scholarly journals Effect of Bisphosphonates on Bone Health in Adult Renal Transplant Patients: Beyond the First Year Posttransplant—A Systematic Review and Meta-Analysis

2019 ◽  
Vol 6 ◽  
pp. 205435811985801 ◽  
Author(s):  
Alyssa Lip ◽  
Ashley Warias ◽  
M. Khaled Shamseddin ◽  
Benjamin Thomson ◽  
D. Thiwanka Wijeratne
Keyword(s):  
Systematic Review ◽  
Lumbar Spine ◽  
Renal Transplant ◽  
Bone Health ◽  
Observational Studies ◽  
Meta Analysis ◽  
First Year ◽  
Bisphosphonate Treatment ◽  
Mineral Density

Background: Bone mineral density (BMD) decreases postrenal transplantation. Evidence demonstrating the effects of bisphosphonates on BMD and fracture risk beyond 1-year posttransplant is sparse in existing literature, but remains essential to enhance clinical outcomes in this population. Objective: Our study aimed to systematically review and meta-analyze the current literature on the use of any bisphosphonate in the adult renal transplant population beyond the first year of renal transplant to determine its effect on BMD and fracture incidence. Design: We conducted a systematic review and meta-analysis of primary research literature that included full-text, English-language, original randomized clinical trials (RCTs) and observational studies. Setting: Patient data were primarily captured in an outpatient setting across various studies. Patients: Our population of interest was patients older than 18 years who received deceased/living donor kidney transplantation and any bisphosphonate with a follow-up greater than 12 months posttransplantation. Measurements: The primary outcome was change in BMD from baseline. Secondary outcomes were the incidence of fractures and effects of other confounders on bone health. Methods: We included RCTs and observational studies that satisfied our inclusion criteria. Each study was analyzed for risk of bias and data were extrapolated to analyze for overall statistical significance accounting for heterogeneity of studies. Results: Sixteen studies (N = 1762) were analyzed. The follow-up ranged from 12 to 98 months. There was a nonsignificant improvement in BMD with bisphosphonate treatment persisting into the second and third years posttransplant at the lumbar spine. The calculated standardized mean BMD difference was −0.29 (−0.75 to 0.17), P = .22. Only 5 studies reported a total of 43 new fractures. Prednisone ( P < .01), low body weight ( P < .001), low body mass index ( P < .01), and male gender ( P < .05) correlated with reduced lumbar and femoral BMD. Limitations: Limitations of this review include the use of BMD as a surrogate outcome, the bias of the included studies, and the incomplete reporting data in numerous analyzed studies. Conclusions: We demonstrate no statistically significant benefit of bisphosphonate treatment on BMD beyond the first year postrenal transplantation. Despite heterogeneity of treatment, a differential nonsignificant improvement in lumbar spine BMD was consistent and may be clinically relevant. Trial Registration: PROSPERO CRD42019125593

scholarly journals Effects of β-Cryptoxanthin on Improvement in Osteoporosis Risk: A Systematic Review and Meta-Analysis of Observational Studies

Foods ◽  
2021 ◽  
Vol 10 (2) ◽  
pp. 296
Author(s):  
Sun Jo Kim ◽  
Nguyen Hoang Anh ◽  
Nguyen Co Diem ◽  
Seongoh Park ◽  
Young Hyun Cho ◽  
...  
Keyword(s):  
Systematic Review ◽  
Hip Fracture ◽  
Bone Health ◽  
Observational Studies ◽  
Meta Analysis ◽  
Random Effects Model ◽  
High Intake ◽  
Quantitative Evidence ◽  
Osteoporosis Risk ◽  
Reduced Risk

Many studies have analyzed the effects of β-cryptoxanthin (BCX) on osteoporosis and bone health. This systematic review and meta-analysis aimed at providing quantitative evidence for the effects of BCX on osteoporosis. Publications were selected and retrieved from three databases and carefully screened to evaluate their eligibility. Data from the final 15 eligible studies were extracted and uniformly summarized. Among the 15 studies, seven including 100,496 individuals provided information for the meta-analysis. A random effects model was applied to integrate the odds ratio (OR) to compare the risk of osteoporosis and osteoporosis-related complications between the groups with high and low intake of BCX. A high intake of BCX was significantly correlated with a reduced risk of osteoporosis (OR = 0.79, 95% confidence interval (CI) 0.70–0.90, p = 0.0002). The results remained significant when patients were stratified into male and female subgroups as well as Western and Asian cohorts. A high intake of BCX was also negatively associated with the incidence of hip fracture (OR = 0.71, 95% CI 0.54–0.94, p = 0.02). The results indicate that BCX intake potentially reduces the risk of osteoporosis and hip fracture. Further longitudinal studies are needed to validate the causality of current findings.

