-
1.
Positive association between metabolic syndrome and bone mineral density among Malaysians.
Chin, KY, Chan, CY, Subramaniam, S, Muhammad, N, Fairus, A, Ng, PY, Jamil, NA, Aziz, NA, Ima-Nirwana, S, Mohamed, N
International journal of medical sciences. 2020;(16):2585-2593
Abstract
Objectives: Metabolic syndrome (MetS) is a cluster of metabolic abnormalities that elevates the individual risk of cardiovascular diseases. These abnormalities are also known to alter bone remodelling. Therefore, MetS may be associated with osteoporosis. This study aims to determine the association between MetS and its components and bone mineral density (BMD) assessed by dual-energy X-ray absorptiometry (DXA) among Malaysians. Methods: 400 Malaysians aged ≥ 40 years (52.5% women) residing in Klang Valley, Malaysia, were recruited. Subjects' demographic and lifestyle details were collected using a questionnaire, and blood pressure and body anthropometry were measured. Subjects' lumbar spine and total hip BMD were measured by DXA. Their fasting blood was collected for blood glucose level and lipid profile analysis. Regression analysis was used to analyze the relationship between MetS or its components and BMD. Results: Subjects with MetS had higher BMD compared to subjects without MetS in models unadjusted for BMI (spine p=0.008; hip p<0.001). This difference was attenuated with BMI adjustment (spine p=0.625; hip p=0.478). Waist circumference was associated positively with BMD in models unadjusted for BMI (spine p=0.012; hip p<0.001), but the association became negative with BMI adjustment (spine p=0.044; hip p=0.021). Systolic blood pressure was associated positively with total hip BMD (p=0.019) but BMI adjustment attenuated the relationship (p=0.080). Triglyceride level was associated with osteoporosis in a fully adjusted model (p=0.001). Overall, MetS was associated with osteoporosis (p=0.019) but lifestyle (p=0.188) and BMI adjustment attenuated the relationship (p=0.904). Conclusion: MetS is positively associated with BMD, and this relationship is predominantly mediated by BMI. Although MetS is not a significant risk factor for osteoporosis, the inverse relationship between waist circumference, a marker of central obesity, and BMD highlights the need to prevent adiposity to improve metabolic and skeletal health.
-
2.
Evaluation of bone health in patients with adrenal tumors.
Athimulam, S, Bancos, I
Current opinion in endocrinology, diabetes, and obesity. 2019;(3):125-132
Abstract
PURPOSE OF REVIEW Adrenal tumors occur in 5% of population with higher prevalence in elderly. Patients with adrenal tumors present with overt hormonal excess in up to 15% of cases, and mild autonomous cortisol secretion in 30-40% of cases. Overt Cushing syndrome, mild autonomous cortisol secretion, pheochromocytoma, and primary aldosteronism have been associated with higher cardiovascular morbidity and mortality. Increasing experimental and clinical evidence also suggests that adrenal hormone excess is detrimental to bone health. This review aims to discuss the effect of cortisol, aldosterone, and catecholamine excess on bone metabolism, secondary osteoporosis, and fragility fractures. RECENT FINDINGS Several studies have reported that patients with hormonally active adrenal tumors demonstrate increased prevalence of fragility fractures incongruous to bone density scan findings. The utility of dual absorptiometry X-ray (DXA) in diagnosing secondary osteoporosis is unclear in patients with cortisol, aldosterone, and catecholamine excess. Trabecular bone score and bone turn over markers could serve as potential diagnostic tools in assessment of severity of bone disease in patients with hormonally active adrenal tumors. SUMMARY Adrenalectomy is the mainstay of therapy in patients with overt hormone production. Appropriate case detection strategies to identify patients at risk of fragility fractures are needed in patients not treated with adrenalectomy, such as bilateral primary aldosteronism and mild autonomous cortisol secretion.
-
3.
[Effect of low-dose or standard-dose conjugated equine estrogen combined with different progesterone on bone density in menopause syndrome women].
