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1
Bellido, M., L. Lugo, S. Castañeda, et al. "PTH Increases Jaw Mineral Density in a Rabbit Model of Osteoporosis." Journal of Dental Research 89, no. 4 (2010): 360–65. http://dx.doi.org/10.1177/0022034510363082.
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Intermittent parathyroid hormone (PTH) administration has been shown to be a promising therapy for systemic bone loss. Accordingly, we hypothesized that PTH could have positive results in treating oral complications of osteoporosis. Hence, we evaluated both mandibular bone loss and its response to PTH in a rabbit model of osteoporosis induced by ovariectomy and glucocorticoid administration. There was a significant and marked decrease in bone mineral density (BMD), bone mineral content (BMC), and calcium content in ash from the osteoporotic peri-alveolar region, which influenced global jaw loss. Remarkably, PTH (1–34) administration to osteoporotic rabbits almost completely reversed BMD, BMC, and calcium content fall in the peri-alveolar region, subsequently reducing global mandibular bone loss. Thus, although the peri-alveolar region is particularly susceptible to osteoporosis, it also responds well to intermittent PTH. Therefore, these results suggest that PTH might represent a valid therapy for improving the osseointegration of dental implants in persons with osteoporosis.
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Kakehasi, Adriana M., Cláudia M. C. Mendes, Luiz G. V. Coelho, Luiz P. Castro, and Alfredo J. A. Barbosa. "The presence of Helicobacter Pylori in postmenopausal women is not a factor to the decrease of bone mineral density." Arquivos de Gastroenterologia 44, no. 3 (2007): 266–70. http://dx.doi.org/10.1590/s0004-28032007000300016.
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BACKGROUND: Osteoporosis affects approximately 30% of postmenopausal women. Gastrectomy, pernicious anemia, and more recently Helicobacter pylori infection, have all been implicated in the pathogenesis of osteoporosis. A reduced parietal cell mass is a common feature in these conditions. AIM: To study a possible relationship between chronic gastritis, parietal cell density of the oxyntic mucosa and bone mineral density in postmenopausal women, as chronic gastritis, Helicobacter pylori infection and osteoporosis are frequently observed in the elderly. METHODS: Fifty postmenopausal women (61.7 ± 7 years) were submitted to gastroduodenal endoscopy and bone densitometry by dual energy X-ray absorptiometry. Glandular atrophy was evaluated objectively by the determination of parietal cell density. Helicobacter pylori infection was evaluated by histology, urease test and breath test with 13C. RESULTS: Thirty-two patients (64%) presented chronic multifocal gastritis, and 20 of them (40%) showed signs of gastric mucosa atrophy. Lumbar spine osteoporosis was found in 18 patients (36%). The parietal cell density in patients with and without osteoporosis was 948 ± 188 and 804 ± 203 cells/mm², respectively. Ten osteoporotic patients (55%) and 24 non-osteoporotic patients (75%) were infected by Helicobacter pylori. CONCLUSION: Postmenopausal women with osteoporosis presented a well-preserved parietal cell density in comparison with their counterparts without osteoporosis. Helicobacter pylori infection was not different between the two groups. We concluded that neither atrophic chronic gastritis nor Helicobacter pylori seem to be a reliable risk factor to osteoporosis in postmenopausal women.
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Ciornei, M., Emese Orban, and Remus Şipoş. "Correlations of lipid metabolism with bone remodeling." Medic.ro 6, no. 1 (2020): 28–30. http://dx.doi.org/10.26416/med.138.6.2020.3996.
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Introduction. Both dyslipidemia and osteoporosis are chronic medical problems, and the relationship between these two pathologies is based on common risk factors and pathogenic mechanisms which favour the development of both diseases. Dyslipidemia can be a risk factor for osteoporosis, therefore it is important to understand the mechanisms underlying the relation between these two pathologies. The link between dyslipidemia and osteoporosis. Lipoprotein oxidation products suppress the differentiation of osteoblasts while stimulating the differentiation of adipocytes and their proliferation, a mechanisms that can contribute to the reduction of bone mineralization and the occurrence of inflammatory events. A number of clinical and experimental studies have been performed, these studies suggesting an inverse correlation between the adipose content of the bone marrow and the density of the bone tissue, in other words, in parallel with the osteoporotic bone loss there is an increase of the adipocyte content in the bone marrow. The role of plasma lipids on bone metabolism. Because in clinic patients with dyslipidemia are often diagnosed with osteoporosis, we can say that serum levels of plasma lipids influence both osteoblastic and osteoclastic activity. Cholesterol correlates with low bone mineral density, while triglycerides are associated with a low incidence of vertebral fractures in osteoporotic women. Effects of lipid-lowering medication on bone tissue. Statins, first introduced to treat patients with hyperlipidemia and hypercholesterolemia, have also been shown to be beneficial for osteoporotic patients and have recently been introduced to prevent fractures and treat osteoporosis through their ability to enhance osteogenesis and inhibit osteoclastogenesis. Conclusions.There is a wide range of studies that have shown that statins, widely used as lipid-lowering agents, could also be utilized in the treatment of osteoporosis, through the beneficial effects they have on bone metabolism, effects with a positive impact on bone mineral density.
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Jaghsi, Sawsan, Taghrid Hammoud, and Shaden Haddad. "Relation Between Circulating Vitamin K1 and Osteoporosis in the Lumbar Spine in Syrian Post-Menopausal Women." Open Rheumatology Journal 12, no. 1 (2018): 1–9. http://dx.doi.org/10.2174/1874312901812010001.
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Background: In the past two decades, Vitamin K has been receiving more attention due to its role in bone health and metabolism. The bone mineral density does not remain steady with age, particularly declining after menopause. Objective: This study is aimed to investigate the relationship between bone mineral density and serum vitamin K1 levels in post-menopausal women, and to evaluate serum vitamin K1 levels as a potential biomarker for postmenopausal osteoporosis. Methods: Serum levels of vitamin k1 were measured in 23 postmenopausal osteoporotic women, and in 15 postmenopausal healthy control women using a standardized Enzyme-Linked Immune Sorbent Assay (ELISA) kit. Bone mineral density BMD was assessed at the lumbar spine. Results: The mean serum vitamin k1 level was significantly lower in the postmenopausal osteoporotic women group than in the normal control group (mean=0.794 vs3.61ng/ml, P< 0.0001), and serum vitamin k1 concentration was positively correlated with lumbar spine BMD among postmenopausal osteoporotic women (R=0.533, p = 0.009), and in postmenopausal healthy control (R=0.563, p = 0.02). Diagnostic sensitivity and specificity of vitamin k1 for osteoporosis were 90% and 98%, respectively (cut-off value: 0.853 ng/ml). The area under the ROC curve (AUC) value for vitamin k1 was 0.984 the odd ratio result was 18.66. Conclusion: Our results suggest that vitamin K1 may contribute to maintain bone mineral density. Vitamin K1 may have a role in diagnosing post-menopausal osteoporosis. Vitamin K1 may be a valuable diagnostic as well as therapeutic marker in post-menopausal osteoporosis.
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Kobza, Alexandra O., Alexandra Papaioannou, Arthur N. Lau, and Jonathan D. Adachi. "Romosozumab in the treatment of osteoporosis." Immunotherapy 12, no. 13 (2020): 965–81. http://dx.doi.org/10.2217/imt-2020-0158.
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Osteoporosis is a disease characterized by weakening of the bone architecture, which leads to an increased risk of fracture. There has been interest in the development of osteoanabolic agents that can increase bone mass and reverse the deteriorating architecture of osteoporotic bone. Romosozumab is a new agent for osteoporosis that both promotes bone formation and inhibits bone resorption. It is a monoclonal antibody that inhibits the activity of sclerostin, which allows the Wnt pathway to promote osteoblastogenesis and inhibit the activity of bone-resorbing osteoclasts. In clinical trials, it has proven to be superior to other agents in terms of increasing bone mineral density and reducing the incidence of fractures. This review will highlight the pharmacology, clinical efficacy and safety profile of romosozumab and suggest where this medication may fit within our current management of osteoporosis.
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Stewart, TL, and SH Ralston. "Role of genetic factors in the pathogenesis of osteoporosis." Journal of Endocrinology 166, no. 2 (2000): 235–45. http://dx.doi.org/10.1677/joe.0.1660235.
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Osteoporosis is a common disease with a strong genetic component characterised by low bone mass, microarchitectural deterioration of bone tissue and an increased risk of fracture. Twin and family studies have shown that genetic factors play an important role in regulating bone mineral density and other determinants of osteoporotic fracture risk, such as ultrasound properties of bone, skeletal geometry and bone turnover. Osteoporosis is a polygenic disorder, determined by the effects of several genes, each with relatively modest effects on bone mass and other determinants of fracture risk. It is only on rare occasions that osteoporosis occurs as the result of mutations in a single gene. Linkage studies in man and experimental animals have defined multiple loci which regulate bone mass but the genes responsible for these effects remain to be defined. Population-based studies and case-control studies have similarly identified polymorphisms in several candidate genes that have been associated with bone mass or osteoporotic fracture, including the vitamin D receptor, oestrogen receptor and collagen type IalphaI gene. The individual contribution of these genes to the pathogenesis of osteoporosis is small however, reflected by the fact that the relationship between individual candidate genes and osteoporosis has been inconsistent in different studies. An important aim of future work will be to define how the genes which regulate bone mass, bone turnover and other aspects of bone metabolism interact with each other and with environmental variables to cause osteoporosis in individual patients. If that aim can be achieved then there is every prospect that preventative therapy could be targeted to those at greatest risk of the osteoporosis, before fractures have occurred.
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Gerstner, Gregory, Mary Lou Damiano, Angela Tom, et al. "Decreased Bone Mineral Density among Patients with Hemophilia." Blood 110, no. 11 (2007): 1153. http://dx.doi.org/10.1182/blood.v110.11.1153.1153.
