Osteoporosis In Postmenopausal Women Research Articles

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>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 < -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<0.031). It was also observed that cases had a notably lower weight than the control group (P<0.0001) and the overall body mass index of cases was significantly low in comparison to control (P<0.0001). Moreover, average BMD of femoral and BMD lumbar were notably greater among the control group (P<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.
 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.

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.

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.

OP129 A Cost-Utility Analysis Of Denosumab (Prolia®) For Treating Osteoporosis In Postmenopausal Women: A Swiss Healthcare Payer Perspective

IntroductionOsteoporosis is characterized by decreased bone mass and density, increasing skeletal fragility, and the risk of fragility fracture. Fragility fractures are associated with a high economic burden. Denosumab (Prolia®) is a pharmacological therapy used to treat osteoporosis and reduce the risk of fragility fracture. This study aimed to assess the cost effectiveness of denosumab, compared with other pharmacological therapies (oral bisphosphonates, intravenous [IV] ibandronate, zoledronate, raloxifene, and bazedoxifene) and no treatment, for treating postmenopausal women with osteoporosis.MethodsA discrete event simulation model was developed using a lifetime time horizon. A Swiss healthcare payer perspective was adopted. Time-to-fracture distributions were derived from Swiss-specific Fracture Risk Assessment Tool (FRAX®) probabilities. Reductions in the risk of vertebral and nonvertebral fractures due to treatment were informed by a Bayesian network meta-analysis. Cost-effectiveness frontier analysis was utilized. Pairwise incremental cost-effectiveness ratios (ICERs) between denosumab and each comparator were also estimated. Sensitivity analyses were conducted to identify key drivers and explore the overall certainty of findings.ResultsAt a hypothetical willingness-to-pay (WTP) threshold of CHF100,000 (EUR101,630), IV ibandronate was the most cost-effective therapy in women aged 60 years who had a very high risk of fracture, and in women aged 70 or 80 years of any risk level. In women aged 60 years with a lower risk level, zoledronate was the most cost-effective option. Nevertheless, ICERs from pairwise comparisons between denosumab and some comparators (no treatment, bazedoxifene, raloxifene, and/or zoledronate depending on the cohort’s age and risk profile) were below the hypothetical WTP threshold. Higher intervention costs, smaller reductions in the risk of hip fracture, and shorter duration of residual benefit associated with denosumab contributed to the high ICER values seen in pairwise comparisons with oral bisphosphonates (as a class) and IV ibandronate.ConclusionsThe present evaluation supported the cost effectiveness of denosumab against some, but not all, comparators. Nevertheless, these results should be interpreted cautiously in light of uncertainty in the true effect of treatments on fracture risk.

OP52 Treating Osteoporosis In Postmenopausal Women With Denosumab (Prolia®): A Systematic Review And Network Meta-Analysis

IntroductionIt is estimated that osteoporosis affects over 200 million people globally. Postmenopausal women (PMW) have an increased risk of developing osteoporosis due to low estrogen levels. This study assessed the safety and effectiveness of denosumab (Prolia®) relative to placebo, selective estrogen receptor modulators (SERMs) (bazedoxifene and raloxifene), and bisphosphonates (alendronate, ibandronate, risedronate, and zoledronate) for the treatment of osteoporosis in PMW.MethodsSystematic searches were conducted in three biomedical databases (PubMed, the Cochrane Library, and Embase) to identify randomized controlled trials (RCTs) of PMW with osteoporosis allocated to denosumab, placebo, bisphosphonates, or SERMs. The Cochrane Risk of Bias 2.0 tool was used to critically appraise included RCTs. Pairwise and Bayesian network meta-analyses were performed on the following predetermined outcomes: fractures (vertebral and nonvertebral); adverse events (AEs); mortality; serious AEs (SAEs); withdrawals due to AEs; bone mineral density (BMD); and AEs caused by denosumab discontinuation.ResultsThe analyses included 12 RCTs (22 publications, 25,879 participants). Denosumab, ibandronate, alendronate, zoledronate, and risedronate produced a statistically significant improvement in total hip (TH) and lumbar-spine (LS) BMD, compared with placebo. Similarly, ibandronate, risedronate, and alendronate showed a statistically significant improvement in femoral neck (FN) BMD. Risedronate produced a statistically significant decrease in nonvertebral fractures (risk ratio 0.20, 95% confidence interval: 0.00, 0.97) relative to placebo. However, there were no significant differences between any of the interventions for rates of vertebral fractures, AEs, SAEs, withdrawals due to AEs, or mortality, compared with placebo.None of the included trials reported evidence on AEs caused by denosumab discontinuation.ConclusionsDenosumab was associated with significant improvements in both LS and TH BMD relative to placebo. Similarly, compared with placebo, denosumab was not associated with significant changes in nonvertebral or vertebral fractures. Denosumab was not associated with significant changes in safety outcomes relative to placebo. Given that some of the analyses suffered from statistical imprecision, these findings should be interpreted with caution. Regarding policy, continued funding of denosumab needs to be reviewed.

