Publications (112) View all
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Article: The effect of soy isoflavone on bone mineral density in postmenopausal Taiwanese women with bone loss: a 2-year randomized double-blind placebo-controlled study.
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ABSTRACT: The treatment of 300-mg/day isoflavones (aglycone equivalents) (172.5 mg genistein + 127.5 mg daidzein) for 2 years failed to prevent lumbar spine and total proximal femur bone mineral density (BMD) from declining as compared with the placebo group in a randomized, double-blind, two-arm designed study enrolling 431 postmenopausal women 45-65 years old. This study evaluated the effects of soy isoflavones on bone metabolism in postmenopausal women. Four hundred and thirty-one women, aged 45-65 years, orally consumed 300-mg/day isoflavones (aglycone equivalents) or a placebo for 2 years in a parallel group, randomized, double-blind, two-arm study. Each participant also ingested 600 mg of calcium and 125 IU of vitamin D(3) per day. The BMD of the lumbar spine and total proximal femur were measured using dual-energy X-ray absorptiometry at baseline and every half-year thereafter. Serum bone-specific alkaline phosphatase, urinary N-telopeptide of type 1 collagen/creatinine, and other safety assessments were examined regularly. Two hundred out of 217 subjects in the isoflavone group and 199 out of 214 cases in placebo group completed the treatment. Serum concentrations of isoflavone metabolites, genistein and daidzein, of the intervention group were remarkably elevated following intake of isoflavones (p < 0.001). However, differences in the mean percentage changes of BMD throughout the treatment period were not statistically significant (lumbar spine, p = 0.42; total femur, p = 0.39) between the isoflavone and placebo groups, according to the generalized estimating equation (GEE) method. A significant time trend of bone loss was observed at both sites as assessed by the GEE method following repeated measurement of BMD (p < 0.001). Differences in bone marker levels were not significant between the two treatment groups. Treatment with 300-mg/day isoflavones (aglycone equivalents) failed to prevent a decline in BMD in the lumbar spine or total femur compared with the placebo group.Osteoporosis International 09/2011; 23(5):1571-80. · 4.58 Impact Factor -
Article: Teriparatide vs. calcitonin in the treatment of Asian postmenopausal women with established osteoporosis.
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ABSTRACT: This study compared the clinical efficacy, safety, and tolerability of daily subcutaneous injections of teriparatide and salmon calcitonin in the treatment of postmenopausal women with established osteoporosis in Taiwan. This 6-month, multicenter, randomized, controlled study enrolled 63 women with established osteoporosis. They were randomized to receive either teriparatide 20 microg or calcitonin 100 IU daily in an open-label fashion. Lumber spine, femoral neck, total hip bone mineral density (BMD), and biochemical markers of bone turnover were measured, and adverse events and tolerability were recorded. The results at 6 months showed that patients using teriparatide had larger mean increases in spinal BMD than those who used calcitonin (4.5% vs. 0.1%), but the BMD changes in these two groups at the femoral neck and the total hip were not significant. There were also larger mean increases in bone markers in the teriparatide group than in the calcitonin group (bone specific alkaline phosphatase 142% vs. 37%; osteocalcin 154% vs. 23%). We conclude that teriparatide has more positive effects on bone formation than salmon calcitonin, as shown by the larger increments of lumbar spine BMD and bone formation markers, and caused only mild adverse events and no significant change in liver, kidney or hematological parameters. Compared with the published global results, teriparatide seems to be equally effective and safe to use in this Asian population.Osteoporosis International 02/2006; 17(3):373-8. · 4.58 Impact Factor -
Article: Do centrally obese Chinese with normal BMI have increased risk of metabolic disorders?
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ABSTRACT: Body mass index (BMI) and waist circumference are highly correlated. One or the other predicts the metabolic syndromes better, depending on characteristic of the population studied, such as age, gender, and ethnicity. We examined the impact of isolated central obesity, isolated BMI elevation, and the combined type of obesity on metabolic disorders, in order to shed lights on the strategy of obesity screening. The study subjects were Chinese aged 20 or above residing in Taiwan. Their data were derived from two large-scale studies: the Nutrition and Health Survey in Taiwan (NAHSIT 1993-1996) and the Cardiovascular Disease Risk Factor Two-township Study (CVDFACTS, 1994-1997). In evaluating the relations between obesity and health risks, the cut-points of BMI (> or =24 kg/m(2) for overweight) and waist circumference (> or =80 cm for women and > or =90 cm for men) recommended by Department of Health in Taiwan for Taiwanese people were used to define various types of obesity. We found that there was a small but nontrivial proportion (1.7% for men and 4.0% for women) of Taiwanese people for whom BMI was in the normal range but their waist circumferences were above normal. These people were at a higher risk of developing metabolic syndromes than those with isolated BMI elevation. Their risks were close to that of the combined type. In order to screen out high-risk obese individuals, isolated centrally obese subjects should not be overlooked. Therefore, we recommend to assess waist circumference in parallel to, not just sequential to the measurement of BMI in Chinese.International Journal of Obesity 08/2005; 29(7):818-25. · 4.69 Impact Factor -
Article: High incidence rate of hip fracture in Taiwan: estimated from a nationwide health insurance database.
