Factors Associated with the Treatment of Osteoporosis in Korean Postmenopausal Women

This retrospective study was designed to investigate the treatment rate of osteopenia and osteoporosis after diagnosis and determine factors related to osteoporosis treatment in Korea. This analysis included postmenopausal women who had visited the health promotion center from March 2010 to May 2011 (n = 375) and been diagnosed with osteoporosis (19.5%) or osteopenia (45.9%). Telephone surveys were performed one year after diagnosis. We employed multiple logistic regression to determine factors associated with treatment using clinical risk factors as covariates in a FRAX model. Receipt of osteoporosis treatment (nutrition, exercise, and medications) to prevent osteoporotic fracture was reported by 108 of 172 (63.4%) women with osteopenia and 66 of 73 (90.4%) with osteoporosis. Only consultation with a doctor for osteopenia or osteoporosis was significantly related to receiving osteoporosis treatment for osteopenia (odds ratio [OR], 5.01; 95% confidence interval [CI], 2.01–12.00) and osteoporosis (OR, 4.91; 95% CI, 1.16–20.75). In the osteopenic group, increased age, being a current smoker, having a history of parental fracture or previous fracture, and secondary osteoporosis were related to consultation with a doctor. Of women with osteopenia 36.6% and 64.4% with osteoporosis received consultation with a doctor. Consultation with a doctor for osteopenia or osteoporosis after being diagnosed could be an effective strategy to increase osteoporosis treatment.     

骨质疏松症患者的心理、社会因素影响及干预措施

骨质疏松症在近 10年被认为是重要的影响公众健康的疾病。以相应性别的年轻健康人作为正常骨密度的标准 ,骨密度与骨体积相比 ,若平均低于两个标准差以上 ,可诊断为骨质疏松症[1] 。骨质疏松在骨质丢失早期往往无任何症状 ,不容易被发现。严重的骨质疏松症要导致椎骨、髋骨、腕骨、肱骨、胫骨骨折。骨质疏松症与年龄因素密切相关 ,男女均可患病 ,但绝经后妇女骨钙的丧失会明显增加。心理、社会影响因素1 绝经期生理、心理的变化　许多中年妇女对年龄增长有惧怕心理。这种细微的心理变化发生在 3 5岁至 40岁左右 ,绝经期时达到顶点。绝经不仅…     

Dietary Patterns and Osteoporosis Risk in Postmenopausal Korean Women

ObjectivesThe prevalence of osteoporosis and related fractures has increased rapidly in Korean women. Proper nutrition intake is associated with the prevention of osteoporosis. We analyzed the association between dietary patterns and the risk of osteoporosis during a 4-year follow-up in postmenopausal Korean women.MethodsPostmenopausal women (n = 1,725) who participated in the Korean Genome and Epidemiology Study were enrolled. Food intake was assessed using a validated semiquantitative food frequency questionnaire, and a quantitative ultrasound device was used to measure the speed of sound at the radius and tibia.ResultsThree major dietary patterns were identified using factor analysis based on baseline intake data: traditional (high intake of rice, kimchi, and vegetables), dairy (high intake of milk, dairy products, and green tea), and western (high intake of sugar, fat, and bread). Multivariate Cox proportional hazards models were used to estimate relative risk for osteoporosis. An inverse association was detected between the dairy dietary pattern and the osteoporosis incidence [relative risk (RR): 0.63, 95% confidence interval (CI): 0.42–0.93, p-trend = 0.055 in radius; RR: 0.56, 95% CI: 0.35–0.90, p-trend = 0.048 in tibia]. Individuals in the highest quintile for the traditional dietary pattern (p-trend = 0.009 in tibia) and western dietary pattern (p-trend = 0.043 in radius) demonstrated a higher risk of osteoporosis incidence than those in the lowest quintile.ConclusionThese results suggested that high consumption of milk, dairy products, and green tea may reduce the risk of osteoporosis in postmenopausal Korean women.     

