Risk Factors For Osteoporosis Research Articles

REPIN1 regulates iron metabolism and osteoblast apoptosis in osteoporosis

Osteoporosis is not well treated due to the difficulty of finding commonalities between the various types of it. Iron homeostasis is a vital component in supporting biochemical functions, and iron overload is recognized as a common risk factor for osteoporosis. In this research, we found that there is indeed evidence of iron accumulation in the bone tissue of patients with osteoporosis and REPIN1, as an origin specific DNA binding protein, may play a key role in this process. We revealed that sh-Repin1 therapy can rescue bone loss in an iron-overload-induced osteoporosis mouse model. Knockdown of Repin1 can inhibit apoptosis and enhance the resistance of osteoblasts to iron overload toxicity. REPIN1 promoted apoptosis by regulating iron metabolism in osteoblasts. Mechanistically, knockdown of Repin1 decreased the expression of Lcn2, which ameliorated the toxic effects of intracellular iron overload. The anti-iron effect of lentivirus sh-Repin1 was partially reversed or replicated by changing LCN2 expression level via si-RNA or plasmid, which indirectly verified the key regulatory role of LCN2 as a downstream target. Furthermore, the levels of BCL2 and BAX, which play a key role in the mitochondrial apoptosis pathway, were affected. In summary, based on the results of clinical specimens, animal models and in vitro experiments, for the first time, we proved the key role of REPIN1 in iron metabolism-related osteoporosis.

Associations between birth season and lumbar spine bone mineral density in perimenopausal Polish women

In European populations, the birth season significantly correlates with many biological features. It is thus possible that the observed clinical effects of bone metabolism disorders are a partial consequence of bone mineral density (BMD), modified by the season of prenatal development (the birth season). The aim of this study was to evaluate the relationship between the birth season and BMD among Polish women in perimenopausal age. A total of 653 Polish women aged 50.0–59.9 years were included in the study. BMDs of lumbar vertebrae were measured by dual-energy x-ray absorptiometry. Statistical analyses were based on measured lumbar BMD values, age, and body mass index (BMI). The analysis of variance (ANOVA) was applied to evaluate the season-related differentiation of mineral density of lumbar vertebrae. BMDs of lumbar vertebrae negatively correlated with age and positively with BMI. We regressed BMD on age and BMI and used the residuals as a measure of age- and BMI-independent lumbar BMD values. The ANOVA results showed that women born in summer had significantly lower BMD of the L1 vertebra compared to those born in autumn, regardless of age and BMI. The results of our study indicate the need to extend the group of risk factors for osteoporosis in Central Europeans with the season of woman’s birth.

Association between ADAMTS14_rs4747096 gene polymorphism and bone mineral density of Chinese Han population residing in fluorine exposed areas in ShanXi Province, China.

This study aimed to investigate the effects of fluorine and ADAMTS14_rs4747096 on bone mineral density (BMD). The survey was explored in a cross-sectional case-control study conducted in Shanxi, China. The BMD was measured by an ultrasonic bone mineral density instrument. The urine fluoride concentration was detected using the fluoride ion electrode. ADAMTS14_rs4747096 polymorphism was examined by multiplex polymerase chain reaction (PCR) and sequencing. The multinomial logistic regressions found that the urine fluoride was a risk factor for osteopenia (OR = 1.379, 95% CI: 1.127-1.687, P = 0.0018), osteoporosis (OR = 1.480, 95% CI: 1.1138-1.926, P = 0.0035), and rs4747096 AG + GG genotype increased the risk of osteoporosis (OR = 2.017, 95% CI: 1.208-3.369, P = 0.0073). In addition, the interaction between urine fluoride and rs4747096 polymorphism on the risk of decreased BMD also was observed. The study suggests that fluoride exposure and mutation G allele in ADAMTS14_rs4747096 may be risk factors for the decrease of BMD. And there is an interaction between the two influencing factors.

