Possible Risk Factors For Osteoporosis Research Articles

Evaluation of association of vitamin D level with types of proximal femoral fractures in elderly patients

<p class="abstract"><strong>Background:</strong> Proximal femoral fractures are very common in elderly patients. These fractures are thought to be associated with osteoporosis. Vitamin D is a possible risk factor for osteoporosis. So, this study was done to evaluate the association of serum vitamin D level with types of femoral fractures in elderly patients.</p><p class="abstract"><strong>Methods:</strong> The study was done between September 2013 to August 2016, 75 patients with age >60 years (male and female both) with proximal femoral fractures were studied. Serum 25-hydroxy vitamin D, calcium, phosphate, alkaline phosphatase levels, liver function test, renal function test, hemoglobin and complete blood counts of all the patients were assessed.<strong></strong></p><p class="abstract"><strong>Results:</strong> On assessment of serum vitamin D in proximal femoral fracture in elderly patients, it shows an increase incidence of proximal femoral fractures in patients with low serum vitamin D level. Fracture of neck of femur was most common among all. Type of fracture has no significant statistical relationship with serum vitamin D levels.</p><p class="abstract"><strong>Conclusions:</strong> Osteoporosis and serum vitamin D level depends on age and sex of the patient. But type of proximal femoral osteoporotic fracture has no association with either grade of osteoporosis or serum vitamin D level.</p>

Association between Urinary Sodium Excretion and Bone Health in Male and Female Adults

Background: High salt intake is a well-known risk factor for osteoporosis, but the association between bone mass and urinary sodium excretion has not been studied as yet. This study investigates the hypothesis that urinary sodium excretion is negatively associated with bone mass and the risk of osteoporosis. Methods: This cross-sectional study was performed using data from the Korea National Health and Nutrition Examination Survey, 2008-2011. Participants (n = 16,279) were divided into age groups; men were categorized as younger than 50 years of age or 50 years or greater, women were categorized as pre- or post-menopausal. Results: Multivariate linear regression analysis showed that urinary sodium excretion was negatively associated with bone mineral content (BMC) and bone mineral density (BMD) in premenopausal and postmenopausal women. Sodium excretion was negatively associated with BMC and BMD of the lumbar spine in women with normal bone health, osteopenia and osteoporosis, but there was no association in men. Increased sodium excretion was significantly associated with risk for osteoporosis/osteopenia in premenopausal women. Conclusions: This study demonstrates that urinary sodium excretion is negatively associated with bone health, suggesting that high salt intake could be a possible risk factor for osteoporosis in Korean women, but not in men.

Successful Renal Transplantation, Bone Mineral Densitometry, and Affecting Factors

BackgroundSuccessful renal transplantation corrects many disorders of bone and mineral metabolism owing to the normalization of serum levels of calcium and phosphorus and restoration of calcitriol production. However, successful transplantation does not guarantee complete resolution of the pre-transplantation osteopathy. MethodsThis study evaluated 100 patients who underwent successful renal transplantation. We determined the possible risk factors for osteoporosis among 72 male and 28 female renal transplant patients of mean age 32.3 ± 10.0 years with 81% of them recipients of living-related grafts. Bone mineral densitometry (BMD) was performed in all patients before and ≥1 year after transplantation. Routine test results and demographic data were recorded. ResultsAt the time of transplantation 76% of the patients had osteoporosis or osteopeni and only 24% of them had normal BMD in 4 regions (femur neck, lumber, radius, and ultradistal). After transplantation, 70% of them had osteopororosis or osteopeni and 30% were normal. After renal transplantation, BMD scores increased (P > .05) although the diagnosis of the bone disease did not change (P < .05). Only preexisting osteodystrophy and smoking were found to be important risk factors for post-transplantation osteoporosis. ConclusionsAfter renal transplantation, BMD scores increased whereas the diagnosis of bone disease did not change statistically. We found that medical management of osteopenia/osteoporosis before transplantation and smoking habit are the main factors to prevent post-transplantation osteoporosis. Further long-term studies may be more helpful for evaluating the risk factors of post-transplantation osteoporosis.

