High Prevalence Of Osteoporosis Research Articles

Correlation between bone mineral density and type 2 diabetes mellitus in elderly men and postmenopausal women

The relationship between bone mineral density and type 2 diabetes is still controversial. The aim of this study is to investigate the relationship between type 2 diabetes mellitus (T2DM) and bone mineral density (BMD) in elderly men and postmenopausal women. The participants in this study included 692 postmenopausal women and older men aged ≥ 50 years, who were divided into the T2DM group and non-T2DM control group according to whether or not they had T2DM. The data of participants in the two groups were collected from the inpatient medical record system and physical examination center systems, respectively, of the Tertiary Class A Hospital. All data analysis is performed in SPSS Software. Compared with all T2DM group, the BMD and T scores of lumbar spines 1–4 (L1–L4), left femoral neck (LFN) and all left hip joints (LHJ) in the non-T2DM group were significantly lower than those in the T2DM group (P < 0.05), and the probability of major osteoporotic fracture in the next 10 years (PMOF) was significantly higher than that in T2DM group (P < 0.001). However, with the prolongation of the course of T2DM, the BMD significantly decreased, while fracture risk and the prevalence of osteoporosis significantly increased (P < 0.05). We also found that the BMD of L1-4, LFN and LHJ were negatively correlated with homeostatic model assessment-insulin resistance (HOMA-IR) (P = 0.028, P = 0.01 and P = 0.047, respectively). The results also showed that the BMD of LHJ was positively correlated with indirect bilirubin (IBIL) (P = 0.018). Although the BMD was lower in the non-T2DM group than in the T2DM group, the prolongation of the course of T2DM associated with the lower BMD. And the higher prevalence of osteoporosis and fracture risk significantly associated with the prolongation of the course of T2DM. In addition, BMD was significantly associated with insulin resistance (IR) and bilirubin levels in T2DM patients.Registration number: China Clinical Trials Registry: MR-51-23-051741; https://www.medicalresearch.org.cn/search/research/researchView?id=c0e5f868-eca9-4c68-af58-d73460c34028.

Clinical Characteristic of Patients Underwent Bone Mineral Density Examination in Prof. Dr. R. Soeharso Orthopaedic Hospital in 2022-2023: A Cross-Sectional Study

Background: In Indonesia, osteoporosis affects roughly 23% of men and women aged 50-70 and a staggering 53% of those over 70. Understanding the characteristics of patients undergoing bone mineral density (BMD) examinations is crucial for developing better strategies for prevention, diagnosis, and treatment. This study investigates the characteristics of patients who had BMD examinations at the Prof. Dr. R. Soeharso Orthopaedic Hospital. Methods: A cross-sectional study was conducted at Prof. Dr. R. Soeharso Orthopaedic Hospital from April 2022 to April 2023, using a total sampling approach and data extracted from digital medical records. The variables included age, gender, body mass index (BMI), BMD T-score from the lumbar spine, hip, and forearm, frequency and location of fragility fracture (FF), osteoporosis frequency, and fracture risk assessment (FRAX) score for major osteoporotic fracture (MOF) and hip fracture. Patients with incomplete data were excluded. Results: This study involved 168 patients, mainly women (83%) and men (17%). Most (81.5%) were aged 50-74, with osteoporosis affecting 29.2% and severe osteoporosis affecting 60.7%. The spine was the most common site of FF (88.2%). Osteoporosis severity correlated with higher BMI (p&lt;0.05). FRAX scores for MOF and hip fractures were mostly in the low-risk category. Conclusions: A high prevalence of osteoporosis and severe osteoporosis among women, particularly those in the age of 50 to 74 years, and higher BMI was correlated with greater severity of osteoporosis. FF was found more common among women with the spine as the most frequently affected site.

The effects of cholecalciferol and afamelanotide on vitamin D levels in erythropoietic protoporphyria; a multicentre cohort study.

