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Chou FF, Chi SY, Wu YJ, Chan YC, Huang SC. Preoperative work-up and results of parathyroidectomy plus auto-transplantation for the elderly with secondary hyperparathyroidism. Asian J Surg 2024; 47:880-885. [PMID: 37989683 DOI: 10.1016/j.asjsur.2023.10.003] [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: 07/23/2023] [Revised: 09/17/2023] [Accepted: 10/06/2023] [Indexed: 11/23/2023] Open
Abstract
BACKGROUND Total parathyroidectomy for secondary hyperparathyroidism has low morbidity and mortality rates and requires a special workup in the preoperative period. METHODS Neck echography and technetium-99m-sestamibi scintigraphy were performed preoperatively. Cardiac echography, a thallium-201 myocardial perfusion scan, and cardiac catheterization were performed if necessary. During surgery, we removed all the parathyroid glands and the upper thymus and autotransplanted 100 mg of the smallest gland into the subcutaneous tissue of the forearm. RESULTS The success rate in three months after total parathyroidectomy was 91.7% without mortality. In the elderly (age ≤65 years, n = 35), bone pain, skin itching, general weakness, and insomnia improved three months after surgery, and grip strength increased significantly. One year after parathyroidectomy, the serum levels of Ca, P, alkaline phosphatase, and intact parathyroid hormone were all within the normal ranges. Except for the bone mineral density (BMD) of the radial distal one-third, the BMD of the lumbar spine (L2 to L4), femoral neck, femoral global, and radial global increased significantly. Furthermore, the bone density T-scores of the lumbar spine (L2 to L4), femoral neck, femoral global, radial distal one-third, and radial global improved significantly. CONCLUSIONS After a meticulous preoperative workup, parathyroidectomy plus autotransplantation can be performed safely for the treatment of symptomatic secondary hyperparathyroidism in the elderly to improve their quality of life and decrease their incidence of bone fractures.
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Affiliation(s)
- Fong-Fu Chou
- Department of Surgery, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
| | - Shun-Yu Chi
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Yi-Ju Wu
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Yi-Chia Chan
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
| | - Shun-Chen Huang
- Department of Pathology, Kaohsiung Chang Gung Memorial Hospital, Taiwan
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de Beurs E, Jadnanansing R, Etwaroo K, Blankers M, Bipat R, Peen J, Dekker J. Norms and T-scores for screeners of alcohol use, depression and anxiety in the population of Suriname. Front Psychiatry 2023; 14:1088696. [PMID: 37181892 PMCID: PMC10172675 DOI: 10.3389/fpsyt.2023.1088696] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 04/10/2023] [Indexed: 05/16/2023] Open
Abstract
Background There is a considerable gap between care provision and the demand for care for common mental disorders in low-and-middle-income countries. Screening for these disorders, e.g., in primary care, will help to close this gap. However, appropriate norms and threshold values for screeners of common mental disorders are lacking. Methods In a survey study, we gathered data on frequently used screeners for alcohol use disorders, (AUDIT), depression, (CES-D), and anxiety disorders (GAD-7, ACQ, and BSQ) in a representative sample from Suriname, a non-Latin American Caribbean country. A stratified sampling method was used by random selection of 2,863 respondents from 5 rural and 12 urban resorts. We established descriptive statistics of all scale scores and investigated unidimensionality. Furthermore, we compared scores by gender, age-group, and education level with t-test and Mann-Whitney U tests, using a significance level of p < 0.05. Results Norms and crosswalk tables were established for the conversion of raw scores into a common metric: T-scores. Furthermore, recommended cut-off values on the T-score metric for severity levels were compared with international cut-off values for raw scores on these screeners. Discussion The appropriateness of these cut-offs and the value of converting raw scores into T-scores are discussed. Cut-off values help with screening and early detection of those who are likely to have a common mental health disorder and may require treatment. Conversion of raw scores to a common metric in this study facilitates the interpretation of questionnaire results for clinicians and can improve health care provision through measurement-based care.
