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Hars M, Fernandez N, Herrmann F, Rizzoli R, Ferrari S, Graf C, Vuilleumier P, Trombetti A. Effects of Dalcroze Eurhythmics Exercise Versus Multicomponent Exercise on Physical and Cognitive Function, and Falls in Older Adults: The EPHYCOS Randomized Controlled Trial. Adv Biol (Weinh) 2024:e2400089. [PMID: 38700122 DOI: 10.1002/adbi.202400089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2024] [Revised: 04/18/2024] [Indexed: 05/05/2024]
Abstract
Currently, robust evidence is lacking to support one exercise type over another in the prevention of physical and cognitive decline and falls among older adults, primarily because of the lack of comparative trials of proven interventions. Therefore, a 12-month randomized, single-blind, comparative effectiveness trial is conducted, in which 142 older adults at high risk for falls are randomized (1:1) to receive an evidence-based Dalcroze Eurhythmics (DE) exercise program (once weekly, group-based) or an evidence-based multicomponent (MULTI) exercise program incorporating balance, functional, and strength training activities (twice weekly, group- and home-based), for 12 months. The primary outcome is gait variability under dual-task at 12 months. At 12 months, the DE group has significant improvements compared with MULTI group on gait under both dual-task (adjusted β for stride variability: -2.3, 95%CI, -3.1 to -1.4; p < 0.001) and single-task, and on a variety of secondary physical and cognitive/executive function outcomes. The adjusted hazard ratio for falls is 0.58 (95%CI, 0.37 to 0.93) for the DE group compared with MULTI group. In conclusion, DE exercise is more effective than MULTI exercise in improving physical and cognitive function and reducing falls in older adults. The mechanisms underlying DE exercise-induced benefits remain to be fully elucidated.
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Affiliation(s)
- Mélany Hars
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
| | - Natalia Fernandez
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, 1205, Switzerland
| | - François Herrmann
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
| | - Serge Ferrari
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
| | - Christophe Graf
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
| | - Patrik Vuilleumier
- Laboratory for Behavioral Neurology and Imaging of Cognition, Department of Neuroscience, Faculty of Medicine, University of Geneva, Geneva, 1205, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, 1205, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, 1226, Switzerland
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Lippuner K, Kyuchukova M, Schwab P, Rizzoli R. Differences in femoral fracture localizations in men and women in Switzerland between 1998 and 2021-reversal of the secular trend? Osteoporos Int 2024; 35:893-902. [PMID: 38396306 PMCID: PMC11031489 DOI: 10.1007/s00198-024-07016-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 12/28/2023] [Indexed: 02/25/2024]
Abstract
Number and age-standardized incidences of femoral fractures by sex and localization were determined annually between 1998 and 2021 in subjects aged 45 years or older living in Switzerland. The number and incidences of femoral neck, pertrochanteric, subtrochanteric, and femoral shaft fractures followed distinct unexpected trend patterns. INTRODUCTION Long-term incidence trends for femoral fractures by individual localizations are unknown. METHODS Annual absolute number of hospitalizations and median age at hospital admission between 1998 and 2021 were extracted from the medical database of the Swiss Federal Office of Statistics by sex and 10-year age groups for the following 10th International Classification of Diseases (ICD-10) codes: femoral neck (ICD-10 S72.0), pertrochanteric (S72.1), subtrochanteric (S72.2), and femoral shaft fractures (S72.3). Age-standardized incidence rates (ASI) and corresponding trends were calculated. RESULTS Over 24 years, the number of femoral neck fractures increased in men (+ 45%) but decreased in women (- 7%) with ASI significantly decreasing by 20% and 37% (p < 0.001 for trend for both), respectively. By contrast, the number of pertrochanteric fractures increased by 67% and 45% in men and women, respectively, corresponding to a horizontal ASI-trend in men (n.s.) and a modest significant decreasing ASI-trend in women (p < 0.001). The number of subtrochanteric fractures increased in both sexes with corresponding modest significant reductions in ASI-trends (p = 0.015 and 0.002, respectively). Femoral shaft fractures almost doubled in men (+ 71%) and doubled in women (+ 100%) with corresponding significant increases in ASI-trends (p = 0.001 and p < 0.001, respectively). Age at admission increased for all fracture localizations, more so in men than in women and more so for subtrochanteric and shaft fractures than for "typical" hip fractures. CONCLUSION Incidence changes of pertrochanteric fractures and femoral shaft fractures deserve increased attention, especially in men. Pooling diagnostic codes for defining hip fractures may hide differing patterns by localization and sex.
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Affiliation(s)
- Kurt Lippuner
- Department of Osteoporosis, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland.
| | - Mariya Kyuchukova
- Department of Osteoporosis, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Patrick Schwab
- Swiss Federal Statistical Office, Neuchâtel, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Wieczorek M, Isler M, Landau K, Becker MD, Dawson-Hughes B, Kressig RW, Vellas B, Orav EJ, Rizzoli R, Kanis JA, Armbrecht G, Da Silva JAP, Egli A, Freystätter G, Bischoff-Ferrari HA. Association Between Visual Acuity and Prospective Fall Risk in Generally Healthy and Active Older Adults: The 3-Year DO-HEALTH Study. J Am Med Dir Assoc 2024; 25:789-795.e2. [PMID: 38640962 DOI: 10.1016/j.jamda.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 03/08/2024] [Accepted: 03/12/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE Although aging has a strong impact on visual acuity (VA) and falls, their interaction is understudied in generally healthy older adults. This study aimed to examine if and to what extent baseline VA is associated with an increased risk of all and injurious falls over 3 years in generally healthy community-dwelling older adults. DESIGN Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial. SETTING AND PARTICIPANTS Multicenter trial with 7 European centers: Zurich, Basel, Geneva (Switzerland), Berlin (Germany), Innsbruck (Austria), Toulouse (France), and Coimbra (Portugal), including 2157 community-dwelling adults aged 70 years and older without any major health events in the 5 years prior to enrollment, sufficient mobility, and good cognitive status. METHODS The numbers of all and injurious falls were recorded prospectively by diary and in-person assessment every 3 months. Decreased VA at baseline was defined as better-eye VA lower than 1.0. We applied negative binomial regression models for all and injurious falls, adjusted for age, sex, prior falls, treatment allocation, study site, baseline body mass index, and use of walking aids. RESULTS Among the 2131 participants included in this analysis (mean age: 74.9 years, 61.7% were women, 82.6% at least moderately physically active), 1464 (68.7%) had decreased VA. Overall, 3290 falls including 2116 injurious falls were recorded over 3 years. Decreased VA at baseline was associated with a 22% increased incidence rate of all falls [adjusted incidence rate ratio (aIRR) = 1.22, 95% CI 1.07, 1.38, P = .003] and 20% increased incidence rate of injurious falls (aIRR = 1.20, 95% CI 1.05, 1.37, P = .007). CONCLUSIONS AND IMPLICATIONS Our findings suggest that decreased VA is an independent predictor of an about 20% increased risk of all and injurious falls, highlighting the importance of regular eye examinations and VA measurements for fall prevention, even in generally healthy and active older adults.
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Affiliation(s)
- Maud Wieczorek
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich, Zurich, Switzerland
| | - Marlis Isler
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland
| | - Klara Landau
- Department of Ophthalmology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Matthias D Becker
- Department of Ophthalmology, City Hospital Zurich, Zurich, Switzerland; Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany; Spross Ophthalmology Research Institute, City Hospital Zurich, Zurich, Switzerland
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Centre on Aging, Tufts University, Boston, MA, USA
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, and University of Basel, Basel, Switzerland
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - Endel John Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - John A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Sheffield, United Kingdom; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Gabriele Armbrecht
- Klinik für Radiologie, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - José António P Da Silva
- Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra and Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
| | - Andreas Egli
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland
| | - Gregor Freystätter
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich, Zurich, Switzerland; University Hospital Toulouse, IHU HealthAge Toulouse, France.
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Giustina A, Bilezikian JP, Adler RA, Banfi G, Bikle DD, Binkley NC, Bollerslev J, Bouillon R, Brandi ML, Casanueva FF, di Filippo L, Donini LM, Ebeling PR, Fuleihan GEH, Fassio A, Frara S, Jones G, Marcocci C, Martineau AR, Minisola S, Napoli N, Procopio M, Rizzoli R, Schafer AL, Sempos CT, Ulivieri FM, Virtanen JK. Consensus Statement on Vitamin D Status Assessment and Supplementation: Whys, Whens, and Hows. Endocr Rev 2024:bnae009. [PMID: 38676447 DOI: 10.1210/endrev/bnae009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Indexed: 04/28/2024]
Abstract
The 6th International Conference, "Controversies in Vitamin D," was convened to discuss controversial topics, such as vitamin D metabolism, assessment, actions, and supplementation. Novel insights into vitamin D mechanisms of action suggest links with conditions that do not depend only on reduced solar exposure or diet intake and that can be detected with distinctive noncanonical vitamin D metabolites. Optimal 25-hydroxyvitamin D (25(OH)D) levels remain debated. Varying recommendations from different societies arise from evaluating different clinical or public health approaches. The lack of assay standardization also poses challenges in interpreting data from available studies, hindering rational data pooling and meta-analyses. Beyond the well-known skeletal features, interest in vitamin D's extraskeletal effects has led to clinical trials on cancer, cardiovascular risk, respiratory effects, autoimmune diseases, diabetes, and mortality. The initial negative results are likely due to enrollment of vitamin D-replete individuals. Subsequent post hoc analyses have suggested, nevertheless, potential benefits in reducing cancer incidence, autoimmune diseases, cardiovascular events, and diabetes. Oral administration of vitamin D is the preferred route. Parenteral administration is reserved for specific clinical situations. Cholecalciferol is favored due to safety and minimal monitoring requirements. Calcifediol may be used in certain conditions, while calcitriol should be limited to specific disorders in which the active metabolite is not readily produced in vivo. Further studies are needed to investigate vitamin D effects in relation to the different recommended 25(OH)D levels and the efficacy of the different supplementary formulations in achieving biochemical and clinical outcomes within the multifaced skeletal and extraskeletal potential effects of vitamin D.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - John P Bilezikian
- Department of Medicine, Vagelos College of Physicians and Surgeons, New York, NY 10032, USA
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA 23284, USA
| | - Giuseppe Banfi
- IRCCS Galeazzi Sant'Ambrogio Hospital, Milano 20161, Italy
- San Raffaele Vita-Salute University, Milan 20132, Italy
| | - Daniel D Bikle
- Department of Medicine, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
- Department of Endocrinology, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
| | - Neil C Binkley
- School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI 53726, USA
| | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, KU Leuven, 3000 Leuven, Belgium
| | - Maria Luisa Brandi
- Italian Foundation for the Research on Bone Diseases (F.I.R.M.O.), Florence 50129, Italy
| | - Felipe F Casanueva
- Department of Medicine, Instituto de Investigación Sanitaria (IDIS), Complejo Hospitalario Universitario and CIBER de Fisiopatologia de la Obesidad y Nutricion (CIBERobn), Santiago de Compostela University, Santiago de Compostela 15706, Spain
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Lorenzo M Donini
- Department of Experimental Medicine, Sapienza University, Rome 00161, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton 3168, Australia
| | - Ghada El-Hajj Fuleihan
- Calcium Metabolism and Osteoporosis Program, WHO CC for Metabolic Bone Disorders, Division of Endocrinology, American University of Beirut, Beirut 1107 2020, Lebanon
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona 37129, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Glenville Jones
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, ON K7L 3N6, Canada
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa 56126, Italy
| | - Adrian R Martineau
- Faculty of Medicine and Dentistry, Queen Mary University of London, London E1 4NS, UK
| | - Salvatore Minisola
- Department of Clinical, Internal, Anesthesiologic and Cardiovascular Sciences, Sapienza University of Rome, Rome 00161, Italy
| | - Nicola Napoli
- Unit of Endocrinology and Diabetes Campus Bio-Medico, University of Rome, Rome 00128, Italy
| | - Massimo Procopio
- Division of Endocrinology, Diabetology and Metabolic Diseases, "Molinette" Hospital, University of Turin, Turin 10126, Italy
| | - René Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva 1205, Switzerland
| | - Anne L Schafer
- Department of Medicine, University of California and San Francisco Veterans Affairs Health Center, San Francisco, CA 94121-1545, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, San Raffaele Vita-Salute University and IRCCS Hospital, Milan 20132, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio FI-70211, Finland
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Giustina A, di Filippo L, Facciorusso A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Casanueva FF, Cavestro GM, Chakhtoura M, Conte C, Donini LM, Ebeling PR, Fassio A, Frara S, Gagnon C, Latella G, Marcocci C, Mechanick JI, Minisola S, Rizzoli R, Santini F, Shaker JL, Sempos C, Ulivieri FM, Virtanen JK, Napoli N, Schafer AL, Bilezikian JP. Correction: Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta‑analysis. Rev Endocr Metab Disord 2024; 25:447-448. [PMID: 38502455 PMCID: PMC10950986 DOI: 10.1007/s11154-023-09837-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, 3000 KU, Leuven, Belgium
| | - Felipe F Casanueva
- Molecular Endocrinology Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS). CIBER de Fisiopatologia de La Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Giulia Martina Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via Di Val Cannuta 247, 00166, Rome, Italy
| | - Lorenzo M Donini
- Experimental Medicine Department, Sapienza University, Rome, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Claudia Gagnon
- Department of Medicine, Université Laval, Quebec City, Canada
| | - Giovanni Latella
- Gastroenterology, Hepatology and Nutrition Division, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jeffrey I Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | | | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ferruccio Santini
- Obesity and Lipodystrophy Center, University Hospital of Pisa, Pisa, Italy
| | - Joseph L Shaker
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Nicola Napoli
- Department of Medicine and Surgery, Research Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Anne L Schafer
- University of California, San Francisco and the San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - John P Bilezikian
- Department of Medicine, Endocrinology Division, Vagelos College of Physicians and Surgeons Columbia University, New York, NY, USA
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Rizzoli R, Biver E. Role of fermented dairy products in the health benefits of a mediterranean diet. Aging Clin Exp Res 2024; 36:75. [PMID: 38502263 PMCID: PMC10950975 DOI: 10.1007/s40520-024-02721-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 02/06/2024] [Indexed: 03/21/2024]
Abstract
Mediterranean diet includes fermented dairy products like yogurt and cheese. These foods provide calcium, phosphorus, fat, carbohydrates and protein, all nutrients influencing various systems including bone, cardiovascular system, intermediary metabolism, cancer, central nervous system, and inflammation. In addition, they contain prebiotics and provide probiotics which are capable of modifiying microbiota composition and metabolism, potentially acting also indirectly on the various systems. A large body of evidence indicates that fermented dairy products consumption significantly contributes to the beneficial effects of a Mediterranean diet on various systems' health.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland.
| | - Emmanuel Biver
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva 14, Switzerland
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7
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Gaengler S, Sadlon A, De Godoi Rezende Costa Molino C, Willett WC, Manson JE, Vellas B, Steinhagen-Thiessen E, Von Eckardstein A, Ruschitzka F, Rizzoli R, da Silva JAP, Kressig RW, Kanis J, Orav EJ, Egli A, Bischoff-Ferrari HA. Effects of vitamin D, omega-3 and a simple strength exercise programme in cardiovascular disease prevention: The DO-HEALTH randomized controlled trial. J Nutr Health Aging 2024; 28:100037. [PMID: 38199870 DOI: 10.1016/j.jnha.2024.100037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2023] [Revised: 01/03/2024] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
BACKGROUND The effects of non-pharmaceutical interventions in the prevention of cardiovascular diseases (CVD) in older adults remains unclear. Therefore, the aim was to investigate the effect of 2000 IU/day of vitamin D3, omega-3 fatty acids (1 g/day), and a simple home strength exercise program (SHEP) (3×/week) on lipid and CVD biomarkers plasma changes over 3 years, incident hypertension and major cardiovascular events (MACE). METHODS The risk of MACE (coronary heart event or intervention, heart failure, stroke) was an exploratory endpoint of DO-HEALTH, incident hypertension and change in biomarkers were secondary endpoints. DO-HEALTH is a completed multicentre, randomised, placebo-controlled, 2 × 2 × 2 factorial design trial enrolling 2157 Europeans aged ≥70 years. RESULTS Participants' median age was 74 [72, 77] years, 61.7% were women, 82.5% were at least moderately physically active, and 40.7% had 25(OH)D < 20 ng/mL at baseline. Compared to their controls, omega-3 increased HDL-cholesterol (difference in change over 3 years: 0.08 mmol/L, 95% CI 0.05-0.10), decreased triglycerides (-0.08 mmol/L, (95%CI -0.12 to -0.03), but increased total- (0.15 mmol/L, 95%CI 0.09; 0.2), LDL- (0.11 mmol/L, 0.06; 0.16), and non-HDL-cholesterol (0.07 mmol/L, 95%CI 0.02; 0.12). However, neither omega-3 (adjustedHR 1.00, 95%CI 0.64-1.56), nor vitamin D3 (aHR 1.37, 95%CI 0.88-2.14), nor SHEP (aHR 1.18, 95%CI 0.76-1.84) reduced risk of MACE or incident hypertension compared to control. CONCLUSION Among generally healthy, active, and largely vitamin D replete, older adults, treatment with omega-3, vitamin D3, and/or SHEP had no benefit on MACE prevention. Only omega-3 supplementation changed lipid biomarkers, but with mixed effects. TRIAL REGISTRATION CLINICALTRIALS. GOV IDENTIFIER NCT01745263.
