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Heuchert J, Kozieł S, Spinek AE. Radiomorphometric indices of the mandible as indicators of decreased bone mineral density and osteoporosis - meta-analysis and systematic review. Osteoporos Int 2024; 35:401-412. [PMID: 37870561 PMCID: PMC10867062 DOI: 10.1007/s00198-023-06949-7] [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: 05/18/2023] [Accepted: 10/09/2023] [Indexed: 10/24/2023]
Abstract
This review aims to evaluate the accuracy of various mandibular radiomorphometric indices in comparison with DEXA BMD measurements in the diagnosis of osteopenia and osteoporosis based on a meta-analysis of the sensitivity and specificity of the indices. PRISMA statement was followed. The materials for analysis were collected in August 2023 by searching three databases: PubMed Central, Web of Science, and Scopus. The selection of studies consisted of three selection stages, and 64 articles were finally obtained. Quality assessment was performed with the QUADAS-2 tool, and the general methodological quality of retrieved studies was low. Statistical analysis was performed based on 2 × 2 tables and estimated sensitivity and specificity were obtained using SROC curves. The most used indices were MCI, MCW and PMI. The best results in detecting reduced BMD obtained for MCW ≤ 3 mm, estimated sensitivity and specificity were 0.712 (95% CI, 0.477-0.870) and 0.804 (95% CI, 0.589-0.921), respectively. The most prone to the risk of bias is the MCI due to the examiner's subjectivism. Radiomorphometric indices of the mandible can be useful as a screening tool to identify patients with low BMD, but should not be used as a diagnostic method. Further research needs to focus on analysing the ability of the indices to detect osteoporosis and also in combination the indices with clinical parameters.
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Affiliation(s)
- Joanna Heuchert
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland.
| | - Sławomir Kozieł
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
| | - Anna E Spinek
- Department of Anthropology, Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, Weigla 12, 53-114, Wrocław, Poland
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2
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Tenório JR, Duarte NT, Andrade NS, Bergamini ML, Mamana AC, Braz-Silva PH, Ortega KL. Assessment of bone metabolism biomarkers in serum and saliva of cirrhotic patients. Clin Oral Investig 2021; 26:1861-1868. [PMID: 34491448 DOI: 10.1007/s00784-021-04161-7] [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: 02/03/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To assess the serum and salivary levels of biomarkers related to bone metabolism in cirrhotic patients as well as the evidence of osteoporotic changes on panoramic radiographs. MATERIALS AND METHODS Thirty-eight cirrhotic patients underwent anamnesis and physical examination. Specimens of blood and saliva were collected for evaluation by using Luminex™ xMAP technology to quantify RANKL, OPG, IL-1β, IL-6 and TNF-α. Panoramic radiographs were evaluated based on the mandibular cortical index (MCI) and the resulting data were compared to the expression of biomarkers in serum and saliva. Descriptive data analysis was performed and the Mann-Whitney's test and Spearman's correlation were used. RESULTS Most of the sample consisted of males (68.4%) who had cirrhosis mostly resulting from alcoholism (28.9%). Median concentration values of RANKL (74.44 pg/mL), IL-1 β (45.91 pg/mL), IL-6 (67.69 pg/mL) and TNF-α (5.97 pg/mL) in saliva were higher than those observed in serum. In 72.7% of the panoramic radiographs, MCI was found to be suggestive of osteoporotic changes. No statistically significant correlation was observed between salivary and serum expressions of biomarkers or between biomarkers and MCI. CONCLUSION RANKL, OPG, IL-1β, IL-6 and TNF-α are expressed differently in serum and saliva and the concentration of these biomarkers is not related to MCI. CLINICAL RELEVANCE This study contributes to the study of the mechanisms of osteoporosis in cirrhotic individuals.
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Affiliation(s)
- Jefferson Rocha Tenório
- Department of Stomatology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, 05508-900, Brazil
| | - Nathália Tuany Duarte
- Department of Stomatology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, 05508-900, Brazil
| | - Natália Silva Andrade
- Department of Stomatology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, 05508-900, Brazil.,Department of Dentistry, Federal University of Sergipe, Lagarto, Sergipe, Brazil
| | - Mariana Lobo Bergamini
- Department of Stomatology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, 05508-900, Brazil
| | - Ana Carolina Mamana
- Laboratory of Virology, Institute of Tropical Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Paulo Henrique Braz-Silva
- Department of Stomatology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, 05508-900, Brazil.,Laboratory of Virology, Institute of Tropical Medicine, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Karem L Ortega
- Department of Stomatology, University of São Paulo School of Dentistry, Av. Prof. Lineu Prestes, 2227-Butantã, São Paulo, SP, 05508-900, Brazil.
