Important Risk Factor For Osteoporosis Research Articles

Evaluation of cortical and trabecular bone structure of the mandible in patients using L-Thyroxine

BackgroundLong-term use of L-Thyroxine (LT4), the synthetic thyroxine hormone used for thyroid hormone replacement therapy, is an important risk factor for osteoporosis. The aim of this study was to investigate the differences between mandibular cortical index (MCI) and trabecular bone fractal dimension (FD) values on panoramic radiographs of patients using LT4 and control subjects.MethodsA total of 142 female patients, 71 cases and 71 controls, were analyzed in the study. Ages were matched in case and control groups and the mean age was 36.6 ± 8.2 (18 to 50) years. MCI consisting of C1 (Normal Mandibular Cortex), C2 (Moderately Resorbed Mandibular Cortex) and, C3 (Severely Resorbed Cortex) scores was determined for case and control groups. Fractal analysis was performed using ImageJ on selected regions of interest from the gonial and interdental regions. The box-count method was used to calculate FD values. Wilcoxon signed-rank test, Mann-Whitney U test, and Spearman correlation analysis were applied to compare the measurements. Statistical significance of differences was established at P < 0.05 level.ResultsFD values did not show statistically significant differences between case and control groups (p > 0.05). The mean FD in the right gonial region was 1.38 ± 0.07 in the case group and 1.38 ± 0.08 in the control group (p = 0.715). The mean FD in the right interdental region was 1.37 ± 0.06 in the cases and 1.36 ± 0.06 in the control group (p = 0.373). The mean FD in the left gonial region was 1.39 ± 0.07 in the cases and 1.39 ± 0.07 in the control group (p = 0.865). The mean FD in the left interdental region is 1.37 ± 0.06 in the cases and 1.38 ± 0.05 in the control group (p = 0.369). The most common MCI score was C1, with 62% in the cases and 83.1% in the control group. MCI scores showed a statistically significant difference between cases and controls (p = 0.016, p < 0.05). While the C2 score was higher in the cases, the C1 score was higher in the controls.ConclusionsLT4 use was not associated with the FD of mandibular trabecular bone, but was associated with MCI values of cortical bone. Further studies on larger samples with different imaging modalities and image processing methods are needed.

Bisphosphonate use for glucocorticoid-induced osteoporosis in older patients with immune thrombocytopenia: a clinical perspective.

Prednisolone, used as a standard initial treatment for immune thrombocytopenia (ITP), is an important risk factor for osteoporosis. Recently, we found that prescription of bisphosphonate during initial loading of prednisolone may prevent reduction in bone mineral density and development of glucocorticoid-induced osteoporosis (GIO) in older patients with ITP receiving prolonged steroid therapy. In this review, I describe the treatment options for older patients with ITP, and present the best practices for screening, evaluating, and diagnosing ITP. I also summarize the literature from 2017 to 2022 on the treatment options for ITP, including discussions on the contraindications and side effects, with an emphasis on GIO, and the relative merits of bisphosphonates as a co-treatment for prevention of GIO. Finally, I present a perspective and an expert recommendation on how older patients with ITP would best be served in the future.

ODP113 Presentation of two similar Klinefelter Syndrome cases with different clinical outcomes

