Positive effect of steroid withdrawal on bone mineral density in renal allograft recipients

2001 ◽  
Vol 33 (1-2) ◽  
pp. 1273-1277 ◽  
Author(s):  
E. Nowacka-Cieciura ◽  
M. Durlik ◽  
T. Cieciura ◽  
M. Tałałaj ◽  
K. Kukuła ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Renal Allograft ◽  
Steroid Withdrawal ◽  
Mineral Density ◽  
Positive Effect

Effects of vitamin D and estrogen receptor polymorphisms on bone mineral density in adolescents with anorexia nervosa

2019 ◽  
Vol 32 (12) ◽  
pp. 1377-1384
Author(s):  
Işıl İnan-Erdoğan ◽  
Sinem Akgül ◽  
Kübra Işgın-Atıcı ◽  
Tuğba Tuğrul-Yücel ◽  
Koray Boduroğlu ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Estrogen Receptor ◽  
Anorexia Nervosa ◽  
Bone Mineral ◽  
Mineral Density ◽  
Vdr Gene ◽  
Positive Effects ◽  
Z Scores ◽  
Positive Effect

Abstract Background Anorexia nervosa (AN) is a serious eating disorder that is associated with decreased bone mineral density (BMD) and greater lifetime risk for fractures. The aim of this study was to determine the correlation between BMD and genetic polymorphisms in AN. Methods This case-control study analyzed vitamin D receptor (VDR) (VDRBsml, VDRFokl) and estrogen receptor (ESR) (ESR1Xbal, ESR1Pvull) polymorphisms in 45 adolescents diagnosed with AN and 46 age-matched healthy controls. BMD values of the AN group were classified as low or normal, and polymorphisms were compared between cases and controls. The effects of body mass index (BMI), duration of disease and amenorrhea on BMD were also evaluated. Results In girls with AN, a positive effect of the bb genotype of VDRBsmI polymorphism on femur Z-scores (p = 0.103) and of the Ff genotype of VDRFokI polymorphism on vertebra Z-scores (p = 0.097) was observed. In boys with AN, a positive effect of the Ff genotype of VDRFokI polymorphism on vertebra BMD (g/cm2) was detected (p = 0.061). No association was detected between ESR polymorphisms. An inverse relationship was observed between BMD and duration of illness and amenorrhea. A direct relationship was detected between BMD and BMI. Conclusions Specific VDR gene polymorphism genotypes may have positive effects on BMD in patients with AN. Additionally, the lack of association between ESR gene polymorphisms on BMD could be attributed to the low estrogen status of the patient.

Habitual Tea Drinking and Bone Mineral Density in Postmenopausal Turkish Women: Investigation of Prevalence of Postmenopausal Osteoporosis in Turkey (IPPOT Study)

2007 ◽  
Vol 77 (6) ◽  
pp. 389-397 ◽  
Author(s):  
Hamdi Kara ◽  
Aydin ◽  
Gemalmaz ◽  
Aktürk ◽  
Yaman ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
High Education ◽  
Bone Mineral ◽  
Milk Product ◽  
Turkish Women ◽  
Mineral Density ◽  
Positive Effects ◽  
Education Levels ◽  
Tea Drinking ◽  
Positive Effect

