Relationship of Depression and Risk Factors in Osteoporotic Men

Although osteoporosis mainly affects women, it could also be seen in men. The aims of the this study were to evaluate the risk factors for osteoporosis in men and to determine their relationships with each other. 49 men with osteoporosis were enrolled in the study. The participants completed a questionnaire covering education, work, alcohol intake, smoking, milk consumption, physical activity and oral glucocorticoid therapy. Additionally, Beck Depression and Visual Analogue Scales were used to assess depression and back pain level. Bone mineral density measurements of the lumbar spine (L2-L4), neck of femur and Ward’s triangle zone were performed by means of dual energy x-ray absorptiometer (DEXA). Dorsal, lumbar x-ray images were taken. According to WHO criteria, patients having Tscores of BMD ≥ -2.5 SD were included. In all patients, positive correlation between the length of education and exercise (r=0.305, p=0.03) and a negative correlation with milk consumption (r= -0.428, p=0.002) were found. Beck Deepression Scale scores were lower in working patients (r=0.457, p=0.001). There was positive corelation between Beck Depression and Visual Analogue Scales values (r=0.376, p=0.01). In men, life style and habits of the individual could be risk factors for osteoporosis and these issues should be taken into consideration before the planning of the treatment

The Comparison Between Affected and Non-Affected Side of the Calcaneal Bone Density in Chronic Hemiparetic Patients

Stroke is a non-traumatic brain injury caused by occlusion or rupture of cerebral blood vessels that results in sudden neurological deficit characterized by loss of motor control, altered sensation, cognitive or language impairment, disequilibrium, or coma. Immobilization is an important risk factor for osteoporosis. The aim of this study was to compare between affected and non-affected side’s calcaneal bone mineral density in chronic hemiparetic patients. Thirty-tree unilateral and independently mobile hemiparetic patients due to stroke were included in the study. The exclusion criteria were to have poor general health status, bilateral involvement, congenital dislocation of hip and past calcaneal fracture history. Motor functional level, spasticity and daily living activities of the patients were assessed by using Brunstrom, Ashworth and Barthel scales, respectively. The calcaneal bone mineral density was evaluated with DXL-Calscan in both affected and non-affected side of all patients. Patients’ mean age and duration of disease were 58.9±11.9 years and 20±19.4 months, respectively. 48.5% of patients were male and 60.6% has right side hemiparesis. Their mean spasticity level was 1.6±1.2 according to Ashworth Scale. Mean motor functional level and activity of daily living score were 4.5±1 and 87.4±22.2, respectively. The calcaneal mean T score was –2.1±0.9 and –1.7±0.7 in affected and non-affected side, respectively. In the pearson correlation analysis, there were positive correlation between age and non-affected Z score (r=0.42, p=0.01); Brunstrom score and affected side T score (r=0.48, p=0.005); Brunstrom score and affected side BMD (r=0.51, p=0.002). On the other hand, there were negative correlation between age and disease duration (r=-0.36, p=0.03); Ashworth score and Brunstrom (r=-0.66, p=0.0001), affected side T score (r=-0.41, p=0.01), affected side Z score (r=-0.35, p=0.04), affected BMD (r=-0.46, p=0.01). However, there was no significant difference between affected and non-affected side’s bone mineral density value according to independent t test. We found out that more spasticity level was lower BMD value was. As a result, spasticity and motor functional level may be determining factors for BMD value in hemiparetic patients

Depression in Osteoporotic and Osteopenic Patients and the Relation with Lifstyle

The aims of this study were to investigate the frequency of depression in osteoporotic and osteopenic women and to determine the relationship between depression and lifestyle, level of education and some risk factors of osteoporosis. Sixty-one osteopenic or osteoporotic postmenopausal women were included in this retrospective study. Patients’ lifestyle, risk factors, pain and depression levels were evaluated by means of lifestyle questionnaire, Visual Analog Scale (VAS) and Beck Depression Inventory (BDI), respectively. The women were divided into two groups as osteopenic and osteoporotic according to WHO criteria. The mean age and menopause duration of the subjects were 61.7±5.2 and 18.9±9.7 years, respectively. Fourty-six percent of women were found to be osteoporotic and the remainig were osteopenic according to the bone density measurement. As the results of lifestyle questionnaire, 73.8% of the patients were housewife, 45.9% graduated from primary school, and 14.8% were exercising regularly. The mean VAS and BDI scores were 5.4±2.01 cm and 17.2±9.8, respectively. According to BDI scores, 30.8% of women had moderate, and 7.7% had severe depression. There were negative correlations between BDI score and education level (r= -0.300, p= 0.031), as well as BDI and history of exercise (r=-0.285, p=0.041). However, positive correlations were found between exercise and level of education (r=0.340 p=0.007), and Hormone Replacement Therapy (HRT) (r=0.430 p=0.001). In conclusion, depression being commonly seen in osteoporotic and osteopenic patients should be taken into account in the treatment and follow-up of patients. In these patients it should be taken into consideration that lifestyle properties like education, dressing, HRT usage, and exercise could have a relation with depression and with each other

The Effect of Glucocorticoids on Bone Mass in Patients with Asthma and Chronic obstructive Pulmonary Disease

Inhaled corticosteroids and bronchodilators have become a key element in the maintenance treatment of bronchial asthma and chronic obstructive pulmanory disease (COPD). It is well known that long-term systemic steroid use causes osteoporosis, whereas inhaled corticosteroids and bronchodilators have been discussed to be cause of such side-affect. The aim of this study was to detect the effect of long term inhaled/oral steroids and bronchodilators on bone mineral density (BMD) with asthma and COPD. Fifty-three patients with bronchial asthma (n=44) and COPD (n=9) were enrolled in this study. BMD were measured and risk factors for osteoporosis were detected. BMD measurements of lumbar area of the spine (L2-4), neck of femur and femoral ward’s triangle zone were performed by the dual energy x-ray absorptiometer (LUNAR). 53 patients evaluated in three groups according to treatment type; 26 patients were using inhaled corticosteroids and bronchodilators (group 1), 18 patients were using only bronchodilators (group 2) and 9 patients were using (group 3) oral corticosteroids and bronchodilators. There were significant differences between group 3 and other two groups in terms of BMD, T and Z scores of the lumbar and femoral neck (p0.05). As a result, we suggest that systemic corticosteroids negatively affect bone mineral density more than inhaled corticosteroids in patients with COPD