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Clinics and Research in Hepatology and... May 2024Many studies reported the prevalence of extrahepatic conditions (EHC) of primary biliary cholangitis (PBC), but the great heterogeneity existed across different studies.... (Meta-Analysis)
Meta-Analysis
BACKGROUND AND AIM
Many studies reported the prevalence of extrahepatic conditions (EHC) of primary biliary cholangitis (PBC), but the great heterogeneity existed across different studies. Therefore, we conducted the systematic review and meta-analyses to determine EHC prevalence and association with PBC.
METHODS
We searched PUBMED and included observational, cross-sectional and case-controlled studies. A random or fixed effects model was used to estimate the pooled prevalence and odd ratio (OR) as appropriate.
RESULTS
Of 5370 identified publications, 129 publications with 133 studies met the inclusion criteria. Sjögren's syndrome had the highest prevalence (21.4 % vs. 3 % in non-PBC individuals), followed by Raynaud's syndrome (12.3 % vs. 1 %), rheumatoid arthritis-like arthritis (5 % vs. 3 %), systemic sclerosis (3.7 % vs. 0 %) and systemic lupus erythematosus (2 % vs. 0 %). The prevalence of overall thyroid diseases (11.3 %), autoimmune thyroid diseases (9.9 %), osteoporosis (21.1 %), celiac disease (1 %) and chronic bronchitis (4.6 %) was also increased among PBC patients.
CONCLUSION
This is the first exhaustive study on the old theme about EHC of PBC. Given increased prevalence of many EHCs in PBC patients, promptly recognizing these EHCs are of great importance for timely and precise diagnosis of PBC.
Topics: Humans; Prevalence; Liver Cirrhosis, Biliary; Sjogren's Syndrome; Scleroderma, Systemic; Raynaud Disease; Arthritis, Rheumatoid; Celiac Disease; Osteoporosis; Lupus Erythematosus, Systemic; Thyroid Diseases; Autoimmune Diseases
PubMed: 38518985
DOI: 10.1016/j.clinre.2024.102321 -
Current Osteoporosis Reports Apr 2024Recently, the American Diabetes Association updated the 2024 guidelines for Standards of Care in Diabetes and recommend that a T-score of - 2.0 in patients with diabetes... (Review)
Review
PURPOSE OF REVIEW
Recently, the American Diabetes Association updated the 2024 guidelines for Standards of Care in Diabetes and recommend that a T-score of - 2.0 in patients with diabetes should be interpreted as equivalent to - 2.5 in people without diabetes. We aimed to evaluate the most recent findings concerning the bone mineral density (BMD)-derived T-score and risk of fractures related to osteoporosis in subjects with diabetes.
RECENT FINDINGS
The dual-energy X-ray absorptiometry (DXA) scan is the golden standard for evaluating BMD. The BMD-derived T-score is central to fracture prediction and signifies both diagnosis and treatment for osteoporosis. However, the increased fracture risk in diabetes is not sufficiently explained by the T-score, complicating the identification and management of fracture risk in these patients. Recent findings agree that subjects with type 2 diabetes (T2D) have a higher T-score and higher fracture risk compared with subjects without diabetes. However, the actual number of studies evaluating the direct association of higher fracture risk at higher T-score levels is scant. Some studies support the adjustment based on the 0.5 BMD T-score difference between subjects with T2D and subjects without diabetes. However, further data from longitudinal studies is warranted to validate if the T-score treatment threshold necessitates modification to prevent fractures in subjects with diabetes.
Topics: Humans; Bone Density; Osteoporosis; Absorptiometry, Photon; Diabetes Mellitus, Type 2; Osteoporotic Fractures; Risk Factors
PubMed: 38509440
DOI: 10.1007/s11914-024-00867-1 -
Reviews in Endocrine & Metabolic... Apr 2024
PubMed: 38502455
DOI: 10.1007/s11154-023-09837-x -
Archives of Rehabilitation Research and... Mar 2024This systematic review aims to determine the effects of exercise on bone and muscle health in men with low bone density. (Review)
Review
OBJECTIVE
This systematic review aims to determine the effects of exercise on bone and muscle health in men with low bone density.
DATA SOURCES
An electronic search in the following databases was performed: Medline, AMED, Embase, Scopus, and SPORTDiscus between January 1940 and September 2021.
STUDY SELECTION
Randomized or non-randomized trials involving any form of exercise in adult men with a densitometric diagnosis of osteoporosis or osteopenia and reported outcomes relating to bone or muscle health. Two independent reviewers screened 12,018 records, resulting in 13 eligible articles.
