aozi Feng
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Tao Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Chong Chen
- School of Public Health, Shaanxi University of Chinese Medicine, Xianyang, China
| | - Ningxia He
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Liying Huang
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
| | - Jun Lyu
- Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, Guangdong, China
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Mazurenko E, Rymar O, Rerikh V, Khrapova Y, Direev A, Shcherbakova L, Malyutina S. Risk Factors for Chronic Non-Communicable Diseases and Osteoporotic Fractures in a Middle and Elderly-Aged Population. J Pers Med 2022; 12:jpm12091475. [PMID: 36143260 PMCID: PMC9503074 DOI: 10.3390/jpm12091475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 09/01/2022] [Accepted: 09/07/2022] [Indexed: 11/16/2022] Open
Abstract
Aim. To study the associations of risk factors for chronic non-communicable diseases (CNCDs) and osteoporotic fractures (OFs) in a population sampling over 50 years. Materials and Methods. The data of a cross-sectional population-based study obtained in the Russian part of the international project HAPIEE (Novosibirsk) are analyzed. The present analysis comprised 7363 men and women aged 50–69 years old. We have assessed the frequency of OFs for the last 12 months and risk factors of CNCDs. Cross-sectional associations between OF history and potential determinants were analyzed using multivariable-adjusted logistic regression. Results. The frequency of OFs in the last 12 months was 3.6% (3.2% in men and 4.0% in women, p = 0.074). In men, the probability of OFs increased with an elevation of blood pressure (BP), high-density lipoprotein cholesterol (HDL-C), ethanol consumption, and reduced with increased body mass index (BMI). In women, the probability of a fracture increased with current smoking and an increased duration of post-menopause and reduced with an increase in triglycerides (TG) levels, independently of other factors. Conclusions. A syndemia of risk factors, both generally recognized for OFs (BMI, tobacco smoking, alcohol consumption, postmenopausal duration) and new factors associated with CNCDs (BP, HDL, TG), have been defined.
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Affiliation(s)
- Elena Mazurenko
- Research Institute of Internal and Preventive Medicine—Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630089 Novosibirsk, Russia
- Novosibirsk Research Institute of Traumatology and Orthopedics Named after Ya. L. Tsivyan, 630112 Novosibirsk, Russia
- Correspondence: ; Tel.: +7-(952)-945–72-11
| | - Oksana Rymar
- Research Institute of Internal and Preventive Medicine—Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630089 Novosibirsk, Russia
| | - Victor Rerikh
- Novosibirsk Research Institute of Traumatology and Orthopedics Named after Ya. L. Tsivyan, 630112 Novosibirsk, Russia
| | - Yuliya Khrapova
- Novosibirsk Research Institute of Traumatology and Orthopedics Named after Ya. L. Tsivyan, 630112 Novosibirsk, Russia
| | - Artem Direev
- Research Institute of Internal and Preventive Medicine—Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630089 Novosibirsk, Russia
| | - Liliya Shcherbakova
- Research Institute of Internal and Preventive Medicine—Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630089 Novosibirsk, Russia
| | - Sofia Malyutina
- Research Institute of Internal and Preventive Medicine—Branch of the Institute of Cytology and Genetics, Siberian Branch of Russian Academy of Sciences, 630089 Novosibirsk, Russia
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Zhang Y, Jia X, Liu X, An W, Li J, Zhang W. Relationship between different body composition and bone mineral density in Qinhuangdao city. REVISTA DA ASSOCIAÇÃO MÉDICA BRASILEIRA 2022; 68:445-449. [PMID: 35649065 DOI: 10.1590/1806-9282.20210669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 12/10/2021] [Indexed: 11/22/2022]
Affiliation(s)
| | | | - Xin Liu
- The First Hospital of Qinhuangdao, China
| | - Wen An
- The First Hospital of Qinhuangdao, China
| | - Jiaqi Li
- The First Hospital of Qinhuangdao, China
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Ni R, Guo X, Yan C, Wen C. Hemodynamic stress shapes subchondral bone in osteoarthritis: An emerging hypothesis. J Orthop Translat 2022; 32:85-90. [PMID: 35070712 PMCID: PMC8755519 DOI: 10.1016/j.jot.2021.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/19/2021] [Accepted: 11/21/2021] [Indexed: 01/29/2023] Open
Abstract
Osteoarthritis (OA) is no longer regarded as a simple wear-and-tear problem of articular cartilage. Instead, OA is a whole joint disorder involving both cartilaginous and non-cartilaginous tissues such as subchondral bone and synovium. Among them, subchondral bone undergoes constant remodeling in response to the changes of mechanical environment. Current understanding of subchondral bone disturbance in OA is limited to its link with an altered local mechanical loading as a result of ligament or meniscus injury. Very recently, hypertension, the most common vascular morbidity, has been emerged as an independent risk factor of OA. It might suggest a plausible role of systemic hemodynamic mechanical stress in subchondral bone remodeling and the pathogenesis of OA. However, their relationship remains not fully understood. Based on our preliminary clinical observation on the association of hemodynamic parameters with subchondral bone mass and microstructure in late-stage knee OA patients, we formulate a vascular etiology hypothesis of OA from a mechanobiology perspective. Noteworthily, hemodynamic stress associated with subchondral bone mineral density; yet compressive mechanical loading does not. Furthermore, hemodynamic parameters positively correlated with subchondral plate-like trabecular bone volume but negatively associated with rod-like trabecular bone volume. In contrast, compressive mechanical loading tends to increase both plate-like and rod-like trabecular bone volume. Taken together, it warrants further investigations into the distinct role of hemodynamic or compressive stress in shaping subchondral bone in the pathophysiology of OA. The Translational potential of this article This work provides a new insight, from the angle of biomechanics, into the emerging role of vascular pathologies, such as hypertension, in the pathogenesis of OA. It might open up a new avenue for the development of a mechanism-based discovery of novel diagnostics and therapeutics.
