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1.
BMC Musculoskelet Disord ; 24(1): 11, 2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36609293

RESUMO

BACKGROUND: The aging of China's population has led to an increase in the incidence rate of osteoporosis, which indirectly increases the risk of OVCF in osteoporosis patients. Low back pain is the main symptom of OVCF, and severe patients can further develop kyphosis. Although the conservative treatment of OVCF can effectively control the patient's condition, long-term bed rest will increase the risk of OVCF complications. Minimally invasive surgery is a common solution for OVCF. METHODS: 100 OVCF patients admitted to our hospital from January 2021 to January 2022 are selected for analysis and randomly divided into PVP group and PKP group, 50 cases in each group. The PVP group and the PKP group undergo PVP and PKP operations respectively. The differences in efficacy indicators and adverse reactions are compared, and the multivariate Logistic regression method is used to analyze the influencing factors of postoperative secondary fractures in patients with vertebral compression fractures. RESULTS: Compared with the PVP group, the total effective rate of PKP group is significantly increased, and the VAS, ODI score, kyphotic Cobb Angle, lateral distribution rate of bone cement and bone cement leakage rate are significantly decreased (P < 0.05). Age ≥ 80 years old, female, glucocorticoid use, lateral distribution of bone cement and bone cement leakage are significantly higher in the proportion of secondary fractures and are independent risk factors for postoperative secondary fractures in patients with OVCF. CONCLUSION: PKP surgery has a higher efficacy in the treatment of OVCF patients, which can reduce the incidence of pain, adverse reactions and promote the recovery of kyphotic Cobb Angle. PKP surgery has a higher value in the treatment of OVCF. In addition, the influencing factors of secondary fracture after minimally invasive surgery in OVCF patients include age, gender, glucocorticoid use, bone cement distribution pattern, bone cement leakage, etc.


Assuntos
Fraturas por Compressão , Cifoplastia , Cifose , Osteoporose , Fraturas por Osteoporose , Fraturas da Coluna Vertebral , Vertebroplastia , Humanos , Feminino , Idoso de 80 Anos ou mais , Fraturas da Coluna Vertebral/diagnóstico por imagem , Fraturas da Coluna Vertebral/cirurgia , Fraturas da Coluna Vertebral/complicações , Fraturas por Compressão/diagnóstico por imagem , Fraturas por Compressão/cirurgia , Fraturas por Compressão/complicações , Cifoplastia/métodos , Vertebroplastia/métodos , Cimentos Ósseos/efeitos adversos , Glucocorticoides , Prognóstico , Osteoporose/complicações , Resultado do Tratamento , Cifose/complicações , Procedimentos Cirúrgicos Minimamente Invasivos/efeitos adversos , Fraturas por Osteoporose/complicações , Estudos Retrospectivos
2.
Molecules ; 28(2)2023 Jan 06.
Artigo em Inglês | MEDLINE | ID: mdl-36677642

RESUMO

As aging progresses, ß-amyloid (Aß) deposition and the resulting oxidative damage are key causes of aging diseases such as senior osteoporosis (SOP). Humulus lupulus L. (hops) is an important medicinal plant widely used in the food, beverage and pharmaceutical industries due to its strong antioxidant ability. In this study, APP/PS1 mutated transgenic mice and Aß-injured osteoblasts were used to evaluate the protective effects of hops extracts (HLE) on SOP. Mice learning and memory levels were assessed by the Morris water maze. Mice femurs were prepared for bone micro-structures and immunohistochemistry experiments. The deposition of Aß in the hippocampus, cortex and femurs were determined by Congo red staining. Moreover, protein expressions related to antioxidant pathways were evaluated by Western blotting. It was found that HLE markedly improved learning abilities and ameliorated memory impairment of APP/PS1 mice, as well as regulated antioxidant enzymes and bone metabolism proteins in mice serum. Micro-CT tests indicated that HLE enhanced BMD and improved micro-architectural parameters of mice femur. More importantly, it was discovered that HLE significantly reduced Aß deposition both in the brain and femur. Further in vitro results showed HLE increased the bone mineralization nodule and reduced the ROS level of Aß-injured osteoblasts. Additionally, HLE increased the expression of antioxidant related proteins Nrf2, HO-1, NQO1, FoxO1 and SOD-2. These results indicated that Humulus lupulus L. extract could protect against senior osteoporosis through inhibiting Aß deposition and oxidative stress, which provides a reference for the clinical application of hops in the prevention and treatment of SOP.


Assuntos
Doença de Alzheimer , Humulus , Osteoporose , Camundongos , Animais , Peptídeos beta-Amiloides/metabolismo , Camundongos Transgênicos , Humulus/metabolismo , Doença de Alzheimer/tratamento farmacológico , Precursor de Proteína beta-Amiloide/metabolismo , Antioxidantes/metabolismo , Estresse Oxidativo , Osteoporose/tratamento farmacológico , Osteoporose/prevenção & controle , Osteoblastos/metabolismo , Presenilina-1/genética , Presenilina-1/metabolismo , Modelos Animais de Doenças
3.
In Vivo ; 37(1): 204-217, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36593033

