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Braz J Med Biol Res ; 52(12): e8754, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31826180


Cuscuta chinensis Lam. (Convolvulaceae) is an important herbal medicine widely used to improve sexual function, treat osteoporosis, and prevent aging, and has been reported to exhibit anti-osteoporotic effects in vitro. However, the activity of Cuscuta chinensis Lam. on glucocorticoid-induced osteoporosis still remains unclear. The present study aimed to assess the protective effect and the underlying mechanism of action of Cuscuta chinensis extract (CCE) against glucocorticoid-induced osteoporosis in vivo. Sprague-Dawley rats were randomly divided into four groups as follows: control group, osteoporosis group, and 2 CCE-treated osteoporosis groups (100 mg·kg-1·day-1). Blood samples and femur bones were collected for immunohistochemistry, biochemical, mRNA expression, and western blot analysis. HPLC analysis revealed that chlorogenic acid, quercetin, and hyperin were the major constituents of CCE. The results indicated that CCE increased bone length, bone weight, and bone mineral density and suppressed dexamethasone (DEX)-induced reduction in body weight. In addition, TRAP staining indicated that CCE reduced osteoclasts in DEX-induced osteoporosis rats. Mechanistically, CCE treatment alleviated the increase of bone resorption markers and the decline of osteogenic markers, which might be partially mediated by regulation of RANKL/OPG and RunX2 pathways. These results suggest that CCE showed promising effects in the protection against glucocorticoid-induced osteoporosis through protecting osteoblasts and suppressing osteoclastogenesis.

Cuscuta/química , Dexametasona/farmacologia , Glucocorticoides/farmacologia , Osteoporose/prevenção & controle , Osteoprotegerina/metabolismo , Extratos Vegetais/farmacologia , Ligante RANK/metabolismo , Animais , Western Blotting , Densidade Óssea/efeitos dos fármacos , Cromatografia Líquida de Alta Pressão , Imuno-Histoquímica , Osteoporose/induzido quimicamente , Osteoprotegerina/efeitos dos fármacos , Ligante RANK/efeitos dos fármacos , RNA Mensageiro , Ratos , Ratos Sprague-Dawley
Int J Sports Med ; 40(14): 931-940, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31639865


Exercise is an effective way to prevent osteoporosis, but its mechanism remains unclear. MicroRNAs (miRNAs) play an essential role in bone metabolism. Recently, mechanical loading was reported to induce changes in miRNA expression in osteoblasts. However, the role of miRNAs in bone under exercise and its underlining mechanisms of action still remain unknown. MiR-214 was reported to regulate the process of osteogenesis and is considered a biomarker of osteoporosis. In this study, we aimed to investigate whether exercise could induce changes in miRNA expression in bone and to study the effects of miR-214 on mechanical loading-induced osteogenesis in osteoblasts. The results showed that miR-214 was down-regulated in both tibia from C57BL/6 mice after exercise in vivo and in osteoblasts after mechanical strain in vitro. Mechanical strain could enhance the ALP activity, promote matrix mineralization, up-regulate the expression of osteogenic factors such as ATF4, Osterix, ALP and ß-catenin, and down-regulate RANKL and RANK expression. Over-expression of miR-214 not only inhibited the expression of these osteogenic factors but also attenuated mechanical strain-enhanced osteogenesis in osteoblasts. Collectively, our results indicated that miR-214 could attenuate the osteogenic effects of mechanical loading on osteoblasts, suggesting that inhibition of miR-214 may be one of the ways in which exercise prevents osteoporosis.

MicroRNAs/fisiologia , Osteoblastos/fisiologia , Osteogênese/fisiologia , Condicionamento Físico Animal , Animais , Diferenciação Celular , Células Cultivadas , Regulação para Baixo , Expressão Gênica , Masculino , Células-Tronco Mesenquimais/fisiologia , Camundongos Endogâmicos C57BL , MicroRNAs/genética , Modelos Animais , Osteoblastos/citologia , Osteoporose/prevenção & controle , Distribuição Aleatória , Estresse Mecânico
Pan Afr Med J ; 33: 37, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31384352


