[Show abstract][Hide abstract] ABSTRACT: Supplementation with elemental calcium 500 mg/day alone for 2 years is able to decrease bone turnover and is effective in retarding bone loss at lumbar spine and slowing bone loss at femoral neck in elderly Thai women who had low dietary calcium intake. INTRODUCTION: Most elderly Thais have a total dietary calcium intake of less than the recommended amount. The aim of the study was to investigate the effect of calcium supplementation on bone mineral density and biochemical indices of bone remodeling in Thai postmenopausal women. METHODS: Four hundred and four healthy postmenopausal women 60 years old or older without osteoporosis were recruited and conducted in a randomized, double-blinded, placebo-controlled trial. They were randomly given elementary calcium 500 mg/day or placebo for 2 years. Dietary calcium intake was calculated from the nutrient compositional analysis of the 3-day food records. Serum 25 hydroxyvitamin D was measured by radioimmunoassay and bone turnover markers were determined by electrochemiluminescence immunoassay. RESULTS: The age of the subjects was 65.8 ± 4.4 years. All baseline characteristics of the subjects in the calcium-supplemented group and the placebo group were not statistically different. At the end of the study, significant decreases in serum C-terminal telopeptide of type I collagen and serum total procollagen type I amino terminal propeptide in the calcium-supplemented group were observed, while there was no change in the placebo group. In addition, plasma parathyroid hormone decreased, although not significantly, only in the calcium-supplemented group. Percent changes from baseline of lumbar spine (L2-L4) bone mineral density increased 2.76 % in the calcium-supplemented group and 0.87 % in the placebo group, whereas the percent changes from baseline of femoral neck decreased 0.21 % in the calcium-supplemented group and 0.90 % in the placebo group. CONCLUSIONS: Calcium supplementation is necessary for the decrease of bone turnover and prevention of bone loss in Thai elderly women.
Osteoporosis International 05/2013; 24(11). DOI:10.1007/s00198-013-2387-5 · 4.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The purpose of this study was to determine the prevalence of sarcopenia using the skeletal muscle index (SMI) criteria in the Thai population. The secondary objective was to demonstrate factors influencing low SMI in this population. Femoral neck bone mass density (BMD) was measured by dual-energy X-ray absorptiometry (GE Lunar, Madison, WI, USA) in 435 urban and 397 rural subjects (334 men and 498 women) between 20 and 84 years of age. Body mass index (BMI) was calculated from weight and height. The respective prevalence of sarcopenia among men and women was 35.33 % (95 % CI, 29.91, 40.41) and 34.74 % (95 % CI, 30.56, 39.10). Factors associated with sarcopenia using multiple logistic regres-sion analyses in both sexes were (a) living in the city, (b) higher BMI, and (c) older age. Living in an urban area was the strongest factor, with an odds ratio (OR) of 17.26 ± 7.12 (95 % CI, 7.68, 38.76) in men and 8.62 ± 2.74 (95 % CI, 4.62, 16.05) in women (p \ 0.05). The prevalence rate ratio for persons living in urban compared to rural areas was 2.01 (95 % CI, 1.14, 3.53) in men and 1.69 (95 % CI, 1.31, 2.17) in women (p \ 0.05). Sarcopenia, as based on SMI, occurs frequently in the Thai population and increases with age. The prevalence of sar-copenia is particularly high among pre-retirement women (50–59 years of age) whereas the number of men with sarcopenia gradually rises with age. An urban environment is the most predictive factor for sarcopenia, followed by high BMI and age. Given the aging population, early rec-ognition of this condition can be beneficial for prevention of an epidemic of sarcopenia-related disability.
Journal of Bone and Mineral Metabolism 02/2013; 31(3). DOI:10.1007/s00774-013-0422-4 · 2.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Background
Numerous emerging data from research on osteoporosis among Asians found differences from Caucasians. Therefore, the aim of this study was to determine the prevalence of vitamin D insufficiency and osteoporosis in elderly participants from two nursing homes in Thailand, a country located near the equator.
