Low bone mineral density and bone mineral content are associated with low cobalamin status in adolescents

Summary Background Cobalamin deficiency is prevalent in vegetarians and has been associated with increased risk of osteoporosis. Aim of the study To examine the association between cobalamin status and bone mineral density in adolescents formerly fed a macrobiotic diet and in their counterparts. Methods In this cross–sectional study bone mineral density (BMD) and bone mineral content (BMC) were determined by DEXA in 73 adolescents (9–15 y) who were fed a macrobiotic diet up to the age of 6 years followed by a lacto–(–ovo–) vegetarian or omnivorous diet. Data from 94 adolescents having consumed an omnivorous diet throughout their lives were used as controls. Serum concentrations of cobalamin, methylmalonic acid (MMA) and homocysteine were measured and calcium intake was assessed by questionnaire. Analysis of covariance (MANCOVA) was performed to calculate adjusted means for vitamin B₁₂ and MMA for low and normal BMC and BMD groups. Results Serum cobalamin concentrations were significantly lower (geometric mean (GM) 246 pmol/L vs. 469 pmol/L) and MMA concentrations were significantly higher (GM 0.27 µmol/L vs. 0.16 µmol/L) in the formerly macrobiotic–fed adolescents compared to their counterparts. In the total study population, after adjusting for height, weight, bone area, percent lean body mass, age, puberty and calcium intake, serum MMA was significantly higher in subjects with a low BMD (p = 0.0003) than in subjects with a normal BMD. Vitamin B₁₂ was significantly lower in the group with low BMD (p = 0.0035) or BMC (p = 0.0038) than in the group with normal BMD or BMC. When analyses were restricted to the group of formerly macrobiotic–fed adolescents, MMA concentration remained higher in the low BMD group compared to the normal BMD group. Conclusion In adolescents, signs of an impaired cobalamin status, as judged by elevated concentrations of methylmalonic acid, were associated with low BMD. This was especially true in adolescents fed a macrobiotic diet during the first years of life, where cobalamin deficiency was more prominent.     

Factors associated with low bone mineral density among white women

OBJECTIVE: To analyze whether the factors causing low bone mineral density among elderly women are the same as those observed in other age groups. METHODS: A cross-sectional study was carried out on the medical records of a random sample of 413 white women seen at an imaging diagnostics service in a city of Southern Brazil, in 2003. Femoral bone mineral densities with adjustment using T-scores were used. The following variables were investigated: age, body mass index, tobacco smoking, alcohol consumption, milk consumption, physical activity and hormone replacement therapy. Univariate and multivariate unconditional logistic regression were used. RESULTS: In the sample, 52.5% were up to 59 years old and 47.5% were 60 or over. The mean bone mineral density was 0.867 g/cm2 (SD=0.151) for the femoral neck. Significant age-adjusted values were obtained for physical activity (adjusted OR=0.47; 95% CI: 0.23;0.97), body mass index greater than or equal to 30.0 kg/m2 (adjusted OR=0.10; 95% CI: 0.05;0.21), alcohol consumption (adjusted OR=7.90; 95% CI: 2.17;28.75), low milk consumption (adjusted OR=3.29; 95% CI: 1.91;5.68) and hormone replacement (adjusted OR = 0.44; 95% CI: 0.21;0.90). Among the elderly women, body mass, milk consumption and physical activity were independent protection factors. CONCLUSIONS: Advanced age, body mass, physical activity, milk and alcohol consumption were important factors in bone mass regulation. The influence of behavioral factors was maintained among the women of advanced aged, thus reinforcing the role of preventive measures in medical practice and public health promotion policies aimed at healthy aging.     

