Monday, 30 November 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis - The Risk Factors

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
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Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia


Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of the loss of bone density over a long period of time. It is a widespread degenerative disease of skeletal joints and often associated with senescence in vertebrates due to excessive or abnormal mechanical loading of weight-bearing joints, arising from heavy long-term use or specific injuries(6).

                           The Risk factors

1. Young Age at Diagnosis, Decreased Lean Mass
In the study to investigate the prevalence and identify the risk factors of osteoporosis, researchers at the Korea Cancer Center Hospital, Seoul, showed that young age at diagnosis(55), and low lean mass(55)(56) are found to be risk factors of the development of osteopenia and osteoporosis(55) 

2. Male sex(55)(56) and adult (GH) growth hormone deficiency or excess
There was the high prevalence of osteoporosis and osteopenia in male sex, a low lean mass, and adult growth hormone replacement(58). Patient with  either GH deficiency (GHD) or GH excess are found to have bone, metabolic, and somatic impairments(57). 

3. Chlamydia pneumoniae
Chlamydia pneumoniae is an bacterial infection causes of pneumoniae. According to the "Sapienza" University, there is an association between the presence of Chlamydia pneumoniae DNA both in osteoporotic bone tissue and peripheral blood mononuclear cells (PBMCs) and the increase in circulating resorptive cytokines(63), probably due to induced of bone loss(64).

5. Race
Race with limit intake of lactos, the lactose a disaccharide sugar found in milk may be associate to risk of osteoporosis(104). According to the joint study lead by Université Libre de Bruxelle, intake of dairy can confer a favourable benefit with regard to bone health(104).
Low calcium intakes(106), and Lactose intolerance(107) also has an impact on low bone density(105)(106) among Hispanic-American and Asian-American populations may create an elevated risk for osteoporosis(105)(107).

6. Family history
The family history is found positively in related to a significant, independent risk factor for osteoporosis in U.S. women aged of 35 and over, according to the the National Center on Birth Defects and Developmental Disabilities(108). 
According to the, risk of  osteoporosis in women was 8.3%. Patient with  positive family history of the diseases have a increased risk of 19.8%  of which is considered as a independent risk of osteoporosis(109). Dr. Betancourt Ortiz SL said "Family history of bone fractures might serve for identifying post-menopausal women at increased risk of loss of BMD", according to his study at the at the "San Juan" Specialities Hospital in Riobamba (Province of Chimborazo, Republic of Ecuado(110)
7. Skin color and body size
Skin color, body size and bone mineral density (BMD) may also be an independent  risk of  osteoporosis among three groups of postmenopausal women: 104 healthy black women, 45 healthy white women, and 52 osteoporotic white women with vertebral fractures(111), especially on large body size on bone mineral density effects in black and white(111)(112). In fact, family history, use of contraceptive device and postnatal environmental factors, are found to associate to infant bone size and bone mass of which may induce long-term consequences in the increased risk of osteoporosis in later life(113).

8. Diet and lifestyle
Certain diet, including typical American diet with high intake of salt, soda, caffeine, process foods, such as can foods, etc,... have been found to induce risk of osteoporosis, according to Elizabeth Ward, MS, RD. In deed, high salt intake was found to associated with osteoporosis and an increased calcium excretion in urine(114) of which induced loss of calcium and risk of osteoporosis.
Negative lifestyle such as smoking(116), heavy alcohol consumption(117)  may reduce bone mineral density and increase the incidence of fragility fracture,
Positive lifestyle such as  green tea drinking(118), dairy products(119) and physical activity(120) improved bone minerals density of which reduced risk of osteoporosis(115).

9. Heavy alcohol intake or alcoholism
Moderate intake of alcohol use may have beneficial effects on bone mineral density of that reduced risk of osteoporosis. Oppositely, Heavy alcohol intake or alcoholism disrupts calcium and bone homeostasis(121) of which leads to reduce bone mineral density and increase the incidence of fragility fracture, according to the study by Albert Einstein College of Medicine and Montefiore Medical Center(122).