Assessment of osteoporosis knowledge, awareness, and risk factors among premenopausal and postmenopausal women from Jordan: a cross-sectional study.

Lack of information about osteoporosis knowledge and awareness among premenopausal compared to postmenopausal women in Jordan. Women had an average-poor knowledge and awareness about osteoporosis. This study highlights the need to improve women's knowledge about osteoporosis, its consequences, potential risk factors, preventive measures, and treatment options. To assess osteoporosis knowledge, awareness, and risk factor profile among premenopausal and postmenopausal women from Jordan. This was a cross-sectional study that involved 490 premenopausal and 488 postmenopausal women from the general population of Jordan. Face-to-face interviews were conducted to collect the sociodemographic and clinical data and to complete the Osteoporosis Knowledge Assessment Tool (OKAT) questionnaire. Premenopausal and postmenopausal women had an average-poor level of knowledge and awareness regarding osteoporosis, with a total mean score of 51.3 and 50.9, respectively, out of the total OKAT score of 100. More than 50% of premenopausal women correctly answered 11 questions, while >50% of postmenopausal women correctly answered 9 questions out of 20 in OKAT, which are related to knowledge and awareness about osteoporosis. The participants' marital status (being married), higher educational level, and higher economic status were significantly associated with better knowledge and awareness about osteoporosis (p-values < 0.05). Postmenopausal women had higher osteoporosis risk profile including older age, higher body mass index, less regular exercise, and less exposure to sunlight versus premenopausal women. Premenopausal and postmenopausal women from Jordan had an average-poor level of knowledge and awareness about osteoporosis. Higher educational levels and higher income are associated with better knowledge and awareness about osteoporosis. It is therefore crucial to improve the knowledge of women in Jordan about osteoporosis and its consequences, as well as the potential risk factors, preventive measures, and treatment options. Conducting periodic osteoporosis awareness and educational campaigns are necessary to spread the awareness of the disease.

Relationships among body weight, lipids and bone mass in elderly individuals with fractures: A case-control study.

The prevalence of osteoporosis and low bone mass is steadily rising each year. Low body weight is commonly linked to diminished bone mass and serves as a robust predictor of osteoporosis. Nonetheless, the connection between body mass index (BMI), bone mineral density, and lipid profiles among the elderly remains elusive. To examine the association between BMI and bone mass, explore the correlation between lipid profiles and bone mass, and delve into the interplay between lipid metabolism and bone health. The study included 520 patients aged ≥ 65 years (178 men and 342 women). Age, sex, weight, and height were recorded. Femoral neck bone mineral density and T scores were determined using a dual-energy X-ray absorptiometry scanner. Blood calcium (Ca), phosphorus (P), albumin (ALB), alkaline phosphatase (ALP), aspartate aminotransferase, alanine aminotransferase, triglyceride (TG), total cholesterol (TC), high-density lipoprotein (HDL) and low-density lipoprotein (LDL) levels were measured. Patients were classified by sex (male and female), age (65-79 years and ≥ 80 years), and T score (normal bone mineral density, osteopenia and osteoporosis). Age, sex, BMI, and ALP and TG levels were independent risk factors for osteoporosis. For the 65-79- and ≥ 80-year-old groups, females presented lower T scores than males. Ca, P, ALB, ALP, TC, HDL and LDL levels were significantly different between men and women in the 65-79-year-old group. In addition, BMI and TG levels were significantly decreased in osteoporotic patients compared with patients with normal bone mass. TC levels declined in 65- to 79-year-old male and female osteoporosis patients. In the group of women aged ≥ 80 years, osteoporotic patients showed significantly increased ALP levels. Furthermore, we found positive correlations between BMI and TG levels in the male and female patient groups. However, we found no significant differences in ALB, Ca, P, HDL and LDL levels in osteoporotic patients compared to patients with normal bone mass. Osteoporotic patients showed significantly decreased BMI and TG levels compared with those with normal bone mass. BMI showed positive correlations with TG levels in male and female patients. These results indicate correlations between BMI and bone mass and between lipid profiles and bone mass.

