The EPATH trial

Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the “Eplerenone in Primary Hyperparathyroidism” (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e’, diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone- specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal pro-brain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted β-coefficient = 0.201, P = 0.035) and e’ (β = 0.188, P = 0.042), respectively. OC (β = 0.192, P = 0.039) and BALP (β = 0.198, P = 0.030) were each independently related with e’. CTX showed no correlations with LVEF or e’. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies

Correlação entre os níveis de vitamina D e densidade mineral óssea em uma população iraniana saudável

ResumoObjetivosConsiderando os resultados controversos sobre a relação entre níveis de vitamina D e densidade mineral óssea em diferentes populações, o presente estudo foi desenhado para avaliar essa correlação em uma população iraniana saudável.MétodosCom uma amostra aleatória de homens e mulheres aparentemente saudáveis, este estudo transversal multicêntrico considerou 4.450 indivíduos que vivem na região urbana de cinco grandes cidades no Irã. Os valores da densidade mineral óssea (DMO) foram analisados em conjunto com os níveis séricos de 25(OH)D e PTH. Análise da variação (Anova) foi usada para estimar os principais efeitos por meio da comparação entre os valores médios desses marcadores e a condição da densidade mineral óssea de cada gênero nesta amostra de estudo.ResultadosNíveis de 25(OH)D foram inversamente proporcionais aos valores de DMO no nível do quadril (r=‐0,062 em homens e r=‐0,057 em mulheres) e da coluna vertebral (r=‐0,076 em homens e r=‐0,107 em mulheres). Após ajuste dos dados para idade, a correlação negativa não foi mais estatisticamente significante.ConclusãoNíveis séricos de 25(OH)D são inversamente correlacionados com os valores de massa óssea em ambos os gêneros.AbstractObjectivesConsidering the controversial results regarding the relationship between vitamin D levels and bone mineral density in different populations, the present study was designed to evaluate this correlation in a healthy Iranian population.MethodsUsing a random cluster sample of apparently healthy men and women, this multicenter cross‐sectional study was carried out among 4450 individuals living in urban areas of five major cities in Iran. Bone mineral density (BMD) values at different sites were analyzed along with the serum levels of 25(OH)D and PTH. Analysis of variance (Anova) was used to estimate the main effects, through comparing the mean values of these markers based on the bone mineral density status of the study group in each sex.Results25(OH)D levels were inversely correlated with BMD values at total hip (r=−0.062 in men and r=−0.057 in women) and spine (r=−0.076 in men and r=−0.107 in women). After adjusting the data for age, the inverse correlation was no longer statistically significant.ConclusionSerum 25(OH)D levels are inversely correlated with bone mass values in both sexes

Relationship between bone turnover and left ventricular function in primary hyperparathyroidism: The EPATH trial

Observational studies suggested a link between bone disease and left ventricular (LV) dysfunction that may be pronounced in hyperparathyroid conditions. We therefore aimed to test the hypothesis that circulating markers of bone turnover correlate with LV function in a cohort of patients with primary hyperparathyroidism (pHPT). Cross-sectional data of 155 subjects with pHPT were analyzed who participated in the \uaaEplerenone in Primary Hyperparathyroidism \uba (EPATH) Trial. Multivariate linear regression analyses with LV ejection fraction (LVEF, systolic function) or peak early transmitral filling velocity (e', diastolic function) as dependent variables and N-terminal propeptide of procollagen type 1 (P1NP), osteocalcin (OC), bone-specific alkaline phosphatase (BALP), or beta-crosslaps (CTX) as the respective independent variable were performed. Analyses were additionally adjusted for plasma parathyroid hormone, plasma calcium, age, sex, HbA1c, body mass index, mean 24-hours systolic blood pressure, smoking status, estimated glomerular filtration rate, antihypertensive treatment, osteoporosis treatment, 25-hydroxy vitamin D and N-terminal probrain B-type natriuretic peptide. Independent relationships were observed between P1NP and LVEF (adjusted \u3b2-coefficient = 0.201, P = 0.035) and e' (\u3b2 = 0.188, P = 0.042), respectively. OC (\u3b2 = 0.192, P = 0.039) and BALP (\u3b2 = 0.198, P = 0.030) were each independently related with e'. CTX showed no correlations with LVEF or e'. In conclusion, high bone formation markers were independently and paradoxically related with better LV diastolic and, partly, better systolic function, in the setting of pHPT. Potentially cardio-protective properties of stimulated bone formation in the context of hyperparathyroidism should be explored in future studies

