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1.
Food Funct ; 10(10): 6556-6567, 2019 Oct 16.
Artigo em Inglês | MEDLINE | ID: mdl-31549110

RESUMO

Postmenopausal osteoporosis (PMO) is a progressive disease occurring in elderly postmenopausal women that is characterized by low bone mass and impaired bone quality. Sclareol is a natural product (initially isolated from the leaves and flowers of Salvia Sclarea) that possesses immune-regulation and anti-inflammatory effects, but its role in osteoclastic formation and function as well as the PMO remains unknown. In the current study, we investigated the inhibitory effect of sclareol on osteoclastogenesis and progression of PMO. In vitro, sclareol not only inhibited osteoclast formation but also suppressed osteoclast function. The expression of the receptor activator of NF-κB ligand (RANKL)-induced osteoclast marker gene and protein was also reduced by sclareol treatment. Mechanistically, we found that sclareol inhibits RANKL-induced NF-κB and MAPK/ERK pathway activation. Furthermore, sclareol exerted a protective effect against bone loss in an ovariectomy-induced mouse model. Taken together, our findings suggest that sclareol has potential value as a therapeutic agent for PMO.


Assuntos
Diterpenos/administração & dosagem , NF-kappa B/metabolismo , Osteoporose Pós-Menopausa/prevenção & controle , Animais , Feminino , Humanos , Sistema de Sinalização das MAP Quinases/efeitos dos fármacos , Camundongos Endogâmicos C57BL , NF-kappa B/genética , Osteoclastos/efeitos dos fármacos , Osteoclastos/metabolismo , Osteogênese/efeitos dos fármacos , Osteoporose Pós-Menopausa/genética , Osteoporose Pós-Menopausa/metabolismo , Osteoporose Pós-Menopausa/fisiopatologia
2.
Medicina (Kaunas) ; 55(9)2019 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-31466381

RESUMO

The menopausal transition, or perimenopause, is characterized by menstrual irregularities, vasomotor symptoms, sleep disturbances, mood symptoms, and urogenital tract atrophy. These changes can also affect the quality of life and one's self-esteem. Hormone replacement therapy (HRT) is considered the best option to achieve therapeutic relief of different menopausal symptoms but is usually restricted to moderate or severe symptoms. Moreover, many women refuse HRT for a variety of reasons concerning the fear of cancer and other adverse effects. According to these considerations, new topics are emerging: Dissatisfaction with drug costs and conventional healthcare, desire for personalized medicines, and the public perception that "natural is good". In this context, nonhormonal therapies are mostly evolving, and it is not unusual that women often request a "natural" approach for their symptoms. The aim of this study is to investigate nonhormonal therapies that have been identified to reduce the menopausal symptoms.


Assuntos
Suplementos Nutricionais , Menopausa , Fitoterapia , Contraindicações de Medicamentos , Terapia de Reposição Hormonal , Fogachos/tratamento farmacológico , Humanos , Osteoporose Pós-Menopausa/prevenção & controle , Fitoestrógenos/efeitos adversos , Fitoestrógenos/uso terapêutico , Fitoterapia/efeitos adversos , Transtornos do Sono-Vigília/tratamento farmacológico , Vitaminas/uso terapêutico
3.
Reumatol. clín. (Barc.) ; 15(4): 211-217, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184413

RESUMO

Objective: Considering the increased fracture risk in early breast cancer patients treated with aromatase inhibitors (AI), we assessed the impact of a preventive intervention conducted by a specialized osteoporosis unit on bone health at AI treatment start. Material and methods: Retrospective cohort of postmenopausal women who started treatment with AI after breast cancer surgical/chemotherapy treatment and were referred to the osteoporosis unit for a comprehensive assessment of bone health. Bone densitometry and fracture screening by plain X-ray were performed at the baseline visit and once a year for 5 years. Results: The final record included 130 patients. At AI treatment start, 49% had at least one high-risk factor for fractures, 55% had osteopenia, and 39% osteoporosis. Based on the baseline assessment, 79% of patients initiated treatment with bisphosphonates, 88% with calcium, and 79% with vitamin D. After a median of 65 (50-77) months, 4% developed osteopenia or osteoporosis, and 14% improved their densitometric diagnosis. Fifteen fractures were recorded in 11 (8.5%) patients, all of them receiving preventive treatment (10 with bisphosphonates). During the follow-up period, patients with one or more high-risk factors for fracture showed a greater frequency of fractures (15% vs. 3%) and experienced the first fracture earlier than those without high-risk factors (mean of 99 and 102 months, respectively; P=0.023). Conclusions: The preventive intervention of a specialized unit at the start of AI treatment in breast cancer survivors allows the identification of patients with high fracture risk and may contribute to preventing bone events in these patients