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Abstract Background: Osteoporosis among adult males is a major and under-recognized problem in the United States. Patients with hemophilia have several predisposing risks for developing decreased bone mineral density (BMD) and osteoporosis, and may represent an important group to target for screening and treatment for fracture prevention. Patients and Methods: Patients over the age of 18 with moderate or severe hemophilia A or B (as defined by factor activity < 5%) and no history of prophylactic factor use prior to age 10 were eligible. Bone mineral densities were obtained using DEXA scans (DXA) along with measurements of joint mobility and physical activity and laboratory parameters. Results: Twenty-eight patients have been consented with accrual ongoing. 21 have undergone DXA scans. Median age of 39 (range 18–61), 86% HCV positive, 26% HIV positive. Median T-score for all sites (lumbar, femoral neck, hip, and other) was −1.7 (−5.8–0.6), with the most effected area being the femoral neck, T-score −1.7 (−5.8–0.8). Based on WHO criteria, 76% of patients had decreased BMD, 33% (n=7) with osteoporosis, and 43% (n=9) with osteopenia. Trends associated with decreased BMD included decreased serum 25-hydroxy-vitamin D levels, increased alkaline phosphatase, and decreased weight. All patients with osteoporosis were HCV positive, and all HIV positive patients had decreased BMD. Median activity scores were lower among osteoporotic patients vs normal BMD. Joint range-of-motion in the lower extremities was limited to 59.5% of predicted values in patients with osteoporosis, 84% in osteopenia, and 93% in patients with normal BMD. Summary: Patients with hemophilia are at markedly increased risk for developing osteoporosis and osteopenia. Potential predictors of risk for decreased BMD are concurrent HCV and HIV infection, low vitamin D levels, elevated alkaline phosphatase, lower weight, decreased range of motion and lower activity scores. More aggressive screening for decreased BMD among moderate and severe hemophilia patients with initiation of therapy is appropriate. Median Values Worst T-Score Activity Score (1–5) Joint ROM (% Pred) Weight (kg) 25-Hydroxy-D (ng/mL) Alk Phos (IU/L) Normal BMD 0.1 5 94.0 91.6 28.0 59 Osteopenia −1.6 4 85.0 80.7 23.0 86 Osteoporosis −3.0 3 68.5 73.0 21.8 99
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Park, Eunkuk, Chang Gun Lee, Jeonghyun Kim, et al. "Anti-Osteoporotic Effects of the Herbal Mixture of Cornus officinalis and Achyranthes japonica In Vitro and In Vivo." Plants 9, no. 9 (2020): 1114. http://dx.doi.org/10.3390/plants9091114.
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Osteoporosis is a porous bone disease caused by bone density loss, which increases the risk of fractures. Cornus officinalis (CO) and Achyranthes japonica (AJ) have been used as traditional herbal medicine for various disorders in East Asia. Although the anti-osteoporotic effects of single extract of CO and AJ have already been reported, the synergistic effect of a combined mixture has not been studied. In this study, we investigated the effects of a CO and AJ herbal mixture on osteoporosis in in vitro and in vivo models. The results demonstrate that treatment with the CO and AJ mixture significantly promoted osteoblast differentiation of MC3T3-E1 mouse preosteoblasts through the upregulation of osteoblastic differentiation-associated genes such as alkaline phosphatase (Alpl), runt-related transcription factor 2 (Runx2), and bone gamma-carboxyglutamic acid-containing protein (Bglap), while the mixture significantly inhibited differentiation of osteoclasts isolated from primary-cultured mouse monocytes. In addition, oral administration of CO and AJ mixture significantly prevented bone mineral density loss and trabecular bone structures in an ovariectomy-induced osteoporotic mouse model. These results suggest that the combination treatment of CO and AJ mixture might be a beneficial therapy for osteoporosis.
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Noble, Jane A., Malachi J. McKenna, and Rachel K. Crowley. "Should denosumab treatment for osteoporosis be continued indefinitely?" Therapeutic Advances in Endocrinology and Metabolism 12 (January 2021): 204201882110100. http://dx.doi.org/10.1177/20420188211010052.
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Denosumab was approved for the treatment of postmenopausal osteoporosis in 2010, based on the FREEDOM study, which indicated a benefit in terms of increased bone mineral density and reduced risk of major osteoporotic fracture. In the initial clinical studies it was noted that discontinuation of denosumab can lead to a rebound of bone turnover markers and loss of accrued bone mineral density. An increased risk of fractures (multiple vertebral fractures in particular) associated with discontinuation was noted after approval and marketing of denosumab. For many patients experiencing gain in bone mineral density and fracture prevention while taking denosumab, there is no reason to stop therapy. However, discontinuation of denosumab may happen due to non-adherence; potential lack of efficacy in an individual; where reimbursement for therapy is limited to those with bone mineral density in the osteoporosis range, when assessment reveals this has been exceeded; or patient or physician concern regarding side effects. This review paper aims to discuss these concerns and to summarize the data available to date regarding sequential osteoporosis therapy following denosumab cessation to reduce the risk of multiple vertebral fracture.
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Alam, M. Faiyaz, M. Azmat Rana, and M. Shamshad Alam. "Osteocalcin, a promising marker of osteoporosis: evaluation in post-menopausal females with osteoporosis." International Journal of Advances in Medicine 6, no. 6 (2019): 1746. http://dx.doi.org/10.18203/2349-3933.ijam20194639.
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Background: Osteocalcin, has high affinity for calcium. In osteoporotic women, deficiency of calcium may lead to lowering of the formation of hydroxyapatite crystals. Thus, in the state of hypo mineralization, free osteocalcin available in the circulation. Therefore, present study was designed to evaluate significance of serum osteocalcin in diagnosis of osteoporosis, and relationship between Serum Osteocalcin and BMD (Bone mineral Density) in post-menopausal females with osteoporosis and without osteoporosis.Methods: One hundred and forty seven post-menopausal women between age 45 to 80 years attending the hospital OPD were studied. To be eligible for the study they had to have been postmenopausal for at least one year. The diagnosis of osteoporosis was made based on T-Scores (BMD) at the lumber spine (L1 to L4 and femaral neck) by DEXA (GE lunar Densitometer). Serum osteocalcin level was estimated by LIAISON osteocalcin assay. Patients with chronic conditions affecting skeletal health and patients on drugs affecting the skeleton were excluded from the study.Results: Serum osteocalcin level in post-menopausal female without osteoporosis was 9.87±1.04ng/ml, while post-menopausal female with osteoporosis had 22.62±2.25ng/ml suggesting significant increase in bone marker level in osteoporotic females (p<0.05.) Correlation study between BMD and osteocalcin showed strong Negative Correlation (r=-0.77, p<0.05).Conclusions: Serum osteocalcin can be considered as a specific marker of osteoblast function as its levels have been shown to correlate with bone formation rates. Thus, serum osteocalcin can be used for diagnosis and monitoring of response to therapy and this may be the better predictor than BMD.
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Wang, Ning, Dongxing Xie, Jing Wu, et al. "Selenium and bone health: a protocol for a systematic review and meta-analysis." BMJ Open 10, no. 10 (2020): e036612. http://dx.doi.org/10.1136/bmjopen-2019-036612.
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IntroductionBone health affects the ability of human body to stay active, and its degradation can cause considerable morbidity and mortality. The factors related to bone health play an important role in preventing osteoporosis and its adverse consequences. However, the risk factors for osteoporosis have not been fully elucidated. Deficiency in the trace element selenium may be one of the risk factors for the development of osteoporosis. Previous studies have investigated the effects of selenium on osteoporosis; however, the results are inconclusive. Therefore, the present study aimed to systematically examine the existing literature on the associations between dietary or serum selenium and bone mineral density (BMD), osteoporosis or osteoporotic fractures, and to quantify such associations through meta-analysis.Methods and analysisPubMed, Embase and Cochrane Library will be searched using a specified search strategy to identify relevant studies up to October 2019. Both interventional and observational studies in humans will be included. The outcomes will include BMD and the prevalence or incidence of osteoporosis and osteoporotic fractures. For dietary or serum selenium and BMD, osteoporosis or osteoporotic fractures pooled analyses, estimates will be expressed as the mean difference, and the pooled OR, relative risk, HR or beta coefficient, and corresponding 95% CIs. Heterogeneity of the studies and publication bias will be investigated accordingly. To assess the quality and the risk of bias of the included studies, the Newcastle-Ottawa Quality Scale or the Cochrane risk of bias assessment tool will be used where appropriate.Ethics and disseminationSince no private and confidential patient data will be included in the reporting, approval from an ethics committee is not required. The results will be published in a peer-reviewed journal. The study raises no ethical issues.PROSPERO registration numberCRD42019147188.
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Tasci, Ilker, Bilgin Bahadir Basgoz, Umit Cintosun, Umut Safer, and Mehmet Ilkin Naharci. "Age at First Osteoporosis Screening Among Older Women and Men: Is Bone Mineral Density Measurement Ordered Timely?" Endocrine, Metabolic & Immune Disorders - Drug Targets 19, no. 4 (2019): 534–40. http://dx.doi.org/10.2174/1871530319666181226125756.
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Background: US National Osteoporosis Foundation has specified age cut-offs for osteoporosis screening in older women and men. Objective: In this study, we investigated whether Turkish seniors undergo their first ever osteoporosis screening early, on time or late. Methods: We determined the age of older women and men at their first-time Bone Mass Densitometry (BMD) testing using the medical records of a geriatric outpatient unit. The timing of the BMD test was considered ‘’late’’ when performed after the age of 65 and 70 in women and men, respectively. An “early” screening was defined as having a BMD measurement before these age cut-offs. Results: We included 481 individuals in the study (mean age: 74.5±6.5 years, women: 62%). On admission, around 18% of the sample could give no definite information and another 35% had never been assessed for osteoporosis. Among those with a past screening, 64.8% reported comorbid osteoporosis and 33% reported no osteoporosis. Mean age of the first-time BMD measurement was 67.4±7.7 years. The first-time BMD measurement was on time in 9.7%, early in 37.4% and late in 52.9% of the subjects. Half of the individuals with a self-reported osteoporosis diagnosis were non-osteoporotic on a new BMD ordered following the geriatric assessment. Multimorbidity (≥3), parental hip fracture, and smoking were the independent predictors of being early screened. Conclusion: We found two-thirds of women and men unscreened for osteoporosis despite being indicated by age. Early and late screening were both prevalent. Self-reported osteoporosis diagnosis was mostly inconsistent with BMD testing in our sample.
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Sun, Bo, Tian Su, Zhibin Meng, and Songjie Tang. "Anhuienoside C Ameliorates Osteoclast Differentiation in Ovariectomy-Induced Osteoporosis by Regulating RANKL/Wnt Signaling Pathways." Current Topics in Nutraceutical Research 20, no. 1 (2020): 51–55. http://dx.doi.org/10.37290/ctnr2641-452x.20:51-55.
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Postmenopausal and ovariectomy-induced osteoporosis is the most common bone disorder. While pharmacotherapy has been valuable in the management of osteoporosis, it has been associated with undesired side effects. Plant bioactives with minimal side effects have been seen as adjunct to classical therapy. Herein, we have evaluated the protective effect of anhuienoside C (AC) in a rat model of ovariectomy-induced osteoporosis. The treatment of osteoporotic rats with AC caused dose-dependent favorable changes in biochemical markers of bone formation and metabolism (osteocalcin, C-telopeptide of type 1 collagen, and procollagen type 1 N-terminal propeptide), enhanced bone mineral density, and decrease in proinflammatory mediators of inflammation and RANKL/Wnt pathway proteins. Furthermore, histopathologic changes in the tibia support beneficial effects of AC. In conclusion, our result reveals that treatment with AC shows beneficial effect against ovariectomy-induced osteoporosis by regulating the RANKL/Wnt pathway.
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Batteux, Benjamin, Sandra Bodeau, Camille André, et al. "Association between Uremic Toxin Concentrations and Bone Mineral Density after Kidney Transplantation." Toxins 12, no. 11 (2020): 715. http://dx.doi.org/10.3390/toxins12110715.