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Affiliation(s)
- Edwin de Beurs
- Department of Clinical Psychology, Leiden Universiteit, Leiden, Netherlands
- Research department, Arkin Mental Health Care, Amsterdam, Netherlands
- *Correspondence: Edwin de Beurs,
| | - Raj Jadnanansing
- Department of Psysiology, Anton de Kom University, Tammenga, Suriname
| | - Kajal Etwaroo
- Department of Psysiology, Anton de Kom University, Tammenga, Suriname
| | - Matthijs Blankers
- Research department, Arkin Mental Health Care, Amsterdam, Netherlands
- Department of Psychiatry, Amsterdam University Medical Center, Amsterdam, Netherlands
- Trimbos Institute, Utrecht, Netherlands
| | - Robbert Bipat
- Department of Psysiology, Anton de Kom University, Tammenga, Suriname
| | - Jaap Peen
- Research department, Arkin Mental Health Care, Amsterdam, Netherlands
| | - Jack Dekker
- Research department, Arkin Mental Health Care, Amsterdam, Netherlands
- Department of Clinical Psychology, Vrije Universiteit, Amsterdam, Netherlands
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Watanabe N, Miyatake K, Takada R, Ogawa T, Amano Y, Jinno T, Koga H, Yoshii T, Okawa A. The prevalence and treatment of osteoporosis in patients undergoing total hip arthroplasty and the levels of biochemical markers of bone turnover. Bone Joint Res 2022; 11:873-880. [PMID: 36464500 PMCID: PMC9792872 DOI: 10.1302/2046-3758.1112.bjr-2022-0252.r1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022] Open
Abstract
AIMS Osteoporosis is common in total hip arthroplasty (THA) patients. It plays a substantial factor in the surgery's outcome, and previous studies have revealed that pharmacological treatment for osteoporosis influences implant survival rate. The purpose of this study was to examine the prevalence of and treatment rates for osteoporosis prior to THA, and to explore differences in osteoporosis-related biomarkers between patients treated and untreated for osteoporosis. METHODS This single-centre retrospective study included 398 hip joints of patients who underwent THA. Using medical records, we examined preoperative bone mineral density measures of the hip and lumbar spine using dual energy X-ray absorptiometry (DXA) scans and the medications used to treat osteoporosis at the time of admission. We also assessed the following osteoporosis-related biomarkers: tartrate-resistant acid phosphatase 5b (TRACP-5b); total procollagen type 1 amino-terminal propeptide (total P1NP); intact parathyroid hormone; and homocysteine. RESULTS The prevalence of DXA-proven hip osteoporosis (T-score ≤ -2.5) among THA patients was 8.8% (35 of 398). The spinal osteoporosis prevalence rate was 4.5% (18 of 398), and 244 patients (61.3%; 244 of 398) had osteopenia (-2.5 < T-score ≤ -1) or osteoporosis of either the hip or spine. The rate of pharmacological osteoporosis treatment was 22.1% (88 of 398). TRACP-5b was significantly lower in the osteoporosis-treated group than in the untreated group (p < 0.001). CONCLUSION Osteoporosis is common in patients undergoing THA, but the diagnosis and treatment for osteoporosis were insufficient. The lower TRACP-5b levels in the osteoporosis-treated group - that is, osteoclast suppression - may contribute to the reduction of the postoperative revision rate after THA.Cite this article: Bone Joint Res 2022;11(12):873-880.
