Reference Database of CrossLaps and Osteocalcin for a Healthy Iranian Population

Markers of bone turnover are becoming an important tool for practitioners in the management of osteoporosis. Therefore, it is essential to establish a reference database of the markers before using them in various clinical settings. A total of 785 individuals (37% males, 63% females) without apparent or suggested abnormalities affecting bone mass were randomly selected from 13 clusters in Bushehr Port in southern Iran. The serum CrossLaps ELISA and the N-MID Osteocalcin ELISA were used for the quantitative measurement of CrossLaps and osteocalcin in sera. Bone mineral density was determined for the lumbar spines (L2-L4), proximal femur (neck), and forearm (the distal part) using dual-energy X-ray absorptiometry. Men had higher biochemical serum bone markers (P60 years. In men, serum CrossLaps levels were decreased progressively by increases in age, with the peak at 20 – 29 years. In women, there was a significant decrease in serum osteocalcin from 20 – 29 years to 30–49 years, followed by a progressive increases during 50 – 59 years, with the peak at >60 years. In men, the highest concentrations for serum osteocalcin occurred at 20 – 29 years. At all sites checked for bone mineral densitys, women in the high osteocalcin quartile had the lowest mean bone mineral densitys values, but women in the high CrossLaps quartile had the lowest mean bone mineral densitys at lumbar and radial sites. However, in men, bone mineral densitys values at neither site differed between the lowest and the highest quartiles of serum biochemical bone markers. We presented a five- year age-specific mean values of bone markers in a general healthy Iranian population. Only women in the high osteocalcin and CrossLaps quartiles had the lowest mean bone mineral densitys values at the lumbar and radial sites. Our results suggest that the significance of osteoclastic bone resorption or bone formation as a determinant of bone mineral densitys may depend on sex

The relationship between anthropometric parameters and bone mineral density in an Iranian referral population

Osteoporosis is a common health concern in both developed and developing countries. In this study the association between anthropometric measures and osteoporosis was investigated in 3630 males and females visiting BMD clinic of Shariati Hospital, Tehran, Iran, a teaching hospital and referral center for osteoporosis affiliated to the Tehran University of Medical Sciences. Anthropometric measurements obtained and also Bone Mineral Density (BMD) measurement was done using a Lunar DPXMD densitometer. Data were analyzed using SPSS with Chi-square and ANOVA with post-hoc tests. Results showed that the weight, BMI and age had the strongest correlation with the BMD values in the studied people. While age is negatively correlated with BMD in all the studied people, a positive association was noted between weight, height and BMI and BMD parameters (P<0.01). It was concluded that certain anthropometric parameters (BMI and weight) can considerably affect one's risk of developing osteoporosis. Further research on the effect of these variables on the association of weight and BMD is needed

Consumption of dairy products in adolescents in Tehran

  Background: Dairy products are required for bone metabolism; however, the majority of adolescent do not consume the products adequately. This study was performed to assess the prevalence of dairy products consumption, daily calcium, vitamin D intake, and vitamin D deficiency.   Methods: In this cross-sectional study, 444 females and males’ students in middle and secondary school were recruited by using mixed sampling method. Food Frequency Questionnaire (FFQ) was used to estimate dietary calcium and vitamin D consumption. Serum calcium, and 25 (OH) vitamin D were measured. The data was analyzed by IBM SPSS Statistics for Windows, Version 19.0. Armonk, NY: IBM Corp. T-test, Chi2 and Spearman correlations tests were used as well.     Results: Out of all participants, 214 (48.2%) were females. The average age of the participants was 14.34 years and 206 (46.6%) of the students were in middle and 238 (53.6%) were in high school. 409 (92.1%) of the students consumed at least one glass of milk per week. Calcium intake from milk and yoghurt was more than calcium intake from other dairy products. The amount of calcium lower than 700 mg/day was consumed in 176 (39.6%) of adolescents. There was a significant positive correlation between weekly calcium intake and serum vitamin D level (P=0.001). The prevalence of vitamin D deficiency was higher in females rather than males (151 (71.2%) vs. 40 (17.5 %)).    Conclusion: Adolescents in Tehran do not consume dairy products enough. Indeed, encouraging teenagers to consume dairy products and alter in dietary patterns that improve calcium intake, should be taken in to consideration

Shift working and risk of lipid disorders: A cross-sectional study

BACKGROUND: previous studies have indicated on association between shift work and lipid profile disturbances. Lipid profile disturbances could be due to internal desynchronization. The aim of this study was to analyze whether there is relationship between shift work and serum lipids, fasting blood glucose and hypertension. RESULTS: A total of 424 rail road workers between the ages of 21 and 64 years in this study filled out a questionnaire, and total cholesterol, triglyceride and HDL-C concentration were measured after 12-hours fasting. Association between shift work and biochemical variables and blood pressure were measured. The X(2 )and fisher's exact test was used for comparing the qualitative variables and for quantitative variables with normal distribution we used the parametric tests. Odds ratio (OR) with the 95% confidence interval (95% CI) was used for comparing the proportions of risk variables. Sub-populations in this study were consisting of 158 (37.3%) shift workers and 266 (62.7%) day workers. High levels of total cholesterol (> 200 mg/dl) and LDL-cholesterol (> 130 mg/dl) were significantly more prevalent in nearly all groups of shift workers irrespective of age. But there is no differences in the serum levels of triglyceride, HDL-C, fasting blood glucose and blood pressure between shift workers and day workers. Adjusted Odd's ratio for the effect of shift working on high serum total cholesterol and LDL-C level were 2.11(95%CI: 1.33–3.36) and 1.76(95%CI: 1.09–2.83), respectively. CONCLUSION: This study showed that high serum total cholesterol and LDL-C level were more common in shift workers than in day workers. This finding persisted after adjustment was made for age and food type. But there was no difference in the prevalence of HDL-C, triglyceride, fasting blood glucose and hypertension between shift working and day working. It was concluded that shift work is a risk factor for lipid profile disturbances

