Higher Risk Of Osteopenia Research Articles

Association between Chronic Atrophic Gastritis and Bone Mineral Density among Women Older than 40 Years of Age in Korea.

Chronic atrophic gastritis causes hypochlorhydria, hypergastrinemia, and malabsorption of nutrients, leading to lower bone mineral density. The few studies that investigated the association between chronic atrophic gastritis and bone mineral density have reported inconsistent findings. As such, the present study assessed the association between chronic atrophic gastritis and bone mineral density among a large sample of women >40 years of age in Korea. Data from 8,748 women >40 years of age who underwent esophagogastroduodenoscopy and bone densitometry were analyzed. Chronic atrophic gastritis was diagnosed using esophagogastroduodenoscopy. Bone mineral density of the lumbar vertebrae (L), femur neck, and femur total, measured using dual-energy X-ray absorptiometry, were the primary outcome variables. Low bone mineral density, which could be diagnosed as osteoporosis or osteopenia, was defined and analyzed as a secondary outcome. Linear regression was used to calculate adjusted mean values of bone mineral density. The association between low bone mineral density and chronic atrophic gastritis was analyzed using multiple logistic regression. The adjusted mean bone mineral density for L1-L4 was 1.063±0.003, femur neck (0.826±0.002), and femur total (0.890±0.002) were significantly lower in patients with chronic atrophic gastritis than others (1.073±0.002, 0.836±0.001, 0.898±0.002, respectively; all P<0.01). Women with chronic atrophic gastritis exhibited an increased likelihood for osteopenia or osteoporosis, even after adjusting for age and other confounding factors (odds ratio, 1.25; 95% confidence interval, 1.13-1.40; P<0.01). However, subgroup analysis revealed statistical significance only in postmenopausal women (odds ratio, 1.27; P<0.001). Chronic atrophic gastritis was associated with lower bone mineral density and a higher risk for osteopenia or osteoporosis among postmenopausal women.

Osteoporosis and bone health in pediatric patients with epidermolysis bullosa: A scoping review.

Nutritional compromise, low levels of vitamin D, chronic inflammation, abnormal growth, and physical inactivity affect bone metabolism and compromise long-term bone health in individuals with epidermolysis bullosa (EB). The result is a high risk for osteopenia, osteoporosis, and pathologic fractures, but this important consequence of EB has been the focus of few investigations. Our scoping review found 21 publications that assessed the current understanding and clinical practices for monitoring of osteoporosis and its treatment in EB. Recommendations summarized from 13 of these publications include early nutritional and weight assessments before 2 years of age; bloodwork every 6-12 months starting at birth; Tanner stage assessments every 6 months to detect any pubertal delay; DEXA scans starting at age 6 years with repeated scans every 1-2 years, except in mild cases; and vitamin D supplementation of 80-320 IU daily for children 0-7 years and 720 IU for patients >8 years.

Osteometabolic changes in patients under antineoplastic treatment: scoping review

Objective: To summarize the main evidence regarding osteometabolic changes in patients undergoing antineoplastic treatment. Methods: This is a scoping review, following the methodology of the Joanna Briggs Institute, using PubMed/MedLine, Cochrane Library, LILACS, The British Library, and Google Scholar. This review is registered in the Open Science Framework. Results: Many antineoplastics affect bone architecture by reducing its density, such as selective estrogen receptor modulators, aromatase inhibitors, androgen deprivation therapy, and glucocorticoids. To avoid such outcomes, treatment and prevention can be achieved by calcium and vitamin D supplementation, physical exercise, use of bisphosphonates, denosumab, and selective estrogen receptor modulators. Conclusion: people at a higher risk of developing cancer also have a higher risk of osteopenia and osteoporosis when the process is already established and undergoing antineoplastic treatment because of the grouping of risk factors. The need for bone densitometry in patients undergoing cancer treatment to prevent and promote bone health in these patients is evident, in addition to more research with a high level of evidence to support such use.

Prenatal and Neonatal Bone Health: Updated Review on Early Identification of Newborns at High Risk for Osteopenia.