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Although uremic osteoporosis is a component of mineral and bone disorder in chronic kidney disease, uremic toxin (UT) concentrations in patients with end-stage kidney disease and bone mineral density (BMD) changes after kidney transplantation have not previously been described. We hypothesized that elevated UT concentrations at the time of transplantation could have a negative impact on bone during the early post-transplantation period. Hence, we sought to determine whether concentrations of UTs (trimethylamine-N-oxide, indoxylsulfate, p-cresylsulfate, p-cresylglucuronide, indole-3-acetic acid, hippuric acid, and 3-carboxy-4-methyl-5-propyl-furanpropionic acid) upon transplantation are predictive markers for (i) osteoporosis one month after transplantation, and (ii) a BMD decrease and the occurrence of fractures 12 and 24 months after kidney transplantation. Between 2012 and 2018, 310 kidney transplant recipients were included, and dual-energy X-ray absorptiometry was performed 1, 12, and 24 months after transplantation. The UT concentrations upon transplantation were determined by reverse-phase high-performance liquid chromatography. Indoxylsulfate concentrations upon transplantation were positively correlated with BMD one month after transplantation for the femoral neck but were not associated with osteoporosis status upon transplantation. Concentrations of the other UTs upon transplantation were not associated with osteoporosis or BMD one month after transplantation. None of the UT concentrations were associated with BMD changes and the occurrence of osteoporotic fractures 12 and 24 months after transplantation. Hence, UT concentrations at the time of kidney transplantation were not predictive markers of osteoporosis or fractures.
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You, Li, Ling Pan, Lin Chen, Wensha Gu, and Jinyu Chen. "MiR-27a is Essential for the Shift from Osteogenic Differentiation to Adipogenic Differentiation of Mesenchymal Stem Cells in Postmenopausal Osteoporosis." Cellular Physiology and Biochemistry 39, no. 1 (2016): 253–65. http://dx.doi.org/10.1159/000445621.
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Background/Aims: Osteoporosis is a progressive bone disease characterized by a decrease in bone mass and density, which results in an increased risk of fractures. Mesenchymal stem cells (MSCs) are progenitor cells that can differentiate into osteoblasts, osteocytes and adipocytes in bone and fat formation. A reduction in the differentiation of MSCs into osteoblasts contributes to the impaired bone formation observed in osteoporosis. MicroRNAs (miRNAs) play a regulatory role in osteogenesis and MSC differentiation. MiR-27a has been reported to be down-regulated in the development of osteoporosis and during adipogenic differentiation. Methods: In this study, a miRNA microarray analysis was used to investigate expression profiles of miRNA in the serum of osteoporotic patients and healthy controls and this data was validated by quantitative real-time PCR (qRT-PCR). MSCs isolated from human and mice with miR-27a inhibition or overexpression were induced to differentiate into osteoblasts or adipocytes. TargetScan and PicTar were used to predict the target gene of miR-27a. The mRNA or protein levels of several specific proteins in MSCs were detected using qRT-PCR or western blot analysis. Ovariectomized mice were used as in vivo model of human postmenopausal osteoporosis for bone mineral density measurement, micro-CT analysis and histomorphometric analysis. Results: Here, we analyzed the role of miR-27a in bone metabolism. Microarray analysis indicated that miR-27a expression was significantly reduced in osteoporotic patients. Analysis on MSCs derived from patients with osteoporosis indicated that osteoblastogenesis was reduced, whereas adipogenesis was increased. MSCs that had undergone osteoblast induction showed a significant increase in miR-27a expression, whereas cells that had undergone adipocyte induction showed a significant decrease in miR-27a expression, indicating that miR-27a was essential for MSC differentiation. We demonstrated that myocyte enhancer factor 2 c (Mef2c), a transcription factor, was the direct target of miR-27a using a dual luciferase assay. An inverse relationship between miR-27a expression and Mef2c expression in osteoporotic patients was shown. Silencing of miR-27a decreased bone formation, confirming the role of miR-27a in bone formation in vivo. Conclusion: In summary, miR-27a was essential for the shift of MSCs from osteogenic differentiation to adipogenic differentiation in osteoporosis by targeting Mef2c.
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Jadžić, Jelena, and Danijela Đonić. "Compromised bone strength in patients with alcoholic liver cirrhosis." Medicinski podmladak 71, no. 4 (2020): 27–34. http://dx.doi.org/10.5937/mp71-27443.
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Osteoporosis and/or osteopenia are frequently observed complications in alcoholic liver disease patients, especially in its irreversible stage (alcoholic liver cirrhosis - ALC). Current literature review regarding osteoporosis incidence increased fracture risk, bone mineral density changes, micro-structural alteration and pathogenetic mechanisms leading to ALC - induced decrease in bone quality is presented. It has been reported that osteoporosis is influenceing significant number of ALC patients, with particular accent on lumbar spine, as most commonly affected skeletal site. Several risk factors and ethio-pathogenic mechanisms have been associated with the loss of bone mineral density, in patients with ALC and other cirrhosis. Certain authors claim that dominant mechanism in ALC-induced bone loss is decrease in bone formation and osteoblastic function, while other results suggest increased bone remodeling as underlying cause of increased bone fragility in ALC patients. Increased bone fragility and susceptibility to osteoporotic fractures significantly affect life expectancy and quality of life in patients with ALC. Thus, osteological screening and individual fracture risk assessment are highly recommended for all patients with alcoholic liver cirrhosis.
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Kim, Hyojune, Wonhee Lee, SeungHyun Choi, et al. "Role of Additional Inferomedial Supporting Screws in Osteoporotic 3-Part Proximal Humerus Fracture: Finite Element Analysis." Geriatric Orthopaedic Surgery & Rehabilitation 11 (January 1, 2020): 215145932095695. http://dx.doi.org/10.1177/2151459320956958.
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Introduction: Importance of inferomedial supporting screws in preventing varus collapse has been investigated for the proximal humerus fracture. However, few studies reported the results of osteoporotic complex fracture. This study aimed to demonstrate the stress distribution pattern, particularly in osteoporotic 3-part proximal humerus fractures involving greater tuberosity (GT) with different screw configurations. Materials and methods: Using the computed tomography (CT) images of 2 patients, who had osteoporosis and the other had normal bone density, 3-part fractures involving the GT, without medial support were reconstructed. To reflect the osteoporosis or real bone density, Hounsfield unit of CT scans were utilized. A force of 200 N was applied in 30° varus direction. The proximal screws were set in 2 ways: 6 screws without inferomedial supporting screws and 9 screws with inferomedial supporting screws. Qualitative and quantitative analysis of internal stress distribution were performed. Results: The most proximal part area near humeral head vertex and near the 1st screw’s passage and tip had more stress concentrated in osteoporotic 3-part fractures. The stress distribution around the proximal screws was found near the GT fracture line and its lateral side, where the local max values located. Inferomedial supporting screws decreased these effects by changing the points to medial side from the GT. The ratio in osteoporotic bone model decreased to that in normal bone model when inferomedial supporting screws were applied (normal bone, 2.97%–1.30%; osteoporosis bone, 4.76%–1.71%). Conclusions: In osteoporotic 3-part proximal humerus fracture, the stress distribution was concentrated on the area near the humeral vertex, 1st row screw tips, and lateral side region from the GT fracture line. Moreover, inferomedial supporting screws ensured that the stress distribution is similar to that in normal bone setting, particularly in osteoporotic condition.
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Prather, Caitlin, Erin Adams, and Whitney Zentgraf. "Romosozumab: A first-in-class sclerostin inhibitor for osteoporosis." American Journal of Health-System Pharmacy 77, no. 23 (2020): 1949–56. http://dx.doi.org/10.1093/ajhp/zxaa285.
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Abstract Purpose The purpose of this article is to review the pharmacology, efficacy, and safety of the sclerostin inhibitor romosozumab for the treatment of osteoporosis, including data from clinical trials of the drug. Summary A review of the literature was performed by searching PubMed and MEDLINE for all relevant articles published between January 2014 and February 2020 using the keywords romosozumab, romosozumab-aqqg, osteoporosis, and fracture. All relevant English-language articles evaluating the pharmacology, efficacy, or safety of romosozumab for the treatment of osteoporosis in humans were included; poster presentations were excluded. Romosozumab has been approved by the Food and Drug Administration and is considered both safe and effective for the treatment of osteoporosis in high-risk postmenopausal females. Phase 2 and phase 3 clinical trials have shown a statistically significant decrease in new vertebral fractures and an increase in bone mineral density with romosozumab use, as compared with both placebo use and use of alternative osteoporosis therapies. The primary safety concern is a potential risk of cardiovascular events; additionally, hypocalcemia must be corrected prior to initiation. Romosozumab is the first anabolic medication that both increases bone formation and decreases bone resorption. Data suggest that romosozumab is more effective than oral bisphosphonates in preventing osteoporotic fractures, though cost and safety concerns must be considered. Conclusion Romosozumab is a novel, 12-month treatment option for postmenopausal women at high risk for osteoporotic fracture that both increases bone formation and decreases bone resorption.
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Patil, Kavita Avinash, K. V. Mahendra Prashanth, and A. Ramalingaiah. "Detection of osteoporosis in lumbar spine [L1-L4] trabecular bone: a review article." International Journal of Research in Orthopaedics 7, no. 4 (2021): 872. http://dx.doi.org/10.18203/issn.2455-4510.intjresorthop20212440.
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<p class="abstract">The human bones are categorized based on elemental micro architecture and porosity. The porosity of the inner trabecular bone is high that is 40-95% and the nature of the bone is soft and spongy where as the cortical bone is harder and is less porous that is 5 to 15%. Osteoporosis is a disease that normally affects women usually after their menopause. It largely causes mild bone fractures and further stages lead to the demise of an individual. This analysis is on the basis of bone mineral density (BMD) standards obtained through a variety of scientific methods experimented from different skeletal regions. The detection of osteoporosis in lumbar spine has been widely recognized as a promising way to frequent fractures. Therefore, premature analysis of osteoporosis will estimate the risk of the bone fracture which prevents life threats. This paper focuses on the advanced technology in imaging systems and fracture probability analysis of osteoporosis detection. The various segmentation techniques are explored to examine osteoporosis in particular region of the image and further significant attributes are extracted using different methods to classify normal and abnormal (osteoporotic) bones. The limitations of the reviewed papers are more in feature dimensions, lesser accuracy and expensive imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and DEXA. To overcome these limitations it is suggested to have less feature dimensions, more accuracy and cost-effective imaging modality like X-ray. This is required to avoid bone fractures and to improve BMD with precision which further helps in the diagnosis of osteoporosis.</p>
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Hassan, Nayera E., Sahar A. El-Masry, Rokia A. El-Banna, and Mohamed S. El Hussieny. "Different Tools for the Assessment of Bone Mass among Egyptian Adults." Open Access Macedonian Journal of Medical Sciences 2, no. 4 (2014): 557–61. http://dx.doi.org/10.3889/oamjms.2014.100.
