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Osteoporosis: HELP
Articles from Miscellaneous cities in China
Based on 297 articles published since 2008
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These are the 297 published articles about Osteoporosis that originated from Miscellaneous cities in China during 2008-2019.
 
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8 · 9 · 10 · 11 · 12
1 Review Prevention and Treatment of Osteoporosis Using Chinese Medicinal Plants: Special Emphasis on Mechanisms of Immune Modulation. 2018

Zhao, Hongyan / Zhao, Ning / Zheng, Peng / Xu, Xiaohong / Liu, Meijie / Luo, Dan / Xu, Huihui / Ju, Dahong. ·Experimental Research Center, China Academy of Chinese Medical Sciences, Beijing 100700, China. · Institute of Basic Theory for Chinese Medicine, China Academy of Chinese Medical Science, Beijing 100700, China. · Institute of Clinical Basic Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China. · Jilin Provincial Hospital of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130021, China. · Changchun University of Chinese Medicine, Changchun 130117, China. · Traditional Chinese Medicine Hospital of Changping District, Beijing 102200, China. ·J Immunol Res · Pubmed #29675436.

ABSTRACT: Numerous studies have examined the pathogenesis of osteoporosis. The causes of osteoporosis include endocrine factors, nutritional status, genetic factors, physical factors, and immune factors. Recent osteoimmunology studies demonstrated that the immune system and immune factors play important regulatory roles in the occurrence of osteoporosis, and people should pay more attention to the relationship between immunity and osteoporosis. Immune and bone cells are located in the bone marrow and share numerous regulatory molecules, signaling molecules, and transcription factors. Abnormal activation of the immune system alters the balance between osteoblasts and osteoclasts, which results in an imbalance of bone remodeling and osteoporosis. The incidence of osteoporosis is also increasing with the aging of China's population, and traditional Chinese medicine has played a vital role in the prevention and treatment of osteoporosis for centuries. Chinese medicinal plants possess unique advantages in the regulation of the immune system and the relationships between osteoporosis and the immune system. In this review, we provide a general overview of Chinese medicinal plants in the prevention and treatment of osteoporosis, focusing on immunological aspects.

2 Review Associations between ERα/β gene polymorphisms and osteoporosis susceptibility and bone mineral density in postmenopausal women: a systematic review and meta-analysis. 2018

Zhu, Heping / Jiang, Jiannong / Wang, Qiang / Zong, Jun / Zhang, Liang / Ma, Tieliang / Xu, Youjia / Zhang, Leiyan. ·Department of Orthopedics, The Affiliated Yixing Hospital of Jiangsu University, Yixing, 214200, China. · Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China. · Department of Orthopedics, Northern Jiangsu People's Hospital, Yangzhou, 225001, China. · Central Laboratory, The Affiliated Yixing Hospital of Jiangsu University, Yixing, 214200, China. · Department of Orthopedics, The Second Affiliated Hospital of Soochow University, Suzhou, 215004, China. xuyoujia@suda.edu.cn. · Department of Orthopedics, The Affiliated Yixing Hospital of Jiangsu University, Yixing, 214200, China. 2004zhp-pp@sohu.com. ·BMC Endocr Disord · Pubmed #29458346.

ABSTRACT: BACKGROUND: Many studies have reported associations between estrogen receptor (ER) gene polymorphisms and postmenopausal osteoporosis (PMOP) risk and bone mineral density (BMD), but the results are controversial. The aim of the present meta-analysis is to verify the association between ERα and ERβ gene polymorphisms and osteoporosis susceptibility and BMD in postmenopausal women. METHODS: PubMed, EMBASE, Web of Science, the Cochrane Library and China WeiPu Library were searched. OR and WMD with 95% CI were calculated to assess the association. RESULTS: Overall, no significant association was observed between ERα XbaI, ERα PvuII and PMOP susceptibility in either overall, Caucasian or Asian populations. ERα G2014A was significantly associated with a decreased risk of PMOP in Caucasian populations. There was a significant association between ERβ RsaI and PMOP risk in both overall and Asian populations. Caucasian PMOP women with ERα XbaI XX and Xx genotypes had a higher LS Z value than women with xx genotype. ERα XbaI XX genotype was associated with increased FN BMD in overall and Caucasian populations, an increased FN Z value in Asians, and a decreased FN Z value in Caucasians. There was also a significant association between ERα XbaI Xx genotype and an increased FN Z value in either Asians or Caucasians. ERα PvuII PP genotype was associated with a low LS Z value in Caucasians and a low FN BMD and Z value in Asians. Pp genotype in PMOP women was significantly correlated with low LS BMD in overall populations, a low FN Z value in either overall, Caucasian or Asian populations. CONCLUSION: Each ERα and ERβ gene polymorphism might have different impact on PMOP risk and BMD in various ethnicities.

3 Review Comprehensive evaluation of the role of soy and isoflavone supplementation in humans and animals over the past two decades. 2018

Xiao, Yunqi / Zhang, Shan / Tong, Haibing / Shi, Shourong. ·Poultry Institute, Chinese Academy of Agriculture Science, 58 Cangjie Road, Yangzhou, 225125, Jiangsu, China. · Jiangsu Co-innovation Center for Prevention and Control of Important Animal Infectious Diseases and Zoonoses, Yangzhou, 225125, Jiangsu, China. ·Phytother Res · Pubmed #29193539.

ABSTRACT: Soy and soy-based foods are considered healthy, particularly in many Asia-Pacific countries, where soy products have long been consumed. Soy and soy-related products have been found to help prevent the occurrence of cardiovascular diseases and certain types of cancer, such as breast and prostate cancer. These products can also have antioxidative effects that alleviate hot flashes during menopause and bone loss. These biological and therapeutic functions are primarily due to the isoflavones derived from soy, whose structure is similar to the structure of 17-β-oestradiol. Despite the many health benefits for humans and animals, the application of isoflavones remains controversial because of their anti-oestrogenic properties. We focused on general information regarding isoflavones, as well as their structure, function, and application. We summarized evidence showing that dietary or supplemental isoflavones exert protective effects on the health of humans and animals. Based on the literature, we conclude that soy foods and isoflavones may be effective and safe; however, more high-quality trials are needed to fully substantiate their potential use.