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Affiliation(s)
- Stephanie Gaengler
- Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland; Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Angélique Sadlon
- Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Caroline De Godoi Rezende Costa Molino
- Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland; Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Walter C Willett
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - JoAnn E Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Laboratory, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital, Boston, MA, USA
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France; IHU HealthAge, University Hospital Toulouse, France
| | | | - Arnold Von Eckardstein
- Institute of Clinical Chemistry, University of Zurich and University Hospital Zurich, Zurich, Switzerland
| | - Frank Ruschitzka
- Department of Cardiology, University Heart Center, University Hospital Zurich, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - José A P da Silva
- Centro Hospitalare Universitário de Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (ICBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER and University of Basel, Basel, Switzerland
| | - John Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Sheffield, United Kingdom; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - E John Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Andreas Egli
- Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland; Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Geriatrics and Aging Research, University of Zurich, Zurich, Switzerland; Centre on Aging and Mobility, University of Zurich, Zurich, Switzerland; Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France; IHU HealthAge, University Hospital Toulouse, France.
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8
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Abstract
PURPOSE OF REVIEW Recent findings in the influence of dietary patterns, dairy products, beverages and microbiota composition and function on bone health are reviewed and discussed. RECENT FINDINGS Evidence is accumulating on the increased risk of fracture in individuals following a vegan diet. Meta-analysis of randomized controlled trials indicates a favourable, though of low amplitude, effect of dairy products on bone mass accrual during childhood and adolescence. Though mostly based on results from observational studies, it seems that dairy product consumption, particularly fermented dairy products, is associated with a lower risk of hip fracture. Regular green tea drinkers may have a lower fracture risk than tea abstainers. Magnesium intake is beneficial for bone health. Prune supplements prevents bone loss in untreated postmenopausal women. This seems to be associated with modification of gut microbiota. SUMMARY This information should help the medical practitioners facing questions from their patients on how to protect bone health through nutrition.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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9
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Giustina A, di Filippo L, Facciorusso A, Adler RA, Binkley N, Bollerslev J, Bouillon R, Casanueva FF, Cavestro GM, Chakhtoura M, Conte C, Donini LM, Ebeling PR, Fassio A, Frara S, Gagnon C, Latella G, Marcocci C, Mechanick JI, Minisola S, Rizzoli R, Santini F, Shaker JL, Sempos C, Ulivieri FM, Virtanen JK, Napoli N, Schafer AL, Bilezikian JP. Vitamin D status and supplementation before and after Bariatric Surgery: Recommendations based on a systematic review and meta-analysis. Rev Endocr Metab Disord 2023; 24:1011-1029. [PMID: 37665480 PMCID: PMC10698146 DOI: 10.1007/s11154-023-09831-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/04/2023] [Indexed: 09/05/2023]
Abstract
Bariatric surgery is associated with a postoperative reduction of 25(OH) vitamin D levels (25(OH)D) and with skeletal complications. Currently, guidelines for 25(OH)D assessment and vitamin D supplementation in bariatric patients, pre- and post-surgery, are still lacking. The aim of this work is to analyse systematically the published experience on 25(OH)D status and vitamin D supplementation, pre- and post-surgery, and to propose, on this basis, recommendations for management. Preoperatively, 18 studies including 2,869 patients were evaluated. Prevalence of vitamin D insufficiency as defined by 25(OH)D < 30 ng/mL (75 nmol/L) was 85%, whereas when defined by 25(OH)D < 20 ng/mL (50 nmol/L) was 57%. The median preoperative 25(OH)D level was 19.75 ng/mL. After surgery, 39 studies including 5,296 patients were analysed and among those undergoing either malabsorptive or restrictive procedures, a lower rate of vitamin D insufficiency and higher 25(OH)D levels postoperatively were observed in patients treated with high-dose oral vitamin D supplementation, defined as ≥ 2,000 IU/daily (mostly D3-formulation), compared with low-doses (< 2,000 IU/daily). Our recommendations based on this systematic review and meta-analysis should help clinical practice in the assessment and management of vitamin D status before and after bariatric surgery. Assessment of vitamin D should be performed pre- and postoperatively in all patients undergoing bariatric surgery. Regardless of the type of procedure, high-dose supplementation is recommended in patients after bariatric surgery.
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Affiliation(s)
- Andrea Giustina
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy.
| | - Luigi di Filippo
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Antonio Facciorusso
- Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy
| | - Robert A Adler
- Richmond Veterans Affairs Medical Center and Virginia Commonwealth University, Richmond, VA, USA
| | | | | | - Roger Bouillon
- Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases, Metabolism and Ageing, 3000 KU, Leuven, Belgium
| | - Felipe F Casanueva
- Molecular Endocrinology Group, Instituto de Investigacion Sanitaria (IDIS), Complejo Hospitalario Universitario de Santiago (CHUS/SERGAS). CIBER de Fisiopatologia de La Obesidad y Nutricion (CIBERobn), Instituto de Salud Carlos III, Madrid, Spain
| | - Giulia Martina Cavestro
- Gastroenterology and Gastrointestinal Endoscopy Unit, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Marlene Chakhtoura
- Calcium Metabolism and Osteoporosis Program, American University of Beirut-Medical Center, Beirut, Lebanon
| | - Caterina Conte
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Via Di Val Cannuta 247, 00166, Rome, Italy
| | - Lorenzo M Donini
- Experimental Medicine Department, Sapienza University, Rome, Italy
| | - Peter R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - Angelo Fassio
- Rheumatology Unit, University of Verona, Verona, Italy
| | - Stefano Frara
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Claudia Gagnon
- Department of Medicine, Université Laval, Quebec City, Canada
| | - Giovanni Latella
- Gastroenterology, Hepatology and Nutrition Division, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Claudio Marcocci
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Jeffrey I Mechanick
- Kravis Center for Clinical Cardiovascular Health at Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | | | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ferruccio Santini
- Obesity and Lipodystrophy Center, University Hospital of Pisa, Pisa, Italy
| | - Joseph L Shaker
- Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Fabio Massimo Ulivieri
- Institute of Endocrine and Metabolic Sciences, Università Vita-Salute San Raffaele, IRCCS Ospedale San Raffaele, Via Olgettina 60, 20132, Milan, Italy
| | - Jyrki K Virtanen
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Nicola Napoli
- Department of Medicine and Surgery, Research Unit of Endocrinology and Diabetes, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21 - 00128, Roma, Italy
- Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200 - 00128, Roma, Italy
| | - Anne L Schafer
- University of California, San Francisco and the San Francisco Veterans Affairs Health Care System, San Francisco, USA
| | - John P Bilezikian
- Department of Medicine, Endocrinology Division, Vagelos College of Physicians and Surgeons Columbia University, New York, NY, USA
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10
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Hidayat K, Tong X, Rizzoli R, Fan JB, Shi YJ, Su HW, Liu B, Qin LQ. The skeletal safety of milk-derived proteins: A meta-analysis of randomized controlled trials. Osteoporos Int 2023; 34:1937-1949. [PMID: 37526672 DOI: 10.1007/s00198-023-06840-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Accepted: 06/21/2023] [Indexed: 08/02/2023]
Abstract
PURPOSE There has been a persistent claim that dairy products contain calcium-leaching proteins, although the soundness of such a claim has been challenged. A meta-analysis of randomized controlled trials (RCTs) on the effects of milk-derived protein supplementation on bone health indices in adults was performed to reconcile the controversy surrounding the potential skeletal safety concerns of proteins of dairy origin. METHODS The PubMed and Web of Science databases were searched for relevant RCTs. A random-effects model was used to generate pooled effect sizes and 95% confidence intervals. RESULTS Milk-derived protein supplementation did not significantly affect whole-body BMD (n = 7 RCTs) and BMD at the lumbar spine (n = 10), hip (n = 8), femoral neck (n = 9), trochanter (n = 5), intertrochanter (n = 2), and ultradistal radius (n = 2). The concentrations of bone formation markers (bone-specific alkaline phosphatase [n = 11], osteocalcin [n = 6], procollagen type 1 amino-terminal propeptide [n = 5]), bone resorption markers (N-terminal telopeptide of type 1 collagen [n = 7], C-terminal telopeptide of type 1 collagen [n = 7], deoxypyridinoline [n = 4]), and parathyroid hormone (n = 7) were not significantly affected. However, increased insulin-like growth factor-1 (IGF-1) concentrations (n = 13) were observed. Reduced IGF-1 concentrations were observed when soy protein was used as a comparator, and increased IGF-1 concentrations were observed when carbohydrate was used. CONCLUSION Our findings do not support the claim that proteins of dairy origin are detrimental to bone health.
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Affiliation(s)
- Khemayanto Hidayat
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China.
| | - Xing Tong
- Laboratory Center, Medical College of Soochow University, Suzhou, 215123, China
| | - René Rizzoli
- Division of Bone Diseases, Department of Internal Medicine, Geneva University Hospitals and Faculty of Medicine, 1211, Geneva, Switzerland
| | - Jing-Bo Fan
- Laboratory Center, Medical College of Soochow University, Suzhou, 215123, China
| | - Yu-Jie Shi
- Branch Company, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, 010110, China
| | - Hong-Wen Su
- Branch Company, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, 010110, China
| | - Biao Liu
- Branch Company, Inner Mongolia Yili Industrial Group Co., Ltd., Hohhot, 010110, China.
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, 215123, China.
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11
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Honvo G, Sabico S, Veronese N, Bruyère O, Rizzoli R, Amuthavalli Thiyagarajan J, Mikton C, Diaz T, Cooper C, Reginster JY. Measures of attributes of locomotor capacity in older people: a systematic literature review following the COSMIN methodology. Age Ageing 2023; 52:iv44-iv66. [PMID: 37902521 PMCID: PMC10615073 DOI: 10.1093/ageing/afad139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Indexed: 10/31/2023] Open
Abstract
BACKGROUND Locomotor capacity (LC) is an important domain of intrinsic capacity and key determinant of functional ability and well-being in older age. The United Nations Decade of Healthy Ageing (2021-2030) calls for strengthening data and research on healthy ageing, including the measurement of older persons' LC. To advance the measurement and monitoring of LC, there is pressing need to identify valid and reliable measures. OBJECTIVE To identify all the available tools that were validated for measurement of LC or of its specific attributes in older people and to assess the methodological quality of the studies and measurement properties of the tools. DESIGN Systematic review. SETTING Anywhere (Community-dwelling; long-term care facility; etc.). SUBJECTS Older people. METHODS We used highly sensitive search strategies to search the following databases: Medline, Embase, Scopus, CINAHL and PsycINFO. The study was conducted following the COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) methodology for systematic review of outcome measurement instruments. RESULTS A total of 125 studies were included, which assessed tools for balance (n = 84), muscle power (n = 12), muscle strength (n = 32, including four studies about tools for balance and muscle power) and endurance (n = 1). No studies on tools for muscle function, joint function, or locomotor capacity overall, were retrieved. We identified 69 clinician-report or objective assessment tools for balance, 30 for muscle strength, 12 for muscle power and 1 endurance assessment tool. The GRADE assessment of quality of evidence showed that only a few tools have high quality evidence for both sufficient validity and reliability: The Balance Evaluation Systems Test (BESTest), the Mini-Balance Evaluation Systems Test (Mini-BESTest), the Berg Balance Scale (BBS) and the Timed Up and Go (TUG) test. CONCLUSIONS A few tools with high quality evidence for sufficient validity and reliability are currently available for balance assessment in older people that may be recommended for use in clinical and research settings. Further validation studies are required for muscle strength, muscle power and endurance assessment tools.
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Affiliation(s)
- Germain Honvo
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Nicola Veronese
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Olivier Bruyère
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - Christopher Mikton
- Demographic Change and Healthy Aging Unit, Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Theresa Diaz
- Epidemiology, Monitoring and Evaluation Unit, Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Cyrus Cooper
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - Jean-Yves Reginster
- World Health Organization (WHO) Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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12
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Ladang A, Beaudart C, Reginster JY, Al-Daghri N, Bruyère O, Burlet N, Cesari M, Cherubini A, da Silva MC, Cooper C, Cruz-Jentoft AJ, Landi F, Laslop A, Maggi S, Mobasheri A, Ormarsdottir S, Radermecker R, Visser M, Yerro MCP, Rizzoli R, Cavalier E. Correction: Biochemical Markers of Musculoskeletal Health and Aging to be Assessed in Clinical Trials of Drugs Aiming at the Treatment of Sarcopenia: Consensus Paper from an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the Centre Académique de Recherche et d'Expérimentation en Santé (CARES SPRL), Under the Auspices of the World Health Organization Collaborating Center for the Epidemiology of Musculoskeletal Conditions and Aging. Calcif Tissue Int 2023; 113:357-358. [PMID: 37488204 PMCID: PMC10449976 DOI: 10.1007/s00223-023-01114-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2023] [Indexed: 07/26/2023]
Affiliation(s)
- Aurélie Ladang
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium.
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Nasser Al-Daghri
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione Geriatrica e Centro Di Ricerca Per L'invecchiamento, IRCCS INRCA, Ancona, Italy
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | | | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Vienna, Austria
| | | | - Ali Mobasheri
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
- State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | - Régis Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liege, CHU de Liège, Liège, Belgium
| | - Marjolein Visser
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - René Rizzoli
- Faculty of Medicine, Service of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
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13
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Beaudart C, Demonceau C, Sabico S, Veronese N, Cooper C, Harvey N, Fuggle N, Bruyère O, Rizzoli R, Reginster JY. Efficacy of osteoporosis pharmacological treatments in men: a systematic review and meta-analysis. Aging Clin Exp Res 2023; 35:1789-1806. [PMID: 37400668 PMCID: PMC10460304 DOI: 10.1007/s40520-023-02478-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 06/07/2023] [Indexed: 07/05/2023]
Abstract
INTRODUCTION The objective of this systematic review and meta-analysis is to systematically identify and review the efficacy of pharmacological treatments in men with osteoporosis. METHODS Medline (via Ovid) and Cochrane CENTRAL were searched up to May 2023 for any randomized controlled trial (RCT) evaluating the efficacy of osteoporotic treatment on the evolution of Bone Mineral Density (BMD) and incidence of fractures of men suffering from primary osteoporosis. If at least two studies used the same pharmacological treatment and evaluated the same outcome, a random effect model meta-analysis was applied to reported pooled mean difference (MD) and 95% confidence interval (CI). RESULTS From the 1,061 studies identified through bibliographic search, 21 RCTs fitted the inclusion criteria. Bisphosphonates (k = 10, n = 2992 men with osteoporosis) improved all three BMD sites compared to placebo; lumbar spine: MD + 4.75% (95% CI 3.45, 6.05); total hip: MD + 2.72% (95% CI 2.06; 3.37); femoral neck: MD + 2.26% (95% CI 1.67; 2.85). Denososumab (k = 2, n = 242), Teriparatide (k = 2, n = 309) and Abaloparatide (k = 2, n = 248) also produced significant improvement of all sites BMD compared to placebo. Romosozumab was only identified in one study and was therefore not meta-analysed. In this study, Romosozumab increased significantly BMD compared to placebo. Incident fractures were reported in 16 RCTs but only four reported fractures as the primary outcome. Treatments were associated with a lower incidence of fractures. CONCLUSIONS Medications used in the management of osteoporosis in women appear to provide similar benefits in men with osteoporosis. Therefore, the algorithm for the management of osteoporosis in men could be similar to the one previously recommended for the management of osteoporosis in women.
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Affiliation(s)
- Charlotte Beaudart
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - Céline Demonceau
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - Shaun Sabico
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451 Saudi Arabia
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine, Geriatrics Section, University of Palermo, via del Vespro, 141, 90127 Palermo, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Nicholas Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD UK
| | - Olivier Bruyère
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Hopitaux Universitaires Geneve, Geneva, Switzerland
| | - Jean-Yves Reginster
- WHO Collaborating Center for Public Health aspects of musculo-skeletal health and ageing, WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Aging, Division of Public Health, Epidemiology and Health Economics, University of Liège, Belgium, Avenue Hippocrate 13, CHU Bât B23, 4000 Liège, Belgium
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14
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Hidayat K, Zhang LL, Rizzoli R, Guo YX, Zhou Y, Shi YJ, Su HW, Liu B, Qin LQ. The Effects of Dairy Product Supplementation on Bone Health Indices in Children Aged 3 to 18 Years: A Meta-Analysis of Randomized Controlled Trials. Adv Nutr 2023; 14:1187-1196. [PMID: 37414219 PMCID: PMC10509403 DOI: 10.1016/j.advnut.2023.06.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2022] [Revised: 05/29/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023] Open
Abstract
Childhood and adolescence are critical periods for optimizing skeletal growth. Dairy products are valuable sources of bone-beneficial nutrients, particularly calcium and protein. A random-effects meta-analysis of published randomized controlled trials was performed to quantitatively assess the effects of dairy supplementation on bone health indices in children and adolescents. The PubMed and Web of Science databases were searched. Dairy supplementation increased whole-body bone mineral content (BMC) (+25.37 g) and areal bone mineral density (aBMD) (+0.016 g/cm2), total hip BMC (+0.49 g) and aBMD (+0.013 g/cm2), femoral neck BMC (+0.06 g) and aBMD (+0.030 g/cm2), lumbar spine BMC (+0.85 g) and aBMD (+0.019 g/cm2), and height (0.21 cm). When expressed as a percentage difference, whole-body BMC was increased by 3.0%, total hip BMC by 3.3%, femoral neck BMC by 4.0%, lumbar spine BMC by 4.1%, whole-body aBMD by 1.8%, total hip aBMD by 1.2%, femoral neck aBMD by 1.5%, and lumbar spine aBMD by 2.6%. Dairy supplementation increased serum insulin-like growth factor I concentrations (19.89 nmol/L) and reduced concentrations of urinary deoxypyridinoline (-1.78 nmol/mmol creatinine) and serum parathyroid hormone (-10.46 pg/mL) but did not significantly affect the serum concentrations of osteocalcin, bone alkaline phosphatase, and C-terminal telopeptide of type 1 collagen. Serum 25-hydroxyvitamin D concentrations (+4.98 ng/mL) increased with vitamin D-fortified dairy supplementation. The positive effects on bone mineral mass parameters and height were generally consistent across subgroups defined by sex, geographical region, baseline calcium intake, calcium from the supplementation, trial duration, and Tanner stages. In summary, dairy supplementation during growth leads to a small but significant increase in bone mineral mass parameters, and these findings are generally supported by the changes in several biochemical parameters related to bone health.
