Associação entre as condições de nascimento e a densidade mineral óssea de adultos das coortes de nascimentos de 1982 e 1993 de Pelotas, Rio Grande do Sul, Brasil / Association between birth conditions and bone mineral density in adults from the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil / Asociación entre las condiciones de nacimiento y la densidad mineral ósea de adultos de las cohortes de nacimiento de 1982 y 1993 en Pelotas, Rio Grande do Sul, Brasil

Resumo: Este estudo avaliou a associação do peso ao nascer, idade gestacional e crescimento intrauterino com a densidade mineral óssea (DMO) aos 22 e 30 anos, nas coortes de nascimentos de 1982 e 1993 de Pelotas, Rio Grande do Sul, Brasil. A DMO foi medida por absorciometria por raios X com dupla energia (DXA), a associação foi avaliada usando análise de variância e a regressão linear múltipla para o controle de confundimento por: sexo, renda familiar ao nascer, tabagismo materno na gestação, escolaridade materna, cor da pele materna e índice de massa corporal pré-gestacional. Foi testado se a gordura corporal na vida adulta era mediadora da associação analisada, por meio da G-computation Formula. Foram avaliados 6.803 participantes das coortes de 1982 e 1993, aos 30 e 22 anos, respectivamente. O peso ao nascer teve associação com a DMO em todos os sítios, com maior diferença no colo femoral. Os nascidos com menos de 2.000g apresentaram, em média, -0,036g/cm2 (IC95%: -0,064; -0,008) de DMO no colo femoral em comparação àqueles com mais de 3.500g. Aqueles com escore-z de crescimento intrauterino com pelo menos 1,28 desvio padrão abaixo da média apresentaram, em média, -0,013g/cm2 (IC95%: -0,024; -0,002) de DMO na coluna lombar, em relação aos com escore-z acima da média. A análise de mediação mostrou que gordura corporal na idade adulta não mediou a associação. As condições de nascimento foram associadas com a densidade mineral óssea na vida adulta, e a identificação dos fatores precoces relacionados à perda de DMO é essencial devido à inversão demográfica em progresso em países de média e baixa renda.

Abstract: This study assessed the association of birth weight, gestational age, and intrauterine growth with bone mineral density (BMD) at 22 and 30 years of age in the 1982 and 1993 birth cohorts in Pelotas, Rio Grande do Sul State, Brazil. BMD was measured by dual-energy X-ray absorptiometry (DXA) and the association was assessed using analysis of variance. Multiple linear regression was used to control for confounding factors: sex; household income at birth; maternal smoking during pregnancy; maternal schooling; maternal ethnicity/skin color; and pre-pregnancy body mass index. The study tested whether body fat in adulthood was a mediator of the association analyzed, using the G-computation Formula. A total of 6,803 participants from the 1982 and 1993 cohorts were evaluated at 30 and 22 years of age, respectively. Birth weight was associated with BMD at all sites, with a greater difference at the femoral neck. Individuals born weighing less than 2,000g had on average -0.036g/cm2 (95%CI: -0.064; -0.008) of BMD in the femoral neck than individuals weighing more than 3,500g. Individuals with an intrauterine growth z-score at least 1.28 standard deviation below the mean had an average of -0.013g/cm2 (95%CI: -0.024; -0.002) of BMD in the lumbar spine compared with individuals with an above-average z-score. The mediation analysis showed that body fat in adulthood did not mediate the association. Birth conditions have been associated with BMD in adulthood and the identification of early factors related to bone loss is essential due to the demographic inversion that has been taking place in low- and middle-income countries.

Resumen: Este estudio evaluó la asociación del peso al nacer, la edad gestacional y el crecimiento intrauterino con la densidad mineral ósea (DMO) a los 22 y 30 años de edad, en las Cohortes de Nacimiento de 1982 y 1993 de Pelotas, Rio Grande do Sul, Brasil. La DMO se midió mediante absorciometría de rayos X de doble emisión (DXA), y la asociación se evaluó mediante ANOVA y regresión lineal múltiple para controlar la confusión por sexo, ingresos familiares al nacer, tabaquismo materno durante el embarazo, escolaridad materna, color de piel materno e índice de masa corporal antes del embarazo. Se comprobó si la grasa corporal en la edad adulta era un mediador de la asociación analizada, utilizando G-computation Formula. Se evaluaron 6.803 participantes de las cohortes 82 y 93, de 30 y 22 años, respectivamente. El peso al nacer se asoció con la DMO en todos los sitios, con la mayor diferencia en el cuello femoral. Los nacidos con un peso inferior a 2.000g tuvieron una media de -0,036g/cm2 (IC95%: -0,064; -0,008) de DMO en el cuello femoral, que aquellos con más de 3.500g. Aquellos con una puntuación z de crecimiento intrauterino de al menos 1,28 desviaciones estándar por debajo de la media presentaron un promedio de -0,013g/cm2 (IC95%: -0,024; -0,002) de DMO en la columna lumbar, con relación a aquellos con un puntaje z superior a la media. El análisis de mediación mostró que la grasa corporal en la edad adulta no medió la asociación. Las condiciones de nacimiento se asociaron con la DMO en la edad adulta, y la identificación temprana de factores relacionados con la pérdida de DMO es esencial debido a la inversión demográfica que ha estado ocurriendo en los países de ingresos medios y bajos.

Association between childhood anthropometric indicators and bone mineral density in adulthood / Associação entre indicadores antropométricos na infância e densidade mineral óssea na idade adulta

ABSTRACT Objective: This study aimed to verify the association between childhood anthropometric indicators and areal bone mineral density (aBMD) in adulthood. Methods: Repeated measures of 137 subjects (68 females) were obtained in childhood (9.2±1.5 years of age) and adulthood (22.3±1.7 years of age). aBMD (g/cm2) was assessed for whole body, lumbar spine, upper and lower limbs, and femoral neck in adulthood using dual-energy X-ray absorptiometry. Anthropometric measurements of body weight (BW), height, triceps and subscapular skinfolds were obtained in childhood. The anthropometric indicators used were BW, body mass index (BMI), and sum of skinfolds (ΣSF). Simple linear regression was used to assess the association between childhood anthropometric indicators and aBMD in adulthood, controlled by chronological age and stratified by sex, with 5% statistical significance. Results: In females, multiple associations were observed between anthropometric indicators and aBMD, with higher coefficients for BMI (β=0.020; R2=0.20; p<0.01 for right femoral neck to β=0.008; R2=0.16; p<0.01 for upper limbs), followed by BW (β=0.003; R2=0.21; p<0.01 for upper limbs to β=0.008; R2=0.20; p<0.01 for right femoral neck) and ΣSF (β=0.001; R2=0.06; p<0.01 for upper limbs to β=0.005; R2=0.12; p<0.01 for right femoral neck). In males, associations were observed only for the lumbar spine region (β=0.016; R2=0.09 for BMI to β=0.004; R2=0.06; p<0.01 for ΣSF). Conclusions: Anthropometric indicators of childhood proved to be sensitive predictors of aBMD in adulthood, especially in females. BMI indicated a greater association with aBMD in both sexes.

