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1.
Artigo em Inglês | MEDLINE | ID: mdl-33807030

RESUMO

The association between osteoporosis and periodontal disease (PD) has been revealed by previous studies, but there have been few studies on the association in younger adults. We enrolled a total of 7298 adults aged 40 to 44 who underwent PD screening between 2003 and 2008. Data on quantitative ultrasound for the measurement of bone mineral density (BMD) were collected for the diagnostic criteria of osteopenia and osteoporosis. The Community Periodontal Index (CPI) was measured for defining PD. A multiple logistic regression model was used to assess the effect of low bone mass on the risk of PD. Of 7298 enrollees, 31% had periodontal pockets >3 mm, 36.2% had osteopenia, and 2.1% had osteoporosis. The 39.8% of PD prevalence was high in adults with osteoporosis, followed by 33.3% in osteopenia. A negative association was found between BMD and CPI value (p < 0.0001). Low bone mass was associated with the risk of PD (adjusted OR: 1.13; 95% CI:1.02-1.26) after adjusting the confounding factors, including age, gender, education level, overweight, smoking status, past history of osteoporosis, and diabetes mellitus. An association between BMD and PD among young adults was found. An intervention program for the prevention of PD and osteoporosis could be considered starting in young adults.


Assuntos
Doenças Ósseas Metabólicas , Osteoporose , Doenças Periodontais , Absorciometria de Fóton , Adulto , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/epidemiologia , Humanos , Pessoa de Meia-Idade , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Doenças Periodontais/epidemiologia , Índice Periodontal , Fatores de Risco , Adulto Jovem
2.
Zhonghua Gan Zang Bing Za Zhi ; 29(3): 204-208, 2021 Mar 20.
Artigo em Chinês | MEDLINE | ID: mdl-33902185

RESUMO

Osteoporosis is a bone loss disease caused by the imbalance of osteoblast and osteoclast. It is a common complication of patients with liver cirrhosis, cholestatic liver disease, and liver transplantation. Over the past few decades, many researchs have raised the awareness of immune cell activation, chronic inflammation, intestinal microflora, etc. in liver cirrhosis and secondary osteoporosis. This article reviews the progress of the epidemiology, pathogenesis, diagnosis and treatment of liver cirrhosis and secondary osteoporosis.


Assuntos
Doenças Ósseas Metabólicas , Colestase , Transplante de Fígado , Osteoporose , Humanos , Cirrose Hepática/complicações , Osteoporose/epidemiologia , Osteoporose/etiologia
3.
Clin Interv Aging ; 16: 571-582, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33854307

RESUMO

Purpose: Temporary cessation of exercise but maintenance of habitual physical activity might be a frequent situation in older people's lives. Particularly the COVID-19 induced lockdown of exercise training facilities with individual outdoor activities still being allowed might be a blueprint for this potentially harmful scenario. Thus, the aim of the present study was to determine the effects of 6 months of detraining after 18 months of high-intensity resistance exercise (HIT-RT) on body composition and cardiometabolic outcomes in predominately obese older men with osteosarcopenia. Materials and Methods: Community-dwelling predominately obese men 72-91 years old with low muscle and bone mass (n=43) were randomly assigned to an 18-month HIT-RT (EG: n=21) or a non-training control group (CG, n=22). After the intervention, participants of the EG discontinued HIT-RT for 6 months, but increased their habitual physical activity. Study outcomes were group differences in detraining changes ("effects") for lean body mass (LBM), total and abdominal body fat rate (determined by dual-energy x-ray absorptiometry) and the Metabolic Syndrome Z-Score (MetSZ). We applied an intention-to-treat analysis with multiple imputation to analyze the data. Results: After the 18-month HIT-RT, we observed significant positive training effects for LBM, total and abdominal body fat rate and the MetSZ (all p<0.001). Abrupt cessation of HIT-RT for 6 months resulted in significantly higher unfavorable changes in the HIT-RT compared with the CG for LBM (p=0.001), total body fat (p=0.003) and the MetSZ (p=0.003), apart from abdominal body fat (p=0.059). However, significant overall effects were still present after 24 months for LBM and body fat indices but not for the MetSZ. Conclusion: The present study clearly indicates the unfavorable effects of 6 months of detraining after HIT-RT. Correspondingly, exercise protocols particularly for older people should focus on continuous exercise with short regeneration periods rather than on intermitted protocols with pronounced training breaks.


