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1.
Vopr Kurortol Fizioter Lech Fiz Kult ; 98(6. Vyp. 2): 31-37, 2021.
Artigo em Russo | MEDLINE | ID: mdl-34965712

RESUMO

Most people who have undergone hip arthroplasty belong to the older age groups, so they often have signs of osteoporosis. A decrease in bone mineral density in combination with a decrease in local blood circulation caused by additional trauma to bone structures and surrounding soft tissues during surgery contributes to osteolysis, early instability of the endoprosthesis and increases the risk of periprosthetic fractures. OBJECTIVE: To study the effectiveness of the developed rehabilitation complex, including the combined effect of a physiotherapeutic factor (increased gravity) and antiresorptive therapy, in patients with osteoporosis who underwent hip arthroplasty. MATERIAL AND METHODS: The study included 40 patients aged 60-75 years with signs of osteoporosis, who underwent total hip arthroplasty, no more than 3 weeks ago. The patients were randomized into two groups: the main group - 16 (40%) people, comparisons - 24 (60%) people. To assess the effectiveness of rehabilitation complexes, orthopedic examination, functional diagnostics of motor pathology of the lower extremities on an automatic hardware-software complex, X-ray densitometry, and indicators of the visual analogue pain scale and Harris scale were evaluated. Patients of both groups were prescribed a rehabilitation complex, including therapeutic exercises, mechanotherapy for training the thigh muscles and electrical stimulation of the thigh muscles, a course of 10 procedures. Patients of the main group were additionally prescribed a course of gravitational and antiresorptive therapy according to our methodology. RESULTS: The intensity of pain before treatment in patients of both groups corresponded to moderate pain syndrome. After 3 months after the course of rehabilitation, the pain intensity in the patients of the main group decreased statistically significantly by 3.1 times, in the patients of the comparison group - by 2.6 times. When assessing the biomechanical data of walking at the beginning of the rehabilitation course, the asymmetry of pressure indices was revealed in patients of both groups, corresponding to the average degree of lameness. After 3 months, the asymmetry coefficient in the patients of the comparison group reached a mild degree, while in the patients of the main group it approached the norm. According to X-ray densitometry, after 12 months, the bone mineral density index only in patients of the main group increased to the level of osteopenia. The indicator of the combined assessments of the Harris scale was statistically significantly different between the groups at 3 and 6 months after the course of rehabilitation. CONCLUSION: The combined use of gravitational therapy and antiresorptive drugs in the treatment and rehabilitation complex in patients with osteoporosis who have undergone total hip arthroplasty helps to reduce pain, reduce signs of osteoporosis, improve the functional parameters of patients' activity, and increase household and social adaptation.


Assuntos
Artroplastia de Quadril , Osteoporose , Idoso , Artroplastia de Quadril/efeitos adversos , Densidade Óssea , Humanos , Osteoporose/etiologia , Medição da Dor
2.
BJS Open ; 5(6)2021 11 09.
Artigo em Inglês | MEDLINE | ID: mdl-34931227

RESUMO

INTRODUCTION: There are few guidelines for screening of osteoporosis in patients who have undergone gastrectomy. This study aimed to develop and validate a nomogram to predict the risk of osteoporosis after gastrectomy in patients with gastric cancer. METHODS: Bone densitometry results for 522 patients with gastric cancer and 2088 individuals from a health-promotion centre were compared using propensity score matching to develop a nomogram to predict osteoporosis after gastrectomy. External validation was performed using an independent data set. RESULTS: In the 10 years after gastrectomy 53.5 per cent of patients developed osteoporosis. In multivariable analysis, the odds ratios of subtotal gastrectomy and total gastrectomy were 5.46 and 8.69 (P < 0.001 for both). Seven risk factors (type of gastrectomy, age, sex, BMI, and serum levels of albumin, creatinine and phosphorus) were incorporated into the nomogram. The prediction accuracy of the nomogram in the development set was 0.830 (area under the curve (AUC)); (95 per cent c.i. 0.812 to 0.848). In the validation set, the AUC was 0.807 (95 per cent c.i. 0.741 to 0.873). CONCLUSION: Gastrectomy was a risk factor for osteoporosis, and its incidence in the first 10 years after surgery was high. This nomogram can help clinicians to identify patients with gastric cancer most at risk of developing osteoporosis after surgery.


Assuntos
Osteoporose , Neoplasias Gástricas , Gastrectomia/efeitos adversos , Humanos , Nomogramas , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/etiologia , Estudos Retrospectivos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/cirurgia
3.
Acta Reumatol Port ; 46(3): 283-285, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34667140

RESUMO

INTRODUCTION: Long-term survivors of cystic fibrosis (CF) have a dramatic increase in the risk of osteoporosis and incident fracture. The objective of this work is to characterize a CF related bone disease in a Portuguese cohort of CF patients. METHODS: We performed a cross-sectional, observational study on a cohort of CF adult patients. Clinical status, laboratory parametres, nutrition, lung function tests, genetics and bone mineral density (BMD) data were collected from a CF reference centre. RESULTS: Of 30 patients, 53.3% were males (n=16). Median age was 32.5 (27.0; 32,5) and median body mass index (BMI) was 22,04 (19,85; 24,55), with 4 patients (13.3%) being underweight (BMI<18.5 kg/m²). Four patients (13.3 %) were diagnosed with osteoporosis and 15 patients (50%) has low BMD. Among them, 2 (6.7%) had fragility fractures. A moderate correlation was found between the lumbar spine (LS) BMD and BMI and, as expected, femural neck BMD and LS BMD has moderate to strong correlations with BMD Z scores. CONCLUSION: Despite the young middle age we found a high prevalence of low BMD and osteoporosis in patients with CF. Early recognition and treatment are the most effective strategies for reducing the morbidity due to osteoporosis in these patients.


