Osteoporosis In Postmenopausal Women Research Articles

Guidelines for fracture risk assessment and management of osteoporosis in postmenopausal women and men above the age of 50 in Qatar

SummaryWe present comprehensive guidelines for osteoporosis management in Qatar. Formulated by the Qatar Osteoporosis Association, the guidelines recommend the age-dependent Qatar fracture risk assessment tool for screening, emphasizing risk-based treatment strategies and discouraging routine dual-energy X-ray scans. They offer a vital resource for physicians managing osteoporosis and fragility fractures nationwide.PurposeOsteoporosis and related fragility fractures are a growing public health issue with an impact on individuals and the healthcare system. We aimed to present guidelines providing unified guidance to all healthcare professionals in Qatar regarding the management of osteoporosis.MethodsThe Qatar Osteoporosis Association formulated guidelines for the diagnosis and management of osteoporosis in postmenopausal women and men above the age of 50. A panel of six local rheumatologists who are experts in the field of osteoporosis met together and conducted an extensive review of published articles and local and international guidelines to formulate guidance for the screening and management of postmenopausal women and men older than 50 years in Qatar.ResultsThe guidelines emphasize the use of the age-dependent hybrid model of the Qatar fracture risk assessment tool for screening osteoporosis and risk categorization. The guidelines include screening, risk stratification, investigations, treatment, and monitoring of patients with osteoporosis. The use of a dual-energy X-ray absorptiometry scan without any risk factors is discouraged. Treatment options are recommended based on risk stratification.ConclusionGuidance is provided to all physicians across the country who are involved in the care of patients with osteoporosis and fragility fractures.

Correlation of serum matrix metalloproteinase 3 with osteoporosis in patients of postmenopausal rheumatoid arthritis

Osteoporosis (OP) is a common complication of postmenopausal women with rheumatoid arthritis (RA). Herein, the objective of our study was to explore the correlation between serum matrix metalloproteinase 3 (MMP3) and OP among postmenopausal women with RA to foster better diagnosis and treatment. A total of 208 elderly postmenopausal women with RA were included in this study, with 83 patients diagnosed with OP after RA diagnosis and 125 patients without OP. Serum MMP3 levels and bone mineral density (BMD) were measured and compared. The predictive value of serum MMP3 for OP in this population was also analyzed using receiver operating curve (ROC) analysis. Postmenopausal women with RA and OP diagnosis had markedly higher serum MMP3 levels, compared to those without OP. ROC analysis showed that serum MMP3 had predictive value for OP. Additionally, a negative correlation was observed between serum MMP3 levels and BMD. High serum MMP3 levels were also found to be associated with high abnormal bone metabolism. We found that serum MMP3 levels are strongly correlated with OP in postmenopausal women with RA and that elevated levels of serum MMP3 are linked to low BMD and high abnormal bone metabolism. Serum MMP3 may be a useful biomarker for predicting OP in this population, and could potentially aid in the development of targeted prevention and treatment strategies.

Investigating and Practicing Orthopedics at the Intersection of Sex and Gender: Understanding the Physiological Basis, Pathology, and Treatment Response of Orthopedic Conditions by Adopting a Gender Lens: A Narrative Overview

In the biomedical field, the differentiation between sex and gender is crucial for enhancing the understanding of human health and personalizing medical treatments, particularly within the domain of orthopedics. This distinction, often overlooked or misunderstood, is vital for dissecting and treating musculoskeletal conditions effectively. This review delves into the sex- and gender-specific physiology of bones, cartilage, ligaments, and tendons, highlighting how hormonal differences impact the musculoskeletal system’s structure and function, and exploring the physiopathology of orthopedic conditions from an epidemiological, molecular, and clinical perspective, shedding light on the discrepancies in disease manifestation across sexes. Examples such as the higher rates of deformities (adolescent idiopathic and adult degenerative scoliosis and hallux valgus) in females and osteoporosis in postmenopausal women illustrate the critical role of sex and gender in orthopedic health. Additionally, the review addresses the morbidity–mortality paradox, where women, despite appearing less healthy on frailty indexes, show lower mortality rates, highlighting the complex interplay between biological and social determinants of health. Injuries and chronic orthopedic conditions such osteoarthritis exhibit gender- and sex-specific prevalence and progression patterns, necessitating a nuanced approach to treatment that considers these differences to optimize outcomes. Moreover, the review underscores the importance of recognizing the unique needs of sexual minority and gender-diverse individuals in orthopedic care, emphasizing the impact of gender-affirming hormone therapy on aspects like bone health and perioperative risks. To foster advancements in sex- and gender-specific orthopedics, we advocate for the strategic disaggregation of data by sex and gender and the inclusion of “Sexual Orientation and Gender Identity” (SOGI) data in research and clinical practice. Such measures can enrich clinical insights, ensure tailored patient care, and promote inclusivity within orthopedic treatments, ultimately enhancing the precision and effectiveness of care for diverse patient populations. Integrating sex and gender considerations into orthopedic research and practice is paramount for addressing the complex and varied needs of patients. By embracing this comprehensive approach, orthopedic medicine can move towards more personalized, effective, and inclusive treatment strategies, thereby improving patient outcomes and advancing the field.