Education and Phone Follow-Up in Postmenopausal Women at Risk for Osteoporosis

Introduction

Postmenopausal osteoporosis remains a substantially underdiagnosed and undertreated disease. There is a lack of knowledge among older individuals of the appropriate measures to slow or prevent bone mineral density (BMD) loss, particularly in regard to their own personal risk of osteoporosis. Bone densitometry combined with education about osteoporosis improves self-reported daily calcium intake and utilization of hormone replacement therapy (HRT). This prospective unblinded randomized controlled trial was undertaken to determine the effect of nurse education plus follow-up phone care on initiation of and persistence with antiresorptive drug therapy, increases in calcium intake, and increases in weight-bearing exercise in postmenopausal women at high risk for osteoporosis, independent of bone densitometry testing.

Methods

The target study population was female patients of a large, multispecialty community practice aged ≥50 years. Study participants were not on HRT or antiresorptive drug therapy, were ≥5 years post menopause, had a score of ≥8 on the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire. A total of 310 patients were enrolled and 287 (92.9%) completed the study. Participants underwent bone densitometry at study entry. They were then randomly assigned to one of two groups: (i) the usual care group who were given two educational brochures regarding osteoporosis; and (ii) the nurse education group who received these brochures plus a 15 minute one-on-one education regarding osteoporosis with a nurse. Both groups were told to follow up with their primary care physician. Those receiving nurse education also had telephone follow-up with the nurse educator at 3, 6, and 9 months. Telephone surveys of all participants were performed at 12 months after bone densitometry to assess self-reported initiation of and persistence with antiresorptive drug therapy after bone densitometry, self-reported changes in calcium intake, and weight-bearing exercise habits.

Results

Nurse education plus phone care follow-up had no effect on commencement of antiresorptive drug therapy (odds ratio [OR] 1.18, 95% CI 0.69, 2.04) or persistence with antiresorptive drug therapy (OR 1.05, 95% CI 0.56, 1.97). Nurse education plus phone care follow-up was associated with improved self-reported calcium intake (OR 2.18, 95% CI 1.36, 3.49) and exercise frequency (OR 1.89, 95% CI 1.11, 3.21).

Conclusion

Nurse education plus follow-up phone care does not improve utilization of drug therapy to prevent BMD loss or osteoporotic fracture, although it does improve the use of nonpharmacologic preventive measures for osteoporosis. Other strategies beyond patient education and follow-up phone care will be required to increase appropriate utilization of osteoporosis drug therapy.

     

Botanicals in Postmenopausal Osteoporosis

Osteoporosis is a systemic bone disease characterized by reduced bone mass and the deterioration of bone microarchitecture leading to bone fragility and an increased risk of fractures. Conventional anti-osteoporotic pharmaceutics are effective in the treatment and prophylaxis of osteoporosis, however they are associated with various side effects that push many women into seeking botanicals as an alternative therapy. Traditional folk medicine is a rich source of bioactive compounds waiting for discovery and investigation that might be used in those patients, and therefore botanicals have recently received increasing attention. The aim of this review of literature is to present the comprehensive information about plant-derived compounds that might be used to maintain bone health in perimenopausal and postmenopausal females.     

Awareness and Prevention of Osteoporosis Among South Asian Women

We examined awareness of osteoporosis prevention among peri- and post-menopausal South Asian women attending two community centers in the Dallas/Fort-Worth Metroplex. We conducted a quasi-experimental study (final N = 61) assessing knowledge about osteoporosis among South Asian women (≥40 years). The mean age was 52.3 years (SD = 8.72). Over 50% were college educated and 64% had no health insurance. We administered a baseline knowledge test, followed by a health education intervention and, 2 weeks later, by a post-test. Participants received one point for each correct answer and scores were added (≤14). Participants showed a significant increase in osteoporosis knowledge post intervention (paired t ₆₀ = −9.5, P < .01). For example, women reported highest knowledge gains on the following: adequate calcium intake is achievable from two glasses of milk a day; very thin women are at risk for developing osteoporosis, and family history of osteoporosis is a risk factor. Intervention completers were better prepared to prevent and manage osteoporosis. Results indicate the efficacy of educational intervention in improving osteoporosis awareness; and point to the potential for knowledge acquisition aimed at developing community-based prevention strategies at the community level.     