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BACKGROUND: Several tools such as, dual X-ray absorptiometry (DXA), quantitative computed tomography (QCT) and self-assessment tool (OST), are being used for diagnosis of osteoporosis.OBJECTIVE: to compare the sensitivity and specify detection rate of bone mineral density (BMD) changes for DXA versus QCT and OST among a sample of Egyptian adults of both sexes.SUBJECTS AND METHODS: This study is a cross sectional one, which included 62 Egyptians, aged 20-65 years. Each individual was assessed for BMD using DXA at femur and spine sites; QCT and OST which take into account body weight and age. Accordingly they were diagnosed as either osteoporotic/osteopenic or normal.RESULTS: The highest prevalence of osteopenia or osteoporosis was diagnosed among menopause women. DXA at femur has diagnosed more cases of osteoporosis (both osteopenic and osteoporotic) as compared to spine DXA or QCT, but OST is out of rang; as it failed to diagnose any case.CONCLUSION: DXA has been found to be more efficacious than QCT scan in the diagnosis of osteoporosis. DXA in femur is better than DXA-spine and QCT. Generally, DXA is the "gold standard" when assessing osteoporosis. Further studies are needed to modify the equation of OST and confirm its efficiency in Egyptians population.
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Puspita Sari, Ratna Dewi, and Samsul Bakrie. "Utilization of Isoflavones with Basic Material of Robusta Coffee Skin with BMD (Bone Marrow Density) Markers in Peri / Post Menopausal Women." Biomedical Journal of Indonesia 5, no. 3 (2019): 100–105. http://dx.doi.org/10.32539/bji.v5i3.8684.
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The increase in life expectancy of women in Indonesia, which reaches 72 years of age causes almost a third of her life span lived at the time of menopause. The population of menopausal women in Indonesia will increase with all the effects due to decreased estrogen in the form of climatic complaints and an increased risk of bone loss / osteoporosis. The best choice and is the standard treatment for climatic complaints and osteoporosis is hormonal therapy (Estrogen + Progesterone / Estrogen). WHI in 2004 stated that hormone therapy in menopausal women increases the risk of breast cancer. In Indonesia, phytoestrogens are widely circulated in the market with the category of supplements and have been used by the public to deal with climatic complaints and osteoporosis. This phytoestrogen has not been scientifically proven to be useful for overcoming climatic and osteoporotic complaints in postmenopausal women. Phytoestrogens on the market used as Permi III pills contain Red Clover, Black Cohosh and calcium. Some studies say that phytoestrogens for osteoporosis therapy can be obtained from isoflavones derived from robusta coffee skins. This isoflavone can affect bone mineral density in peri / postmenopausal women. The use of phytoestrogens (isoflavones) from the skin of coffee beans affects peri / postmenopausal women and helps maintain and build bone mass (reduce the occurrence of osteoporosis complaints).
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Ibrahim, Muhammad Huda Ramadhan, Abdullah Hasib Hasib, Siti Nur Rohmah, Salsabilla Abani, Samsi Yordan, and Ira Sari Yudaniayanti. "Utilization of Honey Apis dorsata as Antiosteoporosis on Requirements of Bone Calcium Ash Density on Ovariohysterectomized White Rat (Ratus norvegicus)." KnE Life Sciences 3, no. 6 (2017): 627. http://dx.doi.org/10.18502/kls.v3i6.1191.
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The purpose of this study was to determine the effect of honey bee Apis dorsata as anti-osteoporosis in calcium ash density (CAD) of bone in osteoporotic-induced rats. The target of this study was to know bone calcium levels after being given honey bees Apis dorsata. In this study, 35 female white rats (Ratus norvegicus) mature was used with weight 200gr. Divided into 5 groups, 2 control groups and 3 treatment groups. The negative control group (SH) was not induced by osteoporosis and was given the only aquadest of 1.5 ml/day. Whereas the positive control group was induced by osteoporosis (OH) and was given only aquadest 1.5 ml/day. T1, T2 and T3 treatment groups were given bee honey with various doses including 1g / kg ad 1.5 ml aquadest, 2g / kg BB ad 1.5 ml aquadest and 3g / kg BB ad 1.5 ml aquadest. Then after 12 weeks, white rats were sacrificed for lumbar vertebrae. Furthermore, the sixth lumbar spine os vertebrae will be examined for calcium bone ash content. The data were obtained was analyzed using statistical analysis of variance (ANOVA) for the results of the calcium ash content data Keywords: Honey; Osteoporosis; CAD
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Ralston, Stuart H. "Genetics of osteoporosis." Proceedings of the Nutrition Society 66, no. 2 (2007): 158–65. http://dx.doi.org/10.1017/s002966510700540x.
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Osteoporosis is a common disease with a strong genetic component characterised by reduced bone mass and an increased risk of fragility fractures. Twin and family studies have shown that genetic factors contribute to osteoporosis by influencing bone mineral density (BMD), and other phenotypes that are associated with fracture risk, although the heritability of fracture itself is modest. Linkage studies have identified several quantitative trait loci that regulate BMD but most causal genes remain to be identified. In contrast, linkage studies in monogenic bone diseases have been successful in gene identification, and polymorphisms in many of these genes have been found to contribute to the regulation of bone mass in the normal population. Population-based studies have identified polymorphisms in several candidate genes that have been associated with bone mass or osteoporotic fracture, although individually these polymorphisms only account for a small amount of the genetic contribution to BMD regulation. Environmental factors such as diet and physical activity are also important determinants of BMD, and in some cases specific nutrients have been found to interact with genetic polymorphisms to regulate BMD. From a clinical standpoint, advances in knowledge about the genetic basis of osteoporosis are likely to be important in increasing the understanding of the pathophysiology of the disease; providing new genetic markers with which to assess fracture risk and in identifying genes and pathways that form molecular targets for the design of the next generation of drug treatments.
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Martin, Andrew C. "Osteoporosis in Men." Journal of Pharmacy Practice 24, no. 3 (2011): 307–15. http://dx.doi.org/10.1177/0897190010397716.
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The prevalence of osteoporosis is estimated to be 18% in men, but 30% of all fractures occur in men. With age, men experience a gradual decline in testosterone production and bone density. The rate of trabecular bone loss in the lumbar spine in men over age 50 can be double the rate of loss in men under age 50. Endogenous testosterone, estradiol, and their metabolites play a role in maintaining bone health, but their specific effects on bone turnover have been difficult to elucidate. Recently, large cohort studies have provided more detailed information confirming estrogen’s associations and further characterizing the effect of endogenous testosterone and its metabolites on bone mineral density and fractures. Very few clinical trials have assessed the impact of testosterone replacement therapy (TRT) on bone density and fractures in men. The few studies that have been conducted are generally small and not robust enough to show the true treatment effect of TRT and adequately determine its safety. In the absence of data on patient outcomes, it is important for pharmacists to understand the impact of drug therapy on biomarkers and surrogate markers of disease for optimal pharmacotherapy selection and monitoring.
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Szamosi, Szilvia, Ágnes Horváth, Zoltán Szekanecz, and Gabriella Szűcs. "D-vitamin-anyagcsere és osteoporosis szisztémás sclerosisban." Orvosi Hetilap 158, no. 32 (2017): 1252–58. http://dx.doi.org/10.1556/650.2017.30816.
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Abstract: In the past few years more and more data have become available on the important role of vitamin D in immunological processes and inflammation. The role of vitamin D deficiency in the pathogenesis as well as in disease progression of different autoimmune and inflammatory conditions is suspected. Vitamin D deficiency is prevalent in several autoimmune diseases, including systemic sclerosis. Hypovitaminosis has been found to be associated with low bone mineral density and higher prevalence of osteoporosis in this group of patients. Determinants of low bone density in SSc are poorly understood. Studies have shown the importance of both traditional osteoporotic as well as disease-specific factors (extent of skin involvement, presence of internal organ manifestation, malabsorption, systemic sclerosis subtype, serological profile, medication) in the development of low bone mineral density. The relationship between low bone density in systemic sclerosis patients and the above mentioned risk factors may be more complex and the real role of each factor is unclear. Yet very few studies reported clinically relevant low bone mass outcomes such as fracture risk assessment and fracture associated mortality in scleroderma. This review aims to synthesize data about the essential role of vitamin D in immune homeostasis as well as the prevalence of hypovitaminosis, low bone density, changes in bone turnover markers and presence of osteoporosis in scleroderma patients. Orv Hetil. 2017; 158(32): 1252–1258.
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Diaz-Coronado, J. C., S. Herrera, D. Hernandez-Parra, et al. "SAT0463 SEVERE OSTEOPOROSIS IN COLOMBIAN PATIENTS WITH SYSTEMIC LUPUS ERYTHEMATOSUS." Annals of the Rheumatic Diseases 79, Suppl 1 (2020): 1188.2–1189. http://dx.doi.org/10.1136/annrheumdis-2020-eular.6582.
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Background:Osteoporosis predominantly affects post-menopausal women. There is an important percentage of the population that have additional risk factors that decrease bone mineral density. Patients with Systemic Lupus Erythematosus (SLE) have an increased risk for osteoporosis due to corticosteroid use and chronic inflammation. This population could have a higher prevalence of osteoporosis when compared to post-menopausal women of equal or older age. There is a paucity of information regarding bone mineral density and SLE in Latin America.Objectives:To describe the prevalence and incidence of osteoporosis and osteoporotic fractures in a Colombian population with Systemic Lupus ErythematosusMethods:We collected 464 clinical records of patients who met either the American College of Rheumatology 1997 or Systemic Lupus International Collaborating Clinics (SLICC) 2012 classification criteria for systemic lupus erythematosus between January 2015 and June 2019. The clinical and immunoserological characteristics, and damage accrual were monitored for one year. The diagnosis of osteoporosis was confirmed with densitometry by energy x-ray absorptiometry (DXA) and the presence of fragility fractures according to the rheumatologist’s report in the clinical history. The description of proportions and incidence rate of osteoporosis and fragility fracture is performed.Results:The mean age was 45 years, 96.5% were women and the mean disease duration was 12 years. Others clinical characteristics in table 1. The prevalence of osteoporosis was 13.8% with an incidence of 1.1 fractures / 100 person-months in the general population with SLE. In postmenopausal women, over 50 years the prevalence of osteoporosis was 28.4% with an incidence of 0.8 fractures / 100 months person. In the densitometric characteristics, the mean bone mineral density was 0.772 gr / cm2, T-score spine -2.9 and T-score femoral -2.6. SLEDAI mean 1.5 (SD 2.92) and SLICC mean 1.Table 1.clinical characteristicsn%Active Smoking8317.9Premature gonadal failure81.7Lupic Nephritis17838.4Proteinuria >2.5grams/24hours347.3End Stage Renal Disease163.4Anti-dsDNA14631.4Anti-Sm11023.7Anti-Ro13829.7Prednisone Cumulative Dose2.8grAntimalarial5712Conclusion:Low bone mineral density and severe osteoporosis are prevalent in our cohort with SLE. We have found a fracture rate of 1080 per 100.000 people, which is well over what has been reported in the general population (53-443 per 100.000 people in women). Osteoporotic fractures are part of damage accrual and thus have an association with morbidity and mortality. Data regarding osteoporotic fractures are necessary in order to develop guidance and health policy in the region. SLE is an important risk factor for severe osteoporosis and must be kept in mind when developing guidance and health policyReferences:[1]Jumei Xia, Ran Luo, Shuiming Guo, et al. Prevalence and Risk Factors of Reduced Bone Mineral Density in Systemic Lupus Erythematosus Patients: A Meta-Analysis. BioMed Research International. Volume 2019, Article ID 3731648, 10 pages.[2]Irene E.M. Bultinka, Willem F. Lemsa. Lupus and fractures. Curr Opin Rheumatol 2016, 28:426–432.Disclosure of Interests:Juan camilo Diaz-Coronado: None declared, Sebastian Herrera Speakers bureau: academic conference, Deicy Hernandez-Parra: None declared, Laura Betancur-Vasquez: None declared, Daniel Gonzalez-Hurtado: None declared, Juanita Gonzalez-Arango: None declared, laura Uribe-Arango: None declared, Maria Fernanda Saavedra Chacón: None declared, Jorge Lacouture-Fierro: None declared, Sebastian Guerra-Zarama: None declared, Santiago Monsalve: None declared, Jose David Serna Giraldo: None declared, Juan david Serna: None declared, Julian Barbosa: None declared, Ricardo Pineda.Tamayo: None declared
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Nordin, BE Christopher. "Nutrition and osteoporosis." British Menopause Society Journal 6, no. 2 (2000): 48–53. http://dx.doi.org/10.1258/136218000322648301.