Objetivo: Evaluar el impacto de la intervención preventiva de una unidad de osteoporosis en supervivientes de cáncer de mama que inician un tratamiento con inhibidores de la aromatasa (IA). Material y métodos: Estudio retrospectivo en mujeres posmenopáusicas con cáncer de mama precoz que iniciaron un tratamiento con IA tras la cirugía y/o quimioterapia, derivadas a la unidad de osteoporosis para una evaluación de la salud ósea, incluyendo densitometrías óseas y búsqueda sistemática de fracturas mediante Rx al inicio del tratamiento y anualmente durante 5 años. Resultados: Se incluyeron 130 pacientes. Al inicio del tratamiento con IA el 49% tenía al menos un factor de riesgo alto para fracturas, el 55% osteopenia y el 39% osteoporosis. Tras la evaluación inicial, el 79% de las pacientes inició un tratamiento con bifosfonatos, el 88% con calcio y el 79% con vitamina D. Tras una mediana de 65 (50-77) meses, el 4% desarrolló osteopenia u osteoporosis y el 14% mejoró el diagnóstico densitométrico. Se registraron 15 fracturas en 11 (8,5%) pacientes, todas ellas en tratamiento preventivo. Durante el seguimiento, las pacientes con ≥1 factores de riesgo altos registraron una mayor frecuencia de fracturas (15 vs. 3%) y un menor tiempo hasta la primera fractura (media de 99 vs. 102 meses; p=0,023). Conclusiones: La intervención preventiva de una unidad de osteoporosis al inicio del tratamiento con IA en supervivientes de cáncer de mama permite identificar pacientes con un elevado riesgo de fracturas y puede contribuir a la prevención de eventos óseos en estas pacientes


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Osteoporose/epidemiologia , Unidades Hospitalares/organização & administração , Neoplasias da Mama/epidemiologia , Inibidores da Aromatase/uso terapêutico , Osteoporose/prevenção & controle , Sobreviventes de Câncer/estatística & dados numéricos , Inibidores da Aromatase/efeitos adversos , Fatores de Risco , Osteoporose Pós-Menopausa/prevenção & controle , Avaliação de Resultado de Ações Preventivas , Estudos Retrospectivos
4.
Nutrients ; 11(6)2019 Jun 21.
Artigo em Inglês | MEDLINE | ID: mdl-31234292

RESUMO

There is growing interest in bioactive substances from marine organisms for their potential use against diverse human diseases. Osteoporosis is a skeletal disorder associated with bone loss primarily occurring through enhanced osteoclast differentiation and resorption. Recently, we reported the anti-osteoclastogenic activity of fermented Pacific oyster (Crassostrea gigas) extract (FO) in vitro. The present study focused on investigating the anti-osteoporotic efficacy of FO in bone loss prevention in an experimental animal model of osteoporosis and elucidating the mechanism underlying its effects. Oral administration of FO significantly decreased ovariectomy-induced osteoclast formation and prevented bone loss, with reduced serum levels of bone turnover biomarkers including osteocalcin and C-terminal telopeptide fragment of type I collagen C-terminus (CTX). FO significantly suppressed receptor activator of nuclear factor-κB ligand (RANKL)-induced differentiation of bone marrow-derived macrophages (BMMs) into osteoclasts and attenuated the induction of osteoclast-specific genes required for osteoclastogenesis and bone resorption. Furthermore, FO inhibited RANKL-mediated IκBα and p65 phosphorylation in BMMs. Taken together, these results demonstrate that FO effectively suppresses osteoclastogenesis in vivo and in vitro, and that FO can be considered as a potential therapeutic option for the treatment of osteoporosis and osteoclast-mediated skeletal diseases.


Assuntos
Conservadores da Densidade Óssea/farmacologia , Crassostrea/microbiologia , Fermentação , Lactobacillus brevis/fisiologia , Osteoclastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Osteoporose Pós-Menopausa/prevenção & controle , Ovariectomia , Alimentos Marinhos/microbiologia , Tíbia/efeitos dos fármacos , Actinas/metabolismo , Animais , Conservadores da Densidade Óssea/isolamento & purificação , Células Cultivadas , Modelos Animais de Doenças , Feminino , Humanos , Camundongos Endogâmicos ICR , NF-kappa B/metabolismo , Osteoclastos/metabolismo , Osteoclastos/patologia , Osteoporose Pós-Menopausa/metabolismo , Osteoporose Pós-Menopausa/patologia , Osteoporose Pós-Menopausa/fisiopatologia , Transdução de Sinais , Tíbia/metabolismo , Tíbia/patologia , Tíbia/fisiopatologia
5.
Scand J Med Sci Sports ; 29(8): 1121-1129, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31034640

