High Incidence Of Osteoporosis Research Articles

Features of bone destruction in rabbits with experimental metabolic syndrome

There is now evidence that abdominal obesity and metabolic syndrome in general are associated with a decrease in bone mineral density, which in turn leads to an increased risk of fractures. A high incidence of osteoporosis and vertebral fractures in patients with MS has been proven. Thus, MS can be considered a new risk factor for osteoporosis. We studied biochemical parameters in rabbits with experimental metabolic syndrome, accompanied by bone destruction, as well as in models of metabolic syndrome (MS) and osteoporosis. The level of glucose and c-peptide indicates the development of insulin resistance in animals with MS and MS, accompanied by bone destruction. It has been shown that with metabolic syndrome associated with bone destruction, rabbits exhibit more profound disorders of lipid metabolism than with MS, the level of which differs slightly from each other. The study of bone remodeling indicators in a model of MS accompanied by bone destruction showed individual and gender differences in the content of bone remodeling markers in blood serum. It has been shown that in most experimental animals there is a decrease in osteocalcin, which is a marker of osteosynthesis, and an increase in the level of type I collagen C-telopeptide, which indicates increased destruction of bone collagen. Moreover, the level of bone destruction was more pronounced in males than in females. A study of biomarkers of cartilage tissue degradation showed that the level of change in COMP and hyaluronic acid was higher in females than in males, and the deviation of aggrecan levels from the reference value was higher in males. From our results we can conclude that in male rabbits with MS, bone tissue damage predominated, while in females the degree of cartilage tissue damage was higher.

Role of brain‐derived extracellular vesicles in bone‐fat imbalance in Alzheimer’s disease

AbstractBackgroundInadequate osteogenesis and excessive adipogenesis of bone marrow mesenchymal stem cells (BMSCs) are key factors in the pathogenesis of osteoporosis. Patients with Alzheimer’s disease (AD) have a higher incidence of osteoporosis than healthy adults, but the underlying mechanism is not clear. The aim of this study was to investigate the role of brain‐derived extracellular vesicles (EVs) from AD mice on the regulation of bone metabolism.MethodBrain‐derived EVs from AD or wide‐type mice was injected into C57BL/6 mice intravenously once a week for two months.ResultHere, we show that brain‐derived EVs from adult AD or wild‐type mice can cross the blood‐brain barrier to reach the distal bone tissue, while only AD brain‐derived EVs (AD‐B‐EVs) significantly promote the shift of the BMSC differentiation fate from osteogenesis to adipogenesis and induce a bone‐fat imbalance. MiR‐483‐5p is highly enriched in AD‐B‐EVs, brain tissues from AD mice, and plasma‐derived EVs from AD patients. This miRNA mediates the anti‐osteogenic, pro‐adipogenic, and pro‐osteoporotic effects of AD‐B‐EVs by inhibiting Igf2.ConclusionThis study identifies the role of B‐EVs as a promoter of osteoporosis in AD by transferring miR‐483‐5p.

Dietary Calcium Intake and Osteoporosis Risk in Arab Adults.

Osteoporosis is a major public health concern in Saudi Arabia's aging population. There is particularly limited information on how diet affects bone loss in this ethnic group. The purpose of this study was to examine the association between dietary calcium (Ca) intake and osteoporosis risk in Saudi adults. A total of 1950 patients (416 males and 1534 females) with known risk factors for osteoporosis participated in this cross-sectional study. A short questionnaire (CaQ) was used to assess dietary Ca intakes in patients attending tertiary hospitals in Riyadh City. The prevalence of osteoporosis was 21.3% and was more common in females (93.5%). Patients with osteoporosis were older (p < 0.001) and had lower BMI (p < 0.001). Results showed that the overall mean Ca intake was only 445.1 mg/day (recommended dietary intake of 1300 mg/day). Tea intake (OR = 0.8 95%CI: 0.7-1.0; p = 0.02) and consumption of fish and eggs (OR = 0.9 95%CI: 0.8-1.0; p = 0.01) were significantly associated with a lower risk of osteoporosis. Furthermore, consumption of biscuits, cake and bread slices were significantly associated with higher incidence of osteoporosis (OR = 1.3 95%CI: 1.0-1.5; p = 0.02). In conclusion, extremely low dietary Ca intake was observed among Saudi adults already at risk of osteoporosis. A balanced diet including high amount of Ca, vitamin D and omega-3 fatty acids accompanied by limiting consumption of foods high in saturated fats and glycemic index may be helpful in reducing osteoporosis risk in the Saudi adult population.

