RESUMO
Reports addressing the effects of oily fish intake on bone health are inconsistent. This study shows that consumption of ≥ 5.2 oily fish servings/week (728 g) is associated with lower prevalence of osteopenia/osteoporosis in elderly women of Amerindian ancestry. Results suggest a beneficial effect of oily fish intake in this population. OBJECTIVES: Oily fish is a major dietary source of omega-3 polyunsaturated fatty acids and other nutrients that may have a positive effect on bone health. However, this association is inconsistent and seems to be more evident in certain ethnic groups. We aimed to assess the association between oily fish intake and bone mineral density (BMD) in frequent fish consumers of Amerindian ancestry living in rural Ecuador. METHODS: This study included 399 individuals aged ≥ 60 years living in three neighboring rural villages of coastal Ecuador. Dietary oily fish intake was quantified systematically using validated surveys and BMD was determined by dual-energy x-ray absorptiometry. Ordinal logistic regression models, adjusted for demographics and cardiovascular risk factors, were fitted to assess the independent association between oily fish intake and bone health. RESULTS: Participants had a mean age of 68.8 ± 6.8 years, and 58% were women. The mean intake of oily fish was 8.5 ± 4.7 servings/week, with 308 (77%) reporting high fish intake (≥ 5.2 servings/week [728 g]). Ninety-four (24%) participants had normal BMD T-scores, 149 (37%) had osteopenia, and 156 (39%) had osteoporosis. Ordinal logistic regression models showed no association between high fish intake and bone health in the total population. When men and women were analyzed separately, the association became significant for women only in both unadjusted (OR: 2.52; 95% C.I.: 1.22 - 5.23) and fully-adjusted models (OR: 2.23; 95% C.I.: 1.03 - 4.81). CONCLUSION: Consumption of ≥ 5.2 oily fish servings/week is associated with lower prevalence of osteopenia and osteoporosis in elderly women of Amerindian ancestry.
Assuntos
Densidade Óssea , Idoso , Animais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Absorciometria de Fóton , Doenças Ósseas Metabólicas/epidemiologia , Dieta/estatística & dados numéricos , Equador/epidemiologia , Óleos de Peixe/administração & dosagem , Peixes , Indígenas Sul-Americanos/estatística & dados numéricos , Osteoporose/epidemiologia , Osteoporose/etnologia , População Rural/estatística & dados numéricos , Alimentos MarinhosRESUMO
INTRODUCTION: There is inconclusive evidence whether osteoporosis increases risk of hearing loss in current literature. OBJECTIVE: We conducted this meta-analysis to determine whether there is an association between hearing loss and osteoporosis. METHODS: This systematic review and meta-analysis was conducted from studies of MEDLINE, EMBASE, and LILACS. Osteoporosis was defined as having a bone mineral density with a T-score of less than -2.5 standard deviation. The outcome was hearing loss as assessed by audiometry or self-reported assessment. Random-effects model and pooled hazard ratio, risk ratio, or odds ratio of hearing loss with 95% confidence intervals were compared between normal bone mineral density and low bone mineral density or osteoporosis. RESULTS: A total of 16 articles underwent full-length review. Overall, there was a statistically significant increased odds of hearing loss in the low bone mineral density or osteoporosis group with odds ratio of 1.20 (95% confidence intervals 1.01-1.42, p=0.04, I2=82%, Pheterogeneity=0.01). However, the study from Helzner et al. reported significantly increase odds of hearing loss in the low bone mineral density in particular area and population included femoral neck of black men 1.37 (95% confidence intervals 1.07-1.76, p=0.01) and total hip of black men 1.36 (95% confidence intervals 1.05-1.76, p=0.02). CONCLUSION: Our study proposed the first meta-analysis that demonstrated a probable association between hearing loss and bone mineral density. Osteoporosis could be a risk factor in hearing loss and might play an important role in age-related hearing loss.
Assuntos
Perda Auditiva Condutiva/etiologia , Perda Auditiva Condutiva-Neurossensorial Mista/etiologia , Perda Auditiva Neurossensorial/etiologia , Osteoporose/complicações , Fatores Etários , Densidade Óssea/fisiologia , Feminino , Perda Auditiva Condutiva/etnologia , Perda Auditiva Condutiva-Neurossensorial Mista/etnologia , Perda Auditiva Neurossensorial/etnologia , Humanos , Masculino , Osteoporose/etnologia , Fatores de Risco , Fatores SexuaisRESUMO
OBJECTIVE: To examine the association between sleep patterns (sleep duration and insomnia symptoms) and total and regional bone mineral density (BMD) among older Boston Puerto Rican adults. MATERIALS/METHODS: We conducted a cross-sectional study including 750 Puerto Rican adults, aged 47-79 y living in Massachusetts. BMD at 3 hip sites and the lumbar spine were measured using dual-energy X-ray absorptiometry. Sleep duration (≤5 h, 6 h, 7 h, 8 h, or ≥9 h/d) and insomnia symptoms (difficulty initiating sleep, difficulty maintaining sleep, early-morning awaking, and non-restorative sleep) were assessed by a questionnaire. Multivariable regression was used to examine sex-specific associations between sleep duration, insomnia symptoms and BMD adjusting for standard confounders and covariates. RESULTS: Men who slept ≥9h/d had significantly lower femoral neck BMD, relative to those reporting 8 h/d sleep, after adjusting for age, education level, smoking, physical activity, depressive symptomatology, comorbidity and serum vitamin D concentration. This association was attenuated and lost significance after further adjustment for urinary cortisol and serum inflammation biomarkers. In contrast, the association between sleep duration and BMD was not significant in women. Further, we did not find any significant associations between insomnia symptoms and BMD in men or women. CONCLUSIONS: Our study does not support the hypothesis that shorter sleep duration and insomnia symptoms are associated with lower BMD levels in older adults. However, our results should be interpreted with caution. Future studies with larger sample size, objective assessment of sleep pattern, and prospective design are needed before a conclusion regarding sleep and BMD can be reached.
