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1.
Medicine (Baltimore) ; 99(24): e20633, 2020 Jun 12.
Artigo em Inglês | MEDLINE | ID: mdl-32541502

RESUMO

Although the positive correlation between serum uric acid (UA) levels and bone mineral density (BMD) has been reported in the general population, there are little data regarding the effect of serum UA levels on bone loss in patients with rheumatoid arthritis (RA).We investigated whether increased serum UA levels were associated with a reduced risk of osteoporosis in postmenopausal women with RA.In this retrospective cross-sectional study, 447 postmenopausal female patients with RA and 200 age-matched, postmenopausal healthy controls underwent BMD examination by dual energy x-ray absorptiometry and serum UA levels measurement. Osteoporosis was diagnosed when the T-score was <-2.5.The median UA level in postmenopausal RA patients was found to be significantly lower than that in the healthy women (4 vs 4.1 mg/dL, P = .012) and the frequency of osteoporosis incidence in the lumbar spine, hip, and either site in RA patients was 25.5%, 15.9%, and 32.5%, respectively; the values were significantly higher than those of the controls. After adjusting for confounding factors, a significantly lower risk for osteoporosis of the hip in RA patients was observed within the highest quartile (odds ratio [OR] = 0.37, 95% confidence interval [CI] = 0.16-0.72, P = .021) and the second highest quartile (OR = 0.44, 95% CI = 0.2-0.95, P = .038) of serum UA levels as compared with the lowest quartile, but this association was not found to be consistent with respect to the lumbar spine. Serum UA levels also showed an independently positive correlation with femoral neck BMD (ß = 0.0104, P = .01) and total hip BMD (ß = 0.0102, P = .017), but not with lumbar BMD.Our data suggest that UA may exert a protective effect on bone loss in RA, especially in the hip.


Assuntos
Artrite Reumatoide/sangue , Artrite Reumatoide/complicações , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/etiologia , Ácido Úrico/sangue , Idoso , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/epidemiologia , Pós-Menopausa , Estudos Retrospectivos , Medição de Risco
2.
Sci Rep ; 10(1): 5692, 2020 03 30.
Artigo em Inglês | MEDLINE | ID: mdl-32231224

RESUMO

Interleukin (IL)-17A is a well-described mediator of bone resorption in inflammatory diseases, and postmenopausal osteoporosis is associated with increased serum levels of IL-17A. Ovariectomy (OVX) can be used as a model to study bone loss induced by estrogen deficiency and the role of IL-17A in osteoporosis development has previously been investigated using various methods to inhibit IL-17A signaling in this model. However, the studies show opposing results. While some publications reported IL-17A as a mediator of OVX-induced osteoporosis, others found a bone-protective role for IL-17 receptor signaling. In this study, we provide an explanation for the discrepancies in previous literature and show for the first time that loss of IL-17A has differential effects on OVX-induced osteoporosis; with IL-17A being important for cortical but not trabecular bone loss. Interestingly, the decrease in trabecular bone after OVX in IL-17A knock-out mice, was accompanied by increased adipogenesis depicted by elevated leptin levels. Additionally, the bone marrow adipose tissue expanded, and the bone-turnover decreased in ovariectomized mice lacking IL-17A compared to ovariectomized WT mice. Our results increase the understanding of how IL-17A signaling influences bone remodeling in the different bone compartments, which is of importance for the development of new treatments of post-menopausal osteoporosis.


Assuntos
Interleucina-17/fisiologia , Osteoporose/fisiopatologia , Absorciometria de Fóton , Animais , Osso Esponjoso/patologia , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Feminino , Fêmur/diagnóstico por imagem , Fêmur/patologia , Humanos , Camundongos , Camundongos Knockout , Osteogênese/efeitos dos fármacos , Osteoporose/diagnóstico por imagem , Osteoporose/etiologia , Osteoporose/patologia , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/fisiopatologia , Ovariectomia/efeitos adversos , Reação em Cadeia da Polimerase em Tempo Real , Receptores de Interleucina-17/fisiologia , Microtomografia por Raio-X
3.
Arch Osteoporos ; 15(1): 49, 2020 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32189157

RESUMO

INTRODUCTION: Observational studies have shown that tea consumption has a potentially beneficial effect on bone health. However, few studies have assessed the effects of types of tea consumed on bone health. We aimed to investigate whether drinking oolong tea is associated with increased calcaneus bone mineral density (BMD) in postmenopausal women. METHODS: From an epidemiological survey in Shantou, 476 postmenopausal women aged 40 to 88 years were enrolled in the study. All women were questioned about their demographic features, lifestyle, health status, types of tea consumed, habit of tea consumption, and habitual dietary intake by use of a structured questionnaire. Estimated areal BMD was measured by calcaneal quantitative ultrasound (QUS). RESULTS: As compared with non-tea drinkers, oolong tea drinkers had higher calcaneus BMD (ß 34.70 [95% CI 10.38, 59.03]). In addition, calcaneus BMD was significantly increased for those drinking 1-5 cups/day (ß 27.43 [95% CI 3.70, 51.16]) but not > 5 cups/day. We observed no linear increase in calcaneus BMD with increasing years of tea consumption and local polynomial regression fitting showed a parabola-shaped association between years of tea consumption and calcaneus BMD. However, symptoms of osteoporosis did not differ by types of tea consumed. CONCLUSION: Long-term moderate oolong tea consumption may have beneficial effects on bone health in postmenopausal women in Shantou of southern China.