Assuntos
Fibrose Cística , Osteoporose , Adulto , Densidade Óssea , Estudos Transversais , Fibrose Cística/complicações , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Osteoporose/etiologia , Portugal/epidemiologia , Adulto Jovem
4.
Chin Med J (Engl) ; 134(21): 2564-2572, 2021 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-34670248

RESUMO

BACKGROUND: Although there are few studies mentioned there may be some relationship between psoriatic arthritis (PsA) and osteoporosis, clinical data in real world still need to be clarified in China. The aim of this study was to assess the areal and volumetric bone mineral density (BMD), frequency of fracture, and risk factors in patients with PsA. METHODS: A total of one hundred PsA patients who visited Peking University First Hospital and one hundred age- and sex-matched healthy controls with DXA data were enrolled in the study. Patients with clinical fractures confirmed by X-ray during follow-up were also recorded. Clinical characteristics of the patients were recorded and compared between the abnormal BMD group and the normal BMD group, as well as between the fracture and non-fracture groups. Risk factors for fracture and low BMD were analyzed. RESULTS: Mean BMD at the total hip and femoral neck was significantly lower in PsA patients than that in healthy controls (0.809 ±â€Š0.193 vs. 0.901 ±â€Š0.152 g/cm2, P  = 0.041; 0.780 ±â€Š0.146 vs. 0.865 ±â€Š0.166 g/cm2, P  = 0.037, respectively). Moreover, lumbar spine BMD was negatively correlated with psoriasis duration, swollen joint count and DAS28-CRP (r = -0.503, -0.580, -0.438; P < 0.05). Total hip BMD and femoral neck BMD were negatively correlated with HAQ (r = -0.521, -0.335; P < 0.05). Fractures occurred in 29 patients during the follow-up period. Logistic regression analysis showed that older age (OR 1.132 [95%CI: 1.026-1.248), P < 0.05], higher HAQ score (OR 1.493, 95%CI: 1.214-1.836, P < 0.01), higher disease activity index for psoriatic arthritis (OR 1.033, 95% CI: 1.002-1.679, P < 0.05) and hip joint involvement (OR 6.401, 95% CI: 4.012-44.180, P < 0.05) were risk factors for fracture in the multivariate model. CONCLUSIONS: Increased risks of osteoporosis and fracture were found in PsA patients compared to healthy controls. Besides age, high disease activity and hip joint involvement were risk factors for decreased BMD and fracture.


Assuntos
Artrite Psoriásica , Osteoporose , Fraturas por Osteoporose , Absorciometria de Fóton , Idoso , Artrite Psoriásica/complicações , Densidade Óssea , Humanos , Vértebras Lombares , Osteoporose/etiologia , Fatores de Risco
5.
Aging Male ; 24(1): 139-147, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34647515

RESUMO

Aim: This study aimed to evaluate the effect of physiological testosterone replacement on male aged rats with orchiectomy-induced osteoporosis in advanced stage.Methods: Thirty male rats (Rattus norvegicus albinus, Holtzman lineage) were randomly distributed into 3 groups (n = 10): 1-sham, 2-orchiectomy (OCX), 3-OCX + testosterone replacement (OCX + T). On day 0, a sham or orchiectomy surgery was performed according to the groups. Thirty and sixty days after surgeries, the animals from OCX + T group received testosterone intramuscularly, and the rats in all groups were euthanized on day 77. The femurs were removed for micro-CT scanning and biomechanical test.Results: Orchiectomy resulted in a marked trabecular bone damage (p < 0.05), which was not reversed with testosterone treatment (OCX + T group). The femoral strength was lower in orchiectomized animals (p < 0.05), while the bone strength in OCX + T group was similar to that observed in the sham animals (p > 0.05) and correlated to this parameter the deformation of rupture was smaller in OCX + T group.Conclusion: In conclusion, testosterone depletion induced by orchiectomy established an osteoporotic environment, mainly affecting the trabecular bone. Moreover, even though testosterone treatment did not enhance these variables, the hormonal replacement improved the femoral fracture strength and promoted beneficial effects on the biomechanical parameters compromised by castration in femoral bone.


Assuntos
Orquiectomia , Osteoporose , Animais , Fêmur , Masculino , Osteoporose/tratamento farmacológico , Osteoporose/etiologia , Projetos Piloto , Ratos , Testosterona
6.
Int J Mol Sci ; 22(19)2021 Sep 30.
Artigo em Inglês | MEDLINE | ID: mdl-34638983

RESUMO

Bone remodeling is a continuous process of bone synthesis and destruction that is regulated by osteoblasts and osteoclasts. Here, we investigated the anti-osteoporotic effects of morroniside in mouse preosteoblast MC3T3-E1 cells and mouse primary cultured osteoblasts and osteoclasts in vitro and ovariectomy (OVX)-induced mouse osteoporosis in vivo. Morroniside treatment enhanced alkaline phosphatase activity and positively stained cells via upregulation of osteoblastogenesis-associated genes in MC3T3-E1 cell lines and primary cultured osteoblasts. However, morroniside inhibited tartrate-resistant acid phosphatase activity and TRAP-stained multinucleated positive cells via downregulation of osteoclast-mediated genes in primary cultured monocytes. In the osteoporotic animal model, ovariectomized (OVX) mice were administered morroniside (2 or 10 mg/kg/day) for 12 weeks. Morroniside prevented OVX-induced bone mineral density (BMD) loss and reduced bone structural compartment loss in the micro-CT images. Taken together, morroniside promoted increased osteoblast differentiation and decreased osteoclast differentiation in cells, and consequently inhibited OVX-induced osteoporotic pathogenesis in mice. This study suggests that morroniside may be a potent therapeutic single compound for the prevention of osteoporosis.