DATA EXTRACTION
One reviewer extracted data into a pre-formed table, including characteristics of the exercise intervention, population examined, and primary and secondary outcomes. Study quality was assessed by 2 independent reviewers using the Tool for assEssment of Study qualiTy and reporting in Exercise (TESTEX).
DATA SYNTHESIS
Thirteen publications, originating from 6 unique trials, were eligible for inclusion, which assessed the effect of resistance training, impact training, whole body vibration, and traditional Chinese exercises. Resistance training was the most effective: it stimulates the replacement of adipose tissue with muscle, and in some cases, improved bone density.
CONCLUSIONS
Exercise, especially resistance training, slowed down the natural progression of osteoporosis and sarcopenia in men. These benefits are reflected in enhancements to function, such as improved mobility and balance. Other exercise modalities, such as whole body vibration and traditional Chinese exercises, generated minimal improvements to bone health, strength, and balance.
PubMed: 38482104
DOI: 10.1016/j.arrct.2023.100313 -
Annals of Physical and Rehabilitation... May 2024Hemi-osteoporosis is a common secondary complication of stroke. No systematic reviews of pharmacological and non-pharmacological agents for post-stroke bone health have... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Hemi-osteoporosis is a common secondary complication of stroke. No systematic reviews of pharmacological and non-pharmacological agents for post-stroke bone health have estimated the magnitude and precision of effect sizes to guide better clinical practice.
OBJECTIVES
To examine the benefits and harms of pharmacological and non-pharmacological agents on bone health in post-stroke individuals.
METHODS
Eight databases were searched (PubMed, Cochrane library, Scopus, CINAHL Complete, Embase, PEDro, Clinicaltrils.gov and ICTRP) up to June 2023. Any controlled studies that applied physical exercise, supplements, or medications and measured bone-related outcomes in people with stroke were included. PEDro and the GRADE approach were used to examine the methodological quality of included articles and quality of evidence for outcomes. Effect sizes were calculated as standardized mean differences (SMD) and risk ratio (RR). Review Manager 5.4 was used for data synthetization.
RESULTS
Twenty-four articles from 21 trials involving 22,500 participants (3,827 in 11 non-pharmacological and 18,673 in 10 pharmacological trials) were included. Eight trials were included in the meta-analysis. The methodological quality of half of the included non-pharmacological studies was either poor or fair, whereas it was good to excellent in 8 of 10 pharmacological studies. Meta-analysis revealed a beneficial effect of exercise on the bone mineral density (BMD) of the paretic hip (SMD: 0.50, 95 % CI: 0.16; 0.85; low-quality evidence). The effects of anti-resorptive medications on the BMD of the paretic hip were mixed and thus inconclusive (low-quality evidence). High-quality evidence showed that the administration of antidepressants increased the risk of fracture (RR: 2.36, 95 % CI 1.64-3.39).
CONCLUSION
Exercise under supervision may be beneficial for hip bone health in post-stroke individuals. The effect of anti-resorptive medications on hip BMD is uncertain. The adverse effects of antidepressants on fracture risk among post-stroke individuals warrant further attention. Further high-quality studies are required to better understand this issue.
REGISTRATION
PROSPERO CRD42022359186.
Topics: Humans; Stroke; Osteoporosis; Bone Density; Bone Density Conservation Agents; Stroke Rehabilitation; Female; Male; Exercise Therapy; Aged; Middle Aged
PubMed: 38479252
DOI: 10.1016/j.rehab.2024.101823 -
Osteoporosis International : a Journal... Jul 2024Our review of 52 RCTs from 5 databases suggests a tendency for notable improvement in BMD when combining herbal medicine with supplements (calcium and vitamin D... (Meta-Analysis)
Meta-Analysis Review
Determination of the Combined Effects of Asian Herbal Medicine with Calcium and/or Vitamin D Supplements on Bone Mineral Density in Primary Osteoporosis: A Systematic Review and Meta-Analysis.
UNLABELLED
Our review of 52 RCTs from 5 databases suggests a tendency for notable improvement in BMD when combining herbal medicine with supplements (calcium and vitamin D variants) compared to supplement monotherapy in primary osteoporosis. However, caution is needed in interpreting results due to substantial heterogeneity among included studies.
PURPOSE
To conduct a systematic review and meta-analysis to determine whether herbal medicine (HM) plus supplements such as calcium (Ca) or vitamin D (Vit.D) improves bone mineral density (BMD) compared to supplements alone in primary osteoporosis (OP) patients.