Zuo, HL, Deng, Y, Wang, YF, Gao, LL, Xue, W, Zhu, SY, Ma, X, Sun, AJ
Zhonghua fu chan ke za zhi. 2018;(4):243-247
Abstract
Objective: To explore the effect of low-dose or standard-dose conjugated equine estrogen (CEE) combined with natural progesterone or dydrogesterone on bone density in menopause syndrome women. Methods: Totally 123 patients with menopause syndrome were recruited and randomly assigned to 3 treatment groups: group A (low-dose CEE+progesterone) , group B (standard-dose CEE+progesterone) , group C (standard-dose CEE+dydrogesterone) . Using continuous sequential regimen, the duration of intervention was 12 cycles. The bone mineral density of lumbar 2-4 and neck of femur, the bone metabolic markers, the level of FSH and estradiol were examined just before the drug administration and 12 months after the beginning of experiment. Results: There were 107 cases completed the one year trial. (1) Bone density: after 12 cycles of treatment, there was no significant change in bone density in group A (P>0.05) ; lumbar vertebrae of group B and C increased significantly, at 3.0% and 2.1%respectively (all P<0.05) . The bone density of left femoral neck of group C significantly increased by 2.9% (P=0.029) . There was no significant difference among the treatment groups at the beginning of experiment (P>0.05) . (2) Bone metabolic markers: after 12 cycles of treatment, the levels of calcium, phosphorus, alkaline phosphatase, Ca/Cr decreased significantly, the difference were statistically significant (all P<0.05) . There was no significant difference among the treatment groups at the beginning of experiment (P>0.05) . (3) Levels of FSH and estradiol: after 12 cycles of treatment, the levels of FSH in three groups were decreased significantly (all P<0.01) . The levels of estradiol in three groups were increased significantly (all P<0.01) . There was no significant difference among the treatment groups at the beginning of experiment (P>0.05) . Conclusions: Both low-dose and standard-dose menopause hormone therapy (MHT) could elevate the level of estradiol, reduce bone turnover, prevent bone loss of postmenopausal women effectively. The standard dose of MHT could also increase the density of vertebrae and femoral neck, and generate more clinical benefits.
-
4.
[Body composition and metabolic risk in small for gestational age children treated with growth hormone].
Aurensanz Clemente, E, Samper Villagrasa, P, Ayerza Casas, A, Ruiz Frontera, P, Moreno Aznar, LA, Bueno Lozano, G
Medicina clinica. 2016;(6):231-7
Abstract
BACKGROUND AND OBJECTIVES Small for gestational age (SGA) children are at increased risk of metabolic syndrome. Our objective is to evaluate changes in body composition produced by growth hormone (GH) treatment. PATIENTS AND METHOD A group of 28 SGA children without catch-up growth and undergoing treatment with GH was selected for evaluation. Over the course of 3 years from the beginning of the treatment with GH, the children's body composition variables (bone mineral density [BMD], fat and lean body mass proportion) were evaluated annually with dual-energy X-ray absorptiometry. A study of correlation between metabolic and body composition variables was also made. RESULTS Treatment with GH produces a reduction in fat mass proportion in relation to lean body mass, decreasing from 25.94±6.09 to 22.88±5.38% (P=.034). In the abdominal regions we observe an increase in lean mass, from 1,356,91±426,71 to 2,570,96±814,36g (P=.000) and a tendency for visceral fat deposits to decrease. BMD in lumbar vertebrae improved from -1.55±0.68 to -0.90±0.79Z (P=.019). CONCLUSIONS Treatment with GH produces changes in body composition, improving BMD and increasing the proportion of lean body mass with a reduction in fat mass. If these changes persisted into adulthood, they may cause a reduction in the metabolic and cardiovascular risk in this group of patients.
-
5.
Resveratrol increases bone mineral density and bone alkaline phosphatase in obese men: a randomized placebo-controlled trial.
