Clinical value of detection of serum β-Crosslaps, PINP and N-MID in postmenopausal women with osteoporosis

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Ou Mengmeng; Huang Jianrong

2011-01-01

To evaluate the clinical value of detection of concentration of β-Crosslaps, PINP and N-MID in postmenopausal women with osteoporosis, 116 postmenopausal women were detected by dual X-ray absorptionmetry and divided into NOP group (51 cases) and OP group (65 cases). The serum levels of three bone markers (β-Crosslaps, PINP and N-MID) were measured. The results showed that serum levels of β-Crosslaps, PINP and N-MID in OP group were significantly higher than that in NOP group (P<0.01). It was suggested that three bone markers level might be closely related with osteoporosis in postmenopausal women. The combined detection of bone markers and bone mineral density has important clinical value in the diagnosis of osteoporosis in postmenopausal women. (authors)

Bone turnover in postmenopausal osteoporosis. Effect of calcitonin treatment.

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Civitelli, R; Gonnelli, S; Zacchei, F; Bigazzi, S; Vattimo, A; Avioli, L V; Gennari, C

1988-10-01

To investigate the effectiveness of calcitonin treatment of postmenopausal osteoporosis in relation to bone turnover, we examined 53 postmenopausal osteoporotic women before and after one year of therapy with salmon calcitonin (sCT), at the dose of 50 IU every other day. Baseline evaluation revealed that 17 (32%) patients had high turnover (HTOP), and 36 (68%) normal turnover osteoporosis (NTOP) as assessed by measurement of whole body retention (WBR) of 99mTc-methylene diphosphonate. The two groups did not differ in terms of bone mineral content (BMC) measured by dual photon absorptiometry at both lumbar spine and femoral diaphysis. However, HTOP patients had higher levels of serum osteocalcin (OC) and urinary hydroxyproline excretion (HOP/Cr). Multivariate regression analysis showed no correlation between parameters of bone turnover (WBR, OC, HOP/Cr) and both femoral and vertebral bone density; the latter being negatively correlated only with the years elapsed since menopause (R2 = 0.406). Treatment with sCT resulted in a significant increase of vertebral BMC in the 53 patients taken as a whole group (+/- 7%, P less than 0.001). When the results obtained in HTOP and NTOP were analyzed separately, only those with HTOP showed a marked increment of spinal BMC (+22%, P less than 0.001), NTOP subjects neither gained nor lost bone mineral during the study. Femoral BMC decreased in the whole group after sCT therapy (-3%, P less than 0.003). However, HTOP patients maintained initial BMC values, whereas those with NTOP lost a significant amount of bone during the study period (-5%, P less than 0.001). The increase of vertebral bone mass was associated with a marked depression of bone turnover detectable in both subsets of patients and in the whole group. (a) assessment of bone turnover cannot help predict the severity of bone loss in postmenopausal osteoporosis; (b) calcitonin therapy appears to be particularly indicated for patients with high-turnover osteoporosis

Osteoporosis risk prediction for bone mineral density assessment of postmenopausal women using machine learning.

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Yoo, Tae Keun; Kim, Sung Kean; Kim, Deok Won; Choi, Joon Yul; Lee, Wan Hyung; Oh, Ein; Park, Eun-Cheol

2013-11-01

A number of clinical decision tools for osteoporosis risk assessment have been developed to select postmenopausal women for the measurement of bone mineral density. We developed and validated machine learning models with the aim of more accurately identifying the risk of osteoporosis in postmenopausal women compared to the ability of conventional clinical decision tools. We collected medical records from Korean postmenopausal women based on the Korea National Health and Nutrition Examination Surveys. The training data set was used to construct models based on popular machine learning algorithms such as support vector machines (SVM), random forests, artificial neural networks (ANN), and logistic regression (LR) based on simple surveys. The machine learning models were compared to four conventional clinical decision tools: osteoporosis self-assessment tool (OST), osteoporosis risk assessment instrument (ORAI), simple calculated osteoporosis risk estimation (SCORE), and osteoporosis index of risk (OSIRIS). SVM had significantly better area under the curve (AUC) of the receiver operating characteristic than ANN, LR, OST, ORAI, SCORE, and OSIRIS for the training set. SVM predicted osteoporosis risk with an AUC of 0.827, accuracy of 76.7%, sensitivity of 77.8%, and specificity of 76.0% at total hip, femoral neck, or lumbar spine for the testing set. The significant factors selected by SVM were age, height, weight, body mass index, duration of menopause, duration of breast feeding, estrogen therapy, hyperlipidemia, hypertension, osteoarthritis, and diabetes mellitus. Considering various predictors associated with low bone density, the machine learning methods may be effective tools for identifying postmenopausal women at high risk for osteoporosis.

An assessment of osteoporosis and low bone density in postmenopausal

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Hafeez, F.; Khurshid, R.

2009-01-01

Assessment of bone mineral density and other risk factors of osteoporosis in postmenopausal age group of Pakistani population and to compare them with premenopausal group. The risk factors of osteoporosis were studied both in premenopausal and postmenopausal groups. These risk factors can be exogenous or endogenous. Endogenous risk factors are aging, altered menstrual status, low bone mass, positive family history and oestrogen deficiency. Exogenous factors include lack of adequate nutrition (milk, calcium, vitamin D etc.) and lack of physical exercise. These risk factors were evaluated by taking history, recording height and weight, doing blood parameters and checking bone mineral density. Oestrogen level was carried out by the Eliza technique. Bone mass density was carried out by the bone heel densitometer. The data was analyzed statistically and the values of two groups were compared. The risk factors in postmenopausal group were low BMD, low oestrogen levels, poor intake of milk and calcium and lack of physical exercise. All women should get checked their BMD in this age group. Regular exercise and adequate calcium intake can still help in postmenopausal age group. (author)

[Parity and menarche as risk factors of osteoporosis in postmenopausal Mexican women].

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Mendoza-Romo, Miguel Angel; Ramírez-Arriola, María Cleofas; Velasco-Chávez, José Fernando; Rivera-Martínez, José Guillermo; Nieva-de Jesús, Rafael Natividad; Valdez-Jiménez, Luis Alvaro

2013-03-01

At the moment the studies lead at world-wide level and even in our country have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. To investigate the relation of osteoporosis in postmenopausal Mexican women with multiparity and age of menarche. A retrospective and analytical cross-sectional study, with a non-probabilistic sampling technique in women rightful claimants of the IMSS, San Luis Potosi. In all of them the bone mineral density was measured with X-ray dual absorptiometry in the distal forearm. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche ( or = 13 yrs). 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria of the World Health Organization, 18% of postmenopausal women had osteoporosis, 39% had osteopenia and 43% had bone normality. No association was found between the number of pregnancies and osteoporosis. Additionally we observed that the women who had four or more children were older than the other women, average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. We found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46, p: 0.035). In postmenopausal women a menarche older than 13 years is a risk factor for osteoporosis.

Quality of life in post-menopausal osteoporosis

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Ortolani Sergio

2005-12-01

Full Text Available Abstract Background To evaluate the impact of osteoporosis on the patients' quality of life, particularly in the absence of fractures. Methods 100 post-menopausal women (age 50-85 - 62 with uncomplicated primary osteoporosis and 38 with primary osteoporosis complicated by vertebral fractures; all already treated - were studied using two validated questionnaires: Qualeffo-41 for quality of life in osteoporosis, and Zung for depression. Data were compared to those of 35 controls of comparable age, affected by a different chronic disease (hypothyroidism. Results Family history of osteoporosis and T-score of spine were similar in the two subgroups of osteoporotic women. Body mass index, age at menopause and education level were similar in the two subgroups of osteoporotic women and in the control group. The patients affected by osteoporosis perceived it as a disease affecting their personal life with undesirable consequences: chronic pain (66% of women with fractures and 40% of women without fractures, impaired physical ability, reduced social activity, poor well-being (21% of women without fractures and depressed mood (42% of women irrespective of fractures. Overall, 41% of the women showed a reduced quality of life. On the contrary, in the control group only 11% reported a reduced quality of life. Conclusion The quality of life of osteoporotic patients should be investigated even before fractures, in order to develop appropriate counselling, support and care interventions to help patients develop efficient strategies for accepting the disease and coping with it.

Is grand multiparity a risk factor for the development of postmenopausal osteoporosis?

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Peker N

2018-03-01

Full Text Available Nuri Peker,1 Özge Çeliker Tosun2 1Department of Obstetrics and Gynecology, İstinye University Bahçeşehir Liv Hospital, Istanbul, Turkey; 2School of Physiotherapy, Dokuz Eylul University, Izmir, Turkey Objective: In this study, we investigated the relationship between the development of postmenopausal osteoporosis and parity.Materials and methods: The retrospective study included 129 postmenopausal women who were divided into three groups depending on the number of parity: Group I,<5; Group II, 5–9; and Group III, ≥10. The mean age of the subjects was 57.71±5.02 years.Results: No significant difference was found among the three groups regarding body mass index values, duration of menopause, mean thyroid stimulating hormone values and frequency of diabetes. Among the three groups, no significant difference was found in terms of the frequency of lumbar osteoporosis (p>0.05, whereas a significant difference was found regarding the frequency of femoral osteoporosis (p=0.012; p<0.05.Conclusion: It was revealed that femoral bone mineral density significantly decreased as the number of parity increased. Keywords: menopause, osteoporosis, parity

Associations Between Reported Dietary Sodium Intake and Osteoporosis in Korean Postmenopausal Women: The 2008-2011 Korea National Health and Nutrition Examination Survey.

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Kim, Yunmi; Kim, Hyun-Young; Kim, Jung Hwan

2017-07-01

Osteoporosis is prevalent among postmenopausal women, and increasing evidence has linked salt intake with this disease. In this article, we explored the association between dietary sodium intake and osteoporosis in Korean postmenopausal women. We analyzed data for 3635 postmenopausal women extracted from the 2008-2011 Korea National Health and Nutrition Examination Survey. We found that 1542 participants (42.4%) have osteoporosis. The adjusted prevalence rates of osteoporosis at the lumbar spine were significantly higher in participants who consumed ≥4001 mg of salt than those who consumed ≤2000 mg. At the femoral neck, rates were significantly higher for those who consumed ≥5001 mg compared with those who consumed ≤4000 mg. Participants with a higher sodium intake showed a significantly higher odds ratio of developing lumbar and femoral neck osteoporosis, compared with those with a lower intake. Our results suggest that excessive daily sodium intake is associated with a higher osteoporosis prevalence in Korean postmenopausal women.

HYPERTENSION AND OSTEOPOROSIS IN POSTMENOPAUSAL WOMEN

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Marina Rašić Popović

2009-04-01

Full Text Available Hypertension is a frequent, chronic cardiovascular disease both in industrially developed and developing countries; its frequency ranges between 20 and 40 %. Although the prevalence of hypertension in women is lower than that in men, it reaches 70% to 80% in women above 70 years of age, and is a strong predictor of cardiovascular risk. Osteoporosis (OP is systematic skeletal disorder with lower bone mass and damages of bone tissue microarchitecture. The aim of this study was to ascertain the association between hypertension and osteoporosis as two mass noninfectious deceases.The examination involved three hundred postmenopausal women who came for densitometry inspection; none of them had some major cardiovascular event (myocardial infarction, cerebrovascular stroke and ischemic heart disease. From all of them were taken personal data, personal and familial case histories. The parameters used in the further analysis were: body mass, body height, waist circumference, blood pressure; laboratory analysis: cholesterol, HDL, LDL, glycemia, Ca and P in serum and Ca in urine. In addition, there was calculated a ten-year risk of cardiovascular event according to SCORE system, using tables for high risk; bone mineral density on Hologic Discovery QDR-C was shown as T score on the lumbar part of the spinal column. The patients were divided into tree groups based on the measures of bone density: the patients with osteoporosis - bone density with T score lower than 2.5 SD (100 patients; patients with osteopenia - T score from -1 to -2,5 SD (100, and control group of patients with normal bone density T score from +1 to -1 SD (100.The mean age of postmenopausal women (control group with normal bone density was 54.10±3.90 years; 56.63±4.76 years in the group with osteopenia (group II; and 60.14±3.55 years in the group of postmenopausal women with osteoporosis.The analysis of variance (ANOVA and post hoc Dunett`s test showed that there were statistically

Bisphosphonate drug holidays in postmenopausal osteoporosis: effect on clinical fracture risk.

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Mignot, M A; Taisne, N; Legroux, I; Cortet, B; Paccou, J

2017-12-01

A cohort of 183 postmenopausal women, who had either discontinued or continued bisphosphonates (BPs) after first-line therapy, was used to investigate the relationships between "drug holiday" and clinical fracture. The risk of new clinical fractures was found to be 40% higher in women who had taken a BP "drug holiday." BPs are the most widely used treatment for postmenopausal osteoporosis. The optimal treatment duration, however, remains unclear. The purpose of this study was to evaluate the fracture risk in postmenopausal women with osteoporosis after discontinuing BP treatment (BP "drug holiday"). A retrospective analysis was performed at Lille University Hospital (LUH) on postmenopausal women with osteoporosis who had taken a "drug holiday" or continued treatment after first-line BP therapy (3 to 5 years). The occurrence of new clinical fractures during follow-up was also explored. Cox proportional hazards models were used to investigate the relationships between BP "drug holiday" and the occurrence of clinical fractures, while controlling for confounding factors. Survival without new clinical fractures was analyzed using Kaplan-Meier curves and log-rank tests. One hundred eighty-three women (mean age: 61.8 years; SD: 8.7) who had previously undergone BP treatment for 3 to 5 years were enrolled in our study. The patients had received alendronate (n = 81), risedronate (n = 73), zoledronic acid (n = 20), and ibandronate (n = 9). In 166 patients ("drug holiday" group: n = 31; continuous-treatment group: n = 135), follow-up ranged from 6 to 36 months (mean duration: 31.8 months; SD: 8.2). The incidences of new clinical fractures during follow-up were 16.1% (5/31) and 11.9% (16/135). After full adjustment, the hazard ratio of new clinical fractures among "drug holiday" patients was 1.40 (95% CI: 1.12-1.60; p = 0.0095). After first-line BP therapy in postmenopausal women with osteoporosis, the risk of new clinical fractures was 40% higher in

Physical activity and osteoporotic fractures in postmenopausal women with osteoporosis in Serbia

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Karadzov-Nikolic Aleksandra

2012-03-01

Full Text Available Introduction: Physical activity in postmenopausal women can slow bone loss and reduce the risk of osteoporotic fractures. Purpose: Analysis of the incidence of fractures in postmenopausal women with osteoporosis in relation to physical activity. Methods: This paper represents a retrospective multicenter study of postmenopausal women with newly found osteoporosis from August 2008 until November 2011. All data concerning the patients were taken from the National Register for Osteoporosis. Patients were divided into two groups: in the first group were physically active and in the second, physically inactive patients. Physical activity included dancing, active or recreational sports, fast walking, running, jumping and lifting. Results: The study included 363 respondents, mean age 64.4 ± 8.6 years, of whom 155 (42.7% were physically active, and 208 (57.3% physically inactive. 86 (23.7% patients had spontaneous single fractures, 23 (14.8% in the physically active group and 63 (30.3% in the physically inactive group, which was statistically significant difference in frequency (p = 0.001. Respondents with multiple spontaneous fractures were separated in a special group and were not included in the above analysis. 21 patients had spontaneous multiple fractures, of whom 4 (2.5% physically active and 17 (7.55% physically inactive, which was statistically significant difference in frequency (p = 0.032. Conclusion: Spontaneous single and multiple fractures are significantly more frequent with physically inactive subjects.

Incidence Rate of Concomitant Systemic Diseases in the Aging Population with Postmenopausal Osteoporosis

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Selçuk Sayılır

2016-08-01

Full Text Available Objective: To evaluate the concomitant systemic diseases with postmenopausal osteoporosis and to investigate the points to be considered in treatment approach of patients with osteoporosis. Materials and Methods: The study included 110 female patients admitted to our clinic and followed up after postmenopausal osteoporosis diagnosis. Besides the demographic data; the concomitant diseases of the patients such as hypertension, hypo-hyperthyroidism, diabetes mellitus, Alzheimer’s disease, malignancy, osteoarthritis, gastrointestinal system diseases, chronic obstructive pulmonary disease (COPD- asthma and depression were also recorded. Results: The mean age of the patients included in our study was 65.9±9.8 years. When the concomitant systemic diseases were examined; 40 patients had hypertension, 32 patients had osteoarthritis, 24 patients had gastrointestinal tract problems, 22 patients had thyroid disease, 21 patients had depression, 15 patients had hyperlipidemia, 12 patients had diabetes mellitus, 10 patients had COPD - asthma, 7 patients had cardiac diseases, 5 patients had malignancy and 2 patients had Alzheimer disease. Conclusion: Osteoporosis is a common disease in the geriatric population. As a chronic disease with an increasing incidence with aging; it can cause many health problems, prevalently pathological bone fractures, in our country and all over the world. Constitutively, prophylaxis of osteoporosis should be the first step. Because systemic diseases with increasing incidence with aging may affect the severity of osteoporosis and impair the treatment; it is important for both clinicians and the society to have sufficient information about osteoporosis.

[High prevalence of osteoporosis in asymptomatic postmenopausal Mapuche women].

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Ponce, Lucía; Larenas, Gladys; Riedemann, Pablo

2002-12-01

Genetic and environmental factors are responsible for variations in the frequency of osteoporosis. Prevalence of osteoporosis in Mapuche women (native Chileans) is unknown. To assess the prevalence and risk factors for osteoporosis in Mapuche women. A random sample of 95 asymptomatic postmenopausal Mapuche females, stratified by age, was studied. Women with diseases or medications that could interfere with calcium metabolism were excluded. Spine and femoral neck bone mass density was determined using a Lunar DPX Alpha densitometer. Seventeen percent of women had normal bone mineral density in both spine and femoral neck. In the spine, 25.3% had a normal bone mineral density, 17.9% had osteopenia and 56.8% had osteoporosis. In the femoral neck, 34.7% had a normal bone mineral density, 57.9% had osteopenia, and 7.4% had osteoporosis. There was a positive correlation between bone mineral density and body mass index. Women with more than one hour per day of physical activity, had a significantly lower proportion of osteopenia or osteoporosis. No association between bone mineral density and parity or calcium intake, was observed. There is a high prevalence of osteopenia and osteoporosis among Mapuche women. Osteoporosis was associated with low body mass index.

The hormonal form of vitamin D in the pathophysiology and therapy of postmenopausal osteoporosis.

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Caniggia, A; Nuti, R; Loré, F; Vattimo, A

1984-08-01

Sixty-two women with symptomatic postmenopausal osteoporosis underwent long-term treatment with 1,25-dihydroxyvitamin D3. The following results were obtained: i) a dramatic improvement of the intestinal transport of radioactive calcium, which was impaired prior to the treatment; ii) non significant increases in fasting serum calcium; iii) significant increases in the 24 h urinary excretion of calcium and phosphate, resulting from the improvement of intestinal calcium absorption, and a decrease in the urinary cAMP/Cr ratio; iv) non significant changes in serum phosphate, serum alkaline phosphatase, urinary hydroxyproline; v) non significant increases in bone mineral content; vi) relief from pain and improvement of motility in all the patients; vii) no side effect was noticed. In conclusion the treatment with 1,25-dihydroxyvitamin D3 was shown to be useful in postmenopausal osteoporosis.

Effects of 1,25-dihydroxycholecalciferol on 47calcium absorption in post-menopausal osteoporosis.

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Caniggia, A; Vattimo, A

1979-07-01

Measurement of 47Calcium absorption was performed on eleven women with post-menopausal osteoporosis. The study was repeated after 10 days treatment with 1 microgram daily of 1,25(OH)2D3. These patients showed a statistically significant improvement of fractional calcium absorption that was inversely correlated to the basal values. The prompt improvement of the intestinal calcium transport in post-menopausal osteoporotic women, a few days after the administration of physiological doses of 1,25(OH)2D3, suggests that these patients synthesize inappropriately small amounts of 1,25(OH)2D3 because of their oestrogen deficiency. This could be an important pathogenetic factor in post-menopausal osteoporosis, as the efficiency of the adaptation of calcium absorption to low calcium intakes is dependent on 1,25(OH)2D3.

Fractal dimension analysis in digital periapical radiographs: A diagnostic indicator of osteoporosis in post-menopausal women

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Mathivanan Kavitha

2017-01-01

Full Text Available Objectives: To assess the alveolar bone density by fractal dimension (FD analysis in radiovisiograph of postmenopausal women of mandibular posterior region and to correlate FD values with t-scores of quantitative ultrasound of the calcaneus bone. Materials and Methods: This study, approved by the institutional review board, included 40 participants, aged 45–60 years divided into two groups. Twenty postmenopausal women with osteoporosis comprised group 1, and 20 postmenopausal women without osteoporosis comprised group 2 based on bone mineral density assessment of ultrasound of the calcaneus bone. Digital dental radiograph of mandibular first molar were obtained and used for assessing alveolar bone density by FD analysis and were correlated with t-scores of ultrasound of calcaneus bone. Results: The mean FD values were evaluated using SPSS 14 version software, and were found to be 1.738 and 1.867 for group 1 and group 2, respectively, which was statistically significant (P 0.05. Conclusion: FD analysis using direct digital periapical radiographs is a novel method, which can be used for early diagnosis of osteoporosis in the alveolar bone.

[Effects of tai chi in postmenopausal women with osteoporosis: a systematic review].

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Chang, Ting-Jung; Ting, Yu-Ting; Sheu, Shei-Lan; Chang, Hsiao-Yun

2014-10-01

Tai chi has been increasingly applied in osteoporosis patients. However, systematic reviews of the efficacy of this practice have been few and of limited scope. This study reviews previous experimental research work using tai chi as an intervention in postmenopausal women with osteoporosis and to appraise the reported research designs used, tai chi methods used, and outcomes. A systematic review method was used to search 14 databases for articles published between January 1980 and July 2013. Searched keywords included: "tai chi," "osteoporosis," and "postmenopausal women". The 2,458 articles initially identified were reduced to 4 valid articles based on considerations of criteria and repeatability. The 4 valid articles used either a randomized clinical trial (RCT) or a controlled clinical trial (CCT). They were further analyzed and synthesized in terms of common variables such as balance, muscle strength, and quality of life. Three of the 4 studies identified significant pretest / posttest differences in physiological aspects of quality of life in participants but did not obtain consistent results in terms of the psychological aspects. While reports identified a significant and positive tai chi effect on balance, they all used different measurements to do so. Only one of the four studies identified significant improvement in muscle strength. Therefore, this review could not identify clear support for the effectiveness of tai chi on balance or muscle strength. This review did not definitively support the positive effects of tai chi on balance, muscle strength, and quality of life in postmenopausal women with osteoporosis. The designs used in the tai chi interventions may be referenced for future studies. We suggest that future studies use data triangulation rather than a single-item tool to validate the research in order to cross-verify the same information. This may strengthen the research and increase the credibility and the validity of related findings.

Bone mass regulation of leptin and postmenopausal osteoporosis with obesity.

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Legiran, Siswo; Brandi, Maria Luisa

2012-09-01

Leptin has been known to play a role in weight regulation through food intake and energy expenditure. Leptin also has an important role in bone metabolism. The role of leptin is determined by leptin receptors, either central or peripheral to the bones. We discuss the role of leptin on bone and molecular genetics of osteoporosis in postmenopausal obese women. The role of leptin in bone preserves bone mineral density (BMD) through increased OPG levels leading to bind RANKL, resulting in reducing osteoclast activity. The estrogen role on bone is also mediated by RANKL and OPG. In postmenopausal women who have estrogen deficiency, it increases the rate of RANKL, which increases osteoclastogenesis. Obese individuals who have a high level of leptin will be effected by bone protection. There are similarities in the mechanism between estrogen and leptin in influencing the process of bone remodeling. It may be considered that the role of estrogen can be replaced by leptin. Molecular genetic aspects that play a role in bone remodeling, such as leptin, leptin receptors, cytokines (e.g. RANK, RANKL, and OPG), require further study to be useful, especially regarding osteoporosis therapy based on genetic analysis.

Follicle-Stimulating Hormone Increases the Risk of Postmenopausal Osteoporosis by Stimulating Osteoclast Differentiation.

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Jie Wang

Full Text Available The objectives of this study were to observe the changes in follicle-stimulating hormone (FSH and bone mineral density (BMD in postmenopausal women, to research the relationship between FSH and postmenopausal osteoporosis, and to observe the effects of FSH on osteoclast differentiation in RAW264.7 cells.We analyzed 248 postmenopausal women with normal bone metabolism. A radioimmunoassay (RIA was used to detect serum FSH, luteinizing hormone (LH, and estradiol (E2. Dual-energy X-ray absorptiometry was used to measure forearm BMD. Then, we analyzed the age-related changes in serum FSH, LH and E2. Additionally, FSH serum concentrations were compared between a group of postmenopausal women with osteoporosis and a control group. Osteoclasts were induced from RAW264.7 cells in vitro by receptor activator of nuclear factor kappa B ligand (RANKL, and these cells were treated with 0, 5, 10, and 20 ng/ml FSH. After the osteoclasts matured, tartrate-resistant acid phosphatase (TRAP staining was used to identify osteoclasts, and the mRNA expression levels of genes involved in osteoclastic phenotypes and function, such as receptor activator of NF-κB (Rank, Trap, matrix metalloproteinase-9 (Mmp-9 and Cathepsin K, were detected in different groups using real-time PCR (polymerase chain reaction.1. FSH serum concentrations in postmenopausal women with osteoporosis increased notably compared with the control group. 2. RANKL induced RAW264.7 cell differentiation into mature osteoclasts in vitro. 3. FSH increased mRNA expression of genes involved in osteoclastic phenotypes and function, such as Rank, Trap, Mmp-9 and Cathepsin K, in a dose-dependent manner.The circulating concentration of FSH may play an important role in the acceleration of bone loss in postmenopausal women. FSH increases osteoclastogenesis in vitro.

Effects of growth hormone administration on bone mineral metabolism, PTH sensitivity and PTH secretory rhythm in postmenopausal women with established osteoporosis.

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Joseph, Franklin; Ahmad, Aftab M; Ul-Haq, Mazhar; Durham, Brian H; Whittingham, Pauline; Fraser, William D; Vora, Jiten P

2008-05-01

Growth hormone (GH) replacement improves target organ sensitivity to PTH, PTH circadian rhythm, calcium and phosphate metabolism, bone turnover, and BMD in adult GH-deficient (AGHD) patients. In postmenopausal women with established osteoporosis, GH and insulin like growth factor-1 (IGF-1) concentrations are low, and administration of GH has been shown to increase bone turnover and BMD, but the mechanisms remain unclear. We studied the effects of GH administration on PTH sensitivity, PTH circadian rhythm, and bone mineral metabolism in postmenopausal women with established osteoporosis. Fourteen postmenopausal women with osteoporosis were compared with 14 healthy premenopausal controls at baseline that then received GH for a period of 12 mo. Patients were hospitalized for 24 h before and 1, 3, 6, and 12 mo after GH administration and half-hourly blood and 3-h urine samples were collected. PTH, calcium (Ca), phosphate (PO(4)), nephrogenous cyclic AMP (NcAMP), beta C-telopeptide of type 1 collagen (betaCTX), procollagen type I amino-terminal propeptide (PINP), and 1,25-dihydroxyvitamin D [1,25(OH)(2)D] were measured. Circadian rhythm analysis was performed using Chronolab 3.0 and Student's t-test and general linear model ANOVAs for repeated measures were used where appropriate. IGF-1 concentration was significantly lower in the women with established osteoporosis compared with controls (101.5 +/- 8.9 versus 140.9 +/- 10.8 mug/liter; p bone mineral metabolism. GH administration to postmenopausal osteoporotic women improves target organ sensitivity to PTH and bone mineral metabolism and alters PTH secretory pattern with greater increases in bone formation than resorption. These changes, resulting in a net positive bone balance, may partly explain the mechanism causing the increase in BMD after long-term administration of GH in postmenopausal women with osteoporosis shown in previous studies and proposes a further component in the development of age

Serum 25-hydroxyvitamin D and bone turnover markers in Palestinian postmenopausal osteoporosis and normal women.

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Kharroubi, Akram; Saba, Elias; Smoom, Riham; Bader, Khaldoun; Darwish, Hisham

2017-12-01

This study evaluated the association of vitamin D and bone markers with the development osteoporosis in Palestinian postmenopausal women. Even though vitamin D deficiency was very high for the recruited subjects, it was not associated with osteoporosis except for bones of the hip. Age and obesity were the strongest determining factors of the disease. The purpose of this study was to investigate the association of bone mineral density (BMD) with serum vitamin D levels, parathyroid hormone (PTH), calcium, obesity, and bone turnover markers in Palestinian postmenopausal women. Three hundred eighty-two postmenopausal women (≥45 years) were recruited from various women clinics for BMD assessment (131 women had osteoporosis and 251 were normal and served as controls). Blood samples were obtained for serum calcium, PTH, 25(OH)D, bone formation (N-terminal propeptide (PINP)), and bone resorption (serum C-terminal telopeptide of type I collagen (CTX1)) markers. Women with osteoporosis had statistically significant lower mean weight, height, body mass index (BMI), and serum calcium (p osteoporosis decreased with increasing BMI (overweight OR = 0.11, p = 0.053; obese OR = 0.05, p = 0.007). There was no direct correlation between BMD and PTH, bone turnover markers, and vitamin D except at the lumbar spine. A negative correlation between BMD and age and a positive correlation with BMI were observed. The protective effect of obesity on osteoporosis was complicated by the effect of obesity on vitamin D and PTH.

Association between Dental Health and Osteoporosis: A Study in South Indian Postmenopausal Women.

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Kapoor, Nitin; Cherian, Kripa Elizabeth; Pramanik, Binay Kumar; Govind, S; Winford, Manna Elizabeth; Shetty, Sahana; Thomas, Nihal; Paul, Thomas Vizhalil

2017-01-01

This study aims to objectively assess the dentition status in South Indian postmenopausal women and compare the dental health of osteoporotic participants with nonosteoporotic individuals. A total of 150 consecutive ambulatory South Indian postmenopausal women (>50 years of age) were assessed for their dental health using an internationally validated scoring system. Bone mineral density (BMD) was assessed using a dual-energy X-ray absorptiometry scanner. About 39% of the participants were found to have osteoporosis and 23% had osteopenia at any site. More than half of them (57%) had poor dental health, and the predominant problems were cavities (43.5%) and loss of teeth (75%). Among 112 women who had tooth loss, the mean tooth loss was 4.8. The mean tooth loss among patients with normal BMD was 1.09 ± 1.2, in osteopenia was 2.1 ± 2, and in osteoporosis was 5.4 ± 2.8 ( P women with osteoporosis had significantly higher number of tooth loss. Tooth loss may thus be used as a surrogate marker to predict osteoporosis.

Does vitamin K2 play a role in the prevention and treatment of osteoporosis for postmenopausal women: a meta-analysis of randomized controlled trials.

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Huang, Z-B; Wan, S-L; Lu, Y-J; Ning, L; Liu, C; Fan, S-W

2015-03-01

To identify the role of vitamin K2 for the prevention and treatment of osteoporosis in postmenopausal women, we conducted this meta-analysis of 19 randomized controlled trials. Our results showed that vitamin K2 might play a role in maintaining the bone mineral density and in reducing the incidence of fractures for postmenopausal women with osteoporosis. Vitamin K2 has been revealed to be effective in the prevention and treatment of osteoporosis in Japan, which was not confirmed in western countries. Thus, we conduct this meta-analysis to verify the hypothesis that vitamin K2 plays a role in the prevention and treatment of osteoporosis for postmenopausal women. We searched the Cochrane Library, Pub Med, EMBASE, and ISI web of knowledge (until December 1, 2013) and reference lists of eligible articles. A meta-analysis of all-including randomized controlled trials was then performed. Nineteen randomized controlled trials encompassing 6759 participants have met the inclusion criteria. Subgroup analysis of postmenopausal women with osteoporosis revealed a significant improvement of vertebral BMD for both medium-term and long-term results favoring vitamin K2 group (p K2 (RR = 0.63, p = 0.08). However, sensitivity analysis by rejecting the study inducing heterogeneity demonstrated a significant difference in the incidence of fractures favoring vitamin K2 (RR = 0.50, p = 0.0005). Significant differences were found in undercarboxylated osteocalcin reduction and osteocalcin increment. The result of adverse reaction analysis showed that vitamin K2 group seemed to have a higher adverse reaction rate (RR = 1.22, p = 0.06). This meta-analysis seemed to support the hypothesis that vitamin K2 plays kind of a role in the maintenance and improvement of vertebral BMD and the prevention of fractures in postmenopausal women with osteoporosis. The reduction of undercarboxylated osteocalcin and increment of osteocalcin may have some relation to the process of bone mineralization

Rationale and design of MUSIC OS-EU: an international observational study of the treatment of postmenopausal women for osteoporosis in Europe and Canada.

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Modi, Ankita; Sen, Shuvayu; Adachi, Jonathan D; Adami, Silvano; Cortet, Bernard; Cooper, Alun L; Geusens, Piet; Mellström, Dan; Weaver, Jessica P; van den Bergh, Joop P; Nguyen, Allison M; Keown, Paul A; Leung, Albert T; Sajjan, Shiva

2015-01-01

The Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC OS-EU) was designed to better understand the rate and burden of gastrointestinal (GI) events on clinical and health care outcomes among postmenopausal women with osteoporosis. MUSIC OS-EU is a prospective, multinational, observational cohort study of postmenopausal women ≥50 years of age diagnosed with osteoporosis and enrolled in physician clinics in six countries: France, Italy, the Netherlands, Sweden, the United Kingdom, and Canada. The MUSIC OS-EU study has three components: (i) a physician survey to describe their management of osteoporotic patients with GI events; (ii) a retrospective chart survey to describe the receipt and type of osteoporosis medication prescribed; and (iii) a prospective cohort study including untreated and treated patients diagnosed with osteoporosis to investigate the rate of GI events and association with osteoporosis medication use patterns, health-related quality of life, treatment satisfaction and resource utilisation among postmenopausal women with osteoporosis. Physicians at 97 sites completed the physician questionnaire and data for 716 patients were abstracted for the retrospective chart review. Enrolment and the baseline data collection for the prospective cohort study were conducted between March 2012 and June 2013 for 292 untreated and 2,959 treated patients, of whom 684 were new users and 2,275 were experienced users of oral osteoporosis medications. The results of MUSIC OS-EU will illuminate the association of GI events with the management of osteoporosis and with patient-reported outcomes among postmenopausal women with osteoporosis in Europe and Canada.

Use of cone beam computed tomography in identifying postmenopausal women with osteoporosis.

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Brasileiro, C B; Chalub, L L F H; Abreu, M H N G; Barreiros, I D; Amaral, T M P; Kakehasi, A M; Mesquita, R A

2017-12-01

The aim of this study is to correlate radiometric indices from cone beam computed tomography (CBCT) images and bone mineral density (BMD) in postmenopausal women. Quantitative CBCT indices can be used to screen for women with low BMD. Osteoporosis is a disease characterized by the deterioration of bone tissue and the consequent decrease in BMD and increase in bone fragility. Several studies have been performed to assess radiometric indices in panoramic images as low-BMD predictors. The aim of this study is to correlate radiometric indices from CBCT images and BMD in postmenopausal women. Sixty postmenopausal women with indications for dental implants and CBCT evaluation were selected. Dual-energy X-ray absorptiometry (DXA) was performed, and the patients were divided into normal, osteopenia, and osteoporosis groups, according to the World Health Organization (WHO) criteria. Cross-sectional images were used to evaluate the computed tomography mandibular index (CTMI), the computed tomography index (inferior) (CTI (I)) and computed tomography index (superior) (CTI (S)). Student's t test was used to compare the differences between the indices of the groups' intraclass correlation coefficient (ICC). Statistical analysis showed a high degree of interobserver and intraobserver agreement for all measurements (ICC > 0.80). The mean values of CTMI, CTI (S), and CTI (I) were lower in the osteoporosis group than in osteopenia and normal patients (p < 0.05). In comparing normal patients and women with osteopenia, there was no statistically significant difference in the mean value of CTI (I) (p = 0.075). Quantitative CBCT indices may help dentists to screen for women with low spinal and femoral bone mineral density so that they can refer postmenopausal women for bone densitometry.

Yoga might be an alternative training for the quality of life and balance in postmenopausal osteoporosis.

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Tüzün, S; Aktas, I; Akarirmak, U; Sipahi, S; Tüzün, F

2010-03-01

Osteoporotic vertebra and hip fractures are major causes of dysfunction, disability, mortality and impaired life quality in the ageing population. In the postmenopausal period, exercises prevent rapid bone loss and increase muscle strength, mobility and flexibility thereby decreasing the risk of falls and fractures. Yoga exercises, which have been an inseparable part of Eastern culture for hundreds of years, are now being used in the field of osteoporosis rehabilitation. Yoga has a positive effect on balance, posture, flexibility, and life quality resulting from its effects on balance, stretching, relaxation and strengthening. The aim of this study was to evaluate the effect of yoga exercises in postmenopausal osteoporotic women on balance and life quality and to compare the results with a classic osteoporosis exercise program. Twenty-six postmenopausal osteoporotic women over 55 years of age were included in the study. A neuromuscular test battery and the QUALEFFO as a life quality index were used for the assessment of balance and life quality, respectively. The results showed that yoga education has a positive effect on pain, physical functions, social functions, general In conclusion, yoga appears to be an alternative physical activity for the rehabilitation of osteoporotic subjects.

Serum carotenoid concentrations in postmenopausal women from the United States with and without osteoporosis.

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Yang, Zhifang; Zhang, Zhumin; Penniston, Kristina L; Binkley, Neil; Tanumihardjo, Sherry A

2008-05-01

Antioxidant defenses may be compromised in osteoporotic women. Little is known about fruit and vegetable or carotenoid consumption among postmenopausal women. The primary carotenoids in human serum are alpha- and beta-carotene, lycopene, beta-cryptoxanthin, lutein, and zeaxanthin. This study investigated the interrelationships among serum carotenoid concentrations, fruit and vegetable intake, and osteoporosis in postmenopausal women (n = 59, 62.7 +/- 8.8 y). Bone density was assessed by dual energy x-ray absorptiometry and osteoporosis diagnosis was based upon T-scores. Serum samples (n = 53) and three-day diet records (n = 49) were analyzed. Logistic regression analyzed differences between carotenoids after adjusting for serum retinol; supplement usage; milk, yogurt, fruit, and vegetable intake; and body mass index (BMI). Pearson statistics correlated carotenoids with specific fruit or vegetable intake. Serum lycopene concentrations were lower in the osteoporosis group than controls (p = 0.03). Beta-cryptoxanthin intake was higher in the osteoporosis group (p = 0.0046). Total fruit and vegetable intakes were correlated with serum lycopene and beta-cryptoxanthin (p = 0.03, 0.006, respectively). Serum alpha-carotene concentration was associated with carrot intake, and zeaxanthin and beta-cryptoxanthin with lettuce intake. Carotenoids that may have beneficial skeletal effects are lower in women with osteoporosis. Research is needed to identify potential protective mechanisms or utilization of carotenoids during osteoporosis.

Quality of life in women with postmenopausal osteoporosis: correlation between QUALEFFO 41 and SF-36.

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de Oliveira Ferreira, Néville; Arthuso, Michael; da Silva, Raimunda; Pedro, Adriana Orcesi; Pinto Neto, Aarão Mendes; Costa-Paiva, Lucia

2009-01-20

To evaluate quality of life (QoL) in women with postmenopausal osteoporosis, correlating the QUALEFFO 41 with the short-form health survey 36 (SF-36) and evaluated some factors that can influenced the QoL of women with osteoporosis. A cross-sectional study was conducted in 220 postmenopausal women (ages ranging from 55 to 80 years). Of the total number, 110 women had osteoporosis and 110 women did not have osteoporosis and these women were age-matched (+/-3 years). Two questionnaires were administered to all subjects for evaluation of QoL: the quality of life questionnaire of the European foundation for Osteoporosis 41 (QUALEFFO 41) and the short-form health survey 36 (SF-36). For data analysis, a significance level of 5% was set (posteoporosis had a worse QoL both in the QUALEFFO 41 and in the SF-36, in all domains studied. Data was adjusted for BMI, race, school education and use of HT (p25 and sedentary lifestyle. In contrast, paid work was associated with a better QoL (CI=95%). Women with osteoporosis had an impaired QoL, especially relating to the physical, psychological and social aspects. The factors associated with QoL were obesity, sedentary lifestyle and paid work.

[Ibandronate in the treatment of postmenopausal osteoporosis].

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Lakatos, Péter

2008-10-01

Postmenopausal osteoporosis affects 7-10% of the population of developed countries. During the past decade, a number of new therapeutical modalities have been made available. Among these, bisphosphonates mean the mainstay of medical treatment. Ibandronate belongs to the amino-bisphosphonate group of these drugs. Amino-bisphosphonates act via the mevalonate metabolic pathway, thus, inhibiting protein prenylation. Several clinical studies have shown a significant reduction in the fracture risk of osteoporotic patients treated with ibandronate. This compound can be administered orally once a month or intravenously once in every 3 months. Longer dosing intervals stimulate patient compliance, and consequently increase efficacy and cost effectiveness.

Association between osteoporosis and periodontal disease among postmenopausal Indian women.

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Richa; R, Yashoda; Puranik, Manjunath P; Shrivastava, Amit

2017-08-01

The aim of the present study was to determine the association between osteoporosis and periodontal disease among postmenopausal Indian women. A cross-sectional comparative study was conducted among postmenopausal women aged 45-65 years attending various hospitals in Bangalore, India. The examination was performed using the plaque index, gingival index, modified sulcus bleeding index, and community periodontal index. The women then underwent a bone mineral density (BMD) test using an ultrasonometer. Based on the BMD scores, participants were divided into osteoporotic and non-osteoporotic groups. For the statistical analysis, χ 2 -test, Student's t-test, and multiple regression analysis were applied. The mean plaque, gingival, and bleeding scores were significantly higher among osteoporotic women (1.83 ± 0.47, 1.73 ± 0.49, 1.82 ± 0.52) compared to the non-osteoporotic women (1.31 ± 0.40, 1.09 ± 0.52, 1.25 ± 0.50). The mean number of sextants affected for codes 3 and 4 of the community periodontal index and codes 1, 2, and 3 of loss of attachment were significantly higher among osteoporotic group compared to the non-osteoporotic group. Multiple logistic regression tests confirmed the statistically-significant association between osteoporosis and menopause duration, loss of attachment, bleeding, and gingivitis scores. Skeletal BMD is related to clinical attachment loss, bleeding, and gingivitis, which suggests that there is an association between osteoporosis and periodontal diseases. © 2016 John Wiley & Sons Australia, Ltd.

Is grand multiparity a risk factor for osteoporosis in postmenopausal women of lower socioeconomic status?

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Demirtaş, Ö; Demirtaş, G; Hurşitoğlu, B S; Terzi, H; Şekerci, Z; Ök, N

2014-01-01

We aimed to determine whether grand multiparity is a risk factor for osteoporosis among postmenopausal women of lower socioeconomic status. We conducted a single center study between February 2012 and February 2013 on 50-60 year old postmenopausal women of lower socioeconomic status without a history of medical disease. Women with a body mass index (BMI) between 20 and 25 were included in the study. The grand multiparous group (group A) consisted of 38 women with 10 or more deliveries. Women with a history of three or fewer deliveries composed the control group (group B). Dual-energy x-ray absorptiometry was used to measure the bone mineral density (BMD) of the proximal femur neck and lumbar spine (L1-L4). The mean ages of groups A and B were found to be 54.3 ± 2.5 and 53.1 ± 2.7 years, respectively. Average parity in groups A and B was 11.1 ± 1.7 and 2.4 ± 0.7, respectively. Time since the onset of menopause was 3.6 ± 2.7 years in group A and 6.0 ± 2.9 in group B. The prevalence of osteoporosis was similar in both groups (71.1%-81.4%, p = 0.273). We found that grand multiparity was an ineffective indicator of either femoral or lumbar osteoporosis (p = 0.87 and p = 0.26), but osteoporosis five years after the onset of menopause was found to be significantly higher (p = 0.02). The duration of menopause is an independent risk factor of osteoporosis. However, the number of pregnancies is neither a determinant nor a protective factor for osteoporosis in postmenopausal women coming from a low socioeconomic background.

Chosen risk factors for osteoporosis and the level of knowledge about the disease in peri- and postmenopausal women

Directory of Open Access Journals (Sweden)

Mariola Janiszewska

2015-03-01

Full Text Available Introduction : Osteoporosis as a chronic disease, affecting especially women in postmenopausal age, is an important, social and economic health problem especially of women of today’s world. The aim of the study was to assess the level of knowledge of women in the peri- and postmenopausal period about the prevention of osteoporosis and show the influence of chosen risk factors on the level of this knowledge. Material and methods : A group of 300 women aged 45-65, being patients of healthcare centres in Chełm, Lublin and Zamość (Lublin voivodeship, south-eastern Poland were included in the study. The purposive sampling was used. Osteoporosis Knowledge Test (OKT 2011 was the research tool. Gathered material was subjected to descriptive and statistical analysis. Tukey’s test, t-student test and variance analysis (ANOVA were all applied. An accepted p materiality level was < 0.05 and p < 0.01. Results : Respondents presented the average level of knowledge about the role of physical activity in the prevention of osteoporosis (M = 13.93 and a low level of knowledge about well-balanced diet rich in calcium (M = 9.77. The knowledge about risk factors, screening and treatment remained on the average level (M = 8.00. An influence of socio-demographic factors on the level of knowledge was shown. Also some behaviours, associated with the lifestyle indeed influenced the level of this knowledge. Conclusions : Professional educational programs on osteoporosis should be implemented in the population of Polish peri- and postmenopausal women.

Osteopenia and osteoporosis in postmenopausal women. Assessment by radiogrammetric measurement

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Celiktas, M.; Aikimbaev, K.S.; Soyupak, S.; Binokay, F. [Cukurova Univ., Balcali Hospital, Adana (Turkey). Dept. of Radiology; Kozanoglu, E. [Cukurova Univ., Balcali Hospital, Adana (Turkey). Dept. of Physical Medicine and Rehabilitation

2002-11-01

Purpose: To compare the ability of the medial cortical thickness ratio to the width of the second metacarpal bone at the midshaft (MCR) in discriminating patients as normal, osteopenic or osteoporotic. Material and Methods: MCR was calculated from radiographs of 120 postmenopausal women. By dual-energy X-ray absorptiometry, the mineral density was measured in the lumbar spine, the wrist and the femoral neck. Patients were grouped in accordance with the diagnostic criteria of WHO on the basis of t-scores. MCR values were compared with t-scores and the ability of the MCR technique in discriminating the patient groups was evaluated. Results: Analysis of radiogrammetric data revealed significant differences in MCR value between the 3 groups. The MCR was lower in patients with osteoporosis and osteopenia compared with the normal group. The mean value of MCR was also slightly lower in patients with osteoporosis than in those with osteopenia. Accuracy assessment (ROC analysis) of MCR in the discrimination of patients with osteoporosis showed that test accuracy was acceptable, but less accurate than spinal, wrist and femoral neck t-scores. Compared with t-scores, this test was found to fairly discriminate those with and without osteopenia. Conclusion: The MCR method can discriminate patients as osteoporotic or normal. However, it seems that the MCR method should not be used for decisions concerning treatment of osteoporosis because of its low accuracy and thereby a risk for misclassification. Bone mineral density osteoporosis osteopenia radiogrammetry.

Osteopenia and osteoporosis in postmenopausal women. Assessment by radiogrammetric measurement

International Nuclear Information System (INIS)

Celiktas, M.; Aikimbaev, K.S.; Soyupak, S.; Binokay, F.; Kozanoglu, E.

2002-01-01

Purpose: To compare the ability of the medial cortical thickness ratio to the width of the second metacarpal bone at the midshaft (MCR) in discriminating patients as normal, osteopenic or osteoporotic. Material and Methods: MCR was calculated from radiographs of 120 postmenopausal women. By dual-energy X-ray absorptiometry, the mineral density was measured in the lumbar spine, the wrist and the femoral neck. Patients were grouped in accordance with the diagnostic criteria of WHO on the basis of t-scores. MCR values were compared with t-scores and the ability of the MCR technique in discriminating the patient groups was evaluated. Results: Analysis of radiogrammetric data revealed significant differences in MCR value between the 3 groups. The MCR was lower in patients with osteoporosis and osteopenia compared with the normal group. The mean value of MCR was also slightly lower in patients with osteoporosis than in those with osteopenia. Accuracy assessment (ROC analysis) of MCR in the discrimination of patients with osteoporosis showed that test accuracy was acceptable, but less accurate than spinal, wrist and femoral neck t-scores. Compared with t-scores, this test was found to fairly discriminate those with and without osteopenia. Conclusion: The MCR method can discriminate patients as osteoporotic or normal. However, it seems that the MCR method should not be used for decisions concerning treatment of osteoporosis because of its low accuracy and thereby a risk for misclassification. Bone mineral density osteoporosis osteopenia radiogrammetry

Molecular genetic variations in vitamin D receptor gene with risk of osteoporosis in postmenopausal women

International Nuclear Information System (INIS)

Zahid, S.; Tahir, M.; Ahmed, S.

2017-01-01

To investigate the association of Vitamin D receptor (VDR) gene polymorphisms and development of osteoporosis. Methodology: This case-control study was conducted at Sir Ganga Hospital and Sheikh Zayed Hospital, Lahore, Pakistan from January 2015 to August 2015. A total of 136 postmenopausal women between 46-75 years of age were included in the study while women with serious internal disease and premature (surgical) menopause before the age of 45 years were excluded. Genotyping of VDR ApaI, TaqI and BsmI loci was done using polymerase chain reaction-restriction fragment length polymorphism. Levels of ionized calcium, C-reactive protein, alkaline phosphatase were measured and body mass index was calculated. Statistical analysis was done by using SPSS version 16.0. Results: Percentage of AA genotype was higher (28%) as compared to controls (16.6%). The postmenopausal cases showed 54% TT, 42%Tt and 4% tt genotype. The Bb genotype (42.6 %) was most frequent in both cases and controls. Postmenopausal cases and controls showed non-significant difference in alkaline phosphatase, C-reactive protein and ionized calcium levels. Conclusions: Findings explained the earlier inconsistent association results and no particular genetic variation in Vitamin D receptor gene had pronounced effect in predisposition to osteoporosis. (author)

Prolonged breast-feeding is an independent risk factor for postmenopausal osteoporosis.

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Okyay, Duygu Ozkale; Okyay, Emre; Dogan, Erbil; Kurtulmus, Secil; Acet, Ferruh; Taner, Cuneyt Eftal

2013-03-01

This study investigated the effects of parity and age at first pregnancy and breast-feeding, as well as duration of BF for total and per child on postmenopausal osteoporosis. The study was conducted among 542 cases who were divided based on the presence or absence of osteoporosis. Patients were separated according to their first pregnancy and breast-feeding age as before or after 27 years. Osteoporosis was defined as a T score of -2.5 or lower. Parity, age at first pregnancy and breast-feeding, breast-feeding period for total and average duration per child according to a questionnaire were assessed. Osteoporosis group had significantly lower parity compared to non-osteoporosis group. The age at first pregnancy and breast-feedingosteoporosis group. They also had prolonged breast-feeding period. Women who had a breast-feeding period per child>1 year under age 27 was higher in osteoporosis group. In multivariate analysis, women who breast-fed>1 year per child had the highest risk for osteoporosis (odds ratio: 12.92; 95% confidence interval, 3.1-52.6) and osteoporosis risk for women who breast-fed>1 year per child under age 27 was 7.1. Increased parity was associated with a significant protective effect for osteoporosis. Extended breast-feeding period per child>1 year is the highest risk factor for osteoporosis independent of first breast-feeding age. However, high parity has a protective effect. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Barriers to Effective Postmenopausal Osteoporosis Treatment: A Qualitative Study of Patients’ and Practitioners’ Views

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2016-01-01

Background Only a minority of patients at high risk for osteoporotic fracture receive treatment. Objective Study patients’ and physicians’ views regarding postmenopausal osteoporosis (PMO) to identify impediments to good care. Methods A qualitative study involving 18 physicians and 37 women (age 57–87) with PMO. Results All women interviewed considered PMO to be somewhat normal wear-and-tear associated with old age. The women identified a large number of "causes" for osteoporosis but finally viewed it as chance. They all described its progression as slow. Three representations of PMO severity were identified: some women tended to interpreted it as benign (21), others tended to dramatize it (11), and the rest were uncertain (5). These representations did not appear linked to age or fracture. Even the women who associated fracture and PMO were uncertain of the link between them. Fractures were considered to be random events, independent of osteoporosis. Women received general life-style recommendations from their physicians positively, but did not connect them specifically to osteoporosis. Indeed, these recommendations, along with the fear of side effects, the absence of tangible results of treatments, the view of PMO as a natural process, and the representations of PMO severity are factors that may deter treatments and impact compliance. As for the physicians, they identified eight risk factors, recognizing menopause as central to PMO and recognized the link between risk of fracture and PMO. However, some considered the impact of fractures to be limited in time, and viewed PMO as a "benign" disease. Seeing the progression of PMO as slow and inevitable reduced their urgency to diagnose and treat it as compared to other diseases. Some physicians acknowledged limited mastery of the existing therapeutic arsenal and unsuccessful handling of patient compliance. Conclusion Women’s and physicians’ perspectives on PMO converged to trivialize postmenopausal

Analysis of the factors influencing the frequency ofpathological fractures in postmenopausal women with osteoporosis

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Karadžov-Nikolić A.

2015-01-01

Full Text Available Introduction: Osteoporosis is a disease characterized by bone strength disorder and weakness of the entire skeleton causing the predisposition to fractures to grow. Identification of factors which may influence pathological fractures in postmenopausal women and determining which of the identified factors have the largest influence on the development of osteoporotic fractures. A retrospective study has included 400 postmenopausal women with newly diagnosed osteoporosis examined at the Institute of Rheumatology in Belgrade. We have examined demographic data and the following fracture risk factors: physical activity, menarche, menopause, fractures after the age of forty, osteoporotic fractures in the family, comorbidity: inflammatory rheumatic diseases, intestine diseases, chronic kidney insufficiency and endocrinopathy (hyperthyroidism and diabetes and taking glucocorticoid therapy. The value of bone density has been measured using DXA method in the spine and hip, and the body mass index has been calculated based on the body height and weight. Logistic regression has been used as the method for analyzing the relation between binary results and potential predictors. Statistical hypotheses have been tested at the statistical significance level of 0.05. In the model of multivariate logistic regression, the significant predictors of osteoporotic fractures are as follows: older age (B = 0.13; p = 0.001, higher BMI values (B = 0.094; p = 0.022 and lower BMD values (hip (B = -3.060; p = 0.023. Elderly overweight women with lower BMD values in the hip are more susceptible to fractures due to osteoporosis; therefore this subgroup of postmenopausal women is important for the application of the measures of primary and secondary prevention of osteoporotic fractures.

The contemporary look at the problem of recognizing and diagnosing postmenopausal osteoporosis and eliminating the risk of a fall

Directory of Open Access Journals (Sweden)

Mariola Janiszewska

2014-03-01

Full Text Available Osteoporosis constitutes a relevant health, social and economic problem of the contemporary world. As a chronic disease, often nicknamed the “silent thief”, it is an object of the clinical research and a reason for many ambiguities. The most noticeable and basic symptom of osteoporosis is a low-energy fracture, which brings pain, physical disability, and a noticeable decrease in one’s quality of life. Osteoporosis affects the entire population; however, women in the postmenopausal period and the elderly are mostly exposed to its progress. The risk of falling ill concerning women simply grows with the age and doubles with every decade after the age of 65. It is estimated that osteoporosis affects 200 million women worldwide, and about 20-25% of them will sustain an injury in the form of a bone fracture. In Poland, the problem of osteoporosis concerns 2.4 million women. The article attempts to show current views on examining and diagnosing postmenopausal osteoporosis and prevention of the fall risk. The BMD (bone mineral density is considered the basis of osteoporosis diagnosis in postmenopausal women as well as an absolute 10-year risk of fractures and experienced osteoporotic fractures. All people at an increased fall risk should be provided with the multifactorial programme of fall prevention.

Chosen risk factors for osteoporosis and the level of knowledge about the disease in peri- and postmenopausal women.

Science.gov (United States)

Janiszewska, Mariola; Kulik, Teresa; Dziedzic, Małgorzata A; Żołnierczuk-Kieliszek, Dorota

2015-03-01

Osteoporosis as a chronic disease, affecting especially women in postmenopausal age, is an important, social and economic health problem especially of women of today's world. The aim of the study was to assess the level of knowledge of women in the peri- and postmenopausal period about the prevention of osteoporosis and show the influence of chosen risk factors on the level of this knowledge. A group of 300 women aged 45-65, being patients of healthcare centres in Chełm, Lublin and Zamość (Lublin voivodeship, south-eastern Poland) were included in the study. The purposive sampling was used. Osteoporosis Knowledge Test (OKT) 2011 was the research tool. Gathered material was subjected to descriptive and statistical analysis. Tukey's test, t-student test and variance analysis (ANOVA) were all applied. An accepted p materiality level was level of knowledge about the role of physical activity in the prevention of osteoporosis (M = 13.93) and a low level of knowledge about well-balanced diet rich in calcium (M = 9.77). The knowledge about risk factors, screening and treatment remained on the average level (M = 8.00). An influence of socio-demographic factors on the level of knowledge was shown. Also some behaviours, associated with the lifestyle indeed influenced the level of this knowledge. Professional educational programs on osteoporosis should be implemented in the population of Polish peri- and postmenopausal women.

study on the serum levels of E2, IL-6 and IGF-I in patients with post-menopausal osteoporosis (PMO)

International Nuclear Information System (INIS)

Lv Kuan; Liu Chunyu; Lu Yingju

2006-01-01

Objective: To study the changes of serum levels of E 2 , IL-6, IGF-I in patients with post-menopausal osteoporosis (PMO). Methods: Serum levels of E 2 (with CLIA), IL-6, IGF-I, BGP (with RIA) were measured in the following subjects: (1) 32 patients with PMO (2) 32 post-menopausal women without PMO and (3) 30 pre-menopausal controls. Serum P, Ca and AKP levels were also determined. Results: As a whole, serum levels of IL -6 in postmenopausal women were higher than those in controls. Levels in subjects with PMO were significantly higher than those without PMO (P 2 and BMD index (r=-0. 587, - 0. 438 respectively, P 2 and BMD index (r=0.569, 0.433 respectively, P 2 levels will in someway promote the expression of IL-6 ( osteoclastic) and reduce the expression of IGF-I (osteoclastic), resulting in lessening of bone mass. HRT, despite of the controversy over cardio-vascalar safety, is beneficial for osteoporosis. (authors)

Patient compliance with drug therapy for postmenopausal osteoporosis

International Nuclear Information System (INIS)

Ahmad, A.; Khan, M.Y.

2007-01-01

To determine compliance and factors affecting compliance to antiresorptive drugs in osteoporosis, and to compare compliant and non compliant groups in a tertiary care setting. A total of 800 patients with postmenopausal osteoporosis were included in the study. The demographic and reproductive characteristics of all the patients were recorded. Type of antiresorptive drugs prescribed, degree of compliance, time and reasons for discontinuation were studied and analyzed. The mean age of the patients was 64 (+-9) years and their mean duration of follow-up 18 (+-5) months. The prevalence of risk factors for osteoporosis were evenly distributed among treatment groups; 73% patients had a co-morbidity besides osteoporosis while 27% were osteoporotic alone. One or more previous vertebral fractures due to osteoporosis was reported by 14.5% of patients, whereas 35.5% had at least one non-vertebral fracture in their medical history. Out of the total patients 21.5% discontinued the prescribed drug before attending the bone mass re-evaluations, more than half of these within first six months of starting the drugs. The medication that was most frequently discontinued within one year was calcium and vitamin-D (33.7%, p<0.01) while the least discontinued medication was Alendronate (5.9%, p < 0.01) which is taken once a week. In this study the most important determinant of compliance was the type of drug prescribed and its dose frequency, with a definite preference for Alendronate once a week. Treatment compliance was particularly poor for calcium and vitamin-D regimen, thereby emphasizing the need to find new ways of administering supplements, particularly for vitamin-D. (author)

Calcium in the prevention of postmenopausal osteoporosis: EMAS clinical guide.

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Cano, Antonio; Chedraui, Peter; Goulis, Dimitrios G; Lopes, Patrice; Mishra, Gita; Mueck, Alfred; Senturk, Levent M; Simoncini, Tommaso; Stevenson, John C; Stute, Petra; Tuomikoski, Pauliina; Rees, Margaret; Lambrinoudaki, Irene

2018-01-01

Postmenopausal osteoporosis is a highly prevalent disease. Prevention through lifestyle measures includes an adequate calcium intake. Despite the guidance provided by scientific societies and governmental bodies worldwide, many issues remain unresolved. To provide evidence regarding the impact of calcium intake on the prevention of postmenopausal osteoporosis and critically appraise current guidelines. Literature review and consensus of expert opinion. The recommended daily intake of calcium varies between 700 and 1200mg of elemental calcium, depending on the endorsing source. Although calcium can be derived either from the diet or supplements, the former source is preferred. Intake below the recommended amount may increase fragility fracture risk; however, there is no consistent evidence that calcium supplementation at, or above, recommended levels reduces risk. The addition of vitamin D may minimally reduce fractures, mainly among institutionalised people. Excessive intake of calcium, defined as higher than 2000mg/day, can be potentially harmful. Some studies demonstrated harm even at lower dosages. An increased risk for cardiovascular events, urolithiasis and even fractures has been found in association with excessive calcium intake, but this issue remains unresolved. In conclusion, an adequate intake of calcium is recommended for general bone health. Excessive calcium intake seems of no benefit, and could possibly be harmful. Copyright © 2017 Elsevier B.V. All rights reserved.

Prevalence of vertebral fractures and quality of life in a sample of postmenopausal Brazilian women with osteoporosis.

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de Oliveira Ferreira, Néville; da Silva, Raimunda Beserra; Arthuso, Michael; Pinto-Neto, Aarão Mendes; Caserta, Nelson; Costa-Paiva, Lúcia

2012-01-01

The prevalence of vertebral fracture was high in postmenopausal Brazilian osteoporotic women; quality of life was impaired regardless of vertebral fractures, despite a direct correlation between the number of vertebral fractures and a worse quality of life score. The purpose of this study is to evaluate the prevalence of vertebral fractures (VF), quality of life (QOL), association between number of VF and QOL scores, and correlate the factors associated with QOL in a sample of postmenopausal Brazilian women with osteoporosis. A cross-sectional study of 126 postmenopausal osteoporotic women aged 55-80 years was conducted. Women were interviewed about sociodemographic and clinical data, responded to QUALEFFO-41 questionnaire, and underwent vertebral radiography to measure the anterior, mean, and posterior height at each vertebra (T4 to L5). VF were classified as anterior wedge, posterior wedge, central collapse, and crush. Data was expressed as means (±SD) and frequencies, Mann-Whitney or Student's T tests were used to compare means, and odds ratio and 95 % confidence interval were used for multiple regression analysis. Values were significant when P value obesity, unemployment, sedentary lifestyle, low level of school education, and non-use of osteoporosis drugs. There was a high prevalence of VF in Brazilian postmenopausal women with osteoporosis. QOL was impaired regardless of VF, despite a direct correlation between number of VF and a worse QOL score.

Relationship among panoramic radiography findings, biochemical markers of bone turnover and hip bone mineral density in the diagnosis of postmenopausal osteoporosis

International Nuclear Information System (INIS)

Johari Khatoonabad, M.; Aghamohammadzade, N.; Taghilu, H.; Esmaeili, F.; Jabbari Khamnei, H.

2011-01-01

Recent investigations have shown that panoramic radiography might be a useful tool in the early diagnosis of osteoporosis. In addition, bone turnover biochemical marker might be valuable in predicting osteoporosis and fracture risks in the elderly, especially in post-menopausal women. The aim of the present study was to evaluate the relationship among the radio morphometric indices of the mandible, biochemical markers of the bone turnover and hip bone mineral density in a group of post-menopausal women. Patients and Methods: Evaluations of mandibular cortical width, mandibular cortical index, panoramic index and alveolar crest resorption ration (M/M ration) were carried out on panoramic radiographs of 140 post-menopausal women with an age range of 44-82 years. Hip bone mineral density was measured by dual-energy X-ray absorptiometry method. Bone mineral density values were divided into three groups of normal (T score>-1.0), Osteopenic (T score, -2.5 to -1.0) and Osteoporotic (T score<-2.5). Serum alkaline phosphatase and 25(OH) D3 were measured. Results: A decrease in mandibular cortical width by 1 mm increases the likelihood of osteopenia or osteoporosis up to 40%, having taken into consideration the effect of menopause duration. A 1 mm decrease in mandibular cortical width increased the likelihood of moderate or severe erosion of the lower cortex of the mandible up to 28% by taking age into consideration. The results did not demonstrate a statistically significant relationship between bone turnover markers and mandibular radio morphometric indices. Conclusion: Panoramic radiography gives sufficient information to make an early diagnosis regarding osteoporosis in post-menopausal women. Panoramic radiographs may be valuable in the prevention of osteoporotic fractures in elderly women.

Denosumab – a new medication in the treatment of postmenopausal osteoporosis

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Radosław Słopień

2017-10-01

Full Text Available Osteoporosis is a chronic, systemic skeletal disorder characterised by decreased bone density. It leads to an increased risk of bone fractures – one of the major causes of disability in modern societies. Bisphosphonates are the most commonly used medications in the treatment of postmenopausal osteoporosis. Denosumab, a new approach to fracture prevention, is a fully human monoclonal antibody that targets nuclear factor-B ligand (RANKL, an important cytokine regulating formation and function of osteoclasts. Generally, denosumab is not used as initial therapy; however, in some cases it should be considered. It concerns patients at high risk of fracture, such as older patients who have difficulty with the dosing requirements of oral bisphosphonates or who have markedly impaired renal function. Denosumab can be also considered in patients who present intolerance or unresponsiveness to other therapies. Clinical studies have shown that denosumab is highly effective in increasing bone mineral density (BMD in postmenopausal women regardless of the site analysed, as well as reducing the risk of bone fractures. The risk of developing antiresorptive, agent-induced osteonecrosis of the jaw related to denosumab therapy is low.

Correlation between absence of bone remodeling compartment canopies, reversal phase arrest, and deficient bone formation in post-menopausal osteoporosis

DEFF Research Database (Denmark)

Andersen, Thomas Levin; Hauge, Ellen Margrethe; Rolighed, Lars

2014-01-01

on the bone surface from the marrow cavity. The present study on human iliac crest biopsy specimens reveals that BRC canopies appear frequently absent above both eroded and formative surfaces in post-menopausal osteoporosis patients, and that this absence was associated with bone loss in these patients...... surfaces was associated with a shift in the osteoblast morphological characteristics, from cuboidal to flattened. Collectively, this study shows that the BRCs are unique anatomical structures implicated in bone remodeling in a widespread disease, such as post-menopausal osteoporosis. Furthermore...

Legumain Regulates Differentiation Fate of Human Bone Marrow Stromal Cells and Is Altered in Postmenopausal Osteoporosis

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Abbas Jafari

2017-02-01

Full Text Available Secreted factors are a key component of stem cell niche and their dysregulation compromises stem cell function. Legumain is a secreted cysteine protease involved in diverse biological processes. Here, we demonstrate that legumain regulates lineage commitment of human bone marrow stromal cells and that its expression level and cellular localization are altered in postmenopausal osteoporotic patients. As shown by genetic and pharmacological manipulation, legumain inhibited osteoblast (OB differentiation and in vivo bone formation through degradation of the bone matrix protein fibronectin. In addition, genetic ablation or pharmacological inhibition of legumain activity led to precocious OB differentiation and increased vertebral mineralization in zebrafish. Finally, we show that localized increased expression of legumain in bone marrow adipocytes was inversely correlated with adjacent trabecular bone mass in a cohort of patients with postmenopausal osteoporosis. Our data suggest that altered proteolytic activity of legumain in the bone microenvironment contributes to decreased bone mass in postmenopausal osteoporosis.

