Journal of Osteoporosis最新文献_第6页

Corrigendum to "New Issues in the Management of Osteoporosis". “骨质疏松症管理的新问题”的更正。

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2017-01-01 Epub Date: 2017-11-22 DOI: 10.1155/2017/7174960

Joonas Sirola, Manuel Diaz Curiel, Risto Honkanen, Jun Iwamoto

[This corrects the article DOI: 10.4061/2011/582789.].

[这更正了文章DOI: 10.4061/2011/582789]。

引用次数: 0

Qualitative Insights from the Osteoporosis Research: A Narrative Review of the Literature 骨质疏松研究的定性见解:文献综述

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-11-22 DOI: 10.1155/2016/7915041

A. Bombak, H. Hanson

Purpose. Much of the research on osteoporosis has been generated quantitatively. However, the qualitative osteoporosis literature provides valuable information on patient and clinician experiences and perspectives, informing the design and implementation of health research and healthcare services. To identify knowledge gaps and inform the design of future qualitative research, a narrative review was conducted to consolidate and synthesize the existing insights available within the qualitative osteoporosis research. Methods. Search terms reflecting the domains of osteoporosis and qualitative research were entered into the Scopus database to generate a comprehensive survey of qualitative research in the area of osteoporosis. Articles were thematically analysed and the results are presented in the form of a narrative review. Results. Forty-four articles were included in the narrative review. Qualitative research in the field of osteoporosis research can be summarized by 3 thematic areas: the meaning of osteoporosis for patients and the public, the lived experience of an osteoporosis diagnosis, and the programmatic approach to osteoporosis prevention and treatment. Conclusions. Qualitative studies provide clinically valuable insights in how osteoporosis is conceptualized and managed and programmatic aspects of osteoporosis treatment. The findings of this narrative review suggest the need for balance between presenting osteoporosis as a serious health condition and producing unwarranted anxiety and inactivity so as to ensure the best possible outcomes for individuals with osteoporosis.

目的。许多关于骨质疏松症的研究都是定量的。然而，定性骨质疏松文献提供了关于患者和临床医生经验和观点的宝贵信息，为健康研究和医疗保健服务的设计和实施提供了信息。为了确定知识差距并为未来定性研究的设计提供信息，进行了一项叙述性回顾，以巩固和综合定性骨质疏松症研究中现有的见解。方法。将反映骨质疏松症和定性研究领域的搜索词输入Scopus数据库，以对骨质疏松症领域的定性研究进行全面调查。文章按主题进行分析，结果以叙述评论的形式呈现。结果。44篇文章被纳入叙述评论。骨质疏松研究领域的定性研究可以概括为3个主题领域:骨质疏松对患者和公众的意义，骨质疏松诊断的生活经验，以及骨质疏松预防和治疗的程序化方法。结论。定性研究为骨质疏松症的概念化和管理以及骨质疏松症治疗的程序化方面提供了临床有价值的见解。这篇叙述性综述的研究结果表明，需要在将骨质疏松症作为一种严重的健康状况和产生不必要的焦虑和不活动之间取得平衡，以确保骨质疏松症患者获得最好的结果。

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引用次数: 15

An Evaluative History of Bisphosphonate Drugs: Dual Physiologic Effects of Pyrophosphate as Inspiration for a Novel Pharmaceutical Class 双膦酸盐药物的评价史:焦磷酸盐的双重生理作用对一类新型药物的启示

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-10-05 DOI: 10.1155/2016/1426279

W. Hinshaw, A. DeLong

The documented history of the development of the bisphosphonate drugs is reviewed in sufficient detail to permit independent evaluation of the consistency of the conclusions reached from the available data. The evidence developed during the early interval of these studies 1960–1975 was sufficient to establish that pyrophosphate shares the subsequently established dual bisphosphonate characteristics of bone resorption inhibition and prevention of tissue mineralization.