4 Review Harnessing low-density lipoprotein receptor protein 6 (LRP6) genetic variation and Wnt signaling for innovative diagnostics in complex diseases. 2018

Wang, Z-M / Luo, J-Q / Xu, L-Y / Zhou, H-H / Zhang, W. ·Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, Hunan, China. · Institute of Clinical Pharmacology, Central South University; Hunan Key Laboratory of Pharmacogenetics, Changsha, Hunan, China. · Department of Epidemiology and Statistics, School of Public Health, Central South University, Changsha, Hunan, China. ·Pharmacogenomics J · Pubmed #28696417.

ABSTRACT: Wnt signaling regulates a broad variety of processes in both embryonic development and various diseases. Recent studies indicated that some genetic variants in Wnt signaling pathway may serve as predictors of diseases. Low-density lipoprotein receptor protein 6 (LRP6) is a Wnt co-receptor with essential functions in the Wnt/β-catenin pathway, and mutations in LRP6 gene are linked to many complex human diseases, including metabolic syndrome, cancer, Alzheimer's disease and osteoporosis. Therefore, we focus on the role of LRP6 genetic polymorphisms and Wnt signaling in complex diseases, and the mechanisms from mouse models and cell lines. It is also highly anticipated that LRP6 variants will be applied clinically in the future. The brief review provided here could be a useful resource for future research and may contribute to a more accurate diagnosis in complex diseases.

5 Review The Effect of Taichi Practice on Attenuating Bone Mineral Density Loss: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. 2017

Zou, Liye / Wang, Chaoyi / Chen, Kevin / Shu, Yankai / Chen, Xiaoan / Luo, Lin / Zhao, Xitang. ·Psychosomatic Laboratory, Springfield College, Springfield, MA 01109, USA. lzou@springfieldcollege.edu. · College of Sports Science, Jishou 416000, China. lzou@springfieldcollege.edu. · College of Physical Education, Jilin University, Changchun 130022, China. yankaishu@yahoo.com. · Integrative Medicine Lab, University of Maryland, Baltimore, MD 21201, USA. anneychen5748@sina.com. · College of Sports Science, Jishou 416000, China. chaoyi@jlu.edu.cn. · College of Sports Science, Jishou 416000, China. kchen@som.umaryland.edu. · Department of Physical Education, North China Electric Power University, Beijing 102206, China. luolin@ncepu.edu.cn. · Department of Physical Education, ZhaoQing University, Zhaoqing 526061, China. xzhao3@springfieldcollege.edu. ·Int J Environ Res Public Health · Pubmed #28862661.

ABSTRACT:

6 Review Cellular and molecular mechanisms of alcohol-induced osteopenia. 2017

Luo, Zhenhua / Liu, Yao / Liu, Yitong / Chen, Hui / Shi, Songtao / Liu, Yi. ·Laboratory of Tissue Regeneration and Immunology, Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Tian Tan Xi Li No. 4, Beijing, 100050, People's Republic of China. · Liaoning Province Key Laboratory of Oral Disease, 117 Nanjing North Street, Shenyang, 110002, People's Republic of China. · Department of Anatomy and Cell Biology, University of Pennsylvania, School of Dental Medicine, Philadelphia, PA, USA. · Laboratory of Tissue Regeneration and Immunology, Department of Periodontics, Beijing Key Laboratory of Tooth Regeneration and Function Reconstruction, School of Stomatology, Capital Medical University, Tian Tan Xi Li No. 4, Beijing, 100050, People's Republic of China. lililiuyi@163.com. ·Cell Mol Life Sci · Pubmed #28674727.

ABSTRACT: Alcoholic beverages are widely consumed, resulting in a staggering economic cost in different social and cultural settings. Types of alcohol consumption vary from light occasional to heavy, binge drinking, and chronic alcohol abuse at all ages. In general, heavy alcohol consumption is widely recognized as a major epidemiological risk factor for chronic diseases and is detrimental to many organs and tissues, including bones. Indeed, recent findings demonstrate that alcohol has a dose-dependent toxic effect in promoting imbalanced bone remodeling. This imbalance eventually results in osteopenia, an established risk factor for osteoporosis. Decreased bone mass and strength are major hallmarks of osteopenia, which is predominantly attributed not only to inhibition of bone synthesis but also to increased bone resorption through direct and indirect pathways. In this review, we present knowledge to elucidate the epidemiology, potential pathogenesis, and major molecular mechanisms and cellular effects that underlie alcoholism-induced bone loss in osteopenia. Novel therapeutic targets for correcting alcohol-induced osteopenia are also reviewed, such as modulation of proinflammatory cytokines and Wnt and mTOR signaling and the application of new drugs.

7 Review Cathepsin B and L inhibitors: a patent review (2010 - present). 2017

Li, Yu-Yao / Fang, Jing / Ao, Gui-Zhen. ·a College of Pharmaceutical Science , Soochow University , Suzhou , PR China. ·Expert Opin Ther Pat · Pubmed #27998201.

ABSTRACT: INTRODUCTION: Cathepsins play an important role in protein degradation and processing. Aberrant cathepsin B or L is closely associated with many serious diseases such as cancer, osteoporosis and autoimmune disorders. Therefore, development of potent and selective cathepsin B and L inhibitors has aroused much attention in recent years. Although several classes of cathepsin inhibitors are presently available, there are still some problems to solve, such as broad-spectrum inhibition to protease, specially cysteine proteases, which lead to unpredictable side effects in clinical trials. Therefore, it is very necessary to discovery new scaffolds and new application of cathepsin B and L inhibitors for developing therapeutic agents for treating diseases mediated by cathepsin B or L. Areas covered: This updated review summarizes new patents on cathepsin B and L inhibitors from 2010 to present. Expert opinion: The review gives the latest development in the area of inhibitors of cathepsin B and L, which have been considered key therapeutic targets for the development of drugs treating related diseases. This review puts emphasis on the discovery of novel small molecule inhibitors of cathepsin B and L, as well as their new application as new therapeutic agents.