RESUMO

BACKGROUND/AIM: 25-hydroxycholesterol (25-HC) plays important roles in lipid metabolism, inflammatory responses, and apoptosis, but its pathophysiological association with osteoporosis (OP) has not been verified in osteoblasts. Hence, we studied the pathophysiological linkage and underlying cellular mechanisms of 25-HC in human osteoblast-like MG-63 cells and an ovariectomy-induced osteoporotic mouse model. MATERIALS AND METHODS: To investigate the pathophysiological linkage between 25-HC-induced osteoblast oxiapoptophagy and OP, 25-HC ELISA assay, MTT assay, cell live/dead staining, hematoxylin and eosin staining, DAPI staining, flow cytometry analysis, western blot, caspase-3 staining, reactive oxygen species (ROS) assay, autophagy staining, immunocytochemistry, Micro-CT image analysis and immunocytochemistry were performed in MG-63 cells and ovariectomy-induced OP animals. RESULTS: The expression of cholesterol-25-hydroxylase (CH25H), an enzyme catalyzing the conversion of cholesterol to 25-HC, and the production of 25-HC were increased by lipopolysaccharide in MG-63 cells. Cytotoxicity was increased by 25-HC in MG-63 cells. Apoptosis with condensed chromatin and altered morphology was induced by 25-HC through cleavage of caspases-8, -9, and -3 in MG-63 cells. 25-HC induced oxidative stress in MG-63 cells via elevation of ROS production, cyclooxygenase-2, and inducible nitric oxide synthase. Furthermore, the expression of autophagy biomarkers, including beclin-1 and microtubule-associated protein 1A/1B-light chain 3, was elevated by 25-HC in MG-63 cells. In addition, p53 expression was increased, whereas Akt phosphorylation was suppressed in 25-HC-incubated MG-63 cells. The expression of CH25H, cleaved caspase-3, and beclin-1 were up-regulated in the femoral bone of ovariectomy-induced mouse osteoporotic animals. CONCLUSION: 25-HC plays a role in OP via the induction of oxiapoptophagic osteoblast death.


Assuntos
Osteoblastos , Osteoporose , Feminino , Camundongos , Animais , Humanos , Espécies Reativas de Oxigênio/metabolismo , Caspase 3/metabolismo , Proteína Beclina-1/metabolismo , Osteoblastos/metabolismo , Colesterol , Osteoporose/etiologia , Osteoporose/metabolismo , Apoptose
4.
In Vivo ; 37(1): 270-285, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36593044

RESUMO

AIM: This study aimed to investigate the effect of Ceratonia siliqua on bone mineral density (BMD) as a non-pharmaceutical alternative treatment for postmenopausal osteoporosis. MATERIALS AND METHODS: Thirty mature female Wistar rats were randomly separated into three groups of 10: Control, ovariectomized (OVX), and ovariectomized-plus-C. siliqua (OVX+CS). Total and proximal BMD were measured by dual-energy X-ray absorptiometry (DEXA) in all groups before ovariectomy, and at 3 and 6 months postoperatively. At the end of the study, the femurs were subjected to a three-point bending test. RESULTS: DEXA revealed no statistically significant difference in absolute values or percentage changes for total tibial BMD between OVX+CS and OVX groups throughout the study. In the proximal tibia, both absolute values and BMD percentage changes from baseline were higher in the OVX+CS group compared to the OVX group after 3 and 6 months of C. siliqua administration. Three-point bending test revealed a significantly higher thickness index in the OVX+CS group compared to the OVX group and a higher cross-sectional area index compared to the control group. CONCLUSION: Long-term administration of C. siliqua may be considered a non-pharmaceutical alternative treatment for postmenopausal osteoporosis. Further research is required to properly investigate the effects, and suitable treatment dose and schedule.


Assuntos
Fabaceae , Osteoporose Pós-Menopausa , Osteoporose , Humanos , Ratos , Feminino , Animais , Densidade Óssea , Osteoporose Pós-Menopausa/tratamento farmacológico , Osteoporose Pós-Menopausa/etiologia , Ratos Wistar , Ratos Sprague-Dawley , Osteoporose/tratamento farmacológico , Osteoporose/etiologia , Ovariectomia/efeitos adversos
5.
BMC Musculoskelet Disord ; 24(1): 46, 2023 Jan 19.
Artigo em Inglês | MEDLINE | ID: mdl-36658540

RESUMO

BACKGROUND: Bone mineral density (BMD) and prevalence of osteoporosis may differ between urban and rural populations. This study aimed to investigate the differences in BMD characteristics between urban and rural populations in Jiangsu, China. METHODS: A total of 2,711 participants aged 20 years and older were included in the cross-sectional study. Multistage and stratified cluster random sampling was used as the sampling strategy. BMD was measured by the method of dual-energy x-ray absorptiometry (DXA). Data were collected through questionnaires/interview. BMD values at the lumbar spine (L1-L4), femoral neck, total hip, and greater trochanter were collected. Descriptive statistics were used to demonstrate the characteristics of urban and rural participants. Multivariate logistic regression analysis was utilized to analyze the factors that may be associated with osteoporosis in urban and rural populations. RESULTS: Of these participants, 1,540 (50.49%) were females and 1,363 (42.14%) were from urban. The prevalence of osteoporosis in urban and rural populations was 5.52% and 10.33%, respectively. In terms of gender, the prevalence of osteoporosis was 2.68% in males and 13.82% in females. For menopausal status, the prevalence of osteoporosis was 30.34% in postmenopausal females and 4.78% in premenopausal females. In urban populations, older age [adjusted odds ratio (AOR) = 2.36, 95%CI, 2.35-2.36), hypertension (AOR = 1.37, 95%CI, 1.36-1.37), unmarried (AOR = 4.04, 95%CI, 3.99-4.09), smoking everyday (AOR = 2.26, 95%CI, 2.23-2.28), family history of osteoporosis (AOR = 1.66, 95%CI, 1.65-1.67), dyslipidemia (AOR = 1.05, 95%CI, 1.04-1.05), and higher ß-crosslaps (ß-CTX) level (AOR = 1.02, 95%CI, 1.02-1.02) were associated with an increased risk of osteoporosis, while males (AOR = 0.04, 95%CI, 0.04-0.04), higher education level (AOR = 0.95, 95%CI, 0.95-0.95), and aquatic product intake (AOR = 0.99, 95%CI, 0.99-0.99) were related to decreased risk of osteoporosis. Similar results were also observed in rural populations, and (all P < 0.05). CONCLUSION: The prevalence of osteoporosis in rural populations was higher than that in urban populations, and the factors associated with the risk of osteoporosis were similar in urban and rural populations.


