scholarly journals Nutrition as prevention and treatment of osteoporosis

2009 ◽  
pp. S7-S11 ◽  
Author(s):  
M Stránský ◽  
L Ryšavá
Keyword(s):  
Bone Mass ◽  
Randomized Trials ◽  
Bone Structure ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Systemic Disease ◽  
Treatment Of Osteoporosis ◽  
Number Of Factors ◽  
Increased Risk ◽  
Endocrine Factors

Osteoporosis is a systemic disease of the skeleton, characterized by reduction of bone mass and concurrent deterioration of bone structure. Consequently, bones are more fragile, and there is increased risk of fractures. The potential for acquisition of maximum bone mass is influenced by a number of factors. Among those are heredity, sex, nutrition, endocrine factors, mechanical influences and some risk factors. The best documented nutrient for metabolism of bone is calcium. Major role in the pathogenesis of osteoporosis have some micro and macro nutrients, prebiotics, alcohol, alternative diets, starvation and anorexia. Meta analysis of 29 randomized trials showed that supplementation with calcium and vitamin D3 reduces risk of bone fractures by 24 % and significantly reduces loss of bone mass. Osteoporosis has multi factor etiology. Osteoporosis is one of diseases which are influenced by nutrition and life style. It is preventable by means of adequate nutrition and sufficient physical activity.

Abstract 2887: Peri-Operative Beta-Blockers in Patients Undergoing Non-cardiac Surgery: A Meta-Analysis of 12,306 Patients from Randomized Trials

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Sripal Bangalore ◽  
Shruthi Chandrashekhar ◽  
Sandeep Pulimi ◽  
Franz H Messerli
Keyword(s):  
Heart Failure ◽  
Cardiac Surgery ◽  
Myocardial Ischemia ◽  
Randomized Trials ◽  
Beta Blockers ◽  
Meta Analysis ◽  
Increased Risk ◽  
All Cause Mortality ◽  
Safety Outcomes ◽  
Β Blockers

Background: The 2007 ACC/AHA guideline on perioperative evaluation recommends perioperative β-blockers for non-cardiac surgery. However, some clinical trials seem to be at odds with these recommendations. Methods: PUBMED/EMBASE/CENTRAL search for randomized trials (RCTs) evaluating β-blockers for non-cardiac surgery. Efficacy outcomes of all-cause mortality, cardiovascular (CV) mortality, nonfatal MI, nonfatal stroke, heart failure, and myocardial ischemia (30 days), and safety outcomes of perioperative bradycardia, hypotension, and bronchospasm. Results: Among 33 RCTs which evaluated 12,306 patients, β-blockers were not associated with any significant reduction in the risk of all-cause mortality, CV mortality, or heart failure, but were associated with a 35% decrease in nonfatal MI, 64% decrease in myocardial ischemia at the expense of a 101% increase (Figure ) in nonfatal strokes. The beneficial effects were driven mainly by trials with high-bias risk, while analyses of low-biased trials showed a 28% and 101% increase in all-cause mortality and stroke with only a 29% and 59% reduction in nonfatal MI and 59%myocardial ischemia. For the safety outcomes, β-blockers were associated with a significantly increased risk of peri-op bradycardia and peri-op hypotension. Conclusions: In patients undergoing non-cardiac surgery, we estimate that treatment of 1000 patients with β-blockers results in 16 fewer nonfatal MI, but at the expense of 3 disabling strokes and 45 and 59 patients with clinically significant perioperative bradycardia and hypotension respectively, and suggests an increase in all-cause mortality.

