RESUMO

PURPOSE: The objective of this study was to analyze the layers of yellow ligament in lumbar canal stenosis and disk herniation. METHODS: Eighteen ligaments were harvested from patients with lumbar spinal canal stenosis. Twenty-nine normal samples from lumbar spine disk herniation patients served as control. All surgical procedures were the same. Ligaments were stained in hematoxylin and eosin; picrosirius-hematoxylin for collagen; Weigert's resorcin-fuchsin for elaunin, oxytalan and elastic fibers; and transmission electron microscopy. Immunohistochemistry was performed for Il-6; Il-10; and CD-31, PGP9.5. Results are described in means and standard error (mean ± SE), and all analyses adopted the significance level of P < 0.05. RESULTS: Spinal stenosis ligaments were 2.5 × thicker. Control superficial ligaments presented a large number of thick, compact collagen fibers and a significant amount of oxytalan and mature elastic fibers. The deep layer presented a large number of mature elastic fibers. In the stenosis group, collagen was thinner and compacted in both layers. There was no difference in the interleukin profile among groups. The deep portion of the stenosis group presented a higher number of vessels and nerves. CONCLUSION: Two layers compose the elastic system of the normal ligamentum flavum, where the deep portion is mainly responsible for its elasticity (elaunin fibers), while its resistance depends on the concentration of oxytalan fibers, which are more present in the superficial layer. Ligamentum flavum in the stenosis samples presents more mononuclear infiltrate and more degraded elastic fibers with a higher number of vessels in its deep portion. These slides can be retrieved under Electronic Supplementary Material.

Assuntos

Degeneração do Disco Intervertebral/metabolismo , Ligamento Amarelo/química , Vértebras Lombares/química , Estenose Espinal/metabolismo , Adulto , Idoso , Idoso de 80 Anos ou mais , Proteínas Contráteis/análise , Tecido Elástico/química , Tecido Elástico/patologia , Tecido Elástico/ultraestrutura , Elasticidade , Proteínas da Matriz Extracelular/análise , Feminino , Humanos , Degeneração do Disco Intervertebral/patologia , Deslocamento do Disco Intervertebral/metabolismo , Deslocamento do Disco Intervertebral/patologia , Ligamento Amarelo/ultraestrutura , Vértebras Lombares/patologia , Masculino , Microscopia Eletrônica , Pessoa de Meia-Idade , Estenose Espinal/patologia , Adulto Jovem

RESUMO

OBJECTIVE: To examine the association between sleep patterns (sleep duration and insomnia symptoms) and total and regional bone mineral density (BMD) among older Boston Puerto Rican adults. MATERIALS/METHODS: We conducted a cross-sectional study including 750 Puerto Rican adults, aged 47-79 y living in Massachusetts. BMD at 3 hip sites and the lumbar spine were measured using dual-energy X-ray absorptiometry. Sleep duration (≤5 h, 6 h, 7 h, 8 h, or ≥9 h/d) and insomnia symptoms (difficulty initiating sleep, difficulty maintaining sleep, early-morning awaking, and non-restorative sleep) were assessed by a questionnaire. Multivariable regression was used to examine sex-specific associations between sleep duration, insomnia symptoms and BMD adjusting for standard confounders and covariates. RESULTS: Men who slept ≥9h/d had significantly lower femoral neck BMD, relative to those reporting 8 h/d sleep, after adjusting for age, education level, smoking, physical activity, depressive symptomatology, comorbidity and serum vitamin D concentration. This association was attenuated and lost significance after further adjustment for urinary cortisol and serum inflammation biomarkers. In contrast, the association between sleep duration and BMD was not significant in women. Further, we did not find any significant associations between insomnia symptoms and BMD in men or women. CONCLUSIONS: Our study does not support the hypothesis that shorter sleep duration and insomnia symptoms are associated with lower BMD levels in older adults. However, our results should be interpreted with caution. Future studies with larger sample size, objective assessment of sleep pattern, and prospective design are needed before a conclusion regarding sleep and BMD can be reached.