Assessing osteoporosis in postmenopausal women: preliminary results using a novel lumbar spine phantom-based MRI scoring method.

To develop a novel magnetic resonance imaging (MRI) phantom for producing F-score (for fat) and W-score (for water) and to evaluate the performance of these scores in assessing osteoporosis and related vertebral fractures. First, a real-time phantom consisting of oil and water tubes was manufactured. Then, 30 female volunteers (age: 62.3 ± 6.3years) underwent lumbar spine examination with MRI (using a novel phantom) and dual-energy X-ray absorptiometry (DXA), following ethical approval. MRI phantom-based F-score and W-score were defined by normalizing the vertebral signal intensities (SIs) by the oil and water SIs of the phantom on T1- and T2-weighted images, respectively. The diagnostic performances of the new scores for assessing osteoporosis and vertebral fractures were examined using receiver operating characteristic analysis and compared with DXA-measured areal bone mineral density (DXA-aBMD). The F-score and W-score were greater in the osteoporotic patients (3.93 and 2.29) than the non-osteoporotic subjects (3.05 and 1.79) and achieved AUC values of 0.85 and 0.74 (p < 0.05), respectively, when detecting osteoporosis. Similarly, F-score and W-score had greater values for the fracture patients (3.94 and 2.53) than the non-fracture subjects (3.14 and 1.69) and produced better AUC values (0.90 for W-score and 0.79 for F-score) compared to DXA-aBMD (AUC: 0.27, p < 0.05). In addition,the F-score and W-score had a strong correlation (r = 0.77; p < 0.001). A novel real-time lumber spine MRI phantom was developed, based upon which newly defined F-score and W-score were able to detect osteoporosis and demonstrated an improved ability over DXA-aBMD in differentiating patients with vertebral fractures.

Anabolic Androgenic Steroids: A Review

Abstract: A lot of athletes, bodybuilders, and those who want to look better in general use AAS (anabolic androgenic steroids) to achieve their goals. These steroids can be found in nature or synthesised in a lab. These substances are attempts to mimic the anabolic (muscle-building) and androgenic (masculinizing) properties of testosterone. Steroids like testosterone, methandienone, Nandrolone Decanoate (ND), and methenolone are only a few examples of AAS that are commonly abused. Initially exclusive to professional bodybuilders, these substances are increasingly being tried out by amateur and professional athletes alike. The anabolic properties of AAS have led to their usage in medicine for the treatment of conditions like chronic renal disease and osteoporosis in postmenopausal women. Despite being banned by the World Anti-Doping Agency, anabolic steroid (AAS) use is estimated to be between 1% and 3% among the general population of the United States (WADA). Their negative effects on several organs, including the cardiovascular and reproductive systems, have aroused concerns. Therefore, there are serious health risks linked with the inappropriate use of AAS. More education is needed for both the general public and medical professionals on how to recognise symptoms, administer effective care, and prevent AAS-related disorders. The goal of this study is to examine the current state of our understanding regarding the functioning of AAS and their associated deleterious consequences.