Brain-derived extracellular vesicles promote bone-fat imbalance in Alzheimer's disease.

Inadequate osteogenesis and excessive adipogenesis of bone marrow mesenchymal stem cells (BMSCs) are key factors in the pathogenesis of osteoporosis. Patients with Alzheimer's disease (AD) have a higher incidence of osteoporosis than healthy adults, but the underlying mechanism is not clear. Here, we show that brain-derived extracellular vesicles (EVs) from adult AD or wild-type mice can cross the blood-brain barrier to reach the distal bone tissue, while only AD brain-derived EVs (AD-B-EVs) significantly promote the shift of the BMSC differentiation fate from osteogenesis to adipogenesis and induce a bone-fat imbalance. MiR-483-5p is highly enriched in AD-B-EVs, brain tissues from AD mice, and plasma-derived EVs from AD patients. This miRNA mediates the anti-osteogenic, pro-adipogenic, and pro-osteoporotic effects of AD-B-EVs by inhibiting Igf2. This study identifies the role of B-EVs as a promoter of osteoporosis in AD by transferring miR-483-5p.

Comprehensive Treatment of Fragility Fractures of Distal Radius, an Opportunity for Prevention the Deterioration of Bone Health and Reduction of other Fractures with Higher Morbidity and Mortality

Report goal: Fragility fractures of distal radius, are the most common fractures of upper extremities in adults and elderly, with higher incidence in females. Are low energy fractures, result of a fall from standing height or less. Such patients have higher incidence of osteoporosis and increased risk of other serious fractures. Research results: From the questionnaire filled by orthopedic doctors, fragility fractures of distal radius are most frequent in patients 50-60 years old female. 54% of doctors order DEXA scan, 60 % refer patients for osteoporosis evaluation and treatment; 36% treat osteoporosis. From patient questionnaire, such patient were mostly 51-70 yo female, 6.5% had family history of fragility fracture, 97% did not have knowledge about osteoporosis, 3% had high education level, 73% did not report social-economical issues, 45% did not have other medical problems. Summary: Fragility fractures of distal radius occur earlier comparing to other fragility fractures. The orthopedic doctor should recommend DEXA scanning, refer or treat osteoporosis to prevent further deterioration of patient bone health and reduce the risk of other fragility fractures with a higher morbidity and mortality.&#x0D; &#x0D; Received: 23 September 2022 / Accepted: 28 November 2022 / Published: 20 December 2022

Relationship between obstructive sleep apnea-hypopnea syndrome and osteoporosis adults: A systematic review and meta-analysis.

This study is undertaken to explore the relationship between obstructive sleep apnea-hypopnea syndrome (OSAHS) and osteoporosis, including the relationship between OSAHS and osteoporosis incidence, lumbar spine bone mineral density (BMD), and lumbar spine T-score. Cochrane Library, PubMed, Embase, Web of Science, and other databases are searched from their establishment to April 2022. Literature published in 4 databases on the correlation between OSAHS and osteoporosis,lumbar spine BMD,lumbar spine T-score is collected. Review Manager 5.4 software is used for meta-analysis. A total of 15 articles are selected, including 113082 subjects. Compared with the control group, the OSAHS group has a higher incidence of osteoporosis (OR = 2.03, 95% CI: 1.26~3.27, Z = 2.90, P = 0.004), the lumbar spine BMD is significantly lower (MD = -0.05, 95% CI: -0.08~-0.02, Z = 3.07, P = 0.002), and the lumbar spine T-score is significantly decreased (MD = -0.47, 95% CI: -0.79~-0.14, Z = 2.83, P = 0. 005). Compared with the control group, the OSAHS group has a higher incidence of osteoporosis and decreased lumbar spine BMD and T-score. In order to reduce the risk of osteoporosis, attention should be paid to the treatment and management of adult OSAHS, and active sleep intervention should be carried out.

