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Prevalence of Osteoporosis in Korean Patients with Chronic Obstructive Pulmonary Disease and Their Health-related Quality of Life According to the Korea National Health and Nutrition Examination Survey 2008-2011
Background: In this study, we evaluated the prevalence of osteoporosis, risk factors associated with osteoporosis, and health-related quality of life (HRQOL) in clinically stable chronic obstructive pulmonary disease (COPD) patients. Methods: A total of 1,081 COPD patients were recruited from the Korea National Health and Nutrition Examination Survey (KNHANES) from July 2008 to May 2011. Bone mineral densities at the lumbar spine, femoral neck, and total proximal femur were measured using dual energy X-ray absorptiometry. HRQOL was assessed using the EuroQOL-5 dimensions (EQ-5D) questionnaire. To identify factors associated with osteoporosis and HRQOL in patients with COPD, multivariate regression analyses was performed. Results: Of the 1,081 COPD patients, 191 (17.7%) were diagnosed with osteoporosis. There were significant differences in age, sex, smoking status, education level, house income, and body mass index (BMI) between the osteoporotic and non-osteoporotic groups. COPD patients with osteoporosis had significantly lower EQ-5D scores than the controls. In multivariate analyses, patients of male sex (odds ratio [OR]=0.06, P<0.001), high house income (OR=0.75, P=0.045), and high BMI (OR=0.74, P<0.001) were less likely to have osteoporosis. In addition, osteoporosis was associated with poor HRQOL (β=-0.21, P=0.023). Conclusions: The prevalence of osteoporosis in COPD patients based on the 2008 to 2011 KNHANES data were relatively lower than that in physician-diagnosed COPD patients. In these COPD patients, older age, female sex, low household income, and low BMI increased the risk for osteoporosis.
Background: The aim of this study is to determine the proportion of cancers presenting with parathyroid hormone (PTH) related protein (PTHrP)-mediated hypercalcemia, examine the clinical and biochemical characteristics, identify predictive factors for survival. And we also compared those characteristics between solid organ and hematologic malignancy groups. Methods: Cancer patients with PTHrP-mediated hypercalcemia who were treated at Chonnam National University Hospital in Korea from January 2005 to January 2015 were retrospectively reviewed. Results: Of all 115 patients, solid organ malignancies were the most common etiology (98 cases, 85.2%), with squamous cell carcinoma (50 cases, 43.4%), adenocarcinoma (27 cases, 23.4%). Interestingly, hepatocellular carcinoma (HCC; 18 cases, 15.7%) and cholangiocarcinoma (11 cases, 9.6%) were much more common causes than other previous reports. Hematologic malignancy was less common (17 cases, 14.8%), with multiple myeloma (9 cases, 7.8%) and non-Hodgkin’s lymphoma (5 cases, 4.3%). Overall median survival was only 37 days. There was significant difference in median survival between two groups (35 days for solid organ malignancy and 72 days for hematologic malignancy; P=0.015). Cox regression analysis identified age, the type of malignancy and the time interval of developing hypercalcemia after cancer diagnosis as independent predictive factors for survival time. Conclusions: PTHrP-mediated hypercalcemia was most frequently caused by solid organ malignancy. However, HCC and cholangiocarcinoma were important causes of PTHrP-mediated hypercalcemia may be due to geographic differences in cancer incidence in Korean population. Age, the type of malignancy and the time interval of developing hypercalcemia after cancer diagnosis were independent poor predictive factors for survival time.
Background: Prior osteoporotic fractures are strongly associated with subsequent fractures. To prevent this, the diagnosis of osteoporosis following an osteoporotic fracture is important. The measurement of bone mineral density (BMD) is the first step in the diagnosis and management of osteoporosis. Therefore, this study aimed 1) to evaluate the rate of BMD measurement after osteoporotic fracture in the Korean population, and 2) to determine whether the rate of BMD measurement after osteoporotic fracture changed between 2005 and 2010. Methods: Using the database of the Health Insurance Review Assessment Service (HIRA), we identified patients with osteoporotic fractures (hip, spine, humerus, and wrist fractures) in 2005 and 2010. BMD examinations were evaluated by using procedure codes and medicines, exclusively approved for osteoporosis treatment. Results: During the study period, about half of all patients with osteoporotic fractures had BMD measurement. Between 2005 and 2010, the rate of BMD measurement significantly increased from 42.0% (65,556/156,190) to 53.9% (103,785/192,556) (P<0.001). Conclusions: Our results showed that about half of all patients with osteoporotic fractures had BMD measurement, and that screening for osteoporosis in patients with osteoporotic fractures increased between 2005 and 2010.
