Prevalence and factors associated with osteoporosis and fragility fractures in patients with primary Sjögren syndrome
- 作者列表："Salman-Monte, Tarek Carlos","Sanchez-Piedra, Carlos","Fernandez Castro, Monica","Andreu, Jose Luis","Martinez Taboada, Victor","Olivé, Alejandro","Rosas, José","Menor, Raúl","Rodríguez, Beatriz","Garcia Aparicio, Angel","Lopez Longo, Francisco Javier","Manrique-Arija, Sara","Garcia Vadillo, Jesus Alberto","Gil Barato, Susana","López-González, Ruth","Galisteo, Carlos","Gonzalez Martin, Jorge","Ruiz Lucea, Esther","Erausquin, Celia","Melchor, Sheila","Moreira, Begoña","Raya, Enrique","Pego-Reigosa, Jose María","Cid, Natalia","Júdez, Enrique","Moriano, Clara","Narváez, Francisco Javier","Corominas, Hèctor","Garcia Magallon, Blanca","Guillen Astete, Carlos","Castellvi, Ivan","Bohórquez, Cristina","Loricera, Javier","Belzunegui, Joaquín","Illera, Óscar","Torrente-Segarra, Vicenç
This study aimed at determining socio-demographic and clinical factors of primary Sjögren syndrome (pSS) associated with osteoporosis (OP) and fragility fracture. SJOGRENSER is a cross-sectional study of patients with pSS, classified according to American European consensus criteria developed in 33 Spanish rheumatology departments. Epidemiological, clinical, serological and treatment data were collected and a descriptive analysis was conducted. Bivariate and multivariate analyses were performed using a binomial logistic regression to study the factors associated with OP and fragility fracture in pSS. 437 patients were included (95% women, with a median age of 58.6 years). 300 women were menopausal (76.4%). Prevalence of OP was 18.5% [in men ( N = 21) this measured 19%]. A total of 37 fragility fractures were recorded. In the multivariate analysis, there was an association between OP and age: in the 51–64 age range (menopausal women), the OR measured 9.993 (95% CI 2301–43,399, p = 0.002); In the age > 64 years group, OR was 20.610 (4.679–90.774, p < 0.001); between OP and disease duration, OR was 1.046 (1.008–1085, p = 0.017); past treatment with corticosteroids, OR 2.548 (1.271–5.105, p = 0.008). Similarly, an association was found between fragility fractures and age: in the 51–64 age group, OR measured 5.068 (1.117–22,995, p = 0.035), age > 64 years, OR was 7.674 (1.675–35,151, p < 0.009); disease duration, OR 1.049 (CI 1.003–1097, p < 0.036) and the ESSDAI index, OR 1.080 (1.029–1134, p = 0.002). Patients with pSS can develop osteoporosis and fragility fractures over the course of the disease. Age, corticosteroids treatment and disease duration were associated with the development of OP. Disease duration and ESSDAI were associated with the development of fractures in patients with pSS.
本研究旨在确定与骨质疏松症 (OP) 和脆性骨折相关的原发性干燥综合征 (pSS) 的社会人口统计学和临床因素。Sjogranser 是一项针对 pSS 患者的横断面研究，根据 33 个西班牙风湿病科制定的美国欧洲共识标准进行分类。收集流行病学、临床、血清学和治疗资料，进行描述性分析。使用二项 logistic 回归进行双变量和多变量分析，研究 pSS 中与 OP 和脆性骨折相关的因素。纳入 437 例患者 (95% 例女性，中位年龄 58.6 岁)。绝经妇女 300 例 (76.4%)。OP 患病率为 18.5% [男性 (N = 21)，测得为 19%]。共记录到 37 例脆性骨折。在多变量分析中，OP 和年龄之间存在关联: 在 51-64 年龄范围内 (绝经妇女)，OR 测量为 9.993 (95% CI 2301-43,399, p = 0.002); 在年龄> 64 岁组，OR 为 20.610 (4.679-90.774，p <0.001); 在 OP 和病程之间，OR 为 1.046(1.008-1085，p = 0.017); 过去用皮质类固醇治疗，或 2.548 (1.271-5.105，p = 0.008)。同样，在脆性骨折和年龄之间也发现了关联: 在 51-64 岁年龄组中，OR 测量为 5.068 (1.117-22,995，p = 0.035),年龄> 64 岁，OR 为 7.674 (1.675-35,151，p <0.009); 病程，OR 1.049 (CI 1.003-1097，p <0.036) 和 ESSDAI 指数，或 1.080(1.029-1134，p = 0.002)。PSS 患者在病程中可发生骨质疏松和脆性骨折。年龄、糖皮质激素治疗和病程与 OP 的发生有关。病程和 ESSDAI 与 pSS 患者骨折的发生有关。