RESUMO Objetivo: O objetivo do estudo foi verificar a associação entre os indicadores antropométricos da infância com a área da densidade mineral óssea (aDMO) na idade adulta. Métodos: Medidas repetidas de 137 sujeitos (68 do sexo feminino) foram obtidos na infância (9,2±1,5 anos de idade) e idade adulta (22,3±1,7 anos de idade). A aDMO (g/cm2) foi avaliada para todo o corpo, coluna lombar, membros superiores e inferiores e colo do fêmur na idade adulta usando a absorciometria radiológica de dupla energia (DXA). Medidas antropométricas de peso corporal, estatura e dobras cutâneas das regiões tricipital e subescapular foram obtidas na infância. Os indicadores antropométricos utilizados para as análises foram o peso corporal (PC), o índice de massa corporal (IMC) e o somatório de dobras cutâneas (ΣDC). Regressão linear simples controlada pela idade e estratificada por sexo foi empregada para avaliar a associação entre os indicadores antropométricos do período da infância na aDMO na idade adulta, com significância estatística de 5%. Resultados: No sexo feminino, múltiplas associações foram observadas entre os indicadores antropométricos e a aDMO, com maiores coeficientes para IMC (β=0,020; R2=0,20; p<0.01 para colo do fêmur direito a β=0,008; R2=0,16; p<0,01 para membros superiores), seguido da PC (β=0,003; r2=0,21; p<0,01 para membros superiores a β=0,008; r2=0,20; p<0,01 para colo do fêmur direito) e ΣDC (β=0,001; R2=0,06; p<0,01 para membros superiores a β=0,005; R2=0,12; p<0,01 para colo do fêmur direito). No sexo masculino, associações ocorreram apenas na região da coluna (β=0,016; R2=0,09 para IMC a β=0,004; R2=0,06; p<0,01 para ΣDC). Conclusões: Indicadores antropométricos da infância mostraram ser sensíveis preditores da aDMO na idade adulta, especialmente no sexo feminino. O IMC indicou maior associação com a aDMO em ambos os sexos.

Assessing bone mineral density in children and adolescents living with HIV and on treatment with tenofovir disoproxil fumarate: a systematic review / Avaliação da densidade mineral óssea em crianças e adolescentes que vivem com HIV e em tratamento com tenofovir disoproxil fumarato: uma revisão sistemática

ABSTRACT Objective: To investigate the impact of tenofovir disoproxil fumarate on bone mineral density and bone mineral content in children and adolescents infected with the human immunodeficiency virus. Data source: The search procedure was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement. The search was carried out until April 2022 in Medical Literature Analysis and Retrieval System Online (Medline), Embase, Cochrane Central, Latin American and Caribbean Health Sciences Literature, Web of Science, Scopus, and MedRxiv. The combination of terms used was: (Children OR Youth OR Teenagers) AND HIV AND (Tenofovir OR "Antiretroviral therapy") AND ("Bone density" OR Osteoporosis OR Osteopenia). The protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42022312851) Data synthesis: The initial searches resulted in 1156 papers. After the exclusion of duplicate studies, three blinded reviewers analyzed the title and abstract of 563 papers, of which 57 remained to be read in full. Only nine papers met the eligibility criteria and were included in descriptive and risk-of-bias analyses. Regarding study design, four were cross-sectional, three were longitudinal before-after studies without a control group, and two were prospective cohorts. Among these nine papers, seven showed no significant association between tenofovir disoproxil fumarate use and reduced bone mass in young people. However, these papers did not have high methodological quality. Conclusions: Although most of the selected papers found no harmful effect of tenofovir disoproxil fumarate on bone mass, further primary research with higher methodological quality is needed so robust scientific evidences can be obtained.

RESUMO Objetivo: Investigar o impacto do tenofovir disoproxil fumarato sobre a densidade mineral óssea e o conteúdo mineral ósseo em crianças e adolescentes infectados pelo vírus da imunodeficiência humana. Fontes de dados: O procedimento de busca foi executado de acordo com o Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement. A busca foi realizada até abril de 2022 nas seguintes bases de dados: Medical Literature Analysis and Retrieval System Online (Medline), Embase, Cochrane Central, Literatura Latino-Americana e do Caribe em Ciências da Saúde (Lilacs), Web of Science, Scopus, and MedRxiv. A combinação de termos utilizada foi: (Children OR Youth OR Teenagers) AND HIV AND (Tenofovir OR "Antiretroviral therapy") AND ("Bone density" OR Osteoporosis OR Osteopenia). O protocolo foi registrado na base International Prospective Register of Systematic Reviews — PROSPERO (CRD42022312851). Síntese dos dados: As pesquisas iniciais resultaram em 1.156 artigos. Após a exclusão dos estudos duplicados, três revisores cegos analisaram título e resumo de 563 estudos, dos quais 57 permaneceram para leitura na íntegra. Somente nove artigos atenderam aos critérios de elegibilidade e foram incluídos para análises descritivas e de risco de viés. Com relação ao desenho dos estudos, quatro foram transversais, três foram estudos longitudinais antes-depois sem grupo controle e dois foram coortes prospectivas. Dos nove artigos, sete não mostraram associação significativa entre uso de TDF e redução de massa óssea em pessoas jovens. Entretanto, esses estudos não tiveram alta qualidade metodológica. Conclusões: Embora a maioria dos estudos selecionados não tenha encontrado efeito prejudicial do TDF sobre massa óssea, novas pesquisas primárias com maior qualidade metodológica são necessárias para que sejam obtidas evidências científicas robustas.