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Affiliation(s)
- Ruiyan Ni
- Department of Biomedical Engineering, Faculty of Engineering, the Hong Kong Polytechnic University, Kowloon, Hong Kong, China
| | - X.Edward Guo
- Department of Biomedical Engineering, Columbia University, New York, United States
| | | | - Chunyi Wen
- Department of Biomedical Engineering, Faculty of Engineering, the Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Research Institute of Smart Ageing, the Hong Kong Polytechnic University, Kowloon, Hong Kong, China
- Corresponding author. Department of Biomedical Engineering, Faculty of Engineering, The Hong Kong Polytechnic University, Hong Kong.
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Feresin RG, Johnson SA, Elam ML, Pourafshar S, Navaei N, Akhavan NS, Tenenbaum G, Figueroa A, Arjmandi BH. Effects of strawberries on bone biomarkers in pre- and stage 1-hypertensive postmenopausal women: a secondary analysis. Food Funct 2021; 12:12526-12534. [PMID: 34812466 DOI: 10.1039/d1fo01555a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Postmenopausal women experience an increase in bone remodeling with the rate of bone resorption superseding the rate of bone formation. This results in a net bone loss with a subsequent increased risk for osteoporosis and fractures. High blood pressure (BP) has been associated with loss of bone mineral density and increased propensity to fractures. Strawberries are rich in polyphenols, which have been shown to have anti-hypertensive and bone-protective properties. Thus, we examined whether daily intake of strawberries would positively affect biomarkers of bone metabolism in postmenopausal women with pre- and stage 1-hypertension. Participants (age: 59 ± 6 years; body mass index: 31.5 ± 4.1 kg m-2; systolic BP: 140 ± 13 mmHg) were randomly assigned to consume (1) 50 g of freeze-dried strawberry powder (FDSP), (2) 25 g FDSP + 25 g of placebo powder, or (3) 50 g placebo powder for eight weeks. Results indicate a significant time-by-treatment interaction (P = 0.04) for serum insulin-like growth factor (IGF)-1, a hormone that plays a major role in bone formation. Serum concentrations of bone-specific alkaline phosphatase, a marker of bone formation, and tartrate-resistant acid phosphatase-5b, a specific marker of bone resorption, were not affected by FDSP compared to placebo. Although not statistically significant, after eight weeks, osteocalcin increased in the 50 g FDSP group with a large effect size (d = 0.6) when compared to the placebo-control group. Adiponectin increased by 5% and 6% in the 25 g and 50 g FDSP groups, respectively, while it declined in the placebo-control group by 25% (P = 0.03 for time-by-treatment interaction). Our findings suggest that consumption of 25 g FDSP increases IGF-1 in postmenopausal women with pre- and stage 1-hypertension. However, further studies are needed to assert the effectiveness of a strawberry intervention for bone health.
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Affiliation(s)
- Rafaela G Feresin
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Department of Nutrition, Georgia State University, Atlanta, GA, 30303, USA.
| | - Sarah A Johnson
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Department of Food Science and Human Nutrition, Colorado State University, Fort Collins, CO, 80523, USA
| | - Marcus L Elam
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Department of Human Nutrition and Food Science, California State Polytechnic University, Pomona, CA, 91768, USA
| | - Shirin Pourafshar
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA.