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3
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Clinical guidelines for the application of panoramic radiographs in screening for osteoporosis. Oral Radiol 2021; 37:189-208. [PMID: 33620644 DOI: 10.1007/s11282-021-00518-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023]
Abstract
Osteoporotic fractures are associated with an increased risk of subsequent fractures, a higher rate of mortality, and incremental medical costs. Incidental findings, which include some measurements related to the mandibular inferior cortex and the alveolar trabecular bone pattern of the mandible determined on panoramic radiographs, are considered to be a useful tool for identifying asymptomatic individuals at risk of having osteoporosis and/or fragility fractures. We undertook a worldwide literature survey and present the following clinical recommendations. Postmenopausal female dental patients with a mandibular inferior cortical width of less than 3 mm on panoramic radiographs may be at risk of having low skeletal bone mineral density (BMD) or osteoporosis, but not fragility fractures. In addition, those with a severely eroded mandibular inferior cortex may have an increased risk of having low skeletal BMD, osteoporosis, and fragility fractures. The alveolar trabecular bone pattern of the mandible might be useful for identifying female dental patients at risk of having fragility fractures, although further investigation is necessary to confirm this possibility. These incidental findings on panoramic radiographs, when used for identifying asymptomatic postmenopausal female patients at risk of having osteoporosis in general dental practice, may be helpful in reducing the incidence of first fractures, with a consequent reduction in the secondary fractures, medical costs, and mortality associated with osteoporotic fragility fractures, without incurring any additional cost.
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Sghaireen MG, Alam MK, Patil SR, Rahman SA, Alhabib S, Lynch CD, Al-Omiri M. Morphometric analysis of panoramic mandibular index, mental index, and antegonial index. J Int Med Res 2020; 48:300060520912138. [PMID: 32228352 PMCID: PMC7132799 DOI: 10.1177/0300060520912138] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mohammed G Sghaireen
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, KSA.,Department of Prosthodontics, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | | | - Santosh R Patil
- Department of Oral Medicine and Radiology, College of Dentistry, Jouf University, Sakaka, KSA
| | - Saifulizan Ab Rahman
- Department of Oral and Maxillofacial Surgery, School of Dental Sciences, Universiti Sains Malaysia, Kelantan, Malaysia
| | - Selham Alhabib
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, KSA
| | - Christopher D Lynch
- School of Dentistry, College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Mahmoud Al-Omiri
- Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Sakaka, KSA
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5
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Frascino AV, Costa C, de Andrade Salgado DMR, Coracin FL, Fava M, Odone-Filho V. Mandibular radiomorphometric assessment of bone mineral density in survivors of pediatric hematopoietic stem-cell transplantation. Clinics (Sao Paulo) 2019; 74:e929. [PMID: 31166472 PMCID: PMC6530437 DOI: 10.6061/clinics/2019/e929] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Accepted: 02/27/2019] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVE Hematopoietic stem-cell transplantation (HSCT) childhood survivors of hematologic malignancies are prone to develop late osteopenia and osteoporosis. The purpose of this retrospective study was to quantitatively and qualitatively assess bone mineral density (BMD) in HSCT childhood survivors and to compare the effectiveness of both qualitative and quantitative assessment methods. METHODS DESIGN BMD assessment using panoramic radiographs of childhood HSCT survivors aged 3.69-18.88 years using two radiomorphometric indexes. Case-control double-blinded comparison of panoramic radiographic images from childhood HSCT survivors and age- and sex-matched healthy controls. Quantitative assessment was performed by measuring the cortical bone width bilaterally at the mental foramen level. Qualitative assessment was performed using the mandibular cortical index bilaterally on all panoramic images. RESULTS Radiographs were taken 6.59-83.95 months after bone marrow transplantation [median±SD=25.92±24.9 months]. Fifty-two panoramic radiographic images were analyzed: 21 from HSCT survivors and 31 from healthy controls aged 3.69-25.1 years [mean±SD=11.89±5.28 years]. The mandibular cortical bone width was 17% smaller in childhood HSCT survivors than in healthy controls (case group: 2.420, control group: 3.307; p=0.00617). Qualitative analysis revealed an increased frequency of severe mandibular cortical erosion in childhood HSCT survivors, although no significant difference was observed (case group: 1.540, control group: 1.490; p=0.32). The interobserver agreement was 85% (Kappa index). CONCLUSIONS HSCT childhood survivors exhibit quantitative and qualitative mandibular bone impairments. Further studies are needed to establish an association between mandibular cortical bone impairment and osteoporosis.
