Age-Related Changes in the Prevalence of Osteoporosis according to Gender and Skeletal Site: The Korea National Health and Nutrition Examination Survey 2008-2010

BackgroundThe incidence of osteoporosis and its related fractures are expected to increase significantly in the rapidly aging Korean population. Reliable data on the prevalence of this disease is essential for treatment planning. However, sparse data on Korean patients is available.MethodsWe analyzed data from the Korea National Health and Nutrition Examination Survey (KNHANES) 2008 to 2010. Bone mineral density (BMD) was measured at the femoral neck and lumbar spine using dual-energy X-ray absorptiometry. Osteopenia and osteoporosis were diagnosed according to the World Health Organization T-score criteria. We analyzed the BMD data of 17,208 people (men, 7,837; women, 9,368).ResultsThe adjusted prevalence of osteoporosis was 7.8% in men versus 37.0% in women. No significant difference was observed in the prevalence of osteopenia between genders (men, 47.0%; women, 48.7%). The prevalence of osteoporosis in men in their 50s was 4.0%, in their 60s was 7.2%, in their 70s was 15.1%, and in their 80s was 26.7%. The figures in women were 15.2%, 36.5%, 62.7%, and 85.8%, respectively. The age group with the maximal BMD differed between genders. In the men, 20s had the highest value in all the skeletal sites. However, in the women, the maximal BMD in the femoral neck, lumbar spine, and the total hip was observed in their 20s, 30s, and 40s, respectively. The onset age of osteoporosis differed between genders. Osteoporosis in the femoral neck began at 55 years in the women and at 60 years in the men.ConclusionThe prevalence of osteoporosis in Korea was significantly high. In addition, the age-related changes in the prevalence of osteoporosis differed according to gender and skeletal site

Number of osteoporotic sites as a modifying factor for bone mineral density

Discordance has been proposed as a new predictor of fracture risk that may affect fracture risk via bone mineral density (BMD). With an emphasis on better understanding the relationship between discordance and BMD, the aim of this study was to determine the effect of the number of osteoporotic sites, as an indicator of discordance, on BMD and to explore the clinical significance of BMD modification by this factor. This study was based on data obtained from the Korea National Health and Nutrition Examination Survey 2008–2011, which is a nationwide cross-sectional study. Among postmenopausal women aged 50 years or older, 3,849 women whose BMD was measured at three sites (lumbar spine, femoral neck, and total hip) were included in the study. The diagnosis was consistent across sites in only 39.2–59.0 % of cases. Lumbar spine T-score was reduced by 0.163 for two osteoporotic sites and by 0.462 for three osteoporotic sites, compared with having one osteoporotic site at the lumbar spine only. Femoral neck T-score was reduced by 0.609 for three osteoporotic sites compared with one or two osteoporotic sites. Using BMD adjusted for discordance, we found fracture risk probability changed significantly. Our results confirmed that BMD discordance was considerably high among Korean women in their 50s and older owing to site-dependent differences in the pattern of BMD reduction with age. Mean BMD decreased with increasing number of osteoporotic sites. Using a modified BMD adjusted for the number of osteoporotic sites may offer more accurate fracture risk assessment

Jujube (Ziziphus jujuba Mill.) Protects Hepatocytes against Alcohol-Induced Damage through Nrf2 Activation

This study aimed at evaluating the cytoprotective activity of jujube water extract (JWE) against alcohol-induced oxidative stress via the activation of the Nrf2 pathway in HepG2 cells. JWE had various phenolic compounds, and the vanillic acid content was the highest in the extract. To determine the cytoprotective effect of JWE against alcohol-induced damage, hepatocytes were treated with JWE and 3% ethanol. JWE (100 μg/mL) markedly increased cell viability by approximately 100% in a dose-dependent manner. Moreover, JWE attenuated the production of malondialdehyde, reactive oxygen species, aspartate, and alanine aminotransferase and the depletion of glutathione. Moreover, JWE enhanced the expression of antioxidant defense enzymes including heme oxygenase-1, NADPH quinone oxidoreductase 1, and γ-glutamate-cysteine ligase catalytic against alcohol-induced oxidative damage in hepatocytes via the activation of Nrf2. Taken together, JWE possesses the protective effect against alcohol-induced oxidative injury in hepatocytes through the upregulation of the Nrf2 signaling pathway. Therefore, jujube fruit might have the potential to improve alcohol-related liver problems

