Familial aggregation of bone mineral density and bone mineral content in a Chinese population

Familial aggregation of bone mineral density (BMD) and bone mineral content (BMC) has been shown in twin and familial studies, but most sample sizes were small. We here report a large familial aggregation study in a Chinese population. A total of 13,973 siblings aged 25–64 years from 3,882 families were enrolled from Anhui, China. We assessed the whole-body, hip and lumbar spine BMD and BMC by dual-energy X-ray absorptiometry (DXA). Intra-class correlation coefficients of BMD and BMC between siblings varied among different skeletal sites and between different age groups of male sib-pairs and premenopausal and postmenopausal female sib-pairs, with a range of 0.228 to 0.397. The sibling recurrence risk ratio (s) of osteoporosis was 2.6 in our population. We also evaluated the joint association of the BMD values of the first siblings and the second siblings with the risk of low BMD (defined as less than the 10th percentile of the same group population) of their younger siblings. If both the first and second siblings BMDs were in the lowest tertile, the odd ratios (ORs) of low BMD in their subsequent siblings were 8.32 [95% confidence interval (CI) 5.59–12.39)], 8.71 (95% CI 5.74–13.22) and 5.90 (95% CI 3.57–9.76) for total body, total hip and lumbar spine, respectively. This study demonstrates a significant familial aggregation of BMD and BMC in a large sample of rural Chinese adults.     

Effects of anticonvulsant drug therapy on bone mineral density in a pediatric population

Twenty epileptic outpatients, aged 5-20 years and taking either phenobarbital or phenytoin for anticonvulsant therapy, were evaluated for femoral neck area bone mineral content and bone mineral density using dual photon absorptiometry. Duration of treatment averaged 51.4 months (range, 9-124 months). A group of 20 normal children who were matched for age, sex, and race served as controls. There were no statistically significant differences between the femoral neck area bone mineral densities of the epileptic patients as compared to the controls. There were also no correlations between duration of anticonvulsant therapy and bone mineral density, nor any differences in bone mineral density values when comparing epileptic patients taking phenobarbital with those patients taking phenytoin.     

Determinants of bone mineral density in Chinese men

Osteoporotic fractures are increasing among Asian populations in both genders, but the risk factors for low bone mineral density (BMD) in Asian men is unclear. To determine the hormonal and lifestyle risk factors for low BMD in Asian men, we studied 407 community-dwelling southern Chinese men aged 50 years and above. Medical history and lifestyle habits were obtained with a structured questionnaire. Dietary calcium and phytoestrogen intake were assessed by a semi-quantitative questionnaire. BMD at the spine and hip were measured by dual-energy X-ray absorptiometry (DXA). Fasting blood was analyzed for 25(OH)D, parathyroid hormone (PTH), total and bioavailable estradiol (bio-E) and testosterone (bio-T). The mean age of the cohort was 68.42±10.4 (50–96) years. In the linear regression model, weight, age, body mass index (BMI), bio-E, PTH, cigarette smoking and weight-bearing exercise were significant determinants of total hip BMD. Together they explained 55% of the total variance of hip BMD, with body weight being the most important determining factor. With age and weight adjustment, height, bio-T and flavonoid intake were identified as additional determinants of total hip BMD. Strategies to prevent bone loss and osteoporosis in Asian men should include lifestyle modification and maintenance of hormonal sufficiency.     

Effects of physical activity and dietary calcium intake on bone mineral density and osteoporosis risk in a rural Thai population

