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Journal of Zhejiang University.... Apr 2023Postmenopausal osteoporosis is a kind of degenerative disease, also described as "invisible killer." Estrogen is generally considered as the key hormone for women to... (Review)
Review
Postmenopausal osteoporosis is a kind of degenerative disease, also described as "invisible killer." Estrogen is generally considered as the key hormone for women to maintain bone mineral content during their lives. Iron accumulation refers to a state of human serum ferritin that is higher than the normal value but less than 1000 μg/L. It has been found that iron accumulation and osteoporosis could occur simultaneously with the decrease in estrogen level after menopause. In recent years, many studies indicated that iron accumulation plays a vital role in postmenopausal osteoporosis, and a significant correlation has been found between iron accumulation and fragility fractures. In this review, we summarize and analyze the relevant literature including randomized controlled trials, systematic reviews, and meta-analyses between January 1996 and July 2022. We investigate the mechanism of the effect of iron accumulation on bone metabolism and discuss the relationship of iron accumulation, osteoporosis, and postmenopausal fragility fractures, as well as the main clinical treatment strategies. We conclude that it is necessary to pay attention to the phenomenon of iron accumulation in postmenopausal women with osteoporosis and explore the in-depth mechanism of abnormal bone metabolism caused by iron accumulation, in order to facilitate the discovery of effective therapeutic targets for postmenopausal osteoporosis.
Topics: Humans; Female; Osteoporotic Fractures; Osteoporosis, Postmenopausal; Postmenopause; Osteoporosis; Bone Density; Estrogens; Iron
PubMed: 37056206
DOI: 10.1631/jzus.B2200519 -
BMC Endocrine Disorders Feb 2018Many studies have reported associations between estrogen receptor (ER) gene polymorphisms and postmenopausal osteoporosis (PMOP) risk and bone mineral density (BMD), but... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Many studies have reported associations between estrogen receptor (ER) gene polymorphisms and postmenopausal osteoporosis (PMOP) risk and bone mineral density (BMD), but the results are controversial. The aim of the present meta-analysis is to verify the association between ERα and ERβ gene polymorphisms and osteoporosis susceptibility and BMD in postmenopausal women.
METHODS
PubMed, EMBASE, Web of Science, the Cochrane Library and China WeiPu Library were searched. OR and WMD with 95% CI were calculated to assess the association.
RESULTS
Overall, no significant association was observed between ERα XbaI, ERα PvuII and PMOP susceptibility in either overall, Caucasian or Asian populations. ERα G2014A was significantly associated with a decreased risk of PMOP in Caucasian populations. There was a significant association between ERβ RsaI and PMOP risk in both overall and Asian populations. Caucasian PMOP women with ERα XbaI XX and Xx genotypes had a higher LS Z value than women with xx genotype. ERα XbaI XX genotype was associated with increased FN BMD in overall and Caucasian populations, an increased FN Z value in Asians, and a decreased FN Z value in Caucasians. There was also a significant association between ERα XbaI Xx genotype and an increased FN Z value in either Asians or Caucasians. ERα PvuII PP genotype was associated with a low LS Z value in Caucasians and a low FN BMD and Z value in Asians. Pp genotype in PMOP women was significantly correlated with low LS BMD in overall populations, a low FN Z value in either overall, Caucasian or Asian populations.
CONCLUSION
Each ERα and ERβ gene polymorphism might have different impact on PMOP risk and BMD in various ethnicities.
Topics: Bone Density; Estrogen Receptor alpha; Estrogen Receptor beta; Female; Genetic Predisposition to Disease; Genotype; Humans; Osteoporosis, Postmenopausal; Polymorphism, Genetic
PubMed: 29458346
DOI: 10.1186/s12902-018-0230-x -
Bone May 2020Diabetes and osteoporosis occur frequently in older adults and are both associated with increased fracture risk. Denosumab treatment reduced new vertebral, nonvertebral,... (Randomized Controlled Trial)
Randomized Controlled Trial
PURPOSE
Diabetes and osteoporosis occur frequently in older adults and are both associated with increased fracture risk. Denosumab treatment reduced new vertebral, nonvertebral, and hip fractures over 3 years, with continued low fracture incidence for up to 10 years in postmenopausal women with osteoporosis. However, its effects in diabetic subjects with osteoporosis have not yet been investigated.