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Affiliation(s)
- Khemayanto Hidayat
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
| | - Li-Li Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - René Rizzoli
- Division of Bone Diseases, Department of Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Ya-Xin Guo
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yan Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Yu-Jie Shi
- Branch Company, Inner Mongolia Yili Industrial Group Co, Ltd, Hohhot, China
| | - Hong-Wen Su
- Branch Company, Inner Mongolia Yili Industrial Group Co, Ltd, Hohhot, China
| | - Biao Liu
- Branch Company, Inner Mongolia Yili Industrial Group Co, Ltd, Hohhot, China.
| | - Li-Qiang Qin
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China.
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15
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Gagesch M, Wieczorek M, Abderhalden LA, Lang W, Freystaetter G, Armbrecht G, Kressig RW, Vellas B, Rizzoli R, Blauth M, Orav EJ, Egli A, Bischoff-Ferrari HA. Grip strength cut-points from the Swiss DO-HEALTH population. Eur Rev Aging Phys Act 2023; 20:13. [PMID: 37543639 PMCID: PMC10403936 DOI: 10.1186/s11556-023-00323-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 07/25/2023] [Indexed: 08/07/2023] Open
Abstract
BACKGROUND While grip strength (GS) is commonly assessed using a Dynamometer, the Martin Vigorimeter was proposed as an alternative method especially in older adults. However, its reference values for Swiss older adults are missing. We therefore aimed to derive sex- and age-specific GS cut-points for the dominant and non-dominant hand (DH; NDH) using the Martin Vigorimeter. Additionally, we aimed to identify clinically relevant weakness and assess convergent validity with key markers of physical function and sarcopenia in generally healthy Swiss older adults. METHODS This cross-sectional analysis includes baseline data from Swiss participants enrolled in DO-HEALTH, a 3-year randomized controlled trial in community-dwelling adults age 70 + . For both DH and NDH, 4 different definitions of weakness to derive GS cut-points by sex and age category (≤ 75 vs. > 75 years) were used: i) GS below the median of the 1st quintile, ii) GS below the upper limit of the 1st quintile, iii) GS below 2-standard deviation (SD) of the sex- and age-specific mean in DO-HEALTH Swiss healthy agers (i.e. individuals without major chronic diseases, disabilities, cognitive impairment or mental health issues) and iv) GS below 2.5-SD of the sex- and age-specific mean in DO-HEALTH Swiss healthy agers. To assess the proposed cut-points' convergent validity, we assessed their association with gait speed, time to complete the 5 Times Sit-To-Stand (5TSTS) test, and present sarcopenia. RESULTS In total, 976 participants had available GS at the DH (mean age 75.2, 62% women). According to the 4 weakness definitions, GS cut-points at the DH ranged from 29-42 and 25-39 kPa in younger and older women respectively, and from 51-69 and 31-50 kPa in younger and older men respectively. Overall, weakness prevalence ranged from 2.0% to 19.3%. Definitions of weakness using the median and the upper limit of the 1st GS quintile were most consistently associated with markers of physical performance. Weak participants were more likely to have lower gait speed, longer time to complete the 5TSTS, and sarcopenia, compared to participants without weakness. CONCLUSIONS In generally healthy Swiss older adults, weakness defined by the median or the upper limit of the 1st GS quintile may serve as reference to identify clinically relevant weakness. Additional research is needed in less healthy populations in order to derive representative population-based cut-points. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01745263.
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Affiliation(s)
- Michael Gagesch
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland.
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland.
| | - Maud Wieczorek
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Lauren A Abderhalden
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Wei Lang
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Gregor Freystaetter
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Gabriele Armbrecht
- Department of Radiology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Berlin, Germany
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, Basel, Switzerland
| | - Bruno Vellas
- UMR INSERM 1027, Gérontopôle, Toulouse University Hospital, University of Toulouse, Toulouse, France
- IHU HealthAge, University Hospital Toulouse, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | | | - E John Orav
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Andreas Egli
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- Center On Aging and Mobility, University Hospital Zurich, City Hospital Zurich Waid and University of Zurich, Zurich, Switzerland
- IHU HealthAge, University Hospital Toulouse, Toulouse, France
- University Clinic for Acute Geriatric Care, City Hospital Waid and Triemli, Zurich, Switzerland
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Moon RJ, Reginster JY, Al-Daghri NM, Thiyagarajan JA, Beaudart C, Bruyère O, Burlet N, Chandran M, da Silva MC, Conaghan PG, Dere WH, Diez-Perez A, Hadji P, Halbout P, Hiligsmann M, Kanis JA, McCloskey EV, Ormarsdottir S, Prieto-Alhambra D, Radermecker RP, Rizzoli R, Al-Saleh Y, Silverman SL, Simon LS, Thomasius F, van Staa T, Laslop A, Cooper C, Harvey NC. Real-world evidence: new opportunities for osteoporosis research. Recommendations from a Working Group from the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO). Osteoporos Int 2023; 34:1283-1299. [PMID: 37351614 PMCID: PMC10382414 DOI: 10.1007/s00198-023-06827-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 04/28/2023] [Indexed: 06/24/2023]
Abstract
This narrative review summarises the recommendations of a Working Group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) for the conduct and reporting of real-world evidence studies with a focus on osteoporosis research. PURPOSE Vast amounts of data are routinely generated at every healthcare contact and activity, and there is increasing recognition that these real-world data can be analysed to generate scientific evidence. Real-world evidence (RWE) is increasingly used to delineate the natural history of disease, assess real-life drug effectiveness, understand adverse events and in health economic analysis. The aim of this work was to understand the benefits and limitations of this type of data and outline approaches to ensure that transparent and high-quality evidence is generated. METHODS A ESCEO Working Group was convened in December 2022 to discuss the applicability of RWE to osteoporosis research and approaches to best practice. RESULTS This narrative review summarises the agreed recommendations for the conduct and reporting of RWE studies with a focus on osteoporosis research. CONCLUSIONS It is imperative that research using real-world data is conducted to the highest standards with close attention to limitations and biases of these data, and with transparency at all stages of study design, data acquisition and curation, analysis and reporting to increase the trustworthiness of RWE study findings.
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Affiliation(s)
- Rebecca J Moon
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK
- Paediatric Endocrinology, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Jean-Yves Reginster
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, Liège, Belgium
- Division of Epidemiology, Public Health and Health Economics, University of Liège, Liège, Belgium
| | - Nasser M Al-Daghri
- Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | | | - Charlotte Beaudart
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, Liège, Belgium
- Division of Epidemiology, Public Health and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- WHO Collaborating Center for Epidemiology of Musculoskeletal Health and Ageing, Liège, Belgium
- Division of Epidemiology, Public Health and Health Economics, University of Liège, Liège, Belgium
| | - Nansa Burlet
- Division of Epidemiology, Public Health and Health Economics, University of Liège, Liège, Belgium
| | - Manju Chandran
- Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | | | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds, Leeds, UK
- NIHR Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK
| | - Willard H Dere
- Department of Internal Medicine, Utah Center for Clinical and Translational Science, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Adolfo Diez-Perez
- Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Barcelona, Spain
| | - Peyman Hadji
- Frankfurt Centre for Bone Health, Frankfurt, Germany
- Philipps University of Marburg, Hesse, Germany
| | | | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - John A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - Eugene V McCloskey
- MRC Versus Arthritis Centre for Integrated Research in Musculoskeletal Ageing, University of Sheffield, Sheffield, UK
- Mellanby Centre for Musculoskeletal Research, Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK
| | | | - Daniel Prieto-Alhambra
- Pharmaco- and Device Epidemiology, Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
| | - Régis P Radermecker
- Department of Clinical Pharmacology, Diabetes, Nutrition and Metabolic Disorders, CHU Liege, Liege, Belgium
| | - René Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Yousef Al-Saleh
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
- Department of Medicine, King Abdulaziz Medical City, Riyadh, Ministry of National Guard-Health Affairs, Riyadh, Saudi Arabia
| | | | | | | | - Tjeerd van Staa
- Centre for Health Informatics, University of Manchester, Manchester, UK
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- National Institute for Health Research (NIHR) Musculoskeletal Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, SO16 6YD, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
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Beaudart C, Reginster JY, Amuthavalli Thiyagarajan J, Bautmans I, Bauer J, Burlet N, Cesari M, Cherubini A, Cooper C, Cruz-Jentoft AJ, Dawson-Hughes B, Fielding RA, Harvey NC, Landi F, Laslop A, Maggi S, Montero-Errasquin B, Concepción PYM, Rolland Y, Rizzoli R, Visser M, Bruyère O. Measuring health-related quality of life in sarcopenia: summary of the SarQoL psychometric properties. Aging Clin Exp Res 2023; 35:1581-1593. [PMID: 37219755 PMCID: PMC10363087 DOI: 10.1007/s40520-023-02438-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 05/08/2023] [Indexed: 05/24/2023]
Abstract
Patient perspectives are now widely recognized as a key element in the evaluation of health interventions. Therefore, the provision of specific and validated Patient Reported Outcome Measures that emphasize the lived experience of patients suffering from specific diseases is very important. In the field of sarcopenia, the only validated specific health-related quality of life (HRQoL) instrument available is the Sarcopenia Quality of Life questionnaire (SarQoL). This self-administrated HRQoL questionnaire, developed in 2015, consists of 55 items arranged into 22 questions and has currently been translated into 35 languages. Nineteen validation studies performed on SarQoL have consensually confirmed the capacity of SarQoL to detect difference in HRQoL between older people with and without sarcopenia, its reliability and its validity. Two further observational studies have also indicated its responsiveness to change. A short form SarQoL, including only 14 items has further been developed and validated to reduce the potential burden of administration. Research on the psychometric properties of SarQoL questionnaire is still encouraged as the responsiveness to change of SarQoL has not yet been measured in the context of interventional studies, as limited prospective data currently exist and as there is still not cut-off score to define a low HRQoL. In addition, SarQoL has mainly been used in community-dwelling older individuals with sarcopenia and would benefit to be studied in other types of populations. This review aims to provide to researchers, clinicians, regulators, pharmaceutical industries and other stakeholders a clear summary of comprehensive evidence on the SarQoL questionnaire published up to January 2023Query.
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Affiliation(s)
- Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium.
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | | | - Ivan Bautmans
- Frailty in Ageing Research Department, Vrije Universiteit Brussel, Brussels, Belgium
| | - Jürgen Bauer
- Center for Geriatric Medicine and Network Aging Research (NAR), Heidelberg University, Heidelberg, Germany
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | | | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, USA
| | - Roger A Fielding
- Nutrition, Exercise Physiology and Sarcopenia Laboratory, Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, USA
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Francesco Landi
- Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, 00168, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | | | | | - Yves Rolland
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, CERPOP UMR 1295, University of Toulouse III, Inserm, Toulouse, France
| | - René Rizzoli
- Service of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Marjolein Visser
- Department of Health Sciences, Faculty of Science, Vrije Universiteit Amsterdam and the Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liège, Belgium
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18
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Cooper C, Dawson-Hughes B, Halbout P, Harvey NC, Kanis JA, Reginster JY, Rizzoli R. In Memoriam : Lorie Fitzpatrick MD - 1954-2023. Osteoporos Int 2023; 34:1281-1282. [PMID: 37162536 DOI: 10.1007/s00198-023-06767-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- C Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Biomedical Research Centre, University of Oxford, Oxford, UK
| | - B Dawson-Hughes
- Division of Endocrinology, Diabetes and Metabolism, Tufts Medical Center, and Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - P Halbout
- International Osteoporosis Foundation, Nyon, Switzerland
| | - N C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - J A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia.
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK.
| | - J-Y Reginster
- World Health Organization (WHO) Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - R Rizzoli
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
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Lecomte M, Tomassi D, Rizzoli R, Tenon M, Berton T, Harney S, Fança-Berthon P. Effect of a Hop Extract Standardized in 8-Prenylnaringenin on Bone Health and Gut Microbiome in Postmenopausal Women with Osteopenia: A One-Year Randomized, Double-Blind, Placebo-Controlled Trial. Nutrients 2023; 15:2688. [PMID: 37375599 DOI: 10.3390/nu15122688] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 05/21/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Estrogen deficiency increases the risk of osteoporosis and fracture. The aim of this study was to investigate whether a hop extract standardized in 8-prenylnaringenin (8-PN), a potent phytoestrogen, could improve bone status of osteopenic women and to explore the gut microbiome roles in this effect. In this double-blind, placebo-controlled, randomized trial, 100 postmenopausal, osteopenic women were supplemented with calcium and vitamin D3 (CaD) tablets and either a hop extract (HE) standardized in 8-PN (n = 50) or a placebo (n = 50) for 48 weeks. Bone mineral density (BMD) and bone metabolism were assessed by DXA measurements and plasma bone biomarkers, respectively. Participant's quality of life (SF-36), gut microbiome composition, and short-chain fatty acid (SCFA) levels were also investigated. In addition to the CaD supplements, 48 weeks of HE supplementation increased total body BMD (1.8 ± 0.4% vs. baseline, p < 0.0001; 1.0 ± 0.6% vs. placebo, p = 0.08), with a higher proportion of women experiencing an increase ≥1% compared to placebo (odds ratio: 2.41 ± 1.07, p < 0.05). An increase in the SF-36 physical functioning score was observed with HE versus placebo (p = 0.05). Gut microbiome α-diversity and SCFA levels did not differ between groups. However, a higher abundance of genera Turicibacter and Shigella was observed in the HE group; both genera have been previously identified as associated with total body BMD. These results suggest that an 8-PN standardized hop extract could beneficially impact bone health of postmenopausal women with osteopenia.
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Affiliation(s)
| | | | - René Rizzoli
- Service of Bone Disease, Geneva University Hospitals and Faculty of Medicine, 1211 Geneva, Switzerland
| | | | | | - Sinead Harney
- Rheumatology Department, Cork University Hospital, T12 DFK4 Cork, Ireland
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Fuggle N, Al-Daghri N, Bock O, Branco J, Bruyère O, Casado E, Cavalier E, Cortet B, de Wit M, Giusti A, Halbout P, Harvey NC, Hiligsmann M, Kaufman JM, Kurth A, Maggi S, Matijevic R, Minisola S, Palacios S, Radermecker RP, Thomasius F, Tuzun S, Veronese N, Kanis JA, Reginster JY, Rizzoli R, Cooper C. Correction: Novel formulations of oral bisphosphonates in the treatment of osteoporosis. Aging Clin Exp Res 2023; 35:1375-1376. [PMID: 36595210 PMCID: PMC10200775 DOI: 10.1007/s40520-022-02319-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Olivier Bock
- Department of Osteoporosis, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland
- International Osteoporosis Foundation, Nyon, Switzerland
| | - Jaime Branco
- Centro Hospitalar de Lisboa Ocidental-Hospital Egas Moniz, CEDOC/NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
| | - Enrique Casado
- Department of Rheumatology, University Hospital Parc Taulí, I3PT Research Institute (UAB), Sabadell, Barcelona, Spain
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CIRM, CHU Sart-Tilman, 4000, Liège, Belgium
| | - Bernard Cortet
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France
| | - Maarten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Andrea Giusti
- Metabolic Bone Diseases Unit and Fracture Liaison Service, Rheumatology Unit, Department of Medical Specialties, Local Health Trust 3, Via Missolungi 14, 16147, Genoa, Italy
| | | | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Andreas Kurth
- Department of Orthopaedic and Trauma Surgery, Community Clinics Middle Rhine, Campus Kemperhof, Koblenz, Germany
| | - Stefania Maggi
- Institute of Neuroscience, Aging Branch, CNR, Padua, Italy
| | - Radmila Matijevic
- Faculty of Medicine, Clinic for Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | - Salvatore Minisola
- Department of Clinical, Internal, Anaesthesiology, and Cardiovascular Sciences, Sapienza University of Rome, 00185, Rome, Italy
| | | | - Régis Pierre Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liège, CHU de Liège, Liège, Belgium
| | | | - Sansin Tuzun
- Department of Physical Medicine and Rehabilitation, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - John A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - Jean-Yves Reginster
- Centro Hospitalar de Lisboa Ocidental-Hospital Egas Moniz, CEDOC/NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - René Rizzoli
- Department of Osteoporosis, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France.
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
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Trost W, Hars M, Fernandez N, Herrmann F, Chevalley T, Ferrari S, Gold G, Rizzoli R, Vuilleumier P, Trombetti A. Functional brain changes in sarcopenia: evidence for differential central neural mechanisms in dynapenic older women. Aging Clin Exp Res 2023; 35:1015-1025. [PMID: 37029271 PMCID: PMC10149465 DOI: 10.1007/s40520-023-02391-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 03/10/2023] [Indexed: 04/09/2023]
Abstract
BACKGROUND The European Working Group on Sarcopenia in Older People (EWGSOP2) recently revised its definition and diagnostic criteria for sarcopenia, placing muscle strength at the forefront. The pathogenesis of dynapenia (or low muscle strength) is still not fully understood, but there is emerging evidence that central neural factors constitute critical determinants. METHODS Our cross-sectional study included 59 community-dwelling older women (mean age 73.1 ± 4.9 years). Participants underwent detailed skeletal muscle assessments for muscle strength defined by handgrip strength and chair rise time measurements using the recently published EWGSOP2 cut-off points. Functional magnetic resonance imaging (fMRI) was assessed during the performance of a cognitive dual-task paradigm, consisting of a baseline, two single-tasks (motor and arithmetic) and one dual-task (motor and arithmetic combined). RESULTS Forty-seven percent (28/59) of participants were classified as dynapenic. fMRI results revealed a differential recruitment of motor circuits in the brain during the dual-task condition in dynapenic as compared with non-dynapenic participants. In particular, while the brain activity during the single-tasks did not differ between the two groups, only during the dual-task non-dynapenic participants showed significant increased activation in dorsolateral prefrontal and premotor cortex, and in supplementary motor area as compared to dynapenic participants. CONCLUSION Our results point to a dysfunctional involvement of brain networks associated with motor control in dynapenia in a multi-tasking paradigm. A better knowledge of the link between dynapenia and brain functions could provide new impulses in the diagnosis and interventions for sarcopenia.