Abstract Case 1 74-year-old Caucasian male with dysphagia, s/p laryngeal carcinoma, partial laryngectomy and past radiotherapy, was referred for breast enlargement with some increase over the last few years. He denied tenderness or breast discharge, but reported bilateral testicular atrophy, which he attributed to agent orange red exposure. Although married for 53 years, he did not have biological children. He had decreased libido, and denied testicular trauma, urinary symptoms, or history of infections, opiate, steroids abuse, or OTC herbal supplements. Pituitary MRI for head injury was normal. Physical exam-HT= 180.3 cm; 172 cm arm span, bilateral testicular atrophy. Laboratory findings: [PO4= 3.2mg/dL (2.5-4.9); Calcium=9.2 mg/dl(8.5-10.1);Magnesium =2.1 mg/dl(1.7-2.4); Vit D,25 OH=52.9 ng/mL (30–100); PTH =54.9 pg/ml (18.4-80.1),;FSH =41.7 mIU/mL(0 .7-10.8); LH=27.5 mIU/mL (1.2-10.6);Prolactin=4.5 ng/mL(2.5 -7.4); total Testosterone 81 ng/dL (250–1100); free testosterone 4.5pg/mL (30. 0-135. 0); Sex HBG 63 nmol/L (10–57); Estradiol &amp;lt;11.80 pg/mL(&amp;lt;11-39.8); Tumor marker BHCG &amp;lt;2mIU/mL (&amp;lt;5 mIU/ml; Cortisol, am=15.5 ug/dl (5.3-22.5);PSA=.260 ng/mL (0. 0- 4. 0)]. Karyotype analysis=47, XXY [15]/46, XX[5]. With supernumerary X chromosome, consistent with KS. DXA= osteopenia in AP spine and severe osteoporosis in other areas: femur neck left T-Score of -3.1. Right femur neck T-Score=-3. 0, total left femur T-Score= -2.9, right total femur T-Score of -2.9, left forearm radius 33% T-Score=-2.8. Mammogram: mild bilateral gynecomastia, L&amp;gt;R, Testosterone supplementation and intravenous zoledronic acid therapy were started. Case 2 74-year-old Caucasian male referred for low energy, generalized weakness, decreased libido and gynecomastia, long thin arms/legs and "difficulty building muscle". He was taking OTC "testosterone enhancers" herbals only. He reported no biological children. Physical exam: height 187.3 cm, with sparse body hair, absent facial hair, gynecomastia, small testes. Laboratory: [total testosterone=40 ng/dl; free testosterone=5.2 pg/ml; SHBG=40 nmol/L;LH=16.1 mIU/ml; FSH=31.8 mIU/ml; Prolactin=4.3 ng/ml; BHCG &amp;lt;3 mIU/ml; Estradiol=33.60 pg/m] Karyotype: mosaic KS 47, XXY[16]/46,XY[4] with additional X chromosome in 16/20 metaphase cells. DXA =normal bone density. Clinical symptoms and testosterone levels improved after starting testosterone supplementation. Discussion Hypogonadism is an important cause of male osteoporosis. Testosterone is known to regulate male bone metabolism both indirectly by aromatization to estrogens and directly through the androgen receptor on osteoblasts, promoting periosteal bone formation during puberty and reducing bone resorption during adult life. Early onset testosterone deficiency, as in KS, is an important risk factor for osteoporosis, although it is seen in only 40% of patients. Aromatization of testosterone into estradiol from adiposity, may also contribute to normal BMD in some patients. Therefore, it is important to recognize that osteoporosis is not always present in all Klinefelter's patients, even without testosterone therapy and that various phenotypes may account for discrepant conditions, as in these cases. Presentation: No date and time listed

The Nutraceutical Genistein-Lycopene Combination Improves Bone Damage Induced by Glucocorticoids by Stimulating the Osteoblast Formation Process.

Chronic glucocorticoid (GC) therapy is the most common cause of iatrogenic osteoporosis and represents an important risk factor for osteoporosis and bone fractures. New therapeutic approaches are required in order to treat osteoporosis and reduce the side effects related to the use of anti-osteoporotic drugs. In this context, previous studies reported the efficacy of some isoflavones and carotenoids, such as lycopene and genistein, on the reduction of the risk of fracture related to osteoporosis. The aim of this study was to investigate the effects of a combined oral treatment, consisting of genistein and lycopene, in an experimental model of glucocorticoid-induced osteoporosis (GIO). GIO was induced by subcutaneous injection of methylprednisolone (MP, 30 mg/kg) for 60 days, whereas the control group (Sham) received saline solution only. Following induction, MP animals randomly were assigned to receive alendronate, genistein, lycopene, or the association of genistein and lycopene or saline solution for additional 60 days together with MP. Femurs obtained from the Sham group were used for osteoblasts extraction; they were then incubated with dexamethasone (DEX) for 24 h to be then treated with lycopene or genistein or the association of lycopene and genistein for an additional 24 h. Treatments with lycopene and genistein restored the impaired mineralization of cells observed following DEX treatment and stimulated osteoblast differentiation by increasing the depressed expression of bALP and RUNX2 (p < 0.0001). Wnt5a, β-catenin, and Nrf-2 expression were significantly increased following genistein and lycopene treatment (p < 0.0001), thus confirming their antioxidant activity as well as their ability in stimulating osteoblast function, mostly when genistein and lycopene were used in association. The combined treatment of genistein and lycopene improved the bone damage induced by glucocorticoids and significantly restored the normal architecture of bones as well as adequate interconnectivity of bone trabeculae, thus increasing bone mineral density parameters. The obtained data demonstrated that genistein and lycopene but in particular their association might prevent GC’s adverse effects, thus stimulating bone formation and reducing bone resorption, improving bone structure and microarchitecture, through different molecular pathways, such as the Wnt/β-catenin and the Nrf-2 signaling.