RESUMO

Exercise is one of the most widely used non-pharmacological strategies to prevent bone resorption during menopause. Given the detrimental consequences of bone demineralization, the purpose of this study was to examine the effects of prescribing different exercise volumes on bone mineral density and content in previously inactive, post-menopausal women during a 12-month intervention and 1 year after intervention completion. Four hundred post-menopausal women were randomized to either 150 min/wk (MODERATE dose group) or 300 min/wk (HIGH dose group) of aerobic exercise. Total bone mineral density (g/cm2 ) and bone mineral content (g) were assessed at baseline, 12 months (end of the intervention) and 24 months (follow-up) using whole body dual-energy X-ray absorptiometry. At 12 months, mean bone mineral density among women in the HIGH dose group was estimated to be 0.006 g/cm2 (95% CI: 0.001-0.010; P = 0.02) higher than that of women randomized to the MODERATE dose group. At 24 months, the mean difference between groups remained statistically significant, indicating higher mean bone mineral density among women in the HIGH dose group (0.007 g/cm2 ; 0.001-0.001; P = 0.04). No significant differences between groups were found at any time point for bone mineral content. In an exploratory analysis, women who completed more min/wk of impact exercises had significantly higher mean levels of bone mineral density at 12 months compared to baseline (0.006 g/cm2 , 95% CI: 0.006-0.012; P = 0.03). These findings suggest that higher volumes of exercise, especially impact exercise, lead to a smaller decline in total bone mineral density, which may remain following intervention completion.


Assuntos
Densidade Óssea , Exercício , Pós-Menopausa , Absorciometria de Fóton , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/prevenção & controle , Fatores de Tempo
7.
PLoS One ; 14(4): e0215018, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30970032

RESUMO

p21(WAF1/CIP1/SDI1) is a critical sentinel of the cell cycle that plays an important role in determining cell fate with respect to proliferation, differentiation and apoptosis. Recent studies have demonstrated that inhibition/loss of p21 promotes osteo-chondro differentiation in progenitor/stem cells, and that p21 knockout (p21-/-) mice demonstrate enhanced bone regeneration compared to wild-type controls after a non-critical size defect. It was therefore hypothesized that the absence of p21 may also protect against bone loss through enhancing bone formation, tilting the balance away from bone resorption, in an ovariectomy-induced osteopenia mouse model, investigated via microCT imaging. While p21-/- mice demonstrated significantly less bone loss after ovariectomy compared to wild-type controls, no increase in the number osteoclasts or osteoblasts in the bone or bone marrow was observed, nor was there an increase in osteoclast activity. Therefore, while the absence of p21 protected mice against estrogen mediated bone loss, the mechanisms/pathways responsible remained elusive. This study demonstrates that p21 may play a significant role in bone remodeling, and a better understanding of how the p21 pathway regulates bone anabolism and catabolism could lead to novel therapies for osteoporosis in the future.


Assuntos
Doenças Ósseas Metabólicas/prevenção & controle , Inibidor de Quinase Dependente de Ciclina p21/deficiência , Animais , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/metabolismo , Remodelação Óssea/genética , Remodelação Óssea/fisiologia , Inibidor de Quinase Dependente de Ciclina p21/genética , Inibidor de Quinase Dependente de Ciclina p21/metabolismo , Modelos Animais de Doenças , Feminino , Humanos , Células-Tronco Mesenquimais/metabolismo , Camundongos , Camundongos Endogâmicos C57BL , Camundongos Knockout , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osteoporose Pós-Menopausa/prevenção & controle , Ovariectomia/efeitos adversos , Microtomografia por Raio-X
8.
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
9.
Am Fam Physician ; 99(6): 370-375, 2019 03 15.
Artigo em Inglês | MEDLINE | ID: mdl-30874405

RESUMO

With declining mortality rates, the number of breast cancer survivors is increasing. Ongoing care after breast cancer treatment is often provided by primary care physicians. This care includes surveillance for cancer recurrence with a history and physical examination every three to six months for the first three years after treatment, every six to 12 months for two more years, and annually thereafter. Mammography is performed annually. Magnetic resonance imaging of the breast is not indicated unless patients are at high risk of recurrence, such as having a hereditary cancer syndrome. Many breast cancer survivors experience long-term sequelae from the disease or treatment. Premature menopause with hot flashes can occur and is managed with pharmacologic and nonpharmacologic treatments. Vaginal dryness is treated with vaginal lubricants and gels. Because cardiotoxicity from chemotherapy is possible, clinicians should be alert for this complication and perform echocardiography if appropriate. Impaired cognition after chemotherapy is also common; treatment includes cognitive rehabilitation therapy. Patients with treatment-induced menopause develop decreased bone density and should receive dual energy x-ray absorptiometry and pharmacologic and nonpharmacologic therapies. Others experience lymphedema, often best managed with weight loss and complex decongestive therapy. Some women develop chronic pain, which is treated by addressing psychological factors and with appropriate pharmacologic therapy.