Yuri da Silva Ventura Faustino-da-Silva,Ricardo Ribeiro Agostinete,André Oliveira Werneck,Santiago Maillane-Vanegas,Kyle Robinson Lynch,Isabella Neto Exupério,Igor Hideki Ito,Romulo Araújo Fernandes 대한골대사학회 2018 대한골대사학회지 Vol.25 No.1
Background: Osteoporosis is considered a public health problem with high worldwide prevalence. One approach to prevention is through the promotion of physical activity, especially exercise, during adolescence. Methods: This study compared bone variables in different body segments in adolescents according to participation in track and field. The study included 34 adolescents (22 boys), of whom 17 were track and field athletes and 17 were control subjects. Bone mineral density (BMD, g/cm2) and bone mineral content (BMC, g) were analyzed using dual energy X-ray absorptiometry (total body stratified by body segments). Peak height velocity was used to estimate somatic maturation. Results: Athletes had higher BMD (P=0.003) and BMC (P=0.011) values in the lower limbs and higher whole body BMD (P=0.025) than the control group. However, when adjusted for confounding factors, the difference was not maintained. The groups had similar lean soft tissue values (P=0.094). Training overload was positively correlated with BMD in the upper limbs (r=0.504; 95% confidence interval, 0.031-0.793). Although track and field athletes had higher BMD and BMC values in the lower limbs, these differences were not significant when adjusted for confounding factors. Conclusions: Track and field participation in adolescence appears to influence BMD and BMC in lower limbs, and fat-free mass seems to mediate this effect. Also, higher training loads were found to be positive for bone health in upper limbs.
Background: It is crystal clear how important healthcare providers are well-aware of reasonable knowledge on osteoporosis, because they are at the forefront of such management. However, no study has been yet assessed in the knowledge on osteoporosis among healthcare providers particularly in nurse. Therefore, we evaluated the knowledge on osteoporosis of nurses. Methods: In April 2017, 67 nurses were evaluated using a modified Facts on Osteoporosis Quiz (FOOQ). Results: Although nurses grasped some points of osteoporosis, their knowledge was insufficient concerning effects of weight, physical exercise and calcium intake during adolescence. Conclusions: The level of knowledge on osteoporosis was evaluated in nurses, and the effect of weight, physical exercise, and calcium intake during adolescence should be focused in an educational program on osteoporosis for nurses.
Sarcopenia is frequently associated with chronic diseases such as chronic obstructive pulmonary disease (COPD) and cancer. COPD, which is characterized by an irreversible airflow limitation, exacerbates respiratory distress as the disease progresses. The prevalence of sarcopenia in stable COPD was reported to be 15% to 25% in previous foreign studies and 25% in a Korean study. As the amount of activity decreases, muscle mass decreases and eventually oxygen cannot be used effectively, resulting in a vicious cycle of deterioration of exercise capacity. Deconditioning due to decreased activity is a major cause of limb muscle dysfunction in patients with COPD. In these patients, the factors that decrease muscle strength and endurance include chronic inflammation, oxidative stress, inactivity, hypoxemia, hormone abnormality, deficits of nutrients such as protein and vitamin D, and the use of systemic corticosteroid. Therefore, treatment and management should either inhibit this process or should be directed toward supplementing the deficiency, such as with exercise, nutritional support, and medications and supplements. The relationship between sarcopenia and COPD is increasingly being reported, with some overlap in clinical features and treatments. We are fascinated to be able to diagnose 2 diseases through similar physical performance tests and to improve both diseases using the same treatment such as exercise. Therefore, this review summarizes the clinical relevance and integrative management of the 2 diseases.
Background: It is a very important social issue for Korea to have a healthy old age as an aged society. Aging causes a lot of physical changes, especially sarcopenia. Sarcopenia is defined as a persistent decrease in skeletal muscle and muscle strength. Sarcopenic obesity is a phenomenon in which fat is replaced instead of muscle. The purpose of this study was to examine the prevalence of sarcopenia and sarcopenic obesity in Korean elderly and to analyze the relationship with chronic disease. Methods: Data from the 2008 to 2011 the Korea National Health and Nutrition Survey were used. A total of 3,492 patients were classified into 3 groups (non-sarcopenia, sarcopenia, sarcopenic obesity), and general, anthropometry, health behavior, nutrient intake and chronic disease status were compared by the statistical analysis. Results: The rate of moderate exercise was significantly lower in the sarcopenia and sarcopenic-obesity group than in the non-sarcopenia group (P=0.007). The sarcopenic obesity group had significantly higher energy (P=0.005), protein (P=0.046) and fat (P=0.001) intake than the sarcopenic group. The sarcopenic-obesity group had the highest ratio of diabetes (P=0.023) and dyslipidemia (P=0.004) in the 3 groups. Compared with the non-sarcopenia group, in the sarcopenia and sarcopenic obesity groups, the odds ratios (ORs) of diabetes was increased by 1.24 and 2.16 while the ORs of dyslipidemia was increased by 1.12 and 1.50, respectively. Conclusions: Regular exercise and adequate nutrient intake (energy, protein and fat) are essential for the prevention of sarcopenia in Korean elderly, and management of chronic disease in sarcopenic obesity elderly is important.