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.

Novel Advances in the Role of Selective Estrogen Receptor Modulators in Hormonal Replacement Therapy: A Paradigm Shift.

Estrogen is a key regulatory hormone in the functioning of a female reproductive system. Estrogen hormone regulates many complex physiological processes, which has its role in reproduction and skeletal and cardiovascular systems by acting on estrogen receptors alpha (ERα) and beta (ERβ), which are nuclear transcription factors. Selective estrogen receptor modulators (SERMs) are now being used to treat bone loss, breast carcinoma, and menopausal symptoms, metabolic neurodegenerativebecause of their characteristics that allow them to function as both estrogen agonists and antagonists,depending on the target tissue. First-generation SERMs, such as Tamoxifen, are used in the management protocol for breast cancer, which is estrogen receptor (ER-positive). Raloxifene is a second-generation SERM that is a valuable adjunct used to treat and prevent osteoporosis in postmenopausal women and prevent compression fractures of the vertebral column. Novel SERM molecules are on the horizon, proven more potent and efficacious in preventing and treating osteoporosis. These include Ospemifene, lasofoxifene, bazedoxifene and arzoxifene. The benefits of Raloxifene versus that of Bazedoxifene are under trial. Despite their therapeutic benefits and actions, these medications are not without adverse effects, such as thromboembolic disorders. Increased risk of uterine cancer has been linked to Tamoxifen. This article delves into the world of SERMs, including their development and discovery. The newer SERMs in late development, ospemifene, lasofoxifene, bazedoxifene, and arzoxifene, are described in detail.

Polysaccharides Derived from Drynaria fortunei Attenuated Osteoclast Differentiation Induced by Receptor Activator of Nuclear Factor-κB Ligand by Modulating NFATc1 and c-Fos

The rhizome of Drynaria fortunei (Kunze ex Mett.) J. Sm., which is known as “Golsebo” in Korea, traditionally has been used to heal various inflammatory conditions, including bone metabolism disorders. It relieves blood extravasation, stops bleeding, repairs broken bone tissue, treats bone fractures, and kills bacteria. In this study, we evaluated the modulatory effects of DFP on the differentiation of bone-marrow-derived macrophages into osteoclasts. We performed tartrate-resistant acid phosphatase assays using DFP (at different concentrations and molecular weights) to evaluate the degree of bone resorption in the receptor activator of nuclear factor-κB ligand (RANKL)-induced osteoclastogenesis of bone-marrow-derived macrophages. TRAP activity increased with increasing DFP concentrations (0–200 µg/mL). Additionally, DFP significantly inhibited RANKL-induced osteoclastogenesis and controlled RANKL-mediated overexpression of c-Fos and nuclear factor of activated T cells 1, thereby downregulating osteoclast-specific gene (Atp6v0d2, cathepsin K, and DC-STAMP) expression. DFP thus has potential as a nutraceutical candidate for treating bone loss diseases, including osteoporosis in postmenopausal women.

A Comprehensive Review on Postmenopausal Osteoporosis in Women

A Comprehensive Review on Postmenopausal Osteoporosis in Women

Effect of educational intervention on preventing osteoporosis in postmenopausal women.