Assuntos
Neoplasias da Mama/diagnóstico , Sobreviventes de Câncer , Recidiva Local de Neoplasia/prevenção & controle , Atenção Primária à Saúde/métodos , Neoplasias da Mama/psicologia , Neoplasias da Mama/terapia , Dor Crônica/etiologia , Dor Crônica/terapia , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/terapia , Feminino , Humanos , Linfedema/etiologia , Linfedema/terapia , Mamografia , Osteoporose Pós-Menopausa/diagnóstico , Osteoporose Pós-Menopausa/etiologia , Osteoporose Pós-Menopausa/prevenção & controle , Guias de Prática Clínica como Assunto , Fatores de Risco
10.
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
11.
J Med Food ; 22(3): 241-247, 2019 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-30888914

RESUMO

Osteoporosis is a systemic bone disease that is characterized by impairments in bone strength that predispose an individual to a higher risk of fractures. Despite the various etiologies, undoubtedly the most important factors are aging of the population and hypogonadism. Although several therapeutic options are available, pharmacological treatments have some risks. Among these are increases in the incidence of thrombosis, breast cancer, ovarian cancer, endometrial cancer, and muscle injury, among others. Herbal medication may be an alternative for the treatment of osteoporosis. Thus, the aim of this study was to evaluate the therapeutic effect of a standardized extract of Tribulus terrestris L. (TT) on ovariectomy (OVX)-induced bone loss in rats. Female rats were first subjected to OVX and treated with TT (3, 30, and 300 mg/[kg·day]) or furosemide (25 mg/kg) orally for 28 days. Bone densitometry and tibial histology were performed, and acute renal function and testosterone, dehydroepiandrosterone (DHEA), and estradiol levels were assessed. Prolonged treatment with TT stimulated bone mass gain in all ovariectomized animals, raising bone mass to levels that were similar to sham-operated rats. DHEA levels significantly increased in TT-treated rats. The TT group also had lower calcium (Ca2+) excretion that OVX control and furosemide-treated rats. Finally, the histopathological analyses showed the maintenance of bone turnover in all TT-treated groups. Overall, the results indicate that the standardized extract of T. terrestris exerted a bone-protective effect by increasing bone mineral density. This activity may be at least partially attributable to an increase in serum DHEA levels and a Ca2+-sparing effect.


Assuntos
Cálcio/sangue , Desidroepiandrosterona/sangue , Osteoporose Pós-Menopausa/prevenção & controle , Extratos Vegetais/administração & dosagem , Tribulus/química , Animais , Densidade Óssea/efeitos dos fármacos , Feminino , Humanos , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/fisiopatologia , Ovariectomia , Ratos , Ratos Sprague-Dawley , Testosterona/sangue
12.
Cancer Nurs ; 42(2): 164-172, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30802224

RESUMO

BACKGROUND: Cancer treatment-induced bone loss is an important long-term effect among breast cancer survivors. Little is known, however, about the pattern of bone loss and the factors associated with it. OBJECTIVE: The aim of this study was to examine annual bone health changes and factors associated with bone loss for 3 years after diagnosis among women with breast cancer. METHODS: Ninety-nine newly diagnosed women with breast cancer (mean age, 51.1 years) were enrolled in a prospective longitudinal study. Bone mineral density (BMD) was measured with dual-energy x-ray absorptiometry at baseline and yearly for 3 years. RESULTS: During the 3-year follow-up, the proportion of women who had osteopenia or osteoporosis increased from 33.3% to 62.5%. The BMD of the participants significantly decreased 6.8% in the lumbar spine, 4.6% in the femur neck, and 3.5% in the total hip, with bone loss the greatest in the first year. In multiple linear regression analysis, chemotherapy was significantly associated with bone loss at all sites, and premenopausal status at diagnosis was significantly related to bone loss at the lumbar spine. We found no significant relationship between health behavior status and BMD change at any site. CONCLUSION: Women newly diagnosed with breast cancer can lose up to 6.8% of BMD during a 3-year follow-up. Chemotherapy and premenopausal status are important risk factors for bone loss. IMPLICATIONS FOR PRACTICE: Identification of premenopausal women at diagnosis and monitoring BMD before and after chemotherapy are key for promoting bone health in women with breast cancer.