Assuntos
Osteoporose Pós-Menopausa , Osteoporose , Masculino , Feminino , Humanos , Estudos Transversais , Prevalência , População Rural , Osteoporose/diagnóstico por imagem , Osteoporose/epidemiologia , Densidade Óssea , Fatores de Risco , Absorciometria de Fóton
6.
Rev Med Suisse ; 19(N° 809-10): 62-65, 2023 Jan 18.
Artigo em Francês | MEDLINE | ID: mdl-36660840

RESUMO

The year 2022 has seen numerous studies: questioning the usefulness of vitamin D, the effect of osteoporosis treatments on mortality, and the benefit of parathyroidectomy on fractures in primary hyperparathyroidism. The efficacy of romosozumab is diminished by the treatments prescribed before its introduction. Finally, and fortunately, promising new molecules are available in various countries for the treatment of rare bone diseases.


L'année 2022 a vu de nombreuses études questionner l'utilité de la vitamine D et s'intéresser à l'effet des traitements de l'ostéoporose sur la mortalité ou encore au bénéfice de la parathyroïdectomie sur les fractures lors d'hyperparathyroïdie primaire. L'efficacité du romosozumab est diminuée selon les traitements prescrits avant son introduction. Finalement, et heureusement, de nouvelles molécules prometteuses sont disponibles dans différents pays pour le traitement des maladies osseuses rares.


Assuntos
Conservadores da Densidade Óssea , Doenças Ósseas , Fraturas Ósseas , Osteoporose , Humanos , Osteoporose/tratamento farmacológico , Osteoporose/etiologia , Vitamina D/uso terapêutico , Osso e Ossos , Densidade Óssea , Conservadores da Densidade Óssea/uso terapêutico
7.
Arch Osteoporos ; 18(1): 24, 2023 Jan 23.
Artigo em Inglês | MEDLINE | ID: mdl-36689130

RESUMO

OBJECTIVE: To evaluate the current frequency of osteoporosis (OP) in Chinese patients with rheumatoid arthritis (RA) through meta-analysis. METHODS: The databases of PubMed, Web of Science, Cochrane Library, CNKI, Wan Fang, CBM, and VIP were searched for relevant literature regarding the occurrence of OP in Chinese patients with RA from January 1, 2000, to September 15, 2022. The literature was screened using inclusion and exclusion criteria, and qualifying articles were subjected to data extraction, quality evaluation, and meta-analysis using Stata 17.0 software. RESULTS: Altogether, 44 publications were included in this study, with a total sample size of 12,264 RA cases and 4532 patients with OP. Meta-analysis revealed that the frequency of OP in patients with RA was 37.67% [95% CI: 34.38%, 40.97%], while subgroup analysis showed that the frequency in South China was 49.43% [95% CI: 40.53%, 58.32%]. Also, the frequency in men was 29.29% [95% CI: 22.42%, 36.16%], which was significantly lower than in women (41.89% [95% CI: 36.87%, 46.90%]). The incidence rate in pre-menopausal women was only 15.19% [95% CI: 8.79%, 21.59%], much lower than the figure of 54.29% [95% CI: 45.28%, 63.30%] for post-menopausal women. Additionally, the frequency rates in the low, intermediate, and high disease activity groups were 24.52% [95% CI: 11.52%, 37.52%)], 27.67% [95% CI: 13.50%, 41.85%], and 57.96% [95% CI: 37.35%, 78.56%], respectively. CONCLUSION: The frequency of OP in the Chinese RA population is higher than the world average, and patients with RA should receive standardized anti-RA therapy at an early stage, with emphasis on bone health in postmenopausal women, patients with high disease activity or longer disease duration.


Assuntos
Artrite Reumatoide , Osteoporose , Humanos , Feminino , Osso e Ossos , China
8.
Orv Hetil ; 164(1): 29-37, 2023 Jan 08.
Artigo em Húngaro | MEDLINE | ID: mdl-36617349

RESUMO

INTRODUCTION: Osteoporosis affects one in three women and one in five men over the age of 50. We do not have an osteoporosis-related knowledge questionnaire over the age of 50, which is considered strong evidence in the prevention and treatment of the disease. OBJECTIVE: Aim of the study was to validate the Hungarian form of the Osteoporosis Questionnaire in Hungarian-speaking women over the age of 50. METHOD: The questionnaire was validated into Hungarian according to Beaton's six-step method. Our sample consisted of 326 women. During our statistical analysis, we calculated descriptive statistics, difference tests, Cronbach's alpha value, and Spearman's correlation coefficient for test-retest and for external validity. Quality of life and physical activity were examined to support the external validity. RESULTS: Our sample (63.08 ± 9.36 years) scored 8.76 ± 6.94 points on the questionnaire. Cronbach's alpha value was 0.89. For the test-retest, Spearman's correlation coefficient showed a value of p≥0.25 for all the questions. Significant correlations were found between knowledge and age (R = 0.37; p<0.001) and years of using hormone replacement therapy (R = 0.34; p = 0.02). The correlation analysis showed significant (p<0.001) correlation between knowledge and all sub-dimensions of quality of life. Significant correlation was found between transport movement (p<0.001; R = 0.21), intensive (p<0.001; R = 0.354), moderate recreational activity (p<0.001; R = 0.348), total moderate (p = 0.041; R = 0.125) total intense movements (p = 0.018; R = 0.145) and knowledge. DISCUSSION: The Hungarian questionnaire was validated in accordance with international practice. CONCLUSION: The Hungarian version of the Osteoporosis Questionnaire is a reliable, adaptable questionnaire for measuring the osteoporosis-related knowledge of the Hungarian female population over 50. Orv Hetil. 2022; 163(51): 29-37.