Assuntos
Conservadores da Densidade Óssea/administração & dosagem , Diferenciação Celular/efeitos dos fármacos , Cornus/química , Glicosídeos/administração & dosagem , Osteoblastos/metabolismo , Osteoclastos/metabolismo , Osteoporose/etiologia , Osteoporose/terapia , Ovariectomia/efeitos adversos , Fitoterapia/métodos , Extratos Vegetais/administração & dosagem , Animais , Densidade Óssea/efeitos dos fármacos , Remodelação Óssea/efeitos dos fármacos , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , Modelos Animais de Doenças , Feminino , Camundongos , Camundongos Endogâmicos ICR , Osteoblastos/efeitos dos fármacos , Osteoclastos/efeitos dos fármacos , Osteogênese/efeitos dos fármacos , Osteoporose/metabolismo
7.
Life Sci Space Res (Amst) ; 31: 80-84, 2021 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-34689953

RESUMO

During spaceflight, astronauts experience 1-1.5% bone loss per month, especially in the lumbar spine, pelvis and lower limbs. The bone loss leads to osteoporosis and increased the risk of fracture. Current researches focus on anti-osteoporosis under microgravity mainly by inhibiting bone resorption of osteoclasts and / or increasing bone formation of osteoblasts. However, studies on the effects of mass transfer in the bone lacunar-canalicular system (LCS) on osteoporosis are lacking. Osteocytes reside in the lacunae and communicate with other osteocytes, osteoblasts and osteoclasts through the LCS in the bone matrix. Osteocytes are mainly responsible for mechanosensing and signal regulation in bone, and the LCS is the basic structure for signaling, mass transfer and mechanical stimulation. Microgravity causes deficient mass transfer in the LCS, especially in the outer layer of osteon. Osteocytes far away from the Haversian canals are inhibited or accelerated apoptosis to stimulate osteoclasts which result in bone loss. Deficient mass transfer in the LCS may be a determinant of human osteoporosis under microgravity, which will open up a new way to treat osteoporosis in space.


Assuntos
Reabsorção Óssea , Osteoporose , Ausência de Peso , Osso e Ossos , Humanos , Osteócitos , Osteoporose/etiologia , Ausência de Peso/efeitos adversos
8.
J Food Biochem ; 45(10): e13918, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34490639

RESUMO

This study aimed to prepare the fortified rice/flour with Cissus quadrangularis (CQ) stem powder to eliminate nutritional deficiency and improve bone health. Mineral analysis by atomic absorption spectroscopy revealed that the CQ stem has adequate quantities of calcium, magnesium, and a moderate amount of phosphorous to meet the Recommended Dietary Allowance (RDA). Thus, the rice and flour were fortified with freeze-dried CQ stem powder to improve its nutraceutical contents. The fortification was done using standard vacuum impregnation and blending process. Furthermore, the recuperative activity of prepared fortified rice (CQFR) and flour (CQFF) was tested in chemically induced osteoporosis and osteoarthritis animal models. The efficiency of CQ fortified diet against these complications was confirmed by hematology, radiology, and histopathological analysis. The rat groups fed with CQFF/CQFR diet showed significant improvement from calcium deficiency and its allied physiological damage. Thus, this study confirms that the CQ fortified rice would provide recovery from skeletal complications associated with calcium deficiency through fixing both homeostasis and bio-accessibility of the calcium. PRACTICAL APPLICATIONS: Micronutrient and mineral deficiency is relatively higher in the regions where rice/rice products are consumed as a staple diet. Dietary intake of calcium and some essential minerals have major influences on bone and joint health. Cissus quadrangularis (CQ) is a familiar herb, conventionally used in India to fix broken bones and strengthen the skeletal system. The Atomic absorption spectroscopy data from this study showed that the CQ stem holds a high amount of calcium and other essential minerals to promote skeletal health. Preparation of fortified rice and flour with CQ stem would be a beneficial source of the essential minerals/ bioactive principles to promote and sustain skeletal health in the underprivileged population. These study data substantiated the practical application of producing the CQ fortified nutraceutical staple diet, especially to the people who are afflicted with morbid skeletal complications.