Assuntos
Densidade Óssea/efeitos dos fármacos , Calcâneo/fisiopatologia , Ingestão de Líquidos/fisiologia , Pós-Menopausa/fisiologia , Chá , Adulto , Idoso , Idoso de 80 Anos ou mais , Calcâneo/diagnóstico por imagem , China , Feminino , Humanos , Estilo de Vida , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/etiologia , Análise de Regressão , Ultrassonografia
4.
Arch Osteoporos ; 15(1): 48, 2020 03 18.
Artigo em Inglês | MEDLINE | ID: mdl-32185512

RESUMO

PURPOSE: To investigate the effects of dairy products on bone mineral density (BMD) in healthy postmenopausal women. METHODS: The EMBASE, Cochrane Library, Medline, and Web of Science databases were systematically searched for relevant studies. The pooled standardized mean difference (SMD) with its 95% confidence interval (CI) was used as the effect size. Subgroup analysis and Begg's test were conducted. RESULTS: Six studies with a total of 618 participants were included in the meta-analysis. Milk was the main dairy product used in the trials. There was a significant association between dairy product consumption and BMD of the lumbar spine (SMD 0.21, 95% CI 0.05-0.37, P = 0.009), femoral neck (SMD 0.36, 95% CI 0.19-0.53, P < 0.001), total hip (SMD 0.37, 95% CI 0.20-0.55, P < 0.001), and total body (SMD 0.58, 95% CI 0.39-0.77, P < 0.001). Subgroup analysis suggested that there was a positive effect of dairy product consumption on the BMD of the total hip starting from 12 months and the femoral neck starting from 18 months. There was also a positive association with the BMD in the four sites in people living in low-calcium intake countries. CONCLUSION: This meta-analysis provides evidence that dairy products can increase BMD in healthy postmenopausal women. Dairy product consumption should be considered an effective public health measure to prevent osteoporosis in postmenopausal women.


Assuntos
Densidade Óssea/fisiologia , Laticínios , Dieta/métodos , Osteoporose Pós-Menopausa/prevenção & controle , Pós-Menopausa/fisiologia , Conservadores da Densidade Óssea/farmacologia , Dieta/efeitos adversos , Feminino , Colo do Fêmur/diagnóstico por imagem , Colo do Fêmur/fisiopatologia , Voluntários Saudáveis , Humanos , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
5.
Sci Rep ; 10(1): 2277, 2020 02 10.
Artigo em Inglês | MEDLINE | ID: mdl-32042021

RESUMO

Megakaryocytes (MKs) play key roles in regulating bone metabolism. To test the roles of MK-secreted factors, we investigated whether MK and promegakaryocyte (pro-MK) conditioned media (CM) may affect bone formation and resorption. K562 cell lines were differentiated into mature MKs. Mouse bone marrow macrophages were differentiated into mature osteoclasts, and MC3T3-E1 cells were used for osteoblastic experiments. Bone formation was determined by a calvaria bone formation assay in vivo. Micro-CT analyses were performed in the femurs of ovariectomized female C57B/L6 and Balb/c nude mice after intravenous injections of MK or pro-MK CM. MK CM significantly reduced in vitro bone resorption, largely due to suppressed osteoclastic resorption activity. Compared with pro-MK CM, MK CM suppressed osteoblastic differentiation, but stimulated its proliferation, resulting in stimulation of calvaria bone formation. In ovariectomized mice, treatment with MK CM for 4 weeks significantly increased trabecular bone mass parameters, such as bone volume fraction and trabecular thickness, in nude mice, but not in C57B/L6 mice. In conclusion, MKs may secrete anti-resorptive and anabolic factors that affect bone tissue, providing a novel insight linking MKs and bone cells in a paracrine manner. New therapeutic agents against metabolic bone diseases may be developed from MK-secreted factors.