Bisphosphonate Use for Glucocorticoid-Induced Osteoporosis in Elderly Patients with Immune Thrombocytopenia Receiving Prolonged Steroid Therapy: A Single Institute Retrospective Study.

Prednisolone, used as a standard initial treatment for immune thrombocytopenia (ITP), is an important risk factor for osteoporosis. To investigate the prevention of glucocorticoid-induced osteoporosis (GIO) in elderly ITP patients receiving prolonged steroid therapy, associations between GIO prevention and the real-world data of score changes of a dual-energy X-ray absorptiometry (DXA) scan, FRAX® and the Garvan tool during the initial loading of prednisolone were examined. In our institute, 22 ITP patients aged ≥ 70 years received 0.5–1.0 mg/kg prednisolone for 2–3 weeks as the initial ITP treatment between 2014 and 2021. The femoral neck bone mineral density (BMD) measured by DXA scan was entered into FRAX® to define the risk-adapted approach to bisphosphonate during the initial loading of prednisolone. Bisphosphonate was administered according to <−1.0 femoral neck BMD T-score measured by DXA scan. Worse scores of FRAX® and the Garvan tool were associated with bisphosphonate use for short-term fracture prevention in primary GIO; however, there were no incidents of fracture or significant differences in probabilities determined by FRAX® and the Garvan tool. During the initial loading of prednisolone, prescribing bisphosphonate might prevent the reduction in BMD in elderly patients with ITP receiving prolonged steroid therapy.

Alcohol Consumption Moderated the Association Between Levels of High Blood Lead or Total Urinary Arsenic and Bone Loss.

Metal exposure and lifestyle are important risk factors for osteoporosis. Our study aimed to investigate the association between red blood cell lead and cadmium, total urinary arsenic, and plasma selenium levels and bone mineral density (BMD). In addition, we explored whether alcohol and coffee consumption modified the association between BMD and metals and metalloids. In total, 437 participants who underwent adult or senile physical examinations were recruited. Bone loss was defined as a calcaneus BMD T-score of <-1. Blood cadmium and lead and plasma selenium levels were measured using inductively coupled plasma mass spectrometry. Levels of urinary arsenic species were determined using high-performance liquid chromatography–hydride generator–atomic absorption spectrometry. The total urinary arsenic level was defined as the sum of the levels of urinary arsenic species. The BMD T-scores decreased significantly with increasing blood lead levels. The BMD T-scores also showed a downward trend with increasing total urinary arsenic levels. The odds ratio (OR) and 95% confidence interval (CI) for bone loss in patients with blood lead levels >57.58 versus 35.74 μg/dL were 1.98 and 1.17–3.34. In addition, the greater the lead or arsenic exposure and alcohol intake was the higher the OR for bone loss with multivariate ORs of 2.57 (95% CI 1.45–4.56) and 2.96 (95% CI 1.67–5.22), respectively. To the best of our knowledge, this study is the first to demonstrate that high total urinary arsenic or blood lead levels and frequent or occasional alcohol consumption had a significant multiplicative interaction for increasing the OR for bone loss.

Icariin Alleviates Glucocorticoid-Induced Osteoporosis through EphB4/Ephrin-B2 Axis.