Assuntos
Cissus , Oryza , Osteoporose , Vitis , Animais , Dieta , Farinha , Osteoporose/etiologia , Osteoporose/prevenção & controle , Pós , Ratos
9.
Biomed Res Int ; 2021: 5567666, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34497849

RESUMO

Background: Fracture risk assessment tool (FRAX) index was developed for estimating of the 10-year risk of major or hip osteoporotic fracture. To date, there is insufficient information regarding the correlation between FRAX and serum bone turnover markers (BTMs), such as soluble ligand of receptor activator of nuclear factor-κB (sRANKL), osteoprotegerin (OPG), and other molecules related with secondary osteoporosis in rheumatoid arthritis (RA). Therefore, this study is aimed at assessing the correlation between the FRAX and serum levels of sRANKL, OPG, sRANKL/OPG ratio, Dickkopf-1 (DKK-1), and sclerostin (SOST) in RA. Methods: Cross-sectional study included 156 postmenopausal women with RA. Bone mineral density (BMD) was measured at lumbar spine (L1-L4) and total hip using dual-energy X-ray absorptiometry (DXA). RA patients were divided into (A) RA + osteoporosis and (B) RA without osteoporosis. FRAX scores were calculated including the total hip BMD. Serum sRANKL, OPG, DKK-1, and SOST levels were measured by ELISA. Pearson tests were used for assessing the correlation between serum levels of these molecules and FRAX scores in RA. Results: The RA + osteoporosis group had elevated sRANKL levels (p = 0.005), higher sRANKL/OPG ratio (p = 0.017), decreased DKK-1 (p = 0.028), and lower SOST levels (p < 0.001). Low total hip BMD correlated with high sRANKL (p = 0.001) and sRANKL/OPG ratio (p = 0.005). Total hip and lumbar spine BMD correlated with DKK-1 (p = 0.009 and p = 0.05, respectively) and SOST levels (p < 0.001 and p < 0.001, respectively). Higher sRANKL levels and sRANKL/OPG ratio correlated with estimated 10-year risk of a major osteoporotic fractures (p = 0.003 and p = 0.003, respectively) and hip fracture (p = 0.002 and p = 0.006, respectively). High serum SOST levels were associated with a low estimated 10-year risk of a major osteoporotic fracture (p = 0.003) and hip fracture (p = 0.009). Conclusion: High sRANKL levels and sRANKL/OPG ratio can be useful to detect a subgroup of RA patients who has an increased 10-year risk of major and hip osteoporotic fractures.


Assuntos
Artrite Reumatoide/sangue , Remodelação Óssea/fisiologia , Osteoporose/sangue , Fraturas por Osteoporose/diagnóstico , Osteoprotegerina/sangue , Ligante RANK/sangue , Artrite Reumatoide/complicações , Artrite Reumatoide/patologia , Biomarcadores/sangue , Densidade Óssea , Estudos Transversais , Feminino , Humanos , Pessoa de Meia-Idade , Osteoporose/etiologia , Osteoporose/patologia , Fraturas por Osteoporose/sangue , Fraturas por Osteoporose/etiologia , Pós-Menopausa/sangue , Prognóstico
10.
Nutrients ; 13(7)2021 Jul 10.
Artigo em Inglês | MEDLINE | ID: mdl-34371870

RESUMO

Kidney transplant recipients are at high risk of progressive bone loss and low-energy fractures in the years following transplantation. Marine n-3 polyunsaturated fatty acids (n-3 PUFA) supplementation may have beneficial effects on bone strength. The Omega-3 fatty acids in Renal Transplantation (ORENTRA) trial was an investigator initiated, randomized, placebo-controlled trial investigating the effects of marine n-3 PUFA supplementation after kidney transplantation. Effects of supplementation on bone mineral density (BMD) and calcium metabolism were pre-defined secondary endpoints. Adult kidney transplant recipients (n = 132) were randomized to 2.6 g marine n-3 PUFA supplement or olive oil (control) from 8 to 52 weeks post-transplant. Dual energy X-ray absorptiometry was performed to assess changes in bone mineral density of hip, spine, and forearm, as well as trabecular bone score (TBS) of the lumbar spine. Student's t test was used to assess between-group differences. There were no differences in ΔBMD between the two groups (intervention vs. control) at lumbar spine (-0.020 ± 0.08 vs. -0.007 ± 0.07 g/cm², p = 0.34), total hip (0.001 ± 0.03 vs. -0.005 ± 0.04, p = 0.38), or other skeletal sites in the intention-to-treat analyses. There was no difference in the change in TBS score (0.001 ± 0.096 vs. 0.009 ± 0.102, p = 0.62). Finally, no effect on biochemical parameters of mineral metabolism was seen. Results were similar when analyzed per protocol. In conclusion, we found no significant effect of 44 weeks of supplementation with 2.6 g of marine n-3 PUFA on BMD in kidney transplant recipients.


Assuntos
Densidade Óssea/efeitos dos fármacos , Suplementos Nutricionais , Ácidos Docosa-Hexaenoicos/administração & dosagem , Ácido Eicosapentaenoico/administração & dosagem , Transplante de Rim , Osteoporose/prevenção & controle , Fraturas por Osteoporose/prevenção & controle , Absorciometria de Fóton , Adulto , Idoso , Biomarcadores/sangue , Cálcio/sangue , Dinamarca , Suplementos Nutricionais/efeitos adversos , Ácidos Docosa-Hexaenoicos/efeitos adversos , Método Duplo-Cego , Combinação de Medicamentos , Ácido Eicosapentaenoico/efeitos adversos , Feminino , Humanos , Transplante de Rim/efeitos adversos , Masculino , Pessoa de Meia-Idade , Osteoporose/etiologia , Osteoporose/fisiopatologia , Fraturas por Osteoporose/etiologia , Fraturas por Osteoporose/fisiopatologia , Fatores de Tempo , Resultado do Tratamento
11.
Nutrients ; 13(7)2021 Jul 04.
Artigo em Inglês | MEDLINE | ID: mdl-34371812