Erythropoietic protoporphyria (EPP) patients experience lifelong painful photosensitivity resulting in a lack of sunlight exposure. Previous studies have shown that 47-63% of EPP patients suffer from vitamin D deficiency and a high prevalence of osteoporosis. As of 2016 an effective treatment for EPP is available: the alpha-MSH analogue afamelanotide. So far studies on vitamin D levels in EPP have only investigated patients who were not treated with afamelanotide. To investigate the effects of afamelanotide treatment on vitamin D levels in EPP. A multi-centre observational cohort study, in adult patients with EPP from the Erasmus Medical Centre, the Netherlands and the University Hospital Düsseldorf, Germany. Routinely-collected vitamin D levels between 2005 and 2021 were used for analysis. Patient exposure to cholecalciferol or afamelanotide was categorized into four treatment groups; untreated, cholecalciferol, afamelanotide, and combined treatment. A linear mixed model for longitudinal data was applied to measure the effect of the treatment groups, compared to the untreated, on vitamin D levels. A total of 230 patients and 1774 vitamin D measurements were included. Prevalence of vitamin D deficiency remained high despite afamelanotide treatment: <50 nmol/l in 71.8% of patients, and severe deficiency <30 nmol/l in 48.1%. Afamelanotide treatment alone did not lead to a significant average increase in vitamin D levels (β:0.5, 95% Confidence Interval [CI]: -3.2 - 4.2). In contrast, cholecalciferol and combined therapy with afamelanotide, led to a significant increase in vitamin D levels (β:11.6, CI: 7.2-15.9 and β:15.2, CI: 12.3-18.1). Cholecalciferol remains essential for treatment of vitamin D deficiency in EPP, irrespective of new treatment options like afamelanotide. Afamelanotide treatment did not affect vitamin D levels. We suggest that future guidelines include continuous monitoring of vitamin D and prescription of cholecalciferol in all patients with EPP, including those treated with afamelanotide.

The association between body mass index and osteoporosis in a Taiwanese population: a cross-sectional and longitudinal study

This study investigates the correlation between body mass index (BMI) and osteoporosis utilizing data from the Taiwan Biobank. Initially, a comprehensive analysis of 119,009 participants enrolled from 2008 to 2019 was conducted to assess the association between BMI and osteoporosis prevalence. Subsequently, a longitudinal cohort of 24,507 participants, initially free from osteoporosis, underwent regular follow-ups every 2–4 years to analyze the risk of osteoporosis development, which was a subset of the main cohort. Participants were categorized into four BMI groups: underweight (BMI < 18.5 kg/m2), normal weight (18.5 kg/m2 ≤ BMI < 24 kg/m2), overweight (24 kg/m2 ≤ BMI < 27 kg/m2), and obese groups (BMI ≥ 27 kg/m2). A T-score ≤ − 2.5 standard deviations below that of a young adult was defined as osteoporosis. Overall, 556 (14.1%), 5332 (9.1%), 2600 (8.1%) and 1620 (6.7%) of the participants in the underweight, normal weight, overweight and obese groups, respectively, had osteoporosis. A higher prevalence of osteoporosis was noted in the underweight group compared with the normal weight group (odds ratio [OR], 2.20; 95% confidence interval [95% CI], 1.99 to 2.43; p value < 0.001) in multivariable binary logistic regression analysis. Furthermore, in the longitudinal cohort during a mean follow-up of 47 months, incident osteoporosis was found in 61 (9%), 881 (7.2%), 401 (5.8%) and 213 (4.6%) participants in the underweight, normal weight, overweight and obese groups, respectively. Multivariable Cox proportional hazards analysis revealed that the risk of incident osteoporosis was higher in the underweight group than in the normal weight group (hazard ratio [HR], 1.63; 95% CI 1.26 to 2.12; p value < 0.001). Our results suggest that BMI is associated with both the prevalence and the incidence of osteoporosis. In addition, underweight is an independent risk factor for developing osteoporosis. These findings highlight the importance of maintaining normal weight for optimal bone health.

Bone evaluation study-2: update on the epidemiology of osteoporosis in Germany

SummaryOsteoporosis is the most common bone disorder. Our data gives an estimate of around 5.87 million cases of osteoporosis in the general German population in 2018. Only 30% of insured individuals who suffered an osteoporotic fracture and/or had a confirmed diagnosis of osteoporosis, received an appropriate prescription.PurposeOsteoporosis is the most common bone disorder. It particularly affects elderly people and increases the risk of atraumatic fractures. The aim of this study was to estimate the prevalence of osteoporosis in the general German population aged ≥ 50 years and to collect data on the frequency of prescription of osteoporosis-specific medication in order to assess the treatment gap.MethodsRetrospective analysis of anonymized data of individuals aged ≥ 50 years insured under statutory healthcare schemes from the database of the Institute for Applied Health Research Berlin (InGef) for 2018 (study population). Insured individuals with osteoporosis were identified based on osteoporosis diagnoses, osteoporosis-specific prescriptions, or osteoporotic fractures. Thus, we estimated the prevalence of osteoporosis in the general German population aged ≥ 50 years. The prevalence of diagnoses, fractures, and prescriptions was determined for the study population and stratified by age and gender.ResultsWithin the study population of 1,599,299 insured individuals, a prevalence of osteoporosis of 15.9% was determined. This estimated approximately 5.87 million cases of osteoporosis for the general German population. 81.6% of the cases were women. Osteoporosis-specific prescriptions were received by 30.0% of the insured individuals in the study population who had been diagnosed with osteoporosis and/or suffered an osteoporotic fracture.ConclusionsGermany has a high prevalence of osteoporosis. Only a small portion of individuals who may require osteoporosis-specific treatment actually receive it.

