Evaluation of Comprehensive Management Protocol for Reduction of the Risk of Fragility Fractures Among Osteoporosis Individuals, Visiting Teaching Hospital, Kolkata

@#Introduction: Fragility fracture from osteoporosis is a major challenging health problem in aging population in developing countries. In order to reduce the risk of development of osteoporotic fragility fractures authors made a study with high risk individuals, divided into two groups and a comprehensive management protocol had been offered in one group where as conventional management protocol had been offered in other to see the efficacy of such comprehensive management protocol to reduce the risk of occurring fragility fracture over at least three months period among the patients, attended in orthopaedic out patient department of state medical college, West Bengal. Methods: The authors selected 30 diagnosed osteoporosis clients of 50 to 90 years age as per inclusion and exclusion criteria, who attended in orthopaedic OPD in SSKM Hospital, Kolkata, West Bengal, India from 2021April to July2021, carrying highest risk factors of developing osteoporosis. Results: In experimental group, mean post test BMD score is higher than the mean pre test BMD, which is statistically significant as calculated t value is 3.666 at 14 df at 0.05 (p<0.05) level of significances. It indicates that comprehensive management protocol is effective to increase the bone strength. Conclusion: The study of comparison of mean difference values of two groups conclude that comprehensive management protocol can reduce the risk of osteoporotic fracture much efficiently in compared to standard pharmaceutical treatment in a short span of time which is applicable for long term management of osteoporosis.

Use of aromatase inhibitors in patients with breast cancer is associated with deterioration of bone microarchitecture and density

ABSTRACT Objective: To evaluate changes in bone density and architecture in postmenopausal women with breast cancer (BC) and use of aromatase inhibitor (AI). Subjects and methods: Thirty-four postmenopausal women with BC, without bone metastasis, renal function impairment and who were not receiving bone-active drugs were selected from a population of 523 outpatients treated for BC. According to the presence of hormonal receptors, HER2 and Ki67, seventeen had positive hormonal receptors and received anastrozole (AI group), and seventeen were triple-negative receptors (non-AI group), previously treated with chemotherapy. Areal bone mineral density (aBMD) and vertebral fracture assessment (VFA) analyses were performed by DXA; vBMD and bone microarchitecture were evaluated by HR-pQCT. Fracture risk was estimated using the FRAX tool. Results: No patient referred previous low-impact fracture, and VFA detected one moderate vertebral fracture in a non-AI patient. AI patients showed lower aBMD and BMD T-scores at the hip and 33% radius and a higher proportion of osteoporosis diagnosis on DXA (47%) vs non-AI (17.6%). AI group had significantly lower values for vBMD at the entire, cortical and trabecular bone compartments, cortical and trabecular thickness and BV/TV. They also had a higher risk for major fractures and for hip fractures estimated by FRAX. Several HR-pQCT parameters evaluated at distal radius and distal tibia were significantly associated with fracture risk. Conclusion: AI is associated with alterations in bone density and microarchitecture of both the cortical and trabecular compartments. These findings explain the overall increase in fracture risk in this specific population.

The Effect of Materials and Porosity on Bone Formation of Degradable Scaffolds / 医用生物力学

Objective To study the effect of different materials and porosities on bone formation in the scaffold after implantation of the degradable bone scaffold into human body. Methods According to natural reaction mechanism of fracture healing, the finite element method was used, combined with geometry of the scaffold, to establish a computationally coupled model based on material degradation curve and bone reconstruction control equation. Through this platform, representative volume elements of the scaffold with five kinds of materials and four types of porosities were selected for calculation and analysis, and dynamic process was reflected by bone mineral density (BMD) and maximum stress of the scaffold. Results The elastic modulus of the materials had a greater influence on growth of bone tissues in the scaffold. The smaller elastic modulus of the materials would lead to the greater amount of bone formation, but it would also have a greater impact on mechanical properties of the scaffold. The scaffold with higher porosity had lower rigidity, which could better promote formation of bone tissues, meanwhile it would also destroy mechanical stability of the scaffold. Conclusions According to performance requirements for different age, gender and location of bone tissues, personalized reference and calculation basis for selection of materials and porosity, structural design and clinical application of degradable porous bone scaffolds can be provided.