充分详细地审查了双膦酸盐药物的发展历史，以便对从现有数据得出的结论的一致性进行独立评估。在1960-1975年这些研究的早期阶段发展的证据足以证明焦磷酸盐具有随后建立的双膦酸盐的特征，即抑制骨吸收和防止组织矿化。

引用次数: 4

Lower Limb Metaphyseal Bone Is Lost in Men with Coeliac Disease and Does Not Relate to Parathyroid Status 乳糜泻患者下肢干骺端骨丢失与甲状旁腺状态无关

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-09-08 DOI: 10.1155/2016/4131794

M. Davie, S. Evans, C. Sharp

Aims. To investigate regional lower limb bone density and associations with weight, PTH, and bone breakdown in coeliac men. Methods. From whole body DXA scans bone mineral density (BMD) was measured in 28 coeliac men, in the lower limb (subdivided into 6 regions, 3 being metaphyseal (mainly trabecular) and 2 diaphyseal (mainly cortical)). BMD at femoral neck (FN) and lumbar spine L2-4, body weight, height, serum calcium, alkaline phosphatase, parathyroid hormone (PTH), and urinary calcium and NTx/Cr, a measure of bone breakdown, were also measured. Age matched healthy men provided values for BMD calculation of z and T scores and for biochemical measurements. Results. Low BMD z scores were found at metaphyseal regions in the leg (p < 0.001) and in the FN (p < 0.05). The distal metaphyseal region BMD in the leg was lower than spine or FN (p < 0.05). PTH, urinary calcium/creatinine, and urinary NTx/Cr were similar to controls. Both metaphyseal and diaphyseal BMD z scores were associated with body weight (p < 0.02), but not with either PTH or urinary NTx/Cr. Conclusions. Low BMD lower limb regions comprising mostly trabecular bone occur early in CD and in the absence of elevated PTH or increased bone resorption. Low BMD is associated with low body weight.

目标研究区域性下肢骨密度与乳糜泻男性体重、甲状旁腺激素和骨破坏的关系。方法。通过全身DXA扫描测量了28例乳糜泻患者的下肢骨密度(BMD)(细分为6个区域，3个干骺端(主要是骨小梁)和2个干骺端(主要是皮质))。测定股骨颈(FN)和腰椎(L2-4)骨密度、体重、身高、血清钙、碱性磷酸酶、甲状旁腺激素(PTH)、尿钙和NTx/Cr(骨质破坏指标)。年龄匹配的健康男性提供了骨密度计算z和T分数以及生化测量的值。结果。腿部干骺端和FN区BMD z评分均较低(p < 0.001)。小腿远端干骺端骨密度低于脊柱和FN (p < 0.05)。PTH、尿钙/肌酐和尿NTx/Cr与对照组相似。干骺端和干骺端BMD z评分均与体重相关(p < 0.02)，但与PTH或尿NTx/Cr无关。结论。低骨密度的下肢区域主要包括小梁骨，在CD早期出现，没有PTH升高或骨吸收增加。低骨密度与低体重有关。

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引用次数: 1

The Effect of Long-Term Exercise on the Production of Osteoclastogenic and Antiosteoclastogenic Cytokines by Peripheral Blood Mononuclear Cells and on Serum Markers of Bone Metabolism 长期运动对外周血单核细胞产生破骨细胞因子和抗破骨细胞因子及骨代谢血清标志物的影响

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-08-24 DOI: 10.1155/2016/5925380

