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Monday, 30 November 2015

Most Common Diseases of elder: The Clinical Trials and Studies of Musculo-Skeletal disorders: Osteoporosis - The Risk Factors

Kyle J. Norton (Scholar)

Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.

Musculoskeletal disorders (MSDs) are  medical condition mostly caused by work related occupations and working environment, affecting patients’ muscles, joints, tendons, ligaments and nerves and developing over time. According to a community sample of 73 females and 32 males aged 85 and over underwent a standardised examination at home, musculoskeletal pain was reported by 57% of those interviewed(1).

      Types of Musculo-Skeletal disorders in elder(2)

1. Osteoarthritis
2. Gout
3. Rheumatoid Arthritis
4. Polymalagia Arthritis
5. Cervical myleopathy and spinal canal stenosis
6. Osteoporosis
7. Low back pain
8. Fibromyalgia

                                Osteoporosis

Osteoporosis is defined as a condition of thinning of bone and bone tissues as a result of the loss of bone density over a long period of time. It is a widespread degenerative disease of skeletal joints and often associated with senescence in vertebrates due to excessive or abnormal mechanical loading of weight-bearing joints, arising from heavy long-term use or specific injuries(6).

                           The Risk factors

1. Young Age at Diagnosis, Decreased Lean Mass
In the study to investigate the prevalence and identify the risk factors of osteoporosis, researchers at the Korea Cancer Center Hospital, Seoul, showed that young age at diagnosis(55), and low lean mass(55)(56) are found to be risk factors of the development of osteopenia and osteoporosis(55) 

2. Male sex(55)(56) and adult (GH) growth hormone deficiency or excess
There was the high prevalence of osteoporosis and osteopenia in male sex, a low lean mass, and adult growth hormone replacement(58). Patient with  either GH deficiency (GHD) or GH excess are found to have bone, metabolic, and somatic impairments(57). 

3. Chlamydia pneumoniae
Chlamydia pneumoniae is an bacterial infection causes of pneumoniae. According to the "Sapienza" University, there is an association between the presence of Chlamydia pneumoniae DNA both in osteoporotic bone tissue and peripheral blood mononuclear cells (PBMCs) and the increase in circulating resorptive cytokines(63), probably due to induced of bone loss(64).

5. Race
Race with limit intake of lactos, the lactose a disaccharide sugar found in milk may be associate to risk of osteoporosis(104). According to the joint study lead by Université Libre de Bruxelle, intake of dairy can confer a favourable benefit with regard to bone health(104).
Low calcium intakes(106), and Lactose intolerance(107) also has an impact on low bone density(105)(106) among Hispanic-American and Asian-American populations may create an elevated risk for osteoporosis(105)(107).

6. Family history
The family history is found positively in related to a significant, independent risk factor for osteoporosis in U.S. women aged of 35 and over, according to the the National Center on Birth Defects and Developmental Disabilities(108). 
According to the, risk of  osteoporosis in women was 8.3%. Patient with  positive family history of the diseases have a increased risk of 19.8%  of which is considered as a independent risk of osteoporosis(109). Dr. Betancourt Ortiz SL said "Family history of bone fractures might serve for identifying post-menopausal women at increased risk of loss of BMD", according to his study at the at the "San Juan" Specialities Hospital in Riobamba (Province of Chimborazo, Republic of Ecuado(110)
7. Skin color and body size
Skin color, body size and bone mineral density (BMD) may also be an independent  risk of  osteoporosis among three groups of postmenopausal women: 104 healthy black women, 45 healthy white women, and 52 osteoporotic white women with vertebral fractures(111), especially on large body size on bone mineral density effects in black and white(111)(112). In fact, family history, use of contraceptive device and postnatal environmental factors, are found to associate to infant bone size and bone mass of which may induce long-term consequences in the increased risk of osteoporosis in later life(113).

8. Diet and lifestyle
Certain diet, including typical American diet with high intake of salt, soda, caffeine, process foods, such as can foods, etc,... have been found to induce risk of osteoporosis, according to Elizabeth Ward, MS, RD. In deed, high salt intake was found to associated with osteoporosis and an increased calcium excretion in urine(114) of which induced loss of calcium and risk of osteoporosis.
Negative lifestyle such as smoking(116), heavy alcohol consumption(117)  may reduce bone mineral density and increase the incidence of fragility fracture,
Positive lifestyle such as  green tea drinking(118), dairy products(119) and physical activity(120) improved bone minerals density of which reduced risk of osteoporosis(115).