Assuntos

Hispânico ou Latino/estatística & dados numéricos , Osteoporose/etnologia , Distúrbios do Início e da Manutenção do Sono/etnologia , Sono , Absorciometria de Fóton , Idoso , Consumo de Bebidas Alcoólicas/epidemiologia , Densidade Óssea , Boston/epidemiologia , Comorbidade , Estudos Transversais , Depressão/epidemiologia , Feminino , Colo do Fêmur/química , Seguimentos , Humanos , Hidrocortisona/sangue , Mediadores da Inflamação/sangue , Vértebras Lombares/química , Masculino , Pessoa de Meia-Idade , Minerais/análise , Porto Rico/etnologia , Fatores Sexuais , Fumar/epidemiologia , Fatores Socioeconômicos , Fatores de Tempo , Vitamina D/análogos & derivados , Vitamina D/sangue

RESUMO

OBJECTIVE: To determine the prevalence of hypothyroidism in an adult female population in Puerto Rico and to determine the relationship between hypothyroidism, bone mineral density and vertebral and non-vertebral fractures in this population. METHODS: Data from the 400 subjects' database of the Latin American Vertebral Osteoporosis Study (LAVOS), Puerto Rico site was reviewed. Patient's medical history, anthropometric data, current medications, laboratories, and DXA results was extracted. Subjects with thyroid dysfunction were identified based on their previous medical history and levels of TSH. Bone Mineral Density was classified using the World Health Organization criteria. Crude prevalence of thyroid dysfunction were estimated with a confidence of 95% and weighted by the population distribution by age, according to the distribution by age group in the 2000 census. Bone mineral densities and prevalence of vertebral and non-vertebral fractures were compared among the groups. RESULTS: The weighted prevalence of hyperthyroidism in this population was 0.0043% (95% CI: -0.0021%, 0.0107%). The weighted prevalence of hypothyroidism was 24.2% (95% CI: 19.9%, 28.4%). Increased prevalence of hypothyroidism was found in participants 70 years or older. The mean BMD at spine, hip and femoral neck was similar among the groups. No difference in the proportion of participants with vertebral and non-vertebral fractures was found among the groups. CONCLUSION: Our study found a high prevalence of hypothyroidism among adult postmenopausal females in Puerto Rico. No association between hypothyroidism and decreased bone mineral densities, vertebral or non-vertebral fractures was found in this population.

Assuntos

Hipotireoidismo/epidemiologia , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Densidade Óssea , Comorbidade , Bases de Dados Factuais , Feminino , Colo do Fêmur/química , Colo do Fêmur/patologia , Fraturas Espontâneas/epidemiologia , Articulação do Quadril/química , Articulação do Quadril/patologia , Humanos , Hipotireoidismo/tratamento farmacológico , Hipotireoidismo/etnologia , América Latina/epidemiologia , Vértebras Lombares/química , Vértebras Lombares/patologia , Pessoa de Meia-Idade , Estudos Multicêntricos como Assunto/estatística & dados numéricos , Obesidade/epidemiologia , Osteoporose Pós-Menopausa/epidemiologia , Osteoporose Pós-Menopausa/metabolismo , Osteoporose Pós-Menopausa/patologia , Pós-Menopausa/sangue , Prevalência , Porto Rico/epidemiologia , Estudos Retrospectivos , Estudos de Amostragem , Fraturas da Coluna Vertebral/epidemiologia , Hormônios Tireóideos/sangue , Hormônios Tireóideos/uso terapêutico , Tireotropina/sangue

RESUMO

OBJECTIVE: To establish whether type 2 diabetes (T2D) is associated with changes in the bone mineral density (BMD) of femoral neck, total hip and lumbar spine. MATERIAL AND METHODS: Comparative cross-sectional study that included 450 patients aged 30 years or more; 245 with, and 205 without T2D. Groups were matched by age. Degenerative joint disease, rheumatoid arthritis, neoplasia, renal failure, chronic liver disease, alcohol intake, prior treatment with drugs that modulate the BMD, Diabetes Mellitus Type 1 and other endocrinopathies were exclusion criteria. RESULTS: In the overall group, the presence of menopause was associated with osteoporosis in the hip (odds ratio -OR-4.2; CI95% 1.4-6.1), whereas T2D was a protective factor (OR 0.8; CI95% 0.4-0.9). Among premenopausal women, central obesity and total adiposity were associated with osteoporosis in the hip (OR 1.9; CI95% 1.1-3.9 and OR 2.1; CI95% 1.2-8.7) and femoral areas (OR 2.1; CI95% 1.2-4.1 and OR 2.3; CI95% 1.3-7.1); T2D remained as protective factor (OR 0.7; CI95% 0.5-0.9 and OR 0.6; CI95% 0.4-0.9). The adjusted analysis by BMI, waist circumference, and total adiposity showed that T2D remained as a protective factor for osteoporosis in the hip (OR 0.8; CI95% 0.6-0.9) and femoral areas (OR 0.7; CI95% 0.5-0.9). CONCLUSIONS: Our results suggest that T2D is an independent protective factor for osteoporosis.