Prevalence of osteoporosis in perimenopausal and postmenopausal women in Malwa region of Punjab

Background: Clinical sign of osteoporosis includes fragility fractures or a T-score that is <2.5 SD below the mean as determined by a dual-energy X-ray absorptiometry (DXA) scan of bone mineral density (BMD). People with T-scores of –2.5 have the highest risk of fracture. People with T-scores of –2.5 have the highest risk of fracture. However, maximum fractures are seen in patients with a T-score between –1 and –2.5 because of more people in this category. As there is very little knowledge of osteoporosis in perimenopausal and postmenopausal women in male region, this study will help us to know the current status of osteoporosis in these females. Aims and Objectives: The objective of the present study was to determine the prevalence of osteoporosis in 296 premenopausal, perimenopausal and postmenopausal women of more than 40 years of age attending midlife health clinic at a tertiary care center in Patiala, Punjab and to observe its correlation with age, menopausal status, body mass index, and dietary intake. Materials and Methods: A detailed medical, surgical, obstetrical, gynecological, and drug history were recorded in a pro forma designed for the study after taking the informed consent. Information about history of fracture on a trivial fall, family history suggestive of osteoporosis, socioeconomic status, educational status, and occupation was documented. Women having history of endocrinal disorders (hypo/hyperthyroidism, hypo/hypergonadism, and hypo/hypercalcemia), receiving therapeutic agents (thiazide diuretics, glucocorticoids, and osteoporosis treatment), having restricted mobility issues and with implants (at lumbar spine, hip, and lower limbs) were excluded from the study. Quantitative ultrasound (QUS) measurement of calcaneum was performed that T-score was generated based on the speed of sound and was used to classify the bone health status of the subjects. Results: Out of 296 women, 227 women had a low bone mass density, that is, <–1 SD. We divided all the participants into three groups as shown in Table 1. Group I (n = 69 [23.2%]) having normal BMD, that is, T score >–1 SD; Group II (n = 204 [69.2%]) included women with BMD between –1 and –2.5 SD (Osteopenia); and Group III (n = 23 [7.6%]) included women with BMD <–2.5 SD (Osteoporosis). Most women in perimenopausal (75%) and postmenopausal (64.6%) group were osteopenic (Group I). Out of all women with osteopenia (Group II, n = 204), 113 (52.1%) were postmenopausal and 82 (40.3%) were perimenopausal. All women with osteoporosis were postmenopausal. The difference between BMD categories and menopausal status was statistically significant (P = 0.014). In these women, the BMD was found to decrease with increase in the average number of years since menopause (YSM) (P = 0.06). Conclusion: Menopause is an important event in a woman’s life cycle which affects bone health with the prevalence of osteoporosis and osteopenia increasing with increasing YSM. QUS technology emerges as cost-effective screening tool for the early detection of osteoporosis for a large population in developing country like India.

Effect of Resistance Training on Body Composition of Adolescents: ABCD Growth Study

Objective: To analyze the relationship between resistance training and body composition in adolescents. Methods: A longitudinal 12-month follow up of 190 adolescents of both sexes categorized into three groups according to resistance training practice, as nonengagement (n=121), irregular engagement (n=44), and frequent engagement (n=25). The outcomes adopted were bone mineral density (BMD), lean soft tissue (LST), and body fatness (BF). Results: Adolescents frequently engaged in resistance training presented higher gains in mean (95%CI) LST [6.1 (3.7 to 8.5) kg vs 2.4 (1.4 to 3.4) kg; P= 0.027] and BMD-upper limbs [0.096 (0.072 to 0.121) g/cm2 vs 0.046 (0.036 to 0.056) g/cm2; P=0.002] than adolescents who were not engaged in resistance training, respectively. Findings were more consistent for boys than girls (models were not significant among girls: LST P= 0.721; BMD-upper limbs P= 0.053). Conclusion: Regular engagement in resistance training was related to higher gains in muscle mass and bone density, especially among boys.

A Randomized Controlled Trial to Assess the Effects of Oral Alkali Therapy in Patients with Diabetic Kidney Disease

Background: To analyze the effects of oral alkali therapy on renal function, nutritional status and bone density in patients of diabetic kidney disease. Material & Methods: A randomized controlled trial was conducted on 60 patients of age>18 years with diabetic kidney disease who were not on dialysis and had plasma bicarbonate levels between 16 and 20 mmol/l. Patients were randomly divided into two groups: Test group (n=30) which received oral alkali therapy as sodium bicarbonate and control group (n=30) who did not receive oral alkali therapy. The patients were followed for 12 months to compare the improvement. Results: In comparison to controls, test group showed a significant improvement in the Hb (0.7 vs. 0.25, P =0.003), significantly less decrease in eGFR (-2.25 vs. -2.9, P=0.049), non-significant less increase in creatinine (-0.26 ± 0.4 vs. -0.43 ± 0.33, P=0.09), significant improvement in bicarbonate levels (7.5 vs. 1, p<0.0001), significant restoration of albumin (0.32 vs. 0.05, P<.0001), significant fall in iPTH levels (50 vs. 25, p=0.007) and ALP levels (32 vs. 12, p=0.015). Bone density (0.28 ± 0.17 vs. 0.01 ± 0.13, P<.0001) and clinical well-being VAS scores improved significantly among the cases (9.83 ± 5.65 vs. -1.67 ± 7.11, P<.0001). Conclusion: In conclusion, oral alkali therapy slows the rate of decline of renal function and the development of end stage renal disease in patients with advanced stages of CKD. This cheap and simple strategy, which is in line with current renal consensus documents, also improves the nutritional status of patients and bone density.

Bone density and implant stability with advanced platelet-rich fibrin in immediately loaded- implant assisted mandibular overdentures / Densidade óssea e estabilidade dos implantes com fibrina rica em plaquetas avançada em overdentures mandibulares com carga imediata

ABSTRACT Objective: The aim of this study is to determine the effect of Advanced Platelet-Rich Fibrin on bone density and implant stability in immediately loaded- implant-assisted mandibular overdentures (Split-mouth study). Material and Methods: Ten completely edentulous patients received two implants in the mandibular canine region and locator attachments were used to retain immediately loaded- implant mandibular overdentures. Each patient served in two Groups, one Group for each side. One side of the mandible received an implant with topical application of Advanced Platelet-Rich Fibrin in the implant osteotomy site (Group I) and the other site received an implant without application of Advanced platelet-rich fibrin (Group II). Each patient was examined clinically for implant stability using Osstell Mentor device and radiographically by ultra-low dose CT scan to measure bone density around the implant at baseline, three, six months, and one year. Results: There were no statistically significant differences (P>.05) in bone density and implant stability among the studied Groups during one year follow-up period. Conclusion : Advanced Platelet-Rich Fibrin has no effect on bone density and implant stability in immediately loaded implant-assisted mandibular overdenture.(AU)

