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BACKGROUND:Exercise training can improve osteoporosis,but its effects and mechanisms on senile osteoporosis are not fully understood. OBJECTIVE:To observe the effect of treadmill exercise on osteoporosis and wnt/β-catenin signal pathway in aged rats. METHODS:Sixteen 24-month-old male Sprague-Dawley rats were randomly divided into osteoporosis group(n=8)and treadmill group(n=8)and eight 6-month-old male Sprague-Dawley rats were used as young control group.The model of senile osteoporosis was replicated by natural aging and the rats in the treadmill group were treated with treadmill exercise once a day,5 days a week,for 8 weeks.Levels of bone metabolic markers such as type I collagen cross-linked C-terminal peptide,tartrate resistant acid phosphatase,osteocalcin and bone specific alkaline phosphatase were detected by ELISA;bone mineral density of the left femur and L5 was measured by dual energy X-ray;bone scanning and bone microstructure quantitative analysis were performed by bone micro-CT;and the mRNA and protein expression levels of wnt3a,β-catenin,LRP5,DKK1 and GSK3β were detected by RT-PCR and western blot,respectively. RESULTS AND CONCLUSION:Compared with the young control group,the osteoporosis group showed a reduction in serum bone specific alkaline phosphatase and osteocalcin levels(P<0.05),bone mineral density of the femur and L5,the number of tibia and L4 bone trabeculae,bone volume,bone volume fraction(P<0.05),and mRNA and protein expression of wnt3a,β-catenin,and LRP5 in bone marrow tissue(P<0.05)as well as an increase in serum levels of tartrate resistant acid phosphatase and type I collagen cross-linked C-terminal peptide(P<0.05),the intertrabecular space between the tibia and L4,structural model index(P<0.05),and mRNA and protein expression of DKK1 and GSK3 β in bone marrow tissue(P<0.05).In addition to the reduced number of trabeculae in the tibia and L4 vertebrae,the trabeculae were structurally disturbed and sparsely aligned and fractured.Compared with the osteoporosis group,the treadmill group showed an increase in serum bone specific alkaline phosphatase and osteocalcin levels(P<0.05),bone mineral density of the femur and L5(P<0.05),the number of tibial trabeculae,bone volume,bone volume fraction(P<0.05),mRNA and protein expression of wnt3a,β-catenin,and LRP5 in bone marrow tissue(P<0.05)but a reduction in the serum levels of tartrate resistant acid phosphatase and type I collagen cross-linked C-terminal peptide,L4 trabecular space,tibial trabecular space,structural model index,and mRNA and protein expression of DKK1 and GSK3 β in bone marrow tissue(P<0.05).In addition to the increased number of tibial and L4 trabeculae,the trabeculae were arranged in a regular and dense pattern and were connected to a network.To conclude,treadmill exercise may improve osteoporosis in aged rats by activating the wnt/β-catenin signal pathway.
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Senile osteoporosis (SOP) is a systemic bone disease characterized by increased susceptibility to fractures. The pathogenesis of SOP is complex and not well understood. Currently, the rapid aging model mouse, senescence accelerated mouse prone 6 (SAMP6), is an ideal model for studying the mechanisms of SOP development and exploring its prevention and treatment. This model exhibits characteristics including increased bone fragility, degradation of bone microstructure, loss of bone matrix, and abnormal metabolism and dysfunction of bone cells, faithfully replicating the process of SOP occurrence and progression at both macroscopic and microscopic levels.
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Objective:Through meta-analysis, the association of three common adipokines (leptin, adiponectin, and chemerin) with bone nutrition of senile osteoporosis (SOP) in China was systematically evaluated.Methods:CNKI, CBM, VIP, Wanfang, PubMed, Web of Science, Embase, Cochrane Library, and other databases were searched for articles published from the establishment of the database to July 30, 2022. After literature screening, data extraction, and quality evaluation of the included studies were independently conducted by two researchers, a meta-analysis was performed using RevMan5.4 and Stata17.0 softwares.Results:A total of 13 studies in the Chinese population were included, including 897 patients with SOP and 673 elderly with normal bone mineral density . The results of the meta-analysis showed that compared with the control group, the serum leptin levels were significantly lower ( MD -2.64, 95% CI -4.04 to -1.23, P < 0.001), chemerin levels were significantly higher ( MD 25.23, 95% CI 14.57 to 35.90, P < 0.001), and adiponectin levels were not significantly different ( MD -0.55, 95% CI -2.26 to 1.17, P > 0.05) in SOP patients. After subgroup analysis according to the measurement method, leptin levels remained lower in SOP patients than in the control group. Conclusions:Compared with the control group, leptin levels were lower and chemerin levels were higher in SOP patients. Therefore, dysregulation of adipokines may play an important role in the occurrence and development of SOP, and regulation of adipokine levels and functions may play a role in the treatment of SOP and the improvement of bone nutrition as a nutritional intervention.
