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1.
Medicine (Baltimore) ; 99(9): e19334, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-32118767

RESUMO

Primary osteoporosis (PO) is a common disease that was characterized by a systemic impairment of bone mass and microarchitecture that results in fragility fractures and constitutes a pressing public health problem. But the effect of acupuncture or moxibustion treatment for PO is controversial.To provide a comprehensive systematic overview of current evidence from systematic reviews (SR)/Meta-analysis of acupuncture treatment for PO pertaining to risk of bias, quality of evidence and report quality.A total of 9 international and Chinese databases were searched for SR/meta-analysis of randomized controlled trials (RCTs). The risk of bias of SR/meta-analysis was appraised using the risk of bias in systematic reviews (ROBIS) instrument, the quality of the evidence was evaluated via Grading of Recommendations Assessment, Development and Evaluation (GRADE), and the report quality of the included studies are estimated by Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA).According to ROBIS, only 2 articles were with risk of low bias; according to PRISMA, and most articles were reported incomplete, mainly in Q2, Q7, Q24, and Q27; according to GRADE, a total of 28 outcome indicators were evaluated under 4 different interventions of experimental group and control group: the evidence quality of bone mineral density (BMD) from treatment of acupuncture and moxibustion/acupuncture and moxibustion plus was high or moderate; Visual Analogue Score (VAS) of acupuncture plus moxibustion or acupuncture plus moxibustion plus other was low or very low; clinical effectiveness of acupuncture plus moxibustion or acupuncture plus moxibustion plus other was uncertain.Acupuncture and moxibustion can improve the BMD of PO patients according to high-quality evidence, and may benefit VAS, pain score, clinical efficacy based on moderate or low-quality evidence. Further research that provides higher quality evidence of SR/RCTs of acupuncture and moxibustion treatment for PO is required.


Assuntos
Terapia por Acupuntura/normas , Moxibustão/normas , Osteoporose/terapia , Terapia por Acupuntura/métodos , Humanos , Moxibustão/métodos , Osteoporose/fisiopatologia , Resultado do Tratamento
2.
BMC Med Genet ; 21(1): 21, 2020 01 31.
Artigo em Inglês | MEDLINE | ID: mdl-32005172

RESUMO

BACKGROUND: More than 95% of individuals with RTT have mutations in methyl-CpG-binding protein 2 (MECP2), whose protein product modulates gene transcription. The disorder is caused by mutations in a single gene and the disease severity in affected individuals can be quite variable. Specific MECP2 mutations may lead phenotypic variability and different degrees of disease severity. It is known that low bone mass is a frequent and early complication of subjects with Rett syndrome. As a consequence of the low bone mass Rett girls are at an increased risk of fragility fractures. This study aimed to investigate if specific MECP2 mutations may affects the degree of involvement of the bone status in Rett subjects. METHODS: In 232 women with Rett syndrome (mean age 13.8 ± 8.3 yrs) we measured bone mineral density at whole body and at femur (BMD-FN and BMD-TH) by using a DXA machine (Hologic QDR 4500). QUS parameters were assessed at phalanxes by Bone Profiler-IGEA (amplitude dependent speed of sound: AD-SoS and bone transmission time: BTT). Moreover, ambulation capacity (independent or assisted), fracture history and presence of scoliosis were assessed. We divided the subjects with the most common point mutations in two group based on genotype-phenotype severity; in particular, there has been consensus in recognising that the mutations R106T, R168X, R255X, R270X are considered more severe. RESULTS: As aspect, BMD-WB, BMD-FN and BMD-TH were lower in subjects with Rett syndrome that present the most severe mutations with respect to subjects with Rett syndrome with less severe mutations, but the difference was statistically significant only for BMD-FN and BMD-TH (p < 0.05). Also both AD-SoS and BTT values were lower in subjects that present the most severe mutations with respect to less severe mutations but the difference was not statistically significant. Moreover, subjects with Rett syndrome with more severe mutations present a higher prevalence of scoliosis (p < 0.05) and of inability to walk (p < 0.05). CONCLUSION: This study confirms that MECP2 mutation type is a strong predictor of disease severity in subjects with Rett syndrome. In particular, the subjects with more severe mutation present a greater deterioration of bone status, and a higher prevalence of scoliosis and inability to walk.


Assuntos
Doenças Ósseas/genética , Proteína 2 de Ligação a Metil-CpG/genética , Osteoporose/genética , Síndrome de Rett/genética , Adolescente , Adulto , Densidade Óssea/genética , Doenças Ósseas/diagnóstico por imagem , Doenças Ósseas/fisiopatologia , Criança , Pré-Escolar , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/genética , Fraturas Ósseas/fisiopatologia , Humanos , Masculino , Mutação , Osteoporose/diagnóstico por imagem , Osteoporose/fisiopatologia , Síndrome de Rett/diagnóstico por imagem , Síndrome de Rett/fisiopatologia , Escoliose/diagnóstico por imagem , Escoliose/genética , Escoliose/fisiopatologia , Índice de Gravidade de Doença , Adulto Jovem
3.
Clín. investig. arterioscler. (Ed. impr.) ; 32(1): 33-42, ene.-feb. 2020. graf, ilus
Artigo em Espanhol | IBECS | ID: ibc-187006