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Affiliation(s)
- Alexandre Viana Frascino
- Departamento de Pediatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, BR
- Corresponding author. E-mail:
| | - Claudio Costa
- Departamento de Estomatologia, Faculdade de Odontologia, Universidade de Sao Paulo, Sao Paulo, SP, BR
| | | | - Fabio Luiz Coracin
- Departamento de Saude, Faculdade de Odontologia, Universidade Nove de Julho, Sao Paulo, SP, BR
| | - Marcelo Fava
- Odontologia Pediatrica, Faculdade de Odontologia, Universidade Estadual Paulista (UNESP), Sao Jose dos Campos, SP, BR
| | - Vicente Odone-Filho
- Departamento de Pediatria, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, São Paulo, SP, BR
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Navabi N, Motaghi R, Rezazadeh M, Balooch H. Relationship between Two Panoramic Radiography Indices and Bone Mineral Density of Postmenopausal Women with Osteopenia and Osteoporosis. JOURNAL OF DENTISTRY (SHIRAZ, IRAN) 2018; 19:181-188. [PMID: 30175187 PMCID: PMC6092463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
STATEMENT OF THE PROBLEM Reduced bone mineral density (BMD) generally affects postmenopausal women and it is classified into moderate (osteopenia) and significant osteoporosis. Based on digital panoramic radiographs (DPRs), several quantitative and qualitative assessment methods have been proposed for the diagnosis and evaluation of bone changes and as a predictor of BMD. PURPOSE The aim of this study was to compare mandibular cortical width (MCW) and mandibular cortical index (MCI) derived from DPRs in evaluating the BMD in osteopenic and osteoporotic post-menopausal women. MATERIALS AND METHOD In this cross-sectional study, the BMD assessment was performed using dual-energy X-ray absorptiometry (DEXA). Then, patients were divided into two groups: osteopenia and osteoporosis based on WHO criteria. Two types of T-scores including TT (trabecular) for lumbar spine, TC (cortical) for femoral neck and finally, MCW and MCI were measured based on DPRs. RESULTS Fifty females with the average age of 57.64±6.03 years were entered into the study. MCW significantly correlated with BMD (p< 0.05). Pearson correlation coefficient test revealed that there was almost significant relationship between MCI and BMD (p= 0.079). The area under the curve (AUC) in ROC suggested that there was a close overlap between MCW (0.773) and TC (0.783), but TT had the greatest AUC (0.996). CONCLUSION The results showed that MCW is an appropriate index of osteoporosis in post-menopausal women. Although the prediction of osteoporosis is poorer at the femoral neck than lumbar spine, MCW can serve as a screening tool for osteoporosis in this area.
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Affiliation(s)
- Nader Navabi
- Dept. of Oral Medicine, Social Determinants on Oral Health Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Reza Motaghi
- Dept. of Oral and Maxillofacial Radiology, Kerman Dental School, Kerman University of Medical Sciences, Kerman, Iran
| | - Mandana Rezazadeh
- Internal Medicine Group, Kerman University of Medical Sciences, Kerman, Iran
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Use of cone beam computed tomography in identifying postmenopausal women with osteoporosis. Arch Osteoporos 2017; 12:26. [PMID: 28265896 DOI: 10.1007/s11657-017-0314-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Accepted: 02/06/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED The aim of this study is to correlate radiometric indices from cone beam computed tomography (CBCT) images and bone mineral density (BMD) in postmenopausal women. Quantitative CBCT indices can be used to screen for women with low BMD. PURPOSE Osteoporosis is a disease characterized by the deterioration of bone tissue and the consequent decrease in BMD and increase in bone fragility. Several studies have been performed to assess radiometric indices in panoramic images as low-BMD predictors. The aim of this study is to correlate radiometric indices from CBCT images and BMD in postmenopausal women. METHODS Sixty postmenopausal women with indications for dental implants and CBCT evaluation were selected. Dual-energy X-ray absorptiometry (DXA) was performed, and the patients were divided into normal, osteopenia, and osteoporosis groups, according to the World Health Organization (WHO) criteria. Cross-sectional images were used to evaluate the computed tomography mandibular index (CTMI), the computed tomography index (inferior) (CTI (I)) and computed tomography index (superior) (CTI (S)). Student's t test was used to compare the differences between the indices of the groups' intraclass correlation coefficient (ICC). RESULTS Statistical analysis showed a high degree of interobserver and intraobserver agreement for all measurements (ICC > 0.80). The mean values of CTMI, CTI (S), and CTI (I) were lower in the osteoporosis group than in osteopenia and normal patients (p < 0.05). In comparing normal patients and women with osteopenia, there was no statistically significant difference in the mean value of CTI (I) (p = 0.075). CONCLUSIONS Quantitative CBCT indices may help dentists to screen for women with low spinal and femoral bone mineral density so that they can refer postmenopausal women for bone densitometry.