201 Prevalence of osteoporosis based on DXA criteria in large sample of older Irish adults attending GP or outpatient services

Abstract Background Osteoporosis has a markedly increased prevalence in older adults with an associated risk of fragility fractures that can significantly impact on morbidity, quality of life and mortality. Despite this, osteoporosis is both underdiagnosed and undertreated and its true prevalence in older Irish adults is not known. In this study, we evaluate the prevalence of osteoporosis in Irish adults aged ≥60 years and also examine its determinants. Methods Participants were from a large cross-sectional study of older Irish adults aged ≥60 years. We excluded those with a known diagnosis of osteoporosis and on pharmacological treatment for same. We also excluded participants with major risk factors for osteoporosis (history of any previous fracture, aromatase inhibitors, androgen deprivation therapy and current or long-term glucocorticoid therapy &amp;gt;3 months). We used logistic regression to assess the relationship between osteoporosis (defined by WHO criteria—DXA T-score &amp;lt; −2.5 at lumbar spine, total hip, or neck of femur) and potential predictor variables. Results There were 1,089 participants. Mean age was 70.0 ± 6.2 and 59.8% were female. 15% had osteoporosis and 47% osteopaenia. The only positive independent predictors of osteoporosis were body mass index (p &amp;lt; 0.0001) and 25-hydroxyvitamin D (p = 0.007) while negative predictors were female sex (p &amp;lt; 0.0001), older age (p = 0.037) and glomerular filtration rate (p = 0.028). Conclusion Almost one in six older adults with no history of fracture or major risk factors for bone loss had osteoporosis. However, half had osteopaenia and overall, two thirds had low bone density. The major predictors of osteoporosis were consistent with other studies. As the mean age in our sample was 70, the prevalence may be much greater with advancing age. The findings support international guidelines which recommend routine DXA screening for women aged ≥65 years and men ≥70 years or at a younger age if risk factors for low bone mass.

Duration of Type 2 Diabetes Mellitus Over 5 Years, HbA1c Levels Over 7%, Alkaline Phospatase Over 130 IU/L, and C-Reactive Protein Over 3 mg/dL as Risk Factors for Osteoporosis in Type 2 DM Patients

BACKGROUND: Type 2 diabetes mellitus (DM) may increases the risk of osteoporosis due to impaired osteoblast and osteoclast function, which affects the morbidity and mortality rates of DM patients. Not many studies investigating the relationship of DM with osteoporosis. AIM: The purpose of this study was to evaluate the duration of DM, hemoglobin A1c (HbA1c), alkaline phosphatase (ALP), and C-reactive protein (CRP) levels as risk factors for osteoporosis. METHODS: Case control study was performed on a total of 44 samples that consist of ostoporosis group and non-osteoporosis group. Difference of HbA1c, ALP, and CRP between groups was evaluated using Chi-square test. RESULTS: Based on statistical analysis, we found that the duration of DM Type II ≥5 years (p = 0.002, odds ratio [OR] 11.08), HbA1c levels ≥7% (p = 0.027, OR 5.4), ALP ≥130 IU/L (p = 0.045, OR 5.2), and CRP ≥3 ng/dL (p = 0.033, OR 4.67) were significant risk factors for osteoporosis. Based on multivariate analysis with logistic regression, we found that risk factors for the duration of DM Type II ≥5 years had the greatest strength of association with osteoporosis. CONCLUSION: In DM patients, duration of DM ≥5 years, HbA1c levels ≥7%, ALP ≥130 IU/L, and CRP ≥3 ng/dL are predictor factors for osteoporosis that can be used in clinical practice. These risk factors can be used as evaluation parameters for DM patients who are suspected to have osteoporosis.

Combining Register and Radiological Visits Data Allows to Reliably Identify Incident Wrist Fractures.