Systematic review of raloxifene in postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia

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Fujiwara S

2014-11-01

Full Text Available Saeko Fujiwara,1 Etsuro Hamaya,2 Masayo Sato,2 Peita Graham-Clarke,3 Jennifer A Flynn,2 Russel Burge41Hiroshima Atomic Bomb Casualty Council, Hiroshima, Japan; 2Lilly Research Laboratories Japan, Eli Lilly Japan K.K., Kobe, Japan; 3Global Health Outcomes, Eli Lilly Australia, Sydney, NSW, Australia; 4Global Health Outcomes, Eli Lilly and Company, Indianapolis, IN, USAPurpose: To systematically review the literature describing the efficacy, effectiveness, and safety of raloxifene for postmenopausal Japanese women with osteoporosis or low bone mass (osteopenia.Materials and methods: Medline via PubMed and Embase was systematically searched using prespecified terms. Retrieved publications were screened and included if they described randomized controlled trials or observational studies of postmenopausal Japanese women with osteoporosis or osteopenia treated with raloxifene and reported one or more outcome measures (change in bone mineral density [BMD]; fracture incidence; change in bone-turnover markers, hip structural geometry, or blood–lipid profile; occurrence of adverse events; and change in quality of life or pain. Excluded publications were case studies, editorials, letters to the editor, narrative reviews, or publications from non-peer-reviewed journals; multidrug, multicountry, or multidisease studies with no drug-, country-, or disease-level analysis; or studies of participants on dialysis.Results: Of the 292 publications retrieved, 15 publications (seven randomized controlled trials, eight observational studies were included for review. Overall findings were statistically significant increases in BMD of the lumbar spine (nine publications, but not the hip region (eight publications, a low incidence of vertebral fracture (three publications, decreases in markers of bone turnover (eleven publications, improved hip structural geometry (two publications, improved blood–lipid profiles (five publications, a low incidence of hot flushes

Prevalence and Risk Factors of Osteoporosis Among Jordanian Postmenopausal Women Attending the National Center for Diabetes, Endocrinology and Genetics in Jordan

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Dana Hyassat

2017-07-01

Full Text Available To assess the prevalence of osteoporosis and osteopenia among Jordanian postmenopausal women attending the National Center for Diabetes, Endocrinology, and Genetics (NCDEG, and to determine the potential associated risk factors. A cross-sectional study was conducted at (NCDEG in Amman, Jordan. A total of 1079 Jordanian postmenopausal women aged between 45 and 84 years were included in this study that was conducted during the period between April 2013 and December 2014. All patients underwent bone mineral density measurement through dual-energy X-ray absorptiometry (DEXA scan. DEXA scan was interpreted in terms of T score as per World Health Organization guidelines. The overall prevalence of osteoporosis and osteopenia was 37.5% and 44.6%, respectively. The maximum prevalence of osteoporosis was observed at the lumbar spine (32.4% followed by the left femoral neck (14.4%, while the maximum prevalence of osteopenia was observed at the left femoral neck (56.1% followed by the lumbar spine (41.3%. Patients with longer menopausal duration, normal or overweight body mass index, high parity, physical inactivity, positive family history of osteoporosis, inadequate sun exposure, high daily caffeine intake, low daily calcium intake, and delay in the age of menarche were all positively associated with osteoporosis. On the other hand, women with type 2 diabetes mellitus had lower risk of osteoporosis. There is a high prevalence of osteoporosis and osteopenia among Jordanian postmenopausal women. Necessary steps are needed for more public education and a wider dissemination of information about osteoporosis and its prevention.

The cut-off point of dual energy X-ray and laser of calcaneus osteoporosis diagnosis in postmenopausal women

International Nuclear Information System (INIS)

Salimzadeh, A.; Forough, B.; Olia, B.; Alishiri, G. H.; Ghasemzadeh, A.

2005-01-01

Dual X-Ray Absorptiometry is a method which can extensively be used for bone mineral densitometry . Another more recent method is dual energy X-ray and laser, which associate with dual X ray absorptiometry, assisted by laser measure heel thickness. In this study the cut off points for dual energy X-ray and laser of calcaneus in the diagnosis of osteoporosis in different bone regions in postmenopausal women had been determined. Materials and Methods: In 268 postmenopausal women, BMD of the spinal and femoral regions was measured by DM, and the value for the calcaneous was measured by dual energy X-ray and laser. The agreement of the two methods in the diagnosis of osteoporosis and optimal cut-off point for dual energy X-ray and laser in defining osteoporosis was obtained. What obtained was the agreement of the two methods in the diagnosis of osteoporosis, as well as the optimal cut-off point for dual energy X-ray and laser in defining osteoporosis. Results: Dual X-Ray Absorptiometry showed osteoporosis in 40.7% of cases with 35.2% in L2-L4, 16.2% in the femoral neck, and 11.7% for the femoral total region. The dual energy X-ray and laser found osteoporosis, considering -2.5 SD as a threshold, in 26.1% of cases. Agreement of the two methods in the diagnosis of osteoporosis (Kappa score) was 0.443 for the lumbar region, 0.464 for the neck, and, 0.421 for total femur regions (all P values were significant). Using Receiver Operating Characteristic curves, it was found that a T-score of -2.1, -2.6 and -2.4 as the optimal cut-off point of dual energy X-ray and laser in the diagnosis of osteoporosis in the lumbar spine, the neck and total region of femur, respectively. Conclusion: The results of this study showed a moderate agreement between the two methods in the diagnosis of osteoporosis. It seems that the dual energy X-ray and laser cannot be used as a substitute for the DM method, but it can be used as a screening method to find (to diagnose) osteoporosis

[Parity and menarche as risk factors for osteoporosis in postmenopausal women].

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Mendoza-Romo, Miguel Angel; Ramírez-Arriola, Mariá Cleofás; Velasco-Chávez, José Fernando; Rivera-Martínez, José Guillermo; de Jesús, Rafael Natividad Nieva; Valdez-Jiménez, Luis Alvaro

2014-02-01

Worldwide studies, even in our country, have thrown discrepant results about the relation between osteoporosis, parity and age of menarche. To investigate the relation of osteoporosis in postmenopausal mexican women with multiparity and age of menarche. Transversal, retrospective and analytical study. Non-probabilistic sampling technique was performing with users women of the IMSS in San Luis Potosí. Reproductive history and age of menarche were obtained by the addition of these items to the previously validated Albrand questionnaire. Women were divided into groups according to the number of pregnancies in: normal parity (0 to 3 childbirths) conformed by 112 patients (46%) and multiparity (> or = 4 pregnancies), 131 women (54%). In relation to menarche with an average of 12.98 years, from this number we divided them in: early menarche (before the age of 13) and late menarche (at 13 years of age or after). It was measured bone mineral density with dual distal forearm x-ray absorptiometry to all patients. 243 women were studied, with an average of age of 55.92, rank 31 to 80 years. Using the criteria, of the World Health Organization, 18% of posmenopausal women had osteoporosis, 39% had osteopenia and 41% had bone normality. No association was found between the number of deeds and osteoporosis. Additionally we observed that the women who had 4 or more children were older than the other women. average 57.42 against 54.16. Also there was significant negative correlation (r = -0.43) between age and densitometry. In addition we found that an age greater to 13 years in the appearance of the menarche was related to osteoporosis (OR 4.46; p = 0.035). In posmenopausal women a menarche at the age of 13 years or after is a risk factor for osteoporosis.

Osteoporosis in postmenopausal women and the influence of physical activities:“an analysis of the literature”

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Antônia Dalla Pria Bankoff

2008-06-01

Full Text Available Osteoporosis, a common postmenopausal disease in women, is the result of progressive bone loss. It is worldwide considered as a public health problem that either invalidates or incapacitates a large number of persons, being a multifactorial illness whose most important danger besides the estrogen role are the behavior factors (physical inactivity, dietary calcium deficiency which can easily be modified. Prevention of osteoporosis must start since childhood and follow for a lifetime and special attention must be given to women when they approach menopause. However, keeping hormonal balance, practicing exercises and having a good nutrition calcium intake proved to be the best preventive actions against this disease. The aim of this study was to collect evidences of the influence of physical activity on osteoporosis in menopausal women.

A randomized placebo-controlled trial of the efficacy of denosumab in Indian postmenopausal women with osteoporosis.

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Pitale, Shailesh; Thomas, Mathew; Rathi, Gaurav; Deshmukh, Vaishali; Kumar, Prasanna; Reddy, Sanjay; Shetty, Naresh; Kakar, Atul; Babhulkar, Sushrut; Mody, Bharat; Chacko, Jacob; Acharya, Sudeep; Joglekar, Sadhna; Halbe, Vipul; Kravitz, Barbara G; Waterhouse, Brian; Nino, Antonio J; Fitzpatrick, Lorraine A

2015-01-01

Osteoporosis is a serious condition affecting up to 50% of Indian postmenopausal women. Denosumab reduces bone resorption by targeting the receptor activator of nuclear factor-κB ligand. This study assessed the efficacy and safety of denosumab in Indian postmenopausal women with osteoporosis. In this double-blind, multicenter, phase 3 study, 250 Indian postmenopausal women aged 55 to 75 years (T-score -4.0 at the lumbar spine or total hip; serum 25(OH) D levels ≥20 ng/mL) were randomized to receive one subcutaneous dose of denosumab 60 mg or placebo. All subjects received oral calcium ≥1000 mg and vitamin D3 ≥ 400 IU daily. The primary end point was mean percent change in bone mineral density (BMD) at the lumbar spine from baseline to Month 6. Secondary end points included mean percent change from baseline in BMD at total hip, femoral neck, and trochanter at Month 6 and median percent change from baseline in bone turnover markers at Months 1, 3, and 6. Total 225 subjects (denosumab = 111, placebo = 114) completed the six-month study. Baseline demographics were similar between groups. A 3.1% (95% confidence interval, 1.9%, 4.2%) increase favoring denosumab versus placebo was seen for the primary end point (P Indian postmenopausal women.

A model-based cost-effectiveness analysis of osteoporosis screening and treatment strategy for postmenopausal Japanese women.

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Yoshimura, M; Moriwaki, K; Noto, S; Takiguchi, T

2017-02-01

Although an osteoporosis screening program has been implemented as a health promotion project in Japan, its cost-effectiveness has yet to be elucidated fully. We performed a cost-effectiveness analysis and found that osteoporosis screening and treatment would be cost-effective for Japanese women over 60 years. The purpose of this study was to estimate the cost-effectiveness of osteoporosis screening and drug therapy in the Japanese healthcare system for postmenopausal women with no history of fracture. A patient-level state transition model was developed to predict the outcomes of Japanese women with no previous fracture. Lifetime costs and quality-adjusted life years (QALYs) were estimated for women who receive osteoporosis screening and alendronate therapy for 5 years and those who do not receive the screening and treatments. The incremental cost-effectiveness ratio (ICER) of the screening option compared with the no screening option was estimated. Sensitivity analyses were performed to examine the influence of parameter uncertainty on the base case results. The ICERs of osteoporosis screening and treatments for Japanese women aged 50-54, 55-59, 60-64, 65-69, 70-74, and 75-79 years were estimated to be $89,242, $64,010, $40,596, $27,697, $17,027, and $9771 per QALY gained, respectively. Deterministic sensitivity analyses showed that several parameters such as the disutility due to vertebral fracture had a significant influence on the base case results. Applying a willingness to pay of $50,000 per QALY gained, the probability that the screening option became cost-effectiveness estimated to 50.9, 56.3, 59.1, and 64.7 % for women aged 60-64, 65-69, 70-74, and 75-79 years, respectively. Scenario analyses showed that the ICER for women aged 55-59 years with at least one clinical risk factor was below $50,000 per QALY. In conclusion, dual energy X-ray absorptiometry (DXA) screening and alendronate therapy for osteoporosis would be cost-effective for

Left in limbo – Experiences and needs among postmenopausal women newly diagnosed with osteoporosis without preceding osteoporotic fractures

DEFF Research Database (Denmark)

Jakobsen, Pernille Ravn; Hermann, Anne Pernille; Søndergaard, Jens

2018-01-01

to participate in treatment decision-making and (3) needs of being able to take care of bone health. Conclusion and implications In general the women experienced as been left ‘in limbo’, and they requested targeted and tailored information about osteoporosis. In particular, they want information about dual...... more attention on the benefits of detecting early stage osteoporosis. The study highlights the call for new approaches to postmenopausal women newly diagnosed with osteoporosis without preceding fractures....

A dairy and fruit dietary pattern is associated with a reduced likelihood of osteoporosis in Korean postmenopausal women.

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Shin, Sangah; Joung, Hyojee

2013-11-01

The aim of the present study was to identify the association of dietary patterns with osteoporosis in Korean postmenopausal women from the Korean Health and Nutrition Examination Survey 2008–10. The present cross-sectional analysis included 3735 postmenopausal women who completed a health interview, nutrition survey and a health examination including bone mineral density (BMD) measurements. The general characteristics and dietary intakes of the participants were obtained using a standardised questionnaire and a 24 h recall method, respectively. The BMD of the femoral neck and lumbar spine was measured using dual-energy X-ray absorptiometry; osteoporosis was defined based on the WHO T-score criteria. Overall, we identified four dietary patterns using factor analysis as follows: 'meat, alcohol and sugar', 'vegetables and soya sauce', 'white rice, kimchi and seaweed' and 'dairy and fruit', which accounted for 30·9% of the total variance in food intake (11·3, 7·7, 6·0 and 5·9%, respectively). The subjects in the highest quintile of the 'dairy and fruit' pattern showed a decreased risk of osteoporosis of the lumbar spine (53 %) compared with those in the lowest quintile, after adjusting for covariates (OR 0·47, 95% CI 0·35, 0·65, P for trendfoods and fruits in the traditional Korean diet, based on white rice and vegetables, may decrease the risk of osteoporosis in Korean postmenopausal women.

Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure.

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Neglia, Cosimo; Argentiero, Alberto; Chitano, Giovanna; Agnello, Nadia; Ciccarese, Roberta; Vigilanza, Antonella; Pantile, Valerio; Argentiero, Domenico; Quarta, Raffaele; Rivezzi, Matteo; Di Tanna, Gian Luca; Di Somma, Carolina; Migliore, Alberto; Iolascon, Giovanni; Gimigliano, Francesca; Distante, Alessandro; Piscitelli, Prisco

2016-11-01

Objectives : We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods : We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis) registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS) to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS)) and the association between demineralization and the presence of other conditions or risk factors. Results : Mean age was 64 ± 9.5 years and mean body mass index (BMI) was 28.7 ± 3.5 kg/m². Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI ( p osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures) in subjects with diabetes and obesity: 1.39 (confidence interval (CI): 1.05-1.83) and 1.46 (CI: 1.20-1.78), respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions : Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis.

Physical exercise and osteoporosis: effects of different types of exercises on bone and physical function of postmenopausal women.

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Moreira, Linda Denise Fernandes; Oliveira, Mônica Longo de; Lirani-Galvão, Ana Paula; Marin-Mio, Rosângela Villa; Santos, Rodrigo Nolasco dos; Lazaretti-Castro, Marise

2014-07-01

Physical exercise is an important stimulus for osteoporosis prevention and treatment. However, it is not clear yet which modality would be better to stimulate bone metabolism and enhance physical function of postmenopausal women. This review paper aims to summarize and update present knowledge on the effects of different kinds of aquatic and ground physical exercises on bone metabolism and physical function of postmenopausal women. Moderate to intense exercises, performed in a high speed during short intervals of time, in water or on the ground, can be part of a program to prevent and treat postmenopausal osteoporosis. Mechanical vibration has proven to be beneficial for bone microarchitecture, improving bone density and bone strength, as well as increasing physical function. Although impact exercises are recognized as beneficial for the stimulation of bone tissue, other variables such as muscle strength, type of muscle contraction, duration and intensity of exercises are also determinants to induce changes in bone metabolism of postmenopausal women. Not only osteoanabolic exercises should be recommended; activities aimed to develop muscle strength and body balance and improve the proprioception should be encouraged to prevent falls and fractures.

Prevalence of osteoporosis, vertebral fractures and hypovitaminosis D in postmenopausal women living in a rural environment.

Science.gov (United States)

Gómez-de-Tejada Romero, María-Jesús; Navarro Rodríguez, María-del-Carmen; Saavedra Santana, Pedro; Quesada Gómez, José-Manuel; Jódar Gimeno, Esteban; Sosa Henríquez, Manuel

2014-03-01

First, to study the difference between two groups of postmenopausal women living in different population centres (rural vs urban) in the prevalence of osteoporosis, fragility fractures and factors which may influence them: hypovitaminosis D, bone mineral density, coexistence of other diseases which predispose to their appearance; secondly, to observe the influence of low socioeconomic status, categorised as poverty. 1229 postmenopausal women were studied, of whom 390 (31.7%), were living in rural areas and 839 (68.3%), in urban areas. Data regarding risk factors related to osteoporosis were obtained, and, among other biochemical measures, 25 hydroxyvitamin D and parathyroid hormone were determined. Bone densitometry was carried out in the lumbar spine and proximal femur, as well as lateral X-rays of the dorsal and lumbar spine. The women who lived in rural areas were older, shorter, heavier and had a higher body mass index than those from urban areas. Among the women from rural areas there was a higher prevalence of poverty, and higher levels of obesity, arterial hypertension and diabetes mellitus were observed, as well as a higher prevalence of densitometric osteoporosis. The rural women had lower values of bone mineral density in the lumbar spine and a higher prevalence of vertebral fractures and hypovitaminosis D. The variables which were associated independently with living in rural areas were poverty, obesity, vertebral fractures, BMD in the lumbar spine and levels of 25 hydroxyvitamin D. In our study, postmenopausal women who live in rural populations have more poverty, lower values of vitamin D, lower BMD in the lumbar spine and a higher prevalence of vertebral fractures and of osteoporosis. The higher prevalence of obesity, arterial hypertension and diabetes mellitus observed in these women may be adjuvant factors, all fostered by their socioeconomic state of poverty. Copyright © 2014. Published by Elsevier Ireland Ltd.

Safety and tolerability of denosumab for the treatment of postmenopausal osteoporosis

Directory of Open Access Journals (Sweden)

Lewiecki EM

2011-12-01

Full Text Available E Michael LewieckiNew Mexico Clinical Research & Osteoporosis Center, Albuquerque, New Mexico, USAAbstract: Denosumab is a fully human monoclonal antibody to receptor activator of nuclear factor kappa-B ligand (RANKL, a cytokine member of the tumor necrosis factor family that is the principal regulator of osteoclastic bone resorption. Postmenopausal osteoporosis (PMO is a systemic skeletal disease associated with high levels of RANKL, resulting in a high rate of bone remodeling and an imbalance of bone resorption over bone formation. By inhibiting RANKL in women with PMO, denosumab reduces the rate of bone remodeling, thereby increasing bone mineral density, improving bone strength, and reducing the risk of fractures. In clinical trials of women with osteoporosis and low bone mineral density, denosumab has been well tolerated, with overall rates of adverse events and serious adverse events in women treated with denosumab similar to those receiving placebo. In the largest clinical trial of denosumab for the treatment of women with PMO, there was a significantly greater incidence of cellulitis reported as a serious adverse event, with no difference in the overall incidence of cellulitis, and a significantly lower incidence of the serious adverse event of concussions with denosumab compared with placebo. The evidence supports a favorable balance of benefits versus risks of denosumab for the treatment of PMO. Assessments of the long-term safety of denosumab are ongoing. Denosumab 60 mg subcutaneously every 6 months is an approved treatment for women with PMO who are at high risk for fracture.Keywords: denosumab, osteoporosis, safety, risk, benefit, FDA

The development of a personalized patient education tool for decision making for postmenopausal women with osteoporosis

NARCIS (Netherlands)

Hiligsmann, M.; Ronda, G.; Weijden, T.T. van der; Boonen, A.

2016-01-01

A personalized patient education tool for decision making (PET) for postmenopausal women with osteoporosis was developed by means of a systematic development approach. A prototype was constructed and refined by involving various professionals and patients. Professionals and patients expressed a

The Relationship Between the FRAX Tool and Bone Turnover Markers in Postmenopausal Osteoporosis

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Murat Uludağ

2013-08-01

Full Text Available Aim: In this study, we aimed to show the correlation between the ten-year fracture risk, calculated with FRAX and bone turnover markers (BTM in a group of postmenopausal women with osteoporosis. Material and Methods: Twenty-four postmenopausal women diagnosed as osteoporosis were included. Patients were assessed for duration of menopause, secondary diseases, medication, habits of nutrition, previous fracture, and family history of fracture. Weight and height measurements were obtained. Bone mineral density (BMD was measured by dual-energy X-ray absorptiometry (DXA, with a Hologic-QDR 4500 plus device. The ten-year risk for major as well as hip fractures were calculated with the FRAX tool. Serum calcium, phosphorus, magnesium, 25-OH Vitamin D, parathormone (PTH, alkaline phosphatase (ALP, and biochemical markers of bone formation (Osteocalcin, Bone-ALP and resorption ( N-terminal collagen type 1 and C terminal collagen type 1 were determined. Results: The mean age of patients was 64.3±8.6 (46-80 years. The mean ten-year major fracture and hip fracture risks were 19.5±6.2% and 16.0±5.1%, respectively. There was a strong correlation between the duration of menopause and hip fracture risk (r: 0.878, p=0.022. There was also a strong relationship between hip fracture risk and NTX (r: 0.759, p=0.042. Conclusion: Resorption markers of bone turnover are relevant components in determining fracture risk. Rate of bone remodeling is a parameter which is not included in the FRAX tool. Since FRAX is an established tool for assessing the ten-year fracture risk, we assessed and found a correlation between hip fracture risk and NTX. Further studies, in larger groups of patients need to make clear the impact of BTM in this tool. (Turkish Journal of Osteoporosis 2013;19: 38-41

[Preliminary results of an open-label observational study evaluating the efficacy and safety of Prolia used in women with postmenopausal osteoporosis].

Science.gov (United States)

Ershova, O B; Lesniak, O M; Belova, K Iu; Nazarova, A V; Manovitskaia, A V; Musaeva, T M; Musraev, R M; Nurlygaianov, R Z; Rozhinskaia, L Ia; Skripnikova, I A; Toroptsova, N V

2014-01-01

To evaluate the efficacy and safety of Denosumab (Prolia), a first-line osteoporosis (OP) medication that is a fully human monoclonal antibody to the receptor activator of nuclear factor xB ligand (RANKL), within an open-label observational study. Patients aged 50 years or older with postmenopausal OP, who were treated with Prolia in clinical practice, were examined. The concentrations of the bone resorption (BR) marker of C-terminal telopeptide and other laboratory indicators (total serum calcium, total alkaline phosphatase, and creatinine) were measured following 3 months. Adverse drug reactions were recorded. Three months after initiation of the investigation, there was a significant decrease in the BR marker C-terminal telopeptide (by 89%; p<0.0001). There were rare adverse reactions: hypocalcemia in 3 (5.9%) patients, arthralgias in 2 (3.9%), and eczema in 1 (1.9%). There were neither serious adverse events nor study withdrawal cases. The preliminary results of the open-label study of Prolia in postmenopausal OP suggest that the significantly lower BR activity determines the efficacy of this drug and its high safety.

Bisphosphonates for osteoporosis in primary biliary cirrhosis

DEFF Research Database (Denmark)

Rudic, Jelena; Giljaca, Vanja; Krstic, Miodrag N

2011-01-01

Bisphosphonates are widely used for treatment of postmenopausal osteoporosis. Patients with primary biliary cirrhosis often have osteoporosis - either postmenopausal or secondary to the liver disease. No systematic review or meta-analysis has assessed the effects of bisphosphonates for osteoporosis...

Treatment of postmenopausal women with osteoporosis with PTH(1-84) for 36 months: treatment extension study

NARCIS (Netherlands)

Zanchetta, J.R.; Bogado, C.E.; Cisari, C.; Aslanidis, S.; Greisen, H.; Fox, J.; Lems, W.F.

2010-01-01

Objective: To determine the safety and efficacy of full-length parathyroid hormone, PTH(184), treatment for up to 36 months by evaluating bone mineral density (BMD) changes, bone histomorphometric indices, and clinical fracture incidence in postmenopausal women with osteoporosis. Background: The TOP

Diabetes and Obesity as Independent Risk Factors for Osteoporosis: Updated Results from the ROIS/EMEROS Registry in a Population of Five Thousand Post-Menopausal Women Living in a Region Characterized by Heavy Environmental Pressure

Directory of Open Access Journals (Sweden)

Cosimo Neglia

2016-11-01

Full Text Available Objectives: We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. Methods: We found 4909 postmenopausal subjects within ≥10,000 records from the ROIS/EMEROS (Ionian and Salento Osteoporosis Registry/Euro Mediterranean Registry of Osteoporosis registry, a population study carried out in an area characterized by heavy environmental pressure between Brindisi and Taranto from 2009 to 2016. All subjects were assessed via phalangeal quantitative ultrasound (QUS to evaluate their bone mineralization (assessed via amplitude dependent speed of sound (AD-SoS and the association between demineralization and the presence of other conditions or risk factors. Results: Mean age was 64 ± 9.5 years and mean body mass index (BMI was 28.7 ± 3.5 kg/m2. Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS and BMI (p < 0.001. By using multivariate logistic regression analysis, we observed significant values of odds ratios (ORs of osteoporosis (adjusted for age, physical activity, and the use of drugs known to increase the risk of fractures in subjects with diabetes and obesity: 1.39 (confidence interval (CI: 1.05–1.83 and 1.46 (CI: 1.20–1.78, respectively. A statistically significant linear trend of higher ORs of osteoporosis was found for increasing values of BMI. Conclusions: Our study confirmed the high impact of obesity and type 1 and type 2 diabetes on osteoporosis.

Anteroposterior displacement behavior of the center of pressure, without visual reference, in postmenopausal women with and without lumbar osteoporosis

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Guilherme Carlos Brech

2013-10-01

Full Text Available OBJECTIVE: The aims of this study were to evaluate the anteroposterior displacement behavior of the center of pressure without any visual reference and determine its relationship with knee muscle strength and reports of falls in postmenopausal women. Among those with osteoporosis, the specific objective was to evaluate the correlation of thoracic kyphosis and vitamin D with center of pressure displacement. METHODS: This was a cross-sectional observational study without intervention. The assessments were performed on 126 postmenopausal women (aged 55-65 years who were grouped according to their lumbar bone density into osteoporosis and control groups. Center of pressure was evaluated on a force platform (100 Hz frequency and 10 Hz filter, with the subjects standing on both feet with eyes closed for 60 seconds. Knee muscle strength was evaluated using an isokinetic dynamometer in concentric/concentric mode at a velocity of 60°/s. In the osteoporosis group, vitamin D was assayed, and the thoracic spine was radiographed. RESULTS: In the control group, there was a correlation between the center of pressure and knee strength (r = 0.37; p<0.003. Reports of falls were not associated with center of pressure displacement (p = 0.056. In the osteoporosis group, thoracic kyphosis and vitamin D levels were not correlated with the center of pressure. CONCLUSION: Anteroposterior center of pressure displacement without visual influence was not associated with falls, thoracic kyphosis or vitamin D in the osteoporosis group. Only knee muscle strength was associated with center of pressure displacement in the control group.

A 2-year phase II study with 1-year of follow-up of risedronate (NE-58095) in postmenopausal osteoporosis

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Clemmesen, B; Ravn, Pernille; Zegels, B

1997-01-01

This paper presents the results of a two-center, double-masked, placebo-controlled, randomized, oral-dose study of risedronate treatment in postmenopausal osteoporosis. Patients had at least one, but no more than four prevalent vertebral fractures at baseline. They received either 2.5 mg continuo...... regimens in order to validate the effect on bone mass, fracture rate and biochemical markers. In these studies another formulation of the drug and other dosing instructions are used.......This paper presents the results of a two-center, double-masked, placebo-controlled, randomized, oral-dose study of risedronate treatment in postmenopausal osteoporosis. Patients had at least one, but no more than four prevalent vertebral fractures at baseline. They received either 2.5 mg continuous...... risedronate, 2.5 mg cyclic risedronate, or placebo for 2 years. Both risedronate and placebo were formulated as hard gelatin capsules. All women furthermore received a daily calcium supplement of 1 g which was taken separately from the study drug. During the 1-year of follow-up, all women received only...

Determination of osteoporosis risk factors using a multiple logistic regression model in postmenopausal Turkish women.

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Akkus, Zeki; Camdeviren, Handan; Celik, Fatma; Gur, Ali; Nas, Kemal

2005-09-01

To determine the risk factors of osteoporosis using a multiple binary logistic regression method and to assess the risk variables for osteoporosis, which is a major and growing health problem in many countries. We presented a case-control study, consisting of 126 postmenopausal healthy women as control group and 225 postmenopausal osteoporotic women as the case group. The study was carried out in the Department of Physical Medicine and Rehabilitation, Dicle University, Diyarbakir, Turkey between 1999-2002. The data from the 351 participants were collected using a standard questionnaire that contains 43 variables. A multiple logistic regression model was then used to evaluate the data and to find the best regression model. We classified 80.1% (281/351) of the participants using the regression model. Furthermore, the specificity value of the model was 67% (84/126) of the control group while the sensitivity value was 88% (197/225) of the case group. We found the distribution of residual values standardized for final model to be exponential using the Kolmogorow-Smirnow test (p=0.193). The receiver operating characteristic curve was found successful to predict patients with risk for osteoporosis. This study suggests that low levels of dietary calcium intake, physical activity, education, and longer duration of menopause are independent predictors of the risk of low bone density in our population. Adequate dietary calcium intake in combination with maintaining a daily physical activity, increasing educational level, decreasing birth rate, and duration of breast-feeding may contribute to healthy bones and play a role in practical prevention of osteoporosis in Southeast Anatolia. In addition, the findings of the present study indicate that the use of multivariate statistical method as a multiple logistic regression in osteoporosis, which maybe influenced by many variables, is better than univariate statistical evaluation.

Evaluation of the validity of osteoporosis and fracture risk assessment tools (IOF One Minute Test, SCORE, and FRAX) in postmenopausal Palestinian women.

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Kharroubi, Akram; Saba, Elias; Ghannam, Ibrahim; Darwish, Hisham

2017-12-01

The need for simple self-assessment tools is necessary to predict women at high risk for developing osteoporosis. In this study, tools like the IOF One Minute Test, Fracture Risk Assessment Tool (FRAX), and Simple Calculated Osteoporosis Risk Estimation (SCORE) were found to be valid for Palestinian women. The threshold for predicting women at risk for each tool was estimated. The purpose of this study is to evaluate the validity of the updated IOF (International Osteoporosis Foundation) One Minute Osteoporosis Risk Assessment Test, FRAX, SCORE as well as age alone to detect the risk of developing osteoporosis in postmenopausal Palestinian women. Three hundred eighty-two women 45 years and older were recruited including 131 women with osteoporosis and 251 controls following bone mineral density (BMD) measurement, 287 completed questionnaires of the different risk assessment tools. Receiver operating characteristic (ROC) curves were evaluated for each tool using bone BMD as the gold standard for osteoporosis. The area under the ROC curve (AUC) was the highest for FRAX calculated with BMD for predicting hip fractures (0.897) followed by FRAX for major fractures (0.826) with cut-off values ˃1.5 and ˃7.8%, respectively. The IOF One Minute Test AUC (0.629) was the lowest compared to other tested tools but with sufficient accuracy for predicting the risk of developing osteoporosis with a cut-off value ˃4 total yes questions out of 18. SCORE test and age alone were also as good predictors of risk for developing osteoporosis. According to the ROC curve for age, women ≥64 years had a higher risk of developing osteoporosis. Higher percentage of women with low BMD (T-score ≤-1.5) or osteoporosis (T-score ≤-2.5) was found among women who were not exposed to the sun, who had menopause before the age of 45 years, or had lower body mass index (BMI) compared to controls. Women who often fall had lower BMI and approximately 27% of the recruited postmenopausal

Clinical, biochemical and histological results of a double-blind trial with 1,25-dihydroxyvitamin D3, estradiol and placebo in post-menopausal osteoporosis.

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Caniggia, A; Delling, G; Nuti, R; Lorè, F; Vattimo, A

1984-01-01

Twenty-eight women with postmenopausal osteoporosis were studied in a double-blind trial aimed to compare the effects of a one-year treatment with 1,25-dihydroxyvitamin D3 (1,25(OH)2D3), estradiol valerate (E2) and placebo. Patients were divided into 4 groups: group 1 was given 1,25(OH)2D3 alone, group 2 was given E2 alone, group 3 was given 1,25(OH)2D3 + E2, group 4 received a placebo. The evaluation of the effects of the treatments included clinical examination of patients, the measurement of a number of biochemical parameters, such as plasma and urinary calcium and phosphate, urinary hydroxyproline, serum alkaline phosphatase, the measurement of intestinal calcium absorption and bone mineral content (BMC) and a histomorphometric study of bone biopsies from the iliac crest. The best clinical results were obtained in the patients who were given 1,25(OH)2D3 alone; appreciable results were also noticed in the patients who were given E2 alone or in combination with 1,25(OH)2D3, while patients in the placebo group worsened. BMC decreased in the placebo group and increased, although non significantly, in the patients treated with 1,25(OH)2D3 or E2 or both. The histomorphometric study showed a significant increase in the mean trabecular diameter in patients treated with 1,25(OH)2D3 alone or in combination with E2. Changes in the volume density of trabecular bone paralleled those in BMC. The results of the trial indicate that 1,25(OH)2D3 is an effective therapeutic agent in postmenopausal osteoporosis.

Impact of gastrointestinal events on patient-reported outcomes in Asia-Pacific women with osteoporosis: baseline results of the MUSIC OS-AP study.

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Modi, A; Ebeling, P R; Lee, M S; Min, Y K; Mithal, A; Yang, X; Baidya, S; Sen, S; Sajjan, S

2017-12-01

The purpose of this study was to describe the impact of gastrointestinal events on patient-reported outcomes and health care resource use among Asia-Pacific women with postmenopausal osteoporosis. The results of this study show that gastrointestinal events decreased adherence, treatment satisfaction, and quality of life in Asia-Pacific women with postmenopausal osteoporosis. This study aimed to describe the impact of gastrointestinal (GI) events on patient-reported outcomes and health care resource use among Asia-Pacific women with postmenopausal osteoporosis. The MUSIC OS-AP study included an observational cohort study of postmenopausal women with osteoporosis. Women were classified as untreated or treated, with treated patients further classified as new or experienced users. Adherence was measured by the Adherence Evaluation of Osteoporosis treatment (ADEOS) questionnaire, treatment satisfaction by the Osteoporosis Patient Satisfaction Questionnaire (OPSAT) while general health-related and osteoporosis-specific quality of life were measured by the European Quality of Life-5 Dimensions (EQ-5D) questionnaire and the Osteoporosis Assessment Questionnaire (OPAQ), respectively. The association of GI events with these outcomes was determined by covariate-adjusted regression analysis of least squares mean differences in the scores of treated patients with and without GI events. Resource utilization was measured as the number of physician visits over the past 3 months, and multivariate regression analysis was used to assess the association of GI events with the likelihood of a visit. The GI event profile, quality of life scores, and resource use were numerically similar in untreated and treated women. The rate of adherence among treated women was higher in experienced than in new users. As indicated by mean scores, experienced users had better quality of life and slightly higher treatment satisfaction and fewer physician visits than new users. Except for adherence in

阿仑膦酸钠对绝经后骨质疏松性骨痛的疗效分析%Effect analysis of alendronate on postmenopausal osteoporosis with bone ache

Institute of Scientific and Technical Information of China (English)

无

2001-01-01

@@ Background: Osteoporosis is a metabolic bone disease characterized by low bone component and regeneration of the microstructure of bone tissues, osteoporosis occurs in postmenopausal women for decreased estrogen level. Those women with osteoporosis often suffer from bone ache, such as pain at low back, back, knees and heels. In severe cases, there may be crookback or non- violent fracture. Objective: To discuss treatment effect of the Alendronate on 56 postmenopausal women with bone ache caused by osteoporosis. Unit: 210 Hospital of PLA.

Obesity as a protective factor for postmenopausal osteoporosis.

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Albala, C; Yáñez, M; Devoto, E; Sostin, C; Zeballos, L; Santos, J L

1996-11-01

Obesity is considered a protective factor for osteoporosis improving bone mass and maintaining higher levels of estrogen during menopause. To determine the association of obesity with bone mineral density (BMD), and its relationship with sex hormone levels. A case-control study in Caucasian obese and non obese postmenopausal women. 113 obese and 50 non-obese postmenopausal women. BMD (dual-photon X-ray absorptiometry) at cervical femur. Ward's triangle, proximal radius and lumbar spine. Plasma levels of glucose, insulin, total estrogen, follicle stimulating hormone (FSH), sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHA-S) and testosterone. Mean BMD at femoral sites were significantly higher in obese women (femoral neck: 0.849 +/- 0.124 g/cm2 vs 0.753 +/- 0.095 g/cm2, P obese women and 0.849 +/- 0.137 g/cm2 in non obese, P obese women was observed. Although total estrogen were similar in both groups, in obese women, SHBG was lower (68.6 +/- 26.84 nmol/l vs. 85.1 +/- 31.18 nmol/l, P obese (77.2 +/- 50.4 Ul/ml vs. 49.4 +/- 24.1 Ul/ml, P obese women and suggest that obesity exerts protection due to a decreased SHBG thus increasing free sex steroids. Besides, hyperinsulinemia may produce a decline in the production of IGFBG-1, leading to an increase of IGF-1, that may stimulate the proliferation of osteoblasts.

Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP): Design of a multinational, prospective, observational study examining the impact of gastrointestinal events on osteoporosis management in postmenopausal women.

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Modi, Ankita; Ebeling, Peter R; Lee, Mel S; Min, Yong-Ki; Mithal, Ambrish; Yang, Xiaoqin; Sajjan, Shiva

2015-12-01

treatment. Physicians at 59 sites completed the physician questionnaire, and data for 300 patients from 26 sites were abstracted for the retrospective chart review. Enrollment and baseline data collection for the prospective cohort study were conducted between July 2013 and August 2014 for 301 untreated and 3287 treated patients, of whom 1416 were new users and 1871 were experienced users of oral osteoporosis medications. The results of MUSIC OS-AP will highlight the association of gastrointestinal events with patient-reported outcomes among postmenopausal women with osteoporosis and elucidate physicians' management of gastrointestinal events among this patient population in the Asia-Pacific region.

Running title: Treatment of postmenopausal osteoporosis.

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Bülent Tiras

2005-12-01

Full Text Available Osteoporosis is characterized with low bone mass and deterioration of skeletal microarchitecture. It leads to a fragile bone and increased risk of fracture by minimal trauma. Today, osteoporotic fractures have become a major health concern. Therefore many different studies have been organized to enlighten basic pathology, and to investigate efficient therapeutic modalities. The change in the prescription attitudes in postmenopausal hormone replacement therapy (HRT increased the value of non-HRT therapies. The purpose of this review is to evaluate all therapeutic modalities which could be used in this setting by analyzing prospective randomized studies. By a general scope of view, the choice of treatment should be individualized with respect to age, risk factors,\tand concomitant disorders. In early menopause HRT can be used for women with severe vasomotor symptoms if there is no contraindication. Since no difference was noted between HRT and bisphosphonates, there is no need to combination regimens.\tAfter vasomotor symptoms are subsided, raloxifene can be used to the patients who have T score of below -2 without non-vertebral fracture. It is obvious that the most efficient therapies to prevent new osteoporotic fractures are bisphosphonates, strontium ranelate, and parathyroid hormone (PTH. PTH should not be used longer than 24 months. The first two large series showed that strontium ranelate prevents fractures very effectively. In addition the side effects of this unique medication is not higher than placebo which is one of the major advantage of it. Many series identified the important role of bisphosphonates in the prevention of osteoporosis related morbidities. Calcitonin has a role in patients having pain. Daily calcium and vitamin D supplement should be recommended to all patients, and diet and exercise programmes should be organized.

Prevention and treatment of postmenopausal osteoporosis.

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Tella, Sri Harsha; Gallagher, J Christopher

2014-07-01

lines of therapy. First OPG was used as a therapy to block RANKL was initially successful but later antibodies against OPG developed and this line of treatment had to be discontinued. The next step was to develop a monoclonal antibody against RANKL and this proved to be highly effective in blocking bone resorption. It led to development of a drug Denosumab that successfully reduces fractures and is now one of the therapeutic options for osteoporosis treatment. On the anabolic side bone biology research showed that osteocytes produces sclerostin an inhibitor of the anabolic WNT signaling pathway. Recent development of a monoclonal antibody against sclerostin has shown remarkable anabolic activity in bone showing large increases in bone density and fracture trials are now underway. The newer treatments for osteoporosis are likely to be based on our understanding of bone biology and the design of new highly specific compounds with fewer side effects. This review summarizes the diagnosis of postmenopausal osteoporosis and various available non-pharmacological and pharmacological therapies available for its management. This article is part of a Special Issue entitled 'Menopause'. Copyright © 2013 Elsevier Ltd. All rights reserved.

Ischaemic cardiac events and use of strontium ranelate in postmenopausal osteoporosis: a nested case-control study in the CPRD.

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Cooper, C; Fox, K M; Borer, J S

2014-02-01

We explored the cardiac safety of the osteoporosis treatment strontium ranelate in the UK Clinical Practice Research Datalink. While known cardiovascular risk factors like obesity and smoking were associated with increased cardiac risk, use of strontium ranelate was not associated with any increase in myocardial infarction or cardiovascular death. It has been suggested that strontium ranelate may increase risk for cardiac events in postmenopausal osteoporosis. We set out to explore the cardiac safety of strontium ranelate in the Clinical Practice Research Datalink (CPRD) and linked datasets. We performed a nested case-control study. Primary outcomes were first definite myocardial infarction, hospitalisation with myocardial infarction, and cardiovascular death. Cases and matched controls were nested in a cohort of women treated for osteoporosis. The association with exposure to strontium ranelate was analysed by multivariate conditional logistic regression. Of the 112,445 women with treated postmenopausal osteoporosis, 6,487 received strontium ranelate. Annual incidence rates for first definite myocardial infarction (1,352 cases), myocardial infarction with hospitalisation (1,465 cases), and cardiovascular death (3,619 cases) were 3.24, 6.13, and 14.66 per 1,000 patient-years, respectively. Obesity, smoking, and cardiovascular treatments were associated with significant increases in risk for cardiac events. Current or past use of strontium ranelate was not associated with increased risk for first definite myocardial infarction (odds ratio [OR] 1.05, 95 % confidence interval [CI] 0.68-1.61 and OR 1.12, 95 % CI 0.79-1.58, respectively), hospitalisation with myocardial infarction (OR 0.84, 95 % CI 0.54-1.30 and OR 1.17, 95 % CI 0.83-1.66), or cardiovascular death (OR 0.96, 95 % CI 0.76-1.21 and OR 1.16, 95 % CI 0.94-1.43) versus patients who had never used strontium ranelate. Analysis in the CPRD did not find evidence for a higher risk for cardiac events associated

Effect of Bisphosphonates on the Levels of Rankl and Opg in Gingival Crevicular Fluid of Patients With Periodontal Disease and Post-menopausal Osteoporosis.

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Verde, María E; Bermejo, Daniela; Gruppi, Adriana; Grenón, Miriam

2015-12-01

The Receptor activator of nuclear factor-kappa B ligand (RANKL)/RANK/Osteoprotegerine (OPG) system has been proposed as essential for osteoclast biology and identified as key part in regulating the physiology and pathology of the skeletal system. The study of the RANKL/RANK/OPG system has increased the understanding of the mechanisms involved in the bone remodeling process, especially in postmenopausal osteoporosis and periodontal disease. Bisphosphonates have become the mainstay of the treatment and prevention of post-menopausal osteoporosis. They inhibit the formation and dissolution of calcium phosphate crystals in bone and also osteoclasts, thus reducing bone turnover.Current investigations relate osteoporosis with the appearance and progression of periodontal disease. Although the etiology of both is different, the bone loss present in both shares several characteristics. Thus, therapy used for osteoporosis can be considered of value in the treatment of periodontal disease. The aim of this study was to evaluate the levels of RANKL, OPG and their relationship in gingival crevicular fluid (GCF) in patients with periodontal disease and postmenopausal osteoporosis/ osteopenia in relation to consumption of bisphosphonates. We studied 66 periodontal active sites obtained from 17 post- menopausal women patients aged between 45-70 years old with osteoporosis/osteopenia and periodontal disease. GCF samples were collected using sterile filter paper strips. To determine the concentration of RANKL and OPG, a commercial ELISA assay was used. The values of RANKL, OPG and their ratio (RANKL/ OPG) were compared with Mann-Whitney U Test. The values of RANKL, OPG and their ratio obtained in patients with osteoporosis/osteopenia and periodontal disease with or without bisphosphonates treatment showed no differences. Bisphosphonates do not alter the concentration of RANKL and OPG and their ratio in the GCF of patients with osteoporosis/ osteopenia and periodontal disease

Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study in the Asia-Pacific Region (MUSIC OS-AP: Design of a multinational, prospective, observational study examining the impact of gastrointestinal events on osteoporosis management in postmenopausal women

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Ankita Modi

2015-12-01

Conclusions: The results of MUSIC OS-AP will highlight the association of gastrointestinal events with patient-reported outcomes among postmenopausal women with osteoporosis and elucidate physicians' management of gastrointestinal events among this patient population in the Asia-Pacific region.

Observer performance in diagnosing osteoporosis by dental panoramic radiographs: results from the osteoporosis screening project in dentistry (OSPD).

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Taguchi, A; Asano, A; Ohtsuka, M; Nakamoto, T; Suei, Y; Tsuda, M; Kudo, Y; Inagaki, K; Noguchi, T; Tanimoto, K; Jacobs, R; Klemetti, E; White, S C; Horner, K

2008-07-01

observers with insufficient intra-observer agreement. Our results reconfirm the efficacy of cortical erosion findings in identifying postmenopausal women at risk for osteoporosis, among observers with sufficient intra-observer agreement. Information gathered from radiographic examination is at least as useful as that gathered from the OST index.

Comparative study of the results of heel ultrasound screening and DXA findings (lumbar spine and left hip of postmenopausal women

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Amila Jaganjac

2012-04-01

Full Text Available Introduction: Osteoporosis is a silent and invisible disease of bone, great presence and is considered to suffer from osteoporosis at least 200 million women worldwide. The goal of this paper is to show average ageof postmenopausal respondents, values of anthropometric parameters (weight, height, BMI, anamnestic data on clinical symptoms, fractures of women in menopause, analysis of heel ultrasound screening results,analysis of lumbar spine DXA results, analysis of left hip DXA results.Methods: In retrospective study 61 respondents were involved, 33 to 79 years old, treated in u Center for Physical Medicine and Acupuncture “AD” in Sarajevo during the period from 01.01.2008 till 31.12.2009. Alldate are shown numerically and percentage account with calculation of mean value, expressed in the form of tables and charts.Results: Finding of heel ultrosound screening compared to T values of postmenopausal respondents indicates on osteoporosis in case of 17 (27,87%, in case of 44 (72,13% respondents osteopenia, while normalvalues were not found. T value with lumbar spine DXA method in postmenopausal female respondents correspond to 43 (70,5% respondents, in 15 respondents (24,6% finding corresponded to osteopenia, while 3 respondents (4,9% had physiological finding. Left hip DXA finding shows 36 (59% respondents corresponded osteoporosis, 19 (31,2% respondents corresponded osteopenia, while physiological finding was found in 6 respondents (9,8%. T value of lumbar spine DXA finding was - 2,71 ± 1,16; DXA finding of left hip -2,35 ±1,36; heel ultrasound screening -2,19 ± 0,54.Conclusion: Research results indicate that DXA finding in relation to the heel ultrasound screening confirms gold standard in diagnosing osteoporosis.

Periodontal Status of Postmenopausal Women

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Timur V. Melkumyan

2014-06-01

Full Text Available The objective of this study was to compare the periodontal status in postmenopausal women with osteopenia and osteoporosis. Material and Methods: We examined 43 postmenopausal women aged from 55 to 74 years. Material assessment of bones in every patient was performed by means of dual energy X-ray absorptiometry (DXA from two points on the skeleton – part of the femur neck and between the first and fourth lumbar vertebrae. A lipid blood test was done for patients of both groups. All patients were divided into two groups (the 1st with osteopenia, and the 2nd with osteoporosis. All patients were subjected to an oral clinical examination: the periodontal examination was composed of Plaque Index (PI, Pocket Score (PS, and Papillary Bleeding Index (PBI. X-ray analysis was performed for every patient. Results: The results of the clinical periodontal examination demonstrated that the mean PBI in patients in the 1st group had no significant differences from the PBI in patients in the 2nd group. PI value and PS findings in patients with general osteoporosis also had no statistical differences from the same parameters in patients with osteopenia. Conclusion: Under the circumstances of these patients’ characteristics and within the limits of the present study, we concluded that there is no significant difference in the periodontal status of postmenopausal women with systemic osteopenia and with osteoporosis.

Adiponectin as a Biomarker of Osteoporosis in Postmenopausal Women: Controversies

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Anna Lubkowska

2014-01-01

Full Text Available The literature reports indicating a link between plasma levels of adiponectin and body fat, bone mineral density, sex hormones, and peri- and postmenopausal changes, draw attention to the possible use of adiponectin as an indicator of osteoporotic changes, suggesting that adiponectin may also modulate bone metabolism. In this study, we attempted to analyze the available in vitro and in vivo results which could verify this hypothesis. Although several studies have shown that adiponectin has an adverse effect on bone mass, mainly by intensifying resorption, this peptide has also been demonstrated to increase the proliferation and differentiation of osteoblasts, inhibit the activity of osteoclasts, and reduce bone resorption. There are still many ambiguities; for example, it can be assumed that concentrations of adiponectin in plasma do not satisfactorily reflect its production by adipose tissue, as well as conflicting in vitro and in vivo results. It seems that the potential benefit in the treatment of patients with osteoporosis associated with the pharmacological regulation of adiponectin is controversial.

THE BENEFIT OF SOY BEAN- CHOCOLATE BEVERAGE ON BONE RESORPTION IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS

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Ainun Rani, Nur; Astuti, Nurpudji; Rasyid, Haerani; Bahar, Burhanuddin

2011-01-01

THE BENEFIT OF SOY BEAN- CHOCOLATE BEVERAGE ON BONE RESORPTION IN POSTMENOPAUSAL WOMEN WITH OSTEOPOROSIS Nur Ainun Rani1, Nurpudji A. Taslim,1,2 Haerani Rasyid1,2, Burhanuddin Bahar3 Department of Clinical Nutrition Faculty of Medicine 1, Department of Nutrition2 Faculty of Medicine, Faculty of Public Health3, Hasanuddin University, Makassar ABSTRACT Background Soybeans and chocolate contain isoflavones, which is the active substance which is recommended as an hormone replacem...

Feasibility of cone beam computed tomography radiomorphometric analysis and fractal dimension in assessment of postmenopausal osteoporosis in correlation with dual X-ray absorptiometry.

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Mostafa, Raghdaa A; Arnout, Eman A; Abo El-Fotouh, Mona M

The aim of the present study was to assess the feasibility of using mandibular CBCT radiomorphometric indices and box-counting fractal dimension (FD) to detect osteoporosis in post-menopausal females, compare them with the healthy control group and to correlate the findings with the bone mineral density measured by dual X-ray absorptiometry (DXA). This study consisted of 50 post-menopausal females, with age ranging from 55 to 70 years. Based on their DXA results, they were classified into osteoporotic and control groups. Mandibular CBCT radiomorphomertic indices and FD analysis were measured. Significant differences were found for the CT cortical index scores (CTCI), CT mental index (CTMI) and CT mandibular index (CTI) between the control and osteoporotic groups. The control group showed higher mean values than the osteoporotic group. For FD values, no significant differences were found between the two groups. CBCT radiomorphometric indices could be used as an adjuvant tool to refer patients at risk of osteoporosis for further assessment.

Use of quantitative ultrasound of the hand phalanges in the diagnosis of two different osteoporotic syndromes: Cushing's syndrome and postmenopausal osteoporosis.

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Camozzi, V; Carraro, V; Zangari, M; Fallo, F; Mantero, F; Luisetto, G

2004-06-01

The aim of this study was to assess the ability of the quantitative ultrasound of the hand phalanges to detect different types of osteoporosis resulting from different pathogenetic mechanisms. For this purpose, postmenopausal and glucocorticoid-induced osteoporosis was studied. Thirteen female patients with Cushing's syndrome (CS) resulting from pituitary-dependent bilateral adrenal hyperplasia (10 patients) and from adrenal adenoma (3 patients), and 32 postmenopausal osteoporotic (OP) women, were examined. The two groups of patients were comparable for body mass index (BMI), but CS patients were significantly younger than OP ones (CS 44.5+/-11.6; OP: 73.9+/-3.6). All the patients had femoral neck bone mineral density (BMD) T-score less than -2.0. Cushing patients had a femoral neck BMD similar to that of OP patients (CS: 603+/-66 mg/cm2; OP: 628+/-69 mg/cm2; p=0.19). In contrast, amplitude-dependent speed of sound (AD-SoS) was significantly higher in CS patients than in OP patients (CS: 1997+/-91 m/s; OP: 1707+/-114 m/s; p<0.0001). By adjusting DXA and ultrasound parameters according to age, femoral neck BMD was significantly lower in CS patients and AD-SoS remained significantly higher than in OP patients. These findings indicate that these two different kinds of osteoporosis can be distinguished by ultrasonography and that ultrasound parameters alone cannot be used for evaluating skeletal status in CS patients.

A 1HNMR-Based Metabonomics Study of Postmenopausal Osteoporosis and Intervention Effects of Er-Xian Decoction in Ovariectomized Rats

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Luping Qin

2011-11-01

Full Text Available A metabonomics method using 1H nuclear magnetic resonance spectroscopy (1HNMR was applied to obtain a systematic view of the development and progression of postmenopausal osteoporosis. Using partial least squares discriminant analysis (PLS-DA, 26 and 34 characteristic resonances were found respectively in urine and plasma of ovariectomized rats (Variable importance, VIP value ≥1.0, and the significant altered metabolites identified in the plasma and urine were 10 and 9, respectively. Changes in these metabolites were related to the pathways of lipid, energy and amino acid metabolism, some of which involved the oxidative system. The described method was also used to analyze the therapeutic effects of Er-Xian Decoction (EXD, a traditional Chinese medicine widely used in the clinical treatment of osteoporosis in China. The results showed that EXD administration could provide satisfactory effects on osteoporosis through partially regulating the perturbed pathways of lipid, energy and amino acid metabolism and improving the anti-oxidative ability.

Influence of treatment with alendronate on the speed of sound, an ultrasound parameter, of the calcaneus in postmenopausal Japanese women with osteoporosis: a clinical practice-based observational study

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Iwamoto J

2012-06-01

Full Text Available Jun Iwamoto,1 Tetsuya Takada,2 Yoshihiro Sato,3 Hideo Matsumoto11Institute for Integrated Sports Medicine, Keio University School of Medicine, Tokyo, 2Department of Internal Medicine, Hiyoshi Medical Clinic, Kanagawa, 3Department of Neurology, Mitate Hospital, Fukuoka, JapanPurpose: The influence of alendronate (ALN treatment on the quantitative ultrasound parameters of the calcaneus remains to be established in Japanese patients. The aim of the present clinical practice-based observational study was to examine the influence of ALN treatment for 1 year on the speed of sound (SOS of the calcaneus and bone turnover markers in postmenopausal Japanese women with osteoporosis.Patients and methods: Forty-five postmenopausal Japanese women with osteoporosis who had received treatment with ALN for more than 1 year were enrolled in the study. The SOS and bone turnover markers were monitored over 1 year of ALN treatment.Results: The urinary levels of cross-linked N-terminal telopeptides of type I collagen and serum levels of alkaline phosphatase decreased significantly from the baseline values (–44.9% at 3 months and –22.2% at 12 months, respectively. The SOS increased modestly, but significantly, from the baseline value (0.6% at both 6 and 12 months. The percentage decrease in the urinary levels of cross-linked N-terminal telopeptides of type I collagen at 3 months was significantly correlated with the percentage increase in the SOS only at 6 months (correlation coefficient, 0.299.Conclusion: The present study confirmed that ALN treatment suppressed bone turnover, producing a clinically significant increase in the SOS of the calcaneus in postmenopausal Japanese women with osteoporosis.Keywords: postmenopausal osteoporosis, quantitative ultrasound (QUS, SOS, bone turnover, biochemical markers

Effectiveness and safety of calcium and vitamin D treatment for postmenopausal osteoporosis.

Science.gov (United States)

Cesareo, R; Iozzino, M; D'onofrio, L; Terrinoni, I; Maddaloni, E; Casini, A; Campagna, G; Santonati, A; Palermo, A

2015-09-01

Imbalance of bone resorption and bone formation is responsible for osteoporosis that is characterized by decreased bone mass and mineral density. The aim of this study was to evaluate the available data that could clarify the effectiveness and safety of supplementations with calcium and vitamin D, alone or in combination, to slow down bone loss in postmenopausal and elderly women. Using search key words, we performed a research both in the PubMed and Cochrane Library in order to find all meta-analysis, prospective and randomized clinical studies published from 2000 to 2014 that had investigated the effectiveness of calcium and vitamin D in the treatment of osteoporosis. At the moment it is not possible either to provide reassurance that calcium supplements given with vitamin D do not cause adverse cardiovascular events or to link them with certainty to increased cardiovascular risk. According to the data now available, vitamin D, at dosage of at least 800 IU/day, alone or in combination with antiresorptive drugs, should be administered in osteoporotic and osteopenic patients for a primary and secondary prevention. Further studies are needed and the debate remains ongoing. However, every administration needs the calculation of the absolute fracture risk of the patient. Especially considering the high cost of osteoporosis prevention, more studies are mandatory to clarify indications and contraindications.

Osteoporosis

Science.gov (United States)

... bearing exercises such as walking, jogging, playing tennis, dancing Free weights, weight machines, stretch bands Balance exercises ... 27759931 www.ncbi.nlm.nih.gov/pubmed/27759931 . Black DM, Rosen CJ. Clinical practice: postmenopausal osteoporosis. N ...

Correlation between bone mineral density and oxidative stress in postmenopausal women

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Tripti Sharma

2015-01-01

Full Text Available Background: Postmenopausal osteoporosis affects large fraction of elderly women. Oxidative stress (OS appears to be involved in its pathogenesis. The scarcity of human studies focusing on the correlation between bone mineral density (BMD and OS in postmenopausal women has prompted us to study on this issue. Materials and Methods: We conducted a cross sectional study in 95 subjects, between 21-65 years of age, including postmenopausal osteoporotic females (n = 35, healthy postmenopausal females (n = 30 and healthy females in reproductive age group (n = 30. We measured serum antioxidant activity of superoxide dismutase (SOD, catalase, glutathione peroxidase (GPx, and total antioxidant power (TAP. BMD was obtained at lumbar spine and femur neck by dual-energy X-ray absorptiometry scan. Osteoporosis was considered when subjects had a BMD of 2.5 standard deviations or more below the mean value for young adults. Results: Serum GPx, SOD, catalase and TAP level were found significantly lower in osteoporotic postmenopausal group as compared to healthy postmenopausal women and women in healthy reproductive age group healthy reproductive women (P 0.005. Conclusion: These findings support that oxidative stress plays an important role in pathogenesis of postmenopausal osteoporosis. We did not find any significant association between BMD and serum level of antioxidants (P > 0.05. The failure to detect this association does not preclude the role of OS in osteoporosis because OS is complex and dynamic process.

Osteoporosis in men

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Waldemar Misiorowski

2017-06-01

Full Text Available Osteoporotic fractures are the leading cause of morbidity and mortality among aging men. 30% of all hip fractures occur in men, and mortality resulting from not only the hip fracture, but also the spine and other major osteoporotic fractures, is significantly higher in men than in women. As in women, hypogonadism is the best documented risk factor for developing osteoporosis in men. In older men, testosterone levels are negatively correlated with the risk of fractures, and it seems that this age-related testosterone deficiency should not be considered as one of the many causes of secondary osteoporosis, rather one of the major and most important mechanisms of senile osteoporosis. Acute hypogonadism induced by ablation treatment for prostate cancer (surgical or pharmacological castration, antiandrogen therapy is associated with an extremely high risk of fracture. Other documented causes of bone loss in men are cigarette smoking and alcohol abuse, and a number of diseases that require corticosteroid treatment. Pharmacotherapy of osteoporosis should be recommended to all men with a diagnosed osteoporotic fracture and all men with a high 10-year absolute fracture risk (FRAXTM. Not all drugs registered for the treatment of postmenopausal osteoporosis have been registered for the treatment of osteoporosis in men, and others have not been the subject of long-term and costly clinical trials required for such registration. The risk reduction of new fractures was documented only for treatment with zoledronic acid. Risedronate, strontium ranelate, teriparatide, and denosumab in men increase in bone mineral density comparable to that seen in postmenopausal women.

Hormone replacement for osteoporosis in women with primary biliary cirrhosis

DEFF Research Database (Denmark)

Rudic, Jelena S; Poropat, Goran; Krstic, Miodrag N

2011-01-01

Women with primary biliary cirrhosis often suffer from postmenopausal osteoporosis due to their age, or osteoporosis secondary to their liver disease, or treatments provided for their liver disease. Hormone replacement increases bone mineral density and reduces fractures in postmenopausal women...

Safety of bazedoxifene in a randomized, double-blind, placebo- and active-controlled phase 3 study of postmenopausal women with osteoporosis

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Palacios Santiago

2010-06-01

Full Text Available Abstract Background We report the safety findings from a 3-year phase 3 study (NCT00205777 of bazedoxifene, a novel selective estrogen receptor modulator under development for the prevention and treatment of postmenopausal osteoporosis. Methods Healthy postmenopausal osteoporotic women (N = 7,492; mean age, 66.4 years were randomized to daily doses of bazedoxifene 20 or 40 mg, raloxifene 60 mg, or placebo for 3 years. Safety and tolerability were assessed by adverse event (AE reporting and routine physical, gynecologic, and breast examination. Results Overall, the incidence of AEs, serious AEs, and discontinuations due to AEs in the bazedoxifene groups was not different from that seen in the placebo group. The incidence of hot flushes and leg cramps was higher with bazedoxifene or raloxifene compared with placebo. The rates of cardiac disorders and cerebrovascular events were low and evenly distributed among groups. Venous thromboembolic events, primarily deep vein thromboses, were more frequently reported in the active treatment groups compared with the placebo group; rates were similar with bazedoxifene and raloxifene. Bazedoxifene showed a neutral effect on the breast and an excellent endometrial safety profile. The incidence of fibrocystic breast disease was lower with bazedoxifene 20 and 40 mg versus raloxifene or placebo. Reductions in total and low-density lipoprotein levels and increases in high-density lipoprotein levels were seen with bazedoxifene versus placebo; similar results were seen with raloxifene. Triglyceride levels were similar among groups. Conclusion Bazedoxifene showed a favorable safety and tolerability profile in women with postmenopausal osteoporosis. Trial Registration Trial registration number: NCT00205777; Trial registration date: September 16, 2005

Performance of the Osteoporosis Self-Assessment Tool in ruling out low bone mineral density in postmenopausal women: a systematic review

DEFF Research Database (Denmark)

Rud, B; Hilden, J; Hyldstrup, L

2007-01-01

SUMMARY: The Osteoporosis Self-Assessment Tool (OST) is a simple test that may be of clinical value to rule-out low bone mineral density. We performed a systematic review to assess its performance in postmenopausal women. We included 36 studies. OST performed moderately in ruling-out femoral neck T...

Performance of the osteoporosis self-assessment tool in ruling out low bone mineral density in postmenopausal women: A systematic review

DEFF Research Database (Denmark)

Rud, B.; Hilden, Jørgen; Hyldstrup, L.

2007-01-01

SUMMARY: The Osteoporosis Self-Assessment Tool (OST) is a simple test that may be of clinical value to rule-out low bone mineral density. We performed a systematic review to assess its performance in postmenopausal women. We included 36 studies. OST performed moderately in ruling-out femoral neck T...

[Osteoporosis in premenopausal women].

Science.gov (United States)

Mitringer, Antje; Pietschmann, P

2002-01-01

Osteoporosis is a systemic disease of bone, which is characterized by decreased bone mass and changes in the microarchitecture of bone tissue followed by brittleness of bones and increased risk of fractures. Osteoporosis frequently is a disease of postmenopausal women, nevertheless, in rare cases, osteoporosis can also occur in young adults. There are only few studies on the pathophysiology of "premenopausal osteoporosis"; in addition to idiopathic forms, osteoporosis in young women can be caused by glucocorticoid treatment, by eating disorders or can be associated with pregnancy.

Time and Dose-Dependent Effects of Labisia pumila on Bone Oxidative Status of Postmenopausal Osteoporosis Rat Model

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Nadia Mohd Effendy

2014-08-01

Full Text Available Postmenopausal osteoporosis can be associated with oxidative stress and deterioration of antioxidant enzymes. It is mainly treated with estrogen replacement therapy (ERT. Although effective, ERT may cause adverse effects such as breast cancer and pulmonary embolism. Labisia pumila var. alata (LP, a herb used traditionally for women’s health was found to protect against estrogen-deficient osteoporosis. An extensive study was conducted in a postmenopausal osteoporosis rat model using several LP doses and duration of treatments to determine if anti-oxidative mechanisms were involved in its bone protective effects. Ninety-six female Sprague-Dawley rats were randomly divided into six groups; baseline group (BL, sham-operated (Sham, ovariectomised control (OVXC, ovariectomised (OVX and given 64.5 μg/kg of Premarin (ERT, ovariectomised and given 20 mg/kg of LP (LP20 and ovariectomised and given 100 mg/kg of LP (LP100. The groups were further subdivided to receive their respective treatments via daily oral gavages for three, six or nine weeks of treatment periods. Following euthanization, the femora were dissected out for bone oxidative measurements which include superoxide dismutase (SOD, glutathione peroxidase (GPx and malondialdehyde (MDA levels. Results: The SOD levels of the sham-operated and all the treatment groups were significantly higher than the OVX groups at all treatment periods. The GPx level of ERT and LP100 groups at the 9th week of treatment were significantly higher than the baseline and OVX groups. MDA level of the OVX group was significantly higher than all the other groups at weeks 6 and 9. The LP20 and LP100 groups at the 9th week of treatment had significantly lower MDA levels than the ERT group. There were no significant differences between LP20 and LP100 for all parameters. Thus, LP supplementations at both doses, which showed the best results at 9 weeks, may reduce oxidative stress which in turn may prevent bone loss via its

A Survey of Osteoporosis and Breast Cancer Risk Perception among Menopausal and Postmenopausal Women in Hong Kong

OpenAIRE

Chow, Louis WC; Cheung, Michael MC; Chu, Jennifer WJ; Li, Ivy CF

2017-01-01

Objectives A lack of understanding in menopausal and postmenopausal women's (PMW) risk perception towards osteoporosis and breast cancer still exists, which is explored in this study. This information might allow health professionals to conduct interventions to improve health behaviors before menopause-related diseases are imminent. Methods Between 10 December 2015 and 31 January 2016, 573 menopausal or PMW were successfully interviewed on 17 questions, comprising separate sections for osteop...

[Influence of spinal orthosis on gait and physical functioning in women with postmenopausal osteoporosis].

Science.gov (United States)

Schmidt, K; Hübscher, M; Vogt, L; Klinkmüller, U; Hildebrandt, H D; Fink, M; Banzer, W

2012-03-01

Osteoporosis is a widespread chronic bone disease leading to an increased risk of bone fractures. The most common clinical consequences are back pain, hyperkyphosis, limitations of physical functioning and activities of daily living as well as reduced quality of life. Furthermore, osteoporosis is associated with decreased strength and deficits of gait and balance, all together resulting in an increased risk of falls and a subsequent aggravation of fracture risk. Besides pharmaceutical and exercise therapy, back orthoses are increasingly being used in the therapy of osteoporosis and rehabilitation after vertebral fractures. Previous studies have shown that wearing a spinal orthosis results in a reduction of pain as well as improvements of posture and back extensor strength. To date there is no study that has evaluated the effects of a spinal orthosis on gait stability and physical functioning in patients with osteoporosis. Therefore the purpose of the present study was to assess the effects of a spinal orthosis on gait and pain-induced limitations of activities of daily living (ADL) in women with osteoporosis. A total of 69 postmenopausal osteoporotic women with and without vertebral fractures were randomly assigned to receive either a spinal orthosis (Thämert Osteo-med intervention group n=35; average age 74 ± 8.3 years, height 158.3 ± 6.3 cm, weight 62.8 ± 9.6 kg, t-score -2.6  ± 1.0, number of vertebral fractures 1.4 ± 2.0) or to a waiting list control group (n= 34, age 74.1 ± 7.7 years, height 159.6 ± 5.9 cm, weight 65.4 ± 11.3 kg, t-score -2.9± 0.8, number of vertebral fractures: 0.9 ± 1.2). The following outcome measures were collected at baseline and at 3 and 6 months follow-up: gait parameters including gait analysis: velocity, stride length and width, double support time (% of gait cycle) and perceived limitations in activities of daily living (numeric rating scale 1-10; 1=best, 10= worst situation). The ANCOVA indicated a

Clinical strategies to address patients' concerns in osteoporosis management with bisphosphonates.