Correlation between bone mineral density and body composition in Japanese females aged 18–40 years with low forearm bone mineral density

Objectives  To clarify the relationship between bone mineral density (BMD) and body composition in Japanese women aged 18–40 years with low forearm BMD. Methods  The subjects were Japanese199 women who had been selected for inclusion in the study based on a low forearm BMD determined at the Annual Women’s Health Examination. The subjects’ mean (± standard deviation) age, body height, body weight, and body mass index (BMI) were 33.5 (±4.3) years, 158.1 (±5.1) cm, 49.6 (±5.7) kg, and 19.8 (±2.1), respectively. The BMD of the lumbar spine, total body, and left arm were measured using dual-energy X-ray absorptiometry (DXA). Fat mass (FM), bone-free lean tissue mass (LTM), and body fat percentage (BF%) were measured simultaneously with DXA. Results  In the structural equation model, the standardized regression weights for the path from BMI to BMD of all sites were 0.273–0.434. Conversely, the BF% to BMD of the total body and left arm were −0.192 and −0.296, respectively. In multiple regression analysis, the FM index (FMI) was significantly associated with the BMD of the lumbar spine as a weight-bearing site. The LTM index (LTMI) was significantly associated with the BMD of the total body and left arm as a non-weight-bearing site. Conclusions  Young females with low forearm BMD had low body weight and BMI. Thinness was shown to be a risk factor for low BMD, in accordance with results reported elsewhere. A gain in body weight may have the effect of increasing BMD, but our results suggest that to increase BMD, the gain in body weight must include increases in LTM, and not FM alone.     

Prevalence and risk factors for low bone mineral density in antiretroviral therapy-naive HIV-infected young men

Objective

We aimed to investigate the prevalence of low bone mineral density (BMD) and associated factors in antiretroviral therapy (ART)-naive HIV-infected young men.

Risk factors for low bone mineral density among a large group of Norwegian women with fractures

The objectives of this study were to determine factors related to fractures and bone mineral density (BMD) in a large group of Norwegian women. In a cross-sectional study, 3803 women aged 50–75, all with a history of fractures, were included in the study. BMD was measured with Dual energy X-ray absorptiometry at both hip (neck) and spine (L1–L4), while information on other factors thought to influence BMD were obtained through a questionnaire. In multivariate analysis, the strongest positive predictor of both hip and spine BMD was current body weight, while weight loss since the age of 25 and number of years since menopause were the strongest inverse predictors. In addition, use of cortisone and maternal history of fractures were associated with lower BMD, as was loss of height since the age of 25. Physical activity was positively correlated with BMD. These results show the complexity of factors involved in the etiology of osteoporosis, with several factors acting in synergism. This points to the need for multifactorial prevention strategies, which most effectively need to be instituted at an early age, before peak bone mass is achieved.     

Dihydrophylloquinone intake is associated with low bone mineral density in men and women

BACKGROUND: Poor diet may affect bone status by displacing nutrients involved in bone health. Dihydrophylloquinone, a form of vitamin K present in foods made with partially hydrogenated fat, is a potential marker of a low-quality dietary pattern. OBJECTIVE: Our objective was to examine the cross-sectional associations between dihydrophylloquinone intake and bone mineral density (BMD) of the hip and spine in men and women. DESIGN: Dihydrophylloquinone intake was estimated with a food-frequency questionnaire, and BMD (in g/cm(2)) was measured by dual-energy X-ray absorptiometry in 2544 men and women (mean age: 58.5 y) who had participated in the Framingham Offspring Study. General linear models were used to examine the associations between dihydrophylloquinone intake (in tertiles: <15.5, 15.5-29.5, and >29.5 microg/d) and hip and spine BMD after adjustment for age, body mass index, energy intake, calcium intake, vitamin D intake, smoking status, physical activity score, and, for women, menopause status and estrogen use. RESULTS: Higher dihydrophylloquinone intakes were associated with lower mean BMD at the femoral neck [lowest-to-highest tertiles (95% CI): 0.934 (0.925, 0.942), 0.927 (0.919, 0.935), and 0.917 (0.908, 0.926), P for trend = 0.02], the trochanter [lowest-to-highest tertiles (95% CI): 0.811 (0.802, 0.820), 0.805 (0.797, 0.813), and 0.795 (0.786, 0.804), P for trend = 0.02], and the spine [lowest-to-highest tertiles (95% CI): 1.250 (1.236, 1.264), 1.243 (1.242, 1.229), and 1.227 (1.213, 1.242), P for trend = 0.03] in men and women after adjustment for the covariates. Further adjustment for markers of healthy and low-quality dietary patterns did not affect the observed associations. CONCLUSIONS: Higher dihydrophylloquinone intakes are associated with lower BMD in men and women. This association remains significant after adjustment for other markers of diet quality.     

