Assessment of fracture risk in a cohort of Egyptian female Systemic Lupus erythematosus patients

Hafez, Eman A.; Bakry, Samah A. El; Ibrahim, Shafica Ibrahim; Morad, Caroline S.; Hamza, Sarah A.; EL-Khalik, Dina M Abd

doi:10.1016/j.ejr.2017.07.006

Cited by 8 publications

(4 citation statements)

References 30 publications

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“…Type 2 DM (T2DM), characterized by hyperglycemia, accounts for about 90% of all diabetes cases worldwide [ 4 ]. Patients with type 1 DM have a lower BMD whereas those with T2DM are at a higher risk of experiencing a bone fracture, given their high or average BMD as measured by dual-energy X-ray absorptiometry (DXA) [ 4 , 5 ]. Other causes that contribute to the development of fractures in patients with T2DM include sarcopenia, impaired balance due to peripheral neuropathy, diabetic retinopathy, and medications used in diabetes [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Bone Mineral Density, Serum Osteocalcin, and Osteopontin Levels in Postmenopausal Women with Type 2 Diabetes Mellitus, with/without Osteoporosis

Roomi

Salih

Noori

et al. 2022

Journal of Osteoporosis

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Objective. Osteoporosis (OP) is a worldwide ailment; we aim to establish new biomarkers in diagnosis by determining the levels of serum osteocalcin and osteopontin along with bone mineral density (BMD) and lumbar T-score, in postmenopausal women with type 2 diabetes mellitus (T2DM) with or without OP. Methods. This observational study included 160 postmenopausal women who were an attendee at outpatient clinics in Al-Hussein Hospital, Thi-Qar province; subdivided into 3 groups based on their T-score testing: Group I (n = 40) comprised postmenopausal women without T2DM as controls, Group II (n = 60) comprised postmenopausal women with T2DM but without OP, and Group III (n = 60) comprised postmenopausal women with T2DM with OP. The dual-energy X-ray absorptiometry was used to measure the BMD (total body, lumbar spine, and femoral) and T-score for lumbar spine and femoral. Glycosylated hemoglobin (HbA1c), fasting blood glucose (FBG), osteocalcin, and osteopontin levels were assessed in all three groups. Results. Compared with controls, Group III demonstrated significantly lower BMD (total body, lumbar spine, and femoral), T-score for lumbar spine and femoral, serum osteocalcin, and osteopontin levels than Group II and Group I ( P < 0.001 ). FBG and HbA1c levels were significantly higher in Group III than in Groups I and II ( P < 0.001 ). A negative correlation was proved between HbA1c levels with BMD, osteocalcin levels, and osteopontin levels in the three groups. Conclusions. Iraqi postmenopausal women with T2DM had a significantly lower bone mineral density, serum osteocalcin, and osteopontin levels. These results may serve as adjuvants in screening for OP, particularly among diabetic patients.

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Section: Introductionmentioning

confidence: 99%

Evaluation of Bone Mineral Density, Serum Osteocalcin, and Osteopontin Levels in Postmenopausal Women with Type 2 Diabetes Mellitus, with/without Osteoporosis

Roomi

Salih

Noori

et al. 2022

Journal of Osteoporosis

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“…A study from Egypt found a prevalence of OP to be 20% and osteopenia to be 35.7%. 25 Many factors contribute to the increased incidence of OP in patients with SLE. Not only the prolonged steroid use but disrupted inflammatory status-driven mainly through interleukin 1 (IL-1), IL-6, IL-17, and tumor necrosis alpha (TNF-α) with subsequent impact on receptor activator of nuclear factor kβ (RANK) receptor activator of nuclear factor kβ ligand (RANKL)–osteoprotegrin (OPG) axis, leading to stimulation of osteoclast differentiation and activity and inhibition of osteoblast activity.…”