Assuntos
Hispânico ou Latino/estatística & dados numéricos , Osteoporose/etnologia , Distúrbios do Início e da Manutenção do Sono/etnologia , Sono , Absorciometria de Fóton , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Densidade Óssea , Boston/epidemiologia , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Feminino , Colo do Fêmur/química , Seguimentos , Humanos , Hidrocortisona/sangue , Mediadores da Inflamação/sangue , Vértebras Lombares/química , Masculino , Pessoa de Meia-Idade , Minerais/análise , Porto Rico/etnologia , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos , Fatores de Tempo , Vitamina D/análogos & derivados , Vitamina D/sangueRESUMO
UNLABELLED: We hypothesized that chronic exposures to traffic combustion products may lower bone mineral density (BMD). We found that proximity to freeways was associated with reduced BMD. Our findings suggest that traffic-related pollution may contribute to the occurrence of osteopenia and osteoporosis. INTRODUCTION: Adults residing in rural areas have been linked with higher BMD. We aimed to determine if this difference is due in part to air pollution by examining the relationships between traffic metrics and ambient air pollution with total body and pelvic BMD. METHODS: Mexican American adults (n = 1,175; mean 34 years; 72 % female) who had participated in the BetaGene study of air pollution, obesity, and insulin resistance were included in this analysis. Total body and pelvic BMD were estimated using dual-energy X-ray absorptiometry. Traffic and ambient air pollutant exposures were estimated at residences using location and ambient monitoring data. Variance component models were used to analyze the associations between residential distance to the nearest freeway and ambient air pollutants with BMD. RESULTS: Residential proximity to a freeway was associated with lower total body BMD (p-trend = 0.01) and pelvic BMD (p-trend = 0.03) after adjustment for age, sex, weight, and height. The adjusted mean total body and pelvic BMD in participants living within 500 m of a freeway were 0.02 and 0.03 g/cm(2) lower than participants living greater than 1,500 m from a freeway. These associations did not differ significantly by age, sex, or obesity status. Results were similar after further adjustment for body fat and weekly physical activity minutes. Ambient air pollutants (NO2, O3, and PM2.5) were not significantly associated with BMD. CONCLUSIONS: Traffic-related exposures in overweight and obese Mexican Americans may adversely affect BMD. Our findings indicate that long-term exposures to traffic may contribute to the occurrence of osteoporosis and its consequences.
Assuntos
Poluição do Ar/efeitos adversos , Osteoporose/etiologia , Emissões de Veículos/toxicidade , Absorciometria de Fóton/métodos , Adulto , Poluição do Ar/análise , Antropometria/métodos , Densidade Óssea/fisiologia , California/epidemiologia , Exposição Ambiental/efeitos adversos , Exposição Ambiental/análise , Monitoramento Ambiental/métodos , Feminino , Humanos , Masculino , Americanos Mexicanos/estatística & dados numéricos , Veículos Automotores , Osteoporose/etnologia , Osteoporose/fisiopatologia , Sobrepeso/complicações , Sobrepeso/etnologia , Ossos Pélvicos/fisiopatologia , Características de Residência/estatística & dados numéricos , Fatores Socioeconômicos , Emissões de Veículos/análiseRESUMO
Osteoporosis is a common disease in the aging population and studies have shown that interleukin-6 (IL-6) is potentially implicated in its pathogenesis. This study was designed to assess the association between the IL-6 gene -634C/G polymorphism and osteoporosis. PubMed, Embase, China National Knowledge Infrastructure, and Wanfang databases were searched for eligible studies published up to and including December 2014 in English or Chinese. Meta-analysis was conducted by the RevMan5.2 software. Weighted mean difference and 95% confidence interval (95%CI) were calculated by a fixed-effect or random-effect model. Bone mineral density (BMD) was regarded as the assessment index. As a result, a total of four articles with 3068 subjects were included. Differences in BMD between the CC and GG genotypes were 0.03 g/cm(2) (95%CI = 0.01 to 0.05) at total body, 0.01 g/cm(2) (95%CI = 0.00 to 0.03) at femoral neck, and 0.03 g/cm(2) (95%CI = 0.00 to 0.06) at the lumbar spine (P < 0.05). For the CG versus GG genotypes, the differences in BMD were 0.03 g/cm(2) (95%CI = 0.02 to 0.05) at total body and 0.02 g/cm(2) (95%CI = 0.00 to 0.03 at the femoral neck (P < 0.05). For the CC versus CG genotypes, the differences in BMD were not significant (P > 0.05). In conclusion, the GG genotype of the -634C/G polymorphism in IL-6 appears to play a role in reducing BMD, which affects normal bone metabolism and leads to osteoporosis.
