Polygenic risk of bone fractures in Spanish women with osteoporosis / Riesgo poligénico de fracturas óseas en mujeres españolas con osteoporosis

Background: osteoporosis is a highly polygenic trait characterized by low bone mineral density (BMD) and/or fragility frac-tures. Over the past decade, polygenic risk scores (PRS) are an emerging tool to try to predict the risk of complex disorderswith a genetic component.Objective: to analyze the capacity of different PRSs to predict osteoporosis in the Spanish population.Material and methods: our dataset consisted of two differentiated groups. The first group included osteoporosis casesdiagnosed and treated at the Marques de Valdecilla University Hospital (n = 304; 293 women) while the second groupconsisted of people from the overall Spanish population (n = 3199; 1458 women). Four previously generated PRSs werecompared with generalized linear models.Results: the osteoporosis group showed a significantly higher genetic risk compared to the control group in 3 PRSs (PRS-1p = 1e-7; PRS-2 p = 1.87e-15; PRS-3 p = 0.1477; PRS-4 p = 8.98e-9). In addition, in these PRSs, the individuals in the upperquartile of risk had a significantly higher risk of osteoporosis, compared to those individuals in the other quartiles (PRS-1OR, 1.83; PRS-2 OR, 2.11; PRS-3 OR, 0.96; PRS-4 OR, 1.72).Conclusions: in summary, the application of PRSs shows significant differences between the overall Spanish populationand patients with osteoporosis, which is suggestive of its utility within strategies for the identification of subjects at riskbased on clinical-genetic criteria.(AU)

[Metabolic syndrome: how about bone?]. / Síndrome metabólico, también del hueso?

In the last decades, the association between cardiovascular disease and osteoporosis has been a matter of an extensive clinical and basic investigation, and in fact, common pathogenic links have been recently proposed. The metabolic syndrome includes a series of cardiovascular risk factors that confer a high risk of morbimortality. On the other hand, osteoporosis and its more serious consequence, fracture, represent a true epidemic nowadays. The aim of the present article is to perform a brief update of the association between the individual components of the metabolic syndrome and bone metabolism, and to analyze the publications that have studied the same association, but considering the metabolic syndrome as a whole.

Síndrome metabólico, ¿también del hueso? / Metabolic syndrome: how about bone?

En las últimas décadas la relación entre la enfermedad cardiovascular y la osteoporosis está siendo objeto de una extensa investigación clínica y básica, y de hecho recientemente se ha propuesto la existencia de vínculos patogénicos comunes. El síndrome metabólico engloba una serie de factores de riesgo cardiovascular que, en conjunto, confieren un elevado riesgo de morbimortalidad. Por otro lado, la osteoporosis y su consecuencia más grave, la fractura, representan una verdadera epidemia en nuestro tiempo. El objetivo de la presente revisión es hacer una breve actualización de la asociación entre los componentes individuales del síndrome metabólico y el metabolismo óseo, así como analizar los trabajos que han estudiado dicha asociación, pero entendiendo el síndrome metabólico como una entidad global

In the last decades, the association between cardiovascular disease and osteoporosis has been a matter of an extensive clinical and basic investigation, and in fact, common pathogenic links have been recently proposed. The metabolic syndrome includes a series of cardiovascular risk factors that confer a high risk of morbimortality. On the other hand, osteoporosis and its more serious consequence, fracture, represent a true epidemic nowadays. The aim of the present article is to perform a brief update of the association between the individual components of the metabolic syndrome and bone metabolism, and to analyze the publications that have studied the same association, but considering the metabolic syndrome as a whole

[Intravenous bisphosphonates]. / Bisfosfonatos intravenosos.

Bisphosphonates possess a fundamental role in the treatment of bone metabolic diseases. Yet their main limitations are poor oral absorption and gastrointestinal side effects, mainly esophageal irritation. Indeed, oral administration is unpleasant for many patients, and it is difficult in bed-confined subjects. Therefore, intravenous administration of these agents can be very useful in several clinical scenarios, especially to improve the compliance. Recently, it has been showed that intravenous bisphosphonates are very useful to control hypercalcemia of malignancy, and to prevent bone complications related to metastases. Their use has also been analyzed in the prevention of bone disease after organ transplantation. Thus, their application to control Paget's disease of bone is well-known, and probably they could have an important role as antiresorptive agents in postmenopausal and steroidal osteoporosis. We present here a state of the art of the use of intravenous bisphosphonates for the aforementioned disorders.

Bisfosfonatos intravenosos / Intravenous bisphosphonates

Los bisfosfonatos tienen hoy un papel fundamental en el tratamiento de las enfermedades metabólicas óseas. Sin embargo, su principal limitación es su escasa absorción oral y sus efectos adversos sobre el tracto digestivo, sobre todo la irritación esofágica. Además, la pauta de administración oral es incómoda para muchos pacientes y es difícil llevarla a cabo en sujetos encamados. Por estas razones, la admi-nistración de estos agentes por vía intravenosa puede resultar muy útil en determinadas situaciones clínicas, especialmente para mejorar el cumplimiento terapéutico. Recientemente se ha demostrado que los bisfosfonatos intravenosos son muy útiles en el control de la hipercalcemia maligna y en la prevención de las complicaciones óseas asociadas a las metástasis. Se ha valorado también su empleo en la prevención de la enfermedad ósea tras el trasplante de órganos. Además, es bien conocida su aplicación en el control de la enfermedad de Paget y, muy probablemente, tengan un importante papel futuro como fármacos antirresortivos en la osteoporosis posmenopáusica y esteroidea. Hemos realizado una puesta al día del uso de los bisfosfonatos intravenosos en las indicaciones mencionadas

Bisphosphonates possess a fundamental role in the treatment of bone metabolic diseases. Yet their main limitations are poor oral absorption and gastrointestinal side effects, mainly esophageal irritation. Indeed, oral administration is unpleasant for many patients, and it is difficult in bed-confined subjects. Therefore, intravenous administration of these agents can be very useful in several clinical scenarios, especially to improve the compliance. Recently, it has been showed that intravenous bisphosphonates are very useful to control hypercalcemia of malignancy, and to prevent bone complications related to metastases. Their use has also been analyzed in the prevention of bone disease after organ transplantation. Thus, their application to control Paget’s disease of bone is well-known, and probably they could have an important role as antiresorptive agents in postmenopausal and steroidal osteoporosis. We present here a state of the art of the use of intravenous bisphos-phonates for the aforementioned disorders