Assuntos
Diferenciação Celular/efeitos dos fármacos , Meios de Cultivo Condicionados/farmacologia , Megacariócitos/metabolismo , Osteogênese/efeitos dos fármacos , Comunicação Parácrina , Animais , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/tratamento farmacológico , Reabsorção Óssea/etiologia , Diferenciação Celular/fisiologia , Meios de Cultivo Condicionados/metabolismo , Modelos Animais de Doenças , Feminino , Fêmur/diagnóstico por imagem , Fêmur/fisiologia , Humanos , Injeções Intravenosas , Células K562 , Macrófagos/efeitos dos fármacos , Macrófagos/fisiologia , Células Progenitoras de Megacariócitos/metabolismo , Camundongos , Osteoclastos/fisiologia , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/tratamento farmacológico , Osteoporose Pós-Menopausa/etiologia , Ovariectomia , Crânio/efeitos dos fármacos , Crânio/fisiologia , Microtomografia por Raio-X
6.
Int Immunopharmacol ; 78: 106014, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31776093

RESUMO

Postmenopausal osteoporosis is one of the most common types of osteoporosis resulting from estrogen deficiency in elderly women. Nonsteroidal anti-inflammatory drugs (NSAIDs) are important drugs for pain relief in patients with osteoporosis. In this study, we report for the first time that flufenamic acid, a clinically approved and widely used NSAID, not only has analgesic properties but also shows a significant effect in terms of preventing postmenopausal osteoporosis. Quantitative RT-PCR analysis showed that treatment with flufenamic acid significantly downregulated the genes associated with osteoclast differentiation. Meanwhile, RNA-sequencing and western blot analyses suggested that flufenamic acid could inhibit the bone resorption by suppressing the phosphorylation of MAPK pathways. Moreover, an ovariectomy (OVX)-induced bone-loss mouse model indicated that flufenamic acid might be a potent drug for preventing osteoporotic fractures, as verified by micro-CT scanning and histological analysis. Therefore, this study proposes an attractive and potent drug with analgesic properties for the prevention of postmenopausal osteoporosis.


Assuntos
Anti-Inflamatórios/farmacologia , Reabsorção Óssea/tratamento farmacológico , Estrogênios/metabolismo , Ácido Flufenâmico/farmacologia , Osteoporose Pós-Menopausa/tratamento farmacológico , Animais , Anti-Inflamatórios/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Reabsorção Óssea/diagnóstico por imagem , Reabsorção Óssea/etiologia , Reabsorção Óssea/patologia , Diferenciação Celular/efeitos dos fármacos , Modelos Animais de Doenças , Feminino , Ácido Flufenâmico/uso terapêutico , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Camundongos , Osteoclastos , Osteogênese/efeitos dos fármacos , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/patologia , Ovariectomia/efeitos adversos , Fosforilação/efeitos dos fármacos , Microtomografia por Raio-X
7.
BMC Musculoskelet Disord ; 20(1): 556, 2019 Nov 20.
Artigo em Inglês | MEDLINE | ID: mdl-31747888

RESUMO

BACKGROUND: Previous studies have found that bone mesenchymal stem cells (BMSCs) were capable of self-replication, multi-differentiation, and regeneration. The aim of this study was to carry out a systematic review and meta-analysis of the efficacy of BMSC therapy for ovariectomized rats. METHODS: The PubMed, Embase, Web of Science, China National Knowledge Infrastructure, VIP, and Chinese Sinomed databases were searched systematically from their initiation date to October 5, 2018. Two researchers independently screened the literatures, which used the bone mineral density (BMD), total bone volume by total tissue volume (BV/TV) (%), and trabecular thickness/spacing (Tb/Sp) as the outcome measures. RESULTS: Five eligible studies were selected. In the BMSC treatment groups, the BMD values and normalized BV/TV values remarkably increased. In addition, in the BMSCs plus other treatment groups, the BMD and Tb/Sp values significantly increased. CONCLUSION: This study showed that BMSCs could accelerate callus maturity, ossification and restore mechanical properties of bones in osteoporotic fractures.


Assuntos
Transplante de Células-Tronco Mesenquimais/métodos , Osteoporose Pós-Menopausa/patologia , Osteoporose Pós-Menopausa/terapia , Ovariectomia/tendências , Animais , Feminino , Humanos , Osteoporose Pós-Menopausa/etiologia , Ovariectomia/efeitos adversos , Ratos , Ratos Sprague-Dawley
8.
Menopause ; 26(11): 1234-1241, 2019 11.
Artigo em Inglês | MEDLINE | ID: mdl-31613830

RESUMO

OBJECTIVE: High consumption of soft drinks has been associated with lower bone mineral density among postmenopausal women. This study explores the association of soft drink consumption, osteoporosis, and incidental fractures in this population. METHODS: Cross-sectional (at baseline) and cohort combined designs, over 11.9 years of median follow-up for 72,342 postmenopausal women participating in the Women's Health Initiative Observational Study. Multiple linear regression models were used to examine the cross-sectional associations between soft drink consumption and hip and lumbar spine bone mineral density. Cox proportional hazards regression models were used to examine the association of soft drink consumption with incident hip fractures. RESULTS: There were no associations between soft drink consumption and hip or lumbar spine t scores. During 700,388 person-years of follow-up, 2,578 hip fractures occurred. Adjusted hazard ratios for incident hip fracture for the highest consumption category compared with no consumption were 1.26 (95% confidence interval [CI] 1.01-1.56) for total soda and 1.32 (95% CI 1.00-1.75) for caffeine-free soda. There was no association between caffeinated soda and incident hip fracture (hazard ratio = 1.16; 95% CI 0.86-1.57). There was no apparent linear trend in the risk of hip fracture across categories of soda consumption in the fully adjusted models, suggesting a threshold effect. A sensitivity analysis using adjudicated hip fractures showed significant associations for all three soda exposures in the highest intake groups. CONCLUSIONS: Consuming more than two servings of soft drinks per day on average showed potential associations with higher risk of hip fracture among postmenopausal women.


