Assessment of mineral intake in the diets of Polish postmenopausal women in relation to their BMI\u2014the RAC-OST-POL study

Background: The diets of postmenopausal women in Western countries tend to be deficient in minerals, even if the energy value is at the recommended level. The objective of the presented population-based cohort study was to assess the intake of minerals (sodium, potassium, calcium, phosphorus, magnesium, iron, zinc and copper) in the diets of women aged above 55 years and to analyse the relations between BMI and mineral intake in this group. Methods: The study was conducted in a group of 406 women who were randomly recruited from the general population of those aged above 55 years. The main outcome measures included BMI, reported sodium, potassium, calcium, phosphorus, magnesium, iron, zinc and copper intake assessed by dietary record (conducted during two typical, non-consecutive days). The distribution was verified with the use of the Shapiro-Wilk test. The comparison between groups was conducted using ANOVA with the LSD post hoc test or Kruskal-Wallis ANOVA with multiple comparisons. A comparison of satisfying nutritional needs was conducted using the chi-square test. Results: Normal body weight individuals were characterised by lower sodium intake per 1000 kcal of diet than obese class II and III individuals (BMI 65 35.0 kg/m2). Overweight individuals were characterised by lower potassium and magnesium intake per 1000 kcal of diet than obese class I individuals (BMI\u3f5 < 30.0; 35.0 kg/m2). The majority of individuals was characterised by insufficient potassium, calcium and magnesium intake. No differences in satisfying nutritional needs between BMI groups were observed for all minerals. Conclusions: Following an improperly balanced diet was observed in the group of postmenopausal female individuals analysed. It was stated that the daily intake of all the assessed minerals was not BMI-dependent for the postmenopausal female individuals, but the nutrient density of diet (for sodium, potassium and magnesium) was associated with BMI

Persistence of back pain symptoms after pregnancy and bone mineral density changes as measured by quantitative ultrasound - a two year longitudinal follow up study

<p>Abstract</p> <p>Background</p> <p>Previous research has shown a loss of bone mineral density (BMD) during pregnancy. This loss has been correlated to the occurrence of back pain symptoms during pregnancy. The objective of this study was to evaluate whether persistence of back pain symptoms 2 years after pregnancy could be associated with BMD changes as measured by quantitative USG of the os calcis.</p> <p>Methods</p> <p>A cohort of patients who reported significant back pain symptoms during pregnancy were surveyed for persistent back pain symptoms 24 to 28 months after the index pregnancy. Os calcis BMD was measured by quantitative ultrasound and compared with the BMD values during pregnancy.</p> <p>Results</p> <p>A cohort of 60 women who had reported significant back pain symptoms in their index pregnancy completed a 24-28 months follow-up survey and BMD reassessment. Persistence of significant back pain symptoms was seen in 24 (40%) of this cohort. These women had higher BMD loss during pregnancy compared to those without further pain (0.047 Vs 0.030 g/cm²; p = 0.03). Those that remained pain free after pregnancy appeared to have completely recovered their BMD loss in pregnancy, while those with persistent pain had lower BMD values (ΔBMD - 0.007 Vs - 0.025 g/cm²; p = 0.023) compared to their early pregnancy values.</p> <p>Conclusion</p> <p>Persistence of back pain symptoms after pregnancy could be related to an inability to recover fully from BMD loss during the index pregnancy.</p

FRAX (R): Prediction of Major Osteoporotic Fractures in Women from the General Population: The OPUS Study

Purposes: The aim of this study was to analyse how well FRAXH predicts the risk of major osteoporotic and vertebral fractures over 6 years in postmenopausal women from general population. Patients and methods: The OPUS study was conducted in European women aged above 55 years, recruited in 5 centers from random population samples and followed over 6 years. The population for this study consisted of 1748 women (mean age 74.2 years) with information on incident fractures. 742 (43.1%) had a prevalent fracture; 769 (44%) and 155 (8.9%) of them received an antiosteoporotic treatment before and during the study respectively. We compared FRAXH performance with and without bone mineral density (BMD) using receiver operator characteristic (ROC) c-statistical analysis with ORs and areas under receiver operating characteristics curves (AUCs) and net reclassification improvement (NRI). Results: 85 (4.9%) patients had incident major fractures over 6 years. FRAXH with and without BMD predicted these fractures with an AUC of 0.66 and 0.62 respectively. The AUC were 0.60, 0.66, 0.69 for history of low trauma fracture alone, age and femoral neck (FN) BMD and combination of the 3 clinical risk factors, respectively. FRAXH with and without BMD predicted incident radiographic vertebral fracture (n = 65) with an AUC of 0.67 and 0.65 respectively. NRI analysis showed a significant improvement in risk assignment when BMD is added to FRAXH. Conclusions: This study shows that FRAXH with BMD and to a lesser extent also without FN BMD predict major osteoporotic and vertebral fractures in the general population