Abstract 776: Change in background contrast enhancement category on abbreviated breast MRI with administration of 6 months of bazedoxifene and conjugated estrogen vs wait list control

Abstract Background MRI background contrast enhancement (BPE) has found to be a marker of breast cancer risk providing information beyond that provided by assessment of breast density. BPE is qualitatively classified into categories that correspond to BPE estimates as minimal, &amp;lt;25% BPE; mild, 25-50% BPE; moderate, 50-75% BPE; and marked, &amp;gt;75% BPE. We divided minimal into minimal and almost none (≤5%). We conducted a feasibility study of change in BPE after 6 months of the selective estrogen receptor modulator bazedoxifene (BZA) 20 mg + conjugated estrogen (CE) 0.45 mg marketed commercially as Duavee™ for relief of hot flashes and prevention of osteoporosis in postmenopausal women. Methods STUDY00145121 started 5-27-2020 with randomization to 6 months of Duavee™ vs waitlist control but was stopped after 11 entrants because participants were unable to receive follow-up breast MRIs due to COVID and Duavee™ became unavailable. STUDY0014761 was opened in early 2022 when a source of BZA was found. Doses of BZA and CE were the same as Duavee™ but given as two pills instead of one. 16 women have been randomized to 6 months of BZA/CE vs a wait list control between 2-14-2022 and 9-19-2023. Inclusion criteria are postmenopausal women ages 45-65 at increased risk for breast cancer, BMI &amp;lt; 36 kg/m2 and having current vasomotor symptoms. Participants had a blood draw, 3D mammogram, and abbreviated breast MRI at baseline and the studies were repeated at 6 months. Volumetric density was assessed by Volpara™ fully automated software. Research evaluation of abbreviated MRI background parenchymal contrast enhancement (BPE) was assessed by 5 categories as almost none, minimal, mild, moderate, and marked. BPE was evaluated by a single radiologist blinded to treatment assignment and compared to the 4-category clinical assessment. Results A total of 27 women have been entered in these studies. Six were not evaluable from STUDY00145121 because of the inability to perform 6-month MRI. Two women on STUDY0014761 are not endpoint evaluable due to early drop out and 3 have not yet completed study. A total of 16 women have completed the 6-month portion of the study and abbreviated MRI, with median age 55 (range 47-62) and median BMI 26 kg/m2 (20-33 kg/m2). At baseline, BPE were 3 almost none, 4 minimal, 8 mild, 1 moderate, and 0 marked. There was little correlation between absolute baseline mammographic fibroglandular volume and baseline BPE. A shift in BPE category using the 5-category assessment was noted in 6/11 women (all but one decreased) randomized to BZA +CE and 2/5 women (both decreased) on waitlist. The one increase and four categorical decreases would not have been detected without expansion of BPE to a 5-category system. Conclusion Using the 5-category classification, abbreviated MRI BPE may have promise as a response biomarker in prevention trials for postmenopausal high-risk women. Citation Format: Carol J. Fabian, Onilisa Winblad, Amy Kreutzjans, Krystal Pittman, Christy Altman, Kandy R. Powers, Mary McCarthy, Lauren Nye, Bruce F. Kimler. Change in background contrast enhancement category on abbreviated breast MRI with administration of 6 months of bazedoxifene and conjugated estrogen vs wait list control [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 776.

Update on the DVO Guideline 2023 "Prophylaxis, diagnosis and treatment of osteoporosis in postmenopausal women and in men aged over 50"-What's new for rheumatology?

In October 2023, the organization of the German-speaking scientific osteological societies (DVO) published the revised guideline on the "Prophylaxis, diagnosis and treatment of osteoporosis in postmenopausal women and in men aged over50." This review article reflects the new features of the guideline and their relevance in the care of patients with inflammatory rheumatic diseases.Akey innovation is the change from the 10-year fracture risk to the 3‑year fracture risk. Basic diagnostics are currently performed without adefined fracture threshold. Treatment thresholds for specific osteological therapy constitute another key innovation, defined as 3% to < 5%, 5% to < 10%, and from 10% for vertebral body and femoral neck fractures. If the 3‑year fracture risk is > 10%, osteoanabolic therapy should primarily be carried out and antiresorptive therapy is initiated following osteoanabolic therapy. In addition, patients with osteoporosis and prolonged glucocorticoid therapy should primarily be treated osteoanabolically with teriparatide. In summary, the changes to the DVO guideline reflect the latest scientific study findings in osteology and lead todetailed differential therapy for osteoporosis.

