PubMed · 9713244
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1998. Streamlined bone measurement.. https://pubmed.ncbi.nlm.nih.gov/9713244/
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BACKGROUND: In a great many of observational studies, whether there is a relevance of resistin levels on bone mineral density (BMD) and fracture occurrence has been inconsistently reported, and the causality is unclear. METHODS: We aim to assess the resistin levels on BMD and fracture occurrence within a Mendelian randomization (MR) analysis. Exposure and outcome data were derived from the Integrative Epidemiology Unit (IEU) Open genome wide association studies (GWAS) database. Screening of instrumental variables (IVs) was performed subject to conditions of relevance, exclusivity, and independence. Inverse variance weighting (IVW) was our primary method for MR analysis based on harmonized data. Weighted median and MR-Egger were chosen to evaluate the robustness of the results of IVW. Simultaneously, heterogeneity and horizontal pleiotropy were also assessed and the direction of potential causality was detected by MR Steiger. Multivariable MR (MVMR) analysis was used to identify whether confounding factors affected the reliability of the results. RESULTS: After Bonferroni correction, the results showed a suggestively positive causality between resistin levels and total body BMD (TB-BMD) in European populations over the age of 60 [β(95%CI): 0.093(0.021, 0.165), P = 0.011]. The weighted median [β(95%CI): 0.111(0.067, 0.213), P = 0.035] and MR-Egger [β(95%CI): 0.162(0.025, 0.2983), P = 0.040] results demonstrate the robustness of the IVW results. No presence of pleiotropy or heterogeneity was detected between them. MR Steiger supports the causal inference result and MVMR suggests its direct effect. CONCLUSIONS: In European population older than 60 years, genetically predicted higher levels of resistin were associated with higher TB-BMD. A significant causality between resistin levels on BMD at different sites, fracture in certain parts of the body, and BMD in four different age groups between 0-60 years of age was not found in our study.
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The clinical presentation of primary hyperparathyroidism has changed considerably after the application of biochemical autoanalysers. The condition was previously found with characteristic symptoms in bone, kidneys and the gastrointestinal tract; less than 1% of patients were assumed to be asymptomatic. Today, most patients have mild and uncharacteristic symptoms. Primary hyperparathyroidism has been detected with increasing frequency in the western world, but there are large variations within demographically otherwise comparable areas. There are also regional differences regarding the incidence of surgical treatment of the disease. Demographic studies have shown increased morbidity and mortality primarily from cardiovascular and possibly malign diseases related to hypercalcemia. Follow-up studies based on surgical series have shown increased mortality related to preoperative serum calcium level. In view of the altered clinical picture of primary hyperparathyroidism, treatment of moderate and possibly "benign" primary hyperparathyroidism has been actualised. At an international consensus conference in 1990, this patient group was defined by an arbitrary serum calcium limit of 3.0 mmol/l, but this limit has been found to be unacceptably high. Regardless of where the upper limit is set, there are so far well accepted indications for surgery, but only one in two patients fulfil these criteria. A working group of endocrinologists and endocrine surgeons from nine university clinics in Scandinavia have recently initiated a prospective, randomised study evaluating surgical treatment and a systematic follow-up of patients with borderline primary hyperparathyroidism.