The objective of the study was to determine the effects of modifiable risk factors on bone mineral density in postmenopausal Thai women. Dietary calcium intake (g/day), energy expenditure (kcal/day), and sunlight exposure (h/day) were assessed in 129 rural Thai women aged 63 years (range 50 to 84 years). Bone mineral density (BMD) at the femoral neck, lumbar spine, and distal radius were measured by dual-energy X-ray absorptiometry (DXA). The average dietary calcium intake was 236 ± 188 g/day (mean ± SD), while the energy expenditure was 2,118 ± 656 kcal/day with 1.1 ± 1.7 h of sunlight exposure. In multiple linear regression analysis, dietary calcium intake, energy expenditure, and years since menopause were significant and independent predictors of BMD at various sites. The three factors together accounted for between 35% and 45% of the variance of BMD. The prevalence of osteoporosis (defined as BMD T-scores –2.5) was 33% at the femoral neck, 42% at the lumbar spine, and 35% at the distal radius. The risk of osteoporosis was higher in women with lower dietary calcium intake (138 mg/day; prevalence rate ratio [PRR], 1.4; 95% confidence interval [CI], 1.0 to 1.9), lower energy expenditure (1,682 kcal; PRR, 1.7; 95% CI, 1.2 to 2.3), and greater years since menopause (6 years; PRR, 2.6; 95% CI, 1.2 to 5.8). The population attributable risk fraction of osteoporosis risk due to the three factors was 70%. These results suggest that in the Thai population, low dietary calcium intake and low physical activity together with advancing years since menopause were independent risk factors for low BMD.     

Genetic determination of variation and covariation of bone mineral density at the hip and spine in a Chinese population

Bone mineral density (BMD) is a significant determinant of risk for osteoporosis. Genetic factors are known to account for a major proportion of variation of BMD in Caucasians. However, the degree of genetic determination of BMD in Chinese populations has seldom been investigated. The aim of our study was to investigate the magnitude of the genetic determination of BMD at the spine and hip, and their genetic covariation, in a population of Shanghai city in P. R. China. The subjects consisted of 44 full-sib pairs of females aged 19–43 years, 186 mother-daughter pairs, and 270 nuclear families. For BMD at the spine and hip, the values for narrow-sense heritability h ² (±SE) were 0.72 ± 0.14 and 0.87 ± 0.14, respectively, when estimated by full-sib pairs, and 0.44 ± 0.07 and 0.77 ± 0.07, respectively, when estimated by mother-daughter pairs. There was a significant genetic correlation r _g (±SE) of BMD between the spine and hip, of 0.97 ± 0.01 and 0.76 ± 0.04, respectively, when estimated by full-sib pairs and mother-daughter pairs. The common household impact on BMD in our study was negligible according to the statistical estimate. We conclude that genetic factors play a major role in the determination of the variation and covariation of BMD at the spine and hip in our Chinese sample.     

Risk assessment instruments for screening bone mineral density in a Mediterranean population

AIM To evaluate the power of six osteoporosis-screening instruments in women in a Mediterranean country.METHODS Data concerning several osteoporosis risk factors were prospectively collected from 1000 postmenopausal women aged 42-87 years who underwent dual-energy X-ray absorptiometry(DEXA) screening. Six osteoporosis risk factor screening tools were applied to this sample to evaluate their performance and choose the most appropriate tool for the study population.RESULTS The most important screening tool for osteoporosis status was the Simple Calculated Osteoporosis Risk Estimation, which had an area under the curve(AUC)of 0.678, a sensitivity of 72%, and a specificity of 72%, with a cut-off point of 20.75. The most important screening tool for osteoporosis risk was the Osteoporosis Self-assessment Tool, which had an AUC of 0.643, a sensitivity of 77%, and a specificity of 46%,with a cut-off point of-2.9.CONCLUSION Some commonly used clinical risk instruments demonstrate high sensitivity for distinguishing individuals with DEXA-ascertained osteoporosis or reduced bone mineral density.     