Introduction: Osteoporosis is characterized by low bone mass and density, as well as change in microarchitecture of bone tissue leading to decreased bone strength. In vitro research shows nicotine can increase osteoblast activity and proliferation, also suppress osteoclast activity. Therefore we explore nicotine anti-resorptive property by in vivo true experimental and randomized posttest only controlled group research that was conducted in 18-20 weeks old Rattus norvegicus. Methods: Twenty-five female rats were divided into five groups, with 5 rats per group. The first group represented normal rats (Sham), while the second to fifth group underwent bilateral ovariectomy. The second group serves as positive control group (ovariectomy-only/OVX). The third to fifth group serve as dose 1 (P1-0.25mg/kg), dose 2 (P2-0.5 mg/kg), and Dose 3 (P3-0.75 mg/kg) treatment group receiving daily per-oral nicotine for 28 days, started 3 weeks post- ovariectomy. After 28 days treatment, the serum was checked. Results: Nicotine has dose-dependent manner on serum osteocalcin and serum DPD level. Level of osteocalcin in P2 group was significantly lower (Mann-Whitney, p = 0.008) compared to OVX group (59.4% lower). Level of DPD in all group was not significantly different (ANOVA, p < 0.05) but shows lowest level in P2 group. For serum calcitonin level, there's no significant different between groups. Conclusion: Nicotine at right low-dose might be able to inhibit osteoclast activity, thus open a possibility of anti-resorptive property of nicotine.

Densidade Óssea/efeitos dos fármacos , Nicotina/farmacologia , Osteoclastos/efeitos dos fármacos , Osteoporose/prevenção & controle , Aminoácidos/sangue , Animais , Biomarcadores/metabolismo , Remodelação Óssea/efeitos dos fármacos , Osso e Ossos/efeitos dos fármacos , Modelos Animais de Doenças , Relação Dose-Resposta a Droga , Feminino , Nicotina/administração & dosagem , Osteoblastos/efeitos dos fármacos , Osteoblastos/metabolismo , Osteocalcina/sangue , Osteoclastos/metabolismo , Osteoporose/patologia , Ovariectomia , Ratos , Ratos Wistar
Medicine (Baltimore) ; 98(32): e16770, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31393399


BACKGROUND: Osteoporosis is a major side effect of aromatase inhibitors (AIs), which are greatly effective in the treatment of breast cancer. However, there are no satisfactory measures against osteoporosis. In this multicenter, randomized, comparative study, we evaluate the efficacy of denosumab for preventing loss of bone mineral density (BMD) induced by adjuvant therapy with AI s in breast cancer patients with normal BMD. PATIENTS AND METHODS: The bone loss-suppressing effect of denosumab will be comparatively evaluated in postmenopausal patients scheduled to receive letrozole or anastrozole as a postoperative endocrine therapy for stage I-IIIA hormone-sensitive breast cancer and a control group. Patients will be administered letrozole 2.5 mg or anastrozole 1 mg once a day, and the treatment will be continued for 5 years unless recurrence, secondary cancer, or unacceptable toxicity develops. Patients in the denosumab group will receive a subcutaneous injection of 60 mg of denosumab every 6 months. The primary endpoint is the rate of change in the lumbar spine (L1-L4) BMD, as determined by dual-energy X-ray absorptiometry (DXA), 12 months after the start of the injection. The secondary endpoints were ETHICS AND DISSEMINATION:: The protocol was approved by the institutional review boards of Kyoto Prefectural University of Medicine and all the participating faculties. Written informed consent was obtained from all patients before registration, in accordance with the Declaration of Helsinki. Results of the study will be disseminated via publications in peer-reviewed journals. TRIAL REGISTRATION: Clinical Identifier: NCT03324932, Japan Registry of Clinical Trial (jRCT): CRB5180001.

Inibidores da Aromatase/efeitos adversos , Densidade Óssea/efeitos dos fármacos , Denosumab/administração & dosagem , Osteoporose/induzido quimicamente , Osteoporose/prevenção & controle , Adulto , Inibidores da Aromatase/uso terapêutico , Biomarcadores , Osso e Ossos/metabolismo , Neoplasias da Mama/tratamento farmacológico , Intervalo Livre de Doença , Feminino , Fraturas Ósseas/epidemiologia , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Projetos de Pesquisa
J Bone Joint Surg Am ; 101(15): 1413-1419, 2019 Aug 07.
Artigo em Inglês | MEDLINE | ID: mdl-31393435


Worldwide, osteoporosis management is in crisis because of inadequate delivery of care, competing guidelines, and confusing recommendations. Additionally, patients are not readily accepting the diagnosis of poor bone health and often are noncompliant with treatment recommendations. Secondary fracture prevention, through a program such as Own the Bone, has improved the diagnosis and medical management after a fragility fracture. In patients who undergo elective orthopaedic procedures, osteoporosis is common and adversely affects outcomes. Bone health optimization is the process of bone status assessment, identification and correction of metabolic deficits, and initiation of treatment, when appropriate, for skeletal structural deficits. The principles of bone health optimization are similar to those of secondary fracture prevention and can be initiated by all orthopaedic surgeons. Patients who are ≥50 years of age should be assessed for osteoporosis risk and, if they are in a high-risk group, bone density should be measured. All patients should be counseled to consume adequate vitamin D and calcium and to discontinue use of any toxins (e.g., tobacco products and excessive alcohol consumption). Patients who meet the criteria for pharmaceutical therapy for osteoporosis should consider delaying surgery for a minimum of 3 months, if feasible, and begin medication treatment. Orthopaedic surgeons need to assume a greater role in the care of bone health for our patients.