Assuntos
Densidade Óssea/genética , Interleucina-6/genética , Osteoporose/genética , Polimorfismo de Nucleotídeo Único , Regiões Promotoras Genéticas , Povo Asiático , Feminino , Colo do Fêmur/metabolismo , Colo do Fêmur/patologia , Expressão Gênica , Genótipo , Humanos , Interleucina-6/metabolismo , Vértebras Lombares/metabolismo , Vértebras Lombares/patologia , Masculino , Osteoporose/diagnóstico , Osteoporose/etnologia , Osteoporose/patologiaRESUMO
SUMMARY: To determine whether there are race/ethnic differences in bone mineral density (BMD) by fracture history in men aged 65 years and older, we performed cross-sectional analysis in five large independent cohorts. Low BMD was associated with a higher prevalence of fracture in all cohorts, and the magnitude of the BMD differences by fracture status was similar across groups. INTRODUCTION: We aimed to determine whether there are race/ethnic and geographic differences in bone mineral density by fracture history in men aged 65 years and older. METHOD: The datasets included the Osteoporotic Fractures in Men (MrOS) Study (5,342 White, 243 African-American, 190 Asian, and 126 Hispanic), MrOS Hong Kong (1,968 Hong Kong Chinese), Tobago Bone Health Study (641 Afro-Caribbean), Namwon Study (1,834 Korean), and Dong-gu Study (2,057 Korean). The two Korean cohorts were combined. RESULTS: The prevalence of self-reported non-traumatic fracture was US white, 17.1 %; Afro-Caribbean, 5.5 %; US African-American, 15.1 %; US Hispanic, 13.7 %; US Asian, 10.5 %; Hong Kong Chinese, 5.6 %, and Korean, 5.1 %. The mean differences in hip and lumbar spine BMD between subjects with fracture and without fracture were statistically significant in all cohorts except US African American and US Asian men. There was a significant race/ethnic interaction for lumbar spine BMD by fracture status (p for interaction = 0.02), which was driven by the small number of Hispanic men. There was no interaction for femoral neck or total hip BMD. There were no significant race/ethnic differences in the odds ratio of fracture by BMD. CONCLUSIONS: Low BMD was associated with a higher prevalence of fracture in all cohorts and the magnitude of the BMD differences by fracture status was similar across groups suggesting homogeneity in the BMD-fracture relationship among older men.
Assuntos
Densidade Óssea/fisiologia , Osteoporose/etnologia , Fraturas por Osteoporose/etnologia , Idoso , Idoso de 80 Anos ou mais , Envelhecimento/etnologia , Envelhecimento/fisiologia , Povo Asiático/estatística & dados numéricos , População Negra/estatística & dados numéricos , Estudos Transversais , Colo do Fêmur/fisiopatologia , Articulação do Quadril/fisiopatologia , Hong Kong/epidemiologia , Humanos , Vértebras Lombares/fisiopatologia , Masculino , Osteoporose/fisiopatologia , Fraturas por Osteoporose/fisiopatologia , Trinidad e Tobago/epidemiologia , Estados Unidos/epidemiologia , População Branca/estatística & dados numéricosRESUMO
Osteoporosis is characterized by low bone mineral density (BMD). One of the most important factors that influence BMD is the genetic contribution. The collagen type 1 alpha 1 (COL1A1) and the JAGGED (JAG1) have been investigated in relation to BMD. The aim of this study was to investigate the possible association between two single-nucleotide polymorphisms (SNPs) of COL1A1, their haplotypes, and one SNP of JAG1 with BMD in postmenopausal Mexican-Mestizo women. Seven hundred and fifty unrelated postmenopausal women were included. Risk factors were recorded and BMD was measured in lumbar spine, total hip, and femoral neck by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Two SNPs in COL1A1 (rs1800012 and rs1107946) and one in JAG1 (rs2273061) were studied. Real-time PCR allelic discrimination was used for genotyping. The differences between the means of the BMDs according to genotype were analyzed with covariance. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r (2), and haplotype analysis of COL1A1 was conducted. Under a dominant model, the rs1800012 polymorphism of the COL1A1 showed an association with BMD of the lumbar spine (P = 0.021). In addition, analysis of the haplotype of COL1A1 showed that the G-G haplotype presented a higher BMD in lumbar spine. We did not find an association between the s1107946 and rs2273061 polymorphisms of the COL1A1 and JAG1, respectively. Our results suggest that the rs1800012 polymorphism of the COL1A1, in addition to one haplotype, were significantly associated with BMD variation in Mexican-Mestizo postmenopausal women.