Aim: In this epidemiological report, we assessed the prevalence of osteopenia and osteoporosis (OP) in postmenopausal Turkish women and the relationship between body mass index (BMI), and some nutritional factors (habitual tea, coffee, tobacco, and milk product consumption) with OP. Methods: This multicenter study was done in postmenopausal women residing in five big cities, in four different regions of Turkey between August and November 2005. An inclusion criterion was being in the postmenopausal period for at least 12 months. A semi-structured questionnaire was completed by face-to-face interview, consisting of closed- and open-ended questions about demographic characteristics, nutritional status, and habits with two or more choices as possible responses. Bone mineral density (BMD) measurements were performed with a MetriScan® Densitometer (Alara Inc., Ca, USA). Results: Seven hundred twenty-four women were included in the study. The mean age was 57.6 ± 9.6 years, and mean age at natural menopause was 46.4 ± 5.6 years. Of the participants, 51% were illiterate. According to WHO classification; 42.5% were normal in terms of BMD, 27.2% had osteopenia, and 30.2% had OP. Women with high education levels had better T-scores (p = 0.019). Increase in BMI also had a positive effect on T-scores (p < 0.0001). A linear correlation was found between age (r= –0.386, p < 0.0001), BMI (r = –0.175, p < 0.0001), and education (r = –0.317, p < 0.0001), with T-scores. The T-scores of women who consumed tea on a regular basis were found to be higher than non-consumers (–1.51 ± 1.68 vs. –1.09 ± 1.66; p = 0.070) [when smokers, those who received hormonal therapy (HT), and those > 65 years were excluded]. Conclusion: OP was determined in 1/3 of the women. Advanced age (> 65) and being illiterate were negative factors, while high education levels, being overweight, and being treated with HT had a positive effects on BMD. Habitual tea drinking also may have a positive effect on BMD. However, tea drinking was not found to be a statistically significant factor in the present study.

MO199DENOSUMAB: NOVEL APPROACH TO TREATMENT OF OSTEOPOROSIS IN RENAL DISEASE

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
Rosita Greco ◽  
Agata Mollica ◽  
Francesco Zincone ◽  
Teresa Papalia
Keyword(s):  
Bone Mineral Density ◽  
Renal Disease ◽  
Bone Mineral ◽  
Renal Allograft ◽  
Mineral Metabolism ◽  
Transplant Recipients ◽  
Mineral Density ◽  
Anca Vasculitis ◽  
T Score ◽  
Bone Mineral Metabolism

Abstract Background and Aims Denosumab is a fully human monoclonal antibody to the receptor activator of nuclear factor kappa-B ligand (RANKL), an osteoclast differentiating factor. It inhibits osteoclast formation, decrease bone resorption, increase bone mineral density (BMD), and reduce the risk of fracture. There is no restriction of its use in patients with renal disease, for whom biphosphonates are considered controindicated. The aim of our study was to evaluate the effectiveness in reducing facture risk and safety of Denosumab in patients with Osteoporosis and renal disease. Method This is a prospective analysis of 17 patients with Osteoporosis (average T-score below -2.5) admitted to our Nephrology Department for CKD in the last four years. in Vasculitis, Renal Allograft Recipients. Patients with severe Hyperparatiroidism were excluded. We estimated creatinine clearance (eGFR) using Cockcroft-Gault and classified levels of kidney function using the modified National Kidney Foundation classification of CKD. All patients were adequately supplemented with calcium and vitamin D before and while taking Denosumab 60 mg every 6 months. The primary endpoint is the change in bone mineral density (BMD) at one and two years. Secondary endpoints include changes in bone mineral metabolism parameters (Ca, P, PTHi, 25-OH VitD), incidence of fractures, and renal/allograft fuction at one and two years. Results The mean age was 52.5±4 years and 8/17 (47%) were females. N.13 patients (76.5%) were renal transplant recipients (RTR) on standard triple immunosoppression including steroids (prednisone 5 mg/day), CNI and MMF, with average eGFR 65.7±12.5 ml/min. N.2 patients (11.75%) were in hemodialysis. N.2 patients (11.75%) with Anca Vasculitis on steroid therapy and average eGFR 35.6±7.2 ml/min. All patients enrolled were with a BMD T-score of greater than -4.0 and less than -2.5. Only 2 patients had a history of fractures confirmed by a radiology report. Baseline parameters: calcium 9.8±0.32 mg/dl, phosphate 3.9±0.8 mg/dl, PTHi 137±91.0 ng/L, 25-OH VitD 18.3±8.9 ng/mL. From baseline at 1 month there were an increase in PTH and a decrease in calcemia in only 2 transplant recipients (CKD II and IV), that improved with an increased dose of Vit D. There were no significant difference in baseline bone mineral metabolism parameters to year 1 and 2 in all other patients. We found no difference in eGFR and proteinuria from baseline to 1 and 2 years in RTR and ANCA vasculitis. Significant improvement in T-score was observed at 1 year and 2 years (&lt; -1) in all patients. No one discontinued therapy for adverse events. Conclusion Denosumab may have advantages in patients with kidney dysfunction, because not excreted by the kidney and there is no need for dose adjustment. This prospective study showed a significant improvement in osteoporosis (at Dexa mean T-score ≤ -1), but particular attention should be paid to ensuring that patients are calcium and Vitamin D replete.