Conservadores da Densidade Óssea/uso terapêutico , Saúde Global , Programas de Rastreamento/organização & administração , Osteoporose/prevenção & controle , Fraturas por Osteoporose/prevenção & controle , Absorciometria de Fóton/métodos , Idoso , Osso e Ossos/fisiologia , Feminino , Nível de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Determinação de Necessidades de Cuidados de Saúde , Ortopedia/organização & administração , Osteoporose/epidemiologia , Prevenção Secundária/métodos , Sociedades Médicas/organização & administração , Vitamina D/uso terapêutico
Cas Lek Cesk ; 158(3-4): 107-111, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31416316


Tibolon is the only therapeutic approach to climacteric symptoms, prevention of osteoporosis and urogenital atrophy with the same efficacy as hormone replacement therapy. Tibolon has more positive effects on sexuality and mood changes in menopausal women. It decreases the mammographic density. Its safety for breast cancer is the same as for only estrogen therapy and better than for estrogen-gestagen therapy. Tibolon is the first choice for postmenopausal women with mood and sexuality disorders, women with mastodynia and high mammographic density.

Moduladores de Receptor Estrogênico , Norpregnenos , Osteoporose , Neoplasias da Mama/induzido quimicamente , Clima , Moduladores de Receptor Estrogênico/efeitos adversos , Moduladores de Receptor Estrogênico/uso terapêutico , Estrogênios , Feminino , Humanos , Menopausa , Norpregnenos/efeitos adversos , Norpregnenos/uso terapêutico , Osteoporose/prevenção & controle , Progestinas
Reumatol. clín. (Barc.) ; 15(4): 211-217, jul.-ago. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-184413


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

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

Humanos , Feminino , Pessoa de Meia-Idade , Idoso , Osteoporose/epidemiologia , Unidades Hospitalares/organização & administração , Neoplasias da Mama/epidemiologia , Inibidores da Aromatase/uso terapêutico , Osteoporose/prevenção & controle , Sobreviventes de Câncer/estatística & dados numéricos , Inibidores da Aromatase/efeitos adversos , Fatores de Risco , Osteoporose Pós-Menopausa/prevenção & controle , Avaliação de Resultado de Ações Preventivas , Estudos Retrospectivos
Cell Mol Biol (Noisy-le-grand) ; 65(5): 24-31, 2019 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-31304902


This study was carried out to evaluate the preventive and curative effects of Pilose antler against osteoporosis due to kidney deficiency, and investigate its potential mechanism of action. A model of osteoporosis due to kidney deficiency was established in rats using bilateral ovariectomy. Pilose antler polypeptide (PAP), Pilose antler polysaccharide (PAP'), and their mixture (PAP+PAP') were separately administered to the rats for 12 weeks, with progynova and xianlingubao tablets (XLGB) as the positive control groups. We determined the bone mineral density (BMD) and uterus Index of the rats. Osteoblastic bone metabolism-related indices in serum and bone tissue were measured with ELISA. Western blotting and RT-PCR were used to investigate the protein and mRNA expressions of Bmp-2, Smad1, Smad5, Runx2 in bone tissue. The morphology of bone tissue was determined using immunohistochemical methods. Compared with control group, PAP, PAP', PAP+PAP' increased BMD and regulated bone metabolism indices in serum and bone tissue. Treatment with Pilose antler up-regulated the mNRA and protein expressions of Bmp-2, Smad1, Smad5 and Runx2. Immunohistochemical staining showed that Bmp-2, Smad1, Smad5 and Runx2 were stained brown, indicating that all of them were positive. There were abnormal changes in the protein expressions of Bmp-2, Smad1, Smad5 and Runx2 in bone tissue, which may be an important mechanism underlying the development of kidney deficiency osteoporosis. Moreover, PAP, PAP' and PAP+PAP' had some preventive effects on osteoporosis, probably via the activation of the Bmp-2/Smad1 and Smad5/Runx2 signaling pathways through induction of high expressions of their mRNAs and proteins.

