OBJECTIVE: This review aimed to provide an overview of the relationship between mevalonate pathway and bone metabolism, as well as agents which act through this pathway to achieve their therapeutic potential.
DISCUSSION: Mevalonate pathway produces farnesyl pyrophosphate and geranylgeranyl pyrophosphate essential in protein prenylation. An increase in protein prenylation favours bone resorption over bone formation. Non-nitrogen containing bisphosphonates inhibit farnesyl diphosphate synthase which produces farnesyl pyrophosphate. They are used as the first line therapy for osteoporosis. Statins, a well-known class of cholesterol-lowering agents, inhibit 3-hydroxy-3-methyl-glutaryl-coenzyme A (HMG-CoA) reductase, the rate-determining enzyme in the mevalonate pathway. It was shown to increase bone mineral density and prevent fracture in humans. Tocotrienol is a group of vitamin E commonly found in palm oil, rice bran and annatto bean. It causes degradation of HMG-CoA reductase. Many studies demonstrated that tocotrienol prevented bone loss in animal studies but its efficacy has not been tested in humans.
CONCLUSION: Mevalonate pathway can be exploited to develop effective antiosteoporosis agents.
Methods: A total of 101 currently enrolled pre-university students were recruited for this cross-sectional study. They answered a questionnaire about their demographic details and their frequency of backpack usage. Their backpacks were weighed for four consecutive school days. The Roland-Morris Disability Questionnaire and Body Discomfort Chart were used to rate discomfort levels.
Results: The use and weight of a backpack were not significantly associated with low back pain, as indicated by the Roland-Morris Disability Questionnaire and Body Discomfort Chart (p > 0.05).
Conclusion: This study did not find an association between the use of a backpack and low back pain in Malaysian pre-university students.
Methods: A cross-sectional study was conducted amongst university students from a Malaysian's public university. A total of 228 students responded to a self-administered questionnaire consisting of items evaluating knowledge and practices of osteoporosis.
RESULTS: The students showed a moderate level of osteoporosis awareness with a score of 63.3%. Male subjects had higher awareness scores of osteoporosis complications compared to female subjects (p= 0.010). Malay (p= 0.002) and Chinese (p= 0.005) had higher levels of osteoporosis awareness compared to Indian students. Coffee and alcohol intakes were significantly different between the sexes (p= 0.013) and the ethnic groups (p= 0.029). Most of the subjects in our study were minimally active (43.9%).
CONCLUSIONS: The students had a reasonable levels of knowledge about osteoporosis, but their health activities to avoid osteoporosis were insufficient. This illustrates the need for educational programmes to improve students' knowledge and awareness for successful osteoporosis prevention.
Patients and Methods: A total of 136 participants who attended an annual health screening programme were recruited. The subjects completed the health examinations, including BMI, BF% and blood pressure measurement. A receiver operating curve (ROC) analysis was conducted to determine the optimal cutoff value of BMI in classifying obesity based on BF% (>25%).
Results: The ROC analysis revealed that the optimal BMI cutoff value in classifying subjects with obesity based on BF% was 24.8 kg/m2. The agreement between the classification scheme based on the new BMI cutoff (>24.8 kg/m2) and BF% was higher (κ=0.722) compared to the standard BMI cutoff (>27.5 kg/m2) (κ=0.532). BMI 24.8 kg/m2 also had higher sensitivity (80.0%) than 27.5 kg/m2 (56.0%) in detecting subjects with high adiposity. The new BMI cutoff also showed a sensitivity of 63.9% in identifying subjects with hypertension compared to the standard cutoff (36.1%).
Conclusion: The current definition of obesity based on BMI value needs to be reassessed by taking BF% into account. A new BMI cutoff point, 24.8 kg/m2 for obesity, can identify a higher percentage of Malaysian at risk for CVD.
HIGHLIGHT: This review aimed to summarize the preclinical and clinical findings on the effects of vitamin E on periodontitis. The current literature suggests that vitamin E could improve the periodontal status by correcting redox status imbalance, reducing inflammatory responses, and promoting wound healing, thus highlighting the potential of vitamin E in the management of periodontitis.
CONCLUSION: Direct evidence for the use of vitamin E supplementation or treatment of periodontitis in humans is still limited. More well-designed and controlled studies are required to ascertain its effectiveness.
Methods: Three-month-old male Sprague Dawley rats were assigned to normal control, H. pylori-inoculated group (negative control) and H. pylori-inoculated group receiving triple therapy consisting of omeprazole [2.035 mg/kg body weight (b.w)], amoxicillin (102.80 mg/kg b.w) and clarithromycin (51.37 mg/kg b.w) (n=6/group). H. pylori infection developed for four weeks after inoculation, followed by two-week triple therapy. At the end of the treatment period, femoral bones of the rats were harvested for analysis. Bone mineral density and content of the femurs were determined using dual-energy X-ray absorptiometry, while bone strength was measured with a universal mechanical tester.
Results: Bone mineral content was significantly lower in the negative control group compared to the triple therapy group (p=0.014). Triple therapy decreased strain (vs negative control, p=0.002) and displacement of the femur (vs normal control, p=0.004; vs untreated control, p=0.005). No significant difference was observed in other parameters among the study groups (p>0.05).
Conclusion: Short-term triple therapy increases bone mineral content but decreases bone strength of rats. Skeletal prophylaxis should be considered for patients on short-term triple therapy containing PPI.
DESIGN: Data-based convergent mixed-method systematic review.
METHODS: Three electronic databases (Web of Science, Scopus, and Cumulative Index to Nursing and Allied Health Literature) will be used in the identification stage. The first search will use the search string for each database to identify relevant studies. The articles retrieved will be screened by year of publication, article type and language. Abstracts and full-text of selected studies will be screened for eligibility independently by a minimum of two reviewers. The reference lists will be manually screened to identify additional publications. The quality assessment will be conducted by two reviewers using the Mixed Methods Appraisal Tools. Quantitative and mixed-method studies will be transformed into qualitative. A thematic approach will be used to synthesize and report the data. Ethics approval and funding have been approved in April 2020.
DISCUSSION: This study will synthesize the types of challenges perceived by final-year undergraduate nursing students in different clinical learning environments across the country.
IMPACT: The proposed study findings will help nursing education stakeholders and faculty provide assistance to final-year nursing students in their transition year to become registered nurses.
OBJECTIVE: This study aimed to compare the circulating markers of osteocytes and calcium homeostasis between Malaysian postmenopausal women with and without osteoporosis.
METHODS: Postmenopausal women with (n=20) or without osteoporosis (n=20) as determined by dual- energy X-ray absorptiometry were randomly drawn from a bone health cohort. Their fasting blood was collected and assayed by a multiplex immunoassay panel.
RESULTS: The results showed that osteoprotegerin and sclerostin levels were significantly lower among postmenopausal women with osteoporosis than the normal control. No significant differences in other markers were observed between the two groups. Sclerostin level correlated positively with spine Bone Mineral Density (BMD), while 25-hydroxyvitamin D correlated negatively with hip BMD in the control group. No significant correlation was observed between other markers with spine or hip BMD.
CONCLUSION: These data provide an insight into the possible roles of osteocyte markers, especially osteoprotegerin and sclerostin, in classifying subjects with osteoporosis. However, the lack of association between these markers and BMD indicates that osteoporosis is a complex and multifactorial condition.