Assuntos
Densidade Óssea , Bebidas Gaseificadas/estatística & dados numéricos , Fraturas do Quadril/epidemiologia , Fraturas por Osteoporose/epidemiologia , Idoso , Bebidas Gaseificadas/efeitos adversos , Estudos de Casos e Controles , Estudos Transversais , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose Pós-Menopausa/etiologia , Pós-Menopausa , Estudos Prospectivos , Inquéritos e Questionários , Saúde da Mulher
9.
Nutrients ; 11(10)2019 Oct 15.
Artigo em Inglês | MEDLINE | ID: mdl-31618877

RESUMO

Osteoporosis, a systemic skeleton disease, can be prevented by increasing calcium levels in serum via administration of calcium salts. However, traditional calcium-based formulations have not appeared to be effective, hence the purpose of the present work has been to prepare and test in vitro/vivo a formulation able to gradually release calcium during transit over the GI tract, thus increasing bioavailability and reducing daily dose, and hence, side effects. Calcium controlled-release granules based on zeolite and Precirol® were prepared. In the best case, represented by granules sized 1.2 mm, containing 20% Precirol®, 19% zeolite, 60% calcium (granule), the release lasted ≈6 h. The release is controlled by diffusion of calcium ions through the aqueous channels forming within granules, once these come into contact with physiological fluids. Such a diffusion is hindered by the interaction of calcium ions with the negatively charged surface of the zeolite. Ovariectomy was used to make rats osteopenic. For in vivo studies, rats were divided into the following groups. Sham: not treated; ova: ovariectomized (ova); CaCl2 1.0 g: ova, treated with 1.0 g/die Ca2+; CaCl2 0.5 g: ova, treated with 0.5 g/die Ca2+; granule 1.0 g, or granule 0.5 g: ova, treated with granules equivalent to 1.0 g/die or 0.5 g/die Ca2+ in humans. Ca2+ amounts in femur bone and bone marrow, femur mechanical characteristics, and femur medullary canalicule diameter were measured and the same efficacy rank order was obtained: ova < CaCl2 0.5 g < CaCl2 1.0 g < granule 0.5 g ≈ granule 1.0 g ≈ sham. The results show promise of an effective prevention of osteoporosis, based on a controlled-rate administration of a calcium dose half that administered by the current therapy, with reduced side effects.


Assuntos
Conservadores da Densidade Óssea/administração & dosagem , Remodelação Óssea/efeitos dos fármacos , Cloreto de Cálcio/administração & dosagem , Diglicerídeos/administração & dosagem , Fêmur/efeitos dos fármacos , Osteoporose Pós-Menopausa/prevenção & controle , Zeolitas/administração & dosagem , Administração Oral , Animais , Biomarcadores/sangue , Conservadores da Densidade Óssea/química , Conservadores da Densidade Óssea/metabolismo , Cloreto de Cálcio/química , Cloreto de Cálcio/metabolismo , Preparações de Ação Retardada , Diglicerídeos/química , Modelos Animais de Doenças , Portadores de Fármacos , Composição de Medicamentos , Liberação Controlada de Fármacos , Fêmur/metabolismo , Fêmur/fisiopatologia , Humanos , Osteocalcina/sangue , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/fisiopatologia , Ovariectomia , Tamanho da Partícula , Ratos Wistar , Zeolitas/química
10.
Diabetes Metab Syndr ; 13(4): 2607-2612, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31405683