Medicamentos de Ervas Chinesas/farmacologia , Osteoporose/etiologia , Peptídeos/farmacologia , Substâncias Protetoras/farmacologia , Insuficiência Renal/complicações , Animais , Densidade Óssea , Proteína Morfogenética Óssea 2/metabolismo , Osso e Ossos/metabolismo , Subunidade alfa 1 de Fator de Ligação ao Core/metabolismo , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/uso terapêutico , Feminino , Osteoporose/tratamento farmacológico , Osteoporose/metabolismo , Osteoporose/prevenção & controle , Ovariectomia/efeitos adversos , Peptídeos/administração & dosagem , Peptídeos/uso terapêutico , Polissacarídeos/administração & dosagem , Polissacarídeos/farmacologia , Polissacarídeos/uso terapêutico , Substâncias Protetoras/administração & dosagem , Substâncias Protetoras/uso terapêutico , RNA Mensageiro/metabolismo , Ratos , Ratos Sprague-Dawley , Transdução de Sinais/efeitos dos fármacos , Proteína Smad1/metabolismo , Proteína Smad5/metabolismo , Útero/patologia
Food Chem Toxicol ; 132: 110668, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-31299293


Ruscus aculeatus is a source of steroidal saponins that could mimic sex hormones and could help alleviate the risk of fracture in osteoporotic patients. The aim of the present study was to evaluate the in vitro effects of an extract from R. aculeatus (ERA) on the proliferation of human osteoblast-like SaOS-2 cell line and to investigate the effects of the ERA administered orally for 10 weeks at three doses (50, 100 and 200 mg/kg) on the bone structure of rats with estrogen deficiency induced by bilateral ovariectomy. Bone turnover markers, hormones, histopathological and radiological disturbances were evidenced in the ovariectomized rats. ERA recovered most of the affected parameters in a dose-dependent manner similar to diosgenin and alendronate used as positive comparators. The main active compounds of ERA (ruscogenin and neoruscogenin) were docked into the Vit. D receptor and oestrogen receptors alpha and beta, and stable complexes were found with binding scores equal to those of estradiol and diosgenin. The findings of this study provide for the first time an insight into the effects of ERA on bone structure and suggest that ERA could be developed as a potential candidate for the prevention of postmenopausal osteoporotic complications.

Osteoporose/prevenção & controle , Ovariectomia/efeitos adversos , Extratos Vegetais/uso terapêutico , Ruscus/química , Animais , Remodelação Óssea , Osso e Ossos/efeitos dos fármacos , Osso e Ossos/metabolismo , Cálcio/metabolismo , Linhagem Celular , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Feminino , Glutationa/metabolismo , Osteoblastos/citologia , Osteoblastos/efeitos dos fármacos , Osteoporose/etiologia , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/farmacologia , Ratos , Ratos Wistar
Nutr. hosp ; 36(extr.3): 3-7, jul. 2019. tab
Artigo em Espanhol | IBECS | ID: ibc-184440


La vitamina D es un nutriente esencial cuya deficiencia se ha asociado con el riesgo de aparición de diversas enfermedades crónicas, como la osteoporosis, la hipertensión arterial, la enfermedad cardiovascular, la diabetes, algunos tipos de cáncer e incluso el padecimiento de sobrepeso y obesidad. A pesar de que la vitamina D puede sintetizarse a nivel cutáneo a partir de la exposición a la luz solar, esta fuente no es siempre suficiente para cubrir las necesidades debido al uso de cremas de protección solar y a la baja exposición que se produce durante el invierno, o, como en el caso de las personas enfermas, que salen poco a la calle o se exponen poco a la luz del sol. De hecho, estudios han constatado que al menos la mitad de la población española presenta déficit de vitamina D. Por ello, el aporte dietético es fundamental. Aunque existen diferentes alimentos fortificados con esta vitamina, son pocos los productos que son una fuente natural, entre los que se encuentran los pescados grasos y los huevos. Sin embargo, de acuerdo con diferentes estudios realizados en la población española, existe un bajo consumo de este último grupo de alimentos. De esta manera, sería recomendable fomentar el consumo de huevo entre la población, ya que este alimento, además de tener numerosos nutrientes, contiene una cantidad elevada de vitamina D, lo que contribuye a evitar la aparición de deficiencias y las consecuencias negativas para la salud que ello implica

Vitamin D is an essential nutrient whose deficiency has been associated with the risk of various chronic diseases such as osteoporosis, hypertension, cardiovascular disease, diabetes, some types of cancer and even overweight and obesity. Although vitamin D can be synthesized at the skin from exposure to sunlight, this source is not always sufficient to meet the needs. For example, the use of sunscreen or the low exposition to the sunlight limits the syntheses. In fact, studies have found that at least half of the Spanish population has vitamin D deficits. Therefore, the dietary contribution is fundamental. Although there are different foods fortified in this vitamin, few products are natural source of it, as fatty fish and eggs. However, according to different studies carried out in the Spanish population, there is a low consumption of this food group. In this way, it would be advisable to promote egg consumption among the population, since this food, in addition to having many nutrients, contains a high amount of vitamin D, which contributes to avoid the appearance of deficiencies and the consequences health consequences that this implies