Section: Discussionmentioning

confidence: 99%

Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study

et al. 2022

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Objective To study the prevalence and impact of comorbidities among a cohort of patients with systemic lupus erythematosus (SLE). Methods This study is retrospective, multicenter including 902 Egyptian patients with SLE. Medical records were reviewed for demographic data, clinical characteristics, routine laboratory findings, immunological profile, and medications. Moreover, SLE Disease Activity Index (SLEDAI), and the Systemic Lupus International Collaborating Clinics/American College Rheumatology Damage Index scores were calculated. Results Comorbidities were found in 75.5% of the studied group with hypertension and dyslipidemia as the most frequent comorbidities (43.1% and 40.1%, respectively), followed by sicca features, avascular necrosis, diabetes, osteoporosis and renal failure (11.5%,9%, 9%,8.9%, and 7.1%, respectively). Multivariate regression model showed statistically significant relation between the presence of comorbid condition and each of age ( P = 0.006), disease duration ( P = 0.041), SLEDAI at onset ( P < 0.001), cyclophosphamide intake ( P = 0.001), and cumulative pulse intravenous methylprednisone ( P < 0.001). Also, when adjusted to age and sex, those with multiple comorbid conditions had 18.5 increased odds of mortality compared to those without comorbidities (odds ratio (OR), 95% confidence interval (CI) = 18.5 (6.65–51.69)]. Conclusion Patients with SLE suffer from several comorbidities, with an increasing risk with age, longer disease duration, higher SLEDAI at onset, cyclophosphamide intake and cumulative pulse intravenous methylprednisone. Risk of mortality is exponentiated with multiple comorbidities.

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“…Physicians should be aware of the high risk of future fractures in SLE [96]. Juvenile onset SLE patients had a high prevalence of OP (15%) that worsened over follow-up reaching 54% [97].…”

Section: Systemic Lupus Erythematosus [Sle]mentioning

confidence: 99%

“…Hafez [96] [85]. Impaired bone formation and uncoupling of bone turnover were more evident in postmenopausal elderly-onset Egyptian RA cases and formed a risk for hip fracture [86].…”

Section: Systemic Lupus Erythematosus [Sle]mentioning

confidence: 99%

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

Hammam¹

2018

Int. J. Clin. Rheumatol

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Background: Osteoporosis (OP) is defined by low bone mass and microstructural deterioration. It is an escalating public health problem due to increase life expectancy and the resulting bone fractures represent a significant burden for both the individual and the society in terms of morbidity, mortality and cost. Osteoporosis, a multifactorial disease, results from the interaction between genetic and environmental risk factors. Currently, the data available regarding OP epidemiology and predisposing risk factors differ greatly between regions and within population ethnicities. Proper estimation of the epidemiology of OP and its health related outcomes can help identity those at risk and permit prophylactic treatment before its occurrence. The main barrier towards disease prevention strategies is the impaired awareness of the disease and its risk. Enhanced understanding of the OP disease may influence personal behaviors and reduce its prevalence.Objectives: This review was undertaken to wrap-up and throw-light on the published literatures related to the epidemiology of osteoporosis in the Middle East and North Africa (MENA) region, and expose the extent of awareness in the corresponding populations. Describing and discussing key points on the current state of knowledge on these hot issues are well thought-out.Conclusion: Osteoporosis prevalence is variable among MENA populations. Limited reports regarding the established prevalence of osteoporotic fractures among those populations and therefore, lack of guidelines for prevention and management were noticed. In order to improve bone health, preventive measures against OP should be considered. Increase OP awareness and preventive practices in the societies as part of the prophylactic strategy need to be initiated.

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Assessment of fracture risk in a cohort of Egyptian female Systemic Lupus erythematosus patients

Cited by 8 publications

References 30 publications

Evaluation of Bone Mineral Density, Serum Osteocalcin, and Osteopontin Levels in Postmenopausal Women with Type 2 Diabetes Mellitus, with/without Osteoporosis

Evaluation of Bone Mineral Density, Serum Osteocalcin, and Osteopontin Levels in Postmenopausal Women with Type 2 Diabetes Mellitus, with/without Osteoporosis

Comorbidities among Egyptian systemic lupus erythematosus: The COMOSLE-EGYPT study

Epidemiology and awareness of osteoporosis: a viewpoint from the Middle East and North Africa

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