Evaluating of VDR gene variation and its interaction with immune regulatory molecules in osteoporosis

To evaluate VDR gene variation and its interaction with immune regulatory molecules in osteoporosis. Totally 205 pre and postmenopausal women were recruited in the study. After an overnight fast, peripheral blood was taken and centrifuged to sprat serum for measurement of serum parathyroid hormone, 25 hydroxyvitamin D, osteocalcin and cross laps. The Fok I polymorphism in exon 2 of the VDR gene was detected by PCR-RFLP. Expression of osteoprotegrin, vitamin D receptor [VDR] and beta-actin genes were quantified by quantitative real-time reverse transcriptase. To design the experimental model we randomly selected five participants of each genotype groups. PBMC were cultured and induced with vitamin D. At several times, cells were harvested and total RNA was extracted. Then expression of target genes evaluated by real time PCR. The frequencies of Ff, FF and ff genotypes were 34.2%, 56.5% and 9.2%. The mean of bone mineral density in FF genotype was higher than other genotypes. Also in this genotype, mean of serum inflammatory cytokines was lower than other genotypes. The expressions of the VDR and osteoprotegrin were up regulated by 1, 25 [OH] 2D3 in PBMC from participants with FF genotype. PBMC from healthy control comparison to osteoporotic patients had a clearly better response to vitamin D3 incubation. Inflammation may important role in osteoporosis whereas osteoporotic patients have elevated pro-inflammatory profile. This cytokine profile and gene expressions of VDR and Osteoprotegrin were different in VDR genotype groups

Vertebral geometry parameters can predict fractures

The aim of this study was to investigate vertebral geometry changes and determine cutoff value of vertebral height to predict fractures. In a cross-sectional study, 280 postmenopausal women recruited .In all subjects bone mineral density and radiography of the lumbar spine performed. Lateral radiographs were evaluated for identification of vertebral fractures, using a validated semiquantitative method. T-score of vertebral height was calculated based on data extracted from Iranian Multi-center Osteoporosis Study. ROC curve used to determine cut off value of vertebral height T-score to predict fractures. The mean of age and BMI were 55.34 +/- 8.7 years and 27.73 +/- 5 kg/m2, respectively. Among osteoporotic women, 59.8% had one or more vertebral fractures and 23.8% had at least 2 fractures. In fracture group the T-score of spine and femur BMD was lower than the others. The mean of vertebral height in women without fractures was 12.94+0.6 cm, and in the patient with 4 or more fractures was 12.3, thus every fracture accompany with 1.2% decreases in the height of vertebrae. The prevalence of vertebral fracture in osteoporotic patients was 71.4% and in healthy cases 39.5%. Better estimation of vertebral height T score in ROC curve was less than -0.7.The sensitivity and specificity of the cut off value were 81.3% and 52.9%, respectively. Vertebral fractures are common fractures in postmenopausal women. There was a correlation between vertebral height and fractures. Vertebral geometric parameters especially height T score can be used for fracture screening

Adequate serum copper concentration could improve bone density, postpone bone loss and protect osteoporosis in women

To determine the protective impact of efficient serum copper concentration on BMD in women and to asses its impression on bone. six hundred healthy women through a national project in Iran, IMOS, were selected via a cluster random sampling and enrolled the study. They were divided to pre menopausal [404/600, 67.7% of total] and post menopausal [190/600, 32%of total] groups. BMD was measured by biphotonic absorptimetry DEXA for hip and lumbar spine. Morning serum copper concentration was determined by atomic absorption spectrometry. Mean age was 40.92 +/- 14.8yr .Mean serum copper concentration 105.85 +/- 40.15microg/dl and mean BMI= 27.13 +/- 4.81 kg/m2.Totaly 2.4% was smoking, 5% had regular physical activities three times a week and 17.5% was copper deficient. Prevalence of Osteoporosis in postmenopausal women was 12.9% in copper deficient persons vs. 11.3% in normal serum copper ones. No significant difference found according to serum copper concentration associated with BMI, age and vitamin D. Spine BMD revealed a significant correlation with serum copper content. [P= 0.001]. This correlation also existed for Total hip [P< 0.05]. Premenopausal women with serum copper level above 105 microg/dl revealed a significant difference in hip BMD compared to whom with less copper concentration. 1.02 +/- 0.13kg/m2 vs. 0.97 +/- 0.13kg/m2 [P = 0.001]. Copper had an independent role on determining hip BMD in pre menopaused women [P= 0.001]. copper has an independent role on bone density in all healthy women. It could have an adjourning factor for bone loss as well as a protective agent for Osteoporosis