Humanos , Deficiência de Vitamina D/complicações , Deficiência de Vitamina D/dietoterapia , Proteínas do Ovo/administração & dosagem , Doença Crônica/prevenção & controle , Vitamina D/administração & dosagem , Osteoporose/dietoterapia , Osteoporose/prevenção & controle , Deficiência de Vitamina D/metabolismo , Vitamina D/metabolismo
PLoS One ; 14(5): e0217223, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31150426


BACKGROUND: Although intake of fruits and vegetables seemed to have a protective effect on bone metabolism, its effect on fractures remains uncertain. METHODS: A systematic review of randomized controlled trials (RCTs) and cohort studies (PROSPERO: CRD42016041462) was performed. RCTs and cohort studies that evaluated the combined intake of fruits and vegetables in men and women aged over 50 years were included. We considered fractures as a primary outcome measure. Changes in bone markers were considered as secondary outcomes. The search strategy included the following descriptors: fruit, vegetables, vegetable products, bone and bones, bone fractures, postmenopausal osteoporosis, and osteoporosis. PubMed, Embase, and Cochrane Library were the databases used. The appraisal of the studies was performed by two independent reviewers, and discussed and agreed upon by both examiners. The data extracted from the RCTs and cohort studies were summarized separately. The risks of fractures were combined across studies using random models. Bone resorption marker (CTx) was summarized with standardized mean differences. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) method was used to evaluate the strength of recommendations. RESULTS: Of the 1,192 studies screened, 13 articles were included in the systematic review and 10 were included in the pooled analysis (6 cohort studies and 4 RCTs). The six cohort studies included in the meta-analysis included a population of 225,062. The pooled hazard ratio (HR) (95% confidence interval (CI)) of the hip in five studies was 0.92 (0.87, 0.98). Its heterogeneity was moderate (I2 = 55.7%, p = 0.060), GRADE (⊕⊕⊕O). Two cohort studies evaluated the risk of any fracture; the HR was 0.90 (95% CI: 0.86-0.96), with aheterogeneity of 24.9% (p = 0.249, GRADE (⊕⊕⊕O)). There was no association between the bone resorption marker CTx and 3 months of fruit and vegetable intake evaluated by four RCTs, GRADE (⊕⊕O O). CONCLUSION: There was an association between the increase of at least one serving of fruits and vegetables per day and decreases in the risk of fractures. The level of evidence for this association is moderate.

Fraturas Ósseas/prevenção & controle , Frutas , Osteoporose/prevenção & controle , Verduras , Comportamento Alimentar , Fraturas Ósseas/epidemiologia , Humanos , Incidência , Osteoporose/epidemiologia
Nursing (Säo Paulo) ; 22(253): 2916-2919, jun.2019.
Artigo em Português | LILACS, BDENF - Enfermagem | ID: biblio-1023862


Avaliar os fatores de risco desde a adolescência, para o desenvolvimento da osteoporose. Trata-se de um estudo de revisão integrativa da literatura, onde foram utilizadas 4 etapas para analisar os artigos: 1ª etapa - linha norteadora. 2ª etapa - pesquisa bibliográfica na eletrônica de acesso aberto SciELO. 3ª etapa - leitura do título seguido do resumo do artigo desta pesquisa. 4ª etapa - interpretação/avaliação dos resultados foi baseada nas características. Foram localizados nas bases de dados da SciELO como: Coleção Brasil, Periódico Todos, Idioma Português, Ano de Publicação 2012 a 2018, SciELO Área Temática Ciências da Saúde. Foram localizados 187 artigos. A osteoporose pode ser prevenida na sua na forma secundária, a melhor estratégia para prevenção deve ser instituída a partir da infância.(AU)

To evaluate risk factors from adolescence to the development of osteoporosis. It is an integrative review of the literature, where 4 steps were used to analyze the articles: 1st stage - guiding line. 2nd stage - bibliographic research in the open access electronics SciELO. Step 3 - reading the title followed by the summary of the article of this research. Stage 4 - interpretation / evaluation of results was based on characteristics. It was located in the databases of SciELO as: Collection Brazil, Periodical All, Portuguese Language, Year of Publication 2012 to 2018, SciELO Subject Area Health Sciences. 187 articles were found. Osteoporosis can be prevented in its in the secondary form, the best strategy for prevention should be instituted from childhood. Keywords: adolescent; osteoporosis; health promotion.(AU)