Adjuvant therapy of acupuncture for elderly patients of primary osteoporosis with intestinal dysfunction: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effects of acupuncture on bone mineral density (BMD), bone metabolism and intestinal function in elderly patients of primary osteoporosis with intestinal dysfunction.@*METHODS@#A total of 128 elderly patients of primary osteoporosis with intestinal dysfunction were randomly divided into an observation group and a control group, 64 cases in each group. Patients in the control group were treated with oral administration of vitamin D calcium chewable tablets (0.6 g, once a day) and calcitriol capsules (0.25 μg, three times a day); the treatment was given for 6 months. On the basis of the treatment in the control group, patients in the observation group were additionally treated with acupuncture at Shenshu (BL 23), Mingmen (GV 4), Pishu (BL 20), Dachangshu (BL 25), Tianshu (ST 25) and Zusanli (ST 36), etc. for 30 min each time, once a day. After 1-week treatment, the patients took a rest for 2 days; the treatment was given for 6 months. Before and after treatment, the BMD of lumbar spine, femoral neck and femoral trochanter was detected by dual energy X-ray absorptiometry, and the serum levels of bone alkaline phosphatase (NBAP), osteocalcin (OC), matrix metalloproteinase-2 (MMP-2) and calcitonin (CT) were detected by ELISA method. The primary symptom scores of intestinal function, serum diamine oxidase (DAO) and D-lactic acid (D-Lac) levels were compared between the two groups before and after treatment, and the clinical efficacy of the two groups was evaluated.@*RESULTS@#The total effective rate was 85.9% (55/64) in the observation group, which was higher than 71.9% (46/64) in the control group (<0.05). After treatment, BMD were increased (<0.05), and serum bone metabolism indexes were improved in the two groups (<0.05); the BMD and serum bone metabolism indexes in the observation group were better than those in the control group (<0.05). After treatment, the primary symptom scores of intestinal function, serum DAO and D-Lac levels in the observation group were decreased (<0.05), and the indexes in the observation group were lower than those in the control group (<0.05).@*CONCLUSION@#The adjuvant therapy of acupuncture could increase BMD, improve bone metabolism and regulate intestinal function in elderly patients of primary osteoporosis with intestinal dysfunction.

Efectos de las plataformas vibratorias en la salud ósea en mujeres posmenopáusicas / Effects of Vibratory Platforms on Bone Health in Postmenopausal Women

Estudios recientes han sugerido que los estímulos mecánicos (vibraciones) de alta frecuencia y baja magnitud pueden ejercer un efecto positivo sobre la morfología ósea y beneficiar su cantidad y calidad. La plataforma vibratoria es una máquina popular que se introdujo en la última década como una nueva promesa contra el tratamiento de la osteoporosis. Actualmente, en el mundo hay más de 200 millones de mujeres posmenopáusicas que sufren osteoporosis. Esta enfermedad es una de las más comunes y costosas de la salud pública. El ejercicio físico complementado con el tratamiento vibratorio puede que sea considerado como una estrategia efectiva para la prevención y tratamiento de la osteoporosis posmenopáusica. Esta revisión ofrece una visión general de cuestiones significativas relacionadas con la terapia con la plataforma vibratoria para la prevención y tratamiento de la osteoporosis en mujeres postmenopáusicas. El objetivo de esta revisión ha sido conocer los últimos avances de entrenamiento con plataformas vibratorias para la mejoría de la masa ósea en mujeres posmenopáusicas. Existe una gran discrepancia respecto al uso de estas como tratamiento osteoporósico, uso de diferentes tipos de plataformas, distintas frecuencias, amplitud, aceleración o duración del tratamiento. La escasa literatura estableció que la plataforma vibratoria Galileo es la que más se utiliza en dicha población, pero se necesitan más intervenciones para concretar los beneficios y daños de este tratamiento en mujeres postmenopáusicas(AU)

Recent studies have suggested that mechanical stimuli (vibrations) of high frequency and low magnitude can exert a positive effect on bone morphology and benefit quantity and quality. The vibrating platform is a popular machine introduced in the last decade as a new promise against the treatment of osteoporosis. Currently, there are more than 200 million postmenopausal women in the world suffering from osteoporosis. This disease is one of the most common and expensive in public health. Physical exercise supplemented with vibrational treatment may be considered an effective strategy for the prevention and treatment of postmenopausal osteoporosis. This review offers an overview of significant issues related to therapy with the vibration platform for the prevention and treatment of osteoporosis in postmenopausal women. The objective of this review is to know the latest advances in vibratory platforms training for the improvement of bone mass in postmenopausal women. There is a great discrepancy regarding the use of vibratory platforms as osteoporosis treatment, the use of different types of platforms, different frequencies, amplitude, acceleration or duration of treatment. The limited literature established that Galileo vibration platform is the most used in this population, but more interventions are needed to grasp the benefits and harms of this treatment in postmenopausal women(AU)