Osteoporosis is a global public health problem currently affecting millions of people worldwide and in Iran. This study was conducted to assess the effect of an educational intervention based on the theory of planned behavior on the prevention of osteoporosis in postmenopausal women. This quasi-experimental study was performed on 160 women aging over 50 who were referred to health centers in Fasa City, Iran, in 2019. A simple random sampling method was applied to assign the participants into control and intervention groups (80 participants for each group). Data were gathered by questionnaires arranged based on the constructs of the theory of planned behavior, nutrition performance, and walking performance. The educational intervention included seven 50-minute educational sessions. The obtained data were analyzed using SPSS 22 software and Chi-square test, independent T-test, and paired T-test, and the significance level was considered 0.05. The mean ages of the studied participants in the experimental and control groups were 59.18 ± 6.56 and 57.92 ± 5.70, respectively. In the experimental group, the average scores of knowledge, constructs of the theory of planned behavior, nutrition performance, and walking performance had a significant enhancement compared to the control group one year after the intervention (p < 0.001). At 12 months after the intervention, the value of the lumbar spine bone mineral density T-score in the experimental group increased, while in the control group, it reduced (p < 0.001). The theory of planned behavior affected nutrition and walking performance in osteoporosis prevention of subjects. This theory can be used as a framework for designing and performing educational interventions for preventing osteoporosis and promoting women's health.

Joint effects between cadmium exposure and dietary antioxidant quality score on osteoporosis and bone mineral density.

To explore the relationship between dietary antioxidant quality score (DAQS) and Cd exposure both alone and in combination with osteoporosis and bone mineral density (BMD) among postmenopausal women. In total, 4920 postmenopausal women from the National Health and Nutrition Examination Survey were included in this cross-sectional study. Weighted univariate and multivariate logistic regression analyses to assess the association between DAQS and Cd exposure with femur neck BMD, total femur BMD, osteoporosis among postmenopausal women, respectively, and the coexistence effect of DAQS and Cd exposure. Four hundred and ninety-nine had osteoporosis. DAQS (OR = 0·86, 95 % CI 0·77, 0·97) and high DAQS (OR = 0·60, 95 % CI 0·36, 0·99) were found to be associated with decreased odds of osteoporosis, while Cd exposure (OR = 1·34, 95 % CI 1·04, 1·72) and high Cd exposure (OR = 1·45, 95 % CI 1·02, 2·06) were related to increased odds of osteoporosis. A positive correlation was observed between high DAQS and both total femur BMD and femur neck BMD. Conversely, Cd exposure was found to be negatively correlated with total femur BMD and femur neck BMD. Additionally, taking low-Cd and high-quality DAQS group as reference, the joint effect of Cd exposure and DAQS showed greater increased odds of osteoporosis and decreased total femur BMD and femur neck BMD as Cd level and DAQS combinations worsened. There may be an interaction between Cd exposure and DAQS for femur neck BMD, total femur BMD, and osteoporosis in postmenopausal women.

Association of a history of gestational diabetes mellitus with osteoporosis, bone mineral density, and trabecular bone score in postmenopausal women

BackgroundStudies on the association of gestational diabetes mellitus (GDM) with osteoporosis, and bone mineral density (BMD) have been inconsistent. The aim of this study was to investigate the association of a history of GDM with osteoporosis, BMD, and trabecular bone score (TBS) in postmenopausal women.MethodsPostmenopausal women from the National Health and Nutrition Examination Survey (NHANES) between 2007 and 2010, between 2013 and 2014, and between 2017 and 2018 were retrospectively included in this cross-sectional study. The logistic regression model was used to explore the relationship between GDM and osteoporosis, and a weighted linear regression model was applied to investigate the association between GDM and total femoral BMD, femoral neck BMD, and total TBS. Subgroup analysis of the association between GDM and osteoporosis was performed according to age, body mass index (BMI), and DM (yes or no).ResultsOf the 6732 women included, 253 women (3.76%) had GDM. No significant differences in total femoral BMD, femoral neck BMD, and total TBS were observed between postmenopausal women with and without a history of GDM. However, a history of GDM was associated with a higher risk of osteoporosis in postmenopausal women [odds ratio (OR): 11.18, 95% confidence intervals (CI): 3.64 to 34.27, P < 0.001]. There was no significant difference between a history of GDM and osteoporosis in postmenopausal women whom BMI is normal and overweight women. However, there was an association between a history of GDM and osteoporosis in postmenopausal obese women (OR: 26.57, 95% CI 10.23 to 68.98, P < 0.001).ConclusionA history of GDM was associated with a higher risk of osteoporosis in postmenopausal women, particularly in postmenopausal obese women.