9. Heavy alcohol intake or alcoholism
Moderate intake of alcohol use may have beneficial effects on bone mineral density of that reduced risk of osteoporosis. Oppositely, Heavy alcohol intake or alcoholism disrupts calcium and bone homeostasis(121) of which leads to reduce bone mineral density and increase the incidence of fragility fracture, according to the study by Albert Einstein College of Medicine and Montefiore Medical Center(122).

10. Smoking and lower serum IGF-I and IGF-binding protein (IGFBP)-3
 levels
The study of middle-aged Korean men, conduced by the Sungkyunkwan University School of Medicine,   suggest that current smoking history, and history of smoking and lower serum IGF-I levels are risk factors for lower BMD  of which can induce risk of osteoporosis(123). In deed, insulin-like growth factor I (IGF-I) and IGF-binding protein (IGFBP)-3 showed to have a significant relation to relationship to osteoporotic spinal fracture and bone mass distribution(124)(125) of that can be used as a predictor for the severity of osteoporosis, and risk of bone fracture associated with osteoporosis(124).

11. Other risk factors
Patient suffered from chronic illness, such as chronic kidney disease(126), chronic inflammatory rheumatic Disease(127, chronic obstructive pulmonary disease(129),cancers(130), etc.... are found to associate to risk of osteopenia and osteoporosis(128) due to slowly decreased bone mineral density, vitamin and calcium diet content, etc...



References
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(2) Musculoskeletal Disorders in the Elderly by Ramon Gheno, Juan M. Cepparo, Cristina E. Rosca,1 and Anne Cotten(PMC)
(3) Osteoporosis(Life extension)
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(56) Body fat is associated with increased and lean mass with decreased knee cartilage loss in older adults: a prospective cohort study. by Ding C1, Stannus O, Cicuttini F, Antony B, Jones G.(PubMed)
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(58) Risk factors for osteoporosis in long-term survivors of intracranial germ cell tumors by Kang MJ1, Kim SM, Lee YA, Shin CH, Yang SW, Lim JS.(PubMed)
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(61) Bone loss and bone size after menopause by Ahlborg HG1, Johnell O, Turner CH, Rannevik G, Karlsson MK.(PubMed)
(62) Secondary osteoporosis by Stein E1, Shane E.(PubMed)
(63) Chlamydia pneumoniae and osteoporosis-associated bone loss: a new risk factor by Di Pietro M1, Schiavoni G, Sessa V, Pallotta F, Costanzo G, Sessa R.(PubMed)
(64) Chlamydia pneumoniae infection results in generalized bone loss in mice by Bailey L1, Engström P, Nordström A, Bergström S, Waldenström A, Nordström P.(PubMed)
(105) Hip osteoarthritis: influence of work with heavy lifting, climbing stairs or ladders, or combining kneeling/squatting with heavy lifting by Jensen LK1.(PubMed)
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(113) Infant programming of bone size and bone mass in 10-year-old black and white South African children by Vidulich L1, Norris SA, Cameron N, Pettifor JM.(PubMed)
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(116) Smoking, radiotherapy, diabetes and osteoporosis as risk factors for dental implant failure: a meta-analysis by Chen H1, Liu N, Xu X, Qu X, Lu E.(PubMed)
(117) Alcohol and bone by Mikosch P1.(PubMed)
(118) Catechin-rich oil palm leaf extract enhances bone calcium content of estrogen-deficient rats by Bakhsh A1, Mustapha NM, Mohamed S.(PubMed)
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(123) Age, body mass index, current smoking history, and serum insulin-like growth factor-I levels associated with bone mineral density in middle-aged Korean men by Rhee EJ1, Oh KW, Lee WY, Kim SW, Oh ES, Baek KH, Kang MI, Park CY, Choi MG, Yoo HJ, Park SW.(PubMed)
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(128) Aging, chronic illness and self-concept: a study of women with osteoporosis by Wilkins S1.(PubMed)
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(130) Osteopenia and osteoporosis in women with breast cancer by Ramaswamy B1, Shapiro CL(PubMed)