Homocysteine, an additional factor, is linked to osteoporosis in postmenopausal women with type 2 diabetes

We explored the relationship between plasma total homocysteine concentration and osteoporosis in postmenopausal patients with type 2 diabetes. Postmenopausal patients with type 2 diabetes (n = 258) were enrolled in a cross-sectional hospital-based study. Osteoporosis was documented by dual energy X-ray absorptiometry. Plasma total homocysteine concentration was measured using fluorescence polarization immunoassay. Risk factors for osteoporosis and determinants of homocysteine were obtained from blood samples and interviewer questionnaire. We found that plasma total homocysteine levels were higher in subjects with osteoporosis and diabetes than without [(9.5 ± 2.0) vs. (10.4 ± 2.4) μmol/l, p = 0.001]. The association of homocysteine with osteoporosis was independent of possible risk factors for osteoporosis in diabetes (e.g., duration of diabetes, HbA1c, body mass index, serum 25-hydroxyvitamin D, thiazolidinediones, and retinopathy) and determinants of homocysteine concentration (age, serum folate and vitamin B12, renal status, and biguanide use) [OR 1.40 (1.02-1.90), p = 0.036]. In addition, bone mineral density was closely correlated with homocysteine as a continuous variable after adjusting for age [r = -0.64 (-0.69 to -0.58), p = 0.002]. Furthermore, per increase of 5.0 μmol/l, plasma homocysteine was related to osteoporosis, after controlling for per unit increase of other factors [OR 1.42 (1.07-1.96), p = 0.027]. The optimal cut-off point for the plasma homocysteine level distinguishing diabetic patients with osteoporosis from without was 10.18 μmol/l. The results suggest that plasma total homocysteine concentration is independently associated with the occurrence of osteoporosis in postmenopausal patients with type 2 diabetes. Future prospective studies are warranted to clarify the relationship.

Simultaneous subchronic exposure to selenium and diazinon as possible risk factor for osteoporosis in adult male rats

BackgroundOsteoporosis and its main health outcome, fragility fractures, are large and escalating health problems. Skeletal damage may be the critical result of low-level prolonged exposure to several xenobiotics in the general population, but the mechanisms of their adverse effects are not clearly understood. The current study was aimed to investigate the possible ability of simultaneous subchronic peroral administration of selenium (Se) and diazinon (DZN) to induce changes in bone of adult male rats.In our study, twenty 1-month-old male Wistar rats were randomly divided into two experimental groups. In the first group, young males were exposed to 5 mg Na2SeO3/L and 40 mg of DZN/L in drinking water, for 90 days. Ten 1-month-old males without Se and DZN intoxication served as a control group. At the end of the experiment, macroscopic and microscopic structures of the femurs were analysed using analytical scales, sliding instrument, and polarized light microscopy.ResultsThe body weight, femoral length and cortical bone thickness were significantly decreased in rats simultaneously exposed to Se and DZN (P < 0.05). These rats also displayed different microstructure in the middle part of the compact bone where vascular canals expanded into central area of substantia compacta. The canals occurred only near endosteal surfaces in rats from the control group. Additionally, a smaller number of primary and secondary osteons, as well as a few resorption lacunae were observed near endosteal surfaces in rats simultaneously administered to Se and DZN. The resorption lacunae as typical structures of bone resorption manifestation are connected with an early stage of osteoporosis. Histomorphometric analysis revealed that area, perimeter, maximum and minimum diameters of primary osteons’ vascular canals were significantly increased (P < 0.05) in the Se-DZN-exposed rats. On the other hand, all measured variables of Haversian canals and secondary osteons were considerable reduced (P < 0.05) in these rats.ConclusionsSimultaneous subchronic peroral exposure to Se and DZN induces changes in macroscopic and microscopic structures of the femurs in adult male rats, and also it can be considered as possible risk factor for osteoporosis. The current study contributes to the knowledge on damaging impact of several xenobiotics on the bone.

Simultaneous subchronic exposure to selenium and diazinon as possible risk factor for osteoporosis in male rats

Simultaneous subchronic exposure to selenium and diazinon as possible risk factor for osteoporosis in male rats

Déficit de vitamina D y densidad mineral ósea en la enfermedad de Crohn

Background and objectives Inadequate serum levels of 25-hydroxyvitamin D (25OHD 3) are deemed as a possible risk factor for osteoporosis in Crohn's disease (CD). Our aim is to determine the prevalence of inadequate serum levels of 25OHD 3 and its possible relationship with low bone mineral disease (BMD) in CD. Patients and methods Sixty-four patients from the province of Granada (Spain) were enrolled. Serum levels of 25OHD3 and intact parathyroid hormone were measured. BMD was assessed by dual-energy x-ray absorptiometry at lumbar spine (LS) and femoral neck (FN). Results Almost 60% of patients showed inadequate serum levels of 25OHD 3, whereas only about 16% showed levels considered as adequate (≥30ng/mL). Z-score at FN was ≤ -2 in 4.7% of patients and 20.3% at LS. Regarding T-score, 4.7 and 46.9% of patients met criteria for osteoporosis and osteopenia at FN, respectively, whereas 6.25 and 42.2% did it at LS, respectively. Patients with inadequate serum levels of 25OHD 3 had non-significant lower BMD, both at the LS and the FN. Conclusions Prevalence of inadequate serum levels of 25-(OH)D was high in our series. A no statistically-significant tendency towards low BMD in patients with inadequate serum levels of 25-(OH)D both at the FN and the LS was observed.