The subjects of this cross-sectional study comprised 93 elderly Thai women who were living in institutional long-term nursing homes for the aged. Demographic data, daily food and calcium intake, physical activity, and sunlight exposure were measured. Lumbar spine and femoral neck bone mineral density (BMD) and biochemical levels including serum 25 hydroxyvitamin D [25(OH)D] and bone turnover markers were assessed. Vitamin D insufficiency was defined as 25(OH)D level < 70 nmol/l.
The mean age of subjects was 75.2 ± 6.0 (SD) years. Dietary calcium intake was low (322 ± 158 mg/day) The mean 25(OH)D level was 64.3 ± 14.9 nmol/L and the prevalence of vitamin D insufficiency was 38.7% (95% CI: 28.8%, 49.4%). There was no correlation between serum 25(OH)D concentrations and age (r = −.11, p = 0.3). The mean BMD of lumbar spine and femoral neck were 0.92 ± 0.19 and 0.65 ± 0.10 g/cm2, respectively. Nearly a half of the subjects had osteopenia (44.1%, 95% CI: 33.8%, 54.8%) and osteoporosis (47.3%, 95% CI: 36.9%, 57.9%). Circulating C-terminal telopeptide of type I collagen (CTx) level correlated significantly with both lumbar spine (r = −0.26, p = 0.01) and femoral neck BMD (r = −0.25, p = 0.02).
More than one-third of Thai elderly women residing in nursing homes had vitamin D insufficiency. Almost all nursing home residents had osteoporosis and/or osteopenia.
[Show abstract][Hide abstract] ABSTRACT: To identify genetic variations associated with parathyroid hormone (PTH) suppression after long-term calcium supplementation.
For high throughput SNP screening, subjects consisted of 171 postmenopausal women without osteoporosis at the lumbar spine. A separate group of 19 premenpausal women were recruited for calcium absorption study. Postmenopausal women in the screening group were given 500 mg/day calcium supplementation.
Parathyroid hormone (PTH) and bone mineral density (BMD) were measured at baseline and 2 years after calcium supplementation. High throughput single-nucleotide polymorphism (SNP) screening was performed by comparing estimated allele frequencies derived from hybridization signal intensities of pooled DNA samples on Affymetrix's 10K SNP genotyping microarrays based responsiveness in PTH after calcium supplementation. Genotyping of SNP rs1112482 in malic enzyme gene (ME1) gene, a SNP among those with highest odds ratio of being related to PTH suppression after calcium, was performed in all postmenopausal subjects in the screening group and premenopausal women in the calcium absorption study group in which fractional calcium absorption was assessed by stable isotope dilution. Data were expressed as mean +/- SEM.
PTH significantly decreased after 2 years of calcium supplementation (4.7 ± 1.9 vs. 4.4 ± 1.6 pmol/L, P < 0.01). There was a significant increase in lumbar spine BMD (1.03 ± 0.01 vs. 1.01 ± 0.01 g/cm2, P < 0.001) but not femoral neck BMD. In 108 subjects whose PTH levels decreased after calcium, the suppression of PTH was higher in those with at least one C allele in rs1112482 of ME1 gene (-26.3 ± 2.1 vs. -16.9 ± 1.4%, P < 0.001). Fractional calcium absorption also tends to the higher in subjects in the calcium absorption study group with at least one C allele (n = 6) compared to those without the C allele (n = 13) (58.0 ± 4.9 vs. 49.3 ± 2.8%, P = 0.054).
Cytosolic malic enzyme 1 gene polymorphism is associated with the degree of suppression of parathyroid hormone after long-term calcium supplementation. The effect is probably mediated through an increase in intestinal calcium absorption.