Different Statin Dosages and Their Effects on Osteoporosis

The aim of the study was to investigate the effect of different doses of statins on the progression of osteoporosis during a 36-month follow-up period. The study included 98 postmenopausal women diagnosed with osteoporosis and the presence of atherosclerosis of lower limb arteries. Patients were divided into 2 groups: women who received statins as part of atherosclerosis treatment (group 1, n=53) and those who did not receive statin therapy for hyperlipidemia (group 2, n=45). After 36 months of follow-up, patients were divided into two groups — with unfavorable (n=42) and favorable (n=56) course of osteoporosis. Progression of osteoporosis was considered unfavorable if during the follow-up period the patients had low traumatic fractures of large bones and/or progressive decrease in bone mineral density (BMD). Depending on the statin dose taken, patients were divided into groups: 1) those taking atorvastatin 20 mg or rosuvastatin 10 mg; 2) those taking atorvastatin 40 mg or rosuvastatin 20 mg. The results revealed a significant association between statin therapy and a favorable course of osteoporosis (OR=0.316, 95% C.I. =0.137-0.727, p=0.003). The use of higher doses of statins (atorvastatin 40 mg or rosuvastatin 20 mg) was associated with the development of low traumatic fractures of large bones and/or progressive decrease in MPC during 36 months of follow-up (OR=3.0, 95% C.I.=1.119-8.040, p=0.030). On the other hand, the use of lower doses of statins (20 mg atorvastatin or 10 mg rosuvastatin) was associated with a favorable course of osteoporosis (OR=0.047, 95% C.I.=0.010-0.212, p=0.030). The dose of statin taken was also moderately negatively correlated with IPC (r=−0.45; p=0.005). Thus, the use of statins for a long period (36 months) in low doses (atorvastatin 20 mg or rosuvastatin 10 mg) is an effective and safe method of treating cardiovascular comorbidities represented by atherosclerosis of lower limb vessels and osteoporosis in postmenopausal women and is characterized by a reduced risk of osteoporosis-related large bone fractures.

Spontaneous fractures in healthy postmenopausal women aged 55+ years in two health centers: Laquintinie Hospital and General Hospital, Douala, Cameroon

Background: Women in their old age are facing some health issues due to physiological changes. It was observed many cases of osteoporosis during menopause. At that stage of their life, women undergo ovaries atrophy caused by hormonal imbalance. Estrogen deficiency is a leading cause of osteoporosis in postmenopausal women. That is why at menopause when its level drops women have fragile bones and are prone to fractures of many kinds. Fractures are associated with a high risk of morbidity which is why we aimed to identify and characterize the state of fractures in older women during menopause in our country. Method: A survey was performed at the orthopedic-traumatology and rheumatology unit of 2 different health centers: Laquintinie Hospital of Douala and Douala General Hospital (DGH). Files of postmenopausal women admitted for fracture were screened. The data were analyzed by SPSS and statistical significance was considered when P-value &lt; 0.05. Results: 643 files of postmenopausal women admitted for fractures were analyzed. Results showed that 29% (186/643) of women at menopause aged above 55 years old had spontaneous fractures. The mean age was 71.89 years, ranging from 55 to 119 years. Falls and domestic accidents were the top two most represented causes (38.2 and 31.7 % respectively). Among those fractures, 70% happened after minimal trauma. The wrist was the favorite anatomical site for patients aged ranged between 55-64 years. As for UEF (Upper end of the femur) fracture, it increased in an age-related manner. Absence of trauma was observed the less in population aged between 55 and 64 years (11.5% ; P&lt;0.001); and it was highest in women aged 85+ years (64%). Conclusion: Postmenopausal women in our population have disabilities due to spontaneous fractures which impact negatively their quality of life. We should spread awareness among women before they reach menopause to take suitable measures to reduce the incidence of fractures and related morbidity at a certain age.

Association of dietary carbohydrate and fiber ratio with postmenopausal bone mineral density and prevalence of osteoporosis: A cross-sectional study.

This study aimed to investigate the associations of carbohydrate to dietary fiber ratio with bone mineral density (BMD) and the prevalence of osteoporosis in postmenopausal women. This cross-sectional study retrieved the data of 2829 postmenopausal women from the National Health and Nutrition Examination Survey (NHANES) database. Weighted univariable logistic regression models were used to investigate the correlations of carbohydrate, dietary fiber, or carbohydrate to fiber ratio with osteoporosis. Higher dietary fiber intake was correlated with decreased odds ratio of osteoporosis [odds ratio(OR) = 0.96, 95% confidence interval (CI): 0.93 to 0.99]. The odds ratio of osteoporosis in postmenopausal women was elevated as the increase of carbohydrate to fiber ratio (OR = 1.80, 95%CI: 1.10 to 2.96). Carbohydrate to fiber ratio >17.09 was related to increased odds ratio of osteoporosis (OR = 1.63, 95%CI: 1.04 to 2.56). Compared to the carbohydrate to fiber ratio ≤11.59 group, carbohydrate to fiber ratio >17.09 was associated with decreased total femur BMD (β = -0.015, 95%CI: -0.028 to -0.001) and femur neck BMD (β = -0.020, 95%CI: -0.033 to -0.006) in postmenopausal women. The femur neck BMD in postmenopausal women was decreased with the increase of carbohydrate to fiber ratio (β = -0.015, 95%CI: -0.028 to -0.001). In postmenopausal women, a high carbohydrate/fiber ratio >17.09 is associated with an increased risk of osteoporosis and lower hip BMD and high fiber intake is associated with less osteoporosis and higher hip BMD.