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Affiliation(s)
- Naoto Watanabe
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan, Naoto Watanabe. E-mail:
| | - Kazumasa Miyatake
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Ryohei Takada
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takahisa Ogawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Yusuke Amano
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Tetsuya Jinno
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan,Dokkyo Medical University Saitama Medical Center, Saitama, Japan
| | - Hideyuki Koga
- Department of Joint Surgery and Sports Medicine, Tokyo Medical and Dental University, Tokyo, Japan
| | - Toshitaka Yoshii
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
| | - Atsushi Okawa
- Department of Orthopaedic Surgery, Tokyo Medical and Dental University, Tokyo, Japan
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Li S, Li Y, Xu X, Shao J, Xie R, Liu S, Peng L, Wang J, Zhou K, Feng H. Lens Autofluorescence Based Advanced Glycation End Products (AGEs) Measurement to Assess Risk of Osteopenia Among Individuals Under the Age of 50. Med Devices (Auckl) 2022; 15:341-347. [PMID: 36105561 PMCID: PMC9467441 DOI: 10.2147/mder.s381115] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2022] [Accepted: 08/24/2022] [Indexed: 06/15/2023] Open
Abstract
INTRODUCTION Simple non-invasive biomarker is urgently needed to detect the largely silent osteopenia in order to prevent osteoporosis-related fracture later in life. The accumulation of advanced glycation end products (AGEs) has been related to reduced bone density and osteoporotic fractures. Whether lens autofluorescence (LAF) based AGEs (LAF-AGEs) measurement could be used to assess the risk of osteopenia is aimed to investigate in this paper. METHODS Through routine health examination, 368 individuals under the age of 50 were enrolled. A dual-energy X-ray absorptiometry (DXA) device was used to measure bone mineral density (BMD) of the forearm and determine osteopenia. AGE levels were derived with LAF along with the other demographic and laboratory parameters. After deriving the age-adjusted AGE levels (AALs), a linear regression analysis and an ordered logistic regression analysis were applied to examine the associations between osteopenia and LAF-AGEs as well as AALs. RESULTS Negative correlations (Pearson r = -0.16, p < 0.001) were found between LAF-AGEs and T-scores. Higher AALs were significantly associated (p = 0.004) with escalated level of osteopenia in the ordered logistic analysis. DISCUSSION After reviewing the relevant studies, it is concluded that LAF-AGE is a more stable measure of long-term metabolic dysfunction than circulating AGE. LAF-AGEs are a valid, practical and non-invasive parameter for osteopenia risk evaluation. Further studies with longer follow-up will be helpful to clarify its effectiveness for osteoporosis risk assessment.
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Affiliation(s)
- Shaoyun Li
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Yuefei Li
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Xiyan Xu
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Jian Shao
- Guangzhou Laboratory, Guangzhou, People’s Republic of China
| | - Ruifeng Xie
- Department of Life Sciences, University of Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Sheng Liu
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Li Peng
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Jin Wang
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
| | - Kaixin Zhou
- Department of Life Sciences, University of Chinese Academy of Sciences, Beijing, People’s Republic of China
| | - Huyi Feng
- The Fifth People’s Hospital of Chongqing, Chongqing, People’s Republic of China
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Zhang X, Xu Y, Li F, Chen M. Associations between bone mineral density and subclinical peripheral arterial disease in elderly men with type 2 diabetes mellitus. Osteoporos Int 2022; 33:1715-1724. [PMID: 35451624 DOI: 10.1007/s00198-022-06404-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] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 04/12/2022] [Indexed: 12/24/2022]
Abstract
UNLABELLED The association between peripheral arterial disease (PAD) and osteoporosis in elderly men with type 2 diabetes mellitus (T2DM) remains unclear. We demonstrated the association between subclinical PAD and decreased total hip bone mineral density (BMD) in men aged ≥ 55 years with T2DM, providing clinical clues for the early detection of decreased bone density in total hip. PURPOSE To investigate the association between subclinical peripheral arterial disease (PAD) and bone mineral density (BMD) at total hip, femoral neck, and lumbar spine (L1-4) in elderly men with type 2 diabetes mellitus (T2DM). METHODS We identified 2,466 patients with confirmed diabetes in this retrospective cross-sectional study. A total of 272 men aged ≥ 55 years with T2DM (50 with subclinical PAD and 222 without PAD) were analyzed. Partial correlation analysis was conducted to explore the associations between ankle-brachial index (ABI) and BMD. Multivariate logistic regression analysis was performed to analyze the contributor for low bone density (T-score < - 1.0). RESULTS Patients with T2DM and subclinical PAD (ABI ≤ 0.9) had significantly lower total hip BMD and T-score (BMD, 0.87 ± 0.14 vs. 0.92 ± 0.15 g/cm2, P = 0.014; T-score, -1.30 [-1.70 to -0.45] vs. -0.80 [-1.40 to 0.00], P = 0.009) than those in the control group. The partial correlation analyses indicated that ABI significantly correlated with the total hip T-score (adjusted r = 0.166, P = 0.009). The logistic regression analysis indicated that subclinical PAD was an independent risk factor for the risk of decreased bone density in total hip (adjusted odds ratio [95% CI]: 8.933 [1.075-74.222], P = 0.043). CONCLUSION: Subclinical PAD (ABI ≤ 0.9) could be used as a risk factor for decreased total hip BMD in men aged ≥ 55 years with T2DM, which provides clinical clues for the early detection of low bone density in total hip in such populations.