The Journal of Nutrition Health and Aging 01/2012; 16(3):246-51. DOI:10.1007/s12603-011-0343-7 · 2.66 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Paget's bone disease is quite common in some parts of Europe and countries inhabited by European emigrants, but it is rare in Asia. There have been only 13 reported cases in Southeast Asia, including one reported case from Thailand. Half of the previously reported cases had bone symptoms and the other half were asymptomatic, but were incidentally discovered when patients were being investigated for other medical problems. Here are reported cases of four asymptomatic patients who presented elevation of serum alkaline phosphatase during routine annual medical checkups. All patients were of Chinese descent and all cases were proven by biopsy. Based on this experience, we are of the opinion that a substantial number of unrecognized cases of Paget's disease exist among ethnic Thais. We feel that they would be revealed if clinicians were alerted of its presence and if they included it as a possible diagnosis together with metastasis and osteoporosis when examining bone lesions or when results for elevated serum alkaline phosphatase are detected during routine checkups. We also anticipate that a higher prevalence of this disease may occur in future Thai generations due to the addition of offspring from Asian-European intermarriages to offspring of Chinese descent in the ethnic Thai population.
Journal of Bone and Mineral Metabolism 11/2011; 30(4):485-92. DOI:10.1007/s00774-011-0330-4 · 2.11 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: We compared osteoblast differentiation gene expressions in the isolated CD105 mesenchymal stromal cells from bone marrow in 10 patients with severe thalassemia and 12 normal donor controls. The fold expressions of osteoblast differentiation genes of CD105 cells from patients with thalassemia were lower than those of normal donors but increased after being cultured in Dulbecco's modified Eagle's medium with 10% fetal calf serum. Moreover, the fold expressions of these genes of CD105 cells from normal donors when cultured with 10% pooled serum of patients with thalassemia were lower than when cultured with 10% pooled serum of normal donors. We have also presented the evidence of reversible suppressed expression of these genes in CD105cells from patients with thalassemia when cultured in pooled serum of normal donors. Moreover, healthy donor CD105 cells exhibited lower expression of these genes when cultured in pooled serum of patients with thalassemia compared with pooled serum of normal donors indicating the existence of circulating factors in thalassemic serum impairing the differentiation of mesenchymal stromal cells to osteoblasts.
[Show abstract][Hide abstract] ABSTRACT: The relationships of fetuin-A and lactoferrin to bone-related phenotypes were investigated in elderly women. Fetuin-A was associated not only with bone mineral density (BMD) but also with bone resorption marker suggesting an influence of fetuin-A on osteoclasts.
The aim of this study is to investigate the relationship of bone-related phenotypes in elderly women with circulating fetuin-A and lactoferrin.
Eighty-two elderly women were studied. Serum fetuin-A, lactoferrin, C-terminal telopeptide of type I collagen (CTx), total procollagen type 1 amino-terminal propeptide, and plasma intact parathyroid hormone (PTH) were analyzed. BMD of the lumbar spine at L2-4 and at the femoral neck was measured.
Serum fetuin-A was significantly associated with L2-4 BMD (r = 0.23, P < 0.05). After controlling for age and body weight, the association remained statistically significant. There was a significant association between serum fetuin-A and serum CTx (r = -0.37, P < 0.001). The association between fetuin-A and L2-4 BMD no longer existed after controlling for serum CTx. There were positive associations of circulating lactoferrin with plasma PTH (r = 0.24, P < 0.05) and serum CTx (r = 0.26, P < 0.05). No association between serum lactoferrin and BMD at the lumbar spine or femoral neck was detected.
Circulating fetuin-A is related to bone mass and bone resorption markers in elderly women. Lactoferrin, in contrast, is associated only with bone resorption markers.