Factors Associated with Postmenopausal Osteoporosis: A Case-Control Study of Belgrade Women

The aim of this study was to investigate factors related to osteoporosis in postmenopausal women in Belgrade. A case-control study was conducted during 2006–2007. The study group consisted of 100 newly diagnosed osteoporosis patients and 100 age-matched controls (±2 years). The inclusion criteria for the case group were newly diagnosed osteoporosis confirmed by dual-energy X-ray absorptiometry of the lumbar spine and being menopausal (at least 2 years of amenorrhea). The inclusion criteria for the control group were postmenopausal women with confirmed normal bone mineral density of the lumbar spine by dual-energy X-ray absorptiometry. All study participants were interviewed using a structured questionnaire. Univariate and multivariate logistic regression analyses were used. The following factors were significantly independently related to osteoporosis: low body weight (P < 0.001), thin constitution in childhood (P = 0.002), history of previous fracture (P = 0.033), menopause at age <47 years (P < 0.001), family history of fracture (P = 0.005), and less frequent consumption of cheese (P = 0.027) and fish (P = 0.020). The majority of factors identified may be modifiable and could be influenced to prevent postmenopausal osteoporosis.     

Management of Postmenopausal Osteoporosis

Postmenopausal osteoporosis is a very common disease, and approximately half of all women aged >50 years will experience an osteoporotic fracture during the remainder of their lifetime. The predominant cause of postmenopausal osteoporosis is the decline in estrogen levels, which causes an increase in bone turnover, and results in a loss of bone mass throughout the entire skeleton. Fragility fractures, either vertebral or nonvertebral, have a considerable adverse effect on quality of life in women with osteoporosis and place a significant burden on society in terms of healthcare costs.Management of postmenopausal osteoporosis includes alteration of modifiable risk factors (e.g. lifestyle and propensity to fall), ensuring adequate calcium and vitamin D intake, and pharmacological treatment to decrease fracture risk by slowing or preventing bone loss and preserving bone strength. Raloxifene (Evista®), a selective estrogen receptor modulator that partially mimics the effects of estrogen on bone and lipid metabolism and acts as an antiestrogen in the breast and endometrium, is indicated for the prevention and treatment of postmenopausal osteoporosis. Raloxifene increases bone mineral density at vertebral and nonvertebral sites, and decreases the risk of vertebral fracture to a similar extent to the bisphosphonates alendronate and risedronate. However, effects on nonvertebral fracture risk, including the risk of hip fracture, have not been observed.Raloxifene appears to reduce breast cancer risk (in women at average risk) and cardiovascular risk (in women at increased risk) without stimulating the endometrium, and does not cause vaginal bleeding or breast pain. However, the drug causes hot flashes in some women, and increases the risk of venous thromboembolic events by about the same amount as hormone replacement therapy (HRT).In economic models, raloxifene is cost effective compared with no treatment, HRT, calcitonin, or alendronate for the prevention or treatment of postmenopausal osteoporosis.In conclusion, raloxifene is a valuable and cost-effective therapy for preventing the progression of osteoporosis and for reducing vertebral fracture risk in osteoporotic postmenopausal women. The tendency for raloxifene to cause hot flashes, and its apparent lack of effect on hip fracture risk, may preclude its use in women with vasomotor symptoms and in patients at high risk for hip fracture. Results from large ongoing trials are needed to confirm the effects of raloxifene on breast cancer and cardiovascular disease. However, the effects of raloxifene on breast cancer and cardiovascular risk without stimulating the endometrium make the drug an attractive therapy for the prevention and treatment of postmenopausal osteoporosis.     