Bone health starts with maternal health and nutrition, which influences bone mass and density already in utero. The mechanisms underlying the effect of the intrauterine environment on bone health are partly unknown but certainly include the 'foetal programming' of oxidative stress and endocrine systems, which influence later skeletal growth and development. With this narrative review, we describe the current evidence for identifying patients with risk factors for developing osteopenia, today's management of these populations, and screening and prevention programs based on gestational age, weight, and morbidity. Challenges for bone health prevention include the need for new technologies that are specific and applicable to pregnant women, the foetus, and, later, the newborn. Radiofrequency ultrasound spectrometry (REMS) has proven to be a useful tool in the assessment of bone mineral density (BMD) in pregnant women. Few studies have reported that transmission ultrasound can also be used to assess BMD in newborns. The advantages of this technology in the foetus and newborn are the absence of ionising radiation, ease of use, and, above all, the possibility of performing longitudinal studies from intrauterine to extrauterine life. The use of these technologies already in the intrauterine period could help prevent associated diseases, such as osteoporosis and osteopenia, which are characterised by a reduction in bone mass and degeneration of bone structure and lead to an increased risk of fractures in adulthood with considerable social repercussions for the related direct and indirect costs.

Older adults physically inactive in occupational and commuting domains have a higher risk for osteopenia and osteoporosis: A 12-month prospective study.

Bone mineral density (BMD) usually decreases with age, and the risk of osteometabolic diseases, such as osteopenia and osteoporosis, increases in older adults. PA is strictly related to BMD. However, the relationship between different domains of PA and bone health in older adults is still unclear, and needs to be further investigated, aiming at the implementation of preventative health measures for this population. Thus, the aim of the current study was to analyze the association between different domains of PA and the risk for osteopenia and osteoporosis in older adults in a 12-month follow-up. Prospective study that included 379 Brazilian community-dwelling older adults, aged ≥ 60years (70 ± 7years, 69% women). Areal bone mineral density (aBMD) total, proximal femur, and lumbar spine were measured by dual energy X-ray absorptiometry (DXA), and PA was self-reported. Binary logistic regression analysis and 95%CI were used to analyze the association between the practice of PA in different domains (at baseline and follow-up) and risk for osteopenia and osteoporosis (follow-up). The risk for osteopenia (total proximal femur or lumbar spine) is higher in older adults who are physically inactive in the occupational domain (OR:3.25; 95%CI:1.24-8.55). In addition, older adults who are physically inactive in the commuting domain (OR:3.43; 95%CI:1.09-10.82) and total PA (OR:5.58; 95%CI:1.57-19.88) present a higher risk for osteoporosis (total proximal femur or lumbar spine) compared to physically active older adults. The risk of osteopenia is higher in older adults who are physically inactive in occupational domain and for osteoporosis the risk is higher in physically inactive in commuting domain and total habitual PA.

Abstract P3-03-26: Osteopenia and osteoporosis in women with breast cancer in Taiwan: single center retrospective data