| | - Negin Navaei
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Department of Nutrition, Life University, Marietta, GA, 30060, USA
| | - Neda S Akhavan
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL, 32306, USA
| | - Gershon Tenenbaum
- Department of Educational Psychology and Learning Systems, Florida State University, Tallahassee, FL, 32306, USA.,Ivcher School of Psychology, The Interdisciplinary Center (IDC), Herzliya, Israel
| | - Arturo Figueroa
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Department of Kinesiology and Sports Management, Texas Tech University, Lubbock, TX, 79409, USA
| | - Bahram H Arjmandi
- Department of Nutrition, Food and Exercise Sciences, Florida State University, Tallahassee, FL, 32306, USA. .,Center for Advancing Exercise and Nutrition Research on Aging (CAENRA), Florida State University, Tallahassee, FL, 32306, USA
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He B, Yin L, Zhang M, Lyu Q, Quan Z, Ou Y. Causal Effect of Blood Pressure on Bone Mineral Density and Fracture: A Mendelian Randomization Study. Front Endocrinol (Lausanne) 2021; 12:716681. [PMID: 34421826 PMCID: PMC8371435 DOI: 10.3389/fendo.2021.716681] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 07/12/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Hypertension may have some association with osteoporosis. This Mendelian randomization (MR) study aimed to explore the causal effect of blood pressure (BP) on bone mineral density (BMD), fall, and fracture. METHODS We used the genome-wide association study (GWAS) summary data among 330,956 European-descent individuals to identify 107 single-nucleotide polymorphisms (SNPs) as the instrumental variables of BP. MR analyses of these instruments were performed on 53,236 European individuals for the association with forearm BMD (FA-BMD), femoral neck BMD (FN-BMD), and lumbar spine BMD (LS-BMD); 451,179 European individuals for fall susceptibility; and up to 1.2 million individuals from European descent for fracture. Conventional inverse variance weighted (IVW) method was adopted to obtain the causal estimates of BP on different outcomes, while weighted median, MR-egger, and MR pleiotropy residual sum and outlier (MR-PRESSO) test were used for sensitivity analyses. RESULTS Genetically high pulse pressure (PP) could significantly improve FA-BMD (beta-estimate: 0.038, 95% confidence interval [CI]: 0.013 to 0.063, SE:0.013, P-value=0.003<Bonferroni correction P) in the IVW analysis, indicating that 1-SD increase in PP was associated with the improvement in FA-BMD levels by 0.038 g/cm2 (95% CI: 0.013 to 0.063). This positive finding was also confirmed by weighted-median analysis (beta-estimate: 0.034, 95% CI: 0.000 to 0.067, SE:0.017, P-value=0.046) and MR-Egger analysis (beta-estimate: 0.117, 95% CI: 0.026 to 0.208, SE:0.046, P-value=0.011). However, there was no remarkable MR association between BP and other outcomes (i.e., FN-BMD, LS-BMD, fall, and fracture). CONCLUSIONS Our findings reveal a potentially causal relationship between high PP and improved FA-BMD, which may provide new sights for the treatment of osteoporosis.
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Affiliation(s)
- Bin He
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Lifeng Yin
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Muzi Zhang
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Qiong Lyu
- Department of General Practice, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Qiong Lyu, ; Zhengxue Quan,
| | - Zhengxue Quan
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
- *Correspondence: Qiong Lyu, ; Zhengxue Quan,
| | - Yunsheng Ou
- Department of Orthopedics, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Martins JM, Aranha P. Bone turnover and bone mineral density in old persons with type 2 diabetes. J Clin Transl Endocrinol 2018; 14:12-18. [PMID: 30302313 PMCID: PMC6174825 DOI: 10.1016/j.jcte.2018.09.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2018] [Revised: 09/09/2018] [Accepted: 09/21/2018] [Indexed: 01/01/2023] Open
Abstract
AIMS To understand the paradox of an increased fracture risk despite increased bone mineral density (BMD) in persons with type 2 diabetes (DM2). PATIENTS AND METHODS We studied 80 old persons with DM2. Mineral metabolism, parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD), bone turnover - osteocalcin, procollagen type 1 N-terminal propeptide (P1NP) and C-terminal telopeptide of type 1 collagen (CTX) - were measured and BMD was assessed at the lumbar spine (LS) and femoral neck (FN). Data was analyzed with the Statistical Package for the Social Sciences Program. RESULTS Low levels of 25OHD (84%) and high values of PTH (20%) were found. Osteocalcin was directly related to CTX, p < 0.001, with increased bone formation and increased BMD (z-score) at LS and FN. PTH was directly related to osteocalcin and CTX and inversely related to BMD at the FN, p < 0.05. Patients with dyslipidemia presented higher P1NP, p < 0.05 and patients with hypertension presented higher BMD at LS and FN, p < 0.01. CONCLUSION Old type 2 diabetics present increased bone formation, PTH-driven. Low grade secondary hyperparathyroidism may explain the paradox of an increased fracture risk despite increased BMD.