Purpose Glucocorticoid (GC) is the most important risk factor for osteoporosis (OP); in the present study, we examined the potential mechanism of icariin, a natural bioactive compound isolated from the traditional Chinese herbal Epimedium, for GC-induced OP to explore its potential therapeutic effect. Methods We used a GC-induced OP mice model and treated with icariin. Pathological changes were measured by H&E staining, and the effects of icariin on osteoblasts and osteoclasts were measured by immunohistochemistry (IHC) staining and western blot (WB) analyses, while trabecular bone parameters were detected by micro-CT imaging in vivo. Results The results showed that in GC-induced OP symptoms, icariin treatment significantly increased the density of the trabecular bone when exposed to GC, revealed by H&E staining and micro-CT imaging. IHC staining showed that GC-induced OP had a lower EphB4 expression and higher Ephrin-B2 expression, but icariin could promote EphB4 while suppressing Ephrin-B2 expression. The WB results also provided evidence of the same protein expression trend, showing that the osteoblast marker OCN and the EphB4 downstream factor RhoA in the GC group were decreased, while both OCN and RhoA expression were significantly increased and the Ephrin-B2 downstream factor Grb4 in in GC group was increased after icariin treatment. Conclusion Icariin could improve the characteristics of OP through regulating the balance of the EphB4/Ephrin-B2 pathway. Further preclinical trial is needed to provide certainty of clinical benefits for OP patients.

Osteoporosis of the Jaws and its Diagnostic Methods: Review of the Literature

Osteoporosis is a chronic, silent, multifactorial and metabolic bone disease characterized by low bone mineral density and altered micro architecture, presenting a high fracture rate with minimal trauma or without trauma (hip, spine and forearms). Osteoporosis can occur in both sexes and in all ages; mainly considered a problem for postmenopausal women, with higher risk of fracture over 50 years old. This increases the morbidity, mortality and costs of the health system, considering it a significant public health issue. Healthy bone has equilibrium characteristics between bone formation by osteoblasts and bone resorption by osteoclasts. In osteoporosis this balance is altered, showing a greater tendency to resorption. The most important risk factors for osteoporosis are age, sex, genetic factors, early menopause, inadequate calcium intake, lack of exercise, alcoholism, and smoking; it can also be associated with some endocrine diseases, such as hyperparathyroidism, kidney failure chronic, liver disease, malabsorption and drugs, including oral glucocorticoids. The objective of this bibliographic review is to provide updated and specific information about osteoporosis in the jaws and its diagnostic methods, which allow the dentist and radiologist to recognize, prevent and / or refer to the specialist indicated cases that may arise with this condition.

Correlation analysis of osteoporosis and cardiovascular disease risk factors in elderly patients

Objective To explore the correlation between osteoporosis and cardiovascular risk factors in elderly patients. Methods From January 2010 to January 2017, 760 patients aged over 80 who were admitted and treated in the department of orthopedics and geriatrics of the hospital were selected.According to the BMD measurement results, 450 patients in the osteoporosis group and 310 patients in the normal bone mass group were randomly divided into two groups. Patients in both groups were recorded with cardiovascular disease and all risk factors that might affect the occurrence of osteoporosis.Possible risk factors included age, gender, weight, BMI(Body Mass Index), homocysteine, uric acid, systolic blood pressure, diastolic blood pressure, left ventricular ejection fraction, triglyceride, total cholesterol, high-density lipoprotein, low-density lipoprotein, blood pressure, smoking history, drinking history, heart failure history, coronary heart disease history, diabetes history, and stroke history.The correlation between the two was recorded analyzed. Results The results of univariate analysis showed that osteoporosis was associated with homocysteine, LDL, gender, hypertension and coronary heart disease (P 0.05). Logistic regression model was used to analyze the significant indicators in the univariate analysis, and the results showed that homocysteine, low-density lipoprotein, hypertension, women's history of coronary heart disease were independent risk factors for osteoporosis in the elderly patients (P<0.05). Conclusions Homocysteine, low density lipoprotein, hypertension, female, coronary heart disease history are the most important risk factors for osteoporosis in elderly patients.In order to reduce the incidence of osteoporosis, individualized and targeted intervention measures should be implemented in the clinic for the elderly patients with such high risk factors. Key words: Osteoporosis; Cardiovascular disease; Risk factors

Vitamin D status in relation to age, bone mineral density of the spine and femur in obese Saudi females – A hospital-based study