Association between Postmenopausal Osteoporosis and IL-6、TNF-α: A Systematic Review and A Meta-analysis.

Postmenopausal osteoporosis (PMOP) greatly increases the risk of bone fracture in postmenopausal women, seriously affects the quality of life of patients, and is an important global public health problem. Persistent chronic systemic inflammation may be involved in the change process of PMOP, and many cytokines, such as TNF-alpha and Interleukin-6, play an important role in the inflammatory response. Therefore, This study takes commonly representative inflammatory factors as indicators to better determine their role in PMOP patients by means of databases from multiple studies for use in Meta-analysis. Systematic review of studies on the relationship between PMOP and markers of inflammation: interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α). Each effect size was expressed with a 95% confidence interval (CI), and I2 quantified the heterogeneity. The final results were aggregated and evaluated using random or fixed effects models. Twenty-one original studies were identified. There were twenty studies involving IL-6 and eleven involving TNF-α. Overall, The levels of IL-6[MD=23.93, 95%CI (19.65, 28.21)] and TNF-α[MD=2.9, 95%CI (2.37, 3.44)] were increased in PMOP patients compared with postmenopausal women without osteoporosis; The levels of IL-6[MD=42.4, 95%CI (38.62, 46.19)] and TNF-α[MD=0.40, 95%CI (0.36, 0.44)] were significantly higher than those of premenopausal healthy women. The levels of inflammatory cytokines IL-6 and TNF-α were significantly increased in PMOP patients compared with controls, suggesting that persistent chronic inflammatory reaction exists in PMOP patients, which may be an important cause of aggravated osteoporosis in postmenopausal women. Therefore, the level of IL-6 and TNF-α indexes may be of great significance for the early prevention, diagnosis, treatment and prognosis assessment of PMOP.

Follicle-stimulating hormone accelerates osteoclast migration by enhancing methyltransferase-like 3-mediated m6A methylation of cathepsin K.

Follicle-stimulating hormone (FSH) accelerates osteoporosis in postmenopausal women, while the underlying mechanism remains uncharacterized. N6-methyladenosine (m6A) is one of the most important regulations in the development of osteoporosis. In this study, we aimed to investigate the role of FSH in m6A modification and osteoclast function. Here, we showed that FSH upregulated m6A levels in osteoclasts via stimulating methyltransferase-like 3 (METTL3) protein expression. FSH enhanced osteoclast migration, while the knockdown of METTL3 eliminated this enhancement. Both MeRIP-seq and RNA sequencing identified that cathepsin K (CTSK) is the potential downstream target of METTL3. Knockdown of CTSK reduced FSH-upregulated osteoclast migration. Furthermore, silencing METTL3 decreased CTSK mRNA stability. Finally, FSH induced phosphorylation of cyclic-AMP response element-binding protein (CREB), while silencing of CREB attenuated the effects of FSH on the promoter transcriptional activity of Mettl3 and CTSK/METTL3 protein. Taken together, these findings indicate that FSH promotes osteoclast migration via the CREB/METTL3/CTSK signaling pathway, which may provide a potential target for suppressing osteoclast mobility and postmenopausal osteoporosis therapy.

Nutrition-Based Support for Osteoporosis in Postmenopausal Women: A Review of Recent Evidence.

Postmenopausal osteoporosis stands as the predominant bone disorder in the developed world, posing a significant public health challenge. Nutritional factors play a crucial role in bone health and may contribute to its prevention or treatment. Calcium and vitamin D, extensively studied with robust scientific evidence, are integral components of the non-pharmacological treatment for this disorder. Nevertheless, other less-explored nutritional elements appear to influence bone metabolism. This review provides a comprehensive summary of the latest evidence concerning the relationship between various nutrients, such as phosphorus, magnesium, vitamins, phytate, and phytoestrogens; specific foods like dairy or soy, and dietary patterns such as the Mediterranean diet with bone health and osteoporosis.