J. Smith, R. Dykes, D. Chi

Although it is recognized that the mechanical stresses associated with physical activity augment bone mineral density and improve bone quality, our understanding of how exercise modulates bone homeostasis at the molecular level is lacking. In a before and after trial involving 43 healthy adults, we measured the effect of six months of supervised exercise training on the spontaneous and phytohemagglutinin-induced production of osteoclastogenic cytokines (interleukin-1α, tumor necrosis factor-α), antiosteoclastogenic cytokines (transforming growth factor-β1 and interleukins 4 and 10), pleiotropic cytokines with variable effects on osteoclastogenesis (interferon-γ, interleukin-6), and T cell growth and differentiation factors (interleukins 2 and 12) by peripheral blood mononuclear cells. We also measured lymphocyte phenotypes and serum markers of bone formation (osteocalcin), bone resorption (C-terminal telopeptides of Type I collagen), and bone homeostasis (25 (OH) vitamin D, estradiol, testosterone, parathyroid hormone, and insulin-like growth factor 1). A combination of aerobic, resistance, and flexibility exercises done on average of 2.5 hours a week attenuated the production of osteoclastogenic cytokines and enhanced the production of antiosteoclastogenic cytokines. These changes were accompanied by a 16% reduction in collagen degradation products and a 9.8% increase in osteocalcin levels. We conclude that long-term moderate intensity exercise exerts a favorable effect on bone resorption by changing the balance between blood mononuclear cells producing osteoclastogenic cytokines and those producing antiosteoclastogenic cytokines. This trial is registered with Clinical Trials.gov Identifier: NCT02765945.

虽然人们认识到与体育活动相关的机械应力增加骨矿物质密度并改善骨质量，但我们对运动如何在分子水平上调节骨稳态的理解尚缺乏。在一项涉及43名健康成人的前后试验中，我们测量了六个月的监督运动训练对自发和植物血凝素诱导的破骨细胞因子(白细胞介素-1α、肿瘤坏死因子-α)、抗破骨细胞因子(转化生长因子-β1和白细胞介素4和10)、对破骨细胞生成有不同影响的多源细胞因子(干扰素-γ、白细胞介素-6)、T细胞生长和分化因子(白细胞介素2和12)。我们还测量了淋巴细胞表型和骨形成(骨钙素)、骨吸收(I型胶原的c端末端肽)和骨稳态(25 (OH)维生素D、雌二醇、睾酮、甲状旁腺激素和胰岛素样生长因子1)的血清标志物。每周平均进行2.5小时的有氧、阻力和柔韧性锻炼的组合可以减少破骨细胞因子的产生，增强抗破骨细胞因子的产生。这些变化伴随着胶原蛋白降解产物减少16%和骨钙素水平增加9.8%。我们的结论是，长期中等强度的运动通过改变血液中产生破骨细胞因子和产生抗破骨细胞因子的单核细胞之间的平衡，对骨吸收有有利的影响。该试验已在Clinical Trials.gov注册，注册号:NCT02765945。

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引用次数: 19

Bone Strength and Arterial Stiffness Impact on Cardiovascular Mortality in a General Population 骨强度和动脉硬度对普通人群心血管死亡率的影响

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-03-07 DOI: 10.1155/2016/7030272

P. Avramovski, M. Avramovska, A. Sikole

Osteoporosis and increased arterial stiffness independently have been found to be associated with higher cardiovascular events rates in the general population (GP). We examined 558 patients from GP by dual-energy X-ray absorptiometry (DXA) and pulse wave velocity (PWV) measurements at baseline, with 36-month follow-up period. DXA assessed bone mineral density of femoral neck (BMD FN) and lumbar spine (BMD LS). Carotid-femoral PWV was assessed by pulsed-Doppler. The aim of our study is to find correlation between bone strength and arterial stiffness and their impact on cardiovascular mortality in GP. The mean ± SD of BMD FN, BMD LS, and PWV was 0.852 ± 0.1432 g/cm2, 0.934 ± 0.1546 g/cm2, and 9.209 ± 1.9815 m/s. In multiple regression analysis we found BMD FN (βst = −6.0094, p < 0.0001), hypertension (βst = 1.7340, p < 0.0091), and diabetes (βst = 0.4595, p < 0.0046). With Cox-regression analysis, after 17 cardiovascular events, the significant covariates retained by the backward model were BMD FN (b = −2.4129, p = 0.015) and PWV (b = 0.2606, p = 0.0318). The cut-off values were PWV = 9.4 m/s, BMD FN = 0.783 g/cm2, and BMD LS = 0.992 g/cm2. The results for BMD FN and PWV hazard ratio risk were 1.116 and 1.297, respectively. BMD FN as a measure of bone strength and PWV as a measure of arterial stiffness are strong independent predictors of cardiovascular mortality in GP.