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8
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Munhoz L, Cortes ARG, Arita ES. Assessment of osteoporotic alterations in type 2 diabetes: a retrospective study. Dentomaxillofac Radiol 2017; 46:20160414. [PMID: 28186836 PMCID: PMC5606278 DOI: 10.1259/dmfr.20160414] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 02/04/2017] [Accepted: 02/09/2017] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVES To analyze the influence of Type 2 diabetes on bone mineral density (BMD) and panoramic radiomorphometry in postmenopausal females, comparing with results from non-diabetic postmenopausal females. METHODS A total of 228 postmenopausal females (mean age: 59.51 ± 11.08 years) were included in this study. Demographics, T scores and Z scores from peripheral dual X-ray absorptiometry (DXA) and mandibular cortical index (MCI) from panoramic radiographs were assessed. Mean comparison between results for diabetics and non-diabetics was carried out with the Student's t-test. In addition, non-parametric correlations between MCI and DXA results were carried out with Spearman's test, at a level of significance of 5%. RESULTS Mean Z score values were significantly higher in diabetics than in non-diabetics (p = 0.001). T and Z score values were also significantly correlated with MCI (r = 0.428, p = 0.001, and r = 0.356, p = 0.022, respectively). CONCLUSIONS Within the limitations of this study, the present results suggest that Type 2 diabetes might increase BMD in postmenopausal females.
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Affiliation(s)
- Luciana Munhoz
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Arthur R G Cortes
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
| | - Emiko S Arita
- Department of Stomatology, School of Dentistry, University of São Paulo, São Paulo, Brazil
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9
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Hao L, Fu J, Tian Y, Wu J. Systematic analysis of lncRNAs, miRNAs and mRNAs for the identification of biomarkers for osteoporosis in the mandible of ovariectomized mice. Int J Mol Med 2017; 40:689-702. [PMID: 28713971 PMCID: PMC5547976 DOI: 10.3892/ijmm.2017.3062] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 06/29/2017] [Indexed: 12/19/2022] Open
Abstract
Osteoporosis is a complex and multifactorial disease caused by an imbalance between bone formation and resorption. Post-menopausal women with endogenous estrogen deficiency suffer from systemic bone loss and osteoporosis, and are at high risk of this affecting the jaw bones. MicroRNAs (miRNAs or miRs) have been implicated in the mechanisms of metabolic bone diseases and are expressed at differential levels in alveolar bone following ovariectomy. In the present study, we systematically analyzed the expression profiles of miRNAs, mRNAs and long non-coding RNA (lncRNAs) in the mandible of ovariectomized (OVX) mice. A complex miRNA-mRNA-lncRNA regulatory network was constructed based on differentially expressed RNAs. Two core differentially expressed genes (DEGs), namely, LRP2 binding protein (Lrp2bp) and perilipin 4 (Plin4), significantly influenced the network targeted by differentially expressed miRNAs. Moreover, peroxisome proliferator-activated receptor (PPAR) and insulin signaling pathways were significantly dysregulated in the mandible of OVX mice. Several differentially expressed lncRNAs were also implicated in the two signaling pathways, which influenced mandible development by forming competing endogenous RNA. On the whole, our data indicate that the comprehensive analysis of miRNAs, mRNAs and lncRNAs provides insight into the pathogenesis of estrogen deficiency-induced osteoporosis in the mandible. This study proposes potential biomarkers for diagnosis or therapeutic targets for osteoporosis which may aid in the development of novel drugs for the treatment of osteoporosis.