Advances in Predicting Fracture Risk Based on Hip Bone Properties / 医用生物力学

With the increasing life span of the population and the increasing proportion of the elderly population, the elderly with osteoporosis are prone to hip fractures, which brings heavy economic burdens to the family and society. The progress in predicting hip fractures from the aspects of the proximal femur geometry, bone mineral density (BMD), fracture risk assessment tool (FRAX) and finite element analysis (FEA) based on computed tomography (CT) imaging was reviewed, in order to understand the influencing factors of fracture risk, improve the accuracy of hip fracture risk prediction for the elderly, detect the high fracture risk group at an early stage, and hence to reduce the occurrence of fractures with appropriate preventing measures, and provide theoretical references for the prevention and treatment of hip fractures.

Effects of Different Landing Postures on Bone Mineral Density and Content During High-Impact Exercises / 医用生物力学

Objective To study effects of different types of high-impact exercises on the increment of bone mineral density (BMD) and bone mineral content (BMC) . Methods Thirty-nine male volunteers, including 13 hoopsters, 13 paratroopers, and 13 common college students as the control, were recruited and divided into two subgroups (subgroup 1:20-22 years old; subgroup 2:23-25 years old). Their BMDs and BMCs on calcaneus, first through fifth metatarsus, hip, and lumbar spine (L1-4) were evaluated. Results The BMC of calcaneus, the first and second metatarsals, total lumbar spine, and total hip in the hoopster group was significantly higher than that in the control group and paratrooper group. The hoopster group obtained statistically higher BMD at the lumbar spine, hip, and femoral neck than the other two groups. However, the BMCs and BMDs of the paratrooper group and control group had no significant differences at almost all measured anatomical locations. Conclusions BMC and BMD are not always in positive correlation with vertical ground reaction forces during normal exercises. Compared with parachuting training, playing basketball as a kind of variable load exercise can effectively increase BMC and BMD, and is more beneficial for reducing the risk of osteoporotic fracture.

Calculation of free and bioavailable vitamin D and its association with bone mineral density in Malaysian women with rheumatoid arthritis

@#Introduction: Low 25-hydroxyvitamin D [25(OH)D] levels have not been consistently associated with bone mineral density (BMD). It has been suggested that calculation of the free/bioavailable 25(OH)D may correlate better with BMD. We examined this hypothesis in a cohort of Malaysian women. Materials and Methods: A cross-sectional study of 77 patients with rheumatoid arthritis (RA) and 29 controls was performed. Serum 25(OH)D was measured using the Roche Cobas E170 immunoassay. Serum vitamin D binding protein (VDBP) was measured using a monoclonal enzymelinked immunosorbent assay (ELISA). Free/bioavailable 25(OH)D were calculated using both the modified Vermuelen and Bikle formulae. Results: Since there were no significant differences between RA patients and controls for VDBP and 25(OH)D, the dataset was analysed as a whole. Calculated free 25(OH)D by Vermeulen was strongly correlated with Bikle (r = 1.00, p < 0.001). A significant positive correlation was noted between measured total 25(OH)D with free/bioavailable 25(OH) D (r = 0.607, r = 0.637, respectively, p < 0.001). Median free/bioavailable 25(OH)D values were significantly higher in Chinese compared with Malays and Indians, consistent with their median total 25(OH)D. Similar to total 25(OH)D, the free/bioavailable 25(OH)D did not correlate with BMD. Conclusion: In this first study of a multiethnic female Malaysian population, free/bioavailable 25(OH)D were found to reflect total 25(OH)D, and was not superior to total 25(OH)D in its correlation with BMD. Should they need to be calculated, the Bikle formula is easier to use but only calculates free 25(OH)D. The Vermuelen formula calculates both free/bioavailable 25(OH)D but is more complex to use.

Massa óssea em crianças e adolescentes com doença celíaca / Bone mass in children and adolescents with celiac disease