To evaluate how comprehensively wrist fractures can be tracked from the national medical registers, and to propose a method for complementing the register data using time stamps of wrist radiography visits recorded in the radiological image archive. For the Kuopio Osteoporosis Risk Factor and Prevention Study (OSTPRE) cohort of 14220 post-menopausal women, we analysed the data from the Care Register for Health Care, Register for Primary Health Care Visits, self-reports, radiological image archive PACS, and patient records to identify the wrist fractures occurred between 2011 and 2021. Using this gold standard of fractures, we validated the coverage of the registers and image archive and created algorithms to automatically identify fracture events from the registers and/or metadata of wrist radiography visits. We show that wrist fractures cannot be comprehensively identified based on national registers. To remedy this, our proposed method of combining register and image archive data can lift the coverage from 81% to 94% and reduce false discoveries from 6% to 2%. The proposed method offers a more reliable way of gathering fracture information. Comprehensive fracture identification is essential in many research settings, such as incidence statistics, prevention studies, and risk assessment models.

Sleep characteristics and parameters of bone turnover and strength in the adult population: results from the Study of Health in Pomerania-TREND.

Poor sleep quality or sleep deprivation may be related to decreased bone mineral density. We aimed to assess whether associations of sleep characteristics and bone turnover or strength are present in adults from the general population and whether these are independent of common risk factors such as sex, age, and obesity. A total of 1037 participants from the Study of Health in Pomerania-TREND underwent laboratory-based polysomnography and quantitative ultrasound measurements at the heel. Of these participants, 804 completed standardised questionnaires to assess daytime sleepiness, insomnia, and sleep quality. Serum concentrations of two bone turnover markers, intact amino-terminal propeptide of type 1 procollagen (P1NP) and carboxy-terminal telopeptide of type 1 collagen (CTX) were measured. Cross-sectional associations of polysomnography variables (total sleep time, sleep efficiency, time spent wake after sleep onset, oxygen desaturation index, apnea-hypopnea index, and obstructive sleep apnea [OSA]), as well as sleep questionnaire scores with the bone turnover markers and the ultrasound-based stiffness index were assessed in linear regression models. In adjusted models, higher insomnia scores and lower sleep quality scores were related to a higher bone turnover in women but not in men. However, associations between polysomnography variables or questionnaire scores and the stiffness index were absent. Our study provides limited evidence for relationships between sleep characteristics and bone turnover and strength independent of common risk factors for OSA and osteoporosis. Nevertheless, women reporting poor sleep or insomnia in combination with risk factors for osteoporosis might benefit from an evaluation of bone health.

Elevated serum leptin may be associated with disease activity and secondary osteoporosis in Chinese patients with rheumatoid arthritis.

Rheumatoid arthritis (RA) is a systemic chronic autoimmune disease in adults that is associated with significant joint issues and systemic inflammation. One of the signs of bone damage in RA is osteoporosis (OP). Leptin is an inflammatory protein that has been reported to be related to RA. The potential relationships among leptin, disease activity, and OP in Chinese patients with RA are not well known. In total, 245 patients with RA and 120 healthy controls were included in this study. Detailed data on the clinical characteristics and laboratory features were collected. Information about physical activity and functional status was recorded using specific questionnaires. Bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry (DXA). The MECALL castor-50-hf model X-ray scanner was used for the two-hand (including wrist) photographs. Serum leptin levels differed significantly between the RA group and healthy control subjects (1.27/3.29 vs. 0.17/0.24, Z=13.29, P<0.001). The positive rate of leptin protein in RA patients was 86.35%, which was higher than that in controls (19.55%) (χ2=28.51, P<0.001). Pearson's correlation test showed that morning stiffness, disease duration, joint swelling, joint tenderness, swollen joint count (SJC), tender joint count (TJC), health assessment questionnaire (HAQ) score, and Sharp-van der Heijde method (Sharp) score were positively correlated with the level of serum leptin (r=0.212, r=0.312, r=0.322, r=0.501, r=0.291, r=0.334, P<0.05). There was a clear increasing trend in the level of serum leptin according to the different disease activity scores and in the 28 joint activity (DAS28) groups (F=13.936, P<0.001). Elevated leptin was a risk factor for increased disease activity and OP according to logistic regression analysis. The median leptin level differed significantly between the normal bone mass group, osteopenia group, and OP group (P<0.001). An increased serum leptin level was a risk factor for RA-induced osteoporosis according to logistic regression analysis (P<0.001). These results suggest that the level of serum leptin is associated with disease activity and secondary OP among Chinese patients with RA. Key Points • Serum leptin levels in RA patients are higher than those in normal control group. • Leptin was associated with disease activity. • Leptin was associated with the occurrence of systemic osteoporosis and affects bone erosion in RA patients.