METHODS
We searched 5 databases for randomized controlled trials (RCTs) using HMs with supplements (Ca or Vit.D variants) as interventions for primary OP patients published until August 31, 2022. Meta-analysis using BMD score as the primary outcome was performed using RevMan 5.4 version. Risk of bias in the included studies was assessed useing RoB 2.0 tool.
RESULTS
In total, 52 RCTs involving 4,889 participants (1,408 men, 3,481 women) were included, with average BMD scores of 0.690 ± 0.095 g/cm (lumbar) and 0.625 ± 0.090 g/cm (femoral neck). As a result of performing meta-analysis using BMD scores for all 52 RCTs included in this review, combination of HMs with Ca and Vit.D variants improved the BMD score by 0.08 g/cm (lumbar, 38 RCTs, 95% CI: 0.06-0.10, p < 0.001, I = 97%) and 0.06 g/cm (femoral neck, 19 RCTs, 95% CI: 0.04-0.08, p < 0.001, I = 92%)compared to controls. However, statistical significance of the lumbar BMD improvement disappeared after adjusting for potential publication bias.
CONCLUSION
Our data suggest that combining of HM and supplements tends to be more effective in improving BMD in primary OP than supplements alone. However, caution is needed in interpretation due to the reporting bias and high heterogeneity among studies, and well-designed RCTs are required in the future.
Topics: Humans; Bone Density; Vitamin D; Dietary Supplements; Osteoporosis; Bone Density Conservation Agents; Calcium; Randomized Controlled Trials as Topic; Drugs, Chinese Herbal; Drug Therapy, Combination
PubMed: 38472336
DOI: 10.1007/s00198-024-07061-0 -
BMC Women's Health Mar 2024We conducted a systematic review and meta-analysis to compare the neutrophil lymphocyte ratio (NLR) levels between women with post-menopausal osteopenia or osteoporosis... (Meta-Analysis)
Meta-Analysis
BACKGROUND
We conducted a systematic review and meta-analysis to compare the neutrophil lymphocyte ratio (NLR) levels between women with post-menopausal osteopenia or osteoporosis to those with normal bone mineral density (BMD).
METHODS
We used Web of Science, PubMed, and Scopus to conduct a systematic search for relevant publications published before June 19, 2022, only in English language. We reported standardized mean difference (SMD) with a 95% confidence interval (CI). Because a significant level of heterogeneity was found, we used the random-effects model to calculate pooled effects. We used the Newcastle-Ottawa scale for quality assessment.
RESULTS
Overall, eight articles were included in the analysis. Post-menopausal women with osteoporosis had elevated levels of NLR compared to those without osteoporosis (SMD = 1.03, 95% CI = 0.18 to 1.88, p = 0.017, I = 98%). In addition, there was no difference between post-menopausal women with osteopenia and those without osteopenia in neutrophil lymphocyte ratio (NLR) levels (SMD = 0.58, 95% CI=-0.08 to 1.25, p = 0.085, I = 96.8%). However, there was no difference between post-menopausal women with osteoporosis and those with osteopenia in NLR levels (SMD = 0.75, 95% CI=-0.01 to 1.51, p = 0.05, I = 97.5%, random-effect model).
CONCLUSION
The results of this study point to NLR as a potential biomarker that may be easily introduced into clinical settings to help predict and prevent post-menopausal osteoporosis.
Topics: Humans; Female; Bone Density; Neutrophils; Postmenopause; Osteoporosis; Bone Diseases, Metabolic; Lymphocytes; Osteoporosis, Postmenopausal
PubMed: 38461235
DOI: 10.1186/s12905-024-03006-1 -
Bone Marrow Transplantation Jun 2024The prevalence of osteoporosis in post stem cell transplantation (SCT) is poorly defined. We performed a systematic review and meta-analysis to determine the prevalence... (Meta-Analysis)
Meta-Analysis
The prevalence of osteoporosis in post stem cell transplantation (SCT) is poorly defined. We performed a systematic review and meta-analysis to determine the prevalence of osteoporosis in patients with hematologic diseases who underwent SCT. PubMed, EMBASE, and Web of Science were searched (from inception to 30th April 2023) using Medical Subject Headlines to find studies that assessed the prevalence of osteoporosis among post SCT. Thirteen articles meeting the inclusion criteria were included in the analysis. The pooled prevalence rates of osteoporosis, osteopenia, and decreased bone mineral density (BMD) were determined to be 14.2% (95% CI 9.7-18.8), 36.0% (95% CI 23.8-48.2), and 47.8% (95% CI 36.6-58.9), respectively. Substantial heterogeneity was observed among the included studies (I² values ranged from 81% to 99%). Subgroup analyses revealed variations in prevalence based on gender, follow-up duration, age, region, sample size, and study quality. These findings suggest a high prevalence of osteoporosis in post-SCT patients. Given the negative impact of osteoporosis on prognosis and recipient survival, clinicians should prioritize preventive measures, early diagnosis, and effective treatments to minimize its impact.