RESUMO Objetivo: O objetivo deste estudo é determinar o efeito da Fibrina Rica em Plaquetas Avançada na densidade óssea e estabilidade dos implantes em Overdentures mandibulares com carga imediata (estudo de boca dividida). Material e Métodos: Dez pacientes edêntulos foram submetidos à instalação de dois implantes mandibulares na região dos caninos e pilares locator foram utilizados como sistema de retenção para as overdentures mandibulares com carga imediata. Cada paciente participou nos dois grupos, sendo um grupo para cada lado. Um lado da mandíbula recebeu implante com aplicação tópica de Fibrina Rica em Plaquetas Avançada no local do sítio cirúrgico do implante (Grupo I) e o outro local recebeu implante sem aplicação de Fibrina Rica em Plaquetas Avançada (Grupo II). Cada paciente foi examinado clinicamente quanto à estabilidade do implante usando o dispositivo Osstell Mentor e radiograficamente por tomografia computadorizada de ultrabaixa dose para medir a densidade óssea ao redor do implante no início do estudo, três, seis meses e um ano. Resultados: Não houve diferenças estatisticamente significativas (P>0,05) na densidade óssea e na estabilidade do implante entre os grupos estudados durante o período de acompanhamento de um ano. Conclusão: A Fibrina Rica em Plaquetas Avançada não tem efeito na densidade óssea e na estabilidade de implantes em Overdentures mandibulares com carga imediata (AU)

Effect of high-intensity training on bone mineral density in basketball players / Efeito do treinamento de alta intensidade na densidade mineral óssea em jogadores de basquete / Efecto del entrenamiento de alta intensidad sobre la densidad mineral ósea en jugadores de baloncesto

ABSTRACT Introduction Increasing the bone mineral density of athletes can provide better basic physical conditions for basketball players, prevent fractures caused by osteopenia and reduce the occurrence of serious sports injuries. Objective Explore the effect of high-intensity training on bone mineral density in basketball players. Methods In this experiment, 30 subjects were divided into male and female groups, and high-intensity exercise training was performed for 60 minutes, three times a week, for eight weeks. The relevant indices were measured before and after training, and their data were classified and analyzed. Results High-intensity training can significantly improve the bone mineral density of basketball players, and the increase of bone mineral density of female basketball players is slightly lower than that of male players. In addition, the increase in bone mineral density can comprehensively improve athletes' muscular strength and physical fitness. Conclusion High-intensity training can improve basketball players' bone mineral density and sports skills, requiring promoting studies for its popularization in colleges and universities. Level of evidence II; Therapeutic studies - investigation of treatment outcomes.

RESUMO Introdução Aumentar o nível de densidade mineral óssea dos atletas pode proporcionar melhores condições físicas básicas para jogadores de basquetebol, prevenir fraturas causadas pela osteopenia e reduzir a ocorrência de lesões esportivas graves. Objetivo Explorar o efeito do treinamento de alta intensidade na densidade mineral óssea de jogadores de basquetebol. Métodos Neste experimento, 30 indivíduos foram divididos em grupo masculino e feminino, o treinamento de exercícios de alta intensidade foi realizado por 60 minutos, três vezes por semana durante um total de 8 semanas. Os índices relevantes foram medidos antes e após o treinamento, seus dados foram classificados e analisados. Resultados O treinamento de alta intensidade pode melhorar significativamente a densidade mineral óssea dos jogadores de basquetebol, e o aumento da densidade mineral óssea das jogadoras de basquetebol feminino é ligeiramente menor do que o dos jogadores masculinos. Além disso, o aumento da densidade mineral óssea pode melhorar de forma abrangente a força muscular e a aptidão física dos atletas. Conclusão O treinamento de alta intensidade pode promover a melhoria da densidade mineral óssea e habilidades esportivas dos jogadores de basquetebol, necessitando de estudos promotores para sua popularização em Faculdades e Universidades. Nível de evidência II; Estudos terapêuticos - investigação dos resultados do tratamento.

RESUMEN Introducción Aumentar el nivel de densidad mineral ósea de los deportistas puede proporcionar mejores condiciones físicas básicas a los jugadores de baloncesto, prevenir las fracturas causadas por la osteopenia y reducir la aparición de lesiones deportivas graves. Objetivo Explorar el efecto del entrenamiento de alta intensidad sobre la densidad mineral ósea en jugadores de baloncesto. Métodos En este experimento, 30 sujetos se dividieron en el grupo de hombres y mujeres, se realizó un entrenamiento de ejercicios de alta intensidad durante 60 minutos, tres veces por semana durante un total de 8 semanas. Se midieron los índices relevantes antes y después del entrenamiento, se clasificaron sus datos y se analizaron. Resultados El entrenamiento de alta intensidad puede mejorar significativamente la densidad mineral ósea de los jugadores de baloncesto, y el aumento de la densidad mineral ósea de las jugadoras de baloncesto es ligeramente inferior al de los jugadores. Además, el aumento de la densidad mineral ósea puede mejorar ampliamente la fuerza muscular y la forma física de los deportistas. Conclusión El entrenamiento de alta intensidad puede promover la mejora de la densidad mineral ósea y de las habilidades deportivas en los jugadores de baloncesto, siendo necesario promover estudios para su popularización en Colegios y Universidades. Nivel de evidencia II; Estudios terapéuticos - investigación de los resultados del tratamiento.

Birth weight and bone mineral density at 18-19 years: birth cohort 1997-1998 / Peso ao nascer e densidade mineral óssea aos 18-19 anos: coorte de nascimentos 1997-1998

ABSTRACT OBJECTIVE To analyze the association between birth weight and bone mineral density (BMD) in adolescence. METHODS A birth cohort study in São Luís, Maranhão, using data from two moments: at birth and at 18-19 years. Exposure was the birth weight in grams, continuously analyzed. The outcome was BMD, using the Z-score index (whole body) measured by double X-ray densitometry (Dexa). A theoretical model was constructed in acyclic graphs to identify the minimum set of adjustment variables - household income, the mother knowing how to read and write at the time of birth, prenatal care, tobacco use during pregnancy, and parity — to evaluate the association between birth weight and bone mineral density in adolescence. Multiple linear regression was used in Stata 14.0 software. A 5% significance level was adopted. RESULTS From 2,112 adolescents, 8.2% had low birth weight and 2.8% had a low BMD for their age. The mean full-body Z-score was 0.19 (± 1.00). The highest birth weight was directly and linearly associated with BMD values in adolescence (Coef.: 0.10; 95%CI: 0.02-0.18), even after adjustment for the variables household income (Coef.: -0.33; 95%CI: -0.66-0.33) and the mother knowing how to read and write (Coef.: 0.23%; 95%CI: 0.03-0.43). CONCLUSION Although after adjusting the variables the association attenuated, birth weight positively and linearly relates to BMD in adolescence.