A doença celíaca (DC) é uma enteropatia sensível ao glúten, histopatologicamente caracterizada por atrofia total ou subtotal da mucosa do intestino delgado proximal, o que faz diminuir a absorção de nutrientes. Dessa maneira, a aquisição de cálcio pode ser afetada, determinando alterações no metabolismo ósseo destes pacientes. É durante a infância e a adolescência que ocorre um aumento significativo da massa óssea, logo, patologias incidentes neste período que prejudiquem a aquisição mineral merecem atenção especial. Objetivo: avaliar a ocorrência de alterações quantitativas da massa óssea em crianças e adolescentes portadores de doença celíaca. Métodos: Para tanto, foram estudados 41 pacientes, sendo 20 pacientes portadores de doença celíaca e 21 controle. Foram analisados peso, altura, idade, dentre outras variáveis. A massa óssea foi analisada segundo os critérios de Zemel (2007). Resultados: Dos pacientes celíacos analisados, 55% (n=11) apresentaram massa óssea normal, 10% (n=2) massa óssea muito baixa e 35% (n=7) baixa massa óssea; enquanto 100% dos pacientes do grupo controle apresentaram massa óssea normal. Encontramos correlação significante entre peso/ DMO e estatura/DMO. Tanto peso quanto estatura foram inferiores no grupo de doentes celíacos. Conclusão: Os resultados obtidos confirmam que há perda de massa óssea significante em pacientes portadores de doença celíaca quando comparados com o grupo controle, mesmo a maioria deles afirmando realizar dieta isenta de glúten.

Celiac disease (CD) is a gluten-sensitive enteropathy, histopathologically characterized by total or subtotal atrophy of the mucous membrane of the proximal small bowel which does the absorption of nutrients to be lower than in patients with normal mucous membrane. Thus, the acquisition of calcium might be affected and can determine the appearance of abnormal bone metabolism in patients with celiac disease. As we already know, it is during childhood and adolescence that there is a significant increase in bone mass thus pathologies incidents during this period that affect the purchase mineral deserve special attention. Background : evaluate the occurrence of quantitative changes in bone mass in children and adolescent patients with celiac disease. Methods: we studied 41 patients in total, and 20 patients with celiac disease and 21 belonging to the control group. We analyzed weight, height, age, among other variables. Results: Of celiac patients tested, 55% (n = 11) had normal bone mass, 10% (n = 2) very low bone mass and 35% (n = 7) had low bone mass, while 100% of patients in the control group showed normal bone mass, according to the criteria of Zemel (2007). Conclusions:We observed significant positive correlation between weight and BMD and height and BMD. As far as stature weight was lower in the group of celiac patients. The results confirm that there is significant loss of bone mass in patients with celiac disease when compared to the control group, even most of them saying they achieve a gluten-free diet.

A CBCT assessment of mandibular bone mineral density in postmenopausal osteoporotic women / 实用口腔医学杂志

Objective:To evlauate the mandibular bone mineral density(BMD) in postmenopausal osteoporotic(PMO) women by cone beam CT(CBCT) and to explore its clinical application.Methods:The BMD of the lumbar vertebrae and mandibular bone of 45 postmenopausal women was examined and calculated by dual energy X-ray absorptiometry(DXA) and CBCT respectively.The subjects were grouped by BMD value of lumbar vertebrae (PMO group,T ≤-2.5;healthy control group,T ≥-1.0).Correlation of CBCT indexes CTI (S),CTI(I) and CTMI with DXA index BMD was analyzed.Results:26 subjects were grouped into PMO (BMD =0.623 ± 0.056) and 19 into healthy control(BMD =0.973 ± 0.055)(P ＜ 0.05).The mandbular BMD in PMO and control groups was 0.776 ± 0.133 and 0.850 ± 0.122 (P ＞ 0.05) respectively.In PMO group all the CBCT indexes of mandibular bone were higher than those in the control group (P ＜ 0.05),no correlation was found between the CBCT indexes and BMD (P ＞ 0.05),while the CBCT indexes of the lumbar vertebrae were positively correlated with the BMD (P ＜ 0.05).Conclusion:CBCT is more sensitive than DXA in the assessment of mandibular BMD in PMO subiects.

Clinical study of medicinal-cake-separated moxibustion for senile osteoporosis / 中国针灸