Assuntos
Densidade Óssea/genética , Proteínas de Ligação ao Cálcio/genética , Colágeno Tipo I/genética , Peptídeos e Proteínas de Sinalização Intercelular/genética , Proteínas de Membrana/genética , Osteoporose/genética , Polimorfismo de Nucleotídeo Único , Absorciometria de Fóton , Análise de Variância , Distribuição de Qui-Quadrado , Cadeia alfa 1 do Colágeno Tipo I , Feminino , Genótipo , Haplótipos , Humanos , Proteína Jagged-1 , México , Pessoa de Meia-Idade , Osteoporose/etnologia , Pós-Menopausa , Fatores de Risco , Proteínas Serrate-Jagged , Inquéritos e QuestionáriosRESUMO
CONTEXT: Xanthosoma sagittifolium Schott. (Araceae) and Laportea aestuans (L.) Chew (Urticaceae) are two medicinal species used as food and to prevent and treat bone diseases, such as osteoporosis, in traditional Brazilian medicine. OBJECTIVE: To investigate the free calcium concentration and further support the traditional use of these species as medicine. MATERIALS AND METHODS: L. aestuans and X. sagittifolium leaves were dehydrated and cooked to evaluate the presence of free calcium. The total oxalate content was determined by heat digestion in H(2)SO(4), oxalate precipitation with CaCl(2) and permanganate titration. RESULTS: The calcium content found in L. aestuans was quite significant (638.00 mg/100 g), whereas the fresh and cooked leaves of X. sagittifolium demonstrated a low content of calcium, at 273.17 and 369.81 mg/100 g, respectively. DISCUSSION AND CONCLUSION: The use of this species for the prevention and treatment of bone diseases is in agreement with the results of the free calcium (Ca(++)) analyses. Our data show that each species may be used as a health supplement in poor communities, provided that studies validate their safe use.
Assuntos
Medicina Tradicional/métodos , Osteoporose/prevenção & controle , Folhas de Planta/química , Urticaceae , Xanthosoma , Brasil/etnologia , Cálcio/uso terapêutico , Osteoporose/etnologia , Extratos Vegetais/isolamento & purificação , Extratos Vegetais/uso terapêutico , Especificidade da EspécieRESUMO
Osteoporotic hip fractures (OHF) are not limited to elderly; however, studies in non-elderly are scarce. Thus, the aim of this study was to evaluate co-morbidities in non-elderly patients with OHF in a Community Teaching Hospital. All hospitalizations due to OHF during a 3-year period in a Community Teaching Hospital were retrospectively evaluated for co-morbidities, and patients 18-64 years old were compared with those ≥65 years old. Of all hospitalizations, 232 (0.73%) were due to hip fractures, and 120/232 (51.7%) patients had OHF. The comparison of the 13 (10.8%) OHF patients <65 years old (47.3 ± 9.7 years) with 107 (89.2%) ≥65 years old (80.4 ± 7.7 years) revealed a male predominance (61.5 vs. 27.1%, P = 0.022) and a distinct ethnic distribution with a lower proportion of Caucasians in the former (61.5 vs. 86.9%, P = 0.033). Moreover, non-elderly OHF patients had higher frequencies of insulin-dependent DM (38.5 vs. 3.7%, P = 0.001) and alcoholism (38.5 vs. 4.7%, P = 0.001) than aged patients. In contrast, rates of age-related co-morbidities such as stroke (7.7 vs. 18.7%, P = 0.461), heart failure (23.1 vs. 14.0%, P = 0.411), and dementia (7.7 vs. 15.9%, P = 0.689) were comparable in both groups. Logistic regression analysis demonstrated that insulin-dependent DM (OR = 25.4, 95% CI = 4.7-136.8, P < 0.001) and alcoholism (OR = 20.3, 95% CI = 3.9-103.3, P < 0.001) remained as independent risk factors for OHF in non-elderly patients. Osteoporosis is an important cause of HF in Community Hospital. Non-elderly patients with OHF have a peculiar demographic profile and associated co-morbidities. These findings reinforce the need of early osteoporosis diagnosis and rigorous fracture prevention in patients with DM and alcoholism.