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Osteoporosis is best defined in terms of whole bone density (apparent density) and is present when this variable falls below the young normal range. Low bone density may be genetically determined or acquired. If acquired it may in principle be due to low bone formation or high resorption. It is most easily produced in experimental animals by calcium deprivation and/or ovariectomy, both of which induce high bone resorption; their effects are additive. The postmenopausal rise in bone resorption is associated with a fall in calcium absorption and a renal tubular leak of calcium which combine to increase requirement of this element but there is also an increase in the sensitivity of bone to resorbing agents. Calcium supplementation inhibits postmenopausal bone loss but not as effectively as oestrogen. Protein and sodium are nutrients which increase calcium requirement by increasing obligatory urine calcium loss. Vitamin D is a nutrient, the deficiency of which increases the risk of hip fracture and the administration of which (with calcium) has been shown to reduce the risk of this fracture in vulnerable nursing-home residents. The implications of these findings are that postmenopausal women should ingest more calcium than premenopausal women, be moderate in their consumption of protein and salt, and receive vitamin D supplementation if their 25-hydroxyvitamin D level falls below about 50 nmol/L.
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Eller-Vainicher, Cristina, Alberto Falchetti, Luigi Gennari, et al. "DIAGNOSIS OF ENDOCRINE DISEASE: Evaluation of bone fragility in endocrine disorders." European Journal of Endocrinology 180, no. 6 (2019): R213—R232. http://dx.doi.org/10.1530/eje-18-0991.
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An underlying disease affecting bone health is present in up to 40 and 60% of osteoporotic postmenopausal women and men respectively. Among the disorders leading to a secondary form of osteoporosis, the endocrine diseases are highly represented. A frequent finding in patients affected with an endocrine-related forms of bone disease is that the skeletal fragility is partially independent of the bone density, since the fracture risk in these patients is related more to a reduction of bone quality than to a decrease of bone mass. As a consequence, bone mineral density evaluation by dual-X-ray absorptiometry may be inadequate for establishing the risk of fracture in the setting of the endocrine-related forms of osteoporosis. In the recent years, several attempts to non-invasively estimating bone quality have been done. Nowadays, some new tools are available in the clinical practice for optimising the fracture risk estimation in patients with endocrine disorders. The aim of this review is to summarise the evidence regarding the role of the different imaging tools for evaluating bone density and bone quality in the most frequent forms of endocrine-related osteoporosis, such as obesity, diabetes, acromegaly, thyrotoxicosis, primary hyperparathyroidism, hypercortisolism and hypogonadism. For each of these disorders, data regarding both the current available tools and the future possible new techniques for assessing bone fragility in patients with endocrine diseases are reported.
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Yıldırım, Murat, Sinan Saral, Tolga Mercantepe, et al. "White Tea Reduced Bone Loss by Suppressing the TRAP/CTX Pathway in Ovariectomy-Induced Osteoporosis Model Rats." Cells Tissues Organs 209, no. 1 (2020): 64–74. http://dx.doi.org/10.1159/000507791.
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Osteoporosis is an important skeletal disease characterized by bone weakness and high risk of fracture in postmenopausal women. Tea consumption is known to play an important role in the prevention or alleviation of osteoporosis. However, the therapeutic effects of aqueous extracts of white tea (WT) have not been evaluated in osteoporosis rat models. The aim of this study was to investigate the potential anti-osteoporotic role of WT in ovariectomized (OVX) rats. WT was given orally at 0.5% w/v doses for 12 weeks in OVX rats. Biochemical parameters in blood samples, bone tartrate-resistant acid phosphatase (TRAP), C-terminal telopeptide of type 1 collagen (CTX) and estradiol levels were evaluated. Bone mineral density and bone mineral content values were measured in the left femur. In addition to histopathological examination, osteolcalcin, osteopontin and TUNEL levels were determined. OVX group data demonstrated that bone loss occurred by thinning of the metaphyseal growth plates of the femur. Similarly, the levels of TRAP and CTX, markers of osteoclastic activity, were found to be high concurrently with a decrease in femoral bone mineral density. In addition, increased osteolcalcin and osteopontin levels were present in the metaphyseal growth zones. On the other hand, while TRAP and CTX levels were suppressed in the OVX-WT group, bone mineral content increased. In addition, TUNEL, osteocalcin and osteopontin positivity decreased in the right femoral metaphysis growth zones, proliferating zone and resting zone cells. These results showed that chronic WT consumption has a protective effect by reducing bone resorption in OVX-induced osteoporotic rats.
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Brown, Matthew A., and Emma L. Duncan. "Genetic studies of osteoporosis." Expert Reviews in Molecular Medicine 1, no. 14 (1999): 1–18. http://dx.doi.org/10.1017/s1462399499000964.
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Osteoporosis is a common condition of men and women, which is characterised by an increase in bone fragility due to a reduction in the amount of bone tissue. Predisposition to osteoporosis is largely genetically determined, and it is likely that several genes, each having a small effect, are involved. Bone density is determined by the peak bone mass achieved, and the rate and timing of subsequent bone loss. Twin and family studies suggest that the genetic determinants of bone density in later life influence predominantly, but not exclusively, peak bone mass. Although many genes influence bone density in both males and females, at different skeletal sites and in different age groups, it is likely that the magnitude of individual genetic effects differs in different population subsets and in different environmental settings. Thus, weak to moderate genetic effects might be identified only in specific subsets of the population. Rapid advances in the field of human genetics during the past decade have greatly improved our chances of successfully identifying genes that are involved in complex genetic conditions such as osteoporosis, and ultimately might lead to the development of new diagnostic and predictive tests as well as novel treatments for this condition. In this review, we have outlined the methods that are currently being employed to identify osteoporosis genes and also the progress that has been made to date in this field.
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Rakieh, C., S. Ho, and R. Butler. "SAT0445 TRABECULAR BONE SCORE IMPROVES FRACTURE RISK STRATIFICATION IN PATIENTS WITH REDUCED BONE MINERAL DENSITY." Annals of the Rheumatic Diseases 79, Suppl 1 (2020): 1179.2–1180. http://dx.doi.org/10.1136/annrheumdis-2020-eular.5585.
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Background:Trabecular bone score (TBS) is a textural index of bone microarchitecture and has been found to be related to 3D bone structure. A number of cohort studies have demonstrated the value of TBS as an independent fracture risk in clinical trials. Yet, very little is known about the performance and clinical value of TBS in real life practice.Objectives:To investigate the sensitivity and specificity of TBS in identifying prevalent fractures when compared with bone mineral density (BMD) measured by DXA. To evaluate the added value of TBS in fracture risk prediction above that obtained from DXA.Methods:Consecutive patients aged ≥ 18 with BMI 15-37 attnding a DXA plus TBS assessment were considered eligible. Sensitivity, specificity, and area under the curve (AUC) for prevalent major osteoporotic fracture (MOF) and clinical vertebral fractures (VF) were assessed for the following parameters: BMD lowest T-score ≤-2.5 (neck of femur, total hip, or spine), TBS T-score ≤-2.5, and either TBS or BMD T-score ≤-2.5. BMD categories (normal, osteopenia, and osteoporosis) were stratified by TBS T-score: normal (T-score ≥-1), moderate (-1≥T-score≥-2.5), and degraded TBS (T-score ≤-2.5) resulting in 9 risk groups. Odds ratios were calculated for all risk categories and fracture prevalence was compared between the best and worst TBS strata at each BMD level using chi-square test.Results:540 patients (87% females, 68.1 ± 11.6 years) were included. 238 (44%) had MOF including 81 (15%) clinical VF. For MOF, BMD had higher sensitivity (49.6% vs 30.7%), lower specificity (68.2% vs 82.1%), and similar AUC (0.59 vs 0.56) versus TBS. For VF, the sensitivity, specificity and AUC for BMD were 60%, 64%, and 0.62 respectively versus 42%, 79.7%, and 0.61 for TBS. Combining TBS and BMD (either T-score ≤ -2.5) increased the sensitivity to 63% for MOF and 75.3% for VF without affecting AUC (0.6 and 0.64 respectively). Patients with osteoporosis and degraded TBS had the highest OR of 2.65 for MOF and 3.8 for VF. The fracture risk increased at the same level of BMD when TBS was degraded. Numerically, the risk of MOF increased steadily from strata 1 to 9 and was statistically significant for osteoporosis with degraded TBS and osteoporosis with moderate TBS. When both TBS and BMD were normal, the risk of fracture was significantly reduced. In the osteopenia and osteoporosis BMD categories, patients with degraded TBS had significantly higher prevalence of fracture compared to those with normal TBS in the same BMD category.Conclusion:Fracture risk stratification can be improved when TBS is added to BMD. The sensitivity of predicting fracture may also improve when TBS and BMD are combined. Patients with both normal TBS and BMD have the lowest fracture risk, whereas those with degraded TBS and osteoporosis have the highest risk of fracture and should be targeted for early or more aggressive treatment.References:[1]Hans D et al. J Bone Miner Res. 2011;26(11).[2]McCloskey EV et al. Calcif Tissue Int. 2015;96(6).Table 1.Prevalence and risk of MOF and VF according to BMD stratified by TBS T-scorePatients within categoryNumber of MOFOR for MOFNumber of VFOR for VFNormal BMD & TBS497 (14.3%)0.19(0.08-0.43)*00.83(0.80-.87)*Normal BMD moderate TBS195 (26.3%)0.44(0.16-1.24)2 (10.5%)0.66(0.15-2.9)Normal BMD degraded TBS72 (28.6%)0.50(0.1-2.6)1 (14.3%)0.94(0.11-7.9)Osteopenia normal TBS9633 (34.4%)0.61(0.39-0.97)7 (7.3%)0.39(0.18-0.88)*Osteopenia moderate TBS9843 (43.9%)0.99(0.64-1.54)11 (11.2%)0.67(0.34-1.32)Osteopenia degraded TBS5730 (52.6%)1.47(.085-2.55)11 (19.3%)1.41(0.7-2.86)Osteoporosis normal TBS3918 (46.2%)1.1(0.57-2.1)6 (15.4%)1(0.42-2.6)Osteoporosis moderate TBS11259 (52.7%)1.55(1.02-2.35)*21 (18.8%)1.42(0.82-2.45)Osteoporosis degraded TBS6341 (65.1%)2.65(1.53-4.59)*22 (34.9%)3.8(2.12-6.83)*Total54023881Acknowledgments:Bone density team, Robert Jones and Agnes Hunt Orthopaedic HospitalDisclosure of Interests:None declared
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Fukumoto, Seiji, and Toshio Matsumoto. "Recent advances in the management of osteoporosis." F1000Research 6 (May 5, 2017): 625. http://dx.doi.org/10.12688/f1000research.10682.1.