Science.gov (United States)

Cole, Raymond E

2011-03-01

Approximately 44 million Americans either have, or are at risk of developing, osteoporosis, a disease associated with an increased risk of fracture and, consequently, morbidity and mortality. Osteoporosis affects 20% to 30% of postmenopausal women, and resulting fractures pose a major economic burden, with estimated annual direct costs ranging from $17 billion to $19 billion. Hip fractures account for the majority of costs (~60%) because they often require costly long-term follow-up care in addition to the direct costs of initial treatment. Screening, diagnosis, and disease management are of paramount importance when treating patients at risk for osteoporosis. The National Osteoporosis Foundation recommends that all postmenopausal women be evaluated for osteoporosis risk factors and that all women aged ≥ 65 years undergo bone mineral density testing. Once the primary care physician has identified a patient at risk for osteoporosis-related fracture, the physician must decide whether and how to treat the patient (ie, nonpharmacologic or pharmacologic options). Bisphosphonates are the first-line pharmacologic treatment for women aged ≥ 50 years with postmenopausal osteoporosis. Bisphosphonates-which have a favorable safety and tolerability profile in clinical trials-have shown efficacy in reducing fractures. However, achieved real world effectiveness is very much dependent on good treatment adherence by the patient. Media attention to rare adverse events has motivated some patients to deliberate nonadherence. Physicians should screen patients for contraindications and adverse event risk factors, educate them on the risks of fracture and benefits and risks of treatment, and monitor them during therapy. To assist primary care physicians in clinical decision making for women at risk for or with confirmed osteoporosis, this article presents a review of the guidelines for the diagnosis and treatment of postmenopausal osteoporosis, recent long-term efficacy data for

Optimizing dosing frequencies for bisphosphonates in the management of postmenopausal osteoporosis: patient considerations

Directory of Open Access Journals (Sweden)

John Sunyecz

2008-12-01

Full Text Available John SunyeczMenopauseRx, Inc., Hopwood, PA, USAAbstract: Postmenopausal osteoporosis is common and underrecognized among elderly women. Osteoporotic fractures cause disability and disfigurement and threaten patients’ mobility, independence, and survival. Care for incident fractures in this age group must go beyond orthopedic repair, to assessment and treatment of the underlying bone fragility. Fracture risk can be reduced by vitamin D and calcium supplementation along with antiresorptive drug treatment. First-line osteoporosis pharmacotherapy employs nitrogen-containing bisphosphonates. The inconvenience of daily oral treatment has motivated development of weekly, monthly, and intermittent oral regimens, as well as quarterly and yearly intravenous (iv regimens. Ibandronate is the first bisphosphonate to have shown direct anti-fracture efficacy with a non-daily regimen; it was approved for once-monthly oral dosing in 2005 and for quarterly iv dosing in 2006. Intermittent oral risedronate and yearly iv zoledronic acid were approved in 2007. Newly available regimens with extended dosing intervals reduce the inconvenience of bisphosphonate therapy and provide patients with a range of options from which to select a maximally sustainable course of treatment. This review discusses the development, efficacy, safety, and tolerability of extended-interval bisphosphonate regimens and examines their potential to improve patient acceptance and long-term success of osteoporosis treatment.Keywords: ibandronate, alendronate, risedronate, zoledronic acid, adherence, persistence

Treatment of osteoporosis after alendronate or risedronate

DEFF Research Database (Denmark)

Eiken, P; Vestergaard, P

2016-01-01

Alendronate (ALN) and risedronate (RIS) are ideal as first-choice therapy options in the treatment of postmenopausal osteoporosis. What to do for patients who do not respond adequately to bisphosphonates has not been conclusively determined, but transitioning to other therapies should be considered....... The aim of this article is to describe potential alternatives for patients switching from ALN or RIS to other therapies for osteoporosis. A systematic search of PubMed was conducted to find papers that evaluate the effects of switching therapies on fractures, bone mineral density (BMD), or bone turnover...... markers. Results from 11 studies that prospectively assessed treatment after ALN or RIS in women with postmenopausal osteoporosis were reviewed. All studies are of short duration (all 24 months or less) and assess the topic of transitioning therapy from ALN or RIS. None of the studies had the statistical...

A Survey of Osteoporosis and Breast Cancer Risk Perception among Menopausal and Postmenopausal Women in Hong Kong.

Science.gov (United States)

Chow, Louis Wc; Cheung, Michael Mc; Chu, Jennifer Wj; Li, Ivy Cf

2017-08-01

A lack of understanding in menopausal and postmenopausal women's (PMW) risk perception towards osteoporosis and breast cancer still exists, which is explored in this study. This information might allow health professionals to conduct interventions to improve health behaviors before menopause-related diseases are imminent. Between 10 December 2015 and 31 January 2016, 573 menopausal or PMW were successfully interviewed on 17 questions, comprising separate sections for osteoporosis and breast cancer. The target respondents were menopausal or PMW aged 45 to 60 years, with no previous diagnosis of osteoporosis or breast cancer, who attended private clinics across Hong Kong for annual physical examination. Regarding menopausal issues, the top three concerns were osteoporosis and fracture (72%), breast cancer (44%), and sleep disorder/insomnia/headache (40%). Among 314 respondents (55%) who tried to prevent osteoporosis, 74% of them began to do it after they were 40 years old. On the other hand, 65% of respondents never had a bone density test. For respondents who said "I'm too young, so I don't need to check", their mean age was 52 years old. Ninety percent of respondents mistakenly believed that regular breast examination, regular breast massage, drink soy milk, or vaccine can prevent breast cancer. This survey revealed osteoporosis and breast cancer as the top concerns among menopausal and PMW in Hong Kong. Inadequate health behaviors and misconceptions still exist despite widespread health education in the recent years.

Lead and osteoporosis: Mobilization of lead from bone in postmenopausal women

Energy Technology Data Exchange (ETDEWEB)

Silbergeld, E.K. (Environmental Defense Fund, WA (USA)); Schwartz, J. (Environmental Protection Agency, Washington, DC (USA)); Mahaffey, K. (National Institute of Environmental Health Sciences, Research Triangle Park, NC (USA))

1988-10-01

Although it has been known that humans accumulate lead in bone, mineralized tissue has been considered primarily as a sequestering compartment and not as a site of toxic action for lead. However, experimental data indicate that bone lead can be released during conditions of demineralization, such as pregnancy and lactation. We have examined lead status in women, before and after menopause, using the NHANES II dataset compiled between 1976 and 1980. In 2981 black and white women there was a highly significant increase in both whole blood and calculated plasma lead concentrations after menopause. The results indicate that bone lead is not an inert storage site for absorbed lead. Moreover, lead may interact with other factors in the course of postmenopausal osteoporosis, to aggravate the course of the disease, since lead is known to inhibit activation of vitamin D, uptake of dietary calcium, and several regulatory aspects of bone cell function. The consequences of this mobilization may also be of importance in assessing the risks of maternal lead exposure to fetal and infant health.

Treated Hypertension has No Influence on the Efficacy of Alendronate in the Therapy of Postmenopausal Osteoporosis: A Non-Randomized, Non-Blind, Controlled Prospective Study

OpenAIRE

Matziolis, Doerte; Drewke, Monika; Matziolis, Georg; Perka, Carsten

2011-01-01

Changes in hormone metabolism during menopause are involved in the development of osteoporosis and arterial hypertension. A mutual influence of these two clinical pictures is evident on the basis of pathophysiological factors. In this study, we investigated whether a drug therapy of hypertension influences the efficacy of a bisphosphonate (alendronate) in the treatment of postmenopausal osteoporosis. For this purpose, 60 female patients were enrolled in the study, 30 of them on drug treatment...

Bone turnover in postmenopausal osteoporosis

International Nuclear Information System (INIS)

Thomsen, K.

1988-02-01

Studies of the bone turnover in postmenopausal osteoporosis are essential, because the associated bone loss is inevitably due to the relative increase of bone resorption compared with bone formation. Measurement of the bone mineral content (BMC) in normal adults is assessed - partly on the uncorrected values and partly in proportion to the body muscle mass. The whole body retention (WBR) method is presented. The WBR and alternative urinary excretion (UE) methods used by the author are characterised and compared with the retention methods described in the literature. The representativity of WBR and UE for the estimation of bone turnover in normal subjects and patients with various bone metabolic diseases is discussed. The conclusion is that the modified retention methods used by the author have a satisfactory precision and accuracy in relation to the clinical studies carried out. The author's modification of the WBR method for determination of bone turnover and the alternative urinary excretion method (UE) consists in continuous scanning in the whole body count, using a gamma camera, and with the collimator a short distance from the volunteer. This procedure has the advantage of restricting the radioactive dose to 2 mCi (72 MBa). This is smaller by a factor of 5-10 than the dose used to measure WBR with equally simple counting equipment: With the author's procedure, using frontal counting, WBR is systematically underestimated by about 4 per cent point compared to the purely dorsal count, but since the frontal position is the most comfortable, requires a smaller radioactive dose, and the error is systematic, it is the preferred counting procedure. Correction of WBR and UE for bone mineral content is in principle a new parameter of bone turnover, whose improved accuracy increases the validity of the retention determinations. 136 refs. (EG)

Concern and risk perception of osteoporosis and fracture among post-menopausal Australian women: results from the Global Longitudinal Study of Osteoporosis in Women (GLOW) cohort.

Science.gov (United States)

Barcenilla-Wong, A L; Chen, J S; March, L M

2013-01-01

The purpose of this study is to identify factors associated with concern and perception of risks of osteoporosis and osteoporotic fractures and determine whether bone mineral density (BMD) testing influenced concern and risk perception. Study subjects (n = 1,082, age 55-94 years) were female Australian participants of the Global Longitudinal Study of Osteoporosis in Women (GLOW). Self-administered questionnaires were sent annually from 2007 to 2010. Study outcomes included 'concern about osteoporosis', 'perception of getting osteoporosis' and 'perception of fracture risk' compared to similar aged women. The closest post-BMD testing or baseline questionnaires were used for women with and without BMD testing, respectively. Multinomial logistic regression was used for the analysis. BMD testing, prior fracture after age 45, younger age and lower self-reported general health were significantly associated with being 'very' or 'somewhat concerned' about osteoporosis and having a 'much higher' or 'little higher' risk perception of osteoporosis and fractures. A poorer BMD result was associated with higher concern and higher risk perceptions. The presence of comorbidities, having ≥2 falls in the preceding year and maternal osteoporosis were associated with higher concern. Maternal osteoporosis, presence of comorbidities, weight loss of ≥5 kg in the preceding year and low body mass index were associated with higher perceptions of osteoporosis risk. Women's concern and risk perception of osteoporosis and osteoporotic fractures were reasonably well founded. However, increasing age, height loss, smoking and drinking were not associated with concern and perception despite being known osteoporosis risk factors. These factors should be considered in planning for education and awareness raising programmes.

Nutritional risk factors for postmenopausal osteoporosis | Berriche ...

African Journals Online (AJOL)

Background: Osteoporosis is a bone disease that combines both a decrease in bone density and its internal architecture changes. Nutrition is one of the major determinants of osteoporosis. Aim: The purpose of our study was to identify nutritional risk factors of osteoporosis of two groups of osteoporotic women and ...

The epidemiology of osteoporosis in Italian postmenopausal women according to the National Bone Health Alliance (NBHA) diagnostic criteria: a multicenter cohort study.

Science.gov (United States)

Cipriani, C; Pepe, J; Bertoldo, F; Bianchi, G; Cantatore, F P; Corrado, A; Di Stefano, M; Frediani, B; Gatti, D; Giustina, A; Porcelli, T; Isaia, G; Rossini, M; Nieddu, L; Minisola, S; Girasole, G; Pedrazzoni, M

2018-04-01

The study was aimed at evaluating the prevalence of osteoporosis, defined by BMD and the National Bone Health Alliance (NBHA) criteria, and the prevalence of clinical risk factors for fractures in Italian postmenopausal women. This is a cross-sectional, multicenter, cohort study evaluating 3247 postmenopausal women aged ≥ 50 and older in different areas of Italy in the period 2012-2014. All the participants were evaluated as far as anthropometrics; questionnaires for FRAX ® and DeFRA calculation were administered and bone mineral density was measured at lumbar spine, femoral neck and total hip by DXA. The prevalence of osteoporosis, as assessed by BMD and NBHA criteria was 36.6 and 57%, respectively. Mean ± SD values of FRAX ® and DeFRA were: 10.2 ± 7.3 and 11 ± 9.4 for major fractures, and 3.3 ± 4.9 and 3.9 ± 5.9 for hip fractures, respectively. Among clinical risk factors for fracture, the presence of previous fracture, particularly non-spine/non-hip fracture, parental history of hip fracture and current smoking were the most commonly observed. Our study showed that more that the half of postmenopausal women aged 50 and older in Italy has osteoporosis on the basis of the NBHA criteria. There is a relevant high risk of femur fracture, as assessed by the FRAX ® and DeFRA and previous fracture, parental history of hip fracture and current smoking are the most common risk factors. The data should be considered particularly in relation to the need to increase prevention strategies on modifiable risk factors and therapeutic intervention.

[Osteoporosis and stress].

Science.gov (United States)

Kumano, Hiroaki

2005-09-01

There may be three ways of relationship between stress and osteoporosis. The first is that stress induces some physiological changes leading to osteoporosis. The second is that stress induces behavioral distortion of eating, drinking, exercise, and sleep habits, which leads to osteoporosis. The third is that osteoporosis, on the other hand, brings about anxiety, depression, loss of social roles, and social isolation, which leads to stress. The susceptible sex and age groups are postmenopausal women and young women. The abrupt decrease of estrogen in postmenopausal women promotes reabsorption of bone, and it was also reported that the increase of interleukin-6 (IL-6) that is downstream of estrogen was related to the production of osteoclast and to the development of disability of the aged. Regarding the association with stress, while it was reported that depression or depressive states directly increased inflammation-induced cytokines including IL-6, it was also pointed out that stress-induced easy infectious may produce chronic infection, which indirectly increases inflammation-induced cytokines. Anorexia Nervosa that is assumed to be associated with adolescent developmental stress is noteworthy in young women. Amenorrhea is always present in this disease, and in addition to bone reabsorption associated with estrogen deficiency, the decrease of bone formation associated with malnutrition may be related to the development of osteoporosis.

Menatetrenone versus alfacalcidol in the treatment of Chinese postmenopausal women with osteoporosis: a multicenter, randomized, double-blinded, double-dummy, positive drug-controlled clinical trial

Directory of Open Access Journals (Sweden)

Jiang Y

2014-01-01

Full Text Available Yan Jiang,1,* Zhen-Lin Zhang,2,* Zhong-Lan Zhang,3 Han-Min Zhu,4 Yi-Yong Wu,5 Qun Cheng,4 Feng-Li Wu,5 Xiao-Ping Xing,1 Jian-Li Liu,3 Wei Yu,6 Xun-Wu Meng11Department of Endocrinology, Key Laboratory of Endocrinology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, 2Metabolic Bone Disease and Genetic Research Unit, Department of Osteoporosis and Bone Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, Shanghai, 3Department of Gynecology and Obstetrics, General Hospital of the People's Liberation Army, Beijing, 4Department of Geriatrics, Shanghai Huadong Hospital, Shanghai, 5Department of Gynecology and Obstetrics, Beijing Hospital, Ministry of Public Health, Beijing, 6Department of Radiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, People's Republic of China*These authors contributed equally to this workObjective: To evaluate whether the efficacy and safety of menatetrenone for the treatment of osteoporosis is noninferior to alfacalcidol in Chinese postmenopausal women.Method: This multicenter, randomized, double-blinded, double-dummy, noninferiority, positive drug-controlled clinical trial was conducted in five Chinese sites. Eligible Chinese women with postmenopausal osteoporosis (N=236 were randomized to Group M or Group A and received menatetrenone 45 mg/day or alfacalcidol 0.5 µg/day, respectively, for 1 year. Additionally, all patients received calcium 500 mg/day. Posttreatment bone mineral density (BMD, new fracture onsets, and serum osteocalcin (OC and undercarboxylated OC (ucOC levels were compared with the baseline value in patients of both groups.Results: A total of 213 patients (90.3% completed the study. After 1 year of treatment, BMD among patients in Group M significantly increased from baseline by 1.2% and 2.7% at the lumbar spine and trochanter, respectively (P<0.001; and the percentage increase of BMD in Group A was 2

The effect of timing of teriparatide treatment on the circadian rhythm of bone turnover in postmenopausal osteoporosis

Czech Academy of Sciences Publication Activity Database

Luchavová, M.; Zikán, V.; Michalská, D.; Raška, I.; Kuběna, Aleš Antonín; Štěpán, J. J.

2011-01-01

Roč. 164, č. 4 (2011), s. 643-648 ISSN 0804-4643 Grant - others:GA MZd(CZ) NS10564 Institutional research plan: CEZ:AV0Z10750506 Keywords : intact parathyroid-hormone * serum cortisol * diurnal rhythm * growth-hormone * in-vivo * resorption * osteoprotegerin * calcium * abnormalities * osteocalcin Subject RIV: FB - Endocrinology, Diabetology, Metabolism, Nutrition Impact factor: 3.423, year: 2011 http://library.utia.cas.cz/separaty/2011/E/kubena-the effect of timing of teriparatide treatment on the circadian rhythm of bone turnover in postmenopausal osteoporosis.pdf

Impact of medication adherence on health care utilization and productivity: self-reported data from a cohort of postmenopausal women on osteoporosis therapy.

Science.gov (United States)

Wade, Sally W; Satram-Hoang, Sacha; Nadkar, Aalok; Macarios, David; Tosteson, Anna N A

2011-12-01

Many pharmacologic agents are approved for the prevention and treatment of osteoporosis, which is common among postmenopausal women. Evidence exists relating treatment persistence to fracture risk. Less is known about treatment persistence and the use of health care service and individual productivity. This study was undertaken to describe health care use and productivity loss relative to osteoporosis medication persistence using women's self-reported data from the Prospective Observational Scientific Study Investigating Bone Loss Experience (POSSIBLE US™), a large, longitudinal (October 2004-December 2009) osteoporosis cohort study of postmenopausal women. Analyses included women on pharmacologic osteoporosis therapy (alendronate, risedronate, ibandronate, calcitonin, raloxifene, or teriparatide) who provided health care use/productivity data collected using semiannual questionnaires over 1 year of follow-up. Participant characteristics, use, and productivity metrics were summarized. Logistic regression models and generalized linear models were used to examine use, time missed from usual activities, number of days spent in bed, and lost work time relative to treatment persistence, adjusting for potential confounders. At entry, of the 2528 women studied (91% white, 3.1% Hispanic/Latino, 2.3% African American/black, 1.1% Asian, and 2.1% American Indian/Native Alaskan, Native Hawaiian/Pacific Islander, or other; mean age, 64.6 [range, 37-97] years), 43.1% had osteoporosis and 23.4% had a previous fracture. After adjustment, subjects who switched therapies during follow-up were more likely to have had any kind of diagnostic testing (95.2% of switchers vs 91.2% of persistent subjects and 88.9% of discontinuers, P work loss (n = 852 employed subjects) by treatment persistence were not significant. Use of diagnostic testing differed significantly by osteoporosis treatment status. Compared with women who persisted with treatment, primary care provider visits were less

Effects of age at first pregnancy and breast-feeding on the development of postmenopausal osteoporosis.

Science.gov (United States)

Schnatz, Peter F; Barker, Kathaleen G; Marakovits, Kimberly A; O'Sullivan, David M

2010-01-01

Although pregnancy and breast-feeding require adequate calcium mobilization, it is not known if these affect the acquisition of a healthy peak bone mass (PBM) and, hence, postmenopausal osteoporosis (OPS). The objective of this study was to analyze previous pregnancies and/or breast-feeding and their association with OPS. After obtaining institutional review board approval, postmenopausal women (>49 y) presenting for a dual-energy x-ray absorptiometry bone density scan were invited to participate. Risk factors for OPS, including previous fractures, pregnancy information, and dual-energy x-ray absorptiometry results, were collected. OPS was defined as a T score of -2.5 or lower. Data were obtained from 619 women. Of these, 49.8% were smokers, 27.2% used a bisphosphonate, 64.1% used hormone therapy, and 5.5% had used steroids. Based on PBM, ages at first pregnancy were dichotomized to younger than 27 years and 27 years or older. Women with a history of breast-feeding had a lower prevalence of OPS (7.6%) versus women who had never breast-fed (18.7%; P pregnancy when they were 27 years or older and a history of breast-feeding had the lowest prevalence of OPS (4.6%) versus women with a first pregnancy when they were younger than 27 years and no history of breast-feeding (16.3%; P = 0.001). Breast-feeding seems to significantly decrease the incidence of postmenopausal OPS. Women whose first pregnancy occurs after PBM (≥27 y of age) and who have a history of breast-feeding had the lowest prevalence of OPS. Thus, an association between OPS and both breast-feeding and age of pregnancy seems to be present.

The relationship between bone mineral density and adipose tissue of postmenopausal women

Energy Technology Data Exchange (ETDEWEB)

Kim, Sun Hwa [Dept. of Radiology, HwaMyeong Iisin christian Hospital, Busan (Korea, Republic of); Kim, Jung Hoon [Dept. of Radiological Science, Catholic University of Pusan, Busan (Korea, Republic of); Im, In Chul [Dept. of Radiological Science, Dong Eui University, Busan (Korea, Republic of)

2017-06-15

Postmenopausal women are at increased risk for osteoporosis and obesity due to changes in hormones. The relationship between osteoporosis and body weight is known, and its relation with body fat mass is discussed. The purpose of this study was to evaluate the bone mineral density(BMD) changes of epicardial adipose tissue(EAT) and abdominal subcutaneous fat. The subjects of this study were 160 postmenopausal women who underwent BMD and echocardiography. The thickness of the epicardial adipose tissue was measured in three sections and the BMD were meassured according to the diagnostic criteria. The results of this study that age increase the risk of osteoporosis increases, and as the weight and BMI decrease, the risk of osteoporosis increases(p<0.05). The relationship between changes in bone mineral density and adipose tissue in postmenopausal women, increased epicardial adipose tissue was negatively correlated with the bone mineral density(p<0.05). conversely, increased abdominal subcutaneous fat thickness was positively correlated with bone mineral density(p<0.05). In other words, the effect of bone mineral density on the location of adipose tissue was different. If Echocardiography is used to periodically examine changes in the thickness of the epicardial adipose tissue, it may be prevented before proceeding to osteoporosis.

The optimal value of BMI for the lowest risk of osteoporosis in postmenopausal women aged 40-88 years.

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Skrzek, A; Kozieł, S; Ignasiak, Z

2014-06-01

The aim of this paper is to establish the optimal values of the body mass index (BMI) which would indicate the most favourable preservation of the bone mineral density in postmenopausal women. The material consists of the data of 369 healthy women aged between 40 and 88 years (mean age 67.84, SD=6.70) inhabitants of Wrocław, which were followed up between 2001 and 2006. The absolute measure of bone mineral density (BMD) of the femoral neck was assessed using dual energy X-ray absorptiometry (DEXA), expressed in g/(100mm(2)) and was transformed to T-score values. According to the value of BMI, the women were divided into eight groups, the reference group with value between 18.0 and 21.9kg/m(2) and seven other groups beginning with the value 22.0 with a 2-point interval. Postmenopausal status was defined according to the occurrence of menstruation within the last 360 days. The women with osteopenia and osteoporosis were pooled together and comprised the risk group, whereas the other women comprised the normal group (T-score values above -1.0). The adjusted odds ratio showed the highest value for intervals between 24.0 and 25.9 units of BMI, and the lowest value for interval 26.0-27.9 units of BMI. The Youden index showed the lowest value in the 26.0-27.9BMI kg/m(2) interval. For our sample the optimal value of BMI, with the lowest risk of osteopenia and/or osteoporosis was the value of 26.9kg/m(2). A further increase of BMI does not result in a favourable effect on the bones, it rather intensifies negative phenomena in the body resulting in the onset of many diseases. Copyright © 2014. Published by Elsevier GmbH.

The cost effectiveness of teriparatide as a first-line treatment for glucocorticoid-induced and postmenopausal osteoporosis patients in Sweden

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Murphy Daniel R

2012-10-01

Full Text Available Abstract Background This paper presents the model and results to evaluate the use of teriparatide as a first-line treatment of severe postmenopausal osteoporosis (PMO and Glucocorticoid-induced osteoporosis (GIOP. The study’s objective was to determine if teriparatide is cost effective against oral bisphosphonates for two large and high risk cohorts. Methods A computer simulation model was created to model treatment, osteoporosis related fractures, and the remaining life of PMO and GIOP patients. Natural mortality and additional mortality from osteoporosis related fractures were included in the model. Costs for treatment with both teriparatide and oral bisphosphonates were included. Drug efficacy was modeled as a reduction to the relative fracture risk for subsequent osteoporosis related fractures. Patient health utilities associated with age, gender, and osteoporosis related fractures were included in the model. Patient costs and utilities were summarized and incremental cost-effectiveness ratios (ICERs for teriparatide versus oral bisphosphonates and teriparatide versus no treatment were estimated. For each of the PMO and GIOP populations, two cohorts differentiated by fracture history were simulated. The first contained patients with both a historical vertebral fracture and an incident vertebral fracture. The second contained patients with only an incident vertebral fracture. The PMO cohorts simulated had an initial Bone Mineral Density (BMD T-Score of −3.0. The GIOP cohorts simulated had an initial BMD T-Score of −2.5. Results The ICERs for teriparatide versus bisphosphonate use for the one and two fracture PMO cohorts were €36,995 per QALY and €19,371 per QALY. The ICERs for teriparatide versus bisphosphonate use for the one and two fracture GIOP cohorts were €20,826 per QALY and €15,155 per QALY, respectively. Conclusions The selection of teriparatide versus oral bisphosphonates as a first-line treatment for the high risk PMO

BONE MARKERS IN MONITORING OF ANTIRESORPTIVE THERAPY IN POSTMENOPAUSAL OSTEOPOROSIS PATIENTS

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Tanja Džopalić

2015-09-01

Full Text Available The aim of this work was to study the effect of two modalities of antiosteoporotic therapy in postmenopausal women at the level of biochemical markers of bone turnover such as bone specific alkaline phosphatase (BALP and deoxypiridinoline (Dpd as well as bone mineral density (BMD. The study included 87 patients with postmenopausal osteoporosis (OP. Group A consisted of 48 patients treated with alendronate (AL, whereas group B included 39 patients treated with hormone replacement therapy (HRT. BMD was measured by Lunar DPX 2000 device, on the lumbar spine and the femur, and bone markers (BM were measured by commercial ELISA assays. There was a statistically significant decrease in the levels of BALP and Dpd after 6 weeks and 8 months of both types of therapy compared to the level of these markers before therapy. There was a statistically significant increase of BMD on both locations after 8 months of both therapies. In addition, there was a statistically significantly higher degree of changes of Dpd values in the group treated with AL than in the group treated with HRT. On the other hand, the changes in the level of BALP were significantly higher in the group treated with HRT. We concluded that the early effect of the two studied antiosteoporotic medications can be monitored by changes in the levels of BM. Dpd as bone resorption marker proved to be a better indicator of the efficiency of applied medications compared to bone formation markers such as BALP.

Preventing Osteoporosis in Postmenopausal Women: Treatment ...

African Journals Online (AJOL)

Osteoporosis is defined as a systemic skeletal disorder that reduces the strength of bone, resulting in an increased risk of fracture. Fractures occur, even if an individual is subjected to minimal trauma such as a fall from own body height. The most common osteoporotic fractures are fractures of the vertebrae, femur neck and ...

The Relation Between Blood Lead Levels and Osteoporosis in Turkish Women

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Nurver Turfaner Ertürk

2004-03-01

Full Text Available Lead is a toxic heavy element which is to 90% deposited in bone until the 6th decade and is given to the blood with pregnancy, lactation and physiologic osteoporosis. When it is over certain amounts it may cause osteoporosis and an increase in cardiac events and cancer. In order to evaluate the effect of menopause and osteoporosis on blood lead 20 post-menopausal osteoporotic, 19 non-osteoporotic and 21 pre-menopausal women were selected and their blood levels were measured. In post-menopausal women, its relation with bone mineral density was also investigated. There was no difference between osteoporotic and non-osteoporotic women and pre and postmenopausal women in terms of blood lead (Pb. There was no relation between age and Pb levels but in non-osteoporotic postmenopausal women there was a negative correlation between Pb levels and duration of menopause. There was no relation between bone mineral density and blood lead whereas blood lead and environmental pollution displayed a meaningful correlation.

[Synthetic human calcitonin in Paget's disease of bone and osteoporosis (author's transl)].

Science.gov (United States)

Nuti, R; Vattimo, A

1981-01-30

Synthetic human calcitonin was used in the treatment of 26 patients over a period of 1-14 months. 17 patients had Paget's disease of the bone, 6 postmenopausal osteoporosis and 3 Sudeck's syndrome. Subjective improvement (reduction of pain, improvement of mobility) was found in 15 patients with Paget's disease, in 4 females with postmenopausal osteoporosis and in all 3 patients with Sudeck's syndrome. Radiographic improvement of bone changes developed only very slowly. These results were confirmed by diminution of the exchangeable calcium pool indicating reduction of rates of osseous degradation. Calcitonin tolerance was acceptable. Transitory nausea and occasional vomiting occurred in 3 patients.

[Frequency of diagnosis of postmenopausal osteoporosis of the spine, distant radius and extravertebral fractures in women with normal body mass, overweight and obesity].

Science.gov (United States)

Popov, A A; Izmozherova, N V; Fominykh, M I; Tagil'tseva, N V; Kozulina, E V; Gavrilova, E I

2008-01-01

To assess features and peculiarities of postmenopausal osteoporosis (OP) in women with normal body mass, overweight and obesity. Dual energy X-ray absorptiometry of the lumbal spine (Lunar DPX) and distal radius X-ray absorptiometry (DTX 200) were performed during cross-section study of 730 symptomatic postmenopausal women. OP was diagnosed in 253 (34.7%) women, 30.5% of them had normal body mass, 43.2% had overweight and 26.3% were obese. Among them 227 had atraumatic fractures at the age over 50 years. Obese OP patients had significantly higher frequency of arterial hypertension, chronic heart failure, osteoarthritis and glucose metabolism disorders than osteoporotic patients with normal body mass. Fracture frequency did not differ between groups with normal body mass, overweight and obesity. Excessive body mass did not decrease fracture risk in women with postmenopausal OP.

The Effect of Alendronate and Calcitonin Treatments on Bone Mineral Density and Quality of Life in Women With Postmenopausal Osteoporosis

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F. Taşçıoğlu

2002-06-01

Full Text Available The aim of this study was to compare the effect of alendronate and calcitonin treatments on bone mineral density (BMD and quality of life of women with postmenopausal osteoporosis. One hundred ninety-three patients were randomly assigned to two groups: 93 patients received daily doses of 10 mg alendronate and calcium 1000 mg, and 98 patients used intranasal salmon calcitonin (sCt at a dosage of 200 IU/day and they also received daily doses of 1000 mg calcium supplements. DXA was used for the measurement of BMD of the lumbar spine and proximal femur before and after the study period. SF-36 was used as a measure of health-related quality of life. At the end of the treatment, ALN produced significant increases in BMD at the lumbar spine (p< 0.001, femur neck (p<0.05, trochanteric region (p<0.001 and at the Ward triangle (p<0.05. In contrast, intranasal sCt treatment resulted in a significant bone loss in the femur neck (p<0.01 and Ward triangle (p<0.05, and only a significant increase in BMD of the lumbar spine was observed with calcitonin treatment(p< 0.05. Quality of life as assessed by SF-36 improved significantly in both groups(p<0.05. In conclusion, alendronate seemed to be more effective than calcitonin, increasing both spinal and femoral BMD, for the treatment of postmenopausal osteoporosis. Both treatments were found to be effective for the improvement of quality of life.

Microstructural properties of trabecular bone autografts: comparison of men and women with and without osteoporosis.

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Xie, Fen; Zhou, Bin; Wang, Jian; Liu, Tang; Wu, Xiyu; Fang, Rui; Kang, Yijun; Dai, Ruchun

2018-03-05

The microstructure of autologous bone grafts from men over 50 years old and postmenopausal women undergoing spinal fusion were evaluated using micro-CT. We demonstrated postmenopausal women, especially those with osteoporosis (OP) presented more serious microarchitectural deterioration of bone grafts. This study was undertaken to determine microstructural properties of cancellous bone used as autologous bone grafts from osteoporosis patients undergoing lumbar fusion by comparing microstructural indices to controls. Cancellous bone specimens from spinous processes were obtained from 41 postmenopausal women (osteoporosis women, n = 19; controls, n = 22) and 26 men over 50 years old (osteoporosis men, n = 8; controls, n = 18) during lumbar fusion surgery. The microstructural parameters were measured using micro-CT. Significant difference in bone volume fraction (BV/TV), specific bone surface (BS/BV), trabecular thickness (Tb.Th), and structure model index (SMI) value existed between postmenopausal women with OP and controls. Significant difference in trabecular number (Tb.N) existed between men over 50 years old with OP and controls. Postmenopausal women exhibited lower BV/TV, Tb.Th, and higher SMI value than men over 50 years old. Postmenopausal women with OP exhibited lower BV/TV, Tb.Th, and higher BS/BV than men over 50 years old with OP. Post-menopausal women and older men with OP have worse bone quality in autografts than non-osteoporotic men and women. Postmenopausal women with OP presented serious microarchitectural deterioration in older population.

[Secondary osteoporosis in gynecology].

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Taguchi, Y; Gorai, I

1998-06-01

Several diseases and medications are known to induce secondary osteoporosis. Among them, same situations are related to gynecological field. They include Turner's syndrome, anorexia nervosa, ovarian dysfunction, oophorectomy, GnRH agonist therapy, and osteoporosis associated with pregnancy. We briefly describe these secondary osteoporosis in this article as follows. Several studies have found osteoporosis to be a common complication of Turner's syndrome and hormone replacement therapy has been used as a possible management; in anorexic patient, low body weight, prolonged amenorrhea, early onset of anorexia nervosa, and hypercortisolism have been reported to be risks for bone demineralization; since oophorectomy which is a common intervention in gynecology leads osteoporosis, it is important to prevent osteoporosis caused by surgery as well as postmenopausal osteoporosis; GnRH agonist, which induces estrogen deficient state and affect bone mass, is commonly used as a management for endometriosis and leiomyoma of uterus; associated with pregnancy, post-pregnancy spinal osteoporosis and transient osteoporosis of the hip are clinically considered to be important and heparin therapy and magnesium sulfate therapy are commonly employed during pregnancy, affecting calcium homeostasis.

Association of urinary sodium/creatinine ratio with bone mineral density in postmenopausal women: KNHANES 2008-2011.

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Kim, Sung-Woo; Jeon, Jae-Han; Choi, Yeon-Kyung; Lee, Won-Kee; Hwang, In-Ryang; Kim, Jung-Guk; Lee, In-Kyu; Park, Keun-Gyu

2015-08-01

Accumulating evidence shows that high sodium chloride intake increases urinary calcium excretion and may be a risk factor for osteoporosis. However, the effect of oral sodium chloride intake on bone mineral density (BMD) and risk of osteoporosis has been inadequately researched. The aim of the present study was to determine whether urinary sodium excretion (reflecting oral sodium chloride intake) associates with BMD and prevalence of osteoporosis in postmenopausal women. This cross-sectional study involved a nationally representative sample consisting of 2,779 postmenopausal women who participated in the Korea National Health and Nutritional Examination Surveys in 2008-2011. The association of urinary sodium/creatinine ratio with BMD and other osteoporosis risk factors was assessed. In addition, the prevalence of osteoporosis was assessed in four groups with different urinary sodium/creatinine ratios. Participants with osteoporosis had significantly higher urinary sodium/creatinine ratios than the participants without osteoporosis. After adjusting for multiple confounding factors, urinary sodium/creatinine ratio correlated inversely with lumbar spine BMD (P = 0.001). Similarly, when participants were divided into quartile groups according to urinary sodium/creatinine ratio, the average BMD dropped as the urinary sodium/creatinine ratio increased. Multiple logistic regression analysis revealed that compared to quartile 1, quartile 4 had a significantly increased prevalence of lumbar spine osteoporosis (odds ratios 1.346, P for trend = 0.044). High urinary sodium excretion was significantly associated with low BMD and high prevalence of osteoporosis in lumbar spine. These results suggest that high sodium chloride intake decreases lumbar spine BMD and increases the risk of osteoporosis in postmenopausal women.

Osteoporosis of the slender smoker. Vertebral compression fractures and loss of metacarpal cortex in relation to postmenopausal cigarette smoking and lack of obesity.

Science.gov (United States)

Daniell, H W

1976-03-01

A group of thirty-eight women under age 70 who sustained vertebral compression fractures during minor trauma included more postmenopausal smokers than a group of 34 similar women with fractures resulting from major trauma and more than a group of 572 other women. Advanced idiopathic osteoporosis occurring before age 65 was found rarely among nonsmokers. The percent cortical area at the second metacarpal midpoint was measured in 103 white women aged 40 to 49 years, and 208 white women aged 60 to 69 years. In the younger group, no quantitative differences were demonstrated between bones of the obese and the nonobese or between smokers and nonsmokers. In contrast, among the older group, postmenopausal smokers exhibited much more bone loss than did nonsmokers (P less than .001), and nonobese women demonstrated much more bone loss than did obese women, this difference being most striking among smokers.

Teriparatide (recombinant human parathyroid hormone 1-34 in postmenopausal women with osteoporosis: systematic review

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Virgínia Fernandes Moça Trevisani

Full Text Available CONTEXT AND OBJECTIVE: Osteoporosis is defined as a disease characterized by low bone mass and deterioration of the bone tissue microarchitecture. Teriparatide stimulates the formation and action of osteoblasts, which are responsible for bone formation, thus promoting bone tissue increase. The aim was to assess the effectiveness and safety of teriparatide for treating postmenopausal osteoporosis. METHODS: A systematic review was conducted using the Cochrane Collaboration methodology. RESULTS: 1 Teriparatide 20 µg or 40 µg versus placebo: there was a benefit from teriparatide, considering the following outcomes: reduction in the number of new vertebral and non-vertebral fractures, and increased whole-body, lumbar and femoral bone mineral density. 2 Teriparatide 40 µg versus alendronate 10 mg/day for 14 months: there was no statistical difference regarding the incidence of new vertebral or non-vertebral fractures, although in the group that received teriparatide there was greater bone mineral density increase in the whole body, lumbar column and femur. 3 Estrogen plus teriparatide 25 µg versus estrogen: there was a benefit, considering the following outcomes: reduction in the number of new vertebral fractures, and increased whole-body, lumbar and femoral bone mineral density after three years. CONCLUSIONS: When teriparatide is intermittently administered in low doses, it reduces the incidence of vertebral fractures (67% and non-vertebral fractures (38% and increases bone mineral density in the lumbar column and femur. There is a need for studies with longer observation in order to allow conclusions regarding the safety and duration of the therapeutic effects.

Influence of exercise on bone remodeling-related hormones and cytokines in ovariectomized rats: a model of postmenopausal osteoporosis.

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Lihui Li

Full Text Available This study aims to explore the effects of exercise on postmenopausal osteoporosis and the mechanisms by which exercise affects bone remodeling. Sixty-three Wistar female rats were randomly divided into five groups: (1 control group, (2 sham-operated group, (3 OVX (Ovariectomy group, (4 DES-OVX (Diethylstilbestrol-OVX group, and (5 Ex-OVX (Exercise-OVX group. The rat osteoporosis model was established through ovariectomy. The Ex-OVX rats were made to run 251.2 meters every day, 6 d/wk for 3 months in a running wheel. Trabecular bone volume (TBV%, total resorption surface (TRS%, trabecular formation surface (TFS%, mineralization rate (MAR, bone cortex mineralization rate (mAR, and osteoid seam width (OSW were determined by bone histomorphometry. The mRNA and protein levels of interleukin-1β (IL-1β2, interleukin-6 (IL-6, and cyclooxygenase-2 (Cox-2 were determined by in situ hybridization and immunohistochemistry, respectively. Serum levels of estrogen estradiol (E2, calcitonin (CT, osteocalcin (BGP, and parathyroid hormone (PTH were determined by ELISA assays. The investigation revealed that compared to the control and the sham-operated groups, the OVX group showed significantly lower levels of TBV%, E2, and CT, but much higher levels of TRS%, TFS%, MAR, OSW, BGP, and PTH. The Ex-OVX group showed increased TBV% and serum levels of E2 and CT compared to the OVX group. Ovariectomy also led to a significant increase in IL-1β mRNA and protein levels in the bone marrow and IL-6 and Cox-2 protein levels in tibias. In addition, the Ex-OVX group showed lower levels of IL-1 mRNA and protein, IL-6 mRNA, and Cox-2 mRNA and protein than those in the OVX group. The upshot of the study suggests that exercise can significantly increase bone mass in postmenopausal osteoporosis rat models by inhibiting bone resorption and increasing bone formation, especially in trabecular bones.

Serum leptin is correlated to high turnover in osteoporosis.

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Hipmair, Gunter; Böhler, Nikolaus; Maschek, Wilma; Soriguer, Federico; Rojo-Martínez, Gemma; Schimetta, Wolfgang; Pichler, Robert

2010-01-01

Clinical data have suggested that obesity protects against osteoporosis. Leptin, mainly secreted by white adipose tissue, might be involved by mediating an effect on bone metabolism. This study was conducted to investigate a possible relationship of leptin and bone turn-over in postmenopausal women with osteoporosis. We measured bone mineral density (BMD), serum leptin levels and markers of bone metabolism, including osteocalcin and cross-laps in 44 patients with osteoporosis. The main group consisted of 32 postmenopausal women. Mean serum leptin was 13.1 microg/L and showed no statistically significant difference to the levels measured in a collective of normal persons adjusted for age and BMI. When related to serum cross-laps as markers of bone resorption, a positive correlation (posteoporosis.

Guidelines for the diagnosis, prevention and treatment of osteoporosis

OpenAIRE

M. Rossini; G. Rini; R. Nuti; S. Minisola; S. Migliaccio; C. Mereu; L. Masi; C. Marcocci; E. Mannarino; G. Luisetto; G.C. Isaia; S. Gonnelli; S. Giannini; B. Frediani; E. Fiore

2011-01-01

The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD) by DXA (dual-e...

The Prevalence of Fibromyalgia in Postmenopausal Osteoporotic Women and to Determination of Related Risk Factors (Preliminary Study)

OpenAIRE

Şule Şahin Onat; Sibel Ünsal Delialioğlu; Sibel Özbudak Demir; Sumru Özel

2014-01-01

Objective: The purpose of the study was to determine the prevalence of fibromyalgia in postmenopausal women with osteoporosis and to determine the associated factors with fibromyalgia. Materials and Methods: Hundred thirty-seven postmenopausal women with osteoporosis admitted to our outpatient clinic were included in the study. A questionnaire that was including patients’age, marital status, education level, occupation, height, weight was completed. Risk factors of osteoporosis we...

An international study of the relationship between alcohol consumption and postmenopausal estradiol levels

DEFF Research Database (Denmark)

Gavaler, J S; Love, K; Van Thiel, D

1991-01-01

Because of the beneficial effect of estrogens on the risk of cardiovascular disease and osteoporosis in postmenopausal women, the factors which influence endogenous postmenopausal estrogen levels are of substantial importance. The major source of postmenopausal estrogen is the aromatization...

The Association between the Consumption of Fish/Shellfish and the Risk of Osteoporosis in Men and Postmenopausal Women Aged 50 Years or Older

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Eunjin Choi

2016-02-01

Full Text Available Fish rich in n-3 polyunsaturated fatty acids have been suggested to have a favorable effect on bone health, but previous epidemiologic studies have shown inconsistent results. The purpose of the present study was to investigate the hypothesis that the consumption of fish and shellfish is positively associated with bone mass and negatively associated with the risk of osteoporosis in Koreans and Americans. Men and postmenopausal women ≥50 years old from the Korean National Health and Nutrition Examination Survey 2008–2011 (n = 7154 and the National Health and Nutrition Examination Survey 2007–2010 (n = 2658 were included. There was a positive correlation between the consumption of fish and shellfish and bone mineral density (BMD of the total femur, femoral neck, and lumbar spine in Koreans. Consistently, multivariate logistic regression analysis showed a significant association between intake of fish and shellfish and the risk of osteoporosis in Koreans but not in Americans. Consumption of fish and shellfish was 4–5 times higher in Koreans than Americans in the present study. In conclusion, intake of fish and shellfish was associated with BMD and the risk of osteoporosis in Koreans but not in Americans, suggesting that a minimum intake level of fish and shellfish might be recommended to protect against bone loss and osteoporosis.

Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women: comparison of measurement methods

International Nuclear Information System (INIS)

Reinbold, W.D.; Genant, H.K.; Reiser, U.J.; Harris, S.T.; Ettinger, B.

1986-01-01

To investigate associations among methods for noninvasive measurement of skeletal bone mass, we studied 40 healthy early postmenopausal women and 68 older postmenopausal women with osteoporosis. Methods included single- and dual-energy quantitative computed tomography (QCT) and dual-photon absorptiometry (DPA) of the lumbar spine, single-photon absorptiometry (SPA) of the distal third of the radius, and combined cortical thickness (CCT) of the second metacarpal shaft. Lateral thoracolumbar radiography was performed, and a spinal fracture index was calculated. There was good correlation between QCT and DPA methods in early postmenopausal women and modest correlation in postmenopausal osteoporotic women. Correlations between spinal measurements (QCT or DPA) and appendicular cortical measurements (SPA or CCT) were modest in healthy women and poor in osteoporotic women. Measurements resulting from one method are not predictive of those by another method for the individual patient. The strongest correlation with severity of vertebral fracture is provided by QCT; the weakest, by SPA. There was a high correlation between single- and dual-energy QCT results, indicating that errors due to vertebral fat are not substantial in these postmenopausal women. Single-energy QCT may be adequate and perhaps preferable for assessing postmenopausal women. The measurement of spinal trabecular bone density by QCT discriminates between osteoporotic women and younger healthy women with more sensitivity than measurements of spinal integral bone by DPA or of appendicular cortical bone by SPA or CCT

Collagen Type I alpha1 (COL1A1 Gene Polymorphism and Bone Mineral Density in Postmenopausal Kazakh Women

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Akbota Aitkulova

2014-12-01

Full Text Available Introduction: Single nucleotide polymorphism (SNP at the collagen type I alpha 1 gene (COL1A1 rs1800012 has been widely studied and has shown an association with bone mineral density (BMD and fractures. A minor allele TT of this SNP was found to be greatly overrepresented in individuals with fractures compared to controls, thus becoming a good predictor of  increased fracture risk. The aim of this investigation was to evaluate potential association between COL1A1 gene polymorphism and osteoporosis in Kazakh postmenopausal women.Methods: The study population included 103 postmenopausal women recruited from Pavlodar and Almaty clinics. BMD was measured using DEXA. Genomic DNA was extracted from peripheral venous blood of study participants with Wizard® Genomic DNA Purification Kit (Promega, USA. Detection of COL1A1 +1245G/T (Sp1 polymorphism was done by the TaqMan® SNP Genotyping Assay of real-time PCR.Results: Densitometry results revealed 36 osteoporotic, 42 osteopenic, and 25 normal postmenopausal women. Data analysis of 1245G>T polymorphism in COL1A1 gene in the group of women with osteopenia and osteoporosis revealed deviation from Hardy-Weinberg equilibrium. The mutant TT genotype was prevalent compared to the heterozygous genotype GT in both groups. Distributions were 83% GG, 3% GT, and 14% TT in the group with osteopenia and 80% GG, 6% GT, and 14% TT in the group with osteoporosis. The distribution of genotypes frequency in the group of normal postmenopausal women was 76% GG, 16% GT, and 8% TT.Conclusion: These results suggest that TT genotype of COL1A1 +1245G/T (Sp1 polymorphism is associated with risk of postmenopausal osteoporosis in Kazakh women. Further studies involving a larger number of women are needed to clarify the relationship of this polymorphism with risk of osteoporosis. 

Nutritional risk factors for postmenopausal osteoporosis

African Journals Online (AJOL)

Olfa Berriche

2016-07-26

Jul 26, 2016 ... Received 12 February 2016; revised 26 March 2016; accepted 31 March 2016. Available online 26 ... greatly affects the health of postmenopausal women and is rec- ognized as a major ..... for public comment. Washington.

Kefir improves bone mass and microarchitecture in an ovariectomized rat model of postmenopausal osteoporosis.

Science.gov (United States)

Chen, H-L; Tung, Y-T; Chuang, C-H; Tu, M-Y; Tsai, T-C; Chang, S-Y; Chen, C-M

2015-02-01

Kefir treatment in ovariectomized (OVX) rats could significantly decrease the levels of bone turnover markers and prevent OVX-induced bone loss, deterioration of trabecular microarchitecture, and biomechanical dysfunction that may be due to increase intracellular calcium uptake through the TRPV6 calcium channel. Osteoporosis is a disease characterized by low bone mass and structural deterioration of bone tissue, leading to an increased fracture risk. The incidence of osteoporosis increases with age and occurs most frequently in postmenopausal women due to estrogen deficiency, as the balance between bone resorption and bone formation shifts towards increased levels of bone resorption. Among various methods of prevention and treatment for osteoporosis, an increase in calcium intake is the most commonly recommended preventive measure. Kefir is a fermented milk product made with kefir grains that degrade milk proteins into various peptides with health-promoting effects, including immunomodulating-, antithrombotic-, antimicrobial-, and calcium-absorption-enhancing bioactivities. The aim of this study is to investigate the effect of kefir on osteoporosis prophylaxis in an ovariectomized rat model. A total of 56 16-week-old female Sprague-Dawley (SD) rats were divided into 7 experimental groups: sham (normal), OVX/Mock, OVX/1X kefir (164 mg/kg BW/day), OVX/2X kefir (328 mg/kg BW/day), OVX/4X kefir (656 mg/kg BW/day), OVX/ALN (2.5 mg/kg BW/day), and OVX/REBONE (800 mg/kg BW/day). After 12-week treatment with kefir, the bone physiology in the OVX rat model was investigated. Accordingly, the aim of this study was to investigate the possible transport mechanism involved in calcium absorption using the Caco-2 human cell line. A 12-week treatment with kefir on the OVX-induced osteoporosis model reduced the levels of C-terminal telopeptides of type I collagen (CTx), bone turnover markers, and trabecular separation (Tb. Sp.). Additionally, treatment with kefir increased

Assessment of bone mineral density with dual energy X-ray absorptiometry in pre-and post-menopausal women

International Nuclear Information System (INIS)

Salamat, M. R.; Rostampour, N.; Shanehsazzadeh, S.; Tavakoli, M. B.; Siavash, M.; Almasi, T.

2008-01-01

Osteoporosis is a chronic disease that contributes substantially to decrease physical activity and decline in the quality of life. Osteoporosis can be diagnosed easily with the use of dual-energy X-ray absorptiometry equipment. The aim of this study was to investigate the magnitude of bone loss on proximal femur and lumbar spine in pre-and post-menopausal women from Isfahan Osteoporosis Diagnosis Center since 2005. Materials and Methods: Bone mineral density measurements using dual-energy X-ray absorptiometry have been performed at Isfahan Osteoporosis Diagnosis Center. 185 pre-menopausal and 174 early post-menopausal women were selected randomly. A Norland XR46 system was used for the investigations. The student t-lest was done to find the difference between the T-scores of the femoral neck and lumbar spine in pre-and post-menopausal women. Results: Mean Bone mineral density for the femoral neck and lumbar spine in pre-menopausal women were 0.859 ± 0.136 and 1.012 ± 0.161 and in post-menopausal women were 0.816 ± 0.119 and 0.919 ± 0.140, respectively. Long-term Bone mineral density CVs of 1.0% and 1.2% for the lumbar spine and femoral neck were found, respectively. The differences between the femoral neck and lumbar spine for pre-and post-menopausal women were t = -9.02, P < 0.05 and t = -3.50, P < 0.05, respectively. Conclusion: In spite of, the reported lower Bone mineral density T-scores for the lumbar spine compared With the femoral neck for women, we found that the femoral neck had significantly lower T-score than lumbar spine for both pre-and post-menopausal women.

Osteoporosis in pregnancy: more than postural backache.

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Topping, J; Black, A J; Farquharson, R G; Fraser, W D

1998-01-01

Though uncommon, osteoporosis can occur in pregnancy or shortly after delivery. The most common feature is back pain, often severely disabling. Suspect osteoporosis if pain of sudden onset in the upper lumbar or thoracic spine is not relieved by simple analgesia, or if there is a noticeable loss of height. X-rays reveal low bone density and fractures of the vertebrae. 70% of cases occur in first pregnancies. Recurrence is unusual. Most cases resolve spontaneously; a minority cause disability lasting months or years. If osteoporosis is diagnosed, breast feeding should be discouraged because of its effect on bone mineral density. Anyone who has had osteoporosis of pregnancy is at risk of postmenopausal osteoporosis and should take medical advice.

The Prevalence of Fibromyalgia in Postmenopausal Osteoporotic Women and to Determination of Related Risk Factors (Preliminary Study

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Şule Şahin Onat

2014-04-01

Full Text Available Objective: The purpose of the study was to determine the prevalence of fibromyalgia in postmenopausal women with osteoporosis and to determine the associated factors with fibromyalgia. Materials and Methods: Hundred thirty-seven postmenopausal women with osteoporosis admitted to our outpatient clinic were included in the study. A questionnaire that was including patients’age, marital status, education level, occupation, height, weight was completed. Risk factors of osteoporosis were recorded. major and minor risk factors were determined according to Canadian diagnosis and treatment guideline. DXA was used to determine bone mineral density of the lumbar spine and femoral neck. Thoracal and lumbar compression fractures were evaulated with thoracal and lumbar radiography. The diagnosis of fibromyalgia was according to the 1990 American College of Rheumatology (ACR criteria. Results: Twenty-six (19% of 137 postmenopausal women with osteoporosis had fibromyalgia. Ninety-four (68.6% of all patients were married and 43 (31.4% of all patients were not married, 63 (46% of all patients were literate, 74 (54% of all patients were illiterate. The average age of patients was 73.56±6.17. According to the results of logistic regression analysis, advanced age, to be married, the number of major risk factors and the decrease of lomber and femur bone mineral density were found to be risk factors for fibromyalgia. Educational level, BMI and the number of minor risk factors were not found to be a risk factors for fibromyalgia. Conclusion: It is importatnt to be careful for fibromyalgia not only in premenopousal women but also in postmenopausal osteoporotic women. (Turkish Journal of Osteoporosis 2014;20: 1-5

2002 clinical practice guidelines for the diagnosis and management of osteoporosis in Canada

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Brown, Jacques P.; Josse, Robert G.

2002-01-01

Objective To revise and expand the 1996 Osteoporosis Society of Canada clinical practice guidelines for the management of osteoporosis, incorporating recent advances in diagnosis, prevention and management of osteoporosis, and to identify and assess the evidence supporting the recommendations. Options All aspects of osteoporosis care and its fracture complications — including classification, diagnosis, management and methods for screening, as well as prevention and reducing fracture risk — were reviewed, revised as required and expressed as a set of recommendations. Outcomes Strategies for identifying and evaluating those at high risk; the use of bone mineral density and biochemical markers in diagnosis and assessing response to management; recommendations regarding nutrition and physical activity; and the selection of pharmacologic therapy for the prevention and management of osteoporosis in men and women and for osteoporosis resulting from glucocorticoid treatment. Evidence All recommendations were developed using a justifiable and reproducible process involving an explicit method for the evaluation and citation of supporting evidence. Values All recommendations were reviewed by members of the Scientific Advisory Council of the Osteoporosis Society of Canada, an expert steering committee and others, including family physicians, dietitians, therapists and representatives of various medical specialties involved in osteoporosis care (geriatric medicine, rheumatology, endocrinology, obstetrics and gynecology, nephrology, radiology) as well as methodologists from across Canada. Benefits, harm and costs Earlier diagnosis and prevention of fractures should decrease the medical, social and economic burdens of this disease. Recommendations This document outlines detailed recommendations pertaining to all aspects of osteoporosis. Strategies for identifying those at increased risk (i.e., those with at least one major or 2 minor risk factors) and screening with central

Osteoporosis in men: a review

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Adler, Robert A

2014-01-01

Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high ri...

Clinical Conformity Between Heel Ultrasound and Densitometry in Postmenopausal Women: A Systematic Review.

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Tabor, Elżbieta; Pluskiewicz, Wojciech; Tabor, Kamil

2018-02-01

To assess the conformity between heel ultrasound and densitometry, and the clinical application of densitometry T-score "gold standard" in quantitative ultrasound as a method of osteoporosis diagnosis in postmenopausal women. The study is a systematic review of studies published in the last 17 years in PubMed, NLM Gateway, Medline, Embase, and Cochrane Library. Calcaneal quantitative ultrasound sensitivity and specificity were analyzed with regard to densitometry measurements in postmenopausal women. In addition, we summarized the values of ultrasound T-scores, for which their accuracy in osteoporosis diagnosis is the highest. The inclusion criteria met 15 research studies conducted on postmenopausal women. In 11 of them, the authors concluded that clinical conformity between heel ultrasound and densitometry is good. The recommended quantitative ultrasound T-score for osteoporosis diagnosis ranged between -1 and -3.65. Heel ultrasound should be considered to be as accurate as densitometry in diagnosing osteoporosis. Nevertheless, it needs to have separate T-score ranges determined, because those used in densitometry are not adequate. © 2017 by the American Institute of Ultrasound in Medicine.

Correlation of Estradiol Serum Levels with Classification of Osteoporosis Risk OSTA (Osteoporosis Self-Assessment Tools for Asian in Menopause Women

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Eva Maya Puspita

2017-01-01

Full Text Available Background: In postmenopausal women, decreasing estrogen levels is a marker of ovarian dysfunction. Hypoestrogenic state has known increasing the risk of osteoporosis. Objective: To determine the correlation between estradiol serum levels with classification of osteoporosis risk OSTA (Osteoporosis Self-Assessment Tools for Asian in menopausal women. Methods: This study was case series study which examined estradiol serum in menopausal women by ELISA and assess the osteoporosis risk using osteoporosis risk classification OSTA. Total 47 samples was collected at Dr. H.Adam malik, dr. Pirngadi, and RSU Networking in Medan. This research was conducted from May to December 2016. Data were statistically analyzed, and presented with Spearman test. Results: In this study, we found the mean levels of estradiol in menopausal women was 18.62 ± 16.85 ng / ml with OSTA osteoporosis risk score of 2.09 ± 2.45. There was a significant positive correlation between estradiol and risk of osteoporosis OSTA with correlation coefficient r = 0.825 and p <0.05. Conclusion: There is a strong positive correlation between serum levels of estradiol with OSTA osteoporosis risk assessment in menopausal women.

Influence of lean and fat mass on bone mineral density (BMD) in postmenopausal women with osteoporosis.

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Dytfeld, Joanna; Ignaszak-Szczepaniak, Magdalena; Gowin, Ewelina; Michalak, Michał; Horst-Sikorska, Wanda

2011-01-01

Despite known positive association between body mass and bone mineral density (BMD), relative contribution of fat and lean tissue to BMD remains under debate. We aimed at investigating the effect of selected anthropometric parameters, including fat content and lean body mass (LBM) on BMD in postmenopausal, osteoporotic women with body mass index (BMI) > 20 kg/m(2). The study involved 92 never-treated women (mean age 69.5 ± 7.3). L1-L4 and femoral neck (FN) BMD were measured by dual energy X-ray absorptiometry (DEXA). Absolute (kg) and relative (%) fat and LBM were assessed by means of electric bioimpedance method. We showed both FN and L1-L4 BMD were positively correlated with body mass, waist circumference (WC), hip circumference (HC) and LBM (kg). Fat content correlated with FN BMD (r = 0.36, p obese. Obese women displayed the highest BMD. Both L1-L4 and FN BMD were higher in women with WC > 80 cm. In postmenopausal osteoporotic women with BMI > 20 kg/m(2) both fat and lean tissue might contribute to BMD. Positive association between body mass and BMD does not make obesity and osteoporosis mutually exclusive. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Teriparatide in the management of osteoporosis

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Donald Bodenner

2008-01-01

Full Text Available Donald Bodenner, Carolyn Redman, Ann RiggsDepartment of Geriatrics, University of Arkansas for Medical Sciences, Little Rock, AR, USAAbstract: Fracture of the hip is frequently a catastrophic event in the elderly, often resulting in death within a year and of the survivors, few regain pre-fracture quality of life. Although less appreciated, fractures of the spine result in significant morbidity and are also associated with increased mortality compared with individuals without a fracture. In recent years there has been an explosion in the development of new drugs for the treatment of osteoporosis. Recombinant human parathyroid hormone (1–34 (20 μg/day is a recent addition to this armamentarium with a novel mechanism of action, which was approved by the US FDA for the treatment of postmenopausal osteoporosis and male osteoporosis secondary to hypogonadism in November 2002. It is the first osteoporosis treatment that leads to the formation of new bone with architecture similar to normal bone. Intense efforts have been made to understand the effect of teriparatide on antiresorptive therapy and vice versa. Although these relationships are not completely understood, the results of recent studies allow clinicians to begin to optimize therapeutic gains in bone mineral density and improve anti-fracture efficacy.Keywords: osteoporosis, teriparatide, fracture

Adherence to treatment with denosumab, its efficacy and safety in women with postmenopausal osteoporosis in clinical practice

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N. V. Toroptsova

2015-01-01

Full Text Available Adherence to treatment with antiosteoporotic drugs is one of the most important factors contributing to their efficacy during longterm therapy. The adherence is assessed by two main lines: firstly, how long a drug is taken and, secondly, whether its dosage regimen is adhered.Subjects and methods. The paper gives the data of a 12-month prospective follow-up study of 40 women with postmenopausal osteoporosis (OP who initiated treatment with the biological agent denosumab.Results and discussion. After the 12-month follow-up, the significant bone mineral density increase was 4.9% in the lumbar spine, 3.2% in the femoral neck, and 3.0% in the total hip. The previous administration of other antiosteoporotic drugs did not lower the efficiency of denosumab therapy. There were no cases of osteoporotic fractures during 1-year follow-up. 95% of the patients received two denosumab injections (an annual cycle; moreover, 90% of the women were noted to adhere to the dosage regimen. Age, marital status, level of education, time taken to reach the clinic, parental femoral fractures, a history of fractures, duration of OP, and previous therapy had no impact on treatment adherence during 12 months.Conclusion. The one-year prospective follow-up study of the outpatients demonstrated that denosumab was an effective and safe agent for the treatment of patients with postmenopausal OP and its dosage regimen implying its rare subcutaneous administration (twice yearly ensured the high patient adherence to therapy.

Cost of osteoporosis-related fracture in Italy. Results of the BLOCK study

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Luca Degli Esposti

2011-09-01

Full Text Available The objectives of the present study were to calculate the cost of illness of osteoporosis and to assess drug utilization patterns in postmenopausal women after a fracture-related hospitalization. The study subjects were enrolled from a large population-based administrative database. Female patients (age ≥ 65 years who were hospitalized for a typical osteoporotic fracture between 1/1/2000 and 31/12/2005 were included. Patients were classified as exposed/unexposed to treatment according to the presence/absence of at least one prescription for an osteoporosis-related medication in the 6 months following the discharge date. Treatment adherence was calculated for patients who were exposed to bisphosphonate therapy and was defined as at least 80% of treatment coverage during the follow-up period of 18 months after the discharge date. Hospitalizations, medications, diagnostic tests, laboratory tests and specialist visits during the 18-month follow-up period were collected and classified as osteoporosis-related or non-related to osteoporosis. A total of 12,376 patients were included in the study (mean age ± SD, 79.1 ± 7.5 years, out of which 97.9% (n = 12,110 were hospitalized due to an osteoporosis-related fracture and only 2.1% (n = 266 had general osteoporosis diagnosis. Among the 12,110 women with a fracture, 15.2% (n = 1,845 had a subsequent fracture-related hospitalization (63.8% of the patients had hip fracture. Only 32.3% (n = 4,001 of all included patients was exposed to osteoporosis-related medications and out of those patients exposed to bisphosphonates (n = 860 only 34.2% (n = 294 was adherent to therapy. The average cost per patient was € 4,481, of which € 1,089 was for osteoporosis-related and € 3,392 for non-osteoporosis-related items. The average cost of a matching cohort of patients without hospitalizations for fracture was € 2,339. Among osteoporosis-related costs, 87.0% was due to hospitalizations for subsequent fractures

Bisfosfonatos: Aplicaciones Actuales en Osteoporosis y Cáncer

OpenAIRE

Poma Carmona, Augusto; Gutiérrez, Guiselle; Casas, Jorge

2014-01-01

Bisphosphonates are antiresorptive agents with high affinity for hidroxiapatite crystals. They are not degraded by pyrophosphatases. Their main indications are treatment of post-menopausic osteoporosis, corticosteroid-induced osteoporosis, Paget´s disease, neoplasm-induced hypercalcemia and osteolytic bone disease by cancer. Los bisfosfonatos son compuestos antirresortivos con alta afinidad por los cristales de hidroxiapatita y no son degradados por las pirofosfatasas. Sus principales indi...

The effect of short-term low-energy ultraviolet B irradiation on bone mineral density and bone turnover markers in postmenopausal women with osteoporosis: A randomized single-blinded controlled clinical trial

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Micić Ivan

2013-01-01

Full Text Available Introduction. The importance of vitamin D on bone health and osteoporosis was studied by many researchers. The main role of the Vitamin D is to absorb calcium and phosphate and increase bone mineralization. Older people are at an increased risk of the inadequate vitamin D production in the skin because of lower sun exposure and reduced ability of the skin to synthesize vitamin D. Objective. The aim of this clinical trial was to evaluate the efficacy and tolerability of short-term (2 weeks low energy UVB irradiation in postmenopausal women with osteoporosis using bone mineral density and bone turnover markers. Methods. A three-month, single-blinded, randomized, placebo-controlled clinical trial was conducted at the University hospital in Daegu, Republic of Korea. Fifty-two postmenopausal Korean women (older than 65 years with osteoporosis were randomly allocated to have either low energy UVB or placebo for 30 minutes a day for two weeks of treatment during winter. Laboratory analysis and physical examination before and 4, 8 and 12 weeks after treatment were carried out and BMD was measured before and 8 and 12 weeks after treatment. The effects of time and treatment interaction between these two groups were evaluated by repeated-measure two-factor analysis, and subgroup analysis was performed to examine UVB effect on the vitamin D insufficient group [serum 25(OHD3 concentration <30 ng/mL]. Results. In vitamin D insufficient group, the effect of UVB irradiation on vitamin D and bone ALP as well as additional benefit on bone formation was confirmed. The vitamin D insufficient group showed statistically significant increment in serum 25(OHD3 compared with the normal group (p<0.05. However, there was no significant difference between two groups in the other bone turnover markers, such as serum calcium, PTH-C, serum osteocalcin, serum CTX and BMD. Conclusion. Low-energy-short-term UVB radiation for postmenopausal women may be of use in vitamin D

Age at menarche, age at menopause and duration of fertility as risk factors for osteoporosis.

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Sioka, C; Fotopoulos, A; Georgiou, A; Xourgia, X; Papadopoulos, A; Kalef-Ezra, J A

2010-02-01

To investigate the relationship of osteopenia and osteoporosis in apparently healthy postmenopausal patients with age at menarche, age at menopause and duration of fertility. One hundred and twenty-four apparently healthy Greek postmenopausal women underwent spinal and hip X-ray absorptiometry scans. Among them, 47 were classified as normal (control group), 52 as osteopenic, and 25 as having osteoporosis. These groups were compared according to their age at menarche (three subgroups of 10-12, 13 and 14-16 years old), at menopause (three subgroups of 40-45, 46-50 and > or = 51 years old) and duration of fertility (four subgroups of 40 and 41-45 years). The groups were not found to differ statistically according to age and age at menarche. However, decreased bone mineral density was found in patients with duration of fertility not exceeding 30 years (p = 0.034) and age at menopause less than 45 years (p = 0.034). No association was found between bone mineral density in Greek postmenopausal women and either number of live births or lactation. In postmenopausal females, the cumulative exposure to endogenous estrogens, measured as years of menstruation, seems to be a significant protective factor against the development of postmenopausal osteoporosis. Age at menopause between 40 and 45 years, but not age at menarche, correlated with low bone mineral density in postmenopausal females.

Effect of reproductive history, lactation, first pregnancy age and dietary habits on bone mineral density in natural postmenopausal women.

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Cavkaytar, Sabri; Seval, Mehmet Murat; Atak, Zeliha; Findik, Rahime Bedir; Ture, Sevgi; Kokanali, Demet

2015-10-01

The aim of this study was to investigate the possible risk factors related with osteoporosis in women with spontaneous menopause. Five hundred and one postmenopausal women were divided into three groups as normal, osteopenic and osteoporotic according to their bone mineral density (BMD). By face-to-face interview, parity, age at menarche, age at menopause, duration of fertility, duration of menopause, first pregnancy age, total lactation period, exercise, smoking were assessed. Women with menopause age before 40 years, surgical menopause, who had any anti-osteoporosis treatment, hormone replacement therapy at the time of BMD measurement and corticosteroid use longer than 6 months were excluded from the study. Among 501 postmenopausal women, 107 women were classified as normal, 170 as osteopenic and 224 as osteoporotic. Among demographic features of patients, there was statistically significant difference between the groups in age, BMI and parity (p osteoporosis (OR 0.42, CI 95 % 0.27-0.66; OR 0.36, CI 95 % 0.24-0.56, respectively), but age was positively correlated with osteoporosis (OR 1.13, CI 95 % 1.01-1.17) CONCLUSIONS: Duration of fertility (years of menstruation) longer than 33 years and body mass index higher than 32 seem to protect against postmenopausal osteoporosis. Age is also an independent risk factor for postmenopausal osteoporosis.

The effects of clinical pilates exercises on bone mineral density, physical performance and quality of life of women with postmenopausal osteoporosis.

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Angın, Ender; Erden, Zafer; Can, Filiz

2015-01-01

The aim of this study was to investigate effects of Clinical Pilates Exercises on bone mineral density (BMD), physical performance and quality of life (QOL) in postmenopausal osteoporosis. Forty-one women were recruited to the study. The subjects were divided into two groups, as the Pilates group and the control group. Subjects were evaluated for BMD at the lumbar region. Physical performance level was measured. Pain intensity level was scored with Visual Analogue Scale. QUALEFFO-41 was used for assessing QOL. BMD values increased in the Pilates group (p Pilates group (p 0.05). Pain intensity level in the Pilates group was significantly decreased after the exercise (pPilates group. Conversely, some parameters of QOL showed decreases in the control group (pPilates Exercises is effective to increase BMD; QOL and walking distance and also beneficial to relieve pain. Physiotherapist can use Pilates Exercises for the subjects with osteoporosis in the clinics.

[Glucocorticoid induced osteoporosis].

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Anić, Branimir; Mayer, Miroslav

2014-01-01

Secondary osteoporosis most often develops due to glucocorticoid therapy. Glucocorticoids affect all stages of the bone remodeling cycle, its formation and resorption. Osteoblasts are primarily affected, decreasing their activity and enhancing apoptosis. Patients treated with glucocorticoids have lower bone mineral density and increased fracture risk. Glucocorticoid-induced osteoporosis can be prevented by administering the minimal effective dose of glucocorticoids, calcium and vitamin D supplementation or, if possible, by hormone replace- ment therapy. Moreover, appropriate physical activity should be encouraged. Patients who are at higher risk for low-energy fractures (for example post-menopausal women) have to be actively treated, usually with antiresorptive drugs among which bisphosphonates are currently the first line therapy.