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Senile osteoporosis is closely related to the level of sex hormones. Estrogen and androgen play important physiological roles in senile men and women with osteoporosis. Androgen can stimulate the proliferation and differentiation of osteoblasts to promote bone formation and improve bone mineral density and bone mass. Estrogen can bind to estrogen receptors to directly regulate bone metabolism and reduce bone resorption. This article reviews the relationship between senile osteoporosis and sex hormones.
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Objective: To investigate the clinical efficacy of Yaotongning Capsule in relieving osteoporotic bone pain in the elderly. Methods: A total of 120 patients with pain VAS score between 3 and 8 in the department of orthopedics and traumatology, Affiliated Hospital of Shaanxi University of Traditional Chinese Medicine from September 2018 to December 2019, in accordance with the diagnostic criteria of senile osteoporosis, were randomly divided into control group (60 cases) and treatment group (60 cases). The control the group was treated with oral Calcium Carbonate and Vitamin D3, 0.6 g, once a day; The treatment group was treated with Yaotongning Capsule on the basis of control group, four capsules each time, 0.5 h before sleeping every night, with 10 mL yellow wine mixed with a small amount of warm boiled water. The dosage of other anti-osteoporosis drugs should not be changed. The drug was administered continuously for 2 weeks. The patients were followed up for 0, 3, 7 and 14 d, respectively, with a time window of ± 1 d. After treatment, according to the changes of visual analogue scale (VAS) score in each visit period, the curative effect was evaluated according to the improvement of pain degree. Serum pain media levels were tested between two groups before and after treatment. Results: The total effective rate of 60 patients in the treatment group was 91.7%. The total effective rate of 60 patients in the control group was 23.3%, which was significantly lower than that in the treatment group, and the difference between the two groups was statistically significant. The scores of pain before and after treatment in the observation group were lower than those in the control group (P < 0.01). After 14 d of treatment, the levels of PGE2, SP and 5-HT did not change significantly in the control group, but decreased significantly in the treatment group (P < 0.01). Conclusion: The results of this study show that Yaotongning Capsule has a rapid onset and significant effect in relieving bone pain of senile osteoporosis.
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According to the procedures for the development of evidence-based medicine guidelines, a multi-disciplinary guideline development working group was established, after three rounds of discussions by the consensus expert group, a new evidencebased guideline for diagnosis and treatment of senile osteoporosis in China(2018) was developed. The grading of recommendations assessment, development and evaluation(GRADE) system was used to rate the quality of evidence and the strength of recommendations. Recommendations were derived from evidence body, and at the same time considered the balance of benefits and harms as well as values and preferences of Chinese patients. The guideline development working group developed 15 recommendations for the diagnosis and treatment of senile osteoporosis. The guideline covered the screening for senile osteoporosis, risk assessment, diagnosis, basic treatment, multiple anti-osteoporosis drugs, therapeutic effect monitoring and evaluation of senile osteoporosis. This guideline aims to serve as a tool for clinicians and patients for best decisions-making in China.