<p><b>OBJECTIVE</b>To explore the clinical efficacy and partial mechanism of medicinal-cake-separated moxibustion for senile osteoporosis.</p><p><b>METHODS</b>Sixty cases of senile osteoporosis were randomly divided into an observation group and a control group according to the random digits table, 30 cases in each one. The two groups were both treated with basic treatment of western medicine. The acupoints included four groups:① Dazhui (GV 14), Dazhu (BL 11) and Ganshu (BL 18); ② Zhongwan (CV 12), Danzhong (CV 17) and Zusanli (ST 36); ③ Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4); ④ Shenque (CV 8) and Guanyuan (CV 4). Each group of acupoints was selected for one treatment. The observation group was treated with medicinal-cake-separated moxibustion, and the medicinal cake was consisted of fructus psoraleae (30 g), prepared rehmannia root (30 g), atractylodes (30 g), codonopsis pilosula (30 g), epimedium herb (20 g), rhizoma curculiginis (20 g), syzygium aromaticum (5 g) and cinnamon (5 g). The control group was treated with wheat-flour-cake moxibustion. Each acupoint was treated with 5 moxa cones in the two groups. The treatment was given once every other day for six months. The symptom score, lumbar and hip bone mineral density (BMD), serum type Ⅰ procollagen amino-terminal propeptide (PINP) and serum β-type Ⅰ collagen carboxy-terminal peptide (β-CTX) were observed before and after treatment.</p><p><b>RESULTS</b>After treatment, the symptom score and serum β-CTX were significantly lowered (all<0.05), while the lumbar and hip BMD and serum PINP were significantly increased (all<0.05) of the two groups. After treatment, the symptom score and serum β-CTX in the observation group were significantly lower than those in the control group (both<0.05), while the lumbar and hip BMD and serum PINP in the observation group were significantly higher than those in the control group (all<0.05).</p><p><b>CONCLUSIONS</b>The medicinal-cake-separated moxibustion has significant efficacy for senile osteoporosis, which is superior to wheat-cake-se-parated moxibustion.</p>

Serum levels of phosphorylated heat shock protein 27 (pHSP27) are associated with bone mineral density in pre- & postmenopausal women: A pilot study.

Background & objectives: Phosphorylated heat shock protein 27 (pHSP27) has been implicated in the pathogenesis of osteoporosis. Oxidative stress and proinflammatory cytokines, which are known to be involved in aetiology of osteoporosis, can trigger HSP27 phosphorylation. Since pHSP27 is present in circulation, it was hypothesized that serum pHSP27 would be elevated in low bone mineral density (BMD) condition and might serve as an indicator of osteoporosis/osteopenia. Hence, the aim of this study was to examine serum levels of pHSP27 in relation with BMD in pre- and postmenopausal women. Methods: Premenopausal (30 to 40 yr) and postmenopausal (50 to 60 yr) women having either low BMD (osteopenia/osteoporosis) or high BMD were selected (n=80) from a prospective cohort (n=200). Serum levels of pHSP27; along with levels of oestradiol, malondialdehyde, total antioxidant capacity, interleukin (IL)-1, IL-6, tumour necrosis factor - alpha, (TNF-α), c-telopeptide fragments of collagen type I (CTX-1) and osteocalcin were estimated. Results: The serum levels of pHSP27 were significantly elevated in low BMD groups in premenopausal and postmenopausal categories (P<0.05). It also exhibited a significant odds ratio (OR) to differentiate between low and high BMD in both premenopausal (OR=1.734, P=0.013) and postmenopausal (OR=1.463, P=0.042) categories. Additionally, area under the curve to predict low BMD was non-significantly higher for pHSP27 than CTX-1 in premenopausal and postmenopausal categories. Interpretation & conclusions: This study highlights a novel relation between serum pHSP27 and BMD in Indian women however, these findings need to be confirmed in larger studies.

Effects of glucocorticoid with different dosage on bone mineral density and biomechanical properties in rats / 医用生物力学

Objective To investigate the effects of exposure to glucocorticoids with different dosage on skeleton of normal 3-month-old rats by dual energy X-ray absorptiometry (DXA), biomechanical testing and bone histopathology. Methods Thirty-one 3-month-old female clean level SD rats were randomly divided into 3 GC-treated groups, with tail intravenous injections of dexamethasone (Dex) at the dosage of 1, 2.5, 5 mg/kg twice per week for 8 weeks, respectively, and 1 normal control group treated with saline. At the end of experiment, bone mineral content (BMC) and bone mineral density (BMD) of the femur and the 3rd lumbar vertebrae in rats were measured by DXA. The 3-point bending test of the total femur and compression test of the 5th lumbar vertebrae were also conducted, respectively. Microstructure of the trabecula in proximal metaphysis of the tibia was observed by bone pathological section for quantitative analysis. Results Compared with control group, the body weight was significantly decreased in all Dex-treated groups, while no obvious decrease in vertebral BMC, BMD and maximum compressive loads was found. The total femoral BMC was also reduced significantly in all Dex-treated groups, while the total femoral BMD, proximal and distal femoral BMD were reduced only in Dex 1mg group. The fracture load, maximum load and elastic load for 3-point bending test were all evidently decreased in Dex 1mg group, while the Dex 2.5mg group and Dex 5mg group only showed a decline in elastic load. All Dex-treated groups showed an unevenly spatial distribution of the trabecula, which indicated a low bone metabolic state. Conclusions The exposure to GC for 8 weeks brings negative effects on skeleton of the 3-month old rats, which will cause more bone loss and worse mechanical properties in femur than in lumbar vertebrae. Higher dosage of Dex does not increase bone mass loss or change the mechanical properties. Both the decline in bone mechanics, especially elastic load, and unevenly density distribution of trabecula indicate that Dex will affect more bone quality other than bone mass. The side effects of GCs on skeleton in clinical application should be evaluated with various methods.

