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Postmenopausal osteoporosis is a kind of degenerative disease, also described as "invisible killer." Estrogen is generally considered as the key hormone for women to maintain bone mineral content during their lives. Iron accumulation refers to a state of human serum ferritin that is higher than the normal value but less than 1000 μg/L. It has been found that iron accumulation and osteoporosis could occur simultaneously with the decrease in estrogen level after menopause. In recent years, many studies indicated that iron accumulation plays a vital role in postmenopausal osteoporosis, and a significant correlation has been found between iron accumulation and fragility fractures. In this review, we summarize and analyze the relevant literature including randomized controlled trials, systematic reviews, and meta-analyses between January 1996 and July 2022. We investigate the mechanism of the effect of iron accumulation on bone metabolism and discuss the relationship of iron accumulation, osteoporosis, and postmenopausal fragility fractures, as well as the main clinical treatment strategies. We conclude that it is necessary to pay attention to the phenomenon of iron accumulation in postmenopausal women with osteoporosis and explore the in-depth mechanism of abnormal bone metabolism caused by iron accumulation, in order to facilitate the discovery of effective therapeutic targets for postmenopausal osteoporosis.
Subject(s)
Humans , Female , Osteoporotic Fractures , Osteoporosis, Postmenopausal/drug therapy , Postmenopause , Osteoporosis , Bone Density , Estrogens , Iron/therapeutic useABSTRACT
BackgroundDuring the current Coronavirus Disease 2019 (COVID-19) pandemic, diabetic patients face disproportionately more. Anti-inflammatory effects of hypoglycemic agents have been reported, and their beneficial or harmful effects in patients with diabetes and COVID-19 remain controversial. PurposeThis study was performed to clarify this association. Data SourcesRelevant literature was searched on China National Knowledge Infrastructure (CNKI), Wanfang Data Knowledge Service Platform, Chinese periodical service platform VIP Database, Sinomed (China Biology Medicine, CBM), MedRxiv, PubMed, ScienceDirect, Web of Science, Ovid Databases (LWW), Springer Link, Wiley Online Library, Oxford Academic, Nature Press Group, Cochrane Library and BMJ Evidence-Based Medicine up to November 14, 2020. Study SelectionOnly observational studies of hypoglycemic agents vs. drugs or therapy without hypoglycemic agents in adult diabetic patients with COVID-19 were included. Data ExtractionData of death and poor composite outcomes were extracted. Data SynthesisThe pooled effects were calculated using the fixed-effects or random-effects models based on heterogeneity assessment. LimitationMost studies were retrospective cohort studies with relative weak capability to verify causality. ConclusionHome use of metformin might be beneficial in decreasing mortality in diabetic patients infected with SARS-CoV-2. There is insufficient evidence to conclude that metformin and other hypoglycemic agents are associated with poor composite outcomes. More prospective studies, especially RCTs are needed. Registration-PROSPEROCRD42020221951.
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Objective Toexplorethecorrelationanalysisofmammographyandclinicalcharacteristicsassociatedwiththerecurrence ofearlystageoftripleGnegativebreastcancer(TNBC).Methods Thedataofmammographyandclinicalcharacteristicsof231TNBC patientsfromJanuary2009to October2017 wereretrospectivelyanalyzed,andthenthedifferencesofmammographyandclinical characteristicswerecomparedbetweenthepatientswithrecurrence(n＝64)andthosewithoutrecurrence(n＝167).Results Compared withthepatientswithoutrecurrence,thepresenceoffamilyhistoryinpatientswithrecurrencewashigherthanthosewithoutrecurrence (12.5%vs3.6%,P＜0.05).Thehistologicalgradesofthepatientswithrecurrenceweremainlyshowedasgrade2(6.3%)and3(93.7%), andthehistologicalgradeinpatientswithrecurrencewashigherthanthosewithoutrecurrence(P＜0.05).Themammographicfindingsin TNBCshowedthatthepatientswithrecurrenceweremorelikelytohavedensebreasttissue(84.4%),axillarylymphnodesinvasion (53.1%)andlowercalcification(12.5%)(P＜0.05).Multivariatelogisticregressionanalysisshowedthatthefamilyhistoryofbreast cancer(P＝0.01,OR＝2.54),histologicalgradeof2(P＝0.01,OR＝2.23)and3(P＜0.001,OR＝3.79),mammographicdensity breasttissue(P＝0.02,OR＝2.32),calcification(P＝0.02,OR＝0.45),andaxillarylymphnodesinvasion(P＝0.03,OR＝1.75)were statisticallysignificancewithTNBCrecurrence.Conclusion Thefamilyhistory,histologicalgrade,thepresenceofdensebreasttissue andaxillarylymphnodesinvasionsatmammographywereassociatedwiththeincreasedriskofrecurrenceinTNBC,whilethepresenceof calcificationwasrelatedtothelowerriskofrecurrenceinTNBC.
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Objective To investigate the changes of the regional homogeneity(ReHo)values of spontaneous brain activity in patients with idiopathic trigeminal neuralgia (ITN).Methods Left ITN (LITN)group (n=23)and the healthy control (HC)group (n=33)underwent resting-state functional magnetic resonance imaging(rs-fMRI)scans.The changes of ReHo values between the two groups were compared.Results Compared with HC group,LITN group yielded increased ReHo values in bilateral nucleus accumbens,bilateral caudate nucleus,right putamen, right precentral gyrus (M1),right supplementary motor area (SMA)and right anterior insula (P<0.01).Conclusion The rs-fMRI shows abnormal ReHo values of brain activity in several regions in ITN patients.The regions are related to pain processing-motion,emotion and endogenous regulation.The suggest that brain involves the developing and regulating mechanism of ITN as an importment factor.
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Objective To investigate the value of MRI in analyzing relationship between compression site of the vascular compression and the facial pain area in patients with primary trigeminal neuralgia (PTN).Methods MRI data of 123 patients with unilateral PTN were retrospectively analyzed,including imaging of three-dimensional-time of flight MRA (3D TOF MRA) sequence,three-dimensional-fast imaging employing steady state acquisition sequence and contrast-enhanced 3D TOF MRA sequence.Neurovascular conflict (NVC) sites were divided into 8 sites according to the sectional anatomy of trigeminal nerve,and the relations between topography of pain and site of NVC were analyzed in 60 PTN patients with a single offending vessel and a single site of NVC.Distance (d) from the root entry point to the site of NVC,the length (L) of cisternal segment of the trigeminal nerve were both measured,and d/L was calculated in 123 patients with 206 NVC points.Results Of 60 patients with single offending vessel and single site of NVC,95.00％ (57/60) sites of NVC matched to topography of pain,5.00％ (3/60) did not,whereas NVC points with d/L≤1/4 accounted for 58.33％ (35/ 60),d/L≤1/2 accounted for 85.00％ (51/60).Among 206 NVC points,the meand was (2.50±1.35)mm,and NVC points with d/L≤1/4 accounted for 44.66％ (92/206),d/L≤1/2 accounted for 74.27％ (153/206).Conclusion MRI is helpful to detecting the offending vessels in PTN patients through judging relationship between the topography of pain and the site of NVC,as well as measuring the distance from the root entry point to the site of NVC.