Assuntos
Composição Corporal , Doenças Ósseas Metabólicas/fisiopatologia , Obesidade/fisiopatologia , Sarcopenia/fisiopatologia , Gordura Abdominal , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Doenças Ósseas Metabólicas/complicações , Exercício Físico/fisiologia , Seguimentos , Humanos , Vida Independente , Masculino , Síndrome Metabólica/fisiopatologia , Obesidade/complicações , Treinamento de Resistência , Sarcopenia/complicações
4.
Top Spinal Cord Inj Rehabil ; 27(1): 57-67, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33814883

RESUMO

Spinal cord injury (SCI) results in dramatic changes in body composition, with lean mass decreasing and fat mass increasing in specific regions that have important cardiometabolic implications. Accordingly, the recent Consortium for Spinal Cord Medicine (CSCM) released clinical practice guidelines for cardiometabolic disease (CMD) in SCI recommending the use of compartmental modeling of body composition to determine obesity in adults with SCI. This recommendation is guided by the fact that fat depots impact metabolic health differently, and in SCI adiposity increases around the viscera, skeletal muscle, and bone marrow. The contribution of skeletal muscle atrophy to decreased lean mass is self-evident, but the profound loss of bone is often less appreciated due to methodological considerations. General-population protocols for dual-energy x-ray absorptiometry (DXA) disregard assessment of the sites of greatest bone loss in SCI, but the International Society for Clinical Densitometry (ISCD) recently released an official position on the use of DXA to diagnose skeletal pathology in SCI. In this review, we discuss the recent guidelines regarding the evaluation and monitoring of obesity and bone loss in SCI. Then we consider the possible interactions of obesity and bone, including emerging evidence suggesting the possible influence of metabolic, autonomic, and endocrine function on bone health in SCI.


Assuntos
Densidade Óssea , Doenças Ósseas Metabólicas/etiologia , Obesidade/complicações , Traumatismos da Medula Espinal/complicações , Absorciometria de Fóton , Doenças Ósseas Metabólicas/diagnóstico por imagem , Humanos
5.
Georgian Med News ; (311): 103-108, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33814401

RESUMO

The state of bone mineral density has not been properly examined yet in patients with systemic lupus erythematosus (SLE) and the pathogenetically associated syntropic comorbid lesions of organs and systems. In a randomized manner, after stratification by the presence of SLE, we enrolled 123 premenopausal women aged 21 to 51 years into the study. Patients with SLE, depending on the diagnosed pathogenetically associated syntropic comorbid lesions of organs and systems, were stratified into twenty groups (with hemorrhagic vasculitis, capillaritis, Raynaud syndrome, atherosclerosis, livedo reticularis, venous thrombosis, myocarditis, secondary hypertension, stable angina, pneumonitis, pneumosclerosis, autoimmune hepatitis, steatohepatitis, chronic pancreatitis, aseptic bone necrosis, arthralgia, myalgia, autoimmune thyroiditis, obesity, and alopecia). The bone mineral density (BMD) was determined for patients in each group through dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine and proximal femur, taking into account the worst T-score result. Having analyzed the data from densitometric examinations of 20 patient groups, we arrived at the following conclusions: a) all patients from seven groups (with hemorrhagic vasculitis, capillaritis, stable angina, autoimmune hepatitis, steatohepatitis, aseptic bone necrosis, autoimmune thyroiditis) had reduced BMD disorders, and the largest proportion of patients with normal BMD were from the group with syntropic venous thrombosis; b) there was only one group of patients (with stable angina) without the cases of the first degree osteopenia, and the largest proportion of such patients was in the group with syntropic venous thrombosis; c) there was only one group of patients (with aseptic bone necrosis) without the cases of the second degree osteopenia, and the largest proportion of such patients was in the group with stable angina; d) there were patients with the third degree osteopenia in all groups, and the largest proportion of the third degree osteopenia cases was in the group with stable angina; e) there were no cases of osteoporosis in groups with syntropic venous thrombosis and stable angina, and the largest proportion of osteoporosis cases was in the groups with syntropic autoimmune hepatitis; the prevalence of osteoporosis is significantly higher than the prevalence of normal BMD and the first degree osteopenia in patients with atherosclerosis and chronic pancreatitis; the prevalence of osteoporosis is also significantly higher that the prevalence of normal BMD and all degrees of osteopenia in patients with autoimmune hepatitis.