Assuntos
Osteoporose , Qualidade de Vida , Masculino , Humanos , Feminino , Hungria , Reprodutibilidade dos Testes , Psicometria , Osteoporose/diagnóstico , Inquéritos e Questionários
9.
Mymensingh Med J ; 32(1): 144-152, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36594314

RESUMO

Renal insufficiency is a risk factor for osteoporosis and can increase risk of fracture. It may be a result of an age-related decline in renal function or chronic kidney disease. In patients with CKD, accurate diagnosis of osteoporosis or CKD-MBD is important for determining the most appropriate treatment. This was a cross sectional study was done at Institute of nuclear medicine and Allied Sciences, BSMMU, Dhaka from 1st January 2014 to 31st December 2014. Study population was total 69 postmenopausal women age over 50 years. Women with Bilateral hip replacement or bilateral hip pins or screws, metallic rods in spine, Carrying out BMD scan within the week after other radiological investigation using contrast media e.g. Barium meals or enema, IVPs were excluded from study. Clinical variables were- age (years), height (cm), weight (kg), BMI. Laboratory variables were- serum creatinine and BMD (Dexa). Estimated GFR was determined by using the serum Creatinine by MDRD formula. Renal function test and Bone mineral density (BMD) were done in all of these patients. Majority (43.4%) of the patients were in 6th decade. The mean weight was found 57.4±11.2kg. Majority 41(59.4%) patients belonged to T score at hip (-1 to -2.5) and their mean T score at hip was found (-1.1±1.1). Osteopenia and osteoporosis were found in 59.4% and 4.3% respectively according to BMD. High serum creatinine level was found in 10.1% cases. Renal function impairment was found in 79.6% of patient. Majority (50.7%) patients had mild decrease of eGFR (60-89 ml/min/1.73m²), There was Pearson's correlation (r=0.156; p=0.200) but not significant was found between age with T score at hip of the patients. Positive Pearson's correlation (r=0.112; p=0.361) was found but not significant between age and serum creatinine level. A significant negative Pearson's correlation (r= -0.274; p=0.023) was found between T score at hip and serum creatinine level of the patients. A significant negative Spearman correlation (r=-0.278; p=0.021) was found between BMD and serum creatinine of the patients. A significant positive Spearman correlation (r=0.580; p=0.001) was found between BMD and estimated GFR of the patients. This study was undertaken to evaluate the relationship between renal function and bone mineral density in postmenopausal women. Majority of the postmenopausal women were in 6th decade and most of them were overweight and obese. Renal function impairment was found in 79.6% of patient. Osteoporosis was found in 04.3% and 20.3% cases according to T score at hip and T score at lumber spine respectively. Significant negative Pearson's correlation was found between T score at hip and serum creatinine level of the patients. Significant negative Spearman correlation was found between BMD and serum creatinine of the patients. Significant positive Spearman correlation was found between BMD and estimated GFR of the patients.


Assuntos
Osteoporose , Insuficiência Renal Crônica , Humanos , Feminino , Pessoa de Meia-Idade , Densidade Óssea , Estudos Transversais , Creatinina , Pós-Menopausa , Bangladesh/epidemiologia , Osteoporose/epidemiologia , Insuficiência Renal Crônica/complicações , Rim/fisiologia , Absorciometria de Fóton
10.
Drug Deliv ; 30(1): 2164094, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36588399

RESUMO

Low bone mass, degeneration of bone tissue, and disruption of bone microarchitecture are all symptoms of the disease osteoporosis, which can decrease bone strength and increase the risk of fractures. The main objective of the current study was to use a phospholipid-based phase separation in-situ gel (PPSG) in combination with an alendronate sodium nanoemulsion (ALS-NE) to help prevent bone resorption in rats. The effect of factors such as concentrations of the ALS aqueous solution, surfactant Plurol Oleique CC 497, and Maisine CC oil on nanoemulsion characteristics such as stability index and globular size was investigated using an l-optimal coordinate exchange statistical design. Injectable PPSG with the best nanoemulsion formulation was tested for viscosity, gel strength, water absorption, and in-vitro ALS release. ALS retention in the rats' muscles was measured after 30 days. The droplet size and stability index of the optimal nanoemulsion were 90 ± 2.0 nm and 85 ± 1.9%, respectively. When mixed with water, the optimal ALS-NE-loaded PPSG became viscous and achieved 36 seconds of gel strength, which was adequate for an injectable in-situ formulation. In comparison with the ALS solution-loaded in-situ gel, the newly created optimal ALS-NE-loaded PPSG produced the sustained and regulated release of ALS; hence, a higher percentage of ALS remained in rats' muscles after 30 days. PPSG that has been loaded with an ALS-NE may therefore be a more auspicious, productive, and effective platform for osteoporosis treatment than conventional oral forms.


Assuntos
Osteoporose , Animais , Ratos , Alendronato , Emulsões , Osteoporose/tratamento farmacológico , Água
11.
Cleve Clin J Med ; 90(1): 26-31, 2023 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-36596600

RESUMO

Bisphosphonates are widely used as first-line therapy to slow bone loss and decrease fracture risk in postmenopausal women with osteoporosis. Nonadherence to oral bisphosphonates diminishes the benefit of reduced bone loss and fracture risk of these medications. Strategies to enhance osteoporosis monitoring and adherence to therapy are crucial to improve outcomes. Dual-energy x-ray absorptiometry (DXA) is the gold standard for monitoring bone mineral density but is slow to detect change after initiation of oral bisphosphonate therapy. Bone turnover markers (BTMs) are by-products released during bone remodeling and are measurable in blood and urine. We review how the rapid change in BTMs can be a useful short-term tool to monitor the effectiveness of oral bisphosphonate therapy, which may ultimately improve adherence to therapy and outcomes.


Assuntos
Conservadores da Densidade Óssea , Doenças Ósseas Metabólicas , Osteoporose Pós-Menopausa , Osteoporose , Feminino , Humanos , Difosfonatos/farmacologia , Difosfonatos/uso terapêutico , Osteoporose/tratamento farmacológico , Densidade Óssea , Conservadores da Densidade Óssea/farmacologia , Conservadores da Densidade Óssea/uso terapêutico , Remodelação Óssea , Doenças Ósseas Metabólicas/tratamento farmacológico , Osteoporose Pós-Menopausa/tratamento farmacológico , Biomarcadores
12.
BMC Endocr Disord ; 23(1): 2, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36597099