Sexual differences in bone markers and bone mineral density of normal Chinese

We measured bone mineral density (BMD) at lumbar (L2–L4) vertebrae and proximal femurs of 385 healthy Chinese women aged 40–70 years and 156 healthy Chinese men aged 20–85, and four markers—bone alkaline phosphatase isozyme (BAP), procollagen-I C terminal propeptide (PICP), osteocalcin (BGP) in serum, and a bone resorption marker, urinary cross-linked N-telopeptide of type I collagen (NTX), of these subjects. The results indicate that in postmenopausal women, levels of all the markers increased with age. In men, serum BAP, PICP, and urinary NTX decreased significantly, and serum BGP decreased with borderline significance (P=0.08). With increasing age, bone density decreased at both sites in post-menopausal women and at the proximal femur in men. The lumbar bone density showed no significant age-related changes in men. In premenopausal women, BMD at either site showed no significant change with increasing age. Despite the different trends between men and women of agerelated changes in BMD and bone markers, bone density of both proximal femur and spine in both sexes correlated inversely with levels of the bone markers in a manner independent of age or body weight. The meaning of opposite age effects on bone markers in men and women needs further investigation. In addition, higher bone marker levels, implying faster bone turnover rate, are associated with lower BMD in both sexes.     

中药对绝经妇女股骨颈骨密度及股骨颈抗骨折能力的影响

目的 观察中药强骨胶囊（QGJN）对绝经妇女股骨颈骨密度（BMD）及股骨颈抗骨折能力（FS）的影响。方法 择自愿参加研究的绝经1年以上，年龄60岁以下的骨量减少或骨质疏松的绝经妇女150例，随机分为3组：中药＋激素组（50例）：采用中药QGJN联合雌激素戊酸雌二醇治疗；中药组（50例）：单纯用中药QGJN治疗；激素组（50例）：单纯用雌激素戊酸雌二醇周期序贯治疗；另50例符合上述条件，目前不愿接受研究用药的绝经妇女作为对照组。各组均于治疗前及治疗后24W采用DEXA骨密度仪测定股骨颈（BMD）。采用肌肉功能分析仪测定股骨颈抗骨折能力（FS）。结果 因各种原因失访18例，182例（包括对照组）完成了总疗程。中药＋激素组（46例）、中药组（48例）、激素组（42例）、股骨颈BMD及FS较治疗前均有明显升高，增幅分别为7．33％、9．04％（P〈0．01）；3．38％，5．87％（P〈0.01）；3．57％，5．91％（P〈0．01），其中中药＋激素组BMD及FS升高幅值均明显高于中药组（P〈0．01）和激素组（P〈0.01）；而激素组上述指标较中药组略高，但差异无显著性（P〉0．05）；对照组（46例）的BMD及FS明显下降。下降幅值分别为3、30％、5．31％。P〈0．01）。结论 中药强骨胶囊能提高绝经妇女股骨颈骨密度及股骨颈抗骨折能力。从而对绝经妇女骨质疏松具有较好的防治作用。其效果与雌激素戊酸雌二醇相仿。两药联用效果更好。     

被动吸烟对大鼠骨密度与骨代谢的影响

目的　探讨大鼠骨质疏松与吸烟的关系。方法　将 32只Wister大白鼠随机分成 4组 ,分别予以不吸烟、被动吸烟 2、3和 4个月 ,测量大鼠骨密度并检测血清骨钙素、尿钙与尿肌酐。结果　吸烟 2个月与 3个月组大鼠骨密度与对照组差异无显著性 (P >0 .0 5) ;吸烟 4个月组大鼠活体腰椎总体和各单个腰椎的骨密度 (g/cm2 )分别为 0 .1 791± 0 .0 0 96、0 .1 774± 0 .0 0 92、0 .1 76 7± 0 .0 1 1 0和 0 .1 799± 0 .0 1 4 0 ,相应的离体骨密度 (g/cm2 )分别为 0 .2 0 5 4± 0 .0 0 88、0 .2 0 1 5± 0 .0 0 72、0 .2 0 94± 0 .0 1 1 2和 0 .2 1 6 9± 0 .0 1 4 0 ,均显著低于对照组 (P <0 .0 1或P <0 .0 5) ,离体股骨和胫骨整体及各感兴趣区骨密度也显著低于对照组 (P <0 .0 1或P <0 .0 5) ,全身骨密度两组差异无显著性 (P >0 .0 5) ;4组大鼠血清骨钙素水平差异无显著性 ;吸烟 2个月组与对照组尿Ca/Cr差异无显著性 ,吸烟 3个月与 4个月组大鼠尿Ca/Cr分别为 0 .787± 0 .2 2 6和0 .781± 0 .2 1 7,显著低于对照组 (P <0 .0 5) ,且吸烟 4个月组大鼠骨密度除全身骨密度外均与尿Ca/Cr呈负相关。结论　吸烟使骨吸收增强从而导致骨丢失、发生骨质疏松 ,尿Ca/Cr较骨密度对骨丢失更敏感     