Evaluar los factores de riesgo desde la adolescencia, para el desarrollo de la osteoporosis. Se trata de un estudio de revisión integrativa de la literatura, donde se utilizaron 4 etapas para analizar los artículos: 1ª etapa - línea orientadora. 2ª etapa - investigación bibliográfica en la electrónica de acceso abierto SciELO. 3ª etapa - lectura del título seguido del resumen del artículo de esta investigación. 4ª etapa - interpretación / evaluación de los resultados se basó en las características. Se encuentra en las bases de datos SciELO como: Colección Brasil, regular todo, el lenguaje portugués, Año de publicación 2012 y 2018, SciELO Área temática Ciencias de la Salud se localizaron 187 artículos. La osteoporosis puede prevenirse en su forma secundaria, la mejor estrategia para la prevención debe ser instituida a partir de la infancia.(AU)

Humanos , Masculino , Feminino , Adolescente , Osteoporose , Osteoporose/prevenção & controle , Fatores de Risco , Saúde do Adolescente , Promoção da Saúde
Rev. patol. respir ; 22(2): 53-58, abr.-jun. 2019. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-185769


La vitamina D juega un papel fundamental en el proceso del remodelado óseo fisiológico y su déficit puede afectar de forma negativa al hueso. Los glucocorticoides son unos fármacos ampliamente utilizados y que presentan diversos mecanismos a través de los cuales producen una disminución de la calidad y cantidad de masa ósea, representando la causa más frecuente de osteoporosis secundaria. Durante el tratamiento es importante realizar una adecuada valoración del riesgo de fractura utilizando para ello la anamnesis y exploración física además de pruebas complementarias como analítica, densitometría ósea y herramientas que estimen el riesgo de fractura. El aporte de calcio y vitamina D para mantener unos niveles adecuados es recomendado por todas las sociedades científicas tanto en pacientes que precisen tratamiento antirresortivo como en aquellos en los que no sea necesario. Por otra parte, el déficit de vitamina D se ha relacionado con ciertas patologías respiratorias pudiendo influir en el hueso

Vitamin D plays a fundamental role in the physiologic osseous remodeling and their deficiency can negatively affect the bone. Glucocorticoids are drugs widely used and produce a decrease in the quality and quantity of bone mass by differents mechanisms, representing the most frequent cause of secondary osteoporosis. During the treatment, it is important to make and adequate assessment of fracture risk using anamnesis and physical examination, as well as complementary test such as blood test, bone densitometry and tools that estimate the risk of fracture. The contribution of calcium and vitamin D to maintain adequate levels is recommended by all scientific societies both in patients requiring antiresorptive treatment and in those in which it is not neccesary. On the other hand, the deficit of vitamin D has been related to certain respiratory pathologies being able to influence in the bone

Humanos , Corticosteroides/efeitos adversos , Deficiência de Vitamina D , Vitamina D/administração & dosagem , Densidade Óssea/efeitos dos fármacos , Osteoporose/induzido quimicamente , Osteoporose/prevenção & controle , Glucocorticoides/efeitos adversos , Doenças Respiratórias/tratamento farmacológico , Corticosteroides/administração & dosagem , Glucocorticoides/administração & dosagem
Biomed Pharmacother ; 115: 108916, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31054506


Lipopolysaccharide (LPS) can induce bone loss by stimulating osteoclast formation. Colony-stimulating factor 1 receptor (CSF 1R) inhibitors have great potential for the treatment of rheumatoid arthritis and tumor-related bone erosion. However, its role in LPS-induced bone loss is still not clarified. In this study, we observed the effects of CSF 1R inhibitor, PLX3397, on LPS-induced bone damage in an animal model. The models were established by LPS administration in male Sprague-Dawley rats. PLX3397 (30 mg/kg body weight) was given by oral gavage. MicroCT analysis, biomechanical properties, biomarker assay, histological examination, and mRNA expression of osteoclast differentiation-related genes (Traf6, Fra1, c-fos and NFATc1) were performed on the 8th week. LPS induced bone loss was shown as the decrease in bone volume fraction and trabecular number and increase in trabecular separation (p < 0.05). LPS exposure also markedly decreased the bone biomechanical properties. PLX3397 significantly abolished the LPS-induced bone microstructure damage (p < 0.05) and loss of biomechanical properties. PLX3397 also inhibited the increases of serum tartrate-resistant acid phosphatase 5b level enhanced by LPS (p < 0.05). PLX3397 attenuated the high expression of Traf6, Fra1, c-fos and NFATc1 stimulated by LPS. Our data demonstrated that PLX3397, a type of CSF 1R inhibitor, can suppress LPS-induced bone loss via the inhibition osteoclast formation.