RESUMO

BACKGROUND: Iron-overloaded patients are recognized as presenting an increased risk of osteoporosis. However, studies on the correlation between osteoporosis and organ iron overload are controversial or scarce. The aim of this study is to assess bone mineral density (BMD) and trabecular bone score (TBS) in correlation with hepatic and pancreatic iron overload. METHODS: Forty-one patients diagnosed with hemoglobinopathies, were studied. BMDs of the lumbar spine (LS), femoral neck (FN), and total hip (TH) were analyzed by Dual-energy X-ray absorptiometry (DXA) scan. LS bone quality was derived from each spine DXA examination using the TBS analysis. Hepatic and pancreatic iron overload were obtained with a multi-echo gradient echo T2* technique. RESULTS: Abnormal microarchitecture and abnormal bone mass were observed in 19/41 (46.3%) and 9/41 (22.0%) patients, respectively. For 26 males, BMD, T-score and Z-score of LS were significantly lower among subjects with moderate-severe hepatic iron-overload than their counterparts, as it is between no- and pancreatic iron-overload groups. For 15 females, patients with moderate-severe hepatic iron-overload had significantly lower BMD and T-score of FN and TH, and patients with pancreatic iron-overload had significantly lower BMD, T-score of FN, and lower BMD, T-score and Z-score of TH than their counterparts. Moreover, pancreatic T2*-value was positively correlated with BMD and T-score at all analyzed sites and Z-score at TH. CONCLUSION: These data showed lower bone mass in patients with organ iron overload, particularly for LS in males, FN and TH in females. TBS may well represent a complementary tool for the evaluation of bone quality and the risk of fracture in iron-overloaded patients.


Assuntos
Sobrecarga de Ferro , Osteoporose , Fraturas por Osteoporose , Masculino , Feminino , Humanos , Densidade Óssea , Osso Esponjoso , Osteoporose/etiologia , Osteoporose/complicações , Absorciometria de Fóton/efeitos adversos , Absorciometria de Fóton/métodos , Colo do Fêmur , Vértebras Lombares/diagnóstico por imagem , Sobrecarga de Ferro/complicações , Sobrecarga de Ferro/diagnóstico por imagem , Imageamento por Ressonância Magnética , Ferro
13.
BMC Endocr Disord ; 23(1): 1, 2023 Jan 03.
Artigo em Inglês | MEDLINE | ID: mdl-36597121

RESUMO

BACKGROUND: Osteoporosis (OP) and diabetes mellitus (DM) are two major healthcare issues in the world. Numerous population based-studies have reported an increased prevalence of OP among individuals with DM, though, estimates vary significantly. PURPOSE: The objective of this study is to estimate the prevalence of OP in patients with DM. METHODS: To identify relevant literature, PubMed, Embase, Medline, CBM and Cochrane Library were searched for studies published from inception till July 2022, The search was conducted, and studies were included without countries and language restrictions. For full-text articles included in the study, the references were also independently searched. Random inverse variance-weighted models were used by Stata version 17.0 to estimate the prevalence of OP in patients with diabetes across studies. The heterogeneity was examined with I2 via the χ2 test on Cochrane's Q statistic. Subgroup analysis and meta-regression were used to explore potential sources of heterogeneity. Egger's test was used to assess publication bias. RESULTS: A high OP prevalence of 27.67% (95% confidence interval (CI) 21.37-33.98%) was found in a pooled analysis of 21 studies involving 11,603 T2DM patients. Methodological value of the included articles was high, with only three medium-quality studies and no low-quality studies. A significantly high heterogeneity (I2 = 98.5%) was observed. CONCLUSIONS: Worldwide, a high prevalence of OP was found in patients with T2DM. Therefore, strong measures to prevent and treat osteoporosis in diabetic patients are required. TRIAL REGISTRATION: This study has been registered on PROSPERO, number CRD42021286580 .


Assuntos
Diabetes Mellitus Tipo 2 , Osteoporose , Humanos , Prevalência , Osteoporose/epidemiologia , Osteoporose/etiologia , Projetos de Pesquisa , Pesquisa Qualitativa , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/epidemiologia
14.
Arch Osteoporos ; 18(1): 17, 2023 Jan 04.
Artigo em Inglês | MEDLINE | ID: mdl-36598583

RESUMO

INTRODUCTION: Hemophilia is a rare X-linked recessive inherited bleeding disorder caused by mutations of the genes encoding coagulation factor VIII (FVIII) or IX (FIX). Patients with hemophilia (PWH) often have a high risk of osteoporosis and fractures that is usually ignored. Herein, we review the underlying mechanisms of osteoporosis and the increased risk of fractures and their treatment in patients with FVIII or FIX deficiency. METHODS: The PubMed, Web of Science, Embase, and Cochrane Library databases were searched to identify original research articles, meta-analyses, and scientific reviews on the mechanisms or treatment of osteoporosis in PWH. RESULTS: The pathogenic mechanisms of osteoporosis in PWH are multifactorial and remain unclear. The available evidence shows that FVIII and FIX deficiency may directly affect bone metabolism by interfering with the RANK/RANKL/OPG pathway. Other potential mechanisms of osteoporosis in PWH include thrombin deficiency and the unloading and immobilization of bone, which will affect osteoblast and osteoclast activity by changing the cytokine profiles. The treatment of osteoporosis in PWH includes antiresorptive, anabolic, and dual-action drugs; weight-bearing exercise; fall prevention; and prophylactic coagulation factor replacement therapy. However, clinical studies of the efficacy of anti-osteoporotic agents in osteoporosis of PWH are urgently needed. CONCLUSION: This review summarizes recent progress in research on the pathogenesis of osteoporosis in PWH and provides insights into potential treatment for osteoporosis in PWH.