Prevalence and related risk factors of osteoporosis in peri- and postmenopausal Indian women.

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Aggarwal, Neelam; Raveendran, Ainharan; Khandelwal, Niranjan; Sen, Ramesh Kumar; Thakur, J S; Dhaliwal, Lakhbir Kaur; Singla, Veenu; Manoharan, Sakthivel Rajan Rajaram

2011-07-01

We undertook this study involving 200 peri- and postmenopausal women to determine the prevalence of osteoporosis, and in turn increase the awareness, education, prevention, and treatment of osteoporosis. Postgraduate Institute of Medical Education and Research, UT Chandigarh, India, and a clinical study. A detailed medical, obstetrical, menstrual, and drug history was recorded in a proforma designated for the study. Height and weight was measured, weight-bearing exercise was assessed, and sunlight exposure per day for each woman was recorded. Food intake was estimated by using the 24-hour dietary recall method, and calcium and vitamin D consumption pattern was assessed. Bone mineral density (BMD) at postero-anterior lumbar spine and dual femurs was assessed by densitometer. Women were classified according to the WHO criteria. Student's t-test, multiple logistic regression analysis. The prevalence of low BMD was found in more than half of this population (53%). The mean age in group I (normal BMD) was found to be 50.56 ± 5.74 years as compared to 52.50 ± 5.94 in group II with low BMD (P=0.02). The two groups were similar with respect to parity, education, socioeconomic status, family history of osteoporosis, hormone replacement therapy, and thyroid disorders. 46.8% of the women in group I and 33% of the women in group II had low physical activity and there was no statistically significant difference in sunlight exposure between the groups. Parity or the number of children and type of menopause was not seen to have much association with low BMD in our study. Lack of exercise and low calcium diet were significantly associated with low BMD. Multiple logistic regression analysis showed that age, exercise, menopause, and low calcium diet acted as significant predictors of low bone density. The findings from the study suggest the need for large community-based studies so that high-risk population can be picked up and early interventions and other life style changes can

Immunization with FSHβ fusion protein antigen prevents bone loss in a rat ovariectomy-induced osteoporosis model

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Geng, Wenxin; Yan, Xingrong; Du, Huicong; Cui, Jihong; Li, Liwen, E-mail: liven@nwu.edu.cn; Chen, Fulin, E-mail: chenfl@nwu.edu.cn

2013-05-03

Highlights: •A GST-FSH fusion protein was successfully expressed in E. coli. •Immunization with GST-FSH antigen can raise high-titer anti-FSH polyclonal sera. •Anti-FSH polyclonal sera can neutralize osteoclastogenic effect of FSH in vitro. •FSH immunization can prevent bone loss in a rat osteoporosis model. -- Abstract: Osteoporosis, a metabolic bone disease, threatens postmenopausal women globally. Hormone replacement therapy (HTR), especially estrogen replacement therapy (ERT), is used widely in the clinic because it has been generally accepted that postmenopausal osteoporosis is caused by estrogen deficiency. However, hypogonadal α and β estrogen receptor null mice were only mildly osteopenic, and mice with either receptor deleted had normal bone mass, indicating that estrogen may not be the only mediator that induces osteoporosis. Recently, follicle-stimulating hormone (FSH), the serum concentration of which increases from the very beginning of menopause, has been found to play a key role in postmenopausal osteoporosis by promoting osteoclastogenesis. In this article, we confirmed that exogenous FSH can enhance osteoclast differentiation in vitro and that this effect can be neutralized by either an anti-FSH monoclonal antibody or anti-FSH polyclonal sera raised by immunizing animals with a recombinant GST-FSHβ fusion protein antigen. Moreover, immunizing ovariectomized rats with the GST-FSHβ antigen does significantly prevent trabecular bone loss and thereby enhance the bone strength, indicating that a FSH-based vaccine may be a promising therapeutic strategy to slow down bone loss in postmenopausal women.

Association of nonalcoholic fatty liver disease with low bone mass in postmenopausal women.

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Moon, Seong-Su; Lee, Young-Sil; Kim, Sung Woo

2012-10-01

Osteoporosis is a disease associated with insulin resistant states such as central obesity, diabetes, and metabolic syndrome. Non-alcoholic fatty liver disease (NAFLD) is also increased in such conditions. However, little is known about whether osteoporosis and nonalcoholic fatty liver disease are etiologically related to each other or not. We examined whether bone mineral density (BMD) is associated with NAFLD in pre- and postmenopausal women. Four hundred eighty-one female subjects (216 premenopausal and 265 postmenopausal) were enrolled. Lumbar BMD was measured using dual-energy X-ray absorptiometry. Liver ultrasonography was done to check the severity of fatty liver. We excluded subjects with a secondary cause of liver disease. Blood pressure, lipid profile, fasting plasma glucose, alanine aminotransferase (ALT), aspartate aminotransferase, and body mass index were measured in every subject. Mean lumbar BMD was lower in subjects with NAFLD than those without NAFLD in postmenopausal women (0.98 ± 0.01 vs. 1.01 ± 0.02 g/cm², P = 0.046). Multiple correlation analysis revealed a significant association between mean lumbar BMD and NAFLD in postmenopausal subjects after adjusting for age, body mass index, ALT, smoking status, and alcohol consumption (β coefficient -0.066, 95% CI -0.105 to -0.027, P = 0.001). Even after adjusting the presence of metabolic syndrome, the significance was maintained (β coefficient -0.043, 95% CI -0.082 to -0.004, P = 0.031). Lumbar BMD is related with NAFLD in postmenopausal females. We suggest that postmenopausal women with NAFLD may have a higher risk of osteoporosis than those without.

Silicon: A Review of Its Potential Role in the Prevention and Treatment of Postmenopausal Osteoporosis

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Charles T. Price

2013-01-01

Full Text Available Physicians are aware of the benefits of calcium and vitamin D supplementation. However, additional nutritional components may also be important for bone health. There is a growing body of the scientific literature which recognizes that silicon plays an essential role in bone formation and maintenance. Silicon improves bone matrix quality and facilitates bone mineralization. Increased intake of bioavailable silicon has been associated with increased bone mineral density. Silicon supplementation in animals and humans has been shown to increase bone mineral density and improve bone strength. Dietary sources of bioavailable silicon include whole grains, cereals, beer, and some vegetables such as green beans. Silicon in the form of silica, or silicon dioxide (SiO2, is a common food additive but has limited intestinal absorption. More attention to this important mineral by the academic community may lead to improved nutrition, dietary supplements, and better understanding of the role of silicon in the management of postmenopausal osteoporosis.

Vitamin D status is associated with anxiety levels in postmenopausal women evaluated for osteoporosis

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Gabriella Martino

2018-04-01

Full Text Available Vitamin D status has been previously associated with a wide range of acute and chronic diseases. The nervous system express vitamin D receptors and thus vitamin D may be involved in mental health. Poor data exist about the correlation between vitamin D and anxiety levels.Our aim was to investigate the association of vitamin D status with anxiety severity. A group of 177 postmenopausal women (mean age 65.5±8.22 yr. referring to an outpatients clinic for the prevention of osteoporosis were evaluated. Severity of perceived anxiety symptoms was measured by the Hamilton Anxiety rating scale (HAMA. Depression levels were also evaluated using the Beck Depression Inventory-second edition scale (BDI-II.  25(OHD serum levels, indicative of vitamin D status, were detected by high-performance liquid chromatography. 25(OHD levels were significantly related HAMA-score (r=-0.15, p=0.04; particularly a deep association was observed between 25(OHD levels and somatic symptoms (r=-0.195, p=0.009. HAMA score was associated with BDI-II score (r=0.487, p=<0.001; HAMA psychic symptom score was also related with age and time since menopause (r=0.149, p=0.039 and r=0.222, p=0.003, respectively. At a multiple regression analysis, after correcting for age and depression levels, 25(OHD was predictive of HAMA score (β =-0,05961, p= 0.02, SE=-2.206, but the strength of association was lost further correcting for time since menopause.  In conclusion, in a setting of postmenopausal women, we observed a significant association between anxiety levels and serum 25(OHD concentrations irrespective of age and depression levels.

Effect of Wearing Style on Vitamin D and Bone Mineral Density in Postmenopausal Osteoporotic Women

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Yeşim Gökçe Kutsal

2011-12-01

Full Text Available Aim: Vitamin D deficiency is one of the most important public health problems as a result of osteomalacia, osteoporosis, muscle pain disease, muscle weakness and increased risk of falls and fracture. Outfitting style effects the synthesis and blood levels of vitamin D. The aim of our study is to investigate the effect of outfitting style on blood vitamin D and bone mineral density in postmenopausal osteoporotic women. Materials and Methods: Fifty-five female patients who were diagnosed with osteoporosis were included in our study. These women were divided into two groups according to their clothing habits as veiled and unveiled. Data of all patients about menopause, exposure to sun light, dual energy x-ray absorptiometry results, blood calcium, phosphate, parathyroid hormone, 25-hydroxyvitamin D levels and osteoporosis treatment were recorded. Results: We found 25-hydroxyvitamin D level was significantly low in women with veiled dressing style (17,0±7,9 ng/ml in veiled and 33.9±22.0 ng/ml in unveiled patients, p<0.001. There was statistically significant correlations between 25-hydroxyvitamin D level and femur neck Z-scores, femur total bone mineral density, femur total T-score L1-L4 bone mineral density, femur neck bone mineral density for different seasons (p<0.05. Conclusion: Postmenopausal osteoporotic veiled women are more prone to vitamin D deficiency than unveiled women. Low concentration of 25-hydroxyvitamin D is accompanying further decrease in bone mineral density. Despite low concentration of 25-hydroxyvitamin D in veiled postmenopausal osteoporotic women, there is not direct correlation between wearing style and bone mineral density. (Turkish Journal of Osteoporosis 2011;17:85-8

Reproductive factors affecting the bone mineral density in postmenopausal women.

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Ozdemir, Ferda; Demirbag, Derya; Rodoplu, Meliha

2005-03-01

Osteoporosis has been defined as a metabolic bone disease characterized by a loss of bone mineral density (BMD) greater than 2.5 standard deviations below young adult peak bone mass or the presence of fracture. By considering that some factors related to female reproductive system might influence the ultimate risk of osteoporosis, we aimed to investigate if a relationship exists between the present BMD of postmenopausal women with their past and present reproductive characteristics. The present study focused on how BMD could be affected by the following factors in postmenopausal women, such as age at menarche, age at first pregnancy, the number of pregnancies and total breast-feeding time. We reviewed detailed demographic history of 303 postmenopausal women. According to the results of the present study, a negative correlation was found between the number of parities and BMD. The BMD values decreased as the number of pregnancies increased. When the BMD values for lumbar vertebrae 2 and Ward's triangle were investigated, it was observed that a significant difference exists between the women with no child birth and those with more than five parities. There was a significant relationship between age at first pregnancy and BMD values at the lumbar vertebrae 2 and Ward's triangle. Women who had five or more abortions were found to have significantly lower spine BMD values compared to women who had no abortions or women who had one or two abortions. These findings indicate that the increased risk of osteoporosis is associated with the increased number of pregnancies and abortions and higher age at first pregnancy.

A review on the performance of osteoporosis self-assessment tool for Asians in determining osteoporosis and fracture risk.

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Chin, Kok-Yong

2017-09-01

The prevalence of osteoporosis in Asian countries is growing. An effective screening method will enable patients at risk for osteoporosis to receive early diagnosis and treatment, and avoid overcrowding the limited dual-energy x-ray absorptiometry (DXA) machines available in Asian countries. Many simple osteoporosis screening algorithms have been developed but they are not validated for use in Asian populations. osteoporosis self-assessment tools for Asians (OSTA), established using a multinational Asian cohort, is the first screening algorithm that caters for the Asian populations. It considers only body weight and age in the algorithm. It shows consistently high performance and sensitivity in identifying postmenopausal women at risk for osteoporosis in many Asian countries. Its usage has been expanded for identifying osteoporosis in men, as well as determining fracture risk for both sexes. However, the performance of OSTA is influenced by age, sex, ethnicity and site of BMD measurement to define osteoporosis. Its usage is also limited in individuals without apparent risk factors. These limitations should be noted by physicians considering the use of OSTA in clinical setting. As a conclusion, OSTA is a cost-effective measure for osteoporosis screening in primary healthcare setting.

Strontium ranelate in the treatment of osteoporosis

African Journals Online (AJOL)

2006-11-05

Nov 5, 2006 ... postmenopausal women (mean age 69 years) with osteoporosis or osteopenia. Strontium ranelate significantly decreased markers of bone resorption and increased biomarkers of formation. Spinal BMD increased by 14%, while vertebral fractures decreased by 49% within the first year, a reduction that was.

The combination of a histogram-based clustering algorithm and support vector machine for the diagnosis of osteoporosis

International Nuclear Information System (INIS)

Heo, Min Suk; Kavitha, Muthu Subash; Asano, Akira; Taguchi, Akira

2013-01-01

To prevent low bone mineral density (BMD), that is, osteoporosis, in postmenopausal women, it is essential to diagnose osteoporosis more precisely. This study presented an automatic approach utilizing a histogram-based automatic clustering (HAC) algorithm with a support vector machine (SVM) to analyse dental panoramic radiographs (DPRs) and thus improve diagnostic accuracy by identifying postmenopausal women with low BMD or osteoporosis. We integrated our newly-proposed histogram-based automatic clustering (HAC) algorithm with our previously-designed computer-aided diagnosis system. The extracted moment-based features (mean, variance, skewness, and kurtosis) of the mandibular cortical width for the radial basis function (RBF) SVM classifier were employed. We also compared the diagnostic efficacy of the SVM model with the back propagation (BP) neural network model. In this study, DPRs and BMD measurements of 100 postmenopausal women patients (aged >50 years), with no previous record of osteoporosis, were randomly selected for inclusion. The accuracy, sensitivity, and specificity of the BMD measurements using our HAC-SVM model to identify women with low BMD were 93.0% (88.0%-98.0%), 95.8% (91.9%-99.7%) and 86.6% (79.9%-93.3%), respectively, at the lumbar spine; and 89.0% (82.9%-95.1%), 96.0% (92.2%-99.8%) and 84.0% (76.8%-91.2%), respectively, at the femoral neck. Our experimental results predict that the proposed HAC-SVM model combination applied on DPRs could be useful to assist dentists in early diagnosis and help to reduce the morbidity and mortality associated with low BMD and osteoporosis.

Study on the therapeutic effect of small dose of estradiol and progesterone on post-menopausal osteoporosis

International Nuclear Information System (INIS)

Li Wenqi; Li Xin; Zhou Jiwen; Zhou Zhengli

2004-01-01

Objective: To explore the therapeutic effect and possible adverse side-effects of small dose of estradiol and progesterone on postmenopausal osteoporosis. Methods: Applying a GBD-928 mono-photon BMD radiometer, 68 women (past-menopausal over 3 years, age 52-59, body weight index 2 0.5 mg with MPA (medroxyprogesterone acetate) 0.5 mg daily. The medication laster for a whole years and BMD value was measured again. All subjects underwent gynecological physical examination, vaginal sonography, vaginal smear study and breast examination with infra-red ray both before and after the test period. Results: After one year medication, mean value of BMD in Group A was 0.49 ± 0.05, three percentage points higher than before. In Group B, this was 0.52 ± 0.06, another three percentage points higher. Ten Women with mild lobular hyperplasia and nine women with small uterine myoma ( 3 ) were all allocated to the hormone treated group. The lesions showed either little change or slight regression after the test period. Conclusion: Osteoporotic women receiving additional small doses of female hormones responded much better than those receiving calcium only. The WHI report which advised against HRT should be more critically studied

Comparative pharmacoeconomic analysis of the use of Bonviva® (ibandronat to prevent fractures in postmenopausal osteoporosis

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E A Pyadushkina

2012-01-01

Full Text Available Objective: to make a pharmacoeconomic analysis of the use of oral (a 150-mg tablet once a month and injectable (a solution for intravenous bolus injection of 3 mg in 3 ml once every 3 months ibandronate in patients with postmenopausal osteoporosis (OP. Material and methods. The cost minimization method was used to calculate differences in the cost of using oral ibandronate, alendronate, and strontium ranelate in patients with postmenopausal OP for a year. The budgetary impact of administration of intravenous bisphosphonates (ibandronate and zoledronic acid was analyzed in patients with OP in a hospital context. A model calculator based on the Microsoft Excel software was applied to estimate how the expenditures of a health care facility were changing when different shares of drugs (ibandronate and zoledronic acid were used in purchase patterns. The cost of therapy with bisphosphonates (ibandronate and zoledronic acid, concomitant therapy (calcium and vitamin D, expendable materials, and therapy for adverse reactions (ARs due to the use of bisphophonates was considered in terms of the incidence of these ARs. Results. Among the oral drugs, ibandronate is more economically sound than alendronate: the difference in annual treatment costs was 7090.02 and 7334.31 rubles per patient, respectively, in favor of ibandronate. The inpatient use of only intravenous ibandronate versus the real administration practice determined on the basis of the data of the Farmekspert Marketing Researches Center on purchases in the hospital segment (30% for ibandronate and 70% for zoledronic acid considerably reduces the expenditures of a hospital, the saving will be 185416.06 rubles per year (if injections will be made in 20 patients. With 100% use of ibandronate, one can additionally provide 39 inpatients with bisphosphonate injections without additional expenditures.

Does a distal forearm fracture lead to evaluation for osteoporosis? A retrospective cohort study in 147 Danish women

DEFF Research Database (Denmark)

Rud, Bo; Greibe, Rasmus; Hyldstrup, Lars

2005-01-01

In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture t......, and it emphasizes the need to decide on a local level how to provide osteoporosis follow-up for women with fragility fractures. Udgivelsesdato: 2005 Spring......In postmenopausal women, a low-trauma distal forearm fracture is a risk factor for osteoporosis and future fracture, which indicates osteoporosis follow-up according to prevailing guidelines. We decided to determine how often women over 45 yr presenting with a low-trauma distal forearm fracture...... to a Danish emergency department during a 1-yr period were followed up for osteoporosis. We performed a retrospective review of hospital records and we sent the women and their general practitioners (GPs) questionnaires regarding the follow-up undertaken in primary care. Finally, we invited the women...

Once-yearly zoledronic acid in the prevention of osteoporotic bone fractures in postmenopausal women

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Irene Lambrinoudaki

2008-09-01

Full Text Available Irene Lambrinoudaki, Sophia Vlachou, Fotini Galapi, Dimitra Papadimitriou, K Papadias2nd Department of Obstetrics and Gynecology, University of Athens, Aretaieio Hospital, GreeceAbstract: Zoledronic acid is a nitrogen-containing, third-generation bisphosphonate that has recently been approved for the treatment of postmenopausal osteoporosis as an annual intravenous infusion. Zoledronic acid is an antiresorptive agent which has a high affinity for mineralized bone and especially for sites of high bone turnover. Zoledronic acid is excreted by the kidney without further metabolism. Zoledronic acid administered as a 5 mg intravenous infusion annually increases bone mineral density in the lumbar spine and femoral neck by 6.7% and 5.1% respectively and reduces the incidence of new vertebral and hip fractures by 70% and 41% respectively in postmenopausal women with osteoporosis. Most common side effects are post-dose fever, flu-like symptoms, myalgia, arthralgia, and headache which usually occur in the first 3 days after infusion and are self-limited. Rare adverse effects include renal dysfunction, hypocalcemia, atrial fibrillation, and osteonecrosis of the jaw.Keywords: zoledronic acid, postmenopausal osteoporosis, bisphosphonate

Postmenopausal hormone therapy and Alzheimer disease

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Tuppurainen, Marjo; Rikkonen, Toni; Kivipelto, Miia; Soininen, Hilkka; Kröger, Heikki; Tolppanen, Anna-Maija

2017-01-01

Objective: To explore the association between postmenopausal hormone therapy (HT) and Alzheimer disease (AD). Methods: Twenty-year follow-up data from the Kuopio Osteoporosis Risk Factor and Prevention study cohort were used. Self-administered questionnaires were sent to all women aged 47–56 years, residing in Kuopio Province starting in 1989 until 2009, every 5th year. Register-based information on HT prescriptions was available since 1995. Probable AD cases, based on DSM-IV and National Institute of Neurological and Communicative Disorders and Stroke–Alzheimer's Disease and Related Disorders Association criteria, were identified from the special reimbursement register (1999–2009). The study population included 8,195 women (227 cases of incident AD). Results: Postmenopausal estrogen use was not associated with AD risk in register-based or self-reported data (hazard ratio/95% confidence interval 0.92/0.68–1.2, 0.99/0.75–1.3, respectively). Long-term self-reported postmenopausal HT was associated with reduced AD risk (0.53/0.31–0.91). Similar results were obtained with any dementia diagnosis in the hospital discharge register as an outcome. Conclusions: Our results do not provide strong evidence for a protective association between postmenopausal HT use and AD or dementia, although we observed a reduced AD risk among those with long-term self-reported HT use. PMID:28202700

Rib fracture as a predictor of future fractures in young and older postmenopausal women: National Osteoporosis Risk Assessment (NORA)

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Sajjan, S. G.; Barrett-Connor, E.; McHorney, C. A.; Miller, P. D.; Sen, S. S.; Siris, E.

2013-01-01

Summary A rib fracture history after age 45 was associated with a 5.4-fold increase in new rib fracture risk and a 2.4-fold increase in risk of any new clinical fracture in 155,031 postmenopausal women. A rib fracture history suggests osteoporosis and should be considered when evaluating patients for interventions to prevent fractures. Introduction Until recently, little attention was paid to rib fracture as an osteoporosis marker. Emerging evidence suggests rib fracture may be an osteoporotic fracture in men and women. We report the 5-year independent association between baseline rib fracture histories and self-reported future fractures by age (decade) in the NORA cohort (155,031 postmenopausal women, 50–99 years). Methods Participants reported fracture history and responded to follow-up surveys at years 1, 3, or 6. Women with a baseline rib fracture history without other fractures were compared with women with no fracture. Results At baseline, 4,758 (3.07%) women reported a rib fracture history without other fractures; 6,300 women reported 6,830 new clinical fractures, including wrist (2,271), rib (1,891), spine (1,136), hip (941), and forearm (591). Adjusted relative risk (ARR) values (95% confidence interval [CI]) for future fractures in women with rib fracture history versus women with no fracture history were 5.4 (4.8–6.1) at the rib, 2.1 (1.7–2.6) at the spine, and 1.4 (1.1–1.7) at the wrist, and not significant for forearm or hip fractures. Future fracture risk was at least doubled in women with a rib fracture history in all ages: ARR (95% CI) 3.4 (2.8–4.0) for ages 50–59, 2.5 (2.1–3.0) for ages 60–69, 2.0 (1.7–2.3) for ages 70–79, and 2.0 (1.6–2.6) for ages >80. Conclusions Rib fracture, the second most common clinical fracture in women (after wrist fracture), predicted future fractures of the rib, wrist, and spine at all ages. Women presenting with rib fractures should be evaluated for appropriate management to prevent future

PROPOSAL OF RATIONAL SCREENING FOR OSTEOPOROSIS IN THE PRIMARY CARE SETTING

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Rok Hren

2002-12-01

Full Text Available Background. Early identification of postmenopausal women with osteoporosis by means of bone mineral density (BMD measurement is a prerequisite for reducing the incidence of osteoporotic fractures. Primary care physicians have a leading role in referring such patients, however, given the cost of the BMD measurement, efficient screening criteria remain to be determined. Currently available criteria (e. g., SCORE, ORAI are very broad with low specificity. Objective of our study is to assess simple decision rules that could enhance identifying patients with high risk of fracture while concurrently minimizing number of unnecessary measurements.Methods. In the study, 357 primary care physicians (GPs and gynecologists referred their patients to BMD measurements based on the following decision rules: women (i should be postmenopausal for at least 5 years, (ii should have body mass index (BMI less than 26 kg/m2, and (iii should have never been diagnosed with osteoporosis. BMD of lumbar spine and/ or hip was measured by dual-energy x-ray absorptiometry (DXA in 5 centers using Hologic (Hologic Corp., Bedford, MA or Lunar (Lunar Corp., Madison, WI densitometers. Results of BMD measurements were expressed in terms of the T-score and were forwarded to the primary care physicians.Results. 2339 postmenopausal women participated in the study; by the end of the study, 327 physicians (92% reported results on 2196 women (94%. 1332 women of 2196 (61% were identified as osteoporotic, 637 (29% as osteopenic, and 227 (10% had normal BMD. Approximately 30% of patients with osteoporosis suffered from previous low-trauma fracture. Among all women, the prevalence of osteoporosis was 34% for ages less than 55 years, 50% for ages 55–59 years, and 69% for ages above 60 years. The number of DXA measurements needed to detect one osteoporotic patient among women older than 60 years and with BMI < 24.5 kg/m2 was 1.32.Conclusions. Results of our study suggest that three simple

Evaluating the risk of osteoporosis through bone mass density

International Nuclear Information System (INIS)

Sayed, S.A.; Khaliq, A.

2017-01-01

Osteoporosis is a bone disorder, characterized by loss of bone mass density. Osteoporosis affects more than 30 percent of post-menopausal women. Osteoporosis is often associated with restricted body movement, pain and joint deformities. Early identification and early intervention can help in reducing these complications. The primary objective of this study was to estimate the burden of Osteoporosis in Urban setting of Sindh among women of different age groups and to access the effect of different protective measures that can reduce the risk of Osteoporosis. Method: In this study, 500 women's of 3 major cities of Sindh were approached by non-probability convenience sampling technique. Women bearing age 20 years or more were included. Women who fall under inclusion criteria were screened for BMD (Bone mineral density) test and were classified as Healthy, Osteopenic and Osteoporotic based on their T-score. The association of different protective measures and risk of osteoporosis was assessed by prevalence relative risk (PRR). Result: The result of this study indicate that the burden of Osteoporosis is very high among the women of Sindh, only 17.4 percent (84) women were found to have normal BMD score. The life style of majority of women was sedentary. The PRR calculated for Exposure to sunlight, regular exercise, and use of nutritional supplement was 12.5, 5.19 and 2.72 folds respectively. Conclusion: The results of study reveal that exposure to sunlight, regular physical exercise and use of nutritional supplements found to be effective in reducing the risk of osteoporosis among women of all age group. Health education and promotion toward osteoporosis prevention can significantly contribute in reducing the morbidity of osteoporosis. (author)

Olive Oil effectively mitigates ovariectomy-induced osteoporosis in rats

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Saleh Hanan A

2011-02-01

Full Text Available Abstract Background Osteoporosis, a reduction in bone mineral density, represents the most common metabolic bone disease. Postmenopausal women are particularly susceptible to osteoporosis when their production of estrogen declines. For these women, fracture is a leading cause of morbidity and mortality. This study was conducted to evaluate the protective effects of olive oil supplementation against osteoporosis in ovariectomized (OVX rats. Methods We studied adult female Wistar rats aged 12-14 months, divided into three groups: sham-operated control (SHAM, ovariectomized (OVX, and ovariectomized rats supplemented with extravirgin olive oil (Olive-OVX orally for 12 weeks; 4 weeks before ovariectomy and 8 weeks after. At the end of the experiment, blood samples were collected. Plasma levels of calcium, phosphorus, alkaline phosphatase (ALP, malondialdehyde (MDA, and nitrates were assayed. Specimens from both the tibia and the liver were processed for light microscopic examination. Histomorphometric analysis of the tibia was also performed. Results The OVX-rats showed a significant decrease in plasma calcium levels, and a significant increase in plasma ALP, MDA, and nitrates levels. These changes were attenuated by olive oil supplementation in the Olive-OVX rats. Light microscopic examination of the tibia of the OVX rats revealed a significant decrease in the cortical bone thickness (CBT and the trabecular bone thickness (TBT. In addition, there was a significant increase in the osteoclast number denoting bone resorption. In the Olive-OVX rats these parameters were markedly improved as compared to the OVX group. Examination of the liver specimens revealed mononuclear cellular infiltration in the portal areas in the OVX-rats which was not detected in the Olive-OVX rats. Conclusions Olive oil effectively mitigated ovariectomy-induced osteoporosis in rats, and is a promising candidate for the treatment of postmenopausal osteoporosis.

Systematic review and meta-analysis of the efficacy and safety of alendronate and zoledronate for the treatment of postmenopausal osteoporosis.

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Serrano, Ana Julissa; Begoña, Leire; Anitua, Eduardo; Cobos, Raquel; Orive, Gorka

2013-12-01

The aim of this meta-analysis was to evaluate the efficacy and safety of two bisphosphonates (alendronate and zoledronate) in the treatment of postmenopausal osteoporosis. The incidence of fractures was considered as primary endpoint. Only randomized trials with a follow-up period of 1 year or more were included in this systematic review and meta-analysis. We excluded studies that included patients with secondary osteoporosis especially in relation to therapy with corticosteroids or other drugs or diseases known to affect bone mineral density. Studies published as subgroup analysis, extension studies, economic evaluations, and comparisons with active control were excluded. The methodological quality of controlled clinical trials that met these inclusion criteria was evaluated. No studies were excluded from analysis due to lack of quality. The risk ratio of hip, vertebral and wrist fractures for alendronate were 0.61 [95% confidence interval (CI) 0.40-0.93], 0.54 (95% CI 0.44-0.66) and 0.65 (95% CI 0.33-1.25), respectively. Zoledronate risk ratio was 0.62 (95% CI 0.46-0.82) and 0.38 (95% CI 0.22-0.67) for hip and vertebral fractures, respectively.

Compliance and treatment satisfaction of post menopausal women treated for osteoporosis. Compliance with osteoporosis treatment

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Huas Dominique

2010-08-01

Full Text Available Abstract Background Adherence to anti-osteoporosis treatments is poor, exposing treated women to increased fracture risk. Determinants of poor adherence are poorly understood. The study aims to determine physician- and patient- rated treatment compliance with osteoporosis treatments and to evaluate factors influencing compliance. Methods This was an observational, cross-sectional pharmacoepidemiological study with a randomly-selected sample of 420 GPs, 154 rheumatologists and 110 gynaecologists practicing in France. Investigators included post-menopausal women with a diagnosis of osteoporosis and a treatment initiated in the previous six months. Investigators completed a questionnaire on clinical features, treatments and medical history, and on patient compliance. Patients completed a questionnaire on sociodemographic features, lifestyle, attitudes and knowledge about osteoporosis, treatment compliance, treatment satisfaction and quality of life. Treatment compliance was evaluated with the Morisky Medication-taking Adherence Scale. Variables collected in the questionnaires were evaluated for association with compliance using multivariate logistic regression analysis. Results 785 women were evaluated. Physicians considered 95.4% of the sample to be compliant, but only 65.5% of women considered themselves compliant. The correlation between patient and physician perceptions of compliance was low (κ: 0.11 [95% CI: 0.06 to 0.16]. Patient-rated compliance was highest for monthly bisphosphonates (79.7% and lowest for hormone substitution therapy (50.0%. Six variables were associated with compliance: treatment administration frequency, perceptions of long-term treatment acceptability, perceptions of health consequences of osteoporosis, perceptions of knowledge about osteoporosis, exercise and mental quality of life. Conclusion Compliance to anti-osteoporosis treatments is poor. Reduction of dosing regimen frequency and patient education may be useful

Low bone mass prevalence and osteoporosis risk factor assessment in African American Wisconsin women.

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Kidambi, Srividya; Partington, Susan; Binkley, Neil

2005-11-01

Post-menopausal osteoporosis is seen in all racial groups. With the increasing population and longevity of minority groups, osteoporosis is becoming an important health concern. Data regarding risk factors for, and prevalence of, low bone mass and awareness of osteoporosis risk in African American (AA) women are limited. This article evaluates the risk factors for, and prevalence of, low bone mass in a population of urban AA women in Wisconsin and assesses this group's perceived risk for osteoporosis. One hundred fifty consecutive community-dwelling AA women > or = 45 years old from Milwaukee, Wis were asked to complete a questionnaire based on currently accepted osteoporosis risk factors. Additionally, their perception of osteoporosis risk was assessed using a Likert scale. All subjects underwent quantitative calcaneal ultrasound. Subject mean age was 54 +/- 7 years. Mean T- and Z-scores were 0.5 and 0.4, respectively. Applying World Health Organization criteria, osteopenia (bone mineral density T-score 2 children), postmenopausal state, and current smoking were associated with lower calcaneal bone mass. Higher education and presence of diabetes were associated with a higher bone mass. Only 25% of the women surveyed thought they were at moderate to high risk for osteoporosis. Low bone mass was present in 33% of these AA women despite their relative young age. Many AA women do not perceive osteoporosis as a health risk. It is necessary to develop strategies to educate AA women regarding osteoporosis risk.

Bone strength and its determinants in peri- and postmenopausal women

International Nuclear Information System (INIS)

Hafeez, F.; Ahmad, M.; Hasan, S.; Khurshid, R.

2011-01-01

Diminished bone strength increases the frequency of osteoporosis and fragility fractures. Weight and gonadal status are important determinants of bone mass in women. This study tried to find out the bone strength and its determinants in peri- and postmenopausal age groups of women. Methods: One hundred and twenty females with age range 25 - 66 years were included in the study. According to their age and menstrual status they were divided into premenopausal (30) peri menopausal (50) and postmenopausal (40). Body Mass Index (MBI) and bone related blood parameter, serum calcium, magnesium, inorganic phosphorus, alkaline phosphatase and estradiol were estimated. Bone mineral density was taken by peripheral densitometer. Results: Blood chemical parameters were not significantly different in these groups. The p-value of serum estradiol was highly significant in peri- and postmenopausal groups. BMI was significantly high in postmenopausal as compared to pre and perimenopausal groups. Conclusion: Early menopause, low levels of oestrogen and BMI values can all affect the health of bones in elderly women. (author)

Posmetnaya TV. Peculiarities of clinical and X-ray findings at women during postmenopause with chronic generalized periodontitis determined by mineral bone density

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Eremina N.V.

2016-12-01

Full Text Available The aim: to study clinical and X-ray specifics of chronic generalized periodontitis of women during a postmenopaus-al period determined by mineral bone density. Material and Methods. 80 women having chronic generalized periodontitis during a postmenopausal period were examined using clinical and X-ray research. Material of bone density was taken into consideration. Results. Decrease of hygienic indices of women at postmenopausal period has been found. It depends on the degree of severity of chronic generalized periodontitis. There was a reverse connection of periodon-tal index and mineral density of bone tissues in the 1-st group: — 0.9 (p<0.05, in the 2-nd group: — 0.5 (p<0.05, in the 3-rd group: — 0.79 (p<0.05. Cone-beam computer tomography made possible to find out the initial signs of edge osteoporosis of interdental partitions at the light degree of chronic generalized periodontitis and signs of spot and homogenous osteoporosis of gum bones, osteoporosis of interdental partitions with osteolysis at mild and severe degrees of severity. Conclusion. The clinical researches with cone-beam computer tomography and densitometry have revealed the exact data on the condition of bone tissues. The results have given an opportunity to plan osteotropic therapy and to control the dynamics of the process correctly.

10 years of denosumab treatment in postmenopausal women with osteoporosis: results from the phase 3 randomised FREEDOM trial and open-label extension.

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Bone, Henry G; Wagman, Rachel B; Brandi, Maria L; Brown, Jacques P; Chapurlat, Roland; Cummings, Steven R; Czerwiński, Edward; Fahrleitner-Pammer, Astrid; Kendler, David L; Lippuner, Kurt; Reginster, Jean-Yves; Roux, Christian; Malouf, Jorge; Bradley, Michelle N; Daizadeh, Nadia S; Wang, Andrea; Dakin, Paula; Pannacciulli, Nicola; Dempster, David W; Papapoulos, Socrates

2017-07-01

Long-term safety and efficacy of osteoporosis treatment are important because of the chronic nature of the disease. We aimed to assess the long-term safety and efficacy of denosumab, which is widely used for the treatment of postmenopausal women with osteoporosis. In the multicentre, randomised, double-blind, placebo-controlled, phase 3 FREEDOM trial, postmenopausal women aged 60-90 years with osteoporosis were enrolled in 214 centres in North America, Europe, Latin America, and Australasia and were randomly assigned (1:1) to receive 60 mg subcutaneous denosumab or placebo every 6 months for 3 years. All participants who completed the FREEDOM trial without discontinuing treatment or missing more than one dose of investigational product were eligible to enrol in the open-label, 7-year extension, in which all participants received denosumab. The data represent up to 10 years of denosumab exposure for women who received 3 years of denosumab in FREEDOM and continued in the extension (long-term group), and up to 7 years for women who received 3 years of placebo and transitioned to denosumab in the extension (crossover group). The primary outcome was safety monitoring, comprising assessments of adverse event incidence and serious adverse event incidence, changes in safety laboratory analytes (ie, serum chemistry and haematology), and participant incidence of denosumab antibody formation. Secondary outcomes included new vertebral, hip, and non-vertebral fractures as well as bone mineral density (BMD) at the lumbar spine, total hip, femoral neck, and one-third radius. Analyses were done according to the randomised FREEDOM treatment assignments. All participants who received at least one dose of investigational product in FREEDOM or the extension were included in the combined safety analyses. All participants who enrolled in the extension with observed data were included in the efficacy analyses. The FREEDOM trial (NCT00089791) and its extension (NCT00523341) are both

Modeling the effect of levothyroxine therapy on bone mass density in postmenopausal women: a different approach leads to new inference

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Tavangar Seyed

2007-06-01

Full Text Available Abstract Background The diagnosis, treatment and prevention of osteoporosis is a national health emergency. Osteoporosis quietly progresses without symptoms until late stage complications occur. Older patients are more commonly at risk of fractures due to osteoporosis. The fracture risk increases when suppressive doses of levothyroxine are administered especially in postmenopausal women. The question is; "When should bone mass density be tested in postmenopausal women after the initiation of suppressive levothyroxine therapy?". Standard guidelines for the prevention of osteoporosis suggest that follow-up be done in 1 to 2 years. We were interested in predicting the level of bone mass density in postmenopausal women after the initiation of suppressive levothyroxine therapy with a novel approach. Methods The study used data from the literature on the influence of exogenous thyroid hormones on bone mass density. Four cubic polynomial equations were obtained by curve fitting for Ward's triangle, trochanter, spine and femoral neck. The behaviors of the models were investigated by statistical and mathematical analyses. Results There are four points of inflexion on the graphs of the first derivatives of the equations with respect to time at about 6, 5, 7 and 5 months. In other words, there is a maximum speed of bone loss around the 6th month after the start of suppressive L-thyroxine therapy in post-menopausal women. Conclusion It seems reasonable to check bone mass density at the 6th month of therapy. More research is needed to explain the cause and to confirm the clinical application of this phenomenon for osteoporosis, but such an approach can be used as a guide to future experimentation. The investigation of change over time may lead to more sophisticated decision making in a wide variety of clinical problems.

Long-term aerobic exercise and omega-3 supplementation modulate osteoporosis through inflammatory mechanisms in post-menopausal women: a randomized, repeated measures study

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Kanaley Jill

2011-10-01

Full Text Available Abstract Background Evidence indicates that dietary fats and physical activity influence bone health. The purpose of this study was to examine the effects of long-term aerobic exercise and omega-3 (N-3 supplementation on serum inflammatory markers, bone mineral density (BMD, and bone biomarkers in post-menopausal women. Methods Seventy-nine healthy sedentary post-menopausal women aged 58-78 years participated in this study. Subjects were randomized to one of 4 groups: exercise + supplement (E+S, n = 21, exercise (E, n = 20, supplement (S, n = 20, and control (Con, n = 18 groups. The subjects in the E+S and E groups performed aerobic exercise training (walking and jogging up to 65% of HRmax, three times a week for 24 weeks. Subjects in the E+S and S groups consumed 1000 mg/d N-3 for 24 weeks. The lumbar spine (L2-L4 and femoral neck BMD, serum tumor necrosis factor (TNF α, interleukin (IL 6, prostaglandin (PG E2, estrogen, osteocalcin, 1, 25-dihydroxyvitamin D3 (1, 25 Vit D, C-telopeptide (CTX, parathyroid hormone (PTH and calcitonin (CT were measured at baseline, the end of week 12 and 24. Results Serum estrogen, osteocalcin, 1, 25 Vit D, CT, L2-L4 and femoral neck BMD measures increased (P 2 decreased (P 2-L4 and femoral neck BMD, estrogen, osteocalcin, and CT were negatively (P 2. PTH and CT were correlated positively and negatively with IL-6, respectively (P Conclusions The present study demonstrates that long-term aerobic exercise training plus N-3 supplementation have a synergistic effect in attenuating inflammation and augmenting BMD in post-menopausal osteoporosis.

Impact of generic alendronate cost on the cost-effectiveness of osteoporosis screening and treatment.

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Smita Nayak

Full Text Available Since alendronate became available in generic form in the Unites States in 2008, its price has been decreasing. The objective of this study was to investigate the impact of alendronate cost on the cost-effectiveness of osteoporosis screening and treatment in postmenopausal women.Microsimulation cost-effectiveness model of osteoporosis screening and treatment for U.S. women age 65 and older. We assumed screening initiation at age 65 with central dual-energy x-ray absorptiometry (DXA, and alendronate treatment for individuals with osteoporosis; with a comparator of "no screening" and treatment only after fracture occurrence. We evaluated annual alendronate costs of $20 through $800; outcome measures included fractures; nursing home admission; medication adverse events; death; costs; quality-adjusted life-years (QALYs; and incremental cost-effectiveness ratios (ICERs in 2010 U.S. dollars per QALY gained. A lifetime time horizon was used, and direct costs were included. Base-case and sensitivity analyses were performed.Base-case analysis results showed that at annual alendronate costs of $200 or less, osteoporosis screening followed by treatment was cost-saving, resulting in lower total costs than no screening as well as more QALYs (10.6 additional quality-adjusted life-days. When assuming alendronate costs of $400 through $800, screening and treatment resulted in greater lifetime costs than no screening but was highly cost-effective, with ICERs ranging from $714 per QALY gained through $13,902 per QALY gained. Probabilistic sensitivity analyses revealed that the cost-effectiveness of osteoporosis screening followed by alendronate treatment was robust to joint input parameter estimate variation at a willingness-to-pay threshold of $50,000/QALY at all alendronate costs evaluated.Osteoporosis screening followed by alendronate treatment is effective and highly cost-effective for postmenopausal women across a range of alendronate costs, and may be cost

Increase in Fracture Risk Following Unintentional Weight Loss in Postmenopausal Women: The Global Longitudinal Study of Osteoporosis in Women†

Science.gov (United States)

Compston, Juliet E.; Wyman, A; FitzGerald, Gordon; Adachi, Jonathan D.; Chapurlat, Roland D.; Cooper, Cyrus; Díez-Pérez, Adolfo; Gehlbach, Stephen H; Greenspan, Susan L.; Hooven, Frederick H.; LaCroix, Andrea Z.; March, Lyn; Coen Netelenbos, J.; Nieves, Jeri W.; Pfeilschifter, Johannes; Rossini, Maurizio; Roux, Christian; Saag, Kenneth G.; Siris, Ethel S.; Silverman, Stuart; Watts, Nelson B.; Anderson, Frederick A.

2016-01-01

Increased fracture risk has been associated with weight loss in postmenopausal women but the time course over which this occurs has not been established. The aim of this study was to examine the effects of unintentional weight loss of ≥10 lb (4.5 kg) in postmenopausal women on fracture risk at multiple sites up to 5 years following weight loss. Using data from the Global Longitudinal Study of Osteoporosis in Women (GLOW) we analyzed the relationships between self-reported unintentional weight loss of ≥10 lb at baseline, year 2, or year 3 and incident clinical fracture in the years following weight loss. Complete data were available in 40,179 women (mean age ± SD 68 ± 8.3 years). Five-year cumulative fracture rate was estimated using the Kaplan-Meier method, and adjusted hazard ratios for weight loss as a time-varying covariate were calculated from Cox multiple regression models. Unintentional weight loss at baseline was associated with a significantly increased risk of fracture of the clavicle, wrist, spine, rib, hip, and pelvis for up to 5 years following weight loss. Adjusted hazard ratios showed a significant association between unintentional weight loss and fracture of the hip, spine, and clavicle within 1 year of weight loss, and these associations were still present at 5 years. These findings demonstrate increased fracture risk at several sites after unintentional weight loss in postmenopausal women. This increase is seen as early as 1 year following weight loss, emphasizing the need for prompt fracture risk assessment and appropriate management to reduce fracture risk in this population. PMID:26861139

Weak cation magnetic separation technology and MALDI-TOF-MS in screening serum protein markers in primary type I osteoporosis.

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Shi, X L; Li, C W; Liang, B C; He, K H; Li, X Y

2015-11-30

We investigated weak cation magnetic separation technology and matrix-assisted laser desorption ionization-time of flight-mass spectrometry (MALDI-TOF-MS) in screening serum protein markers of primary type I osteoporosis. We selected 16 postmenopausal women with osteoporosis and nine postmenopausal women as controls to find a new method for screening biomarkers and establishing a diagnostic model for primary type I osteoporosis. Serum samples were obtained from controls and patients. Serum protein was extracted with the WCX protein chip system; protein fingerprints were examined using MALDI-TOF-MS. The preprocessed and model construction data were handled by the ProteinChip system. The diagnostic models were established using a genetic arithmetic model combined with a support vector machine (SVM). The SVM model with the highest Youden index was selected. Combinations with the highest accuracy in distinguishing different groups of data were selected as potential biomarkers. From the two groups of serum proteins, 123 cumulative MS protein peaks were selected. Significant intensity differences in the protein peaks of 16 postmenopausal women with osteoporosis were screened. The difference in Youden index between the four groups of protein peaks showed that the highest peaks had mass-to-charge ratios of 8909.047, 8690.658, 13745.48, and 15114.52. A diagnosis model was established with these four markers as the candidates, and the model specificity and sensitivity were found to be 100%. Two groups of specimens in the SVM results on the scatterplot were distinguishable. We established a diagnosis model, and provided a new serological method for screening and diagnosis of osteoporosis with high sensitivity and specificity.

Educational status and knowledge level of pre- and postmenopausal women about osteoporosis and risk factors: a cross-sectional study in a group of Turkish female subjects.

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Okumus, M; Ceceli, E; Tasbas, O; Kocaoglu, S; Akdogan, S; Borman, P

2013-01-01

Most women are unaware of the risk factors for osteoporosis (OP). In an effort to prevent the development of OP, women need to have a raised awareness on this issue. The aims of this study were to determine any differences in the level of awareness and knowledge about OP between pre- and postmenopausal women. Three hundred and six women who presented to the outpatient clinic of the Physical Medicine and Rehabilitation Department were included into the study. Demographic characteristics of the subjects were recorded. The participants were interviewed via an OP awareness questionnaire, which was designed to determine their knowledge of OP and risk factors. The mean ages of the 126 pre- and 180 postmenopausal women were 41.3 ± 5.9 and 58.9 ± 8.1 years, respectively. Thirty-two percent of premenopausal and 51% of postmenopausal women had heard about OP (p 0.05). Both pre- and postmenopausal women with a higher level of education demonstrated better knowledge of OP based on their awareness questionnaire score (pwomen reported having some awareness of OP, their level of knowledge was poor, particularly with regard to the risk factors associated with the condition and its complications. Having information about the risks of OP and a better understanding of the health beliefs of those at risk are important, as both may play a major role in influencing an individual's OP-preventing behaviors.

Evaluating The Risk Of Osteoporosis Through Bone Mass Density.

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Sayed, Sayeeda Amber; Khaliq, Asif; Mahmood, Ashar

2016-01-01

Osteoporosis is a bone disorder, characterized by loss of bone mass density. Osteoporosis affects more than 30% of post-menopausal women. Osteoporosis is often associated with restricted body movement, pain and joint deformities. Early identification and early intervention can help in reducing these complications. The primary objective of this study was to estimate the burden of Osteoporosis in Urban setting of Sindh among women of different age groups and to access the effect of different protective measures that can reduce the risk of Osteoporosis. In this study, 500 women's of 3 major cities of Sindh were approached by non-probability convenience sampling technique. Women bearing age 20 years or more were included. Women who fall under inclusion criteria were screened for BMD (Bone mineral density) test and were classified as Healthy, Osteopenic and Osteoporotic based on their T-score. The association of different protective measures and risk of osteoporosis was assessed by prevalence relative risk (PRR). The result of this study indicate that the burden of Osteoporosis is very high among the women of Sindh, only 17.4% (84) women were found to have normal BMD score. The life style of majority of women was sedentary. The PRR calculated for Exposure to sunlight, regular exercise, and use of nutritional supplement was 12.5, 5.19 and 2.72 folds respectively. The results of study reveal that exposure to sunlight, regular physical exercise and use of nutritional supplements found to be effective in reducing the risk of osteoporosis among women of all age group. Health education and promotion toward osteoporosis prevention can significantly contribute in reducing the morbidity of osteoporosis.

Secondary osteoporosis.

Science.gov (United States)

Boyle, I T

1993-10-01

Osteoporosis with attendant increased fracture risk is a common complication of many other diseases. Indeed, almost all chronic diseases make some impact on life-style, usually by restricting physical activity and hence reducing the anabolic effect of exercise and gravitational strains on the skeleton. Restricted appetite and modified gastrointestinal tract function is another commonplace finding that has an impact on bone nutrition and synthesis, as on other systems. Sex hormone status is of particular importance for the maintenance of the normal skeleton, and the postmenopausal woman is at particular risk for most causes of secondary osteoporosis. In dealing with secondary osteoporosis in the hypo-oestrogenic woman, the question of giving hormone replacement therapy in addition to other disease-specific therapy should always be considered, as, for example, in a young amenorrhoeic woman with Crohn's disease. Similarly, in hypogonadal men the administration of testosterone is useful for bone conservation. The wider availability of bone densitometry ought to make us more aware of the presence of osteoporosis in the many disease states discussed above. This is particularly important as the life span of such patients is now increased by improved management of the underlying disease process in many instances. Even in steroid-induced osteoporosis--one of the commonest and most severe forms of osteoporosis--we now have some effective therapy in the form of the bisphosphonates and other anti-bone-resorbing drug classes. The possibility of prophylaxis against secondary osteoporosis has therefore become a possibility, although the very long-term effects of such drug regimens are still unknown. In some situations, such as thyrotoxicosis, Cushing's syndrome and immobilization, spontaneous resolution of at least part of the osteoporosis is possible after cure of the underlying problem. The shorter the existence of the basic problem, the more successful the restoration of the

Osteoporosis in premenopausal women.

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Langdahl, Bente L

2017-07-01

The scope of this review was to review the newest developments in the context of the existing knowledge on premenopausal bone fragility. Fragility fractures are common in postmenopausal women and men and diagnostic criteria for osteoporosis have been agreed and multiple pharmacological treatments have been developed over the last 25 years. In premenopausal women, fragility fractures and very low bone mass are uncommon and osteoporosis in premenopausal women has therefore attracted much less interest. Recent studies have highlighted that lifestyle and dietary habits affect premenopausal bone mass. Bone mass may be improved by sufficient intake of calcium and vitamin D together with increased physical activity in premenopausal women with idiopathic osteoporosis. If pharmacological treatment is needed, teriparatide has been demonstrated to efficiently increase bone mass; however, no fracture studies and no comparative studies against antiresorptive therapies have been conducted. Pregnancy affects bone turnover and mass significantly, but pregnancy-associated osteoporosis is a rare and heterogeneous condition. The diagnosis of osteoporosis should only be considered in premenopausal women with existing fragility fractures, diseases or treatments known to cause bone loss or fractures. Secondary causes of osteoporosis should be corrected or treated if possible. The women should be recommended sufficient intake of calcium and vitamin and physical activity. In women with recurrent fractures or secondary causes that cannot be eliminated, for example glucocorticoid or cancer treatment, pharmacological intervention with bisphosphonates or teriparatide (not in the case of cancer) may be considered.

The effects of organic nitrates on osteoporosis: a systematic review.

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Jamal, S A; Reid, L S; Hamilton, C J

2013-03-01

Current treatments for osteoporosis are limited by lack of effect on cortical bone, side effects, and, in some cases, cost. Organic nitrates, which act as nitric oxide donors, may be a potential alternative. This systematic review summarizes the clinical data that reports on the effects of organic nitrates and bone. Organic nitrates, which act as nitric oxide donors, are novel agents that have several advantages over the currently available treatments for osteoporosis. This systematic review summarizes the clinical data that reports on the effects of organic nitrates on bone. We searched Medline (1966 to November 2012), EMBASE (1980 to November 2012), and the Cochrane Central Register of Controlled Trials (Issue 11, 2012). Keywords included nitrates, osteoporosis, bone mineral density (BMD), and fractures. We identified 200 citations. Of these, a total of 29 were retrieved for more detailed evaluation and we excluded 19 manuscripts: 15 because they did not present original data and four because they did not provide data on the intervention or outcome of interest. As such, we included ten studies in literature review. Of these ten studies two were observational cohort studies reporting nitrate use was associated with increased BMD; two were case control studies reporting that use of nitrates were associated with lower risk of hip fracture; two were randomized controlled trials (RCT) comparing alendronate to organic nitrates for treatment of postmenopausal women and demonstrating that both agents increased lumbar spine BMD. The two largest RCT with the longest follow-up, both of which compared effects of organic nitrates to placebo on BMD in women without osteoporosis, reported conflicting results. Headaches were the most common adverse event among women taking nitrates. No studies have reported on fracture efficacy. Further research is needed before recommending organic nitrates for the treatment of postmenopausal osteoporosis.

Vitamin D supplementation in elderly or postmenopausal women: a 2013 update of the 2008 recommendations from the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO).

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Rizzoli, R; Boonen, S; Brandi, M-L; Bruyère, O; Cooper, C; Kanis, J A; Kaufman, J-M; Ringe, J D; Weryha, G; Reginster, J-Y

2013-04-01

Vitamin D insufficiency has deleterious consequences on health outcomes. In elderly or postmenopausal women, it may exacerbate osteoporosis. There is currently no clear consensus on definitions of vitamin D insufficiency or minimal targets for vitamin D concentrations and proposed targets vary with the population. In view of the potential confusion for practitioners on when to treat and what to achieve, the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) convened a meeting to provide recommendations for clinical practice, to ensure the optimal management of elderly and postmenopausal women with regard to vitamin D supplementation. Vitamin D has both skeletal and extra-skeletal benefits. Patients with serum 25-hydroxyvitamin D (25-(OH)D) levels 50 nmol/L. Similar relationships have been reported for frailty, nonvertebral and hip fracture, and all-cause mortality, with poorer outcomes at milk) can help improve vitamin D intake. Above the threshold of 50 nmol/L, there is no clear evidence for additional benefits of supplementation. On the other hand, in fragile elderly subjects who are at elevated risk for falls and fracture, the ESCEO recommends a minimal serum 25-(OH)D level of 75 nmol/L (i.e. 30 ng/mL), for the greatest impact on fracture.

Effect of parity on bone mineral density among postmenopausal Saudi Arabian women.

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Sadat-Ali, Mir; Al-Habdan, Ibrahim; Al-Mulhim, Abdul-Aziz; El-Hassan, Abdallah Y

2005-10-01

Osteoporosis and osteopenia among postmenopausal Saudi Arabian women are common to the extent of over 60%. Pregnancy, multiparity and prolonged lactation are suggested as factors modifying negatively in the development of osteoporosis. Earlier reports from the institution indicated a beneficial role of multiparity in postmenopausal osteoporosis (PMO). We conducted this study to measure the effect of parity on bone mineral density (BMD) measurement of lumbar spine and the upper femur. We conducted this prospective study at King Fahd Hospital of the University, College of Medicine, King Faisal University, Dammam, Saudi Arabia, between January 2002 and June 2003. This study analyzed 256 patients who attended orthopedic clinics. The data gathered was age, duration of menopause, number of children borne, height and weight for body mass index (BMI) calculation. We excluded women with secondary osteoporosis from the study. We entered the patients orthopedic complaints in the database. We carried out the BMD measurements using Hologic total body DEXA machine. We analyzed the data using SPSS package with significance at p6 children and group B with women of 6 children, 25.4% were osteoporotic in group A and in group B 48%. As per the World Health Organization classification 56% in group A had an increased risk of fracture as compared to 77.5% in group B women. Our results indicate that women who had borne >6 children were less osteoporotic and of low fracture risk as compared to those women who had 6 children was statistically higher than their counterparts, and they sustain this after prolonged lactation. We believe that increased parity protects women from osteoporosis and the severity of the disease, and it is our suggestion that women with osteoporosis should be investigated and treated accordingly.

The implication of assessing a polymorphism in estrogen receptor alpha gene in the risk assessment of osteoporosis using a screening tool for osteoporosis in Asians.

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Ongphiphadhanakul, Boonsong; Chanprasertyothin, Suwannee; Payattikul, Penpan; Saetung, Sunee; Rajatanavin, Rajata

2003-10-01

Both genetic and environmental factors interact to determine bone mass and the risk for developing postmenopausal osteoporosis. Recently, an Asian-specific tool, the Osteoporosis Self-Assessment Tool for Asians (OSTA), has been developed to assess the risk of osteoporosis in women. An index is calculated by multiplying the difference in body weight in kilograms and age in years by 0.2 and disregarding the decimal digits. The risk of osteoporosis is classified as high, intermediate or low according to the OSTA index less than -4, -4 to -1 and greater than -1. In the present study we examined how a single nucleotide polymorphism (SNP) in exon 8 of the estrogen receptor alpha (ERalpha) gene affected the predictive value of the OSTA index. Subjects consisted of 358 postmenopausal women who were at least 55 years old. BMDs were measured by DXA, and the SNP in the ERalpha gene was assessed by PCR-RFLP. When considering both the OSTA index and ERalpha genotype in a logistic regression model, it was found that both the OSTA index and the ERalpha genotype independently contributed to the risk of osteoporosis. The odds ratios were 1.58 (95% CI 1.26-1.91) and 2.51 (95% CI 1.42-4.44) for one unit decrement in the OSTA index and each copy of the A allele of the ERalpha genotype, respectively. The joint effect conformed more to a multiplicative model of interaction than an additive model. This suggests that persons with the high-risk genotype are at far greater risk of developing osteoporosis with advancing age or decreasing body weight, the two variables from which the OSTA index is derived. Targeting preventive measures for osteoporosis subjects with risk factors and also disease-susceptibility alleles is likely to be more cost effective.

Influence of ferutinin on bone metabolism in ovariectomized rats. II: Role in recovering osteoporosis

Science.gov (United States)

Ferretti, Marzia; Bertoni, Laura; Cavani, Francesco; Zavatti, Manuela; Resca, Elisa; Carnevale, Gianluca; Benelli, Augusta; Zanoli, Paola; Palumbo, Carla

2010-01-01

The aim of the present investigation, which represents an extension of a previous study, was to investigate the effect of ferutinin in recovering severe osteoporosis due to estrogen deficiency after rat ovariectomy and to compare phytoestrogen effects with those of estrogens commonly used in hormone replacement therapy (HRT) by women with postmenopausal osteoporosis. The animal model used was the Sprague–Dawley ovariectomized rat. Ferutinin was orally administered (2 mg kg−1 per day) for 30 or 60 days starting from 2 months after ovariectomy (i.e. when osteoporosis was clearly evident) and its effects were compared with those of estradiol benzoate (1.5 μg per rat twice a week, subcutaneously injected) vs. vehicle-treated ovariectomized (OVX) and sham-operated (SHAM) rats. Histomorphometric analyses were performed on trabecular bone of lumbar vertebrae (4th and 5th) and distal femoral epiphysis, as well as on cortical bone of femoral diaphysis. Bone histomorphometric analyses showed that ferutinin seems to display the same effects on bone mass recorded with estradiol benzoate, thus suggesting that it could enhance the recovery of bone loss due to severe estrogen deficiency in OVX rats. On this basis, the authors propose listing ferutinin among the substances representing a potential alternative for the treatment of postmenopausal osteoporosis, which occurs as a result of estrogen deficiency. PMID:20492429

Protective effect of Rhizoma drynariae extract on osteoporosis in ...

African Journals Online (AJOL)

has been a popular therapeutic strategy designed for postmenopausal osteoporosis [8,9]. However, the long-term application of HRT has potential malignant effects on reproductive tissues [10-13]. Other medicines that stimulate bone formation (e.g., growth hormone, sodium uoride, and parathyroid hormone) or inhibit bone.

CD38 is associated with premenopausal and postmenopausal bone mineral density and postmenopausal bone loss.

LENUS (Irish Health Repository)

Drummond, Frances J

2012-02-03

One goal of osteoporosis research is to identify the genes and environmental factors that contribute to low bone mineral density (BMD) and fracture. Linkage analyses have identified quantitative trait loci (QTLs), however, the genes contributing to low BMD are largely unknown. We examined the potential association of an intronic polymorphism in CD38 with BMD and postmenopausal bone loss. CD38 resides in 4p15, where a QTL for BMD has been described. CD38-\\/- mice display an osteoporotic phenotype at 3 months, with normalization of BMD by 5 months. The CD38 polymorphism was identified by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) analysis in 457 postmenopausal and 173 premenopausal Caucasian women whose spine and hip BMD was measured by dual energy X-ray absorptiometry (DXA). Influence of the CD38 polymorphism on bone loss was analyzed in 273 postmenopausal women over a follow-up of 2.94 +\\/- 1.50 years. The CD38-PvuII polymorphism was significantly associated with premenopausal and postmenopausal (P = 0.001) lumbar spine BMD. Women homozygous for the G allele had >14% lower spinal BMD than women with GC\\/CC genotypes. An allele dose effect was observed at the spine in premenopausal (P = 0.002) and postmenopausal (P < 0.001) cohorts. The CD38-PvuII polymorphism was significantly associated with femoral neck BMD in pre- and postmenopausal women (P = 0.002 and P = 0.011, respectively). However, significance was lost following adjustment of hip BMD for covariates in the postmenopausal cohort (P = 0.081). The CD38-PvuII polymorphism was weakly associated with bone loss at the spine (P = 0.024), in postmenopausal women not taking hormone replacement therapy. We suggest that the CD38-PvuII polymorphism may influence the attainment and maintenance of peak BMD and postmenopausal bone loss.

The Regulatory Roles of MicroRNAs in Bone Remodeling and Perspectives as Biomarkers in Osteoporosis

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Mengge Sun

2016-01-01

Full Text Available MicroRNAs are involved in many cellular and molecular activities and played important roles in many biological and pathological processes, such as tissue formation, cancer development, diabetes, neurodegenerative diseases, and cardiovascular diseases. Recently, it has been reported that microRNAs can modulate the differentiation and activities of osteoblasts and osteoclasts, the key cells that are involved in bone remodeling process. Meanwhile, the results from our and other research groups showed that the expression profiles of microRNAs in the serum and bone tissues are significantly different in postmenopausal women with or without fractures compared to the control. Therefore, it can be postulated that microRNAs might play important roles in bone remodeling and that they are very likely to be involved in the pathological process of postmenopausal osteoporosis. In this review, we will present the updated research on the regulatory roles of microRNAs in osteoblasts and osteoclasts and the expression profiles of microRNAs in osteoporosis and osteoporotic fracture patients. The perspective of serum microRNAs as novel biomarkers in bone loss disorders such as osteoporosis has also been discussed.

Guidelines for the diagnosis, prevention and treatment of osteoporosis

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M. Rossini

2011-06-01

Full Text Available The guidelines for the osteoporosis management were first drafted by a working group and then critically evaluated by the board of SIOMMMS. The most relevant points are: Definition: Osteoporosis is defined as a quantitative and qualitative deterioration of bone tissue leading to increased risk of fracture. Postmenopausal and senile osteoporosis are defined as primitive. Diagnosis: The cornerstone for the diagnosis of osteoporosis is the measurement of bone mineral density (BMD by DXA (dual-energy X-ray absortiometry at the femoral neck with T-score values -2.5 is usually not justified. Pharmacological intervention: The use of drugs registered for the treatment of osteoporosis are recommended when the benefits overcome the risk. This is the case only when the risk of fracture is rather high. FRAX™ is recognized as a useful tool for easily estimate the long-term fracture risk. SIOMMMS with these guidelines is committed to validate and further develop this diagnostic tool.

Transcriptional profiling of human femoral mesenchymal stem cells in osteoporosis and its association with adipogenesis.

Science.gov (United States)

Choi, Yong Jun; Song, Insun; Jin, Yilan; Jin, Hyun-Seok; Ji, Hyung Min; Jeong, Seon-Yong; Won, Ye-Yeon; Chung, Yoon-Sok

2017-10-20

Genetic alterations are major contributing factors in the development of osteoporosis. Osteoblasts and adipocytes share a common origin, mesenchymal stem cells (MSCs), and their genetic determinants might be important in the relationship between osteoporosis and obesity. In the present study, we aimed to isolate differentially expressed genes (DEGs) in osteoporosis and normal controls using human MSCs, and elucidate the common pathways and genes related to osteoporosis and adipogenesis. Human MSCs were obtained from the bone marrow of femurs from postmenopausal women during orthopedic surgeries. RNA sequencing (RNA-seq) was carried out using next-generation sequencing (NGS) technology. DEGs were identified using RNA-seq data. Ingenuity pathway analysis (IPA) was used to elucidate the common pathway related to osteoporosis and adipogenesis. Candidate genes for the common pathway were validated with other independent osteoporosis and obese subjects using RT-PCR (reverse transcription-polymerase chain reaction) analysis. Fifty-three DEGs were identified between postmenopausal osteoporosis patients and normal bone mineral density (BMD) controls. Most of the genetic changes were related to the differentiation of cells. The nuclear receptor subfamily 4 group A (NR4A) family was identified as possible common genes related to osteogenesis and adipogenesis. The expression level of the mRNA of NR4A1 was significantly higher in osteoporosis patients than in controls (p=0.018). The expression level of the mRNA of NR4A2 was significantly higher in obese patients than in controls (p=0.041). Some genetic changes in MSCs are involved in the pathophysiology of osteoporosis. The NR4A family might comprise common genes related to osteoporosis and obesity. Copyright © 2017 Elsevier B.V. All rights reserved.

Fluoride in the prevention and treatment of glucocorticoid-induced osteoporosis

NARCIS (Netherlands)

Lems, WF; Jacobs, JWG; Bijlsma, JWJ

2000-01-01

Since the use of fluoride has been shown to stimulate bone formation and since decreased bone formation is a key feature in the pathogenesis of corticosteroid-induced osteoporosis (CIOP), fluoride is, at least theoretically, attractive for the prevention and treatment of CIOP. In postmenopausal

Relation of parity and homocysteine to bone mineral density of postmenopausal women.

Science.gov (United States)

Yilmaz, Necat; Kepkep, Necip; Ciçek, Hülya Kanbur; Celik, Ahmet; Meram, Iclal

2006-01-01

Osteoporosis is a major problem in contemporary society. However, there is not enough data on multiparity and osteoporosis from developing and/or undeveloped countries on a large scale. Selection of participants in this study was aimed at the detection of bone status in healthy (normal bone mineral density) postmenopausal (n = 46, 55.3 +/- 6.7 years) and osteoporotic postmenopausal women (n: 33) of similar age. Bone mineral density (BMD) was evaluated using dual energy X-ray absorptiometry. At the DEXA evaluation, 33 women had osteoporotic (T score below -2.5) and 46 had normal BMD values. The number of pregnancies was found to range from 3 to 12 (with an overall mean of 6.7 +/- 2.5), while 2.6 +/- 1.9 (range, 1-7) were miscarriages in all of the 33 postmenopausal osteoporotic women. Serum homocysteine (t-Hcy) and urinary deoxypyridinoline (DPD) levels were significantly higher in osteoporotic postmenopausal women (11.96 +/- 3.84 micromol/L, 15.4 +/- 7.0 nM/mM cr) than in non-osteoporotic postmenopausal women (10.93 +/- 3.6 micromol/L, 10.6 +/- 9.1 nM/mM cr), p pregnancies is unclear, and the relationship may only be by chance. In conclusion, the present study firstly suggests that the number of pregnancies has an effect on the t-Hcy levels. In addition, our study indicates that there is a significant negative correlation between the number of pregnancies and the lumbar spine BMD.

Bone turnover biomarkers in obese postmenopausal Saudi women ...

African Journals Online (AJOL)

Background: There is a high prevalence of diabetes mellitus type-2 (T2DM) and osteoporosis are problems worldwide. In this study, we evaluated the correlation between T2DM and bone turnover in diabetic obese postmenopausal Saudi women. Subjects and Methods: The present study included total of 65 T2-DM obese ...

Association Analysis between g.18873C>T and g.27522G>A Genetic Polymorphisms of OPG and Bone Mineral Density in Chinese Postmenopausal Women

Directory of Open Access Journals (Sweden)

Fei Wang

2014-01-01

Full Text Available Several studies report that the OPG is an important candidate gene in the pathogenesis of osteoporosis. This study aimed to detect the potential association of OPG gene polymorphisms with osteoporosis in postmenopausal women. We recruited 928 subjects containing 463 with primary postmenopausal osteoporosis and 465 healthy volunteers as controls. The BMD of neck hip, lumbar spine (L2–4, and total hip were assessed by dual-energy X-ray absorptiometry (DEXA. Through the created restriction site-polymerase chain reaction (CRS-PCR, PCR-restriction fragment length polymorphism (PCR-RFLP, and DNA sequencing methods, the g.18873C>T and g.27522G>A have been investigated. As for g.18873C>T, our data indicated that subjects with CC genotype have significantly higher BMD value than those of CT and TT genotypes (all P values A, the BMD values of subjects with GG genotype were significantly higher than those of GA and AA genotypes (all P values T and g.27522G>A genetic polymorphisms are associated with the decreased risk for osteoporosis in Chinese postmenopausal women.