The Effect of Calcium or Calcium and Vitamin D Supplementation on Bone Mineral Density in Healthy Males: A Systematic Review and Meta-Analysis

2015 ◽  
Vol 25 (5) ◽  
pp. 510-524 ◽  
Author(s):  
Leslie N. Silk ◽  
David A. Greene ◽  
Michael K. Baker
Keyword(s):  
Bone Mineral Density ◽  
Systematic Review ◽  
Vitamin D ◽  
Lumbar Spine ◽  
Calcium Supplementation ◽  
Meta Analysis ◽  
Vitamin D Supplementation ◽  
Mineral Density ◽  
Total Body ◽  
Healthy Males

Research examining the preventative effects of calcium and vitamin D supplementation has focused on children and females, leaving the effects on male bone mineral density (BMD) largely unexplored. Thus, the aim of this systematic review and meta-analysis is to examine the efficacy of calcium supplementation, with or without vitamin D for improving BMD in healthy males. Medline, EMBASE, SPORTDiscus, Academic Search Complete, CINHAHL Plus and PubMed databases were searched for studies including healthy males which provided participants calcium supplementation with or without vitamin D and used changes to BMD as the primary outcome measure. Between trial standardized mean differences of percentage change from baseline in BMD of femoral neck, lumbar spine, total body and total hip sites were calculated. Nine studies were included in the systematic review with six references totaling 867 participants contributing to the meta-analysis. Significant pooled effects size (ES) for comparison between supplementation and control groups were found at all sites included in the meta-analysis. The largest effect was found in total body (ES = 0.644; 95% CI = 0.406–0.883; p < .001), followed by total hip (ES = 0.483, 95% CI= 0.255–0.711, p < .001), femoral neck (ES = 0.402, 95% CI = 0.233–0.570, p = .000) and lumbar spine (ES = 0.306, 95% CI = 0.173–0.440, p < .001). Limited evidence appears to support the use of calcium and vitamin D supplementation for improving BMD in older males. There is a need for high quality randomized controlled trials, especially in younger and middle-aged male cohorts and athletic populations to determine whether supplementation provides a preventative benefit.

scholarly journals Aspirin and fracture risk: a systematic review and exploratory meta-analysis of observational studies

BMJ Open ◽  
2020 ◽  
Vol 10 (2) ◽  
pp. e026876 ◽  
Author(s):  
A L Barker ◽  
Sze-Ee Soh ◽  
Kerrie M Sanders ◽  
Julie Pasco ◽  
Sundeep Khosla ◽  
...  
Keyword(s):  
Systematic Review ◽  
Fracture Risk ◽  
Observational Studies ◽  
Meta Analysis ◽  
Large Population ◽  
Mineral Density ◽  
Random Effects Models ◽  
Manual Search ◽  
Relative Risks ◽  
Hip Bmd

ObjectivesThis review provides insights into the potential for aspirin to preserve bone mineral density (BMD) and reduce fracture risk, building knowledge of the risk-benefit profile of aspirin.MethodsWe conducted a systematic review and exploratory meta-analysis of observational studies. Electronic searches of MEDLINE and Embase, and a manual search of bibliographies was undertaken for studies published to 28 March 2018. Studies were included if: participants were men or women aged ≥18 years; the exposure of interest was aspirin; and relative risks, ORs and 95% CIs for the risk of fracture or difference (percentage or absolute) in BMD (measured by dual energy X-ray absorptiometry) between aspirin users and non-users were presented. Risk of bias was assessed using the Joanna Briggs Institute Critical Appraisal Checklists for observational studies. Pooled ORs for any fracture and standardised mean differences (SMDs) for BMD outcomes were calculated using random-effects models.ResultsTwelve studies met the inclusion criteria and were included in the meta-analysis. Aspirin use was associated with a 17% lower odds for any fracture (OR 0.83, 95% CI 0.70 to 0.99; I2=71%; six studies; n=511 390). Aspirin was associated with a higher total hip BMD for women (SMD 0.03, 95% CI −0.02 to 0.07; I2=0%; three studies; n=9686) and men (SMD 0.06, 95% CI −0.02 to 0.13, I2=0%; two studies; n=4137) although these associations were not significant. Similar results were observed for lumbar spine BMD in women (SMD 0.03, 95% CI −0.03 to 0.09; I2=34%; four studies; n=11 330) and men (SMD 0.08; 95% CI −0.01 to 0.18; one study; n=432).ConclusionsWhile the benefits of reduced fracture risk and higher BMD from aspirin use may be modest for individuals, if confirmed in prospective controlled trials, they may confer a large population benefit given the common use of aspirin in older people.