Role of the Whole Body Vibration Machine in the Prevention and Management of Osteoporosis in Old Age: A Systematic Review

A literature search of related articles was carried out in electronic data sources. Initially, 276 randomised controlled trials related to the title were collected, after which 44 were selected using the keywords. Overlapping articles, articles with a study duration of less than six months, and studies involving young participants were removed from the list. The remaining 20 articles were checked for entitlement using the PEDro scale. A total of nine eligible articles with 1486 participants were analysed. Seven trials used dual-energy x-ray absorptiometry (DXA) to measure bone mineral density (BMD). The six trials published from 2005 to 2013 found a significant increase in BMD. In the remaining one trial, there was no significant increase in BMD. One study published in 2013 reported a significant increase in BMD measured with peripheral qualitative computed tomography, whereas another trial published in 2014 stated that there was a reduction in calcaneal bone density measured by peripheral qualitative ultrasound. From these findings it can be concluded that the whole body vibration machine is a good adjunctive therapy for the prevention and management of osteoporosis in postmenopausal women. However, further investigations are necessary before the same can be recommended for elderly men.

Research about the changes of calcium regulation hormone and bone mineral density in patients with type 2 diabetes mellitus / 中国糖尿病杂志

Objective To research the changes of calcium regulation hormone and bone mineral density (BMD) in type 2 diabetes mellitus (T2DM ) patients and analyze the main impact factors. Methods 117 T2DM patients (T2DM group ,M/F=52/65 ,age 40~79 years) and 63 age‐ and gender‐matched healthy people (NC group) were selected in this study. According to the course of diabetes ,blood glucose control and the value of BMD ,T2DM patients were divided into subgroups :course≤10 years ,and>10 years ;HbA1 c≤8% ,and>8% ;normal BMD ,osteopenia ,and osteoporosis (OP). Serum 25‐hydroxy vitamin D3 [25(OH)D3 ]and Parathormone (PTH) were measured and BMDs of lumbar spine (L1 ~L4 ) , femoral neck ,total hip ,and whole body were evaluated for all the subjects. Result (1)Compared with NC group ,the level of serum 25(OH)D3 and BMDs of femoral neck and total hip decreased significantly in T2DM group[ (35.57 ± 12.30)nmol/L ,(0.848 ± 0.136)g/cm2 ,(0.873 ± 0.150)g/cm2 vs(44.94 ± 17.40) nmol/L ,(0.927 ± 0.173)g/cm2 ,(0.934 ± 0.140)g/cm2 ,respectively ,P10 years[ (0.814 ± 0.148) ,(0.840 ± 0.157) vs (0.882 ± 0.111) ,(0.908 ± 0.139) g/cm2 ,respectively ,P0.05). (3)Compared with HbA1c≤8% group ,BMD of femoral neck and total hip in HbA1c> 8% group decreased [(0.830 ± 0.131) ,(0.832 ± 0.161) vs (0.891 ± 0.130) ,(0.949 ± 0.130)g/cm2 ,respectively ,P 0.05). (4)The rates of OP and osteopenia (41.03% ,47.86% ) in T2DM were higher than those in NC group (26.98% ,33.33% ) (χ2 =4.367 ,4.669 ,P<0.05). The duration of diabetes and the levels of HbA1c and PTH were longer or higher in OP group than those with normal BMD or osteopenia (P<0.05). (5)Logistic regression analysis showed that BMD negatively correlated with the duration of diabetes ,HbA1c ,and PTH (β= 0.076 ,0.213 ,0.112 ,respectively ,P< 0.05) ,and positively correlated with 25(OH)D3 (β= -0.043 ,P<0.05). Conclusion The values of BMD decreased and the incidence of OP is higher in T2DM patients ,particularly in patients with longer diabetic duration and poor glycemic control.