Abstract P068: Obstructive Sleep Apnea is Associated with an Increase Risk of Osteoporosis

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Anawin Sanguankeo ◽  
Sikarin Upala
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Primary Outcome ◽  
Meta Analysis ◽  
Systemic Disease ◽  
Obstructive Sleep ◽  
Increased Risk ◽  
Increase Risk ◽  
Osteoporosis Risk ◽  
Stimulation Of

Background: Obstructive sleep apnea (OSA) is thought to be a systemic disease and has been associated with many disorders such as metabolic, endocrine, and especially cardiovascular diseases. One of the consequences of OSA is hypoxia, which can lead to a reduction in growth of osteoblast and a stimulation of osteoclast. Our meta-analysis was conducted to determine the risk of osteoporosis in patients with OSA compared to controls. Objectives: Eligible studies assessing the effects of obstructive sleep apnea on osteoporosis risk were comprehensively searched in PubMed/MEDLINE, EMBASE, and CENTRAL from their inception to September 2014. Two authors independently assessed article quality and extracted the data. Primary outcome were number of participants, prevalence, or risk ratio of osteoporosis in OSA and controls. Results: From 40 full-text articles, 3 studies involving 113,090 participants were included in the meta-analysis that were based on the random effects model. Compared with controls, participants who were diagnosed with obstructive sleep apnea had increased risk of osteoporosis (pooled risks ratio, 1.85; 95% CI, 1.34, 2.56). Conclusion: Patients with OSA had a higher risk of developing osteoporosis. Further study is needed to evaluate the possible mechanisms between these two conditions and to find potential treatment for OSA that could prevent osteoporosis.

Are Elderly Patients at Increased Risk of Complications Following Pacemaker Implantation? A Meta-Analysis of Randomized Trials

2011 ◽  
Vol 35 (2) ◽  
pp. 131-134 ◽  
Author(s):  
LUCIANA V. ARMAGANIJAN ◽  
WILLIAM D. TOFF ◽  
JENS C. NIELSEN ◽  
HENNING R. ANDERSEN ◽  
STUART J. CONNOLLY ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Pacemaker Implantation ◽  
Increased Risk

scholarly journals Global prevalence of osteoporosis among the world older adults: a comprehensive systematic review and meta-analysis

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nader Salari ◽  
Niloofar Darvishi ◽  
Yalda Bartina ◽  
Mojdeh Larti ◽  
Aliakbar Kiaei ◽  
...  
Keyword(s):  
Systematic Review ◽  
Confidence Interval ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Qualitative Evaluation ◽  
Total Sample ◽  
Policy Makers ◽  
Increased Risk ◽  
The World ◽  
Prevalence Of Osteoporosis

Abstract Background Osteoporosis is one of the most common bone system diseases that is associated with an increased risk of bone fractures and causes many complications for patients. With age, the prevalence of this disease increases so that it has become a serious problem among the elders. In this study, the prevalence of osteoporosis among elders around the world is examined to gain an understanding of its prevalence pattern. Methods In this systematic review and meta-analysis, articles that have focused on prevalence of osteoporosis in the world’s elders were searched with these key words, such as Prevalence, Osteoporosis, Elders, Older adult in the Science Direct, Embase, Scopus, PubMed, Web of Science (WoS) databases and Google Scholar search engine, and extracted without time limit until March 2020 and transferred to information management software (EndNote). Then, duplicate studies were eliminated and the remaining studies were evaluated in terms of screening, competence and qualitative evaluation based on inclusion and exclusion criteria. Data analysis was performed with Comprehensive Meta-Analysis software (Version 2) and Begg and Mazumdar test was used to check the publication bias and I2 test was used to check the heterogeneity. Results In a review of 40 studies (31 studies related to Asia, 5 studies related to Europe and 4 studies related to America) with a total sample size of 79,127 people, the prevalence of osteoporosis in the elders of the world; 21.7% (95% confidence interval: 18.8–25%) and the overall prevalence of osteoporosis in older men and women in the world, 35.3% (95% confidence interval: 27.9–43.4%), 12.5% (95% confidence interval: 9.3–16.7%) was reported. Also, the highest prevalence of osteoporosis in the elders was reported in Asia with; 24.3% (95% confidence interval: 20.9–28.1%). Conclusion The results of the present study showed that the prevalence of osteoporosis in the elders and especially elders' women is very high. Osteoporosis was once thought to be an inseparable part of elders’ lives. Nowadays, Osteoporosis can be prevented due to significant scientific advances in its causes, diagnosis, and treatment. Regarding the growing number of elderly people in the world, it is necessary for health policy-makers to think of measures to prevent and treat osteoporosis among the elders.