Abstract Purpose: Osteopenia and osteoporosis are commonly encounter in elder women. One third of women elder than fifty years suffer a fracture second to osteoporosis around the world. Standard treatments for breast cancer such as chemotherapy or hormonal therapy may increase the risk of both osteopenia and osteoporosis. Premenopausal women treated with standard adjuvant chemotherapy frequently develop ovarian failure, or early menopause, which is associated with accelerated bone loss. Trabecular bone score (TBS), an index extracted by DXA that provides an indirect measurement of bone axial microarchitecture. In addition to the BMD, TBS are warranted to improve the prediction of fracture risk at the individual level. However, due to regulations of National Health Insurance in Taiwan, data are limited on the incidence of osteopenia and osteoporosis in women with breast cancer in Taiwan. In this study, we investigated the proportion of osteopenia and osteoporosis in women with breast cancer in Taiwan. Materials and Methods: There were enrolled 201 female who diagnosed with breast cancer between May 2019 and December 2020 in this retrospective study. Patients with bone metastasis (n=11) and double cancer(n=3) were excluded. All patients received dual energy X-ray absorptiometry (DXA) at least once, including bone mineral density (BMD), T-score (spine and total hip) and trabecular bone score (TBS) data. The data were retrospectively analyzed baseline age, BMD, breast cancer type, aromatase inhibitors (AIs) usage status by Kruskal-Wallis test. Results: Basing on the lowest T-score from measurements at the spine or total hip, 58.8% (n=110) of osteopenia (-2.5≤T←1) and 27.8%(n=52) of osteoporosis (T←2.5) were identified in women with breast cancer (figure1). Statistics significance was noted in patients’ age and BMI between three groups. There was no difference in bone mineral density according to breast cancer subtype. (table 1) Patients who ever use aromatase inhibitors (n=90) had lower BMD (T=-2.14) and trabecular bone score (TBS=1.3) than non-AI group (n=97, T=-1.84, TBS=1.34). (figure 2) (table 2) Conclusions: According to Taiwan’s NHI sampling data from 1999 to 2001, the averaged prevalence of osteoporosis in those aged ≥50 years was 11.35% for women. Breast cancer survivors are at higher risk for osteopenia and osteoporosis compared to cancer-free women in Taiwan. Aromatase inhibitors (AIs) group had lower BMD and TBS (p&amp;lt; 0.05). In our study, forty percent of TNBC patients diagnosed osteoporosis, which is compatible with increased bone loss due to chemotherapy-induced ovarian failure. Therefore, clinicians should be aware not only of AI-associated bone loss but also of patients who ever accepted long-term chemotherapy. A normal range for TBS values in postmenopausal women has been proposed: a TBS of ≥1.350 is considered normal; a TBS between 1.20 and 1.35 is considered consistent with partially degraded microarchitecture, and a TBS of ≤ 1.200 defines degraded microarchitecture. In our study, mean TBS in women with breast cancer (n=187) is 1.32. Further research is needed to determine the validity of cut-points for guiding treatment decisions. Figure 1. Inclusion/exclusion criteria and flow chart Figure 1. Inclusion/exclusion criteria and flow chart Table 1 Figure 2. Aromatase inhibitors group had lower BMD and Trabecular bone score Figure 2. Aromatase inhibitors group had lower BMD and Trabecular bone score Citation Format: Chia-Hua Liu, Chih-Chiang Hung, I-Chen Tsai. Osteopenia and osteoporosis in women with breast cancer in Taiwan: single center retrospective data [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-03-26.

Assessment of bone mineral density and bone turnover markers in patients with juvenile idiopathic arthritisy

Juvenile idiopathic arthritis (JIA) is one of the most common chronic inflammatory diseases occurring in childhood, associated with decreased bone mineral density (BMD) and increased risk of osteopenia and osteoporosis, which increases the fracture risk. Aim of the work: to assess BMD and bone turnover markers (serum osteocalcin for bone formation and C terminal telopeptide of type 1 collagen for bone resorption) in JIA patients and their relation to disease activity. This study included 50 patients with JIA (female:male – 20:30). The study was approved by the Ethical Research Committee and Institutional Review Board of the Faculty of Medicine, Menoufia University, Egypt (Approval number: 19519INTPH48). Written informed consent was obtained from each patient or the parents. These patients were diagnosed with JIA according to the criteria of classification of the International League of Associations for Rheumatology. BMD was measured by Dual-energy X-ray absorptiometry (DEXA) of the lumbar spine using the Z-score. The results were correlated with JIA disease duration, disease activity, bone turnover markers and serum level of vitamin D. Clinical disease activity was evaluated by juvenile arthritis disease activity score (JADAS-27). There was a significant negative correlation between DEXA Z-score and disease activity (p-value &lt; 0.001), bone turnover markers (p-value &lt; 0.001), and duration of JIA (p-value &lt; 0.05). There was a significant difference between vitamin D level and DEXA Z-score; DEXA Z-score was lower in vitamin D deficient patients. JIA patients with higher disease activity are at a higher risk of osteopenia and osteoporosis. Well-timed and efficient treatment of JIA and proper control of disease activity may help to improve the bone status and reduce the incidence of osteoporosis. Consequently, valuable targeted interventions are essential to preserve bone health during JIA.

Bone Mineral Content Estimation in People Living with HIV: Prediction and Validation of Sex-Specific Anthropometric Models.