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Affiliation(s)
- Wiebke Trost
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
- Laboratory for Behavioural Neurology and Imaging of Cognition, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Mélany Hars
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Natalia Fernandez
- Laboratory for Behavioural Neurology and Imaging of Cognition, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - François Herrmann
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - Thierry Chevalley
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
| | - Serge Ferrari
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
| | - Gabriel Gold
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland
| | - Patrik Vuilleumier
- Laboratory for Behavioural Neurology and Imaging of Cognition, Campus Biotech, University of Geneva, Geneva, Switzerland
| | - Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva 14, Switzerland.
- Division of Geriatrics and Rehabilitation, Department of Rehabilitation and Geriatrics, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland.
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22
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Rizzoli R. A tribute to Uri A. Liberman, 1935-2022. Osteoporos Int 2023; 34:821-822. [PMID: 36725702 DOI: 10.1007/s00198-023-06677-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- René Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Veronese N, Honvo G, Bruyère O, Rizzoli R, Barbagallo M, Maggi S, Smith L, Sabico S, Al-Daghri N, Cooper C, Pegreffi F, Reginster JY. Knee osteoarthritis and adverse health outcomes: an umbrella review of meta-analyses of observational studies. Aging Clin Exp Res 2023; 35:245-252. [PMID: 36331799 PMCID: PMC9895027 DOI: 10.1007/s40520-022-02289-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 10/19/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Knee osteoarthritis (OA) is a common condition, associated with a high rate of disability and poor quality of life. Despite the importance of such evidence in public health, no umbrella review (i.e., a review of other systematic reviews and meta-analyses) has systematically assessed evidence on association between knee OA and adverse health outcomes. AIMS To map and grade all health outcomes associated with knee OA using an umbrella review approach. METHODS The search was made across several databases up to 22 April 2022. We used an umbrella review of systematic reviews with meta-analyses of observational studies assessing the effect sizes, based on random effect summary, 95% prediction intervals, heterogeneity, small study effects, and excess significance bias. The evidence was then graded from convincing (class I) to weak (class IV). RESULTS Among 3,847 studies initially considered, five meta-analyses were included for a total of five different outcomes. Three adverse outcomes were significantly associated with knee OA (i.e., cardiovascular mortality, falls, and subclinical atherosclerosis). The presence of knee OA was associated with a significantly higher risk of cardiovascular mortality (odds ratio, OR = 1.17; 95%CI, confidence intervals: 1.02-1.34), falls (RR = 1.34; 95%CI: 1.10-1.64), and conditions associated with subclinical atherosclerosis (OR = 1.43; 95%CI: 1.003-2.05). The certainty of each of this evidence was weak. CONCLUSIONS Our umbrella review suggests that knee OA can be considered as putative risk factor for some medical conditions, including cardiovascular diseases and falls, however, it is important to note that the evidence is affected by potential biases.
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Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy.
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia.
| | - Germain Honvo
- World Health Organization (WHO) Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Olivier Bruyère
- World Health Organization (WHO) Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- World Health Organization (WHO) Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy
| | | | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Shaun Sabico
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Francesco Pegreffi
- Department for Life Quality Studies, University of Bologna, Bologna, Italy
| | - Jean-Yves Reginster
- World Health Organization (WHO) Collaborating Center for Public Health Aspects of Musculoskeletal Health and Aging, University of Liège, Liège, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
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24
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Ladang A, Beaudart C, Reginster JY, Al-Daghri N, Bruyère O, Burlet N, Cesari M, Cherubini A, da Silva MC, Cooper C, Cruz-Jentoft AJ, Landi F, Laslop A, Maggi S, Mobasheri A, Ormarsdottir S, Radermecker R, Visser M, Yerro MCP, Rizzoli R, Cavalier E. Biochemical Markers of Musculoskeletal Health and Aging to be Assessed in Clinical Trials of Drugs Aiming at the Treatment of Sarcopenia: Consensus Paper from an Expert Group Meeting Organized by the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) and the Centre Académique de Recherche et d'Expérimentation en Santé (CARES SPRL), Under the Auspices of the World Health Organization Collaborating Center for the Epidemiology of Musculoskeletal Conditions and Aging. Calcif Tissue Int 2023; 112:197-217. [PMID: 36633611 PMCID: PMC9859913 DOI: 10.1007/s00223-022-01054-z] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 12/18/2022] [Indexed: 01/13/2023]
Abstract
In clinical trials, biochemical markers provide useful information on the drug's mode of action, therapeutic response and side effect monitoring and can act as surrogate endpoints. In pharmacological intervention development for sarcopenia management, there is an urgent need to identify biomarkers to measure in clinical trials and that could be used in the future in clinical practice. The objective of the current consensus paper is to provide a clear list of biochemical markers of musculoskeletal health and aging that can be recommended to be measured in Phase II and Phase III clinical trials evaluating new chemical entities for sarcopenia treatment. A working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) proposed classifying biochemical markers into 2 series: biochemical markers evaluating musculoskeletal status and biochemical markers evaluating causal factors. For series 1, the group agreed on 4 biochemical markers that should be assessed in Phase II or Phase III trials (i.e., Myostatin-Follistatin, Brain Derived Neurotrophic Factor, N-terminal Type III Procollagen and Serum Creatinine to Serum Cystatin C Ratio - or the Sarcopenia Index). For series 2, the group agreed on 6 biochemical markers that should be assessed in Phase II trials (i.e., the hormones insulin-like growth factor-1 (IGF-I), dehydroepiandrosterone sulphate, and cortisol, and the inflammatory markers C-reactive protein (CRP), interleukin-6 and tumor necrosis factor-α), and 2 in Phase III trials (i.e., IGF-I and CRP). The group also proposed optional biochemical markers that may provide insights into the mode of action of pharmacological therapies. Further research and development of new methods for biochemical marker assays may lead to the evolution of these recommendations.
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Affiliation(s)
- Aurélie Ladang
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium.
| | - Charlotte Beaudart
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Nasser Al-Daghri
- Biochemistry Department, College of Science, Chair for Biomarkers of Chronic Diseases, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
| | - Nansa Burlet
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
| | - Matteo Cesari
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
- Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antonio Cherubini
- Geriatric Unit, IRCCS Istituti Clinici Scientifici Maugeri, Milan, Italy
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | | | - Francesco Landi
- Department of Geriatrics, Neurosciences and Orthopedics, Catholic University of the Sacred Heart, Rome, Italy
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Vienna, Austria
| | | | - Ali Mobasheri
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing,, University of Liège, Liège, Belgium
- State Research Institute Centre for Innovative Medicine, Vilnius, Lithuania
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China
| | | | - Régis Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liege, CHU de Liège, Liège, Belgium
| | - Marjolein Visser
- Department of Health Sciences, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | - René Rizzoli
- Faculty of Medicine, Service of Bone Diseases, Geneva University Hospitals, Geneva, Switzerland
| | - Etienne Cavalier
- Department of Clinical Chemistry, CHU de Liège, University of Liège, Liège, Belgium
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25
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Huberty S, Freystätter G, Wieczorek M, Dawson-Hughes B, Kanis JA, Rizzoli R, Kressig RW, Vellas B, Da Silva JAP, Armbrecht G, Theiler R, Egli A, Orav EJ, Bischoff-Ferrari HA. Association Between Multimorbidity and Rate of Falls: A 3-Year 5-Country Prospective Study in Generally Healthy and Active Community-Dwelling Adults Aged ≥70 Years. J Am Med Dir Assoc 2023:S1525-8610(22)00971-9. [PMID: 36657487 DOI: 10.1016/j.jamda.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 10/25/2022] [Accepted: 12/06/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To examine the association between the baseline number of chronic diseases and multimorbidity with regard to the incidence of all and injurious falls over 3 years among European community-dwelling older adults. DESIGN Observational analysis of DO-HEALTH, a double-blind, randomized controlled trial. SETTING AND PARTICIPANTS Multicenter trial with 7 European centers: Zurich, Basel, Geneva (Switzerland), Berlin (Germany), Innsbruck (Austria), Toulouse (France), and Coimbra (Portugal), including 2157 community-dwelling adults aged 70 years and older without any major health events in the 5 years prior to enrollment, sufficient mobility, and good cognitive status. METHODS The main outcomes were the number of all falls and injurious falls experienced over 3 years. The number of chronic diseases and multimorbidity, defined as the presence of 3 or more chronic diseases at baseline, were assessed with the Self-Administered Comorbidity Questionnaire by Sangha et al. RESULTS Among the 2155 participants included in the analyses (mean age: 74.9 years, 62% were women, 52% were physically active more than 3 times a week), 569 (26.4%) had multimorbidity at baseline. Overall, each 1-unit increase in the baseline number of chronic diseases was linearly associated with a 7% increased incidence rate of all falls [adjusted incidence rate ratio (aIRR) 1.07, 95% CI 1.03-1.12, P < .001] and a 6% increased incidence rate of injurious falls (aIRR 1.06, 95% CI 1.02-1.11, P = .003). Baseline multimorbidity was associated with a 21% increased incidence rate of all falls (aIRR 1.21, 95% CI 1.07-1.37, P = .002) and a 17% increased incidence rate of injurious falls (aIRR 1.17, 95% CI 1.03-1.32, P = .02). CONCLUSIONS AND IMPLICATIONS Baseline number of prevalent chronic diseases and multimorbidity in generally healthy and active community-dwelling older adults were associated with increased incidence rates of all and injurious falls over 3 years. These findings support that multimorbidity may need consideration as a risk factor for falls, even in generally healthy and active older adults.
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Affiliation(s)
- Sarah Huberty
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland
| | - Gregor Freystätter
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland; University Clinic for Aging Medicine, City Hospital Zurich, Waid, Zurich, Switzerland
| | - Maud Wieczorek
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Centre on Aging, Tufts University, Boston, MA, USA
| | - John A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Sheffield, United Kingdom; Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Reto W Kressig
- University Department of Geriatric Medicine, Felix Platter and University of Basel, Basel, Switzerland
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - José A P Da Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal; Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Gabriele Armbrecht
- Klinik für Radiologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Robert Theiler
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland
| | - Andreas Egli
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland
| | - Endel J Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland; Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland; University Clinic for Aging Medicine, City Hospital Zurich, Waid, Zurich, Switzerland.
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26
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Stuck AK, Tsai LT, Freystaetter G, Vellas B, Kanis JA, Rizzoli R, Kressig KS, Armbrecht G, Da Silva JAP, Dawson-Hughes B, Egli A, Bischoff-Ferrari HA. Comparing Prevalence of Sarcopenia Using Twelve Sarcopenia Definitions in a Large Multinational European Population of Community-Dwelling Older Adults. J Nutr Health Aging 2023; 27:205-212. [PMID: 36973929 DOI: 10.1007/s12603-023-1888-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVES Multinational prevalence data on sarcopenia among generally healthy older adults is limited. The aim of the study was to assess prevalence of sarcopenia in the DO-HEALTH European trial based on twelve current sarcopenia definitions. SETTING AND PARTICIPANTS This is an analysis of the DO-HEALTH study including 1495 of 2157 community-dwelling participants age 70+ years from Germany, France, Portugal, and Switzerland with complete measurements of the sarcopenia toolbox including muscle mass by DXA, grip strength, and gait speed. MEASUREMENTS The twelve sarcopenia definitions applied were Asian Working Group on Sarcopenia (AWGS1), AWGS2, Baumgartner, Delmonico, European Working Group on Sarcopenia in Older People (EWGSOP1), EWGSOP2, EWGSOP2-lower extremities, Foundation for the National Institutes of Health (FNIH1), FNIH2, International Working Group on Sarcopenia in Older People (IWGS), Morley, and Sarcopenia Definitions and Outcomes Consortium (SDOC). RESULTS Mean age was 74.9 years (SD 4.4); 63.3% were women. Sarcopenia prevalence ranged between 0.7% using the EWGSOP2 or AWGS2 definition, up to 16.8% using the Delmonico definition. Overall, most sarcopenia definitions, including Delmonico (16.8%), Baumgartner (12.8%), FNIH1(10.5%), IWGS (3.6%), EWGSOP1 (3.4%), SDOC (2.0%), Morley (1.3%), and AWGS1 (1.1%) tended to be higher than the prevalence based on EWGSOP2 (0.7%). In contrast, the definitions AWGS2 (0.7%), EWGSOP2-LE (1.1%), FNIH2 (1.0%) - all based on muscle mass and muscle strength - showed similar lower prevalence as EWGSOP2 (0.7%). Moreover, most sarcopenia definitions did not overlap on identifying sarcopenia on an individual participant-level. CONCLUSION In this multinational European trial of community-dwelling older adults we found major discordances of sarcopenia prevalence both on a population- and on a participant- level between various sarcopenia definitions. Our findings suggest that the concept of sarcopenia may need to be rethought to reliably and validly identify people with impaired muscle health.
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Affiliation(s)
- A K Stuck
- Anna K. Stuck, Dr. med., Centre on Aging and Mobility, University Hospital Zurich and University of Zurich, c/o Stadtspital Waid, Tièchestrasse 99, 8037 Zürich
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27
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Minisola S, Arnold A, Belaya Z, Brandi ML, Clarke BL, Hannan FM, Hofbauer LC, Insogna KL, Lacroix A, Liberman U, Palermo A, Pepe J, Rizzoli R, Wermers R, Thakker RV. Epidemiology, Pathophysiology, and Genetics of Primary Hyperparathyroidism. J Bone Miner Res 2022; 37:2315-2329. [PMID: 36245271 PMCID: PMC10092691 DOI: 10.1002/jbmr.4665] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 07/18/2022] [Accepted: 07/29/2022] [Indexed: 11/11/2022]
Abstract
In this narrative review, we present data gathered over four decades (1980-2020) on the epidemiology, pathophysiology and genetics of primary hyperparathyroidism (PHPT). PHPT is typically a disease of postmenopausal women, but its prevalence and incidence vary globally and depend on a number of factors, the most important being the availability to measure serum calcium and parathyroid hormone levels for screening. In the Western world, the change in presentation to asymptomatic PHPT is likely to occur, over time also, in Eastern regions. The selection of the population to be screened will, of course, affect the epidemiological data (ie, general practice as opposed to tertiary center). Parathyroid hormone has a pivotal role in regulating calcium homeostasis; small changes in extracellular Ca++ concentrations are detected by parathyroid cells, which express calcium-sensing receptors (CaSRs). Clonally dysregulated overgrowth of one or more parathyroid glands together with reduced expression of CaSRs is the most important pathophysiologic basis of PHPT. The spectrum of skeletal disease reflects different degrees of dysregulated bone remodeling. Intestinal calcium hyperabsorption together with increased bone resorption lead to increased filtered load of calcium that, in addition to other metabolic factors, predispose to the appearance of calcium-containing kidney stones. A genetic basis of PHPT can be identified in about 10% of all cases. These may occur as a part of multiple endocrine neoplasia syndromes (MEN1-MEN4), or the hyperparathyroidism jaw-tumor syndrome, or it may be caused by nonsyndromic isolated endocrinopathy, such as familial isolated PHPT and neonatal severe hyperparathyroidism. DNA testing may have value in: confirming the clinical diagnosis in a proband; eg, by distinguishing PHPT from familial hypocalciuric hypercalcemia (FHH). Mutation-specific carrier testing can be performed on a proband's relatives and identify where the proband is a mutation carrier, ruling out phenocopies that may confound the diagnosis; and potentially prevention via prenatal/preimplantation diagnosis. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Salvatore Minisola
- Department of Clinical, Internal, Anaesthesiologic and Cardiovascular Sciences, 'Sapienza', Rome University, Rome, Italy
| | - Andrew Arnold
- Center for Molecular Oncology and Division of Endocrinology & Metabolism, University of Connecticut School of Medicine, Farmington, CT, USA
| | - Zhanna Belaya
- Department of Neuroendocrinology and Bone Disease, The National Medical Research Centre for Endocrinology, Moscow, Russia
| | - Maria Luisa Brandi
- F.I.R.M.O. Italian Foundation for the Research on Bone Diseases, Florence, Italy
| | - Bart L Clarke
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic, Rochester, MN, USA
| | - Fadil M Hannan
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), Churchill Hospital, Oxford, UK.,Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Lorenz C Hofbauer
- Division of Endocrinology, Diabetes, and Bone Diseases & Center for Healthy Aging, Technische Universität Dresden, Dresden, Germany
| | - Karl L Insogna
- Yale Bone Center Yale School of Medicine, Yale University, New Haven, CT, USA
| | - André Lacroix
- Division of Endocrinology, Department of Medicine and Research Center, Centre Hospitalier de l'Université de Montréal (CHUM), Montréal, Canada
| | - Uri Liberman
- Department of Physiology and Pharmacology, Tel Aviv University School of Medicine, Tel Aviv, Israel
| | - Andrea Palermo
- Unit of Metabolic Bone and Thyroid Disorders, Fondazione Policlinico Universitario Campus Bio-Medico and Unit of Endocrinology and Diabetes, Campus Bio-Medico University, Rome, Italy
| | - Jessica Pepe
- Department of Clinical, Internal, Anaesthesiologic and Cardiovascular Sciences, 'Sapienza', Rome University, Rome, Italy
| | - René Rizzoli
- Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Robert Wermers
- Division of Endocrinology, Diabetes, Metabolism, and Nutrition and Department of Medicine, Mayo Clinic, Rochester, MN, USA
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford Centre for Diabetes, Endocrinology and Metabolism (OCDEM), Churchill Hospital, Oxford, UK.,Oxford National Institute for Health Research (NIHR) Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, John Radcliffe Hospital, Oxford, UK
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28
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Chevalley T, Brandi ML, Cashman KD, Cavalier E, Harvey NC, Maggi S, Cooper C, Al-Daghri N, Bock O, Bruyère O, Rosa MM, Cortet B, Cruz-Jentoft AJ, Cherubini A, Dawson-Hughes B, Fielding R, Fuggle N, Halbout P, Kanis JA, Kaufman JM, Lamy O, Laslop A, Yerro MCP, Radermecker R, Thiyagarajan JA, Thomas T, Veronese N, de Wit M, Reginster JY, Rizzoli R. Role of vitamin D supplementation in the management of musculoskeletal diseases: update from an European Society of Clinical and Economical Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group. Aging Clin Exp Res 2022; 34:2603-2623. [PMID: 36287325 PMCID: PMC9607746 DOI: 10.1007/s40520-022-02279-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 10/10/2022] [Indexed: 01/04/2023]
Abstract
Vitamin D is a key component for optimal growth and for calcium-phosphate homeostasis. Skin photosynthesis is the main source of vitamin D. Limited sun exposure and insufficient dietary vitamin D supply justify vitamin D supplementation in certain age groups. In older adults, recommended doses for vitamin D supplementation vary between 200 and 2000 IU/day, to achieve a goal of circulating 25-hydroxyvitamin D (calcifediol) of at least 50 nmol/L. The target level depends on the population being supplemented, the assessed system, and the outcome. Several recent large randomized trials with oral vitamin D regimens varying between 2000 and 100,000 IU/month and mostly conducted in vitamin D-replete and healthy individuals have failed to detect any efficacy of these approaches for the prevention of fracture and falls. Considering the well-recognized major musculoskeletal disorders associated with severe vitamin D deficiency and taking into account a possible biphasic effects of vitamin D on fracture and fall risks, an European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) working group convened, carefully reviewed, and analyzed the meta-analyses of randomized controlled trials on the effects of vitamin D on fracture risk, falls or osteoarthritis, and came to the conclusion that 1000 IU daily should be recommended in patients at increased risk of vitamin D deficiency. The group also addressed the identification of patients possibly benefitting from a vitamin D loading dose to achieve early 25-hydroxyvitamin D therapeutic level or from calcifediol administration.