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Affiliation(s)
- X Zhang
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - Y Xu
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - F Li
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | - M Chen
- Department of Orthopaedics, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
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Kılınc RM, Açan AE, Türk G, Kılınç CY, Yeniçeri İÖ. Evaluation of femoral head bone quality by Hounsfield units: a comparison with dual-energy X-ray absorptiometry. Acta Radiol 2022; 63:933-941. [PMID: 34078124 DOI: 10.1177/02841851211021035] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND Osteoporosis is associated with decreases in bone mineral density (BMD) and is diagnosed using dual-energy X-ray absorptiometry (DXA). Computed tomography (CT), performed in routine practice, can also be used to evaluate bone quality without additional cost. PURPOSE To determine whether Hounsfield units (HU), a standardized CT attenuation coefficient, measured from the femoral head correlated with DXA-measured BMD. MATERIAL AND METHODS We evaluated 82 patients (14 men, 68 women; mean age, 67 years) undergoing femoral DXA and CT (non-enhanced abdominopelvic and hip scans) with 130 kV to determine whether HU correlated with T-scores. HU were measured by two radiologists using the largest spherical region of interest including the medullary bone of the femoral head from the junction point of the most caudal section of the femoral head with the femoral neck in 5-mm axial sections. The correlations of both sides' HU values with their ages and DXA femur T-score were evaluated. RESULTS HU values obtained from both femoral heads showed significant variation between the osteoporotic and non-osteoporotic groups (both P = 0.000) and strongly correlated with each other and DXA femur T-scores (left r = 0.75, right r = 0.73, respectively). In ROC curve analysis, predictive power of left HU values in identifying patients with osteoporotic femur DXA T-score was 0.905, and for right HU values it was 0.924. Osteoporosis cutoff values were 198 HU and 204 HU for the left and right hips, respectively. CONCLUSIONS HU obtained from CT performed in routine practice correlated with the DXA scores, thus providing an alternative method to determine regional bone quality without additional cost. This may be useful when choosing a fixation method, especially in trauma cases with already-performed abdominopelvic or pelvic CT in emergency services.
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Affiliation(s)
- Rabia Mihriban Kılınc
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Radiology, Mugla, Turkey
| | - Ahmet Emrah Açan
- Balıkesir University, Faculty of Medicine, Department of Orthopedics and Traumatology, Balıkesir, Turkey
| | - Gamze Türk
- Kayseri Training and Research Hospital, Department of Radiology, Kayseri, Turkey
| | - Cem Yalın Kılınç
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Orthopedics and Traumatology, Muğla, Turkey
| | - İbrahim Önder Yeniçeri
- Muğla Sıtkı Koçman University Training and Research Hospital, Department of Radiology, Mugla, Turkey
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Luo W, Ali MS, Limb R, Cornforth C, Perry DC. Use of the PROMIS Mobility score in assessing function in adolescents and adults previously affected by childhood hip disease. Bone Jt Open 2021; 2:1089-1095. [PMID: 34931526 PMCID: PMC8711660 DOI: 10.1302/2633-1462.212.bjo-2021-0154.r1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Aims The Patient-Reported Outcomes Measurement Information System (PROMIS) has demonstrated faster administration, lower burden of data capture and reduced floor and ceiling effects compared to traditional Patient Reported Outcomes Measurements (PROMs). We investigated the suitability of PROMIS Mobility score in assessing physical function in the sequelae of childhood hip disease. Methods In all, 266 adolscents (aged ≥ 12 years) and adults were identified with a prior diagnosis of childhood hip disease (either Perthes’ disease (n = 232 (87.2%)) or Slipped Capital Femoral Epiphysis (n = 34 (12.8%)) with a mean age of 27.73 years (SD 12.24). Participants completed the PROMIS Mobility Computer Adaptive Test, the Non-Arthritic Hip Score (NAHS), EuroQol five-dimension five-level questionnaire, and the Numeric Pain Rating Scale. We investigated the correlation between the PROMIS Mobility and other tools to assess use in this population and any clustering of outcome scores. Results There was a strong correlation between the PROMIS Mobility and other established PROMs; NAHS (rs = 0.79; p < 0.001). There was notable clustering in PROMIS at the upper end of the distribution score (42.5%), with less seen in the NAHS (20.3%). However, the clustering was broadly similar between PROMIS Mobility and the comparable domains of the NAHS; function (53.6%), and activity (35.0%). Conclusion PROMIS Mobility strongly correlated with other tools demonstrating convergent construct validity. There was clustering of physical function scores at the upper end of the distributions, which may reflect truncation of the data caused by participants having excellent outcomes. There were elements of disease not captured within PROMIS Mobility alone, and difficulties in differentiating those with the highest levels of function. Cite this article: Bone Jt Open 2021;2(12):1089–1095.