Investigation of the risk factors related to osteoporosis in postmenopausal women.

Osteoporosis is a substantial global public health issue. The objective of this study was to evaluate the risk variables related with osteoporosis among patients seeking care at an outpatient menopausal clinic in a tertiary university hospital. In this retrospective cross-sectional study a total of 1148 postmenopausal women who applied to the outpatient menopause clinic of the Başkent University Hospital between June 01, 2014, and August 31, 2015, were enrolled. Patients' datasheets were reviewed and data including age, body mass index (BMI), 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. The measurement of bone mineral density (BMD) was conducted at the femur neck and lumbar spine with a Dual Energy X-ray Absorptiometry (DEXA) scanner. The mean age of the patients was 53.5±6.7 years, the mean duration of menopause was 7.1±6.2 years and the mean age of menopause was 46.3±5.1 years. Among all, 235 patients were diagnosed to have osteoporosis (20.5%). The average femur and lumbar T values showed a decrease in normal weight patients in comparison to overweight, obese, and morbidly obese patients (F=22.337, p=0.000 and F=50.195, p=0.000, 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 osteoporosis.

Label-free quantitative proteomics in serum reveals candidate biomarkers associated with low bone mineral density in Mexican postmenopausal women.

Postmenopausal osteoporosis is a public health problem leading to an increased risk of fractures, negatively impacting women's health. The absence of sensitive and specific biomarkers for early detection of osteoporosis represents a substantial challenge for improving patient management. Herein, we aimed to identify potential candidate proteins associated with low bone mineral density (BMD) in postmenopausal women from the Mexican population. Serum samples from postmenopausal women (40 with normal BMD, 40 with osteopenia (OS), and 20 with osteoporosis (OP)) were analyzed by label-free LC-MS/MS quantitative proteomics. Proteome profiling revealed significant differences between the OS and OP groups compared to individuals with normal BMD. A quantitative comparison of proteins between groups indicated 454 differentially expressed proteins (DEPs). Compared to normal BMD, 14 and 214 DEPs were found in OS and OP groups, respectively, while 226 DEPs were identified between OS and OP groups. The protein-protein interaction and enrichment analysis of DEPs were closely linked to the bone mineral content, skeletal morphology, and immune response activation. Based on their role in bone metabolism, a panel of 12 candidate biomarkers was selected, of which 1 DEP (RYR1) was found upregulated in the OS and OP groups, 8 DEPs (APOA1, SHBG, FETB, MASP1, PTK2B, KNG1, GSN, and B2M) were upregulated in OP and 3 DEPs (APOA2, RYR3, and HBD) were downregulated in OS or OP. The proteomic analysis described here may help discover new and potentially non-invasive biomarkers for the early diagnosis of osteoporosis in postmenopausal women.

Low BMI, blood calcium and vitamin D, kyphosis time, and outdoor activity time are independent risk factors for osteoporosis in postmenopausal women.

To explore the risk factors of osteoporosis in postmenopausal women in China. This study collected all patient data from January 2014 to December 2015. Basic information and questionnaires were collected from 524 postmenopausal women in Sanya and Hainan Province. The questionnaire was administered to the enrolled participants by endocrinologists. Biochemical parameters were measured using fasting blood samples, and bone density was measured by dual energy X-ray absorptiometry at the department of radiology of Hainan hospital, PLA General Hospital. Participants with an R-value of ≤-2.5 were diagnosed with osteoporosis. After deleting missing values for each factor, 334 participants were divided into the osteoporosis (n=35) and non-osteoporosis (n=299) groups according to the R-values. The participants had a median age of 60.8 years (range: 44-94 years). Among the 334 postmenopausal women included in this study, 35 (10.5%) were diagnosed with osteoporosis. Univariate analysis showed statistically significant differences in age, BMI, type of work, alkaline phosphatase, years of smoking, blood calcium levels, kyphosis, fracture, and asthma between the two groups (P<0.05). In addition, multivariate logistic analysis showed that age (odds ratio [OR]: 1.185, 95% confidence interval [CI]: 1.085-1.293, P<0.001) and kyphosis times (OR:1.468, 95% CI: 1.076-2.001, P=0.015) were positively correlated with postmenopausal osteoporosis, whereas BMI (OR: 0.717, 95% CI: 0.617-0.832, P<0.001), blood calcium levels (OR: 0.920, 95% CI: 0.854-0.991, P=0.027), vitamin D levels (OR: 0.787, 95% CI: 0.674-0.918, P=0.002), and outdoor activity time (OR: 0.556, 95% CI: 0.338-0.915, P=0.021) were negatively correlated with postmenopausal osteoporosis. Low BMI, blood calcium and vitamin D levels, kyphosis time, and outdoor activity time are independent risk factors for osteoporosis in postmenopausal women.

