Osteoporosis and Sarcopenia最新文献

英文中文

Efficacy of plain cholecalciferol versus ergocalciferol in raising serum vitamin D level in Thai female healthcare workers 普通胆钙化醇与麦角钙化醇在提高泰国女性卫生保健工作者血清维生素D水平中的疗效

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-12-01 DOI: 10.1016/j.afos.2022.12.001

Tanawat Amphansap, Atiporn Therdyothin, Nitirat Stitkitti, Lertkong Nitiwarangkul, Vajarin Phiphobmongkol

Objectives

To compare the efficacy of cholecalciferol and ergocalciferol in raising 25-hydroxyvitamin D (25(OH)D) level in Thai female healthcare workers.

Methods

A randomized control trial was conducted in healthy female healthcare workers. Randomization allocated the participants into vitamin D2 group (N = 43), receiving ergocalciferol 20,000 IU weekly and vitamin D3 group (N = 40), receiving cholecalciferol 1000 IU daily for 12 months. Venous blood sample was collected at baseline, 6 and 12 months for serum 25(OH)D, parathyroid hormone and calcium. Compliance was also assessed.

Results

The mean age of the participants was 50.6 ± 9.9 and 50.9 ± 8.4 years in vitamin D2 and D3 groups (P = 0.884). The mean 25(OH)D levels were 16.91 ± 6.07 ng/mL and 17.62 ± 4.39 ng/mL (P = 0.547), respectively. Both groups had significant improvement in 25(OH)D level at 6 months (from 16.91 ± 6.07 to 21.67 ± 5.11 ng/mL and 17.62 ± 4.39 to 26.03 ± 6.59 ng/mL in vitamin D2 and D3 group). Improvement was significantly greater with cholecalciferol (P = 0.018). The level plateaued afterwards in both groups. Only cholecalciferol could increase 25(OH)D in participants without vitamin D deficiency (6.88 ± 4.20 ng/mL increment). Compliance was significantly better in vitamin D2 group (P = 0.025).

Conclusions

Daily cholecalciferol supplementation resulted in a larger increase in serum 25(OH)D level during the first 6 months comparing to weekly ergocalciferol. While vitamin D3 could increase serum 25(OH)D level in all participants, vitamin D2 could not do so in participants without vitamin D deficiency.

目的比较胆钙化醇和麦角钙化醇对提高泰国女性医护人员25-羟基维生素D (25(OH)D)水平的作用。方法对健康女性卫生工作者进行随机对照试验。将参与者随机分为维生素D2组(N = 43)和维生素D3组(N = 40)，维生素D2组每周接受麦角钙化醇20,000 IU，维生素D3组每天接受胆钙化醇1,000 IU，持续12个月。在基线、6月和12月采集静脉血，测定血清25(OH)D、甲状旁腺激素和钙。还评估了依从性。结果维生素D2组和D3组的平均年龄分别为50.6±9.9岁和50.9±8.4岁(P = 0.884)。平均25(OH)D水平分别为16.91±6.07 ng/mL和17.62±4.39 ng/mL (P = 0.547)。两组在6个月时25(OH)D水平均显著改善(维生素D2和D3组从16.91±6.07降至21.67±5.11 ng/mL, 17.62±4.39降至26.03±6.59 ng/mL)。胆骨化醇组改善明显更大(P = 0.018)。之后两组的水平都趋于稳定。在无维生素D缺乏的受试者中，只有胆骨化醇能增加25(OH)D(6.88±4.20 ng/mL)。维生素D2组依从性较对照组明显提高(P = 0.025)。结论:与每周补充麦角钙化醇相比，每天补充胆钙化醇可导致前6个月血清25(OH)D水平的显著升高。虽然维生素D3可以提高所有参与者的血清25(OH)D水平，但维生素D2在没有维生素D缺乏症的参与者中不起作用。

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引用次数: 2

Reply on “Treatment adherence and risk of vertebral fracture” 关于“治疗依从性与椎体骨折风险”的答复

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-12-01 DOI: 10.1016/j.afos.2022.11.003

Seihee Kim, Yoon-Sok Chung, Yunhwan Lee

引用次数: 0

TOC

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-12-01 DOI: 10.1016/S2405-5255(22)00076-0

引用次数: 0

Trabecular bone score as an additional therapeutic decision tool in osteoporosis and osteopenia 骨小梁评分作为骨质疏松和骨质减少的额外治疗决策工具

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/j.afos.2022.09.001

Atiporn Therdyothin , Tanawat Amphansap , Kamonchalat Apiromyanont

Objectives

To evaluate the role of trabecular bone score (TBS), in addition to bone mineral density (BMD), and to aid decision making to initiate anti-osteoporotic treatment in postmenopausal women with osteopenia.