Relationship between osteoporosis and Cushing syndrome based on bioinformatics.

Many clinical studies have reported a relatively high incidence of osteoporosis and fragility fractures in patients with Cushing syndrome (CS). However, few papers have investigated osteoporosis and CS in terms of pathogenesis, so this study explores the association between the 2 and predicts upstream micro-ribonucleic acids (miRNAs) through bioinformatics, which provides potential targets for simultaneous pharmacological interventions in both diseases and also provides a basis for pathological screening. We used Genecards, Online Mendelian Inheritance in Man and Therapeutic Target Database databases to screen the targets of osteoporosis and Cushing syndrome; import target genes to Database for Annotation, Visualization and Integrated Discovery for Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis; the intersecting genes were uploaded to Search Tool for the Retrieval of Genes and Genomes database to construct protein-protein interaction network; Cytoscape software was used to screen core genes, and Molecular Complex Detection module was used to analyze cluster modules; finally, the NetworkAnalyst data platform was used to predict the miRNAs that interact with core genes. The core genes of osteoporosis and Cushing syndrome were insulin, tumor necrosis factor, signal transducer and activator of transcription 3 (STAT3), interleukin-6, insulin-like growth factor 1, etc. A total of 340 upstream miRNAs including hsa-let-7a-5p, hsa-mir-30a-5p and hsa-mir-125b-5p were predicted. The biological processes involved include regulating the transcription of ribonucleic acid polymerase II promoter and participating in the transduction of cytokine signaling pathways, which focus on the binding of nerve system ligand, JAK-STAT signaling pathway, Rap1 signaling pathway, PI3K-Akt signaling pathway, etc. Osteoporosis and Cushing syndrome are closely related in terms of targets and molecular mechanisms. In this study, bioinformatics methods were used to identify their targets and mechanisms, providing potential targets for drug simultaneous regulation of the 2 diseases, and providing a new direction for exploring the relationship between diseases.

A Survey Study on the Status of Somatic Symptoms in Young and Middle-Aged Patients with Mental Illness during Long-Term Hospitalization.

Psychiatric disorders include severe psychiatric disorders and those in general with some psychiatric disorders having a clear etiology or in which a significant psychiatric predisposing factor is present. Whereas, psychiatric disorders precisely refer to those characterized by mild depression and mild anxiety and appear to affect a large number of people in any community. It has been reported that the disease is highly prevalent and has a huge impact on the individual, family, and community levels, resulting in a heavy burden on the healthcare system of a country. To explore the status of somatic symptoms in young and middle-aged psychiatric patients during long-term hospitalization, a total of 114 young and middle-aged psychiatric patients with prolonged hospitalization (more than 5 years) were included. Data information of the hospitalized patients was recorded, including preadmission somatic symptoms, electrocardiogram (ECG), echocardiogram, abdominal ultrasound, and blood tests. In addition, a homemade questionnaire was administered, and general information about the patients was also collected, including gender, age, current medication use, and duration of medication use. Correlations between cardiometabolic disease, osteoporosis, and long-term oral antipsychotic medication were analyzed in these young and middle-aged patients. The prevalence of comorbid somatic symptoms was 77.2%, and concomitant disorders included mainly cardiometabolic disorders, osteoporosis, pulmonary infections, cerebrovascular disorders, digestive disorders, fractures, and skin conditions. The incidence of somatic symptoms caused by long-term use of antipsychotic drugs was about 88.6%, and the incidence of concomitant somatic symptoms was higher in young and middle-aged psychiatric patients who were hospitalized for a long time. The current study observed a high prevalence of somatic symptoms in young and middle-aged patients with long-term inpatient psychiatric illness. Endocrine and metabolic disorders, particularly dyslipidemia, may trigger a range of deleterious effects. In addition to this, there is a high incidence of osteoporosis. Special attention should be paid to the side effects of antipsychotic drugs, and appropriate measures are needed to make early diagnosis and provide early treatment to reduce the occurrence of cardiometabolic diseases and osteoporosis.