Assuntos
Doenças Ósseas Metabólicas , Lúpus Eritematoso Sistêmico , Absorciometria de Fóton , Adulto , Densidade Óssea , Feminino , Humanos , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/epidemiologia , Pessoa de Meia-Idade , Prevalência , Adulto Jovem
7.
Eur J Radiol ; 136: 109568, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-33545629

RESUMO

PURPOSE: We aimed define thresholds for HU values observed on opportunistic CT scans that suggest abnormal bone mineral density (BMD) in a heterogeneous Middle Eastern population. METHODS: Consecutive patients who had undergone CT and dual-energy X-ray absorptiometry (DXA) test of the lumbar spine within 6 months were included in this retrospective study. Hounsfield units (HU) on lateral lumbar spine CT and BMD at the spine and hip on DXA were compared. Potential HU thresholds suggestive of abnormal BMD were established using receiver operating characteristic (ROC) analysis. RESULTS: 246 patients (mean age of 64 ±â€¯11.6 years; 83 % female) were included. On DXA, 27 % had osteoporosis, 56 % had osteopenia, and 17 % had normal BMD. To distinguish osteoporosis from non-osteoporosis (osteopenia, normal BMD), a threshold of HU160 had sensitivity 95 % and the balanced threshold was HU121 (sensitivity 74 %, specificity 61 %). To distinguish normal from abnormal BMD (osteoporosis, osteopenia), a threshold of HU110 had specificity 93 % and the balanced threshold was HU149 (sensitivity 76 %, specificity 74 %). CONCLUSIONS: In a heterogeneous Middle-Eastern population, our study supports the reported correlation between HU values on lumbar spine CT and BMD on DXA. In this population, HU > 160 correlates with low probability of osteoporosis on DXA, and screening examination is not warranted unless a vertebral fracture is detected; for HU ≤ 110 there is high probability of abnormal (osteoporosis or osteopenia) BMD, DXA examination is warranted; Finally, for HU 110-160, there is an intermediate chance of abnormal BMD, DXA examination may be warranted in specific patients with other risk factors.


Assuntos
Doenças Ósseas Metabólicas , Osteoporose , Absorciometria de Fóton , Idoso , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/epidemiologia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Estudos Retrospectivos , Tomografia Computadorizada por Raios X
9.
Arch Osteoporos ; 16(1): 22, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33527234

RESUMO

We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but further studies for dose response are required. PURPOSE: Cadmium exposure can exert detrimental effects on bone health, particularly in post-menopausal women. However, previous studies have failed to report an association in Korean post-menopausal women. We aimed to investigate the association between cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. METHODS: In total, 5432 participants from the 4th and 5th Korean National Health and Nutrition Examination Survey (KNHANES) were randomly sampled for measurements of heavy metal concentrations in the blood, bone mass density (BMD), and nutrient intake. We analyzed data for 1031 post-menopausal women ≥50 years of age. Blood cadmium levels were categorized into quartiles, and a multinomial logistic regression model was used for analysis. RESULTS: There was a significant positive association between cadmium levels and the risk of osteopenia and osteoporosis, but the odds ratio (OR) at the 4th level was lower than that at the 3rd level (OR and 95% confidence interval (CI) for osteopenia: 2nd quartile: 1.24, 0.88-1.74; 3rd quartile: 3.22, 2.24-4.64; 4th quartile: 1.27, 0.87-1.85; P for trend <0.001; OR and 95% CI for osteoporosis: 2nd quartile: 1.54, 1.05-2.25; 3rd quartile: 3.63, 2.31-5.69; 4th quartile: 1.70, 1.03-2.81; P for trend <0.001). This trend was consistent in the sensitivity analysis. CONCLUSION: Our findings suggest that there is an association between blood cadmium levels and the risk of osteopenia and osteoporosis in Korean post-menopausal women. However, further prospective studies are required to determine whether there is a dose-response relationship and address potential selection bias, especially in patients with femoral neck osteoporosis.


Assuntos
Doenças Ósseas Metabólicas , Osteoporose Pós-Menopausa , Osteoporose , Densidade Óssea , Doenças Ósseas Metabólicas/induzido quimicamente , Doenças Ósseas Metabólicas/epidemiologia , Cádmio , Estudos Transversais , Feminino , Humanos , Inquéritos Nutricionais , Osteoporose/induzido quimicamente , Osteoporose/epidemiologia , Osteoporose Pós-Menopausa/epidemiologia , Pós-Menopausa , Estudos Prospectivos , República da Coreia/epidemiologia
10.
J Zoo Wildl Med ; 51(4): 958-969, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33480576