Consumo de calcio y densidad mineral ósea en hombres jóvenes con diferentes niveles de actividad física

Objetivo: Evaluar el estado nutricional del calcio en hombres jóvenes con diferentes grados de actividad física, mediante la estimación del consumo de calcio y de la masa mineral ósea total, con el fin de realizar recomendaciones que disminuyan el riesgo de osteoporosis. Métodos: Se realizó un estudio descriptivo y transversal en 80 hombres con edades entre 25 y 50 años, con distintos niveles de actividad física. La densidad mineral ósea (DMO) se determinó utilizando un densitómetro DEXA (Dual Energy X-ray Absorptiometry). La ingesta de calcio se midió a través de un cuestionario de frecuencia de consumo de alimentos semicuantitativa. El nivel de actividad física se determinó a través del cuestionario IPAQ (International Physical Activity Questionnaire). Resultados: En promedio, los hombres estudiados presentaron un consumo alto de calcio (1.926 mg/día), sin diferencias asociadas al nivel de actividad física. El valor promedio registrado para la DMO central fue de 1,147 g/cm² y para la DMO periférica fue de 0,993 g/cm². El 24% de los sujetos presentó valores de DMO por debajo del rango esperado para su edad y género. La DMO se asoció positivamente con el consumo de calcio (r=0,29; p < 0,01), mientras que la relación fue inversamente proporcional con la edad (r= - 0,42; p < 0,01). No se encontró relación entre la DMO ni central ni periférica, y el nivel de actividad física. Conclusión: Los valores bajos de densidad ósea observados en la población masculina joven estudiada sugieren que es necesario evaluar factores de riesgo asociados al estilo de vida, como el consumo de calcio y la actividad física.

Objective: To evaluate the calcium nutritional state in young men with different physical activity levels, through calcium intake and mineral density estimation, to make recommendations that could decrease the risk to develop osteoporosis. Methods: A cross-sectional study was designed with 80 men aged 25 to 50 and with different levels of physical activity. Bone mineral density (BMD) was established through DEXA (Dual Energy X-ray Absorptiometry) densitometry. A semi-quantitative food frequency questionnaire was designed to estimate calcium intake. Physical activity levels were established through IPAQ (International Physical Activity Questionnaire). Results: On average, the men that participated in the study had high calcium intakes (1.926 mg/day), with no differences associated with the level of physical activity. The average value recorded for the central BMD was 1.147 g/cm2 and for the peripheral BMD was 0.993 g/cm2. About 24% of the subjects had BMD values below the expected range for their age and gender. The BMD was positively associated with calcium intake (r=0.29; p < 0.01), while the association was inversely proportional to age (r= - 0.42; p < 0.01). No relationship was found between central or peripheral BMD, and physical activity level. Conclusions: Low values of bone density observed in the young male population studied suggest the need to assess risk factors associated with lifestyle, such as calcium intake and physical activity.

Fermented soybeans by Rhizopus oligosporus reduce femoral bone loss in ovariectomized rats

BACKGROUND/OBJECTIVES: Soy isoflavones are structurally similar to estrogen and bind to estrogen receptors, suggesting that they exhibit estrogenic activities; therefore, they are referred to as phytoestrogens. Fermentation may affect the bioavailability of isoflavones altering soy isoflavone glycosides in the form of aglycones. Thus, this study investigated the effects of fermented soybeans by Rhizopus oligosporus on bone metabolism in both young rats as a pilot test and in ovariectomized (ovx) old rats as a model of menopause. MATERIALS/METHODS: In the pilot test, a total of 24 seven-week-old female Sprague-Dawley (SD) rats were fed one of three diets for a period of four weeks: casein, unfermented soybean product, or fermented soybean product by R. oligosporus. In the ovx rat model, 20-week-old SD rats weighing 260-290 g underwent either sham-operation (n = 10) or bilateral ovariectomy (n = 30) and were then fed the AIN-93M diet for one week. Thereafter, rats were fed sham-casein, ovx-casein, ovx-soybean, or ovx-fermented soybean diet for five weeks. After decapitation, femoral bones were isolated and preserved in 9% formalin for assessment of bone mineral density (BMD), bone mineral content (BMC), and bone-breaking strength (BBS). RESULTS: Ovx rats showed significantly increased weight gain and decreased uterine wet weight. Of particular interest, ovx rats fed fermented soybeans showed increased uterine wet weights compared to control rats. Fermented soybean diet caused a significant increase in plasma 17-beta estradiol concentrations in young rats, and 17-beta estradiol levels were enhanced in ovx rats to match those of sham-operated ones. Significantly lower femoral BMD and BMC were observed in ovx rats compared to sham-operated controls, whereas bone areas did not differ statistically among the groups. In addition, BBS tended to be increased in ovx rats fed soybeans and fermented soybeans. CONCLUSIONS: Supplementation of fermented soybeans could have preventive and therapeutic effects against osteoporosis in postmenopausal women.