RESUMO

Osteoporosis is the most common metabolic bone disorder that is common in postmenopausal women with type 2 diabetes. Different studies have reported different prevalence of osteoporosis. This systematic review and meta-analysis was conducted to estimate the pooled prevalence of osteoporosis in Iranian postmenopausal women with type 2 diabetes. Search for eligible articles was performed using the keywords of osteoporosis, osteopenia, bone mineral density, OP, bone loss, Post menopaus*, diabetes, hyperglycemia, and Iran, and their possible combinations in the following databases: Scientific Information Database (SID), MagIran, PubMed, Scopus, and Web of Science. Heterogeneity between studies was examined with I2. The data were analyzed using the meta-analysis method and random effects model with Stata version 11.0. The analysis of 4 papers with a sample size of 562 showed that the prevalence of osteoporosis in the lumbar spine and femoral neck of the Iranian post-menopausal women with type II diabetes was 25.26% (95% CI: 7.22-30.30) and 17.45% (95% CI: 0.25-34.65), respectively. Also, the prevalence of osteopenia in the lumbar spine and femoral neck of these patients was 45.23% (95% CI: 40.66-49.79) and 44.53% (95% CI: 36.60-52.47), respectively. There was no relationship between the prevalence of osteoporosis and osteopenia with sample size, year of publication, age and body mass index. Osteoporosis and osteopenia are prevalent in women, so healthy lifestyle education for these postmenopausal women are necessary to reduce the prevalence of these problems.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Osteoporose Pós-Menopausa/epidemiologia , Feminino , Humanos , Irã (Geográfico)/epidemiologia , Osteoporose Pós-Menopausa/etiologia , Prevalência , Prognóstico
11.
Sci Adv ; 5(8): eaax1387, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31457100

RESUMO

Adenosine and its receptors play a key role in bone homeostasis and regeneration. Extracellular adenosine is generated from CD39 and CD73 activity in the cell membrane, through conversion of adenosine triphosphate to adenosine monophosphate (AMP) and AMP to adenosine, respectively. Despite the relevance of CD39/CD73 to bone health, the roles of these enzymes in bona fide skeletal disorders remain unknown. We demonstrate that CD39/CD73 expression and extracellular adenosine levels in the bone marrow are substantially decreased in animals with osteoporotic bone loss. Knockdown of estrogen receptors ESR1 and ESR2 in primary osteoprogenitors and osteoclasts undergoing differentiation showed decreased coexpression of membrane-bound CD39 and CD73 and lower extracellular adenosine. Targeting the adenosine A2B receptor using an agonist attenuated bone loss in ovariectomized mice. Together, these findings suggest a pathological association of purine metabolism with estrogen deficiency and highlight the potential of A2B receptor as a target to treat osteoporosis.


Assuntos
Adenosina Trifosfatases/metabolismo , Adenosina/metabolismo , Osteoporose Pós-Menopausa/metabolismo , Agonistas do Receptor A2 de Adenosina/farmacologia , Animais , Biomarcadores , Membrana Celular , Células Cultivadas , Receptor alfa de Estrogênio/genética , Receptor alfa de Estrogênio/metabolismo , Espaço Extracelular/metabolismo , Expressão Gênica , Humanos , Camundongos , Osteoclastos/metabolismo , Osteogênese/genética , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/prevenção & controle , Receptor A2B de Adenosina/metabolismo , Microtomografia por Raio-X
12.
Osteoporos Int ; 30(7): 1395-1401, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30944954

RESUMO

Individuals with poor knowledge of osteoporosis and lower socioeconomic status, including being single and having a lower level of annual income, are less likely to be assessed or treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors. INTRODUCTION: Despite the negative health consequences of osteoporosis and the availability of effective treatment, a pervasive and persistent prevention care gap for osteoporosis remains present throughout the world. We attempted to identify the factors affecting the willingness of patients to either undergo or avoid assessment and treatment for osteoporosis. METHODS: A nationwide online survey was conducted in 926 Korean women over age 50. The survey included questions addressing three domains: (1) clinical and socio-demographic characteristics, (2) questions concerning the reasons for undergoing or avoiding osteoporosis assessment or treatment, and (3) knowledge of osteoporosis as measured using the modified Korean version of Facts on Osteoporosis Quiz. The assessed and non-assessed participants were compared in terms of their clinical and socioeconomic statuses, reasons for undergoing or avoiding osteoporosis management, and levels of knowledge of osteoporosis. RESULTS: The highest-ranked reason for undergoing osteoporosis assessment was fear of osteoporotic fracture, while the highest-ranked reason for avoiding osteoporosis assessment was not feeling a need to get tested for osteoporosis. Participants who sought assessment for osteoporosis were older and more likely to be married, and had greater knowledge of osteoporosis than those who did not seek assessment. The two groups were found to be similar in terms of tobacco use and daily alcohol use. Patients who had been diagnosed with osteoporosis but either did not initiate or discontinued osteoporosis treatment within 1 year were younger and had lower levels of annual income than those who began and continued treatment. CONCLUSION: Individuals with poor knowledge of osteoporosis and those of lower socioeconomic status, including those who were single and had a lower level of annual income, were less likely to be assessed and treated for osteoporosis. Individuals with particular osteoporosis risk factors such as smokers and heavy drinkers are overlooked for diagnosis. Further study is needed to identify and address the existing barriers and to promote osteoporosis management for women with these risk factors.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/tratamento farmacológico , Aceitação pelo Paciente de Cuidados de Saúde/psicologia , Idoso , Conservadores da Densidade Óssea/uso terapêutico , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/psicologia , Fraturas por Osteoporose/prevenção & controle , República da Coreia , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
14.
FASEB J ; 33(8): 8913-8924, 2019 08.
Artigo em Inglês | MEDLINE | ID: mdl-31017804