Histological Study of the Periodontal Ligament and Alveolar Bone in Magnesium-deficient Rats

Recently, magnesium (Mg) deficiency has been identified as a possible risk factor for osteoporosis. This study investigated the effect of Mg deficiency on the morphology of the periodontal ligament (PDL) and alveolar bone in rats. Wistar rats (8 weeks old) were fed either a normal control diet (n=24) or Mg-deficient diet (n=24) for 28 days. Fluorescent labels, tetracycline or calcein, were administrated intraperitoneally each week during the experimental period. Serum Mg, calcium (Ca), phosphorus (P) and alkaline phosphatase (ALP) were measured at the end of the experiment. The maxilla, including the first molar and the femurs, were collected to detect the fluorescent labels, for histological observation, histochemical localization of ALP, and X-ray microanalysis. In rats fed the Mg-deficient diet, serum Mg, P, and ALP were significantly decreased, but serum Ca was increased, while tetracycline and calcein labeling showed partly retarded new bone formation in femoral midshafts; however, new bone formation on the periosteal side of the alveolar crest area of the maxilla was not affected by Mg deficiency over the experimental period. Histological observations demonstrated a widening of the periodontal ligament space, disarray of the periodontal fibers, and an increase in fibroblasts with collagen-containing vesicles in their cytoplasm. Color mapping showed that Mg content was significantly decreased in bone formed in the alveolar crest area. In summary, Mg deficiency causes disarray of the periodontal fibers and influences collagen fiber metabolism in growing rats. While bone growth of the alveolar bone on the periosteal side was not affected by Mg deficiency over the experimental period, no new bone formation on the periodontal side was observed.

Risk Factors For Fragility Fracture in Seremban District, Malaysia: A Comparison of Patients With Fragility Fracture in the Orthopedic Ward Versus Those in the Outpatient Department

Osteoporosis is a silent disease and becomes clinically significant in the presence of fragility fracture. Identifying risk factors that are associated with osteoporosis in the community is important in reducing the incidence of fragility fracture. The aim of this study is to identify risk factors associated with fragility fracture in the Seremban District of Malaysia. This is a population comparison study between orthopedic ward patients and outpatients attending a community health clinic for 6 months. Epidemiological data and the possible risk factors for osteoporosis were collected by direct interview. This study demonstrates that advancing age, low body weight, smoking, lack of regular exercise, low consumption of calcium containing foods, and using bone depleting drugs (steroids, thyroid hormone, and frusemides) are major risk factors for fragility fracture. Most of these risk factors are modifiable through effective lifestyle intervention.

The LCT 13910 C/T polymorphism as a risk factor for osteoporosis, has no impact on metastatic bone disease in breast cancer

To the editorThe most common skeletal complication of breast can-cer is bone metastasis, which occurs in 80% of patientswith advanced disease [1, 2].The maintenance of skeletal integrity in a healthyindividual requires a balanced bone remodeling. Osteo-clast-mediated bone resorption is a common factor in thepathogenesis of osteoporosis and metastatic bone disease[3, 4]. Evidence is given, that tumor mediated osteoclastactivation disrupts the normal equilibrium of boneremodeling, allowing tumor cells to survive and grow inthis microenvironment [4, 5].A functional dimorphism, 13910 C/T (LCT) which isassociated with adult lactose intolerance, has been sug-gested as a possible risk factor for osteoporosis and bonefractures, particularly in postmenopausal women [6].In the present study, we investigated the impact of the13910 C/T LCT polymorphism on the risk of bonemetastasis in 500 breast cancer patients. Patient charac-teristics have been described previously [7]. The study wasperformed according to the Austrian Gene Technology Actand had been approved by the local ethics committee.Written informed consent was obtained from all subjects.LCT -13910 genotypes were determined as describedpreviously [7]. SPSS 14.0 for Windows was used for sta-tistical analysis. Continuous values were analyzed byStudent’s t-test, and proportions of groups compared by the