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Affiliation(s)
- Lingyu Hao
- Department of Prosthodontics, School and Hospital of Stomatology, Tongji University and Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, P.R. China
| | - Jiayao Fu
- Department of Prosthodontics, School and Hospital of Stomatology, Tongji University and Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, P.R. China
| | - Yawen Tian
- Department of Prosthodontics, School and Hospital of Stomatology, Tongji University and Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, P.R. China
| | - Junhua Wu
- Department of Prosthodontics, School and Hospital of Stomatology, Tongji University and Shanghai Engineering Research Center of Tooth Restoration and Regeneration, Shanghai 200072, P.R. China
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Barngkgei I, Halboub E, Almashraqi AA, Khattab R, Al Haffar I. IDIOS: An innovative index for evaluating dental imaging-based osteoporosis screening indices. Imaging Sci Dent 2016; 46:185-202. [PMID: 27672615 PMCID: PMC5035724 DOI: 10.5624/isd.2016.46.3.185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Revised: 10/13/2015] [Accepted: 12/11/2015] [Indexed: 01/10/2023] Open
Abstract
Purpose The goal of this study was to develop a new index as an objective reference for evaluating current and newly developed indices used for osteoporosis screening based on dental images. Its name; IDIOS, stands for Index of Dental-imaging Indices of Osteoporosis Screening. Materials and Methods A comprehensive PubMed search was conducted to retrieve studies on dental imaging-based indices for osteoporosis screening. The results of the eligible studies, along with other relevant criteria, were used to develop IDIOS, which has scores ranging from 0 (0%) to 15 (100%). The indices presented in the studies we included were then evaluated using IDIOS. Results The 104 studies that were included utilized 24, 4, and 9 indices derived from panoramic, periapical, and computed tomographic/cone-beam computed tomographic techniques, respectively. The IDIOS scores for these indices ranged from 0 (0%) to 11.75 (78.32%). Conclusion IDIOS is a valuable reference index that facilitates the evaluation of other dental imaging-based osteoporosis screening indices. Furthermore, IDIOS can be utilized to evaluate the accuracy of newly developed indices.
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Affiliation(s)
- Imad Barngkgei
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria.; Department of Oral Medicine, Faculty of Dentistry, Syrian Private University, Damascus, Syria
| | - Esam Halboub
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia
| | - Abeer Abdulkareem Almashraqi
- Department of Maxillofacial Surgery and Diagnostic Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.; Department of Oral and Maxillofacial Radiology, Faculty of Dentistry, Ibb University, Ibb, Yemen
| | - Razan Khattab
- Department of Periodontology, Faculty of Dentistry, Damascus University, Damascus, Syria
| | - Iyad Al Haffar
- Department of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus, Syria
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Lin CW, Chen YY, Chen YJ, Liang CY, Lin MS, Chen W. Prevalence, risk factors, and health-related quality of life of osteoporosis in patients with COPD at a community hospital in Taiwan. Int J Chron Obstruct Pulmon Dis 2015; 10:1493-500. [PMID: 26251589 PMCID: PMC4524376 DOI: 10.2147/copd.s85432] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
Background Data regarding osteoporosis in COPD patients in Taiwan remain limited. The primary end point of this study was to evaluate the prevalence and risk factors of osteoporosis in COPD patients in Taiwan. The secondary end point was to examine the association between osteoporosis and health-related quality of life (HRQL) in COPD patients. Materials and methods This prospective cross-sectional study enrolled 125 COPD patients (mean age 73.6 years, forced expiratory volume in 1 second [FEV1] 1.19±0.43 L) who had bone mineral-density measurements performed consecutively. Demographic data, lung function, and HRQL including modified Medical Research Council dyspnea scale, St George’s Respiratory Questionnaire, oxygen-cost diagram, Center for Epidemiologic Studies – depression scale, and COPD Assessment Test scores were recorded. Results A total of 50 (40%) participants were diagnosed as having osteoporosis. In a multivariate logistic regression model including age, smoking amount (pack-year), body mass index (BMI), and FEV1, only BMI (odds ratio 0.824, 95% confidence interval 0.73–0.93; P=0.002) and FEV1 (odds ratio 0.360, 95% confidence interval 0.13–0.98; P=0.046) were negatively associated with an increased risk of osteoporosis in COPD patients. In addition, COPD patients with osteoporosis had significantly higher modified Medical Research Council dyspnea scale scores (1.7±0.8 vs 1.4±0.8, P=0.046), St George’s Respiratory Questionnaire scores (36.6 vs 28.0, P=0.01), and COPD Assessment Test scores (14.7±8 vs 11.5±7, P=0.019), and lower oxygen-cost diagram score (4.8±1.8 vs 5.4±1.6, P=0.045) than patients without osteoporosis. Conclusion The prevalence of osteoporosis in COPD patients was high at a community hospital in Taiwan. BMI and FEV1 were the independent risk factors for osteoporosis in COPD. In addition, COPD patients with osteoporosis had worse HRQL than those without osteoporosis.