RESUMO

La osteoporosis es una enfermedad esquelética sistémica, caracterizada por baja masa ósea y deterioro en la microarquitectura del tejido óseo, que origina un aumento de la fragilidad ósea y, en consecuencia, mayor susceptibilidad a fracturas. Es la enfermedad metabólica ósea más frecuente en nuestra población, y las fracturas resultantes de la osteoporosis son cada vez más comunes. Por otro lado, la calcificación vascular es un factor de riesgo reconocido de morbimortalidad cardiovascular, que históricamente era considerada como un proceso pasivo y degenerativo. Sin embargo, en la actualidad se reconoce como un proceso activo que tiene características histopatológicas, de composición mineral y de mecanismos de iniciación y desarrollo propias de la formación del hueso. Paradójicamente, los pacientes con osteoporosis muestran con frecuencia calcificaciones vasculares. Tradicionalmente se han considerado como procesos independientes relacionados con la edad, aunque estudios epidemiológicos recientes han evidenciado que existe una estrecha relación entre la pérdida de masa ósea y la calcificación vascular, independiente de la edad. De hecho, ambas entidades comparten factores de riesgo y mecanismos fisiopatológicos. Entre ellos destacan la relación entre proteínas de origen óseo, como la osteopontina y la osteoprotegerina, con la patología vascular, y el sistema intercelular proteico RANK/RANKL/OPG y la vía de señalización Wnt. Los mecanismos vinculados en ambas patologías deben considerarse en las decisiones clínicas, dado que los tratamientos para la osteoporosis podrían tener efectos imprevistos en la calcificación vascular, y a la inversa. En definitiva, una mejor comprensión de la relación entre ambas entidades puede contribuir a plantear estrategias para disminuir la prevalencia creciente de calcificación vascular y osteoporosis en la población que envejece


Osteoporosis is a systemic skeletal disease, characterised by low bone mass and deterioration in the micro-architecture of bone tissue, which causes increased bone fragility and consequently greater susceptibility to fractures. It is the most frequent metabolic bone disease in our population, and fractures resulting from osteoporosis are becoming more common. Furthermore, vascular calcification is a recognised risk factor of cardiovascular morbidity and mortality that historically has been considered a passive and degenerative process. However, it is currently recognised as an active process, which has histopathological characteristics, mineral composition and initiation and development mechanisms characteristic of bone formation. Paradoxically, patients with osteoporosis frequently show vascular calcifications. Traditionally, they have been considered as independent processes related to age, although more recent epidemiological studies have shown that there is a close relationship between the loss of bone mass and vascular calcification, regardless of age. In fact, both conditions share risk factors and pathophysiological mechanisms. These include the relationship between proteins of bone origin, such as osteopontin and osteoprotegerin (OPG), with vascular pathology, and the intercellular protein system RANK/RANKL/OPG and the Wnt signalling pathway. The mechanisms linked in both pathologies should be considered in clinical decisions, given that treatments for osteoporosis could have unforeseen effects on vascular calcification, and viceversa. In short, a better understanding of the relationship between both entities can help in proposing strategies to reduce the increasing prevalence of vascular calcification and osteoporosis in the aging population


Assuntos
Humanos , Osteoporose/etiologia , Calcificação Vascular/etiologia , Fatores de Risco , Doenças Cardiovasculares/epidemiologia , Osteoporose/fisiopatologia , Calcificação Vascular/fisiopatologia , Calcificação Vascular/classificação , Cálcio/uso terapêutico , Osteoclastos/metabolismo , beta Catenina
4.
PLoS One ; 15(1): e0227765, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31940409

RESUMO

BACKGROUND: Patients with low bone density or osteoporosis need information for effective prevention or disease management, respectively. However, patients may not be getting enough information from their primary care providers or other sources. Inadequate disease information leaves patients ill-informed and creates misconceptions and unnecessary concerns about the disease. OBJECTIVE: We systematically reviewed and synthesized the available literature to determine patient knowledge, beliefs, and concerns about osteoporosis and identify potential gaps in knowledge. METHODS: A systematic search was conducted for full-text qualitative studies addressing understanding, literacy, and/or perceptions about osteoporosis and its management, using Medline, EMBASE, Web of Science, Cochrane Library, CINAHL, ERIC, PsychINFO, Psyc Behav Sci Collec, and PubMed, from inception through September 2016. Studies were selected by two reviewers, assessed for quality, and themes extracted using the Joanna Briggs Institute data extraction tool. Thematic analysis was used to identify themes and subthemes. RESULTS: Twenty-five studies with a total of 757 participants (including 105 men) were selected for analysis out of 1031 unique citations. Selected studies were from Australia, Canada, Denmark, Norway, the United Kingdom, and the United States. Four main themes emerged: inadequate knowledge, beliefs and misconceptions, concerns about osteoporosis, and lack of information from health care providers. Participants had inadequate knowledge about osteoporosis and were particularly uninformed about risk factors, causes, treatment, and prevention. Areas of concern for participants included diagnosis, medication side effects, and inadequate information from primary care providers. CONCLUSION: Although there was general awareness of osteoporosis, many misconceptions and concerns were evident. Education on bone health needs to reinforce areas of knowledge and address deficits, misconceptions, and concerns.