Construction of predictive model for osteoporosis related factors among postmenopausal women on the basis of logistic regression and Bayesian network

Osteoporosis is a prevalent chronic disease that often goes unnoticed in postmenopausal women. Early identification of risk factors for osteoporosis in postmenopausal women is essential. This study aimed to develop predictive models for osteoporosis-related factors among postmenopausal women in the U.S. and explore the influencing factors. In this cross-sectional study, we included 4417 postmenopausal women from the NHANES (2009–2010, 2013–2014, and 2017–2020). Through multiple regression analysis, we found that age, minutes of sedentary activity, prednisone or cortisone usage, arthritis, bone loss around teeth, and trouble sleeping were risk factors for osteoporosis after menopause. Conversely, height, BMI, and age at the last menstrual period were identified as protective factors. The findings from the Bayesian network analysis indicated that several factors influenced osteoporosis, including age, BMI, bone loss around teeth, prednisone or cortisone usage, arthritis, and age at the last menstrual period. On the other hand, minutes of sedentary activity and height might have indirect effects, while trouble sleeping may not have a significant impact. Both logistic regression and Bayesian network models demonstrated good predictive capabilities in predicting osteoporosis among postmenopausal women. In addition, Bayesian networks offer a more intuitive depiction of the intricate network risk mechanism between diseases and factors.

Gastrointestinal disease is an important influencing factor of osteoporosis fracture:a retrospective study in chinese postmenopausal women

BackgroudThe influencing factors of osteoporosis are complex, the incidence of osteoporosis is higher in middle-aged and elderly women, and osteoporotic fractures (OF) can seriously affect quality of life. Currently, the correlation analysis between gastrointestinal diseases and OF focuses more on diseases such as gastric cancer and inflammatory bowel disease (IBD). This study analyzed the risk factors for osteoporosis and osteoporotic fractures in 1567 postmenopausal women in Fuzhou, China. The purpose is to explore the potential influence of gastrointestinal diseases on the occurrence of OF.MethodsAccording to inclusion and exclusion criteria, a total of 1567 subjects were included in the analysis of OP risk factors, including 647 in the OP group and 920 in the NOP group. A total of 616 subjects were included in the analysis of correlation between OF and gastrointestinal diseases, including 132 in OF group and 484 in NF group. Statistical analysis shows that age (OR = 1.062, 95% CI = 1.045–1.080), height (OR = 0.089, 95% CI = 0.009–0.857), weight (OR = 0.981,95% CI = 0.967–0.995) and nature of work (P = 0.010) are the main risk factors for osteoporosis in postmenopausal women in southeast China, and gastrointestinal diseases (OR = 1.583, 95% CI = 1.070–2.343) and height (OR = 0.003, 95% CI = 0.000-0.104) are the main risk factors of OF.ConclusionsThe main factors affecting the occurrence of OP in postmenopausal women in southeast China are individual characteristic. Gastrointestinal diseases that do not directly affect BMD increase the risk of OF in osteoporotic patients.