People living with HIV (PWH) experience an accelerated reduction in bone mineral content (BMC), and a high risk of osteopenia and osteoporosis. Anthropometry is an accurate and low-cost method that can be used to monitor changes in body composition in PWH. To date, no studies have used anthropometry to estimate BMC in PWH. To propose and validate sex-specific anthropometric models to predict BMC in PWH. This cross-sectional study enrolled 104 PWH (64 males) aged >18 years at a local university hospital. BMC was measured using dual energy X-ray absorptiometry (DXA). Anthropometric measures were collected. We used linear regression analysis to generate the models. Cross-validations were conducted using the “leave one out”, from the predicted residual error sum of squares (PRESS) method. Bland–Altman plots were used to explore distributions of errors. We proposed models with high coefficient of determination and reduced standard error of estimate for males (r2 = 0.70; SEE = 199.97 g; Q2PRESS = 0.67; SEEPRESS = 208.65 g) and females (r2 = 0.65; SEE = 220.96 g; Q2PRESS = 0.62; SEEPRESS = 221.90 g). Our anthropometric predictive models for BMC are valid, practical, and a low-cost alternative to monitoring bone health in PWH.

Bronchial Asthma and Sarcopenia: An Upcoming Potential Interaction.

Background: Sarcopenia seems to be an emerging health issue worldwide, concerning the progressive loss of skeletal muscle mass, accompanied by adverse outcomes. Asthma is a chronic inflammatory respiratory condition that is widespread in the world, affecting approximately 8% of adults. Although data are scarce, we aim to shed light on the potential association between low muscle mass and asthma and point out any probable negative feedback on each other. Methods: We searched within the PubMed, Scopus, MEDLINE, and Google Scholar databases. Study selections: Three studies were included in our analysis. Only original studies written in English were included, while the references of the research articles were thoroughly examined for more relevant studies. Moreover, animal model studies were excluded. Results: 2% to 17% of asthmatics had sarcopenia according to the existent literature. Sarcopenic asthmatic patients seem to have reduced lung function, while their mortality risk may be increased. Furthermore, patients with asthma- chronic obstructive pulmonary disease (COPD) overlap syndrome phenotype and sarcopenia might have a higher risk of osteopenia and osteoporosis progression, leading consequently to an increased risk of fractures and disability. Conclusions: Emerging data support that pulmonologists should be aware of the sarcopenia concept and be prepared to evaluate the existence of low muscle mass in their asthmatic patients.

Combination of Quantitative Computed Tomography and Blood Biochemistry for Evaluating the Relationship Between Nutrition and Bone Mineral Density in Patients on Maintenance Hemodialysis

PurposeTo investigate the effect of nutritional factors on bone mineral density (BMD) using quantitative computed tomography combined with blood biochemistry in patients on maintenance hemodialysis (MHD). MethodsSixty patients on MHD were divided into osteopenia (n = 20) and nonosteopenia (n = 40) groups. BMD, fat, and muscle mass were measured by quantitative computed tomography. The calcification of coronary artery and hilar lymph node and computed tomography attenuation values of the liver and spleen were also analyzed. Differences between the two groups were compared, and the risk factors for osteopenia were analyzed by logistic regression analysis. ResultsPatients in the osteopenia group had lower albumin levels than those in the nonosteopenia group (37.84 ± 3.00 vs 42.03 ± 4.05 g/L; P < .001). Logistic regression showed that patients with lower albumin levels had a higher risk of osteopenia (odds ratio, 1.462; 95% confidence interval, 1.313–1.801; P = .003). BMD was negatively correlated with fat mass (r = −0.365, P = .004) and positively correlated with the ratio of muscle mass to fat mass (r = 0.431, P = .001). There was no significant difference in the rate of calcification of coronary artery or hilar lymph nodes between the two groups. Computed tomography values of the liver and spleen were positively correlated with the duration of dialysis (r = 0.55, P = .001; r = 0.42, P < .001, respectively). ConclusionLow albumin levels are associated with an increased risk of osteopenia in patients on MHD. Abdominal fat is a risk factor for reduction in BMD in MHD patients, and the ratio of abdominal muscle mass to fat mass is a protective factor for BMD.

The risk of revision following total hip arthroplasty in patients with inflammatory bowel disease, a registry based study.

