Association of dyslipidaemia with osteoporosis in postmenopausal women

ObjectiveTo assess the association of dyslipidaemia with osteoporosis in postmenopausal women.MethodsData from 160 postmenopausal women with newly diagnosed osteoporosis (osteoporosis group) and 156 healthy controls (control group) were retrospectively reviewed from 2016 to 2020. The primary outcomes were laboratory values assessed by a multivariate binary logistic regression model.ResultsFactors that greatly increased the risk of being in the osteoporosis group included high low-density lipoprotein (LDL) and low high-density lipoprotein (HDL) levels. The osteoporosis group had lower HDL and higher LDL levels than the control group. A multivariate binary logistic regression model showed that lower HDL and higher LDL levels were the only variables that were significantly associated with osteoporosis (odds ratio 1.86, 95% confidence interval: 3.66–4.25 and odds ratio 1.47, 95% confidence interval: 1.25–2.74, respectively).ConclusionLow HDL and high LDL levels may be associated with the occurrence of osteoporosis in postmenopausal women.     

绝经女性骨质疏松的运动干预

目的:通过大量文献研究,阐述运动预防绝经后骨质疏松的依据和影响运动疗效的因素,对女子骨质疏松实施运动干预提供参考性建议。资料来源:运用计算机检索“中国期刊全文数据库”1994-01/2004-04期间相关文献,检索词为“骨质疏松”、“绝经后骨质疏松”、“骨密度”,“运动”等。资料选择:对资料进行初审,选择关于绝经后骨质疏松的运动干预方面的文献。并查找全文,然后筛除重复研究。资料提炼:共收集到19篇关于绝经后骨质疏松的运动干预方面的文献,他们的实验都针对绝经期妇女采用运动疗法,通过骨密度测量来评价运动干预对预防骨质疏松的效果。资料综合:运动干预是预防女子绝经后骨质疏松的最积极办法。运动的最佳方式是力量训练、快走、健身跑、游泳等中等强度有氧运动;运动干预时间至少在一年以上;运动干预的敏感年龄是绝经后最初几年;运动干预效果与女子体成分、瘦体质量等呈高度相关。测量仪器及测量的部位的选择会影响运动干预效果的评价。结论:长期从事有氧运动是绝经后女子骨质疏松干预的最积极疗法,但其疗效受许多因素影响。     

Evaluating the possible association between systemic osteoporosis and periodontal disease progression in postmenopausal women

To evaluate the association between systemic osteoporosis and periodontal diseases in postmenopausal women. A total of 300 women aged (50–70 years) were divided into an osteoporotic (OP) group (n = 150) and non-osteoporotic (NOP) group (n = 150) depending on BMD measured using (DXA) at the femoral neck and lumbar spine. Periodontal examination including PI, GI, PPD, and CAL was measured. A standard digital dental panoramic radiograph was taken for each patient and analyzed using specially developed software graphic program to assess the alveolar bone level and BMD. Elemental analysis of root surfaces of extracted teeth was done for detecting Ca, P, F, Mg, and K using (LIBS). Results showed the differences between both groups were not statistically significant in PI, GI, and PPD. A statistically significant difference was found between both groups in CAL, the distance between CEJ-AC and alveolar bone density. Elemental analysis of the root surfaces revealed that Ca was statistically significantly less in the OP group while the differences between both groups regarding F and P were not statistically significant. Mg and K found to be significantly more in the OP group than in the NOP group. To conclude osteoporosis is certainly a risk factor for periodontal disease and seems to plays a vital role in disease progression.     

Serum interleukin-18 concentrations in patients with inflammatory bowel disease

Elevated expression of interleukin (IL)-18 mRNA and protein in intestinal mucosa, attributable to activated monocytes and macrophages in that site, has been reported in patients with inflammatory bowel disease (IBD). However, changes in serum IL-18 concentrations in patients with IBD have not been reported. We measured bioactive IL-18 in serum from patients with IBD, using an enzyme-linked immunosorbent assay (ELISA). Mean serum IL-18 concentrations in 5 patients with Crohn disease (CD) were 400 pg/mL, approximately 1.7 times higher than concentrations in 21 control subjects (p < 0.01). However, serum IL-18 was not increased in patients with ulcerative colitis (UC). These results suggest that like other T-helper type 1 (Th1) cytokines IL-18 may play a key pathogenetic role in Th1-mediated disorders, such as CD. Regulation and expression of IL-18 appears to differ between CD and UC, and serum IL-18 may be a useful clinical marker for CD.     