RESUMO

An increase in cases of metabolic bone disease (MBD) in chicks of six species of heron and egret (family Ardeidae) was identified at a wildlife rehabilitation center in the spring and summer of 2018. The outbreak affected 34.3% of birds in care for four or more days during the first 3 mo of the study and was the most common reason for euthanasia during that time. Cases were characterized by lameness, increased flexibility of multiple long bones, angular deformities, and bone fractures. Gross postmortem examinations were conducted on 145 nestlings and fledglings that died or were euthanatized either because of MBD or for unrelated conditions. Histology was performed in four cases and three controls. Histologic findings were characterized by multiple lesions in the appendicular long bones, including variable elongation of the physis, retention of cartilage cores in the metaphyseal primary spongiosa, poorly mineralized osteoid seams within the primary spongiosa, thinning or lack of diaphyseal cortical bone compaction, and folding fractures typically propagating through the physis-metaphyseal interface. Folding fractures were often associated with focal metaphyseal fibroplasia. The parathyroid gland diameter of birds diagnosed postmortem with MBD in care was significantly larger than that of unaffected birds. The authors hypothesized that a dietary deficiency of vitamin D3 because of low levels in the bird's captive diet of capelin (Mallotus villosus) was the cause of the MBD. Starting in mid-July every chick's diet was supplemented with 714 IU oral vitamin D3/kg body weight per day, after which the number of birds developing MBD declined to a rate of 4.3%. This study characterizes the clinical, gross, radiographic, and histologic features of vitamin D3-responsive MBD in young herons and egrets and provides evidence to support the recommendation that captive birds on a diet of capelin be supplemented with vitamin D3, especially during growth.


Assuntos
Ração Animal/análise , Doenças Ósseas Metabólicas/veterinária , Colecalciferol/uso terapêutico , Peixes , Deficiência de Vitamina D/veterinária , Animais , Aves , Doenças Ósseas Metabólicas/etiologia , Doenças Ósseas Metabólicas/terapia , Deficiência de Vitamina D/tratamento farmacológico , Deficiência de Vitamina D/etiologia
11.
Neurology ; 96(9): e1290-e1300, 2021 03 02.
Artigo em Inglês | MEDLINE | ID: mdl-33431517

RESUMO

OBJECTIVE: To test the hypothesis that bone mineral loss is mechanistically related to cerebral small vessel disease (SVD), we investigated the relationship between bone mineral density and the prevalence and intensity of SVD among patients with stroke. METHODS: We analyzed data of 1,190 consecutive patients with stroke who were >50 years of age and underwent both brain MRI and dual-energy x-ray absorptiometry from the stroke registry of Chung-Ang University Hospital in Seoul, Korea. The patients were categorized into 3 groups according to their bone mineral density (normal, osteopenia, and osteoporosis). White matter hyperintensities, silent lacunes, cerebral microbleeds, and extensive perivascular space were assessed from brain MRI. Multinomial logistic regression model was used to examine the association between osteoporosis and total SVD score. We also recruited 70 patients with stroke to study serum bone turnover markers and microRNAs related to both cerebral atherosclerosis and bone metabolism to understand bone and brain interaction. RESULTS: Osteoporosis was determined among 284 patients (23.9%), and 450 patients (37.8%) had osteopenia. As bone mineral density decreased, total SVD score and the incidence of every SVD phenotype increased except strictly lobar cerebral microbleeds. Multinomial logistic regression analysis showed that osteoporosis was independently associated with severe SVD burden. The levels of microRNA-378f were significantly increased among the patients with osteoporosis and maximal total SVD score and positively correlated with parathyroid hormone and osteocalcin. CONCLUSIONS: These findings suggest a pathophysiologic link between bone mineral loss and hypertensive cerebral arteriolar degeneration, possibly mediated by circulating microRNA.


Assuntos
Densidade Óssea , Doenças de Pequenos Vasos Cerebrais/patologia , Absorciometria de Fóton , Idoso , Idoso de 80 Anos ou mais , Doenças Ósseas Metabólicas/complicações , Encéfalo/diagnóstico por imagem , Doenças de Pequenos Vasos Cerebrais/complicações , Doenças de Pequenos Vasos Cerebrais/diagnóstico por imagem , Feminino , Humanos , Arteriosclerose Intracraniana/complicações , Arteriosclerose Intracraniana/diagnóstico por imagem , Hemorragias Intracranianas/diagnóstico por imagem , Imagem por Ressonância Magnética , Masculino , MicroRNAs/genética , Pessoa de Meia-Idade , Osteocalcina/sangue , Osteoporose/complicações , Hormônio Paratireóideo/sangue , Acidente Vascular Cerebral/diagnóstico por imagem , Acidente Vascular Cerebral/patologia , Substância Branca/diagnóstico por imagem
12.
Nutrients ; 13(2)2021 Jan 20.
Artigo em Inglês | MEDLINE | ID: mdl-33498519