Assuntos
Fraturas do Quadril/epidemiologia , Osteoporose/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Alcoolismo/epidemiologia , Brasil/epidemiologia , Doenças Cardiovasculares/epidemiologia , Distribuição de Qui-Quadrado , Comorbidade , Demência/epidemiologia , Diabetes Mellitus/epidemiologia , Feminino , Fraturas do Quadril/etnologia , Hospitais Comunitários , Hospitais de Ensino , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Razão de Chances , Osteoporose/etnologia , Estudos Retrospectivos , Medição de Risco , Fatores de Risco , Adulto JovemRESUMO
OBJECTIVE: To investigate linkage to chromosome 1q and 11q region for lumbar spine, femoral neck and total body BMD and volumetric BMD in Brazilian sister adolescents aged 10-20-year-old and 57 mothers. METHODS: We evaluated 161 sister pairs (n=329) aged 10-20 years old and 57 of their mothers in this study. Physical traits and lifestyle factors were collected as covariates for lumbar spine (LS), femoral neck (FN) and total body (TB) BMD and bone mineral apparent density (BMAD). We selected nine microsatellite markers in chromosome 1q region (spanning nearly 33cM) and eight in chromosome 11q region (spanning nearly 34cM) to perform linkage analysis. RESULTS: The highest LOD score values obtained from our data were in sister pairs LS BMAD analysis. Their values were: 1.32 (P<0.006), 2.61 (P<0.0002) and 2.44 (P<0.0004) in D1S218, D1S2640 and D1S2623 markers, respectively. No significant LOD score was found with LS and FN BMD/BMAD in chromosome 11q region. Only TB BMD showed significant linkage higher than 1.0 for chromosome 11q region in the markers D11S4191 and D11S937. DISCUSSION/CONCLUSIONS: Our results provided suggestive linkage for LS BMAD at D1S2640 marker in adolescent sister pairs and suggest a possible candidate gene (LHX4) related to adolescent LS BMAD in this region. These results reinforce chromosome 1q21-23 as a candidate region to harbor one or more bone formation/maintenance gene. In the other hand, it did not repeat for chromosome 11q12-13 in our population.
Assuntos
Densidade Óssea/genética , Cromossomos Humanos Par 11/genética , Cromossomos Humanos Par 1/genética , Ligação Genética , Osteoporose/etnologia , Osteoporose/genética , Adolescente , Adulto , Brasil/epidemiologia , Criança , Feminino , Predisposição Genética para Doença/etnologia , Predisposição Genética para Doença/genética , Genótipo , Humanos , Escore Lod , Repetições de Microssatélites/genética , Pessoa de Meia-Idade , Mães/estatística & dados numéricos , Adulto JovemRESUMO
BACKGROUND: Fat mass is thought to be protective against osteoporosis, primarily because of its weight-bearing effect. Few studies have evaluated the association between abdominal fat mass (AFM) and bone health beyond its weight-bearing effect. OBJECTIVE: We tested the hypothesis that higher body weight-adjusted AFM is associated with poor bone health. DESIGN: A cross-sectional study was conducted in 629 Puerto Rican adults aged 47-79 y. Bone mineral density (BMD) of the femoral neck, trochanter, total femur, and lumbar spine (L2-L4) were measured by using dual-energy X-ray absorptiometry (DXA). AFM and total fat mass (TFM) were assessed by using body-composition software from whole-body DXA scans. Osteoporosis and osteopenia were defined as T-scores ≤ -2.5 and -1.0 to -2.5 SD, respectively, at the respective bone site. RESULTS: After confounders were controlled for, body weight-adjusted AFM was inversely associated with BMD at all 4 bone sites in women and at the femoral neck in men. For TFM, small inverse associations were seen at the trochanter and total femur in women. In men, similar associations were seen at the 3 femur sites. In both sexes, the odds for osteoporosis or osteopenia at each of the femoral sites increased by 10-16% for every 100-g increase in body weight-adjusted AFM. CONCLUSIONS: Higher AFM was associated with poor bone health in this Puerto Rican sample. Efforts to reduce abdominal obesity will not only reduce the risk of chronic disease but may also improve bone health. This trial is registered at clinicaltrials.gov as NCT01231958.
Assuntos
Gordura Abdominal/patologia , Densidade Óssea , Reabsorção Óssea/etnologia , Reabsorção Óssea/etiologia , Obesidade Abdominal/fisiopatologia , Adiposidade , Idoso , Índice de Massa Corporal , Doenças Ósseas Metabólicas/epidemiologia , Doenças Ósseas Metabólicas/etnologia , Doenças Ósseas Metabólicas/etiologia , Reabsorção Óssea/epidemiologia , Boston/epidemiologia , Estudos de Coortes , Estudos Transversais , Feminino , Seguimentos , Hispânico ou Latino , Humanos , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/patologia , Osteoporose/epidemiologia , Osteoporose/etnologia , Osteoporose/etiologia , Porto Rico/etnologia , Fatores de Risco , Fatores SexuaisRESUMO
Little is known about the progression of bone loss during young adulthood and whether it differs between men and women. As part of the San Antonio Family Osteoporosis Study we tested whether bone mineral density (BMD) changed over time in men or women, and whether the rate of BMD change differed between the sexes. BMD of the proximal femur, spine, radius, and whole body was measured in 115 men and 202 pre-menopausal women (ages 25 to 45 years; Mexican American ancestry) by dual-energy x-ray absorptiometry at two time points (5.6 years apart), from which annual percent change-in-BMD was calculated. Likelihood-based methods were used to test whether change-in-BMD differs from zero or differs between men and women. In men, percent change-in-BMD was significantly greater than zero for the 1/3 radius (i.e. indicating a gain of BMD; Bonferroni-adjusted p<0.01), less than zero for the femoral neck, lumbar spine, ultradistal radius, and whole body (i.e. indicating a loss of BMD; p<0.01 for all), and not different than zero for the total hip (p=0.24). In women, percent change-in-BMD was greater than zero for the total hip, 1/3 radius, and whole body (p<0.01 for all), less than zero for the ultradistal radius (p<0.01), and not significantly different than zero for the femoral neck and lumbar spine (p=1.0 for both). For all skeletal sites, men experienced greater decrease in BMD (or less increase in BMD) than women; this result was observed both with and without adjustment for age, BMI, and change-in-BMI (p<0.05 for all). These results suggest that significant bone loss occurs at some skeletal sites in young men and women, and that loss of BMD is occurring significantly faster, or gain of BMD is occurring significantly slower, in young men compared to young women.