RESUMO OBJETIVO Analisar a associação entre o peso ao nascer e a densidade mineral óssea (DMO) na adolescência. MÉTODOS Estudo de coorte de nascimentos em São Luís, Maranhão, utilizando dados de dois momentos: ao nascimento e aos 18-19 anos. A exposição foi o peso ao nascer em gramas, analisado de forma contínua. O desfecho foi a DMO, utilizando o índice Z-escore (corpo inteiro) medido pela densitometria por dupla emissão de raios X (DEXA). Foi construído modelo teórico em gráficos acíclicos direcionados para identificar o conjunto mínimo de variáveis de ajuste - renda familiar, a mãe saber ler e escrever à época do nascimento, realização de pré-natal, tabagismo durante a gestação e paridade - para avaliar a associação entre o peso ao nascer e a densidade mineral óssea na adolescência. Utilizou-se regressão linear múltipla no software Stata 14.0. O nível de significância adotado foi de 5%. RESULTADOS Dos 2.112 adolescentes, 8,2% apresentaram baixo peso ao nascer e 2,8% apresentaram DMO considerada baixa para a idade. O Z-escore médio de corpo inteiro foi de 0,19 (± 1,00). O maior peso ao nascer foi associado de forma linear e direta aos valores de DMO na adolescência (Coef.: 0,10; IC95% 0,02-0,18), mesmo após ajuste para as variáveis renda familiar (Coef.: -0,33; IC95% -0,66-0,33) e a mãe saber ler e escrever (Coef.: 0,23; IC95% 0,03-0,43). CONCLUSÕES Apesar de a associação ter sido atenuada após ajuste das variáveis, o peso ao nascer está associado de forma positiva e linear à DMO na adolescência.

Analysis of the Degree of Information of Dental Surgeons about Antiresorptive Drugs According to the Time Since Graduation in Dentistry

ABSTRACT Objective: To determine the level of scientific information of dental surgeons who carry out their professional activities in Brazil about antiresorptive drugs and indicated pharmacological procedures aiming at the prevention of osteonecrosis of the jaws and the therapy of drug sequelae that may occur, considering the time since graduation in Dentistry. Material and Methods: This is a quantitative cross-sectional study in which 339 dentists were consulted using the virtual questionnaire containing topics of personal nature, elements contained in the anamnesis carried out and knowledge about antiresorptive drugs, including indications, adverse effects and treatments applied. Chi-square and Fisher's exact tests were performed to analyze associations of data described by absolute and relative frequencies with professionals' time since graduation. All analyses were performed using the R software, with a 5% significance level. Results: Those who revealed to have graduated for more than five years with the highest academic degree were those who demonstrated maximum knowledge of antiresorptive drugs or revealed that, somehow, they had information about them (p<0.05). Conclusion: Dental surgeons in Brazil who have more than five years since graduation have more scientific information about antiresorptive drugs and pharmacological procedures, which can positively contribute to the prevention of osteonecrosis of the jaws and treatment of drug sequelae that may occur.

Feasibility of using cortical bone trajectory screws in osteoporotic thoracolumbar fixation based on evaluation of bone CT values at bone-screw interface / 中华创伤骨科杂志

Objective:To evaluate the feasibility of using cortical bone trajectory (CBT) screws in the osteoporotic thoracolumbar fixation by comparing the bone CT values at the bone-screw interface between traditional trajectory (TT) screws and CBT screws in patients with different bone densities.Methods:The high-resolution CT imaging data of thoracolumbar segments following thoracic or lumbar spine fractures from April 2020 to October 2022 were collected at The Second Hospital Affiliated to Wenzhou Medical University for retrospective analysis. They were divided into 3 groups: a normal bone mass group, an osteopenia group and an osteoporosis group. From each group 30 cases were chosen (90 cases in total, 36 males and 54 females). All the data were imported into Mimics 18.0 for three-dimensional bone reconstruction in which placement of TT and CBT screws was simulated on the vertebrae from T10 to L2 (non-fractured vertebrae). Regions of interest (ROI) where each simulated screw intersected the bone were segmented to measure their CT bone values. For each vertebra in each group, the relative difference percentage in average CT value of ROI between TT and CBT screws was calculated. The CT values of ROI were compared in the same group between TT and CBT screws from T10 to L2; the CT values of ROI were compared in the same screws among the 3 groups from T10 to L2; the CT values of ROI were compared between the CBT screws in the osteopenia and osteoporosis groups and the TT screws in the normal bone mass group; the relative difference percentages in average CT value of ROI between CBT and TT screws were compared between the 3 groups from T10 to L2.Results:The average CT value of ROI for CBT screws was significantly higher than that for TT screws from T10 to L2 in every group ( P< 0.001); as for the CT values of ROI for CBT and TT screws from T10 to L2, the osteoporosis group<the osteopenia group<the normal bone mass group ( P<0.001); from T10 to L2, the CT value of ROI for CBT screws in the osteopenia group was significantly higher than that for TT screws in the normal bone mass group ( P<0.001); the CT value of ROI for CBT screws in the osteoporosis group was not significantly different from that for TT screws in the normal bone mass group ( P>0.05). At T10, T12, and L1, the relative difference percentage in average CT value of ROI between CBT and TT screws was significantly higher in the osteopenia and osteoporosis groups than that in the normal bone mass group ( P<0.05), but there was no such a difference between the osteopenia and the osteoporosis groups ( P>0.05). At T11 and L2, there was no significant difference between the 3 groups in the relative difference percentage in average CT value of ROI between CBT and TT screws ( P>0.05). Conclusions:As bone mass decreases, both CBT and TT screws lead to a significant decrease in the bone density at the bone-screw interface. In patients with osteoporosis, CBT screws can still lead to a higher bone density at the bone-screw interface than TT screws, thus providing a higher strength at the bone-screw interface.