Assuntos
Doenças Ósseas Metabólicas/etiologia , Neoplasias da Mama/complicações , Osteoporose Pós-Menopausa/etiologia , Absorciometria de Fóton , Adulto , Densidade Óssea , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/prevenção & controle , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/fisiopatologia , Feminino , Humanos , Estudos Longitudinais , Vértebras Lombares/fisiopatologia , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/prevenção & controle , Pré-Menopausa , Estudos Prospectivos
13.
Biochem Biophys Res Commun ; 510(1): 53-58, 2019 02 26.
Artigo em Inglês | MEDLINE | ID: mdl-30660362

RESUMO

PURPOSE: The aim of this study was to investigate the mechanism of let-7a-5p in osteogenic differentiation of bone marrow mesenchymal stem cells (BMSCs) in postmenopausal osteoporosis (PMOP) mice. METHODS: A mouse model of PMOP was established and osteoporosis model was identified by micro-CT scan. BMSCs in the sham group and PMOP group were cultured and osteogenic differentiation was induced. The expression of let-7a-5p in BMSCs was detected by qRT-PCR, and BMSCs was induced by osteogenic differentiation in sham and PMOP group. The BMSCs treated by let-7a-5p mimics, let-7a-5p inhibitor and negative control were named as let-7a-5p mimics group, mimics NC group, let-7a-5p inhibitor group and inhibitor NC group, respectively. ALP staining and alizarin red staining were used to detect osteogenic differentiation ability, qRT-PCR and western blot were used to detect the expression of Runt-related transcription factor 2 (Runx2) and Osterix. The targeting relationship between let-7a-5p and TGFBR1 were verificated by target scan and luciferase reporter gene assay. RESULTS: The PMOP mouse model was successfully established. The expression of let-7a-5p in BMSCs of PMOP group was significantly higher than that in the sham group (P < 0.05). Let-7a-5p reduced the expression of ALP and the formation of calcified nodules, while also inhibited the expression of Runx2 and Osterix. TGFBR1 is the target gene of let-7a-5p. CONCLUSION: Let-7a-5p might inhibit the osteogenic differentiation of BMSCs in PMOP mice by regulating TGFBR1.


Assuntos
Células-Tronco Mesenquimais/citologia , MicroRNAs/fisiologia , Osteogênese/efeitos dos fármacos , Osteoporose Pós-Menopausa/prevenção & controle , Receptor do Fator de Crescimento Transformador beta Tipo I/antagonistas & inibidores , Animais , Diferenciação Celular , Subunidade alfa 1 de Fator de Ligação ao Core/antagonistas & inibidores , Modelos Animais de Doenças , Humanos , Células-Tronco Mesenquimais/efeitos dos fármacos , Camundongos , MicroRNAs/farmacologia , Fator de Transcrição Sp7/antagonistas & inibidores
14.
Complement Ther Med ; 42: 302-311, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30670259

RESUMO

OBJECTIVES: Several epidemiological investigations have assessed the association between vegetable-based diet intake (VDI) and risk of osteoporosis in postmenopausal subjects (OPS), but the outcomes have been inconsistent. We performed a review of the updated literature to evaluate this correlation. METHODS: We searched for relevant studies published in September 2018 or earlier. Two researchers conducted eligibility assessment and data extraction. Discrepancies were resolved through consultation with a third expert. Pooled odds ratios (ORs) were calculated with 95% confidence intervals (CIs). RESULTS: Ten studies, which included 14,247 subjects, were identified. On comparing the highest category of VDI consumption with the lowest category of VDI consumption, the pooled OR for OPS was 0.73 (95% CI = 0.57-0.95), i.e., participants with a higher intake of vegetables had a 27% (95% CI = 5-43%) lower risk of OPS. Significant benefits were found on subgroup analyses of case-control studies (OR, 0.61 [95% CI, 0.48-0.78]), but not on subgroup analyses of cross-sectional studies (OR, 0.82 [95% CI, 0.57-1.16]). The synthesized effect estimates were in the direction of decreased risk of OPS on subgroup analyses of the femoral region (OR, 0.57, 95% CI = 0.41-0.80) and the lumbar spine (OR = 0.55, 95% CI = 0.38-0.81), but not on subgroup analyses of the calcaneus (OR = 0.85, 95% CI = 0.33-2.16) and the lumbar and/or femoral region (OR = 1.04, 95%CI = 0.79-1.38). Positive results were observed on pooled analyses of the Dual energy X-ray absorptiometry (DEXA) measurement method (OR, 0.72 [95% CI, 0.54-0.95]), but not on pooled analyses of the Standardized Quantitative Ultrasound (QUS) measurement method (OR, 0.85 [95% CI, 0.33-2.16]). This might have resulted from a type II error due to wide confidence intervals and less number of included studies. CONCLUSION: This meta-analysis seemingly confirms that higher consumption of VDI was associated with a lower risk of OPS. Taken together, these results highlight the need for future high-quality design-based trials on quantified vegetable intake and OPS.