RESUMO

Osteopenia/osteoporosis and sarcopenia are common geriatric diseases among older adults and harm activities of daily living (ADL) and quality of life (QOL). Osteosarcopenia is a unique syndrome that is a concomitant of both osteopenia/osteoporosis and sarcopenia. This review aimed to summarize the related factors and clinical outcomes of osteosarcopenia to facilitate understanding, evaluation, prevention, treatment, and further research on osteosarcopenia. We searched the literature to include meta-analyses, reviews, and clinical trials. The prevalence of osteosarcopenia among community-dwelling older adults is significantly higher in female (up to 64.3%) compared to male (8-11%). Osteosarcopenia is a risk factor for death, fractures, and falls based on longitudinal studies. However, the associations between osteosarcopenia and many other factors have been derived based on cross-sectional studies, so the causal relationship is not clear. Few studies of osteosarcopenia in hospitals have been conducted. Osteosarcopenia is a new concept and has not yet been fully researched its relationship to clinical outcomes. Longitudinal studies and high-quality interventional studies are warranted in the future.


Assuntos
Doenças Ósseas Metabólicas , Osteoporose , Sarcopenia , Acidentes por Quedas , Idoso , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/epidemiologia , Doenças Ósseas Metabólicas/terapia , Comorbidade , Feminino , Fraturas Ósseas/etiologia , Fragilidade , Humanos , Vida Independente , Masculino , Mortalidade , Força Muscular , Osteoporose/complicações , Osteoporose/epidemiologia , Osteoporose/terapia , Fatores de Risco , Sarcopenia/complicações , Sarcopenia/epidemiologia , Sarcopenia/terapia
13.
AIDS ; 35(2): 213-218, 2021 02 02.
Artigo em Inglês | MEDLINE | ID: mdl-33394669

RESUMO

OBJECTIVES: Osteopenia is frequent in HIV-infected patients treated with antiretroviral therapy (ART) and has been linked to increased osteoclastogenesis. Little is known about the effects of ART on osteogenesis. DESIGN: We investigated the effect on human mesenchymal stem cells (hMSC) and osteoblasts of Darunavir and Dolutegravir, the most highly used as anchor drugs within a three-drug regimen, and Atazanavir, which was widely utilized in the past. RESULTS: We found that Atazanavir and Dolutegravir delay the osteogenic differentiation of hMSC, impair the activity of osteoblasts and inhibit their conversion into osteocytes, whereas Darunavir exerts no effect. CONCLUSION: Atazanavir and Dolutegravir impair osteogenesis. It is essential to diagnose impaired osteogenesis early and to devise effective therapeutic interventions to preserve bone health in ART-treated HIV patients, putting it in the context of a correct antiretroviral combination.


Assuntos
Fármacos Anti-HIV , Sulfato de Atazanavir/efeitos adversos , Doenças Ósseas Metabólicas , Darunavir/efeitos adversos , Infecções por HIV , Compostos Heterocíclicos com 3 Anéis/efeitos adversos , Oxazinas/efeitos adversos , Piperazinas/efeitos adversos , Piridonas/efeitos adversos , Fármacos Anti-HIV/efeitos adversos , Sulfato de Atazanavir/uso terapêutico , Doenças Ósseas Metabólicas/induzido quimicamente , Darunavir/uso terapêutico , Infecções por HIV/complicações , Infecções por HIV/tratamento farmacológico , Compostos Heterocíclicos com 3 Anéis/uso terapêutico , Humanos , Osteogênese , Oxazinas/uso terapêutico , Piperazinas/uso terapêutico , Piridonas/uso terapêutico
14.
BMC Geriatr ; 21(1): 69, 2021 01 19.
Artigo em Inglês | MEDLINE | ID: mdl-33468069

RESUMO

BACKGROUND: The purpose of this study was to investigate the prevalence of osteosarcopenia in the over 60-year-old community and to evaluate whether osteosarcopenia is associated with disability, frailty and depression. METHODS: This study was performed using the baseline data of Namgaram-2, among the 1010 surveyed subjects, 885 study subjects who were 60 years or older and had all necessary tests performed were selected. The Kaigo-Yobo checklist (frailty), World Health Organization Disability Assessment Schedule (WHODAS) and Geriatric Depression Scale-Short Form-Korean (GDSSF-K) were used. The Asian Working Group for Sarcopenia (AWGS 2019) were applied in this study. Osteopenia was measured using data from dual energy X-ray absorptiometry (DEXA) and osteopenia was diagnosed when the T-score was less than - 1.0. The study subjects were divided into four groups: the normal group, in which both sarcopenia and osteopenia were undiagnosed, osteopenia only, sarcopenia only and the osteosarcopenia group, which was diagnosed with both sarcopenia and osteopenia. RESULTS: Of the 885 subjects over 60 years old evaluated, the normal group comprised 34.0%, the only osteopenia group 33.7%, the only sarcopenia group 13.1%, and the osteosarcopenia group 19.2%. WHODAS (17.5, 95% CI: 14.8-20.1), Kaigo-Yobo (3.0, 95% CI: 2.6-3.4), and GDSSF mean score (4.6, 95% CI: 3.9-5.4) were statistically significantly higher in the osteosarcopenia group compared the other groups. Partial eta squared (ηp2) of WHODAS (0.199) and Kaigo-Yobo (0.148) values ​​according to Osteosarcopenia were large, and GDSSF (0.096) was medium CONCLUSIONS: Osteosarcopenia is a relatively common disease group in the older adults community that may cause deterioration of health outcomes. Therefore, when evaluating osteopenia or sarcopenia in the older adults, management of those in both disease groups should occur together.