Aminopiridinas/farmacologia , Reabsorção Óssea/prevenção & controle , Osteoclastos/efeitos dos fármacos , Osteoporose/prevenção & controle , Pirróis/farmacologia , Receptor de Fator Estimulador de Colônias de Macrófagos/antagonistas & inibidores , Animais , Fenômenos Biomecânicos , Densidade Óssea/efeitos dos fármacos , Reabsorção Óssea/metabolismo , Reabsorção Óssea/patologia , Osso Esponjoso/efeitos dos fármacos , Osso Esponjoso/metabolismo , Osso Esponjoso/patologia , Modelos Animais de Doenças , Lipopolissacarídeos/farmacologia , Masculino , Osteoclastos/metabolismo , Osteoclastos/patologia , Osteoporose/induzido quimicamente , Osteoporose/metabolismo , Osteoporose/patologia , Ratos Sprague-Dawley , Tíbia/efeitos dos fármacos , Tíbia/metabolismo , Tíbia/patologia
Biomed Res Int ; 2019: 8171897, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31139653


Physical activity or appropriate exercise prevents the development of osteoporosis. However, the exact mechanism remains unclear although it is well accepted that exercise or mechanical loading regulates the hormones, cytokines, signaling pathways, and noncoding RNAs in bone. Accumulating evidence has shown that bone is a highly vascularized tissue, and dysregulation of vasculature is associated with many bone diseases such as osteoporosis or osteoarthritis. In addition, exercise or mechanical loading regulates bone vascularization in bone microenvironment via the modulation of angiogenic mediators, which play a crucial role in maintaining skeletal health. This review discusses the effects of exercise and its underlying mechanisms for osteoporosis prevention, as well as an angiogenic and osteogenic coupling in response to exercise.

Osso e Ossos/irrigação sanguínea , Exercício/fisiologia , Neovascularização Fisiológica , Osteoporose/prevenção & controle , Humanos , Osteogênese , Transdução de Sinais
Adv Nutr ; 10(suppl_2): S120-S143, 2019 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-31089740


Nutrition plays an important role in bone health. The aim of our study was to update the evidence regarding dairy intake, osteoporotic fracture (OF) risk, and prospective bone mass density (BMD) evolution assessed by dual-energy X-ray absorptiometry in Europeans and non-Hispanic whites from North America. A systematic search was conducted in MEDLINE, EMBASE, and Scopus for papers published from 1 January, 2000 to 30 April, 2018. The eligibility criteria were as follows: healthy adults; measurable dairy exposure; hip, vertebral, wrist or OF as outcomes; and cohort or case-control studies. Two independent investigators conducted the search and the data extraction. A pooled analysis was conducted with random-effects models. Publication bias and meta-regression were considered. Ten cohort studies relating to OF risk were selected for meta-analysis. Three papers reporting BMD changes associated with dairy intake could not be aggregated in the meta-analysis. The pooled HRs of the highest compared with the lowest levels of dairy intake were 0.95 (95% CI: 0.87, 1.03; I2 = 82.9%; P-heterogeneity < 0.001) for OF at any site; 0.87 (95% CI: 0.75, 1.01; I2 = 86.7%; P-heterogeneity < 0.001) for hip fractures; and 0.82 (95% CI: 0.68, 0.99; I2 = 0.0%; P-heterogeneity = 0.512) for vertebral fractures. Concerning BMD, the selected studies described a 1.7-3% lower hip BMD in young and postmenopausal women with poor intake of milk in their youth, a positive relationship between baseline milk ingestion and the percentage of trochanter BMD change in elderly people, and a positive correlation between milk consumption and BMD change at the radius in women aged >65 y. In conclusion, in the studied population, the highest consumption of dairy products did not show a clear association with the total OF or hip fracture risks; however, a diminished risk of vertebral fracture could be described. The results regarding BMD change were heterogeneous and did not allow for a definitive conclusion.

Osso e Ossos , Laticínios , Dieta , Grupo com Ancestrais do Continente Europeu , Comportamento Alimentar , Fraturas Ósseas/prevenção & controle , Osteoporose/prevenção & controle , Adulto , Idoso , Idoso de 80 Anos ou mais , Animais , Densidade Óssea , Osso e Ossos/lesões , Osso e Ossos/metabolismo , Europa (Continente) , Feminino , Fraturas do Quadril/prevenção & controle , Humanos , Masculino , Pessoa de Meia-Idade , Leite , América do Norte , Fraturas por Osteoporose/prevenção & controle , Fraturas da Coluna Vertebral/prevenção & controle , Adulto Jovem
ABCS health sci ; 44(1): 22-27, 02 maio 2019.
Artigo em Português | LILACS | ID: biblio-995008