Osteoporosis International 10/2010; 22(7):2159-64. DOI:10.1007/s00198-010-1439-3 · 4.17 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: This study investigated whether single nucleotide polymorphisms (SNP) in the aquaporin 9 (AQP9) gene is associated with bone mineral density (BMD) in Thai postmenopausal women, after an initial genome-wide screening using high-throughput SNP genotyping in pooled DNA samples. Subjects consisted of 516 postmenopausal women aged 50 or more. High-throughput SNP screening was performed by comparing the estimated allele frequency derived from hybridization signal intensities of pooled DNA samples on the Affymetrix 500 K SNP genotyping chip set. The SNP was then genotyped for each subject individually. Data were expressed as mean ± SEM. Pooled DNA SNP screening revealed the allele frequency of an intronic A/T SNP rs2414539 in the AQP9 gene as being different between subjects with femoral neck BMD in tertiles 1 and 3. Individual genotyping in all subjects revealed that femoral neck BMD in subjects with TT, TA, and AA genotypes were 0.79 ± 0.06 (n = 3), 0.75 ± 0.01 (n = 98), and 0.71 ± 0.01 g/cm(2) (n = 415), respectively. The presence of the T allele in rs2414539 was associated with femoral neck BMD (r = 0.11, P < 0.05) but not with lumbar spine BMD. The relationship was still significant after controlling for body weight and age (P < 0.05). Genetic variation in the AQP9 gene is associated with femoral neck BMD in postmenopausal women, and may represent one of the susceptibility genes for phenotypes related to bone mass.
[Show abstract][Hide abstract] ABSTRACT: The prevalence of hypovitaminosis D varies in different countries. Therefore, the current study was designed to assess vitamin D status and bone health in elderly women in Thailand, which is situated near the equator.
This cross-sectional study was performed in 446 healthy women aged 60-97 y.
Serum 25-hydroxyvitamin D (25(OH)D) was 67.6 ± 15.7 (mean ± SD) nmol/L. Daily calcium intake was 309.5 ± 147.2 mg/d. Serum 25(OH)D levels tended to decline with bone mineral density (BMD) status. Based on functional health-based reference values, plasma-intact parathyroid hormone began to rise below serum 25(OH)D level 70 nmol/L and increase significantly when serum 25(OH)D was ≤ 60 nmol/L. Thirty-two percent of elderly women had 25(OH)D insufficiency (≤ 60 nmol/L). There was no trend toward a decrease in the concentration of serum 25(OH)D with age (r = -0.078, P = 0.10) and no significant inverse relationship with plasma intact parathyroid hormone values (r = -0.079, P = 0.097). However, a positive relationship was observed between serum 25(OH)D level and femoral neck BMD (r = 0.156, P = 0.001) but not lumbar spine L(2)-L(4) BMD (r = 0.093, P = 0.050). In addition, BMD at the femoral neck but not lumbar spine of the vitamin D insufficiency group was significantly lower than that of the vitamin D sufficiency group.
The optimum level of serum 25(OH) value in Thai elderly women should be higher than 70 nmol/L. Vitamin D insufficiency is observed in one-third of elderly women in Bangkok.
[Show abstract][Hide abstract] ABSTRACT: To investigate the influence of vitamin D status on parathyroid hormone and bone mass after a 2-year supplementation of calcium alone.
Randomized, double-blind, placebo-controlled clinical trial, in healthy postmenopausal women without osteoporosis: three hundred and thirty-six subjects aged 60-97 years were studied and randomized to receive elemental calcium 500 mg/day (n = 175) or placebo (n = 161) for 2 years.
Changes in parathyroid hormone (PTH) and bone mineral density (BMD) from baseline and vitamin D status. Values are presented as means +/- SD.