Study of bone mineral density in lumbar spine and femoral neck in a Spanish population

The aim of this study was to generate standard curves for bone mineral density (BMD) in a Spanish population using dual-energy X-ray absorptiometry (DXA), at both lumbar spine and femoral neck sites. The total sample size was 2442 subjects of both sexes aged 20–80 years, stratified according to survival rates, demographic distribution by local regions and sex ratio in the Spanish population. Subjects with suspected conditions affecting bone metabolism or receiving any treatment affecting bone mineralization were excluded. The study was carried out in 14 hospitals and bone density measurements were performed, using a QDR/1000 Hologic device. In the female population, the highest value for lumbar spine BMD was found within the 30–39 years age group, being significantly lower after the age of 49 years. In the male population, the highest values for lumbar spine BMD are found one decade earlier than in the female population and become significantly lower after the age of 69 years. The highest values for femoral neck BMD in men and women was found in the 20–29 year age group. Values for femoral neck BMD in the female population become statistically lower after the age of 49 years, while in the male population this effect was seen after the age of 69 years. Values for femoral neck BMD were higher in men than women at all ages.Others investigators of the Multicentre Research Project on Osteoporosis: Drs Torrijos, Aguado, Espinosa (H. La Paz, Madrid); Drs Lozano, Gonzalez (H. Clínico San Carlos, Madrid); Drs Yagüe, López Gavilanes (F. Jimenez Díaz, Madrid); Drs Portugal, Del Pino, Martín (H. Clínico Univ., Salamanda); Drs Roig, Nolla (Ciudad Sanitaria Bellvitge, Barcelona); Drs Farrerons, Lopez Navidad, Yoldi (H. Sta. Creu i San Pau, Barcelona); Drs Diez Pérez, Kanterewicz, Martínez Izquierdo, H. de la Esperanza, Barcelona); Drs. Romeu, Edo, Monzó (H. La Fe, Valencia); Drs Moruno, Vazquez (H. Clínico Univesitario, Sevilla); Drs Escobar, Muñoz Torres, Raya, Salvatierra (H. Clínico Universitario, Granada); Drs Cannata, Gómez Alonso, Virgós (H. Central de Asturias); Drs Ferrer, Peguero (H. Miguel Servet, Zaragoza); Drs Ganoza, Barrios (Clinica Universitaria, Pamplona); Drs Betancor, Sosa Henríquez, Hernandez Hernandez (H. Insular Las Palmas).     

Effects of tobacco use on axial and appendicular bone mineral density

Tobacco use has been identified as being a risk factor for the development of osteoporosis. While some data have suggested an effect on peripheral bone mass there are little previous data examining the role of tobacco use in axial skeletal bone loss. We examined tobacco use in relation to lumbar spine and proximal femur bone mineral density and forearm bone mineral content in 203 women. Data from identical twin pairs, comprising a subgroup of the larger group as well as a small number of male twin pairs, was also analyzed. The data show a difference in lumbar and proximal femur BMD of 0.03 and 0.06 g/cm2 respectively between smoking and nonsmoking identical twins. There was however no difference in the cross-sectional studies and no significant deleterious effect detected of tobacco use on forearm bone mineral content. The effect of smoking on lumbar and proximal femur bone mineral density, in identical twins discordant for tobacco use, was equivalent on average to 3 to 4 years of normal postmenopausal bone loss.     