Cost-Effectiveness of Using Clinical Risk Factors with and without DXA for Osteoporosis Screening in Postmenopausal Women

Background:  According to several guidelines, the assessment of postmenopausal fracture risk should be based on clinical risk factors (CRFs) and bone density. Because measurement of bone density by dual x-ray absorptiometry (DXA) is quite expensive, there has been increasing interest to estimate fracture risk by CRFs.
Objective:  The aim of this study was to determine the cost-effectiveness of osteoporosis screening of CRFs with and without DXA compared with no screening in postmenopausal women in Germany.
Methods:  A cost-utility analysis and a budget-impact analysis were performed from the perspective of the statutory health insurance. A Markov model simulated costs and benefits discounted at 3% over lifetime.
Results:  Cost-effectiveness of CRFs compared with no screening is €4607, €21,181, and €10,171 per quality-adjusted life-year (QALY) for 60-, 70-, and 80-year-old women, respectively. Cost-effectiveness of DXA plus CRFs compared with CRFs alone is €20,235 for 60-year-old women. In women above the age of 70, DXA plus CRFs dominates CRFs alone. DXA plus CRFs results in annual costs of €175 million, or 0.4% of the statutory health insurance's annual budget.
Conclusion:  Funders should be careful in adopting a strategy based on CRFs alone instead of DXA plus CRFs. Only if DXA is not available, assessing CRFs only is an acceptable option in predicting a woman's risk of fracture.     

戊酸雌二醇预防围绝经期、绝经后骨质疏松的系统评价

目的 系统评价戊酸雌二醇(E2V)预防围绝经期、绝经后骨质疏松症(OP)的疗效和安全性.方法 计算机检索Medline(1950年1月至2012年3月),EMbase(1974年1月至2012年3月),Cochrane 图书馆临床试验资料库(2012年第1期),中国生物医学文献数据库(CBMdisc,1979年1月至2012年3月),中国期刊全文数据库[清华同方(CNKI)](1994年1月至2012年3月),中文科技期刊全文数据库[维普(VIP)](1989年1月至2012年3月).收集有关E2V预防围绝经期、绝经后妇女OP的疗效的文献,并比较E2V+甲羟孕酮(MPA)或E2V+醋酸环丙孕酮(CPA)(纳入E2V+ MPA组,E2V+ CPA组)与安慰剂(纳入对照组)预防围绝经期、绝经后妇女OP的随机对照试验(RCTs)结果.由2位评价员独立对纳入文献进行资料提取和质量评价,并采用RevMan 4.2.10统计学分析软件对相关预防围绝经期、绝经后妇女OP方案的疗效进行Meta分析.结果 本系统分析共纳入4个E2V预防围绝经期、绝经后妇女OPRCTs,包括764例研究对象.其中,E2V+ MPA组,E2V+ CPA组与对照组各纳入受试者为370例,231例和163例.Meta分析结果显示,有合并分析时采用异质性分析,有异质性的采用随机效应模式E2V+MPA组或E2V+ CPA组,增加妇女的腰椎(L2～L4)和股骨颈的骨密度(BMD)优于对照组.E2V+MPA组或E2V+CPA组的E2V剂量为1.5 mg或2.0 mg时,对于提高腰椎(L2～L4)及股骨颈BMD疗效有优于E2V剂量为1.0 mg的趋势,但差异无统计学意义(WMD=-9.80,95％CI:-21.66～2.06;P=0.11).有2项研究提供了不良反应结果的报道,显示E2V预防组与对照组的不良反应比较,差异均无统计学意义(RD=0.04,95％CI:-0.07～0.15,P=0.48).结论 采用E2V预防围绝经期、绝经后OP效肯定,能提高腰椎(L2～L4)及股骨颈的BMD,且不增加不良反应发生风险.     