在普通人群(GP)中，骨质疏松症和动脉僵硬度增加与较高的心血管事件发生率独立相关。我们在基线时通过双能x线吸收仪(DXA)和脉冲波速度(PWV)测量检查了558例GP患者，随访36个月。DXA评估股骨颈(BMD FN)和腰椎(BMD LS)的骨密度。采用脉冲多普勒评估颈股动脉PWV。我们研究的目的是发现骨强度和动脉硬度之间的相关性及其对GP心血管死亡率的影响。BMD FN、BMD LS和PWV的平均值±SD分别为0.852±0.1432 g/cm2、0.934±0.1546 g/cm2和9.209±1.9815 m/s。在多元回归分析中，我们发现BMD FN (βst = - 6.0094, p < 0.0001)、高血压(βst = 1.7340, p < 0.0091)和糖尿病(βst = 0.4595, p < 0.0046)。cox回归分析显示，17例心血管事件发生后，逆向模型保留的显著协变量为BMD FN (b = - 2.4129, p = 0.015)和PWV (b = 0.2606, p = 0.0318)。截断值为PWV = 9.4 m/s, BMD FN = 0.783 g/cm2, BMD LS = 0.992 g/cm2。BMD FN和PWV风险比分别为1.116和1.297。衡量骨强度的BMD FN和衡量动脉硬度的PWV是GP心血管死亡率的强有力的独立预测因子。

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引用次数: 15

Understanding Referral Patterns for Bone Mineral Density Testing among Family Physicians: A Qualitative Descriptive Study 了解家庭医生骨密度检测的转诊模式:一项定性描述性研究

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-01-19 DOI: 10.1155/2016/2937426

S. Munce, S. Allin, L. Carlin, J. Sale, G. Hawker, Sandra A. Kim, D. Butt, I. Polidoulis, K. Tu, S. Jaglal

Introduction. Evidence of inappropriate bone mineral density (BMD) testing has been identified in terms of overtesting in low risk women and undertesting among patients at high risk. In light of these phenomena, the objective of this study was to understand the referral patterns for BMD testing among Ontario's family physicians (FPs). Methods. A qualitative descriptive approach was adopted. Twenty-two FPs took part in a semi-structured interview lasting approximately 30 minutes. An inductive thematic analysis was performed on the transcribed data in order to understand the referral patterns for BMD testing. Results. We identified a lack of clarity about screening for osteoporosis with a tendency for baseline BMD testing in healthy, postmenopausal women and a lack of clarity on the appropriate age for screening for men in particular. A lack of clarity on appropriate intervals for follow-up testing was also described. Conclusions. These findings lend support to what has been documented at the population level suggesting a tendency among FPs to refer menopausal women (at low risk). Emphasis on referral of high-risk groups as well as men and further clarification and education on the appropriate intervals for follow-up testing is warranted.

介绍。有证据表明，在低风险妇女中检测过度，在高风险妇女中检测不足，骨密度(BMD)检测不适当。鉴于这些现象，本研究的目的是了解安大略省家庭医生(FPs)的骨密度测试转诊模式。方法。采用了定性描述方法。22名FPs参加了持续约30分钟的半结构化面试。对转录数据进行归纳性专题分析，以了解BMD检测的转诊模式。结果。我们发现骨质疏松症筛查缺乏明确性，在健康的绝经后妇女中有基线骨密度检测的趋势，尤其是在男性筛查的合适年龄方面缺乏明确性。还描述了对后续检测的适当间隔缺乏明确规定。结论。这些发现支持了在人口水平上的记录，表明FPs倾向于转诊绝经期妇女(低风险)。强调高危人群和男性的转诊，并进一步澄清和教育后续检测的适当间隔是必要的。

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引用次数: 9

The Effects of Noncompliance to Prolia (Denosumab) on the Changes in Bone Mineral Density: A Retrospective Review 不遵医嘱服用Prolia (Denosumab)对骨密度变化的影响:回顾性回顾