Correlation of BUA, SOS, T-score and SI with bone mineral density in elderly women with knee osteoarthritis and their diagnostic efficacy in osteoporosis / 中国医师杂志

Objective:To analyze the broadband ultrasound attenuation (BUA), speed of sound (SOS), standard deviation of bone density (T-Score) and stiffness index (SI) with bone mineral density (BMD) in elderly female patients with knee osteoarthritis and their diagnostic efficacy of osteoporosis.Methods:Fifty elderly female patients with knee osteoarthritis admitted o Tangshan People′s Hospital from January 2021 to January 2022 were selected as the observation group, and 40 healthy female patients during the same period were selected as the control group. The results of BUA, SI, T-score and SOS in observation group and control group were analyzed and compared. The BUA, SI, T-score and SOS in elderly women with knee osteoarthritis at different ages and with different bone densities were compared, and the diagnostic value of BUA, SI, T-score and SOS in osteoporosis was analyzed by receiver operating characteristic (ROC) curve.Results:The BUA, SI and T-score of observation group were lower than that in the control group, while SOS was higher than that in the control group (all P<0.05). Among elderly female patients with knee osteoarthritis of different ages, the older the age, the lower the BUA, SI and T-score (all P<0.05), while there was no statistical significance in SOS of elderly female patients with knee osteoarthritis of different ages ( P>0.05). In elderly women with knee osteoarthritis with different BMD grades, the BUA, SI, and T-score in the osteoporosis group were lower than those in the osteopenia group and the normal bone group, and the BUA, SI, and T-score in the osteopenia group were lower than those in the normal bone group; the SOS in the osteoporosis group was higher than those in the osteopenia group and the normal bone group, and the SOS in the osteopenia group was higher than those in the normal bone group (all P<0.05). BUA, SOS, T-score and SI had high sensitivity and specificity in the diagnosis of osteoporosis in elderly women with knee osteoarthritis (all P<0.05). Conclusions:BMD in elderly women with knee osteoarthritis is associated with BUA, SI, T-score, and SOS, and has high diagnostic value for osteoporosis.

Efficacy of modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule after surgical treatment of osteoporotic fractures / 中国基层医药

Objective:To investigate the clinical application value of modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule after surgical treatment of osteoporotic fracture. Methods:Eighty patients undergoing surgical treatment of osteoporotic fractures in Jiamusi Orthopedic Hospital from January 2019 to January 2021 were included in this study. They were randomly divided into a control group ( n = 40, receiving routine western medicine treatment) and a study group ( n = 40, receiving adjuvant treatment with modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule based on routine western medicine treatment). All patients were treated for 6 consecutive months. The Fugl-Meyer Assessment scale score of motor function, traditional Chinese medicine symptom score, modified Barthel Index (MBI) score, bone mineral density T value at different treatment time points, clinical efficacy, and incidence of adverse reactions were compared between the two groups before and after treatment. Results:At 1, 2, 3 and 6 months of treatment, the T value of bone mineral density in the study group was significantly higher than that in the control group (all P < 0.001). At the end of treatment, the modified Barthel Index and the Fugl-Meyer Assessment scale score in the study group were (78.05 ± 4.26) points and (88.53 ± 2.35) points, which were significantly greater than (70.02 ± 6.58) points and (82.75 ± 2.44) points in the control group ( t = 6.49, 13.92, both P < 0.05). At the end of treatment, the symptom score in the study group was significantly lower than that in the control group ( P < 0.001). Total response rate in the study group was significantly higher than that in the control group [97.5% (39/40) vs. 80.0% (32/40), χ2 = 6.14, P < 0.05]. There was no significant difference in incidence of adverse reactions between the two groups ( P > 0.05). Conclusion:Modified prescription of Bushen Huoxue Decoction combined with Zhengguling Capsule can effectively improve motor ability and increase bone mineral density T value in patients after surgical treatment for osteoporotic fracture.

Clinical features of bone mass loss in liver cirrhosis and its association with sarcopenia / 临床肝胆病杂志

ObjectiveTo investigate the influence of sarcopenia on bone mass loss， the risk factors for bone mass loss in liver cirrhosis， and the correlation between body composition and bone mineral density （BMD） by comparing the clinical features of bone mass loss in patients with liver cirrhosis. MethodsA total of 92 patients who were hospitalized and diagnosed with liver cirrhosis in Department of Gastroenterology， The Second Affiliated Hospital of Kunming Medical University， from April to December of 2022 were enrolled， and based on the results of dual-energy X-ray absorptiometry， they were divided into bone mass loss group （osteopenia/osteoporosis） with 57 patients and normal bone mass group with 35 patients. The two groups were compared in terms of general data， laboratory examination， imaging data， and body composition analysis. The independent samples t-test or the Mann-Whitney U test was used for comparison of continuous data between two groups， and the chi-square test or the continuity correction chi-square test was used for comparison of categorical data between two groups； Pearson correlation analysis and Spearman correlation analysis were used to investigate correlation； a binary logistic regression analysis was used to investigate the risk factors for bone mass loss in liver cirrhosis. ResultsCompared with the normal bone mass group， the bone mass loss group had significantly higher age （t=-3.597， P<0.05）， proportion of female patients （χ2=8.393， P<0.05）， N-terminal middle molecular fragment of osteocalcin （N-MID） （Z=-3.068， P<0.05）， β isomer of C-terminal telopeptide of type I collagen （β-CTX） （t=-2.784， P<0.05）， and proportion of patients with sarcopenia （χ2=13.884， P<0.05） and significantly lower calcitonin （CT） （Z=-2.340， P<0.05） and L3 skeletal muscle index （L3-SMI） （t=4.621， P<0.05）. Compared with the normal bone mass group， the bone mass loss group had significantly lower total muscle mass （Z=-2.952， P<0.05）， right upper limb muscle mass （Z=-2.929， P<0.05）， left upper limb muscle mass （Z=-2.680， P<0.05）， right lower limb muscle mass （Z=-3.366， P<0.05）， left lower limb muscle mass （Z=-3.374， P<0.05）， presumed bone mass （t=2.842， P<0.05）， body water mass （Z=-2.779， P<0.05）， basal metabolic rate （BMR） （Z=-3.153， P<0.05）， and BMD of L1— L4 and femoral neck （t=9.789， t=10.280， t=10.832， Z=-7.298， t=8.945， all P<0.05）. Total muscle mass， muscle mass of trunk and limbs， presumed bone mass， BMR， and body water mass in body component analysis were positively correlated with L1 — L4 BMD and femoral neck BMD （all P<0.05）， and fat mass was positively correlated with L1 — L4 BMD （all P<0.05）. Sarcopenia （odds ratio ［OR］=8.737， 95% confidence interval ［CI］： 2.237 — 34.129， P=0.002）， age （OR=1.094， 95%CI： 1.019 — 1.175， P=0.013）， and N-MID （OR=1.095， 95%CI： 1.019 — 1.176， P=0.014） were independent risk factors for bone mass loss in patients with liver cirrhosis. ConclusionOld age， female sex， sarcopenia， elevated N-MID， elevated β-CTX， reduction in CT， low muscle mass， low presumed bone mass， low BMR， and low body water mass are the features of bone mass loss in patients with liver cirrhosis， and sarcopenia， age， and N-MID are independent risk factors for bone mass loss in patients with liver cirrhosis. Detailed assessment of body composition changes can help to identify abnormal BMD in patients with liver cirrhosis.