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ABSTRACT: The objective of this study was to describe the incidence rate of hip fracture from 1996 to 2000 in Taiwan, based on an inpatient database of the National Health Insurance Program. A total of 54,199 patients, who had a first-time admission for a diagnosis of hip fracture (ICD9 code 820.0 through 820.9, 820.21, 820.22, and 820.31) on discharge from January 1996 through December 2000 and aged 50 to 100 years, were identified and included in the study. The results showed that the age-specific incidence rates of hip fractures were higher with increasing age in both genders, in an exponential manner after 65 years of age. The incidence was 1.6 times higher and rose about 5 years earlier among women than among men. Thus in these 5 years the age-adjusted incidence rates (95% confidence interval) of hip fracture in Taiwan were 225 (95% CI, 188-263) per 100,000 in men and 505 (95% CI, 423-585) per 100,000 in women (adjusted to US white population of 1989), as compared with US white rate of 187 in men and 535 in women. More than half of the fractures were peritrochanteric, and the recorded cause in most cases was a fall on the same level, from slipping, tripping, or stumbling (ICD9 E885). A total of 37.8% patients had hip hemiarthroplasty, 51.2% had open reduction of fracture with internal fixation, and 10.5% had closed reduction of fracture with internal fixation. We concluded that, using the data from a nationwide health insurance database of Taiwan, we found a high annual incidence rate of hip fracture for both men and women in 5 consecutive years. These incidence rates were higher than other reports on Chinese populations reported in the past 10 years and similar to that of Western countries. With the rapid aging of the populations of Taiwan and other Asian countries in the years to come, our results clearly demonstrated the impact of osteoporosis and hip fracture in this region.Osteoporosis International 01/2005; 15(12):998-1002. · 4.58 Impact Factor -
Article: Raloxifene versus continuous combined estrogen/progestin therapy: densitometric and biochemical effects in healthy postmenopausal Taiwanese women.
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ABSTRACT: We treated 116 healthy postmenopausal women (age 47-66 years, mean 57 years) in Taiwan with either raloxifene (RLX) 60 mg (n = 92) or 0.625 mg conjugated equine estrogen plus 5 mg medroxyprogesterone acetate (CCEP, n = 24) daily for 12 months in a randomized, double-masked, active-controlled fashion. The results showed that both regimens increased bone mineral density (BMD) at hip sites (means: RLX 2.5-4.9%, CCEP 4.6-7.9%, all p<0.005 compared with baseline), and the difference between the two regimens was not significant. The spinal BMD increased significantly in both groups (1.4% with RLX and 6.0% with CCEP, both p<0.01), and more with CCEP (p<0.003). Osteocalcin levels and urinary type I collagen C-telopeptide/creatinine ratios decreased significantly in both regimens, but the decreases were significantly larger with CCEP. Compared with baseline, both RLX and CCEP decreased the total cholesterol (median 4.9% and 8.6% respectively, p<0.001) and LDL-cholesterol (median 11% and 19% respectively, p<0.001), and increased HDL-cholesterol (median 8.6% and 10.7% respectively, p<0.01). Both regimens increased triglyceride levels (median 3.2% and 18.9% respectively, both p<0.05), although to a lesser extent with RLX than with CCEP (p<0.05). Only 3 subjects (3.3%) reported vaginal bleeding in the RLX group, as compared with 31% (7/22) with CCEP (p<0.05). We conclude that in healthy, postmenopausal Taiwanese women, RLX 60 mg given daily has favorable results in BMD, bone turnover and serum lipids, although the dosage we used showed a potency less than that of conventional CCEP.Osteoporosis International 01/2002; 12(12):1020-5. · 4.58 Impact Factor