8 Review Efficacy of statins for osteoporosis: a systematic review and meta-analysis. 2017

An, T / Hao, J / Sun, S / Li, R / Yang, M / Cheng, G / Zou, M. ·Department of Life Sciences and Biopharmaceutics, Shenyang Pharmaceutical University, Shenyang, 110016, China. · Department of Blood Purification, General Hospital of Shenyang Military Command, Shenyang, 110016, China. · Department of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, China. · Department of Pharmacy, Shenyang Pharmaceutical University, Shenyang, 110016, China. zoumeijuan@163.com. ·Osteoporos Int · Pubmed #27888285.

ABSTRACT: Our meta-analysis assessed the efficacy of statins on the risk of fracture, bone mineral density (BMD), and the markers of bone metabolism by collecting data from 33 clinical trials. We found that statin treatment was associated with bone metabolism. And statins seemed to be more effective on male patients with osteoporosis. The efficacy of statins for the treatment of osteoporosis has been controversial in previous studies and meta-analyses. Our meta-analysis was conducted to examine in detail the efficacy of statins on osteoporosis. We searched PubMed, Embase, and the Cochrane Library databases for clinical trials from inception to May 2016. We included studies that described the effect of statins on the risk of fracture, BMD, or bone turnover markers. Moreover, we also conducted subgroup analyses according to the skeleton site, patient gender, and length of follow-up. A total of 33 studies which included 23 observational studies (16 cohort studies and 7 case-control studies) and 10 randomized controlled trials (RCTs) were evaluated. These 33 studies included 314,473 patients in statin group and 1,349,192 patients in control group. Statins decreased the risk of overall fractures (OR = 0.81, 95% CI 0.73-0.89) and hip fractures (OR = 0.75, 95% CI 0.60-0.92). Furthermore, the use of statins was associated with increased BMD at the total hip (standardized mean difference (SMD) = 0.18, 95% CI 0.00-0.36) and lumbar spine (SMD = 0.20, 95% CI 0.07-0.32) and improved the bone formation marker, osteocalcin (OC) (SMD = 0.21, 95% CI 0.00-0.42). However, there was no positive effect on vertebral fractures, upper extremity fractures, BMD at the femoral neck, bone-specific alkaline phosphatase (BALP), and serum C-terminal peptide of type I collagen (S-CTX). Also, compared with male subgroups, the effect on female subgroups was only slightly positive or of no statistical significance. Our meta-analysis indicates that statin treatment may be associated with a decreased risk of overall fractures and hip fractures, an increased BMD at the total hip, BMD at the lumbar spine, and OC. Moreover, our results also show that statin treatment may have a greater effect on male patients than on female patients.

9 Review Herb Medicines against Osteoporosis: Active Compounds & Relevant Biological Mechanisms. 2017

Wu, Lei / Ling, Zhuoyan / Feng, Xueqin / Mao, Caiping / Xu, Zhice. ·Institute for Fetology and Reproductive Medicine Center, First Hospital of Soochow University, Suzhou, China. · Centers for Disease Control and Prevention at Suzhou Industrial Park, Suzhou, China. ·Curr Top Med Chem · Pubmed #27848901.

ABSTRACT: Osteoporosis is one of common bone disorders, affecting millions of people worldwide. Treatments of osteoporosis consist of pharmacotherapy and non-pharmacological interventions, such as mineral supplementation, lifestyle changes, and exercise programs. Due to the minimum side effects and favorable cost-effective therapeutic effects, herbal medicine has been widely applied in clinical practices for more than 2,000 years in China. Of the many traditional formulas reported for treating bone diseases, 4 single herbs namely (1) Herba Epimedii, (2) Rhizoma Drynariae, (3) Fructus Psoraleae, and (4) Cortex Eucommiae, are considered as the featured "Kidney-Yang" tonics, and frequently and effectively applied for preventing and treating osteoporosis. With the accruing development of modern chemistry, hundreds of active compounds have been identified and isolated for their anti-osteoporotic effects. This review would first sketch the phytochemistry of these featured "Kidney- Yang" tonics and present the pharmacological characteristics of the most abundant and bioactive compounds derived from the herb Herba Epimedii and Rhizoma Drynariae, including icariin and naringin. Then, the cellular and molecular underpinnings under anti-osteoporotic effects of icariin and naringin are discussed. The concerned structure-function relationships of the featured active herbal compounds would also be reviewed so as to pave the way for future drug design in treating osteoporosis.

10 Review Alendronate for the Treatment of Osteoporosis in Men: A Meta-Analysis of Randomized Controlled Trials. 2017

Xu, Zhiguo. ·Department of Orthopaedics, Central Hospital of Zaozhuang Mining Group, Zaozhuang, China. ·Am J Ther · Pubmed #27058577.

ABSTRACT: BACKGROUND: Alendronate has been widely used in the treatment of osteoporosis. However, the effect of alendronate in the male osteoporosis remains controversial. STUDY QUESTION: We conducted a meta-analysis to assess the efficacy of alendronate in the treatment of men with osteoporosis. STUDY DESIGN: PubMed, Embase, and Web of Science were searched from their inception to October 25, 2015. Eligible studies were randomized controlled trials that evaluated the effect of alendronate in the male osteoporosis. MEASURES AND OUTCOMES: The outcomes included mean percentage changes in bone mineral density (BMD) of lumbar spine, femoral neck, total hip, trochanter, and total body, and the incidence of new vertebral fractures. Results were expressed with weighted mean difference (WMD), and risk ratio with 95% CIs. A fixed-effects model or random-effects model was used for the meta-analysis according to heterogeneity. RESULTS: Eight studies involving 988 patients met the inclusion criteria. Alendronate significantly increased the mean percentage BMD at the lumbar spine (WMD = 4.95, 95% CI, 2.40-7.49; P < 0.001), femoral neck (WMD = 2.59, 95% CI, 1.52-3.66; P < 0.001), and total hip (WMD = 2.39, 95% CI, 1.05-3.27; P < 0.001), but not at the trochanter (WMD = 1.76, 95% CI, -0.69 to 4.21; P = 0.158) and total body (WMD = 3.29, 95% CI, -0.04 to 6.62; P = 0.053). Moreover, alendronate was also decreased the incidence of vertebral fractures (risk ratio = 0.46, 95% CI, 0.28-0.77; P = 0.003). Subgroup analysis showed that among the male osteoporosis, greater increase in the lumbar spine BMD (WMD = 5.99, 95% CI, 3.42-8.56; P < 0.001) and femoral neck BMD (WMD = 3.66, 95% CI, 2.57-4.76; P = 0.023) was observed when the alendronate was administrated with a dose of 10 mg. CONCLUSION: Based on current evidence, alendronate shows beneficial effect on the lumbar spine, femoral neck, and total hip BMD, and the incidence of new vertebral fractures.

