Lead exposure is a risk for worsening bone mineral density in middle-aged male workers

Abstract

Objective: Lead exposure linked to osteoporosis in women. However, there is no direct evidence whether lead exposure has effects on bone metabolism in middle-aged male subjects. Therefore, the present study investigated the relationship between bone mineral densitometry measurements, bone markers, endocrine hormones and blood lead levels.

Material and methods: The present study included lead exposure patients (n: 30) and control subjects (n: 32). We recorded information on patient demographics and risk factors of osteoporosis. Blood lead levels were evaluated using Varian AA 240Z atomic absorption spectrophotometry. Bone mineral density measurements were measured using dual-energy X-ray absorptiometry.

Results: Each lumbar T and Z scores in the lead exposure group were lower than the control group. There were no significant differences in femur neck and femur total T and Z scores between two groups. Blood lead levels were also negatively correlated with lumbar 2-4 T score, total lumbar T score, lumbar 2-4 Z score and total lumbar Z score. Urinary hydroxyproline and urinary deoxypyridinoline levels in the lead exposure group were significantly higher compared to controls. Blood lead levels were strong, positively correlated with urinary deoxypyridinoline. Endocrine hormone levels and 1,25-dihydroxy-vitamin D3 levels were comparable between lead exposure and control group.

Conclusion: Lead exposure in male workers is an important factor for deterioration in bone mineral density. We should be screening blood lead levels and history of lead exposure in male osteoporosis.     

The effects of daily alendronate,daily calcitonin and alendronate every other day on bone mineral density in osteoporotic men

Objectives. Biphosphonates have been widely used in the treatment of osteoporosis, but there is not enough data on their use in men. The aim of this study is to investigate the effects of twelve months' treatment with daily 10 mg alendronate, every other day 10 mg alendronate and daily 200 IU calcitonin on bone mineral density (BMD) in men with osteoporosis.

Materials and methods. 46 men with osteoporosis were randomly allocated to three groups: 15 patients in the first group received daily 10 mg alendronate and calcium (1000 mg/day), 14 patients in the second group used every other day 10 mg alendronate and calcium and 17 patients in the third group were given intranasal salmon calcitonin and calcium. At the baseline, sixth and twelfth months, BMD was measured at lumbar spine (L_2–4), femoral neck and Ward's triangle zone by means of dual energy X-ray absorptiometry (LUNAR).

Results. In daily and every other day alendronate and calcitonin groups there was a significant increase in BMD at lumbar spine (p = 0.004, p = 0.001, p = 0.04), but no difference at the femoral neck (p > 0.05) at the end of twelve months. When the groups were compared with each other, no significant differences in BMD levels at lumbar spine, femoral neck and Ward's triangle were found (p > 0.05).     

Effects of testosterone replacement therapy on hypogonadal men with osteopenia or osteoporosis: a subanalysis of a prospective randomized controlled study in Japan (EARTH study)

Objective: We investigated the effects of testosterone replacement therapy (TRT) on bone mineral density (BMD) among hypogonadal men with osteopenia/osteoporosis.

Methods: From our previous EARTH study population, 74 patients with a clinical diagnosis of osteopenia or osteoporosis and hypogonadism were included in this study, as the TRT (n?=?35) and control (n?=?34) groups. The TRT group was administered 250?mg of testosterone enanthate injection every 4 weeks for 12 months. The BMD, waist circumference, body mass index, body fat percentage, and muscle volume were measured at baseline and at 12 months. Blood biochemical data, including total cholesterol, triglycerides, HDL-cholesterol, hemoglobin A1c, and adiponectin values were also evaluated.

Results: At the 12-month visit, BMD significantly increased in both groups. However, comparisons on changes of parameter values from baseline to the 12-month visit between the TRT and control groups were significantly different in BMD (5.0?±?5.0 vs. 3.0?±?3.2; p?=?.0434) and in adiponectin value (?0.90?±?3.33 vs. 0.10?±?2.04; p?=?.0192). There were no significant changes in other parameters.

Conclusions: TRT for 12 months could improve BMD with a decrease in adiponectin levels among hypogonadal men with osteopenia/osteoporosis.     