Ornstrup, MJ, Harsløf, T, Kjær, TN, Langdahl, BL, Pedersen, SB
The Journal of clinical endocrinology and metabolism. 2014;(12):4720-9
Abstract
CONTEXT Metabolic syndrome (MetS) is associated with low-grade inflammation, which may harmfully affect bone. Resveratrol (RSV) possesses anti-inflammatory properties, and rodent studies suggest bone protective effects. OBJECTIVE This study sought to evaluate effects of RSV treatment on bone in men with MetS. SETTING AND DESIGN The study was conducted at Aarhus University Hospital as a randomized, double-blinded, placebo-controlled trial assessing changes in bone turnover markers, bone mineral density (BMD), and geometry. PARTICIPANTS The study population comprised 74 middle-aged obese men with MetS recruited from the general community, of which 66 completed all visits. Mean age of participants was 49.3 ± 6.3 years and mean body mass index was 33.7 ± 3.6 kg/m(2). INTERVENTION Oral treatment with 1.000 mg RSV (RSV(high)), 150 mg RSV (RSV(low)), or placebo daily for 16 weeks. MAIN OUTCOME MEASURE Prespecified primary endpoint was change in bone alkaline phosphatase (BAP). RESULTS BAP increased dose dependently with RSV (R = 0.471, P < .001), resulting in a significantly greater increase in BAP in the RSV(high) group compared with placebo at all time-points (week 4, 16.4 ± 4.2%, P < .001; week 8, 16.5 ± 4.1%, P < .001; week 16, 15.2 ± 3.7%, P < .001). Lumbar spine trabecular volumetric bone mineral density (LS vBMD(trab)) also increased dose dependently with RSV (R = 0.268, P = .036), with a significant increase of 2.6 ± 1.3% in the RSV(high) group compared with placebo (P = .043). In addition, changes in BAP and LS vBMD(trab) were positively correlated (R = 0.281, P = .027). No consistent changes were detected in bone density at the hip. CONCLUSIONS Our data suggest that high-dose RSV supplementation positively affects bone, primarily by stimulating formation or mineralization. Future studies of longer duration comprising populations at risk of osteoporosis are needed to confirm these results.
-
6.
The association between metabolic syndrome and bone mineral density: a meta-analysis.
Xue, P, Gao, P, Li, Y
Endocrine. 2012;(3):546-54
Abstract
Previous researches demonstrate uncertainty about the effect of metabolic syndrome (MS) on bone. We performed a meta-analysis to investigate the association of MS with bone mineral density (BMD) of spine and femoral neck (FN). In this meta-analysis, searches of Medline, Embase, Cochrane Library, Chinese biological medical database and China national knowledge infrastructure were undertaken to identify studies in humans of the association between MS and BMD. Random effects model was used for this meta-analysis. The results of our research were reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 11 studies (including an outlier study) with 13,122 subjects were included in our research. We detected a significant overall association of MS with increased BMD of spine (weighted mean difference, WMD = 0.027, 95 % confidence interval, CI [0.011, 0.042]) and no significant overall association of MS with BMD of FN (WMD = 0.008, CI [-0.011, 0.026]). Subgroup analyses indicated significant association between MS and increased BMD of spine in subjects whose BMD was measured by dual-energy X-ray absorptiometry (DXA) scanner manufactured by Hologic Inc., subjects diagnosed by International Diabetes Federation criteria and subjects diagnosed by National Cholesterol Education Program's Adult Treatment Panel III (NCEP-ATP III) criteria. And significant association between MS and increased BMD of FN in Caucasian subjects, subjects whose BMD was measured by DXA scanner manufactured by Hologic Inc. and subjects diagnosed by NCEP-ATP III criteria was also found. Our meta-analysis suggests that MS has no clear influence on BMD, or its influence maybe beneficial.
-
7.
[Cytokines in bone diseases. Wnt signaling and osteoporosis-pseudoglioma syndrome].
Ozono, K
Clinical calcium. 2010;(10):1520-5
Abstract
Wnt signaling system plays essential roles in development, cancer and bone metabolism. Canonical wnt signaling, which involves wnt ligands, receptor named frizzled and co-receptors LRP5/6, beta-catenin and transcription factors named LEF/TCF is well characterized and its defect causes bone abnormalities. The loss-of-function type of the LRP5 gene mutation is responsible for osteoporosis-pseudoglioma syndrome. In addition, the LRP6 gene mutation leads to osteoporosis and metabolic syndrome. Thus, wnt signaling system is one of determinant factors for bone mineral density.
-
8.
Effect of atorvastatin on bone mineral density in patients with acute coronary syndrome.