METHODS
Post hoc analysis of the 3-year, placebo-controlled FREEDOM study and 7-year Extension included postmenopausal women with osteoporosis and diabetes. Effects on BMD, vertebral, and nonvertebral fracture incidence were evaluated.
RESULTS
Of 7808 subjects in FREEDOM, 508 with diabetes received denosumab (n = 266) or placebo (n = 242). Among those, BMD increased significantly with denosumab versus placebo in FREEDOM, and continued to increase during the Extension in long-term (continuing denosumab) and crossover (placebo to denosumab) denosumab subjects. In FREEDOM, denosumab-treated subjects with diabetes had significantly lower new vertebral fracture rates (1.6%) versus placebo (8.0%) (RR: 0.20 [95% CI 0.07-0.61]; p = .001). Nonvertebral fracture incidence was higher with denosumab (11.7%) versus placebo (5.9%) (HR: 1.94 [95% CI 1.00-3.77]; p = .046), although there were fewer hip fractures with denosumab (World Health Organization, 2017 [1]) than placebo (4; nonsignificant). During the first 3 years in FREEDOM Extension, new vertebral and nonvertebral fracture incidences were low in long-term and crossover denosumab diabetic groups (≤6%), consistent with the overall Extension population; yearly nonvertebral fracture incidence was comparable to the FREEDOM placebo group.
CONCLUSION
Denosumab significantly increased BMD and decreased vertebral fracture risk in subjects with osteoporosis and diabetes. No reduction in nonvertebral fractures was observed.
Topics: Aged; Bone Density; Bone Density Conservation Agents; Denosumab; Diabetes Mellitus; Female; Humans; Osteoporosis; Osteoporosis, Postmenopausal; Postmenopause
PubMed: 32058020
DOI: 10.1016/j.bone.2020.115268 -
Menopause (New York, N.Y.) Oct 2022The aims of this study were to investigate trends in bone mineral density (BMD) loss and related factors in early postmenopausal women in Japan, identify risk factors...
OBJECTIVE
The aims of this study were to investigate trends in bone mineral density (BMD) loss and related factors in early postmenopausal women in Japan, identify risk factors for future osteoporosis, and predict osteoporosis before it occurs.
METHODS
The study population consisted of women who were 50 to 54 years old at the time of the survey in 2002 or 2006. The study included a questionnaire and physical measurement findings (BMD, height, body weight [WT], body mass index [BMI], and handgrip strength). One hundred sixty-seven women continued to participate in the study and had BMD measurements at the 9- or 10-year follow-up of the Japanese Population-based Osteoporosis study. Statistical analyses were performed using Pearson correlation to examine each factor of physical measurement and BMD for lumbar spine (LS) and femoral neck (FN). The receiver operating characteristic curve of this data was also predictive of osteoporosis in 2011 for 2002 data; BMD at the age of 50 to 54 years was then used to predict the likelihood of being diagnosed with osteoporosis 9 and 10 years later.
RESULTS
At the baseline in 2002 and 2006, WT, BMI, height, and handgrip strength were positively correlated with BMD. The optimal cutoff values for BMD in 2006 to predict osteoporosis in 2016 were LS less than 0.834 g/cm 2 and FN less than 0.702 g/cm 2 . These data were also predictive of osteoporosis in 2011 for 2002 data; applying this to the 2002 data, LS/FN had a sensitivity of 92%/100%, a specificity of 87%/81%, a positive predictive value of 55%/48%, and a negative predictive value of 98%/100%. The larger WT and BMI also resulted in a greater decrease in BMD of FN after 9 or 10 years.
CONCLUSIONS
We have identified a cutoff value for BMD to predict future osteoporosis in menopausal women and found a negative correlation between WT and BMI in menopausal women and changes in BMD of the FN over the next 10 years.
Topics: Absorptiometry, Photon; Body Weight; Bone Density; Female; Femur Neck; Hand Strength; Humans; Japan; Lumbar Vertebrae; Middle Aged; Osteoporosis; Osteoporosis, Postmenopausal; Perimenopause; Risk Factors
PubMed: 35969496
DOI: 10.1097/GME.0000000000002034 -
Archives of Osteoporosis Aug 2022This observational study assessed the impact on the fracture incidence of osteoporosis medications in postmenopausal women in Germany. Continued treatment with... (Observational Study)
Observational Study
UNLABELLED
This observational study assessed the impact on the fracture incidence of osteoporosis medications in postmenopausal women in Germany. Continued treatment with osteoporosis medications was associated with reductions of fracture rates in a real-world setting.