The aim of the present study was to evaluate the association between Bone mineral density in lumber spine and femoral neck with serum total levels of vitamin D, sun exposure and Consumption of vitamin D Supplement in obese Saudi females aged between 30 and 54 years old. Recent attention to the high prevalence of osteoporosis and its association with low vitamin D levels in adults has raised the importance of vitamin D evaluation. A low level of vitamin D is considered to be one of the most important risk factors for osteoporosis. In this study; 120 obese Saudi females with no diagnosed chronic diseases attending the Outpatient clinic at king Khalid University hospital in Riyadh. Saudi Arabia, recruited randomly in period of 12 months. In this study, Serum levels of total Vitamin D were considered to be severe deficient if it was lower than 25 ng/mL, mild to moderate deficient if it was between 25 and 60 ng/mL and optimum level if it was 61–200 ng/mL. The results showed that; sun exposure was significantly affect and Correlate with serum level of Vitamin D in the subjects. In addition, daily consumption of Vitamin D supplement was significantly affect and Correlate with serum level of Vitamin D in the subjects of this study. Moreover, the results showed that; 50% of the age group (40–49 years old) having severe deficiency of Vitamin D. While, 50% of the age group (50–59 years old) having optimal level of Vitamin D. And these results mean that age is not Correlated with vitamin D deficiency in subjects of this study.

Identification of novel variants associated with osteoporosis, type 2 diabetes and potentially pleiotropic loci using pleiotropic cFDR method

Clinical and epidemiological findings point to an association between type 2 diabetes (T2D) and osteoporosis. Genome-wide association studies (GWASs) have been fruitful in identifying some loci potentially associated with osteoporosis and T2D respectively. However, the total genetic variance for each of these two diseases and the shared genetic determination between them are largely unknown. The aim of this study was to identify novel genetic variants for osteoporosis and/or T2D. First, using a pleiotropic conditional false discovery rate (cFDR) method, we analyzed two GWAS summary data of femoral neck bone mineral density (FN_BMD, n = 53,236) and T2D (n = 159,208) to identify novel shared genetic loci. FN_BMD is an important risk factor for osteoporosis. Next, to explore the potential functions of the identified potential pleiotropic genes, differential expression analysis was performed for them in monocytes and peripheral blood mononuclear cells (PBMCs) as these cells are relevant to the etiology of osteoporosis and/or T2D. Further, weighted gene co-expression analysis (WGCNA) was conducted to identify functional connections between novel pleiotropic genes and known osteoporosis/T2D susceptibility genes by using transcriptomic expression datasets in bone biopsies (E-MEXP-1618) and pancreatic islets (GSE50397). Finally, multi-trait fine mapping for the detected pleiotropic risk loci were conducted to identify the SNPs that have the highest probability of being causal for both FN_BMD and T2D. We identified 27 significant SNPs with cFDR<0.05 for FN_BMD and 61 SNPs for T2D respectively. Four loci, rs7068487 (PLEKHA1), rs10885421 (TCF7L2), rs944082 (GNG12-AS1 (WLS)) and rs2065929 (PIFO||PGCP1), were found to be potentially pleiotropic and shared between FN_BMD and T2D (ccFDR<0.05). PLEKHA1 was found differentially expressed in circulating monocytes between high and low BMD subjects, and PBMCs between diabetic and non-diabetic conditions. WGCNA showed that PLEKHA1 and TCF7L2 were interconnected with multiple osteoporosis and T2D associated genes in bone biopsy and pancreatic islets, such as JAG, EN1 and CPE. Fine mapping showed that rs11200594 was a potentially causal variant in the locus of PLEKHA1. rs11200594 is also an eQTL of PLEKHA1 in multiple tissue (e.g. peripheral blood cells, adipose and ovary) and is in strong LD with a number of functional variants. Four potential pleiotropic loci were identified for shared genetic determination of osteoporosis and T2D. Our study highlights PLEKHA1 as an important potentially pleiotropic gene. The findings may help us gain a better understanding of the shared genetic determination between these two important disorders.

Association of Vitamin D Receptor (FokI and BsmI) Gene Polymorphism with Bone Mineral Density and Their Effect on 25-Hydroxyvitamin D Level in North Indian Postmenopausal Women with Osteoporosis.