Assuntos
Densidade Óssea/fisiologia , Conhecimentos, Atitudes e Prática em Saúde , Osteoporose/prevenção & controle , Educação de Pacientes como Assunto , Pesquisa Qualitativa , Humanos , Osteoporose/fisiopatologia
5.
PLoS One ; 15(1): e0227893, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-31935270

RESUMO

INTRODUCTION: Use of tenofovir based anti-retroviral therapy (ART) in HIV patients is associated with low bone mineral density (BMD). Low BMD predisposes people living with HIV (PLWHIV) to fractures thereby increasing morbidity and mortality. Since the introduction of tenofovir based ARV regimens in 2011, information on the prevalence of low BMD in PLWHIV and receiving ART is still scarce in Malawi. This study aimed to determine the prevalence and associated factors of low BMD among adults living with HIV and receiving ART in Blantyre, Malawi. METHODOLOGY: This was a cross sectional study involving 282 HIV-positive adults of whom 102 (36%) were males. The participants aged 18-45 years were recruited from three primary and one tertiary health care facilities. Patients with no other comorbidities or conditions associated with low BMD and on ART >12 months were included. Data on BMD (femoral neck and lumbar spine) were collected using Dual-Energy X-ray Absorptiometry (DEXA). The International Physical Activity Questionnaire (IPAQ) was used to assess the physical activity (PA) levels. Participants' body weight (kg) and height (m) were also measured. Descriptive statistics, Chi-Square test and multivariable logistic regression were used to analyse data. RESULTS: Mean age of participants was 37(± 6.4) years, mean duration on ART was 5(± 3.5) years and mean body mass index (BMI) was 23(± 4.5) kg/m2. Twenty percent (55) had reduced BMD. More males (28%) had reduced BMD than females (14%) (p = 0.04). There was a significant association between lumbar BMD and femoral neck BMD (r = 0.66,p<0.001). However, on average, lumbar BMD (g/cm2) was significantly lower than the femoral BMD (p < 0.001). Participants with low PA level (OR 1.23,p = 0.6) had higher odds of having reduced BMD compared to those with high PA level. CONCLUSIONS AND RECOMMENDATION: Prevalence of reduced BMD is high among PLWHIV in Malawi especially male Malawian adults. Occurrence of low BMD is associated with low PA level. There is need for health care providers to routinely monitor BMD and PA levels of this population.


Assuntos
Doenças Ósseas Metabólicas/epidemiologia , Exercício Físico , Infecções por HIV/epidemiologia , Osteoporose/epidemiologia , Adolescente , Adulto , Terapia Antirretroviral de Alta Atividade/métodos , Peso Corporal , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/diagnóstico por imagem , Doenças Ósseas Metabólicas/virologia , Feminino , Colo do Fêmur/fisiopatologia , HIV/efeitos dos fármacos , HIV/patogenicidade , Infecções por HIV/complicações , Infecções por HIV/virologia , Humanos , Malaui/epidemiologia , Masculino , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/fisiopatologia , Fatores de Risco , Caracteres Sexuais , Adulto Jovem
6.
Comput Methods Biomech Biomed Engin ; 23(2): 54-68, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31813291

RESUMO

Osteoporosis is an osteometabolic disease, which promotes structural degradation of bone tissue and reduction of mineral density. We reported here a mechanical resistance assay from normal, osteopenic and osteoporotic trabecular vertebral bones of human cadavers. We performed a compressed test on ninety samples, evaluating Young's modulus and X-ray microtomography to measure bone volume fraction and trabecular thickness. This experimental data are employed for computing the orthotropic macroscopic behavior of vertebral trabecular bones using known analytical formulae that were obtained by Galka et al. (Arch Mech 51: 335-355, 1999) via an asymptotic homogenization model. A geometrical model with a periodic orthogonal plate-like structure is applied. The properties of the bone-trabecular mass are considered linear, homogeneous and orthotropic. Average values for all technical or engineering elastic properties are computed for three important regions of the trabecular bones corresponding to thirty individuals classified as normal, osteopenic or osteoporotic by calcaneus ultrassometry. This study could be useful for a better understanding of the elastic behavior of trabecular bones in human vertebral bodies, allowing an estimation of bone answer under stress in different directions and the risk of fracture associated with osteoporosis.HighlightsDescribing the elastic behavior of trabecular bones in human vertebral bodies at the micro and macroscopic.Allow a better estimation of the stress in different directions and risk of fracture associated with osteoporosis.Model request a very low computational cost.Offer a better understand the global effective coefficients of samples of trabecular bone, from the model of a periodic unit cell, in the format orthogonal plate-like structure with homogeneous bone mass.


Assuntos
Osso Esponjoso/fisiopatologia , Osteoporose/fisiopatologia , Coluna Vertebral/fisiopatologia , Densidade Óssea , Osso Esponjoso/diagnóstico por imagem , Módulo de Elasticidade , Elasticidade , Humanos , Masculino , Osteoporose/diagnóstico por imagem , Coluna Vertebral/diagnóstico por imagem , Microtomografia por Raio-X
7.
Arch Osteoporos ; 15(1): 4, 2019 12 19.
Artigo em Inglês | MEDLINE | ID: mdl-31858278

