Osteoporosis in multiple sclerosis

2010 ◽  
Vol 16 (9) ◽  
pp. 1031-1043 ◽  
Author(s):  
Andrew P Hearn ◽  
Eli Silber
Keyword(s):  
Risk Factors ◽  
Multiple Sclerosis ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Significant Risk ◽  
Mineral Density ◽  
Increased Risk ◽  
Review Management ◽  
Multiple Sclerosis Patients ◽  
Reduced Mobility

Fractures resulting from osteoporosis are a major cause of morbidity and mortality in the developed world. People with multiple sclerosis experience reduced mobility and are susceptible to falls. Glucocorticoid use and reduced mobility are known risk factors for osteoporosis. This paper is a review of osteoporosis in people with multiple sclerosis, looking at its prevalence, risk factors and possible mechanisms. We also review management guidelines for osteoporosis in the general population and use these to propose guidelines for osteoporosis management amongst multiple sclerosis patients. A number of studies have examined the incidence of reduced bone mineral density amongst people with multiple sclerosis; the majority provide convincing evidence that bone mineral density is significantly reduced in multiple sclerosis patients. The most significant risk factors appear to arise from the chronic disease process of multiple sclerosis and not from glucocorticoid use. There are currently no guidelines or consensus as how best to treat osteoporosis amongst multiple sclerosis patients despite their being at an increased risk. We propose an algorithm for the screening and treatment of osteoporosis in people with multiple sclerosis.

The effect of menarche age, parity and lactation on bone mineral density in premenopausal ambulatory multiple sclerosis patients

2015 ◽  
Vol 4 (4) ◽  
pp. 287-290 ◽  
Author(s):  
Chrissa Sioka ◽  
Andreas Fotopoulos ◽  
Stilianos Papakonstantinou ◽  
Athanasia Georgiou ◽  
Sygliti-Henrietta Pelidou ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Mineral Density ◽  
Multiple Sclerosis Patients ◽  
Menarche Age

scholarly journals Associations of Serum MicroRNA with Bone Mineral Density in Community-Dwelling Subjects: The Yakumo Study

2020 ◽  
Vol 2020 ◽  
pp. 1-7 ◽  
Author(s):  
Hiroaki Nakashima ◽  
Kei Ando ◽  
Kazuyoshi Kobayashi ◽  
Taisuke Seki ◽  
Shinya Ishizuka ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Logistic Regression ◽  
Regression Analysis ◽  
Bone Mineral ◽  
Logistic Regression Analysis ◽  
Odds Ratio ◽  
Significant Risk ◽  
Mineral Density ◽  
Confidential Interval

Osteoporosis is a disease characterized by deterioration of bone tissue and mass, with an increasing global prevalence. Therefore, the discovery of biomarkers for osteoporosis would help to guide appropriate treatment. Circulating microRNAs (miRNAs) have become increasingly recognized as biomarkers for detecting diseases. However, few studies have investigated the association of circulating miRNA with osteoporosis in the general population. The aim of this study was to identify miRNA associated with osteoporosis in a general resident health check-up for potential use as an osteoporosis biomarker. We conducted a cross-sectional study as part of a health check-up program and recruited 352 volunteers (139 men, 213 women, mean age 64.1±9.6 years). Osteoporosis was diagnosed according to the WHO classification. Twenty-two candidate microRNAs were screened through real-time quantitative PCR, and miRNAs associated with osteoporosis were analyzed using logistic regression analysis including other risk factors. In total, 95 females and 30 males were diagnosed with osteoporosis with bone mineral density tests (BMD: T‐score<−2.5). We found that miR195 was significantly lower in females, while miR150 and miR222 were significantly higher in males. The results of the logistic regression analysis indicated that in females, higher age and lower miR195 (odds ratio: 0.45, 95% confidential interval: 0.03–0.98) were significant risk factors for lower BMD, while the presence of a smoking habit and lower miR150 (odds ratio: 1.35, 95% confidential interval: 1.02–1.79) were significant risk factors for osteoporosis. Serum levels of miR195 and miR150 are independently associated with low bone mineral density in females and males, respectively.

scholarly journals Fragility fractures and bone remodeling in type 2 diabetes mellitus

2017 ◽  
Vol 14 (3) ◽  
pp. 11-18 ◽  
Author(s):  
Tatiana O. Yalochkina ◽  
Zhanna E. Belaya
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Type 2 Diabetes ◽  
Bone Tissue ◽  
Bone Mineral ◽  
Bone Fragility ◽  
Mineral Density ◽  
Severe Diabetes ◽  
Increased Risk