After 2 years, subjects with calcium supplementation had significant decrease in plasma PTH level (4.4 +/- 1.7 vs 4.7 +/- 1.9 pmol/l, P < 0.01), improved lumbar BMD (1.031 +/- 0.12 vs 1.004 +/- 0.12 g/cm(2), P < 0.001) and total hip BMD (0.890 +/- 0.10 vs 0.883 +/- 0.10 g/cm(2), P < 0.001) without change in femoral neck BMD. In the placebo group, PTH level significantly increased (4.8 +/- 1.6 vs 4.5 +/- 1.5 pmol/l, P < 0.001), lumbar BMD slightly increased (1.027 +/- 0.14 vs 1.018 +/- 0.14 g/cm(2), P < 0.001), total hip and femoral neck BMD decreased (0.876 +/- 0.11 vs 0.887 +/- 0.11 g/cm(2), P < 0.001 and 0.783 +/- 0.10 vs 0.798 +/- 0.10 g/cm(2), P < 0.001, respectively). When subjects were classified according to baseline 25-hydroxyvitamin D [25(OH)D] levels into those with 25(OH)D in the lower tertile (lowVitD) and those in the middle and upper tertiles combined (normVitD). The degree of PTH suppression after calcium supplementation was significantly higher in the normVitD compared to the lowVitD groups (-5.6 +/- 26.7%vs 1.3 +/- 27.2%, P < 0.05). No effect of vitamin D status on the change in lumbar BMD after calcium supplementation was demonstrated. Despite the higher suppression of PTH, there was a slight decrease in femoral neck BMD after calcium supplementation in the normVitD group while femoral neck BMD was more or less maintained in the lowVitD group (-0.6 +/- 3.2%vs 0.5 +/- 2.9%, P < 0.05).
Calcium supplementation appears to affect femoral bone mass less in Thai postmenopausal women with adequate vitamin D status, despite higher suppression of PTH.
[Show abstract][Hide abstract] ABSTRACT: A worldwide secular trend towards earlier onset of puberty in girls has been noted during recent years. However, the data on sexual maturation of boys are relatively scarce and normative data of sexual maturation in Thai boys are still lacking.
To determine the age of secondary sexual maturation in normal Thai boys.
Three hundred healthy urban boys aged 9-18 years were recruited during January 1997 to December 1999. Genital and pubic hair maturity staging was determined using the method of Marshall and Tanner. Testicular size was assessed by Prader orchidometer. Probit analysis was used to analyze the onset of puberty (gonadarche) and pubarche.
Median (range) ages of the onset of puberty and pubarche were 10.8 (9.5-12) and 12.4 (10.9-13.9) years, respectively.
The age of onset of genital development in boys living in Bangkok seems to be slightly earlier than that of boys in other countries. However, the onset of pubic hair development is comparable.
[Show abstract][Hide abstract] ABSTRACT: To study the risk factors associated of femoral neck and intertrochanteric fractures in Thai women.
A case,control study was conducted in Bangkok and its vicinity between 1997 and 1998 to compare factors related to each type of hip fracture in Thai women. Cases, aged > or =51 years old, were diagnosed as intertrochanteric or femoral neck fracture and were matched with controls by age and sex. Multinomial logistic regression was performed for significant associated factors.
Recent physical activity and steroid-containing traditional medicine were strongly associated with intertrochanteric fractures (adjusted odds ratio (OR) 0.17 (95% CI: 0.07, 0.42) and 6.50 (95% CI: 1.93, 21.82), respectively) when compared to femoral neck fractures. Cerebrovascular accident (CVA) was more related to femoral neck fractures when compared to intertrochanteric fractures (adjusted OR 8.63 (95% CI: 2.28, 32.66), and 4.79 (95% CI: 1.19, 19.29), respectively).
Intertrochanteric fracture could be minimized more by encouraging physical activities and avoidance of steroid use while the reduction of femoral neck fracture should be achieved more by CVA prevention.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 12/2009; 92 Suppl 6:S172-80.
[Show abstract][Hide abstract] ABSTRACT: The objective of this study was to compare the risk factors related to hip fracture between intertrochanteric fracture and femoral neck fracture in Thai men.
The study was conducted in Bangkok and its vicinity from July 1997 to September 1998. The cases were recruited and matched with the controls by age and sex. Multilogit model was performed for finding the significant factors associated to each type of hip fracture.
There were 73 femoral neck fractures, 144 intertrochanteric fractures, and 177 controls. It was found that both types of hip fracture were associated with the physical activity and the cerebrovascular accident. However, the Chinese parent race was significantly related to the femoral neck only (adjusted odds ratio (OR) 2.59, 95% confidence interval (CI): 1.21, 5.54) whereas the walking disability was specifically associated with the intertrochanteric fracture (adjusted OR 3.23, 95% CI: 1.29, 8.08).