The positive effect of dietary vitamin D intake on bone mineral density in men is modulated by the polyadenosine repeat polymorphism of the vitamin D receptor

Bone ◽  
2006 ◽  
Vol 39 (6) ◽  
pp. 1343-1351 ◽  
Author(s):  
Karl Michaëlsson ◽  
Alicja Wolk ◽  
Annica Jacobsson ◽  
Andreas Kindmark ◽  
Elin Grundberg ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Vitamin D ◽  
Bone Mineral ◽  
Vitamin D Receptor ◽  
Dietary Vitamin ◽  
Repeat Polymorphism ◽  
Mineral Density ◽  
Vitamin D Intake ◽  
Dietary Vitamin D ◽  
Positive Effect

scholarly journals P0879EARLY STEROID WITHDRAWAL HAS A POSITIVE EFFECT ON BONE KIDNEY TRANSPLANT RECIPIENTS: A PROPENSITY SCORE STUDY WITH INVERSE PROBABILITY-OF-TREATMENT WEIGHTING

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Benjamin Batteux ◽  
Valérie Gras-Champel ◽  
Mathilde Lando ◽  
François Brazier ◽  
Isabelle Desailly-Henry ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Kidney Transplantation ◽  
Bone Mineral ◽  
Steroid Withdrawal ◽  
Transplant Recipients ◽  
Kidney Transplant Recipients ◽  
Mineral Density ◽  
Inverse Probability

Abstract Background and Aims Long-term corticosteroid use after kidney transplantation is associated with a decrease in bone mineral density and a high fracture risk. We hypothesized that patients with early steroid withdrawal (ESW) would display a gain in bone mineral density in the year following kidney transplantation, when compared with patients on long-term corticosteroid therapy (LTCT). Method In a cohort of kidney transplant recipients, 317 patients were included between 2012 and 2018. Dual-energy X-ray absorptiometry was performed 1 and 12 months after transplantation. The data were analyzed using linear regression with inverse probability-of-treatment weighting based on a propensity score. Results One year after transplantation, the gain in bone mineral density was significantly greater in recipients with ESW than in recipients on LTCT for the lumbar spine (+0.027 g/cm, P &lt; 0.001) and the femoral neck (+0.021 g/cm, P = 0.035). Among patients with ESW, (i) none had osteoporosis, (ii) the percentage with normal bone mineral density increased from 35.0% at month 1 to 56.4% at month 12, and (ii) the percentage with osteopenia fell from 52.5% to 43.6%. In patients undergoing LTCT, the fracture incidence was 14.5 per 1000 person-years. None of the patients in the ESW group experienced a fracture. Cardiovascular risk factors were more prominent in the LTCT group relative to the ESW group: patients in LTCT group (i) were more likely to have high blood pressure (p&lt;0.001), (ii) gained more weight gain (p=0.032) and (iii) displayed a greater increase in serum triglyceride levels (p=0.004).The acute rejection rate was similar in the two groups. Conclusion Early steroid withdrawal is associated with a spontaneous increase in bone mineral density at 12 months post-transplantation (relative to patients on long-term steroid therapy), with a reduction in several cardiovascular risk factors and does not appear to harm the graft.

scholarly journals Hypolipemiant Treatment: Making the Right Choice for Osteoporotic Patients

2013 ◽  
Vol 59 (1) ◽  
pp. 18-24
Author(s):  
Remus Șipoș ◽  
Ioana Șuș ◽  
Zsuzsanna Pap ◽  
Anna Szidónia Szalai ◽  
Anamaria Victoria Gabor ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Bone Mineral ◽  
Repair Process ◽  
Fracture Repair ◽  
Point Of View ◽  
Control Group ◽  
Mineral Density ◽  
Experimental Conditions ◽  
The Right ◽  
Positive Effect