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Affiliation(s)
- Thierry Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Maria Luisa Brandi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - Kevin D Cashman
- Cork Centre for Vitamin D and Nutrition Research, School of Food and Nutritional Sciences, University College Cork, Cork, Ireland
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Liege, Belgium
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- UKNIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science King Saud University, Riyadh, 11451, Saudi Arabia
| | - Oliver Bock
- Department of Osteoporosis, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
- International Osteoporosis Foundation, Nyon, Switzerland
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Liege, Belgium
| | - Mario Miguel Rosa
- Centro de Estudos Egas Moniz Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Bernard Cortet
- Department of Rheumatology, University of Lille, CHU Lille, MABlab ULR 4490, Lille, France
| | | | - Antonio Cherubini
- Dipartimento dei percorsi geriatrici della fragilità, Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamentodella continuità di cura e riabilitativi, IRCCS INRCA, Ancona, Italy
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Roger Fielding
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, USA
| | - Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - Olivier Lamy
- Bone Unit, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Austrian Medicines and Medical Devices Agency, Vienna, Austria
| | | | - Régis Radermecker
- Department of Clinical Pharmacology Diabetes, Nutrition and Metabolic Disorders, CHU Liege, Liège, Belgium
| | | | - Thierry Thomas
- Department of Rheumatology, North Hospital, CHU Saint-Etienne and INSERM U1059, University of Lyon-University Jean Monnet, Saint-Etienne, France
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Marten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Jean-Yves Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Fuggle N, Al-Daghri N, Bock O, Branco J, Bruyère O, Casado E, Cavalier E, Cortet B, de Wit M, Giusti A, Halbout P, Harvey NC, Hiligsmann M, Kaufman JM, Kurth A, Maggi S, Matijevic R, Minisola S, Palacios S, Radermecker RP, Thomasius F, Tuzun S, Veronese N, Kanis JA, Reginster JY, Rizzoli R, Cooper C. Novel formulations of oral bisphosphonates in the treatment of osteoporosis. Aging Clin Exp Res 2022; 34:2625-2634. [PMID: 36331798 PMCID: PMC9675642 DOI: 10.1007/s40520-022-02272-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/03/2022] [Indexed: 11/06/2022]
Abstract
Oral bisphosphonates are a key intervention in the treatment of osteoporosis and in reducing the risk of fragility fractures. Their use is supported by over 3 decades of evidence; however, patient adherence to oral bisphosphonates remains poor in part due to complex dosing instructions and adverse events, including upper gastrointestinal symptoms. This problem has led to the development of novel oral bisphosphonate formulations. Buffered, effervescent alendronate is dissolved in water and so seeks to reduce upper gastro-intestinal adverse events, and gastro-resistant risedronate aims to reduce the complexity of dosing procedure (e.g. fasting prior to consumption) whilst still maintaining the efficacy of fracture risk reduction. Clinical trials and real-world data have been employed to demonstrate some benefits in terms of reduced upper gastro-intestinal adverse events, adherence, persistence and health economic outcomes. This report describes the result of an ESCEO (European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis) expert working group, which explores where oral bisphosphonates sit in current clinical practice guidelines, review their risk-benefit profile and the consequences of poor adherence before exploring novel oral bisphosphonate formulations and their potential clinical and health economic impact. Further research is required but there are signs that these novel, oral bisphosphonate formulations may lead to improved tolerance of oral bisphosphonates and thus, improved adherence and fracture outcomes.
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Affiliation(s)
- Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Olivier Bock
- Department of Osteoporosis, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland
- International Osteoporosis Foundation, Nyon, Switzerland
| | - Jaime Branco
- Centro Hospitalar de Lisboa Ocidental-Hospital Egas Moniz, CEDOC/NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
| | - Enrique Casado
- Department of Rheumatology, University Hospital Parc Taulí, I3PT Research Institute (UAB), Sabadell, Barcelona, Spain
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CIRM, CHU Sart-Tilman, 4000, Liège, Belgium
| | - Bernard Cortet
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France
| | - Maarten de Wit
- Department of Medical Humanities, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Andrea Giusti
- Metabolic Bone Diseases Unit and Fracture Liaison Service, Rheumatology Unit, Department of Medical Specialties, Local Health Trust 3, Via Missolungi 14, 16147, Genoa, Italy
| | | | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Tremona Road, Southampton, UK
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, 9000, Ghent, Belgium
| | - Andreas Kurth
- Department of Orthopaedic and Trauma Surgery, Community Clinics Middle Rhine, Campus Kemperhof, Koblenz, Germany
| | - Stefania Maggi
- Institute of Neuroscience, Aging Branch, CNR, Padua, Italy
| | - Radmila Matijevic
- Faculty of Medicine, Clinic for Orthopedic Surgery and Traumatology, Clinical Center of Vojvodina, University of Novi Sad, Novi Sad, Serbia
| | - Salvatore Minisola
- Department of Clinical, Internal, Anaesthesiology, and Cardiovascular Sciences, Sapienza University of Rome, 00185, Rome, Italy
| | | | - Régis Pierre Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liège, CHU de Liège, Liège, Belgium
| | | | - Sansin Tuzun
- Department of Physical Medicine and Rehabilitation, Cerrahpaşa Medical Faculty, Istanbul University Cerrahpaşa, Istanbul, Turkey
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - John A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield, Sheffield, UK
| | - Jean-Yves Reginster
- Centro Hospitalar de Lisboa Ocidental-Hospital Egas Moniz, CEDOC/NOVA Medical School, Nova University of Lisbon, Lisbon, Portugal
| | - René Rizzoli
- Department of Osteoporosis, Inselspital-Bern University Hospital, University of Bern, Bern, Switzerland
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.
- Department of Rheumatology, Univ. Lille, CHU Lille, MABlab ULR 4490, 59000, Lille, France.
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK.
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30
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Fuggle N, Bere N, Bruyère O, Rosa MM, Prieto Yerro MC, Dennison E, Dincer F, Gabay C, Haugen IK, Herrero-Beaumont G, Hiligsmann M, Hochberg MC, Laslop A, Matijevic R, Maheu E, Migliore A, Pelletier JP, Radermecker RP, Rannou F, Uebelhart B, Uebelhart D, Veronese N, Vlaskovska M, Rizzoli R, Mobasheri A, Cooper C, Reginster JY. Management of hand osteoarthritis: from an US evidence-based medicine guideline to a European patient-centric approach. Aging Clin Exp Res 2022; 34:1985-1995. [PMID: 35864304 PMCID: PMC9464159 DOI: 10.1007/s40520-022-02176-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 06/08/2022] [Indexed: 12/02/2022]
Abstract
Hand osteoarthritis is the most common joint condition and is associated with significant morbidity. It is of paramount importance that patients are thoroughly assessed and examined when complaining of hand stiffness, pain, deformity or disability and that the patient's concerns and expectations are addressed by the healthcare professional. In 2019 the American College of Rheumatology and Arthritis Foundation (ACR/AF) produced guidelines which included recommendations for the treatment of hand osteoarthritis. An ESCEO expert working group (including patients) was convened and composed this paper with the aim to assess whether these guidelines were appropriate for the treatment of hand osteoarthritis therapy in Europe and whether they met with the ESCEO patient-centered approach. Indeed, patients are the key stakeholders in healthcare and eliciting the patient's preference is vital in the context of an individual consultation but also for informing research and policy-making. The patients involved in this working group emphasised the often-neglected area of aesthetic changes in hand osteoarthritis, importance of developing pharmacological therapies which can alleviate pain and disability and the need of the freedom to choose which approach (out of pharmacological, surgical or non-pharmacological) they wished to pursue. Following robust appraisal, it was recommended that the ACR/AF guidelines were suitable for a European context (as described within the body of the manuscript) and it was emphasised that patient preferences are key to the success of individual consultations, future research and future policy-making.
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Affiliation(s)
- Nicholas Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Nathalie Bere
- European Medicines Agency, Amsterdam, The Netherlands
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
| | | | | | - Elaine Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK
| | - Fitnat Dincer
- Department of Physical and Rehabilitation Medicine, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Cem Gabay
- Division of Rheumatology, University Hospital of Geneva, and Department of Pathology and Immunology, University of Geneva of Medicine, Geneva, Switzerland
| | - Ida K Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Gabriel Herrero-Beaumont
- Head of Rheumatology Department, Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, 28040, Madrid, Spain
| | - Mickaël Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, 6200 MD, Maastricht, The Netherlands
| | - Marc C Hochberg
- Departments of Medicine and Epidemiology and Public Health, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Vienna, Austria
| | - Radmila Matijevic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinical Center of Vojvodina, Clinic for Orthopedic Surgery, Novi Sad, Serbia
| | - Emmanuel Maheu
- Rheumatology Department, Hospital Saint-Antoine, AP-HP, and Private Office, Paris, France
| | - Alberto Migliore
- Rheumatology Unit - San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM) and Arthritis Division, University of Montreal Hospital Centre (CHUM), Montreal, Canada
| | - Régis Pierre Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liège, CHU de Liège, Liège, Belgium
| | - François Rannou
- Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires-Paris Centre, Groupe Hospitalier Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, INSERM U1124, Paris, France
| | - Brigitte Uebelhart
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Daniel Uebelhart
- Division of Musculoskeletal, Internal Medicine and Oncological Rehabilitation, Leukerbad Clinic -Private Rehabilitation Clinic, 3954, Leukerbad, Switzerland
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology and Toxicology, Medical University Sofia, Sofia, Bulgaria
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ali Mobasheri
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, 90014, Oulu, Finland
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, 08406, Vilnius, Lithuania
- Departments of Orthopedics, Rheumatology and Clinical Immunology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, 510080, China
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Tremona Road, Southampton, SO16 6YD, UK.
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
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Veronese N, Cooper C, Bruyère O, Al-Daghri NM, Branco J, Cavalier E, Cheleschi S, da Silva Rosa MC, Conaghan PG, Dennison EM, de Wit M, Fioravanti A, Fuggle NR, Haugen IK, Herrero-Beaumont G, Honvo G, Laslop A, Matijevic R, Migliore A, Mobasheri A, Pelletier JP, Prieto Yerro MC, Radermecker RP, Rannou F, Rizzoli R, Reginster JY. Multimodal Multidisciplinary Management of Patients with Moderate to Severe Pain in Knee Osteoarthritis: A Need to Meet Patient Expectations. Drugs 2022; 82:1347-1355. [PMID: 36112341 PMCID: PMC9512723 DOI: 10.1007/s40265-022-01773-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2022] [Indexed: 11/17/2022]
Abstract
Knee osteoarthritis (OA) is one of the most common and disabling medical conditions. In the case of moderate to severe pain, a single intervention may not be sufficient to allay symptoms and improve quality of life. Examples include first-line, background therapy with symptomatic slow-acting drugs for OA (SYSADOAs) or non-steroidal anti-inflammatory drugs (NSAIDs). Therefore, the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) performed a review of a multimodal/multicomponent approach for knee OA therapy. This strategy is a particularly appropriate solution for the management of patients affected by knee OA, including those with pain and dysfunction reaching various thresholds at the different joints. The multimodal/multicomponent approach should be based, firstly, on different combinations of non-pharmacological and pharmacological interventions. Potential pharmacological combinations include SYSADOAs and NSAIDs, NSAIDs and weak opioids, and intra-articular treatments with SYSADOAs/NSAIDs. Based on the available evidence, most combined treatments provide benefit beyond single agents for the improvement of pain and other symptoms typical of knee OA, although further high-quality studies are required. In this work, we have therefore provided new, patient-centered perspectives for the management of knee OA, based on the concept that a multimodal, multicomponent, multidisciplinary approach, applied not only to non-pharmacological treatments but also to a combination of the currently available pharmacological options, will better meet the needs and expectations of patients with knee OA, who may present with various phenotypes and trajectories.
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Affiliation(s)
- Nicola Veronese
- Geriatrics Section, Department of Internal Medicine and Geriatrics, University of Palermo, via del Vespro, 141, 90127, Palermo, Italy.
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Olivier Bruyère
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
| | - Nasser M Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, 11451, Saudi Arabia
| | - Jaime Branco
- Department of Rheumatology, CHRC, NOVA Medical School, CHLO, EPE, Hospital Egas Moniz, Universidade Nova de Lisboa, Lisbon, Portugal
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liège, CHU Sart-Tilman, Bât B35, 4000, Liège, Belgium
| | - Sara Cheleschi
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | | | - Philip G Conaghan
- Leeds Institute of Rheumatic and Musculoskeletal Medicine, NIHR Leeds Biomedical Research Centre, University of Leeds, Leeds, UK
| | - Elaine M Dennison
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Maarten de Wit
- Chair EULAR Study Group for Collaborative Research, Amsterdam, The Netherlands
| | - Antonella Fioravanti
- Rheumatology Unit, Department of Medicine, Surgery and Neuroscience, Azienda Ospedaliera Universitaria Senese, Policlinico Le Scotte, Viale Bracci 1, 53100, Siena, Italy
| | - Nicholas R Fuggle
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Ida K Haugen
- Division of Rheumatology and Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Gabriel Herrero-Beaumont
- Head of Rheumatology Department, Bone and Joint Research Unit, IIS-Fundación Jiménez Díaz UAM, 28040, Madrid, Spain
| | - Germain Honvo
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
| | - Andrea Laslop
- Scientific Office, Austrian Medicines and Medical Devices Agency, Federal Office for Safety in Health Care, Vienna, Austria
| | - Radmila Matijevic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinic for Orthopedic Surgery, Clinical Center of Vojvodina, Novi Sad, Serbia
| | - Alberto Migliore
- Unit of Rheumatology, San Pietro Fatebenefratelli Hospital, Rome, Italy
| | - Ali Mobasheri
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
- Department of Regenerative Medicine, State Research Institute Centre for Innovative Medicine, LT-08406, Vilnius, Lithuania
- Departments of Orthopedics, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
- Departments of Rheumatology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
- Departments of Clinical Immunology, University Medical Center Utrecht, 3584 CX, Utrecht, The Netherlands
- Department of Joint Surgery, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510080, China
- Research Unit of Medical Imaging, Physics and Technology, Faculty of Medicine, University of Oulu, FI-90014, Oulu, Finland
| | - Jean-Pierre Pelletier
- Osteoarthritis Research Unit, University of Montreal Hospital Research Centre (CRCHUM) and Arthritis Division, University of Montreal Hospital Centre (CHUM), Montreal, Canada
| | | | - Régis Pierre Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liège, CHU de Liège, Liège, Belgium
| | - François Rannou
- Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Hôpitaux Universitaires-Paris Centre, Groupe Hospitalier Cochin, Assistance Publique-Hôpitaux de Paris, Université de Paris, INSERM U1124, Paris, France
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Jean-Yves Reginster
- Division of Public Health, Epidemiology and Health Economics, WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, Avenue Hippocrate 13, CHU B23, 4000, Liege, Belgium
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Trombetti A, Al-Daghri N, Brandi ML, Cannata-Andía JB, Cavalier E, Chandran M, Chaussain C, Cipullo L, Cooper C, Haffner D, Harvengt P, Harvey NC, Javaid MK, Jiwa F, Kanis JA, Laslop A, Laurent MR, Linglart A, Marques A, Mindler GT, Minisola S, Yerro MCP, Rosa MM, Seefried L, Vlaskovska M, Zanchetta MB, Rizzoli R. Interdisciplinary management of FGF23-related phosphate wasting syndromes: a Consensus Statement on the evaluation, diagnosis and care of patients with X-linked hypophosphataemia. Nat Rev Endocrinol 2022; 18:366-384. [PMID: 35484227 DOI: 10.1038/s41574-022-00662-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/10/2022] [Indexed: 12/17/2022]
Abstract
X-linked hypophosphataemia (XLH) is the most frequent cause of hypophosphataemia-associated rickets of genetic origin and is associated with high levels of the phosphaturic hormone fibroblast growth factor 23 (FGF23). In addition to rickets and osteomalacia, patients with XLH have a heavy disease burden with enthesopathies, osteoarthritis, pseudofractures and dental complications, all of which contribute to reduced quality of life. This Consensus Statement presents the outcomes of a working group of the European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases, and provides robust clinical evidence on management in XLH, with an emphasis on patients' experiences and needs. During growth, conventional treatment with phosphate supplements and active vitamin D metabolites (such as calcitriol) improves growth, ameliorates leg deformities and dental manifestations, and reduces pain. The continuation of conventional treatment in symptom-free adults is still debated. A novel therapeutic approach is the monoclonal anti-FGF23 antibody burosumab. Although promising, further studies are required to clarify its long-term efficacy, particularly in adults. Given the diversity of symptoms and complications, an interdisciplinary approach to management is of paramount importance. The focus of treatment should be not only on the physical manifestations and challenges associated with XLH and other FGF23-mediated hypophosphataemia syndromes, but also on the major psychological and social impact of the disease.