American College Health Association

Abstract

Objective: The purpose of this cross-sectional investigation was to examine (1) gender differences in osteoporosis-related knowledge and beliefs and (2) if these beliefs could predict vigorous physical activity behavior in university students. Participants: Male (n = 176) and female (n = 351) university students participated in the study. Methods: Participants completed self-report measures of osteoporosis knowledge and health beliefs and vigorous physical activity. Results: Regardless of gender, osteoporosis knowledge was relatively poor. Women reported higher knowledge, perceived susceptibility, perceived severity, and calcium barriers, and lower exercise self-efficacy than men. Regression analyses showed that for women, perceived susceptibility, health motivation, and exercise self-efficacy predicted vigorous physical activity, whereas for men, exercise barriers was the only predictor. Conclusions: Gender differences in osteoporosis health beliefs appear to be greater in older adults than college-aged students. Interventions designed to increase vigorous physical activity may want to target different beliefs for men and women.     

Characteristics of the Female Athlete Triad in Collegiate Cross-Country Runners

The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. Objective and Participants: The author's purpose in this study was to examine female cross-country runners' (N = 300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual dysfunction. Methods: The author used measures including the Orientation to Exercise Questionnaire, Calcium Rapid Assessment Method, and questions related to height, weight, exercise time, perceptions of eating disorders, and menstrual status. Previous or current eating disorders were reported by 19.4% of the women, 23.0% had irregular menstrual cycles, and 29.1% had inadequate calcium intake. Results: Those athletes perceiving a previous/current eating disorder scored higher on the Orientation to Exercise questionnaire than did those who did not perceive such. Conclusion: The author recommends educational efforts for the prevention of components of the Female Athlete Triad.     

Racial and sex differences of fruit and vegetable self-efficacy and intake among college students in a rural,southern location

Abstract

Objective: To examine fruit and vegetable intake and self-efficacy among U.S. college students in a rural, Southern location. Participants: Undergraduate students (n?=?1503) enrolled in a university-wide health class at one large public institution during the spring 2017 semester. Methods: Cross-sectional survey data were collected online and analyzed using independent samples t test, one-way ANOVA, and regression. Results: On average, participants did not meet fruit or vegetable intake recommendations. Mean self-efficacy scores were 17.2 (SD?=?3.4) and 16.42 (SD?=?3.7) for fruit and vegetables, respectively, with statistically significant differences observed by sex and race (p?<?0.05). Hierarchical multiple regression results indicated self-efficacy explained 20.9% (fruit) and 29.3% (vegetables) of the variance in consumption. Similar patterns were found for meeting daily fruit and vegetable intake recommendations. Conclusions: Health campaigns are needed to address sex and racial disparities in college student fruit and vegetable intake and self-efficacy.     

Osteoporosis knowledge and attitudes: a cross-sectional study among college-age students

OBJECTIVE: The authors' purpose in this study was to investigate the influence of knowledge of osteoporosis, attitudes regarding osteoporosis, and knowledge of dietary calcium on dairy product intake in both male and female college-age students. PARTICIPANTS: The authors conducted this cross-sectional study on 911 men and women enrolled in 2 demographically similar universities. METHODS: A modified osteoporosis knowledge questionnaire assessed participant's general osteoporosis knowledge and perceived disease risk. RESULTS: The authors found that knowledge of osteoporosis and calcium did not significantly influence dairy product intake. Attitude regarding osteoporosis was a significant predictor of dairy product intake in men but was not significant for the women. CONCLUSIONS: The authors recommend development and implementation of educational programs designed to increase awareness of calcium-rich food sources as well as other risk factors of this crippling disease.     

Association of serum calcium with serum sex steroid hormones in men in NHANES III

Abstract

Background: Bone is a positive regulator of male fertility, which indicates a link between regulation of bone remodeling and reproduction or more specifically a link between calcium and androgens. This possibly suggests how calcium is linked to prostate cancer development through its link with the reproductive system. We studied serum calcium and sex steroid hormones in the Third National Health and Nutrition Examination Survey (NHANES III).

Methods: Serum calcium and sex steroid hormones were measured for 1262 men in NHANES III. We calculated multivariable-adjusted geometric means of serum concentrations of total and estimated free testosterone and estradiol, androstanediol glucuronide (AAG), and sex hormone binding globulin (SHBG) by categories of calcium (lowest 5% [<1.16?mmol/L], mid 90%, top 5% [≥1.30?mmol/L]).

Results: Levels of total and free testosterone, total estradiol or AAG did not differ across categories of serum calcium. Adjusted SHBG concentrations were 36.4 for the bottom 5%, 34.2 for the mid 90% and 38.9?nmol/L for the top 5% of serum calcium (P_trend?=?0.006), free estradiol levels were 0.88, 0.92 and 0.80?pg/ml (P_trend?=?0.048).

Conclusions: This link between calcium and sex steroid hormones, in particular the U-shaped pattern with SHBG, may, in part, explain why observational studies have found a link between serum calcium and risk of prostate cancer.     