Fracture risk is significantly increased in both type 1 and type 2 diabetes and individuals with diabetes experience worse fracture outcomes compared to normoglycemic individuals. Patients with T1DM have decreased bone mineral density (BMD), whereas patients with T2DM demonstrate increased BMD compared to healthy control. The latest studies show increased incidence of low-traumatic fractures in patients with T2DM instead of high bone mineral density (BMD). The risk of osteoporotic fractures in patients with T2DM can be explained by disease complications and increased risk of falls and consequent trauma. However, the most important cause of bone fragility in T2DM is the deterioration in bone microarchitecture, the mechanism of which is not completely understood. High BMD in patients with T2DM does not allow us to use dual-energy X-ray-absorptiometry as a gold standard test for diagnosticsof osteoporosis. Consequently,new risk factors and diagnostic algorithm as well as treatment strategy should be developed for patients with T2DM. In addition to this, some researchers considered that the group of T2DM is geterogenous and physicians might face patients with osteoporosis and mild diabetes that add very little to bone fragility; patients with osteoporosis and moderate or severe diabetes which also affects bone tissue diabetoosteoporosis; and patients without osteoporosis but severe diabetes which cause bone tissue deterioration with the development of diabetic bone disease. New diagnostic tools and algorithm and new experimental research are needed for better understanding bone deterioration in patients with T2DM. This review summarizes our current knowledge on fracture rate, risk factors for fractures and causes of bone deterioration in subjects with T2DM.

scholarly journals Risk Factors for Systemic Reduced Bone Mineral Density in Premenopausal Female Patients with Early Untreated Rheumatoid Arthritis

2018 ◽  
Vol 45 (04) ◽  
pp. 334-340
Author(s):  
Hamada S. Ahmed ◽  
Sherif E. Farrag ◽  
Amr E. Okasha ◽  
Gamal Othman ◽  
Ibrahim Shady
Keyword(s):  
Rheumatoid Arthritis ◽  
Risk Factors ◽  
Bone Mineral Density ◽  
Rheumatoid Factor ◽  
Bone Mineral ◽  
Early Rheumatoid Arthritis ◽  
Mineral Density ◽  
T Score ◽  
Increased Risk ◽  
Treatment Naïve

Abstract Background Systemic osteoporosis (OP) is evident among patients with early rheumatoid arthritis (ERA). This study aimed to investigate the OP risk factors in patients with ERA and who was treatment-naïve at inclusion. Subjects and Methods Systemic bone mineral density (BMD) of the lumbar spine (LS), femoral neck (FN) and total hip (TH) was measured in 135 treatment-naïve premenopausal females with early Rheumatoid Arthritis (ERA). For all patients, demographic data, vitamin D status, and the specific parameters of the disease, including disease activity, serum levels of rheumatoid factor and anti-citrullinated protein antibodies (ACPA) were evaluated. Results T score was<−1.0 in the LS in 16.2%, in the FN in 22.2% and in the TH in 23.7%. Among our patients, 29.6% had below normal T score at any site. Demographic characteristics, RA duration, diseases activity did not significantly impact BMD. However, patients with decreased BMD were more prevalent ACPA- and rheumatoid factor (RF)-positive than patients with normal BMD. Also, high titer ACPA or RF is associated with more marked reduction in BMD. In regression analysis, after adjustment for possible confounders, patient stratification according to ACPA status and RF status (into negative, low-positive and high positive) still a significant independent variable associated with lower BMD values. Conclusion Presence of ACPA or RF is associated with increased risk for development of reduced systemic BMD from very early stage of rheumatoid arthritis. Furthermore, this risk increases more with higher levels of ACPA or RF. Measurement of BMD should be performed for ACPA- or RF-positive patients with early RA.

scholarly journals Physiological Factors of Female Runners With and Without Stress Fracture Histories: A Pilot Study

2020 ◽  
Vol 12 (4) ◽  
pp. 334-340
Author(s):  
Therese E. Johnston ◽  
Colleen Dempsey ◽  
Frances Gilman ◽  
Ryan Tomlinson ◽  
Ann-Katrin Jacketti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Turnover ◽  
Bone Mineral ◽  
Bone Turnover Markers ◽  
Mineral Density ◽  
Physiological Factors ◽  
Physiological Factor ◽  
Increased Risk ◽  
Turnover Markers