10. Smoking and lower serum IGF-I and IGF-binding protein (IGFBP)-3
The study of middle-aged Korean men, conduced by the Sungkyunkwan University School of Medicine,   suggest that current smoking history, and history of smoking and lower serum IGF-I levels are risk factors for lower BMD  of which can induce risk of osteoporosis(123). In deed, insulin-like growth factor I (IGF-I) and IGF-binding protein (IGFBP)-3 showed to have a significant relation to relationship to osteoporotic spinal fracture and bone mass distribution(124)(125) of that can be used as a predictor for the severity of osteoporosis, and risk of bone fracture associated with osteoporosis(124).

11. Other risk factors
Patient suffered from chronic illness, such as chronic kidney disease(126), chronic inflammatory rheumatic Disease(127, chronic obstructive pulmonary disease(129),cancers(130), etc.... are found to associate to risk of osteopenia and osteoporosis(128) due to slowly decreased bone mineral density, vitamin and calcium diet content, etc...

(1) Prevalence of rheumatic symptoms, rheumatoid arthritis, ankylosing spondylitis, and gout in Shanghai, China: a COPCORD study by Dai SM1, Han XH, Zhao DB, Shi YQ, Liu Y, Meng JM.(PubMed
(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) Osteoporosis(Life extension)
(4) Hormone and bone by Francisco Bandeira1, Marise Lazaretti-Castro2, John P. Bilezikian3
(5) Growth hormone and bone by Ohlsson C1, Bengtsson BA, Isaksson OG, Andreassen TT, Slootweg MC.(PubMed)
(6) GH and bone--experimental and clinical studies by Isaksson OG1, Ohlsson C, Bengtsson BA, Johannsson G.(PubMed)
(55) Young age at diagnosis, male sex, and decreased lean mass are risk factors of osteoporosis in long-term survivors of osteosarcoma by Lim JS1, Kim DH, Lee JA, Kim DH, Cho J, Cho WH, Lee SY, Jeon DG.(PubMed)
(56) Body fat is associated with increased and lean mass with decreased knee cartilage loss in older adults: a prospective cohort study. by Ding C1, Stannus O, Cicuttini F, Antony B, Jones G.(PubMed)
(57) The role for growth hormone in linking arthritis, osteoporosis, and body composition by Tauchmanova L1, Di Somma C, Rusciano A, Lombardi G, Colao A.(PubMed)
(58) Risk factors for osteoporosis in long-term survivors of intracranial germ cell tumors by Kang MJ1, Kim SM, Lee YA, Shin CH, Yang SW, Lim JS.(PubMed)
(59) Treatment of primary osteoporosis in men by Giusti A1, Bianchi G2.(PubMed)
(60) Age- and menopause-related bone loss compromise cortical and trabecular microstructure by Seeman E1.(PubMed)
(61) Bone loss and bone size after menopause by Ahlborg HG1, Johnell O, Turner CH, Rannevik G, Karlsson MK.(PubMed)
(62) Secondary osteoporosis by Stein E1, Shane E.(PubMed)
(63) Chlamydia pneumoniae and osteoporosis-associated bone loss: a new risk factor by Di Pietro M1, Schiavoni G, Sessa V, Pallotta F, Costanzo G, Sessa R.(PubMed)
(64) Chlamydia pneumoniae infection results in generalized bone loss in mice by Bailey L1, Engström P, Nordström A, Bergström S, Waldenström A, Nordström P.(PubMed)
(105) Hip osteoarthritis: influence of work with heavy lifting, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting by Jensen LK1.(PubMed)
(106) Consumption of calcium-fortified cereal bars to improve dietary calcium intake of healthy women: randomized controlled feasibility study by Lee JT1, Moore CE2, Radcliffe JD2.(PubMed)
(107) Lactose intolerance and health disparities among African Americans and Hispanic Americans: an updated consensus statement by Bailey RK1, Fileti CP, Keith J, Tropez-Sims S, Price W, Allison-Ottey SD.(PubMed)