The Health Belief Model and the Contraceptive Behavior of College Women: Implications for Health Education

Abstract

“The Incidence of Primary Cardiac Arrest During Vigorous Exercise,” David S. Siscovick, et al. To examine the risk of primary cardiac arrest during vigorous exercise, we interviewed the wives of 133 men without known prior heart disease who had had primary cardiac arrest. Cases were classified according to their activity at the time of cardiac arrest and the amount of their habitual vigorous activity. From interviews with wives of a random sample of healthy men, we estimated the amount of time members of the community spent in vigorous activity.

Among men with low levels of habitual activity, the relative risk of cardiac arrest during exercise compared with that of other times was 56 (95% confidence limits, 23 to 131). The risk during exercise among men at the highest level of habitual activity was also elevated, but only by a factor of 5 (95% confidence limits, 2 to 14). However, among the habitually vigorous men, the overall risk of cardiac arrest—i.e., during and not during vigorous activity—was only 40% that of the sedentary men (95% confidence limits, 0.23 to 0.67).

Although the risk of primary cardiac arrest is transiently increased during vigorous exercise, habitual vigorous exercise is associated with an overall decreased risk of primary cardiac arrest. (New England Journal of Medicine 1984;311:874-7.)

“Osteoporosis in Women with Anorexia Nervosa,” Nancy A. Rigotti, et al. Because estrogen deficiency predisposes to osteoporosis, we assessed the skeletal mass of women with anorexia nervosa, using direct photon absorptiometry to measure radial bone density in 18 anorectic women and 28 normal controls. The patients with anorexia had significantly reduced mean bone density as compared with the controls (0.64 ±0.06 vs. 0.72 ±0.04 g per square centimeter, P < 0.001). Vertebral compression fractures developed in two patients, and bone biopsy in one of them demonstrated osteoporosis. Bone density in the patients was not related to the estradiol level (r = 0.02). Levels of parathyroid hormone, 25-hydroxyvitamin D, and 1,25-dihydroxyvitamin D were normal despite low calcium intakes.

The patients with anorexia who reported a high physical activity level had a greater bone density than the patients who were less active (P < 0.001); this difference could not be accounted for by differences in age, relative weight, duration of illness, or serum estradiol levels. The bone density of physically active patients did not differ from that of active or sedentary controls.

We conclude that women with anorexia nervosa have a reduced bone mass due to osteoporosis, but that a high level of physical activity may protect their skeletons. (New England Journal of Medicine 1984;311:1601-6.)     

Management of a Campus Rubella Epidemic

Abstract

Health Plan: The Only Practical Solution to the Soaring Cost of Medical Care. By Alain C. Enthoven. (Reading Massachusetts: Addison-Wesley, 1980.)

HMOs and the Politics of Health System Reform. By Joseph L. Faulkson, Ph.D. (Chicago, Illinois: American Hospital Association and Robert J. Brady Company, 1980.)     

Arsenic exposure associated with decreased bone mineralization in male

Abstract

Objective: Arsenic (As) exposure may cause several medical problems. There were a few studies investigated whether it has affected bone tissue in women. However, there was no study in men. The aim of this study was to evaluate associations between bone mineral density (BMD) and As exposure in men subjects.

Material and methods: We enrolled in this study 254 subjects who due to chronic As exposure suspected and 82 subjects as a control group. Hair As levels were detected by a hair analysis (Varian AA240Z Zeeman Atomic Absorption Spectrometer, USA). BMD measurements were obtained using dual-energy X-ray absorptiometry instrumentation. We investigated associations between the hair As levels and BMD measurements.

Results: The frequency of osteoporosis and osteopenia was found to be 0.8% and 54.5%, respectively, in the As exposure group. The frequency of osteoporosis was found to be 1% and osteopenia was 32.4% in control subjects. There was significant difference between two groups (p?<?0.001). Hair As level has a median 1.01 (min: 0.06 and max: 25.71). There were no significant correlation between hair As levels and BMD measurements.

Conclusion: According to our observations, As exposure was associated with bone metabolism. Possible cause of osteopenia may be exposure to As. Further investigations are needed to estimate the relationship between As and bone metabolism.     