11 Review Metabolomics and Its Application in the Development of Discovering Biomarkers for Osteoporosis Research. 2016

Lv, Huanhuan / Jiang, Feng / Guan, Daogang / Lu, Cheng / Guo, Baosheng / Chan, Chileung / Peng, Songlin / Liu, Baoqin / Guo, Wenwei / Zhu, Hailong / Xu, Xuegong / Lu, Aiping / Zhang, Ge. ·Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. lvhuan1988@aliyun.com. · Institute of Precision Medicine and Innovative Drug Discovery, HKBU (Haimen) Institute of Science and Technology, Haimen 226133, China. lvhuan1988@aliyun.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. jiangfenghz@163.com. · Institute of Precision Medicine and Innovative Drug Discovery, HKBU (Haimen) Institute of Science and Technology, Haimen 226133, China. jiangfenghz@163.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. guanyufei122@163.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. cheng0816@163.com. · Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China. cheng0816@163.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. boris.g.guo@gmail.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. clchan@hkbu.edu.hk. · Deparment of Spine Surgery, Shenzheng People's Hospital, Shenzheng 518020, China. psling824@163.com. · Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou 450007, China. liubqmm@163.com. · Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou 450007, China. gww555@sina.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. hailong.zhu@gmail.com. · Zhengzhou Hospital of Traditional Chinese Medicine, Zhengzhou 450007, China. xuxg1115@126.com. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. aipinglu@hkbu.edu.hk. · Institute of Arthritis Research, Shanghai Academy of Chinese Medical Sciences, Guanghua Integrative Medicine Hospital/Shanghai University of Traditional Chinese Medicine, Shanghai 200052, China. aipinglu@hkbu.edu.hk. · Institute for Advancing Translational Medicine in Bone & Joint Disease, School of Chinese Medicine, Hong Kong Baptist University, Hong Kong 999077, China. zhangge@hkbu.edu.hk. ·Int J Mol Sci · Pubmed #27918446.

ABSTRACT: Osteoporosis is a progressive skeletal disorder characterized by low bone mass and increased risk of fracture in later life. The incidence and costs associated with treating osteoporosis cause heavy socio-economic burden. Currently, the diagnosis of osteoporosis mainly depends on bone mineral density and bone turnover markers. However, these indexes are not sensitive and accurate enough to reflect the osteoporosis progression. Metabolomics offers the potential for a holistic approach for clinical diagnoses and treatment, as well as understanding of the pathological mechanism of osteoporosis. In this review, we firstly describe the study subjects of osteoporosis and bio-sample preparation procedures for different analytic purposes, followed by illustrating the biomarkers with potentially predictive, diagnosis and pharmaceutical values when applied in osteoporosis research. Then, we summarize the published metabolic pathways related to osteoporosis. Furthermore, we discuss the importance of chronological data and combination of multi-omics in fully understanding osteoporosis. The application of metabolomics in osteoporosis could provide researchers the opportunity to gain new insight into the metabolic profiling and pathophysiological mechanisms. However, there is still much to be done to validate the potential biomarkers responsible for the progression of osteoporosis and there are still many details needed to be further elucidated.

12 Review Osteoimmunology: memorandum for rheumatologists. 2016

Zhao, Lidan / Huang, Linfang / Zhang, Xuan. ·Department of Rheumatology & Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, the Ministry of Education Key Laboratory, Beijing, 100730, China. · Department of Rheumatology, the First People's Hospital of Yueyang, Yueyang, 414000, China. · Department of Rheumatology & Clinical Immunology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, the Ministry of Education Key Laboratory, Beijing, 100730, China. zxpumch2003@sina.com. ·Sci China Life Sci · Pubmed #27650950.

ABSTRACT: Rapid progress has been made in exploring the connections between the skeletal system and the immune system over the past decade. Bone tissue forms developmental niches for hematopoietic stem cells, and activated immune cells are involved in bone metabolism regulation and are potent mediators of osteoporosis and bone erosion under pathological conditions. The interdisciplinary field of osteoimmunology has emerged to pool the knowledge of the interdependence of these two systems, including the shared ligands and receptors, their crosstalk and interaction, and common intracellular signaling pathways with bidirectional influence. The receptor activator of nuclear factor-kappa B (RANK)/RANK ligand (RANKL)/osteoprotegerin (OPG) triad is the key vinculum, with multifaceted potency, being not only essential for osteoclastogenesis but also critical for lymph node organogenesis and lymphopoiesis as well as for immune regulation. In this review, we summarize the progress in this area, focusing on those aspects of interest concerning rheumatic diseases.

13 Review Oxidative Stress-Related Biomarkers in Postmenopausal Osteoporosis: A Systematic Review and Meta-Analyses. 2016

Zhou, Qiaozhen / Zhu, Li / Zhang, Dafeng / Li, Ning / Li, Qiao / Dai, Panpan / Mao, Yixin / Li, Xumin / Ma, Jianfeng / Huang, Shengbin. ·Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China. · Department of Pediatric Dentistry, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China. · Department of Prosthodontics, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China; Institute of Stomatology, School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou 325027, China. ·Dis Markers · Pubmed #27594735.