Prevalence of vitamin D level disorders in therapeutic patients and features of their correction

Objective: to study the prevalence of vitamin D level disorders in therapeutic patients and the features of their correction. Materials and methods: 322 patients who applied for medical help in the field of therapy («rheumatology» and «cardiology») were examined. Materilas and methods: clinical, laboratory (study of the level of vitamin D in the blood), statistical. Results: it was found, that among patients with a therapeutic profile, vitamin D concentration disorders (deficiency and insufficiency) occur in 72.7% of the surveyed. There is a high prevalence of risk factors for osteoporosis in the examined patients: female sex prevails (81%), age (average age was 53.6 ±14.3 years), drug use (50% take proton pump inhibitors, 21.4% take glucocorticoids). When comparing the proportion of people with impaired vitamin D levels in comparison with the data of previous years, there was a decrease in the proportion of people with vitamin D deficiency and an increase in the proportion of people with vitamin D deficiency. Among people with a vitamin D level of 30-100 ng/ml, daily use of vitamin D preparations in dosages exceeding the recommended consumption levels was noted. Conclusion: based on the data obtained, the prevalence of vitamin D deficiency and insufficiency remains high. However, recently there has been a trend towards a decrease in the proportion of people with vitamin D deficiency and an increase in the proportion of people with vitamin D deficiency. In this connection, it is necessary to inform the population about the recommended adequate levels of vitamin D in blood serum and safe dosages of vitamin D preparations for daily intake.

Prevalence and risk factors of osteoporosis detected by dual-energy X-ray absorptiometry among Chinese patients with primary biliary cholangitis.

Osteoporosis is an extrahepatic complication of primary biliary cholangitis (PBC) that increases the risk of fractures and mortality. However, Epidemiological studies of osteoporosis in patients with PBC in China and the Asia-Pacific region is lack. To assess the prevalence and clinical characteristics of osteoporosis in Chinese patients with PBC. This retrospective analysis included consecutive patients with PBC from a tertiary care center in China who underwent bone mineral density (BMD) assessment using dual-energy X-ray absorptiometry between January 2013 and December 2021. We defined subjects with T-scores ≤ -2.5 in any sites (L1 to L4, femoral neck, or total hip) as having osteoporosis. Demographic, serological, clinical, and histological data were collected. Independent risk factors for osteoporosis were identified by multivariate logistic regression analysis. A total of 268 patients with PBC [236 women (88.1%); mean age, 56.7 ± 10.6 years; 163 liver biopsies (60.8%)] were included. The overall prevalence of osteoporosis in patients with PBC was 45.5% (122/268), with the prevalence of osteoporosis in women and men being 47.0% and 34.4%, respectively. The prevalence of osteoporosis in postmenopausal women was significantly higher than that in premenopausal women (56.3% vs 21.0%, P < 0.001). Osteoporosis in patients with PBC is associated with age, fatigue, menopausal status, previous steroid therapy, body mass index (BMI), splenomegaly, gastroesophageal varices, ascites, Mayo risk score, histological stage, alanine aminotransferase, albumin, bilirubin, platelet and prothrombin activity. Multivariate regression analysis identified that older age, lower BMI, previous steroid therapy, higher Mayo risk score, and advanced histological stage as the main independent risk factors for osteoporosis in PBC. Osteoporosis is very common in Chinese patients with PBC, allowing for prior screening of BMD in those PBC patients with older age, lower BMI, previous steroid therapy and advanced liver disease.

Osteoporosis: A Narrative Review.

Osteoporosis is a disease of global concern, with significant implications for mortality, morbidity, strain on national health resources, and the negative impact on the quality of life associated with the condition. As we witness a primarily aging population, future predictions indicate that risk factors for osteoporosis will be more prevalent, leading to an increase in the number of individuals suffering from the condition and associated fractures.However, the future of osteoporosis in terms of diagnosis and treatment is optimistic. Understanding of bone quality and examination of it has improved with the onset of magnetic resonance imaging (MRI) and other imaging techniques such as micro-computer tomography. Innovative therapies specifically targeting osteoporotic bone metabolism on a microscopic level hold promise.This narrative review provides details on the background, prognosis, and future treatment strategies of osteoporosis.