Abstract Introduction: It has been shown that dyslipidemia is related to bone mineral density and fragility. Hypolipemiant drugs as statins or fibrates seem to increase the bone mineral density and probably to protect against fractures. The question that arises in this context is whether statins or fibrates have a positive effect on bone fracture repair process and which is their behaviour in an osteoporotic context. Our objective was to study the incidence of osteoporosis, dyslipidemia and of the association of these diseases, and to compare the effect of statins and fibrates on fracture repair in experimental conditions. Material and method: We studied the incidence of dyslipidemia and osteoporosis in the activity of a private family medicine cabinet. In the experimental part we observed from a radiographic point of view the fracture repair process of rats’ femurs. We analyzed 6 subgroups of 12 rats each: (1) ovariectomized control, (2) ovariectomized treated with statins, (3) ovariectomized treated with fibrates, (4) nonovariectomized control, (5) ) nonovariectomized treated with statins, (6) ) nonovariectomized treated with fibrates. The radiographic aspect has been objectified with a score at 2, 4, 6 and 8 weeks. Results: From the total of 646 patients included in the study, 193 (29.87%) had dyslipidemia while osteoporosis was diagnosed at 152 (23.53%) patients. 301 (46.6%) patients presented the association of these diseases. Comparing the subgroups of the OVX group, we had the following results: subgroup 1 - 5.5 points, group 2 - 11 points and group 3 - 4.5 points. In the case of the NOVX subgroups, the scores were: subgroup 4 - 7.5 points, subgroup 5 - 10 points and subgroup 6 - 6.5 points. Conclusions: The fact that the incidence of dyslipidemia is higher than that of osteoporosis is an argument for the necessity of choosing a hypolipemiant treatment that has, at the same time, a protective effect on bone. Hypolipemiant treatment influences the fracture repair process. The positive effect of statins on this process is more important on the ovariectomized group, in contrast with fibrates which have an accentuated effect on the nonovariectomized group and this suggests an interference between hypolipemiant treatment and estrogens level. However, the treatment with fibrates delays the fracture repair, groups (3) and (6) scores being inferior to those of the control group. We sustain the helping effect of statins treatment on fracture repair process.

scholarly journals Dosage of estradiol, bone and body composition in Turner syndrome: a 5-year randomized controlled clinical trial

2017 ◽  
Vol 176 (2) ◽  
pp. 233-242 ◽  
Author(s):  
Line Cleemann ◽  
Kirsten Holm ◽  
Hanne Kobbernagel ◽  
Bent Kristensen ◽  
Sven Oluf Skouby ◽  
...  
Keyword(s):  
Bone Mineral Density ◽  
Body Composition ◽  
Bone Mineral ◽  
Bone Markers ◽  
Whole Body ◽  
Controlled Clinical Trial ◽  
Mineral Density ◽  
Randomized Controlled ◽  
Positive Effect ◽  
Over Time

Objective Reduced bone mineral density (BMD) is seen in Turner syndrome (TS) with an increased risk of fractures, and body composition is characterized by increased body fat and decreased lean body mass. To evaluate the effect of two different doses of oral 17B-estradiol in young TS women on bone mineral density (BMD), biochemical markers of bone turnover and body composition with the hypothesis of a positive effect of the higher dose. Design A double-blind 5-year randomized controlled clinical trial. 20 young TS women participated. Inclusion criteria were diagnosis of TS, age 15–25 years and current treatment with 2 mg oral estradiol daily. Methods The low-dose (LD) group was administered 2 mg 17B-estradiol/day orally and placebo, the high-dose (HD) group was administered 2 + 2 mg 17B-estradiol/day orally. Main outcome measures were whole body and regional bone mineral density (BMD), lean body mass (LBM), fat mass (FM) measured yearly by DXA scan and resorptive and formative bone markers in serum. Results BMD, whole body and regional, increased over time with an attenuation toward the end of the study, and bone turnover markers decreased over time, both with no differences between the treatment groups (P = 0.2–0.9). LBM increased significantly more in the HD group (P = 0.02). FM remained stable in both groups. Conclusions A steady increase in BMD over time in TS was found similar to healthy young women. The higher estrogen dose did not differentially affect BMD or bone markers. The positive effect on body composition may have long-ranging health benefits in TS.

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