Abstract 124: Association Between Low Bone Mineral Density and Risk of Peripheral Vascular Disease: A Systematic Review and Meta-analysis

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Sikarin Upala ◽  
Anawin Sanguankeo
Keyword(s):  
Bone Mineral Density ◽  
Systematic Review ◽  
Vascular Disease ◽  
Peripheral Vascular Disease ◽  
Bone Mineral ◽  
Observational Studies ◽  
Meta Analysis ◽  
Peripheral Vascular ◽  
Mineral Density ◽  
Increased Risk

Background: Previous studies have suggested that osteoporosis and coronary heart disease have shared common risk factors. Some studies also suggested that low bone mineral density (BMD) also increased risk of peripheral vascular disease (PVD) or stroke. However, few longitudinal studies did not find significant association between these two conditions. We performed a systematic review and meta-analysis to explore association between low BMD and risk of PVD or stroke from prospective studies. Methods: We comprehensively searched the databases of PubMed/MEDLINE, EMBASE, and Cochrane Databases from their dates of inception to December 2015. The inclusion criteria were published prospective observational studies of PVD, stroke, BMD, osteoporosis, or fractures. Two authors independently assessed the quality of the articles and extracted the data. The primary outcome of interest was risk of new PVD or stroke events comparing between low BMD and normal BMD groups. Results: From 36 full-text articles, five observational studies involving 3,287 participants were included in the meta-analysis based on the random-effects model. There was increased risk of new peripheral vascular disease or stroke events in groups with low BMD compared with normal BMD controls with pooled hazard risk (HR) of 3.10 (95% CI: 1.32-7.23). In the subgroup analysis of fracture as a risk factor, there was no significant difference in risk of PVD or stroke in group with pooled HR of 1.17 (95% CI: 0.78-1.75). Conclusions: Low BMD is associated with increased risk of PVD and stroke from the meta-analysis of prospective observational studies. Clinicians should be aware of the close association between these two conditions. Early identification of PVD in patients with low BMD should be performed.

Negative impact of polycystic ovary syndrome on bone health: a systematic review and meta-analysis

2019 ◽  
Vol 25 (5) ◽  
pp. 634-646 ◽  
Author(s):  
Júlia Mottecy Piovezan ◽  
Melissa Orlandin Premaor ◽  
Fábio Vasconcellos Comim
Keyword(s):  
Systematic Review ◽  
Polycystic Ovary Syndrome ◽  
Bone Health ◽  
Bone Markers ◽  
Bone Fractures ◽  
Polycystic Ovary ◽  
Meta Analysis ◽  
Mineral Density ◽  
Ovary Syndrome ◽  
The Impact

Abstract BACKGROUND Polycystic ovary syndrome (PCOS) has reproductive and metabolic aspects that may affect bone health. Controversial results from different studies regarding the risk of fractures, bone mineral density (BMD) or bone markers led to uncertainty whether PCOS might improve or deteriorate bone health. OBJECTIVE AND RATIONALE This study aimed to investigate the impact of PCOS on bone markers, BMD and fracture risk. SEARCH METHODS A systematic review and a meta-analysis were carried out. PubMed, EMBASE and Cochrane databases were searched for eligible studies from 1st of January of 1990 to 9th of October of 2018. Eligible studies enrolled women older than 18 years with PCOS, which should be diagnosed according to the Rotterdam Consensus, the Androgen Excess Society, the National Institutes of Health Consensus or the International Classification of Diseases. The studies were grouped according to patient mean BMI: <27 kg/m2 or ≥27 kg/m2. The results were polled as mean difference (MD), standardized MD (SMD) and hazard ratio (HR). OUTCOMES Overall, 921 studies were retrieved, and 31 duplicated studies were removed. After screening the titles and abstracts, 80 studies were eligible for full text reading. Of those, 23 studies remained for qualitative synthesis. With the exception of one study, all studies were considered high quality based on the Newcastle–Ottawa scale (NOS; score ≥6). Meta-analysis was performed in 21 studies, with a total of 31 383 women with PCOS and 102 797 controls. Women with PCOS with BMI <27 kg/m2 had lower BMD of the total femur (MD, −0.04; 95% CI, −0.07 to 0.00; I2 = 31%; P = 0.22) and spine (MD, −0.07; 95% CI, −0.13 to −0.01; I2 = 70%; P < 0.01) when compared with the control group, whereas for women with BMI ≥27 kg/m2 no difference was observed (femur: MD, 0.02; 95% CI, −0.02 to 0.05; I2 = 20%, P = 0.29; spine: MD, 0.02; 95% CI, −0.06 to 0.05; I2 = 0%; P = 0.84). Osteocalcin was remarkably reduced in women with PCOS with BMI <27 kg/m2 (SMD, −2.68; 95% CI, −4.70 to −0.67; I2 = 98%; P < 0.01), but in women with BMI ≥27 kg/m2, there were no differences between PCOS and controls. Few studies (n = 3) addressed the incidence of bone fractures in women with PCOS. The HR for total bone fractures did not identify differences between women with PCOS and controls. WIDER IMPLICATIONS On the basis of the available evidence, it is possible to assume that PCOS in women with BMI <27 kg/m2 is associated with reduced BMD in the spine and femur, and decreased bone formation, as manifested by lower levels of circulating osteocalcin. These findings suggest that bone parameters in PCOS may be linked, to some extent, to adiposity. These studies included premenopausal women, who have already achieved peak bone mass. Hence, further prospective studies are necessary to clarify the existence of increased risk of fractures in women with PCOS.

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