Milk consumption behavior and its impact on bone mineral density among 696 pupils in Hainan Province / 中国学校卫生

Objective@#To investigate the milk drinking behavior and bone mineral density level of pupils in Hainan Province, and to explore the correlation between bone mineral density and milk drinking behavior, in order to provide scientific basis for promoting the healthy development of bones in children and adolescents.@*Methods@#In November 2021, a cross sectional survey including demographic characteristics, milk intake, unhealthy eating behavior, physical activity and sleep was conducted among 696 students from grades 3 to 5 in Sanya and Baisha, Hainan by stratified cluster random sampling, and bone mineral density at the distal 1/3 of the right forearm was measured by dual energy X-ray absorptiometry. t-test was used to compare the differences in bone mineral density among different milk drinking behaviors of pupils, and multiple linear regression was used to analyze the correlation between milk consumption and bone mineral density.@*Results@#About 25.3% students consumed milk daily and 13.9% consumed ≥ 300 g of milk daily. The mean bone mineral density at the distal 1/3 of the right forearm was (0.237±0.041)g/cm 2. The bone mineral density was greater in the group with daily milk intake than in the group without daily milk intake [(0.250± 0.037 )(0.204±0.034) g/cm 2 , t=15.00, P <0.01], and the bone mineral density was greater in the group with daily average milk intake ≥300 g than in the group with daily average milk intake <300 g [(0.284±0.036)(0.229±0.037)g/cm 2, t=13.48, P < 0.01 ]. Multiple linear regression analysis showed that daily average milk intake was positively correlated with bone mineral density, with a correlation coefficient ( β=0.020, t=21.46, P <0.01).@*Conclusion@#Milk consumption among pupils is inadequate, and milk drinking behavior has a positive impact on bone mineral density, so effective milk drinking intervention should be carried out to promote children s bone development.

Correlation between serum non-high density lipoprotein cholesterol and bone mass levels in different body parts in physical examination population / 中华健康管理学杂志

Objective:To compare the relationship between non-high-density lipoprotein cholesterol (non-HDL-C) and bone mass in different body parts in the physical examination population.Methods:It was a cross-sectional study. The data of 595 physical examiners who visited the Institute of Health Management, PLA General Hospital from June to September 2016 were retrospectively analyzed. The bone mass levels of lumbar 1-4 vertebral body (spine) and femur, average bone density were measured by double light energy X-ray bone density instrument. The basic information and biochemical indices of the physical examiners were collected. The difference between blood lipid components (including Non-HDL-C) and bone mass level of each body part were analyzed.Results:According to blood lipid stratification, there were significant differences in spine T value (T-spine) between triglyceride (TG) groups (-0.15±1.41 vs -0.38±1.3), Non-HDL-C groups (-1.01±0.74 vs -1.21±0.59, -1.04±0.73 vs -1.30±0.45,-1.07±0.71 vs -1.30±0.26) and low-density lipoprotein cholesterol (LDL-C) groups (-1.01±0.71 vs -1.32±0.56)(all P<0.05). There was no statistically significant difference in other lipid groups and femoral T values in each component′s blood lipids. The T-spine decreased significantly in the LDL-C≥3.4 mmol/L group, and the differences were all significant among the Non-HDL-C group (all P<0.05). In binary logistic regression analysis, LDL-C≥3.4 mmol/L ( OR=3.961,95% CI:1.310-11.974) and Non-HDL-C>4.1 mmol/L ( OR=3.600,95% CI:1.035-12.524) were risk factors for vertebral bone mass loss (both P<0.05). Conclusion:People with elevated serum TG, Non-HDL-C and LDL-C in the physical examination population are prone to bone abnormalities. Non-HDL-C≥4.1 mmol/L and LDL-C≥3.4 mmol/L are more closely related to the vertebral bone mass loss and are the risk factors for vertebral bone mass loss.

Research on the MRI/CT-based pre-operative bone quality assessment method for patients with cervical degenerative diseases and validation of its diagnostic efficacy / 中华骨科杂志

Objective:To investigate the diagnostic efficacy of MRI-based or CT-based measurements and the combined evaluation methods for preoperative bone quality assessment in patients with cervical degenerative diseases.Methods:Patients who underwent spine surgery for cervical degenerative diseases at the Department of Orthopedics, Huashan Hospital, Fudan University from September 2020 to March 2022 with available preoperative X-ray, CT, MRI and dule energy X-Ray absorptiometry (DEXA) data were included in this study. Vertebral bone quality score (VBQ) based on MRI T1-weightedimages and CT Hounsfiled unit (HU) values of the cervical spine were measured, and a combined diagnostic formula based on the binary logistic regression was constructed. The patients were divided into normal bone mass (T≥-1.0) and osteopenia/osteoporosis groups (T<-1.0). The student's t-test and Chi-square test were performed for comparisons between groups. The Pearson correlation coefficient was also used to investigate the correlation between DEXA-T scores, cervical VBQ and CT HU values. In addition, receiver operating characteristic curve (ROC) were plotted to explore the diagnostic efficacy of VBQ, CT HU and their combined diagnosis. Meanwhile, the corresponding sensitivity and specificity were obtained. Results:A total of 71 patients were included in this study (17 in the normal group and 54 in the osteopenia/osteoporosis group). The student's t-test showed that VBQ (2.90±0.70 vs. 3.83±0.83, t=4.23, P<0.001) and CT HU values (370.26±85.38 vs. 295.20±67.96, t=3.73, P=0.002) were significantly different between the two groups. The area under the ROC curve (AUC) for VBQ and CT values of the cervical spine were 0.81 and 0.75, respectively, and the AUC for the combined diagnostic value constructed on the basis of both was 0.85. Applying VBQ scores alone had a diagnostic sensitivity of 80% and a specificity of 70%, and the combined diagnosis with VBQ and CT HU had a sensitivity of 90% and a specificity of 75%. Person correlation analysis showed a significant correlation between DEXA T value, cervical VBQ value and CT HU value. The detailed formula was: DEXA T score=-0.63×cervical VBQ+0.64 ( r=-0.55, P<0.001), CT HU value=-40.20×cervical VBQ+458.40 ( r=-0.45, P<0.001), DEXA T score=0.006×CT HU-3.47 ( r=0.45, P<0.001). Conclusion:This study confirmed the feasibility of using cervical VBQ values, CT HU values and combined diagnostics for preoperative bone density screening in patients with degenerative cervical spine diseases. This method allows surgeons to perform an initial preoperative bone density screening based on the patient's existing imaging data, and thus could aid in confirming the indication and scheme of surgery. The method could be a powerful tool for preoperative bone density assessment screening in patients with cervical degenerative diseases.