Assuntos
Doenças Ósseas Metabólicas , Fragilidade , Sarcopenia , Idoso , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/epidemiologia , Depressão/diagnóstico , Depressão/epidemiologia , Fragilidade/diagnóstico , Fragilidade/epidemiologia , Humanos , Vida Independente , Sarcopenia/diagnóstico , Sarcopenia/epidemiologia
15.
Arch Osteoporos ; 16(1): 9, 2021 01 06.
Artigo em Inglês | MEDLINE | ID: mdl-33409707

RESUMO

Using national representative data, we found the prevalence of and risk factors associated with low BMD differed by race and ethnicity. PURPOSE: Race/ethnicity is an important determinant of osteoporosis risk. The study aims were to (1) estimate the racial and ethnic differences in the prevalence of low BMD, (2) identify factors associated with low BMD by race and ethnic group, and (3) evaluate if the association between sleep duration and low BMD is modified by age, sex, gender, and/or race/ethnicity. METHODS: Using data from the National Health and Nutrition Examination Survey (NHANES) database from 2005 to 2014, totally, 7992 participants aged ≥ 50 years were included as the primary cohort. Three race/ethnic groups were included: non-Hispanic Whites, Hispanics, and non-Hispanic Blacks. Low BMD was defined by femoral neck BMD T-scores less than - 1, as measured by DXA scan. Univariate and multivariate analyses were performed to determine associations between participants' demographics, comorbidities, lifestyle characteristics, and prevalent low BMD. RESULTS: Prevalence of low BMD was 50.8% among non-Hispanic Whites, 23.7% among non-Hispanic Blacks, and 44.0% among Hispanics. After adjusting for confounders, advanced age, female gender, and fracture history were significantly associated with increased odds of low BMD in all three race/ethnic groups. Family history of osteoporosis, ever used glucocorticoids daily, and vitamin D deficiency or insufficiency were associated with increased odds of low BMD only among non-Hispanic Whites. Cardiovascular disease (CVD) history and diabetes were associated with low BMD only among non-Hispanic Blacks. Short sleep duration was not associated with low BMD in all ethnic groups, but was significantly associated with low BMD in older adults (> 65 years) and females. CONCLUSIONS: Prevalence of low BMD among three race/ethnic groups in the USA is determined, with race/ethnic disparities in several risk factors associated with low BMD identified. By contrast, advanced age, female gender, and fracture history are associated with increased odds of low BMD across all race/ethnic groups. The association between sleep duration and low BMD is modified by age and sex. Together, these findings may help clinicians and healthcare providers formulate better care for individual's bone health.


Assuntos
Densidade Óssea , Doenças Ósseas Metabólicas , Idoso , Feminino , Colo do Fêmur/diagnóstico por imagem , Hispano-Americanos , Humanos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Fatores Raciais
16.
BMJ Case Rep ; 14(1)2021 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-33431459

RESUMO

Primary Sjögren's syndrome (pSS) is a chronic slowly progressive autoimmune disease characterised by lymphocytic infiltration of salivary and lacrimal glands with varying degree of systemic involvement. Renal involvement, a recognised extraglandular manifestation of pSS, is commonly related to tubular dysfunction and generally manifests as distal renal tubular acidosis (RTA), proximal RTA, tubular proteinuria and nephrogenic diabetes insipidus. Untreated long-standing RTA is known to cause metabolic bone disease. Here, we present the report of a patient with sclerotic metabolic bone disease related to pSS with combined distal and proximal RTA and negative workup for other causes of sclerotic bone disease. A significant clinical and biochemical improvement, including recovery of proximal tubular dysfunction, was noted with alkali therapy. This case suggests the need to consider pSS in the diagnostic algorithm of a patient presenting with sclerotic bone disease.