Osteoporosis is a systemic disease with a strong genetic component. Vitamin D receptor (VDR) has been suggested as a candidate gene for osteoporosis. Therefore the present study was aimed to investigate the pattern of allelic variants of VDR gene polymorphism (FokI and BsmI), its influence on vitamin D levels and bone mineral density (BMD) in North Indian postmenopausal women with osteoporosis for possible genetic association. 254 postmenopausal osteoporotic women and 254 postmenopausal non osteoporotic women were included in the study. VDR FokI and BsmI gene polymorphism gene were assessed by the PCR-RFLP method. Serum 25-hydroxyvitamin D was measured by the ELISA. BMD at the L1-L4 lumbar spine, hip, forearm and femoral neck was assessed by dual energy X-ray absorptiometry. The average BMD at spine and hip in postmenopausal women with bb and spine, hip, femoral neck and forearm with ff genotype had significantly low BMD. The frequency of ff genotype and f allele was significantly higher in postmenopausal osteoporotic women when compared with postmenopausal non osteoporotic women. However, no significant association was found between the genotypes and vitamin D levels. Our study reveals that VDR gene FokI and BsmI polymorphism is significantly associated with low bone mineral density. Therefore the ff genotype and f allele of VDR FokI gene may be used as an important risk factor for osteoporosis.

Prevalence of osteoporosis in patients with chronic kidney disease (stages 3-5) in comparison with age- and sex-matched controls: A study from Kashmir Valley Tertiary Care Center.

Chronic kidney disease (CKD) is associated with a range of metabolic bone diseases. Fracture rates are higher in CKD patients than age-matched controls throughout all the five stages of CKD. Dialysis patients have 4 times as many hip fractures as expected for their age. CKD forms an independent risk factor for osteoporosis, even in the absence of traditional risk factors. This study was carried out at the nephrology unit in a tertiary care center of Kashmir to know the prevalence of osteoporosis in CKD patients having glomerular filtration rate (GFR) <60 mL/min (stages 3-5). Among the 151 cases studied, the average estimated GFR was 16.78 ± 10.714 mL/min. There were 98 males (64.9%) and 53 females (35.1%). Their mean age was 51.01 ± 14.138 years. Osteoporosis based on femoral neck T-Score was seen in 31 patients (31.6%) while 43 patients (28.5%) had osteoporosis at L1, L2 lumbar vertebrae. The prevalence of osteoporosis based on femoral neck T-Score as well as osteopenia was highest in stage-5 CKD. In our study, the body mass index (BMI) had a positive correlation with osteoporosis; low BMI patients were at higher risk for osteoporosis (P = 0.014). In the Kashmir valley, the prevalence of osteoporosis was 31.8% in CKD patients against 22% in controls. Thus, CKD forms an important risk factor for osteoporosis even in the absence of traditional risk factors. We recommend early screening, detection, and management of osteoporosis to reduce the burden of morbidity and mortality in this subset of patients.

Lead as a Risk Factor for Osteoporosis in Post-menopausal Women.

Lead exposure is increasingly becoming an important risk factor for osteoporosis. In adults, approximately 80-90% of absorbed lead is stored in the bones. These bone lead deposits are released into the blood during periods of enhanced bone resorption like menopause, forming a potential endogenous source of lead exposure. Postmenopausal women are at a higher risk for bone lead release because of hormonal and age related changes in bone metabolism. Estrogen deficiency is associated with increase in osteoclasts number and activity leading to both the early and late form of osteoporosis. Hence, high blood lead level coupled with concomitant environmental exposure exposes women in this age group to lead related adverse outcomes like hypertension, reduced kidney and neurocognitive functions as well as increased risk of atherosclerosis and cardiovascular mortality. A few studies have also identified coexisting variates like ethnicity, occupation, residence, education, smoking, alcohol medications, water etc. as significant determinants of bone and blood lead in women, thus increasing the magnitude of postmenopausal bone changes. Hence, interventions focused on reducing the intensity of bone resorption during menopause will help decrease exposure to endogenous lead. This would play a significant role in decreasing the morbidity and mortality associated with menopause. Also, identification of modifiable factors that prevent bone lead release will reduce the risk of chronic lead exposure and improve the health outcomes of post-menopausal women.