Diagnosis of osteoporosis from dental panoramic radiographs using the support vector machine method in a computer-aided system

International Nuclear Information System (INIS)

Kavitha, M S; Asano, Akira; Taguchi, Akira; Kurita, Takio; Sanada, Mitsuhiro

2012-01-01

Early diagnosis of osteoporosis can potentially decrease the risk of fractures and improve the quality of life. Detection of thin inferior cortices of the mandible on dental panoramic radiographs could be useful for identifying postmenopausal women with low bone mineral density (BMD) or osteoporosis. The aim of our study was to assess the diagnostic efficacy of using kernel-based support vector machine (SVM) learning regarding the cortical width of the mandible on dental panoramic radiographs to identify postmenopausal women with low BMD. We employed our newly adopted SVM method for continuous measurement of the cortical width of the mandible on dental panoramic radiographs to identify women with low BMD or osteoporosis. The original X-ray image was enhanced, cortical boundaries were determined, distances among the upper and lower boundaries were evaluated and discrimination was performed by a radial basis function. We evaluated the diagnostic efficacy of this newly developed method for identifying women with low BMD (BMD T-score of -1.0 or less) at the lumbar spine and femoral neck in 100 postmenopausal women (≥50 years old) with no previous diagnosis of osteoporosis. Sixty women were used for system training, and 40 were used in testing. The sensitivity and specificity using RBF kernel-SVM method for identifying women with low BMD were 90.9% [95% confidence interval (CI), 85.3-96.5] and 83.8% (95% CI, 76.6-91.0), respectively at the lumbar spine and 90.0% (95% CI, 84.1-95.9) and 69.1% (95% CI, 60.1-78.6), respectively at the femoral neck. The sensitivity and specificity for identifying women with low BMD at either the lumbar spine or femoral neck were 90.6% (95% CI, 92.0-100) and 80.9% (95% CI, 71.0-86.9), respectively. Our results suggest that the newly developed system with the SVM method would be useful for identifying postmenopausal women with low skeletal BMD

Osteoporosis in men: a review.

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Adler, Robert A

2014-01-01

Osteoporosis and consequent fracture are not limited to postmenopausal women. There is increasing attention being paid to osteoporosis in older men. Men suffer osteoporotic fractures about 10 years later in life than women, but life expectancy is increasing faster in men than women. Thus, men are living long enough to fracture, and when they do the consequences are greater than in women, with men having about twice the 1-year fatality rate after hip fracture, compared to women. Men at high risk for fracture include those men who have already had a fragility fracture, men on oral glucocorticoids or those men being treated for prostate cancer with androgen deprivation therapy. Beyond these high risk men, there are many other risk factors and secondary causes of osteoporosis in men. Evaluation includes careful history and physical examination to reveal potential secondary causes, including many medications, a short list of laboratory tests, and bone mineral density testing by dual energy X-ray absorptiometry (DXA) of spine and hip. Recently, international organizations have advocated a single normative database for interpreting DXA testing in men and women. The consequences of this change need to be determined. There are several choices of therapy for osteoporosis in men, with most fracture reduction estimation based on studies in women.

Construction of an miRNA-Regulated Pathway Network Reveals Candidate Biomarkers for Postmenopausal Osteoporosis

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Min Shao

2017-01-01

Full Text Available We aimed to identify risk pathways for postmenopausal osteoporosis (PMOP via establishing an microRNAs- (miRNA- regulated pathway network (MRPN. Firstly, we identified differential pathways through calculating gene- and pathway-level statistics based on the accumulated normal samples using the individual pathway aberrance score (iPAS. Significant pathways based on differentially expressed genes (DEGs using DAVID were extracted, followed by identifying the common pathways between iPAS and DAVID methods. Next, miRNAs prediction was implemented via calculating TargetScore values with precomputed input (log fold change (FC, TargetScan context score (TSCS, and probabilities of conserved targeting (PCT. An MRPN construction was constructed using the common genes in the common pathways and the predicted miRNAs. Using false discovery rate (FDR < 0.05, 279 differential pathways were identified. Using the criteria of FDR < 0.05 and log⁡FC≥2, 39 DEGs were retrieved, and these DEGs were enriched in 64 significant pathways identified by DAVID. Overall, 27 pathways were the common ones between two methods. Importantly, MAPK signaling pathway and PI3K-Akt signaling pathway were the first and second significantly enriched ones, respectively. These 27 common pathways separated PMOP from controls with the accuracy of 0.912. MAPK signaling pathway and PI3K/Akt signaling pathway might play crucial roles in PMOP.

The circulating concentration and ratio of total and high molecular weight adiponectin in post-menopausal women with and without osteoporosis and its association with body mass index and biochemical markers of bone metabolism.

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Sodi, R; Hazell, M J; Durham, B H; Rees, C; Ranganath, L R; Fraser, W D

2009-09-01

There is increasing evidence suggesting that adiponectin plays a role in the regulation of bone metabolism. This was a cross-sectional study of 34 post-menopausal women with and 37 without osteoporosis. All subjects had body mass index (BMI), bone mineral density (BMD), total-, high molecular weight (HMW)-adiponectin and their ratio, osteoprotegerin (OPG), a marker of bone resorption (betaCTX) and formation (P1NP) measured. We observed a positive correlation between BMI and BMD (r=0.44, plean subjects but there was no difference between those with or without osteoporosis. There were significant negative correlations between HMW/total-adiponectin ratio and BMI (r=-0.27, p=0.030) and with OPG (r=-0.44, pproduction of OPG thereby affecting osteoclasts mediated bone resorption.

The assessment of osteoporosis risk factors in Iranian women compared with Indian women

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Chakravarty Devlina

2008-02-01

Full Text Available Abstract Background Osteoporosis is an important public health problem in older adults. It is more common in postmenopausal women and not only gives rise to morbidity but also markedly diminishes the quality of life in this population. There is lack of information about the risk factor of osteoporosis in developing countries. In this study we aimed to assess the risk factors for osteoporosis in postmenopausal women from selected BMD centers of two developing Asian countries (Iran and India. Methods This study is a multicenter interview-based study conducted in selected hospitals and health centers from urban areas in Iran and India. The case group included postmenopausal osteoporotic women who were identified as patients with bone density higher than 2.5 SD below average of young normal bone density (in L1–L4 spine region interest and/or total femoral region by using DEXA method. The controls were chosen from postmenopausal women with normal bone density (in L1–L4 spine and total femoral regions using DEXA method matching in age groups was strategy of choice. The sample sizes included from Iran a total of 363 subjects (178 osteoporotic and 185 normal and from India a total of 354 subjects (203 osteoporotic and 151 normal. Results The significant (p Lower education defined as less than class 12 or nil college (2.1 (2.7, duration of menopause greater than 5 years: (2.2 (1.4, Menarche age (after 14 years: (1.9 (1.6, Menopause age (before 45 years: (1.1 (2, Parity more than 3: (1.1 (1, Bone and joint problem (2.3 (2.2. Calcium supplementation (0.6 and HRT (0.4 were shown as protective factors and steroid therapy (3.3 was found as a risk factor in Iran. Calcium supplementation more than 1 year (0.3 was shown as a protective factor in India. Pure vegetarianism: (2.2 and Red meat consumption more than 4 times per week (1.4 was shown as a risk factor in Indian and Iranian subjects respectively. Regular consumption of Soya (0.3, almond (0.5, fish (0

D-hormone analog alfacalcidol: an update on its role in post-menopausal osteoporosis and rheumatoid arthritis management.

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Richy, Florent; Deroisy, Rita; Lecart, Marie-Paule; Hanssens, Linda; Mawet, Audrey; Reginster, Jean-Yves

2005-04-01

Alfacalcidol (1-alpha-hydroxyvitamin D3) is a non-endogenous analog of vitamin D which can bypass the renal and intestinal regulatory mechanisms that control the production of calcitriol (1,25-hydroxyvitamin D3, the active form of vitamin D, D-Hormone). Alfacalcidol may be metabolized into calcitriol with a limited risk of hypercalcemia. Alfacalcidol and calcitriol have been evaluated in animal and human studies assessing their effects on bone mineral density and fracture rates. More recently, they have been shown to produce beneficial effects in muscle, immune system, and autoimmune diseases, including rheumatoid arthritis. This paper discusses the therapeutic efficacy of alfacalcidol in reports in which it has been proposed as an interesting alternative to vitamin D or calcitriol. Some recent findings about general metabolism and regulation of vitamin D and its analogs are discussed. The biological and clinical effects of alfacalcidol in post-menopausal osteoporosis are reviewed, followed by critical appraisal of its efficacy in preventing bone loss and falls in the elderly. The last two sections discuss the role of D analogs in regulating the immune system, with particular regard to rheumatoid arthritis. The main results of this review show that alfacalcidol may have a wider range of therapeutic applicability, beyond simply restricting it to patients in hemodialysis or peritoneal dialysis with high serum levels of intact PTH.

The effects of IL-6 and its receptors on bone loss in postmenopausal women

International Nuclear Information System (INIS)

Huang Xin; Yang Weiwen; Zhang Xueguang

2001-01-01

Objective: To investigate the effects of IL-6 and its receptors on bone loss in healthy women, and to assess the pathogenesis of the postmenopausal osteoporosis in women. Methods: One hundred and thirty one healthy women aged 31-72 including 64 sexual maturity women aged 31-52 were enrolled in four groups and 67 postmenopausal women, the years of menopause from 1 month to 23 years, were also enrolled in four groups. The bone mass of the lumbar-spine and femur were measured using dual-energy X-rays absorptiometry; the serum E 2 , FSH, BGP by radioimmunoassay (RIA); the serum IL-6, sIL-6R, sgp 130 by ELISA; the serum AKP, calcium, phosphate by auto-biochemistry instrument. Results: The BMD of lumbar-spine and right femur decreased following increase of age and the duration of menopause. Significant positive correlation was observed between BMD and E 2 . The serum IL-6, sIL-6R, sgp 130 level was low, and stable before menopause. The level of IL-6, sIL-6R, sgp 130 increased with variation of age and the duration of menopause. Significant negative correlation was observed between IL-6, sIL-6R, sgp 130 and E 2 , BMD. Serum AKP and BGP level was higher in postmenopausal women than that in sexual maturity women. The serum calcium level increased significantly soon after menopausal, then decreased to the normal level. The serum phosphate level had no difference in these groups. Conclusion: The main cause of postmenopausal osteoporosis is the unbalance of the bone formation and resorption

Effect of 6 months of whole body vibration on lumbar spine bone density in postmenopausal women: a randomized controlled trial

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Lai CL

2013-12-01

Full Text Available Chung-Liang Lai,1,2 Shiuan-Yu Tseng,1,2 Chung-Nan Chen,3 Wan-Chun Liao,2 Chun-Hou Wang,4 Meng-Chih Lee,1,5,* Pi-Shan Hsu5,* 1Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan; 2Department of Physical Medicine and Rehabilitation, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 3Department of Radiology, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan; 4School of Physical Therapy, Chung Shan Medical University, Taichung, Taiwan; 5Department of Family Medicine, Taichung Hospital, Ministry of Health and Welfare, Taichung, Taiwan*These authors contributed equally to this workBackground: The issue of osteoporosis-induced fractures has attracted the world's attention. Postmenopausal women are particularly at risk for this type of fracture. The nonmedicinal intervention for postmenopausal women is mainly exercise. Whole body vibration (WBV is a simple and convenient exercise. There have been some studies investigating the effect of WBV on osteoporosis; however, the intervention models and results are different. This study mainly investigated the effect of high-frequency and high-magnitude WBV on the bone mineral density (BMD of the lumbar spine in postmenopausal women.Methods: This study randomized 28 postmenopausal women into either the WBV group or the control group for a 6-month trial. The WBV group received an intervention of high-frequency (30 Hz and high-magnitude (3.2 g WBV in a natural full-standing posture for 5 minutes, three times per week, at a sports center. Dual-energy X-ray absorptiometry was used to measure the lumbar BMD of the two groups before and after the intervention.Results: Six months later, the BMD of the WBV group had significantly increased by 2.032% (P=0.047, while that of the control group had decreased by 0.046% (P=0.188. The comparison between the two groups showed that the BMD of the WBV group had increased significantly (P=0.016.Conclusion: This study found

Prevalência de osteoporose e fraturas vertebrais em mulheres na pós-menopausa atendidas em serviços de referência Prevalence of osteoporosis and vertebral fractures in postmenopausal women attending reference centers

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Francisco Bandeira

2007-03-01

Full Text Available Este estudo tem por objetivo verificar a prevalência de osteoporose e a presença de fraturas vertebrais em mulheres na pós-menopausa. Foram estudadas, em serviços de referências, 627 mulheres com idade acima de 50 anos, com média de idade de 63,9 ± 8,3 anos, tempo de menopausa de 16,2 ± 8,6 anos, e índice de massa corpórea de 26,6 ± 4.3 Kg/m2. A prevalência de osteoporose foi de 28,8% na coluna lombar e de 18,8% no colo do fêmur. Esta foi maior nas pacientes que apresentaram história de fraturas quando jovens. Na faixa entre 60 a 69 anos, 33,2% tinham osteoporose na coluna lombar e entre 70 e 79 anos, 38,2%. Das pacientes com mais de 80 anos 54,5% apresentam osteoporose na coluna lombar e 72,7% no colo do fêmur. Trinta e sete por cento tinham fraturas, sendo que 9% apresentam fraturas grau I, e 10,9% fraturas severas. Considerando-se os diversos grupos etários, a prevalência de fraturas vertebrais foi de 20% entre 50 e 59 anos, 25,6% entre 60 e 69 anos, 58,3% entre 70 e 79 anos, e 81,8% entre 80 e 89 anos. Em mulheres na pós-menopausa, a maioria sem sintomas clínicos, verificamos uma alta taxa de prevalência de osteoporose, e fraturas vertebrais.The aim of this study was to determine the prevalence of osteoporosis and vertebral fractures in postmenopausal women. We studied 627 women, aged 50 years and over in reference centers (mean age 63.9±8.3 years, 16.2 ± 8.6 mean years since menopause, and mean body mass index 26.6 ± 4.3 Kg/m2. The prevalence of osteoporosis was 28.8% for lumbar spine and 18.8% for femoral neck. The prevalence was higher in patients who had had a fracture during youth. In the 60-69 year-old group, 32.2% had lumbar spine osteoporosis and 17.4% femoral neck osteoporosis. In the 70-79 year-old group, 38.2% had lumbar spine osteoporosis and 34% femoral neck osteoporosis. In the 80 years and over age group, 54.5% had lumbar spine osteoporosis and 72.7% femoral neck osteoporosis. Thirty-seven percent had

[Association between risk factors of cardiovascular diseases and osteoporosis in postmenopausal Chinese women].

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Xue, Wen-qiong; Deng, Juan; Li, Jing-jing; Liu, Jing; He, Li-ping; Chen, Zong-qiu; Chen, Yu-ming

2011-06-01

To assess the relationship between cardiovascular risk factors and osteoporosis. 2202 women aged 50 - 73 years were included in this cross-sectional study from the communities in Guangzhou, from July 2008 to January 2010. Cardiovascular risk factors including age, years since menopause, physical activity, anthropometrics, body composition, blood pressure, fasting serum lipids, glucose and uric acid, intima-media thickness (IMT) of carotid artery were assessed. Ultrasonic bone density (speed of sound) at the radius and tibia were determined. Osteoporosis was defined as T-score ≤ -2.5. Common factors for the cardiovascular risk factors were extracted using the factor analysis method. Eight common factors representing obesity, lean mass, blood triglycerides and uric acid, cholesterol, age, blood pressure, IMT and physical activity were extracted. Data from the Multivariate logistic regression showed a dose-dependent association of greater scores of age and IMT factors and lower score of lean mass factor with the increased risk of osteoporosis at the radius and tibia. As compared with the bottom quartile, the OR (95%CI) of radius and tibia osteoporosis were 0.62 (0.44 - 0.88) and 0.62 (0.48 - 0.80) for lean mass factor, 4.02 (2.72 - 5.94) and 3.68 (2.81 - 4.82) for age factor, 1.41 (1.00 - 2.00) and 1.54 (1.19 - 2.00) for IMT factors, respectively. Moreover, greater blood pressure score was associated with higher risk of radius osteoporosis while the higher obese score, was correlated with the increased risk of tibia osteoporosis. The cardiovascular-related risk factors of greater IMT, obesity, blood pressure and lower lean mass scores were associated with increased osteoporosis risks while called for more concern among the Chinese women.

Polymorphisms of estrogen metabolism-related genes ESR1 , UGT2B17 , and UGT1A1 are not associated with osteoporosis in artificial menopausal Japanese women

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Megumi Yokota

2015-09-01

Full Text Available Introduction : Bilateral salpingo-oophorectomy (BSO is a risk factor for osteoporosis. Previous studies have reported an association between genetic polymorphisms and the risk of developing osteoporosis. However, the relationship between osteoporosis and genetic polymorphisms in Japanese women treated with BSO is not well understood. To improve the quality of life for post-BSO patients, it is important to determine the genetic factors that influence their risk for osteoporosis. The aim of this study was to investigate the association between gene variations of estrogen metabolism-related genes and osteoporosis in surgically menopausal patients, which may improve the quality of life for surgically menopausal patients. Material and methods : This study included 203 menopausal women treated with BSO because of gynecologic disorders. One hundred and twenty-six women with artificial (surgical menopause, who had undergone BSO in the premenopausal period, were compared with 77 women with natural menopause, who had undergone BSO in the postmenopausal period. The women were tested for bone mineral density to diagnose osteoporosis. Polymorphisms of estrogen receptor 1 ( ESR1 and UDP-glucuronosyl transferase (UGT genes UGT2B17 and UGT1A1 were analyzed, and their association with bone mass and osteoporosis was statistically evaluated. Results : No significant association was found between osteoporosis and polymorphisms in ESR1 , UGT2B17 , or UGT1A1 in both groups, suggesting that BSO might be a more significant physiological factor in influencing bone mass density compared to genetic variations. Conclusions : These results suggest that the ESR1 , UGT2B17 , and UGT1A1 polymorphisms are not genetic factors affecting osteoporosis in postmenopausal Japanese women.

Osteoporosis: Modern Paradigms for Last Century's Bones.

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Kruger, Marlena C; Wolber, Frances M

2016-06-17

The skeleton is a metabolically active organ undergoing continuously remodelling. With ageing and menopause the balance shifts to increased resorption, leading to a reduction in bone mineral density and disruption of bone microarchitecture. Bone mass accretion and bone metabolism are influenced by systemic hormones as well as genetic and lifestyle factors. The classic paradigm has described osteoporosis as being a "brittle bone" disease that occurs in post-menopausal, thin, Caucasian women with low calcium intakes and/or vitamin D insufficiency. However, a study of black women in Africa demonstrated that higher proportions of body fat did not protect bone health. Isoflavone interventions in Asian postmenopausal women have produced inconsistent bone health benefits, due in part to population heterogeneity in enteric bacterial metabolism of daidzein. A comparison of women and men in several Asian countries identified significant differences between countries in the rate of bone health decline, and a high incidence rate of osteoporosis in both sexes. These studies have revealed significant differences in genetic phenotypes, debunking long-held beliefs and leading to new paradigms in study design. Current studies are now being specifically designed to assess genotype differences between Caucasian, Asian, African, and other phenotypes, and exploring alternative methodology to measure bone architecture.

Use of MR-based trabecular bone microstructure analysis at the distal radius for osteoporosis diagnostics: a study in post-menopausal women with breast cancer and treated with aromatase inhibitor.

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Baum, Thomas; Karampinos, Dimitrios C; Seifert-Klauss, Vanadin; Pencheva, Tsvetelina D; Jungmann, Pia M; Rummeny, Ernst J; Müller, Dirk; Bauer, Jan S

2016-01-01

Treatment with aromatase inhibitor (AI) is recommended for post-menopausal women with hormone-receptor positive breast cancer. However, AI therapy is known to induce bone loss leading to osteoporosis with an increased risk for fragility fractures. The purpose of this study was to investigate whether changes of magnetic resonance (MR)-based trabecular bone microstructure parameters as advanced imaging biomarker can already be detected in subjects with AI intake but still without evidence for osteoporosis according to dual energy X-ray absorptiometry (DXA)-based bone mineral density (BMD) measurements as current clinical gold standard. Twenty-one postmenopausal women (62±6 years of age) with hormone-receptor positive breast cancer, ongoing treatment with aromatase inhibitor for 23±15 months, and no evidence for osteoporosis (current DXA T-score greater than -2.5) were recruited for this study. Eight young, healthy women (24±2 years of age) were included as controls. All subjects underwent 3 Tesla magnetic resonance imaging (MRI) of the distal radius to assess the trabecular bone microstructure. Trabecular bone microstructure parameters were not significantly (p>0.05) different between subjects with AI intake and controls, including apparent bone fraction (0.42±0.03 vs. 0.42±0.05), trabecular number (1.95±0.10 mm(-1) vs 1.89±0.15 mm(-1)), trabecular separation (0.30±0.03 mm vs 0.31±0.06 mm), trabecular thickness (0.21±0.01 mm vs 0.22±0.02 mm), and fractal dimension (1.70±0.02 vs. 1.70±0.03). These findings suggest that the initial deterioration of trabecular bone microstructure as measured by MRI and BMD loss as measured by DXA occur not sequentially but rather simultaneously. Thus, the use of MR-based trabecular bone microstructure assessment is limited as early diagnostic biomarker in this clinical setting.

Influence of obesity on bone mineral density in postmenopausal asthma patients undergoing treatment with inhaled corticosteroids

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Burcu Yanik

2009-04-01

Full Text Available OBJECTIVES: The etiology of osteoporosis in asthma is complex as various factors contribute to its pathogenesis. The purpose of our study was to investigate the effects of obesity and inhaled steroids, as well as the severity and duration of asthma, on osteoporosis in postmenopausal asthma patients as compared to healthy controls. METHODS: A total of 46 patients with asthma and 60 healthy female controls, all postmenopausal, were enrolled in our study. Bone mineral density was assessed at the lumbar spine and hip using a Lunar DPX-L densitometer. RESULTS: Bone mineral density (BMD scores were comparable between the asthmatic and control groups, with average scores of 0.95 ± 0.29 and 0.88 ± 0.14 g/cm², respectively. Likewise, osteoporosis was diagnosed in a similar percentage of patients in the asthmatic (39.1% and control (43.3% groups. Bone fracture was identified in four patients with asthma (8.6% and in six patients from the control group (10%. We could not detect any relationship between BMD and duration of asthma, asthma severity, inhaled steroids or body mass index (BMI. There was no difference between the two groups with respect to age or years since menopause. Although asthma patients were more likely to be overweight and presented higher BMD scores on average than the control subjects, these differences were not statistically significant. CONCLUSIONS: There is a slight positive protective effect of high BMI against osteoporosis in asthma patients, but this effect is overcome by time and menopause status. Therefore, the protective effect of obesity against osteoporosis in asthma patients seems to not be significant.

Insulin-like growth factors I and II in healthy women with and without established osteoporosis

DEFF Research Database (Denmark)

Ravn, Pernille; Spencer, E M; Christiansen, C

1995-01-01

.05) was seen in the nandrolone decanoate-treated group. The same tendency was seen for hormone replacement therapy, although it was not significant. In conclusion, the serum level of IGF-I is high in young women, when peak bone mass is attained, and low in postmenopausal women with established osteoporosis.......We measured serum concentrations of insulin-like growth factors I and II (IGF-I and IGF-II) by radioimmunoassay in 107 healthy women aged 28-78 years and in 116 women with established osteoporosis. The women with established osteoporosis were randomized to a 1-year double-blind, placebo...

Alpha-1 antitrypsin gene therapy prevented bone loss in ovariectomy induced osteoporosis mouse model

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Osteoporosis is a major healthcare burden affecting mostly postmenopausal women characterized by compromised bone strength and increased risk of fragility fracture. Although pathogenesis of this disease is complex, elevated proinflammatory cytokine production is clearly involved in bone loss at meno...

Doença periodontal em mulheres na pós-menopausa e sua relação com a osteoporose Periodontal disease in women in post-menopause and its relationship with osteoporosis

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Lívia de Almeida Barros Bertulucci

2012-12-01

attachment level (CAL, gingival bleeding index (GI, plaque index (PI, and probing depth (PD were determined in all participants by a single examiner. The data were submitted to BioEstat 2.0 software through parametric analysis of variance (ANOVA and the Bonferroni test, with the level of significance set at 5%. RESULTS: Women with osteoporosis presented the highest percentage of periodontal disease, with higher average CAL (2.6±0.4 mm and PD (2.8±0.6 mm, GI (72.8±25.9 mm and PI (72.9±24.2 mm. Statistical analysis revealed a significant difference in periodontal situation between Gn and Gporosis (p=0,01 and between Gpenia and Gporosis (p=0,03. CONCLUSION: Osteoporosis may have an influence on periodontal condition, based on the relation between periodontitis and osteoporosis in postmenopausal women.

Risedronate/zinc-hydroxyapatite based nanomedicine for osteoporosis

Energy Technology Data Exchange (ETDEWEB)

Khajuria, Deepak Kumar, E-mail: deepak_kumarkhajuria@yahoo.co.in [Laboratory for Integrative Multiscale Engineering Materials and Systems, Department of Aerospace Engineering, Indian Institute of Science, Bangalore 560012 (India); Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore 560027 (India); Disha, Choudhary [Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore 560027 (India); Vasireddi, Ramakrishna [Laboratory for Integrative Multiscale Engineering Materials and Systems, Department of Aerospace Engineering, Indian Institute of Science, Bangalore 560012 (India); Razdan, Rema [Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore 560027 (India); Mahapatra, D. Roy [Laboratory for Integrative Multiscale Engineering Materials and Systems, Department of Aerospace Engineering, Indian Institute of Science, Bangalore 560012 (India)

2016-06-01

Targeting of superior osteogenic drugs to bone is an ideal approach for treatment of osteoporosis. Here, we investigated the potential of using risedronate/zinc-hydroxyapatite (ZnHA) nanoparticles based formulation in a rat model of experimental osteoporosis. Risedronate, a targeting moiety that has a strong affinity for bone, was loaded to ZnHA nanoparticles by adsorption method. Prepared risedronate/ZnHA drug formulation was characterized by field-emission scanning electron microscopy, X-ray diffraction analysis and fourier transform infrared spectroscopy. In vivo performance of the prepared risedronate/ZnHA nanoparticles was tested in an experimental model of postmenopausal osteoporosis. Therapy with risedronate/ZnHA drug formulation prevented increase in serum levels of bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase 5b better than risedronate/HA or risedronate. With respect to improvement in the mechanical strength of the femoral mid-shaft and correction of increase in urine calcium and creatinine levels, the therapy with risedronate/ZnHA drug formulation was more effective than risedronate/HA or risedronate therapy. Moreover, risedronate/ZnHA drug therapy preserved the cortical and trabecular bone microarchitecture better than risedronate/HA or risedronate therapy. Furthermore, risedronate/ZnHA drug formulation showed higher values of calcium/phosphorous ratio and zinc content. The results strongly implicate that risedronate/ZnHA drug formulation has a therapeutic advantage over risedronate or risedronate/HA therapy for the treatment of osteoporosis. - Highlights: • Risedronate functionalized zinc-hydroxyapatite nanoparticles were prepared. • Risedronate was used as a carrier to deliver zinc-hydroxyapatite nanoparticles to bones. • Application of risedronate/ZnHA drug formulation in osteoporosis is described.

Relationship between intima-media thickness and bone mineral density in postmenopausal women: a cross-sectional study.

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Mohammadi, Afshin; Shateri, Kamran; Behzadi, Farhad; Maleki-Miandoab, Tooraj; Lesha, Emal; Ghasemi-Rad, Mohammad; Rosta, Yousef

2014-01-01

Osteoporosis and atherosclerosis are two conditions that confer the major cause of mortality and morbidity in postmenopausal women. Several studies have suggested that these two conditions are negatively correlated by a common pathway. The aim of our study was to show a relationship between bone mineral density (BMD) and carotid intima media thickness (CIMT), as two factors that are directly related to osteoporosis and atherosclerosis respectively. The study group consisted of 136 postmenopausal women that presented at the Radiology Clinic of our hospital for BMD measurements. The CIMT was measured using High Resolution B mode Ultrasonography; BMD was measured at the lumbar spine and femoral neck using Dual-energy X-Ray Absorptiometry. The mean IMT value in osteoporotic women (0.7±0.1 mm) was significantly higher compared to non-osteoporotic women (0.6±0.1 mm, P media thickness are negatively correlated, thus showing a possible relationship between osteoporosis and atherosclerosis. However, more research is necessary to determine the pathway that connects these two conditions.

Eucommia leaf extract (ELE) prevents OVX-induced osteoporosis and obesity in rats.

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Zhang, Wenping; Fujikawa, Takahiko; Mizuno, Kaito; Ishida, Torao; Ooi, Kazuya; Hirata, Tetsuya; Wada, Atsunori

2012-01-01

The cortex of Eucommia ulmoides Oliver is widely used to treat kidney deficiency in traditional Chinese medicine. Its leaves have recently been reported to have anti-obesity properties in metabolic syndrome-like rat models. Due to a sharp decline in estrogen production, obesity, together with osteoporosis, are common problems in postmenopausal women. In this study, we examined the potential effect of Eucommia leaf extract (ELE) in preventing osteoporosis and obesity induced by ovariectomy (OVX). Forty-six female Wistar rats were divided into six groups: Sham-Cont, OVX-Cont, and four OVX groups administered estradiol and different concentrations of ELE 1.25%, ELE 2.5%, and ELE 5%. Treatments were administered after ovariectomy at six weeks of age and continued for 12 weeks. OVX induced a significant decrease in the bone mineral density (BMD) of the lumbar, femora, and tibiae, together with a marked increase in body mass index (BMI). The administration of 5% ELE led to a significant increase in tibial and femoral BMD, as well as significantly increased bone-strength parameters when compared with OVX-Cont rats. According to the suppressed Dpd and increased osteocalcin concentrations in ELE 5% rats, we suggest that varying proportions of bone formation and bone absorption contributed to the enhanced BMD in the femora and tibiae. In addition, significant decreases in body weight, BMI and fat tissue in 5% ELE rats were also observed. These results suggest that ELE may have curative properties for BMD and BMI in OVX rats, and could provide an alternative therapy for the prevention of both postmenopausal osteoporosis and obesity.

Central and peripheral fat body mass have a protective effect on osteopenia or osteoporosis in adults and elderly?

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Freitas, P M S S; Garcia Rosa, M L; Gomes, A M; Wahrlich, V; Di Luca, D G; da Cruz Filho, R A; da Silva Correia, D M; Faria, C A; Yokoo, E M

2016-04-01

This cross-sectional study involves randomly selected men aged 50 to 99 years and postmenopausal women. Either central fat mass or peripheral fat mass were associated to osteoporosis or osteopenia independently from fat-free body mass and other confounding factors. Obesity and osteoporosis are public health problems that probably share common pathophysiological mechanisms. The question if body fat mass, central or peripheral, is protective or harmful for osteoporosis or osteopenia is not completely resolved. This study aims to investigate the association between osteoporosis or osteopenia, and fat body mass (central and peripheral) independently from fat-free body mass, in men aged 50 to 99 years old and postmenopausal women randomly selected in the community. This is a cross-sectional investigation with a random sample of registered population in Niterói Family Doctor Program (FDP), State of Rio de Janeiro, Brazil. Bone mineral density (BMD) and fat-free mass were assessed by dual X-ray absorptiometry (DXA). There was statistically significant bivariate association between bone loss with gender, age, skin color, alcohol consumption at risk dose, use of thiazide, fat-free body mass, and fat body mass (central and peripheral). In the multiple analysis of fat-free body mass, central and peripheral fat body mass showed an independent and protective effect on the presence of osteoporosis or osteopenia (p value obesity and osteoporosis are public health problems worldwide, strategies aimed at preventing both conditions should be encouraged during aging.

Epidemiology and treatment of osteoporosis in women: an Indian perspective.

Science.gov (United States)

Khadilkar, Anuradha V; Mandlik, Rubina M

2015-01-01

The number of women with osteoporosis, ie, with reduced bone mass and the disruption of bone architecture, is increasing in India. While data on prevalence of osteoporosis among women in India come from studies conducted in small groups spread across the country, estimates suggest that of the 230 million Indians expected to be over the age of 50 years in 2015, 20%, ie, ~46 million, are women with osteoporosis. Thus, osteoporosis is a major public health problem in Indian women. Low calcium intakes with extensive prevalence of vitamin D deficiency, increasing longevity, sex inequality, early menopause, genetic predisposition, lack of diagnostic facilities, and poor knowledge of bone health have contributed toward the high prevalence of osteoporosis. Bone health may be optimized by creating an environment to achieve peak bone mass during adolescence, maintenance of healthy bone throughout the life cycle, and prevention of bone loss postmenopausal. In Indian women, calcium, vitamin D, and bisphosphonates are the commonest first-line therapies used. The use of other drugs such as hormone replacement therapy, estrogen agonists, calcitonin, parathyroid hormone, and denosumab is decided as per the affordability and availability of treatment options. Major gaps still remain in the diagnosis and management of osteoporosis, thus highlighting the need for more structured research in this area. This review focuses on the epidemiology of osteoporosis in Indian women and available treatments.

Osteoporosis in men: epidemiology and treatment with denosumab.

Science.gov (United States)

Sidlauskas, Kristel M; Sutton, Emily E; Biddle, Michael A

2014-01-01

Osteoporosis is a major public health care concern. Although often described as a disease affecting postmenopausal women, researchers and clinicians have emphasized its prevalence in men in recent years. The National Osteoporosis Foundation has stated that up to 25% of men over the age of 50 years will experience a fracture due to osteoporosis. Men who suffer from a major fracture have higher mortality rates than women. Pharmacologic therapy options for treating osteoporosis are limited for men as compared with women, so each medication approved for use in this population represents an important clinical option. In September 2012, the US Food and Drug Administration approved a new indication for denosumab to increase bone mass in men with osteoporosis at high risk for fracture. Denosumab is a fully human monoclonal antibody and novel antiresorptive agent that works by binding receptor activator of nuclear factor kappa-β ligand (RANKL) and inhibiting the signaling cascade that causes osteoclast maturation, activity, and survival. Ultimately, denosumab suppresses bone turnover and increases bone mineral density in both trabecular and cortical bone. Approval for treating osteoporosis in men was based on data from the ADAMO trial which displayed efficacy in increasing bone mineral density at the lumbar spine, total hip, femoral neck, hip trochanter, and one-third radius. Studies indicate that denosumab is effective and safe, and has superior adherence rates and patient satisfaction. Although long-term data and further research on fracture reduction rates in men should be explored, at this time denosumab is one of several appropriate first-line treatment options for men with osteoporosis.

Alveolar bone mass in pre- and postmenopausal women with serum calcium as a marker: A comparative study

Directory of Open Access Journals (Sweden)

Amitha Ramesh

2011-01-01

Conclusion: Postmenopausal women exhibit a reduced alveolar bone mass and lowered levels of serum total calcium with the increasing age. These changes may be useful indicators for low skeletal bone mineral density or osteoporosis.

Transient regional osteoporosis.

Science.gov (United States)

Cano-Marquina, Antonio; Tarín, Juan J; García-Pérez, Miguel-Ángel; Cano, Antonio

2014-04-01

Transient regional osteoporosis (TRO) is a disease that predisposes to fragility fracture in weight bearing joints of mid-life women and men. Pregnant women may also suffer the process, usually at the hip. The prevalence of TRO is lower than the systemic form, associated with postmenopause and advanced age, but may be falsely diminished by under-diagnosis. The disease may be uni- or bilateral, and may migrate to distinct joints. One main feature of TRO is spontaneous recovery. Pain and progressive limitation in the functionality of the affected joint(s) are key symptoms. In the case of the form associated with pregnancy, difficulties in diagnosis derive from the relatively young age at presentation and from the clinical overlapping with the frequent aches during gestation. Densitometric osteoporosis in the affected region is not always present, but bone marrow edema, with or without joint effusion, is detected by magnetic resonance. There are not treatment guidelines, but the association of antiresorptives to symptomatic treatment seems to be beneficial. Surgery or other orthopedic interventions can be required for specific indications, like hip fracture, intra-medullary decompression, or other. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Osteoporosis in the Women's Health Initiative: Another Treatment Gap?

Science.gov (United States)

Sattari, Maryam; Cauley, Jane A; Garvan, Cynthia; Johnson, Karen C; LaMonte, Michael J; Li, Wenjun; Limacher, Marian; Manini, Todd; Sarto, Gloria E; Sullivan, Shannon D; Wactawski-Wende, Jean; Beyth, Rebecca J

2017-08-01

Osteoporotic fractures are associated with high morbidity, mortality, and cost. We performed a post hoc analysis of the Women's Health Initiative (WHI) clinical trials data to assess osteoporosis treatment and identify participant characteristics associated with utilization of osteoporosis medication(s) after new diagnoses of osteoporosis or fracture. Information from visits prior to and immediately subsequent to the first fracture event or osteoporosis diagnosis were evaluated for medication use. A full logistic regression model was used to identify factors predictive of osteoporosis medication use after a fracture or a diagnosis of osteoporosis. The median length of follow-up from enrollment to the last WHI clinic visit for the study cohort was 13.9 years. Among the 13,990 women who reported new diagnoses of osteoporosis or fracture between enrollment and their final WHI visit, and also had medication data available, 21.6% reported taking an osteoporosis medication other than estrogen. Higher daily calcium intake, diagnosis of osteoporosis alone or both osteoporosis and fracture (compared with diagnosis of fracture alone), Asian or Pacific Islander race/ethnicity (compared with White/Caucasian), higher income, and hormone therapy use (past or present) were associated with significantly higher likelihood of osteoporosis pharmacotherapy. Women with Black/African American race/ethnicity (compared with White/Caucasian), body mass index ≥30 (compared with body mass index of 18.5-24.9), current tobacco use (compared with past use or lifetime nonusers), and history of arthritis were less likely to use osteoporosis treatment. Despite well-established treatment guidelines in postmenopausal women with osteoporosis or history of fractures, pharmacotherapy use was suboptimal in this study. Initiation of osteoporosis treatment after fragility fracture may represent an opportunity to improve later outcomes in these high-risk women. Specific attention needs to be paid to

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

2000-01-01

The overall purpose of this study is to determine the relationship between skeletal and oral bone density, identify factors influencing bone loss, and determine the relationship between osteoporosis...

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

1999-01-01

The overall purpose of this study is to determine the relationship between skeletal and oral bone density, identify factors influencing bone loss, and determine the relationship between osteoporosis...

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

2001-01-01

The overall purpose of this study is to determine the relationship between skeletal and oral bone density, identify factors influencing bone loss, and determine the relationship between osteoporosis...

Effect of electroacupuncture on the bio-chemical indices of bone and bone collagen metabo-lism and TNF-α in osteoporosis model rats without ovaries

Institute of Scientific and Technical Information of China (English)

鲍圣涌

2013-01-01

Objective To explore the mechanisms of electroacu-puncture(EA) on postmenopausal osteoporosis(PMO).Methods Sixty female SD rats aged 6 months were selected,resected double ovaries and fed for 90 days in order to make the model of experimental osteoporosis,and then,they were randomly divided into a model control group

Protocol for the Osteoporosis Choice trial. A pilot randomized trial of a decision aid in primary care practice

Directory of Open Access Journals (Sweden)

Tulledge-Scheitel Sidna M

2009-12-01

Full Text Available Abstract Background Bisphosphonates can reduce fracture risk in patients with osteoporosis, but many at-risk patients do not start or adhere to these medications. The aims of this study are to: (1 preliminarily evaluate the effect of an individualized 10-year osteoporotic fracture risk calculator and decision aid (OSTEOPOROSIS CHOICE for postmenopausal women at risk for osteoporotic fractures; and (2 assess the feasibility and validity (i.e., absence of contamination of patient-level randomization (vs. cluster randomization in pilot trials of decision aid efficacy. Methods/Design This is a protocol for a parallel, 2-arm, randomized trial to compare an intervention group receiving OSTEOPOROSIS CHOICE to a control group receiving usual primary care. Postmenopausal women with bone mineral density T-scores of STEOPOROSIS CHOICE on five outcomes: (a patient knowledge regarding osteoporosis risk factors and treatment; (b quality of the decision-making process for both the patient and clinician; (c patient and clinician acceptability and satisfaction with the decision aid; (d rate of bisphosphonate use and adherence, and (e trial processes (e.g., ability to recruit participants, collect patient outcomes. To capture these outcomes, we will use patient and clinician surveys following each visit and video recordings of the clinical encounters. These video recordings will also allow us to determine the extent to which clinicians previously exposed to the decision aid were able to recreate elements of the decision aid with control patients (i.e., contamination. Pharmacy prescription profiles and follow-up phone interviews will assess medication start and adherence at 6 months. Discussion This pilot trial will provide evidence of feasibility, validity of patient randomization, and preliminary efficacy of a novel approach -- decision aids -- to improving medication adherence for postmenopausal women at risk of osteoporotic fractures. The results will inform

Alendronate in early postmenopausal women

DEFF Research Database (Denmark)

Ravn, Pernille; Weiss, S R; Rodriguez-Portales, J A

2000-01-01

We studied the effect on bone mass of alendronate treatment for 5 yr and its withdrawal. Four hundred and forty-seven postmenopausal women with normal bone mass entered a 3-yr randomized trial followed by a 2-yr open label extension. Three hundred and eleven women completed the first 3 yr, and 263...... consented to continue and completed the extension. We are reporting data from groups using the dose of alendronate currently approved for osteoporosis prevention (5 mg) or from the group in which alendronate treatment was withdrawn: 52 women received alendronate (5 mg) for 5 yr (group I), 56 received 3 yr...

A comparison of teriparatide and calcitonin therapy in postmenopausal Asian women with osteoporosis: a 6-month study.

Science.gov (United States)

Kung, A W C; Pasion, E G; Sofiyan, M; Lau, E M C; Tay, B K; Lam, K S; Wilawan, K; Ongphiphadhanakul, B; Thiebaud, D

2006-05-01

The number of hip fractures is expected to double in the next 20 years, with current estimates that Asia will account for 37% of these cases. As bone mineral density (BMD) may be used as a measure of fracture risk, we sought to compare the effects of teriparatide with salmon calcitonin treatment on changes in BMD, biochemical bone markers, and safety in postmenopausal Asian women with osteoporosis. A total of 104 patients (n = 47 teriparatide [20 g/day subcutaneously] and n = 57 calcitonin [100 IU/day subcutaneously]) were enrolled in Hong Kong, Singapore, Philippines, Malaysia, and Thailand. Calcium (> or = 500 mg/day) and vitamin D (200-400 IU/day) supplements were taken throughout the 6-month controlled, randomized study. Teriparatide was associated with a 5.03 +/- 4.77% increase in lumbar spine BMD (p < 0.0001, mean +/- SD change from baseline), whereas changes in lumbar spine BMD for patients on calcitonin were not statistically significant (mean change of 0.36 +/- 4.12%, p = 0.16). Comparison of the two groups indicated that teriparatide treatment improved lumbar spine BMD statistically significantly more than calcitonin (p < 0.0001). No statistically significant changes were observed for total hip or femoral neck BMD. Serum bone-specific alkaline phosphatase (BSAP) increased by 55.9% (median change from baseline, p < 0.0001) in the teriparatide group, and remained stable with calcitonin (5.0% change, p = 0.24); osteocalcin increased by 156.15% (median change from baseline, p < 0.0001) with teriparatide, and decreased with calcitonin (-15.25%, p = 0.03). Similar rates of adverse events were observed, with nausea and dizziness the most commonly reported for both groups (teriparatide versus calcitonin, 13.0% versus 23.2% p = 0.21, 10.9% versus 21.4% p = 0.19, respectively). There were no clinically relevant changes observed in laboratory parameters. Both treatments were similarly tolerated, however teriparatide was associated with greater increases in lumbar

[Osteoporosis in all young daughters of a mother with multiple osteoporotic fractures. A case of familial osteoporosis].

Science.gov (United States)

Parisi, M S; Díaz, A G; Oliveri, M B; Di Gregorio, S; Mautalen, C A

2001-01-01

We herein describe a family whose female members are all osteoporotic: a postmenopausal mother and her three premenopausal daughters. The mother aged 60 presented axial and peripheral fractures, and very low bone mineral density (BMD). She reported that her grandmother had suffered a hip fracture. The eldest daughter aged 30 suffered multiple vertebral fractures during pregnancy and lactation associated with very low BMD. In view of these observations, the other two daughters aged 29 and 27 years respectively were evaluated. BMD was found to be severely diminished according to densitometric values for osteoporosis established by WHO, but they had no history of bone fractures. Probably the strong genetic component in bone mass is responsible for the severely diminished BMD observed in all the women in this family, as well as the occurrence of bone fractures in two of them. To our knowledge, there are no similar reports in the literature. Our results evidence the importance of evaluating bone mass in the offspring of an individual presenting severe osteoporosis, in order to detect family members with low bone mass and at high risk of developing bone fractures.

Status of drug development for the prevention and treatment of osteoporosis

DEFF Research Database (Denmark)

Schwarz, Peter; Jørgensen, Niklas Rye; Abrahamsen, Bo

2014-01-01

supplementation. Several new medications for the treatment of postmenopausal osteoporosis are in the pipeline. AREAS COVERED: The authors present the most recent studies on new and current antiresorptive as well as anabolic drugs. Specifically, the authors present the current knowledge on drugs directed against...... cathepsin K and sclerostin as well as the new pathways of interest from preclinical studies. EXPERT OPINION: New scientific results have identified novel signaling pathways as potential targets for future development of anti-osteoporotic drugs. The treatments close to marketing at the moment are odanacatib...

Risk factors associated with incident clinical vertebral and nonvertebral fractures in postmenopausal women: the Canadian Multicentre Osteoporosis Study (CaMos).

Science.gov (United States)

Papaioannou, Alexandra; Joseph, Lawrence; Ioannidis, George; Berger, Claudie; Anastassiades, Tassos; Brown, Jacques P; Hanley, David A; Hopman, Wilma; Josse, Robert G; Kirkland, Susan; Murray, Timothy M; Olszynski, Wojciech P; Pickard, Laura; Prior, Jerilynn C; Siminoski, Kerry; Adachi, Jonathan D

2005-05-01

Utilizing data from the Canadian Multicentre Osteoporosis Study (CaMos), we examined the association between potential risk factors and incident vertebral and nonvertebral fractures. A total of 5,143 postmenopausal women were enrolled. Information collected during the study included data from the CaMos baseline and annually mailed fracture questionnaires, the Short Form 36 (SF-36), the Health Utilities Index, and physical measurements. Participants were followed for 3 years. Postmenopausal women were classified into four groups according to their incident fracture status since baseline: those without a new fracture; those with a new clinically recognized vertebral fracture; those with an incident nonvertebral fracture at the wrist, hip, humerus, pelvis, or ribs (main nonvertebral fracture group); and those with any new nonvertebral fracture (any-nonvertebral-fracture group). We performed multivariate Cox proportional hazard analysis using all possible risk factors to determine the association between risk factors and the time to the first minimal trauma fracture. Best predictive models were also determined using variables that were included in the full models. The Bayesian information criterion was used for model selection. For all analyses, relative risks and associated 95% confidence intervals were calculated. During the follow-up period, 34, 163, and 280 women developed a vertebral, a main nonvertebral, or any nonvertebral fracture, respectively. The best predictive models indicated that a five point lower quality of life as measured by the SF-36 physical component summary score was associated with relative risks of 1.21 (95% CI, 1.02 to 1.44), 1.17 (95% CI, 1.07 to 1.28), and 1.19 (95% CI, 1.11 to 1.27) for incident vertebral, main nonvertebral, and all nonvertebral fractures, respectively. In addition, for a one standard deviation (SD=0.12) lower femoral neck BMD, the relative risks for incident vertebral, main nonvertebral, and any nonvertebral fractures

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

2000-01-01

... and oral bone loss, periodontal disease and tooth loss. We hypothesize that reduction in bone density leading to osteoporosis, plays a significant role in increasing susceptibility to destructive periodontitis and tooth loss...

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

1999-01-01

... and oral bone loss, periodontal disease and tooth loss. We hypothesize that reduction in bone density leading to osteoporosis, plays a significant role in increasing susceptibility to destructive periodontitis and tooth loss...

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

2001-01-01

... and oral bone loss, periodontal disease and tooth loss. We hypothesize that reduction in bone density leading to osteoporosis, plays a significant role in increasing susceptibility to destructive periodontitis and tooth loss...

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wacawski-Wende, Jean

1997-01-01

... and oral bone loss, periodontal disease and tooth loss. We hypothesize that reduction in bone density leading to osteoporosis, plays a significant role in increasing susceptibility to destructive periodontitis and tooth loss...

Risk Factors for Osteoporosis and Oral Bone Loss in Postmenopausal Women

National Research Council Canada - National Science Library

Wactawski-Wende, Jean

1998-01-01

... and oral bone loss, periodontal disease and tooth loss. We hypothesize that reduction in bone density leading to osteoporosis, plays a significant role in increasing susceptibility to destructive periodontitis and tooth loss...

Osteoporosis in men: epidemiology and treatment with denosumab

Directory of Open Access Journals (Sweden)

Sidlauskas KM

2014-04-01

Full Text Available Kristel M Sidlauskas, Emily E Sutton, Michael A Biddle Albany College of Pharmacy and Health Sciences-Vermont Campus, Colchester, VT, USA Abstract: Osteoporosis is a major public health care concern. Although often described as a disease affecting postmenopausal women, researchers and clinicians have emphasized its prevalence in men in recent years. The National Osteoporosis Foundation has stated that up to 25% of men over the age of 50 years will experience a fracture due to osteoporosis. Men who suffer from a major fracture have higher mortality rates than women. Pharmacologic therapy options for treating osteoporosis are limited for men as compared with women, so each medication approved for use in this population represents an important clinical option. In September 2012, the US Food and Drug Administration approved a new indication for denosumab to increase bone mass in men with osteoporosis at high risk for fracture. Denosumab is a fully human monoclonal antibody and novel antiresorptive agent that works by binding receptor activator of nuclear factor kappa-β ligand (RANKL and inhibiting the signaling cascade that causes osteoclast maturation, activity, and survival. Ultimately, denosumab suppresses bone turnover and increases bone mineral density in both trabecular and cortical bone. Approval for treating osteoporosis in men was based on data from the ADAMO trial which displayed efficacy in increasing bone mineral density at the lumbar spine, total hip, femoral neck, hip trochanter, and one-third radius. Studies indicate that denosumab is effective and safe, and has superior adherence rates and patient satisfaction. Although long-term data and further research on fracture reduction rates in men should be explored, at this time denosumab is one of several appropriate first-line treatment options for men with osteoporosis. Keywords: denosumab, osteoporosis, men, treatment

[The new concept of osteoporosis. Early diagnosis, prevention and therapy are possible today].

Science.gov (United States)

Hesch, R D; Harms, H; Rittinghaus, E F; Brabant, G

1990-04-15

A paradigma of osteoporosis pathology is discussed, at the center of which is the hormone-related disturbance of the osteoblast/osteoclast functional unit. A liberal replacement of estrogen-gestagen in post-menopausal women is advocated. Early diagnosis with the aid of quantitative computed tomography makes it possible to establish the indication for timely hormonal treatment in the future, which can result in a measureable increase in bone mass. Late therapy, that is, treatment initiated after the occurrence of fractures, has proven largely ineffective.

[The influence of hormonal replacement therapy on bone density in postmenopausal women depending on polymorphism of vitamin D receptor (VDR) and estrogen receptor (ER) genes].

Science.gov (United States)

Brodowska, Agnieszka

2003-01-01

genes? 3. What estrogen concentration is necessary to protect bone tissue depending on the polymorphism of VDR and ER genes? The study group included 44 postmenopausal women aged 44-75 years with primary osteoporosis on cyclic HRT (hormonal replacement therapy). Two hormonal preparations were administered: Systen 50 (Jansen Cilag) transdermal system twice per week between day 1 and 21 of the cycle; Provera (Upjohn) 5 mg tablets daily between day 16 and 27 of the cycle. This therapy was supplemented with vitamin D analogue (Alphacalcidolum, Glaxo-Poznan) orally at 0.25 microg per day, calcium-enriched (1200 mg daily) diet and regular physical exercise. Patients were qualified to the study on the basis of a questionnaire. Women with secondary osteoporosis were excluded. TSH, FT3, and FT4 concentrations, as well as fasting glucose were measured. 24 h glycemia was established in women with elevated glucose levels. Polymorphism of the ER gene was studied with Xba I and Pvu II restrictases. Polymorphism of the VDR gene was studied with Bsm I restrictase. Age and BMI were recorded. Spine BMD was determined with DEXA (Dual Energy X-ray Absorptiometry (Lunar instrument) before treatment and after 12 months of HRT. Serum estradiol concentrations were measured before treatment and after 2 months of HTR. The following conclusions were drawn: 1. There is no connection between VDR and ER gene polymorphism and degree of osteoporosis before treatment. 2. XX, PP and Bb markers or X, P, B alleles are associated with a significant decrease in therapeutic efficacy. Nevertheless, satisfactory results were achieved in each woman with primary osteoporosis. 3. Estradiol concentration in serum before and during HRT does not depend on the polymorphism of VDR and ER genes.

Study on the serum prolactin (PRL) level in post-menopausal women

International Nuclear Information System (INIS)

Li Wenqi; Li Xin; Zhou Jiwen; Zhou Zhengli

2004-01-01

Objective: To explore the clinical value of determination of serum PRL levels inpost-menopausal women. Methods: Serum PRL levels were determined with RIA in 596 post-menopausal women (age 45-59, mean 55). Results: The normal range of serum PRL level in this laboratory was 0-30 ng/ml. Among the 596 women tested, 77(13%) had their PRL levels above 30 ng/ml. Further investigation with CT and/or MRI revealed presence of micro-pituitary-adenoma in 31 of the Symptoms of menopausal syndrome and osteoporosis were much more severe in women with hyperprolactinemia then in those without. Conclusion: As hyperprolactinemia might be a high risk factor for development of breast cancer, hormone replacement therapy (HRT) in menopausal women with hyperprolactinemia should be applied very cautiously, even withheld at all. Determination of serum prolactin levels in post-menopausal women is of practical clinical value. (authors)

THE DIFFERENCES OF BONE METABOLISM IN MALES WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE AND POSTMENOPAUSAL FEMALES

Directory of Open Access Journals (Sweden)

O. A. Mardanova

2014-07-01

Full Text Available Aim — to compare bone metabolism activity in males with chronic obstructive pulmonary disease (COPD and postmenopausal females.Materials and methods. The prospective cohort study was conducted. 33 male patients with COPD over 55 years old and 33 female patients without respiratory diseases over 55 were included. General examination, clinical and biochemical blood analyses, densitometry of lumbar spine and proximal part of left femoral bone, respiratory function, osteocalcin and C-telopeptids blood levels have been performed to the patients.Results. Male patients with COPD had lower T-score for the femoral neck than postmenopausal female patients without pulmonary disorders,(–1.05 ± 0.85 SD and –0.36 ± 1.24 SD respectively, р < 0.05. Osteocalcin level in males with COPD was significantly higher and C‑telopeptids level was significantly lower than in postmenopausal females (р < 0.05.Conclusion. Male patients with COPD have lower T‑score for the femoral neck than postmenopausal females without pulmonary disorders of the same age. Furthermore osteoclasts in COPD patients seem to be more activated than in postmenopausal females, on the contrary osteoblasts activity is significantly depressed. Therefore it is necessary to use another approach of prevention and treatment of osteoporosis in patients with COPD.

Influence of obesity on bone mineral density in postmenopausal asthma patients undergoing treatment with inhaled corticosteroids.

Science.gov (United States)

Yanik, Burcu; Ayrim, Aylin; Ozol, Duygu; Koktener, Asli; Gokmen, Derya

2009-01-01

The etiology of osteoporosis in asthma is complex as various factors contribute to its pathogenesis. The purpose of our study was to investigate the effects of obesity and inhaled steroids, as well as the severity and duration of asthma, on osteoporosis in postmenopausal asthma patients as compared to healthy controls. A total of 46 patients with asthma and 60 healthy female controls, all postmenopausal, were enrolled in our study. Bone mineral density was assessed at the lumbar spine and hip using a Lunar DPX-L densitometer. Bone mineral density (BMD) scores were comparable between the asthmatic and control groups, with average scores of 0.95 +/- 0.29 and 0.88 +/- 0.14 g/cm(2), respectively. Likewise, osteoporosis was diagnosed in a similar percentage of patients in the asthmatic (39.1%) and control (43.3%) groups. Bone fracture was identified in four patients with asthma (8.6%) and in six patients from the control group (10%). We could not detect any relationship between BMD and duration of asthma, asthma severity, inhaled steroids or body mass index (BMI). There was no difference between the two groups with respect to age or years since menopause. Although asthma patients were more likely to be overweight and presented higher BMD scores on average than the control subjects, these differences were not statistically significant. There is a slight positive protective effect of high BMI against osteoporosis in asthma patients, but this effect is overcome by time and menopause status. Therefore, the protective effect of obesity against osteoporosis in asthma patients seems to not be significant.

Osteoporosis - a risk factor for cardiovascular diseases: A follow-up study

Directory of Open Access Journals (Sweden)

Tasić Ivan

2015-01-01

Full Text Available Introduction. Cardiovascular (CV diseases and bone fractures due to osteoporosis are the leading causes of death in the elderly. Objective. The aim of this study was to demonstrate a correlation between the overall risk for CV events, and low bone density in postmenopausal women, and its impact on the incidence of serious CV events. Methods. Our prospective study involved 300 postmenopausal women. All the examinees were divided into three groups based on their measured bone density: Group I - 84 examinees with osteoporosis; Group II - 115 examinees with osteopenia; and Group III - 101 examinees with normal bone density. In all examinees the overall ten-year risk for a fatal CV event was calculated using the SCORE system tables. Results. After a 36-month follow-up, CV events occurred in 19 (6.3% examinees. Significant differences in the incidence of CV events were demonstrated between the patients with osteoporosis, osteopenia, and normal bone density (χ2=28.7; p<0.001, as well as between those with a high and low CV risk (χ2=22.6; p<0.001. Multivariate logistic regression analysis showed that smoking (OR: 2.23; 95% CI: 1.02 to 6.19; p=0.035, and increase of overall CV score (OR: 1.36; 95% CI: 1.17 to 1.58; p<0.001 are associated with increased CV event risk, while the increase of T score value is associated with decreased risk of CV event (OR: 0.42; 95% CI: 0.25 to 0.73; p=0.002. Conclusion. Measurement of bone density with a standard assessment of the total CV risk could be useful for selecting women who need intensive prevention and treatment of atherosclerosis.

Hormonal replacement therapy reduces forearm fracture incidence in recent postmenopausal women - results of the Danish Osteoporosis Prevention Study

DEFF Research Database (Denmark)

Mosekilde, Leif; Beck-Nielsen, H.; Sørensen, O.H.

2000-01-01

-to-treat analysis (n=2016), overall fracture risk was borderline statistically significantly reduced (RR=0.73, 95% CI: 0.50-1.05), and forearm fracture risk was significantly reduced (RR=0.45, 95% CI: 0.22-0.90) with HRT. Restricting the analysis to women who had adhered to their initial allocation of either HRT (n......OBJECTIVES: To study the fracture reducing potential of hormonal replacement therapy (HRT) in recent postmenopausal women in a primary preventive scenario. METHODS: Prospective controlled comprehensive cohort trial: 2016 healthy women aged 45-58 years, from three to 24 months past last menstrual...... by own choice). First line HRT was oral sequential oestradiol/norethisterone in women with intact uterus and oral continuous oestradiol in hysterectomised women. RESULTS: After five years, a total of 156 fractures were sustained by 140 women. There were 51 forearm fractures in 51 women. By intention...

Incidence of osteonecrosis of the jaw in women with postmenopausal osteoporosis in the health outcomes and reduced incidence with zoledronic acid once yearly pivotal fracture trial.

Science.gov (United States)

Grbic, John T; Landesberg, Regina; Lin, Shou-Qing; Mesenbrink, Peter; Reid, Ian R; Leung, Ping-Chung; Casas, Noemi; Recknor, Christopher P; Hua, Ye; Delmas, Pierre D; Eriksen, Erik F

2008-01-01

The authors determined incidence of osteonecrosis of the jaw (ONJ) in a large, prospective three-year clinical trial of zoledronic acid in women with postmenopausal osteoporosis (PMO). A total of 7,714 women with PMO received intravenous zoledronic acid 5 mg or a placebo. No spontaneous reports of ONJ were received. An independent, blinded adjudication committee searched the trial's adverse event database by using 60 terms. On an ongoing basis, the committee reviewed the identified events, and it defined ONJ as exposed bone in the maxillofacial area with delayed healing for more than six weeks despite appropriate care. One participant who received a placebo and one participant who received zoledronic acid experienced delayed healing associated with infection. Both conditions resolved after antibiotic therapy, débridement or both. The occurrence of ONJ is rare in a PMO population, and delayed healing of lesions can occur with and without bisphosphonate use over three years. The low incidence of ONJ must be assessed in the context of the clinical benefit of zoledronic acid therapy in reducing hip, vertebral and nonvertebral fractures in this at-risk population. There is no evidence to suggest that healthy patients with osteoporosis who are receiving bisphosphonates require any special treatment beyond routine dental care or to support altering standard treatment practices.

Association between lumbar bone mineral density and serum uric acid in postmenopausal women: a cross-sectional study of healthy Chinese population.

Science.gov (United States)

Han, Wen; Bai, Xiaojuan; Wang, Nan; Han, Lulu; Sun, Xuefeng; Chen, Xiangmei

2017-12-01

Partial correlation and regression analyses were used in this study. We showed that there is a linear relationship between bone mineral density and serum uric acid within the normal physiologic range, and higher serum uric acid levels had a protective effect on bone loss in postmenopausal osteoporosis. The significance of the relationship between lumbar bone mineral density ( BMD) and serum uric acid (SUA) levels is unclear. The aims of this study were to investigate on a population-level the association between lumbar BMD and SUA within the normal physiologic range and to determine whether SUA plays a protective role in bone loss in healthy postmenopausal Chinese women. This was a community-based cross-sectional study involving 390 healthy postmenopausal women, 47-89 years of age, conducted in Shenyang, China. The BMD was measured at the lumbar spine using dual-energy X-ray absorptiometry (DXA). The SUA levels were obtained at each DXA visit. Partial correlation and regression analyses were applied to determine the associations. The SUA levels were significantly different between the normal BMD, osteopenia, and osteoporosis groups. The lumbar BMD was positively correlated with SUA in postmenopausal women after adjustment for age (r = 0.212). After adjustment for age, body mass index, systolic blood pressure, diastolic blood pressure, hip circumference, cigarette smoking, alcohol consumption, milk intake, physical exercise, fracture history, total protein, total bilirubin, triglycerides, total cholesterol, high-density lipoprotein cholesterol, fasting blood glucose, serum calcium, and estimated glomerular filtration rate, the lumbar BMD was associated with SUA and the odds ratio of the third SUA quartile was 0.408 (95%CI, 0.198-0.841, P = 0.015), compared to the first quartile of SUA levels. The lumbar BMD was linearly associated with SUA levels within the normal physiologic range of postmenopausal women. Higher SUA levels had a protective effect on bone loss

Assessment of bone mineral density by DXA and the trabecular microarchitecture of the calcaneum by texture analysis in pre- and postmenopausal women in the evaluation of osteoporosis

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Karunanithi R

2007-01-01

Full Text Available The in vivo evaluation of trabecular bone structure could be useful in the diagnosis of osteoporosis for the characterization of therapeutic response and understanding the role of parameters other than bone mineral density (BMD in defining skeletal status. This study was made to evaluate changes taking place in the trabecular architecture of bone with age and menopausal status in women. The findings are compared with the femoral neck bone as well as the trochantar bone mineral density determined by dual energy X-ray absorptiometry (DXA, which is a standard reference test for evaluation of osteoporosis. Seventy females were recruited for the study, 25 pre-menopausal (mean age ± SD: 39.4 ± 3.8 and 45 postmenopausal (mean age ± SD: 57.9 ± 7.9 women. The right femoral neck bone mineral density was measured for them by dual energy X-ray absorptiometry (DXA. For the same individuals, lateral view radiographs of the right calcaneum were taken as well. The radiographs were digitized and the region of interest (ROI of 256 x 256 pixels was selected, the run-length matrix was computed for calculating seven parameters [Table 1] and the two-dimensional fast Fourier transform of the image was calculated. Using the FFT, the power spectral density (PSD was derived and the root mean square (RMS value was determined. Our results confirm that age has a significant influence on the texture of the trabecular bone and bone mineral density.

The Cell Surface Markers Expression in Postmenopausal Women and Relation to Obesity and Bone Status.

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Horváthová, Mira; Ilavská, Silvia; Štefíková, Kornélia; Szabová, Michaela; Krivošíková, Zora; Jahnová, Eva; Tulinská, Jana; Spustová, Viera; Gajdoš, Martin

2017-07-11

The age-related changes and hormonal deprivation in postmenopausal women are associated with the immune response alteration. The excessive fat accumulation, local and systemic inflammation may lead to dysregulation in immune function and relevant health problems, including obesity and osteoporosis. We analyzed the expression of cell surface markers in the venous blood specimens, stained with fluorophores-conjugated monoclonal antibodies and analysed by multicolour flow cytometry. The significant changes of cytotoxic, naive, and memory T-lymphocytes, plasmacytoid dendritic cells (DCs) were in postmenopausal women versus fertile women. Body mass index (BMI) affected markedly the cell surface expression of CD265/RANK. Osteoporosis is linked to reduced percentage of plasmacytoid DCs, and elevated natural Treg cells ( p < 0.05). The confounding factors such as women age, BMI, bone mineral density (BMD), waist size and tissue fat affect the expression of RANK on myeloid DCs and CD40L on T-lymphocytes that might be the immunophenotypic modulators after menopause.

The Cell Surface Markers Expression in Postmenopausal Women and Relation to Obesity and Bone Status

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Mira Horváthová

2017-07-01

Full Text Available The age-related changes and hormonal deprivation in postmenopausal women are associated with the immune response alteration. The excessive fat accumulation, local and systemic inflammation may lead to dysregulation in immune function and relevant health problems, including obesity and osteoporosis. We analyzed the expression of cell surface markers in the venous blood specimens, stained with fluorophores-conjugated monoclonal antibodies and analysed by multicolour flow cytometry. The significant changes of cytotoxic, naive, and memory T-lymphocytes, plasmacytoid dendritic cells (DCs were in postmenopausal women versus fertile women. Body mass index (BMI affected markedly the cell surface expression of CD265/RANK. Osteoporosis is linked to reduced percentage of plasmacytoid DCs, and elevated natural Treg cells (p < 0.05. The confounding factors such as women age, BMI, bone mineral density (BMD, waist size and tissue fat affect the expression of RANK on myeloid DCs and CD40L on T-lymphocytes that might be the immunophenotypic modulators after menopause.

Postmenopausal osteoporosis: early screening of risk patients by spinal biphotonic absorptiometry

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Sabatier, J.P.; Guaydier-Souquieres, G.; Loyau, G.

1990-01-01

With quantification techniques of the spinal bone condition, especially with spinal biphotonic absorptiometry, early screening of patients risking subsequent development of osteoporosis complicated with vertebral compression is possible. An investigation was conducted in Lower Normandy, in 386 women who had undergone menopause or an ovariectomy, with ages ranging between 40 and 56 years; 274 were in a peri-menopausal state. A curve of the bone mineral content according to age was previously established. From this curve, in semilogarithmic representation, each patient risk was assessed. This risk is considered as high in 30 p. cent of the patients, non existent in 52 p. cent and 18 p. cent are borderline. The percentage of high risk patients increases with the number of years since menopause. It is hoped that the incidence of osteoporosis will decrease with early screening and preventive therapeutic measures [fr

Osteoporose Osteoporosis

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Julio Cesar Gali

2001-06-01

Full Text Available A osteoporose é uma doença ósteo-metabólica que atinge especialmente mulheres após a menopausa. Segundo a Organização Mundial de Saúde 1/3 das mulheres brancas acima dos 65 anos são portadoras de osteoporose. Entretanto estima-se que um homem branco de 60 anos tenha 25 % de chance de ter uma fratura osteoporótica. O diagnóstico e planejamento terapêutico são baseados na densitometria óssea e na dosagem laboratorial dos marcadores de formação e reabsorção óssea. A densitometria também é o melhor preditor de fraturas. Os medicamentos atualmente disponíveis atuam mais na inibição da reabsorção óssea. A principal forma de tratamento da osteoporose é a prevenção: deve-se evitar o fumo; álcool e café devem ser consumidos com moderação; a atividade física e ingestão adequada de cálcio são fundamentais; o treinamento proprioceptivo pode colaborar para prevenir quedas e, conseqüentemente, as fraturas.Osteoporosis is an osteometabolic disease affecting mainly postmenopausal women. According to the World Health Organization, 1/3 of older than 65 white women are affected by osteoporosis. Notwithstanding, the estimates say that 60-year old white males have a 25% chance of osteoporotic fractures. Diagnosis and the therapeutic design are based on bone densitometry and laboratory determinations of formation and bone reabsorption markers. Densitometry is the best fracture predictor. Currently available drugs act inhibiting bone reabsorption. The main form of treatment of osteoporosis is prevention: smoking must be avoided; alcohol and coffee drinking must be moderate; physical activity and adequate calcium intake are fundamental; proprioceptive training can prevent falls and, consequently, fractures.

Effect of tailored educational intervention to improve self-care maintenance and quality of life in postmenopausal osteoporotic women after a fragility fracture: the Guardian Angel® study.