Assuntos
Reabsorção Óssea/etnologia , Reabsorção Óssea/patologia , Americanos Mexicanos/etnologia , Osteoporose/etnologia , Osteoporose/patologia , Caracteres Sexuais , Adulto , Densidade Óssea/fisiologia , Família , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Modelos Biológicos , Osteoporose/fisiopatologia , Texas , Fatores de TempoRESUMO
Quantitative ultrasound (QUS) appears to be developing into an acceptable, low-cost and readily-accessible alternative to dual X-ray absorptiometry (DXA) measurements of bone mineral density (BMD) in the detection and management of osteoporosis. Perhaps the major difficulty with their widespread use is that many different QUS devices exist that differ substantially from each other, in terms of the parameters they measure and the strength of empirical evidence supporting their use. But another problem is that virtually no data exist outside of Caucasian or Asian populations. In general, heel QUS appears to be most tested and most effective. Some, but not all heel QUS devices are effective assessing fracture risk in some, but not all populations, the evidence being strongest for Caucasian females > 55 years old, though some evidence exists for Asian females > 55 and for Caucasian and Asian males > 70. Certain devices may allow to estimate the likelihood of osteoporosis, but very limited evidence exists supporting QUS use during the initiation or monitoring of osteoporosis treatment. Likely, QUS is most effective when combined with an assessment of clinical risk factors (CRF); with DXA reserved for individuals who are not identified as either high or low risk using QUS and CRF. However, monitoring and maintenance of test and instrument accuracy, precision and reproducibility are essential if QUS devices are to be used in clinical practice; and further scientific research in non-Caucasian, non-Asian populations clearly is compulsory to validate this tool for more widespread use.
Assuntos
Densidade Óssea , Osteoporose/diagnóstico por imagem , Algoritmos , Povo Asiático , Calcâneo/diagnóstico por imagem , Densitometria/economia , Densitometria/instrumentação , Feminino , Fraturas Espontâneas/etiologia , Humanos , Masculino , Osteoporose/etnologia , Osteoporose/terapia , Medição de Risco/métodos , Ultrassonografia/instrumentação , População BrancaRESUMO
Little is known about the magnitude, pattern, and determinants of bone loss with advancing age among men, particularly among those of African descent. We examined the rate of decline in hip BMD and identified factors associated with BMD loss among 1478 Afro-Caribbean men >or=40 yr of age. BMD was measured at baseline and after an average of 4.4 yr by DXA. The rate of decline in femoral neck BMD was 0.29 +/- 0.81%/yr in the total sample (p < 0.0001). However, a U-shaped relationship between advancing age and the rate of decline in BMD was observed. The rate of decline in BMD at the femoral neck was -0.38 +/- 0.77%/yr among men 40-44 yr of age, decelerated to -0.15 +/- 0.81%/yr among men 50-54 yr of age, and then accelerated to -0.52 +/- 0.90%/yr among those 75+ yr of age (all p < 0.003). Men who lost >or=5% of their body weight during follow-up had significantly greater BMD loss than those who remained weight stable or gained weight (p < 0.0001). The relationship between weight loss and BMD loss was more pronounced among men who were older and leaner at study entry (p < 0.03). We also observed a strong impact of advanced prostate cancer and its treatment with androgen deprivation on BMD loss. Men of African ancestry experience substantial BMD loss with advancing age that seems to be comparable to the rate of loss among white men in other studies. Additional studies are needed to better define the natural history and factors underlying bone loss with aging in men of African ancestry.