Effects of glucocorticoids on bone mineral density in rheumatoid arthritis patients

We carried out a comparative study in 78 post-menopausal women with rheumatoid arthritis (RA). Forty-four women with a mean disease duration of 17.5 years had been treated with low-dose glucocorticoid (prednisone at < 5 mg/day) for at least 12 months. They were studied for an average period of 3 years and 8 months. The remaining 34 women had been treated only with non-steroidal anti-rheumatic drugs (NSAIDs) and served as the control group. Bone mineral density (BMD) in the lumbar spine (L2–4) and femoral neck was measured by dual-energy X-ray absorptiometry (DXA). Reduction of BMD in the lumbar spine was significant in both groups (P < 0.05 ∼ 0.01), but there was no statistically significant difference between the two groups. BMD of the femoral neck decreased significantly (P < 0.05) in the prednisone group, but again the difference was not significant between the two groups. Our data suggest that low-dose prednisone administration probably does not induce significant axial bone loss in female RA patients. Received: 29 January 1998     

Effects of short-term alendronate on bone mineral density in haemodialysis patients

BACKGROUND: Low bone mineral density (BMD) is common in dialysis patients. Low BMD predicts the fracture risk in the general population. Bisphosphonate therapy improves BMD and lowers the fracture risk in many populations, but has not been tested in dialysis patients because of concerns about toxicity. In this investigation, the effect of a short course of alendronate on BMD in haemodialysis (HD) patients is evaluated. METHODS: Thirty-one healthy HD patients were randomized to placebo versus 40 mg alendronate, taken once a week for 6 weeks. Hip and lumbar spine BMD were measured by dual energy X-ray absorptiometry at baseline and at 6 months. Osteocalcin, parathyroid hormone, calcium, phosphorous and alkaline phosphatase levels were assayed at baseline and at 1, 3 and 6 months. RESULTS: The BMD and T-scores in specific regions of the hip were stable in the treatment group and decreased in the placebo group (P=0.05). The lumbar spine density increased minimally in both groups. In the treatment group, osteocalcin levels declined significantly at 1 month (P<0.05) and remained low. The main side-effect in the alendronate group was occurrence of gastroesophageal reflux symptoms in three subjects. CONCLUSIONS: Low-dose alendronate, administered for a limited duration, appears to be well tolerated in dialysis patients. The BMD and T-scores declined at certain hip regions in the placebo group over 6 months, while remaining stable in the treatment group, suggesting a bone-preserving effect of alendronate. Further studies of longer duration, and including examination of bone histology, are needed to assess whether bisphosphonates can be used to preserve BMD in dialysis patients.     

绝经前女性被动吸烟对骨密度的影响

目的 观察绝经前女性被动吸烟对骨密度的影响.方法 对394例我院门诊进行骨密度检查的绝经前女性,通过问卷调查方法,确定被动吸烟状况,并计算相应被动吸烟指数;通过双能X线骨密度仪测量左侧股骨颈、大转子和Word三角等部位骨密度;并用方差和协方差分析法,分析被动吸烟对骨密度的影响.结果 394例绝经前妇女中,被动吸烟妇女各部位(左侧股骨颈、Torch、Ward三角)骨密度随吸烟指数增加而下降,被动吸烟绝经前妇女骨密度低于不吸烟组(P均＜0.05～0.01).结论 被动吸烟可导致绝经前女性骨密度降低,其影响和被动吸烟指数呈正相关.被动吸烟也是骨质疏松的一个危险因素,预防骨质疏松应提倡戒烟,净化环境很重要.     

不同民族及部分生活因子对骨密度的影响

目的　确定部分生活因子对不同民族骨密度影响因素的影响 ,以便指导骨质疏松症的防治工作。方法　对新疆乌鲁木齐、伊犁、乌苏、吐鲁番地区 787例 2 0～ 70岁汉族、维吾尔族、哈萨克族健康人用问卷方法进行生活因子的调查 ,并用QCT法测定腰椎松质骨密度 (BMD)值 ,将有关的调查结果进行统计学处理。结果　 (1 )各民族相比较 ,哈、维女性BMD高于汉族女性 (P <0 0 5) ;(2 )各民族均未见吸烟、饮酒对BMD的影响 ;(3)维族男性、女性和哈族男性及汉族女性体重与BMD呈负相关 (P <0 0 1 ) ;汉族女性身高与BMD呈正相关 (P <0 0 1 ) ;(4)汉族女性参加体育锻炼者的骨密度高于不参加体育锻炼者 ;(5)汉族人群中 ,每天饮用牛奶 50 0g以上者的骨密度高于每天饮用 50 0g以下或不饮用牛奶者。结论　 (1 )不同民族BMD有差异 ;(2 )吸烟、饮酒不影响BMD ;(3)身高、体重是BMD的影响因素 ;(4)运动可增加骨密度。我们认为健康的生活习惯可预防骨密度降低     