Synergy of sarcopenia and vitamin D deficiency in vertebral osteoporotic fractures in rheumatoid arthritis.

To explore the synergistic effect of vitamin D deficiency and sarcopenia on vertebral osteoporostic fracture (VF) in patients with rheumatoid arthritis (RA). A total of 188 patients with RA and 158 control subjects were enrolled. Bone mineral density (BMD) at the total hip, neck of femur, lumbar vertebra 1-4, and skeletal muscle mass was measured by dual energy X-ray absorptiometry (DXA) and biological electrical impedance, respectively. Serum 25(OH)D was tested by electrochemiluminescence. The prevalence of VF and osteoporosis (OP) were compared between RA and controls. The synergism of sarcopenia and vitamin D deficiency on VF in patients with RA was tested by χ2 test and logistic regression. The prevalence of OP at all measured sites and VF in RA patients were all higher than those in controls (P < 0.0001). The incidence of VF in RA either with sarcopenia or with vitamin D deficiency was higher than for those without sarcopenia or without vitamin D deficiency (χ2 = 5.069, P = 0.027, χ2 = 8.822, P = 0.001). Age, disease duration, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), DAS28, health assessment questionnaire (HAQ), Sharp score, and body mass index (BMI) were significantly different between RA with sarcopenia or not (P < 0.05). Logistic regression analysis found that age (OR = 1.095, 95%, CI: 1.044-1.150, P < 0.0001) was a significant risk factor for VF in patients with RA, while high skeletal muscle mass (SMI) (OR = 0.513, 95% CI: 0.327-0.804, P = 0.004) was a protective factor for VF in RA patients. VF, sarcopenia, and vitamin D deficiency are common in patients with RA. Sarcopenia and vitamin D deficiency may be risk factors for the incidence of VF in RA patients. • RA patients had a higher incidence of OP and VF, also a high prevalence of sarcopenia and vitamin D deficiency. • Vitamin D deficiency and sarcopenia may might have a synergistic effect on VF in RA. • Aging and sarcopenia are risk factors for VF in RA patients, and sarcopenia were associated with disease activity and structural damage.

Factors affecting sarcopenia in older patients with chronic diseases.

Sarcopenia is an age-related disease characterized by a progressive loss of systemic muscle mass and/or decreased muscle strength and physical function. The occurrence of sarcopenia in patients with chronic diseases will not only cause further deterioration of diseases and adverse clinical outcomes, but also lead to high medical cost, suggesting a necessity and a great significance to explore the associated factors of sarcopenia in chronic patients in order to improve their quality of life. This study aimed to investigate factors affecting sarcopenia among older hospitalized patients with chronic diseases. A total of 121 older patients with chronic diseases admitted to the Department of Geriatrics of Affiliated Kunshan Hospital of Jiangsu University from May 2019 to April 2021 were enrolled. According to the diagnostic criteria of sarcopenia formulated by the Asian Working Group for Sarcopenia (AWGS), the subjects were divided into a sarcopenia group (n=57) and a non-sarcopenia group (n=64). We analyzed the associated factors including bone mineral density, nutritional biomarkers, hormone levels and inflammatory cytokines. Compared to the non-sarcopenia group, the sarcopenia group was of older average age (P<0.001), exhibited a lower body mass index (BMI) (P<0.001), a lower bone mineral density (BMD) of the femoral neck (P<0.01), and a higher incidence of osteoporosis. In terms of hematology, the sarcopenia group exhibited significantly lower serum iron and zinc levels (both P<0.05), a higher growth hormone (GH) level (P<0.05), a significantly lower IGF-1 level (P<0.01), and a lower level of iron (P<0.01). Poor nutritional status (assessed via measurement of albumin and prealbumin levels) positively correlated with sarcopenia (P<0.01). Sarcopenia is closely associated with aging, and has a close relationship with osteoporosis. Anemia, malnutrition, vitamin and trace element deficiencies, changes in hormone levels, and chronic inflammation are correlated with sarcopenia. Patients with these features above call for the screenig of sarcopenia. Additionally, these characteristics may help providing clues for further research on the pathogenesis and risk factors of sarcopenia, along with disease prevention and intervention.