Serum zinc concentration could predict bone mineral density and protect osteoporosis in healthy men

A growing body of investigations demonstrated the essence role of zinc on growing and maintaining bone tissue .The idea that zinc could enhance bone content and adjourn or prevent osteoporosis in men, has been experimented as a hypothesis. Six hundred healthy men [age 20-69 yr] through Iranian Multicenter Osteoporosis Study [IMOS] which is a national project running in 5 provinces in Iran for prevention and treatment of osteoporosis was selected via a cluster random sampling and enrolled the study. Bone Mineral Density was measured by biphotonic absorptimetry DEXA for hip and lumbar spine. Zinc morning serum concentration was determined by atomic absorption spectrometry. SPSS 11.5 was used for data analysis. Body Mass Index [BMI] has been calculated by Weight [kg]/Height [meter][2] for each person. The mean age was 40.83 +/- 15.06 yr .Mean BMI was 24.79 +/- 3.94 kg/m2, overlay 27.3% were smoking, 12.5% had regular physical activities three times a week and 12.2% had a history of renal stone. Among them 30.1% had zinc depletion, 56.8% normal range and 13.1% had serum zinc excess. 57.1% of individuals over 40 yr with hip osteoporosis were zinc deficient whereas 22.1% of them with normal BMD had this deficiency [P< 0.001]. It is concluded that zinc has a positive association with BMD in men over 40 yr and zinc deficiency is more common in osteoporotic individuals

study of bone mineral density in diabetic patients

In view of the current high prevalence of diabetes mellitus [DM] and osteoporosis, today there is great interest in studying the possible association between these two disorders. The aim of this study was to determine the association between type-2 DM, and Bone mineral density [BMt]] in Iranian women. BMD was determined in the femoral neck and at the L2-L4 level [DEXA] Of 518 women aged 40-80 years old, referred to bone densitometry unit of Endocrinology and Metabolism Research Center of Tehran University of Medical Sciences [146 patients with type 2 diabetes and 372 normal controls]. In diabetics patients, BMD values at the vertebral site were higher than non-diabetic patients but the difference was only significant in postmenopausal subgroup [P= 0.045]. Besides, BMD values at the hip site were higher when com-pared with non-diabetes group, but the difference was not significant. Frequency of osteoporosis risk factors [tea consumption, sunlight exposure, late menarche, low physical activity, smoking habits, family history of osteoporosis and inadequate calcium intake] were not significantly different between diabetic and non-diabetic women, but prevalence of early menopause was higher in diabetic women [P= 0.046]. Prevalence of osteoporosis in premenopausal and postmenopausal was 7% and 41.6% in diabetic and 15% and 36.8% in non-diabetic women, respectively. Prevalence of osteoporosis and osteopenia was not significantly different in diabetic and non-diabetic groups. The present results demonstrate that there is not clear association between BMD and type 2 diabetes mellitus

Association between renal stone, bone mineral density and biochemical parameters

To investigate the relationship between renal stone formation and osteoporosis. Eight hundred thirty healthy subjects aged between 20 and 76 years were randomly selected from 50 clusters to take part in the study. Of these, 68 [8.2%] had a previous history of renal stone disease. All participants underwent clinical examination and bone mineral densitometry of the lumbar spine and femur using the dual-energy X-ray absorptiometry technique. Plasma levels of vitamin D3, calcium, phosphate, alkaline phosphatase, and parathyroid hormone were also measured. Data showed that patients with a history of renal stones had a higher prevalence of osteoporosis [16.7%] and os-teopenia [53.3%] than the subjects without a history of renal stone disease [11.2% and 35.7%, respectively]. For both men and women the mean age of patients with a history of renal stone disease was significantly lower than patients with no dis-ease history [men: with history 44.27 +/- 14.8, without history 50.28 +/- 12.3; P= 0.02] [women: with history 43.21 +/- 11.8, without history 49.06 +/- 9.6; P= 0.02]. Female patients with a history of renal stone disease also had a significantly lower [8.74%] mean spinal bone density [P= 0.02], but there were no other significant differences in either the biochemical parameters that were measured or in the hip bone density. These data suggest that osteoporosis may be more prevalent in those patients that have had a history of renal stone formation