Bone Density in Children with Hypermobility Spectrum Disorder Compared to Children with Benign Hypermobility

Background: Hypermobility spectrum disorder (HSD), likely a multifactorial condition characterized by musculoskeletal pain, joint instability, and reduced bone mineral density (BMD), is the focus of this study. Objectives: The aim of this study was to assess and compare bone density in children diagnosed with HSD and those with benign hypermobility. Methods: This case-control study involved 73 pediatric patients diagnosed with hypermobility spectrum disorder and benign hypermobility, who were referred to the Rheumatology clinic of Mofid Hospital in Tehran between February and November 2022. Bone mineral density was measured using Z-scores from L1-L4 and the whole body less head via dual-energy X-ray absorptiometry (DEXA). Results: Significant differences were observed in the frequency distribution of spine BMD Z-scores between the two groups (P = 0.002). There was no significant correlation between spine and whole body BMD Z-scores with age and gender (P &gt; 0.05). A notable correlation was found between spine and whole body BMD Z-scores (P &lt; 0.001 and r = 0.64). Among the HSD group, 18 patients (81.8%) had normal BMD, while 4 patients (18.2%) exhibited low bone density, with no cases of osteoporosis. In contrast, osteoporosis was observed in 7.3% of patients in the benign hypermobility group. Conclusions: Given the high prevalence of osteoporosis in patients with benign hypermobility, clinicians should be vigilant for tendencies toward osteopenia when treating such patients.

The impact of chronic obstructive pulmonary disease on bone strength.

Chronic obstructive pulmonary disease (COPD) is a lifestyle-related disease that develops in middle-aged and older adults, often due to smoking habits, and has been noted to cause bone fragility. COPD is a risk factor for osteoporosis and fragility fracture, and a high prevalence of osteoporosis and incidence of vertebral fractures have been shown in patients with COPD. Findings of lung tissue analysis in patients with COPD are primarily emphysema with a loss of alveolar septal walls, and the severity of pulmonary emphysema is negatively correlated with thoracic spine bone mineral density (BMD). On the other hand, epidemiological studies on COPD and fracture risk have reported a BMD-independent increase in fracture risk; however, verification in animal models and human bone biopsy samples has been slow, and the essential pathogenesis has not been elucidated. The detailed pathological/molecular mechanisms of musculoskeletal complications in patients with COPD are unknown, and basic research is needed to elucidate the mechanisms. This paper discusses the impacts of COPD on bone strength, focusing on findings in animal models in terms of bone microstructure, bone metabolic dynamics, and material properties.

Low screening rates and high prevalence of osteoporosis in cirrhosis: A real-world retrospective analysis.

Patients with cirrhosis are at increased risk for osteoporosis, and those who suffer a fracture are at high risk for mortality. Despite this, osteoporosis is often overlooked and undertreated. This study aimed to evaluate osteoporosis screening, management, and adverse osteoporosis medication events in patients with cirrhosis. We performed a retrospective chart review of adult outpatients with compensated and decompensated cirrhosis seen in single health system over a 6-year period. Patient demographics, liver and bone health comorbidities, DEXA scan results, and medications were abstracted. In total, 5398 patients met criteria. The cohort was predominately white (79.1%) and older (age 59). 44.4% were female. 64.6% had decompensated cirrhosis. Median MELD-Na score was 12.8. 23.5% had a DEXA scan ordered, approximately 50% completed this test. Patients who were older, female, white, with more severe liver disease, and other osteoporosis risk factors were more likely to have a DEXA scan ordered. 48.5% of patients had osteopenia and 30.2% had osteoporosis on DEXA scan. Only 22.6% of patients with osteoporosis received treatment, most commonly oral bisphosphonates. Oral bisphosphonate prescription was not associated with variceal bleeding (8.4% without vs. 4.8% with, p = 0.487). A minority of patients with cirrhosis were screened for osteoporosis. The majority screened had osteopenia or osteoporosis on DEXA scan. Less than a quarter of patients with osteoporosis were started on treatment. Real-world experience of oral bisphosphonate use did not reveal higher rates of gastrointestinal bleeding. There is room for improvement in all aspects of bone health care in cirrhosis.