Background: There are growing concerns about the role of vitamin D deficiency in cardiovascular diseases. Therefore, we investigated the correlation between serum 25-hydroxy-vitamin D (25[OH]D) and arterial stiffness among Korean adults. Methods: We retrospectively reviewed the medical charts of 302 people (115 women and 187 men) who visited a tertiary hospital from January 2015 to December 2016. Serum 25(OH)D was measured using the radioimmunoassay technique, and brachial-ankle pulse wave velocity (baPWV) was measured using an automatic wave analyzer. We obtained the doctor’s report on the medical history of the participants, their alcohol consumption and smoking habits, and their exercise status. Metabolic syndrome was diagnosed based on guidelines from the National Cholesterol Education Program (NCEP)-Adult Treatment Panel (ATP III) and the International Diabetes Federation (IDF). Results of basic blood tests and physical assessment were also collected. Results: In the Pearson correlation analysis, serum 25(OH)D and baPWV showed a statistically significant inverse relationship (r=-0.279, P<0.001). Using multiple regression analysis, and after adjusting for possible confounders, serum 25(OH)D concentration was found to be significantly associated with baPWV (β=-0.121, P=0.011). Conclusions: We observed an association between serum 25(OH) D concentration and arterial stiffness. Further studies involving larger sample sizes will be needed to confirm this associations.
Objectives: The purpose of this study is to identify whether the change of pH affects the proliferation and the differentiation of human bone marrow stem cells (hBMSCs) and what mechanism is underlied. Methods: To achieve objective of this study, hBMSCs were cultivated in the conditioned media adjusted to potential of hydrogen (pH) ranging from 6.4 to 8.0 using addition of hydrochloric acid (HCl) and sodium hydroxide (NaOH). The ratio of proliferation of hBMSCs according to the change of pH was measured for 24 h, 48 h, and 72 h using water-soluble tetrazolium salt (WST)-8 method. To elucidate the mechanism involved, hBMSCs was subjected to blocking extracellular signal-regulated kinases (ERK) and calcium sensing receptor (CaSR) activation. The Osteogenicrelated genes and alkaline phosphatase (ALP) activity were tested under the conditioned media. Results: The proliferation of hBMSCs was promoted under extracellular alkali conditions (pH 7.6~8.0) via CaSR/ERK pathway. On the other hand, the differentiation was inhibited/delayed via decreased ALP activity besides gene expression at pH 8.0. Conclusion: Extracellular alkali or acidic surrounding according to pH alteration can play a crucial role in hBMSC behavior including the proliferation and the differentiation. 연구목적: 본 연구는 세포 외 pH 변화에 따른 골수 기질세포의 증식 및 분화에 어떠한 영향을 미치는 지와 그와 관련된기전을 알아보았다. 연구방법: 본 연구의 가설을 검증하기 위해 HCl과 NaOH를 이용하여 배양액의 pH를 6.4에서 8.0의 다양한 범위를 유도하여 골수 기질세포의 증식 및 분화를 확인하였다. 또한, 관련 기전을 알아보기 위해 CaSR 및 ERK의 활성 억제를 통해골수 기질세포의 증식을 관찰하였다. 또한, 분화능과 관련하여 골 형성 관련 유전자인 Runx2, ALP, 및 OCN의 mRNA 발현 양상과 ALP 활성을 관찰하였다. 결 과: 골수 기질세포의 증식은 pH 7.6~8.0에서 통계적으로 유의하게 증가함을 보였으며, 이러한 변화는 CaSR/ERK pathway와 관련이 있음을 보였다. 반면에, pH 7.6 혹은 8.0에서는 감소된 ALP 및 OCN mRNA 발현 감소와 ALP 활성의감소가 관찰되었다. 결 론: 골수 기질세포의 증식 및 분화 능력은 다양한 요인에 의해 변화될 수 있는데, 그 중 세포 외 pH 변화에 따른알칼리 및 산성 환경도 하나의 중요한 요인으로 작용될 수 있음을 시사한다.