Association of bone mineral density and lifestyle in men

Recently, osteoporosis is an increasingly important public health problem in men. The aim of this study was to investigate relationship between life style and bone mineral density in men. Among the 20-76 year-old men of Tehran, 325 persons were selected randomly from 50 clusters. The persons suffering from rheumatoid arthritis, thyroid diseases, fractures or other conditions which effect bone metabolism were excluded. All participants underwent clinical examinations and lumbar and spinal densitometry using DXA method. In lumbar spine, peak bone density was seen between ages 25 and 40 yr and in hip, between 20 and 30. In men older than 50 yr, prevalence of osteoporosis and osteopenia, were 3.9% and 50%, respectively. Bone mineral density was significantly correlated to calcium and vitamin D intake, physical activity and smoking. Nutritional intake and physical activity are important factors in maintaining bone mineral density. Peak bone density in 20-40 year-old population and its relation to life style could be useful in policy-making for the prevention of osteoporosis

Relationship between tea drinking and bone mineral density in Iranian population

Tea is the most commonly consumed beverage by Iranian adults after water, and while previous studies have examined the negative effects of coffee-based caffeine on Bone Mineral Density [BMD], the relationship between the consumption of tea and BMD has not been clearly explored. The aim of this study was to investigate the relationship between habitual tea drinking and BMD in the adult Iranian population. BMD was measured at the lumbar spine and hip, in 830 men and women living in Tehran, all aged between 20 and 76 yr old. The degree of tea consumption was assessed by questionnaire, and subjects were categorized as either tea drinkers [more than 5 cups of tea per day] or non-tea drinkers [equal or less than 5 cups of tea per day]. After adjusting for age and body mass index, it was found that female tea drinkers had a small [4.2%], but significantly higher BMD in the hip [P= 0.01]. This may suggest a potentially positive effect for habitual tea drinking on the BMD of those women with an inadequate consumption of calcium and vitamin D

Peak bone mass measurement in iranian healthy population

Osteoporosis is a disabling disease characterized by compromised bone strength, which predisposes a patient to increased risk of fracture. The aim of this study was evaluation the pattern of bone mass in Iranian healthy population. The study was performed between December 2000 and May 2001 on one thousand three healthy Iranian subjects who currently live in Tehran. They were selected randomly by cluster random sampling among men and women of 10-76 yr from 50 clusters. The volunteer people were referred to the Bone Mineral Density BMD unit of EMRC. The participants were recalled for three times and the response rate was 83%. BMD was measured by DXA using Lunar DPX-MD device. Females achieved maximum lumbar BMD up to 25-35. Femur BMD maximized in 30 to 35 and after 45 the intensity of bone loss increased. Female peak bone mass in lumbar region was 1.19 +/- 0.12 g/cm2and in femur was 1.02 +/- 0.12 g/cm2. Male peak bone mass in lumbar region occurred between ages 25-40 yr, Male's femur BMD maximized in 20-30. In male peak lumbar bone mass was 1.22 +/- 0.16 g/cm2 and femur was 1.08 +/- 0.15 g/cm2. Osteopenia was recognized in 50% and 48.8% of women above 50 in spine and total femur, respectively, however these percentages were 37.1% and 34.8% among male subjects. Iranian BMD values sufficiently different from other countries to warrant a separate reference sample with which to compare individuals for the purpose of diagnosing osteoporosis and osteopenia according to the WHO criteria

Relationship between family history of osteoporotic fracture and femur geometry

The principal aim of this study was therefore to investigate association between family history of osteo-porotic hip fracture, BMD and femur geometry in Bushehr city in South of Iran. In this cross-sectional study, data were obtained from Iranian Multi-center Osteoporosis Study [IMOS] in Bushehr. Healthy men and women aged 50 to 75 years were selected based on randomized clustered sampling of all regions of the corresponding city. BMD was measured once at the lumbar spine [L2-L4] and proximal femur with dual X-ray absorptiometry using Lunar DPX densitometers. From the DXA image the operator manually determines the hip axis length [HAL] and femoral neck-shaft angle. The HAL was measured from the inner pelvic brim to the lateral side of the femur .The femoral neck-shaft angle was defined as the angle between the femoral neck axis and the femoral shaft axis. There were no significant differences between the family fracture history groups with regard to the potential confounders of age and body mass index [BMI]. HAL of women with history of hip fracture was greater but history of hip fracture showed no significant relation with other variables. These findings suggest that individuals with a positive family history may be at higher risk of osteoporotic hip fracture because they have greater HAL and more prone to buckle at the femur neck

Relationship between serum umbilical cord and maternal leptin and adiponectin concentrations with fetal growth parameters