Dual energy X-ray absorptiometry diagnostic discordance between Z scores and T scores in a young Iranian population

Background: Dual-energy X-ray Absorptiometry (DXA) is considered the gold standard for non-invasive measurement of bone mass. T-scores and Z-scores are used to present the results of bone mass. The present study was designed to evaluate the discordance between T-scores and Z-scores calculated at a same level and its relation with age, gender and body mass index (BMI) in a representative sample of normal population. Methods: This cross-sectional study was conducted as a part of a comprehensive survey, Iranian Multicenter Osteoporosis Study (IMOS), designed to assess bone health among healthy adults. Each individual underwent both L1–L4 antero-posterior lumbar spine and hip DXA scan. The difference between the T- and Z-scores measured at each of the four skeletal sites was then calculated. Results: A -1.21 to 1.21 point difference was noted in the Z- and T- scores measured at each site. While the difference between the T- and Z-scores was less than 0.5 SD in most of the cases, the difference was higher than 1 SD in about 5% of the subjects. Conclusion: Standardization of Z-score definition and calculation techniques as well as developing an ethnicity-matched reference population is needed to improve the reliability of DXA-generated Z-scores

Numerical simulation of a multi-inlet microfluidic device for biosensing purposes in osteoporosis management

Objectives In this paper, the effect of the position of the inlet and outlet microchannels on the flow profile and the geometry of the recognition chamber for sample pre-treatment in an electrochemical biosensor to be used in osteoporosis management were investigated. Methods All numerical computation presented in this work were performed using COMSOL Multiphysics and Fluent. Simulation was performed for a three-dimensional, incompressible Navier-Stokes flow and so explicit biphasic volume of fluid (VOF) equations were used. Results In the designed microfluidic system, a pressure-driven laminar flow with no-slip boundary condition was responsible for fluid actuation through microchannels in a reproducible approach. Based on the simulation results, the number of outlets was increased and the angel through which the inlets and outlets were attached to the microchamber was changed so that the dead volume would be eliminated and the fluid flow trajectory, the velocity field and pressure were evenly distributed across the chamber. The Re number in the inlets was equal to 4.41, suggesting a laminar flow at this site. Conclusion The simulation results along with the fact that the design change was tested using laser ablated tape and a color dye at different steps provided the researchers with the opportunity to study the changes in a fast and accurate but cheap method. The absence of backflow helps with the cross-talk concern in the channels and the lack of bubbles and complete coverage of the chamber helps with a better surface modification and thus better sensing performance

Magnetic resonance spectroscopy in the management of tophaceous gout: A case report

Development of chronic tophaceous arthritis with marked joint impairment may follow repeated acute attacks. We present a 60 year-old man with huge urate deposits and severe gouty arthropathy with underlying hypothyroidism. During the past years, he had undergone several surgeries with different degrees of amputation to remove the tophus. Magnetic resonance spectroscopy (MRS) of foot finger revealed high peak of lactate, suggesting that high lactate levels is linked with chronic gout and frequent attacks. The patient was treated with levothyroxine along with gout medication, and his thyroid-stimulating hormone (TSH) and urate levels were soon normal, suggesting that the underlying hypothyroidism had aggravated his gout condition

New horizons in treatment of osteoporosis

BACKGROUND: Prevalence of osteoporosis is increasing both in developed and developing countries. Due to rapid growth in the burden and cost of osteoporosis, worldwide, it seems reasonable to focus on the reduction of fractures as the main goal of treatment. Although, efficient pharmacological agents are available for the treatment of osteoporosis, there still remains a need to more specific drugs with less adverse effects. MAIN BODY: This review article provides a brief update on the pathogenesis, presenting current pharmacological products approved by the US Food and Drug Administration (FDA) or Europe, and also newer therapeutic agents to treat osteoporosis according to the clinical trial data available at PubMed, UpToDate, International Osteoporosis Foundation (IOF), and clinical practice guidelines. As well, the effect of combination therapy and recommendations for future research will be further discussed. SHORT CONCLUSION: The use of current antiresorptive and anabolic agents alone or in combinations for the treatment of osteoporosis entails several limitations. Mainly, their efficacy on non-vertebral fracture reduction is lower than that observed on vertebral fracture. In addition, they have potential adverse events on long time usage. Development of newer agents such as cathepsin k inhibitor and strontium ranelate not only have increased the available options for treating osteoporosis, but also have opened doors of opportunity to improvements in the effective treatment. However, the high cost of new agents have restricted their usage in selective patients who are at high risk of fracture or whom failed response to first line treatment options. Thus, personalized medicine should be considered for future evaluation of genetic risk score and also for environmental exposure assessment. In addition to permanent attention to early diagnosis of osteoporosis and understanding of the pathophysiology of osteoporosis for novel approach in drug discovery, there seems a need to more well-designed clinical trials with larger sample sizes and longer duration on current as well as on newer agents. Also, continuous research on plant-derived components as the source of discovering new agents, and conducting more clinical trials with combination of two or more synthetic drugs, plants, or drug-plant for the treatment of osteoporosis are recommended. GRAPHICAL ABSTRACT: Summary of treatment modalities for osteoporosis. [Image: see text