Assuntos
Envelhecimento , Peso Corporal , Densidade Óssea , Colo do Fêmur/fisiopatologia , Osteoporose/fisiopatologia , Idoso , População Negra , Colo do Fêmur/patologia , Seguimentos , Quadril , Humanos , Masculino , Pessoa de Meia-Idade , Osteoporose/epidemiologia , Osteoporose/etnologia , Osteoporose/patologia , Neoplasias da Próstata/epidemiologia , Neoplasias da Próstata/etnologia , Neoplasias da Próstata/patologia , Neoplasias da Próstata/fisiopatologia , Trinidad e Tobago/epidemiologia , Trinidad e Tobago/etnologiaRESUMO
Glucocorticoid use is a leading cause of secondary osteoporosis. This post hoc analysis compared teriparatide vs alendronate on bone mineral density (BMD) in Hispanic and non-Hispanic patients with glucocorticoid-induced osteoporosis. The 18-mo results from all patients (N=428) in a double-blind trial of teriparatide (20 microg/d) and alendronate (10 mg/d) who had taken glucocorticoids for >or=3 mo were reported (Saag et al. N Engl J Med 2007). The present study analyzed results from the Hispanic (n=61) and non-Hispanic (n=367) cohorts. The BMD was measured by dual-energy X-ray absorptiometry (DXA). In the Hispanic cohort at 18 mo, there were significantly greater increases from baseline in the teriparatide vs alendronate group in lumbar spine BMD (9.8%+/-1.7% vs 4.2%+/-1.4%; p<0.001; mean+/-SE) and total hip BMD (5.9%+/-1.6% vs 1.3%+/-1.3%, p<0.001), with no significant difference between groups at the femoral neck (4.3%+/-2.2% vs 2.0%+/-1.8%, p=0.228). Within each treatment group, the BMD responses were not significantly different in the Hispanic vs non-Hispanic cohort. The number of patients reporting >or=1 adverse event was not significantly different between treatments in either cohort, with more patients reporting nausea in the teriparatide group. In summary, teriparatide was more efficacious than alendronate in increasing BMD in Hispanic and non-Hispanic patients with glucocorticoid-induced osteoporosis. Both treatments were generally well tolerated.
Assuntos
Alendronato/farmacologia , Conservadores da Densidade Óssea/farmacologia , Densidade Óssea/efeitos dos fármacos , Osteoporose/tratamento farmacológico , Osteoporose/etnologia , Teriparatida/farmacologia , Argentina , Brasil , Estudos de Coortes , Colômbia , Método Duplo-Cego , Feminino , Glucocorticoides/efeitos adversos , Hispânico ou Latino , Humanos , Masculino , México , Pessoa de Meia-Idade , Osteoporose/induzido quimicamente , VenezuelaRESUMO
Quantitative ultrasound (QUS) appears to be developing into an acceptable, low-cost and readily-accessible alternative to dual X-ray absorptiometry (DXA) measurements of bone mineral density (BMD) in the detection and management of osteoporosis. Perhaps the major difficulty with their widespread use is that many different QUS devices exist that differ substantially from each other, in terms of the parameters they measure and the strength of empirical evidence supporting their use. But another problem is that virtually no data exist outside of Caucasian or Asian populations. In general, heel QUS appears to be most tested and most effective. Some, but not all heel QUS devices are effective assessing fracture risk in some, but not all populations, the evidence being strongest for Caucasian females > 55 years old, though some evidence exists for Asian females > 55 and for Caucasian and Asian males > 70. Certain devices may allow to estimate the likelihood of osteoporosis, but very limited evidence exists supporting QUS use during the initiation or monitoring of osteoporosis treatment. Likely, QUS is most effective when combined with an assessment of clinical risk factors (CRF); with DXA reserved for individuals who are not identified as either high or low risk using QUS and CRF. However, monitoring and maintenance of test and instrument accuracy, precision and reproducibility are essential if QUS devices are to be used in clinical practice; and further scientific research in non-Caucasian, non-Asian populations clearly is compulsory to validate this tool for more widespread use.
El ultrasonido cuantitativo (QUS) es una alternativa para la detección y manejo de la osteoporosis de bajo costo y uso práctico, si se compara con las densitometrías de rayos X de doble haz de baja energía (DXA) que determinan densidad mineral ósea (BMD). La mayor dificultad para el uso generalizado del QUS por un lado es que existen muchos instrumentos que son significativamente diferentes uno del otro y por otro en la calidad de la evidencia en que se justifica su empleo, que generalmente es insuficiente y/o poco sistematizada. Otro problema importante del QUS, es que prácticamente no existe información que no sea la generada en poblaciones asiáticas o caucásicas. En general, los estudios de calcáneo realizados con QUS son los más utilizados y mejor validados para evaluar el riesgo de fracturas en algunas poblaciones. La evidencia más grande de su efectividad se conoce para las mujeres caucásicas y asiáticas mayores de 55 años e incluso para los hombres asiáticos mayores de 70 años. Varios instrumentos cuentan con buen sustento científico, que los vuelve confiables para establecer un pronóstico preciso e identificar el riesgo individual de sufrir fracturas por osteoporosis, sin embargo, existe poca evidencia que respalde su uso para iniciar y monitorear el resultado del tratamiento de la osteoporosis. El QUS mejora su efectividad diagnóstica cuando se combina con los resultados de un cuestionario que identifica riesgos clínicos. En un escenario ideal, el DXA se debe reservar solo para aquellos individuos que no puedan ser identificados de manera confiable usando QUS y el cuestionario de riesgos clínicos. Si se quiere aceptar a los instrumentos QUS en la práctica clínica, para el monitoreo es indispensable asegurar y mantener la exactitud, precisión y reproducibilidad de los instrumentos y de los técnicos que los utilizan. Se requieren más estudios científicos de poblaciones no caucásicas o asiáticas para validar el uso generalizado del QUS.
