Journal of Bone and Mineral Metabolism最新文献

Introduction: Few studies assessed comprehensive effects of composite unhealthy lifestyles on aging and musculoskeletal health. This study aimed to address such issues with the UK Biobank datasets.

Materials and methods: An unhealthy lifestyle score (UHLS) was constructed based on 9 lifestyle behaviors. Aging indicators were calculated from 18 clinical traits. General linear and Cox proportional hazards regression models were used to analyze associations between UHLS, aging, and musculoskeletal morbidity. Mendelian randomization (MR) analysis was performed for causal relationship exploration.

Results: Among 396,037 participants, 54.5% and 3.3% of them were designated to the low (scored 0-2) and high UHLS (scored 6-9) groups, respectively. Increasing UHLS was associated with elevated aging acceleration (AA) based on biological age (0.343 per unit; 95% CI: 0.331, 0.355) and phenotypic age (AA_PA) (0.408 per unit; 95% CI: 0.394, 0.422), and higher morbidity of low grip strength (HR = 1.025; 95% CI: 1.001, 1.050), slow walking pace (HR = 1.134; 95% CI: 1.074, 1.198), osteoporosis (HR = 1.077; 95% CI: 1.063, 1.091), fracture (HR = 1.059; 95% CI: 1.048, 1.069) and osteoarthritis (HR = 1.036; 95% CI: 1.030, 1.042). Unhealthy lifestyles in conjunction with AA jointly increased musculoskeletal morbidity. Besides, AA mediated UHLS effects on slow walking pace, osteoporosis and fracture, with mediating proportion of 4.85%-12.79%. MR analyses revealed causal relationships between UHLS and low grip strength, osteoarthritis, and reduced femoral neck bone mineral density. In addition, AA_PA suggestively mediated the UHLS-osteoarthritis association.

Conclusions: Composite unhealthy lifestyles accelerate aging and impair musculoskeletal health. Both mediating and joint effects of AA showed unhealthy lifestyle-associated musculoskeletal morbidity.

Introduction: Coronavirus disease 2019 (COVID-19) is a worldwide pandemic, and mortality increases in elderly patients with comorbidities. This study aims to examine the in-hospital complications and mortality for elderly patients with proximal femur fractures during the COVID-19 pandemic or countermeasure periods.

Materials and methods: The proximal femur fractures undergoing surgery during the COVID-19 pandemic or countermeasure period were compared with the pre-pandemic in a Japanese national inpatient data. The assessed outcomes were the development of pneumonia, deep vein thrombosis (DVT), pulmonary embolism (PE), and mortality during hospitalization in two periods, and those for COVID-19-positive patients.

Results: A total of 284,922 proximal femur fractures aged over 65 years were included. In the COVID-19 pandemic period compared to the pre-pandemic, the odds of pneumonia, DVT, PE, and mortality decreased to 0.942 (95% confidence interval [CI]: 0.901 - 0.986, P = 0.0102) and 0.839 (95% CI: 0.745 - 0.946, P = 0.004), increased to 1.153 (95% CI: 1.112 - 1.195, P < 0.001), and 1.048 (95% CI: 0.982 - 1.118, P = 0.1554), respectively. For COVID-19 positivity at admission, the odds of PE increased significantly to 12.95 (95% CI: 8.795 - 19.06, P < 0.001). For COVID-19 positivity during hospitalization, the odds of pneumonia and mortality were increased to 2.896 (95% CI: 1.820 - 4.608, P < 0.001) and 6.303 (95% CI: 3.440 - 11.55, P < 0.001), respectively.

Conclusion: These findings alert healthcare professionals and patients to the elevated complications, especially PE rate for proximal femoral fracture with COVID-19 positive.

Introduction: The purpose of this study is to evaluate the increase in bone mineral density (BMD) and achievement of treatment goals based on the ASBMR/BHOF position statement over 3 years of sequential therapy with 2 years of twice-weekly teriparatide (2/W TPTD) followed by 1 year of bisphosphonate (BP) therapy.

Materials and methods: This was a multicenter, retrospective study. Thirty-eight postmenopausal patients with primary osteoporosis at very high risk of fracture according to the Diagnostic Criteria for Primary Osteoporosis in Japan were enrolled. Changes in BMD at the lumbar spine (LS) and total hip (TH) were evaluated. Patients were divided into the naïve group (no history of osteoporosis treatment) and the pre-BP group (prior BP treatment). The treatment goals were assessed using the BMD T-score as follows; Baseline T-score ≤ - 2.5: Greater than - 2.5 at 3 years and baseline T-score > - 2.5: Increase at least 0.5 for LS and 0.2 for TH.

Results: The naïve group showed a significant increase in LS-BMD and TH-BMD of 14.6% and 4.8%, respectively, and the pre-BP group only showed a significant increase in LS-BMD of 8.4% over 3 years. In the naïve group, 60.7% (17/28) achieved the treatment goal for LS-BMD, and 39.3% (11/28) achieved for TH-BMD. In the pre-BP group, 50.0% (4/8) achieved the treatment goal for LS-BMD, but no patient achieved the goal for TH-BMD.

Conclusion: After 3 years of sequential therapy from 2/W TPTD to BP, 50% or more of the patients achieved the treatment goal in the LS-BMD but not in the TH-BMD.