scholarly journals Physiotherapy rehabilitation in patients with osteoporosis

2020 ◽  
Author(s):  
Nava Tiziana
Keyword(s):  
Bone Mass ◽  
Rheumatic Diseases ◽  
Preventive Measures ◽  
Mineral Metabolism ◽  
Systemic Disease ◽  
Italian Society ◽  
Risk Of Fracture ◽  
Increased Risk ◽  
Post Menopausal

Osteoporosis is defined as a systemic disease of the skeleton characterized by reduction and alteration of the qualitative bone mass, accompanied by increased risk of fracture. According to the Italian Society of Mineral Metabolism and Osteoporosis SIOMMMS (2012) we can distinguish “primitive” post menopausal and senile forms from “secondary” ones determined by many diseases and assumption of drugs. Unlike other rheumatic diseases, osteoporosis is a condition for which preventive measures are really important as well as treatment according to the personal patient’s characteristics and age. Prevention must start early and subsequently adapted to the characteristics of the different life cycles2 .

scholarly journals Wnt1 is an Lrp5-independent bone-anabolic Wnt ligand

2018 ◽  
Vol 10 (466) ◽  
pp. eaau7137 ◽  
Author(s):  
Julia Luther ◽  
Timur Alexander Yorgan ◽  
Tim Rolvien ◽  
Lorenz Ulsamer ◽  
Till Koehne ◽  
...  
Keyword(s):  
Bone Mass ◽  
Early Onset ◽  
Therapeutic Potential ◽  
Bone Fractures ◽  
Treatment Of Osteoporosis ◽  
High Prevalence ◽  
And Function ◽  
Mass Increase ◽  
Bone Mass Regulation

WNT1mutations in humans are associated with a new form of osteogenesis imperfecta and with early-onset osteoporosis, suggesting a key role of WNT1 in bone mass regulation. However, the general mode of action and the therapeutic potential of Wnt1 in clinically relevant situations such as aging remain to be established. Here, we report the high prevalence of heterozygousWNT1mutations in patients with early-onset osteoporosis. We show that inactivation of Wnt1 in osteoblasts causes severe osteoporosis and spontaneous bone fractures in mice. In contrast, conditional Wnt1 expression in osteoblasts promoted rapid bone mass increase in developing young, adult, and aged mice by rapidly increasing osteoblast numbers and function. Contrary to current mechanistic models, loss of Lrp5, the co-receptor thought to transmit extracellular WNT signals during bone mass regulation, did not reduce the bone-anabolic effect of Wnt1, providing direct evidence that Wnt1 function does not require the LRP5 co-receptor. The identification of Wnt1 as a regulator of bone formation and remodeling provides the basis for development of Wnt1-targeting drugs for the treatment of osteoporosis.

scholarly journals Comparative safety of the sodium glucose co-transporter 2 (SGLT2) inhibitors: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e022577 ◽  
Author(s):  
Jennifer R Donnan ◽  
Catherine A Grandy ◽  
Eugene Chibrikov ◽  
Carlo A Marra ◽  
Kris Aubrey-Bassler ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bone Fractures ◽  
Meta Analysis ◽  
Kidney Injury ◽  
Sglt2 Inhibitors ◽  
Current Evidence ◽  
Random Effects Models ◽  
Relative Risks ◽  
Increased Risk ◽  
Tract Infections