Inflammatory bowel disease (IBD) is characterized by chronic inflammation of the intestinal tract and is associated with decreased bone mineral density. IBD patients are at higher risk of osteopenia, osteoporosis and fracture compared to non-IBD patients. The impact of IBD on the performance of orthopedic implants has not been well studied. We hypothesized that a history of IBD at the time of primary total hip arthroplasty (THA) would increase the risk of subsequent failure as assessed by revision surgery. A retrospective implant survival analysis was completed using the Swedish Hip Arthroplasty Registry and the Sweden National Patient Register. A total of 150,073 patients undergoing THA for osteoarthritis within an 18-year period were included in the study. THA patients with (n = 2,604) and without (n = 147,469) a history of IBD at the time of THA were compared with primary revision as the main endpoint and adjusted using sex, age category and comorbidity (Elixhauser scores) as covariates. We found that patients with a history of IBD had a relatively higher risk of revision surgery for septic causes while the non-IBD patients had a relatively higher risk of revision for aseptic causes (p = 0.004). Our findings suggest there may be an association between gut health and THA performance.

Metabolic bone diseases in sickle cell anemia patients and evaluation of associated factors

BackgroundMetabolic or non-metabolic many bone diseases can be distinguished in sickle cell anemia. Patients with sickle cell anemia have a high risk of osteopenia and osteoporosis. The aim of this study is to reveal bone mineral density abnormalities and related factors in patients with sickle cell anemia. MethodsA total of 70 patients with sickle cell anemia were retrospectively included in our study. Complete blood count (CBC) parameters, serum creatinine, lactate dehydrogenase (LDH), total bilirubin, direct bilirubin, uric acid, calcium, phosphorus, parathormone, alkaline phosphatase, 25 (OH) vitamin D, ferritin, C reactive protein (CRP) and calculated bone mineral densitometry measurements by Dual-Energy X-ray Absorptiometry (DEXA) were assessed and recorded to the statistics program. We diagnosed osteopenia and osteoporosis according to World Health Organization (WHO) criteria. To determine the status of avascular necrosis and bone fracture, we examined x-ray and magnetic resonance imaging reports and epicrisis reports of patients from the records. ResultsThe average age was 30.01 ± 8.64 years. Eighteen (26.5%) of the 68 patients whose Z-score was evaluated by DEXA had bone mass below the expected age-related range according to the Z score, while 50 (73.5%) had bone mass within the expected age-related range. Of the patients whose T score was evaluated by DEXA, 46.8% were normal (n=29), 45.1% were osteopenic (n=28) and 8.1% were osteoporotic (n=5). ConclusionsPatients with sickle cell anemia are at increased risk for osteoporosis, osteopenia, and osteomalacia. Bone health should be emphasized in these patients.

Evaluation of Body Composition, Physical Activity, and Food Intake in Patients with Inborn Errors of Intermediary Metabolism.

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

Prevalence of and Risk Factors for the Different Stages of Bone Loss in Postmenopausal Women and Elderly Men: A Community-Based Cross-Sectional Study