Pérez-Castrillón, JL, Abad, L, Vega, G, Sanz-Cantalapiedra, A, García-Porrero, M, Pinacho, F, Dueñas, A
European review for medical and pharmacological sciences. 2008;(2):83-8
Abstract
OBJECTIVE The aim of this paper is to evaluate the effect of atorvastatin on bone mineral density in patients with acute ischemic heart disease. MATERIAL AND METHODS Eighty-three patients (52 male and 31 female) with acute coronary syndrome were studied. They received treatment with atorvastatin using low doses (20 mg) and high doses (40 mg-80 mg). Initial and final cholesterol, triglyceride, calcium, phosphorus, 25-hydroxyvitamin D were obtained from every patient. Spine and hip bone mineral density were performed at the beginning and one year later. RESULTS Atorvastatin treatment increases vitamin D (33%, p = 0.007) and decreases the individuals with vitamin D insufficiency. Bone mineral density increased in the spine (1.31%, p = 0.02), but it was significant only in male and patients presenting vitamin D levels higher than 30 nmol/l. CONCLUSION Atorvastatin has a beneficial effect on bone metabolism in patients with acute ischemic heart disease (mainly males) by incrementing bone mineral density in which vitamin D levels are required to be higher than 30 nmol/l for the drug to be effective.
-
9.
Effect of vitamin D and calcium supplementation on bone turnover in institutionalized adults with Down's Syndrome.
Zubillaga, P, Garrido, A, Mugica, I, Ansa, J, Zabalza, R, Emparanza, JI
European journal of clinical nutrition. 2006;(5):605-9
Abstract
OBJECTIVE To assess the status of vitamin D and the effects of calcium and vitamin D3 supplementation on the bone metabolism in a group of adults with Down's syndrome (DS). DESIGN Randomized, parallel, controlled and open clinical trial. SETTING Institution for mentally handicapped: Fundación Uliazpi, Diputación Foral de Guipúzcoa, San Sebastián, Spain. SUBJECTS A total of 23 persons with DS, residents at the Uliazpi Foundation were recruited and all completed the study. INTERVENTION In all, 12 participants were randomly allocated to receive 1 g of calcium and 800 IU of vitamin D once daily for 1 year while 11 were assigned to the control group, receiving no supplementation. RESULTS We found no differences between groups regarding serum calcium and phosphorous levels. The remaining parameters showed differences between the two groups consistent with a beneficial effect of the intervention: serum levels of parathyroid hormone, osteocalcin and crosslaps diminished while serum 25 OH vitamin D3 level increased. CONCLUSIONS The results obtained allow to include people with DS as a risk group with regards to vitamin D deficit, which that can be corrected with vitamin D and calcium supplementation, and giving rise to an improvement of the biochemical markers related to the phospho-calcium metabolism and bone remodelling.
-
10.
[Pharmacotherapeutic assessment of antiosteoporotic properties of alpha-calcidol in chronic obstructive pulmonary disease].
Kochetkova, EA, Volkova, MV, Grigor'eva, OIu, Gel'tser, BI
Terapevticheskii arkhiv. 2006;(3):20-5
Abstract
AIM: To evaluate antiresorptive properties of alphacalcidol in the treatment of osteopenic syndrome in patients with chronic obstructive pulmonary disease (COPD). MATERIAL AND METHODS A total of 94 COPD patients with low densitometric indices were studied for bone densitometric parameters, calcium-phosphorus metabolism, markers of bone tissue metabolism (osteocalcine-OC, tartrate-resistent acid phosphatase--TRAP, beta CrossLaps - BCL), cytokine profile in the course of 6-month continuous therapy with alpha-calcidol (alpha-D3-TEVA) in a dose 0.75-1 mcg/day. RESULTS Six-month treatment with alpha-calcidol relieved pain, increased bone densitometric parameters, normalized calcium-phosphorus metabolism. While 3-month therapy induced positive dynamics in markers of bone metabolism (OC level increased, concentrations of BCL, TRAP reduced), 6-month therapy resulted in these parameters normalization close to the level of healthy persons. Proinflammatory cytokines (IL-1beta, IL-6 TNF-alpha) in COPD lowered significantly. CONCLUSION Alpha-calcidol have analgetic, antiresorptive and immunomodulating effects which make this drug effective in prevention and pathogenetic therapy of osteopenic syndrome in COPD.