RESUMO

There is growing evidence that bone health may be programmed in the first years of life. Factors during the prenatal period, especially maternal nutrition, may have an influence on offspring's skeletal development and thus the risk of osteoporosis in further life, which is an increasing societal, health and economic burden. However, it is still inconclusive which early life factors are the most important and to what extent they may affect bone health. We searched through three databases (PubMed, Google Scholar, Cochrane Library) and after eligibility criteria were met, the results of 49 articles were analyzed. This narrative review is an overall summary of up-to-date studies on maternal diet, nutritional status, and birth-related factors that may affect offspring bone development, particularly bone mineral density (BMD). Maternal vitamin D status and diet in pregnancy, anthropometry and birth weight seem to influence BMD, however other factors such as subsequent growth may mediate these associations. Due to the ambiguity of the results in the analyzed studies, future, well-designed studies are needed to address the limitations of the present study.


Assuntos
Densidade Óssea , Dieta/efeitos adversos , Exposição Materna/efeitos adversos , Fenômenos Fisiológicos da Nutrição Materna , Efeitos Tardios da Exposição Pré-Natal/fisiopatologia , Adulto , Peso ao Nascer , Desenvolvimento Ósseo , Criança , Pré-Escolar , Estudos de Coortes , Feminino , Humanos , Lactente , Recém-Nascido , Estado Nutricional , Estudos Observacionais como Assunto , Osteoporose/etiologia , Osteoporose/fisiopatologia , Gravidez , Efeitos Tardios da Exposição Pré-Natal/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto
12.
Medicina (Kaunas) ; 57(8)2021 Jul 27.
Artigo em Inglês | MEDLINE | ID: mdl-34440966

RESUMO

BACKGROUND AND OBJECTIVES: Osteoprotegerin (OPG), a potent osteoclast activation inhibitor, decreases bone resorption and plays a role in mediating bone mineral density (BMD). Our aim was to evaluate the relationship between BMD and serum OPG in maintenance hemodialysis (MHD) patients. MATERIALS AND METHODS: Fasting blood samples were obtained from 75 MHD patients. BMD was measured by dual-energy X-ray absorptiometry in lumbar vertebrae (L2-L4). The WHO classification criteria were applied to define osteopenia and osteoporosis. A commercial enzyme-linked immunosorbent assay was used to measure serum OPG values. RESULTS: Among all MHD patients, seven (9.3%) and 20 patients (26.7%) were defined as osteoporosis and osteopenia, respectively. Female patients had lower lumbar BMD than males (p = 0.002). Older age (p = 0.023), increased serum OPG (p < 0.001) urea reduction rate (p = 0.021), Kt/V (p = 0.027), and decreased body mass index (p = 0.006) and triglycerides (p = 0.020) were significantly different between the normal, osteopenia, and osteoporosis groups. Lumbar spine BMD was positively correlated with body mass index (BMI) (p < 0.001) but negatively correlated with OPG (p < 0.001) and age (p = 0.003). After grouping patients into T scores < -1 and < -2.5, female sex and OPG (adjusted odds ratio [aOR] 1.022, 95% confidence interval [C.I.] 1.011-1.034, p < 0.001) were predictors of T scores < -1, whereas only OPG was predictive of T scores < -2.5 (aOR 1.015, 95% C.I. 1.005-1.026, p = 0.004) by multivariate stepwise logistic regression analysis. The areas under the curve for predicting T scores < -1 or < -2.5 were 0.920 (95% C.I. 0.834-0.970, p < 0.001) and 0.958 (95% C.I. 0.885-0.991, p < 0.001), respectively. CONCLUSIONS: Increased serum OPG negatively correlated with lumbar BMD and could be a potential biomarker predictive of osteoporosis in MHD patients.


Assuntos
Densidade Óssea , Osteoporose , Absorciometria de Fóton , Idoso , Feminino , Humanos , Masculino , Osteoporose/epidemiologia , Osteoporose/etiologia , Osteoprotegerina , Diálise Renal
13.
Molecules ; 26(16)2021 Aug 04.
Artigo em Inglês | MEDLINE | ID: mdl-34443306

RESUMO

This study aimed to evaluate and compare the effects of co-treatment with purified annatto oil (PAO) or its granules (GRA, Chronic®) with that of testosterone on the orchiectomy-induced osteoporosis in Wistar rats. After surgery, rats were treated from day 7 until day 45 with testosterone only (TES, 7 mg/kg, IM) or TES + PAO or GRA (200 mg/kg, p.o.). The following parameters were evaluated: food/water intake, weight, HDL, LDL, glucose, triglycerides (TG), total cholesterol (TC), alkaline phosphatase levels, blood phosphorus and calcium contents, femur weight, structure (through scanning electron microscopy), and calcium content (through atomic absorption spectrophotometry). Our results show that orchiectomy could significantly change the blood lipid profile and decrease bone integrity parameters. Testosterone reposition alone could improve some endpoints, including LDL, TC, bone weight, and bone calcium concentration. However, other parameters were not significantly improved. Co-treatment with PAO or GRA improved the blood lipid profile and bone integrity more significantly and improved some endpoints not affected by testosterone reposition alone (such as TG levels and trabeculae sizes). The results suggest that co-treatment with annatto products improved the blood lipid profile and the anti-osteoporosis effects of testosterone. Overall, GRA had better results than PAO.