Diabetes and Bone

Based on the 2014 National Diabetes Statistics Report, 29.1 million people (9.3% of population) have diabetes mellitus (DM) within the United States. The same year, a report on the prevalence of osteoporosis in the United States estimated that 54 million adults greater than the age of 50 years are affected by low bone mass. Diabetes has emerged as an important risk factor for osteoporosis in the last 10 years. The staggering numbers of people affected by both these conditions begs a need to evaluate the possibility of a cause-and-effect relationship between these disorders, and to determine if the bone disease can be considered a complication of diabetes. Recent advancements in the management of diabetes, especially type 1 diabetes (DM1), have resulted in increased patient longevity, which in turn has brought into clinical focus disease-related comorbidities that were previously not a concern.

Depression, Anxiety, and Stress Symptoms in Menopausal Arab Women: Shedding More Light on a Complex Relationship.

Background:The association between depression, anxiety, and stress among Arab menopause and postmenopausal women have been explored in detailed.Aim:The objective of this study was to determine the correlation between depression, anxiety, and stress in menopausal and postmenopausal women and shedding more light on a complex relationship.Subjects and Methods:A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the primary health care centers in Qatar. A representative sample of 1468 women aged 45–65 years were approached during July 2012 and May 2014 and 1101 women agreed to participate (75.0%) and responded to the study. Depression, anxiety, and stress were measured using the Depression Anxiety Stress Scales 21. Data on body mass index (BMI), clinical and other parameters were used. Univariate, multivariate, and matrix correlation analysis were performed for statistical analysis.Results:A total of 1101 women agreed to participate after informed consent was obtained. The mean age and standard deviation (SD) of the menopausal age were 49.55 (3.12), the mean and SD of postmenopausal age was 58.08 (3.26) (P < 0.001). There were statistically significant differences between menopausal stages with regards to age, ethnicity, educational status, occupation status, and place of living. Furthermore, there were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure (BP), Vitamin D deficiency, and diseases. Depression and anxiety were more common among postmenopause women. Furthermore, there were no differences between the groups regarding the frequency of certain levels of stress among menopause and postmenopause. The multivariate regression analyses revealed that age in years, diastolic BP, consanguinity, regular exercise were a predictor for depression. Meanwhile, diastolic BP, occupation, and physical activity considered the main risk factors for anxiety. Furthermore, age in years, occupation, and sheesha smoking habits were considered as the main risk factors associated with stress.Conclusion:A large number of factors were associated with experiencing menopausal and psycho-social problems and which had negative effects on the quality of life among Arabian women. Depression, anxiety, and stress should be considered as important risk factors for osteoporosis.

Depressive symptoms and bone mineral density in menopause and postmenopausal women: A still increasing and neglected problem.

Background:The association between depression and loss of bone mineral density (BMD) has been reported as controversial.Objective:The objectıve of the current study was to investigate whether an association exists between depression and low BMD during the menopausal and postmenopausal period.Materials and Methods:A cross-sectional descriptive study was used to generate menopause symptoms experienced by Arabian women at the Primary Health Care Centers in Qatar. A multi-stage sampling design was used, and a representative sample of 1650 women aged 45–65 years were included during July 2012 and November 2013. This prospective study explored the association between bone density and major depressive disorder in women. Bone mineral densitometry measurements (BMD) (g/m2) were assessed at the BMD unit using a lunar prodigy DXA system (Lunar Corp., Madison, WI). Data on body mass index (BMI), clinical biochemistry variables including serum 25-hydroxyvitamin D were collected. The Beck Depression Inventory was administered for depression purposes.Results:Out of 1650 women 1182 women agreed to participate in the study (71.6%). The mean age and standard deviation (SD) of the menopausal age were 48.71 ± 2.96 with depressed and 50.20 ± 3.22 without depressed (P < 0.001). Furthermore, the mean and SD of postmenopausal age were 58.55 ± 3.27 with depression and 57.78 ± 3.20 without depression (P < 0.001). There were statistically significant differences between menopausal stages with regards to a number of parity, and place of living. There were statistically significant differences between menopausal stages with regards to BMI, systolic and diastolic blood pressure, Vitamin D deficiency, calcium deficiency and shisha smoking habits. Overall, osteopenia and osteoporosis and bone loss were significantly lower in postmenopausal women than in menopausal women (P < 0.001). Similarly, T-score and Z-score were lower with depression menopause and postmenopausal women (P < 0.001). The multivariate logistic regression analyses revealed that the depression, the mean serum Vitamin D deficiency, calcium level deficiency, less physical activity, comorbidity, number of parity, systolic and diastolic blood pressure and shisha smoking habits were considered as the main risk factors associated with bone mineral loss after adjusting for age, BMI and other variables.Conclusion:Depression is associated with low BMD with a substantially greater BMD decrease in depressed women and cases of clinical depression. Depression should be considered as an important risk factor for osteoporosis.