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Affiliation(s)
- João Martin Martins
- Endocrine Department, Hospital Santa Maria, 6th Floor, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
- Endocrine University Clinic, Lisbon Medical School, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
| | - Patrícia Aranha
- Internal Medicine Department, Hospital Santa Maria, 3rd Floor, Avenida Professor Egas Moniz, 1649-028 Lisboa, Portugal
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Yilmaz V, Umay E, Gundogdu I, Cakcı FA. Effect of Primary Hypertension on Treatment Outcomes of Patients with Postmenopausal Osteoporosis: A 5 Year Follow Up Retrospective Study. High Blood Press Cardiovasc Prev 2018; 26:61-67. [PMID: 30467637 DOI: 10.1007/s40292-018-0291-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 11/19/2018] [Indexed: 10/27/2022] Open
Abstract
AIM To investigate the efficacy of primary hypertension (HTN) on the treatment prognosis of patients with postmenopausal osteoporosis (PMOP). METHODS 45 patients who were diagnosed as PMOP with lumbar and/or femur neck bone mineral density screening (BMD) but have no history of PMOP treatment including calcium and vitamin D, have comorbid primary HTN and treated with a vasodilator antihypertensive drug at least a year were included to the study. Control group was constituted with 44 patients with PMOP at same age but have no comorbidity. Demographic features including age, height, weight, occupation, educational level menarche and menopause age, clothing style, daily intake of calcium, smoking and/or alcohol consumption, daily physical activity level, personal history of fragility fracture or in mother and duration of primary HTN diagnosis were recorded. Biochemical parameters were also recorded. Patients were treated with bisphosphonate, calcium and vitamin D and same parameters were evaluated at the end of first and fifth year. RESULTS Demographic and disease characteristics were not different between groups before treatment (p > 0.05). In group analysis, there was significant improvement in lumbar and femur neck T scores of PMOP + HT and PMOP groups after 1 and 5 years of treatment compared to baseline (p < 0.05) Lumbar and femur neck T score variations between the baseline, first and fifth years of treatment were not significantly different in PMOP + HT and PMOP groups (p < 0.05). CONCLUSIONS Although the results vary between populations, primary HTN does not have an impact on the prognosis of PMOP treatment in Turkish population.
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Affiliation(s)
- Volkan Yilmaz
- Physical Rehabilitation Medicine Clinic, Yildirim Beyazit Training and Research Hospital, Ankara, Turkey.
| | - Ebru Umay
- Physical Rehabilitation Medicine Clinic, Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Ibrahim Gundogdu
- Physical Rehabilitation Medicine Clinic, Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
| | - Fatma Aytul Cakcı
- Physical Rehabilitation Medicine Clinic, Yildirim Beyazit Training and Research Hospital, Ankara, Turkey
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Zhou L, Song J, Yang S, Meng S, Lv X, Yue J, Mina A, Puchi B, Geng Y, Yang L. Bone mass loss is associated with systolic blood pressure in postmenopausal women with type 2 diabetes in Tibet: a retrospective cross-sectional study. Osteoporos Int 2017; 28:1693-1698. [PMID: 28154942 DOI: 10.1007/s00198-017-3930-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Accepted: 01/19/2017] [Indexed: 01/31/2023]
Abstract
UNLABELLED We conducted an observational cross-section study to investigate the status of bone mineral mass of Tibetan postmenopausal women with type 2 diabetes and the possible predictors for osteoporosis. We found that prevalence of osteoporosis was 27.0% and blood pressure was an independent risk factor for bone mass loss. INTRODUCTION The aims of this study is to investigate the prevalence of osteoporosis in postmenopausal women with type 2 diabetes dwelling in Tibet and the possible risk factors for bone mass loss. METHODS We recruited 99 Chinese Tibetan postmenopausal women with type 2 diabetes from the department of endocrinology of People's Hospital Tibet Autonomous Region. Multiple sites of bone mineral density (BMD) were measured by dual-energy X-ray absorptiometry (DXA). The subjects were divided into three groups based on BMD T-score: osteoporosis, osteopenia, and normal. The clinical characteristics were compared between groups. The risk factors for bone mass loss were assessed by multiple linear regression analysis. RESULTS Among diabetic postmenopausal women dwelling in high altitude, mean age was 62 ± 8 years, the median postmenopausal period was 12 years (5, 20), the median duration of diabetes mellitus was 3 years (1, 8), and mean BMI was 27.6 ± 4.2 kg/m2. Patients (52.5%) had hypertension. The percentages of patients with osteoporosis, osteopenia and normal BMD were 27.3, 42.4, and 30.3%, respectively. HbA1c and systolic blood pressure (SBP) were independently associated with T-scores of spine; ages and SBP were independently associated with T-scores of femoral neck or hip. CONCLUSIONS Among diabetic postmenopausal women dwelling in high altitude, 27.3% patients have osteoporosis, 42.4% patients have osteopenia, and 30.3% are normal. The BMD T-score of spine was inversely associated with SBP and positively associated with HbA1c, while the BMD T-score of femoral neck or hip was inversely associated with ages and SBP.