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Affiliation(s)
- Weisang Luo
- Trauma and Orthopaedics, Alder Hey Children's Hospital, Liverpool, UK
| | - Mohammed S Ali
- Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Liverpool, UK
| | - Richard Limb
- Trauma and Orthopaedics, Aintree University Hospitals NHS Foundation Trust, Liverpool, UK
| | - Christine Cornforth
- Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Liverpool, UK
| | - Daniel C Perry
- Trauma and Orthopaedics, Alder Hey Children's Hospital, Liverpool, UK.,Department of Women's and Children's Health, University of Liverpool Institute of Translational Medicine, Liverpool, UK.,Trauma and Orthopaedics, University of Liverpool and Alder Hey Children's Hospital, Liverpool, UK
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Kaushal N, Vohora D, Jalali RK, Jha S. Prevalence of osteoporosis and osteopenia in an apparently healthy Indian population - a cross-sectional retrospective study. Osteoporos Sarcopenia 2018; 4:53-60. [PMID: 30775543 PMCID: PMC6362954 DOI: 10.1016/j.afos.2018.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2018] [Revised: 03/08/2018] [Accepted: 04/26/2018] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES An understanding of bone mineral density (BMD) pattern in a population is crucial for prevention and diagnosis of osteoporosis and management of its complications in later life. This study aimed to screen the bone health status and factors associated with osteoporosis in an apparently healthy Indian population. METHODS A retrospective review of medical records was done in a tertiary-care hospital for the subjects who had undergone preventive health-check-ups that included BMD measurements at femur-neck, total-femur, and lumbar-spine. RESULTS We evaluated 524 subjects (age, 50.0 ± 12.4 years) including 41.2% female and 58.8% male subjects. Osteoporosis was present in 6.9% subjects (female, 11.1%; male, 4.2%) and osteopenia in 34% subjects (female, 40.3%; male, 29.9%). Absolute BMD was higher in male subjects (P < 0.001) compared to female subjects at all bone sites. Prevalence of osteoporosis increased with age in female subjects, but not in male subjects. Osteoporosis rates in the age-groups of 30-39, 40-49, 50-59, 60-69, and ≥70 years were 3%, 3.4%, 14.3%, 18.6%, and 36.4%, respectively in female subjects while prevalence in male subjects was 0%, 4%, 6.5%, 4.3%, and 5.6%, respectively, at lumbar spine. Height (r = 0.234-0.358), weight (r = 0.305-0.388), body mass index (r = 0.143-0.285) and physical activity (r = 0.136-0.153) were positively; and alkaline phosphatase (r = -0.133 to -0.203) was negatively correlated with BMD (all P < 0.01) at all sites. These parameters retained significant correlation after controlling for age and sex. No correlation of serum 25-hydroxy-vitamin-D and calcium was noted with BMD (P > 0.05) at any site. CONCLUSIONS Further data on absolute BMD, T scores, and prevalence rates of osteoporosis/osteopenia on multiple bone sites have been presented in this article.