Pelvic Fractures—An Underestimated Problem? Incidence and Mortality Risk after Pelvic Fracture in Austria, 2010–2018

(1) Background: Pelvic fractures (PFs) are related to osteoporosis, and represent a serious individual and socioeconomic burden. (2) Methods: We examined age- and sex-standardised incidence rates (SIRs) of PF, along with rates of all-cause overall and one-year mortality among patients with PF. We compared the mortality rates between PF patients and a matched fracture-free cohort. Patients ≥50 years old in Austria hospitalised with PF in 2010–2018, along with their dates of death, were recorded. (3) Results: We identified 54,975 patients with PF, of whom 70.9% were women. Between 2010 and 2018 the SIR of PF increased in men by 10.0%—from 125.3 (95% Confidence Interval 118.9–132.0) to 137.8 (95% CI 131.8–144.0) per 100,000—and in women by 2.7%—from 218.7 (95% CI 212.0–225.6) to 224.7 (95% CI 218.3–231.3) per 100,000. The one-year post-PF mortality rate was higher in men than in women (13.0% and 11.1%, respectively; p < 0.001). Pelvic fracture patients aged ≥65 had an elevated mortality risk (Hazard Ratio 1.75, 95% CI 1.71–1.79, p < 0.001) compared to controls. (4) Conclusions: There is a clear increase in the incidence of PF in the elderly population, with a greater increase in men over time. Pelvic fracture itself contributes to increased mortality in individuals aged 65 and above

Vitamin D status and its relationship with bone mineral density in a healthy Iranian population

ABSTRACT OBJECTIVES: Considering the controversial results regarding the relationship between vitamin D levels and bone mineral density in different populations, the present study was designed to evaluate this correlation in a healthy Iranian population. METHODS: Using a random cluster sample of apparently healthy men and women, this multicenter cross-sectional study was carried out among 4450 individuals living in urban areas of five major cities in Iran. Bone mineral density (BMD) values at different sites were analyzed along with the serum levels of 25(OH)D and PTH. Analysis of variance (ANOVA) was used to estimate the main effects, through comparing the mean values of these markers based on the bone mineral density status of the study group in each sex. RESULTS: 25(OH)D levels were inversely correlated with BMD values at total hip (r = -0.062 in men and r = -0.057 in women) and spine (r = -0.076 in men and r = -0.107 in women). After adjusting the data for age, the inverse correlation was no longer statistically significant. CONCLUSION: Serum 25(OH)D levels are inversely correlated with bone mass values in both sexes

Bone microarchitectural parameters in postmenopausal women with prevalent fracture : a HR-PQCT characterization

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Association between vitamin D levels and BMI values in an Iranian population

Background: This study aimed to determine the relationship between vitamin D levels and body mass index (BMI) values in a group of Iranian people. Methods: In this cross-sectional study, the anthropometric values and serum vitamin D levels were measured in more than 3500 healthy adults, representing a random sample of the Iranian population in the urban areas of five large cities of Iran. The data used in this study were from the database of the Iranian Multi-centric Osteoporosis Studies (IMOS), previously conducted to assess bone health in the country. The association between BMI values and serum level of 25(OH)D was thereafter calculated. Results: About 46% of the studied 3669 subjects had moderate to severe vitamin D deficiency regardless of their gender. About 43.2% of the overweight individuals and 45.2% of the obese had moderate-to-severe vitamin D deficiency. A linear but weak increasing trend was reported in the serum levels of 25(OH)D based on increasing BMI values. The significance of the value, however, disappeared after the data was adjusted for the possible confounders. Conclusions: A statistically positive association found between serum levels of 25(OH)D and BMI values raised concerns over the available data, suggesting that more studies should be performed in this regard