Pregnancy and accelerated fetal growth always are related with major metabolic changes and body fat redistribution and adiponectin is one of principle adipocyte hormones, so studying adiponectin changes during pregnancy may reveal some hidden parts of fetal metabolism. The aim of this study was to assess adiponectin and leptin levels in umbilical cord and maternal serum, their relation with each other and with neonatal weight, birth length and other fetal growth markers. The study was carried out with 72 appropriate for age newborns [36 female, 36 male] and their mothers. The anthropometric variables of the newborns studied were birth weight, birth length, and birth weight/birth length and ponderal index. Maternal and umbilical cord adiponectin and leptin levels were measured by ELISA and compared. The median of cord blood adiponectin concentration were 3 fold higher than those of maternal group. Umbilical cord blood leptin levels were significantly correlated with neonatal birth weight and birth weight/ birth length [r= 0.29, P=0.01 and r= 0.24, P= 0.04, respectively]. No statistical difference has been demonstrated between both groups of male and female neonates regarding birth weight, birth length, maternal and neonatal leptin levels, ponderal index and maternal and neonatal adiponectin levels. Neonatal leptin is related to birth weight. Adiponectin has no relation with birth weight. Neither leptin nor adi-ponectin correlated with gender difference

Effect of calcium and vitamin D intake on maternal and neonatal anthropometric parameters

Vitamin D is essential for the health of pregnant women and their newborns. The aim of this study was to determine the relationship between the outcome of pregnancy and maternal calcium and vitamin D intake. This cross-sectional study included 449 healthy pregnant women at the time of delivery and also their newborns after delivery. Maternal and neonatal anthropometric data were collected and Calcium and Vitamin D intake was determined. The mean values for vitamin D and calcium intake in mothers were 2.26 +/- 1.87 microg/d and 816.284 +/- 370.47 mg/d respectively. Our findings showed that, the mean Apgar score and height of the newborns whose mothers had adequate calcium and vitamin D intake were higher than those of infants of mothers with inadequate intake [p=0.04, p=0.03; respectively]. Our study showed a significant correlation between adequate maternal calcium and vitamin D intake and appropriate neonatal birth weight, height and one-minute Apgar score. We found that mothers with adequate intake of calcium and vitamin D had greater weight gain. Therefore proper nutritional plans for pregnant women are necessary. Consumption of foods rich in calcium and vitamin D, in particular dairy products, fortification of foods and addition of supplements to diet regimen of the population at risk of developing such nutritional deficiencies should be taken into consideration

Vitamin D status in pregnant and their newborns

Adequate vitamin D concentrations during pregnancy are necessary for neonatal calcium homeostasis, bone maturation and mineralization. The purpose of this study was to evaluate serum vitamin D in mothers and their newborns. This study comprised 552 pregnant women from Tehran University hospitals. Maternal and cord blood samples were obtained in delivery room just after child birth. The serum samples were assayed for 25-hydroxyvitamin D3, calcium, phosphorus and parathyroid hormone. Prevalence of vitamin D deficiency in mothers and cord blood were 66.8% and 93.3% [<35nmol/l] respectively. There was a significant correlation between maternal and cord blood levels of vitamin D. In mothers with vitamin D deficiency, cord blood vitamin D levels were lower than those of normal mothers [p=0.001]. Furthermore, considering increased requirements of calcium and vitamin D during pregnancy; intake of higher amounts of these nutrients are recommended

Epidemiologic feature of thyroid cancer based on cancer registry data system

This study was undertaken to define the epidemiological aspects of thyroid carcinoma in Iran, an area of endemic iodine deficiency nearly until recently. The Tehran Cancer Institute Data System Registry [TCIDSR] was used to identify patients with different histological types of thyroid cancer [TC] in Iran. Data were analyzed from 438 thyroid cancer cases identified by the TCIDSR in 1998-99. Disease prevalence was calculated by age, time and place. The TCIDSR recorded 438 primary malignancies of the thyroid gland: papillary, follicular, medullary, and anaplastic carcinomas accounted for 67.1%, 10.7%, 5.3% and 4.3% of cases, respectively. The remaining 12.6% was classified as OD [other diagnoses]. The prevalence of TC was the highest in Farsis population. The age range of patients was 8-85 yr. Mean patient age was 44.52 +/- 17.03 yr [mean +/- SD] overall, 47.74 +/- 18.10 yr in male patients and 43.04 +/- 16.34 in female patients. Anaplastic [6.5% vs. 3.3%] and medullary [10.0% vs. 3.0%] cancers were more common in men than women. Against expectation for an iodine-deficient area, the frequency distribution of tumours in our study was closer to that seen in iodine-rich areas. Additional research on the risk factors for thyroid cancer-genetic, ethnic, geographic and environmental is needed to explain the high incidence of PTC overall, and among Farsis population in particular, in Iran