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MESH Headings
- Absorptiometry, Photon/methods
- Aged
- Altitude
- Blood Pressure/physiology
- Bone Density/physiology
- Bone Diseases, Metabolic/epidemiology
- Bone Diseases, Metabolic/etiology
- Bone Diseases, Metabolic/physiopathology
- Cross-Sectional Studies
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/physiopathology
- Female
- Humans
- Hypertension/complications
- Hypertension/epidemiology
- Hypertension/physiopathology
- Middle Aged
- Osteoporosis, Postmenopausal/epidemiology
- Osteoporosis, Postmenopausal/etiology
- Osteoporosis, Postmenopausal/physiopathology
- Prevalence
- Retrospective Studies
- Risk Factors
- Tibet/epidemiology
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Affiliation(s)
- L Zhou
- Department of Endocrinology and Metabolism, Peking University of People's Hospital, Beijing, China
| | - J Song
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - S Yang
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - S Meng
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - X Lv
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - J Yue
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - A Mina
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - B Puchi
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - Y Geng
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China
| | - L Yang
- Department of Endocrinology, People's Hospital of Tibet Autonomous Region, Lhasa, Tibet, China.
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Bone Strength and Arterial Stiffness Impact on Cardiovascular Mortality in a General Population. J Osteoporos 2016; 2016:7030272. [PMID: 27047700 PMCID: PMC4800107 DOI: 10.1155/2016/7030272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 02/06/2016] [Accepted: 02/14/2016] [Indexed: 11/29/2022] Open
Abstract
Osteoporosis and increased arterial stiffness independently have been found to be associated with higher cardiovascular events rates in the general population (GP). We examined 558 patients from GP by dual-energy X-ray absorptiometry (DXA) and pulse wave velocity (PWV) measurements at baseline, with 36-month follow-up period. DXA assessed bone mineral density of femoral neck (BMD FN) and lumbar spine (BMD LS). Carotid-femoral PWV was assessed by pulsed-Doppler. The aim of our study is to find correlation between bone strength and arterial stiffness and their impact on cardiovascular mortality in GP. The mean ± SD of BMD FN, BMD LS, and PWV was 0.852 ± 0.1432 g/cm(2), 0.934 ± 0.1546 g/cm(2), and 9.209 ± 1.9815 m/s. In multiple regression analysis we found BMD FN (βst = -6.0094, p < 0.0001), hypertension (βst = 1.7340, p < 0.0091), and diabetes (βst = 0.4595, p < 0.0046). With Cox-regression analysis, after 17 cardiovascular events, the significant covariates retained by the backward model were BMD FN (b = -2.4129, p = 0.015) and PWV (b = 0.2606, p = 0.0318). The cut-off values were PWV = 9.4 m/s, BMD FN = 0.783 g/cm(2), and BMD LS = 0.992 g/cm(2). The results for BMD FN and PWV hazard ratio risk were 1.116 and 1.297, respectively. BMD FN as a measure of bone strength and PWV as a measure of arterial stiffness are strong independent predictors of cardiovascular mortality in GP.
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Genetic Sharing with Cardiovascular Disease Risk Factors and Diabetes Reveals Novel Bone Mineral Density Loci. PLoS One 2015; 10:e0144531. [PMID: 26695485 PMCID: PMC4687843 DOI: 10.1371/journal.pone.0144531] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 11/19/2015] [Indexed: 01/14/2023] Open
Abstract
Bone Mineral Density (BMD) is a highly heritable trait, but genome-wide association studies have identified few genetic risk factors. Epidemiological studies suggest associations between BMD and several traits and diseases, but the nature of the suggestive comorbidity is still unknown. We used a novel genetic pleiotropy-informed conditional False Discovery Rate (FDR) method to identify single nucleotide polymorphisms (SNPs) associated with BMD by leveraging cardiovascular disease (CVD) associated disorders and metabolic traits. By conditioning on SNPs associated with the CVD-related phenotypes, type 1 diabetes, type 2 diabetes, systolic blood pressure, diastolic blood pressure, high density lipoprotein, low density lipoprotein, triglycerides and waist hip ratio, we identified 65 novel independent BMD loci (26 with femoral neck BMD and 47 with lumbar spine BMD) at conditional FDR < 0.01. Many of the loci were confirmed in genetic expression studies. Genes validated at the mRNA levels were characteristic for the osteoblast/osteocyte lineage, Wnt signaling pathway and bone metabolism. The results provide new insight into genetic mechanisms of variability in BMD, and a better understanding of the genetic underpinnings of clinical comorbidity.
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Zhang J, Zhang K, Shi H, Tang Z. A cross-sectional study to evaluate the associations between hypertension and osteoporosis in Chinese postmenopausal women. Int J Clin Exp Med 2015; 8:21194-21200. [PMID: 26885054 PMCID: PMC4723899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Accepted: 11/10/2015] [Indexed: 06/05/2023]
Abstract
BACKGROUND This relationship between hypertension (HTN) and osteoporosis (OP) is not well documented among the population in China. The study sought to study the relationship between HTN and OP in Chinese postmenopausal women. METHODS This cross-sectional study involved 1878 Chinese postmenopausal women with an average age of 62.38 years. OP was diagnosed by standardized quantitative ultrasound at the calcaneus and HTN was defined by blood pressure data and/or the use of antihypertensive medication. The relationship for OP and HTN were calculated using univariate and multivariate regression analyses. RESULTS The prevalence of OP was 28.17% in the postmenopausal women, and there was a significant difference in the prevalence of OP between the two groups according to HTN (P value = 0.003). Univariate analysis demonstrates a positive correlation between HTN and OP. After adjustment for relevant potential confounding factors, multivariate logistic regression analyses detected significant associations between HTN and OP (P value = 0.096). In participants with HTN, the OR for OP was 1.209 (95% CI: 0.967-1.513). CONCLUSION The prevalence of OP was more frequent in Chinese postmenopausal women with HTN, and HTN was independently and significantly associated with OP.