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Affiliation(s)
- Neelam Kaushal
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Divya Vohora
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India
| | - Rajinder K. Jalali
- Medical Affairs & Clinical Research, Sun Pharmaceutical Industries Limited, Gurgaon, India
| | - Sujeet Jha
- Institute of Endocrinology, Diabetes and Metabolism, Max Healthcare Inst. Ltd., New Delhi, India
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Kaushal N, Vohora D, Jalali RK, Jha S. Raised serum uric acid is associated with higher bone mineral density in a cross-sectional study of a healthy Indian population. Ther Clin Risk Manag 2018; 14:75-82. [PMID: 29379298 PMCID: PMC5759848 DOI: 10.2147/tcrm.s147696] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Purpose Oxidative stress has been implicated as a fundamental mechanism in the decline of bone mass. Reactive oxygen species are reported to suppress osteoblast generation and differentiation and enhance osteoclast development and activity. Increasing evidence suggests favorable effect of serum uric acid (UA) on bone metabolism due to its antioxidant properties. Therefore, we investigated the association between serum UA levels and bone mineral density (BMD) in healthy adult Indian subjects. Materials and methods We reviewed the medical records of 524 subjects who had undergone preventive health check-ups in a tertiary care hospital that included UA and BMD measurements at femur neck, total femur, and lumbar spine. Subjects concomitantly taking drugs or having a medical condition that would affect the bone metabolism or UA levels were excluded. Results The final analysis included 310 subjects (mean age: 47.2±12.2 years; females: 43.5%; males: 56.5%). Study population was categorized into two groups based on the group median value for UA (ie, 5.4 mg/dL). BMD was significantly higher at all skeletal sites in subjects with UA >5.4 mg/dL compared to subjects with UA ≤5.4 mg/dL (p<0.001). On correlation analysis, UA was positively associated with BMD at all skeletal sites (r=0.211–0.277; p<0.05). The correlation remained significant after controlling for age (p<0.05) and lifestyle factors (smoking, alcohol use, physical activity, and diet; p<0.05) independently. UA significantly (p<0.001) accounted for 4.5%–7.7% of the variance in BMD (r2=0.045–0.077) in unadjusted model and 1.6%–3.2% of the variance (p<0.05) when adjusted for age and body mass index combined at lumbar spine and right femur neck, respectively. Conclusion We conclude that raised UA levels are associated with higher BMD at all skeletal sites and UA may have a protective role in bone metabolism owing to its antioxidant effect.
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Affiliation(s)
- Neelam Kaushal
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi
| | - Divya Vohora
- Pharmaceutical Medicine, Department of Pharmacology, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi
| | - Rajinder K Jalali
- Medical Affairs and Clinical Research, Sun Pharmaceutical Industries Limited, Gurgaon
| | - Sujeet Jha
- Institute of Endocrinology, Diabetes and Metabolism, Max Healthcare Inst. Ltd, New Delhi, India
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Heidari B, Khashayar P, Rezai Homami M, Pajouhi A, Soltani A, Larijani B. Dual-energy X-ray absorptiometry diagnostic discordance between Z-scores and T-scores in a young Iranian population. Med J Islam Repub Iran 2014; 28:151. [PMID: 25695009 PMCID: PMC4322344] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2013] [Accepted: 06/25/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Dual-energy X-ray Absorptiometry (DXA) is considered the gold standard for non-invasive measurement of bone mass. T-scores and Z-scores are used to present the results of bone mass. The present study was designed to evaluate the discordance between T-scores and Z-scores calculated at a same level and its relation with age, gender and body mass index (BMI) in a representative sample of normal population. METHODS This cross-sectional study was conducted as a part of a comprehensive survey, Iranian Multicenter Osteoporosis Study (IMOS), designed to assess bone health among healthy adults. Each individual underwent both L1-L4 antero-posterior lumbar spine and hip DXA scan. The difference between the T- and Z-scores measured at each of the four skeletal sites was then calculated. RESULTS A -1.21 to 1.21 point difference was noted in the Z- and T- scores measured at each site. While the difference between the T-and Z-scores was less than 0.5 SD in most of the cases, the difference was higher than 1 SD in about 5% of the subjects. CONCLUSION Standardization of Z-score definition and calculation techniques as well as developing an ethnicity-matched reference population is needed to improve the reliability of DXA-generated Z-scores.