ABSTRACT: Numerous studies suggested that oxidative stress (OS) played a central role in the onset and development of postmenopausal osteoporosis (PO); however, conflicting results were obtained as to the association of OS-related biomarkers and PO. This meta-analysis aimed to identify the association between these markers and PO, and explore factors that may explain the inconsistencies in these results. A systematic literature search was conducted in relevant database. Search terms and selection criteria were priorly determined to identify and include all studies that detected markers of OS in PO patients. We pooled data with a random effects meta-analysis with standardized mean differences and 95% confidence interval. Total 17 studies including 12 OS markers were adopted. The results showed that superoxide dismutase (SOD) in erythrocytes, catalase (CAT), total antioxidant status (TAS), hydroperoxides (HY), advanced oxidation protein products (AOPP), malondialdehyde (MDA), and vitamin B12 (VB12) in plasma/serum were not statistically different between the PO and control group, whereas significantly increased level of homocysteine (Hcy) and nitric oxide (NO), along with decreased SOD, glutathione peroxidase (GPx), folate, and total antioxidant power (TAP) in plasma/serum were obtained in the PO group. In summary, OS might serve as potential biomarkers in the etiopathophysiology and clinical course of PO.

14 Review Nanotechnology Treatment Options for Osteoporosis and Its Corresponding Consequences. 2016

Wei, Donglei / Jung, Jinsuh / Yang, Huilin / Stout, David A / Yang, Lei. ·Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China. · International Research Center for Translational Orthopaedics (IRCTO), Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China. · Department of Biology, University of Waterloo, Waterloo, ON, N2L 3G1, Canada. · International Research Center for Translational Orthopaedics (IRCTO), Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China. david.stout@csulb.edu. · Department of Mechanical and Aerospace Engineering, California State University, Long Beach, 1250 Bellflower Blvd. ECS-632, Long Beach, CA, 90802, USA. david.stout@csulb.edu. · Orthopaedic Institute, Department of Orthopaedics, The First Affiliated Hospital, Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China. leiy@suda.edu.cn. · International Research Center for Translational Orthopaedics (IRCTO), Soochow University, Suzhou, 215006, Jiangsu, People's Republic of China. leiy@suda.edu.cn. ·Curr Osteoporos Rep · Pubmed #27542011.

ABSTRACT: Unfortunately, osteoporosis, as a worldwide disease, is challenging human health with treatment only available for the symptoms of osteoporosis without managing the disease itself. Osteoporosis can be linked as the common cause of fractures and increased mortality among post-menopausal women, men, and the elderly. Regrettably, due to osteoporosis, incidents of fractures are more frequent among the presented populations and can be afflictive for carrying out everyday life activities. Current treatments of osteoporosis encompass changing lifestyles, taking orthopedic drugs, and invasive surgeries. However, these treatment options are not long lasting and can lead to complications after post-surgical life. Therefore, to solve this impairment, researchers have turned to nanotechnologies and nanomaterials to create innovative and alternative treatments associated with the consequences of osteoporosis. This review article provides an introduction to osteoporotic compression vertebral fractures (OVCFs) and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. The methods of applying bioactive agents (bone morphogenetic protein-2 (BMP-2), parathyroid hormone 1-34 (PTH 1-34)), as well as 3D printing will be presented from an osteoporosis treatment perspective. Additionally, the application of nanoparticles and nanotube arrays onto the current surgical treatments and orthopedic drug administration methods addressed will show that these systems reinforce a better mechanical performance and provide precise and slow-releasing drug delivery for better osseointegration, bone regeneration, and bone strength. In summary, nanomaterials can be seen as an alternative and more effective treatment for individuals with osteoporosis.

15 Review Increased risk of vertebral fracture in patients with diabetes: a meta-analysis of cohort studies. 2016

Wang, Jie / You, Wenjun / Jing, Zhaohai / Wang, Robin / Fu, Zhengju / Wang, Yangang. ·Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China. · Department of Endocrinology, Jining No 1 People's Hospital, Jining, 272000, China. · Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China. echony32@126.com. · Department of Endocrinology, Affiliated Hospital of Qingdao University, Qingdao, 266003, China. qingyiwangyg@163.com. ·Int Orthop · Pubmed #27029481.

ABSTRACT: PURPOSE: The relationship between diabetes and risk of fracture has been reported differently in study design and risk estimates, and the relationship between diabetes and risk of vertebral fracture remained unclear. Therefore, we performed a meta-analysis of prospective or retrospective cohort studies to assess the potential relationship between diabetes and vertebral fracture. METHODS: We searched medical databases for prospective or retrospective cohort studies on the association between diabetes and vertebral fracture risk. Pooled relative risks (RR) and corresponding 95 % confidence intervals (95 % CI) were calculated with a random-effects model of meta-analysis. RESULTS: Meta-analysis of eight studies showed that the pooled RR of vertebral fracture for diabetic individuals was 2.03 (95 % CI 1.60-2.59; p < 0.0001). Subgroup analysis by gender showed that the corresponding RRs for male and female were 2.70 (95 % CI 1.34-5.43; p = 0.005) and 1.93 (95 % CI 1.18-3.13; p = 0.008), respectively. Subgroup analysis by study design showed that the corresponding RRs for prospective design and retrospective design were 1.81 (95  % CI 1.19-2.75; p = 0.006) and 2.23 (95  % CI 1.60-3.10; p < 0.0001), respectively. Subgroup analysis by time of follow-up showed that the RR of vertebral fracture for patients with >20 and <20 years of follow-up were 2.23 (95 % CI 1.98-3.62; p < 0.0001) and 1.67 (95  % CI 1.29-2.16; p < 0.0001), respectively. CONCLUSIONS: Diabetes is an independent risk factor for vertebral fracture, primarily being due to diabetic osteoporosis.