Assuntos
Dieta , Comportamento Alimentar , Osteoporose Pós-Menopausa/prevenção & controle , Verduras , Idoso , Feminino , Humanos , Masculino , Pessoa de Meia-Idade
15.
J Electromyogr Kinesiol ; 44: 124-131, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30611015

RESUMO

High impact exercise can reduce postmenopausal bone loss, however stimulus frequency (loading cycles per second) can affect osteogenesis. We aimed to examine the effect of stimulus frequency on the mechanical loading of four common osteoporosis prevention exercises, measuring body acceleration and muscle activation with accelerometry and electromyography (EMG), respectively. Fourteen early postmenopausal women completed randomised countermovement jumps (CMJ), box-drops (BD), heel-drops (HD) and stamp (STP) exercises for continuous and intermittent stimulus frequencies. Sacrum accelerometry and surface electromyography (EMG) of four muscles were recorded. CMJ (mean ±â€¯SD: 10.7 ±â€¯4.8 g & 10.0 ±â€¯5.0 g), BD (9.6 ±â€¯4.1 g & 9.5 ±â€¯4.0 g) and HD (7.3 ±â€¯3.8 g & 8.6 ±â€¯4.4 g) conditions generated greater peak acceleration than STP (3.5 ±â€¯1.4 g & 3.6 ±â€¯1.7 g) across continuous and intermittent trials. CMJ and BD generated greater acceleration gradients than STP across continuous and intermittent trials. CMJ generated greater rectus femoris EMG than all other exercises, CMJ and BD generated greater semitendinosus and tibialis anterior EMG than HD across continuous and intermittent trials. CMJ and BD provide greater peak acceleration than STP and remain similar during different stimulus frequencies. CMJ, BD and HD may exceed STP in maintaining postmenopausal bone health.


Assuntos
Terapia por Exercício/métodos , Músculo Esquelético/fisiologia , Osteoporose Pós-Menopausa/prevenção & controle , Condicionamento Físico Humano/métodos , Idoso , Feminino , Humanos , Perna (Membro)/fisiologia , Região Lombossacral/fisiologia , Pessoa de Meia-Idade , Contração Muscular , Suporte de Carga
16.
J Am Geriatr Soc ; 67(1): 81-86, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30359476

RESUMO

OBJECTIVES: To examine the effect of 25-hydroxyvitamin D (25(OH)D) levels recommended by Endocrine Society guidelines (>30 ng/mL) on cognition in healthy older African-American women over 3 years. DESIGN: Randomized, double-blind, placebo-controlled clinical trial. SETTING: Bone Mineral Research Center at New York University Winthrop Hospital. PARTICIPANTS: Healthy postmenopausal African American women aged 65 and older (N=260; mean age 68.2 ± 4.9; 46% college education or higher). INTERVENTION: Half of the women were randomized to receive vitamin D (adjusted to achieve a serum level > 30 ng/mL) with calcium (diet and supplement total of 1,200 mg), and half were randomized to receive placebo with calcium (1,200 mg). MEASUREMENTS: Cognitive assessments every 6 months using the Mini-Mental State Examination (MMSE) to detect cognitive decline. Mean MMSE scores were calculated over time for both groups. Those with MMSE scores less than 21 at baseline were excluded. RESULTS: The average dose of vitamin D3 was 3,490 ± 1,465 IU per day, and average serum 25(OH)D at 3 years was 46.8 ± 1.2 ng/mL in the active group and 20.7 ± 1.1 ng/mL in the placebo group. Serum 25(OH)D concentration was maintained at greater than 30 ng/mL in 90% of the active group. Over the 3-year period, MMSE scores increased in both groups (p < .001), although change over time was not significantly different between the groups. No adverse events associated with vitamin D were observed. CONCLUSION: There was no difference in cognition over time between older African-American women with serum concentrations of 25(OH)D of 30 ng/mL and greater than those taking placebo. There is no evidence to support vitamin D intake greater than the recommended daily allowance in this population for preventing cognitive decline. J Am Geriatr Soc 67:81-86, 2019.


