Suchergebnisse

The effects of valproic acid (VPA) and carbamazepine (CBZ) on bone mineral density were evaluated in 53 children with primary epilepsy treated for longer than 1 year at the Gulhane Military Academy, Ankara, Turkey.

Abstract

Background: Although results from prior publications have indicated that normative bone mineral density (BMD) in Saudi Arabian women is significantly lower than their North American and European counterparts, there has been no systematic attempt to study these differences across the age-spectrum.

Objectives: To explore these issues in more detail, a new Saudi Arabian normative BMD dataset was systematically derived from patient data at King Faisal Specialist Hospital & Research Centre in Riyadh. Changes in mean BMD were studied with respect to both age and years-since-menopause.

Methods: A retrospective analysis of BMD was carried out among 858 Saudi Arabian women who had undergone routine dual-energy x-ray absorptiometry. In addition to the usual patient details collected at each scan, information from questionnaires summarizing the patient's medical, lifestyle and menopause history was also used to identify a subset of 179 presumed-normal women.

Results: The normative BMD results for the L2-L4 AP-spine scans agree very closely with published data describing Jeddah women and indicate that during their postmenopausal years, the BMD of an average Saudi Arabian woman drops from a premenopausal plateau (i.e. peak bone mass) of 1.14 g cm−2, to a residual postmenopausal plateau of 0.92 g cm−2. The time-constant for this loss is 4.64 years.

Conclusions: We conclude that the average BMD of normal Saudi Arabian women is approximately 0.1 g cm−2 lower than European women across the entire adult age-range, but that the extent and rate of postmenopausal bone loss appears to lie within the normal European range. This suggests that osteoporosis is first manifested in young adults.

Objectives: To examine the influence of non-alcoholic fatty liver disease (NAFLD) and hepatic fat content on bone mineral density (BMD), and to investigate whether the relationship between NAFLD and BMD is independent of lifestyle factors related to BMD. Methods: Hepatic fat content (magnetic resonance imaging), BMD, lean mass index, total and abdominal fat mass (dual-energy-X-ray absorptiometry), moderate to vigorous physical activity (MVPA) (accelerometry), and calcium and vitamin D intake (two 24 h recalls) were measured in 115 children with overweight/obesity aged 10.6 +/- 1.1 years old. Result: Children with NAFLD had lower BMD than children without NAFLD regardless of sex, puberty stage, lean mass index, fat mass, MVPA, and calcium and vitamin D intake (0.89 +/- 0.01 vs. 0.93 +/- 0.01 g/cm(2) for NAFLD and non-NAFLD, respectively, P < 0.01). Higher hepatic fat content was significantly associated with lower BMD regardless of confounders (adjusted P < 0.05). Conclusions: Findings of the current study suggest that hepatic fat accumulation is associated with decreased BMD independently of adiposity, and regardless of those lifestyle factors closely related to bone mineral accrual in children. These results may have implication in the clinical management of children with overweight/obesity given the high prevalence of pediatric NAFLD. ; The current project was supported by the Spanish Ministry of Industry and Competitiveness (DEP2016-78377-R), by "Fondos Estructurales de la Union Europea (FEDER), Una manera de hacer Europa", and by the University of the Basque Country (GIU14/21). This work was also supported by grants from Spanish Ministry of Economy and Competitiveness (RYC-2010-05957; RYC-2011-09011), Spanish Ministry of Education, Culture and Sports (FPU14/03329), and by the Education, Linguistic Policy and Culture Department of the Government of the Basque Country (PRE_2016_1_0057), and also by "Programa de Captacion de Talento - UGR Fellows" as part of "Plan Propio" of the University of Granada (Spain).

Abstract

Aim
To investigate abnormalities in bone mineral density, trabecular bone score and vertebral fractures in male patients with alcohol use disorder to understand the impact on bone health.