Assuntos
Acidose Tubular Renal/diagnóstico , Dor nas Costas/imunologia , Doenças Ósseas Metabólicas/diagnóstico , Síndrome de Sjogren/diagnóstico , Absorciometria de Fóton , Acidose Tubular Renal/sangue , Acidose Tubular Renal/tratamento farmacológico , Acidose Tubular Renal/imunologia , Adulto , Fosfatase Alcalina/sangue , Dor nas Costas/sangue , Densidade Óssea/imunologia , Doenças Ósseas Metabólicas/sangue , Doenças Ósseas Metabólicas/tratamento farmacológico , Doenças Ósseas Metabólicas/imunologia , Feminino , Humanos , Citrato de Potássio/uso terapêutico , Cintilografia , Síndrome de Sjogren/sangue , Síndrome de Sjogren/complicações , Síndrome de Sjogren/imunologia , Esqueleto/diagnóstico por imagem , Bicarbonato de Sódio/uso terapêutico
17.
Clin Interv Aging ; 16: 83-96, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33469276

RESUMO

The menopausal transition is a critical period in women's lives. Exercise might be the most promising non-pharmaceutic intervention to address the large variety of risk factors related to the pronounced estradiol decline during peri- and early-postmenopause. The aim of this study was to determine the effect of an 18-month multipurpose exercise program on risk factors and symptoms related to the menopausal transition. Fifty-four women 1-5 years postmenopause with osteopenia or osteoporosis were randomly assigned 1) to a high impact weight-bearing/high-intensity/velocity resistance training group (EG: n=27) exercising three times a week or 2) to an attendance control group (CG: n=27) that performed low-intensity exercise once a week. Both groups were supplemented with cholecalciferol and calcium. The primary study endpoint was bone mineral density (BMD) at lumbar spine (LS) and total hip, secondary outcomes were lean body mass (LBM), total and abdominal body percentage, metabolic syndrome Z-Score (MetS-Z), menopausal symptoms and muscle strength and power. Due to COVID-19, the study was stopped after 13 months. We observed significant effects for BMD-LS (EG: 0.002±.018 versus CG: -.009±0.018 mg/cm2, p=0.027) but not for BMD total hip (EG: -0.01±.016 versus CG: -.009±0.020 mg/cm2, p=0.129). LBM improved significantly in the EG and decreased in the CG (0.39±1.08 vs -0.37±1.34 kg, p=0.026). Total and abdominal body fat improved significantly in the EG and was maintained in the CG (-1.44±1.49 vs -0.02±1.55 kg, p=0.002 and -1.50±2.33 vs 0.08±2.07 kg, p=0.011). Significant effects in favor of the EG were also determined for menopausal symptoms (p=0.029), hip/leg extension strength (p<0.001) and power (p<0.001). However, changes of the MetS-Z did not differ significantly (p=0.149) between EG and CG. In summary, with minor exceptions, we demonstrated the effectiveness of a multipurpose exercise protocol dedicated to early-postmenopausal women on various risk factors and complaints related to the menopausal transition.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Doenças Ósseas Metabólicas , Treinamento Intervalado de Alta Intensidade/métodos , Síndrome Metabólica/prevenção & controle , Osteoporose Pós-Menopausa , Pós-Menopausa , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico , Doenças Ósseas Metabólicas/terapia , Feminino , Humanos , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/terapia , Avaliação de Resultados em Cuidados de Saúde , Fatores de Risco , Comportamento de Redução do Risco
18.
Adv Rheumatol ; 61: 11, 2021. tab
Artigo em Inglês | LILACS | ID: biblio-1152745

RESUMO

Abstract Background: Sickle cell disease (SCD) is an autosomal recessive genetic disease in which a mutation occurs in the β-globin chain gene, resulting in abnormal hemoglobin levels. In an environment with reduced oxygen concentration, red blood cells change their conformation, resulting in chronic hemolysis and consequent anemia and vaso-occlusive crises with injuries to several organs, with a significant impairment of the osteoarticular system. This study aimed to verify the chronic osteoarticular alterations and their association with clinical and laboratory characteristics of patients with SCD with a more severe phenotype (SS and Sβ0), on a steady-state fasis. Methods: Fifty-five patients were referred to a medical consultation with a specialized assessment of the locomotor system, followed by laboratory tests and radiographic examinations. Results: In total, 74.5% patients had hemoglobinopathy SS; 67.3% were female; and 78.2% were non-whites. The mean patient age was 30.5 years. Most patients (61.8%) reported up to three crises per year, with a predominance of high-intensity pain (65.5%). Radiographic alterations were present in 80% patients. A total of 140 lesions were identified, most which were located in the spine, femur, and shoulders. Most lesions were osteonecrosis and osteoarthritis and were statistically associated with the non-use of hydroxyurea. Conclusions: There was a high prevalence of chronic osteoarticular alterations, which was statistically associated only with the non-regular use of hydroxyurea.(AU)