PURPOSE
The efficacy of osteoporosis medications has been demonstrated in clinical trials, but a lack of evidence exists of their real-world effectiveness. This real-world study assessed the treatment patterns and impact on the fracture incidence of osteoporosis medications in postmenopausal women in Germany.
METHODS
This cohort study used data from the WIG2 benchmark database, a German anonymised healthcare claims database. All women ≥ 50 years of age with ≥ 1 prescription for osteoporosis medication between 1 January 2013 and 31 December 2017 were included. The primary outcome was treatment effectiveness, evaluated as the change in fracture incidence after initiating treatment. Fracture types included all fractures, clinical vertebral, hip and wrist/forearm. Fracture incidence was assessed during the early-treatment period (0-3 months) and the on-treatment period (4-12, 13-24, 25-36 and 37-48 months).
RESULTS
Baseline covariates and treatment patterns were determined for 41,861 patients. The median duration of therapy was longer with denosumab (587 days) than with intravenous ibandronate (451 days), intravenous zoledronate (389 days) or oral bisphosphonates (258 days). The baseline incidence rate of all fractures was higher in patients receiving denosumab than in those receiving other treatments (87.6, 78.2, 56.6 and 66.0 per 1000 person-years for denosumab, oral bisphosphonates, intravenous ibandronate and intravenous zoledronate, respectively). Rates of all fractures declined with continued denosumab (by 38%, 50%, 56% and 67% at 12, 24, 36 and 48 months, respectively) and oral bisphosphonates (by 39%, 44%, 49% and 42%, respectively) treatment.
CONCLUSION
Continued treatment with osteoporosis medications was associated with reductions of fracture rates in a real-world setting.
Topics: Bone Density Conservation Agents; Cohort Studies; Denosumab; Diphosphonates; Female; Fractures, Bone; Germany; Humans; Ibandronic Acid; Osteoporosis; Osteoporosis, Postmenopausal; Osteoporotic Fractures; Zoledronic Acid
PubMed: 36044096
DOI: 10.1007/s11657-022-01156-z -
International Journal of Environmental... Jul 2022Osteoporosis is considered a widespread health problem that affects senior citizens, particularly older women, after the menopause. This national study aimed to estimate...
Osteoporosis is considered a widespread health problem that affects senior citizens, particularly older women, after the menopause. This national study aimed to estimate the prevalence of osteoporosis among Jordanian postmenopausal women and to determine the association of demographic and nutritional factors, such as calcium and vitamin D supplement intake, with osteoporosis in postmenopausal women. A cross-sectional study was conducted among 884 postmenopausal women aged ≥50 years. A multistage sampling technique was used to select participants from three geographic regions of Jordan (north, middle, and south). The data were collected from the participants by a team of field researchers comprising men and women through a standard questionnaire. The prevalence of osteoporosis was 19.8% among postmenopausal Jordanian women. The study results showed that age (p ˂ 0.001), geographic region (p = 0.019), occupation (p = 0.002), and educational level (p = 0.001) were significantly associated with osteoporosis. Moreover, osteoporosis was significantly associated with calcium and vitamin D supplement intake (p < 0.05). There is a high prevalence of osteoporosis among postmenopausal Jordanian women. Therefore, there is a need to educate women at this age, and probably at an earlier age, to prevent or reduce the development of osteoporosis.
Topics: Aged; Bone Density; Calcium; Calcium, Dietary; Cross-Sectional Studies; Female; Humans; Jordan; Male; Osteoporosis; Osteoporosis, Postmenopausal; Postmenopause; Vitamin D
PubMed: 35886655
DOI: 10.3390/ijerph19148803 -
The Journal of the American Osteopathic... Jan 2000Osteoporosis is a silent epidemic that is preventable and treatable. Few people are currently having osteoporosis diagnosed early enough to receive the benefit of... (Review)
Review
Osteoporosis is a silent epidemic that is preventable and treatable. Few people are currently having osteoporosis diagnosed early enough to receive the benefit of prevention. Therefore, most present with a fracture as the first clinical manifestation of the disease. The physician taking a history must have a high index of suspicion for osteoporosis. All women should be counseled about risk factors for osteoporosis. The diagnosis of this disease includes an evaluation of bone mineral density by radiologic technique. The osteopathic physician is uniquely well trained to recognize and diagnose osteoporosis.