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Affiliation(s)
- Andrea Trombetti
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
- Division of Geriatrics, Department of Rehabilitation and Geriatrics, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Nasser Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | | | - Jorge B Cannata-Andía
- Hospital Universitario Central de Asturias (HUCA), Oviedo, Spain
- Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Retic REDinREN-RICORS, 2040-ISCIII, Madrid, Spain
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liège, Liège, Belgium
| | - Manju Chandran
- Complicated Metabolic Bone Disorders Clinic, Osteoporosis and Bone Metabolism Unit, Department of Endocrinology, Singapore General Hospital, Singapore, Singapore
| | - Catherine Chaussain
- Université de Paris, Institut des maladies musculo-squelettiques, URP2496, UFR Odontologie, Montrouge, France
- AP-HP, FHU DDS-Net, Centre de Référence des Maladies Rares du Métabolisme du Calcium et du Phosphore, Service médecine bucco-dentaire, Hôpital Bretonneau, GH Paris Nord Université de Paris, Paris, France
| | - Lucia Cipullo
- Patient representative with XLH, Geneva, Switzerland
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Dieter Haffner
- Department of Paediatric Kidney, Liver and Metabolic Diseases, Hannover Medical School, Hannover, Germany
| | - Pol Harvengt
- XLH Belgium, Belgian association of patients with XLH (a member of the International XLH Alliance), Waterloo, Belgium
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | | | - Famida Jiwa
- Chair of the Committee of Patients Societies at the International Osteoporosis Foundation, Osteoporosis Canada, Toronto, Canada
| | - John A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Andrea Laslop
- Scientific Office, Federal Office for Safety in Health Care, Vienna, Austria
| | - Michaël R Laurent
- Centre for Metabolic Bone Diseases, University Hospitals Leuven, Leuven, Belgium
| | - Agnès Linglart
- Paris-Saclay University, INSERM U1185, Le Kremlin-Bicêtre, France
- AP-HP, endocrinology and diabetes for children, Reference centre for rare diseases of calcium and phosphate metabolism, OSCAR network, Platform of expertise for rare diseases of Paris Saclay Hospital, Bicêtre Paris Saclay Hospital, Le Kremlin-Bicêtre, France
| | - Andréa Marques
- Rheumatology Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICiSA:E), Nursing School of Coimbra, Coimbra, Portugal
| | - Gabriel T Mindler
- Department of Paediatric Orthopaedics, Orthopaedic Hospital Speising, Vienna, Austria
- Vienna Bone and Growth Center, Vienna, Austria
| | - Salvatore Minisola
- Department of Clinical, Internal, Anaesthesiologic and Cardiovascular Sciences, 'Sapienza', Rome University, Rome, Italy
| | | | - Mario Miguel Rosa
- Departamento de Neurociências, Laboratório de Farmacologia Clínica E Terapêutica Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
| | - Lothar Seefried
- Orthopedic Department, University of Würzburg, Würzburg, Germany
| | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology, Medical University Sofia, Sofia, Bulgaria
| | - María Belén Zanchetta
- Instituto de Investigaciones Metabólicas (IDIM), Universidad del Salvador, Buenos Aires, Argentina
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
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Beaudart C, Boonen A, Li N, Bours S, Goemaere S, Reginster JY, Roux C, McGowan B, Diez-Perez A, Rizzoli R, Cooper C, Hiligsmann M. Patient preferences for lifestyle behaviours in osteoporotic fracture prevention: a cross-European discrete choice experiment. Osteoporos Int 2022; 33:1335-1346. [PMID: 35080632 PMCID: PMC9106627 DOI: 10.1007/s00198-022-06310-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 01/12/2022] [Indexed: 11/26/2022]
Abstract
UNLABELLED Using a discrete choice experiment, we aimed to assess patients' preferences with regard to adopting lifestyle behaviours to prevent osteoporotic fractures. Overall, the 1042 patients recruited from seven European countries were favourable to some lifestyle behaviours (i.e., engaging in moderate physical activity, taking calcium and vitamin D supplements, reducing their alcohol consumption and ensuring a normal body weight). INTRODUCTION Alongside medical therapy, healthy lifestyle habits are recommended for preventing osteoporotic fractures. In this study, we aimed to assess patients' preferences with regard to adopting lifestyle changes to prevent osteoporotic fractures. METHODS A discrete choice experiment was conducted in seven European countries. Patients with or at risk of osteoporosis were asked to indicate to what extent they would be motivated to adhere to 16 lifestyle packages that differed in various levels of 6 attributes. The attributes and levels proposed were physical activity (levels: not included, moderate or high), calcium and vitamin D status (levels: not included, taking supplements, improving nutrition and assuring a minimal exposure to sunlight daily), smoking (levels: not included, quit smoking), alcohol (levels: not included, moderate consumption), weight reduction (levels: not included, ensure a healthy body weight) and fall prevention (levels: not included, receiving general advice or following a 1-day fall prevention program). A conditional logit model was used to estimate a patient's relative preferences for the various attributes across all participants and per country. RESULTS In total, 1042 patients completed the questionnaire. Overall, patients were favourable to lifestyle behaviours for preventing osteoporotic fractures. However, among the lifestyle behaviours proposed, patients were consensually not prone to engage in a high level of physical activity. In addition, in Ireland, Belgium, the Netherlands and Switzerland, patients were also not inclined to participate in a 1-day fall prevention program and Belgian, Swiss and Dutch patients were not prone to adhere to a well-balanced nutritional program. Nevertheless, we observed globally that patients felt positively about reducing their alcohol consumption, engaging in moderate physical activity, taking calcium and vitamin D supplements and ensuring a normal body weight, all measures aimed at preventing fractures. CONCLUSIONS In a patient-centred approach, fracture prevention should take these considerations and preferences into account.
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Affiliation(s)
- C Beaudart
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
| | - A Boonen
- Division of Rheumatology, Department of Internal Medicine, and CAPRHI Care and Public Health Research Institute, Maastricht University Medical Center, Maastricht, the Netherlands
| | - N Li
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - S Bours
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
| | - S Goemaere
- Department of Rheumatology and Endocrinology, Ghent University Hospital, Ghent, Belgium
| | - J-Y Reginster
- WHO Collaborating Center for Public Health Aspects of Musculo-Skeletal Health and Ageing, Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - C Roux
- Department of Rheumatology, Paris Descartes University, Paris, France
| | - B McGowan
- The North Western Rheumatology Unit, Our Lady's Hospital, Manorhamilton, Co. Leitrim, Ireland
| | - A Diez-Perez
- Musculoskeletal Research Unit (IMIM) and CIBERFES, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
| | - M Hiligsmann
- Department of Health Services Research, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands
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Bischoff-Ferrari HA, Freystätter G, Vellas B, Dawson-Hughes B, Kressig RW, Kanis JA, Willett WC, Manson JE, Rizzoli R, Theiler R, Hofbauer LC, Armbrecht G, da Silva JAP, Blauth M, de Godoi Rezende Costa Molino C, Lang W, Siebert U, Egli A, Orav EJ, Wieczorek M. Effects of vitamin D, omega-3 fatty acids, and a simple home strength exercise program on fall prevention: the DO-HEALTH randomized clinical trial. Am J Clin Nutr 2022; 115:1311-1321. [PMID: 35136915 DOI: 10.1093/ajcn/nqac022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 01/24/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND The roles of vitamin D, omega-3 fatty acids, and home exercise on fall prevention among generally healthy and active older adults are unclear. OBJECTIVES We tested the effects of daily supplemental vitamin D, daily supplemental marine omega-3s fatty acids, and a simple home exercise program (SHEP), alone or in combination, on the incidences of total and injurious falls among generally healthy older adults. METHODS We performed a 2 × 2 × 2 factorial-design randomized controlled trial among 2157 community-dwelling adults aged 70 years and older, who had no major health events in the 5 years prior to enrolment, recruited from Switzerland, Germany, Austria, France, and Portugal between December 2012 and November 2014. Participants were randomly assigned to supplementation with 2000 international units/day of vitamin D3 and/or 1 g/day of marine omega-3s, and/or a SHEP compared with placebo and/or control exercise over 3 years. The primary endpoint for the present fall analysis was the incidence rate of total falls. Falls were recorded prospectively throughout the trial. Since there were no interactions between treatments, the main effects are reported based on a modified intent-to-treat analysis. RESULTS Of 2157 randomized participants, 1900 (88%) completed the study. The mean age was 74.9 years, 61.7% were women, 40.7% had a serum 25-hydroxyvitamin D concentration < 20 ng/ml, and 83% were at least moderately physically active. In total, 3333 falls were recorded over a median follow-up of 2.99 years. Overall, vitamin D and the SHEP had no benefit on total falls, whilst supplementation with omega-3s compared to no omega-3 supplementation reduced total falls by 10% (incidence rate ratio = 0.90; 95% CI, 0.81-1.00; P = 0.04). CONCLUSIONS Among generally healthy, active, and vitamin D-replete older adults, omega-3 supplementation may have a modest benefit on the incidence of total falls, whilst a daily high dose of vitamin D or a SHEP had no benefit.
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Affiliation(s)
- Heike A Bischoff-Ferrari
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland.,University Clinic for Aging Medicine, City Hospital Zurich, Waid, Zurich, Switzerland
| | - Gregor Freystätter
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland.,University Clinic for Aging Medicine, City Hospital Zurich, Waid, Zurich, Switzerland
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Centre Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Centre on Aging, Tufts University, Boston, MA, USA
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, and University of Basel, Basel, Switzerland
| | - John A Kanis
- Centre for Metabolic Diseases, University of Sheffield Medical School, Sheffield, United Kingdom.,Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, Victoria, Australia
| | - Walter C Willett
- Department of Epidemiology and Department of Nutrition, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Robert Theiler
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland
| | - Lorenz C Hofbauer
- Centre for Healthy Aging, Department of Medicine III Dresden University Medical Centre, Dresden, Germany.,Centre for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden, Germany
| | - Gabriele Armbrecht
- Klinik für Radiologie, Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - José A P da Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Michael Blauth
- Department for Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Caroline de Godoi Rezende Costa Molino
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland
| | - Wei Lang
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland
| | - Uwe Siebert
- Department of Public Health, Health Services Research and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Hall i.T., Austria.,Center for Health Decision Science, Departments of Epidemiology and Health Policy & Management, Harvard T.H. Chan School of Public Health, Boston, MA, USA.,Program on Cardiovascular Research, Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Andreas Egli
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland
| | - Endel J Orav
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Maud Wieczorek
- Centre on Aging and Mobility, University of Zurich and City Hospital Zurich, Waid, Zurich, Switzerland.,Department of Aging Medicine and Aging Research, University of Zurich and University Hospital, Zurich, Switzerland
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Bischoff-Ferrari HA, Willett WC, Manson JE, Dawson-Hughes B, Manz MG, Theiler R, Braendle K, Vellas B, Rizzoli R, Kressig RW, Staehelin HB, Da Silva JAP, Armbrecht G, Egli A, Kanis JA, Orav EJ, Gaengler S. Combined Vitamin D, Omega-3 Fatty Acids, and a Simple Home Exercise Program May Reduce Cancer Risk Among Active Adults Aged 70 and Older: A Randomized Clinical Trial. Front Aging 2022; 3:852643. [PMID: 35821820 PMCID: PMC9261319 DOI: 10.3389/fragi.2022.852643] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/16/2022] [Indexed: 12/19/2022]
Abstract
Objective: The aim of this study was to test the individual and combined benefit of vitamin D, omega-3, and a simple home strength exercise program on the risk of any invasive cancer. Design: The DO-HEALTH trial is a three-year, multicenter, 2 × 2 × 2 factorial design double-blind, randomized-controlled trial to test the individual and combined benefit of three public health interventions. Setting: The trial was conducted between December 2012 and December 2017 in five European countries. Participants: Generally healthy community-dwelling adults ≥70 years were recruited. Interventions: Supplemental 2000 IU/day of vitamin D3, and/or 1 g/day of marine omega-3s, and/or a simple home strength exercise (SHEP) programme compared to placebo and control exercise. Main outcome: In this pre-defined exploratory analysis, time-to-development of any verified invasive cancer was the primary outcome in an adjusted, intent-to-treat analysis. Results: In total, 2,157 participants (mean age 74.9 years; 61.7% women; 40.7% with 25-OH vitamin D below 20 /ml, 83% at least moderately physically active) were randomized. Over a median follow-up of 2.99 years, 81 invasive cancer cases were diagnosed and verified. For the three individual treatments, the adjusted hazard ratios (HRs, 95% CI, cases intervention versus control) were 0.76 (0.49–1.18; 36 vs. 45) for vitamin D3, 0.70 (0.44–1.09, 32 vs. 49) for omega-3s, and 0.74 (0.48–1.15, 35 vs. 46) for SHEP. For combinations of two treatments, adjusted HRs were 0.53 (0.28–1.00; 15 vs. 28 cases) for omega-3s plus vitamin D3; 0.56 (0.30–1.04; 11 vs. 21) for vitamin D3 plus SHEP; and 0.52 (0.28–0.97; 12 vs. 26 cases) for omega-3s plus SHEP. For all three treatments combined, the adjusted HR was 0.39 (0.18–0.85; 4 vs. 12 cases). Conclusion: Supplementation with daily high-dose vitamin D3 plus omega-3s, combined with SHEP, showed cumulative reduction in the cancer risk in generally healthy and active and largely vitamin D–replete adults ≥70 years. Clinical Trial Registration:ClinicalTrials.gov, Identifier: NCT01745263.
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Affiliation(s)
- Heike A. Bischoff-Ferrari
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
- University Clinic for Aging Medicine, Zurich City Hospital-Waid, Zurich, Switzerland
- *Correspondence: Heike A. Bischoff-Ferrari,
| | - Walter C. Willett
- Department of Epidemiology and Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - JoAnn E. Manson
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Bess Dawson-Hughes
- Jean Mayer USDA Human Nutrition Research Center on Aging, Tufts University, Boston, MA, United States
| | - Markus G. Manz
- Department of Medical Oncology and Hematology, University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Robert Theiler
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Kilian Braendle
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Bruno Vellas
- UMR INSERM 1027, Gérontopôle de Toulouse, Institut Du Vieillissement, Center Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - René Rizzoli
- Division of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Reto W. Kressig
- University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - Hannes B. Staehelin
- University Department of Geriatric Medicine Felix Platter, University of Basel, Basel, Switzerland
| | - José A. P. Da Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Gabriele Armbrecht
- Klinik für Radiologie, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Andreas Egli
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - John A. Kanis
- Center for Metabolic Diseases, University of Sheffield Medical School, Sheffield, United Kingdom
- Mary MacKillop Institute for Health Research, Australian Catholic University, Melbourne, VIC, Australia
| | - Endel J. Orav
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA, United States
| | - Stephanie Gaengler
- Center on Aging and Mobility, University Hospital Zurich, Zurich City Hospital-Waid and University of Zurich, Zurich, Switzerland
- Department of Aging Medicine and Aging Research, University Hospital Zurich and University of Zurich, Zurich, Switzerland
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Curtis EM, Reginster JY, Al-Daghri N, Biver E, Brandi ML, Cavalier E, Hadji P, Halbout P, Harvey NC, Hiligsmann M, Javaid MK, Kanis JA, Kaufman JM, Lamy O, Matijevic R, Perez AD, Radermecker RP, Rosa MM, Thomas T, Thomasius F, Vlaskovska M, Rizzoli R, Cooper C. Management of patients at very high risk of osteoporotic fractures through sequential treatments. Aging Clin Exp Res 2022; 34:695-714. [PMID: 35332506 PMCID: PMC9076733 DOI: 10.1007/s40520-022-02100-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 02/18/2022] [Indexed: 12/11/2022]
Abstract
Osteoporosis care has evolved markedly over the last 50 years, such that there are now an established clinical definition, validated methods of fracture risk assessment and a range of effective pharmacological agents. Currently, bone-forming (anabolic) agents, in many countries, are used in those patients who have continued to lose bone mineral density (BMD), patients with multiple subsequent fractures or those who have fractured despite treatment with antiresorptive agents. However, head-to-head data suggest that anabolic agents have greater rapidity and efficacy for fracture risk reduction than do antiresorptive therapies. The European Society for Clinical and Economic Aspects of Osteoporosis, Osteoarthritis and Musculoskeletal Diseases (ESCEO) convened an expert working group to discuss the tools available to identify patients at high risk of fracture, review the evidence for the use of anabolic agents as the initial intervention in patients at highest risk of fracture and consider the sequence of therapy following their use. This position paper sets out the findings of the group and the consequent recommendations. The key conclusion is that the current evidence base supports an "anabolic first" approach in patients found to be at very high risk of fracture, followed by maintenance therapy using an antiresorptive agent, and with the subsequent need for antiosteoporosis therapy addressed over a lifetime horizon.