Assuntos
Hemofilia A , Hemofilia B , Osteoporose , Humanos , Hemofilia A/terapia , Hemofilia A/tratamento farmacológico , Hemofilia B/tratamento farmacológico , Hemofilia B/genética , Fator IX/genética , Fator IX/metabolismo , Fator IX/uso terapêutico , Osteoporose/terapia , Osteoporose/tratamento farmacológico , Osteoclastos/metabolismo , Osteoclastos/patologia
15.
PLoS One ; 18(1): e0279981, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36598910

RESUMO

PURPOSE: Androgen deprivation therapy (ADT) is the standard of care in advanced prostate cancer. We conducted a Taiwan National Health Insurance Research Database (NHIRD) study to evaluate the association between ADT and fracture risk in patient with prostate cancer in Taiwan. METHODS: Between 2001 and 2008, data from the Taiwan NHIRD was collected. We separated newly diagnosed prostate cancer patients into four groups: the injection of gonadotropin-releasing hormone agonists and antagonists group, the orchiectomy group, the oral antiandorgens group and the radical prostatectomy only group. A non-cancer matched control group was also assigned for comparison. T tests, chi-squared tests, multivariate Cox proportional hazard regression were performed. A subsequent fracture event was defined according to the appropriate diagnosis codes (ICD9-CM 800-829) with hospitalization. Patients with fracture before their diagnosis with prostate cancer were excluded. RESULTS: Overall, 22517 newly diagnosed patients with prostate cancer were enrolled in the study. After exclusion criteria were applied, 13321 patients were separated into the injection group (5020 subjects), the orchiectomy group (1193 subjects), the oral group (6059 subjects) and the radical prostatectomy only group (1049 subjects). The mean age of the overall study population was 74.4 years. Multi-variant analysis disclosed a significantly increased risk of fracture in the injection group, the orchiectomy group, and the oral group (hazard ratio [HR] = 1.55, 95%, confidence interval [CI] 1.36 to 1.76, p<0.001, HR = 1.95, 95%, CI 1.61 to 2.37, p<0.001, HR = 1.37, 95%, CI 1.22 to 1.53, p<0.001, respectively). In contrast, a significantly decreased fracture risk was noted in the radical prostatectomy only group (HR = 0.51, 95%, CI 0.35 to 0.74, p = 0.001). Patients receiving osteoporosis medication had a significantly decreased fracture risk (HR = 0.26, 95%, CI 0.19-0.37, p<0.001). CONCLUSIONS: ADT is associated with an increased risk of fracture. For patients receiving long-term prostate cancer castration therapy, doctors should always keep this complication in mind and arrange proper monitoring and provide timely osteoporosis medication.


Assuntos
Fraturas Ósseas , Osteoporose , Neoplasias da Próstata , Masculino , Humanos , Idoso , Neoplasias da Próstata/tratamento farmacológico , Neoplasias da Próstata/epidemiologia , Antagonistas de Androgênios/efeitos adversos , Androgênios , Fraturas Ósseas/etiologia , Osteoporose/tratamento farmacológico , Orquiectomia/efeitos adversos , Hormônio Liberador de Gonadotropina/efeitos adversos
16.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(1): 12-20, Ene-Feb. 2023. ilus, tab, graf
Artigo em Espanhol | IBECS | ID: ibc-214343

RESUMO

Introducción: Las fracturas por fragilidad (FF) son frecuentes en pacientes osteoporóticos. Existen una serie de factores de riesgo y variables clínicas, que podrían predecir su aparición. Material y método: Se realizó un estudio observacional retrospectivo de casos y controles. Los casos estuvieron definidos por la presencia de una FF (326 participantes) y los controles por pacientes de similares características sin FF (629 participantes). Resultados: Ciertos factores aumentan el riesgo de FF, como un diagnóstico previo de DM tipo 2 (OR: 2,001), las elevaciones de 1ng/mL del CTX (OR: 1,88), tener antecedentes parentales de fractura de cadera (OR: 1,667), el aumento en 5 años en la edad (OR: 1,39) y los incrementos de 1kg/m2 del IMC (OR: 1,041). Por el contrario, otros factores evaluados disminuyen ese riesgo, como mantener unos niveles de 25(OH)D≥30ng/mL (OR: 0,686) y una T-score≥−2,5 (OR: 0,642). Conclusiones: Niveles de 25(OH)D≥30ng/mL y una T-score en el cuello femoral≥−2,5 son factores protectores de las FF, mientras que el diagnóstico previo de DM tipo 2, un CTX elevado, el antecedente parental de fractura de cadera, un incremento de 1kg/m2 del IMC y el aumento de la edad en 5 años serían predisponentes a padecer FF.(AU)


Introduction: Fragility fractures (FF) are frequent in osteoporotic patients. There are a series of risk factors and clinical variables that could predict their appearance. Material and method: A retrospective observational study of cases and controls was carried out. Cases were defined by the presence of FF (326 participants) and controls by patients with similar characteristics without FF (629 participants). Results: Certain factors increase the risk of FF, such as a previous diagnosis of type 2 DM (OR: 2.001), 1ng/mL elevations of CTX (OR: 1.88), having a parental history of hip fracture (OR: 1.667), 5-year increase in age (OR: 1.39), and 1kg/m2 increases in BMI (OR: 1.041). In contrast, other factors evaluated decreased this risk, such as maintaining 25(OH)D levels≥30ng/mL (OR: 0.686) and a T-score≥−2.5 (OR: 0.642). Conclusions: Levels of 25(OH)D≥30ng/mL and a T-score at the femoral neck≥−2.5 are protective factors for FF, while a previous diagnosis of type 2 DM, an elevated CTX, a parental history of hip fracture, an increase of 1kg/m2 in BMI and an increase in age by 5 years would be predisposing to FF.(AU)


Assuntos
Humanos , Masculino , Feminino , Fragilidade , Fraturas por Osteoporose , Vitamina D , Fatores de Risco , Densidade Óssea , Osteoporose , Estudos de Casos e Controles , Estudos Retrospectivos
17.
Rev. esp. cir. ortop. traumatol. (Ed. impr.) ; 67(1): T12-T20, Ene-Feb. 2023. ilus, tab, graf
Artigo em Inglês | IBECS | ID: ibc-214344

RESUMO

Introduction: Fragility fractures (FF) are frequent in osteoporotic patients. There are a series of risk factors and clinical variables that could predict their appearance. Material and method: A retrospective observational study of cases and controls was carried out. Cases were defined by the presence of FF (326 participants) and controls by patients with similar characteristics without FF (629 participants). Results: Certain factors increase the risk of FF, such as a previous diagnosis of type 2 DM (OR: 2.001), 1ng/mL elevations of CTX (OR: 1.88), having a parental history of hip fracture (OR: 1.667), 5-year increase in age (OR: 1.39), and 1kg/m2 increases in BMI (OR: 1.041). In contrast, other factors evaluated decreased this risk, such as maintaining 25(OH)D levels≥30ng/mL (OR: 0.686) and a T-score≥−2.5 (OR: 0.642). Conclusions: Levels of 25(OH)D≥30ng/mL and a T-score at the femoral neck≥−2.5 are protective factors for FF, while a previous diagnosis of type 2 DM, an elevated CTX, a parental history of hip fracture, an increase of 1kg/m2 in BMI and an increase in age by 5 years would be predisposing to FF.(AU)