Assuntos
Afro-Americanos/estatística & dados numéricos , Colecalciferol/administração & dosagem , Cognição/efeitos dos fármacos , Osteoporose Pós-Menopausa/prevenção & controle , Vitaminas/administração & dosagem , Idoso , Idoso de 80 Anos ou mais , Disfunção Cognitiva/sangue , Demência/etiologia , Suplementos Nutricionais , Método Duplo-Cego , Feminino , Voluntários Saudáveis , Humanos , Desempenho Físico Funcional , Pós-Menopausa , Recomendações Nutricionais , Resultado do Tratamento , Vitamina D/análogos & derivados , Vitamina D/sangue , Deficiência de Vitamina D
17.
Gynecol Endocrinol ; 35(2): 165-169, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30449208

RESUMO

The aim of the study is to compare the bone sparing effect of half-dose with standard-dose conjugated equine estrogen (CEE) combined with progestin. A total of 123 participants were administrated with 0.625 mg of CEE and 100 mg of micronized progesterone (MP) in group A, 0.3 mg of CEE and 100 mg of MP in group B, 0.625 mg of CEE and 10 mg of dydrogesterone (DDG) in group C for one year. Percent changes from baseline in BMD at lumbar spine and fracture rate were primary outcomes. Secondary endpoints included changes of BMD at femoral neck, total hip and arm, bone markers (alkaline phosphatase, calcium and phosphorus), serum alanine aminotransferase (ALT) and endometrial thickness. No fractures occurred during the treatment. Standard dose of CEE leads to significant changes in lumbar spine and arm. The 3.78% growth of BMD at femoral neck in group C marked a statistically difference. There was no statistically remarkable bone loss at hip in all three groups. Bone turnover markers and ALT significantly decreased from basic values. Endometrium thickened more with traditional dose of CEE. Both the half and standard dose CEE are effective in BMD preservation among early menopausal women with subtle side effects. Low-dose estrogen is less efficacious than traditional one.


Assuntos
Didrogesterona/uso terapêutico , Estrogênios Conjugados (USP)/administração & dosagem , Estrogênios/administração & dosagem , Fraturas Ósseas/epidemiologia , Osteoporose Pós-Menopausa/prevenção & controle , Progestinas/uso terapêutico , Alanina Transaminase/sangue , Fosfatase Alcalina/sangue , Densidade Óssea , Cálcio/sangue , Quimioterapia Combinada , Endométrio/patologia , Feminino , Colo do Fêmur/diagnóstico por imagem , Humanos , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Tamanho do Órgão , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/diagnóstico por imagem , Osteoporose Pós-Menopausa/tratamento farmacológico , Fósforo/sangue
18.
BMC Womens Health ; 18(1): 202, 2018 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-30558600

RESUMO

BACKGROUND: Osteoporosis is a skeletal metabolic disorder characterized by low bone mineral density (BMD) and reduced bone strength leading to higher bone fractures risk. The present study attempted to investigate the effects of concurrent training (aerobic-resistance) and milk consumption on some markers of BMD in women with osteoporosis. METHODS: For this purpose, forty women diagnosed with osteoporosis within an age range of 30-45 years were divided into four groups of ten including concurrent training-milk, concurrent training, milk consumption and control group. The concurrent exercises were performed in ten weeks with three sessions in each week including aerobic training (running at 55-75% of maximum heart rate) and resistance training (4 move in a circle performed two times with 10 repetition maximum (RM)). Milk consumption was two times of 250 ml per day in ten weeks. Before and after treatment, BMDs in the hip and lumbar spine area were estimated with Dual-energy X-ray absorptiometry (DEXA) device and 5 cc blood was taken from a vein in the arm to determine the blood levels of 25-hydroxyvitamin D (25OH-D) and alkaline phosphatase (ALP). RESULTS: Based on the results, blood levels 25OH-D and ALP significantly increased in concurrent training-milk, concurrent training and milk group with higher increase in concurrent training-milk group (P < 0.05). Furthermore, the right and left hip BMD in concurrent training-milk and concurrent training groups increased significantly with higher increase in concurrent training-milk group (p < 0.05). Also, lumbar spine BMD increased significantly in concurrent training-milk and concurrent training (p < 0.05). CONCLUSIONS: It seems that combination of concurrent training and milk consumption has more efficient impacts on the BMD of young women diagnosed with osteoporosis compared to the milk or concurrent training groups alone. This treatment can be used as an effective way to improve BMD in young women with diagnosed osteoporosis.


Assuntos
Densidade Óssea/fisiologia , Exercício , Leite , Osteoporose/prevenção & controle , Absorciometria de Fóton , Adulto , Animais , Feminino , Fraturas Ósseas/prevenção & controle , Humanos , Vértebras Lombares/diagnóstico por imagem , Pessoa de Meia-Idade , Osteoporose/metabolismo , Osteoporose Pós-Menopausa/prevenção & controle , Vitamina D/análogos & derivados , Vitamina D/análise
19.
Rev. osteoporos. metab. miner. (Internet) ; 10(4): 139-145, nov.-dic. 2018.
Artigo em Espanhol | IBECS | ID: ibc-178640