Sarcopenia May Be a Risk Factor for Osteoporosis in Chinese Patients with Rheumatoid Arthritis.

PurposeOsteoporosis (OP) has been classically considered a co-morbidity of rheumatoid arthritis (RA). This investigation determined the clinical significance of sarcopenia in patients with RA combined with OP or whether sarcopenia influences RA when combined with OP.Materials and MethodsData pertaining to the duration of RA, C-reactive protein (CRP) level, and erythrocyte sedimentation rate (ESR) were collected from 549 RA cases and 158 healthy individuals. Disease activity score at 28 joints (DAS28), the body mass index (BMI), health assessment questionnaire (HAQ), bone mineral density (BMD), and Sharp score were compared between the 2 groups.ResultsThe prevalence of OP (33.3% vs 12.7%, χ2= 69.992, P < 0.0001) and sarcopenia (61.7% vs 9.0%, χ2= 135.336, P < 0.01) was greater in patients with RA than in healthy controls. RA patients with sarcopenia had a higher incidence of OP at all measured sites than RA patients without sarcopenia (all P < 0.0001), and the incidence of OP was significantly higher than in patients with mild-to-moderate or severe RA without sarcopenia (P < 0.0001). Differences in age, gender, course of disease, CRP level, ESR, DAS28, BMI, HAQ, BMD, and Sharp score were statistically different between the RA with or without sarcopenia groups (P < 0.01). The incidence of OP and sarcopenia was higher in RA patients treated than not treated with glucocorticoids [GCs] (36.4% vs 29.3%, P < 0.05 and 66.1% vs 56.0%, respectively; P < 0.05). Logistic regression showed that the risk factors for OP in RA individuals were female (OR, 14.671; 95% CI, 6.877–31.300; P < 0.0001), age (OR, 1.100; 95% CI, 1.076–1.124; P < 0.0001), and sarcopenia (OR, 3.561; 95% CI, 2.214–5.726; P < 0.0001).ConclusionOP and sarcopenia are common in RA patients. Sarcopenia may be a risk factor for OP occurrence in Chinese patients with RA.

Retrospective analysis of the use of osteoporosis medication at the presentation of non-vertebral fragility fractures in a predominantly Hispanic population.

Background: Despite the high incidence of osteoporosis, many patients at risk of fragility fractures may not initiate treatment due to concerns about side effects, cost or under-diagnosis, such as the case of vertebral fractures. We aimed to identify whether the patient population with non-vertebral fragility fractures where already receiving prophylactic treatment for osteoporosis at presentation within a regional hospital in the southernmost region of the United States. This region is characterized by a high number of patients from Hispanic/Latino heritage (80%) and reduced access to healthcare services. Methods: We conducted a three-year, retrospective cohort study of patients presenting with low impact fractures of the humerus or the shoulder griddle, lower end of radius or ulna and forearm, hip fractures (femoral neck, intertrochanteric/ subtrochanteric), and ankle fractures. Male and female subjects of 50 years or older were included. Demographic data and information on medications reported at fracture presentation were extracted from electronic medical records. Results: We found that 42% of the patients were taking at least one medication to prevent osteoporosis. The predominant combination was vitamin D plus calcium and bisphosphonates. If patients taking only vitamin D plus calcium are excluded, 16.7% of the sample took osteoporosis medications at the fragility fracture presentation. The likelihood of taking osteoporosis medication was increased by age and type of health insurance (Medicare/private insurance), and concomitant diagnosis of impaired gait and mobility. The percentage of the patients taking prophylactic medications for osteoporosis at the time of a fragility fracture was comparable to reported national standards and associated with increased age and health insurance coverage. Conclusion: In a predominantly Hispanic/Latino patient population living in a medically underserved region, there is substantial recognition and prevention strategies for osteoporosis.