16 Review Fracture risk and bone mineral density levels in patients with systemic lupus erythematosus: a systematic review and meta-analysis. 2016

Wang, X / Yan, S / Liu, C / Xu, Y / Wan, L / Wang, Y / Gao, W / Meng, S / Liu, Y / Liu, R / Xu, D. ·Department of Rheumatology and Immunology, The Affiliated Hospital of Weifang Medical University, Weifang, 261000, Shandong Province, China. · Department of Anorectal Surgery, The Affiliated Hospital of Weifang Medical University, Weifang, 261000, China. · Clinical Laboratory, First Affiliated Hospital, Nanjing Medical University, Nanjing, 210029, China. · Occupational Safety and Health Research Center of the State Administration of Work Safety, Beijing, 100000, China. · Department of Rheumatology and Immunology, The Affiliated Hospital of Weifang Medical University, Weifang, 261000, Shandong Province, China. lrr20003@sina.com. · Department of Rheumatology and Immunology, The Affiliated Hospital of Weifang Medical University, Weifang, 261000, Shandong Province, China. flower322@163.com. ·Osteoporos Int · Pubmed #26753541.

ABSTRACT: Previous studies suggested possible bone loss and fracture risk in patients with systemic lupus erythematosus (SLE). The aim of this systematic review and meta-analysis was to assess the strength of the relationship of SLE with fracture risk and the mean difference of bone mineral density (BMD) levels between SLE patients and controls. Literature search was undertaken in multiple indexing databases on September 26, 2015. Studies on the relationship of SLE with fracture risk and the mean difference of BMD levels between SLE patients and controls were included. Data were combined using standard methods of meta-analysis. Twenty-one studies were finally included into the meta-analysis, including 15 studies on the mean difference of BMD levels between SLE patients and controls, and 6 studies were on fracture risk associated with SLE. The meta-analysis showed that SLE patients had significantly lower BMD levels than controls in the whole body (weighted mean difference [WMD] = -0.04; 95 % CI -0.06 to -0.02; P < 0.001), femoral neck (WMD = -0.06; 95 % CI -0.07 to -0.04; P < 0.001), lumbar spine (WMD = -0.06; 95 % CI -0.09 to -0.03; P < 0.001), and total hip (WMD = -0.05; 95 % CI -0.06 to -0.03; P < 0.001). In addition, the meta-analysis also showed that SLE was significantly associated with increased fracture risk of all sites (relative risk [RR] = 1.97, 95 % CI 1.20-3.25; P = 0.008). Subgroup analysis by adjustment showed that SLE was significantly associated with increased fracture risk of all sites before and after adjusting for confounding factors (unadjusted RR = 2.07, 95 % CI 1.46-2.94, P < 0.001; adjusted RR = 1.22, 95 % CI 1.05-1.42, P = 0.01). Subgroup analysis by types of fracture showed that SLE was significantly associated with increased risks of hip fracture (RR = 1.99, 95 % CI 1.55-2.57; P < 0.001), osteoporotic fracture (RR = 1.36, 95 % CI 1.21-1.53; P < 0.001), and vertebral fracture (RR = 2.97, 95 % CI 1.71-5.16; P < 0.001). This systematic review and meta-analysis provides strong evidence for the relationship of SLE with bone loss and fracture risk.

17 Review Current Status of Research on Osteoporosis after Solid Organ Transplantation: Pathogenesis and Management. 2015

Lan, Gong-bin / Xie, Xu-biao / Peng, Long-kai / Liu, Lei / Song, Lei / Dai, He-long. ·Center of Organ Transplantation, The Second Xiangya Hospital of Central South University, Changsha 410011, China. ·Biomed Res Int · Pubmed #26649301.

ABSTRACT: Improved survival following organ transplantation has brought to the forefront some long-term complications, among which osteoporosis and associated fractures are the major ones that adversely affect the quality of life in recipients. The pathogenesis of osteoporosis in transplant recipients is complex and multifactorial which may be related to increased bone resorption, decreased bone formation, or both. Studies have shown that the preexisting underlying metabolic bone disorders and the use of immunosuppressive agents are the major risk factors for osteoporosis and fractures after organ transplantation. And rapid bone loss usually occurs in the first 6-12 months with a significant increase in fracture risk. This paper will provide an updated review on the possible pathogenesis of posttransplant osteoporosis and fractures, the natural history, and the current prevention and treatment strategies concerning different types of organ transplantation.

18 Review COL1A1 gene -1997G/T polymorphism and risk of osteoporosis in postmenopausal women: a meta-analysis. 2015

Yu, K H / Tang, J / Dai, C Q / Yu, Y / Hong, J J. ·Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China. · Department of Orthopedic Surgery, The Second Affiliated Hospital of Wenzhou Medical University, Wenzhou, China hongmed@126.com. ·Genet Mol Res · Pubmed #26400328.

ABSTRACT: Studies investigating the association between the COL1A1 gene -1997G/T polymorphism and the risk of osteoporosis in postmenopausal women have reported conflicting results. We performed a meta-analysis based on the evidence currently available from the literature to make a more precise estimation of this relationship. We conducted searches of the published literature in the PubMed and Embase databases up to September 2014. We estimated the pooled odds ratios with their 95% confidence intervals to assess the associations using fixed- or random-effect models. Publication bias was investigated by Begg's funnel plot. Meta-analysis was performed using the STATA package version 12.0. No significant association was found between the -1997G/T polymorphism in the COL1A1 gene and osteoporosis risk in the total population analysis (TT vs GG: OR = 1.28, 95%CI = 0.76-2.17; TT vs GT: OR = 1.04, 95%CI = 0.60-1.78; dominant model: OR = 0.84, 95%CI = 0.50-1.40; recessive model: OR = 1.18, 95%CI = 0.84- 1.66). In a subgroup analysis by nationality, the results also showed that no significant associations between the COL1A1 gene -1997G/T polymorphism and osteoporosis risk existed in either Caucasian or Asian populations. No evidence of publication bias was found. In conclusion, the COL1A1 gene -1997G/T polymorphism might not be a risk factor for osteoporosis in postmenopausal women. Further large and well-designed studies are needed to confirm these conclusions.

19 Review Nanotechnology for treating osteoporotic vertebral fractures. 2015

Gao, Chunxia / Wei, Donglei / Yang, Huilin / Chen, Tao / Yang, Lei. ·Department of Orthopaedic Surgery and Orthopaedic Institute, First Affiliated Hospital, Soochow University, Suzhou, People's Republic of China. · Robotics and Microsystems Center, Collaborative Innovation Center of Suzhou Nano Science and Technology, Soochow University, Suzhou, People's Republic of China. · Department of Orthopaedic Surgery and Orthopaedic Institute, First Affiliated Hospital, Soochow University, Suzhou, People's Republic of China ; Laboratory of Nonlinear Mechanics, Institute of Mechanics, Chinese Academy of Sciences, Beijing, People's Republic of China. ·Int J Nanomedicine · Pubmed #26316746.