Assuntos

Densidade Óssea , Diabetes Mellitus Tipo 2/epidemiologia , Osteoporose/epidemiologia , Adiposidade , Adulto , Idoso , Índice de Massa Corporal , Estudos Transversais , Diabetes Mellitus Tipo 2/tratamento farmacológico , Feminino , Colo do Fêmur/química , Colo do Fêmur/patologia , Articulação do Quadril/química , Articulação do Quadril/patologia , Humanos , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Vértebras Lombares/química , Vértebras Lombares/patologia , Masculino , Pessoa de Meia-Idade , Obesidade Abdominal/epidemiologia , Polimedicação , Pós-Menopausa , Pré-Menopausa , Circunferência da Cintura

RESUMO

UNLABELLED: Controversial data suggest that patients with type 2 diabetes mellitus have an increased risk of fractures despite having, in some studies, higher bone mineral density. METHODS: The aim of this study was to determine the prevalence of osteoporosis and morphometric vertebral fractures in 148 postmenopausal diabetic women, aged 61.87±7.85 years, and their relationship with clinical and metabolic factors and chronic complications of the disease. RESULTS: The prevalence of osteoporosis was 30.4% at lumbar spine (LS) and 9.5% at femoral neck (FN). The prevalence of vertebral fractures was 23%, mostly mild and located at the thoracic spine. Patients with fractures were older (P<.001), had been in the menopause for a long period (P=.005), had lower creatinine clearance (P=.026) had and lower bone mineral density at LS (P=.01) and FN (P=.042). The frequency of fractures increased with age (P<.001), with the duration of the disease (P=.037) and with the presence of retinopathy (P=.030). In patients with fractures, the prevalence of osteoporosis increased to 40% at LS (P=.004) and to 35.7% at FN (P=.049). After logistic regression adjustment, it was observed that the likelihood of presenting vertebral fractures was significantly increased at the age of 60 years or older (P<.001) and with the presence of osteoporosis at LS (P=.006), irrespective of blood glucose control. CONCLUSION: We found a high prevalence of osteoporosis and vertebral fractures in postmenopausal women with type 2 diabetes mellitus, irrespective of blood glucose control, and these conditions were more frequent in long-standing disease and in patients with retinopathy and impaired renal function.

Assuntos

Diabetes Mellitus Tipo 2/complicações , Osteoporose Pós-Menopausa/epidemiologia , Pós-Menopausa , Fraturas da Coluna Vertebral/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Glicemia/análise , Densidade Óssea , Doenças Ósseas Metabólicas/complicações , Doenças Ósseas Metabólicas/epidemiologia , Brasil/epidemiologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/terapia , Nefropatias Diabéticas/complicações , Retinopatia Diabética/complicações , Feminino , Fraturas do Colo Femoral/epidemiologia , Colo do Fêmur/química , Colo do Fêmur/lesões , Humanos , Vértebras Lombares/química , Vértebras Lombares/lesões , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/complicações , Prevalência , Índice de Gravidade de Doença , Fraturas da Coluna Vertebral/complicações , Vértebras Torácicas/química , Vértebras Torácicas/lesões

RESUMO

Collagen hydrolysates (CHs) are mixtures of peptides obtained by partial hydrolysis of gelatins that are receiving scientific attention as potential oral supplements for the recovery of osteoarticular tissues. The effect of supplementing the diets with a CH was assessed in 48 ovariectomized rats by analyzing the compositional and biomechanical characteristics of the bone. Six groups of rats (three ovariectomized, one sham-operated, and two intact) were fed a standard diet, supplemented with either CH or gelatin (Control), at two levels: a dose equivalent to five times the amount suggested for humans (10 g/day) or another 10 times greater. After 8 weeks, the femora and vertebrae were excised, the blood was collected, and serum alkaline phosphatase and osteocalcin were determined. Bone weight, total protein, and biomechanical strength were also determined. The vertebrae of the ovariectomized group that received the higher dosage of CH withstood a load four times greater and exhibited higher levels of protein and osteocalcin content than those receiving either gelatin or no supplement. CH supplementation at the higher level in the ovariectomized rat had an unequivocal contribution in the conservation or preservation of vertebral mass, protein content, and mechanical strength not seen when gelatin was used as a supplement. Similar treatment of the intact rat with the CH, however, appeared to have the opposite effect.