ObjectiveTo estimate the association between the use of sodium glucose co-transporter-2 (SGLT2) inhibitors and postmarket harms as identified by drug regulatory agencies.DesignWe conducted a systematic review and meta-analysis of randomised controlled trials (RCT). Six large databases were searched from inception to May 2018. Random effects models were used to estimate pooled relative risks (RRs).InterventionSGLT2 inhibitors, compared with placebo or active comparators.Primary outcomesAcute kidney injury (AKI), diabetic ketoacidosis (DKA), urinary tract infections (UTI), bone fractures and lower limb amputations.ResultsWe screened 2418 citations of which 109 were included. Most studies included one of four SGLT2 inhibitors, dapagliflozin, canagliflozin, empagliflozin and ipragliflozin. When compared with placebo, SGLT2 inhibitors were found to be significantly protective against AKI (RR=0.59; 95% CI 0.39 to 0.89; I2=0.0%), while no difference was found for DKA (RR 0.66; 95% CI 0.30 to 1.45, I2=0.0%), UTI (RR 1.02; 95% CI 0.95 to 1.09, I2=0.0%) or bone fracture (RR 0.87; 95% CI 0.69 to 1.09, I2=1.3%). Three studies reported on amputation, with one finding a significant increase risk. No increased risk for either outcome was found when compared with active controls. Subgroup analysis did show an increased risk of UTI with dapagliflozin only (RR 1.21; 95% CI 1.02 to 1.43, I2=0.0%), but no other analysis supported an increased risk of AKI, DKA, UTI or fracture.ConclusionsCurrent evidence from RCTs does not suggest an increased risk of harm with SGLT2 inhibitors as a class over placebo or active comparators with respect to AKI, DKA, UTI or fracture. However, wide CIs for many comparisons suggest limited precision, and therefore clinically important adverse events cannot be ruled out. Dapagliflozin, appears to independently increase the risk of UTI, although the mechanism for this intraclass variation in risk is unclear.PROSPERO registration numberCRD42016038715.

scholarly journals Stem cells in Osteoporosis: From Biology to New Therapeutic Approaches

2019 ◽  
Vol 2019 ◽  
pp. 1-16 ◽  
Author(s):  
Vasilis Paspaliaris ◽  
George Kolios
Keyword(s):  
Stem Cells ◽  
Stem Cell ◽  
Bone Resorption ◽  
Bone Fractures ◽  
Bone Mineralization ◽  
Financial Burden ◽  
Systemic Disease ◽  
The Elderly ◽  
Future Application ◽  
Increased Risk

Osteoporosis is a systemic disease that affects the skeleton, causing reduction of bone density and mass, resulting in destruction of bone microstructure and increased risk of bone fractures. Since osteoporosis is a disease affecting the elderly and the aging of the world’s population is constantly increasing, it is expected that the incidence of osteoporosis and its financial burden on the insurance systems will increase continuously and there is a need for more understanding this condition in order to prevent and/or treat it. At present, available drug therapy for osteoporosis primarily targets the inhibition of bone resorption and agents that promote bone mineralization, designed to slow disease progression. Safe and predictable pharmaceutical means to increase bone formation have been elusive. Stem cell therapy of osteoporosis, as a therapeutic strategy, offers the promise of an increase in osteoblast differentiation and thus reversing the shift towards bone resorption in osteoporosis. This review is focused on the current views regarding the implication of the stem cells in the cellular and physiologic mechanisms of osteoporosis and discusses data obtained from stem cell-based therapies of osteoporosis in experimental animal models and the possibility of their future application in clinical trials.