ABSTRACT: Osteoporosis is a serious public health problem affecting hundreds of millions of aged people worldwide, with severe consequences including vertebral fractures that are associated with significant morbidity and mortality. To augment or treat osteoporotic vertebral fractures, a number of surgical approaches including minimally invasive vertebroplasty and kyphoplasty have been developed. However, these approaches face problems and difficulties with efficacy and long-term stability. Recent advances and progress in nanotechnology are opening up new opportunities to improve the surgical procedures for treating osteoporotic vertebral fractures. This article reviews the improvements enabled by new nanomaterials and focuses on new injectable biomaterials like bone cements and surgical instruments for treating vertebral fractures. This article also provides an introduction to osteoporotic vertebral fractures and current clinical treatments, along with the rationale and efficacy of utilizing nanomaterials to modify and improve biomaterials or instruments. In addition, perspectives on future trends with injectable bone cements and surgical instruments enhanced by nanotechnology are provided.

20 Review Epidemiology and management of osteoporosis in the People's Republic of China: current perspectives. 2015

Lin, Xiao / Xiong, Dan / Peng, Yi-Qun / Sheng, Zhi-Feng / Wu, Xi-Yu / Wu, Xian-Ping / Wu, Feng / Yuan, Ling-Qing / Liao, Er-Yuan. ·Institute of Metabolism and Endocrinology, Central South University, Changsha, Hunan, People's Republic of China. · Department of Pathology, The Second Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China. ·Clin Interv Aging · Pubmed #26150706.

ABSTRACT: With the progressive aging of the population, osteoporosis has gradually grown into a global health problem for men and women aged 50 years and older because of its consequences in terms of disabilities and fragility fractures. This is especially true in the People's Republic of China, which has the largest population and an increasing proportion of elderly people, as osteoporosis has become a serious challenge to the Chinese government, society, and family. Apart from the fact that all osteoporotic fractures can increase the patient's morbidity, they can also result in fractures of the hip and vertebrae, which are associated with a significantly higher mortality. The cost of osteoporotic fractures, moreover, is a heavy burden on families, society, and even the country, which is likely to increase in the future due, in part, to the improvement in average life expectancy. Therefore, understanding the epidemiology of osteoporosis is essential and is significant for developing strategies to help reduce this problem. In this review, we will summarize the epidemiology of osteoporosis in the People's Republic of China, including the epidemiology of osteoporotic fractures, focusing on preventive methods and the management of osteoporosis, which consist of basic measures and pharmacological treatments.

21 Review Efficacy and safety of odanacatib treatment for patients with osteoporosis: a meta-analysis. 2015

Feng, Shi / Luo, Zhicheng / Liu, Da. ·Department of Orthopaedic Surgery, Shengjing Hospital, China Medical University, 36 Sanhao Road, Shenyang, 110004, China. ·J Bone Miner Metab · Pubmed #24996529.

ABSTRACT: The aim of this study was to evaluate the efficacy and safety of odanacatib (ODN) for the treatment of osteoporosis, using data in studies reported in the literature. We performed a literature search to compare the outcomes of applications of once-weekly ODN 50 mg and control. The outcomes of osteoporosis evaluated include primary outcome as bone mineral density (BMD) at different skeletal sites, and secondary outcomes, including adverse events (AEs), such as incidence of skin AEs, fracture, and serious adverse events (SAEs). Four trials were included. Mean difference (95% CI) of lumbar spine BMD was 3.41 (1.57-5.24) at 12 months and 4.89 (2.72-7.05) at 24 months; mean difference (95% CI) of femoral neck BMD was 1.90 (0.73-3.08) at 12 months and 3.85 (2.55-5.15) at 24 months; mean difference (95% CI) of total hip BMD was 2.65 (1.20-4.09) at 12 months and 3.70 (1.76-5.64) at 24 months; risk ratio (95% CI) of AEs was 0.98 (0.91-1.07); risk ratio (95% CI) of SAEs was 1.11 (0.72-1.72); risk ratio (95% CI) of skin AEs was 0.92 (0.63-1.35); and risk ratio (95% CI) of fracture was 0.34 (0.16-0.70). In this study, application of 50 mg ODN produced significantly greater BMD increases and lower fracture incidence than that of the control. In addition, ODN was generally well tolerated.

22 Review Comparing complications of vertebroplasty and kyphoplasty for treating osteoporotic vertebral compression fractures: a meta-analysis of the randomized and non-randomized controlled studies. 2015

Xiao, Haixiang / Yang, Jiandong / Feng, Xinming / Chen, Pengtao / Li, Yinan / Huang, Cheng / Liang, Yuan / Chen, Hongzhou. ·Medical School of Yangzhou University, 11 N. Huaihai Street, Yangzhou, 225001, China, 604740702@qq.com. ·Eur J Orthop Surg Traumatol · Pubmed #24989933.

ABSTRACT: PURPOSE: To compare complications of percutaneous vertebroplasty (PVP) and balloon kyphoplasty (BKP) for the treatment of osteoporotic vertebral compression fractures (OVCFs). BACKGROUND: PVP and BKP are two minimally invasive procedures for treating OVCFs, while few studies emphases attention to intra- and post-operative complications about the two procedures. METHODS: Online databases were searched for studies comparing complications of PVP and BKP for OVCFs, the randomized controlled trials, clinical controlled trials and cohort studies that provided related data were identified. Demographic characteristics and complications related to procedures were extracted and analysed from all of the included studies. RESULTS: Nineteen studies encompassing 1,787 patients in total, of whom 887 received PVP and 900 received BKP, met the inclusion criteria. For subsequent fractures, our meta-analysis detected no significant difference between the two procedures, both for adjacent fractures (p = 0.29) and non-adjacent fractures (p = 0.37). For cement extravasations, there was no significant difference between the two interventions if considering disc spaces extravasations only (p = 0.24), while considering total extravasations and paravertebral extravasations, the cement leakage rate in the PVP group was significantly higher than the BKP group (total: p < 0.01; paravertebral: p < 0.01). CONCLUSIONS: The two procedures suffer from equal risk of subsequent spinal fractures; PVP has a significant higher cement leakage rate compared to BKP, mainly caused by a higher paravertebral leakage, patients with extremely poor pulmonary function or unstable haemodynamic are better candidates for BKP.