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Basilici Zannetti, Emanuela; D'Agostino, Fabio; Cittadini, Noemi; Feola, Maurizio; Pennini, Annalisa; Rao, Cecilia; Vellone, Ercole; Tarantino, Umberto; Alvaro, Rosaria

2017-01-01

Osteoporosis has a significant impact on affected patients. Healthcare providers should encourage postmenopausal women to improve self-care maintenance behaviors and quality of life following a fragility fracture. The aims of this study were to a) develop two new instruments for measuring, respectively, self-care maintenance and quality of life, in postmenopausal women with osteoporosis; b) evaluate the effectiveness of a tailored educational intervention to improve self-care maintenance and quality of life after a fragility fracture in postmenopausal women. For the first aim, a cross-sectional study will be performed; for the second aim, a multicenter, quasi-experimental, interventional design will be used. A convenience sample of postmenopausal women admitted to 44 hospitals in Italy with a diagnosis of bone fragility fracture will be enrolled and surveyed at 7, 30, 60 and 180 days after discharge. Trained nurses will conduct the educational intervention. The new instruments will allow the measurement of self-care and quality of life in postmenopausal women following a fragility fracture. Through tailored educational interventions, women can be helped to take their medications correctly, adopt a healthy lifestyle, reduce the occurrence of bone fractures, and have a better quality of life.

The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys

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Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung

2016-01-01

Purpose Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. Methods A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008–2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. Results After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43–0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Conclusions Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association. PMID:26816211

The relationship of total body composition with bone mineral density in postmenopausal women with type 2 diabetes

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Vadim Valer'evich Klimontov

2015-03-01

Full Text Available AimTo determine the relationship between bone mineral density (BMD and total body composition in postmenopausal women with type 2 diabetes.Materials and MethodsThe study included 78 women, from 50 to 70 years of age (median 63 years. Twenty women had normal body mass index (BMI, 29 ones were overweight and 29 had obesity. The body composition and BMD was studied by dual-energy X-ray absorptiometry.ResultsWomen with normal BMD had higher BMI, total and truncal fat mass, as well lean mass as compared to women with osteoporosis and osteopenia (all p <0.05. Patients with osteoporosis had a lower fat mass at the hips, compared with those with normal BMD. Total and truncal fat mass, as well as lean mass were positively correlated with BMD in the lumbar spine and proximal femur, femoral neck and radius. In multivariate regression analysis fat mass was an independent predictor for total BMD, after adjusting for age, BMI, duration of menopause, HbA1c, glomerular filtration rate and other total body composition parameters.ConclusionsIn postmenopausal type 2 diabetic women BMI and fat mass is associated positively with BMD.

Monocyte Proteomics Reveals Involvement of Phosphorylated HSP27 in the Pathogenesis of Osteoporosis

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Bhavna Daswani

2015-01-01

Full Text Available Peripheral monocytes, precursors of osteoclasts, have emerged as important candidates for identifying proteins relevant to osteoporosis, a condition characterized by low Bone Mineral Density (BMD and increased susceptibility for fractures. We employed 4-plex iTRAQ (isobaric tags for relative and absolute quantification coupled with LC-MS/MS (liquid chromatography coupled with tandem mass spectrometry to identify differentially expressed monocyte proteins from premenopausal and postmenopausal women with low versus high BMD. Of 1801 proteins identified, 45 were differentially abundant in low versus high BMD, with heat shock protein 27 (HSP27 distinctly upregulated in low BMD condition in both premenopausal and postmenopausal categories. Validation in individual samples (n=80 using intracellular ELISA confirmed that total HSP27 (tHSP27 as well as phosphorylated HSP27 (pHSP27 was elevated in low BMD condition in both categories (P<0.05. Further, using transwell assays, pHSP27, when placed in the upper chamber, could increase monocyte migration (P<0.0001 and this was additive in combination with RANKL (receptor activator of NFkB ligand placed in the lower chamber (P=0.05. Effect of pHSP27 in monocyte migration towards bone milieu can result in increased osteoclast formation and thus contribute to pathogenesis of osteoporosis. Overall, this study reveals for the first time a novel link between monocyte HSP27 and BMD.

Profile of bazedoxifene/conjugated estrogens for the treatment of estrogen deficiency symptoms and osteoporosis in women at risk of fracture

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Rossini M

2013-07-01

Full Text Available Maurizio Rossini,1 Stefano Lello,2 Ignazio Sblendorio,3 Ombretta Viapiana,1 Elena Fracassi,1 Silvano Adami,1 Davide Gatti11Department of Medicine, Rheumatology Unit, University of Verona, Italy; 2Endocrinological Gynecology, Pathophysiology of Menopause and Osteoporosis, Dermopathic Institute of Immacolata, Roma, Italy; 3Medical Coach Italia Center, Bari, ItalyAbstract: Decreasing levels of estrogens during menopause are associated with reduced bone density and an increased risk of osteoporosis. Many women also experience bothersome vasomotor and vaginal symptoms during the menopausal transition. Results of systematic reviews and meta-analyses of randomized controlled trials have shown that both systemic estrogen therapy or hormone therapy (estrogen combined with a progestin are useful to prevent bone loss, and they are the most effective treatment for such climacteric symptoms as hot flushes, sweating, vaginal dryness, and dyspareunia. Unfortunately, estrogen therapy and hormone therapy increase the risk of endometrial and breast cancer, respectively. The selective estrogen receptor modulators (SERMs result in positive estrogenic effects on bone, with no negative effects on the endometrium and breast but do not provide relief from postmenopausal symptoms. The combination of a SERM with estrogen as a tissue selective estrogen complex (TSEC is a new strategy for the prevention of bone loss and the treatment of climacteric symptoms. This combination is particularly interesting from a clinical point of view, taking into account that estrogen alone did not increase breast cancer risk by the Women's Health Initiative. TSEC is hypothesized to provide the benefits of estrogen-alone therapy, with an improved tolerability profile because the SERM component can make possible the elimination of progestin. The objective of this review was to critically evaluate the evidence from the reports published to date on the use of bazedoxifene (a third

Electroacupuncture stimulation at CV4 prevents ovariectomy-induced osteoporosis in rats via Wnt-β-catenin signaling.

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Fan, Huailing; Ji, Feng; Lin, Ying; Zhang, Mulan; Qin, Wei; Zhou, Qi; Wu, Qiang

2016-03-01

The present study aimed to investigate the effect of electroacupuncture stimulation at CV4 (also termed Guanyuan) on femoral osteocalcin also termed bone gla protein (BGP), alkaline phosphatase (ALP), bone mineral density (BMD) and biomechanics, as well as the Wnt‑β‑catenin signaling pathway in rats with postmenopausal osteoporosis. Female Sprague‑Dawley rats (4.5‑months old) were randomly divided into sham, Ovx, CV4 and mock groups (n=10/group). With the exception of those in the sham group, the rats were ovariectomized to induce postmenopausal osteoporosis. The rats in the CV4 and mock groups were given electroacupuncture at CV4 and non‑acupoint, respectively. The rats in the Ovx model and sham groups underwent identical fixing procedures, but did not undergo electroacupuncture. Following treatment, hematoxylin and eosin staining was used to observe morphological changes in the left femoral trabecular bone, and a three‑point‑bending test was used to analyze femur biomechanics and determine the BMD. In addition, an enzyme‑linked immunosorbent assay was used to measure the serum levels of ALP/BGP and reverse transcription‑quantitative polymerase chain reaction was used detect the expression levels of Wnt3a, β‑catenin and Runx2. In the present study, it was demonstrated that electroacupuncture at CV4 significantly improved the osteoporotic morphological changes that occurred in the ovariectomized rats, increased serum ALP and BGP levels, enhanced the maximum and fracture loads, increased BMD (Pelectroacupuncture stimulation at CV4 affected bone formation and promoted bone metabolism in rats with postmenopausal osteoporosis, possibly by activating the Wnt‑β‑catenin signaling pathway.

Osteoporosis prediction from the mandible using cone-beam computed tomography

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Al Haffar, Iyad; Khattab, Razan

2014-01-01

Purpose This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. Materials and Methods Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cm×15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. Results RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. Conclusion Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program. PMID:25473633

Association of vitamin D receptor gene polymorphism (TaqI and Apa1) with bone mineral density in North Indian postmenopausal women.

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Ahmad, Israr; Jafar, Tabrez; Mahdi, Farzana; Ameta, Keerti; Arshad, Md; Das, Siddharth Kumar; Waliullah, Shah; Rizvi, Imran; Mahdi, Abbas Ali

2018-06-15

Vitamin D receptor (VDR) gene has an important role as a candidate gene for the regulation of bone mass in osteoporosis. However, its association with bone mineral density (BMD) is controversial and has not been established in different ethnic populations. To enhance the understanding of VDR gene polymorphism in the context of BMD, we investigated the plausible genetic association of TaqI and ApaI polymorphism with BMD in North Indian postmenopausal women with osteoporosis.254 osteoporotic women (Age 55.82 ± 6.91) and 254 postmenopausal non osteoporotic women (Age 54.76 ± 6.26) were included in the study. VDR TaqI and ApaI polymorphism were determined by PCR (polymerase chain reaction) and RFLP (restriction fragment length polymorphism). BMD was assessed by dual energy X-ray absorptiometry (DXA) at the lumbar spine (L 1 -L 4 ), hip, forearm and femoral neck. The average BMD with TT genotype was significantly lower at lumbar spine, hip and forearm. The Frequency of TT genotype and t allele was significantly high in osteoporotic women when compared with controls. The average BMD with Aa genotype was higher in ApaI. Furthermore, comparison of frequency distribution of genotype and allele for VDR ApaI between osteoporotic patients and controls did not show any significant difference. Our findings revealed that TaqI gene TT genotype was associated with low BMD in North Indian osteoporotic women. Moreover, TT genotype and t allele associated significantly with osteoporosis in postmenopausal women. Therefore, VDR TaqI gene is an important determinant of risk factor for osteoporosis. Copyright © 2018 Elsevier B.V. All rights reserved.

Pharmacological treatment of osteoporosis in the oldest old

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Vandenbroucke A

2017-07-01

Full Text Available A Vandenbroucke,1 FP Luyten,2,3 J Flamaing,4 E Gielen3,4 1Clinical Department of Internal Medicine, UZ Leuven, 2Skeletal Biology and Engineering, Department of Development and Regeneration, KU Leuven, 3Center for Metabolic Bone Disease, UZ Leuven, 4Gerontology and Geriatrics, Department of Clinical and Experimental Medicine, KU Leuven, Leuven, Belgium Abstract: The incidence of osteoporotic fractures increases with age. Consequently, the global prevalence of osteoporotic fractures will increase with the aging of the population. In old age, osteoporosis is associated with a substantial burden in terms of morbidity and mortality. Nevertheless, osteoporosis in old age continues to be underdiagnosed and undertreated. This may, at least partly, be explained by the fact that evidence of the antifracture efficacy of osteoporosis treatments comes mainly from randomized controlled trials in postmenopausal women with a mean age of 70–75 years. However, in the last years, subgroup analyses of these landmark trials have been published investigating the efficacy and safety of osteoporosis treatment in the very elderly. Based on this evidence, this narrative review discusses the pharmacological management of osteoporosis in the oldest old (≥80 years. Because of the high prevalence of calcium and/or vitamin D deficiency in old age, these supplements are essential in the management of osteoporosis in the elderly people. Adding antiresorptive or anabolic treatments or combinations, thereof, reduces the risk of vertebral fractures even more, at least in the elderly with documented osteoporosis. The reduction of hip fracture risk by antiresorptive treatments is less convincing, which may be explained by insufficient statistical power in some subanalyses and/or a higher impact of nonskeletal risk factors in the occurrence of hip fractures. Compared with younger individuals, a larger absolute risk reduction is observed in the elderly because of the higher

Both raloxifene and estrogen reduce major cardiovascular risk factors in healthy postmenopausal women: A 2-year, placebo-controlled study

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Valk-de Roo, G.W. de; Stehouwer, C.D.A.; Meijer, P.; Mijatovic, V.; Kluft, C.; Kenemans, P.; Cohen, F.; Watts, S.; Netelenbos, C.

1999-01-01

Currently raloxifene, a selective estrogen receptor modulator, is being investigated as a potential alternative for postmenopausal hormone replacement to prevent osteoporosis and cardiovascular disease. We compared the 2-year effects of raloxifene on a wide range of cardiovascular risk factors with

Value of Von Willebrand Factor as a Predictor for Osteoporosis Development in Women with Hypothyroidism

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I.V. Pankiv

2015-08-01

Full Text Available The paper presents the study of the value of von Willebrand factor as a marker of endothelial dysfunction for osteoporosis development and for prediction of risk of its formation in women with hypothyroidism. Postmenopausal women with hypothyroidism have significant increase of von Willebrand factor at lumbar osteopenia. High concentrations of von Willebrand factor in women with hypothyroidism follows to consider it as a predictor for osteoporosis development. Increased level of С-reactive protein belongs to the unfavorable prognostic signs in relation to the decline of bone mineral density for patients with primary hypothyroidism.

Obesity and Fractures in Postmenopausal Women: A Primary-care Cross-Sectional Study at Santa Maria, Brazil.

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Copês, Rafaela Martinez; Comim, Fabio Vasconcellos; Langer, Felipe Welter; Codevilla, Antonio Aurelio da Silveira; Sartori, Giovani Ruviaro; de Oliveira, Cristina; Cocco, Aline Rubin; de Almeida, Adriana Maria; de Almeida, Luciana Leiria; Dal Osto, Léo Canterle; Compston, Juliet Elizabeth; Premaor, Melissa Orlandin

2015-01-01

Obesity and osteoporosis are chronic disorders with increasing prevalence worldwide. The aim of this study was to investigate the association between obesity and fracture in postmenopausal women from Santa Maria, Brazil. A cross-sectional study was carried out at Santa Maria (parallel 29° south), Brazil. Postmenopausal women aged ≥55 yr who had at least 1 appointment at the primary care in the 2 years before the study were recruited from March 1, 2013 to August 31, 2013. The Global Longitudinal Study of Osteoporosis in Women study questionnaire was applied with permission of The Center for Outcomes Research, University of Massachusetts Medical School. Height and weight were measured according to the World Health Organization protocol. Bone fractures (excluding hand, feet, and head) that occurred after the age of 45 yr were considered as the outcome. Overall, 1057 women completed the study, of whom 984 had body mass index measured. The mean (standard deviation) age and body mass index of the women included in the study were 67.1 (7.6) yr and 29.2 (5.5) kg/m(2), respectively. The prevalence of fractures in obese and nonobese women was similar (17.3% vs 16.0%); 41.4% of all fractures occurred in obese women. Obese postmenopausal women make a substantial contribution to the overall burden of prevalent fractures in this population. Our results provide further evidence in support of the concept that obesity is not protective against fracture. Copyright © 2015 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

CORRELATION OF PHYSICAL ACTIVITY LEVEL WITH BONE MINERAL DENSITY, CARDIO-RESPIRATORY FITNESS AND BODY COMPOSITION IN POST-MENOPAUSAL WOMEN

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Niyati N Khona

2017-09-01

Full Text Available Background: Due to the hormonal changes in postmenopausal women they are prone for many complications like increased CVD risk factors, osteoporosis, obesity, mood swings and urinary incontinence. Physical inactivity in postmenopausal women leads to higher risk of developing CVD and osteoporosis. The objective was to find out the correlation of physical activity level with BMD, cardio-respiratory fitness and body composition in post-menopausal women Methods: 42 postmenopausal women were included. A detailed clinical evaluation with physical activity level (IPAQ-METS-mins/week, , BMD ( T-Scores, body composition (BMI, waist circumference, BIA & Skin fold calliper for fat %, cardio-respiratory fitness was measured by Balke protocol and VO2peak (ml/kg/min is estimated. Correlation of physical activity level with BMD, cardio-respiratory fitness and body composition were analysed using “Pearson’s product moment correlation co-efficient and Spearman’s rho.” Results: Spearman’s rank correlation rho for IPAQ with VO2 peak was 0.420,BMI was -0.388 and visceral fat was -0.384 indicating moderate positive correlation between IPAQ and cardio-respiratory fitness and weak negative correlation between IPAQ and BMI and visceral fat. Pearson’s product moment correlation coefficient of IPAQ with BMD was 0.147, body fat was -0.234 and waist circumference was -0.256 indicating no correlation. P value was significant for correlation of IPAQ with CRF (0.006, BMI (0.011 and Visceral fat (0.012. Conclusion: There is moderate positive correlation between IPAQ and cardio-respiratory fitness, weak negative correlation between IPAQ and BMI and visceral fat and no correlation between IPAQ and BMD, body fat and waist circumference

Selective estrogen receptor modulators (SERM: A new choice for postmenopausal women and physicians who worry on cancer

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Ali Baziad

2001-09-01

Full Text Available The postmenopausal state is characterized by the cessation of menstruation, loss of ovarian function, and a dramatic decrease in the level of circulating estrogen. This state of estrogen deficiency contributes to the acceleration of several age-related health problems in women, including cardiovascular disease, osteoporosis, and dementia. Estrogen replacement is clearly effective in the short-term and long-term treatment and prevention of postmenopausal symptoms. However, until now, the amount of HRT user is still very low. Fear of breast cancer and endometrial cancer are the most common concern in using hormone replacement therapy (HRT, although the relationship between long-term HRT and breast cancer remains controversial. For physicians or patients, who worry on cancer, the ideal drug is now available i.e. the selective estrogen receptor modulators (SERM, with the generic name raloxifine. (Med J Indones 2001; 10: 187-90Keywords: HRT, raloxifine, osteoporosis, CVD, tamoxifen

Bone mineral measurements and the pathogenesis of osteoporosis

International Nuclear Information System (INIS)

Aloia, J.F.; Vaswani, A.N.; Ellis, K.J.; Cohn, S.H.

1986-01-01

Low bone mass (osteopenia) is a major factor in the development of osteoporotic fractures in women after the menopause. The pathogenesis of postmenopausal osteoporosis has been pursued by dual lines of investigation: (1) development of a model to describe involutional bone loss, (2) identification of those factors which result in some healthy women having a greater risk for osteoporosis than others. Bone mineral measurements have been made using in vivo neutron activation analysis and whole body counting for the measurement of total body calcium (TBCa), single photon absorptiometry for the measurement of bone mineral content of the distal radius and dual photon absorptiometry for measurement of the bone density of the spine. TBCa is higher in men than women and is lost at a slow linear rate in men. Blacks have a skeletal mass about 8-9% higher than Caucasians. Women have a similar loss of TBCa to men prior to menopause, but then have an accelerated rate of loss after menopause. The change in bone density of the radius and spine with increasing age is also best described by a 2 phase regression in women, with appreciable loss after age 50

Diagnosis and management of osteoporosis in the older senior

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Sheryl F Vondracek

2009-03-01

Full Text Available Sheryl F Vondracek, Sunny A LinneburDepartment of Clinical Pharmacy, School of Pharmacy C238-L15, University of Colorado Denver, Aurora, CO, USAAbstract: The older senior is at high risk for osteoporosis. It is important for healthcare providers to be fully aware of the potential risks and benefits of diagnosing and treating osteoporosis in the older senior population. Data indicate that bone mineral density testing is under-utilized and drug therapy is often not initiated when indicated in this population. Bone mineral density testing with central dual energy x-ray absorptiometry is essential and cost-effective in this population. All older seniors should be educated on a bone-healthy lifestyle including age-appropriate weightbearing exercise and smoking cessation if necessary. It is important to remember that falls play a very important role in the risk for osteoporotic fractures, especially in the older senior. All older seniors should be evaluated annually for falls and strategies should be implemented to reduce fall risk in this population. The risk for vitamin D insufficiency and deficiency is high in the older senior and can contribute to falls and fractures. Adequate intakes of calcium and vitamin D are important and deficiencies need to be treated. Data on osteoporosis drug therapy in the older senior are lacking. Based on data from subgroup analyses of large osteoporosis trials in postmenopausal women, current osteoporosis therapies appear safe and efficacious in the older senior and most will live long enough to derive a benefit from these therapies. Further studies are needed in older seniors, especially men, to better understand the risks and benefits of pharmacologic therapy for the management of osteoporosis.Keywords: osteoporosis, aged, elderly, eighty and over, senior, diphosphonates

Long-term Results of the Patients with Regional Transient Osteoporosis

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Kenan Akgün

2002-09-01

Full Text Available Transient regional osteoporosis is an uncommon cause of hip pain. It affects mostly healthy middle-aged men, and women in the third trimester of pregnancy. The aetiology is unknown. Eight patients (3 females, 5males who were diagnosed as transient regional osteoporosis of hip were included in the study. Long-term results of all the patients were evaluated. Their mean follow-up duration was 5.1 years. Following every hip involvement, after a mean duration of 6.6 months, all the patients were asymptomatic and returned to full activitiy without residual effects. Both hips were affected in 5 patients, in 4 of which the involvement was migratory. Migratory involvement duration ranged from 3 months to 4 years. In conclusion, Transient regional osteoporosis is self-limiting and resolves symptomatically and radiologically within some months of presentation.

P2X7 receptor regulates osteoclast function and bone loss in a mouse model of osteoporosis.

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Wang, Ning; Agrawal, Ankita; Jørgensen, Niklas Rye; Gartland, Alison

2018-02-22

Post-menopausal osteoporosis is a condition that affects millions worldwide and places a huge socio-economic burden on society. Previous research has shown an association of loss of function SNPs in the gene for the purinergic receptor P2X7R with low bone mineral density, increased rates of bone loss and vertebral fractures in post-menopausal women. In this study we use a mouse model of oestrogen deficiency-induced bone loss and the BALB/cJ P2X7R -/- to show that absence of the P2X7R resulted in increased bone loss. Osteoclast precursors were isolated from both BALB/cJ P2X7R -/- and BALB/cJ P2X7R +/+ mice and then cultured in vitro to form mature resorbing osteoclasts. The BALB/cJ P2X7R -/- derived precursors generated slightly more osteoclasts but with a significant reduction in the amount of resorption per osteoclast. Furthermore, when using modified culture conditions osteoclast activity was additionally increased in the absence of the P2X7R suggest that P2X7R may regulate the lifespan and activity of osteoclasts. Finally using mechanical loading as an anabolic stimulus for bone formation, we demonstrated that the increased oestrogen-deficient bone loss could be rescued, even in the absence of P2X7R. This study paves the way for clinical intervention for women with post-menopausal osteoporosis and P2XR7 loss of function polymorphisms.

Total reflection X-ray fluorescence analysis of oral fluids of women affected by osteoporosis and osteopenia

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Sánchez, Héctor Jorge; Valentinuzzi, María Cecilia; Grenón, Miram; Abraham, José

2008-12-01

Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures; the early stage of decreased bone density is called osteopenia. More than 200 million people are affected and about 50% of post-menopausic women are expected to develop the disease. Osteoporosis, osteopenia and periodontal disease have in common several risk factors, being hyperthyroidism and smoking habits the most important ones. There is scarce information in the literature about the association between periodontal disease and osteoporosis and/or osteopenia. Some works suggest that osteoporotic women are susceptible to a higher loss of periodontal insertion, alveolar bones, and teeth. Thirty adult post-menopausic women were studied; some of them were healthy (control group) and the rest of them were undergoing some stage of osteoporosis or osteopenia. All the subjects were healthy, non-smokers, not having dental implants, and with communitarian periodontal index higher than 1(CPI > 1). Samples of saliva and gingival crevice fluid were extracted with calibrated micro-capillaries and deposited on Si reflectors. Known amounts of Ga were added to the samples in order to act as internal standard for quantification by the total reflection x-ray fluorescence technique. Experimental concentrations of several elements (P, S, Cl, K, Ca, Cr, Fe, NI, Cu, and Zn) were determined. The concentration of some elements in saliva showed different behavior as compared to gingival crevice fluid. Some critical elements of bone composition, such as Ca and Zn, present very distinguishable behavior. Improvements in the statistics are required for a better assessment of a routine method and to establish some correlation with periodontal disease. TXRF seems to be a promising method to evaluate the evolution of osteoporosis.

Total reflection X-ray fluorescence analysis of oral fluids of women affected by osteoporosis and osteopenia

International Nuclear Information System (INIS)

Sanchez, Hector Jorge; Valentinuzzi, Maria Cecilia; Grenon, Miram; Abraham, Jose

2008-01-01

Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures; the early stage of decreased bone density is called osteopenia. More than 200 million people are affected and about 50% of post-menopausic women are expected to develop the disease. Osteoporosis, osteopenia and periodontal disease have in common several risk factors, being hyperthyroidism and smoking habits the most important ones. There is scarce information in the literature about the association between periodontal disease and osteoporosis and/or osteopenia. Some works suggest that osteoporotic women are susceptible to a higher loss of periodontal insertion, alveolar bones, and teeth. Thirty adult post-menopausic women were studied; some of them were healthy (control group) and the rest of them were undergoing some stage of osteoporosis or osteopenia. All the subjects were healthy, non-smokers, not having dental implants, and with communitarian periodontal index higher than 1(CPI > 1). Samples of saliva and gingival crevice fluid were extracted with calibrated micro-capillaries and deposited on Si reflectors. Known amounts of Ga were added to the samples in order to act as internal standard for quantification by the total reflection x-ray fluorescence technique. Experimental concentrations of several elements (P, S, Cl, K, Ca, Cr, Fe, NI, Cu, and Zn) were determined. The concentration of some elements in saliva showed different behavior as compared to gingival crevice fluid. Some critical elements of bone composition, such as Ca and Zn, present very distinguishable behavior. Improvements in the statistics are required for a better assessment of a routine method and to establish some correlation with periodontal disease. TXRF seems to be a promising method to evaluate the evolution of osteoporosis

Total reflection X-ray fluorescence analysis of oral fluids of women affected by osteoporosis and osteopenia

Energy Technology Data Exchange (ETDEWEB)

Sanchez, Hector Jorge [Facultad de Matematica Astronomia y Fisica, Universidad Nacional de Cordoba, 5000 Cordoba (Argentina)], E-mail: jsan@famaf.unc.edu.ar; Valentinuzzi, Maria Cecilia [Facultad de Matematica Astronomia y Fisica, Universidad Nacional de Cordoba, 5000 Cordoba (Argentina); Grenon, Miram [Facultad de Odontologia, Universidad Nacional de Cordoba, 5000 Cordoba (Argentina); Abraham, Jose [Facultad de Matematica Astronomia y Fisica, Universidad Nacional de Cordoba, 5000 Cordoba (Argentina)

2008-12-15

Osteoporosis is a disease characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to bone fragility and an increased susceptibility to fractures; the early stage of decreased bone density is called osteopenia. More than 200 million people are affected and about 50% of post-menopausic women are expected to develop the disease. Osteoporosis, osteopenia and periodontal disease have in common several risk factors, being hyperthyroidism and smoking habits the most important ones. There is scarce information in the literature about the association between periodontal disease and osteoporosis and/or osteopenia. Some works suggest that osteoporotic women are susceptible to a higher loss of periodontal insertion, alveolar bones, and teeth. Thirty adult post-menopausic women were studied; some of them were healthy (control group) and the rest of them were undergoing some stage of osteoporosis or osteopenia. All the subjects were healthy, non-smokers, not having dental implants, and with communitarian periodontal index higher than 1(CPI > 1). Samples of saliva and gingival crevice fluid were extracted with calibrated micro-capillaries and deposited on Si reflectors. Known amounts of Ga were added to the samples in order to act as internal standard for quantification by the total reflection x-ray fluorescence technique. Experimental concentrations of several elements (P, S, Cl, K, Ca, Cr, Fe, NI, Cu, and Zn) were determined. The concentration of some elements in saliva showed different behavior as compared to gingival crevice fluid. Some critical elements of bone composition, such as Ca and Zn, present very distinguishable behavior. Improvements in the statistics are required for a better assessment of a routine method and to establish some correlation with periodontal disease. TXRF seems to be a promising method to evaluate the evolution of osteoporosis.

Osteosarcopenic obesity is associated with reduced handgrip strength, walking abilities, and balance in postmenopausal women.

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Ilich, J Z; Inglis, J E; Kelly, O J; McGee, D L

2015-11-01

We determined the prevalence of osteosarcopenic obesity (loss of bone and muscle coexistent with increased adiposity) in overweight/obese postmenopausal women and compared their functionality to obese-only women. Results showed that osteosarcopenic obese women were outperformed by obese-only women in handgrip strength and walking/balance abilities indicating their higher risk for mobility impairments. Osteosarcopenic obesity (OSO) is a recently defined triad of osteopenia/osteoporosis, sarcopenia, and adiposity. We identified women with OSO in overweight/obese postmenopausal women and evaluated their functionality comparing them with obese-only (OB) women. Additionally, women with osteopenic/osteoporotic obesity (OO), but no sarcopenia, and those with sarcopenic obesity (SO), but no osteopenia/osteoporosis, were identified and compared. We hypothesized that OSO women will have the lowest scores for each of the functionality measures. Participants (n = 258; % body fat ≥35) were assessed using a Lunar iDXA instrument for bone and body composition. Sarcopenia was determined from negative residuals of linear regression modeled on appendicular lean mass, height, and body fat, using 20th percentile as a cutoff. Participants with T-scores of L1-L4 vertebrae and/or total femur OSO (n = 32) included women with both osteopenia/osteoporosis and sarcopenia, while those with normal bone and no sarcopenia were classified as OB (n = 99). Functionality measures such as handgrip strength, normal/brisk walking speed, and right/left leg stance were evaluated and compared among groups. Women with OSO presented with the lowest handgrip scores, slowest normal and brisk walking speed, and shortest time for each leg stance, but these results were statistically significantly different only from the OB group. These findings indicate a poorer functionality in women presenting with OSO, particularly compared to OB women, increasing the risk for bone fractures and immobility from

Search for genetic markers determining the efficiency of therapy with bisphosphonates in Russian women with postmenopausal osteoporosis: A pilot study

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M. Yu. Krylov

2016-01-01

Full Text Available Many clinical observations show that patient’s genetic background is of great importance in determining the efficiency of treatment.Subjects and methods. The instigation included 50 postmenopausal women with osteoporosis (OP, who were followed up at the Laboratory of osteoporosis, V.A. Nasonova Research Institute of Rheumatology. Body mineral density (BMD in the lumbar spine (LI-IV, femoral neck (FN, and total hip was measured using dual-energy X-ray absorptiometry before and 12 months after treatment with bisphosphonates (BP. To estimate BMD changes, the investigators used ΔBMD in percent (Δ, %.Results and discussion. The whole group showed a positive effect of BP therapy during a year, which was most pronounced in the lumbar spine (mean ΔBMD, about 4%, and a small increment in the proximal hip BMD (mean ΔBMD, about 2%. An analysis indicated a statistically significant correlation of MCP1 -2518A>G polymorphism with changes in LI-IV BMD after 12-month BP therapy. Thus, the female patients who were A allele carriers had a twice lower increase in LI-IV BMD due to BP therapy than those without this allele. The genetic variants of the CCR5 gene, which were related to Δ32 deletion, and IL1β -511C/T polymorphism were also associated with changes in FN BMD following 12-month BP therapy. The BMD increase due to BP therapy in the carriers of the CCR5 Δ32 mutation (wt/Δ32 genotype was 3.5-fold than that in the carriers of the wild type gene (wt/wt genotype. Examination of IL1 -511C/T polymorphism demonstrated that the FN BMD increment in the carriers of the CC genotype was significantly higher than in those of the CT genotype (4.2±4.8 and 1.0±3.7%, respectively; р = 0.023. Our investigation revealed no significant relationship between VDR, LEPR, IL10, MHTFR, PPARG, SPP1, and CCR5(G/A gene polymorphisms and 12-month BP therapy-induced BMD changes in the three study skeletal regions. The findings may suggest that genetic testing may be used to

Bone strength and management of postmenopausal fracture risk with antiresorptive therapies: considerations for women’s health practice

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Cheung AM

2016-09-01

Full Text Available Angela M Cheung,1–3 Heather Frame,4 Michael Ho,5 Erin S Mackinnon,6 Jacques P Brown7 1Department of Medicine, University of Toronto, 2Centre of Excellence in Skeletal Health Assessment, Joint Department of Medical Imaging, University Health Network (UHN, 3Mount Sinai Hospital, University of Toronto, Toronto, ON, 4Assiniboine Clinic, Winnipeg, MB, 5University Health Network, Toronto, 6Amgen Canada, Inc, Mississauga, ON, 7Rheumatology Division, CHU de Québec Research Centre, Laval University, Quebec City, QC, Canada Abstract: Bone strength – and, hence, fracture risk – reflects the structural and material properties of the skeleton, which changes with bone turnover during aging and following effective pharmacotherapy. A variety of powerful new techniques (quantitative computed tomography, as well as peripheral quantitative computed tomography and high-resolution peripheral quantitative computed tomography provide precise images of bone structure and can be used to model the response of specific bones to different types of mechanical load. This review explores the various components of bone strength and the clinical significance of measures, such as bone mineral density, bone turnover markers, and modern imaging data, with regard to fracture risk in women with postmenopausal osteoporosis, before and after initiating antiresorptive therapy. These imaging and related techniques offer an ever-clearer picture of the changes in bone structure and bone mineral metabolism during normal aging and in osteoporosis, as well as in response to treatment. However, because the newer techniques are not yet available in routine practice, validated tools for absolute fracture risk assessment remain essential for clinical decision making. These tools, which are tailored to patient risk data in individual countries, are based on bone mineral density and other readily available clinical data. In addition, bone turnover marker measurements can be useful in

Bone mineral density status and frequency of osteoporosis and clinical fractures in 155 patients with psoriatic arthritis followed in a university hospital.

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Busquets, Noemi; Vaquero, Carmen Gómez; Moreno, Jesús Rodríguez; Vilaseca, Daniel Roig; Narváez, Javier; Carmona, Loreto; Nolla, Joan M

2014-01-01

To assess the bone mineral density (BMD) and the frequency of osteoporosis and clinical fractures in a large group of Spanish patients with psoriatic arthritis (PsA). BMD was determined by DXA in all the patients who were willing to participate and had peripheral PsA regularly evaluated in a tertiary university hospital. All patients underwent a physical examination and general laboratory analysis. We gathered demographic and clinical variables related with BMD and risk of fractures. We also recorded the history of clinical low impact fractures. The population of reference to calculate T-score and Z-score came from a Spanish database. One hundred and fifty-five patients were included (64 postmenopausal women, 26 premenopausal women and 65 men). The clinical forms of PsA were: 46% oligoarticular and 54% polyarticular. Mean disease duration was 13.7±9.4 years and mean ESR was 21.8±13.9mm/h; 66% of patients had received glucocorticoid treatment. We found no differences in BMD status between the patients and the Spanish general population, neither in the whole series nor in each defined subgroup. Frequency of osteoporosis was 16%; it was higher in postmenopausal women (28%) than in men (9%) or premenopausal women (4%). Frequency of clinical fractures was 13%; it accounted specially in postmenopausal women. The magnitude of the problem of osteoporosis in PsA seems to be mild. Copyright © 2013 Elsevier España, S.L. All rights reserved.

Increased bone mineral density in postmenopausal women with type 2 diabetes mellitus

International Nuclear Information System (INIS)

Hadzibegovic, I.; Miskic, B.; Prvulovic, D.; Bistrovic, D.; Cosic, V.

2008-01-01

Studies of bone mineral density (BMD) in women with type 2 diabetes mellitus have shown conflicting results. We conducted this study to determine whether postmenopausal women with diabetes have higher BMD than non-diabetic women of similar age and to investigate the relationship between BMD and relevant clinical characteristics in these groups of women. We retrospectively analyzed lumbar spine, femoral neck and radius BMD data and other relevant clinical data for 130 postmenopausal women with type 2 diabetes mellitus and 166 non-diabetic women collected during a voluntary screening for osteoporosis in postmenopausal women without a history of low bone mass or osteoporotic fractures. Women with type 2 diabetes mellitus had significantly higher mean lumbar spine BMD (0.903 +-0.165 vs. 0.824+-0.199, respectively, P<0.001) and mean femoral neck BMD (0.870+-0.132 vs. 0.832+-0.134, respectively, P<0.05) than non-diabetic women. In both groups of women, age correlated negatively with BMD levels at all three anatomical sites. Higher body mass index was associated only with higher lumber spine BMD in both groups. Alkaline phosphatase levels showed a negative correlation with BMD at all sites in women with type 2 diabetes mellitus. Postmenopausal women with type 2 diabetes mellitus have higher BMD levels than non-diabetic women with similar clinical characteristics and require a more scrutinized approach in managing low bone mass. (author)

Obesity and fractures in postmenopausal women.

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Premaor, Melissa Orlandin; Pilbrow, Lesley; Tonkin, Carol; Parker, Richard A; Compston, Juliet

2010-02-01

Low body mass index (BMI) is a recognized risk factor for fragility fracture, whereas obesity is widely believed to be protective. As part of a clinical audit of guidance from the National Institute of Health and Clinical Excellence (NICE), we have documented the prevalence of obesity and morbid obesity in postmenopausal women younger than 75 years of age presenting to our Fracture Liaison Service (FLS). Between January 2006 and December 2007, 1005 postmenopausal women aged less than 75 years with a low-trauma fracture were seen in the FLS. Of these women, 805 (80%) underwent assessment of bone mineral density (BMD) by dual energy X-ray absorptiometry (DXA), and values for BMI were available in 799. The prevalence of obesity (BMI 30 to 34.9 kg/m(2)) and morbid obesity (BMI > or = 35 kg/m(2)) in this cohort was 19.3% and 8.4%, respectively. Normal BMD was reported in 59.1% of obese and 73.1% of morbidly obese women, and only 11.7% and 4.5%, respectively, had osteoporosis (p obesity in postmenopausal women presenting to the FLS with low-trauma fracture. Most of these women had normal BMD, as measured by DXA. Our findings have important public heath implications in view of the rapidly rising increase in obesity in many populations and emphasize the need for further studies to establish the pathogenesis of fractures in obese individuals and to determine appropriate preventive strategies. Copyright 2010 American Society for Bone and Mineral Research.

Animal models of osteoporosis - necessity and limitations

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Turner A. Simon

2001-06-01

Full Text Available There is a great need to further characterise the available animal models for postmenopausal osteoporosis, for the understanding of the pathogenesis of the disease, investigation of new therapies (e.g. selective estrogen receptor modulators (SERMs and evaluation of prosthetic devices in osteoporotic bone. Animal models that have been used in the past include non-human primates, dogs, cats, rodents, rabbits, guinea pigs and minipigs, all of which have advantages and disadvantages. Sheep are a promising model for various reasons: they are docile, easy to handle and house, relatively inexpensive, available in large numbers, spontaneously ovulate, and the sheep's bones are large enough to evaluate orthopaedic implants. Most animal models have used females and osteoporosis in the male has been largely ignored. Recently, interest in development of appropriate prosthetic devices which would stimulate osseointegration into osteoporotic, appendicular, axial and mandibular bone has intensified. Augmentation of osteopenic lumbar vertebrae with bioactive ceramics (vertebroplasty is another area that will require testing in the appropriate animal model. Using experimental animal models for the study of these different facets of osteoporosis minimizes some of the difficulties associated with studying the disease in humans, namely time and behavioral variability among test subjects. New experimental drug therapies and orthopaedic implants can potentially be tested on large numbers of animals subjected to a level of experimental control impossible in human clinical research.

Frequency of Osteoporosis and Osteopenia According To Bone Mineral Density of Proximal Femur Subregions in Normal and Osteopenic Postmenopausal Women With Respect to Total Hip Bone

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Murat Ersöz

2002-09-01

Full Text Available In this study 29 normal (mean age: 65.6 ± 5.1 years and 33 osteopenic (mean age: 67.6 ± 4.9 years postmenopausal women according to total bone mineral density (BMD of the hip were evaluated for BMD values of subregions of proximal femur. The percentages for osteoporosis and osteopenia with respect to subregions were 13.8% and 58.6% for femoral neck and 20.7% and 41.4% for Ward’s triangle in normal group. In trochanteric and intertrochanteric measurements there were no T scores below –2.5 but 17.2% of the subjects were osteopenic with regard to trochanteric and 6.9% were osteopenic due to intertrochanteric BMD values. The percentages for osteoporosis and osteopenia with respect to subregion measurements were 57.6% and 42.4% for femoral neck, 60.6% and 36.4% for Ward’s triangle, 3% and 78.8% for trochanteric, 9.1% and 87.9% for intertrochanteric regions in osteopenic group according to total hip values. Knowing that hip fracture risk is increasing 2-3 fold for 1 standart deviation decrease from the young adult mean value for all subregions and knowing the relation between cervical hip fractures and BMD values of Ward’s triangle and femoral neck and the relation between intertrochanteric fractures and trochanteric BMD values, it is recommended to evaluate the BMD values of subregions of the hip besides the total hip values in daily practice.

Management of osteoporosis and menopausal symptoms: focus on bazedoxifene/conjugated estrogen combination

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Mirkin S

2013-08-01

Full Text Available Sebastian Mirkin,1 James H Pickar21Pfizer Inc, Collegeville, PA, 2Department of Obstetrics and Gynecology, Columbia University Medical Center, New York, NY, USAAbstract: Loss of estrogen production in women during menopause results in a state of estrogen deficiency which has been associated with multiple problems, including vasomotor symptoms, symptoms of vulvovaginal atrophy, bone loss, and difficulties with sleep, mood, memory, and sexual activity. The only treatment option currently available to address multiple postmenopausal symptoms in women with an intact uterus is estrogen/progestin-containing hormone therapy (HT. Concerns surrounding side effects and published data regarding the association of HT with the increased risk for breast cancer have induced a decrease in the number of women seeking, initiating, and continuing this type of therapy. A combination containing bazedoxifene and conjugated estrogens (BZA/CE maintains the established benefits of estrogen therapy for treatment of postmenopausal vasomotor symptoms, vulvovaginal atrophy, and osteoporosis, while certain estrogenic effects, such as stimulation of the uterus and breast, are antagonized without the side effects associated with HT. BZA/CE has been evaluated in a series of multicenter, randomized, double-blind, placebo-controlled, and active-controlled Phase III trials known as the Selective estrogens, Menopause, And Response to Therapy (SMART trials. BZA/CE demonstrated clinically meaningful improvements in vasomotor symptoms, vulvovaginal atrophy, and a protective effect on the skeleton. These clinical benefits were associated with an acceptable safety profile and an improved tolerability compared with HT. BZA/CE showed a favorable safety profile on the breast, endometrium, and ovaries. The incidence of venous thromboembolism was low and the risk does not appear to be any greater than for CE alone or BZA alone or greater than HT. The incidence of coronary heart disease and

Gastrointestinal symptoms and association with medication use patterns, adherence, treatment satisfaction, quality of life, and resource use in osteoporosis: baseline results of the MUSIC-OS study.

Science.gov (United States)

Modi, A; Sen, S; Adachi, J D; Adami, S; Cortet, B; Cooper, A L; Geusens, P; Mellström, D; Weaver, J; van den Bergh, J P; Nguyen, A M; Sajjan, S

2016-03-01

The Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC-OS) is a prospective, observational study of women with osteoporosis in Europe and Canada. At baseline, patients with gastrointestinal symptoms reported lower adherence to osteoporosis treatment, treatment satisfaction, and health-related quality of life, than those without gastrointestinal symptoms. The aim of the study was to examine gastrointestinal (GI) symptoms and the association between GI symptoms and treatment adherence, treatment satisfaction, and health-related quality of life (HRQoL) among osteoporotic women in Europe and Canada. Baseline results are reported here for a prospective study which enrolled postmenopausal, osteoporotic women who were initiating (new users) or continuing (experienced users) osteoporosis treatment at study entry (baseline). A patient survey was administered at baseline and included the occurrence of GI symptoms during 6-month pre-enrolment, treatment adherence (adherence evaluation of osteoporosis (ADEOS), score 0-22), treatment satisfaction (Osteoporosis Treatment Satisfaction Questionnaire for Medications (OPSAT-Q), score 0-100) and HRQoL (EuroQol-5 dimension (EQ-5D) utility, score 0-1; OPAQ-SV, score 0-100). The association between GI symptoms and ADEOS (experienced users), OPSAT-Q (experienced users), and HRQoL (new and experienced users) was assessed by general linear models adjusted for patient characteristics. A total of 2959 patients (2275 experienced and 684 new users) were included. Overall, 68.1% of patients experienced GI symptoms in the past 6 months. Compared with patients without GI symptoms, patients with GI symptoms had lower mean baseline scores on most measures. The mean adjusted differences were ADEOS, -0.43; OPSAT-Q, -5.68; EQ-5D, -0.04 (new users) and -0.06 (experienced users), all P < 0.01. GI symptoms were also associated with lower OPAQ-SV domain scores: physical function, -4.17 (experienced

Exercise and fractures in postmenopausal women. Final results of the controlled Erlangen Fitness and Osteoporosis Prevention Study (EFOPS).

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Kemmler, W; Bebenek, M; Kohl, M; von Stengel, S

2015-10-01

The EFOPS trial clearly established the positive effect of long-term exercise on clinical low-trauma fractures in postmenopausal women at risk. Bearing in mind that the complex anti-fracture exercise protocols also affect a large variety of diseases of increased age, we strongly encourage older adults to perform multipurpose exercise programs. Physical exercise may be an efficient option for autonomous fracture prevention during increasing age. The aim of the study was to evaluate the effect of exercise on clinical overall fracture incidence and bone mineral density (BMD) in elderly subjects at risk. In 1998 initially, 137 early-postmenopausal, osteopenic women living in Erlangen-Nuremberg, Germany, were included in the EFOPS trial. Subjects of the exercise group (EG; n = 86) conducted two supervised group and two home exercise sessions/week while the control group (CG; n = 51) was requested to maintain their physical activity. Primary study endpoints were clinical overall low-trauma fractures determined by questionnaires, structured interviews, and BMD at the lumbar spine and femoral neck assessed by dual-energy X-ray absorptiometry. In 2014, 105 subjects (EG: n = 59 vs. CG: n = 46) representing 1680 participant-years were included in the 16-year follow-up analysis. Risk ratio in the EG for overall low-trauma fractures was 0.51 (95% confidence interval (95% CI) 0.23 to 0.97, p = .046), rate ratio was 0.42 (95% CI 0.20 to 0.86, p = .018). Based on comparable baseline values, lumbar spine (MV -1.5%, 95% CI -0.1 to -2.8 vs. -5.8%, -3.3 to -7.2%) and femoral neck (-6.5%, -5.2 to -7.7 vs. -9.6%, -8.2 to 11.1%) BMD decreased in both groups; however, the reduction was more pronounced in the CG (p ≤ .001). This study clearly evidenced the high anti-fracture efficiency of multipurpose exercise programs. Considering furthermore the favorable effect of exercise on most other risk factors of increasing age, we strongly encourage older adults to perform multipurpose

Association of gastrointestinal events with quality of life and treatment satisfaction in osteoporosis patients: results from the Medication Use Patterns, Treatment Satisfaction, and Inadequate Control of Osteoporosis Study (MUSIC OS).

Science.gov (United States)

Modi, A; Sen, S; Adachi, J D; Adami, S; Cortet, B; Cooper, A L; Geusens, P; Mellström, D; Weaver, J P; van den Bergh, J P; Keown, P A; Sajjan, S

2017-10-01

The purpose of this study was to assess the association of GI events with HRQoL and treatment satisfaction. The effect of baseline GI events persisted through 1 year of follow-up, as indicated by lower EQ-5D, OPAQ-SV, and treatment satisfaction scores among patients with vs without baseline GI events. The presence of GI events is an independent predictor of decreased HRQoL and treatment satisfaction in patients being treated for osteoporosis. The goal of this study was to assess the association of gastrointestinal (GI) events with health-related quality of life (HRQoL) and treatment satisfaction in patients being treated for osteoporosis. MUSIC OS was a multinational, prospective, observational study examining the impact of GI events on osteoporosis management in postmenopausal women. In this analysis, HRQoL and treatment satisfaction were assessed at baseline, 6, and 12 months and compared between patients with and without GI events. Covariate-adjusted scores were calculated using multivariate least-squares regression analysis, and differences between the mean scores of patients with and without baseline and post-baseline GI events were determined. Among the 2959 patients in the analysis, unadjusted scores at each time point were lower (i.e., worse) for patients with GI events than patients without GI events. In adjusted analyses, the effect of baseline GI events persisted through 1 year of follow-up, as indicated by lower EQ-5D and OPAQ-SV scores at 12 months among patients with vs without baseline GI events (-0.04 for the EQ-5D utility score, -5.07 for the EQ-5D visual analog scale, -3.35 for OPAQ physical function, -4.60 for OPAQ emotional status, and -8.50 for OPAQ back pain; P ≤ 0.001 for all values). Decrements in month 12 treatment satisfaction scores were -6.46 for patients with baseline GI events and -7.88 for patients with post-baseline GI events. The presence of GI events is an independent predictor of decreased HRQoL and treatment satisfaction

Relationship between nutritional profile, measures of adiposity, and bone mineral density in postmenopausal Saudi women.

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Alissa, Eman M; Alnahdi, Wafa A; Alama, Nabeel; Ferns, Gordon A

2014-01-01

Osteoporosis remains a major health problem in all developed countries and is a condition in which several dietary factors have been implicated. To assess the nutritional status and levels of adiposity of postmenopausal women in relation to bone mineral density. A cross-sectional study in which dietary intake was estimated by a food frequency questionnaire in 300 Saudi postmenopausal women aged 46-88 years. Bone profile biochemistry (serum calcium, phosphate, parathyroid hormone [PTH], vitamin D) and bone mineral density (BMD) in 3 skeletal sites were determined for all participants. Overweight and obesity were highly prevalent among the study population. No significant correlation was found between dietary calcium and vitamin D and bone mass at any site. Dietary intake of calcium and vitamin D was significantly less than the recommended levels for a large proportion of the cohort. Energy-adjusted intakes of carbohydrates, fat, protein, and unsaturated fatty acids were associated with BMD in the postmenopausal women. Age, body weight, and residency type were predictors of BMD at all sites. Serum-intact PTH was a predictor of BMD at lumbar spine and femoral neck. Waist : hip ratio (WHR) was a predictor for BMD at femoral neck. These results suggest that BMD is influenced by dietary factors other than calcium and vitamin D. However, nondietary factors such as age, WHR, PTH, and body weight may be important determinants of BMD in postmenopausal women.

Osteoporosis prediction from the mandible using cone-beam computed tomography

Energy Technology Data Exchange (ETDEWEB)

Barngkgei, Imad; Al Haffar, Iyad [Dept. of Oral Medicine, Faculty of Dentistry, Damascus University, Damascus (Syrian Arab Republic); Khattab, Razan [Dept. of Periodontology, Faculty of Dentistry, Damascus University, Damascus (Syrian Arab Republic)

2014-12-15

This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cmx15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

Osteoporosis prediction from the mandible using cone-beam computed tomography

International Nuclear Information System (INIS)

Barngkgei, Imad; Al Haffar, Iyad; Khattab, Razan

2014-01-01

This study aimed to evaluate the use of dental cone-beam computed tomography (CBCT) in the diagnosis of osteoporosis among menopausal and postmenopausal women by using only a CBCT viewer program. Thirty-eight menopausal and postmenopausal women who underwent dual-energy X-ray absorptiometry (DXA) examination for hip and lumbar vertebrae were scanned using CBCT (field of view: 13 cmx15 cm; voxel size: 0.25 mm). Slices from the body of the mandible as well as the ramus were selected and some CBCT-derived variables, such as radiographic density (RD) as gray values, were calculated as gray values. Pearson's correlation, one-way analysis of variance (ANOVA), and accuracy (sensitivity and specificity) evaluation based on linear and logistic regression were performed to choose the variable that best correlated with the lumbar and femoral neck T-scores. RD of the whole bone area of the mandible was the variable that best correlated with and predicted both the femoral neck and the lumbar vertebrae T-scores; further, Pearson's correlation coefficients were 0.5/0.6 (p value=0.037/0.009). The sensitivity, specificity, and accuracy based on the logistic regression were 50%, 88.9%, and 78.4%, respectively, for the femoral neck, and 46.2%, 91.3%, and 75%, respectively, for the lumbar vertebrae. Lumbar vertebrae and femoral neck osteoporosis can be predicted with high accuracy from the RD value of the body of the mandible by using a CBCT viewer program.

Symptomatic Hypocalcemia Associated with Zoledronic Acid Treatment for Osteoporosis: A Case Report

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Abdulmohsen H. Al Elq

2013-03-01

Full Text Available Intravenous bisphosphonates are widely used in the management of solid tumors, metastatic bone disease, metabolic bone diseases and hypercalcemia of malignancies. Recently, yearly intravenous injections of zoledronic acid, one of the potent nitrogen-containing bisphosphonates, have also been approved for the prevention and treatment of osteoporosis. Although infrequently observed, asymptomatic hypocalcemia mainly due to intravenous bisphosphonates has been documented. Here we report a female patient who exhibited profound symptomatic hypocalcemia after receiving intravenous zoledronic acid as treatment of postmenopausal osteoporosis. The patient was not assessed for calcium status prior to the intravenous bisphosphonate therapy, and she was later found to have severe vitamin D deficiency. To our knowledge, this is the first patient with symptomatic hypocalcemia to be reported after zoledronic acid was approved for the management of osteoporosis. We highlight the importance of evaluating calcium and vitamin D levels before initiating intravenous bisphosphonate treatment, particularly in the presence of widespread vitamin D deficiency and the likelihood of future increases in the prescription of intravenous bisphosphonates.

Combined bioavailable isoflavones and probiotics improve bone status and estrogen metabolism in postmenopausal osteopenic women: a randomized controlled trial

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Lambert, Max Norman Tandrup; Thybo, Catrine Bundgaard; Lykkeboe, Simon

2017-01-01

estrogen receptor affinity show potential to prevent and treat osteoporosis while minimizing or eliminating carcinogenic side effects. Objective: In this study, we sought to determine the beneficial effects of a bioavailable isoflavone and probiotic treatment against postmenopausal osteopenia. Design: We...... used a novel red clover extract (RCE) rich in isoflavone aglycones and probiotics to concomitantly promote uptake and a favorable intestinal bacterial profile to enhance isoflavone bioavailability. This was a 12-mo, double-blind, parallel design, placebo-controlled, randomized controlled trial of 78...... postmenopausal osteopenic women supplemented with calcium (1200 mg/d), magnesium (550 mg/d), and calcitriol (25 mg/d) given either RCE (60 mg isoflavone aglycones/d and probiotics) or a masked placebo [control (CON)]. Results: RCE significantly attenuated bone mineral density (BMD) loss at the L2–L4 lumbar spine...

Effects of vitamin K in postmenopausal women: mini review.

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Guralp, Onur; Erel, Cemal Tamer

2014-03-01

Possible benefits of vitamin K on bone health, fracture risk, markers of bone formation and resorption, cardiovascular health, and cancer risk in postmenopausal women have been investigated for over three decades; yet there is no clear evidence-based universal recommendation for its use. Interventional studies showed that vitamin K1 provided significant improvement in undercarboxylated osteocalcin (ucOC) levels in postmenopausal women with normal bone mineral density (BMD); however, there are inconsistent results in women with low BMD. There is no study showing any improvement in bone-alkaline-phosphatase (BAP), n-telopeptide of type-1 collagen (NTX), 25-hydroxy-vitamin D, and urinary markers. Improvement in BMD could not be shown in the majority of the studies; there is no interventional study evaluating the fracture risk. Studies evaluating the isolated effects of menatetrenone (MK-4) showed significant improvement in osteocalcin (OC); however, there are inconsistent results on BAP, NTX, and urinary markers. BMD was found to be significantly increased in the majority of studies. The fracture risk was assessed in three studies, which showed decreased fracture risk to some extent. Although there are proven beneficial effects on some of the bone formation markers, there is not enough evidence-based data to support a role for vitamin K supplementation in osteoporosis prevention among healthy, postmenopausal women receiving vitamin D and calcium supplementation. Interventional studies investigating the isolated role of vitamin K on cardiovascular health are required. Longterm clinical trials are required to evaluate the effect of vitamin K on gynecological cancers. MK-4 seems safe even at doses as high as 45 mg/day. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Chinese Herbal Medicine for Osteoporosis: A Meta-analysis of Randomized Controlled Trials.

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Jin, Yong-Xiang; Wu, Peng; Mao, Yi-Fan; Wang, Bo; Zhang, Jia-Feng; Chen, Wen-Liang; Liu, Zhong; Shi, Xiao-Lin

Osteoporosis is a major public health problem in the elderly population. Several studies have suggested that Chinese herbal medicine has antiosteoporotic activities that might be beneficial for osteoporosis. This study aimed to assess the effectiveness of Chinese herbal medicine in osteoporosis patients. We comprehensively searched for randomized controlled trials (until December 2016) that compared Chinese herbal medicine with Western medicine in adults with osteoporosis and reported bone mineral densities (BMDs). A total of 10 randomized controlled trials were included. The pooled results suggested that the increased spine BMD was lower but not significant in the Chinese herbal medicine group than in the Western drug group (standard mean difference [SMD] = -0.11, 95% confidence interval [CI]: -0.62 to 0.39, p > 0.05). In the subgroup analysis, in postmenopausal women, Chinese herbal medicine also showed a insignificantly higher increment in BMD than the control group (SMD = 0.22, 95% CI: -0.00 to 0.43, p = 0.05). For different treatment durations, subgroups over 6 mo (SMD = 0.09, 95% CI: -0.24 to 0.41, p > 0.05) and less than 6 mo (SMD = -0.25, 95% CI: -1.14 to 0.64, p > 0.05) showed comparable BMDs between the 2 therapies. Our study demonstrated that Chinese herbal medicine alone did not significantly increase lumbar spine BMD. Further studies with better adherence to the intervention are needed to confirm the results of this meta-analysis. Copyright © 2017 The International Society for Clinical Densitometry. Published by Elsevier Inc. All rights reserved.

The Cell Surface Markers Expression in Postmenopausal Women and Relation to Obesity and Bone Status

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Horv?thov?, Mira; Ilavsk?, Silvia; ?tef?kov?, Korn?lia; Szabov?, Michaela; Krivo??kov?, Zora; Jahnov?, Eva; Tulinsk?, Jana; Spustov?, Viera; Gajdo?, Martin

2017-01-01

The age-related changes and hormonal deprivation in postmenopausal women are associated with the immune response alteration. The excessive fat accumulation, local and systemic inflammation may lead to dysregulation in immune function and relevant health problems, including obesity and osteoporosis. We analyzed the expression of cell surface markers in the venous blood specimens, stained with fluorophores-conjugated monoclonal antibodies and analysed by multicolour flow cytometry. The signific...

Relationship between bone mineral density and alcohol intake: A nationwide health survey analysis of postmenopausal women.

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Hae-Dong Jang

Full Text Available Among a variety of relevant factors of osteoporosis, the association between alcohol intake and postmenopausal women's bone mineral density (BMD by using data from the Korean National Health and Nutrition Examination Survey was evaluated in this study.Among a total of 31,596 subjects, males, premenopausal women, participants without BMD data were excluded. Finally, a total number of subjects in the study was 3,312. The frequency and amount of alcohol intake were determined by self-reported questionnaires, and BMD was measured by dual-energy x-ray absorptiometry.Mean femoral BMD for light drinkers was statistically significantly greater than that for heavy drinkers and non-drinkers. We observed the characteristic trends for BMD by drinking frequency; the mean BMD gradually increased from non-drinkers to the participants who drank 2-3 times per week; these participants exhibited the highest BMD. Participants who drank alcohol greater than 4 times per week showed a lower BMD. In the risk factor analysis, the adjusted odds ratio for osteoporosis (at femoral neck was 1.68 in non-drinkers and 1.70 in heavy drinkers compared with light drinkers.Light alcohol intake (2-3 times per week and 1-2 or 5-6 glasses per occasion in South Korean postmenopausal women was related to high femoral BMD. Non-drinkers and heavy drinkers had approximately a 1.7-times greater risk for osteoporosis than light drinkers.

The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys.

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Eunjoo Choi

Full Text Available Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women.A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011, who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA examination. Bone mineral density (BMD was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use.After adjusting for various demographic and lifestyle confounders (including hormonal factors, subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015. This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively. In addition, age- and body mass index (BMI-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively.Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.

The Benefit of Bone Health by Drinking Coffee among Korean Postmenopausal Women: A Cross-Sectional Analysis of the Fourth & Fifth Korea National Health and Nutrition Examination Surveys.

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Choi, Eunjoo; Choi, Kyung-Hyun; Park, Sang Min; Shin, Doosup; Joh, Hee-Kyung; Cho, Eunyoung

2016-01-01

Although the concern about coffee-associated health problems is increasing, the effect of coffee on osteoporosis is still conflicting. This study aimed to determine the relationship between coffee consumption and bone health in Korean postmenopausal women. A population-based, cross-sectional study was performed using a nationally representative sample of the Korean general population. All 4,066 postmenopausal women (mean age 62.6 years) from the fourth and fifth Korean National Health and Nutrition Examination Survey (2008-2011), who completed the questionnaire about coffee consumption and had data of dual-energy X-ray absorptiometry (DXA) examination. Bone mineral density (BMD) was measured using DXA at the femoral neck and lumbar spine and osteoporosis was defined by World Health Organization T-score criteria in addition to self-report of current anti-osteoporotic medication use. After adjusting for various demographic and lifestyle confounders (including hormonal factors), subjects in the highest quartile of coffee intake had 36% lower odds for osteoporosis compared to those in the lowest quartile (Adjusted odds ratio [aOR] = 0.64; 95% confidence interval [CI], 0.43-0.95; P for trend = 0.015). This trend was consistent in osteoporosis of lumbar spine and femoral neck (aOR = 0.65 and 0.55; P for trend = 0.026 and 0.003, respectively). In addition, age- and body mass index (BMI)-adjusted BMD of the femoral neck and lumbar spine increased with higher coffee intake (P for trend = 0.019 and 0.051, respectively). Coffee consumption may have protective benefits on bone health in Korean postmenopausal women in moderate amount. Further, prospective studies are required to confirm this association.

Prevention of aromatase inhibitor-induced bone loss with alendronate in postmenopausal women: The BATMAN Trial.

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Lomax, Anna J; Yee Yap, Saw; White, Karen; Beith, Jane; Abdi, Ehtesham; Broad, Adam; Sewak, Sanjeev; Lee, Chooi; Sambrook, Philip; Pocock, Nicholas; Henry, Margaret J; Yeow, Elaine G; Bell, Richard

2013-12-01

Postmenopausal women on aromatase inhibitors (AI) are at risk of aromatase inhibitor-associated bone loss (AIBL) and fractures. In 2005 Osteoporosis Australia proposed an algorithm for bisphosphonate intervention. Three hundred and three postmenopausal women with early breast cancer (EBC) were enrolled (osteoporotic, n=25; osteopaenic, n=146; normal bone mineral density (BMD), n=126). Weekly alendronate (70 mg) treatment efficacy as triggered by the algorithm in preventing bone loss was evaluated. All patients received anastrozole (1 mg daily), calcium and vitamin D. All osteoporotic patients received alendronate at baseline. Eleven out of the 146 (7.5%) osteopaenic patients commenced alendronate within 18 months of participation and eleven commenced after. One hundred and twenty four out of the 146 (84.9%) osteopaenic patients and all 126 with normal baseline BMD did not trigger the algorithm. At three years, lumbar spine mean BMD increased (15.6%, p<0.01) in the osteoporotic group. BMD in the osteopaenic group with early intervention significantly increased at three years (6.3%, p=0.02). No significant change was seen in the late intervention group. No change was observed in those with osteopaenia without alendronate. There was a significant drop in lumbar spine (-5.4%) and hip (-4.5%) mean BMD, in the normal BMD group, none of whom received alendronate. Fracture data will be presented. In postmenopausal women with endocrine-responsive EBC, BMD improved over time when a bisphosphonate is administered with anastrozole in osteoporotic patients using an osteoporosis schedule. Subjects with normal baseline BMD experienced the greatest BMD loss, although none became osteoporotic.

Cyproterone acetate, an alternative gestagen in postmenopausal estrogen/gestagen therapy

International Nuclear Information System (INIS)

Riis, B.J.; Jensen, J.; Christiansen, C.

1986-01-01

Seventy six healthy, early postmenopausal women (aged 45-54 years) were allocated to 2 years of treatment with a cyclic combination of 2 mg estradiol valerate (21 days) and 1 mg cyproterone acetate (11 days) or placebo. Sixty five women (86%) completed the study. In the hormone treated group there was a significant decrease in biochemical estimates of bone turnover (serum alkaline phosphatase, serum phosphate, fasting urinary calcium and hydroxyproline), whereas these values were unchanged placebo treated group. In the placebo group the bone mineral content in the forearms (measured by single photon absorptiometry) and the bone mineral content in the lumbar spine and in the total skeleton (measured by dual photon absorptiometry) decreased significantly and at the same magnitude (p < 0.001), whereas all bone mass measurements remained unchanged in the hormone treated group. From the present study it can be concluded that treatment with a cyclic combination of 2 mg estradiol valerate and 1 mg cyproterone acetate is effective as prophylaxis in postmenopausal osteoporosis

Low bone mineral density is related to atherosclerosis in postmenopausal Moroccan women

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Cherkaoui Mohammed

2009-10-01

Full Text Available Abstract Background Some studies have implicated several possible metabolic linkages between osteoporosis and vascular calcification, including estrogen deficiency, vitamin D excess, vitamin K deficiency and lipid oxidation products. Nevertheless, it remains unclear whether osteoporosis and atherosclerosis are related to each other or are independent processes, both related to aging. The aim of this cross-sectional study was to evaluate the correlation between arterial thickening and bone status in a sample of apparently healthy Moroccan women. Methods Seventy-two postmenopausal women were studied. All patients were without secondary causes that might affect bone density. Bone status was assessed by bone mineral density (BMD in lumbar spine and all femoral sites. Arterial wall thickening was assessed by intima-media thickness (IMT in carotid artery (CA and femoral artery (FA. Prevalent plaques were categorized into four groups ranging from low echogenicity to high echogenicity. Results The mean age was 59.2 ± 8.3 years. 84.7% had at least one plaque. By Spearman Rank correlation, CA IMT was negatively correlated to Femoral total BMD (r = -0.33, Femoral neck BMD (r = -0.23, Ward triangle BMD (r = -0.30 and Trochanter BMD (r = -0.28 while there was no association with lumbar BMD. In multiple regression analysis, CA IMT emerged as an independent factor significantly associated with all femoral sites BMD after adjusting of confounding factors. FA IMT failed to be significantly associated with both Femoral and Lumbar BMD. No significant differences between echogenic, predominantly echogenic, predominantly echolucent and echolucent plaques groups were found concerning lumbar BMD and all femoral sites BMD Conclusion Our results demonstrate a negative correlation between bone mineral density (BMD qnd carotid intima-media thickness (IMT in postmenopausal women, independently of confounding factors. We suggest that bone status should be evaluated in

Predictive values of diagnostic codes for identifying serious hypocalcemia and dermatologic adverse events among women with postmenopausal osteoporosis in a commercial health plan database.

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Wang, Florence T; Xue, Fei; Ding, Yan; Ng, Eva; Critchlow, Cathy W; Dore, David D

2018-04-10

Post-marketing safety studies of medicines often rely on administrative claims databases to identify adverse outcomes following drug exposure. Valid ascertainment of outcomes is essential for accurate results. We aim to quantify the validity of diagnostic codes for serious hypocalcemia and dermatologic adverse events from insurance claims data among women with postmenopausal osteoporosis (PMO). We identified potential cases of serious hypocalcemia and dermatologic events through ICD-9 diagnosis codes among women with PMO within claims from a large US healthcare insurer (June 2005-May 2010). A physician adjudicated potential hypocalcemic and dermatologic events identified from the primary position on emergency department (ED) or inpatient claims through medical record review. Positive predictive values (PPVs) and 95% confidence intervals (CIs) quantified the fraction of potential cases that were confirmed. Among 165,729 patients with PMO, medical charts were obtained for 40 of 55 (73%) potential hypocalcemia cases; 16 were confirmed (PPV 40%, 95% CI 25-57%). The PPV was higher for ED than inpatient claims (82 vs. 24%). Among 265 potential dermatologic events (primarily urticaria or rash), we obtained 184 (69%) charts and confirmed 128 (PPV 70%, 95% CI 62-76%). The PPV was higher for ED than inpatient claims (77 vs. 39%). Diagnostic codes for hypocalcemia and dermatologic events may be sufficient to identify events giving rise to emergency care, but are less accurate for identifying events within hospitalizations.

Complex association between body weight and fracture risk in postmenopausal women.

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Mpalaris, V; Anagnostis, P; Goulis, D G; Iakovou, I

2015-03-01

Osteoporosis is a common disease, characterized by low bone mass with micro-architectural disruption and skeletal fragility, resulting in an increased risk of fracture. A substantial number of studies has examined the possible relationship between body weight, bone mineral density and fracture risk in post-menopausal women, with the majority of them concluding that low body weight correlates with increased risk of fracture, especially hip fracture. Controversies about the potential protective effect of obesity on osteoporosis and consequent fracture risk still exist. Several recent studies question the concept that obesity exerts a protective effect against fractures, suggesting that it stands as a risk factor for fractures at specific skeletal sites, such as upper arm. The association between body weight and fracture risk is complex, differs across skeletal sites and body mass index, and is modified by the interaction between body weight and bone mineral density. Some potential explanations that link obesity with increased fracture risk may be the pattern of falls and impaired mobility in obese individuals, comorbidities, such as asthma, diabetes and early menopause, as well as, increased parathyroid hormone and reduced 25-hydroxy-vitamin D concentrations. © 2015 World Obesity.