RESUMO

Los fitoestrógenos representan una familia de componentes derivados de plantas. Tienen una estructura esteroidea y son capaces de actuar en el receptor estrogénico. Poseen propiedades tanto estrogénicas como antiestrogénicas, en función del tejido en el que actúen. Los mecanismos potenciales por los cuales los fitoestrógenos pueden afectar a las actividades celulares se han dividido en efectos genómicos y no genómicos. Los primeros actúan a través de receptores de estrógenos, y estos últimos están mediados por proteínas celulares. El mecanismo de acción de las isoflavonas de soja en el hueso puede considerarse beneficioso, ya que actúan estimulando la actividad de los osteoblastos. Por otra parte, a través del sistema RANK-L/OPG inducen una disminución en la supervivencia y la actividad de los osteoclastos. Este artículo revisa estudios in vitro, en animales y humanos, que involucran a las isoflavonas y la salud ósea con el fin de conocer el efecto que sobre ésta tendrán dichas sustancias en aquellas mujeres postmenopáusicas que las utilizan en el contexto del tratamiento o prevención del síndrome climatérico. En general, la valoración global de los estudios en humanos muestra variabilidad en el diseño, en la variedad de fuentes de isoflavonas, en el tiempo del análisis y en la dosis. Además, es preciso considerar la variabilidad en la biodisponibilidad y el metabolismo de las isoflavonas entre los sujetos. Todo ello dificulta obtener conclusiones consistentes. En conclusión, los resultados arrojan algunos resultados positivos, justificando la necesidad de investigaciones adicionales. Desde un punto de vista clínico, las isoflavonas son utilizadas en aquellas mujeres con síntomas climatéricos que no pueden o no desean realizar terapia hormonal. No estarían indicadas con el objetivo de tratar la osteoporosis, pero aquellas mujeres que las utilizan a las dosis y tiempo adecuados pueden esperar un beneficio en el sentido de mantenimiento de su masa ósea


Phytoestrogens are a family of plant-derived components that present a steroid structure and can act in the estrogen receptor. They contain both estrogenic and antiestrogenic properties, depending on the tissue in which they act. The potential mechanisms by which phytoestrogens can affect cell activities have been divided into genomic and non-genomic effects. The former act through estrogen receptors, and the latter are mediated by cellular proteins. The active mechanism of soy isoflavones in bone may be beneficial, as they act by stimulating the activity of the osteoblasts. On the other hand, through the RANK-L/OPG system they bring about a decrease in osteoclast survival and activity. This article reviews in vitro studies, in animals and humans, that involve isoflavones and bone health to ascertain how these substances affect those postmenopausal women who use them in treatment or prevention of the climacteric syndrome.In general, the global assessment of human studies shows variability in the design, in the variety of isoflavone sources, in the time of the analysis and in the dose. In addition, the variability in the bioavaila-bility and metabolism of isoflavones between the subjects must be considered. All this makes it difficult to obtain consistent conclusions. To sum up, some positive results justify the need for further research. From a clinical point of view, isoflavones are used in women with climacteric symptoms who cannot or do not wish to undergo hormone therapy. They would not be indicated for treating osteoporosis, but those women who use them at the right doses and time can expect a benefit in maintaining bone mass


Assuntos
Humanos , Animais , Isoflavonas/administração & dosagem , Densidade Óssea/efeitos da radiação , Osteoporose Pós-Menopausa/prevenção & controle
20.
Reprod Biomed Online ; 37(3): 359-366, 2018 09.
Artigo em Inglês | MEDLINE | ID: mdl-30314888

RESUMO

At the dawn of humanity, it was rare to live beyond the age of 35 years, so the ovary was intended to function for a woman's entire life. Nowadays, it is not unusual for women to live into their 80s. This means that many of them spend 30-40% of their lives in the menopause at increased risk of various conditions associated with an absence of oestrogens (cardiovascular disease, bone mineral density loss). Reimplantation of frozen-thawed ovarian tissue is able to restore long-term ovarian endocrine function that can persist for more than 7 years (12 years if the procedure is repeated). If ovarian tissue reimplantation is capable of restoring ovarian activity after menopause induced by chemotherapy, radiotherapy, surgery, or a combination of all three, why not propose it to recover sex steroid secretion after natural menopause and prevent menopause-related conditions in the ageing population? In this application, the graft site could be outside the pelvic cavity, e.g., forearm or rectus muscle. Could ovarian tissue freezing at a young age followed by reimplantation upon reaching menopause be the anti-ageing therapy of the future? Sufficient existing evidence now surely merits serious debate.


Assuntos
Terapia de Reposição Hormonal/métodos , Osteoporose Pós-Menopausa/prevenção & controle , Ovário/transplante , Criopreservação , Feminino , Humanos , Pessoa de Meia-Idade
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