23 Review A review of osteoporotic vertebral fracture nonunion management. 2014

Yang, Huilin / Pan, Jun / Wang, Genlin. ·From the Department of Orthopaedic Surgery, the First Affiliated Hospital of Soochow University, Suzhou, China. ·Spine (Phila Pa 1976) · Pubmed #25504096.

ABSTRACT: Osteoporotic vertebral fractures are a frequently encountered clinical problem, and like other fractures, they may develop nonunion that can often go unrecognized. The aim of this study is to review the related articles reporting the osteoporotic vertebral fracture nonunion and discuss the radiological characteristics, diagnosis, and treatment of osteoporotic vertebral fractures.

24 Review Systematic review and meta-analysis of the bone protective effect of phytoestrogens on osteoporosis in ovariectomized rats. 2014

Fu, Song-wen / Zeng, Gao-feng / Zong, Shao-hui / Zhang, Zhi-yong / Zou, Bin / Fang, Ye / Lu, Li / Xiao, De-qiang. ·Department of Nutrition and Food Hygiene, Graduate School of Guangxi Medical University, Nanning, Guangxi, China. · Department of Nutrition and Food Hygiene, College of Public Hygiene of Guangxi Medical University, Nanning, Guangxi, China. Electronic address: zengweilin2013@126.com. · Department of Spine Osteopathia, the First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China. · Department of Nutrition and Food Hygiene, College of Public Hygiene of Guangxi Medical University, Nanning, Guangxi, China. ·Nutr Res · Pubmed #25026913.

ABSTRACT: Phytoestrogens are candidate drugs for the treatment of osteoporosis. Many experiments have been designed to investigate the preventive effects of phytoestrogens for osteoporosis; however, it is easy for a single dissenting result from animal experiments to mislead clinical investigations. Herein, we use meta-analysis to assess the evidence for a protective effect of phytoestrogens on ovariectomized rat models of osteopenia. With respect to osteoporosis, PubMed and Web of Science were searched from January 2000 to March 2013 for relevant studies of phytoestrogens in ovariectomized rats. Two reviewers independently selected and assessed the studies. Data were aggregated using a random effects model. Meta-analysis revealed that the phytoestrogen treatment group demonstrated a significantly higher femur bone mineral density and trabecular bone and lower bone turnover markers (serum alkaline phosphatase and serum osteocalcin) compared with the control ovariectomized group, thus showing a bone protective effect of phytoestrogens in ovariectomized rats. Subsequent sensitivity analyses indicated that the effect of phytoestrogens on serum alkaline phosphatase and serum osteocalcin are not robust. Despite the high heterogeneity in the systematic review of animal experiments, the present results indicated that phytoestrogens may offer the most potential for the prevention of bone loss by reducing the expected loss of trabecular bone and bone mineral density. Their effects are likely due to inhibition of bone resorption, but their benefits on bone formation are still unclear. Further studies are needed to assess the effect of phytoestrogens on bone formation and the efficacy and safety of individual phytoestrogens.

25 Review A systematic review and meta-analysis of randomized controlled trials of unilateral versus bilateral kyphoplasty for osteoporotic vertebral compression fractures. 2013

Yang, Li-Yu / Wang, Xing-Li / Zhou, Long / Fu, Qin. ·Department of Orthopedic Surgery, The Shengjing Hospital of China Medical University, China. ·Pain Physician · Pubmed #23877445.

ABSTRACT: BACKGROUND: Kyphoplasty reduces the pain caused by osteoporotic vertebral compression fracture (OVCF). Although the procedure is typically carried out using a bilateral approach, it is now increasingly performed using a unilateral approach because of the concern for long-term adverse effects. However, little evidence is available to demonstrate superior safety of the unilateral approach. OBJECTIVE: The purpose of this study was to compare the short- and long-term safety and efficacy of unilateral vs. bilateral kyphoplasty. STUDY DESIGN: A systematic review and meta-analysis of randomized controlled trials. SETTINGS: MEDLINE, EMBASE, Cochrane Central Register of Controlled Trials, and abstracts published in the related orthopedic journals were systematically searched up to September 2012, using "unilateral kyphoplasty" and "osteoporotic vertebral compression fractures" as key words. METHODS: Two investigators independently searched and identified relevant reports and abstracts using the PRISMA statement criteria. Relevant studies cited by the identified papers were also included. The level of evidence was classified as good, fair, and limited (or poor) based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). RESULTS: Four randomized controlled trials (RCTs) of 159 cases were enrolled. The methodological quality of the articles was determined as moderate. We did not find any significant difference between unilateral and bilateral kyphoplasty on pain relief, in either short-term or long-term follow-up (P = 0.65 and P = 0.69, respectively). The rate of adjacent vertebral fracture was not statistically different with a P value of 0.88 and 95% CI (confidence intervals) of 0.25-3.26. Cement leakage was comparable between unilateral and bilateral kyphoplasty (P = 0.56, 95% CI = 0.46-4.26). The loss of vertebral height in long-term follow-up was not different (P = 0.10, 95% CI = -0.39-4.54). Operation time and cement dosage were considerably less for unilateral kyphoplasty (P < 0.01 and P < 0.05, respectively). LIMITATIONS: Only 4 RCTs and 159 patients were included in this systematic review. Publication bias also existed among the studies included. CONCLUSIONS: Both unilateral and bilateral kyphoplasty are effective in alleviating the back pain caused by OVCF. Two approaches have the same degree of safety. More RCTs are needed to examine the efficacy and adverse reactions of the 2 approaches.

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