Introducción: Las fracturas por fragilidad (FF) son frecuentes en pacientes osteoporóticos. Existen una serie de factores de riesgo y variables clínicas, que podrían predecir su aparición. Material y método: Se realizó un estudio observacional retrospectivo de casos y controles. Los casos estuvieron definidos por la presencia de una FF (326 participantes) y los controles por pacientes de similares características sin FF (629 participantes). Resultados: Ciertos factores aumentan el riesgo de FF, como un diagnóstico previo de DM tipo 2 (OR: 2,001), las elevaciones de 1ng/mL del CTX (OR: 1,88), tener antecedentes parentales de fractura de cadera (OR: 1,667), el aumento en 5 años en la edad (OR: 1,39) y los incrementos de 1kg/m2 del IMC (OR: 1,041). Por el contrario, otros factores evaluados disminuyen ese riesgo, como mantener unos niveles de 25(OH)D≥30ng/mL (OR: 0,686) y una T-score≥−2,5 (OR: 0,642). Conclusiones: Niveles de 25(OH)D≥30ng/mL y una T-score en el cuello femoral≥−2,5 son factores protectores de las FF, mientras que el diagnóstico previo de DM tipo 2, un CTX elevado, el antecedente parental de fractura de cadera, un incremento de 1kg/m2 del IMC y el aumento de la edad en 5 años serían predisponentes a padecer FF.(AU)


Assuntos
Humanos , Masculino , Feminino , Fragilidade , Fraturas por Osteoporose , Vitamina D , Fatores de Risco , Densidade Óssea , Osteoporose , Estudos de Casos e Controles , Estudos Retrospectivos
18.
Med. clín (Ed. impr.) ; 160(2): 51-59, enero 2023. tab
Artigo em Espanhol | IBECS | ID: ibc-JHG-230

RESUMO

Objetivos: Evaluar aspectos del metabolismo óseo basal en pacientes con cáncer de próstata y el efecto, en práctica clínica habitual, de diferentes esquemas de tratamiento (intermitente o continuo) con agonistas de la hormona liberadora de hormona luteinizante (LH-RH) y del denosumab en la evolución de la densidad mineral ósea (DMO).MétodosEstudio observacional retrospectivo de una cohorte de pacientes con cáncer de próstata en tratamiento con agonistas LH-RH, valorados en el servicio de reumatología de un hospital de tercer nivel. Se recogieron datos demográficos, índice de FRAX, esquema de tratamiento LH-RH, tratamiento de osteoporosis, datos de laboratorio y de DMO. Se usaron modelos de regresión lineal de efecto mixto analizando la interacción de los esquemas de tratamiento LH-RH, denosumab y la evolución de DMO.ResultadosSe incluyeron 83 pacientes (73±8años). Evaluación basal: el 16% de los pacientes presentaron osteoporosis densitométrica y además un 27% un riesgo elevado de fractura (FRAX). El 80% tenían niveles de vitaminaD <30ng/l. La pauta intermitente de agonistas LH-RH y los niveles elevados de vitaminaD se asociaron a mejor DMO basal. No se detectó asociación entre la evolución de la DMO y las pautas de tratamiento de agonistas LH-RH, pero sí se encontró una correlación positiva con denosumab.ConclusionesUna elevada proporción de pacientes presentaban un alto riesgo de fractura o niveles insuficientes de vitaminaD no detectados previamente. El estudio tanto del metabolismo óseo como del riesgo de fractura son convenientes en estos pacientes. En práctica clínica habitual el efecto sobre la DMO del denosumab se detecta a corto plazo, mientras que el del esquema intermitente con agonistas LH-RH es menos evidente. (AU)


Objectives: To evaluate the aspects of the basal bone health status in prostate cancer patients. Furthermore, to evaluate in a real-world setting the effect of different schemes (intermittent or continuous) of androgen deprivation therapy (ADT) and the effect of denosumab in bone mass density (BMD).MethodsObservational, retrospective study of a cohort of prostate cancer patients in treatment with luteinizing hormone-releasing hormone (LH-RH) agonists, evaluated in the rheumatology department of a tertiary center. Demographics, FRAX score, LH-RH treatment scheme, osteoporosis treatment, laboratory data and BMD were collected. Mixed effect regression models to analyze the interaction between LH-RH treatment scheme, denosumab and BMD evolution were used.ResultsEighty-three patients (mean age 71±8years) were included. At the basal evaluation, 16% of patients presented densitometric osteoporosis and 27% of patients presented high fracture risk. Eighty percent of patients had inadequate vitaminD levels. VitaminD >30ng/mL was correlated with higher T-scores. There was no association between LH-RH treatment scheme and BMD evolution, however there was a positive association with denosumab.ConclusionA high proportion of patients presented elevated fracture risk or inadequate vitaminD levels, not previously recognized. Bone health assessment and fracture risk evaluation are convenient in these patients. In a real-world setting, the effect of denosumab in BMD is detected, however the effect of intermittent LH-RH schema treatment is less evident. (AU)


Assuntos
Humanos , Antagonistas de Androgênios/efeitos adversos , Androgênios , Densidade Óssea , Denosumab/farmacologia , Denosumab/uso terapêutico , Osteoporose/induzido quimicamente , Neoplasias da Próstata/tratamento farmacológico , Fraturas Ósseas , Hormônio Liberador de Gonadotropina
20.
Cochrane Database Syst Rev ; 1: CD002010, 2023 01 10.
Artigo em Inglês | MEDLINE | ID: mdl-36625789