Characteristics of the female athlete triad in collegiate cross-country runners

The Female Athlete Triad is a life-threatening syndrome defined by disordered eating, amenorrhea, and osteoporosis. OBJECTIVE AND PARTICIPANTS: The author's purpose in this study was to examine female cross-country runners' (N=300) calcium consumption, along with the prevalence of 2 components of the triad: disordered eating and menstrual dysfunction. METHODS: The author used measures including the Orientation to Exercise Questionnaire, Calcium Rapid Assessment Method, and questions related to height, weight, exercise time, perceptions of eating disorders, and menstrual status. Previous or current eating disorders were reported by 19.4% of the women, 23.0% had irregular menstrual cycles, and 29.1% had inadequate calcium intake. RESULTS: Those athletes perceiving a previous/current eating disorder scored higher on the Orientation to Exercise questionnaire than did those who did not perceive such. CONCLUSION: The author recommends educational efforts for the prevention of components of the Female Athlete Triad.     

Bone mineral density at distal forearm in men over 40 years of age in Mae Chaem district,Chiang Mai Province,Thailand: a pilot study

Objective: To study the prevalence of bone mineral density (BMD) and osteoporosis in the distal forearm among Thai men over 40 years of age in Mae Chaem District, Chiang Mai Province, Thailand.

Methods: The subjects in this study were 194 Thai men, aged between 40 and 87 years who resided in Mae Chaem District, Chiang Mai Province, Thailand. Self-administered questionnaires were used for receiving the demographic characteristics information. BMD was measured by peripheral dual energy X-ray absorptiometry at the nondominant distal forearm in all men.

Results: The BMD was highest in the age-group 40–49 years and lowest in the age-group 70–87 years. The average T-score at the distal forearm was also highest in the age-group 40–49 years and lowest in the age-group 70–87 years. The BMD decreased as a function of age-group (p?p?p?>?.05). The percentage of osteopenia and osteoporosis are increased as a function of age-group in, while decreased in that of normal bone density.

Conclusions: We found the prevalence of osteoporosis in men who resided in Mae Chaem District, Chiang Mai Province, Thailand.     

LOH–pitfalls of an ambiguous abbreviation

Osteoporosis in elderly men is becoming an important health issue with the aging society. Elderly men with androgen deficiency are exposed to osteoporosis and can be treated with testosterone replacement. In this study, Eurycoma longifolia (EL), a plant with androgenic effects, was supplemented to an androgen-deficient osteoporotic aged rat as alternative to testosterone. Aged 12 months old Sprague-Dawley rats were divided into groups of normal control (NC), sham-operated (SO), orchidectomised-control (OrxC), orchidectomised and supplemented with EL (Orx?+?El) and orchidectomised and given testosterone (Orx?+?T). After 6 weeks of treatment, serum osteocalcin, serum terminal C-telopeptide Type 1 collagen (CTX) and the fourth lumbar bone calcium were measured. There were no significant differences in the osteocalcin levels before and after treatment in all the groups. The CTX levels were also similar for all the groups before treatment. However, after treatment, orchidectomy had caused significant elevation of CTX compared to normal control rats. Testosterone replacements in orchidectomised rats were able to prevent the rise of CTX. Orchidectomy had also reduced the bone calcium level compared to normal control rats. Both testosterone replacement and EL supplementation to orchidectomised rats were able to maintain the bone calcium level, with the former showing better effects. As a conclusion, EL prevented bone calcium loss in orchidectomised rats and therefore has the potential to be used as an alternative treatment for androgen deficient osteoporosis.     

Proceedings of the Fifty-Eighth Annual Meeting of the American College Health Association San Diego,California, 1980

Abstract

Objective: The objective of this study was to assess dietary intakes and eating habits of female college athletes and compared them with the minimum sports nutrition standards. Participants: Data were obtained from 52 female college athletes from a National Collegiate Athletic Association (NCAA) Division I university between January 2009 and May 2010. Methods: Participants completed anthropometric measurements and dietary assessment using a 3-day food record, a 24-hour recall, and a nutrition questionnaire. Results: t tests indicated the energy and carbohydrate intakes were below the minimum recommended amount (p < .001), with only 9% of the participants meeting their energy needs. Seventy-five percent of the participants failed to consume the minimum amount of carbohydrates that is required to support training. The majority of the participants reported no regular breakfast, 36% consumed < 5 meals/day, and only 16% monitored their hydration status. Conclusions: Effective nutrition interventions are needed to improve dietary intakes and eating habits of female college athletes.     