Association between Body Mass Index and Bone Mineral Density in Patients Referred for Dual-Energy X-Ray Absorptiometry Scan in INMAS, Sylhet

With an aging population, osteoporosis is increasingly becoming a public health concern. Bangladesh has a high incidence of osteoporosis and occurs among a relatively younger age group than in the developed world. There are several factors that could be associated with bone mineral density (BMD). We are keen to determine the association with BMD and BMI. The study was carried out on 152 patients who were referred to INMAS for dual energy X- ray absorptiometry (DEXA) measurement of bone mineral density (BMD) during the periods of January 2018 to July 2019. BMD was measured at right femoral neck and lumbar spines. Data about age and sex, BMI were recorded. Reporting was done according to the T score following WHO criteria. Prevalence were compared using chi-squared tests. Among 152 patients, 84.9% were females and 15.1% were males. Results showed for right femur that normal bone density in 91 (59.1%), osteopenia in 54 (35.1%), osteoporosis in 9 (5.8%) and BMD in spine was normal in 57 (37.0%) osteopenia in 44 (28.6%), osteoporosis in 53 (34.4%). About 60% of the study population was normal weight and others were underweighted or overweighed. Status of BMD was associated with BMI in the lumbar spine and femur. In this study group, total 61.2% and 26.3%were found low BMD in spine and right femur respectively. In age group ≥ 60 years, low BMD in spinewas 72.0% that is 42.29% higher compare to below 60 years’ group (50.6%).Correlation of BMI with lumbar spine T score, right femur and left femur T score were measured by Pearson’s correlation coefficient test. Positive significant Pearson’s correlation was observedbetween BMI with spine T score (r = 0.397; p = &lt;0.001), BMI with right femur T score (r = 0.347; p = &lt;0.001) and BMI with left femur T score (r = 0.382; p = &lt;0.001).&#x0D; Bangladesh J. Nuclear Med. 22(2): 108-113, Jul 2019

The association between keloid and osteoporosis: real-world evidence

BackgroundKeloids are characterized by disturbance of fibroblast proliferation and apoptosis, deposition of collagen, and upregulation of dermal inflammation cells. This benign dermal fibro-proliferative scarring condition is a recognized skin inflammation disorder. Chronic inflammation is a well-known contributor to bone loss and its sequelae, osteoporosis. They both shared a similar pathogenesis through chronic inflammation. We assessed whether keloids increase osteoporosis risk through using National Health Insurance Research Database.MethodsThe 42,985 enrolled patients included 8597 patients with keloids but no history of osteoporosis; 34,388 controls without keloids were identified from the general population and matched at a one-to-four ratio by age, gender. Kaplan-Meier method was applied to determine cumulative incidence of osteoporosis. Cox proportional hazard regression analysis was performed after adjustment of covariates to estimate the effect of keloids on osteoporosis risk.ResultsOf the 8597 patients with keloids, 178 (2.07%) patients were diagnosed with osteoporosis while in the 34,388 controls, 587 (1.71%) were diagnosed with osteoporosis. That is, the keloids patients had 2.64-fold higher risk of osteoporosis compared to controls after adjustment for age, gender, Charlson Comorbidity Index and related comorbidities. The association between keloids and osteoporosis was strongest in patients younger than 50 years (hazard ratio = 7.06%) and in patients without comorbidities (hazard ratio = 4.98%). In the keloids patients, a high incidence of osteoporosis was also associated with advanced age, high Charlson Comorbidity Index score, hyperlipidemia, chronic liver disease, stroke, and depression.ConclusionsOsteoporosis risk was higher in patients with keloids compared to controls, especially in young subjects and subjects without comorbidities.