Bone response around titanium alloy implants in osteoporosis

There has been a concerted effort among material scientists and clinicians worldwide to improve the performance of dental implants, with the aim of accelerating and maintaining their integration into hard and soft tissues and/or extend their range of application. The use of osseointegrated implants in the treatment of edentulous patients has become a common alternative to conventional prosthetic dentistry. The success of osseointegration depends in part on the state of the host bone and its healing capacity, and concerns have been raised about various conditions affecting its quality and quantity. Osteoporosis, which is a major health problem for the elderly population, is a reduction in the volume of bony tissue relative to the entire bone volume. The underlying clinical problem is a deficiency of bone mass. Because age and sex are reported to be important risk factors for osteoporosis, the rate of implant loss caused by the failure of osseointegration may also be expected to increase correspondingly. Thus, a large proportion of the target population for dental implants may be at high risk of implant failure. If so, the choice between conventional treatment and implant-supported prostheses in the prosthodontic treatment of older patients would need to be reassessed. For that reason, systems of dental care and plans for regenerative medicine need to be established based on an understanding of osteoporosis. Various experiments are being undertaken using osteoporotic models to obtain findings for that purpose. Effects such as delays in new bone formation in the maxilla and mandible and incomplete bone repair in the extraction socket in rat models with osteoporosis have been reported. In contrast, Mori et al. has reported that good osseointegration was obtained even in groups with decreased bone mineral content following ovariectomy. Shoji et al. reported that the effect of ovariectomy (OVX) on osteoprogenitors is either Bone response around titanium alloy implants in osteoporosis

English

There has been a worldwide increase in the prevalence of obesity and a parallel resurgence of vitamin D deficiency. Vitamin D deficiency and low calcium intakes are important risk factors for osteoporosis. The present study was done to find out the prevalence of Vitamin D and Lipid profile derangements in obese population of North India. 50 obese individuals (25M & 25 F) with WHR >0.85 and BMI> 30 were taken in study group in age group ranging from 25 to 60 years. Equal numbers of healthy subjects were taken (26M & 24F) and these patients were screened at Adesh Medical College Bathinda, Punjab, India. We observed significantly increased levels of Cholesterol (p<0.006), Triglycerides (p <0.001), S.L.D.L (p <0.001), S.V.L.D.L (p <0.001) & S.A.L.P (p <0.001) levels in obese Individuals as compared to normal individuals.

Low serum levels of zinc, copper, and iron as risk factors for osteoporosis: a meta-analysis.

Zinc (Zn), copper (Cu), and iron (Fe) are essential trace elements for the growth, development, and maintenance of healthy bones. However, there are conflicting reports as to the relationship between serum level of Zn, Cu, or Fe and osteoporosis (OP). The purpose of the present study is to clarify the relationship between serum Zn, Cu, or Fe and OP using a meta-analysis approach. We searched all articles indexed in PubMed published up to May 2014 concerning the association between serum level of Zn, Cu, or Fe and OP. Eight eligible articles involving 2,188 subjects were identified. Overall, pooled analysis indicated that patients with OP had a lower serum level of Zn, Cu, or Fe than the healthy controls (Zn standardized mean difference (SMD) = -1.396, 95% confidence interval (CI) = [-2.129, -0.663]; Cu SMD = -0.386, 95% CI = [-0.538, -0.234]; Fe SMD = -0.22, 95% CI = [-0.30, -0.13]). Further subgroup analysis found that geographical location and gender had an influence on the serum level of Zn in OP and healthy controls, but not on the serum level of Cu or Fe. No evidence of publication bias was observed. In conclusion, this meta-analysis suggests that low serum levels of Zn, Cu, and Fe seem to be important risk factors for OP and well-designed studies with adequate control for confounding factors are required in future investigations.