The Association of Multiple Risk Factors With Fruit and Vegetable Intake Among a Nationwide Sample of College Students

Few college students meet fruit and vegetable intake recommended requirements, and most receive no information from their institutions about this issue. The avoidable disease burden among students is large, the necessary information infrastructure exists, and Healthy People 2010 objectives indicate efforts should be taken to increase intake. Objective: The authors examined the association of high-risk behaviors and fruit and vegetable intake to inform design of multiple risk factor interventions. Participants and Methods: The authors obtained data from a sample of 40,209 18- to 25-year-old college students who completed the American College Health Association-National College Health Assessment during the spring 2002 and 2003 semesters. Results: Predictors of high fruit and vegetable intake for men and women included better: seatbelt and helmet use, physical activity, perceived health, sleep, self-care behaviors, and grades. Other notable predictors of high intake were reduced likelihood of cigarette smoking, alcohol use, drinking and driving, and feeling hopeless in both sexes; reduced likelihood of drinking and driving among men; and a greater likelihood of anorexia among women. Conclusions: The authors discuss implications of these findings.     

Prevalence of low forearm bone mineral density in Bulgarian men: a pilot study

Objective. To determine the prevalence of osteoporosis at the distal forearm in a male cohort referred for bone density testing and to compare it to published data of Bulgarian women.

Design and subjects. 315 consecutive Bulgarian men aged 20 to 84 years were included (mean age 53.74 ± 14.67 years). 59% of them were self-referrals. The comparative female group consisted of 8869 Bulgarian women whose forearm bone mineral density (BMD) was measured in another study.

Measurements. BMD was measured by single X-ray absorptiometry at the distal forearm (distal and ultradistal sites) in all men. T-scores were calculated from manufacturer-provided Danish male reference data.

Results. The ratio of female to male patients was 28.2 (8869 to 315). Peak BMD was observed in men aged 30 to 39 years: 0.560 ± 0.065 g/cm² (distal site) and 0.490 ± 0.070 g/cm² (ultradistal site). A steady BMD decline followed reaching 0.492 ± 0.064 g/cm² at the distal and 0.412 ± 0.069 g/cm² at the ultradistal site in age group >70. Age had a rather weak negative impact on forearm BMD described by a linear model. In men aged over 50 years the prevalence of osteoporosis at the distal site was 21.19%, compared to 20.45% in women. Low bone mass was seen in 48.77% of men and 32.50% of women. Normal BMD was more frequent in women (47.05%) than in men (30.04%).

Conclusions. We found a high prevalence of forearm osteoporosis in Bulgarian men which is comparable to that already known in women.     

Caffeine intake is not associated with serum testosterone levels in adult men: cross-sectional findings from the NHANES 1999–2004 and 2011–2012

Objective: The association of caffeine intake with testosterone remains unclear. We evaluated the association of caffeine intake with serum testosterone among American men and determined whether this association varied by race/ethnicity and measurements of adiposity.

Methods: Data were analyzed for 2581 men (≥20?years old) who participated in the cycles of the NHANES 1999–2004 and 2011–2012, a cross-sectional study. Testosterone (ng/mL) was measured by immunoassay among men who participated in the morning examination session. We analyzed 24-h dietary recall data to estimate caffeine intake (mg/day). Multivariable weighted linear regression models were conducted.

Results: We identified no linear relationship between caffeine intake and testosterone levels in the total population, but there was a non-linear association (p_nonlinearity?p_nonlinearity?≤?.03 both) and only among men with waist circumference <102?cm and body mass index <25?kg/m² (p_nonlinearity?Conclusion: No linear association was identified between levels of caffeine intake and testosterone in US men, but we observed a non-linear association, including among racial/ethnic groups and measurements of adiposity in this cross-sectional study. These associations are warranted to be investigated in larger prospective studies.     

Subject index for Volume 3, 2000

Aim.?The aim of this study was to investigate the effects of the bisphosphonate ibandronate (IBN) in a male osteoporosis animal model.

Methods.?Two studies were performed in 9-month-old orchidectomised (ORX) or sham-operated rats. In prevention study, subcutaneous IBN was administered daily (1?μg/kg) or monthly (28?μg/kg every 28 days) starting on day of surgery for 5 months. In treatment study, the same treatment started 6 months after ORX. After sacrifice, bone analyses by dual-energy X-ray absorptiometry, 3-dimensional micro-computed tomography, and 3-point bending were performed in femora or vertebrae. Serum tartrate-resistant acid phosphatase 5b (TRAP-5b) and aminoterminal propeptide of collagen I (PINP) were analysed for resorption and osteocalcin (BGP) for bone formation.

Results.?In both studies, ORX resulted in significant femoral and vertebral bone loss and microarchitectural deterioration after 5 months of ORX, and became more pronounced after 11 months. Biomechanical strength was also decreased. Serum levels for TRAP-5b and BGP increased while PINP levels were reduced or unchanged. Both daily and monthly IBN prevented or even restored ORX-induced changes in both studies, with the intermittent regimen showing a improvement in efficacy with respect to many of the biomechanical parameters.