RESUMO

This comparison of osteoporosis treatment strategies and intervention thresholds highlights tradeoffs in terms of number of individuals qualifying for treatment and estimated fractures prevented. PURPOSE: The current analysis was performed to inform the following key question as part of the Osteoporosis Canada's Osteoporosis Guidelines Update: "What is the best strategy to identify those at high fracture risk for pharmacotherapy in order to prevent the most fractures, considering both population and patient perspectives?" METHODS: The study population consisted of 66,878 women age 50 years and older (mean age 66.0 ± 9.7 years) with documented fracture probability assessment (FRAX) and fracture outcomes. Fractures over the next 5 years were identified through linked administrative healthcare data. We estimated the fraction of the population that would warrant treatment and the number of fractures avoided per 1000 person-years according to multiple strategies and thresholds. Strategies were then rank ordered using 19 metrics. RESULTS: During mean 4.4 years, 863 (3.5%) sustained one or more major osteoporotic fractures (MOF), 212 (0.8%) sustained a hip fracture, and 1210 (4.9%) sustained any incident fracture. For woman age 50-64 years, the highest ranked strategy was treatment based upon total hip T score ≤ -2.5, but several other strategies fell within 0.5 overall ranking. For women age 65 years and older, MOF > 20% was the highest ranked strategy with no closely ranked strategies. Pooling both age subgroups gave MOF > 20% as the highest ranked strategy, with several other strategies within 0.5 overall ranking. CONCLUSIONS: Choice of treatment strategy and threshold for osteoporosis management strongly influences the number of individuals for whom pharmacologic treatment would be recommended and on estimated fracture rates in the population. This evidence-based approach to comparing these strategies will help to inform guidelines development in Canada and may be on interest elsewhere.


Assuntos
Tomada de Decisão Clínica/métodos , Fraturas do Quadril/prevenção & controle , Osteoporose/tratamento farmacológico , Fraturas por Osteoporose/prevenção & controle , Medição de Risco , Idoso , Densidade Óssea , Canadá/epidemiologia , Feminino , Fraturas do Quadril/epidemiologia , Humanos , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/fisiopatologia , Fraturas por Osteoporose/epidemiologia , Fatores de Risco
8.
Life Sci ; 237: 116890, 2019 Nov 15.
Artigo em Inglês | MEDLINE | ID: mdl-31606379

RESUMO

AIMS: Telmisartan (TEL), an angiotensin II type I receptor blocker and PPARγ partial agonist, has been used for to treat hypertension. It is known that PPARγ activation induces bone loss. Therefore, we evaluate the effects of telmisartan on PPARγ protein expression, biomechanics, density and bone microarchitecture of femurs and lumbar vertebrae in SHR ovariectomized animals, a model of hypertension in which preexisting bone impairment has been demonstrated. MAIN METHODS: SHR females (3 months old) were distributed into four groups: sham (S), sham + TEL (ST), OVX (C) and OVX + TEL (CT). TEL (5 mg/kg/day) or vehicle were administered according to the groups. After the protocol, blood pressure was measured and density, microarchitecture and biomechanics of bone were analyzed. Western blotting analysis was performed to evaluate PPARγ protein expression in the bones. KEY FINDINGS: Castration induced a deleterious effect on mineral density and trabecular parameters, with telmisartan enhancing such effects. Telmisartan increased PPARγ levels, which were at their highest when the treatment was combined with castration. As to biomechanical properties, telmisartan reduced the stiffness in the castration group (CT vs. S or C group), as well as resilience and failure load in ST group (vs. all others groups). SIGNIFICANCE: These results demonstrated that telmisartan compromised bone density and microarchitecture in animals that shows preexisting osteoporotic bone disorders, probably via mechanisms associated with increased PPARγ. If this translates to humans, a need for greater caution in the use of telmisartan by patients that have preexisting bone problems, as in the postmenopausal period, may be in order.


Assuntos
Bloqueadores do Receptor Tipo 1 de Angiotensina II/farmacologia , Doenças Ósseas/tratamento farmacológico , Osso Esponjoso/efeitos dos fármacos , Regulação da Expressão Gênica/efeitos dos fármacos , Osteoporose/tratamento farmacológico , PPAR gama/metabolismo , Telmisartan/farmacologia , Animais , Densidade Óssea/efeitos dos fármacos , Doenças Ósseas/metabolismo , Doenças Ósseas/fisiopatologia , Osso Esponjoso/diagnóstico por imagem , Osso Esponjoso/patologia , Feminino , Osteoporose/metabolismo , Osteoporose/fisiopatologia , PPAR gama/genética , Ratos , Ratos Endogâmicos SHR , Tomografia Computadorizada por Raios X
10.
Nutrients ; 11(9)2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31491937

RESUMO

Because of its high prevalence worldwide, osteoporosis is considered a serious public health concern. Many known risk factors for developing osteoporosis have been identified and are crucial if planning health care needs. Recently, an association between uric acid (UA) and bone fractures had been explored. Extracellular UA exhibits antioxidant properties by effectively scavenging free radicals in human plasma, but this benefit might be disturbed by the hydrophobic lipid layer of the cell membrane. In contrast, intracellular free oxygen radicals are produced during UA degradation, and superoxide is further enhanced by interacting with NADPH oxidase. This intracellular oxidative stress, together with inflammatory cytokines induced by UA, stimulates osteoclast bone resorption and inhibits osteoblast bone formation. UA also inhibits vitamin D production and thereby results in hyper-parathyroidism, which causes less UA excretion in the intestines and renal proximal tubules by inhibiting the urate transporter ATP-binding cassette subfamily G member 2 (ABCG2). At normal or high levels, UA is associated with a reduction in bone mineral density and protects against bone fracture. However, in hyperuricemia or gout arthritis, UA increases bone fracture risk because oxidative stress and inflammatory cytokines can increase bone resorption and decrease bone formation. Vitamin D deficiency, and consequent secondary hyperparathyroidism, can further increase bone resorption and aggravated bone loss in UA-induced osteoporosis.