Association between Visit-to-Visit Glucose Variability and Cognitive Function in Aged Type 2 Diabetic Patients: A Cross-Sectional Study

<div><p>Background and Purpose</p><p>Diabetes is associated with cognitive decline as well as the development of dementia. Although mean blood glucose levels are typically used to assess the status of diabetic patients, glucose variability is also involved in the manifestation of macro- and microvascular complications in this population. Thus, the present study sought to determine whether visit-to-visit glucose variability contributes to cognitive decline in patients with type 2 diabetes.</p><p>Methods</p><p>The present study assessed 68 patients with type 2 diabetes using several validated neuropsychological measures. All patients had no cerebrovascular disease, history of hypoglycemia, psychiatric conditions, or other medical illnesses. Standard deviations (SDs) and coefficients of variance (CVs) of the patients’ blood glucose (after fasting and 2 hours postprandial; FBS and PP2), and glycated hemoglobin (HbA1c) values were used as indices of glucose variability. The cognitive outcome parameters were transformed with z-scores and entered into a multiple linear regression model that included educational status, age, sex, vascular risk factors, and mean glucose parameters as covariates.</p><p>Results</p><p>The mean age of the total patient population was 70.9 years; 46 (67.6%) of the patients were men, and the median follow-up duration at our endocrinology outpatient clinic was 4.8 years. The mean FBS and PP2 glucose levels of the patients were 132 mg/dL and 199 mg/dL, respectively, and the mean HbA1c level was 8.0%. A univariable analysis revealed that only the PP2 value was associated with the Mini-Mental State Examination (MMSE) score, and multivariable analysis revealed that a high SD and/or CV for PP2 glucose were associated with low scores on the Rey Complex Figure Copy test and/or the Verbal Learning Test. Additionally, a high SD and a higher CV for HbA1c level were significantly associated with low MMSE and Digit Span test scores even after adjusting for mean HbA1c values.</p><p>Conclusions</p><p>The present data indicate that a greater degree of visit-to-visit glucose variability influenced specific types of cognitive function in type 2 diabetic patients independently of mean blood glucose levels. Future studies should focus on whether reductions in glycemic variability will improve the cognitive decline observed in type 2 diabetic patients.</p></div

Linear Regression Analysis results between global cognition, attention, visuospatial and memory scores and glycemic variability parameters.

<p><i>B</i> (regression coefficient), CI (confidence interval). The analysis was adjusted for hypertension, hyperlipidemia, current smoking, and mean glucose parameters. For example, SD or CV of FBS glucose values were adjusted for mean FBS values.</p><p>*mean fasting glucose</p><p>**mean postprandial 2 hour glucose</p><p>***mean glycated hemoglobin</p><p>Linear Regression Analysis results between global cognition, attention, visuospatial and memory scores and glycemic variability parameters.</p

Baseline characteristics of study subjects.

<p>Abbreviations: FBS, fasting blood glucose; PP2, postprandial 2 hour blood glucose; HbA1c, glycated hemoglobin; SD, standard deviation); IQR, interquartile range; z, z-score; MMSE, Mini Mental State Examination (total score,30); BNT, Boston Naming Test (total score, 50); RCFT, Rey Complex Figure Copy Test (total score, 36); VLT, verbal Learning test [total score, delayed recall (12) and recognition (12)]; COWAT, Controlled Oral Word Association Test [total score, semantic (20) and phonemic (15)]</p><p>* FBS, PP2 and HbA1c values reported as the median numbers are frequency values, indicating how many glucose measurement had been checked in a participant.</p><p>** Digit Span (forward-backward score, total score, 9).</p><p>Baseline characteristics of study subjects.</p