Methods

TBS was assessed in a cohort of Thai postmenopausal women with BMD of femoral neck (FN), total hip (TH), and lumbar spine (LS) performed at the Police General Hospital, Bangkok, Thailand from July 2019 to October 2020. We retrospectively reviewed hospital database for underlying diseases, medication, and fractures, including relevant imaging and vertebral fracture assessment (VFA). Patients with previous osteoporosis treatment, skeletal malignancy, high-energy trauma, and uninterpretable BMD were excluded.

Results

In total there were 407 postmenopausal women, including 115 with osteoporotic fractures. The mean TBS of the cohort was 1.264 ± 0.005. The proportion of osteoporotic subjects ranged from 9.1% by TH BMD to 27.0% by lowest BMD. In fractured patients, 21.7%–54.8% were found to have osteoporosis while osteopenia was found in 37.4%–43.5%. Among subjects with osteopenia and degraded TBS, fractures ranged from 21.7 to 50.9%. Addition of osteopenic subjects with degraded microarchitecture yielded a significantly higher number of subjects eligible for treatment with 3.25-fold increase in non-fractured participants, and 7 to 11 additional osteopenic patients should be treated to detect 1 fracture.

Conclusions

Addition of TBS helped capturing osteopenic women with high risk of fracture. Decision to treat osteopenic women with degraded TBS increased the number of patients receiving treatment. We recommend evaluating TBS in osteopenic women without fractures to aid therapeutic decision on treatment initiation.

目的评价骨小梁评分(TBS)和骨密度(BMD)在绝经后骨质减少妇女中抗骨质疏松治疗中的作用。方法对2019年7月至2020年10月在泰国曼谷警察总医院接受股骨颈(FN)、全髋关节(TH)和腰椎(LS)骨密度检查的泰国绝经后妇女进行stbs评估。我们回顾性地回顾了基础疾病、药物和骨折的医院数据库，包括相关的影像学和椎体骨折评估(VFA)。既往有骨质疏松治疗、骨骼恶性肿瘤、高能创伤和无法解释的骨密度的患者被排除在外。结果绝经后妇女407例，其中骨质疏松性骨折115例。该队列的平均TBS为1.264±0.005。骨质疏松的比例从最低骨密度的9.1%到最低骨密度的27.0%不等。骨折患者骨质疏松发生率为21.7% ~ 54.8%，骨质减少发生率为37.4% ~ 43.5%。在骨质减少和TBS退化的受试者中，骨折发生率从21.7%到50.9%不等。微结构退化的骨质减少患者的加入使得符合治疗条件的患者数量显著增加，非骨折患者增加了3.25倍，并且需要治疗7 - 11个骨质减少患者才能发现1个骨折。结论TBS治疗有助于捕获骨质减少的高危骨折患者。决定治疗患有退化TBS的骨质减少妇女增加了接受治疗的患者数量。我们建议评估无骨折的骨质减少妇女的TBS，以帮助治疗决定开始治疗。

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引用次数: 3

Adherence of bisphosphonate and decreased risk of clinical vertebral fracture in osteoporotic patients: A propensity score matching analysis 骨质疏松症患者坚持使用双膦酸盐和降低临床椎体骨折风险:倾向评分匹配分析

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/j.afos.2022.05.004

Seihee Kim , Yoon-Sok Chung , Yunhwan Lee

Objectives

Bisphosphonate is associated with a decreased risk of vertebral fractures due to osteoporosis. However, there are limited studies on how poor compliance with bisphosphonate affects the risk of vertebral fractures in a nationwide cohort. We aim to evaluate whether adherence to bisphosphonate affects the risk of fracture in osteoporosis patients.

Methods

We used the data of the Korean National Health Insurance Service Senior Cohort. A total of 33,315 (medication possession ratio [MPR]: 50) osteoporosis patients were matched using the propensity score matching method: those who received low-dose bisphosphonate and those who received high-dose bisphosphonate. Twenty-two confounding variables, including age, socioeconomic status, medications prescribed, and underlying diseases that may affect the risk of fracture were adjusted for propensity score matching. The risk of vertebral fracture was assessed by Cox proportional hazards regression.