Assuntos
Osso e Ossos/metabolismo , Hiperuricemia/sangue , Osteoporose/sangue , Fraturas por Osteoporose/sangue , Ácido Úrico/sangue , Animais , Biomarcadores/sangue , Remodelação Óssea , Osso e Ossos/fisiopatologia , Humanos , Hiperparatireoidismo Secundário/sangue , Hiperparatireoidismo Secundário/epidemiologia , Hiperuricemia/epidemiologia , Hiperuricemia/fisiopatologia , Mediadores da Inflamação/metabolismo , Osteoporose/epidemiologia , Osteoporose/fisiopatologia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/fisiopatologia , Estresse Oxidativo , Espécies Reativas de Oxigênio/metabolismo , Medição de Risco , Fatores de Risco , Transdução de Sinais , Deficiência de Vitamina D/sangue , Deficiência de Vitamina D/epidemiologia
11.
Braz Oral Res ; 33: e079, 2019 Sep 09.
Artigo em Inglês | MEDLINE | ID: mdl-31531565

RESUMO

Cell therapy associated with guided bone regeneration (GBR) can be used to treat bone defects under challenging conditions such as osteoporosis. This study aimed to evaluate the effect of mesenchymal stem cells (MSCs) in combination with a poly(vinylidene-trifluoroethylene)/barium titanate (PVDF-TrFE/BT) membrane on bone repair in osteoporotic rats. Osteoporosis was induced in female rats by bilateral removal of the ovaries (OVX) or sham surgery (SHAM), and the osteoporotic condition was characterized after 5 months by microtomographic and morphometric analyses. Calvarial defects were created in osteoporotic rats that immediately received the PVDF-TrFE/BT membrane. After 2 weeks, bone marrow-derived MSCs from healthy rats, characterized by the expression of surface markers using flow cytometry, or phosphate-buffered saline (PBS) (Control) were injected into the defects and bone formation was evaluated 4 weeks post-injection by microtomographic, morphometric, and histological analyses. A reduction in the amount of bone tissue in the femurs of OVX compared with SHAM rats confirmed the osteoporotic condition of the experimental model. More bone formation was observed when the defects were injected with MSCs compared to that with PBS. The modification that we are proposing in this study for the classical GBR approach where cells are locally injected after a membrane implantation may be a promising therapeutic strategy to increase bone formation under osteoporotic condition.


Assuntos
Compostos de Bário/farmacologia , Regeneração Tecidual Guiada/métodos , Células-Tronco Mesenquimais/fisiologia , Osteogênese/efeitos dos fármacos , Osteoporose/terapia , Polivinil/farmacologia , Titânio/farmacologia , Animais , Compostos de Bário/química , Densidade Óssea , Regeneração Óssea/efeitos dos fármacos , Regeneração Óssea/fisiologia , Feminino , Citometria de Fluxo , Imageamento Tridimensional , Células-Tronco Mesenquimais/química , Osteogênese/fisiologia , Osteoporose/fisiopatologia , Ovariectomia , Polivinil/química , Distribuição Aleatória , Ratos Wistar , Reprodutibilidade dos Testes , Fatores de Tempo , Titânio/química , Resultado do Tratamento
12.
Dtsch Med Wochenschr ; 144(16): 1120-1124, 2019 08.
Artigo em Alemão | MEDLINE | ID: mdl-31416103

RESUMO

Adequate intake of vitamin D and calcium are fundamental for the treatment of osteoporosis. A normal vitamin D status is required for optimal intestinal calcium absorption. However, general calcium and vitamin D supplementation is not sufficient for prevention of osteoporotic fractures in persons older than 50 years. Nevertheless, vitamin D deficiency should be avoided and corrected. In particular, parts of the population with increased risk for vitamin D deficiency (immobilized or older individuals, swarthy, migrants) should be tested. Secondary causes of vitamin D deficiency should be identified and treated.


Assuntos
Conservadores da Densidade Óssea , Osteoporose , Vitamina D , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/uso terapêutico , Cálcio/administração & dosagem , Cálcio/uso terapêutico , Suplementos Nutricionais , Humanos , Osteoporose/tratamento farmacológico , Osteoporose/fisiopatologia , Vitamina D/administração & dosagem , Vitamina D/uso terapêutico , Deficiência de Vitamina D
13.
Food Funct ; 10(9): 5350-5360, 2019 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-31393485

RESUMO

Diabetic osteoporosis (DOP) is a systemic endocrine-metabolic osteopathy which has the characteristics of bone mineral density (BMD) reduction and bone microstructural destruction. Although anthocyanin-rich extract from black rice (AEBR) was reported to have a beneficial effect on diabetic rats, no studies have been performed on whether black rice anthocyanins are beneficial for diabetic osteoporosis. Therefore, in this study, a streptozotocin-induced diabetic rat model was established to investigate the protective effect of AEBR on diabetes-induced osteoporosis and its possible mechanism. AEBR at three doses (0.5, 1.0, and 2.0 g kg-1 d-1) were administered by oral gavage to diabetic rats for 8 weeks. The blood glucose, BMD, bone histomorphometry parameters, serum bone turnover biomarkers, bone marrow adipocyte numbers, as well as osteoprotegerin (OPG), runt-related transcription factor 2 (RUNX 2), and receptor activator of nuclear factor-κ B ligand (RANKL) protein expression in bone and serum were detected. The results indicated that AEBR dose-dependently decreased the blood glucose, increased the BMD, and decreased the serum bone turnover markers. The bone microstructure and osteoclast numbers in bone tissues returned to normal in the high AEBR dosage group; at the same time, the AEBR dose-dependently suppressed bone marrow adipogenesis. The RUNX 2 as well as the OPG/RANKL ratio in diabetic rats' bone tissues increased significantly in the AEBR treatment group. Our results indicate that AEBR administration can ameliorate bone loss caused by diabetes; this is mainly attributed to its inhibition of bone turnover, suppression of bone marrow adipogenesis, and up-regulation of RUNX 2 and the OPG/RANKL expression ratio.