Risk of osteoporosis and fracture in long-term breast cancer survivors.

High incidence of osteoporosis has been reported in breast cancer patients due to early menopause triggered by adjuvant treatment and temporary ovarian function suppression. In this study, we sought to determine whether long-term breast cancer survivors had an elevated risk of low bone density compared to the general population. Long-term breast cancer survivors who had been treated for more than 5 years were selected for this study. Data were obtained from medical records and using a questionnaire from the Korea National Health and Nutrition Examination Survey (KNHANES). An age-matched non-cancer control group was selected from the KNHANES records. Incidence of fracture and bone mineral density (BMD) were compared between the two groups. In total, 74 long-term breast cancer survivors and 296 non-cancer controls were evaluated. The incidence of fracture did not differ between the two groups (P=0.130). No differences were detected in lumbar BMD (P=0.051) following adjustment for body mass index, while hip BMD was significantly lower in breast cancer survivors (P=0.028). Chemotherapy and endocrine treatment were not related to low BMD in breast cancer survivors. In more than half of the survivors, the 10-year risk of osteoporotic fracture was less than 1%. Long-term breast cancer survivors had low bone density but a comparable risk of fracture compared to non-cancer age-matched controls. Further studies on the factors related to low bone density in long-term breast cancer survivors are required.

Evaluation and Management of Osteoporosis and Sarcopenia in Patients with Distal Radius Fractures.

Distal radius fractures (DRFs) are one of the most common fractures seen in elderly people. Patients with DRFs have a high incidence of osteoporosis and an increased risk of subsequent fractures, subtle early physical performance changes, and a high prevalence of sarcopenia. Since DRFs typically occur earlier than vertebral or hip fractures, they reflect early changes of the bone and muscle frailty and provide physicians with an opportunity to prevent progression of frailty and secondary fractures. In this review, we will discuss the concept of DRFs as a medical condition that is at the start of the fragility fracture cascade, recent advances in the diagnosis of bone fragility including emerging importance of cortical porosity, fracture healing with osteoporosis medications, and recent progress in research on sarcopenia in patients with DRFs.

Prevalence and risk factors associated with vertebral osteoporotic fractures in patients with rheumatoid arthritis.

To explore the prevalence and risk factors of osteoporosis (OP) and vertebral osteoporotic fracture (VOPF) in patients with rheumatoid arthritis (RA). Anteroposterior and lateral X-ray examination of the vertebral column (T4-L4) was used for the semi-quantitative assessment of VOPF. Bone mineral density was measured by dual-energy X-ray absorptiometry. Of 865 RA patients, the prevalence of OP and VOPF was 33.6% and 20.2%, respectively. Patients with OP or VOPF were older, and had longer term use and a larger daily amount and cumulative dose of glucocorticoids (GCs), longer disease duration, and higher Health Assessment Questionnaire (HAQ) scores and Sharp scores than patients without OP or VOPF (P < 0.05). OP was also correlated with higher disease activity. The patients treated with GCs had higher incidences of OP and VOPF than the patients without GCs (P < 0.05). The cutoff values in the area under curve (AUC) of the daily dose or treatment course of GCs-VOPF were 9mg and 37.5days. Older age, female sex, and a higher Sharp score were risk factors for OP in RA patients, while higher BMI was a protective factor. Older age and a high GC daily dose were risk factors for VOPF in RA patients. RA patients have a high prevalence of OP and VOPF. Older age, female sex, lower BMI, and higher activity and severity of RA are closely related with OP. Older age and a higher GC daily dose are risk factors for VOPF in RA patients. Key Points • Older age, female sex, lower BMI, and a higher Sharp score were risk factors for OP in RA patients. • Older age and a high GC daily dose were risk factors for VOPF in RA patients. • OP and VOPF in RA patients were correlated with longer disease duration and higher severity of RA.