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Affiliation(s)
- Behnam Heidari
- 1. MD, MPH, General Physician, Research Fellow, Endocrinology and Metabolism Research Center, Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran.
| | - Patricia Khashayar
- 2. MD, PhD by Research Student, Endocrinology & Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Mohsen Rezai Homami
- 3. MD, PhD, Epidemiologist, Assistant Professor, Rasul-Akram Hospital, Iran University of Medical Sciences Tehran, Iran.
| | - Atieh Pajouhi
- 4. MD, General Physician, Research Fellow, Endocrinology & Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Akbar Soltani
- 5. MD, Associate Professor, Endocrinology & Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Bagher Larijani
- 6. MD, Professor,Endocrinology & Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
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Schousboe JT, Tanner SB, Leslie WD. Definition of osteoporosis by bone density criteria in men: effect of using female instead of male young reference data depends on skeletal site and densitometer manufacturer. J Clin Densitom 2014; 17:301-6. [PMID: 24269168 DOI: 10.1016/j.jocd.2013.09.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [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: 07/03/2013] [Accepted: 09/05/2013] [Indexed: 10/26/2022]
Abstract
Whether to use young male or young female reference data to calculate bone mineral density (BMD) T-scores in men remains controversial. The third National Health and Nutrition Examination and Survey (NHANES III) data show that the mean and standard deviation of femoral neck and total hip BMD is greater in young men than young women, and therefore differences in T-scores at these sites using NHANES III female vs male norms becomes less as BMD decreases. In contrast, manufacturer-specific reference databases generally assume similar standard deviations of BMD in men and women. Using NHANES III reference data for the femoral neck and total hip, respectively we found that men with T-scores of -2.5 when young male norms are used have T-scores of -2.4 and -2.3 when young female norms are used. Using manufacturer-specific reference data, we found that men with T-scores of -2.5 when young male norms are used at the femoral neck, total hip, lumbar spine, or one-third of the forearm would have T-scores ranging from -2.4 to -0.4 when young female norms are used, depending on skeletal site and densitometer manufacturer. The change of proportions of men diagnosed with osteoporosis when young female norms are used instead of young male reference data differs substantially according to skeletal site and densitometer manufacturer.
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Affiliation(s)
- John T Schousboe
- Park Nicollet Osteoporosis Center and Institute for Research and Education, Minneapolis, MN, USA; Division of Health Policy and Management, University of Minnesota, Minneapolis, MN, USA.
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12
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Kuo SJ, Wang FS, Sheen JM, Yu HR, Wu SL, Ko JY. Complement component C3: Serologic signature for osteogenesis imperfecta. Analysis of a comparative proteomic study. J Formos Med Assoc 2014; 114:943-9. [PMID: 24612500 DOI: 10.1016/j.jfma.2014.01.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2013] [Revised: 01/20/2014] [Accepted: 01/26/2014] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/PURPOSE Osteogenesis imperfecta (OI) is a disease characterized by low bone mass and bony fragility. This study investigated the serum proteomic profiles and their correlation with bone density for OI cases. METHODS Twenty OI patients and 20 control participants were included. Comparative serum proteomic profiles were analyzed by two-dimensional electrophoresis and tandem mass spectrometry. Serum protein levels were measured by enzyme-linked immunosorbent assay. Cutoff values and areas under the curve were estimated by the receiver operating characteristic curve. Bone mineral density data was obtained from all OI patients. RESULTS Candidate proteins identified by electrophoresis were complement component C3 (C3), vitamin D-binding protein (DBP), and haptoglobin (HP). Enzyme-linked immunosorbent assay validation showed that OI patients had decreased C3 and DBP and increased HP. The results were not affected by age or bisphosphonate use. Serum C3 levels significantly correlated with bone mineral density of the lumbar spine and hip. C3 had the greatest areas under the curve to distinguish OI from healthy controls. CONCLUSION Serum C3, DBP, and HP are emerging serologic signatures for OI. Concentrations of serum C3 correlated with the T score of OI patients. C3 had the greatest areas under the curve of the three proteins to distinguish OI from healthy controls.