A hospital based study of biochemical markers of bone turnovers & bone mineral density in north Indian women.

Background & objectives: The osteoporotic risk for women increases soon after menopause. Bone turnover markers are known to be associated with bone loss and fracture risk. This study was aimed to assess bone turnover using bone markers and their correlation with bone mineral density (BMD) in pre- and post-menopausal women. Methods: A total of 255 healthy women (160 pre- and 95 post-menopausal) were enrolled. Serum bone alkaline phosphatase (sBAP) and serum N-terminal telopeptide of type I collagen (NTX) were measured to evaluate the bone formation and resorption, respectively. Bone mineral density was determined at lumbar spine (L2-L4) anteroposteriorly, femoral neck and Ward’s triangle using Prodigy dual-energy X-ray absorptiometry (DXA) system. The comparison of years since menopause with respect to BMD and bone markers was also evaluated. Results: NTX and sBAP showed significant negative correlation with BMD of femur neck and Ward’s triangle in postmenopausal women. BMD of all three sides were significant variables for NTX and BMD of femur neck and Ward’s triangle for sBAP in postmenopausal women. BMD lumbar spine was a significant variable for sBAP in premenopausal women. The mean values of NTX increased significantly with increase in the duration of years since menopause. The BMD of all three sides decreased significantly with increase in the duration of years since menopause. Interpretation & conclusions: Serum NTX and sBAP were inversely correlated to BMD of femur neck and Ward’s triangle in post-menopausal women. Simultaneous measurements of NTX and BMD in the north Indian women, suggest that bone resorption in women with low BMD remains high after menopause.

Effect of neurectomy and chemodenervation of the masseter muscle on mandibular bone mineral density / 中华医学美学美容杂志

Objective To evaluate the effect of neurectomy and chemodenervation of the masseter muscle on mandible bone mineral density.Methods Thirty 28-day-old Wistar rats were divided into four groups:operation groups 1 and 2,botulinum toxin group and control group.The main trunk and initial branches of masseteric nerve on the right side were resected in the operation group 1.The nerve was exposed,but not resected in the operation group 2.The right side of masseter muscle was injected with botulinum toxin type A and the left side was injected with sterile saline in botulinum toxin group when the rats were 28 days old.The control group was only anaesthetised.Bilateral mandibles of all four groups were scanned by GE lunar prodigy bone densitometer when the rats were 75 days old.Results BMD was (0.184±0.012) g/cm2 on the left side and (0.184±0.026) g/cm2on the right side in operation group 1.BMD was (0.179±0.022) g/cm2 on the left side and (0.173±0.019) g/cm2 on the right side in operation group 2.BMD was (0.165±0.061) g/cm2 on the left side and (0.158±0.051) g/cm2 on the right side in botulinum toxin group.BMD was (0.196±0.026) g/cm2 on the left side and (0.185±0.022) g/cm2 on the right side in control group.The variance of BMD between two sides of each group was not significant difference.The variances of BMD among the right side of the four groups were not significant difference.Conclusions No pathological changes in mandibular bone mineral density after denervation and chemodenervation of the massetermuscle are observed in this study.

Proximal Femur and Lumbar Spine's DXA T-score Concurrence in Diagnosis of Osteoporosis / 대한골다공증학회지

OBJECTIVES: To evaluate the correlation between T-score of lumbar spine and that of proximal femur using dual energy x-ray absorptiometry (DXA) and the accuracy of the diagnosis of osteoporosis. MATERIAL AND METHODS: From December 2009 to January 2012, 300 female patients were selected who underwent bone mineral density (BMD) test using DXA. After measuring BMD of proximal femur and lumbar spine, the score of BMD in each age group was compared by two sites. Also, the concordance of the diagnosis of osteoporosis was evaluated. RESULTS: The result showed significantly lower T-score and BMD as it goes to the elderly group. As it goes for 60's age group and even more for 70's age group, lumbar spine showed lower BMD than proximal femur. In all age groups, lumbar spine and proximal femur T-score showed significant correlation; however, it showed the least states at 60's age group. Discordance rate of osteoporosis diagnosis was 33% and 47.3% each at lowest t-score and total t-score. 60's age group showed the highest discordance rate, and osteoporosis group showed the highest rate. CONCLUSIONS: When measuring BMD for diagnosis of osteoporosis, since it shows significant discordance between proximal femur and lumbar spine, it is necessary to measure BMD simultaneously on both parts.