Serum ionic fluoride concentrations are significantly decreased after treatment with alendronate in patients with osteoporosis

BackgroundWe determined serum ionic fluoride (SIF) concentrations before and after treatment of osteoporosis with alendronate to clarify whether SIF concentrations directly reflect a change in bone metabolism.MethodsA total of 45 postmenopausal women with primary osteoporosis who were treated with alendronate over a 6-month period were enrolled (mean age, 64.2 years). SIF concentrations were measured by the flow injection method with an ion-selective electrode. Concentrations of bone turnover markers (serum bone alkaline phosphatase, serum osteocalcin, serum type I collagen cross-linked N-telopeptide and urinary deoxypryridinoline) and lumbar spine BMD (LsBMD) were also measured. SIF, bone turnover markers and LsBMD before and after treatment were compared.ResultsConcentrations of SIF as well as concentrations of all bone turnover markers were significantly decreased after treatment: means (standard deviations) before and after treatment were 0.62 (0.13) and 0.32 (0.09) μmol/l, respectively (P < 0.001) and the percent change was ? 46.3%. LsBMD was also significantly increased by 6.7% after treatment.ConclusionsThe reduction of SIF concentrations is probably caused by inhibition of bone resorption due to the action of alendronate. The findings suggest that SIF concentrations directly reflect a change in bone metabolism.     

Association between moderate physical activity,spinal motion and back muscle strength in postmenopausal women with and without osteoporosis

Objective. The purpose of this study was to determine whether physical activity levels of postmenopausal women were associated with their bone mineral density (BMD), back extensor strength (BES), severity of thoracic kyphosis and range of spinal motion.

Method. This study adopted a cross-sectional design. 189 female subjects from 50 to 80 years of age were divided into moderately active (n = 63) and sedentary (n = 126) groups according to their physical activity level, which is measured by the physical activity score. BMD (lumbar spine and hip), BES, severity of thoracic kyphosis and range of spinal motion in the sagittal and frontal plane were measured in each subject.

Results. The groups differed significantly in the range of spinal motion in the sagittal plane (p = 0.01) (moderately active: 26.9±10.8; sedentary: 23.0±10.2), as well as in the right frontal plane (p < 0.001) (moderately active: 27.1 ± 6.4; sedentary: 23.4 ± 7.5) and left frontal plane (p < 0.001) (moderately active: 27.6 ± 6.5; sedentary 23.7 ± 7.4). There were no significant differences in BMD (active: 0.88 ± 0.18 g/cm²; sedentary: 0.98 ± 0.15 g/cm²), severity of thoracic kyphosis (active: 52.9 ± 12.4; sedentary: 51.9 ± 11.8) or BES (active: 49.0 N ± 14.6; sedentary: 46.6 N ± 15.1).

Conclusions. This study demonstrates that active women had better range of spinal motion than sedentary women, but they did not differ significantly in severity of thoracic kyphosis, BES and BMD.     