Assuntos
Bixaceae/química , Carotenoides/química , Fêmur/efeitos dos fármacos , Lipídeos/sangue , Orquiectomia , Osteoporose/sangue , Osteoporose/etiologia , Extratos Vegetais/química , Óleos Vegetais/farmacologia , Testosterona/farmacologia , Animais , Peso Corporal/efeitos dos fármacos , Comportamento de Ingestão de Líquido/efeitos dos fármacos , Comportamento Alimentar/efeitos dos fármacos , Fêmur/ultraestrutura , Masculino , Substâncias Protetoras/farmacologia , Ratos Wistar
14.
Nutrients ; 13(8)2021 Aug 23.
Artigo em Inglês | MEDLINE | ID: mdl-34445056

RESUMO

Musculoskeletal deficits are among the most commonly reported extra-intestinal manifestations and complications of inflammatory bowel disease (IBD), especially in those with Crohn's disease. The adverse effects of IBD on bone and muscle are multifactorial, including the direct effects of underlying inflammatory disease processes, nutritional deficits, and therapeutic effects. These factors also indirectly impact bone and muscle by interfering with regulatory pathways. Resultantly, individuals with IBD are at increased risk of osteoporosis and sarcopenia and associated musculoskeletal morbidity. In paediatric IBD, these factors may contribute to suboptimal bone and muscle accrual. This review evaluates the main pathogenic factors associated with musculoskeletal deficits in children and adults with IBD and summarises the current literature and understanding of the musculoskeletal phenotype in these patients.


Assuntos
Colite Ulcerativa/complicações , Doença de Crohn/complicações , Doenças Musculoesqueléticas/etiologia , Sarcopenia/etiologia , Fatores Etários , Composição Corporal , Remodelação Óssea , Colite Ulcerativa/sangue , Colite Ulcerativa/fisiopatologia , Doença de Crohn/sangue , Doença de Crohn/tratamento farmacológico , Doença de Crohn/fisiopatologia , Citocinas/sangue , Glucocorticoides/efeitos adversos , Humanos , Mediadores da Inflamação/sangue , Doenças Musculoesqueléticas/sangue , Doenças Musculoesqueléticas/fisiopatologia , Estado Nutricional , Osteoporose/sangue , Osteoporose/etiologia , Osteoporose/fisiopatologia , Medição de Risco , Fatores de Risco , Sarcopenia/sangue , Sarcopenia/fisiopatologia
15.
PLoS One ; 16(7): e0253892, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34197518

RESUMO

INTRODUCTION: Osteoporosis and metabolic syndrome (MetS) are diseases that have serious public health consequences, reducing the quality of life of patients and increasing morbidity and mortality, with substantial healthcare expenditures. OBJECTIVE: To evaluate the impact of MetS on bone mineral density (BMD) and biochemical markers of bone formation and resorption in adolescents with excess weight. METHOD: A descriptive and analytical cross-sectional study was performed that evaluated 271 adolescents of both sexes (10 to 16 years). From the total sample, 42 adolescents with excess weight and the presence of MetS (14%) were selected. A further 42 adolescents with excess weight and without MetS were chosen, matched for chronological age, bone age, and pubertal developmental criteria to those with MetS, for each sex. Anthropometric measurements, blood pressure collection, and biochemical tests were performed in all adolescents, as well as evaluation of BMD and the bone biomarkers osteocalcin (OC), bone alkaline phosphatase (BAP), and carboxy-terminal telopeptide (S-CTx). RESULTS: The adolescents with excess weight and MetS exhibited significantly lower transformed BMD and concentrations of BAP, OC, and S-CTx compared to the matched group, except for OC in boys. A negative and significant correlation was observed between total body BMD and BAP (r = -0.55568; p = 0.005), OC (r = -0.81760; p = < .000), and S-CTx (r = -0.53838; p = 0.011) in girls. CONCLUSION: Metabolic syndrome may be associated with reduced bone mineral density and biochemical markers of bone formation and resorption in adolescents with excess weight.


Assuntos
Desenvolvimento do Adolescente/fisiologia , Densidade Óssea/fisiologia , Remodelação Óssea , Síndrome Metabólica/complicações , Osteoporose/epidemiologia , Adolescente , Fosfatase Alcalina/sangue , Biomarcadores/sangue , Criança , Colágeno Tipo I/sangue , Estudos Transversais , Feminino , Humanos , Masculino , Síndrome Metabólica/sangue , Síndrome Metabólica/fisiopatologia , Osteocalcina/sangue , Osteoporose/sangue , Osteoporose/etiologia , Osteoporose/fisiopatologia , Peptídeos/sangue , Qualidade de Vida , Fatores de Risco
16.
Nutrients ; 13(6)2021 Jun 20.
Artigo em Inglês | MEDLINE | ID: mdl-34202936