Types of hip fracture should be concerned for strategic prevention in men since they have significant difference of risk factors.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 12/2009; 92 Suppl 6:S165-71.
[Show abstract][Hide abstract] ABSTRACT: To investigate the effect of oral glucose on bone resorption and osteoprotegerin (OPG) in subjects with varying degrees of glucose tolerance.
In a cross-sectional study, 163 postmenopausal women aged 50-88 years without previous history of diabetes, impaired fasting glucose (IFG) or impaired glucose tolerance (IGT) were recruited. All subjects underwent a 75-g oral glucose tolerance test (OGTT) and were then classified as having normal glucose tolerance (NGT), IFG, IGT or diabetes according to American Diabetes Association (ADA) criteria.
Plasma glucose, serum insulin, C-terminal telopeptide of type I collagen (CTX-I) and OPG were measured.
Fasting insulin levels increased progressively from subjects with NGT, IFG/IGT to diabetes. After adjusted for age and body mass index (BMI), there was no significant difference in fasting CTX-I and OPG levels across the various degrees of glucose tolerance. After oral glucose, there was a significant decrease in serum CTX-I and OPG (P < 0.001) except for serum OPG in diabetic subjects. In addition, the percentages of change from baseline for both serum CTX-I and OPG were significantly less in diabetic subjects when compared to those in NGT subjects (-40.9% and 0.6% for diabetes and -50.2% and -10.6% for NGT, respectively).
Oral glucose intake causes suppression of serum CTX-I and OPG in postmenopausal women. The effect is attenuated in women with type 2 diabetes.
[Show abstract][Hide abstract] ABSTRACT: To investigate the relative contribution of dietary calcium intake on bone mineral density (BMD) and biochemical bone turnover markers in rural Thai women.
A cross-sectional investigation was designed in 255 rural Thai women. Usual dietary calcium intake was determined by 3-day food records and quantitative food-frequency questionnaire. BMD was measured by DXA. The three markers for bone turnover event: serum total alkaline phosphatase, serum N-mid osteocalcin and type I collagen C-telopeptide, including serum calcium and were determined in 125 women in the present study.
An average daily calcium intake in the present study was 265 mg/day. Two hundred and thirty three out of 255 women (87%) consumed dietary calcium less than half of the recommended value and only 3% of women (n = 7) had calcium intake > 800 mg/day. After controlling certain parameters: age and body mass index, women who consumed higher amount of dietary calcium had significantly higher BMD at all sites. Moreover highly increased bone turnover markers were observed in those with lowest quartile calcium intake. Women with osteopenia and osteoporosis were older, lower BMI, consumed less calcium and had significantly higher values of all biochemical bone turnover markers than those who had normal BMD.
The present study showed that a habitual diet of the rural Thai population might not provide enough calcium as needed for bone retention and for prevention of bone loss in the following years. Modification of eating pattern by promotion of increased consumption of locally available calcium rich food may be beneficial for prevention of osteoporosis among this population.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 04/2008; 91(3):295-302.
[Show abstract][Hide abstract] ABSTRACT: The present study examined the amount and relative contribution of calcium from the habitual diet among rural Thais.
Calcium intake was assessed using 3-day food records and interviewer-administered quantitative food-frequency questionnaire, containing 73 food items.
The authors recruited 436 healthy participants (181 men and 255 women), between 20 and 85 years of age. Averaged daily calcium intake among men and women were 378.6 and 265.6 mg, respectively. Sixty-seven percent of men and eighty seven percent of women had less dietary calcium intake than half of the recommended level (< 400 mg/day) whereas only 6 and 3% had an intake more than 800 mg/day. The major food sources of dietary calcium was glutinous rice (32 percent) followed by small animals with edible bones (31 percent) and fresh and fermented fish (20 percent). Dairy products and vegetables constituted only 8 and 5% of dietary calcium, respectively.
The habitual diet among rural Northeast Thais does not meet the recommended calcium intake level. To promote more consumption of dairy products and locally-available calcium-rich foods would be beneficial to prevent osteoporosis among this population.