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There has been substantial progress in the management of patients with osteoporosis and the prevention of osteoporotic fractures. Currently available strong anti-resorptive agents are bisphosphonates and an anti-receptor activator of nuclear factor-kappa B ligand (RANKL) antibody, denosumab. Although bisphosphonates and denosumab both inhibit bone resorption and prevent vertebral and non-vertebral fractures, their mechanisms of action are different. Whereas bisphosphonates’ effects on bone mineral density and fracture peak around 3 to 5 years and become plateaued, those of denosumab are maintained for up to 10 years. There are differences in the modes of action of these two drugs. Bisphosphonates accumulate on the mineralized bone surface and are released by the acid environment under osteoclastic bone resorption, whereas denosumab is not accumulated on bone but directly binds RANKL and inhibits its binding to the receptor RANK. Thus, the reduction in denosumab concentration 4 to 6 months after injection may enable RANK to bind to RANKL, where it is highly expressed, such as in damaged bone regions. As anabolic agents, only teriparatide has been available for a long time, but abaloparatide, a synthetic analog of PTHrP(1–34), is currently under development. Because of the difference in the preferential binding conformations of PTH1 receptor between teriparatide and abaloparatide, the latter shows anabolic effects with fewer bone resorptive effects. Romosozumab, an anti-sclerostin antibody, inhibits the action of sclerostin, a canonical Wnt signal inhibitor secreted from osteocytes, and enhances canonical Wnt signaling. Romosozumab robustly increases vertebral and proximal femoral bone mineral density within 12 months and inhibits vertebral and clinical fractures in patients with osteoporosis by enhancing bone formation and inhibiting bone resorption. In this review, we summarize the recent advances in therapeutic agents for the treatment of osteoporosis and discuss future prospects with their use.
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O’Donnell, Siobhan. "Screening, prevention and management of osteoporosis among Canadian adults." Health Promotion and Chronic Disease Prevention in Canada 38, no. 12 (2018): 445–54. http://dx.doi.org/10.24095/hpcdp.38.12.02.
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Introduction This study provides a benchmark for the nationwide use of osteoporosis screening, prevention and management strategies among Canadians aged 40 years and older (40+) using data collected one year prior to the release of Osteoporosis Canada’s latest (2010) clinical practice guidelines. Methods Data are from the 2009 Canadian Community Health Survey—Osteoporosis Rapid Response Component. The study sample (n = 5704) was divided into four risk subgroups: (1) osteoporosis diagnosis and major fracture; (2) osteoporosis diagnosis only; (3) major fracture only; or (4) neither osteoporosis diagnosis nor major fracture. We calculated descriptive statistics and performed multinomial multivariate logistic regression analyses to examine factors independently associated with osteoporosis screening, prevention and management strategies. Estimates were weighted to represent the Canadian household population (40+) living in the 10 provinces. Results Approximately 10.1% of the population or 1.5 million Canadians 40+ reported having been diagnosed with osteoporosis. The majority related taking vitamin D or calcium supplements and having been prescribed osteoporosis medication(s), while less than 40% reported regular physical activity. Among those without a reported osteoporosis diagnosis, an estimated 6.7% or 1 million reported having had a major fracture, of which one-third reported having had a bone density test and less than half reported taking vitamin D supplements, calcium supplements or engaging in regular physical activity. Major fracture history was not associated with bone density testing or osteoporosis medication use. Conclusion A large proportion of Canadians at risk for osteoporosis—those with a major fracture history—are not undergoing bone density testing nor are they engaging in lifestyle approaches known to help maintain healthy bones. This study provides the historical information required to evaluate whether the latest clinical practice guidelines have had an impact on osteoporosis care in Canada.
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Wang, Jing, Bing Shu, Chen-Guang Li, et al. "Polymorphisms of genes related to vitamin D metabolism and transportation and its relationship with the risk of osteoporosis: protocol for a multicentre prospective cohort study in China." BMJ Open 9, no. 11 (2019): e028084. http://dx.doi.org/10.1136/bmjopen-2018-028084.
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IntroductionOsteoporotic fracture is one of the most common causes of disability and a major contributor to medical care costs in many regions of the world. The polymorphisms of genes related to vitamin D metabolism and transportation are associated with variation in bone mineral density and the risk of osteoporosis.Methods and analysisThe China Community-based Cohort of Osteoporosis study is an observational, longitudinal, multicentre, prospective cohort study for middle-aged and older permanent residents of China, which has been ongoing in six cities since 2016. Female residents aged 45–80 years old and male residents aged 50–80 years old are identified through permanent resident lists. All the enrolled participants will complete questionnaires on their personal characteristics and histories. The bone mineral density of their lumbar vertebrae and left hip will be measured and serum bone metabolism parameters assessed. Polymorphisms of genes related to vitamin D metabolism and transportation will be detected, and their relationship with the risk of osteoporosis, and osteoporotic fracture, will be analysed. About 18 000 residents will be involved in the study.Ethics and disseminationThe study was approved by Institutional Ethics Board of Longhua Hospital affiliated to Shanghai University of Traditional Chinese Medicine (2016LCSY065). Results will be published in peer-reviewed journals. The results of this study are expected to improve the understanding of the association between polymorphisms of genes related to vitamin D metabolism and transportation and the risk of osteoporosis and osteoporotic fracture among middle-aged and older residents of China.Trial registration numberNCT02958020
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Yao, F. A., A. S. Dobs, and T. T. Brown. "Alternative Therapies for Osteoporosis." American Journal of Chinese Medicine 34, no. 05 (2006): 721–30. http://dx.doi.org/10.1142/s0192415x06004235.
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A variety of common complementary and alternative medicine therapies are now being examined for effectiveness in the management of osteoporosis. Short-term studies in postmenopausal women show beneficial effects of soy isoflavone supplementation on bone density, but its long-term effects require clarification. Prospective controlled trials have shown that physical training can increase bone density to varying degrees. Other therapies that have been examined include herbal formulae, essential fatty acids and vitamins A, C, and K, but few data regarding their effectiveness, mechanisms and safety have been published. Further randomized controlled trials are needed.
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Mizutani, Kento, Kana Isono, Yoshiaki Matsushima, et al. "Inflammatory Skin-Derived Cytokines Accelerate Osteoporosis in Mice with Persistent Skin Inflammation." International Journal of Molecular Sciences 21, no. 10 (2020): 3620. http://dx.doi.org/10.3390/ijms21103620.
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Secondary osteoporosis can also be caused by chronic inflammatory skin disease as well as rheumatoid arthritis or inflammatory bowel disease. However, the exact role of osteoporosis in inflammatory skin conditions has not been elucidated. Using a mouse model of dermatitis, we investigated the pathophysiology of osteoporosis in inflammatory skin conditions and the therapeutic impact of osteoporosis medication on inflammatory skin disease. We employed model mice of spontaneous skin inflammation, specifically overexpressing human caspase-1 in the epidermis. Bone density and the expression of various mRNAs in the femur were examined by micro CT and RT-PCR. The effects of minodronate and anti-RANKL antibody on bone structure, histology, and femur blood flow were studied. The mouse model of skin inflammation showed a marked decrease in bone density compared to wild-type littermates with abnormalities in both bone resorption and formation. Minodronate improved bone density by decreasing osteoclasts, but anti-RANKL antibody did not improve. In the dermatitis model, the blood flow in the bone marrow was decreased, and minodronate restored this parameter. A model of persistent dermatitis exhibited marked osteoporosis, but the impact of chronic dermatitis on osteoporosis has not been thoroughly investigated. We should explore the pathogenesis of osteoporosis in skin inflammatory diseases.
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Lirani-Galvão, Ana Paula Rebucci, and Marise Lazaretti-Castro. "Physical approach for prevention and treatment of osteoporosis." Arquivos Brasileiros de Endocrinologia & Metabologia 54, no. 2 (2010): 171–78. http://dx.doi.org/10.1590/s0004-27302010000200013.
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Osteoporosis and its consequent fractures are a major problem in public health. To complement the conventional pharmacological treatment for this metabolic disease, non-pharmacological treatment options have been developed in the last decades. Several studies demonstrate that physical exercise programs including impact exercises, specific strength training, balance and coordination training may maintain or increase spine and hip bone mineral density as well as decrease the frequency of falls among osteoporotic and osteopenic patients. Furthermore, some physical agents such as vibratory platforms, low intensity electrical stimulation, laser therapy and ultrasound show positive effects on osteoporotic tissue as well. Consequently, while planning treatment for an osteoporotic patient, non-pharmacological management options should be considered and integrated to the conventional treatment in order to maximize its effects and improve the quality of life of these patients.
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Ward, Leanne M., David R. Weber, Craig F. Munns, Wolfgang Högler, and Babette S. Zemel. "A Contemporary View of the Definition and Diagnosis of Osteoporosis in Children and Adolescents." Journal of Clinical Endocrinology & Metabolism 105, no. 5 (2019): e2088-e2097. http://dx.doi.org/10.1210/clinem/dgz294.
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Abstract The last 2 decades have seen growing recognition of the need to appropriately identify and treat children with osteoporotic fractures. This focus stems from important advances in our understanding of the genetic basis of bone fragility, the natural history and predictors of fractures in chronic conditions, the use of bone-active medications in children, and the inclusion of bone health screening into clinical guidelines for high-risk populations. Given the historic focus on bone densitometry in this setting, the International Society for Clinical Densitometry published revised criteria in 2013 to define osteoporosis in the young, oriented towards prevention of overdiagnosis given the high frequency of extremity fractures during the growing years. This definition has been successful in avoiding an inappropriate diagnosis of osteoporosis in healthy children who sustain long bone fractures during play. However, its emphasis on the number of long bone fractures plus a concomitant bone mineral density (BMD) threshold ≤ −2.0, without consideration for long bone fracture characteristics (eg, skeletal site, radiographic features) or the clinical context (eg, known fracture risk in serious illnesses or physical-radiographic stigmata of osteoporosis), inappropriately misses clinically relevant bone fragility in some children. In this perspective, we propose a new approach to the definition and diagnosis of osteoporosis in children, one that balances the role of BMD in the pediatric fracture assessment with other important clinical features, including fracture characteristics, the clinical context and, where appropriate, the need to define the underlying genetic etiology as far as possible.