Background: Despite large populations with osteoporosis worldwide, no comprehensive study on the risk factors for different bone loss stages exists. We therefore assessed bone health status and the prevalence of and risk factors for the different bone loss stages. Methods: This cross-sectional study included a representative sample of postmenopausal women and elderly men aged ≥50 years (N=1,412: 1,031 women, 381 men) recruited from eight communities in Guangzhou. All participants underwent measurement of bone mineral density of the lumbar vertebrae and left hip and an assessment of serum bone metabolism parameters. Demographic, clinical, and laboratory data were compared among patients with different bone loss stages. We used univariable and multivariable logistic regression models to explore the risk factors associated with osteopenia or osteoporosis. Findings: The prevalence of osteopenia and osteoporosis was 48·7% and 36·5% in women and 58·3% and 22·3% in men, respectively. For postmenopausal women with normal bone mass, a higher risk of osteoporosis was associated with older age, menstruation duration <35 years, menopause duration ≥10 years, lower education (primary school and lower), higher alkaline phosphatase (ALP), and family history of osteoporosis, whereas a lower risk with a large body mass index (BMI) and waist circumference. For postmenopausal women with osteopenia, a higher risk of osteoporosis was associated with older age, menstruation duration <35 years, higher procollagen I N-terminal peptide (PINP), higher Mg, and family history of osteoporosis, whereas a lower risk with a large BMI. For elderly men with normal bone mass, a higher risk of osteopenia was associated with a higher ALP, higher phosphorus, and higher Mg, while a lower risk with a large BMI and left handgrip strength. A higher risk of osteoporosis was associated with higher phosphorus levels and retirement, while a lower risk with a large BMI. For elderly men with osteopenia, no risk factor was associated with osteoporosis. Interpretation: The incidence of osteoporosis was higher in postmenopausal women than in the elderly men, whereas the incidence of osteopenia was more than 50% in the elderly men, which was significantly higher than that in postmenopausal women. Risk factors vary across bone loss stages in postmenopausal women and elderly men and for postmenopausal women include older age, menstruation duration <35 years, menopause duration ≥10 years, lower education (primary school and lower), higher ALP, higher PINP, higher Mg, family history of osteoporosis, lower BMI, and lower waist circumference, whereas for elderly men include higher ALP, higher phosphorus, higher Mg, lower BMI, lower left handgrip strength, and retirement. Caffeinated beverages and lack of Ca and vitamin D were not risk factors in the population. Hence, accurate prediction and early prevention should be prioritised in China to reduce osteoporotic fracture-related morbidity and mortality. Funding Statement: This study was funded by Special Research Project for the Construction of the National TCM Clinical Research Base of the State Administration of Traditional Chinese Medicine (Grant number: JDZX2015078); National Natural Science Foundation of China (Grant number: 81674000, 81774338, 81904225); and Major Research Project of Guangzhou University of Chinese Medicine. Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: The study was approved by the ethics committee of the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine (NO·ZYYECK [2016]028). We obtained written informed consent from all study participants.

ASSOCIATION OF BONE MINERAL DENSITY WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE IN POSTMENOPAUSAL WOMEN.

Osteoporosis (OP) is common in patients with chronic obstructive pulmonary disease (COPD). The relationship between OP and COPD has been primarily studied in male patients, and few reports are available in postmenopausal women. The purpose of this study was to investigate the association between bone mineral density (BMD) and COPD in postmenopausal women. This cross-sectional study included 133 clinically stable female ex-smokers with confirmed COPD, and 31 age-matched "ex-smoker" female controls. We analyzed groups according to their airway obstruction category. BMD was measured on dual-energy X-ray absorptiometry images of the left femoral neck. Patients with COPD had lower T-scores and higher prevalence of osteopenia/OP than the control group. In the COPD group, the airway obstruction category was significantly associated with the T-score after adjustment for confounders. Multivariate logistic regression analysis showed COPD was an independent marker for increased risk of osteopenia/OP in postmenopausal women. COPD and airway obstruction category were strongly related to BMD. Postmenopausal women with COPD, especially those with severe airway obstruction, had a higher prevalence rate and a higher risk of osteopenia and OP than female controls without COPD.

Mechanisms of implementation of osteopenic conditions in patients with combined course of chronic pancreatitis and hypertensive disease