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Affiliation(s)
- Jin Zhang
- Department of Cardiology, Huashan Hospital, Fudan UniversityShanghai, China
| | - Keqin Zhang
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityShanghai, China
| | - Haiming Shi
- Department of Cardiology, Huashan Hospital, Fudan UniversityShanghai, China
| | - Zihui Tang
- Department of Endocrinology and Metabolism, Shanghai Tongji Hospital, School of Medicine, Tongji UniversityShanghai, China
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Cakmak HA, Cakmak BD, Yumru AE, Aslan S, Enhos A, Kalkan AK, Coskun EI, Acikgoz AS, Karatas S. The relationships between blood pressure, blood glucose, and bone mineral density in postmenopausal Turkish women. Ther Clin Risk Manag 2015; 11:1641-8. [PMID: 26586948 PMCID: PMC4634834 DOI: 10.2147/tcrm.s95017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Hypertension, diabetes mellitus, and osteoporosis are important comorbidities commonly seen in postmenopausal women. The aim of the present study was to investigate the relationships between blood pressure, blood glucose, and bone mineral density (BMD) in postmenopausal Turkish women. METHODS In this cross-sectional study, 270 consecutive patients who were admitted to an outpatient clinic with vasomotor symptoms and/or at least 1 year of amenorrhea were included. The patients were categorized into three groups according to their blood pressure and metabolic status as follows: normotensive, hypertensive nondiabetics, and hypertensive diabetics. The T- and z-scores of the proximal femur and lumbar vertebrae were measured with the dual-energy X-ray absorptiometry method to assess the BMD of the study groups. RESULTS Lumbar vertebral T-scores (P<0.001), lumbar vertebral z-scores (P<0.003), and proximal femoral T-scores (P<0.001) were demonstrated to be significantly lower in the hypertensive diabetic group compared to the hypertensive nondiabetic and normotensive groups. Systolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.382; P=0.001), lumbar vertebral z-scores (r=-0.290; P=0.001), and proximal femoral T-scores (r=-0.340; P=0.001). Moreover, diastolic blood pressure was significantly inversely correlated with lumbar vertebral T-scores (r=-0.318; P=0.001), lumbar vertebral z-scores (r=-0.340; P=0.001), and proximal femoral T-scores (r=-0.304; P=0.001). Hypertension (odds ratio [OR]: 2.541, 95% confidence interval [CI]: 1.46-3.48, P=0.003), diabetes mellitus (OR: 2.136, 95% CI: 1.254-3.678, P=0.006), and age (OR: 1.069, 95% CI: 1.007-1.163, P=0.022) were found to be significant independent predictors of osteopenia in a multivariate analysis, after adjusting for other risk parameters. CONCLUSION The present study is the first to evaluate the relationships between blood pressure, blood glucose, and BMD in postmenopausal Turkish women. Moreover, both hypertension and diabetes were demonstrated as significant independent predictors of osteopenia in postmenopausal Turkish women. Clinicians should be aware of the high risk of developing osteopenia in diabetic hypertensive postmenopausal women.