Association of Vitamin D Gene Receptor Polymorphism with Osteoporosis in Postmenopausal Women

Osteoporosis is a critical and complicated systemic musculoskeletal disorder that encompasses low bone density (LBD) and weakening of osseous tissue at a microarchitectural level. This predisposes to increased bone fragility and subsequent risk of fractures. It is frequently encountered in postmenopausal women and has also been seen in elderly men. Vitamin D synchronizes bone and calcium homeostasis in the body by modifying the transcription of target genes through the Vitamin D receptor (VDR) and thus aids calcium uptake and bone-forming proteins. The main objective of the present research was to study the relationship of single nucleotide polymorphisms (SNP) (rs1544410 G&gt;A) of the VDR gene with postmenopausal women who have osteoporosis in a Pakistani cohort. A total of 100 postmenopausal women, 50 without osteoporosis to be in the control group, and 50 with osteoporosis as cases, were enrolled in this study. The patients had no immediate family connections with each other. All the patients underwent BMD measurements at the lumbar spine and femoral neck by dual-energy X-ray absorptiometry scan for their diagnosis of osteoporosis based on World Health Organization (WHO) criteria (T score &lt; -2.5 SD). A total of 25 participants had at least one allele of rs1544410, of which 14 were cases and 11 controls. The number of heterozygous and homozygous were present with similar ratios in both groups (p=0.973). Age was noted to be correlated with osteoporosis (OR: 1.06; 95%CI: 1.004-1.12), (P&lt;0.031). It was also observed that cases had a notably lower weight than the control group (P&lt;0.0001) and the overall body mass index of cases was significantly low in comparison to control (P&lt;0.0001). Moreover, average BMD of femoral and BMD lumbar were notably greater among the control group (P&lt;0.0001) as compared to cases. The SNP (rs1544410) is not significantly associated with BMD but significantly correlated with age which was identified as a risk factor while body mass index was found to be a protective factor for osteoporosis

The Impact of Practicing Exercise and Risk Factors Categorize in Osteoporotic Concerning Postmenopausal Women (Analytical study using binary logistic regression)

Background: Osteoporosis is an illness that may be categorized as a "silent pandemic" because of its worldwide incidence. The essential characteristics of osteoporosis are bone mass reduction and degeneration in bone tissue's micro-architecture. Postmenopausal osteoporosis (PMO) seems to be the most prevalent skeletal disorder. Objective: To study investigates the influence of practicing exercise and physical activity as the most critical contributing factors of osteoporosis in postmenopausal women. Patients and Methods: A cross-sectional survey was conducted at Baghdad Teaching Hospital from July 1, 2021, to December 31, 2021. Data were collected directly through interviews using a special questionnaire. One hundred and fifty postmenopausal women with osteoporosis participated in this study. A rheumatologist clinically diagnosed all participants using a bone density screening (DEXA). Results: the current study's results indicate the prevalence of osteoporosis among postmenopausal women, with a higher percentage of 69.3% in the age group (≥50 years). 60.7% of all participants were overweight and obese according to body mass index (BMI). Calcium deficiency was found in 87.3% of the subjects, more than two third (76%) of them were not practicing exercises, and 86.7% suffered from vitamin D deficiency. Reclassifying the actual and wrong percentile demonstrates the accurate percentile (overall percentage = 78.7), 32 individuals were wrongly classified, and the probability of total error was reported at around 21.3%. The most important finding was that postmenopausal women with osteoporosis who exercised and participated in physical activity regularly were 13.7 times in better health than those who did not exercise. Conclusion: Exercising and physical activity lower risk factors for postmenopausal women. It is becoming more necessary to reconsider the importance of performing exercises in maintaining and enhancing postmenopausal women's health. Keywords: Risk Factors, Osteoporosis, Postmenopausal, Practicing Exercises.