Assuntos

Colágeno/uso terapêutico , Suplementos Nutricionais , Vértebras Lombares/química , Vértebras Lombares/metabolismo , Osteoporose Pós-Menopausa/dietoterapia , Hidrolisados de Proteína/uso terapêutico , Fosfatase Alcalina/sangue , Animais , Biomarcadores , Conservadores da Densidade Óssea/administração & dosagem , Conservadores da Densidade Óssea/efeitos adversos , Conservadores da Densidade Óssea/uso terapêutico , Colágeno/administração & dosagem , Colágeno/efeitos adversos , Força Compressiva , Feminino , Fêmur/química , Fêmur/metabolismo , Fêmur/patologia , Gelatina/administração & dosagem , Gelatina/uso terapêutico , Humanos , Vértebras Lombares/patologia , Fenômenos Mecânicos , Osteocalcina/sangue , Osteoporose Pós-Menopausa/sangue , Osteoporose Pós-Menopausa/metabolismo , Osteoporose Pós-Menopausa/patologia , Ovariectomia , Hidrolisados de Proteína/administração & dosagem , Hidrolisados de Proteína/efeitos adversos , Distribuição Aleatória , Ratos , Ratos Wistar

RESUMO

BACKGROUND: Chronic corticosteroid (CS) use is associated with bone mass loss. METHODS: Bone mineral density (BMD) was assessed in 72 patients (25 males/47 premenopausal females) with glomerular diseases, primary (n = 35) or secondary to systemic lupus erythematosus (n = 37) with normal renal function, who were taking CS, as prednisone and/or methylprednisolone, in doses > or =7.5 mg/day, for a period of at least 6 months. Cumulative dose and duration of prior CS therapy, as well as biochemical parameters and other factors contributing to bone loss were evaluated. RESULTS: We found 37 (52%) patients with LOW BMD (29 with osteopenia and 8 with osteoporosis). The low BMD group presented a lower mean weight and body mass index (BMI) versus the normal BMD group (62 +/- 15 vs. 70 +/- 10 kg and 25 +/- 4 vs. 27 +/- 5, mean +/- SD, p < 0.05). The estimated calcium intake was lower than 400 mg/day in all patients with low BMD, and they had taken furosemide as a concomitant drug for a longer mean period of time when compared to normal BMD patients (30 +/- 29 vs. 16 +/- 27 months, p < 0.05). A higher mean number of pulses per patient and mean cumulative dose of methylprednisolone were observed in the low versus normal BMD group (7.7 +/- 4.0 vs. 5.6 +/- 4.0 pulses and 6.5 +/- 3.9 vs. 3.9 +/- 2.7 g, p < 0.05). CONCLUSIONS: These findings suggest a high frequency of osteopenia among young and premenopausal patients with glomerular diseases given long-term corticosteroid therapy. The lower BMI and calcium intake, as well as the concomitant furosemide use, might have contributed to such a bone loss. The higher number of pulse therapies leading to higher cumulative intravenous doses of corticosteroid mainly in lupus nephritis patients shows that pulse therapy may be deleterious to bone.

Assuntos

Corticosteroides/efeitos adversos , Corticosteroides/uso terapêutico , Doenças Ósseas Metabólicas/induzido quimicamente , Nefropatias/tratamento farmacológico , Adulto , Anti-Inflamatórios/administração & dosagem , Anti-Inflamatórios/efeitos adversos , Anti-Inflamatórios/uso terapêutico , Densidade Óssea/efeitos dos fármacos , Doenças Ósseas Metabólicas/sangue , Cálcio/sangue , Cálcio/metabolismo , Esquema de Medicação , Feminino , Colo do Fêmur/química , Colo do Fêmur/efeitos dos fármacos , Colo do Fêmur/patologia , Humanos , Infusões Intravenosas , Nefropatias/sangue , Nefropatias/etiologia , Vértebras Lombares/química , Vértebras Lombares/efeitos dos fármacos , Vértebras Lombares/patologia , Lúpus Eritematoso Sistêmico/complicações , Lúpus Eritematoso Sistêmico/patologia , Masculino , Metilprednisolona/administração & dosagem , Metilprednisolona/efeitos adversos , Metilprednisolona/uso terapêutico , Prednisona/administração & dosagem , Prednisona/efeitos adversos , Prednisona/uso terapêutico , Pulsoterapia/efeitos adversos , Pulsoterapia/métodos