Genetic and environmental determinants of bone mineral density in Chinese women

BMD is a complex trait determined by genetic and lifestyle factors. To assess the genetic and environmental determinants of BMD in southern Chinese women, we studied a community-based cohort of 531 pre- and postmenopausal southern Chinese women and assessed the influence of 12 candidate gene loci and lifestyle risk factors on spine and hip BMD. The candidate genes studied include estrogen receptor alpha (ESR1) and beta (ESR2), calcium sensing receptor (CASR), vitamin D receptor (VDR), collagen type Ialpha1 (COLIA1), and LDL receptor-related protein 5 (LRP5). Social, medical, reproductive history, dietary habits and lifestyle factors were determined using a structured questionnaire. Single nucleotide polymorphisms (SNPs) of the COLIA1 and LRP5 gene in Chinese were determined by direct sequencing. Nucleotide (nt) -1363C/G and -1997 G/T of COLIA1, nt 266A/G, 2220C/T and 3989C/T of LRP5 gene were analyzed. Using stepwise multiple linear regression analyses, body weight was the strongest predictor for BMD in premenopausal women (n = 262), which accounted for 15.9% of the variance at the spine, 20% at femoral neck, 17.1% at trochanter, 24.3% at total hip and 10.9% at the Ward's triangle. Other significant predictors were ESR1 Ivs1-397T/C genotype (2.2% at the spine); LRP5 2220C/T genotype (1.3% at the spine, 1.6% at the trochanter); LRP5 266A/G genotype (1.1% at Ward's triangle); age at menarche (1.3% at trochanter) and age (2.0% at Ward's triangle). As for postmenopausal women (n = 269), body weight ( approximately 25% at various sites) and age (approximately 16% at femoral neck, trochanter, total hip and Ward's triangle sites) were the strongest predictors of BMD. Other significant predictors were age at menarche (4.4% at spine, 0.7% at femoral neck, 1.4% at trochanter, and 1.4% at Ward's triangle); weight bearing physical activity (2.1% at trochanter and 1% at total hip); calcium intake (1.1% at femoral neck, 0.9% at trochanter, and 1.7% at total hip) ; height (0.7% at trochanter); and ESR2 1082A/G genotype (0.8% at trochanter). We conclude that BMD at various sites and at different time span of a woman is modified by different genetic and lifestyle factors, suggesting that BMD is highly dependent on gene-environmental interactions.     

ALDH2 polymorphisms and bone mineral density in an elderly Japanese population

Introduction Osteoporosis is a multifactorial genetic disease which greatly increases the risk of bone fracture in elderly persons. Methods Four hundred and three recipients of a community health screening program were examined for the presence/absence of osteoporosis and 11 kinds of gene polymorphisms as a means of determining the relation between these gene polymorphisms and osteoporosis. The gene polymorphisms screened were: alcohol sensitivity-associated polymorphisms of alcohol dehydrogenase (ADH2) Arg47His, aldehyde dehydrogenase (ALDH2) Glu487Lys, smoking sensitivity-associated polymorphisms of glutathione S transferase (GST) M1, (GST)T1, NAD(P)H quinone oxidoreductase 1 (NQO1) C609T, inflammation-associated polymorphisms of interleukin-1β (IL-1B)T-31C, tumor necrosis factor α (TNF-α) T-1031C, endothelial constitutive nitric oxide synthase (ecNOS) Glu298Asp, longevity-associated polymorphism of mitochondrial DNA (mtDNA) 5178 A/C, allergy-associated polymorphism of interleukin-4 (IL-4), and immunity-associated polymorphism of CD14. Results A significant association was found between the ALDH2Glu478Lys gene polymorphisms and osteoporosis. In the osteoporosis group of patients, a significant difference was noted between the Lys/Lys group and the group comprising Glu/Lys and Glu/Glu groups (namely, the genotypes including Glu alleles). In the Lys/Lys group, after age, sex, BMI, smoking history and alcohol consumption history had been adjusted for, the morbidity rate was significantly elevated [odds ratio (OR): 3.33; 95% confidence interval (95% CI): 1.28–8.71; p=0.014], and the effect was even more evident in the sub-group of women with osteoporosis (OR: 4.31; 95% CI: 1.24–14.92; p=0.021). Conclusions The present results suggest that active prophylactic interventions such as dietary, exercise, and pharmacological therapies should be offered to non-carriers of the Glu allele (Lys/Lys).     