Background: Female runners are at increased risk of stress fractures (SFs) compared with men. Literature is lacking with regard to best practice for preventing and treating SFs in women. The purpose of the study was to compare physiological measures and running-related factors between women of various ages and running abilities with and without a history of running-related SFs. Hypothesis: Women with and without SF histories will differ with regard to medical and menstrual history, bone health, body composition, nutrition, and running history. Study Design: Prospective cohort study. Level of Evidence: Level 2. Methods: A total of 20 female runners with SF histories were matched based on age and running distance with 20 women without SF histories. Data included medical, menstrual, running, injury, and nutritional histories; blood histology related to nutritional, hormonal, and bone-related risk factors; and bone density, fat, and lean tissue using dual energy x-ray absorptiometry. Paired t tests were used to examine differences between women with and without SF histories, and Spearmen correlations were conducted to examine relationships between physiological factors. Results: Women with SF histories had lower hip bone mineral density compared with women without SF histories ( P < 0.05). SF history was moderately correlated with menstrual changes during increased training times ( r = 0.580; P < 0.0001) but was not correlated with any other physiological factor. There was a moderate correlation within the SF group ( r = 0.65; P = 0.004) for bone markers for resorption and formation both increasing, indicating increased bone turnover. Conclusion: Female runners with low hip bone mineral density, menstrual changes during peak training, and elevated bone turnover markers may be at increased risk of SF. Clinical Relevance: Female runners need routine screening for risks associated with SF occurrence. As bone mineral density and bone turnover markers are not routinely assessed in this population, important risk factors may be missed.

scholarly journals Osteoporosis Risk Factors and Bone Mineral Density in Women With MS

2002 ◽  
Vol 4 (1) ◽  
pp. 17-29 ◽  
Author(s):  
Suzanne C. Smeltzer ◽  
Vanessa Zimmerman ◽  
Theresa Capriotti ◽  
Lilia Fernandes
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Health Care Providers ◽  
Calcium Supplementation ◽  
Care Providers ◽  
Risk Minimization ◽  
Mineral Density ◽  
Os Calcis ◽  
Increased Risk

Purpose: To describe the results of bone mineral density (BMD) screening in women with multiple sclerosis (MS) and to identify risk factors for osteoporosis in women with MS and their use of preventive strategies. Methods: BMD screening was performed at the os calcis. A self-administered survey, formatted as a checklist, asked women with MS about their risk factors for osteoporosis and their use of osteoporosis prevention strategies. Findings: 142 women with MS completed the study. Using a modified classification system suggested for use with peripheral measurements of BMD, 44.4% of women in the sample were categorized as having normal BMD, 35.2% were osteopenic, and 20.4% were osteoporotic. The number of risk factors for osteoporosis reported by women with MS ranged from zero to 10 with a mean of 4.6 ± 1.8. Relatively few women were using strategies to minimize their risks for osteoporosis. Of those who did employ a risk-minimization strategy, the lowest number of women in the sample (4.3%) used raloxifene, and the highest number of women (38.6%) used calcium supplementation. Conclusions: Low BMD is common in women with MS, increasing their risk for osteoporosis and osteoporotic fractures. Greater awareness is needed among health care providers regarding the increased risk and high incidence of osteoporosis in women with MS. Strategies to detect and prevent osteoporosis are warranted in women with MS in order to prevent further disability caused by osteoporosis-related fractures. (Int J MS Care. 2002; 4: 17–23, 29)

A Lifestyle Modification Intervention for the Treatment of Osteoporosis

2005 ◽  
Vol 20 (1) ◽  
pp. 28-33 ◽  
Author(s):  
Janine A. Pearson ◽  
Emily Burkhart ◽  
W. Bradley Pifalo ◽  
Tina Palaggo-Toy ◽  
Kelly Krohn
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Lifestyle Modification ◽  
Significant Risk ◽  
Exercise Adherence ◽  
Repeated Measure ◽  
Control Group ◽  
Mineral Density