Results

Patients with a higher MPR showed a decreased vertebral fracture risk than those with a lower MPR (MPR 50 = hazard ratio [HR] 0.909; 95% confidence interval [CI] 0.877–0.942 P < 0.001; MPR 70 = HR: 0.874, 95% CI: 0.838–0.913, P < 0.001; MPR 90 = HR: 0.822, 95% CI: 0.780–0.866, P < 0.001). MPR was associated with a decreased vertebral fracture risk in both groups with or without history of fracture. In the subgroup analysis, MPR was associated with a decreased vertebral fracture risk in women, in all ages, with or without T2DM, and with or without hypertension.

Conclusions

Higher MPR is associated with a lower vertebral fracture risk.

目的:双膦酸盐可降低骨质疏松所致椎体骨折的风险。然而，在全国范围内，关于双膦酸盐依从性差如何影响椎体骨折风险的研究有限。我们的目的是评估坚持使用双膦酸盐是否会影响骨质疏松症患者骨折的风险。方法采用韩国国民健康保险服务老年人队列数据。采用倾向评分匹配法对33,315例骨质疏松患者(药物占有比[MPR]: 50)进行低剂量双膦酸盐组与高剂量双膦酸盐组的匹配。22个混杂变量，包括年龄、社会经济地位、处方药物和可能影响骨折风险的潜在疾病，被调整为倾向评分匹配。采用Cox比例风险回归法评估椎体骨折的风险。结果MPR高的患者椎体骨折风险低于MPR低的患者(MPR 50 =危险比[HR] 0.909;95%置信区间[CI] 0.877-0.942 P <0.001;MPR 70 = HR: 0.874, 95% CI: 0.838 ~ 0.913, P <0.001;MPR 90 = HR: 0.822, 95% CI: 0.780-0.866, P <0.001)。无论是否有骨折史，MPR均与椎体骨折风险降低相关。在亚组分析中，MPR与女性椎体骨折风险降低相关，不论年龄大小，不论有无T2DM，不论有无高血压。结论较高的MPR与较低的椎体骨折风险相关。

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引用次数: 3

Changes in bone mineral density in unconscious immobile stroke patients from the acute to chronic phases of brain diseases 脑疾病急性期至慢性期无意识卒中患者骨密度的变化

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/j.afos.2022.08.001

Shoko Merrit Yamada

Objectives

Decreased bone mineral density (BMD) is observed in immobile stroke patients. But it is not clarified yet how rapidly BMD reduction occurs or what the most influencing factor to BMD loss is.

Methods

BMDs in the lumbar vertebrae and the proximal femur of the paralyzed side were measured in 100 immobile stroke patients at 1 week (0 month), 1 month, and 2 months after admission. The levels of serum calcium, phosphorous, 25-hydroxyvitamin D, and urine cross-linked N-telopeptide of type I collagen (NTx) were also measured.

Results

The average age of patients was 75.0 ± 11.4 years (31–94 years). No BMD reduction was identified in the lumbar vertebrae in 2 months; however, BMD in the femur significantly decreased in 2 months in female patients (P < 0.05). Serum calcium and phosphorous levels remained within the normal range during hospitalization, and 25-hydroxyvitamin D value rose in 2 months. Urine NTx significantly increased in both males and females in 2 months (male: P < 0.05, female: P < 0.01).

Conclusions

While there was no significant change in lumbar spine BMD in the 2 month period of immobilization after stroke, BMD in the proximal femur showed a significant reduction, particularly in women. The differential loss of BMD in the 2 regions of interest could possibly be due to the physical forces acting on different body parts during mobilization and nutritional factors. More studies are needed with larger study samples and prolonged follow-up to check the accuracy of these observations.