Assuntos
Humanos , Osteoartrite/etiologia , Osteonecrose/etiologia , Doenças Ósseas Metabólicas/etiologia , Hidroxiureia/administração & dosagem , Anemia Falciforme/fisiopatologia , Prognóstico , Estudos Transversais/instrumentação , Fatores de Risco , Hidroxiureia/efeitos adversos
19.
Osteoporos Int ; 32(5): 865-871, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-33313993

RESUMO

In elderly ambulatory men, high platelet and high neutrophil counts are related to low bone mineral density (BMD), after adjustment for relevant covariates. Low hemoglobin (hgb) is even associated with low BMD, but this relationship seems to be dependent on estradiol and osteocalcin. PURPOSE: Blood and bone cells exist in close proximity to each other in the bone marrow. Accumulating evidence, from both preclinical and clinical studies, indicates that these cell types are interconnected. Our hypothesis was that BMD measurements are associated with blood count variables and bone remodeling markers. METHODS: We analyzed blood count variables, bone remodeling markers, and BMD, in subjects from the MrOS cohort from Gothenburg, Sweden. Men with at least one blood count variable (hgb, white blood cell count, or platelet count) analyzed were included in the current analysis (n = 1005), median age 75.3 years (range 69-81 years). RESULTS: Our results show that high platelet counts were related to low BMD at all sites (total hip BMD; r = - 0.11, P = 0.003). No statistically significant association was seen between platelet counts and bone remodeling markers. Neutrophil counts were negatively associated with total body BMD (r = - 0.09, P = 0.006) and total hip BMD (r = - 0.08, P = 0.010), and positively related to serum ALP (r = 0.15, P < 0.001). Hgb was positively related to total hip BMD (r = 0.16, P < 0.001), and negatively to serum osteocalcin (r = - 0.13, P < 0.001). The association between platelet and neutrophil counts and total hip BMD was statistically significant after adjustments for other covariates, but the association between hgb and total hip BMD was dependent on estradiol and osteocalcin. CONCLUSIONS: Our observations support the hypothesis of an interplay between blood and bone components.


Assuntos
Densidade Óssea , Doenças Ósseas Metabólicas , Idoso , Idoso de 80 Anos ou mais , Biomarcadores , Humanos , Masculino , Osteocalcina , Contagem de Plaquetas , Suécia/epidemiologia
20.
Am J Physiol Renal Physiol ; 320(2): F203-F211, 2021 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-33308018

RESUMO

Chronic kidney disease mineral bone disorder (CKD-MBD) is a virtually universal complication of kidney diseases, starting early in the course of disease and resulting in devastating clinical consequences ranging from bone fragility to accelerated atherosclerosis and early cardiovascular death. Guidelines for therapeutic goals for CKD-MBD have been published, and achievement of these guidelines is associated with improved survival. However, the incomplete understanding of CKD-MBD and the individual variability in the manifestations of CKD-MBD have made it difficult to achieve these guidelines. We hypothesized that the progression of MBD through all stages of CKD, including end-stage kidney disease, could be represented by a quantitative systems pharmacology/systems biology (QSP) model. To address this hypothesis, we constructed a QSP model of CKD-MBD, building on an open-source model of calcium and phosphorus metabolism. Specifically, we estimated and validated the model using data from 5,496 patients with CKD enrolled in the Chronic Renal Insufficiency Cohort study. Our model accurately predicted changes in markers of mineral metabolism related to progressing CKD. We demonstrated that the incorporation of fibroblast growth factor 23 and the soft tissue compartment is essential for accurate modeling of the changes in calcium, phosphorus, intact parathyroid hormone, and calcitriol in CKD-MBD. We conclude that our systems biology model accurately represents CKD-MBD disease progression and can be used as a test bench for improving therapeutic interventions.


Assuntos
Doenças Ósseas Metabólicas/metabolismo , Cálcio/metabolismo , Aprendizado de Máquina , Modelos Biológicos , Fosfatos/metabolismo , Insuficiência Renal Crônica/fisiopatologia , Doenças Ósseas Metabólicas/etiologia , Fatores de Crescimento de Fibroblastos/genética , Fatores de Crescimento de Fibroblastos/metabolismo , Regulação da Expressão Gênica , Humanos , Hormônio Paratireóideo/metabolismo , Insuficiência Renal Crônica/complicações
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