RESUMO

OBJECTIVE: To examine changes in bone and body composition of adolescent female artistic gymnasts (GYM; n = 7), level 5+, compared with nongymnast controls (CON; n = 10) over 3 years. STUDY DESIGN: Areal bone mineral density (aBMD; g/cm(2)), bone mineral content (BMC; g) and bone area (cm(2)), of the total body (TB), total proximal femur (TPF), trochanter (Tr), femoral neck, lumbar spine (LS), and distal radius were measured using dual-energy X-ray absorptiometry. Fat-free soft tissue mass (FFST; g), fat mass (g), and percent body fat (%FAT) were also assessed. RESULTS: No initial differences in height or weight between GYM and CON were observed, and both groups demonstrated parallel increases in these parameters over time (P <.05; h(2) >or=0.15). At baseline, GYM possessed significantly lower %FAT and higher aBMD at all sites (except TB; P <.05; h(2) >or=0.15). Over 3 years, GYM increased more than CON (P <.05; eta (2) >or=0.15) in TB, Tr, and TPF aBMD, TB and LS BMC, and FFST. CONCLUSION: Female adolescents participating in competitive artistic gymnastics training over 3 years have enhanced rates of aBMD, BMC and FFST accrual.

Assuntos

Composição Corporal/fisiologia , Densidade Óssea/fisiologia , Ginástica/fisiologia , Adolescente , Determinação da Idade pelo Esqueleto , Antropometria , Criança , Proteção da Criança , Exercício Físico/fisiologia , Feminino , Fêmur/química , Fêmur/fisiologia , Seguimentos , Humanos , Vértebras Lombares/química , Vértebras Lombares/fisiologia , Análise por Pareamento , Estudos Prospectivos , Maturidade Sexual/fisiologia , Estados Unidos , Saúde da Mulher

RESUMO

The purpose of this trial is to demonstrate that a women with high body mass index (BMI > or = 28) has greater bone mineral density (BMD) from that with lower BMI. We studied 922 healthy women who met the inclusion criteria. They were classified into four groups according to their BMI (> or = 28 and < 28) and age (> or = 35 and < 35 years). Bone mineral measurement was performed by dual-energy X-ray absorptiometry (DEXA) in the hip and at the lumbar region. BMD in overweight women older than 35 years was significantly higher in comparison with that of women with lower BMI, both in the hip and the lumbar spine. In overweight women younger than 35 years, we found greater BMD in the hip reaching statistical significance, but not at the lumbar spine. We conclude that obesity is associated with greater BMD (4% at the lumbar spine; 11% at the hip) probably due to both greater physical stress and higher estrogen levels.

Assuntos

Índice de Massa Corporal , Densidade Óssea , Calcificação Fisiológica , Obesidade/metabolismo , Adulto , Estrogênios/análise , Feminino , Articulação do Quadril/química , Humanos , Vértebras Lombares/química , México , Estudos de Amostragem

RESUMO

El objetivo del estudio fue demostrar que la mujer con un índice de masa corporal (IMC) alto (= 28) tiene mayor densidad mineral ósea (DMO) que aquella con IMC más bajo. Se estudiaron 922 mujeres sanas que cumplieron los requisitos de inclusión. Se clasificaron en cuatro grupos en relación a IMC (= 28 y < 28) y edad (= de 35 y < 35 años). Se realizó densitometría DEXA en cadera y columna. La DMO del grupo de mujeres mayores de 35 años con sobrepeso es significativamente mayor a las pacientes con IMC menor en cadera y columna. En el grupo de mujeres menores de 35 años con sobrepeso, se encontró mayor DMO en cadena con significancia estadística, pero no en la columna. Se concluye que la obesidad se asocia con mayor DMO en un promedio de 4 por ciento en columna y 11 en cadera, probablemente asociado tanto al esfuerzo de una mayor carga mecánica como a la presencia de mayores niveles estrogénicos en la mujer obesa

Assuntos

Humanos , Feminino , Adulto , Articulação do Quadril/química , Índice de Massa Corporal , Densidade Óssea , Calcificação Fisiológica , Estrogênios/análise , Método Simples-Cego , México , Obesidade/metabolismo , Vértebras Lombares/química