Prevalence of Osteoporosis and Osteopenia among Cancer Patients and Its Risk Factors: A Retrospective Analysis at Najran Cancer Center, Saudi Arabia

Objective: The assessment of bone mineral density (BMD) in patients with a higher risk for significant bone loss, such as cancer patients, was recommended by recent clinical guidelines. Herein, we aim to report the prevalence of osteoporosis and osteopenia and their associated factors in cancer patients.Methods: This retrospective cross-sectional study was conducted from February 2021 to March 2022, and it included 39 adult cancer patients who were being treated at the King Khalid Hospital Cancer Center in Najran, Saudi Arabia. The participants were interviewed, and their BMD was assessed using Dual-energy X-ray absorptiometry (DXA) scans of the lumbar spine and femur neck. Univariate analysis was carried out to examine the association between osteoporosis and osteopenia and other variables. Results: The study involved 39 adult cancer patients in Najran, Saudi Arabia with a mean age of 60.15 ± 12.26 years, the majority of patients (53.8%) were aged between (60-69) years old, and most of them (64.1%) were female. The primary diagnosis was mostly breast cancer (35.9%) followed by prostate cancer (25.6%). 66.7% received chemotherapy and 64.1% received hormone therapy. Results showed osteopenia, osteoporosis, and normal BMD in 7 (17.9%), 28 (71.8%), and 4 (10.3%) patients respectively. 43.6% had low serum vitamin D levels. There was no significant relationship between osteopenia/osteoporosis and various factors, but it was more frequent in older patients, those undergoing chemotherapy, and those with low vitamin D levels (p=0.04, 0.05, 0.005). Conclusion: Higher prevalence of osteoporosis and osteopenia were observed in cancer patients undergoing chemotherapy, older patients, and those with low vitamin D levels. Further research is necessary to determine the most effective strategies for minimizing bone loss in this population.

Prevalence of Osteoporosis and Its Correlation With Common Secondary Risk Factors in Population from Rural Areas of South India

Background. Osteoporosis is a common metabolic disorder characterised by decreased bone mass and weakened micro-architecture of bone tissue. After 50 years of age, one in three women and one in five men experience osteoporotic fractures. This is projected to cause a yearly loss of 5.8 million healthy life years to disability. The number of patients who attend the outpatient clinic and emergency department of Sanjay Gandhi Institute of Trauma and Orthopaedics with fragility fractures has been increasing, hence to know the prevalence of osteoporosis in the general population who were asymptomatic, we decided to conduct a study in the rural areas of south India.&#x0D; Aims: 1) to estimate the prevalence of osteoporosis among the population above 50 years in rural areas of south India; 2) to determine the correlation between common secondary risk factors for osteoporosis like tobacco consumption, alcohol, diabetes, and hypertension.&#x0D; Results. The prevalence of osteoporosis in the rural population was more in females at 42.2%, whereas the males had a prevalence of 32.5%. Among the population with habits of tobacco consumption and alcohol consumption, the prevalence was 78% and 30.6% respectively. 20.2% of non-smokers and 39.7% of non-alcoholics were osteoporotic. Among the population with comorbidities, 53.6% of diabetes and 55.4% of hypertensives were osteoporotic. 33.7% of non-diabetics were osteoporotic, and 29.5% of hypertensives were osteoporotic. The correlation between osteoporosis and the individual risk factors ranged between weak negative to moderately positive (r = -0.2 to 0.5). The correlation between the combination of all the four risk factors and osteoporosis is weakly positive (r = 0.339), which is highly significant (p0.001).&#x0D; Conclusion. Overall, the findings of this study suggest that addictive habits such as tobacco and alcohol consumption may have a significant impact on bone health, with a higher prevalence of osteopenia and osteoporosis observed in individuals with these habits. Comorbidities such as diabetes and hypertension were also found to be associated with a higher prevalence of osteoporosis. These findings emphasize the importance of early detection and prevention of addictive habits and comorbidities to reduce the risk of osteopenia and osteoporosis. Furthermore, the study highlights the need for further research to fully understand the complex relationships between sociodemographic factors, addictive habits, comorbidities, and bone health.

Osteoporosis and vitamin D consumption: knowledge and practice in different Arab countries.

Osteoporosis is the most common skeletal disease, which usually remains silent until fractures occur. Vitamin D deficiency impairs bone mineralization and increases the risk of osteoporosis. Despite being relatively sunny, the Middle East and North Africa (MENA) region has a high prevalence of osteoporosis and hypovitaminosis D. This study aims to assess the knowledge about osteoporosis and vitamin D-related practices and to determine the correlation between them in some countries of the MENA region. A cross-sectional study was performed in Lebanon, Syria, Egypt, Palestine, Iraq, Jordan, and Saudi Arabia. From each country, 600 participants were enrolled. The survey included four sections: sociodemographic information, past medical history, Osteoporosis Knowledge Assessment Tool to assess the knowledge about osteoporosis, and Practice Towards Vitamin D scale to assess vitamin D-related practices. Our study found that 67.14% of respondents had moderate knowledge about osteoporosis and 42.31% had moderate vitamin D-related practices. Higher knowledge level was reported in the young, females, Syrians, singles, postgraduates, and healthcare employees (p < 0.05). Better vitamin D-related practices were detected in the elderly, males, Egyptians, married, and high school or below educational level (p < 0.05). The Internet was the most listed source of information. Adequate osteoporosis knowledge was associated with better vitamin D-related practices (p < 0.001). Most participants, representing some countries of the MENA region, displayed moderate knowledge regarding osteoporosis and moderate vitamin D-related practices. Adequate knowledge about osteoporosis is essential to improve practices, so awareness campaigns and screening programs should be more frequently implemented.