Topics: Bone Density; Female; Humans; Male; Osteoporosis; Osteoporosis, Postmenopausal; Risk Factors
PubMed: 10705678
DOI: 10.7556/jaoa.2000.100.1.4s -
Frontiers in Immunology 2022Postmenopausal osteoporosis (PMO) is influenced by estrogen metabolism and immune response, which are modulated by several factors including the microbiome and...
BACKGROUND
Postmenopausal osteoporosis (PMO) is influenced by estrogen metabolism and immune response, which are modulated by several factors including the microbiome and inflammation. Therefore, there is increasing interest in understanding the role of microbiota in PMO.
OBJECTIVES
To investigate variations in gut microbiota (GM) and vaginal microbiota (VM) in postmenopausal women with osteoporosis.
METHODS
A total of 132 postmenopausal women were recruited for the study and divided into osteoporosis (n = 34), osteopenia (n = 47), and control (n = 51) groups based on their T score. The serum levels of interleukin (IL)-10, tumor necrosis factor (TNF)-α, and lipopolysaccharide-binding protein were determined enzyme-linked immunosorbent assay. Additionally, 16S rRNA gene V3-V4 region sequencing was performed to investigate the GM and VM of the participants.
RESULTS
Significant differences were observed in the microbial compositions of fecal and vaginal samples between groups ( < 0.05). It was noted that for GM, , and spp. were enriched in the control group, whereas the abundances of , , and spp. were higher in the osteoporosis group than in the other groups. Additionally, for VM, was enriched in the control group, whereas the abundances of , and spp. were higher in the osteoporosis group than in the other groups. The predicted functional capacities of GM and VM were different in the various groups. We also found that the serum level of IL-10 in the osteoporosis group was significantly lower than that in the control group and osteopenia group, while TNF-α was significantly higher in the osteoporosis group than that in the control group ( < 0.05).
CONCLUSION
The results show that changes in BMD in postmenopausal women are associated with the changes in GM and VM; however, changes in GM are more closely correlated with PMO than VM.
Topics: Bone Diseases, Metabolic; Female; Gastrointestinal Microbiome; Humans; Osteoporosis; Osteoporosis, Postmenopausal; RNA, Ribosomal, 16S; Tumor Necrosis Factor-alpha; Vagina
PubMed: 36032115
DOI: 10.3389/fimmu.2022.930244 -
Arthritis Research & Therapy 2009In the past decade, we have witnessed a revolution in osteoporosis diagnosis and therapeutics. This includes enhanced understanding of basic bone biology, recognizing... (Review)
Review
In the past decade, we have witnessed a revolution in osteoporosis diagnosis and therapeutics. This includes enhanced understanding of basic bone biology, recognizing the severe consequences of fractures in terms of morbidity and short-term re-fracture and mortality risk and case finding based on clinical risks, bone mineral density, new imaging approaches, and contributors to secondary osteoporosis. Medical interventions that reduce fracture risk include sufficient calcium and vitamin D together with a wide spectrum of drug therapies (with antiresorptive, anabolic, or mixed effects). Emerging therapeutic options that target molecules of bone metabolism indicate that the next decade should offer even greater promise for further improving our diagnostic and treatment approaches.
Topics: Female; Fractures, Bone; Humans; Osteoporosis, Postmenopausal; Risk Assessment; Risk Factors
PubMed: 19849819
DOI: 10.1186/ar2815 -
The Journal of the American Osteopathic... Jan 2000Osteoporosis is a major public health problem. It is a skeletal disorder characterized by low bone mass and an increased susceptibility to fractures. In the United... (Review)
Review
Osteoporosis is a major public health problem. It is a skeletal disorder characterized by low bone mass and an increased susceptibility to fractures. In the United States, it affects more than 25 million people, accounts for 1.5 million fractures annually, and costs the nation in excess of $10 billion. The consequences of osteoporosis include decreased functional independence and increased morbidity and mortality. Osteoporosis is a multifactorial disease. The pathogenesis of the disorder has genetic, hormonal, and environmental influences that affect peak bone mass, perimenopausal bone loss, and age-dependent bone loss.
Topics: Adult; Aged; Aging; Bone Remodeling; Female; Humans; Male; Osteoporosis; Osteoporosis, Postmenopausal
PubMed: 10705677
DOI: 10.7556/jaoa.2000.100.1.1s