Distribution pattern and related factors of single osteoporotic vertebral compression fractures / 中华骨科杂志

Objective:To identify the anatomical distribution of and factors related to single-segment osteoporotic vertebral compression fractures (OVCF).Methods:The radiology and clinical data of 944 patients with single-segment OVCF hospitalized in Zhongda Hospital Southeast University between June 2016 and October 2020 were retrospectively analyzed, including 175 males and 769 females, aged 72.1±9.6 years (range, 45-97 years). The anatomical distribution of OVCF was quantified. The demographics, comorbidity profile, spine trauma, back pain duration, vertebral compression degree, and bone mineral density of the OVCF patients in different anatomical segments were summarized and compared.Results:Of the 944 single-segment OVCF, 864 were located in the lower thoracic and lumbar spine that peaked at L 1 (Modal-1 group), and 80 were located in the middle and upper thoracic spine (Modal-2 group) that peaked at T 7, demonstrating an asymmetric bimodal distribution. The difference in the female/male ratio between the two groups was insignificant (χ 2=0.06, P=0.803). Patients in Modal-2 were aged 75.0±9.8 years and on average older than the patients (aged 71.8±9.6 years) in Modal-1 ( t=2.78, P=0.005). The female patients in Modal-2 (aged 75.0±9.6 years) were significantly older than that (aged 71.2±9.3 years) in Modal-1 ( t=3.17, P=0.002). The ratio of back pain duration for <1 week in Modal-2 (43.8%) was lower than that in Modal-1 (60.2%), and the ratio of back pain for 1-weeks (28.8%) was significantly higher than that (15.5%) in Modal-1 (χ 2=11.50, P=0.009). The most frequently reported spine traumas in Modal-2 (50.0%) were heavy lifting injury, lumbar sprain, and strenuous cough, which were significantly different from and less apparent than the fall on ground or crush injury to the spine (64.1%) in Modal-1 (χ 2=60.71, P<0.001). The anterior to posterior height ratio of the fractured vertebrae in Modal-2 was 0.78±0.13, 0.83±0.14, 0.84±0.13, and 0.78±0.18 in the OVCF patients complaining of back pain for <1 week, 1-weeks, 2-weeks, and >4 weeks respectively, showing no significant difference between groups ( F=1.01, P=0.009). In Modal-1, the anterior to posterior height ratio of the fractured vertebrae was lower in the OVCF patients complaining of back pain for 2-weeks (0.80±0.15) and >4 weeks (0.77±0.19) than in those with back pain for <1 week (0.85±0.11) and 1-weeks (0.86±0.14), with sinificant differences ( P<0.05). 32.4% (306/944) of the OVCF patients had one of the following geriatric comorbidities: hypertension, diabetes mellitus, coronary heart disease, cerebral infarction, and chronic obstructive pulmonary disease. The OVCF patients in Model-2 had higher comorbidity of coronary heart disease (21.3%) and cerebral infarction (36.3%) than those in Model-1 (11.6% and 20.3%). Bone mineral density information was available from 371 patients (308 females). In the age groups of <70, 70-, and >80 years, no significant difference was detected in the T-score values of the lumbar spine or hip joint between the OVCF patients in Model-1 and Model-2 ( F=0.13, P=0.880; F=0.62, P=0.538). Conclusion:Single-segment OVCF feature an asymmetric bimodal distribution that is demarcated by the T 10 vertebrae. The distribution pattern is not determined by gender or baseline bone mineral density but highlights the risk of mechanical stress and vertebral fragility within a specific segment. OVCF in the middle and upper thoracic spine is less frequent but common in older patients with higher comorbidity of coronary heart disease and cerebral infarction, which tend to be caused by less apparent spine trauma and maintain vertebral compression but complain of long back pain duration.

Effects of metabolic and bariatric surgery on bone metabolism in patients with obesity: A meta-analysis / 国际外科学杂志

Objective:To systematically evaluate the effect of bariatric and metabolic surgery on bone metabolism in obese patients.Methods:Search terms for the present meta-analysis included "bariatric surgery, metabolic surgery, sleeve gastrectomy, gastric bypass, bone metabolic indicators, bone mineral density", both in English and corresponding Chinese. PubMed, WOS, Cochrane, CNKI, and VIP databases were searched for longitudinal studies from the establishment of the database to September 20, 2022. The data on bone mineral density and bone metabolic markers in obese patients before and after bariatric surgery were extracted. RevMan5.4 and Stata17.0 software were used for Meta-analysis.Results:A total of 8 clinical studies with 420 patients were included. The results of the meta-analysis showed that compared with the preoperative baseline, lumbar spine bone mineral density ( WMD=0.05, 95% CI: -0.00~0.1), femoral neck bone mineral density( WMD=0.10, 95% CI: 0.05-0.15), hip bone mineral density( WMD=0.14, 95% CI: 0.10-0.17), and serum vitamin D 3 ( WMD=-4.87, 95% CI: -6.34--3.40)were decreased, while parathyroid hormone ( WMD=10.04, 95% CI: 5.32-14.76) was elevated after surgery. Conclusions:Current evidence demonstrates that metabolic and bariatric surgery can lead to decreased bone mineral density and impairs in bone metabolic markers early after surgery. Roux-en-Y gastric bypass surgery cause more adverse effects on bone metabolism than sleeve gastrectomy. The results imply that all patients undergoing metabolic and bariatric surgery should be monitored for bone metabolism and routinely take vitamin D and calcium supplements.

Long-Term Mechanical Property Prediction of the Proximal Tibia after Knee Arthroplasty / 医用生物力学

Objective To study the short-term variation patterns of graft viscosity after anterior cruciate ligament reconstruction (ACLR) surgery. Methods Six male New Zealand rabbits were selected. The ACLR animal model of unilateral knee was made with Achilles tendon as the graft. The experimental rabbits were euthanized 15 days after ACLR surgery, with removal of the graft, healthy anterior cruciate ligament (ACL) and Achilles tendon. The cross-sectional area and viscosity coefficient of the graft were measured, and the creep experiments were carried out under equilibrium conditions of 0.1 MPa and 1 MPa, respectively. The viscosity coefficent was calculated. Variation patterns of graft viscosity were summarize. The grafts were compared with healthy ACL. Results The cross-sectional area of the graft increased slowly within 15 days after ACLR surgery. The viscosity of ACL and graft changed nonlinearly. The viscosity coefficient was quite different under different stresses. The viscosity coefficient of the graft decreased with the time after ACLR surgery, which was more obviously under the condition of low stress. Conclusions The results are helpful to guide the implementation of early postoperative rehabilitation plan after ACLR surgery .