(108) Prevalence, family history, and prevention of reported osteoporosis in U.S. women by Robitaille J1, Yoon PW, Moore CA, Liu T, Irizarry-Delacruz M, Looker AC, Khoury MJ.(PubMed)
(109) Is family history of osteoporosis associated with osteoporosis preventive behavior in US women? A population-based study by Julie Robitaille, Paula W. Yoon, Margarita Irizarry-De La Cruz, Tiebin Liu, Cynthia A. Moore, Muin J. Khoury(CDC.GOV)
(110) [Bone mineral density, dietary calcium and risk factor for presumptive osteoporosis in Ecuadorian aged women].[Article in Spanish] by Betancourt Ortiz SL1.(PubMed)
(111) Skin color and body size as risk factors for osteoporosis by Nelson DA1, Kleerekoper M, Peterson E, Parfitt AM.(PubMed)
(112) Bone mass, skin color and body size among black and white women by Nelson DA1, Kleerekoper M, Parfitt AM.(PubMed)
(113) Infant programming of bone size and bone mass in 10-year-old black and white South African children by Vidulich L1, Norris SA, Cameron N, Pettifor JM.(PubMed)
(114) Salt intake, hypertension, and osteoporosis by Caudarella R1, Vescini F, Rizzoli E, Francucci CM.(PubMed)
(115) Osteoarthritis of the knee and hip. Part I: aetiology and pathogenesis as a basis for pharmacotherapy. by Adatia A1, Rainsford KD, Kean WF.(PubMed)
(116) Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis by Chen H1, Liu N, Xu X, Qu X, Lu E.(PubMed)
(117) Alcohol and bone by Mikosch P1.(PubMed)
(118) Catechin-rich oil palm leaf extract enhances bone calcium content of estrogen-deficient rats by Bakhsh A1, Mustapha NM, Mohamed S.(PubMed)
(119) Dairy products consumption and serum 25-hydroxyvitamin D level in Saudi children and adults by Al-Daghri NM1, Aljohani N2, Al-Attas OS1, Krishnaswamy S3, Alfawaz H4, Al-Ajlan A5, Alokail MS1.(PubMed)
(120) Physical activity in the prevention and amelioration of osteoporosis in women : interaction of mechanical, hormonal and dietary factors by Borer KT1.(PubMed)
(121) [Osteoporosis and alcohol intake].[Article in Japanese] by Kogawa M1, Wada S.
(122) Association between alcohol consumption and both osteoporotic fracture and bone density by Berg KM1, Kunins HV, Jackson JL, Nahvi S, Chaudhry A, Harris KA Jr, Malik R, Arnsten JH.(PMC)
(123) Age, body mass index, current smoking history, and serum insulin-like growth factor-I levels associated with bone mineral density in middle-aged Korean men by Rhee EJ1, Oh KW, Lee WY, Kim SW, Oh ES, Baek KH, Kang MI, Park CY, Choi MG, Yoo HJ, Park SW.(PubMed)
(124) Serum levels of insulin-like growth factor (IGF) I, IGF-binding protein (IGFBP)-2, and IGFBP-3 in osteoporotic patients with and without spinal fractures by Sugimoto T1, Nishiyama K, Kuribayashi F, Chihara K.(PubMed)
(125) Serum levels of insulin-like growth factor (IGF); IGF-binding proteins-3, -4, and -5; and their relationships to bone mineral density and the risk of vertebral fractures in postmenopausal women by Yamaguchi T1, Kanatani M, Yamauchi M, Kaji H, Sugishita T, Baylink DJ, Mohan S, Chihara K, Sugimoto T.(PubMed)
(126) [Osteoporosis treatment for patients with chronic kidney disease].[Article in Japanese] by Konishi Y.(PubMed)
(127) Identification of Osteoporosis & Chronic Inflammatory Rheumatic Disease In French Claims Data. by Belhassen M1, Levy-Bachelot L2, Laforest L1, Ginoux M1, van Ganse E1.(PubMed)
(128) Aging, chronic illness and self-concept: a study of women with osteoporosis by Wilkins S1.(PubMed)
(129) The chronic obstructive pulmonary disease comorbidity spectrum in Japan differs from that in western countries by Takahashi S1, Betsuyaku T2.(PubMed)
(130) Osteopenia and osteoporosis in women with breast cancer by Ramaswamy B1, Shapiro CL(PubMed)

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