The Impact of Practicing Exercise and Risk Factors Categorize in Osteoporotic Concerning Postmenopausal Women (Analytical study using binary logistic regression)

Background: Osteoporosis is an illness that may be categorized as a "silent pandemic" because of its worldwide incidence. The essential characteristics of osteoporosis are bone mass reduction and degeneration in bone tissue's micro-architecture. Postmenopausal osteoporosis (PMO) seems to be the most prevalent skeletal disorder.&#x0D; Objective: To study investigates the influence of practicing exercise and physical activity as the most critical contributing factors of osteoporosis in postmenopausal women.&#x0D; Patients and Methods: A cross-sectional survey was conducted at Baghdad Teaching Hospital from July 1, 2021, to December 31, 2021. Data were collected directly through interviews using a special questionnaire. One hundred and fifty postmenopausal women with osteoporosis participated in this study. A rheumatologist clinically diagnosed all participants using a bone density screening (DEXA).&#x0D; Results: the current study's results indicate the prevalence of osteoporosis among postmenopausal women, with a higher percentage of 69.3% in the age group (≥50 years). 60.7% of all participants were overweight and obese according to body mass index (BMI). Calcium deficiency was found in 87.3% of the subjects, more than two third (76%) of them were not practicing exercises, and 86.7% suffered from vitamin D deficiency. Reclassifying the actual and wrong percentile demonstrates the accurate percentile (overall percentage = 78.7), 32 individuals were wrongly classified, and the probability of total error was reported at around 21.3%. The most important finding was that postmenopausal women with osteoporosis who exercised and participated in physical activity regularly were 13.7 times in better health than those who did not exercise.&#x0D; Conclusion: Exercising and physical activity lower risk factors for postmenopausal women. It is becoming more necessary to reconsider the importance of performing exercises in maintaining and enhancing postmenopausal women's health.

Polymorphisms in the glucagon-like peptide-1 receptor gene and their interactions on the risk of osteoporosis in postmenopausal Chinese women.

Postmenopausal osteoporosis (PMOP) is a prevalent form of primary osteoporosis, affecting over 40% of postmenopausal women. Previous studies have suggested a potential association between single nucleotide polymorphisms (SNPs) in glucagon-like peptide-1 receptor (GLP-1R) and PMOP in postmenopausal Chinese women. However, available evidence remains inconclusive. Therefore, this study aimed to investigate the possible association between GLP-1R SNPs and PMOP in Han Chinese women. Thus, we conducted a case-control study with 152 postmenopausal Han Chinese women aged 45-80 years, including 76 women with osteoporosis and 76 without osteoporosis. Seven SNPs of the GLP-1R were obtained from the National Center of Biotechnology Information and Genome Variation Server. We employed three genetic models to assess the association between GLP-1R genetic variants and osteoporosis in postmenopausal women, while also investigating SNP-SNP and SNP-environment interactions with the risk of PMOP. In this study, we selected seven GLP-1R SNPs (rs1042044, rs2268641, rs10305492, rs6923761, rs1126476, rs2268657, and rs2295006). Of these, the minor allele A of rs1042044 was significantly associated with an increased risk of PMOP. Genetic model analysis revealed that individuals carrying the A allele of rs1042044 had a higher risk of developing osteoporosis in the dominant model (P = 0.029, OR = 2.76, 95%CI: 1.09-6.99). Furthermore, a multiplicative interaction was found between rs1042044 and rs2268641 that was associated with osteoporosis in postmenopausal women (Pinteraction = 0.034). Importantly, this association remained independent of age, menopausal duration, family history of osteoporosis, and body mass index. However, no significant relationship was observed between GLP-1R haplotypes and PMOP. In conclusion, this study suggests a close association between the A allele on the GLP-1R rs1042044 and an increased risk of PMOP. Furthermore, this risk was significantly augmented by an SNP-SNP interaction with rs2268641. These results provide new scientific insights into the development of personalized prevention strategies and treatment approaches for PMOP.

Investigation of the risk factors associated with osteoporosis in postmenopausal women

Osteoporosis is a substantial global public health issue. The objective of this study was to evaluate the risk variables associated with osteoporosis among patients seeking care at an outpatient menopausal clinic in a tertiary university hospital. In this retrospective, cross-sectional study postmenopausal women who attended the outpatient menopause clinic of Başkent University Hospital between June 01, 2014, and August 31, 2015, were enrolled. Patients’ datasheets were reviewed and data including age, body mass index, parity, duration and age of menopause, history of smoking and oral contraceptive pills (OCPs) use, natural or surgical menopause, and calcium-containing food consumption were collected through a standardized questionnaire. Bone mineral density (BMD) was measured at the femur neck and lumbar spine by dual energy X-ray absorptiometry. A total of 1,148 women with a mean age of 53.5±6.7 years, mean duration of menopause 7.1±6.2 years and mean age of menopause 46.3±5.1 years were identified. Of these, 235 (20.5%) were diagnosed as having osteoporosis. The average femur and lumbar T-values showed a decrease in normal weight patients compared to overweight, obese, and morbidly obese patients (F=22,337, p<0.001 and F=50,195, p<0.001, respectively). The mean femur T-values were higher in participants who used OCPs, regularly consumed a calcium-rich diet, and performed regular physical activity (p<0.05, p<0.01 and p<0.05). Positive correlations were noted between giving birth and femur T-values (r=0.065, p=0.027), between natural menopause and lumbar T-values (r=0.060, p=0.043), and between consuming a calcium-rich diet and femur T-values (r=0.087, p=0.003 and r=0.064, p=0.031, respectively). Using OCPs, lifelong physical activity, and a healthy diet rich in calcium are important factors for the prevention of low lumbar spine and femoral BMD and by implication, osteoporosis.