PREVALENCE AND ASSOCIATED RISK FACTORS OF OSTEOPOROSIS AMONG ELDERLY PATIENTS IN AL-AHSA REGION, SAUDI ARABIA: A CROSS-SECTIONAL STUDY

Background: Osteoporosis, an ageing bone disease, where the bone mineral density and bone mass decreases leading to decrease in the bone strength ,is a leading cause of bone fracture among the older population. Multiple risk factors participate in developing the osteoporosis which include age, gender, previous fractures, family history of osteoporosis diet deficient in calcium, sedentary lifestyle, Body Mass Index (BMI) ,smoking, corticosteroid medication, or having hyperparathyroidism and chronic liver disease. The present study was conducted to assess prevalence of osteoporosis and to determine its risk factors in Al Ahsa district of Saudi Arabia in order to control and manage this condition. Material and Methods:It was a cross-sectional study conducted at all the primary health care centers of Al Ahsa district of Saudi Arabia. All the patients with bone ailment over 60 years of age attending the Primary Health Care Centers for their bone ailment were the study population. The minimum sample size for this study has been calculated to be 384.A probability sampling in form of multistage stratified random sampling technique was used to select the sample. A special data sheet was prepared based on a similar earlier study, The data were entered and analyzed by using the statistical package for social sciences, version 21 .Descriptive statistics were presented using counts, proportions (%), mean ± standard deviation whenever appropriate/ The association of risk factors with the osteoporosis was tested by chi square test .Logistic regression analysis was also done for comparative study. A p-value cut off point of 0.05 at 95% CI was used to determine statistical significance. Results:A total of 422 patients attended the selected PHCs for the treatment of bone ailment making the response rate of 90%. The mean age of the patients was 67.36 years Std. Dev. 6.46 years (Range 60-91 years).The sex of the patients were almost equally distributed (Male: 50.1%, Female: 49.1%).More than sixty one percent of the patients were detected on DXA as suffering from osteopenia (27.3%) and osteoporosis (34%). Majority of them (55.5%) had all the signs of osteoporosis while the rest had osteopenia on DXA. On logistic regression analysis, obese patients over 60 years old were having almost 3 times more risk to develop osteopenia and osteoporosis than those with normal weight (OR2.77, 95% CI 1.48-6.25, P= 0.032 ) . Similarly those patients who had family history of osteoporosis were 5 times more likelihood of developing osteopenia and osteoporosis (OR:5.56 95% CI 2.58-8.34, P = 0.003) .The patients with smoking habit, those who were suffering from liver disease and those who were not involved in physical exercise were 3.5 times ( OR 3,56 , 95% CI 1.58-634, P= 0.032 ) , 4 times (OR 4.32 , 95% CI 2.12-5.63, P= 0.045 ) and 2,7 ( OR 2.77 , 95% CI 1.48-6.25, P= 0.032 ) times likelihood of developing osteopenia and osteoporosis among the patients above 60 years of age. Conclusion:The present study has provided vital information on the prevalence of osteoporosis among the elderly population of Al Ahsa region of Saudi Arabia. Osteoporosis is a leading cause of fracture of bone among the elderly population leading to morbidity. The high prevalence of osteoporosis in this region necessitates developing an effective awareness programme among the elderly population for the prevention of osteoporosis at least by controlling the modifiable risk factors.

Addressing gaps in osteoporosis screening in kuwait using opportunistic quantitative computer tomography (QCT): a retrospective study

To demonstrate the feasibility and clinical utility of opportunistic osteoporosis screening in Kuwait using QCT, aiming to increase screening rates in a country with a relatively high prevalence of osteoporosis and an alarming trend of increasing incidence of fractures. At a tertiary referral center, all abdominal CT scans performed on females ≥60 years old between 12/2020 and 12/2021 were retrospectively utilized for asynchronous QCT acquisition. The average volumetric bone mineral density (vBMD) was calculated, and rates of osteoporosis (vBMD < 80 mg/cm3 calcium hydroxyapatite) and osteopenia (80-120 mg/cm3) were determined. CT images were reviewed to assess for the presence of vertebral fractures. For each patient, the electronic health record was reviewed for any previous DXA scans. vBMD was calculated in 305 females ≥60 years old (mean [SD] 71 [8.7], range 60-93). Low bone mass was detected in 258 patients (84.6%); 148 (48.5%) met criteria for osteopenia and 110 (36.1%) for osteoporosis. Osteoporotic vertebral fractures were observed in 64 (21.0%) study participants. Only 73 patients (23.9% of total) had a previous DXA documented in the reviewed health records. For 231 patients who were ≥65 years old, who would routinely qualify for a screening DXA, only 63 (27.3%) had a documented DXA available. vBMD measurements obtained by opportunistic QCT had comparable rates of osteopenia and osteoporosis detection to those previously reported using DXA in a similar population in Kuwait. These findings suggest that opportunistic QCT on preexisting CT scans can be effectively utilized to narrow gaps in osteoporosis screening.