Risk Factors for Osteoporosis in Young Renal Transplant Recipients

Osteoporosis is a frequent complication after renal transplantation. Although several risk factors have been defined in its pathogenesis, the parameters influencing this complication in young patients with functioning grafts have not been well defined. We sought to determine the possible risk factors for osteoporosis among 55 male and 27 female renal transplant patients of mean age 35.5 ± 11.7 years with 68.8% recipients of living-related grafts. Bone mineral densitometry was performed in all patients at 1 year after transplantation. The study utilized the World Health Organization recommendations that define normal (group 1, n = 19), osteopenic (group 2, n = 24), or osteoporotic (group 3, n = 39) patients according to T-score values. Pre- and posttransplant data included gender, age at dialysis onset; age at transplantation; pretransplant dialysis duration; body mass index (BMI); serum calcium, albumin, phosphorus, parathyroid hormone (PTH), and C-reactive protein levels; lipid profile, cumulative doses of immunosuppressive drugs, and pulse steroid dose. Differences between groups 1 and 3 showed that patients with osteoporosis were younger ( P < .003) and had started dialysis and underwent transplantation at a younger age than those without osteoporosis ( P < .01, P < .003). In addition, pretransplant body weight ( P < .02), posttransplant BMI ( P < .01), and pretransplant PTH ( P < .04), posttransplant total cholesterol, and high-density lipoprotein cholesterol levels were lower among group 3 ( P < .004, P < .003). Young adults who started dialysis and underwent transplantation at a younger age were prone to osteoporosis. Additionally, high BMI and cholesterol levels seemed to be preventative for bone loss after transplantation.

Search for occult secondary osteoporosis: impact of identified possible risk factors on bone mineral density.

To determine whether the use of more elaborate diagnostic tests can identify possible risk factors for secondary osteoporosis and to evaluate the impact of these possible risk factors on the severity of bone disease in the study population. Cross-sectional study. We have investigated 377 subjects (285 females, 92 males) with osteoporosis (T-score less than -2.5 in dual energy X-ray absorption) or nontraumatic lumbar vertebral fractures; these patients were referred to our hospital, a secondary care centre, for evaluation and treatment of osteoporosis. Osteoporosis without attributable risk factor was diagnosed in 106 women (37%) and 30 men (33%). In 241 patients (179 women, 62 men) one or more possible risk factors for osteoporosis (in this paper also called subclinical disease) were revealed. The most common were lactose malabsorption, disturbed exocrine pancreatic function and renal tubular disturbances, including renal hypercalciuria, incomplete renal tubular acidosis and mild phosphate diabetes. The number of possible risk factors in the individual patient was significantly related to the severity of osteoporosis as assessed by Z-scores (Spearman correlation r = -0.43, P < 0.001, n = 172 for females; r = -0.28, P < 0.05, n = 65 for males). All the identified subclinical diseases would have remained undetected if the currently accepted guidelines for the investigation of patients with osteoporosis were applied. The statistically significant correlation between the number of identified possible risk factors and the severity of bone disease in the individual patient strongly suggests the pathogenetic significance of the identified subclinical diseases. It is yet to be shown, whether specific treatment of these subclinical diseases yields additional improvement of bone mass as compared with standard treatment of osteoporosis.

Bone mineral density in young women of the city of São Paulo, Brazil: correlation with both collagen type I alpha 1 gene polymorphism and clinical aspects.

Osteoporosis is a multifactorial disease with great impact on morbidity and mortality mainly in postmenopausal women. Although it is recognized that factors related to life-style and habits may influence bone mass formation leading to greater or lower bone mass, more than 85% of the variation in bone mineral density (BMD) is genetically determined. The collagen type I alpha 1 (COLIA1) gene is a possible risk factor for osteoporosis. We studied a population of 220 young women from the city of São Paulo, Brazil, with respect to BMD and its correlation with both COLIA1 genotype and clinical aspects. The distribution of COLIA1 genotype SS, Ss and ss in the population studied was 73.6, 24.1 and 2.3%, respectively. No association between these genotypes and femoral or lumbar spine BMD was detected. There was a positive association between lumbar spine BMD and weight (P<0.0001), height (P<0.0156), and body mass index (BMI) (P<0.0156), and a negative association with age at menarche (P<0.0026). There was also a positive association between femoral BMD and weight (P<0.0001), height (P<0.0001), and BMI (P<0.0001), and a negative correlation with family history for osteoporosis (P<0.041). There was no association between the presence of allele s and reduced BMD. We conclude that a family history of osteoporosis and age at menarche are factors that may influence bone mass in our population.