Assuntos
Antocianinas/administração & dosagem , Complicações do Diabetes/tratamento farmacológico , Oryza/química , Osteoporose/tratamento farmacológico , Extratos Vegetais/administração & dosagem , Animais , Antocianinas/análise , Glicemia/metabolismo , Densidade Óssea/efeitos dos fármacos , Subunidade alfa 1 de Fator de Ligação ao Core/genética , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Complicações do Diabetes/genética , Complicações do Diabetes/metabolismo , Complicações do Diabetes/fisiopatologia , Feminino , Humanos , Osteoclastos/citologia , Osteoclastos/metabolismo , Osteoporose/genética , Osteoporose/metabolismo , Osteoporose/fisiopatologia , Osteoprotegerina/genética , Osteoprotegerina/metabolismo , Ligante RANK/genética , Ligante RANK/metabolismo , Ratos , Ratos Sprague-Dawley
14.
J Orthop Res ; 37(12): 2491-2498, 2019 12.
Artigo em Inglês | MEDLINE | ID: mdl-31444806

RESUMO

There is clinical evidence that patient-specific comorbidities like osteoporosis, concomitant tissue injury, and ischemia may strongly interfere with bone regeneration. However, underlying mechanisms are still unclear. To study these mechanisms in detail, appropriate animal models are needed. For decades, bone healing has been studied in large animals, including dogs, rabbits, pigs, or sheep. However, large animal models display a limited ability to study molecular pathways and cellular functions. Therefore in recent years, mice and rats have become increasingly popular as a model organism for fracture healing research due to the availability of molecular analysis tools and transgenic models. Both large and small animals can be used to study comorbidities and risk factors, modelling the human clinical situation. However, attention has to be paid when choosing an appropriate model due to species differences between large animals, rodents, and humans. This review focuses on large and small animal models for the common comorbidities ischemic injury/reduced vascularization, osteoporosis, and polytrauma, and critically discusses the translational and molecular aspects of these models. Here, we review material which was presented at the workshop "Animal Models of Comorbidities in Fracture Healing Research" at the 2019 ORS Annual Meeting in Austin Texas. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2491-2498, 2019.


Assuntos
Comorbidade , Modelos Animais de Doenças , Consolidação da Fratura , Animais , Consolidação da Fratura/fisiologia , Humanos , Traumatismo Múltiplo/fisiopatologia , Osteoporose/fisiopatologia
15.
Biomed Res Int ; 2019: 4789679, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31467895

RESUMO

Objectives: Chronic inflammatory disease might affect osteoporosis; however, few studies have reported the association between herpes zoster and osteoporosis. The goal of this study was to estimate the association between herpes zoster and osteoporosis in Korean residents. Methods: The Korean National Health Insurance Service-National Sample Cohort, which includes individuals aged ≥ 50 years, was assessed from 2002 to 2013. In total, 68,492 osteoporosis participants were matched with 68,492 control participants at a ratio of 1:1 by age, sex, income, and region of residence. We assayed the prior histories of herpes zoster in the osteoporosis and control groups. The diagnoses of herpes zoster and osteoporosis were based on ICD-10 codes and claim codes. Crude and adjusted models of odds ratios (ORs) were explored using conditional logistic regression analyses, and the 95% confidence intervals (CIs) were computed. The participants were stratified according to age, sex, income, and region of residence. Subgroup analyses were performed to investigate the role of age and sex. Results: The rate of herpes zoster in the osteoporosis group (5.1% [3,487/68,492]) was higher than that in the control group (4.0% [2,738/68,492]). The adjusted OR of herpes zoster in the osteoporosis group was 1.17 (95% CI = 1.11-1.24). In the subgroup analyses, the adjusted OR was 1.34 (95% CI = 1.01-1.78) among males aged < 65 years, 1.20 (95% CI = 1.12-1.29) among females aged < 65 years, and 1.19 (95% CI = 1.04-1.36) among males aged ≥ 65 years. Conclusion: The ORs of herpes zoster were increased among the osteoporosis patients. This correlation was reliable in all subgroups by age and sex except group of women ≥ 65 years old.