Recent Insights into Pregnancy and Lactation-Associated Osteoporosis (PLO).

During pregnancy and lactation, female physiology adapts to fulfill the fetal and neonatal calcium and phosphorus requirements. The physiological changes that take place during these periods do not affect maternal skeleton resistance to fracture in most of the cases. However, there is a small percentage of women that do experience fragility fractures during these times of life. Pregnancy and lactation-associated osteoporosis (PLO) is an infrequent condition defined by the occurrence of non-traumatic fractures - most frequently vertebral - during the third trimester of gestation and/or the first months of postpartum. Its physiopathology has not yet been completely elucidated. Several authors have reported that risk factors for secondary osteoporosis might be present in up to 80% of the cases of PLO patients. According to recent studies, genetic factors might also play a relevant role in PLO. Given its rarity, the available literature on this condition is limited. Most of the published data consist on case reports and case series articles. There are not any randomized controlled trials regarding this disorder. Although there is consensus about discontinuation of lactation and calcium and vitamin D supplementation as the first steps in the treatment of these patients, there is still controversy regarding the long-term and/or pharmacological management of this condition. Recent data on the use of teriparatide in this population looks promising. In this review, we aimed to revise and summarize current knowledge about the physiopathology and management of PLO.

Dual X-ray absorptiometry-derived bone status indexes and videocapsule intestinal aspects in celiac disease.

Celiac disease is a risk factor for osteopenia and osteoporosis. Our aim was to evaluate the possible correlation between villous atrophy extension and dual-energy X-ray absorptiometry (DXA)-derived parameters of bone status. We have retrospectively analyzed data of 47 celiac patients (36 women, 52 ± 14 years of age) who underwent video capsule endoscopy and DXA scans within 1 year of interval from 2006 to 2019. Quantitative, qualitative and geometric DXA parameters were collected only from the most recent DXA measurements. . Patients were divided into three categories; the first included those with no lesions at video capsule endoscopy (23 patients), the second those with typical lesions (mucosal atrophy, mosaicism and scalloping) in less than one-third of the small bowel (SB) (16 patients) and the third those with typical lesions in more than one-third of the SB (7 patients). In the third group, bone mineral density seemed to be lower in both the lumbar spine and the hip ( P = 0.026 and P = 0.011, respectively). The deterioration of bone structure in patients with severe and extended SB atrophy was statistically significant ( P = 0.032). Furthermore, bone density, structure and geometry did not correlate with the duration of the gluten-free diet. Notably, autoimmune comorbidities did not affect DXA results. Neither endoscopic nor histological atrophy itself can explain the deterioration of bone mineralization and structure, whereas atrophy extension appeared to be responsible for bone impairment.

Association of age-related declined renal function and osteoporosis based on trabecular bone score in Bushehr Elderly Health (BEH) program

PurposeOsteoporosis is a systemic disease characterized by decreased bone strength and an increased risk of fracture in old age. Age and pathologic renal failure are independent risk factors for osteoporosis. However, it is not determined whether age-related decreased renal function, in the context of senescence, can be considered as an independent risk factor for osteoporosis. Therefore, this study was conducted to evaluate the effect of senescence-induced renal failure on bone quality and trabecular bone score.MethodsThis study used a cross-sectional design and was carried out based on data collected during the Bushehr Elderly Health (BEH) program, Phase II. A total of 2,125 elderly participants aged over 60 years old entered the study after meeting the inclusion criteria and providing informed consent. They underwent examinations for weight, height, abdominal and hip circumference, as well as blood pressure measurement. All participants also underwent DXA to assess bone mass density (BMD). Trabecular bone score (TBS) was calculated using the DXA apparatus software output. Univariate and adjusted multivariate linear regression analyses were used to evaluate the associations.ResultsIn the univariate linear regression analysis, there was a direct correlation between age-related renal failure and TBS (β = 0.038, p < 0.0001), neck of femur BMD (β = 0.047, p < 0.0001), and lumbar BMD (β = 0.055, p < 0.0001). However, after adjusting for BMI, age, sex, smoking, and physical activity, no significant association was observed for these variables.ConclusionIt is hypothesized that age-related renal failure cannot be considered as an independent risk factor for osteoporosis in elderly individuals aged over 60 years old.