Relationship between Regular Green Tea Intake and Osteoporosis in Korean Postmenopausal Women: A Nationwide Study

Mixed results have been reported regarding whether habitual tea intake affects bone health. This study investigated the relationship between green tea intake and bone mineral density (BMD) in postmenopausal Korean women. We used data from the Korean National Health and Nutrition Examination Surveys from 2008 to 2011 and divided the participants into three groups according to their frequency of green tea intake over the past 12 months. BMD of the lumbar spine, total femur, and femur neck was measured using dual-energy X-ray absorptiometry. The odds ratios (ORs) and 95% confidence intervals (CIs) of osteoporosis and osteopenia according to green tea consumption were analyzed. Participants who did not consume green tea or consumed less than one cup per day were more likely to have osteopenia of the lumbar spine or femur than those who consumed it once to three times a day (OR 1.81 and 1.85, 95% CI, 1.20–2.71; and 1.23–2.77). Moreover, ORs for osteoporosis were 1.91 (95% CI 1.13–3.23) and 1.82 (95% CI 1.09–3.05) in non-consumers and consumers who drank less than one cup per day, respectively, compared with the reference group. These results support that green tea consumption may have benefits on bone health.     

Vitamin D Boosts Alendronate Tail Effect on Bone Mineral Density in Postmenopausal Women with Osteoporosis

Vitamin D modulates bisphosphonate (BP) efficacy, but its contribution to bone mineral density (BMD) after BP discontinuation is not known. To address this topic, we performed a retrospective analysis of postmenopausal women exposed to alendronate (ALN) to treat osteoporosis who regularly continued the supplementation of cholecalciferol or calcifediol at recommended doses. In the ninety-six recruited women (age 61.1 ± 6.9 years), ALN was administered for 31.2 ± 20.6 months and then discontinued for 33.3 ± 18.9 months. The modification of 25(OH)D serum levels over time was associated with a change of alkaline phosphatase (r = −0.22, p = 0.018) and C-terminal collagen type 1 telopeptide (r = −0.3, p = 0.06). Women in the tertile of the highest increase in 25(OH)D level showed a 5.7% BMD gain at lumbar spine, that was twice as great in comparison with participants with a lower 25(OH)D variation. At a multiple regression analysis, BMD change was associated with time since menopause (ß = 2.28, SE 0.44, p < 0.0001), FRAX score for major fracture (ß = −0.65, SE 0.29, p = 0.03), drug holiday duration (ß = −2.17, SE 0.27, p < 0.0001) and change of 25(OH)D levels (ß = 0.15, SE 0.03, p = 0.0007). After ALN discontinuation, improving the vitamin D status boosts the ALN tail effect on BMD.     

Bazedoxifene versus Oral Bisphosphonates for the Prevention of Nonvertebral Fractures in Postmenopausal Women with Osteoporosis at Higher Risk of Fracture: A Network Meta-Analysis

ObjectiveTo compare the efficacy of bazedoxifene and oral bisphosphonates for the prevention of nonvertebral fractures (NVFs) in women with higher risk of postmenopausal osteoporosis (i.e., the Fracture Risk Assessment Tool [FRAX] score ≥ 20%), based on currently available evidence from randomized controlled trials.MethodsRandomized controlled trials evaluating the NVF relative risk reduction (RRR) with oral bisphosphonates or bazedoxifene were identified by a systematic literature review and combined by means of a network meta-analysis. A subgroup of patients with a FRAX score of 20% or more in the bazedoxifene phase III osteoporosis study was selected as the population of interest on the basis of the bazedoxifene label. In one analysis (analysis 1), the placebo response of the subgroup with a FRAX score of 20% or more was the benchmark to select comparable bisphosphonate trials. Additional analyses incorporated the aggregate data from the bisphosphonate trials with all the FRAX subgroups (analysis 2) or with the individual patient data from the bazedoxifene trial (analysis 3).ResultsNine identified bisphosphonate trials (alendronate, ibandronate, risedronate; N = 23,440 patients) with a similar placebo response as observed for the subgroup of high risk patients in the bazedoxifene trial were included in analysis 1. The results of the network meta-analysis of this study set suggest that bazedoxifene is expected to have an RRR of 0.43 (95% credible interval [CrI] ?0.19 to 0.72) versus alendronate, 0.58 (95% CrI 0.05–0.81) versus ibandronate, and 0.39 (95% CrI ?0.29 to 0.70) versus risedronate. Analyses in which treatment effects with bisphosphonates were projected to a population with a FRAX score of 20% or more with meta-regression approaches (analysis 2 and analysis 3) provide similar findings.ConclusionBased on an indirect comparison of randomized trials, bazedoxifene is expected to have at least a comparable RRR of NVF as alendronate, ibandronate, and risedronate in women with higher risk of postmenopausal osteoporosis.     