目的观察不活动脑卒中患者骨密度(BMD)下降。但骨密度降低的速度和影响骨密度损失的最主要因素是什么，目前还不清楚。方法对100例脑卒中患者在入院后1周(0个月)、1个月、2个月分别测定瘫痪侧腰椎和股骨近端bmd。测定血清钙、磷、25-羟基维生素D和尿I型胶原交联n端肽(NTx)水平。结果患者平均年龄75.0±11.4岁(31 ~ 94岁)。2个月未发现腰椎骨密度降低;然而，女性患者股骨骨密度在2个月内显著下降(P <0.05)。住院期间血钙、磷水平维持在正常范围内，25-羟基维生素D值在2个月内升高。2个月后，男性和女性尿液中NTx显著增加(男性:P <0.05，女:P <0.01)。结论:卒中后2个月的固定治疗期间，腰椎骨密度无明显变化，股骨近端骨密度明显降低，尤其是女性。两个相关区域骨密度损失的差异可能是由于在运动和营养因素时作用于不同身体部位的物理力。需要更多的研究，更大的研究样本和长时间的随访来检查这些观察结果的准确性。

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引用次数: 0

Reply on “Significant change for body composition data” 关于“身体成分数据发生重大变化”的回复。

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/j.afos.2022.09.004

Dahan da Cunha Nascimento, Diane Nogueira Paranhos Amorim, Vicente Paulo Alves, Karla Helena Coelho Vilaça e Silva, Whitley Stone

引用次数: 1

Significant change for body composition data 身体成分数据发生了重大变化

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/j.afos.2022.09.005

Joseph C. Lee, Alaa Alghamry

引用次数: 1

Support vector machines are superior to principal components analysis for selecting the optimal bones’ CT attenuations for opportunistic screening for osteoporosis using CT scans of the foot or ankle 支持向量机优于主成分分析，可以选择最佳的骨骼CT衰减，从而利用足部或踝关节的CT扫描进行骨质疏松症的机会筛查

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/j.afos.2022.09.002

Ronnie Sebro , Cynthia De la Garza-Ramos

Objectives

To use the computed tomography (CT) attenuation of the foot and ankle bones for opportunistic screening for osteoporosis.

Methods

Retrospective study of 163 consecutive patients from a tertiary care academic center who underwent CT scans of the foot or ankle and dual-energy X-ray absorptiometry (DXA) within 1 year of each other. Volumetric segmentation of each bone of the foot and ankle was done in 3D Slicer to obtain the mean CT attenuation. Pearson's correlations were used to correlate the CT attenuations with each other and with DXA measurements. Support vector machines (SVM) with various kernels and principal components analysis (PCA) were used to predict osteoporosis and osteopenia/osteoporosis in training/validation and test datasets.

Results

CT attenuation measurements at the talus, calcaneus, navicular, cuboid, and cuneiforms were correlated with each other and positively correlated with BMD T-scores at the L1-4 lumbar spine, hip, and femoral neck; however, there was no significant correlation with the L1-4 trabecular bone scores. A CT attenuation threshold of 143.2 Hounsfield units (HU) of the calcaneus was best for detection of osteoporosis in the training/validation dataset. SVMs with radial basis function (RBF) kernels were significantly better than the PCA model and the calcaneus for predicting osteoporosis in the test dataset.

Conclusions

Opportunistic screening for osteoporosis is possible using the CT attenuation of the foot and ankle bones. SVMs with RBF using all bones is more accurate than the CT attenuation of the calcaneus.

目的利用足部和踝关节骨CT衰减对骨质疏松症进行机会性筛查。方法回顾性研究163例来自某三级医疗学术中心的连续患者，这些患者在1年内分别接受足部或踝关节CT扫描和双能x线吸收仪(DXA)检查。在3D切片器中对足、踝各骨进行体积分割，得到CT平均衰减。Pearson相关性用于将CT衰减相互关联并与DXA测量相关联。采用多核支持向量机(SVM)和主成分分析(PCA)在训练/验证和测试数据集上预测骨质疏松症和骨质疏松症。结果距骨、跟骨、舟骨、长方体和楔形体的ct衰减测量结果相互相关，并与L1-4腰椎、髋关节和股骨颈的BMD t评分呈正相关;然而，与L1-4骨小梁评分无显著相关性。在训练/验证数据集中，跟骨的CT衰减阈值为143.2 Hounsfield单位(HU)是检测骨质疏松症的最佳阈值。基于径向基函数(RBF)核的支持向量机预测骨质疏松的效果明显优于PCA模型和跟骨模型。结论利用足部和踝关节骨的CT衰减对骨质疏松症进行筛查是可行的。与CT对跟骨的衰减相比，基于RBF的支持向量机对所有骨骼的测量更准确。

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引用次数: 1

TOC 技术选择委员会

IF 2 Q3 ENDOCRINOLOGY & METABOLISM

Osteoporosis and Sarcopenia

Pub Date : 2022-09-01 DOI: 10.1016/S2405-5255(22)00055-3

引用次数: 0

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