The Utility and Limitations of FRAX: A US Perspective

The FRAX calculator is a major achievement in terms of our understanding of measuring fracture risk. Along with being an easily accessible web-based tool, it is the only model based on extensive data on multiple cohorts. FRAX will help clinicians identify individuals who need osteoporosis treatments, while also screening out those who do not require osteoporosis treatments. However, FRAX is limited by a number of factors. Although it is web based, few physicians have the means to access it. It also assumes that body mass index and mortality are constant across different racial and ethnic groups. FRAX is further limited by the exclusion of variables known to be associated with fracture risk, lack of dose-response relationships for variables, increased subsequent fracture risk after initial fracture, restriction to only one bone mineral density site, racial and ethnic differences that may influence fracture risk, and availability of racial and ethnic fracture risk data to be used in the FRAX calculator. Finally, the values obtained from FRAX should not take the place of good clinical judgment

Screening for low bone mass with quantitative ultrasonography in a community without dual-energy X-ray absorptiometry: population-based survey

BACKGROUND: Dual-energy x-ray absorptiometry (DXA) is the criterion standard to identify low bone mineral density (BMD), but access to axial DXA may be limited or cost prohibitive. We screened for low bone mass with quantitative ultrasonography (QUS) in a community without DXA, analyzed its reliability and obtained reference values and estimated the prevalence of low QUS values. METHODS: We enrolled 6493 residents of Kinmen, Taiwan, and a reference group (96 men and 70 women aged 20–29 years) for this cross-sectional, community-based study. All participants completed a questionnaire and underwent ultrasonographic measurements. Reliability and validity of QUS measurements were evaluated. Broadband ultrasound attenuation (BUA) values were obtained and statistically analyzed by age, sex and weight. Annual loss of BUA was determined. Trends in the prevalence of QUS scores were evaluated. RESULTS: Two QUS were used and had a correlation coefficient of 0.90 (p < 0.001). Calcaneal BUA was significantly correlated with BMD in the femoral neck (r = 0.67, p < 0.001) and BMD of the total lumbar spine (r = 0.59, p < 0.001). BUAs in the reference group were 92.72 ± 13.36 and 87.90 ± 10.68 dB/MHz for men and women, respectively. Estimated annual losses of calcaneal BUA were 0.83% per year for women, 0.27% per year for men, and 0.51% per year for the total population. The prevalence of severely low QUS values (T-score = -2.5) tended to increase with aging in both sexes (p < 0.001). Across age strata, moderately low QUS values (-2.5 < T-score < -1.0) were 31.6–41.0% in men and 23.7–38.1% in women; a significant trend with age was observed in men (p < 0.001). CONCLUSION: Age-related decreases in calcaneal ultrasonometry, which reflected the prevalence of low bone mass, were more obvious in women than in men

Association of physical exercise and calcium intake with bone mass measured by quantitative ultrasound

<p>Abstract</p> <p>Background</p> <p>Interventions other than medications in the management of osteoporosis are often overlooked. The purpose of this study was to investigate the association of physical activity and calcium intake with bone parameters.</p> <p>Methods</p> <p>We measured the heel T-score and stiffness index (SI) in 1890 pre- and postmenopausal women by quantitative ultrasound (QUS) and assessed physical activity and dietary calcium intake by questionnaire. Participants were divided according to their weekly physical activity (sedentary, moderately active, systematically active) and daily calcium consumption (greater than or less than 800 mg/day).</p> <p>Results</p> <p>SI values were significantly different among premenopausal groups (p = 0.016) and between sedentary and systematically active postmenopausal women (p = 0.039). QUS T-scores in systematically active premenopausal women with daily calcium intake > 800 mg/day were significantly higher than those in all other activity groups (p < 0.05) independent of calcium consumption.</p> <p>Conclusions</p> <p>Systematic physical activity and adequate dietary calcium intake are indicated for women as a means to maximize bone status benefits.</p