RESUMO

Children with inborn errors of intermediary metabolism (IEiM) must follow special diets that restrict their intake of essential nutrients and may compromise normal growth and development. We evaluated body composition, bone mineral density, physical activity, and food intake in IEiM patients undergoing dietary treatment. IEiM patients (n = 99) aged 5-19 years and healthy age- and sex-matched controls (n = 98) were recruited and underwent dual-energy X-ray absorptiometry to evaluate anthropometric characteristics and body composition. Data on food intake and physical activity were also collected using validated questionnaires. The height z-score was significantly lower in IEiM patients than controls (-0.28 vs. 0.15; p = 0.008), particularly in those with carbohydrate and amino acid metabolism disorders. Significant differences in adiposity were observed between patients and controls for the waist circumference z-score (-0.08 vs. -0.58; p = 0.005), but not the body mass index z-score (0.56 vs. 0.42; p = 0.279). IEiM patients had a significantly lower total bone mineral density (BMD) than controls (0.89 vs. 1.6; p = 0.001) and a higher risk of osteopenia (z-score < -2, 33.3% vs. 20.4%) and osteoporosis (z-score < -2.5, 7.1% vs. 0%), but none presented fractures. There was a significant positive correlation between natural protein intake and BMD. Our results indicate that patients with IEiM undergoing dietary treatment, especially those with amino acid and carbohydrate metabolism disorders, present alterations in body composition, including a reduced height, a tendency towards overweight and obesity, and a reduced BMD.


Assuntos
Composição Corporal , Ingestão de Alimentos , Exercício Físico , Erros Inatos do Metabolismo/fisiopatologia , Adiposidade , Adolescente , Índice de Massa Corporal , Densidade Óssea , Doenças Ósseas Metabólicas/etiologia , Criança , Pré-Escolar , Estudos Transversais , Dieta , Carboidratos da Dieta/administração & dosagem , Proteínas na Dieta/administração & dosagem , Feminino , Humanos , Masculino , Erros Inatos do Metabolismo/dietoterapia , Osteoporose/etiologia , Adulto Jovem
17.
Int J Biochem Cell Biol ; 137: 106033, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34216755

RESUMO

In clinical treatment, there is increasingly prevalent that traditional Chinese medicine treats common bone diseases including osteoporosis. Hydroxysafflor yellow A (HSYA), one of the essential compounds of Safflower, has been used as the therapy for thrombus, myocardial ischemia, and inflammation, but its effect on osteogenesis through epigenetic control and ovariectomy-induced bone loss in vivo has not been explored. Therefore, the study aimed to explore the function and mechanism of HSYA on bone formation and development. We found HSYA could enhance the cell viability and promote osteogenesis of hBMSCs in vitro. Mechanistically, HSYA could increase the expression of ß-catenin leading to its accumulation in the nucleus and activation of downstream targets to promote osteogenesis. Besides, RNA-seq and quantitative RT-PCR and western blot showed KDM7A was significantly increased by HSYA. The occupancy of H3K27me2 on ß-catenin promoter was significantly decreased by HSYA, which could be reversed by silencing endogenous KDM7A. More importantly, HSYA promoted bone development in chick embryos and prevented ovariectomy (OVX)-induced bone loss in SD rats. Taken together, our study has shown convincing evidence that HSYA could promote osteogenesis and bone development via epigenetically regulating ß-catenin and prevent ovariectomy-induced bone loss.


Assuntos
Desenvolvimento Ósseo/efeitos dos fármacos , Chalcona/análogos & derivados , Osteogênese , Osteoporose/tratamento farmacológico , Ovariectomia/efeitos adversos , Quinonas/farmacologia , beta Catenina/metabolismo , Animais , Proliferação de Células , Chalcona/farmacologia , Feminino , Osteoporose/etiologia , Osteoporose/patologia , Ratos , Ratos Sprague-Dawley , Transdução de Sinais , beta Catenina/genética
18.
Eur J Endocrinol ; 185(4): 515-524, 2021 Aug 27.
Artigo em Inglês | MEDLINE | ID: mdl-34324430

RESUMO

Objective: In primary hyperparathyroidism (PHPT) with osteoporosis, bone mineral density (BMD) improves after parathyroidectomy. It is unclear whether combining surgery with postoperative bisphosphonate treatment can further improve bone health. Design: This randomized, placebo-controlled study compared the effects of surgery alone and surgery combined with zoledronic acid on bone metabolism in PHPT with osteoporosis. Methods: Fifty-six patients (f/m 47/9, mean age 68.4 years) with PHPT and osteoporosis were randomized 1-3 months after parathyroidectomy to receive a 2-year treatment of zoledronic acid or placebo. Dual-energy X-ray absorptiometry (DXA) and bone turnover markers (N-terminal propeptide of type 1 procollagen, C-terminal telopeptide of type 1 collagen, and alkaline phosphatase) were measured annually during the 2-year follow-up. Results: Two years after parathyroidectomy, BMD was significantly higher in the zoledronic acid (ZOL) group compared with the placebo (PBO) group at the femoral neck (P = 0.045 for Z-score) and lumbar spine (P = 0.039 and 0.017 for T- and Z-scores, respectively). Bone turnover markers were significantly lower in the ZOL group (P < 0.001 for all markers). Of the 18 patients who had received bisphosphonates for >1 year before surgery, BMD improved significantly in the ZOL group both in the femoral neck and lumbar spine (n = 10; all P < 0.001-0.01), but in the PBO group, only in the lumbar spine (n = 8, P = 0.03), (P = 0.08-0.95 for between-group changes). Conclusion: BMD increases after parathyroidectomy both with and without zoledronic acid but the increase is significantly higher with postoperative zoledronic acid.