RESUMO

BACKGROUND: Osteoporosis is a disorder of bone mineralisation occurring in about one third of adults with cystic fibrosis. Bisphosphonates can increase bone mineral density and decrease the risk of new fractures in post-menopausal women and people receiving long-term oral corticosteroids. This is an updated version of a previous review. OBJECTIVES: To assess the effects of bisphosphonates on the frequency of fractures, bone mineral density, quality of life, adverse events, trial withdrawals, and survival in people with cystic fibrosis. SEARCH METHODS: We searched the Cystic Fibrosis and Genetic Disorders Group's Trials Register of references (identified from electronic database searches and hand searches of journals and abstract books) on 5 May 2022. We performed additional searches of PubMed, clinicaltrials.gov and the WHO ICTRP (International Clinical Trials Registry Platform) on 5 May 2022. SELECTION CRITERIA: Randomised controlled trials of at least six months duration studying bisphosphonates in people with cystic fibrosis. DATA COLLECTION AND ANALYSIS: Authors independently selected trials, extracted data and assessed risk of bias in included studies. Trial investigators were contacted to obtain missing data. We judged the certainty of the evidence using GRADE. MAIN RESULTS: We included nine trials with a total of 385 participants (272 adults and 113 children (aged five to 18 years)). Trial durations ranged from six months to two years. Only two of the studies were considered to have a low risk of bias for all the domains.  Bisphosphonates compared to control in people with cystic fibrosis who have not had a lung transplant Seven trials included only adult participants without lung transplants, one trial included both adults and children without lung transplantation (total of 238 adults and 113 children). We analysed adults (n = 238) and children (n = 113) separately. Adults Three trials assessed intravenous bisphosphonates (one assessed pamidronate and two assessed zoledronate) and five trials assessed oral bisphosphonates (one assessed risedronate and four assessed alendronate). Bisphosphonates were compared to either placebo or calcium (with or without additional vitamin D). Data showed no difference between treatment or control groups in new vertebral fractures at 12 months (odds ratio (OR) 0.22, 95% confidence interval (CI) 0.02 to 2.09; 5 trials, 142 participants; very low-certainty evidence) and two trials (44 participants) reported no vertebral fractures at 24 months. There was no difference in non-vertebral fractures at 12 months (OR 2.11, 95% CI 0.18 to 25.35; 4 trials, 95 participants; very low-certainty evidence) and again two trials (44 participants) reported no non-vertebral fractures at 24 months. There was no difference in total fractures between groups at 12 months (OR 0.57, 95% CI 0.13 to 2.50; 5 trials, 142 participants) and no fractures were reported in two trials (44 participants) at 24 months. At 12 months, bisphosphonates may increase bone mineral density at the lumbar spine (mean difference (MD) 6.31, 95% CI 5.39 to 7.22; 6 trials, 171 participants; low-certainty evidence) and at the hip or femur (MD 4.41, 95% 3.44 to 5.37; 5 trials, 155 participants; low-certainty evidence). There was no clear difference in quality of life scores at 12 months (1 trial, 47 participants; low-certainty evidence), but bisphosphonates probably led to more adverse events (bone pain) at 12 months (OR 8.49, 95% CI 3.20 to 22.56; 7 trials, 206 participants; moderate-certainty evidence). Children The single trial in 113 children compared oral alendronate to placebo. We graded all evidence as low certainty. At 12 months we found no difference between treatment and placebo in new vertebral fractures (OR 0.32, 95% CI 0.03 to 3.13; 1 trial, 113 participants) and non-vertebral fractures (OR 0.19, 95% CI 0.01 to 4.04; 1 trial, 113 participants). There was also no difference in total fractures (OR 0.18, 95% CI 0.02 to 1.61; 1 trial, 113 participants). Bisphosphonates may increase bone mineral density at the lumbar spine at 12 months (MD 14.50, 95% CI 12.91 to 16.09). There was no difference in bone or muscle pain (MD 3.00, 95% CI 0.12 to 75.22), fever (MD 3.00, 95% CI 0.12 to 75.22) or gastrointestinal adverse events (OR 0.67, 95% CI 0.20 to 2.26). The trial did not measure bone mineral density at the hip/femur or report on quality of life.  Bisphosphonates compared to control in people with cystic fibrosis who have had a lung transplant One trial of 34 adults who had undergone lung transplantation compared intravenous pamidronate to no bisphosphonate treatment. It did not report at 12 months and we report the 24-month data (not assessed by GRADE). There was no difference in the number of fractures, either vertebral or non-vertebral. However, bone mineral density increased with treatment at the lumbar spine (MD 6.20, 95% CI 4.28 to 8.12) and femur (MD 7.90, 95% CI 5.78 to 10.02). No participants in either group reported either bone pain or fever. The trial did not measure quality of life. AUTHORS' CONCLUSIONS: Oral and intravenous bisphosphonates may increase bone mineral density in people with cystic fibrosis, but there are insufficient data to determine whether treatment reduces fractures. Severe bone pain and flu-like symptoms may occur with intravenous bisphosphonates. Before any firm conclusions can be drawn, trials in larger populations, including children, and of longer duration are needed to determine effects on fracture rate and survival. Additional trials are needed to determine if bone pain is more common or severe (or both) with the more potent zoledronate and if corticosteroids can ameliorate or prevent these adverse events. Future trials should also assess gastrointestinal adverse effects associated with oral bisphosphonates.


Assuntos
Conservadores da Densidade Óssea , Fibrose Cística , Fraturas Ósseas , Dor Musculoesquelética , Osteoporose , Fraturas da Coluna Vertebral , Adulto , Criança , Feminino , Humanos , Alendronato/uso terapêutico , Conservadores da Densidade Óssea/efeitos adversos , Fibrose Cística/complicações , Fibrose Cística/tratamento farmacológico , Difosfonatos/efeitos adversos , Fraturas Ósseas/prevenção & controle , Dor Musculoesquelética/induzido quimicamente , Osteoporose/tratamento farmacológico , Pamidronato/uso terapêutico , Qualidade de Vida , Ácido Zoledrônico/uso terapêutico , Ensaios Clínicos Controlados Aleatórios como Assunto
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