Up-regulation of plasma miRNA-21 and miRNA-422a in postmenopausal osteoporosis.

Many researchers focused on diverse miRNAs in the progression of osteoporosis in postmenopausal women. This study aimed to evaluate the association between plasma miRNA-21-5p and miRNA-422a with osteoporosis in postmenopausal women. This cross-sectional comparative study was performed on 126 randomly selected postmenopausal women aged 50-65, including 65 osteoporotic and 61 normal-bone mineral density (BMD) women. miRNA-21 and miRNA-422a were identified using qRT-PCR in these women. BMD was evaluated by the dual-energy X-ray absorptiometry method. A binary logistic regression model adjusted for confounders was used to evaluate the associations between plasma miRNAs' expression levels and osteoporosis. The Area Under Curve (AUC) was calculated to differentiate low BMD in the postmenopausal period using Receiver-Operator Characteristic (ROC) curves. miRNA-21 and miRNA-422a were significantly up-regulated in osteoporotic compared to non-osteoporotic postmenopausal women. The expression levels of miRNA-21 and miRNA-422a indicated a significant reverse correlation with both lumbar spine and femoral neck density. After adjusting the confounders, the likelihood of osteoporosis in the postmenopausal women with under the median plasma levels of miRNA-21 (OR = 0.025; 95% CI: 0.003 to 0.198, p<0.001) and miRNA-422a (OR = 0.037; 95% CI: 0.007 to 0.211, p<0.001) was significantly less than the women with the levels above the median. There were significant inverse correlations between miRNA-21 (p<0.001, r = -0.511) and miRNA-422a (p<0.001, r = -0.682) with BMD-lumbar spine as well as an inverse correlation between miRNA-21(p<0.001, r = -0.374) and miRNA-422a (p<0.001, r = -0.602) with BMD-femoral neck. The AUC (95%CI) for miRNA-21 and miRNA-422a was 0.84 (0.77 to 0.91) and 0.98 (0.96 to 0.99), respectively. ROC analysis illustrated that sensitivity and specificity values were 83.1% and 74%, respectively, for miRNA-21 at the cut-off point of 3.38. Also, at the cut-off point of 2.86, a sensitivity of 94% as well as a specificity of 89% was determined for miRNA-422a. This study indicated that the odds of osteoporosis in postmenopausal women increased with the higher expression of plasma miRNA-21 and miRNA-422a.

Machine learning-based prediction of osteoporosis in postmenopausal women with clinical examined features: Aquantitative clinical study.

Osteoporosis is a skeletal disease that is commonly seen in older people but often neglected due to its silent nature. To overcome the issue of osteoporosis in men and women, we proposed an advanced prediction model with the help of machine learning techniques which can help to identify the potential occurrence of this bone disease by its advanced screening tools. To achieve more reliable and accurate results, various machine-learning techniques were applied to the presented data sets. Moreover, we also compared the performance of our results with other existing algorithms to solely focus on the advanced features of the proposed methodology. The two data sets, the clinical tests of patients in Taiwan and medical reports of postmenopausal women in Korea through Korean Health and Nutrition Examination Surveys (2010-2011) were considered in this study. To predict bone disorders, we utilized the data about females and developed a system using artificial neural networks, support vector machines, and K-nearest neighbor. To compare the performance of the model Area under the Receiver Operating Characteristic Curveand other evaluation metrics were compared. The achieved results from all the algorithms and compared them with Osteoporosis Self-Assessment Tool for Asiansand the results were noticeably better and more reliable than existing systems due to the involvement of ML. Using machine learning techniques to predict these types of diseases is better because physicians and patients can take early action to prevent the consequences in advance.