Assuntos
Hiperparatireoidismo Primário , Osteoporose , Ácido Zoledrônico/administração & dosagem , Idoso , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Terapia Combinada , Método Duplo-Cego , Esquema de Medicação , Feminino , Finlândia , Humanos , Hiperparatireoidismo Primário/complicações , Hiperparatireoidismo Primário/tratamento farmacológico , Hiperparatireoidismo Primário/cirurgia , Masculino , Pessoa de Meia-Idade , Osteoporose/tratamento farmacológico , Osteoporose/etiologia , Osteoporose/cirurgia , Paratireoidectomia , Período Pós-Operatório , Resultado do Tratamento
19.
J Cachexia Sarcopenia Muscle ; 12(5): 1179-1188, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34264024

RESUMO

BACKGROUND: Sarcopenia often co-occurs with osteoporosis in cross-sectional studies. However, this association has rarely been studied in prospective studies. This study aimed to investigate the association between sarcopenia categories-along with its individual components-and incident osteoporosis in both middle-aged and older men and women from the UK Biobank study. METHODS: A total of 168,682 participants (48.8% women, aged 37 to 70 years at baseline) were included in this prospective study. Categories of sarcopenia (pre-sarcopenia and sarcopenia), and its individual components, were defined according to the EWGSOP2 criteria (2019). Associations with incident osteoporosis by sex were investigated using Cox-proportional hazard models adjusted for socio-demographic, lifestyle and health-related factors, and morbidity count. Associations between categories of sarcopenia and incident osteoporosis were also investigated by age-groups and subtype of osteoporosis (with and without pathological fractures). RESULTS: After a median follow-up of 7.4 years, 6296 participants were diagnosed with osteoporosis. When the analyses were adjusted for a range of relevant confounding factors, pre-sarcopenia was associated with 1.3-times higher risk of osteoporosis in men (HR: 1.30 [95% CI: 1.03 to 1.63]) but not in women, and sarcopenia was associated with 1.66-times increased osteoporosis risk in women (HR: 1.66 [95% CI: 1.33 to 2.08]) but not in men compared with people without sarcopenia or pre-sarcopenia. A similar magnitude of associations was found in osteoporosis without pathological fractures but weaker for those with pathological fractures. Within the individual components, low muscle mass (HRwomen : 1.36 [95% CI: 1.22 to 1.51] and HRmen : 3.07 [95% CI: 1.68 to 5.59]), followed by slow gait speed (HRwomen : 1.30 [95% CI: 1.17 to 1.45] and HRmen : 1.70 [95% CI: 1.43 to 2.02]), were associated with a higher risk of incident osteoporosis in both sexes. Low grip strength was associated with a higher risk of incident osteoporosis in men (HR: 1.38 [95% CI: 1.15 to 1.65]), but not in women. No significant interaction between the exposures and incident osteoporosis by age groups were identified. CONCLUSIONS: Our findings demonstrated that pre-sarcopenic men and sarcopenic women had a higher risk of developing osteoporosis even after adjustment for a large range of potential confounders. Considering that sarcopenia could be prevented, health interventions to improve physical capability may delay or prevent the onset of osteoporosis.


Assuntos
Osteoporose , Sarcopenia , Idoso , Bancos de Espécimes Biológicos , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Osteoporose/etiologia , Estudos Prospectivos , Sarcopenia/epidemiologia , Reino Unido/epidemiologia
20.
Sci Rep ; 11(1): 14905, 2021 07 21.
Artigo em Inglês | MEDLINE | ID: mdl-34290287

RESUMO

Androgen deprivation therapy (ADT) for men with prostate cancer (PCa) results in accelerated bone loss and increased risk of bone fracture. The aim of the present study was to evaluate serum bone markers-sclerostin, Dickkopf-1 (DKK-1) and osteoprotegerin (OPG), in a cohort of 88 PCa patients without known bone metastases, managed with and without ADT, and to analyse their relationship with bone mineral density (BMD) and sex steroids. The cross-sectional analysis between acute-, chronic- and former-ADT groups and PCa controls showed that sclerostin and OPG levels significantly differed between them (p = 0.029 and p = 0.032). Groups contributing to these significant changes were recorded. There were no significant differences in serum DKK-1 levels across the four groups (p = 0.683). In the longitudinal analysis, significant % decreases within groups were seen for DKK-1 [chronic-ADT (- 10.06%, p = 0.0057), former-ADT (- 12.77%, p = 0.0239), and in PCa controls group (- 16.73, p = 0.0022); and OPG levels in chronic ADT (- 8.28%, p = 0.003) and PCa controls group (- 12.82%, p = 0.017)]. However, % changes in sclerostin, DKK-1, and OPG did not differ significantly over 6-months across the evaluated groups. Sclerostin levels showed significant positive correlations with BMD at baseline in the ADT group, while in PCa controls this correlation existed at both baseline and 6-month time points. Sclerostin correlated negatively with testosterone in former ADT users and in PCa controls. Possible prognostic features denoted by parallel increases in sclerostin and BMD are discussed.


Assuntos
Proteínas Adaptadoras de Transdução de Sinal/sangue , Antagonistas de Androgênios/efeitos adversos , Antagonistas de Androgênios/uso terapêutico , Peptídeos e Proteínas de Sinalização Intercelular/sangue , Osteoporose/diagnóstico , Osteoporose/etiologia , Osteoprotegerina/sangue , Neoplasias da Próstata/tratamento farmacológico , Biomarcadores/sangue , Densidade Óssea/efeitos dos fármacos , Estudos Transversais , Humanos , Estudos Longitudinais , Masculino , Osteoporose/metabolismo
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