基于logistic模型对影响绝经期妇女骨质疏松症的动物性饮食因素研究

目的描述绝经期妇女动物性食品摄入情况,探讨摄入动物类食品对骨质疏松的影响。方法随机抽取哈尔滨市区281名年龄在50岁至65岁之间的绝经期妇女。采用CRF健康问卷表进行调查;并使用双能X线骨密度仪(NorlandXR-36型)测量腰椎骨的骨密度。利用SAS9.1统计软件对绝经期妇女动物性食品摄入情况进行描述;控制混杂因素后,使用logistic回归分析骨质疏松与摄入动物性食品之间的关系。结果绝经期妇女平均每日肉类摄入量为82.25g,海产品为44.51g,蛋类为56.70g,奶制品为205.59g;单因素分析显示:年龄、肥胖、学历、收入、生育个数、蔬菜类及牛肉类食物与骨质疏松的患病有关(P<0.05)。多因素分析显示,动物性食物中的牛肉为骨质疏松发生的保护因素、蛋类为骨质疏松发生的危险因素(P<0.05)。结论绝经期妇女肉类、蛋类平均每日摄入量高于推荐摄入量,水产品、奶类平均每日摄入量低于推荐摄入量;食用动物性食品中的牛肉可能预防骨质疏松的发生,但过多的摄入蛋类可能增加骨质疏松的患病风险,未发现饮用牛奶与骨质疏松的患病存在关联。     

防治骨质疏松的研究进展

1 骨质疏松的一般状况1.1 骨质疏松的流行病学骨质疏松症(Osteoporosis Synd-rome)是一种与年龄有关,原因不明的非特异性骨代谢障碍疾病.主要导致易骨折甚至自发性骨折,使病人被迫卧床,生活不能自理,继发栓塞性疾病和由于生理、心理的痛苦引发心脑血管疾病,还有造成自伤自残性结果的可能[1].     

128例绝经后发生反复下尿路感染病人的临床诊治分析

目的分析并总结女性绝经后发生反复下尿路感染的有效治疗方法。方法对我院自2010年6月至2011年12月期间收治的128例绝经后反复下尿路感染病人长时间给予小剂量抗生素,并配合使用α-受体阻滞剂及雌激素实施治疗。结果经治疗后,全部128例病人中总有效115例（89.84%）,其中78例（60.94%）为痊愈,23例（17.97%）为显效,14例（10.94%）为改善,13例（10.16%）为无效。11例病人口服坦索罗辛缓释胶囊发生程度不等的恶心、头晕、头痛、心慌以及体位性低血压等反应,但均出现于服药早期,症状均较轻微,通过减量后病人反应减轻并消失,未对病人的继续治疗产生影响。结论对绝经后发生反复下尿路感染病人长时间给予小剂量抗生素,并配合使用α-受体阻滞剂及雌激素等综合疗法实施治疗可以得到令人满意的临床疗效,值得临床广泛推广并应用。     