Structural model for osteoporosis preventing behavior in postmenopausal women

BACKGROUND: Osteoporosis prevention behaviors (OPBs) can prevent and delay bone deterioration; dual-energy X-ray absorptiometry (DXA) scan can identify osteoporosis and provide personal osteoporosis risk information that may promote prevention behaviors. OBJECTIVES: This study was designed to estimate relationships between receiving personal knowledge of bone mineral density (gained through DXA scan), general knowledge of osteoporosis, health beliefs, and the two OPBs of calcium intake and weight-bearing exercise in healthy postmenopausal women 50 to 65 years. METHODS: In this longitudinal, randomized clinical trial (including covariates), receipt of personal DXA information was manipulated by random assignment to the experimental or control group. The remaining antecedent and outcome variable measures were collected by questionnaire at three time points (initial [T1; pre-DXA], 6 months [T2], 12 months [T3]) and by bone density assessment from 203 women over an 18-month period in 2001-2003. RESULTS: The experimental manipulation (DXA results) had a direct positive effect (beta = .23, p < .05) on calcium intake at T2, and indirectly at T3 through T2. Women in the experimental group who were informed they had osteopenia or osteoporosis had a greater T1-T2 change in daily calcium intake than those with normal bone density (beta = .23, p < .05). However, providing DXA results did not relate to change in exercise. Health beliefs and general osteoporosis knowledge predicted initial calcium and exercise levels; there was tentative evidence that susceptibility beliefs partially mediate between DXA results and change in calcium intake. DISCUSSION: Personal knowledge of DXA results was related significantly to increases in calcium intake in postmenopausal women, but not to exercise. Directions for further study are discussed.     

绝经后2型糖尿病女性骨质疏松与胱抑素C的关系

目的 探讨绝经后2型糖尿病女性骨质疏松(OP)与血清胱抑素C(cysC)的关系.方法 应用免疫放射比浊法测定cysC,并根据Coekcroft-Gault公式推算出的肾小球滤过率(GFR),85例绝经后2型糖尿病女性分为骨质疏松(OP)组与非骨质疏松(non-OP)组,比较尿素氮(BUN)、肌酐(Cr)、尿白蛋白/肌酐(ACR)、GFR等指标;将骨密度(BMD)与上述指标进行pearson相关分析;根据 GFR将85例患者从高到低分为三组,比较三组的骨密度及OP患病率.结果 OP组较non-OP组Cr、ACR高(P＜0.05或P＜0.01),GFR低(P＜0.01),BMD与GFR正相关.双侧股骨BMD (F=3.454,P＜0.05)及OP患病率(x2=9.435,P＜0.05)在不同GFR水平上的差异有统计学意义.结论 绝经后2型糖尿病女性可应用cysC的测定,及早发现肾功能的下降,以便对骨质疏松进行及早的预防和干预.     

Fecal levels of leukocyte markers reflect disease activity in patients with ulcerative colitis

OBJECTIVE: A prominent feature of inflammatory bowel disease (IBD) is the presence of inflammatory cells in the gut mucosa, and which contribute to the ongoing inflammatory process. The aim of the study was to evaluate fecal neutrophil, eosinophil, mast cell and macrophage markers in the assessment of disease activity in patients with ulcerative colitis (UC). METHODS: Twenty-eight patients with active UC; 4 with proctitis, 16 with left-side colitis and 8 with total colitis, were included in the study. Patient history, endoscopy and histopathology were examined and fecal and serum samples were evaluated at inclusion and after 4 and 8 weeks of treatment. Fecal samples were analysed for myeloperoxidase (MPO), eosinophil protein X (EPX), mast cell tryptase, IL-1beta and TNF-alpha using immunoassays. Blood samples were analysed for MPO, EPX, C-reactive protein, orosomucoid and leucocyte counts. RESULTS: Fecal MPO and IL-1beta levels were elevated in all patients at inclusion despite different disease extensions. Striking reductions in fecal levels of MPO, EPX, tryptase and IL-1beta were observed after 4 weeks of treatment in 20/28 patients with complete remission after 8 weeks. No further reductions were seen in 20/27 patients at 8 weeks. Endoscopic score correlated to IL-1beta at all visits (p<0.01), to MPO at visits 2 and 3 (p<0.05, p<0.001), EPX at visit 2 (p<0.05) and tryptase at visit 3 (p<0.01). Levels of fecal markers also related to histological indices of the disease. CONCLUSIONS: Measurements of fecal MPO, EPX and IL-1beta could be objective complements to endoscopical and histopathological evaluations in the daily care of patients with UC.     