INTRODUÇÃO: Entre pacientes diagnosticados e em tratamento para osteoporose, acredita-se que há desconhecimento geral sobre a doença. Entre os pacientes em faixa etária de risco, não diagnosticados, crê-se que o desconhecimento é maior. OBJETIVO: Avaliar as considerações de mulheres sobre o conceito da osteoporose e sua prevenção. MÉTODOS: Estudo qualitativo, descritivo, realizado no Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, com 10 pacientes portadores de osteoporose, e 10 pacientes sem. A tabulação dos dados ocorreu por meio da utilização de três figuras metodológicas: ideia central, expressões chave e o discurso sujeito coletivo. O estudo foi aprovado pelo Comitê de Ética e Pesquisa com Seres Humanos. RESULTADOS: Dentre as pacientes com diagnóstico, destacou-se como ideias centrais a vulnerabilidade às fraturas e os conceitos de apresentação da doença como osteopenia e osteoporose. No grupo sem diagnóstico, 40% desconhecia a doença. Na prevenção, observou-se maior conhecimento no grupo portador da doença, sendo as ideias centrais destacadas: os exercícios físicos, alimentação rica em cálcio e vitamina D, além da exposição solar. CONCLUSÃO: Evidenciou-se um conhecimento limitado sobre a osteoporose e suas formas de prevenção, sobretudo no grupo sem diagnóstico, porém em faixa etária de risco. Assim, conclui-se que, tratando-se de uma doença de elevada prevalência, de altos custos orçamentários para a saúde pública, e com riscos significativos uma vez não diagnosticados e não tratada, medidas resolutivas de maior esclarecimento sobre a doença devem ser praticadas em todas as esferas da saúde pública.

INTRODUCTION: Among patients diagnosed and under treatment for osteoporosis, it is believed that there is general ignorance about the disease. Among undiagnosed patients at risk, it is believed that the lack of knowledge is larger. OBJECTIVE: To evaluate the considerations of women about the concept of osteoporosis and its prevention. METHODS: A qualitative, descriptive study was carried out at Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte, Brazil, with 10 patients with osteoporosis and 10 patients without the disease. Data tabulation occurred using three methodological figures: central idea, key expressions and collective subject discourse. The study was approved by the Committee of Ethics and Research with Human Beings. RESULTS: Among the diagnosed patients, the central ideas were vulnerability to fractures and the concepts of disease presentation like osteopenia and osteoporosis. In the undiagnosed group, 40% were unaware of the disease. About prevention, greater knowledge was observed in the group with the disease, with the main ideas being highlighted: physical exercises, calcium and vitamin D rich food, as well as sun exposure. CONCLUSION: There was limited knowledge about osteoporosis and its prevention, especially in the group without diagnosis, but in the age group at risk. Thus, it is concluded that, in the case of a disease of high prevalence, of high budgetary costs for public health, and with significant risks once it is undiagnosed and untreated, resolute measures of greater clarity about the disease should be practiced in all spheres of public health.

Humanos , Feminino , Idoso , Osteoporose , Osteoporose/prevenção & controle , Saúde da Mulher , Prevenção de Doenças
PLoS Genet ; 15(4): e1008060, 2019 04.
Artigo em Inglês | MEDLINE | ID: mdl-31022172


The promise of personalized genomic medicine is that knowledge of a person's gene sequences and activity will facilitate more appropriate medical interventions, particularly drug prescriptions, to reduce the burden of disease. Early successes in oncology and pediatrics have affirmed the power of positive diagnosis and are mostly based on detection of one or a few mutations that drive the specific pathology. However, genetically more complex diseases require the development of polygenic risk scores (PRSs) that have variable accuracy. The rarity of events often means that they have necessarily low precision: many called positives are actually not at risk, and only a fraction of cases are prevented by targeted therapy. In some situations, negative prediction may better define the population at low risk. Here, I review five conditions across a broad spectrum of chronic disease (opioid pain medication, hypertension, type 2 diabetes, major depression, and osteoporotic bone fracture), considering in each case how genetic prediction might be used to target drug prescription. This leads to a call for more research designed to evaluate genetic likelihood of response to therapy and a call for evaluation of PRS, not just in terms of sensitivity and specificity but also with respect to potential clinical efficacy.

Herança Multifatorial , Medicina de Precisão/métodos , Transtorno Depressivo Maior/tratamento farmacológico , Transtorno Depressivo Maior/genética , Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/genética , Feminino , Humanos , Hipertensão/tratamento farmacológico , Hipertensão/genética , Masculino , Mutação , Transtornos Relacionados ao Uso de Opioides/genética , Transtornos Relacionados ao Uso de Opioides/prevenção & controle , Osteoporose/genética , Osteoporose/prevenção & controle , Testes Farmacogenômicos/métodos , Medicina Preventiva/métodos , Fatores de Risco