The comorbidity of chronic pancreatitis (CP) and hypertensive disease (HD), which are often combined with each other, can be considered as predictor states of the complication formation. This is due to the intersection of individual pathogenic links, which are enhanced by their combination. As such a complication, it is possible to consider osteoporotic conditions, leading to metabolic disturbances of bone tissue with quantitative and qualitative changes. The emergence of secondary osteoporosis (SO) is not only phenotypically but also genetically conditioned, which is the basis for studying the gene aberrations of “osteopenically directed genes” and determining the content of SO biochemical markers.&#x0D; Aim of study: to establish the features of the comorbid course of CP and hypertension, to optimize the diagnosis of osteoporotic conditions by studying the content of biochemical markers of OP (total acid phosphatase (TAP) and tartrate-resistant acid phosphatise (TRAP)) and polymorphism of the vitamin D receptor genes (VDR).&#x0D; Materials and methods of research. To solve this problem, 110 patients with CP were examined and further divided into 2 groups: treatment group — 70 persons with CP and hypertensive disease (HD), and the comparison group — 40 patients with isolated CP. These groups were representative by age and sex. The condition of bone tissue was studied in assessing the content of indicators of total acid phosphatase (TAP) and non-prostatic acid phosphatase (TRAP) in blood serum. At the same time, VDR was determined.&#x0D; Results. It was found that the vast majority of patients in the treatment group (84.3%) had an unfavourable B-allele; against the comparison group — 77.5% of events. Changes in the VDR gene polymorphism affected the incidence of the osteoarticular system (CCP, χ2 = 20.81, p &lt;0.01) and had a statistically significant relationship in the distribution of alleles between groups (CCP, χ2 = 30.08, p &lt;0.01). The parameters of TAP and TRAP in patients with combined course of HP and CP were 8.7 ± 2.3 U/L and 5.1 ± 2.3 U/L, respectively, and in the comparison group — 6.9 ± 3.0 U/L and 3.5 ± 2.1 U/L. Thus, the content of TAP and TRAP exceeded the control in the treatment group by 2.5 (TAP) and 1.9 (TRAP) times (p&lt;0.01) and in the comparison group by 2.0 (TAP) and 1.3 TRAP) times (p&lt;0.01), which allowed us to state the development of osteopenic conditions. The distribution of alleles of the VDR gene was characterized by the predominance of the B-allele and was “supported” by changes in the biochemical markers of osteoporosis, which led to the development of osteopenicconditions in such individuals. Thus, the combination of HP and CP is an unfavourable factor in the development of osteoporosis and the basis for early detection of osteoporetic changes.&#x0D; Conclusions. In the combined course of CP and arterial hypertension, there is an increase in the number of persons with the B-allele of the VDR gene (84.3% of cases), the carriers of which have a high risk of osteopenia. With the comorbidity of CP and HD, there are fluctuations in the content of TAP and TRAP, correlating with VDR. Increase in the content of TAP and TRAP in patients with CP and HD often occurs against the background of an unfavourable B-allele of the VDR gene. Combined course of CP and HD is the basis for early diagnosis of osteoporotic complications.

Evaluation of osteopenia and osteoporosis in younger breast cancer survivors compared with cancer-free women: a prospective cohort study

BackgroundOsteoporosis, an indicator of significant bone loss, has been consistently reported among older breast cancer survivors. Data are limited on the incidence of osteopenia, an earlier indicator of bone loss, and osteoporosis in younger breast cancer survivors compared with cancer-free women.MethodsWe prospectively examined bone loss in 211 breast cancer survivors (mean age at breast cancer diagnosis = 47 years) compared with 567 cancer-free women in the same cohort with familial risk for breast cancer. Multivariable-adjusted Cox proportional hazards models were used to estimate HRs and 95% CIs of osteopenia and/or osteoporosis incidence based on physician diagnosis.ResultsDuring a mean follow-up of 5.8 years, 66% of breast cancer survivors and 53% of cancer-free women reported having a bone density examination, and 112 incident cases of osteopenia and/or osteoporosis were identified. Breast cancer survivors had a 68% higher risk of osteopenia and osteoporosis compared to cancer-free women (HR = 1.68, 95% CI = 1.12–2.50). The association was stronger among recent survivors after only 2 years of follow-up (HR = 2.74, 95% CI = 1.37–5.47). A higher risk of osteopenia and osteoporosis was also observed among survivors aged ≤ 50 years, estrogen receptor-positive tumors, and those treated with aromatase inhibitors alone or chemotherapy plus any hormone therapy relative to cancer-free women.ConclusionsYounger breast cancer survivors are at higher risk for osteopenia and osteoporosis compared to cancer-free women. Studies are needed to determine effective approaches to minimize bone loss in this population.

Risk for osteoporosis in gastric cancer survivorship.