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Affiliation(s)
- Elizabeth M Curtis
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
| | - Jean-Yves Reginster
- WHO Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liège, Belgium
- Department of Public Health, Epidemiology and Health Economics, University of Liège, CHU Sart Tilman B23, 4000, Liège, Belgium
| | - Nasser Al-Daghri
- Biochemistry Department, College of Science, King Saud University, 11451, Riyadh, Kingdom of Saudi Arabia
| | - Emmanuel Biver
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Maria Luisa Brandi
- F.I.R.M.O, Italian Foundation for the Research on Bone Diseases, Florence, Italy
| | - Etienne Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liège, Liège, Belgium
| | - Peyman Hadji
- Center of Bone Health, Frankfurt, Germany
- Philipps-University of Marburg, Marburg, Germany
| | | | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Mickaël Hiligsmann
- Department of Health Services Research, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | | | - John A Kanis
- Mary McKillop Institute for Health Research, Australian Catholic University, Melbourne, Australia
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Beech Hill Road, Sheffield, UK
| | - Jean-Marc Kaufman
- Department of Endocrinology, Ghent University Hospital, Gent, Belgium
| | - Olivier Lamy
- University of Lausanne, UNIL, CHUV, Lausanne, Switzerland
| | - Radmila Matijevic
- Faculty of Medicine, University of Novi Sad, Novi Sad, Serbia
- Clinical Center of Vojvodina, Clinic for Orthopedic Surgery, Novi Sad, Serbia
| | - Adolfo Diez Perez
- Department of Internal Medicine, Hospital del Mar-IMIM, Autonomous University of Barcelona and CIBERFES, Instituto Carlos III, Madrid, Spain
| | - Régis Pierre Radermecker
- Department of Diabetes, Nutrition and Metabolic Disorders, Clinical Pharmacology, University of Liege, CHU de Liège, Liège, Belgium
| | | | - Thierry Thomas
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | | | - Mila Vlaskovska
- Medical Faculty, Department of Pharmacology and Toxicology, Medical University Sofia, Sofia, Bulgaria
| | - René Rizzoli
- Division of Bone Diseases, Department of Medicine, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Cyrus Cooper
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton, UK.
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK.
- NIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK.
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Schietzel S, Chocano-Bedoya PO, Sadlon A, Gagesch M, Willett WC, Orav EJ, Kressig RW, Vellas B, Rizzoli R, da Silva JAP, Blauth M, Kanis JA, Egli A, Bischoff-Ferrari HA. Prevalence of healthy aging among community dwelling adults age 70 and older from five European countries. BMC Geriatr 2022; 22:174. [PMID: 35236290 PMCID: PMC8889763 DOI: 10.1186/s12877-022-02755-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
Background To compare the prevalence of healthy aging among adults age 70 and older from 5 European countries recruited for the DO-HEALTH clinical trial. Participants were selected for absence of prior major health events. Methods Cross-sectional analysis of DO-HEALTH baseline data. All 2,157 participants (mean age 74.9, SD 4.4; 61.7% women) were included and 2,123 had data for all domains of the healthy aging status (HA) definition. HA was assessed based on the Nurses` Health Study (NHS) definition requiring four domains: no major chronic diseases, no disabilities, no cognitive impairment (Montreal Cognitive Assessment, MoCA ≥25), no mental health limitation (GDS-5 <2, and no diagnosis of depression). Association between HA and age, BMI, gender, and physical function (sit-to-stand, gait speed, grip strength) was assessed by multivariate logistic regression analyses adjusting for center. Results Overall, 41.8% of DO-HEALTH participants were healthy agers with significant variability by country: Austria (Innsbruck) 58.3%, Switzerland (Zurich, Basel, Geneva) 51.2%, Germany (Berlin) 37.6%, France (Toulouse) 36.7% and Portugal (Coimbra) 8.8% (p <0.0001). Differences in prevalence by country persisted after adjustment for age. In the multivariate model, younger age (OR = 0.95, 95% CI 0.93 to 0.98), female gender (OR = 1.36, 95% CI 1.03 to 1.81), lower BMI (OR = 0.94, 95% CI 0.91 to 0.96), faster gait speed (OR = 4.70, 95% CI 2.68 to 8.25) and faster performance in sit-to-stand test (OR = 0.90, 95% CI 0.87 to 0.93) were independently and significantly associated with HA. Conclusions Despite the same inclusion and exclusion criteria preselecting relatively healthy adults age 70 years and older, HA prevalence in DO-HEALTH varied significantly between countries and was highest in participants from Austria and Switzerland, lowest in participants from Portugal. Independent of country, younger age, female gender, lower BMI and better physical function were associated with HA. Trial registration DO-HEALTH was registered under the protocol NCT01745263 at the International Trials Registry (clinicaltrials.gov), and under the protocol number 2012–001249-41 at the Registration at the European Community Clinical Trial System (EudraCT). Supplementary Information The online version contains supplementary material available at 10.1186/s12877-022-02755-8.
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Affiliation(s)
- Simeon Schietzel
- Department of Aging Medicine and Aging Research, University of Zurich and University Hospital Zurich, Switzerland, Zurich, Switzerland. .,Center on Aging and Mobility (CAM), University of Zurich, University Hospital Zurich, and City Hospital Zurich, Waid, Switzerland.
| | - Patricia O Chocano-Bedoya
- Center on Aging and Mobility (CAM), University of Zurich, University Hospital Zurich, and City Hospital Zurich, Waid, Switzerland.,Institute of Primary Health Care (BIHAM), University of Bern, Bern, Switzerland.,Population Health Laboratory (#PopHealthLab), University of Fribourg, Fribourg, Switzerland
| | - Angelique Sadlon
- Department of Aging Medicine and Aging Research, University of Zurich and University Hospital Zurich, Switzerland, Zurich, Switzerland.,Center on Aging and Mobility (CAM), University of Zurich, University Hospital Zurich, and City Hospital Zurich, Waid, Switzerland
| | - Michael Gagesch
- Department of Aging Medicine and Aging Research, University of Zurich and University Hospital Zurich, Switzerland, Zurich, Switzerland.,Center on Aging and Mobility (CAM), University of Zurich, University Hospital Zurich, and City Hospital Zurich, Waid, Switzerland
| | - Walter C Willett
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Endel J Orav
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Reto W Kressig
- University Department of Geriatric Medicine Felix Platter and University of Basel, Basel, Switzerland
| | - Bruno Vellas
- Gérontopôle de Toulouse, Institut du Vieillissement, Center Hospitalo-Universitaire de Toulouse, Toulouse, France.,UMR INSERM 1027, University of Toulouse III, Toulouse, France
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - José A P da Silva
- Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal.,Coimbra Institute for Clinical and Biomedical Research (iCBR), Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Michael Blauth
- Department for Trauma Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - John A Kanis
- Centre for Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - Andreas Egli
- Department of Aging Medicine and Aging Research, University of Zurich and University Hospital Zurich, Switzerland, Zurich, Switzerland.,Center on Aging and Mobility (CAM), University of Zurich, University Hospital Zurich, and City Hospital Zurich, Waid, Switzerland
| | - Heike A Bischoff-Ferrari
- Department of Aging Medicine and Aging Research, University of Zurich and University Hospital Zurich, Switzerland, Zurich, Switzerland.,Center on Aging and Mobility (CAM), University of Zurich, University Hospital Zurich, and City Hospital Zurich, Waid, Switzerland.,University Clinic for Aging Medicine, City Hospital Zurich, Zurich, Waid, Switzerland
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38
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Pinto D, Alshahrani M, Chapurlat R, Chevalley T, Dennison E, Camargos BM, Papaioannou A, Silverman S, Kaux JF, Lane NE, Morales Torres J, Paccou J, Rizzoli R, Bruyere O. The global approach to rehabilitation following an osteoporotic fragility fracture: A review of the rehabilitation working group of the International Osteoporosis Foundation (IOF) committee of scientific advisors. Osteoporos Int 2022; 33:527-540. [PMID: 35048200 DOI: 10.1007/s00198-021-06240-7] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 11/11/2021] [Indexed: 12/14/2022]
Abstract
PURPOSE To conduct a review of the current state of the evidence for rehabilitation strategies post-fragility fracture. METHODS Narrative review conducted by the Rehabilitation Working Group of the International Osteoporosis Foundation Committee of Scientific Advisors characterizing the range of rehabilitation modalities instrumental for the management of fragility fractures. RESULTS Multi-modal exercise post-fragility fracture to the spine and hip is strongly recommended to reduce pain, improve physical function, and improve quality of life. Outpatient physiotherapy post-hip fracture has a stronger evidence base than outpatient physiotherapy post-vertebral fracture. Appropriate nutritional care after fragility fracture provides a large range of improvement in morbidity and mortality. Education increases understanding of osteoporosis which in turn increases utilization of other rehabilitation services. Education may improve other health outcomes such as pain and increase a patient's ability for self-advocacy. CONCLUSION Rehabilitation interventions are inter-reliant, and research investigating the interaction of exercise, nutrition, and other multi-modal therapies may increase the relevance of rehabilitation research to clinical care.
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Affiliation(s)
- D Pinto
- Department of Physical Therapy, Marquette University, P.O. Box 1881, Wisconsin, 53201, Milwaukee, USA.
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, 4000, Liège, Belgium.
| | - M Alshahrani
- Department of Physical Therapy, Marquette University, P.O. Box 1881, Wisconsin, 53201, Milwaukee, USA
- Department of Medical Rehabilitation Science, King Khalid University, Abha, Kingdom of Saudi Arabia
| | - R Chapurlat
- INSERM UMR 1033, Université de Lyon, Hôpital Edouard Herriot, Lyon, France
| | - T Chevalley
- Division of Bone Diseases, Department of Medicine, University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - E Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - B M Camargos
- Densitometry Diagnostic Unit - Rede Materdei de Saúde, Belo Horizonte, Mina Gerais, Brazil
| | - A Papaioannou
- Department of Medicine, Division of Geriatrics, McMaster University, Hamilton, Canada
| | - S Silverman
- Cedars-Sinai Medical Center and University of California, Los Angeles, CA, USA
| | - J-F Kaux
- Department of Physical and Rehabilitation Medicine, University Hospital of Liège, University of Liège, Liège, Belgium
| | - N E Lane
- Department of Medicine and Rheumatology, Davis School of Medicine, University of California, Sacramento, CA, USA
| | - J Morales Torres
- University of Guanajuato at León, Osteoporosis Unit, Hospital Aranda de La Parra, León, Mexico
| | - J Paccou
- Département Universitaire de Rhumatologie, Centre Hospitalier Et Universitaire, Hôpital Roger Salengro, Lille, France
| | - R Rizzoli
- Division of Bone Diseases, Department of Medicine, University Hospitals and Faculty of Medicine of Geneva, Geneva, Switzerland
| | - O Bruyere
- Department of Public Health, Epidemiology and Health Economics, WHO Collaborating Centre for Public Health Aspects of Musculo-Skeletal Health and Ageing, University of Liège, 4000, Liège, Belgium
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Koy EHS, Amouzougan A, Biver E, Chapurlat R, Chevalley T, Ferrari SL, Fouilloux A, Locrelle H, Marotte H, Normand M, Rizzoli R, Vico L, Thomas T. Reference microarchitectural values measured by HR-pQCT in a Franco-Swiss cohort of young adult women. Osteoporos Int 2022; 33:703-709. [PMID: 34642812 DOI: 10.1007/s00198-021-06193-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 10/04/2021] [Indexed: 10/20/2022]
Abstract
UNLABELLED Bone microarchitecture assessed by high-resolution peripheral quantitative computed tomography varies across populations of different origin. The study presents a reference dataset of microarchitectural parameters in a homogeneous group of participants aged within 22-27 range determined by a discriminant analysis of a larger cross-sectional cohort of 339 women. INTRODUCTION High-resolution peripheral quantitative computed tomography (HR-pQCT) non-invasively measures three-dimensional bone microarchitectural parameters and volumetric bone mineral density. Previous studies established normative reference HR-pQCT datasets for several populations, but there were few data assessed in a reference group of young women with Caucasian ethnicity living in Western Europe. It is important to obtain different specific reference dataset for a valid interpretation of cortical and trabecular microarchitecture data. The aim of our study was to find the population with the most optimal bone status in order to establish a descriptive reference HR-pQCT dataset in a young and healthy normal-weight female cohort living in a European area including Geneva, Switzerland, Lyon and Saint-Etienne, France. METHODS We constituted a cross-sectional cohort of 339 women aged 19-41 years with a BMI > 18 and < 30 kg/m2. All participants had HR-pQCT measurements at both non-dominant distal radius and tibia sites. RESULTS We observed that microarchitectural parameters begin to decline before the age of 30 years. Based on a discriminant analysis, the optimal bone profile in this population was observed between the age range of 22 to 27 years. Consequently, we considered 43 participants aged 22-27 years to establish a reference dataset with median values and percentiles. CONCLUSION This is the first study providing reference values of HR-pQCT measurements considering specific age bounds in a Franco-Swiss female cohort at the distal radius and tibia sites.
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Affiliation(s)
- E How Shing Koy
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - A Amouzougan
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - E Biver
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - R Chapurlat
- INSERM U1033, Hôpital Edouard Herriot, HCL, Lyon, France
| | - T Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - S L Ferrari
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Fouilloux
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - H Locrelle
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - H Marotte
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - M Normand
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - L Vico
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - T Thomas
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France.
- INSERM U1059, Université de Lyon, Saint-Etienne, France.
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Abstract
Peak bone mass (PBM) is a key determinant of bone mass and fragility fractures later in life. The increase in bone mass during childhood and adolescence is mainly related to an increase in bone size rather to changes in volumetric bone density. Race, gender, and genetic factors are the main determinants of PBM achievement. Nevertheless, environmental factors such as physical activity, calcium and protein intakes, weight and age at menarche, are also playing an important role in bone mass accrual during growth. Therefore, optimization of calcium and protein intakes and weight-bearing physical activity during growth is an important strategy for optimal acquisition of PBM and bone strength and for contributing to prevent fractures later in life.
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Affiliation(s)
- Thierry Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Veronese N, Honvo G, Amuthavalli Thiyagarajan J, Rizzoli R, Cooper C, Bruyère O, Mikton C, Sumi Y, Diaz T, Reginster JY, Banerjee A. Attributes and definitions of locomotor capacity in older people: a World Health Organisation (WHO) locomotor capacity working group meeting report. Aging Clin Exp Res 2022; 34:481-483. [PMID: 35133612 PMCID: PMC8894172 DOI: 10.1007/s40520-022-02080-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 01/18/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Nicola Veronese
- Geriatric Unit, Department of Medicine, University of Palermo, Palermo, Italy.
| | - Germain Honvo
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | | | - René Rizzoli
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- Division of Bone Diseases, Faculty of Medicine, Geneva University Hospitals, University of Geneva, Geneva, Switzerland
| | - Cyrus Cooper
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- MRC Life Course Epidemiology Unit, Southampton General Hospital, University of Southampton, Southampton, UK
| | - Olivier Bruyère
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Christopher Mikton
- Demographic Change and Healthy Aging Unit, Social Determinants of Health, World Health Organization, Geneva, Switzerland
| | - Yuka Sumi
- Ageing and Health Unit, Department of Maternal, Newborn, Child and Adolescent Health & Ageing, WHO HQ, Geneva, Switzerland
| | - Theresa Diaz
- Epidemiology, Monitoring and Evaluation Unit, Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Jean-Yves Reginster
- World Health Organization Collaborating Centre for Public Health Aspects of Musculoskeletal Health and Aging, Liege, Belgium
- Division of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - Anshu Banerjee
- Ageing and Health Unit, Department of Maternal, Newborn, Child and Adolescent Health & Ageing, WHO HQ, Geneva, Switzerland
- Epidemiology, Monitoring and Evaluation Unit, Maternal, Newborn, Child, Adolescent Health and Ageing, World Health Organization, Geneva, Switzerland
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How Shing Koy E, Amouzougan A, Biver E, Chapurlat R, Chevalley T, Ferrari SL, Fouilloux A, Locrelle H, Marotte H, Normand M, Rizzoli R, Vico L, Thomas T. Correction to: Reference microarchitectural values measured by HR-pQCT in a Franco-Swiss cohort of young adult women. Osteoporos Int 2022; 33:711. [PMID: 34746966 DOI: 10.1007/s00198-021-06223-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- E How Shing Koy
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - A Amouzougan
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - E Biver
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - R Chapurlat
- INSERM U1033, Hôpital Edouard Herriot, HCL, Lyon, France
| | - T Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - S L Ferrari
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - A Fouilloux
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - H Locrelle
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - H Marotte
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - M Normand
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - L Vico
- INSERM U1059, Université de Lyon, Saint-Etienne, France
| | - T Thomas
- Department of Rheumatology, Hôpital Nord, CHU Saint-Etienne, Saint-Etienne, France.
- INSERM U1059, Université de Lyon, Saint-Etienne, France.
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Gagesch M, Chocano-Bedoya PO, Abderhalden LA, Freystaetter G, Sadlon A, Kanis JA, Kressig RW, Guyonnet S, DaSilva JAP, Felsenberg D, Rizzoli R, Blauth M, Orav EJ, Egli A, Bischoff-Ferrari HA. Prevalence of Physical Frailty: Results from the DO-HEALTH Study. J Frailty Aging 2022; 11:18-25. [PMID: 35122086 DOI: 10.14283/jfa.2021.18] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Frailty is a geriatric syndrome associated with multiple negative health outcomes. However, its prevalence varies by population and instrument used. We investigated frailty and pre-frailty prevalence by 5 instruments in community-dwelling older adults enrolled to a randomized-controlled trial in 5 European countries. METHODS Cross-sectional baseline analysis in 2,144 DO-HEALTH participants recruited from Switzerland, Austria, France, Germany, and Portugal with complete data for frailty. Frailty status was assessed by the Physical Frailty Phenotype [PFP], SOF-Frailty Index [SOF-FI], FRAIL-Scale, SHARE-Frailty Instrument [SHARE-FI], and a modified SHARE-FI, and compared by country, age, and gender. Logistic regression was used to determine relevant factors associated with frailty and pre-frailty. RESULTS Mean age was 74.9 (±4.4) years, 61.6% were women. Based on the PFP, overall frailty and pre-frailty prevalence was 3.0% and 43.0%. By country, frailty prevalence was highest in Portugal (13.7%) and lowest in Austria (0%), and pre-frailty prevalence was highest in Portugal (57.3%) and lowest in Germany (37.1%). By instrument and overall, frailty and pre-frailty prevalence was highest based on SHARE-FI (7.0% / 43.7%) and lowest based on SOF-FI (1.0% / 25.9%). Frailty associated factors were residing in Coimbra (Portugal) [OR 12.0, CI 5.30-27.21], age above 75 years [OR 2.0, CI 1.17-3.45], and female gender [OR 2.8, CI 1.48-5.44]. The same three factors predicted pre-frailty. CONCLUSIONS Among relatively healthy adults age 70 and older enroled to DO-HEALTH, prevalence of frailty and pre-frailty differed significantly by instrument, country, gender, and age. Among instruments, the highest prevalence of frailty and pre-frailty was documented by the SHARE-FI and the lowest by the SOF-FI.