Mild autonomous cortisol secretion in adrenal incidentalomas and risk of fragility fractures: a large cross-sectional study.

Mild autonomous cortisol secretion (MACS) has been associated with a higher prevalence of osteoporosis, although most data rely on single-center studies with limited sample size. We aimed to assess the prevalence of fragility fractures and contributing factors in a large cohort of patients with adrenal incidentalomas. Medical records of 1023 patients with adrenal incidentalomas from 1990 to 2019 were reviewed, and 735 patients were selected. Clinically obtained electronic radiological images closest to first endocrine evaluation, such as lateral views of spine X-rays or CT thoraco-abdominal scans, were reviewed to screen for asymptomatic morphometric vertebral fractures. Clinical fragility fractures, hormonal, and dual-energy x-ray absorptiometry (DXA) indices were also recorded. Four hundred seventy-four patients had nonfunctioning (NF) adrenal incidentalomas, 238 had MACS and 23 adrenal Cushing's syndrome (AC). Prevalence of fragility fractures was different (P = .018) between groups, respectively, 24.1% (NF), 34.0% (MACS), and 30.4% (AC), with significant difference between NF and MACS (P = .012). When analyzed separately by sex and menopausal status, this difference remained significant in postmenopausal women (P = .011), with a fracture prevalence of 22.2% (NF) and 34.6% (MACS). Fracture prevalence was similar in males. Women with MACS aged ≥65 years reported a 48.8% prevalence of fractures, as compared with 29.5% in NF (P < .01). In postmenopausal women, fragility fractures were associated with age (odds ratio [OR] 1.1, P < .001), smoking (OR 1.8, P = .048), and 1 mg-dexamethasone suppression test (DST) cortisol (OR 3.1, P = .029), while in men, only age was associated with fragility fractures. A considerable fracture burden was shown in postmenopausal women with adrenal incidentalomas and MACS, with clinical implications for the evaluation and management of bone metabolism.

Adipopenia is associated with osteoporosis in community-dwelling non-underweight adults independent of sarcopenia.

Although underweight is risk factor for osteoporosis, the association of low body fat percent (adipopenia) with osteoporosis in non-underweight adults remains unclear. Among individuals aged ≥ 50years with body mass index ≥ 18.5kg/m2 in the Korean National Health and Nutrition Examination Survey 2008-2011, appendicular lean mass (ALM) and body fat percent (BFP) were measured using dual-energy x-ray absorptiometry. Low lean mass was defined as ALM/height2 < 7.0kg/m2 and < 5.4kg/m2 in men and women, respectively. Osteoporosis was defined as a bone mineral density (BMD) T-score ≤ -2.5 at the lumbar spine, femoral neck, or total hip. Participants were grouped into adipopenia (BFP < 17% in men; < 30%, in women; 1 standard deviation below the mean), normal, and obesity (BFP > 30% in men; > 40% in women) groups. Of the 5,830 participants (women 50.2%, mean age 63.9years), 793 had adipopenia. The adipopenia group had a higher prevalence of osteoporosis (31%) than the normal (21%) or obesity groups (27%; p < 0.001). The presence of adipopenia was associated with 61% elevated odds of prevalent osteoporosis (p < 0.001) independent of low lean mass and covariates, which remained robust using different thresholds for adipopenia. Individuals with adipopenia and low lean mass had 3.5-fold elevated odds of osteoporosis compared to those with normal lean mass and fat percent. The association between adipopenia and osteoporosis was stronger in older women compared to middle-aged women (OR 1.93 vs. 0.99, P for interaction = 0.023). Adipopenia was associated with osteoporosis in non-underweight adults, independent of low lean mass and covariates.

Relationship of blood heavy metals and osteoporosis among the middle-aged and elderly adults: A secondary analysis from NHANES 2013 to 2014 and 2017 to 2018.