The Association Between SHBG and Osteoporosis: A NHANES Cross-Sectional Study and A Bidirectional Mendelian Randomization.

This study aimed to examine the association between sex hormone-binding globulin (SHBG) and osteoporosis through a cross-sectional study and a two-sample bidirectional Mendelian randomization (MR). We used the National Health and Nutrition Examination Survey(NHANES) 2013-2014 and 2015-2016 data, with exposure as serum SHBG and outcome as osteoporosis and performed multivariate logistic regression to test the correlation between SHBG and osteoporosis. To determine the causal relationship between SHBG and osteoporosis, a two-sample bidirectional MR was employed. The genome-wide association study (GWAS) dataset for SHBG (n = 189,473) was obtained from the IEU database, and the GWAS dataset for osteoporosis (n = 212,778) was obtained from the FinnGen bioBank. The principal MR technique was inverse-variance weighting (IVW). In MR analyses, the MR-Egger intercept and Cochran Q test were used to detect multiple validity and horizontal heterogeneity. 1249 older adult participants (age ≥ 60) were involved in the cross-sectional study, including 113 osteoporosis cases. We identified a significant relationship between circulating SHBG concentration and osteoporosis risk [OR 3.963, 95% CI (2.095-7.495), P < 0.05]. Subgroup analysis indicated that SHBG was closely linked to the risk of osteoporosis in the female population [OR 1.008, 95% CI (1.002-1.013), P = 0.005] but not in males (P = 0.065). In addition, The IVW approach suggested a causal connection between SHBG and increased osteoporosis risk [OR 1.479, 95% CI (1.144-1.912), P = 0.003], and the MR-Egger intercept and the Cochran Q test validated the consistency of the MR results. Finally, the reverse MR analysis declined to identify a causal relation between SHBG and osteoporosis. Our research demonstrates a significant causal connection between circulating SHBG levels and increased osteoporosis risk. These results indicate that high SHBG may be associated with the risk of osteoporosis in postmenopausal women, but more research is needed.

Osteoprotegerin Gene as a Biomarker in the Development of Osteoporosis in Postmenopausal Women.

Osteoporosis is a multifactorial and polygenic disease caused by an imbalance between osteoclastogenesis and osteoblastogenesis, leading to a decrease in bone mineral density and the occurrence of disorders in the microarchitecture and metabolism of bone tissue. In postmenopausal women, there is a significant decrease in the production of estrogens, which play a key role in maintaining proper bone mineral density. Estrogens have an inhibitory effect on the development and activity of osteoclasts by reducing the synthesis of pro-resorption cytokines and stimulating the expression of osteoprotegerin (OPG). Osteoprotegerin is a cytokine that prevents bone loss by inhibiting the process of osteoclastogenesis, reducing bone resorption. The aim of our study was to determine the influence of the rs3102735 (-163A>G), rs3134070 (-245T>G), rs207361 (-950T>C), rs7844539 (6890A>C), and rs2073618 (1181G>C) polymorphisms of the OPG gene on the risk of osteoporosis and osteopenia in postmenopausal Polish women. The study included 802 unrelated women (osteoporosis: n = 317, osteopenia: n = 110, controls: n = 375) at postmenopausal age (54.7 ± 8.6 years). Genetic analysis was performed using real-time PCR. BMD values as well as clinical and bone parameters with the tested polymorphisms were analyzed among the study population. Analysis of the PPARG rs1801282 variants did not show any association with the risk of osteoporosis and osteopenia. However, for the OPG rs207361 polymorphism, we observed a statistically significant association with the risk of osteoporosis, suggesting that the OPG rs207361 variant may be one of the genetic markers associated with the pathogenesis of osteoporosis.