Teriparatide: Its Use in the Treatment of Osteoporosis

2011 ◽  
Vol 3 ◽  
pp. CMT.S2358 ◽  
Author(s):  
Charles A. Inderjeeth ◽  
Kien Chan ◽  
Paul Glendenning
Keyword(s):  
Bone Formation ◽  
Bone Mass ◽  
Animal Studies ◽  
Safety Data ◽  
Ageing Population ◽  
Mineral Density ◽  
Duration Of Treatment ◽  
Treatment Of Osteoporosis ◽  
Teriparatide Treatment ◽  
Increased Risk

The prevalence of osteoporosis is likely to rise with the increase in life expectancy of an ageing population. Current first line therapies for the treatment of osteoporosis are predominantly anti-resorptive. Teriparatide is a first in class, anabolic agent with a unique mechanism that results in increased bone formation. Daily subcutaneous injection for 6–24 months was effective in reducing vertebral and non-vertebral fracture rates, in improving bone mineral density (BMD) and in increasing bone formation rates in postmenopausal osteoporosis, with effects persisting following treatment cessation. Similar benefits on bone mass and bone formation were seen in men with osteoporosis and glucocorticoid induced osteoporosis. Beneficial effects on bone mass have been demonstrated in treatment naive subjects treated with teriparatide alone, sequentially with anti-resorptive therapy and concomitantly with some, but not all, anti-resorptive treatments due to an early blunting of the anabolic effect. Teriparatide is generally well tolerated. However, the high treatment cost and inconvenient mode of administration has limited it's use to patients with osteoporosis who have experienced an unsatisfactory response, who are intolerant to other osteoporosis therapies, or to patients at very high risk of fracture. Teriparatide treatment is currently restricted to a total lifetime treatment dose of 18 months of daily subcutaneous therapy due to concerns from animal studies suggesting an increased risk of osteosarcoma. More safety data may permit a longer duration of treatment in the future but will necessitate prolonged human studies. Teriparatide may serve a more prominent role in the treatment of older patients who continue to fracture despite low bone turnover or sustain side effects with anti-resorptive therapy.

scholarly journals Nintedanib, Pirfenidone and Pirfenidone Versus Nintedanib: A Systematic Review And Meta-Analysis

2021 ◽  
Author(s):  
Tyler Pitre ◽  
Renata Husnudinov ◽  
Muhammad Faran Khalid ◽  
Melanie C. Zhang ◽  
Sonya Cui ◽  
...  
Keyword(s):  
Systematic Review ◽  
Randomized Trials ◽  
Meta Analysis ◽  
Drug Effects ◽  
Mean Difference ◽  
Drug Discontinuation ◽  
Inverse Variance ◽  
Increased Risk ◽  
Acute Exacerbations ◽  
All Cause Mortality

Abstract Background: Patients with idiopathic pulmonary fibrosis have a poor overall prognosis. Only nintedanib and pirfenidone have been shown to reduce mortality. Objective: This systematic review and meta-analysis aims to assess the efficacy of nintedanib, pirfenidone, and pirfenidone vs nintedanib on patient important outcomes. Methods: Randomized trials were retrieved from MEDLINE, Cochrane, and EMBASE. The primary outcome was mortality. The secondary outcomes included change in FVC, acute exacerbations and hospitalizations and adverse drug effects leading to discontinuation. We used an inverse variance random effects meta-analysis method to calculate pooled relative risk (RR), standardized mean difference (SMD) and mean difference (MD).Results: A total of 13 studies were included. Both nintedanib [RR 0.63 (0.47,0.85); moderate certainty] and pirfenidone [RR 0.68 (0.47,0.99); moderate certainty] probably reduce all-cause mortality when compared to placebo, but only nintedanib [SMD 0.47 (0.34, 0.60); high certainty] reduces change in FVC. Nintedanib [RR 0.69 (0.48,0.99); moderate certainty],but not pirfenidone probably reduces acute exacerbations or hospitalizations compared to placebo. Compared with placebo, neither nintedanib nor pirfenidone increased risk of drug discontinuation due to adverse effect but there is probably risk of patient drug discontinuation with pirfenidone compared to nintedanib [RR 4.34 (1.72 to 10.98); moderate certainty].Conclusion: Both nintedanib and pirfenidone probably reduce all-cause mortality. Nintedanib is probably more tolerable to pirfenidone in regard to compliance and may be more effective than pirfenidone in reducing mortality rate and in slowing disease progression. Larger head to head randomized trials are needed.

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