Cost effectiveness of different recruitment strategies for self-help smoking cessation programs

The Pawtucket Heart Health Program has used a variety of recruitmentstrategies to enhance participation in its smokingcessationprograms. The current report provides cost effectiveness datafor worksites and for a major community event (Octoberfest)in terms of participants recruited and successful quit ratesfor five annual community-wide smoking cessation campaigns beginningin 1983. Adapted from the Quit and Win contest developed bythe Minnesota Heart Health Program, these campaigns relied primarilyupon a short but intensive recruitment effort for a smokingcessation program based on self-help strategies. The winnerwas determined by a lottery drawing that included the namesof all those who had successfully abstained from smoking fora 1-month period. Even though only one component of PHHP's diverseefforts to affect the smoking rates of Pawtucket, the contestapproach appears to be one of the best suited for large-scaleadoption. The data clearly indicate that while the cost perparticipant is much less for recruitment during a large publicevent, the cost per quitter was much less for worksites. Also,while the cost per quitter at worksites is important, focused‘staff’ involvement appears to be important bothin the recruitment of worksites for participation and in guidingthe volunteers from worksites in their recruitment efforts.     

Depot medroxyprogesterone and bone mineral density

OBJECTIVE: To investigate depot medroxyprogesterone (DMPA)-associated bone loss in a general practice setting. DESIGN: Forty-eight patients from a single practice who had used DMPA for contraception for more than 2 years. All patients had a serum oestradiol and if the serum level was <52 pmol/l or >52 pmol/l with menopausal symptoms, bone mineral densitometry (BMD) measurements were made at the lumbar spine (LS) and femoral neck (FN) using dual-energy x-ray absorptiometry (DEXA). Thirty-two patients had bone densitometry, of whom 27 had a serum oestradiol <52 pmol/l and five >52 pmol/l associated with menopausal symptoms. Of the remaining 16 patients, nine patients had a serum oestradiol <52 pmol/l but did not have a BMD as they moved away (five women) or switched to another contraceptive (four women). RESULTS: BMD results showed a significantly reduced bone mass at both sites with mean Z score LS -0.84 (95% CI -1.17 to -0.52) and FN -0.32 (95% CI -0.62 to -0.02). Eighteen women (56% of 32 women) had either osteopenia (15 cases) (T score < -1.0) or osteoporosis (three cases) (T score < -2.5) at the LS. There were trends to an association of a family history of height loss or tobacco smoking (current or past) for LS and FN Z scores that did not quite achieve significance. There was also a trend to lower body weight in those with a possible family history of osteoporosis or who were smokers and an inverse correlation of weight with BMD at the FN (p < 0.05) and a non-significant inverse correlation at the LS. CONCLUSION: The present results demonstrate that a low bone mass should be considered in patients with prolonged DMPA usage especially if they have risk factors for osteoporosis.     

Cost effectiveness of cervical cancer screening strategies in Tunisia

Cervical cancer is a public health problem in developing countries and is the first cancer among women in several of these countries. Screening using the Pap test is the principle control strategy for this cancer. The aim of this study is to identify the highest cost-effectiveness strategy of Pap test screening, according to age group (20-64 years, 35-64 years and 40-64 years) and the frequency of this test (every 3 years or every 5 years). Number of cases avoid by screening and mean cost to prevent one case were used to compare these screening strategies. The principles results showed that the number of cervical cancer cases avoid increase with the coverage level of the screening and age group size, and decrease with the frequency of the Pap tests. The screening strategy interesting age group "40-64 years" every 5 years observed the highest cost-effectiveness ratio (19 MD); however cost is 23 MD for age grovy 35-64 years. These results lead to choice a frequency of Pap tests every 5 years. However, for determination of age group, other factors, as psycho-social ones, should be taken into account besides economic criterias.     