Purpose. The purpose of this evaluation was to evaluate the effectiveness of a multidisciplinary educational and exercise program for individuals at risk for osteoporosis-related fractures. Methods. The Highmark Osteoporosis Prevention and Education (HOPE) program is an ongoing, 8-week program with two postintervention follow-up assessments at 6 months and 2 years. Adults (n = 375) with osteoporosis or significant risk factors, most already engaged in healthy behaviors, self-selected for participation. Baseline measures included bone mineral density scans; fitness assessments; and surveys of depression, exercise, and nutrition behaviors. At course end and 6-month follow-up, assessments were repeated for fitness measures, depression, and exercise and nutrition adherence. Two-year postprogram assessments included bone mineral density scans and adherence measures. Results. Paired t-tests showed significant improvements at course end in all measures (p < .0001) for the 87% completing the course. A repeated measure analysis of variance after 2 years with 79% retention indicated that adherence to nutrition recommendations was maintained at 2-year follow-up (p < .0001), whereas exercise adherence decreased but continued to exceed baseline measures (p < .0001). At 2 years, participants averaged two strength training sessions and 131 minutes aerobic exercise per week and consumed an average of 97% and 99% of the recommended calcium and vitamin D. Conclusions. Although findings of this nonexperimental study are limited because of lack of a control group, the HOPE program suggests that a comprehensive community-based education and behavior change program can significantly reduce risk factors for osteoporosis and related fractures. Participants maintained lifestyle modifications for a minimum of 2 years despite advancing age.

Pilot Algorithm studying of regional features of the risk factors for osteoporosis and fractures in the Khanty-Mansiysk autonomous okrug-Yugra, TYumen region

10.12737/4787 ◽  
2014 ◽  
Vol 8 (1) ◽  
pp. 1-8
Author(s):  
Михайлин ◽  
A. Mikhaylin
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Significant Risk ◽  
Osteoporotic Fractures ◽  
Mineral Density ◽  
Risk Of Fracture ◽  
X Ray ◽  
Identification Of Persons ◽  
Low Sensitivity

Modern methods of determination of bone mineral density by means of dual energy x-ray absorptiometry with sufficient specificity and a low sensitivity don’t always available. In this regard, to identify the patients for appointment of therapy, the search strategy consisting in the identification of persons with a high risk of fracture was carried out. As priority direction in the diagnosis is not the fact of having osteoporosis, but the assessment of the risk of fracture. Geographical feature of the Khanty-Mansiysk Autonomous Okrug – Yugra, the lack of equipment x-ray osteodensitometry in medical institutions and their absence in clinics indicate low diagnostic availability in the assessment of the bone mineral density of the population – this determines the importance of research in the region the significant risk factors of osteoporosis and important risk factors for osteoporotic fractures.

scholarly journals Prevalence and Risk Factors of Osteoporosis in Women Referring to the Bone Densitometry Academic Center in Urmia, Iran

2015 ◽  
Vol 8 (7) ◽  
pp. 135 ◽  
Author(s):  
Marzieh Saei Ghare Naz ◽  
Giti Ozgoli ◽  
Mir Amir Aghdashi ◽  
Fatemeh Salmani
Keyword(s):  
Risk Factors ◽  
Bone Mineral Density ◽  
Bone Mineral ◽  
Bone Fracture ◽  
Significant Risk ◽  
The Body ◽  
Mineral Density ◽  
Total Prevalence ◽  
History Of ◽  
Prevalence Of Osteoporosis

<p><strong>BACKGROUND: </strong>Osteoporosis is one of the fastest growing health problems around the world. Several factors can affect this silent disease. The current study aimed to determine the prevalence and risk factors of osteoporosis in women in Urmia, a city in northwestern Iran.</p><p><strong>METHODS: </strong>This cross‑sectional study was performed on 360 non-pregnant women over the age of 15 who referred for bone density testing to the Urmia Imam Khomeini Academic Hospital. Data were collected by questionnaire, and bone mineral density of the femoral neck and lumbar spines L1- L4 was evaluated by dual X-ray absorptiometry.</p><p><strong>RESULTS:</strong> The total prevalence of osteoporosis in this study was 42.2%; prevalence of osteoporosis among women 45 years old or less was 14.3% and over the age of 45 years was 50.7%. The factors such as level of education, history of bone fracture, disease history (rheumatoid arthritis, diabetes, high blood pressure), gravidity and parity values, duration of lactation (p&lt;0.001), nutrition dimension of lifestyle (p=0.03), and green tea consumption (p=002) showed a statistically significant association with the bone mineral density. According to the regression model, age (OR=1.081), history of bone fracture (OR=2.75), and gravidity (OR=1.14) were identified as significant risk factors for osteoporosis, while the body mass index (OR=0.94) was identified as a protector against osteoporosis.</p><p><strong>CONCLUSION: </strong>The prevalence of osteoporosis in this study was high, and findings showed that the advancement of age, lifestyle, and reproductive factors (especially gravidity and duration of lactation) were determining factors for osteoporosis .Appropriate educational programs and interventions could help to increase the women’s peak bone mass therefore reducing their risk of developing osteoporosis.</p>

Sign in / Sign up

Export Citation Format

Share Document