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Affiliation(s)
| | - Burcu Dincgez Cakmak
- Department of Obstetric and Gynecology, Rize Kackar Government Hospital, Rize, Turkey
| | - Ayse Ender Yumru
- Department of Obstetric and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
| | - Serkan Aslan
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Asim Enhos
- Department of Cardiology, Mustafakemalpasa Government Hospital, Bursa, Turkey
| | - Ali Kemal Kalkan
- Department of Cardiology, Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Training and Research Hospital, Istanbul, Turkey
| | - Ebru Inci Coskun
- Department of Obstetric and Gynecology, Inonu University, Malatya, Turkey
| | - Abdullah Serdar Acikgoz
- Department of Obstetric and Gynecology, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Suat Karatas
- Department of Obstetric and Gynecology, Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, Turkey
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Lee HT, Shin J, Min SY, Lim YH, Kim KS, Kim SG, Kim JH, Lim HK. The relationship between bone mineral density and blood pressure in the Korean elderly population: the Korea National Health and Nutrition Examination Survey, 2008–2011. Clin Exp Hypertens 2014; 37:212-7. [DOI: 10.3109/10641963.2014.933971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Hyung Tak Lee
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
| | - Jinho Shin
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
| | - Seung Yeon Min
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
| | - Young-Hyo Lim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
| | - Kyung-Soo Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
| | - Soon Gil Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Guri Hospital, Guri, Korea
| | - Jeong Hyun Kim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
| | - Heon Kil Lim
- Division of Cardiology, Department of Internal Medicine, Hanyang University Medical Center, Seoul, Korea and
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Prolonged Diuretic Activity and Calcium-Sparing Effect of Tropaeolum majus: Evidence in the Prevention of Osteoporosis. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:958291. [PMID: 25028592 PMCID: PMC4083603 DOI: 10.1155/2014/958291] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/06/2014] [Accepted: 05/27/2014] [Indexed: 01/13/2023]
Abstract
Although several studies indicate high effectiveness in the use of the hydroethanolic extract from Tropaeolum majus (HETM) as a diuretic, the impact of its prolonged use in the presence of low estrogen levels remains unclear. Thus, the aim of this study was to investigate the diuretic effects of prolonged administration of HETM in ovariectomized rats and their interrelationship between calcium excretion and bone turnover. Forty-two female Wistar rats were ovariectomized (OVX) and treated orally with different doses of HETM (3, 30, and 300 mg/kg) for 4 weeks. On the first day of treatment and at weekly intervals for four weeks the diuretic activity was evaluated. Electrolyte concentrations and creatinine levels were estimated from urine sample of each rat. The serum lipids, urea, creatinine, and osteocalcin were also measured at the end of the experiment. The data revealed that the HETM was able to sustain its diuretic effect after prolonged treatment. Moreover, its use has not affected the urinary calcium or potassium excretion, reduces lipid levels, and maintains osteocalcin levels similarly to untreated rats. These findings support the potential of HETM as a candidate to be used in clinical conditions in which the renal loss of calcium is not desired.
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19
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Liang DK, Bai XJ, Wu B, Han LL, Wang XN, Yang J, Chen XM. Associations between bone mineral density and subclinical atherosclerosis: a cross-sectional study of a Chinese population. J Clin Endocrinol Metab 2014; 99:469-77. [PMID: 24248180 DOI: 10.1210/jc.2013-2572] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
CONTEXT The significance of associations between bone mineral density (BMD) and atherosclerosis in the Asian population is less clear. OBJECTIVE The aim of this study was to explore the population-level associations between BMD and subclinical atherosclerosis. DESIGN AND SETTING This was a community-based cross-sectional study conducted in Shenyang, China. PARTICIPANTS A total of 385 Chinese women and men aged 37-87 years were studied. MAIN OUTCOME MEASURES The BMD was measured at the total hip and lumbar spine using dual-energy x-ray absorptiometry. The ankle-brachial index (ABI), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) were measured to assess atherosclerosis. Multiple regression analysis was applied to study the associations. Multicolinearity was examined using the variance inflation factor, condition index, and variance proportions. Factor analysis and principal component regression were used to remove the problem of multicolinearity. RESULTS The differences of ABI, PWV, and CIMT among the normal BMD, osteopenia, and osteoporosis groups were not found. Total hip BMD was correlated with ABI in women after adjustment for age (r = 0.156). Sex-specific regression models included adjustment for age, body mass index, cigarette smoking, alcohol consumption, menopausal status (women), systolic blood pressure, diastolic blood pressure, triglycerides, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, fasting blood glucose, serum uric acid, estimated glomerular filtration rate, high-sensitivity C-reactive protein, and fibrinogen. Total hip BMD was associated with ABI in women after adjustment for age (per SD decrease in ABI: -0.130 g/cm(2), P = .022), but the association was borderline significant after full adjustment (P = .045). Total hip BMD and lumbar spine BMD were not associated with ABI, PWV, and CIMT after full adjustment in participants without a fracture history. The risk of osteoporosis was not associated with ABI, PWV, and CIMT. CONCLUSIONS Low BMD is not associated with subclinical atherosclerosis as assessed by ABI, PWV, and CIMT.