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Griffin, Sarah. "Primary prevention of osteoporosis." InnovAiT: Education and inspiration for general practice 6, no. 3 (2013): 148–54. http://dx.doi.org/10.1177/1755738012467437.
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Osteoporosis is a chronic condition characterized by progressive loss of both bone mass and density. It is the most common bone disease, affecting 70% of women over the age of 80 years, and renders bones brittle and vulnerable to fracture. One in every two women and one in every five men sustain an osteoporosis-related fracture within their lifetime. Most of these fractures occur before a formal diagnosis of osteoporosis has been made; thus there is a clear role for primary prevention in preosteoporotic patients. There are numerous established risk factors for the development of osteoporosis, ranging from age, ethnicity and gender to specific medical conditions, medications, family history and lifestyle. Considering these as part of a primary care assessment allows patients at risk to be identified. Appropriate interventions can then be offered with the view to delaying, or ideally preventing, the onset of osteoporosis and its symptoms.
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Lau, Tang Ching. "Current Challenges in Osteoporosis Treatment Discontinuation." Singapore Family Physician 47, no. 3 (2021): 17–18. http://dx.doi.org/10.33591/sfp.47.3.u3.
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Osteoporosis is a chronic disease that may require lifelong therapy. Therefore, evidence-based approach regarding the efficacy and safety of long‐term osteoporosis therapy and therapy discontinuation is important. The most important goals for osteoporosis and fragility fracture patients are the recovery of pre-fracture functional level and reduction of fracture risk. There has been increasing consensus that a treat-to-target (T2T) strategy is applicable to osteoporosis and that bone mineral density (BMD) is currently the most clinically appropriate target. However, there is no clear consensus with regard to the definition of a specific BMD treatment target and timeframes applicable to T2T in osteoporosis, and these would need to be individually determined. Treatment with bisphosphonates may be interrupted after 3-5 years, only in patients in whom fracture risk is low or lowered because of the treatment itself. It is recommended never to discontinue treatment in patients with one or more prevalent osteoporotic fractures or in whom the BMD values are still below -2.5 (T score). Recent reports imply that denosumab discontinuation may lead to an increased risk of multiple vertebral fractures. Patients considered at high fracture risk should either continue denosumab therapy for up to ten years or be switched to an alternative treatment. For patients at low-risk, a decision to discontinue denosumab could be made after five years, but bisphosphonate therapy should be considered to reduce or prevent the rebound increase in bone turnover.
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Wei, Min, Zhonglin Yang, Ping Li, Yabo Zhang, and Wing Cho Sse. "Anti-Osteoporosis Activity of Naringin in the Retinoic Acid-Induced Osteoporosis Model." American Journal of Chinese Medicine 35, no. 04 (2007): 663–67. http://dx.doi.org/10.1142/s0192415x07005156.
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Isoflavonoids isolated from plants have been confirmed to fight osteoporosis and promote bone health. However, few studies have been conducted to describe the anti-osteoporosis activity of botanical flavonone. Based on the experimental outcomes, we demonstrated the ability of naringin to fight osteoporosis in vitro. We developed a retinoic acid-induced osteoporosis model of rats to assess whether naringin has similar bioactivity against osteoporosis in vitro. After a 14-day supplement of retinoic acid to induce osteoporosis, SD rats were administered naringin. A blood test showed that naringin-treated rats experienced significantly lower activity of serum alkaline phosphatase and had higher femur bone mineral density, compared to untreated rats. All three dosages of naringin improved the decrease in bone weight coefficient, the length and the diameter of the bone, the content of bone ash, calcium, and phosphorus content induced by retinoic acid. The data of histomorphological metrology of naringin groups showed no difference as compared to normal control rats. These outcomes suggest that naringin offer a potential in the management of osteoporosis in vitro.
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Vaghaiwalla, Z., P. Wasserman, and G. Kaeley. "POS0165 STUDY OF VERTEBRAL AND FEMUR FRACTURE PREVALENCE AND SCANOGRAPHIC BONE ATTENUATION COEFFICIENT OF THE FIRST LUMBAR VERTEBRA IN AN ACADEMIC HOSPITAL SETTING." Annals of the Rheumatic Diseases 80, Suppl 1 (2021): 295.1–295. http://dx.doi.org/10.1136/annrheumdis-2021-eular.1475.
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Background:Patients with osteoporosis are prone to suffer fragility fractures leading to an increased risk of future fractures. Detection of osteoporosis has been led by dual energy-ray absorptiometry (DEXA) as the gold standard. However, in acute fracture incidents, DEXA imaging is typically unavailable, and treatment is often delayed. In recent years scanographic bone attenuation coefficient of the first lumbar vertebra (SBAC-L1) on incidental computed tomography (CT) scans of the lumbar spine has been utilized as an alternative assessment of bone density. In particular, SBAC-L1 ≤ 145 HU correlates with osteoporotic bone density on DEXA imaging.2Objectives:This study aims to assess the SBAC-L1 in HU of incidental CT scans in patients presenting with vertebra or femur fragility fractures in an academic hospital as it relates to osteoporosis.Methods:We conducted a retrospective chart review of patients aged ≥ 45 admitted to an academic hospital for active vertebral or femur fracture between 1/1/2017- 1/31/2019, excluding traumatic and pathological fractures. Measurement of SBAC-L1 in HU was obtained on incidental CT scan imaging.Sex, race, prior and post diagnoses of osteoporosis, prior and post DEXA scan orders, use of calcium, vitamin D, and steroids were abstracted.Results:There were 297 patients with vertebral or femur fractures from 1/1/2017- 1/31/2019. Of 297 patients, 85 deemed appropriate after excluding pathological, traumatic fractures, and lack of CT scan on the admission for fracture.Average SBAC-L1 for all patients was 100.4 ± standard deviation (SD) of 46.5 HU. 82% of all patients had SBAC-L1 ≤ 145 HU. Caucasian patients had a lower average SBAC-L1 [99.4 HU] than African American (AA) patients [122.1 HU]. More Caucasian [n=15] had prior diagnoses of osteoporosis than AA [n=2]. Caucasian patients were prescribed Calcium and Vitamin D more often [n=39] than AA [n=3]. DEXA scan orders were placed more often in Caucasian patients [n=4] than AA patients [n=1]. Osteoporosis medications were prescribed more often in Caucasian patients [n=8] than AA patients [n=0].Male average SBAC-L1 was 97.4 HU compared to females at 106.3 HU. Females were prescribed calcium and vitamin D more often [n=38] than males [n=8]. DEXA scan orders were placed more frequently in females [n=5] than males [n=2]. Osteoporosis medications were prescribed more often in females [n=9] than male patients [n=0].Table 1.Study CharacteristicsTotal Patients [n=85]Caucasian Patients[n=67]AA Patients[n=16]Male Patients[n=31]Female Patients[n=54]SBAC- L1 Average ± SD (HU)100.4 ± 46.599.4 ± 44.1122.1 ± 49.997.4 ± 44.3106.3 ± 47.2Patients with SBAC- L1 ≤ 145 HU7058102644Patients with SBAC- L1 > 145 HU1596510Vertebral Fractures574781938Femur Fractures282081216Age Average71.77270.97470.4Prior diagnosis of osteoporosis16151214Post diagnosis of osteoporosis62224Calcium20162218Vitamin D26231620Osteoporosis medication98009Steroid use54123DEXA prior13121013DEXA after74125Conclusion:70 of 85 patients with incidental fragility fractures exhibited SBAC-L1 ≤ 145 HU. This is consistent with osteoporotic bone density on DEXA imaging supporting the use of SBAC-L1 measurement to corroborate the diagnosis osteoporosis. SBAC-L1 ≤ 145 HU can be utilized to increase inpatient diagnostic confidence of osteoporosis in the setting of acute fragility fractures to allow initiation of treatment prior to awaiting outpatient DEXA imaging.The results here also highlight health disparities present among African Americans and males of all races when considering bone health.References:[1]Lewiecki, E. Michael, et al. “Healthcare policy changes in osteoporosis can improve outcomes and reduce costs in the United States.” JBMR plus 3.9 (2019): e10192.[2]Fauny, Marine, et al. “Study of vertebral fracture and Scanographic Bone Attenuation Coefficient in rheumatoid arthritis and ankylosing spondylitis vs. controls.” Scientific reports 9.1 (2019): 1-9.Disclosure of Interests:None declared
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Cosman, Felicia. "ANABOLIC THERAPY AND OPTIMAL TREATMENT SEQUENCES FOR PATIENTS WITH OSTEOPOROSIS AT HIGH RISK FOR FRACTURE." Endocrine Practice 26, no. 7 (2020): 777–86. http://dx.doi.org/10.4158/ep-2019-0596.
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Objective: Provide an update regarding anabolic medications for osteoporosis, which are often considered to be the last resort for patients with osteoporosis, after multiple fractures have already occurred and other medications have already been administered. Methods: Literature review and discussion. Results: Recent pivotal trial data for anabolic agents and randomized trials comparing anabolic and antiresorptive medications suggest that three anabolic agents (teriparatide, abaloparatide, and romosozumab) reduce nonvertebral and vertebral fractures faster and to a greater extent than potent antiresorptive treatments. Furthermore, bone density accrual is maximized when patients are given anabolic agents first, followed by potent antiresorptive therapy. Since total hip bone density during or after osteoporosis treatment has emerged as an excellent surrogate for future fracture risk, attaining a greater hip bone mineral density is a treatment goal for high-risk osteoporosis patients. Conclusion: This review defines the highest-risk patients and summarizes the rationale for the evolving role of anabolic therapy in the management of postmenopausal women at high risk for fracture. Abbreviations: ACTIVE = Abaloparatide Comparator Trial in Vertebral Endpoints; ARCH = Active Controlled Fracture Study in Postmenopausal Women with Osteoporosis at High Risk; BMD = bone mineral density; FRAME = Fracture Study in Postmenopausal Women with Osteoporosis; FRAX = Fracture Risk Assessment Tool; PTH = parathyroid hormone; TBS = trabecular bone score
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Liang, Jinqian, Chong Chen, Hongzhe Liu, et al. "Gossypol Promotes Bone Formation in Ovariectomy-Induced Osteoporosis through Regulating Cell Apoptosis." BioMed Research International 2018 (December 13, 2018): 1–9. http://dx.doi.org/10.1155/2018/3635485.