Topics: Humans; Osteoporosis; Prevalence; Stem Cell Transplantation; Bone Density; Female; Male
PubMed: 38424174
DOI: 10.1038/s41409-024-02243-0 -
The International Journal of Oral &... Feb 2024To determine the characteristics of dental implant transmucosal surfaces that influence soft tissue attachment and marginal bone loss (MBL).
PURPOSE
To determine the characteristics of dental implant transmucosal surfaces that influence soft tissue attachment and marginal bone loss (MBL).
MATERIALS AND METHODS
The PubMed, Embase, and Cochrane Library electronic databases were searched based on predefined PICO eligibility criteria. Data from animal studies that compared junctional epithelium and connective tissue attachment and MBL from 4 days to 72 weeks were analyzed. The risk of bias was performed with the Systematic Review Centre for Laboratory Animal Experimentation tool. A rank analysis evaluation of data was performed, and the most frequently appearing materials/surfaces for each tissue compartment were identified.
RESULTS
The search identified 3,549 studies, 28 of which were eligible for analysis, with an average risk of bias of 28% ± 10%. Machined, polished, etched, sandblasted, or coated titanium and zirconia materials/surfaces were most frequently examined. Several studies investigated lithium disilicate, polyether ether ketone (PEEK) or polyether ketone ketone (PEKK), aluminum oxide, and gold. Based on ranking and frequency of use at different time points, titanium grade IV (Ti-4) microthreads with a polished neck area most frequently supported natural tooth-like junctional epithelial attachment (≤ 1.5 mm), while machined Ti-4 and machined titanium grade V (Ti-5) most frequently supported connective tissue attachment (≤ 1.25 mm) and led to the least MBL (≤ 0.75 mm).
CONCLUSIONS
Analyzed data suggest that Ti-4 microthreads with a polished neck area and machined Ti-4 and Ti-5 were the materials/surfaces of choice for the transmucosal part of implants. However, the extensive heterogeneity in reported studies precludes solid identification of the best materials/surfaces.
Topics: Animals; Dental Implants; Titanium; Bone Diseases, Metabolic; Aluminum Oxide; Epithelial Attachment
PubMed: 38416011
DOI: 10.11607/jomi.10398 -
The International Journal of Oral &... Feb 2024To review experimental peri-implantitis studies using rat models and summarize different peri-implantitis induction techniques and evaluate their effectiveness. (Meta-Analysis)
Meta-Analysis
PURPOSE
To review experimental peri-implantitis studies using rat models and summarize different peri-implantitis induction techniques and evaluate their effectiveness.
MATERIALS AND METHODS
Electronic searches were conducted by two independent examiners to address the following issues. Meta-analyses explored the marginal bone loss (MBL) of four types of peri-implantitis induction methods in rats. The detailed induction tactics-such as the implant design, implant size, surgical process, time cost, induction methods, and endpoint measurements-were summarized.
RESULTS
Of the 18 included studies, 38.9% of the studies placed implants at the maxillary first molar, and 44.4% placed them at the alveolar ridge region anterior to the maxillary first molar. As for the induction method, the numbers of published studies on ligature methods, bacterial inoculation, and bacterial lipopolysaccharide inoculation were equally high among all selected studies. The total implant survival rate at the end was 160 out of 213 implants (75.11%). Eight studies with high pooled heterogeneity (I2 = 98, P < .01) in the meta-analysis reported an overall MBL (μ-CT) of 0.47 mm (95% CI = 0.14 to 0.81). A subgroup analysis estimated an MBL of 0.31 mm (95% CI = 0.12 to 0.50) for bacterial inoculation and 0.66 mm (95% CI = 0.07 to 1.26) for the ligature method. Histopathologic analysis revealed that peri-implantitis in rats was similar to peri-implantitis lesions in humans.
CONCLUSIONS
Implant placement at the maxillary first molar with bacterial inoculation and the silk ligature method to build peri-implantitis rat models is reliable to use for research on peri-implantitis.
Topics: Humans; Animals; Rats; Peri-Implantitis; Alveolar Process; Bone Diseases, Metabolic; Molar
PubMed: 38416001
DOI: 10.11607/jomi.10424