RESUMO

Osteoporosis is a major health problem, making bones fragile and susceptible to fracture. Previous works showed that mechanical loading stimulated bone formation and accelerated fracture healing. Focusing on the role of Wnt3a (wingless/integrated 3a), this study was aimed to assess effects of mechanical loading to the spine, using ovariectomized (OVX) mice as a model of osteoporosis. Two-week daily application of this novel loading (4 N, 10 Hz, 5 min/d) altered bone remodeling with an increase in Wnt3a. Spinal loading promoted osteoblast differentiation, endothelial progenitor cell migration, and tube formation and inhibited osteoclast formation, migration, and adhesion. A transient silencing of Wnt3a altered the observed loading effects. Spinal loading significantly increased bone mineral density, bone mineral content, and bone area per tissue area. The loaded OVX group showed a significant increase in the number of osteoblasts and reduction in osteoclast surface/bone surface. Though expression of osteoblastic genes was increased, the levels of osteoclastic genes were decreased by loading. Spinal loading elevated a microvascular volume as well as VEGF expression. Collectively, this study supports the notion that Wnt3a-mediated signaling involves in the effect of spinal loading on stimulating bone formation, inhibiting bone resorption, and promoting angiogenesis in OVX mice. It also suggests that Wnt3a might be a potential therapeutic target for osteoporosis treatment.-Li, X., Liu, D., Li, J., Yang, S., Xu, J., Yokota, H., Zhang, P. Wnt3a involved in the mechanical loading on improvement of bone remodeling and angiogenesis in a postmenopausal osteoporosis mouse model.


Assuntos
Remodelação Óssea , Neovascularização Fisiológica , Osteoporose Pós-Menopausa/metabolismo , Suporte de Carga , Proteína Wnt3A/metabolismo , Animais , Densidade Óssea , Células Cultivadas , Feminino , Humanos , Camundongos , Camundongos Endogâmicos C57BL , Osteoblastos/citologia , Osteoblastos/metabolismo , Osteogênese , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/terapia , Ovariectomia/efeitos adversos , Fator A de Crescimento do Endotélio Vascular/genética , Fator A de Crescimento do Endotélio Vascular/metabolismo , Proteína Wnt3A/genética
15.
Asian Nurs Res (Korean Soc Nurs Sci) ; 13(2): 161-167, 2019 May.
Artigo em Inglês | MEDLINE | ID: mdl-31026513

RESUMO

PURPOSE: This study aimed to identify the effect of parity and breastfeeding duration and the occurrence of lumbar vertebral and femoral neck osteoporosis in Korean postmenopausal women. METHODS: This study analyzed the data of 1,770 women based on the 2010-2011 results of the Korea National Health and Nutrition Examination Survey. Extracted data concerning bone density included variables known to be associated with osteoporosis. Complex sample multivariate logistic regression analysis was conducted to determine whether parity and breastfeeding duration were associated with osteoporosis in postmenopausal women. RESULTS: Parity was not associated with postmenopausal osteoporosis in the femoral neck or lumbar vertebrae; however, the risk of femoral neck osteopenia was significantly higher in women with a history of 12-24 months of breastfeeding than in women who breastfed for less than 12 months (odds ratio = 2.12, 95% confidence interval = 1.07-4.21). In women who breastfed for 24 months or longer, the risk of lumbar vertebral osteoporosis was significantly higher than in those who breastfed for less than 12 months (odds ratio = 2.73, 95% confidence interval = 1.18-6.32). CONCLUSION: Breastfeeding duration may affect the occurrence of lumbar vertebral or femoral neck osteopenia or osteoporosis. Therefore, women who breastfeed for one year or more require education on the risk of bone loss and the need for preventive measures such as adequate calcium intake and physical exercise.


Assuntos
Densidade Óssea , Aleitamento Materno , Paridade , Pós-Menopausa , Absorciometria de Fóton , Aleitamento Materno/estatística & dados numéricos , Feminino , Humanos , Modelos Logísticos , Pessoa de Meia-Idade , Inquéritos Nutricionais , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose Pós-Menopausa/etiologia , Pós-Menopausa/fisiologia , Gravidez , Prevalência , República da Coreia/epidemiologia , Fatores de Risco
16.
Nutrients ; 11(4)2019 Apr 19.
Artigo em Inglês | MEDLINE | ID: mdl-31010225