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Affiliation(s)
- M Gagesch
- Michael Gagesch, MD, Department of Geriatrics, University Hospital Zurich, Ramistrasse 100, 8091 Zurich, Switzerland, , https://orcid.org/0000-0003-3089-5768
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Gagesch M, Wieczorek M, Vellas B, Kressig RW, Rizzoli R, Kanis J, Willett WC, Egli A, Lang W, Orav EJ, Bischoff-Ferrari HA. Effects of Vitamin D, Omega-3 Fatty Acids and a Home Exercise Program on Prevention of Pre-Frailty in Older Adults: The DO-HEALTH Randomized Clinical Trial. J Frailty Aging 2022; 12:71-77. [PMID: 36629088 DOI: 10.14283/jfa.2022.48] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The benefits of supplemental vitamin D3, marine omega-3 fatty acids, and a simple home exercise program (SHEP) on frailty prevention in generally healthy community-dwelling older adults are unclear. OBJECTIVE To test the effect of vitamin D3, omega-3s, and a SHEP, alone or in combination on incident pre-frailty and frailty in robust older adults over a follow-up of 36 months. METHODS DO-HEALTH is a multi-center, double-blind, placebo-controlled, 2x2x2 factorial randomized clinical trial among generally healthy European adults aged 70 years or older, who had no major health events in the 5 years prior to enrollment, sufficient mobility and intact cognitive function. As a secondary outcome of the DO-HEALTH trial, among the subset of participants who were robust at baseline, we tested the individual and combined benefits of supplemental 2,000 IU/day of vitamin D3, 1 g/day of marine omega-3s, and a SHEP on the odds of being pre-frail and frail over 3 years of follow-up. RESULTS At baseline, 1,137 out of 2,157 participants were robust (mean age 74.3 years, 56.5% women, mean gait speed 1.18 m/s). Over a median follow-up time of 2.9 years, 696 (61.2%) became pre-frail and 29 (2.6%) frail. Odds ratios for becoming pre-frail were not significantly lower for vitamin D3, or omega 3-s, or SHEP, individually, compared to control (placebo for the supplements and control exercise). However, the three treatments combined showed significantly decreased odds (OR 0.61 [95% CI 0.38-0.98; p=0.04) of becoming pre-frail compared to control. None of the individual treatments or their combination significantly reduced the odds of becoming frail. CONCLUSION Robust, generally healthy and active older adults without major comorbidities, may benefit from a combination of high-dose, supplemental vitamin D3, marine omega-3s, and SHEP with regard to the risk of becoming pre-frail over 3 years.
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Affiliation(s)
- M Gagesch
- Michael Gagesch, MD, Department of Aging Medicine, University Hospital Zurich, Rämistrasse 100, 8091 Zurich, Switzerland,
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Bégin MJ, Audet MC, Chevalley T, Portela M, Padlina I, Hannouche D, Ing Lorenzini K, Meier R, Peter R, Uebelhart B, Rizzoli R, Ferrari S, Biver E. Fracture Risk Following an Atypical Femoral Fracture. J Bone Miner Res 2022; 37:87-94. [PMID: 34668223 PMCID: PMC9298806 DOI: 10.1002/jbmr.4461] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 10/05/2021] [Accepted: 10/14/2021] [Indexed: 12/11/2022]
Abstract
Atypical femoral fractures (AFFs) occurring during the course of osteoporosis treatment usually lead to discontinuation of anti-resorptive (AR) drugs. However, the risk of fracture after an AFF is unknown. We conducted a follow-up study of patients with AFF matched 1:3 for age and gender with patients with a peripheral major osteoporotic fracture (pMOF), in the setting of a fracture liaison service, to investigate the incidence of subsequent low-trauma fractures. Fifty-five patients with AFF (95% women, age [mean ± standard deviation] 75 ± 10 years, 89% exposed to AR drugs), followed for 6.2 ± 3.7 years, were compared to 165 matched controls with a pMOF (hip 85%) followed for 4.3 ± 2.6 years. During the follow-up, 38% of patients in the AFF group and 16% in the pMOF group received AR therapies. Continuation of AR drugs after an AFF was associated with contralateral AFF in 27% of subjects. The risks of new low-trauma, major osteoporotic and imminent (within 2 years) fractures, were similar between the two groups: incidence rate ratio (95% confidence interval [CI]) of subsequent fracture following AFF relative to pMOF, 1.30 (95% CI, 0.82-2.04), 1.28 (95% CI, 0.74-2.15), and 1.11 (95% CI, 0.54-2.15), respectively. Moreover, the risk of sustaining multiple fractures per participant was significantly increased among patients with AFF compared to pMOF (hazard ratio 1.48 [95% CI, 1.00-2.19]; p = 0.049). When taking mortality into account, the risk of subsequent fractures tended to be higher in the AFF group (sub-hazard ratio 1.42 [95% CI, 0.95-2.12]). In conclusion, patients who sustained an AFF are at high risk of subsequent fragility fractures, at least equal or even greater to the risk observed after a pMOF. However, continuation of AR drugs increases the risk of contralateral AFF. Therefore, optimal modalities for secondary fracture prevention after AFF require further evaluation. © 2021 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Marie-Josée Bégin
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marie-Claude Audet
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Thierry Chevalley
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Marina Portela
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Ivan Padlina
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Didier Hannouche
- Division of Orthopedic Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Kuntheavy Ing Lorenzini
- Division of Clinical Pharmacology and Toxicology, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Raphaël Meier
- Department of Surgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Robin Peter
- Division of Orthopedic Surgery, Department of Surgery, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Brigitte Uebelhart
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Serge Ferrari
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Emmanuel Biver
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland
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Chevalley T, Brandi ML, Cavalier E, Harvey NC, Iolascon G, Cooper C, Hannouche D, Kaux JF, Kurth A, Maggi S, Maier G, Papavasiliou K, Al-Daghri N, Sosa-Henríquez M, Suhm N, Tarantino U, Reginster JY, Rizzoli R. How can the orthopedic surgeon ensure optimal vitamin D status in patients operated for an osteoporotic fracture? Osteoporos Int 2021; 32:1921-1935. [PMID: 34013461 PMCID: PMC8134831 DOI: 10.1007/s00198-021-05957-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/09/2021] [Indexed: 12/19/2022]
Abstract
In this narrative review, the role of vitamin D deficiency in the pathophysiology, healing of fragility fractures, and rehabilitation is discussed. Vitamin D status can be assessed by measuring serum 25(OH)-vitamin D level with standardized assays. There is a high prevalence of vitamin D insufficiency (25(OH)D < 50 nmol/l (i.e., 20 ng/mL)) or deficiency (25(OH)D < 25 nmol/l (i.e., 10 ng/mL)) in patients with fragility fractures and especially in those with a hip fracture. The evidence on the effects of vitamin D deficiency and/or vitamin D supplementation on fracture healing and material osseointegration is still limited. However, it appears that vitamin D have a rather positive influence on these processes. The fracture liaison service (FLS) model can help to inform orthopedic surgeons, all caregivers, and fractured patients about the importance of optimal vitamin D status in the management of patients with fragility fractures. Therefore, vitamin D status should be included in Capture the Fracture® program as an outcome of FLS in addition to dual-energy X-ray absorptiometry (DXA) and specific antiosteoporosis medication. Vitamin D plays a significant role in the pathophysiology and healing of fragility fractures and in rehabilitation after fracture. Correction of vitamin D deficiency should be one of the main outcomes in fracture liaison services.
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Affiliation(s)
- T Chevalley
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - M L Brandi
- Metabolic Bone Diseases Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - E Cavalier
- Department of Clinical Chemistry, University of Liege, CHU de Liege, Liege, Belgium
| | - N C Harvey
- MRC Lifecourse Epidemiology Unit, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - G Iolascon
- Department of Medical and Surgical Specialties and Dentistry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, NIHR Southampton Biomedical Research Centre, University of Southampton, University Hospital Southampton NHS Foundation Trust, Southampton, UK
- UKNIHR Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - D Hannouche
- Service of Orthopaedics and Trauma Surgery, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - J-F Kaux
- Department of Physical Medicine and Rehabilitation, University and University Hospital of Liège, Liège, Belgium
| | - A Kurth
- Department of Orthopaedic and Trauma Surgery, Campus Kemperhof, Community Clinics Middle Rhine, Koblenz, Germany
| | - S Maggi
- CNR Aging Branch-IN, Padua, Italy
| | - G Maier
- Department of Orthopaedic and Rheumatological Rehabilitation, Rehazentrum am Meer, Bad Zwischenahn, Germany
| | - K Papavasiliou
- 3rd Orthopaedic Department, Aristotle University of Thessaloniki Medical School, Papageorgiou General Hospital, Thessaloniki, Greece
| | - N Al-Daghri
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science King Saud University, Riyadh, 11451, Saudi Arabia
| | - M Sosa-Henríquez
- University Institute of Investigation on Biomedical Sciences (IUIBMS), University of Las Palmas de Gran Canaria, Las Palmas de Gran Canaria, Canary Islands, Spain
- Bone Metabolic Unit, Hospital University Insular, Las Palmas de Gran Canaria, Canary Islands, Spain
| | - N Suhm
- Department of Orthopaedic and Trauma Surgery, University Hospital Basel, Spitalstrasse 21, 4031, Basel, Switzerland
| | - U Tarantino
- Department of Clinical Sciences and Translational Medicine, Faculty of Medicine and Surgery, Tor Vergata University of Rome, Via Montpellier 1, 00133, Rome, Italy
| | - J-Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
| | - R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
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Grygorieva N, Povoroznyuk R, Matijevic R, Cooper C, Rizzoli R, Reginster JY. In memoriam: Vladyslav Povoroznyuk. Osteoporos Int 2021; 32:1905-1906. [PMID: 34322724 DOI: 10.1007/s00198-021-06048-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- N Grygorieva
- Department of Clinical Physiology&Pathology of Locomotor Apparatus, Dmytro F. Chebotarov Institute of Gerontology of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine
| | - R Povoroznyuk
- Department of Theory and Practice of Translation from English, Institute of Philology, Taras Shevchenko National University of Kyiv, Kyiv, Ukraine
| | - R Matijevic
- Department for Medical rehabilitation, Medical faculty, University of Novi Sad, Novi Sad, Serbia.
- Orthopaedic and Trauma Clinic, Clinical Centre of Vojvodina, Novi Sad, Serbia.
| | - C Cooper
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Musculoskeletal Biomedical Research Unit, University of Oxford, Oxford, UK
| | - R Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - J-Y Reginster
- Department of Public Health, Epidemiology and Health Economics, University of Liège, Liège, Belgium
- Chair for Biomarkers of Chronic Diseases, Biochemistry Department, College of Science, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Abstract
Osteoporotic or fragility fractures affect one in two women and one in five men who are older than 50. These events are associated with substantial morbidity, increased mortality, and an impaired quality of life. Recommended general measures for fragility fracture prevention include a balanced diet with an optimal protein and calcium intake and vitamin D sufficiency, together with regular weight-bearing physical exercise. In this narrative Review, we discuss the role of nutrients, foods, and dietary patterns in maintaining bone health. Much of this information comes from observational studies. Bone mineral density, microstructure-estimated bone strength, and trabecular and cortical microstructure are positively associated with total protein intake. Several studies indicate that fracture risk might be lower with a higher dietary protein intake, provided that the calcium supply is sufficient. Dairy products are a valuable source of these two nutrients. Hip fracture risk appears to be lower in consumers of dairy products, particularly fermented dairy products. Consuming less than five servings per day of fruit and vegetables is associated with a higher hip fracture risk. Adherence to a Mediterranean diet or to a prudent diet is associated with a lower fracture risk. These various nutrients and dietary patterns influence gut microbiota composition or function, or both. The conclusions of this Review emphasise the importance of a balanced diet including minerals, protein, and fruit and vegetables for bone health and in the prevention of fragility fractures.
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Affiliation(s)
- René Rizzoli
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland.
| | - Emmanuel Biver
- Service of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Tara C Brennan-Speranza
- School of Medical Sciences and School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
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Abstract
Biomineralization is the process by which organisms produce mineralized tissues. This crucial process makes possible the rigidity and flexibility that the skeleton needs for ambulation and protection of vital organs, and the hardness that teeth require to tear and grind food. The skeleton also serves as a source of mineral in times of short supply, and the intestines absorb and the kidneys reclaim or excrete minerals as needed. This Review focuses on physiological and pathological aspects of the hormonal regulation of biomineralization. We discuss the roles of calcium and inorganic phosphate, dietary intake of minerals and the delicate balance between activators and inhibitors of mineralization. We also highlight the importance of tight regulation of serum concentrations of calcium and phosphate, and the major regulators of biomineralization: parathyroid hormone (PTH), the vitamin D system, vitamin K, fibroblast growth factor 23 (FGF23) and phosphatase enzymes. Finally, we summarize how developmental stresses in the fetus and neonate, and in the mother during pregnancy and lactation, invoke alternative hormonal regulatory pathways to control mineral delivery, skeletal metabolism and biomineralization.
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Affiliation(s)
- Andrew Arnold
- Division of Endocrinology & Metabolism and Center for Molecular Oncology, University of Connecticut School of Medicine, Farmington, CT, USA.
| | - Elaine Dennison
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Christopher S Kovacs
- Faculty of Medicine - Endocrinology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Michael Mannstadt
- Endocrine Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - René Rizzoli
- Division of Bone Diseases, Geneva University Hospitals and Faculty of Medicine, Geneva, Switzerland
| | - Maria Luisa Brandi
- Department of Biochemical, Experimental and Clinical Sciences, University of Florence, Florence, Italy
| | - Bart Clarke
- Mayo Clinic Division of Endocrinology, Diabetes, Metabolism, and Nutrition, Rochester, MN, USA
| | - Rajesh V Thakker
- Academic Endocrine Unit, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
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Kendler DL, Body JJ, Brandi ML, Broady R, Cannata-Andia J, Cannata-Ortiz MJ, El Maghraoui A, Guglielmi G, Hadji P, Pierroz DD, de Villiers TJ, Ebeling PR, Rizzoli R. Osteoporosis management in hematologic stem cell transplant recipients: Executive summary. J Bone Oncol 2021; 28:100361. [PMID: 33996429 PMCID: PMC8095179 DOI: 10.1016/j.jbo.2021.100361] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Revised: 03/26/2021] [Accepted: 03/28/2021] [Indexed: 01/09/2023] Open
Abstract
Hematopoietic stem cell transplant (HSCT) patients are living longer. Bone health is an important long-term comorbidity post-HSCT. HSCT patients are at high risk of bone loss and fragility fracture. HSCT patients are at high risk of bone loss and fragility fracture. Recommendations are provided for better monitoring of bone health. Recommendations include bone assessment, dietary advice and osteoporosis medication.
Background Treatment advances have reduced the adverse events associated with hematopoietic stem cell transplant (HSCT) and led to an increased number of transplants performed. HSCT patients are living longer with concerns on long-term outcomes. Bone fragility and fracture are at the forefront for long-term morbidities post-HSCT. Results In HSCT recipients, evidence has accumulated to support recommendations for more extensive monitoring of bone fragility and more appropriate administration of osteoporosis pharmacotherapies for patients at high risk of bone loss and/or fracture. Conclusion This executive summary reports and summarizes the main recommendations published previously, including bone assessment, dietary and lifestyle recommendations and osteoporosis medication.
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Affiliation(s)
- D L Kendler
- Department of Medicine, Division of Endocrinology, University of British Columbia, Vancouver, Canada
| | - J J Body
- CHU Brugmann, Université Libre de Bruxelles, Brussels, Belgium
| | - M L Brandi
- Mineral and Bone Metabolic Unit, Department of Surgery and Translational Medicine, University of Florence, Florence, Italy
| | - R Broady
- Department of Medicine, Division of Hematology, University of British Columbia, Vancouver, Canada
| | - J Cannata-Andia
- Servicio de Metabolismo Óseo y Mineral, Hospital Universitario Central de Asturias, Universidad de Oviedo, Oviedo, Spain
| | - M J Cannata-Ortiz
- Haematology Department, Hospital de la Princesa, IIS Princesa, Madrid, Spain
| | - A El Maghraoui
- Rheumatology Department, Military Hospital Mohammed V, Mohammed V-Souissi University, Rabat, Morocco
| | - G Guglielmi
- Department of Radiology, University of Foggia, Foggia, Italy
| | - P Hadji
- Frankfurt Center of Bone Health, Frankfurt/Main, Germany
| | - D D Pierroz
- International Osteoporosis Foundation (IOF), Nyon, Switzerland
| | - T J de Villiers
- Department of Gynaecology, Faculty of Health Sciences, Stellenbosch University and Mediclinic Panorama, Cape Town, South Africa
| | - P R Ebeling
- Department of Medicine, School of Clinical Sciences, Monash University, Clayton, Australia
| | - R Rizzoli
- Division of Bone Diseases, Geneva University Hospitals & Faculty of Medicine, Geneva, Switzerland
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