Frequency of osteoporosis and fractures in patients with spine and spinal cord injuries

An increase in the life expectancy of patients with spine and spinal cord injuries leads to an increased risk of late complications, such as osteoporosis and fractures due to low-energy trauma. Objective: to determine the incidence of osteoporosis and fractures in individuals with spine and spinal cord injuries. Methods: 137 patients with spine and spinal cord injuries (90 men and 47 women) were examined with duration of the post-traumatic period from 3 months up to 38 years with complete transverse spinal cord injury and 137 individuals in the comparison control group. The bone mineral density was determined. Results: in patients with spine and spinal cord injuries and duration of the post-traumatic period less than 5 years, osteoporosis was detected in 40.6 % of cases, and in the comparison group normal bone mineral density was recorded (DI: 28.4–51.1; χc 2 = 37.4; p < 0.0001). With an increase in the post-traumatic period for more than 5 years, osteoporosis or low bone mineral density has been revealed (in women of reproductive age and men younger than 50 years). In the comparison group, osteoporosis was not diagnosed, and a low bone mineral density was detected in 10 persons (3 men, 7 women). Among patients with spine and spinal cord injuries, the fracture rate was 18.2 % — 25 (10 men, 15 women). The average duration of the post-traumatic period at the time of the frac­ture was (9.7 ± 7.8) years. In the comparison group, fractures were significantly less common in 2 (1.5 %) patients (χc 2 = 21.4; p < 0.0001; DI: 10.0–24.0). A significantly greater prevalence of fractures was observed in patients with spinal cord injury at the level of the lumbar spine (39.3 %) than cervical and thoracic — 11.1 % (χс 2 = 5.4; p < 0.05; DI: 3.1–37.1) and 13.7 % (χс 2 = 4.2; p < 0.05; DI: 0.8–34.7) respectively. The incidence of fractures increased with increasing duration of the post-traumatic period. Conclusions: the high incidence of osteoporosis and fractures in individuals with spine and spinal cord injuries causes specific preventive and curative measures to improve their bone tissue.

Design of a surrogate for evaluation of methods to predict bone bending stiffness

The high incidence of osteoporosis and related fractures demands for the use and development of methods capable of detecting changes in bone mechanical properties. The most common clinical and laboratory methods used to detect changes in bone mechanical properties, such as stiffness, strength, or flexural rigidity, include: mechanical testing, medical imaging, medical image-based analytical calculations, and medical image-based finite element analysis. However, the innate complexity of bone makes validation of the results from each method difficult. The current study presents the design, fabrication, and functional testing of a bi-material and computed tomography scan compatible bone-surrogate which provides consistent reproducible mechanical properties for methodological evaluation of experimental, analytical, and computational bone bending stiffness prediction methods.

Correlation between Degenerative Changes and Osteoporosis in Lumbar Spine of Elderly Women in Dhaka city, Bangladesh

Aims: Degenerative joint diseases and decreased bone mass i.e. osteoporosis are two common age related skeletal disorders responsible for pain and disability. Bangladesh has a high incidence of osteoporosis and the incidence particularly in women, occurs among a relatively younger age group than in the developed world. However little is known about the correlation between degenerative changes and osteoporosis in lumbar spine of elderly women. The purpose of this study was to clarify this relationship in elderly women of Dhaka, Bangladesh. Methods: A cross-sectional study was conducted at the department of radiology and imaging of Bangladesh institute of research and rehabilitation in diabetes, endocrine and metabolic disorders (BIRDEM), Dhaka during the period of 1st January, 2009 to 31st December, 2010. DEXA scan of spine and BMD measurement were done at a renowned private hospital of Dhaka. Total 63 elderly female aged between 50-75 years were randomly selected for this study. Results: An inverse relationship between osteoporosis and spondylosis in postmenopausal women as evaluated by bone mineral density and semiquantitative scoring of spinal degeneration was observed. A significant negative correlation (r=-0.53:p&lt;0.05) was found between T-score and grade. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13740 City Dent. Coll. J Volume-10, Number-1, January-2013