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Objective To investigate the clinical effect of salmon calcitonin in the treatment of senile osteoporosis , and to observe the effect of salmon calcitonin on bone mineral density ( BMD ) and pain.Methods 180 cases of patients diagnosed as osteoporosis from September 2015 to September 2016 in our hospital were retrospectively analyzed, the patients were divided into control group and treatment group according to the random number table method.The clinical efficacy and side effects of the two groups were evaluated.The bone mineral density (BMD) of the lumbar vertebrae, femur and radius were measured by dual energy X-ray absorptiometry.The VAS was used to evaluate the two groups before and after the treatment.( ODI) were used to evaluate the functional status of the patients before and after treatment.The self-made questionnaire was used to evaluate the quality of life of the patients before and after treatment.Results The total effective rate of treatment group was 94.44%, significantly higher than the control group 75.56%(P<0.05).After treatment, the treatment group of lumbar spine bone mineral density, bone mineral density and radial bone mineral density was significantly higher than the control group (P<0.05).After treatment, spontaneous low back pain, flexion extension pain, turn over pain and weight pain were significantly lower in the treatment group than in the control group (P<0.05).The ODI index of the treatment group was significantly lower than that of the control group (P<0.05).After treatment, the quality of life scores in the two groups were significantly higher than those before treatment, and the treatment group was higher than the control group(P<0.05).No significant adverse reactions occurred in two groups during the treatment.Conclusion Salmon calcitonin treatment of osteoporosis in elderly patients with a significant effect, help to improve bone mineral density, reduce pain and improve its dysfunction, and has high security.
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<p><b>OBJECTIVE</b>To explore the clinical efficacy and partial mechanism of medicinal-cake-separated moxibustion for senile osteoporosis.</p><p><b>METHODS</b>Sixty cases of senile osteoporosis were randomly divided into an observation group and a control group according to the random digits table, 30 cases in each one. The two groups were both treated with basic treatment of western medicine. The acupoints included four groups:① Dazhui (GV 14), Dazhu (BL 11) and Ganshu (BL 18); ② Zhongwan (CV 12), Danzhong (CV 17) and Zusanli (ST 36); ③ Pishu (BL 20), Shenshu (BL 23) and Mingmen (GV 4); ④ Shenque (CV 8) and Guanyuan (CV 4). Each group of acupoints was selected for one treatment. The observation group was treated with medicinal-cake-separated moxibustion, and the medicinal cake was consisted of fructus psoraleae (30 g), prepared rehmannia root (30 g), atractylodes (30 g), codonopsis pilosula (30 g), epimedium herb (20 g), rhizoma curculiginis (20 g), syzygium aromaticum (5 g) and cinnamon (5 g). The control group was treated with wheat-flour-cake moxibustion. Each acupoint was treated with 5 moxa cones in the two groups. The treatment was given once every other day for six months. The symptom score, lumbar and hip bone mineral density (BMD), serum type Ⅰ procollagen amino-terminal propeptide (PINP) and serum β-type Ⅰ collagen carboxy-terminal peptide (β-CTX) were observed before and after treatment.</p><p><b>RESULTS</b>After treatment, the symptom score and serum β-CTX were significantly lowered (all<0.05), while the lumbar and hip BMD and serum PINP were significantly increased (all<0.05) of the two groups. After treatment, the symptom score and serum β-CTX in the observation group were significantly lower than those in the control group (both<0.05), while the lumbar and hip BMD and serum PINP in the observation group were significantly higher than those in the control group (all<0.05).</p><p><b>CONCLUSIONS</b>The medicinal-cake-separated moxibustion has significant efficacy for senile osteoporosis, which is superior to wheat-cake-se-parated moxibustion.</p>
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<p><b>OBJECTIVE</b>To compare the clinical efficacy differences between acupoint plaster therapy with midnight-noon ebb-flow hour-prescription method and traditional acupoint plaster therapy for senile osteoporosis (SOP).</p><p><b>METHODS</b>With randomized controlled blind design, 76 SOP patients with deficiency of liver and kidney syndrome were randomly divided into an observation group and a control group, 38 cases in each one. Based on oral administration of caltrate D, the patients in the observation group were treated with acupoint plaster therapy with midnight-noon ebb-flow hour-prescription method at Yingu (KI 10), Taixi (KI 3), Dazhong (KI 4), Fuliu (KI 7) and Zhiyin (BL 67), while the patients in the control group were treated with traditional acupoint plaster therapy. Each plaster therapy lasted for 6 h, once a day; there was an interval of 2 d after consecutive 5-day treatment; 4 weeks were taken as one course, and totally 2 courses were given. Visual analogue scale (VAS) and Oswestry Disability Index (ODI) were used to evaluate the pain and dysfunction before intervention, after 4 weeks and 8 weeks intervention. Osteoporosis symptom rating sale and quality of life questionnaire of the European foundation for Osteoporosis (QUALEFFO-41) were adopted to evaluate the TCM syndrome and quality of life before and after 8-week intervention.