Lead exposure and spine bone mineral density

OBJECTIVE: The purpose of this study was to assess changes in spine BMD over time in relation to changes in bone and blood lead levels and baseline risk factors among female former smelter workers in Bunker Hill, Idaho. METHODS: Spine BMD was measured using Norland XR-26 X-Ray bone densitometer. Cd109 K XRF system was used to estimate tibia bone lead content. Blood lead levels were analyzed using graphite furnace atomic absorption with Zeeman effect background correction. Information about risk factors was obtained through a questionnaire. RESULTS: In the final backward stepwise multivariate regression model after controlling for baseline BMD, baseline blood lead measured in 1994 and time since menopause; spine bone density in 2000 decreased with increasing blood lead levels in 2000 in all these women, especially if they worked in a technical job (miner) most of the time at the smelter. CONCLUSIONS: Blood lead may adversely affect bone mineral density.     

Cadmium and lead in blood in relation to low bone mineral density and tubular proteinuria

Long-term exposure to cadmium may cause kidney and bone damage. Urinary cadmium is commonly used as the dose estimate for the body burden of cadmium. However, elevated levels of cadmium in the urine may reflect not only high levels of cadmium dose but also renal dysfunction. In this study we used blood cadmium as the dose estimate. In addition, we analyzed blood lead. We examined 479 men and 542 women, ages 16-81 years, who were environmentally or occupationally exposed to cadmium and lead. We used urinary protein alpha 1-microglobulin as a marker for tubular proteinuria and measured forearm bone mineral density using dual-energy X-ray absorptiometry. The relationship between blood cadmium and tubular proteinuria was strong, even when we excluded occupationally exposed participants. The subgroup with the highest blood cadmium levels had a 4-fold risk of tubular proteinuria compared to the subgroup with the lowest blood cadmium levels. In the older age group (age > 60), the risk of low bone mineral density (z-score < -1) for the subgroup with the highest blood cadmium levels was almost 3-fold compared to the group with lowest blood cadmium levels. We found no similar associations for lead. The observed effects may be caused by higher cadmium exposure in the past. This study strengthens previous evidence that cadmium exposure may affect both bone mineral density and kidney function.     

妊娠期糖尿病母亲新生儿低骨密度危险因素分析及相关模型构建

目的 探究影响妊娠期糖尿病(gestational diabetes mellitus,GDM)母亲新生儿低骨密度的危险因素,并构建预测模型.方法 选取2017年1月至2019年12月在广西壮族自治区江滨医院进行产检与分娩的200例GDM孕妇及其所产新生儿作为研究对象,根据新生儿是否出现低骨密度分为低骨密度组(50例)...     

女性人群骨密度分布描述及其预测模型的研究

目的通过了解农村地区成年女性人群骨矿物质密度随年龄的变化趋势及年龄、身高、体重、绝经年限对骨密度的独立作用,建立骨密度的预测模型。方法根据统一的问卷收集了3008对农村女性双生子的人口学特征及环境资料,利用美国Norland公司生产的外周双能X光吸收骨密度仪(pDXA)测定腰椎、髋部及前臂近端桡骨骨密度。采用SAS6·12软件包及SPLUS进行数据分析。结果研究的结局变量为腰椎、股骨颈、股骨三角区、大转子、手臂骨及全身骨6个部位的骨密度。不同部位的骨密度值在年龄上的分布趋势类似,但它们达到骨峰值的年龄及骨丢失上存在着区别:以小梁骨为主要成份的骨密度达骨峰值年龄较早,并先出现骨丢失,骨丢失率较高;年龄、绝经年限、身高、体重在整个年龄段中对骨密度的独立作用不呈线性关系;将人群分成3个年龄段,建立年龄、绝经年限、身高及体重对各部位的预测模型,经检验,这些预测模型所获得的估计值与实际值较为接近。结论预测模型能较好地利用一些易测量的指标来预测个体的骨密度值,为中国农村地区女性人群的骨质疏松症诊断提供了简便的手段。     