Evaluation of osteoporosis using conventional radiographic methods and dual energy x-ray absorptiometry

International Nuclear Information System (INIS)

Anburajan, M.

2001-01-01

In India, conventional radiographs play a major part in evaluating osteoporosis since advanced bone densitometers are expensive and not widely available. Our aim in this study was to investigate the usefulness of conventional radiographic methods, viz., clavicle and metacarpal radiogrammetry, quantitative vertebral morphometry, Singh's index, hip geometry compared to a sophisticated method, viz., DXA for studying osteoporosis in south Indian men (n=663) and women (n=741). This study provides data on BMD of the proximal femur in normal south Indian females. In women, aged above 65 years, BMD of femoral neck, trochanter, and Ward's triangle decreased by 0.90%, 0.84%, and 1.66% per annum, respectively. In 45 pre- and post-menopausal women without fractures, total hip BMD correlated significantly ( p 2 =0.47), medial cortical thickness of the femoral shaft (r 2 =0.38) and neck (r 2 =0.29), combined cortical thickness (CCT) and %CCT of the clavicle (r 2 =0.54 each), and the second metacarpal (r 2 =0.51 and r 2 =0.53, respectively). On comparing variables studied for osteoporotic women with corresponding values in the premenopausal group, the average difference in SD from the mean was greatest for clavicle radiogrammetry (-3.7 SD for %CCT of the clavicle). An empirical formula for predicting total hip BMD with good sensitivity was derived from a multiple linear regression equation involving three independent variables, viz., CCT, %CCT of the clavicle (measured from the chest radiograph) and the patient's age. This author's equation, with modified weightings, has 82% sensitivity and 94% specificity and a positive and negative predictive value of 88% and 91% respectively. A chest radiograph in combination with the formula would serve as a readily available, inexpensive tool for assessing post-menopausal osteoporosis, especially in developing countries

Fracture History in Osteoporosis: Risk Factors and its Effect on Quality of Life

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Pınar Kuru

2014-12-01

Full Text Available Background: Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. Aims: The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Study Design: Cross-sectional study. Methods: We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo- 41 questionnaire was also used for evaluating quality of life. Results: The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial. When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Conclusion: Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.

PERFORMANCE OF QUANTITATIVE ULTRASOUND AND SIX OSTEOPOROSIS RISK INDEXES IN MENOPAUSAL WOMEN: VALIDATION AND COMPARATIVE EVALUATION STUDY.

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Imad GHOZLANI

2016-12-01

Full Text Available Background: A number of questionnaire-based systems and the use of portable quantitative ultrasound scanners (QUS have been devised in an attempt to produce a cost-effective method of screening for osteoporosis.Objective: to assess the sensitivity and specificity of different techniques and their ability to act as screening tools in relation to dual energy X-ray absorptiometry (DXA.Methods: 295 white postmenopausal women aged over 60 were enrolled. Each subject completed a standardized questionnaire which permits the measure of six osteoporosis indexes and had bone mineral density (BMD measured using QUS and DXA. Sensitivity and specificity of the different techniques in relation to DXA were plotted as receiver-operating characteristic (ROC curves at DXA T-score total hip ≤ -2.5 (osteoporosis.Results: BUA sensitivity and specificity values were respectively 76.8% and 51.2% at the total hip. The optimal cut-off T-score for QUS was -2 at the total hip. The osteoporosis self-assessment tool (OST provided consistently the highest AUC (0.80 among the clinical tools and had the best sensitivity and specificity balance (90.2%-44.5%. OST negative likelihood ratio was 0.22.Conclusion: OST (based only on the weight and the age performed slightly better than QUS and other risk questionnaires in predicting low BMD at the total hip

Association of Vitamin D Deficiency and Thyroid Function in Postmenopausal Women

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Mitra Niafar

2016-12-01

Full Text Available Pupose: Although there are reports of vitamin D (VitD insufficiency in immune-mediated hypothyroidism, an association between VitD and thyroid-stimulating hormone (TSH levels has yet to be shown. We aim to examine VitD and TSH levels among postmenopausal women, as both conditions are more prevalent in elderly women. Methods: The clinic records of postmenopausal women during their routine maintenance visits were reviewed. All patients were examined for the symptoms related to thyroid function and osteoporosis. Participants were divided into three subgroups according to their TSH levels (below 4.0 mIU/L. Patient characteristics and VitD levels were compared between these subgroups. Multivariate linear regression model was constructed using serum VitD and serum TSH as the dependent variables to identify factors independently associated with these laboratory values. Results: Two-hundred and nighty nine postmenopausal women were included. Average age was 62.2±7.5 years old. VitD was insufficient (10-30 ng/mL in 12.0% and deficient (<10 ng/mL in 60.9% of the participants. In 11.3%, TSH was low and in 7.6% of women, TSH was high, while the remaining 80.1%, had normal TSH levels. Subjects with low TSH had significantly higher VitD concentrations (34.2±29.1 ng/mL compared to the other two groups (P-value: 0.039. In multivariate regression analysis, TSH was not a contributing factor, as age was the only significant predictor of VitD levels. Meanwhile, no predictor (including age and VitD was identified for TSH levels in linear regression analysis. Conclusion: Age was the only independent predictor of serum VitD in this study population. Though suppressed TSH was associated with higher VitD levels, the association was not linear between TSH and VitD in postmenopausal women.

Postmenopausal hormone replacement therapy--clinical implications

DEFF Research Database (Denmark)

Ravn, S H; Rosenberg, J; Bostofte, E

1994-01-01

The menopause is defined as cessation of menstruation, ending the fertile period. The hormonal changes are a decrease in progesterone level, followed by a marked decrease in estrogen production. Symptoms associated with these hormonal changes may advocate for hormonal replacement therapy....... This review is based on the English-language literature on the effect of estrogen therapy and estrogen plus progestin therapy on postmenopausal women. The advantages of hormone replacement therapy are regulation of dysfunctional uterine bleeding, relief of hot flushes, and prevention of atrophic changes...... in the urogenital tract. Women at risk of osteoporosis will benefit from hormone replacement therapy. The treatment should start as soon after menopause as possible and it is possible that it should be maintained for life. The treatment may be supplemented with extra calcium intake, vitamin D, and maybe calcitonin...

Muscular strength measurements indicate bone mineral density loss in postmenopausal women

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Zhou Z

2013-10-01

Full Text Available Zhixiong Zhou,1,2 Lu Zheng,3 Dengyun Wei,4 Ming Ye,3 Xun Li2 1School of Physical Education and Coaching Science, Capital University of Physical Education and Sports, Beijing, People’s Republic of China; 2Graduate School, Beijing Sport University, Beijing, People’s Republic of China; 3School of Kinesiology and Health Education, Capital University of Physical Education and Sports, Beijing, People’s Republic of China; 4Department of Physical Education, Anhui Normal University, Anhui, People’s Republic of China Background: The literature is inconsistent and inconclusive on the relationship between bone mineral density (BMD and muscular strength in postmenopausal women. Objective: To evaluate the relationship between isokinetically and isometrically determined muscle strength and BMD in postmenopausal women of different age groups. Methods: Healthy postmenopausal women (n = 293; mean age, 54.22 ± 3.85 years were enrolled in this study. They were grouped by age according to World Health Organization life expectancy: 45–50 years, 51–53 years, 54–56 years, 57–59 years, and 60–64 years. Total BMD, L2–4 BMD, and femoral neck BMD were measured by dual-energy X-ray bone densitometry; isokinetic and isometric muscle strength of the right hip and trunk muscles were measured during contractile exercise. Stepwise regression analysis was used to examine the relationships between BMD and strength measures, controlling for subject age and years since menopause. Results: Results of stepwise regression showed that hip extensor and flexor strength at 120°/second and back extend strength at 30°/second accounted for 26% total BMD variance among menopausal subjects, 19% L2–4 BMD variance, and 15% femoral neck BMD variance; in postmenopausal women of different age groups, hip extensor and flexor strength at 120°/second and back extend strength at 30°/second accounted for 25%–35% total BMD variance. Conclusion: Different optimal strength

RANKL inhibition with denosumab does not influence 3-year progression of aortic calcification or incidence of adverse cardiovascular events in postmenopausal women with osteoporosis and high cardiovascular risk.

Science.gov (United States)

Samelson, Elizabeth J; Miller, Paul D; Christiansen, Claus; Daizadeh, Nadia S; Grazette, Luanda; Anthony, Mary S; Egbuna, Ogo; Wang, Andrea; Siddhanti, Suresh R; Cheung, Angela M; Franchimont, Nathalie; Kiel, Douglas P

2014-02-01

Atherosclerosis and osteoporosis are chronic diseases that progress with age, and studies suggest aortic calcification, an indicator of atherosclerosis, is inversely associated with bone mineral density (BMD). The osteoprotegerin (OPG)/receptor activator of NF-κB (RANK)/RANK ligand (RANKL) system has been proposed as a shared regulatory system for bone and vasculature. Denosumab (DMAb), a monoclonal antibody against RANKL, improved BMD and reduced fracture risk in the Fracture Reduction Evaluation of Denosumab in Osteoporosis Every 6 Months (FREEDOM) trial. We evaluated whether or not treatment with DMAb influenced progression of aortic calcification (AC) and incidence of cardiovascular (CV) adverse events. We included 2363 postmenopausal women with osteoporosis (1142 placebo, 1221 DMAb), selected from 7808 participants in the FREEDOM trial (3906 placebo, 3902 DMAb), at high risk of CV events according to modified Raloxifene Use for the Heart (RUTH) criteria. CV adverse events were reported by participants. AC scores were assessed using a semiquantitative method from lateral spine X-rays. Change in AC score from baseline to 12 (n = 1377), 24 (n = 1231), and 36 months (n = 1045) was calculated as AC score at follow-up minus AC score at baseline. AC progression was defined as change in AC score >0. Baseline characteristics, CV risk factors, and AC scores were similar between treatment groups. Mean age of participants was 74 years (range, 60-90), 88% were white, and 77% had AC score >0 at baseline. Frequency of AC progression over 3 years did not differ between women in placebo (22%) and DMAb (22%) groups (p = 0.98). AC progression did not differ between treatment groups when analyzed by baseline estimated glomerular filtration rate or by baseline AC scores. Frequency of CV adverse events did not differ between placebo (40%) and DMAb (38%) groups (p = 0.26). In conclusion, DMAb treatment had no effect on progression of AC or incidence of CV

Secondary osteoporosis.

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Gennari, C; Martini, G; Nuti, R

1998-06-01

Generalized osteoporosis currently represents a heterogeneous group of conditions with many different causes and pathogenetic mechanisms, that often are variably associated. The term "secondary" is applied to all patients with osteoporosis in whom the identifiable causal factors are other than menopause and aging. In this heterogeneous group of conditions, produced by many different pathogenetic mechanisms, a negative bone balance may be variably associated with low, normal or increased bone remodeling states. A consistent group of secondary osteoporosis is related to endocrinological or iatrogenic causes. Exogenous hypercortisolism may be considered an important risk factor for secondary osteoporosis in the community, and probably glucocorticoid-induced osteoporosis is the most common type of secondary osteoporosis. Supraphysiological doses of corticosteroids cause two abnormalities in bone metabolism: a relative increase in bone resorption, and a relative reduction in bone formation. Bone loss, mostly of trabecular bone, with its resultant fractures is the most incapacitating consequence of osteoporosis. The estimated incidence of fractures in patients prescribed corticosteroid is 30% to 50%. Osteoporosis is considered one of the potentially serious side effects of heparin therapy. The occurrence of heparin-induced osteoporosis appeared to be strictly related to the length of treatment (over 4-5 months), and the dosage (15,000 U or more daily), but the pathogenesis is poorly understood. It has been suggested that heparin could cause an increase in bone resorption by increasing the number of differentiated osteoclasts, and by enhancing the activity of individual osteoclasts. Hyperthyroidism is frequently associated with loss of trabecular and cortical bone; the enhanced bone turnover that develops in thyrotoxicosis is characterized by an increase in the number of osteoclasts and resorption sites, and an increase in the ratio of resorptive to formative bone

Relation of bone mineral density with homocysteine and cathepsin K levels in postmenopausal women

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Madhukar Mittal

2018-01-01

Full Text Available Background: Homocysteine (HCY interferes with collagen cross-linking in bones and stimulates osteoclast activity. The activated osteoclasts secrete cathepsin K (CathK, a cysteine protease, in eminent quantity during bone resorption. Hyperhomocysteinemia may effect bone mineral density (BMD through CathK. We, therefore, examined the relation between HCY and BMD along with CathK, 25-hydroxyvit-D (25[OH]D, intact parathyroid hormone (iPTH, and Vitamin B12. Materials and Methods: We recruited a total of 93 postmenopausal women between the age group of 45–60 years, attending the Endocrinology outpatient department at King George's Medical University, Lucknow. BMD was done by DXA scan using Hologic QDR1000 system. Based on the WHO criteria, patients were segregated into three groups as follows; normal bone mass, osteopenia, and osteoporosis. All women underwent routine biochemical laboratory parameters, HCY, Vitamin B12, and CathK levels. Results: Among 93 postmenopausal women, 56% (52 had osteoporosis. Nineteen percent (18 had normal BMD (mean age, 53.22 ± 8.5 years and 23 (25% had osteopenia (mean age 52.86 ± 6.67 years. The mean age in the osteoporetic group was 56.2 ± 6.9 years. The median (interquartile range levels of HCY in the three groups were 14.5 μmol/L (12.2–24.7, 15.05 μmol/L (12.1–19.9 and 13.2 μmol/L (10.3–17.0, respectively. CathK levels were similar in three groups 7.6 ng/ml (7.0–80.5, 8.3 ng/ml (7.3–8.5, and 8.6 ng/ml (7.2–8.9. Both HCY and CathK were found positively associated with serum phosphorus (r = 0.584, P < 2.01 and r = 0.249, P < 0.05, respectively. Levels of HCY positively correlate with PTH (r = 0.303, P < 0.01 and inversely with Vitamin B12 (r = −0.248, P < 0.05. No significant association was seen between CathK level and 25(OH D, iPTH, serum calcium. Conclusion: Low bone mass by DXA is a significant problem in postmenopausal females. HCY and CathK do not reliably correlate with bone loss in

Evaluation of periodontal condition of menopause women with osteoporosis and osteopenia and comparison with control group

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Khorsand A.

2006-08-01

Full Text Available Background and Aim: Several risk factors directly affect the development of periodontal diseases. Also some systemic diseases act indirectly as predisposing and aggrevating factors. Osteoporosis is one of these factors and one of its main causes is lack of physical activity in postmenopause period. The incidence of osteoporosis is increasing in our country. The goal of this study was to evaluate the periodontal condition of women with osteoporosis and osteopenia referred to bone densitometric division of Loghman hospital in 2003 and compare to control group. Materials and Methods: In this case control study based on BMD (Bone Mineral Density measurement of back and thigh using DEXA method, 60 patients referred to bone densitometric division of Loghman hospital, were randomly selected. Cases were divided into three groups, 20 with osteoporosis, 20 with osteopenia and 20 normal cases. Periodontal indices consisting of plaque index (PI, tooth loss (TL, gingival recession (GR, probing pocket depth (PPD and papilla bleeding index (PBI were evaluated by clinical and radiographic examination. Data were analyzed by Kruskall Wallis and Dunn tests with p<0.05 as the limit of significance. Results: PBI, PI and TL were significantly higher in osteoporotic group than osteopenic and normal group. PPD was not different in the three groups. Due to the low prevalence of recession in our study, this parameter was not included in the statistical analysis. Conclusion: It seems that osteoporosis does not increase the incidence of periodontal diseases because it affects bone quality rather than quantity. In osteoporosis calcium deficiency and increasing age lead to decreased physical activity and ultimately affect the patient's oral hygiene performance. Thus, periodontal manifestations are presented as gingival bleeding and gingivitis.

When, where and how osteoporosis-associated fractures occur: an analysis from the Global Longitudinal Study of Osteoporosis in Women (GLOW.

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Aline G Costa

Full Text Available To examine when, where and how fractures occur in postmenopausal women.We analyzed data from the Global Longitudinal Study of Osteoporosis in Women (GLOW, including women aged ≥55 years from the United States of America, Canada, Australia and seven European countries. Women completed questionnaires including fracture data at baseline and years 1, 2 and 3.Among 60,393 postmenopausal women, 4122 incident fractures were reported (86% non-hip, non-vertebral [NHNV], 8% presumably clinical vertebral and 6% hip. Hip fractures were more likely to occur in spring, with little seasonal variation for NHNV or spine fractures. Hip fractures occurred equally inside or outside the home, whereas 65% of NHNV fractures occurred outside and 61% of vertebral fractures occurred inside the home. Falls preceded 68-86% of NHNV and 68-83% of hip fractures among women aged ≤64 to ≥85 years, increasing with age. About 45% of vertebral fractures were associated with falls in all age groups except those ≥85 years, when only 24% occurred after falling.In this multi-national cohort, fractures occurred throughout the year, with only hip fracture having a seasonal variation, with a higher proportion in spring. Hip fractures occurred equally within and outside the home, spine fractures more often in the home, and NHNV fractures outside the home. Falls were a proximate cause of most hip and NHNV fractures. Postmenopausal women at risk for fracture need counseling about reducing potentially modifiable fracture risk factors, particularly falls both inside and outside the home and during all seasons of the year.

The relationship of total body composition with bone mineral density in postmenopausal women with type 2 diabetes

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Vadim Valer'evich Klimontov

2015-03-01

Full Text Available Aim. To determine the relationship between bone mineral density (BMD and total body composition in postmenopausal women with type 2 diabetes. Materials and Methods. The study included 78 women, from 50 to 70 years of age (median 63 years. Twenty women had normal body mass index (BMI, 29 ones were overweight and 29 had obesity. The body composition and BMD was studied by dual-energy X-ray absorptiometry. Results. Women with normal BMD had higher BMI, total and truncal fat mass, as well lean mass as compared to women with osteoporosis and osteopenia (all p

Clinical and therapeutic aspects of osteoporosis

Energy Technology Data Exchange (ETDEWEB)

Compston, Juliet [University of Cambridge School of Clinical Medicine, Box 157, Department of Medicine, Addenbrookes Hospital, Hills Road, Cambridge CB2 2QQ (United Kingdom)], E-mail: jec1001@cam.ac.uk

2009-09-15

Osteoporosis is characterized by reduced bone mass and alteration in bone architecture, resulting in increased fracture risk. These fractures are a major cause of morbidity and mortality in the elderly and impose a huge economic burden on health services. Oestrogen deficiency plays a major role in the pathogenesis of bone loss and fracture in both women and men. Other pathogenetic factors include reduced physical activity and vitamin D insufficiency. A range of options is available for the prevention of fractures in high risk postmenopausal women. These include the bisphosphonates, strontium ranelate, raloxifene and parathyroid hormone peptides. Because of their broad spectrum of demonstrated anti-fracture efficacy, alendronate, risedronate, zoledronate and strontium ranelate are generally considered as front-line options for most women. The optimum duration of treatment has not been established but re-evaluation of risk and the need for continued therapy after 5 years of treatment may be appropriate. Compliance and persistence with long-term treatment is poor but may be improved by less frequent dosing regimens.

Clinical and therapeutic aspects of osteoporosis

International Nuclear Information System (INIS)

Compston, Juliet

2009-01-01

Osteoporosis is characterized by reduced bone mass and alteration in bone architecture, resulting in increased fracture risk. These fractures are a major cause of morbidity and mortality in the elderly and impose a huge economic burden on health services. Oestrogen deficiency plays a major role in the pathogenesis of bone loss and fracture in both women and men. Other pathogenetic factors include reduced physical activity and vitamin D insufficiency. A range of options is available for the prevention of fractures in high risk postmenopausal women. These include the bisphosphonates, strontium ranelate, raloxifene and parathyroid hormone peptides. Because of their broad spectrum of demonstrated anti-fracture efficacy, alendronate, risedronate, zoledronate and strontium ranelate are generally considered as front-line options for most women. The optimum duration of treatment has not been established but re-evaluation of risk and the need for continued therapy after 5 years of treatment may be appropriate. Compliance and persistence with long-term treatment is poor but may be improved by less frequent dosing regimens.

Challenges in the management of osteoporosis and vitamin D deficiency in HIV infection.

Science.gov (United States)

Brown, Todd T

2013-01-01

Until 2013, the National Osteoporosis Foundation guidelines did not include HIV infection and highly active antiretroviral therapy as osteoporosis risk factors that should trigger dual-energy x-ray absorptiometry (DEXA) screening for low bone mineral density (BMD) in older adults, but numerous data indicate that individuals with HIV infection are at early and increased risk for osteoporosis and fracture. For this reason, experts support the use of DEXA screening for HIV-infected postmenopausal women and men older than 50 years. Factors contributing to increased risk of low BMD in individuals with HIV infection include inflammation, effects of antiretroviral therapy, and numerous patient risk factors, including vitamin D deficiency. Workup for low BMD should include assessment for fracture risk and secondary causes of low BMD, including vitamin D deficiency, hyperparathyroidism, subclinical hyperthyroidism, hypogonadism, and phosphate wasting. Bisphosphonates are the preferred treatment to prevent fracture in low BMD but are not appropriate for treating osteomalacia, which is characterized by vitamin D deficiency and phosphate wasting. This article summarizes a presentation by Todd T. Brown, MD, PhD, at the IAS-USA continuing education program held in Atlanta, Georgia, in April 2013.

Influence of gastrointestinal events on treatment of osteoporosis in Asia-Pacific women: Perspectives from physicians in the MUSIC OS-AP study.

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Modi, A; Ebeling, P R; Lee, M S; Min, Y K; Mithal, A; Yang, X; Baidya, S; Sen, S; Sajjan, S

2017-12-01

The objectives of the physician survey component of the MUSIC OS-AP study were to describe physicians' approaches to treatment of women with postmenopausal osteoporosis and to understand the influence of gastrointestinal (GI) events on treatment in clinical practice. Physicians were recruited from 5 Asia-Pacific countries. Questionnaires collected information about physicians' standard practices for treatment of patients with osteoporosis, as well as their perspectives on the influence of GI events on osteoporosis treatment approaches. A total of 59 physicians participated in the study. The most frequently prescribed or recommended treatments were vitamin D (84% of patients), calcium (82%), and oral bisphosphonates (59%). When choosing a medication for treatment-naïve patients, GI sensitivity was often or always a factor for 79% of physicians. Among physicians not prescribing pharmacologic treatment, a mean of 18% of non-prescriptions were due to GI sensitivity. For patients with pre-existing GI conditions, physicians most frequently ranked use of non-oral osteoporosis medication as the first treatment strategy (47%), followed by co-prescription with a proton pump inhibitor or other gastro-protective agent (31%). For patients developing GI symptoms after starting pharmacologic treatment, the most frequently first-ranked management strategy was to check if patients were taking their osteoporosis medication correctly as prescribed (64%), followed by temporary discontinuation of the medication (i.e., a drug holiday) until GI events have resolved (31%) and co-prescription with a proton pump inhibitor or other gastroprotective agent (24%). These results suggest that GI events influence the prescribing practices of physicians in the Asia-Pacific region and sometimes result in non-treatment of women with osteoporosis.

Bilateral femoral neck fractures resulting from pregnancy-associated osteoporosis showed bone marrow edema on magnetic resonance imaging.

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Kasahara, Kyoko; Kita, Nobuyuki; Kawasaki, Taku; Morisaki, Shinsuke; Yomo, Hiroko; Murakami, Takashi

2017-06-01

Femoral neck fractures resulting from pregnancy-associated osteoporosis is a rare condition. Herein, we report an undoubted case of pregnancy-associated osteoporosis in a 38-year-old primiparous patient with pre-existing anorexia nervosa who suffered bilateral femoral neck fractures in the third trimester and early post-partum period. Magnetic resonance imaging revealed femoral neck fractures as well as diffuse marrow edema involving both femoral heads, which are considered under ordinary circumstances as characteristic imaging findings of transient osteoporosis of the hip. Based on our experience, we propose that pregnancy-associated osteoporosis might be present in femoral neck fractures attributed to transient osteoporosis of the hip in pregnancy. Conversely, bone status should be carefully and accurately estimated in cases of potential transient osteoporosis of the hip in pregnancy to reduce future fracture risk. © 2017 The Authors Journal of Obstetrics and Gynaecology Research published by John Wiley & Sons Australia, Ltd on behalf of Japan Society of Obstetrics and Gynecology.

Public priorities for osteoporosis and fracture research: results from a general population survey.

Science.gov (United States)

Paskins, Zoe; Jinks, Clare; Mahmood, Waheed; Jayakumar, Prakash; Sangan, Caroline B; Belcher, John; Gwilym, Stephen

2017-12-01

This is the first national study of public and patient research priorities in osteoporosis and fracture. We have identified new research areas of importance to members of the public, particularly 'access to information from health professionals'. The findings are being incorporated into the research strategy of the National Osteoporosis Society. This study aimed to prioritise, with patients and public members, research topics for the osteoporosis research agenda. An e-survey to identify topics for research was co-designed with patient representatives. A link to the e-survey was disseminated to supporters of the UK National Osteoporosis Society (NOS) in a monthly e-newsletter. Responders were asked to indicate their top priority for research across four topics (understanding and preventing osteoporosis, living with osteoporosis, treating osteoporosis and treating fractures) and their top three items within each topic. Descriptive statistics were used to describe demographics and item ranking. A latent class analysis was applied to identify a substantive number of clusters with different combinations of binary responses. One thousand one hundred eighty-eight (7.4%) respondents completed the e-survey. The top three items overall were 'Having easy access to advice and information from health professionals' (63.8%), 'Understanding further the safety and benefit of osteoporosis drug treatments' (49.9%) and 'Identifying the condition early by screening' (49.2%). Latent class analysis revealed distinct clusters of responses within each topic including primary care management and self-management. Those without a history of prior fracture or aged under 70 were more likely to rate items within the cluster of self-management as important (21.0 vs 12.9 and 19.8 vs 13.3%, respectively). This is the first study of public research priorities in osteoporosis and has identified new research areas of importance to members of the public including access to information. The findings

Physical Activity, Bone Health, and Obesity in Peri-/Pre- and Postmenopausal Women: Results from the EPIC-Potsdam Study.

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Menzel, Juliane; di Giuseppe, Romina; Wientzek, Angelika; Kroke, Anja; Boeing, Heiner; Weikert, Cornelia

2015-10-01

Physical activity (PA) is suggested to increase the peak bone mass and to minimize age-related bone loss, and thereby to reduce the risk of osteoporosis. However, the relation between PA and bone health considering the obesity status is unclear so far. The present study examines the association between PA levels and calcaneal broadband ultrasound attenuation (BUA), particularly under consideration of obesity. Data from a population-based sample of 6776 German women from the EPIC-Potsdam cohort were analyzed. Calibrated PA data were used. Statistical analyses were stratified by menopausal and obesity status. Multiple linear regression was used to model the relationship between PA and BUA levels after adjustment for age, body mass index (BMI), smoking status, education, alcohol and calcium intake, and hormone use. Peri-/premenopausal had higher BUA levels (112.39 ± 10.05 dB/MHz) compared to postmenopausal women (106.44 ± 9.95 dB/MHz). In both groups, BUA levels were higher in the fourth compared to the lowest quartile of PA (p for trend obesity, a significant positive relationship was also observed in women with BMI < 30 kg/m(2) but with higher waist circumference or BF%. In conclusion, our results strengthen the hypothesis that PA has a positive influence on BUA levels, though dependent on weight.

Studies of osteoporosis in Croatia using isotope related techniques

International Nuclear Information System (INIS)

Dekanic, D.; Cvijetic, S.; Bolanca, S.; Blanusa, M.; Prester, L.; Korsic, M.

1998-01-01

) and a combined treatment (group B) with nandrolone-decanoate (50 mg once a month for three months in every other etidronate cycle) and etidronate (given in the same manner as in group A), was compared in postmenopausal women with spinal osteopenia or osteoporosis and no history of vertebral fractures. In an open study 43 women, randomly assigned to the treatment groups A or B, were treated for one year, and 16 women for two years. Bone mineral density was measured by dual energy X-ray absorptiometry in the lumbar spine and femoral neck at the beginning of the study and at yearly intervals thereafter. The results showed that combined intermittent cyclical regimen of etidronate and nandrolone-decanoate has not proven to be superior to the intermittent cyclical regimen of etidronate alone. (author)

Alendronate sodium hydrate (oral jelly for the treatment of osteoporosis: review of a novel, easy to swallow formulation

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Imai K

2013-06-01

Full Text Available Kazuhiro Imai Department of Life Sciences, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan Abstract: Osteoporosis is a skeletal disorder characterized by loss of bone mass, decreased bone strength, and an increased risk of bone fracture. The disease progresses with age, especially in postmenopausal women. Japan is one of the most rapidly aging societies worldwide. Japanese individuals over 65 years of age constituted 23.0% of the population in 2010 and 25.1% to 25.2% as of 2013. The estimated number of people with osteoporosis in Japan is currently 13 million. Bisphosphonates increase bone mineral density by inhibiting osteoclast-mediated bone resorption, thereby reducing the risk of fractures. Alendronate sodium hydrate (alendronate is a bisphosphonate that potently inhibits bone resorption and is used to treat osteoporosis. Sufficient water is required to take an alendronate oral tablet; insufficient water could result in digestive system diseases, such as esophageal ulceration. Elderly patients with swallowing difficulty may choke on the tablet. Taking a tablet with oral jelly is a method to prevent digestive system disease and reduce the choking hazard. Once-weekly alendronate oral jelly was approved in 2012 by the Ministry of Health, Labour, and Welfare of Japan as the world's first drug for osteoporosis in a jelly formulation. It consists of a jelly portion and an air portion. The jelly formulation is smoothly discharged by pushing the air portion. Therefore, elderly patients with physical disabilities are able to easily take all of the jelly formulation from the package. In this review, this new formulation of alendronate sodium hydrate (oral jelly is introduced and discussed in terms of osteoporosis treatment. This new formulation provides an alternative so that patients may select a method of dosing tailored to their preferences. Management of osteoporosis involves assessing fracture risk and preventing

Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se?

DEFF Research Database (Denmark)

Bagger, Y Z; Rasmussen, Henrik Berg; Alexandersen, P

2007-01-01

Epidemiological observations suggest links between osteoporosis and risk of acute cardiovascular events and vice versa. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. We investigated whether serum lipids...

The relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous poliomyelitis.

Science.gov (United States)

Chang, Kwang-Hwa; Tseng, Sung-Hui; Lin, Yu-Ching; Lai, Chien-Hung; Hsiao, Wen-Tien; Chen, Shih-Ching

2015-04-01

Articles in the literature describing the association between body composition and osteoporosis in subjects with poliomyelitis are scarce. To assess the relationship between body composition and femoral neck osteoporosis or osteopenia in adults with previous polio. After excluding postmenopausal women, 44 polio (mean age ± standard deviation, 46.1 ± 3.3 years) and 44 able-bodied control volunteers (47.0 ± 4.0 years) participated in the study. Each participant's femoral neck bone mineral density (FNBMD) and whole body composition were measured using dual-energy X-ray absorptiometry. With local reference BMD values of normal young adults installed in the instrument, we obtained T-score values that depended on each FNBMD value. A T-score value of ≤-1.0 indicated decreased T-score, including osteoporosis (T-score ≤ -2.5) and osteopenia (-1.0 to -2.5). This study conducted logistic regression analyses to find factors associated with osteoporosis and osteopenia. Based on the FNBMD T-score values, 60.0% of middle-aged men with polio had osteoporosis. In adjusted logistic regression analyses, total lean tissue mass (Adjusted odds ratio [95% confidence interval], 0.74 [0.56-0.99], P < 0.05) and male gender (947.16 [6.02-148,926.16], P < 0.01) were important factors associated with decreased T-score in polio group. Osteoporosis or osteopenia is a common medical problem for middle-aged men with polio. Reduced total lean tissue mass seems to be one of the important factors associated with osteoporosis or osteopenia among subjects with polio. Further research for a clinical tool to assess lean tissue mass for subjects with polio is needed. Copyright © 2015 Elsevier Inc. All rights reserved.

Relationship between metabolic syndrome and its components with bone densitometry in postmenopausal women.

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Abbasi, Mahnaz; Farzam, Seyed Amir; Mamaghani, Zahra; Yazdi, Zohreh

2017-11-01

Prevention of osteoporosis and bone fracture and the relationship between metabolic syndrome and bone density are controversial issues. The aim of this study was to evaluate the association between metabolic syndrome and its components with bone mineral density in post menopausal women referred for bone mineral density (BMD) test. A total of 143 postmenopausal women with at least one year of menopause experience participated in this cross-sectional study. Demographic and anthropometric characteristics for all participants were collected. Also, biochemical parameters including fasting blood sugar, Cholesterol (HDL and LDL), triglyceride were measured. Association between the components of metabolic syndrome and bone densitometry were analyzed by statistical methods. In this study, 72% of participants did not have metabolic syndrome. Among them, 43.4% and 28.7% had osteoporosis and normal density, respectively. Of remaining participants with metabolic syndrome, 12.6% and 15.4% had osteoporosis and normal density, respectively. Among the metabolic syndrome components, waist circumference, HDL cholesterol, and waist to hip ratio were significantly associated with bone mass (Pmetabolic syndrome did not have significant differences than women without metabolic syndrome in terms of lumbar and femoral neck density (P>0.05). Results from this study showed that metabolic syndrome and its components did not induce bone mass loss. The discrepancies of the studies in this area call for more large scale studies in population so as to prevent women problems in this area. Copyright © 2016 Diabetes India. Published by Elsevier Ltd. All rights reserved.

Osteoporosis – a current view of pharmacological prevention and treatment

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Das S

2013-05-01

Full Text Available Subhajit Das, Julie C Crockett Musculoskeletal Research Programme, School of Medicine and Dentistry, University of Aberdeen, Aberdeen, UK Abstract: Postmenopausal osteoporosis is the most common bone disease, associated with low bone mineral density (BMD and pathological fractures which lead to significant morbidity. It is defined clinically by a BMD of 2.5 standard deviations or more below the young female adult mean (T-score = −2.5. Osteoporosis was a huge global problem both socially and economically – in the UK alone, in 2011 £6 million per day was spent on treatment and social care of the 230,000 osteoporotic fracture patients – and therefore viable preventative and therapeutic approaches are key to managing this problem within the aging population of today. One of the main issues surrounding the potential of osteoporosis management is diagnosing patients at risk before they develop a fracture. We discuss the current and future possibilities for identifying susceptible patients, from fracture risk assessment to shape modeling and in relation to the high heritability of osteoporosis now that a plethora of genes have been associated with low BMD and osteoporotic fracture. This review highlights the current therapeutics in clinical use (including bisphosphonates, anti-RANKL [receptor activator of NF-κB ligand], intermittent low dose parathyroid hormone, and strontium ranelate and some of those in development (anti-sclerostin antibodies and cathepsin K inhibitors. By highlighting the intimate relationship between the activities of bone forming (osteoblasts and bone-resorbing (osteoclasts cells, we include an overview and comparison of the molecular mechanisms exploited in each therapy. Keywords: BMD, fracture, bisphosphonate, strontium, denosumab, teriparatide, raloxifene

Usefulness of quantitative computed tomography for measurement of vertebral bone mineral density in osteoporosis

International Nuclear Information System (INIS)

Shaura, Kozo

1986-01-01

The present studies were undertaken to elucidate the usefullnes of the qantitative computed tomography in mesurement of bone densites of lumbar spine in senile and postmenopausal osteoporosis. The CT-numbers of the spongiosum of the second lumbar spine and K2HPO4 solusion phantom were mesured in the same series scanning, and the bone densities were displayed as concentrations of K2HPO4 solution (QCT-value). The QCT-values are well related with the bone densities which were mesured with single photon absorptiometor (Norland-Cameron) at one third and one sixth distal ends of radiuses. The QCT-values decrease with aging, and the decrement in female is more remarkable than that in male. The decrement of QCT-value starts at in 3rd decade of their life time. It is defferent from the conclusions those were obtained with the measurement of clavicular cortex index, or single photon absorptiometor. The QCT-values of the patients with lumbargo are lower than those of the patients without lumbargo. The QCT-values of the patients without compression fructure in lumbar spine are higher than those of the patients with compression fructure, but the number of the sites of compression fructures in lumbar spine appears to have no effect on the QCT-values. The QCT-values of postmenopausal osteoporosis were improved by the administration of calcium and 1α-OHVit. D3 (0.5 μg/day. for a year). (author)

Evaluation Of Hormone Profile And Dexa Values in Premenopausal, Perimenopausal and Postmenopausal Women

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Esra Esen

2005-09-01

Full Text Available This study was carried out in 130 women, between 44-55 ages, admitted to outpatient clinic of Physical Medicine and Rehabilitation Department of Trakya University Medical Faculty in order to make. comparison of hormone profile and DEXA values of premenopausal, perimenopausal, and postmenopausal women . Three groups were allocated according to climacteric symptoms and menopause condition. Premenopausal group consisted of women who had regular menstruation and did not have any climacteric symptoms , perimenopausal group consisted of women who had menstruation disorder and climacteric symptoms within one year and postmenopausal group consisted of women who had last menstruation within more than one year and less than 5 years. Women who had prior osteoporosis diognosis and treatment, hormone replacement therapy, surgical menopause and menopause duration more than 5 years were excluded from the study. Age, body weight ,height, hormone profile including estradiol (E2, progesterone (P, follicule stimulating hormone (FSH, luteinizing hormone (LH, parathyroid hormone (PTH, thyroid hormones (T3, T4, thyroid stimulating hormone (TSH and DEXA values representing bone mineral density (BMD of both groups were evaluated. In peri and postmenopausal groups, E2, P, FSH and LH values were significantly lower, while there was no significant difference for PTH and thyroid hormone levels comparing to premenopausal group. For DEXA values, T scores of L2-L4, L2, L3, L4, femur neck, trochanter, Wards and Z scores of femur neck, Wards area were significantly lower in peri and postmenopausal groups. It was demonstrated paralel to literature that BMD decreased in peri and early postmenopausal women associated with hormone profile changes, mainly lower E2.

Impact of degenerative radiographic abnormalities and vertebral fractures on spinal bone density of women with osteoporosis

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Lúcia Costa Paiva

2002-01-01

Full Text Available CONTEXT: Measurements of bone density taken by dual-energy x-ray absorptiometry are the most accurate procedure for the diagnosis of osteoporosis. This procedure has the disadvantage of measuring the density of all mineral components, including osteophytes, vascular and extra vertebral calcifications. These alterations can influence bone density results and densitometry interpretation. OBJECTIVE: To correlate radiography and densitometry findings from women with osteoporosis, analyzing the influence of degenerative processes and vertebral fractures on the evaluation of bone density. DESIGN: Retrospective study. SETTING: Osteoporosis outpatients' clinic at Hospital das Clínicas, Universidade Estadual de Campinas. PARTICIPANTS: Ninety-six postmenopausal women presenting osteoporosis diagnosed by bone density. MAIN MEASUREMENTS: Bone mineral density of the lumbar spine and femoral neck were measured by the technique of dual-energy x-ray absorptiometry, using a LUNAR-DPX densitometer. Fractures, osteophytes and aortic calcifications were evaluated by simple x-rays of the thoracic and lumbar spine. RESULTS: The x-rays confirmed vertebral fractures in 41.6%, osteophytes in 33.3% and calcifications of the aorta in 30.2%. The prevalence of fractures and aortic calcifications increased with age. The mean bone mineral density was 0.783g/cm² and the mean T-score was --3.47 DP. Neither fractures nor aortic calcifications had significant influence on bone mineral density (P = 0.36 and P = 0.09, respectively, despite the fractured vertebrae having greater bone mineral density (P < 0.02. Patients with lumbar spine osteophytes showed greater bone mineral density (P = 0.04. Osteophytosis was associated with lumbar spine bone mineral density after adjustment for fractures and aortic calcifications by multiple regression (P = 0.01. CONCLUSION: Osteophytes and lumbar spine fractures can overestimate bone density interpretation. The interpretation of densitometry

The effect of serum vitamin D level and bone mineral density on balance and the risk of falling in postmenopausal women

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Ayşegül Küçükali Türkyılmaz

2013-01-01

Full Text Available Objective: The aim of this study was to investigate the effect of bone mineral density and vitamin D level on the risk of falling and balance in postmenopausal women.Methods: The age ranged from 44 to 67 (57.25±7.27 years, 133 postmenopausal women were enrolled. Age, height, weight, socio-demographic information, history of falling and fracture in last year, risk factors for osteoporosis, and menopause duration were recorded. Serum 25OHD3 level and bone mineral density (BMD of participants were measured. Postural balance function and the risk of falling were evaluated by time-up and go test (TUG, and Berg balance scale (BBS. Patients were divided into 4 groups; group 1: low vitamin D and osteoporosis, group 2: only low vitamin D, group 3: only osteoporotic, group 4: normal. Results: There was significant difference between the groups according to TUG (p<0.001. There were significant differences between group 1 and 2, group 1 and 4, group 3 and 4 (each, p= 0.001. There was significant difference between the groups according to BBS (p<0.001. Significant differences were found between group 1 and 2, group 1 and 4, group 2 (each, p<0.001 and 3 (p= 0.002, group 3 and 4 (p<0.001. There were negative correlations between TUG, L1-L4 and femoral neck BMD (r=-0.488, p<0.001 and r =-0.462, p<0.001, respectively. There were positive correlations between BBS, L1-L4 and femoral neck BMD (r=-0.488, p<0.001 and r=-0.462, p<0.001, respectively. Conclusion: We concluded that whereas vitamin D level had no effect on balance and the risk of falling, whereas osteoporosis had effects both on balance and risk of falling. Key words: Vitamin D, bone mineral density, balance, risk of falling

Insulin-like growth factors I and II in healthy women with and without established osteoporosis

DEFF Research Database (Denmark)

Ravn, Pernille; Spencer, E M; Christiansen, C

1995-01-01

-controlled treatment with continuous estrogen/progestogen, anabolic steroids, salmon calcitonin or placebo and the IGFs were measured every 6 months. Women less than 35 years of age had 29% higher levels of IGF-I (p ....05) was seen in the nandrolone decanoate-treated group. The same tendency was seen for hormone replacement therapy, although it was not significant. In conclusion, the serum level of IGF-I is high in young women, when peak bone mass is attained, and low in postmenopausal women with established osteoporosis....

P2X7 receptor regulates osteoclast function and bone loss in a mouse model of osteoporosis

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Wang, Ning; Agrawal, Ankita; Jørgensen, Niklas Rye

2018-01-01

Post-menopausal osteoporosis is a condition that affects millions worldwide and places a huge socio-economic burden on society. Previous research has shown an association of loss of function SNPs in the gene for the purinergic receptor P2X7R with low bone mineral density, increased rates of bone...... loss and vertebral fractures in post-menopausal women. In this study we use a mouse model of oestrogen deficiency-induced bone loss and the BALB/cJ P2X7R-/- to show that absence of the P2X7R resulted in increased bone loss. Osteoclast precursors were isolated from both BALB/cJ P2X7R-/- and BALB/cJ P2X7......R+/+ mice and then cultured in vitro to form mature resorbing osteoclasts. The BALB/cJ P2X7R-/- derived precursors generated slightly more osteoclasts but with a significant reduction in the amount of resorption per osteoclast. Furthermore, when using modified culture conditions osteoclast activity...

Ten-year prediction of osteoporosis from baseline bone mineral density: development of prognostic thresholds in healthy postmenopausal women. The Danish Osteoporosis Prevention Study

DEFF Research Database (Denmark)

Abrahamsen, Bo; Rejnmark, Lars; Nielsen, Stig Pors

2006-01-01

Osteopenia is common in healthy women examined in the first year or two following menopause. Short-term fracture risk is low, but we lack algorithms to assess long-term risk of osteoporosis. Because bone loss proceeds at only a few percent per year, we speculated that baseline bone mineral density....... We analyzed dual energy X-ray absorptometry (DXA) of the lumbar spine (LS) and femoral neck (FN) from 872 women, who participated in the non-HRT arms of the Danish Osteoporosis Prevention Study and had remained on no HRT, bisphosphonates or raloxifene since inclusion 10 years ago. We defined...... development of a T -score below -2.5 at the LS and/or FN or incident fracture as end-point, and we derived prognostic thresholds for baseline BMD, defining 90% NPV (negative predictive value) and 90% sensitivity, respectively. Seventy-six percent of the variation in BMD of the LS at 10 years was predicted...

Relationship between parity and bone mass in postmenopausal women according to number of parities and age.

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Heidari, Behzad; Heidari, Parnaz; Nourooddini, Haj Ghorban; Hajian-Tilaki, Karim Ollah

2013-01-01

To investigate the impact of multiple pregnancies on postmenopausal bone mineral density (BMD). BMD at the femoral neck (FN) and lumbar spine (LS) was measured by dual energy X-ray absorptiometry (DXA) method. Diagnosis of osteoporosis (OP) was confirmed by World Health Organization criteria. Women were stratified according to number of parity as 7 parity groups as well as in age groups of or = 65 years. BMD values and frequency of OP were compared across the groups according to age. Multiple logistic regression analysis with calculation of adjusted odds ratio (OR) was used for association. A total of 264 women with mean age of 63 +/- 8.7 and mean menopausal duration of 15.8 +/- 10.2 years were studied. LS-OP and FN-OP were observed in 28% and 58.3% of women, respectively. There were significant differences in BMD values across different parity groups at both sites of LS and FN (p = 0.011 and p = 0.036, respectively). Parity 4-7 (vs. 7 significantly decreased LS-BMD and FN-BMD as compared with 0-7 parity (p = 0.006 and p = 0.009, respectively). Parity > 7 increased the risk of LS-OP by OR = 1.81 (95% CI 1.03-3.1, p = 0.037) and FN-OP by OR = 1.67 (95% CI 0.97-2.8, p = 0.063). In addition, women with high parity had lower BMD decline at LS and FN by age (> or = 65 vs. 7 is associated with spinal trabecular bone loss in younger postmenopausal women as well as an osteoprotective effect against age-related bone loss, which counteracts the early negative effect. Therefore, parity should not be considered as a risk factor for postmenopausal osteoporosis.

Inhibitory effects on bone resorption in postmenopausal osteoporosis model mice by delivery of serum calcium decreasing factor (caldecrin) gene

International Nuclear Information System (INIS)

Oi, Michi; Kido, Seisui; Hasegawa, Hiroya; Fujimoto, Kengo; Tomomura, Mineko; Kanegae, Haruhide; Suda, Naoto; Tomomura, Akito

2011-01-01

Osteoporosis is a common condition in which decrease in the bone volume and strength occurs due to increased bone resorption. Caldecrin is a serine protease, with a molecular weight of 28kDa, and it is the causative factor of hypocalcemia frequently seen in acute pancreatitis. Recent reports have shown that caldecrin also acts to inhibit both differentiation of the osteoclasts and function of the mature osteoclasts. In this study, the osteoporosis model mice were used and bilateral ovariectomy was conducted in these mice. Effect of bone absorption was estimated after introducing genetically the pCaldecrin-IRES-hrGFP expressing vector into the femoral muscle by use of the hemagglutinating virus of Japan (HVJ)-liposomes. After the bilateral ovariectomy, serum calcium levels were raised and the bone mass of the femur was decreased. However, in the genetically introduced groups of the model mice, serum calcium levels were significantly lowered. Concomitantly, significant increase in bone density, trabecular width and number of trabecular was observed. Moreover, based on the histological findings, inhibition of bone resorption in the caldecrin-introduced osteoporosis model mice was confirmed. The present study indicates that caldecrin can be expected to become a novel cure for osteoporosis. (author)

Impact of osteoporosis and vertebral fractures on quality-of-life. a population-based study in Valencia, Spain (The FRAVO Study).

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Sanfélix-Genovés, José; Hurtado, Isabel; Sanfélix-Gimeno, Gabriel; Reig-Molla, Begoña; Peiró, Salvador

2011-04-06

To describe the health related quality of life in a population sample of postmenopausal women over the age of 50 and resident in the city of Valencia (Spain), according to the presence/absence of osteoporosis and the severity of prevalent morphometric vertebral fractures. A cross-sectional age-stratified population-based sample of 804 postmenopausal women of 50 years of age and older were assessed with the SF-12 questionnaire. Information about demographic features, lifestyle, clinical features, educational level, anti-osteoporotic and other treatments, comorbidities and risk factors for osteoporosis were collected using an interviewer-administered questionnaire and densitometric evaluation of spine and hip and spine x-rays were carried out. In the non-adjusted analysis, mild and moderate-severe vertebral fractures were associated with decreased scores in the SF-12 Physical Component Summary (PCS) but not in the Mental Component Summary (MCS), while densitometric osteoporosis with no accompanying fracture was not associated with a worse health related quality of life. In multivariate analysis worse PCS scores were associated to the age groups over 70 (-2.43 for 70-74 group and -2.97 for 75 and older), chronic conditions (-4.66, -6.79 and -11.8 according to the presence of 1, 2 or at least 3 conditions), obesity (-5.35), peripheral fracture antecedents (-3.28), hypoestrogenism antecedents (-2.61) and the presence of vertebral fracture (-2.05). After adjusting for confounding factors, the physical components of health related quality of life were significantly lower in women with prevalent osteoporotic vertebral fractures than in women--osteoporotic or not--without vertebral fractures.

The Role of Calcium in Osteoporosis

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Arnaud, C. D.; Sanchez, S. D.

1991-01-01

Calcium requirements may vary throughout the lifespan. During the growth years and up to age 25 to 30, it is important to maximize dietary intake of calcium to maintain positive calcium balance and achieve peak bone mass, thereby possibly decreasing the risk of fracture when bone is subsequently lost. Calcium intake need not be greater than 800 mg/day during the relatively short period of time between the end of bone building and the onset of bone loss (30 to 40 years). Starting at age 40 to 50, both men and women lose bone slowly, but women lose bone more rapidly around the menopause and for about 10 years after. Intestinal calcium absorption and the ability to adapt to low calcium diets are impaired in many postmenopausal women and elderly persons owing to a suspected functional or absolute decrease in the ability of the kidney to produce 1,25(OH)2D2. The bones then become more and more a source of calcium to maintain critical extracellular fluid calcium levels. Excessive dietary intake of protein and fiber may induce significant negative calcium balance and thus increase dietary calcium requirements. Generally, the strongest risk factors for osteoporosis are uncontrollable (e.g., sex, age, and race) or less controllable (e.g., disease and medications). However, several factors such as diet, physical activity, cigarette smoking, and alcohol use are lifestyle related and can be modified to help reduce the risk of osteoporosis.

Osteoporosis and Somatization of Anxiety

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Maria Papanikou

2013-12-01

Full Text Available Chronic stress can now be physiologically traced as a significant player in the creation of osteoporotic bones. The present pilot study involved 100 women (N = 42 have been diagnosed with osteopenia, N = 21 have been diagnosed with osteoporosis, N = 37 had a non-osteoporotic condition who participated in the Hellenic Society of Osteoporosis Association Support. Correlations between somatic symptoms of anxiety and osteoporosis, and among medications and somatization in women were explored. Assessments were based on a self-report demographic questionnaire and on the Short Anxiety Screening Test (SAST administered for detection of anxiety disorder and somatization. Statistical analysis detected non-significant differences regarding the correlation between anxiety symptomatology or somatization due to osteoporosis and osteopenia diagnosis. The same pattern is observed among women’s age group, the occupational and marital status. Hypothesis that the osteoporosis and osteopenia group would manifest significant relationships with the age group and medicines was confirmed, as well as between somatization and medicines that women with osteoporosis and osteopenia undertake. The results suggest that women are not prone to manifest anxiety or somatization in relation to the osteoporosis condition. However, the majority of women with osteoporosis and osteopenia consume more than two medicines other than those for osteoporosis. This quantity and combination they undertake appear to contribute and deteriorate their anxiety/somatization symptomatology. Further research based on a larger sample would give more definite results.

Osteoporosi: la malattia e il suo costo sanitario

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Gianpaolo Zara

2002-12-01

Full Text Available Osteoporosis is a disorder of bone re-modeling, characterized by loss of its micro-architecture and decreased bone density, which lead to fragility and high risk of fracture following moderate traumata. Osteoporosisrelated pathological fractures occur more frequently in post-menopausal women, and the WHO estimates that the risk of osteoporotic fractures in women is approximately 40% during lifetime. The prevention of these osteoporotic fractures is considered one of the primary objectives for the control of the economical health burden of modern societies. The first part of this paper briefly outlines the physio-pathological basis, the epidemiology, the diagnosis and the available treatment options for osteoporosis, with particular regard to those therapies that are able to reduce the incidence of pathological fractures, that represent the main cost factor of the disease. In the second part, we reviewed the economical evaluations published on the cost of illness and of the costefficacy of the treatments. The studies that have analyzed the cost of osteoporosis, although incompletely, highlight that the greatest expenditures are related to hospitalization and rehabilitation after hip fracture, while the cost for the pharmacological treatment is relatively low. The cost-efficacy and cost-utility analyses conducted on pharmacological treatment are quite heterogeneous, and therefore hardly comparable, beside being conducted in countries with different health systems; the obtained data are nor directly transferable to the Italian setting. However, it emerges that diphosphonates, estrogens and SERMs (selective estrogen receptor modulators are among the drugs with more favorable cost/effectiveness ratio, but there is still an uncertainty in the detection of the appropriate patient groups, which is crucial for the clinical, economical and ethical optimization of prevention interventions.

Lycopene treatment against loss of bone mass, microarchitecture and strength in relation to regulatory mechanisms in a postmenopausal osteoporosis model.

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Ardawi, Mohammed-Salleh M; Badawoud, Mohammed H; Hassan, Sherif M; Rouzi, Abdulrahim A; Ardawi, Jumanah M S; AlNosani, Nouf M; Qari, Mohammed H; Mousa, Shaker A

2016-02-01

Lycopene supplementation decreases oxidative stress and exhibits beneficial effects on bone health, but the mechanisms through which it alters bone metabolism in vivo remain unclear. The present study aims to evaluate the effects of lycopene treatment on postmenopausal osteoporosis. Six-month-old female Wistar rats (n=264) were sham-operated (SHAM) or ovariectomized (OVX). The SHAM group received oral vehicle only and the OVX rats were randomized into five groups receiving oral daily lycopene treatment (mg/kg body weight per day): 0 OVX (control), 15 OVX, 30 OVX, and 45 OVX, and one group receiving alendronate (ALN) (2μg/kg body weight per day), for 12weeks. Bone densitometry measurements, bone turnover markers, biomechanical testing, and histomorphometric analysis were conducted. Micro computed tomography was also used to evaluate changes in microarchitecture. Lycopene treatment suppressed the OVX-induced increase in bone turnover, as indicated by changes in biomarkers of bone metabolism: serum osteocalcin (s-OC), serum N-terminal propeptide of type 1 collagen (s-PINP), serum crosslinked carboxyterminal telopeptides (s-CTX-1), and urinary deoxypyridinoline (u-DPD). Significant improvement in OVX-induced loss of bone mass, bone strength, and microarchitectural deterioration was observed in lycopene-treated OVX animals. These effects were observed mainly at sites rich in trabecular bone, with less effect in cortical bone. Lycopene treatment down-regulated osteoclast differentiation concurrent with up-regulating osteoblast together with glutathione peroxidase (GPx) catalase (CAT) and superoxide dismutase (SOD) activities. These findings demonstrate that lycopene treatment in OVX rats primarily suppressed bone turnover to restore bone strength and microarchitecture. Copyright © 2015. Published by Elsevier Inc.

The Relevance of Osteoclastic and Osteoblastic Activity Markers Follow-Up in Patients on Antiresorptive Osteoporosis Treatment.

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Smilic, Tanja N; Novakovic, Tatjana R; Markovic-Jovanovic, Snezana R; Smilic, Ljiljana L J; Mitic, Javorka S; Radunovic, Miodrag L

2017-11-02

In general, markers of bone formation and markers of bone resorption are changing synergistically, so the monitoring of any osteoclastic and any osteoblastic marker should reflect the rate of bone transformation. The aim of the study is to monitor the bone metabolism markers in postmenopausal women with osteoporosis and osteopenia along with the variations caused by the effects of bisphosphonate therapy. The study involved 55 women of average age of 57.95 years, with osteopenia or osteoporosis. The patients with osteoporosis were treated with bisphosphonates (75 mg once a week); the laboratory tests were performed before the treatment and 6 months later. Patients with osteopenia were evaluated at the first assessment and 6 months later. The tests included bone densitometry, dual-energy X-ray absorptiometry, osteocalcin, alkaline phosphatase, collagen 1 N-terminal pro-peptide (P1NP), and beta C telopeptide of type I collagen (CTX). The mean T-score was -2.80 ± 0.63 before therapy and -2.64 ± 0.45 6 months later (p < 0.001). Women with osteoporosis had elevated levels of osteocalcin and P1NP at the first assessment, whereas the alkaline phosphatase level did not change with the treatment. After the introduction of antiresorptive therapy, the levels of osteocalcin and P1NP significantly decreased (p < 0.001). In the group with osteopenia, the biochemical markers activity were increased in both assessments. In patients with osteoporosis, Beta-CTX was increased in the first evaluation, and decreased after treatment (p = 0.001). The results indicate that the assessment of biochemical markers of bone metabolism show excellent results in the assessment of prognosis, monitoring the course and the response to various treatment regimens of osteoporosis and evince strong correlation with standard densitometry and dual-energy X-ray absorptiometry procedures. P1NP and CTX show better diagnostic applicability compared with osteocalcin and alkaline phosphatase

Ten-year prediction of osteoporosis from baseline bone mineral density: development of prognostic thresholds in healthy postmenopausal women. The Danish Osteoporosis Prevention Study

DEFF Research Database (Denmark)

Abrahamsen, Bo; Rejnmark, Lars; Nielsen, Stig Pors

2006-01-01

Osteopenia is common in healthy women examined in the first year or two following menopause. Short-term fracture risk is low, but we lack algorithms to assess long-term risk of osteoporosis. Because bone loss proceeds at only a few percent per year, we speculated that baseline bone mineral density....... We analyzed dual energy X-ray absorptometry (DXA) of the lumbar spine (LS) and femoral neck (FN) from 872 women, who participated in the non-HRT arms of the Danish Osteoporosis Prevention Study and had remained on no HRT, bisphosphonates or raloxifene since inclusion 10 years ago. We defined...... development of a T -score below -2.5 at the LS and/or FN or incident fracture as end-point, and we derived prognostic thresholds for baseline BMD, defining 90% NPV (negative predictive value) and 90% sensitivity, respectively. Seventy-six percent of the variation in BMD of the LS at 10 years was predicted...

Links between cardiovascular disease and osteoporosis in postmenopausal women: serum lipids or atherosclerosis per se?

DEFF Research Database (Denmark)

Bagger, Y Z; Rasmussen, Henrik Berg; Alexandersen, P

2007-01-01

Epidemiological observations suggest links between osteoporosis and risk of acute cardiovascular events and vice versa. Whether the two clinical conditions are linked by common pathogenic factors or atherosclerosis per se remains incompletely understood. We investigated whether serum lipids...... and polymorphism in the ApoE gene modifying serum lipids could be a biological linkage....

The development and validation of the Satisfaction Questionnaire for Osteoporosis Prevention in Malaysia

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Toh LS

2014-09-01

Full Text Available Li Shean Toh,1 Pauline Siew Mei Lai,2 David Bin-Chia Wu,3 Kok Thong Wong,1 Bee Yean Low,1 Alexander Tong Boon Tan,4 Claire Anderson5 1School of Pharmacy, University of Nottingham, Semenyih, Malaysia; 2Department of Primary Care Medicine, University of Malaya Primary Care Research Group, University of Malaya, Kuala Lumpur, Malaysia; 3School of Pharmacy, Monash University Malaysia, Bandar Sunway, Malaysia; 4Department of Medicine, University of Malaya, Kuala Lumpur, Malaysia; 5Division of Social Research in Medicine and Health, School of Pharmacy, University of Nottingham, Nottingham, UK Purpose: To develop and validate the English version of the Satisfaction Questionnaire for Osteoporosis Prevention (SQOP in Malaysia.Methods: The SQOP was modified from the Osteoporosis Patient Satisfaction Questionnaire and developed based on literature review and patient interviews. Face and content validity were established via an expert panel. The SQOP consists of two sections: clinical services and types of counseling. There were 23 items in total, each with a five-point Likert-type response. Satisfaction score was calculated by converting the total score to a percentage. A higher score indicates higher satisfaction. English speaking, non-osteoporotic, postmenopausal women aged ≥50 years were included in the study. Participants were randomized to either the control or intervention group. Intervention participants were provided counseling, whereas control participants received none. Participants answered the SQOP at baseline and 2 weeks later.Results: A total of 140 participants were recruited (control group: n=70; intervention group: n=70. No significant differences were found in any demographic aspects. Exploratory factor analysis extracted seven domains. Cronbach’s a for the domains ranged from 0.531–0.812. All 23 items were highly correlated using Spearman’s correlation coefficient 0.469–0.996 (P<0.05, with no significant change in the control

5-year follow-up of a randomized controlled trial of immediate versus delayed zoledronic acid for the prevention of bone loss in postmenopausal women with breast cancer starting letrozole after tamoxifen: N03CC (Alliance) trial.

Science.gov (United States)

Wagner-Johnston, Nina D; Sloan, Jeff A; Liu, Heshan; Kearns, Ann E; Hines, Stephanie L; Puttabasavaiah, Suneetha; Dakhil, Shaker R; Lafky, Jacqueline M; Perez, Edith A; Loprinzi, Charles L

2015-08-01

Postmenopausal women with breast cancer receiving aromatase inhibitors are at an increased risk of bone loss. The current study was undertaken to determine whether upfront versus delayed treatment with zoledronic acid (ZA) impacted bone loss. This report described the 5-year follow-up results. A total of 551 postmenopausal women with breast cancer who completed tamoxifen treatment and were undergoing daily letrozole treatment were randomized to either upfront (274 patients) or delayed (277 patients) ZA at a dose of 4 mg intravenously every 6 months. In the patients on the delayed treatment arm, ZA was initiated for a postbaseline bone mineral density T-score of prevented bone loss compared with delayed treatment in postmenopausal women receiving letrozole and these differences were maintained at 5 years. The incidence of osteoporosis or fractures was not found to be significantly different between treatment arms. © 2015 American Cancer Society.

Fracture history in osteoporosis: risk factors and its effect on quality of life.

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Kuru, Pınar; Akyüz, Gülseren; Cerşit, Hülya Peynirci; Çelenlioğlu, Alp Eren; Cumhur, Ahmet; Biricik, Şefikcan; Kozan, Seda; Gökşen, Aylin; Özdemir, Mikail; Lüleci, Emel

2014-12-01

Fractures are one of the main outcomes in osteoporosis and have an important effect on the general health status. The purpose of this study was to determine the effect of major fracture history on quality of life. We also investigated the important risk factors and their effect on bone mineral density and fracture history. Cross-sectional study. We recruited 105 patients who were admitted to an osteoporosis outpatient clinic. Medical history, family history, calcium intake, physical activity level and biochemical tests were evaluated. Lumbar spine and femur neck bone mineral density were measured. The Qualeffo-41 questionnaire was also used for evaluating quality of life. The average age of the 105 patients included in the study was 56.04±13.73 and 89% of them were post-menopausal women. The average body mass index was 26.84±5.99, which means that the women were overweight. Also, 48.5% of the patients were diagnosed with osteoporosis and 51.5% of them were diagnosed as low bone density. A total of 34 patients had a fracture history with minor trauma and some of the patients had more than one fracture (12 ankle and foot, 10 forearm, 9 vertebral, 4 hand, 3 hip, 2 rib, 1 tibial). When the patients with and without fracture history were compared, the mean Qualeffo-41 score in patients with fracture was 43.85±2.57 and in the non-fracture group was 36.27±2.01. Forearm, ankle and foot fractures can be commonly seen in osteoporosis patients with fracture history. We suggest that it is important to recognise osteoporosis prior to first fracture and disease-specific quality of life assessment should be done.

Relationship of weight, height, and body mass index with fracture risk at different sites in postmenopausal women: the Global Longitudinal study of Osteoporosis in Women (GLOW).

Science.gov (United States)

Compston, Juliet E; Flahive, Julie; Hosmer, David W; Watts, Nelson B; Siris, Ethel S; Silverman, Stuart; Saag, Kenneth G; Roux, Christian; Rossini, Maurizio; Pfeilschifter, Johannes; Nieves, Jeri W; Netelenbos, J Coen; March, Lyn; LaCroix, Andrea Z; Hooven, Frederick H; Greenspan, Susan L; Gehlbach, Stephen H; Díez-Pérez, Adolfo; Cooper, Cyrus; Chapurlat, Roland D; Boonen, Steven; Anderson, Frederick A; Adami, Silvano; Adachi, Jonathan D

2014-02-01

Low body mass index (BMI) is a well-established risk factor for fracture in postmenopausal women. Height and obesity have also been associated with increased fracture risk at some sites. We investigated the relationships of weight, BMI, and height with incident clinical fracture in a practice-based cohort of postmenopausal women participating in the Global Longitudinal study of Osteoporosis in Women (GLOW). Data were collected at baseline and at 1, 2, and 3 years. For hip, spine, wrist, pelvis, rib, upper arm/shoulder, clavicle, ankle, lower leg, and upper leg fractures, we modeled the time to incident self-reported fracture over a 3-year period using the Cox proportional hazards model and fitted the best linear or nonlinear models containing height, weight, and BMI. Of 52,939 women, 3628 (6.9%) reported an incident clinical fracture during the 3-year follow-up period. Linear BMI showed a significant inverse association with hip, clinical spine, and wrist fractures: adjusted hazard ratios (HRs) (95% confidence intervals [CIs]) per increase of 5 kg/m(2) were 0.80 (0.71-0.90), 0.83 (0.76-0.92), and 0.88 (0.83-0.94), respectively (all p fractures, linear weight showed a significant positive association: adjusted HR per 5-kg increase 1.05 (1.02-1.07) (p fractures, only linear height was significantly associated: adjusted HRs per 10-cm increase were 0.85 (0.75-0.97) (p = 0.02) and 0.73 (0.57-0.92) (p = 0.009), respectively. For pelvic and rib fractures, the best models were for nonlinear BMI or weight (p = 0.05 and 0.03, respectively), with inverse associations at low BMI/body weight and positive associations at high values. These data demonstrate that the relationships between fracture and weight, BMI, and height are site-specific. The different associations may be mediated, at least in part, by effects on bone mineral density, bone structure and geometry, and patterns of falling. © 2014 American Society for Bone and Mineral Research.

Studies of osteoporosis in Croatia using isotope related techniques

International Nuclear Information System (INIS)

Dekanic, D.; Blanusa, M.; Cvijetic, S.; Prester, L.; Uzelac, V.

1996-01-01

A short overview is presented of research activities concerning osteoporosis and trace element exposure monitoring carried out by the Institute for Medical Research and Occupational Health in Zagreb during the last forty years. The overview includes: cross-sectional and Prospective epidemiological studies in districts with habitually low and high calcium intake; clinical studies concerning peak bone mass and bone mineral density in Postmenopausal women; studies on trace element exposure monitoring. The collaborating institutions, agencies and relevant recent publications are quoted. A survey is given of relevant methods which were used in earlier studies as well as the techniques which will be used in the current IAEA project. A brief description of the work which will be undertaken (particularly during the first year) within the framework of the IAEA CRP is given. (author)

Thyroid Dysfunction Does Not Affect the Bone Mineral Density in Postmenopausal Women

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Hatice Deniz

2013-10-01

Full Text Available Aim: To investigate the relationship between bone mineral density (BMD and thyroid dysfunction in postmenopausal women. Material and Method: A total of 261 postmenopausal women, who were examined between 2006 and 2008, were included in this prospective cohort study. Levels of thyroid stimulating hormone (TSH, free T3 (triiodothyronine, free T4 (tiroxin, and thyroid antibodies (anti-thyroglobulin antibody -antiTG Ab; anti-thyroid peroxidase antibody - antiTPO Ab were measured in all subjects. The subjects were classified into four groups: hyperthyroidism, hypothyroidism, autoimmune thyroiditis, and euthyroid(control. Bone mineral densities (BMDs from the lumbar 1–4 (L 1–4 vertebrae and the femoral neck regions of interest were measured using the dual energy x-ray absorptiometry (DEXA method and used to yield T-score values which were compared between groups. Results: The mean L1 – 4 T-score was 1.26 ± 1.25 in 56 cases (21.5% with hypothyroidism ; -1.46 ± 1.36 in 42 (16.1% cases with hyperthyroidism and -1.51 ± 1.22 in 37 cases (14.2% with autoimmune thyroiditis . The mean L1 – 4 T-score of the control group that consisted of 126 (48.3% cases was -1.28 ± 1.20. The mean femoral neck T-score was -0.31 ±1.15 in hypothyroid group; -0.80 ±1.41 in hyperthyroid group and -0.60 ±1.19 in cases with autoimmune thyroiditis . The mean femoral neck T-score of the control group was -0.55 ±1.08. When the T-scores of the entire L1 – 4 region and those of the femoral neck were compared, the values were not significantly different between the four patient groups (p = 0.680 and p = 0.258, respectively. Discussion: The present study indicated that thyroid dysfunction does not significantly affect BMD in postmenopausal women with hyperthyroidism, hypothyroidism, or autoimmune thyroiditis. This result suggests that thyroid dysfunctions do not have a significant role in the development of osteoporosis during the postmenopausal period, perhaps because

Quantitative evaluation of vertebral marrow adipose tissue in postmenopausal female using MRI chemical shift-based water–fat separation

International Nuclear Information System (INIS)

Li, G.-W.; Xu, Z.; Chen, Q.-W.; Tian, Y.-N.; Wang, X.-Y.; Zhou, L.; Chang, S.-X.