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Osteoporosis is among the most common forms of age-related diseases, especially for females, which has been a grave public health problem. Drug therapies have shown promising outcomes to promote bone formation and bone density. This study identified a novel potential drug, gossypol, for the treatment of osteoporosis. Treatments of ovariectomy-induced osteoporosis mice with gossypol significantly increased serum osteocalcin and osteoprotegerin (OPG) levels; meanwhile they decreased serum RANKL levels. Microcomputed tomography (microCT) analysis showed that treatment of gossypol improved bone density and strength and decreased bone postyield displacement for both medullar and cortical bones. In vitro experiments also showed that gossypol increased cell viability in a time- and dose-dependent manner. Furthermore, incubation of the osteoblast MC3T3-E1 cells with gossypol inhibited cell apoptosis through intrinsic apoptotic pathway as evidenced by the Annexin V/PI assay, TUNEL assay, biochemical analysis, and western blot assays. Moreover, the classical Wnt/β-catenin signaling pathway was found to be regulated by gossypol treatments. Inhibition of Wnt/β-catenin signaling reversed the prevention effects of gossypol in osteoporosis. Our findings provided novel clues for the treatment of osteoporosis in clinic.
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He, Q.-F., H. Sun, L.-Y. Shu, et al. "Radiographic predictors for bone mineral loss." Bone & Joint Research 7, no. 7 (2018): 468–75. http://dx.doi.org/10.1302/2046-3758.77.bjr-2017-0332.r1.
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Objectives Researchers continue to seek easier ways to evaluate the quality of bone and screen for osteoporosis and osteopenia. Until recently, radiographic images of various parts of the body, except the distal femur, have been reappraised in the light of dual-energy X-ray absorptiometry (DXA) findings. The incidence of osteoporotic fractures around the knee joint in the elderly continues to increase. The aim of this study was to propose two new radiographic parameters of the distal femur for the assessment of bone quality. Methods Anteroposterior radiographs of the knee and bone mineral density (BMD) and T-scores from DXA scans of 361 healthy patients were prospectively analyzed. The mean cortical bone thickness (CBTavg) and the distal femoral cortex index (DFCI) were the two parameters that were proposed and measured. Intra- and interobserver reliabilities were assessed. Correlations between the BMD and T-score and these parameters were investigated and their value in the diagnosis of osteoporosis and osteopenia was evaluated. Results The DFCI, as a ratio, had higher reliability than the CBTavg. Both showed significant correlation with BMD and T-score. When compared with DFCI, CBTavg showed better correlation and was better for predicting osteoporosis and osteopenia. Conclusion The CBTavg and DFCI are simple and reliable screening tools for the prediction of osteoporosis and osteopenia. The CBTavg is more accurate but the DFCI is easier to use in clinical practice. Cite this article: Q-F. He, H. Sun, L-Y. Shu, Y. Zhu, X-T. Xie, Y. Zhan, C-F. Luo. Radiographic predictors for bone mineral loss: Cortical thickness and index of the distal femur. Bone Joint Res 2018;7:468–475. DOI: 10.1302/2046-3758.77.BJR-2017-0332.R1.
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Francis, R. M. "Management of Corticosteroid-Induced Osteoporosis." British Menopause Society Journal 4, no. 2 (1998): 52–56. http://dx.doi.org/10.1177/136218079800400206.
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The pathogenesis of corticosteroid-induced osteoporosis is different from postmenopausal osteoporosis in that the major abnormality is a reduction in bone formation. Corticosteroids result in a 10–15% overall bone loss leading to an increased risk of fracture. Patients on corticosteroids also appear to fracture at a higher bone density than other postmenopausal women. It may therefore be appropriate to start treatment for osteoporosis in corticosteroid-treated patients at a higher bone density than for other postmenopausal women. The various treatments that have been employed are discussed, including calcium and vitamin D, calcitriol, hormone replacement therapy, bisphosphonates, calcitonin, anabolic steroids and fluoride salts. Bisphosphonates are the most extensively investigated treatments. The use of hormone replacement therapy should also be encouraged. The role of other treatments such as calcitriol, calcitonin and fluoride salts remains uncertain.
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Chou, Hsin-Hua, Sao-Lun Lu, Sen-Te Wang, Ting-Hsuan Huang, and Sam Li-Sheng Chen. "The Association between Bone Mineral Density and Periodontal Disease in Middle-Aged Adults." International Journal of Environmental Research and Public Health 18, no. 6 (2021): 3321. http://dx.doi.org/10.3390/ijerph18063321.
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The association between osteoporosis and periodontal disease (PD) has been revealed by previous studies, but there have been few studies on the association in younger adults. We enrolled a total of 7298 adults aged 40 to 44 who underwent PD screening between 2003 and 2008. Data on quantitative ultrasound for the measurement of bone mineral density (BMD) were collected for the diagnostic criteria of osteopenia and osteoporosis. The Community Periodontal Index (CPI) was measured for defining PD. A multiple logistic regression model was used to assess the effect of low bone mass on the risk of PD. Of 7298 enrollees, 31% had periodontal pockets >3 mm, 36.2% had osteopenia, and 2.1% had osteoporosis. The 39.8% of PD prevalence was high in adults with osteoporosis, followed by 33.3% in osteopenia. A negative association was found between BMD and CPI value (p < 0.0001). Low bone mass was associated with the risk of PD (adjusted OR: 1.13; 95% CI:1.02–1.26) after adjusting the confounding factors, including age, gender, education level, overweight, smoking status, past history of osteoporosis, and diabetes mellitus. An association between BMD and PD among young adults was found. An intervention program for the prevention of PD and osteoporosis could be considered starting in young adults.
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Daga, Mradul Kumar. "Osteoporosis in Chronic Obstructive Pulmonary Disease: More than just a Comorbidity." Journal of Advanced Research in Medicine 07, no. 03 (2020): 7–21. http://dx.doi.org/10.24321/2349.7181.202011.
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Chronic Obstructive Pulmonary Disease (COPD) is one of the leading causes of mortality and loss of Disability-Adjusted Life-Years (DALYs) worldwide. It often is accompanied by the presence of various systemic comorbidities including osteoporosis which may have an impact on the course of the disease. Osteopenia and osteoporosis are the consequences of loss of Bone Mineral Density (BMD) and have been widely known major comorbidities in COPD patients. Female sex, age, and smoking are common pathogenic factors for both COPD and osteoporosis, other factors such as reduced daily physical activity, malnutrition, low body mass index, hypogonadism, vitamin D deficiency, chronic renal insufficiency, chronic hypoxemia, and drugs like corticosteroids, have been invoked to explain such a frequent association between them. Osteoporosis in COPD is however often undertreated. It has been shown in recent studies that both decreased Bone Mineral Density (BMD) and impaired bone quality contribute to bone fragility, causing fractures in COPD patients. Pulmonary function and activities of the daily life of COPD patients may be further deteriorated by osteoporosis-associated fractures. Calcium and vitamin D, hormone replacement when indicated, calcitonin, and bisphosphonate administration are few effective strategies to tackle bone loss and osteoporosis. Awareness about this high prevalence of osteoporosis in COPD patients is critically important and physicians should look for such fracture risks. Routine screening and early diagnosis of osteoporosis will enable physicians to provide the appropriate treatment to prevent fracture, which leads to improved quality of life as well as better long-term prognosis.
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Uçan Tokuç, Firdevs Ezgi, Fatma Genç, Abidin Erdal, and Yasemin Biçer Gömceli. "Management of bone metabolism in epilepsy." Ideggyógyászati szemle 74, no. 7-8 (2021): 257–65. http://dx.doi.org/10.18071/isz.74.0257.
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Many systemic problems arise due to the side effects of antiepileptic drugs (AEDs) used in epilepsy patients. Among these adverse effects are low bone mineral density and increased fracture risk due to long-term AED use. Although various studies have supported this association with increased risk in recent years, the length of this process has not been precisely defined and there is no clear consensus on bone density scanning, intervals of screening, and the subject of calcium and vitamin D supplementation. In this study, in accordance with the most current recommendations, our applications and data, including the detection of possible bone mineralization disorders, treatment methods, and recommendations to prevent bone mineralization disorders, were evaluated in epilepsy patients who were followed up at our outpatient clinic. It was aimed to draw attention to the significance of management of bone metabolism carried out with appropriate protocols. Epilepsy patients were followed up at the Antalya Training and Research Hospital Department of Neurology, Epilepsy Outpatient Clinic who were at high risk for osteoporosis (use of valproic acid [VPA] and enzyme-inducing drugs, using any AED for over 5 years, and postmenopausal women) and were evaluated using a screening protocol. According to this protocol, a total of 190 patients suspected of osteoporosis risk were retrospectively evaluated. Four patients were excluded from the study due to secondary osteoporosis. Of the 186 patients who were included in the study, 97 (52.2%) were women and 89 (47.8%) were men. Prevalence of low bone mineral density (BMD) was 42%, in which osteoporosis was detected in 11.8% and osteopenia in 30.6% of the patients. Osteoporosis rate was higher at the young age group (18-45) and this difference was statistically significant (p=0.018). There was no significant difference between male and female sexes according to osteoporosis and osteopenia rates. Patients receiving polytherapy had higher osteoporosis rate and lower BMD compared to patients receiving monotherapy. Comparison of separate drug groups according to osteoporosis rate revealed that osteoporosis rate was highest in patient groups using VPA+ carbamazepine (CBZ) (29.4%) and VPA polytherapy (19.4%). Total of osteopenia and osteoporosis, or low BMD, was highest in VPA polytherapy (VPA+ non-enzyme-inducing AED [NEID]) and CBZ polytherapy (CBZ+NEID) groups, with rates of 58.3% and 55.1%, respectively. In addition, there was no significant difference between drug groups according to bone metabolism markers, vitamin D levels, and osteopenia-osteoporosis rates. Assuming bone health will be affected at an early age in epilepsy patients, providing lifestyle and diet recommendations, avoiding polytherapy including VPA and CBZ when possible, and evaluating bone metabolism at regular intervals are actions that should be applied in routine practice.
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Paspaliaris, Vasilis, and George Kolios. "Stem cells in Osteoporosis: From Biology to New Therapeutic Approaches." Stem Cells International 2019 (June 2, 2019): 1–16. http://dx.doi.org/10.1155/2019/1730978.
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Osteoporosis is a systemic disease that affects the skeleton, causing reduction of bone density and mass, resulting in destruction of bone microstructure and increased risk of bone fractures. Since osteoporosis is a disease affecting the elderly and the aging of the world’s population is constantly increasing, it is expected that the incidence of osteoporosis and its financial burden on the insurance systems will increase continuously and there is a need for more understanding this condition in order to prevent and/or treat it. At present, available drug therapy for osteoporosis primarily targets the inhibition of bone resorption and agents that promote bone mineralization, designed to slow disease progression. Safe and predictable pharmaceutical means to increase bone formation have been elusive. Stem cell therapy of osteoporosis, as a therapeutic strategy, offers the promise of an increase in osteoblast differentiation and thus reversing the shift towards bone resorption in osteoporosis. This review is focused on the current views regarding the implication of the stem cells in the cellular and physiologic mechanisms of osteoporosis and discusses data obtained from stem cell-based therapies of osteoporosis in experimental animal models and the possibility of their future application in clinical trials.