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Affiliation(s)
- Shu-Jui Kuo
- Department of Orthopedic Surgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Feng-Sheng Wang
- Department of Medical Research, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jiunn-Ming Sheen
- Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan
| | - Hong-Ren Yu
- Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital-Kaohsiung Medical Center, Kaohsiung, Taiwan
| | - Shin-Long Wu
- Department of Medical Research, Chang Gung University College of Medicine, Kaohsiung, Taiwan
| | - Jih-Yang Ko
- Department of Orthopedic Surgery, Chang Gung University College of Medicine, Kaohsiung, Taiwan; Graduate Institute of Clinical Medical Science, Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Watts NB, Leslie WD, Foldes AJ, Miller PD. 2013 International Society for Clinical Densitometry Position Development Conference: Task Force on Normative Databases. J Clin Densitom 2013; 16:472-81. [PMID: 24076161 DOI: 10.1016/j.jocd.2013.08.001] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [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: 07/27/2013] [Accepted: 08/06/2013] [Indexed: 01/13/2023]
Abstract
Following the standard protocol for development of Official Positions for the International Society for Clinical Densitometry, the Expert Panel heard the report and recommendations from the Task Force on Normative Databases; using the RAND methodology, agreement was reached on the following statements: 1. Manufacturers should continue to use their own databases for the lumbar spine as the reference standard for T-scores. 2. Manufacturers should continue to use National Health and Nutrition Examination Survey III data as the reference standard for femoral neck and total hip T-scores. 3. If local reference data are available, they should be used to calculate only Z-scores but not T-scores. 4. A uniform Caucasian (non-race adjusted) female reference database should be used to calculate T-scores for men of all ethnic groups.
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Affiliation(s)
- Nelson B Watts
- Mercy Health Osteoporosis and Bone Health Services, Cincinnati, OH, USA.
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Blake GM, Noon E, Spector TD, Fogelman I. Intervertebral T-score differences in younger and older women. J Clin Densitom 2013; 16:329-335. [PMID: 22717905 DOI: 10.1016/j.jocd.2012.05.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/30/2012] [Revised: 05/11/2012] [Accepted: 05/17/2012] [Indexed: 11/23/2022]
Abstract
The T-score discordance among skeletal sites is an important aspect of dual-energy X-ray absorptiometry (DXA) measurements. In the spine, large T-score differences between vertebrae are frequently seen in elderly patients owing to degenerative disease. However, it is unclear how often such differences occur in younger adults with healthy spines. The T-scores for individual lumbar vertebrae were compared for 2391 female singletons (18-79 yr) recruited to the Twins UK Adult Twin Register. Women were divided into 6 age bands and 5 bands by body weight, respectively, and the T-score differences between the pairs of vertebrae were examined using correlation coefficients and the standard error of the estimate (SEE) from linear regression analysis. Correlations between the T-scores for adjacent lumbar vertebrae were r = 0.92 decreasing to r = 0.79 between L1 and L4. When plotted as a function of age, r-values were constant for the 5 younger age bands, but decreased in the oldest group. In contrast, the T-score SEE values increased progressively with age from 0.4 to 0.5 for the younger groups to 0.7 for the oldest. Similar trends were seen when women were divided according to body weight. Both increasing age and higher body weight were statistically significantly associated with a higher T-score SEE. The incidence of large T-score differences between vertebrae varies with age and body weight, but is common even among younger women. Clinically significant T-score differences can occur in the absence of osteoarthritis, and visual assessment of spine DXA scans for evidence of degenerative disease is advised before vertebrae are omitted from scan analyses.
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Affiliation(s)
- Glen M Blake
- Osteoporosis Research Unit, King's College London, King's Health Partners, Guy's Hospital, London, UK.
| | - Edward Noon
- Osteoporosis Research Unit, King's College London, King's Health Partners, Guy's Hospital, London, UK
| | - Tim D Spector
- Department of Twin Research and Genetic Epidemiology, King's College London, King's Health Partners, St Thomas' Hospital, London, UK
| | - Ignac Fogelman
- Osteoporosis Research Unit, King's College London, King's Health Partners, Guy's Hospital, London, UK
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