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-01-04 DOI: 10.1155/2016/7903128

M. Wong-Pack, A. Kalani, J. Hordyk, G. Ioannidis, R. Bensen, W. Bensen, A. Papaioannou, J. Adachi, A. Lau

Although denosumab (Prolia) has been shown to be a safe and efficacious therapy for osteoporotic patients in numerous clinical trials, few studies have determined its effectiveness in real world clinical practice. A retrospective review of patients prescribed Prolia assessing the impact that noncompliance from the regular dosing regimen of six months for denosumab has on bone mineral density (BMD) was performed. 924 patient records were reviewed between August 2012 and September 2013 with 436 patients meeting the eligibility criteria. Patients were divided into three groups: subsequent injection of denosumab (1) less than five months, (2) between five and seven months, and (3) more than seven months after their initial subcutaneous injection. A multivariable regression analysis was conducted comparing the differences among the three prespecified groups in BMD change (g/cm2) after one year of denosumab therapy at both the lumbar spine (LS) and femoral neck (FN). The differences in LS and FN BMD have shown that the relationship between the timing of drug administration in these three groups and change in BMD over 1 year was not clinically or statistically significant (p > 0.05). A follow-up study with a larger sample size and longer follow-up duration is required to further characterize this relationship.

尽管在许多临床试验中，denosumab (Prolia)已被证明是一种安全有效的治疗骨质疏松症患者的方法，但很少有研究确定其在现实世界的临床实践中的有效性。对服用Prolia的患者进行回顾性研究，评估不遵守6个月的denosumab常规给药方案对骨密度(BMD)的影响。在2012年8月至2013年9月期间审查了924例患者记录，其中436例患者符合资格标准。患者被分为三组:随后注射denosumab(1)少于5个月，(2)在5到7个月之间，(3)在首次皮下注射后超过7个月。采用多变量回归分析比较三个预先指定组在接受denosumab治疗一年后腰椎(LS)和股骨颈(FN)骨密度变化(g/cm2)的差异。LS和FN BMD的差异表明，三组患者给药时间与1年内BMD变化的关系无临床意义或统计学意义(p > 0.05)。需要更大样本量和更长随访时间的随访研究来进一步表征这种关系。

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引用次数: 1

Effect of Denosumab on Bone Mineral Density and Markers of Bone Turnover among Postmenopausal Women with Osteoporosis. 地诺单抗对绝经后骨质疏松妇女骨密度和骨转换标志物的影响。

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-01-01 Epub Date: 2016-08-08 DOI: 10.1155/2016/8738959

A Sánchez, L R Brun, H Salerni, P R Costanzo, D González, A Bagur, B Oliveri, M B Zanchetta, V Farías, L Maffei, V Premrou, J L Mansur, M S Larroudé, M A Sarli, P Rey, M R Ulla, M M Pavlove, S Karlsbrum, M L Brance

The aim of this study was to evaluate the effect of denosumab (Dmab) on bone mineral density (BMD) and bone turnover markers after 1 year of treatment. Additionally, the effect of Dmab in bisphosphonate-naïve patients (BP-naïve) compared to patients previously treated with bisphosphonates (BP-prior) was analyzed. This retrospective study included 425 postmenopausal women treated with Dmab for 1 year in clinical practice conditions in specialized centers from Argentina. Participants were also divided according to previous bisphosphonate treatment into BP-naïve and BP-prior. A control group of patients treated with BP not switched to Dmab matched by sex, age, and body mass index was used. Data are expressed as mean ± SEM. After 1 year of treatment with Dmab the bone formation markers total alkaline phosphatase and osteocalcin were significantly decreased (23.36% and 43.97%, resp.), as was the bone resorption marker s-CTX (69.61%). Significant increases in BMD were observed at the lumbar spine, femoral neck, and total hip without differences between BP-naïve and BP-prior. A better BMD response was found in BP-prior group compared with BP treated patients not switched to Dmab. Conclusion. Dmab treatment increased BMD and decreased bone turnover markers in the whole group, with similar response in BP-naïve and BP-prior patients. A better BMD response in BP-prior patients versus BP treated patients not switched to Dmab was observed.