RESUMO

Post menopause is considered a critical period for bone-mass loss. Impaired bone metabolism during this phase can increase the risk of fractures in old age. Inflammation is a risk factor for bone health, and diet is a potential source of inflammation. However, few studies have examined the association between the dietary inflammatory index (DII®) and bone-mineral density (BMD) in postmenopausal women in Korea. The objective of this study was to determine, by means of a Korean cross-sectional investigation, whether higher DII scores are associated with decreased BMD in postmenopausal women. To that end, the raw data from the fourth and fifth Korea National Health and Nutrition Examination Surveys (KNHANES, 2009-2011) for 2778 postmenopausal women aged over 50 years were analyzed. The subjects' BMD were measured by dual-energy x-ray absorptiometry, and their DII® scores were calculated from a single 24-h dietary recall. Further, the participants were classified into three groups according to DII® score. Women with more pro-inflammatory diets (i.e., those in the highest tertile of DII®) had significantly lower BMD in the femoral neck as compared with women in the lowest tertile (p for trend <0.05) after adjustment for age, body-mass index (BMI), household income, education status, smoking habits, physical activity, total calcium intake, female-hormone use, age at menopause, and blood vitamin D levels. Multiple logistic regression analyses revealed that the odds ratio (OR) of total femur osteopenia/osteoporosis was higher in women in the highest tertile of DII® than in those in the lowest (OR 1.27, 95% CI 1.00-1.62, p for trend < 0.05). This study established that more pro-inflammatory diets might be associated with lower BMD in postmenopausal Korean women.


Assuntos
Grupo com Ancestrais do Continente Asiático , Densidade Óssea , Dieta/efeitos adversos , Fêmur/metabolismo , Inflamação/etiologia , Osteoporose Pós-Menopausa/etiologia , Pós-Menopausa , Absorciometria de Fóton/métodos , Idoso , Estudos Transversais , Inquéritos sobre Dietas , Feminino , Colo do Fêmur/metabolismo , Humanos , Modelos Logísticos , Rememoração Mental , Pessoa de Meia-Idade , Minerais , Razão de Chances , Osteoporose Pós-Menopausa/metabolismo , República da Coreia , Fatores de Risco
17.
Osteoporos Int ; 30(4): 771-786, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30840113

RESUMO

Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures in order to identify categories that should be targeted in future campaigns and educational programs. Higher knowledge scores were reached in women who already heard about the disease and had a formal education. As a result, osteoporosis awareness campaigns and educational programs are mostly needed in populations with lower educational levels. INTRODUCTION: Our study investigated the characteristics of Lebanese women population groups with the poorest knowledge of osteoporosis definition, risk factors, and preventive measures. METHODS: A cross-sectional study, conducted between March and June 2018, enrolled 560 community dwelling women aged 40 years and above. A questionnaire was used to collect data. A proportionate random sample from all Lebanese Mohafazat was used. Data collection was performed through personal interviews. The median was used as a cutoff point for both the Knowledge and Health Belief scales. RESULTS: The study results showed that 47.3% of participants had a poor knowledge score. Women who received no education, compared to a higher education and have not previously heard about the disease, had lower knowledge scores. In addition, women not taking calcium and vitamin D supplements and not exercising or exercising less than 20 min per day compared to those having these characteristics had lower osteoporosis knowledge levels. A lower knowledge score was associated with less recognized benefits of adequate calcium intake and regular physical activity, more perceived barriers towards their practice, and a less important health motivation. A lower level of education correlated to the same results. CONCLUSION: Lower knowledge scores were reached in women who have never heard of osteoporosis and had a lower level of education. As a result, osteoporosis awareness campaigns and educational programs need to target population categories with lower educational levels.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Osteoporose/etiologia , Adulto , Fatores Etários , Estudos Transversais , Escolaridade , Feminino , Humanos , Líbano , Pessoa de Meia-Idade , Osteoporose/prevenção & controle , Osteoporose/psicologia , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/prevenção & controle , Osteoporose Pós-Menopausa/psicologia , Fatores de Risco , Fatores Socioeconômicos , Inquéritos e Questionários
18.
Subcell Biochem ; 91: 453-476, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30888662

RESUMO

Osteoporosis is a "skeletal disorder characterized by compromised bone strength predisposing a person to an increased risk of fracture" which, in light of demographic change, is becoming an increasing burden on health care worldwide. Increasing age and female gender are associated with the condition, although a wider range of clinical risk factors are being used increasingly to identify those at risk of osteoporosis and its most important sequelae, fracture.While osteoporosis and fracture have long been associated with women in the post-menopausal age, fracture incidence increases because of the ageing of our population. Interventions to abate the progression of osteoporosis and to prevent fractures must focus on the old and the very old. Evidence associating nutritional factors, particularly calcium and vitamin D are reviewed as are the association of falls risk with fracture and the potential for interventions to prevent falls. Finally, the assessment of frailty in the oldest old, associated sarcopenia and multi-morbidity are considered in the evaluation of fall and fracture risk and the management of osteoporosis in the ninth decade of life and beyond.