Determinants of persistence with bisphosphonates: a study in women with postmenopausal osteoporosis

BACKGROUND: Although bisphosphonates are useful in the management of osteoporosis, patients often discontinue treatment. OBJECTIVES: The aims of this study were to investigate persistence with bisphosphonates, and to assess whether the dose interval influenced persistence, among women with postmenopausal osteoporosis. METHODS: Data were obtained from the PHARMO Record Linkage System, which includes, among other databases, drug-dispensing records from community pharmacies linked to hospital discharge records of > 1 million subjects in defined areas in The Netherlands. Women who were new users of alendronate (daily or weekly), etidronate (daily), or risedronate (daily) during the period from January 2000 through September 2003 were eligible for inclusion in the study if they were aged > or = 55 years or had been hospitalized for a menopausal disorder. One-year rates of persistence with treatment (defined as the percentage of patients who used the drug for > or = 365 days without failure to continue renewals) were determined by using episodes of bisphosphonate treatment. The association between persistence and dose intervals, type of bisphosphonate, and other determinants (including age, occurrence of gastrointestinal adverse events as measured by use of concomitant medications [eg, antacids, proton pump inhibitors, histamine2 (H2)-receptor antagonists, misoprostol, laxatives, antidiarrheals, bowel motility enhancers] and fractures) was assessed. To study whether persistence with bisphosphonates was associated with the former use of other antiosteoporosis medication or the presence of drug-induced osteoporosis, the use of hormone replacement therapy, raloxifene, and systemic corticosteroids in the 6 months before the index date were included as determinants. RESULTS: The study sample included 2124 women who were new users of bisphosphonates. The mean (SD) age of the study population was 71.6 (8.7) years. After 1 year, 51.9% of weekly alendronate users and 30.1% to 42.2% of daily bisphosphonate users were persistent. In the multivariate analysis (which included age, concomitant medication, and fractures), patients using alendronate weekly were significantly more likely to persist than those using alendronate daily (relative risk [RR], 1.56 [95% CI, 1.32-1.85]). The likelihood of persistence was similar among those who used the daily regimens of risedronate, etidronate, and alendronate. The occurrence of gastrointestinal adverse events was associated with decreased persistence with bisphosphonates (H2)-receptor antagonists: RR, 0.71 [95% CI, 0.53-0.94]; bowel motility enhancers: RR, 0.78 [95% CI, 0.65-0.94]). CONCLUSIONS: In this study, dose interval and the occurrence of gastrointestinal adverse events were independent determinants of persistence with bisphosphonate therapy. Although the likelihood of persistence with bisphosphonate use was significantly higher among those who used a less frequently administered regimen, persistence rates were still suboptimal.     

全身振动对绝经后骨质疏松症患者细胞因子的影响

目的探讨全身振动对绝经后骨质疏松症患者细胞因子水平的影响。方法采用随机对照研究,70例入选的绝经后骨质疏松症志愿者随机分为振动组(n=35)和对照组(n=35)。两组受试者每日均服用钙尔奇D600mg。振动组:应用频率为30Hz的振动治疗仪,3次/周,10min/次,共12周振动干预;对照组仅服用相同剂量的钙尔奇D。观察两组患者干预前后腰椎骨密度(BMD)、疼痛程度和血清内IL-1β、TNF-α和IGF-1的变化。结果与干预前相比,振动组和对照组患者的腰椎BMD均有显著上升[(0.797±0.074)g/cm2vs.(0.734±0.071)g/cm2,(0.802±0.073)g/cm2vs.(0.740±0.064)g/cm2,均P<0.05],骨痛症状均有明显改善,但是振动组BMD的提高及骨痛的改善更为明显(与对照组相比,P<0.05);振动干预后患者血清内IL-1β和TNF-α显著降低[(15.9±4.4)ng/Lvs.(10.1±3.8)ng/L,(165.4±20.6)ng/Lvs.(82.5±18.6)ng/L,均P<0.05],IGF-1显著增高[(96.5±17.2)μg/Lvs.(178.3±22.5)μg/L,P<0.05];对照组实验前后三者均无显著变化。结论 30Hz全身振动具有防治绝经后骨质疏松症的作用,其机制可能与其下调IL-1β、TNF-α水平,上调IGF-1水平有关。