</p><p><b>RESULTS</b>All the outcomes were significantly improved after treatment in the two groups (<0.01,<0.05); after 4 weeks and 8 weeks of treatment, the VAS and ODI in the observation group were lower than those in the control group (all<0.05). Repeated ANOVA indicated the VAS and ODI were significant in group effect, time effect and interaction effect (all<0.01). Further comparison showed that VAS and ODI at later time points were lower than those in the early time points (all<0.01). After the treatment, the scores of TCM syndrome and QUALEFFO-41 in the observation group were lower than those in the control group (all<0.05). The effective rate was 85.7% (30/35) in the observation group, which was superior to the effective rate in the control group[74.3%(26/35),<0.05].</p><p><b>CONCLUSIONS</b>The acupoint plaster therapy with midnight-noon ebb-flow hour-prescription method is superior to traditional acupoint plaster therapy in improving pain, dysfunction, TCM syndrome and quality of life in SOP patients; in addition, its clinical efficacy is significant.</p>
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Objective To explore the risk factors and nursing measures for senile patients with osteoporosis. Methods All 160 cases of senile osteoporosis patients in January 2012 to August 2014 in our hospital and 160 cases of non senile osteoporosis patients at the same period were as the research object,the osteoporosis patients were as the observation group,the non osteoporosis patients were as the control group,general information of two groups were compared,includ-ing age,height,weight and BMI,and analyzed the influence factors of osteoporosis,including risk factors Logistic re-gression in senile osteoporosis risk factors by univariate Logistic regression of senile osteoporosis and multiple factors,and to explore the nursing measures. Results①The average height of the observation group was(165.21±4.89)cm,the control group (168.44±6.23)cm, with statistical difference (t=4.2069, P<0.05); the average weight of the observation group was(64.21±10.01)kg,the control group was(68.37±10.24)kg,with statistical difference(t=3.3607,P<0.05);②Single factor Logistic regression analysis showed that the factors associated with senile osteoporosis including lie in bed,height, exercise, calcium agent and drink milk; ③Logistic multi factor regression analysis showed taller, sport and drinking milk were protective factors of senile osteoporosis,and lie in bed was the risk factor of senile osteoporosis. Conclusion The taller,sport and drinking milk are protective factors of senile osteoporosis,and lie in bed is risk factor for senile osteoporosis.
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Bisphosphonates are widely prescribed and highly effective at limiting the bone loss that occurs in many disorders characterized by increased osteoclast-mediated bone resorption, including senile osteoporosis in both men and women. Although, they are generally well-tolerated, potential adverse effects may limit bisphosphonate use in some patients. Optimal use of bisphosphonates for osteoporosis requires adequate calcium and vitamin D intake before and during therapy. Long-term adverse effects of bisphosphonate therapy include osteonecrosis of the jaw and atypical fractures of femur. We report a case of a 78-year-old man who presented with pain and inability to move the left thigh from 11 am on the day of admission. He was diagnosed to have transverse subtrochanteric fracture of the left femur with relatively thick cortex. He had been religiously taking alendronate (a bisphosphonates) 70 mg once a week along with calcium preparation (elemental calcium 500 mg with cholecalciferol 250 units twice-daily) for 5 years. With this background of a ‘chalk stick’ like transverse fracture of the subtrochanteric region of femur in an otherwise healthy elderly man, an ‘atypical fracture of femur’ from long-term use of bishphosphonates was the likely cause.
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Osteoporosis is a kind of systemic metabolic bone diseases ,characterized by bone loss , bone subtle structural dam-age.Leptin is a peptide hormone which secreted by fat cells , that has both positive and negative effects to the bone , and plays a role of regulating on bone metabolism .In vitro, Leptin can regulate proliferation of osteoblast and inhibit reabsorption of osteoblasts depend on osteoclast.In vivo, Leptin can inhibit the synthesis of serotonin in the brain stem and increase the sympathetic nerve signals output by the hypothalamus to the bone , it mainly has a negative effect .But clinical trials about the correlation between Leptin and senile oste-oporosis, the role of Leptin in the central nervous system and peripheral tissue problems are still unclear .In this paper, we will make a comprehensive overview about the latest research progress in the correlation between leptin and senile osteoporosis .
