Risk factors of male osteoporosis

Osteoporosis [OP] is a growing health problem not only in women but also in men. Significant risk factors of OP include previous fragility fractures, hypogonadism, low calcium intake and use of bone resorbing medications amongst others. To find out risk factors in the induction of osteoporosis in apparently healthy Egyptian males. This study was carried out on one hundred apparently healthy men. Their age ranged from 30-65 years with a mean +/- SD of [44.65 +/- 8.3]. All of them were recruited from the workers of Assiut University Hospital during a period of one year. Complete clinical history included occupational history, smoking habits, physical activity and calcium intake. Complete clinical examination was performed. Laboratory investigations included serum calcium, phosphorus and osteocalcin. Bone Mineral Density [BMD] was measured with calcaneal ultrasound. Sixty three percent of participants were normal BMD, 37% had BMD, 26% were osteopenic and 11% were osteoporotic. Smoking was a strong predictor of BMD. A significant positive correlation was found between BMD and physical activity, body mass index, serum calcium and osteocalcin. Osteoporosis is not only a disease of females, but also it is a disease of males. Smoking, physical inactivity and low body index are significant risk factors. Low serum calcium, low serum osteocalcin and high serum phosphorus are biochemical risk factors of OP in males

Clinico-pathologic assessment of the value of anti-chromatin antibodies in the diagnosis of SLE and lupus nephritis

Background: Lupus nephritis is the major cause of morbidity and mortality in systemic lupus erythematosus [SLE] patients, and renal biopsy is the most accurate method for the evaluation of the degree of renal affection. Recent studies suggest that antichromatin antibodies [anti-CHR] could help in early detection of lupus nephritis in SLE patients

Objective: To assess the prevalence of serum anti-CHR antibodies in SLE patients, to evaluate their clinical significance and their value as a marker of lupus nephritis and to correlate them with histopathological findings of lupus nephritis

Methodology: Serum anti-CHR antibodies were determined by an enzyme linked immonsorbent assay [ELISA] in 30 SLE patients, and 30 control subjects [10 cases of rheumatoid arthritis [RA], 10 cases of osteoarthritis [OA] and 10 healthy persons]. Patients and controls were also subjected to history taking, clinical examination and routine laboratory investigations including CBC, ESR, serum complement, serum creatinine, creatinine clearance; in addition to complete urine analysis, urinary protein measurement and serum albumin. Renal biopsy was performed on 20 patients of SLE with clinical and laboratory evidence of nephritis and examined by both light microscopy [LM] and electron microscopy [EM]

Results: Anti-CHR antibodies in SLE patients were positive in 20/30 [66.7%], while they were negative in all controls including cases of RA and OA, with a 66.7% diagnostic sensitivity and 100% specificity. Anti-dsDNA antibodies were detected in 13/30 [43.3%] cases of SLE only, with a 43.3% diagnostic sensitivity and 100% specificity. Positive results of anti-CHR antibodies were found in 17/20 [85%] cases of lupus nephritis [85% diagnostic sensitivity and 70% specificity]; whereas anti-dsDNA antibodies were detected in 11/20 cases [55%] only [55% diagnostic sensitivity and 80% specificity]. Significant positive correlations were found between anti-CHR antibodies and disease duration, disease activity, serum creatinine, creatinine clearance, proteinuria, ESR, ANA level and nephritic lesions seen in renal biopsy. Meanwhile, negative correlations were found with blood platelets, serum albumin, serum complement C3 level [p<0.05]. A highly significant correlation was also found between anti-CHR antibodies and disease activity score measured by ECLAM [p<0.001]. Renal biopsy findings showed that WHO class of lupus nephritis had a significant impact on anti-CHR antibody level [p<0.05], with the association of higher antibody levels with proliferative glomerular lesions and frequent electron dense deposits mainly in the subendothelial location, while no significant difference was found in case of anti-dsDNA antibodies

Conclusion: Antichromatin antibodies are more sensitive and specific than anti-dsDNA antibodies for the diagnosis of SLE and more sensitive as regards lupus nephritis. Moreover, serum level of anti-CHR antibodies can be a helpful test to expect the extent of renal affection and hence -choose patients candidate for renal biopsy