This study aimed to assess the relationship between blood heavy metals and a higher prevalence of osteoporosis in middle-aged and elderly US adults using the National Health and Nutritional Examination Surveys (NHANES). The secondary data analysis was performed using the data of NHANES 2013-2014 and 2017-2018. We used the information, including physical examination, laboratory tests, questionnaires, and interviews, provided by participants in NHANES. Logistic regression and weighted quantile sum (WQS) regression models were used to explore the relationships between levels of blood heavy metals and a higher prevalence of osteoporosis. A total of 1,777 middle-aged and elderly participants were analyzed in this study, comprising 115 participants with osteoporosis and 1,662 without osteoporosis. Adjusted model 1 showed a significant positive relationship between cadmium (Cd) levels and a higher prevalence of osteoporosis (quartile 2, OR = 7.62; 95% CI, 2.01-29.03; p = 0.003; quartile 3, OR = 12.38; 95% CI, 3.88-39.60; p < 0.001; and quartile 4, OR = 15.64; 95% CI, 3.22-76.08; p = 0.001). The fourth quartile of selenium (Se) level (OR = 0.34; 95% CI, 0.14-0.39; p < 0.001) led to a lower prevalence of osteoporosis and exerted a protective effect on model 1. Other models produced similar results to those of model 1. A subgroup analysis showed that Cd levels were positively related to a higher prevalence of osteoporosis in all three models in women, while this relationship was not found in men. The fourth quartile of the Se level was related to a lower prevalence of osteoporosis in both male and female analyses. A significant positive relationship was found between the blood Cd level and a higher prevalence of osteoporosis in the non-smoking subgroup. Blood Se level showed a protective effect on the fourth quartile in both the smoking and non-smoking subgroups. Blood Cd level aggravated the prevalence of osteoporosis, while blood Se level could be a protective factor in osteoporosis among the US middle-aged and older populations.

Relationship between geriatric nutritional risk index and osteoporosis in type 2 diabetes in Northern China

Osteoporosis is a very common bone disease in the elderly population and can lead to fractures and disability. Malnutrition can lead to osteoporosis. The geriatric nutritional risk index (GNRI) is a tool used to assess the risk of malnutrition and complications associated with nutritional status in older patients and is a crucial predictor of many diseases. Hence, this study investigated the association between the GNRI and the presence of osteoporosis and assessed the value of this index for predicting osteoporosis in patients with type 2 diabetes mellitus (T2DM). This cross-sectional study enrolled 610 elderly patients with T2DM. General and laboratory data of the patients were collected, along with their measurements of bone mineral density (BMD). The GNRI was calculated based on ideal body weight and serum albumin (ABL) levels. Correlation analysis was performed to determine the relationship between the GNRI and BMD and bone metabolism indices. The GNRI predictive value for osteoporosis development was analyzed through logistic regression analysis and by creating a receiver operating characteristic curve (ROC), calculating the area under the curve (AUC). All patients were divided into the no-nutritional risk and nutritional risk groups. Compared with the no-nutritional risk group, the nutritional risk group had a longer diabetes course, older age, higher HbA1c levels, higher prevalence of osteoporosis; lower BMI, ABL,triglyceride (TG),Calcium (Ca),25-hydroxy-vitamin-D(25(OH)D),and parathyroid hormone(PTH) and lower femoral neck BMD,total hip BMD (P < 0.05). All patients were also assigned to the non-osteoporosis and osteoporosis groups. The non-osteoporosis group had higher GNRI values than the osteoporosis group (P < 0.05). Correlation analysis revealed a positive correlation between the GNRI and lumbar BMD, femoral neck BMD, and total hip BMD (P < 0.05). After the adjustment for confounding factors, Spearman's correlation analysis revealed that the GNRI was positively correlated with Ca, 25(OH)D, and PTH and negatively correlated with alkaline phosphatase (ALP) and procollagen of type-1 N-propeptide (P1NP). Regression analysis exhibited that the GNRI was significantly associated with osteoporosis. The ROC curve analysis was performed using the GNRI as the test variable and the presence of osteoporosis as the status variable. This analysis yielded an AUC for the GNRI of 0.695 and was statistically significant (P < 0.05). A lower GNRI among T2DM patients in northern China is associated with a higher prevalence of osteoporosis.