Peak bone mineral density and its determinants in an Asian Indian population

Data on peak bone mineral density (BMD) and its determinants in Asian Indians are limited. We studied the peak BMD and its determinants in Asian Indians. A total of 1137 young (age: 25--35yr) healthy volunteers of either sex (558 men and 579 women) were recruited for dietary evaluation, analyses of serum calcium, inorganic phosphorus, alkaline phosphatase, 25-hydroxyvitamin D [25(OH)D], and intact parathyroid hormone (iPTH) levels, and measurement of BMD with dual-energy X-ray absorptiometry. In men and women, peak bone mass (PBM) at the femoral neck, femoral trochanter, total femur, and lumbar spine was achieved between 25 and 30yr of age, whereas PBM at the femoral intertrochanter occurred between 30 and 35yr of age. Peak BMD was lower than that of Caucasians by 15.2--21.1% in men and 14.4--20.6% in women. On stepwise multiple regression, height and weight were the most consistent predictors of BMD at all sites in both groups. In men, 25(OH)D positively predicted BMD at the hip, whereas in women, serum iPTH negatively predicted BMD at the femoral trochanter and total femur. The study concluded that Asian Indians have significantly lower peak BMD than Caucasians and that weight and height are the most consistent predictors of BMD at all sites in both men and women.     

Effects of statins on bone mineral density: a meta-analysis of clinical studies

CONTEXT: Statins inhibit HMG-CoA reductase, preventing synthesis of mevalonate but also of isoprenoids, which affect osteoclast activity. Amino-bisphosphonates share this effect. In vitro and in vivo, statins show convincing anabolic and anti-resorptive bone effects. However, in a clinical meta-analysis (MA), they did not prevent hip fractures. OBJECTIVE AND DESIGN: Our meta-analysis studied the impact of statins on bone mineral density (BMD) at various sites and compared the effects of lipophilic and more hydrophilic statins. DATA SOURCES: Our PubMed and Embase queries using two keywords (statins, BMD) were updated to October 2006. DATA COLLECTION: Two readers independently collected BMDs from studies. DATA SYNTHESIS: Twenty-one studies, mostly observational (three randomized controlled trials and one pseudo-randomized study), were assessed. Two studies were excluded (no control groups). Three studies could not be analyzed. The sixteen studies analyzed mainly included postmenopausal osteopenic women (2971 patients under statins). Statins significantly increased BMD at total hip (TH) and femoral neck (FN). Effect sizes (ESs) were modest: 0.21 at TH (95% confidence interval [CI]: 0.16-0.25) and 0.20 at FN (CI: 0.08-0.28). Among women, statins acted similarly (ES: 0.20 for TH and 0.18 for FN; CI: 0.14-0.25 and 0.06-0.31 respectively); lipophilic statins (simvastatin, lovastatin) almost entirely caused this effect, at both TH (ES: 0.20; CI: 0.15-0.26) and FN (ES: 0.22; CI: 0.06-0.37). CONCLUSION: Our findings of modest but statistically significant beneficial effects of statins on hip BMD should promote large double-blind randomized controlled trials on their bone effects, in view of their major beneficial cardiovascular effects with excellent safety profile.