121 Background: Gastrectomy is a risk factor for low bone mass. We aimed to investigate the relative risk for osteoporosis in gastric cancer survivorship compared to general population. Methods: Using Korea National Health and Nutrition Examination Survey (KNHANES III-IV), 2008-2011, we identified the 8,156 individuals over 50 years old who have been tested the dual-energy X-ray absorptiometry (DXA). Gastric cancer survivors (n = 103) who had a history of gastric cancer in questionnaire were defined as case. Control subjects were matched to case subjects by age (plus or minus 1 year) and sex with 1:5 ratio. Osteopenia ( -2.5 &lt; T-score &lt; -1.0 ) and osteoporosis (T-score ≤ -2.5) were used to define the status of bone mass. We performed multinominal logistic regression to compare the risk for osteopenia and osteoporosis between case and control. Results: After adjusting for sex, age, body mass index, smoking status, alcohol consumption, physical activity and bone health related history (history of fracture or family history of osteoporosis), there was a significant high risk for osteopenia (adjusted relative risk (RR) = 2.90; 95% confidence interval (CI) 1.16–7.25) and osteoporosis (adjusted RR = 4.63; 95% CI 1.12–13.3) in gastric cancer survivor. The risk for osteoporosis was most prominent for femur total in gastric cancer survivors (adjusted RR = 16.3; 95% CI 3.35–82.6). In addition, the serum Vitamin D level was lower in gastric cancer survivors (20.3 ± 0.5 IU vs 17.5 ± 1.2 IU, p-value = 0.011). Conclusions: Gastric cancer survivors showed significantly high risk for osteoporosis. Our finding clinically implies the importance of managing osteoporosis in gastric cancer survivors.[Table: see text]

Non traumatic osteonecrosis of the femoral head is associated with low bone mass

ObjectiveOsteoporosis (OP) and osteonecrosis of the femoral head (ONFH) share common clinical and pathophysiological features we sought to determine whether ONFH was associated with an increased prevalence of OP and whether the increased prevalence of OP was related to the stage of ONFH at diagnosis. MethodsWe included 243 patients with ONFH and 399 age and sex-matched healthy controls. Data was gathered including demography, risk factors, ARCO staging of ONFH and bone mineral density (BMD). ResultsOverall, BMD (defined by the T-score) was significantly lower in the ONFH group at both the femoral head (−0.96±1.11) and the lumbar spine (−1.22±1.47) compared to the control group (−0.55±0.97 and −0.73±1.31) (p<0.01). The ONFH group depicted a significantly higher proportion of osteopenia (50.39% vs 40.87%, p=0.027) and of OP (18.78% vs 7.33%, p<0.001) relative to the control group. Stage 1 and 2 ONFH patients (53.86%, p=0.0203; OR=1.54 (95% CI: [1.04; 2.29])) were at a higher risk of osteopenia than the control group (40.88%), but not stages 3 or 4 (48.47%, p=0.2569; OR=1.27 (95% CI: [0.78; 2.06]). Patients with stage 3 or 4 ONFH (25.31%, p<0.001; OR=3.93 (95% CI: [1.63; 10.96])) were at a higher risk of osteoporosis than patients in the stage 1 and 2 ONFH (7.24%), and compared to the control group (7.33%, adj. p-value<0.001; OR=4.89 (95% CI: [2.77; 8.76]). ConclusionsNon-traumatic osteonecrosis of the femoral heads is associated with low bone mineral density. This study showed that fractural stages ONFH were associated with a 5-fold risk of osteoporosis.

Association of eating out with bone density in Taiwan.

The present study analysed data derived from the 2004-2008 Nutrition and Health Survey in Taiwan, conducted by the Ministry of Health and Welfare, to understand the relationship among eating-out behaviour, related non-nutritional factors and osteopenia in the Taiwanese population. Design/Setting/Subjects Data of 1140 adults who had been evaluated with dual-energy X-ray absorptiometry in June 2007 were included. The data were analysed through descriptive and inferential statistics to determine the association of osteopenia with the frequency of eating out, demographic variables (i.e. age, sex, level of education, marital status and place of birth), BMI, waist circumference and food consumption. Gender, age, education level, personal income and waist circumference were all factors found to be significantly associated with eating-out frequency and the incidence of osteopenia. Eating-out frequency was negatively associated with the incidence of osteopenia. Individuals with BMI>27 kg/m2 had a lower frequency of eating out and a lower incidence of osteopenia. Individuals with a lower monthly income had a significantly greater chance of developing osteopenia. Men living without spouses had significantly higher chances of osteopenia. Ca intake was negatively associated with breakfast eating-out frequency. Eating-out frequency was not associated with an increasing incidence of osteopenia, but affected the Ca intake in the Taiwanese population. Having a balanced selection of food is crucial to reduce the incidence of osteopenia. Improving nutritional knowledge for those under higher risk of osteopenia is necessary to prevent osteopenia and Ca deficiency.