Vitamin K2 Therapy for Postmenopausal Osteoporosis

Vitamin K may play an important role in the prevention of fractures in postmenopausal women with osteoporosis. Menatetrenone is the brand name of a synthetic vitamin K₂ that is chemically identical to menaquinone-4. The present review study aimed to clarify the effect of menatetrenone on the skeleton in postmenopausal women with osteoporosis, by reviewing the results of randomized controlled trials (RCTs) in the literature. RCTs that investigated the effect of menatetrenone on bone mineral density (BMD), measured by dual-energy X-ray absorptiometry and fracture incidence in postmenopausal women with osteoporosis, were identified by a PubMed search for literature published in English. Eight studies met the criteria for RCTs. Small RCTs showed that menatetrenone monotherapy decreased serum undercarboxylated osteocalcin (ucOC) concentrations, modestly increased lumbar spine BMD, and reduced the incidence of fractures (mainly vertebral fracture), and that combined alendronate and menatetrenone therapy enhanced the decrease in serum ucOC concentrations and further increased femoral neck BMD. This review of the literature revealed positive evidence for the effects of menatetrenone monotherapy on fracture incidence in postmenopausal women with osteoporosis. Further studies are required to clarify the efficacy of menatetrenone in combination with bisphosphonates against fractures in postmenopausal women with osteoporosis.     

补钙对骨质疏松防治作用的研究进展

本文就近年来钙在防治骨质疏松中作用的研究进展，如钙对骨密度增加、抗骨折效应、减少骨质丢失作用、不同钙源的吸收率、补钙的剂量和方案，以及补钙的安全性等作简要综述。     

杨浦区中老年妇女预防骨质疏松及营养摄入状况调查

迄今为止 ,骨质疏松仍缺乏理想的治疗方法 ,积极的预防则显得尤为重要。合理饮食、补充足够的钙质作为预防骨质疏松的一项重要措施 ,已越来越受到人们的重视。为了解中老年妇女对骨质疏松所持的态度 ,有针对性地开展健康教育 ,2 0 0 2年 1 1月 ,第二军医大学护理系对上海市杨浦区中老年妇女进行了调查研究。对象与方法1 对象　上海市杨浦区五角场社区 40岁以上的中老年妇女 1 0 0人。发放调查问卷 1 0 0份 ,回收 89份 ,有效回收问卷 89份 ,有效率为 89 0 %。调查对象年龄从 40～ 84岁 ,平均年龄为 58 4± 1 0 5岁。在 89名被调查者中 ,大…     

DANCR Mediates the Rescuing Effects of Sesamin on Postmenopausal Osteoporosis Treatment via Orchestrating Osteogenesis and Osteoclastogenesis

As one of the leading causes of bone fracture in postmenopausal women and in older men, osteoporosis worldwide is attracting more attention in recent decades. Osteoporosis is a common disease mainly resulting from an imbalance of bone formation and bone resorption. Pharmaceutically active compounds that both activate osteogenesis, while repressing osteoclastogenesis hold the potential of being therapeutic medications for osteoporosis treatment. In the present study, sesamin, a bioactive ingredient derived from the seed of Sesamum Indicum, was screened out from a bioactive compound library and shown to exhibit dual-regulating functions on these two processes. Sesamin was demonstrated to promote osteogenesis by upregulating Wnt/β-catenin, while repressing osteoclastogenesis via downregulating NF-κB signaling . Furthermore, DANCR was found to be the key regulator in sesamin-mediated bone formation and resorption . In an ovariectomy (OVX)-induced osteoporotic mouse model, sesamin could rescue OVX-induced bone loss and impairment. The increased serum level of DANCR caused by OVX was also downregulated upon sesamin treatment. In conclusion, our results demonstrate that sesamin plays a dual-functional role in both osteogenesis activation and osteoclastogenesis de-activation in a DANCR-dependent manner, suggesting that it may be a possible medication candidate for osteoporotic patients with elevated DNACR expression levels.