Pediatric DXA: clinical applications

Normal bone mineral accrual requires adequate dietary intake of calcium, vitamin D and other nutrients; hepatic and renal activation of vitamin D; normal hormone levels (thyroid, parathyroid, reproductive and growth hormones); and neuromuscular functioning with sufficient stress upon the skeleton to induce bone deposition. The presence of genetic or acquired diseases and the therapies that are used to treat them can also impact bone health. Since the introduction of clinical DXA in pediatrics in the early 1990s, there has been considerable investigation into the causes of low bone mineral density (BMD) in children. Pediatricians have also become aware of the role adequate bone mass accrual in childhood has in preventing osteoporotic fractures in late adulthood. Additionally, the availability of medications to improve BMD has increased with the development of bisphosphonates. These factors have led to the increased utilization of DXA in pediatrics. This review summarizes much of the previous research regarding BMD in children and is meant to assist radiologists and clinicians with DXA utilization and interpretation

Ultrasound measurements at the calcaneus in men: differences between healthy and fractured persons and the influence of age and anthropometric features on ultrasound parameters. Osteoporos Int 10: 47e51

Abstract. The aim of this cross-sectional study was to assess the ability of quantitative ultrasound at the calcaneus to discriminate between fractured and unfractured men, fracture probability, and the relationship of ultrasonic parameters to age and body size. The study included 224 men (age range 36-86 years) with no history of diseases or therapy affecting bone metabolism. The subjects were divided into two groups (unfractured, n = 148; fractured, n = 76) matched for age and body size. Bone status was assessed by ultrasound measurements at the calcaneus. Long-term in vitro CV% values were 0.88% for speed of sound (SOS) and 0.54% for broadband ultrasound attenuation (BUA). In vivo CV% values were 0.33% for SOS and 2.48% for BUA, while sCV% values were 4.66% and 6.58%, respectively. The following SOS/BUA values were obtained: in unfractured men, SOS = 1517.5 + 35.3 m/s and BUA = 114.0 + 13.3 dB/MHz; in fractured men, SOS = 1492.6 + 24.6 m/s and BUA = 106.1 + 11.6 dB/MHz. The differences were significant (p50.0001). The odds ratio for BUA for all fractures was 1.05 (95% CI, 0.03-2.07) and for SOS 2.13 (95% CI, 0.77-3.49). Only the agerelated decrease in SOS in unfractured men was significant (r = 70.17, p50.05). In fractured men, weight and body mass index (BMI) were found to correlate significantly with BUA (r = 0.31, p = 0.007, r = 0.31, p = 0.007, respectively). The areas under receiver operating characteristics (ROC) curves were 0.706 for SOS and 0.665 for BUA. Ultrasound measurements at the calcaneus thus enable discrimination between fractured and healthy males. Different patterns of the relationship between age and body size in the two groups suggest the presence of other, unknown factors affecting bone status. Their identification requires further prospective studies

Common ophthalmic problems of urban and rural postmenopausal women in a populatin sample of Raciborz district, a RAC-OST-POL Study

Introduction and objective. We wished to establish the prevalence of eye diseases and eye disease risk factors at postmenopausal age and to compare ophthalmic problems in urban and rural areas of Raciborz. Patients and methods. The study was performed in 2010. Out of the whole population of Raciborz, Poland, 10 percent (1750) of women were randomly selected for the reported study. Finally, ocular diseases, ophthalmic agents, health status (physical activity level, body mass index – BMI, reproductive history, the use of psychotropic drugs and hormone replacement therapy – HRT) were recorded in 623 women. The women underwent visual acuity test and anterior segment examination, applanation tonometry and indirect ophthalmoscopy. Results. The mean age of the selected patients was 66.01±7.76 years, 275 (44%) of them originating from rural and 348 (56%) from urban regions. The average woman was obese (BMI=30.54±5.38 kg/m2), with near normal agility and reproductive history of 2.59±1.55 births, 147 (24%) subjects remained under regular HRT support. According to the WHO, the visual acuity was classified as normal or near normal in 87.5%, while no blindness was recorded at all. Visual acuity depended, first of all, on lens status and was better among subjects with good agility (R=-0.31, p=0.001). Dry eye prevalence increased significantly over age of 67 years (p=0.000) and HRT seemed to be a dry eye protective factor (p=0.010). Except age, No other risk factors of cataract, other than age, were identified. Normal agility (p=0.003) and HRT (p=0.032) were associated with lower AMD (age-related macular degeneration) prevalence rates. The differences between urban and rural participants were presented only in education, reproductive history, hypertension and frequency of ophthalmic examinations. Conclusions. Older adult women living in neighboring urban and rural areas present no differential in ophthalmic health problems