Journal of the Medical Association of Thailand = Chotmaihet thangphaet 02/2008; 91(2):153-8.
[Show abstract][Hide abstract] ABSTRACT: To present data on the relationship between the concentration of thyroid-stimulating hormone (TSH) in whole blood or serum from neonates and the concentration of iodine in their mother's urine collected at birth to contribute to the contention that the recommended iodine intake during pregnancy should be increased.
Data were provided by current programmes of neonatal screening of congenital hypothyroidism in Bangkok and rural areas of Thailand.
A total of 5144 cord serum samples were collected in 2003 and measured for TSH concentrations. Paired samples of blood and urine were collected in 2000 from 203 infants and their mothers and from 1182 infant-mother pairs in 2002-03 in six rural provinces. Iodine was measured in the urine and TSH was measured in cord serum.
The urinary iodine concentration of mothers in rural Thailand is adequate, with a median of 103 microg l-1. However, in 2000, the median urinary iodine concentration of mothers in Bangkok was only 85 microg l-1. The concentration of TSH in whole blood collected on filter paper from neonates was not sensitive enough to be used as a monitoring tool for iodine nutrition in the neonates, as there was no relationship with the concentration of iodine in the urine of the children's mothers. This was in contrast to the concentration of TSH in serum collected from cord blood.
Several conclusions were drawn from this data: 1) Neonatal TSH screening using whole blood collected from a heel prick at 3 days of age is not sensitive enough to assess the iodine nutrition of neonates; 2) Neonatal TSH screening using cord sera can be used to assess iodine nutrition in neonates; 3) The optimum median maternal urinary iodine concentration in Thailand appears to be 103 microg l-1; 4) The criteria proposed by WHO, UNICEF, and ICCIDD to assess iodine nutrition using data on neonatal TSH concentrations should be reassessed; and 5) Neonatal TSH screening can be effectively performed by collecting cord serum in district hospitals in Thailand.
Public Health Nutrition 01/2008; 10(12A):1602-5. DOI:10.1017/S1368980007360990 · 2.48 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: An Asian-specific screening tool for osteoporosis, the so-called OSTA index, was devised and is likely to be helpful in determining which postmenopausal women need bone mineral density (BMD) measurement. Besides BMD, prevalent vertebral fracture is a strong risk factor for future fractures. However, the relationship of the OSTA index to prevalent vertebral fractures is currently unknown. In this study, we evaluated the performance of the OSTA index in elderly Thai women and assessed the relationship of the index to prevalent vertebral deformities. Subjects consisted of 741 healthy Thai elderly women. BMD was measured by DEXA and T-score <or=2.5 SD is defined as osteoporosis. Prevalent vertebral deformities were determined by morphometric X-ray absorptiometry. OSTA index >-1 is classified as having low risk of osteoporosis, -1 to -4 as intermediate risk and, <-4 as high risk. Data were expressed as mean +/- SD. The mean age and body weight of subjects were 67 +/- 4.8 years and 57.8 +/- 8.7 kg, respectively. The area under the ROC curve for OSTA index to identify osteoporosis at femoral neck and lumbar spine was 0.80 and 0.72, respectively. Femoral neck osteoporosis was found in 40.4%, 6.3%, and 2.4% of subjects with high-risk, intermediate-risk, and low-risk OSTA indexes, respectively. With regard to vertebral deformities, the area under the ROC curve relating OSTA index to vertebral deformities was 0.70 (P < 0.001). The prevalence of vertebral deformities in according to the OSTA index was 19.2% in the high-risk, 7.9% in the intermediate-risk, and 2.8% in the low-risk group. We concluded that the OSTA index can be of assistance in the selection of postmenopausal women for BMD measurement. In addition, this index may be helpful in the identification of postmenopausal women with vertebral deformity and those who need antifracture treatments.
Journal of Bone and Mineral Metabolism 01/2008; 26(1):47-52. DOI:10.1007/s00774-007-0796-2 · 2.11 Impact Factor