Assuntos
Feminino , Humanos , Masculino , Densidade Óssea , Osteoporose , Algoritmos , Povo Asiático , Calcâneo , Densitometria/economia , Densitometria/instrumentação , População Branca , Fraturas Espontâneas/etiologia , Osteoporose/etnologia , Osteoporose/terapia , Medição de Risco/métodos , Ultrassonografia/instrumentaçãoRESUMO
Measuring quality of life (QOL) is important, but to date, questionnaires to measure QOL in Mexican patients with osteoporosis (OP) have not been validated. A study was carried out to culturally adapt and validate the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO) in a Mexican population. Interviews were performed with 160 women, 80 patients with at least one vertebral fracture, and 80 patients with OP as determined by the World Health Organization criteria. Several cultural modifications were made to the Spanish version of the QUALEFFO. Content validity was assessed by a group of experts, and a pilot study was undertaken. At the same time, the Spanish version of the Short Form 36 (Medical Outcomes Study) was applied. The mean age of patients was 71.9 +/- 11.1. The QOL questionnaire showed a test-retest reproducibility (R (i) = 0.94) and internal consistency (alpha = 0.92), while social function scored low (alpha = 0.46). Concurrent validity was significant (r = -0.837, p < 0.001). Significant differences were found between the two groups for pain (p < 0.05), physical function (p < 0.01), social function (p < 0.01), mental function (p < 0.05), and number of fractures (p < 0.001). Discriminatory characteristics between the groups were significant for physical (p < 0.001), social (p < 0.001), and mental (p < 0.02) function. The cultural adaptation of the QUALEFFO was consistent, homogenous, and discriminative. It also showed deterioration in the QOL group of Mexicans with vertebral fractures. The QUALEFFO can be used in a Mexican population to measure the QOL in patients with vertebral fractures after some cultural modifications to take into account local sensibilities.
Assuntos
Osteoporose/complicações , Qualidade de Vida , Inquéritos e Questionários , Idoso , Idoso de 80 Anos ou mais , Estudos de Casos e Controles , Competência Cultural , Feminino , Fraturas Ósseas , Humanos , Entrevistas como Assunto , México , Osteoporose/etnologia , Sensibilidade e Especificidade , Traumatismos da Coluna VertebralRESUMO
An association has been reported between cardiovascular disease (CVD) and osteoporosis, perhaps attributable to the presence of common risk factors. To assess this possibility, we measured areal bone mineral density (BMD) and carotid artery intimal medial thickness (IMT), a measure of preclinical atherosclerosis, in 535 women and 335 men from the San Antonio Family Osteoporosis Study. Variance decomposition methods were used to determine whether cross-sectional measures of areal BMD (measured by dual-energy X-ray absorptiometry) of the total hip, spine, and forearm were correlated with IMT, serum lipids, and/or C-reactive protein (CRP), a marker of inflammation, after accounting for known environmental factors. We observed significant inverse correlations of IMT and BMD at all bone sites in women >60 years of age (P < 0.001) and modest positive correlations (not significant) of IMT on hip BMD (P < 0.1) in women <60 years of age. Similarly, we observed negative correlations between IMT and forearm BMD in men >60 years of age (P < 0.001) and positive correlations in men <60 years of age (P = 0.05). Variation in risk factors for CVD, including serum levels of low- and high-density lipoprotein cholesterol, low-density lipoprotein particle size, triglycerides, paraoxonase 1 activity, and CRP did not account for the relationship between BMD and IMT in either older or younger men or women. In summary, our results demonstrate that decreased BMD is correlated with increased IMT in older (but not younger) Mexican American men and women, independent of serum CVD risk factors.
Assuntos
Arteriosclerose/etnologia , Arteriosclerose/etiologia , Densidade Óssea , Osteoporose/complicações , Osteoporose/etnologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Artérias Carótidas/diagnóstico por imagem , Feminino , Humanos , Masculino , Americanos Mexicanos , Pessoa de Meia-Idade , Osteoporose/diagnóstico por imagem , Radiografia , Fatores de Risco , Texas/epidemiologia , Túnica Íntima/diagnóstico por imagemRESUMO
Osteoporosis in men was not recognized as a major health problem until recently, and increased research in this area resulted in the approval of alendronate for the treatment of osteoporosis in men at the beginning of this decade. Low bone mineral density (BMD) has been demonstrated to be a strong predictor of fracture in men as it is in women. The causes of osteoporosis in men are variable and can be classified as primary or secondary. The aim of these report is to present the response of BMD in 10 Puerto Rican men with secondary causes of osteoporosis treated with alendronate. A significant increase of BMD in spine, total hip, trochanter and intertrochanteric regions were noted. A non-significant increase in femoral neck was observed.