Остеопороз у пацієнтів із хронічним панкреатитом – особливості діагностики

The purpose of the study was to determine the features of the development of osteoporotic bone changes in patients with fibrotic changes of the pancreas against the background of chronic pancreatitis. Materials and methods. 55 patients with chronic pancreatitis were examined. 30 examined were women, 25 were men. The average age of the patients was 47.3±3.5 years. To be included in the study, all patients were excluded from the presence of concomitant diseases. For female patients, preservation of menstrual function was a mandatory condition for inclusion in the study. The degree of fibrotic changes of the pancreas was established on the basis of conducting 2D shear wave elastometry with transcutaneous access by the shear wave method in the SWE mode. Determination of bone mineral density was carried out using a DEXXUM T X-ray densitometer by the method of dual-energy absorptiometry. Results and discussion. The severity of fibrotic changes in the pancreatic parenchyma also affected the prevalence of osteoporosis and osteopenia. Among patients with parenchyma density indicators corresponding to grade 3-4 of fibrotic changes, a decrease in bone mineral density was observed in 83% of examined patients, while among patients with grade 1-2 of such changes, osteoporosis and osteopenia were found in 34% (p = 0.003). In patients with fibrotic changes in the parenchyma of the pancreas, osteoporotic changes in the area of the lumbar vertebrae were noted in 55% of cases with reduced bone mineral density, an isolated decrease in the mineral density of the lumbar spine was diagnosed in 11 patients (28.2% of patients with a decrease in bone mineral density), 5 patients (12.8%) had a combination of a decrease in the mineral density of the spine with a decrease in the mineral density of the hip, the average T criterion of the vertebrae was -2.4±0.5, the average T criterion of the femoral neck was -2.6±0.36. In patients with fibrosis of the parenchyma of the pancreas of 1-2 stages bone mineral density decreased mainly to the level of osteopenia, with a combination of osteopenic changes in the lumbar spine and a decrease in hip mineral density. The average T criterion of vertebrae was -1.6±0.15, femoral neck -1.76±0.18 Conclusion. Patients with chronic pancreatitis are characterized by a high prevalence of osteoporosis and osteopenia. Patients with stages 3-4 of pancreatic fibrosis have a greater risk of developing this complication. The reduction of bone mineral density in patients with chronic pancreatitis is influenced not only by population risk factors, but also by the duration of pancreatitis. The severity of fibrotic changes in the pancreas affects the localization of changes in bone tissue

Bone Loss in Patients with Pancreatic Neuroendocrine Tumors.

Pancreatic diseases may affect nutritional status, which is one of the important associated factors of bone health. High prevalence of osteoporosis or osteopenia has been reported in patients with pancreatitis. The bone loss in pancreatic neuroendocrine tumors (PNETs) has not been reported. In this study, we showed the prevalence of bone loss and possible associated factors in PNET patients. A total of 91 PNET patients were included. Bone status was evaluated based on computed tomography (CT) attenuation (Housfield units, HU): &gt;160 HU, normal bone mineral density; osteopenia, 135 HU ≤ CT value ≤ 160 HU; osteoporosis, &lt;135 HU. Associated factors for bone loss were identified by logistic regression analyses. The average age was 55.76 years old in PNET patients. The prevalence of osteoporosis and low bone mass was 37.4% and 60.4%, respectively. Higher prevalence of osteoporosis was observed in patients older than 50 years (64.0%). Multivariate logistic analysis showed that age was an associated factor for low bone mass (odds ratio (OR) = 1.13, 95% confidence interval (CI): 1.04-1.22) and osteoporosis (OR = 1.14, 95% CI: 1.03-1.20). Diabetes was also associated with bone loss in PNET patients after adjusting with confounders (OR = 13.56, 95% CI: 1.02-132.4). Our data show that bone loss is common in patients with PNETs. Age and diabetes are associated with bone loss in PNET patients.

ODP077 Adipopenia is associated with low bone mass in community-dwelling non-underweight adults, independent of sarcopenia

Abstract The interaction between fat, muscle, and bone mass is complex. Although sarcopenia and underweight are well-established risk factors for osteoporosis, the association between low body fat percent (adipopenia) and low bone mass in non-underweight adults remains unclear. In Korean National Health and Nutrition Examination Survey dataset 2008-2011, we analyzed individuals aged 50 or older with body mass index (BMI)≥18.5 kg/m 2 . Appendicular skeletal muscle mass (ASMM) and body fat percent were measured using dual-energy x-ray absorptiometry. Sarcopenia was defined as ASMM/height 2 &amp;lt;7. 0 kg/m 2 and &amp;lt;5.4 kg/m 2 in men and women, respectively. Subjects were grouped into adipopenia (&amp;lt;17% in men and &amp;lt;30% in women; 1 standard deviation below the mean of the study population with round down to integer value), normal, or obesity (&amp;gt;30% in men and &amp;gt;40% in women) according to body fat percent. Osteoporosis was defined as T-score≤ -2.5 at the lumbar spine, femoral neck, or total hip. Among 5830 subjects (women 50.2%, mean age 63.9±8.5 years), 793 subjects had adipopenia (13.6%). The adipopenia group had a higher prevalence of osteoporosis (31%) compared to normal (21%) or obesity groups (27%; p&amp;lt;0. 001). Body fat percent showed a positive association with bone mineral density at all sites after adjustment for age, sex, height, and lean mass. In the multivariable logistic model, the presence of adipopenia was associated with 61% elevated odds of osteoporosis (adjusted odds ratio [aOR] 1.61, p&amp;lt;0. 001), independent of sarcopenia (aOR 1.71, p&amp;lt;0. 001), age, sex, height, and covariates, which remained robust in sensitivity analysis with sex-specific lowest 20% quantile thresholds (roughly &amp;lt;18.4% in men; &amp;lt;31.5% in women). In conclusion, adipopenia was associated with osteoporosis independent of sarcopenia in non-underweight adults, which merits further investigation. Presentation: No date and time listed