MRI-based Vertebral Bone Quality Score for Osteoporosis Screening Based on Different Osteoporotic Diagnostic Criteria Using DXA and QCT.

In this study, we aim to evaluate the correlation between T score measured by dual X-ray absorptiometry (DXA), volumetric bone mineral density (vBMD) derived from quantitative computed tomography (QCT) and MRI-based vertebral bone quality (VBQ), explore the diagnostic performance of VBQ in osteoporosis and determine the recognition value of VBQ in osteoporotic fracture in a relatively large cohort of elderly patients scheduled to undergo spinal surgery. A total of 260 patients were enrolled in the study. DXA and QCT were used to evaluate osteoporotic status. We calculated the lumbar VBQ score, analyzed the correlation between T score, vBMD and VBQ, and explored whether VBQ was an influential factor of bone quality and fracture by binary logistic regression as well as the diagnostic performance of VBQ in osteoporosis and fracture by ROC curve. VBQ was negatively correlated with vBMD and T score. (r = -0.487 vs. r = -0.220). The VBQ score was a risk factor for osteoporosis under the QCT diagnostic criteria (OR = 2.245, 95% CI 1.456-3.460) and osteoporotic fractures (OR = 1.496, 95% CI 1.097-2.040). It exhibited superior discriminant performance for osteoporosis diagnosed by QCT, with a cutoff value of 3.70 and an AUC of 0.7354. Its cutoff value for osteoporotic fractures was 3.72, and its AUC was 0.6717. In a cohort of elderly patients scheduled to undergo spinal surgery, the VBQ score was more strongly associated with vBMD than the T score and could identify patients with osteoporosis and corresponding vertebral compression fracture (VCF).

A genome-wide genomic score added to standard recommended stratification tools does not improve the identification of patients with very low bone mineral density

SummaryThe role of integrating genomic scores (GSs) needs to be assessed. Adding a GS to recommended stratification tools does not improve the prediction of very low bone mineral density. However, we noticed that the GS performed equally or above individual risk factors in discrimination.PurposeWe aimed to investigate whether adding a genomic score (GS) to recommended stratification tools improves the discrimination of participants with very low bone mineral density (BMD).MethodsBMD was measured in three thoracic vertebrae using CT. All participants provided information on standard osteoporosis risk factors. GSs and FRAX scores were calculated. Participants were grouped according to mean BMD into very low (<80 mg/cm3), low (80–120 mg/cm3), and normal (>120 mg/cm3) and according to the Bone Health and Osteoporosis Foundation recommendations for BMD testing into an “indication for BMD testing” and “no indication for BMD testing” group. Different models were assessed using the area under the receiver operating characteristics curves (AUC) and reclassification analyses.ResultsIn the total cohort (n=1421), the AUC for the GS was 0.57 (95% CI 0.52–0.61) corresponding to AUCs for osteoporosis risk factors. In participants without indication for BMD testing, the AUC was 0.60 (95% CI 0.52–0.69) above or equal to AUCs for osteoporosis risk factors. Adding the GS to a clinical risk factor (CRF) model resulted in AUCs not statistically significant from the CRF model. Using probability cutoff values of 6, 12, and 24%, we found no improved reclassification or risk discrimination using the CRF-GS model compared to the CRF model.ConclusionOur results suggest adding a GS to a CRF model does not improve prediction. However, we noticed that the GS performed equally or above individual risk factors in discrimination. Clinical risk factors combined showed superior discrimination to individual risk factors and the GS, underlining the value of combined CRFs in routine clinics as a stratification tool.