本研究的目的是评估denosumab (Dmab)治疗1年后对骨密度(BMD)和骨转换标志物的影响。此外，还分析了Dmab对bisphosphonate-naïve患者(BP-naïve)的影响，并将其与先前接受双膦酸盐治疗的患者(BP-prior)进行了比较。这项回顾性研究包括425名在阿根廷专业中心接受Dmab治疗1年的绝经后妇女。参与者也根据先前的双膦酸盐治疗分为BP-naïve和BP-prior。对照组患者治疗BP未切换到Dmab匹配的性别，年龄和体重指数。数据以平均值±SEM表示。Dmab治疗1年后，骨形成标志物、总碱性磷酸酶和骨钙素显著降低(分别为23.36%和43.97%)，骨吸收标志物s-CTX显著降低(分别为69.61%)。在腰椎、股骨颈和全髋关节的骨密度显著增加，BP-naïve和BP-prior之间没有差异。与未改用Dmab的BP治疗患者相比，BP治疗组的BMD反应更好。结论。Dmab治疗增加了整个组的骨密度，降低了骨转换标志物，BP-naïve和bp既往患者的反应相似。观察到，与未改用Dmab的BP治疗患者相比，BP既往患者的BMD反应更好。

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引用次数: 14

Bone Mineral Density in Postmenopausal Women Heterozygous for the C282Y HFE Mutation. 绝经后妇女C282Y HFE突变的杂合骨密度。

IF 1.9 Q3 ORTHOPEDICS

Journal of Osteoporosis

Pub Date : 2016-01-01 Epub Date: 2016-03-31 DOI: 10.1155/2016/5638273

Jenny E Gunton, Frances Gates, Greg R Fulcher, Phillip B Clifton-Bligh

Mutations in the HFE gene may be associated with increased tissue iron stores reflected in an elevated serum ferritin. With homozygous mutation C282Y, the increase in serum ferritin may be associated with tissue damage in the liver, pancreas, and pituitary and with a reduced bone mineral density. With heterozygous mutation C282Y, the degree of iron retention is less but information relating to how a heterozygous C282Y mutation might impact bone mineral density is uncertain. The present study was undertaken to study the relationships between bone mineral density measured by dual energy X-ray absorptiometry and the serum ferritin and serum iron in postmenopausal women heterozygous for the C282Y mutation. The spinal bone mineral density, L2-4, was significantly less than age matched community controls (P = 0.016). There was no significant change in the femoral neck bone mineral density compared to age matched community controls. The correlation between the spinal bone mineral density, L2-4, the femoral neck bone mineral density, and the serum ferritin was not significant. The serum iron correlated significantly inversely with the femoral neck bone mineral density (P = 0.048). The heterozygous C282Y mutation may be associated with impairment of bone cell function in postmenopausal women when only small increases in the serum iron or serum ferritin have occurred.

HFE基因突变可能与组织铁储量增加有关，反映在血清铁蛋白升高中。纯合子突变C282Y，血清铁蛋白的增加可能与肝脏、胰腺和垂体的组织损伤以及骨密度降低有关。对于杂合突变C282Y，铁保留程度较低，但有关杂合C282Y突变如何影响骨密度的信息尚不确定。本研究旨在研究C282Y突变杂合绝经后妇女双能x线骨密度测量与血清铁蛋白和血清铁的关系。脊髓骨密度L2-4显著低于同龄社区对照组(P = 0.016)。与年龄匹配的社区对照相比，股骨颈骨密度没有显著变化。脊髓骨密度、L2-4、股骨颈骨密度与血清铁蛋白的相关性不显著。血清铁与股骨颈骨密度呈显著负相关(P = 0.048)。杂合C282Y突变可能与绝经后妇女骨细胞功能受损有关，此时血清铁或血清铁蛋白仅小幅升高。

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引用次数: 2