METHODS::Apparent calcium absorption, total bone mineral content and density, and mineral contents of the right femur were studied using a growing rat model. Twenty-four male Wistar rats were fed with diets based on extruded whole grain red (RSD) or white sorghum (WSD), and control diet (CD) up to 60 days. The animals fed with sorghum diets consumed less and gained less weight compared to those fed with CD, but the efficiency of all diets was similar. Calcium intake was lower in animals fed with sorghum diets, related to the lower total intake of these animals. Apparent calcium absorption in animals fed with RSD was lower than in those fed with CD (CD: 72.7%, RSD: 51.0%, WSD: 64.8%). No significant differences in bone mineral density of total body, spin, femur, distal femur, tibia and proximal tibia were observed among the groups. However, Ca and P contents in the right femur of the rats consuming RSD were lower, indicating a certain imbalance in the metabolism of these minerals.
METHODS:OBJECTIVE:Controversy exists about the impact of bone mineral density (BMD) and fracture risk in newly diagnosed patients with breast cancer (BC). It is presumed that there are differences in BMD between women with BC and healthy controls. BMD is therefore considered as a potential marker to predict BC risk. This study was conducted to investigate the association of BMD, trabecular bone score (TBS) and fracture risk in younger postmenopausal women with hormone responsive BC. METHODS:Overall, 343 women were examined. Women with BC were matched to a control group of the general population. Forty-nine women and fifty-nine controls were included in the final analysis. All subjects underwent dual energy x-ray absorptiometry (DXA) of the lumbar spine, femoral neck, and the total hip to evaluate bone mineral density. The 10-year fracture risk for a major osteoporotic fracture was assessed using the FRAX-score and the TBS-adjusted FRAX-Score, respectively. RESULTS:Lumbar and femoral neck BMD were similar in BC patients and controls. No difference was found for TBS of the spine (1.38 ± 0.1 vs.1.36 ± 0.09) in the BC and the control group, respectively (p = 0.19). The 10- year probability for a major osteoporotic fracture (MoF) or femoral neck (FN) fracture was 6.1 (± 2.6%) and 0.9 (± 1.2%) in the BC group vs. 6.7 (± 3.5%) (p = 0.33) and 0.9 (± 1.1%) (p = 0.73) in the control group. CONCLUSION:Postmenopausal women younger than 60 years with breast cancer do not show any differences in baseline BMD, TBS, or TBS adjusted FRAX in comparison to controls.
METHODS::The goals of this study are to evaluate the ability of the multicomponent collagen-elastin-like polypeptide (ELP)-Bioglass scaffolds to support osteogenesis of rat mesenchymal stem cells (rMSCs), demonstrate in vivo biocompatibility by subcutaneous implantation in Sprague-Dawley rats, monitor degradation noninvasively, and finally assess the scaffold's ability in healing critical-sized cranial bone defects. The collagen-ELP-Bioglass scaffold supports the in vitro osteogenic differentiation of rMSCs over a 3 week culture period. The cellular (rMSC-containing) or acellular scaffolds implanted in the subcutaneous pockets of rats do not cause any local or systemic toxic effects or tumors. The real-time monitoring of the fluorescently labeled scaffolds by IVIS reveals that the scaffolds remain at the site of implantation for up to three weeks, during which they degrade gradually. Micro-CT analysis shows that the bilateral cranial critical-sized defects created in rats lead to greater bone regeneration when filled with cellular scaffolds. Bone mineral density and bone microarchitectural parameters are comparable among different scaffold groups, but the histological analysis reveals increased formation of high-quality mature bone in the cellular group, while the acellular group has immature bone and organized connective tissue. These results suggest that the rMSC-seeded collagen-ELP-Bioglass composite scaffolds can aid in better bone healing process.