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Affiliation(s)
- Chun-Wei Lin
- Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; Division of Chest, Division of Pulmonary Medicine, Kuang Tien General Hospital, Taichung, Taiwan
| | - Yih-Yuan Chen
- Department of Internal Medicine, Chia-Yi Christian Hospital, Chiayi, Taiwan
| | - Yi-Jen Chen
- Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Chi-Yen Liang
- Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan
| | - Ming-Shian Lin
- Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; Department of Respiratory Care, Chang Gung University of Science and Technology, Chiayi, Taiwan
| | - Wei Chen
- Division of Pulmonary and Critical Care Medicine, Chia-Yi Christian Hospital, Chia-Yim, Taiwan ; College of Nursing, Dayeh University, Taichung, Taiwan ; Department of Respiratory Therapy, China Medical University, Taichung, Taiwan
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12
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Apolinário AC, Figueiredo PT, Guimarães AT, Acevedo AC, Castro LC, Paula AP, Paula LM, Melo NS, Leite AF. Pamidronate affects the mandibular cortex of children with osteogenesis imperfecta. J Dent Res 2015; 94:95S-102S. [PMID: 25608973 DOI: 10.1177/0022034514567334] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
We hypothesized that mandibular cortical width (MCW) is smaller in children with osteogenesis imperfecta (OI) than in healthy children and that pamidronate can improve the cortical mandibular thickness. The aim of this study was to assess changes in the MCW on dental panoramic radiographs (DPRs) of children with normal bone mineral density (BMD) and with OI. We also compared the MCW of children with different types of OI regarding the number of pamidronate cycles and age at the beginning of treatment. MCW measurements were retrospectively obtained from 197 DPRs of 66 children with OI types I, III, and IV who were in treatment with a comparable dosage of cyclical intravenous pamidronate between 2007 and 2013. The control group had 92 DPRs from normal BMD children. Factorial analysis of variance was used to compare MCW measurements among different age groups and between sexes and also to compare MCW measurements of children with different types of OI among different pamidronate cycles and age at the beginning of treatment. No significant differences in results were found between male and female subjects in both OI and healthy children, so they were evaluated altogether (P > 0.05). There was an increase of MCW values related to aging in all normal BMD and OI children but on a smaller scale in children with OI types I and III. Children with OI presented lower mean MCW values than did children with normal BMD at the beginning of treatment (P < 0.05). A linear model estimated the number of pamidronate cycles necessary to achieve mean MCW values equivalent to those of healthy children. The thinning of the mandibular cortex depended on the number of pamidronate cycles, the type of OI, and the age at the beginning of treatment. DPRs could thus provide a way to identify cyclic pamidronate treatment outcomes in patients with OI.
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Affiliation(s)
- A C Apolinário
- Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | - P T Figueiredo
- Oral Radiology, Department of Dentistry, Faculty of Health Science, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | - A T Guimarães
- Biostatistics, Biological Sciences Department, State University of West Paraná, Cascavel, Paraná, Brazil
| | - A C Acevedo
- Oral Care Center for Inherited Diseases, Department of Dentistry, Faculty of Health Science, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | - L C Castro
- Endocrinology, University of Brasília's Hospital, L2 Norte, Brasília, Brazil
| | - A P Paula
- Hospital de Base of Federal District, Brasília, Brazil
| | - L M Paula
- Oral Care Center for Inherited Diseases, Department of Dentistry, Faculty of Health Science, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | - N S Melo
- Oral Pathology, Department of Dentistry, Faculty of Health Science, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
| | - A F Leite
- Oral Radiology, Department of Dentistry, Faculty of Health Science, Campus Universitário Darcy Ribeiro, University of Brasília, Brasília, Brazil
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