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Affiliation(s)
- Dong-Ke Liang
- Departments of Gerontology and Geriatrics (D.-K.L., B.W., X.-N.W.) and Cardiac Function (J.Y.), the First Affiliated Hospital, China Medical University, Shenyang 110001, China; Departments of Gerontology and Geriatrics (X.-J.B., L.-L.H.), Sheng Jing Hospital, China Medical University, Shenyang 110004, China; and Department of Kidney (X.-M.C.), General Hospital of Chinese People's Liberation Army, Beijing 100853, China
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Ertek S, Akgül E, Cicero AF, Kütük U, Demirtaş S, Çehreli S, Erdoğan G. 25-Hydroxy vitamin D levels and endothelial vasodilator function in normotensive women. Arch Med Sci 2012; 8:47-52. [PMID: 22457674 PMCID: PMC3309436 DOI: 10.5114/aoms.2012.27280] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2011] [Revised: 10/12/2011] [Accepted: 10/26/2011] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Vitamin D was shown to be related to endothelial function and blood pressure. Reactive hyperaemia index (RHI) measurement by pulse arterial tonometry is a new method to evaluate vasodilator function of endothelium. We aimed to evaluate the relationship between vitamin D levels and RHI in women. MATERIAL AND METHODS We enrolled 56 normotensive, nonsmoker, normolipidemic and normoglycemic women, (23 with 25-OH-vitamin D levels>20 µg/l, and 33 with values lower than 20 µg/l). The cardiologist who was blind for vitamin D results executed measurements by pulse arterial tonometry. The measurement was performed on the lying patient with pre- and post-occlusion measurements of RHI by digital sensors placed on each index finger, by 5 min intervals. Pulse amplitudes were recorded, pre-occlusion and post-occlusion ratio was compared by the software of device. Stepwise linear regression and multiple regression analyses were performed to evaluate predictors of endothelial function. RESULTS The low vitamin D group had a lower RHI value than the normal vitamin D group (p = 0.042). In regression analysis, positive predictors of RHI were serum 25-OHD (β = 0.401; 95% CI 0.010-0.042, p = 0.002), serum albumin (β = 0.315; 95% CI 0.286-2.350, p = 0.013), and, inversely, serum calcium (β = -0.247; 95% CI (-1.347)-(-0.010), p = 0.047). CONCLUSIONS Serum 25-hydroxy vitamin D was significantly related to endothelial functions measured as RHI, even in healthy non-smoker women.
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Affiliation(s)
- Sibel Ertek
- Endocrinology and Metabolic Diseases Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey
| | - Ebru Akgül
- Cardiology Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey
| | - Arrigo F. Cicero
- Internal Medicine, Aging and Kidney Diseases Department, Bologna University, Atherosclerosis and Metabolic Diseases Research Center, Bologna, Italy
| | - Utku Kütük
- Cardiology Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey
| | - Selda Demirtaş
- Biochemistry Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey
| | - Sengül Çehreli
- Cardiology Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey
| | - Gürbüz Erdoğan
- Endocrinology and Metabolic Diseases Department, Ufuk University Medical Faculty, Dr. R. Ege Hospital, Ankara, Turkey
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Ertek S, Francesco Cicero A, Erdoğan G. The relationship between calcium metabolism, insulin-like growth factor-1 and pulse pressure in normotensive, normolipidaemic and non-diabetic patients. Arch Med Sci 2011; 7:776-80. [PMID: 22291821 PMCID: PMC3258801 DOI: 10.5114/aoms.2011.25551] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2011] [Revised: 05/30/2011] [Accepted: 09/06/2011] [Indexed: 12/22/2022] Open
Abstract
INTRODUCTION Recent evidence suggests an interaction between bone metabolism and blood pressure (BP) regulation. The aim of our study was to evaluate endocrinological and metabolic factors related to pulse pressure (PP) in normotensive, normolipidaemic, non-smoker subjects. MATERIAL AND METHODS We consecutively enrolled 156 adults (37 males, 119 females) in summer 2009. The BP and body mass index (BMI) were recorded, and serum samples were taken for 25-hydroxy vitamin D (25-OHD), insulin-like growth factor-1 (IGF-1), growth hormone (GH), parathormone (PTH), calcium, albumin, phosphorus, glucose, triglyceride and cholesterol levels. RESULTS In the postmenopausal group, PP was significantly associated with age and BMI, while in premenopausal patients it was inversely related to ionized calcium. In men, a reverse relationship was present between GH and IGF-1 levels and PP. CONCLUSIONS The PP was predicted by different parameters in different genders and these predictors change even in the same gender before and after menopause. Well-known predictors of PP such as age and BMI were more pronounced in postmenopausal women, but none of the groups showed a relationship between PP and 25-OHD or PTH.
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Affiliation(s)
- Sibel Ertek
- Department of Endocrinology and Metabolic Diseases, Ufuk University Medical Faculty, Ankara, Turkey
| | - Arrigo Francesco Cicero
- Internal Medicine, Aging and Kidney Diseases Department, Atherosclerosis and Metabolic Diseases Research Center, Bologna University, Bologna, Italy
| | - Gürbüz Erdoğan
- Department of Endocrinology and Metabolic Diseases, Ufuk University Medical Faculty, Ankara, Turkey
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Salari P, Abdollahi M. Behind the pathogenesis of osteoporosis and cardiovascular diseases. Arch Med Sci 2011; 7:568-9. [PMID: 22291788 PMCID: PMC3258779 DOI: 10.5114/aoms.2011.24121] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2011] [Revised: 08/09/2011] [Accepted: 08/10/2011] [Indexed: 02/05/2023] Open
Affiliation(s)
- Pooneh Salari
- Medical Ethics and History of Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Abdollahi
- Faculty of Pharmacy and Pharmaceutical Sciences Research Center, Endocrinology and Metabolism Research Institute, Tehran University of Medical Sciences, Tehran, Iran
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