Methods
The study subjects included 134 male patients. Controls were 134 age matched healthy males. Assessments were made of the bone mineral density (BMD), trabecular bone score (TBS) and vertebral morphometry (VFA) for vertebral fractures. Biochemical measurements included serum total T4, thyroid stimulating hormone (TSH), parathyroid hormone (PTH) and 25- Hydroxyvitamin D 25(OH) D.


Results
The mean BMD at total forearm, proximal forearm (or distal 1/3) and mid forearm was significantly higher in the alcohol use disorders (AUD) group than the controls (P &lt; 0.01). Around 15% of patients with AUD had VFs compared with 9.0% of the healthy controls (P = 0.19). For each kg/m2 gain in body mass index (BMI), lumbar spine and total hip BMD increased by 0.009 and 0.014 g/cm2, respectively. Lumbar and hip BMD decreased by 0.002 and 0.003 g/cm2 per year increase in duration of alcohol used. For every 5 years increase in age of the patients the odds of having VFs increased by 39% (odds ratio 1.393 [95% confidence interval = 1.031–1.881, P = 0.03]).


Conclusion
The findings of the current study suggest that persons with AUD in third and fourth decades of life, with BMI in normal range and with alcohol use disorder duration of around one decade might have no major alteration in BMD and TBS. Impact of alcohol use in this population was manifest by marginal increase in the prevalence of mild grade of vertebral fractures, mostly in the thoracic region.

Background: Osteoporosis is diagnosed by the measurement of bone mineral density, which is a highly heritable and multifactorial trait. We aimed to identify genetic loci that are associated with bone mineral density. Methods: In this genome-wide association study, we identified the most promising of 314 075 single nucleotide polymorphisms (SNPs) in 2094 women in a UK study. We then tested these SNPs for replication in 6463 people from three other cohorts in western Europe. We also investigated allelic expression in lymphoblast cell lines. We tested the association between the replicated SNPs and osteoporotic fractures with data from two studies. Findings: We identified genome-wide evidence for an association between bone mineral density and two SNPs (p<5×10-8). The SNPs were rs4355801, on chromosome 8, near to the TNFRSF11B (osteoprotegerin) gene, and rs3736228, on chromosome 11 in the LRP5 (lipoprotein-receptor-related protein) gene. A non-synonymous SNP in the LRP5 gene was associated with decreased bone mineral density (rs3736228, p=6·3×10-12for lumbar spine and p=1·9×10-4for femoral neck) and an increased risk of both osteoporotic fractures (odds ratio [OR] 1·3, 95% CI 1·09-1·52, p=0·002) and osteoporosis (OR 1·3, 1·08-1·63, p=0·008). Three SNPs near the TNFRSF11B gene were associated with decreased bone mineral density (top SNP, rs4355801: p=7·6×10-10for lumbar spine and p=3·3×10-8for femoral neck) and increased risk of osteoporosis (OR 1·2, 95% CI 1·01-1·42, p=0·038). For carriers of the risk allele at rs4355801, expression of TNFRSF11B in lymphoblast cell lines was halved (p=3·0×10-6). 1883 (22%) of 8557 people were at least heterozygous for these risk alleles, and these alleles had a cumulative association with bone mineral density (trend p=2·3×10-17). The presence of both risk alleles increased the risk of osteoporotic fractures (OR 1·3, 1·08-1·63, p=0·006) and this effect was independent of bone mineral density. Interpretation: Two gene variants of key biological proteins increase the risk of osteoporosis and osteoporotic fracture. The combined effect of these risk alleles on fractures is similar to that of most well-replicated environmental risk factors, and they are present in more than one in five white people, suggesting a potential role in screening. Funding: Wellcome Trust, European Commission, NWO Investments, Arthritis Research Campaign, Chronic Disease Research Foundation, Canadian Institutes of Health Research, European Society for Clinical and Economic Aspects of Osteoporosis, Genome Canada, Genome Quebéc, Canada Research Chairs, National Health and Medical Research Council of Australia, and European Union.