Investigation of the relationship between low environmental exposure to metals and bone mineral density,bone resorption and renal function

Environmental exposure to metals has been linked to adverse health outcomes. Exposure to cadmium has been associated with decreased bone density, an increased risk of osteoporotic fracture and possible renal dysfunction. Older women are a group at risk of renal and bone density impacts and exposure to metals may be an important risk factor for these health outcomes. This study was a cross sectional study of 77 women aged 50 years and above examining the relationship between metals exposure and renal and bone health. Urinary and blood metals concentrations, plasma creatinine, iron, ferritin and transferrin were measured in these subjects. Bone biomarkers assessed included the pyridinium crosslinks, pyridinoline and deoxypyridinoline measured by ELISA. Renal function was assessed using eGFR and KIM-1. Whole body, hip and lumbar spine bone mineral density was assessed using DEXA. Blood and urinary metals concentrations were generally low in the subjects, with a median urinary cadmium concentration of 0.26 μg/g creatinine (range <0.065–1.03 μg/g). Urinary cadmium was found to be a significant predictor of bone mineral density at whole body, lumber spine, total hip and femoral neck, with increasing urinary Cd concentrations associated with decreased bone density. Urinary cadmium and aluminium concentrations were positively correlated with bone resorption whilst blood zinc and mercury concentrations were negatively correlated. Urinary aluminium was positively correlated with KIM-1 concentrations, a marker of early kidney damage, however blood zinc concentrations were significantly negatively correlated with this biomarker. This study provides additional support for low cadmium exposure being of concern for the health of older women. Further investigation into the role of exposure to other metals on bone and renal health is warranted.     

原发性高血压与骨密度的关系

目的:探讨原发性高血压与骨密度的关系.方法:选取122例受试者者,将其分为对照组(60例)和高血压组(62例),两组患者分别接受体重、身高、腰围、臀围的测量,同时接受双能x线骨密度仪检测,得到骨矿含量、骨密度及T值、Z值.结果:在纠正年龄、体重、身高、BMI、腰围、臀围等影响后,收缩压与骨密度呈正相关,舒张压与骨密度无关.结论:收缩压与骨密度呈正相关,舒张压与骨密度无关,考虑控制血压有助于高血压患者的骨质疏松症的防治.     

Long-term depot-medroxyprogesterone acetate and bone mineral density.

The association between long-term use of depot-medroxyprogesterone acetate (DMPA) and bone mineral density (BMD) has been controversial, as seen in three case-control studies in New Zealand, Thailand, and the United Kingdom. In the present case-controlled study of BMD, a group of 67 Chinese women who had used DMPA from 5-15 years was compared with 218 women of the same age range who had not used any steroidal hormones. DMPA users were found to have a significantly lower BMD at lumbar vertebra (L2-4) (0.93 g/cm2), neck of femur (0.69 g/cm2), trochanter (0.59 g/cm2), and Ward's triangle (0.58 g/cm2), as compared with the control group, whose corresponding BMD values were 1.03 g/cm2, 0.83 g/cm2, 0.71 g/cm2, and 0.78 g/cm2, respectively (p < 0.001). The average percentage of bone loss per year was estimated to be 1.1% in L2-4, 2.3% in neck of femur, 2.4% in trochanter, and 3.5% in Ward's triangle. The percentage of bone loss in L2-4 was found to be more pronounced with age. This study provided information that the use of DMPA in a Chinese group for > 5 years in associated with bone loss, and a prospective study is needed to confirm these data, which are different from two case-control studies.