2014-01-01

Aim: To investigate the feasibility of assessing vertebral marrow adipose tissue using a magnetic resonance imaging (MRI) chemical shift-based water–fat separation technique at 3 T. Material and methods: A modified Dixon technique was performed to obtain the vertebral marrow fat fraction (FF) in a study of 58 postmenopausal females (age range 49.2–77.4 years), including 24 normal bone density, 19 osteopaenia, and 15 osteoporosis as documented with dual-energy X-ray absorptiometry. The reliability of FF measurements performed by two radiologists independently was evaluated with the intraclass correlation coefficient (ICC). Ten participants were scanned twice to assess the reproducibility of FF measurements. FF values were compared between each vertebral level and between groups. Results: The mean coefficient of variation of FF measurements was 2.1%. According to the ICC, the measurements were reliable (ICC = 0.900 for normal bone density, ICC = 0.937 for osteopaenia and ICC = 0.909 for osteoporosis, p < 0.001 for all). There was an inverse association between mean FF at L1–L4 vertebrae and lumbar spine BMD (r = −0.459, p = 0.006), which remained significant even after controlling for confounders (age, height, and body weight). FF values at different vertebral levels were significantly correlated to each other (r = 0.703–0.921, p < 0.05 for all). There was a general trend toward increased marrow adiposity for more inferior vertebral bodies. Patients with osteopaenia and osteoporosis had a higher marrow fat content compared with normal bone mass after adjusting for confounders, although no significant differences in each vertebral level and average marrow fat content were found between the osteopaenia and osteoporosis groups. Conclusion: Chemical shift-based water–fat separation enables the quantitation of vertebral marrow adiposity with excellent reproducibility, which appears to be a useful method to provide complementary information to osteoporosis

Radiological diagnosis of osteoporosis

International Nuclear Information System (INIS)

Heuck, F.H.W.

1990-01-01

The roentgen-morphologic findings of 'osteoporosis' in the different regions of the skeleton are demonstrated. A combination of osteoporosis and osteomalacia induced by hormonal and metabolic bone diseases occur frequently. The results of sequential studies are discussed. Diagnostic informations obtained by quantitative radiology, especially by different methods like x-ray morphometry, densitometry with gamma-rays of isotopes of different energies, quantitative computed tomography, and imaging analysis with electronic methods are described. The sequential use of diagnostic imaging techniques in cases of suspected osteoporosis are explained. (Author)

Obesity, Healthcare Utilization and Health-Related Quality of Life after Fracture in Postmenopausal Women: Global Longitudinal Study of Osteoporosis in Women (GLOW)

Science.gov (United States)

Compston, Juliet E.; Flahive, Julie; Hooven, Frederick H.; Anderson, Frederick A.; Adachi, Jonathan D.; Chapurlat, Roland D.; Cooper, Cyrus; Díez-Perez, Adolfo; Greenspan, Susan L.; LaCroix, Andrea Z.; Lindsay, Robert; Netelenbos, J. Coen; Pfeilschifter, Johannes; Roux, Christian; Saag, Kenneth G.; Silverman, Stuart; Siris, Ethel S.; Watts, Nelson B.; Gehlbach, Stephen H.

2013-01-01

Fractures in obese postmenopausal women may be associated with higher morbidity than in non-obese women. We aimed to compare healthcare utilization, functional status, and health-related quality of life (HRQL) in obese, non-obese and underweight women with fractures. Information from GLOW, started in 2006, was collected at baseline and at 1, 2 and 3 years. In this subanalysis, self-reported incident clinical fractures, healthcare utilization, HRQL and functional status were recorded and examined. Women in GLOW (n = 60,393) were aged ≥55 years, from 723 physician practices at 17 sites in 10 countries. Complete data for fracture and body mass index were available for 90 underweight, 3,270 non-obese and 941 obese women with ≥1 incident clinical fracture during the 3-year follow-up. The median hospital length of stay, adjusted for age, comorbidities and fracture type, was significantly greater in obese than non-obese women (6 vs. 5 days, P = 0.017). Physical function and vitality score were significantly worse in obese than in non-obese women, both before and after fracture, but changes after fracture were similar across groups. Use of anti-osteoporosis medication was significantly lower in obese than in non-obese or underweight women. In conclusion, obese women with fracture undergo a longer period of hospitalization for treatment and have poorer functional status and HRQL than non-obese women. Whether these differences translate into higher economic costs and adverse effects on longer-term outcomes remains to be established. PMID:24077896

Tongue coating microbiome regulates the changes in tongue texture and coating in patients with post-menopausal osteoporosis of Gan-shen deficiency syndrome type.

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Liang, Wenna; Li, Xihai; Li, Yachan; Li, Candong; Gao, Bizheng; Gan, Huijuan; Li, Sumin; Shen, Jianying; Kang, Jie; Ding, Shanshan; Lin, Xuejuan; Liao, Linghong

2013-11-01

Tongue inspection is a unique and important method of diagnosis in traditional Chinese medicine (TCM). It is a diagnostic approach which involves observing the changes in the tongue proper and tongue coating in order to understand the physiological functions and pathological changes of the body. However, the biological basis of TCM tongue diagnosis remains to be poorly understood and lacks systematic investigation at the molecular level. In this study, we evaluated the effects of tongue coating microbiome on changes in the tongue texture and coating in patients with post-menopausal osteoporosis (PMO) of Gan‑shen deficiency syndrome type. Our aim was to delineate the mechanisms of tongue coating microbiome-induced changes in the tongue texture and coating by investigating the histomorphological changes and performing a bacterial analysis of the tongue coating. We found that the number of intermediate cells in the red tongue with a thin coating was higher, while the number of superficial cells in the red tongue with a thin coating was lower. The maturation value (MV) of tongue exfoliated cells in the red tongue with a thin coating decreased, compared with that in the pale red tongue with a thin white coating. Furthermore, the total bacterial count, oral streptococcus, Gram‑positive (G+) and Gram‑negative (G-) anaerobic bacteria in the red tongue with a thin coating was significantly decreased compared with the pale red tongue with a thin white coating. The results of ultrastructural examination demonstrated that the number of epithelial cells and bacteria in the red tongue with a thin coating decreased compared with that in the pale red tongue with a thin white coating. These observations indicate that the tongue coating microbiome may be an important factor contributing to changes in the tongue in patients with PMO of Gan‑shen deficiency syndrome type.

The association between genetic variants of RUNX2, ADIPOQ and vertebral fracture in Korean postmenopausal women.

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Kim, Kyong-Chol; Chun, Hyejin; Lai, ChaoQiang; Parnell, Laurence D; Jang, Yangsoo; Lee, Jongho; Ordovas, Jose M

2015-03-01

Contrary to the traditional belief that obesity acts as a protective factor for bone, recent epidemiologic studies have shown that body fat might be a risk factor for osteoporosis and bone fracture. Accordingly, we evaluated the association between the phenotypes of osteoporosis or vertebral fracture and variants of obesity-related genes, peroxisome proliferator-activated receptor-gamma (PPARG), runt-related transcription factor 2 (RUNX2), leptin receptor (LEPR), and adiponectin (ADIPOQ). In total, 907 postmenopausal healthy women, aged 60-79 years, were included in this study. BMD and biomarkers of bone health and adiposity were measured. We genotyped for four single nucleotide polymorphisms (SNPs) from four genes (PPARG, RUNX2, LEPR, ADIPOQ). A general linear model for continuous dependent variables and a logistic regression model for categorical dependent variables were used to analyze the statistical differences among genotype groups. Compared with the TT subjects at rs7771980 in RUNX2, C-carrier (TC + CC) subjects had a lower vertebral fracture risk after adjusting for age, smoking, alcohol, total calorie intake, total energy expenditure, total calcium intake, total fat intake, weight, body fat. Odds ratio (OR) and 95% interval (CI) for the vertebral fracture risk was 0.55 (95% CI 0.32-0.94). After adjusting for multiple variables, the prevalence of vertebral fracture was highest in GG subjects at rs1501299 in ADIPOQ (p = 0.0473). A high calcium intake (>1000 mg/day) contributed to a high bone mineral density (BMD) in GT + TT subjects at rs1501299 in ADIPOQ (p for interaction = 0.0295). Even if the mechanisms between obesity-related genes and bone health are not fully established, the results of our study revealed the association of certain SNPs from obesity-related genes with BMD or vertebral fracture risk in postmenopausal Korean women.

Impact of genetic variants of IL-6, IL6R, LRP5, ESR1 and SP7 genes on bone mineral density in postmenopausal Mexican-Mestizo women with obesity.

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Méndez, Juan Pablo; Rojano-Mejía, David; Coral-Vázquez, Ramón Mauricio; Coronel, Agustín; Pedraza, Javier; Casas, María José; Soriano, Ruth; García-García, Eduardo; Vilchis, Felipe; Canto, Patricia

2013-10-10

Since obesity and osteoporosis present a high genetic predisposition and polymorphisms of IL-6, IL6R, LRP5, ESR1 and SP7 may influence the risk of both diseases, the aim of this study was to analyze the possible association of polymorphisms in these genes, as well as their haplotypes, with BMD variations in postmenopausal Mexican-Mestizo women with grade 2 or grade 3 obesity. One hundred eighty unrelated postmenopausal women with grade 2 or grade 3 obesity were included. BMD was measured in total hip and lumbar spine by dual-energy X-ray absorptiometry. DNA was obtained from blood leukocytes. Rs1800795 of IL-6, rs2228145 of IL6R, rs3736228 of LRP5, rs9340799 (XbaI) and rs2234693 (PvuII), of ESR1, rs10876432 and rs2016266, of SP7 (and their haplotypes), were studied by real-time PCR allelic discrimination. Deviations from Hardy-Weinberg equilibrium were tested. Pairwise linkage disequilibrium between single nucleotide polymorphisms was calculated by direct correlation r(2), and haplotype analysis was conducted. Using WHO criteria, 54.5% had grade 2 obesity, and 45.5% had grade 3 obesity. Regarding DXA results, 11.1% women had osteoporosis, 41.7% had osteopenia, and 47.2% had normal BMD. Genotype and haplotype analysis showed no significant differences with BMD variations at the lumbar spine, total hip or femoral neck. We did not find a significant association between the polymorphisms analyzed or their haplotypes and BMD variations in postmenopausal women with obesity. The higher BMD observed in women with obesity could be the result of an adaptive response to the higher loading of the skeleton. © 2013 Elsevier B.V. All rights reserved.

[Parathyroid hormone and its analogues - molecular mechanisms of action and efficacy of osteoporosis therapy].

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Misiorowski, Waldemar

2011-01-01

Most medical agents currently applied in osteoporosis therapy act by inhibiting bone resorption and reducing bone remodelling, i.e. they inhibit the process of bone mass loss by suppressing bone resorption processes. These drugs provide an ideal therapeutic option to prevent osteoporosis progression. They however have a rather limited usefulness when the disease has already reached its advanced stages with distinctive bone architecture lesions. The fracture risk reduction rate, achieved in the course of anti-resorptive therapy, is insufficient for patients with severe osteoporosis to stop the downward spiral of their quality of life (QoL) with a simultaneously increasing threat of premature death. The activity of the N-terminal fragment of 1-34 human parathormone (teriparatide - 1-34 rhPTH), a parathyroid hormone (PTH) analogue obtained via genetic engineering , is expressed by increased bone metabolism, while promoting new bone tissue formation by stimulating the activity of osteoblasts more than that of osteoclasts. The anabolic activity of PTH includes both its direct effect on the osteoblast cell line, and its indirect actions exerted via its regulatory effects on selected growth factors, e.g. IGF-1 or sclerostin. However, the molecular mechanisms responsible for the actual anabolic effects of PTH remain mostly still unclear. Clinical studies have demonstrated that therapeutic protocols with the application of PTH analogues provide an effective protection against all osteoporotic fracture types in post-menopausal women and in elderly men with advanced osteoporosis. Particular hopes are pinned on the possibility of applying PTH in the therapy of post-steroid osteoporosis, mainly to suppress bone formation, the most important pathological process in this regard. The relatively short therapy period with a PTH analogue (24 months) should then be replaced and continued by anti-resorptive treatment.

Parathyroid hormone and its analogues--molecular mechanisms of action and efficacy in osteoporosis therapy.

Science.gov (United States)

Misiorowski, Waldemar

2011-01-01

Most medical agents currently applied in osteoporosis therapy act by inhibiting bone resorption and reducing bone remodelling, i.e. they inhibit the process of bone mass loss by suppressing bone resorption processes. These drugs provide an ideal therapeutic option to prevent osteoporosis progression. They however have a rather limited usefulness when the disease has already reached its advanced stages with distinctive bone architecture lesions. The fracture risk reduction rate, achieved in the course of anti-resorptive therapy, is insufficient for patients with severe osteoporosis to stop the downward spiral of their quality of life (QoL) with a simultaneously increasing threat of premature death. The activity of the N-terminal fragment of 1-34 human parathormone (teriparatide - 1-34 rhPTH), a parathyroid hormone (PTH) analogue obtained via genetic engineering , is expressed by increased bone metabolism, while promoting new bone tissue formation by stimulating the activity of osteoblasts more than that of osteoclasts. The anabolic activity of PTH includes both its direct effect on the osteoblast cell line, and its indirect actions exerted via its regulatory effects on selected growth factors, e.g. IGF-1 or sclerostin. However, the molecular mechanisms responsible for the actual anabolic effects of PTH remain mostly still unclear. Clinical studies have demonstrated that therapeutic protocols with the application of PTH analogues provide an effective protection against all osteoporotic fracture types in post-menopausal women and in elderly men with advanced osteoporosis. Particular hopes are pinned on the possibility of applying PTH in the therapy of post-steroid osteoporosis, mainly to suppress bone formation, the most important pathological process in this regard. The relatively short therapy period with a PTH analogue (24 months) should then be replaced and continued by anti-resorptive treatment.

INFLUENCE OF HOMOCYSTEINE AND VERTEBRAL FRACTURES ON PREVALENT ABDOMINAL AORTIC CALCIFICATION IN POSTMENOPAUSAL WOMEN - A MULTICENTRIC CROSS-SECTIONAL STUDY

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Imad GHOZLANI

2017-08-01

Full Text Available The main of this study was to examine the relationship between plasma homocysteine (Hcy, asymptomatic osteoporotic vertebral fractures (VFs using vertebral fracture assessment (VFA and prevalent abdominal aortic calcification (AAC in Moroccan postmenopausal women. The study cohort consisted of 188 consecutive postmenopausal women with no prior known diagnosis of osteoporosis or taking medication interfering with bone metabolism. Mean age, weight, height, body mass index and plasma homocysteine were determined. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy Vision densitometer (GE Healthcare Inc., Waukesha, WI. VFs were defined using a combination of Genant’s semiquantitative approach and morphometry. VFA images were also scored for prevalent AAC using a validated 24 point scale. Fifty-eight (30.9% patients had densitometric osteoporosis. VFs were identified using VFA in 76 (40.4% patients: 61 women had grade 1 VFs and 15 had grade 2 or 3 VFs. One hundred twenty nine women (68.6% did not have any detectable AAC, whereas the prevalence of significant atherosclerotic burden defined as AAC score of 5 or higher, was 13.8%. A significant positive correlation between AAC score and homocysteine was observed. Women with extended AAC, were older, had a lower weight, BMI and BMD, higher homocysteine levels and more prevalent VFs than women without extended AAC. Multiple regression analysis showed that the presence of extended AAC was significantly associated with Age and grade 2/3 VFs and not independently associated with homocysteine levels.This study did not confirm that homocysteine is important determinant of extended AAC in postmenopausal women. However, this significant atherosclerotic marker is independently associated with VFs regardless of age. 

Osteoporosis and trace elements

DEFF Research Database (Denmark)

Aaseth, J.; Boivin, G.; Andersen, Ole

2012-01-01

More than 200 million people are affected by osteoporosis worldwide, as estimated by 2 million annual hip fractures and other debilitating bone fractures (vertebrae compression and Colles' fractures). Osteoporosis is a multi-factorial disease with potential contributions from genetic, endocrine...... in new bone and results in a net gain in bone mass, but may be associated with a tissue of poor quality. Aluminum induces impairment of bone formation. Gallium and cadmium suppresses bone turnover. However, exact involvements of the trace elements in osteoporosis have not yet been fully clarified...

The Effect of a Long-Term, Community-Based Exercise Program on Bone Mineral Density in Postmenopausal Women with Pre-Diabetes and Type 2 Diabetes

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Bello Marieni

2014-12-01

Full Text Available The aim of this study was to evaluate the impact of a community-based exercise program on bone mineral density and body composition in postmenopausal women with pre-diabetes and type 2 diabetes. Twenty postmenopausal women (aged 61.3 ± 6.0 years with pre-diabetes and type 2 diabetes were randomly assigned to a community-based exercise program group (n=10 or a control group (n=10. The community-based exercise program was multicomponent, three days per week for 32 weeks, and included walking, resistance and aquatic exercises. Body composition and bone mineral density were measured pre and post-training by dual X-ray absorptiometry. In the exercise group significant increases were found in the ward’s triangle bone mineral density (+7.8%, p=0.043, and in fat-free mass (+2.4%, p=0.018. The findings suggest that regular multicomponent training is effective in preventing osteoporosis and sarcopenia among postmenopausal women with pre-diabetes and type 2 diabetes.

Prevention and treatment of glucocorticoid-induced osteoporosis in International and Italian scenarios

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A. Delle Sedie

2011-09-01

Full Text Available Osteoporosis (OP and increased risk of fracture (Fx associated with chronic glucocorticoid treatment pushed panels of experts and scientific societies to produce recommendations for both prevention and treatment of glucocorticoid-induced OP (GIO. Recently the American College of Rheumatology developed and/or endorsed their updated guidelines and recommendations for the prevention and treatment of GIO. In these recommendations the use of FRAX tool, for the 10-year probability of a major osteoporotic Fx, was integrated with other clinical risk factors to define low-, medium-, and high-risk patients. Updated approaches are delineated for post-menopausal women and men >50 years, pre-menopausal women not of childbearing potential, men 50 years, receiving >5 mg/day prednisone equivalent for >3 months; more recently teriparatide has also been included, only for those patients presenting ≥1 prevalent fragility Fx and receiving >5 mg/day prednisone equivalent for >12 months. Also zoledronic acid has been approved by Italian Agency of the Drug (AIFA, 30/08/10 for “… post-menopausal women and men chronically treated with GC ad high risk of Fx”, but the drug is dispensed exclusively at the hospital.

Influence of obesity on vertebral fracture prevalence and vitamin D status in postmenopausal women.

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El Maghraoui, A; Sadni, S; El Maataoui, A; Majjad, A; Rezqi, A; Ouzzif, Z; Mounach, A

2015-01-01

It is well established that weight is an important determinant of bone health. Whereas obesity is associated with increased mortality and morbidity from diabetes and cardiovascular diseases, high body weight is widely believed to be associated to hypovitaminosis D and protective against the development of osteoporosis and fracture risk. The objective of the study was to evaluate the effect of BMI on vitamin D status and on densitometric vertebral fractures (VFs) in a large series of asymptomatic women aged over 50 who had a VFA examination during their bone mineral density (BMD) testing. We enrolled 429 postmenopausal women (mean age, weight and BMI of 59.5 ± 8.3 (50 to 83) years, 75.8 ± 13.3 (35 to 165) kgs and 29.9 ± 5.2 (14.6 to 50.8) kg/m(2), respectively. Lateral VFA images and scans of the lumbar spine and proximal femur were obtained using a Lunar Prodigy densitometer. VFs were defined using the Genant semiquantitative (SQ) approach. Clinical risk factors of osteoporosis were collected and 25-hydroxivitamin D was measured using electrochimiluminescence (Roche). Prevalence of osteoporosis and hypovitaminosis D (obese women had a higher BMD and less proportion of women with osteoporosis and VFs grade 2/3 than lean and overweight women. The prevalence of VFs globally increased with age and as BMI and BMD declined. Stepwise regression analysis showed that the presence of osteoporosis was independently related to BMI and history of fractures while the presence of grade 2/3 VFs was independently related to age, hypovitaminosis D and years of menopause. Obese women had a higher BMD and lower prevalence of VFs. VFs were significantly related to age, hypovitaminosis D and years since menopause. However, among obese women, prevalence of VFs was increased in osteoporotic women.

Bone mineral content (bmc and bone mineral density (bmd in postmenopausal women formerly practising kayaking and fencing

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B Raczyńska

2003-06-01

Full Text Available The investigation was aimed at answering the following questions: 1 Can a prolonged career in sports associated with considerable training loads, in conjunction with other osteoporosis risk factors (both past and present, affect the bone mineral content (BMC and bone mineral density (BMD of the former female athletes in their postmenopausal period of life?, and 2 How does the present lifestyle of the tested women, including physical activity and diet (calcium intake, influence the preservation of the optimal bone mass in these subjects? The postmenopausal subjects recruited to the present study included 15 former athletes (ten kayakers and five fencers and 11 women who never actively engaged in sports (control group. BMC (g and BMD (g/cm2 were densitometrically determined in the lumbar segment (L2-L4 of the spine, and the bone stiffness coefficient was ultrasonically determined in calcaneus. The effects of the osteoporosis risk factors (both past and present were estimated from individual replies to the questionnaire inquiries about the past career in sports, present physical activity, gonadal dysfunctions (dysmenorrhoea during the career and the present need for hormonal supplementary treatment, and the current dietary patterns. The results indicate that mean BMC and BMD values detected in the former athletes did not differ significant from those obtained in the non-athlete, control women: the BMC values equalled to 54.5±10.5, 52.6±14.6, and 46.5±3.2 g in the kayakers, the fencers, and the control women, respectively, while the respective BMD values were 1.05±0.45, 0.96±0.66, and 1.08±0.58 g/cm2. The questionnaire-based studies showed that neither the former female athletes nor the non-athlete controls exhibited in the past longer (i.e., lasting more than three months periods of hormonal disorders (amenorrhoea. As assessed from the dietary intake, only in the former fencers the diet covered the demand for calcium in 100%. In conclusion

Plasma organochlorine concentrations and bone ultrasound measurements: a cross-sectional study in peri-and postmenopausal Inuit women from Greenland

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Mulvad Gert

2006-12-01

Full Text Available Abstract Background Inuit women are highly exposed through their traditional seafood based diet to organochlorine compounds, some of them displaying endocrine disrupting properties. We hypothesized that this exposure might be related to bone characteristics that are altered in osteoporosis, because hormone deficiency is a known risk factor for the disease. Methods We measured quantitative ultrasound parameters (QUS at the right calcaneum of 153 peri- and postmenopausal Inuit women (49–64 year old from Nuuk, Greenland, and investigated the relation between these parameters and plasma organochlorine concentrations. We used high-resolution gas chromatography with electron capture detection to analyze plasma samples for 14 polychlorinated biphenyls (PCB congeners and 11 chlorinated pesticides and metabolites. We analysed morning urine samples for cadmium, a potential confounder, by atomic absorption spectrometry. We used a validated questionnaire to document dietary and lifestyle habits as well as reproductive and medical histories. Results Concentrations of PCB 153, a surrogate of exposure to most organochlorines present in plasma samples, were inversely correlated to QUS parameters in univariate analyses (p 2 = 0.39; p Conclusion Overall we found little evidence that organochlorines exposure is related to osteoporosis in Greenlandic Inuit women, but the hypothesis that exposure to dioxin-like compounds might be linked to decreased bone quality and osteoporosis deserves further attention.

Association between bone mineral density and low backache in postmenopausal women

International Nuclear Information System (INIS)

Qayum, M.; Ali, W.

2017-01-01

Objective: To determine association between bone mineral density (BMD) and low backache in post menopausal women in general population of Lahore. Study Design: Descriptive study. Place and Duration of Study: Gynaecological outpatint department of Punjab Rangers Hospital Lahore during the period, from Feb 2015 to Feb 2016. Material and Methods: Screening for association between BMD and low backache in 481 post menopausal women was carried out. Low back pain was considered clinically relevant if the patient complained of moderate to severe pain, or if the patient needed any medical treatment. Their BMD was measured. The measurement site for BMD was the calcaneus of patient. The diagnosis was based on T score. Data was analyzed. Result: Osteoporosis was found in 303 (88.3%) of 50-60 years age group and 40 (11.7%) of 61-plus years age group. Conclusion: Bone mineral density was significantly lower in postmenopausal women and there was a strong association between low back ache and decreased BMD value. (author)

Absorption of silicon from artesian aquifer water and its impact on bone health in postmenopausal women: a 12 week pilot study

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Lee Tsz

2010-10-01

Full Text Available Abstract Background Decreased bone mineral density and osteoporosis in postmenopausal women represents a growing source of physical limitations and financial concerns in our aging population. While appropriate medical treatments such as bisphosphonate drugs and hormone replacement therapy exist, they are associated with serious side effects such as osteonecrosis of the jaw or increased cardiovascular risk. In addition to calcium and vitamin D supplementation, previous studies have demonstrated a beneficial effect of dietary silicon on bone health. This study evaluated the absorption of silicon from bottled artesian aquifer water and its effect on markers of bone metabolism. Methods Seventeen postmenopausal women with low bone mass, but without osteopenia or osteoporosis as determined by dual x-ray absorptiometry (DEXA were randomized to drink one liter daily of either purified water of low-silicon content (PW or silicon-rich artesian aquifer water (SW (86 mg/L silica for 12 weeks. Urinary silicon and serum markers of bone metabolism were measured at baseline and after 12 weeks and analyzed with two-sided t-tests with p Results The urinary silicon level increased significantly from 0.016 ± 0.010 mg/mg creatinine at baseline to 0.037 ± 0.014 mg/mg creatinine at week 12 in the SW group (p = 0.003, but there was no change for the PW group (0.010 ± 0.004 mg/mg creatinine at baseline vs. 0.009 ± 0.006 mg/mg creatinine at week 12, p = 0.679. The urinary silicon for the SW group was significantly higher in the silicon-rich water group compared to the purified water group (p Conclusions These findings indicate that bottled water from artesian aquifers is a safe and effective way of providing easily absorbed dietary silicon to the body. Although the silicon did not affect bone turnover markers in the short-term, the mineral's potential as an alternative prevention or treatment to drug therapy for osteoporosis warrants further longer-term investigation

Diabetes Mellitus and Osteoporosis

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Dilek Durmuş

2005-09-01

Full Text Available Osteoporosis is a condition of bone fragility resulting from micro-architectural deterioration and decreased bone mass. Studies on the presence of a generalized osteoporosis related to diabetes mellitus (DM are few and controversial. Factors associated with osteoporosis diabetes in which may account for the patogenesis of diabetic bone loss have been studied. This article will review the relevant litarature relating to diabetes and osteoporosis including cellular and animal models. These studies include vascular and neuropathic mechanism, poor glisemic control, abnormalities of calcium and vitamin D metabolism and hypercalciuria with secondary increase in parathyroid hormone secretion, the role of insülin and insülin like growth factor I. It appears that there is a great deal of variability in the bone mineral density and fracture rates in both type I and type II DM. This may reflect multiple factors such as the population, age, duration of diabetes and insülin use. There is need for further longitudinal studies, including the incidence and risk factors for osteoporosis in DM.

Efficacy of Vitamin K2 for Glucocorticoid-induced Osteoporosis in Patients with Systemic Autoimmune Diseases.

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Shikano, Kotaro; Kaneko, Kaichi; Kawazoe, Mai; Kaburaki, Makoto; Hasunuma, Tomoko; Kawai, Shinichi

2016-01-01

Objective Vitamin K2 (menatetrenone) is an effective treatment for patients with postmenopausal osteoporosis. We herein performed a subanalysis of patients with systemic autoimmune diseases undergoing glucocorticoid therapy in our previous prospective study. Methods Sixty patients were categorized into a group with vitamin K2 treatment (n=20, Group A) and a group without vitamin K2 treatment (n=40, Group B). All patients were treated with bisphosphonates. Results Serum levels of osteocalcin and undercarboxylated osteocalcin decreased significantly after the start of glucocorticoid therapy in both groups, while the serum osteocalcin level was significantly higher in Group A than Group B during the third (p=0.0250) and fourth weeks (p=0.0155). The serum level of the N-terminal peptide of type I procollagen, a bone formation marker, decreased during glucocorticoid therapy, but was significantly higher in Group A than Group B during the fourth week (p=0.0400). The bone mineral density and fracture rate showed no significant differences between the two groups. Conclusion Although vitamin K2 improves bone turnover markers in patients with osteoporosis on glucocorticoid therapy, it has no significant effect on the bone mineral density and fracture rate after 1.5 years of treatment.

Management of Aromatase Inhibitor-Associated Bone Loss (AIBL in postmenopausal women with hormone sensitive breast cancer: Joint position statement of the IOF, CABS, ECTS, IEG, ESCEO, IMS, and SIOG

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Peyman Hadji

2017-06-01

Conclusions: In all patients initiating AI treatment, fracture risk should be assessed and recommendation with regard to exercise and calcium/vitamin D supplementation given. Bone-directed therapy should be given to all patients with a T-score−1.5 SD and no risk factors should be managed based on BMD loss during the first year and the local guidelines for postmenopausal osteoporosis. Compliance should be regularly assessed as well as BMD on treatment after 12 - 24 months. Furthermore, because of the decreased incidence of bone recurrence and breast cancer specific mortality, adjuvant bisphosphonates are recommended for all postmenopausal women at significant risk of disease recurrence.

Relationship of homocysteine levels with lumbar spine and femur neck BMD in postmenopausal women

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Elton Bahtiri

2015-10-01

Full Text Available Objective: The focus of several studies in recent years has been the association between increased plasma concentrations of homocysteine (Hcy, reduced bone mineral density and increased risk of bone fractures. Nevertheless, inconsistencies persist in the literature. Thus, the objective of this study was to investigate the possible relationship between serum Hcy and vitamin B12 status, and bone mineral density, on a group of post-menopausal women. Materials and methods: One hundred thirty-nine postmenopausal women were recruited to enter this cross-sectional study. Bone mineral density (BMD of total hip, femoral neck and lumbar spine was measured by dual-energy X-ray absorptiometry (DXA and serum Hcy, vitamin B12, parathyroid hormone (PTH, total calcium and magnesium levels were determined. In addition, we investigated the relationship of Hcy and vitamin B12 and BMD using a meta-analysis approach. Results: Serum Hcy levels were significantly higher in osteoporotic women when compared to other BMD groups, and were inversely related to lumbar spine BMD and femur neck BMD. Body mass index and serum Hcy levels were shown to be significant predictors of BMD at lumbar spine, femur neck and total hip. The performed meta-analysis showed that serum Hcy levels were significantly higher in osteoporotic subjects compared to normal BMD subjects. Conclusion: This study shows that Hcy status, but not vitamin B12 status, is associated with BMD in this cohort of postmenopausal women. We therefore confirm that high Hcy levels are an independent risk factor for osteoporosis. BMD evaluation in women at post menopause with high Hcy levels may be helpful in advising precautionary measures.

Osteoporosis and Hispanic Women

Science.gov (United States)

... Osteoporosis Osteoporosis and Hispanic Women Osteoporosis and Hispanic Women It is a common misconception that osteoporosis only ... seizures. Are There Any Special Issues for Hispanic Women Regarding Bone Health? Several studies indicate a number ...

Long-term use of Bonviva for the treatment of postmenopausal osteoporosis: new evidence

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Olga Borisovna Yershova

2012-01-01

Full Text Available Osteoporosis is a disease of great social importance. Its treatment is a complicated problem and it is associated with low compliance and a risk for adverse reactions. Ibandronate belongs to a group of bisphosphonates. The performed trials have proven the efficacy of its two formulations (a tablet once monthly and intravenous injection once every 3 months in reducing the risk of bone fractures. At present there are data of trials of long-term therapy with this drug, which demonstrate its positive effect on bone mineral density and bone metabolism markers. The agent has been also shown to be highly safe when used long.

The relationship of intrinsic fall risk factors to a recent history of falling in older women with osteoporosis.

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Arnold, Cathy M; Busch, Angela J; Schachter, Candice L; Harrison, Liz; Olszynski, Wojciech

2005-07-01

Cross-sectional descriptive analysis investigating intrinsic fall risk factors in postmenopausal women with osteoporosis. To examine the relationships between history of recent falls and balance, pain, quality of life, function, posture, strength, and mobility. Women with osteoporosis who fall are at a high risk of fracture due to decreased bone strength. Identifying fall risk factors for older women with osteoporosis is a crucial step in decreasing the incidence of falls and fracture. METHOD AND MEASURES: Seventy-three women over 60 years of age with established osteoporosis participated in comprehensive testing of fall history, physical function, and quality of life. Significant correlations were found between a recent history of falls and degree of kyphosis (r = 0.29), fear of falls/emotional status (r = -0.27), and balance (r = -0.27). Degree of kyphosis and fear of falls/emotional status explained 20% of the variance of recent fall history using binary logistic regression. Women with an increased kyphosis were more likely to have had a recent fall (odds ratio [OR], 1.17; 95% CI, 1.03-1.34) and those with better emotional status and less fear of falling were less likely to have had a recent fall (OR, 0.61; 95% CI, 0.38-0.97). Increased thoracic kyphosis and fear of falling are 2 intrinsic factors associated with recent falls in women with osteoporosis. To design more effective interventions to decrease fall risk in this population, future prospective, longitudinal studies should monitor kyphosis, fear of falling, balance reactions, and other potential risk factors not identified in this study.

Radiology of osteoporosis

International Nuclear Information System (INIS)

Grampp, S.

2008-01-01

This second edition of Radiology of Osteoporosis has been fully updated so as to represent the current state of the art. It provides a comprehensive overview of osteoporosis, the pathologic conditions that give rise to osteoporosis, and the complications that are frequently encountered. After initial chapters devoted to pathophysiology, the presentation of osteoporosis on conventional radiographs is illustrated and discussed. Thereafter, detailed consideration is given to each of the measurement methods employed to evaluate osteoporosis, including dual x-ray absorptiometry, vertebral morphometry, spinal and peripheral quantitative computed tomography, quantitative ultrasound, and magnetic resonance imaging. The role of densitometry in daily clinical practice is appraised. Finally, a collection of difficult cases involving pitfalls is presented, with guidance to their solution. The information contained in this volume will be invaluable to all with an interest in osteoporosis. (orig.)

Novel therapeutic intervention for osteoporosis prepared with strontium hydroxyapatite and zoledronic acid: In vitro and pharmacodynamic evaluation

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Khajuria, Deepak Kumar, E-mail: deepak_kumarkhajuria@yahoo.co.in [The Musculoskeletal Genetics Laboratory, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed (Israel); Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore (India); Vasireddi, Ramakrishna; Trebbin, Martin [Hamburg Center for Ultrafast Imaging, University of Hamburg, Hamburg (Germany); Karasik, David [The Musculoskeletal Genetics Laboratory, Faculty of Medicine in the Galilee, Bar-Ilan University, Safed (Israel); Razdan, Rema [Department of Pharmacology, Al-Ameen College of Pharmacy, Bangalore (India)

2017-02-01

Osteoporosis therapeutics has been monopolized mainly by bisphosphonates, which are potent anti-osteoporotic drugs, while they do not promote bone formation or replenish the already resorbed bone. Although strontium substituted hydroxyapatite (SrHA) has been proclaimed to improve bone properties in an osteoporotic animal model, there is no published data on direct delivery of SrHA nanoparticles by bisphosphonate-like zoledronic acid (ZOL) to the bone. Therefore, this study was designed to investigate the potential of using SrHA/ZOL nanoparticle-based drug formulation in an ovariectomized rat model of postmenopausal osteoporosis. SrHA and SrHA/ZOL nanoparticles were prepared and characterized by field-emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) and Fourier transform infrared spectroscopy (FTIR). Twelve weeks after ovariectomy, rats were treated with either single intravenous dose of SrHA/ZOL (100, 50 or 25 μg/kg); ZOL (100 μg/kg); or SrHA (100 μg/kg). Saline-treated OVX and SHAM-OVX groups served as controls. The energy-dispersive X-ray (EDX) microanalysis of bone specimen obtained from SrHA/ZOL groups yielded range between 64.3 ± 6.7 to 66.9 ± 6.8 of calcium weight (wt) % and 1.64 ± 0.6 to 1.74 ± 0.8 of calcium/phosphorus (Ca/P) ratio which was significantly higher when compared with 39.7 ± 9.3 calcium and 1.30 ± 0.2 Ca/P ratio for OVX group. Moreover, the strontium wt% in SrHA/ZOL group (between 3.1 ± 0.5 and 6.8 ± 0.4) was significantly higher than SrHA group (1.8 ± 0.9). These results confirmed targeted delivery of SrHA nanoparticles by ZOL to the bone. Therapy with SrHA/ZOL showed significant improvements in trabecular bone microarchitecture and mechanical strength as compared to ZOL or SrHA (p < 0.05). Moreover, treatment with SrHA/ZOL significantly precluded an increase in serum bone-specific alkaline phosphatase and tartrate-resistant acid phosphatase than either ZOL or SrHA (p < 0.05). These results strongly implicate

Health beliefs and sense of one’s own efficacy and prophylaxis of osteoporosis in peri- and post-menopausal women

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Mariola Janiszewska

2015-12-01

It was stated that respondents had thought that osteoporosis is an averagely serious health problem, and they did not feel peculiarly exposed to falling ill with the disease. They attached great significance to the benefits of physical activity and correct nutrition. The perception of barriers to calcium intake and everyday exercise was moderate. Health motivation remained at the average level. Socio-demographic conditions influenced the respondents’ health beliefs in a statistically significant way. Sense of self-efficacy from the aspect of taking possible action preventing osteoporosis remained on the average level; in addition, respondents more often declared the desire for a change in eating habits than resorting to physical activity.

Effect of periodontitis on the development of osteoporosis: results from a nationwide population-based cohort study (2003-2013).

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Choi, Jung-Kyu; Kim, Young-Taek; Kweon, Hye-In; Park, Eun-Cheol; Choi, Seong-Ho; Lee, Jae-Hong

2017-09-11

The prevalence of osteoporosis associated with the aging process is anticipated to increase along with the rising aging population. Periodontitis that the most common chronic infections of humankind is considered the risk factor for osteoporosis. The aim of this study was to identify the association between osteoporosis and periodontitis using a population-based cohort. The case group was defined as patients diagnosed with periodontitis and treated with subgingival curettage, root conditioning, periodontal flap operation, bone grafting for alveolar bone defects, and guided tissue regeneration. Case and control groups matched for gender, age, household income, type of social security, disability, and residential area were generated. A Cox proportional hazard model was constructed to examine the difference in the development of osteoporosis between the case and control groups. The final sample included 13,464 participants. The incidence of osteoporosis was 1.1% in males and 15.8% in females during a 10-year period. The risk factors for osteoporosis in males were increasing age and Charlson Comorbidity Index score. Periodontitis was not associated with the development of osteoporosis in males. The risk factors for osteoporosis in females were increasing age, body mass index, Charlson Comorbidity Index score, diabetes, and periodontitis. Women with periodontitis were more likely to also develop osteoporosis (HR: 1.22, 95% CI: 1.01-1.48). Periodontitis has an effect on the development of osteoporosis in females. Managing good teeth is required for the prevention and delay of osteoporosis. This includes dental examinations, regular cleanings and gum treatment.

Management of osteoporosis

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Lewiecki E Michael

2004-07-01

Full Text Available Abstract Osteoporosis or osteopenia occurs in about 44 million Americans, resulting in 1.5 million fragility fractures per year. The consequences of these fractures include pain, disability, depression, loss of independence, and increased mortality. The burden to the healthcare system, in terms of cost and resources, is tremendous, with an estimated direct annual USA healthcare expenditure of about $17 billion. With longer life expectancy and the aging of the baby-boomer generation, the number of men and women with osteoporosis or low bone density is expected to rise to over 61 million by 2020. Osteoporosis is a silent disease that causes no symptoms until a fracture occurs. Any fragility fracture greatly increases the risk of future fractures. Most patients with osteoporosis are not being diagnosed or treated. Even those with previous fractures, who are at extremely high risk of future fractures, are often not being treated. It is preferable to diagnose osteoporosis by bone density testing of high risk individuals before the first fracture occurs. If osteoporosis or low bone density is identified, evaluation for contributing factors should be considered. Patients on long-term glucocorticoid therapy are at especially high risk for developing osteoporosis, and may sustain fractures at a lower bone density than those not taking glucocorticoids. All patients should be counseled on the importance of regular weight-bearing exercise and adequate daily intake of calcium and vitamin D. Exposure to medications that cause drowsiness or hypotension should be minimized. Non-pharmacologic therapy to reduce the non-skeletal risk factors for fracture should be considered. These include fall prevention through balance training and muscle strengthening, removal of fall hazards at home, and wearing hip protectors if the risk of falling remains high. Pharmacologic therapy can stabilize or increase bone density in most patients, and reduce fracture risk by about 50

Psychometric evaluation of the Osteoporosis Patient Treatment Satisfaction Questionnaire (OPSAT-Q™, a novel measure to assess satisfaction with bisphosphonate treatment in postmenopausal women

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Shikiar Richard

2006-07-01

Full Text Available Abstract Background The Osteoporosis Patient Satisfaction Questionnaire (OPSAT-Q is a new measure of patient satisfaction with bisphosphonate treatment for osteoporosis. The objective of this study was to evaluate the psychometric characteristics of the OPSAT-Q. Methods The OPSAT-Q contains 16 items in four subscales: Convenience, Confidence with Daily Activities, Side Effects, and Overall Satisfaction. All four subscale scores and an overall composite satisfaction score (CSS can be computed. The OPSAT-Q, Osteoporosis Targeted Quality of Life (OPTQoL, and sociodemographic/clinical questionnaires, including 3 global items on convenience, functioning and side effects, were self-administered to women with osteoporosis or osteopenia recruited from four US clinics. Analyses included item and scale performance, internal consistency reliability, reproducibility, and construct validity. Reproducibility was measured using the intraclass correlation coefficient (ICC via a follow-up questionnaire completed by participants 2 weeks post baseline. Results 104 women with a mean age of 65.1 years participated. The majority were Caucasian (64.4%, living with someone (74%, and not currently employed (58.7%. 73% had osteoporosis and 27% had osteopenia. 80% were taking weekly bisphosphonates and 18% were taking daily medication (2% missing data. On a scale of 0–100, individual patient subscale scores ranged from 17 to 100 and CSS scores ranged from 44 to 100. All scores showed acceptable internal consistency reliability (Cronbach's alpha > 0.70 (range 0.72 to 0.89. Reproducibility ranged from 0.62 (Daily Activities to 0.79 (Side Effects for the subscales; reproducibility for the CSS was 0.81. Significant correlations were found between the OPSAT-Q subscales and conceptually similar global measures (p Conclusion The findings from this study confirm the validity and reliability of the OPSAT-Q and support the proposed composition of four subscales and a composite

Whole body vibration exercise improves body balance and walking velocity in postmenopausal osteoporotic women treated with alendronate: Galileo and Alendronate Intervention Trail (GAIT).

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Iwamoto, J; Sato, Y; Takeda, T; Matsumoto, H

2012-09-01

A randomized controlled trial was conducted to determine the effect of 6 months of whole body vibration (WBV) exercise on physical function in postmenopausal osteoporotic women treated with alendronate. Fifty-two ambulatory postmenopausal women with osteoporosis (mean age: 74.2 years, range: 51-91 years) were randomly divided into two groups: an exercise group and a control group. A four-minute WBV exercise was performed two days per week only in the exercise group. No exercise was performed in the control group. All the women were treated with alendronate. After 6 months of the WBV exercise, the indices for flexibility, body balance, and walking velocity were significantly improved in the exercise group compared with the control group. The exercise was safe and well tolerated. The reductions in serum alkaline phosphatase and urinary cross-linked N-terminal telopeptides of type I collagen during the 6-month period were comparable between the two groups. The present study showed the benefit and safety of WBV exercise for improving physical function in postmenopausal osteoporotic women treated with alendronate.

SCOPE: a scorecard for osteoporosis in Europe

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Kanis, J. A.; Borgström, F.; Compston, J.; Dreinhöfer, K.; Nolte, E.; Jonsson, L.; Lems, W. F.; McCloskey, E. V.; Rizzoli, R.; Stenmark, J.

2013-01-01

The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. Introduction: The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to...

A Retrospective Longitudinal Database Study of Persistence and Compliance with Treatment of Osteoporosis in Hungary.

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Lakatos, Péter; Takács, István; Marton, István; Tóth, Emese; Zoltan, Cina; Lang, Zsolt; Psachoulia, Emi; Intorcia, Michele

2016-03-01

This study assessed persistence and compliance with anti-osteoporosis therapies, and associations between compliance and clinical outcomes (fracture, fracture-related hospitalization and death), in Hungarian women with postmenopausal osteoporosis. The study used the Hungarian National Health Insurance Fund Administration database and included women with PMO aged at least 50 years, for whom a prescription for anti-osteoporosis medication had been filled between 1 January 2004 and 31 December 2013 (index event). Persistence (prescription refilled within 8 weeks of the end of the previous supply) was evaluated over 2 years; good compliance (medication possession ratio ≥ 80 %) was evaluated at 1 year. Associations between compliance and clinical outcomes (data collected for up to 6 years) were assessed with adjustment for baseline covariates. A total of 296,300 women met the inclusion criteria (524,798 index events). Persistence and compliance were higher for less frequent and parenteral therapies (1- and 2-year persistence: half-yearly [parenteral] vs. daily/weekly/monthly [oral and parenteral], 81 and 38 % vs. 21-34 and 10-18 %, respectively; parenteral vs. oral, 75 and 36 % vs. 32 and 16 %; good compliance: half-yearly vs. daily/weekly/monthly, 70 vs. 24-39 %; parenteral vs. oral 78 vs. 36 %). Good compliance significantly reduced the risks of fracture, fracture-related hospitalization and death (relative risk vs. non-compliance [95 % confidence interval]: 0.77 [0.70-0.84], 0.72 [0.62-0.85] and 0.57 [0.51-0.64], respectively; P < 0.01). Improving compliance through long-interval parenteral therapies may result in clinical benefits for patients.

Transient regional osteoporosis

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F. Trotta

2011-09-01

Full Text Available Transient osteoporosis of the hip and regional migratory osteoporosis are uncommon and probably underdiagnosed bone diseases characterized by pain and functional limitation mainly affecting weight-bearing joints of the lower limbs. These conditions are usually self-limiting and symptoms tend to abate within a few months without sequelae. Routine laboratory investigations are unremarkable. Middle aged men and women during the last months of pregnancy or in the immediate post-partum period are principally affected. Osteopenia with preservation of articular space and transitory edema of the bone marrow provided by magnetic resonance imaging are common to these two conditions, so they are also known by the term regional transitory osteoporosis. The appearance of bone marrow edema is not specific to regional transitory osteoporosis but can be observed in several diseases, i.e. trauma, reflex sympathetic dystrophy, avascular osteonecrosis, infections, tumors from which it must be differentiated. The etiology of this condition is unknown. Pathogenesis is still debated in particular the relationship with reflex sympathetic dystrophy, with which regional transitory osteoporosis is often identified. The purpose of the present review is to remark on the relationship between transient osteoporosis of the hip and regional migratory osteoporosis with particular attention to the bone marrow edema pattern and relative differential diagnosis.

SCOPE: a scorecard for osteoporosis in Europe.

Science.gov (United States)

Kanis, J A; Borgström, F; Compston, J; Dreinhöfer, K; Nolte, E; Jonsson, L; Lems, W F; McCloskey, E V; Rizzoli, R; Stenmark, J

2013-01-01

The scorecard summarises key indicators of the burden of osteoporosis and its management in each of the member states of the European Union. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard for osteoporosis in Europe (SCOPE) is an independent project that seeks to raise awareness of osteoporosis care in Europe. The aim of this project was to develop a scorecard and background documents to draw attention to gaps and inequalities in the provision of primary and secondary prevention of fractures due to osteoporosis. The SCOPE panel reviewed the information available on osteoporosis and the resulting fractures for each of the 27 countries of the European Union (EU27). The information researched covered four domains: background information (e.g. the burden of osteoporosis and fractures), policy framework, service provision and service uptake e.g. the proportion of men and women at high risk that do not receive treatment (the treatment gap). There was a marked difference in fracture risk among the EU27. Of concern was the marked heterogeneity in the policy framework, service provision and service uptake for osteoporotic fracture that bore little relation to the fracture burden. For example, despite the wide availability of treatments to prevent fractures, in the majority of the EU27, only a minority of patients at high risk receive treatment for osteoporosis even after their first fracture. The elements of each domain in each country were scored and coded using a traffic light system (red, orange, green) and used to synthesise a scorecard. The resulting scorecard elements were then assembled on a single sheet to provide a unique overview of osteoporosis in Europe. The scorecard will enable healthcare professionals and policy makers to assess their country's general approach to the disease and provide indicators to inform future provision of healthcare.

The presence of Helicobacter Pylori in postmenopausal women is not a factor to the decrease of bone mineral density A presença do Helicobacter pylori em mulheres na pós-menopausa não constitui fator de risco para a diminuição da densidade mineral óssea

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Adriana M. Kakehasi

2007-09-01

Full Text Available BACKGROUND: Osteoporosis affects approximately 30% of postmenopausal women. Gastrectomy, pernicious anemia, and more recently Helicobacter pylori infection, have all been implicated in the pathogenesis of osteoporosis. A reduced parietal cell mass is a common feature in these conditions. AIM: To study a possible relationship between chronic gastritis, parietal cell density of the oxyntic mucosa and bone mineral density in postmenopausal women, as chronic gastritis, Helicobacter pylori infection and osteoporosis are frequently observed in the elderly. METHODS: Fifty postmenopausal women (61.7 ± 7 years were submitted to gastroduodenal endoscopy and bone densitometry by dual energy X-ray absorptiometry. Glandular atrophy was evaluated objectively by the determination of parietal cell density. Helicobacter pylori infection was evaluated by histology, urease test and breath test with 13C. RESULTS: Thirty-two patients (64% presented chronic multifocal gastritis, and 20 of them (40% showed signs of gastric mucosa atrophy. Lumbar spine osteoporosis was found in 18 patients (36%. The parietal cell density in patients with and without osteoporosis was 948 ± 188 and 804 ± 203 cells/mm², respectively. Ten osteoporotic patients (55% and 24 non-osteoporotic patients (75% were infected by Helicobacter pylori. CONCLUSION: Postmenopausal women with osteoporosis presented a well-preserved parietal cell density in comparison with their counterparts without osteoporosis. Helicobacter pylori infection was not different between the two groups. We concluded that neither atrophic chronic gastritis nor Helicobacter pylori seem to be a reliable risk factor to osteoporosis in postmenopausal women.RACIONAL: A osteoporose afeta aproximadamente 30% das mulheres na pós-menopausa. Gastrectomia, anemia perniciosa e mais recentemente, a infecção pelo H. pylori, têm sido implicados na patogênese da osteoporose. A diminuição da massa de células parietais constitui

Study on the relationship between serum testosterone level and forearm distal bone density in post-menopausal women

International Nuclear Information System (INIS)

Li Wenqi; Zhou Zhengli; Li Xin; Zhou Jiwen

2002-01-01

Objective: To study the relationship between the androgen level and bone density in post-menopausal women. Methods: Serum testosterone (T) level and forearm distal bone density (BMD) were measured in 39 past-menopausal women who had never taken any estrogen or calcium preparation. Their serum estradiol (E 2 ) levels were about the same. According to their BMD, the 39 subjects were divided into normal (n = 22) and osteoporotic (n = 17) groups. Results: The mean serum testosterone (T) level in the normal group was significantly higher than that in the osteoporotic group (p 1 = 0.72, r 2 0.75; p 1 and r 2 was 0.14, suggesting similarity of the positive cor-relationship for both groups (p > 0.05). Conclusion: Serum testosterone level seems to bear close relationship with bone density and osteoporosis

Soy isoflavone tablets reduce osteoporosis risk factors and obesity in middle-aged Japanese women.

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Mori, Mari; Aizawa, Toru; Tokoro, Minoru; Miki, Tomohiro; Yamori, Yukio

2004-12-01

1. This study examines whether the supplementation of isoflavones (ISO) exerts beneficial effects on the bone mineral density (BMD) measured by dual energy X-ray absorptiometry (DEXA). 2. Eighty-one healthy Japanese pre- and postmenopausal women were randomly assigned to the following two groups taking either ISO (100 mg) tablets (ISO group) or placebo tablets (P group) containing vitamins C (25 mg) and E (5 mg) daily for 24 weeks in a double-blind placebo controlled parallel design. 3. Seventy women completed the intervention study (34 on ISO, 36 on P), only ISO group was proven to increase significantly BMD (P osteoporosis and obesity and, thus to overall health promotion in menopausal women.

Radiotherapy of presenile spinal osteoporosis

International Nuclear Information System (INIS)

Keim, H.M.; Schiebusch, M.

1982-01-01

Painfull conditions of presenile spinal osteoporosis may no longer respond to medication or physical therapy. Analgesic radiotherapy coupled with mild physical therapy and if necessary supported by orthopedic measures frequently results in pain relief and physical stability. Fifty-two cases of osteoporosis and osteoporotic spinal fractures illustrate how better longterm results are achieved by increasing the customary dosage and speeding up radiotherapy. (orig.) [de

Carotid intima-media thickness and calcification in relation to bone mineral density in postmenopausal women-the OSTPRE-BBA study.

Science.gov (United States)

Värri, Miika; Tuomainen, Tomi-Pekka; Honkanen, Risto; Rikkonen, Toni; Niskanen, Leo; Kröger, Heikki; Tuppurainen, Marjo T

2014-08-01

Atherosclerosis (AS) and osteoporosis are common diseases in elderly people and may be metabolically related. The aim of this cross-sectional population-based study was to explore the association between common carotid artery intima-media thickness (cIMT), carotid artery calcification (CAC), and BMD in postmenopausal women. In addition, the association of postmenopausal hormone therapy (HT) and selected diseases with cIMT and carotid calcification was studied. The 290 women (mean age 73.6 years) included in this Bone Brain Atherosclerosis study (OSTPRE-BBA) were randomly selected from the population-based Kuopio Osteoporosis Risk Factor and Prevention (OSTPRE) study cohort, Finland. For this cross-sectional study, cIMT was measured with B-mode ultrasound; femoral neck and total body BMD were measured with dual-energy X-ray absorptiometry. There were no statistically significant associations between mean cIMT and femoral neck T-score (p>0.05). However, an increased maximum cIMT was significantly associated with low femoral neck T-score. In the osteoporotic group (T-score -1, n=122), it was 1.93±0.64mm (p=0.001). The odds of having CAC were approximately four-fold higher in the osteoporotic group compared with the group with a normal femoral neck T-score (odds ratio [OR]=4.2, p=0.038). The maximum cIMT was smaller in HT users (1.98±0.56mm, n=190) than in non-users (2.16±0.74mm, n=156, p=0.036). The results of our population-based study suggest that BMD is related to AS, at least in carotid arteries. They indirectly support the hypothesis of partially shared pathophysiological mechanisms between these two disorders. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

[Secondary osteoporosis induced by anticoagulants?].

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Riess, H; Loew, A; Himmelreich, G

2001-07-01

Generalized osteoporosis is a result of different causes and pathogenic mechanisms, which often combine forces to become clinically relevant. Among the different exogenic factors, drugs play an important role, frequently in connection with other factors such as immobilization or pregnancy. It has been suggested that anticoagulation therapy with heparins or coumarins may induce osteoporotic changes or enhance the development of osteoporosis for other reasons. According to in vitro experiments, preclinical trials, and clinical investigations, it seems reasonable to assume that heparins induce increased bone loss in a time- and dose-related manner. Low-molecular-weight heparins most likely have less effect on bone turnover when compared to unfractionated heparin. Oral anticoagulation therapy with vitamin K-antagonists is believed to have a weak effect on induction of osteoporosis, but clinical studies are contradictory. In spite of the fact that a relevant effect of these drugs on the induction of osteoporosis is questionable, it must be taken into consideration that anticoagulant drugs may enhance the negative effects on bone density of other risk factors capable of inducing osteoporosis such as immobilization, pregnancy, or endocrinological disorders.

Detection and significance of serum insulin-like growth factor-1 in patients with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis

Institute of Scientific and Technical Information of China (English)

Yan-Rong Kang; Pei-Li Gu

2016-01-01

Objective:To investigate the content of insulin-like growth factor-1 (IGF-1) in serum and the relationship with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis.Methods:A total of 86 cases of patients with type 2 diabetes, 82 cases of patients with osteoporosis, 79 cases of patients with type 2 diabetic osteoporosis and 86 cases of healthy person were selected, the levels of IGF-1, diabetes related factors (fasting plasma c-peptide, FIN, HbA1c, GLU) and osteoporosis related factors (BMP, osteocalcin,β-CTx, P1NP, lumbar vertebra BMD) were detected, the relationship between the above indicators were compared with those of the disease.Results: In each group, content change of IGF-1 was not statistically significant; content changes of IGF-1, BMP and osteocalcin were control group>type 2 diabetes group>osteoporosis group>type 2 diabetic osteoporosis group. Diabetic osteoporosis enhanced the decrease of IGF-1 content. The contents ofβ-CTx and P1NP in osteoporosis group and diabetic osteoporosis group were similar, which were significantly lower than that in control group and type 2 diabetes group. The level of lumbar vertebra BMD in osteoporosis group and diabetic osteoporosis group were the lowest. Fasting plasma c-peptide in diabetes group and diabetic osteoporosis group were significantly lower than that in control group and osteoporosis group, and the content of fasting plasma c-peptide in diabetic osteoporosis group was the lowest. The contents of FIN, HbA1c and GLU in type 2 diabetes group and type 2 diabetic osteoporosis group were significantly higher than that in control group and osteoporosis group.Conclusion:IGF-1 was related with type 2 diabetes, osteoporosis and type 2 diabetic osteoporosis, and could offer help for predicting type 2 diabetes and osteoporosis in the future.

The epidemiology of serum sex hormones in postmenopausal women

International Nuclear Information System (INIS)

Cauley, J.A.; Kuller, L.H.; LeDonne, D.; Gutai, J.P.; Powell, J.G.

1989-01-01

Serum sex hormones may be related to the risk of several diseases including osteoporosis, heart disease, and breast and endometrial cancer in postmenopausal women. In the current report, the authors examined the epidemiology of serum sex hormones in 176 healthy, white postmenopausal women (mean age 58 years) recruited from the metropolitan Pittsburgh, Pennsylvania, area. The data were collected during 1982-1983; none of the women were on estrogen replacement therapy. Serum concentrations of estrone, estradiol, testosterone, and androstenedione were measured by a combination of extraction, column chromatography, and radioimmunoassay. Neither age nor time since menopause was a significant predictor of sex hormones. The degree of obesity was a major determinant of estrone and estradiol. The estrone levels of obese women were about 40% higher than the levels of nonobese women. There was a weak relation between obesity and the androgens. Cigarette smokers had significantly higher levels of androstenedione than nonsmokers, with little difference in serum estrogens between smokers and nonsmokers. Both estrone and estradiol levels tended to decline with increasing alcohol consumption. Physical activity was an independent predictor of serum estrone. More active women had lower levels of estrone. There was a positive relation of muscle strength with estrogen levels. The data suggest interesting relations between environmental and lifestyle factors and serum sex hormones. These environmental and lifestyle factors are potentially modifiable and, hence, if associations between sex hormones and disease exist, modification of these factors could affect disease risks

The epidemiology of serum sex hormones in postmenopausal women

Energy Technology Data Exchange (ETDEWEB)

Cauley, J.A.; Kuller, L.H.; LeDonne, D. (Univ. of Pittsburgh, PA (USA)); Gutai, J.P. (Wayne State Univ., Detroit, MI (USA)); Powell, J.G. (East Carolina School of Medicine, Greenville, NC (USA))

1989-06-01

Serum sex hormones may be related to the risk of several diseases including osteoporosis, heart disease, and breast and endometrial cancer in postmenopausal women. In the current report, the authors examined the epidemiology of serum sex hormones in 176 healthy, white postmenopausal women (mean age 58 years) recruited from the metropolitan Pittsburgh, Pennsylvania, area. The data were collected during 1982-1983; none of the women were on estrogen replacement therapy. Serum concentrations of estrone, estradiol, testosterone, and androstenedione were measured by a combination of extraction, column chromatography, and radioimmunoassay. Neither age nor time since menopause was a significant predictor of sex hormones. The degree of obesity was a major determinant of estrone and estradiol. The estrone levels of obese women were about 40% higher than the levels of nonobese women. There was a weak relation between obesity and the androgens. Cigarette smokers had significantly higher levels of androstenedione than nonsmokers, with little difference in serum estrogens between smokers and nonsmokers. Both estrone and estradiol levels tended to decline with increasing alcohol consumption. Physical activity was an independent predictor of serum estrone. More active women had lower levels of estrone. There was a positive relation of muscle strength with estrogen levels. The data suggest interesting relations between environmental and lifestyle factors and serum sex hormones. These environmental and lifestyle factors are potentially modifiable and, hence, if associations between sex hormones and disease exist, modification of these factors could affect disease risks.

The Cooccurrence of Obesity, Osteoporosis, and Sarcopenia in the Ovariectomized Rat: A Study for Modeling Osteosarcopenic Obesity in Rodents.

Science.gov (United States)

Ezzat-Zadeh, Zahra; Kim, Jeong-Su; Chase, P Bryant; Arjmandi, Bahram H

2017-01-01

Obesity, osteoporosis, and sarcopenia may individually occur due to age-related gradual alterations in body composition. This study investigates the cooccurrence of these age-related diseases in female animals with low levels of ovarian hormone in the absence of complex multifactorial process of chronological aging. Thirty-six 5- and 10-month-old female rats were chosen to model pre- and postmenopausal women, respectively. Rats were divided into three treatment groups in each age category-sham, ovariectomized (ovx), and ovx + E 2 (17 β -estradiol, 10  μ g/kg)-and were pair-fed. Volunteer wheel running activity, body composition, bone microstructure, serum C-telopeptides of type I collagen, bone specific alkaline phosphatase, E 2 , and gastrocnemius and soleus muscles were analyzed. The cooccurrence of osteoporosis, sarcopenia, and obesity was observed in the older ovx rats associated with a significant ( p obesity and body composition translational research in females without the confounding effect of genetic background.

Association between serum 25-hydroxyvitamin D levels and bone mineral density in normal postmenopausal women

Directory of Open Access Journals (Sweden)

Vasundhara Kamineni

2016-01-01

Full Text Available Aim: This study was conducted with the objective of assessing serum 25-hydroxyvitamin D (25(OHD in postmenopausal women (PMW, to detect osteopenia or osteoporosis in PMW and to establish a correlation between serum 25(OHD levels and bone mineral density (BMD. Materials and Methods: A total of 100 healthy PMW were selected, and a prospective observational study was conducted to correlate the BMD with serum 25(OHD levels. Their laboratory investigations along with serum 25(OHD levels were done. Their BMD was assessed with dual-energy X-ray absorptiometry at lumbar spine and neck of femur; T-scores were derived. Correlation analysis was done to investigate the relationship between serum 25(OHD levels and BMD. Results: The proportion of osteoporosis at the hip was 31.9% in deficient group, 16.1% in insufficient, and 18.2% in sufficient group and at lumbar spine, it was 27.7%, 16.1%, and 22.7%, respectively. Forty-seven percent of PMW had deficient (<20 ng/ml serum 25(OHD levels and 31% had insufficiency. T-score at hip in deficient group was −2.05 ± 0.25, and in an insufficient group, it was −1.79 ± 0.13; T-score at lumbar spine was −1.92 ± 0.12 and −1.79 ± 0.12, respectively, but both were not statistically significant. Osteoporosis was seen in 24%, osteopenia in 55% at hip level and 23% and 59% respectively at lumbar spine. There was no association between serum 25(OHD levels and BMD neither at hip nor at lumbar spine ( P = 0.51 and P = 0.79 respectively. Conclusion: In this study, among our cohort of patients there was no correlation between serum 25(OHD levels and BMD. However, Vitamin D deficiency coexists with low BMD. Vitamin D insufficiency is a common risk factor for osteoporosis associated with increased bone remodeling and low bone mass.

Negative correlation between bone mineral density and TSH receptor antibodies in long-term euthyroid postmenopausal women with treated Graves’ disease

DEFF Research Database (Denmark)

Ercolano, Monica A; Drnovsek, Monica L; Croome, Maria C

2013-01-01

Thyrotoxicosis is a cause of secondary osteoporosis. High concentrations of triiodotironine (T3) in Graves' disease stimulate bone turnover, but it is unclear if euthyroidism will always normalize bone metabolism. Thyrotropin (TSH) is known to affect directly the bone metabolism through the TSH...... receptor and TSH receptor antibodies (TRAb) may have an important role in bone turn-over.The aim of our study was to determine, in pre and postmenopausal euthyroidism patients with previous overt hyperthyroidism due to Graves' disease the bone mineral density (BMD) as well as factors that could affect BMD...

Cytokines and T-lymphocyte subsets in healthy post-menopausal women: estrogen retards bone loss without affecting the release of IL-1 or IL-1ra

DEFF Research Database (Denmark)

Abrahamsen, Bo; Bendtzen, Klaus; Beck-Nielsen, H

1997-01-01

resorptive cytokines and have also been linked with bone metabolism and the development of osteoporosis. Cytokine secretion from whole blood cell cultures was compared between two randomized groups of healthy early post-menopausal women (mean age 52.5 yrs, N = 91) and lymphocyte subsets were quantitated....... There was no association between cytokine release and bone mass or loss assessed over 2 yrs. The only exception was a weak estrogen-independent correlation between basal IL-1ra secretion and bone loss (r = -0.21, p loss...... cells may be important in the pathophysiology of post-menopausal bone loss. The possibility that IL-1ra acts as an independent bone-sparing factor unrelated to estrogen withdrawal warrants further investigation. In conclusion, ERT maintains bone without affecting the release of the IL-1 family...

Evaluation of MicroRNA 125b as a potential biomarker for ...

African Journals Online (AJOL)

Purpose: To identify significant dysregulated miRNAs in postmenopausal osteoporosis in Chinese women and to test whether any of these miRNAs have diagnostic potential as circulatory biomarkers for postmenopausal osteoporosis. Methods: Thirty osteoporotic patients and 30 non-osteoporotic healthy individuals were ...

A multi-modal intervention for Activating Patients at Risk for Osteoporosis (APROPOS): Rationale, design, and uptake of online study intervention material.

Science.gov (United States)

Danila, Maria I; Outman, Ryan C; Rahn, Elizabeth J; Mudano, Amy S; Thomas, Tammi F; Redden, David T; Allison, Jeroan J; Anderson, Fred A; Anderson, Julia P; Cram, Peter M; Curtis, Jeffrey R; Fraenkel, Liana; Greenspan, Susan L; LaCroix, Andrea Z; Majumdar, Sumit R; Miller, Michael J; Nieves, Jeri W; Safford, Monika M; Silverman, Stuart L; Siris, Ethel S; Solomon, Daniel H; Warriner, Amy H; Watts, Nelson B; Yood, Robert A; Saag, Kenneth G

2016-12-15

To develop an innovative and effective educational intervention to inform patients about the need for osteoporosis treatment and to determine factors associated with its online uptake. Postmenopausal women with a prior fracture and not currently using osteoporosis therapy were eligible to be included in the Activating Patients at Risk for OsteoPOroSis (APROPOS). Four nominal groups with a total of 18 racially/ethnically diverse women identified osteoporosis treatment barriers. We used the Information, Motivation, Behavior Skills conceptual model to develop a direct-to-patient intervention to mitigate potentially modifiable barriers to osteoporosis therapy. The intervention included videos tailored by participants' race/ethnicity and their survey responses: ranked barriers to osteoporosis treatment, deduced barriers to treatment, readiness to behavior change, and osteoporosis treatment history. Videos consisted of "storytelling" narratives, based on osteoporosis patient experiences and portrayed by actresses of patient-identified race/ethnicity. We also delivered personalized brief phone calls followed by an interactive voice-response phone messages aimed to promote uptake of the videos. To address the factors associated with online intervention uptake, we focused on participants assigned to the intervention arm (n = 1342). These participants were 92.9% Caucasian, with a mean (SD) age 74.9 (8.0) years and the majority (77.7%) had some college education. Preference for natural treatments was the barrier ranked #1 by most (n = 130; 27%), while concern about osteonecrosis of the jaw was the most frequently reported barrier (at any level; n = 322; 67%). Overall, 28.1% (n = 377) of participants in the intervention group accessed the videos online. After adjusting for relevant covariates, the participants who provided an email address had 6.07 (95% CI 4.53-8.14) higher adjusted odds of accessing their online videos compared to those who did not. We developed and

Recurrent Hip Fracture Prevention With Osteoporosis Management

Directory of Open Access Journals (Sweden)

A. Shahla

2007-02-01

Full Text Available Background:Osteoporosis is a major public health threat,and hip fracture is a serious consequence of osteoporosis.Apatient with an osteoporosis-related hip fracture has an increased risk for a second hip fracture.The effect of osteoporosis management on the risk of recurrent hip fracture was evaluated in this study.Methods:58 hip fracture patients older than 50yr and BMD < 2.5 were discharged from hospital with Ca-Vitamin D- Alendronate prescriptions, and followed up for 4 years to determine the rate of recurrent hip fractures. Rate of second hip fractures was compared with 58 hip fractures in the control group (without osteoporosis treatment which were also followed for 4 years. Results:72% of patients continued treatment for 2 years. There were no second hip fractures in the critical first 12 months in the treated group.Overall second hip fractures in osteoporosis treated and control groups were 3.4% and 8.6%(p<0.03, respectively.Conclusion:Management of hip fractures in the elderly should include bone mineral density determination and osteoporosis treatment to prevent further fractures.