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Objective To study the curative effect and safety of senile osteoporotic vertebral compression fractures with balloon ky-phoplasty. Methods The clinical data of 80 patients in our hospital during July 2008 to July 2012 with senile osteoporotic vertebral compres-sion fractures were analysed retrospectively. And the clinical effect was evaluated by observing the charges of visual analog scale (VAS), height of vertebral bodies and Cobb’ s angle, the quality of life score in patients respectively before and after operation. Results The pain of the patients were controlled effectively after operation, and the patients had significant and sustained improvement in anterior and midline ver-tebral body height after operation, with (56. 02 ± 12. 08) % and (58. 19 ± 13. 11) % before preoperation respectively, and (72. 10 ± 16. 19) % and (78. 33 ± 19. 02) % after surgery respectively. VAS score reduced from (8. 31 ± 1. 22) to (1. 65 ± 0. 33) after surgery;Cobb’s angle reduced from (24. 12 ± 3. 28)° to (13. 56 ± 2. 05)° after operation. The differences of the frontal height and flange height, VAS scores, and Cobb’s angle before and after operation were statistically significant (P<0. 05). The incidence of complications reduced from 23. 75% to 1. 25% after operation, which indicates significant difference (P<0. 01). According to QLQC-30 quality of life score, the postoperative life of patients were much better than that of the preoperative life, and the difference of all statistical index were of statistical significance (P<0. 05). Conclusion Balloon kyphoplasty in the treatment of senile osteoporotic vertebral compression fractures has signifi-cant effect and high safety, it should be popularized and applied in clinical.
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Objective To summarize the nursing methods and effect of artificial femoral head replacement in treatment of osteoporotic interttochanteric fracture in elderly patients. Methods 55 patients with esteoporotic intertrochanteric fracture were selected in our hospital from February 2007 to February 2011.All patients were cared by targeted preoperative and postoperative nursing,helping them conducting functional training in time,giving discharge counseling and follow-up.The hip functional recovery of patients was evaluated by using the Harris evaluation standard,and the excellent rate of surgery was also evaluated. Results After the targeted care,55 patients went through the perioperative period safely,the average length of stay was ( 14.0 ± 3.1 )days,a total of 5 cases (9.09％)patiants suffered varying degrees of complications which were improved after symptomatic treatment.Patients were followed up for 3 to 36 months,only 2 patients died of cerebral vascular accident,all patients gained good recovery of hip function.Harris score was (84.45 ± 9.38),the excellent rate of surgery reached 78.18％. Conclusions Atificial femoral head replacement proves significant effect in treatment of osteoporotic intertrochanteric fractures in elderly patients,but with the accompanying surgical compliuations,special care and timely functional exercise methods should be paid attention to.
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Objective: To explore the mechanisms of acupuncture in improving osteoporosis. Methods: In this study, the expression of OPG and BMP-2 proteins of femur in SAMP6 control group, SAMP6 acupuncture group, SAMP6 sham-acupuncture group and SAMR1 control group were determined by Western Blot technique. Results: Compared with SAMR1 control group, the expression of OPG and BMP-2 proteins of the femur in SAMP6 control mice decreased obviously. Acupuncture could stimulate the expression of OPG and BMP-2 and no differences were detected between the SAMR1 control group and SAMP6 acupuncture group. Conclusion: Osteoporosis observed in SAMP6 was correlated with low expression of OPG and BMP-2. After acupuncture treatment, both of them showed increased expression, it suggested that the curative effects of acupuncture on osteoporosis were partly due to stimulating skeleton formation, inducing the production of some local factors of bone metabolism and decreasing the bone turnover rate.
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OBJECTIVE:To study the cost-effectiveness of four kinds of calcium drugs in treating senile osteoporosis.METHODS:228cases of senile osteoporosis were collected and divided into four groups,which were Calcichew D 3 (A),Osteo?form(B),Calcium Citrate Tablets+Vitamin AD(C),Shengu Capsules+Vitamin AD(D).Data was evaluated using the phar?macoeconomic cost-effectiveness analysis.RESULTS:The costs of four groups were938.05、1346.85、1946.35and1690.85yuan respectively.The effective rates of four groups were95.6%、80.0%、68.0%and72.0%respectively.Compared with scheme A,scheme B、C、D drug price need to be decreased by41.5%、65.6%、58.1%respectively so that their cost-effec?tiveness ratios can be better than scheme A.CONCLUSION:Among the four schemes,A is the best one.