Assuntos
Herpes Zoster/epidemiologia , Herpesvirus Humano 3/patogenicidade , Osteoporose/epidemiologia , Fatores Etários , Idoso , Estudos de Casos e Controles , Feminino , Herpes Zoster/complicações , Herpes Zoster/fisiopatologia , Herpes Zoster/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/complicações , Osteoporose/fisiopatologia , Osteoporose/virologia , República da Coreia/epidemiologia , Fatores de Risco , Fatores Sexuais
16.
Aging Clin Exp Res ; 31(11): 1549-1556, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31317519

RESUMO

BACKGROUND: As the general population is aging worldwide, the incidence of sarcopenia and osteoporosis is also rapidly increasing. Studies have found the link between sarcopenia and osteoporosis, but the relationship between sarcopenia and osteoporosis, especially bone microarchitecture, remains unclear. AIMS: To investigate the relationship between components of sarcopenia (muscle mass, handgrip strength, and gait speed) and components of osteoporosis [bone mass measured by bone mineral density (BMD) and bone microarchitecture measured by trabecular bone score (TBS)] in Chinese subjects. METHODS: 318 Chinese men and 203 Chinese women were included in our study. Muscle mass and BMD were measured by dual-energy X-ray absorptiometry (DXA). TBS iNsight® software was used for TBS. Jamar hydraulic hand dynamometer was used to assess muscle strength, and gait speed was used to assess physical performance. RESULTS: We found that the relative appendicular skeletal muscle mass (RASM) in both genders and handgrip strength in women correlated positively with TBS, RASM in men and handgrip strength in women correlated positively with BMDs. In the multiple linear regression model, RASM was positively associated with TBS in both genders, but no significant association was observed between RASM and BMDs. Interestingly, handgrip strength showed positive association with all evaluated BMDs and TBS in women, but not in men. Women with sarcopenia had lower TBS and BMDs at all evaluated sites. Men with sarcopenia had lower BMDs only at femur neck and total hip. CONCLUSIONS: The reduction of muscle mass and strength was significantly associated with decreased bone mass and deteriorated bone microarchitecture. More importantly, low muscle mass is an independent risk factor for bone microarchitecture in Chinese subjects.


Assuntos
Densidade Óssea/fisiologia , Osso Esponjoso/fisiologia , Osteoporose/fisiopatologia , Sarcopenia/fisiopatologia , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Força Muscular/fisiologia , Osteoporose/diagnóstico , Sarcopenia/diagnóstico , Fatores Sexuais , Velocidade de Caminhada
17.
Int J Med Sci ; 16(6): 822-830, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31337955

RESUMO

Electrical stimulation (ES)-induced muscle contraction has multiple effects; however, mechano-responsiveness of bone tissue declines with age. Here, we investigated whether daily low-frequency ES-induced muscle contraction treatment reduces muscle and bone loss and ameliorates bone fragility in early-stage disuse musculoskeletal atrophy in aged rats. Twenty-seven-month-old male rats were assigned to age-matched groups comprising the control (CON), sciatic nerve denervation (DN), or DN with direct low-frequency ES (DN+ES) groups. The structural and mechanical properties of the trabecular and cortical bone of the tibiae, and the morphological and functional properties of the tibialis anterior (TA) muscles were assessed one week after DN. ES-induced muscle contraction force mitigated denervation-induced muscle and trabecular bone loss and deterioration of the mechanical properties of the tibia mid-diaphysis, such as the stiffness, but not the maximal load, in aged rats. The TA muscle in the DN+ES group showed significant improvement in the myofiber cross-sectional area and muscle force relative to the DN group. These results suggest that low-frequency ES-induced muscle contraction treatment retards trabecular bone and muscle loss in aged rats in early-stage disuse musculoskeletal atrophy, and has beneficial effects on the functional properties of denervated skeletal muscle.


Assuntos
Envelhecimento/fisiologia , Terapia por Estimulação Elétrica/métodos , Músculo Esquelético/fisiopatologia , Transtornos Musculares Atróficos/terapia , Osteoporose/terapia , Animais , Densidade Óssea/fisiologia , Modelos Animais de Doenças , Masculino , Contração Muscular/fisiologia , Denervação Muscular/efeitos adversos , Músculo Esquelético/inervação , Transtornos Musculares Atróficos/etiologia , Transtornos Musculares Atróficos/fisiopatologia , Osteoporose/fisiopatologia , Ratos , Ratos Endogâmicos F344 , Tíbia/fisiopatologia , Resultado do Tratamento
18.
Osteoporos Int ; 30(9): 1865-1872, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31317248

RESUMO

We studied 46,797 older adults who initiated denosumab in Ontario, Canada. Patient characteristics remained relatively stable over time and aligned with public reimbursement restrictions. Almost half of patients persisted with therapy for at least 3 years. Fifty-nine percent of patients who discontinued denosumab returned to treatment within 3.6 years. INTRODUCTION: The purpose of this study was to describe the characteristics of patients who initiated denosumab and estimate persistence with therapy. METHODS: We identified older adults (aged ≥ 66 years) in Ontario who initiated denosumab between 2012/02 and 2015/03 and followed them to 2016/03. Patient characteristics were summarized using medical and pharmacy claims in the year before starting denosumab and osteoporosis drug use considered since 1996/10. Persistence with denosumab and return after discontinuation (> 90-day gap) were estimated using Kaplan-Meier curves. Analyses were stratified by community and long-term care (LTC) residence. RESULTS: We identified 46,797 patients (monthly mean = 1263, SD = 187); 97% female, 13% LTC. Community-dwelling patients had a higher prevalence of bone mineral density testing (62% vs. 5%), yet were younger (mean age 78.5 vs. 86.6 years) and had lower prevalence of hip fractures (3% vs. 10%) compared to LTC patients. Eighty-two percent of patients had used osteoporosis medications in the past; 99% of whom took an oral bisphosphonate. Persistence was similar between community-dwelling and LTC patients: 59% persisted ≥ 2 years, 48% ≥ 3 years, and 38% ≥ 4 years, yet a larger proportion of LTC patients returned to denosumab after discontinuation (76% vs. 57%). CONCLUSIONS: Denosumab utilization is increasing at a steady rate in Ontario. However, persistence remains a concern given the highly reversible pharmacokinetic profile of denosumab that results in a rapid increased fracture risk following discontinuation. Over 80% of patients had a history of oral bisphosphonate therapy, which may persist in bone despite discontinuing denosumab. Consequently, better understanding of denosumab safety and effectiveness among real-world users is important.