Assuntos
Envelhecimento/patologia , Osteoporose Pós-Menopausa/patologia , Acidentes por Quedas/prevenção & controle , Envelhecimento/efeitos dos fármacos , Densidade Óssea/efeitos dos fármacos , Cálcio/metabolismo , Cálcio/farmacologia , Feminino , Fraturas Ósseas/etiologia , Fraturas Ósseas/prevenção & controle , Humanos , Osteoporose Pós-Menopausa/complicações , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/prevenção & controle , Fatores de Risco , Vitamina D/metabolismo , Vitamina D/farmacologia
19.
J Clin Endocrinol Metab ; 104(8): 3576-3584, 2019 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-30896743

RESUMO

CONTEXT: Calcium intakes are commonly lower than the recommended levels, and increasing calcium intake is often recommended for bone health. OBJECTIVE: To determine the relationship between dietary calcium intake and rate of bone loss in older postmenopausal women. PARTICIPANTS: Analysis of observational data collected from a randomized controlled trial. Participants were osteopenic (hip T-scores between -1.0 and -2.5) women, aged >65 years, not receiving therapy for osteoporosis nor taking calcium supplements. Women from the total cohort (n = 1994) contributed data to the analysis of calcium intake and bone mineral density (BMD) at baseline, and women from the placebo group (n = 698) contributed data to the analysis of calcium intake and change in BMD. BMD and bone mineral content (BMC) of the spine, total hip, femoral neck, and total body were measured three times over 6 years. RESULTS: Mean calcium intake was 886 mg/day. Baseline BMDs were not related to quintile of calcium intake at any site, before or after adjustment for baseline age, height, weight, physical activity, alcohol intake, smoking status, and past hormone replacement use. There was no relationship between bone loss and quintile of calcium intake at any site, with or without adjustment for covariables. Total body bone balance (i.e., change in BMC) was unrelated to an individuals' calcium intake (P = 0.99). CONCLUSIONS: Postmenopausal bone loss is unrelated to dietary calcium intake. This suggests that strategies to increase calcium intake are unlikely to impact the prevalence of and morbidity from postmenopausal osteoporosis.


Assuntos
Doenças Ósseas Metabólicas/complicações , Cálcio na Dieta/análise , Dieta/efeitos adversos , Osteoporose Pós-Menopausa/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea , Inquéritos sobre Dietas , Ingestão de Alimentos , Feminino , Humanos , Osteoporose Pós-Menopausa/etiologia , Pós-Menopausa , Prevalência , Ensaios Clínicos Controlados Aleatórios como Assunto
20.
Osteoporos Int ; 30(6): 1215-1222, 2019 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-30868182

RESUMO

INTRODUCTION: Screening for osteoporosis is crucial in rheumatoid arthritis (RA) patients. The aim of this study was to assess the value of thoraco-abdomino-pelvic CT-derived bone mineral density (BMD) results in L1, compared to dual energy X-ray absorptiometry (DXA) results for osteoporosis screening in rheumatoid arthritis patients. METHODS: Consecutive RA patients who underwent a CT-scan and DXA within a 2-year period were retrospectively included. The CT sagittal images were then evaluated for vertebral fractures from T4 to L5 using the Genant classification. The CT-attenuation values (in Hounsfield units (HU)) of trabecular bone in L1 were measured on axial images and compared to the DXA results. RESULTS: This study included 105 patients (mean age 61.1 years (± 9.5), 78.1% women). There were 28 patients (26.7%) with DXA-defined osteoporosis and 32 (30%) with osteoporotic fractures (vertebral and/or non-vertebral). The CT assessment indicated that the mean (SD) vertebral L1 attenuation was 142.2 HU (± 18.5). The diagnostic performance for the vertebral CT-attenuation measurement was acceptable: the AUC was 0.67 for predicting osteoporotic fractures and of 0.69 for predicting vertebral fractures. Among patients with osteoporotic fractures, there were 23 (74%) patients categorized as osteoporotic with a L1 CT-attenuation of 135 HU or less, whereas there were only 13 patients (42%) identified by DXA. CONCLUSION: CT offers a combined opportunistic screening for osteoporosis by assessing both vertebral fractures and bone density on routine CT-scans. This approach may be particularly interesting for RA patients with a high osteoporosis risk.


Assuntos
Artrite Reumatoide/diagnóstico por imagem , Osteoporose/diagnóstico por imagem , Fraturas por Osteoporose/diagnóstico por imagem , Fraturas da Coluna Vertebral/diagnóstico por imagem , Absorciometria de Fóton/métodos , Idoso , Artrite Reumatoide/complicações , Artrite Reumatoide/fisiopatologia , Densidade Óssea/fisiologia , Feminino , Humanos , Achados Incidentais , Vértebras Lombares/fisiopatologia , Masculino , Programas de Rastreamento/métodos , Pessoa de Meia-Idade , Osteoporose/etiologia , Osteoporose/fisiopatologia , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/fisiopatologia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/fisiopatologia , Estudos Retrospectivos , Fraturas da Coluna Vertebral/etiologia , Fraturas da Coluna Vertebral/fisiopatologia , Tomografia Computadorizada por Raios X/métodos
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