Assuntos
Conservadores da Densidade Óssea/uso terapêutico , Denosumab/uso terapêutico , Adesão à Medicação/estatística & dados numéricos , Osteoporose/tratamento farmacológico , Idoso , Idoso de 80 Anos ou mais , Densidade Óssea/efeitos dos fármacos , Conservadores da Densidade Óssea/administração & dosagem , Bases de Dados Factuais , Denosumab/administração & dosagem , Esquema de Medicação , Uso de Medicamentos/estatística & dados numéricos , Feminino , Seguimentos , Fraturas do Quadril/epidemiologia , Fraturas do Quadril/fisiopatologia , Fraturas do Quadril/prevenção & controle , Humanos , Estimativa de Kaplan-Meier , Masculino , Ontário/epidemiologia , Osteoporose/epidemiologia , Osteoporose/fisiopatologia , Osteoporose Pós-Menopausa/tratamento farmacológico , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose Pós-Menopausa/fisiopatologia , Fraturas por Osteoporose/epidemiologia , Fraturas por Osteoporose/fisiopatologia , Fraturas por Osteoporose/prevenção & controle , Pacientes Desistentes do Tratamento/estatística & dados numéricos , Características de Residência/estatística & dados numéricos
19.
Mol Med Rep ; 20(3): 2851-2858, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31322188

RESUMO

Glucocorticoids are the most common cause of glucocorticoid­induced osteoporosis (GIOP). Moreover, the role of circular RNAs (circRNAs) in the regulation of bone metabolism remains unclear. Therefore, in the present study, it was hypothesized that hsa_circ_0006393 may play an important role in GIOP. To investigate the role of circRNAs in GIOP, treatment with dexamethasone or transfection with a vector overexpressing hsa_circ_0006393 were performed using in vitro cell and in vivo mouse models. Reverse transcription­quantitative PCR, fluorescence in situ hybridization and western blotting were performed to investigate the function of hsa_circ_0006393 in vitro. In addition, the effects of hsa_circ_0006393 on osteogenesis were investigated. Dual­energy X­ray absorptiometry analysis was performed to examine the osteogenic potential of hsa_circ_0006393 in vivo. Moreover, the mechanism underlying hsa_circ_0006393­mediated bone metabolism regulation via the microRNA (miR)­145­5p/forkhead box O1 (FOXO1) pathway was investigated. The present results suggested that the expression level of hsa_circ_0006393 was decreased in patients with GIOP. Furthermore, the overexpression of hsa_circ_0006393 increased the expression level of genes associated with osteogenesis. Moreover, hsa_circ_0006393 was identified to be localized mainly in the cytoplasm and nucleus of bone marrow mesenchymal stem cells. miR­145­5p was found to be directly targeted by hsa_circ_0006393. Collectively, hsa_circ_0006393 increases the expression levels of osteogenic genes during bone remodeling by sponging miR­145­5p and upregulating FOXO1.


Assuntos
Proteína Forkhead Box O1/genética , MicroRNAs/genética , Osteogênese , Osteoporose/genética , /genética , Adulto , Idoso , Animais , Células Cultivadas , Regulação para Baixo , Feminino , Glucocorticoides , Humanos , Masculino , Camundongos Endogâmicos C57BL , Pessoa de Meia-Idade , Osteoporose/induzido quimicamente , Osteoporose/fisiopatologia , Regulação para Cima
20.
Comput Methods Biomech Biomed Engin ; 22(13): 1093-1102, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31268350

RESUMO

Osteoporosis (OP) is common with advancing age. Several studies have shown a strong correlation between OP and otosclerosis. However, no studies have investigated OP of the malleus, incus or stapes in the human middle ear, its effect on middle ear transfer function. Here, we investigate whether these three ossicles develop OP, and how this affects middle ear transfer function. The effect of OP on middle ear transfer function was investigated in simulations based on a finite element (FE) method. First, the FE model used in our previous study was refined, and optimized by introducing viscoelastic properties to selected soft tissues of the middle ear. Then, the FE model was used to simulate OP of the three ossicles and assess its influence on middle ear transfer function. Other possible age-related changes, such as stiffness of the joints or ligaments in the middle ear, were also investigated. The results indicated that OP of the ossicles could increase the high frequency displacement of both the umbo and stapes footplate (FP). However, the stiffness of the middle ear soft tissue can lead to the decrease of middle ear gain at lower frequencies. Furthermore, loosening of these joints or ligaments could increase displacement of the umbo and stapes FP. In conclusion, although age-related hearing loss is most commonly conceived of as sensorineural hearing loss (SNHL), we found that age-related changes may also include OP and changes in joint stiffness, but these will have little effect on middle ear transfer function in elderly people.


Assuntos
Envelhecimento/fisiologia , Orelha Média/fisiologia , Idoso , Simulação por Computador , Módulo de Elasticidade , Análise de Elementos Finitos , Humanos , Ligamentos/fisiologia , Osteoporose/fisiopatologia , Estribo/fisiologia , Viscosidade
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